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3. VoxelScape: Large Scale Simulated 3D Point Cloud Dataset of Urban Traffic Environments

Author

Saleh, K, Hossny, M, Abobakr, A, Attia, M, Iskander, J, Saleh, K, Hossny, M, Abobakr, A, Attia, M, and Iskander, J

Abstract

Having a profound understanding of the surrounding environment is considered one of the crucial tasks for the reliable operation of future self-driving cars. Light Detection and Ranging (LiDAR) sensor plays a critical role in achieving such understanding due to its capability to perceive the world in 3D. Similar to 2D perception tasks, current state-of-the-art methods in 3D perception tasks rely on deep neural networks (DNNs). However, the performance of 3D perception tasks, specially point-wise semantic segmentation, is not on par with their 2D counterparts. One of the main reasons is the lack of publicly available labelled 3D point cloud datasets (PCDs) from 3D LiDAR sensors. In this work, we are introducing the VoxelScape dataset, a large-scale simulated 3D PCD with 100K annotated point cloud scans. The annotations in the VoxelScape dataset include both point-wise semantic labels and 3D bounding box labels. Additionally, we used a number of baseline approaches to validate the transferability of VoxelScape to real 3D PCD for two challenging 3D perception tasks. The promising results have shown that training DNNs on VoxelScape boosted the performance of the 3D perception tasks on the real PCD. Furthermore, we are also releasing the proposed data generation pipeline for the research community to facilitate realistic simulation of 3D LiDAR point cloud data for different scenarios beyond those covered in our VoxelScape dataset. The VoxelScape dataset and the corresponding LiDAR simulation codes are publicly available at https://voxel-scape.github.io/dataset

Published
2023

4. Refined Continuous Control of DDPG Actors via Parametrised Activation

Author

Hossny, M, Iskander, J, Attia, M, Saleh, K, Abobakr, A, Hossny, M, Iskander, J, Attia, M, Saleh, K, and Abobakr, A

Abstract

Continuous action spaces impose a serious challenge for reinforcement learning agents. While several off-policy reinforcement learning algorithms provide a universal solution to continuous control problems, the real challenge lies in the fact that different actuators feature different response functions due to wear and tear (in mechanical systems) and fatigue (in biomechanical systems). In this paper, we propose enhancing the actor-critic reinforcement learning agents by parameterising the final layer in the actor network. This layer produces the actions to accommodate the behaviour discrepancy of different actuators under different load conditions during interaction with the environment. To achieve this, the actor is trained to learn the tuning parameter controlling the activation layer (e.g., Tanh and Sigmoid). The learned parameters are then used to create tailored activation functions for each actuator. We ran experiments on three OpenAI Gym environments, i.e., Pendulum-v0, LunarLanderContinuous-v2, and BipedalWalker-v2. Results showed an average of 23.15% and 33.80% increase in total episode reward of the LunarLanderContinuous-v2 and BipedalWalker-v2 environments, respectively. There was no apparent improvement in Pendulum-v0 environment but the proposed method produces a more stable actuation signal compared to the state-of-the-art method. The proposed method allows the reinforcement learning actor to produce more robust actions that accommodate the discrepancy in the actuators’ response functions. This is particularly useful for real life scenarios where actuators exhibit different response functions depending on the load and the interaction with the environment. This also simplifies the transfer learning problem by fine-tuning the parameterised activation layers instead of retraining the entire policy every time an actuator is replaced. Finally, the proposed method would allow better accommodation to biological actuators (e.g., muscles) in biomechanical syst

Published
2021

5. Fast intent prediction of multi-cyclists in 3D point cloud data using deep neural networks

Author

Saleh, K, Abobakr, A, Hossny, M, Nahavandi, D, Iskander, J, Attia, M, Nahavandi, S, Saleh, K, Abobakr, A, Hossny, M, Nahavandi, D, Iskander, J, Attia, M, and Nahavandi, S

Abstract

Inferring the intended actions of road-sharing users with autonomous ground vehicles in particularly vulnerable ones like cyclists is considered one of the tough tasks facing the wide-spread deployment of autonomous ground vehicles. One of the main reasons for that is the scarcity of the available datasets for that task due to the difficulty in obtaining those datasets in real environments. In this work, we first propose a pipeline that can synthetically produce 3D LiDAR data of cyclists hand-signalling a set of intended actions that are commonly done in real environments. Given the synthetically-produced labelled 3D LiDAR data sequences, we trained a framework that can simultaneously detect, track and give predictions about the intended actions of multi-cyclists in the scene on time. The proposed framework was evaluated using both synthetic and real data from a physical 3D LiDAR sensor. Our proposed framework has scored competitive and robust results in both synthetic and real environments with 88% in F1 measure with higher frame per second rate (12.9 FPS) than the 3D LiDAR sensor frame rate (10 Hz).

Published
2021

6. 'Toxic' and 'Nontoxic'

Author

Hoover, M.D., primary, Cash, L.J., additional, Mathews, S.M., additional, Feitshans, I.L., additional, Iskander, J., additional, and Harper, S.L., additional

Published
2014
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8. Domain adaptation for vehicle detection from bird's eye view lidar point cloud data

Author

Saleh, K, Abobakr, A, Attia, M, Iskander, J, Nahavandi, D, Hossny, M, Nahvandi, S, Saleh, K, Abobakr, A, Attia, M, Iskander, J, Nahavandi, D, Hossny, M, and Nahvandi, S

Abstract

© 2019 IEEE. Point cloud data from 3D LiDAR sensors are one of the most crucial sensor modalities for versatile safety-critical applications such as self-driving vehicles. Since the annotations of point cloud data is an expensive and time-consuming process, therefore recently the utilisation of simulated environments and 3D LiDAR sensors for this task started to get some popularity. However, the generated synthetic point cloud data are still missing the artefacts usually exist in point cloud data from real 3D LiDAR sensors. Thus, in this work, we are proposing a domain adaptation framework for bridging this gap between synthetic and real point cloud data. Our proposed framework is based on the deep cycle-consistent generative adversarial networks (CycleGAN) architecture. We have evaluated the performance of our proposed framework on the task of vehicle detection from a bird's eye view (BEV) point cloud images coming from real 3D LiDAR sensors. The framework has shown competitive results with an improvement of more than 7% in average precision score over other baseline approaches when tested on real BEV point cloud images.

Published
2020

11. Fingerprint Synthesis Via Latent Space Representation

Author

Attia, M, Attia, MH, Iskander, J, Saleh, K, Nahavandi, D, Abobakr, A, Hossny, M, Nahavandi, S, Attia, M, Attia, MH, Iskander, J, Saleh, K, Nahavandi, D, Abobakr, A, Hossny, M, and Nahavandi, S

Abstract

Fingerprint recognition and indexing were addressed extensively in the literature. However, the number of the datasets that are used for research and validation is limited. Due to privacy laws and acts in several countries, it is challenging to release finger prints to the public. Consequently, this imposes a challenge on validating these search techniques on larger datasets that can be couple of hundreds of millions. To overcome this limitation, synthetic fingerprints datasets have been introduced as an alternative solution. In this paper we propose a generative model for synthesising fingerprint datasets. In this present work, the synthetic fingerprints are generated from the latent space representation using variational auto encoder. The network is trained to generate random samples that have same distribution as real finger print using latent vectors. By examining the generated synthetic fingerprints images, the ridge patterns were recognisable in most of cases. The unrecognisable synthetic images are reflecting the presence of low quality images in the training samples of the original dataset. Moreover, the extraction of minutiae relies on the quality of the input fingerprint images. In conclusion, the proposed method was able to generate synthetic image that can be further processed to accurately extract the finger minutiae and orientation field

Published
2019

12. Exploring the Effect of Virtual Depth on Pupil Diameter

Author

Iskander, J, Attia, M, Saleh, K, Abobakr, A, Nahavandi, D, Hossny, M, Nahavandi, S, Iskander, J, Attia, M, Saleh, K, Abobakr, A, Nahavandi, D, Hossny, M, and Nahavandi, S

Abstract

Virtual and Augmented reality (VR/AR) are being extensively used in many applications that extends from entertainment, training to rehabilitation and treatment of disorders. Studies on the effects of extended use of VR immersion has been performed. However, the change of pupil diameter with the change of VR simulated depth has not been investigated. Pupil dilation is an indicative measure of cognitive overload. In this paper, we investigate the relationship between VR simulated depth and the pupil diameter change. Results showed a significant difference in pupil diameter change with simulated depth and also a strong negative correlation. This indicates that as the depth of the VR object increase (distance from the VR user increase), the VR user's pupil diameter decreases. These results show that change in pupil diameter can be an indicative of change in the depth of the observed virtual object. This can be an effective VR/AR scene scanning and understanding tool.

Published
2019

13. From car sickness to autonomous car sickness: A review

Author

Iskander, J, Attia, M, Saleh, K, Nahavandi, D, Abobakr, A, Mohamed, S, Asadi, H, Khosravi, A, Lim, CP, Hossny, M, Iskander, J, Attia, M, Saleh, K, Nahavandi, D, Abobakr, A, Mohamed, S, Asadi, H, Khosravi, A, Lim, CP, and Hossny, M

Abstract

© 2019 Elsevier Ltd Motion sickness comprises a set of symptoms, such as nausea, headaches, and disorientation, that affects healthy individuals when undergoing different types of motion, including virtual motion. The ways of mitigating motion sickness is a controversial issue as it strongly depends on variability among individuals due to anthropometric, physical as well as physiological traits, making it difficult to identify and derive a universal solution. With the introduction of autonomous vehicles, we are moving from car sickness, which is motion sickness induced when riding in cars, to autonomous car sickness, which arises from riding in autonomous vehicles. To ensure advancement of fully-autonomous vehicles, a comfortable experience must be provided to the passengers. An important factor that affects the acceptance of autonomous cars is the capability of passengers to perform non-driving tasks like reading, relaxing, and/or socialising in a comfortable style with no or limited motion sickness symptoms. Drivers, who never suffer from motion sickness while driving, might be, when riding as passengers in autonomous cars, susceptible to motion sickness due to the lack of controllability on the vehicle in addition to sensory conflicts. Therefore, in-depth investigations on the causes of autonomous car sickness are required. In this paper, we present different theories explaining the ‘how’ and ‘why’ of motion sickness and then discuss whether these factors are applicable to autonomous car sickness. The adaptation of different motion sickness predictors that can be used to limit autonomous car sickness are also discussed, with a proposal of a framework that provides a viable solution to mitigate autonomous carsickness.

Published
2019

14. Cyclist Intent Prediction using 3D LIDAR Sensors for Fully Automated Vehicles

Author

Saleh, K, Abobakr, A, Nahavandi, D, Iskander, J, Attia, M, Hossny, M, Nahavandi, S, Saleh, K, Abobakr, A, Nahavandi, D, Iskander, J, Attia, M, Hossny, M, and Nahavandi, S

Abstract

One of the main barriers against the full deployment of autonomous vehicles in urban traffic environments is the understanding of the intentions and behaviours of the human around them. Moreover, understanding and predicting intentions of vulnerable road users such as cyclists is still one of the most challenging tasks. In this work, we are proposing a novel framework for the task of intent prediction of cyclists via hand signalling from point cloud scans. We utilised our developed data generation pipeline for generating synthetic point cloud scans of cyclists doing a set of hand signals in urban traffic environments. Then, we feed a sequence of the generated point cloud scans to our framework which jointly segments all cyclists instances and predicts their most probable intended actions in an end-to-end fashion. Our proposed framework has achieved superior results with 83% in F 1 -Measure score over the testing split of our generated dataset. Additionally, the proposed framework outperformed other compared baseline approaches with more than 39% improvement in F 1 -Measure score.

Published
2019

15. SSDPose: A Single Shot Deep Pose Estimation and Analysis

Author

Abobakr, A, Abdelkader, H, Iskander, J, Nahavandi, D, Saleh, K, Attia, M, Hossny, M, Nahavandi, S, Abobakr, A, Abdelkader, H, Iskander, J, Nahavandi, D, Saleh, K, Attia, M, Hossny, M, and Nahavandi, S

Abstract

Human posture estimation is a fundamental challenge in computer vision research. This is a task that has received substantial interest due to the importance of evaluating the human performance in several disciplines. The ultimate goal for the vision-based pose estimation task is the markerless accurate prediction of necessary postural information. This paper proposes a single shot deep human posture detection and estimation network. The proposed SSDPose architecture increments standard object detection networks to feature posture estimation. SSDPose is an end-to-end trainable model that detects and estimates the body posture from a single image. Further, our network has been trained to predict joint angles which are essential information for several domains such as biomechanic and ergonomic posture analysis. The reference joint angles have been generated using motion capture sequences and a novel inverse kinematics method. Experimental results demonstrate that SSDPose effectively detects and estimates the posture by achieving person mean average precision (mAP) of 98.2%, an average joint angles MAE of 3.16 ± 1.23 deg and an RMSE of 4.22 ± 1.73 deg at up to 30 FPS.

Published
2019

16. High Frame Rate Photorealistic Flame Rendering via Generative Adversarial Networks

Author

Attia, M, Abobakr, A, Wei, L, Saleh, K, Iskander, J, Zhou, H, Nahavandi, D, Hossny, M, Nahavandi, S, Attia, M, Abobakr, A, Wei, L, Saleh, K, Iskander, J, Zhou, H, Nahavandi, D, Hossny, M, and Nahavandi, S

Abstract

In this paper we propose accelerating live rendering of flame using generative adversarial neural networks. The proposed method targets entertainment and simulation-based training industries whose demands for high fidelity and high frame rate increases steadily. The proposed approach takes image frames rendered with low voxel resolution (8 × 8 × 8 voxels at 90 FPS) and produces image frames equivalent to imagery produced from high voxel resolution (64 × 64 × 64 voxels) typically rendered at 3 FPS. The error was evaluated using the structural similarity image metric (SSIM). The average error between generated image frames and the ground truth recorded 92:7%±4:6%.

Published
2019

17. A k-NN Classification based VR User Verification using Eye Movement and Ocular Biomechanics

Author

Iskander, J, Abobakr, A, Attia, M, Saleh, K, Nahavandi, D, Hossny, M, Nahavandi, S, Iskander, J, Abobakr, A, Attia, M, Saleh, K, Nahavandi, D, Hossny, M, and Nahavandi, S

Abstract

VR user identification is of utmost importance especially with the increased applications of VR that will include e-payment among other applications that requires a high level of security. Biometric identification through eye movement, has been used previously due to the intrinsic characteristics of eye movement that characterises a person uniquely. In this paper, we propose using eye movement along with extraocular muscle activations in VR user verification. The muscle activations are calculated using an ocular biomechanical model. The k-NN classification results showed approximately 90% accuracy when using a feature set with eye movement parameters (3 joint angles), muscle activations for all 6 muscles along with the VR object position in 3D. The classifier is a biometric VR user verification tool that provides an easy and non-intrusive methods that can be easily integrated in different VR applications that require user verification.

Published
2019

24. Clinical Characteristics and Outcomes of Cardiac Findings in Young Persons Following SARS-CoV-2 Infection

Author

Jones, Milissa U., Richard, Stephanie A., Malloy, Allison M. W., Colombo, Rhonda E., May, Joseph, Saunders, David, Lindholm, David A., Ganesan, Anuradha, Sablak, Ceyda, Hickey, Patrick W., Dobson, Craig P., Pollett, Simon D., Flanagan, Ryan, Cowden, J., Darling, M., DeLeon, S., Lindholm, D., Markelz, A., Mende, K., Merritt, S., Merritt, T., Turner, N., Wellington, T., Bazan, S., Love, P.K, Dimascio-Johnson, N., Elnahas, N., Ewers, E., Gallagher, K., Glinn, C., Jarral, U., Jennings, D., Larson, D., Reterstoff, K., Rutt, A., Silva, A., West, C., Al-Eid, H., Blair, P., Chenoweth, J., Clark, D., Bowman, J., Chambers, S., Colombo, C., Colombo, R., Conlon, C., Everson, K., Faestel, P., Ferguson, T., Gordon, L., Grogan, S., Lis, S., Martin, M., Mount, C., Musfeldt, D., Odineal, D., Perreault, M., Robb-McGrath, W., Sainato, R., Schofield, C., Skinner, C., Stein, M., Switzer, M., Timlin, M., Wood, S., Banks, S., Carpenter, R., Kim, L., Kronmann, K., Lalani, T., Lee, T., Smith, A., Smith, R., Tant, R., Warkentien, T., Berjohn, C., Cammarata, S., Kirkland, N., Libraty, D., Maves, R., Utz, G., Bradley, C., Chi, S., Flanagan, R., Fuentes, A., Jones, M., Leslie, N., Lucas, C., Madar, C., Miyasato, K., Uyehara, C., Adams, H., Agan, B., Andronescu, L., Austin, A., Barton, B., Becher, D., Broder, C., Burgess, T., Byrne, C., Chung, K, Davies, J., English, C., Epsi, N., Fox, C., Fritschlanski, M., Hadley, A., Hickey, P., Laing, E., Lanteri, C., Livezey, J., Malloy, A., Michel, A., Mohammed, R., Morales, C., Nwachukwu, P., Olsen, C., Parmelee, E., Pollett, S., Richard, S., Rothenberg, J., Rozman, J., Rusiecki, J., Saunders, D., Samuels, E., Sanchez, M., Scher, A., Simons, M., Snow, A., Telu, K., Tribble, D., Tso, M., Ulomi, L., Wayman, M., Hockenbury, N., Chao, T., Chapleau, R., Christian, M., Fries, A., Harrington, C., Hogan, V., Huntsberger, S., Lanter, K., Macias, E., Meyer, J., Purves, S., Reynolds, K., Rodriguez, J., Starr, C., Iskander, J., Kamara, I., Barton, B., Hostler, D., Hostler, J., Lago, K., Maldonado, C., Mehrer, J., Hunter, T., Mejia, J., Mody, R., Montes, J., Resendez, R., Sandoval, P., Barahona, I., Baya, A., Ganesan, A., Huprikar, N., Johnson, B., and Peel, S.

Abstract

We studied cardiac complications in young persons with severe acute respiratory syndrome coronavirus 2. In a prospective cohort of 127 Military Health System beneficiaries 0–22 years old, 3.1% had cardiac abnormalities, all resolved within 6 months. Our findings support guidelines against routine cardiac screening in mild COVID-19 cases without cardiac symptoms.

Published
2024
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25. Postmarketing monitoring of intussusception after RotaTeq™ vaccination--United States, February 1, 2006-February 15, 2007

Author

Belongia, E., Izurieta, H., Braun, M.M., Ball, R., Haber, P., Baggs, J., Weintraub, E., Gargiullo, P., Vellozzi, C., Iskander, J., Patel, M., Parashar, U., and Cortese, M.

Subjects
RotaTeq (Medication) -- Dosage and administration -- Complications and side effects, Management, Diagnosis, Care and treatment, Complications and side effects, Dosage and administration, Company business management, Intussusception -- Management -- Diagnosis -- Care and treatment -- Complications and side effects, Infants -- Care and treatment, Vaccination -- Complications and side effects -- Dosage and administration, Intestines -- Intussusception
Abstract

Rotavirus is the leading cause of severe gastroenteritis in children aged In the United States, the postmarketing safety of RotaTeq is being monitored jointly by CDC and the Food and [...]

Published
2007

29. Update: recommendations from the Advisory Committee on Immunization Practices (ACIP) regarding administration of combination MMRV vaccine

Author

Klein, N.P., Yih, W.K., Marin, M., Jumaan, A.O., Seward, J.F., Broder, K., Iskander, J., and Snider, Jr., D.E.

Subjects
Complications and side effects, Case studies, Dosage and administration, Seizures (Medicine) -- Case studies -- Complications and side effects, Measles-mumps-rubella vaccines -- Case studies -- Dosage and administration -- Complications and side effects, Measles-mumps-rubella vaccine -- Case studies -- Dosage and administration -- Complications and side effects
Abstract

On February 27, 2008, new information was presented to the Advisory Committee on Immunization Practices (ACIP) regarding the risk for febrile seizures among children aged 12-23 months after administration of [...]

Published
2008

30. Suspension of rotavirus vaccine after reports of intussusception--United States, 1999

Author

Iskander, J., Haber, P., Murphy, T.V., Chen, R.T., and Sabin, M.

Subjects
Intussusception, Vaccines, Rotavirus infections, Intestinal obstruction, Intestines -- Obstructions -- Intussusception
Abstract

On July 16, 1999, CDC recommended that health-care providers suspend use of the licensed rhesus-human rotavirus reassortant-tetravalent vaccine (RRV-TV) (RotaShield®, Wyeth Laboratories, Inc., Marietta, Pennsylvania) in response to 15 cases [...]

Published
2004

31. List of Contributors

Author

Abdolahi, A., Abdolghaffari, A.H., Abdollahi, M., Achanzar, W.E., Acquisto, N.M., Adatsi, F.K., Adekola, F.A., Agarwal, D., Aizawa, H., Akbar Malekirad, A., Allen, J.A., Allison, B., Alonso Blazquez, N., Altkorn, R., Amanlou, M., Amini, M., Anand, S.S., Andres, S.A., Angelini, D.J., Angelo, G., Api, A.M., Apte, U., Armendáriz, C.R., Asha, S., Atlason, P., Attene-Ramos, M.S., Austin, C.P., Babich, M.A., Badanthadka, M., Baeeri, M., Baer, K.N., Baghaei, A., Bahadar, H., Balali-Mood, B., Balali-Mood, M., Bale, A.S., Ballantyne, B., Banasik, M., Banks, C.N., Banton, M., Baran, K.P., Barata, C., Barefoot, A.C., Barlow, S.M., Barr, D.B., Barrueto, F., Barton, C., Barton, N., Battalora, M., Bayrami, Z., Bazl, R., Beckett, R.D., Bečková, V., Beedanagari, S., Behboudi, A.F., Beilke, L.D., Beltrán, E.M., Benson, A., Bergamo, L., Bergueiro, J., Berman, F.W., Betharia, S., Bhattacharya, S., Biglar, M., Biswas, S., Black, A.T., Bloomhuff, A.B., Bloomquist, J.R., Bolduc, D.L., Bolger, P.M., Bolt, H.M., Bonventre, J.A., Borek, H.A., Borghoff, S.J., Borzelleca, J.F., Botelho, M.C., Boxall, A.B.A., Bradford, H., Brady, P.M., Broderick, M., Brown, D.A., Brown, J., Bruce, R.D., Brugge, D., Brugger, K.E., Bryant, M.A., Bucklin, M.H., Burns-Naas, L.A., Burr, S.A., Caballero, J.M., Cai, Z., Calabrese, E.J., Calvo, M., Cammack, J., Campbell, A., Canedy, T., Cantrell, F.L., Caquet, T., Carbonell, G., Carlson-Lynch, H., Carmichael, N., Carmo, H., Carr, D., Carrington, C.D., Carvalho, F., Carvalho, M., Casa-Resino, I. de la, Cash, L.J., Castranova, V., Cesnaitis, R., Chadwick, K.D., Chakraborty, P., Chan, P.P.K., Chang, S., Chapin, R.E., Chateauvieux, S., Chattopadhyay, A., Chaumot, A., Chen, G., Chen, X., Chesser, R.K., Chilakapati, J., Chojnacka, K., Chou, K., Christoforidis, J., Clark, A.K., Clewell, H.J., Clough, S.R., Coelho, P.C.S., Coggins, C.R.E., Cohen, S.M., Cole, S.D., Corcoran, G.B., Cornu, C., Corsini, E., Cory-Slechta, D.A., Costa, C., Costa, L.G., Costa, S., Covaci, A., Cowden, J., Cumpston, K.L., Curfman, E., Czerczak, S., Daam, M.A., Dahlstrom, D.L., Darracq, M.A., Darwich, A.S., Das, S.R., Davis, J.A., de la Casa Resino, I., de la Torre, A.H., de Lourdes Bastos, M., del Río, E., de Marcellus, S., Demers, P.A., de Peyster, A., Derakhshani, M., Desai, S.N., de San Andrés Larrea, M.I., Descotes, J., Devi, S.S., Devlin, J.J., de Voogt, P., Devriese, L., DeWoskin, R.S., de Zwart, D., Diederich, M., Dieter, H.H., Di Guardo, A., Đikić, D., Dincer, I., Dissanayake, V., DiZio, S.M., Dodd-Butera, T., Doke, D., Dorsey, R.M., Dougherty, M.M., Dourson, M.L., Drake, V.J., Duffus, J.H., Dumancas, G.G., Dumbacher, J.P., DuTeaux, S.B., Dydek, S.T., Dykens, J.A., Eagle, S.R., Eastmond, D.A., Easton, J.D., Eidemiller, B.J., Eisen, E.A., Emami, A., Emami, S., Embry, M.R., Emswiler, M.P., Erraguntla, N.K., Escribano, M., Espín, S., Estevan, C., Estévez, J., Etemad, L., Everson, G.W., Ewers, L.M., Fain, J.H., Fan, A.M., Farris, F.F., Farshchi, A., Fatoki, O.S., Feakes, D., Feasel, M., Fedoruk, M.J., Feitshans, I.L., Fent, G.M., Fernández-Tajes, J., Fernández, Á.J.G., Fernández, C., Fernández Rodríguez, M.D., Ferrari, B., Fidalgo, J., Fields, A., Finch, G.L., Finizio, A., Finnveden, G., Fitzgerald, L., Foroumadi, A., Fuentes, D., Gad, K., Gad, S.C., Gad, S.E., Gadagbui, B., Gammon, D.W., García-Fernández, A.J., García Gómez, M.C., Gardner, D.E., Garrard, A., Garric, J., Gautam, G., Geffard, O., Genter, M.B., Gevaart-Durkin, A., Ghafouri, N., Ghazali, A.R., Ghoreishi, K., Ghosh, B., Gilbert, S.G., Giordano, G., Giouleme, O., Gironés, M.C.L.R., Gobba, F., Goel, S., Gohari, A.R., Gohlke, J.M., Golbabaei, S., Gold, S.C., Gómez-López, V.M., Gómez-Ramírez, P., González-Canga, A., González, G.L., Goodman, J.E., Gordon, E., Gordon, T., Gorodetsky, R., Gray, J.P., Green, M.D., Greim, H., Griffiths, J.C., Groth, C.M., Guedes de Pinho, P., Gupta, N., Gupta, R.C., Gutiérrez, A.J., Guy, R.C., Haber, L.T., Hacatoglu, K., Hahn, K., Haines, J.A., Hakkinen, P.J., Hall, E.J., Hall, G.J., Hall, V.R., Hambright, K.D., Handler, J.A., Hansen, D.K., Hanson, K.M., Hanson, M., Hardison, L.S., Hardisson, A., Harper, S.L., Hartmann, A.C., Hartung, T., Hartwig, A., Hassani, S., Hatlelid, K.M., Hayes, A.W., Hayes, A.N., Heidari, M.R., Henderson, J., Henriksen, B., Hernández-Moreno, D., Hertzberg, R.C., Hesterberg, T., Heyndrickx, M., Hicks, D., Hikkaduwa Koralege, R.S., Hilburn, M.E., Hinderliter, P., Hines, E.P., Hirakawa, B., Hirata, C.M., Ho, S., Hobson, D.W., Hoffmann, S., Holloway, A.C., Holstege, C.P., Holstege, E., Hon, S.L., Honeycutt, M., Hong, S., Hoover, M.D., Hopf, N.B., Hopp, A.G., Horiguchi, H., Hosseini-Tabatabaei, A., Hosseini, A., Hostetler, M.A., Hsu, C.H., Huang, F.X., Hulla, J.E., Hultén, P., Hultin, M.L., Hurst, H.E., Iannucci, A., Inayat-Hussain, S.H., Inselman, A.L., Iskander, J., Jabbour, R.E., Jaberidoost, M., Jacobs, M., Jamei, M., Jamison, K.P., Janes, M., Janz, D.M., Jazayeri, S.B., Jenkins, A., Jiang, M., Jin, N., John, K., Jones, L., Jones, P.D., Jordan, S.A., Jurado, A.S., Kalapos, M.P., Kamrin, M.A., Kapp, R.W., Karami-Mohajeri, S., Karanth, S., Karimi, G., Katz, S.A., Kem, W.R., Kempegowda, P., Kennedy, G.L., Kester, J.E., Khaksar, M.R., Kharabaf, S., Khoobi, M., Kiersma, M.E., Kilpinen, J.M., Kim, D.H., Kim, S.T., Kimbrough, R.D., Klein, S.J., Knechtges, P.L., Knuckles, T.L., Knudsen, T.B., Korrapati, M.C., Koshlukova, S.E., Kovacic, P., Kraft, A., Krafts, K., Krishnan, P., Kruger, C.L., Kubic, A., Kulkarni, S., Kwok, E.S.C., Laffon, B., Lagadic, L., Lambert, C.E., Landolph, J.R., Lange, R.W., Lank, P., Lari, P., Lasley, W., Lawana, V., Lazo, C.R., Ledrich, M.-L., Le Goff, F., Lein, P.J., Leung, H.-W., Leung, Y.L., Lewandowski, T.A., Li, X., Liesivuori, J., Lim, L., Limaye, P., Lin, H.H., Lin, S.C., Litovitz, T., Liu, F., Liu, J., Lloyd-Smith, M., Lo, J.C.Y., Loccisano, A.E., Logan, P., López, S., Lord-Garcia, J., Lotti, M., Luschützky, E., Mahdaviani, P., Maier, A., Makhaeva, G.F., Malátová, I., Malekirad, A.A., Manayi, A., Mangas, I., Mangino, M., Mangipudy, R.S., Maples, R.D., Marcel, B.J., Marigómez, I., Marraffa, J.M., Martínez-López, E., Mathews, S.M., Maxim, L.D., Maxwell-Stuart, P.G., Mayor, A., McClane, B.A., McCoole, M.D., McCormick, D.B., McGregor, D., McKee, J.M., McMartin, K., Meek, B., Megharaj, M., Mehendale, H.M., Mehrpour, O., Mendes, A., Méndez, J., Menn, F.-M., Meyer, S.A., Michalak, I., Míguez-Santiyán, M.P., Mikulewicz, M., Milanez, S., Mileson, B.E., Miller, G.W., Miller, S.J., Miller, S.M., Millner, G.C., Minarchick, V.C., Miracle, A.L., Mirajkar, N.S., Mirkes, P.E., Mitra, M.S., Mody, V., Mogl, S., Mohammadirad, A., Mojica, E.-R.E., Molander, L., Molina López, A.M., Momen-Heravi, F., Montague, P., Monteiro, J.P., Monticelli, F., Morceau, F., Moreno, M., Morgan, B.W., Mortensen, S.R., Moser, V.C., Moshiri, M., Mostafalou, S., Moyer, R.A., Mumy, K.L., Munday, R., Murdianti, B.S., Murray, A., Murray, T.M., Murta, T.L., Nadri, H., Naidu, R., Naile, J.E., Naistat, D.M., Nakajima, T., Nalliah, R.E., Nance, P., Nathan, S., Navarro, L., Navas, I.M., Nelson, L.S., Nerin, C., Newsted, J., Nikfar, S., Nili-Ahmadabadi, A., Nobay, F., Nony, P., Nurkiewicz, T.R., Oi, M., Okoro, H.K., Oliveira, P.A., Olsen, L.R., Oropesa Jiménez, A.L., Othumpangat, S., Pablos, M.V., Pakulska, D., Pakzad, M., Pallasch, E.M., Pamies, D., Parihar, H.S., Parmar, M.S., Parod, R.J., Paschos, P., Patterson, J., Patterson, T.J., Patterson, T.A., Paulo Teixeira, J., Pawlaczyk, A., Pearson, M.A., Pellerano, M.B., Pellizzato, F., Perales, C.M., Peredy, T., Pereira, J., Pérez-López, M., Peri, R., Persad, A.S., Persson, H., Perwaiz, S., Peterson, M.K., Pham, P.J., Pham, T., Philip, B.K., Pichery, C., Pickett, A.J., Piña, B., Pinkerton, K.E., Pleus, R.C., Podder, S., Poirier, M.C., Pomerleau, A.C., Pope, C., Posthuma, L., Potting, J., Pournourmohammadi, S., Pravasi, S.D., Preston, R.J., Prusakov, P.A., Punja, M., Puran, A.C., Purcell, M.M., Qian, L., Qozi, M., Quintana, P.J.E., Rabiei, M., Radulovic, L.L., Rahmani, N., Rajabi, M., Raman, P., Ramasahayam, S., Ramos-Peralonso, M.J., Rankin, G.O., Rao, C.V., Rao, P.S., Rashedinia, M., Rath, A.D., Ray, D.E., Ray, S.D., Reed, N.R., Remião, F., Rezaee, R., Rezvanfar, M.A., Rezvani, N., Rhomberg, L.R., Riar, N.K., Rice, G., Richardson, J.R., Richardson, R.J., Richter, P., Rider, G., Rivera, H.L., Robbens, J., Roberts, D.J., Roberts, L.G., Robinson, P.J., Robles, H., Rodgers, B.E., Rodgers, K., Rodriguez, Y.R., Rodriguez Fernández, C., Roede, J.R., Rogawski, M.A., Rojo, L., Romano, J.A., Rose, S.R., Rosen, M.A., Rossol, M., Rostami–Hodjegan, A., Rourke, J.L., Roy, R., Roy, S.S., Rozman, K.K., Rubin, A.L., Rubio, C., Ruch, R.J., Rumbeiha, W.K., Rushton, W., Sabzevari, O., Saeedi, M., Saeid, A., Saeidnia, S., Saghir, S.A., Saili, K.S., Salem, H., Salvago, M.R. Moyano, Salvatore, J.R., San Andrés Larrea, M.D., San Andrés Larrea, M.I., Sarazan, R.D., Sardari, S., Sasaki, T., Sawant, S.P., Schaeffer, V., Schep, L.J., Schlesinger, R.B., Schneider, S.M., Schreffler, S.M., Schultz, M.M., Schwartz, M., Schwela, D., Scott, A.L., Scott, B.R., Scribner, K., Seabury, R.W., Seco, B., Seeley, M., Seifert, J., Sellamuthu, R., Serex, T.L., Sexton, K., Shadnia, S., Shafiee, A., Shah, I., Shankar, K., Sheets, L.P., Sheppard, L., Shiotsuka, R.N., Shirley, S., Shojaei Saadi, H.A., Sibbald, K.N., Sidell, F.R., Siegrist, M., Simmons, J.E., Sinal, C.J., Singh, P., Skoglund, R., Skonberg, C., Slaughter, R.J., Sledge, C.L., Slothower, J.D., Smith, M., Smith, M.T., Snider, D.B., Snyman, R.G., Sobanska, M., Sogorb, M.Á., Soler-Rodríguez, F., Solgi, R., Solomon, K.R., Somanathan, R., Sonawane, B.R., Song, X., Soni, M.G., Sorensen, J., Soucy, N.V., Southard, R.J., Spainhour, C.B., Spencer, P.S., Spiller, H.A., Spoelhof, B., Stanard, B., Stanek, L.W., Stapleton, P.A., Stedeford, T., Steidl-Nichols, J., Stephens, M., Steyn, N.P., Stickney, J., Stohs, S.J., Stone, D., Stool, D., Stork, C.M., Strohm, B., Stromberg, P.E., Sullivan, D.W., Sullivan, M.R., Sultatos, L.G., Suryanarayanan, A., Syed, I., Szabo, D.T., Szynkowska, M.I., Takacs, Z., Talaska, G., Talbot, P., Tanguay, R.L., Tarazona, J.V., Teixeira, J.P., Temple, N.J., Temple, W.A., Tena, A., Teuschler, L.K., Thackaberry, E.A., Thakore, K.N., Theodorakis, C., Thompson, R.E., Thornton, S.L., Ting, D., Tirmenstein, M.A., Touwaide, A., Towne, T.G., Traven, S.A., Tritscher, A., Troendle, M., Trosko, J.E., Tsai, W.-T., Tsai-Turton, M., Tsatsakis, A., Tsitsimpikou, C., Tsubura, A., Tsuda, T., Tyl, R.W., Udarbe Zamora, E.M., Utell, M.J., Vahabzadeh, M., Vaidya, V.S., Valdiglesias, V., Valentovic, M.A., Valerio, L.G., Vales, T., Vandenberg, L.N., van den Brink, P.J., van der Kolk, J., Van Vleet, T.R., van Vliet, E., Varga, J., Venkateswarlu, K., Verslycke, T., Versonnen, B., Verstraete, K., Vighi, M., Vilanova, E., Vincent, L., Vincent, M., Visser, R., Volger, B., von Stackelberg, K., Vulimiri, S.V., Wahl, M., Walker, N.J., Walker, T.D., Wallace, D.R., Wang, C., Wang, G.S., Wanna-Nakamura, S.C., Watson, R.E., Wattenberg, E.V., Wax, P.M., Weaver, J.A., Webber, N.R., Weber, J.A., Weber, L.P., Weinrich, A.J., Weiss, B., Wennberg, A., Wernke, M.J., Weston, A., Wexler, P., White, L.D., Whittaker, M.H., Wiedenfeld, H., Wiegand, T.J., Wikoff, D.S., Wild, C.P., Will, Y., Willett, C., Willhite, C.C., Willis, A., Willis, K., Wills, B.K., Wilson, B.W., Wittliff, J.L., Wojcinski, Z.W., Wolfe, M.S., Wood, C.S., Woodall, G.M., Woolley, A., Xia, M., Ximba, B.J., Yan, B., Yanagiba, Y., Yang, D., Yang, N., Yoon, M., Yorifuji, T., Yoshizawa, K., Young, R.A., Zamor, R.M., and Zhao, Q.J.

Published
2014
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34. Preventable mix-ups of tuberculin and vaccines: reports to the US Vaccine and Drug Safety Reporting Systems.

Author

Chang S, Pool V, O'Connell K, Polder JA, Iskander J, Sweeney C, Ball R, Braun MM, Chang, Soju, Pool, Vitali, O'Connell, Kathryn, Polder, Jacquelyn A, Iskander, John, Sweeney, Colleen, Ball, Robert, and Braun, M Miles

Abstract

Background: Errors involving the mix-up of tuberculin purified protein derivative (PPD) and vaccines leading to adverse reactions and unnecessary medical management have been reported previously.Objectives: To determine the frequency of PPD-vaccine mix-ups reported to the US Vaccine Adverse Event Reporting System (VAERS) and the Adverse Event Reporting System (AERS), characterize adverse events and clusters involving mix-ups and describe reported contributory factors.Methods: We reviewed AERS reports from 1969 to 2005 and VAERS reports from 1990 to 2005. We defined a mix-up error event as an incident in which a single patient or a cluster of patients inadvertently received vaccine instead of a PPD product or received a PPD product instead of vaccine. We defined a cluster as inadvertent administration of PPD or vaccine products to more than one patient in the same facility within 1 month.Results: Of 115 mix-up events identified, 101 involved inadvertent administration of vaccines instead of PPD. Product confusion involved PPD and multiple vaccines. The annual number of reported mix-ups increased from an average of one event per year in the early 1990s to an average of ten events per year in the early part of this decade. More than 240 adults and children were affected and the majority reported local injection site reactions. Four individuals were hospitalized (all recovered) after receiving the wrong products. Several patients were inappropriately started on tuberculosis prophylaxis as a result of a vaccine local reaction being interpreted as a positive tuberculin skin test. Reported potential contributory factors involved both system factors (e.g. similar packaging) and human errors (e.g. failure to read label before product administration).Conclusions: To prevent PPD-vaccine mix-ups, proper storage, handling and administration of vaccine and PPD products is necessary. [ABSTRACT FROM AUTHOR]

Published
2008
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35. Syncope After Vaccination -- United States, January 2005-July 2007.

Author

Sutherland, A., Izurieta, H., Ball, R., Braun, M. M., Miller, E. R., Broder, K. R., Slade, B. A., Iskander, J. K., Kroger, A. T., Markowitz, L. E., and Huang, W. T.

Subjects
SYNCOPE, LOSS of consciousness, TEENAGERS, YOUTH
Abstract

The article reports on medical cases of postvaccination syncope in adolescents in the U.S. from January 2005 to July 2007. Analyses were done by the Centers for Disease Control and Prevention and the Food and Drug Administration using data from the Vaccine Adverse Event Reporting System. Details on the number of postvaccination episodes by selected characteristics are presented. Also noted are the four limitations of the analyses.

Published
2008

36. How can you promote vaccine safety?

Author

Miller ER, Iskander J, Pickering S, and Varricchio F

Abstract

Learn from the experts how to prevent adverse events related to immunization and what to do when they occur. [ABSTRACT FROM AUTHOR]

Published
2007
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37. Adverse events after inactivated influenza vaccination among children less than 2 years of age: analysis of reports from the Vaccine Adverse Event Reporting System, 1990-2003.

Author

McMahon AW, Iskander J, Haber P, Chang S, Woo EJ, Braun MM, and Ball R

Abstract

BACKGROUND: In April 2002, the Advisory Committee on Immunization Practices (ACIP) encouraged providers to vaccinate healthy 6- to 23-month-old infants and children with trivalent influenza vaccine (TIV). OBJECTIVES: To describe adverse events (AEs) reported to the Vaccine Adverse Event Reporting System (VAERS) after TIV vaccination among children <2 years of age and to compare reports before the ACIP guideline (January 1990 to June 2002) and after the ACIP guideline (July 2002 to June 2003). METHODS: VAERS is a passive vaccine safety surveillance system begun by the Food and Drug Administration and the Centers for Disease Control and Prevention in 1990. We reviewed reports to VAERS for children <2 years of age who received TIV, alone or in combination with other vaccines. Influenza seasons were defined as the period from July 1 of one year to June 30 of the following year. RESULTS: Between 1990 and 2003, VAERS received 166 TIV reports for children <2 years of age. There were 62 reports (37%) after administration of TIV alone and 104 reports (63%) after administration of TIV and > or =1 other vaccine. Approximately one third of reports (N = 61) were in the post-ACIP guideline period. The 4 most frequent AE coding terms were fever (N = 59, 35%), unspecified or urticarial rash (42, 25%), seizure (28, 17%), and injection site reaction (28, 17%). The median number of days from vaccination to symptom onset, the percentage of reports that represented serious AEs, and the gender distribution were similar in the pre-ACIP guideline and post-ACIP guideline periods. The percentage of reports describing an underlying medical condition for the subject decreased from 58% before the ACIP guideline to 37% after the ACIP guideline. Nineteen of 28 seizure reports (68%) described fever with the seizure within 2 days after vaccination. Seizure was the most frequent coding term (N = 10, 7 with fever) among 23 serious reports. The annual number of TIV-related VAERS reports for children <2 years of age increased in the post-ACIP guideline period, probably at least in part because of an increase in the number of vaccinees after the ACIP announcement. The safety profiles in the pre-ACIP guideline and post-ACIP guideline periods were similar. CONCLUSIONS: In October 2003, the ACIP recommended that all healthy children 6 to 23 months of age be vaccinated with TIV, starting in the 2004-2005 influenza season. This study provides generally reassuring, although limited, data regarding the safety of TIV among children in this age range. Continued surveillance for seizures and other clinically significant AEs is warranted and will continue. [ABSTRACT FROM AUTHOR]

Published
2005
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38. Guillain-Barré syndrome following influenza vaccination.

Author

Haber P, DeStefano F, Angulo FJ, Iskander J, Shadomy SV, Weintraub E, Chen RT, Haber, Penina, DeStefano, Frank, Angulo, Fredrick J, Iskander, John, Shadomy, Sean V, Weintraub, Eric, and Chen, Robert T

Abstract

Context: An unexplained increase in the risk of Guillain-Barre syndrome (GBS) occurred among recipients of the swine influenza vaccine in 1976-1977. Guillain-Barre syndrome remains the most frequent neurological condition reported after influenza vaccination to the Vaccine Adverse Events Reporting System (VAERS) since its inception in 1990.Objective: To evaluate trends of reports to VAERS of GBS following influenza vaccination in adults.Design, Setting, and Participants: VAERS is the US national spontaneous reporting system for adverse events following vaccination. Reports of GBS in persons 18 years or older following influenza vaccination were evaluated for each influenza season from July 1, 1990, through June 30, 2003. The number of people vaccinated was estimated from the National Health Interview Survey and US census data. Beginning in 1994, active follow-up was conducted to verify GBS diagnosis and obtain other clinical details.Main Outcome Measure: Reporting rates of GBS following influenza vaccination over time.Results: From July 1990 through June 2003, VAERS received 501 reports of GBS following influenza vaccination in adults. The median onset interval (13 days) was longer than that of non-GBS reports of adverse events after influenza vaccine (1 day) (P<.001). The annual reporting rate decreased 4-fold from a high of 0.17 per 100,000 vaccinees in 1993-1994 to 0.04 in 2002-2003 (P<.001). A GBS diagnosis was confirmed in 82% of reports. Preceding illness within 4 weeks of vaccination was identified in 24% of reported cases.Conclusions: From 1990 to 2003, VAERS reporting rates of GBS after influenza vaccination decreased. The long onset interval and low prevalence of other preexisting illnesses are consistent with a possible causal association between GBS and influenza vaccine. These findings require additional research, which can lead to a fuller understanding of the causes of GBS and its possible relationship with influenza vaccine. [ABSTRACT FROM AUTHOR]

Published
2004
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39. Syncope After Vaccination-- United States, January 2005- July2007.

Author

Sutherland, A., Izurieta, H., Ball, R., Braun, M. M., Miller, E. R., Broder, K. R., Slade, B. A., Iskander, J. K., Kroger, A. T., Markowitz, L. E., and Huang, W. T.

Subjects
LOSS of consciousness, VACCINATION complications, HUMAN papillomavirus vaccines, COMPLICATIONS in immunization of children, VACCINATION of children
Abstract

The article presents a report from the U.S. Centers of Disease Control and Prevention regarding the incidence of syncope or fainting following vaccination in the U.S. between January 2005 and July 2007. Findings reveal the number of postvaccination syncope events in females aged 11-18 years has increased since the licensing of vaccines to treat quadrivalent human papillomavirus and other vaccines commonly used to treat adolescents. The Advisory Committee on Immunization Practices recommends observing patients for 15 minutes after vaccination. Several syncope case studies involving girls who received vaccinations are presented.

Published
2008
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40. Postmarketing Monitoring of Intussusception After RotaTeq™ Vaccination-- United States, February 1, 2006- February 15,2007.

Author

Belongia, E., Izurieta, H., Braun, M.M., Ball, R., Haber, P., Baggs, J., Weintraub, E., Gargiullo, P., Vellozzi, C., Iskander, J., Patel, M., Parashar, U., Cortese, M., Gentsch, J., Wallace, G., and Bartlett, D.

Subjects
ROTAVIRUS vaccines, VACCINE safety, INTUSSUSCEPTION in children, INTESTINAL intussusception, INFANT health services
Abstract

This article presents information from the United States Centers for Disease Control and Prevention (CDC). The CDC looked into the postmarketing monitoring of the rotovirus vaccine RotaTeq in infants in the United States. Concern had been raised that there might be a chance of intussusception following the recall of a similar vaccine called Rotashield. The study found no cases of intussusception occurred within 30 days of vaccination with RotaTeq although 8 cases resulted from the administration of other vaccines.

Published
2007
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42. CDC grand rounds: The growing threat of multidrug-resistant gonorrhea

Author

Hook Iii, E. W., Shafer, W., Deal, C., Robert Kirkcaldy, and Iskander, J.

Subjects
Male, Black People, Articles, Health Status Disparities, Homosexuality, Microbial Sensitivity Tests, Drug Resistance, Multiple, Neisseria gonorrhoeae, United States, White People, Anti-Bacterial Agents, Gonorrhea, Social Class, Humans, Female, Public Health
Abstract

Although gonorrhea has afflicted humans for centuries, and the causative bacterium, Neisseria gonorrhoeae, was identified more than a century ago, gonorrhea remains a public health problem in the United States. Gonorrhea is the second most commonly reported notifiable infection in the United States;300,000 cases were reported in 2011. In the United States, health inequities persist; the incidence of reported gonorrhea among blacks is 17 times the rate among whites, likely because of structural socioeconomic factors.

44. Update: Recommendations From the Advisory Committee on Immunization Practices (ACIP) Regarding Administration of Combination MMRV Vaccine.

Author

Klein, N. P., Yih, W. K., Marin, M., Jumaan, A. O., Seward, J. F., Broder, K., Iskander, J., and Snider Jr, D. E.

Subjects
MMR vaccines, IMMUNIZATION of children, COMBINED vaccines, FEBRILE seizures, IMMUNIZATION, SAFETY
Abstract

The article reports on updates made to recommendations regarding the administering of combination measles, mumps, rubella, and varicella (MMRV) vaccine and the risk of febrile seizures among children between 12 to 23 months. The Vaccine Safety Datalink detected an increased risk for seizure among children who received the combination MMRV vaccination compared to those who received MMR vaccine and varicella vaccine separately at the same visit. The updated recommendation's removing the Advisory Committee on Immunization Practices' previous preference for MMRV over separate MMR and varcella vaccination is discussed.

Published
2008
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45. Frequency of medically attended adverse events following tetanus and diphtheria toxoid vaccine in adolescents and young adults: a Vaccine Safety Datalink study

Author

Naleway Allison, Baxter Roger, Nelson Jennifer, Hambidge Simon J, Belongia Edward A, Yu Onchee, Jackson Lisa A, Gay Charlene, Nordin James, Baggs James, and Iskander John

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Local reactions are the most commonly reported adverse events following tetanus and diphtheria toxoid (Td) vaccine and the risk of local reactions may increase with number of prior Td vaccinations. Methods To estimate the risk of medically attended local reactions following Td vaccination in adolescents and young adults we conducted a six-year retrospective cohort study assessing 436,828 Td vaccinations given to persons 9 through 25 years of age in the Vaccine Safety Datalink population from 1999 through 2004. Results Overall, the estimated risk of a medically attended local reaction was 3.6 events per 10,000 Td vaccinations. The lowest risk (2.8 events per 10,000 vaccinations) was found in the 11 to 15 year old age group. In comparison with that group, the event risks were significantly higher in both the 9 to 10 and 21 to 25 year old age groups. The risk of a local reaction was significantly higher in persons who had received another tetanus and diphtheria toxoid containing vaccine (TDCV) in the previous five years (incidence rate ratio, 2.9; 95% confidence interval, 1.2 to 7.2). Twenty-eight percent of persons with a local reaction to Td vaccine were prescribed antibiotics. Conclusion Medically attended local reactions were uncommon following Td vaccination. The risk of those reactions varied by age and by prior receipt of TDCVs. These findings provide a point of reference for future evaluations of the safety profile of newer vaccines containing tetanus or diphtheria toxoid.

Published
2009
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46. A multi-organ map of the human immune system across age, sex and ethnicity.

Author

Mangiola S, Milton M, Ranathunga N, Li-Wai-Suen C, Odainic A, Yang E, Hutchison W, Garnham A, Iskander J, Pal B, Yadav V, Rossello J, Carey VJ, Morgan M, Bedoui S, Kallies A, and Papenfuss AT

Abstract

Understanding tissue biology's heterogeneity is crucial for advancing precision medicine. Despite the centrality of the immune system in tissue homeostasis, a detailed and comprehensive map of immune cell distribution and interactions across human tissues and demographics remains elusive. To fill this gap, we harmonised data from 12,981 single-cell RNA sequencing samples and curated 29 million cells from 45 anatomical sites to create a comprehensive compositional and transcriptional healthy map of the healthy immune system. We used this resource and a novel multilevel modelling approach to track immune ageing and test differences across sex and ethnicity. We uncovered conserved and tissue-specific immune-ageing programs, resolved sex-dependent differential ageing and identified ethnic diversity in clinically critical immune checkpoints. This study provides a quantitative baseline of the immune system, facilitating advances in precision medicine. By sharing our immune map, we hope to catalyse further breakthroughs in cancer, infectious disease, immunology and precision medicine., Competing Interests: FJR receives institutional support as a coinvestigator and is subcontracted by the Peter MacCallum Cancer Centre for an investigator-initiated trial, which receives funding support from Sanofi/Regeneron Pharmaceuticals. The remaining authors declare no competing interests.

Published
2024
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47. Multidisciplinary Care May Help to Reduce Disparities Associated With Race in Youth With Psychogenic Nonepileptic Seizures.

Author

Burch MM, Rossiter S, McGinty-Kolbe K, Fredwall M, Tschirner C, Enciso L, Iskander J, Trott K, Jackson K, and Albert DVF

Subjects
Adult, Child, Humans, Adolescent, Seizures diagnosis, Retrospective Studies, Psychogenic Nonepileptic Seizures, Electroencephalography, Epilepsy diagnosis, Conversion Disorder
Abstract

Background: Psychogenic nonepileptic seizures (PNES) are a common type of functional neurological disorder in which patients experience seizurelike episodes. Health disparities based on race and socioeconomics, documented in children with epilepsy and adults with PNES, have not been reported in children and adolescents with PNES. We hypothesize that disparities exist in this population, which impact overall care and therefore influence outcomes., Methods: We retrospectively analyzed youth referred to our multidisciplinary clinic from 2018 to 2020. All patient charts were screened by social work before the visit to identify potential barriers to care, and a nurse conducted follow-up calls. Patients' race was identified from the electronic health record and compared with several variables. Outcomes were collected via phone follow-up. Descriptive statistics were produced, and comparisons between white patients and patients of other races were completed using Fisher exact tests and multivariable logistic regressions., Results: During the study period, 237 patients were eligible for the analysis. Sixty-eight patients (29%) identified as a race other than white. Only 60%, 56%, and 40% of the cohort were reached for follow-up at one, three, and 12 months, respectively. In general, outcomes were similar between racial groups; however, we found that patients of nonwhite race were more likely to receive support from social work due to barriers identified in screening (P = 0.045)., Conclusions: Health disparities based on race may exist in youth with PNES. A multidisciplinary clinic including social work may help mitigate barriers leading to more equitable care and similar outcomes for white and nonwhite youth with PNES., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Published
2024
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49. Polysubstance Use in Pregnancy: Surveillance, Interventions, and Next Steps.

Author

Park Y, Dang EP, Board A, Gilboa SM, Ondersma SJ, Smid MC, Shakib JH, Mitchell KT, England LJ, Broussard CS, Meaney-Delman D, Iskander J, and Kim SY

Subjects
Child, Female, Humans, Infant, Infant, Newborn, Pregnancy, Centers for Disease Control and Prevention, U.S., United States, Substance-Related Disorders epidemiology
Abstract

Substance use during pregnancy increases risk for a wide range of adverse maternal and neonatal health outcomes. Polysubstance use is common among people who use substances during pregnancy; however, the risks of combined substance exposures during pregnancy are poorly understood. In this report, we provide an overview of the activities of the Centers for Disease Control and Prevention (CDC) and partners and identified gaps related to (1) surveillance, (2) routine screening, and (3) prevention of polysubstance use during pregnancy. Efforts by CDC and other partners to reduce polysubstance use during pregnancy can improve the health of pregnant people and their infants and children.

Published
2023
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50. Preventing Suicidal Behavior Among American Indian and Alaska Native Adolescents and Young Adults.

Author

Mpofu JJ, Crosby A, Flynn MA, LaFromboise T, Iskander J, Hall JE, Penman-Aguilar A, and Thorpe P

Subjects
Adolescent, Humans, Young Adult, United States epidemiology, Adult, American Indian or Alaska Native, Suicidal Ideation
Abstract

From 2009 to 2018, overall suicide rates in the United States increased by 20.3% and increased by 43.5% among non-Hispanic American Indian and Alaska Native (AI/AN) communities. Combining years 2009 through 2018, suicide rates per 100 000 population among non-Hispanic AI/AN adolescents and young adults aged 15 to 34 years were 2 to 4 times higher than those of adolescents and young adults of other races and ethnicities. An estimated 14% to 27% of non-Hispanic AI/AN adolescents attempted suicide during that time. The elevated rates of suicidal behavior among non-Hispanic AI/AN adolescents and young adults reflect inequities in the conditions that create health. In this topical review, we describe school-based educational efforts that are driven by local AI/AN communities, such as the American Indian Life Skills curriculum, that teach stress and coping skills and show promise in reducing suicidal ideation attempts and fatalities among AI/AN adolescents. Using a social-determinants-of-health lens, we review the availability and quality of employment as an important influencer of suicidal behavior, as well as the role of the workplace as an environment for suicide prevention in AI/AN communities. Working with tribal, state, local, and federal colleagues, the public health community can implement programs known to be effective and create additional comprehensive strategies to reduce inequities and ultimately reduce suicide rates.

Published
2023
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