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1.
Ann Intern Med ; 175(4): 513-522, 2022 04.
Article in English | MEDLINE | ID: covidwho-1811218

ABSTRACT

BACKGROUND: Thrombosis with thrombocytopenia syndrome (TTS) is a potentially life-threatening condition associated with adenoviral-vectored COVID-19 vaccination. It presents similarly to spontaneous heparin-induced thrombocytopenia. Twelve cases of cerebral venous sinus thrombosis after vaccination with the Ad26.COV2.S COVID-19 vaccine (Janssen/Johnson & Johnson) have previously been described. OBJECTIVE: To describe surveillance data and reporting rates of all reported TTS cases after COVID-19 vaccination in the United States. DESIGN: Case series. SETTING: United States. PATIENTS: Case patients receiving a COVID-19 vaccine from 14 December 2020 through 31 August 2021 with thrombocytopenia and thrombosis (excluding isolated ischemic stroke or myocardial infarction) reported to the Vaccine Adverse Event Reporting System. If thrombosis was only in an extremity vein or pulmonary embolism, a positive enzyme-linked immunosorbent assay for antiplatelet factor 4 antibodies or functional heparin-induced thrombocytopenia platelet test result was required. MEASUREMENTS: Reporting rates (cases per million vaccine doses) and descriptive epidemiology. RESULTS: A total of 57 TTS cases were confirmed after vaccination with Ad26.COV2.S (n = 54) or a messenger RNA (mRNA)-based COVID-19 vaccine (n = 3). Reporting rates for TTS were 3.83 per million vaccine doses (Ad26.COV2.S) and 0.00855 per million vaccine doses (mRNA-based COVID-19 vaccines). The median age of patients with TTS after Ad26.COV2.S vaccination was 44.5 years (range, 18 to 70 years), and 69% of patients were women. Of the TTS cases after mRNA-based COVID-19 vaccination, 2 occurred in men older than 50 years and 1 in a woman aged 50 to 59 years. All cases after Ad26.COV2.S vaccination involved hospitalization, including 36 (67%) with intensive care unit admission. Outcomes of hospitalizations after Ad26.COV2.S vaccination included death (15%), discharge to postacute care (17%), and discharge home (68%). LIMITATIONS: Underreporting and incomplete case follow-up. CONCLUSION: Thrombosis with thrombocytopenia syndrome is a rare but serious adverse event associated with Ad26.COV2.S vaccination. The different demographic characteristics of the 3 cases reported after mRNA-based COVID-19 vaccines and the much lower reporting rate suggest that these cases represent a background rate. PRIMARY FUNDING SOURCE: Centers for Disease Control and Prevention.


Subject(s)
COVID-19 , Thrombocytopenia , Thrombosis , Vaccines , /adverse effects , Adolescent , Adult , Aged , COVID-19/epidemiology , COVID-19 Vaccines/adverse effects , Female , Humans , Male , Middle Aged , RNA, Messenger , Syndrome , Thrombocytopenia/chemically induced , Thrombocytopenia/epidemiology , Thrombosis/chemically induced , Thrombosis/etiology , United States/epidemiology , Vaccination/adverse effects , Vaccines/adverse effects , Young Adult
2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-295956

ABSTRACT

Background Thrombosis with thrombocytopenia syndrome (TTS) is a potentially life-threatening condition associated with adenoviral-vectored COVID-19 vaccination. TTS presents similarly to autoimmune heparin-induced thrombocytopenia. Twelve cases of cerebral venous sinus thrombosis following Janssen/Johnson & Johnson (Ad26.COV2.S) COVID-19 vaccination have been described. Objective Describe surveillance data and reporting rates of TTS cases following COVID-19 vaccination. Design Case series. Setting United States Patients Case-patients reported to the Vaccine Adverse Event Reporting System (VAERS) receiving COVID-19 vaccine from December 14, 2020 through August 31, 2021, with thrombocytopenia and thrombosis (excluding isolated ischemic stroke or myocardial infarction). If thrombosis was only in an extremity vein or pulmonary embolism, a positive enzyme-linked immunosorbent assay for anti-platelet factor 4 antibody was required. Measurements Reporting rates (cases/million vaccine doses) and descriptive epidemiology. Results 52 TTS cases were confirmed following Ad26.COV2.S (n=50) or mRNA-based COVID-19 (n=2) vaccination. TTS reporting rates were 3.55 per million (Ad26.COV2.S) and 0.0057 per million (mRNA-based COVID-19 vaccines). Median age of patients with TTS following Ad26.COV2.S vaccination was 43.5 years (range: 18–70);70% were female. Both TTS cases following mRNA-based COVID-19 vaccination occurred in males aged >50 years. All cases following Ad26.COV2.S vaccination involved hospitalization including 32 (64%) with intensive care unit admission. Outcomes of hospitalizations following Ad26.COV2.S vaccination included death (12%), discharge to post-acute care (16%), and discharge home (72%). Limitations Under-reporting and incomplete case follow-up. Conclusion TTS is a rare but serious adverse event associated with Ad26.COV2.S vaccination. The different demographic characteristics of the two cases reported after mRNA-based COVID-19 vaccines and the much lower reporting rate suggest that these cases represent a background rate. Funding Source CDC

3.
Sustainability ; 13(8):4539, 2021.
Article in English | ProQuest Central | ID: covidwho-1362602

ABSTRACT

To move closer to achieving the United Nations’ Sustainable Development Goals (SDGs), a change from the traditional paradigm of the linear economy towards the circular economy is of paramount importance. One of the key promoters of this shift is servitization, which involves a shift from a purely transactional product-selling model to customer satisfaction through providing the service inherent to the product. Although servitization is a promising field for academics and practitioners, its adoption faces different challenges and drivers that need to be understood and addressed. A latent issue is the lack of common language around the topic. In the present study, a systematic literature review has been conducted to allow the identification and classification of the main challenges and drivers. Based on the findings, we propose a classification framework that identifies, classifies, and groups common challenges and drivers to different areas of knowledge on servitization through intensity heat maps. From a managerial point of view, our results highlight the importance of embracing servitization as a collective effort from the different departments within a company.

4.
Polymers (Basel) ; 13(8)2021 Apr 12.
Article in English | MEDLINE | ID: covidwho-1305783

ABSTRACT

3D printing PLA wastes were recovered from a well-known reference grade and from different sources. The recovered wastes were subjected to an energic washing step and then reprocessed into films by melt-extrusion, followed by compression molding to simulate the industrial processing conditions. The obtained materials were characterized and the optical, structural, thermal and crystallization behavior are reported. The mechanical recycling process leads to an increase of the crystallinity and a decrease of the intrinsic viscosity of the formulations, particularly in the sample based on blends of different 3D-PLA wastes. Moreover, the obtained films were disintegrated under composting conditions in less than one month and it was observed that recycled materials degrade somewhat faster than the starting 3D-PLA filament, as a consequence of the presence of shorter polymer chains. Finally, to increase the molecular weight of the recycled materials, the 3D-PLA wastes were submitted to a solid-state polymerization process at 110, 120, and 130 °C, observing that the recycled 3D-wastes materials based on a well-known reference grade experiences an improvement of the intrinsic viscosity, while that coming from different sources showed no significant changes. Thus, the results show that 3D printing PLA products provides an ideal environment for the implementation of distributed recycling program, in which wastes coming from well-known PLA grades can successfully be processed in films with good overall performance.

5.
Sustainability ; 12(22):9563, 2020.
Article in English | MDPI | ID: covidwho-927415

ABSTRACT

The COVID-19 crisis has taken the world by surprise, and its effects are widening pre-existing inequalities such as socioeconomical, educational, and digital divides. The gender gap is no exception, and research shows that lockdowns are strongly impacting women, who, on the whole, are more vulnerable to the effects of a crisis. This study analyzes the impact of the COVID-19 lockdown in Spain on families, from a gender perspective. To this end, 663 participants related to the STEM (Science, Technology, Engineering, and Mathematics) fields were recruited to participate in the research through their connection with the Equality Office of the major technical university of Spain, Universidad Politécnica de Madrid, which offers most engineering and architecture degrees. The results indicate that the great myths of gender inequality are still alive in Spain, and that a crisis of this nature can perpetuate them. However, the crisis also presents an opportunity for change. Will the STEM careers be prepared to take advantage of this opportunity, or will this crisis end up perpetuating their markedly masculine character? Are we ready for a revolution? The COVID-19 crisis and its learnings about the importance of care can open the path to change.

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