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BackgroundThe emergence of novel SARS-CoV-2 variants challenges immunity, particularly among immunocompromised kidney transplant recipients (KTRs). To address this, vaccines have been adjusted to circulating variants. Despite intensive vaccination efforts, SARS-CoV-2 infections surged among KTRs during the Omicron wave, enabling a direct comparison of variant-specific immunity following-vaccination against Omicron BA.4/5 or Omicron infection in KTRs.Methods98 SARS-CoV-2 naïve KTRs who had received four vaccine doses were studied. Before and after a 5th antigen exposure, either via the bivalent vaccine composed of ancestral SARS-CoV-2 and Omicron BA.4/5 (29 KTRs) or via natural infection with Omicron (38 BA.4/5, 31 BA.1/2), spike-specific T cells were quantified using Elispot and serum pseudovirus neutralizing activity was assessed against the ancestral Wuhan strain, BA.5 and XBB.1.5.ResultsCompared to BA.4/5 vaccination, spike-specific T-cell responses and neutralization activity were higher up to six months post-Omicron infection and reached levels similar to healthy controls. Vaccinated KTRs showed modestly boosted neutralization activity against the Wuhan strain and BA.5, but not XBB.1.5. Baseline immunity correlated with immune responses three months post-vaccination and post-infection, indicating a predictive value for peak immune responses. Tixagevimab/Cilgavimab treatment was associated with robust neutralization of the Wuhan strain, but ineffective against XBB.1.5.ConclusionThe BA.4/5 vaccine improved neutralizing activity against the BA.4/5 variant, but not against the subsequently circulating XBB.1.5 variant in KTRs. Conversely, omicron infection boosted T cells and humoral responses more effectively, showing efficacy against XBB.1.5. These findings suggest that infection-induced immunity associates with greater protection than vaccination against future variants in KTRs.

Mechanical impingement of the rotator cuff tendons against the acromion (subacromial) and glenoid (internal) during shoulder motions has long been thought to contribute to tears. Clinically, the risk for impingement is thought to be influenced by scapular movement impairments. Therefore, our purpose was to determine the extent to which simulated changes in scapular orientation impact the proximity between the rotator cuff tendon footprint and the acromion and glenoid during scapular plane abduction. Specifically, shoulder kinematics were tracked in 25 participants using a high-speed biplane videoradiography system. Scapular movement impairments were simulated by rotating each participant's scapula from their in vivo orientation about the scapular axes (±2°, ±5°, and ±10°). Subacromial and internal proximities were described using minimum distances, proximity center locations, and prevalence of contact. Statistical parametric mapping was used to investigate the extent to which these measures were impacted by simulated changes in scapular orientation. Simulated changes in scapular orientation significantly altered proximity patterns in a complex manner that depended on the impingement mechanism, humerothoracic elevation angle, and magnitude of the simulated change. Clinicians should be mindful of these factors when interpreting the potential effects during a clinical examination. [ABSTRACT FROM AUTHOR]

How instructional sequences guide learning processes are often regarded as a neutral act. However, does designing instruction carry a politics? This investigation explores how instruction is made as a pedagogical object. The purpose is to explore the epistemological principles and conceptual framework that produce instruction's formalized pedagogical processes, each of which carries uncontested cultural and political aspects. Through textual analysis, the article considers theoretically and historically the problem of how instruction's design entangles people, power, and technology to operate as social technology, making up human kinds when instruction is designed as rule-bound programming--as an algorithm. Such algorithms engineer cultural action to engineer more harmonious human relations, embodying a greater political project that closes a technocultural lag, ameliorating human deficiencies while producing social exclusion and inequality.

Capital joins the list of monumental works that are "very famous and almost unknown", writes Jonathan Ree in his review of a new English translation by Paul Reitter, edited by [...]

Leo Tolstoy's War and Peace rejected the "great man" theory of history, made fashionable by Thomas Carlyle. Napoleon, Cromwell and Caesar were "history's slaves", fulfilling the will of Providence, argued [...]

On my first visit to Edinburgh I was taken to see the memorial erected to Greyfriars Bobby, the terrier who spent fourteen years guarding the tomb of his owner, John [...]

Having been entranced by a vision of the youthful Marie Antoinette, 'glittering like the morning star', Edmund Burke raged at the Queen of France's execution at the hands of uncouth [...]

The James Baldwin revival continues in the 100th anniversary year of his birth. A trickle of biographies has become a flood, and the causes for which he stood, racial equality [...]

Most of the northeastern region of Brazil (NEB) has a maize production system based on family farming, with no technological advances and totally dependent on the natural rainfall regime, which is concentrated in 4 to 5 months in most parts of the region. This means that the productivity of this crop is low in the NEB. In the northern mesoregions of the NEB, rainfall is concentrated between January and June, in the east of the NEB from April to September, and in the west of the NEB from October to March. The growing season takes place during these semesters. With this in mind, our objective was to develop a model based on canonical correlation analysis (CCA) to predict corn production in the mesoregions of the NEB between 1981 and 2010, using accumulated precipitation per semester as the predictor variable and predicting the observed production in kg/ha. Our results showed that the CCA model presented higher correlations between observed and simulated production than that obtained simply from the direct relationship between accumulated rainfall and production. The other two metrics used, RMSE and NRMSE, showed that, on average, in most mesoregions, the simulation error was around 200 kg/ha, but the accuracy was predominantly moderate, around 29% in most mesoregions, with values below 20% in six mesoregions, indicative of better model accuracy, and above 50% in two mesoregions, indicative of low accuracy. In addition, we investigated how the different combinations between two modes of climate variability with a direct influence on precipitation in the NEB impacted production in these 30 years, with the combination of El Niño and a positive Atlantic dipole being the most damaging to harvests, while years when La Niña and a negative Atlantic dipole acted together were the most favorable. Despite the satisfactory results and the practical applicability of the model developed, it should be noted that the use of only one predictor, rainfall, is a limiting factor for better model simulations since other meteorological variables and non-climatic factors have a significant impact on crops. However, the simplicity of the model and the promising results could help agricultural managers make decisions in all the states that make up the NEB.

Novels that make the Booker prize shortlist often get overlooked in the TLS's Books of the Year feature. This year, however, Percival Everett's reimagining of Huckleberry Finn, James, received more [...]

Contemplating his likely end, Vladimir Putin's gadfly opponent Alexei Navalny joked that his memoir, Patriot (reviewed by Wendy Slater), was bound to be a bestseller--'The book's author has been murdered [...]

Asked why he liked horror films, or terror films as he preferred to call them, Kingsley Amis wrote: "like Mark Twain on a dissimilar occasion, I have an answer to [...]

The popular story of the glory that was Greece begins at the monumental Lion Gate of the Bronze Age citadel of Mycenae, attributed to the work of giant Cyclopes by [...]

Sylvia Plath once said that 'nothing stinks like a pile of unpublished writing'. Ted Hughes curated two editions of her prose in 1977 and 1979, but admitted that his selections [...]

'Does Britain have a national literature?', asks Tim Parks in his first Afterthoughts column. Once upon a time the Italians drove nothing but Italian cars, owned Italian refrigerators, ate and [...]

James Baldwin declared that "the great problem" was "how to be--in the best sense of that kaleidoscopic word--a man". Ralf Webb's study of literary masculinity in mid-century America, Strange Relations, [...]

Trypanosomatid parasites undergo developmental regulation to adapt to the different environments encountered during their life cycle. In Trypanosoma brucei, a genome wide selectional screen previously identified a regulator of the protein family ESAG9, which is highly expressed in stumpy forms, a morphologically distinct bloodstream stage adapted for tsetse transmission. This regulator, TbREG9.1, has an orthologue in Trypanosoma congolense, despite the absence of a stumpy morphotype in that parasite species, which is an important cause of livestock trypanosomosis. RNAi mediated gene silencing of TcREG9.1 in Trypanosoma congolense caused a loss of attachment of the parasites to a surface substrate in vitro, a key feature of the biology of these parasites that is distinct from T. brucei. This detachment was phenocopied by treatment of the parasites with a phosphodiesterase inhibitor, which also promotes detachment in the insect trypanosomatid Crithidia fasciculata. RNAseq analysis revealed that TcREG9.1 silencing caused the upregulation of mRNAs for several classes of surface molecules, including transferrin receptor-like molecules, immunoreactive proteins in experimental bovine infections, and molecules related to those associated with stumpy development in T. brucei. Depletion of TcREG9.1 in vivo also generated an enhanced level of parasites in the blood circulation consistent with reduced parasite attachment to the microvasculature. The morphological progression to insect forms of the parasite was also perturbed. We propose a model whereby TcREG9.1 acts as a regulator of attachment and development, with detached parasites being adapted for transmission.

ABSTRACT BACKGROUND: Achalasia is an esophageal motility disorder, with clinical presentation of dysphagia and regurgitation. This is a chronic condition with no cure. Current treatment options aim to reduce lower esophageal sphincter tone by pharmacological, endoscopic or surgical means, with the aim of improving patients’ symptoms. Peroral endoscopic myotomy (POEM) is an alternative endoscopic surgery to Heller cardiomyotomy, in which the procedure is performed orally, by endoscopy, offering efficacy comparable to surgical myotomy, with relative ease and minimal invasion, without external incisions. AIMS: To study the safety of POEM by analyzing its results, adverse events and perioperative complications and the main ways to overcome them, in addition to evaluating the effectiveness of the procedure and the short-term postoperative quality of life. METHODS: A qualitative and quantitative, observational and cross-sectional study that analyzed patients who underwent the POEM in a reference center, from December 2016 to December 2022, maintaining the technical standard of pre-, peri- and postoperative protocol. RESULTS: A total of 94 patients were included in the study, and only three had postoperative complications. The average early postoperative Eckardt score was 0.93 and the late 1.40, with a mean improvement of 7.1 in early results and 6.63 in late results (p

The Victorians astound us with their energy. The most famous Victorian of them all, after the queen herself, William Gladstone chopped down trees for exercise. With equal vigour he kept [...]

Moral panic over the habits of the young will always be with us. 'Reefer madness' in the 1930s was followed by the 'posture panic' over slouching American teenagers in the [...]

The most common and destructive form of conflict is civil war', writes Brian Holden Reid in his review of the latest edition of The New Makers of Modern Strategy, for [...]

Is Joe Biden fit to serve a second term as president of the United States? After a faltering performance in his first debate with Donald Trump last month, many of [...]

In the musical My Fair Lady, Henry Higgins, an archetypal male intellectual bully, complains: 'Why can't a woman be more like a man?' The anthropologist and primatologist Sarah Blaffer Hrdy's [...]

Some writers have peculiar ideas about getting away from it all. One of Mary Beard's choices for our Summer Books feature is brave, even masochistic. The TLS's Classics Editor thinks [...]

Sigmund Freud gets his turn on the couch in this week's TLS. Frank Tallis's Mortal Secrets, reviewed by George Prochnik, asks intriguing questions of psychoanalysis's founding father that bear on [...]