COVID-19 post-vaccination in healthcare workers and vaccine effectiveness, Brazil, 2021

Objects: This study aimed to describe COVID-19 cases in healthcare workers at a large tertiary hospital, after a vaccination campaign, to understand the individual characteristics, timeliness, symptomatology, and severity of the conditions. Methods: The COVID-19 reporting files from the hospital's healthcare workers and their records in the vaccine registry were analyzed, regarding vaccination status, symptoms, sociodemographic characteristics, comorbidities, and outcomes. Vaccination descriptive analysis was carried out and the impact and effectiveness of vaccination in relation to symptomatic infection and hospitalization were estimated. Results: In a total of 696 PCR-confirmed COVID-19 patients, vaccination coverage for the 1st and 2nd dose was 92.8% and 85.5%. Patients with complete doses had a mean interval of 96.8 days between vaccination and the onset of symptoms. Of the 664 participants with available clinical data, 165 had at least 1 comorbidity. During the study, 12 patients were hospitalized, 58.3% with a complete vaccination schedule. Three of this group died. The effectiveness of vaccination for symptomatic cases and hospitalization was 22.1% and 69.0%, respectively. The impact of vaccination on symptomatic cases and hospitalization was 81.4% and 89.7%, respectively. Discussion: The majority of COVID-19 cases in the study were classified as mild. The impact of vaccination for confirmed cases was significant, both in reducing the incidence of symptomatic cases and hospitalizations. The presence of comorbidities in approximately ¼ of the patients increased the risk of these individuals. The mean time interval between diagnosis and the 2nd dose of vaccine was longer in the hospitalized group, reinforcing the protective decline over longer periods

Humanistic and economic impact of moderate to severe plaque psoriasis in Brazil

Introduction Psoriasis is an immune-mediated, chronic, inflammatory disease, which has a substantial humanistic and economic burden. This study aimed to assess the impact of this disease on health-related quality of life (HRQoL), work productivity, and direct and indirect costs from a societal perspective among Brazilian patients. Methods This is a cross-sectional, observational, multicenter study, enrolling patients with moderate to severe plaque psoriasis according to physician evaluation. Data collection was performed from December 2015 to November 2016 through face-to-face interviews using a structured questionnaire and five standardized patient-reported outcomes instruments. Direct costs were estimated by multiplying the amount of resources used (12-month recall period) by the corresponding unit cost. Indirect costs were grouped in two time horizons: annual costs (income reduction and absenteeism) and lifetime costs (demission and early retirement). Results A total of 188 patients with moderate to severe plaque psoriasis were included, with mean age of 48.0 (SD 13.1). “Anxiety and depression” and “pain and discomfort” were the most impaired dimensions, according to the EuroQol Five-Dimension-Three-Level (EQ-5D-3L). The highest effect was found for “symptoms and feelings” [mean (SD) 2.4 (1.7)] Dermatology Life Quality Index (DLQI) subscale. Psoriatic arthritis (PsA) presence and biologic-naïve status were associated with worse HRQoL. Presenteeism was more frequent than absenteeism, according to the Work Productivity and Activity Impairment questionnaire-General Health (WPAI-GH) [17.4% vs. 6.3%], while physical demands and time management were the most affected Work Limitations Questionnaire (WLQ) subscales [means (SD) 23.5 (28.5) and 17.7 (24.9), respectively]. The estimated annual cost per patient was USD 4034. Direct medical costs accounted for 87.7% of this estimate, direct non-medical costs for 2.4%, and indirect costs for 9.9%. Conclusions Results evidenced that moderate to severe plaque psoriasis imposes substantial costs to society. Our data showed that this disease negatively affects both work productivity and HRQoL of Brazilian patients. Subgroups with PsA and biologic-naïve patients presented lower HRQoL, showing the impact of this comorbidity and the relevance of biologics in psoriasis treatment

Analytic models and forward scattering from accelerator to cosmic-ray energies

Analytic models for hadron-hadron scattering are characterized by analytical parametrizations for the forward amplitudes and the use of dispersion relation techniques to study the total cross section $\sigma_{tot}$ and the $\rho$ parameter. In this paper we investigate four aspects related to the application of the model to $pp$ and $\bar{p}p$ scattering, from accelerator to cosmic-ray energies: 1) the effect of different estimations for $\sigma_{tot}$ from cosmic-ray experiments; 2) the differences between individual and global (simultaneous) fits to $\sigma_{tot}$ and $\rho$; 3) the role of the subtraction constant in the dispersion relations; 4) the effect of distinct asymptotic inputs from different analytic models. This is done by using as a framework the single Pomeron and the maximal Odderon parametrizations for the total cross section. Our main conclusions are the following: 1) Despite the small influence from different cosmic-ray estimations, the results allow us to extract an upper bound for the soft pomeron intercept: $1 + \epsilon = 1.094$; 2) although global fits present good statistical results, in general, this procedure constrains the rise of $\sigma_{tot}$; 3) the subtraction constant as a free parameter affects the fit results at both low and high energies; 4) independently of the cosmic-ray information used and the subtraction constant, global fits with the odderon parametrization predict that, above $\sqrt s \approx 70$ GeV, $\rho_{pp}(s)$ becomes greater than $\rho_{\bar{p}p}(s)$, and this result is in complete agreement with all the data presently available. In particular, we infer $\rho_{pp} = 0.134 \pm 0.005$ at $\sqrt s = 200$ GeV and $0.151 \pm 0.007$ at 500 GeV (BNL RHIC energies).Comment: 16 pages, 7 figures, aps-revtex, wording changes, corrected typos, to appear in Physical Review

P-P Total Cross Sections at VHE from Accelerator Data

Comparison of P-P total cross-sections estimations at very high energies - from accelerators and cosmic rays - shows a disagreement amounting to more than 10 %, a discrepancy which is beyond statistical errors. Here we use a phenomenological model based on the Multiple-Diffraction approach to successfully describe data at accelerator energies. The predictions of the model are compared with data On the basis of regression analysis we determine confident error bands, analyzing the sensitivity of our predictions to the employed data for extrapolation. : using data at 546 and 1.8 TeV, our extrapolations for p-p total cross-sections are only compatible with the Akeno cosmic ray data, predicting a slower rise with energy than other cosmic ray results and other extrapolation methods. We discuss our results within the context of constraints in the light of future accelerator and cosmic ray experimental results.Comment: 26 pages aqnd 11 figure

Cortical and cerebellar activation induced by reflexive and voluntary saccades

Reflexive saccades are driven by visual stimulation whereas voluntary saccades require volitional control. Behavioral and lesional studies suggest that there are two separate mechanisms involved in the generation of these two types of saccades. This study investigated differences in cerebral and cerebellar activation between reflexive and self-paced voluntary saccadic eye movements using functional magnetic resonance imaging. In two experiments (whole brain and cerebellum) using the same paradigm, differences in brain activations induced by reflexive and self-paced voluntary saccades were assessed. Direct comparison of the activation patterns showed that the frontal eye fields, parietal eye field, the motion-sensitive area (MT/V5), the precuneus (V6), and the angular and the cingulate gyri were more activated in reflexive saccades than in voluntary saccades. No significant difference in activation was found in the cerebellum. Our results suggest that the alleged separate mechanisms for saccadic control of reflexive and self-paced voluntary are mainly observed in cerebral rather than cerebellar areas