Development and acceptability of a video-based vaccine promotion tutorial for obstetric care providers.

A prenatal care provider's recommendation for maternal vaccines is one of the strongest predictors of vaccine acceptance during pregnancy. Aside from basic talking points, few resources exist to help obstetric care providers effectively navigate conversations with vaccine hesitant patients. This paper describes the development and acceptability of "VaxChat," an hour-long, evidence-based video tutorial aimed at improving obstetric care providers' ability to promote maternal vaccines. Between June and November 2017, 62 obstetric care providers registered to receive continuing medical education credit for viewing VaxChat. Of the post-tutorial responses received, over 90% said VaxChat increased their knowledge of what to say to vaccine hesitant patients, increased their confidence in addressing vaccinations with their pregnant patients, and will help them improve their practice culture regarding maternal vaccine promotion. Eighty percent intend to change how they approach vaccine conversations. These data suggest VaxChat may be a welcome complement to existing provider-to-patient talking points.

Improving influenza and Tdap vaccination during pregnancy: A cluster-randomized trial of a multi-component antenatal vaccine promotion package in late influenza season.

BACKGROUND: Evidence-based interventions to improve influenza vaccine coverage among pregnant women are needed, particularly among those who remain unvaccinated late into the influenza season. Improving rates of antenatal tetanus, diphtheria and acellular pertussis (Tdap) vaccination is also needed. PURPOSE: To test the effectiveness of a practice-, provider-, and patient-focused influenza and Tdap vaccine promotion package on improving antenatal influenza and Tdap vaccination in the obstetric setting. METHODS: A cluster-randomized trial among 11 obstetric practices in Georgia was conducted in 2012-2013. Intervention practices adopted the intervention package that included identification of a vaccine champion, provider-to-patient talking points, educational brochures, posters, lapel buttons, and iPads loaded with a patient-centered tutorial. Participants were recruited from December 2012-April 2013 and included 325 unvaccinated pregnant women in Georgia. Random effects regression models were used to evaluate primary and secondary outcomes. RESULTS: Data on antenatal influenza and Tdap vaccine receipt were obtained for 300 (92.3%) and 291 (89.5%) women, respectively. Although antenatal influenza and Tdap vaccination rates were higher in the intervention group than the control group, improvements were not significant (For influenza: risk difference (RD)=3.6%, 95% confidence interval (CI): -4.0%, 11.2%; for Tdap: RD=1.3%, 95% CI: -10.7%, 13.2%). While the majority of intervention package components were positively associated with antenatal vaccine receipt, a provider's recommendation was the factor most strongly associated with actual receipt, regardless of study group or vaccine. CONCLUSIONS: The intervention package did not significantly improve antenatal influenza or Tdap vaccine coverage. More research is needed to determine what motivates women remaining unvaccinated against influenza late into the influenza season to get vaccinated. Future research should quantify the extent to which clinical interventions can bolster a provider's recommendation for vaccination. This study is registered with clinicaltrials.gov, study ID NCT01761799.

Exploring diagonal gait using a forward dynamic three-dimensional chimpanzee simulation.

Primates are unusual among terrestrial quadrupedal mammals in that at walking speeds they prefer diagonal rather than lateral gaits. A number of reasons have been proposed for this preference in relation to the arboreal ancestry of modern primates: stability, energetic cost, neural control, skeletal loading, and limb interference avoiding. However, this is a difficult question to explore experimentally since most primates only occasionally use anything other than diagonal gaits. An alternative approach is to produce biologically realistic computer simulations of primate gait that enable the constraints of biomechanical loading and the energetics of different modes of locomotion to be explored. In this paper we describe such a model for the chimpanzee Pan troglodytes. The simulation is able to produce spontaneous quadrupedal locomotion, and the footfall sequences generated are split between lateral and diagonal footfall sequences with no obvious energetic benefit associated with either option. However, out of 10 successful simulation runs, 5 were lateral sequence/lateral couplet gaits indicating a preference for a specific lateral footfall sequence with a relatively tightly constrained phase difference between the fore- and hindlimbs. This suggests that the choice of diagonal walking gaits in chimpanzees is not a simple mechanical phenomenon and that diagonal walking gaits in primates are selected for by multiple factors.

Age estimation of archaeological remains using amino acid racemization in dental enamel: a comparison of morphological, biochemical, and known ages-at-death.

The poor accuracy of most current methods for estimating age-at-death in adult human skeletal remains is among the key problems facing palaeodemography. In forensic science, this problem has been solved for unburnt remains by the development of a chemical method for age estimation, using amino acid racemization in collagen extracted from dentine. Previous application of racemization methods to archaeological material has proven problematic. This study presents the application to archaeological human remains of a new age estimation method utilizing amino acid racemization in a potentially closed system-the dental enamel. The amino acid composition and extent of racemization in enamel from two Medieval cemeteries (Newcastle Blackgate and Grantham, England) and from a documented age-at-death sample from a 19th century cemetery (Spitalfriedhof St Johann, Switzerland) were determined. Alterations in the amino acid composition were detected in all populations, indicating that diagenetic change had taken place. However, in the Medieval populations, these changes did not appear to have substantially affected the relationship between racemization and age-at-death, with a strong relationship being retained between aspartic acid racemization and the morphological age estimates. In contrast, there was a poor relationship between racemization and age in the post-medieval documented age-at-death population from Switzerland. This appears to be due to leaching of amino acids post-mortem, indicating that enamel is not functioning as a perfectly closed system. Isolation of amino acids from a fraction of enamel which is less susceptible to leaching may improve the success of amino acid racemization for archaeological age estimation.

The energetic costs of load-carrying and the evolution of bipedalism.

The evolution of habitual bipedalism is still a fundamental yet unsolved question for paleoanthropologists, and carrying is popular as an explanation for both the early adoption of upright walking and as a positive selection pressure once a terrestrial lifestyle had been adopted. However, to support or reject any hypothesis that suggests carrying efficiency was an important selective pressure, we need quantitative data on the costs of different forms of carrying behavior, especially infant-carrying since reduction in the grasping capabilities of the foot would have prevented infants from clinging on for long durations. In this study, we tested the hypothesis that the mode of load carriage influences the energetic cost of locomotion. Oxygen consumption was measured in seven female participants walking at a constant speed while carrying four different 10-kg loads (a weighted vest, 5-kg dumbbells carried in each hand, a mannequin infant carried on one hip, and a 10-kg dumbbell carried in a single hand). Oxygen consumption was also measured during unloaded standing and unloaded walking. The results show that the weighted vest requires the least amount of energy of the four types of carrying and that, for this condition, humans are as efficient as mammals in general. The balanced load was carried with approximately the predicted energy cost. However, the asymmetrical conditions were considerably less efficient, indicating that, unless infant-carrying was the adaptive response to a strong environmental selection pressure, this behavior is unlikely to have been the precursor to the evolution of bipedalism.

Bone mineral change during experimental heating: an X-ray scattering investigation.

The effects of heating and burning on bone mineral have previously been studied using techniques such as X-ray diffraction (XRD) with the aim of discerning a characteristic signature of crystal change. This would enable a better understanding of alteration to bone mineral during heating, which would in turn impact on the preparation and use of natural bone hydroxyapatite as a biomaterial resource. In addition, this knowledge could prove invaluable in the investigation of burned human remains from forensic and archaeological contexts in cremation and funerary practice. Here we describe a complementary method, small-angle X-ray scattering (SAXS), to determine more accurately the changes to bone crystallite size and shape during an experimental heating regimen. Samples were subjected to controlled heating at 500 degrees C, 700 degrees C, or 900 degrees C for 15 or 45 min. Our results show bone crystallites begin to alter in the first 15 min of heating to 500 degrees C or above. They then appear to stabilise to a temperature-specific thickness and shape with prolonged heating. While the samples heated to lower temperatures or for shorter periods produce XRD traces showing little alteration to the apatite, corresponding information obtained from SAXS shows an early, subtle change in crystal parameters.

Age estimation from the auricular surface of the ilium: a revised method.

A revised method for estimating adult age at death using the auricular surface of the ilium has been developed. It is based on the existing auricular surface aging method of Lovejoy et al. ([1985] Am. J. Phys. Anthropol. 68:15-28), but the revised technique is easier to apply, and has low levels of inter- and intraobserver error. The new method records age-related stages for different features of the auricular surface, which are then combined to provide a composite score from which an estimate of age at death is obtained. Blind tests of the method were carried out on a known-age skeletal collection from Christ Church, Spitalfields, London. These tests showed that the dispersion of age at death for a given morphological stage was large, particularly after the first decade of adult life. Statistical analysis showed that the age-related changes in auricular surface are not significantly different for males and females. The scores from the revised method have a slightly higher correlation with age than do the Suchey-Brooks pubic symphysis stages. Considering the higher survival rates of the auricular surface compared with the pubic symphysis, this method promises to be useful for biological anthropology and forensic science.

Microfocus small angle X-ray scattering reveals structural features in archaeological bone samples: detection of changes in bone mineral habit and size.

Microfocus X-ray scattering provides a powerful nondestructive technique capable of providing important information about the size, habit, and arrangement of mineral crystals in bone. The technique is capable of probing textural differences in a sample at a micron scale resolution. The study presented here involved the analysis of a number of archaeological bones by microfocus X-ray scattering at the ESRF Grenoble in order to determine local changes in mineral durability. The results showed that regions of bone with a modified microscopic morphology contained a greater dispersion of crystal shape when compared with more intact regions and control contemporary bone samples, but the crystal thickness values showed similar consistency. We speculate that the persistence of collagen in the archaeological bone may allow diagenetic remodeling of bone in terms of crystallite shape but defines the size of remodelled crystallites. The ability to detect such local changes in texture has wide potential for determining crystal characteristics in healthy and diseased bone samples.

Genetic evidence for Near-Eastern origins of European cattle.

The limited ranges of the wild progenitors of many of the primary European domestic species point to their origins further east in Anatolia or the fertile crescent. The wild ox (Bos primigenius), however, ranged widely and it is unknown whether it was domesticated within Europe as one feature of a local contribution to the farming economy. Here we examine mitochondrial DNA control-region sequence variation from 392 extant animals sampled from Europe, Africa and the Near East, and compare this with data from four extinct British wild oxen. The ancient sequences cluster tightly in a phylogenetic analysis and are clearly distinct from modern cattle. Network analysis of modern Bos taurus identifies four star-like clusters of haplotypes, with intra-cluster diversities that approximate to that expected from the time depth of domestic history. Notably, one of these clusters predominates in Europe and is one of three encountered at substantial frequency in the Near East. In contrast, African diversity is almost exclusively composed of a separate haplogroup, which is encountered only rarely elsewhere. These data provide strong support for a derived Near-Eastern origin for European cattle.

Extraction of single-copy nuclear DNA from forensic specimens with a variety of postmortem histories.

Specimens of human bone, teeth and dried blood spots from 3 months to 91 years old, with a variety of postmortem histories, were used in a comparative study of recovery of single-copy nuclear DNA sequences from forensic material. Sequences of the amelogenin and HLA-DPB1 genes were chosen for their value in sexing and identification. Sequences of the mitochondrial non-coding region V were also amplified to compare the recovery of mitochondrial and single-copy nuclear DNA. A variation of the silica method for DNA extraction was refined for application to the forensic specimens in this sample. Single-copy nuclear DNA was amplified from 100% of recent postoperative bone specimens (n = 6), 80% of forensic teeth and bone specimens (n = 10), 78% of recently extracted teeth (n = 18), 78% of exhumed bone up to 91 years old (n = 37) and 69% of 15 year old bone specimens fixed in 10% formalin (n = 20). Amelogenin sexing was correct in 85% of cases (n = 74) in which the sex of the donor had been recorded. There was no correlation between the age of the specimen and the extent of DNA preservation.

Forensic three-dimensional facial reconstruction: historical review and contemporary developments.

Despite varied attempts to achieve standardization in traditional techniques and the promotion of some newly developed ones, facial reconstruction remains on the threshold between art and science. It is the point at which science ends and the medical illustrator takes over that has led to most reservations over this branch of forensic anthropology. The purpose of this paper is to demonstrate that many techniques of facial reconstruction are prima facie questionable and to illustrate some possible solutions to the problems which are currently being explored by the Facial Reconstruction Project at the University of Sheffield (UK). The review includes 15 responses to a questionnaire which was offered to facial reconstruction experts and related specialists. The use of 3D color laser scanning equipment, collection of tissue depth measurements from CT scans and the development of a computer system for 3D forensic facial reconstruction, are described.

Sib competition and sperm competitiveness: an answer to 'why so many sperms?' and the recombination/sperm number correlation.

Sperm, or inter-ejaculate, competition leads to the evolution of many sperm per ejaculate. However, sperm competition theory does not predict the correlation between sperm number and chiasma, or that between sperm number and haploid chromosome number. Firstly, we show that phylogenetic inertia cannot account for at least the latter relation, and secondly, a model is presented which incorporates sib competition (intra-ejaculate competition) and sperm competitiveness to explain the relation between sperm numbers and recombination and the question 'Why so many sperms?'. It is argued that if there are deleterious mutations which affect sperm competitiveness this will lead to sib or intra-ejaculate competition. If inter-ejaculate competition also exists, then there will be selection for increased recombination. A chiasmate male heterozygous for n mutations which reduce sperm competitiveness can produce gametes with 0...n mutations. The proportion of gametes with 0 mutations per ejaculate is s = 0.5n, which is a small fraction. This means that to ensure on average one sperm with 0 mutations per ejaculate, a chiasmate male must produce 1/s sperm. We may therefore expect that 1/s will be positively correlated with sperm numbers. If inter-ejaculate competition leads to an optimum sperm number of x, then the optimum number of sperm per ejaculate is x/s. Sperm numbers will be increased by: (i) the number of loci which affect sperm competitiveness in the haploid state; (ii) the mutation rate; and (iii) the recombination rate. A correlation between recombination rates and sperm numbers is therefore to be expected.

Fluctuating asymmetry in gorilla canines: a sensitive indicator of environmental stress.

Populations of the western lowland gorilla (Gorilla gorilla gorilla) have decreased markedly as a result of human encroachment. The species is therefore likely to have been exposed to substantial environmental stress. Fluctuating asymmetry (FA) is one measure of environmental stress. We examined the expression of FA in the canines and second premolars of the upper jaw of western lowland gorillas. The canines had patterns of FA typical of secondary sexual characters, whereas the expression of premolar FA was typical of non-sexually selected traits. We found that FA in male canines was positively correlated with year of collection (YOC) or year of collection and acquisition (YOCA) of the specimen. This suggested a sustained environmental deterioration. However, there was no relation between FA and YOC, or FA and YOCA, in female canines. There was a correlation between FA and YOC in male premolars, but this was relatively weak and disappeared when FA and YOCA were considered. There was no correlation between FA and YOC or YOCA in the premolars of females. We conclude that these patterns of FA support the argument that sexually selected structures are sensitive to environmental stress but non-sexually selected structures are not.

Fluctuating asymmetry, sexual selection and canine teeth in primates.

Fluctuating asymmetry arises as small deviations from symmetry which can be expressed on either side of the body. Increases in fluctuating asymmetry can suggest genomic stress such as results from directional selection. It has been argued that epigamic structures and weapons should show high levels of fluctuating asymmetry because sexual selection is essentially directional in nature. We tested this prediction by examining the expression of fluctuating asymmetry in the upper canines of 21 species of Old World primates. We found, for males but not for females, that asymmetry was correlated with measures of sexual selection including canine dimorphism, canine size, mass dimorphism, and intra-male competition. However, there was no significant correlation with diet type and body mass, which are only weakly associated with sexual selection. Phylogenetic inertia did not account for the association between fluctuating asymmetry and sexual selection. We also found that species with high values of canine dimorphism and intra-male competition tended to have a negative correlation between asymmetry and mean canine height, and this latter effect was present in both males and females. The implications of these findings for sexual selection theory are discussed.

Osteochondroma in a British neolithic skeleton.

The skeletal remains of past populations provide an important source of information on the natural history of disease. Relatively few cases of bone tumours have been reported in archaeological material. This paper describes one of the oldest occurrences of osteochondroma to have been identified in a human skeleton.