Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Following Prior Infection or Vaccination.

BACKGROUND: The extent to which infection versus vaccination has conferred similarly durable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunity during the Omicron era remains unclear. METHODS: In a cohort of 4496 adults under continued serological surveillance throughout the first year of Omicron-predominant SARS-CoV-2 transmission, we examined incidence of new infection among individuals whose last known antigenic exposure was either recent (<90 days) or remote (≥90 days) infection or vaccination. RESULTS: We adjudicated 2053 new-onset infections occurring between 15 December 2021 through 22 December 2022. In multivariable-adjusted analyses, compared to individuals whose last known exposure was remote vaccination, those with recent vaccination (odds ratio [OR], 0.82 [95% confidence interval {CI}, .73-.93]; P = .002) or recent infection (OR, 0.14 [95% CI, .05-.45]; P = .001) had lower risk for new infection within the subsequent 90-day period. Given a significant age interaction (P = .004), we found that remote infection compared to remote vaccination was associated with significantly greater new infection risk in persons aged ≥60 years (OR, 1.88 [95% CI, 1.13-3.14]; P = .015) with no difference seen in those <60 years (1.03 [95% CI, .69-1.53]; P = .88). CONCLUSIONS: During the initial year of Omicron, prior infection and vaccination both offered protection against new infection. However, remote prior infection was less protective than remote vaccination for individuals aged ≥60 years. In older adults, immunity gained from vaccination appeared more durable than immunity gained from infection.

Multi-Organ System Metabolic Stress and Sex-Divergent Vascular Associations.

Introduction: Women experience excess cardiovascular risk compared to men in the setting of similar metabolic disease burden. This consistent finding could be related to sex differences in the vascular response to various forms of metabolic stress. In this study we examine the association of both systemic and organ-specific metabolic stress with vascular health in women and men. Methods: We conducted an observational study of 4,299 adult participants (52% women, aged 59±13 years) of the National Health and Nutrition Examination Survey (NHANES) 2017-2018 cohort and 110,225 adult outpatients (55% women, aged 64±16 years) of the Cedars-Sinai Medical Center (CSMC) 2019 cohort. We used natural splines to examine the association of systemic and organ-specific measures of metabolic stress including body mass index (BMI), hemoglobin A1c (HbA1c), hepatic FIB-4 score, and CKD-EPI estimated glomerular filtration rate (eGFR) on systolic blood pressure (SBP). Piecewise linear models were generated using normal value thresholds (BMI <25 kg/m 2 , HbA1c <5.7%, FIB-4 <1.3, and eGFR ≥90 ml/min), which approximated observed spline breakpoints. The primary outcome was increase in SBP (relative to a sex-specific physiologic baseline SBP) in association with increase in level of each metabolic measure. Results: Women compared to men demonstrated larger magnitudes and an earlier onset of increase in SBP per increment increase across all metabolic stress measures. The slope of SBP increase per increment of each metabolic measure was greater for women than men particularly for metabolic measures within the normal range, with slope differences of 1.71 mmHg per kg/m2 of BMI, 9.61 mmHg per %HbA1c, 6.45 mmHg per FIB-4 unit, and 0.37 mmHg per ml/min decrement of eGFR in the NHANES cohort (P difference <0.05 for all). Overall results were consistent in the CSMC cohort. Conclusions: Women exhibited greater vascular sensitivity in the setting of multiple types of metabolic stress, particularly in periods representing the transition from metabolic health to disease. These findings underscore the importance of involving early metabolic health interventions as part of efforts to mitigate vascular risks in both women and men.

Blood pressure variability supersedes heart rate variability as a real-world measure of dementia risk.

Blood pressure variability (BPV) and heart rate variability (HRV) have been associated with Alzheimer's Disease and Related Dementias (ADRD) in rigorously controlled studies. However, the extent to which BPV and HRV may offer predictive information in real-world, routine clinical care is unclear. In a retrospective cohort study of 48,204 adults (age 54.9 ± 17.5 years, 60% female) receiving continuous care at a single center, we derived BPV and HRV from routinely collected clinical data. We use multivariable Cox models to evaluate the association of BPV and HRV, separately and in combination, with incident ADRD. Over a median 3 [2.4, 3.0] years, there were 443 cases of new-onset ADRD. We found that clinically derived measures of BPV, but not HRV, were consistently associated with incident ADRD. In combined analyses, only patients in both the highest quartile of BPV and lowest quartile of HRV had increased ADRD risk (HR 2.34, 95% CI 1.44-3.81). These results indicate that clinically derived BPV, rather than HRV, offers a consistent and readily available metric for ADRD risk assessment in a real-world patient care setting. Thus, implementation of BPV as a widely accessible tool could allow clinical providers to efficiently identify patients most likely to benefit from comprehensive ADRD screening.

Genome-Wide Meta-Analysis Identifies 11 Susceptibility Variants of Vitiligo in the Chinese Han Population.

Vitiligo is an autoimmune disease involving loss of melanocytes. Although several genetic studies have confirmed that genetic factors play an important role, its pathogenesis remains incompletely characterized. In this study, a genome-wide meta-analysis was conducted to search for more susceptibility variants of vitiligo. Tang et al performed a GWAS for cohort I (1117 vitiligo cases and 1701 healthy controls) previously, and we conducted a GWAS for cohort II (3323 vitiligo cases and 7186 healthy controls) in this study, with the results subjected to a genome-wide meta-analysis and linkage disequilibrium analysis. We identify, to our knowledge, 11 previously unreported susceptibility variants, of which 6 variants are located in the intronic regions, and the remaining 5 variants are located within intergenic regions between genes. In addition, the results of polygenic risk score show that the best evaluated effect for target data is among significant SNVs of the base data. The susceptibility genes of vitiligo are mainly enriched in the immune-related functions and pathways. The susceptibility variants expand the role of genetic factors associated with vitiligo. The bioinformatics analysis for risk genes provides further insight into the pathogenesis of vitiligo.

Assessing the post hoc effectiveness of tixagevimab-cilgavimab for prevention of SARS-CoV-2 infections in solid organ transplant recipients.

BACKGROUND: Tixagevimab-cilgavimab (Tix-Cil) was authorized for prophylaxis against COVID-19 in immunocompromised patients from December 2021 through January 2023. Real-world effectiveness for solid organ transplant (SOT) recipients has been unclear. METHODS: We enrolled 911 SOT recipients into a longitudinal COVID-19 serology study, of whom 381 (42%) received ≥1 dose of Tix-Cil. We collected and analyzed data on incident SARS-CoV-2 infections and antibody kinetics for all patients from January 2022 to March 2023, including periods dominated by Omicron BA and BQ subvariants. RESULTS: Over 253 ± 131 days of follow-up, there were 324 new-onset SARS-CoV-2 infections: 117 (31%) in Tix-Cil treated and 207 (39%) in Tix-Cil untreated patients (p = .012). In analyses adjusting for demographic, clinical, and COVID-19 exposure factors, any Tix-Cil treatment was associated with lower infection risk (OR 0.52, 95% CI 0.27-0.96, p = .039) throughout the surveillance period including when more resistant BQ.1 and BQ.1.1 subvariants had emerged (12/1/2022 onwards). Among treated patients, receiving a Tix-Cil dose was associated with substantial and sustained increase in anti-spike IgG antibody and angiotensin-converting enzyme 2 binding inhibition levels (Abbott Architect assay) that together also demonstrated association with lower infection risk (p = .042). During the full surveillance period, the frequency of infections requiring hospitalization was low overall (N = 26, 2.9% of the total cohort) and not significantly different between Tix-Cil recipients (N = 12, 3.2% of treated patients) and non-Tix-Cil recipients (N = 14, 2.6% of untreated patients) with unadjusted p = .31 for between-group difference. CONCLUSION: In a large cohort of SOT recipients, we found that Tix-Cil reduced infection risk even amidst emergent Omicron subvariants. Additionally, the extent of measurable humoral response to Tix-Cil may indicate relative effectiveness. Pre-exposure monoclonal antibody therapy may represent a strategy that will continue to offer clinical benefit for immunocompromised persons who are known to derive limited protection from vaccinations.

Clinical Utility of SARS-CoV-2 Serological Testing and Defining a Correlate of Protection.

Herein, we review established clinical use cases for SARS-CoV-2 antibody measures, which include diagnosis of recent prior infection, isolating high titer convalescent plasma, diagnosing multisystem inflammatory syndrome in children (MIS-C), and booster dosing in the immunosuppressed and other populations. We then address whether an antibody correlate of protection (CoP) for SARS-CoV-2 has been successfully defined with the following considerations: Antibody responses in the immunocompetent, vaccine type, variants, use of binding antibody tests vs. neutralization tests, and endpoint measures. In the transition from the COVID-19 pandemic to endemic, there has been much interest in defining an antibody CoP. Due to the high mutability of respiratory viruses and our current knowledge of SARS-CoV-2 variants defining a CoP for prevention of infection is unrealistic. However, a CoP may be defined for prevention of severe disease requiring hospitalization and/or death. Most SARS-CoV-2 CoP research has focused on neutralization measurements. However, there can be significant differences in neutralization test methods, and disparate responses to new variants depending on format. Furthermore, neutralization assays are often impractical for high throughput applications (e.g., assessing humoral immune response in populations or large cohorts). Nevertheless, CoP studies using neutralization measures are reviewed to determine where there is consensus. Alternatively, binding antibody tests could be used to define a CoP. Binding antibody assays tend to be highly automatable, high throughput, and therefore practical for large population applications. Again, we review studies for consensus on binding antibody responses to vaccines, focusing on standardized results. Binding antibodies directed against the S1 receptor binding domain (S1-RBD) of the viral spike protein can provide a practical, indirect measure of neutralization. Initially, a response for S1-RBD antibodies may be selected that reflects the peak response in immunocompetent populations and may serve as a target for booster dosing in the immunocompromised. From existing studies reporting peak S1-RBD responses in standardized units, an approximate range of 1372-2744 BAU/mL for mRNA and recombinant protein vaccines was extracted that could serve as an initial CoP target. This target would need to be confirmed and potentially adjusted for updated vaccines, and almost certainly for other vaccine formats (i.e., viral vector). Alternatively, a threshold or response could be defined based on outcomes over time (i.e., prevention of severe disease). We also discuss the precedent for clinical measurement of antibodies for vaccine-preventable diseases (e.g., hepatitis B). Lastly, cellular immunity is briefly addressed for its importance in the nature and durability of protection.

Association of blood pressure variability during acute care hospitalization and incident dementia.

Background and objectives: Recognized as a potential risk factor for Alzheimer's disease and related dementias (ADRD), blood pressure variability (BPV) could be leveraged to facilitate identification of at-risk individuals at a population level. Granular BPV data are available during acute care hospitalization periods for potentially high-risk patients, but the incident ADRD risk association with BPV measured in this setting is unknown. Our objective was to evaluate the relation of BPV, measured during acute care hospitalization, and incidence of ADRD. Methods: We retrospectively studied adults, without a prior ADRD diagnosis, who were admitted to a large quaternary care medical center in Southern California between January 1, 2013 and December 31, 2019. For all patients, determined BPV, calculated as variability independent of the mean (VIM), using blood pressure readings obtained as part of routine clinical care. We used multivariable Cox proportional hazards regression to examine the association between BP VIM during hospitalization and the development of incident dementia, determined by new ICD-9/10 coding or the new prescription of dementia medication, occurring at least 2 years after the index hospitalization. Results: Of 81,892 adults hospitalized without a prior ADRD diagnosis, 2,442 (2.98%) went on to develop ADRD (2.6 to 5.2 years after hospitalization). In multivariable-adjusted Cox models, both systolic (HR 1.05, 95% CI 1.00-1.09) and diastolic (1.06, 1.02-1.10) VIM were associated with incident ADRD. In pre-specified stratified analyses, the VIM associations with incident ADRD were most pronounced in individuals over age 60 years and among those with renal disease or hypertension. Results were similar when repeated to include incident ADRD diagnoses made at least 1 or 3 years after index hospitalization. Discussion: We found that measurements of BPV from acute care hospitalizations can be used to identify individuals at risk for developing a diagnosis of ADRD within approximately 5 years. Use of the readily accessible BPV measure may allow healthcare systems to risk stratify patients during periods of intense patient-provider interaction and, in turn, facilitate engagement in ADRD screening programs.

Robust weakly supervised learning for COVID-19 recognition using multi-center CT images.

The world is currently experiencing an ongoing pandemic of an infectious disease named coronavirus disease 2019 (i.e., COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Computed Tomography (CT) plays an important role in assessing the severity of the infection and can also be used to identify those symptomatic and asymptomatic COVID-19 carriers. With a surge of the cumulative number of COVID-19 patients, radiologists are increasingly stressed to examine the CT scans manually. Therefore, an automated 3D CT scan recognition tool is highly in demand since the manual analysis is time-consuming for radiologists and their fatigue can cause possible misjudgment. However, due to various technical specifications of CT scanners located in different hospitals, the appearance of CT images can be significantly different leading to the failure of many automated image recognition approaches. The multi-domain shift problem for the multi-center and multi-scanner studies is therefore nontrivial that is also crucial for a dependable recognition and critical for reproducible and objective diagnosis and prognosis. In this paper, we proposed a COVID-19 CT scan recognition model namely coronavirus information fusion and diagnosis network (CIFD-Net) that can efficiently handle the multi-domain shift problem via a new robust weakly supervised learning paradigm. Our model can resolve the problem of different appearance in CT scan images reliably and efficiently while attaining higher accuracy compared to other state-of-the-art methods.

Can Clinical Symptoms and Laboratory Results Predict CT Abnormality? Initial Findings Using Novel Machine Learning Techniques in Children With COVID-19 Infections.

The rapid spread of coronavirus 2019 disease (COVID-19) has manifested a global public health crisis, and chest CT has been proven to be a powerful tool for screening, triage, evaluation and prognosis in COVID-19 patients. However, CT is not only costly but also associated with an increased incidence of cancer, in particular for children. This study will question whether clinical symptoms and laboratory results can predict the CT outcomes for the pediatric patients with positive RT-PCR testing results in order to determine the necessity of CT for such a vulnerable group. Clinical data were collected from 244 consecutive pediatric patients (16 years of age and under) treated at Wuhan Children's Hospital with positive RT-PCR testing, and the chest CT were performed within 3 days of clinical data collection, from January 21 to March 8, 2020. This study was approved by the local ethics committee of Wuhan Children's Hospital. Advanced decision tree based machine learning models were developed for the prediction of CT outcomes. Results have shown that age, lymphocyte, neutrophils, ferritin and C-reactive protein are the most related clinical indicators for predicting CT outcomes for pediatric patients with positive RT-PCR testing. Our decision support system has managed to achieve an AUC of 0.84 with 0.82 accuracy and 0.84 sensitivity for predicting CT outcomes. Our model can effectively predict CT outcomes, and our findings have indicated that the use of CT should be reconsidered for pediatric patients, as it may not be indispensable.

Potential of preparing cement clinker by adding the fluorine-containing sludge into raw meal.

Fluorine-containing sludge from semiconductor industries were one kind of hazardous wastes, there was hardly effective treatment to realize its safe disposal and utilization. This paper evaluated the potential of preparing cement clinker by adding the sludge into raw meal by a series of experiments. The results revealed 2.0 % addition of the sludge markedly improved the burnability of the produced clinker, and promoted the formation of alite with more amounts and smaller size, but the 5.0 % addition of the sludge resulted in the abundant formation of interstitial phases to inhibit the formation of alite and belite. The better workability was gained with the addition of 2.0 %, and the optimal 28 d compressive strength was 50.76 MPa. The distribution of fluorine was higher in silicate phases, and it was mainly accumulated in the interfaces of silicate phases. Fluorine in the sludge was immobilized by calcium to form the binding forms of calcium fluoride in produced clinker and hydration products. The immobilization ratios of fluorine, copper, zinc and nickel were more than 99.5 %, and the addition of the sludge (≤5.0 %) into raw meal could not induce further environment hazards.

Systematic and Comprehensive Automated Ventricle Segmentation on Ventricle Images of the Elderly Patients: A Retrospective Study.

Background and Objective: Ventricle volume is closely related to hydrocephalus, brain atrophy, Alzheimer's, Parkinson's syndrome, and other diseases. To accurately measure the volume of the ventricles for elderly patients, we use deep learning to establish a systematic and comprehensive automated ventricle segmentation framework. Methods: The study participation included 20 normal elderly people, 20 patients with cerebral atrophy, 64 patients with normal pressure hydrocephalus, and 51 patients with acquired hydrocephalus. Second, get their imaging data through the picture archiving and communication systems (PACS) system. Then use ITK software to manually label participants' ventricular structures. Finally, extract imaging features through machine learning. Results: This automated ventricle segmentation method can be applied not only to CT and MRI images but also to images with different scan slice thicknesses. More importantly, it produces excellent segmentation results (Dice > 0.9). Conclusion: This automated ventricle segmentation method has wide applicability and clinical practicability. It can help clinicians find early disease, diagnose disease, understand the patient's disease progression, and evaluate the patient's treatment effect.

Optical current sensing mechanism under a non-uniform magnetic field.

The effect of the inhomogeneous magnetic field on the Faraday rotation angle and output light intensity was analyzed using finite element simulation, at different distances between the conductor and the magneto-optical glass. The results show that under an inhomogeneous magnetic field, the magnetic birefringence effect due to the Cotton-Mouton effect decreases the output light intensity of the straight-through optical path. The Faraday rotation angle is non-linearly inversely proportional to the distance. Based on these results, which were verified by the theoretical model, a reasonable geometric arrangement of the sensing component of a straight-through optical current sensor is proposed.

Oxytetracycline increases the mobility of carbon nanotubes in porous media.

The effect of engineered nanoparticles on the mobility of co-existing contaminants has been increasingly studied, while the reverse effect receives little attention. This study provides results from investigating the effect of oxytetracycline (OTC) on the mobility of oxidized multi-walled carbon nanotubes (O-MWCNTs) in quartz sand (QS) columns at various solution ionic strengths (ISs) and pHs. The mobility of O-MWCNTs in QS columns was significantly enhanced by the presence of OTC under all of the tested solution conditions (IS: 0.1, 1.0, and 10mM; pH: 3.0, 5.5, and 8.5), with an increase of 8.6-50.9%. Such enhancement was nonlinear over OTC concentration, which firstly increased (0 to 2.5mgL-1 OTC) and then decreased (2.5 to 20mgL-1OTC) at pH5.5. The major contributor to the OTC-enhanced O-MWCNTs mobility was competition of the two analytes for adsorption sites on the QS surface. Batch attachment results show that the adsorption of O-MWCNTs in the presence of OTC onto QS was also nonlinear with OTC concentration (firstly decreased and then increased with increasing OTC) at pH5.5, which gave the plausible explanation for the nonlinear enhancement of O-MWCNTs transport in QS columns by the presence of OTC. In turn, both the carrier and competition actions of O-MWCNTs determined the mobility of OTC in QS columns and the carrier action was stronger when more OTC was associated with O-MWCNTs in the influent. These results imply that the mobility of O-MWCNTs in OTC polluted water and soil can be significantly stronger than that in non-polluted area. CAPSULE: OTC can increase the migration of O-MWCNTs mainly through the competition for adsorption sites on collectors.

[Characteristics of Carbon and Nitrogen in the Downstream Columnar Sediment of Maozhou River, Shenzhen].

Based on the determinations of total nitrogen (TN), organic matter (OM), carbon-nitrogen ratio (C/N), δ15 N, and δ13 C on 12 sediment cores, the distribution characteristics and the sources of nitrogen and organic matter were analyzed in sediments from the lower reaches and main tributaries of the Maozhou River. The results showed that the average concentrations of total nitrogen (TN) and organic matter (OM) were 1815.37 mg·kg-1 and 22 401.68 mg·kg-1, respectively, in the Maozhou River sediments, which were higher than in TaihuLake and ChaohuLake. The levels of TN and OM in the study area were high and varied greatly with the increase of depth. The δ15 N content in the sediments of the MaozhouRiver downstream ranged from 2.20 ‰ to 32.78 ‰, while the δ13 C content ranged from -27.53 ‰ to -21.95 ‰. The average concentrations of δ15 N and δ13 C were 6.78 ‰ and -25.41 ‰. Moreover, the C/N ratio ranged from 0.49 to -18.23. The δ13 C varied slightly with the increase of depth, while δ15 N and C/N varied greatly. A source analysis in the study area indicated that C3 plants and chemical fertilizer were the main sources in the surface sediments (0-40 cm) downstream of the Maozhou River. Furthermore, algae were the main sources of organic matter in the deep sediments downstream of the Maozhou River and in tributary sediments of the Shajing River. Nitrogen in the surface sediments (0-40 cm) downstream of the Maozhou River mainly comes from inorganic fertilizer and soil organic nitrogen, while nitrogen in the Maozhou River deep sediments and Shajing River sediments mainly come from soil erosion and soil organic nitrogen.

Distinguishable co-transport mechanisms of phenanthrene and oxytetracycline with oxidized-multiwalled carbon nanotubes through saturated soil and sediment columns: vehicle and competition effects.

To date mechanisms underlying co-transports of engineered nanomaterials (ENMs) with contaminants have not been adequately explored, which involve complex interactions among ENMs, contaminants, and soils. This study investigated co-transport behaviors of 3 oxidized-multiwalled carbon nanotubes (o-MWCNTs) with phenanthrene (PHE) and oxytetracycline (OTC) in soil and sediment columns. Sorptions and desorptions of PHE and OTC by the o-MWCNTs were examined to facilitate the discussion of co-transport mechanisms. The results showed that mobilities of PHE and OTC in the columns were significantly enhanced by the presences of o-MWCNTs in the influents; the eluted o-MWCNTs were positively correlated to the eluted total PHE but negatively correlated to the eluted total OTC; the eluted PHE was mainly in the o-MWCNTs-associated form, while it was mainly the dissolved OTC breaking through the columns. It was thus concluded that the o-MWCNTs acted as vehicles facilitating the PHE transport, while besides the vehicle effect the o-MWCNTs also competed for the adsorption sites on soil particles with OTC and thereby enhancing the OTC mobility. These findings provide new insight into the mechanisms regulating co-transports of ENMs and contaminants in porous media.

Enhanced transport of CeO2 nanoparticles in porous media by macropores.

This is the first study to investigate the effect of macropores on the transport of CeO2 nanoparticles (nCeO2) in quartz sand and soil. The artificial macropore types are the vertical continuous macropore (O-O), and the vertical discontinuous macropore (O-C). The results indicated that the mobility of nCeO2 was significantly enhanced by the macropore in both quartz sand and soil, and the enhancement was greater in the continuous macropore than in the discontinuous macropore. Compared with the homogeneous column, both the O-O and O-C macropores in quartz sand favored an earlier breakthrough and a larger initial effluent recovery rate of nCeO2. However, there was little influence on the plateau concentration and the total effluent recovery rate. In soil, both types of macropores significantly shortened nCeO2 breakthrough time, and favored a higher plateau concentration, and a larger initial and total effluent recovery rate. The O-O macropore which accounted for only 1% of the total pore volume had doubly increased the total mobility of nCeO2 in soil; even the mobility was increased by 30% with the O-C macropore. It was found that the effect of preferential flow on nCeO2 transport was greater in soil than it was in quartz sand.

Transport of TiO2 nanoparticles in soil in the presence of surfactants.

This paper aimed to investigate the influences of surfactants on the nanoparticle transport behavior in soil. The transport behaviors of TiO2 nanoparticles (nTiO2) in soil with three different surfactants, including Triton X-100 (TX-100), sodium dodecylbenzene sulfonate (SDBS) and cationic cetyl trimethylammonium bromide (CTAB) were studied. Results showed that all the three surfactants decreased the mobility of nTiO2 in soil column, which were mainly caused by the strong adsorption of surfactants on soil and nTiO2. The inhibition order was as follows: CTAB>SDBS>TX-100. Combined effect experiments showed that when solution ionic strength (IS) increased, TX-100 or CTAB inhibited the mobility of nTiO2 in soil. However, the effect of SDBS on nTiO2 transport shifted from inhibition to facilitation when IS increased from 0.1 to 5mM. This was mainly attributed to the decreasing adsorption of SDBS on soil with increased IS, whereas the adsorption of TX-100 and CTAB was independent of IS. This innovative information motivates further insight into the role of surfactants on nanoparticle transport behavior in soil.