Treatment of Hepatitis C in Children: A Systematic Review

Background: Current guidelines recommend children be treated for hepatitis C virus (HCV) using the same principles applied in adults. There are however few published studies which assess the efficacy and safety of HCV therapy in children. Methodology/Principal Findings: A systematic review of the literature was completed for studies of any design that evaluated HCV therapy in children. The primary outcome was sustained virologic response (SVR), with sub-group analysis of response rates by genotype. There were 4 randomized controlled trials (RCTs) and 31 non-randomized studies, all involving interferon, pegylated interferon (PEG-IFN), or combinations of these drugs with ribavirin. The SVR rate could not be directly compared as the populations and interventions differed across studies. Genotype was not reported or differed substantially from study to study. The overall SVR rate for PEG-IFN and ribavirin ranged from 30 to 100 % which is comparable to the rate in adults. Similar to adults, the SVR rates were significantly higher in children with genotype 2 or 3 compared to genotype 1. Adverse effects were primarily flu-like symptoms and neutropenia. There were insufficient data to assess the applicability of the week 12 stop rule (stopping therapy at week 12 if there is less than a 2 log drop in HCV RNA) or the efficacy of shortening therapy to 24 weeks in children with genotype 2 and 3. Conclusions/Significance: Current guidelines for the treatment of HCV in children are based on limited data. Furthe

Get it from the Source: Identifying Library Resources and Software Used in Faculty Research

Libraries and Information Technology departments aim to support the educational and research needs of students, researchers, and faculty members. Close matches between the resources those departments provide and the resources the institution’s community members actually use highlight the value of the departments, demonstrate fiscally responsibility, and show attentiveness to the community’s needs. Traditionally, libraries rely on usage statistics to guide collection development decisions, but usage statistics can only imply value. Identifying a resource by name in a publication demonstrates the value of that resource more clearly. This pilot project examined the full-text of articles published in 2016-2017 by faculty members at a mid-sized, special-focus institution to answer the questions “Do faculty members have university-provided access to the research tools they need to publish?” and “If not, where are they getting them?” Using a custom database, the presenters indexed every publication by author, publication, resources used, availability of the identified resources, and more. This pilot study can be adapted to projects at other institutions, allowing them to gain a better understanding of the strengths and weaknesses of their own institution’s offerings. In addition, they will be able to identify ways to use that data to negotiate for additional resources, inform strategic partnerships, and facilitate open discussions with the institution’s community

Factors associated with comprehensive medication review completion rates: A national survey of community pharmacists

Background Completion rates for medication therapy management (MTM) services have been lower than desired and the Centers for Medicare and Medicaid Services has added MTM comprehensive medication review (CMR) completion rates as a Part D plan star measure. Over half of plans utilize community pharmacists via contracts with MTM vendors. Objectives The primary objective of this survey study was to identify factors associated with the CMR completion rates of community pharmacies contracted with a national MTM vendor. Methodsl Representatives from 27,560 pharmacy locations contracted with a national MTM vendor were surveyed. The dependent variable of interest was the pharmacies' CMR completion rate. Independent variables included the pharmacy's progressiveness stratum and number of CMRs assigned by the MTM vendor during the time period, as well as self-reported data to characterize MTM facilitators, barriers, delivery strategies, staffing, selected items from a modified Assessment of Chronic Illness Care, and pharmacist/pharmacy demographics. Univariate negative binomial models were fit for each independent variable, and variables significant at p < 0.05 were entered into a multivariable model. Results Representatives from 3836 (13.9%) pharmacy locations responded; of these, 90.9% (n = 3486) responses were useable. The median CMR completion rate was 0.42. Variables remaining significant at p < 0.05 in the multivariable model included: progressiveness strata; pharmacy type; scores on the facilitators scale; responses to two potential barriers items; scores on the patient/caregiver delivery strategies sub-scale; providing MTM at multiple locations; reporting that the MTM vendor sending the survey link is the primary MTM vendor for which the respondent provides MTM; and the number of hours per week that the pharmacy is open. Conclusions Factors at the respondent (e.g., responses to facilitators scale) and pharmacy (e.g., pharmacy type) levels were associated with CMR completion rates. These findings could be used by MTM stakeholders to improve CMR completion rates

Most soil trophic guilds increase plant growth: a meta-analytical review

Trophic cascades are important drivers of plant and animal abundances in aquatic and aboveground systems, but in soils trophic cascades have been thought to be of limited importance due to omnivory and other factors. Here we use a meta-analysis of 215 studies with 1526 experiments that measured plant growth responses to additions or removals of soil organisms to test how different soil trophic levels affect plant growth. Consistent with the trophic cascade hypothesis, we found that herbivores and plant pathogens (henceforth pests) decreased plant growth and that predators of pests increased plant growth. The magnitude of this trophic cascade was similar to that reported for aboveground systems. In contrast, we did not find evidence for trophic cascades in decomposer- and symbiont-based (henceforth mutualist) food chains. In these food chains, mutualists increased plant growth and predators of mutualists also increased plant growth, presumably by increasing nutrient cycling rates. Therefore, mutualists, predators of mutualists and predators of pests all increased plant growth. Further, experiments that added multiple organisms from different trophic levels also increased plant growth. As a result, across the dataset, soil organisms increased plant growth 29% and non-pest soil organisms increased plant growth 46%. Omnivory has traditionally been thought to confound soil trophic dynamics, but here we suggest that omnivory allows for a simplified perspective of soil food webs – one in which most soil organisms increase plant growth by preying on pests or increasing nutrient cycling rates. An implication of this perspective is that processes that decrease soil organism abundance (e.g. soil tillage) are likely to decrease aboveground productivity. Synthesis Soil foodwebs have resisted generalizations due to their diversity and interconnectedness. Here we use results from a meta-analysis to inform a simplified perspective of soil foodwebs: one in which most soil trophic guilds increase plant growth. Our review also includes the first widespread support for the presence of trophic cascades in soils

Value of Online Medication Therapy Management Resources: Community Pharmacist Perspectives

Objectives: To describe pharmacists’ attitudes toward and satisfaction with on-line training modules on MTM tools and tips for pharmacists and to characterize how useful the tools and concepts in the modules were to pharmacists when delivering MTM services. Methods: Researchers distributed a web-based survey to pharmacists who had viewed the training modules that had been posted onto the training web site of OutcomesMTM. The majority of survey questions consisted of a 6-point Likert scale. Questions assessed pharmacists’ opinions on the use of the tools. Information also was collected on implementing MTM tips, pharmacist demographics, and practice site characteristics. Results: Respondents rated the Tool to Improve Medications in the Elderly via Review (TIMER) and DRug Adherence Work-up (DRAW) tools favorably across multiple items. Many pharmacists integrated the MTM tips into their practices, and reported increased efficiency in their delivery of MTM services. Conclusion: Pharmacist training and tools such as the TIMER and DRAW tools plus MTM practice tips can assist pharmacists in providing MTM services to patients

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

Convergence of Cells from the Progenitor Fraction of Adult Olfactory Bulb Tissue to Remyelinating Glia in Demyelinating Spinal Cord Lesions

Progenitor cells isolated from adult brain tissue are important tools for experimental studies of remyelination. Cells harvested from neurogenic regions in the adult brain such as the subependymal zone have demonstrated remyelination potential. Multipotent cells from the progenitor fraction have been isolated from the adult olfactory bulb (OB) but their potential to remyelinate has not been studied. cell bodies adjacent to and surrounding peripheral-type myelin rings.We report that neural cells from the progenitor fraction of the adult rat OB grown in monolayers can be expanded for several passages in culture and that upon transplantation into a demyelinated spinal cord lesion provide extensive remyelination without ectopic neuronal differentiation

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Gangs and Social Policy

Youth involvement in gangs in urban areas is significantly increasing. These youth are at high risk for physical, mental, emotional, and behavioral disorders. Exposure to community violence is linked to aggressive behavior, lower academic performance, lower levels of social competence, and negative mental health outcomes. The purpose of this paper is to set the agenda on how to deal with gangs and gang members from a social policy perspective. This paper will outline the nature of the gang problem in Providence, Rhode Island from three different perspectives: Violence, Forgiveness, and Practice. Literature will be presented and discussed and recommendations for social policy using Ortiz\u27s (2007) Social Diagnosis will be presented