Adverse events of special interest following the use of BNT162b2 in adolescents: a population-based retrospective cohort study

Accruing evidence suggests an increased risk of myocarditis in adolescents from messenger RNA COVID-19 vaccines. However, other potential adverse events remain under-researched. We conducted a retrospective cohort study of adolescents aged 12–18 with a territory-wide electronic healthcare database of the Hong Kong population linked with population-based vaccination records and supplemented with age- and sex-specific population numbers. Two age- and sex-matched retrospective cohorts were formed to observe 28 days following the first and second doses of BNT162b2 and estimate the age- and sex-adjusted incidence rate ratios between the vaccinated and unvaccinated. Thirty AESIs adapted from the World Health Organization’s Global Advisory Committee on Vaccine Safety were examined. Eventually, the first-dose cohort comprised 274,881 adolescents (50.25% received the first dose) and the second-dose cohort 237,964 (50.29% received the second dose). Ninety-four (34.2 per 100,000 persons) adolescents in the first-dose cohort and 130 (54.6 per 100,000 persons) in the second-dose cohort experienced ≥1 AESIs. There were no statistically significant differences in the risk of any AESI associated with BNT162b2 except myocarditis [first-dose cohort: incidence rate ratio (IRR) = 9.15, 95% confidence interval (CI) 1.14–73.16; second-dose cohort: IRR = 29.61, 95% CI 4.04–217.07] and sleeping disturbances/disorders after the second dose (IRR = 2.06, 95% CI 1.01–4.24). Sensitivity analysis showed that, with myocarditis excluded as AESIs, no significantly elevated risk of AESIs as a composite outcome associated with vaccination was observed (P = 0.195). To conclude, the overall absolute risk of AESIs was low with no evidence of an increased risk of AESIs except myocarditis and sleeping disturbances/disorders

Probing the Reactivity of the Ce=O Multiple Bond in a Cerium(IV) Oxo Complex

The reactivity of the cerium­(IV) oxo complex [(L_OEt)₂Ce^IV(O)­(H₂O)]·MeC­(O)­NH₂ (<b>1</b>; L_OEt^– = [CoCp­{P­(O)­(OEt)₂}₃]⁻, where Cp = η⁵-C₅H₅) toward electrophiles and Brønsted acids has been investigated. The treatment of <b>1</b> with acetic anhydride afforded the diacetate complex [Ce^IV(L_OEt)₂(O₂CMe)₂] (<b>2</b>). The reaction of <b>1</b> with B­(C₆F₅)₃ yielded [Ce^IV(L_OEt)₂(Me₂CONH₂)₂]­[B­(C₆F₅)₃(OH)]₂ (<b>3</b>), in which the [B­(C₆F₅)₃(OH)]⁻ anions are H-bonded to the O-bound acetamide ligands. The treatment of <b>1</b> with HCl and HNO₃ afforded [Ce^IV(L_OEt)₂Cl₂] and [Ce^IV(L_OEt)₂(NO₃)₂], respectively. Protonation of <b>1</b> with triflic acid (HOTf) gave the diaqua complex [Ce^IV(L_OEt)₂(H₂O)₂]­(OTf)₂ (<b>4</b>), in which the triflate anions are H-bonded to the two aqua ligands. The treatment of <b>1</b> with phenol afforded the phenoxide complex [Ce^IV(L_OEt)₂(OPh)₂] (<b>5</b>). The oxo-bridged bimetallic complex [(L_OEt)₂(Me₂CONH₂)­Ce^IV(O)­NaL_OEt] (<b>6</b>) with the Ce–O_oxo and Na–O_oxo distances of 1.953(4) and 2.341(4) Å, respectively, was obtained from the reaction of <b>1</b> with [NaL_OEt]. Density functional theory calculations showed that the model complex [(L_OMe)₂Ce^IV(Me₂CONH₂)­(O)­NaL_OMe] (<b>6A</b>; L_OMe^– = [CoCp­{P­(O)­(OMe)₂}₃]⁻) contains a polarized CeO multiple bond. The energy for dissociation of the {NaL_OMe} fragment from <b>6A</b> in acetonitrile was calculated to be +33.7 kcal/mol, which is higher than that for dissociation of the H-bonded acetamide from [(L_OMe)₂Ce^IV(O)­(H₂O)]·MeC­(O)­NH₂ (<b>1A</b>) (calculated to be +17.4 kcal/mol). In hexanes containing trace water, complex <b>1</b> decomposed readily to a mixture of a tetranuclear cerium­(IV) oxo cluster, [Ce^IV₄(L_OEt)₄(μ₄-O)­(μ₂-O)₄(μ₂-OH)₂] (<b>7</b>), and a cerium­(III) complex, [Ce^III(L_OEt)₂(H₂O)₂]­[L_OEt] [<b>8</b>(L_OEt)], whereas the cerium/sodium oxo complex <b>6</b> is stable under the same conditions. The crystal structures of <b>3</b>, <b>4</b>·H₂O, <b>6</b>, and <b>8</b>(L_OEt) have been determined

A population-based cohort study of 394,401 children followed for 10 years exhibits sustained effectiveness of scoliosis screening

© 2015 Elsevier Inc. All rights reserved. Background context: The value of scoliosis screening has been recently shown in a multicenter randomized controlled trial. However, the long-term sustainability of the clinical effectiveness of scoliosis screening as a routine health service remains unknown. Purpose: The aim of this study was to assess the sustainability of the clinical effectiveness of school scoliosis screening. Study design/setting: A large population-based cohort study with a 10-year follow-up was conducted. Patient sample: A total of 394,401 students who were in the fifth grade during the five academic years from 1995/1996 to 1999/2000 formed five consecutive annual cohorts. The students were eligible for the Hong Kong scoliosis screening program, with their screening history and medical records until their nineteenth birthdays being assessed. Outcome measures: The outcome measures considered in the study were development of adolescent idiopathic scoliosis by the 19 years of age and the Cobb angle. Methods: The clinical effectiveness of scoliosis screening was assessed by referral rate for radiographic diagnosis, sensitivity, specificity, and predictive values. Results: A total of 306,144 students (78%) participated in scoliosis screening, which used a two-tier system. The prevalence of curves of 20 or greater was 1.8% (95% confidence interval [CI], 1.7-1.8%), whereas the referral rate for radiography, the sensitivity, and the positive predictive value (PPV) for curves of 20 or greater were 4.1% (95% CI, 4.0-4.2%), 91% (95% CI, 90-92%), and 40% (95% CI, 39-41%), respectively. Across the five consecutive annual cohorts, the prevalence and sensitivity for curves of 20 or greater increased by 0.23% (95% CI, 0.21-0.25%; p<.001) and 0.76% (95% CI, 0.43-1.04%; p<.001) per year, respectively; however, the PPV was reduced by 1.71% (95% CI, 1.09-2.33%; p<.001) per year. Conclusions: This report describes the first large population-based study with a long-term follow-up indicating that a scoliosis screening program can have sustained clinical effectiveness in identifying patients with adolescent idiopathic scoliosis needing clinical observation. As the prevalence of adolescent idiopathic scoliosis increases, scoliosis screening should be continued as a routine health service in schools or by general practitioners if there is no scoliosis screening policy.postprin