TuBerculosis Vaccine Initiative

Rumen microbial communities are known to drive methane (CH4) production, but their dynamics in variable “real-world” farming environments are less understood. This research aims to identify specific microbial taxa linked to CH4 emission in commercial dairy farms by employing 16S rRNA gene sequencing, thereby providing a more ecologically relevant understanding of CH4 production in real-world settings.Rumen fluid samples were collected from 212 cows across seventeen Dutch dairy farms. Methane production was measured from these dairy cows using the GreenFeed system and expressed as CH4 intensity (g fat- and protein-corrected milk yield−1). Rumen microbiota was analyzed using 16S rRNA gene amplicon sequencing. Analysis was performed to assess association between microbial taxa and CH4 intensity, using data from individual cattle across the dairy farm. We observed that diet and lactation stage influenced CH4 intensity, consistent with previous studies. Results showed higher CH4 intensity in cows during late lactation, and feeding type, particularly fresh grass intake, strongly influenced rumen microbiota. However, after classifying low and high CH4 emitting cows, only limited differences in microbiota composition could be measured. Few taxa, like Lachnospiraceae, were common across both groups, while Ruminoccocaceae and Rikenellaceae were more abundant in low emitters, and Oscillospiraceae in high emitters. Methanobrevibacter differentiated CH4 emission groups, but archaeal methanogen abundance may not accurately reflect CH4 variation due to methodological limitations, including reliance on relative abundance, limited taxonomic resolution, and primer bias. Using a bacterial-biased 16S rRNA approach, we observed a limited number of consistent bacterial taxa associated with CH4 intensity highlights the challenges of studying dairy farms under practical conditions, where variability in diet, genetics, and management practices complicates the identification of specific rumen microbes associated with CH4 emission. Even with control over key variables, the inherent variability of on-farm conditions impeded the detection of stable microbial patterns. In conclusion, our study clearly indicates that understanding CH4 emissions from dairy cattle in real-world settings fundamentally requires a broader ecological perspective where rumen microbes are recognized as key determinants influencing microbiota signals within multi-factorial farm settings.

ABSTRACT Introduction The historical focus of vaccines on child health coupled with the advent of novel vaccines targeting adult populations necessitates exploring strategies for adult vaccine implementation. Areas covered This scoping review extracts insights from the past decade’s experiences introducing adult vaccines in low- and middle-income countries. Among 25 papers reviewed, 19 focused on oral cholera vaccine, 2 on Meningococcal A vaccines, 2 on tetanus toxoid vaccine, 1 on typhoid vaccine, and 1 on Ebola vaccine. Aligned with WHO’s Global Framework for New TB Vaccines for Adults and Adolescents, our findings center on vaccine availability, accessibility, and acceptance. Expert Opinion Availability findings underscore the importance of understanding disease burden for prioritization, multi-sectoral collaboration during planning, and strategic resource allocation and coordination. Accessibility results highlight the benefits of leveraging existing health infrastructure and adequately training healthcare workers, and contextually tailoring vaccine delivery approaches to reach challenging sub-groups like working male adults. Central to fostering acceptance, resonant sensitization, and communication campaigns engaging the communities and utilizing trusted local leaders countered rumors and increased awareness and uptake. As we approach the introduction of a new adult TB vaccine, insights from this review equips decision-makers with key evidence-based recommendations to support successful and equitable vaccinations targeting adults.

ABSTRACT DTaP5-HBV-IPV-Hib (Vaxelis®) is a hexavalent combination vaccine (HV) indicated in infants and toddlers for the prevention of diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis, and invasive disease due to Haemophilus influenzae type b. Switching between HVs during the childhood vaccination series is sometimes necessary due to, for example, vaccine availability, health-care provider preference, and/or tender awards. The purpose of this study was to describe the safety, tolerability, and immunogenicity of a booster dose of Vaxelis® in participants who previously received a primary infant series of either DTaP2-HBV-IPV-Hib (Hexyon®) or Vaxelis®. Healthy participants approximately 11–13 months of age who previously received a two-dose primary series of Hexyon® (HHV group) or Vaxelis® (VVV group) all received a Vaxelis® booster dose. Immunogenicity was evaluated by measuring antibody levels to individual vaccine antigens approximately 30 days following booster vaccination. Safety was evaluated as the proportion of participants with adverse events (AEs). The proportions of participants with antibody-specific responses for antigens contained in both Vaxelis® and Hexyon® at 30 days post-toddler-booster vaccination with Vaxelis® were comparable between groups, and higher in the VVV group for Vaxelis® antigens PRN and FIM2/3. The overall proportions of participants with AEs were generally comparable between groups. Following a booster dose of Vaxelis®, immune responses were comparable between groups for all shared antigens, and higher in the VVV group for antigens found only in Vaxelis®. The booster was well tolerated in both groups. These data support the use of Vaxelis® as a booster in mixed HV regimens.

Accounting automation has emerged as an essential tool in the business environment, offering significant advantages for both SMEs and large corporations. SMEs, with more agile structures, can adapt quickly to technological innovations, although they face challenges related to limited resources. On the other hand, large companies, despite their vast resources, face challenges in integrating new technologies due to complex organizational structures. Ongoing staff training and education is crucial for both, ensuring that the benefits of automation are maximized. Data security has become a priority, with the need to ensure the integrity and protection of accounting information. In conclusion, accounting automation is not just a trend, but a necessary evolution. Companies that adopt and adapt to it will be better positioned to thrive in a competitive and digitized future. It is imperative that organizations, regardless of size, recognize the potential of accounting automation and take proactive steps to implement it in their operations.

Background: One in two patients developing tuberculosis (TB) in low- and middle-income countries (LMICs) faces catastrophic household costs. We assessed the potential financial risk protection from introducing novel TB vaccines, and how health and economic benefits would be distributed across income quintiles. Methods: We modelled the impact of introducing TB vaccines meeting the WHO preferred product characteristics in 105 LMICs. For each country, we assessed the distribution of health gains, patient costs, and household financial vulnerability following introduction of an infant vaccine, and separately for an adolescent/adult vaccine, compared to a 'no-new-vaccine' counterfactual. Patient-incurred direct and indirect costs of TB disease exceeding 20% of annual household income were defined as catastrophic. Findings: Over 2028-2050, the health gains resulting from vaccine introduction were greatest in lower income quintiles, with the poorest two quintiles in each country accounting for 56% of total LMIC TB cases averted. Over this period, the infant vaccine was estimated to avert $5.9 (95% uncertainty interval: $5.3-6.5) billion in patient-incurred total costs, and the adolescent/adult vaccine was estimated to avert $38.9 ($36.6-41.5) billion. Over this period, 3.7 (3.3-4.1) million fewer households were projected to face catastrophic costs with the infant vaccine, and 22.9 (21.4-24.5) million with the adolescent/adult vaccine, with 66% of these gains accruing in the poorest two income quintiles. Interpretation: Under a range of assumptions, introducing novel TB vaccines would reduce income-based inequalities in the health and household economic outcomes of TB in LMICs.