Methodologic considerations of household-level methicillin-resistant Staphylococcus aureus decolonization among persons living with HIV.

Background: People living with HIV (PLWH) have a higher prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization and likelihood of recurrent infection than the general population. Simultaneously treating MRSA-colonized household members may improve success with MRSA decolonization strategies. This article describes a pilot trial testing household-level MRSA decolonization and documents methodologic and pragmatic challenges of this approach.

Axon Death Pathways Converge on Axundead to Promote Functional and Structural Axon Disassembly.

Axon degeneration is a hallmark of neurodegenerative disease and neural injury. Axotomy activates an intrinsic pro-degenerative axon death signaling cascade involving loss of the NAD biosynthetic enzyme Nmnat/Nmnat2 in axons, activation of dSarm/Sarm1, and subsequent Sarm-dependent depletion of NAD. Here we identify Axundead (Axed) as a mediator of axon death.

Treatment outcomes for Hodgkin lymphoma: First report from the Brazilian Prospective Registry.

Data about Hodgkin lymphoma (HL) in developing countries are scarce and suggest the existence of substantial disparities in healthcare and outcomes in large areas of the world. In 2009, a prospective registry of HL was implemented in Brazil. Web-based data were contributed by 20 institutions across the country participating in the Brazilian Prospective Hodgkin's Lymphoma Registry.

Evaluation of flood preparedness in government healthcare facilities in Eastern Province, Sri Lanka.

Background: Sri Lanka is vulnerable to floods and other hydro-meteorological disasters. Climate change is projected to increase the intensity of these events.

Objective: This study aimed to assess the flood preparedness in healthcare facilities in Eastern Province.

A phase Ib study of pembrolizumab plus chemotherapy in patients with advanced cancer (PembroPlus).

Background: Pembrolizumab (P) is an anti-PD-1 antibody that blocks the interaction between programmed cell death protein 1 (PD-1) on T-cells and PD-L1 and PD-L2 on tumour cells. A phase Ib trial of P plus chemotherapy was undertaken to evaluate the safety and efficacy.

Methods: Patients with advanced, metastatic solid tumours were enrolled onto one of six treatment arms.

Correction for Fletcher et al., "Vaccine Potential of the Neisseria meningitidis 2086 Lipoprotein".

[This corrects the article DOI: 10.1128/IAI.72.

Bivalent rLP2086 (Trumenba®): Development of a well-characterized vaccine through commercialization.

The phrase "Process is the Product" is often applied to biologics, including multicomponent vaccines composed of complex components that evade complete characterization. Vaccine production processes must be defined and locked early in the development cycle to ensure consistent quality of the vaccine throughout scale-up, clinical studies, and commercialization. This approach of front-loading the development work helped facilitate the accelerated approval of the Biologic License Application for the well-characterized vaccine bivalent rLP2086 (Trumenba®, Pfizer Inc) in 2014 under Breakthrough Therapy Designation.

IGF-1 has sexually dimorphic, pleiotropic, and time-dependent effects on healthspan, pathology, and lifespan.

Reduced circulating levels of IGF-1 have been proposed as a conserved anti-aging mechanism that contributes to increased lifespan in diverse experimental models. However, IGF-1 has also been shown to be essential for normal development and the maintenance of tissue function late into the lifespan. These disparate findings suggest that IGF-1 may be a pleiotropic modulator of health and aging, as reductions in IGF-1 may be beneficial for one aspect of aging, but detrimental for another.

Diversity dynamics: The experience of male Robert Wood Johnson Foundation nurse faculty scholars.

Background: Managing diversity dynamics in academic or clinical settings for men in nursing has unique challenges resulting from their minority status within the profession.

Purpose: The purpose of this study was to share challenges and lessons learned identified by male scholars in the Robert Wood Johnson Foundation Nurse Faculty Scholars program and suggest strategies for creating positive organizations promoting inclusive excellence.

Methods: Multiple strategies including informal mentored discussions and peer-to-peer dialogue throughout the program, formal online surveys of scholars and National Advisory Committee members, and review of scholar progress reports were analyzed as part of the comprehensive evaluation plan of the program.

Parenting and Adolescent Self-Regulation Mediate between Family Socioeconomic Status and Adolescent Adjustment.

Using two waves of longitudinal data, we utilized the family stress model of economic hardship (Conger & Conger, 2002) to test whether family socioeconomic status is related to adolescent adjustment (substance use and academic achievement) through parental knowledge and adolescent self-regulation (behavioral self-control and delay discounting). Participants included 220 adolescent (55% male, mean age = 13 years at Wave 1, mean age = 15 years at Wave 2) and primary caregiver dyads. Results of Structural Equation Modeling revealed significant three-path mediation effects such that low family socioeconomic status at Wave 1 is associated with low parental knowledge at Wave 1, which in turn was related to low academic performance and high substance use at Wave 2 mediated through low adolescent behavioral self-control at Wave 2.

Obtaining tissue diagnosis in lung cancer patients with poor performance status and its influence on treatment and survival.

Introduction: 25% of patients with lung cancer have performance status 3 or 4. A pragmatic approach to investigative procedures is often adopted based on the risks and benefits in these patients and whether tissue diagnosis is necessary for anticipated future treatment. This cohort study investigated factors influencing a clinician's decision to pursue a tissue diagnosis in patients with lung cancer and performance status 3 and 4 and to examine the association of tissue diagnosis with subsequent management and survival.

Continuity of medication management in Medicaid patients with chronic comorbid conditions: An examination by mental health status.

Objective: Patients with serious mental illness (SMI) often have comorbid cardiometabolic conditions (CMCs) that may increase the number of prescribers involved in treatment. This study examined whether patients with SMI (depression and schizophrenia) and comorbid CMCs experience greater discontinuity of prescribing than patients with CMCs alone.

Methods: 2009 Medicaid data were used to compare number and types of prescribers (primary care, cardiometabolic, psychiatric, other) in individuals with 1-3 CMCs (diabetes, hypertension, dyslipidemia) alone (n=76.

Errors in the Administration Technique of Insulin Pen Devices: A Result of Insufficient Education.

Insulin is a high-alert medication in both inpatient and outpatient settings. Insulin can cause significant harm when administered in error. Despite advancements in insulin pen technology, errors in the administration technique remain an issue.

Prescription Drug Utilization and Reimbursement Increased Following State Medicaid Expansion in 2014.

Background: The Affordable Care Act (ACA) expanded health care and medication insurance coverage through Medicaid expansion in select states. Expansion has the potential to increase the availability of health services to patients, including prescription medications. However, limited studies have examined how expansion affected prescription drug utilization and reimbursement.

Effect of Medicaid Policy Changes on Medication Adherence: Differences by Baseline Adherence.

Background: In 2001, the North Carolina (NC) Medicaid program reduced the number of days prescription supply that enrollees could fill from 100 days to 34 days and increased copayments for brand-name medications. Previous work has shown that a change in these policies led to a decrease in medication adherence from 2.9 to 8.

Pharmacy characteristics associated with the provision of medication management services within an integrated care management program.

Objectives: To examine pharmacy operational and personnel characteristics that influence engagement in providing a community pharmacy medication management service within a statewide integrated care management program.

Methods: Before the program launch, all of the pharmacies were surveyed to collect demographic, operational, and personnel characteristics such as weekly prescription volume and number of staff, respectively. Those data were then compared with engagement in the program.

Does the Presence of Anxiety and ADHD Symptoms Add to Social Impairment in Children with Autism Spectrum Disorder?

Children with autism spectrum disorder (ASD) experience internalizing and externalizing problems at higher rates than typically developing children, which could worsen social impairment. The present study compared impairment scores (social responsiveness scale, 2nd edition; SRS-2 scores) in 57 children (3-17 years, 82.5% male) with ASD, either with or without heightened levels of anxiety or ADHD symptoms, all per parent report.

Interactions with Astroglia Influence the Shape of the Developing Dendritic Arbor and Restrict Dendrite Growth Independent of Promoting Synaptic Contacts.

Astroglia play key roles in the development of neurons, ranging from regulating neuron survival to promoting synapse formation, yet basic questions remain about whether astrocytes might be involved in forming the dendritic arbor. Here, we used cultured hippocampal neurons as a simple in vitro model that allowed dendritic growth and geometry to be analyzed quantitatively under conditions where the extent of interactions between neurons and astrocytes varied. When astroglia were proximal to neurons, dendrites and dendritic filopodia oriented toward them, but the general presence of astroglia significantly reduced overall dendrite growth.

Platinum-Gemcitabine-Avastin (PGA) for platinum-resistant/refractory ovarian cancer.

Objectives: Synergism between gemcitabine and platinum is known clinically. Bevacizumab in combination with single-agent chemotherapy has demonstrated significant clinical activity in platinum-resistant recurrent ovarian cancer in AURELIA study. However, the efficacy of platinum-gemcitabine-bevacizumab (PGA) has not been investigated in the platinum-resistant population.

Behavioral and Other Characteristics Associated with HIV Viral Load in an Outpatient Clinic.

Persons living with HIV (PLWH) who are engaged in care, yet not virally suppressed, represent a risk for transmission and opportunity for risk reduction interventions. This study describes characteristics of an outpatient clinic cohort of PLWH by laboratory confirmed viral suppression status and examines associations with demographics and sexual and drug use behaviors gathered through questionnaire. From a sample of 500 clinic patients, 438 were prescribed antiretroviral treatment (ART) and 62 were not.

Controlled Substance Lock-In Programs: Examining An Unintended Consequence Of A Prescription Drug Abuse Policy.

Controlled substance lock-in programs are garnering increased attention from payers and policy makers seeking to combat the epidemic of opioid misuse. These programs require high-risk patients to visit a single prescriber and pharmacy for coverage of controlled substance medication services. Despite high prevalence of the programs in Medicaid, we know little about their effects on patients' behavior and outcomes aside from reducing controlled substance-related claims.