Impact of herpes zoster vaccination on incident dementia: A retrospective study in two patient cohorts

Background Herpes zoster (HZ) infection increases dementia risk, but it is not known if herpes zoster vaccination is associated with lower risk for dementia. We determined if HZ vaccination, compared to no HZ vaccination, is associated with lower risk for incident dementia. Methods and findings Data was obtained from Veterans Health Affairs (VHA) medical records (10/1/2008–9/30/2019) with replication in MarketScan® commercial and Medicare claims (1/1/2009-12/31/2018). Eligible patients were ≥65 years of age and free of dementia for two years prior to baseline (VHA n = 136,016; MarketScan n = 172,790). Two index periods (either start of 2011 or 2012) were defined, where patients either had or did not have a HZ vaccination. Confounding was controlled with propensity scores and inverse probability of treatment weighting. Competing risk (VHA) and Cox proportional hazard (MarketScan) models estimated the association between HZ vaccination and incident dementia in all patients and in age (65–69, 70–74, ≥75) and race (White, Black, Other) sub-groups. Sensitivity analysis measured the association between HZ vaccination and incident Alzheimer’s dementia (AD). HZ vaccination at index versus no HZ vaccination throughout follow-up. VHA patients mean age was 75.7 (SD±7.4) years, 4.0% were female, 91.2% white and 20.2% had HZ vaccination. MarketScan patients mean age was 69.9 (SD±5.7) years, 65.0% were female and 14.2% had HZ vaccination. In both cohorts, HZ vaccination compared with no vaccination, was significantly associated with lower dementia risk (VHA HR = 0.69; 95%CI: 0.67–0.72; MarketScan HR = 0.65; 95%CI:0.57–0.74). HZ vaccination was not related to dementia risk in MarketScan patients aged 65–69 years. No difference in HZ vaccination to dementia effects were found by race. HZ vaccination was associated with lower risk for AD. Conclusions HZ vaccination is associated with reduced risk of dementia. Vaccination may provide nonspecific neuroprotection by training the immune system to limit damaging inflammation, or specific neuroprotection that prevents viral cytopathic effects.

HPV vaccination and factors influencing vaccine uptake among people of Indian ancestry living in the United States.

126 Background: Despite HPV vaccine availability, approximately one-third of annual global cervical cancer deaths occur in India. This may be related to cultural norms that lead to vaccine hesitancy. We sought to determine whether people of Indian ancestry (POIA) who move to the US continue to have disproportionately lower HPV vaccination rates than the rest of the US population and factors that influence HPV vaccine uptake in this group. Methods: The National Health Interview Survey (NHIS) is the largest source of health information for Americans and is designed to be representative of the entire civilian non-institutionalized US population. We utilized the 2018 NHIS to compare HPV vaccine initiation and completion rates between POIA and the general US population and factors correlating with HPV vaccine uptake in this group. Results: There were 17,004 people, representing 185,065,802 in the population, who were between the ages of 18-64 and who responded to questions regarding racial ancestry and HPV vaccination. Of this cohort, 1.69% identified themselves as being of Indian ancestry. Compared to other racial groups, POIA had a significantly lower rate of HPV vaccination (8.18% vs. 12.16%, 14.70%, 16.07%, and 12.41%, in White, Black, Other Asian, and those of other/mixed ancestry, respectively, p = 0.003). However, of those who received one HPV shot there was no difference in vaccine series completion between racial groups (3.17% vs. 4.27%, 3.51%, 4.31%, and 5.04% for POIA vs. White, Black, Other Asian, and those of other/mixed ancestry, respectively, p = 0.465). Among POIA, younger individuals and those who were single were more likely to obtain HPV vaccination (vaccination rates of 38.12%, 6.45% and 1.79% for ages 18-25, 26-45, and 46-64, respectively, p = 0.018, and 29.53% vs. 3.11% for single vs. married, respectively, p = 0.006). All individuals who were vaccinated had some form of health insurance (p = 0.020). Those born in the US had a higher rate of vaccination than those who were not (p = 0.019); however, duration of residence in the US did not influence vaccination rates among POIA (p = 0.502). While high levels of English proficiency were associated with a higher vaccination rate (p = 0.029), education status was not correlated (p = 0.231). Interestingly, both male and female POIA had equivalent rates of vaccination (3.12% and 2.81%, respectively, p = 0.949). Conclusions: POIA are significantly less likely to receive HPV vaccination than the general US population but are equally likely to complete the vaccine series if initiated. Age, insurance status, being born in the US, English speaking proficiency, and marital status significantly influence HPV vaccine initiation among POIA. These data suggest that public health measures promoting HPV vaccination among POIA immigrants may significantly improve vaccination rates among this population.

‘Ek is Kain’: ’n Hermeneutiek van weerloosheid as ’n antwoord op die dekoloniale diskoers

‘I am Cain’: A hermeneutics of vulnerability in response to decolonial discourse. Given the theological justification of apartheid by past influential theologians such as Totius, a hermeneutics of vulnerability is presented in response to the experiences of those who suffered heavily under apartheid in an attempt to render accountable those who benefited from apartheid. The effect of acknowledging the negative influence apartheid had on the black Other, places the white Bible reader in the position of an implicated evildoer or a sinful human being. The author wants to put this awkward position on the table by looking at Cain’s position and whether there is any empowerment in his story. In the first part of the article, after the introduction, a brief account is given of certain aspects of Reformed hermeneutics with which the author, as reader, wants to map himself. In the second part, Cain’s role is linked to whiteness under apartheid and colonialism, and to the German adaptation of the Holocaust in World War II under the rule of the National Socialist Party in Nazi Germany. Finally, the reader pays attention to the figure of Cain in Genesis 4 under the heading ‘I am Cain!’ As part of a final word, I seek to connect his interpretation to Reformed hermeneutics.Contribution: With this, the author hope to draw attention to the role of whiteness (and masculinity) of the reader in the Bible reading process in a period where people within the Reformed religious tradition must reposition themselves in a post-apartheid and decolonial society. It makes the white male reader uncomfortable, but within a hermeneutics of vulnerability, it contributes positively to change.

Proanthocyanidins and Flavan-3-ols in the Prevention and Treatment of Periodontitis—Immunomodulatory Effects, Animal and Clinical Studies

This paper continues the systematic review on proanthocyanidins and flavan-3-ols in the prevention and treatment of periodontal disease and covers the immunomodulatory effects, and animal- and clinical studies, while the other part discussed the direct antibacterial properties. Inflammation as a major response of the periodontal tissues attacked by pathogenic microbes can significantly exacerbate the condition. However, the bidirectional activity of phytochemicals that simultaneously inhibit bacterial proliferation and proinflammatory signaling can provide a substantial alleviation of both cause and symptoms. The modulatory effects on various aspects of inflammatory and overall immune response are covered, including confirmed and postulated mechanisms of action, structure activity relationships and molecular targets. Further, the clinical relevance of flavan-3-ols and available outcomes from clinical studies is analyzed and discussed. Among the numerous natural sources of flavan-3-ols and proanthocyanidins the most promising are, similarly to antibacterial properties, constituents of various foods, such as fruits of Vaccinium species, tea leaves, grape seeds, and tannin-rich medicinal herbs. Despite a vast amount of in vitro and cell-based evidence of immunomodulatory there are still only a few animal and clinical studies. Most of the reports, regardless of the used model, indicated the efficiency of these phytochemicals from cranberries and other Vaccinium species and tea extracts (green or black). Other sources such as grape seeds and traditional medicinal plants, were seldom. In conclusion, the potential of flavan-3-ols and their derivatives in prevention and alleviation of periodontal disease is remarkable but clinical evidence is urgently needed for issuing credible dietary recommendation and complementary treatments.

Proanthocyanidins and Flavan-3-ols in the Prevention and Treatment of Periodontitis - Immunomodulatory Effects, Animal and Clinical Studies

This paper continues the review study on antimicrobial properties relevant to the periodontal diseases. Inflammation as a major response of the periodontal tissues attacked by pathogenic microbes can significantly exacerbate the condition. However, the bidirectional activity of phytochemicals that simultaneously inhibit bacterial proliferation and proinflammatory signaling can provide a substantial alleviation of both cause and symptoms. The modulatory effects on various aspects of inflammatory and overall immune response has been covered, including confirmed and postulated mechanisms of action, structure activity relationships and molecular targets. Further, the clinical relevance of flavan-3-ols and available outcomes from clinical studies has been analyzed and discussed. Among the numerous natural sources of flavan-3-ols and proanthocyanidins the most promising are, similarly to antibacterial properties, constituents of various foods, such as fruits of Vaccinium species, tea leaves, grape seeds, and tannin-rich medicinal herbs. Despite a vast amount of in vitro and cell-based evidence of immunomodulatory there is still much less studies using animal models and only a few clinical studies. Most of the studies, regardless of the used model indicated efficiency of these phytochemicals from cranberries and other Vaccinium species and tea extracts (green or black). Other sources such as grape seeds and traditional medicinal plants, were seldom. In conclusion, the potential of flavan-3-ols and their derivatives in prevention and alleviation of periodontitis is remarkable but clinical evidence is urgently needed for issuing credible dietary recommendation and complementary treatments.

Exposure, Marketing, and Access: Malt Liquor and the Racialization of Taste

This chapter investigates how the lack of diversity and representation in the craft beer industry has led to the systematic exclusion of black people from beer consumption. One way to do this is to focus on the use of racially targeted marketing to sell cheaper products of lesser quality to communities of color; malt liquor is a critical case. Another way is to interrogate the ways in which the contemporary craft beer industry has appropriated black culture and iconography to sell beer to white people. The issue of representation, both socially and culturally, is of key importance in looking at the marketing of beer. According to interview data, the issue of representation is a major barrier in preventing black, other minority, and female participation in craft beer and its cultures. Given this reality, it is not surprising at all that most significant efforts to diversify the beer industry have mostly been led by consumers.

White Zombie as Captivity Narrative and the Death of Certainty

Horror films such as White Zombie (1932) reveal viewers to themselves by narrating in the currency of audience anxiety. Such movies evoke fright because they recapitulate fear and trauma that audiences have already internalized or continue to experience, even if they are not aware of it. White Zombie’s particular tack conjures up an updated captivity narrative wherein a virginal white damsel is abducted by a savage Other. The shell of the captivity story, of course, is as old as America. In its earliest incarnation it featured American Indians in the role as savage Other, fiendishly imagined as having been desperate to get their clutches on white females and all that hey symbolized. In this way, it generated much of the emotional heat stoking Manifest Destiny, that is, American imperial conquest both of the continent and then, later, as in the case of Haiti, of the Caribbean Basin. White Zombie must of course be understood in the context of the American invasion and occupation of Haiti (1915-1934). As it revisits the terrain inhabited by the American black Other, it also speaks to the history of American slavery. The Other here is African-American, not surprisingly given the date and nature of American society of the day, typically imagined in wildly pejorative fashion in early American arts and culture. This essay explores White Zombie as a modified captivity narrative, pace Last of the Mohicans through John Ford’s The Searchers (1956), the Rambo trilogy (1982, 1985, 1988), the Taken trilogy (2008, 1012, 2014), even Mario and Luigi’s efforts to rescue Princess Peach from Bowser.

Symbolic Economies between a Black Mirror and Black Aesthetic

This essay seeks to review the edges of Eric Lott's Black Mirror. But to approach the inner and outer edges of “a black mirror” is to sense the threat that they could become two sides of the same coin. In chapter 1, “Black Mirror: State Fantasy and Symbolic Surplus Value,” Lott writes, “we should explore the dimensions and especially the consequences of the fantasy race is – consequences that suffuse the consciousness of class, sexuality, gender, and other lines of force. Live there a while, in thought as in life. That is what this book tries to do.” To take up this invitation is therefore to first locate that space which readers are asked to live in for a while. However, to near that territory is not to enter the fantasy of race, if only to critique it, for we are already there. Nor is it accessed by abandoning the value of race, Lott contends, especially while the economy of whiteness continues profiting from “black symbolic capital.” Here we encounter the daunting scope of a “black mirror,” where horizon lines become Fata Morganas: an area that covers “the mechanics, dispositions, and effects of the dominant culture's looking at itself always through a fantasized black Other” (xvii). The dimensions of that mirror prove wider still, as any race, gender or class is shown capable of reflecting itself in it. More specifically, Black Mirror questions how signs of racial difference might possibly divest from the dominant symbolic economies in which they are exchanged, except Black Mirror largely does so by demonstrating their reinvestment. When analyzing the fantasies, angles and contradictions of a “black mirror,” readers are compelled to seek its outer edges, a market with real use-value, spaces where gifts are exchanged, or a beyond alluded to as “occupying the tain of the mirror – the mirror's tin backing that allows it to reflect at all” (20).