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Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1476
Author(s):  
Fengming Pan ◽  
Hongyu Zhao ◽  
Stephen Nicholas ◽  
Elizabeth Maitland ◽  
Rugang Liu ◽  
...  

Since 2019, the COVID-19 pandemic has resulted in sickness, hospitalizations, and deaths of the old and young and impacted global social and economy activities. Vaccination is one of the most important and efficient ways to protect against the COVID-19 virus. In a review of the literature on parents’ decisions to vaccinate their children, we found that widespread vaccination was hampered by vaccine hesitancy, especially for children who play an important role in the coronavirus transmission in both family and school. To analyze parent vaccination decision-making for children, our review of the literature on parent attitudes to vaccinating children, identified the objective and subjective influencing factors in their vaccination decision. We found that the median rate of parents vaccinating their children against COVID-19 was 59.3% (IQR 48.60~73.90%). The factors influencing parents’ attitudes towards child vaccination were heterogeneous, reflecting country-specific factors, but also displaying some similar trends across countries, such as the education level of parents. The leading reason in the child vaccination decision was to protect children, family and others; and the fear of side effects and safety was the most important reason in not vaccinating children. Our study informs government and health officials about appropriate vaccination policies and measures to improve the vaccination rate of children and makes specific recommendations on enhancing child vaccinate rates.


Author(s):  
Mohammad H. Alshaer ◽  
Sylvain Goutelle ◽  
Barbara Santevecchi ◽  
Bethany Shoulders ◽  
Veena Venugopalan ◽  
...  

Cefepime is the second most common cephalosporin used in U.S. hospitals. We aim to develop and validate cefepime population pharmacokinetic (PK) model and integrate into precision dosing tool for implementation. Two datasets (680 patients) were used to build cefepime PK model in Pmetrics, and three datasets (34 patients) were used for the validation. A separate application dataset (115 patients) was used for the implementation and validation of a precision dosing tool. The model support points and covariates were used to generate the optimal initial dose (OID). Cefepime PK was described by a two-compartment model including weight and creatinine clearance (CrCl) as covariates. The median rate of elimination was 0.30 hr −1 (adults) and 0.96 hr −1 (pediatrics), central volume of distribution 13.85 L, and rate of transfer from the central to the peripheral compartments 1.22 hr −1 and from the peripheral to the central compartments 1.38 hr −1 . After integration in BestDose, the observed vs. predicted cefepime concentration fit using the application dataset was excellent (R 2 >0.98) and the median difference between observed and what BestDose predicted in a second occasion was 4%. For OID, cefepime 0.5-1g 4-hour infusion q8-24hr with CrCl<70 mL/min was needed to achieve a target range of free trough:MIC 1-4 at MIC 8 mg/L, while continuous infusion was needed for higher CrCl and weight values. In conclusion, we developed and validated a cefepime model for clinical application. The model was integrated in a precision dosing tool for implementation and the median concentration prediction bias was 4%. OID algorithm was provided.


2021 ◽  
Author(s):  
Yushi Nomura ◽  
Michiru Sawahata ◽  
Yosikazu Nakamura ◽  
Ryousuke Koike ◽  
Otohiro Katsube ◽  
...  

ABSTRACTObjectiveWe aimed to determine antibody titres at 6 months and their rate of change during 3-6 months after the second dose of the BNT162b2 coronavirus disease 2019 (COVID-19) mRNA vaccine (Pfizer/BioNTech) and to explore clinical variables associated with titres in Japan.MethodsWe enrolled 365 healthcare workers (250 women, 115 men) whose 3-month antibody titres were analyzed in our previous study and whose blood samples were collected 183 ± 15 days after the second dose. Participant characteristics collected previously were used. The relationships of these factors with antibody titres at 6 months and rates of change in antibody titres during 3-6 months were analyzed.ResultsMedian age was 44 years. Median antibody titre at 6 months was 539 U/mL. Older participants had significantly lower antibody titres (20s, 752 U/mL; 60s–70s, 365 U/mL). In age-adjusted analysis, smoking was the only factor associated with lower antibody titres. Median rate of change in antibody titres during 3-6 months was −29.4%. The only factor significantly associated with the rate of change in Ab titres was not age or smoking, but sex (women, −31.6%; men, −25.1%).ConclusionThe most important factors associated with lower antibody titres at 6 months were age and smoking, as at 3 months, probably reflecting their effect on peak antibody titres. However, antibody titres significantly attenuated during 3-6 months in women alone, which reduced the sex difference in antibody titres seen during the first 3 months. Antibody titres may be affected by different factors at different time points.


2021 ◽  
Author(s):  
Gian Luca Salvagno ◽  
Brandon M. Henry ◽  
Laura Pighi ◽  
Simone De Nitto ◽  
Gianluca Gianfilippi ◽  
...  

Abstract Background: This observational retrospective study aimed to define the kinetics of serum levels of anti-SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) spike trimeric and anti-receptor binding domain (RBD) IgG antibodies up to 6 months after BNT162b2 vaccination. Methods: The sample consisted of 86 SARS-CoV-2 baseline seronegative subjects (median age 45 years, IQR 31-53 years; 52.3% females) undergoing vaccination with Pfizer/BioNTech BNT162b2. Blood was drawn before receiving the first and the second vaccine dose, as well as 1, 3 and 6 months after the second vaccine dose. The serum levels of anti-SARS-CoV-2 spike trimeric IgG and RBD IgG antibodies were assayed.Results: The peak of both antibodies types was reached 1 month after the second dose (2808 and 2163 BAU/mL for anti-SARS-CoV-2 spike trimeric IgG and RBD IgG), after which serum levels progressively declined, falling after 6 months to 486 BAU/mL and 167 BAU/mL for anti-SARS-CoV-2 spike trimeric IgG and RBD IgG, respectively. The median rate of 6-month decline was 85% and 93% for anti-SARS-CoV-2 spike trimeric IgG and RBD IgG, respectively. The rate of vaccine recipients with serum antibodies levels above the 80% threshold of vaccine efficacy declined from over 95% at the peak to 72% and 5% at 6 months for anti-SARS-CoV-2 spike trimeric IgG and RBD IgG, respectively.Conclusions: The results of this retrospective observational study are consistent with the need for timely administration of vaccine boosters to prevent that humoral immunity will wane.


Geology ◽  
2021 ◽  
Author(s):  
Douglas A. Edmonds ◽  
Harrison K. Martin ◽  
Jeffery M. Valenza ◽  
Riley Henson ◽  
Gary S. Weissmann ◽  
...  

The process of river avulsion builds floodplains and fills alluvial basins. We report on a new style of river avulsion identified in the Landsat satellite record. We found 69 examples of retrogradational avulsions on rivers of densely forested fluvial fans in the Andean and New Guinean alluvial basins. Retrogradational avulsions are initiated by a channel blockage, e.g., a logjam, that fills the channel with sediment and forces water overbank (dechannelization), which creates a chevron-shaped flooding pattern. Dechannelization waves travel upstream at a median rate of 387 m/yr and last on average for 13 yr; many rivers show multiple dechannelizing events on the same reach. Dechannelization ends and the avulsion is complete when the river finds a new flow path. We simulate upstreammigrating dechannelization with a one-dimensional morphodynamic model for open channel flow. Observations are consistent with model results and show that channel blockages can cause dechannelization on steep (10–2 to 10–3), low-discharge (~101 m3 s–1) rivers. This illustrates a new style of floodplain sedimentation that is unaccounted for in ecologic and stratigraphic models.


Cartilage ◽  
2021 ◽  
pp. 194760352110188
Author(s):  
Niv Marom ◽  
Tyler Warner ◽  
Riley J. Williams

Objective We sought to report on the demographics and epidemiology of knee cartilage injuries and preferred management in soccer players, across FIFA Medical Centers of Excellence (FMCE). Design A descriptive questionnaire focusing on characteristics of knee cartilage injuries and their management in soccer players during the 10-year period prior to the distribution of the questionnaire was sent to all FMCE around the world in September 2019 via an online platform. Voluntary responses from centers were processed and analyzed. Descriptive characteristics were reported using median and interquartile ranges (IQR) for continuous variables and frequencies and percentages (%) for discrete variables. Results A total of 15 centers from 5 continents responded to the questionnaire and reported on a total of 4526 soccer players. Among centers, the median age was 27 years (IQR: 23-38), the median rate of male players was 75% (IQR: 68-90), and the median rate of professional players was 10% (IQR: 5-23). The most common reported etiology for cartilage injury was traumatic (median 40%, IQR: 13-73). The most common nonoperative treatment utilized was physical therapy (median 90%, IQR: 51%-100%) and the most common operative treatment utilized was bone marrow stimulation/micro-fracture (median 40%, IQR: 19-54%). The utilization of other cartilage restoration procedures varied across centers. Conclusions Our findings highlight different tendencies in the management of these injuries across FMCE and emphasize the need for collaborative efforts focusing on establishing consensus guidelines for the optimal management of these challenging injuries in soccer players.


2021 ◽  
Author(s):  
Tristan Watson ◽  
Jeffrey C Kwong ◽  
Kathy Kornas ◽  
Sharmistha Mishra ◽  
Laura C Rosella

Purpose: There is limited information on the role of individual and neighbourhood level characteristics in explaining the geographic variation in the novel coronavirus 2019 (COVID-19) between regions. This study quantified the magnitude of the variation in COVID-19 rates between neighbourhoods in Ontario, Canada, and examined the extent to which neighbourhood-level differences are explained by census-based neighbourhood measures, after adjusting for individual-level covariates (i.e., age, sex, and chronic conditions). Methods: We conducted a multilevel population-based study of individuals nested within neighbourhoods. COVID-19 laboratory testing data were obtained from a centralized laboratory database and linked to health administrative data. The median rate ratio and the variance partition coefficient were used to quantify the magnitude of the neighbourhood-level characteristics on the variation of COVID-19 rates. Results: The unadjusted median rate ratio for the between-neighbourhood variation in COVID-19 was 2.22 (95% CI, 2.41 to 2.77). In the fully adjusted regression models, the individual and neighbourhood level covariates accounted for about 44% of the variation in COVID-19 between neighbourhoods, with 43% attributable to neighbourhood-level census-based characteristics. Conclusion: Neighbourhood-level characteristics could explain almost half of the observed geographic variation in COVID-19. Understanding how neighbourhood-level characteristics influence COVID-19 rates can support jurisdictions in creating effective and equitable intervention strategies.


Author(s):  
Braeden Hill ◽  
Nicholas Grubic ◽  
Dermot M. Phelan ◽  
Aaron L. Baggish ◽  
Paul Dorian ◽  
...  

Background: Sudden cardiac arrest is the leading medical cause of death amongst athletes and a common cause of death during exercise. The provision of cardiopulmonary resuscitation (CPR) and automatic external defibrillator (AED) use by bystanders can greatly improve survival outcomes in sudden cardiac arrest. However, the effectiveness of these interventions within exertional settings requires further investigation. Objective: To evaluate the role of bystander-initiated CPR and AED use on survival outcomes amongst sports-related sudden cardiac arrest (SrSCA). Methods: Several databases and grey literature sources were queried from inception until November 2020 using a comprehensive search strategy. Abstract screening, full-text review, and data extraction of eligible studies were conducted independently by two reviewers. SrSCA was defined as a cardiac arrest which occurred during (or within 1-hour of) physical activity, sport, or exercise. Bystander CPR and AED rates, as well as appropriate survival outcomes, were extracted from each study, and overall summary measures were calculated. Results: A total of 2,850 unique records were identified, with 176 articles selected for full-text review, of which 32 studies were included in this review. The median rate of bystander CPR and AED use was 75% and 24%, respectively. Survival to hospital discharge ranged from 11%-93%, with a median rate of 33%. Conclusions: Majority of SrSCAs received bystander CPR and achieved a high rate of survival to hospital discharge, yet AED use was low. These findings encourage layperson education in basic life support, the availability of AEDs in athletic facilities, and emergency action plans to ensure timely resuscitation.


2021 ◽  
Vol 34 (1) ◽  
pp. 243-258 ◽  
Author(s):  
Qiaohong Sun ◽  
Xuebin Zhang ◽  
Francis Zwiers ◽  
Seth Westra ◽  
Lisa V. Alexander

AbstractThis paper provides an updated analysis of observed changes in extreme precipitation using high-quality station data up to 2018. We examine changes in extreme precipitation represented by annual maxima of 1-day (Rx1day) and 5-day (Rx5day) precipitation accumulations at different spatial scales and attempt to address whether the signal in extreme precipitation has strengthened with several years of additional observations. Extreme precipitation has increased at about two-thirds of stations and the percentage of stations with significantly increasing trends is significantly larger than that can be expected by chance for the globe, continents including Asia, Europe, and North America, and regions including central North America, eastern North America, northern Central America, northern Europe, the Russian Far East, eastern central Asia, and East Asia. The percentage of stations with significantly decreasing trends is not different from that expected by chance. Fitting extreme precipitation to generalized extreme value distributions with global mean surface temperature (GMST) as a covariate reaffirms the statistically significant connections between extreme precipitation and temperature. The global median sensitivity, percentage change in extreme precipitation per 1 K increase in GMST is 6.6% (5.1% to 8.2%; 5%–95% confidence interval) for Rx1day and is slightly smaller at 5.7% (5.0% to 8.0%) for Rx5day. The comparison of results based on observations ending in 2018 with those from data ending in 2000–09 shows a consistent median rate of increase, but a larger percentage of stations with statistically significant increasing trends, indicating an increase in the detectability of extreme precipitation intensification, likely due to the use of longer records.


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