Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

BACKGROUND: Vaccine hesitancy and lack of access remain major issues in disseminating COVID-19 vaccination to liver patients globally. Factors predicting poor response to vaccination and risk of breakthrough infection are important data to target booster vaccine programs. The primary aim of the current study was to measure humoral responses to 2 doses of COVID-19 vaccine. Secondary aims included the determination of factors predicting breakthrough infection. METHODS: COVID-19 vaccination and Biomarkers in cirrhosis And post-Liver Transplantation is a prospective, multicenter, observational case-control study. Participants were recruited at 4-10 weeks following first and second vaccine doses in cirrhosis [n = 325; 94% messenger RNA (mRNA) and 6% viral vaccine], autoimmune liver disease (AILD) (n = 120; 77% mRNA and 23% viral vaccine), post-liver transplant (LT) (n = 146; 96% mRNA and 3% viral vaccine), and healthy controls (n = 51; 72% mRNA, 24% viral and 4% heterologous combination). Serological end points were measured, and data regarding breakthrough SARS-CoV-2 infection were collected. RESULTS: After adjusting by age, sex, and time of sample collection, anti-Spike IgG levels were the lowest in post-LT patients compared to cirrhosis (p < 0.0001), AILD (p < 0.0001), and control (p = 0.002). Factors predicting reduced responses included older age, Child-Turcotte-Pugh B/C, and elevated IL-6 in cirrhosis; non-mRNA vaccine in AILD; and coronary artery disease, use of mycophenolate and dysregulated B-call activating factor, and lymphotoxin-α levels in LT. Incident infection occurred in 6.6%, 10.6%, 7.4%, and 15.6% of cirrhosis, AILD, post-LT, and control, respectively. The only independent factor predicting infection in cirrhosis was low albumin level. CONCLUSIONS: LT patients present the lowest response to the SARS-CoV-2 vaccine. In cirrhosis, the reduced response is associated with older age, stage of liver disease and systemic inflammation, and breakthrough infection with low albumin level

Measurement of the cross-section for producing a W boson in association with a single top quark in pp collisions at √s = 13 TeV with ATLAS

The inclusive cross-section for the associated production of a W boson and top quark is measured using data from proton-proton collisions at √ s = 13 TeV. The dataset corresponds to an integrated luminosity of 3.2 fb−1 , and was collected in 2015 by the ATLAS detector at the Large Hadron Collider at CERN. Events are selected requiring two opposite sign isolated leptons and at least one jet; they are separated into signal and control regions based on their jet multiplicity and the number of jets that are identified as containing b hadrons. The W t signal is then separated from the tt¯ background using boosted decision tree discriminants in two regions. The cross-section is extracted by fitting templates to the data distributions, and is measured to be σW t = 94±10 (stat.) +28 −22 (syst.)±2 (lumi.) pb. The measured value is in good agreement with the SM prediction of σtheory = 71.7±1.8 (scale)± 3.4 (PDF) pb [1]

Search for large missing transverse momentum in association with one top-quark in proton-proton collisions at s√=13 TeV with the ATLAS detector

This paper describes a search for events with one top-quark and large missing transverse momentum in the final state. Data collected during 2015 and 2016 by the ATLAS experiment from 13 TeV proton–proton collisions at the LHC corresponding to an integrated luminosity of 36.1 fb−1 are used. Two channels are considered, depending on the leptonic or the hadronic decays of the W boson from the top quark. The obtained results are interpreted in the context of simplified models for dark-matter production and for the single production of a vector-like T quark. In the absence of significant deviations from the Standard Model background expectation, 95% confidence-level upper limits on the corresponding production cross-sections are obtained and these limits are translated into constraints on the parameter space of the models considered

Staff workload and adverse events during mechanical ventilation in neonatal intensive care units

Submitted by Santos Bárbara ([email protected]) on 2015-01-08T11:35:48Z No. of bitstreams: 1 Carga de trabalho de profissionais da saúde e eventos adversos durante ventilação mecânica em unidades....pdf: 265224 bytes, checksum: a86721d23466bc07539fc7295ee3fee4 (MD5)Approved for entry into archive by Santos Bárbara ([email protected]) on 2015-01-08T11:36:06Z (GMT) No. of bitstreams: 1 Carga de trabalho de profissionais da saúde e eventos adversos durante ventilação mecânica em unidades....pdf: 265224 bytes, checksum: a86721d23466bc07539fc7295ee3fee4 (MD5)Approved for entry into archive by Santos Bárbara ([email protected]) on 2015-01-08T11:57:55Z (GMT) No. of bitstreams: 1 Carga de trabalho de profissionais da saúde e eventos adversos durante ventilação mecânica em unidades....pdf: 265224 bytes, checksum: a86721d23466bc07539fc7295ee3fee4 (MD5)Made available in DSpace on 2015-01-08T11:57:55Z (GMT). No. of bitstreams: 1 Carga de trabalho de profissionais da saúde e eventos adversos durante ventilação mecânica em unidades....pdf: 265224 bytes, checksum: a86721d23466bc07539fc7295ee3fee4 (MD5) Previous issue date: 2011Universidade Federal do Maranhão. Departamento de Medicina III. São Luís, MA, Brasil.Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Neonatologia. Rio de Janeiro, RJ, Brasil.Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil.Universidade Federal do Maranhão. Departamento de Medicina I. São Luís, MA, Brasil.Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil.Objetivo: Investigar uma possível associação entre a carga de tra-balho de profissionais da saúde e eventos adversos intermediários, tais como extubação acidental, obstrução do tubo endotraqueal e desconexão acidental do circuito do ventilador, durante ventilação mecânica neonatal em unidades neonatais de alto risco. Método: Este estudo de coorte prospectiva analisou os dados refe-rentes a 543 recém-nascidos de unidades de terapia intensiva neonatal (UTINs) de São Luís (MA) por 6 meses, durante os quais 136 recém-nascidos foram submetidos a ventilação mecânica em 1.108 turnos e foram observados 4.554 vezes. Resultados:Ocorreram eventos adversos 117 vezes durante esse período. As associações entre carga de trabalho e eventos adversos foram analisadas por meio de equações de estimação generalizada. As variáveis de ajuste foram: peso de nascimento, gênero, maternidade estudada, pontuação no índice de risco clínico para bebês (clinical risk index for babies) e demanda de cuidados, determinada pela escala desenvolvida pela Northern Neonatal Network. Quanto maior o número de recém-nas-cidos classificados de acordo com a demanda de cuidados (RCDCs) por enfermeiro e técnico em enfermagem, maior a probabilidade da ocorrência de eventos adversos intermediários relacionados à ventilação mecânica. Um número de RCDCs > 22 por enfermeiro [risco relativo (RR) = 2,86] e > 4,8 por enfermeiro auxiliar (RR = 3,41) esteve associado a uma maior prevalência de eventos adversos intermediários. Conclusões: A carga de trabalho dos profissionais de UTINs parece interferir nos resultados intermediários do cuidado neonatal e, portanto, deve ser levada em conta na avaliação dos desfechos na UTIN.Objective:To investigate a possible association between the intensity of staff workload and intermediate adverse events, such as accidental extubation, obstruction of the endotracheal tube, and accidental disconnection of the ventilator circuit, during neonatal mechanical ventilation in high-risk neonatal units. Method:This prospective cohort study analyzed data of 543 newborns from public neonatal intensive care units (NICUs) in the city of São Luís, state of Maranhão, Northeastern Brazil, for 6 months, during which 136 newborns were submitted to mechanical ventilation in 1,108 shifts and were observed a total of 4,554 times. Results: Adverse events occurred 117 times during this period. The associations between workload and adverse events were analyzed by means of generalized estimating equations. The adjustment variables were: birth weight, gender, maternity unit, Clinical Risk Index for Babies score, and care demand, the latter measured by the Northern Neonatal Network Scale. The larger the number of newborns classified by care demand (NCCD) per nurse and nursing technician, the more likely the occurrence of intermediate adverse events linked to mechanical ventilation. A number of NCCD > 22 per nurse (relative risk [RR] = 2.86) and > 4.8 per auxiliary nurse (RR = 3.41) was associated with a higher prevalence of intermediate adverse events. Conclusions: The workload of NICU professionals seems to interfere with the intermediate results of neonatal care and thus should be taken into consideration when evaluating NICU outcome

Synthesis of vinyl sulfides by copper-catalyzed decarboxylative C-S cross-coupling

10.1021/ol101729kOrganic Letters12184134-413