All statistical testing was performed with two-tailed tests Of t

All statistical testing was performed with two-tailed tests. Of the 500 people who were scheduled for TKA, 405 (81%) participated in the study. The characteristics of participants are presented in Table 1. The mean age of the cohort was 68 years (SD 10) and 249 (62%) were female. Selleck Crenolanib In total, 380 (94%) participants had two or more comorbid conditions, among which 60 (15%) had diabetes. Hypertension was the most prevalent comorbidity (n = 216, 53%) followed by low back pain (n = 155, 38%). Contralateral joint involvement affected 117 (18%) at the hip and 298 (25%) at the knee. Postoperative in-hospital complications occurred in 18% of participants with diabetes and 13% of participants without diabetes. The most common types

of complications were postoperative delirium (n = 17, 4%), joint or wound infection (n = 15, 4%) and urinary tract infection (n = 14, 3%). The mean length of stay in acute care was 6 days (SD 3). The diagnosis of diabetes

had 97% exact agreement between chart review and participant reports. Of the 60 participants with diabetes, 19 (32%) participants reported that diabetes impacted their ability to perform daily routine activities. The number of participants with self-reported diabetes remained relatively constant over the 6 months. Eighty Ion Channel Ligand Library solubility dmso percent of participants with diabetes had hospital admission glucose levels above 6.0 mmol/L and 65% were taking either oral hypoglycaemics or insulin for their diabetes. No significant differences were seen between the diabetic and non-diabetic participants for age (p = 0.42), gender (p = 0.26), or chronic comorbidities such as heart disease,

kidney disease and visual impairment, as presented in Table 1. Participants with diabetes that impacted on routine activities had a mean body mass index (BMI) of 35.8 kg/m2 (SD 7.1), which was higher than participants with diabetes that did not impact on routine activities (mean 33.7 kg/m2, SD 6.6) and participants without diabetes (mean 31.7 kg/m2, SD 6.3). Pre-operative WOMAC pain and function scores were similar among the three groups Phosphoprotein phosphatase (Figure 1). At 1, 3 and 6 months after surgery, participants with diabetes that impacted on routine activities had greater pain scores than the other two groups. These differences were of a magnitude that people typically consider to be somewhat different. 22 A similar pattern was also seen with the WOMAC function scores. Participants with diabetes that impacted on routine activities had poorer function than the other two groups ( Figure 1). Although no statistically significant differences were seen among the groups at 1 month, function scores were significantly poorer for participants in the diabetes with impact group than the other two groups at 3 (p < 0.01) and 6 months (p < 0.05). At baseline, the overall HUI3 scores for the three groups differed by more than 0.03, which was the threshold that was adopted as being clinically meaningful.

, 2010 and Tanti et al , 2012), and neurogenesis in the adult hip

, 2010 and Tanti et al., 2012), and neurogenesis in the adult hippocampus (Tanti et al., 2012). Neurogenesis-ablated animals, even when in an environmental enrichment, presented a submissive behaviour (Schloesser et al., 2010), thus PD0325901 mouse confirming the importance

of adult hippocampal neurogenesis in response to stress and resilience to it. Housing animals in an enriched environment, including voluntary exercise, increases glucocorticoid levels (Stranahan et al., 2008, Vivinetto et al., 2013 and Zhang et al., 2013), leading to the suggestion that this increase is essential for increased adult hippocampal neurogenesis and stress resilience (Schloesser et al., 2010 and Sampedro-Piquero et al., 2014). In fact, when rats

are adrenalectomized, environmental enrichment-induced increases in adult hippocampal neurogenesis are no longer apparent (Lehmann et al., 2013), thus demonstrating the requirement of glucocorticoid action on facilitating adult hippocampal neurogenesis. On the other hand, the blunted glucocorticoid action in adrenalectomized animals with intact neurogenesis generates a resilient animal, increasing cell survival (Lehmann et al., 2013). This protective effect of adrenalectomy during EPZ-6438 ic50 stress is neurogenesis-dependent (Lehmann et al., 2013). Similarly, it has been reported that moderate increases in corticosterone by some protocols of chronic stress increases adult hippocampal neurogenesis and promotes antidepressant-like behaviour (Parihar et al., 2011). Taken together, it appears that glucocorticoids,

the key substrates of the Isotretinoin stress response, play dual roles in adult hippocampal neurogenesis, reducing or increasing it depending upon the amount released and the environmental challenge and in parallel also play dual roles in both susceptibility and resilience to stress-induced changes in behaviour whereby both environmental enrichment and adrenalectomy can lead to stress-resilience. Taken together, the precise role of adult hippocampal neurogenesis in stress susceptibility remains unclear as a lack of association as well as associations with both increased susceptibility and increased resilience have been reported. Discrepancies in the literature might be due to differences in the methodology used, such as species, type of stressor and method of ablation of neurogenesis. On the other hand, the presence of intact adult hippocampal neurogenesis has been shown to contribute to the protective effects of adrenalectomy and environmental enrichment against stress-induced changes in behaviour. Moreover, the use of genetic models supports the study of how some factors such as BDNF and cannabinoid signalling may influence adult hippocampal neurogenesis and stress susceptibility and these factors may be a future target for the treatment of stress-induced reductions in adult hippocampal neurogenesis and maladaptive behavioural responses. Fig.

9, 24 3, 54 9–60 0 ppm for SCH3, CH3, and OCH3 respectively The

9, 24.3, 54.9–60.0 ppm for SCH3, CH3, and OCH3 respectively. The signals appeared at around δ 107.0, 114.0, 143.0, 162.0 ppm for C-5, C-6, C-7a, C-2 and carbons of aromatic rings at δ 127.0–134.0 ppm respectively. Further HRMS gave all the molecular ion peaks corresponding to molecular weight of confirmed novel compounds. In the present paper, we report the synthesis, spectral studies, and antifungal activity of a new series of novel diaryl substituted imidazo [2, 1-b]-benzothiazole derivatives (8a–y). These novel heterocyclic compounds were prepared by cyclo–dehydration

reaction between the various substituted 2-amino benzothiazole derivatives (3a–h) and various substituted a-bromo-1-[4′-substituted] phenyl-2-[4″-substituted] phenyl-1-ethanones (7a–i) in the presence of anhydrous ethanol, under the influence of a trace quantity Epacadostat solubility dmso of phosphorus pentoxide. In general, the results of the antifungal activity are also encouraging, as out of twenty five compounds tested, compounds 8k, 8l, 8m, 8n, 8q, 8r and 8y exhibited significant activities, which are comparable or more potent regarding their activity than the reference drug. The overall outcome of this model revealed that: (i) the imidazo [2, 1-b]-benzothiazole nucleus ring is satisfactory backbone for antifungal activity, (ii) presence of a nitro (-NO2), or carboxylic acid functional group at position C-6 and C-7 of the imidazo [2, 1-b]-benzothiazole

nucleus contributed to a better antifungal, (iii) presence of electron withdrawing group on the C-7 and phenyl ring at C-3 and of the imidazo [2, 1-b]-benzothiazole selleck screening library nucleus favors the activity. These preliminary encouraging results of biological screening of the tested compounds could offer an excellent framework in this field that may lead to discovery of potent

antifungal agent. 1H NMR spectra were measured at 300 MHz with a JEOL GSX 270 ft NMR spectrometer. from Chemical shifts were measured relative to internal standard TMS (δ: 0). 13C NMR spectra were recorded at 67.8 MHz on the same instrument with internal TMS (δ: 0, CDCl3). IR spectra were recorded on a UNICAM series FT-instrument. Mass spectra were recorded on AEI MS 902 or VG ZAB-E-instruments. Microanalyses were performed by MEDAC Ltd, Surrey. Melting points were determined on Gallenkamp capillary melting point apparatus and are uncorrected. Optical rotations were measured in chloroform solution using a Bellingham and Stanley ADP 220 polarimeter. Flash chromatography was performed using Fluka silica gel 60 (230–400 mesh). Thin layer chromatography was carried out using pre-coated aluminum plates (Merck Kieselghur 60 F254) which were visualized under UV light and then with either phosphomolybdic acid or basic aqueous potassium permanganate as appropriate. The appropriately substituted aniline (0.1 mol) and potassium thiocyanate (0.2 mol) were dissolved in 150 mL of glacial acetic acid, cooled in ice, and stirred mechanically while a solution of bromine (0.

S Centers for Disease Control and Prevention for helpful comment

S. Centers for Disease Control and Prevention for helpful comments on the manuscript; Ana Rita de Cássia L. Vasconcelos and, most of all, the immunization program team of the Municipal Health Department of Salvador, Brazil. This study was supported by grants from the Bahia State Foundation for the support of research (PP-SUS0001/2009) and National Program of Post-doctoral (CAPES-PNPD 1472/2008). “
“Human papillomavirus (HPV) vaccines have the potential to significantly reduce the incidence of cervical cancer, the leading cause of cancer mortality among women in sub-Saharan Africa [1] and [2]. Two HPV vaccines have

selleck chemicals now been approved for use in many countries. These provide a high degree of protection against HPV 16/18 infections and associated cervical lesions [3], [4] and [5]. The World Health Organisation recommends offering HPV vaccine to girls at ages 9–14, prior to sexual debut, since the vaccine has highest efficacy if girls have not already acquired

HPV [6]. Many high-income countries and some middle-income countries have started national HPV vaccination programs, either school-based or on-demand programs, with vaccine coverage (completion of the 3-dose regimen) ranging from 9% (Greece) to 32% (US) and 76% (UK) [7], [8], [9] and [10]. INCB024360 mw In sub-Saharan Africa, two vaccine demonstration projects have been completed [11] and [12]; Rwanda has embarked on a national HPV vaccination programme [13] and [14], and Tanzania plans to start a similar programme in 2012. Research in Africa on HPV vaccine acceptability and delivery is needed to understand how best to deliver this vaccine to adolescent girls among populations who have little or no knowledge about cervical Bumetanide cancer, and may be suspicious of vaccines that target young women or a sexually transmitted infection (STI) [15], [16], [17], [18], [19], [20], [21] and [22]. Between August 2010 and June 2011, in preparation for a national HPV immunisation program, a phase IV cluster-randomised trial (NCT01173900) in schoolgirls in Mwanza Region, Tanzania, was conducted to measure the

feasibility, uptake, and acceptability of two school-based HPV vaccine delivery strategies: age-based (all girls born in 1998) or class-based (all girls in Year 6 of primary school in 2010) [12]. We present findings from a qualitative sub-study conducted before the actual HPV vaccination started in August 2010. The sub-study’s objectives were to learn what people knew about cervical cancer and HPV vaccination, whether they would find HPV vaccination acceptable, and how they viewed vaccine delivery and consent procedures. These findings were used to improve sensitisation and vaccination procedures within the trial and to assist preparations for a national HPV vaccination program. The qualitative sub-study study took place in the two districts of Mwanza city and a neighbouring rural district (Misungwi), between March and August 2010.

In order to investigate any correlation between the different ser

In order to investigate any correlation between the different serotypes/serogroups and age, two-tailed Likelihood Ratio (LR) and a multivariable logistic regression was performed. Serotype/serogroup was significantly associated with age (≥65 years; P < 0.001). Subsequent single serotype analysis showed that cases with serotypes/serogroups 6A, 23F, 6B, 11, 14 and 15 infection were most significantly (OR > 2) associated with the age ≥65 years compared to those

infected with the serotypes of the reference group (1 and 7F) ( Fig. 1A). Serotype was also associated with case fatality (P = 0.001) and scrutinizing the individual serotypes revealed that serotypes 3, 19A and 19F were saliently associated with increased case-fatality, compared to the reference

group ( Fig. 1B). As for the manifestations, suffering from pneumonia (P < 0.001), meningitis (P < 0.01) and bacteremia without focus (P < 0.01) was associated by serotype, too. IPD due to serotypes/serogroups 35, 23, 19F and 15 infection were clearly (OR > 2) associated with a bacteremia without focus compared to infection with a reference group serotype Pazopanib 1 and 7F ( Fig. 2A). In addition, meningitis was associated with serotypes 35, 15, 11, 18C and 23F (OR > 6) compared to the reference group. These findings were independent of age, sex and number of comorbidities. As for pneumonia, none of the serotypes was more likely than the chosen reference group. In more detail, serotypes 15, 35, 18C, 19F, these 23, 23F, 6B and 11 were the rarest and resulted in OR < 0.5. As for morbidity, serotype was associated with different numbers of comorbidities (i.e. having at least one versus no comorbidity; P < 0.001). Results displayed that cases infected

with serotypes other than serogroup 8 suffered from one or more comorbidities significantly more often than those infected with the serotypes of the reference group (1 and 7F) ( Fig. 2B). Among these serotypes/serogroups OR were highest for 23, 35, 6B, 19F and 20. Of those, serogroups 20 and 35 are neither covered by PCV7 nor PCV13. Regarding type of comorbidity, immunosuppression (P < 0.001) but not chronic diseases (P = 0.2) and pre-existing underlying respiratory disease (P = 0.4) were significantly associated with serotype using the two-tailed Likelihood Ratio (LR) test. As for the first, cases infected with serotypes/serogroups other than 4 and 8 were more often immunocompromised than those infected with the serotypes of the reference group (1 and 7F) ( Fig. 2C). This population-based study evaluates the serotype epidemiology of invasive S. pneumoniae isolates, from 2003 to 2012 including association of causing serotype with IPD characteristics and case-fatality in adult Swiss residents aged ≥16 years reported from 2007 to 2010. The study period for the latter covered the years after recommendation of the complementary vaccination with PCV7, but before recommendation of PCV13 for infants [13] and [22].

Data presented in this study suggest that for TcdB, the latter ap

Data presented in this study suggest that for TcdB, the latter approach is far from optimal as it omits key toxin-neutralising epitopes. A further important consideration click here in the antigen design is whether the generated antibodies provide protection against a broad range of C. difficile isolates. Antibodies produced with TxA4 potently neutralised TcdA toxinotypes, 0, 3 and 5 with similar efficacy. Potent neutralisation by TxB4 antibodies was also observed against various TcdB toxinotypes albeit with some reduction in neutralising efficacy: <3-fold

against TcdB toxinotypes 3 and 5 and approximately a 7-fold reduction against a TcdB toxinotype 10. It is notable that the latter unusual TcdB Crizotinib molecular weight variant [39] showed least sequence homology compared to TcdB toxinotype 0 (85.7% overall and 88.1% within the central region). In conclusion, the designed constructs TxA4 and TxB4 have several properties which make them attractive as antigen candidates. They can be expressed in a soluble form in scalable, low cost E. coli-based expression systems and were shown to induce the production of antibodies which neutralise

potently key toxinotypes of TcdA and TcdB. In addition, a mixture of the resulting antibodies was shown to afford protection from severe CDI using the hamster infection model. Data presented in the study reveal significant differences between TcdA and TcdB with respect to the domains which evoke a toxin-neutralising immune response. The described antigens will support

large-scale antibody production and so underpin the development of an immunotherapeutic platfom for the treatment of CDI. This report is work commissioned by the National Institute of 3-mercaptopyruvate sulfurtransferase Health Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. The work reported in this study was funded by the Health Protection Agency, NIHR Centre for Health Protection Research and by the Welsh Development Agency (Smart Award). The authors would also like to thank Kin Chan for his assistance in carrying out the fermentation studies and Dr. Ibrahim Al-Abdulla for his assistance in purifying some of the antibody preparations. Conflict of interest statement: The authors declare that they have no conflict of interest. “
“Cervical cancer (CC) is the third most common cancer in women, with an estimated 530,000 new cases worldwide in 2008 [1]. Despite screening, the burden of CC remains high, with 275,000 deaths estimated for 2008 [1]. The burden of CC varies considerably between countries, with 85% of cases and 88% of deaths occurring in developing nations [1] and [2]. Human papillomavirus (HPV) is established as a necessary cause of CC, with HPV identified in 99.7% of CC cases worldwide [3]. The two HPV types most commonly associated with CC are HPV types 16 and 18.

The attenuating effects of exercise on the initial forced swimmin

The attenuating effects of exercise on the initial forced swimming-induced molecular responses in the Wnt inhibitor dentate gyrus may correspond with the reduced state of anxiety in exercising animals. The change in emotionality in these animals may be the result of adjustments in the GABAergic system. We had published that, besides distinct changes in the expression of GABA-A

receptor subunits (e.g. the extra-synaptic receptor associated delta and alpha-5 subunits), regular physical activity led to increased gene transcription of the GABA-synthesizing enzyme GAD67 (Hill et al., 2010). Moreover, our recent preliminary data indicate that GABA synthesis is increased in the dentate gyrus/CA3 of exercising rats (Kersanté et al., unpublished observations). This is an important observation as we have previously reported that GABAergic neurotransmission

is a critical regulator of stress-evoked (pERK1/2- and pMSK1/2-targeted) epigenetic and IEG transcriptional responses in the dentate gyrus (Papadopoulos et al., 2008). We found that a single injection of a non-sedative dose of the anxiolytic benzodiazepine, Lorazepam (a GABA-A receptor allosteric modulator) blocked the novelty stress-induced SB203580 rise in H3S10p-K14ac- and c-Fos-positive granule neurons in the dentate gyrus. Moreover, administration of the partial inverse agonist FG7142 resulted in strongly enhanced novelty-induced increases in H3S10p-K14ac-

and c-Fos-positive neurons in the dentate gyrus (Papadopoulos et al., 2008). FG7142 has been shown to be an anxiogenic drug in rats and humans by lowering GABA-A receptor function (Dorow et al., 1983, Kalueff and Nutt, 1996 and Evans and Lowry, 2007). Additional information on the not role of anxiety state and GABAergic neurotransmission on epigenetic, gene transcriptional and behavioral responses can be found elsewhere (Reul, 2014). Collectively, it seems that the beneficial effects of regular physical exercise on anxiety state and behavioral responses involve the enhancement of GABAergic inhibitory control. Thus, in addition to glucocorticoids, GABA may be an important mediator of the positive effects of exercise on resilience. Studies on the effects of regular exercise (and physical activity in general) on mood and affect in humans have been conducted over the past 20 years. The outcome picture has been rather mixed. For instance, some studies have been published showing improvements in measures of anxiety and depression (Steptoe et al., 1989, Byrne and Byrne, 1993 and Salmon, 2001) whereas an investigation looking into the effects of ‘facilitated physical activity’ in addition to usual care (antidepressant treatment) reported no significant effects (Chalder et al., 2012).

No-targeted MS/MS data was processed by qualitative MassHunter an

No-targeted MS/MS data was processed by qualitative MassHunter and Mass Profiler. A total number of 8261 metabolites at 5000 cps threshold were extracted to avoid false positives. Data was further processed to get molecular features which are significant and differentially expressed in the samples using one way ANOVA with Benjamini-Hochberg correction and fold change analysis. A 40 fold decrease in molecular features was observed after selecting the metabolite with fold change ≥2 and of high abundance.

PCA was performed via transformation of measured variables into uncorrelated principal components, each being a linear combination of the original variables. Analysis of molecular features gave a clear separation in PCA space of the analyzed S. asoca samples

and drugs [ Fig. 2]. Fig. 2A shows more variability among MFs from different plant parts [i.e. bark, regenerated bark, flower and leaves], as compared to that of variability between MFs obtained from hot and cold water extracts of the same part of the plant. The first PCA axis in the analysis of plant parts showed approximately 26.8% of the total variance allowing a full separation of the samples [ Fig. 2A]. It indicates large biological fluctuation in metabolite composition of plant parts. The leading PCA axes for metabolite profiles of the Ashokarista showed 40.87% of the total metabolic variance. These observations reflect that metabolites Androgen Receptor Antagonist research buy in different plant parts are very diverse and extraction procedure [hot and cold water extract] has less effect on variation in molecular features. Interestingly as show in Fig. 2B, major variations were observed only in the Ashokarista formulations as compared to plant parts. Variations in PCA space was due to the marker ions that accounted for the difference among the S. asoca samples and drugs. Additionally, Venn diagram indicated 53.59% variations in between

the formulations of Ashokarishta. SNK Post Hoc test was applied to find out the differentially and non-differentially expressed molecular features. A total number of 637 metabolites were selected on the basis of their frequency across the Adenylyl cyclase samples and significance [p < 0.05]. Table 2 showing the entities found to be differentially expressed and entities found not to be differentially expressed across the samples. PLS-DA, a widely used supervised pattern recognition method capable of sample class prediction was used to construct and validate a statistical model for sample classification and discrimination. The results of sample classification are presented in terms of discrimination and recognition abilities, representing the percentage of the samples correctly classified during model training and cross-validation. The recognition ability of the model was found to be 93.33% which was almost equal to the discrimination ability [94.

Staes et al (2009), on the other hand, reported better reliabilit

Staes et al (2009), on the other hand, reported better reliability for end-feel assessment of accessory intercarpal motion as compared to mobility classifications.

With respect to spinal movement, Haneline et al (2008) similarly found somewhat higher reliability for measurement of end-feel. We hypothesise that measuring physiological movement for joints with large ranges of motion using goniometers or inclinometers, and measuring end-feel for joints with limited range of motion will lead to more reliable decisions about joint restrictions in clinical practice. Since Selleckchem FK228 few studies have investigated reliability of measurement of end-feel or accessory movements in upper extremity joints, future research should focus on the inter-rater reliability of these measures compared with measurements of physiological movements within the same sample of participants and raters. In this review, we found studies investigating inter-rater reliability of upper extremity joint motion examination to have been poorly conducted. Only one study satisfied all external validity criteria Selleck Vemurafenib and only two met all internal validity criteria. None of the included studies was both externally and internally valid. This finding

is no different from that of reviews of reliability of measurements of spinal movement (Seffinger et al 2004, Van Trijffel et al 2005). The majority of the studies in our review met the criterion concerning blinding procedures. However, criteria about the stability of participants’ and raters’ characteristics during the study were often either unmet or unknown. Instability of the participants’ characteristics under investigation, in this case joint range of motion or end-feel, may be caused

by changes in the biomechanical properties of connective tissues as a result of natural variation over time or the effect of the measurement procedure itself (Rothstein and Echternach 1993). Similarly, instability of the raters, in this case their consistency in making judgments, may be caused by mental fatigue. Instability of raters’ or participants’ characteristics can lead to underestimations of reliability, whereas a lack of appropriate these blinding of raters can lead to overestimation. In the presence of all of these methodological flaws, direction of risk of bias is difficult to predict. Factors about internal validity are closely linked to issues of generalisation of results. For instance, performing several measurements on a large number of participants in a limited time period is not only susceptible to bias but also does not reflect clinical practice. Reliability of measurements varies across populations of participants and raters (Streiner & Norman 2008).

In the case of the rPsaA immunized mice, no functional anti-PS an

In the case of the rPsaA immunized mice, no functional anti-PS antibodies were detected. Anti-PsaA antibodies have shown to be opsonophagocytic [58]. The standard and modified OPA in this study were not optimum Crizotinib clinical trial for measuring the functional

antibodies to PsaA. An assay utilizing adherence to human cells may also be used for the detection of functional anti-PsaA antibodies [59]. Even though the mouse model is well established [15] and [35], the murine susceptibility to S. pneumoniae varies primarily because S. pneumoniae does not naturally colonize in mice [51] and [60]. The variation we have observed in our colony counts from one serotype to another may be due to differences in susceptibility. The type of mouse buy ABT-199 strain and phenotype of the bacteria used also may contribute to this varying susceptibility. McCool and Weiser observed differences in density and length of Pnc colonization among three murine strains [51]. The transparent phenotype is thought to play the main role in Pnc colonization, although mixed phenotypes naturally occur in the nasopharynx and in murine colonization studies [25], [51] and [61]. This study demonstrates immunization of mice simultaneously

with rPsaA and PCV7 reduces colonization of non-PCV serotype (19A) without inhibiting immunogenicity of either immunogen. Additional colonization studies with other non-PCV serotypes should be performed to determine whether co-administering rPsaA with PCV7 does further expand coverage to other non-PCV serotypes. If so, the inclusion of additional serotypes to Pnc Ps vaccines may not be necessary for the expansion of protection. This research was supported in part by an appointment of M.J. Whaley to the Emerging Infectious Diseases Fellowship Program administered by the Association of Public Health Laboratories and funded by CDC. We thank

Yvonne Reed and Kay Montgomery for the daily care of the animals and sharing their expertise. The findings of this study are those crotamiton of the authors and do not necessarily represent the views of CDC. “
“Human infection with the pandemic influenza A (H1N1) 2009 virus was first identified in April 2009 [1] and on June 11, 2009 the World Health Organization (WHO) declared a pandemic by raising the worldwide pandemic alert level to phase 6. This novel strain is antigenically and genetically distinct from other H1N1 influenza strains that have been in circulation since 1977 [2]. Consequently, most of the world’s population is thought to have had little or no pre-existing antibody against the pandemic strain. Indeed, serological studies have detected cross-reactive antibodies to the A (H1N1) 2009 virus in 6–9% of adults aged 18–64 years and 33% of adults older than 60 years [3] and [4]. In accordance with WHO recommendations, pandemic influenza vaccines were manufactured using the A/California/07/2009 (H1N1) strain.