bluuebunny/crossref_metadata_2025 huggingface dataset:
Attitudes and Preferences Regarding Non–Clinic-Based Self-Collection for Sexually Transmitted Infection Testing Among Clinic Attendees in British Columbia, Canada
Authors: Gottschlich Anna , Smith Laurie W. , Caird Hannah , Gilbert Mark , Grennan Troy , Ogilvie Gina
Published: July 2021

Background

Sexually transmitted infections (STIs) are a global epidemic; although screening programs reduce transmission, barriers, including access and stigma, hinder success. The World Health Organization highlights the ability to maintain health without the direct support of a health care provider as one form of self-care, which can be applied to STI testing. Self-care through non–clinic-based self-collection for STI testing can address barriers while providing comprehensive care. Before implementation of innovative changes to screening approaches, it is important to understand if communities who rely on in-person care will self-collect outside of the clinic setting. This study investigated willingness to use non–clinic-based self-collection for STI testing among STI clinic attendees in British Columbia, Canada.

Methods

Participants (n = 446) were recruited from STI clinics offering clinic-based self-collection for STI testing and completed a survey assessing self-care attitudes, including willingness to self-collect urine samples, throat swabs, and anogenital swabs outside of the clinic setting. Descriptive statistics, bivariable analyses, and multivariable models were conducted to investigate willingness to use non–clinic-based STI self-collection methods and associated correlates.

Results

This population reported high willingness to use non–clinic-based self-collection methods for STI testing (urine samples, 73%; throat swabs, 67%; anogenital swabs, 65%). Those aged 35 to 54 years compared with 15 to 34 years were more likely to be willing (adjusted odds ratio, 1.87; 95% confidence interval, 1.03–3.50); those identifying as straight/mostly straight compared with gay/lesbian were less likely to be willing (adjusted odds ratio, 0.39; 95% confidence interval, 0.23–0.65).

Conclusions

Non–clinic-based self-collection for STI testing can address barriers to testing while maintaining quality care. Those currently receiving in-person care find these methods highly acceptable. These findings reinforce that self-collection for STI testing used in British Columbia clinics is acceptable to clients and may be extended to collection performed outside of the clinical setting.
Physicochemical stability of lurbinectedin reconstituted at 500 μg/mL and diluted at 15, 30, and 70 μg/mL in 0.9% sodium chloride and 5% dextrose
Authors: Loeuille Guillaume , Vigneron Jean , D’Huart Elise , Demoré Béatrice
Published: July 2021

Background:

Lurbinectedin (ZEPZELCA) is a cytotoxic, with alkylating properties. The commercially available pharmaceutical form is a glass vial containing 4 mg of lyophilized powder of lurbinectedin. The recommended dose of lurbinectedin is 3.2 mg/m2. For a 1.7-m2 body surface area, the average dosage is 5.44 mg. The manufacturer indicates a 30-hour stability for the reconstituted solution which cannot give the possibility to re-use the vial for the following days resulting in an average loss of 3600 € per preparation.

Objectives:

The first objective was to study the stability of 500 μg/mL reconstituted lurbinectedin in water for injection after storage at 2 to 8°C. The second objective was to study the stability of 15 to 70 μg/mL diluted lurbinectedin in 0.9% NaCl or dextrose 5% in water stored at 2 to 8°C.

Methods:

Three solutions in glass tubes for each condition (reconstituted 15 and 70 μg/mL solutions) were prepared. Due to the high cost, only 1 infusion bag at 30 μg/mL in polyolefin container was prepared. At each time of the analysis, 3 samples for each vial were analyzed by high-performance liquid chromatography coupled to a photodiode array detector. Physical stability was evaluated by visual and subvisual inspection (spectrophotometry).

Results:

The analytical method was validated according to International Conference on Harmonisation guidelines Q2 (R1). The 500 μg/mL lurbinectedin reconstituted solution retained more than 95% of the initial concentration after 14 days as the 15 to 70 μg/mL diluted solutions. No interaction between the polyolefin infusion bag and lurbinectedin was observed. No physical changes were observed both visually and subvisually.

Conclusion:

The reconstituted solution and the diluted lurbinectedin solutions were physically and chemically stable for 14 days when stored at 2 to 8°C protected from light. This new data makes it possible to re-use the reconstituted vial and to store a preparation in case of cancellation of an administration.
Defining Substantial Lymphovascular Space Invasion in Endometrial Cancer
Authors: Peters Elke E.M. , León-Castillo Alicia , Smit Vincent T.H.B.M. , Boennelycke Marie , Hogdall Estrid , Hogdall Claus , Creutzberg Carien , Jürgenliemk-Schulz Ina M. , Jobsen Jan J. , Mens Jan Willem M. , Lutgens Ludy C.H.W. , van der Steen-Banasik Elzbieta M. , Ortoft Gitte , Bosse Tjalling , Nout Remi
Published: July 2021

Lymphovascular space invasion (LVSI) occurs in a minority of endometrial cancer (EC) cases, and the extent of LVSI is an important risk factor for recurrence and/or metastases. Our aim was to improve the reproducibility of measuring clinically meaningful LVSI by performing a quantitative analysis of the correlation between LVSI and the risk of pelvic lymph node recurrence in EC. EC samples from PORTEC-1 and PORTEC-2 trials were retrieved and used to collect quantitative data, including the number of LVSI-positive vessels per H&E-stained slide. Using a predefined threshold for clinical relevance, the risk of pelvic lymph node recurrence risk was calculated (Kaplan-Meier method, with Cox regression) using a stepwise adjustment for the number of LVSI-positive vessels. This analysis was then repeated in the Danish Gynecological Cancer Database (DGCD) cohort. Among patients in PORTEC-1 and PORTEC-2 trials who did not receive external beam radiotherapy, the 5-yr pelvic lymph node recurrence risk was 3.3%, 6.7% (P=0.51), and 26.3% (P<0.001), respectively when 0, 1 to 3, or ≥4 vessels had LVSI involvement; similar results were obtained for the DGCD cohort. Furthermore, both the average number of tumor cells in the largest embolus and the number of LVSI-positive H&E slides differed significantly between focal LVSI and substantial LVSI. On the basis of these results, we propose a numeric threshold (≥4 LVSI-involved vessels in at least one H&E slide) for defining clinically relevant LVSI in EC, thereby adding supportive data to the semiquantitative approach. This will help guide gynecologic pathologists to differentiate between focal and substantial LVSI, especially in borderline cases.
Olfactory Changes After Military Deployment Are Associated With Emotional Distress but Not With Mild Traumatic Brain Injury History
Authors: Rothman David J. , McDonald Scott D. , Walker William C. , Feldman George
Published: July 2021

Objective

The aim of the study was to identify the impact of mild traumatic brain injury history and current emotional status on olfactory functioning.

Design

This was a cross-sectional study of 49 predominantly male, military veterans, reservists, and active duty service members with Operations Enduring Freedom, Iraqi Freedom, and New Dawn deployments and varying mild traumatic brain injury histories.

Results

Those with a positive history of mild traumatic brain injury (n = 32) endorsed significantly higher rates of self-reported olfactory disturbance. However, there were no differences between the mild traumatic brain injury and no mild traumatic brain injury groups for rates of objective odor identification dysfunction (none vs. microsmia or more severe) or overall accuracy of odor identification. In keeping with this, self-reported olfactory disturbance also failed to associate with odor identification dysfunction. In both groups, those self-reporting olfactory disturbance reported significantly greater emotional distress, severity of posttraumatic stress symptoms, and attentional impulsivity. However, self-reported olfactory disturbance was not associated with other behavioral factors frequently attributed to TBI, such as aggression, motor impulsiveness, poor planning, and cognitive flexibility.

Conclusions

These findings indicate mild traumatic brain injury is not a risk factor for postacute microsomia among Operations Enduring Freedom, Iraqi Freedom, and New Dawn military veterans. Higher observed rates of self-reported olfactory disturbance in patients with mild traumatic brain injury may be a function of emotional distress rather than organic brain injury.
Hydrodissection for Carpal Tunnel Syndrome
Authors: Neo Edmund Jin Rui , Shan Ni Thu , Tay San San
Published: July 2021

Hydrodissection is an ultrasound-guided technique that has received more attention recently for its role in nerve entrapment syndromes. The purposes of this systematic review were to evaluate the safety and effectiveness of hydrodissection in carpal tunnel syndrome and to investigate the ideal parameters for injectate type, dosage, volume, and frequency; injection approach and technique; as well as operator experience and training required. We searched the Embase, MEDLINE, and PubMed databases with supplemental searches in the CINAHL, Web of Science, and Google Scholar databases for relevant randomized controlled trials. Primary outcome measures were adverse outcomes and clinical effectiveness. Six randomized controlled trials involving 356 wrists were included. All studies used ultrasound guidance in their interventions. No safety-related adverse outcomes were found, although not all studies declared this. Only one study was placebo controlled and revealed symptomatic as well as functional improvements at 6 mos, whereas the rest investigated hydrodissection with different injectate types. We concluded that nerve hydrodissection for carpal tunnel syndrome can be safely performed under ultrasound guidance. However, it is unclear whether the hydrodissection mechanism truly causes improvements in clinical outcomes. We were also unable to draw conclusions regarding the ideal procedure-related parameters. We recommend that future work should not only investigate safety and clinical effectiveness but also attempt to clarify the ideal procedure-related parameters.
Inferring population HIV incidence trends from surveillance data of recent HIV infection among HIV testing clients
Authors: Godin Arnaud , Eaton Jeffrey W. , Giguère Katia , Marsh Kimberly , Johnson Leigh F. , Jahn Andreas , Mbofana Francisco , Ehui Eboi , Maheu-Giroux Mathieu
Published: July 2021

Background:

Measuring recent HIV infections from routine surveillance systems could allow timely and granular monitoring of HIV incidence patterns. We evaluated the relationship of two recent infection indicators with alternative denominators to true incidence patterns.

Methods:

We used a mathematical model of HIV testing behaviours, calibrated to population-based surveys and HIV testing services programme data, to estimate the number of recent infections diagnosed annually from 2010 to 2019 in Côte d’Ivoire, Malawi, and Mozambique. We compared two different denominators to interpret recency data: those at risk of HIV acquisition (HIV-negative tests and recent infections) and all people testing HIV positive. Sex and age-specific longitudinal trends in both interpretations were then compared with modelled trends in HIV incidence, testing efforts and HIV positivity among HIV testing services clients.

Results:

Over 2010–2019, the annual proportion of the eligible population tested increased in all countries, while positivity decreased. The proportion of recent infections among those at risk of HIV acquisition decreased, similar to declines in HIV incidence among adults (≥15 years old). Conversely, the proportion of recent infections among HIV-positive tests increased. The female-to-male ratio of the proportion testing recent among those at risk was closer to 1 than the true incidence sex ratio.

Conclusion:

The proportion of recent infections among those at risk of HIV acquisition is more indicative of HIV incidence than the proportion among HIV-positive tests. However, interpreting the observed patterns as surrogate measures for incidence patterns may still be confounded by different HIV testing rates between population groups or over time.
Duration of antibiotic therapy in central venous catheter-related bloodstream infection due to Gram-negative bacilli
Authors: Ruiz-Ruigómez María , Aguado Jose María
Published: July 2021

Purpose of review

The aim of this study was to review recent data evaluating the duration of antibiotic therapy in central venous catheter-related bloodstream infection (CRBSI) due to Gram-negative bacilli (GNB).

Recent findings

CRBSI is the most common complication associated with the use of intravascular catheters. CRBSI directly contributes to increase additional days of hospitalization, morbidity and therefore economic costs.

The incidence of GNB CRBSI has been increasing considerably in the last years; this has raised a concern due to the high reported rate of multi drug resistant bacteria in these infections what poses a considerable challenge for effective treatment. However, there are no specific guidelines for management of GNB-CRBSI and optimal treatment duration has not been clearly defined.

Recent studies evaluating the impact of the duration of antibiotic therapy of GNB-CRBSI have shown that short-course antibiotic therapy might be as effective as long-course therapy once the central venous catheter (CVC) has been removed.

CRBSI due to GNB has shown a rapid increase in the last years. Current guidelines recommend antibiotic treatment for at least 7–14 days, although no randomized clinical trials have evaluated the optimal duration of antibiotic therapy for GNB-CRBSI. Recent data suggest that administration of appropriate antibiotic therapy for 7 days or less may be as well tolerated and effective as longer courses in episodes of GNB-CRBSI, once the CVC has been removed.
Apert Syndrome Outcomes: Comparison of Posterior Vault Distraction Osteogenesis Versus Fronto Orbital Advancement
Authors: Raposo-Amaral Cassio Eduardo , Oliveira Yuri Moresco , Raposo-Amaral Cesar Augusto , Ghizoni Enrico
Published: July 2021

Background:

Presenting a wide clinical spectrum and large variety of clinical features, successful treatment of Apert syndrome necessitates performance of sequential multiple surgeries before a patient's facial skeleton growth is complete.

The objective of this study is to compare forehead contour asymmetry and clinical outcomes between Apert patients who underwent either fronto-orbital advancement (FOA) or posterior vault distraction osteogenesis (PVDO).

Methods:

A retrospective study was performed on consecutive patients with Apert syndrome who underwent either FOA or PVDO between 2007 and 2019, and participated in at least 6 months of follow-up care. Forehead contour asymmetry and surgical outcomes for each of the included patients were verified through medical records, clinical photographs, and interviews with the parents of the patients. The need for additional craniofacial procedures based on the surgical outcomes of each patient was graded from I to IV utilizing the Whitaker outcome classification system.

Results:

Forehead contour asymmetry for all included patients was rated under the Whitaker grading scale as type II (n = 4) 44.4%, type III (n = 2) 22.2%, and type IV (n = 3) 33.3% for FOA, and type I (n = 5) 35.7%, type II (n = 7) 50%, and type III (n = 2) 14.3%, for PVDO (P < 0.05). The average transfused blood volume was 47.77 ± 9.42 mL/kg for patients who underwent FOA, and 22.75 ± 10.31 mL/kg for patients who underwent PVDO (P < 0.05).

Conclusions:

Patients who underwent PVDO had lower forehead contour asymmetry as per the Whitaker outcome grading scale than patients who underwent FOA.
Vitamin C, Hydrocortisone, and the Combination Thereof Significantly Inhibited Two of Nine Inflammatory Markers Induced by Escherichia Coli But Not by Staphylococcus Aureus – When Incubated in Human Whole Blood
Authors: Medeiros Pedro Miguel Coelho , Schjalm Camilla , Christiansen Dorte , Sokolova Marina , Pischke Soeren Erik , Würzner Reinhard , Mollnes Tom Eirik , Barratt-Due Andreas
Published: July 2021

Vitamin C combined with hydrocortisone is increasingly being used to treat septic patients, even though this treatment regimen is based on questionable evidence. When used, a marked effect on key players of innate immunity would be expected, as sepsis is featured by a dysregulated immune response.

Here, we explored the effect of vitamin C and hydrocortisone alone and combined, in an ex vivo human whole-blood model of Escherichia coli- or Staphylococcus aureus-induced inflammation. Inflammatory markers for activation of complement (terminal C5b-9 complement complex [TCC]), granulocytes (myeloperoxidase), platelets (β-thromboglobulin), cytokines (tumor necrosis factor [TNF], IL-1β, IL6, and IL-8), and leukocytes (CD11b and oxidative burst) were quantified, by enzyme-linked immunosorbent assay, multiplex technology, and flow cytometry.

In E. coli- and S. aureus-stimulated whole blood, a broad dose-titration of vitamin C and hydrocortisone alone did not lead to dose–response effects for the central innate immune mediators TCC and IL-6. Hence, the clinically relevant doses were used further. Compared to the untreated control sample, two of the nine biomarkers induced by E. coli were reduced by hydrocortisone and/or vitamin C. TNF was reduced by hydrocortisone alone (19%, P = 0.01) and by the combination (31%, P = 0.01). The oxidative burst of monocytes and granulocytes was reduced for both drugs alone and their combination, (ranging 8–19%, P < 0.05). Using S. aureus, neither of the drugs, alone nor in combination, had any effects on the nine biomarkers.

In conclusion, despite the limitation of the ex vivo model, the effect of vitamin C and hydrocortisone on bacteria-induced inflammatory response in human whole blood is limited and following the clinical data.
The Impact of Molecular Subtyping on Pathological Staging of Pancreatic Cancer
Authors: Dreyer Stephan B. , Rae Sarah , Bisset Kirsty , Upstill-Goddard Rosie , Gemenetzis Georgios , Johns Amber L. ,   Australian Pancreatic Cancer Genome Initiative,   Glasgow Precision Oncology Laboratory, Dickson Euan J. , Mittal Anubhav , Gill Anthony J. , Duthie Fraser , Pea Antonio , Lawlor Rita T. , Scarpa Aldo , Salvia Roberto , Pulvirenti Alessandra , Zerbi Alessandro , Marchesi Federica , McKay Colin J. , Biankin Andrew V. , Samra Jaswinder S. , Chang David K. , Jamieson Nigel B.
Published: July 2021

Background:

The long-term outcomes following surgical resection for pancreatic ductal adenocarcinoma (PDAC) remains poor, with only 20% of patients surviving 5 years after pancreatectomy. Patient selection for surgery remains suboptimal largely due to the absence of consideration of aggressive tumor biology.

Objective:

The aim of this study was to evaluate traditional staging criteria for PDAC in the setting of molecular subtypes.

Methods:

Clinicopathological data were obtained for 5 independent cohorts of consecutive unselected patients, totaling n = 1298, including n = 442 that underwent molecular subtyping. The main outcome measure was disease-specific survival following surgical resection for PDAC stratified according to the American Joint Commission for Cancer (TNM) staging criteria, margin status, and molecular subtype.

Results:

TNM staging criteria and margin status confers prognostic value only in tumors with classical pancreatic subtype. Patients with tumors that are of squamous subtype, have a poor outcome irrespective of favorable traditional pathological staging [hazard ratio (HR) 1.54, 95% confidence interval (CI) 1.04–2.28, P = 0.032]. Margin status has no impact on survival in the squamous subtype (16.0 vs 12.1 months, P = 0.374). There were no differences in molecular subtype or gene expression of tumors with positive resection margin status.

Conclusions:

Aggressive tumor biology as measured by molecular subtype predicts poor outcome following pancreatectomy for PDAC and should be utilized to inform patient selection for surgery.
Racial and Ethnic Bias Impact Perceptions of Surgeon Communication
Authors: Tran Thuy B. , Raoof Mustafa , Melstrom Laleh , Kyulo Namgyal , Shaikh Zameer , Jones Veronica C. , Erhunmwunsee Loretta , Fong Yuman , Warner Susanne G.
Published: July 2021

Objective:

To evaluate patient satisfaction scores as a function of physician and patient race and sex.

Background:

Patient satisfaction is increasingly used as a surrogate for physician performance. How patient and surgeon race and ethnicity affect perceptions of surgeon communication and care is not widely explored.

Methods:

Press Ganey patient satisfaction surveys collected from January 2019 to September 2020 were studied. Multivariate logistic regressions were used to identify factors associated with favorable surgeon performance as a function of patient and surgeon demographics.

Results:

A total of 4732 unique outpatient satisfaction survey responses were analyzed. The majority of patients were White (60.5%), followed by Asian (8.6%), Black (4.2%), and Hispanic (4.3%). URM accounted for 8.9% of the 79 surgeons evaluated, and 34% were female. Black, Hispanic, and Asian patients were more likely to report unfavorable experiences than their White counterparts (P < 0.01). Spanish-speaking patients were most likely to perceive that surgeon show less respect for patient concerns (13.9% vs 9.3%, P = 0.004) and inadequate time spent explaining health concerns (12.6% vs 9.2%, P < 0.001). Female surgeons were more likely to achieve the highest overall ratings for effective communication, whereas Asian surgeons received lower scores. Asian surgeons were more likely than non-Asian surgeons to receive lower scores in explanation (37.3% vs 44.1%, P = 0.003). After adjusting for confounding factors, Asian surgeons had 26% lower odds of receiving favorable scores for overall communication (odds ratio: 0.736, 95% confidence interval: 0.619–0.877, P = 0.001).

Conclusions:

Both patient and surgeon race and sex drive negative perceptions of patient-physician communication. As URM report more negative experiences, further studies should focus on effects of surgeon cultural awareness on underrepresented patient satisfaction.
Age-related Opioid Exposure in Trauma: A Secondary Analysis of the Multimodal Analgesia Strategies for Trauma (MAST) Randomized Trial
Authors: Hatton Gabrielle E. , Kregel Heather R. , Pedroza Claudia , Puzio Thaddeus J. , Adams Sasha D. , Wade Charles E. , Kao Lillian S. , Harvin John A.
Published: July 2021

Objective:

Evaluate the effect of age on opioid consumption after traumatic injury.

Summary Background Data:

Older trauma patients receive fewer opioids due to decreased metabolism and increased complications, but adequacy of pain control is unknown. We hypothesized that older trauma patients require fewer opioids to achieve adequate pain control.

Methods:

A secondary analysis of the multimodal analgesia strategies for trauma Trial evaluating the effectiveness of 2 multimodal pain regimens in 1561 trauma patients aged 16 to 96 was performed. Older patients (≥55 years) were compared to younger patients. Median daily oral morphine milligram equivalents (MME) consumption, average numeric rating scale pain scores, complications, and death were assessed. Multivariable analyses were performed.

Results:

Older patients (n = 562) had a median age of 68 years (interquartile range 61–78) compared to 33 (24–43) in younger patients. Older patients had lower injury severity scores (13 [9–20] vs 14 [9–22], P = 0.004), lower average pain scores (numeric rating scale 3 [1–4] vs 4 [2–5], P < 0.001), and consumed fewer MME/day (22 [10–45] vs 52 [28–78], P < 0.001). The multimodal analgesia strategies for trauma multi-modal pain regimen was effective at reducing opioid consumption at all ages. Additionally, on multivariable analysis including pain score adjustment, each decade age increase after 55 years was associated with a 23% reduction in MME/day consumed.

Conclusions:

Older trauma patients required fewer opioids than younger patients with similar characteristics and pain scores. Opioid dosing for post-traumatic pain should consider age. A 20 to 25% dose reduction per decade after age 55 may reduce opioid exposure without altering pain control.
Successful Implementation of Enhanced Recovery in Elective Colorectal Surgery is Variable and Dependent on the Local Environment
Authors: Cardell Chelsea F. , Knapp Leandra , Cohen Mark E. , Ko Clifford Y. , Wick Elizabeth C.
Published: July 2021

Objective:

To evaluate local hospital success with enhanced recovery implementation as measured by colorectal surgery process measure (PM) compliance and characterize local environment factors associated with success within a contemporary quality improvement collaborative.

Summary Background Data:

Enhanced recovery programs (ERP) have proven an effective perioperative quality improvement strategy, but local variation in implementation can hinder patient outcome improvement.

Methods:

Individual hospitals participating in a national colorectal ERP quality improvement program were evaluated with quantitative (patient-level process and outcome) and qualitative (survey and structured interviews with hospital teams) data between 2017 and 2020. Hospitals with implementation success were identified: high performers (80% of elective colorectal surgery patients compliant with >6/9 PMs) and high improvers (top quartile of PM adherence improvement over time). Hospital and implementation characteristics were compared with chi-square tests. Trends in average annual outcome change were estimated with logistic and linear regression.

Results:

Of 207 total hospitals, 62 were characterized as High Performance and 52 as High Improvement. High Performance hospitals were larger, with more annual colorectal surgeries (128 vs 101, P = 0.039). Qualitative assessment revealed fewer barriers of staff buy-in and competing priorities, and more experience with standardized perioperative care in High Performance hospitals. High Improvement hospitals had lower baseline PM adherence (54.1% vs 69.6%, P < 0.001) and less experience with standardized perioperative care (30.8% vs 58.1%, P < 0.001) but were noted to have a positive trend in annual patient outcomes: annual morbidity (Δ-1.14% vs -0.20%, P = 0.035), readmission (Δ-1.85% vs 0.002%, P = 0.037), and prolonged length of stay (Δ-3.94 vs -1.19, P = 0.037) compared to Low Improvement hospitals.

Conclusions:

When evaluating a collection of hospitals implementing ERP, only half of hospitals reached consistent High Performance or high improvement. Characteristics of the local environment need further study to understand the barriers to effective implementation in a pragmatic setting.
Optimal Timing of Administration of Direct-acting Antivirals for Patients With Hepatitis C-associated Hepatocellular Carcinoma Undergoing Liver Transplantation
Authors: Turgeon Michael K. , Shah Shimul A. , Delman Aaron M. , Tran Benjamin V. , Agopian Vatche G. , Wedd Joel P. , Magliocca Joseph F. , Kim Ahyoung , Cameron Andrew , Olyaei Ali , Orloff Susan L. , Anderson Matthew P. , Kubal Chandrashekhar A. , Cannon Robert M. , Locke Jayme E. , Simpson Mary A. , Akoad Mohamed E. , Wongjirad Chelsey P. , Emamaullee Juliet , Moro Amika , Aucejo Federico , Feizpour Cyrus A. , Vagefi Parsia A. , Nguyen Mindie H. , Esquivel Carlos O. , Dhanireddy Kiran , Subramanian Vijay , Chavarriaga Alejandro , Kazimi Marwan M. , Anderson Maia S. , Sonnenday Christopher J. , Kim Steven C. , Foley David P. , Abdouljoud Marwan , Salgia Reena J. , Moris Dimitrios , Sudan Debra L. , Ganesh Swaytha R. , Humar Abhinav , Doyle Majella , Chapman William C. , Maithel Shishir K.
Published: July 2021

Objective:

To investigate the optimal timing of direct acting antiviral (DAA) administration in patients with hepatitis C-associated hepatocellular carcinoma (HCC) undergoing liver transplantation (LT).

Summary of Background Data:

In patients with hepatitis C (HCV) associated HCC undergoing LT, the optimaltimingof direct-acting antivirals (DAA) administration to achieve sustained virologic response (SVR) and improved oncologic outcomes remains a topic of much debate.

Methods:

The United States HCC LT Consortium (2015–2019) was reviewed for patients with primary HCV-associated HCC who underwent LT and received DAA therapy at 20 institutions. Primary outcomes were SVR and HCC recurrence-free survival (RFS).

Results:

Of 857 patients, 725 were within Milan criteria. SVR was associated with improved 5-year RFS (92% vs 77%,P< 0.01). Patients who received DAAs pre-LT, 0–3 months post-LT, and ≥3 months post-LT had SVR rates of 91%, 92%, and 82%, and 5-year RFS of 93%, 94%, and 87%, respectively. Among 427 HCV treatment-naïve patients (no previous interferon therapy), patients who achieved SVR with DAAs had improved 5-year RFS (93% vs 76%,P< 0.01). Patients who received DAAs pre-LT, 0–3 months post-LT, and ≥3 months post-LT had SVR rates of 91%, 93%, and 78% (P< 0.01) and 5-year RFS of 93%, 100%, and 83% (P= 0.01).

Conclusions:

The optimal timing of DAA therapy appears to be 0 to 3 months after LT for HCV-associated HCC, given increased rates of SVR and improved RFS. Delayed administration after transplant should be avoided. A prospective randomized controlled trial is warranted to validate these results.
The Incidence and Cumulative Risk of Major Surgery in Older Persons in the United States
Authors: Becher Robert D. , Vander Wyk Brent , Leo-Summers Linda , Desai Mayur M. , Gill Thomas M.
Published: July 2021

Objective:

The objective of this study was to estimate the incidence and cumulative risk of major surgery in older persons over a 5-year period and evaluate how these estimates differ according to key demographic and geriatric characteristics.

Background:

As the population of the United States ages, there is considerable interest in ensuring safe, high-quality surgical care for older persons. Yet, valid, generalizable data on the occurrence of major surgery in the geriatric population are sparse.

Methods:

We evaluated data from a prospective longitudinal study of 5571 community-living fee-for-service Medicare beneficiaries, aged 65 or older, from the National Health and Aging Trends Study from 2011 to 2016. Major surgeries were identified through linkages with Centers for Medicare and Medicaid Services data. Population-based incidence and cumulative risk estimates incorporated National Health and Aging Trends Study analytic sampling weights and cluster and strata variables.

Results:

The nationally representative incidence of major surgery per 100 person-years was 8.8, with estimates of 5.2 and 3.7 for elective and nonelec-tive surgeries. The adjusted incidence of major surgery peaked at 10.8 in persons 75 to 79 years, increased from 6.6 in the non-frail group to 10.3 in the frail group, and was similar by sex and dementia. The 5-year cumulative risk of major surgery was 13.8%, representing nearly 5 million unique older persons, including 12.1% in persons 85 to 89 years, 9.1% in those ≥90 years, 12.1% in those with frailty, and 12.4% in those with probable dementia.

Conclusions:

Major surgery is a common event in the lives of community-living older persons, including high-risk vulnerable subgroups.
Misophonia Successfully Treated of With Fluoxetine: A Case Report
Authors: Sarigedik Enes , Yurteri Nihal
Published: July 2021

Objective

A large number of people experience misophonia. In 2013, the Amsterdam Study Group recommended diagnostic criteria for misophonia. However, misophonia is not yet included in the Diagnostic and Statistical Manual of Mental Disorders. This report is the first report on drug use that directly affects misophonia and demonstrates a 14-year-old adolescent girl with misophonia successfully treated with fluoxetine.

Methods

The patient's misophonia symptoms had been continuing for approximately 2 years, and her quality of life was significantly reduced. Psychotherapy conditions could not be applied, and fluoxetine 10 mg/d was started and increased to 20 mg/d after a week. At the second-month follow-up, because of partial improvement, fluoxetine dose was increased to 30 mg/d.

Results

At the fourth-month follow-up, there was a 40% decrease in Amsterdam Misophonia Scale score with a 70% decrease in the children’s global assessment scale scores. By the 16th week, the overall functionality level was good at the end.

Conclusions

Fluoxetine may be used as an effective drug in the treatment of misophonia.
Rhodococcus spelaei sp. nov., isolated from a cave, and proposals that Rhodococcus biphenylivorans is a later synonym of Rhodococcus pyridinivorans, Rhodococcus qingshengii and Rhodococcus baikonurensis are later synonyms of Rhodococcus erythropolis, and Rhodococcus percolatus and Rhodococcus imtechensis are later synonyms of Rhodococcus opacus
Authors: Lee Soon Dong , Kim In Seop
Published: July 2021

Two novel actinobacterial strains, designated C9-5T and C3-43, were isolated from soil samples of a cave in Jeju Island, Republic of Korea, and subjected to taxonomic study by a polyphasic approach. The organisms exhibited a typical rod–coccus developmental cycle during growth and grew at 10–30 °C, pH 5–9 and 0–3 % (w/v) NaCl. In 92 single-copy core gene sequence analysis, strain C9-5T was loosely associated with

Rhodococcus tukisamuensis

, albeit sharing low 16S rRNA gene sequence similarity (97.4 %). A combination of morphological and chemotaxonomic characteristics supported assignment with the genus

Rhodococcus

. With respect to 16S rRNA gene sequence similarity, the novel isolates showed the highest identity to the type strain of

Rhodococcus subtropicus

(98.7 % sequence similarity), followed by

Rhodococcus olei

(98.5 %) and

Rhodococcus pedocola

(98.4 %).The average nucleotide identity and digital DNA–DNA hybridization values between strain C9-5T and members of the genus

Rhodococcus

were ≤81.5 and ≤37.1 %, respectively. A set of physiological and chemotaxonomic properties together with overall genomic relatedness differentiated the novel isolates from members of the genus

Rhodococcus

, for which the name Rhodococcus spelaei sp. nov. is proposed. The type strain is C9-5T (=KACC 19822T=DSM 107558T). Based on genome analysis performed here, it is also proposed that

Rhodococcus biphenylivorans

Su et al. 2015 is a later heterotypic synonym of

Rhodococcus pyridinivorans

Yoon et al. 2000,

Rhodococcus qingshengii

Xu et al. 2007 and

Rhodococcus baikonurensis

Li et al. 2004 are later heterotypic synonyms of

Rhodococcus erythropolis

(Gray and Thornton 1928) Goodfellow and Alderson 1979 (Approved Lists 1980), and

Rhodococcus percolatus

Briglia et al. 1996 and

Rhodococcus imtechensis

Ghosh et al. 2006 are later heterotypic synonyms of

Rhodococcus opacus

Klatte et al. 1995.
Continental-scale genomic analysis suggests shared post-admixture adaptation in Americas
Authors: Ongaro Linda , Mondal Mayukh , Flores Rodrigo , Marnetto Davide , Molinaro Ludovica , Alarcón-Riquelme Marta E. , Moreno-Estrada Andrés , Mabunda Nedio , Ventura Mario , Tambets Kristiina , Hellenthal Garrett , Capelli Cristian , Kivisild Toomas , Metspalu Mait , Pagani Luca , Montinaro Francesco
Published: July 2021

American populations are one of the most interesting examples of recently admixed groups, where ancestral components from three major continental human groups (Africans, Eurasians and Native Americans) have admixed within the last 15 generations. Recently, several genetic surveys focusing on thousands of individuals shed light on the geography, chronology and relevance of these events. However, despite the fact that gene-flow could drive adaptive evolution, it is not clear whether and how natural selection acted on the resulting genetic variation in the Americas.

In this study, we analysed the patterns of local ancestry of genomic fragments in genome-wide data for ∼6,000 admixed individuals from ten American countries. In doing so, we identified regions characterized by a Divergent Ancestry Profile (DAP), in which a significant over or under ancestral representation is evident.

Our results highlighted a series of genomic regions with Divergent Ancestry Profiles (DAP) associated with immune system response and relevant medical traits, with the longest DAP region encompassing the Human Leukocyte Antigen locus. Furthermore, we found that DAP regions are enriched in genes linked to cancer-related traits and autoimmune diseases. Then, analyzing the biological impact of these regions, we showed that natural selection could have acted preferentially towards variants located in coding and non-coding transcripts, and characterized by a high deleteriousness score.

Taken together, our analyses suggest that shared patterns of post admixture adaptation occurred at continental scale in the Americas, affecting more often functional and impactful genomic variants.
The collective behavior of ant groups depends on group genotypic composition
Authors: Walsh Justin T. , Garonski Anna , Jackan Claire , Linksvayer Timothy A.
Published: July 2021

Increasingly, researchers document variation between groups in collective behavior, but the genetic architecture of collective behavior and how the genotypic composition of groups affects collective behavior remains unclear. Social insects are ideal for studying the effects of genetic variation on collective behavior because their societies are defined by social interactions. To explore how the genetic composition of groups affects collective behavior, we constructed groups of pharaoh ants (Monomorium pharaonis) from 33 genetically distinct colonies of known pedigree. The groups consisted of either all workers from the same single colony or workers from two genetically different colonies, and we assayed the exploration and aggression of the groups. We found that collective behavior depended on the specific genotypic combination of group members, i.e. we found evidence for genotype-by-genotype epistasis for both collective behaviors. Furthermore, the observed collective behavior of groups differed from the additive genetic expectations of groups, further demonstrating the importance of genotype-by-genotype effects. Finally, the collective aggression of the groups was negatively correlated with the pairwise relatedness estimates between workers within the group. Overall, this study highlights that specific combinations of genotypes influence group-level phenotypes and the difficulty of predicting group-level phenotypes using only additive models.
Birth during the COVID-19 pandemic, but not maternal SARS-CoV-2 infection during pregnancy, is associated with lower neurodevelopmental scores at 6-months
Authors: Shuffrey Lauren C. , Firestein Morgan R. , Kyle Margaret , Fields Andrea , Alcántara Carmela , Amso Dima , Austin Judy , Bain Jennifer M. , Barbosa Jennifer , Bence Mary , Bianco Catherine , Fernández Cristina , Goldman Sylvie , Gyamfi-Bannerman Cynthia , Hott Violet , Hu Yunzhe , Hussain Maha , Factor-Litvak Pam , Lucchini Maristella , Mandel Arthur , Marsh Rachel , McBrian Danielle , Mourad Mirella , Muhle Rebecca , Noble Kimberly , Penn Anna , Rodriguez Cynthia , Sania Ayesha , Silver Wendy G. , O’Reilly Kally C. , Stockwell Melissa , Tottenham Nim , Welch Martha G. , Zork Noelia , Fifer William P. , Monk Catherine , Dumitriu Dani
Published: July 2021

The intrauterine environment strongly influences development. Neurodevelopmental effects of in utero exposure to maternal SARS-CoV-2 infection are widely speculated but currently unknown. The COVID-19 Mother Baby Outcomes (COMBO) initiative was established at Columbia University Irving Medical Center (CUIMC) in New York City to prospectively study the health and wellbeing of infants with and without in utero exposure to maternal SARS-CoV-2 infection. We report findings on 6-month neurodevelopmental outcomes using the parental-report Ages & Stages Questionnaire, 3rd Edition (ASQ-3), from 107 in utero exposed and 131 unexposed full-term infants born between March and December, 2020. We compare these infants to a historical cohort comprised of 62 infants born at CUIMC at least two months prior to the onset of the pandemic. In utero exposure to maternal SARS-CoV-2 infection was not associated with differences on any ASQ-3 subdomain regardless of infection timing or severity, however, infants born during the pandemic had significantly lower scores on gross motor, fine motor, and personal-social subdomains when compared to the historical cohort. Infants born to women who were in the first trimester of pregnancy during the peak of the pandemic in NYC had the lowest personal-social scores. Birth during the pandemic, but not maternal SARS-CoV-2 infection, was associated with differences in neurodevelopmental outcomes at 6-months. These early findings suggest significantly higher public health impact for the generation born during the COVID-19 pandemic than previously anticipated.
Over-Representation of Potential SP4 Target Genes within Schizophrenia-Risk Genes
Authors: Zhou Xianjin
Published: July 2021

Reduction of Sp4 expression causes age-dependent hippocampal vacuolization and many other intermediate phenotypes of schizophrenia in Sp4 hypomorphic mice. Recent human genetic studies from both the Schizophrenia Exome Sequencing Meta-Analysis (SCHEMA) and the Genome-Wide Association Study (GWAS) validated SP4 as a schizophrenia-risk gene over the exome-wide or the genome-wide significance. Truncation of human SP4 gene has an odds ratio of 9.37 (3.38-29.7) for schizophrenia. Despite successful identification of many schizophrenia-risk genes, it is unknown whether and how these risk genes may interact with each other in the development of schizophrenia. By taking advantage of the specific localization of the GC-boxes bound by SP4 transcription factors, I analyzed the relative abundance of these GC-boxes in the proximal promoter regions of schizophrenia-risk genes. I found that the GC-box containing genes are significantly over-represented within schizophrenia-risk genes, suggesting that SP4 is not only a high-risk gene for schizophrenia, but may also act as a hub of network in regulation of many other schizophrenia-risk genes via these GC-boxes in the pathogenesis of schizophrenia.
Challenges and costs of asexuality: Variation in premeiotic genome duplication in gynogenetic hybrids from Cobitis taenia complex
Authors: Dedukh D. , Marta A. , Janko K.
Published: July 2021

The transition from sexual reproduction to asexuality is often triggered by hybridization. The gametogenesis of many hybrid asexuals involves a stage of premeiotic genomic endoreduplication leading to the production of clonal gametes and bypassing genomic incompatibilities that would normally cause hybrid sterility. However, it is still not clear at what gametogenic stage the endoreplication occurs, how many gonial cells it affects and whether its rate differs among clonal lineages. Here, we investigated meiotic and premeiotic cells of diploid and triploid hybrids of spined loaches (Cypriniformes: Cobitis) that reproduce by gynogenesis. We found that naturally as well as experimentally produced F1 hybrid strains undergo an obligatory genome duplication event to achieve asexuality, occurring in the gonocytes just before entering meiosis or, rarely, one or few divisions before meiosis. Surprisingly however, the genome endoreplication was observed only in a minor fraction of the hybrid’s gonocytes, while the vast majority were unable to duplicate their genomes and consequently could not proceed beyond pachytene due to defects in pairing and bivalent formation. We also noted that the rate of endoreplication was significantly higher among gonocytes of hybrids from successful natural clones than of experimentally produced F1 hybrids, indicating that interclonal selection may favour lineages which maximize the rate of premeiotic endoreduplication. We conclude that asexuality and hybrid sterility are intimately related phenomena and the transition from sexual reproduction to asexuality must overcome significant problems with genome incompatibilities with possible impact on reproductive potential.
Developing a measurement scale for employee engagement: a validation study in a South Korean context
Authors: So Byung Han , Kim Ji Hyun , Ro Yun Jeong , Song Ji Hoon
Published: July 2021

Purpose

The purpose of this paper is to develop a reliable and valid measurement scale of employee engagement that can be used in human resources departments in any industry field.

Design/methodology/approach

This study used the measurement development process with three steps. The first step was to generate items for measuring employee engagement. For this reason, the authors proposed an integrated conceptual model based on the results of a literature review and justify the concepts from self-determination theory and person-environment fit theory as the theoretical foundation. The second step was to determine the types of questions suitable for measurement, examining the content validity. Content validity was conducted two times by the group, academic experts and business practitioners. The last step was to examine the exploratory factor analysis (EFA), confirmatory factor analysis (CFA), multi-group analysis and reliability with 352 survey responses from the South Korean business context.

Findings

Findings of the measurement scale development procedure, i.e. employee engagement, should be managed in a balanced manner in all dimensions, as it is composed of four dimensions (person engagement, work engagement, organization engagement and relation engagement) and 16 sub-factors. Additionally, organization engagement was the major factor among the four dimensions of employee engagement with the highest variance explanation. From the statistical standpoint, the employee engagement scale (EES) is possible to use in any industry field because it demonstrated not only content validity and internal consistency reliability but also the three steps of factor analysis (EFA, CFA and multi-group analysis).

Research limitations/implications

This survey was conducted with an assistant manager located in Korea. Therefore, it will be necessary to analyze both leader and employee engagement for those who live in foreign countries. The EES is useful to leaders and human resource managers because it is applicable to managing engagement levels of employees and fosters customized training programs.

Originality/value

This is the first study to develop measurement tools for employee engagement in South Korea. In addition, most studies demonstrated that individual feeling was valued to drive employee engagement. This research, however, proposes an extended concept of employee engagement for four dimensions (person, work, relation and organization) and emphasizes the important relationship between individuals and colleagues in an organization. Based on these results, a theoretically integrated model of employee engagement was developed and a practically valid measurement tool for capturing comprehensive domains of employee engagement was proposed.