Randomized,double-blind,placebo-controlled,safety and immunogenicity study of 4 formulations of Anthrax Vaccine Adsorbed plus CPG 7909 (AV7909) in healthy adult volunteers

A new anthrax vaccine that could accelerate the immune response and possibly reduce the number of injections needed for protection would be desirable in a post-exposure setting.     

Monoclonal antibodies for prophylactic and therapeutic use against viral infections

Neutralizing antibodies play an essential part in antiviral immunity and are instrumental in preventing or modulating viral diseases. Polyclonal antibody preparations are increasingly being replaced by highly potent monoclonal antibodies (mAbs). Cocktails of mAbs and bispecific constructs can be used to simultaneously target multiple viral epitopes and to overcome issues of neutralization escape. Advances in antibody engineering have led to a large array of novel mAb formats, while deeper insight into the biology of several viruses and increasing knowledge of their neutralizing epitopes has extended the list of potential targets. In addition, progress in developing inexpensive production platforms will make antiviral mAbs more widely available and affordable.     

Incarceration and Sexual Risk: Examining the Relationship Between Men’s Involvement in the Criminal Justice System and Risky Sexual Behavior

In this study, we used data from Add Health Waves II and III to compare men who had been incarcerated to those who had not, and examined whether incarceration was associated with increased numbers of sexual partners and increased odds of concurrent partnerships. We used multivariate regression and propensity-score matching to compare sexual behavior of Wave III male respondents who had been incarcerated with those who had not, and compared sexual behavior at Wave II to identify differences in sexual behavior prior to incarceration. Incarceration was associated with an increased rate of lifetime sexual partnership, but this was attenuated by substance use. Criminal justice involvement was associated with increased odds of having partners who report concurrent partnerships, but no further increase was seen with incarceration. There were no significant sexual behavior differences prior to incarceration. These results suggest that the criminal justice system and substance use may interact to shape sexual behavior.     

The Feasibility and Validity of Body-Worn Sensors to Supplement Timed Walking Tests for Children with Neurological Conditions

Aims: The 10-meter walk test (10 mWT) and Timed Up and Go (TUG) are assessments of speed/time with a ceiling effect in pediatric populations. This study aimed to (1) determine whether collecting spatiotemporal data with inertial sensors (Mobility Lab, APDM Inc.) during these tests improves their discriminative validity, and (2) evaluate the clinical feasibility of Mobility Lab. Methods: Fifteen children with spina bifida (SB) or cerebral palsy (CP) (7.9 ± 3.1 years old) and fifteen age- and sex-matched typically-developing (TD) children completed the 10 mWT and TUG wearing Mobility Lab. Spatiotemporal data were compared between groups. Mobility Lab's potential to distinguish children with SB/CP from TD children was examined using conditional logistic regression. Feasibility was evaluated through participant adherence and a clinical utility scale. Results: For the 10 mWT, group differences (p < 0.01) were found in horizontal and frontal trunk range of motion, horizontal trunk velocity, and swing asymmetry. Children with SB/CP took significantly longer to turn during the TUG. These five variables together distinguished the two groups (p = 0.006). 78% of participants with SB/CP completed the testing protocol. Mobility Lab scored 4/10 on the clinical utility scale. Conclusions: Instrumenting the 10 mWT and TUG improves the tests’ ability to discriminate between children with SB/CP and TD children.     

Cardiac Intensive Care Unit Management of Patients After Cardiac Arrest: Now the Real Work Begins

Survival with a good quality of life after cardiac arrest continues to be abysmal. Coordinated resuscitative care does not end with the effective return of spontaneous circulation (ROSC)—in fact, quite the contrary is true. Along with identifying and appropriately treating the precipitating cause, various components of the post–cardiac arrest syndrome also require diligent observation and management, including post–cardiac arrest neurologic injury and myocardial dysfunction, systemic ischemia-reperfusion phenomenon with potential consequent multiorgan failure, and the various sequelae of critical illness. There is growing evidence that an early invasive approach to coronary reperfusion with percutaneous coronary intervention, together with active targeted temperature management and optimization of hemodynamic, ventilator, and metabolic parameters, may improve survival and neurologic outcomes in cardiac arrest survivors. Neuroprognostication is complex, as are survivorship issues and long-term rehabilitation. Our paramedics, emergency physicians, and resuscitation specialists are all to be congratulated for ever-increasing success with ROSC… but now the real work begins.