By understanding pandemics and compounding disasters as disruptive sociopolitical processes rooted in histories and geographies of systemic inequality, we reflect on both novel and familiar ...manifestations of research practice, ethical decision making, and responsibility during the COVID-19 pandemic. We advocate for the importance of flexible, care-driven research methods that forefront local expertise and collaborations and relational ethics that are, oftentimes, at odds with neoliberal and institutional temporalities. Lastly, we reflect on how our own positionalities and experiences shape how we have navigated, reconceptualized, and challenged our own research practices in the context of a global pandemic.
COVID-19 is associated with a wide range of clinical manifestations, including autoimmune features and autoantibody production. Here we develop three protein arrays to measure IgG autoantibodies ...associated with connective tissue diseases, anti-cytokine antibodies, and anti-viral antibody responses in serum from 147 hospitalized COVID-19 patients. Autoantibodies are identified in approximately 50% of patients but in less than 15% of healthy controls. When present, autoantibodies largely target autoantigens associated with rare disorders such as myositis, systemic sclerosis and overlap syndromes. A subset of autoantibodies targeting traditional autoantigens or cytokines develop de novo following SARS-CoV-2 infection. Autoantibodies track with longitudinal development of IgG antibodies recognizing SARS-CoV-2 structural proteins and a subset of non-structural proteins, but not proteins from influenza, seasonal coronaviruses or other pathogenic viruses. We conclude that SARS-CoV-2 causes development of new-onset IgG autoantibodies in a significant proportion of hospitalized COVID-19 patients and are positively correlated with immune responses to SARS-CoV-2 proteins.
OBJECTIVE:We tested whether antibody screening samples of patients with suspected autoimmune encephalitis with additional research assays would improve the detection of autoimmune encephalitis ...compared with standard clinical testing alone.
METHODS:We examined 731 samples (333 CSF, 182 sera, and 108 pairs) from a cohort of 623 patients who were tested for CNS autoantibodies by the University of Pennsylvania clinical laboratory over a 24-month period with cell-based assays (CBAs) on commercially obtained slides of fixed cells for antibodies to NMDA receptor (NMDAR), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), γ-aminobutyric acid-B receptor (GABABR), leucine-rich glioma-inactivated 1 (LGI1), contactin-associated protein-like 2 (Caspr2), and glutamic acid decarboxylase (GAD65). In parallel, our research laboratory screened all samples for reactivity to brain sections and for anti-NMDAR using in-house CBAs. Samples with brain reactivity or positive clinical studies were examined with CBAs for a larger panel of antibodies.
RESULTS:The clinical laboratory reported positive findings for NMDAR (80 samples), GAD65 (8), LGI1 (5), Caspr2 (2), and GABABR (4). Sixty-five serum samples and 32 CSF samples were indeterminate for one or more antibodies. In our research laboratory, all but 4 positive results were confirmed, 88 of 97 indeterminate results were resolved, and 15 additional samples were found positive (10 NMDAR, 1 AMPAR, 3 LGI1, and 1 Caspr2). Clinical information supported these diagnoses. Overall, informative autoantibodies were detected in 15.5% of cases.
CONCLUSIONS:Standard clinical laboratory kits were specific, but some tests were insensitive and prone to indeterminate results. Screening with immunohistochemistry for reactivity to brain sections, followed by additional CBAs for cases with brain reactivity, improves the diagnostic accuracy of testing for autoimmune encephalitis.
Abstract Patients with B-cell lymphomas have altered cellular components of vaccine responses due to malignancy and therapy, and the optimal timing of vaccination relative to therapy remains unknown. ...Severe acute respiratory syndrome coronavirus 2 vaccines created an opportunity for new insights in vaccine timing because patients were challenged with a novel antigen across multiple phases of treatment. We studied serologic messenger RNA vaccine response in retrospective and prospective cohorts with lymphoma and chronic lymphocytic leukemia, paired with clinical and research immune parameters. Reduced serologic response was observed more frequently during active treatment, but nonresponse was also common within observation and posttreatment groups. Total immunoglobulin A and immunoglobulin M correlated with successful vaccine response. In individuals treated with anti-CD19–directed chimeric antigen receptor–modified T cells, nonresponse was associated with reduced B and T follicular helper cells. Predictors of vaccine response varied by disease and therapeutic group, and therefore further studies of immune health during and after cancer therapies are needed to individualize vaccine timing.
•Chronic mountain sickness secondary to polycythemia is a major problem in certain areas of the Andes.•Here we present a clinical trial determining if acetazolamide, n-acetylcysteine, or their ...combination could be of clinical benefit as determined by examining the effects on chronic mountain sickness score or hematocrit.•We confirm that acetazolamide is of benefit, likely by stimulating respiratory rate, while N-acetylcysteine had modest effects on CMS score but not on hematocrit.
Patients suffering from chronic mountain sickness (CMS) have excessive erythrocytosis. Low −level cobalt toxicity as a likely contributor has been demonstrated in some subjects. We performed a randomized, placebo controlled clinical trial in Cerro de Pasco, Peru (4380m), where 84 participants with a hematocrit (HCT) ≥65% and CMS score>6, were assigned to four treatment groups of placebo, acetazolamide (ACZ, which stimulates respiration), N-acetylcysteine (NAC, an antioxidant that chelates cobalt) and combination of ACZ and NAC for 6 weeks. The primary outcome was change in hematocrit and secondary outcomes were changes in PaO2, PaCO2, CMS score, and serum and urine cobalt concentrations. The mean (±SD) hematocrit, CMS score and serum cobalt concentrations were 69±4%, 9.8±2.4 and 0.24±0.15μg/l, respectively for the 66 participants. The ACZ arm had a relative reduction in HCT of 6.6% vs. 2.7% (p=0.048) and the CMS score fell by 34.9% vs. 14.8% (p=0.014) compared to placebo, while the reduction in PaCO2 was 10.5% vs. an increase of 0.6% (p=0.003), with a relative increase in PaO2 of 13.6% vs. 3.0%. NAC reduced CMS score compared to placebo (relative reduction of 34.0% vs. 14.8%, p=0.017), while changes in other parameters failed to reach statistical significance. The combination of ACZ and NAC was no better than ACZ alone. No changes in serum and urine cobalt concentrations were seen within any treatment arms. ACZ reduced polycythemia and CMS score, while NAC improved CMS score without significantly lowering hematocrit. Only a small proportion of subjects had cobalt toxicity, which may relate to the closing of contaminated water sources and several other environmental protection measures.
Patients with B-cell lymphomas have altered cellular components of vaccine responses due to malignancy and therapy, and the optimal timing of vaccination relative to therapy remains unknown. ...SARS-CoV-2 vaccines created an opportunity for new insights in vaccine timing because patients were challenged with a novel antigen across multiple phases of treatment. We studied serologic mRNA vaccine response in retrospective and prospective cohorts with lymphoma and CLL, paired with clinical and research immune parameters. Reduced serologic response was observed more frequently during active therapies, but non-response was also common within observation and post-treatment groups. Total IgA and IgM correlated with successful vaccine response. In individuals treated with CART-19, non-response was associated with reduced B and T follicular helper cells. Predictors of vaccine response varied by disease and therapeutic group, and therefore further studies of immune health during and after cancer therapies are needed to allow individualized vaccine timing.
Ante la constante evolución, hoy en día las tiendas textiles deben estar más preparadas para la excesiva competencia y a la exigencia de los clientes a la hora de adquirir este tipo de productos. ...Ahora, más que nunca, la calidad del servicio ha tomado un papel importante ya que es necesario cumplir los requerimientos del cliente y garantizar que todas las actividades de la organización contribuyan a satisfacer sus necesidades. El objetivo de este artículo es investigar la influencia de la calidad del servicio sobre la fidelización del cliente y el carácter mediador de la imagen de marca sobre dicha relación en las principales cadenas de moda textil ecuatorianas; a través del análisis relacional entre los constructos mencionados. La metodología utilizada es de tipo cuantitativo con una muestra de 384 clientes de tiendas textiles. Los resultados permiten la aceptación de las hipótesis planteadas, demostrando empíricamente, que la calidad del servicio influye de manera positiva en la fidelización e imagen de marca hacia las tiendas de moda textil. Además, a partir de este trabajo se puede direccionar nuevas investigaciones para de esta manera estudiar el comportamiento del consumidor y que pueda servir como base para que las empresas del sector puedan aplicar estrategias de marketing y brindar una mejor calidad del servicio para lograr la fidelización del cliente.
In the world, there is currently an inefficiency at the level of food safety, in 2020 in Colombia there were 268 outbreaks of ETA'S (Foodborne diseases) involving 3079 sick people. According to the ...World Health Organization (WHO) in 2020, 600 million people got sick of which 420.000 died from this cause which generates different outbreaks of ETA'S 1. This project aims to design a prototype which can preserve food safety focused on food at the time of being distributed to the final consumer, based on a traction system exerted by a conveyor belt through a hermetic box using an electronic system to drive spray lines completing the process in a drying line, thus obtaining a safer food at the time of ingestion, a saving of 70% water is achieved compared to previous prototypes used for the same purpose.
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