Fighting Misconceptions to Improve Compliance with Influenza Vaccination among Health Care Workers: An Educational Project

The compliance with influenza vaccination is poor among health care workers (HCWs) due to misconceptions about safety and effectiveness of influenza vaccine. We proposed an educational prospective study to demonstrate to HCWs that influenza vaccine is safe and that other respiratory viruses (RV) are the cause of respiratory symptoms in the months following influenza vaccination. 398 HCWs were surveyed for adverse events (AE) occurring within 48 h of vaccination. AE were reported by 30% of the HCWs. No severe AE was observed. A subset of 337 HCWs was followed up during four months, twice a week, for the detection of respiratory symptoms. RV was diagnosed by direct immunofluorescent assay (DFA) and real time PCR in symptomatic HCWs. Influenza A was detected in five episodes of respiratory symptoms (5.3%) and other RV in 26 (27.9%) episodes. The incidence density of influenza and other RV was 4.3 and 10.8 episodes per 100 HCW-month, respectively. The educational nature of the present study may persuade HCWs to develop a more positive attitude to influenza vaccination.

Optimized Duration of Clopidogrel Therapy Following Treatment with the Endeavor Zotarolimus-Eluting Stent in Real-World Clinical Practice (OPTIMIZE) Trial: Rationale and design of a large-scale, randomized, multicenter study

Background Current recommendations for antithrombotic therapy after drug-eluting stent (DES) implantation include prolonged dual antiplatelet therapy (DAPT) with aspirin and clopidogrel >= 12 months. However, the impact of such a regimen for all patients receiving any DES system remains unclear based on scientific evidence available to date. Also, several other shortcomings have been identified with prolonged DAPT, including bleeding complications, compliance, and cost. The second-generation Endeavor zotarolimus-eluting stent (E-ZES) has demonstrated efficacy and safety, despite short duration DAPT (3 months) in the majority of studies. Still, the safety and clinical impact of short-term DAPT with E-ZES in the real world is yet to be determined. Methods The OPTIMIZE trial is a large, prospective, multicenter, randomized (1: 1) non-inferiority clinical evaluation of short-term (3 months) vs long-term (12-months) DAPT in patients undergoing E-ZES implantation in daily clinical practice. Overall, 3,120 patients were enrolled at 33 clinical sites in Brazil. The primary composite endpoint is death (any cause), myocardial infarction, cerebral vascular accident, and major bleeding at 12-month clinical follow-up post-index procedure. Conclusions The OPTIMIZE clinical trial will determine the clinical implications of DAPT duration with the second generation E-ZES in real-world patients undergoing percutaneous coronary intervention. (Am Heart J 2012;164:810-816.e3.)

Searching for the first stars with the Gaia mission

Aims. We construct a theoretical model to predict the number of orphan afterglows (OA) from gamma-ray bursts (GRBs) triggered by primordial metal-free (Pop III) stars expected to be observed by the Gaia mission. In particular, we consider primordial metal-free stars that were affected by radiation from other stars (Pop III. 2) as a possible target. Methods. We use a semi-analytical approach that includes all relevant feedback effects to construct cosmic star formation history and its connection with the cumulative number of GRBs. The OA events are generated using the Monte Carlo method, and realistic simulations of Gaia's scanning law are performed to derive the observation probability expectation. Results. We show that Gaia can observe up to 2.28 +/- 0.88 off-axis afterglows and 2.78 +/- 1.41 on-axis during the five-year nominal mission. This implies that a nonnegligible percentage of afterglows that may be observed by Gaia (similar to 10%) could have Pop III stars as progenitors.

Milky Way demographics with the VVV survey I. The 84-million star colour-magnitude diagram of the Galactic bulge

Context. The Milky Way (MW) bulge is a fundamental Galactic component for understanding the formation and evolution of galaxies, in particular our own. The ESO Public Survey VISTA Variables in the Via Lactea is a deep near-IR survey mapping the Galactic bulge and southern plane. Particularly for the bulge area, VVV is covering similar to 315 deg(2). Data taken during 2010 and 2011 covered the entire bulge area in the JHKs bands. Aims. We used VVV data for the whole bulge area as a single and homogeneous data set to build for the first time a single colour-magnitude diagram (CMD) for the entire Galactic bulge. Methods. Photometric data in the JHK(s) bands were combined to produce a single and huge data set containing 173 150 467 sources in the three bands, for the similar to 315 deg(2) covered by VVV in the bulge. Selecting only the data points flagged as stellar, the total number of sources is 84 095 284. Results. We built the largest colour-magnitude diagrams published up to date, containing 173.1+ million sources for all data points, and more than 84.0 million sources accounting for the stellar sources only. The CMD has a complex shape, mostly owing to the complexity of the stellar population and the effects of extinction and reddening towards the Galactic centre. The red clump (RC) giants are seen double in magnitude at b similar to -8 degrees-10 degrees, while in the inner part (b similar to -3 degrees) they appear to be spreading in colour, or even splitting into a secondary peak. Stellar population models show the predominance of main-sequence and giant stars. The analysis of the outermost bulge area reveals a well-defined sequence of late K and M dwarfs, seen at (J - K-s) similar to 0.7-0.9 mag and K-s greater than or similar to 14 mag. Conclusions. The interpretation of the CMD yields important information about the MW bulge, showing the fingerprint of its structure and content. We report a well-defined red dwarf sequence in the outermost bulge, which is important for the planetary transit searches of VVV. The double RC in magnitude seen in the outer bulge is the signature of the X-shaped MW bulge, while the spreading of the RC in colour, and even its splitting into a secondary peak, are caused by reddening effects. The region around the Galactic centre is harder to interpret because it is strongly affected by reddening and extinction.