Post-licensure deployment of oral cholera vaccines: a systematic review.

OBJECTIVE: To describe and analyse the characteristics of oral cholera vaccination campaigns; including location, target population, logistics, vaccine coverage and delivery costs. METHODS: We searched PubMed, the World Health Organization (WHO) website and the Cochrane database with no date or language restrictions. We contacted public health personnel, experts in the field and in ministries of health and did targeted web searches. FINDINGS: A total of 33 documents were included in the analysis. One country, Viet Nam, incorporates oral cholera vaccination into its public health programme and has administered approximately 10.9 million vaccine doses between 1997 and 2012. In addition, over 3 million doses of the two WHO pre-qualified oral cholera vaccines have been administered in more than 16 campaigns around the world between 1997 and 2014. These campaigns have either been pre-emptive or reactive and have taken place under diverse conditions, such as in refugee camps or natural disasters. Estimated two-dose coverage ranged from 46 to 88% of the target population. Approximate delivery cost per fully immunized person ranged from 0.11-3.99 United States dollars. CONCLUSION: Experience with oral cholera vaccination campaigns continues to increase. Public health officials may draw on this experience and conduct oral cholera vaccination campaigns more frequently.

THE TRENDS AND INCIDENCE OF ALCOHOL-ASSOCIATED HEPATITIS HOSPITALIZATIONS FROM 2016-2020 AND THE IMPACT OF THE COVID-19 PANDEMIC.

INTRODUCTION: The impact of the COVID-19 pandemic on hospitalizations for alcohol-associated hepatitis (AH) is poorly understood. Here we explore AH trends from 2016-2020 and evaluate demographic disparities including sex and race. METHODS: A retrospective analysis of the 2016-2020 Healthcare Cost and Utilization Project National Inpatient Sample was performed to assess temporal trends in hospitalizations for AH. The 2020 dataset was evaluated to compare AH hospitalizations between those with and without an additional diagnosis of COVID-19. RESULTS: Included were 607,140 weighted inpatient AH discharges per 145,055,152 all-cause discharges from 2016-2020. AH hospitalizations increased at a rate of 23.4 hospitalizations per 100,000 all-cause discharges per year between 2016-2019 and increased to 113 hospitalizations per 100,000 all-cause discharges in 2020. Mortality was higher in females despite lower rates of hospitalization than males. The adjusted odds of hospitalization for AH in 2020 were higher than in 2016-2019 (aOR= 1.28, p < 0.001). The Hispanic population had greater odds of hospitalization with AH and COVID-19 compared to other races (aOR= 2.71, p <0.001). DISCUSSION: Increased efforts toward primary prevention of excessive alcohol use and greater social support for those with alcohol used disorder are needed. More research is required to elucidate the racial disparities among the Hispanic population with AH and COVID-19.

The design and use of an optical mapping system for the study of intracardiac electrical signaling.

Fluorescent optical mapping of electrically active cardiac tissues provides a unique method to examine the excitation wave dynamics of underlying action potentials. Such mapping can be viewed as a bridge between cellular level and organ systems physiology, e.g., by facilitating the development of advanced theoretical concepts of arrhythmia. We present the design and use of a high-speed, high-resolution optical mapping system composed entirely of "off the shelf" components. The electrical design integrates a 256 element photodiode array with a 16 bit data acquisition system. Proper grounding and shielding at various stages of the design reduce electromagnetic interference. Our mechanical design provides flexibility in terms of mounting positions and applications (use for whole heart or tissue preparations), while maintaining precise alignment between all optical components. The system software incorporates a user friendly graphical user interface, e.g., spatially recorded action potentials can be represented as intensity graphs or in strip chart format. Thus, this system is capable of displaying cardiac action potentials with high spatiotemporal resolution. Results from cardiac action potential mapping with intact mouse hearts are provided. It should be noted that this system could be readily configured to study isolated myocardial biopsies (e.g., isolated ventricular trabeculae). We describe the details of a versatile, user-friendly system that could be employed for a magnitude of study protocols.