COVID-19 mRNA vaccines induce robust levels of IgG but limited amounts of IgA within the oronasopharynx of young children.

Background: Understanding antibody responses to SARS-CoV-2 vaccination is crucial for refining COVID-19 immunization strategies. Generation of mucosal immune responses, including mucosal IgA, could be of potential benefit to vaccine efficacy, yet limited evidence exists regarding the production of mucosal antibodies following the administration of current mRNA vaccines to young children. Methods: We measured the levels of antibodies against SARS-CoV-2 from a cohort of children under 5 years of age undergoing SARS-CoV-2 mRNA vaccination (serially collected, matched serum and saliva samples, N=116) or on convenience samples of children under 5 years of age presenting to a pediatric emergency department (nasal swabs, N=103). Further, we assessed salivary and nasal samples for the ability to induce SARS-CoV-2 spike-mediated neutrophil extracellular traps (NET) formation. Results: Longitudinal analysis of post-vaccine responses in saliva revealed the induction of SARS-CoV-2 specific IgG but not IgA. Similarly, SARS-CoV-2 specific IgA was only observed in nasal samples obtained from previously infected children with or without vaccination, but not in vaccinated children without a history of infection. In addition, oronasopharyngeal samples obtained from children with prior infection were able to trigger enhanced spike-mediated NET formation, and IgA played a key role in driving this process. Conclusions: Despite the induction of specific IgG in the oronasal mucosa, current intramuscular vaccines have limited ability to generate mucosal IgA in young children. These results confirm the independence of mucosal IgA responses from systemic humoral responses following mRNA vaccination and suggest potential future vaccination strategies for enhancing mucosal protection in this young age group.

Latino families, primary care, and childhood obesity: a randomized controlled trial.

BACKGROUND: Few successful treatment modalities exist to address childhood obesity. Given Latinos' strong identity with family, a family-focused intervention may be able to control Latino childhood obesity. PURPOSE: To assess the feasibility and effectiveness of a family-centered, primary care-based approach to control childhood obesity through lifestyle choices. DESIGN: Randomized waitlist controlled trial in which control participants received the intervention 6 months after the intervention group. SETTING/PARTICIPANTS: Forty-one Latino children with BMI >85%, aged 9-12 years, and their caregivers were recruited from an urban community health center located in a predominantly low-income community. INTERVENTION: Children and their caregivers received 6 weeks of interactive group classes followed by 6 months of culturally sensitive monthly in-person or phone coaching to empower families to incorporate learned lifestyles and to address both family and social barriers to making changes. MAIN OUTCOMES MEASURES: Caregiver report on child and child self-reported health-related quality of life (HRQoL); metabolic markers of obesity; BMI; and accelerometer-based physical activity were measured July 2010-November 2011 and compared with post-intervention assessments conducted at 6 months and as a function of condition assignment. Data were analyzed in 2012. RESULTS: Average attendance rate to each group class was 79%. Socio-environmental and family factors, along with knowledge, were cited as barriers to changing lifestyles to control obesity. Caregiver proxy and child self-reported HRQoL improved for both groups with a larger but not nonsignificant difference among intervention vs control group children (p=0.33). No differences were found between intervention and control children for metabolic markers of obesity, BMI, or physical activity. CONCLUSIONS: Latino families are willing to participate in group classes and health coaching to control childhood obesity. It may be necessary for primary care to partner with community initiatives to address childhood obesity in a more intense manner. TRIAL REGISTRATION: This study is registered at Clinicaltrials.partners.org 2009P001721.

The U-Beam bridge: an advancement in the fiber-reinforced resin-bonded fixed partial denture.

Conservative, esthetic restorative dentistry has become an essential component in modern clinical dental practice. This article reviews the literature regarding the fiber-reinforced resin-bonded fixed partial dentures. A clinical case illustrates the technique. The main supportive framework is a U-beam and reinforcing rod composed of unidirectional, pretensed quartz fibers bound in an epoxy resin matrix. This composite resin restoration is ideal as an interim solution when an implant is being considered for placement in the undetermined future or as a medium to long-term restoration in certain clinical cases where occlusal forces are controlled and the abutment teeth in good health.