Assessing the Effectiveness of Phone Call Proactive Naloxone Co-Prescribing Enrollment

Opioid use is increasing at never-before-seen rates. As a result, it is imperative that medical facilities educate and provide resources for those who may be at risk of an opioid overdose. With our study, we aimed to see the demographics of our population here at Rowan Medicine and identify associations of those participating in our naloxone co-prescription program. Majority of enrollees in our program were aged 50 or older and identified as Caucasian. A large proportion also reported being unable to work. Given this information, improvements in our naloxone coprescription program may include spreading more awareness of the benefits of naloxone to minority populations, as well as to the younger population at risk of an opioid overdose

What Motivates Patients to Enroll in a Naloxone Co-Prescribing Program?

Patients were contacted via phone call to establish knowledge of and prescription status regarding naloxone. They were then invited to enroll in a research study consisting of two online surveys. The patients who had been prescribed naloxone by the time the study had started ranked being persuaded by a medical professional as being the most important reason for accepting the naloxone prescription. Insufficient data collected during the six-week time frame to draw statistically significant conclusions about what motivates patients to receive naloxone co-prescriptions. Correlations seen in this study are interesting and warrant further investigation

Powersharing and Democratic Survival

Democracy is often fragile, especially in states that have recently experienced civil conflict. To protect emerging democracies, many scholars and practitioners recommend political powersharing institutions. Yet there is little empirical research on whether powersharing promotes democratic survival, and some concern that it can limit electoral accountability. To fill this gap, we differentiate between inclusive, dispersive, and constraining powersharing and analyze their effects on democratic survival using a new global dataset. We find sharp distinctions across types of powersharing and political context. Inclusive powersharing, such as ethnic quotas, promotes democratic survival only in post-conflict settings. In contrast, dispersive institutions such as federalism destabilize post-conflict democracies. Only constraining powersharing consistently facilitates democratic survival in societies both with and without recent conflict. Our results suggest that institution-builders and international organizations should prioritize institutions that constrain leaders, including independent judiciaries, civilian control of the armed forces, and constitutional protections of individual and group rights

Posttranslational Modification of α-Dystroglycan, the Cellular Receptor for Arenaviruses, by the Glycosyltransferase LARGE Is Critical for Virus Binding

The receptor for lymphocytic choriomeningitis virus (LCMV), the human pathogenic Lassa fever virus (LFV), and clade C New World arenaviruses is α-dystroglycan (α-DG), a cell surface receptor for proteins of the extracellular matrix (ECM). Specific posttranslational modification of α-DG by the glycosyltransferase LARGE is critical for its function as an ECM receptor. In the present study, we show that LARGE-dependent modification is also crucial for α-DG's function as a cellular receptor for arenaviruses. Virus binding involves the mucin-type domain of α-DG and depends on modification by LARGE. A crucial role of the LARGE-dependent glycosylation of α-DG for virus binding is found for several isolates of LCMV, LFV, and the arenaviruses Mobala and Oliveros. Since the posttranslational modification by LARGE is crucial for α-DG recognition by both arenaviruses and the host-derived ligand laminin, it also influences competition between virus and laminin for α-DG. Hence, LARGE-dependent glycosylation of α-DG has important implications for the virus-host cell interaction and the pathogenesis of LFV in humans

MHC class I diversity in chimpanzees and bonobos

Major histocompatibility complex (MHC) class I genes are critically involved in the defense against intracellular pathogens. MHC diversity comparisons among samples of closely related taxa may reveal traces of past or ongoing selective processes. The bonobo and chimpanzee are the closest living evolutionary relatives of humans and last shared a common ancestor some 1 mya. However, little is known concerning MHC class I diversity in bonobos or in central chimpanzees, the most numerous and genetically diverse chimpanzee subspecies. Here, we used a long-read sequencing technology (PacBio) to sequence the classical MHC class I genes A, B, C, and A-like in 20 and 30 wild-born bonobos and chimpanzees, respectively, with a main focus on central chimpanzees to assess and compare diversity in those two species. We describe in total 21 and 42 novel coding region sequences for the two species, respectively. In addition, we found evidence for a reduced MHC class I diversity in bonobos as compared to central chimpanzees as well as to western chimpanzees and humans. The reduced bonobo MHC class I diversity may be the result of a selective process in their evolutionary past since their split from chimpanzees

Malaria after international travel: A GeoSentinel analysis, 2003-2016

BACKGROUND: More than 30,000 malaria cases are reported annually among international travellers. Despite improvements in malaria control, malaria continues to threaten travellers due to inaccurate perception of risk and sub-optimal pre-travel preparation. METHODS: Records with a confirmed malaria diagnosis after travel from January 2003 to July 2016 were obtained from GeoSentinel, a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. Records were excluded if exposure country was missing or unascertainable or if there was a concomitant acute diagnosis unrelated to malaria. Records were analyzed to describe the demographic and clinical characteristics of international travellers with malaria. RESULTS: There were 5689 travellers included; 325 were children <18 years. More than half (53%) were visiting friends and relatives (VFRs). Most (83%) were exposed in sub-Saharan Africa. The median trip duration was 32 days (interquartile range 20-75); 53% did not have a pre-travel visit. More than half (62%) were hospitalized; children were hospitalized more frequently than adults (73 and 62%, respectively). Ninety-two per cent had a single Plasmodium species diagnosis, most frequently Plasmodium falciparum (4011; 76%). Travellers with P. falciparum were most frequently VFRs (60%). More than 40% of travellers with a trip duration ≤7 days had Plasmodium vivax. There were 444 (8%) travellers with severe malaria; 31 children had severe malaria. Twelve travellers died. CONCLUSION: Malaria remains a serious threat to international travellers. Efforts must focus on preventive strategies aimed on children and VFRs, and chemoprophylaxis access and preventive measure adherence should be emphasized

A Digest on the Role of the Tumor Microenvironment in Gastrointestinal Cancers

Experimental studies and analyses of clinical material have convincingly demonstrated that tumor formation and progression occurs through a concerted action of malignant cells and the surrounding microenvironment of the tumor stroma. The tumor microenvironment is comprised of various cell types like fibroblasts, immune cells, vascular cells and bone-marrow-derived cells embedded in the extracellular matrix. This review, focusing on recent findings in the context of gastrointestinal tumors, introduces the different stromal cell types and delineates their contributions to cancer initiation, growth and metastasis. By selected examples we also present how the tumor microenvironment is emerging as a promising target for therapeutic intervention