Immunocompromised individuals are at increased risk of COVID‐19 breakthrough infection, hospitalization, and death in the post‐vaccination era:A systematic review

Introduction: Immunocompromised individuals have been shown to mount a reduced response to vaccination, resulting in reduced vaccine effectiveness in this cohort. Therefore, in the postvaccination era, immunocompromised individuals remain at high risk of breakthrough infection and COVID‐19 related hospitalization and death, which persist despite vaccination efforts. There has been a marked paucity of systematic reviews evaluating existing data describing the clinical measures of efficacy of COVID‐19 vaccination, specifically in immunocompromised populations. In particular, there is a scarcity of comprehensive evaluations exploring breakthrough infections and severe COVID‐19 in this patient population. Methods: To address this gap, we conducted a systematic review which aimed to provide a summary of current clinical evidence of the effectiveness of COVID‐19 vaccination in the immunocompromised population. Using PRISMA guidelines, we conducted a literature search on PubMed and the Cochrane database published between January 1, 2021 to September 1, 2022. Results: Our findings demonstrated that despite vaccination, immunocompromised patients remained at high risk of new breakthrough COVID‐19 infection and severe COVID‐19 outcomes compared to the general population. We found increased average relative risk (RR) of breakthrough infections in the immunocompromised population, including patients with cancer (RR = 1.4), HIV (RR = 1.92), chronic kidney disease (RR = 2.26), immunodeficiency (RR = 2.55), and organ transplant recipients (RR = 6.94). These patients are also at greater risk for hospitalizations and death following COVID‐19 breakthrough infection. We found that the RR of hospitalization and death in Cancer patients was 1.08 and 2.82, respectively. Conclusion: This demonstrated that vaccination does not offer an adequate level of protection in these groups, necessitating further measures such as Evusheld and further boosters

Immunocompromised individuals are at increased risk of COVID‐19 breakthrough infection, hospitalization, and death in the post‐vaccination era: A systematic review

Introduction: Immunocompromised individuals have been shown to mount a reduced response to vaccination, resulting in reduced vaccine effectiveness in this cohort. Therefore, in the postvaccination era, immunocompromised individuals remain at high risk of breakthrough infection and COVID‐19 related hospitalization and death, which persist despite vaccination efforts. There has been a marked paucity of systematic reviews evaluating existing data describing the clinical measures of efficacy of COVID‐19 vaccination, specifically in immunocompromised populations. In particular, there is a scarcity of comprehensive evaluations exploring breakthrough infections and severe COVID‐19 in this patient population. Methods: To address this gap, we conducted a systematic review which aimed to provide a summary of current clinical evidence of the effectiveness of COVID‐19 vaccination in the immunocompromised population. Using PRISMA guidelines, we conducted a literature search on PubMed and the Cochrane database published between January 1, 2021 to September 1, 2022. Results: Our findings demonstrated that despite vaccination, immunocompromised patients remained at high risk of new breakthrough COVID‐19 infection and severe COVID‐19 outcomes compared to the general population. We found increased average relative risk (RR) of breakthrough infections in the immunocompromised population, including patients with cancer (RR = 1.4), HIV (RR = 1.92), chronic kidney disease (RR = 2.26), immunodeficiency (RR = 2.55), and organ transplant recipients (RR = 6.94). These patients are also at greater risk for hospitalizations and death following COVID‐19 breakthrough infection. We found that the RR of hospitalization and death in Cancer patients was 1.08 and 2.82, respectively. Conclusion: This demonstrated that vaccination does not offer an adequate level of protection in these groups, necessitating further measures such as Evusheld and further boosters

Metric trees of generalized roundness one

Every finite metric tree has generalized roundness strictly greater than one. On the other hand, some countable metric trees have generalized roundness precisely one. The purpose of this paper is to identify some large classes of countable metric trees that have generalized roundness precisely one. At the outset we consider spherically symmetric trees endowed with the usual combinatorial metric (SSTs). Using a simple geometric argument we show how to determine decent upper bounds on the generalized roundness of finite SSTs that depend only on the downward degree sequence of the tree in question. By considering limits it follows that if the downward degree sequence $(d_{0}, d_{1}, d_{2}...)$ of a SST $(T,\rho)$ satisfies $|\{j \, | \, d_{j} > 1 \}| = \aleph_{0}$, then $(T,\rho)$ has generalized roundness one. Included among the trees that satisfy this condition are all complete $n$-ary trees of depth $\infty$ ($n \geq 2$), all $k$-regular trees ($k \geq 3$) and inductive limits of Cantor trees. The remainder of the paper deals with two classes of countable metric trees of generalized roundness one whose members are not, in general, spherically symmetric. The first such class of trees are merely required to spread out at a sufficient rate (with a restriction on the number of leaves) and the second such class of trees resemble infinite combs.Comment: 14 pages, 2 figures, 2 table

Nomenclature for alleles of the thiopurine methyltransferase gene

The drug-metabolizing enzyme thiopurine methyltransferase (TPMT) has become one of the best examples of pharmacogenomics to be translated into routine clinical practice. TPMT metabolizes the thiopurines 6-mercaptopurine, 6-thioguanine, and azathioprine, drugs that are widely used for treatment of acute leukemias, inflammatory bowel diseases, and other disorders of immune regulation. Since the discovery of genetic polymorphisms in the TPMT gene, many sequence variants that cause a decreased enzyme activity have been identified and characterized. Increasingly, to optimize dose, pretreatment determination of TPMT status before commencing thiopurine therapy is now routine in many countries. Novel TPMT sequence variants are currently numbered sequentially using PubMed as a source of information; however, this has caused some problems as exemplified by two instances in which authors' articles appeared on PubMed at the same time, resulting in the same allele numbers given to different polymorphisms. Hence, there is an urgent need to establish an order and consensus to the numbering of known and novel TPMT sequence variants. To address this problem, a TPMT nomenclature committee was formed in 2010, to define the nomenclature and numbering of novel variants for the TPMT gene. A website (http://www.imh.liu.se/tpmtalleles) serves as a platform for this work. Researchers are encouraged to submit novel TPMT alleles to the committee for designation and reservation of unique allele numbers. The committee has decided to renumber two alleles: nucleotide position 106 (G>A) from TPMT*24 to TPMT*30 and position 611 (T>C, rs79901429) from TPMT*28 to TPMT*31. Nomenclature for all other known alleles remains unchanged

Sheep Updates 2015 - Katanning

This session covers fourteen papers from different authors: 1. The Sheep Industry Business Innovation project, Bruce Mullan, Sheep Industry Development Director, Department of Agriculture and Food, Western Australia 2. Western Australian sheep stocktake, Kate Pritchett and Kimbal Curtis, Research Officers, Department of Agriculture and Food, Western Australia 3. Wool demand and supply - short term volatility, long term opportunities, Chris Wilcox, Principal of Poimena Analysis 4. Lifetime management for maternal ewes, Mike Hyder, Research Officer, Department of Agriculture and Food, Western Australia 5. National Livestock Identification System (NLIS) for sheep and goats - what is the NLIS database? Leigh Sonnermann, Biosecurity Officer, Department of Agriculture and Food, Western Australia 6. Myths, Facts and the role of animal welfare in farming, Lynne Bradshaw, president, RSPCA WA 7. Latest research and development on breech strike prevention, Geoff Lindon, Manager Productivity and Animal Welfare, AWI 8. Lamb Survival Initiative and 100% Club, Katherine Davies, Development Officer, Department of Agriculture and Food, Western Australia 9. How to boost your lamb survival, Joe Young, Sheep Consultant, R.B. Young and Son 10. Using genomic technology to increase genetic gain, Stephen Lee, School of Animal and Veterinary Sciences, University of Adelaide and Sheep Cooperative Research Centre (CRC) & Ian Robertson, Merinotech WA 11. Economics of feed lotting - to feed-lot or not?, Lucy Anderton, Economist, Department of Agriculture and Food, Western Australia 12. Anameka and other shrubs to fill feed gaps, Hayley Norman CSIRO & Ed Barrett-Lennard UWA & Department of Agriculture and Food, Western Australia 13. Sheep industry traineeships - encouraging a new generation of farmers, Jackie Jarvis, Consultant, Agrifood Labour & Skills 14. Opportunities and challenges facing youth in the sheep and wool industry, Ben Patrick, Yarrawonga Stu

Machine learning for determining lateral flow device results for testing of SARS-CoV-2 infection in asymptomatic populations

Rapid antigen tests, in the form of lateral flow devices (LFD) allow testing of a large population for SARS-CoV-2. To reduce the variability seen in device interpretation, we show the design and testing of an AI algorithm based on machine learning. The machine learning (ML) algorithm is trained on a combination of artificially hybridised LFDs and LFD data linked to RT-qPCR result. Participants are recruited from assisted test sites (ATS) and health care workers undertaking self-testing and images analysed using the ML algorithm. A panel of trained clinicians are used to resolve discrepancies. In total, 115,316 images are returned. In the ATS sub study, sensitivity increased from 92.08% to 97.6% and specificity from 99.85% to 99.99%. In the self-read sub-study, sensitivity increased from 16.00% to 100%, and specificity from 99.15% to 99.40%. An ML-based classifier of LFD results outperforms human reads in asymptomatic testing sites and self-reading