Crystallographic and biophysical analysis of the fusion core from SARS-CoV-2 spike protein

Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is a newly emerging infectious pathogen causing coronavirus disease 2019 (COVID-19). The virus primarily infects cells via its spike glycoprotein, which is cleaved into S1 and S2 subunits to aid in cell attachment and membrane fusion, respectively. Heptad repeat 1 (HR1) and heptad repeat 2 (HR2) of the S2 subunit are essential for membrane fusion, culminating in an expected six-helix bundle termed fusion core. To better understand the structural and biophysical features of the SARS-CoV-2 fusion core, we designed, constructed, and bacterially produced a recombinant single-chain HR1-L6-HR2 protein and conducted a series of biochemical and biophysical experiments. Our findings demonstrate that the HR1-L6-HR2 protein spontaneously assembles into a highly stable trimeric complex, further confirmed by x-ray crystallographic analysis. The crystal structure of the fusion core reveals a trimeric coiled-coil structure of HR1 antiparallelly surrounded by three HR2 to form a six-helical bundle. Additionally, four residues of HR1 that contribute to binding with HR2 through the formation of hydrogen bonds and salt bridges were observed. These results indicate that the SARS-CoV-2 fusion core exhibits similar characteristics to other class I viral glycoproteins, suggesting potential for drug repurposing as an alternative strategy to combat COVID-19. © 2023 Chemical Society Located in Taipei and Wiley-VCH GmbH.

Service Evaluation: The Role of Same Day Emergency Care in Managing Acute Neurological Presentations

Background and aim During the COVID-19 pandemic, the neurology department at St Mary's Hospital had to direct the bulk of its acute work to a newly expanded 'hot clinic' running Monday to Friday through Same Day Emergency Care (SDEC). Face to face clinic appointments were also halted and instead triaged to SDEC when examination of the patient was necessary. Patients were referred through a number of routes directly to the neurology consultants or on-call registrar, and subsequently seen on an urgent basis. We were interested in evaluating the types of referrals made to this service as well as their final outcomes. Results A total of 255 patients were seen between 3 March 2021 and 3 August 2021. Approximately a third were from the A&E department and just less than a third were from the Western Eye Hospital, our local ophthalmology A&E. Most referrals were for headache or visual change, and 61% of patients did not need to re-attend SDEC. Importantly, a quarter were discharged home after specialist review, and none required admission from clinic. Thus our emergency service was successful in avoiding admissions while ensuring patients received the care they required in a timely fashion.

A new Software Training Model at Belle II

The physics output of modern experimental HEP collaborations hinges not only on the quality of its software but also on the ability of the collaborators to make the best possible use of it. With the COVID-19 pandemic making in-person training impossible, the training paradigm at Belle II was shifted from periodic workshops towards guided self-study. To that end, the study material was rebuilt from scratch as a series of modular and hands-on lessons tightly integrated with the software documentation using Sphinx. Each lesson contains multiple exercises that are supplemented with hints and complete solutions. Rather than duplicating information, students are systematically taught to work with the technical reference documentation to find the important sections for themselves. Unit tests ensure that all examples work with different software versions, and feedback buttons make it easy to submit comments for improvements. © Published under licence by IOP Publishing Ltd.

Cruise revenue management: cross-discipline literature review and development of an integrated cruise revenue management framework

Purpose: This study aims to adopt a holistic approach to understand cruise revenue management (RM) practices that cover ticket and onboard revenues, through a cross-disciplinary literature review and practitioner interviews. An integrated cruise RM framework was developed and served as a blueprint for future cruise studies and practices. Design/methodology/approach: A multi-stage approach was adopted, including a systematic literature review, two-waves of interviews with 26 cruise industry practitioners and the development of a holistic RM framework. Findings: This study clarifies cruise RM functions across product planning, delivery stages and identifies ticket and onboard RM components. These are incorporated into the integrated framework, with weather and itinerary/ route attractiveness as additional considerations. Interviews revealed that there is no difference in the RM cycle before and during the COVID-19 pandemic, although strategies and tactics may vary in response to the market situation. Research limitations/implications: Suggestions are made regarding product and service bundling and ways for ticket and onboard revenue teams to work together to optimize total revenue. Future research directions are also provided under the categories of RM applications and concepts, ticket core activities, onboard core activities and overall issues. Originality/value: To the best of the authors' knowledge, this is the first paper to conduct a cross-disciplinary systematic literature review of cruise RM without imposing publication dates or specific databases and the first to develop an integrated cruise "total” RM framework that includes ticket and onboard revenues. © 2023, Emerald Publishing Limited.

Research on KNN-Based GNSS Coordinate Classification for Epidemic Management

As epidemics such as COVID-19 and monkeypox spread, tracing specific people with restricted activities (targets) within administrative areas (targeted areas) is an effective option to slow the spread. Global Navigation Satellite Systems (GNSS) that can provide autonomous geospatial positioning of targets can assist this issue. K-nearest neighbors (KNN) is one of the most widely used algorithms for various classifications or predictions. In this paper, we will use the technique of KNN to classify the areas of the targets and explore the relationship between the density of targets to a area and the accuracy of classifications. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

The impact on the job of working from home teleworkers: a report on the Asian context of COVID-19

Working from home is a potentially powerful alternative method of work arrangement recently in order to maintain essential business operations in response to pandemic disruptions, thanks to the advancement of technologies that have shifted the traditional working way that requires a physical presence to a virtual environment. With the purpose of validating a theoretical model that forecasts the turnover possibility of teleworking employees during an ongoing challenge as the COVID-19 airborne disease spreads, the present research proposes a new and improved theoretical model by incorporating: 1) the stress-strain-outcome model;2) the relevance between professional remoteness and turnover motivation. The present study reveals that professional isolation is no longer relevant to worker's turnover intentions in the presence of limited job opportunities due to the global economic threats of downturns. It also offers perspectives and potential lessons for managers and organisations to develop strategies to optimise the values of teleworking and improve the rate of job retention. Copyright © 2022 Inderscience Enterprises Ltd.

Spatial-Slice Feature Learning Using Visual Transformer and Essential Slices Selection Module for COVID-19 Detection of CT Scans in the Wild

Computed tomography (CT) imaging could be convenient for diagnosing various diseases. However, the CT images could be diverse since their resolution and number of slices are determined by the machine and its settings. Conventional deep learning models are hard to tickle such diverse data since the essential requirement of the deep neural network is the consistent shape of the input data in each dimension. A way to overcome this issue is based on the slice-level classifier and aggregating the predictions for each slice to make the final result. However, it lacks slice-wise feature learning, leading to suppressed performance. This paper proposes an effective spatial-slice feature learning (SSFL) to tickle this issue for COVID-19 symptom classification. First, the semantic feature embedding of each slice for a CT scan is extracted by a conventional 2D convolutional neural network (CNN) and followed by using the visual Transformer-based sub-network to deal with feature learning between slices, leading to joint feature representation. Then, an essential slices set algorithm is proposed to automatically select a subset of the CT scan, which could effectively remove the uncertain slices as well as improve the performance of our SSFL. Comprehensive experiments reveal that the proposed SSFL method shows not only excellent performance but also achieves stable detection results. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Camera-Based Blood Pressure Estimation via Windkessel Model and Waveform Features

Blood pressure (BP) is generally regarded as the vital sign most strongly correlated with human health. However, for decades, BP measurement has involved a cuff, which causes discomfort and even carries a risk of infection, given the current prevalence of COVID-19. Some studies address these problems using remote photoplethysmography (rPPG), which has shown great success in heart rate detection. Nevertheless, these approaches are not robust, and few have been evaluated with a sufficiently large dataset. We propose an rPPG-based BP estimation algorithm that predicts BP by leveraging the Windkessel model and hand-crafted waveform characteristics. A waveform processing procedure is presented for the rPPG signals to obtain a robust waveform template and thus extract BP-related features. Redundant and unstable features are eliminated via Monte Carlo simulation and according to their relationship with latent parameters (LSs) in the Windkessel model. For a comprehensive evaluation, the Chiao Tung BP (CTBP) dataset was constructed. The experiment was conducted over a four-week period of time to evaluate the validity period of the personalization in our system. On all the data, the proposed method outperforms the benchmark algorithms and yields mean absolute errors (MAEs) of 6.48 and 5.06 mmHg for systolic BP (SBP) and diastolic BP (DBP), respectively. The performance achieves a 'B' grade according to the validation protocol from the British Hypertension Society (BHS) for both SBP and DBP. © 1963-2012 IEEE.

The application of emotions, sharing motivations, and psychological distance in examining the intention to share COVID-19-related fake news

Purpose: Coronavirus disease 2019-related fake news consistently appears on social media. This study uses appraisal theory to analyze the impact of such rumors on individuals' emotions, motivations, and intentions to share fake news. Furthermore, the concept of psychological distance and construal level theory are used in combination with appraisal theory to compare toilet paper shortages and celebrity scandal rumors. Design/methodology/approach: Data collected from 299 Taiwanese respondents to 150 toilet paper shortage-related and 149 celebrity gossip-related questionnaires were processed using partial least squares regression and multigroup analysis. Findings: In both cases, surprise is felt most intensely. However, unlike in the celebrity fake news scenario, worry plays a prominent role in driving the altruistic sharing motivation related to the toilet paper shortage rumor. Furthermore, while emotional attributes (basic or self-conscious, concrete, or ) serve as a guide for how emotions change with psychological distance, the degree to which an emotion is relevant to the fake news context is key to its manifestation. Originality/value: This study examines the impact of individuals' emotions on their motivations and intention to share fake news, applying the appraisal theory and the psychological distance concept in a single study to fake news sharing intention. It evaluates the relationship between psychological distance and emotions, revealing that it is not absolute and need not necessarily shift according to psychological distance change;rather, the relationship is context-sensitive. © 2022, Emerald Publishing Limited.

Camera-based Blood Pressure Estimation via Windkessel Model and Waveform Features

Blood pressure (BP) is generally regarded as the vital sign most strongly correlated with human health. However, for decades, BP measurement has involved a cuff, which causes discomfort and even carries a risk of infection, given the current prevalence of COVID-19. Some studies address these problems using remote photoplethysmography (rPPG), which has shown great success in heart rate detection. Nevertheless, these approaches are not robust, and few have been evaluated with a sufficiently large dataset. We propose an rPPG-based BP estimation algorithm that predicts BP by leveraging the Windkessel model and hand-crafted waveform characteristics. A waveform processing procedure is presented for the rPPG signals to obtain a robust waveform template and thus extract BP-related features. Redundant and unstable features are eliminated via Monte Carlo simulation and according to their relationship with latent parameters in the Windkessel model. For a comprehensive evaluation, the Chiao Tung Blood Pressure (CTBP) dataset was constructed. The experiment was conducted over a four week period of time to evaluate the validity period of the personalization in our system. On all the data, the proposed method outperforms the benchmark algorithms and yields mean absolute errors of 6.48 mmHg and 5.06 mmHg for SBP and DBP, respectively. The performance achieves a “B”grade according to the validation protocol from the British Hypertension Society for both SBP and DBP. IEEE

Prolonged peripheral seronegative spondyloarthritis following BioNTech coronavirus disease 2019 vaccination: A case report

A female 17-year-old diagnosed with seronegative spondyloarthritis (SpA) following the first jab of the BioNTech162b2 (BNT162b2) vaccine presented with recurrent swelling and painful knee accompanied by posterior heel tenderness over the past 1.5 months. Laboratory investigations revealed elevated serum erythrocyte sedimentation rate and C-reactive protein. Synovial aspiration yielded level 3 crystal-free, aseptic and inflammatory effusion. She tested positive for the human leukocyte antigen-B27 and was diagnosed with peripheral SpA. She received daily celecoxib (400 mg), methylprednisolone (8 mg), and sulfasalazine (2 g), but the effect was limited. Nonetheless, her symptoms improved significantly with weekly subcutaneous etanercept administration (50 mg). Four weeks later, her arthritis was completely resolved. To our knowledge, this is the first case report of newly diagnosed seronegative peripheral SpA in an autoimmunity-disease-free individual following messenger RNA BNT coronavirus disease 2019 vaccination.

Augmentation of rPPG Benchmark Datasets: Learning to Remove and Embed rPPG Signals via Double Cycle Consistent Learning from Unpaired Facial Videos

Remote estimation of human physiological condition has attracted urgent attention during the pandemic of COVID-19. In this paper, we focus on the estimation of remote photoplethysmography (rPPG) from facial videos and address the deficiency issues of large-scale benchmarking datasets. We propose an end-to-end RErPPG-Net, including a Removal-Net and an Embedding-Net, to augment existing rPPG benchmark datasets. In the proposed augmentation scenario, the Removal-Net will first erase any inherent rPPG signals in the input video and then the Embedding-Net will embed another PPG signal into the video to generate an augmented video carrying the specified PPG signal. To train the model from unpaired videos, we propose a novel double-cycle consistent constraint to enforce the RErPPG-Net to learn to robustly and accurately remove and embed the delicate rPPG signals. The new benchmark “Aug-rPPG dataset” is augmented from UBFC-rPPG and PURE datasets and includes 5776 videos from 42 subjects with 76 different rPPG signals. Our experimental results show that existing rPPG estimators indeed benefit from the augmented dataset and achieve significant improvement when fine-tuned on the new benchmark. The code and dataset are available at https://github.com/nthumplab/RErPPGNet. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Regorafenib in patients (pts) with unresectable hepatocellular carcinoma (uHCC) in real-world practice in Asia: Final analysis of the prospective, observational REFINE study

Background: In an interim analysis of Asian pts with uHCC in the observational REFINE study of regorafenib (NCT03289273), treatment-emergent adverse events (TEAEs) were consistent with those reported in the global, phase 3 RESORCE trial. Here, we present the final analysis of Asian pts with uHCC in REFINE. Method(s): REFINE is an international, prospective, multicenter study that enrolled pts with uHCC for whom a decision to treat with regorafenib was made by the treating physician prior to enrollment, according to the local health authority approved label. The primary objective is safety, including the incidences of TEAEs and dose modifications due to TEAEs (NCI-CTCAE v4.03). Secondary endpoints include overall survival, progression-free survival, and treatment duration. Result(s): Of the 1005 evaluable pts, 557 (55%) were from Asia (Korea [31%], Japan [26%], Taiwan [24%], China [18%], Thailand [1%]) and 82% were male. At baseline, median age was 65 years (range 21-94) and the most common HCC etiology in Asian pts was hepatitis B (60%) and in non-Asian pts was alcohol use (36%;Table). More Asian pts (71%) had received prior transarterial chemoembolization vs non-Asian pts (42%). The initial daily regorafenib dose was 160/120/80/40 mg in 51%/12%/35%/3% of Asian pts and 42%/9%/45%/4% of non-Asian pts. The median treatment duration was 3.7 months (range 0-34.4) in Asian pts and 3.6 months (range 0-38.9) in non-Asian pts. The most common TEAEs in Asian pts were hand-foot skin reaction (40%), diarrhea (27%), and decreased appetite (17%). TEAEs led to dose modification in 44% of Asian pts. [Formula presented]. Conclusion(s): These final data from REFINE confirm the safety and effectiveness of regorafenib in Asian pts with uHCC from a broad population in real-world practice. Final analyses from REFINE are ongoing and will be presented at the conference. Clinical trial identification: NCT03289273. Editorial acknowledgement: Editorial assistance in the preparation of this manuscript was provided by Matthew Reynolds of OPEN Health Communications (London, UK), with financial support from Bayer. Legal entity responsible for the study: Bayer. Funding(s): Bayer. Disclosure: Y.J. Kim: Financial Interests, Personal, Advisory Role: Bayer, Bristol Myers Squibb, Samil, PharmaKing, Celltrion, Bukwang;Financial Interests, Personal, Invited Speaker: Roche, AbbVie, Eisai, Ipsen, Boston Scientific, Bristol Myers Squibb, BTG, Bayer, MSD, Gilead Sciences, Novo Nordisk, Green Cross Cell, Boehringer Ingelheim, AstraZeneca;Financial Interests, Personal, Funding: BTG, Bayer, Boston Scientific, AstraZeneca, Gilead Sciences, Samjin, BL&H. M. Kurosaki: Financial Interests, Personal, Speaker's Bureau: Gilead Sciences, AbbVie, Eisai, Chugai, Lilly, Takeda. H.Y. Lim: Financial Interests, Personal, Advisory Role: Bayer, Eisai, Roche, Ipsen. M. Ikeda: Financial Interests, Personal, Advisory Board: AstraZeneca, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Ono, Takeda, GlaxoSmithKline;Financial Interests, Personal, Invited Speaker: AstraZeneca, Bayer, Bristol Myers Squibb, Chugai, Eli Lilly Japan, Eisai, Nihon Servier, Novartis, Taiho, Yakult, Teijin Pharma, AbbVie, Abbott Japan, Fujifilm Toyama Chemical, Incyte Biosciences Japan, ASLAN, Chugai, Nihon Servier, Takeda;Financial Interests, Institutional, Invited Speaker: Bayer, Bristol Myers Squibb, Eisai, AstraZeneca, Eli Lilly Japan, Chugai Pharmaceutical, Merck Serono, MSD, Ono, Yakult, Novartis, Takeda, J-Pharma, Pfizer, Chiome Bioscience, Nihon Servier, Delta-Fly Pharma, Syneos Health, Merus.N.V. M. Kudo: Financial Interests, Personal, Invited Speaker: Eisai, Chugai, Eli Liiy, Bayer, Takeda, MSD;Financial Interests, Institutional, Research Grant: Otsuka, Sumitomo Dainippon Pharma, EA Pharma, Taiho, Eisai, AbbVie, Gilead Sciences, Takeda, GE Healthcare, Chugai. Y. Huang: Financial Interests, Personal, Advisory Role: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Interests, Personal, Invited Speaker: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Inte ests, Personal, Speaker's Bureau: Eisai, Bayer, BMS, Ono, Gilead, Lilly, AbbVie, Roche;Financial Interests, Institutional, Funding: Gilead. N. Kato: Financial Interests, Personal, Invited Speaker: Gilead Sciences Inc., AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Olympus Corporation, Eisai Co., Ltd., Aska Pharmaceutical Co., Ltd., Tsumura & Co., Mochida Pharmaceutical Co., Ltd., Miyarisan Pharmaceutical Co., Ltd., Covidien Japan Inc., Eli Lilly Japan K.K., Nobelpharma Co., Ltd., Kowa Company, Ltd., Incyte Biosciences Japan GK, Yakult Honsha Co.,Ltd., Olympus Marketing, Inc., Taisho Pharmaceutical Co.,Ltd., Janssen Pharmaceutical K.K.;Financial Interests, Institutional, Research Grant: AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Sumitomo Dainippon Pharma Co., Ltd., Shionogi & Co., Ltd., Eisai Co., Ltd., Tsumura & Co., Nippon Kayaku Co., Ltd., JIMRO Co., Ltd., Kowa Company, Ltd. C. Hsu: Financial Interests, Personal, Speaker's Bureau: Bristol Myers Squibb, Ono Pharmaceutical, Merck Sharp & Dohme, Roche, Eisai;Financial Interests, Institutional, Funding: Ono Pharmaceutical, AstraZeneca, MSD, Merck Serono, Taiho Pharmaceutical, Bristol Myers Squibb, BeiGene, NuCana BioMed, Johnson & Johnson, Roche/Genentech, BeiGene;Financial Interests, Personal, Advisory Role: Ono Pharmaceutical, MSD, Bristol Myers Squibb, Merck Serono, Roche/Genentech. B. Chewaskulyong: Financial Interests, Personal, Advisory Role: Pfizer, STADA;Financial Interests, Personal, Invited Speaker: AstraZeneca, Pfizer, DKSH, Janssen, BMS, MSD, Roche, TAIHO;Financial Interests, Personal, Speaker's Bureau: AstraZeneca, Pfizer, DKSH, Janssen, BMS, MSD, Roche, TAIHO;Financial Interests, Institutional, Funding: Bayer. J. Khan: Financial Interests, Institutional, Full or part-time Employment: Bayer. K. Ozgurdal: Financial Interests, Institutional, Full or part-time Employment: Bayer;Financial Interests, Personal, Stocks/Shares: Bayer. All other authors have declared no conflicts of interest. Copyright © 2022

SARS-CoV-2 Anti-Spike IgG Antibody Binding Units and Associated Outcomes in Maintenance Dialysis Patients

Background: Maintenance dialysis patients' SARS-CoV-2 receptor binding spike antibody (RBD s-Ab) levels decline rapidly in the months following initial vaccination. We describe the association of RBD s-Ab levels with a subsequent diagnosis of COVID-19 and COVID-related hospitalization or death. Method(s): We identified all vaccinated adult maintenance dialysis patients at Dialysis Clinic, Inc. who were diagnosed with COVID-19 between June 20, 2021 and May 8, 2022. Descriptive analyses illustrate the association of RBD s-Ab levels assessed 7-45 days prior to COVID-19 diagnosis with COVID-related hospitalization or death. Result(s): There were 340 maintenance dialysis patients with RBD s-Ab levels assessed at a median 23 [16,40] days prior to COVID diagnosis, with mean age 65+/-13 years, 51% female, 51% White, 91% HD and vintage 4.3+/-4.3 years. While COVID-19 diagnosis and COVID-related hospitalization or death events occurred across RBD s-Ab levels (Figure), 74 of 93 (80%) COVID-related hospitalizations and 24 of 25 deaths (96%) occurred at RBD s-Ab level <500 BAU/mL Conclusion(s): Maintenance dialysis patients are at risk for serious COVID events when RBD s-Ab < 500 BAU/mL. Routine RBD s-Ab measurement informing personalized vaccination strategies to keep titers above 500 BAU/mL may benefit this high-risk population.

Vaccine Effectiveness of One, Two, or Three Doses of SARS-CoV-2 mRNA Vaccines in Maintenance Dialysis Patients

Background: Preventing COVID-19 infection or its consequences through SARSCoV- 2 vaccination in maintenance dialysis patients, a high risk population, is imperative. We determined relative vaccine effectiveness (VE) of 1, 2, or 3 doses of an mRNA vaccine in preventing SARS-CoV-2 infection, hospitalization, and death. Method(s): All adult maintenance dialysis patients at Dialysis Clinic, Inc. offered an mRNA vaccine between 12/15/20 and 2/28/22 were included, with follow up time through 3/31/22. Using a multivariable logistic regression model, we calculated adjusted odds ratios (OR) for COVID-19 infection and associated hospitalization and death within 30 days during pre-Delta (12/15/20-6/19/21), Delta (6/20-12/18/21) and Omicron (12/19/21-2/28/22) periods. VE was calculated as (1-adjusted OR) x 100%. Patients were censored at infection, death, or transplantation. Result(s): The 17,309 maintenance dialysis patients included had mean age of 63+/-15 years, 58% male, 35% Black, 47% White, 87% HD and mean vintage 42+/-55 months. Across all three COVID-19 variant periods, VE increased with each successive mRNA dose received, improving protection against infection, hospitalization and death (Table). VE was highest among patients vaccinated with homologous mRNA-1273 regimens. Conclusion(s): Two or more SARS-CoV-2 mRNA vaccine doses exhibited VE protecting against COVID-19 related associated hospitalization and death in maintenance dialysis patients irrespective of variant era. At least 3 doses maximizes protection and may be necessary due to uremia-related mild to moderate immunodeficiency. (Table Presented).

Seroresponse to Additional Doses of SARS-CoV-2 Vaccine Among Maintenance Dialysis Patients Over 6 Months

Background: Among patients receiving maintenance dialysis, seroresponse to an initial vaccine series wanes over time. Previously, we showed that additional doses elicit a substantial short-term increase in seroresponse. Here, we assess seroresponse over time in a national sample of maintenance dialysis patients. Method(s): Using retrospective clinical data, we assessed seroresponse to additional SARS-CoV-2 vaccine doses over time among maintenance dialysis patients cared for at Dialysis Clinic, Inc (DCI) facilities. Via a clinical protocol available to dialysis providers, antibodies against SARS-CoV-2 spike antigen were assessed monthly alongside routine labwork. Patients with history of COVID-19 prior to additional dose and patients who received Janssen vaccine as an additional dose were excluded. Titers after a second additional dose (i.e., for most, a fourth dose) or after COVID-19 diagnosis were excluded from analysis. Result(s): Among 1707 patients who had received an additional vaccine dose and had at least one titer level measured after the additional dose, more than 75% had a titer level at the upper limit of the assay in the first month after the additional dose. Titer levels then waned across vaccine types. By Month 6, median [IQR] titer was 68.37 [22.30, >=100] among Moderna recipients, 59.94 [39.90, 79.97] among Moderna half-dose recipients, and 71.29 [22.46, >=100] among Pfizer recipients. Conclusion(s): Among patients receiving maintenance dialysis, anti-spike IgG levels after an additional SARS-CoV-2 vaccine dose wane over time across vaccine types. These results suggest a role for routine antibody monitoring to assess possible need for further re-dosing.