Cost-benefit evaluation of routine influenza immunisation in people 65-74 years of age

OBJECTIVES: To determine the cost-effectiveness of influenza vaccination in people aged 65-74 years in the absence of co-morbidity. DESIGN: Primary research: randomised controlled trial. SETTING: Primary care. PARTICIPANTS: People without risk factors for influenza or contraindications to vaccination were identified from 20 general practitioner (GP) practices in Liverpool in September 1999 and invited to participate in the study. There were 5875/9727 (60.4%) people aged 65-74 years identified as potentially eligible and, of these, 729 (12%) were randomised. INTERVENTION: Participants were randomised to receive either influenza vaccine or placebo (ratio 3:1), with all individuals receiving pneumococcal vaccine unless administered in the previous 10 years. Of the 729 people randomised, 552 received vaccine and 177 received placebo; 726 individuals were administered pneumococcal vaccine. MAIN OUTCOME MEASURES AND METHODOLOGY OF ECONOMIC EVALUATION: GP attendance with influenza-like illness (ILI) or pneumonia (primary outcome measure); or any respiratory symptoms; hospitalisation with a respiratory illness; death; participant self-reported ILI; quality of life (QoL) measures at 2, 4 and 6 months post-study vaccination; adverse reactions 3 days after vaccination. A cost-effectiveness analysis was undertaken to identify the incremental cost associated with the avoidance of episodes of influenza in the vaccination population and an impact model was used to extrapolate the cost-effectiveness results obtained from the trial to assess their generalisability throughout the NHS. RESULTS: In England and Wales, weekly consultations for influenza and ILI remained at baseline levels (less than 50 per 100,000 population) until week 50/1999 and then increased rapidly, peaking during week 2/2000 with a rate of 231/100,000. This rate fell within the range of 'higher than expected seasonal activity' of 200-400/100,000. Rates then quickly declined, returning to baseline levels by week 5/2000. The predominant circulating strain during this period was influenza A (H3N2). Five (0.9%) people in the vaccine group were diagnosed by their GP with an ILI compared to two (1.1%) in the placebo group [relative risk (RR), 0.8; 95% confidence interval (CI) = 0.16 to 4.1]. No participants were diagnosed with pneumonia by their GP and there were no hospitalisations for respiratory illness in either group. Significantly fewer vaccinated individuals self-reported a single ILI (4.6% vs 8.9%, RR, 0.51; 95% CI for RR, 0.28 to 0.96). There was no significant difference in any of the QoL measurements over time between the two groups. Reported systemic side-effects showed no significant differences between groups. Local side-effects occurred with a significantly increased incidence in the vaccine group (11.3% vs 5.1%, p = 0.02). Each GP consultation avoided by vaccination was estimated from trial data to generate a net NHS cost of 174 pounds. CONCLUSIONS: No difference was seen between groups for the primary outcome measure, although the trial was underpowered to demonstrate a true difference. Vaccination had no significant effect on any of the QoL measures used, although vaccinated individuals were less likely to self-report ILI. The analysis did not suggest that influenza vaccination in healthy people aged 65-74 years would lead to lower NHS costs. Future research should look at ways to maximise vaccine uptake in people at greatest risk from influenza and also the level of vaccine protection afforded to people from different age and socio-economic populations.

Interactions between age and apoE genotype on fasting and postprandial triglycerides levels

Objective The influences of genetic determinants on the magnitude of postprandial lipaemia are presently unclear. Here the impact of the common apolipoprotein (apo)E epsilon mutation on the postprandial triglyceride (TG) response is determined, along with an assessment of genotype penetrance according to age, body mass index and gender. Methods and results Healthy adults (n = 251) underwent a postprandial investigation, in which blood samples were taken at regular intervals after a test breakfast (0 min, 49 g fat) and lunch (330 min, 29 g fat) until 480 min after the test breakfast. There was a significant impact of apoE genotype on fasting total cholesterol (TC), (P = 0.027), LDL-cholesterol (LDL-C), (P = 0.008), and %LDL3 (P = 0.001), with higher and lower levels in the E4 and E2 carriers respectively relative to the E3/E3 genotype. Reflective of a higher fasting TG (P = 0.001), a significantly higher area under the curve for the postprandial TG response (TG AUC) was evident in the E4 carriers relative to the E3/E3 group (P = 0.038). In the group as a whole, a significant age × genotype interaction was observed for fasting TC (P = 0.021). In the participants >50 years there was a significant impact of genotype on TC (P = 0.005), LDL-C (P = 0.001) and TAG AUC (P = 0.028). Conclusions It is possible that an exaggerated postprandial lipaemia contributes to the increased coronary heart disease risk associated with carriers of the E4 allele; an effect which is more evident in older adults.

Production of relative clauses in monolingual Turkish children

Research on the production of relative clauses (RCs) has shown that in English, although children start using intransitive RCs at an earlier age, more complex, bi-propositional object RCs appear later (Hamburger & Crain, 1982; Diessel and Tomasello, 2005), and children use resumptive pronouns both in acceptable and unacceptable ways (McKee, McDaniel, & Snedeker, 1998; McKee & McDaniel, 2001). To date, it is unclear whether or not the same picture emerges in Turkish, a language with an SOV word-order and overt case marking. Some studies suggested that subject RCs are more frequent in adults and children (Slobin, 1986) and yield a better performance than object RCs (Özcan, 1996), but others reported the opposite pattern (Ekmekçi, 1990). Our study addresses this issue in Turkish children and adults, and uses participants’ errors to account for the emerging asymmetry between subject and object RCs. 37 5-to-8 year old monolingual Turkish children and 23 adult controls participated in a novel elicitation task involving cards, each consisting of four different pictures (see Figure 1). There were two sets of cards, one for the participant and one for the researcher. The former had animals with accessories (e.g., a hat) whereas the latter had no accessories. Participants were instructed to hold their card without showing it to the researcher and describe the animals with particular accessories. This prompted the use of subject and object RCs. The researcher had to identify the animals in her card (see Figure 2). A preliminary repeated measures ANOVA with the factor Group (pre-school, primary-school children) showed no differences between the groups in the use of RCs (p>.1), who were therefore collapsed into one for further analyses. A repeated measures ANOVA with the factors Group (children, adults) and RC-Type (Subject, Object) showed that children used fewer RCs than adults (F(1,58)=7.54, p<.01), and both groups used fewer object than subject RCs (F(1,58)=22.46, p<.001), but there was no Group by RC-Type interaction (see Figure 3). A similar ANOVA on the rate of grammatical RCs showed a main effect of Group (F(1,58)=77.25, p<.001), a main effect of RC-Type (F(1,58)=66.33, p<.001), and an interaction of Group by RC-Type (F(1,58)=64.6, p<.001) (see Figure 4). Children made more errors than adults in object RCs (F(1,58)=87.01, p<.001), and children made more errors in object compared to subject RCs (F(1,36)=106.35, p<.001), but adults did not show this asymmetry. The error analysis revealed that children systematically avoided the object-relativizing morpheme –DIK, which requires possessive agreement with the genitive-marked subject. They also used resumptive pronouns and resumptive full-DPs in the extraction site similarly to English children (see Figure 5). These findings are in line with Slobin (1986) and Özcan (1996). Children’s errors suggest that they avoid morphosyntactic complexity of object RCs and try to preserve the canonical word order by inserting resumptive pronouns in the extraction site. Finally, cross-linguistic similarity in the acquisition of RCs in typologically different languages suggests a higher accessibility of subject RCs both at the structural (Keenan and Comrie, 1977) and conceptual level (Bock and Warren, 1986).

Nutritional factors and gender influence age-related DNA methylation in the human rectal mucosa

Aberrant methylation of CpG islands (CGI) occurs in many genes expressed in colonic epithelial cells, and may contribute to the dysregulation of signalling pathways associated with carcinogenesis. This cross-sectional study assessed the relative importance of age, nutritional exposures and other environmental factors in the development of CGI methylation. Rectal biopsies were obtained from 185 individuals (84 male, 101 female) shown to be free of colorectal disease, and for whom measurements of age, body size, nutritional status and blood cell counts were available. We used quantitative DNA methylation analysis combined with multivariate modelling to investigate the relationships between nutritional, anthropometric and metabolic factors and the CGI methylation of 11 genes, together with LINE-1 as an index of global DNA methylation. Age was a consistent predictor of CGI methylation for 9/11 genes but significant positive associations with folate status and negative associations with vitamin D and selenium status were also identified for several genes. There was evidence for positive associations with blood monocyte levels and anthropometric factors for some genes. In general, CGI methylation was higher in males than in females and differential effects of age and other factors on methylation in males and females were identified. In conclusion, levels of age-related CGI methylation in the healthy human rectal mucosa are influenced by gender, the availability of folate, vitamin D and selenium, and perhaps by factors related to systemic inflammation

What happens to precocious readers’ performance by the age of 11 years?

This paper reports on the progress made by a group of fourteen 11-year-old children who had been originally identified as being precocious readers before they started primary school at the age of 5-years. The data enable comparisons to be made with the performance of the children when they were younger so that a six year longitudinal analysis can be made. The children who began school as precocious readers continued to make progress in reading accuracy, rate and comprehension, thereby maintaining their superior performance relative to a comparison group. However, their progress appeared to follow the same developmental trajectory as that of the comparison group. Measures of phonological awareness showed that there are long term, stable individual differences which correlated with all measures of reading. The children who were reading precociously early showed significantly higher levels of phonological awareness than the comparison children. In addition, they showed the same levels of performance on this task as a further group of high achieving young adults. A positive effect of being able to read at precociously early age was identified in the significantly higher levels of receptive vocabulary found amongst the these children. The analyses indicated that rises in receptive vocabulary resulted from reading performance rather than the other way round

Age differences in brain activity during emotion processing: reflections of age-Related decline or increased emotion regulation?

Despite the fact that physical health and cognitive abilities decline with aging, the ability to regulate emotion remains stable and in some aspects improves across the adult life span. Older adults also show a positivity effect in their attention and memory, with diminished processing of negative stimuli relative to positive stimuli compared with younger adults. The current paper reviews functional magnetic resonance imaging studies investigating age-related differences in emotional processing and discusses how this evidence relates to two opposing theoretical accounts of older adults’ positivity effect. The aging-brain model [Cacioppo et al. in: Social Neuroscience: Toward Understanding the Underpinnings of the Social Mind. New York, Oxford University Press, 2011] proposes that older adults’ positivity effect is a consequence of age-related decline in the amygdala, whereas the cognitive control hypothesis [Kryla-Lighthall and Mather in: Handbook of Theories of Aging, ed 2. New York, Springer, 2009; Mather and Carstensen: Trends Cogn Sci 2005;9:496–502; Mather and Knight: Psychol Aging 2005;20:554–570] argues that the positivity effect is a result of older adults’ greater focus on regulating emotion. Based on evidence for structural and functional preservation of the amygdala in older adults and findings that older adults show greater prefrontal cortex activity than younger adults while engaging in emotion-processing tasks, we argue that the cognitive control hypothesis is a more likely explanation for older adults’ positivity effect than the aging-brain model.

I owe you: age-related similarities and differences in associative memory for gains and losses

Older adults often experience associative memory impairments but can sometimes remember important information. The current experiments investigate potential age-related similarities and differences associate memory for gains and losses. Younger and older participants were presented with faces and associated dollar amounts, which indicated how much money the person “owed” the participant, and were later given a cued recall test for the dollar amount. Experiment 1 examined face-dollar amount pairs while Experiment 2 included negative dollar amounts to examine both gains and losses. While younger adults recalled more information relative to older adults, both groups were more accurate in recalling the correct value associated with high value faces compared to lower value faces and remembered gist-information about the values. However, negative values (losses) did not have a strong impact on recall among older adults versus younger adults, illustrating important associative memory differences between younger and older adults.

Syntactic complexity in the comprehension of wh-questions and relative clauses in typical language development and autism

This study investigates effects of syntactic complexity operationalised in terms of movement, intervention and (NP) feature similarity in the development of A’ dependencies in 4-, 6-, and 8-year old typically developing (TD) French children and children with Autism Spectrum Disorders (ASD). Children completed an off-line comprehension task testing eight syntactic structures classified in four levels of complexity: Level 0: No Movement; Level 1: Movement without (configurational) Intervention; Level 2: Movement with Intervention from an element which is maximally different or featurally ‘disjoint’ (mismatched in both lexical NP restriction and number); Level 3: Movement with Intervention from an element similar in one feature or featurally ‘intersecting’ (matched in lexical NP restriction, mismatched in number). The results show that syntactic complexity affects TD children across the three age groups, but also indicate developmental differences between these groups. Movement affected all three groups in a similar way, but intervention effects in intersection cases were stronger in younger than older children, with NP feature similarity affecting only 4-year olds. Complexity effects created by the similarity in lexical restriction of an intervener thus appear to be overcome early in development, arguably thanks to other differences of this intervener (which was mismatched in number). Children with ASD performed less well than the TD children although they were matched on non-verbal reasoning. Overall, syntactic complexity affected their performance in a similar way as in their TD controls, but their performance correlated with non-verbal abilities rather than age, suggesting that their grammatical development does not follow the smooth relation to age that is found in TD children.

Probing the Large Magellanic Cloud age gap at intermediate cluster masses

The Large Magellanic Cloud (LMC) has a rich star cluster system spanning a wide range of ages and masses. One striking feature of the LMC cluster system is the existence of an age gap between 3 and 10 Gyr. But this feature is not clearly seen among field stars. Three LMC fields containing relatively poor and sparse clusters whose integrated colours are consistent with those of intermediate-age simple stellar populations have been imaged in BVI with the Optical Imager (SOI) at the Southern Telescope for Astrophysical Research (SOAR). A total of six clusters, five of them with estimated initial masses M < 104 M(circle dot), were studied in these fields. Photometry was performed and colour-magnitude diagrams (CMDs) were built using standard point spread function fitting methods. The faintest stars measured reach V similar to 23. The CMD was cleaned from field contamination by making use of the three-dimensional colour and magnitude space available in order to select stars in excess relative to the field. A statistical CMD comparison method was developed for this purpose. The subtraction method has proven to be successful, yielding cleaned CMDs consistent with a simple stellar population. The intermediate-age candidates were found to be the oldest in our sample, with ages between 1 and 2 Gyr. The remaining clusters found in the SOAR/SOI have ages ranging from 100 to 200 Myr. Our analysis has conclusively shown that none of the relatively low-mass clusters studied by us belongs to the LMC age gap.

Grain size and heavy minerals of the Late Quaternary eolian sediments from the Imbituba-Jaguaruna coast, Southern Brazil: Depositional controls linked to relative sea-level changes

The stratigraphic subdivision and correlation of dune deposits is difficult, especially when age datings are not available. A better understanding of the controls on texture and composition of eolian sands is necessary to interpret ancient eolian sediments. The Imbituba-Jaguaruna coastal zone (Southern Brazil, 28 degrees-29 degrees S) stands out due to its four well-preserved Late Pleistocene (eolian generation 1) to Holocene eolian units (eolian generations 2, 3, and 4). In this study, we evaluate the grain-size and heavy-mineral characteristics of the Imbituba-Jaguartma eolian units through statistical analysis of hundreds of sediment samples. Grain-size parameters and heavy-mineral content allow us to distinguish the Pleistocene from the Holocene units. The grain size displays a pattern of fining and better sorting from generation 1 (older) to 4 (younger), whereas the content of mechanically stable (dense and hard) heavy minerals decreases from eolian generation 1 to 4. The variation in grain size and heavy-mineral content records shifts in the origin and balance (input versus output) of eolian sediment supply attributable mainly to relative sea-level changes. Dunefields submitted to relative sea-level lowstand conditions (eolian generation 1) are characterized by lower accumulation rates and intense post-depositional dissection by fluvial incision. Low accumulation rates favor deflation in the eolian system, which promotes concentration of denser and stable heavy minerals (increase of ZTR index) as well as coarsening of eolian sands. Dissection involves the selective removal of finer sediments and less dense heavy minerals to the coastal source area. Under a high rate of relative sea-level rise and transgression (eolian generation 2), coastal erosion prevents deflation through high input of sediments to the coastal eolian source. This condition favors dunefield growth. Coastal erosion feeds sand from local sources to the eolian system. including sands from previous dunefields (eolian generation 1) and from drowned incised valleys. Therefore, dunefields corresponding to transgressive phases inherit the grain-size and heavy-mineral characteristics of previous dunefields, leading to selective enrichment of finer sands and lighter minerals. Eolian generations 3 and 4 developed during a regressive-progradational phase (Holocene relative sea level highstand). The high rate of sediment supply during the highstand phase prevents deflation. The lack of coastal erosion favors sediment supply from distal sources (fluvial sediments rich in unstable heavy minerals). Thus, dunefields of transgressive and highstand systems tracts may be distinguished from dunefields of the lowstand systems tract through high rates of accumulation (low deflation) in the former. The sediment source of the transgressive dunefields (high input of previously deposited coastal sands) differs from that of the highstand dunefields (high input of fluvial distal sands). Based on this case study, we propose a general framework for the relation between relative sea level, sediment supply and the texture and mineralogy of eolian sediments deposited in siliciclastic wet coastal zones similar to the Imbituba-Jaguaruna coast (C) 2009 Elsevier B.V. All rights reserved.

Preliminary study on age- and sex-dependent alterations in the composition of skeletal muscle fibers of Brasileiro de Hipismo horses

The aim of this work was to characterize the distribution of myofibers in the gluteus medius muscle of inactive horses of the Brasileiro de Hipismo (BH) breed at different ages by means of histochemical analyses, according to sex and depth of the biopsy. A total of 78 inactive horses (9 castrated males, 35 stallions, and 34 females) of the BH breed, aged 1 to 4 years, were used. A percutaneous muscle biopsy was obtained with a 6.0-mm Bergstrom-type needle, which allowed the removal of muscle fragments at depths of 20 and 60 mm. Myofiber types were determined based on myofibrillar adenosine triphosphatase (mATPase) and nicotinamide dinucleotide tetrazolium reductase (NADH-TR) techniques. Morphometry of the fibers was determined based on cross-sectional area (CSA), mean frequency (F), and relative cross-sectional area (RCSA). The current study demonstrated that BH horses 3 and 4 years of age show a greater percentage of, and area occupied by, type IIA fibers and lower percentage of type IIX fibers in the gluteus medius muscle compared with horses 1 and 2 years of age. No difference was found between sexes in the frequency of and area occupied by the different fiber types at any of the depths and ages studied. In this study, females showed a greater CSA for all fibers in comparison with males, at 1 year of age. The results of the current study indicate that the gluteus medius muscle of inactive BH horses shows modifications in its structural and biochemical composition during the growth of the animals, leading to a better oxidative capacity.

Age-related changes in muscle fiber type frequencies and cross-sectional areas in straightbred and crossbred rabbits

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of broiler breeder age on pancreas enzymes activity and digestive tract weight of embryos and chicks

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of lesion age, humidity, and fungicide application on sporulation of Alternaria alternata, the cause of brown spot of tangerine

Alternaria brown spot, caused by Alternaria alternata, causes yield losses and fruit blemishes on many tangerines and their hybrids in most citrus areas of the world where susceptible cultivars are grown. Although the conditions affecting infection and disease severity are known, little information is available on inoculum production on infected tissue. We found that sporulation on leaves began about 10 days after symptoms developed, was abundant from 20 to 40 days, and declined thereafter. Conidial production was far greater on leaf than on fruit or twig lesions. Spore production per unit area of leaf lesion was greater on the more susceptible hybrids, Minneola and Orlando tangelos, than on the less susceptible Murcott tangor. At 74% relative humidity, conidial production on leaf lesions was low, but it was abundant at 85, 92.5, 96, and 100%. Application of Q(o)I or copper fungicides, but not ferbam, suppressed sporulation on leaf lesions for about 14 to 21 days after application. Additional applications did not appear to be more effective than a single spray in reducing inoculum production.

Dietary electrolyte balance for broiler chickens under moderately high ambient temperatures and relative humidities

Cobb male broiler chicks (1,000) on new litter were used to evaluate effects of dietary electrolyte balance [DEB; Na+K-Cl, milliequivalents (mEq) per kilogram] under tropical summer conditions. Corn-soybean meal-based mash diets had salt (NaCl) alone or in combination with one or more supplements: sodium bicarbonate (NaHCO3), ammonium chloride (NH4Cl), or potassium bicarbonate (KHCO3). A completely randomized design, with five starter and grower feed treatments (control: 145, then 130 mEq/kg; or 0, 120, 240, or 360 mEq/kg throughout) and four replicate pens (1.5 x 3.2 m) per treatment (50 chicks per pen), was used. Diets were analyzed for Na, K, and Cl for confirmation. There were no significant (P < 0.05) effects of treatments on mortality or processing parameters. Water intake increased linearly with increasing DEB, giving higher litter moistures and lower rectal temperatures. Blood HCO3 and pH increased with the highest DEB (360 mEq/kg) causing respiratory alkalosis. The DEB of 240 mEg/kg gave best weight gain and feed conversion ratio, and ideal DEB predicted by regression analyses were 186 and 197 mEq/kg from 0 to 21 d of age and 236 and 207 mEq/kg of feed from 0 to 42 d, respectively. These DEB corresponded to estimated (interpolated) values in predicted optimal 186 to 197 mEq/kg starter of Na 0.38 to 0.40% and Cl 0.405 to 0.39% (K = 0.52%), in 207 to 236 mEq/kg starter, Na 0.409 to 0.445% and Cl 0.326 to 0.372% Cl (K = 0.52%), and in grower Na 0.41 to 0.445%, Cl 0.315 to 0.267% (K = 0.47%).