Purpose: A 2-dose varicella vaccination strategy has been introduced in many countries worldwide, aiming to increase vaccine effectiveness (VE) against varicella infection. In this network meta-analysis, we aimed to provide a comprehensive evaluation and an overall estimated effect of varicella vaccination strategies, via a Bayesian model. Methods: For each eligible study, we collected trial characteristics, such as: 1-dose vs. 2-dose, demographic characteristics, and outcomes of interest. For studies involving different doses, we aggregated the data for the same number of doses delivered into one arm. The preventive effect of 1-dose vs. 2-dose of varicella vaccine were evaluated in terms of the odds ratio (OR) and corresponding equal-tailed 95% confidence interval (95% CI). Results: A total of 903 studies were retrieved during our literature search, and 25 interventional or observational studies were selected for the Bayesian network metaanalysis. A total of 49,265 observed individuals were included in this network meta-analysis.Compared to the 0-dose control group, the OR of all varicella infections were 0.087 (95% CI, 0.046–0.164) and 0.310 (95% CI, 0.198–0.484) for 2-doses and one-dose, respectively, which corresponded to VE of 69.0% (95% CI, 51.6–81.2) and VE of 91.3% (95% CI, 83.6–95.4) for 1- and 2-doses, respectively. Conclusions A 2-dose vaccine strategy was able to significantly reduce varicella burden.The effectiveness of 2-dose vaccination on reducing the risk of infection was demonstrated by sound statistical evidence, which highlights the public health need for a 2-dose vaccine recommendation.

Objectives: Remote ischemic preconditioning (rIPC) is a novel technique in which brief episodes of ischemia and reperfusion in one organ confer protection against prolonged ischemia in a distant organ.In contrast, anesthetic-induced preconditioning (APC) utilizes volatile anesthetics to protect multiple organs from ischemia-reperfusion injury. Both methods are easily integrated into various clinical scenarios for cardioprotection. However, it remains unclear whether simultaneous application of these techniques could result in complementary, additive, synergistic, or adverse effects. Methods: An adult rabbit heart Langendorff model of global ischemia/reperfusion injury was used to compare the cardioprotective effect of rIPC and APC alone and in combination relative to untreated (control) hearts. The rIPC group underwent four cycles of 5-minute ischemia on the hind limb, each followed by 5 minutes of reperfusion. The APC group received 2.5 vol% sevoflurane for 20 minutes via a face mask, followed by a 20-minute washout period. Results: Both in vivo rIPC, induced by four 5-minute cycles of ischemia/reperfusion on the hind limb, and APC, administered as 2.5 vol% sevoflurane via a mask, significantly reduced the size of myocardial infarction following 30 minutes of global ischemia by >50% compared to the untreated control group (rIPC, 12.1±1.7%; APC, 13.5±2.1%; P<0.01 compared to control, 31.3±3.0%). However, no additional protective effect was observed when rIPC and APC were combined (rIPC+APC, 14.4±3.3%). Conclusion Although combining rIPC and APC did not provide additional protection, there was no inhibitory effect of one intervention on the other.

Objectives: Remote ischemic preconditioning (rIPC) is a novel technique in which brief episodes of ischemia and reperfusion in one organ confer protection against prolonged ischemia in a distant organ.In contrast, anesthetic-induced preconditioning (APC) utilizes volatile anesthetics to protect multiple organs from ischemia-reperfusion injury. Both methods are easily integrated into various clinical scenarios for cardioprotection. However, it remains unclear whether simultaneous application of these techniques could result in complementary, additive, synergistic, or adverse effects. Methods: An adult rabbit heart Langendorff model of global ischemia/reperfusion injury was used to compare the cardioprotective effect of rIPC and APC alone and in combination relative to untreated (control) hearts. The rIPC group underwent four cycles of 5-minute ischemia on the hind limb, each followed by 5 minutes of reperfusion. The APC group received 2.5 vol% sevoflurane for 20 minutes via a face mask, followed by a 20-minute washout period. Results: Both in vivo rIPC, induced by four 5-minute cycles of ischemia/reperfusion on the hind limb, and APC, administered as 2.5 vol% sevoflurane via a mask, significantly reduced the size of myocardial infarction following 30 minutes of global ischemia by >50% compared to the untreated control group (rIPC, 12.1±1.7%; APC, 13.5±2.1%; P<0.01 compared to control, 31.3±3.0%). However, no additional protective effect was observed when rIPC and APC were combined (rIPC+APC, 14.4±3.3%). Conclusion Although combining rIPC and APC did not provide additional protection, there was no inhibitory effect of one intervention on the other.

Objectives: Remote ischemic preconditioning (rIPC) is a novel technique in which brief episodes of ischemia and reperfusion in one organ confer protection against prolonged ischemia in a distant organ.In contrast, anesthetic-induced preconditioning (APC) utilizes volatile anesthetics to protect multiple organs from ischemia-reperfusion injury. Both methods are easily integrated into various clinical scenarios for cardioprotection. However, it remains unclear whether simultaneous application of these techniques could result in complementary, additive, synergistic, or adverse effects. Methods: An adult rabbit heart Langendorff model of global ischemia/reperfusion injury was used to compare the cardioprotective effect of rIPC and APC alone and in combination relative to untreated (control) hearts. The rIPC group underwent four cycles of 5-minute ischemia on the hind limb, each followed by 5 minutes of reperfusion. The APC group received 2.5 vol% sevoflurane for 20 minutes via a face mask, followed by a 20-minute washout period. Results: Both in vivo rIPC, induced by four 5-minute cycles of ischemia/reperfusion on the hind limb, and APC, administered as 2.5 vol% sevoflurane via a mask, significantly reduced the size of myocardial infarction following 30 minutes of global ischemia by >50% compared to the untreated control group (rIPC, 12.1±1.7%; APC, 13.5±2.1%; P<0.01 compared to control, 31.3±3.0%). However, no additional protective effect was observed when rIPC and APC were combined (rIPC+APC, 14.4±3.3%). Conclusion Although combining rIPC and APC did not provide additional protection, there was no inhibitory effect of one intervention on the other.

Background: This study aimed to investigate the epidemiological characteristics and outcomes of myocarditis/pericarditis after BNT162b2 vaccination in Korean adolescents. Methods: This was a retrospective cohort analysis of adolescents aged 12–19 years old diagnosed with myocarditis/pericarditis within 42 days of BNT162b2 mRNA vaccination. All reported cases were investigated by city or government epidemiologists and the diagnostic certainty and causality was determined by the Korea Disease Control and Prevention Agency’s Adverse Event Following Immunization Expert Advisory Committee according to the modified version of Brighton Collaboration Myocarditis/Pericarditis Working group’s case definitions. Results: A total 3,709,063 adolescents aged 12–19 received 8,135,240 doses of the BNT162b2 vaccine in South Korea, and 184 cases met the Brighton criteria for the case definition of myocarditis and pericarditis with diagnostic certainty of possible and above. The median age was 17 years old (interquartile range [IQR], 15–18) and boys accounted for 81.5% (n = 150/184) of the cases. The overall incidence was 2.25 (95% confidence interval [CI], 1.94–2.60) cases per 100,000 doses and severe cases was 0.25 (95% CI, 0.15–3.80) cases per 100,000 doses.The highest incidence rate was observed in boys after the second dose, with 5.01 (95% CI, 4.12–6.17) cases per 100,000 doses. A total 89.1% (164/184) were classified as mild, and no deaths were reported. Conclusion The highest incidence of myocarditis/pericarditis after BNT162b2 immunization was observed in male adolescents after the second dose, with majority of the cases presenting with a mild clinical course and favorable outcome.

Background: This study aimed to investigate the epidemiological characteristics and outcomes of myocarditis/pericarditis after BNT162b2 vaccination in Korean adolescents. Methods: This was a retrospective cohort analysis of adolescents aged 12–19 years old diagnosed with myocarditis/pericarditis within 42 days of BNT162b2 mRNA vaccination. All reported cases were investigated by city or government epidemiologists and the diagnostic certainty and causality was determined by the Korea Disease Control and Prevention Agency’s Adverse Event Following Immunization Expert Advisory Committee according to the modified version of Brighton Collaboration Myocarditis/Pericarditis Working group’s case definitions. Results: A total 3,709,063 adolescents aged 12–19 received 8,135,240 doses of the BNT162b2 vaccine in South Korea, and 184 cases met the Brighton criteria for the case definition of myocarditis and pericarditis with diagnostic certainty of possible and above. The median age was 17 years old (interquartile range [IQR], 15–18) and boys accounted for 81.5% (n = 150/184) of the cases. The overall incidence was 2.25 (95% confidence interval [CI], 1.94–2.60) cases per 100,000 doses and severe cases was 0.25 (95% CI, 0.15–3.80) cases per 100,000 doses.The highest incidence rate was observed in boys after the second dose, with 5.01 (95% CI, 4.12–6.17) cases per 100,000 doses. A total 89.1% (164/184) were classified as mild, and no deaths were reported. Conclusion The highest incidence of myocarditis/pericarditis after BNT162b2 immunization was observed in male adolescents after the second dose, with majority of the cases presenting with a mild clinical course and favorable outcome.