Frontiers in Oral Mucosal Immunity and the Microbiome

The 2nd International Conference on Oral Mucosal Immunity and the Microbiome (OMIM) took place at the Grecotel Kos Imperial Hotel, Kos, Greece, between 25th and 30th September 2021, under the auspices of the Aegean Conferences. This has only been the second Aegean Conference of this thematic, the first one having taken place in 2018 in Crete, during the same period of the year. Given the hardships in travel and heightened infection transmission risks amid the COVID-19 pandemic, the Conference was well attended by 29 international speakers across the world. For many of the participants, this was the first conference travel in the post-pandemic era, and quite significant that it has taken place on the island of Hippocrates. Stringent regional health and safety regulations had to be followed to accomplish for this in-person Conference to take place. Frontiers in Oral Health has hosted papers from presentations of the Conference, whereas the present article serves as the proceedings of the Conference with summaries of the presentations.

SIR model for propagation of COVID-19 in the Paraíba's State (Brazil)

This work aims to apply the SIR-type compartmental model (Susceptible - Infected - Removed) in the evolution of Covid-19 in Paraíba's State and Campina Grande City. For that, the parameters of the model were considered to be variable during time evolution, within an appropriate range. The system of differential equations was solved numerically using the Euler method. The parameters were obtained by adjusting the model to the infected data provided by the Paraíba Health Department. According to the results obtained, the model describes the infected population well. There was a reduction in the effective reproduction number in Paraíba and the town of Campina Grande. It is noteworthy that understanding the dynamics of infection transmission and evaluating the effectiveness of control measures is crucial to assess the potential for sustained transmission to occur in new areas. The model can also be applied to describe epidemic dynamics in other regions and countries.

Prevention and control of tuberculosis infections: a phenomenology study

This study aims to determine the experience of nurses in health centers regarding the factors that affect the prevention and control of TB infection and to determine the risk of nosocomial infection transmission. This research is qualitative research using a phenomenological approach, structured interviews. The research sample was 4 Health Centers nurses in Indonesia. The sampling technique was total sampling. The interview in the confidential meeting room, conducted in Indonesian, lasted about 30 minutes. Participants' responses were recorded during the interview. We typed and examined the coded script. Interviews were recorded using a tape recorder. Four themes were found, namely the lack of health service facilities, socio-cultural factors, patient behavior in utilizing health services.

Estimates of reduced vaccine effectiveness against hospitalization, infection, transmission and symptomatic disease of a new SARS-CoV-2 variant, Omicron (B.1.1.529), using neutralizing antibody titers

The emergence of the Omicron variant (B.1.1.529) of SARS-CoV-2 has raised concerns about how mutations in the spike protein might influence immune escape and vaccine protection against infection and disease, COVID-19. Initial estimates of immune escape measure neutralizing antibody titers, which have been shown to be a correlate of protection for COVID-19, but vary among studies. However, no studies have examined variation in vaccine effectiveness (VE) using estimated reductions in neutralizing antibody titers across virus variants. We quantified consistency in relative neutralizing antibody titers across studies. We then examined relationships between variant-specific reductions in neutralizing antibodies and protection against documented infection, symptomatic disease, and hospitalizations across variants and vaccines. We found considerable variation in variant-specific neutralizing antibody titers between studies, but within-study comparisons across variants were far more robust. There was insufficient data to estimate VE for a single vaccine across variants, especially for higher levels of immune evasion (>7-fold reductions in neutralizing antibody titers) observed with the Omicron variant (40-fold). Instead, we leveraged variation among both vaccines and virus variants to estimate VE - neutralizing antibody titer relationships across a 30 to 100-fold range of neutralizing antibody titers reduction. Omicron increased the risk of hospitalization four to five-fold and increased the risk of symptomatic disease seven to ten-fold for mRNA vaccinees, with similar relative effects for recently vaccinated, or individuals with waned antibody titers. Third doses restored titers and protection to levels similar to waned immunity against Delta. Overall, these analyses indicate that vaccine effectiveness against severe disease is significantly diminished for waned individuals, and protection against infection, symptomatic disease and transmission is nearly eliminated. However, third doses significantly ameliorate these reductions but only restore protection to levels equivalent to waned protection against the Delta variant. The invasion of Omicron is likely to result in widespread infection, and substantial hospitalizations unless widespread boosting of immunity occurs.

Hurdles in the Access of Regular Dental Care among the Medical & Dental Students of Lahore

Introduction: Despite the great leaps in oral health globally, many countries of the world still face a horde of dental problems. Especially poverty ridden populations of the developing nations. Distribution of oral disease varies among different communities and sometimes even in the same community due to various environmental factors, factors of personal hygiene and oral habits among different demographics. However, the condition of oral health in the patients of Lahore is abysmal as determined by various previous dental surveys. The prevalence of cavities in dental patients is 82.3% while the rest of 17.7% have swollen gums, abscess, infection, and pain. Thus, this study aims to test the barriers in the way of regular dental care by evaluating a major portion of medical and dental students by using a cross sectional, questionnaire-based study, and to make regular dental care more accessible to the students of this metropolis. Objective: To determine the factors that become a hurdle in the way of regular dental care among the medical and dental students of Lahore and to pave the way for further studies on this topic. Methodology: This survey, after approval from the Internal Review Board of de’Montmorency College of Dentistry, was carried out from July to October 2021. Sample size was calculated using OpenEpi, keeping the confidence level at 95% and the margin of error at 6%. The sampling population included 234 respondents who were randomly selected from 4 different medical and dental colleges of Lahore including both public and private sector colleges. Data was collected using a structured questionnaire titled; Questionnaire for Assessment of Perceived Oral Health Care Needs, Barriers to Accessing Oral Health Care Services and Its Utility8. Statistical analysis was performed using SPSS® version 22. Result: All of the participants were students of medical and dental colleges of Lahore. More than half of the participants agreed to have not visited a dentist regularly for regular checkups for maintenance of oral health. About 55% of the participants agreed to not visiting a dentist due to fear of infection transmission. We also found a significant association between the stream of education and regular dental visits (p=0.000). Conclusion: For medical and dental students, the biggest barrier in regular oral healthcare is fear of infection transmission, and unavailability of time. However, fear of dental procedures and high cost of service also play a role. Moreover, the high cost of service is not as strong of a factor as it is for the general population.

Effectiveness of ACB-IP 1.0 Universal Pathogen Free Concentrated Cocktail Convalescent Plasma in COVID-19 Infection

BACKGROUNDThe efficacy of SARS-CoV2 single donor convalescent plasma (CP) varied according to the application time and the amount of antibody that is administered. Single donor CP has some drawbacks; such as the insufficient levels of neutralizing antibody activities, the requirements of blood group compatibility, and the risk of infection transmission. In this study, the safety and efficacy of pathogen inactivated, isohemagglutinin-depleted (concentrated) and pooled CP product was investigated. MATERIALS AND METHODSA total of sixteen patients were treated with either single donor CP (N:9) or pathogen-free, concentrated, pooled CP (ACB-IP 1.0) (N:7).RESULTSFive out of six single donor plasma SARS-CoV2 antibody titers remained below 12 s/co, but the antibody titers of all ACB-IP 1.0 plasma were above 12 s/co. SARS-CoV2 total antibody titers of ACB-IP 1.0 plasma were statistically higher than the antibody titers of single donor CP. Mean total plasma neutralizing antibody activity of ACB-IP 1.0 plasma (1.5421) was found statistically higher than single donor CP (0.9642) in 1:256 dilution (ρ<0.01)The mortality rates of the patients treated with ACB-IP 1.0 plasma were statistically lower (p< 0.05) than the patients treated with single donor CP. The administration of either single donor CP or ACB-IP 1.0 plasma to the patients within eight days significantly shortened the length of hospitalization (ρ< 0.01).CONCLUSIONThe present study established ACB-IP 1.0 plasma product as a safe and potentially effective treatment for COVID-19, allowing rapid access to patients in need.TRIAL REGISTRATIONTrial Registration Number: NCT04769245Trial Registration Date: 17.03.2021

The COVID-19 Pandemic: Are There Any Impacts on Sustainability?

This paper sets out to explain and describe the potential ways to control COVID-19′s impact on the environment and what controllable strategies and anticipations emerge from rethinking sustainable production. The rapid and devastating spread of this disease has made millions of people throughout the world cover themselves, wear gloves, and use hand sanitizers and other medical applications. However, it means that a huge amount of clinical waste is being dumped into landfills or the oceans, and such activity may simply worsen the infection’s transmission and the sustainability of the environment, the socio-economy, and sustainable productions. This disease has greatly changed the way people live and has caused considerable occupational job losses and misfortunes, sending sustainable businesses and other organizations to the wall. Virtually every country is trying to stop the infection transmission by testing patients and isolating people, but the environmental effects of the pandemic and sustainable business have not previously been analyzed. The study suggests that the current options for sustainable production must be measured and also further researched.

Modeling the impact of school reopening and contact tracing strategies on Covid-19 dynamics in different epidemiologic settings in Brazil

Among the various non–pharmaceutical interventions implemented in response to the Covid–19 pandemic during 2020, school closures have been in place in several countries to reduce infection transmission. Nonetheless, the significant short and long–term impacts of prolonged suspension of in–person classes is a major concern. There is still considerable debate around the best timing for school closure and reopening, its impact on the dynamics of disease transmission, and its effectiveness when considered in association with other mitigation measures. Despite the erratic implementation of mitigation measures in Brazil, school closures were among the first measures taken early in the pandemic in most of the 27 states in the country. Further, Brazil delayed the reopening of schools and stands among the countries in which schools remained closed for the most prolonged period in 2020. To assess the impact of school reopening and the effect of contact tracing strategies in rates of Covid–19 cases and deaths, we model the epidemiological dynamics of disease transmission in 3 large urban centers in Brazil under different epidemiological contexts. We implement an extended SEIR model stratified by age and considering contact networks in different settings – school, home, work, and elsewhere, in which the infection transmission rate is affected by various intervention measures. After fitting epidemiological and demographic data, we simulate scenarios with increasing school transmission due to school reopening. Our model shows that reopening schools results in a non–linear increase of reported Covid-19 cases and deaths, which is highly dependent on infection and disease incidence at the time of reopening. While low rates of within[&ndash]school transmission resulted in small effects on disease incidence (cases/100,000 pop), intermediate or high rates can severely impact disease trends resulting in escalating rates of new cases even if other interventions remain unchanged. When contact tracing and quarantining are restricted to school and home settings, a large number of daily tests is required to produce significant effects of reducing the total number of hospitalizations and deaths. Our results suggest that policymakers should carefully consider the epidemiological context and timing regarding the implementation of school closure and return of in-person school activities. Also, although contact tracing strategies are essential to prevent new infections and outbreaks within school environments, our data suggest that they are alone not sufficient to avoid significant impacts on community transmission in the context of school reopening in settings with high and sustained transmission rates.