Incidence and Risk Factors of Immediate Hypersensitivity Reactions and Immunization Stress-Related Responses With COVID-19 mRNA Vaccine.

BACKGROUND: With the implementation of mass vaccination campaigns against COVID-19, the safety of vaccine needs to be evaluated. OBJECTIVE: We aimed to assess the incidence and risk factors for immediate hypersensitivity reactions (IHSR) and immunization stress-related responses (ISRR) with the Moderna COVID-19 vaccine. METHODS: This nested case-control study included recipients who received the Moderna vaccine at a mass vaccination center, Japan. Recipients with IHSR and ISRR were designated as cases 1 and 2, respectively. Controls 1 and 2 were selected from recipients without IHSR or ISRR and matched (1 case: 4 controls) with cases 1 and cases 2, respectively. Conditional logistic regression analysis was used to identify risk factors associated with IHSR and ISRR. RESULTS: Of the 614,151 vaccine recipients who received 1,201,688 vaccine doses, 306 recipients (cases 1) and 2478 recipients (cases 2) showed 318 events of IHSR and 2558 events of ISRR, respectively. The incidence rates per million doses were estimated as IHSR: 266 cases, ISRR: 2129 cases, anaphylaxis: 2 cases, and vasovagal syncope: 72 cases. Risk factors associated with IHSR included female, asthma, atopic dermatitis, thyroid diseases, and a history of allergy; for ISRR, the risk factors were younger age, female, asthma, thyroid diseases, mental disorders, and a history of allergy and vasovagal reflex. CONCLUSION: In the mass vaccination settings, the Moderna vaccine can be used safely owing to the low incidence rates of IHSR and anaphylaxis. However, providers should be aware of the occurrence of ISRR. Although recipients with risk factors are associated with slightly increased risks of IHSR and ISRR, this is not of sufficient magnitude to warrant special measures regarding their vaccination.

Suppressing aggregation of quinacridone pigment and improving its color strength by using chitosan nanofibers.

Quinacridone, a red pigment, is prone to aggregation, which results in undesirable color changes. Cellulose nanofibers (NFs) have been reported to adsorb quinacridone and suppress its aggregation. In this study, we investigated the potential of chitin and chitosan NFs which possess acetoamide and amino groups, as a quinacridone dispersant. Chitosan NFs, obtained by fibrillation using high-pressure homogenizer, adsorbed more quinacridone than cellulose NFs. SEM observations showed that chitosan NFs inhibited the aggregation of quinacridone, but chitin NFs did not. NMR analysis suggested the hydrogen bonding between chitosan NFs and quinacridone induced by the amino groups. The results indicated that the amino groups more facilitated the intermolecular interactions between NFs and quinacridone than the hydroxyl groups whereas the acetamide groups hindered them. Color measurements showed that the redness of quinacridone improved when cellulose or chitosan NFs were added. Chitosan NFs were found to be a novel candidate for quinacridone dispersants.

Properties of natural rubber reinforced with cellulose nanofibers based on fiber diameter distribution as estimated by differential centrifugal sedimentation.

Cellulose nanofibers (CNFs) with different degrees of fibrillation are prepared by the mechanical fibrillation of kraft pulp using wet disk milling, and dispersions of the prepared CNFs were subjected to differential centrifugal sedimentation (DCS) in order to estimate the diameter distributions of the CNFs. The low-fibrillated CNFs (fiber diameter (d): >10 µm) had a weak reinforcing effect on natural rubber (NR), while the medium-fibrillated CNFs (d: 0.1-10 µm) dramatically improve the initial modulus and decrease the elongation at break. The high-fibrillated CNFs (d: <0.1 µm) enhanced the tensile strength even further while maintaining the elongation at break. The reinforcing mechanism of the NR composites reinforced by the CNFs (NR-CNFs) was confirmed by field-emission scanning electron microscopy imaging, dynamic mechanical analysis, and toluene uptake measurements. It was concluded that these characteristic mechanical properties of the NR-CNFs were determined by the morphologies of the CNFs. The branching structure of the medium-fibrillated CNFs affected high improvement of the initial modulus, and the network formed by the high-fibrillated CNFs were involved in enhancement of the tensile strength without compromising viscoelastic properties. Understanding the effect of their diameter distribution can potentially reduce the production cost of CNFs and thus expand their applicability.

Fast and Robust Nanocellulose Width Estimation Using Turbidimetry.

The dimensions of nanocelluloses are important factors in controlling their material properties. The present study reports a fast and robust method for estimating the widths of individual nanocellulose particles based on the turbidities of their water dispersions. Seven types of nanocellulose, including short and rigid cellulose nanocrystals and long and flexible cellulose nanofibers, are prepared via different processes. Their widths are calculated from the respective turbidity plots of their water dispersions, based on the theory of light scattering by thin and long particles. The turbidity-derived widths of the seven nanocelluloses range from 2 to 10 nm, and show good correlations with the thicknesses of nanocellulose particles spread on flat mica surfaces determined using atomic force microscopy.

3 nm Thick Lignocellulose Nanofibers Obtained from Esterified Wood with Maleic Anhydride.

Esterification with maleic anhydride before mechanical treatments enabled wood to fibrillate into thin and uniform thick lignocellulose nanofibers. The esterification did not affect the crystal structure of the cellulose, and carboxyl groups introduced by the esterification facilitated the fibrillation of the wood. Moisture in the reaction system caused hydrolysis of some of the lignin and hemicellulose, thereby assisting the fibrillation. The esterification significantly reduced the number of passes through the disk mill required for the production of lignocellulose nanofibers with large specific surface areas. By using a high-pressure homogenizer, 97 wt % of the esterified wood was fibrillated into 3 nm thick lignocellulose nanofibers.

Mechanical and Thermal Properties of Polypropylene Composites Reinforced with Lignocellulose Nanofibers Dried in Melted Ethylene-Butene Copolymer.

Lignocellulose nanofibers were prepared by the wet disk milling of wood flour. First, an ethylene-butene copolymer was pre-compounded with wood flour or lignocellulose nanofibers to prepare master batches. This process involved evaporating the water of the lignocellulose nanofiber suspension during compounding with ethylene-butene copolymer by heating at 105 °C. These master batches were compounded again with polypropylene to obtain the final composites. Since ethylene-butene copolymer is an elastomer, its addition increased the impact strength of polypropylene but decreased the stiffness. In contrast, the wood flour- and lignocellulose nanofiber-reinforced composites showed significantly higher flexural moduli and slightly higher flexural yield stresses than did the ethylene-butene/polypropylene blends. Further, the wood flour composites exhibited brittle fractures during tensile tests and had lower impact strengths than those of the ethylene-butene/polypropylene blends. On the other hand, the addition of the lignocellulose nanofibers did not decrease the impact strength of the ethylene-butene/polypropylene blends. Finally, the addition of wood flour and the lignocellulose nanofibers increased the crystallization temperature and crystallization rate of polypropylene. The increases were more remarkable in the case of the lignocellulose nanofibers than for wood flour.

Atomic Force Microscopy Observation of Polylactide Stereocomplex Edge-On Crystals in Thin Films: Effects of Molecular Weight on Lamellar Curvature.

The shapes of the edge-on lamellar crystals of equiweight poly(l-lactide) (PLLA)/poly(d-lactide) (PDLA) stereocomplexes with various combinations of molecular weights were investigated by using atomic force microscopy. In the cases of the PLLA/PDLA blends with equivalent molecular weights, the straight-shaped edge-on lamellae were observed. On the other hand, the curved edge-on crystals were able to be seen for the PLLA/PDLA stereocomplexes with nonequivalent molecular weights. It was revealed that the direction of lamellar curvature in the polylactide (PLA) stereocomplexes with nonequivalent molecular weights is the same as that of PLA having lower molecular weight. In addition to the PLLA/PDLA blending ratio, the incidence of chain folding, which is strongly influenced by molecular weight, was considered to have a crucial effect on the lamellar curvature in the edge-on crystals of PLA stereocomplexes.

Pore size determination of TEMPO-oxidized cellulose nanofibril films by positron annihilation lifetime spectroscopy.

Wood cellulose nanofibril films with sodium carboxylate groups prepared from a 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO)-oxidized pulp exhibited an extremely low oxygen permeability of 0.0008 mL µm m(-2) day(-1) kPa(-1) at 0% relative humidity (RH). Positron annihilation lifetime spectroscopy (PALS) was used to determine the pore sizes in wood and tunicate TEMPO-oxidized cellulose nanofibril (TOCN-COONa) films in a vacuum (i.e., at 0% RH). PALS analysis revealed that the pore size of the wood TOCN-COONa films remained nearly at 0.47 nm from the film surface to the interior of the film. This is probably the cause of this high oxygen-barrier properties at 0% RH. The crystalline structure of TOCN-COONa also contributes to the high oxygen-barrier properties of the wood TOCN-COONa films. However, the oxygen permeability of the wood TOCN-COONa films increased to 0.17 mL µm m(-2) day(-1) kPa(-1) at 50% RH, which is one of the shortcomings of hydrophilic TOCN-COONa films.

Structure and mechanical properties of wet-spun fibers made from natural cellulose nanofibers.

Cellulose nanofibers were prepared by TEMPO-mediated oxidation of wood pulp and tunicate cellulose. The cellulose nanofiber suspension in water was spun into an acetone coagulation bath. The spinning rate was varied from 0.1 to 100 m/min to align the nanofibers to the spun fibers. The fibers spun from the wood nanofibers had a hollow structure at spinning rates of >10 m/min, whereas the fibers spun from tunicate nanofibers were porous. Wide-angle X-ray diffraction analysis revealed that the wood and tunicate nanofibers were aligned to the fiber direction of the spun fibers at higher spinning rates. The wood spun fibers at 100 m/min had a Young's modulus of 23.6 GPa, tensile strength of 321 MPa, and elongation at break of 2.2%. The Young's modulus of the wood spun fibers increased with an increase in the spinning rate because of the nanofiber orientation effect.

Therapeutic mild hypothermia: effects on coagulopathy and survival in a rat hemorrhagic shock model.

OBJECTIVE: : To determine the effects of therapeutic hypothermia on coagulation parameters during hemorrhagic shock (HS) and fluid resuscitation and on survival, in a rat HS model. METHODS: : Under light anesthesia and spontaneous breathing, 24 rats underwent HS (phase I) for 90 minutes, during which 2.5 mL/100 g blood was withdrawn over 15 minutes; fluid resuscitation (phase II) for 60 minutes, during which no blood was reinfused but 5.0 mL/100 g lactated Ringer's solution was infused over 30 minutes; and an observation (phase III) without anesthesia until 72 hour. After the volume-controlled hemorrhage, rats were randomized into a hypothermia group (n = 12, 33 degrees C) or a normothermia group (n = 12, 38 degrees C). The rectal temperature in each group was maintained during phases I and II. Whole blood coagulopathy was assessed by Sonoclot analysis (SA) at baseline and the end of phases I and II. Fibrinolysis parameters of thrombin-antithrombin III complex and plasma-alpha-2-plasmin inhibitor complex were also monitored. RESULTS: : At 72 hour, 10 of 12 hypothermia group rats, and 5 of 12 normothermia group rats remained alive (p < 0.05). Fluid resuscitation significantly decreased hematocrit (20% +/- 5%) compared with baseline (33% +/- 5%; p < 0.05) in all rats. SA showed no significant differences between groups at the end of phase I. However, at the end of phase of II, SA revealed a decreased "clot rate" in hypothermia compared with normothermia (22 clot signal/min +/- 11 clot signal/min vs. 34 clot signal/min +/- 14 clot signal/min; p < 0.05) and a prolonged "time to peak" in hypothermia (15 minutes +/- 5 minutes versus 6 minutes +/- 2 minutes; p < 0.05). No differences in thrombin-antithrombin III complex and plasma-alpha-2-plasmin inhibitor complex values were seen between groups throughout the experiment. CONCLUSIONS: : Therapeutic mild hypothermia of 33 degrees C did not cause coagulopathy during HS, but did impair SA coagulation parameters during fluid resuscitation, probably because of dilution. Hypothermia also prolonged survival after HS. Impairments to coagulation parameters did not worsen outcomes in the rat HS model.

Elastic modulus of single cellulose microfibrils from tunicate measured by atomic force microscopy.

The elastic modulus of single microfibrils from tunicate ( Halocynthia papillosa ) cellulose was measured by atomic force microscopy (AFM). Microfibrils with cross-sectional dimensions 8 x 20 nm and several micrometers in length were obtained by oxidation of cellulose with 2,2,6,6-tetramethylpiperidine-1-oxyl radical (TEMPO) as a catalyst and subsequent mechanical disintegration in water and by sulfuric acid hydrolysis. The nanocellulosic materials were deposited on a specially designed silicon wafer with grooves 227 nm in width, and a three-point bending test was applied to determine the elastic modulus using an AFM cantilever. The elastic moduli of single microfibrils prepared by TEMPO-oxidation and acid hydrolysis were 145.2 +/- 31.3 and 150.7 +/- 28.8 GPa, respectively. The result showed that the experimentally determined modulus of the highly crystalline tunicate microfibrils was in agreement with the elastic modulus of native cellulose crystals.

Effects of various concentrations of inhaled oxygen on tissue dysoxia, oxidative stress, and survival in a rat hemorrhagic shock model.

OBJECTIVE: To test the hypothesis that a fractional inspired oxygen (F(I)O(2)) of 1.0 compared to 0.4 during hemorrhagic shock (HS) and fluid resuscitation (FR): mitigates tissue dysoxia; however, enhances the oxidative stress; therefore, offsets the benefit on survival. METHODS: Thirty rats underwent: HS for 75min, during which 3.0mL/100g of blood was withdrawn, followed by FR for 75min, during which 1.0mL/100g of shed blood and 3.0mL/100g of crystalloid solution were infused. Ten rats were randomized into one of three F(I)O(2) (0.21 vs. 0.4 vs. 1.0) groups, and observed for survival until 72h in each group. Hemodynamics, liver tissue PO(2) (P(T)O(2)), and, plasma antioxidants levels were also monitored. RESULTS: Oxygen inhalation increased mean arterial pressure (MAP) and decreased heart rate (HR) during HS and FR. Liver P(T)O(2) was less than 10Torr in all groups throughout HS; while it increased to average 26-35Torr in oxygen groups during FR, it remained at 10Torr with F(I)O(2) 0.21 (P<0.01). MAP, HR, and P(T)O(2) did not differ significantly between oxygen groups. Plasma antioxidants levels did not differ among the three groups. All rats treated with oxygen, but eight of 10 rats with F(I)O(2) 0.21 survived up to 72h (NS). CONCLUSIONS: Supplemental oxygen does not mitigate tissue dysoxia during HS, but does reduce tissue dysoxia without enhancing oxidative stress during subsequent FR. Increased F(I)O(2) appears to prolong survival. These beneficial effects of supplemental oxygen do not differ between an F(I)O(2) of 0.4 and 1.0.

Usefulness of transcatheter arterial embolization for intercostal arterial bleeding in a patient with burst fractures of the thoracic vertebrae.

A 25-year-old man was injured in a motorcycle accident and hemodynamically unstable on admission. Right hemothorax and fractures of the ninth, tenth, and 11th thoracic vertebrae were confirmed in chest X-ray. Tube thoracostomy in the right chest was performed and about 400 mL of blood was drained. Contrast-enhanced CT showed a large hematoma around the vertebrae fractures and contrast extravasation from the intercostal arteries. As hemodynamics of the patient was very unstable, angiography was immediately performed with massive fluid resuscitation. Angiography showed contrast extravasation from the bilateral ninth, tenth, and 11th intercostal arteries. Transcatheter arterial embolization (TAE) was performed using Gelfoam particles. The contrast extravasation had disappeared in all arteries. The hemodynamics of the patient gradually stabilized after TAE. On hospital day 44, he was transferred to a hospital near his home for an operation on the thoracic vertebrae and rehabilitation. When the reliability, rapidity, and low invasiveness of TAE for arterial bleeding are taken into consideration, we believed that this patient's life could be saved by TAE.

Pontine infarction induced by injury of the perforating branch of the basilar artery after blunt head impact: case report.

A 77-year-old male pedestrian was hit by a car. On admission, he had disturbance of consciousness and left hemiplegia. Computed tomography (CT) indicated only left frontal subcutaneous hematoma and minor hemorrhage in the left frontal lobe, suggesting axonal injury. CT on hospital day 2 revealed a low density area in the right paramedian pons, but CT angiography showed no dissection or occlusion of the vertebrobasilar artery. The diagnosis was pontine infarction resulting from shearing force injury to the paramedian branch of the basilar artery. He was transferred to another hospital for rehabilitation without improvement of symptoms on hospital day 51. Paramedian pontine infarction tends to occur in patients with risk factors for arteriosclerosis, including hypertension, diabetes mellitus, hyperlipidemia, or smoking. The present elderly patient had hypertension and hyperlipidemia, so arteriosclerosis in the paramedian branch may have contributed to his susceptibility to such injury.

The effect of hemicelluloses on wood pulp nanofibrillation and nanofiber network characteristics.

Hemicelluloses as matrix substances showed an important role in nanofibrillation of wood pulp. Never-dried and once-dried pulps with different amounts of hemicelluloses were fibrillated using a grinding treatment. The degree of fibrillation was evaluated by scanning electron microscopy observation of the fibrillated pulps and light transmittance measurements of the fibrillated pulp/acrylic resin composites. With a one-pass grinding treatment, the once-dried pulp with higher hemicellulose content was fibrillated into 10-20 nm wide fibers as easily as the never-dried pulps, while the once-dried pulp with lower hemicellulose content was not fibrillated into uniform nanosized fibers. This result indicates that hemicelluloses act as inhibitors of the coalescence of microfibrils during drying and facilitate the nanofibrillation of once-dried pulp. Furthermore, hemicelluloses provide adhesion between nanofibers, contributing to reduction of thermal expansion and enhancement of mechanical properties in the composites.

Evaluation of the accuracy of CT numbers in statistical correction of nonlinearity for polychromatic X-ray CT projection data.

The CT number is theoretically independent of the number of incident photons and the thickness of a subject. However, when noise is added, the CT number becomes dependent on the number of incident photons because of the nonlinearity of the logarithm operation, and so the accuracy of the CT number is degraded, especially in a photon-starved state. The inconsistency of the CT number due to nonlinearity generates an intense streak artifact in a reconstructed image. We have theoretically clarified the statistical characteristics of both the nonlinearity of the logarithm transform and the non-zero/non-negative restriction in the logarithm operation. Moreover, we have formulated a correction method for such nonlinearity according to the statistical distribution of noise, and we carried out computer simulations for monochromatic X-ray beams. However, the applicability to polychromatic-energy photons has not been confirmed. The artifacts induced by the beam-hardening effect, which occurs when incident beams are polychromatic, remarkably deteriorate the accuracy of the CT number. In this paper, we quantitatively evaluate the improvement of the quality of reconstructed images by our correction method by using a numerical experiment when incident beams are polychromatic. The experimental results show that there is less influence on spatial resolution and that the CT number is hardly dependent on the number of incident photons for a polychromatic beam as well as a monochromatic beam. Moreover, the results suggest the possibility that the same image quality is obtained at a much lower exposure level than the clinical exposure level of low-dose CT.

[Case of suicide by hanging complicated by cerebral sinus thrombosis].

A 43-year-old male with respiratory arrest due to neck hanging was resuscitated at the scene. The head CT on arrival showed diffuse brain swelling predominantly in the right cerebral hemisphere. The swelling improved but right transverse sinus thrombosis was recognized on the 4th hospital day. His conscious state gradually recovered and recanalization of the sinus was confirmed on a subsequent MR venography. He was discharged without neurological deficit. A sinus thrombosis should be considered as a differential diagnosis of brain swelling after hanging.