Antibody Kinetics after Three Doses of SARS-CoV-2 mRNA Vaccination in Patients with Inflammatory Bowel Disease.

Background: The emergence of new SARS-CoV-2 variants calls for more data on SARS-CoV-2 mRNA vaccine response. Aims: We aimed to assess the response to a third mRNA vaccine dose against SARS-CoV-2 in inflammatory bowel disease (IBD) patients. Methods: This was a single-center, observational prospective study of IBD patients who received a third mRNA vaccine dose against SARS-CoV-2. Antibody titers were taken post-third-dose at one and three months using the Roche Elecsys anti-SARS-CoV-2-S enzyme immunoassay. Titers less than 0.8 units/mL were considered negative according to the manufactures. Titers between 0.8 units/mL and 250 units/mL were considered non-neutralizing. Titers greater than 250 units/mL were considered neutralizing. Results: Eighty-three patients were included, all of whom had detectable antibodies at 3 months post-third dose. A total of 89% showed neutralizing and 11% non-neutralizing titers. Participants with non-neutralizing titers were more likely to be on systemic corticosteroids (p = 0.04). Two participants seroconverted from negative to positive, whereas 86% with non-neutralizing titers boosted to neutralizing levels. Only one participant with neutralizing titers after a third dose had a decrease to a non-neutralizing level within 3 months. Conclusions: Our findings support the ongoing recommendations for additional doses in immunocompromised individuals. However, longitudinal studies with a greater-sized patient population are needed.

Antibody Response Six Months after SARS-CoV-2 mRNA Vaccination in Patients with Inflammatory Bowel Disease.

Patients with inflammatory bowel disease (IBD) are recommended to receive vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), regardless of their immunosuppression status. Immunosuppressive medications represent a mainstay of therapy in moderate to severe IBD; however, their impact on the SARS-CoV-2 vaccine response remains unclear. Studies thus far have shown that patients with IBD on various therapies had detectable antibody responses after standard vaccinations.1-5 To date, one study has examined the kinetics of antibody response at 3 months after vaccination in patients with IBD, but data beyond this time point are not yet available.6 The aim of this study was to assess anti-spike antibody response 6 months after completion of standard SARS-CoV-2 vaccination in patients with IBD. Secondarily, we observed antibody kinetics over 6 months in a subset of patients post-vaccination.

Antibody Response 3 Months After 2-Dose SARS-CoV-2 mRNA Vaccination in Patients With Inflammatory Bowel Disease.

INTRODUCTION: The response to SARS-CoV-2 vaccination of patients with inflammatory bowel disease (IBD) on immune-modifying therapies requires further investigation because previous studies indicate that patients on immune therapy might have decreased antibody concentrations. METHODS: We present the antireceptor binding domain antibody response over a period of 3 months in 217 patients with IBD who completed standard 2-dose SARS-CoV-2 mRNA vaccine series. RESULTS: Almost all (98.6%) IBD vaccine recipients had a positive antireceptor binding domain antibody response at least 3 months after vaccination. Decreased antibody titers at 3 months were seen in a subset of patients on antitumor necrosis factor-alpha. Approximately 10% of the participants with high-titer antibodies at 1 month had a decrease to low-positive titers at 3 months, which was mostly observed in those on combination therapy and antitumor necrosis factor-alpha monotherapy. DISCUSSION: Larger longitudinal studies are required to define the response in IBD population and its clinical impact.

Forest microclimate and composition mediate long-term trends of breeding bird populations.

Climate change is contributing to biodiversity redistributions and species declines. However, cooler microclimate conditions provided by old-growth forest structures compared with surrounding open or younger forests have been hypothesized to provide thermal refugia for species that are sensitive to climate warming and dampen the negative effects of warming on population trends of animals (i.e., the microclimate buffering hypothesis). In addition to thermal refugia, the compositional and structural diversity of old-growth forest vegetation itself may provide resources to species that are less available in forests with simpler structure (i.e., the insurance hypothesis). We used 8 years of breeding bird abundance data from a forested watershed, accompanied with sub-canopy temperature data, and ground- and LiDAR-based vegetation data to test these hypotheses and identify factors influencing bird population changes from 2011 to 2018. After accounting for imperfect detection, we found that for 5 of 20 bird species analyzed, abundance trends tended to be less negative or neutral at sites with cooler microclimates, which supports the microclimate buffering hypothesis. Negative effects of warming on two species were also reduced in locations with greater forest compositional diversity supporting the insurance hypothesis. We provide the first empirical evidence that complex forest structure and vegetation diversity confer microclimatic advantages to some animal populations in the face of climate change. Conservation of old-growth forests, or their characteristics in managed forests, could help slow the negative effects of climate warming on some breeding bird populations via microclimate buffering and possibly insurance effects.

Landowners' Socio-Cultural Valuation of Ecosystem Services Provided by Trees in Costa Rican Agricultural Landscapes.

Over one-fourth of the world's land area is dedicated to agriculture, and these lands provide important ecosystem services (ES). Trees are a key component of agricultural ecosystems' ability to provide ES, especially in tropical regions. Agricultural landowners' evaluation of the ES provided by trees influences management decisions, impacting tree cover at large scales. Using a case study approach, we conducted semi-structured interviews with four types of agricultural landowners in southern Costa Rica to better understand how they value ES provided by trees. We used a socio-cultural valuation method, which revealed that landowners highly valued regulating and provisioning ES provided by trees and that the number and type of ES identified was influenced by the principle economic activity. Those farmers with larger amounts of forests on their properties more often identified cultural ES. The socio-cultural valuation methods revealed that respondents valued trees as wildlife habitat, coupling supporting and cultural services with both material (e.g., tourism) and non-material benefits (e.g., beauty). Few farmers in the study benefited from payment for ecosystem services programs, but the high value farmers placed on trees indicates there are other opportunities to increase tree cover on farms, such as promotion of live fencing and expanded riparian corridors. Results from this work can help improve conservation outcomes by shifting the focus of ecosystem service valuation to the needs and concerns of small-scale farmers in the development of outreach programs, management plans, and policies aimed at increasing tree cover on private lands in agricultural landscapes.

A systematic review of multi-level stigma interventions: state of the science and future directions.

BACKGROUND: Researchers have long recognized that stigma is a global, multi-level phenomenon requiring intervention approaches that target multiple levels including individual, interpersonal, community, and structural levels. While existing interventions have produced modest reductions in stigma, their full reach and impact remain limited by a nearly exclusive focus targeting only one level of analysis. METHODS: We conducted the first systematic review of original research on multi-level stigma-reduction interventions. We used the following eligibility criteria for inclusion: (1) peer-reviewed, (2) contained original research, (3) published prior to initiation of search on November 30, 2017, (4) evaluated interventions that operated on more than one level, and (5) examined stigma as an outcome. We stratified and analyzed articles by several domains, including whether the research was conducted in a low-, middle-, or high-income country. RESULTS: Twenty-four articles met the inclusion criteria. The articles included a range of countries (low, middle, and high income), stigmatized conditions/populations (e.g., HIV, mental health, leprosy), intervention targets (e.g., people living with a stigmatized condition, health care workers, family, and community members), and stigma reduction strategies (e.g., contact, social marketing, counseling, faith, problem solving), with most using education-based approaches. A total of 12 (50%) articles examined community-level interventions alongside interpersonal and/or intrapersonal levels, but only 1 (4%) combined a structural-level intervention with another level. Of the 24 studies, only 6 (25%) were randomized controlled trials. While most studies (17 of 24) reported statistically significant declines in at least one measure of stigma, fewer than half reported measures of practical significance (i.e., effect size); those that were reported varied widely in magnitude and were typically in the small-to-moderate range. CONCLUSIONS: While there has been progress over the past decade in the development and evaluation of multi-level stigma interventions, much work remains to strengthen and expand this approach. We highlight several opportunities for new research and program development.

Imaging glial activation in patients with post-treatment Lyme disease symptoms: a pilot study using [11C]DPA-713 PET.

The pathophysiology of post-treatment Lyme disease syndrome (PTLDS) may be linked to overactive immunity including aberrant activity of the brain's resident immune cells, microglia. Here we used [11C]DPA-713 and positron emission tomography to quantify the 18 kDa translocator protein, a marker of activated microglia or reactive astrocytes, in the brains of patients with post-treatment Lyme disease symptoms of any duration compared to healthy controls. Genotyping for the TSPO rs6971 polymorphism was completed, and individuals with the rare, low affinity binding genotype were excluded. Data from eight brain regions demonstrated higher [11C]DPA-713 binding in 12 patients relative to 19 controls. [11C]DPA-713 PET is a promising tool to study cerebral glial activation in PTLDS and its link to cognitive symptoms.

eHealth for Stigma Reduction Efforts Designed to Improve Engagement in Care for People Living with HIV.

PURPOSE OF REVIEW: HIV-related stigma remains a significant barrier to engagement in care for persons living with HIV (PLWH) worldwide. This review examines the use of eHealth technologies for reducing stigma as a pathway toward improved engagement in care for PLWH. We provide a brief overview of effective stigma reduction interventions for PLWH, both eHealth and others; identify gaps in the research on use of eHealth technologies for stigma reduction; and suggest potential research avenues moving forward. RECENT FINDINGS: The majority of HIV-related eHealth studies use technology to improve ART adherence. To date, few HIV-related eHealth studies have included any measurement of stigma. Given the current narrow evidence base, further research is needed to determine whether eHealth technologies can help to reduce stigma and improve engagement in care for PLWH.

Sociocultural and structural perpetuators of domestic violence in pregnancy: A qualitative look at what South Indian women believe needs to change.

In India, reported rates of domestic violence rise as high as 31%. Abuse against pregnant women in India is associated with depressive and PTSD symptoms, and poor birth outcomes, yet no evidence-based interventions have been tested on this population. In this cross-sectional qualitative study, we sought perspective on South Indian women's concerns about abuse during pregnancy and what they believed would help. Participants cited economic dependence on husbands and sociocultural structures as factors perpetuating domestic violence. Women also described resilience factors that can protect against abuse. Our participants highlighted a requisite for interventions within health and social systems.

Beyond arctic and alpine: the influence of winter climate on temperate ecosystems.

Winter climate is expected to change under future climate scenarios, yet the majority of winter ecology research is focused in cold-climate ecosystems. In many temperate systems, it is unclear how winter climate relates to biotic responses during the growing season. The objective of this study was to examine how winter weather relates to plant and animal communities in a variety of terrestrial ecosystems ranging from warm deserts to alpine tundra. Specifically, we examined the association between winter weather and plant phenology, plant species richness, consumer abundance, and consumer richness in 11 terrestrial ecosystems associated with the U.S. Long-Term Ecological Research (LTER) Network. To varying degrees, winter precipitation and temperature were correlated with all biotic response variables. Bud break was tightly aligned with end of winter temperatures. For half the sites, winter weather was a better predictor of plant species richness than growing season weather. Warmer winters were correlated with lower consumer abundances in both temperate and alpine systems. Our findings suggest winter weather may have a strong influence on biotic activity during the growing season and should be considered in future studies investigating the effects of climate change on both alpine and temperate systems.

The impact of domestic violence and depressive symptoms on preterm birth in South India.

PURPOSE: India has the highest absolute number of maternal deaths, preterm birth cases, and under-5 mortality in the world, as well as high domestic violence (DV) rates. We sought to examine the impact of DV and its psychosocial correlates on pregnancy and birth outcomes. METHODS: Women seeking antenatal care in Tamil Nadu, South India (N = 150) were assessed during pregnancy, and birth outcomes were abstracted from medical records after the babies were born. RESULTS: We found that psychological abuse (OR 3.9; 95% CI 1.19-12.82) and mild or greater depressive symptoms (OR 3.3; 95% CI 0.99-11.17) were significantly associated with increased risk of preterm birth. Physical abuse was also associated with increased risk of preterm birth, but this was not statistically significant (OR 1.9; 95% CI 0.59-6.19). In each of the above adjusted models, low maternal education was associated with increased risk of preterm birth, in the analysis with depressive symptoms OR 0.18, CI 0.04-0.86 and in the analyses with psychological abuse OR 0.19, CI 0.04-0.91. CONCLUSIONS: These findings suggest that future research should focus on understanding the psychosocial antecedents to preterm birth, to better target interventions and improve maternal child health in limited resource settings.

Tropical forest fragmentation limits pollination of a keystone understory herb.

Loss of native vegetation cover is thought to be a major driver of declines in pollination success worldwide. However, it is not well known whether reducing the fragmentation of remaining vegetation can ameliorate these negative effects. We tested the independent effects of composition vs. configuration on the reproductive success of a keystone tropical forest herb (Heliconia tortuosa). To do this we designed a large-scale mensurative experiment that independently varied connected forest-patch size (configuration) and surrounding amount of forest (composition). In each patch, we tested whether pollen tubes, fruit, and seed set were associated with these landscape variables. We also captured hummingbirds as an indication of pollinator availability in a subset of patches according to the same design. We found evidence for an effect of configuration on seed set of H. tortuosa, but not on other aspects of plant reproduction; proportion of seeds produced increased 40% across the gradient in patch size we observed (0.64 to > 1300 ha), independent of the amount of forest in the surrounding landscape at both local and landscape scales. We also found that the availability of pollinators was dependent upon forest configuration; hummingbird capture rates increased three and one-half times across the patch size gradient, independent of forest amount. Finally, pollinator availability was strongly positively correlated with seed set. We hypothesize that the effects of configuration on plant fitness that we observed are due to reduced pollen quality resulting from altered hummingbird availability and/or movement behavior. Our results suggest that prioritizing larger patches of tropical forest may be particularly important for conservation of this species.

Characterization of indoor air quality and resident health in an Arizona senior housing apartment building.

A survey of key indoor air quality (IAQ) parameters and resident health was carried out in 72 apartments within a single low-income senior housing building in Phoenix, Arizona. Air sampling was carried out simultaneously with a questionnaire on personal habits and general health of residents. Mean PM10 concentrations are 66 +/- 16, 58 +/- 13, and 24 +/- 3 microg/m3 and mean PM2.5 concentrations are 62 +/- 16, 53 +/- 13, and 20 +/- 2 microg/m3 for the living room, kitchen, and outdoor balcony, respectively. Median PM10 concentrations are 17, 18 and 17 microg/m3 and median PM25 concentrations are 13, 14, and 13 microg/m3, respectively. The initial results indicate that increased indoor particle concentrations coincide with residents who report smoking cigarettes. Indoor formaldehyde concentrations revealed median levels of 36.9, 38.8, and 4.3 ppb in the living room, kitchen, and balcony, respectively. Results show that 36% of living room samples and 44% of kitchen samples exceeded the Health Canada REL for chronic exposure to formaldehyde (40 ppb). Associations between occupants' behavior self-reported health conditions, and IAQ are evaluated.

Development and evaluation of a virtual reality training for emergency treatment of shortness of breath based on frameworks for serious games.

Background: Virtual reality (VR) can offer an innovative approach to providing training in emergency situations, especially in times of COVID-19. There is no risk of infection, and the procedure is scalable and resource-efficient. Nevertheless, the challenges and problems that can arise in the development of VR training are often unclear or underestimated. As an example, we present the evaluation of the feasibility of development of a VR training session for the treatment of dyspnoea. This is based on frameworks for serious games, and provides lessons learned. We evaluate the VR training session with respect to usability, satisfaction, as well as perceived effectiveness and workload of participants. Methods: The VR training was developed using the established framework (Steps 1-4) for serious games of Verschueren et al. and Nicholson's RECIPE elements for meaningful gamification. Primary validation (Step 4) was performed at the University of Bern, Switzerland, in a pilot study without control group, with a convenience sample of medical students (n=16) and established measurement tools. Results: The theoretical frameworks permitted guided development of the VR training session. Validation gave a median System Usability Scale of 80 (IQR 77.5-85); for the User Satisfaction Evaluation Questionnaire, the median score was 27 (IQR 26-28). After the VR training, there was a significant gain in the participants' confidence in treating a dyspnoeic patient (median pre-training 2 (IQR 2-3) vs. post-training 3 (IQR 3-3), p=0.016).Lessons learned include the need for involving medical experts, medical educators and technical experts at an equivalent level during the entire development process. Peer-teaching guidance for VR training was feasible. Conclusion: The proposed frameworks can be valuable tools to guide the development and validation of scientifically founded VR training. The new VR training session is easy and satisfying to use and is effective - and is almost without motion sickness.