Nevin Manimala

Vaccines (Basel). 2024 Jul 22;12(7):815. doi: 10.3390/vaccines12070815.

ABSTRACT

The most widely known pyrogen impurity in vaccines is the Gram-negative bacterial endotoxin lipopolysaccharide (LPS). When administered at toxic doses, endotoxin triggers inflammatory responses, which lead to endotoxic shock. The literature on endotoxic content (EC) for preclinical vaccines’ formulations used in animal studies is very poor, and the recommended thresholds are solely based on commercial vaccine limits set for humans and are, therefore, not connected to the actual impact of EC on animal welfare for species used in preclinical research studies. An extensive study to evaluate the presence of a potential relationship between endotoxin content in formulations administered to mice (the most common species used in preclinical research studies) and their welfare was conducted to calculate an EC threshold for formulations of candidate vaccines. Three years of historical data, from more than 500 formulations of different antigen types (i.e., proteins, glycoconjugates, OMV/GMMA) injected into more than 5000 mice, was evaluated with two alternative statistical methodologies, both demonstrating that there is no significant relationship between actual endotoxin levels and mouse welfare. The calculation of thresholds was, therefore, performed by consistency versus formulations that demonstrated no impact on animal welfare.

PMID:39066452 | DOI:10.3390/vaccines12070815

Vaccines (Basel). 2024 Jul 19;12(7):803. doi: 10.3390/vaccines12070803.

ABSTRACT

Despite the availability of a safe and effective vaccination, uptake of human papillomavirus (HPV) vaccination remains low worldwide. We aimed to analyze the coverage of HPV immunization during the first year of the immunization program and the sociodemographic characteristics across different administrative units in Serbia and Montenegro. Coverage of HPV vaccination in Serbia for females aged 9-14 and 15-19 years was 5.5% and 5.9%, respectively. The coverage rate of immunization against HPV in Montenegro for girls aged 9-14 years was 22.1%. Within Serbia, only one administrative region (Moravica) had HPV immunization coverage in girls 9-19 years old above 10%, 11 districts had coverage from 5 to 10%, while 13 districts had coverage below 5%. As per Montenegro, two administrative units, Cetinje and Berane, reported the highest coverage, with 39% and 36.4% of vaccinated eligible girls, respectively. When we explored the coverage of HPV immunization among girls aged 9-19 years across different regions in Serbia, we observed that the level of coverage did not correlate with the number of pediatricians or with the population density. In Montenegro, we observed a similar situation. On the other hand, we noticed a statistically significant moderate negative correlation (r = -0.446; p = 0.026) between HPV immunization coverage and the percentage of illiterate women in the administrative units. Comparing the coverage between the two countries we found that the higher coverage in Montenegro corresponded with a smaller number of female populations aged 9-14 years, with higher average net monthly income, with smaller population density and smaller number of pediatricians, among divorced persons, and among those without formal education or incompletely primary education. Taking into account the experiences in Montenegro, increasing immunization coverage in Serbia could be achieved through a more vigorous educational campaign targeting schools, the general population, and healthcare workers as well as by additionally incentivizing those engaged in these activities.

PMID:39066441 | DOI:10.3390/vaccines12070803

Vaccines (Basel). 2024 Jul 18;12(7):796. doi: 10.3390/vaccines12070796.

ABSTRACT

The annual seasonal influenza vaccination rate among high-risk healthcare workers (HCWs) has fallen below expectations, underscoring the importance of exploring the impact of perception on vaccination behavior. An online survey, grounded in the Health Belief Model (HBM), was administered to high-risk healthcare workers at West China Hospital. The data analysis encompassed descriptive statistics, logistic regression for univariate analysis, and path regression for multivariate analysis. A total of 1845 healthcare workers completed the survey, with an acceptance rate of 83.90% (95% CI, 82.20-85.60%). Path analysis revealed significant correlations between vaccination acceptance and perceived susceptibility (β = 0.142), perceived benefits (β = 0.129), perceived barriers (β = 0.075), exposure to vaccination advertisements (β = 0.115), and knowledge about seasonal influenza (β = 0.051). Vaccination education efforts should prioritize elucidating the risks associated with the disease and emphasizing the benefits of vaccination. Furthermore, leveraging advertising proves to be an effective strategy for promotion.

PMID:39066434 | DOI:10.3390/vaccines12070796

Vaccines (Basel). 2024 Jul 15;12(7):778. doi: 10.3390/vaccines12070778.

ABSTRACT

Health professionals’ recommendations increase vaccine uptake. We aimed to document stances, practices regarding adult vaccination, and their predictors among undergraduate medical and biomedical science students, as well as their perspectives on increasing vaccine confidence. Among the 430 participants, third-year students from two universities in Greece, only 25.4% were in favor of all vaccines, while no refuters were detected. Predictors of recommending vaccination were the Attitudes Towards Adult Vaccination (ATAVAC) Value (OR 3.26, p < 0.001) and ATAVAC Safety subscales scores (OR 1.36, p < 0.05), being a medical student (OR 2.45, p < 0.05), and having better self-rated health status (OR 2.27, p < 0.05). The importance of getting vaccinated as health professionals was recognized by participants with a higher ATAVAC value (OR 5.39, p < 0.001), ATAVAC Safety scores (OR 1.46, p < 0.05), and increased knowledge regarding the National Immunization Program (OR 1.31, p < 0.05). The God Locus of Health Control (GLHC) was a predictor only in vaccination against COVID-19 (OR 0.91, p < 0.05). Improving community health literacy and health providers’ education, boosting trust in authorities, and adopting a person-centered approach emerged as the main themes regarding how to increase vaccine confidence. Mapping health professionals’ confidence in vaccines and providing lifelong training support is pivotal in supporting positive attitudes, enhancing their competence, and promoting vaccination in the post-COVID-19 era.

PMID:39066416 | DOI:10.3390/vaccines12070778

Vaccines (Basel). 2024 Jul 14;12(7):772. doi: 10.3390/vaccines12070772.

ABSTRACT

Vaccination among pregnant and breastfeeding women is critical for protecting this vulnerable population and their children. COVID-19 vaccination is recommended both during pregnancy and breastfeeding; however, we still do not fully understand the determinants that influence hesitancy towards COVID-19 vaccination. This study aimed to identify the determinants of vaccine hesitancy in pregnant and breastfeeding, puerperium women. A multicenter, cross-sectional study, involving 435 pregnant and breastfeeding women, was conducted. Vaccination hesitancy was evaluated by administering the Vaccination Attitudes (VAX) Scale and the Zung Anxiety Self-Assessment Scale (SAS) was adopted to measure anxiety levels. Overall, 14% of the participants reported that they did not receive the COVID-19 vaccine, and 78.3% received their first dose during pregnancy or while breastfeeding. The descriptive statistics for the VAX scale showed a total mean score of 3.35 (±1.6), and 75% of participants reported an anxiety index equal to or lower than the threshold. Vaccine hesitancy increased as “adverse events after vaccination” increased (p < 0.01), while SAS levels positively correlated with the participants’ mean age (p < 0.05). Investigating the factors influencing vaccine hesitancy enables the development of targeted health policies and SARS-CoV-2 vaccination programs.

PMID:39066410 | DOI:10.3390/vaccines12070772

Neural Netw. 2024 Jul 14;179:106534. doi: 10.1016/j.neunet.2024.106534. Online ahead of print.

ABSTRACT

As Deep Neural Networks (DNNs) continue to grow in complexity and size, leading to a substantial computational burden, weight pruning techniques have emerged as an effective solution. This paper presents a novel method for dynamic regularization-based pruning, which incorporates the Alternating Direction Method of Multipliers (ADMM). Unlike conventional methods that employ simple and abrupt threshold processing, the proposed method introduces a reweighting mechanism to assign importance to the weights in DNNs. Compared to other ADMM-based methods, the new method not only achieves higher accuracy but also saves considerable time thanks to the reduced number of necessary hyperparameters. The method is evaluated on multiple architectures, including LeNet-5, ResNet-32, ResNet-56, and ResNet-50, using the MNIST, CIFAR-10, and ImageNet datasets, respectively. Experimental results demonstrate its superior performance in terms of compression ratios and accuracy compared to state-of-the-art pruning methods. In particular, on the LeNet-5 model for the MNIST dataset, it achieves compression ratios of 355.9× with a slight improvement in accuracy; on the ResNet-50 model trained with the ImageNet dataset, it achieves compression ratios of 4.24× without sacrificing accuracy.

PMID:39059046 | DOI:10.1016/j.neunet.2024.106534

Seizure. 2024 Jun 21;121:23-29. doi: 10.1016/j.seizure.2024.06.018. Online ahead of print.

ABSTRACT

Surgical removal of the mesial temporal lobe can effectively treat drug-resistant epilepsy but may lead to mood disorders. This fact is of particular interest in patients without a prior psychiatric history. The study investigates the relationship between Temporal Lobe Epilepsy (TLE), mood disorders, and the functional connectivity of the Hippocampus (Hipp) and Nucleus Accumbens (NAcc). In this case control study, twenty-seven TLE patients and 18 control subjects participated, undergoing structural and functional magnetic resonance imaging (MRI) scans before and after surgery. Post-surgery, patients were categorized into those developing de novo depression (DnD) within the first year and those without depression (nD). Functional connectivity maps between NAcc and the whole brain were generated, and connectivity strength between the to-be-resected Hipp area and NAcc was compared. Within the first year post-surgery, 7 out of 27 patients developed DnD. Most patients (88.8 %) exhibited a significant reduction in NAcc-Hipp connectivity compared to controls. The DnD group showed notably lower connectivity values than the nD group, with statistically significant disparities. Receiver Operating Characteristic (ROC) curve analysis identified a potential biomarker threshold (Crawford-T value of -2.08) with a sensitivity of 0.83 and specificity of 0.76. The results suggest that functional connectivity patterns within the reward network could serve as a potential biomarker for predicting de novo mood disorders in TLE patients undergoing surgery. This insight may assist in identifying individuals at a higher risk of developing DnD after surgery, enhancing therapeutic guidance and clinical decision-making.

PMID:39059034 | DOI:10.1016/j.seizure.2024.06.018

Stud Hist Philos Sci. 2024 Jul 25;106:196-207. doi: 10.1016/j.shpsa.2024.06.006. Online ahead of print.

ABSTRACT

The first formal definition of randomness, seen as a property of sequences of events or experimental outcomes, dates back to Richard von Mises’ work in the foundations of probability and statistics. The randomness notion introduced by von Mises is nowadays widely regarded as being too weak. This is, to a large extent, due to the work of Jean Ville, which is often described as having dealt the death blow to von Mises’ approach, and which was integral to the development of algorithmic randomness-the now-standard theory of randomness for elements of a probability space. The main goal of this article is to trace the history and provide an in-depth appraisal of two lesser-known, yet historically and methodologically notable proposals for how to modify von Mises’ definition so as to avoid Ville’s objection. The first proposal is due to Abraham Wald, while the second one is due to Claus-Peter Schnorr. We show that, once made precise in a natural way using computability theory, Wald’s proposal constitutes a much more radical departure from von Mises’ framework than intended. Schnorr’s proposal, on the other hand, does provide a partial vindication of von Mises’ approach: it demonstrates that it is possible to obtain a satisfactory randomness notion-indeed, a canonical algorithmic randomness notion-by characterizing randomness in terms of the invariance of limiting relative frequencies. More generally, we argue that Schnorr’s proposal, together with a number of little-known related results, reveals that there is more continuity than typically acknowledged between von Mises’ approach and algorithmic randomness. Even though von Mises’ exclusive focus on limiting relative frequencies did not survive the passage to the theory of algorithmic randomness, another crucial aspect of his conception of randomness did endure; namely, the idea that randomness amounts to a certain type of stability or invariance under an appropriate class of transformations.

PMID:39059029 | DOI:10.1016/j.shpsa.2024.06.006

Int Braz J Urol. 2024 Jul 26;50. doi: 10.1590/S1677-5538.IBJU.2024.9915. Online ahead of print.

ABSTRACT

PURPOSE: The continuous improvement and development of fertility care, internationally, requires ongoing monitoring of current delivery processes and outcomes in clinical practice. This descriptive and exploratory mixed-methods study was conducted in eight countries (Brazil, China, France, Germany, Italy, Mexico, Spain and the United Kingdom) to assess the unmet needs of fertility patients (male and female), and existing challenges, barriers and educational gaps of physicians and laboratory specialists involved in human fertility care during the COVID-19 pandemic.

MATERIALS AND METHODS: The study was deployed sequentially in two phases: 1) in-depth 45-minute semi-structured interviews (n=76), transcribed, coded and thematically analysed using an inductive reasoning approach, 2) an online survey (n=303) informed by the findings of the qualitative interviews, face validated by experts in reproductive medicine, and analysed using descriptive and inferential statistical methods.

RESULTS: The integrated results of both phases indicated numerous areas of challenges, including: 1) investigating male-related infertility; 2) deciding appropriate treatment for men and selective use of assisted reproductive technology; and 3) maintaining access to high-quality fertility care during a pandemic.

CONCLUSIONS: The paper presents a reflective piece on knowledge and skills that warrant ongoing monitoring and improvement amongst reproductive medicine healthcare professionals amidst future pandemics and unanticipated health system disruptions. Moreover, these findings suggest that there is an additional need to better understand the required changes in policies and organizational processes that would facilitate access to andrology services for male infertility and specialized care, as needed.

PMID:39059016 | DOI:10.1590/S1677-5538.IBJU.2024.9915

JMIR Res Protoc. 2024 Jul 26;13:e56163. doi: 10.2196/56163.

ABSTRACT

BACKGROUND: Significant reforms are occurring in health practitioner regulation across Canada. Within the nursing profession, growing workforce challenges and health system demands have accelerated the pace of changes to nursing regulation policies and practices. There is significant political investment to modernize and harmonize nursing regulation across Canada, and evidence is needed to guide regulatory decision-making. To better understand the current state of scholarship and the gaps that exist, a comprehensive understanding of the available literature informing nursing regulation in Canada is first warranted.

OBJECTIVE: The objective of this scoping review is to examine the nature, extent, and range of literature focused on nursing regulation in Canada.

METHODS: The review will be conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. We will search electronic databases, including Ovid MEDLINE, Ovid EMBASE, CINAHL, Scopus, and Web of Science Core Collection. We will also search for grey literature using the websites of Canadian nursing regulatory bodies, nursing organizations, and other leading Canadian regulatory organizations. No limitations will be placed on the year of publication. The review will include papers that explore nursing regulation in Canada, including topics such as education program accreditation or approval, licensure, standards of practice and code of conduct/ethics development and enforcement, continuing competence, discipline and conduct, regulatory models, governance, and reform. We will extract data using a predeveloped tool. Data will be analyzed using descriptive statistics and conventional content analysis.

RESULTS: A preliminary search in Ovid MEDLINE was undertaken on December 7, 2023, and a full search was conducted in 5 academic databases on March 15, 2024. Findings will be presented using evidence tables and a narrative summary. Reporting will follow the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. This scoping review is expected to be completed in early 2025.

CONCLUSIONS: The results will be disseminated through conference presentations and a publication in a peer-reviewed journal. The findings will provide a comprehensive overview of the state of nursing regulation literature across Canada and inform the development of a focused research agenda.

TRIAL REGISTRATION: Open Science Framework osf.io/3qk8t; https://osf.io/bm7jv.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56163.

PMID:39059008 | DOI:10.2196/56163