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\"The most comprehensive and accurate examination of one of the least studied and least understood theaters--the Central Highlands--in what Americans came to call the Vietnam War (or what the Vietnamese called the Second Indochina War, following France's defeat in 1954). Focusing on the 1960-1965 period, Harris provides a detailed look at and evaluation of military operations by both sides, culminating in three chapters devoted to the famous battles in the Ia Drang river valley\"-- Provided by publisher.

Background Syndromic surveillance systems are an essential component of public health surveillance and can provide timely detection of infectious disease cases and outbreaks. Whilst surveillance systems are generally embedded within healthcare, there is increasing interest in novel data sources for monitoring trends in illness, such as over-the-counter purchases, internet-based health searches and worker absenteeism. This systematic review considers the utility of school attendance registers in the surveillance of infectious disease outbreaks and occurrences amongst children. Methods We searched eight databases using key words related to school absence, infectious disease and syndromic surveillance. Studies were limited to those published after 1st January 1995. Studies based in nursery schools or higher education settings were excluded. Article screening was undertaken by two independent reviewers using agreed eligibility criteria. Data extraction was performed using a standardised data extraction form. Outcomes included estimates of absenteeism, correlation with existing surveillance systems and associated lead or lag times. Results Fifteen studies met the inclusion criteria, all of which were concerned with the surveillance of influenza. The specificity of absence data varied between all-cause absence, illness absence and syndrome-specific absence. Systems differed in terms of the frequency of data submissions from schools and the level of aggregation of the data. Baseline rates of illness absence varied between 2.3–3.7%, with peak absences ranging between 4.1–9.8%. Syndrome-specific absenteeism had the strongest correlation with other surveillance systems (r = 0.92), with illness absenteeism generating mixed results and all-cause absenteeism performing the least well. A similar pattern of results emerged in terms of lead and lag times, with influenza-like illness (ILI)-specific absence providing a 1–2 week lead time, compared to lag times reported for all-cause absence data and inconsistent results for illness absence data. Conclusion Syndrome-specific school absences have potential utility in the syndromic surveillance of influenza, demonstrating good correlation with healthcare surveillance data and a lead time of 1–2 weeks ahead of existing surveillance measures. Further research should consider the utility of school attendance registers for conditions other than influenza, to broaden our understanding of the potential application of this data for infectious disease surveillance in children. Systematic review registration PROSPERO 2019 CRD42019119737.

OBJECTIVE:: To examine the maternal and foetal risks of adverse pregnancy outcome in relation to maternal obesity, expressed as body mass index (BMI, kg/m2 ) in a large unselected geographical population. DESIGN:: Retrospective analysis of data from a validated maternity database system which includes all but one of the maternity units in the North West Thames Region. A comparison of pregnancy outcomes was made on the basis of maternal BMI at booking. SUBJECTS:: A total of 287 213 completed singleton pregnancies were studied including 176 923 (61.6%) normal weight (BMI 20-24.9), 79 014 (27.5%) moderately obese (BMI 25-29.9) and 31 276 (10.9%) very obese (BMI≥30) women. MEASUREMENTS:: Ante-natal complications, intervention in labour, maternal morbidity and neonatal outcome were examined and data presented as raw frequencies and adjusted odds ratios with 99% confidence intervals following logistic regression analysis to account for confounding variables. RESULTS:: Compared to women with normal BMI, the following outcomes were significantly more common in obese pregnant women (odds ratio (99% confidence interval) for BMI 25-30 and BMI≥30 respectively): gestational diabetes mellitus (1.68 (1.53-1.84), 3.6 (3.25-3.98)); proteinuric pre-eclampsia (1.44 (1.28-1.62), 2.14 (1.85-2.47)); induction of labour (2.14 (1.85-2.47), 1.70 (1.64-1.76)); delivery by emergency caesarian section (1.30 (1.25-1.34), 1.83 (1.74-1.93)); postpartum haemorrhage (1.16 (1.12-1.21), 1.39 (1.32-1.46)); genital tract infection (1.24 (1.09-1.41), 1.30 (1.07-1.56)); urinary tract infection (1.17 (1.04-1.33), 1.39 (1.18-1.63)); wound infection (1.27 (1.09-1.48), 2.24 (1.91-2.64)); birthweight above the 90th centile (1.57 (1.50-1.64), 2.36 (2.23-2.50)), and intrauterine death (1.10 (0.94-1.28), 1.40 (1.14-1.71)). However, delivery before 32 weeks' gestation (0.73 (0.65-0.82), 0.81 (0.69-0.95)) and breastfeeding at discharge (0.86 (0.84-0.88), 0.58 (0.56-0.60)) were significantly less likely in the overweight groups. In all cases, increasing maternal BMI was associated with increased magnitude of risk. CONCLUSION:: Maternal obesity carries significant risks for the mother and foetus. The risk increases with the degree of obesity and persists after accounting for other confounding demographic factors. The basis of many of the complications is likely to be related to the altered metabolic state associated with morbid obesity. INTERNATIONAL JOURNAL OF OBESITY: (2001) 25, 1175-1182

Background Norovirus has a higher level of under-reporting in England compared to other intestinal infectious agents such as Campylobacter or Salmonella , despite being recognised as the most common cause of gastroenteritis globally. In England, this under-reporting is a consequence of the frequently mild/self-limiting nature of the disease, combined with the passive surveillance system for infectious diseases reporting. We investigated heterogeneity in passive surveillance system in order to improve understanding of differences in reporting and laboratory testing practices of norovirus in England. Methods The reporting patterns of norovirus relating to age and geographical region of England were investigated using a multivariate negative binomial model. Multiple model formulations were compared, and the best performing model was determined by proper scoring rules based on one-week-ahead predictions. The reporting patterns are represented by epidemic and endemic random intercepts; values close to one and less than one imply a lower number of reports than expected in the given region and age-group. Results The best performing model highlighted atypically large and small amounts of reporting by comparison with the average in England. Endemic random intercept varied from the lowest in East Midlands in those in the under 5 year age-group (0.36, CI 0.18–0.72) to the highest in the same age group in South West (3.00, CI 1.68–5.35) and Yorkshire & the Humber (2.93, CI 1.74–4.94). Reporting by age groups showed the highest variability in young children. Conclusion We identified substantial variability in reporting patterns of norovirus by age and by region of England. Our findings highlight the importance of considering uncertainty in the design of forecasting tools for norovirus, and to inform the development of more targeted risk management approaches for norovirus disease.

Rotavirus is a major cause of gastroenteritis in young children. New vaccines for rotavirus are now available and countries need to establish the health and economic burden of rotavirus disease to assess whether vaccine introduction is advisable. This study assesses the fraction of acute gastroenteritis in children under 5 years that may be attributable to rotavirus using multiple linear regression. Results suggest around 45% of hospitalisations, 25% of GP consultations, 27% of NHS Direct calls and 20% of accident and emergency (A&E) attendances for acute gastroenteritis in this age group may be attributable to rotavirus. The annual incidence is estimated to be 4.5 hospitalisations, 9.3 A&E consultations, and 28-44 GP consultations per 1000 children under five years of age. The cost to the health service is estimated to be pound 14.2m per annum. Rotavirus vaccination has the potential to reduce this burden of disease. This study provides a sound basis on which to make this assessment and serves as a baseline against which any reductions that do occur if vaccination is introduced can be measured against.

A synchrotron wide-angle x-ray scattering study of mung bean (Vigna radiata) primary cell walls was combined with published solid-state nuclear magnetic resonance data to test models for packing of (1→4)-β-glucan chains in cellulose microfibrils. Computer-simulated peak shapes, calculated for 36-chain microfibrils with perfect order or uncorrelated disorder, were sharper than those in the experimental diffractogram. Introducing correlated disorder into the models broaden the simulated peaks but only when the disorder was increased to unrealistic magnitudes. Computer-simulated diffractograms, calculated for 24- and 18-chain models, showed good fits to experimental data. Particularly good fits to both x-ray and nuclear magnetic resonance data were obtained for collections of 18-chain models with mixed cross-sectional shapes and occasional twinning. Synthesis of 18-chain microfibrils is consistent with a model for cellulose-synthesizing complexes in which three cellulose synthase polypeptides form a particle and six particles form a rosette.

A new surveillance system for outbreaks of norovirus in English hospitals, the hospital norovirus outbreak reporting system (HNORS), was launched in January 2009. On site investigators were enabled to enter data on outbreaks of norovirus directly onto a tailored system via an internet-based front end. A standard dataset was designed to collect information describing the key epidemiological characteristics of each outbreak. In the period 1992–2008, 1817 suspected and confirmed outbreaks of norovirus in English hospitals were reported to national surveillance. After introduction of the new system there were 3980 reports of outbreaks of suspected and confirmed norovirus received in the years 2009–2011. Data from the new reporting system demonstrates that transmission of norovirus levies a heavy burden on English hospitals. On average, reported outbreaks are associated with 13 000 patients and 3400 staff becoming ill, 8900 days of ward closure and the loss of over 15 500 bed-days annually.

• The role of arbuscular mycorrhizal fungi (AMF) in arsenate resistance in arbuscular mycorrhizal associations is investigated here for two Glomus spp. isolated from the arsenate-resistant grass Holcus lanatus. • Glomus mosseae and Glomus caledonium were isolated from H. lanatus growing on an arsenic-contaminated mine-spoil soil. The arsenate resistance of spores was compared with nonmine isolates using a germination assay. Short-term arsenate influx into roots and long-term plant accumulation of arsenic by plants were also investigated in uninfected arsenate resistant and nonresistant plants and in plants infected with mine and nonmine AMF. • Mine AMF isolates were arsenate resistant compared with nonmine isolates. Resistant and nonresistant G. mosseae both suppressed high-affinity arsenate/phosphate transport into the roots of both resistant and nonresistant H. lanatus. Resistant AMF colonization of resistant H. lanatus growing in contaminated mine spoil reduced arsenate uptake by the host. • We conclude that AMF have evolved arsenate resistance, and conferred enhanced resistance on H. lanatus.