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BLACK feminism, HISTORY of feminism, FEMINISM, BLACK feminists, WORLD history, CONVERSATION, and RACISM

This roundtable stems from a Zoom event, "New Directions in Feminism and Global Race Studies (a Book Conversation)" with authors Tiffany N. Florvil, Kaiama L. Glover, Annette K. Joseph-Gabriel, Katherine M. Marino, Robin Mitchell, and Jacqueline-Bethel Tchouta Mougoué, hosted by Samantha Pinto. These scholars discussed their recently published books, which expand how we think about transnational feminism and global Black feminisms in the Americas, the Caribbean, Africa, and Europe. The lightly edited transcript of the conversation explores how putting Black women at the center of histories of global feminisms and race studies transforms these fields and the questions that are usually asked. The authors also discussed navigating research challenges and confronting racism in the sources and in the archives. The conversation underscores the importance of intellectual community, as well as the relevance and urgency of Black feminist scholarship today. [ABSTRACT FROM AUTHOR]

Abstract Controversial topics may be uncomfortable for teachers to include in their in-class discussions. However, there are considerable cognitive and social-emotional benefits to engagement in controversial conversations, or classroom discussion about controversial topics. It is critical that teachers support students in respectful discussion to help them develop skills such as problem solving, critical thinking, and the ability to consider issues from multiple perspectives. These skills can enable students to meet larger educational goals such as engaged citizenship. The goal of this article is to highlight the benefits of controversial conversations in the classroom and describe teaching approaches that facilitate effective controversial conversations. First, we identify important factors for teachers’ consideration in supporting effective and beneficial controversial conversations. Second, we provide examples of topics of conversations that may be appropriate for students of varying ages. Third, we review how the structure of conversation, scaffolding, classroom context, relationships, and students’ individual differences can shape controversial conversations. [ABSTRACT FROM AUTHOR]

COVID-19, SARS-CoV-2, and REMDESIVIR

Profoundly B-cell-depleted patients can have prolonged severe acute respiratory syndrome coronavirus 2 infections with evidence of active viral replication, due to inability to mount an adequate humoral response to clear the virus. We present 3 B-cell-depleted patients with prolonged coronavirus disease 2019 infection who were successfully treated with a combination of casirivimab/imdevimab and remdesivir. [ABSTRACT FROM AUTHOR]

COMMUNICABLE diseases, INFECTIOUS arthritis, HOSPITAL patients, CELLULITIS, DRUG abuse, DRUGS, and FISHER exact test

Injection drug use poses a public health challenge. Clinical experience indicates that people who inject drugs (PWID) are hospitalized frequently for infectious diseases, but little is known about outcomes when admitted. Charts were identified from local hospitals between 2013–2018 using consultation lists and hospital record searches. Included individuals injected drugs in the past six months and presented with infection. Charts were accessed using the hospital information system, undergoing primary and secondary reviews using Research Electronic Data Capture (REDCap). The Wilcoxon rank-sum test was used for comparisons between outcome categories. Categorical data were summarized as count and frequency, and compared using Fisher's exact test. Of 240 individuals, 33% were admitted to the intensive care unit, 36% underwent surgery, 12% left against medical advice (AMA), and 9% died. Infectious diagnoses included bacteremia (31%), abscess (29%), endocarditis (29%), cellulitis (20%), sepsis (10%), osteomyelitis (9%), septic arthritis (8%), pneumonia (7%), discitis (2%), meningitis/encephalitis (2%), or other (7%). Sixty-six percent had stable housing and 60% had a family physician. Fifty-four percent of patient-initiated discharges were seen in the emergency department within 30 days and 29% were readmitted. PWID are at risk for infections. Understanding their healthcare trajectory is essential to improve their care. [ABSTRACT FROM AUTHOR]

Heterologous vaccination (“mixing platforms”) for the third (D3) dose of SARS‐CoV‐2 vaccine is a potential strategy to improve antibody responses in solid organ transplant recipients (SOTRs), but data are mixed regarding potential differential immunogenicity. We assessed for differences in immunogenicity and tolerability of homologous (BNT162b2 or mRNA‐1273; D3‐mRNA) versus heterologous (Ad.26.COV2.S; D3‐JJ) D3 among 377 SARS‐CoV‐2‐infection naïve SOTRs who remained seronegative after two mRNA vaccines. We measured anti‐spike titers and used weighted Poisson regression to evaluate seroconversion and development of high‐titers, comparing D3‐JJ to D3‐mRNA, at 1‐, 3‐, and 6 month post‐D3. 1‐month post‐D3, seroconversion (63% vs. 52%, p = .3) and development of high‐titers (29% vs. 25%, p = .7) were comparable between D3‐JJ and D3‐mRNA recipients. 3 month post‐D3, D3‐JJ recipients were 1.4‐fold more likely to seroconvert (80% vs. 57%, weighted incidence‐rate‐ratio: wIRR = 1.101.401.77, p = .006) but not more likely to develop high‐titers (27% vs. 22%, wIRR = 0.440.921.93, p = .8). 6 month post‐D3, D3‐JJ recipients were 1.41‐fold more likely to seroconvert (88% vs. 59%, wIRR = 1.04 1.411.93, p = .029) and 2.63‐fold more likely to develop high‐titers (59% vs. 21%, wIRR = 1.382.635.00, p = .003). There was no differential signal in alloimmune events or reactogenicity between platforms. SOTRs without antibody response after two mRNA vaccines may derive benefit from heterologous Ad.26.COV2.S D3. [ABSTRACT FROM AUTHOR]

COVID-19, SEDENTARY behavior, PHYSICAL activity, HOSPITAL care, and PATIENTS' attitudes

Many patients with COVID-19 experience severe and even fatal disease. Survivors may have long-term health consequences, but data on physical activity and sedentary behaviour are scarce. Therefore, we objectively assessed physical activity (PA) patterns among post-hospitalised patients with COVID-19 and explored associations with patient characteristics, disease severity and cardiac dysfunction. We objectively assessed PA, sedentary behaviour and sleep duration for 24 h/day during 8 days at 3-6 months after COVID-19 hospitalisation. PA and sedentary time were compared across pre-defined subgroups based on patient and disease characteristics, cardiac biomarker release during hospitalisation, abnormal transthoracic echocardiogram at 3-6 months post-hospitalisation and persistence of symptoms post-discharge. PA and sedentary behaviour were assessed in 37 patients (60 ± 10 years old; 78% male). Patients spent 4.2 [3.2; 5.3] h/day light-intensity PA and 1.0 [0.8; 1.4] h/day moderate-to-vigorous intensity PA. Time spent sitting was 9.8 [8.7; 11.2] h/day, which was accumulated in 6 [5; 7] prolonged sitting bouts (≥30 min) and 41 [32; 48] short sitting bouts (<30 min). No differences in PA and sedentary behaviour were found across subgroups, but sleep duration was higher in patients with versus without persistent symptoms (9.1 vs. 8.3 h/day, p = 0.02). Taken together, high levels of sedentary time are common at 3–6 months after COVID-19 hospitalisation, whilst PA and sedentary behaviour are not impacted by patient or disease characteristics. [ABSTRACT FROM AUTHOR]

DISABILITY awareness, PEOPLE with social disabilities, PEOPLE with disabilities, CRITICAL thinking, RESEARCH personnel, and STRATEGIC planning

Objective: The main objectives were to 1) search and map current disability awareness and training activities in Quebec, Canada, 2) collectively reflect on these practices, and 3) develop a five-year strategic plan.Methods: We used an integrated knowledge translation approach whereby researchers and community partners were involved in all stages. This project consisted of two sequential phases: 1) an environmental scan (web review and interview) of current practices, and 2) a reflection process with an external expert-facilitator in social transformation. Outcome results and process data are reported.Results: We identified 129 activities (71 training, 58 awareness) from 39 organizations (from 123 organizations initially invited). A wide range of characteristics were collected for each activity which allowed for the identification of gaps. The working group met seven times in one year to discuss results from phase 1 and co-create a five-year strategic plan. Main priorities are 1) the development of a methodology for measuring collective impact and 2) content synchronization of activities.Conclusion: Involvement of partners and researchers enabled a concerted and efficient approach to the development of a five-year strategic plan.Practice Implications: A transition committee led by partners will ensure implementation and sustainability of the plan across the province. [ABSTRACT FROM AUTHOR]

ANTIBODY formation, VACCINE effectiveness, HEART transplant recipients, SARS-CoV-2, and MESSENGER RNA

While several studies have observed that solid organ transplant recipients experience diminished antibody responses to SARS-CoV-2 mRNA vaccination, data specific to heart and lung transplant (HT/LT) recipients remains sparse. US adult HT and LT recipients completed their vaccine series between January 7 and April 10, 2021. Reactogencity and SARS-CoV-2 anti-spike antibody were assessed after a priming dose (D1) and booster dose (D2). Modified Poisson regression with robust variance estimator was used to evaluate associations between participant characteristics and antibody development. Of 134 heart recipients, there were 38% non-responders (D1-/D2-), 48% booster responders (D1-/D2+), and 14% priming dose responders (D1+/D2+). Of 103 lung recipients, 64% were non-responders, 27% were booster responders, and 9% were priming dose responders. Lung recipients were less likely to develop antibodies (p <.001). Priming dose antibody response was associated with younger recipient age (p =.04), transplant-to-vaccination time ≥6 years (p <.01), and lack of anti-metabolite maintenance immunosuppression (p <.001). Pain at injection site was the most commonly reported reaction (85% after D1, 76% after D2). Serious reactions were rare, the most common being fatigue (2% after D1 and 3% after D2). No serious adverse events were reported. HT and LT recipients experienced diminished antibody response following vaccination; reactogenicity was comparable to that of the general population. LT recipients may exhibit a more impaired antibody response than HT recipients. While current recommendations are to vaccinate eligible candidates and recipients, further studies characterizing the cell-mediated immune response and clinical efficacy of these vaccines in this population are needed. [ABSTRACT FROM AUTHOR]

PROFESSIONAL education, IDENTITY (Psychology), PROFESSIONAL identity, INTERPERSONAL conflict, CONFLICT management, and CURRICULUM

This article describes the development and assessment of teaching strategies to enhance student professional identity development by shifting the pedagogical focus from content knowledge to the practice of interpersonal and conflict resolution skills, and reflection to create awareness, observe growth, and find meaning. [ABSTRACT FROM AUTHOR]

GENDER mainstreaming and REHABILITATION

COVID-19 pandemic, MEDICAL personnel, PEOPLE with epilepsy, SOCIAL distancing, and CAREGIVER attitudes

• The COVID-19 and Epilepsy (COV-E) global surveys were launched in Brazil during the first wave of the pandemic. • People with epilepsy reported worsening seizure control, psychosocial stress, and impaired mental health. • There were difficulties in obtaining drug supplies because of canceled appointments. • Discussion of risk, including SUDEP, was infrequent even before the pandemic. • The surveys remain open to enable new participants to enter data providing insights as the pandemic evolves. The COVID-19 pandemic has had an unprecedented impact on people and healthcare services. The disruption to chronic illnesses, such as epilepsy, may relate to several factors ranging from direct infection to secondary effects from healthcare reorganization and social distancing measures. As part of the COVID-19 and Epilepsy (COV-E) global study, we ascertained the effects of COVID-19 on people with epilepsy in Brazil, based on their perspectives and those of their caregivers. We also evaluated the impact of COVID-19 on the care delivered to people with epilepsy by healthcare workers. We designed separate online surveys for people with epilepsy and their caregivers. A further survey for healthcare workers contained additional assessments of changes to working patterns, productivity, and concerns for those with epilepsy under their care. The Brazilian arm of COV-E initially collected data from May to November 2020 during the country's first wave. We also examined national data to identify the Brazilian states with the highest COVID-19 incidence and related mortality. Lastly, we applied this geographic grouping to our data to explore whether local disease burden played a direct role in difficulties faced by people with epilepsy. Two hundred and forty-one people returned the survey, 20% were individuals with epilepsy (n = 48); 22% were caregivers (n = 53), and 58% were healthcare workers (n = 140). Just under half (43%) of people with epilepsy reported health changes during the pandemic, including worsening seizure control, with specific issues related to stress and impaired mental health. Of respondents prescribed antiseizure medication, 11% reported difficulty taking medication on time due to problems acquiring prescriptions and delayed or canceled medical appointments. Only a small proportion of respondents reported discussing significant epilepsy-related risks in the previous 12 months. Analysis of national COVID-19 data showed a higher disease burden in the states of Sao Paulo and Rio de Janeiro compared to Brazil as a whole. There were, however, no geographic differences observed in survey responses despite variability in the incidence of COVID-19. Our findings suggest that Brazilians with epilepsy have been adversely affected by COVID-19 by factors beyond infection or mortality. Mental health issues and the importance of optimal communication are critical during these difficult times. Healthcare services need to find nuanced approaches and learn from shared international experiences to provide optimal care for people with epilepsy as the direct burden of COVID-19 improves in some countries. In contrast, others face resurgent waves of the pandemic. [ABSTRACT FROM AUTHOR]

GENETIC variation, REWARD (Psychology), and BRAIN imaging

COVID-19, TRANSPLANTATION of organs, tissues, etc., COVID-19 pandemic, SARS-CoV-2, and MEDICAL research

Immunosuppression and comorbidities might place solid organ transplant (SOT) recipients at higher risk from COVID‐19, as suggested by recent case series. We compared 45 SOT vs. 2427 non‐SOT patients who were admitted with COVID‐19 to our health‐care system (March 1, 2020 ‐ August 21, 2020), evaluating hospital length‐of‐stay and inpatient mortality using competing‐risks regression. We compared trajectories of WHO COVID‐19 severity scale using mixed‐effects ordinal logistic regression, adjusting for severity score at admission. SOT and non‐SOT patients had comparable age, sex, and race, but SOT recipients were more likely to have diabetes (60% vs. 34%, p <.001), hypertension (69% vs. 44%, p =.001), HIV (7% vs. 1.4%, p =.024), and peripheral vascular disorders (19% vs. 8%, p =.018). There were no statistically significant differences between SOT and non‐SOT in maximum illness severity score (p =.13), length‐of‐stay (sHR: 0.91.11.4, p =.5), or mortality (sHR: 0.10.41.6, p =.19), although the severity score on admission was slightly lower for SOT (median [IQR] 3 [3, 4]) than for non‐SOT (median [IQR] 4 [3–4]) (p =.042) Despite a higher risk profile, SOT recipients had a faster decline in disease severity over time (OR = 0.760.810.86, p <.001) compared with non‐SOT patients. These findings have implications for transplant decision‐making during the COVID‐19 pandemic, and insights about the impact of SARS‐CoV‐2 on immunosuppressed patients. [ABSTRACT FROM AUTHOR]

COVID-19, MEDICAL research, COVID-19 treatment, VIRUS diseases, and COMMUNICABLE diseases

Keywords: clinical research/practice; infection and infectious agents; infection and infectious agents - viral; infectious disease EN clinical research/practice infection and infectious agents infection and infectious agents - viral infectious disease 2306 2306 1 06/07/21 20210601 NES 210601 I To the Editor: i We thank Drs. The 45 SOT recipients included 28 kidney, six liver, two liver/kidney, five lung, three heart, and one composite tissue allograft recipient. Outcomes of COVID-19 in hospitalized solid organ transplant recipients compared to a matched cohort of non-transplant patients at a national healthcare system in the United States. [Extracted from the article]

DROWSINESS, NAPS (Sleep), ALZHEIMER'S disease, GENOME-wide association studies, SLEEP, RESEARCH, SEQUENCE analysis, RESEARCH methodology, MEDICAL cooperation, EVALUATION research, COMPARATIVE studies, and RESEARCH funding

Background: It is established that Alzheimer's disease (AD) patients experience sleep disruption. However, it remains unknown whether disruption in the quantity, quality or timing of sleep is a risk factor for the onset of AD.Methods: We used the largest published genome-wide association studies of self-reported and accelerometer-measured sleep traits (chronotype, duration, fragmentation, insomnia, daytime napping and daytime sleepiness), and AD. Mendelian randomization (MR) was used to estimate the causal effect of self-reported and accelerometer-measured sleep parameters on AD risk.Results: Overall, there was little evidence to support a causal effect of sleep traits on AD risk. There was some suggestive evidence that self-reported daytime napping was associated with lower AD risk [odds ratio (OR): 0.70, 95% confidence interval (CI): 0.50-0.99). Some other sleep traits (accelerometer-measured 'eveningness' and sleep duration, and self-reported daytime sleepiness) had ORs of a similar magnitude to daytime napping, but were less precisely estimated.Conclusions: Overall, we found very limited evidence to support a causal effect of sleep traits on AD risk. Our findings provide tentative evidence that daytime napping may reduce AD risk. Given that this is the first MR study of multiple self-report and objective sleep traits on AD risk, findings should be replicated using independent samples when such data become available. [ABSTRACT FROM AUTHOR]

ANTIBODY formation, VIRAL vaccines, COVID-19 pandemic, IMMUNE response, TRANSPLANTATION of organs, tissues, etc., MESSENGER RNA, and VACCINATION

This follow-up study measures the antibody response following the second dose of SARS-CoV-2 mRNA vaccine in recipients of solid organ transplants. [ABSTRACT FROM AUTHOR]

ANTIBODY formation, VACCINES, MESSENGER RNA, COVID-19, IMMUNOCOMPROMISED patients, and TRANSPLANTATION of organs, tissues, etc.

This study quantifies antispike protein antibody responses to first-dose messenger RNA (mRNA) COVID-19 vaccines in solid organ transplant recipients to better understand the immunogenicity of the vaccines in immunocompromised individuals. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic, LIVER transplantation, COVID-19, MEDICAL care, and PANDEMICS

COVID‐19 has profoundly affected the American health care system; its effect on the liver transplant (LT) waitlist based on COVID‐19 incidence has not been characterized. Using SRTR data, we compared observed LT waitlist registrations, waitlist mortality, deceased donor LTs (DDLT), and living donor LTs (LDLT) 3/15/2020‐8/31/2020 to expected values based on historical trends 1/2016‐1/2020, stratified by statewide COVID‐19 incidence. Overall, from 3/15 to 4/30, new listings were 11% fewer than expected (IRR = 0.84 0.890.93), LDLTs were 49% fewer (IRR = 0.37 0.510.72), and DDLTs were 9% fewer (IRR = 0.85 0.910.97). In May, new listings were 21% fewer (IRR = 0.74 0.790.84), LDLTs were 42% fewer (IRR = 0.39 0.580.85) and DDLTs were 13% more (IRR = 1.07 1.151.23). Centers in states with the highest incidence 3/15‐4/30 had 59% more waitlist deaths (IRR = 1.09 1.592.32) and 34% fewer DDLTs (IRR = 0.50 0.660.86). By August, waitlist outcomes were occurring at expected rates, except for DDLT (13% more across all incidences). While the early COVID‐affected states endured major transplant practice changes, later in the pandemic the newly COVID‐affected areas were not impacted to the same extent. These results speak to the adaptability of the transplant community in addressing the pandemic and applying new knowledge to patient care. This registry‐based study of liver transplantation in the United States describes the substantial impact of the COVID‐19 pandemic on waitlist events over time and highlights the resiliency of the transplant community. [ABSTRACT FROM AUTHOR]

BIOSIMILARS, DRUG efficacy, PRODUCT safety, PRODUCT reviews, and INFORMATION sharing

The World Health Organization (WHO) issued guidelines for the regulatory evaluation of biosimilars in 2009 and has provided considerable effort toward helping member states implement the evaluation principles in the guidelines into their regulatory practices. Despite this effort, a recent WHO survey (conducted in 2019–2020) has revealed four main remaining challenges: unavailable/insufficient reference products in the country; lack of resources; problems with the quality of some biosimilars (and even more with noninnovator products); and difficulties with the practice of interchangeability and naming of biosimilars. The following have been identified as opportunities/solutions for regulatory authorities to deal with the existing challenges: (1) exchange of information on products with other regulatory authorities and accepting foreign licensed and sourced reference products, hence avoiding conducting unnecessary (duplicate) bridging studies; (2) use of a "reliance" concept and/or joint review for the assessment and approval of biosimilars; (3) review and reassessment of the products already approved before the establishment of a regulatory framework for biosimilar approval; and (4) setting appropriate regulatory oversight for good pharmacovigilance, which is essential for the identification of problems with products and establishing the safety and efficacy of interchangeability of biosimilars. [ABSTRACT FROM AUTHOR]

SOFT contact lenses, CONTACT lenses, ALLERGIC conjunctivitis, BLEPHARITIS, EYE diseases, MEIBOMIAN glands, DIAGNOSIS, DISEASE complications, OPTOMETRY, DRY eye syndromes, CORNEA diseases, CONJUNCTIVA, and TEARS (Body fluid)

Contact lens-related complications are common, affecting around one third of wearers, although most are mild and easily managed. Contact lenses have well-defined anatomical and physiological effects on the ocular surface and can result in other consequences due to the presence of a biologically active material. A contact lens interacts with the tear film, ocular surface, skin, endogenous and environmental microorganisms, components of care solutions and other antigens which may result in disease specific to contact lens wear, such as metabolic or hypersensitivity disorders. Contact lens wear may also modify the epidemiology or pathophysiology of recognised conditions, such as papillary conjunctivitis or microbial keratitis. Wearers may also present with intercurrent disease, meaning concomitant or pre-existing conditions unrelated to contact lens wear, such as allergic eye disease or blepharitis, which may complicate the diagnosis and management of contact lens-related disease. Complications can be grouped into corneal infection (microbial keratitis), corneal inflammation (sterile keratitis), metabolic conditions (epithelial: microcysts, vacuoles, bullae, tight lens syndrome, epithelial oedema; stromal: superficial and deep neovascularisation, stromal oedema [striae/folds], endothelial: blebs, polymegethism/ pleomorphism), mechanical (corneal abrasion, corneal erosion, lens binding, warpage/refractive error changes; superior epithelial arcuate lesion, mucin balls, conjunctival epithelial flaps, ptosis, discomfort), toxic and allergic disorders (papillary conjunctivitis, solution-induced corneal staining, incomplete neutralisation of peroxide, Limbal Stem Cell Deficiency), tear resurfacing disorders/dry eye (contact lens-induced dry eye, Meibomian gland dysfunction, lid wiper epitheliopathy, lid parallel conjunctival folds, inferior closure stain, 3 and 9 o'clock stain, dellen, dimple veil) or contact lens discomfort. This report summarises the best available evidence for the classification, epidemiology, pathophysiology, management and prevention of contact lens-related complications in addition to presenting strategies for optimising contact lens wear. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic, PEOPLE with epilepsy, AT-risk people, EPILEPSY, MEDICAL care, and COVID-19

• The COVID-19 and Epilepsy (COV-E) global surveys were launched in May 2020. • UK respondents (n = 463) report changes in seizure frequency, mental health, and sleep. • Discussion of risk, including of SUDEP, was infrequent even before the pandemic. • COVID-19 is having far-reaching consequences on people with epilepsy. • Our study exemplifies the importance of delivering optimal care to mitigate risk. The COVID-19 pandemic has caused global anguish unparalleled in recent times. As cases rise, increased pressure on health services, combined with severe disruption to people's everyday lives, can adversely affect individuals living with chronic illnesses, including people with epilepsy. Stressors related to disruption to healthcare, finances, mental well-being, relationships, schooling, physical activity, and increased isolation could increase seizures and impair epilepsy self-management. We aim to understand the impact that COVID-19 has had on the health and well-being of people with epilepsy focusing on exposure to increased risk of seizures, associated comorbidity, and mortality. We designed two online surveys with one addressing people with epilepsy directly and the second for caregivers to report on behalf of a person with epilepsy. The survey is ongoing and has yielded 463 UK-based responses by the end of September 2020. Forty percent of respondents reported health changes during the pandemic (n = 185). Respondents cited a change in seizures (19%, n = 88), mental health difficulties (34%, n = 161), and sleep disruption (26%, n = 121) as the main reasons. Thirteen percent found it difficult to take medication on time. A third had difficulty accessing medical services (n = 154), with 8% having had an appointment canceled (n = 39). Only a small proportion reported having had discussions about epilepsy-related risks, such as safety precautions (16%, n = 74); mental health (29%, n = 134); sleep (30%, n = 140); and Sudden Unexpected Death in Epilepsy (SUDEP; 15%, n = 69) in the previous 12 months. These findings suggest that people with epilepsy are currently experiencing health changes, coupled with inadequate access to services. Also, there seems to be a history of poor risk communication in the months preceding the pandemic. As the UK witnesses a second COVID-19 wave, those involved in healthcare delivery must ensure optimal care is provided for people with chronic conditions, such as epilepsy, to ensure that avoidable morbidity and mortality is prevented during the pandemic, and beyond. [ABSTRACT FROM AUTHOR]

KIDNEY transplantation, URINARY tract infections, NOSOLOGY, and DIAGNOSIS

Infections remain a major threat to successful kidney transplantation (KT). To characterize the landscape and impact of post‐KT infections in the modern era, we used United States Renal Data System (USRDS) data linked to the Scientific Registry of Transplant Recipients (SRTR) to study 141 661 Medicare‐primary kidney transplant recipients from January 1, 1999 to December 31, 2014. Infection diagnoses were ascertained by International Classification of Diseases, Ninth Revision (ICD‐9) codes. The cumulative incidence of a post‐KT infection was 36.9% at 3 months, 53.7% at 1 year, and 78.0% at 5 years. The most common infections were urinary tract infection (UTI; 46.8%) and pneumonia (28.2%). Five‐year mortality for kidney transplant recipients who developed an infection was 24.9% vs 7.9% for those who did not, and 5‐year death‐censored graft failure (DCGF) was 20.6% vs 10.1% (P <.001). This translated to a 2.22‐fold higher mortality risk (adjusted hazard ratio [aHR]: 2.152.222.29, P <.001) and 1.92‐fold higher DCGF risk (aHR: 1.841.911.98, P <.001) for kidney transplant recipients who developed an infection, although the magnitude of this higher risk varied across infection types (for example, 3.11‐fold higher mortality risk for sepsis vs 1.62‐fold for a UTI). Post‐KT infections are common and substantially impact mortality and DCGF, even in the modern era. Kidney transplant recipients at high risk for infections might benefit from enhanced surveillance or follow‐up to mitigate these risks. This national study of kidney transplant recipients shows that infections are common, are associated with approximately twofold increased risk of both mortality and death‐censored graft failure, and thus are still an important driver of posttransplant outcomes. [ABSTRACT FROM AUTHOR]

COVID-19, SOCIAL responsibility, LIBRARY school students, and STAY-at-home orders

Population of the study The online intervention classes focused mainly on Library and Information Science Students from across universities in Africa. Among the 100 level students, few of the excerpts of the responses are presented below: I did not have any experience in Library and Information Science as some of my classmates do. Among the 300 Level Students, participants discussed more about the insight they have on careers they could pursue in the field of Library and Information Science. All the students are studying Library and Information Science in their respective universities. [Extracted from the article]

KIDNEY transplantation, ORGAN donors, PEDIATRICS, KIDNEY failure, TRANSPLANTATION of organs, tissues, etc., STATISTICAL significance, DESCRIPTIVE statistics, and COVID-19 pandemic

Background: In March 2020, COVID-19 infections began to rise exponentially in the USA, placing substantial burden on the healthcare system. As a result, there was a rapid change in transplant practices and policies, with cessation of most procedures. Our goal was to understand changes to pediatric kidney transplantation (KT) at the national level during the COVID-19 epidemic. Methods: Using SRTR data, we examined changes in pediatric waitlist registration, waitlist removal or inactivation, and deceased donor and living donor (DDKT/LDKT) events during the start of the disease transmission in the USA compared with the same time the previous year. Results: We saw an initial decrease in DDKT and LDKT by 47% and 82% compared with expected events and then a continual increase, with numbers reaching expected prepandemic levels by May 2020. In the early phase of the pandemic, waitlist inactivation and removals due to death or deteriorating condition rose above expected values by 152% and 189%, respectively. There was a statistically significant decrease in new waitlist additions (IRR 0.49 0.65 0.85) and LDKT (IRR 0.17 0.38 0.84) in states with high vs. low COVID activity. Transplant recipients during the pandemic were more likely to have received a DDKT, but had similar calculated panel–reactive antibody (cPRA) values, waitlist time, and cause of kidney failure as before the pandemic. Conclusions: The COVID-19 pandemic initially reduced access to kidney transplantation among pediatric patients in the USA but has not had a sustained effect. [ABSTRACT FROM AUTHOR]

COVID-19, TRANSPLANTATION of organs, tissues, etc., SARS-CoV-2, CRITICALLY ill, and KIDNEYS

In our first survey of transplant centers in March 2020, >75% of kidney and liver programs were either suspended or operating under restrictions. To safely resume transplantation, we must understand the evolving impact of COVID‐19 on transplant recipients and center‐level practices. We therefore conducted a six‐week follow‐up survey May 7‐15, 2020, and linked responses to the COVID‐19 incidence map, with a response rate of 84%. Suspension of live donor transplantation decreased from 72% in March to 30% in May for kidneys and from 68% to 52% for livers. Restrictions/suspension of deceased donor transplantation decreased from 84% to 58% for kidneys and from 73% to 42% for livers. Resuming transplantation at normal capacity was envisioned by 83% of programs by August 2020. Exclusively using local recovery teams for deceased donor procurement was reported by 28%. Respondents reported caring for a total of 1166 COVID‐19–positive transplant recipients; 25% were critically ill. Telemedicine challenges were reported by 81%. There was a lack of consensus regarding management of potential living donors or candidates with SARS‐CoV‐2. Our findings demonstrate persistent heterogeneity in center‐level response to COVID‐19 even as transplant activity resumes, making ongoing national data collection and real‐time analysis critical to inform best practices. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic, KIDNEY transplantation, COVID-19, MACHINE learning, and PANDEMICS

Clinical decision‐making in kidney transplant (KT) during the coronavirus disease 2019 (COVID‐19) pandemic is understandably a conundrum: both candidates and recipients may face increased acquisition risks and case fatality rates (CFRs). Given our poor understanding of these risks, many centers have paused or reduced KT activity, yet data to inform such decisions are lacking. To quantify the benefit/harm of KT in this context, we conducted a simulation study of immediate‐KT vs delay‐until‐after‐pandemic for different patient phenotypes under a variety of potential COVID‐19 scenarios. A calculator was implemented (http://www.transplantmodels.com/covid%5fsim), and machine learning approaches were used to evaluate the important aspects of our modeling. Characteristics of the pandemic (acquisition risk, CFR) and length of delay (length of pandemic, waitlist priority when modeling deceased donor KT) had greatest influence on benefit/harm. In most scenarios of COVID‐19 dynamics and patient characteristics, immediate KT provided survival benefit; KT only began showing evidence of harm in scenarios where CFRs were substantially higher for KT recipients (eg, ≥50% fatality) than for waitlist registrants. Our simulations suggest that KT could be beneficial in many centers if local resources allow, and our calculator can help identify patients who would benefit most. Furthermore, as the pandemic evolves, our calculator can update these predictions. This simulation study and interactive online tool model the survival benefit or harm of kidney transplantation in the context of COVID‐19, based on epidemic parameters and individual patient characteristics. McElroy et al comment on page 2971. [ABSTRACT FROM AUTHOR]

KIDNEY transplantation, COVID-19, COVID-19 pandemic, and EXPECTED returns

In March 2020, coronavirus disease 2019 (COVID‐19) spread rapidly nationally, causing widespread emergent changes to the health system. Our goal was to understand the impact of the epidemic on kidney transplantation (KT), at both the national and center levels, accounting statistically for waitlist composition. Using Scientific Registry of Transplant Recipients data, we compared data on observed waitlist registrations, waitlist mortality, and living‐donor and deceased‐donor kidney transplants (LDKT/DDKT) March 15‐April 30, 2020 to expected events calculated from preepidemic data January 2016‐February 2020. There were few changes before March 15, at which point the number of new listings/DDKT/LDKT dropped to 18%/24%/87% below the expected value (all P <.001). Only 12 centers performed LDKT March 15‐31; by April 30, 40 centers had resumed LDKT. The decline in new listings and DDKT was greater among states with higher per capita confirmed COVID‐19 cases. The number of waitlist deaths was 2.2‐fold higher than expected in the 5 states with highest COVID‐19 burden (P <.001). DCD DDKT and regional/national imports declined nationwide but most steeply in states with the highest COVID‐19 burden. The COVID‐19 epidemic has resulted in substantial changes to KT; we must adapt and learn rapidly to continue to provide safe access to transplantation and limit the growing indirect toll of an already deadly disease. The authors present national‐ and center‐level data on reduced kidney transplant activity early in the COVID‐19 pandemic and link findings to state‐level COVID‐19 burden. [ABSTRACT FROM AUTHOR]

ACCELEROMETERS, FOOD habits, GLOBAL Positioning System, HEALTH behavior, INGESTION, POPULATION geography, SCHOOL environment, BUILT environment, HOME environment, CROSS-sectional method, SEDENTARY lifestyles, PHYSICAL activity, DESCRIPTIVE statistics, and ADOLESCENCE

Background: Investigation of physical activity and dietary behaviors across locations can inform "setting-specific" health behavior interventions and improve understanding of contextual vulnerabilities to poor health. This study examined how physical activity, sedentary time, and dietary behaviors differed across home, school, and other locations in young adolescents. Methods: Participants were adolescents aged 12–16 years from the Baltimore-Washington, DC and the Seattle areas from a larger cross-sectional study. Participants (n = 472) wore an accelerometer and Global Positioning Systems (GPS) tracker (Mean days = 5.12, SD = 1.62) to collect location-based physical activity and sedentary data. Participants (n = 789) completed 24-h dietary recalls to assess dietary behaviors and eating locations. Spatial analyses were performed to classify daily physical activity, sedentary time patterns, and dietary behaviors by location, categorized as home, school, and "other" locations. Results: Adolescents were least physically active at home (2.5 min/hour of wear time) and school (2.9 min/hour of wear time) compared to "other" locations (5.9 min/hour of wear time). Participants spent a slightly greater proportion of wear time in sedentary time when at school (41 min/hour of wear time) than at home (39 min/hour of wear time), and time in bouts lasting ≥30 min (10 min/hour of wear time) and mean sedentary bout duration (5 min) were highest at school. About 61% of daily energy intake occurred at home, 25% at school, and 14% at "other" locations. Proportionately to energy intake, daily added sugar intake (5 g/100 kcal), fruits and vegetables (0.16 servings/100 kcal), high calorie beverages (0.09 beverages/100 kcal), whole grains (0.04 servings/100 kcal), grams of fiber (0.65 g/100 kcal), and calories of fat (33 kcal/100 kcal) and saturated fat (12 kcal/100 kcal) consumed were nutritionally least favorable at "other" locations. Daily sweet and savory snacks consumed was highest at school (0.14 snacks/100 kcal). Conclusions: Adolescents' health behaviors differed based on the location/environment they were in. Although dietary behaviors were generally more favorable in the home and school locations, physical activity was generally low and sedentary time was higher in these locations. Health behavior interventions that address the multiple locations in which adolescents spend time and use location-specific behavior change strategies should be explored to optimize health behaviors in each location. [ABSTRACT FROM AUTHOR]

ON-site evaluation, STREAMING video & television, VIDEO excerpts, and MEDICAL technology

Introduction: Telecytology using real‐time microscopy has gained popularity for rapid on‐site evaluations (ROSE). Although proficiency testing is routinely used in cytopathology, no established means of competency assessment is currently available for telecytology. Our aim was to determine the feasibility of a dynamic (real‐time) platform to assess telecytology competency. Methods: Remote Medical Technology dynamic (real‐time) video streaming platform for ROSE is used at our institution, and short video clips of telecytology cases were recorded using Camtasia Studio 8 software during different ROSE sessions. Selected MP4 videos (range 13‐88 seconds, mean 33 seconds), along with clinical histories, were used to build a multiple‐choice question test with one training case and 20 test cases, utilising Tutor (Philips) software to host the web‐based test. The test was voluntary for cytopathologists and cytotechnologists. Answers and feedback from test takers were analysed. Results: Thirteen participants—four cytopathologists and nine cytotechnologists—previously trained to use telecytology, volunteered to take the test. Individual scores ranged from 10 (50%) to 19 (95%) with a median of 16 (80%). Most feedback received involved technical difficulties. Conclusions: We present, to the best of our knowledge, the first tool to assess telecytology competency for ROSE using pre‐recorded dynamic streaming videos. Despite technical challenges related to incorporating videos into a web‐based test, the test was feasible and provided users with valuable feedback about their ROSE performance. Future effort will be devoted to establishing a more user‐friendly test platform and establishing a benchmark for passing scores. This paper illustrates that an assessment tool for telecytology competency for ROSE using pre‐recorded dynamic streaming videos is feasible. In addition, the novel test provided users with valuable feedback about their ROSE performance and provides feedback on the challenges related to telecytology ROSE. [ABSTRACT FROM AUTHOR]

SCHOOL children, CHILDREN with dyslexia, EMERGENT literacy, PHONOLOGICAL awareness, NOISE, and ARTIFICIAL satellite tracking

Humans' propensity to acquire literacy relates to several factors, including the ability to understand speech in noise (SiN). Still, the nature of the relation between reading and SiN perception abilities remains poorly understood. Here, we dissect the interplay between (1) reading abilities, (2) classical behavioral predictors of reading (phonological awareness, phonological memory, and rapid automatized naming), and (3) electrophysiological markers of SiN perception in 99 elementary school children (26 with dyslexia). We demonstrate that, in typical readers, cortical representation of the phrasal content of SiN relates to the degree of development of the lexical (but not sublexical) reading strategy. In contrast, classical behavioral predictors of reading abilities and the ability to benefit from visual speech to represent the syllabic content of SiN account for global reading performance (i.e., speed and accuracy of lexical and sublexical reading). In individuals with dyslexia, we found preserved integration of visual speech information to optimize processing of syntactic information but not to sustain acoustic/phonemic processing. Finally, within children with dyslexia, measures of cortical representation of the phrasal content of SiN were negatively related to reading speed and positively related to the compromise between reading precision and reading speed, potentially owing to compensatory attentional mechanisms. These results clarify the nature of the relation between SiN perception and reading abilities in typical child readers and children with dyslexia and identify novel electrophysiological markers of emergent literacy. Humans' propensity to acquire literacy relates to several factors, one of which is the ability to understand speech in noise. This neuroimaging study reveals that reading abilities and neuronal traces of speech processing in noise are related in multiple specific ways. [ABSTRACT FROM AUTHOR]

PREMATURE labor, BIRTH weight, LOW birth weight, BIRTH intervals, COHORT analysis, CHORIOAMNIONITIS, and CHILDBIRTH at home

Background: Approximately 20.5 million infants were born weighing <2500 g (defined as low birthweight or LBW) in 2015, primarily in low- and middle-income countries (LMICs). Infants born LBW, including those born preterm (<37 weeks gestation), are at increased risk for numerous consequences, including neonatal mortality and morbidity as well as suboptimal health and nutritional status later in life. The objective of this study was to identify predictors of LBW and preterm birth among infants in rural Uganda. Methods: Data were derived from a prospective birth cohort study conducted from 2014–2016 in 12 districts across northern and southwestern Uganda. Birth weights were measured in triplicate to the nearest 0.1 kg by trained enumerators within 72 hours of delivery. Gestational age was calculated from the first day of last menstrual period (LMP). Associations between household, maternal, and infant characteristics and birth outcomes (LBW and preterm birth) were assessed using bivariate and multivariable logistic regression with stepwise, backward selection analyses. Results: Among infants in the study, 4.3% were born LBW (143/3,337), and 19.4% were born preterm (744/3,841). In multivariable analysis, mothers who were taller (>150 cm) (adjusted Odds Ratio (aOR) = 0.42 (95% CI = 0.24, 0.72)), multigravida (aOR = 0.62 (95% CI = 0.39, 0.97)), or with adequate birth spacing (>24 months) (aOR = 0.60 (95% CI = 0.39, 0.92)) had lower odds of delivering a LBW infant Mothers with severe household food insecurity (aOR = 1.84 (95% CI = 1.22, 2.79)) or who tested positive for malaria during pregnancy (aOR = 2.06 (95% CI = 1.10, 3.85)) had higher odds of delivering a LBW infant. In addition, in multivariable analysis, mothers who resided in the Southwest (aOR = 0.64 (95% CI = 0.54, 0.76)), were ≥20 years old (aOR = 0.76 (95% CI = 0.61, 0.94)), with adequate birth spacing (aOR = 0.76 (95% CI = 0.63, 0.93)), or attended ≥4 antenatal care (ANC) visits (aOR = 0.56 (95% CI = 0.47, 0.67)) had lower odds of delivering a preterm infant; mothers who were neither married nor cohabitating (aOR = 1.42 (95% CI = 1.00, 2.00)) or delivered at home (aOR = 1.25 (95% CI = 1.04, 1.51)) had higher odds. Conclusions: In rural Uganda, severe household food insecurity, adolescent pregnancy, inadequate birth spacing, malaria infection, suboptimal ANC attendance, and home delivery represent modifiable risk factors associated with higher rates of LBW and/or preterm birth. Future studies on interventions to address these risk factors may be warranted. [ABSTRACT FROM AUTHOR]

COVID-19, COVID-19 pandemic, KIDNEY transplantation, TRANSPLANTATION of organs, tissues, etc., and INVESTIGATIONAL therapies

COVID‐19 is a novel, rapidly changing pandemic: consequently, evidence‐based recommendations in solid organ transplantation (SOT) remain challenging and unclear. To understand the impact on transplant activity across the United States, and center‐level variation in testing, clinical practice, and policies, we conducted a national survey between March 24, 2020 and March 31, 2020 and linked responses to the COVID‐19 incidence map. Response rate was a very high 79.3%, reflecting a strong national priority to better understand COVID‐19. Complete suspension of live donor kidney transplantation was reported by 71.8% and live donor liver by 67.7%. While complete suspension of deceased donor transplantation was less frequent, some restrictions to deceased donor kidney transplantation were reported by 84.0% and deceased donor liver by 73.3%; more stringent restrictions were associated with higher regional incidence of COVID‐19. Shortage of COVID‐19 tests was reported by 42.5%. Respondents reported a total of 148 COVID‐19 recipients from <1 to >10 years posttransplant: 69.6% were kidney recipients, and 25.0% were critically ill. Hydroxychloroquine (HCQ) was used by 78.1% of respondents; azithromycin by 46.9%; tocilizumab by 31.3%, and remdesivir by 25.0%. There is wide heterogeneity in center‐level response across the United States; ongoing national data collection, expert discussion, and clinical studies are critical to informing evidence‐based practices. In this national survey of transplant centers during the COVID‐19 pandemic, the authors report substantial reduction in transplant activity, wide variation in COVID‐19 testing practices, and use of off‐label or investigational therapies in the treatment of 148 COVID‐19‐SOT recipients. [ABSTRACT FROM AUTHOR]

CLOSTRIDIOIDES difficile, GLUTAMATE dehydrogenase, TREATMENT duration, and ENZYME-linked immunosorbent assay

A proportion of patients suspected of Clostridium difficile infection are unnecessarily placed in contact isolation. By introducing a random-access glutamate dehydrogenase (GDH) test for C. difficile, we aimed to reduce isolation time. In addition, we investigated whether the result of the toxin A&B enzyme immunoassay (EIA) was associated with the decision to initiate antibiotic treatment against C. difficile. This retrospective pre- and post-implementation study was from June 3, 2016, to June 4, 2018. Pre-implementation, only a NAAT was performed. In the post-implementation period, a GDH test was performed; if positive, a toxin A&B EIA followed the same day and subsequently a NAAT. Contact isolation for CDI was discontinued when the GDH test was negative. Median time in isolation was 50.8 h pre-implementation (n = 189) versus 28.0 h post-implementation (n = 119), p < 0.001. The GDH test had a negative predictive value of 98.8% (95% CI 97.9–99.4). In 7/31 (22.6%) patients with a positive NAAT and GDH test and a negative toxin A&B EIA, no antibiotics against C. difficile were initiated versus 4/28 (14.3%) patients who were NAAT, GDH and toxin A&B EIA positive. Introducing a random-access screening test resulted in a significant decrease in patient isolation time. The GDH test had a high negative predictive value making it suitable to determine whether contact isolation can be discontinued. Furthermore, the result of a toxin A&B EIA had limited added value on the percentage of patients in whom antibiotic treatment against C. difficile was initiated. [ABSTRACT FROM AUTHOR]

LUNGS, LONGITUDINAL method, HISTORY, and LUNG transplantation

Summary: The aim of this study was to investigate whether there is an impact of donation rates on the quality of lungs used for transplantation and whether donor lung quality affects post‐transplant outcome in the current Lung Allocation Score era. All consecutive adult LTx performed in Eurotransplant (ET) between January 2012 and December 2016 were included (N = 3053). Donors used for LTx in countries with high donation rate were younger (42% vs. 33% ≤45 years, P < 0.0001), were less often smokers (35% vs. 46%, P < 0.0001), had more often clear chest X‐rays (82% vs. 72%, P < 0.0001), had better donor oxygenation ratios (20% vs. 26% with PaO2/FiO2 ≤ 300 mmHg, P < 0.0001), and had better lung donor score values (LDS; 28% vs. 17% with LDS = 6, P < 0.0001) compared with donors used for LTx in countries with low donation rate. Survival rates for the groups LDS = 6 and ≥7 at 5 years were 69.7% and 60.9% (P = 0.007). Lung donor quality significantly impacts on long‐term patient survival. Countries with a low donation rate are more oriented to using donor lungs with a lesser quality compared to countries with a high donation rate. Instead of further stretching donor eligibility criteria, the full potential of the donor pool should be realized. [ABSTRACT FROM AUTHOR]

TOXOPLASMA, POLYMERS, TUBULINS, MICROTUBULES, XENOPUS, and RELATIVES

Background: TgDCX is a doublecortin-domain protein associated with the conoid fibers, a set of strongly curved non-tubular tubulin-polymers in Toxoplasma. TgDCX deletion impairs conoid structure and parasite invasion. TgDCX contains two tubulin-binding domains: a partial P25α and the DCX/doublecortin domain. Orthologues are found in apicomplexans and their free-living relatives Chromera and Vitrella. Results: We report that isolated TgDCX-containing conoid fibers retain their pronounced curvature, but loss of TgDCX destabilizes the fibers. We crystallized and determined the 3D-structure of the DCX-domain, which is similar to those of human doublecortin and well-conserved among TgDCX orthologues. However, the orthologues vary widely in targeting to the conoid in Toxoplasma and in modulating microtubule organization in Xenopus cells. Several orthologues bind to microtubules in Xenopus cells, but only TgDCX generates short, strongly curved microtubule arcs. EM analysis shows microtubules decorated with TgDCX bundled into rafts, often bordered on one edge by a "C"-shaped incomplete tube. A Chromera orthologue closely mimics TgDCX targeting in Toxoplasma and binds to microtubules in Xenopus cells, but does not generate arcs or "C"-shaped tubes, and fails to rescue the defects of the TgDCX-knockout parasite. Conclusions: These observations suggest that species-specific features of TgDCX enable it to generate strongly curved tubulin-polymers to support efficient host-cell invasion. [ABSTRACT FROM AUTHOR]

PHASED array antennas, OPTICAL images, COHERENCE (Optics), BEAM steering, SILICON solar cells, and PHOTONICS

Recent advances in silicon photonics have enabled large-scale optical phased arrays for applications such as beam steering and directional light detection. However, to date, these results have only been applied to coherent light. Many applications, including passive imaging with natural illumination, require operation using incoherent and/or broadband light. Here, we implement an optical phased array designed for these applications using a planar, fractal, path length-matching architecture known as an "H-tree." We demonstrate electronic beamsteering and natural light imaging using this flat, broadband, photonic-integrated device. [ABSTRACT FROM AUTHOR]

PEDIATRIC emergency services, TEENAGE suicide, SUICIDE, SUICIDE prevention, and CONCEPT mapping

The purpose of this study was to include youth, parents, researchers, and clinicians in the identification of feasible and acceptable strategies for teen suicide screening in the pediatric emergency department (ED). Concept mapping methodology was used to elicit stakeholder responses. Regarding the most important result of suicide screening for teens in the pediatric ED, suicide prevention and education for parents, friends, and community members was rated easiest to implement, while short- and long-term follow-up and treatment was rated most important. In terms of successful suicide screening for teens in the pediatric ED, provision of resources and information was rated most feasible, and a safe, friendly, private screening environment was rated most important. The concept maps can be used to align suicide risk screening with the priorities and recommendations of pediatric ED stakeholders. [ABSTRACT FROM AUTHOR]

ERYTHROCYTES, BLOOD platelets, BLOOD groups, ANTIGENS, and POLYMERASE chain reaction

Background: Genotyping has expanded the number red blood cell (RBC) and platelet (PLT) antigens that can readily be typed, but often represents an additional testing cost. The analysis of existing genomic data offers a cost-effective approach. We recently developed automated software (bloodTyper) for determination of RBC and PLT antigens from whole genome sequencing. Here we extend the algorithm to whole exome sequencing (WES).Study Design and Methods: Whole exome sequencing was performed on samples from 75 individuals. WES-based bloodTyper RBC and PLT typing was compared to conventional polymerase chain reaction (PCR) RHD zygosity testing and serologic and single-nucleotide polymorphism (SNP) typing for 38 RBC antigens in 12 systems (17 serologic and 35 SNPs) and 22 PLT antigens (22 SNPs). Samples from the first 20 individuals were used to modify bloodTyper to interpret WES followed by blinded typing of 55 samples.Results: Over the first 20 samples, discordances were noted for C, M, and N antigens, which were due to WES-specific biases. After modification, bloodTyper was 100% accurate on blinded evaluation of the last 55 samples and outperformed both serologic (99.67% accurate) and SNP typing (99.97% accurate) reflected by two Fyb and one N serologic typing errors and one undetected SNP encoding a Jknull phenotype. RHD zygosity testing by bloodTyper was 100% concordant with a combination of hybrid Rhesus box PCR and PCR-restriction fragment length polymorphism for all samples.Conclusion: The automated bloodTyper software was modified for WES biases to allow for accurate RBC and PLT antigen typing. Such analysis could become a routing part of future WES efforts. [ABSTRACT FROM AUTHOR]

EDUCATIONAL leadership, EDUCATIONAL planning, HIGHER education, EDUCATIONAL programs, and POSTSECONDARY education

Promoting the development of educational leadership in higher education is essential for strengthening the quality of teaching and learning. Additional research is needed to conceptualize educational leadership, especially within informal roles. We analysed how faculty members in an academic development program conceptualized educational leadership. Five key characteristics emerged that inform the development of educational leadership capacity in postsecondary contexts: affective qualities, mentoring and empowering, action-orientation, teaching excellence, and research and scholarship. Three characteristics of academic programs aimed at developing educational leadership were also identified: funding and resources to implement a change initiative, building interdisciplinary communities, and embracing identity. [ABSTRACT FROM AUTHOR]

IMMUNOGLOBULIN M, URINE, TUBERCULOSIS, ANTIBODY formation, IMMUNOGLOBULINS, and BODY fluids

Background: Simple methods for the accurate triaging and screening of HIV-associated tuberculosis (TB) are urgently needed. We hypothesized that combining serum antibody with urine lipoarabinomannan (U-LAM) detection can improve the detection of HIV-associated TB. Methods: We performed a case-control study with sampling from a prospective study of South African HIV-infected subjects who were screened for TB prior to initiating antiretroviral therapy. Sera from all available TB cases (n = 74) and randomly selected non-TB controls (n = 30), all tested for U-LAM, sputum microscopy, GeneXpert, and cultures, were evaluated for antibodies to LAM and arabinomannan (AM). Diagnostic logistic regression models for TB were developed based on the primary test results and the additive effect of antibodies with leave-one-out cross-validation. Results: Antibody responses to LAM and AM correlated strongly (p<0.0001), and IgG and IgM reactivities were significantly higher in TB than non-TB patients (p<0.0001). At 80% specificity, the target specificity for a non-sputum-based simple triage/screening test determined by major TB stakeholders, combining U-LAM with IgG detection significantly increased the sensitivity for HIV-associated TB to 92% compared to 30% for U-LAM alone (p<0.001). Sputum microscopy combined with IgG detection increased sensitivity to 88% compared to 31% for microscopy alone, and Xpert with IgG increased sensitivity to 96% and 99% compared to 57% for testing one, and 70% for testing two sputa with Xpert alone, respectively. Conclusion: Combining U-LAM with serum antibody detection could provide a simple low-cost method that meets the requirements for a non-sputum-based test for the screening of HIV-associated TB. [ABSTRACT FROM AUTHOR]

CHILDREN and AGE

Introduction and Aims: Parental role modelling of alcohol use is known to influence alcohol consumption in adolescence and in later life. This study aimed to assess relationships between parental status, child age and alcohol consumption, which have not been well documented.Design and Methods: Data were sourced from the 2013 Australian National Drug Strategy Household Survey. Analyses were conducted for 25-55 year olds (n = 11 591) by parental status, gender and age of youngest child in the household, controlling for socio-demographic factors.Results: Parents were less likely than non-parents to exceed the alcohol guideline for increased lifetime risk (18.2% vs. 24.2%) and short-term risk: at least weekly (14.2% vs. 21.2%); and at least monthly (27.5% vs. 35.9%). Fathers were just as likely to exceed the guidelines for lifetime risk as other men, but those with children aged 0-2, were less likely to exceed the guideline for short-term risk. Women were least likely to exceed the guideline for lifetime risk if they had children aged 0-2, 6-11 or 15 years and over, or the guideline for short-term risk, if they had children aged 0-2, or 15 years and over in the household. Parents were more likely to report drinking in the home.Discussion and Conclusions: Parents were less likely to exceed alcohol guidelines than non-parents, especially mothers whose youngest child was an infant or in high school or older. Consistent with population rates in men, fathers were more likely to exceed alcohol guidelines than mothers, and this excess consumption warrants public health attention. [ABSTRACT FROM AUTHOR]

CLINICAL competence, COMMUNICATION, NURSING, QUALITY assurance, TEACHING methods, HUMAN services programs, EVALUATION of human services programs, DESCRIPTIVE statistics, and OUTPATIENT medical care nursing

Supplemental digital content is available in the text. BACKGROUND/PURPOSE: Ongoing dissatisfaction with anonymous peer feedback led to problem solving to equip nurses to provide and receive respectful and meaningful feedback during face-to-face peer review. PROBLEM: Giving and receiving feedback about other's performance and collaboration are a vital aspect of teambuilding; yet, no programmatic training existed to prepare and equip nurses to feel confident and comfortable in providing or receiving face-to-face peer feedback. A search of the literature demonstrated a dearth of evidence related to developing these teambuilding relationships. The facilitator role appeared in some literature outside nursing but was poorly articulated and yet appeared important to the process. METHODS: This was a quality improvement project that utilized online surveys with both multiple-choice and open-ended questions for data collection across 3 time points for 2 different cohorts over a 2-year implementation period. Strategies included education related to providing feedback with positive intent regardless of feedback type. A facilitator role was used to ensure effective communication and provide support to the peers during the process. RESULTS: Nurse participants described increased comfort and knowledge related to providing/receiving face-to-face feedback. Training and use of a facilitator provided the necessary support; 75% of participants reported comfort with giving face-to-face feedback. However, the greater majority, 80% to 92%, of participants reported increased comfort with receiving face-to-face feedback. CONCLUSIONS: Using active peer-to-peer support has become an accepted standard for face-to-face peer feedback as an aspect of the annual review process. [ABSTRACT FROM AUTHOR]

CANCER relapse, NON-small-cell lung carcinoma, NEOPLASTIC cell transformation, CELL proliferation, and ADENOCARCINOMA

Recurrent broad-scale heterozygous deletions are frequently observed in human cancer. Here we tested the hypothesis that compound haploinsufficiency of neighboring genes at chromosome 8p promotes tumorigenesis. By targeting the mouse orthologs of human DOK2 and DUSP4 genes, which were co-deleted in approximately half of human lung adenocarcinomas, we found that compound-heterozygous deletion of Dok2 and Dusp4 in mice resulted in lung tumorigenesis with short latency and high incidence, and that their co-deletion synergistically activated MAPK signaling and promoted cell proliferation. Conversely, restoration of DOK2 and DUSP4 in lung cancer cells suppressed MAPK activation and cell proliferation. Importantly, in contrast to downregulation of DOK2 or DUSP4 alone, concomitant downregulation of DOK2 and DUSP4 was associated with poor survival in human lung adenocarcinoma. Therefore, our findings lend in vivo experimental support to the notion that compound haploinsufficiency, due to broad-scale chromosome deletions, constitutes a driving force in tumorigenesis. [ABSTRACT FROM AUTHOR]

SEISMOLOGY, MASS-wasting (Geology), ACOUSTIC signal processing, VOLCANIC ash, tuff, etc., DEBRIS avalanches, and ROCKFALL

Abstract Surficial mass movements, such as debris avalanches, rock falls, lahars, pyroclastic flows, and outburst floods, are a dominant hazard at many volcanoes worldwide. Understanding these processes, cataloging their spatio-temporal occurrence, and detecting, tracking, and characterizing these events would advance the science of volcano monitoring and help mitigate hazards. Seismic and acoustic methods show promise for achieving these objectives: many surficial mass movements generate observable seismic and acoustic signals, and many volcanoes are already monitored. Significant progress has been made toward understanding, modeling, and extracting quantitative information from seismic and infrasonic signals generated by surficial mass movements. However, much work remains. In this paper, we review the state of the art of the topic, covering a range of scales and event types from individual rock falls to sector collapses. We consider a full variety of volcanic settings, from submarine to subaerial, shield volcano to stratovolcano. Finally, we discuss future directions toward operational seismo-acoustic monitoring of surficial mass movements at volcanoes. Highlights • Surficial mass movements are common in volcanic areas and generate signals that are recorded by seismic and acoustic arrays. • Our understanding of the relation of these signals to characteristics of the mass movement is limited but improving. • We review the literature on the study of mass movements at volcanoes using seismic and acoustic monitoring. • We discuss future research directions and steps toward operational monitoring. [ABSTRACT FROM AUTHOR]

BODY image in women, WOMEN college students, FOOD habits, AEROBIC exercises, BODY size, SELF-esteem in women, EXERCISE & psychology, INGESTION, BODY image, BREAKFASTS, COMPARATIVE studies, RESEARCH methodology, MEDICAL cooperation, RESEARCH, SATISFACTION, SELF-perception, EVALUATION research, RANDOMIZED controlled trials, and PSYCHOLOGY

Food intake and exercise have been shown to alter body satisfaction in a state-dependent manner. One-time consumption of food perceived as unhealthy can be detrimental to body satisfaction, whereas an acute bout of moderate-intensity aerobic exercise can be beneficial. The current study examined the effect of exercise on state body image and appearance-related self-esteem following consumption of isocaloric foods perceived as healthy or unhealthy in 36 female college students (18-30 years old) in the Northeastern United States. Using a randomized-controlled design, participants attended six study sessions with breakfast conditions (healthy, unhealthy, no food) and activity (exercise, quiet rest) as within-participants factors. Body image questionnaires were completed prior to breakfast condition, between breakfast and activity conditions, and following activity condition. Results showed that consumption of an unhealthy breakfast decreased appearance self-esteem and increased body size perception, whereas consumption of a healthy breakfast did not influence appearance self-esteem but increased body size perception. Exercise did not influence state body image attitudes or perceptions following meal consumption. Study findings suggest that morning meal type, but not aerobic exercise, influence body satisfaction in college-aged females. [ABSTRACT FROM AUTHOR]

LUNG disease diagnosis, LUNG transplantation, ALLOCATION of organs, tissues, etc., PULMONARY hypertension, ORGAN transplant waiting lists, and PATIENTS

Summary: Both Eurotransplant (ET) and the US use the lung allocation score (LAS) to allocate donor lungs. In 2015, the US implemented a new algorithm for calculating the score while ET has fine‐tuned the original model using business rules. A comparison of both models in a contemporary patient cohort was performed. The rank positions and the correlation between both scores were calculated for all patients on the active waiting list in ET. On February 6th 2017, 581 patients were actively listed on the lung transplant waiting list. The median LAS values were 32.56 and 32.70 in ET and the US, respectively. The overall correlation coefficient between both scores was 0.71. Forty‐three per cent of the patients had a < 2 point change in their LAS. US LAS was more than two points lower for 41% and more than two points higher for 16% of the patients. Median ranks and the 90th percentiles for all diagnosis groups did not differ between both scores. Implementing the 2015 US LAS model would not significantly alter the current waiting list in ET. [ABSTRACT FROM AUTHOR]

BONE marrow and MULTIPLE myeloma

Bone marrow niches support multiple myeloma, providing signals and cell-cell interactions essential for disease progression. A 3D bone marrow niche model was developed, in which supportive multipotent mesenchymal stromal cells and their osteogenic derivatives were co-cultured with endothelial progenitor cells. These co-cultured cells formed networks within the 3D culture, facilitating the survival and proliferation of primary CD138+ myeloma cells for up to 28 days. During this culture, no genetic drift was observed within the genomic profile of the primary myeloma cells, indicating a stable outgrowth of the cultured CD138+ population. The 3D bone marrow niche model enabled testing of a novel class of engineered immune cells, so called TEGs (αβT cells engineered to express a defined γδTCR) on primary myeloma cells. TEGs were engineered and tested from both healthy donors and myeloma patients. The added TEGs were capable of migrating through the 3D culture, exerting a killing response towards the primary myeloma cells in 6 out of 8 donor samples after both 24 and 48 hours. Such a killing response was not observed when adding mock transduced T cells. No differences were observed comparing allogeneic and autologous therapy. The supporting stromal microenvironment was unaffected in all conditions after 48 hours. When adding TEG therapy, the 3D model surpassed 2D models in many aspects by enabling analyses of specific homing, and both on- and off-target effects, preparing the ground for the clinical testing of TEGs. The model allows studying novel immunotherapies, therapy resistance mechanisms and possible side-effects for this incurable disease. [ABSTRACT FROM AUTHOR]

CELEBRITIES, DRAMA, EMPATHY, IMAGINATION, MOTION pictures, PERSONALITY, SELF-evaluation, SENSES, SOCIAL skills, NARRATIVES, and PAIN measurement

Transportation, the experience of feeling "transported" into a fictional world, differs widely across individuals. We examined transportation in 3 studies. Study 1 investigated links between individual differences in various measures of audience response, whereas the latter 2 studies examined links between trait measures (independent variables) and audience response (dependent variables). Study 1 found that individual differences in self-reported transportation to a film explained variation in virtually all other dependent measures, such as identification with characters, emotion, and attribution of blame for the protagonist's struggles. Group bonding after watching the film was nonlinearly related to endorphin response (as measured by pain threshold), and transportation related to these variables as well (although more weakly). Study 2 found that individual differences in celebrity worship predicted transportation, as well as tendency to identify with the characters and approve of their behavior. Study 3 demonstrated that individual differences in trait measures of sensation seeking and empathy independently predicted viewers' transportation in 2 very different film genres. Transportation measures for both films were highly correlated, suggesting that tendency to be transported may be less genre-specific than other dependent measures. Altogether, these results illustrate the usefulness of individual differences approaches in the psychological study of fiction. [ABSTRACT FROM AUTHOR]

MEDICAL care, PHARMACY, RURAL nursing, MEDICAL social work, COMMUNITY health nursing, and HEALTH care teams

The Northumberland Vanguard model of care has pharmacists and technicians working in both hospital and primary care settings, and based in geographical hubs. Each team is part of a wider enhanced care team including community nursing, social care and general practice. The model stratifies patients from low to high need for support with medicines, and a range of clinical pharmacy services are provided to improve patient care and outcomes while reducing costs and hospital admissions/readmissions. The care home model ensures rapid follow-up and support for new and discharged residents, including community pharmacy reviews. Since July 2016, over 15 months, the integrated pharmacy team has made 5,124 interventions for 2,445 patients through their caseload, with an estimated 223 hospital admissions avoided. The service continues to evolve and is currently being scaled and further evaluated. In addition, the foundation training programme has allowed newly qualified pharmacists to develop clinical skills in hospital and general practice. This article describes the Northumberland Vanguard model of care and how it has benefitted patients. [ABSTRACT FROM AUTHOR]