scholarly journals Breakthrough infection after COVID-19 vaccination: A threat for Nepal due to SARS-CoV-2 variants circulating in 2nd wave ravaging India

2021 ◽  
Vol 8 (2) ◽  
pp. 69-79
Author(s):  
Jay Narayan Shah ◽  
Priscilla Samson ◽  
Nabees Man Singh Pradhan ◽  
Shreekrishna Maharjan ◽  
Ashis Shrestha ◽  
...  
Keyword(s):  
Preventive Measures ◽  
Population Analysis ◽  
Meta Analysis ◽  
Local Population ◽  
Real Life ◽  
Breakthrough Infection ◽  
Adverse Event Following Immunization ◽  
Minor Adverse Event

After a year of the COVID-19 pandemic, the meta-analysis in Dec 2020 did not support its reinfections. Now it’s clear that not only reinfection following earlier exposure is a reality, but also breakthrough infections after vaccinations have been increasingly reported. A breakthrough infection means that the infection has broken through the protection provided by the vaccine. The course of the disease, strict observation for preventive measures, together with safe vaccines is necessary long-term solutions. The effectiveness of the vaccine, durability of immunity, the role of the virus variants, the incidence and severity of breakthrough infections are the challenges in real life. A breakthrough infection is the detection of SARS-CoV-2 RNA or antigen in the respiratory specimen ≥14 days after inoculation of a vaccine. A breakthrough infection of 0.04 to 13% has been reported in the literature. Nepal began vaccine rollout in late Jan 2021. Nearly 3 million population has been vaccinated by two vaccines, the Covishield (AstraZeneca, from India) and Vero Cell (Sinopharm, China). Only minor ‘Adverse Event Following Immunization’ after the initial vaccine rollout has been reported. There is a lack of reports on the breakthrough infection for these vaccines in the local population. Analysis of the data on breakthrough infection from the vaccine rollouts in Nepal is awaited.

scholarly journals The Role of Dispersal in Interacting Patches Subject to an Allee Effect

2013 ◽  
Vol 45 (4) ◽  
pp. 1182-1197
Author(s):  
N. Lanchier
Keyword(s):  
Allee Effect ◽  
Interacting Particle Systems ◽  
Local Population ◽  
Critical Value ◽  
Initial Distribution ◽  
Interacting Particle ◽  
Strong Allee Effect ◽  
Long Term Behavior

This article is concerned with a stochastic multipatch model in which each local population is subject to a strong Allee effect. The model is obtained by using the framework of interacting particle systems to extend a stochastic two-patch model that was recently introduced by Kang and the author. The main objective is to understand the effect of the geometry of the network of interactions, which represents potential migrations between patches, on the long-term behavior of the metapopulation. In the limit as the number of patches tends to ∞, there is a critical value for the Allee threshold below which the metapopulation expands and above which the metapopulation goes extinct. Spatial simulations on large regular graphs suggest that this critical value strongly depends on the initial distribution when the degree of the network is large, whereas the critical value does not depend on the initial distribution when the degree is small. Looking at the system starting with a single occupied patch on the complete graph and on the ring, we prove analytical results that support this conjecture. From an ecological perspective, these results indicate that, upon arrival of an alien species subject to a strong Allee effect to a new area, though dispersal is necessary for its expansion, fast long-range dispersal drives the population toward extinction.

scholarly journals Hemostatic Changes in Patients with COVID-19: A Meta-Analysis with Meta-Regressions

2020 ◽  
Vol 9 (7) ◽  
pp. 2244 ◽  
Author(s):  
Matteo Nicola Dario Di Minno ◽  
Ilenia Calcaterra ◽  
Roberta Lupoli ◽  
Antonio Storino ◽  
Giorgio Alfredo Spedicato ◽  
...  
Keyword(s):  
Regression Models ◽  
Meta Analysis ◽  
C Reactive Protein ◽  
Long Term Outcomes ◽  
Chronic Disability ◽  
Reactive Protein ◽  
The Difference ◽  
D Dimer

Background: Complications of coronavirus disease 2019 (COVID-19) include coagulopathy. We performed a meta-analysis on the association of COVID-19 severity with changes in hemostatic parameters. Methods: Data on prothrombin time (PT), activated partial thromboplastin time (aPTT), D-Dimer, platelets (PLT), or fibrinogen in severe versus mild COVID-19 patients, and/or in non-survivors to COVID-19 versus survivors were systematically searched. The standardized mean difference (SMD) was calculated. Results: Sixty studies comparing 5487 subjects with severe and 9670 subjects with mild COVID-19 documented higher PT (SMD: 0.41; 95%CI: 0.21, 0.60), D-Dimer (SMD: 0.67; 95%CI: 0.52, 0.82), and fibrinogen values (SMD: 1.84; 95%CI: 1.21, 2.47), with lower PLT count (SMD: −0.74; 95%CI: −1.01, −0.47) among severe patients. Twenty-five studies on 1511 COVID-19 non-survivors and 6287 survivors showed higher PT (SMD: 0.67; 95%CI: 0.39, 0.96) and D-Dimer values (SMD: 3.88; 95%CI: 2.70, 5.07), with lower PLT count (SMD: −0.60, 95%CI: −0.82, −0.38) among non-survivors. Regression models showed that C-reactive protein values were directly correlated with the difference in PT and fibrinogen. Conclusions: Significant hemostatic changes are associated with COVID-19 severity. Considering the risk of fatal complications with residual chronic disability and poor long-term outcomes, further studies should investigate the prognostic role of hemostatic parameters in COVID-19 patients.

scholarly journals Human Capital, Skills, and Uneven Intraurban Employment Growth: The Case of Göteborg, Sweden, 1990–2008

2014 ◽  
Vol 2014 ◽  
pp. 1-14 ◽  
Author(s):  
Jonathan Borggren ◽  
Rikard H. Eriksson
Keyword(s):  
Human Capital ◽  
Urban Areas ◽  
Employment Growth ◽  
Local Population ◽  
Urban Dynamics ◽  
High Concentrations ◽  
Growth Differences ◽  
Severe Recession

Recent research has elucidated the role of talents to explain urban growth differences but it remains to be shown whether urban dynamics, such as human capital and a mixed local population, can be linked to intraurban employment growth. By use of a unique longitudinal database, we track the economic development through the lens of intraurban employment growth of a number of primary urban areas (PUA) in Göteborg, Sweden. Regarding factors influencing employment growth, we find that relative concentrations of human capital protect areas from rising unemployment during severe recession (1990–1993) and recovery (1990–2000) while the composition of skills is beneficial during recovery (1990–2000) and long-term growth (1990–2008). Our findings suggest that neither too high concentrations of creative occupations nor too low ones are beneficial. Thus, human capital drives much of the employment changes in relation to the recession and early transition from manufacturing to service but composition of skills is more relevant for explaining long-term intraurban employment growth.

The Role of Long Acting Antipsychotics in Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S15-S15
Author(s):  
E. Vieta
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Term Treatment ◽  
Patient Profile ◽  
Long Term Treatment ◽  
Short And Long Term ◽  
Competing Interest ◽  
Long Acting

Antipsychotics are widely used for the short and long-term treatment of bipolar disorder. Depot and long-acting injectable formulations (LAIs) can be particularly useful for certain subgroups of patients. This lecture will discuss the available data from randomized controlled trials of LAIs in bipolar disorder. A recently published meta-analysis and individual studies assessing depot medications, as well as modern LAIs such as risperidone, paliperidone and aripiprazole, will be reviewed, looking carefully into the prevention of either pole of illness and tolerability. Potential indications and patient profile, based on data and clinical experience, will be discussed.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Cesarean section. Is the choice justified? Risks to children’s health

2018 ◽  
pp. 16-21
Author(s):  
I. N. Zakharova ◽  
I. M. Osmanov ◽  
I. V. Berezhnaya ◽  
К. A. Koltsov ◽  
O. V. Dedikova ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Perinatal Mortality ◽  
Preventive Measures ◽  
Meta Analysis ◽  
Operative Delivery ◽  
Neonatal Deaths ◽  
Adaptive Mechanisms ◽  
Short And Long Term ◽  
Cytokine Cascade

Operative delivery is one of the preventive measures to reduce maternal and perinatal mortality. Due to objective reasons, the indicators of perinatal and early neonatal deaths of children in the Russian Federation have been steadily declining over the past decades. Operative delivery is one of the preventive measures to reduce maternal and perinatal mortality. However, it is necessary to take into account the risks of operative delivery for both mother and baby. The planned caesarean section does not allow to fully activate the adaptive mechanisms of the baby, which disrupts the cytokine cascade and leads to various immunological disorders, one of which is allergy. The last meta-analysis of 13 trials showed a high risk of developing bronchial asthma in children born by cesarean section. Autoimmune diseases, oncological processes and systemic diseases is clearly in evidence in this group. This article discusses the risks for children born by planned cesarean section in the short and long term and the possibility of prevention according to modern trials.

scholarly journals Paclitaxel Exposure and Dosage of Drug-coated Devices for the Treatment of Femoropopliteal Peripheral Artery Disease

2021 ◽  
Vol 4 ◽  
Author(s):  
Ceazón T Edwards ◽  
Peter A Schneider ◽  
Cindy Huynh
Keyword(s):  
Dose Response ◽  
Meta Analysis ◽  
Arterial Disease ◽  
Long Term Results ◽  
Real Patient ◽  
All Cause Mortality ◽  
Artery Disease ◽  
Peripheral Arterial

The role of paclitaxel in the treatment of femoropopliteal peripheral arterial disease is currently ambiguous. A summary-level meta-analysis of randomised trials published in 2018 demonstrated that paclitaxel-coated devices were associated with an increased all-cause mortality in those who underwent treatment at 2 years and 5 years. Further evaluation has been undertaken to establish whether there is a specific dose response, mechanism or reproducible signal. At this time, there has been no confirmation of dose response, as was initially asserted by the summary-level meta-analysis. No mechanism of harm has been identified. Although an association with increased mortality has been confirmed by patient-level meta-analysis, the strength of the signal has been inconsistent. The information suggests there is only an association between paclitaxel-coated devices and increased all-cause mortality, not causation. The authors encourage additional studies designed to follow long-term results after treatment with paclitaxel-coated devices, using real patient data, before a conclusion can be made.

scholarly journals Long-Term Infliximab Treatment in Psoriasis Patients: A National Multicentre Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Clémentine Carlet ◽  
Damien Bichard ◽  
Marie Aleth Richard ◽  
Emmanuel Mahé ◽  
Clémence Saillard ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Critical Role ◽  
Real Life ◽  
Solid Cancer ◽  
Infliximab Treatment ◽  
Efficacy And Safety ◽  
Drug Survival ◽  
The Mean

Background. Although infliximab (IFX) has been available since 2005, there are very little data on the long-term drug survival of infliximab in real-life. Objective. Our aim was to identify and describe psoriasis patients treated with IFX for longer than 6 years. Methods. Psoriasis patients treated with IFX for longer than 6 years were retrospectively included. Demographic and clinical data were collected in May 2018. Results. Between January 2005 and December 2012, 43 patients were maintained on IFX for 6 years or longer. IFX was introduced as a 4.5 line of systemic therapy. The mean duration of IFX treatment was 8.5 years (6–12). In May 2018, 30 patients (70%) were still maintained on IFX at 4–6 mg/kg every 8–10 weeks with an efficiency of about 100%. IFX was stopped in 13 patients (30%) mainly for loss of efficacy in 6 patients (46%). Three patients developed solid cancer including bladder cancer, lung cancer, and prostate cancer. Limitation. Retrospective study. Conclusion. We report the efficacy and safety of IFX maintained for up to 12 years in psoriasis patients. The long-term use of IFX was associated with a high BMI confirming the critical role of weight-based dosing for this drug.

Creating the Deserved Protection: Reflections on Civilian Joint Task Force Counter-insurgency Operations in the North-Eastern Region of Nigeria

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
'Seun Bamidele
Keyword(s):  
Task Force ◽  
Local Population ◽  
Eastern Region ◽  
The North ◽  
Post Conflict ◽  
Joint Task ◽  
North Eastern ◽  
Joint Task Force

This article considers the role of the Civilian Joint Task Force (popularly called CJTF), a group of armed local population participating in the joint battle against Boko Haram, has become a platform for recruitment into the Nigerian security institutions in north-eastern Nigeria. CJTF members have played many roles, from mostly discrete surveillance networks in the north-eastern region of Nigeria to military combat auxiliaries or semi-autonomous fighting forces in the country. For the region’s overstretched and under pressure militaries, they have somewhat filled the security gap and provided local knowledge. CJTF can be a powerful counter-insurgency tool, but there is a compelling need to confront the immediate concerns it raises, notably in terms of impunity, and to begin planning for its long-term post-conflict transformation. The article adopts Galula’s theory of counter-insurgency. It reveals several lessons in how a community-based security structure can be applied to a conventional security engagement.

Abstract 221: Prognostic Role of elevated Myeloperoxidase in Patients with Acute Coronary Syndrome: A Systemic Review and Meta-Analysis.

2014 ◽  
Vol 115 (suppl_1) ◽  
Author(s):  
Andrew R Kolodziej ◽  
Charles L Campbell ◽  
Richard Charnigo ◽  
Raphael Twerenbold ◽  
Christian Mueller ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Systemic Review ◽  
Major Adverse Cardiovascular Events ◽  
Poor Prognostic Factor ◽  
Coronary Syndrome ◽  
Prospective Trials ◽  
Long Term Prognosis

BACKGROUND: It has been shown that Myeloperoxidase (MPO) is intimately involved in pathogenesis of atherosclerosis and Acute Coronary Syndrome (ACS). Small studies have shown that high levels of MPO are a poor prognostic factor in patients presenting with ACS. However, due to the small nature of these studies, the relationship between MPO and outcomes has not been confirmed. Here we aimed to examine the prognostic value of MPO in patients with ACS. METHODS: We performed a meta-analysis to compare the long-term prognosis of ACS patients with high MPO and low MPO levels. The literature was retrieved by formal searches of electronic databases (PubMed, EMBASE, Medline, OVID, and web of knowledge) from inception to November 2013. A total of 16 trials were included in this meta-analysis involving 10572 patients. Data were analyzed using random-effects model and study quality was assessed using appropriate scales. RESULTS: High MPO group was associated with overall worse outcomes than low MPO group in terms of recurrent myocardial infarction (9% [211 of 2336] vs. 7.7% [240 of 3101], odds ratio [OR] 1.4, 95% confidence interval [CI]: 0.92-2.15, p 0.11); all cause mortality (8% [236 of 2920] vs. 5% [209 of 4263], OR 1.83, 95% CI: 1.31-2.54, p <0.0004) and Major Adverse Cardiovascular Events (MACE) (24% [334 of 1400] vs. 14% [133 of 949], OR 2.04, 95% CI: 1.46-2.85, p< 0.0001) (Figure). CONCLUSIONS: In this meta-analysis examining the long-term outcomes in ACS patients, high MPO levels were associated with worse outcomes. These observations support prospective trials tailoring more aggressive therapy to patients with suspected worse prognosis.

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