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Effectiveness of EV-A71 vaccination in prevention of paediatric hand, foot, and mouth disease associated with EV-A71 virus infection requiring hospitalisation in Henan, China, 2017-18: a test-negative case-control study. 2017-18年中国河南接种EV-A71疫苗对预防与EV-A71病毒感染相关的需要住院治疗的小儿手足口病的效果:一项检测阴性病例对照研究。
Pub Date : 2019-10-01 Epub Date: 2019-07-30 DOI: 10.1016/S2352-4642(19)30185-3
Yu Li, Yonghong Zhou, Yibing Cheng, Peng Wu, Chongchen Zhou, Peng Cui, Chunlan Song, Lu Liang, Fang Wang, Qi Qiu, Chun Guo, Mengyao Zeng, Lu Long, Benjamin J Cowling, Hongjie Yu
<p><strong>Background: </strong>Inactivated monovalent enterovirus A71 (EV-A71) vaccines are now available in China to reduce the substantial public health burden of hand, foot, and mouth disease. However, post-licensure monitoring of vaccine effectiveness is important. We did an observational test-negative study of EV-A71 vaccine effectiveness.</p><p><strong>Methods: </strong>Children with hand, foot, and mouth disease who were admitted to Henan Children's Hospital (Zhengzhou, China) within 7 days of illness onset were invited to participate in this test-negative case-control study. Participant vaccination history with EV-A71, including the number of doses received and the date of each dose of vaccination, was elicited from parents or legal guardians of participants with a standardised questionnaire. Children must have received two doses before hospitalisation to be counted as fully vaccinated. Patients who had received a single dose before hospitalisation were classified as partly vaccinated. Children who had received no EV-A71 vaccine before hospitalisation were classified as unvaccinated. Throat swabs and stool samples collected from patients were tested by RT-PCR to identify EV-A71 and other enteroviruses. The primary outcome of the study was paediatric hand, foot, and mouth disease associated with EV-A71 requiring hospitalisation. We estimated vaccine effectiveness with conditional logistic regression models adjusted for potential confounders.</p><p><strong>Findings: </strong>Between Feb 15, 2017, and Feb 15, 2018, we enrolled 1803 children aged 6-71 months with hand, foot, and mouth disease. 234 (13%) children tested positive for EV-A71, 1529 (85%) tested positive for other enteroviruses-528 (29%) were positive for Coxsackievirus (CV)-A6 and 342 (19%) were positive for CV-A16-and 29 (2%) tested negative for all enteroviruses. 11 (1%) children with neither throat swab nor stool testing results were excluded from further analyses. Overall vaccine effectiveness was estimated to be 85·4% (95% CI 53·2 to 95·4) for fully vaccinated children and 63·1% (13·1 to 84·3) for partly vaccinated children. The vaccine effectiveness for full vaccination was estimated to be 91·1% (35·1 to 98·8) among non-severe cases compared with 73·3% (-32·6 to 94·6) in severe cases. The vaccine effectiveness for partial vaccination was 77·9% (4·3 to 94·9) in children aged 24-71 months and 40·8% (-71·1 to 79·5) in children aged 6-23 months. We found no significant association between full or partial vaccination and CV-A6 or CV-A16-related hand, foot, and mouth disease.</p><p><strong>Interpretation: </strong>EV-A71 vaccination was effective in preventing non-severe hand, foot, and mouth disease associated with EV-A71 virus infection in children aged 6-71 months, and we found evidence that one dose of vaccination provided partial protection for children aged 24-71 months. Introduction of multivalent vaccines could further reduce the burden of hand, foot, and mouth disease.<
背景:单价肠道病毒 A71 (EV-A71) 灭活疫苗现已在中国上市,可减轻手足口病对公共卫生造成的巨大负担。然而,对疫苗有效性进行许可后监测非常重要。我们对 EV-A71 疫苗的有效性进行了观察性试验-阴性研究:方法:邀请河南省儿童医院(中国郑州)收治的发病 7 天内的手足口病患儿参与这项试验阴性病例对照研究。通过标准化问卷向参与者的父母或法定监护人了解参与者的 EV-A71 疫苗接种史,包括接种次数和每次接种的日期。儿童必须在住院前接种过两剂疫苗,才算完全接种。住院前只接种过一剂疫苗的患者被归类为部分接种。住院前未接种过 EV-A71 疫苗的儿童被归类为未接种疫苗。从患者身上采集的咽拭子和粪便样本通过 RT-PCR 进行检测,以确定 EV-A71 和其他肠道病毒。研究的主要结果是与需要住院治疗的 EV-A71 相关的小儿手足口病。我们通过条件逻辑回归模型估计了疫苗的有效性,并对潜在的混杂因素进行了调整:2017年2月15日至2018年2月15日期间,我们共招募了1803名6-71个月大的手足口病患儿。234名(13%)儿童的EV-A71检测结果呈阳性,1529名(85%)儿童的其他肠道病毒检测结果呈阳性--528名(29%)儿童的柯萨奇病毒(CV)-A6检测结果呈阳性,342名(19%)儿童的CV-A16检测结果呈阳性,29名(2%)儿童的所有肠道病毒检测结果呈阴性。11名(1%)既没有咽拭子检测结果也没有粪便检测结果的儿童被排除在进一步分析之外。据估计,完全接种疫苗的儿童的疫苗总有效率为 85-4%(95% CI 53-2 至 95-4),部分接种疫苗的儿童的疫苗总有效率为 63-1%(13-1 至 84-3)。在非严重病例中,完全接种的疫苗有效性估计为 91-1%(35-1 至 98-8),而在严重病例中为 73-3%(-32-6 至 94-6)。部分接种的疫苗有效性在 24-71 个月大的儿童中为 77-9%(4-3 至 94-9),在 6-23 个月大的儿童中为 40-8%(-71-1 至 79-5)。我们发现完全或部分接种与 CV-A6 或 CV-A16 相关手足口病之间没有明显关联:EV-A71疫苗接种可有效预防6-71个月大儿童感染EV-A71病毒引起的非严重手足口病,我们发现有证据表明,接种一剂疫苗可为24-71个月大儿童提供部分保护。引入多价疫苗可进一步减轻手足口病的负担:国家杰出青年学者科学基金。
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引用次数: 0
The triune brain in evolution: Role in paleocerebral functions 进化中的三位一体脑:在古脑功能中的作用
Pub Date : 1991-01-01 DOI: 10.1016/0140-1750(91)90007-D
C.Don Keyes
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引用次数: 81
Kant and Darwin 康德和达尔文
Pub Date : 1991-01-01 DOI: 10.1016/0140-1750(91)90023-J
C.U.M. Smith

The central theses of Kant's critical philosophy are sometimes said to have been overtaken by evolutionary biology. This paper considers how far this proposition can be sustained. I argue that the ‘architectonic’ or ‘system-building’ character of the mind, the categories and the forms of intuition, can indeed be seen as the outcome of a particular evolutionary lineage in a Darwinian world. I argue, further, that the principal motive energizing the critical philosophy is the 'nightmare' of physical determinism. An alternative escape route from this particular nightmare is rehearsed. If this route is taken, the intricate arguments of the Critiques are unnecessary to save moral action in a world of things. Nonetheless, insofar as 'first philosophy' necessarily starts from within the philosopher's own subjectivity, Kant's work retains its power. I suggest that the Kantian and the Darwinian interpretations are to an extent complementary. If this is so, some form of evolutionarily-informed dual-aspect psychoneural identity theory could combine the essence of the two interpretations.

康德批判哲学的中心论点有时被认为已被进化生物学所取代。本文考虑了这一命题在多大程度上是成立的。我认为,心灵的“架构性”或“系统构建性”特征,直觉的类别和形式,确实可以被视为达尔文世界中特定进化谱系的结果。我进一步认为,使批判哲学充满活力的主要动机是物理决定论的“噩梦”。从这个特殊的噩梦中逃生的另一条路线是排练好的。如果走这条路,那么《批判》中那些错综复杂的论证对于在一个物质世界中拯救道德行为是不必要的。然而,既然第一哲学必然是从哲学家自己的主体性出发,那么康德的论著就保留了它的力量。我认为康德的解释和达尔文的解释在某种程度上是互补的。如果是这样的话,某种形式的基于进化的双重心理神经认同理论可以将这两种解释的本质结合起来。
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引用次数: 8
The nature of politics: by Roger D. Masters. New Haven, CT: Yale University Press, 1989, xvii + 291 pp., $25.00 (cloth) 《政治的本质》罗杰·d·马斯特斯著。纽黑文,康涅狄格州:耶鲁大学出版社,1989,17 + 291页,25.00美元(布)
Pub Date : 1991-01-01 DOI: 10.1016/0140-1750(91)90031-K
J. Losco
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引用次数: 0
The biology of life and learning 生命和学习的生物学
Pub Date : 1991-01-01 DOI: 10.1016/0140-1750(91)90357-V
Christine A. Skarda
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引用次数: 3
The replicative model of the evolution of the business organization 企业组织演化的复制模型
Pub Date : 1991-01-01 DOI: 10.1016/0140-1750(91)90097-A
Mika Pantzar , Vilmos Csányi
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引用次数: 21
Editor's introduction 编辑器的介绍
Pub Date : 1991-01-01 DOI: 10.1016/0140-1750(91)90037-Q
PL
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引用次数: 0
Editor's introduction 编辑器的介绍
Pub Date : 1991-01-01 DOI: 10.1016/0140-1750(91)90011-E
PL
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引用次数: 0
Into the wild blue yonder: On the emergence of the ethnoneurologies—the social science-based neurologies and the philosophy-based neurologies 走进远方的蔚蓝:论民族神经学的出现——以社会科学为基础的神经学和以哲学为基础的神经学
Pub Date : 1991-01-01 DOI: 10.1016/0140-1750(91)90013-G
Warren D. TenHouten

The development of cognitive science and neuroscience has stimulated the emergence of social science-based and philosophy-based neurosciences. A classification of the neurosciences is presented. The new neurosciences are viewed as ethnoneurologies, having as their common object the study of brain—in neurophysiological, neuroelectrical, neurochemical, and other functioning as related to mental level of experience and to structures, arrangements, and processes in the social world. This approach focuses not on how people perceive the brain, but rather on the uses they make of brain. Thus, the ethnoneurologies refer to a closely related family of interdisciplinary, neurocognitive fields of inquiry. The behavioral science based neurosciences—neurocommunications, neuroethology, neurolinguistics, and neuropsychology—contain within themselves topics, problems, and levels of analysis that are ethnoneurological, although not defined as ethnoneurologies. The social science based ethnoneurologies are neurosociology, neuroanthropology, neuropolitics, and neuroeconomics. The philosophy/humanities based ethnoneurologies include neurophilosophy, neuroaesthetics, neuroepistemology, neurophenomenology, and neuro-ontology. An ethnoneurological perspective provides a strategy for resolving the culture-and-cognition paradox, according to which (i) cultural differences are viewed as variations in the expression of universal human mentation, and (ii) such cultural differences reflect qualitatively different cognitive structures.

认知科学和神经科学的发展促进了以社会科学和哲学为基础的神经科学的出现。介绍了神经科学的分类。新的神经科学被看作是民族神经学,它们的共同目标是研究大脑的神经生理学、神经电学、神经化学和其他与精神层面的经验以及社会世界中的结构、安排和过程有关的功能。这种方法关注的不是人们如何感知大脑,而是他们如何使用大脑。因此,民族神经学指的是一个密切相关的跨学科、神经认知领域的研究。以神经科学为基础的行为科学——神经传播学、神经行为学、神经语言学和神经心理学——虽然没有定义为民族神经学,但它们本身包含了民族神经学的主题、问题和分析水平。以社会科学为基础的民族神经学有神经社会学、神经人类学、神经政治学和神经经济学。以哲学/人文为基础的民族神经学包括神经哲学、神经美学、神经认识论、神经现象学和神经本体论。民族神经学视角为解决文化与认知悖论提供了一种策略,根据该策略,(i)文化差异被视为人类普遍心理表达的变化,(ii)这种文化差异反映了本质上不同的认知结构。
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引用次数: 8
Selection, competition, and specificity: Elements of an ecological evolutionary epistemology 选择、竞争和特异性:生态进化认识论的要素
Pub Date : 1991-01-01 DOI: 10.1016/0140-1750(91)90217-E
Edward S. Reed
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引用次数: 4
期刊
Journal of social and biological structures
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