27 Subplate neurons, a transient cell population important for developing thalamocortical connections, are also vulnerable.28 Thalamocortical connections are disrupted in preterm infants,29 and altered functional connectivity in children and adolescents born preterm is an important risk factor for adverse cognitive outcomes.25,30

see more Importantly, there is altered cortical activation and functional connectivity during language and visual spatial processing in children and adults born preterm who have normal intelligence.30–33 Procedural pain/stress in very preterm infants is associated with abnormal brain development in the NICU, above and beyond other clinical risk factors associated with prematurity.34,35 Inhibitors,research,lifescience,medical These Inhibitors,research,lifescience,medical findings are consistent with animal studies revealing that inflammatory pain or acute pain from repeated injections increased apoptosis in the neonatal rat brain.36,37 Altered microstructure may be related to pain-related increases in proinflammatory cytokines in the periphery and the central nervous system, or over-stimulation of immature neurons.35,38,39 Inhibitors,research,lifescience,medical Pain-related stress may also have indirect effects on the brain, or may interact

with other factors implicated in development, since our group found that greater neonatal pain/stress exposure (adjusted for clinical confounders) is associated with slower body and head growth in preterm infants from early in life to term-equivalent Inhibitors,research,lifescience,medical age,40 and on diffusion tensor imaging slower growth was associated with altered cortical gray matter in infants born very preterm.41 Mechanisms whereby pain-related stress exposure may affect multiple systems remain to be addressed. Diffusely abnormal microstructure and metabolism42 and altered functional

connectivity relative to term controls29 are associated with adverse neurodevelopment.22–28,30,41,43 Rodent studies provide strong evidence that early life experience can alter both the structure and function of the developing brain.44 In humans, exposure to stressors in the NICU is associated with regional alterations in brain structure and function. In two independent cohorts, Grunau, Miller, and colleagues Inhibitors,research,lifescience,medical found that greater neonatal procedural pain/stress (adjusted for clinical confounders including gestational age (GA), early illness severity, infection, surgeries, and duration of mechanical ventilation) is associated with altered brain development of preterm infants in the neonatal period35,45 and at school-age.31,46,47 We also too showed that neonatal pain/stress is associated at age 7 years with altered IQ that is mediated by brain microstructural changes.46 Others found that neonatal brain maturation on MRI is improved (compared to standard care)by an intervention designed to help parents recognize and respond to stress in their preterm infant in the NICU.48 This parent stress-reduction intervention shows that effects of reduced neonatal stress can be detected on brain images with advanced MRI techniques.

Telomerase reverse transcriptase (TERT) is an enzyme required for the proliferative capacity and survival of cells. It is an RNA-dependent DNA polymerase responsible for de novo elongation of telomere repeats at the chromosome termini, by adding telomeric repeats to the 3’ end of the telomeric strand, through copying of the template sequence present in Inhibitors,research,lifescience,medical its RNA moiety (21, 22). Low level of telomerase activity has been discovered in mitotically active cells, including skin, lymphocytes, and endometrium and stem cells (23). In the present study we find significantly decreased levels in telomerase activity among DMD patients compared to controls. Evidence support that, a correlation

Inhibitors,research,lifescience,medical is observed between the level of induced telomerase activity and change in telomere length, such that telomere lengthening rather than telomere loss was found in cells when telomerase activity reached relatively high levels; conversely, telomere loss was evident when telomerase activity was low (24). The decrease in telomerase activity observed in DMD

patients compared to controls can be attributed to the fact that increased oxidative stress induces a decrease Inhibitors,research,lifescience,medical in telomerase activity (25). Bax genes expresses a Bax, a pro-apoptotic Bcl-2 family member, can heterodimerize with either Bcl-2 or Bcl-xL to nullify their anti-apoptotic properties (26). Increased Bax mRNA expression has been observed in ageing human lymphocytes (27, 28). Exercise loading caused an increased expression in Bax localization in muscular dystrophy animal model (29). Meaning that oxidative stress due to exercise in DMD brings damage similar to that observed in aging, which coincide with our results. An aging hypothesis states that aged tissues are Inhibitors,research,lifescience,medical characterized by the accumulation of a variety of types of advanced glycation end products (AGEs), which are the products of nonenzymatic glycation and oxidation of proteins and lipids and DNA (30, 31). RAGE is a multiligand receptor

of the immunoglobulin superfamily expressed in almost all body cells including endothelial cells, Inhibitors,research,lifescience,medical monocytes, neutrophils, myoblasts and vascular smooth muscle cells (32). RAGE has been identified as receptor, which binds β-sheet fibrils characteristic of amyloid; proinflammatory cytokine-like mediators of the S100/Selumetinib chemical structure calgranulin Digestive enzyme family. Engagement of RAGE by these ligands activates key signal transduction pathways, such as p21ras, erk 1/2 kinases and nuclear factor-κB in endothelial cells, monocytes, and vascular smooth muscle cells (33). This cascade of events leads to RAGE-mediated-enhanced expression of proinflammatory mediators. Evidence support that RAGE mediate the effects of AGEs by both ligand engagement and signal transduction (34). There was a significant increase in RAGEs mRNA expression in peripheral blood mononuclear cells of DMD compared to controls.

To all the calibration standards (0.2 mL)

or QC samples (0.2 mL) taken in polypropylene tubes, 50 μL of internal standard was added and vortexed for 30 s. 0.25 mL of 2.00% ortho phosphoric acid in water was added to the plasma samples, vortexed for 30 s. The samples were transferred to a 1 cc/30 mg Oasis HLB SPE column, which had been conditioned with 1.0 mL methanol, followed by 1.0 mL water. After application of the samples, the SPE column was dried for 1.0 min by applying positive pressure at maximum flow rate. The column was eluted with 1.00 mL mobile phase. The SPE eluates were transferred into 1 mL LC vials for injection of 10 μL into the LC system. Validation was carried out according to the US Food and Drug Administration (FDA) Bioanalytical Method Validation Guidance.20 and 21 VE-822 molecular weight Accuracy, precision and linearity of the calibration curve were determined. Intra- and inter-day precision were carried out on three different days. Each validation run

consisted of a minimum of one set of calibration standards and six sets of QC samples at four concentrations. Recoveries of AMX, CLV, Libraries AMX-D4 and AMP in aqueous solutions were determined at lower limit of quantification (LLOQ QC), low QC (LQC), medium QC (MQC) and high QC (HQC) levels. The stabilities of the stock solution, bench top, autosampler solutions, long term and freeze–thaw stability Ceritinib ic50 were carried out. For specificity, six different lots of blank plasma were evaluated for any interference at the retention

times of AMX, CLV, AMX-D4 (IS) and AMP (IS). Selectivity was carried out by analyzing the six blank plasma samples spiked with AMX and CLV (LLOQ level) and IS. Matrix effect was assessed by comparing the mean area responses Terminal deoxynucleotidyl transferase of samples spiked after extraction with those of standard solutions in mobile phase at low and high QC levels. The linearity of the method was evaluated using bulk spiked plasma samples in the concentration range as mentioned above using the method of least squares. Five such linearity curves were analyzed. Each calibration curve consisted of a blank sample, a zero sample (blank + IS) and eight concentrations. Samples were quantified using the ratio of peak area of analyte to that of IS. A weighted linear regression (1/concentration) was performed with the nominal concentrations of calibration levels. Peak area ratios were plotted against plasma concentrations. The extraction efficiency of AMX and CLV was evaluated by comparing the mean peak responses of three QC samples 150.30, 9411.75 and 18823.24 ng/mL of AMX and 76.98, 2368.62 and 4737.23 ng/mL of CLV concentrations to the mean peak responses of three standards of equivalent concentration. Similarly, the recovery of IS was evaluated by comparing the mean peak responses in the three quality control samples to mean peak responses of three standards at a concentration of 9411.62 ng/mL of AMX-D4 and 2368.62 ng/mL of AMP.

3mL. The Carfilzomib order cumulative amount of DE permeated through skin was plotted versus time (h). Each data was expressed as mean ± SD of three determinations. The steady-state flux value (Jss) was calculated from the slope of linear portion of cumulative amount permeated-time plots for a zero-order model and expressed as the mass of DE passing across 1cm2 of skin over time. The enhancement ratio (ER) was determined using the following equation: ER=Flux  (with  enhancer)Flux  (without  enhancer)  . (2) 2.5.

Characterization of Developed MDTS Formulations The qualitative tests performed for the MDTS formulations included the evaluation of spray pattern, effectiveness Inhibitors,research,lifescience,medical of pump seal, average weight per metered dose, and content uniformity [13]. The spray pattern was assessed by delivering the spray through the MDTS onto paper. To maintain a constant distance between the point of Inhibitors,research,lifescience,medical exit of the spray from the device to the paper, the container was fixed

by a fixator for every actuation. The formulation was held at a distance of 5cm from the paper. The wet part formed was outlined, then the outlined part was clipped from the paper and weighted. Effectiveness of the pump seal was evaluated by pump Inhibitors,research,lifescience,medical seal efficiency test. The filled containers under test were placed in the upright position at 30° for 3 days. The containers were weighed before and after the test period. The change in the weight of the container was recorded Inhibitors,research,lifescience,medical and the leakage rates were calculated. Average weight per metered dose was measured. The initial weight of the container was

recorded; then the container was weighed again after successive deliveries were sprayed from the MDTS. The difference between the initial and final weight of the container divided by the number of delivery sprayed from the containers was used to determine the average weight per metered dose. The DE content per spray was determined by actuating designed sprays in a beaker containing methanol. Then the drug content was analyzed by HPLC. The drug administration area of each pump was calculated by the following equation: Ax=Wo×AoWx, (3) where Wo and Ao are Inhibitors,research,lifescience,medical the known weight and area, respectively, of the paper we clipped from the paper, Wx is the weight of the paper after certain MDTS actuation, and Ax is the area of certain pump. Taking paper with area of 10cm × 10cm and weighted 0.8166g as a sample, Wo is 0.8166g and Ao is 100cm2. The pump seal efficiency was calculated by the following equation: Leakage  rate=(Wbefore  test−Wafter  test)Wbefore  test; (4) Wbeforetest and Waftertest tuclazepam were the weight of the container before and after the test period, respectively. Average weight per metered dose was measured by the following equation: Wn−m=(Wn−Wm)(m−n)×100%, (5) where Wn and Wm were the weight of the “n” and “m” actuation times, respectively. Wn−m was the average weight per metered dose during the “n” to “m” actuation times. 2.6. Pharmacokinetic Study Healthy female Sprague-Dawley rats weighing 240 ± 20g were used in this study.

Moreover, we did not examine vaccination-related attitudes and knowledge as determinants of vaccine uptake despite existing literature emphasizing on their role as key determinants of vaccination decisions neither did we collect information on which inhibitors parent nor guardian brought the child for vaccination. However, a supplementary survey is currently underway to help understand the role of fathers or

other male household decision-makers as well as vaccine-related attitudes in influenza vaccine uptake. Despite the considerable burden of influenza disease from existing literature, the cost or opportunity cost for an introduction of an influenza

vaccine is yet to be defined and NVP-AUY922 supplier analyses are currently underway to describe these costs. Finally, there was potential for misclassification regarding occupations that do or do not result in lots of time away from home. While further validation of the occupational categories is warranted, misclassification in this variable CHIR-99021 order would likely place a conservative bias on the observed association. We found that demographic, geographical and educational characteristics of mothers and families were important determinants of vaccine uptake among children during a seasonal influenza vaccine campaign in Kenya. Future vaccination campaigns will need to consider ways to adapt vaccination schedules and locations to accommodate parents who work outside the home. Finally, mobilization efforts may also need to more extensively target more children below two years of age since they bear greatest burden of influenza and

respiratory diseases, and who often require multiple doses of vaccine. We thank seasonal influenza vaccine effectiveness study participants and study team members for their participation in the study, MoPHS, DDSR for technical oversight during study implementation, John Mephenoxalone Williamson of CDC – Kenya for his statistical advice, Sanofi Pasteur for donation of influenza vaccine, and the director for KEMRI for permission to publish these data. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. Author contributions: Conception and design of the study: NAO, JAM. Acquisition of data: NAO, EL, JAM, BN, GE, AA. Analysis and interpretation of data: NAO, JAM, BN, GE, AA. Drafting the article or revising it critically for important intellectual content and final approval of the version to be submitted: NAO, JAM, BN, GE, EL, AA, MW, PM, GB, RFB, RO, DB, MAK, DKS. “
“The conference was opened by DCVMN President, M.

Females had lower risk of dying compared to males (HR=0.916, 95%CI: 0.881−0.952) and mortality increased with age at diagnosis (P<0.001, Table 1). There was no significant difference in OS across race/ethnicity groups (P=0.16, Table 1). Sex, race, grade/differentiation and MGC The effect of sex on OS was significantly varied by race and tumor differentiation in Pazopanib patients with MGC (P for interaction=0.003 and 0.005, respectively, Table 2). White and African American woman had significantly lower risk of dying compared to their male counterparts. In Asian, Hispanic,

and Native American populations, men and women had equivalent survival (Table 2.) Women also had a significantly lower risk of dying compared to males in patients Inhibitors,research,lifescience,medical whose tumors were poorly differentiated

or undifferentiated or had unknown Inhibitors,research,lifescience,medical tumor grade (Table 2). Table 2 Overall survival of patients with gastric cancer by sex, SEER data 1988-2004 Discussion This cohort of metastatic gastric cancer patients from the SEER database represents a wide cross-section of patients with variable socioeconomic and ethnic backgrounds. Our analysis also included a robust variety of pathology and is likely a more generalizable Inhibitors,research,lifescience,medical representation than can be found in clinical trials or case series. As expected, we found tumor characteristics such as grade, differentiation, and histology were associated with survival in advanced gastric cancer. Inhibitors,research,lifescience,medical Notably, there was a survival advantage attributable to gastric cardia lesions when compared to non-cardia lesions. This survival advantage persisted after controlling for the increased prevalence of cardia lesions in Caucasians and

men. Survival differences between cardia and non-cardia lesions may reflect differences in pathogenesis and tumor biology. H. pylori infection is recognized as a unique risk factor for non-cardia lesions while gastroesophageal reflux disease plays a role in the development of proximal lesions (38),(39). Interestingly, there is growing evidence that H2N expression is variably expressed in proximal and distal gastric cancer lesions (40). The proto-oncogene Her-2/neu (H2N) is Inhibitors,research,lifescience,medical located on chromosome 17q21 and encodes a transmembrane tyrosine kinase growth factor receptor featuring substantial homology with the EGFR (41),(42). Over-expression of the H2N protein has been identified in from 10 to 34% of breast cancers and is associated next with a poor prognosis (43). Over-expression of H2N has been reported in gastric and gastro-esophageal tumors (24). Additionally, there are studies describing H2N as a poor prognostic factor in gastric cancer (40). Further studies are needed to investigate its role in the development of proximal and distal gastric lesions. In addition to tumor characteristics, patient features, such as age and sex, also had significant prognostic impact. Ethnicity – often described in gastric cancer literature as having a prominent prognostic role – had no effect on survival.

This program was

repeated for 35 cycles. In every run, both positive and negative controls were considered. PCR Product Detection Two percent agarose gel electrophoresis was used. Twenty five µl of the PCR products were mixed with two µl of 6x loading buffer dye and loaded into the individual wells. The electrophoresis was performed in Tris Acetate EDTA (TAE) buffer for one hour. At the end, the gel was stained in ethidium bromide solution(1 µg/ml) for 15 minutes. The results were analyzed according to the product length which Inhibitors,research,lifescience,medical were visualized on gel documentation system and photographed. Data were analyzed using Statistical Package for Social Sciences (SPSS, version 14). The results of the bacterial cultures and PCR assays were analyzed using Chi-Square test. Differences between the groups were considered statistically significant if P values were <0.05. Results A total of 36 patients including 23 boys and 13 girls with a mean±SD age of 6.72±2.95 Inhibitors,research,lifescience,medical years (range; 2-13 years) participated in the study. Twenty

seven (75%) had bilateral and nine (25%) had unilateral OME, therefore, a total of 63 samples were obtained. Two patients were identified incidentally during routine examination of ear, nose and throat, and remaining 34 patients presented with chief complaints of hearing impairment (70%), otalgia (24%), or both (6%). The mean duration of symptoms Inhibitors,research,lifescience,medical (hearing loss and/or otalgia) was 6 months (Range; 2-14). One patient had a history of previous tympanostomy tube insertion. Glue was the most common (n=50, 79.4%) type of aspirated fluid. Ten (15.9%) of ears had serous fluid. Purulent material was seen only in three (4.8%) of the ears. The results of PCR and Inhibitors,research,lifescience,medical bacterial culture are presented in table 1 and ​and2.2. In the standard Olaparib bacteriologic culture, bacterial growth was detected in 38 (60.3%) samples. The most frequent pathogens Inhibitors,research,lifescience,medical were S. pneumoniae, H. influenzae, M .catarrhalis and coagulase negative Staphylococci (49.2%). The percentages of culture positive effusions for

S. pneumoniae, H. influenzae and M. catarrhalis were 15.9%, 9.5%, and 9.5%, respectively. PCR assay was done for because three of frequently-occuring bacterial pathogen(s) in OME including S. pneumoniae, H. influenzae and M. catarrhalis. The DNAs of one or more of these bacteria were present in 60 (95.2%) samples. The DNAs of S. pneumoniae, M. catarrhalis and H. influenzaee were detected in 19%, 36.5% and 95.2% of the samples, respectively. In 32 (50.7%) samples, the DNA of only one bacterial species, and in 28 (44.5%) samples the DNAs of more than one bacterial species were detected. Three (4.8%) samples had no DNA content. Also, the number of H. influenzae isolate was significantly higher than those for other bacteria (P<0.05). The representative results of multiplex PCR are displayed in figure 1.

136 The work with velnacrine indicates that improvements can occur rapidly with anticholinesterases,115,135 and early phase 2 trials would benefit greatly if a range of doses could be rapidly evaluated. In fact, it is quite feasible that many compounds could produce acute improvements, as have been seen with volunteers in the previous section. To evaluate such effects, short repeatable tests would be necessary, and one recent study suggests this is feasible in AD patients using the CDR system.33 Here, the acute cognitive effects of

intravenous flumazenil were identified Inhibitors,research,lifescience,medical in AD patients by assessing them prior to infusion and again at 15, 40, and 240 minutes later. Three tests from the CDR system were employed, two to measure attention (simple and choice reaction time), and a test of episodic secondary memory (picture recognition). This enabled a double-blind, placebo-controlled, single-dose, 2-way crossover trial to be conducted in AD patients, Inhibitors,research,lifescience,medical the first time to the knowledge of these authors that multiple repeated testing over so short a period has been possible in AD. The sensitivity of the system was demonstrated by identifying short-term Inhibitors,research,lifescience,medical impairments with the compound in two of the tasks, despite the trial only having 11 patients. Dementia with Lewy bodies An important newly identified dementia

is dementia with Lewy bodies (DLB), believed to account for up to 20 % of all dementias, and previously Inhibitors,research,lifescience,medical largely mistaken for AD.137-141 The condition is known to be more cholinergically specific than AD, and thus more likely to respond to cholinergic treatment. There is also a larger nicotinic component to the cholinergic damage. Here, unlike other dementias, attentional deficits are recognized as a core symptom of the disease, and recent, work with the CDR system has shown greater attentional impairments in DLB patients than in Inhibitors,research,lifescience,medical AD patients, while showing a double dissociation with DLB patients having smaller verbal memory deficits than

AD patients.137-141 The condition can also be differentiated from vascular dementia.142 In comparative work using the CDR system with four types of dementia, AD, DLB, vascular dementia, and Huntington’s disease, it, is clear that, each has its unique profile of cognitive impairment, over the various tasks and measures. Any ABT-263 mw scales therefore that, yield single scores for cognitive impairment, will not properly reflect the diversity of the cognitive impairment seen nor see more the implications of this diversity for the true behavioral profile of the different diseases. The cholinergic nature of the attentional deficits has been further confirmed by comparing nonhallucinators with patients who do hallucinate.143 It has been shown that hallucinators have greater cholinergic deficits than nonhallucinators, and comparing the two groups on CDR tests of attention showed greater attentional deficits in the hallucinators.

The GIST decreased from its initial size of 13.5 x 8.7 cm in November 2008 to 9.0 x 6.0 cm in January 2009. The primary tumour continued to decrease in size from 6.3 x 3.7 cm in June 2009 to 5.2 x 3.5 cm in November 2009. Figure 4 CT scan of the abdomen following treatment with imatinib mesylate revealing a reduction of GIST (top arrow). The colon mass is now visible (bottom arrow)

The CT scan in November 2009 revealed the presence of a colonic mass with mesenteric lymphadenopathy. The presence of the newly identified mass was confirmed on colonoscopy, Inhibitors,research,lifescience,medical which revealed the presence of an intraluminal mass at 80 cm from the anal verge. Biopsy of this lesion revealed an invasive, moderately differentiated adenocarcinoma of colonic origin. After discussion at tumor board, a Inhibitors,research,lifescience,medical decision was made to resect the primary colonic mass as well as the primary GIST. In December 2009, the patient underwent a left hemicolectomy in addition to resection of the

primary GIST, which originated in the small bowel. The pathology Inhibitors,research,lifescience,medical of the colonic mass revealed a moderately differentiated adenocarcinoma with 7 out 12 lymph nodes involved. The small bowel pathology revealed a spindle cell lesion consistent with a GIST, which was positive for CD117 and CD34. The Ki67 stain showed LEE011 order positivity in less than 1% of tumour cells. The mitotic count was less than 1 per 50 High Power Fields (HPF). The tumour showed large hypocellular areas of hyalinization, an area of Inhibitors,research,lifescience,medical necrosis, and several areas of hemorrhage as well as a focal hemangiopericytoma-like pattern, consistent with treatment (imatinib mesylate) effect. Of note, the laboratory findings did not include a preoperative CEA, however, a CEA level was drawn shortly after the surgery, measuring 2.5 ug/L. She subsequently received 12 cycles of modified FOLFOX-6 chemotherapy while remaining on imatinib for her metastatic

GIST. She did not experience any unexpected toxicity from either the imatinib or chemotherapy and remains well with continued regression Inhibitors,research,lifescience,medical of her liver metastasis (GIST). Case 2 A 61-year-old Caucasian gentleman presented with a change in bowel habits and rectal bleeding in March 2009. He reported no associated anorexia or weight loss. Colonoscopy and biopsy revealed an adenocarcinoma at the splenic flexure. A staging CT scan also revealed a few subcentimeter lymph nodes and a 5 cm mass at the gastrohepatic ligament also Thymidine kinase suspected to be an enlarged metastatic lymph node (Fig 5). Figure 5 CT scan demonstrating a mass later confirmed to be a primary gastric GIST In May 2009, at the time of surgery, the gastrohepatic mass was resected. Once confirmed on a frozen section to be a spindle cell tumour consistent with a GIST, a partial gastrectomy was performed. During the same operation, the patient also underwent a left hemicolectomy.

Working groups must include one or more regular voting members as well as one medical specialist from the PHAC (as Medical Lead). There are currently two Medical Leads (including the Executive Secretary) distributed among eighteen working groups. A PHAC Medical Lead is a physician Stem Cells inhibitor who works closely with the Working Group chair and NACI Secretariat to assist with the technical analysis, literature review, and drafting of Advisory Committee Statements in addition to other roles and responsibilities, such as

responding to medical inquiries to NACI. External content experts or other consultants may be invited to serve on a Working Group (e.g. representatives from the Canadian Immunization Committee or the Committee to Advise on inhibitors Tropical Medicine and Travel) as necessary to provide broad input. Information on NACI’s structure and processes is contained within its Terms of Reference, available publicly on the PHAC website (http://www.phac-aspc.gc.ca/naci-ccni/tor-eng.php#12). These Terms of Reference may be amended at any Pazopanib in vitro meeting by consensus or by vote. The National Advisory Committee on Immunization has three face-to-face meetings a year which occur over 2 days. Ad hoc teleconferences of the full committee are held as needed, and email correspondence occurs regularly. Meetings are not open to

the public. Additional observers (e.g. health care students/post-graduate physician trainees or PHAC staff) may attend upon request and approval of the NACI

Executive Committee, and after agreeing to confidentiality requirements. Experts, including representatives from vaccine manufacturers, may be invited to make presentations as needed. For each meeting, detailed Minutes and a succinct Summary of Discussions are prepared by the Secretariat, reviewed by the Executive Secretary and Chair of NACI, and approved by the NACI. The Summary of Discussions is used for information sharing beyond NACI however the detailed Minutes is a confidential Dichloromethane dehalogenase document that is not distributed beyond the Committee. The agenda for NACI meetings is created based on changes in the epidemiology of vaccine-preventable diseases, new products, or new evidence about existing products. Potential topics may be submitted by committee members and other stakeholders, and are accepted for addition to the agenda by the Executive Secretary, in consultation with the Chair. An executive committee (consisting of the Chair, Vice-Chair, Executive Secretary, PHAC Medical Leads and NACI Secretariat) meets regularly by teleconference between meetings to oversee the progress of the Working Groups, plan full NACI meetings and deal with inter-current issues that arise. Members, liaison representatives and consultants are required to submit annual conflict of interest declarations to the Executive Secretary, based on Conflict of Interest Guidelines.