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  1. Article ; Online: The New Precision Stewards?

    Karen M. Meagher / Sara Watson / Gina A. Suh / Abinash Virk

    Journal of Personalized Medicine, Vol 12, Iss 1308, p

    2022  Volume 1308

    Abstract: The precision health era is likely to reduce and respond to antimicrobial resistance (AMR). Our stewardship and precision efforts share terminology, seeking to deliver the “right drug, at the right dose, at the right time.” Already, rapid diagnostic ... ...

    Abstract The precision health era is likely to reduce and respond to antimicrobial resistance (AMR). Our stewardship and precision efforts share terminology, seeking to deliver the “right drug, at the right dose, at the right time.” Already, rapid diagnostic testing, phylogenetic surveillance, and real-time outbreak response provide just a few examples of molecular advances we dub “precision stewardship.” However, the AMR causal factors range from the molecular to that of global health policy. Mirroring the cross-sectoral nature of AMR science, the research addressing the ethical, legal and social implications (ELSI) of AMR ranges across academic scholarship. As the rise of AMR is accompanied by an escalating sense of its moral and social significance, what is needed is a parallel field of study. In this paper, we offer a gap analysis of this terrain, or an agenda for “the ELSI of precision stewardship.” In the first section, we discuss the accomplishments of a multi-decade U.S. national investment in ELSI research attending to the advances in human genetics. In the next section, we provide an overview of distinct ELSI topics pertinent to AMR. The distinctiveness of an ELSI agenda for precision stewardship suggests new opportunities for collaboration to build the stewardship teams of the future.
    Keywords antimicrobial drug resistance ; microbial genetics ; antimicrobial stewardship ; biomedical ethics ; biomedical research ; environment and public health ; Medicine ; R
    Subject code 170
    Language English
    Publishing date 2022-08-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Implementation of a multisite, interdisciplinary remote patient monitoring program for ambulatory management of patients with COVID-19

    Jordan D. Coffey / Laura A. Christopherson / Amy E. Glasgow / Kristina K. Pearson / Julie K. Brown / Shelby R. Gathje / Lindsey R. Sangaralingham / Eva M. Carmona Porquera / Abinash Virk / Robert Orenstein / Leigh L. Speicher / Dennis M. Bierle / Ravindra Ganesh / Debra L. Cox / R. Nicole Blegen / Tufia C. Haddad

    npj Digital Medicine, Vol 4, Iss 1, Pp 1-

    2021  Volume 11

    Abstract: Abstract Established technology, operational infrastructure, and nursing resources were leveraged to develop a remote patient monitoring (RPM) program for ambulatory management of patients with COVID-19. The program included two care-delivery models with ...

    Abstract Abstract Established technology, operational infrastructure, and nursing resources were leveraged to develop a remote patient monitoring (RPM) program for ambulatory management of patients with COVID-19. The program included two care-delivery models with different monitoring capabilities supporting variable levels of patient risk for severe illness. The primary objective of this study was to determine the feasibility and safety of a multisite RPM program for management of acute COVID-19 illness. We report an evaluation of 7074 patients served by the program across 41 US states. Among all patients, the RPM technology engagement rate was 78.9%. Rates of emergency department visit and hospitalization within 30 days of enrollment were 11.4% and 9.4%, respectively, and the 30-day mortality rate was 0.4%. A multisite RPM program for management of acute COVID-19 illness is feasible, safe, and associated with a low mortality rate. Further research and expansion of RPM programs for ambulatory management of other acute illnesses are warranted.
    Keywords Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 005
    Language English
    Publishing date 2021-08-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Humoral Responses After SARS-CoV-2 mRNA Vaccination and Breakthrough Infection in Cancer Patients

    Saranya Chumsri, MD / Pooja P. Advani, MD / Tanmayi S. Pai, MD / Zhuo Li, MS / Ashita Mummareddy / Marites Acampora, APRN / Gina A. Reynolds, APRN / Natasha Wylie, APRN / Ashton W. Boyle / Yanyan Lou, MD, PhD / Kabir Mody, MD / Alvaro Moreno-Aspitia, MD / Melanie D. Swift, MD, MPH / Abinash Virk, MD / Adil E. Bharucha, MD / Christopher P. Marquez, MD / Tushar C. Patel, MD / Gregory J. Gores, MD / Keith L. Knutson, PhD

    Mayo Clinic Proceedings: Innovations, Quality & Outcomes, Vol 6, Iss 2, Pp 120-

    2022  Volume 125

    Abstract: Objective: To evaluate the magnitude of humoral response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients with cancer receiving active therapies. Patients and Methods: Patients 18 years or older in ...

    Abstract Objective: To evaluate the magnitude of humoral response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients with cancer receiving active therapies. Patients and Methods: Patients 18 years or older in whom SARS-CoV-2 spike antibody (anti-S Ab) levels were measured after 2 doses of SARS-CoV-2 mRNA vaccines were included. Patients with prior coronavirus disease 2019 (COVID-19) infection or receiving other immunosuppressive therapy were excluded. Results: Among 201 patients who met the criteria, 61 were immunocompetent, 91 had a hematologic malignancy, and 49 had a solid malignancy while receiving treatments associated with cytopenia, including chemotherapy or cyclin-dependent kinase 4 and 6 inhibitors. A significantly greater proportion of immunocompetent patients (96.7% [59 of 61]) had anti-S Ab titers of 500 U/mL or greater compared to patients with hematologic (7.7% [7 of 91) and solid (55.1% [27 of 49]) malignancy (P<.001). Despite 2 doses of SARS-CoV-2 mRNA vaccines, 52.7% of patients with hematologic malignancy (48 of 91) and 8.2% of those with solid malignancy (4 of 49) receiving cytopenic therapy had no seroconversion (spike antibody titers <0.8 U/mL). Two patients subsequently had development of breakthrough COVID-19 infection after full vaccination. Conclusion: A substantial proportion of patients with hematologic and solid malignancies receiving chemotherapies and CDK4/6i had poor humoral responses after SARS-CoV-2 mRNA vaccination. Our study adds to a growing body of literature suggesting that immunosuppressed patients have a suboptimal humoral response to COVID-19 vaccination. Our study also underscores the importance of assessing antibody response after COVID-19 vaccines in these vulnerable patients.
    Keywords Medicine (General) ; R5-920
    Subject code 610 ; 616
    Language English
    Publishing date 2022-04-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Mycobacterium lepromatosis Lepromatous Leprosy in US Citizen Who Traveled to Disease-Endemic Areas

    Abinash Virk / Bobbi Pritt / Robin Patel / James R. Uhl / Spencer A. Bezalel / Lawrence E. Gibson / Barbara M. Stryjewska / Margot S. Peters

    Emerging Infectious Diseases, Vol 23, Iss 11, Pp 1864-

    2017  Volume 1866

    Abstract: We report Mycobacterium lepromatosis infection in a US-born person with an extensive international travel history. Clinical symptoms, histopathology, and management are similar to those of infections caused by M. leprae. Clinicians should consider this ... ...

    Abstract We report Mycobacterium lepromatosis infection in a US-born person with an extensive international travel history. Clinical symptoms, histopathology, and management are similar to those of infections caused by M. leprae. Clinicians should consider this pathogen in the diagnosis of patients with symptoms of leprosy who have traveled to endemic areas.
    Keywords 16S ribosomal RNA gene PCR ; lepromatosis ; lepromatous ; leprosy ; mycobacteria ; Mycobacterium ; Medicine ; R ; Infectious and parasitic diseases ; RC109-216
    Language English
    Publishing date 2017-11-01T00:00:00Z
    Publisher Centers for Disease Control and Prevention
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Immunization education for internal medicine residents: A cluster-randomized controlled trial

    Whitaker, Jennifer A / Caroline M. Poland / Thomas J. Beckman / John B. Bundrick / Rajeev Chaudhry / Diane E. Grill / Andrew J. Halvorsen / Jill M. Huber / Mary J. Kasten / Karen F. Mauck / Ramila A. Mehta / Timothy Olson / Kris G. Thomas / Matthew R. Thomas / Abinash Virk / Majken T. Wingo / Gregory A. Poland

    Vaccine. 2018 Mar. 27, v. 36

    2018  

    Abstract: The aims of this study are to evaluate the impact of a novel immunization curriculum based on the Preferred Cognitive Styles and Decision Making Model (PCSDM) on internal medicine (IM) resident continuity clinic patient panel immunization rates, as well ... ...

    Abstract The aims of this study are to evaluate the impact of a novel immunization curriculum based on the Preferred Cognitive Styles and Decision Making Model (PCSDM) on internal medicine (IM) resident continuity clinic patient panel immunization rates, as well as resident immunization knowledge, attitudes, and practices (KAP).A cluster-randomized controlled trial was performed among 143 IM residents at Mayo Clinic to evaluate the PCSDM curriculum plus fact-based immunization curriculum (intervention) compared to fact-based immunization curriculum alone (control) on the outcomes of resident continuity clinic patient panel immunization rates for influenza, pneumococcal, tetanus, pertussis, and zoster vaccines. Pre-study and post-study immunization KAP surveys were administered to IM residents.Ninety-nine residents participated in the study. Eighty-two residents completed pre-study and post-study surveys. Influenza and pertussis immunization rates improved for both intervention and control groups. There was no significant difference in immunization rate improvement between the groups. Influenza immunization rates improved significantly by 33.4% and 32.3% in the intervention and control groups, respectively. The odds of receiving influenza immunization at the end of the study relative to pre-study for the entire study cohort was 4.6 (p < 0.0001). The odds of having received pertussis immunization at the end of the study relative to pre-study for the entire study cohort was 1.2 (p = 0.0002). Both groups had significant improvements in immunization knowledge. The intervention group had significant improvements in multiple domains that assessed confidence in counseling patients on immunizations.Fact-based immunization education was useful in improving IM resident immunization rates for influenza and pertussis. The PCSDM immunization curriculum did not lead to increases in immunization rates compared with the fact-based curriculum, but it did significantly increase resident confidence in communicating with patients about vaccines.
    Keywords attitudes and opinions ; cognition ; counseling ; curriculum ; decision making ; immunization ; influenza ; medicine ; models ; patients ; surveys ; tetanus ; vaccines
    Language English
    Dates of publication 2018-0327
    Size p. 1823-1829.
    Publishing place Elsevier Ltd
    Document type Article
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2018.02.082
    Database NAL-Catalogue (AGRICOLA)

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