Infections after chimeric antigen receptor (CAR)-T-cell therapy for hematologic malignancies.

Chimeric antigen receptor (CAR)-T-cell therapies have revolutionized the management of acute lymphoblastic leukemia, non-Hodgkin lymphoma, and multiple myeloma but come at the price of unique toxicities, including cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, and long-term "on-target off-tumor" effects. All of these factors increase infection risk in an already highly immunocompromised patient population. Indeed, infectious complications represent the key determinant of non-relapse mortality after CAR-T cells. The temporal distribution of these risk factors shapes different infection patterns early versus late post-CAR-T-cell infusion. Furthermore, due to the expression of their targets on B lineage cells at different stages of differentiation, CD19, and B-cell maturation antigen (BCMA) CAR-T cells induce distinct immune deficits that could require different prevention strategies. Infection incidence is the highest during the first month post-infusion and subsequently decreases thereafter. However, infections remain relatively common even a year after infusion. Bacterial infections predominate early after CD19, while a more equal distribution between bacterial and viral causes is seen after BCMA CAR-T-cell therapy, and fungal infections are universally rare. Cytomegalovirus (CMV) and other herpesviruses are increasingly breported, but whether routine monitoring is warranted for all, or a subgroup of patients, remains to be determined. Clinical practices vary substantially between centers, and many areas of uncertainty remain, including CMV monitoring, antibacterial and antifungal prophylaxis and duration, use of immunoglobulin replacement therapy, and timing of vaccination. Risk stratification tools are available and may help distinguish between infectious and non-infectious causes of fever post-infusion and predict severe infections. These tools need prospective validation, and their integration in clinical practice needs to be systematically studied

Prevalence of disordered eating in elite female athletes in team sports in Greece

The purpose of the study was to assess a) the prevalence of disordered eating (DE) in elite female team sports players compared to non-athletes and b) to compare DE prevalence in elite female players in basketball, volleyball and water polo. One hundred and seventy-five females were recruited (age 23.10 ± 5.4, BMI 21.85 ± 2.3 kg/m2), 53 were elite basketball players, 42 were elite volleyball players, 34 were elite water polo players and 46 were non-athletes. Participants completed the Eating Disorders Questionnaire (EDE-Q) and a physical activity questionnaire. The EDE-Q incorporates 36 statements which relate to the occurrence and frequency of key behaviours of eating disorders, under the following four subscales: Restraint, eating concern, shape concern and weight concern and a global score of disordered eating. No differences were found in the EDE-Q subscale score and global score between athletes and non-athletes. Only 6.2% of the total number of participants exhibited DE using the global score >2.3. Water polo players had significantly higher scores in the ‘eating concern’ subscale and in the frequency of key behavioural features of DE such as binge eating episodes and objective and subjective bulimic episodes, compared to volleyball and basketball players. In conclusion, team sport elite female players do not exhibit greater prevalence of DE compared to non-athletes. Water polo, a sport that emphasizes leanness and control of body weight for international distinctions, is associated with a higher tendency to exhibit DE, when compared to other team sports

Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Family Business Internationalisation and Networks: Emerging Pathways

Purpose: The aim of this study is twofold: 1) to provide a meta-synthesis of the current state of knowledge in FB internationalisation research, adopting a network perspective; 2) to highlight emerging themes that may set the stage for future work on FB internationalisation, for the benefit of researchers adopting a network perspective. Methodology: In order to address the twofold purpose of the study, the current paper provides a state-of the art review of 25 peer-reviewed journal articles published from 1993 to 2014. It also presents a meta-synthesis of the theoretical approaches, key findings and concepts that were pinpointed in the review, and proposes emerging key themes that are likely set the stage for future work within this specific field. Findings: The results indicated that since the mid-1990s, research in the field from a network perspective has mainly focused on three aspects, namely: 1) the role of networks and relationships in the internationalisation process, 2) the factors that influence network formation, and 3) strategic/managerial issues in the formation and building of network ties. The current paper pinpoints emerging themes within these three aspects, and proposes future pathways. Research limitations: The review and meta-synthesis are restricted to 25 studies identified in this specific field. Originality: The study comprises an initial attempt to encompass the interface of FB internationalisation and networks

Evaluation of skis of alpine skiing behavior on the snow

Purpose: The purpose of this study was to evaluate the behavior of the skis on snow depending on sex, type of ski and the level of training of the technical skier. Material: in the research participated 57 skiers, generally of age 26 +/- 8.62 years (34 males and 23 females) at the ski center of Parnassos (Greece). The evaluation of the ski behavior on snow came up via the scores on Test 1 to Test 5 in practice, to the rating scale from 0 to 10 respectively. The participants, after performing daily training with their skis completed the questionnaire. The questionnaire included the following elements: sex, height, weight, the type of skis and the type of TEST as: 1-2) behavior of skis in long and short turning radius, respectively, 3) grip of the ski edges in turn, 4) stability of ski riding, 5) usage of general muscle strength (fatigue). Results: The correlation between the first four tests (Test 1-4) was significant at statistical significance level p < 0.05, apart from test 5, which shows reduced physical fitness of the skier. Also the majority of skiers prefer parabolic skis (carving ski), although the racing skis were highly rated. Conclusions: The widespread “carving skis” are skis with medium score in both of all five tests in comparison to the Race ski. Finally, as expected, the highest score was given by the athletes (r = 0.69-0.99). It is recommended for further research of the correct selection of the ski in relation to: the physical fitness of the skier, prevention and injuries

Maternal mild thyroid dysfunction and offspring cognitive and motor development from infancy to childhood: the Rhea mother-child cohort study in Crete, Greece

BACKGROUND: Maternal thyroid hormones’ supply is crucial for fetal neurodevelopment; however, the role of maternal mild thyroid dysfunction is not clear. We aimed to assess the association of maternal mild thyroid dysfunction with child neuropsychological development from infancy to early childhood. METHODS: We included 757 mother-child pairs from the prospective “Rhea” cohort on Crete, Greece. Maternal thyroid functioning was assessed by quantitative analysis of serum thyroid stimulating hormone (TSH), free thyroxine (fT4), thyroid peroxidase antibodies (TPO-Abs), and thyroglobulin antibodies (Tg-Abs) at early gestation (mean=14 weeks). Neuropsychological assessment was based on Bayley Scales of Infant Development (18 months of age), McCarthy Scales of Children’s Abilities (4 years of age), Raven’s Coloured Progressive Matrices, Trail Making Test, and Finger Tapping Test (6 years of age). RESULTS: In multivariate adjusted linear regression analyses maternal hypothyroxinemia was associated with decreased verbal scores at 4 years and reduced motor speed at 6 years of age. Maternal thyroid autoimmunity was associated with decreased child perceptual and motor ability at 4 years of age. Four trajectories of longitudinal non-verbal cognitive development were identified and children exposed to maternal thyroid autoimmunity had increased risk for belonging to an adverse trajectory (“Low”: adjusted-RRR = 2.7 95%CI: [1.4, 5.2], “High-decreasing”: adjusted-RRR = 2.2 95%CI: [1.2, 4.0], “Low-increasing”: adjusted-RRR = 1.8 95%CI: [1.0, 3.2]). CONCLUSION: Maternal hypothyroxinemia is associated with reduced offspring verbal and motor ability. Maternal thyroid autoimmunity is associated with decreased offspring perceptual performance and motor ability and increased risk for adverse non-verbal cognitive development from infancy to childhood

The longitudinal association of eating behaviour and ADHD symptoms in school age children: a follow-up study in the RHEA cohort

BACKGROUND: Previous evidence suggests a link between ADHD symptoms and disordered eating behaviours, however the direction of the causal association remains unclear. Building on our previous research, we aimed to examine the longitudinal association between eating behaviours at 4 years, ADHD symptoms at 6 years of age, and the role of body mass index (BMI). METHODS: We included children from the RHEA mother-child cohort in Greece, followed up at 4 and 6 years (n=926). Parents completed the Children’s Eating Behaviour Questionnaire (CEBQ) to assess children’s eating behaviour at 4 years and the ADHD Test (ADHDT) and Child Behaviour Checklist for ages 6–18 (CBCL/6–18) to evaluate ADHD symptoms at 4 and 6 years respectively, as well as measures of BMI. Longitudinal Structural Equation Modeling (SEM) was carried out to evaluate the associations of all variables between 4 and 6 years. RESULTS: Food responsiveness at 4 years was positively associated with hyperactivity at age 6, whereas emotional overeating was negatively associated with hyperactivity. There was no evidence of an association between eating behaviours of preschoolers and BMI at 6 years, or BMI at 4 years and later ADHD symptoms and vice versa. CONCLUSIONS: Findings suggest that food responsiveness is an early marker of ADHD symptoms at 6 years of age. In contrast to our hypothesis there was no significant association between ADHD at age 4 and BMI at age 6