Effect of SARS-CoV-2 vaccination on symptoms from post-acute COVID syndrome: results from the national VAXILONG survey

IntroductionFew data are available concerning the effect of SARS-CoV-2 vaccination on the persistent symptoms associated with COVID-19, also called long-COVID or post-acute COVID-19 syndrome (PACS). Patients and methodsWe conducted a nationwide online survey among adult patients with PACS as defined by symptoms persisting over 4 weeks following a confirmed or probable COVID-19, without any identified alternative diagnosis. Information concerning PACS symptoms, vaccine type and scheme and its effect on PACS symptoms were studied. ResultsSix hundred and twenty surveys were completed and 567 satisfied the inclusion criteria and were analyzed. Respondents were 83.4% of women of median age 44 (IQR 25-75: 37-50). Initial infection was proven in 365 patients (64%) and 5.1% had been hospitalized to receive oxygen. 396 patients had received at least one injection of SARS-CoV-2 vaccine at the time of the survey, after a median of 357 [198-431] days following the initially-reported SARS-CoV-2 infection. Among the 380 patients who reported persistent symptoms at the time of SARS-CoV-2 vaccination, 201 (52.8%) reported variation of symptoms following the injection, without difference based on the type of vaccine used. After a complete vaccination scheme, 93.3% (28/30) of initially seronegative patients reported a positive anti-SARS-CoV-2 IgG. 170 PACS patients had not been vaccinated. The most common reasons for postponing SARS-CoV-2 vaccine were a fear of worsening PACS symptoms (55.9%) and the idea that vaccination was contraindicated because of PACS (15.6%). ConclusionOur study suggests that SARS-CoV-2 vaccination is well tolerated in the majority of PACS patients and has good immunogenicity. Disseminating these reassuring data might prove crucial to increase vaccine coverage in patients with PACS.

Refining long-COVID by a prospective multimodal evaluation of patients with long-term symptoms related to SARS-CoV-2 infection

BackgroundCOVID-19 long-haulers or "long-COVID" represent 10% of COVID-19 patients and remain understudied. MethodsIn this prospective study, we recruited 30 consecutive patients seeking medical help for persistent symptoms (> 30 days) attributed to COVID-19. All reported a viral illness compatible with COVID-19. The patients underwent a multi-modal evaluation including clinical, psychological, virological, specific immunological assays and were followed longitudinally. ResultsThe median age was 40 [interquartile range: 35-54] and 18 (60%) were female. After a median time of 152 [102-164] days after symptom onset, fever, cough and dyspnea were less frequently reported as compared with the initial presentation, but paresthesia and burning pain emerged in 18 (60%) and 13 (43%) patients, respectively. The clinical examination was unremarkable in all patients although the median fatigue and pain visual analogic scales were 7 [5-8] and 5 [2-6], respectively. Extensive biological studies were unremarkable, as were multiplex cytokine and ultra-sensitive interferon-a2 measurements. At this time, nasopharyngeal swab and stool RT-PCR were negative for all tested patients. Using SARS-CoV-2 serology and IFN-{gamma} ELISPOT, we found evidence of a previous SARS-CoV-2 infection in 50% (15/30) of patients, with objective evidence of lack or waning of immune response in two. Finally, psychiatric evaluation showed that 11 (36.7%), 13 (43.3%) and 9 (30%) patients had a positive screening for anxiety, depression and post-traumatic stress disorder, respectively. ConclusionsHalf of patients seeking medical help for long-COVID lack SARS-CoV-2 immunity. The presence of SARS-CoV-2 immunity did not cluster clinically or biologically long haulers, who reported severe fatigue, altered quality of life, and exhibited psychological distress. Key pointsO_LIAmong 30 consecutive patients reporting persistent symptoms (median 6 months) self-attributed to COVID-19, pain, fatigue and disability were reported in virtually all patients. C_LIO_LIMore than one third of patients suffer from psychological disorders such as anxiety, depression and/or post-traumatic stress disorder, regardless of SARS-CoV-2 immunity. C_LIO_LIAt the time of evaluation, only 50% of patients had cellular and/or humoral sign of a past SARS-CoV-2, and serology positivity varied depending of the kit used. C_LIO_LIExhaustive clinical, biological and immunological evaluations failed to find an alternative diagnosis, or to identify specific cytokine signature including type I interferon. C_LI

Fusion-Based Hypoxia Estimates: Combining Geostatistical and Mechanistic Models of Dissolved Oxygen Variability.

The need to characterize and track coastal hypoxia has led to the development of geostatistical models based on in situ observations of dissolved oxygen (DO) and mechanistic models based on a representation of biophysical processes. To integrate the benefits of these two distinct modeling approaches, we develop a space-time geostatistical framework for synthesizing DO observations with hydrodynamic-biogeochemical model simulations and meteorological time series (as covariates). This fusion-based approach is used to estimate hypoxia in the northern Gulf of Mexico across summers from 1985 to 2017. Deterministic trends with dynamic covariates explain over 35% of the variability in DO. Moreover, cross-validation results indicate that 58% of DO variability is explained when combining these trends with spatiotemporal interpolation, which is substantially better than mechanistic or conventional geostatistical hypoxia modeling alone. The fusion-based approach also reduces hypoxic area uncertainties by 11% on average and up to 40% in months with sparse sampling. Moreover, our new estimates of mean summer hypoxic area changed by >10% in a majority of years, relative to previous geostatistical estimates. These fusion-based estimates can be a valuable resource when assessing the influence of hypoxia on the coastal ecosystem.

Realization and simulation of high-power holmium doped fiber lasers for long-range transmission.

We report on our realization of a high-power holmium doped fiber laser, together with the validation of our numerical simulation of the laser. We first present the measurements of the physical parameters that are mandatory to model accurately the laser-holmium interactions in our silica fiber. We then describe the realization of the clad-pumped laser, based on a triple-clad large mode area holmium (Ho) doped silica fiber. The output signal power is 90 W at 2120 nm, with an efficiency of about 50% with respect to the coupled pump power. This efficiency corresponds to the state of the art for clad-pumped Ho-doped fiber lasers in the 100 W power class. By comparing the experimental results to our simulation, we demonstrate its validity and use it to show that the efficiency is limited, for our fiber, by the non-saturable absorption caused by pair-induced quenching between adjacent holmium ions.

Time-Evolving, Spatially Explicit Forecasts of the Northern Gulf of Mexico Hypoxic Zone.

The Mississippi-Atchafalaya River Basin delivers large amounts of freshwater and nutrients to the northern Gulf of Mexico promoting the development of a large hypoxic zone every summer. Statistical and semiempirical models have long been used to provide seasonal forecasts of the mid-summer hypoxic extent using historic time series of spring nutrient load and mid-summer hypoxic extent. These forecasts consist of a scalar estimate of the hypoxic area with uncertainty but do not include spatial distributions or temporal evolution of hypoxic conditions. Three-dimensional (3D) circulation-biogeochemical models of the coastal ocean simulate the temporal evolution of hypoxia in a spatially explicit manner but have not yet been used for seasonal hypoxia forecasting. Here, we present a hybrid method for seasonal, spatially explicit, time-evolving forecasts of the hypoxic zone that combines statistical forecasting with information from a 3D biogeochemical model. The hybrid method uses spring nitrate load and a multiyear (1985-2018) 3D hindcast simulation to produce a seasonal forecast. Validation shows that the method explains up to 76% of the observed year-to-year variability in the hypoxic area. The forecasts suggest that the maximum seasonal extent of hypoxia is reached, on average, on August 13, 2 weeks after the completion of the annual cruise. An analysis of month-to-month variations in hypoxia forecasts due to variability in wind speed and freshwater discharge allows estimates of weather-related uncertainties in the forecast.

[Evaluation of compression bandage application technique in patients with venous leg ulcers: A mixed methods observational study]. / Évaluation des techniques de pose des bandes de compression médicale chez les patients porteurs d'ulcères veineux : une étude observationnelle mixte.

Introduction: Treating venous leg ulcers involves replacing dressings and applying compression bandages (CB). The technique for applying these bandages set out in the best practice guidelines shows nurses how to achieve the required level of pressure. Considerable differences have been observed between these guidelines and the actual application of CB. Methodology: An observational study combining a quantitative and a qualitative component was conducted to analyze CB application and explore the elements taken into account by nurses when they perform this procedure. Results: For the 261 patients included in the study, 27% of CB were applied as described in the guidelines. The main difference was that the heel was not included in the bandage in 48% of patients. The freelance nurses interviewed reported taking patient views into account in order to encourage adherence. Discussion: The nursing knowledge identified from the nurse interviews was compared to Carper's "Patterns of Knowing" classification. It would seem that Carper's empirical knowledge is not the only "pattern of knowing" taken into consideration. Patient involvement in the choice of CB application technique, which could be likened to Carper's "esthetic knowledge," helps guide nursing practice.

Radiation hardened high-power Er3+/Yb3+-codoped fiber amplifiers for free-space optical communications.

The radiation responses of different high-power erbium/ytterbium-codoped fiber amplifiers (HP-EYDFA) have been investigated up to 100 krad (SiO2) dose levels. These devices are able to deliver 20 W of signal output power at 1565 nm by pumping at 915 nm (43 W) radiation tolerant (Er/Yb) or radiation hardened (ErYbCe) active few mode fibers; these performances are needed for free-space communications between low-orbit satellites and ground transceivers. X-ray irradiation results show that, thanks to a positive influence of the photo- and thermal-bleaching phenomena associated with such high-power operating conditions, the gain degradation levels of HP-EYDFA based on radiation hardened fibers remain below 6% after 100 krad at an accelerated dose rate of 3.4 rad/s.

Prevalence of pulmonary tuberculosis among prison inmates: A cross-sectional survey at the Correctional and Detention Facility of Abidjan, Côte d'Ivoire.

BACKGROUND: In Côte d'Ivoire, a TB prison program has been developed since 1999. This program includes offering TB screening to prisoners who show up with TB symptoms at the infirmary. Our objective was to estimate the prevalence of pulmonary TB among inmates at the Correctional and Detention Facility of Abidjan, the largest prison of Côte d'Ivoire, 16 years after this TB program was implemented. METHODS: Between March and September 2015, inmates, were screened for pulmonary TB using systematic direct smear microscopy, culture and chest X-ray. All participants were also proposed HIV testing. TB was defined as either confirmed (positive culture), probable (positive microscopy and/or chest X-ray findings suggestive of TB) or possible (signs or symptoms suggestive of TB, no X-Ray or microbiological evidence). Factors associated with confirmed tuberculosis were analysed using multivariable logistic regression. RESULTS: Among the 943 inmates screened, 88 (9.3%) met the TB case definition, including 19 (2.0%) with confirmed TB, 40 (4.2%) with probable TB and 29 (3.1%) with possible TB. Of the 19 isolated TB strains, 10 (53%) were TB drug resistant, including 7 (37%) with multi-resistance. Of the 10 patients with TB resistant strain, only one had a past history of TB treatment. HIV prevalence was 3.1% overall, and 9.6%among TB cases. Factors associated with confirmed TB were age ≥30 years (Odds Ratio 3.8; 95% CI 1.1-13.3), prolonged cough (Odds Ratio 3.6; 95% CI 1.3-9.5) and fever (Odds Ratio 2.7; 95% CI 1.0-7.5). CONCLUSION: In the country largest prison, pulmonary TB is still 10 (confirmed) to 44 times (confirmed, probable or possible) as frequent as in the Côte d'Ivoire general population, despite a long-time running symptom-based program of TB detection. Decreasing TB prevalence and limiting the risk of MDR may require the implementation of annual in-cell TB screening campaigns that systematically target all prison inmates.

Radiation hardening techniques for Er/Yb doped optical fibers and amplifiers for space application.

We investigated the efficiencies of two different approaches to increase the radiation hardness of optical amplifiers through development of improved rare-earth (RE) doped optical fibers. We demonstrated the efficiency of codoping with Cerium the core of Erbium/Ytterbium doped optical fibers to improve their radiation tolerance. We compared the γ-rays induced degradation of two amplifiers with comparable pre-irradiation characteristics (~19 dB gain for an input power of ~10 dBm): first one is made with the standard core composition whereas the second one is Ce codoped. The radiation tolerance of the Ce-codoped fiber based amplifier is strongly enhanced. Its output gain decrease is limited to ~1.5 dB after a dose of ~900 Gy, independently of the pump power used, which authorizes the use of such fiber-based systems for challenging space missions associated with high total doses. We also showed that the responses of the two amplifiers with or without Ce-codoping can be further improved by another technique: the pre-loading of these fibers with hydrogen. In this case, the gain degradation is limited to 0.4 dB for the amplifier designed with the standard composition fiber whereas 0.2 dB are reported for the one made with Ce-codoped fiber after a cumulated dose of ~900 Gy. The mechanisms explaining the positive influences of these two treatments are discussed.