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Introduction: The mRNA-based vaccine was released as a COVID-19 prophylactic;however, its efficacy in organ transplant recipients is unknown. This study aimed to clarify this in liver transplant recipients. Methods: Herein, liver transplant recipients from two hospitals who received vaccines were included. Immunoglobulin-G antibodies against the spike and nucleocapsid proteins were measured chronologically after the second, third, and fourth vaccine doses. Results: Antibody levels in 125 liver transplant recipients and 20 healthy volunteers were analyzed. The median age at transplant was 35 (interquartile range 1, 53) years, and the period between transplant and the first dose was 15.2 ± 7.7 years. After the second and third doses, 89.1% and 100% of recipients displayed a positive humoral response, respectively. Anti-spike antibodies after the second dose were significantly reduced at 3 and 6 months, compared to that at 1 month (26.0 [5.4, 59.5], 14.7 [6.5, 31.4] vs. 59.7 [18.3, 164.0] AU/mL, respectively, p < 0.0001). However, a booster vaccine significantly elevated anti-spike antibodies in LT recipients (p < 0.0001) as well as in healthy controls (p < 0.0001). Additionally, the decay rate was comparable between the transplant recipients and controls (2.1 [0.8, 4.5] vs. 2.7 [1.1, 4.1] AU/mL/day, p = 0.9359). Only 4.0% of vaccinated transplant recipients were positive for anti-nucleocapsid antibodies. Conclusion: Liver transplant recipients can acquire immunity similar to that of healthy people through vaccination against SARS-CoV-2. The antibody decay rate is the same, and booster vaccinations should be administered similarly to that in healthy individuals. © 2023 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.
ABSTRACT
Society 5.0, Japan’s innovation policy, aims to build a human-centered society with information technologies. However, it is not easy to satisfy human-centered design and country wide or global scalability. In this paper, we discuss ways to realize a regional digital strategy of enhancing the services provided by utilizing data provided by various stakeholders outside of the region with case analysis of COVID-19 vaccine management system in Tamba city with lens of the adaptive integrated digital architecture framework (AIDAF). Society 5.0 Reference Architecture and related specifications help municipalities to enhance their digital strategy to comply with global environment. It is especially important to realize alignment in technology architecture of trust framework and data architecture. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has influenced epidemiology through direct and indirect effects, yet the impact on out-of-hospital cardiac arrest (OHCA) is unclear. We aimed to evaluate the impact of the pandemic on the incidence, characteristics, and clinical outcomes of OHCA. Hypothesis: We hypothesized that compared to the pre-pandemic period, the COVID-19 pandemic period was associated with increased incidence and case fatality rate (CFR) of OHCA, as well as decreased rates of intermediate clinical outcomes (termination of resuscitation [TOR], return of spontaneous circulation [ROSC], survival to hospital admission, and survival to hospital discharge). We further postulated that there was a change in the etiologies of OHCA during the pandemic as well as a decline in the rate of shockable rhythm as the initial presenting rhythm. Methods: In this systematic review and meta-analysis, five scientific databases were searched from inception to May 3, 2021. Meta-analyses were performed for the primary outcomes, secondary outcomes, and clinical characteristics. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021253879). Results: The search yielded 966 articles. 20 articles were included for analysis. The COVID-19 pandemic was associated with a 39.5% increase in pooled annual OHCA incidence (p<0.001). Pooled CFR was increased by 2.65% (p<0.001), with an odds ratio (OR) of 1.95 for mortality (95% confidence interval [95%CI] 1.51-2.51). There was increased field TOR (OR=2.46, 95%CI 1.62- 3.74). There were decreased ROSC (OR=0.65, 95%CI 0.55-0.77), survival to hospital admission (OR=0.65, 95%CI 0.48-0.89), and survival to discharge (OR=0.52, 95%CI 0.40-0.69). There was decreased shockable rhythm (OR=0.73, 95%CI 0.60-0.88) and increased asphyxial etiology of OHCA (OR=1.17, 95%CI 1.02-1.33). There was moderate-to-high statistical heterogeneity. Findings were robust to sensitivity analyses, with no publication bias detected. Conclusions: The COVID-19 pandemic was associated with significant changes in OHCA epidemiology. Compared to the pre-pandemic period, the pandemic period was associated with increased OHCA incidence and worse outcomes.
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Humid heat impacts a large portion of the world's population that works outdoors. Previous studies have quantified humid heat impacts on labor productivity by relying on exposure response functions that are based on uncontrolled experiments under a limited range of heat and humidity. Here we use the latest empirical model, based on a wider range of temperatures and humidity, for studying the impact of humid heat and recent climate change on labor productivity. We show that globally, humid heat may currently be associated with over 650 billion hours of annual lost labor (148 million full time equivalent jobs lost), 400 billion hours more than previous estimates. These differences in labor loss estimates are comparable to losses caused by the COVID-19 pandemic. Globally, annual heat-induced labor productivity losses are estimated at 2.1 trillion in 2017 PPP$, and in several countries are equivalent to more than 10% of gross domestic product. Over the last four decades, global heat-related labor losses increased by at least 9% (>60 billion hours annually using the new empirical model) highlighting that relatively small changes in climate (<0.5 degrees C) can have large impacts on global labor and the economy.
ABSTRACT
The COVID-19 vaccine was developed less than a year after the global pandemic first began to spread, but storage at ultralow temperatures and multiple vaccinations are required. The logistics for the successful acquisition of herd immunity are complex and difficult to prepare. Tamba City, Japan, is trying to quickly build a vaccination system by utilizing the existing regional comprehensive care system linked to the basic resident register. For this system to contribute to the suppression of the spread of COVID-19 infection and the efficiency of the treatment system, it is necessary to evolve the architecture, including the data architecture to handle distributed and diversified data. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.