Seroprevalence of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-Cov-2) Among Healthcare Providers Prior to the Vaccine Era in an Integrated Midwestern Healthcare System

We performed severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antinucleocapsid IgG testing on 5,557 healthcare providers and found a seroprevalence of 3.9%. African Americans were more likely to test positive than Whites, and HCWs with household exposure and those working on COVID-19 cohorting units were more likely to test positive than their peers

Clinical Impact of Ceftriaxone Resistance in Escherichia coli Bloodstream Infections: A Multicenter Prospective Cohort Study

BACKGROUND: Ceftriaxone-resistant (CRO-R) Escherichia coli bloodstream infections (BSIs) are common. METHODS: This is a prospective cohort of patients with E coli BSI at 14 United States hospitals between November 2020 and April 2021. For each patient with a CRO-R E coli BSI enrolled, the next consecutive patient with a ceftriaxone-susceptible (CRO-S) E coli BSI was included. Primary outcome was desirability of outcome ranking (DOOR) at day 30, with 50% probability of worse outcomes in the CRO-R group as the null hypothesis. Inverse probability weighting (IPW) was used to reduce confounding. RESULTS: Notable differences between patients infected with CRO-R and CRO-S E coli BSI included the proportion with Pitt bacteremia score ≥4 (23% vs 15%, P = .079) and the median time to active antibiotic therapy (12 hours [interquartile range {IQR}, 1-35 hours] vs 1 hour [IQR, 0-6 hours]; P \u3c .001). Unadjusted DOOR analyses indicated a 58% probability (95% confidence interval [CI], 52%-63%) for a worse clinical outcome in CRO-R versus CRO-S BSI. In the IPW-adjusted cohort, no difference was observed (54% [95% CI, 47%-61%]). Secondary outcomes included unadjusted and adjusted differences in the proportion of 30-day mortality between CRO-R and CRO-S BSIs (-5.3% [95% CI, -10.3% to -.4%] and -1.8 [95% CI, -6.7% to 3.2%], respectively), postculture median length of stay (8 days [IQR, 5-13 days] vs 6 days [IQR, 4-9 days]; P \u3c .001), and incident admission to a long-term care facility (22% vs 12%, P = .045). CONCLUSIONS: Patients with CRO-R E coli BSI generally have poorer outcomes compared to patients infected with CRO-S E coli BSI, even after adjusting for important confounders

Large Scale Association Analysis Identifies Three Susceptibility Loci for Coronary Artery Disease

Genome wide association studies (GWAS) and their replications that have associated DNA variants with myocardial infarction (MI) and/or coronary artery disease (CAD) are predominantly based on populations of European or Eastern Asian descent. Replication of the most significantly associated polymorphisms in multiple populations with distinctive genetic backgrounds and lifestyles is crucial to the understanding of the pathophysiology of a multifactorial disease like CAD. We have used our Lebanese cohort to perform a replication study of nine previously identified CAD/MI susceptibility loci (LTA, CDKN2A-CDKN2B, CELSR2-PSRC1-SORT1, CXCL12, MTHFD1L, WDR12, PCSK9, SH2B3, and SLC22A3), and 88 genes in related phenotypes. The study was conducted on 2,002 patients with detailed demographic, clinical characteristics, and cardiac catheterization results. One marker, rs6922269, in MTHFD1L was significantly protective against MI (OR = 0.68, p = 0.0035), while the variant rs4977574 in CDKN2A-CDKN2B was significantly associated with MI (OR = 1.33, p = 0.0086). Associations were detected after adjustment for family history of CAD, gender, hypertension, hyperlipidemia, diabetes, and smoking. The parallel study of 88 previously published genes in related phenotypes encompassed 20,225 markers, three quarters of which with imputed genotypes The study was based on our genome-wide genotype data set, with imputation across the whole genome to HapMap II release 22 using HapMap CEU population as a reference. Analysis was conducted on both the genotyped and imputed variants in the 88 regions covering selected genes. This approach replicated HNRNPA3P1-CXCL12 association with CAD and identified new significant associations of CDKAL1, ST6GAL1, and PTPRD with CAD. Our study provides evidence for the importance of the multifactorial aspect of CAD/MI and describes genes predisposing to their etiology

The call to believe and the weak God in William James's philosophy of religion

The following dissertation argues that James’s will to believe is a call to believe that has at its origin a divine being. The will is not absolute but shaped by the call; however, the caller can also has at its origin the human being who calls God through prayers. On the other side, there is a divine being calling and hearing the calls; this divine being is a weak God, or as James states a finite God; however, I argue that the weakness of God is practical and not ontological. God in himself is omnipotent, thus, his weakness is from a human’s understanding, God does not lack power in himself but he lacks power over us; out of respect to our freedom. The first chapter discusses the caller and the called, the call is not always a religious call but it can be a human call, it is the human calling another human to live in an ethical community, moreover, the call can be originated from the self toward itself as in the form of a Heideggerian call. However, the call must be answered because it is a genuine option. The second chapter defines religion according to James as an experience related to feelings and differentiates between the first and second hand religion and between the religion of healthy-mindedness and sick souls. The third chapter studies the practical fruits of religion and the four marks of mystical experience. The fourth chapter examines the human answer to the divine call and defines the call to believe as a call to change the world and not a mere call to believe in a set of dogmas. The call to believe is a call to assume responsibilities as individuals and to live a moral and religious life

sj-xlsx-3-phr-10.1177_00333549221119143 – Supplemental material for SARS-CoV-2 Seroprevalence Among First Responders in Northeastern Ohio, 2020

Supplemental material, sj-xlsx-3-phr-10.1177_00333549221119143 for SARS-CoV-2 Seroprevalence Among First Responders in Northeastern Ohio, 2020 by Xiaochun Zhang, Elie Saade, Jaime H. Noguez and Christine Schmotzer in Public Health Reports</p

sj-jpeg-1-phr-10.1177_00333549221119143 – Supplemental material for SARS-CoV-2 Seroprevalence Among First Responders in Northeastern Ohio, 2020

Supplemental material, sj-jpeg-1-phr-10.1177_00333549221119143 for SARS-CoV-2 Seroprevalence Among First Responders in Northeastern Ohio, 2020 by Xiaochun Zhang, Elie Saade, Jaime H. Noguez and Christine Schmotzer in Public Health Reports</p

sj-docx-2-phr-10.1177_00333549221119143 – Supplemental material for SARS-CoV-2 Seroprevalence Among First Responders in Northeastern Ohio, 2020

Supplemental material, sj-docx-2-phr-10.1177_00333549221119143 for SARS-CoV-2 Seroprevalence Among First Responders in Northeastern Ohio, 2020 by Xiaochun Zhang, Elie Saade, Jaime H. Noguez and Christine Schmotzer in Public Health Reports</p

Carbapenem-Resistant Enterobacter cloacae in Patients from the US Veterans Health Administration, 2006–2015

We analyzed carbapenem-resistant Enterobacteriaceae (CRE) trends among patients from the US Veterans Health Administration (VHA). After the emergence of CRE in the eastern United States, resistance rates remained stable in Klebsiella pneumoniae but increased in Enterobacter cloacae complex, suggesting a "second epidemic". VHA offers a vantage point for monitoring nationwide CRE trends

SARS-CoV-2 infection in a patient on chronic hydroxychloroquine therapy: Implications for prophylaxis

People exposed to COVID-19 have a risk of developing disease, and health care workers are at risk at a time when they are badly needed during a health care crisis. Hydroxychloroquine and chloroquine have been used as treatment and are being considered as prophylaxis. Our patient developed COVID-19 while on hydroxychloroquine and although more work is needed, this calls into question the role of these medications as preventive therapy