BACKGROUND: Many countries have applied the wastewater surveillance of the COVID-19 pandemic to their national public health monitoring measures. The most used methods for detecting SARS-CoV-2 in wastewater are quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR) and reverse transcriptase-droplet digital polymerase chain reaction (RT-ddPCR). Previous comparison studies have produced conflicting results, thus more research on the subject is required.
OBJECTIVE: This study aims to compare RT-qPCR and RT-ddPCR for detecting SARS-CoV-2 in wastewater. It also aimed to investigate the effect of changes in the analytical pipeline, including the RNA extraction kit, RT-PCR kit, and target gene assay, on the results. Another aim was to find a detection method for low-resource settings.
METHODS: We compared 2 RT-qPCR kits, TaqMan RT-qPCR and QuantiTect RT-qPCR, and RT-ddPCR based on sensitivity, positivity rates, variability, and correlation of SARS-CoV-2 gene copy numbers in wastewater to the incidence of COVID-19. Furthermore, we compared 2 RNA extraction methods, column- and magnetic-bead-based. In addition, we assessed 2 target gene assays for RT-qPCR, N1 and N2, and 2 target gene assays for ddPCR N1 and E. Reverse transcription strand invasion-based amplification (RT-SIBA) was used to detect SARS-CoV-2 from wastewater qualitatively.
RESULTS: Our results indicated that the most sensitive method to detect SARS-CoV-2 in wastewater was RT-ddPCR. It had the highest positivity rate (26/30), and its limit of detection was the lowest (0.06 gene copies/µL). However, we obtained the best correlation between COVID-19 incidence and SARS-CoV-2 gene copy number in wastewater using TaqMan RT-qPCR (correlation coefficient [CC]=0.697, P<.001). We found a significant difference in sensitivity between the TaqMan RT-qPCR kit and the QuantiTect RT-qPCR kit, the first having a significantly lower limit of detection and a higher positivity rate than the latter. Furthermore, the N1 target gene assay was the most sensitive for both RT-qPCR kits, while no significant difference was found between the gene targets using RT-ddPCR. In addition, the use of different RNA extraction kits affected the result when the TaqMan RT-qPCR kit was used. RT-SIBA was able to detect SARS-CoV-2 RNA in wastewater.
CONCLUSIONS: As our study, as well as most of the previous studies, has shown RT-ddPCR to be more sensitive than RT-qPCR, its use in the wastewater surveillance of SARS-CoV-2 should be considered, especially if the amount of SARS-CoV-2 circulating in the population was low. All the analysis steps must be optimized for wastewater surveillance as our study showed that all the analysis steps including the compatibility of the RNA extraction, the RT-PCR kit, and the target gene assay influence the results. In addition, our study showed that RT-SIBA could be used to detect SARS-CoV-2 in wastewater if a qualitative result is sufficient.

UNASSIGNED: Current guidance to furlough health care staff with mild COVID-19 illness may prevent the spread of COVID-19 but may worsen nursing home staffing shortages as well as health outcomes that are unrelated to COVID-19.
UNASSIGNED: To compare COVID-19-related with non-COVID-19-related harms associated with allowing staff who are mildly ill with COVID-19 to work while masked.
UNASSIGNED: This modeling study, conducted from November 2023 to June 2024, used an agent-based model representing a 100-bed nursing home and its residents, staff, and their interactions; care tasks; and resident and staff health outcomes to simulate the impact of different COVID-19 furlough policies over 1 postpandemic year.
UNASSIGNED: Simulating increasing proportions of staff who are mildly ill and are allowed to work while wearing N95 respirators under various vaccination coverage, SARS-CoV-2 transmissibility and severity, and masking adherence.
UNASSIGNED: The main outcomes were staff and resident COVID-19 cases, staff furlough days, missed care tasks, nursing home resident hospitalizations (related and unrelated to COVID-19), deaths, and costs.
UNASSIGNED: In the absence of SARS-CoV-2 infection in the study\'s 100-bed agent-based model, nursing home understaffing resulted in an annual mean (SD) 93.7 (0.7) missed care tasks daily (22.1%), 38.0 (7.6) resident hospitalizations (5.2%), 4.6 (2.2) deaths (0.6%), and 39.7 (19.8) quality-adjusted life years lost from non-COVID-19-related harms, costing $1 071 950 ($217 200) from the Centers for Medicare & Medicaid Services (CMS) perspective and $1 112 800 ($225 450) from the societal perspective. Under the SARS-CoV-2 Omicron variant conditions from 2023 to 2024, furloughing all staff who tested positive for SARS-CoV-2 was associated with a mean (SD) 326.5 (69.1) annual furlough days and 649.5 (95% CI, 593.4-705.6) additional missed care tasks, resulting in 4.3 (95% CI, 2.9-5.9) non-COVID-19-related resident hospitalizations and 0.7 (95% CI, 0.2-1.1) deaths, costing an additional $247 090 (95% CI, $203 160-$291 020) from the CMS perspective and $405 250 (95% CI, $358 550-$451 950) from the societal perspective. Allowing 75% of staff who were mildly ill to work while masked was associated with 5 additional staff and 5 additional resident COVID-19 cases without added COVID-19-related hospitalizations but mitigated staffing shortages, with 475.9 additional care tasks being performed annually, 3.5 fewer non-COVID-19-related hospitalizations, and 0.4 fewer non-COVID-19-related deaths. Allowing staff who were mildly ill to work ultimately saved an annual mean $85 470 (95% CI, $41 210-$129 730) from the CMS perspective and $134 450 (95% CI, $86 370-$182 540) from the societal perspective. These results were robust to increased vaccination coverage, increased nursing home transmission, increased importation of COVID-19 from the community, and failure to mask while working ill.
UNASSIGNED: In this modeling study of staff COVID-19 furlough policies, allowing nursing home staff to work with mild COVID-19 illness was associated with fewer resident harms from staffing shortages and missed care tasks than harms from increased COVID-19 transmission, ultimately saving substantial direct medical and societal costs.

The article analyzes publications considering motivation of plasma donors by factors related to ethical and socio-economic aspects. Their detailed analysis and systematical consideration in the work contributes into more effective informing of new potential donors, improving recruitment and retention of donors. The detailed analysis established among causes of negative beliefs and negative experiences regarding donorship such factors as increased risk of infectious diseases, decreased vitality, vaso-vagal reactions and reduced iron content. It is demonstrated that experienced plasma donors try to maintain practice of donorship in conditions of intensive life activity, often applying flexible approach to frequency of plasma donation. Their knowledge about contribution that their donation makes is key factor in continuing donation. However, the COVID-19 pandemic developed additional obstacles to donorship due to state preventive measures and increased personal health risks. In order to develop donorship policy during pandemic in the future, it is important to study changes in motivation of donors during pandemic.

The article considers issues of how population behavior impacts realization of state anti-epidemic measures and efforts to control pandemic. Materials and Methods. The methodology of the study is based on such methods as text analysis, elastic network and construction of regression equations. The analysis of indicators characterizing state policy measures controlling pandemic was applied according to data from The Oxford COVID-19 Government Response Tracker portal. The behavioral reactions of population were assessed by text analysis of messages in Twitter and VKontakte social networks using the Rulexicon, tonalities dictionary of Russian language. The analysis of mobility was implemented on basis of data from Google Community Mobility Reports (GCMR). The study base includes data of March 12, 2020 - August 1, 2021. It is established that in controlling pandemic the most effective is to apply combination of measures implemented at state level of the Ministry of Health and the Ministry of Economic Development of the Russian Federation that permits to compensate negative effect of quarantine regimen. In the Russian Federation,effect of self-isolation measures, organization of remote work of employees of enterprises, closure of schools, wearing masks is controversial and their incorrect application can contribute to virus propagation. The vaccination measures are also effective in reducing morbidity of disease, but they are characterized by lagging effect. The approval and acceptance by population anti-epidemic measures significantly impact efficiency of pandemic control. The study results can be applied in practice of implementation of anti-epidemic measures as a tool preventing excessive risks of population morbidity and mortality.

The article considers issues of organizational and legal progress of social protection of workers involved in medical care during period of COVID-19. The purpose of the study is to analyze regulatory legal documents that define state guarantees that provide social protection for persons involved in the provision of medical care during COVID-19. The attempt was made to analyze international and national information on relevant morbidity, mortality and disability of health care workers, but respective data was not readily available in open admission. The analysis of international documents (the WHO, CDC, JHU reports), public documents of the Russian Federation, information from official websites of the President of the Russian Federation and the executive authorities of the Russian Federation (state reports on sanitary and epidemiological well-being of the population in the Russian Federation in 2020-2022) demonstrated the following. The whole world faced with the problem of protecting health care workers from contamination with new corona-virus infection. In the Russian Federation, unprecedented measures were taken to ensure social protection for this category of workers, including provision of additional social benefits.

BACKGROUND: A 2-dose mRNA-1273 primary series in children aged 6 months-5 years (25-µg) and 6-11 years (50-µg) had an acceptable safety profile and was immunogenic in the phase 2/3 KidCOVE study. We present data from KidCOVE participants who received an mRNA-1273 booster dose.
METHODS: An mRNA-1273 booster dose (10-µg for children aged 6 months-5 years; 25-µg for children aged 6-11 years; age groups based on participant age at enrollment) was administered ≥6 months after primary series completion. The primary safety objective was the safety and reactogenicity of an mRNA-1273 booster dose. The primary immunogenicity objective was to infer efficacy of an mRNA-1273 booster dose by establishing noninferiority of neutralizing antibody (nAb) responses after a booster in children compared with nAb responses observed after the mRNA-1273 primary series in young adults (18-25 years) from the pivotal efficacy study. Data were collected from March 2022 to June 2023.
RESULTS: Overall, 153 (6 months-5 years) and 2519 (6-11 years) participants received an mRNA-1273 booster dose (median age at receipt of booster: 2 and 10 years, respectively). The booster dose safety profile was generally consistent with that of the primary series in children; no new safety concerns were identified. An mRNA-1273 booster dose elicited robust nAb responses against ancestral SARS-CoV-2 among children and met prespecified noninferiority success criteria when compared with responses observed after the primary series in young adults.
CONCLUSIONS: Safety and immunogenicity data support administration of a mRNA-1273 booster dose in children aged 6 months to 11 years.
BACKGROUND: NCT04796896.

BACKGROUND: The Plastic Surgery Integrated track remains one of the most competitive fields in the National Residency Match Program. Match trends during the COVID-19 pandemic featured a distinct rise in regional and home program matches among plastic surgery applicants. The purpose of this study is to evaluate whether these trends have continued into the most recent residency match cycle in 2024.
METHODS: Residency match data from 2019 to 2024 was gathered through the Accreditation Council for Graduate Medical Education, Electronic Residency Application Service, integrated plastic surgery program websites, and plastic surgery residency program social media accounts. Current trends were compared with match cycles before and during the pandemic.
RESULTS: After COVID, the number of students matching at their home institution decreased to rates consistent with prepandemic norms. In the 2024 cycle, 46.9% of applicants matched at integrated plastic surgery programs within the geographical region of their medical school, which is similar to pre-COVID rates. Further, the emergence of a female-predominant plastic surgery match cohort during the pandemic has continued. In 2024, 125 (58.7%) of 213 matched applicants into integrated plastic surgery programs were female, which represents a continuation of female-majority resident cohorts since 2021. Our data showed that a sizable component of matched applicants completed visiting student electives at their matched institution. Finally, a large number of matched applicants completed a research fellowship, and a historically stable number completed research fellowships at their matched institution.
CONCLUSIONS: Our group reports stabilization in plastic surgery match trends in the wake of the COVID-19 pandemic, along with the continuation of growth in the number of female plastic surgery residents. Although home institution retention rates returned to the baseline proportionality exhibited prior to COVID-19, medical school geographical region may continue to play an important role in the integrated plastic surgery residency match.

Inflammation and autoimmune responses contribute to the pathophysiology of Long COVID, and its affective and chronic fatigue syndrome symptoms, labeled \"the physio-affective phenome.\" To investigate whether Long COVID and its physio-affective phenome are linked to autoimmunity to the tight junction proteins, zonulin and occludin (ZOOC), and immune reactivity to lipopolysaccharides (LPS), and whether the latter are associated with signs of human herpes virus-6 (HHV-6) reactivation, autoimmunity directed against oligodendrocyte and neuronal proteins, including myelin basic protein. IgA/IgM/IgG responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), HHV-6, ZOOC, and neuronal proteins, C-reactive protein (CRP), and advanced oxidation protein products (AOPPs), were measured in 90 Long COVID patients and 90 healthy controls. The physio-affective phenome was conceptualized as a factor extracted from physical and affective symptom domains. Neural network identified IgA directed to LPS (IgA-LPS), IgG-ZOOC, IgG-LPS, and IgA-ZOOC as important variables associated with Long COVID diagnosis with an area under the ROC curve of 0.755. Partial Least Squares analysis showed that 40.9% of the variance in the physio-affective phenome was explained by CRP, IgA-myelin basic protein (MBP), and IgG-MBP. A large part of the variances in both autoimmune responses to MBP (36.3%-39.7%) was explained by autoimmunity (IgA and IgG) directed to ZOOC. The latter was strongly associated with indicants of HHV-6 reactivation, which in turn was associated with increased IgM-SARS-CoV-2. Autoimmunity against components of the tight junctions and increased bacterial translocation may be involved in the pathophysiology of Long COVID\'s physio-affective phenome.

SARS-CoV-2 is a novel zoonotic positive-sense RNA virus (ssRNA+) belonging to the genus beta coronaviruses (CoVs) in the Coronaviridae family. It is the causative agent for the outbreak of the disease, COVID-19. It is the third CoV causing pneumonia around the world in the past 2 decades. To date, it has caused significant deaths worldwide. Notably, the emergence of new genetic variants conferring efficient transmission and immune evasion remained a challenge, despite the reduction in the number of death cases, owing to effective vaccination regimen (boosting) and safety protocols. Thus, information harnessed from SARS-CoV-2 genomic organization is indispensable for seeking laboratory diagnosis and treatment options. Here in, we review previously circulating variants of SARS-CoV-2 designated variant of concern (VOC) including the Alpha (United Kingdom), Beta (South Africa), Gamma (Brazil), Delta (India), and recently circulating VOC, Omicron (South Africa) and its divergent subvariants (BA.1, BA.2, BA.3, BA.2.12.1, BA.4 and BA.5) with BA.5 currently becoming dominant and prolonging the COVID pandemic. In addition, we address the role of computational models for mutagenesis analysis which can predict important residues that contribute to transmissibility, virulence, immune evasion, and molecular detections of SARS-CoV-2. Concomitantly, the importance of harnessing the immunobiology of SARS-CoV-2 and host interaction for therapeutic purpose; and use of an in slilico based biocomputational approaches to achieve this purpose via predicting novel therapeutic agents targeting PRR such as toll like receptor, design of universal vaccine and chimeric antibodies tailored to the emergent variant have been highlighted.

UNASSIGNED: Detection and tracing of suspicious adverse reactions (ARs) in community pharmacies after the second of COVID-19 vaccine dose. Comparison between doses.
UNASSIGNED: Design: prospective observational study.
UNASSIGNED: Vaccinated against COVID-19, of legal age, who consent to participate.
UNASSIGNED: Number and percentage of participants with ARs. Number, type and frequency of ARs. Impact on their daily life. Relations between variables.Approved by the Galician Ethical Committee of Research with medicines.
UNASSIGNED: 693 participants with the 2nd dose, 63.6% women. Age 56.8 years. 312 (45.0%) vaccinated, 49.4% women and 37.3% men (p<0.0001), reported at least one AR: 43.9% with Comirnaty®, 37.7% with Vaxzevria®, 63.0% with Spikevax®.There were 972 ARs, 75.2% in women and 24.8% in men (p<0.0001). Mean 1.4/vaccinated (maximum 11). The most prevalent AR: pain at injection site 197 (28.4%), tiredness/fatigue 141 (20.3%), myalgia 112 (16.2%), headache 95 (13.7%), fever 84 (12.1%).51 participants with ARs needed professional help: 10 from the doctor, 6 in the emergency room, 3 in hospitals (1 referral), 33 in the pharmacy. 70 (15.1%) were prevented from their daily activity. 201 Ars from vaccinated persons were reported.Number of people vaccinated with ARs and the number of ARs were less with the 2nd dose (p<0.05).Inverse relationship (p<0.05) between \"age\" and \"number of vaccinated with ARs\", \"need for professional care\" and \"prevented daily activity\".
UNASSIGNED: The number of vaccinated participants with ARs and their number was also high with the second dose, although lower than with the first. Women and younger people are predictive of increased risk of AR after vaccination against COVID-19.