KPE162 - PECO Assignment

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Biology

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Dec 6, 2023

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1 1. Identify the principal / primary truth claim made in the assigned publication from a popular medium using the PECO format. In so doing, you must clearly specify what Population, Exposure, Comparator, and Outcome are involved (or whether that is unclear or indeterminate based on what is said in the publication). If the publication makes more than one truth claim, choose whatever you think the primary claim made is (that is, choose one to analyze). (2 marks) Overall truth claim: An overactive immune response (elevated inflammatory cytokine levels) to the mRNA Covid vaccines is the cause of rare cases of myocarditis in some young men. Population : young men, specifically 23 patients (mostly male: 87%) ages 13 to 21 Exposure : Pfizer-BioNTech or Moderna vaccine. Control : Unstated in the popular press article (healthy vaccinated patients) Outcome : elevated cytokine levels in blood samples of those exposed to the vaccine → plays a role in tissue inflammation which is claimed to cause inflammation of heart tissue and myocarditis 1. Does the scholarly article referenced by the popular medium address the PECO question identified in question 1? Briefly explain how or why it does or does not address the PECO question identified in question 1. (1 mark) The scholarly article referenced by the popular medium does well in addressing the PECO question of the underlying mechanisms that cause myocarditis, regarding the SARS-CoV- 2 mRNA vaccines. The truth claim made by the popular press article suggests that myocarditis can be attributed to inflammation due to elevated cytokine levels. This is reflected in the study, stating that, “our results demonstrate up-regulation in inflammatory cytokines and corresponding lymphocytes with tissue-damaging capabilities, suggesting a cytokine-dependent pathology,” (Barmada et al. , 2023). 2. Does the truth claim identified above involve correlation, causation, or both? Does the scholarly article involve descriptive or experimental studies, or both? Briefly justify your answers. (1 mark) The truth claim identified above involves correlation. It seeks to identify the specific mechanisms of myocarditis arising from the COVID-19/SARs vaccine, however this is not possible with the nature of the study conducted. There was no independent variable being directly manipulated, rather researchers were observing different dependent variables between two groups; healthy vaccinated individuals and patients with myopericarditis. This is characteristic of a descriptive study, and studies of this nature are unable to yield insight into the direct cause-relationship between the claims being made. It yielded insight into the correlation between elevated inflammatory cytokines and myocarditis, however the direct causation of myocarditis is yet to be confirmed. 3. Does the popular medium publication accurately reflect, exaggerate, or misrepresent the scholarly literature it refers to? Briefly justify your answer. (1

2 mark) The popular medium publication slightly misrepresents the scholarly literature it refers to. This is because the popular medium population suggests a direct causation type relationship between myocarditis and elevated cytokine levels, “overactive immune response to the mRNA Covid vaccines may be the culprit in rare cases of heart inflammation,” (Lovelace, 2023). This is slightly inaccurate as the information in the scholarly source does not provide a direct conclusion into the causation relationship between vaccines, cytokine levels, and myocarditis, but rather yields insight into the correlation between these occurrences. Despite this slight misrepresentation, the information that the article presents is nevertheless mostly accurate.

3 References Alami, A., Villeneuve, P. J., Farrell, P. J., Mattison, D., Farhat, N., Haddad, N., Wilson, K., Gravel, C. A., Crispo, J. A. G., Perez-Lloret, S., & Krewski, D. (2023). Myocarditis and Pericarditis Post-mRNA COVID-19 Vaccination: Insights from a Pharmacovigilance Perspective. Journal of clinical medicine, 12(15), 4971. https://doi.org/10.3390/jcm12154971 Barmada, A., Klein, J., Ramaswamy, A., Brodsky, N. N., Jaycox, J. R., Sheikha, H., Jones, K. M., Habet, V., Campbell, M., Sumida, T. S., Kontorovich, A., Bogunovic, D., Oliveira, C. R., Steele, J., Hall, E. K., Pena-Hernandez, M., Monteiro, V., Lucas, C., Ring, A. M., … Lucas, C. L. (2023). Cytokinopathy with aberrant cytotoxic lymphocytes and profibrotic myeloid response in SARS-CoV-2 mRNA vaccine–associated myocarditis. Science Immunology , 8 (83), eadh3455–eadh3455. https://doi.org/10.1126/SCIIMMUNOL.ADH3455 Bozkurt, B., Kamat, I., & Hotez, P. J. (2021). Myocarditis With COVID-19 mRNA Vaccines. Circulation , 144 (6), 471–484. https://doi.org/10.1161/CIRCULATIONAHA.121.056135 Cadegiani F. A. (2022). Catecholamines Are the Key Trigger of COVID-19 mRNA Vaccine-Induced Myocarditis: A Compelling Hypothesis Supported by Epidemiological, Anatomopathological, Molecular, and Physiological Findings. Cureus, 14(8), e27883. https://doi.org/10.7759/cureus.27883 Cushion, S., Arboleda, V., Hasanain, Y., Demory Beckler, M., Hardigan, P., & Kesselman, M. M. (2022). Comorbidities and Symptomatology of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2)-Related Myocarditis and SARS-CoV-2 Vaccine-Related Myocarditis: A Review. Cureus, 14(4), e24084. https://doi.org/10.7759/cureus.24084

4 Delıce, A. (2010). The sampling issues in quantitative research. Kuram Ve Uygulamada Eğitim Bilimleri, 10(4), 2001-2018. http://myaccess.library.utoronto.ca/login?qurl=https%3A %2F%2Fwww.proquest.com%2Fscholarly-journals%2Fsampling-issues-quantitative- research%2Fdocview%2F1431011942%2Fse-2%3Faccountid%3D14771 1 Hromić-Jahjefendić, A., Sezer, A., Aljabali, A. A. A., Serrano-Aroca, Á., Tambuwala, M. M., Uversky, V. N., Redwan, E. M., Barh, D., & Lundstrom, K. (2023). COVID-19 Vaccines and Myocarditis: An Overview of Current Evidence. Biomedicines, 11(5), 1469. https://doi.org/10.3390/biomedicines11051469 Hsieh, M. H., & Yamaguchi, Y. (2022). Immune Response in Regard to Hypersensitivity Reactions after COVID-19 Vaccination. Biomedicines, 10(7), 1641. https://doi.org/10.3390/biomedicines10071641 Husby, A., Hansen, J. V., Fosbøl, E., Thiesson, E. M., Madsen, M., Thomsen, R. W., Sørensen, H. T., Andersen, M., Wohlfahrt, J., Gislason, G., Torp-Pedersen, C., Køber, L., & Hviid, A. (2021). SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study. BMJ (Clinical research ed.), 375, e068665. https://doi- org.myaccess.library.utoronto.ca/10.1136/bmj-2021-068665 Kim, I. C., Kim, H., Lee, H. J., Kim, J. Y., & Kim, J. Y. (2021). Cardiac Imaging of Acute Myocarditis Following COVID-19 mRNA Vaccination. Journal of Korean medical science, 36(32), e229. https://doi- org.myaccess.library.utoronto.ca/10.3346/jkms.2021.36.e229 Kyaw, T., Drummond, G., Bobik, A., & Peter, K. (2023). Myocarditis: causes, mechanisms, and evolving therapies. Expert opinion on therapeutic targets, 27(3), 225–238. https://doi.org/10.1080/14728222.2023.2193330 1 Source was used in part 4- Reflection on Evidentiary Support, and is unrelated to the truth claim.

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