ABSTRACT. The Food and Drug Administration licensed a live-virus varicella vaccine (Varivax In March 1995, the Food and Drug Administration approved a live-attenuated varicella vaccine for use in healthy individuals 12 months of age and older. The vaccine has been shown to be safe and effective in healthy children and adults, 1,2 as well as in children with leukemia. [3][4][5] The American Academy of Pediatrics does not recommend routine screening of children for human immunodeficiency virus (HIV) infection before vaccination. In addition, routine administration of varicella vaccine is not recommended for all HIV-infected children. 6 Significant morbidity and mortality is caused by varicella-zoster virus (VZV) in immunocompromised individuals, including those infected with HIV. 7-9 Postexposure varicella-zoster immune globulin prophylaxis decreases the likelihood and severity of varicella in high-risk individuals, but the breakthrough rate can be as high as 26%. 4,5 Exposures to varicella are often not recognized, further limiting the utility of postexposure prophylaxis. Immunization, on the other hand, has the potential of establishing permanent immunity. After primary infection in HIV-infected adults, the risk of reactivation remains low well into the progression of acquired immunodeficiency syndrome. These individuals are at risk of developing zoster, but have a relatively low risk of dissemination. 8 This suggests that the immunization of HIV-infected children could prevent primary (wild-type) infection, thereby eliminating viral entry into dorsal root ganglia 3 and subsequent reactivation.Immunization of immunocompromised patients has been limited to children with leukemia and solid tumors following strict guidelines to limit the potential for serious adverse events. 5 Routine immunization of all healthy children carries the potential risk that unrecognized immunocompromised children could be inadvertently vaccinated. Reported here is a 16-month-old, previously undiagnosed, HIV-infected boy who developed dissemination of the vaccine strain of varicella zoster virus after routine immunization. CASE REPORTA previously healthy 16-month-old boy who was admitted to the University of Michigan Mott Children's Hospital with a 5-day history of increasing respiratory distress, fever (101°F), cough, emesis, and lower extremity weakness. In addition, he had a 1-month history of a progressive erythematous papular rash, which began in the groin and upper right thigh progressing to involve the trunk, axilla, and right knee and foot. The rash was associated with a low-grade fever and the patient had recently been refusing to walk for several days. On admission, he had a pulse of 173 beats/min, and a respiratory rate of 24 breaths/min. Weight (9 kg), height (74 cm), and head circumference (45 cm) were all below the fifth percentile. Physical examination was remarkable for oral thrush, diffuse rhonchi, and scattered wheezes, and a confluent macular rash over the trunk and arms. There was also an erythematous zosteriform patc...

This work seeks to understand how design practitioners discover, select, and adapt design methods and methodologies. Design methods and methodologies are mainly used for educational purposes and are not formally transferred into design practice and industry. This prevents design practitioners from accessing the rich body of research and knowledge posed by academia. Various web platforms and textbooks allow users to discover or search for design methods, but little support is provided to assess whether or not a method is appropriate for the context or the task at hand. In this exploratory study, interviews were conducted with practicing engineers and designers. Interview responses were coded and analyzed in an effort to understand the patterns in searching, selecting, assessing, and exchanging experiences with peers in professional practice. This analysis showed that interviewees would like to search for design methods based on their desired outcomes. Additionally, interviewees considered their personal contacts to be the most valuable source of new methods. These insights show that web-based communities of practice may be a potential link between academia and industry, but existing web repositories and communities require further development in order to better meet the needs of the design practitioner community.

BackgroundThe presence of a vpx gene distinguishes HIV-2 from HIV-1, the main causative agent of AIDS. Vpx degrades the restriction factor SAMHD1 to boost HIV-2 infection of macrophages and dendritic cells and it has been suggested that the activation of antiviral innate immune responses after Vpx-dependent infection of myeloid cells may explain why most HIV-2-infected individuals efficiently control viral replication and become long-term survivors. However, the role of Vpx-mediated SAMHD1 antagonism in the virological and clinical outcome of HIV-2 infection remained to be investigated.ResultsHere, we analyzed the anti-SAMHD1 activity of vpx alleles derived from seven viremic and four long-term aviremic HIV-2-infected individuals. We found that effective Vpx-mediated SAMHD1 degradation and enhancement of myeloid cell infection was preserved in most HIV-2-infected individuals including all seven that failed to control the virus and developed AIDS. The only exception were vpx alleles from an aviremic individual that predicted a M68K change in a highly conserved nuclear localization signal which disrupted the ability of Vpx to counteract SAMHD1. We also found that HIV-2 is less effective than HIV-1 in inducing innate immune activation in dendritic cells.ConclusionsEffective immune control of viral replication in HIV-2-infected individuals is not associated with increased Vpx-mediated degradation of SAMHD1.

Both Rwanda and Australia have made significant strides to eradicate cervical cancer. To understand the successes in Rwanda and Australia, a comparative policy analysis was conducted based on key informant interviews and a review of peer‐reviewed literature and policy briefs. Notable findings were identified that offer lessons for countries across the income spectrum. To address cervical cancer, low‐ and middle‐income countries can leverage foreign aid, international collaboration, and strong political advocacy, as Rwanda did. High‐income countries can invest in translational research that builds capacity from basic science research to implementation of novel and impactful health products and services, as Australia did. All countries can consider rolling out HPV vaccination by targeting the social and/or physical environment (e.g., a school‐based vaccination program, as both Rwanda and Australia did). Cervical cancer is preventable, and eradication is within reach for countries across the income spectrum around the world. Cervical cancer screening programs are needed to minimize the incidence of and mortality from cervical cancer in the short term, and HPV vaccination programs are the best strategy to eradicate cervical cancer in the long term.

Human-centered design (HCD) offers a systematic approach to innovation practice, driven by customer research and feedback throughout the design process. Within the community of engineers and researchers who engage in design for global development, interest in HCD has grown in the past decade. In this paper, we examine the human-centered design for development (HCD+D) academic community to better understand the interactions between researchers. By building and evaluating a co-authorship network from a dataset of HCD+D papers, in which the nodes are researchers and the connecting links are co-authorship relationships, we provide a decade-long benchmark to answer a variety of questions about collaboration patterns within this emerging field. Our analysis shows that most HCD+D authors publish few papers and are part of small, well-connected sub-communities. Influential authors that bridge separate communities are few. HCD+D is emerging from disparate disciplines and widely shared scholarship across disciplines continues to be developed. Influential authors in HCD+D play a large role in shaping HCD+D, yet there are few authors that are in a position to connect and influence collaborative research. Our analysis gives rise to several implications including an increased need for cross-disciplinary collaboration and the need for a stronger core of HCD+D practitioners.