Burden of invasive pneumococcal disease in Harris County, Texas (2003--2010) and the implication for enhanced public health surveillance of isolates

Invasive pneumococcal disease (IPD) causes significant health burden in the US, is responsible for the majority of bacterial meningitis, and causes more deaths than any other vaccine preventable bacterial disease in the US. The estimated National IPD rate is 14.3 cases per 100,000 population with a case-fatality rate of 1.5 cases per 100,000 population. Although cases of IPD are routinely reported to the local health department in Harris County Texas, the incidence (IR) and case-fatality (CFR) rates have not been reported. Additionally, it is important to know which serotypes of S. pneumoniae are circulating in Harris County Texas and to determine if ‘replacement disease’ is occurring. ^ This study reported incidence and case-fatality rates from 2003 to 2009, and described the trends in IPD, including the IPD serotypes circulating in Harris County Texas during the study period, particularly in 2008 and 2010. Annual incidence rates were calculated and reported for 2003 to 2009, using complete surveillance-year data. ^ Geographic information system (GIS) software was used to create a series of maps of the data reported during the study period. Cluster and outlier analysis and hot spot analysis were conducted using both case counts by census tract and disease rate by census tract. ^ IPD age- and race-adjusted IR for Harris County Texas and their 95% confidence intervals (CIs) were 1.40 (95% CI 1.0, 1.8), 1.71 (95% CI 1.24, 2.17), 3.13 (95% CI 2.48, 3.78), 3.08 (95% CI 2.43, 3.74), 5.61 (95% CI 4.79, 6.43), 8.11 (95% CI 7.11, 9.1), and 7.65 (95% CI 6.69, 8.61) for the years 2003 to 2009, respectively (rates were age- and race-adjusted to each year's midyear US population estimates). A Poisson regression model demonstrated a statistically significant increasing trend of about 32 percent per year in the IPD rates over the course of the study period. IPD age- and race-adjusted case-fatality rates (CFR) for Harris County Texas were also calculated and reported. A Poisson regression model demonstrated a statistically significant increasing trend of about 26 percent per year in the IPD case-fatality rates from 2003 through 2009. A logistic regression model associated the risk of dying from IPD to alcohol abuse (OR 4.69, 95% CI 2.57, 8.56) and to meningitis (OR 2.42, 95% CI 1.46, 4.03). ^ The prevalence of non-vaccine serotypes (NVT) among IPD cases with serotyped isolates was 98.2 percent. In 2008, the year with the sample more geographically representative of all areas of Harris County Texas, the prevalence was 96 percent. Given these findings, it is reasonable to conclude that ‘replacement disease’ is occurring in Harris County Texas, meaning that, the majority of IPD is caused by serotypes not included in the PCV7 vaccine. Also in conclusion, IPD rates increased during the study period in Harris County Texas.^

Fiscal Federalism and Tax Equalization: The potential for progressive local taxes

We construct an empirically informed computational model of fiscal federalism, testing whether horizontal or vertical equalization can solve the fiscal externality problem in an environment in which heterogeneous agents can move and vote. The model expands on the literature by considering the case of progressive local taxation. Although the consequences of progressive taxation under fiscal federalism are well understood, they have not been studied in a context with tax equalization, despite widespread implementation. The model also expands on the literature by comparing the standard median voter model with a realistic alternative voting mechanism. We find that fiscal federalism with progressive taxation naturally leads to segregation as well as inefficient and inequitable public goods provision while the alternative voting mechanism generates more efficient, though less equitable, public goods provision. Equalization policy, under both types of voting, is largely undermined by micro-actors' choices. For this reason, the model also does not find the anticipated effects of vertical equalization discouraging public goods spending among wealthy jurisdictions and horizontal encouraging it among poor jurisdictions. Finally, we identify two optimal scenarios, superior to both complete centralization and complete devolution. These scenarios are not only Pareto optimal, but also conform to a Rawlsian view of justice, offering the best possible outcome for the worst-off. Despite offering the best possible outcomes, both scenarios still entail significant economic segregation and inequitable public goods provision. Under the optimal scenarios agents shift the bulk of revenue collection to the federal government, with few jurisdictions maintaining a small local tax.

Tax differentials and inflow of foreign direct investments : evidence from foreign operations of U.S. multinational companies

This paper concerns the measurement of the impact of tax differentials across countries on inflow of Foreign Direct Investment (FDI) by using comprehensive data on the foreign operations of U.S. multinational corporations that has been collected by the Bureau of Economic Analysis (BEA), the U.S. Department of Commerce. In particular, this research focuses on examining: (1) how responsive FDI locations are to tax differentials across countries, (2) how different the tax effect on FDI inflow is between developed and developing countries, and (3) whether investment location decisions have become more or less sensitive to tax differences between countries over time ranging from the late 1990s to the early 2000s. Estimation results suggest that high rates of corporate income taxation are associated with reduced foreign assets of U.S. multinational firms in all industries by decreasing the return to foreign asset investment. Further, foreign assets of U.S. multinationals in all industries have become more responsive to non-income tax differentials across countries than to income tax differences from 1999 to 2004. Empirical estimates also indicate that foreign investment by American firms is associated with higher tax sensitivity more in developed countries than in those that are developing.

The emission reduction effect and economic impact of an energy tax vs. a carbon tax in China : a dynamic CGE model analysis

Chinese government commits to reach its peak carbon emissions before 2030, which requires China to implement new policies. Using a CGE model, this study conducts simulation studies on the functions of an energy tax and a carbon tax and analyzes their effects on macro-economic indices. The Chinese economy is affected at an acceptable level by the two taxes. GDP will lose less than 0.8% with a carbon tax of 100, 50, or 10 RMB/ton CO2 or 5% of the delivery price of an energy tax. Thus, the loss of real disposable personal income is smaller. Compared with implementing a single tax, a combined carbon and energy tax induces more emission reductions with relatively smaller economic costs. With these taxes, the domestic competitiveness of energy intensive industries is improved. Additionally, we found that the sooner such taxes are launched, the smaller the economic costs and the more significant the achieved emission reductions.

Fighting tax evasion: a cellular automata approach

Estudio de la dinámica de una población donde los individuos son contribuyentes (pagadores de impuestos) o no mediante un autómata celular 2D

A QUALIFICAÇÃO E A INSERÇÃO NO MUNDO DO TRABALHO DA PESSOA PORTADORA DE DEFICIÊNCIA: UM ESTUDO SOBRE O IMPACTO DA EXTINÇÃO DA LEI 6.297/75

O presente estudo tem como objetivo, analisar sobre as dificuldades enfrentadas tanto pelas Empresas em cumprir a Legislação de Cotas, como também da Pessoa Portadora de Deficiência (PPDs) em ser inserida no mercado de trabalho, devido a falta de qualificação dos candidatos. Através da pesquisa literária ficou claro que nossa Legislação demonstra de forma evidente que o legislador pretendeu assegurar aos PPDs, as condições mínimas de participação influente na vida ativa da sociedade brasileira e num avanço sem precedentes, criaram-se as linhas básicas do processo de integração do deficiente à sociedade e ao mercado produtivo nacional. Verificou-se também que as empresas estão em busca de profissionais dentre o universo dos PPDs, já qualificados, o que normalmente não encontram. As Organizações do Direito Privado também já desenvolveram alguns projetos para a qualificação desses PPDs. A Lei 6.297/75 que garantia às empresas o desconto em dobro no IR dos gastos com treinamento, foi extinta em 12 de Dezembro de 1990. As empresas precisam de um incentivo financeiro para que possam tratar da qualificação desses profissionais, não mais como um peso, mas sim como um projeto social. Caso as empresas fossem beneficiadas por incentivos fiscais, assim como eram na vigência dessa Lei, teriam as empresas uma visão diferenciada por ocasião da contratação dos PPDs? A metodologia de pesquisa prevê um levantamento bibliográfico e uma pesquisa exploratória que será feita em empresas privadas, instituições que visam ajudar na inserção dos PPDs e nas Organizações do Direito Privado tais como Senai, Sesi, Força Sindical, Fiesp. Verificou-se, mediante a pesquisa, que há uma preocupação por parte de todos os envolvidos, em encontrar meios eficazes para garantir a inserção dos PPDs no mercado de trabalho, embora a falta de qualificação ainda seja o maior problema. A criação de Leis similares à Lei 6.297/75 foi apontada como uma grande ajuda às empresas, já que a elas foi imposta essa responsabilidade.(AU)

A QUALIFICAÇÃO E A INSERÇÃO NO MUNDO DO TRABALHO DA PESSOA PORTADORA DE DEFICIÊNCIA: UM ESTUDO SOBRE O IMPACTO DA EXTINÇÃO DA LEI 6.297/75

O presente estudo tem como objetivo, analisar sobre as dificuldades enfrentadas tanto pelas Empresas em cumprir a Legislação de Cotas, como também da Pessoa Portadora de Deficiência (PPDs) em ser inserida no mercado de trabalho, devido a falta de qualificação dos candidatos. Através da pesquisa literária ficou claro que nossa Legislação demonstra de forma evidente que o legislador pretendeu assegurar aos PPDs, as condições mínimas de participação influente na vida ativa da sociedade brasileira e num avanço sem precedentes, criaram-se as linhas básicas do processo de integração do deficiente à sociedade e ao mercado produtivo nacional. Verificou-se também que as empresas estão em busca de profissionais dentre o universo dos PPDs, já qualificados, o que normalmente não encontram. As Organizações do Direito Privado também já desenvolveram alguns projetos para a qualificação desses PPDs. A Lei 6.297/75 que garantia às empresas o desconto em dobro no IR dos gastos com treinamento, foi extinta em 12 de Dezembro de 1990. As empresas precisam de um incentivo financeiro para que possam tratar da qualificação desses profissionais, não mais como um peso, mas sim como um projeto social. Caso as empresas fossem beneficiadas por incentivos fiscais, assim como eram na vigência dessa Lei, teriam as empresas uma visão diferenciada por ocasião da contratação dos PPDs? A metodologia de pesquisa prevê um levantamento bibliográfico e uma pesquisa exploratória que será feita em empresas privadas, instituições que visam ajudar na inserção dos PPDs e nas Organizações do Direito Privado tais como Senai, Sesi, Força Sindical, Fiesp. Verificou-se, mediante a pesquisa, que há uma preocupação por parte de todos os envolvidos, em encontrar meios eficazes para garantir a inserção dos PPDs no mercado de trabalho, embora a falta de qualificação ainda seja o maior problema. A criação de Leis similares à Lei 6.297/75 foi apontada como uma grande ajuda às empresas, já que a elas foi imposta essa responsabilidade.(AU)

Tumor burden and clonality in multiple intestinal neoplasia mouse/normal mouse aggregation chimeras

Aggregation chimeras were formed between C57BL/6 mice heterozygous for the Apcmin (Min) mutation and wild-type SWR mice, that differ in their Pla2g2a status, a modifier of Apcmin, and also in their resistance to intestinal polyp formation. Variation in the dolichos biflorus agglutinin-staining patterns of the intestines of these mouse strains was used to determine the chimeric composition of the intestine in individual mice and to examine the clonal composition of adenomas. Macroscopic adenoma numbers in chimeric mice were compared with the expected adenoma numbers based on the percentage of C57BL/6J-Apcmin/+ epithelium in individual mice. These results unexpectedly show that there was no apparent inhibitory effect of the SWR-derived (Pla2g2a wild-type) tissue on adenoma formation in the C57BL/6J-Apcmin/+ epithelium. This suggests that the main genetic modifiers of the Min phenotype act at a cellular or crypt-restricted level with no discernable systemic effect. All adenomas were seen to contain C57BL/6J-Apcmin/+-derived epithelium, confirming that the germ-line mutation of the mApc gene is necessary to initiate tumorigenesis in this model system, and that the mApc gene acts in a cell autonomous fashion.

Co-morbidity burden in Parkinson’s disease : Comparison with controls and its influence on prognosis

Open Access funded by Parkinson's UK Financial support: This study was funded by Parkinson’s UK, the Scottish Chief Scientist Office, NHS Grampian endowments, the BMA Doris Hillier award, RS Macdonald Trust, the BUPA Foundation, and SPRING. The funders had no involvement in the study. We acknowledge funding for the PINE study from Parkinson’s UK (G-0502, G-0914 G-1302), the Scottish Chief Scientist Office (CAF/12/05), the BMA Doris Hillier award, RS Macdonald Trust, the BUPA Foundation, NHS Grampian endowments and SPRING. We thank the patients and controls for their participation and the research staff who collected data and supported the study database.

National burden of disease in India from indoor air pollution

In the last decade, a number of quantitative epidemiological studies of specific diseases have been done in developing countries that for the first time allow estimation of the total burden of disease (mortality and morbidity) attributable to use of solid fuels in adult women and young children, who jointly receive the highest exposures because of their household roles. Few such studies are available as yet for adult men or children over 5 years. This paper evaluates the existing epidemiological studies and applies the resulting risks to the more than three-quarters of all Indian households dependent on such fuels. Allowance is made for the existence of improved stoves with chimneys and other factors that may lower exposures. Attributable risks are calculated in reference to the demographic conditions and patterns of each disease in India. Sufficient evidence is available to estimate risks most confidently for acute respiratory infections (ARI), chronic obstructive pulmonary disease (COPD), and lung cancer. Estimates for tuberculosis (TB), asthma, and blindness are of intermediate confidence. Estimates for heart disease have the lowest confidence. Insufficient quantitative evidence is currently available to estimate the impact of adverse pregnancy outcomes (e.g., low birthweight and stillbirth). The resulting conservative estimates indicate that some 400–550 thousand premature deaths can be attributed annually to use of biomass fuels in these population groups. Using a disability-adjusted lost life-year approach, the total is 4–6% of the Indian national burden of disease, placing indoor air pollution as a major risk factor in the country.

Peripheral anti-Aβ antibody alters CNS and plasma Aβ clearance and decreases brain Aβ burden in a mouse model of Alzheimer's disease

Active immunization with the amyloid β (Aβ) peptide has been shown to decrease brain Aβ deposition in transgenic mouse models of Alzheimer's disease and certain peripherally administered anti-Aβ antibodies were shown to mimic this effect. In exploring factors that alter Aβ metabolism and clearance, we found that a monoclonal antibody (m266) directed against the central domain of Aβ was able to bind and completely sequester plasma Aβ. Peripheral administration of m266 to PDAPP transgenic mice, in which Aβ is generated specifically within the central nervous system (CNS), results in a rapid 1,000-fold increase in plasma Aβ, due, in part, to a change in Aβ equilibrium between the CNS and plasma. Although peripheral administration of m266 to PDAPP mice markedly reduces Aβ deposition, m266 did not bind to Aβ deposits in the brain. Thus, m266 appears to reduce brain Aβ burden by altering CNS and plasma Aβ clearance.