Day: July 2, 2024

Pentagon: Fresh weapons package worth over $2.3bn for Ukraine almost ready  Press TV

‘Room to maneuver’: Ex-federal prosecutor details Jack Smith’s narrow path forward  AlterNet

Objectives: We evaluated the efficacy and acceptability of awake-prone positioning (APP) in a randomised controlled trial, using a dedicated APP implementation team and wearable continuous-monitoring devices to monitor position and oximetry. Methods: The trial was performed at a tertiary level hospital in Ho Chi Minh City, Vietnam, recruiting adults ([≥]18 years) hospitalised with moderate or severe COVID-19 and receiving supplemental oxygen therapy via nasal/facemask systems or high-flow nasal canulae. Participants were randomized (1:1) to standard care or APP. The primary outcome was escalation of respiratory support within 28 days of randomisation. Results: Ninety-three patients were enrolled between March 2022 and March 2023; 80 (86%) had received [≥]2 doses of SARS-CoV2 vaccine. Significantly greater mean daily APP times were achieved in those allocated to APP, although most did not achieve the target 8 hours/day. We did not detect significant differences in the primary outcome (RR 0.85, 95% CI 0.40-1.78, p=0.67) or secondary outcomes, including intubation rate and 28-day mortality. Particpants reported prone positioning was comfortable, although almost all preferred supine positioning. No adverse events associated with the intervention were reported. Conclusions: APP was not associated with benefit, but was safe. Continuous monitoring with wearable devices was feasible and acceptable to patients.

Different factors influence the spread of SARS-CoV-2, from the inherent transmission capabilities of the different variants to the control measurements put in place. Here we studied the introduction of the Alpha, Delta, and Omicron-BA.1 variants of concern (VOCs) into Spain. For this, we collected genomic data from the GISAID database and combined it with connectivity data from different countries with Spain to perform a phylodynamic Bayesian analysis of the introductions. Our findings reveal that the introductions of these VOCs predominantly originated from France, especially in the case of Alpha. As travel restrictions were eased during the Delta and Omicron-BA.1 waves, the number of introductions from distinct countries increased, with the United Kingdom and Germany becoming significant sources of the virus. The largest number of introductions detected corresponded to the Delta wave, which was associated with fewer restrictions and the summer period, when Spain receives a considerable number of tourists. This research underscores the importance of monitoring international travel patterns and implementing targeted public health measures to manage the spread of SARS-CoV-2.

Abstract Background: Sudden cardiac death (SCD) remains a significant threat to pilots and is a leading cause of death worldwide, jeopardizing flight safety and causing devastating consequences. This review examines the trends in SCD among pilots from a global perspective, analyzing evidence from 2011 to 2023, with a focus on its growing impact as a global crisis and recent findings pointing to a potential rise in incidence, particularly after 2019. Methods: A systematic search of peer-reviewed literature, international aviation databases, and pilot associations was conducted to identify relevant data. The analysis focused on trends in SCD prevalence, risk factors, prevention strategies, and recent findings, including the potential impact of COVID-19, the role of vaccination, and important biomarkers to screen for predisposition. Results: Recent studies suggest a potential increase in SCD incidence among pilots following the COVID-19 pandemic. Cardiovascular complications, increased stress, disruptions in healthcare, and changes in lifestyle may contribute to this potential rise. Biomarkers such as troponin, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP) have been identified as potential indicators of increased SCD risk in pilots. Conclusion: SCD remains a significant and rising threat to pilots, posing a global crisis that requires immediate attention. Through a comprehensive approach that includes risk assessment, preventive measures, emergency response, and preventive protocols, the aviation industry can mitigate this risk and safeguard the lives of pilots and passengers. The proposed standardized examination protocol for pilots includes regular cardiovascular risk assessment, biomarker screening, monitoring of COVID-19 and vaccination status, lifestyle modifications, and a standardized reporting system. The adoption of a standardized protocol by aviation regulatory bodies and airlines worldwide is crucial to address the growing threat of SCD among pilots and ensure the highest standards of aviation safety. Keywords: Sudden cardiac death (SCD) | Pilots | Aviation safety | Global crisis | Rising threat | COVID-19 | Biomarkers | Prevention strategies

Background In several countries, COVID-19 booster vaccinations are offered annually to priority groups, but many people have not been vaccinated in over a year. We aimed to assess the association between time since booster vaccination and characteristics of breakthrough infection. We also assessed whether incident COVID-19 continued to associate with asthma exacerbations in boosted individuals, and whether risk of COVID-19-associated exacerbation was affected by time since vaccination. Methods COVIDENCE UK is a prospective, longitudinal, population-based study of COVID-19. We included adult participants who had received [≥]1 booster vaccination. Time since vaccination was binarised at 6 months or 12 months according to vaccine eligibility subgroup. We used logistic, Cox, and linear regression to obtain adjusted estimates for the association between time since vaccination and breakthrough infection severity, symptom duration, and acute changes to health-related quality of life (measured by the EQ-5D-3L Index). We then assessed the association of incident COVID-19 with asthma exacerbations using multilevel mixed models, by time since vaccination. Results 7391 boosted participants reported a breakthrough infection. Across all eligibility subgroups, greater time since vaccination associated with increased odds of infection requiring bedrest (vs milder symptoms), with the highest odds for adults aged 65-75 years (1.83 [95% CI 1.51-2.23] when vaccinated >6 months vs [≤]6 months prior). However, we observed little evidence of association between time since vaccination and symptom duration. Vaccination >12 months prior (vs [≤]12 months) was associated with a small decrease in EQ-5D-3L Index among participants younger than 65 years (-0.03 points [-0.04 to -0.01]). Among 2100 participants with asthma, incident COVID-19 associated with increased risk of asthma exacerbation, both [≤]12 months after vaccination (OR 5.31 [4.36-6.48]) and later (6.06 [3.23-11.38]), with a greater difference in point estimates when specifically considering severe asthma exacerbations (6.82 [4.88-9.54] for [≤]12 months vs 10.06 [3.90-25.92] for >12 months). Conclusion Longer time since booster vaccination consistently associates with more severe breakthrough infections, and may potentially increase risk of severe asthma exacerbations. These findings highlight the importance of ensuring those currently eligible receive their booster vaccinations, and the need for research on further vaccinations in people with asthma no longer eligible for boosters.