It's time to apply outbreak response best practices to avian influenza: A national call to action.

Cases of high pathogenicity avian influenza (HPAI) in Canada are upon us again and with reports of infection in US dairy cattle and a dairy farmer in the United States, concern has been raised. Although panic isn't helpful, this heightened level of concern is appropriate, given that reports of human infections with the H5N1 virus often indicate high mortality rates. These can range from 14 to 50%. The current devastating impact of the virus on the poultry industry, as well as its propensity to mutate are also reasons for concern. At the same time, HPAI provides an opportunity for the poultry and livestock industries to align and organize coherently for the management of all zoonotic diseases and other industry issues. To manage HPAI more effectively, it is essential to align all stakeholders under Outbreak Response Best Practices using a formal Quality Management System (QMS). The objective of this article is to describe this approach with examples drawn from management of the Walkerton waterborne disease crisis. We urge the veterinary profession to rise to the challenge of HPAI and use it as a context in which to align more coherently with national stakeholders for the prevention and management of all priority issues within the areas of Agri-food and Public Health.

Les cas de grippe aviaire hautement pathogène (HPAI) sont de nouveau aux portes du Canada et, avec les rapports d'infection chez des bovins laitiers américains et chez un producteur laitier aux États-Unis, des inquiétudes ont été soulevées. Même si la panique n'aide pas, ce niveau d'inquiétude accru est approprié, étant donné que les rapports d'infections humaines par le virus H5N1 indiquent souvent des taux de mortalité élevés. Ceux-ci peuvent aller de 14 à 50 %. L'impact dévastateur actuel du virus sur l'industrie avicole, ainsi que sa propension à muter sont également des motifs d'inquiétude. Dans un même temps, l'HPAI offre aux secteurs de la volaille et de l'élevage l'opportunité de s'associer et de s'organiser de manière cohérente pour la gestion de toutes les maladies zoonotiques et d'autres problèmes industriels. Pour gérer l'HPAI plus efficacement, il est essentiel d'aligner toutes les parties prenantes sur les meilleures pratiques de réponse aux épidémies en utilisant un système de gestion de la qualité (QMS) formel. L'objectif de cet article est de décrire cette approche avec des exemples tirés de la gestion de la crise des maladies d'origine hydrique à Walkerton. Nous exhortons la profession vétérinaire à relever le défi de l'HPAI et à l'utiliser comme un contexte dans lequel s'aligner de manière plus cohérente avec les parties prenantes nationales pour la prévention et la gestion de toutes les questions prioritaires dans les domaines de l'agroalimentaire et de la santé publique.(Traduit par Docteur Serge Messier).

Predicting Outcomes in Patients with Diffuse Axonal Injury: External Validation of the Widely Used Prognostic Instruments.

AIM: Accurate prognosis of diffuse axonal injury (DAI) is important in directing clinical care, allocating resources appropriately, and communicating with families and surrogate decision-makers. METHODS: A study was conducted on patients with clinical DAI due to closed-head traumatic brain injury treated at a trauma center in Brazil from July 2013 to September 2015.  The objective efficacy of the Glasgow Coma Scale (GCS), Trauma and Injury Severity Scoring system (TRISS), New Trauma and Injury Severity Scoring system (NTRISS), Abbreviated Injury Scale (AIS)/head, Corticosteroid Randomization After Significant Head Injury (CRASH), and International Mission on Prognosis and Analysis of Clinical Trials (IMPACT) models in the prediction of mortality at 14 days and 6-months and unfavorable outcomes at 6 months was tested. RESULTS: Our cohort comprised 95 prospectively recruited adults (85 males, 10 females, mean age 30.3 ± 10.9 years) admitted with DAI. Model efficacy was assessed through discrimination (area under the curve [AUC]), and Cox calibration. The AIS/head, TRISS, NTRISS, CRASH, and IMPACT models were able to discriminate both mortality and unfavorable outcomes (AUC 0.78-0.87). IMPACT models resulted in a statistically perfect calibration for both 6-month outcome variables; mortality and 6-month unfavorable outcome. Calibration also revealed that TRISS, NTRISS, and CRASH systematically overpredicted both outcomes, except for 6-month unfavorable outcome with TRISS. CONCLUSIONS: The results of this study suggest that TRISS, NTRISS, CRASH, and IMPACT models satisfactorily discriminate between mortality and unfavorable outcomes. However, only the TRISS and IMPACT models showed accurate calibration when predicting 6-month unfavorable outcome.

Risk factors affecting the feeding site predilection of ticks on cattle in Ghana.

Ticks are important disease vectors affecting animal health and causing substantial economic loss, especially in the tropics and subtropics. To examine the tick burden of cattle and associated risk factors for tick infestation, ticks were collected from 388 cattle within five regions in Ghana. Most of the cattle were males (50.3%) and generally older than 3 years (65%). Of the animals sampled, 2187 ticks were collected with a mean tick burden of 5.6 ticks per cattle, and the average tick burden on the udder/scrotum being significantly higher than in the anal region (Generalized Linear Mix Model [GLMM], p = 0.01197). The tick species identified were predominantly Amblyomma variegatum (42.6%) and Hyalomma rufipes (26.2%). High proportions of cattle examined were found to have A. variegatum infesting the udder/scrotum. Furthermore, H. rufipes infested mostly the anal region compared to other examined body parts (OR 14.8, 95% CI 8.6-25.4, p < 0.001). Using the GLMM, tick abundance was found to be significantly higher in cattle older than 3 years. The tick burden in the udder/scrotum was higher than that from the chest and leg/thigh of the cattle (GLMM, p < 0.05). The tick burden at the anal region was also significantly higher than the leg/thigh and chest. This study indicates that the preferred attachment sites of ticks on cattle are species-dependent and effective treatment with acaricides should take into consideration the udder/scrotum and anal regions as well as prioritizing older cattle.

Influence of exposure time, physicochemical properties, and plant transpiration on the uptake dynamics and translocation of pharmaceutical and personal care products in the aquatic macrophyte Typha latifolia.

Typha latifolia is widely used as a phytoremediation model plant for organic compounds. However, the dynamic uptake and translocation of pharmaceutical and personal care products (PPCPs) and their relationship with physicochemical properties, such as lipophilicity (LogKow), ionization behavior (pKa), pH-dependent lipophilicity (LogDow), exposure time and transpiration, are scarcely studied. In the current study, hydroponically grown T. latifolia was exposed to carbamazepine, fluoxetine, gemfibrozil, and triclosan at environmentally relevant concentrations (20 µg/L each). Eighteen out of thirty-six plants were exposed to the PPCPs and the other eighteen were untreated. Plants were harvested at 7, 14, 21, 28, 35, and 42 days and separated into root, rhizome, sprouts, stem, and lower, middle, and upper leaf sections. Dry tissue biomass was determined. PPCP tissue concentrations were analyzed by LC-MS/MS. PPCP mass per tissue type was calculated for each individual compound and for the sum of all compounds during each exposure time. Carbamazepine, fluoxetine, and triclosan were detected in all tissues, while gemfibrozil was detected only in roots and rhizomes. In roots, triclosan and gemfibrozil mass surpassed 80% of the PPCP mass, while in leaf carbamazepine and fluoxetine mass represented 90%. Fluoxetine accumulated mainly in the stem and the lower and middle leaf, while carbamazepine accumulated in the upper leaf. The PPCP mass in roots and rhizome was strongly positively correlated with LogDow, while in leaf it was correlated with water transpired and pKa. PPCP uptake and translocation in T. latifolia is a dynamic process determined by the properties of contaminants and plants.

Safety and immunogenicity of intramuscular, single-dose V590 (rVSV-SARS-CoV-2 Vaccine) in healthy adults: Results from a phase 1 randomised, double-blind, placebo-controlled, dose-ranging trial.

BACKGROUND: Vaccines against COVID-19 are needed to overcome challenges associated with mitigating the global pandemic. We report the safety and immunogenicity of V590, a live recombinant vesicular stomatitis virus-based COVID-19 vaccine candidate. METHODS: In this placebo-controlled, double-blind, three-part phase 1 study, healthy adults were randomised to receive a single intramuscular dose of vaccine or placebo. In Part 1, younger (18-54 years) and, in Part 2, older (≥55 years) adults seronegative for SARS-CoV-2 nucleocapsid received one of four V590 dose levels (5.00 × 105; 2.40 × 106; 1.15 × 107; or 5.55 × 107 plaque-forming units [pfu]) or placebo. In Part 3, a single V590 dose level (5.55 × 107 pfu) or placebo was administered to younger SARS-CoV-2 seropositive adults. Primary endpoints included adverse events (AEs) and for Parts 1 and 2 anti-SARS-CoV-2 serum neutralising antibody responses measured by 50% plaque reduction neutralisation (PRNT50) assay at Day 28. Registration NCT04569786 [P001-02]. FINDINGS: 232 participants were randomised and 219 completed the study. In seronegative participants, anti-SARS-CoV-2 spike-specific antibody responses to V590 were low and comparable to placebo across the lower dose levels. At the highest dose level (5.55 × 107 pfu), anti-SARS-CoV-2 spike-specific PRNT50 was 2.3-fold higher than placebo. The most frequently reported AEs were injection-site pain (38.4%), headache (15.1%) and fatigue (13.4%). INTERPRETATION: V590 was generally well-tolerated. However, Day 28 anti-SARS-Cov-2 spike-specific antibody responses in seronegative participants following a single intramuscular administration of V590 were not sufficient to warrant continued development. FUNDING: The study was funded by Merck Sharp & Dohme LLC., a subsidiary of Merck & Co., Inc., Rahway, NJ, USA.

Epidural Steroid Injections.

Epidural steroid injections (ESI) can be an effective treatment of radicular pain, while also providing potential for functional improvement. There are 3 main interventional approaches including: interlaminar (IL), transforaminal (TF), and caudal. The risks and efficacy data vary between these routes of injection and the underlying pathology with the TF route having the most robust efficacy data. However, selecting an injection approach should be based on a patient's clinical presentation, pathology, anatomy, consideration of the natural course of pain, and the unique risks and benefits of the particular technique.

Contaminants of emerging concern (CECs) in Zea mays: Uptake, translocation and distribution tissue patterns over the time and its relation with physicochemical properties and plant transpiration rate.

Passive uptake of contaminants of emerging concern (CECs) and its relationship with physicochemical properties, such as lipophilicity (LogKow), ionization behavior (pKa), distribution coefficient (LogDow) and transpiration rate are scarcely studied. In the current study, hydroponically grown corn (Zea mays) was exposed to carbamazepine (CBZ), fluoxetine (FLX), gemfibrozil (GBZ), triclosan (TRI) and atrazine (ATZ)) at environmentally relevant concentrations (20 µg/L each one). Plant tissue concentrations of CECs were determined several times over 21 days. Eighteen plants were used, nine exposed to the CECs and nine untreated. Whole plants were harvested at 7, 14 and 21 days and separated into roots, stem, leaf and male bud flower (only at 21 days). Hydroponic solution was maintained at pH 5.5 throughout the study. CECs concentrations in the exposure solution and tissues were determined by LC-MS/MS. ATZ metabolites desisopropylatrazine (DIA) and desethylatrazine (DEA) were determined by LC-DAD. In shoot tissues, CBZ, FLX and ATZ were detected, while TRI and GBZ were detected only in roots. Root concentrations were related with LogKow (R2ROOT = 0.415). Leaf and stem concentrations of CBZ, FLX and ATZ were linked with LogKow and strongly linked with pKa. Transpiration was related with CBZ and ATZ in shoot, but not related with FLX shoot levels. Neutral compounds such as CBZ (pKa = 13.94; 100% neutral) and ATZ (pKa = 1.6; 85% neutral) were taken up passively with transpiration. Root accumulation was related with CECs lipophilicity, while translocation and bioaccumulation in shoot were not only related with lipophilicity, but also with CECs ionization behavior and transpiration.

Atrazine uptake, translocation, bioaccumulation and biodegradation in cattail (Typha latifolia) as a function of exposure time.

The extensive use and environmental persistence of atrazine has resulted in its ubiquitous occurrence in water resources. Some reports have described atrazine bioaccumulation and biodegradation pathways in terrestrial plants, but few have done so in aquatic macrophytes. Thus, in this study, we aimed to analyze morphological changes, uptake, translocation and bioaccumulation patterns in tissues of the aquatic macrophyte Typha latifolia (cattail) after long-term atrazine exposure and to determine the presence of atrazine biodegradation metabolites, desethylatrazine (DEA) and desisopropylatrazine (DIA), in tissues. Plants were hydroponically exposed to 20 µg/L atrazine (18 exposed and 18 non-exposed) for 7, 14, 21, 28, 35 and 42 days. Plants were separated into root, rhizome, stem, and lower, middle and upper leaf sections. Atrazine was analyzed by LC-MS/MS and DIA and DEA by LC-DAD. Plants showed reductions in weight (after 21 days) and transpiration (after 28 days), both symptoms of chronic phytotoxicity. The distribution of atrazine within tissues, expressed as concentration levels (µg/kg dry weight), was as follows: middle leaf (406.10 ± 71.77) = upper leaf (339.15 ± 47.60) = lower leaf (262.43 ± 7.66) = sprout (274.53 ± 58.1) > stem (38.63 ± 7.55) = root (36.00 ± 3.49) = rhizome (26.15 ± 3.96). In submerged tissues, DEA and DIA were detected at similar concentrations. In leaves, DIA was the main metabolite identified. Results indicated that atrazine was taken up from roots to shoots and induced phytotoxicity effects that reduced the translocation to shoots. Typha likely is able to biodegrade atrazine via different metabolic pathways.

Attention Trade-Off for Localization and Saccadic Remapping.

Predictive remapping may be the principal mechanism of maintaining visual stability, and attention is crucial for this process. We aimed to investigate the role of attention in predictive remapping in a dual task paradigm with two conditions, with and without saccadic remapping. The first task was to remember the clock hand position either after a saccade to the clock face (saccade condition requiring remapping) or after the clock being displaced to the fixation point (fixation condition with no saccade). The second task was to report the remembered location of a dot shown peripherally in the upper screen for 1 s. We predicted that performance in the two tasks would interfere in the saccade condition, but not in the fixation condition, because of the attentional demands needed for remapping with the saccade. For the clock estimation task, answers in the saccadic trials tended to underestimate the actual position by approximately 37 ms while responses in the fixation trials were closer to veridical. As predicted, the findings also revealed significant interaction between the two tasks showing decreased predicted accuracy in the clock task for increased error in the localization task, but only for the saccadic condition. Taken together, these results point at the key role of attention in predictive remapping.

Is it feasible to assess self-reported quality of life in individuals who are deaf and have intellectual disabilities?

PURPOSE: There is consensus that Quality of Life (QOL) should be obtained through self-reports from people with intellectual Disability (ID). Thus far, there have been no attempts to collect self-reported QOL from people who are deaf and have ID. METHODS: Based on an established short measure for QOL (EUROHIS-QOL), an adapted easy-to-understand sign language interview was developed and applied in a population (n = 61) with severe-to-profound hearing loss and mild-to-profound ID. Self-reports were conducted at two time points (t1 and t2), 6 months apart. The Stark QOL, an established picture-based questionnaire, was also obtained at t2 and three Proxy ratings of QOL (from caregivers) were conducted for each participant at t1. RESULTS: Self-reported QOL was successfully administered at both time points for 44 individuals with mild and moderate ID (IQ reference age between 3.3 and 11.8 years). The self-reports showed sufficient test-retest reliability and significant correlations with the Stark QOL. As anticipated, self-reported QOL was higher than proxy-reported QOL. Test-retest reliability and internal consistency were good for self-reported QOL. CONCLUSION: Reliable and valid self-reports of QOL can be obtained from deaf adults with mild-moderate ID using standard inventories adapted to the linguistic and cognitive level of these individuals.

Association of the Meaningful Use Electronic Health Record Incentive Program With Health Information Technology Venture Capital Funding.

Importance: Although the Health Information Technology for Economic and Clinical Health (HITECH) Act has accelerated electronic health record (EHR) adoption since its passage, clinician satisfaction with EHRs remains low, and the association of HITECH with health care information technology (IT) entrepreneurship has remained largely unstudied. Objective: To determine whether the passage of the HITECH Act was associated with an increase in key measures of health care IT entrepreneurship. Design, Setting, and Participants: This economic evaluation of venture capital (VC) activity in the US from 2000 to 2019 examined funding trends in health care IT, EHR-related companies, and all VC investments before and after the passage of HITECH. A difference-in-differences analysis compared investments in health care IT companies with those of companies in 3 categories: general health care (non-IT), IT (non-health care), and all US VC transactions. Data were analyzed from September 2018 to August 2019. Exposures: Venture capital funding received by US companies before and after the HITECH Act. Main Outcomes and Measures: Venture capital investment in health care IT companies and the proportion of those investments going to seed-stage companies, a proxy for very early-stage entrepreneurship and innovation. Results: The data included 70 982 investments, of which 9425 (13.3%) were seed stage, 10 706 (15.1%) were early stage, and 50 851 (71.6%) were growth stage. After passage of the HITECH Act, investment in both health care IT companies and EHR-related companies increased at a rate much faster (13.0% and 11.4%, respectively) than VC as a whole (6.9%). In addition, the proportion of investments going to seed-stage health care IT companies increased compared with both overall VC investments and non-IT health care investments. Health care IT companies saw increased probabilities of transactions being seed-stage of 5.1% (SE, 2.2%; 95% CI, 0.8% to 9.3%; P = .02) compared with the entire sample of VC transactions and 13.6% (SE, 1.9%; 95% CI, 9.9% to 17.2%; P < .001) compared with non-IT health care VC transactions. Health care IT had essentially 0 increased probability of a transaction being seed stage compared with IT companies outside health care (-0.8% probability; SE, 2.4%; 95% CI, -5.4% to 3.9%; P = .75). Conclusions and Relevance: Although widespread clinician dissatisfaction with EHR systems remains a challenge, the HITECH Act's incentive program may have catalyzed early-stage entrepreneurship in health care IT, suggesting an important role for incentives in promoting innovation.

Feasibility and acceptance of a cloud-based mobile app for antimicrobial stewardship and infection control in Colombian hospitals.

Infection control and antimicrobial stewardship programs (ICASPs) are essential to reduce the emergence and spread of antimicrobial resistance. The primary objective of this study was to assess the feasibility of extending a commercial off-the-shelf (COTS) software for ICASPs in low- and middle-income countries (LMICs). This project involved three hospitals in Colombia, including Centro Médico Imbanaco, Clínica San Francisco, and DIME Clínica Neurocardiovascular. A COTS platform (ILÚM Health Solutions™ Kenilworth, NJ) was extended to function in a range of technology settings, and translatable to almost any language. ICASP features were added, including clinical practice guidelines, hand hygiene (HH) documentation, and isolation precaution (IP) documentation. The platform was delivered as a smartphone mobile application ("app") for both iOS and Android. The app was successfully implemented at all sites, however, full back-end data integration was not feasible at any site. In contrast to the United States, a suite of surveillance tools and physician-focused decision support without patient data proved to be valuable. Language translation processing occurred quickly and incurred minimal costs. HH and IP compliance tracking were the most used features among ICASP staff; treatment guidelines were most often used by physicians. Use of the app streamlined activities and reduced the time spent on ICASP tasks. Users consistently reported positive impressions including simplicity of design, ease of navigation, and improved efficiency. This ICASP app was feasible in limited-resource settings, highly acceptable to users, and represents an innovative approach to antimicrobial resistance prevention.

Feasibility and Outcomes of the Early Start Denver Model Implemented with Low Intensity in a Community Setting in Austria.

OBJECTIVE: To investigate the feasibility and effectiveness of early autism intervention with the Early Start Denver Model (ESDM) implemented with low intensity in a community service in Europe. METHODS: Subjects were boys (n = 13, ages 34-54 months, mean age 43.3 months) consecutively diagnosed with autism spectrum disorder in a regional autism center in Austria. The subjects either received the ESDM intervention for 4.6 hours weekly over 12 months (n = 7) or intervention as usual (n = 6). Feasibility of the ESDM intervention was evaluated by parent and teacher questionnaires, ESDM fidelity measures, and therapists' feedback. Developmental status was assessed through standardized instruments (Mullen Scales of Early Learning [MSEL], Vineland Adaptive Behavior Scales Second Edition, Communicative Development Inventory, Pervasive Developmental Disorder Behavior Inventory [PDDBI], Parenting Sense of Competence Scale) at baseline and after intervention. RESULTS: The ESDM intervention was delivered with high fidelity (>80%) by a newly trained multiprofessional team. Acceptability by parents was rated as high. The ESDM was considered to be compatible with both family and preschool routines without any major adaptations. The ESDM group showed a trend toward improved receptive language (MSEL receptive language; p = 0.09, effect size [ES] = 0.72) and reduction in parent-reported core autism symptoms (PDDBI Autism Composite Score; p = 0.04; ES = 0.95). No such improvement was noted in the control group. CONCLUSION: Low-intensity implementation of the ESDM in a non-English-speaking community service context is feasible. Although outcomes from this small feasibility study should be interpreted with caution, our findings suggest a more favorable response to the ESDM intervention group compared with the control group.

Heterogeneity in Circulating Tumor Cells: The Relevance of the Stem-Cell Subset.

The release of circulating tumor cells (CTCs) into vasculature is an early event in the metastatic process. The analysis of CTCs in patients has recently received widespread attention because of its clinical implications, particularly for precision medicine. Accumulated evidence documents a large heterogeneity in CTCs across patients. Currently, the most accepted view is that tumor cells with an intermediate phenotype between epithelial and mesenchymal have the highest plasticity. Indeed, the existence of a meta-stable or partial epithelial⁻mesenchymal transition (EMT) cell state, with both epithelial and mesenchymal features, can be easily reconciled with the concept of a highly plastic stem-like state. A close connection between EMT and cancer stem cells (CSC) traits, with enhanced metastatic competence and drug resistance, has also been described. Accordingly, a subset of CTCs consisting of CSC, present a stemness profile, are able to survive chemotherapy, and generate metastases after xenotransplantation in immunodeficient mice. In the present review, we discuss the current evidence connecting CTCs, EMT, and stemness. An improved understanding of the CTC/EMT/CSC connections may uncover novel therapeutic targets, irrespective of the tumor type, since most cancers seem to harbor a pool of CSCs, and disclose important mechanisms underlying tumorigenicity.

Sugammadex efficacy for reversal of rocuronium- and vecuronium-induced neuromuscular blockade: A pooled analysis of 26 studies.

STUDY OBJECTIVE: To summarize and compare efficacy of sugammadex with neostigmine or placebo for reversal of rocuronium- or vecuronium-induced neuromuscular blockade (NMB), and to demonstrate consistency of sugammadex results across various patient populations. DESIGN: Pooled analysis on data from 26 multicenter, randomized, Phase II and III studies. SETTING: Operating room. PATIENTS: 1855 adults undergoing surgery under general anesthesia and receiving rocuronium or vecuronium for NMB. INTERVENTIONS: Sugammadex (2.0mg/kg at second twitch reappearance [T2; moderate NMB], 4.0mg/kg at 1-2 post-tetanic counts [PTC; deep NMB] or 16.0mg/kg at 3min after rocuronium 1.2mg/kg), neostigmine or placebo. MEASUREMENTS: Time to recovery of the train-of-four (TOF) ratio to 0.9. MAIN RESULTS: Geometric mean (95% CI) times to recovery to TOF ratio of 0.9 were 1.9 (1.8-2.0) min following sugammadex 2.0mg/kg and 10.6 (9.8-11.6) min following neostigmine administration at T2 after rocuronium, and 2.9 (2.5-3.4) min and 17.4 (13.4-22.6) min, respectively, after vecuronium. Recovery times were 2.2 (2.1-2.3) min following sugammadex 4.0mg/kg and 19.0 (14.8-24.6) min following neostigmine administered at a target of 1-2 PTC after rocuronium, and 3.8 (3.0-5.0) min and 67.6 (56.3-81.2) min after vecuronium. Sugammadex administered 3min after rocuronium 1.2mg/kg resulted in rapid recovery (1.7 [1.5-2.0] min). Modest increases in mean recovery time were associated with vecuronium use (+1.6min [78%; (61%-98%)] versus rocuronium), mild-to-moderate renal impairment (+0.4min [20%; (9%-32%)] versus normal renal function) and geographic location (+1.0min [38%; (25%-52%)] in subjects in USA/Canada versus Europe/Japan). CONCLUSIONS: Sugammadex administered at recommended doses provides rapid and predictable reversal of rocuronium and vecuronium-induced moderate and deep NMB, and effective reversal 3min after rocuronium 1.2mg/kg. Robust recovery was seen across various patient factors, providing further confirmation of labeled dose recommendations.

Author Impact Metrics in Communication Sciences and Disorder Research.

Purpose: The purpose was to examine author-level impact metrics for faculty in the communication sciences and disorder research field across a variety of databases. Method: Author-level impact metrics were collected for faculty from 257 accredited universities in the United States and Canada. Three databases (i.e., Google Scholar, ResearchGate, and Scopus) were utilized. Results: Faculty expertise was in audiology (24.4%; n = 490) and speech-language pathology (75.6%; n = 1,520). Women comprised 68.1% of faculty, and men comprised 31.9% of faculty. The percentage of faculty in the field of communication sciences and disorders identified in each database was 10.5% (n = 212), 44.0% (n = 885), and 84.4% (n = 1,696) for Google Scholar, ResearchGate, and Scopus, respectively. In general, author-level impact metrics were positively skewed. Metric values increased significantly with increasing academic rank (p < .05), were greater for men versus women (p < .05), and were greater for those in audiology versus speech-language pathology (p < .05). There were statistically significant positive correlations between all author-level metrics (p < .01). Conclusions: These author-level metrics may serve as a benchmark for scholarly production of those in the field of communication sciences and disorders and may assist with professional identity management, tenure and promotion review, grant applications, and employment.

Nose-to-brain transport of imatinib mesylate: A pharmacokinetic evaluation.

The delivery of drugs to the brain is a constant challenge due to limitations imposed by the blood-brain barrier (BBB). Various methods of bypassing the BBB are under investigation. One approach is intranasal administration, where the olfactory region of the nasal cavity extends up to the cranial cavity and provides direct access to the brain. The pharmacokinetics of this transport and factors that determine transport rates and capacity is of vital importance for evaluating the clinical value of this route. Here, the pharmacokinetics of intranasally administered imatinib has been explored. Imatinib is distributed into the brain following intravenous administration, and then rapidly removed. Following intravenous administration, the brain/plasma ratio for imatinib was calculated to be 2% and remained at this ratio for 30min. The brain/plasma ratio following intranasal administration, however, was found to be 5.3% and remained at this ratio for up to 90min. Imatinib was found to be rapidly transported into the brain via the olfactory region, by shutting down the nose-to-blood-to-brain transport with epinephrine. The increased brain concentration of imatinib (0.33µg/g tissue) achieved by intranasal administration, compared with an IV injection, is likely to provide a model for developing a wide range of CNS active molecules that were previously removed from consideration as drug candidates due to their lack of CNS access. Furthermore, brain imatinib levels were increased by co-administration of the p-gp substrates, elacridar and pantoprazole, showing that both compounds were able to inhibit the elimination of imatinib from the brain.