Estimating the Lineage Dynamics of Human Influenza B Viruses.

The prediction of the lineage dynamics of influenza B viruses for the next season is one of the largest obstacles for constructing an appropriate influenza trivalent vaccine. Seasonal fluctuation of transmissibility and epidemiological interference between the two major influenza B lineages make the lineage dynamics complicated. Here we construct a parsimonious model describing the lineage dynamics while taking into account seasonal fluctuation of transmissibility and epidemiological interference. Using this model we estimated the epidemiological and evolutional parameters with the time-series data of the lineage specific isolates in Japan from the 2010-2011 season to the 2014-2015 season. The basic reproduction number is similar between Victoria and Yamagata, with a minimum value during one year as 0.82 (95% highest posterior density (HPD): 0.77-0.87) for the Yamagata and 0.83 (95% HPD: 0.74-0.92) for Victoria, the amplitude of seasonal variation of the basic reproduction number is 0.77 (95% HPD:0.66-0.87) for Yamagata and 1.05 (95% HPD: 0.89-1.02) for Victoria. The duration for which the acquired immunity is effective against infection by the Yamagata lineage is shorter than the acquired immunity for Victoria, 424.1days (95% HPD:317.4-561.5days). The reduction rate of susceptibility due to immune cross-reaction is 0.51 (95% HPD: 0.084-0.92) for the immunity obtained from the infection with Yamagata against the infection with Victoria and 0.62 (95% HPD: 0.42-0.80) for the immunity obtained from the infection with Victoria against the infection with Yamagata. Using estimated parameters, we predicted the dominant lineage in 2015-2016 season. The accuracy of this prediction is 68.8% if the emergence timings of the two lineages are known and 61.4% if the emergence timings are unknown. Estimated seasonal variation of the lineage specific reproduction number can narrow down the range of emergence timing, with an accuracy of 64.6% if the emergence times are assumed to be the time at which the estimated reproduction number exceeds one.

Incidence and severity of acute adverse reactions to four different gadolinium-based MR contrast agents.

PURPOSE: Differences in acute adverse reactions to different gadolinium (Gd)-based contrast agents have not been thoroughly evaluated. We investigated the relationships among the incidence and severity of acute adverse reactions, backgrounds of patients, and 4 types of different Gd-based contrast agents (gadopentetate dimeglumine, gadoteridol, gadoterate meglumine, and gadoxetate disodium). MATERIALS AND METHODS: We retrospectively reviewed the radiological records of 10,595 consecutive patients (4,343 female; 6,252 male; mean age, 63.8 ± 14.0 years) who underwent contrast-enhanced magnetic resonance imaging between August 2006 and March 2011. Adverse reactions were classified as mild, moderate, and severe according to the definition of the American College of Radiology. The incidence of adverse reactions were compared on the basis of clinical characteristics and type, dose, and delivery methods of contrast agents by univariate and multivariate logistic regression analyses. RESULTS: The incidence of overall reactions was 0.45% (48/10,595); 45 reactions were mild and three were moderate. No severe reactions were observed. Although the incidence of adverse reactions did not differ significantly between male and female patients, younger individuals were at higher risk for acute adverse reactions. The contrast injection rate and contrast dose were not significantly related to the incidence of adverse reactions. The incidence of adverse reactions was significantly higher for gadoxetate disodium (0.82%) than gadopentetate dimeglumine (0.43%). CONCLUSION: The incidence of acute adverse reactions elicited by Gd-based contrast agents injection was only 0.45%. Younger age was a risk factor for acute reactions. All 4 agents were found to be safe, although gadoxetate disodium showed a relatively higher incidence of adverse reactions.