ONRAB® oral rabies vaccine is shed from,but does not persist in,captive mammals

ONRAB® is a human adenovirus rabies glycoprotein recombinant vaccine developed to control rabies in wildlife. To support licensing and widespread use of the vaccine, safety studies are needed to assess its potential residual impact on wildlife populations. We examined the persistence of the ONRAB® vaccine virus in captive rabies vector and non-target mammals. This research complements work on important rabies vector species (raccoon, striped skunk, and red fox) but also adds to previous findings with the addition of some non-target species (Virginia opossum, Norway rats, and cotton rats) and a prolonged period of post vaccination monitoring (41 days). Animals were directly inoculated orally with the vaccine and vaccine shedding was monitored using quantitative real-time PCR applied to oral and rectal swabs. ONRAB® DNA was detected in both oral and rectal swabs from 6 h to 3 days post-inoculation in most animals, followed by a resurgence of shedding between days 17 and 34 in some species. Overall, the duration over which ONRAB® DNA was detectable was shorter for non-target mammals, and by day 41, no animal had detectable DNA in either oral or rectal swabs. All target species, as well as cotton rats and laboratory-bred Norway rats, developed robust humoral immune responses as measured by competitive ELISA, with all individuals being seropositive at day 31. Similarly, opossums showed good response (89% seropositive; 8/9), whereas only one of nine wild caught Norway rats was seropositive at day 31. These results support findings of other safety studies suggesting that ONRAB® does not persist in vector and non-target mammals exposed to the vaccine. As such, we interpret these data to reflect a low risk of adverse effects to wild populations following distribution of ONRAB® to control sylvatic rabies.     

The reliability and validity of the Seasonal Pattern Assessment Questionnaire: a comparison between patient groups

Background: The Seasonal Pattern Assessment Questionnaire (SPAQ) is a frequently used screening instrument in the research on Seasonal Affective Disorder (SAD). Nevertheless, studies on its reliability and validity are relatively scarce. In the present study the reliability and the contrast validity of the SPAQ are investigated. Methods: SAD patients, selected by means of a clinical interview, non-seasonal depressed out-patients, non-depressed out-patients, and a control group, are contrasted to estimate the discriminating power of the SPAQ. Also, the reliability and factor structure of the seasonality and the climate subscales are investigated. To study food intake the Seasonal Food Preference Questionnaire (SFPQ) was developed. Results: The SAD criterion of the SPAQ shows good specificity (94%), but a low sensitivity (44%). Discriminant analysis shows sufficient ability to classify subjects (81% correctly classified). The Global Seasonality Scale has a good internal consistency. It consists of two factors, a psychological factor and a food factor. The SFPQ is sensitive for carbohydrate intake by SAD patients. Limitations: Most SAD patients had received treatment and completed the SPAQ while they were not depressed, which may have influenced the sensitivity. Conclusions: The SPAQ is not sensitive enough to be considered a diagnostic instrument for SAD. Nevertheless, it is accurate enough to be used as a screenings instrument. The only false positives were found in the depressive group. The accuracy of prevalence Figs. can be improved by completion of the SPAQ in the summer months, combined with the completion of a depression scale.     

Screening for Depression in Emergency Department Patients

Background: Depression is a common disease, yet it is not commonly studied in the Emergency Medicine literature. Study Objectives: To evaluate the prevalence of emergency department (ED) patients who have the symptoms of depression. Design: This was a prospective observational study performed at two EDs over a 9-month period. Adult patients were screened for depression symptoms by Diagnostic and Statistical Manual of Mental Disorders, 4^th edition criteria. Results: There were 505 patients screened from April through December, 2004. Of the 505 patients, 109 (21.6%) screened positive for the symptoms of depression. The prevalence of positive screens was similar at each ED. Conclusion: About 1 in 5 ED patients may be suffering with depression.     

Rate of intrusion of maxillary incisors in Class II Div 1 malocclusion using skeletal anchorage device and Connecticut intrusion arch

BackgroundNonsurgical correction of deep bite involves either extrusion of posterior teeth, intrusion of incisors, or combination of both. The introduction of skeletal anchorage device with microimplant provides near absolute anchorage without producing any untoward effects on anchor unit. Connecticut Intrusion Arch (CIA) provided an efficient system of intruding anterior segment without producing much adverse affects on anchor teeth.MethodsThe study comprised of 30 patients of Class II Div 1 malocclusion with overbite of >6 mm and required therapeutic extractions of all first premolars, randomly distributed into two groups. Group 1 was treated using orthodontic microimplants, while Group 2 treated with CIA. Lateral cephalograms were taken pre-intrusion (T1) and post-intrusion at the end of six months (T2).ResultsThe rate of intrusion was 0.51 and 0.34 mm/month for Group 1 and Group 2 respectively. The average amount of change in centroid point to PP distance and U1-SN angle was significantly higher in Group 1 compared to Group 2 (P < 0.001). The average amount of change in U6 to PP distance did not differ significantly between two study groups (P > 0.05).ConclusionThe amount of intrusion is significantly higher in SAD group. Although vertical molar positional change was higher in CIA group than the SAD group, it was not changed significantly in both treatment modalities. SAD group overall had better results and was easier in handling during intrusion.     

Assessment of myocardial regional strain and strain rate by tissue tracking in B-mode echocardiograms

To date, established ultrasonic methods for myocardial regional deformation recovery are based on the Doppler effect, which has inherent limitations restricting its accuracy and use. The reported time domain methods show in vivo insufficient accuracy. A novel approach is elaborated mimicking the human observer who reaches robust diagnosis upon the B-mode data. In a region-of-interest (ROI), acoustic markers stable for tracking are selected. A weighting index presenting the quality of tracking of each marker is used for spatial polynomial fitting. For the feasibility study, a simple straight ROI was selected, which matches the septum. A thorough proof of concept is provided by comparing with a gold standard method and by applying the method to clinical datasets. The peak systolic longitudinal strains of 12 normals were -15% + -2.3% and, of 12 patients with a light-to-mild dysfunction of the apical-septal segment, they were -9% + -0.8% (p < 0.05). Enhancements of the method using spline fitting are introduced.     

精神分裂症恢复期社交焦虑的研究

为探讨精神分裂症恢复期社交焦虑(SAD),对200例精神分裂症恢复期患者用汉密顿焦虑量表(HAMA)、社交焦虑量表(LSAS)进行评分。结果,200例精神分裂症恢复期患者出现社交焦虑者占33.5％,其中社会功能和学习功能受影响者占41.79％。提示,对精神分裂症恢复期患者出现SAD者应引起高度重视。     

Estimating the effect of differing assumptions on the population health impact of introducing a Reduced Risk Tobacco Product in the USA

We use Population Health Impact Modelling to assess effects on tobacco prevalence and mortality of introducing a Reduced Risk Tobacco Product (RRP). Simulated samples start in 1990 with a US-representative smoking prevalence. Individual tobacco histories are updated annually until 2010 using estimated probabilities of switching between never/current/former smoking where the RRP is not introduced, with current users subdivided into cigarette/RRP/dual users where it is. RRP-related mortality reductions from lung cancer, IHD, stroke and COPD are derived from the histories and the assumed relative risks of the RRP.A basic analysis assumes a hypothetical RRP reduces effective dose 80% in users and 40% in dual users, with an uptake rate generating ∼10% RRP and ∼6% dual users among current users after 10 years. Sensitivity study changes in tobacco prevalence and mortality from varying effective doses, current smoking risks, quitting half-lives and rates of initiation, switching, re-initiation and cessation. They also study extreme situations (e.g. everyone using RRP), and investigate assumptions which might eliminate the RRP-related mortality reduction. The mortality reduction is proportional to the dose reduction, increasing rapidly with time of follow-up. Plausible increases in re-initiation or dual users’ consumption, or decreased quitting by smokers would not eliminate the drop.     

The sagittal abdominal diameter: Role in predicting severe liver disease in the general population

The role of the sagittal abdominal diameter (SAD) as a predictor of incident liver disease is unknown. 6626 individuals from the Finnish population-based Health 2000 Study were linked with national registers for liver-related admissions, mortality and cancer. SAD predicted incident liver disease (HR 1.32, 95% CI 1.06–1.65) when adjusted for age and sex, but the association was weaker than for waist–hip ratio (HR 1.86, 95% CI 1.35–2.55), waist circumference (HR 1.42, 95% CI 1.12–1.81), and waist–height ratio (HR 1.44, 95% CI 1.12–1.87); BMI was non-significant. In conclusion, SAD provided no additional benefit to other obesity measures in predicting incident severe liver disease.