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© 2016 Nature America, Inc.To compare lung adenocarcinoma (ADC) and lung squamous cell carcinoma (SqCC) and to identify new drivers of lung carcinogenesis, we examined the exome sequences and copy number profiles of 660 lung ADC and 484 lung SqCC tumor-nor

Background: To collect and analyze state-level Health Impact Assessment (HIA) legislative activity. Methods: Two longitudinal datasets examining state-level HIA legislation across the United States between January 1, 2012 and December 31, 2016 were developed using the policy surveillance process. One dataset captures the characteristics of all HIA bills that were introduced and failed, or introduced and were still under consideration, during the time period of the study; the second dataset captures the characteristics of all HIA laws that were enacted or amended, including statutes and regulations. Results: Forty-three HIA bills were introduced that require, encourage, or incentivize the use of an HIA, and three of these bills were enacted or amended into law, between January 1, 2012 and December 31, 2016. Conclusions: Additional research is necessary to understand the factors that drive success or failure of HIA legislation, and the impacts of such legislation when implemented on decision-making, health determinants and outcomes, and health equity. Policy Implications: Although legislation can encourage further use of HIAs, they need to provide sufficient clarity, guidance, and resources to effectively foster use of HIAs.

The PLSP summarizes results from the phase 2/3 KidCOVE trial examining mRNA-1273 (Moderna's COVID-19 vaccine) in children 6 through 11 years of age. This study reviewed results from two parts of the KidCOVE clinical trial: Part 1 of the study was performed to select a dose of mRNA-1273 (50 μg or 100 μg) in children. A 50-μg dose was selected for further evaluation based on minimally unwanted side effects and sufficient antibodies (immune responses) against SARS-CoV-2. Part 2 of the study further evaluated the 50-μg dose of mRNA-1273 and compared it with placebo in children. Two 50-μg doses of mRNA-1273 were well tolerated with no new safety concerns. Two 50-μg doses also produced antibodies (immune responses) similar to those in young adults who received mRNA-1273 (100 μg) in a separate phase 3 study (the COVE trial). Study findings suggest that two 50-μg doses of mRNA-1273 were well-tolerated, and can prevent COVID-19 in children 6 through 11 years of age. Clinical Trial Registration:NCT04796896 (ClinicalTrials.gov) [ABSTRACT FROM AUTHOR]

It is commonly assumed that Hispanic immigrants in the United States subscribe to a patriarchal ideology that keeps women subordinated to men, often through violence and exploitative reproductive behaviors. If this assumption is true, we might expect to find that in the Hispanic culture patriarchal males control decision-making about access to and use of birth control. Structured interviews of 100 Hispanic men and 100 Hispanic women who were recent immigrants to a Midwest community were conducted to examine this assumption. Results did not support this assumption among this study population. We found no patriarchal ideology supporting women’s subordination to men, violence as a mechanism of control, reproduction as a way of exploitation, or cultural influences discouraging access to and use of birth control in the Hispanic community. Rather, these immigrants revealed adequate knowledge of birth control use and positive perceptions of gender equality. Gaining a better understanding of the limited influence of patriarchal ideology on the use of birth control and family planning services among this Hispanic community may inform the development of family planning services tailored for new Hispanic immigrants. [ABSTRACT FROM AUTHOR]

Previously, we evaluated 2 doses of H5N1 influenza vaccine in persons 18-64 years of age (placebo and 7.5-, 15-, 45-, or 90-microg doses), separated by 28 days. In this study, 337 participants received a third dose, 6 months thereafter. Microneutralization (MN) and hemagglutination-inhibition geometric mean titers (GMTs) of antibody declined before the third dose. Twenty-eight days after the third dose, 78%, 67%, 43%, and 31% of recipients in the 90-, 45-, 15-, and 7.5-mug-dose groups had a MN GMT > or =1:40, respectively. Five months later, MN GMTs were significantly greater than those after the second dose. (Trial registration: Clinical Trials.gov identifier NCT00240968 .). Copyright © 2008 The Hospital Infection Society [ABSTRACT FROM AUTHOR]

Rationale: High-resolution computed tomography (HRCT) has been suggested as a potential outcome surrogate for cystic fibrosis (CF) lung disease. An important attribute of a valid outcome surrogate is that the surrogate reflects true clinical outcomes. Objectives: We performed this study to validate HRCT, a proposed surrogate outcome measure for CF lung disease, against a true clinical outcome, the number of respiratory tract exacerbations occurring in 2 yr, and to assess the correlation of CT scores and pulmonary function tests (PFTs) with this clinical outcome. Methods: CTs and PFTs were performed on 6- to 10-yr-old children at the beginning and end of a 2-yr study during which the number of exacerbations were recorded. Spearman correlations and Poisson models were used to assess the correlation of the number of exacerbations with baseline values and changes in PFTs and CT scores. Measurements and Main Results: Nine of 61 subjects had a total of 22 respiratory tract exacerbations. At baseline, PFTs and four CT scores showed significant correlation with number of exacerbations, but no variable by itself predicted exacerbations with high accuracy. For change over the 2-yr period, three CT scores showed significant correlation with exacerbations, whereas no PFTs showed significant correlation. Conclusion: This is the first study showing correlation between CT and a true clinical outcome. Change in CT scores correlates moderately well with the number of exacerbation. Poor correlation between change in FEV1 and exacerbations suggests that HRCT may be a more appropriate outcome surrogate for longitudinal studies of young children. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the reliability of measurements with Semmes-Weinstein monofilaments as presented with a six piece foot kit. Sixteen females and six males who had diabetes and ranged in age from 47 to 95 years were tested three times during one session: two times by one tester to determine intratester reliability and another time by a second tester to determine intertester reliability. During each of these times the participants were tested for the sensation to a point of pressure with one to six monofilaments on nine sites of the right foot. Since Spearman correlation coefficients of the measurements of only two sites for intratester reliability and three sites for intertester reliability represented good reliability, the measurements overall did not demonstrate an adequate level of reliability. When the data were re-organized, Kappa values of all of the sites demonstrated substantial levels of agreement or excellent agreement for the determination of absence of protective sensation. [ABSTRACT FROM AUTHOR]

This phase 1 trial assessed the safety and immunogenicity of an investigational tetanus/diphtheria/acellular pertussis vaccine combined with CpG 1018 adjuvant 1500 μg (Tdap-1018 1500 μg) or 3000 μg (Tdap-1018 3000 μg) in adults and adolescents. In this randomized, active-controlled, multicenter, dose-escalation trial, healthy participants aged 10 to 22 years received 1 dose of Tdap-1018 1500 μg, Tdap-1018 3000 μg, or Boostrix. Geometric mean concentrations (GMCs) and booster response rates (BRRs) for antibodies against pertussis (pertussis toxin, filamentous hemagglutinin, pertactin), tetanus, and diphtheria antigens, and neutralizing antibodies against pertussis toxin were assessed 4 weeks after vaccination. Safety and tolerability were assessed for solicited post-injection reactions within 7 days after vaccination and unsolicited adverse events up to 12 weeks after vaccination. Of 117 enrolled participants, 80 adults (92%) and 30 adolescents (100%) completed the study. Both Tdap-1018 formulations were generally well tolerated, with no vaccine-related serious adverse events. Frequency and severity in post-injection reactions after Tdap-1018 administration were similar to Boostrix except for higher proportions of moderate pain for Tdap-1018. In adults at week 4, ratio of GMCs and BRRs for all antigens in the 3000-μg group were similar to or higher than Boostrix, with significantly higher GMC ratios for anti-pertussis toxin (2.1 [1.5-3.0]) and anti-tetanus (1.8 [1.1-2.9]) and significantly higher BRRs for anti-pertussis toxin (difference [95% CI]: 34.5% [13.4-54.6]), anti-pertactin (19.2% [4.4-38.1]), and anti-tetanus (30.0% [3.6-52.7]) antibodies. For adolescents, in the 3000-μg group, ratio of GMCs and BRRs were similar to or higher than Boostrix for all antigens. Both Tdap-1018 formulations showed acceptable safety and tolerability profiles. Tdap-1018 3000 μg induced similar or higher immune responses than Boostrix. ACTRN12620001177943 (Australian New Zealand Clinical Trials Registry; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=ACTRN12620001177943p)., Competing Interests: Declaration of competing interest F.X. and O.G. are consultants for Dynavax Technologies Corporation. J.D.C., O.H., and R.S.J. are employees of Dynavax Technologies Corporation and may hold company stock. P.R. has served on pertussis vaccine scientific advisory boards on behalf of his institution for GlaxoSmithKline and Sanofi outside the submitted work. T.N. has served on vaccine scientific advisory boards for GSK, Sanofi, Pfizer, CSL Seqirus, MSD, Moderna, and AstraZeneca, and on clinical trial data and safety monitoring boards for GSK, CSL Seqirus, Statens Serum Institute, SK Bioscience Korea, Zeria Pharmaceuticals, Clover, Novavax, Serum Institute of India, and Moderna. A.M., F.N-F., J.K., A.L., and N.W. report no potential conflicts., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Study Objective: Identification of HIV remains a critical health priority for which emergency departments (EDs) are a central focus. The comparative cost-effectiveness of various HIV screening strategies in EDs remains largely unknown. The goal of this study was to compare programmatic costs and cost-effectiveness of nontargeted and 2 forms of targeted opt-out HIV screening in EDs using results from a multicenter, pragmatic randomized clinical trial., Methods: This economic evaluation was nested in the HIV Testing Using Enhanced Screening Techniques in Emergency Departments (TESTED) trial, a multicenter pragmatic clinical trial of different ED-based HIV screening strategies conducted from April 2014 through January 2016. Patients aged 16 years or older, with normal mental status and not critically ill, or not known to be living with HIV were randomized to 1 of 3 HIV opt-out screening approaches, including nontargeted, enhanced targeted, or traditional targeted, across 4 urban EDs in the United States. Each screening method was fully integrated into routine emergency care. Direct programmatic costs were determined using actual trial results, and time-motion assessment was used to estimate personnel activity costs. The primary outcome was newly diagnosed HIV. Total annualized ED programmatic costs by screening approach were calculated using dollars adjusted to 2023 as were costs per patient newly diagnosed with HIV. One-way and multiway sensitivity analyses were performed., Results: The trial randomized 76,561 patient visits, resulting in 14,405 completed HIV tests, and 24 (0.2%) new diagnoses. Total annualized new diagnoses were 12.9, and total annualized costs for nontargeted, enhanced targeted, and traditional targeted screening were $111,861, $88,629, and $70,599, respectively. Within screening methods, costs per new HIV diagnoses were $20,809, $23,554, and $18,762, respectively. Enhanced targeted screening incurred higher costs but with similar annualized new cases detected compared with traditional targeted screening. Nontargeted screening yielded an incremental cost-effectiveness ratio of $25,586 when compared with traditional targeted screening. Results were most sensitive to HIV prevalence and costs of HIV tests., Conclusion: Nontargeted HIV screening was more costly than targeted screening largely due to an increased number of HIV tests performed. Each HIV screening strategy had similar within-strategy costs per new HIV diagnosis with traditional targeted screening yielding the lowest cost per new diagnosis. For settings with budget constraints or very low HIV prevalences, the traditional targeted approach may be preferred; however, given only a slightly higher cost per new HIV diagnosis, ED settings looking to detect the most new cases may prefer nontargeted screening., (Copyright © 2024 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.)