Longer Intervals Research Articles

Comparison of Rate of Force Development between Explosive Sustained Contractions and Ballistic Pulse-like Contractions during Isometric Ankle and Knee Extension Tasks

Background: The rate of force development (RFD) is a measure of explosive strength, commonly evaluated within the same repetition as peak force/torque, by instructing the participants to produce “fast” and “hard” contraction. Previous studies have indicated that attempting to achieve the maximal RFD and maximal force/torque within the same contraction may not be optimal. Methods: This study assessed the differences between explosive sustained (“fast-and-hard”) and ballistic (pulse-like) contractions on the RFD during isometric ankle and knee extensions in young, recreationally active participants (n = 33; age: 23.4 ± 5.6 years). The participants performed both contraction types for isometric ankle and knee extension tasks. The RFD was calculated for time intervals 50, 100, 150 and 200 ms from the contraction onset and also in between these time points (50–100, 100–150 and 150–200 ms). Findings: The results of this study showed a higher RFD in the ballistic contractions in later time intervals (100–150 and 150–200 ms) compared to that of the explosive sustained contractions (effect size (Hedge’s g) = 0.51–0.73). The differences between explosive sustained and ballistics contractions were larger and occurred for more outcome variables in females than males. Peak RFD was also larger in ballistic contractions, both for females (p = 0.010; Hedge’s g = 0.54) and males (p = 0.003; Hedge’s g = 0.78). The intra-session reliability of the RFD was similar for both contraction types, increasing from moderate to excellent with longer time intervals. Conclusion: Our results suggest that ballistic contractions should be used when the assessment of the RFD is the primary goal. When the aim is to assess both the RFD and peak force, it is suggested to use the combination of separate explosive sustained contractions and ballistic contractions in the protocol.

Economic Downturns, Urban Growth and Suburban Fertility in a Mediterranean Context

Despite the wealth of micro–macro data on short-term demographic dynamics, the impact of metropolitan growth and economic downturns on local fertility is still under-investigated in advanced economies. Recent studies in low-fertility contexts have assumed suburban birth rates as being systematically higher than urban and rural rates. This assumption (hereafter, known as the ‘suburban fertility hypothesis’) was grounded on stylized facts and spatial regularities that imply a significant role of both macro (contextual) and micro (behavioral) factors positively influencing fertility in suburban locations. To verify such a hypothesis from a macro (contextual) perspective, the present study compares the general fertility rate of urban, suburban, and rural settlements of the Athens’ metropolitan region (Greece) at various observation years between 1860 and 2020. Long-term Athens’ growth represented a sort of ‘quasi-experiment’ for Mediterranean Europe, linking sequential urban stages and distinctive waves of economic expansion and recession. Using multivariate exploratory analysis and global/local econometric models, a dominant ‘rural’ fertility regime was recorded for 1860 and 1884. A characteristic ‘urban’ fertility regime was, instead, found over a relatively long, intermediate period between 1956 and 1990. Higher fertility in suburban settlements (10 km away from downtown Athens, on average) was, finally, observed since 2000. Considering a sufficiently long-time interval, the existence of multiple fertility regimes along the distance gradient has demonstrated how fertility dynamics are intrinsically bonded with metropolitan growth, economic downturns, and social transformations in Mediterranean Europe.

Association Between Critical Events in the PICU and Outcomes in Neighboring Patients.

OBJECTIVE:PICU patients who experience critical illness events, such as intubation, are at high risk for morbidity and mortality. Little is known about the impact of these events, which require significant resources, on outcomes in other patients. Therefore, we aimed to assess the association between critical events in PICU patients and the risk of similar events in neighboring patients over the next 6 hours.DESIGN:Retrospective observational cohort study.SETTING:Quaternary care PICU at the University of Chicago.PATIENTS:All children admitted to the PICU between 2012 and 2019.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:The primary outcome was a critical event defined as the initiation of invasive ventilation, initiating vasoactive medications, cardiac arrest, or death. The exposure was the occurrence of a critical event among other patients in the PICU within the preceding 6 hours. Discrete-time survival analysis using fixed 6-hour blocks beginning at the time of PICU admission was used to model the risk of experiencing a critical event in the PICU when an event occurred in the prior 6 hours. There were 13,628 admissions, of which 1,886 (14%) had a critical event. The initiation of mechanical ventilation was the most frequent event (n = 1585; 59%). In the fully adjusted analysis, there was a decreased risk of critical events (odds ratio, 0.82; 95% CI, 0.70–0.96) in the 6 hours following exposure to a critical event. This association was not present when considering longer intervals and was more pronounced in patients younger than 6 years old when compared with patients 7 years and older.CONCLUSION:Critical events in PICU patients are associated with decreased risk of similar events in neighboring patients. Further studies targeted toward exploring the mechanism behind this effect as well as identification of other nonpatient factors that adversely affect outcomes in children are warranted.

Adverse childhood experiences and fronto-subcortical structures in the developing brain.

The impact of adverse childhood experiences (ACEs) differs between individuals and depends on the type and timing of the ACE. The aim of this study was to assess the relation between various recently occurred ACEs and morphology in the developing brain of children between 8 and 11 years of age. We measured subcortical volumes, cortical thickness, cortical surface area and fractional anisotropy in regions of interest in brain scans acquired in 1,184 children from the YOUth cohort. ACEs were based on parent-reports of recent experiences and included: financial problems; parental mental health problems; physical health problems in the family; substance abuse in the family; trouble with police, justice or child protective services; change in household composition; change in housing; bereavement; divorce or conflict in the family; exposure to violence in the family and bullying victimization. We ran separate linear models for each ACE and each brain measure. Results were adjusted for the false discovery rate across regions of interest. ACEs were reported for 83% of children in the past year. Children were on average exposed to two ACEs. Substance abuse in the household was associated with larger cortical surface area in the left superior frontal gyrus, t(781) = 3.724, pFDR = 0.0077, right superior frontal gyrus, t(781) = 3.409, pFDR = 0.0110, left pars triangularis, t(781) = 3.614, pFDR = 0.0077, left rostral middle frontal gyrus, t(781) = 3.163, pFDR = 0.0195 and right caudal anterior cingulate gyrus, t(781) = 2.918, pFDR = 0.0348. Household exposure to violence (was associated with lower fractional anisotropy in the left and right cingulum bundle hippocampus region t(697) = −3.154, pFDR = 0.0101 and t(697) = −3.401, pFDR = 0.0085, respectively. Lower household incomes were more prevalent when parents reported exposure to violence and the mean parental education in years was lower when parents reported substance abuse in the family. No other significant associations with brain structures were found. Longer intervals between adversity and brain measurements and longitudinal measurements may reveal whether more evidence for the impact of ACEs on brain development will emerge later in life.

Microplastic particle trapping through microfluidic devices with different shaped pillars

This study investigates microplastic particle trapping through planar microchannels with different shaped single pillars or three square-shaped pillars arranged in a line. Micro-sized polyethylene particles are used as the microplastic dispersion. The particle-trapping probability and the trapped-particle concentration around the pillar are measured using a microscope with a high-speed camera. Among the four types of shapes (circular, triangular, square, and diamond) applied to the single pillar, the microchannel with a square pillar exhibits the highest performance. This is because, in this case, the region where the flowing particles can approach the pillar exists not only in front of the pillar, but also along the sides of the pillar toward the rear corners. For three square pillars set in a line, the microchannel with square pillars of increasing size and with a longer interval between pillars exhibits the highest performance, mainly due to active particle transport toward the rear pillar resulting from flow recovery at the rear of the front pillar.

Ziconotide for the Management of Cancer Pain: A Budget Impact Analysis

ObjectivesRecent recommendations on starting dose, smaller dose increments, and longer intervals between dose increase have the potential to increase the safety of ziconotide administration in addition to improving its value for money. Ziconotide is not routinely commissioned in England, with one of the concerns being whether it represents the best use of resources. The aim of this project is to conduct a budget impact analysis to estimate the costs or savings associated with the changes in ziconotide dosage in addition to its use in combination with morphine for the management of cancer pain. Materials and MethodsAn open, Markov-like cohort decision analytic model was developed to estimate the budget impact of ziconotide in combination with morphine (ziconotide combination therapy) vs morphine monotherapy through intrathecal drug delivery (ITDD) for the management of cancer pain. The perspective adopted was that of the UK National Health Service, with a five-year time horizon. Sensitivity analyses were conducted to evaluate different scenarios. ResultsZiconotide combination therapy was more expensive than treatment with morphine monotherapy. The total costs of ziconotide combination therapy and morphine monotherapy for the first year were £395,748 and £136,628 respectively. The estimated five-year cumulative budget impact of treatment with ziconotide combination therapy for the five-year time horizon was £2,487,539, whereas that of morphine monotherapy was £913,804. The additional costs in any of the first five years are below the resource impact significance level of £1 million for medical technologies in England. ConclusionsThe results of this budget impact analysis suggest that although a combination of intrathecal ziconotide in combination with morphine is associated with higher costs to the health care system in England, the incremental costs are not significant. Routine commissioning of ziconotide alone or in combination with morphine would provide an alternative for a population with limited ITDD treatment options.

Factors associated with the time to complete clinical exome sequencing in a pediatric patient population.

Exome sequencing (ES) is becoming increasingly important for diagnosing rare genetic disorders. Patients and clinicians face several barriers when attempting to obtain ES. This study is aimed to describe factors associated with a longer time interval between provider recommendation of testing and sample collection for ES. A retrospective chart review was conducted for insurance-authorized, completed pediatric ES in which initial requests were reviewed by Stanford's Genetic Testing Optimization Service between November 2018 and December 2019. Regression analysis was used to determine the association between the geocoded median household income and 3 different time point intervals defined as time to test, insurance decision, and scheduling/consent. Of the 281 charts reviewed, 115 cases were included in the final cohort. The average time from provider preauthorization request to sample collection took 104.4 days, and income was negatively correlated with the length of the insurance decision interval. Pediatric patients undergo a lengthy, uncertain process when attempting to obtain ES, some of which is associated with income. More research and clinician interventions are required to clarify specific socioeconomic factors that influence the ability to obtain timely ES and develop optimal protocols.

Epidemiology, risk factors, and outcomes of lung retransplantation: An analysis of the International Society for Heart and Lung Transplantation Thoracic Transplant Registry.

Lung retransplantation is a complex surgical decision that represents the only potential treatment option for recipients suffering from lung allograft failure. We sought to describe the modern landscape of lung retransplantation and to compare the relative importance of selected clinical, donor, and recipient factors on mortality in the year following lung retransplantation. We conducted a retrospective cohort study of first-time adult recipients of deceased donor lung retransplants reported to the International Society for Heart and Lung Transplantation (ISHLT) Thoracic Transplant Registry from May 2005 through June 2017. In addition to describing the characteristics of lung retransplant recipients, we examined 1 year survival overall, and by initial transplant-retransplant procedure type, recipient age, retransplant indication, and time-to-lung retransplantation (i.e., inter-transplant interval). We used the Somers' Dxy rank correlation statistic for censored data to assess the relative importance of several potential prognostic risk factors for mortality in the year following lung retransplantation. Our cohort included 1,597 lung retransplant recipients. 2005 was the first year with more than 100 retransplants, and since 2007, 138 to 188 retransplants (approximately 4%-6% of all transplants) were reported annually to the ISHLT Registry. The median inter-transplant interval was 3.4 years (interquartile range: 1.6-6.2 years). Forty-three percent of the cohort had an obliterative bronchiolitis retransplant indication, whereas 17% had primary graft failure. One-third (32%) were retransplanted within 2 years of their primary transplant, and 64% received a double lung transplant both times, whereas 36% received consecutive single lung transplants. Six-month and 1 year survival (82% and 76%) were higher for double-double lung retransplant recipients than for single-single recipients (76% and 69%). The 3 strongest prognostic factors for 1 year mortality were the inter-transplant interval (decreasing hazard with longer intervals), donor age (increasing hazard with older age), and need for mechanical ventilation preceding lung retransplantation. Retransplants comprise approximately 5% of annual lung transplants worldwide. The factor most strongly associated with 1 year mortality in this population was the duration of time since the primary lung transplant, with a persistent reduction in risk as more time elapses.

Muscle preactivation and the limits of muscle power output during jumping in the Cuban tree frog Osteopilus septentrionalis.

Previous studies of jumping in frogs have found power outputs in excess of what is possible from direct application of muscle power and concluded that jumping requires the storage and release of elastic strain energy. Of course, the muscles must produce the work required and their power output should be consistent with known muscle properties if the total duration of muscle activity is known. Using the Cuban tree frog, Osteopilus septentrionalis, I measured jumping performance from kinematics and used EMG measurements of three major jumping muscles to determine the duration of muscle activity. Using the total mass of all the hindlimb muscles, muscle mass-specific work output up to 60 J kg-1 was recorded. Distributed over the duration of the jump, both average and peak muscle mass-specific power output increased approximately linearly with the work done, reaching values of over 750 and 2000 W kg-1, respectively. However, the muscles were activated before the jump started. Both preactivation duration and EMG amplitude increased with increasing amounts of work performed. Assuming the muscles could produce work from EMG onset until toe-off, the average muscle mass-specific power over this longer interval also increased with work done, but only up to a work output of 36 J kg-1. The mean power above this value of work was 281 W kg-1, which is approximately 65% of the estimated maximum isotonic power. Several reasons are put forward for suggesting this power output, although within the known properties of the muscles, is nevertheless an impressive achievement.

Koolen-de Vries syndrome associated with continuous spike-wave in sleep

Koolen-de Vries syndrome (KdVS) is a genetic condition caused by 17q21.31 microdeletions or pathogenic variants in KANSL1. Affected patients most commonly exhibit some or all of the following: neonatal hypotonia, developmental impairment, facial dysmorphic features, and congenital malformations. Epilepsy occurs in approximately half, often with phenotypes on the epilepsyaphasia spectrum. We describe six children with KdVS found to have continuous spike-wave in sleep (CSWS) on EEG, four of whom were diagnosed with epileptic encephalopathy with CSWS and two with Landau-Kleffner syndrome. When compared with other children with CSWS on EEG, patients with KdVS may present at slightly later ages and with a longer interval between seizure diagnosis and identification of CSWS. There is no clear best treatment for children with CSWS, but two patients in our cohort were trialed on a variation of the ketogenic diet, and both reported clinical improvement. In one of the patients, the response was dramatic, and CSWS recurred when weaning of the ketogenic diet was attempted. Based on our findings, an EEG capturing a prolonged period of sleep should be arranged in any child with KdVS presenting with developmental regression or plateau, particularly if they have a preceding history of seizures.

ABCL-542 Prevalence and Characterization of EBV-Negative Post-Transplant Lymphoproliferative Disorder

A common and potentially fatal post-solid organ transplant (SOT) complication is post-transplant lymphoproliferative disorder (PTLD). While the association of Epstein-Barr virus (EBV) with the development of PTLD is well recognized, little is known about the etiology of EBV-negative PTLD. To characterize the differences between EBV-positive and EBV-negative PTLD to better understand the pathogenesis of EBV-negative PTLD. This was a retrospective study that reviewed patients who developed PTLD after SOT. Data was collected on PTLD patients (>18 years) from 2011 to 2021. Data included demographics, SOT type, time from SOT to PTLD development, tumor EBV status, PTLD site, histopathological morphology, tumor markers, and overall survival. EBV tumor status was compared using χ2, Fisher's Exact, and Wilcoxon Rank Sum tests. A single, large academic center. A total of 99 patients met the inclusion criteria. Of those, 45.5% were EBV-positive and 54.5% were EBV-negative. Tumor EBV status did not differ by race, but males were more likely to be EBV-negative (63% v. 44.4% of females, p=0.065). EBV tumor status did not differ by SOT type. The interval between SOT and PTLD diagnosis was longer in EBV-negative patients (8.68 years) than EBV-positive patients (4.93 years) (p=0.001). There was a significant difference in EBV-negative PTLD site (p=0.046) and PTLD subtypes (p=0.002). Site of EBV-negative PTLD consisted of gastrointestinal (38.9%), head/neck (11.1%), liver/spleen (11.1%), CNS (3.7%), other lymph (24%), and other non-lymph (11.1%). Monomorphic (65.5%) and T-cell (90%) subtypes were more common in EBV-negative patients, compared to the polymorphic (15.4%) and plasmablastic/plasmacytic (27.3%) subtypes. Expression of CD20 did not differ by tumor EBV status. Those who were CD30-negative were more likely to be EBV-negative (90% v. 25%, p=<0.001). Those who were CD138-negative were more likely to be EBV-negative (75% v. 26.7%, p=0.012). There was no difference in overall survival by tumor EBV status. This single institution retrospective review shows that there are distinct differences between EBV-negative and EBV-positive PTLD. EBV-negative PTLD has a longer interval from SOT to PTLD development, is more likely to occur in the gastrointestinal tract, and is more likely to have a monomorphic morphology.

Expected changes in physician outpatient interventional practices as a result of coronavirus disease 2019 and recent changes in Medicare physician fee schedule

ObjectiveWe examined the economic and practice effects of the coronavirus disease 2019 (COVID-19) pandemic and decreased Medicare physician payments on outpatient vascular interventional procedures. MethodsA 21-point survey was constructed and sent electronically to the physician members of the Outpatient Endovascular and Interventional Society and the American Vein and Lymphatic Society. The survey responses were converted to a Likert scale and statistical analyses performed to examine the associations between the response variables and the characteristics and practice patterns of the physician respondents. ResultsA total of 165 physicians responded to the survey, of whom 33% were vascular surgeons, 18% were radiologists, and 15% were general surgeons. For slightly more than one half (55%), their interventional practice was limited to the office setting, with the remainder also performing procedures in an office-based laboratory (OBL), ambulatory surgery center (ASC), or hospital. Almost all respondents had performed superficial venous interventions, with slightly more than one third also performing either deep venous procedures and/or peripheral arterial interventions. The COVID-19 pandemic had affected 98% of the practices, with a staff shortage reported by 63%. The most-established physicians, those with the longest interval since training completion, were the least likely to have experienced staff shortages. Almost all (94%) the respondents expected that the recent Medicare payment changes will have a negative effect on their practice. Physicians with only an office-based practice were less likely to add a physician associate compared with those with an OBL (P = .036). More than one quarter reported that it was likely they would close or sell their interventional practice in the next 2 years and 43% reported they were planning to retire early. The anticipated ameliorative responses to the decreased Medicare physician payments included adding wound care (24%) or other clinical services (36%) to their practices, with the alternatives considered more by younger physicians (P = .002) and nonsurgeons (P = .047). Only 10% expected to convert their practices to an ASC or hybrid ASC/OBL (16%). ConclusionsThe emotional and economic effects of the COVID-19 pandemic and the decreased Medicare physician reimbursement rates for vascular outpatient interventionalists have been significant. Even greater challenges for the financial viability of office practices and OBLs can be expected in the near future if additional further planned cuts are put into effect.

Fine intervals are required when using point intercept transects to assess coral reef status

The Point Intercept Transect (PIT) method has commonly been used in recent decades for estimating the status of coral reef benthic communities. It is a simple method that is efficiently performed underwater, as benthic components are recorded only as presence or absence at specific interval points along transects. Therefore, PIT is also popular in citizen science activities such as Reef Check programs. Longer intervals are commonly associated with longer transects, yet sampling interval length can significantly influence benthic coverage calculations. Despite this, the relative accuracy of longer or shorter intervals related to transect length has not been tested for PIT. In this study, we tested the optimum intervals of PIT for several commonly used transect lengths using the bootstrap method on empirical data collected on tropical coral reefs and non-reefal coral communities. Our results recommend fine intervals of 10 cm or shorter, depending on the length of the transect, to increase the accuracy of estimating benthic community status on coral reefs. Permanent transects should also be considered in long-term monitoring programs to improve data quality.

A Decision-Support System for Economic Feasibility of Subsurfaced Poultry Litter

Cattle (Bos spp.) producers routinely spread fertilizer or broadcast poultry (Gallus gallus L.) litter to improve forage production. With poultry litter widely available across the southeastern United States and being a cheaper source of plant nutrition than commercial fertilizer when proximal to application sites, the novel application of litter below the soil surface, while costly, allows for greater nutrient retention than broadcasting. Since quantifying costs and benefits of subsurfaced litter is complex, we develop and present a decision support spreadsheet for automated farm-scale model comparisons across modes of nutrient management. We compare subsurfaced litter to commercial fertilizer and broadcast litter in user-specific scenarios involving equipment choices (new, used, custom), desired nutrient needs for crops grown, litter nutrient concentration, and interval between litter application given the slow-release nature of litter compared to commercial fertilizer. Using Visual Basic for Applications programming available with Microsoft Excel®, we develop a decision aid that collects relevant user-specific farm parameters that allow customization of output. Performance data of the innovative subsurface application equipment as observed during field operation and published engineering equipment performance standards, combined with cost information, allow estimation of relative performance metrics. Break-even and sensitivity analyses are performed to identify key equipment modifications or subsidies needed to speed adoption of subsurfacing poultry litter to minimize odor and nutrient runoff externalities experienced with broadcast litter. Results showed that subsurfaced litter can compete with commercial fertilizer on a cost/return basis and especially so in situations where organic farming practices may be targeted. With a longer interval between litter application, enhanced annual capacity utilization of the applicator, and a good match between nutrient needs of crops fertilized and litter nutrient content, the decision aid demonstrated cost savings with subsurfaced litter over commercial fertilizer while being more or less cost-neutral in comparison to broadcast litter. The decision aid lends itself to estimating operation-specific subsidies needed to encourage adoption of subsurface application of litter with the intent to reduce nutrient runoff and odor externalities. Alternatively, the sensitivity analyses pinpointed the need to enhance the performance rate of subsurface application that may be achievable by increasing the implement’s width.

Effects of contralateral nephrectomy timing and ischemic conditions on kidney fibrosis after unilateral kidney ischemia-reperfusion injury

Acute kidney injury (AKI) is an important cause of chronic kidney disease (CKD), but the underlying mechanisms are unclear. Animal models are tools for studying the AKI-CKD progression. Kidney ischemia-reperfusion injury (IRI) models, especially the unilateral IRI (uIRI) model with delayed contralateral kidney resection, are commonly used to induce fibrotic progression to CKD after AKI. However, in previous studies, we found that details of the operation had a significant impact on the long-term outcomes of the kidney in this uIRI model. In this study, we investigated the effects of resection timing of the contralateral intact kidney, core body temperatures during ischemia, and time length of kidney ischemia on kidney function, histological injury and kidney fibrosis after AKI, using a mouse uIRI model with delayed contralateral nephrectomy. The results showed that all these parameters significantly affected the AKI-CKD transition. The post-AKI fibrosis worsened and the survival rate declined with a longer interval between contralateral nephrectomy and uIRI, higher ischemic body temperature, or longer ischemic duration when the other two variables were fixed. In conclusion, in the uIRI model with delayed contralateral nephrectomy, kidney fibrosis after AKI is influenced by many factors. Strictly controlling the experimental conditions is very important for the stability and consistency of the model.

Cerebrospinal fluid infiltration by chronic myeloid leukaemia: Evaluation of cytomorphological features.

To describe the cytomorphological findings of all cerebrospinal fluid (CSF) cytology samples showing infiltration by chronic myeloid leukaemia (CML) and their correlation with haematological findings. A retrospective analysis of all CSF samples reported as showing infiltration by CML on cytology from January 2014 to December 2021 was performed. A total of 10 cases with positive CSF cytology were evaluated. The mean age of the patients was 34.1 years (range 17-70 years). There were more males than females. All cases were pre-diagnosed cases of CML on haematological investigations. On cytology, the smears showed atypical/immature blast-like cells, with a high nucleo-cytoplasmic ratio, opened-up chromatin, 1-2 conspicuous nucleoli and a scant to moderate amount of agranular to fine granular cytoplasm along with occasional granulocytic precursors. The shortest time interval for CSF positivity in a known case of CML was 5 months, and the longest interval was 11 years. It is extremely uncommon to encounter CML infiltration in CSF. Timely analysis of CSF cytology samples can allow quick diagnosis and alter the patient management protocol.

Humoral immunity induced by mRNA COVID-19 vaccines in Nursing Home Residents previously infected with SARS-CoV-2

BackgroundNursing home (NH) residents suffered the greatest impact of the COVID-19 pandemic. Limited data are available on vaccine-induced immunity and on the protection ensured by a prior infection in this population.AimsThe present study aims to monitor antibody levels and their persistence over a 6-month period in NH residents according to the history of prior SARS-CoV-2 infection.MethodsWe measured anti-trimeric Spike IgG antibody levels in a sample of 395 residents from 25 NHs in 6 Italian Regions at study enrolment (prior to the first dose of vaccine, T0) and then after 2 (T1) and 6 months (T2) following the first vaccine dose. All participants received mRNA vaccines (BNT162b2 or mRNA-1273). Analyses were performed using log-transformed values of antibody concentrations and geometric means (GM) were calculated.ResultsSuperior humoral immunity was induced in NH residents with previous SARS-CoV-2 infection. (T0: GM 186.6 vs. 6.1 BAU/ml, p < 0.001; T1: GM 5264.1 vs. 944.4 BAU/ml, p < 0.001; T2: GM 1473.6 vs. 128.7 BAU/ml, p < 0.001). Residents with prior SARS-CoV-2 infection receiving two vaccine doses presented significantly higher antibody concentration at T1 and T2. A longer interval between previous infection and vaccination was associated with a better antibody response over time.DiscussionIn a frail sample of NH residents, prior SARS-CoV-2 infection was associated with a higher humoral response to vaccination. Number of vaccine doses and the interval between infection and vaccination are relevant parameters in determining humoral immunity.ConclusionsThese findings provide important information to plan future immunization policies and disease prevention strategies in a highly vulnerable population.

Influence of Karst Reservoir Capacity on Flood in Lijiang Basin Based on Modified HEC-HMS through Soil Moisture Accounting Loss

The objective of this work was to modify the HEC-HMS flood prediction for the karstic watershed of the Lijiang River, South China, through the quantitative inclusion into the model of the available reservoir capacity of karst (ARCK) as a case study. Due to the complexities caused by hidden drainage networks in karst hydrology, as a new approach, soil moisture accounting loss was used to reflect the ARCK in flood forecasting. The soil moisture loss was analyzed against daily rainfall runoff data across 1.5 years by using an artificial neural network via phyton programming. Through the correlations found among the amounts of soil moisture and river flow fluctuations in response to precipitation and its intervals, coefficients were introduced to the model for output modifications. ARCK analysis revealed that while heavy rainfalls with longer intervals (i.e., 174 mm/2d after 112 days of the dry season) may not cause considerable changes in the river flow magnitude (0.1–0.64 higher owing to high ARCK), relatively small rainfalls with higher frequency (i.e., 83 mm/4d during the wet season) can cause drastic raise of river flow (10–20 times greater at different stations) due to lower ARCK. Soil moisture accounting loss coefficients did enhance the model’s simulated hydrographs accuracy (NSE) up to 16% on average as compared to the initial forecasting via real data. However, the modifications were valid for flood events within a few years from the soil moisture observation period. Our result suggested that the inclusion of ARCK in modeling through soil moisture accounting loss can lead to increased prediction accuracy through consistent monitoring.

Sperm quality is not affected by the BNT162b2 mRNA SARS-CoV-2 vaccine: results of a 6-14months follow-up.

Purpose We aimed to investigate the possible effect of SARS-CoV-2 vaccination on sperm quality by evaluating semen analyses of men prior to vaccination and 6–14 months after vaccination.MethodsThis was a retrospective cohort study, conducted in a university-affiliated in vitro fertilization center between October 2021 and March 2022, including men not previously infected with the SARS-CoV-2 virus who received at least 2 doses of the Pfizer-BioNTech (BNT162b2) SARS-CoV-2 vaccine. Semen analyses of samples given pre-vaccination and 6–14 months post-vaccination were analyzed for the parameters of volume, concentration, motility, morphology, and total motile count (TMC) and compared. These parameters were also compared separately for men who received a third (booster) dose and for men with pre-vaccination normal and abnormal sperm. Correlations between time from vaccination and post-vaccination sperm parameters were also assessed.ResultsFifty-eight men were included in the final analysis. Semen volume (2.9 ± 1.4 vs. 2.9 ± 1.6 ml), sperm concentration (42.9 ± 37.9 vs. 51.5 ± 46.2 million/ml), motility (42.5 ± 23.1 vs. 44.3 ± 23.4 percent), morphology (8.8 ± .16.6 vs. 6.6 ± 8.8 percent), and TMC (55.7 ± 57.9 vs. 71.1 ± 77.1 million) were comparable between the pre- and post-vaccination samples. This was true for the entire study cohort, for the subgroup of men who received a third dose and for the subgroups of men with a pre-vaccination normal and abnormal semen samples. No correlation was found between time from vaccination and post-vaccination sperm parameters.ConclusionsThe Pfizer-BioNTech (BNT162b2) SARS-CoV-2 vaccine does not impair any of the sperm parameters over a relatively long-time interval of 6 to 14 months from vaccination.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10815-022-02621-x.

Factors Predictive of Varicella Zoster Virus Encephalitis/Meningitis: A Single-Center, Retrospective Study.

BackgroundThe outcomes of varicella zoster virus (VZV) encephalitis/meningitis vary from complete recovery to severe complications. This study aimed to investigate the predictive factors of encephalitis and meningitis caused by VZV reactivation.Material/MethodsVZV encephalitis/meningitis patients (n=39) who were treated between January 2019 and December 2021 were included. Patients were followed up for 3 months after discharge and divided into a favorable outcome group (FO, n=18; 46.2%) and an unfavorable outcome group (UO, n=21; 53.8%) according to whether it affects quality of life. The clinical data were retrospectively analyzed and compared between groups.ResultsAs compared to the FO group, patients in the UO group were more likely to have higher body temperature (>38°C) at admission, longer interval from onset of CNS symptoms to initial of antiviral therapy, higher white blood cells (WBC) and adenosine deaminase (ADA) in the cerebrospinal fluid (CSF) and higher CRP in the blood (P<0.05 or P<0.01). Univariate logistic regression analysis showed CSF ADA (OR=1.279, 95% CI: 0.996~1.642) and interval from onset of CNS symptoms to initial of antiviral therapy (OR=1.299, 95% CI: 1.011~1.669) were independent risk factors for unfavorable outcomes (P<0.05). The sensitivity and specificity of combined CSF ADA and time interval from onset of CNS symptoms to initial of antiviral therapy were 78.8% and 95.2%, respectively, in predicting outcomes.ConclusionsHigher CSF ADA and longer interval from onset of CNS symptoms to initial of antiviral therapy predict an unfavorable outcome, and the combination of both factors can achieve better performance.