scholarly journals Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alpha and Delta variant prevalence

2021 ◽  
Author(s):  
Arjun Puranik ◽  
Patrick J Lenehan ◽  
Eli Silvert ◽  
Michiel JM Niesen ◽  
Juan Corchado-Garcia ◽  
...  
Keyword(s):  
Health System ◽  
Mayo Clinic ◽  
Severe Disease ◽  
Time Period ◽  
Protein Encoding ◽  
Highly Effective ◽  
Dosing Regimens ◽  
History Of ◽  
Alpha Variant ◽  
Pronounced Reduction

Although clinical trials and real-world studies have affirmed the effectiveness and safety of the FDA-authorized COVID-19 vaccines, reports of breakthrough infections and persistent emergence of new variants highlight the need to vigilantly monitor the effectiveness of these vaccines. Here we compare the effectiveness of two full-length Spike protein-encoding mRNA vaccines from Moderna (mRNA-1273) and Pfizer/BioNTech (BNT162b2) in the Mayo Clinic Health System over time from January to July 2021, during which either the Alpha or Delta variant was highly prevalent. We defined cohorts of vaccinated and unvaccinated individuals from Minnesota (n = 25,589 each) matched on age, sex, race, history of prior SARS-CoV-2 PCR testing, and date of full vaccination. Both vaccines were highly effective during this study period against SARS-CoV-2 infection (mRNA-1273: 86%, 95%CI: 81-90.6%; BNT162b2: 76%, 95%CI: 69-81%) and COVID-19 associated hospitalization (mRNA-1273: 91.6%, 95% CI: 81-97%; BNT162b2: 85%, 95% CI: 73-93%). In July, vaccine effectiveness against hospitalization has remained high (mRNA-1273: 81%, 95% CI: 33-96.3%; BNT162b2: 75%, 95% CI: 24-93.9%), but effectiveness against infection was lower for both vaccines (mRNA-1273: 76%, 95% CI: 58-87%; BNT162b2: 42%, 95% CI: 13-62%), with a more pronounced reduction for BNT162b2. Notably, the Delta variant prevalence in Minnesota increased from 0.7% in May to over 70% in July whereas the Alpha variant prevalence decreased from 85% to 13% over the same time period. Comparing rates of infection between matched individuals fully vaccinated with mRNA-1273 versus BNT162b2 across Mayo Clinic Health System sites in multiple states (Minnesota, Wisconsin, Arizona, Florida, and Iowa), mRNA-1273 conferred a two-fold risk reduction against breakthrough infection compared to BNT162b2 (IRR = 0.50, 95% CI: 0.39-0.64). In Florida, which is currently experiencing its largest COVID-19 surge to date, the risk of infection in July after full vaccination with mRNA-1273 was about 60% lower than after full vaccination with BNT162b2 (IRR: 0.39, 95% CI: 0.24-0.62). Our observational study highlights that while both mRNA COVID-19 vaccines strongly protect against infection and severe disease, further evaluation of mechanisms underlying differences in their effectiveness such as dosing regimens and vaccine composition are warranted.

scholarly journals Longitudinal changes in age and race of patients with SARS-CoV-2 in a multi-hospital health system

2021 ◽  
Author(s):  
Ian J. Barbash ◽  
Lee H. Harrison ◽  
Jana L. Jacobs ◽  
Faraaz Ali Shah ◽  
Tomeka L. Suber ◽  
...  
Keyword(s):  
Health System ◽  
Severe Disease ◽  
Patient Characteristics ◽  
The United States ◽  
Electronic Health Record Data ◽  
Younger Patients ◽  
Ethnic Subgroups ◽  
Media Reports ◽  
Alpha Variant ◽  
The Impact

ABSTRACTBackgroundThe COVID-19 pandemic continues to affect the United States and the world. Media reports have suggested that the wave of the alpha variant in the Spring of 2021 in the US caused more cases among younger patients and racial and ethnic subgroups.ApproachWe analyzed electronic health record data from a multihospital health system to test whether younger patients accounted for more cases and more severe disease, and whether racial disparities are widening. We compared demographics, patient characteristics, and hospitalization variables for patients admitted from November 2020 through January 2021 to those admitted in March and April 2021.ResultsWe analyzed data for 37, 502 unique inpatients and outpatients at 21 hospitals from November 1, 2020 to April 30, 2021. Compared to patients from November through January, those with positive tests in March and April were younger and less likely to die. Among patients under age 50, those with positive tests in March and April were three times as likely to be hospitalized and twice as likely to require ICU admission or mechanical ventilation. Individuals identified as Black represented a greater proportion of cases and hospitalizations in March and April as compared to November through January.ConclusionsWe found that relative COVID-19 hospitalization rates for younger individuals and individuals identified as Black were rising over time. These findings have important implications for ongoing public health measures to mitigate the impact of the pandemic.

The Tempo and mode(S) of Prebiotic Evolution

1997 ◽  
Vol 161 ◽  
pp. 419-429 ◽  
Author(s):  
Antonio Lazcano
Keyword(s):  
Origin Of Life ◽  
Organic Compounds ◽  
Biological Evolution ◽  
Current Evidence ◽  
Early Diversification ◽  
Time Period ◽  
The Galaxy ◽  
History Of ◽  
Widespread Phenomenon ◽  
The Origin Of Life

AbstractDifferent current ideas on the origin of life are critically examined. Comparison of the now fashionable FeS/H2S pyrite-based autotrophic theory of the origin of life with the heterotrophic viewpoint suggest that the later is still the most fertile explanation for the emergence of life. However, the theory of chemical evolution and heterotrophic origins of life requires major updating, which should include the abandonment of the idea that the appearance of life was a slow process involving billions of years. Stability of organic compounds and the genetics of bacteria suggest that the origin and early diversification of life took place in a time period of the order of 10 million years. Current evidence suggest that the abiotic synthesis of organic compounds may be a widespread phenomenon in the Galaxy and may have a deterministic nature. However, the history of the biosphere does not exhibits any obvious trend towards greater complexity or «higher» forms of life. Therefore, the role of contingency in biological evolution should not be understimated in the discussions of the possibilities of life in the Universe.

Corticosteroids in Inflammatory Bowel Disease patients: a practical guide for physicians.

2020 ◽  
Vol 15 ◽  
Author(s):  
Maria Carla Di Paolo ◽  
Cristiano Pagnini ◽  
Maria Giovanna Graziani
Keyword(s):  
Severe Disease ◽  
Unknown Etiology ◽  
History Of Disease ◽  
Bowel Diseases ◽  
Literature Evidence ◽  
History Of ◽  
Inflammatory Bowel ◽  
Favorable Safety ◽  
Pass Metabolism

: Inflammatory bowel diseases (IBDs) are chronic conditions characterized by unknown etiology and pathogenesis with deregulation of mucosal immunity. Among possible treatments, corticosteroids, already available from the 50’, are still the mainstay of treatment for moderate-severe disease. Nonetheless, the use of steroids is still largely empirical and solid evidence about therapeutic schemes are lacking. Moreover, due to the important side-effects and for the unsatisfactory impact on long-term natural history of disease, the steroid sparing has become an important therapeutic goal in IBD management. Besides conventional steroids, the so called “low bioavailability” steroids, which are steroids with high affinity for peripheral receptors and elevated hepatic first-pass metabolism, have demonstrated efficacy and more favorable safety profile. In the present review of the literature evidence of efficacy and safety of conventional and low bioavailability steroids in IBD patients are evaluated, and practical suggestions for a correct use in clinical practice are presented according to the current clinical guidelines.

Evaluating the readiness of mobile technology in Saudi Arabia: An Integrative Perspective with respect to e-health (Preprint)

2020 ◽  
Author(s):  
Fahad Alanezi
Keyword(s):  
Saudi Arabia ◽  
Health System ◽  
Mobile Phones ◽  
Personal Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Apps ◽  
History Of ◽  
Vision 2030 ◽  
Awareness Programs

UNSTRUCTURED E-health system is emerging and providing health services and solutions through different electronic gadgets. Saudi Arabia has launched a program called Saudi Arabia vision 2030, in which providing state-of-the-art health facilities to their citizen is of topmost priority. After all the efforts, the residents of Saudi Arabia are still reluctant for the adaptation of e-health system. The current study was conducted to evaluate the obstacle in adoption of the e-health system through the mobile phones. The current study was cross-sectional survey and was conducted by developing a self-administered structured questionnaire asking the utilization of mobile phone in state of health emergency prior to ask any medical history. Majority of the participants was married and doing jobs in different firms and have their personal mobile phones (p = 0.100, > 0.05) which indicates easily access to the e-health apps. The majority of the participants suffers from either obesity or high blood pressure (p = 0.018, < 0.05) regardless of either history of mental disorder or other family history of mental diseases. The pattern of diseases with mental disorders correlate well with adoption of e-health in government policies. The obstacles in adopting e-health includes fear of the loss of personal data and information (p = 0.0401, < 0.05). Moreover, they did not trust on online medications as the doctor cannot prescribe medicines without seeing physical health of the patient. The current study concluded that by making improvement in policies and proper commercializing the e-health apps together with awareness programs can boast the adoption of e-health in Saudi Arabia.

A Very Brief History of Internet Jurisdiction

2017 ◽  
Author(s):  
Dan Jerker B. Svantesson
Keyword(s):  
Academic Community ◽  
Court Decisions ◽  
Time Period ◽  
Technological Developments ◽  
History Of

This chapter provides a brief history of Internet jurisdiction taking account of key court decisions, legislation as well as developments in the academic thinking on the topic. In doing so, it divides the history of Internet jurisdiction into four relatively distinct phases. The discussion in the chapter highlights facts such as that: (1) law has largely been reactive, responding to technological developments; (2) the level of creativity applied in the search for workable solutions was seemingly higher in the earlier stages than in more recent times; and (3) unsurprisingly, the attitudes of courts, legislators, and the academic community have varied considerably over the time period examined.

scholarly journals COVID-19 in a Cohort of Patients with Congenital Myasthenic Syndrome

2021 ◽  
pp. 1-3
Author(s):  
Setareh Alabaf ◽  
Karen O'Connell ◽  
Sithara Ramdas ◽  
David Beeson ◽  
Jacqueline Palace
Keyword(s):  
High Risk ◽  
Neuromuscular Transmission ◽  
Genetic Disorders ◽  
Severe Disease ◽  
Congenital Myasthenic Syndrome ◽  
Referral Centre ◽  
History Of ◽  
Myasthenic Syndrome ◽  
The Uk ◽  
Rare Group

Congenital Myasthenic Syndrome (CMS) are a rare group of genetic disorders of neuromuscular transmission. Some subtypes of CMS can be associated with respiratory and bulbar weakness and these patients may therefore be at high risk of developing a severe disease from COVID-19. We screened 73 patients with genetically confirmed CMS who were attending the UK national referral centre for evidence of previous Severe Acute Respiratory Syndrome Corona Virus 2 infection and their clinical outcome. Of 73 patients, seven had history of confirmed COVID-19. None of the infected patients developed a severe disease, and there were no signals that CMS alone carries a high risk of severe disease from COVID-19.

Detection of Pavement Maintenance Treatments using Deep-Learning Network

2021 ◽  
pp. 036119812110078
Author(s):  
Lu Gao ◽  
Yao Yu ◽  
Yi Hao Ren ◽  
Pan Lu
Keyword(s):  
Deep Learning ◽  
Measurement Errors ◽  
Short Term Memory ◽  
Learning Networks ◽  
Pavement Maintenance ◽  
Time Period ◽  
Learning Techniques ◽  
Maintenance And Rehabilitation ◽  
History Of ◽  
Deep Learning Network

Pavement maintenance and rehabilitation (M&R) records are important as they provide documentation that M&R treatment is being performed and completed appropriately. Moreover, the development of pavement performance models relies heavily on the quality of the condition data collected and on the M&R records. However, the history of pavement M&R activities is often missing or unavailable to highway agencies for many reasons. Without accurate M&R records, it is difficult to determine if a condition change between two consecutive inspections is the result of M&R intervention, deterioration, or measurement errors. In this paper, we employed deep-learning networks of a convolutional neural network (CNN) model, a long short-term memory (LSTM) model, and a CNN-LSTM combination model to automatically detect if an M&R treatment was applied to a pavement section during a given time period. Unlike conventional analysis methods so far followed, deep-learning techniques do not require any feature extraction. The maximum accuracy obtained for test data is 87.5% using CNN-LSTM.

Naval Service Cohort Study of Occupational Stress: Background to the research and a review of the latest findings

2008 ◽  
Vol 94 (1) ◽  
pp. 22-30
Author(s):  
R S Bridger
Keyword(s):  
Occupational Stress ◽  
Psychological Health ◽  
Prevalence Rate ◽  
Pathological Process ◽  
Work Demands ◽  
Cross Sectional ◽  
Time Period ◽  
History Of ◽  
Made In ◽  
Naval Service

AbstractThe Naval Service has been actively involved in research on occupational stress for almost 10 years. Three cross-sectional studies have been completed during this time period. It has been shown that the prevalence rate of psychological strain amongst personnel is relatively constant at 31-34%. Several smaller studies, of personnel at sea and of the availability of support services have also been completed. In general, the research has shown that the prevalence rate of strain is higher in the NS than in the general population and is comparable to that found in similar uniformed service organisations, such as the Police.Recognising the limitations of crosssectional research methods, the decision was made, in 2006, to follow a cohort of personnel over a 6-year period in order to gain better understanding of the processes by which work demands impact on psychological health and to determine whether psychological ill-health has an adverse impact on factors such as premature voluntary retirement and medical downgrading.The paper presents the history of the research and some of the work in progress.‘Disease is a pathological process that, at least in theory, is amenable to objective, external verification. Illness, on the other hand, is by definition, a subjective state’. D. Coggan 2006(1).

scholarly journals The history of introduction of the African baobab ( Adansonia digitata , Malvaceae: Bombacoideae) in the Indian subcontinent

2015 ◽  
Vol 2 (9) ◽  
pp. 150370 ◽  
Author(s):  
Karen L. Bell ◽  
Haripriya Rangan ◽  
Christian A. Kull ◽  
Daniel J. Murphy
Keyword(s):  
West Africa ◽  
Indian Subcontinent ◽  
Central India ◽  
Adansonia Digitata ◽  
Multiple Introductions ◽  
Human Interactions ◽  
Time Period ◽  
History Of ◽  
Genetic Clusters ◽  
Southeast India

To investigate the pathways of introduction of the African baobab, Adansonia digitata , to the Indian subcontinent, we examined 10 microsatellite loci in individuals from Africa, India, the Mascarenes and Malaysia, and matched this with historical evidence of human interactions between source and destination regions. Genetic analysis showed broad congruence of African clusters with biogeographic regions except along the Zambezi (Mozambique) and Kilwa (Tanzania), where populations included a mixture of individuals assigned to at least two different clusters. Individuals from West Africa, the Mascarenes, southeast India and Malaysia shared a cluster. Baobabs from western and central India clustered separately from Africa. Genetic diversity was lower in populations from the Indian subcontinent than in African populations, but the former contained private alleles. Phylogenetic analysis showed Indian populations were closest to those from the Mombasa-Dar es Salaam coast. The genetic results provide evidence of multiple introductions of African baobabs to the Indian subcontinent over a longer time period than previously assumed. Individuals belonging to different genetic clusters in Zambezi and Kilwa may reflect the history of trafficking captives from inland areas to supply the slave trade between the fifteenth and nineteenth centuries. Baobabs in the Mascarenes, southeast India and Malaysia indicate introduction from West Africa through eighteenth and nineteenth century European colonial networks.

scholarly journals Clinico-Pathological Findings of Bangladeshi Covid 19 Patients with their Clinical Outcome: Study of A Cohort of 201 Cases

2020 ◽  
pp. 37-42
Author(s):  
Nasir Uddin Ahmed ◽  
Md Azizul Islam ◽  
Md Anwarul Kabir ◽  
Md Habibur Rahman ◽  
SM Anwar Sadat
Keyword(s):  
Clinical Outcome ◽  
Respiratory Distress ◽  
Sore Throat ◽  
Respiratory System ◽  
Clinical Presentation ◽  
Severe Disease ◽  
Age Groups ◽  
Military Hospital ◽  
Human Beings ◽  
History Of

Introduction: COVID-19 is a major threat to human beings. Clinical characterization, rapid identification of cases and isolation are vital for containments of rapidly spreading disease. The objectives of the study were to evaluate the clinico pathologic profile of Covid 19 positive Bangladeshi patients and also to see their clinical outcome within defined period. Methods: This cohort study on 201 Bangladeshi cases was done in Combined Military Hospital, a tertiary level hospital in Dhaka, Bangladesh from April 2020 to May 2020. Total 201 COVID-19 cases were enrolled after getting the result positive for RT-PCR. After collection, data were analysed to show the characteristics of Covid 19 and their outcome after treatment. Results: Among 201 cases, 180 (90%) were male and 21 (10%) were female. The most prevalent affected age groups were 71 (35.5%) patients in 26-35 years age, 54 (27%) in 16- 25 years, 49 (24.5%) in 35-45 years. Mean age is 32.2±2. Among the total cases, 146 (73%) have positive history of contact, 37 (18.5%) have no history of any contact, 8 (4%) denied any contact with COVID-19 patients. Regarding clinical presentations, 67 (33.5%) patients presented with only one symptoms, 125 (62.5%) had multiple symptoms and 9 (4.5%) cases were asymptomatic. 154 (77%) patients presented with fever. Other presentations were cough 71 (35.5%), headache 27 (13.5%), myalgia 25 (12.5%), sore throat 25 (12.5%), malaise 15 (7.5%), respiratory distress 11 (5.5%). Respiratory system was the dominant domain of clinical presentation. Leukopenia was presented by 12 patients and 12 had lymphopenia. 18 patients had mild thrombocytopenia. Pulse oxymetry showed oxygen saturation below 88% in 12 cases. After oxygen therapy 7 cases were improved and 5 cases were shifted to Corona ICU as their saturation fell below 70. These 5 patients are categorised as severe disease, rest 196 patients were mild in nature. Conclusion: COVID 19 affects male more than female. Common symptoms are fever, cough, headache, myalgia, sore throat, malaise, respiratory distress. Respiratory system is the dominant domain of clinical presentation. ICU support was needed in 2.5 % cases and death rate was 1% which was associated with comorbidity of CKD. J Bangladesh Coll Phys Surg 2020; 38(0): 37-42

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