bluuebunny/crossref_metadata_2025 huggingface dataset:
MO221: Glomerulopathies After COVID-19 Vaccination. Report of Cases in Our Centre
Authors: Perea-Ortega Lara , Polo Criado Carolina , Hidalgo Guzman Pilar , Laura Fuentes Sanchez Maria , Toledo Rojas Remedios
Published: May 2022

BACKGROUND AND AIMS

After the start of the vaccination campaign against the SARS-COV-2 pandemic, it is possible that the number of cases of de novo and relapsing glomerulopathies will increase.

So far, most of the publications related to post-vaccination minimal change disease (also associated with other vaccines against influenza virus, hepatitis B, pneumococcus, etc.) and IgA nephropathy. However, post-vaccination cases of membranous nephropathy, ANCA vasculitis or anti-glomerular basement membrane glomerulonephritis are anecdotal.

Likewise, there are no cases of segmental and focal glomerulonephritis published in the literature.

We present the cases that have appeared in our centre in order to support the theory of a more than probably causal relationship. We highlight two cases of focal and segmental glomerulonephritis, making this publication the first to report this pathology post-vaccination.

METHOD

We present a total of 8 cases reported in our centre since the start of the vaccination campaign. We only considered cases that started with symptoms within 1 month after the first or second dose of the SARS Cov2 vaccine.

Histological diagnosis was obtained in four patients with de novo glomerulopathy. In the other four patients with a flare of their baseline disease, renal biopsy was not performed. In these patients, the diagnosis of recurrence was made on the basis of laboratory and clinical data.

RESULTS

Five patients of the total that appeared in our centre developed minimal change disease (4 of them were recurrences and 1 de novo), 2 cases of de novo focal and segmental glomerulomephritis and 1 case of de novo IgA nephropathy.

Nephrotic range proteinuria and macroscopic haematuria were the most frequent symptoms in our patients and completely reversed after immunosuppressive treatment or, in some cases, with supportive care.

All of them received mRNA-based vaccines (six patients with Pfizer and two with Moderna). The mean time to onset of symptoms after vaccination was 13 days.

There was no difference in sex and the mean age was 40 years.

CONCLUSION

The development of vaccines has been a key factor in the control of the SARS Cov-2 pandemic. The cases reported so far are minimal, compared with the millions of doses administered, so the benefits exceed the risks.

However, according to the literature, we recommend closer follow-up in patients with known glomerulopathies and to perform renal biopsy as soon as possible after the onset of symptoms related to post-vaccination renal disease.

In our centre, most of the cases appeared after the first dose of vaccination and we induced the administration of the remaining doses because all our patients did well with treatment. However, we suggested that one option might be to delay, but not to stop, the second dose in order not to interfere with the immune response to vaccination in patients who are receiving immunosuppression.
MO334: Incidence of AKI Among Hospitalized COVID-19 Patients During the First and Sixth Waves of the Pandemic
Authors: Ardura Paula , Lorenzo Arturo , Martínez Manrique María , Lucía Valencia Ana , Acosta-Ochoa Isabel , Mendiluce Alicia , Fidalgo Veronica , Reinaldo Sanchez Gil Jimmy , Coca Armando
Published: May 2022

BACKGROUND AND AIMS

During the last 2 years, we have witnessed several waves of the COVID-19 pandemic characterized by massive infections among the general population, sudden increases in the number of hospitalizations and variable rates of complications and mortality among patients.

Acute kidney injury (AKI) has been described as a common and serious complication of COVID-19. However, multiple factors that are involved in the development of this complication have been modified throughout these months, including the appearance of new variants of the virus, the modification of treatment protocols or the advancement of vaccination among the general population.

In this study, we aimed to compare the rates of AKI among patients who required admission due to COVID-19 in the first and current (sixth) waves of the pandemic.

METHOD

Consecutive patients that required admission due to COVID-19 in a tertiary referral hospital during the first (March to May 2020) and current (December 2021) waves of the pandemic were enrolled in the study. Patient characteristics, rates of AKI incidence, 28-day mortality and in-hospital length of stay were compared between groups. Viral infection was confirmed by real-time RT-qPCR in all cases. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines using peak serum creatinine and acute dialysis criteria. Multivariate logistic regression was performed to define potential predictors of AKI.

RESULTS

Table 1 summarizes demographic and clinical characteristics among enrolled patients. Compared with the current wave, patients admitted during the first wave were older, had higher baseline serum creatinine and lower baseline eGFR. During the first wave, patients presented higher peak serum creatinine values and a higher incidence of in-hospital AKI. Age, male sex, hypertension, diabetes, CKD and pandemic wave were included in multivariate logistic regression analysis as potential predictors of AKI. Only past history of hypertension [OR 2.867; 95% confidence interval (95% CI) 1.279–6.424; P-value: .011] and CKD (OR 2.418; 95% CI 1.237–4.73; P-value: .01) independently predicted AKI in the sample.

CONCLUSION

Despite multiple changes that have occurred throughout the pandemic, including new treatment protocols, the appearance of new variants of the virus with different clinical profiles or the extensive application of vaccines, these changes have not translated into a significant decrease in the risk of AKI among patients admitted due to COVID-19, which appears to still be conditioned mainly by comorbidities of each patient, including past history of CKD.
MO385: Performance of Creatinine-Based Equations to Estimate Glomerular Filtration Rate in White and Black Subjects From Europe, Brazil and Africa
Authors: Delanaye Pierre , Bjork Jonas , Vidal-Petiot Emmanuelle , Ebert Natalie , Odvar Eriksen Bjørn , Dubourg Laurence , Grubb Anders , Hansson Magnus , Lamb Edmund , Littman Karin , Mariat Christophe , Melsom Toralf , Schaeffner Elke , Sundin Per-Ola , Bokenkamp Arend , Berg Ulla , Asling-Monemi Kasja , Åkesson Anna , Larsson Anders , Cavalier Etienne , Dalton Neil , Courbebaisse Marie , Couzi Lionel , Gaillard François , Garrouste Cyril , Jacquemont Lola , Kamar Nassim , Legendre Christophe , Rostaing Lionel , Stehlé Thomas , Haymann Jean-Philippe , Selistre Luciano , Strogoff-de-Matos Jorge , Bukabau Justine , Sumaili Ernest , Yayo Eric , Monnet Dagui , Nyman Ulf , Pottel Hans , Flamant Martin
Published: May 2022

BACKGROUND AND AIMS

Current Glomerular filtration rate (GFR) estimating equations based on serum creatinine are facing increased criticism due to the inclusion of a race correction in black Americans with the CKD-EPI equation (CKD-EPIASR, A = Age, S = Sex, R = Race). A new equation without race (CKD-EPIAS) has been proposed. However, this equation was developed mainly from US cohorts. The performance of this new equation has been poorly compared with current European-developed creatinine-based equations, i.e. the Lund-Malmö Revised (LMR), and the new European Kidney Function Consortium (EKFC)

METHOD

Data from subjects over 18 years, representing 11 cohorts from Europe (previously described as the EKFC dataset, n = 13 856), and enhanced with data from Brazil (n = 100), France (n = 4429) and Africa [Democratic Republic of Congo (DRC) and Côte d'Ivoire, n = 508] were considered (n = 18 893 for the whole cohort). The EKFC cohort was considered as non-black population. All data from Africa derived from black individuals. From France, 964 subjects were self-reported as black (=Blacks from Paris). Measured GFR as a reference method and IDMS creatinine results were available. Median bias (eGFR—mGFR) with 95% confidence intervals (CI), imprecision (interquartile range: IQR), and P30 accuracy (percentage of eGFR-values within ± 30% of mGFR) with 95% CI were calculated.

RESULTS

Results are summarized in Table.

CONCLUSION

The new CKD-EPIAS has been launched in the USA for societal reasons and is now recommended by US guidelines. However, in Europe and Africa, its performance was suboptimal. The EKFC equation, using the usual Q values, or population-specific Q values (when available), displays the best performance over the whole age range for populations in Europe and Africa.
MO493: Covid-19 Among Romanian HAemodialysis Patients: Risk Factors and Outcomes. Data From the Romanian Renal Registry
Authors: Stefan Gabriel , Garneata Liliana , Podgoreanu Eugen , Mircescu Gabriel
Published: May 2022

BACKGROUND AND AIMS

During the COVID-19 pandemic, patients on maintenance heamodialysis (HD) are vulnerable due to their comorbidities, uremia-impaired immunity and limited physical distancing. We aimed to evaluate the risk factors and outcomes of SARS-CoV-2 infection in HD patients in our country.

METHOD

All HD patients enrolled in the national COVID-19 screening programme between 1 September 2020 and 28 February 2021, were included in this retrospective 6-month cohort study, with outcomes ascertained through 28 February 2021.

We excluded patients under 18 years who received a preemptive kidney graft, recovered kidney function or were lost to follow-up during the first 90 days of HD.

Screening for COVID-19 infection was performed by RT-PCR on nasopharyngeal swabs, every 14 days or at staff indication.

SARS-CoV-2 infection severity was defined as mild, moderate, severe and critical as previously described.

We aimed to evaluate the risk factors for COVID-19 as well as for all-causes of death within 90 days of COVID-19.

RESULTS

A total of 15 401 patients on maintenance HD were included. The median age was 64 years, and two-thirds were >60 years old; 57% were male. Glomerular, diabetic kidney and tubulo-interstitial diseases were the main causes of CKD (18, 11 and 10%, respectively).

During the 6-months, 5386 patients (35%) were COVID-19 positive. Compared with negative patients, they had longer vintages, were more often treated by public dialysis providers and had a higher mortality.

Patients in the first 90 days of HD treated by public providers were more prone to SARS-CoV-2 infection in the multivariate logistic regression analysis (Table 1A).

A total of 15% of the COVID-19 patients died; those with the critical SARS-CoV-2 infection had the lowest survival of 8%, followed by those with severe (35%), medium (72%) and asymptomatic (89%) (Fig. 1).

COVID-19 patients >70 years, of male sex, in the first 90 days of HD, with diabetic kidney disease, and from a public unit had higher mortality. Moreover, the same risk factors were retained in the multivariate Cox proportional hazard model (Table 1B).

CONCLUSION

The COVID-19 pandemic has had a substantial effect on mortality in HD patients affected by SARS-CoV-2 in Romania, especially those elderly and diabetic, with severe and critical clinical forms.
MO496: Serum Urea Levels and Cardiovascular Disease in Patients With Chronic Kidney Disease
Authors: Laville Solene , Couturier Aymeric , Lambert Oriane , Metzger Marie , Nicolas Mansencal , Jacquelinet Christian , Laville Maurice , Frimat Luc , Fouque Denis , Combe Christian , Robinson Bruce , Stengel Benedicte , Liabeuf Sophie , Massy Ziad
Published: May 2022

BACKGROUND AND AIMS

Elevated serum urea levels are common in moderate-to-advanced CKD. Several studies have shown that urea is a direct and indirect uremic toxin, especially with regard to cardiovascular disease. We sought to determine whether serum urea levels are associated with adverse cardiovascular events and death before kidney replacement therapy (KRT) in patients with CKD.

METHOD

CKD-REIN is a prospective cohort of CKD nephrology outpatients not receiving maintenance dialysis. The 2507 patients included in the analysis were divided into three groups according to the baseline serum urea level (T1 < 10.5, T2:10.5–15.1 and T3 ≥ 15.1 mmol/L). Cause-specific Cox proportional hazard models were used to estimate hazard ratios (HRs) for the first atheromatous or nonatheromatous cardiovascular (CV) events and all-cause mortality before KRT. The models were adjusted for baseline comorbidities, laboratory data, and medications. Cardiovascular events of the first 3 years of follow-up in the CKD-REIN study were assessed carefully according to the Cardiovascular and Stroke Endpoint Definitions for Clinical Trials. Each death before KRT occurring during the 5-year follow-up period was used in the all-cause mortality model.

RESULTS

Of the 2507 included patients {median [first quartile–third quartile (Q1–Q3)] age: 69 (61–77); mean (standard deviation) eGFR 33.5(11.6) mL/min/1.73 m²}, 54% had a history of cardiovascular disease.

Over a median follow-up of 3.0 years [Q1–Q3, 2.2–3.1], 451 experienced their first atheromatous or nonatheromatous cardiovascular event (fatal or nonfatal), leading to an incidence rate (IR) [95% confidence interval (95% CI)] of 7.1 (6.4–7.7)/100 person-years (PYs) (Fig. 1).

Over a median follow-up period of 4.8 (3.3–5.1) years, 407 patients died before KRT, leading to an IR of 4.0 (3.6–4.3)/100 PYs.

After multiple adjustments for cardiovascular risk factors (including eGFR), patients in T3 had a higher risk of atheromatous and nonatheromatous cardiovascular events than patients in T1 [HR (95% CI), 2.08 (1.50–2.88), Fig. 1]. A nonsignificant trend towards a higher risk was also noted for patients in T2 [1.28 (0.96–1.71)]. The adjusted HRs for death before KRT were 1.30 (0.96–1.75] and 1.73 (1.22–2.45) for patients in T2 and those in T3, respectively.

CONCLUSION

Beyond CV risk factors including eGFR, this hypothesis-generating study suggests that serum urea level is a predictor of cardiovascular outcomes in patients with moderate to advanced CKD. Further research is needed to confirm current findings and explore mechanisms.
MO778: Influence of Therapy on the Duration of First Arteriovenous Fistula in Haemodialysis Patients—A Multicenter Longitudinal Study
Authors: Knezevic Violeta , Azasevac Tijana , Celic Dejan , Petkovic Dobrila , Paunic Zoran , Dudic Svetlana , Stolic Radojica , Radovic Milan , Vavic Neven , Zivanov Dusan
Published: May 2022

BACKGROUND AND AIMS

A 5-year research was conducted on haemodialysis patients with the aim to determine the effect of therapy on the patency of arteriovenous fistula (AVF) for haemodialysis.

METHOD

The study included 338 haemodialysis patients with the incidence of the creation of AVF in 2014. Patients were divided into two groups, according to the duration time of AVF namely short-term (≤6 months) and long-term (>6 months) patency. Clinical and laboratory parameters were analysed as well as type and frequency of complications, characteristics of AVF and treatment. The data were analysed with a chi-squared test, ANOVA test and an ordinally logistic regression. There was a statistical significance, P <0.05.

RESULTS

From a total of 338 patients, the average age of 59.06 ± 12.45, 66.6% of patients were men. 80.7% of the patients were in the short-term group. Patients taking anti-platelet drugs make 14.8%, patients taking anticoagulation therapy and double anti-platelets therapy make 1.8%, patients taking statins, angiotensin-converting enzyme inhibitors (ACE)/angiotensin-receptor blockers (ARB) and calcium channel blockers make 47% and 2.6% of patients took no medication. The number of AVF complications was thrombosis in 19.1%, haemorrhage in 1.9%, aneurism and pseudoaneurysm in 0.5%, ‘Steal’ syndrome in 0.3%, infections in 0.3% and other complications in 2.2%. In accordance with the length of anti-platelets therapy (˂30 days, between 30 and 90 days, and ˃90 days) after the creation of AVF, it was concluded that the most influential effect was in the period between 30 and 90 days after creation. Patients with AVF for ˂6 months had significantly more vascular calcifications (P =.0017). The groups did not differ in the length of anti-platelets and anti-coagulation therapy before the creation of AVF (<1 year, >1 year, no therapy), time of maturity of AVF (4–6 weeks, 6–8 weeks, ˃8 weeks), indications for reducing or stopping with anti-platelets or anticoagulation therapy in the moment of AVF creation. Four models of ordinally logistic regression (2015, 2016, 2017, 2018) were created in which the dependent variables were the complications of AVF by years, the factors were the type of treatment and the frequency of each complication for each year, while the covariate was the number of months after the AVF creation (Table).

CONCLUSION

Patients that started taking anti-platelets drugs from 30 to 90 days of AVF, had AVF for a significantly longer time. The model showed in years states that the frequency of complications decreases over time and that there are more infections and other complications than thrombosis and haemorrhage.
MO984: Increased Mortality After Kidney Transplantation in Mildly Frail Recipients: Need for Pretransplant Intervention
Authors: Pascual Julio , Arias Cabrales Carlos , Redondo Pachon Dolores , Burballa Carla , Buxeda Anna , Bach Anna , Faura Anna , Marco Esther , Rodriguez Leocadio , Crespo Marta , José Pérez-Saéz María
Published: May 2022

BACKGROUND AND AIMS

Frailty is associated with a higher rate of complications and mortality after kidney transplantation (KT). Physical frailty phenotype (PFP) is the most used frailty instrument among KT recipients, it comprises five criteria and classifies patients as frail if they have ≥3. We aimed to determine the impact of scoring 1 PFP criterion (mild frailty) on transplant outcomes.

METHOD

We have prospectively followed 449 KT candidates evaluated for frailty by PFP at the time of inclusion on the KT waiting list. Patients were classified as follows: 0, robust; 1, pre-frail-1; 2, pre-frail-2; and ≥3, frail. A prospective longitudinal study was performed in all patients in the cohort who underwent KT. Clinical outcomes and survival after transplantation according to frailty status at listing was assessed.

RESULTS

About 71.3% of total listed cohort resulted to be pre-frail (one criterion 41%, two criteria 19.8%) or frail (10.5%). Disparities were observed between sexes, with 5.2% of men and 21.9% of women being frail (P  < 0.01). During the study period (median 26 months [IQR 16–39]), 296 patients got a KT and 153 remained listed. Patients who did not get transplanted were more frequently frail (16.3 versus 7.4%, P = 0.013). Frail patients had more hospital admissions during the first year after listing (43.4% if PFP ≥1 versus 20.8% if PFP = 0) and more cardiovascular events or major infectious events. In a multivariate model including only patients scoring 0 (robust) or prefail-1-criterion (n = 217), older age, previous cerebrovascular disease, peripheral vascular disease and mild pre-frailty were independent risk factors for mortality after KT (Figure 1).

CONCLUSION

Frailty is frequent in KT candidates, more frequent in women than men. Frail patients have less chances to receive a KT. KT candidates are frequently listed with one (out of five) frailty criterion, and this has an independent impact on patient survival after KT. A pre-transplant clinical framework for multimodal prehabilitation interventions to mitigate the effects of frailty and poor fitness after KT may be justified even in mildly pre-frail candidates.
FC 115: Long-Term Outcomes in Eculizumab-Treated Kidney Transplant Patients Enrolled in the Global Atypical Haemolytic Uraemic Syndrome Registry
Authors: Gema Ariceta Iraola Maria , Al-Dakkak Imad , Anokhina Katerina , Ardissino Gianluigi , Greenbaum Laurence A , Kumar Gurinder , Licht Christoph , Siedlecki Andrew , Van de Walle Johan
Published: May 2022

BACKGROUND AND AIMS

The global atypical haemolytic uraemic syndrome (aHUS) registry (NCT01522183), the largest repository of real-world data on patients with aHUS, provides key insights into disease course, natural history, and patient (pt) outcomes with and without complement inhibitor therapy. Prior to eculizumab availability, pts with aHUS had a reportedly high risk of disease recurrence and graft loss following a kidney transplant (KTx). We report the long-term clinical outcomes of eculizumab-treated pts who received a KTx.

METHOD

This analysis included pts enrolled from April 2012–November 2021. Pts were included in a long-term treatment outcomes study if they had ever been treated with eculizumab and were excluded if they had DGKE mutations or their diagnosis was later revised to any condition other than aHUS. The current analysis set included pts who had received a KTx no more than 30 days prior to eculizumab start or up to 60 days post eculizumab start date, had ≥3 years of follow-up (FU) post-transplant and had serum creatinine (SCr) measurements at baseline (BL) and post 3 years FU. Changes in kidney function, haematological parameters and clinical characteristics at last follow-up (LFU) were assessed.

RESULTS

A total of 329/1970 adult and paediatric registry pts met the inclusion criteria and received a KTx; 78 pts from 12 countries met sub-group inclusion criteria. BL demographics are shown in Table 1. Mean (SD) treatment duration was 5.7 (2.4) years and 47 (60%) pts had pathogenic genetic variants. Lab parameters at BL (closest measurement at or following KTx) and LFU are reported in Table 2. Despite large ranges, median SCr levels remained stable at LFU. Median eGFR and platelet levels were similar at BL and LFU, while lower median lactose dehydrogenase levels were seen at LFU. At LFU: four pts (5%)—three adult—had subsequent KTx(s); eight (10%)—seven adults—had received dialysis by last observation; and two (3%) had received plasma exchange/infusion. Two pts (3%) died during the observation period.

CONCLUSION

This study assessed a large, real-world population of pts at high risk of KTx failure. Lab parameters suggest most pts benefitted from eculizumab treatment, with few TMA-related complications and stable kidney function and haematological parameters for ≥3 years. Overall, the proportions of female pts and of pts with pathogenic genetic variants were consistent with previous studies. A potential study limitation was the relatively stringent sub-population-specific inclusion criteria. However, these data further demonstrate the beneficial impact of eculizumab treatment in the long-term management of aHUS in pts requiring KTx.
Association of osteopontin with kidney function and kidney failure in chronic kidney disease patients: the GCKD study
Authors: Steinbrenner Inga , Sekula Peggy , Kotsis Fruzsina , von Cube Maja , Cheng Yurong , Nadal Jennifer , Schmid Matthias , Schneider Markus P , Krane Vera , Nauck Matthias , Eckardt Kai-Uwe , Schultheiss Ulla T ,   the GCKD investigators, Eckardt Kai-Uwe , Meiselbach Heike , Schneider Markus P , Schiffer Mario , Prokosch Hans-Ulrich , Bärthlein Barbara , Beck Andreas , Reis André , Ekici Arif B , Becker Susanne , Becker-Grosspitsch Dinah , Alberth-Schmidt Ulrike , Hausknecht Birgit , Weigel Anke , Walz Gerd , Köttgen Anna , Schultheiß Ulla T , Kotsis Fruzsina , Meder Simone , Mitsch Erna , Reinhard Ursula , Floege Jürgen , Saritas Turgay , Schaeffner Elke , Baid-Agrawal Seema , Theisen Kerstin , Haller Hermann , Menne Jan , Zeier Martin , Sommerer Claudia , Theilinger Johanna , Wolf Gunter , Busch Martin , Paul Rainer , Sitter Thomas , Wanner Christoph , Krane Vera , Börner-Klein Antje , Bauer Britta , Kronenberg Florian , Raschenberger Julia , Kollerits Barbara , Forer Lukas , Schönherr Sebastian , Weissensteiner Hansi , Oefner Peter , Gronwald Wolfram , Schmid Matthias , Nadal Jennifer
Published: May 2022

Background

Osteopontin (OPN), synthesized in the thick ascending limb of Henle's loop and in the distal tubule, is involved in the pathogenesis of kidney fibrosis, a hallmark of kidney failure (KF). In a cohort of chronic kidney disease (CKD) patients, we evaluated OPN's association with kidney markers and KF.

Methods

OPN was measured from baseline serum samples of German Chronic Kidney Disease study participants. Cross-sectional regression models for estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) as well as Cox regression models for all-cause mortality and KF were evaluated to estimate the OPN effect. Additionally, the predictive ability of OPN and time-dependent population-attributable fraction were evaluated.

Results

Over a median follow-up of 6.5 years, 471 KF events and 629 deaths occurred among 4950 CKD patients. One-unit higher log(OPN) was associated with 5.5 mL/min/1.73 m2 lower eGFR [95% confidence interval (95% CI) –6.4 to –4.6] and 1% change in OPN with 0.7% higher UACR (estimated effect 0.7, 95% CI 0.6–0.8). Moreover, higher OPN levels were associated with a higher risk of KF [hazard ratio (HR) 1.4, 95% CI 1.2–1.7] and all-cause mortality (HR 1.5, 95% CI 1.3–1.8). After 6 years, 31% of the KF events could be attributed to higher OPN levels (95% CI 3%–56%).

Conclusions

In this study, higher OPN levels were associated with kidney function markers worsening and a higher risk for adverse outcomes. A larger proportion of KF could be attributed to higher OPN levels, warranting further research on OPN with regards to its role in CKD progression and possible treatment options.
The Role of Attentional Networks in Smoking Behavior Among Young Adults: Specific Contribution of Executive Control
Authors: Maurage Pierre , Heeren Alexandre , Lannoy Séverine , Flaudias Valentin
Published: May 2022

Introduction

The exploration of cognitive impairments associated with tobacco use disorder has expanded during the last decades, centrally showing working memory and executive deficits among smokers. Despite their critical role in everyday life and in the smoking cessation process, attentional abilities have seldom been explored. Previous studies yielded discordant results, and the involvement of attentional deficits in smoking habits remains unclear.

Aims and Methods

Capitalizing on the Attention Network Test, a theory-grounded task allowing the simultaneous but distinct evaluation of three attentional networks (alerting, orienting, executive control), we explored attentional abilities in three groups of 25 college students (nonsmokers, light smokers, heavy smokers), matched for demographic and psychopathological characteristics.

Results

While light smokers did not present any deficit compared with nonsmokers, heavy smokers showed a specific impairment of the executive control subcomponent of attention, contrasting with preserved alerting and orienting attentional abilities. The executive control deficit was not related to current craving or to smoking duration.

Conclusions

Beyond the already explored memory and executive deficits, tobacco use disorder is associated with attentional impairments, characterized by a reduced ability to focus attentional resources on pertinent stimuli and resist to distractors interference. Given the assumed role of attentional impairments in smoking, our findings suggest that a critical step in future translational iterations is to develop neuropsychological rehabilitation programs tapping into the executive network of attention among smokers.

Implications

This study clarifies the presence and extent of attentional impairments in tobacco use disorder. We measured three attention networks (alerting, orienting, executive control) in light smokers, heavy smokers and matched healthy controls through a theory-grounded task (Attention Network Test). Heavy smokers (but not light ones) present a specific deficit for the executive control of attention. This deficit, uncorrelated with psychopathological comorbidities or current craving, appears directly related to smoking. Given the currently scattered literature on this topic, attentional processes deserve a thorough audit in tobacco use disorder, notably to develop specific neurocognitive rehabilitation.
Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Through Solid Organ Transplantation and Outcomes of Coronavirus Disease 2019 Among Recent Transplant Recipients
Authors: Free Rebecca J , Annambhotla Pallavi , La Hoz Ricardo M , Danziger-Isakov Lara , Jones Jefferson M , Wang Lijuan , Sankthivel Senthil , Levi Marilyn E , Michaels Marian G , Kuhnert Wendi , Klassen David , Basavaraju Sridhar V , Kracalik Ian T
Published: May 2022

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmissible through lung transplantation, and outcomes among infected organ recipients may be severe. Transmission risk to extrapulmonary organ recipients and recent (within 30 days of transplantation) SARS-CoV-2–infected recipient outcomes are unclear.

Methods

During March 2020–March 2021, potential SARS-CoV-2 transmissions through solid organ transplantation were investigated. Assessments included SARS-CoV-2 testing, medical record review, determination of likely transmission route, and recent recipient outcomes.

Results

During March 2020–March 2021, approximately 42 740 organs were transplanted in the United States. Forty donors, who donated 140 organs to 125 recipients, were investigated. Nine (23%) donors and 25 (20%) recipients were SARS-CoV-2 positive by nucleic acid amplification test (NAAT). Most (22/25 [88%]) SARS-CoV-2–infected recipients had healthcare or community exposures. Nine SARS-CoV-2–infected donors donated 21 organs to 19 recipients. Of these, 3 lung recipients acquired SARS-CoV-2 infections from donors with negative SARS-CoV-2 testing of pretransplant upper respiratory tract specimens but from whom posttransplant lower respiratory tract (LRT) specimens were SARS-CoV-2 positive. Sixteen recipients of extrapulmonary organs from SARS-CoV-2–infected donors had no evidence of posttransplant COVID-19. All-cause mortality within 45 days after transplantation was 6-fold higher among SARS-CoV-2–infected recipients (9/25 [36%]) than those without (6/100 [6%]).

Conclusions

Transplant-transmission of SARS-CoV-2 is uncommon. Pretransplant NAAT of lung donor LRT specimens may prevent transmission of SARS-CoV-2 through transplantation. Extrapulmonary organs from SARS-CoV-2–infected donors may be safely usable, although further study is needed. Reducing recent recipient exposures to SARS-CoV-2 should remain a focus of prevention.
COVID-19 Vaccine Hesitancy Among Health Care Workers in Four Health Care Systems in Atlanta
Authors: Kandiah Sheetal , Iheaku Onyinye , Farrque Mirza , Hanna Jasmah , Johnson Kalisha Bonds , Wiley Zanthia , Franks Nicole M , Carroll Kelley , Shin Sangmin Ryan , Sims Kanika Michele , Kulshreshtha Ambar ,   CROSS Collaborative, Rebolledo Paulina , Cantos Valeria , Kobaidze Ketino , Sexton Marybeth , Kirkconnell Hall Mary Ann
Published: May 2022

Coronavirus disease 2019 (COVID-19) vaccine hesitancy among health care workers (HCWs) undermines community vaccine confidence. Predictors and reasons for HCW hesitancy in the Atlanta region were evaluated using a survey between May and June 2021. Vaccine hesitancy was highest in younger and less educated HCWs. Interventions to address vaccine hesitancy in HCWs are necessary.
Rapid Treatment Initiation for Hepatitis C in Young People Who Inject Drugs: The Seek, Test, and Rapid Treatment Randomized Trial
Authors: Eckhardt Benjamin , Kapadia Shashi N , Mateu-Gelabert Pedro , Pai Melinda , Fong Chunki , Aponte-Melendez Yesenia , Marks Kristen M
Published: May 2022

Background

Young people who inject drugs (PWID) have high hepatitis C virus (HCV) incidence and low treatment initiation rates. Novel, simplified care models need to be developed to engage, treat, and cure hard-to-reach patient populations, such as young PWID. We present final data from the randomized pilot clinical trial “HCV-Seek Test and Rapid Treatment” for curing HCV in young PWID.

Methods

Participants were recruited from the community and eligible if they were 18–29 years of age, HCV antibody-positive, treatment naive, and had injected drugs in the past 30 days. Participants were randomized 1:1 to “Rapid Treatment or Usual Care”. Participants randomized to Rapid Treatment received same-day medical evaluation, confirmatory and baseline laboratory testing, and a 7-day starter pack of sofosbuvir/velpatasvir at a syringe service program (SSP). Participants in “Usual Care” received same-day HCV confirmatory testing at the SSP and, if positive, facilitated referral to local providers. The primary endpoint was sustained virologic response at 12 weeks (SVR12) in HCV ribonucleic acid (RNA)+ participant.

Results

Forty-seven HCV antibody-positive participants were enrolled, and 25 participants had confirmed HCV and were included in the modified intention to treat analysis, with 9 of 14 (64%) of the Rapid Treatment arm and 1 of 11 (9.1%) of the Usual Care arm achieving a confirmed SVR12 (P = .01).

Conclusions

Among young HCV RNA+ PWID, significantly higher rates of cure were achieved using the Rapid Treatment model compared with facilitated referral. Providing easy access to HCV treatment for young PWID in low-threshold settings and initiating HCV treatment quickly appears to be a promising strategy for treating this hard-to-reach population.
PROPHETIC EU: Prospective Identification of Pneumonia in Hospitalized Patients in the Intensive Care Unit in European and United States Cohorts
Authors: Bergin Stephen P , Calvert Sara B , Farley John , Sun Jie-Lena , Chiswell Karen , Dieperink Willem , Kluytmans Jan , Lopez-Delgado Juan Carlos , Leon-Lopez Rafael , Zervos Marcus J , Kollef Marin H , Sims Matthew , Kabchi Badih A , Rubin Daniel , Santiago Jonas , Natarajan Mukil , Tenaerts Pamela , Fowler Vance G , Holland Thomas L , Bonten Marc J , Hullegie Sebastiaan J
Published: May 2022

Background

The prospective identification of patients at high risk for hospital-acquired/ventilator-associated bacterial pneumonia may improve clinical trial feasibility and foster antibacterial development. In a prior study conducted in the United States, clinical criteria were used to prospectively identify these patients; however, these criteria have not been applied in a European population.

Methods

Adults considered high risk for pneumonia (treatment with ventilation or high levels of supplemental oxygen) in the intensive care units of 7 European hospitals were prospectively enrolled from June 12 to December 27, 2017. We estimated the proportion of high-risk patients developing pneumonia according to US Food and Drug Administration guidance and a subset potentially eligible for antibacterial trial enrollment. We compared patient characteristics, treatment exposures, and pneumonia incidence in a European cohort and a previously described US cohort.

Results

Of 888 high-risk patients, 211/888 (24%) were treated for possible pneumonia, and 150/888 (17%) met the Food and Drug Administration definition for hospital-acquired/ventilator-associated bacterial pneumonia. A higher proportion of European patients treated for possible pneumonia met the pneumonia definition (150/211 [71%] vs 537/1464 [37%]; P < .001). Among patients developing pneumonia, a higher proportion of European patients met antibacterial trial eligibility criteria (124/150 [83%] vs 371/537 [69%]; P < .001).

Conclusions

Clinical criteria prospectively identified high-risk patients with high rates of pneumonia in the European cohort. Despite higher rates of established risk factors and incident pneumonia, European patients were significantly less likely to receive antibiotics for possible pneumonia than US patients. Different treatment practices may contribute to lower rates of antibacterial trial enrollment in the United States.
Inhibitory postsynaptic density from the lens of phase separation
Authors: Bai Guanhua , Zhang Mingjie
Published: May 2022

To faithfully transmit and decode signals released from presynaptic termini, postsynaptic compartments of neuronal synapses deploy hundreds of various proteins. In addition to distinct sets of proteins, excitatory and inhibitory postsynaptic apparatuses display very different organization features and regulatory properties. Decades of extensive studies have generated a wealth of knowledge on the molecular composition, assembly architecture and activity-dependent regulatory mechanisms of excitatory postsynaptic compartments. In comparison, our understanding of the inhibitory postsynaptic apparatus trails behind. Recent studies have demonstrated that phase separation is a new paradigm underlying the formation and plasticity of both excitatory and inhibitory postsynaptic molecular assemblies. In this review, we discuss molecular composition, organizational and regulatory features of inhibitory postsynaptic densities through the lens of the phase separation concept and in comparison with the excitatory postsynaptic densities.
A review of ultrawide bandgap materials: properties, synthesis and devices
Authors: Xu Mingfei , Wang Dawei , Fu Kai , Mudiyanselage Dinusha Herath , Fu Houqiang , Zhao Yuji
Published: May 2022

Ultrawide bandgap (UWBG) materials such as diamond, Ga2O3, hexagonal boron nitride (h-BN) and AlN, are a new class of semiconductors that possess a wide range of attractive properties, including very large bandgap, high critical electric field, high carrier mobility and chemical inertness. Due to these outstanding characteristics, UWBG materials are promising candidates to enable high-performance devices for power electronics, ultraviolet photonics, quantum sensing and quantum computing applications. Despite their great potential, the research of UWBG semiconductors is still at a nascent stage and represents a challenging interdisciplinary research area of physics, materials science and devices engineering. In this review, the material properties, synthesis methods and device applications of UWBG semiconductors diamond, Ga2O3, h-BN and AlN will be presented and their recent progress, challenges and research opportunities will be discussed.
Return to school and mask-wearing in class during the COVID-19 pandemic: Student perspectives from a school simulation study
Authors: Coelho Sophie G , Segovia Alicia , Anthony Samantha J , Lin Jia , Pol Sarah , Crosbie Jennifer , Science Michelle , Matava Clyde T , Parekh Rulan S , Caldeira-Kulbakas Monica , Carroll Stacie , Greenwood Jodi L , Panzera Giovanna , Imgrund Ryan , Osokin Konstantin , Korczak Daphne J
Published: May 2022

Objectives

This study examined children’s perspectives about returning to in-person school following lockdown due to the pandemic and about mask-wearing in class, as well as the mental health of children and parents during the pandemic.

Methods

This cross-sectional study was part of a 2-day school simulation exercise that randomized students to different masking recommendations. Parent-report of mental health and post-simulation child-report of COVID-19-related anxiety and mask-wearing were analyzed using descriptive and multiple regression analyses. Semi-structured focus groups were conducted with older students to supplement questionnaire data.

Results

Of 190 students in this study, 31% were in grade 4 or lower 95% looked forward to returning to in-person school. Greater child anxiety about COVID-19 was predicted by increased parent/caregiver anxiety (β=0.67; P<0.001), and lower parental educational attainment (β=1.86; P<0.002). Older students were more likely than younger students to report that mask-wearing interfered with their abilities to interact with peers (χ2(1)=31.16; P<0.001) and understand the teacher (χ2(1)=13.97; P<0.001). Students in the group that did not require masks were more likely than students in the masking group to report worries about contracting COVID-19 at school (χ2(1)=10.07; P<0.05), and anticipated difficulty wearing a mask (χ2(1)=18.95; P<0.001).

Conclusions

For children anxious about COVID-19, parental anxiety and education about COVID-19 may be targets for intervention. Future research should examine the impact of prolonged implementation of public health mitigation strategies in school on academic achievement and children’s mental health.
Mental health impacts of the COVID-19 pandemic on children with underlying health and disability issues, and their families and health care providers
Authors: Nicholas David B , Zulla Rosslynn T , Conlon Olivia , Dimitropoulos Gina , Urschel Simon , Rapoport Adam , Katz Sherri Lynne , Bruce Aisha , West Lori J , Belletrutti Mark , Cullen Emma , Zwaigenbaum Lonnie
Published: May 2022

Objectives

The COVID-19 pandemic has impacted mental health at a population level. Families of children with health vulnerabilities have been disproportionately affected by pandemic-related policies and service disruptions as they substantially rely on the health and social care system. We elicited the impact of the COVID-19 pandemic on children with health and disability-related vulnerabilities, their families, and their health care providers (HCPs).

Methods

Children with diverse health vulnerabilities (cardiac transplantation, respiratory conditions, sickle cell disease, autism spectrum disorder, mental health issues, and nearing the end of life due to a range of underlying causes), as well as their parents and HCPs, participated in semi-structured interviews. Data were analyzed using qualitative content analysis in determining themes related to impact and recommendations for practice improvement.

Results

A total of 262 participants (30 children, 76 parents, 156 HCPs) were interviewed. Children described loneliness and isolation; parents described feeling burnt out; and HCPs described strain and a sense of moral distress. Themes reflected mental health impacts on children, families, and HCPs, with insufficient resources to support mental health; organizational and policy influences that shaped service delivery; and recommendations to enhance service delivery.

Conclusion

Children with health vulnerabilities, their families and HCPs incurred profound mental health impacts due to pandemic-imposed public health restrictions and care shifts. Recommendations include the development and application of targeted pandemic information and mental health supports. These findings amplify the need for capacity building, including proactive strategies and mitigative planning in the event of a future pandemic.
Mental health profiles of autistic children and youth during the COVID-19 pandemic
Authors: Charalampopoulou Marina , Choi Eun Jung , Korczak Daphne J , Cost Katherine T , Crosbie Jennifer , Birken Catherine S , Charach Alice , Monga Suneeta , Kelley Elizabeth , Nicolson Rob , Georgiades Stelios , Ayub Muhammad , Schachar Russell J , Iaboni Alana , Anagnostou Evdokia
Published: May 2022

Objectives

Canadian province-wide lockdowns have challenged children’s mental health (MH) during the COVID-19 pandemic, with autistic children being at particular risk. The purpose of our study was to identify sub-groups of autistic children with distinct mental health change profiles, to understand the child-, parent-, and system-specific factors associated with such profiles in order to ultimately inform future interventions.

Methods

Data were drawn from a large Canadian cohort (N=1,570) across Ontario, resulting in 265 autistic children (mean age=10.9 years, 76% male). K-means clustering analyses were employed to partition distinct MH profiles in six MH measures (mood, anxiety, OCD symptoms, irritability, inattention, hyperactivity) and group differences were examined with reference to the above factors. Additionally, we investigated the characteristics of children who accessed acute MH services.

Results

The optimal number of clusters was two; one included those experiencing MH deterioration across all six MH measures (61.3%, 95% confidence interval [CI]=54.9 to 67.4), and a second included youth that did not experience MH changes (38.7%, 95%CI=32.6 to 45.1). Child-specific factors associated with MH deterioration included higher pre-existing internalizing symptoms, high levels of COVID stress. Parental MH challenges and system-specific factors, such as the loss of learning supports, access to physicians and material deprivation, were also associated with MH deterioration. Access to acute MH services were primarily associated with financial insecurity and loss of services.

Conclusions

More than half of autistic children experienced MH deterioration, and person-specific (pre-existing MH, COVID related stress), parent-specific (Parent MH) and system-level (loss of services and material deprivation) characteristics were associated with such decline, providing clinical and policy opportunities for intervention at multiple levels.
Outpatient management of moderate cellulitis in children using high-dose oral cephalexin
Authors: Trottier Evelyne D , Farley St-Amand Beatrice , Vincent Mélanie , Chevalier Isabelle , Autmizguine Julie , Tremblay Stéphanie , Gouin Serge
Published: May 2022

Objectives

To evaluate the effectiveness of a high-dose (HD) oral cephalexin treatment guideline for children with moderate cellulitis treated as outpatients.

Methods

In this retrospective cohort study, we included children who presented to the emergency department (ED) with moderate cellulitis and treated according to the institution’s HD oral cephalexin guideline over a 2-year period. All children had standardized follow-up at a medical day hospital (MDH). Treatment was considered effective in the absence of treatment failure, defined as admission, switch to IV treatment or ED visit within 2 weeks of discharge from the MDH. Safety was ascertained by recording adverse events and severe complications at follow-up.

Results

A total of 123 children were treated as outlined in the guideline, including 117 treated with HD oral cephalexin. The success rate was 89.7% (105/117). Among 12 (10.3%) children who had treatment failure, 10 (8.5%) required admission, 1 (0.9%) received IV antibiotics at the MDH and 1 (0.9%) had a return visit to the ED without admission. No severe complications were reported; four abscesses required drainage and one patient had a rash. The mean number of visits per child at the MDH was 1.6 (SD 1.0).

Conclusions

With a success rate of 89.7%, HD oral cephalexin seems effective and safe for the treatment of children with moderate cellulitis. Its use potentially reduces hospitalization rates for this condition and decreases the need for IV insertion.
Higher-derivative extension of the functional renormalization group
Authors: Tanaka Gota , Tsuchiya Asato
Published: May 2022

We study the higher-derivative extension of the functional renormalization group (FRG). We consider FRG equations for a scalar field that consist of terms with higher functional derivatives of the effective action and arbitrary cutoff functions. We show that the ϵ expansion around the Wilson–Fisher fixed point is indeed reproduced by the local potential approximation of the FRG equations.