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ABSTRACTInterest in Australian cedar (Toona ciliataM. Roemer var. australis) has increased due to its economic potential as an alternative to the use of native hardwood, and because of its resistance to the Hypsipyla grandellamoth, which affects native cedars. The use of growth regulators such as paclobutrazol (PBZ) in the planting of T. ciliatais aimed mostly at obtaining seedlings with greater resistance to H. grandellaand a desirable height for handling. However, this growth regulator tends to induce modifications to both leaf anatomy and photosynthetic potential. The present study aimed to evaluate the effect of increasing concentrations of PBZ on the leaf anatomy and gas exchange pattern in different T. ciliataclones. Seedlings from four T. ciliataclones (BV1110, BV1321, BV1120 and BV1151) were propagated by rooting cuttings and exposed to four concentrations of PBZ (0 μM, 0.5 μM, 1.0 μM and 2.0 μM), then the anatomy of the leaf blade and midrib vascular bundles and parameters related to gas exchange were analysed. Clones were significantly different for most of the characteristics studied. PBZ showed an effect only on the thickness of the palisade and spongy parenchyma. There was no effect of PBZ on gas exchange, but higher concentrations of PBZ induced thicker leaflets with scleromorphic characteristics.

The sol–gel process has been successfully combined with the “mixed cation” effect to produce novel luminescent and ion conducting biohybrids composed of a diurethane cross-linked poly(ε-caprolactone) (PCL530)/siloxane hybrid network (PCL stands for the poly(ε-caprolactone) biopolymer and 530 is the average molecular weight in gmol–1) doped with a wide range of concentrations of lithium and europium triflates (LiCF3SO3and Eu(CF3SO3)3, respectively) (molar ratio of ca. 50:50). The hybrid samples are all semicrystalline: whereas at n= 52.6 and 27.0 (n, composition, corresponds to the number of (C(O)(CH2)5O) repeat units of PCL(530) per mixture of Li+and Eu3+ions) a minor proportion of crystalline PCL(530) chains is present, at n= 6.1, a new crystalline phase emerges. The latter electrolyte is thermally stable up to 220 °C and exhibits the highest conductivity over the entire range of temperatures studied (3.7 × 10–7and 1.71 × 10–4S cm–1at 20 and 102 °C, respectively). According to infrared spectroscopic data, major modifications occur in terms of hydrogen bonding interactions at this composition. The electrochemical stability domain of the biohybrid sample with n= 27 spans more than 7 V versus Li/Li+. This sample is a room temperature white light emitter. Its emission color can be easily tuned across the Commission Internationale d’Éclairage (CIE) chromaticity diagram upon simply changing the excitation wavelength. Preliminary tests performed with a prototype electrochromic device (ECD) comprising the sample with n= 6.1 as electrolyte and WO3as cathodically coloring layer are extremely encouraging. The device exhibits switching time around 50 s, an optical density change of 0.15, good open circuit memory under atmospheric conditions (ca. 1 month) and high coloration efficiency (577 cm2C–1in the second cycle).

Campylobacter is the most common bacterial cause of gastroenteritis in England and Wales, with 45000 cases reported annually. Campylobacter incidence is highly seasonal; the consistent peak in late spring suggests a role for meteorological factors in the epidemiology of this organism. We investigated the relationship between ambient temperature and Campylobacter enteritis using time-series analysis to study short-term associations between temperature and number of Campylobacter reports adjusted for longer-term trend and seasonal patterns. We found a linear relationship between mean weekly temperature and reported Campylobacter enteritis, with a 1 °C rise corresponding to a 5% increase in the number of reports up to a threshold of 14 °C. There was no relationship outside this temperature range. Our findings provide evidence that ambient temperature influences Campylobacter incidence, and suggest that its effect is likely to be indirect, acting through other intermediate pathways.

The sequelae of Infectious Intestinal Disease (IID) in a population-based sample of cases and matched controls were investigated for a period of 3 months following the initial infection. Incident cases of IID presenting to GPs or occurring in the community and controls were studied at 3 weeks and over a 3-month follow-up period. Cases were six times more likely than controls to have gastrointestinal symptoms, particularly diarrhoea, at 3 weeks. Ten per cent of cases consulted their GP in the 3 months after episode and 2·3% were referred to hospital. GP presentation rates were twice as high in cases. Gastrointestinal symptoms persist after IID, leading to an increased likelihood of GP consultation and hospital referral. Diagnosis of irritable bowel syndrome may be more likely following IID. The burden of IID is likely to be considerable given its high incidence and the frequency of such sequelae.

To assess the socio-economic impact of infectious intestinal disease (IID) on the health care sector, cases and their families, cases of IID ascertained from a population cohort component and those presenting to general practices were sent a socio-economic questionnaire 3 weeks after the acute episode. The impact of the illness was measured and the resources used were identified and costed. The duration, severity and costs of illness linked to viruses were less than those linked to bacteria. The average cost per case of IID presenting to the GP was £253 and the costs of those not seeing a GP were £34. The average cost per case was £606 for a case with salmonella, £315 for campylobacter, £164 for rotavirus and £176 for SRSV. The estimated cost of IID in England was £743m expressed in 1994/5 prices. The costs of IID are considerable and the duration of the illness was found to be longer than previous reports have suggested.

In Brazil, there continues to be an excessive use of emergency services by patients with elective medical problems. Those patients who report having a primary care physician are less likely to utilize the emergency department for non-urgent consultations.

This is a case-control study aimed at identifying risk factors for intestinal infection with Campylobacter jejuni. Cases were defined as subjects with diarrhoea occurring in community cohorts or presenting to General Practitioners (GPs) with Campylobacter jejuni in stools. Controls were selected from GP lists or cohorts, matched by age, sex, and GP practice. Travel abroad and consumption of chicken in a restaurant were statistically significantly associated with being a case. There was no statistically significant risk associated with consumption of chicken other than in restaurants nor with reported domestic kitchen hygiene practices. Consumption of some foods was associated with a lower risk of being a case. Most cases remained unexplained. We suggest that infection with low numbers of micro-organisms, and individual susceptibility may play a greater role in the causation of campylobacter infection than previously thought. It is possible that in mild, sporadic cases infection may result from cross contamination from kitchen hygiene practices usually regarded as acceptable. Chicken may be a less important vehicle of infection for sporadic cases than for outbreaks, although its role as a source of infection in both settings requires further clarification in particular in relation to the effect of domestic hygiene practices. The potential effect of diet in reducing the risk of campylobacteriosis requires exploration.

Objective: To identify risk factors for infectious intestinal disease (IID) due to rotavirus group A in children aged under 16 years. Methods: Case-control study of cases of IID with rotavirus infection presenting to general practitioners (GPs) or occurring in community cohorts, and matched controls. Results: There were 139 matched pairs. In children under 16 years the following risk factors were significantly associated with rotavirus IID: living in rented council housing (adjusted OR=3·78, P=0·022), accommodation with more than five rooms (OR=0·72, P=0·002), contact with someone ill with IID (OR=3·45, P<0·001). Some foods were associated with decreased risk. In infants, bottle feeding with or without breast feeding was associated with increased risk (OR=9·06, P<0·05). Conclusions: Contact with persons with IID, living in rented council housing and accommodation with fewer rooms, were significant risk factors for sporadic rotavirus IID in children whereas breast feeding is protective in infants.

The World Health Organization suggested that the prevalence of Schistosoma mansoni among 7- to 14-year-olds be used to guide treatment strategies in endemic areas. This study explores how well the prevalence in that age group predicted the overall prevalence in the community in data from stool examinations (Kato–Katz method) from 180000 people in 3 municipalities in Brazil in 1984 and 1985. The median prevalence was higher in 1984, before community treatment was introduced. There was a strong relationship between the prevalence among 7- to 14-year-olds and the overall prevalence in the community. We present sensitivities and positive predictive values for the use of prevalence in the indicator group to select communities for mass treatment as recommended by WHO. For a range of assumptions sensitivity and positive predictive value were never both above 80%. We suggest that the estimates of validity presented in this paper inform future evaluations of strategies for S. mansoni control.

This paper deals with short-time planning and scheduling in multipurpose plants subject to a variable demand profile. In this case, production delays are often due to equipment overload, and this paper addresses a two-level approach that is intended to help managers engineer a scheduling solution that fulfills a compromise between products' demands and plant loading. At the first level, once a product's demand and raw-material delivery plan are defined, backward and forward explosion procedures are developed in such a way that time windows, defined by the earliest starting time and latest finishing time for each batch, are generated. Those time windows are submitted to an extended capacity analysis, based on constraint-propagation mechanisms, which is intended to reduce the time windows. If, after the capacity analysis, the problem is still feasible and the plant loading is accepted, then a scheduling procedure is launched. The scheduling approach is based on a uniform discrete time representation that is intended to explore plant features, such as, zero-wait policies, limited storage, and/or low equipment demand. The mixed integer linear problem (MILP) approach, combined with the time-window shortening procedure at the planning level, leads to smaller MILP problems, thereby reducing the solution time.

One of the aims of the Study of Infectious Intestinal Disease (IID) in England is to estimate the incidence of IID presenting to general practice. This sub-study aims to estimate and correct the degree of under-ascertainment in the national study.

The verbal autopsy (VA) is used to collect information on cause-specific mortality from bereaved relatives. A cause of death may be assigned by physician review of the questionnaires, or by an algorithm. We compared the diagnostic accuracy of physician review, an expert algorithm, and data-derived algorithms.

Continued medical care (including having a personal doctor) is regarded as an essential aspect of a good health service.

Two different measures of hospital-acquired infection (HAI), risk per discharge and incidence rate, were used to analyse the incidence of 225 primary HAIs detected in 3,090 patients in an 11-month survey. Longer hospital stay was associated with a greater risk of developing HAI, but the strength of the association was different for the two measures used. Day-specific incidence rates were found to vary, with a peak between the 14th and 19th days of hospitalisation. Similar patterns were observed when the data were stratified by age, sex and operation. Methods for calculating HAI should control for the length of hospital stay. Further studies are required to clarify the mechanisms that affect the temporal pattern of incidence of HAI observed with length of hospitalisation.

The aim was to examine the factors associated with incomplete vaccination in an urban area in Sao Paulo, Brazil; and to explore whether differences in vaccine coverage in the catchment area of health centres remain after the demographic constitution of the population in these areas is controlled for.

The aim was to investigate whether the winter increase in risk of sudden infant death was similar across social classes.

The aim was to assess the protection conferred by BCG given during the first year of life against tuberculosis among children of Asian ethnic origin born in England.

ABSTRACTThe ongoing Zika virus (ZIKV) outbreak in Latin America, the Caribbean, and the Pacific Islands has underlined the need for a coordinated research network across the whole region that can respond rapidly to address the current knowledge gaps in Zika and enhance research preparedness beyond Zika. The European Union under its Horizon 2020 Research and Innovation Programme awarded three research consortia to respond to this need. Here we present the ZikaPLAN (Zika Preparedness Latin American Network) consortium. ZikaPLAN combines the strengths of 25 partners in Latin America, North America, Africa, Asia, and various centers in Europe. We will conduct clinical studies to estimate the risk and further define the full spectrum and risk factors of congenital Zika virus syndrome (including neurodevelopmental milestones in the first 3 years of life), delineate neurological complications associated with ZIKV due to direct neuroinvasion and immune-mediated responses in older children and adults, and strengthen surveillance for birth defects and Guillain–Barré Syndrome. Laboratory-based research to unravel neurotropism and investigate the role of sexual transmission, determinants of severe disease, and viral fitness will underpin the clinical studies. Social messaging and engagement with affected communities, as well as development of wearable repellent technologies against Aedesmosquitoes will enhance the impact. Burden of disease studies, data-driven vector control, and vaccine modeling as well as risk assessments on geographic spread of ZIKV will form the foundation for evidence-informed policies. While addressing the research gaps around ZIKV, we will engage in capacity building in laboratory and clinical research, collaborate with existing and new networks to share knowledge, and work with international organizations to tackle regulatory and other bottlenecks and refine research priorities. In this way, we can leverage the ZIKV response toward building a long-term emerging infectious diseases response capacity in the region to address future challenges.

ObjectivesTo determine whether BCG vaccination protects against Mycobacterium tuberculosisinfection as assessed by interferon γ release assays (IGRA) in children.DesignSystematic review and meta-analysis. Searches of electronic databases 1950 to November 2013, checking of reference lists, hand searching of journals, and contact with experts.SettingCommunity congregate settings and households.Inclusion criteriaVaccinated and unvaccinated children aged under 16 with known recent exposure to patients with pulmonary tuberculosis. Children were screened for infection with M tuberculosiswith interferon γ release assays.Data extraction Study results relating to diagnostic accuracy were extracted and risk estimates were combined with random effects meta-analysis.ResultsThe primary analysis included 14 studies and 3855 participants. The estimated overall risk ratio was 0.81 (95% confidence interval 0.71 to 0.92), indicating a protective efficacy of 19% against infection among vaccinated children after exposure compared with unvaccinated children. The observed protection was similar when estimated with the two types of interferon γ release assays (ELISpot or QuantiFERON). Restriction of the analysis to the six studies (n=1745) with information on progression to active tuberculosis at the time of screening showed protection against infection of 27% (risk ratio 0.73, 0.61 to 0.87) compared with 71% (0.29, 0.15 to 0.58) against active tuberculosis. Among those infected, protection against progression to disease was 58% (0.42, 0.23 to 0.77).ConclusionsBCG protects against M tuberculosisinfection as well as progression from infection to disease.Trial registrationPROSPERO registration No CRD42011001698 (www.crd.york.ac.uk/prospero/).

Cutts F T (Epidemiology Service, Ministry of Health, Mozambique), Rodrigues L C, Colombo S and Bennett S. Evaluation of factors influencing vaccine uptake in Mozambique. International Journal of Epidemiology 1989, 18: 427–433. A pulse immunization project was started in Mozambique to compensate for the decrease in routine immunization caused by destabilization. A study was conducted to evaluate the project and identify determinants of vaccination in urban and rural areas of Mozambique. Vaccine coverage based on a documented record, the ‘Road to Health’ card, was 53% in urban and 60% in rural project areas, and 12% higher if a verbal history of vaccination was considered. A further 17% of children would have received effective vaccination if the correct schedule had been followed for all vaccines given and all preventive health services contacts had been used for vaccination. Factors relating to the individual mother and child and factors relating to the clusters were investigated for their association with vaccine uptake. Those which showed a strong negative association included vaccination on offer at the nearest vaccination post for only a small number of days per week; cancellation of an outreach session; knowing a child with a post-vaccination abscess; child born at home; at least five children in the family; mother's inability to speak Portuguese and her inability to name at least two target diseases. Improving the supervision of health services and immunizing at least three days per week at permanent immunization clinic sites may be the most important measures to improve coverage further.

Smith P G (Department of Medical Statistics and Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK), Rodrigues L C and Fine P E M. Assessment of the protective efficacy of vaccines against common diseases using case-control and cohort studies. International Journal of Epidemiology 1984, 13: 87–93. Case-control and cohort studies may be employed to assess the protective efficacy of vaccines. The appropriate measure of vaccine efficacy is shown to depend upon the mode of action of the vaccination. Two models of vaccine action are considered. In the first, vaccination is assumed to reduce the instantaneous disease-rate in the total vaccinated population by a constant proportion and, in the second, vaccination is assumed to render a constant proportion of individuals totally immune from the disease. The implications of these two models on the behaviour of different measures of vaccine efficacy in cohort studies is explored. It is shown that the design of case-control studies to measure vaccine efficacy is dependent upon which model is considered appropriate. In particular, under the second model, individuals who have already had the disease under study should not be excluded from the control group.