Prospective monitoring of adverse events following vaccination with Modified vaccinia Ankara - Bavarian Nordic (MVA-BN) administered to a Canadian population at risk of Mpox: A Canadian Immunization Research Network study.

MVA-BN is an orthopoxvirus vaccine that provides protection against both smallpox and mpox. In June 2022, Canada launched a publicly-funded vaccination campaign to offer MVA-BN to at-risk populations including men who have sex with men (MSM) and sex workers. The safety of MVA-BN has not been assessed in this context. To address this, the Canadian National Vaccine Safety Network (CANVAS) conducted prospective safety surveillance during public health vaccination campaigns in Toronto, Ontario and in Vancouver, British Columbia. Vaccinated participants received a survey 7 and 30 days after each MVA-BN dose to elicit adverse health events. Unvaccinated individuals from a concurrent vaccine safety project evaluating COVID-19 vaccine safety were used as controls. Vaccinated and unvaccinated participants that reported a medically attended visit on their 7-day survey were interviewed. Vaccinated participants and unvaccinated controls were matched 1:1 based on age group, gender, sex and provincial study site. Overall, 1,173 vaccinated participants completed a 7-day survey, of whom 75 % (n = 878) also completed a 30-day survey. Mild to moderate injection site pain was reported by 60 % of vaccinated participants. Among vaccinated participants 8.4 % were HIV positive and when compared to HIV negative vaccinated individuals, local injection sites were less frequent in those with HIV (48 % vs 61 %, p = 0.021), but health events preventing work/school or requiring medical assessment were more frequent (7.1 % vs 3.1 %, p = 0.040). Health events interfering with work/school, or requiring medical assessment were less common in the vaccinated group than controls (3.3 % vs. 7.1 %, p < 0.010). No participants were hospitalized within 7 or 30 days of vaccination. No cases of severe neurological disease, skin disease, or myocarditis were identified. Our results demonstrate that the MVA-BN vaccine appears safe when used for mpox prevention, with a low frequency of severe adverse events and no hospitalizations observed.

Comparison of observer reliability of three-dimensional cephalometric landmark identification on subject images from Galileos and i-CAT cone beam CT.

OBJECTIVES: Recently, there has been increasing interest in the use of cone beam CT (CBCT) for three-dimensional cephalometric analysis and craniofacial reconstruction in orthodontic and orthognathic surgical treatment planning. However, there is a need to redefine the cephalometric landmarks in three dimensional cephalometric analysis and to demonstrate the reproducibility of landmark identification on the type of CBCT machine being used. METHODS: CBCT images of 20 subjects aged 15-25 years were selected, ten each from Galileos(®) (Sirona Dental Systems Inc., Bensheim, Germany) and Next Generation i-CAT(®) (Imaging Sciences International, Hatfield, PA). 2 observers located 18 landmarks on each subject twice using Dolphin-3D v. 11 software (Dolphin Imaging and Management Systems, Chatsworth, CA). Inter- and intraobserver reliability was assessed using Euclidean distances and linear mixed models. RESULTS: Overall, the intra- and interobserver reliability was excellent for both machines. The landmarks Gonion, Nasion, Orbitale and Anterior Nasal Spine (ANS) showed the greatest median Euclidean distances for both intra- and interobserver measurements. There were significant observer effects in the unified models for Sella, Menton and all six dental landmarks. For Sella, the distances between the measures were significantly smaller (more closely spaced) on the i-CAT machine than on the Galileos in both intra- and interobserver measurements. CONCLUSIONS: The intra- and interobserver reliability was excellent for both machines. Some of the landmarks were not as reproducible as others. Which machine produced the highest reliability depended on the landmark considered.

Feather lead concentrations and (207)Pb/(206)Pb ratios reveal lead exposure history of California Condors (Gymnogyps californianus).

Lead poisoning is a primary factor impeding the survival and recovery of the critically endangered California Condor (Gymnogyps californianus). However, the frequency and magnitude of lead exposure in condors is not well-known in part because most blood lead monitoring occurs biannually, and biannual blood samples capture only approximately 10% of a bird's annual exposure history. We investigated the use of growing feathers from free-flying condors in California to establish a bird's lead exposure history. We show that lead concentration and stable lead isotopic composition analyses of sequential feather sections and concurrently collected blood samples provided a comprehensive history of lead exposure over the 2-4 month period of feather growth. Feather analyses identified exposure events not evident from blood monitoring efforts, and by fitting an empirically derived timeline to actively growing feathers, we were able to estimate the time frame for specific lead exposure events. Our results demonstrate the utility of using sequentially sampled feathers to reconstruct lead exposure history. Since exposure risk in individuals is one determinant of population health, our findings should increase the understanding of population-level effects from lead poisoning in condors; this information may also be helpful for other avian species potentially impacted by lead poisoning.

Adapting to changes in molecular biosciences and technologies.

Dental education, like any other educational programme in a research-intensive university environment, must be research led or at least research informed. In this context, as the research and knowledge base of dentistry lies in the biological and physical sciences, dental education must be led by advances in research in both these areas. There is no doubt that biotechnology and nanotechnology have, over the past 25 years, led research in both these areas. It is therefore logical to assume that this has also impacted on dental education. The aim of this paper is twofold; on one hand to examine the effects of biotechnology and nanotechnology and their implications for dental education and on the other to make recommendations for future developments in dental education led by research in biotechnology and nanotechnology. It is now generally accepted that dental education should be socially and culturally relevant and directed to the community it serves. In other words, there can be no universal approach and each dental school or indeed curriculum must apply the outcomes in their own social, cultural and community settings.

Modeling the intraurban variability of ambient traffic pollution in Toronto, Canada.

The objective of this paper is to model determinants of intraurban variation in ambient concentrations of nitrogen dioxide (NO2) in Toronto, Canada, with a land use regression (LUR) model. Although researchers have conducted similar studies in Europe, this work represents the first attempt in a North American setting to characterize variation in traffic pollution through the LUR method. NO2 samples were collected over 2 wk using duplicate two-sided Ogawa passive diffusion samplers at 95 locations across Toronto. Independent variables employed in subsequent regression models as predictors of NO2 were derived by the Arc 8 geographic information system (GIS). Some 85 indicators of land use, traffic, population density, and physical geography were tested. The final regression model yielded a coefficient of determination (R2) of .69. For the traffic variables, density of 24-h traffic counts and road measures display positive associations. For the land use variables, industrial land use and counts of dwellings within 2000 m of the monitoring location were positively associated with NO2. Locations up to 1500 m downwind of major expressways had elevated NO2 levels. The results suggest that a good predictive surface can be derived for North American cities with the LUR method. The predictive maps from the LUR appear to capture small-area variation in NO2 concentrations. These small-area variations in traffic pollution are probably important to the exposure experience of the population and may detect health effects that would have gone unnoticed with other exposure estimates.

Gender differences in attitudes toward AIDS clinical trials among urban HIV-infected individuals from racial and ethnic minority backgrounds.

Racial/ethnic minorities and women are under-represented in AIDS clinical trials (ACTs). We examined gender differences in willingness to participate in ACTs among urban HIV-infected individuals (N = 286). Sixty percent of participants were male, and most were from racial/ethnic minority backgrounds (55% African-American, 34% Latino/Hispanic, 11% White/other). Knowledge of ACTs was poor. Males and females did not differ substantially in their distrust of AIDS scientists, or in barriers to ACTs. Almost all (87%) were somewhat or very willing to join ACTs. Females were less willing than males to join, including trials testing new medications or new medication combinations. Males and females differed in correlates of willingness to participate in ACTs. Despite long-standing barriers to medical research among minorities and women, willingness to participate was substantial, particularly for men, although the factors that might motivate them to join differed by gender. Women appeared more averse to trials involving new anti-retroviral regimens than men. Gender-specific outreach, behavioural intervention, and social marketing efforts are needed.

Lifesaving explains mortality decline with time.

Mortality rates of human populations in developed countries are declining with time. We show that this effect can be explained via a 'lifesaving' methodology. Our approach is based on considering a non-homogeneous Poisson process of potentially harmful events. Each of these events can be 'cured' with a given probability or can result in a termination of the Poisson process (death) with a complementary probability. A lifesaving ratio, defining the corresponding relative increase in life expectancy for homogeneous and heterogeneous populations is analyzed. Some generalizations are discussed. Several simple examples are considered.

A cohort study of mortality among Ontario pipe trades workers.

AIMS: To study mortality in a cohort of members of the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada and to compare results with two previous proportional mortality studies. METHODS: A cohort of 25,285 workers who entered the trade after 1949 was assembled from records of the international head office. Mortality was ascertained by linkage to the Canadian Mortality Registry at Statistics Canada. Standardised mortality ratios were computed using Ontario general population mortality rates as the reference. RESULTS: There were significant increases in lung cancer mortality rates (SMR 1.27; 95% CI 1.13 to 1.42). Increased lung cancer risk was observed among plumbers, pipefitters, and sprinkler fitters. Increased risk was observed among workers joining the Union as late as the 1970s. A random effects meta-analysis of this study and the two PMR studies found significant increases in oesophageal (RR 1.24; 95% CI 1.00 to 1.53), lung (RR 1.31; 95% CI 1.19 to 1.44), and haematological/lymphatic (RR 1.21; 95% CI 1.08 to 1.35) malignancies. CONCLUSIONS: The mortality pattern is consistent with the effects of occupational exposure to asbestos. Increased risk due to other respiratory carcinogens such as welding fume cannot be excluded. There are substantial amounts of asbestos in place in industrial and commercial environments. The education and training of workers to protect themselves against inhalation hazards will be necessary well into the future.

Immune function of cryopreserved avian peripheral white blood cells: potential biomarkers of contaminant effects in wild birds.

Contaminants can cause detrimental effects in wild birds. However, these effects are difficult to measure in all but the most severe cases. Immune function is a sensitive and meaningful biological marker of contaminant-induced effects in captive birds but has more limitations in wild birds due in part to the lack of a proven blood preservation method. We developed methods to assess ex vivo immune function in wild birds using cryopreserved peripheral white blood cells (WBCs). We assessed the effects of cryopreservation on WBC viability and functionality in two immunoassays (concavalin A-induced T lymphocyte proliferation and macrophage phagocytosis) in domestic chickens (Gallus spp.: white Wyandottes and Dominiques) and validated this approach on cryopreserved WBC samples from wild American coots (Fulicia americana). Cryopreservation of chicken WBCs caused a slight but significant decrease in cell viability (99% +/- 0.2 SE for fresh cells versus 84% +/- 2 SE for cryopreserved cells, p = 0.001, Mann-Whitney U, n = 8). No difference was detected in viability between cells that were cryopreserved for less than 10 days (88% +/- 3.7 SE) and more than 50 days (89% +/- 1.3 SE) (n = 6). Overall, there was no statistical difference in the performance of cryopreserved cells compared to fresh cells. Across multiple experiments, cryopreserved T lymphocytes exhibited 200-900% stimulated proliferation above nonstimulated cells, and 40-80% of cryopreserved macrophages ingested yeast. 9,10,Dimethyl-1,2-benz-anthracene (DMBA) reduced proliferation and phagocytosis in cryopreserved cells over an ex vivo exposure range of 0-170 microM DMBA. Tests of immune function on American coot WBCs cryopreserved for up to 10 months (viability of 72% +/- 2.5 SE, n = 24) were similar to the cryopreserved chicken WBCs. This study will facilitate greater use of ex vivo immune function assays as tools to study effects of contaminant exposure in wildlife by demonstrating the viability and functionality of cryopreserved avian cells.

A model of aging and a shape of the observed force of mortality.

A probabilistic model of aging is considered. It is based on the assumption that a random resource, a stochastic process of aging (wear) and the corresponding anti-aging process are embedded at birth. A death occurs when the accumulated wear exceeds the initial random resource. It is assumed that the anti-aging process decreases wear in each increment. The impact of environment (lifestyle) is also taken into account. The corresponding relations for the observed and the conditional hazard rate (force of mortality) are obtained. Similar to some demographic models, the deceleration of mortality phenomenon is explained via the concept of frailty. Simple examples are considered.

Deciduous canine and permanent lateral incisor differential root resorption.

When a permanent maxillary canine erupts apical to the permanent lateral incisor and the deciduous canine, resorption typically takes place only on the deciduous canine root. An understanding of this differential resorption could provide insight into the reasons for excessive iatrogenic root resorption during orthodontic tooth movement. The purpose of the present study was to examine the response of roots of permanent lateral incisors and deciduous canines to simulated resorption, and to acid and enzyme attack, reflecting the physiologic environment of an erupting permanent canine. Groups of maxillary permanent lateral incisor and deciduous canine roots were exposed to 5 combinations of Ten Cate demineralizing solution, Ten Cate demineralizing solution with EDTA, and a Type I collagenase solution. Sections of the roots were examined under a polarized light microscope. Analysis of variation of the resulting root lesions demonstrated that the lesion depths for deciduous canines were greater than those for permanent lateral incisors when averaged across 4 of the conditions (F(1,24) = 7.49, P =.0115). On average, deciduous canine roots demonstrated lesions 10% deeper than did permanent lateral incisor roots. We concluded that when deciduous canine and permanent lateral incisor roots are subjected to acid and enzyme attack, reflecting the physiologic environment of an erupting permanent canine, significantly deeper demineralized lesions are seen in the deciduous roots compared with the permanent roots. This finding may partially explain the differential root resorption during permanent tooth eruption.

Do factors other than need determine utilization of physicians' services in Ontario?

BACKGROUND: Universal health care systems seek to ensure access to care on the basis of need, rather than income, but there are concerns about preferential access to cardiovascular and specialist care for high income patients. In this study, I used population-based, individual-level health, income and utilization data to determine whether whether there is evidence for differential access to physician care in relation to household income. METHODS: I studied data for 2170 Ontario respondents to the 1995 National Population Health Survey (aged 40 to 79 years) who had approved linkage of their survey responses to the administrative databases of the Ontario Health Insurance Plan and for whom income data were available. I used linear and generalized linear regression to model the mean per capita expenditures on physician care and the probability of referral to a specialist in relation to income and self-reported health status. RESULTS: Residents of higher income households incurred lower per capita expenditures for physicians' services than those in lower income households; for example, the mean per capita expenditure in the upper middle income group was $220 less (95% confidence interval -$87 to -$334) than the mean per capita expenditure in the lowest income group. Expenditures were significantly related to self-reported health status; for example, the mean per capita expenditure among those reporting fair health status was $590 higher (95% confidence interval $465 to $737) than among those reporting excellent health. After adjustment for health status, there was no association between income and the expenditures on all physician services, out-of-hospital services or specialist care. INTERPRETATION: Utilization of physicians' services in Ontario is based on need, rather than income.

Exposure estimation in the presence of nondetectable values: another look.

A common problem faced by industrial hygienists is the selection of a valid way of dealing with those samples reported to contain nondetectable values of the contaminant. In 1990, Hornung and Reed compared a maximum likelihood estimation (MLE) statistical method and two methods involving the limit of detection, L. The MLE method was shown to produce unbiased estimates of both the mean and standard deviation under a variety of conditions. That method, however, was complicated, requiring difficult mathematical calculations. Two simpler alternatives involved the substitution of L/2 or L/square root of 2 for each nondetectable value. The L/square root of 2 method was recommended when the data were not highly skewed. Although the MLE method produces the best estimates of the mean and standard deviation of an industrial hygiene data set containing values below the detection limit, it was not practical to recommend this method in 1990. However, with advances in desktop computing in the past decade the MLE method is now easily implemented in commonly available spreadsheet software. This article demonstrates how this method may be implemented using spreadsheet software.