Search

Respiratory syncytial virus (RSV) is a leading cause of acute respiratory illness, with severe outcomes in older adults. Information on the prevalence, hospitalization rate, and impact on the health-related quality of life (HRQoL) of RSV in older adults with acute respiratory infections (ARI) in outpatient settings in Japan is limited.

Introduction: Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract disease in older adults, resulting in substantial morbidity and mortality. Methods: This study estimates the public health impact of vaccination with the adjuvanted RSVPreF3 vaccine among adults aged ≥ 60 years in the United States (US). A static, multi-cohort Markov model was used to estimate RSV-related outcomes over a 3-year time horizon for scenarios with and without one-time RSV vaccination. The base-case analysis assumed the same vaccination coverage as for influenza vaccines, with key epidemiology and vaccine inputs obtained from the published literature and phase 3 clinical trial results for the adjuvanted RSVPreF3 vaccine. Model outcomes included the clinical burden of RSV (symptomatic RSV acute respiratory illness [RSV-ARI] cases [classified as upper or lower respiratory tract disease], pneumonia complications, and mortality) and RSV-related healthcare resource use (hospitalizations, emergency department visits, outpatient visits, and antibiotic prescriptions). Results: In the base-case analysis, approximately 56.7 million adults aged ≥ 60 years received the vaccine, resulting in 2,954,465 fewer symptomatic RSV-ARI cases over 3 years compared with no vaccination, including 321,019 fewer X-ray confirmed pneumonia cases and 16,660 fewer RSV-related deaths. Vaccination also prevented a substantial number of RSV-related hospitalizations (203,891), emergency department visits (164,060), outpatient visits (1,577,586), and antibiotic prescriptions (1,343,915) over the 3-year period. A considerable public health impact was observed across a range of sensitivity analyses. Conclusions: These findings highlight the potential of the adjuvanted RSVPreF3 vaccine to substantially reduce RSV disease burden among US older adults aged ≥ 60 years.

ABSTRACTRespiratory syncytial virus (RSV) is a common cause of acute respiratory illness in individuals of all ages, with adults aged ≥60 years and adults with certain chronic conditions at increased risk of severe RSV-related outcomes. This study evaluates the cost-effectiveness of the adjuvanted RSVPreF3 vaccine versus no vaccine in adults aged ≥60 years in the United States (US). A multi-cohort Markov model was developed with a 5-year time horizon and 1-month cycle length to compare outcomes for no vaccination and one-time adjuvanted RSVPreF3 vaccination (assuming the same vaccination as for influenza vaccines). Clinical parameters (e.g., vaccine efficacy) were based on phase 3 clinical trial data over 3 seasons, with all other inputs obtained from public US sources and scientific literature. Outcomes included total and incremental quality-adjusted life year (QALY) losses and costs, as well as incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were conducted to evaluate the sensitivity of results to inputs. In the base case, the model estimated that vaccinating 52.7 million adults aged ≥60 years with the adjuvanted RSVPreF3 vaccine once would result in 244,424 fewer QALY losses and an incremental societal cost of $4.5 billion over 5 years, with vaccination costs partially offset by reduced disease-related costs. From the societal perspective, adjuvanted RSVPreF3 vaccination resulted in an ICER of $18,430 per QALY gained. Results were relatively robust across sensitivity analyses and indicate that adjuvanted RSVPreF3 vaccination is a cost-effective option for the prevention of RSV in US adults aged ≥ 60 years, reducing the substantial burden within this population.

ABSTRACTChildren have a high burden of influenza and play a central role in spreading influenza. Routinely vaccinating children against influenza may, thus, not only reduce their disease burden, but also that of the general population, including the elderly who frequently suffer severe complications. Using the published individual-based tool 4Flu, we simulated how pediatric vaccination would change infection incidence in Germany. Transmission of four influenza strains was simulated in 100,000 individuals with German demography and contact structure. After initialization with the recorded trivalent influenza vaccination coverage for 20 years (1997–2016), all vaccinations were switched to quadrivalent influenza vaccine (QIV). Scenarios where vaccination coverage of children (0.5-17-year-old) was increased from the current value (4.3%) to a maximum of 10-60% were compared to baseline with unchanged coverage, averaging results of 1,000 pairs of simulations over a 20-year evaluation period (2017–2036). Pediatric vaccination coverage of 10-60% annually prevented 218–1,732 (6.3–50.5%) infections in children, 204–1,961 (2.9–28.2%) in young adults and 95–868 (3.1–28.9%) in the elderly in a population of 100,000 inhabitants; overall, 34.1% of infections in the total population (3.7 million infections per year in Germany) can be prevented if 60% of all children are vaccinated annually. 4.4–4.6 vaccinations were needed to prevent one infection among children; 1.7–1.8 were needed to prevent one in the population. Enhanced pediatric vaccination prevents many infections in children and even more in young adults and the elderly.

ABSTRACTSeasonal influenza causes many cases and related deaths in Europe annually, despite ongoing vaccination programs for older adults and people at high-risk of complications. Children have the highest risk of infection and play a key role in disease transmission. Our cost-utility analysis, based on a dynamic transmission model, estimated the impact of increasing the current vaccination coverage with inactivated quadrivalent influenza vaccine in Germany to all (healthy and high-risk) children under 5 years of age (40% uptake), or under 18 years (40% uptake), or only high-risk children under 18 years (90% uptake). Eight influenza complications were modeled, hospitalization and death rates were based on age and risk status. All three vaccination strategies provided more health benefits than the existing vaccination situation, reducing influenza cases, complications, hospitalizations and deaths across the entire population. The strategy targeting all children under 5 years was highly cost-effective (€6/quality-adjusted life-year gained, payer perspective). The other strategies were cost saving from the payer and societal perspectives. The vaccination strategy targeting all children under 18 years was estimated to provide the most health benefits (preventing on average 1.66 million cases, 179,000 complications, 14,000 hospitalizations and 3,600 deaths due to influenza annually) and the most cost savings (annually €20.5 million and €731.3 million from payer and societal perspectives, respectively). Our analysis provides policy decision-makers with evidence supporting strategies to expand childhood influenza vaccination, to directly protect children, and indirectly all other unvaccinated age groups, in order to reduce the humanistic and economic burden on healthcare systems and society.

Quality demands of castings is elemental in recent years and becoming more stringent. Foundries are faced by the need to produce high quality castings, but nonetheless to produce them economically. To fulfill this demand, experimental castings, especially in case of individual production or small runs, are uneconomical. In these cases computer simulation can be the only economical tool for testing and approval. The modulus technique of Chvorinov is an applicable method to examine the local solidification process and to determine the application of chills, geometry modification and feeding. Numerically the control volume method is used to check the solidification process of large steel castings with non-uniform wall thicknesses.

In this work, we provide a simultaneous and accurate description of the π+π- and π ± J/ψ invariant mass distributions of the recent BESIII data on e+e- → J/ψ π+π-, together with the e+e- → J/ψ K+K- cross sections at e+e- center-of-mass energies q = 4.23 GeV and q = 4.26 GeV. The rescattering effects between pions in the S and D waves are taken into account through the Muskhelishvili-Omnès formalism. Since the physical region of the ππ invariant mass extends above 1 GeV, the important KK̅ intermediate state in the S wave is implemented through coupled-channel unitarity. For the left-hand cuts, we account for the well established charged exotic state Zc(3900) in t and u channels, while the other contributions are absorbed in the subtraction constants. For the e+e- → J/ψ KK̅, we provide the prediction of the two-kaon invariant mass distribution. The constructed amplitudes serve as an essential framework to interpret the present and forthcoming measurements by the BESIII and Belle II Collaborations. [ABSTRACT FROM AUTHOR]