These systems are sexually dimorphic (Bangasser and Valentino, 20

These systems are sexually dimorphic (Bangasser and Valentino, 2014), (Gillies et al., 2014), but their role in producing sex differences in fear behavior has only just begun to be studied. find more Until the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) was issued in 2013, PTSD was classified as an anxiety disorder. The symptomatology profiles of anxiety disorders and PTSD overlap substantially, and comorbidity amongst

patients is well-documented (Kessler et al., 1995), (Spinhoven et al., 2014). Like PTSD, anxiety disorders are twice as prevalent in women as in men (Wittchen et al., 2011), an epidemiological phenomenon whose biological basis also remains unknown. The neural mechanisms that underlie anxiety have been studied extensively using animal models like the elevated plus maze (EPM) and open field test (OFT), which are designed to probe the conflicting drives of an animal to both explore yet protect itself from potentially life-threatening situations (Walf and Frye, 2007), (Campos et al., 2013). As is the case with learned fear paradigms, the vast majority of this work has been done in males, but a relatively more substantial body of literature includes females as well. Surprisingly, a majority of studies that use both sexes in these tests find that females display less anxiety than males (Imhof et al., 1993), (Frye et al.,

2000). This discrepancy between the directionality of sex differences in animal and human populations Selleckchem INK128 may be due to inherent problems in the outcome measures of the animal models themselves: specifically, while they may provide accurate indices of

anxiety in males, they may in fact primarily measure general activity in females (File, 2001), (Fernandes et al., 1999). This possibility presents obvious obstacles to the interpretation of sex differences when using these models, and is discussed in detail in an excellent new review by Kokras and Dalla (2014). PTSD is now classified as a “trauma and stress-related disorder,” meaning that exposure to a traumatic event is a primary diagnostic criterion. It could thus be argued that variability in measures of fear and anxiety alone may not identify PTSD resilient and susceptible Non-specific serine/threonine protein kinase subpopulations, but that behavior on these measures after exposure to a distinct stressful event may instead provide better insight. There are many models of stress exposure in rodents; classic approaches include repeated physical restraint, foot- or tail-shock, exposure to predator odor, or a combination of several different stressors (unpredictable mild stress). These stressors activate the hypothalamic-pituitary-adrenal (HPA) axis and can cause alterations in neuronal morphology (Shansky and Morrison, 2009), as well as affect a wide variety of behaviors and learning and memory tasks in both males and females (Shansky, 2009).

The external primers used were 5′-CACGGTACCTCTTTCTTTATCG-3′ (KpnI

The external primers used were 5′-CACGGTACCTCTTTCTTTATCG-3′ (KpnI restriction site underlined) and 5′-GGTTCTCTGCAGAGACATGC-3′ (PstI restriction site underlined). The internal primers responsible for introducing the mutation leading to the amino acid replacement

G33D were 5′-GAATCGATGGCAGATAAAAG-3′ and 5′-CTCTTTTATCTGCCATCGAT-3′. The amplification reactions were performed PS-341 clinical trial as described previously [39]. The resulting fragment was purified using a gel purification kit (Ilustra™ GFX™ PCR DNA and Gel Band Purification Kit, GE Healthcare), digested with restriction enzymes and then ligated into the corresponding KpnI and PstI sites of the linearized pBSPKS (−) vector [41], generating the recombinant plasmid pKSLTG33D. The pKSLTG33D plasmid was subsequently introduced into chemically competent E. coli DH5α bacteria. One bacterial clone carrying the correct plasmid was named LDVLTG33D. The correct sequence of the etxG33D gene was confirmed by DNA sequencing. LTG33D was purified by galactose-affinity

chromatography following a standard LT purification procedure [40]. Briefly, the LDVLTG33D lineage was cultivated in Terrific Broth (TB) [42], TGF-beta inhibitor containing 200 μg/ml of ampicillin, overnight at 37 °C in an orbital shaker set at 200 rpm. Cells were suspended at a 10% (w/v) concentration in TEAN buffer (50 mM Tris; 1 mM EDTA; 3 mM azide-Na and 200 mM NaCl; pH 7.5) and lysed by mechanical shearing in an APLAB-10 homogenizer (ARTEPEÇAS, Brazil). The soluble extract was applied into

a XK 16/20 column (GE Amershan Biosciences) containing immobilized d-galactose gel (Pierce), extensively washed with TEAN buffer prepared with pyrogen-free water, and subsequently eluted with TEAN buffer containing 0.3 M Rutecarpine galactose. The final amount of LTG33D was determined in GeneQuant spectrophotometer (GE Amershan Biosciences). The purification of the DENV2 NS1 recombinant protein was achieved after denaturation/refolding steps of the protein expressed in bacterial cells and affinity chromatography, as previously reported [36]. Endotoxin levels in LTG33D and NS1 preparations were determined with the Chromogenic Limulus Amebocyte Lysate assay (Cambrex Bio Science) [43]. The recombinant NS1 and LTG33D proteins were analyzed for purity and antigenicity by SDS-PAGE and Western blot. Protein aliquots (2 μg) were sorted in 15% polyacrylamide gels after heat treatment (100 °C for 10 min) or kept at room temperature with sample buffer [36] and [44]. Standard ELISA assays were performed as previously described [36] and [45]. The recombinant NS1 protein was tested in the non-heated or in heat-denatured state with serum samples collected from a DENV2-infected individual (kindly supplied by Dr. Bergman M. Ribeiro, Brasília University, FD, Brazil). A serum sample generated after immunization of mice with heat-denatured (100 °C for 10 min) NS1 in FA after the same immunization regimen described bellow (Fig.

The drawbacks of the study are as follows: all stool samples coll

The drawbacks of the study are as follows: all stool samples collected were primarily analyzed by ELISA for detection of rotavirus antigen; tests for the detection of other pathogens were not performed. As a result all cause gastroenteritis in infants with shedding was classified as rotavirus gastroenteritis. The ELISA test used for detecting rotavirus shedding in transmission cases may not be sufficiently sensitive to detect low concentrations of the viral antigen. The results of this study showed that transmission of the Rotarix™ (HRV) vaccine strain

occurred in twins living in the same household in a developing country. The transmission of the vaccine strain to the placebo recipients was not associated with any safety concerns. Although protection afforded through indirect protection can be expected theoretically, it remains unknown at this stage selleck chemicals whether transmission of the HRV vaccine strain to unvaccinated population could JNJ-26481585 indeed help in reducing rotavirus disease burden. We thank the infants and their families for participating in this trial; all investigators, the study nurses, and other staff members for contributing in many ways to this study in particular. We are indebted to Keerthi Thomas and data management team: Giovanny Alcantara, Hospital Maternidad

Ntra Sra de la Altagracia for acquisition of data; to Yolanda Guerra and safety team for management of safety information; to Catherine Bougelet and team for laboratory testing; to DDL Diagnostic Laboratory, The Netherlands to perform the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and VP4 and VP7 genotyping; to Pascale Dieryck and Frederic Henry for global study management. The authors thank Geetha Subramanyam and Nancy Van Driessche for providing writing and editorial support in preparing this manuscript (both are employees of GSK). Rotarix and Infanrix hexa are trademarks of GlaxoSmithKline group of companies. Contributors: All authors were involved at study conception and design stage and/or acquisition of data, analyses and/or interpretation of data; draft/critical Sodium butyrate revision of the article and final approval of the

manuscript. Conflict of interest statement: Drs. L. Rivera and L. Peña do not have any conflicts of interest to declare. I. Stainier, P. Gillard, B. Cheuvart, IV Smolenov, E. Ortega-Barria and H.H. Han are employed by the GlaxoSmithKline Group of Companies. Drs. Han, Ortega-Barria, Gillard and Smolenov have stock ownership. Funding: GlaxoSmithKline Biologicals, Belgium. “
“Neisseria meningitidis is a human pathogen and one of the major causes of bacterial meningitis [1]. Polysaccharide vaccines available both in protein conjugated and non-conjugated form, have been introduced against capsular serogroups A, C,W-135 and Y, but are ineffective against serogroup B meningococci, which cause a significant burden of disease in many parts of the world.

3B and C) Although S-IgA in saliva may not obtain access to bact

3B and C). Although S-IgA in saliva may not obtain access to bacteria accumulated within gum pockets, it is worth investigating check details whether S-IgA can eliminate the halitosis generated from plaque biofilms on the surface of mouse incisors and/or oral epithelium. Furthermore, since both IgG in serum and S-IgA in saliva were measurable in FomA-immunized mice, determination of other IgG subclasses (such as IgG1 and IgG2a) [25] and cell-mediated immunity may increase understanding of the potency of FomA-targeted vaccines. A qualitative

and quantitative examination of biofilm formation in vivo is still a challenge. Recently, a novel combination of measurements using an integrated nuclear magnetic resonance and confocal laser scanning microscope have been developed to study the processes occurring within biofilm communities [52]. These techniques may provide new tools for evaluation of the effects of vaccination on biofilm formation in vivo. Overall, we have demonstrated that FomA is a necessary component for co-aggregation of F. nucleatum with P. gingivalis. Bacterial co-aggregation

resulted in an enhancement of biofilm formation and VSC production in vitro and gum inflammation in vivo. Blocking FomA with a neutralizing antibody Alpelisib order significantly attenuated this enhancement. Vaccination targeting FomA effectively suppressed co-infection-induced gum swelling and the production of MIP-2 cytokine. These results strongly suggested that FomA is critical mediator for bacterial co-aggregation and its associated pathogenicities. Inhibition of co-aggregation by inactivation of F. nucleatum FomA will prevent the progress of oral infections at an early stage. F. nucleatum and P. gingivalis have been implicated in the pathogenesis of several diseases [5], including urinary tract infections, bacteremia, pericarditis, and disorders of the oral cavity Bumetanide such as pulpal infections,

alveolar bone abscesses, periodontal disease and halitosis. The immunization approach developed in this study will benefit patients with diseases mentioned above. Most importantly, the concept of blocking bacterial co-aggregation and biofilm formation forms a model system for the study of other biofilm-related pathogenic phenotypes, including those that develop in skin ulcers and other chronic infections. This work was supported by National Institutes of Health Grants (R01-AI067395-01, R21-R022754-01, R21-I58002-01 and 1R41AR056169-01). We thank Dan MacLeod for critical review. “
“The authors would like to apologise for an error appearing in Fig. 4A in their paper. The correct version of the figure appears below. “
“Rather than pVenv4, a pSC11-based plasmid was used that encoded a lengthier BH10 envelope sequence. The predicted envelope sequence encoded by this construct extended to amino acid position 723 (based on the nomenclature of Owens et. al., J. Virol. 68 (1994) 570–574), and was followed by amino acids GDPTGPKE at the C terminus.

La pathologie myocardique sous-jacente constitue un substrat aryt

La pathologie myocardique sous-jacente constitue un substrat arythmogène et l’exercice physique intense crée l’environnement favorable à l’apparition et au développement de cette arythmie. L’accident est précédé de prodromes dans seulement la moitié des cas [6] and [9]. La survenue d’une arythmie fatale inaugurale, alors que le sportif est régulièrement exposé aux contraintes de l’exercice, reste inexpliquée. Après

35 ans, la maladie coronaire est la première cause des décès. Avant 35 ans, les cardiopathies congénitales ou génétiques this website dominent largement. Les principales causes de mort subite chez le jeune athlète sont, sans hiérarchie vraiment établie, la cardiomyopathie hypertrophique, l’anomalie de naissance des coronaires, la maladie arythmogène du ventricule droit, la myocardite, les canalopathies mais aussi la coronaropathie [11], [12], [13] and [14]. La cardiomyopathie hypertrophique (15 à 35 %) est une anomalie génétique complexe et polymorphe, qui génère des troubles du rythme ventriculaires potentiellement mortels à l’effort quelle que soit son intensité, Kinase Inhibitor Library mais également au repos. L’anomalie de naissance des coronaires (15 à 20 %) avec trajet

anormal entre les gros vaisseaux de la base, peut être responsable d’une ischémie myocardique lors d’efforts intenses, à l’origine d’un trouble du rythme ventriculaire éventuellement mortel. La mort subite est souvent inaugurale et son diagnostic préventif difficile. Toute symptomatologie évocatrice liée à l’effort (douleurs, malaises,

syncopes, palpitations chez l’enfant) doit être respectée et bénéficier d’un bilan cardiovasculaire avant de conclure hâtivement à une douleur pariétale, un malaise vagal, une hypoglycémie ou une crise d’épilepsie [23]. Le diagnostic positif repose sur le scanner coronaire ou l’IRM. La maladie arythmogène du ventricule droit (5 à 20 %) se caractérise par le développement de plaques fibro-adipeuses dans le ventricule droit plus souvent que gauche. Cette pathologie, le plus souvent génétique, concerne les protéines constitutives des desmosomes, zones de jonction intercellulaires. no La myocardite (6 à 12 %) fait suite à un épisode infectieux viral. Elle est parfois silencieuse cliniquement. La fréquence des canalopathies (10 %), affections génétiques touchant la repolarisation et/ou les mouvements calciques intra-cellulaires des cardiomyocytes, est sous-estimée vu la rareté des tests génétiques lors de l’autopsie [20]. La fréquence de la coronaropathie (10 à 15 %) augmente dans cette population jeune. D’autres causes plus rares, comme le syndrome de Wolff-Parkinson-White, la dissection aortique, les valvulopathies obstructives (rétrécissements aortique ou pulmonaire surtout) sont parfois rapportées. Il ne faut pas occulter le rôle potentiel du dopage qui concerne tous les niveaux sportifs.

The combined study based on the computational and experimental te

The combined study based on the computational and experimental techniques helped in identifying novel inhibitors that bind to SAM binding site.21, 22 and 23 The present work is to identify the inhibitor lead molecules for Flavivirus NS5 MTase using computational approach. The

dengue MTase has separate binding sites for RTP and SAM. E-pharmacophore studies were performed using both the sites for studying the substrate and inhibitor binding in the active site of MTase. Finally, these pharmacophores were used as queries for virtual screening using compounds from the Asinex database and induced fit docking (IFD) was carried out for the short-listed compounds. The identification of pharmacophore features

was carried out by aligning all the compounds together in a 3D Cartesian space. The earlier studies focused on the structure-based buy Tenofovir virtual screening and ligand-based pharmacophore models, keeping the active site of the protein rigid.18, 19 and 20 AT13387 The structure-based pharmacophore was used to derive pharmacophore features from the inhibitors or substrates that bind at different sites, separately. The X-ray crystal structures of the dengue MTase complex, MTase–SAM complex (PDB id: 3P97), MTase–SAH complex (PDB id: 1R6A), MTase–RTP complex (PDB id: 1R6A) specific to the Flavivirus were retrieved from Protein Data Bank. 25 During protein preparation, water molecules were removed, hydrogen atoms were added, bond orders were assigned and orientation of hydroxyl groups were optimized. Energy minimization was carried out using OPLS2005 force field to converge RMSD of 0.30Å. The receptor grid was generated around the centroid of the ligand contained by enzyme file and the ligands with cut off size of 10 Å were allowed to dock. The ligands were docked with the active site using the ‘Extra Precision’ Glide algorithm. 26 and 27 Glide includes ligand–protein interaction energies, hydrophobic interactions,

hydrogen bonds, internal energy, π–π stacking interactions and root mean square deviation (RMSD) and desolvation. Finally, best pose of the particular ligand was selected based on the Glide all score. Energy-optimized pharmacophores (e-pharmacophores)28 were evaluated through mapping the energetic terms from the Glide XP scoring function onto atom center. Pharmacophore sites were automatically generated from the protein–ligand docked complex with Phase (Phase, v.3.0, Schrodinger, LLC) using the default set of six chemical features, hydrogen bond acceptor (A), hydrogen bond donor (D), hydrophobic (H), negative ionizable (N), positive ionizable (P), and aromatic ring (R). Glide XP descriptors include terms for hydrophobic enclosure, hydrophobically packed correlated hydrogen bonds, electrostatic rewards, π–π stacking, π cation and other interactions.

(2014) in their recent systematic review found that community-wid

(2014) in their recent systematic review found that community-wide interventions reported a positive effect on children’s weight status.

It is therefore recommended that Small molecule library any commissioning decisions to target specific schools for obesity prevention need to be based on robust data and, as is increasingly being recognised, consideration needs to be given to how any obesity prevention interventions will affect the wider environment and extend beyond the school gates. The authors declare that there are no conflicts of interest We thank the reviewers for their constructive comments. The authors would like to thank the staff of Devon County Council (including the former NHS Devon) for their advice throughout the project and for supplying the data. In particular we

thank Dr Virginia Pearson, Ian Tearle, Jane Batten, Teresa Lawless, Steve Kibble and Lucy O’Loughlin. AJW is funded by a Medical Research Council Doctoral Training Grant (MRC DTG PCMD/GS002) and Sport and Health Sciences, University of Exeter. SL, KMW, and WEH are partially supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Selumetinib Health Research and Care (CLAHRC) for the South West Peninsula. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health in England. “
“Colorectal cancer (CRC) is a leading cause of global cancer burden among men and women (Ferlay et al., 2010). In the United Kingdom (UK), CRC is the third most common incident cancer and cause of cancer death, Digestive enzyme with over 40,000 new cases and over 15,000 deaths in 2010 (Cancer Research UK, 2013). England is one of the first countries worldwide to implement a national, organised, publicly available screening

programme using the faecal occult blood test (FOBT). The screening programme, entitled the National Bowel Cancer Screening Programme, is operated through the National Health Service (NHS) and was fully implemented in 2010. All adults aged 60–69 (currently being extended to 74) are eligible and receive a written screening invitation through the post with screening information and the home-based FOBT kit biennially beginning in the year of the 60th or 61st birthday. Although the FOBT reduces mortality (Hewitson et al., 2008 and Mandel et al., 1993), overall uptake of screening in England is low and substantially socially graded. An analysis of the first 2.6 million invitations to the programme from 2006 to 09 found that overall uptake was 54%, but was substantially lower among men and among adults living in deprived and ethnically diverse neighbourhoods (von Wagner et al., 2011). A further source of inequality in CRC screening participation in England may be low health literacy. Health literacy is defined as an individual’s capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (Institute of Medicine, 2004).

paeoniifolius have anxiolytic activity in mice in the open field

paeoniifolius have anxiolytic activity in mice in the open field model. A. paeoniifolius did not show

any significant increase in anxiolytic activity using the light and dark test. Fig. 3 The present work demonstrates that the petroleum ether extract of A. paeoniifolius has anxiolytic activity in mice using behavioural parameters, like elevated plus maze and open field test paradigms. The phytochemical tests of petroleum ether extract of A. paeoniifolius revealed the presence of steroids, carbohydrate, fat & fixed oil. The EPM is one of the most popular behavioural models of anxiety. Increase in the number of entries and time spent in open arm are considered to be the most representative indices of anxiolytic see more activity. In EPM, mice will normally prefer to spend much of their allotted time in the closed arms. This preference appears to reflect an aversion towards open arm that is generated by fear of open spaces. Drugs that increase open arm exploration are considered to be anxiolytic & the reverse holds true for anxiogenics.11 In this study,

A. paeoniifolius (150 & 200 mg/kg) induced significant increase in the both the number of entries and time spent in open arms in a dose dependent manner compared to control animals. The open field Idelalisib concentration test model examines anxiety related behaviour characterized by the normal aversion of the animal to an open, brightly lit area. 12 Data obtained from this model also showed anxiolytic activity of petroleum ether extract of A. paeoniifolius as it significantly increased in the number of rearings and number of square crossed in the open field compared to the vehicle treated group. The light and dark paradigm is based Thymidine kinase on the natural aversion of mice to brightly lit places. Anxiolytics reduce the natural aversion to light and increase the time spent in the in the brightly lit compartment. 13 However

in this model, compared to vehicle, A. paeoniifolius did not produce any significant increase in time spent in the lighted box. This may suggest that light and dark task may be less sensitive or a different component of anxiety is assessed in the light and dark test compared to elevated plus and open field test as reported by others. 14, 15 and 16 The anxiolytic, anticonvulsant, muscle relaxant, and sedative hypnotic actions of benzodiazepines make them the most important GABAA modulating drugs. A. Paeoniifolius have synergistic action with diazepam, 4 hence the mechanism responsible for its anxiolytic activity may be similar to benzodiazepines, mediated by inhibitory neurotransmitter GABA. The result obtained in this study suggests that, the petroleum ether extract of A. paeoniifolius containing steroids, fats & fixed oil possess anxiolytic activity. The current study was carried out using crude extract and further studies are needed to ascertain the main phytoconstituents responsible for this pharmacological action.

Finally, the ASHT-protocol does not provide details regarding enc

Finally, the ASHT-protocol does not provide details regarding encouragement. Verbal encouragement was given to stimulate children to attempt BLU9931 mw their very best. The content of encouragement was the same for all children, and the type and volume was kept as consistent as possible. Unfortunately, the goal of including 200 children

for each age group was not achieved in the two oldest groups, owing mainly to the fact that participation of high schools was difficult to arrange. Also, we did not systematically record exactly how many children refused to participate. However, the available data indicate that only a marginal proportion of children refused, which makes the data highly representative. Other limitations are a direct result of the exclusion criteria, meaning results can only be applied to the healthy population and cannot be extrapolated to other age groups. In summary, this study presents reference values for grip strength in children. These reference values for both the dominant and the non-dominant hand are provided graphically according

to gender and age, to facilitate comparison to patients’ values. These graphics also allow monitoring of progression over time. In addition the results of this study show that gender, age, height, and weight are strongly associated with the development of grip strength in children. Finally, detailed equations are provided to give a more precise prediction regarding Histone Methyltransferase inhibitor a specific patient when height and weight

are known. Ethics: The study was conducted in accordance with the regulations of the METC Institutional Review Board of the University Medical Center Groningen. Children were included in the study after permission of parents had been given. However, it was also ensured that each child knew the examination was not mandatory, and children were not included if they did not want to participate. Support: None. Competing interests: There are no competing interests. The authors thank all the children, their parents, and the schools for their contribution to this study as well as the students who aided the researchers with measurements. The authors also thank PU Dijkstra, A Shepherd, RE Stewart, many and WFA Klijn for their assistance. “
“Running is widely known to be beneficial for general health (Marti 1991, Williams 1997, Williams 2007, Williams 2008). However, one of the consequences of running is running-related injuries (RRI), with incidence rates ranging from 18.2% to 92.4% (Satterthwaite et al 1999, van Gent et al 2007, Van Middelkoop et al 2008a) or 6.8 to 59 injuries per 1000 hours of running exposure (Bovens et al 1989, Buist et al 2010, Lun et al 2004, Lysholm and Wiklander 1987, Rauh et al 2006, Wen et al 1998).

Where partial clinical efficacy is demonstrated availability of s

Where partial clinical efficacy is demonstrated availability of standardised assay data will maximise the chances of identification of correlates of protection which can then be used to iteratively improve vaccine efficacy. Where efficacy is absent, confidence in immunological outcome data is equally important to allow developers to make conclusions Bioactive Compound Library cell assay about whether the vaccine concept has been tested to failure and can thus be confidently terminated. A coordinated multilateral approach to assay harmonization, standardization and identification of central testing centers is underway and will be critical for the development of a highly

effective second generation malaria vaccine. Many in the malaria R&D arena feel that such a vaccine will be necessary if malaria transmission is to be successfully interrupted in high malaria transmission buy CT99021 settings. Thus

the drive towards validated assays for immunological outcomes in malaria vaccination may prove vital if malaria is ever to be eradicated globally. The views expressed in this article are those of the authors and do not necessarily represent the views, opinions or stated policy of the World Health Organization. “
“In many parts of the developed world, uptake of measles–mumps–rubella (MMR) vaccine is suboptimal [1], [2] and [3]. The most recent UK data show uptake of the recommended 2 MMR doses by 5 years [4] stands at 84.8% [5], in comparison with the WHO target of 95% [6]. In one UK study, failure to immunise with MMR was attributed to conscious parental choice in around 75% of cases [7], arguably at least in part a legacy of the purported link between MMR and autistic enterocolitis [7], [8], [9] and [10]. The paper from which the controversy stemmed, published by Dr Andrew Wakefield and colleagues in 1998 [11], detailed a case series of 12 children presenting within a few days of receiving the MMR vaccine with inflammatory

bowel symptoms and a loss of language and other basic skills. Parvulin That paper, since discredited on methodological and ethical grounds [12], did not actually provide empirical evidence of a link between MMR and autism, and subsequent studies have shown no association [13], however substantial and sustained media attention around the purported link [14] and [15] was sufficient to create fear and uncertainty in a generation of parents [13] and [16]. MMR uptake has still not fully recovered – coverage remains lower than it was before the controversy took hold [17] and [18] – but it is slowly and steadily increasing [18]. The diseases against which MMR protects are highly contagious and symptoms can be severe: 40% of European measles cases in 2009, and 23% of US measles cases in 2001–2008, were hospitalised [19] and [20], and up to 9% of cases experience otitis media, pneumonia or diarrhoea [4].