Seroconversion to mRNA SARS-CoV-2 Vaccines in Hematologic Patients

Hematologic patients show lower responses to SARS-CoV-2 vaccines, but predictors of seroconversion are lacking. In this prospective cohort study, hematologic patients undergoing SARS-CoV-2 mRNA vaccination at a single center in Milan, Italy, were sampled for anti-Spike and anti-Nucleocapsid IgG titer at 5 +/- 1 weeks and at 3 months from the second vaccine dose. Patients (N = 393) received either BNT162b2 (Pfizer-BioNTech, 48%) or MRNA-1273 (Moderna, 52%), and 284 (72%) seroconverted and 100% persisted at 3 months. Non-response was higher in chronic lymphocytic leukemia (CLL) and lymphoma patients, and in those treated with small molecules and monoclonal antibodies. In myeloid neoplasms, lower responses were detected in patients with acute myeloid leukemia treated with venetoclax plus hypomethylating agents and in patients with myelofibrosis receiving ruxolitinib. Multivariable analysis showed that seroconversion was favorably associated with a diagnosis other than indolent lymphoma/CLL [OR 8.5 (95% CI 4.1-17.6)], lack of B-cell-depleting therapy [OR 3.15 (1.7-5.9)], and IgG levels within the normal range [OR 2.2 (1.2-4.2)]. We developed a simple algorithm according to these 3 risk factors [(A) diagnosis of indolent lymphoma/CLL, (B) B-cell-depleting treatment, and (C) low IgG] to predict non-response. IgG levels and treatment may be modifiable risk factors and should be considered for timing of vaccine administration

Clinical and echocardiographic predictors of long-term outcome of a large cohort of patients with bicuspid aortic valve.

Abstract BACKGROUND AND OBJECTIVES: Bicuspid aortic valve (BAV) disease is the most common congenital cardiac malformation. The aim of the present article is to determine clinical and echocardiographic prognostic factors and provide a predictive model of outcome of a large cohort of patients with BAV. METHODS: We retrospectively enrolled 337 patients consecutively assessed for echocardiography at our Cardiology Department from 1993 to 2014. We considered aortic valve replacement, aortic surgery and cardiovascular death as a clinical combined end-point. Predictors of outcome were determined by Cox regression. RESULTS: Mean age was 29.2\u200a\ub1\u200a19.8 years, median 27.1 years. A total of 38.4% patients presented a history of hypertension. Mean duration of follow-up was 8.4\u200a\ub1\u200a6.1\u200ayears, range 0-21 years. A total of 73 patients underwent aortic valve replacement and/or aortic surgery during follow-up. Age at surgery was 45.2\u200a\ub1\u200a15.6 years. Seven patients died because of cardiovascular causes. At multivariate analysis, baseline clinical predictors were history of hypertension [hazard ratio (HR) 2.289, 95% confidence interval (CI) 1.350-3.881, P\u200a=\u200a0.002], larger ascending aortic diameter (HR 2.537, 95% CI 1.888-3.410, P\u200a<\u200a0.001), moderate-to-severe aortic regurgitation (HR 2.266, 95% CI 1.402-3.661, P\u200a=\u200a0.001) and moderate-to-severe aortic stenosis (HR 2.807, 95% CI 1.476-5.338, P\u200a=\u200a0.002). A predictive model was created by integrating these four independent covariates. It allows the calculation of calculate a risk score for each patient, which helps better tailor appropriate treatment in BAV patients. CONCLUSION: At enrolment, history of hypertension, a wider aortic diameter, moderate-to-severe aortic regurgitation and aortic stenosis were independently correlated to combined end-point. Long-term follow-up showed low cardiovascular mortality (2.1%) and a high prevalence of cardiac surgery (21.6%)

Highly efficient sequestration of aqueous lead on nanostructured calcite substrates

Following defocused ion beam sputtering, large area highly corrugated and faceted nanoripples are formed on calcite (10.4) faces in a self-organized fashion. High resolution atomic force microscopy (AFM) imaging reveals that calcite ripples are defined by facets with highly kinked (11.0) and (2$\overline{1}$.12) terminations. In situ AFM imaging during the exposure of such modified calcite surfaces to PbCl2 aqueous solution reveals that the nanostructured calcite surface promotes the uptake of Pb. In addition, we observed the progressive smoothing of the highly reactive calcite facet terminations and the formation of Pb-bearing precipitates elongated in registry with the underlying nanopattern. By SEM–EDS analysis we quantified a remarkable 500% increase of the Pb uptake rate, up to 0.5 atomic weight % per hour, on the nanorippled calcite in comparison to its freshly cleaved (10.4) surfaces. These results suggest that nanostructurated calcite surfaces can be used for developing future systems for lead sequestration from polluted waters.Ministry of Ciencia e InnovaciónMinistero dell'Università e della RicercaNational Recovery and Resilience PlanEuropean UnionDepto. de Mineralogía y PetrologíaFac. de Ciencias GeológicasTRUEpu