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Comp Immunol Microbiol Infect Dis 2021 May 10;77:101669. Epub 2021 May 10.

Shanghai Key Laboratory of Embryo Original Diseases, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China. Electronic address:

Approximately 15 % of clinically recognized pregnancies end in miscarriage. To explore the vaginal microbiota profile in women diagnosed with early pregnancy miscarriage (including missed miscarriage [M] or empty-sac miscarriage [E]), the microbial community structure in vaginal fluid was evaluated by Illumina MiSeq sequencing of the 16S rRNA gene V4 region and compared with that in women with normal pregnancy (P). Taxa identified in samples from the P, E, and M groups formed distinct clusters. Read More

Clin Microbiol Infect 2021 Jun 8. Epub 2021 Jun 8.

Infectious Diseases Unit, Hospital Universitari Mútua de Terrassa, Barcelona; Universitat Internacional de Catalunya. Electronic address:

Objectives: The aim of the study was to assess the performance of real-time polymerase chain reaction (PCR) targeting the lytA gene (rtPCR-lytA) in plasma, urine and nasopharyngeal (NP) samples for the diagnosis of pneumococcal community-acquired pneumonia (P-CAP).

Methods: Prospective observational study including all consecutive adult CAP patients from November 2015 to May 2017. P-CAP was defined if pneumococcus was identified using conventional methods (CM) and/or a positive rtPCR-lytA was detected in blood, urine or NP samples (NP cut-off ≥8000 copies/mL). Read More

Transpl Int 2021 Jun 11. Epub 2021 Jun 11.

Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.

Background: The COVID-19 pandemic has challenged the delivery of health services. Telehealth allows delivery of care without in-person contacts and minimizes the risk of vial transmission. We aimed to describe the perspectives of kidney transplant recipients on the benefits, challenges and risks of telehealth. Read More

PLoS One 2021 11;16(6):e0253177. Epub 2021 Jun 11.

KNCV Tuberculosis Foundation, The Hague, The Netherlands.

Background: Health care workers (HCWs) are at an increased risk of acquiring tuberculosis (TB) compared to the general population, because of the frequent face to face contact or potential exposure to TB through shared air or space with infectious patient(s), regardless of economic setting and local TB incidence. Information on the burden of active TB disease among HCWs will help guide control measures, can be utilized to evaluate the effectiveness of TB infection prevention programs in the health care setting, and guide necessary actions. However, data on TB among HCW in Ethiopia is limited. Read More

PLoS One 2021 11;16(6):e0253078. Epub 2021 Jun 11.

Department of Radiology, University Hospital Basel, Basel, Switzerland.

Introduction: Pancreatic islet-cell tumors (PICT) often present with atypical signal-characteristics and are often missed on preoperative imaging. The aim of this study is to provide a multiparametric PICT characterization and investigate factors impeding PICT detection.

Material And Methods: This is a detailed MRI analysis of a prospective, monocenter study, including 49 consecutive patients (37 female, 12 male; median age 50) with symptoms due to endogenous hyperinsulinemic hypoglycemia (EHH) and mostly negative prior-imaging. Read More

PLoS One 2021 11;16(6):e0252902. Epub 2021 Jun 11.

Department of Radiology, University of Washington, Seattle, Washington, United States of America.

To evaluate the diagnostic impact of point-of-care breast ultrasound by trained primary care physicians (PCPs) as part of a breast cancer detection program using clinical breast exam in an underserved region of Peru. Medical records and breast ultrasound images of symptomatic women presenting to the Breast Cancer Detection Model (BCDM) in Trujillo, Peru were collected from 2017-2018. Performance was measured against final outcomes derived from regional cancer center medical records, fine needle aspiration results, patient follow-up (sensitivity, specificity, positive, and negative predictive values), and by percent agreement with the retrospective, blinded interpretation of images by a fellowship-trained breast radiologist, and a Peruvian breast surgeon. Read More

JBJS Case Connect 2021 Jun 11;11(2). Epub 2021 Jun 11.

Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois.

Case: A 34-year-old man presented to the emergency department with rhabdomyolysis, acute kidney injury, and pain in the gluteal region after falling asleep on his side after heroin and alcohol use. On examination, he had swollen gluteal compartment musculature; however, he tolerated full passive range of motion with minimal pain. Intercompartmental pressure measured >110 mm Hg; therefore, emergent fasciotomy of the gluteal compartment musculature was performed. Read More

Pediatr Radiol 2021 Jun 11. Epub 2021 Jun 11.

Department of Radiology, Massachusetts General Hospital, 55 Fruit St., BLK SB-0029A, Boston, MA, 02114, USA.

Background: Missed appointments can have an adverse impact on health outcomes by delaying appropriate imaging, which can be critical in influencing treatment decisions.

Objective: To assess for socioeconomic and imaging exam factors associated with missed appointments among children scheduled for diagnostic imaging.

Materials And Methods: We retrospectively analyzed children (<18 years) scheduled for outpatient diagnostic imaging during a 12-month period. Read More

JAMA Netw Open 2021 Jun 1;4(6):e2111788. Epub 2021 Jun 1.

Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor.

Importance: Venous thromboembolism (VTE) is a common complication of COVID-19. It is not well understood how hospitals have managed VTE prevention and the effect of prevention strategies on mortality.

Objective: To characterize frequency, variation across hospitals, and change over time in VTE prophylaxis and treatment-dose anticoagulation in patients hospitalized for COVID-19, as well as the association of anticoagulation strategies with in-hospital and 60-day mortality. Read More

Stat Commun Infect Dis 2020 Sep 11;12(Suppl 1). Epub 2020 Nov 11.

Indiana University Purdue University at Indianapolis, Biostatistics, Indianapolis, IN, USA.

Objectives: Estimation of the cascade of HIV care is essential for evaluating care and treatment programs, informing policy makers and assessing targets such as 90-90-90. A challenge to estimating the cascade based on electronic health record concerns patients "churning" in and out of care. Correctly estimating this dynamic phenomenon in resource-limited settings, such as those found in sub-Saharan Africa, is challenging because of the significant death under-reporting. Read More

Nat Commun 2021 06 10;12(1):3545. Epub 2021 Jun 10.

Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Digital Health Center, Kapelle-Ufer 2, 10117, Berlin, Germany.

Multiplexed fluorescence in situ hybridization techniques have enabled cell-type identification, linking transcriptional heterogeneity with spatial heterogeneity of cells. However, inaccurate cell segmentation reduces the efficacy of cell-type identification and tissue characterization. Here, we present a method called Spot-based Spatial cell-type Analysis by Multidimensional mRNA density estimation (SSAM), a robust cell segmentation-free computational framework for identifying cell-types and tissue domains in 2D and 3D. Read More

Enferm Infecc Microbiol Clin 2021 Jun 7. Epub 2021 Jun 7.

Unidad de coordinación de la Cohorte de la Red de Investigación en Sida (CoRIS), Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España. Electronic address:

Introduction: In Spain HIV testing is recommended to people with risk behaviors for HIV and with indicator conditions related to HIV infection. Missed diagnostic opportunities (MO) are defining as situations where these recommendations are not followed.

Objective: To characterize MO due to risk behaviors (directed) and due to indicator conditions (indicated) among people diagnosed with HIV in the Region of Madrid. Read More

Am J Public Health 2021 Jun 10:e1-e2. Epub 2021 Jun 10.

The author is with the HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, and Columbia University, New York, and is a doctoral candidate at the Graduate School of Public Health and Health Policy, City University of New York.

Growing up as a gay cisgender man on the rural west coast of Puerto Rico, I was no stranger to the dearth of resources to manage my sexual health and navigate a patriarchal society that often ignored the needs of my community. Puerto Rico, a commonwealth territory, ranks as the third most densely populated area in the United States and has among the highest rates of HIV prevalence and incidence in the country. The HIV epidemic in Puerto Rico is largely concentrated among sexual minority men. Read More

Sex Transm Dis 2021 Mar 16. Epub 2021 Mar 16.

1Hawaii Department of Health, Honolulu, HI 96816 2Office of Public Health Studies, University of Hawaii, Honolulu, HI 96822 3University of California San Francisco School of Medicine, San Francisco, CA 94110 4John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96813.

A case of congenital syphilis due to multiple missed opportunities, highlights the challenges of treating syphilis during pregnancy. While cases are increasing in the United States, congenital syphilis, a disease with devastating consequences, is preventable. Read More

JAMA Netw Open 2021 Jun 1;4(6):e2113193. Epub 2021 Jun 1.

The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.

Importance: Early discussion of end-of-life (EOL) care preferences improves clinical outcomes and goal-concordant care. However, most EOL discussions occur approximately 1 month before death, despite most patients desiring information earlier.

Objective: To describe successful navigation and missed opportunities for EOL discussions (eg, advance care planning, palliative care, discontinuation of disease-directed treatment, hospice care, and after-death wishes) between oncologists and outpatients with advanced cancer. Read More

Mod Pathol 2021 Jun 9. Epub 2021 Jun 9.

Department of Pathology, Michigan Medicine, Ann Arbor, MI, USA.

Vibration-controlled transient elastography (VCTE) is a non-invasive method of evaluating liver fibrosis and steatosis. It can easily be performed in the outpatient setting and has been suggested as an alternative to liver biopsy. However, VCTE and biopsy discrepancies commonly occur. Read More

Gut 2021 Jun 9. Epub 2021 Jun 9.

Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain

Objective: Implementation of faecal immunochemical tests (FIT) as a triage test in primary healthcare may improve the efficiency of referrals without missing cases of colorectal cancer (CRC). We aim to summarise the performance characteristics of FITs for CRC in symptomatic patients presenting to primary healthcare.

Design: We performed a systematic literature review of Medline and EMBASE databases from May 2018 to November 2020. Read More

BMJ Open 2021 Jun 9;11(6):e046333. Epub 2021 Jun 9.

Faculty of Medicine, Université Laval, Quebec, QC, Canada.

Objectives: We aimed to develop a systematic synthesis of systematic reviews of health impacts of climate change, by synthesising studies' characteristics, climate impacts, health outcomes and key findings.

Design: We conducted an overview of systematic reviews of health impacts of climate change. We registered our review in PROSPERO (CRD42019145972). Read More

Trials 2021 Jun 9;22(1):389. Epub 2021 Jun 9.

The Aurum Institute, Parktown, Johannesburg, South Africa.

Background: South Africa has achieved drug-susceptible TB (DS-TB) treatment success of only 77% among people with new and previously treated TB. Alternative approaches are required to improve medication adherence and treatment completion to limit transmission, TB relapse and the development of resistance. This study aims to implement and evaluate the use of adherence medication monitors (Wisepill evriMED 1000) with a differentiated response to patient care, among DS-TB patients in three provinces of South Africa. Read More

J Chromatogr A 2021 May 28;1651:462299. Epub 2021 May 28.

R&D Neurosciences, Janssen Pharmaceutica, Turnhoutseweg 30, Beerse, Belgium. Electronic address:

In Alzheimer's disease (AD) brain, one of the histopathological hallmarks is the neurofibrillary tangles consisting of aggregated and hyperphosphorylated tau. Currently many tau binding antibodies are under development to target the extracellular species responsible for the spreading of the disease in the brain. As such, an in-house developed antibody JNJ-63733657 with picomolar affinity towards tau phosphorylated at both T212 and T217 (further named p217+tau) was recently tested in phase I clinical trial NCT03375697. Read More

PLoS One 2021 9;16(6):e0241254. Epub 2021 Jun 9.

Environmental and Fisheries Sciences Division, Northwest Fisheries Science Center, National Marine Fisheries Service, National Oceanographic and Atmospheric Administration, Port Orchard, WA, United States of America.

Harbor seals (Phoca vitulina richardii) in the inland waters of Washington were reduced by predator control programs in the twentieth century, but stocks have rebounded since being protected in the 1970s. Three management stocks are recognized, but there is little information on their current abundance. We conducted 38,431 km of aerial line-transect surveys throughout the range of these stocks in 2013-2016, sighting a total of 4,678 groups of harbor seals. Read More

Epileptic Disord 2021 Jun 9. Epub 2021 Jun 9.

Department of Neurology, Vikram Hospital, Bangalore, India.

Posterior parietal epilepsy can be difficult to identify due to complex clinical presentation and non-localisable electrophysiological findings. The inferior parietal lobule (IPL) exhibits normal gyral variation, and hidden among this are cases of refractory surgically remediable epilepsies. We present a case series of four patients with refractory parietal epilepsy in which IPL gyral variation was associated with dysplasia, confirmed histopathologically in three of the cases. Read More

Ecology 2021 Jun 9:e03432. Epub 2021 Jun 9.

Department of Biology, Queen's University, Kingston, Ontario, K7L 3N6, Canada.

Ecological experiments usually infer long-term processes from short-term data, and the analysis of geographic range limits is a good example. Species' geographic ranges may be limited by low fitness due to niche constraints, a hypothesis most directly tested by comparing the fitness of populations transplanted within and beyond the range. Such studies often fail to find beyond-range fitness declines strong enough to conclude that geographic range limits are solely imposed by niche limits. Read More

Pacing Clin Electrophysiol 2021 Jun 8. Epub 2021 Jun 8.

Division of Pacing and Electrophysiology, Rambam Health Care Campus, Haifa, Israel.

Objective: To evaluate the diagnostic and prognostic yield of a comprehensive protocol involving clinical and broad genetic testing in consecutive sudden cardiac arrest (SCA) population.

Background: Determining the pathogenesis of non-ischemic SCA is crucial for management and SCA prevention in other family members METHODS: Families with unexplained non-ischemic SCA event underwent rigorous clinical and genetic protocol after referral to our inherited arrhythmia clinic, during 2011-.2017. Read More

Vox Sang 2021 Jun 8. Epub 2021 Jun 8.

Department of Immunohematology & Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Naturally occurring anti-Kp antibody is extremely rare and was first reported in 1957, named after the first producer 'Penney'. However, the subsequent anti-Kp reports presented were all anti-Kp due to isoimmunization. Individuals with severe bacterial infections particularly Gram-negative bacteria are known to be capable of producing cross-reactive antibodies against Kell blood group system. Read More

J Travel Med 2021 Jun 8. Epub 2021 Jun 8.

Saw Swee Hock School of Public Health, National University of Singapore and National University Health System.

Background: The COVID-19 pandemic has resulted in the closure or partial closure of international borders in almost all countries. Here we investigate the efficacy of imported case detection considering quarantine length and different testing measures for travellers on arrival.

Methods: We examine 8 broad border control strategies from utilising quarantine alone, pretesting, entry and exit testing, and testing during quarantine. Read More

ERJ Open Res 2021 Jan 8;7(1). Epub 2021 Feb 8.

Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia.

Introduction: Acute exacerbations of COPD (AECOPD) are accompanied by escalations in cardiac risk superimposed upon elevated baseline risk. Appropriate treatment for coronary artery disease (CAD) and heart failure with reduced ejection fraction (HFrEF) could improve outcomes. However, securing these diagnoses during AECOPD is difficult, so their true prevalence remains unknown, as does the magnitude of this treatment opportunity. Read More

Methodist Debakey Cardiovasc J 2021 Apr 25;17(1):65-67. Epub 2021 Mar 25.

Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas.

Loperamide, a μ-opioid receptor agonist, can cause cardiotoxicity by inhibiting the potassium ion channel and slowing cardiomyocyte repolarization. This, in turn, can lead to frequent early afterdepolarizations, the most common mechanism of drug-induced long QT syndrome and torsades de pointes. Apical hypertrophic cardiomyopathy (AHCM) is a nonobstructive hypertrophic cardiomyopathy rarely associated with malignant arrhythmias. Read More

Sci Rep 2021 Jun 8;11(1):12073. Epub 2021 Jun 8.

Collaborative Innovation Center for Improving Quality and Increasing Profits of Protected Vegetables in Shanxi, College of Horticulture, Shanxi Agricultural University, Taigu, 030801, Shanxi, People's Republic of China.

The CO saturation point can reach as high as 1819 μmol· mol in carrot (Daucus carota L.). In recent years, carrot has been cultivated in out-of-season greenhouses, but the molecular mechanism of CO enrichment has been ignored, and this is a missed opportunity to gain a comprehensive understanding of this important process. Read More