Bacteremic pneumonia before and after withdrawal of 13-valent pneumococcal conjugate vaccine from a public vaccination program in Spain: a case-control study

The objective of this study is to compare the incidence and epidemiology of bacteremic community-acquired pneumonia (CAP) in the setting of changes in 13-valent pneumococcal conjugate vaccine (PCV13) coverage. In the region of Madrid, universal immunization with the PCV13 started in May 2010. In July 2012, public funding ceased. Vaccination coverage decreased from >95% to 82% in 2013 and to 67% in 2014. We performed a multicenter surveillance and case-control study from 2009-2014. Cases were hospitalized children with bacteremic CAP. Controls were children selected 1:1 from next-admitted with negative blood cultures and typical, presumed bacterial CAP. Annual incidence of bacteremic CAP declined from 7.9/100 000 children (95% CI 5.1-11.1) in 2009 to 2.1/100 000 children (95% CI 1.1-4.1) in 2012. In 2014, 2 years after PCV13 was withdrawn from the universal vaccination program, the incidence of bacteremic CAP increased to 5.4/100 000 children (95% CI 3.5-8.4). We enrolled 113 cases and 113 controls. Streptococcus pneumoniae caused most of bloodstream infections (78%). Empyema was associated with bacteremia (P = .003, OR 3.6; 95% CI 1.4-8.9). Simple parapneumonic effusion was not associated with bacteremia. Incomplete PCV immunization was not a risk factor for bacteremic pneumonia.

Genome-wide association with bone mass and geometry in the Framingham Heart Study

BACKGROUND:Osteoporosis is characterized by low bone mass and compromised bone structure, heritable traits that contribute to fracture risk. There have been no genome-wide association and linkage studies for these traits using high-density genotyping platforms.METHODS:We used the Affymetrix 100K SNP GeneChip marker set in the Framingham Heart Study (FHS) to examine genetic associations with ten primary quantitative traits: bone mineral density (BMD), calcaneal ultrasound, and geometric indices of the hip. To test associations with multivariable-adjusted residual trait values, we used additive generalized estimating equation (GEE) and family-based association tests (FBAT) models within each sex as well as sexes combined. We evaluated 70,987 autosomal SNPs with genotypic call rates [greater than or equal to]80%, HWE p [greater than or equal to] 0.001, and MAF [greater than or equal to]10% in up to 1141 phenotyped individuals (495 men and 646 women, mean age 62.5 yrs). Variance component linkage analysis was performed using 11,200 markers.RESULTS:Heritability estimates for all bone phenotypes were 30-66%. LOD scores [greater than or equal to]3.0 were found on chromosomes 15 (1.5 LOD confidence interval: 51,336,679-58,934,236 bp) and 22 (35,890,398-48,603,847 bp) for femoral shaft section modulus. The ten primary phenotypes had 12 associations with 100K SNPs in GEE models at p < 0.000001 and 2 associations in FBAT models at p < 0.000001. The 25 most significant p-values for GEE and FBAT were all less than 3.5 x 10-6 and 2.5 x 10-5, respectively. Of the 40 top SNPs with the greatest numbers of significantly associated BMD traits (including femoral neck, trochanter, and lumbar spine), one half to two-thirds were in or near genes that have not previously been studied for osteoporosis. Notably, pleiotropic associations between BMD and bone geometric traits were uncommon. Evidence for association (FBAT or GEE p < 0.05) was observed for several SNPs in candidate genes for osteoporosis, such as rs1801133 in MTHFR; rs1884052 and rs3778099 in ESR1; rs4988300 in LRP5; rs2189480 in VDR; rs2075555 in COLIA1; rs10519297 and rs2008691 in CYP19, as well as SNPs in PPARG (rs10510418 and rs2938392) and ANKH (rs2454873 and rs379016). All GEE, FBAT and linkage results are provided as an open-access results resource at http://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?id=phs000007.CONCLUSION:The FHS 100K SNP project offers an unbiased genome-wide strategy to identify new candidate loci and to replicate previously suggested candidate genes for osteoporosis.

Mapping the gene for autosomal dominant restless legs syndrome in an Irish family

Restless Legs Syndrome (RLS) is a common neurological disorder affecting nearly 15% of the general population. Ironically, RLS can be described as the most common condition one has never heard of. It is usually characterised by uncomfortable, unpleasant sensations in the lower limbs inducing an uncontrollable desire to move the legs. RLS exhibits a circadian pattern with symptoms present predominantly in the evening or at night, thus leading to sleep disruption and daytime somnolence. RLS is generally classified into primary (idiopathic) and secondary (symptomatic) forms. Primary RLS includes sporadic and familial cases of which the age of onset is usually less than 45 years and progresses slowly with a female to male ratio of 2:1. Secondary forms often occur as a complication of another health condition, such as iron deficiency or thyroid dysfunction. The age of onset is usually over 45 years, with an equal male to female ratio and more rapid progression. Ekbom described the familial component of the disorder in 1945 and since then many studies have been published on the familial forms of the disorder. Molecular genetic studies have so far identified ten loci (5q, 12q, 14p, 9p, 20p, 16p, 19p, 4q, 17p). No specific gene within these loci has been identified thus far. Association mapping has highlighted a further five areas of interest. RLS6 has been found to be associated with SNPs in the BTBD9 gene. Four other variants were found within intronic and intergenic regions of MEIS1, MAP2K5/LBXCOR1, PTPRD and NOS1. The pathophysiology of RLS is complex and remains to be fully elucidated. Conditions associated with secondary RLS, such as pregnancy or end-stage renal disease, are characterised by iron deficiency, which suggests that disturbed iron homeostasis plays a role. Dopaminergic dysfunction in subcortical systems also appears to play a central role. An ongoing study within the Department of Pathology (University College Cork) is investigating the genetic characteristics of RLS in Irish families. A three generation RLS pedigree RLS3002 consisting of 11 affected and 7 unaffected living family members was recruited. The family had been examined for four of the known loci (5q, 12q, 14p and 9p) (Abdulrahim 2008). The aim of this study was to continue examining this Irish RLS pedigree for possible linkage to the previously described loci and associated regions. Using informative microsatellite markers linkage was excluded to the loci on 5q, 12q, 14p, 9p, 20p, 16p, 19p, 4q, 17p and also within the regions reported to be associated with RLS. This suggested the presence of a new unidentified locus. A genome-wide scan was performed using two microsatellite marker screening sets (Research Genetics Inc. Mapping set and the Applied Biosystems Linkage mapping set version 2.5). Linkage analysis was conducted under an autosomal dominant model with a penetrance of 95% and an allele frequency of 0.01. A maximum LOD score of 3.59 at θ=0.00 for marker D19S878 indicated significant linkage on chromosome 19p. Haplotype analysis defined a genetic region of 6.57 cM on chromosome 19p13.3, corresponding to 2.5 Mb. There are approximately 100 genes annotated within the critical region. Sequencing of two candidate genes, KLF16 and GAMT, selected on the assumed pathophysiology of RLS, did not identify any sequence variant. This study provides evidence of a novel RLS locus in an Irish pedigree, thus supporting the picture of RLS as a genetically heterogeneous trait.

I can see it both ways: first- and third-person visual perspectives at retrieval.

The number of studies examining visual perspective during retrieval has recently grown. However, the way in which perspective has been conceptualized differs across studies. Some studies have suggested perspective is experienced as either a first-person or a third-person perspective, whereas others have suggested both perspectives can be experienced during a single retrieval attempt. This aspect of perspective was examined across three studies, which used different measurement techniques commonly used in studies of perspective. Results suggest that individuals can experience more than one perspective when recalling events. Furthermore, the experience of the two perspectives correlated differentially with ratings of vividness, suggesting that the two perspectives should not be considered in opposition of one another. We also found evidence of a gender effect in the experience of perspective, with females experiencing third-person perspectives more often than males. Future studies should allow for the experience of more than one perspective during retrieval.

Logística externa de exportación de Quinua : estudio comparativo entre Perú y Bolivia

En los últimos años la quinua se ha constituido en un alimento de gran demanda por sus bondades nutritivas, con un elevado contenido proteico que fluctúa entre 13 a 20 por ciento el cual supera cualitativamente y cuantitativamente a otros cereales como el arroz, avena, cebada, etc. (7 a 11 por ciento). El ciclo de producción de la quinua se encuentra en un proceso de crecimiento exponencial en el cual, Perú viene posicionándose como principal productor y exportador mundial de quinua (50 por ciento), superando a Bolivia (49 por ciento) e ingresando a más de 45 mercados, con una demanda liderada por Estados Unidos. Cabe resaltar que el precio de comercialización de quinua viene siendo determinado por el mercado internacional por cuanto la quinua ha tendido a convertirse en un `commodity` y no varía de manera substancial, si proviene de Bolivia (US$ 6,64 por Kg.) o Perú (US$ 5,64 por Kg.), por lo cual estos costos serán variables de acuerdo a la eficiencia logística de proceso y distribución que permita generar una diferencia competitiva en el mercado. El objetivo de este trabajo es describir y comparar el sistema logístico de exportación de la Quinua peruana y boliviana, con la finalidad de identificar la diferencia competitiva en el mercado internacional utilizando indicadores logísticos emitidos por el Banco mundial, apoyado del diamante de Porter con énfasis en dos determinantes que son la condición de los factores y de la demanda. De acuerdo a los resultados obtenidos Perú en infraestructura, comercio exterior, idoneidad logística, trazabilidad y justo a tiempo; posee mejor desempeño comparado a Bolivia. Además, en los fletes internos (terrestres) y externos (marítimo) de quinua a mercados como EE.UU (Los Ángeles) y España (Puerto de Barcelona), el Perú tiene menores costos de exportación (US$/contenedor 890) que Bolivia (US$/contenedor 1.440), pero mayores al promedio de Latinoamérica. Uno de los factores que se apalancó para esta competitividad, son sus ventajas comparativas (cercanía de Puerto con zonas productoras), y competitivas (modernización del puerto de Callo). Además la iniciativa que ha tenido el estado peruano en la concesión de sus puertos para la modernización y la reducción de trámite documentario, así como el TLC con EE.UU que permitió a Perú tener mejores relaciones comerciales (52 ranking de 144 países evaluados) comparado con Bolivia (82). Y por último se concluye de manera general que el sistema logístico de quinua de Perú logísticamente es más competitivo que el sistema logístico de quinua de Bolivia, ya que obtuvo 10 por ciento más de ampliación de mercado externo, creando una ventaja diferenciada respecto a Bolivia que al 2014 disminuyo en un 15 por ciento en sus exportaciones con respecto al 2013. Asimismo, cerca del 70 por ciento del valor total exportado de la quinua de Perú representa quinua convencional y el otro 30 por ciento quinua orgánica, siendo esta última en promedio un 10 por ciento mejor pagada que el producto convencional. Y que generalmente la mercancía es despachada y puesta a disposición al importador generalmente dado por precio FOB.

Factores que afectan los rendimientos en la región maicera Argentina

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Modelling electromagnetically levitated liquid droplet oscillations

This work comprises accurate computational analysis of levitated liquid droplet oscillations in AC and DC magnetic fields. The AC magnetic field interacting with the induced electric current within the liquid metal droplet generates intense fluid flow and the coupled free surface oscillations. The pseudo-spectral technique is used to solve the turbulent fluid flow equations for the continuously dynamically transformed axisymmetric fluid volume. The volume electromagnetic force distribution is updated with the shape and position change. We start with the ideal fluid test case for undamped Rayleigh frequency oscillations in the absence of gravity, and then add the viscous and the DC magnetic field damping. The oscillation frequency spectra are further analysed for droplets levitated against gravity in AC and DC magnetic fields at various combinations. In the extreme case electrically poorly conducting, diamagnetic droplet (water) levitation dynamics are simulated. Applications are aimed at pure electromagnetic material processing techniques and the material properties measurements in uncontaminated conditions.

Use of Web Logs (Blogs) in Learning Environments: Blogs for Student Support

Innovation in technology and communications and particularly the advent of the Web is changing the structure of teaching and learning today. While there is much debate about the use of technology in learning and how e-learning is creating new approaches to delivery of learning there is been very little if any work on the use of of the emerging technologies in providing student support through their learning process. This paper reports on research and development undertaken by the eCentre based at the University of Greenwich School Of Computing in designing and developing a "Project Blog System" in order to address some long standing issues related to supervision of final year degree student projects. The paper will report on the methodology used to design the system and will discuss some of the results from students and staff evaluation of the system developed.

Mathematical prerequisites for learning statistics in Psychology: Assessing core skills of numeracy and mathematical reasoning among undergraduates.

This study sought to extend earlier work by Mulhern and Wylie (2004) to investigate a UK-wide sample of psychology undergraduates. A total of 890 participants from eight universities across the UK were tested on six broadly defined components of mathematical thinking relevant to the teaching of statistics in psychology - calculation, algebraic reasoning, graphical interpretation, proportionality and ratio, probability and sampling, and estimation. Results were consistent with Mulhern and Wylie's (2004) previously reported findings. Overall, participants across institutions exhibited marked deficiencies in many aspects of mathematical thinking. Results also revealed significant gender differences on calculation, proportionality and ratio, and estimation. Level of qualification in mathematics was found to predict overall performance. Analysis of the nature and content of errors revealed consistent patterns of misconceptions in core mathematical knowledge , likely to hamper the learning of statistics.

Potential improvements in the therapeutic ratio of prostate cancer irradiation: dose escalation of pathologically identified tumour nodules using intensity modulated radiotherapy.

The potential of intensity modulated radiotherapy (IMRT) to improve the therapeutic ratio in prostate cancer by dose escalation of intraprostatic tumour nodules (IPTNs) was investigated using a simultaneous integrated boost technique. The prostate and organs-at-risk were outlined on CT images from six prostate cancer patients. Positions of IPTNs were transferred onto the CT images from prostate maps derived from sequential large block sections of whole prostatectomy specimens. Inverse planned IMRT dose distributions were created to irradiate the prostate to 70 Gy and all the IPTNs to 90 Gy. A second plan was produced to escalate only the dominant IPTN (DIPTN) to 90 Gy, mimicking current imaging techniques. These plans were compared with homogeneous prostate irradiation to 70 Gy using dose–volume histograms, tumour control probability (TCP) and normal tissue complication probability (NTCP) for the rectum. The mean dose to IPTNs was increased from 69.8 Gy to 89.1 Gy if all the IPTNs were dose escalated (p=0.0003). This corresponded to a mean increase in TCP of 8.7–31.2% depending on the /ß ratio of prostate cancer (p