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Article ; Online: Use of Letermovir for CMV Prophylaxis after Allogeneic Hematopoietic Stem Cell Transplantation

Jessica Gill / Davide Stella / Irene Dogliotti / Chiara Dellacasa / Luisa Giaccone / Alessandro Busca

Hemato, Vol 4, Iss 13, Pp 158-

Review of the Literature and Single-Center Real-Life Experience

2023 Volume 169

Abstract: Cytomegalovirus (CMV) reactivation after allogeneic hematopoietic stem cell transplant (allo-HSCT) is mainly due to an increase of latent viremia in previously exposed patients. Furthermore, CMV reactivation in this setting has a significant impact on ... ...

Abstract	Cytomegalovirus (CMV) reactivation after allogeneic hematopoietic stem cell transplant (allo-HSCT) is mainly due to an increase of latent viremia in previously exposed patients. Furthermore, CMV reactivation in this setting has a significant impact on patient survival. Traditional approach to CMV reactivation post allo-HSCT was a pre-emptive treatment with antivirals in the case of increased viremia. However, since 2017, a new antiviral compound, letermovir, has been introduced in clinical practice and is deeply changing the common CMV approach. The toxicity profile of letermovir allowed its use in prophylaxes in patients at high risk of CMV reactivation. This review will focus on the present role of letermovir post allo-HSCT and discuss some possible future applications of the drug. Finally, our single center CMV management in view of the recent introduction of letermovir will be discussed.
Keywords	allogeneic hematopoietic stem cell transplant ; CMV ; pre-emptive therapy ; letermovir ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Simulation translation differences between craft groups

Jye Gard / Chi Duong / Kirsty Murtagh / Jessica Gill / Katherine Lambe / Ian Summers

Advances in Simulation, Vol 7, Iss 1, Pp 1-

2022 Volume 8

Abstract: Abstract Background Many simulation-based clinical education events (SBCEE) aim to prepare healthcare professionals with the knowledge, skills, and features of professionalism needed to deliver quality patient care. However, how these SBCEE learnings are ...

Abstract	Abstract Background Many simulation-based clinical education events (SBCEE) aim to prepare healthcare professionals with the knowledge, skills, and features of professionalism needed to deliver quality patient care. However, how these SBCEE learnings are translated into broader workplace practices by learners from different craft groups has not been described. Objectives To understand how learners from different craft groups (doctors and nurses) anticipate simulation-based learnings will translate to their workplaces and the process by which translation occurs. Design Qualitative descriptive study design using pre- and post-SBCEE questionnaires. Settings A large tertiary Australian hospital-based simulation centre that facilitates SBCEE for multi-professional graduate and undergraduate clinicians from 16 hospitals. Methods Participants who attended SBCEEs between May and October 2021 completed questionnaires at two touchpoints, on the day of attending a SBCEE and 6 weeks after. Based on a phenomenological approach, the study examined clinicians’ experiences in relation to simulation education, intended simulation learning use in the workplace, and perceived success in subsequently using these learnings to improve clinical outcomes. Qualitative inductive thematic data analysis was used to develop narratives for different learner cohorts. Results Three overarching themes were identified regarding simulation participants’ perceptions of the success of translating simulation learnings into the workplace. These were: scenario-workplace mirroring, self-assessment, and successful confidence. Doctor participants found it difficult to map SBCEE learnings to their workplace environments if they did not mirror those used in simulation. Nurses sought peer evaluation to analyse the effectiveness of their workplace translations, whereas doctors relied on self-assessment. Learners from both craft groups highly prized ‘confidence-building’ as a key indicator of improved workplace performance achieved through SBCEE learning. ...
Keywords	Delivery of healthcare ; Medical simulation ; Interprofessional learning ; Clinical Translation Science ; Computer applications to medicine. Medical informatics ; R858-859.7
Subject code	690
Language	English
Publishing date	2022-07-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Bacterial Bloodstream Infections after Allogeneic Hematopoietic Stem Cell Transplantation

Jessica Gill / Alessandro Busca / Natascia Cinatti / Roberto Passera / Chiara Maria Dellacasa / Luisa Giaccone / Irene Dogliotti / Sara Manetta / Silvia Corcione / Francesco Giuseppe De Rosa

Microorganisms, Vol 11, Iss 742, p

Etiology, Risk Factors and Outcome in a Single-Center Study

2023 Volume 742

Abstract: Background—Allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are subject to major risks for bacterial bloodstream infections (BSIs), including emergent multidrug-resistant (MDR) organisms, which still represent the main cause of ... ...

Abstract	Background—Allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are subject to major risks for bacterial bloodstream infections (BSIs), including emergent multidrug-resistant (MDR) organisms, which still represent the main cause of morbidity and mortality in transplanted patients. Methods: We performed an observational, retrospective, single-center study on patients undergoing allo-HSCT between 2004 and 2020 at the Stem Cell Transplant Unit in Turin to assess the incidence, etiology, and outcomes of BSIs and to explore any risk factors for bacteriaemia. Results: We observed a total of 178 bacterial BSIs in our cohort of 563 patients, resulting in a cumulative incidence of 19.4%, 23.8%, and 28.7% at 30, 100, and 365 days, respectively. Among isolated bacteria, 50.6% were Gram positive (GPB), 41.6% were Gram negative (GNB), and 7.9% were polymicrobial infections. Moreover, BSI occurrence significantly influenced 1-year overall survival. High and very high Disease Risk Index (DRI), an haploidentical donor, and antibacterial prophylaxis were found as results as independent risk factors for bacterial BSI occurrence in multivariate analysis. Conclusions: In our experience, GNB have overwhelmed GPB, and fluoroquinolone prophylaxis has contributed to the emergence of MDR pathogens. Local resistance patterns and patients’ characteristics should therefore be considered for better management of bacteremia in patients receiving an allogeneic HSCT.
Keywords	bloodstream infections ; allogeneic hematopoietic stem cell transplantation ; multidrug-resistant bacteria ; anti-bacterial prophylaxis ; fluoroquinolones ; antimicrobial stewardship ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Epigenetic Mechanisms Shape the Biological Response to Trauma and Risk for PTSD

Morgan Heinzelmann / Jessica Gill

Nursing Research and Practice, Vol

A Critical Review

2013 Volume 2013

Keywords	Nursing ; RT1-120 ; Medicine ; R ; DOAJ:Nursing ; DOAJ:Health Sciences
Language	English
Publishing date	2013-01-01T00:00:00Z
Publisher	Hindawi Publishing Corporation
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Extracellular vesicle concentrations of glial fibrillary acidic protein and neurofilament light measured 1 year after traumatic brain injury

Spencer Flynn / Jacqueline Leete / Pashtun Shahim / Cassandra Pattinson / Vivian A. Guedes / Chen Lai / Christina Devoto / Bao-Xi Qu / Kisha Greer / Brian Moore / Andre van der Merwe / Vindhya Ekanayake / Jessica Gill / Leighton Chan

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 8

Abstract: Abstract Traumatic brain injury (TBI) is linked to long-term symptoms in a sub-set of patients who sustain an injury, but this risk is not universal, leading us and others to question the nature of individual variability in recovery trajectories. ... ...

Abstract	Abstract Traumatic brain injury (TBI) is linked to long-term symptoms in a sub-set of patients who sustain an injury, but this risk is not universal, leading us and others to question the nature of individual variability in recovery trajectories. Extracellular vesicles (EVs) are a promising, novel avenue to identify blood-based biomarkers for TBI. Here, our aim was to determine if glial fibrillary acidic protein (GFAP) and neurofilament light (NfL) measured 1-year postinjury in EVs could distinguish patients from controls, and whether these biomarkers relate to TBI severity or recovery outcomes. EV GFAP and EV NfL were measured using an ultrasensitive assay in 72 TBI patients and 20 controls. EV GFAP concentrations were elevated in moderate and severe TBI compared to controls (p’s < 0.001) and could distinguish controls from moderate (AUC = 0.86) or severe TBI (AUC = 0.88). Increased EV GFAP and EV NfL levels were associated with lower 1-year Glasgow Outcome Scale–Extended (GOS-E) score (p’s < 0.05). These findings suggest that blood-derived EV concentrations of GFAP and NfL drawn even 1 year after injury are higher in TBI patients compared to controls, and are related to injury severity and poor recovery outcomes, suggesting that TBIs alter the activity of these biomarkers, likely contributing to individual variability in recovery.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Inflammation Relates to Chronic Behavioral and Neurological Symptoms in Military Personnel with Traumatic Brain Injuries

Christina Devoto / Lindsay Arcurio / Joseph Fetta / Mary Ley / Tamar Rodney / Rebekah Kanefsky / Jessica Gill

Cell Transplantation, Vol

2017 Volume 26

Abstract: Studies have shown that the presence of acute inflammation during recovery is indicative of poor outcomes after a traumatic brain injury (TBI); however, the role of chronic inflammation in predicting post-TBI-related symptoms remains poorly understood. ... ...

Abstract	Studies have shown that the presence of acute inflammation during recovery is indicative of poor outcomes after a traumatic brain injury (TBI); however, the role of chronic inflammation in predicting post-TBI-related symptoms remains poorly understood. The purpose of this study was to compare inflammatory biomarkers (tumor necrosis factor [TNF]-α, interleukin [IL]-6, and IL-10) in active duty personnel who either sustained or did not sustain a TBI. Service members were also assessed for post-traumatic stress disorder (PTSD), depression, and quality of life through self-reported measures. IL-6 and TNF-α concentrations were greater in the TBI group than in the control group. Of those with a TBI, IL-6 and TNF-α concentrations were greater in the high-PTSD group than the low-PTSD group. No significant differences were found in IL-10 or the IL-6/IL-10 ratios between those with low and high PTSD. Exploratory factor analysis was conducted to describe the latent structure of variables relating to emotional and physical health (i.e., Short Form 36 subcomponents, etc.) and their relationships within the TBI group with inflammatory cytokines. Four symptom profiles were found, with the third component most relating to PTSD and depression symptoms and high inflammation. This study indicates that the comorbidity of TBI and PTSD is associated with inflammation in a military sample, emphasizing the necessity for intervention in order to mitigate the risks associated with inflammation.
Keywords	Medicine ; R
Subject code	150
Language	English
Publishing date	2017-07-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Fluid Biomarkers of Traumatic Brain Injury and Intended Context of Use

Tanya Bogoslovsky / Jessica Gill / Andreas Jeromin / Cora Davis / Ramon Diaz-Arrastia

Diagnostics, Vol 6, Iss 4, p

2016 Volume 37

Abstract: Traumatic brain injury (TBI) is one of the leading causes of death and disability around the world. The lack of validated biomarkers for TBI is a major impediment to developing effective therapies and improving clinical practice, as well as stimulating ... ...

Abstract	Traumatic brain injury (TBI) is one of the leading causes of death and disability around the world. The lack of validated biomarkers for TBI is a major impediment to developing effective therapies and improving clinical practice, as well as stimulating much work in this area. In this review, we focus on different settings of TBI management where blood or cerebrospinal fluid (CSF) biomarkers could be utilized for predicting clinically-relevant consequences and guiding management decisions. Requirements that the biomarker must fulfill differ based on the intended context of use (CoU). Specifically, we focus on fluid biomarkers in order to: (1) identify patients who may require acute neuroimaging (cranial computerized tomography (CT) or magnetic resonance imaging (MRI); (2) select patients at risk for secondary brain injury processes; (3) aid in counseling patients about their symptoms at discharge; (4) identify patients at risk for developing postconcussive syndrome (PCS), posttraumatic epilepsy (PTE) or chronic traumatic encephalopathy (CTE); (5) predict outcomes with respect to poor or good recovery; (6) inform counseling as to return to work (RTW) or to play. Despite significant advances already made from biomarker-based studies of TBI, there is an immediate need for further large-scale studies focused on identifying and innovating sensitive and reliable TBI biomarkers. These studies should be designed with the intended CoU in mind.
Keywords	traumatic brain injury (TBI) ; biomarkers ; TBI management ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2016-10-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Circulating Brain Injury Exosomal Proteins following Moderate-To-Severe Traumatic Brain Injury

Stefania Mondello / Vivian A. Guedes / Chen Lai / Endre Czeiter / Krisztina Amrein / Firas Kobeissy / Yehia Mechref / Andreas Jeromin / Sara Mithani / Carina Martin / Chelsea L. Wagner / Andras Czigler / Luca Tóth / Bálint Fazekas / Andras Buki / Jessica Gill

Cells, Vol 9, Iss 977, p

Temporal Profile, Outcome Prediction and Therapy Implications

2020 Volume 977

Abstract: Brain injury exosomal proteins are promising blood biomarker candidates in traumatic brain injury (TBI). A better understanding of their role in the diagnosis, characterization, and management of TBI is essential for upcoming clinical implementation. In ... ...

Abstract	Brain injury exosomal proteins are promising blood biomarker candidates in traumatic brain injury (TBI). A better understanding of their role in the diagnosis, characterization, and management of TBI is essential for upcoming clinical implementation. In the current investigation, we aimed to explore longitudinal trajectories of brain injury exosomal proteins in blood of patients with moderate-to-severe TBI, and to evaluate the relation with the free-circulating counterpart and patient imaging and clinical parameters. Exosomal levels of glial (glial fibrillary acidic protein (GFAP)) and neuronal/axonal (ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), neurofilament light chain (NFL), and total-tau (t-tau)) proteins were measured in serum of 21 patients for up 5 days after injury using single molecule array (Simoa) technology. Group-based trajectory analysis was used to generate distinct temporal exosomal biomarker profiles. We found altered profiles of serum brain injury exosomal proteins following injury. The dynamics and levels of exosomal and related free-circulating markers, although correlated, showed differences. Patients with diffuse injury displayed higher acute exosomal NFL and GFAP concentrations in serum than those with focal lesions. Exosomal UCH-L1 profile characterized by acutely elevated values and a secondary steep rise was associated with early mortality ( n = 2) with a sensitivity and specificity of 100%. Serum brain injury exosomal proteins yielded important diagnostic and prognostic information and represent a novel means to unveil underlying pathophysiology in patients with moderate-to-severe TBI. Our findings support their utility as potential tools to improve patient phenotyping in clinical practice and therapeutic trials.
Keywords	traumatic brain injury ; biomarkers ; exosomes ; exosomal protein ; serum ; GFAP ; Biology (General) ; QH301-705.5
Subject code	610 ; 616
Language	English
Publishing date	2020-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Patient Barriers for Weight Management Among African American Women

Owen Bowie / Jennifer Kusch / George L. Morris III / Tracy Flood / Jessica Gill / Renee E. Walker / Ron A. Cisler / Jennifer T. Fink

Journal of Patient-Centered Research and Reviews, Vol 5, Iss 4, Pp 287-

2018 Volume 297

Abstract: Purpose: The primary aim of this study was to assess the perceptions of local African American women who are overweight or obese using semi-structured focus groups to identify barriers to weight management and factors that support strategy success. The ... ...

Abstract	Purpose: The primary aim of this study was to assess the perceptions of local African American women who are overweight or obese using semi-structured focus groups to identify barriers to weight management and factors that support strategy success. The secondary aim of this study was to determine recommendations for patient-centered weight management interventions established specifically for African American women in the Milwaukee-area community. Methods: Three semi-structured focus groups to explore barriers to weight management were performed among women patients. Participants (N = 41) were recruited via email, postal mail, and phone as available from an academic medical center in Milwaukee, Wisconsin. Focus group discussions were transcribed verbatim, reviewed by the study team, and coded based on recurring themes within and across interviews. Responses were analyzed by frequency of occurrence using qualitative computer software. Results: Five primary barriers to weight management were identified from focus groups: food choices, lifestyle changes, social support, locus of control, and health education. Based on participant reports, improvements to present practice and health literacy for patients may be merited. There was expressed interest by patients for being involved in future research and development of patient-centered interventions. Conclusions: This study provides support for the use of a community-based participatory research approach in determining appropriate considerations for weight management interventions suitable for this patient population. Future research should include stakeholders not included in this study, such as community organization leaders, and primary care physicians to develop a refined intervention targeting the primary barriers to weight management.
Keywords	weight management ; obesity ; women ; community advisory board ; community-based participatory research ; Medicine ; R
Subject code	360
Language	English
Publishing date	2018-10-01T00:00:00Z
Publisher	Advocate Aurora Health
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Whole blood transcriptomic profiles can differentiate vulnerability to chronic low back pain.

Susan G Dorsey / Cynthia L Renn / Mari Griffioen / Cameron B Lassiter / Shijun Zhu / Heather Huot-Creasy / Carrie McCracken / Anup Mahurkar / Amol C Shetty / Colleen K Jackson-Cook / Hyungsuk Kim / Wendy A Henderson / Leorey Saligan / Jessica Gill / Luana Colloca / Debra E Lyon / Angela R Starkweather

PLoS ONE, Vol 14, Iss 5, p e

2019 Volume 0216539

Abstract: The mechanisms underlying the transition from acute to chronic pain remain unclear. Here, we sought to characterize the transcriptome associated with chronic low back pain as well as the transcriptome of the transition from acute to chronic low back pain. ...

Abstract	The mechanisms underlying the transition from acute to chronic pain remain unclear. Here, we sought to characterize the transcriptome associated with chronic low back pain as well as the transcriptome of the transition from acute to chronic low back pain. For the analysis, we compared the whole blood transcriptome of: (a) patients at the onset of low back pain who no longer had pain within 6 weeks after onset (acute) with patients who developed chronic low back pain at 6 months (chronic T5); and, (b) patients at the onset of low back pain (chronic T1) who developed chronic pain at 6 months with healthy pain-free (normal) controls. The majority of differentially expressed genes were protein coding. We illustrate a unique chronic low back pain transcriptome characterized by significant enrichment for known pain genes, extracellular matrix genes, and genes from the extended major histocompatibility complex (MHC) genomic locus. The transcriptome of the transition from acute to chronic low back pain was characterized by significant upregulation of antigen presentation pathway (MHC class I and II) genes and downregulation of mitochondrial genes associated with oxidative phosphorylation, suggesting a unique genomic signature of vulnerability to low back pain chronicity.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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