Variability in published rates of influenza-associated hospitalizations: A systematic review, 2007-2018.

BACKGROUND: Influenza burden estimates help provide evidence to support influenza prevention and control programs at local and international levels. METHODS: Through a systematic review, we aimed to identify all published articles estimating rates of influenza-associated hospitalizations, describe methods and data sources used, and identify regions of the world where estimates are still lacking. We evaluated study heterogeneity to determine if we could pool published rates to generate global estimates of influenza-associated hospitalization. RESULTS: We identified 98 published articles estimating influenza-associated hospitalization rates from 2007-2018. Most articles (65%) identified were from high-income countries, with 34 of those (53%) presenting estimates from the United States. While we identified fewer publications (18%) from low- and lower-middle-income countries, 50% of those were published from 2015-2018, suggesting an increase in publications from lower-income countries in recent years. Eighty percent (n = 78) used a multiplier approach. Regression modelling techniques were only used with data from upper-middle or high-income countries where hospital administrative data was available. We identified variability in the methods, case definitions, and data sources used, including 91 different age groups and 11 different categories of case definitions. Due to the high observed heterogeneity across articles (I2 >99%), we were unable to pool published estimates. CONCLUSIONS: The variety of methods, data sources, and case definitions adapted locally suggests that the current literature cannot be synthesized to generate global estimates of influenza-associated hospitalization burden.

Underdetection of laboratory-confirmed influenza-associated hospital admissions among infants: a multicentre, prospective study.

BACKGROUND: Since influenza often presents non-specifically in infancy, we aimed to assess the extent to which existing respiratory surveillance platforms might underestimate the frequency of severe influenza disease among infants. METHODS: The Influenza and Respiratory Syncytial Virus in Infants (IRIS) study was a prospective observational study done at four hospitals in Albania, Jordan, Nicaragua, and the Philippines. We included acutely ill infants aged younger than 1 year admitted to hospital within 10 days or less of illness onset during two influenza seasons (2015-16 and 2016-17) in Albania, Jordan, and Nicaragua, and over a continuous 34 week period (2015-16) in the Philippines. We assessed the frequency of influenza virus infections by real-time RT-PCR (rRT-PCR) and serology. The main study outcome was seroconversion, defined as convalescent antibody titres more than or equal to four-fold higher than acute sera antibody titres, and convalescent antibody titres of 40 or higher. Seroconverison was confirmed by haemagglutination inhibition assay for influenza A viruses, and by hemagglutination inhibition assay and microneutralisation for influenza B viruses. FINDINGS: Between June 27, 2015, and April 21, 2017, 3634 acutely ill infants were enrolled, of whom 1943 were enrolled during influenza seasons and had complete acute-convalescent pairs and thus were included in the final analytical sample. Of the 1943 infants, 94 (5%) were influenza-positive by both rRT-PCR and serology, 58 (3%) were positive by rRT-PCR-only, and 102 (5%) were positive by serology only. Seroconversion to at least one of the influenza A or B viruses was observed among 196 (77%) of 254 influenza-positive infants. Of the 254 infants with influenza virus, 84 (33%) only had non-respiratory clinical discharge diagnoses (eg, sepsis, febrile seizures, dehydration, or other non-respiratory viral illness). A focus on respiratory diagnoses and rRT-PCR-confirmed influenza underdetects influenza-associated hospital admissions among infants by a factor of 2·6 (95% CI 2·0-3·6). Findings were unchanged when syndromic severe acute respiratory infection criteria were applied instead of clinical diagnosis. INTERPRETATION: If the true incidence of laboratory-confirmed influenza-associated hospital admissions among infants is at least twice that of previous estimates, this substantially increases the global burden of severe influenza and expands our estimates of the preventive value of maternal and infant influenza vaccination programmes. FUNDING: US Centers for Disease Control and Prevention.

Is It Facebook Official? Coming Out and Passing Strategies of Young Adult Gay Men on Social Media.

The rapid proliferation of social media, mobile applications, and Internet technologies has shifted a wide variety of social interaction from physical spaces to an online environment. Drawing from 42 semistructured, in-depth interviews with gay college-aged men between the ages of 18 and 27, this article explores these changing patterns of social interaction among gay men. I discuss three strategies of identity management college-aged gay men use to disclose or conceal their sexual identity to others. The first group of men, "Out and Proud," uses Facebook as a way to celebrate and reaffirm their sexual identity, in addition to actively coming out to others on the social media Web site. The second group, "Out and Discreet," uses Facebook to indirectly come out to some of their friends while hiding this information from others. The men in the last group I identify, "Facebook Closeted," actively manage their online profiles to ensure their sexual identity is not exposed. Facebook is both transformative and risky for college-aged gay men, as it represents a new platform for them to come out as gay to friends and family, as well as other areas of their lives where they must actively manage the presentation of their sexual identity.

Hydrogen bridging in the compounds X2H (X=Al,Si,P,S).

X2H hydrides (X=Al, Si, P, and S) have been investigated using coupled cluster theory with single, double, and triple excitations, the latter incorporated as a perturbative correction [CCSD(T)]. These were performed utilizing a series of correlation-consistent basis sets augmented with diffuse functions (aug-cc-pVXZ, X=D, T, and Q). Al2H and Si2H are determined to have H-bridged C2v structures in their ground states: the Al2H ground state is of 2B1 symmetry with an Al-H-Al angle of 87.6 degrees, and the Si2H ground state is of 2A1 symmetry with a Si-H-Si angle of 79.8 degrees. However, P2H and S2H have nonbridged, bent Cs structures: the P2H ground state is of 2A' symmetry with a P-P-H angle of 97.0 degrees, and the S2H ground state is of 2A' symmetry with a S-S-H angle of 93.2 degrees. Ground state geometries, vibrational frequencies, and electron affinities have been computed at all levels of theory. Our CCSD(T)/aug-cc-pVQZ adiabatic electron affinity of 2.34 eV for the Si2H radical is in excellent agreement with the photoelectron spectroscopy experiments of Xu et al. [J. Chem. Phys. 108, 7645 (1998)], where the electron affinity was determined to be 2.31+/-0.01 eV.