Comparison of Homologous and Heterologous Booster SARS-CoV-2 Vaccination in Autoimmune Rheumatic and Musculoskeletal Patients.

Vaccination against SARS-CoV-2 to prevent COVID-19 is highly recommended for immunocompromised patients with autoimmune rheumatic and musculoskeletal diseases (aiRMDs). Little is known about the effect of booster vaccination or infection followed by previously completed two-dose vaccination in aiRMDs. We determined neutralizing anti-SARS-CoV-2 antibody levels and applied flow cytometric immunophenotyping to quantify the SARS-CoV-2 reactive B- and T-cell mediated immunity in aiRMDs receiving homologous or heterologous boosters or acquired infection following vaccination. Patients receiving a heterologous booster had a higher proportion of IgM+ SARS-CoV-2 S+ CD19+CD27+ peripheral memory B-cells in comparison to those who acquired infection. Biologic therapy decreased the number of S+CD19+; S+CD19+CD27+IgG+; and S+CD19+CD27+IgM+ B-cells. The response rate to a booster event in cellular immunity was the highest in the S-, M-, and N-reactive CD4+CD40L+ T-cell subset. Patients with a disease duration of more than 10 years had higher proportions of CD8+TNF-α+ and CD8+IFN-γ+ T-cells in comparison to patients who were diagnosed less than 10 years ago. We detected neutralizing antibodies, S+ reactive peripheral memory B-cells, and five S-, M-, and N-reactive T-cells subsets in our patient cohort showing the importance of booster events. Biologic therapy and <10 years disease duration may confound anti-SARS-CoV-2 specific immunity in aiRMDs.

Prioritization of hazards for risk and resilience management through elicitation of expert judgement.

Risk assessment in communities or regions typically relies on the determination of hazard scenarios and an evaluation of their impact on local systems and structures. One of the challenges of risk assessment for infrastructure operators is how to identify the most critical scenarios that are likely to represent unacceptable risks to such assets in a given time frame. This study develops a novel approach for prioritizing hazards for the risk assessment of infrastructure. Central to the proposed methodology is an expert elicitation technique termed paired comparison which is based on a formal mathematical technique for quantifying the range and variance in the judgements of a group of stakeholders. The methodology is applied here to identify and rank natural and operational hazard scenarios that could cause serious disruption or have disastrous effects to the infrastructure in the transnational Øresund region over a period of 5 years. The application highlighted substantial divergences of views among the stakeholders on identifying a single 'most critical' natural or operational hazard scenario. Despite these differences, it was possible to flag up certain cases as critical among the natural hazard scenarios, and others among the operational hazards.

Humoral and Cellular Immunogenicity and Safety of Five Different SARS-CoV-2 Vaccines in Patients With Autoimmune Rheumatic and Musculoskeletal Diseases in Remission or With Low Disease Activity and in Healthy Controls: A Single Center Study.

Background: Vaccine-induced immunity is essential for controlling the COVID-19 pandemic. Data on humoral and cellular immunogenicity and safety of different SARS-CoV-2 vaccines in patients with autoimmune rheumatic and musculoskeletal diseases (RMDs) are limited. Methods: A single center observational study evaluated the immunogenicity and safety of the two-dose regimen of the BBIBP-CorV inactivated, Gam-COVID-Vac and AZD1222 adenovirus-based, and BNT162b2 and mRNA-1273 mRNA-based vaccines in patients with RMDs (n = 89) compared with healthy controls (n = 74). Neutralizing anti-RBD (receptor binding domain) specific antibodies and SARS-CoV-2 specific T-cell response were measured one and four months after the second vaccine dose in parallel with vaccination efficacy and safety. Results: Disease-specific comparison showed that antibody response at four months was higher in spondylarthropathies compared to rheumatoid arthritis and autoimmune RMDs. Risk factors for reduced immunogenicity included longer disease duration, positive immunoserological profile and anti-CD20 therapy of patients. The rate of positive anti-RBD antibody response for healthy controls versus patients after 4 months post vaccination was 69% vs. 55% for the inactivated viral vaccine BBIBP-CorV, 97% vs. 53% for the pooled data of adenovirus vector-based vaccines Gam-COVID-Vac and AZD1222, or 100% vs. 81% for the pooled data of mRNA vaccines BNT162b2 and mRNA-1273, respectively. Patients who received the Gam-COVID-Vac or mRNA-1273 vaccines had a higher proportion of TNF-α producing CD4+ T-cells upon SARS-CoV-2 antigen stimulation compared to the inactivated viral vaccine. Conclusion: All five investigated vaccines were immunogenic in the majority of patients and healthy controls with variable antibody and T-cell response and an acceptable safety profile.

Efficient emergency responses to vehicle collision, earthquake, snowfall, and flooding on highways and bridges: A review.

This review article analyzes factors affecting emergency response to hazardous events on highways and their bridges, with focus on man-made and natural scenarios: heavy vehicle collision with a bridge, earthquake, heavy snowfall, and flooding. For each disaster scenario, selected historical events were compiled to determine influential factors and success criteria for efficient emergency response, both related to organizational and technical measures. This study constituted a part of a resilience management process, recently developed and demonstrated within the European Union (EU)-funded H2020 project IMPROVER and can be a useful approach in aiding operators of transportation infrastructure to improve their resilience to emergency incidents.

Numerical Analysis and 1D/2D Sensitivity Study for Monolithic and Laminated Structural Glass Elements under Thermal Exposure.

Glass is largely used in architectural and engineering applications (i.e., buildings and vehicles) as a structural material, especially in the form of laminated glass (LG) sections. To achieve adequate and controlled safety levels in these applications, the well-known temperature-dependent behavior of viscoelastic interlayers for LG sections should be properly accounted for during the design process. Furthermore, the materials' thermomechanical degradation with increases of temperature could severely affect the load-bearing performance of glass assemblies. In this context, uncoupled thermomechanical finite element (FE) numerical models could represent a robust tool and support for design engineers. Key input parameters and possible limits of the FE method, however, should be properly calibrated and assessed, so as to enable reliable estimations for the real behavior of glazing systems. In this paper, FE simulations are proposed for monolithic (MG) and LG specimens under radiant heating, based on one-dimensional (1D) and two-dimensional (2D) models. A special attention is focused on thermal effects, being representative of the first step for conventional uncoupled, thermomechanical analyses. Based on experimental results available in the literature, FE parametric studies are discussed, giving evidence of limits and issues due to several modeling assumptions. In particular, careful consideration is paid for various thermal material properties (conductivity, specific heat) and thermal boundaries (conductivity, emissivity), but also for other influencing parameters like the geometrical features of samples (thickness tolerances, cross-sectional properties, etc.), the composition of LG sections (interlayer type, thickness), the loading pattern (heat transfer distribution) and the presence of additional mechanical restraints (i.e., supports of different materials). Comparative FE results are hence critically discussed, highlighting the major effects of such influencing parameters.