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BACKGROUND: Thrombosis with thrombocytopenia syndrome (TTS) is a potentially life-threatening condition associated with adenoviral-vectored COVID-19 vaccination. It presents similarly to spontaneous heparin-induced thrombocytopenia. Twelve cases of cerebral venous sinus thrombosis after vaccination with the Ad26.COV2.S COVID-19 vaccine (Janssen/Johnson & Johnson) have previously been described. OBJECTIVE: To describe surveillance data and reporting rates of all reported TTS cases after COVID-19 vaccination in the United States. DESIGN: Case series. SETTING: United States. PATIENTS: Case patients receiving a COVID-19 vaccine from 14 December 2020 through 31 August 2021 with thrombocytopenia and thrombosis (excluding isolated ischemic stroke or myocardial infarction) reported to the Vaccine Adverse Event Reporting System. If thrombosis was only in an extremity vein or pulmonary embolism, a positive enzyme-linked immunosorbent assay for antiplatelet factor 4 antibodies or functional heparin-induced thrombocytopenia platelet test result was required. MEASUREMENTS: Reporting rates (cases per million vaccine doses) and descriptive epidemiology. RESULTS: A total of 57 TTS cases were confirmed after vaccination with Ad26.COV2.S (n = 54) or a messenger RNA (mRNA)-based COVID-19 vaccine (n = 3). Reporting rates for TTS were 3.83 per million vaccine doses (Ad26.COV2.S) and 0.00855 per million vaccine doses (mRNA-based COVID-19 vaccines). The median age of patients with TTS after Ad26.COV2.S vaccination was 44.5 years (range, 18 to 70 years), and 69% of patients were women. Of the TTS cases after mRNA-based COVID-19 vaccination, 2 occurred in men older than 50 years and 1 in a woman aged 50 to 59 years. All cases after Ad26.COV2.S vaccination involved hospitalization, including 36 (67%) with intensive care unit admission. Outcomes of hospitalizations after Ad26.COV2.S vaccination included death (15%), discharge to postacute care (17%), and discharge home (68%). LIMITATIONS: Underreporting and incomplete case follow-up. CONCLUSION: Thrombosis with thrombocytopenia syndrome is a rare but serious adverse event associated with Ad26.COV2.S vaccination. The different demographic characteristics of the 3 cases reported after mRNA-based COVID-19 vaccines and the much lower reporting rate suggest that these cases represent a background rate. PRIMARY FUNDING SOURCE: Centers for Disease Control and Prevention.
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COVID-19 , Trombocitopenia , Trombose , Vacinas , Ad26COVS1/efeitos adversos , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , Vacinas contra COVID-19/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RNA Mensageiro , Síndrome , Trombocitopenia/induzido quimicamente , Trombocitopenia/epidemiologia , Trombose/induzido quimicamente , Trombose/etiologia , Estados Unidos/epidemiologia , Vacinação/efeitos adversos , Vacinas/efeitos adversos , Adulto JovemRESUMO
Textiles waste is relatively small in terms of weight as compared to other waste streams, but it has a large impact on human health and environment, and its rate is increasing due to the 'fast fashion' model. In this paper, we examine the French national programme for managing post-consumer textiles and clothing through a case study research. To date, France is the only country in the world implementing an extended producer responsibility (EPR) policy for end-of-use clothing, linen and shoes. The case highlights the benefits of using an EPR policy and provides interesting insights about the challenges faced by the textiles waste sector. For instance, the EPR policy has contributed to a threefold increase in the collection and recycling rates of post-consumer textiles since 2006. In addition, the material recovery rate of the post-consumer textiles can reach 90%, 50% of which can be directly reused. However, the 'reuse' stream is facing some challenges because its main market is in Africa and many African countries are considering banning the import of used textiles to encourage a competitive textiles industry locally and internationally. The EPR policy shows a great potential to identify new markets for 'reuse' and to improve the textiles waste sector. Such an EPR policy also could drive societies to financially support innovation and research to provide feasible solutions for fashion producers to adopt eco-design and design for recycling practices. This paper provides guidance for policy makers, shareholders, researchers and practitioners interested in diverting post-consumer textiles and clothing waste from landfills and promoting circular textiles transition.
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Vestuário , Têxteis , Gerenciamento de Resíduos , África , França , ReciclagemRESUMO
BACKGROUND: Erythritol is a polyol that is used in the food and beverage industry. Due to its non-caloric and non-cariogenic properties, the popularity of this sweetener is increasing. Large scale production of erythritol is currently based on conversion of glucose by selected fungi. In this study, we describe a biotechnological process to produce erythritol from light and CO2, using engineered Synechocystis sp. PCC6803. METHODS: By functionally expressing codon-optimized genes encoding the erythrose-4-phosphate phosphatase TM1254 and the erythrose reductase Gcy1p, or GLD1, this cyanobacterium can directly convert the Calvin cycle intermediate erythrose-4-phosphate into erythritol via a two-step process and release the polyol sugar in the extracellular medium. Further modifications targeted enzyme expression and pathway intermediates. CONCLUSIONS: After several optimization steps, the best strain, SEP024, produced up to 2.1 mM (256 mg/l) erythritol, excreted in the medium.
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Eritritol/biossíntese , Engenharia Genética/métodos , Synechocystis/crescimento & desenvolvimento , Synechocystis/genética , Synechocystis/metabolismo , Aldeído Redutase/genética , Aldeído Redutase/metabolismo , Processos Autotróficos , Escherichia coli , Luz , Organismos Geneticamente Modificados , Fotossíntese/genética , Fosfatos Açúcares/metabolismo , Edulcorantes/metabolismoRESUMO
The GSK and Pfizer respiratory syncytial virus (RSV) vaccines are both indicated for adults aged 60 years and older, but only the Pfizer product is approved for use in pregnancy to prevent RSV-associated lower respiratory tract disease in infants aged younger than 6 months. To assess for vaccine administration errors (ie, administration of the GSK RSV vaccine to pregnant persons) VAERS (Vaccine Adverse Event Reporting System), a U.S. passive reporting system, was searched for the time period from August 2023 to January 2024. A total of 113 reports of these administration errors were identified. Most reports (103, 91.2%) did not describe an adverse event. These administration errors are preventable with proper education and training and other preventive measures.
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Infecções por Vírus Respiratório Sincicial , Vacinas contra Vírus Sincicial Respiratório , Adulto , Feminino , Humanos , Gravidez , Infecções por Vírus Respiratório Sincicial/prevenção & controle , Infecções por Vírus Respiratório Sincicial/induzido quimicamente , Vacinas contra Vírus Sincicial Respiratório/efeitos adversos , Vacinação , Erros MédicosRESUMO
Heterocytous cyanobacteria are important players in the carbon and nitrogen cycle. They can fix dinitrogen by using heterocytes, specialized cells containing the oxygen-sensitive nitrogenase enzyme surrounded by a thick polysaccharide and glycolipid layer which prevents oxygen diffusion and nitrogenase inactivation. Heterocyte glycolipids can be used to detect the presence of heterocytous cyanobacteria in present-day and past environments, providing insight into the functioning of the studied ecosystems. However, due to their good preservation throughout time, heterocyte glycolipids are not ideal to detect and study living communities, instead methods based on DNA are preferred. Currently cyanobacteria can be detected using untargeted genomic approaches such as metagenomics, or they can be specifically targeted by, for example, the use of primers that preferentially amplify their 16S rRNA gene or their nifH gene in the case of nitrogen fixing cyanobacteria. However, since not all cyanobacterial nitrogen fixers are heterocytous, there is currently no fast gene-based method to specifically detect and distinguish heterocytous cyanobacteria. Here, we developed a PCR-based method to specifically detect heterocytous cyanobacteria by designing primers targeting the gene (hglT) encoding the enzyme responsible for the last step in the biosynthesis of heterocyte glycolipid (i.e., a glycosyltransferase). We designed several primer sets using the publicly available sequences of 23 heterocytous cyanobacteria, after testing them on DNA extracts of 21 heterocyte-forming and 7 non-heterocyte forming freshwater cyanobacteria. The best primer set was chosen and successfully used to confirm the presence of heterocytous cyanobacteria in a marine environmental sample.
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The objective of this work is to evaluate the reprocessing of PLA 3D printing waste from different origins, into filaments and films, and without the addition of any additive. Two types of waste were considered: a blend of different printing wastes (masks, visors, other components) of personal protective equipment coming from an association of Spanish coronamakers, and PLA waste from a single known commercial source. Both types of materials were subjected to repeated extrusion cycles and processed into films by compression molding. Samples were characterized after each cycle and their mechanical and viscosity properties evaluated. Diffusion-ordered NMR spectroscopy (DOSY) experiments were also carried out to estimate molecular weights. The results show a better performance for the PLA waste from the known origin, capable of withstanding up to three re-extrusion cycles per two for the waste blending, without significant degradation. Additionally, a model to address collection and mechanical recycling cycles under two different scenarios (full traceability and not full traceability) was proposed.
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BACKGROUND: Following the authorization and recommendations for use of the U.S. COVID-19 vaccines, the Centers for Disease Control and Prevention (CDC)'s Immunization Safety Office (ISO) responded to inquiries and questions from public health officials, healthcare providers, and the general public on COVID-19 vaccine safety. METHODS: We describe COVID-19 vaccine safety inquiries, by topic, received and addressed by ISO from December 1, 2020-August 31, 2022. RESULTS: Of the 1978 COVID-19 vaccine-related inquiries received, 1655 specifically involved vaccine safety topics. The most frequently asked-about topics included deaths following vaccination, myocarditis, pregnancy, and reproductive health outcomes, understanding or interpreting data from the Vaccine Adverse Event Reporting System (VAERS), and thrombosis with thrombocytopenia syndrome. CONCLUSIONS: Inquiries about vaccine safety generally reflect issues that receive media attention. ISO will continue to monitor vaccine safety inquiries and provide accurate and timely information to healthcare providers, public health officials, and the general public.
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COVID-19 , Vacinas , Gravidez , Feminino , Estados Unidos , Humanos , Vacinas contra COVID-19/efeitos adversos , Sistemas de Notificação de Reações Adversas a Medicamentos , COVID-19/prevenção & controle , Vacinação/efeitos adversos , Vacinas/efeitos adversos , Imunização/efeitos adversos , Centers for Disease Control and Prevention, U.S.RESUMO
Nursing faculty are challenged to integrate immunization content in prelicensure nursing curricula. Historically, most immunization content has been delivered in pediatrics courses, with less emphasis on other populations across the lifespan. Skills related to vaccine administration may be prioritized over the most current immunization science, such as pathophysiology, immunology, and epidemiology. As the most trusted profession rated by the public (Saad, 2020), nurses are ideally suited to address vaccine hesitancy and promote vaccination in the communities they serve. Nurses apply active listening, problem solving, and communication skills with patients and their families, contributing to a person's confidence in their decision to be vaccinated. The Centers for Disease Control and Prevention and the Association for Prevention Teaching and Research collaborated to develop a framework for immunization content and teaching resources, Immunization Resources for Undergraduate Nursing (IRUN), for faculty to use in designing the nursing curricula. Content includes a curriculum framework, curriculum mapping tool, multiple teaching resources, and a dedicated website (IRUNursing.org). The framework provides guidance for faculty on integrating immunization content into a curriculum. Teaching resources include case studies, simulation scenarios, and PowerPoint slide decks. Although primarily focused on prelicensure nursing education, resources are also relevant to advanced professional nursing education.
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Bacharelado em Enfermagem , Educação em Enfermagem , Estudantes de Enfermagem , Vacinas , Criança , Currículo , Humanos , VacinaçãoRESUMO
3D printing PLA wastes were recovered from a well-known reference grade and from different sources. The recovered wastes were subjected to an energic washing step and then reprocessed into films by melt-extrusion, followed by compression molding to simulate the industrial processing conditions. The obtained materials were characterized and the optical, structural, thermal and crystallization behavior are reported. The mechanical recycling process leads to an increase of the crystallinity and a decrease of the intrinsic viscosity of the formulations, particularly in the sample based on blends of different 3D-PLA wastes. Moreover, the obtained films were disintegrated under composting conditions in less than one month and it was observed that recycled materials degrade somewhat faster than the starting 3D-PLA filament, as a consequence of the presence of shorter polymer chains. Finally, to increase the molecular weight of the recycled materials, the 3D-PLA wastes were submitted to a solid-state polymerization process at 110, 120, and 130 °C, observing that the recycled 3D-wastes materials based on a well-known reference grade experiences an improvement of the intrinsic viscosity, while that coming from different sources showed no significant changes. Thus, the results show that 3D printing PLA products provides an ideal environment for the implementation of distributed recycling program, in which wastes coming from well-known PLA grades can successfully be processed in films with good overall performance.
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BACKGROUND: Mannitol is a C(6) polyol that is used in the food and medical sector as a sweetener and antioxidant, respectively. The sustainable production of mannitol, especially via the direct conversion of CO2 by photosynthetic cyanobacteria, has become increasingly appealing. However, previous work aiming to achieve mannitol production in the marine Synechococcus sp. PCC7002 via heterologous expression of mannitol-1-phosphate-5-dehydrogenase (mtlD) and mannitol-1-phosphatase (m1p, in short: a 'mannitol cassette'), proved to be genetically unstable. In this study, we aim to overcome this genetic instability by conceiving a strategy to stabilize mannitol production using Synechocystis sp. PCC6803 as a model cyanobacterium. RESULTS: Here, we explore the stabilizing effect that mannitol production may have on cells faced with osmotic stress, in the freshwater cyanobacterium Synechocystis sp. PCC6803. We first validated that mannitol can function as a compatible solute in Synechocystis sp. PCC6803, and in derivative strains in which the ability to produce one or both of the native compatible solutes was impaired. Wild-type Synechocystis, complemented with a mannitol cassette, indeed showed increased salt tolerance, which was even more evident in Synechocystis strains in which the ability to synthesize the endogenous compatible solutes was impaired. Next we tested the genetic stability of all these strains with respect to their mannitol productivity, with and without salt stress, during prolonged turbidostat cultivations. The obtained results show that mannitol production under salt stress conditions in the Synechocystis strain that cannot synthesize its endogenous compatible solutes is remarkably stable, while the control strain completely loses this ability in only 6 days. DNA sequencing results of the control groups that lost the ability to synthesize mannitol revealed that multiple types of mutation occurred in the mtlD gene that can explain the disruption of mannitol production. CONCLUSIONS: Mannitol production in freshwater Synechocsytis sp. PCC6803 confers it with increased salt tolerance. Under this strategy, genetically instability which was the major challenge for mannitol production in cyanobacteria is tackled. This paper marks the first report of utilization of the response to salt stress as a factor that can increase the stability of mannitol production in a cyanobacterial cell factory.
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El Síndrome de Stevens-Johnson (SSJ) es una enfermedad dermatológica rara con afectación mucocutánea y sistémica, siendo la forma más grave de eritema exudativo multiforme y presentándose como una variante de la necrólisis epidérmica tóxica relacionado con etiologíamúltiple. Presentamos el caso de una paciente geriátrica de 84 años de edad, presentado SSJ relacionado con la toma de levofloxacino. La complejidad de cuidados que requirió en una unidad de hospitalización, así como la escasez de referentes bibliográficos en nuestro medio nos conllevaron a elaborar este plan de cuidados enfermeros (AU)
Stevens-Johnson Syndrome (SJS) is a rare dermatological disease with mucocutaneous and systemic involvement,with the mose severe forme of SJS, presenting as a variant of toxic epidermal necrolysis related to a multiple etiology.We report a case of geriatric patient 84 years of age present the syndrome associated with taking levofloxacin. The complexity of care require in an inpatient unit, and the paucity of references in our environment led us to develop this plan of nursing (AU)