Susceptibility to COVID-19 and Immunologic Response to Vaccination in Patients With Immune-Mediated Inflammatory Diseases.

Immune-mediated inflammatory diseases (IMIDs) are a highly heterogeneous group of diseases that share a common etiology of immune dysregulation, such as rheumatoid arthritis, inflammatory bowel disease, and psoriasis, among others. It is estimated that the prevalence of IMIDs ranges between 5% and 7% in developed countries. As current management of IMIDs includes the use of immunomodulatory medications, the resulting weakened immune response can increase the risk of infection, including with SARS-CoV-2 (the causative agent of COVID-19) and reduce response to vaccination, placing these individuals at continued risk of severe outcomes from COVID-19. In this article, we summarize the current literature related to COVID-19 outcomes and the immunogenicity and reactogenicity of COVID-19 mRNA vaccination among patients with rheumatologically dominated IMIDs, as well as the effect of immunomodulatory therapies on these outcomes. We conclude by providing current COVID-19 vaccination recommendations for individuals with IMID.

Type of mRNA COVID-19 vaccine and immunomodulatory treatment influence humoral immunogenicity in patients with inflammatory rheumatic diseases.

Patients with inflammatory rheumatic diseases (IRD) are at increased risk for worse COVID-19 outcomes. Identifying whether mRNA vaccines differ in immunogenicity and examining the effects of immunomodulatory treatments may support COVID-19 vaccination strategies. We aimed to conduct a long-term, model-based comparison of the humoral immunogenicity following BNT162b2 and mRNA-1273 vaccination in a cohort of IRD patients. Patients from the Swiss IRD cohort (SCQM), who assented to mRNA COVID-19 vaccination were recruited between 3/2021-9/2021. Blood samples at baseline, 4, 12, and 24 weeks post second vaccine dose were tested for anti-SARS-CoV-2 spike IgG (anti-S1). We examined differences in antibody levels depending on the vaccine and treatment at baseline while adjusting for age, disease, and past SARS-CoV-2 infection. 565 IRD patients provided eligible samples. Among monotherapies, rituximab, abatacept, JAKi, and TNFi had the highest odds of reduced anti-S1 responses compared to no medication. Patients on specific combination therapies showed significantly lower antibody responses than those on monotherapy. Irrespective of the disease, treatment, and past SARS-CoV-2 infection, the odds of higher antibody levels at 4, 12, and 24 weeks post second vaccine dose were, respectively, 3.4, 3.8, and 3.8 times higher with mRNA-1273 versus BNT162b2 (p < 0.0001). With every year of age, the odds ratio of higher peak humoral immunogenicity following mRNA-1273 versus BNT162b2 increased by 5% (p < 0.001), indicating a particular benefit for elderly patients. Our results suggest that in IRD patients, two-dose vaccination with mRNA-1273 versus BNT162b2 results in higher anti-S1 levels, even more so in elderly patients.

Assessing the environmental impacts of freshwater thermal pollution from global power generation in LCA.

Freshwater heat emissions from power plants with once-through cooling systems constitute one of many environmental pressures related to the thermoelectric power industry. The objective of this work was to obtain high resolution, operational characterization factors (CF) for the impact of heat emissions on ecosystem quality, and carry out a comprehensive, spatially, temporally and technologically differentiated damage-based environmental assessment of global freshwater thermal pollution. The aggregation of CFs on a watershed level results in 12.5% lower annual impacts globally and even smaller differences for the most crucial watersheds and months, so watershed level CFs are recommended when the exact emission site within the basin is unknown. Long-range impacts account for almost 90% of the total global impacts. The Great Lakes, several Mississippi subbasins, the Danube, and the Yangtze are among the most thermally impacted watersheds globally, receiving heat emissions from predominantly coal-fuelled and nuclear power plants. Globally, over 80% of the global annual impacts come from power plants constructed during or before the 1980s. While the impact-weighted mean age of the power plants in the Mississippi ranges from 38 to 51years, in Chinese watersheds including the Yangtze, the equivalent range is only 15 to 22years, reflecting a stark contrast in thermal pollution mitigation approaches. With relatively high shares of total capacity from power plants with once-through freshwater cooling, and tracing a large part of the Danube, 1kWh of net electricity mix is the most impactful in Hungary, Bulgaria and Serbia. Monthly CFs are provided on a grid cell level and on a watershed level for use in Life Cycle Assessment. The impacts per generating unit are also provided, as part of our effort to make available a global dataset of thermoelectric power plant emissions and impacts.

Investigating the relationship between toxicity and organic sum-parameters in kraft mill effluents.

Elaborate toxicity diagnostics, such as toxicity identification evaluation (TIE) and effects-directed analysis (EDA) have helped in identifying the causative agents of effluent wastewater toxicity. However, simpler means of relating ecotoxicological effects to effluent composition could be useful for effluent management practices when there is no scope for more complex procedures. The aim of this work was to investigate and isolate the relationship between biological responses and commonly measured organic sum-parameters, such as chemical- and biochemical oxygen demand (COD and BOD, respectively) in kraft mill effluents. In a top-down approach, the whole effluent toxicity (WET) of effluent samples was first determined from Pseudokirchneriella subcapitata and Ceriodaphnia dubia bioassays. The theoretical toxicity that could be attributed to the metal content was then estimated, via a combination of equilibrium chemical speciation- and metal toxicity modelling. By assuming concentration addition, the metal toxicity was subtracted from the WET, isolating the toxicity thought to be caused by the organics. Strong and significant correlations between the 'corrected' toxicity and organic sum-parameters were found for both species. The growth of P. subcapitata was negatively associated with increasing COD concentrations, whereas reproduction of C. dubia was negatively associated with increasing BOD concentrations. The linear relationships, along with robust estimations of their uncertainty bounds, can provide valuable, albeit rough, guidance for kraft mill effluent management practices.