Morgan, Lewis & Bockius (United States)

ObjectiveAs part of the Dose Reduction Immunobridging and Safety Study of Two HPV Vaccines in Tanzanian Girls (DoRIS; NCT02834637), the current study is one of the first to evaluate the financial and economic costs of the national rollout of an HPV vaccination program in school-aged girls in sub-Saharan Africa and the potential costs associated with a single dose HPV vaccine program, given recent evidence suggesting that a single dose may be as efficacious as a two-dose regimen.MethodsThe World Health Organization’s (WHO) Cervical Cancer Prevention and Control Costing (C4P) micro-costing tool was used to estimate the total financial and economic costs of the national vaccination program from the perspective of the Tanzanian government. Cost data were collected in 2019 via surveys, workshops, and interviews with local stakeholders for vaccines and injection supplies, microplanning, training, sensitization, service delivery, supervision, and cold chain. The cost per two-dose and one-dose fully immunized girl (FIG) was calculated.ResultsThe total financial and economic costs were US$10,117,455 and US$45,683,204, respectively, at a financial cost of $5.17 per two-dose FIG, and an economic cost of $23.34 per FIG. Vaccine and vaccine-related costs comprised the largest proportion of costs, followed by service delivery. In a one-dose scenario, the cost per FIG reduced to $2.51 (financial) and $12.18 (economic), with the largest reductions in vaccine and injection supply costs, and service delivery.ConclusionsThe overall cost of Tanzania’s HPV vaccination program was lower per vaccinee than costs estimated from previous demonstration projects in the region, especially in a single-dose scenario. Given the WHO Strategic Advisory Group of Experts on Immunization’s recent recommendation to update dosing schedules to either one or two doses of the HPV vaccine, these data provide important baseline data for Tanzania and may serve as a guide for improving coverage going forward. The findings may also aid in the prioritization of funding for countries that have not yet added HPV vaccines to their routine immunizations.

Abstract Background: Private sector malaria programs contribute to government-led malaria elimination strategies in Cambodia, Lao PDR, and Myanmar by increasing access to quality malaria services and surveillance data. However, reporting from private sector providers remains suboptimal in many settings. To support surveillance strengthening for elimination, a key program strategy is to introduce electronic surveillance tools and systems to integrate private sector data with national systems, and enhance the use of data for decision-making. During 2013-2017, an electronic surveillance system based on open source software, District Health Information System 2 (DHIS2), was implemented as part of a private sector malaria case management and surveillance program. The electronic surveillance system covered 16,000 private providers in Myanmar (electronic reporting conducted by 200 field officers with tablets), 710 in Cambodia (585 providers reporting through mobile app), and 432 in Laos (250 providers reporting through mobile app).Methods: We conducted a study to document the costs of introducing electronic surveillance systems and mobile reporting solutions in Cambodia, Lao PDR, and Myanmar, comparing the cost in different operational settings, the cost of introduction and maintenance over time, and assessing the affordability and financial sustainability of electronic surveillance. The data collection methods included extracting data from PSI’s financial and operational records, collecting data on prices and quantities of resources used, and interviewing key informants in each setting. The costing study used an ingredients-based approach and estimated both financial and economic costs.Results: Annual economic costs of electronic surveillance systems were $130,293 in Laos, $221,749 in Cambodia, and $504,456 in Myanmar. The annual economic cost per private provider surveilled was $32 in Myanmar, $379 in Cambodia, and $521 in Laos. Cost drivers varied depending on operational settings and number of private sector outlets covered in each country; whether purchased or personal mobile devices were used; and whether electronic (mobile) reporting was introduced at provider level or among field officers who support multiple providers for case reporting. Conclusion: The study found that electronic surveillance comprises less than 1% of National Malaria Strategic Plan cost and 6%-8% of surveillance budgets and deemed to be affordable and financially sustainable.

Single-crystal X-ray diffraction is a maturing technique; with structure determination becoming more routine, there are an increasing number of non-expert users collecting data, solving and refining structures.As the technique improves, easier access to synchrotron radiation and more sensitive detectors means that more data collections are showing features beyond the realms of conventional crystallography.The concept of non-Bragg diffraction is well understood in solid state chemistry, however, the phenomena of diffuse scattering and modulation have been studied less in molecular materials.Barluenga's reagent, IPy 2 BF 4 , has been shown to exhibit a transient modulated phase on cooling from a dynamic room temperature phase to an ordered low temperature structure.Systematic studies on the derivatives of Barluenga's reagent have been carried out in which iodine with bromine, the BF 4 anion is replaced with other small anions including ClO 4 and PF 6 and the pyridine is replaced with 2,4,6-trimethyl pyridine (collidine).While attempting to map the phase behaviour of these materials we discovered that the intense radiation at synchrotron facilities can interact with the satellite reflections indicative of the modulated phase.Understanding these effects could, not only improve our knowledge of the causes of modulation in molecular materials, but also further our understanding of the causes of radiation damage.

Abstract The construction of impassable dams severely affected many Pacific salmon Oncorhynchus spp. populations, resulting in reintroduction efforts that are now focused on returning anadromous fish to areas located upstream of these dams. A primary strategy for moving adult salmon and steelhead O. mykiss around a dam or multiple dams involves trapping fish downstream and transporting them to upstream areas (“trap and haul”) for spawning. We conducted a 4-year radiotelemetry study to evaluate behavior and movement patterns of hatchery- and natural-origin adult spring Chinook Salmon O. tshawytscha after a trap-and-haul program was implemented around three dams on the Cowlitz River, Washington. A multistate model was used to describe how factors such as origin, sex, release site location, and discharge affected transition rates to riverine areas where spawning habitat was located. Natural-origin Chinook Salmon moved upstream from a reservoir release site and entered one of two rivers more quickly and in greater proportions than hatchery-origin fish. Results from the multistate model indicated that transition rates from the reservoir to the Cowlitz River were 2.2 times higher for natural-origin Chinook Salmon than for hatchery-origin fish. About one-half (49.6%) of the reservoir-released hatchery-origin Chinook Salmon moved upstream into the Cowlitz River or the Cispus River during the spawning period. The release of hatchery-origin Chinook Salmon directly into these rivers increased the percentage of fish with river fates during the spawning period to 72.3–75.4%. Results from the multistate model showed that factors such as release site location, origin, day of year, and discharge were important predictors of transition intensities between specific locations in the study area. These findings illustrate the need to evaluate how salmon and steelhead respond to trap-and-haul methods, allowing for better management of reintroduction efforts in the future.

Homebound elders are vulnerable to decreased quality of life, related to their social and emotional isolation. This article discusses development of a Compassionate Visitation Program in the faith community, including recruitment and training of visitors, assessment of visitees and their environment, and structure and record-keeping of visits.

Purpose To explain recent guidance released by the Financial Industry Regulatory Authority (FINRA) regarding research analyst conflicts of interest that arise during the underwriter selection process. Design/methodology/approach The article discusses the risks associated with different communications between research analysts and issuers during the three phases of the underwriter selection process: the pre-IPO period; the solicitation period; and the post-mandate period. Findings While many questions remain, the FINRA guidance provides valuable insight to firms regarding the types of communications between research analysts and issuers that are permitted during different periods in the solicitation process. The risk levels associated with different types of communications during those time periods range from low to high to “unmanageable”. The article provides practical guidance on what research analysts can say and do during the different periods. Practical implications Broker-dealers should evaluate their policies and procedures to ensure compliance with the new FINRA guidelines. Originality value Practical guidance from experienced securities lawyers who are on the front lines in dealing with these issues.

BackgroundMultipartite mitochondrial genomes are very rare in animals but have been found previously in two insect orders with highly rearranged genomes, the Phthiraptera (parasitic lice), and the Psocoptera (booklice/barklice).ResultsWe provide the first report of a multipartite mitochondrial genome architecture in a third order with highly rearranged genomes: Thysanoptera (thrips). We sequenced the complete mitochondrial genomes of two divergent members of the Scirtothrips dorsalis cryptic species complex. The East Asia 1 species has the single circular chromosome common to animals while the South Asia 1 species has a genome consisting of two circular chromosomes. The fragmented South Asia 1 genome exhibits extreme chromosome size asymmetry with the majority of genes on the large, 14.28 kb, chromosome and only nad6 and trnC on the 0.92 kb mini-circle chromosome. This genome also features paralogous control regions with high similarity suggesting a very recent origin of the nad6 mini-circle chromosome in the South Asia 1 cryptic species.ConclusionsThysanoptera, along with the other minor paraenopteran insect orders should be considered models for rapid mitochondrial genome evolution, including fragmentation. Continued use of these models will facilitate a greater understanding of recombination and other mitochondrial genome evolutionary processes across eukaryotes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12864-015-1672-4) contains supplementary material, which is available to authorized users.

We previously reported that a dual PI3K-mTOR inhibitor BEZ235 (BEZ) induced cardiac hypertrophy. Here, we investigated potential mechanisms. Methods: three month old FVB/n female mice were treated with BEZ for five weeks. Cardiac function was monitored by serial echocardiography during the treatment and hemodynamic measurements at the end of the study. Cell signaling was analyzed by RT-PCR, Western blotting and ELISA. Results: BEZ induced a dose-dependent increase of left ventricular (LV) wall thickness and systolic function. These were associated with increased hypertrophic markers ANP, BNP, β-MHC and α-skeletal actin in the heart. In addition, in chronic BEZ-treated mouse hearts, the activations of PI3Ks, mTOR and ERK were increased. We conducted further studies to understand these contradictory results. We found that BEZ induced an increase of hepatic gluconeogenesis gene expression which was associated with increased fasting glucose, increased serum insulin level, a worsened glucose and pyruvate tolerance and increased IGFR/Insulin receptor activation in the heart. Injections of insulin lowered blood glucose, improved glucose and pyruvate tolerance, but further aggravated BEZ-induced cardiac dysfunction. On the other hand, OSI-906 (an IGFR/IR inhibitor) normalized cardiac function in BEZ-treated mice. Conclusions: Chronic BEZ treatment induced cardiac hypertrophy may be caused by increased insulin receptor activation in the heart.