BACKGROUND Given the increasing incidence of measles, the aim was to assess the seroprevalence of measles immunity among employees of a Czech tertiary care hospital and to assess their willingness to revaccination. METHODS 3027 hospital employees (2421 females, 606 males) underwent a serological analysis of their measles antibody levels with an option of revaccination in case of an insufficient level. RESULTS The median age of participants was 42 years. Seropositivity was noted in 54% of the participants, with the antibody values higher in the oldest study participants and with a decrease around the birth year 1968. Logistic regression analysis confirmed a significant relationship of seropositivity with age (odds ratio 0.97, p  less then  0.005). Out of the seronegative, 80.9% individuals got revaccinated. CONCLUSIONS 46% of the participants did not reach a sufficient antibody level set by the assay's manufacturer. Although the routine vaccination system is well established it may be ineffective. INTRODUCTION CD4+ T cells are essential for inducing optimal CD8+ T cell and antibody-producing B cell responses and maintaining their long-term immunological memory. Therefore, CD4+ T cells are a critical component in HIV vaccine development. Due to enormous viral gene variation and significant human host genetic diversity, HIV vaccines may need to be custom-made for different countries. METHODS Previously, we designed a CD4+ T cell vaccine based on Chinese HIV isolates and HLA-DR alleles using bioinformatics tools and predicted that 20 epitopes could cover 98.1% of the Chinese population. In vivo testing of the poly-epitope antigen in mice only activated specific T cells for some epitopes. To elucidate the mechanism of the observed differential immunogenicity, we examined poly-epitope antigen processing and presentation using in vitro and in vivo analytical methods. RESULTS Enzymatic digestion indicated that all 20 epitopes comprising the poly-epitope antigen could be liberated, but MHC II binding assays showed that neither binding affinity nor dissociation rate was associated with the magnitude of T cell immune responses elicited by each peptide epitope in vaccinated mice. Mass spectrometry analysis of MHC II-bound peptides suggested that the abundance of endogenously processed peptides bound to MHC II molecules was significantly associated with the relative immunodominance of these epitopes. CONCLUSION These results provide a new rationale for improving the design and testing of poly-epitope vaccines for HIV and other diseases. https://www.selleckchem.com/products/msdc-0160.html In addressing end-of-life care in veterinary medicine, the role of the veterinary technician can have a profound impact on quality of life during the final days in a pet's life. The role of the veterinary technician in end-of-life care is multifaceted, as duties range from nursing care to social and emotional support for pet caregivers. Human hospice care is helpful as a a model to better understand the importance of palliative care in animals. The skills of the veterinary technician are well suited for caring for hospice and palliative care patients. This article demonstrates and reviews how a technician's expertise is used in end-of-life care including assistance in the euthanasia process. BACKGROUND This contemporaneous large multicenter retrospective study reflective of current practice, assesses the impact of patient factors, prosthesis selection, and implant features on the risk of dislocation after hip hemiarthroplasty for femoral neck fracture. METHODS Radiographic records for 4116 consecutive patients who underwent a hip hemiarthroplasty between January 1, 2009 and September 30, 2017 at 3 acute hospitals (including a regional major trauma center) for a neck of femur fracture were reviewed in conjunction with United Kingdom National Hip Fracture Database records. RESULTS In total, 4116 patients were eligible for inclusion in the study; 63 of 4116 (1.5%) dislocations were identified. Patient age, gender, preoperative abbreviated mental test score, postoperative abbreviated mental test score, and American Society of Anaesthesiologists grade were not found to be significant predictors of dislocation rates (P less then .05). The Furlong prosthesis was the most commonly used implant (2280/4116, 55.4%) followed by the Exeter V40 + Unitrax head (1179/4116, 28.6%), other implants used during the study period were the monoblock Austin-Moore and Thompson implants. Hemiarthroplasty operations undertaken with the Thompson (24/273, 3.7%) were found to have significantly higher dislocation rates (P less then .05). Cemented vs uncemented, variable vs fixed offset, and monoblock vs modular implant designs did not contribute to higher dislocation rates (P less then .05). Surgeon seniority was also not a significant risk factor for subsequent dislocation (P less then .05). CONCLUSIONS Thompson hip hemiarthroplasties are associated with higher dislocation rates when compared to a contemporaneous cohort of implant choices and considerations for their use should be made in conjunction with this major risk factor for the need for subsequent operations. BACKGROUND Pulmonary hypertension in response to exercise is a marker of the hemodynamic severity of mitral stenosis (MS). However, the factors related to elevated pulmonary pressure with exercise are not well defined. The aim of this study was to assess the parameters associated with the pulmonary pressure response to exercise in patients with pure rheumatic MS. An additional aim was to determine the impact of exercise-induced pulmonary hypertension on clinical outcome. METHODS One hundred thirty patients with MS (94% women; mean age, 45 ± 11 years) underwent exercise echocardiography. A range of echocardiographic parameters were obtained at rest and at peak exercise. Symptom-limited graded ramp bicycle exercise was performed in the supine position. The primary end point was mitral valve intervention, either percutaneous or surgical. RESULTS In the overall population, systolic pulmonary artery pressure (SPAP) increased from 38.3 ± 13.4 mm Hg at rest to 65.8 ± 20.7 mm Hg during exercise. Increases in mean mitral gradient, right ventricular function, left atrial volume, and net atrioventricular compliance were independently associated with SPAP at peak exercise, after adjusting for changes in heart rate.