Determinants of SARS-CoV-2 IgG response and decay in Canadian healthcare workers: A prospective cohort study.

INTRODUCTION: Healthcare workers (HCWs) from an interprovincial Canadian cohort gave serial blood samples to identify factors associated with anti-receptor binding domain (anti-RBD) IgG response to the SARS-CoV-2 virus. METHODS: Members of the HCW cohort donated blood samples four months after their first SARS-CoV-2 immunization and again at 7, 10 and 13 months. Date and type of immunizations and dates of SARS-CoV-2 infection were collected at each of four contacts, together with information on immunologically-compromising conditions and current therapies. Blood samples were analyzed centrally for anti-RBD IgG and anti-nucleocapsid IgG (Abbott Architect, Abbott Diagnostics). Records of immunization and SARS-CoV-2 testing from public health agencies were used to assess the impact of reporting errors on estimates from the random-effects multivariable model fitted to the data. RESULTS: 2752 of 4567 vaccinated cohort participants agreed to donate at least one blood sample. Modelling of anti-RBD IgG titer from 8903 samples showed an increase in IgG with each vaccine dose and with first infection. A decrease in IgG titer was found with the number of months since vaccination or infection, with the sharpest decline after the third dose. An immunization regime that included mRNA1273 (Moderna) resulted in higher anti-RBD IgG. Participants reporting multiple sclerosis, rheumatoid arthritis or taking selective immunosuppressants, tumor necrosis factor inhibitors, calcineurin inhibitors and antineoplastic agents had lower anti-RBD IgG. Supplementary analyses showed higher anti-RBD IgG in those reporting side-effects of vaccination, no relation of anti-RBD IgG to obesity and lower titers in women immunized in early or mid-pregnancy. Sensitivity analysis results suggested no important bias in the self-report data. CONCLUSION: Creation of a prospective cohort was central to the credibility of results presented here. Serial serology assessments, with longitudinal analysis, provided effect estimates with enhanced accuracy and a clearer understanding of medical and other factors affecting response to vaccination.

Work and health challenges of Indigenous people in Canada.

The Truth and Reconciliation Commission of Canada has published 94 calls to action to redress the legacy of residential schools where thousands of Indigenous children have died. The objective of this narrative review is to address some of these calls by summarising the available evidence on work and health issues encountered by Indigenous workers in Canada. We searched seven databases to retrieve studies on Indigenous people, in Canada, and on occupational health as defined by the International Labour Organization. We included 31 studies, from which we found that Indigenous workers are experiencing intersectionality issues: in addition to having differential health issues related to a below-average socioeconomic status, Indigenous workers face discrimination in workplaces that affects their mental health. Indigenous workers might also cumulate occupational and environmental exposures from industries that have settled close to their dwellings (eg, exposure to polychlorobiphenyls). There is a scarcity of studies on major occupational health topics such as occupational cancers or musculoskeletal disorders in Indigenous people.

Classification of aerosol-generating procedures: a rapid systematic review.

In the context of covid-19, aerosol generating procedures have been highlighted as requiring a higher grade of personal protective equipment. We investigated how official guidance documents and academic publications have classified procedures in terms of whether or not they are aerosol-generating. We performed a rapid systematic review using preferred reporting items for systematic reviews and meta-analyses standards. Guidelines, policy documents and academic papers published in english or french offering guidance on aerosol-generating procedures were eligible. We systematically searched two medical databases (medline, cochrane central) and one public search engine (google) in march and april 2020. Data on how each procedure was classified by each source were extracted. We determined the level of agreement across different guidelines for each procedure group, in terms of its classification as aerosol generating, possibly aerosol-generating, or nonaerosol-generating. 128 documents met our inclusion criteria; they contained 1248 mentions of procedures that we categorised into 39 procedure groups. Procedures classified as aerosol-generating or possibly aerosol-generating by ≥90% of documents included autopsy, surgery/postmortem procedures with high-speed devices, intubation and extubation procedures, bronchoscopy, sputum induction, manual ventilation, airway suctioning, cardiopulmonary resuscitation, tracheostomy and tracheostomy procedures, non-invasive ventilation, high-flow oxygen therapy, breaking closed ventilation systems, nebulised or aerosol therapy, and high frequency oscillatory ventilation. Disagreements existed between sources on some procedure groups, including oral and dental procedures, upper gastrointestinal endoscopy, thoracic surgery and procedures, and nasopharyngeal and oropharyngeal swabbing. There is sufficient evidence of agreement across different international guidelines to classify certain procedure groups as aerosol generating. However, some clinically relevant procedures received surprisingly little mention in our source documents. To reduce dissent on the remainder, we recommend that (a) clinicians define procedures more clearly and specifically, breaking them down into their constituent components where possible; (b) researchers undertake further studies of aerosolisation during these procedures; and (c) guideline-making and policy-making bodies address a wider range of procedures.

Midline frontal and occipito-temporal activity during error monitoring in dyadic motor interactions.

Discrepancies between sensory predictions and action outcome are at the base of error coding. However, these phenomena have mainly been studied focussing on individual performance. Here, we explored EEG responses to motor prediction errors during a human-avatar interaction and show that Theta/Alpha activity of the frontal error-monitoring system works in phase with activity of the occipito-temporal node of the action observation network. Our motor interaction paradigm required healthy individuals to synchronize their reach-to-grasp movements with those of a virtual partner in conditions that did (Interactive) or did not require (Cued) movement prediction and adaptation to the partner's actions. Crucially, in 30% of the trials the virtual partner suddenly and unpredictably changed its movement trajectory thereby violating the human participant's expectation. These changes elicited error-related neuromarkers (ERN/Pe - Theta/Alpha modulations) over fronto-central electrodes during the Interactive condition. Source localization and connectivity analyses showed that the frontal Theta/Alpha activity induced by violations of the expected interactive movements was in phase with occipito-temporal Theta/Alpha activity. These results expand current knowledge about the neural correlates of on-line interpersonal motor interactions linking the frontal error-monitoring system to visual, body motion-related, responses.

[Better screening for work-related cancers: The experience of Brest University Hospital Occupational Disease Center inpatient service]. / Améliorer le repérage des cancers professionnels : bilan de la consultation de pathologie professionnelle de liaison du centre hospitalier universitaire de Brest.

INTRODUCTION: An in-patient clinical service has been set up in March 2016 in the Occupational Diseases Center of Brest University Hospital, France, to seek for work-relatedness of diseases in patients hospitalized into the oncology and hematology departments. We present here data after two years of existence. METHODS: All cases of cancers or malignant hematological diseases (ICD-10 codes C00 to C97 and D37 to D48) seen between March 1, 2016, and March 1, 2018, have been identified. We present sociodemographic data, occupational exposures, occupation, business sector, and tobacco consumption. The causation level between the disease and each of the occupational exposures has been rated as strong, intermediate, weak or null by the occupational medicine specialist of the Occupational Diseases Center. RESULTS: Among the 196 patients encountered, there are 127 work-related diseases and 82 of these had one occupational exposure rated as strong or intermediate. The most frequent occupational hazards were asbestos (48 cases) and ionizing radiation (23 cases). The most frequent business sectors were metallurgy, mechanical engineering, and agriculture. Lung cancer was the most frequently reported disease (49 cases). DISCUSSION: . We identified well-known couples with occupational exposures and diseases, such as asbestos and lung cancer. We also identified a link between pesticides and leukemias. This in-patient clinical service is helpful to identify work-related exposures and in helping patients to get compensated.

Prevalence of problem gambling in an employed population in Brittany, France.

Some employees may have recourse to gambling, notably as an adaptive strategy. Although many studies have been performed on specific occupational groups (i.e. gambling industry, transportation or teaching), none have been conducted with workers followed-up by Occupational Health Services (OHS). Our aim was to evaluate the prevalence of problem gambling in an employed population and its links with work. We performed a cross-sectional study between November 2016 and April 2017, in an OHS in France. We evaluated the prevalence of gambling using the Lie or Bet questionnaire and the Canadian Problem Gambling Index. Among the 410 employees included, 138 (33.7%) had gambled in the previous year, 12 (2.9%) considered their gambling experience to be work-related, 13 (3.2%) were identified as problem gamblers. The influence of colleagues and the workplace hierarchy and ease of access to gambling (in tobacco shops, bars…) could be risk factors. Screening for gambling behavior could be offered by occupational health services, using the Lie or Bet, especially for employees exposed to readily available gambling opportunities at their workplace.

Role of the occipito-temporal theta rhythm in hand visual identification.

Neuroimaging and EEG studies have shown that passive observation of the full body and of specific body parts is associated with 1) activity of an occipito-temporal region named the extrastriate body area (EBA), 2) amplitude modulations of a specific posterior event-related potential (ERP) component (N1/N190), and 3) a theta-band (4-7 Hz) synchronization recorded from occipito-temporal electrodes compatible with the location of EBA. To characterize the functional role of the occipito-temporal theta-band increase during the processing of body-part stimuli, we recorded EEG from healthy participants while they were engaged in an identification task (match-to-sample) of images of hands and nonbody control images (leaves). In addition to confirming that occipito-temporal electrodes show a larger N1 for hand images compared with control stimuli, cluster-based analysis revealed an occipito-temporal cluster showing an increased theta power when hands are presented (compared with leaves) and show that this theta increase is higher for identified hands compared with nonidentified ones while not being significantly different between not identified nonhand stimuli. Finally, single trial multivariate pattern analysis revealed that time-frequency modulation in the theta band is a better marker for classifying the identification of hand images than the ERP modulation. The present results support the notion that theta activity over the occipito-temporal cortex is an informative marker of hand visual processing and may reflect the activity of a network coding for stimulus identity.NEW & NOTEWORTHY Hands provide crucial information regarding the identity of others, which is a key information for social processes. We recorded EEG activity of healthy participants during the visual identification of hand images. The combination of univariate and multivariate pattern analysis in time- and time-frequency domain highlights the functional role of theta (4-7 Hz) activity over visual areas during hand identification and emphasizes the robustness of this neuromarker in occipito-temporal visual processing dynamics.

Lung Cancer in an Orthoprosthetist Using Vermiculite.

Occupational exposure to certain substances would cause cancer. Herein, we report on a case of a 58-year-old former orthoprostethist who died from a lung adenocarcinoma. He had a 3 pack-year history of smoking and a single exposure to asbestos during his professional career. Between 1979 and 2010, he used vermiculite plaques daily to build medical prostheses, using no personal protective equipment. Contamination of vermiculite with amphibole asbestos has been described in Libby, Montana. Expert opinion on this case has raised the hypothesis of the use of this kind of vermiculite during this period and the occupational etiology of this cancer. It seems important to point out the possibility of vermiculite-related lung cancers in unusual occupations in order to better document such cases in the future.

[The "room of errors" called into question]. / Les chambres des erreurs en question.

The "room of errors" called into question. In order to raise caregivers' awareness in relation to patient safety, some hospitals have setup a room of errors. The main aim of this method is to remind caregivers of best practices. However, it can give professionals the feeling of being inadequate and transfers certain responsibilities from the institution to the individual. Consequently, it is perhaps worthwhile reconsidering this approach.