Waning Effectiveness of SARS-CoV-2 mRNA Vaccines in Older Adults: A Rapid Review

The U.S. Centers for Disease Control and Prevention (CDC) and other health agencies have recently recommended a booster dose of COVID-19 vaccines for specific vulnerable groups including adults 65 years and older. There is limited evidence whether vaccine effectiveness in older adults decreases over time, especially against severe COVID-19. We performed a rapid review of published studies available through 04 November 2021 that provide effectiveness data on mRNA vaccines approved/licensed in the United States and identified eight eligible studies which evaluated vaccine effectiveness in older adults. There is evidence of a decline in vaccine effectiveness against both SARS-CoV-2 infection and severe COVID-19 in older adults among studies which analyzed data up to July-October 2021. Our findings suggest that vaccine effectiveness diminishes in older adults, which supports the current recommendation for a booster dose in this population.

Analysis of pipe axial displacements from a monitored pipeline connected to an operating district heating network

The development of a monitored district heating piping system has allowed the study of axial displacement variations in a buried pipeline. This piping system includes four instrumented sections of piping within an in use district heating network. There are also different conditions under testing such as thickness of expansion cushions, temperature ranges and bedding soil types. The pipe axial displacements were on-line monitored by means of extensometers in six positions along each of the four sections of the pipeline. Measured maximum pipe axial displacements were 24 and 25 mm in the corners of the 41 m long monitored pipelines, while estimated values were 23 mm using current recommendation procedures and 27 mm using calibrated commercial computer programs. One temperature unloading-reloading caused displacements to not return to the same values as before, but around 3 mm smaller. Therefore, several unloading-reloading temperature cycles may affect the pipe deformation behaviour in the short and long term.

Rare Metastasis to the Submandibular Gland in Oral Squamous Cell Carcinoma

PurposeIn the current recommendation of neck dissection in oral squamous cell carcinoma (OSCC), the submandibular gland (SMG) should also be removed. This study aimed to investigate the incidence and the patterns of SMG involvement in OSCC patients.MethodsPatients initially diagnosed with OSCC between January 2018 and October 2020 were included. The distribution of lymph nodes metastasis in level IB was analyzed.ResultsWe included 145 patients who underwent primary surgery and neck dissection in this study. All patients had level IB lymph node dissection and simultaneous removal of the SMG. Of these patients, only one patient (0.7%) had involvement in SMG by directly infiltrating from the primary tumor. A total of 18 positive lymph nodes were found in level IB in 16 patients, and no positive lymph nodes were located in the SMG. There were 6 lymph nodes located in the lateral part of the SMG and 12 lymph nodes located in the anterior of the SMG. Patients with tumors located in the buccal mucosa and N3 stage were the independent predictive factors associated with level IB nodal metastasis.ConclusionInvolvement of SMG in OSCC is quite rare. Preservation of the SMG during neck dissection in selected patients with OSCC seems to be feasible and oncologically safe.

Relevance of Routine Abdominopelvic Ultrasound in Suspected Child Abuse in Children Under 2 years of Age: Review of 15 years of Experience

In France, the current recommendation is to perform a routine abdominopelvic ultrasound in any child under 2 years of age who is suspected to have been abused. We retrospectively studied the relevance of this practice in our center over the past fifteen years. This was a descriptive, retrospective study of all children under 2 years of age who had been subject to suspected abuse. Abdominal images and reports were reviewed and cross-referenced with possible clinical and biological signs. Four hundred and five children were included between 2006 and 2020, of whom 296 underwent abdominal imaging (2 initial abdominopelvic CT scans, 4 ultrasounds followed by CT scans, and 290 ultrasounds alone). Four examinations revealed traumatic abnormalities related to abuse. These four children all had clinical or biological anomalies. In the absence of clinical or biological signs, no imagery showed any abnormality related to abuse.

Military Aviators with Inflammatory Bowel Diseases Continued Flying

INTRODUCTION: Military aviators are likely to be first diagnosed with inflammatory bowel diseases (IBD) during military service. Current recommendations support continuing flying with restrictions, but risks may be significant. The aim of the study was to document the long-term results of aviators newly diagnosed with IBD. METHODS: A prospective observational study over a 23-yr period included all Israeli Air Force (IAF) aviators with IBD. Primary end point was the qualification and safety to continue operational flying following IBD diagnosis. RESULTS: Subjects were 16 male aviators with an average follow-up of 130 mo. Average age was 27 (2045) and average time from symptoms onset to final diagnosis was 7.3 mo. Eight (50%) patients had Crohns disease (CD), and the other eight had ulcerative colitis (UC). Eight (50%) were high performance platform aviators. Two patients received biologic treatment, two were treated with repeated corticosteroid courses, and four with immunosuppressive therapy. Two patients underwent surgery and four needed different lengths of hospitalizations. Eight (50%) aviators (3 CD, 5 UC) were grounded for a mean of 177 d (5590). Altogether grounding for IBD aviators was 46/2087 mo (2.2%). Most grounding periods were short term and reversible. All aviators continued flying under annual monitoring or as needed and no compromise of their abilities was documented. CONCLUSIONS: All aviators were able to continue flying and no events of sudden incapacitation or severe disabling flares have been seen among patients. Our study findings support the current recommendation to continue flying when IBD is in stable remission. Tehori O, Koslowsky B, Gabbai D, Shapira S, Ben-Ari O. Military aviators with inflammatory bowel diseases continued flying. Aerosp Med Hum Perform. 2021; 92(10):831834.

Cryptogenic Stroke: Cardiac Rhythm Monitoring as An Indispensable Screening Modality

The prevalence of stroke in Indonesia increased overtime. CS ranges from 15 to 40% from all ischemic strokes. Finding the etiology of ischemic stroke is important to prevent recurrence. AF is predicted as the etiology behind CS. The current recommendation only supports short period of ECG monitoring. However, studies have shown that a higher detection rate can be achieved with longer duration of monitoring. ICM, a diagnostic tool with the highest detection rate, is still considered cost-effective when the calculation takes into account the QALY gained. Digital health tools such as handheld devices and smartwatch ECG have revolutionized the screening of AF however it is still considered as pre-diagnostic and verification is needed to confirm the rhythm generated.

Effects of Nitrate Supplementation on Exercise Performance in Humans: A Narrative Review

Nitrates have become increasingly popular for their potential role as an ergogenic aid. The purpose of this article was to review the current scientific evidence of nitrate supplementation on human performance. The current recommendation of nitrate supplementation is discussed, as well as possible health complications associated with nitrate intake for athletes, and dietary strategies of covering nitrate needs through sufficient intake of nitrate-rich foods alone are presented. Pubmed, Scopus, and Web of Science were searched for articles on the effects of nitrate supplementation in humans. Nitrates are an effective ergogenic aid when taken acutely or chronically in the range of ~5–16.8 mmol (~300–1041 mg) 2–3 h before exercise and primarily in the case of exercise duration of ~10–17 min in less trained individuals (VO2max < 65 mL/kg/min). Nitrate needs are most likely meet by ingesting approximately 250–500 g of leafy and root vegetables per day; however, dietary supplements might represent a more convenient and accurate way of covering an athlete’s nitrate needs. Athletes should refrain from mouthwash usage when nitrate supplementation benefits are desired. Future research should focus on the potential beneficial effects of nitrate supplementation on brain function, possible negative impacts of chronic nitrate supplementation through different nitrate sources, and the effectiveness of nitrate supplementation on strength and high-intensity intermittent exercise.

Indentation modulus extrapolation and thickness estimation of ta-C coatings from nanoindentation

Coatings used in tribological applications often exhibit high hardness and stiffness to achieve high wear resistance. One coating characterization method frequently used is nanoindentation which allows the determination of indentation hardness and indentation modulus among other material properties. The indentation modulus describes the elastic surface behavior during indentation and is, among hardness, a direct indicator for wear resistance. To obtain the true indentation modulus of a coating, it must be measured with varying loads and then extrapolated to zero load. Current recommendation of the standard ISO 14577-4:2016 is a linear extrapolation which fits poorly for nonlinear curves. Such nonlinear curves are commonly found for high hardness mismatches between coating and substrate, for example, superhard tetrahedral amorphous carbon coatings (ta-C) on a steel substrate. In this study, we present a new empirical fit model, henceforth named sigmoid. This fit model is compared to several existing fit models described in the literature using a large number of nanoindentation measurements on ta-C coatings with wide ranges of indentation modulus and coating thickness. This is done by employing a user-independent and model agnostic fitting methodology. It is shown that the sigmoid model outperforms all other models in the combination of goodness of fit and stability of fit. Furthermore, we demonstrate that the sigmoid model’s fit parameter directly correlates with coating thickness and thus allows for a new approach of determining ta-C coating thickness from nanoindentation.

Urinary Iodine Status at Delivery in Rural Pregnant Mothers from KONKAN Region of India (BKLWHANC-2)

Adequate iodine is necessary in pregnancy for normal maternal as well as fetal thyroid function. Fetus cannot produce thyroid hormone so it is exclusively dependent on mother. During pregnancy, iodine demand is increased by 50%. An adequate intake of dietary iodine in pregnancy is essential for the normal neurodevelopment of the offspring. We measured urinary iodine concentrations in 220 pregnant women who reported for delivery at a rural hospital in the KONKAN region of the State of Maharashtra, India. The mean age and gestation at delivery were 26.9 years and 38.2 weeks respectively. The observed median UIC was 84.6μg/l. Urinary iodine of mother was not associated with neonatal anthropometric measurements (weight, length and head circumference). We have found low median UIC levels at delivery among pregnant women. The increased demand in pregnancy could be met by iodine supplementation or increasing iodine content in the salt. The burden of poor iodine status in pregnant women will further adversely affect the fetal neurodevelopment. There should be universal screening of every pregnant woman for the identification of iodine status. A simple strategy of improving iodine content in the salt beyond the current recommendation for pregnant women might be beneficial for mother as well as fetus but continuous monitoring for adequate iodine is warranted.

Dietary Intake Patterns of Community-Dwelling Older Adults after Acute Hospitalization

Background Malnutrition and sarcopenia are a growing concern in community-dwelling older adults. Hospitalization increases the risk of malnutrition and leads to a decline in functional and nutritional status at discharge. Persistent malnutrition after hospital discharge may worsen post-hospital outcomes, including readmissions. The aim of this study was to determine dietary intakes and nutrient distribution patterns of community-dwelling older adults after acute hospitalization. Methods Participants (≥65 yrs old, n=85) were enrolled during acute hospitalization and dietary 24-hour recalls were collected weekly for one month post-discharge. Analysis included: change in dietary intake over recovery timeframe; daily intake of energy, protein, fruit, vegetables, and fluids; comparison of intake to recommendations; distribution of energy and protein across mealtimes; and analysis of most common food choices. Results Most participants did not meet current recommendations for energy, fruit, vegetables, or fluids. Average protein consumption was significantly higher than the current recommendation of 0.8g/kg/day; however only 55% of participants met this goal and less than 18% met the 1.2 g/kg/day proposed optimal protein intake for older adults. The protein distribution throughout the day was skewed and no one met the 0.4 g/meal protein recommendation at all meals. Conclusions Our findings indicate that community-dwelling older adults did not meet their nutritional needs during recovery after hospitalization. These data highlight the need for better nutritional evaluation and support of geriatric patients recovering from hospitalization.