Cumulative effects of excess high-normal alanine aminotransferase levels in relation to new-onset metabolic dysfunction-associated fatty liver disease in China

BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected.The incidence rate,cumulative times,and equally and unequally weighted cumulative effects of excess high-normal ALT levels(ehALT)were measured.Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.RESULTS A total of 83.13%of participants with MAFLD had normal ALT levels.The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group.Compared with those in the low-normal ALT group,the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651[95%confidence interval(CI):1.199-2.273]and 1.535(95%CI:1.119-2.106)in the third quartile and 1.616(95%CI:1.162-2.246)and 1.580(95%CI:1.155-2.162)in the fourth quartile,respectively.CONCLUSION Most participants with MAFLD had normal ALT levels.Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.

Dynamics of information diffusion and disease transmission in time-varying multiplex networks with asymmetric activity levels

While the interaction between information and disease in static networks has been extensively investigated,many studies have ignored the characteristics of network evolution.In this study,we construct a new two-layer coupling model to explore the interactions between information and disease.The upper layer describes the diffusion of disease-related information,and the lower layer represents the disease transmission.We then use power-law distributions to examine the influence of asymmetric activity levels on dynamic propagation,revealing a mapping relationship characterizing the interconnected propagation of information and diseases among partial nodes within the network.Subsequently,we derive the disease outbreak threshold by using the microscopic Markov-chain approach(MMCA).Finally,we perform extensive Monte Carlo(MC)numerical simulations to verify the accuracy of our theoretical results.Our findings indicate that the activity levels of individuals in the disease transmission layer have a more significant influence on disease transmission compared with the individual activity levels in the information diffusion layer.Moreover,reducing the damping factor can delay disease outbreaks and suppress disease transmission,while improving individual quarantine measures can contribute positively to disease control.This study provides valuable insights into policymakers for developing outbreak prevention and control strategies.

Dynamic characteristics of coal specimens with varying static preloading levels under low-frequency disturbance load

The mechanical properties of residual coal pillars under the influence of upward mining disturbances significantly affect the safety of residual mining activities on working faces.This study conducted low-frequency disturbance dynamic uniaxial compression tests on coal specimens using a self-developed dynamic-static load coupling electro-hydraulic servo system,and studied the strength evolutions,surface deformations,acoustic emission(AE)characteristic parameters,and the failure modes of coal specimens with different static preloading levels were studied.The disturbance damage is positively correlated with the coal specimen static preload level.Specifically,the cumulative AE count rates of the initial accelerated damage stage for the coal specimens with static preloading level of 60%and 70%of the uniaxial compressive strength(UCS)were 2.66 and 3.19 times that of the 50%UCS specimens,respectively.Macroscopically,this behaviour manifested as a decrease in the compressive strength,and the mean strengths of the disturbance-damaged coal specimens with 60%and 70%of UCS static preloading decreased by 8.53%and 9.32%,respectively,compared to those of the specimens under pure static loading.The crack sources,such as the primary fissures,strongly control the dynamic response of the coal specimen.The difference between the dynamic responses of the coal specimens and that of dense rocks is significant.

Source and level of dietary iron influence semen quality by affecting inflammation, oxidative stress and iron utilization levels in boars

Background Boars fed a mixed form of inorganic and organic iron in excess of the NRC recommended levels still develop anemia,which suggested that the current level and form of iron supplementation in boar diets may be inappropriate.Therefore,56 healthy Topeka E line boars aged 15–21 months were randomly divided into 5 groups:basal diet supplemented with 96 mg/kg ferrous sulfate(FeSO_(4))and 54 mg/kg glycine chelated iron(Gly-Fe,control);80 mg/kg or 115 mg/kg Gly-Fe;80 mg/kg or 115 mg/kg methionine hydroxyl analogue chelated iron(MHA-Fe,from CalimetFe)for 16 weeks.The effects of dietary iron supplementation with different sources and levels on semen quality in boars were investigated.Results 1)Serum Fe and hemoglobin concentrations were not affected by reduced dietary iron levels in the 80 mg/kg or 115 mg/kg Gly-Fe and MHA-Fe groups compared with the control group(P>0.05).2)Serum interleukin-6(IL-6)and sperm malondialdehyde(MDA)levels in the 80 mg/kg or 115 mg/kg MHA-Fe groups were lower than those in the control group(P<0.05),and higher serum superoxide dismutase levels and lower MDA levels in the 115 mg/kg MHA-Fe group(P<0.05).3)Boars in the 80 mg/kg or 115 mg/kg Gly-Fe and MHA-Fe groups had lower serum hepcidin(P<0.01),ferritin(P<0.05),and transferrin receptor(P<0.01)concentrations,and boars in the 115 mg/kg MHA-Fe group had higher seminal plasma Fe concentrations compared with the control group.4)Boars in the 80 mg/kg and 115 mg/kg MHA-Fe groups had lower abnormal sperm rate and in situ oscillating sperm ratio compared to the control group at weeks 12 and/or 16 of the trial.However,the effect of Gly-Fe on improving semen quality in boars was not evident.5)Serum IL-6 level was positively correlated with hepcidin concentration(P<0.05),which in turn was significantly positively correlated with abnormal sperm rate(P<0.05).Furthermore,significant correlations were also found between indicators of iron status and oxidative stress and semen quality parameters.Conclusions Dietary supplementation with 80 mg/kg or 115 mg/kg MHA-Fe did not induce iron deficiency,but rather reduced serum inflammatory levels and hepcidin concentration,alleviated oxidative stress,increased body iron utilization,and improved semen quality in adult boars.

Antibody Levels and Infection Status of Pertussis in the Population under Pertussis Resurgence in Guangxi in 2018:A Cross-Sectional Survey

Objective Pertussis cases have increased markedly since 2018 in Guangxi.The aim of this study was to evaluate antibody levels and the infection status of pertussis in the resident population.Method A total of 10,215 serum samples from residents were collected from August-November 2018 and tested for anti-pertussis IgG and toxin IgG using the enzyme-linked immunosorbent assay(ELISA).Results Of the collected samples,1,833(17.94%)tested positive for anti-pertussis IgG,with the median concentration of 16.06 IU/mL.Antibody level<10 IU/mL accounted for more than 60%in children under 4 years of age,but declined with age,whereas the percentages of the other three levels(10-40,40-50,and≥50 IU/mL)increased almost with age(P<0.001).Moreover,7,924 samples were selected for anti-pertussis toxin IgG,of which 653(8.24%)tested positive(≥40 IU/mL)with the median concentration of 5.89 IU/mL,and 204 participants(2.56%)had recent pertussis infection(≥100 IU/mL).Among the different age groups,the highest rates of positivity and recent infection were observed at 11-20 years of age,the lowest positivity rate at 5 years of age,and the lowest recent infection rate at 4 years of age(P<0.001,P=0.005,respectively).Conclusion The survey results showed that all age groups in Guangxi lacked immunity against pertussis,which was one of the main factors contributing to the resurgence of pertussis in 2018.In addition,the prevalence of pertussis is relatively high in Guangxi,and its incidence is seriously underestimated,especially in adolescents and adults.

Levels of evidence and grades of recommendation supporting European society for medical oncology clinical practice guidelines

Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.

Adaptive Modeling of Monthly Depression Levels in Terms of Daily Assessments of Opioid Medications Taken and Pain Levels for Cancer Patients

A research study collected intensive longitudinal data from cancer patients on a daily basis as well as non-intensive longitudinal survey data on a monthly basis. Although the daily data need separate analysis, those data can also be utilized to generate predictors of monthly outcomes. Alternatives for generating daily data predictors of monthly outcomes are addressed in this work. Analyses are reported of depression measured by the Patient Health Questionnaire 8 as the monthly survey outcome. Daily measures include numbers of opioid medications taken, numbers of pain flares, least pain levels, and worst pain levels. Predictors are averages of recent non-missing values for each daily measure recorded on or prior to survey dates for depression values. Weights for recent non-missing values are based on days between measurement of a recent value and a survey date. Five alternative averages are considered: averages with unit weights, averages with reciprocal weights, weighted averages with reciprocal weights, averages with exponential weights, and weighted averages with exponential weights. Adaptive regression methods based on likelihood cross-validation (LCV) scores are used to generate fractional polynomial models for possible nonlinear dependence of depression on each average. For all four daily measures, the best LCV score over averages of all types is generated using the average of recent non-missing values with reciprocal weights. Generated models are nonlinear and monotonic. Results indicate that an appropriate choice would be to assume three recent non-missing values and use the average with reciprocal weights of the first three recent non-missing values.

Parameter-driven Level of Detail Derivation Method for Semantic Building Facade Model

The relentless progress in the research of geographic spatial data models and their application scenarios is propelling an unprecedented rich Level of Detail(LoD)in realistic 3D representation and smart cities.This pursuit of rich details not only adds complexity to entity models but also poses significant computational challenges for model visualization and 3D GIS.This paper introduces a novel method for deriving multi-LOD models,which can enhance the efficiency of spatial computing in complex 3D building models.Firstly,we extract multiple facades from a 3D building model(LoD3)and convert them into individual semantic facade models.Through the utilization of the developed facade layout graph,each semantic facade model is then transformed into a parametric model.Furthermore,we explore the specification of geometric and semantic details in building facades and define three different LODs for facades,offering a unique expression.Finally,an innovative heuristic method is introduced to simplify the parameterized facade.Through rigorous experimentation and evaluation,the effectiveness of the proposed parameterization methodology in capturing complex geometric details,semantic richness,and topological relationships of 3D building models is demonstrated.

The Impact of Optimizing Details in the Operating Room on the Level of Knowledge, Attitude, and Practice of Hospital Infection Prevention and Control by Surgeons, as Well as the Effectiveness of Infection Control

Objective: This paper aims to explore the impact of optimizing details in the operating room on the level of knowledge, attitude, and practice of hospital infection prevention and control by surgeons, as well as the effectiveness of infection control. Methods: From January 2022 to June 2023, a total of 120 patients were screened and randomly divided into a control group (routine care and hospital infection management) and a study group (optimizing details in the operating room). Results: Significant differences were found between the two groups in the data of surgeons’ level of knowledge, attitude, and practice in hospital infection prevention and control, infection rates, and nursing satisfaction, with the study group showing better results (P Conclusion: The use of optimizing details in the operating room among surgeons can effectively improve surgeons’ level of knowledge, attitude, and practice in hospital infection prevention and control, reduce infection occurrence, and is worth promoting.

Nested Levels of Hybrid Cryptographical Technique for Secure Information Exchange

Data security is a very important part of data transmission over insecure channels connected through high-speed networks. Due to COVID-19, the use of data transmission over insecure channels has increased in an exponential manner. Hybrid cryptography provides a better solution than a single type of cryptographical technique. In this paper, nested levels of hybrid cryptographical techniques are investigated with the help of Deoxyribonucleic Acid (DNA) and Paillier cryptographical techniques. In the first level, information will be encrypted by DNA and at the second level, the ciphertext of DNA will be encrypted by Paillier cryptography. At the decryption time, firstly Paillier cryptography will be processed, and then DAN cryptography will be processed to get the original text. The proposed algorithm follows the concept of Last Encryption First Decryption (LEFD) at the time of decryption. The computed results are depicted in terms of tables and graphs.

Employment and development levels in rural areas of the Russian Federation

The development of agro-industrial complex is important for ensuring national food security and national health.The development of rural areas is subject to the development of agriculture and local infrastructure,as well as the availability of various services.This study selected 15 indicators in 2021 to analyze the employment and development levels in rural areas of 71 regions of the Russian Federation using the analytical grouping method.The results indicated that 20 regions(Group 1)had the highest percentage of rural population(33.10%).The percentage of population engaged in agriculture had the highest value(12.40%)in 31 regions(Group 2).Moreover,20 regions(Group 3)had the highest investments in fixed assets at the expense of municipal budget(11.80 USD/person).Increasing the investments in fixed assets carried out from the budget of the municipality can improve the employment level in rural areas.Then,we used cluster analysis to divide 14 regions of the Volga Federal District in the Russian Federation into 3 clusters.Cluster 1 covered Kirov Region and Republic of Mari El;Cluster 2 included Ulyanovsk Region,Saratov Region,Nizhny Novgorod Region,Perm Territory,Orenburg Region,Chuvash Region,and Republic of Mordovia;and Cluster 3 contained Republic of Tatarstan,Samara Region,Udmurtian Republic,Penza Region,and Republic of Bashkortostan.Results indicated that the 2 regions of Cluster 1 need to increase the availability of resources and natural gas and improve the investment attractiveness of rural areas.The 7 regions of Cluster 2 needed to develop infrastructure,public services,and agricultural production.We found the highest employment level in rural areas,the largest investments in fixed assets at the expense of municipal budget,the largest residential building area per 10,000 persons,and the largest individual residential building area in the 5 regions of Cluster 3.This study makes it possible to draw up a comprehensive regional development program and proves the need for the development of rural areas,which is especially important for the sustainable development of the Russian Federation.

A Study on the Effects of Different Interaction Combinations and Language Levels on Continuous Writing in Online Environments

This study was conducted with non-English sophomore students,aiming to explore the effects of different interaction combinations and language levels on continuous writing in an online environment,and compare the differences in lexical alignments and composition quality of learners with different interaction combinations and language levels in the same continuous writing task through experiments.The results show that the mean values of the word-phrase alignment of the paired group were higher than those of the individual group in different interaction combinations,and the two groups showed significant differences;in terms of composition quality,the individual group was better than the paired group,but there was no significant difference between the two groups in terms of task continuation.Secondly,the word-phrase alignment and composition scores of the different language-level groups were higher than those of the same language-level groups,and there was a significant difference between the two groups in terms of word-phrase alignments,but not in terms of composition scores.The results of this study can be useful and informative for second language teachers in future continuous teaching in online environments.

Effect of TSH Suppression Therapy on Sex Hormone Levels after Thyroid Cancer Surgery

Objective:To analyze the effect of thyroid-stimulating hormone(TSH)suppression therapy on sex hormone levels in patients undergoing postoperative treatment for thyroid cancer.Methods:A total of 40 patients undergoing postoperative thyroid cancer treatment were selected for data analysis.TSH suppression therapy was implemented during the postoperative period.Patients were grouped according to the TSH level:TSH<0.1,0.1≤TSH<0.5,and TSH≥0.5.Results:Among male patients,there were no significant differences in sex hormone levels at different dosing times and TSH levels(P>0.05).For female patients,testosterone levels at different dosing times showed no significant differences under the same circumstances(P>0.05).The comparison of testosterone levels at different TSH levels over 5 years of TSH suppression therapy did not yield significant differences(P>0.05).However,the comparison of testosterone levels within 5 years of TSH suppression therapy yielded significant differences(P<0.05),with the lowest levels observed at 0.1≤TSH<0.5.Conclusion:The use of TSH suppression therapy in postoperative thyroid cancer treatment minimally affects sex hormone levels in male patients.However,it has a significant impact on female patients.Therefore,preoperative sex hormone testing is recommended,and postoperative monitoring should include regular sex hormone testing.

Comprehensive effects of traditional Chinese medicine treatment on heart failure and changes in B-type natriuretic peptide levels: A meta-analysis

BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are lacking.This study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF treatment.It encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established standards.The results offer crucial insights into the potential advantages and constraints of TCM in HF management.RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and PubMed.Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software.Finally,the quality of evidence was rated according to the GRADE criteria.RESULTS A total of 1098 RCTs were initially retrieved.After screening,16 RCTs were finally included in our study,which were published between 2020 and 2023.These RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 months.TCM syndrome differentiation was analyzed in 11 of the included RCTs.In all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP levels.The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0.61,-0.47;P<0.00001],TCM syndrome scores[weighted mean difference(WMD)=-142.07;95%CI=-147.56,-136.57;P<0.00001],and BNP levels(WMD=-142.07;95%CI=-147.56,-136.57;P<0.00001).According to the GRADE criteria,RCTs where"TCM improves clinical comprehensive outcomes"were rated as low-quality evidence,and RCTs where"TCM reduces TCM syndrome scores"or"TCM decreases BNP levels"were rated as medium-quality evidence.CONCLUSION TCM combined with CWM treatment effectively improves comprehensive clinical outcomes and diminishes TCM syndrome scores and BNP levels in HF patients.Given the low and medium quality of the included RCTs,the application of these results should be cautious.

Analgesic Effect of Combined Spinal-Epidural Anesthesia and its Effect on TNF-α and CRP Levels in Elderly Patients with Hip Fracture During Surgical Treatment

Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion.

基于能量函数基元提取的建筑物LOD2模型自动生成方法

近年来,随着实景三维中国和数字中国的快速发展,建筑物三维模型重建已成为智慧城市建设的重要环节。本文提出了一种全自动建筑物LOD2模型生成框架,旨在解决城市级实景三维场景中建筑物LOD2模型生成的难题。为了自动提取大场景建筑物对象,首先利用场景正射影像,通过图像分割获取建筑物的边界信息;然后使用改进的增强型平面区域分割方法提取高质量的分割平面,并利用混合线性模型对分割结果进行优化,能够更好地处理城市建筑物的局部破损和重建错误等问题。试验结果表明,本文算法生成的建筑物LOD2模型质量和效率更高,能够应对城市建筑模型的复杂情况,得到更稳健的重建结果。

Effects of Different Nitrogen Fertilizer Levels on Lodging and Yield of Rice

[Objective] This study aimed to investigate the effects of different fertilizer levels on lodging and yield of rice. [Method] A total of four treatments were designed and applied with 6, 9, 12 and 15 kg of nitrogen fertilizer, respectively. After seedling transplanting, the biological characteristics of rice at different growth stages in each treatment and the biological and economic characteristics of rice after lodging were determined for statistical analysis. [Result] Application with 15 kg of nitrogen fertilizer had significant promotion effect on the increase of rice yield; compared with the control (6 kg of nitrogen fertilizer), rice yield in three experimental treatments (9, 12 and 15 kg of nitrogen fertilizer, respectively) increased by 50.74%, 89.11% and 94.48%, respectively; lodging-resistance mechanical strengths of the three experimental treatments were 103.97%, 132.01% and 89.83% of the control, respectively; rice lodging resistance of treatment C (12 kg of nitrogen fertilizer) was the strongest, with the highest yield. [Conclusion] This study provides reference data and technical support for the rational fertilization of rice production.

Ridge regression energy levels calculation of neutral ytterbium(Z=70)

In view of the difficulty in calculating the atomic structure parameters of high-Z elements,the Hartree–Fock with relativistic corrections(HFR)theory in combination with the ridge regression(RR)algorithm rather than the Cowan code’s least squares fitting(LSF)method is proposed and applied.By analyzing the energy level structure parameters of the HFR theory and using the fitting experimental energy level extrapolation method,some excited state energy levels of the Yb I(Z=70)atom including the 4f open shell are calculated.The advantages of the ridge regression algorithm are demonstrated by comparing it with Cowan code’s LSF results.In addition,the results obtained by the new method are compared with the experimental results and other theoretical results to demonstrate the reliability and accuracy of our approach.

Air Pollution and Sex Hormone Levels among Mechanics in Brazzaville (Republic of Congo)

Air pollution is today a real concern across the world, responsible for around 7 million deaths per year around the world. It is currently involved in the appearance and worsening of several non-transmissible pathologies, making it an environmental, health, and societal problem. The objective of this work was to evaluate the effects of short-term exposure to air pollution on the level of sex hormones in mechanics. We conducted a cross-sectional, analytical, prospective case-control study in Brazzaville on 228 patients (76 cases and 152 controls) from June 2020 to December 2022, a period of 30 months. This study made it possible to evaluate, on the one hand, the level of sexual hormones in men exposed to automobile pollution according to the automated method (ELFA) on mini vidas and, on the other hand, the quality of the air by a colorimetric, punctual method on a Dräger tube coupled with a Dräger accuro pump. The results obtained made it possible to establish a statistically significant link between automobile pollutants (CO, CO2, NO2, SO2) and the increase in LH and FSH on the one hand and the decrease in testosterone on the other hand. We also noted that the concentrations of automotive pollutants during this study were all above the standards required by the WHO. Exposure to automobile pollutants affects the hypothalamic-pituitary axis and therefore disrupts the level of sex hormones.

Evolution of Acquired Humoral Immunity after Full Vaccination against SARS-CoV-2. IgG Levels in Healthcare Workers at 6 and 9 Months

Background: The COVID-19 pandemic continues to be a major worldwide health problem. The present study aims to contribute to surveillance of the immune and clinical response of vaccines to SARS-CoV-2. Methods: Observational medication study on acquired immunity and effectiveness of vaccines. Population: 620 workers in the health service of Almansa (Spain). Representative sample of 150 individuals. Sociodemographic, clinical, and epidemiological data and samples were recorded to determine anti-SARS-CoV-2 serum IgG levels 6 and 9 months after vaccination with Pfizer. Results: Mean age 46.45 years;76% women;85.1% working in a hospital. 19.3% had had COVID-19 in the year prior to vaccination. 96.7% were fully vaccinated with Pfizer/BioNTech. At 6 months, 100% seropositivity and mean IgG levels of 3017.2 AU/ml. Significant variations in IgG levels in individuals with prior COVID-19 infection and smokers. At 9 months, 99.3% remained seropositive;2.8% infected after vaccination. The repeated measures analysis showed a difference in means of 669.0 AU/ml (significant decrease in IgG levels of 28.9%). Conclusion: Antibody levels remained positive 6 and 9 months after vaccination, although IgG levels were found to decay.