Hydraulics Near Unscreened Diversion Pipes in Open Channels: Large Flume Experiments

Most of the water diversions on the Sacramento and San Joaquin Rivers (California, United States) and their tributaries are currently unscreened. These unscreened diversions are commonly used for irrigation and are potentially harmful to migrating and resident fishes. A large flume (test section: 18.29 m long, 3.05 m wide and 3.20 m high) was used to investigate the hydraulic fields near an unscreened water diversion under ecologically and hydraulically relevant diversion rates and channel flow characteristics. We investigated all combinations of three diversion rates (0.28, 0.42, and 0.57 m3/s) and three sweeping velocities (0.15, 0.38, and 0.61 m/s), with one additional test at 0.71 m3/s and 0.15 m/s. We measured the three-dimensional velocity field at seven cross sections near a diversion pipe and constructed regression equations of the observed maximum velocities near the pipe. Because the velocity components in three directions (longitudinal, transverse, and vertical) were significantly greater near the diversion pipe inlet compared with those farther from it, they cannot be neglected in the modeling and design of fish guidance and protection devices for diversion pipes. Our results should be of great value in quantifying the hydraulic fields that are formed around fish guidance devices to design more effective protection for fishes from entrainment into unscreened water-diversion pipes

If we build it they will come: targeting the immune response to breast cancer.

Historically, breast cancer tumors have been considered immunologically quiescent, with the majority of tumors demonstrating low lymphocyte infiltration, low mutational burden, and modest objective response rates to anti-PD-1/PD-L1 monotherapy. Tumor and immunologic profiling has shed light on potential mechanisms of immune evasion in breast cancer, as well as unique aspects of the tumor microenvironment (TME). These include elements associated with antigen processing and presentation as well as immunosuppressive elements, which may be targeted therapeutically. Examples of such therapeutic strategies include efforts to (1) expand effector T-cells, natural killer (NK) cells and immunostimulatory dendritic cells (DCs), (2) improve antigen presentation, and (3) decrease inhibitory cytokines, tumor-associated M2 macrophages, regulatory T- and B-cells and myeloid derived suppressor cells (MDSCs). The goal of these approaches is to alter the TME, thereby making breast tumors more responsive to immunotherapy. In this review, we summarize key developments in our understanding of antitumor immunity in breast cancer, as well as emerging therapeutic modalities that may leverage that understanding to overcome immunologic resistance

Tratamiento quirúrgico e intervencionista de la coartación aórtica nativa en neonatos y lactantes

Introduction: Surgical relief of Coarctation of the aorta (CoA) and catheter interventional techniques are available alternatives even though no consensus has been reached in regard to the method of intervention (surgery vs. balloon angioplasty) in neonates and infants with native CoA. Many cardiologists prefer surgical intervention, whereas a few may choose for balloon angioplasty.Objective: To analyze surgical and interventional techniques outcomes in neonates and infants with native CoA. To identify the complications and the intensive care unit (ICU) stays. To determine the risk factors related to recoarctation (ReCoA).Method: An observational, analytical, longitudinal and prospective study was made aiming to analyze the surgical and balloon angioplasty outcomes in newborns and infants with native CoA at the William Soler Pediatric Cardiology Hospital from 2006 - 2011. Patients were distributed in two groups: Group I: patients treated with surgery (n=50); Group II: patients treated with angioplasty (n=14).Results: 75.0 % of patients in Group I and 57.1 % of the Group II were less than the six months old. ICU stays of patients treated surgically were the largest (median of 36 hours). The percentage of ReCoA was higher in patients treated with angioplasty (28.5 %). Paradoxical arterial hypertension was the most common complication found (60.0 %). A residual gradient higher than 15 mm Hg following surgical correction or balloon angioplasty was identified as a risk factor for ReCoA (interventional catheterization RR: 7.5; surgery RR: 11.4).Conclusions: ICU stays were longer in the patients underwent surgery. Patients treated with balloon angioplasty showed higher incidence of ReCoA. Complications were not so frequent. A gradient higher than 15 mm Hg was identified as a risk factor for ReCoA irrespective of the procedure performed.Introduction: le soulagement chirurgicale de coarctation de l'aorte (CoA) et le cathéter d'intervention techniques sont des alternatives disponibles, même si aucun consensus n'a été atteint en ce qui concerne la méthode d'intervention (chirurgie vs angioplastie par ballonnet) dans les nouveau-nés et les nourrissons avec natif CoA. Beaucoup de cardiologues préfèrent une intervention chirurgicale, tandis que quelques-uns peuvent choisir pour l'angioplastie par ballonnet. Objectif: analyser les techniques chirurgicales et interventionnelles résultats dans les nouveau-nés et les nourrissons avec natif CoA. Pour identifier les complications et les unités de soins intensifs (USI). Pour déterminer les facteurs de risque liés à recoarctation (ReCoA). Méthode: Une étude observationnelle analytique, longitudinale et prospective a été faite visant à analyser la chirurgie et l'angioplastie par ballonnet résultats des nouveau-nés et les nourrissons avec natif CoA à l'hôpital William Soler cardiologie pédiatrique de 2006 - 2011. patients ont été répartis en deux groupes: Groupe I : patients traités par chirurgie (n = 50); Groupe II: patients traités par angioplastie (n = 14). Résultats: 75,0% des patients du groupe I et 57,1% du groupe II étaient inférieures à la l'âge de six mois. Séjours aux soins intensifs des patients traités chirurgicalement ont le plus grand (médiane de 36 heures). Le pourcentage de ReCoA était plus élevée dans les patients traités à l'angioplastie (28,5%). L'hypertension artérielle paradoxale a été la complication la plus commune (60,0%). Un gradient résiduel supérieur à 15 mm Hg suivante chirurgicale correction ou l'angioplastie par ballonnet a été identifié comme un facteur de risque pour ReCoA (interventionnelle cathétérisme RR: 7,5; chirurgie RR: 11,4). Conclusions: séjours en soins intensifs étaient plus dans les patients ont été opérés. Les patients traités par angioplastie par ballonnet ont montré une incidence plus élevée de ReCoA. Les complications sont pas si fréquentes. Un gradient supérieur à 15 mm Hg a été identifiée comme un facteur de risque pour ReCoA quelle que soit l'intervention effectuée.Introdução: alívio cirúrgico da coarctação da aorta (CoA) e cateter intervencionista técnicas são alternativas disponíveis, embora nenhum consenso foi alcançado em relação ao método de intervenção (cirurgia vs angioplastia por balão) em recém-nascidos e lactentes com CoA nativa. Muitos cardiologistas preferem intervenção cirúrgica, enquanto que alguns podem optar por angioplastia com balão. Objetivo: Analisar a técnica cirúrgica e intervencionista resultados em recém-nascidos e lactentes com CoA nativa. Para identificar as complicações e Unidade de Terapia Intensiva (UTI) estadias. Para determinar os fatores de risco relacionados à recoartaram (RECOA). Método: um estudo observacional, analítico e prospectivo foi feito com o objetivo de analisar a cirurgia e balão de angioplastia resultados em recém-nascidos e lactentes com CoA nativa no William Soler Cardiologia Pediátrica do Hospital de 2006 - 2011. Os pacientes foram distribuídos em dois grupos: Grupo I : os doentes tratados com a cirurgia (n = 50); Grupo II: os doentes tratados com angioplastia (n = 14). Resultados: 75,0% dos pacientes do Grupo I e 57,1% do grupo II foram menores do que os seis meses de idade. Permanência na UTI de pacientes tratados cirurgicamente foram o maior (média de 36 horas). O percentual de RECOA foi maior nos pacientes tratados com angioplastia (28,5%). Hipertensão arterial paradoxal foi a complicação mais comum encontrada (60,0%). Um gradiente residual maior que 15 mm Hg após correção cirúrgica ou balão de angioplastia foi identificado como um fator de risco para RECOA (intervencionista RR cateterismo: 7,5; cirurgia RR: 11,4). Conclusões: permanência na UTI foram maiores quando os pacientes foram submetidos a cirurgia. Os pacientes tratados com angioplastia com balão mostrou maior incidência de RECOA. As complicações não foram tão freqüentes. Um gradiente maior que 15 mm Hg foi identificado como um fator de risco para RECOA independentemente do procedimento realizado.Introducción: La Coartación aórtica se puede resolver con cirugíao a través del intervencionismo. Aunque existe controversia, la mayor parte de los autores recomiendan laprimera para el tratamiento de la coartación aórtica nativa en menores de un año.Objetivos: Analizar losresultados de lacirugía y elcateterismo intervencionista en neonatos y lactantes con coartación de la aorta nativa. Identificar las complicaciones posprocedimiento y la estadía en la terapia intensiva .Determinar los factores de riesgo en la aparición de recoartación.Método: Se realizó un estudio observacional, analítico, prospectivo y longitudinal con el objetivo de analizar los resultados de la cirugía y el cateterismo intervencionista en recién nacidos y lactantes con Coartación de la Aorta nativa en el Cardiocentro Pediátrico“William Soler”, durante el período 2006 a 2011. Los pacientes se dividieron en dos grupos: Grupo I: pacientes operados (n=50); Grupo II: intervenidos por cateterismo intervencionista(n=14). Resultados: Los menores de 6 meses constituyeron 76,5% del grupo I y 57,1 % del grupo II. La estadía en laterapia intensiva fue mayor en los pacientes operados (mediana de 36 horas). El porciento de recoartación fue mayor en los pacientes llevados a hemodinámica (28,5 %). La complicación posprocedimiento más frecuente fue la hipertensión arterial paradójica (60 %). Elgradiente mayor de 15 mm Hg posproceder fue un factor de riesgo para la recidiva (hemodinamia RR: 7,5, cirugía RR: 11,4).Conclusiones: La estadía en la unidad de cuidados intensivos es mayor en los intervenidos quirúrgicamente. En la coartación aortica la recoartación es más frecuente en los tratados con angioplastia percutánea de balón. Las complicaciones son infrecuentes, y los pacientes con gradiente mayor de 15 mm Hg posprocedertienen un riesgo aumentado de recoartación en ambos grupos

Advances, gaps and way forward in provision of climate services over the Greater Horn of Africa

The Greater Horn of Africa is prone to extreme climatic conditions, thus, making climate services increasingly important in supporting decision-making processes across a range of climate sensitive sectors. This study aims to provide a comprehensive review of the recent advances, gaps and challenges in the provision of climate services over the region, for each of the components of the Global Framework for Climate Services. The study explores various milestones that have been achieved toward climate service delivery. The achievements include improvement of station network coverage, and enhancing the capacity of member states to utilize various tools in data analysis and generate routine climate products. The advancement in science, and availability of High-Performance Computing has made it possible for forecast information to be provided from nowcasting to seasonal timescales. Moreover, operationalizing of the objective forecasting method for monthly and seasonal forecasts has made it possible to translate tercile forecasts for applications models. Additionally, innovative approaches to user engagement through co-production, communication channels, user-friendly interfaces, and dissemination of climate information have also been developed. Despite the significant progress that has been made in the provision of climate services, there are still many challenges and gaps that need to be overcome in order to ensure that these services are effectively meeting the needs of users. The research of the science underpinning climate variability, capacity building and stakeholder engagement, as well as improved data management and quality control processes are some of the gaps that exist over the region. Additionally, communication and dissemination of climate information, including timely warnings and risk communication, require improvement to reach diverse user groups effectively. Addressing these challenges will require strengthened partnerships, increased investment in capacity building, enhanced collaboration between the climate information producers and stakeholders, and the development of user-friendly climate products. Bridging these gaps will foster greater resilience to climate-related hazards and disasters in the Greater Horn of Africa and support sustainable development in the region

Immune Imprinting and Protection against Repeat Reinfection with SARS-CoV-2

More than 2 years into the coronavirus disease 2019 (Covid-19) pandemic, the global population carries heterogeneous immune histories derived from various exposures to infection, viral variants, and vaccination.1 Evidence at the level of binding and neutralizing antibodies and B-cell and T-cell immunity suggests that a history of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can have a negative effect on subsequent protective immunity.1 In particular, the immune response to B.1.1.529 (omicron) subvariants could be compromised by differential immune imprinting in persons who have had a previous infection with the original virus or the B.1.1.7 (alpha) variant.

Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar.

BACKGROUND: Waning of vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (Covid-19) is a concern. The persistence of BNT162b2 (Pfizer-BioNTech) vaccine effectiveness against infection and disease in Qatar, where the B.1.351 (or beta) and B.1.617.2 (or delta) variants have dominated incidence and polymerase-chain-reaction testing is done on a mass scale, is unclear. METHODS: We used a matched test-negative, case-control study design to estimate vaccine effectiveness against any SARS-CoV-2 infection and against any severe, critical, or fatal case of Covid-19, from January 1 to September 5, 2021. RESULTS: Estimated BNT162b2 effectiveness against any SARS-CoV-2 infection was negligible in the first 2 weeks after the first dose. It increased to 36.8% (95% confidence interval [CI], 33.2 to 40.2) in the third week after the first dose and reached its peak at 77.5% (95% CI, 76.4 to 78.6) in the first month after the second dose. Effectiveness declined gradually thereafter, with the decline accelerating after the fourth month to reach approximately 20% in months 5 through 7 after the second dose. Effectiveness against symptomatic infection was higher than effectiveness against asymptomatic infection but waned similarly. Variant-specific effectiveness waned in the same pattern. Effectiveness against any severe, critical, or fatal case of Covid-19 increased rapidly to 66.1% (95% CI, 56.8 to 73.5) by the third week after the first dose and reached 96% or higher in the first 2 months after the second dose; effectiveness persisted at approximately this level for 6 months. CONCLUSIONS: BNT162b2-induced protection against SARS-CoV-2 infection appeared to wane rapidly following its peak after the second dose, but protection against hospitalization and death persisted at a robust level for 6 months after the second dose. (Funded by Weill Cornell Medicine-Qatar and others.)

Protection against the omicron variant from previous SARS-CoV-2 infection

Natural infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) elicits strong protection against reinfection with the B.1.1.7 (alpha),1,2 B.1.351 (beta),1 and B.1.617.2 (delta)3 variants. However, the B.1.1.529 (omicron) variant harbors multiple mutations that can mediate immune evasion. We estimated the effectiveness of previous infection in preventing symptomatic new cases caused by omicron and other SARS-CoV-2 variants in Qatar. In this study, we extracted data regarding coronavirus disease 2019 (Covid-19) laboratory testing, vaccination, clinical infection data, and related demographic details from the national SARS-CoV-2 databases, which include all results of polymerase-chain-reaction (PCR) testing, vaccinations, and hospitalizations and deaths for Covid-19 in Qatar since the start of the pandemic

Bivalent mRNA-1273.214 vaccine effectiveness against SARS-CoV-2 omicron XBB* infections

In October of 2022, Qatar introduced COVID-19 bivalent vaccination for persons ≥ 12 years using the 50-μg mRNA-1273.214 vaccine combining SARS-CoV-2 ancestral and omicron BA.1 strains.1 We estimated this vaccine’s effectiveness against SARS-CoV-2 infection. Using Qatar’s national SARS-CoV-2 databases, we conducted a matched, retrospective, cohort study to compare infection incidence in the national cohort of persons who received the vaccine (bivalent cohort) to that in the national cohort of Qatar residents whose last vaccination was ≥6 months before follow-up start (no-recent-vaccination cohort; Supplementary Appendix 1). The 6-month cut-off was chosen because of negligible effectiveness of first-generation vaccines against omicron infection ≥ 6 months after vaccination.2 Incidence of infection was defined as the first SARS-CoV-2 PCR-positive or rapid-antigen-positive test after the start of follow-up, regardless of symptoms. Cohorts were balanced on observed confounders through exact matching. Follow-up started 7 days after the person in the bivalent cohort received their vaccine dose. Associations were estimated using Cox proportional-hazards models adjusted for the matching factors and testing rate