Digital Commons Network^™

Community Mobilisation For Adoption Of Clean Cookstoves And Clean Fuel To Reduce Household Air Pollution And Blood Pressure In Lagos, Nigeria: Protocol For A Cluster-Randomised Trial, Ololade Wright, Juliet Iwelunmor, Et Al.

2020-Current year OA Pubs

INTRODUCTION: In Africa, 75% of households are exposed to household air pollution (HAP), a key contributor to cardiovascular disease (CVD). In Nigeria, 90 million households rely on solid fuels for cooking, and 40% of adults have hypertension. Though clean fuel and clean stove (CF-CS) technologies can reduce HAP and CVD risk, their adoption in Africa remains limited.

METHODS AND ANALYSIS: Using the Exploration, Preparation, Implementation and Sustainment framework, this cluster-randomised controlled trial evaluates the implementation and effectiveness of a community mobilisation (CM) strategy versus a self-directed condition (i.e., receipt of information on CF-CS use without CM) on adoption of CF-CS …

Intestinal Microbiome Changes In Response To Amino Acid And Micronutrient Supplementation: Secondary Analysis Of The Amaze Trial, Monica N Mweetwa, Kazi Ahsan, John Louis-Auguste, Ellen Besa, Joram M Posma, Nathan Mcnulty, Micheal J Barrat, Jeff Gordon, Paul Kelly

2020-Current year OA Pubs

Microbial dysbiosis has been linked to environmental enteropathy (EE) and alterations in nutrient absorption; however, compositional modifications following exposure to supplementary nutrients are poorly understood. Here, we report the effect of amino acid and micronutrient supplementation on the gut microbiome of adults with EE. In the AMAZE trial, adults with EE were randomized to amino acids (AA) and/or micronutrients (MM) for 16 weeks in a 2 × 2 factorial design against placebo. Endoscopy was performed before and after intervention, during which duodenal aspirates were collected as well as fecal samples. 16S rRNA amplicon sequencing was performed on both these samples, …

Handling Hemolytic Blood Samples From High-Risk Clinical Areas: A Call To Action, Alan H B Wu, Jerrold H Levy, W Franklin Peacock, Ramzy Rimawi, Manuel Sanchez Luna, Christopher Farnsworth, Hugo Stiegler, Robert H Christenson

2020-Current year OA Pubs

BACKGROUND: Spectrophotometric testing to detect sample hemolysis is available from central laboratory chemistry analyzers. While the cause and preventative measures are known, hemolysis continues to be a common preanalytical error, especially for specimens collected from the emergency department (ED) and intensive care units (ICUs) where point-of-care analyzers are commonly used for whole blood electrolyte testing. Recently, these analyzers have employed technology to detect hemolysis directly on whole blood samples.

METHODS: Experienced laboratorians and physicians from the clinical laboratory, ED, adult and neonatal ICUs provide a summary of the medical importance of in vitro hemolysis. Causes for in vivo hemolysis are …

Risk Of Cardiovascular Events During Delivery Hospitalization Among Pregnant Patients With Mental Health Conditions, Kavya Parekh, R J Waken, Khavya Avula, Katelin B Nickel, Kathryn J Lindley, Cynthia Rogers, Karen E Joynt Maddox

2020-Current year OA Pubs

BACKGROUND: Cardiovascular disease remains the leading cause of maternal mortality. Mental health disorders are risk factors for cardiovascular disease in nonpregnant populations, but their association with delivery outcomes is unknown.

METHODS: This cross-sectional study used delivery hospitalizations from the 2021 National Inpatient Sample. We used generalized estimating equations to fit quasi-Poisson regression models for cardiovascular severe maternal morbidity and mortality (SMM) events as defined by the Centers for Disease Control and Prevention, and non-SMM cardiovascular conditions or complications as defined by the Alliance for Innovation on Maternal Health. Incidence rate ratios were calculated for depression, anxiety, psychosis, bipolar, obsessive-compulsive disorder, …

Rezafungin Versus Caspofungin For The Treatment Of Candidemia And Invasive Candidiasis: Results From The Double-Blind, Randomized, Phase 3 Restore Trial Including The China Extension Study, George R Thompson, Haihui Huang, Sizhou Feng, Yunsong Yu, Alex Soriano, Oliver A Cornely, Bart Jan Kullberg, Peter G Pappas, Marin Kollef, Jose A Vazquez, Patrick M Honore, Laura Cox, Matteo Bassetti

2020-Current year OA Pubs

BACKGROUND: Rezafungin is approved for use in adults with candidemia and/or invasive candidiasis (IC) based on data from the ReSTORE trial (NCT03667690), which demonstrated noninferior efficacy to caspofungin. For regulatory purposes, an additional cohort of patients from China was recruited to ReSTORE. Here, we compared rezafungin and caspofungin in patients with candidemia and/or IC through analysis of the ReSTORE global data plus the China extension study.

METHODS: Adults with candidemia/IC were randomized (1:1) to receive weekly rezafungin (400/200 mg) or daily caspofungin (70/50 mg) for ≤28 days. Noninferiority was concluded for primary efficacy endpoints if the upper bound of the …

Comparative Outcomes Following Candida Bloodstream Infection In Patients With Left Ventricular Assist Devices, Armaghan-E-Rehman Mansoor, Gayathri Krishnan, Julio C Zuniga-Moya, Benjamin Papadopoulus, Andrej Spec, Ige George

2020-Current year OA Pubs

BACKGROUND: Candida bloodstream infections (BSI) carry a high risk of adverse outcomes. Left ventricular assist devices (LVADs) are increasingly used to manage end-stage heart failure; however, they carry a risk of infection. This study evaluates the impact of LVAD presence on outcomes in patients with

METHODS: A total of 1233 patients with

RESULTS: Patients with

CONCLUSIONS: In patients with

Identifying Care Gaps Along The Hiv Treatment Failure Cascade: A Multistate Analysis Of Viral Load Monitoring, Re-Suppression, And Regimen Switches In Zambia, Kombatende Sikombe, Noelle Le Tourneau, Brian Rice, Jake M. Pry, Sandra Simbeza, Laura K. Beres, Anjali Sharma, Njekwa Mukamba, Alison Wringe, James R. Hargreaves, Jacob Mutale, Carolyn Bolton Moore, Izukanji Sikazwe, Elvin Geng, Aaloke Mody

2020-Current year OA Pubs

BACKGROUND: Timely response to treatment failure is critical for improved outcomes and viral re-suppression among people living with HIV, but care gaps along the treatment failure cascade can occur due to delays by both clients (e.g., retention and adherence) and health systems (e.g., fidelity to viral load [VL] monitoring guidelines). We used multistate analysis to identify drivers of implementation gaps in the treatment failure cascade, including time to HIV VL monitoring, re-suppression, and regimen switches, in Zambia.

METHODS AND FINDINGS: We used national electronic HIV health records to identify adults on antiretroviral therapy (ART) for more than 6 months who …

Characterization Of A Mouse Model Of Osteoarticular Infection Using Clinical Isolates Of Staphylococcus Aureus, Philip M Roper, Jessica Beetner, Jennifer L Davis, Christine Shao, Jason Zhang, Linda Cox, Nitin Kumar Pokhrel, James E Cassat, Javier Rangel-Moreno, Gowrishankar Muthukrishnan, Deborah J Veis

2020-Current year OA Pubs

Osteoarticular infection, most commonly due to

Vaccination With Acinetobacter Baumannii Adhesin Abp2d Provides Protection Against Catheter-Associated Urinary Tract Infection, Morgan R Timm, Kevin O Tamadonfar, Taylor M Nye, Jesús Bazán Villicaña, Jerome S Pinkner, Karen W Dodson, Ali H Ellebedy, Scott J Hultgren

2020-Current year OA Pubs

Catheter-associated urinary tract infections (CAUTIs) contribute greatly to the burden of healthcare-associated infections. Acinetobacter baumannii is a Gram-negative bacterium with high levels of antibiotic resistance that is of increasing concern as a CAUTI pathogen. A. baumannii expresses fibrinogen-binding adhesins (Abp1D and Abp2D) that mediate biofilm formation on catheters, which become coated with fibrinogen upon insertion. Here we develop a protein subunit vaccine against the Abp1D and Abp2D receptor binding domains (RBD) and show that vaccination significantly reduces bacterial titers in a female mouse model of CAUTI. We further demonstrate that immunity to Abp2D

Hsp70 Is A Chaperone For Il-33 Activity In Chronic Airway Disease, Omar A. Osorio, Heather E. Raphael, Colin E. Kluender, Ghandi F. Hassan, Lucy S. Cohen, Deborah F. Steinberg, Ella Katz-Kiriakos, Morgan D. Payne, Ethan M. Luo, Jamie L. Hicks, Derek E. Byers, Jennifer Alexander-Brett

2020-Current year OA Pubs

IL-33 is a key driver of type 2 inflammation and implicated in pathology of chronic obstructive pulmonary disease (COPD) and asthma. However, the mechanism for IL-33 secretion and regulation in the context of chronic airway disease is poorly understood. We previously reported an airway disease-associated isoform IL-33Δ34 that escapes nuclear sequestration and is tonically secreted from epithelial cells. Here, we describe how this IL-33Δ34 isoform interacts with HSP70 within cells and is targeted to secretory organelles through coordinated binding to phosphatidylserine (PS) and delivered to compartments for unconventional protein secretion (CUPS). Once secreted, extracellular HSP70 (eHSP70) in complex with IL-33Δ34 …

Society For Healthcare Epidemiology Of America (Shea) Infectious Diseases Fellow Infection Prevention And Control And Healthcare Epidemiology Curriculum, Elise M Martin, Catherine Cichon, Rebecca Choudhury, Shandra R Day, Yasaman Fatemi, Vera P Luther, Terri Stillwell, Abby Sung

2020-Current year OA Pubs

With the rapid expansion of the Infection Prevention Control/Healthcare Epidemiology (IPC/HE) fields over recent decades, the pivotal roles of IPC/HE in hospital regulation, quality improvement, patient safety, and healthcare finances have become increasingly apparent. Consequently, the demand for effective IPC/HE leaders has surged.

Implementation Outcomes Of A Patient Decision-Aid In A Diverse Population With Systemic Lupus Erythematosus In 15 Us Rheumatology Clinics, Jasvinder A Singh, Seth Eisen, Alfred Kim, Et Al.

2020-Current year OA Pubs

OBJECTIVE: The objective of this study was to examine the clinical outcomes during the implementation of a self-administered patient decision-aid (PtDA) for lupus.

METHODS: We provided an effective computerized lupus PtDA in 15 rheumatology outpatient clinics 2019-2024 (including the COVID pandemic). We undertook Organizational Readiness to Implement Change Surveys (ORICs) and Team Learning and Psychological Safety Surveys (TLPSSs) at baseline. The primary study outcome objective measure, percent penetration/reach, was defined as the number of patients who viewed the lupus PtDA at the end of the study, divided by the total number of eligible patients (times 100). We used validated clinical …

Benefit Of Early Oseltamivir Therapy For Adults Hospitalized With Influenza A: An Observational Study, Nathaniel M Lewis, Jennie H Kwon, Et Al.

2020-Current year OA Pubs

BACKGROUND: Clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza.

METHODS: A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during 1 October 2022-21 July 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), …

Dissemination And Implementation Of A Telehealth-Enabled Program For Providing Infectious Disease Expertise In Rural Settings, Robin L P Jump, Jason P Burnham, Et Al.

2020-Current year OA Pubs

BACKGROUND: Telehealth can facilitate improving antibiotic use and related antimicrobial stewardship activities in facilities underserved by infectious diseases (IDs) expertise. We describe implementation of the Department of Veterans Affairs (VA) videoconference antimicrobial stewardship team (VAST) to connect multidisciplinary teams from rural VA medical centers (VAMCs) with geographically distant ID experts.

METHODS: We implemented VASTs at 10 rural VAMCs from September 2021 to February 2024. VASTs consisted of regular meetings between rural VAMCs and an off-site ID expert who met by videoconference to discuss clinical cases, emphasizing recommendations for antibiotic prescribing. The VA Corporate Data Warehouse was used to collect information …

Massively Parallel Immunopeptidome By Dna Sequencing Provides Insights Into Cancer Antigen Presentation, Quanming Shi, Cheryl F Lichti, Et Al.

2020-Current year OA Pubs

Human leukocyte antigens (HLAs) are encoded by the most polymorphic genes in the human genome. HLA class I alleles control antigen presentation for T cell recognition, which is pivotal for autoimmunity, infectious diseases and cancer. Current knowledge of HLA-bound peptides is limited, skewed and falls short of population-wide HLA binding profiles for high-value targets. Here we present ESCAPE-seq (enhanced single-chain antigen presentation sequencing), a massively parallel platform for comprehensive screening of class I HLA-peptide combinations for antigen presentation via deep DNA sequencing. ESCAPE-seq demonstrates programmability, high throughput, sensitivity and nominated viral and cancer epitopes. We simultaneously assessed over 75,000 peptide-HLA …

Let's Doff: A Gown Conservation Strategy For Multidrug-Resistant Organism Colonization During The Covid-19 Pandemic And Beyond, Kelsey L Rowe, Josephine Fox, Carole Leone, Lydia J Grimes, Kenneth Whalen, David K Warren, Jonas Marschall

2020-Current year OA Pubs

A COVID-19 pandemic gown conservation strategy for methicillin-resistant

Macrophage-T Cell Interactions Promote Slamf1 Expression For Enhanced Tb Defense, G V R Krishna Prasad, Steven J Grigsby, Gideon A Erkenswick, Cynthia Portal-Celhay, Ekansh Mittal, Guozhe Yang, Samuel M Fallon, Fengyixin Chen, Thais Klevorn, Neharika Jain, Yuanyuan Li, Makedonka Mitreva, Amanda J Martinot, Joel D Ernst, Jennifer A Philips

2020-Current year OA Pubs

CD4+ T cells are crucial for protective immunity to intracellular pathogens. In addition to secreting cytokines, CD4+ T cells promote control of Mycobacterium tuberculosis infection through cognate interactions with macrophages, but the mechanism has been unclear. Here, we show that SLAMF1/CD150 is highly and uniquely induced in macrophages by antigen-specific interactions with CD4+ T cells. In macrophages, SLAMF1 enhances the generation of reactive oxygen species and restricts Mtb replication. Mtb-infection of mice promotes SLAMF1 expression specifically on infected macrophages, not uninfected bystanders. SLAMF1 expression depends on adaptive immunity and also autophagy. Moreover, Slamf1

Unlocking Efficiency In Real-World Collaborative Studies: A Multi-Site International Study With One-Shot Lossless Glmm Algorithm, Jiayi Tong, Chongliang Luo, Et Al.

2020-Current year OA Pubs

The widespread adoption of real-world data has given rise to numerous healthcare-distributed research networks, but multi-site analyses still face administrative burdens and data privacy challenges. In response, we developed a Collaborative One-shot Lossless Algorithm for Generalized Linear Mixed Models (COLA-GLMM), the first-ever algorithm that achieves both lossless and one-shot properties. COLA-GLMM ensures accuracy against the gold standard of pooled data while requiring only summary statistics and completes within a single communication round, eliminating the usual back-and-forth overhead. We further introduced an enhanced version that employs homomorphic encryption to reduce the risks of summary statistics misuse at the coordinating center. The …

Establishment Of A Reverse Genetics System For Studying Human Immune Functions In Mice, Priya Pal, Shuai Gao, Hongbo Gao, Xiwen Qin, Marina Cella, Qiankun Wang, Liang Shan

2020-Current year OA Pubs

Reverse genetics approaches in mice are widely used to understand gene functions and their aberrations in diseases. However, limitations exist in translating findings from animal models to human physiology. Humanized mice provide a powerful bridge to understanding human physiology and mechanisms of disease pathogenesis while maintaining the feasibility of working with small animals. Methods for generating humanized mouse models that allow scientists to probe contributions of particular genes have been rudimentary. Here, we established an efficient method for generating genetically modified human cord blood-derived CD34

A Single High-Zinc Activation Enhancer Can Control Two Genes Oriented Head-To-Head In Caenorhabditis Elegans, Hanwenheng Liu, Brian Earley, Adelita Mendoza, Patrick Hunt, Sean Teng, Daniel Luke Schneider, Kerry Kornfeld

2020-Current year OA Pubs

Enhancers play critical roles in gene expression, but a full understanding of their complex functions has yet to be defined. The cellular response to excess zinc levels in Caenorhabditis elegans requires the HIZR-1 transcription factor, which binds the high-zinc activation (HZA) enhancer in the promoters of multiple target genes. Cadmium hijacks the excess zinc response by binding and activating HIZR-1. By analyzing the genome-wide transcriptional response to excess zinc and cadmium, we identified two positions in the genome where head-to-head oriented genes are both induced by metals. In both examples, a single predicted HZA enhancer is positioned between the two …

Beliefs About The Causes And Treatment Of Common Mental Illnesses And Suicidality In Rural Uganda, Yang Jae Lee, Rita Mbabazi, Ondine Jevremov, Shakira Nakaweesi, Ella Brodey, Jason Wykoff, Roshan Sivakumar, Rauben Kazungu, Ibrahim Ssekalo, Robert Rosenheck, Alexander C Tsai

2020-Current year OA Pubs

BACKGROUND: Mental illnesses constitute a large and escalating portion of the global burden of disease, particularly in low- and middle-income countries like Uganda. Understanding community perceptions towards mental illness is crucial for developing effective interventions.

AIMS: To explore beliefs about the perceived causes and treatment of common mental illnesses (depression, anxiety, alcohol use disorder) and suicidality in rural eastern Uganda.

METHOD: Qualitative study using 31 in-depth interviews and 4 focus group discussions with healthcare workers, community health workers, community leaders and general community members in Buyende District, Uganda. Vignettes were used to depict mental illnesses to elicit perceptions, and data …

Cord Blood Proteomics Identifies Biomarkers Of Early-Onset Neonatal Sepsis, Leena B. Mithal, Mark E. Becker, Ted Ling-Hu, Young Ah Goo, Sebastian Otero, Aspen Kremer, Surya Pandey, Nicola Lancki, Yawei Li, Yuan Luo, William Grobman, Denise Scholtens, Karen K. Mestan, Patrick C. Seed, Judd F. Hultquist

2020-Current year OA Pubs

BACKGROUNDSymptoms of early-onset neonatal sepsis (EOS) in preterm infants are nonspecific and overlap with normal postnatal physiological adaptations and noninfectious pathologies. This clinical uncertainty and the lack of reliable EOS diagnostics results in liberal use of antibiotics in the first days to weeks of life, leading to increased risk of antibiotic-related morbidities in infants who do not have an invasive infection. METHODSTo identify potential biomarkers for EOS in newborn infants, we used unlabeled tandem mass spectrometry proteomics to identify differentially abundant proteins in the umbilical cord blood of infants with and without culture-confirmed EOS. Proteins were then confirmed using immunoassay, …

The Trapping Of Live Neutrophils By Macrophages During Infection, Kelley N Cooper, Marina Terekhova, Barbara Potempa, Ana D'Aubeterre, Jerome Timbol, Si An Chen, Antoine Dufour, Shunying Jin, Maxim N Artyomov, Jan Potempa, Juhi Bagaitkar

2020-Current year OA Pubs

Neutrophils are highly abundant in the oral mucosal tissues, and their balanced activation and clearance are essential for immune homeostasis. Here, we demonstrate that neutrophils infected with the bacterial pathogen Porphyromonas gingivalis (Pg) are captured alive by macrophages in a manner that bypasses all known receptor-ligand interactions involved in the phagocytosis of either live or dead cells. Mechanistically, upon interaction with Pg, or its protease RgpB (gingipains), live neutrophils undergo rapid remodeling of their proteomes, generating neoepitopes. N-terminomics-based proteomic profiling identified multiple RgpB cleavage sites on several azurophilic granule proteins that are translocated to the surface of live neutrophils via …

High-Frequency, At-Home Monitoring Of Drug Safety And Tolerability In Clinical Trials: Results From Studies Of Fluvoxamine For Covid-19 Treatment, Eric J Lenze, Madeline Nykamp, J Philip Miller, Angela Stevens, Julia Schweiger, Torie Gettinger, Michael Yingling, Yi Zhang, Ginger E Nicol, Charles F Zorumski, Angela M Reiersen

2020-Current year OA Pubs

Clinical trials are increasingly using remote monitoring techniques at the patient's home. We conducted a secondary analysis of remote safety and tolerability monitoring from two fully-remote clinical trials that tested fluvoxamine for the acute treatment of COVID-19. Both trials assessed pulse and blood pressure daily, and one study assessed symptoms daily via Ecological Momentary Assessment. On average, patients provided data on vital signs on 93% of the study days and provided data on side effects on 81% of the study days. With respect to safety, patients taking fluvoxamine had reduced pulse rate compared to placebo, with the greatest difference-5 points-at …

First-Trimester Antibiotic Use For Urinary Tract Infection And Risk Of Congenital Malformations, Sarah S Osmundson, Katelin B Nickel, Susan M. Shortreed, Sascha Dublin, Dustin Stwalley, Michael J Durkin, Paige D Wartko, John M Sahrmann, Ryan Colvin, Anne M Butler

2020-Current year OA Pubs

IMPORTANCE: Clinical guidelines recommend screening and treating bacteriuria in early pregnancy given that urinary tract infections (UTIs) can cause serious maternal and neonatal consequences. Evidence regarding antibiotic exposure during early pregnancy and risk of congenital malformations is limited and inconsistent.

OBJECTIVE: To compare the risk of congenital malformations following first-trimester exposure to different antibiotic agents used to treat UTI.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study included commercially insured pregnant individuals aged 15 to 49 years who were treated for UTI and linked liveborn infants in the Merative MarketScan Commercial Database (2006-2022).

EXPOSURE: First-trimester antibiotic prescription fill of nitrofurantoin, …

Dna Methylation Epitypes Of Burkitt Lymphoma With Distinct Molecular And Clinical Features, Nicole Thomas, Nancy L Bartlett, Et Al.

2020-Current year OA Pubs

UNLABELLED: The genetic subtypes of Burkitt lymphoma have been defined, but the role of epigenetics remains to be comprehensively characterized. We searched genomic DNA from 218 patients across four continents for recurrent DNA methylation patterns and their associations with clinical and molecular features. We identified DNA methylation patterns that were not fully explained by the Epstein-Barr virus status or mutation status, leading to two epitypes described here as HypoBL and HyperBL. Each is characterized by distinct genomic and clinical features including global methylation, mutation burden, aberrant somatic hypermutation, and survival outcomes. Methylation, gene expression, and mutational differences between the epitypes …

Increasing Birth-Dose Hepatitis B Vaccination In Nigeria: Qualitative Analysis Of Data From A Crowdsourcing Open Call, Sonam J Shah, Maria Afadapa, Nkiruka Obodoechina, Olufunto A Olusanya, Temitope Ojo, Dawit Alemu, Juliet Iwelunmor, Et Al.

2020-Current year OA Pubs

BACKGROUND: Despite World Health Organization and Nigerian recommendations for hepatitis B birth-dose (HepB-BD) vaccination, only one-third of Nigerian newborns receive timely HepB-BD vaccination, This study identified facilitators to increasing HepB-BD vaccination based on data from a crowdsourcing open call in Nigeria.

METHODS: Our team conducted an open call across Nigeria for teams to submit ideas on how to increase HepB-BD vaccination. Independent judges evaluated the submissions based on predefined criteria. We analyzed textual data from the top 29 entries using iterative coding and thematic analysis within a socioecological model to identify priority facilitators.

RESULTS: The open call received 362 total …

Integrating Nonindividual Patient Features In Machine Learning Models Of Hospital-Onset Bacteremia, M Cristina Vazquez-Guillamet, Jingwen Zhang, Alice Bewley, Andrew Atkinson, Heidi Holtz, Ziqian Wang, Nicole Brougham, Chenyang Lu, Marin H Kollef, Philip Payne, David Warren, Victoria J Fraser

2020-Current year OA Pubs

IMPORTANCE: Hospital-onset bacteremia and fungemia (HOB) are common and potentially preventable complications of hospital care.

OBJECTIVE: To assess whether nonindividual patient features, which summarize interactions with other patients and health care workers (HCWs), can contribute to predictive and causal machine learning models for HOB.

DESIGN, SETTING, AND PARTICIPANTS: This prognostic study included adult patients admitted to Barnes-Jewish Hospital, an academic hospital in St Louis, Missouri, in 2021. Analyses were developed between October 2023 and August 2024 and in April 2025.

EXPOSURE: Individual patient features were extracted from electronic health records and used to engineer nonpatient features, including interactions with HCWs …

Utility Of The Us Preventive Services Task Force For Preeclampsia Risk Assessment And Aspirin Prophylaxis, Thomas F Mcelrath, Antonina I Frolova, Et Al.

2020-Current year OA Pubs

IMPORTANCE: The US Preventive Services Task Force (USPSTF) guidelines on preeclampsia risk assessment and aspirin prophylaxis (AP) have not been evaluated for clinical utility.

OBJECTIVE: To evaluate which characteristics in the USPSTF guidelines identify risk status and the association of preeclampsia risk with AP recommendations.

DESIGN, SETTING, AND PARTICIPANTS: This observational cohort study enrolled from July 2020 to March 2023 with data analysis performed from October to December 2024. Enrollment occurred at 11 centers throughout the US or via direct-to-participant recruitment. Pregnant participants aged 18 years or older with a singleton pregnancy less than 22 weeks' gestation were selected via …

Covid-19-Associated Pulmonary Aspergillosis In Mechanically Ventilated Patients At 7 Us Hospitals: Epidemiology And Estimated Likelihood Of Invasive Pulmonary Aspergillosis-Results Of The Prospective Msg-017 Study, M Hong Nguyen, Sixto M Leal, Luis Ostrosky-Zeichner, Andrej Spec, George R Thompson, Thomas F Patterson, John Baddley, Rachel Mcmullen, Drashti Shah, Cornelius J Clancy, Gerald Mcgwin, Peter G Pappas

2020-Current year OA Pubs

BACKGROUND: There is no prospective, US multicenter study of COVID-19-associated pulmonary aspergillosis (CAPA). CAPA definitions do not differentiate invasive aspergillosis (IPA) from colonization. Validity of single mycologic test results is unclear.

METHODS: We performed a prospective 7-center US study of mechanically ventilated adults with COVID-19 (April 2021-May 2022). Mycoses Study Group (MSGERC) CAPA criteria include host and clinical factors, imaging and test results (histopathology; bronchoalveolar lavage [BAL] culture and/or BAL or serum galactomannan-immunoassay). Proven, putative, and unlikely IPA were defined by clinical criteria. CAPA-unlikely IPA criteria included survival or negative autopsy following no/limited antifungal treatment. IPA likelihood was estimated using …