Egebergtrujillo0035

BACKGROUND Since 2013, quadrivalent influenza vaccines containing two B viruses gradually replaced trivalent vaccines in the United States. We compared vaccine effectiveness of quadrivalent to trivalent inactivated vaccines (IIV4 to IIV3) against illness due to influenza B during the transition when IIV4 use increased rapidly. METHODS The US Influenza Vaccine Effectiveness (Flu VE) Network analyzed 25,019 of 42,600 outpatients aged ≥6 months enrolled within 7 days of illness-onset during six seasons from 2011-2012. Upper respiratory specimens were tested for influenza virus type and B-lineage. Using logistic regression, we estimated IIV4 or IIV3 effectiveness by comparing the odds of influenza B infection overall, and by B lineage among vaccinated versus unvaccinated participants. Over four seasons from 2013-2014, we compared relative odds of influenza B infection among IIV4 versus IIV3 recipients. RESULTS Trivalent vaccines included the predominantly circulating B lineage in four of six seasons. During four influenza seasons when both IIV4 and IIV3 were widely used, overall effectiveness against any influenza B was 53% (95% confidence interval [CI], 45 to 59) for IIV4 versus 45% (95% CI, 34 to 54) for IIV3. IIV4 was more effective than IIV3 against the B lineage not included in IIV3, but comparative effectiveness against illness related to any influenza B favored neither vaccine valency. CONCLUSIONS Uptake of quadrivalent inactivated influenza vaccines was not associated with increased protection against any influenza B illness, despite higher effectiveness of quadrivalent vaccines against the added B virus lineage. Public health impact and cost-benefit analyses are needed globally. © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.STUDY OBJECTIVES The usage of wrist-worn wearables to detect sleep-wake states remains a formidable challenge, particularly among individuals with disordered sleep. We developed a novel and unbiased data-driven method for detection of sleep-wake and compared its performance to the well-established Oakley algorithm (OA) relative to polysomnography (PSG) in elderly men with disordered sleep. METHODS Overnight in-lab PSG from 102 participants was compared to accelerometry and photoplethysmography simultaneously collected with a wearable device (Empatica E4). A binary segmentation algorithm was used to detect change points in these signals. A model that estimates sleep or wake states given the changes in these signals was established (Change Point Decoder, CPD). The CPD's performance was compared to the performance of the OA in relation to PSG. RESULTS On the Testing Set, OA provided sleep accuracy of 0.85, wake accuracy of 0.54, AUC of 0.67, and Kappa of 0.39. Comparable values for CPD were 0.70, 0.74, 0.78, and 0.40. The CPD method had sleep onset latency error of -22.9 minutes, sleep efficiency error of 2.09%, and underestimated the number of sleep/wake transitions with an error of 64.4. The OA method's performance was 28.6 minutes, -0.03%, and -17.2 respectively. CONCLUSIONS The CPD aggregates information from both cardiac and motion signals for state determination as well as the cross-dimensional influences from these domains. Therefore, CPD classification achieved balanced performance and higher AUC, despite underestimating sleep/wake transitions. The CPD could be used as an alternate framework to investigate sleep/wake dynamics within the conventional time frame of 30-second epochs. © Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.BACKGROUND Efforts to better understand the risk factors associated with respiratory failure (RF) and fatal LRTI in premature children in developing countries are necessary to elaborate evidenced-based preventive interventions. We aim to characterize the burden of RSV and hMPV LRTI in premature children and determine risk factors for RF and fatal illness in a vulnerable population. METHODS A prospective, population-based, cross-sectional study. Subjects with severe LRTI were enrolled during respiratory season. Risk factors for RF and death in premature infants were investigated. RESULTS 664 premature children participated. Infant's hospitalization rate due to LRTI was 82.6/1,000 (95% confidence interval (CI), 68.6-96.7/1,000). find more Infant's RSV and hMPV rates were 40.9/1,000 (36.3-45.6 /1,000) and 6.6/1,000 (3.9-9.2 /1,000), respectively. The RF rate was 8.2/1,000 (4.9-11.5 /1,000). LRTI mortality was 2.2/1,000 (0.7-3.7 /1,000); for RSV was 0.8/1,000 (0-1.7 /1,000) with a case fatality ratio of 1.8%. Never breastfeeding, malnutrition, younger than 6 months, congenital heart disease and lower hematocrit were risk factors for RF. Experiencing pneumonia, pneumothorax, sepsis or apnea were clinical determinants of poor outcomes. CONCLUSIONS Premature children under 2 years old in vulnerable environments experience RF and death more often than term counterparts. Modifiable risk factors associated with poor outcomes should prompt evidence-based interventions. © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.Effective suppression of container-inhabiting Asian Tiger [Aedes albopictus (Skuse)] (Diptera Culicidae) and yellow fever [Aedes aegypti (L.)] (Diptera Culicidae) mosquitoes presents one of the most intractable problems for modern mosquito control. Traditional tools often fail to control populations of these mosquito species, and are prohibitively expensive or have negative environmental impacts. Novel approaches and tools are urgently needed for integrated container-inhabiting mosquito management programs. One of the most promising techniques is autodissemination. We present the results of a long-term large-scale study conducted in a temperate urbanized environment representing typical Ae. albopictus habitats. Three treatment sites with autodissemination stations and three nearby reference sites were monitored for eggs, immature, and adult mosquitoes over a period of 3 yr from 2014 to 2016. Elevated larval and pupal mortality of 12-19% on average was the most notable outcome in sentinel cups of the treatment sites.