PLoS Medicine最新文献

[This corrects the article DOI: 10.1371/journal.pmed.1004794.].

Background: To mitigate the risk of outbreaks of serotype 2 poliomyelitis after withdrawal of this serotype from oral poliovirus vaccine (OPV) in 2016, inactivated poliovirus vaccine (IPV) was introduced into the routine immunization (RI) programmes of all countries using OPV. Since 2022, WHO has recommended a 2-dose schedule, with a first dose at 14 weeks of age followed by a second dose at least 4 months later (e.g., 14-39 week schedule), although an earlier schedule may be adopted, despite lower immunogenicity, if vaccine coverage is low at older ages.

Methods and findings: We combined published data on type-2 IPV seroconversion with age, national RI coverage estimates, dose introduction dates, and country-specific schedules using a cohort model of population immunity to estimate IPV-induced immunity from 2024-2031 for 112 countries using either one or two doses of IPV. We projected immunity for current, 6-14, and 14-39 week schedules to find the optimal schedule and estimate the impact of interventions such as schedule changes and catch-ups. Under current schedules, estimated median serotype 2 population immunity in 2025 among children under five years of age is at 61% (IQR: 52%, 72%), rising to 71% (IQR: 57%, 80%) in 2031. The later 14-39 week schedule was optimal in all countries, with potential for the median immunity to rise to 78% (IQR: 66%, 85%) by 2031 if adopted by all countries in 2026. Eight countries would still have <50% immunity, rising to 65%-72% if catch-up campaigns with 80% coverage were implemented in 2030. The work is limited by the fact that IPV provides only a partial picture of total immunity where there has been emergency type-2 OPV use. Furthermore, national estimates may mask subnational coverage differences and pockets of extremely low immunity.

Conclusions: Under these estimates, IPV schedules and coverage are suboptimal in many countries. Those with a single dose should introduce a second on the 14-39 week schedule; those on early schedules would benefit from adopting the 14-39 week schedule. IPV catch-up campaigns are recommended where RI coverage is low.

Benchmarking life expectancy against what is achievable reveals how sex disadvantage shifts by age, place, and time, and reframes inequality as unrealized potential due to social and structural constraints rather than differences in biology.

The explosion of Mendelian Randomization (MR) submissions of dubious quality to journals globally is well recognized. Contributing to this deluge of publications may be the poor understanding among practitioners, reviewers, and editors of gene-environment equivalence, the fundamental principle of MR.

Background: In the United States, already-prevalent power outages are increasing in frequency and duration with climate change. Studies from New York State show that power outages may increase hospitalizations for cardiovascular disease (CVD) and respiratory disease in vulnerable populations such as older adults, but exposure data limitations have constrained nationwide studies of power outages and health. Here, we tested if power outages were associated with emergency CVD and respiratory disease-related hospitalizations among older adults in the United States.

Methods and findings: We developed a national dataset of power outage exposure and identified county-days with ≥1% of customers exposed to 8+ hour power outages in 2018. We leveraged data on 23 million Medicare Fee-For-Service beneficiaries aged 65+ to estimate daily county-level rates of emergency CVD- and respiratory-related hospitalizations. We applied a case-crossover design with a conditional Poisson model to estimate the lagged association (up to 1 week) between daily county-level power outage exposure and cause-specific hospitalization rates. Models controlled for daily temperature, precipitation, and wind speed.

Results: Power outages were associated with increased emergency CVD and respiratory hospitalizations. The association between power outage and CVD hospitalizations was strongest the day after power outage exposure (rate ratio [RR]=1.02, 95% CI: 1.01, 1.03), while the association between outage and respiratory disease was strongest the day of power outage exposure (RR = 1.03, 95% CI: 1.01, 1.04). We estimated this association using county-level power outage data; future studies could use higher spatial resolution data.

Conclusions: Power outages may increase the risk of CVD and respiratory hospitalizations among US older adults. Improving electricity reliability could support community health and protect older adults from CVD and respiratory disease exacerbations.

Digitally automated spatial profiling of immune-tumor cell interactions using multispectral immunofluorescence holds promise as a biomarker to predict outcomes in early-stage breast cancer, but prospective validation and harmonization with existing biomarkers is necessary before clinical adoption.