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Global burden of vaccine-associated hepatobiliary and gastrointestinal adverse drug reactions, 1967-2023: a comprehensive analysis of the international pharmacovigilance database
No full textAlthough previous studies have focused on hepatobiliary and gastrointestinal adverse drug reactions (ADRs) associated with COVID-19 vaccines, literature on such ADRs with other vaccines is limited, particularly on a global scale. Therefore, we aimed to investigate the global burden of vaccine-associated hepatobiliary and gastrointestinal ADRs and identify the vaccines implicated in these occurrences. This study utilized data from the World Health Organization (WHO) international pharmacovigilance database to extract reports of vaccine-associated hepatobiliary and gastrointestinal ADRs from 1967 to 2023 (total reports = 131 255 418). Through global reporting counts, reported odds ratios (ROR) with 95% confidence interval (CI), and information components (IC) with IC0.25, the study examined the association between 16 vaccines and the incidence of hepatobiliary and gastrointestinal ADRs across 156 countries. Of the 6 842 303 reports in the vaccine-associated ADRs, 10 786 reports of liver injury, 927 870 reports of gastrointestinal symptoms, 2978 reports of pancreas and bile duct injury, and 96 reports of intra-abdominal hemorrhage between 1967 and 2023 were identified. Most hepatobiliary and gastrointestinal ADRs surged after 2020, with the majority of reports attributed to COVID-19 messenger RNA (mRNA) vaccines. Hepatitis A vaccines exhibited the highest association with liver injury (ROR [95% CI]: 10.30 [9.65–10.99]; IC [IC0.25]: 3.33 [3.22]), followed by hepatitis B, typhoid, and rotavirus. Specifically, ischemic hepatitis had a significant association with both Ad5-vectored and mRNA COVID-19 vaccines. Gastrointestinal symptoms were associated with all vaccines except for tuberculosis vaccines, particularly with rotavirus (11.62 [11.45–11.80]; 3.05 [3.03]) and typhoid (11.02 [10.66–11.39]; 3.00 [2.96]). Pancreas and bile duct injury were associated with COVID-19 mRNA (1.99 [1.89–2.09]; 0.90 [0.83]), MMR (measles, mumps, and rubella), and papillomavirus vaccines. For intra-abdominal hemorrhage, inactivated whole-virus COVID-19 vaccines (3.93 [1.86–8.27]; 1.71 [0.41]) had the highest association, followed by COVID-19 mRNA (1.81 [1.42–2.29]; 0.77 [0.39]). Most of these ADRs had a short time to onset, within 1 day, and low mortality rate. Through a global scale database, the majority of ADRs occurred within 1 day, emphasizing the importance of healthcare workers' vigilant monitoring and timely management.</p
Breast‐torso movement coordination during running in different breast support
No full textTo reduce breast motion with a bra, we need to understand what drives the motion of the breasts, and what variables change as support increases. Quantifying breast‐torso coordination and movement complexity across the gait cycle may offer deeper insights than previously reported discrete time lag. We aimed to compare breast‐torso coordination and mutual influence across breast support conditions during running. Twelve female participants ran on a treadmill at 10 km h−1 with an encapsulation and compression sports bra, and in no bra. Nipple and torso position was recorded. Vector coding, granger causality and transfer entropy were calculated within gait cycles. In both bra conditions, a greater percentage of gait cycles was spent with the breast and torso in‐phase (> 90%) compared to no bra running (~ 66%, p < 0.001), with most time spent in‐phase in the encapsulation versus compression bra (p = 0.006). There was a main effect of breast support condition on Granger causality (p < 0.001), both from breast to torso and torso to breast. Transfer of information was highest from torso to breast, compared to breast to torso in all conditions. Overall, these results provide novel insight into the mutual and complex interaction between the breast and the torso while running in different bra conditions. The approaches presented allow for a greater understanding of bra support conditions than existing discrete measures, which may relate to comfort and performance. Therefore, measures of coupling, predictability and transfer of complexity should be employed in future work examining these features.</p
Toward a nomenclature consensus for diverse intelligent systems: Call for collaboration
No full textDisagreements about language use are common both between and within fields. Where interests require multidisciplinary collaboration or the field of research has the potential to impact society at large, it becomes critical to minimize these disagreements where possible. The development of diverse intelligent systems, regardless of the substrate (e.g., silicon vs. biology), is a case where both conditions are met. Significant advancements have occurred in the development of technology progressing toward these diverse intelligence systems. Whether progress is silicon based, such as the use of large language models, or through synthetic biology methods, such as the development of organoids, a clear need for a community-based approach to seeking consensus on nomenclature is now vital. Here, we welcome collaboration from the wider scientific community, proposing a pathway forward to achieving this intention, highlighting key terms and fields of relevance, and suggesting potential consensus-making methods to be applied.</p
Art and craft of music therapy for stroke rehabilitation in a remote north Indian community
No full textThis case study describes how a music therapist (Stephen) and a music therapy intern (Sahitya) worked conjointly with a client and her granddaughter in a remote part of North India. The description provides a unique insight into conditions, culture, and lifestyle in this location, and how these two clinicians were able to merge broader arts-based and holistic approaches, on a journey towards client-centered and functional neurologic music therapy exercises to help the client regain more independence. The background to initial work undertaken by the music therapist, which lasted for one year and eleven months, is followed by a summary of five weekly conjoint sessions with the intern, including the evolution of exercises, rationale, and client responses, illustrated with embedded video excerpts. The communication, relationship, and trust-building with the client and her granddaughter, together with the intern joining the dynamic, paved the way for assimilating music therapy theoretical models that were new to them, and adapting neurologic music therapy approaches using an electronic keyboard that incorporated preferred facilitating music. This resulted in greater client engagement with higher levels of motivation and adherence and increased hand use in daily activities.</p
A quantitative investigation of the acid catalysed conversion of cannabidiol to tetrahydrocannabinol
No full textOver the counter cannabidiol (CBD) oils can be used in acid catalysed reactions that convert the CBD present in the oil to THC. Online forums exist to lead people through the process to manufacture 9 – tetrahydrocannabinol (THC) from CBD oils. The legal landscape for cannabis-based products and their control varies widely across the world with cannabis-based products being legal in the US and some parts of Europe but there are no quality control guidelines for CBD oils which has led to many problems like mislabelling of products.To test the ease by which CBD oil could be converted to THC, quantification of the acid catalysed conversion of CBD to THC was undertaken following a detailed review of the methods available. Three over the counter CBD oils with varying CBD concentrations were selected. These oils were screened by thin layer chromatography (TLC) for possible THC contamination. Then the oils were catalysed by a mixture of sulphuric acid and glacial acetic acid. The reaction mixture was then neutralised with sodium bicarbonate and extracted with petroleum ether. The petroleum ether layer was then analysed by TLC and gas-chromatography – mass spectrometry (GC-MS) to screen and confirm the content of the reaction mixtures respectively. All reaction mixtures were compared with CBD and THC standards as well as negative controls of each acid and solvent used.The CBD oils catalysed produced different mixtures with THC present in every mixture and unknown peaks which can be tentatively identified using mass spectrum comparison on the NIST database. Screening the CBD oils for possible THC contamination suggests misleading product labelling was not found in products examined. Calculating THC yield from the conversion method resulted in a range of 0.007-0.015%. Finally, THC yield comparisons from the selected oils using the same conversion method produced minor percentage yield increases.</p
National trends of allergic diseases and pandemic–related factors among individuals with obesity in South Korea: A nationwide representative serial study, 2005–2021
No full textBackground
Although obesity is known to be related to allergic diseases, few studies have investigated the prevalence of allergic diseases in individuals with obesity, especially during the COVID–19 pandemic. Thus, this study aimed to analyze national trends of allergic diseases among individuals with obesity and sociodemographic factors.
Methods
This study used data from the Korea National Health and Nutrition Examination Survey to examine the prevalence of allergic diseases among individuals with obesity in South Korea from 2005 to 2021. A nationally representative sample of 118,275 participants aged over 2 years or above was divided into six groups for analysis. This study used weighted multivariate regression analysis to examine the estimates of related factors. It assessed the weighted odds ratios or β–coefficients for these factors across different categories, including age, sex, region of residence, education level, household income, and body mass index for the entire population.
Results
All allergic diseases showed a general upward trend from 2005 to 2021, but each disease showed different prevalence trends when compared by age. Before the pandemic, those aged ≤39 years had an increasing trend for asthma and AD, but those aged ≥40 years had a decreasing trend. For asthma, β–coefficients were 0.629 (95% CI, 0.299 to 0.958) for 19–39 years, –0.245 (–0.450 to –0.040) for 40–59 years, and –0.668 (–1.024 to –0.313) for ≥60 years. For AD, β–coefficients were 2.514 (1.258 to 3.769) in those aged 2–18 years, 0.630 (0.173 to 1.086) in those aged 19–39 years, –0.458 (–0.648 to –0.268) in those aged 40–59 years, and –0.253 (–0.454 to –0.052) in those aged ≥60 years. However, for both asthma and AD, there were no significant changes in prevalence during the pandemic. In the case of AR, trends were different from those of asthma and AD. Before the pandemic, AR showed an increasing trend in those aged ≤39 years and those aged ≥40 years: β–coefficients were 3.067 (2.344 to 3.790) in 19–39 years, 2.051 (1.609 to 2.493) in 40–59 years, and 1.173 (0.820 to 1.526) in ≥60 years. During the pandemic, there was an increasing trend only among those aged 40-59, with no significant changes in other age groups: β–coefficients were 1.438 (0.065 to 2.811) in 40–59 years.
Conclusions
From 2005 to 2021, all allergic diseases (asthma, AD, and AR) increased overall, but with different age-related trends. No significant link was found between COVID–19 and allergic diseases, possibly due to preventive measures like mask-wearing and social distancing. Anxiety about accessing healthcare during the pandemic likely contributed to a decline in allergy diagnoses, highlighting the need for comprehensive strategies to manage and prevent allergic diseases.</p
Associations and within-group differences in physical characteristics and golf performance data in high-level amateur players
No full textThe aim of the present study was to assess the relationship between a comprehensive physical testing battery and golf performance, as quantified through a variety of previously determined usable metrics from launch monitor data. Twenty-six high-level, amateur golfers undertook a series of physical assessments, including anthropometry measurements, isometric mid-thigh pull (IMTP), isometric bench press, countermovement jump (CMJ), seated medicine ball throws for distance, and seated thoracic rotation tests. In addition, golf shot data were recorded in an indoor biomechanics laboratory, with a driver and 6-iron to quantify clubhead speed (CHS), ball speed, carry distance, and smash factor. Pearson’s r associative analyses showed that the strongest relationships with the golf shot data were with the isometric bench press for the upper body (r values up to 0.76) and countermovement jump for the lower body (r values up to 0.82). In addition, the median split analysis of the physical performance data revealed that players who were able to exhibit greater maximal and explosive strength capabilities in the IMTP, isometric bench press, and CMJ assessments had a significantly greater CHS (g range = 1.09–1.28; p < 0.05), ball speed (g range = 1.18–1.41; p < 0.05), carry distance (g range = 1.06–1.53; p < 0.05), and smash factor (g range = 0.81–1.17; p < 0.05). These data underscore the importance of superior physical capacity for golfers, especially for maximal force production in both the lower and upper body, as well as explosive force production for the lower body
Moving from a small and medium enterprise (SME) to a large enterprise (LE) in Trinidad and Tobago
No full textThe growth and development of Small and Medium Enterprises (SMEs) into Large Enterprises (LEs) is a significant milestone in business. This study aimed to explore the critical success factors SMEs use to transition to a LE. A qualitative research design was used to achieve this objective, employing a case study approach. Data were collected from the pioneer and leader of private tertiary education in Trinidad and Tobago, which had organically transformed from an SME to LE, through in-depth interviews and questionnaires with key informants, including the company's employees. The author also had unlimited access to the company’s policies, minutes of meetings at all levels of the organisation, and observations from working there for over 34 years.The results of this study revealed that the move from SMEs to LEs was not based on one singular factor but on the integration of elements. These factors include the culture of innovation, access to the global talent pool, readiness for digital transformation and leadership.Furthermore, the study found that successful SMEs' growth into an LE depends on effective leadership. A new leadership style emerged, which the author refers to as orchestrated leadership. The Orchestrated Leader embodies the characteristics of a balance of personal humility and professional will, as well as the ability to integrate the culture of innovation, access to the global talent pool, and readiness for digital transformation while adapting to the ever-changing business landscape.This study provided valuable insights into transforming SMEs into LEs. The study contributes to the body of knowledge on SMEs and LEs. It is expected to inform policymakers, entrepreneurs, and researchers about the factors that contribute to the success of an SME’s transition to LEs.</p
A phase 1/2 clinical trial of invariant natural killer T cell therapy in moderate-severe acute respiratory distress syndrome
No full textInvariant natural killer T (iNKT) cells, a unique T cell population, lend themselves for use as adoptive therapy due to diverse roles in orchestrating immune responses. Originally developed for use in cancer, agenT-797 is a donor-unrestricted allogeneic ex vivo expanded iNKT cell therapy. We conducted an open-label study in virally induced acute respiratory distress syndrome (ARDS) caused by the severe acute respiratory syndrome-2 virus (trial registration NCT04582201). Here we show that agenT-797 rescues exhausted T cells and rapidly activates both innate and adaptive immunity. In 21 ventilated patients including 5 individuals receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO), there are no dose-limiting toxicities. We observe an anti-inflammatory systemic cytokine response and infused iNKT cells are persistent during follow-up, inducing only transient donor-specific antibodies. Clinical signals of associated survival and prevention of secondary infections are evident. Cellular therapy using off-the-shelf iNKT cells is safe, can be rapidly scaled and is associated with an anti-inflammatory response. The safety and therapeutic potential of iNKT cells across diseases including infections and cancer, warrants randomized-controlled trials.</p
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