Preoperative psychological health impacts pain and disability outcomes following anterior cervical discectomy and fusion for cervical radiculopathy

This study aimed to estimate the effects of preoperative psychological health on postoperative outcomes in patients undergoing surgery for cervical spondylotic radiculopathy. This retrospective cohort study included data from patients enrolled in the Canadian Spine Outcomes and Research Network who underwent anterior cervical discectomy and fusion for radiculopathy. Preoperative psychological health was measured with the Patient Health Questionnaire-8 (PHQ-8), and depression and severe psychological symptomology were measured with the Mental Component Score of the Short Form Survey-12 (MCS). Surgical outcomes comprised trajectory subgroups for neck pain and arm pain (numeric rating scales) and disability (neck disability index) measured preoperatively and 3, 12, and 24 months after surgery. For each outcome, patients were dichotomized as following either a poor or a fair-to-excellent trajectory. Average treatment effects were estimated with doubly robust propensity score models using inverse probability of treatment weights accounting for multiple confounders. We included data from 352 patients (43.8% female). Approximately half (52.1%) of patients were identified as depressed based on the PHQ-8, while 61.8% and 33.1% were classified as experiencing depression or severe psychological symptomology, respectively, on the MCS. In fully adjusted models, patients with PHQ-8-measured depression were at increased risk of poor postoperative outcomes for disability (risk ratio[95% CI] = 6.73[1.85 to 24.45]) and neck pain (RR[95% CI] = 1.90[1.09 to 3.32]). Patients with MCS-measured depression were at elevated risk of a poor disability outcome (RR[95% CI] = 2.77[1.30 to 5.90]). Patients reporting severe psychological symptomatology had an increased likelihood of poor disability, neck pain, and arm pain outcomes (RR[95% CI] = 1.82 [1.17 to 2.82] to 2.84[1.58 to 5.09]). These findings highlight the high prevalence of negative psychological features and their impacts on neck surgery outcomes. Future research should prioritize the development and evaluation of preoperative interventions to optimize psychological well-being and improve surgical outcomes in this population.</p

The Public Repository of Xenografts enables discovery and randomized phase II-like trials in mice

More than 90% of drugs with preclinical activity fail in human trials, largely due to insufficient efficacy. We hypothesized that adequately powered trials of patient-derived xenografts (PDX) in mice could efficiently define therapeutic activity across heterogeneous tumors. To address this hypothesis, we established a large, publicly available repository of well-characterized leukemia and lymphoma PDXs that undergo orthotopic engraftment, called the Public Repository of Xenografts (PRoXe). PRoXe includes all de-identified information relevant to the primary specimens and the PDXs derived from them. Using this repository, we demonstrate that large studies of acute leukemia PDXs that mimic human randomized clinical trials can characterize drug efficacy and generate transcriptional, functional, and proteomic biomarkers in both treatment-naive and relapsed/refractory disease

Redução de inóculo de Aphelenchoides besseyi em sementes de Brachiaria brizantha tratadas com óleos essenciais

Óleos essenciais foram testados com o objetivo de controlar Aphelenchoides besseyi em sementes de Brachiaria brizantha cv. 'Marandu'. Sementes naturalmente infestadas por A. besseyi foram tratadas com óleos essenciais de mostarda (Brassica nigra), canela (Cinnamomum zeylanicum), verbena (Lippia citriodora) e Bioprotector (r) (produto comercial composto por extratos e óleos essenciais derivados de plantas), nas concentrações de 0,5% e 1,0%. Avaliou-se também o efeito dos tratamentos após aplicação direta nos juvenis (ensaio in vitro). Todos os óleos tiveram sua efetividade reduzida no ensaio em semente (in vivo) em relação ao ensaio in vitro. Os tratamentos não erradicaram o nematoide das sementes, sendo que os óleos essenciais de canela e verbena, nas concentrações 0,5% e 1,0%, Bioprotector (r) a 1,0% e óleo de mostarda a 1,0% reduziram o nível populacional do nematoide em sementes contaminadas. O óleo de mostarda a 1,0% destacou-se dos demais por ter apresentado ação nematicida sem alterar a germinação das sementes

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation &lt;92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p&lt;0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p&lt;0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Trust antecedents: emotional intelligence and perceptions of others

Purpose – The purpose of this paper is to examine if teachers’ trust in others is predicted by their perceptions of others and their emotional intelligence. Employees need to trust others to achieve outcomes, and a lack of trust can have a negative impact on workplace performance. Design/methodology/approach – The paper surveys a sample of 84 employed teachers. Findings – Our findings show that perceptions of others’ ability, benevolence and integrity are strongly and positively associated with trust. The emotional intelligence ability to perceive emotions is also related to trust. Regression analysis showed that perceptions of others (ability and integrity) and an individual’s emotional intelligence (perceiving) combined to predict a large portion of the variance in trust. Research limitations/implications – This study was limited by a small sample size and the use of a cross-sectional design. These issues were addressed in our analysis. Originality/value – The majority of trust research examines employee-to-manager trust. Our study is one of the few to examine trust among co-workers. This study also contributes to research on the emotional intelligence and trust relationship by showing that the ability to perceive one’s own and others emotions significantly predicts increases in trust. It also reaffirms that perceptions of others’ integrity and ability are strongly linked to trust, but that further investigation of the benevolence construct is required.Griffith Business School, Dept of Employment Relations and Human ResourcesNo Full Tex