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Considerations for Causality Assessment of Neurological And
Occasional essay J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp-2021-326924 on 6 August 2021. Downloaded from Considerations for causality assessment of neurological and neuropsychiatric complications of SARS- CoV-2 vaccines: from cerebral venous sinus thrombosis to functional neurological disorder Matt Butler ,1 Arina Tamborska,2,3 Greta K Wood,2,3 Mark Ellul,4 Rhys H Thomas,5,6 Ian Galea ,7 Sarah Pett,8 Bhagteshwar Singh,3 Tom Solomon,4 Thomas Arthur Pollak,9 Benedict D Michael,2,3 Timothy R Nicholson10 For numbered affiliations see INTRODUCTION More severe potential adverse effects in the open- end of article. The scientific community rapidly responded to label phase of vaccine roll- outs are being collected the COVID-19 pandemic by developing novel through national surveillance systems. In the USA, Correspondence to SARS- CoV-2 vaccines (table 1). As of early June Dr Timothy R Nicholson, King’s roughly 372 adverse events have been reported per College London, London WC2R 2021, an estimated 2 billion doses have been million doses, which is a lower rate than expected 1 2LS, UK; timothy. nicholson@ administered worldwide. Neurological adverse based on the clinical trials.6 kcl. ac. uk events following immunisation (AEFI), such as In the UK, adverse events are reported via the cerebral venous sinus thrombosis and demyelin- MB and AT are joint first Coronavirus Yellow Card reporting website. As of ating episodes, have been reported. In some coun- authors. early June 2021, approximately 250 000 Yellow tries, these have led to the temporary halting of BDM and TRN are joint senior Cards have been submitted, equating to around authors. -
European Contact Lens Society of Ophthalmologists ECLSO
European Contact Lens Society of Ophthalmologists ECLSO Course de Base en Contactologie I – IV Basiskurs in Kontaktologie I - IV Dr. med. Albert Franceschetti, Genève Michael Bärtschi, M.Sc.Optom. et M.Med.Educ.,Bern Optics and Contact Lenses What should I know about optics and physiological optics when I fit contact lenses ? Visual acuity = 1.0 • US notation 20/20 (20 feet) • Metric notation 6/6 (6 meters) • Decimal 10/10 (Monoyer) • Logarythmic Distance spectacles-eye • The position of the contact lens is different in relation to the eye. This is obviously the first criterion to take into consideration. • According to the power of the spectacles, the difference ǻ between the power of spectacle lenses and the contact lenses will be more or less important. Formula • DL power of the glasses (supposed perfect DL correction) DCL = -------------- 1 – d D • DCL power of the contact L lens (lens + tear meniscus) • d distance between the lens and the contact lens • ǻ difference between the power DCL and DL ǻ • ǻ = DCL –DL is always positive • ǻ = DCL –DL increases if the distance eye- glasses increases • The value d can be superior to 12mm if one uses trial lenses or refractor. Variation of powers between the two systems (contact lenses and spectacle) Distance eye- DL -20 -15 -10 -8 -5 +4 +10 glasses -16.13 -12.71 -8.93 -7.30 -4.72 +4.20 +11.36 DCL d=12m 3.87 2.29 1.07 0.70 0.28 0.20 1.36 m ǻ -15.38 -12.24 -8.70 -7.14 -4.65 +4.26 +11.76 DCL D=15 ǻ 4.62 2.76 1.30 0.86 0.35 0.26 1.76 mm Magnification • The distance eye-spectacles versus eye contact lens being different, the magnification of the retinal image will be different. -
An Overview of COVID Vaccine Clinical Trial Results & Some Challenges
An overview of COVID vaccine clinical trial results & some challenges DCVMN Webinar December 8th, 2020 Access to COVID-19 tools ACCESSACCESS TO TOCOVID-19 COVID-19 TOOLS TOOLS (ACT) (ACT) ACCELERATOR ACCELERATOR (ACT) accelerator A GlobalA GlobalCollaboration Collaboration to Accelerate tothe AccelerateDevelopment, the Production Development, and Equitable Production Access to New and Equitable AccessCOVID-19 to New diagnostics, COVID-19 therapeutics diagnostics, and vaccines therapeutics and vaccines VACCINES DIAGNOSTICS THERAPEUTICS (COVAX) Development & Manufacturing Led by CEPI, with industry Procurement and delivery at scale Led by Gavi Policy and allocation Led by WHO Key players SOURCE: (ACT) ACCELERATOR Commitment and Call to Action 24th April 2020 ACT-A / COVAX governance COVAX COORDINATION MEETING CEPI Board Co-Chair: Jane Halton Co-Chair: Dr. Ngozi Gavi Board Workstream leads + DCVMN and IFPMA-selected Reps As needed – R&D&M Chair; COVAX IPG Chair Development & Manufacturing Procurement and delivery Policy and allocation (COVAX) at scale Led by (with industry) Led by Led by R&D&M Investment Committee COVAX Independent Product Group Technical Review Group Portfolio Group Vaccine Teams SWAT teams RAG 3 COVAX SWAT teams are being set up as a joint platform to accelerate COVID- 19 Vaccine development and manufacturing by addressing common challenges together Timely and targeted Multilateral Knowledge-based Resource-efficient Addresses specific cross- Establishes a dialogue Identifies and collates Coordinates between developer technical and global joint effort most relevant materials different organizations/ challenges as they are across different COVID-19 and insights across the initiatives to limit raised and/or identified vaccines organizations broader COVID-19 duplications and ensure on an ongoing basis (incl. -
Gene-Based Vaccines (GBV)
Advanced Drug Delivery Reviews 170 (2021) 113–141 Contents lists available at ScienceDirect Advanced Drug Delivery Reviews journal homepage: www.elsevier.com/locate/addr Advances in gene-based vaccine platforms to address the COVID-19 pandemic Deborah Pushparajah a,1, Salma Jimenez a,c,1,ShirleyWonga,HibahAlattasa, Nafiseh Nafissi b, Roderick A. Slavcev a,b,c,⁎ a School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener N2G 1C5, Canada b Mediphage Bioceuticals, 661 University Avenue, Suite 1300, Toronto, ON, M5G 0B7, Canada c Theraphage, 151 Charles St W Suite # 199, Kitchener, ON, N2G 1H6, Canada article info abstract Article history: The novel betacoronavirus, SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), has spread across Received 1 October 2020 the globe at an unprecedented rate since its first emergence in Wuhan City, China in December 2019. Scientific Received in revised form 23 December 2020 communities around the world have been rigorously working to develop a potent vaccine to combat COVID-19 Accepted 1 January 2021 (coronavirus disease 2019), employing conventional and novel vaccine strategies. Gene-based vaccine platforms Available online 7 January 2021 based on viral vectors, DNA, and RNA, have shown promising results encompassing both humoral and cell-mediated immune responses in previous studies, supporting their implementation for COVID-19 vaccine de- Keywords: Coronavirus velopment. In fact, the U.S. Food and Drug Administration (FDA) recently authorized the emergency use of two COVID-19 RNA-based COVID-19 vaccines. We review current gene-based vaccine candidates proceeding through clinical SARS-CoV-2 trials, including their antigenic targets, delivery vehicles, and route of administration. -
Hatchery Disinfection Policy and Procedures
MAINE DEPARTMENT OF INLAND FISHERIES & WILDLIFE Chapter 11 Disinfection Policy & Procedures Editors: David C. Rayner, Fish Culture Supervisor, Governor Hill State Fish Hatchery, Augusta, Maine (19XX- Present) & G. Russell Danner MS, DVM, Fish Pathologist, Fish Health Laboratory, Augusta, Maine (1998 – Present) Date: September 24, 1999. “Or if a person touches anything ceremonially unclean-whether the carcasses of unclean wild animals or of unclean livestock or of unclean creatures that move along the ground-even though he is unaware of it, he has become unclean and is guilty” Lev. 5:2 Several factors should be included in an evaluation of a disinfectant. A prerequisite for a disinfectant is its effectiveness against the expected spectrum of pathogens (Table 11- 1, 11-2, and 11-3). A general guideline for effective killing of pathogens by a disinfectant is a 5-log killing of bacteria and a 4-log killing of viruses. In addition to the activity of the disinfectant, its compatibility with devices should be reviewed in detail; this should include a review of data on devices that have been immersed for longer than recommended times. Instruments can be forgotten after immersion, and this mistake should not necessarily result in irreparable damage to the device. Other issues are toxicity, odor, compatibility with other compounds, and residual activity. Various and numerous organisms can cause diseases in fish. Viruses, bacteria, fungi, protozoan and many invertebrate animals are included in this list. No single disinfectant destroys them all. It is up to the applicant to decide what is the pathogen of most concern, and how it is to be reduced or eliminated. -
U.S. EPA, Pesticide Product Label, 776 DISINFECTANT VIRUCIDE
, 1-ls-lf9 UNITED ST ATES ENVIRONMENTAL PROTECTION AGENCY Carroll Company 2900 West Kingsley Road Garland, TX 75041 Subject: 776 Disinfectant, Virucide and Cleaner EPA Registration No. 4313-22 Amendment Dated November 9, 1998 Attn: Linda Kirk Kirby Director, Regulatory Compliance The amendment referred to above, submitted in connection with registration under the Federal Insecticide, Fungicide and Rodenticide Act, as amended, is acceptable. A stamped copy of the label is enclosed for your records. Submit one (I) copy ofthe finished printed label before this product is released for shipment. If you have any questions concerning the comments in this letter, you should contact Zenobia Jones at (703) 308-6198. Sincerely, ) JJ~lvJHdL Velma Noble Product Manager 31 Regulatory Management Branch I Antimicrobial Division (751 OW) COHCURRI!HCI!S ::::} ·m·I~ .Q........ ................ - ....................................... -................................ _............................. DATE ) . \-1i.-9l1... ....... ................... ................. .................................................................................... OFFICIAL FILE COpy Primed Oft R~cye/~d Paper ~' '....,-. " DISINFECTANT, UIRUCIDE* AND CLEANER FOR HOSPITAL INSTITUTIONAL ACTIVE INGREDIENT: AND iNDUSTRIAL USE Alkyl (C14 50%, C12 40%, C16 10%) dimelhyl • benzyl ammonium chloride........... 3.3 Yo ·Hum8n immunodeficiency virus, Type 1 (HIV-l) INERT INGR~DIENTS .................. 96.7% KEEP OUT OF REACH OF CHILDREN DANGER See back panel for additional precautionary -
Chemical Disinfectants | Disinfection & Sterilization Guidelines | Guidelines Library | Infection Control | CDC 3/19/20, 14:52
Chemical Disinfectants | Disinfection & Sterilization Guidelines | Guidelines Library | Infection Control | CDC 3/19/20, 14:52 Infection Control Chemical Disinfectants Guideline for Disinfection and Sterilization in Healthcare Facilities (2008) Alcohol Overview. In the healthcare setting, “alcohol” refers to two water-soluble chemical compounds—ethyl alcohol and isopropyl alcohol —that have generally underrated germicidal characteristics 482. FDA has not cleared any liquid chemical sterilant or high- level disinfectant with alcohol as the main active ingredient. These alcohols are rapidly bactericidal rather than bacteriostatic against vegetative forms of bacteria; they also are tuberculocidal, fungicidal, and virucidal but do not destroy bacterial spores. Their cidal activity drops sharply when diluted below 50% concentration, and the optimum bactericidal concentration is 60%–90% solutions in water (volume/volume) 483, 484. Mode of Action. The most feasible explanation for the antimicrobial action of alcohol is denaturation of proteins. This mechanism is supported by the observation that absolute ethyl alcohol, a dehydrating agent, is less bactericidal than mixtures of alcohol and water because proteins are denatured more quickly in the presence of water 484, 485. Protein denaturation also is consistent with observations that alcohol destroys the dehydrogenases of Escherichia coli 486, and that ethyl alcohol increases the lag phase of Enterobacter aerogenes 487 and that the lag phase e!ect could be reversed by adding certain amino acids. The bacteriostatic action was believed caused by inhibition of the production of metabolites essential for rapid cell division. Microbicidal Activity. Methyl alcohol (methanol) has the weakest bactericidal action of the alcohols and thus seldom is used in healthcare 488. The bactericidal activity of various concentrations of ethyl alcohol (ethanol) was examined against a variety of microorganisms in exposure periods ranging from 10 seconds to 1 hour 483. -
Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 William A. Rutala, Ph.D., M.P.H.1,2, David J. Weber, M.D., M.P.H.1,2, and the Healthcare Infection Control Practices Advisory Committee (HICPAC)3 1Hospital Epidemiology University of North Carolina Health Care System Chapel Hill, NC 27514 2Division of Infectious Diseases University of North Carolina School of Medicine Chapel Hill, NC 27599-7030 1 Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 3HICPAC Members Robert A. Weinstein, MD (Chair) Cook County Hospital Chicago, IL Jane D. Siegel, MD (Co-Chair) University of Texas Southwestern Medical Center Dallas, TX Michele L. Pearson, MD (Executive Secretary) Centers for Disease Control and Prevention Atlanta, GA Raymond Y.W. Chinn, MD Sharp Memorial Hospital San Diego, CA Alfred DeMaria, Jr, MD Massachusetts Department of Public Health Jamaica Plain, MA James T. Lee, MD, PhD University of Minnesota Minneapolis, MN William A. Rutala, PhD, MPH University of North Carolina Health Care System Chapel Hill, NC William E. Scheckler, MD University of Wisconsin Madison, WI Beth H. Stover, RN Kosair Children’s Hospital Louisville, KY Marjorie A. Underwood, RN, BSN CIC Mt. Diablo Medical Center Concord, CA This guideline discusses use of products by healthcare personnel in healthcare settings such as hospitals, ambulatory care and home care; the recommendations are not intended for consumer use of the products discussed. 2 -
Compatible Cleaning Solutions Chart*
Compatible Cleaning Solutions Chart* Reactive Chemicals Natural Rubber Polyurethane 316 Stainless Vinyl Nitrile FKM (Viton) Aluminum Neoprene Hypalon Silicone UHMW Hytrel Nitrile / SBR EPDM Nylon Brass XLPE Steel PTFE CPE Fluid PVC Notes: Alcohols +++++++–+–+– +++++ • Ingredient in Some (Methanol & Ethanol) Anti-Viral Cleansers Bleaching and Cleaning Bleach Solution + + • ••––– • + • – + • • – – – + – – Agent; Sodium (Sodium Hypochlorite) Hypochlorite Butyl Alcohol + + • + + + + + + + – + + + + + + + + + Potent virucidal agent Chlorine – – – – – – + + – – • • • Antiseptic; Anti-Viral – + + + + + ••– • + + • + + + + • + – – Insecticides and Citric Acid disinfectants; Antiviral Copper Chloride – + + + ••+++++++++++ +–– Copper Chloride Ethyl Alcohol + + + + + + + + • + • + + + + + + • + + + • + Ingredient in Some (Ethanol) Anti-Viral Cleansers Toilet, Tile and Porcelain Hydrochloric Acid +++–––––++–+++–––––– Cleaner; Anti-Viral (Polio) Hydrogen Peroxide + • – – – – – + • + – + • • – + • • ••–– Multipurpose Cleaner +++ –++–+––+ • ••–––– Antiseptic; Antiviral Iodine (Polio) + + + + ••+++–++++++++++++ Ingredient in Some Isopropyl Alcohol Anti-Viral Cleansers Phenol + • – – – – – – + – – + + + – – + + • + ••– Anti-Virus (Rhinovirus) (Carbolic Acid) (Adenovirus) Sodium Chloride ++++++++++++++++ • + – • Anti-Virus Sodium Hypochlorite ••+++––––++– • + + – – – ••–– Bleaching and Cleaning Agent (Bleach) Quaternary Ammonium + + + + + + + Common Anti-Viral; Salts (Lysol) Benzalkonium Chloride (Lysol) Lactic Acid – + • + – + + • + • • + + – + + + – -
En Este Número
Boletín Científico No. 18 (1-10 julio/2021) EN ESTE NÚMERO VacCiencia es una publicación dirigida a Resumen de candidatos vacu- investigadores y especialistas dedicados a nales contra la COVID-19 ba- la vacunología y temas afines, con el ob- sadas en la plataforma de sub- jetivo de serle útil. Usted puede realizar unidad proteica en desarrollo a sugerencias sobre los contenidos y de es- nivel mundial. (segunda parte) ta forma crear una retroalimentación Artículos científicos más que nos permita acercarnos más a sus recientes de Medline sobre necesidades de información. vacunas. Patentes más recientes en Patentscope sobre vacunas. Patentes más recientes en USPTO sobre vacunas. 1| Copyright © 2020. Todos los derechos reservados | INSTITUTO FINLAY DE VACUNAS Resumen de vacunas contra la COVID-19 basadas en la plataforma de subunidad proteica en desarrollo a nivel mundial (segunda parte) Las vacunas de subunidades antigénicas son aquellas en las que solamente se utilizan los fragmentos específicos (llamados «subunidades antigénicas») del virus o la bacteria que es indispensable que el sistema inmunitario reconozca. Las subunidades antigénicas suelen ser proteínas o hidratos de carbono. La mayoría de las vacunas que figuran en los calendarios de vacunación infantil son de este tipo y protegen a las personas de enfermedades como la tos ferina, el tétanos, la difteria y la meningitis meningocócica. Este tipo de vacunas solo incluye las partes del microorganismo que mejor estimulan al sistema inmunitario. En el caso de las desarrolladas contra la COVID-19 contienen generalmente, la proteína S o fragmentos de la misma como el Dominio de Unión al Receptor (RBD, por sus siglas en inglés). -
US EPA, Pesticide Product Label, XHC-IA,06/07/2018
UNITED STATES ENVIRONMENTAL PROTECTION AGENCY WASHINGTON, DC 20460 OFFICE OF CHEMICAL SAFETY AND POLLUTION PREVENTION June 7, 2018 Bridget Middleton, M.S. Regulatory Specialist Ecolab Inc. 1 Ecolab Place St. Paul, MN 55102 Subject: PRIA Label Amendment – Adding Efficacy Claims and Emerging Viral Pathogens Language Product Name: XHC-IA EPA Registration Number: 1677-249 Application Date: January 16, 2018 Decision Number: 537595 Dear Ms. Middleton: The amended label referred to above, submitted in connection with registration under the Federal Insecticide, Fungicide and Rodenticide Act, as amended, is acceptable. This approval does not affect any conditions that were previously imposed on this registration. You continue to be subject to existing conditions on your registration and any deadlines connected with them. A stamped copy of your labeling is enclosed for your records. This labeling supersedes all previously accepted labeling. You must submit one copy of the final printed labeling before you release the product for shipment with the new labeling. In accordance with 40 CFR 152.130(c), you may distribute or sell this product under the previously approved labeling for 18 months from the date of this letter. After 18 months, you may only distribute or sell this product if it bears this new revised labeling or subsequently approved labeling. “To distribute or sell” is defined under FIFRA section 2(gg) and its implementing regulation at 40 CFR 152.3. Because you have opted to add statements pertaining to emerging viral pathogens to your label as described in the August 19, 2016, Guidance to Registrants: Process For Making Claims Against Emerging Viral Pathogens Not On EPA-Registered Disinfectant Labels (“Guidance”), https://www.epa.gov/sites/production/files/2016- 09/documents/emerging_viral_pathogen_program_guidance_final_8_19_16_001_0.pdf, you are subject to the following additional terms of registration: 1. -
Heterologous Prime-Boost COVID-19 Vaccination: Initial Reactogenicity Data
Correspondence Heterologous (100 participants with additional 24 (21%) of 112 recipients of BNT for prime-boost COVID-19 visits), at baseline (before the prime both prime and boost (difference 21%, dose), at day 28 (before the boost 95% CI 8–33%). Similar increases were Published Online vaccination: initial dose) and 7 days post-boost, graded observed for chills, fatigue, headache, May 12, 2021 https://doi.org/10.1016/ according to a modified US Food joint pain, malaise, and muscle ache reactogenicity data S0140-6736(21)01115-6 and Drug Administration toxicity (figure; appendix). There were no There is significant international scale (appendix). All analyses are hospitalisations due to solicited See Online for appendix interest in heterologous prime-boost descriptive, as the study was not symptoms, and most of this increase in COVID-19 vaccination to mitigate powered for reactogenicity, with reactogenicity was observed in the 48 h against supply shocks or shortages endpoints reported as frequencies and after immunisation (appendix). that might otherwise reduce the speed percentages, together with absolute Participants were advised that of vaccine roll-out. Additionally, in differences between heterologous and paracetamol might reduce vaccine light of changing recommendations homologous vaccine schedules and side-effects but were not actively coun- regarding use of the ChAdOx1 nCoV-19 corresponding 95% CIs. selled to medicate prophylactically. (ChAd) COVID-19 vaccine (Vaxzevria, Recruitment commenced on Paracetamol use in the 48 h post-boost AstraZeneca), several countries are now Feb 11, 2021, and was completed on vaccine was reported by 40 (36%) of advising that individuals previously Feb 26, 2021, with 830 participants 112 recipients of ChAd for both prime primed with this vaccine should now enrolled and randomised from and boost, 63 (57%) of 110 recipients receive an alternative vaccine as 978 screened (the CONSORT flow of ChAd for prime and BNT for boost, their second dose, most commonly diagram is available in the appendix).