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No difference in mortality was observed between the two groups. CONCLUSION This study confirms the efficacy of letermovir in preventing CMV reactivation in CMV R+ allogeneic HCT recipients in first 100&nbsp;days post-HCT and suggests sustained efficacy after discontinuation of prophylaxis. © 2020 John Wiley &amp; Sons A/S. Published by John Wiley &amp; Sons Ltd.Intervertebral discs are important for maintaining mobility and offer support to the body trunk. If these discs lose their biomechanical features, lower back pain can occur. We previously reported that hepatocyte growth factor (HGF) promotes cell proliferation and suppresses apoptosis, inflammation, and matrix degradation in nucleus pulposus (NP) cells. In the present study, we investigated the molecular mechanisms of how HGF promotes the proliferation of NP cells in hypoxic conditions. Hypoxic stimulation promoted modest cell proliferation, which was further upregulated by HGF. Expression of hypoxia-inducible factor (HIF-1α) protein, which contributes to the maintenance of homeostasis in NP cells, was also upregulated in hypoxia-treated cell groups; HGF further increased HIF-1α expression in NP cells. Additionally, knockdown of HIF-1α expression significantly reduced the proliferation of NP cells. An MAPK inhibitor inhibited the expression of HIF-1α and pERK, as well as cell proliferation in a dose-dependent manner. Similarly, inhibiting the PI3K/Akt and STAT3 pathways also decreased the expression of HIF-1α and cell proliferation. These results show that under hypoxic conditions, HGF promotes NP cell proliferation via HIF-1α-, MAPK-, PI3K/Akt-, and STAT3-mediated signaling which is involved in this pathway. The control of these signaling pathways may be a target for potential therapeutic strategies for the treatment of disc degeneration in hypoxic conditions. © 2020 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.In their article "Beyond summative decision-making illuminating the broader roles of Competence Committees", Pack et al.1 report on a grounded theory study that highlights the range of roles that Canadian Competence Committees (CCs) undertake, through an analysis of data collected at seven postgraduate programmes within one institution. They show how the in-depth data review, synthesis and analysis undertaken to make summative assessment judgments, provided CC members with unique insights and opportunities to identify problems linked to individual learners or programmes and develop practical solutions. Such activities went beyond the committee name or terms of reference but afforded real potential to ensure trainees received the best possible education. This article is protected by copyright. All rights reserved.AIM To investigate the relationships between spirituality, somatic symptom distress/severity, depressive symptoms and quality of life for adolescents diagnosed with spina bifida. [https://www.selleckchem.com/products/capsazepine.html Capsazepine] DESIGN Exploratory, cross-sectional design. METHODS Fifty-eight adolescents with spina bifida in southern California were recruited during routine visits to a multidisciplinary clinic at a healthcare university from January 2016 - January 2017. Each adolescent completed a series of self-report measures, including the System of Belief Inventory, Somatic Symptom Scale, Patient Health Questionnaire and Pediatric Quality of Life Inventory. Path analysis was performed to examine regression coefficients for each direct and indirect effect. RESULTS The mediation-moderation analysis showed that depressive symptoms fully mediated the relationship between symptom distress and quality of life (B = 0.029(0.014), CI [0.007, 0.061]) and higher levels of spirituality moderated the relationship between depressive symptoms and quality of life (B = 0.epressive symptoms when assessing these adolescents and their physical symptoms/distress levels. This article is protected by copyright. All rights reserved.Observational studies of treatment effects attempt to mimic a randomized experiment by balancing the covariate distribution in treated and control groups, thus removing biases related to measured confounders. Methods such as weighting, matching, and stratification, with or without a propensity score, are common in cross-sectional data. When treatments are initiated over longitudinal follow-up, a target pragmatic trial can be emulated using appropriate matching methods. The ideal experiment of interest is simple; patients would be enrolled sequentially, randomized to one or more treatments and followed subsequently. This tutorial defines a class of longitudinal matching methods that emulate this experiment and provides a review of existing variations, with guidance regarding study design, execution, and analysis. These principles are illustrated in application to the study of statins on cardiovascular outcomes in the Framingham Offspring cohort. We identify avenues for future research and highlight the relevance of this methodology to high-quality comparative effectiveness studies in the era of big data. © 2020 The Authors. Statistics in Medicine published by John Wiley &amp; Sons, Ltd.Pre-participation cardiovascular screening (PPCS) is recommended by several scientific and sporting organizations on the premise that early detection of cardiac disease provides a platform for individualized risk assessment and management; which has been proven to lower mortality rates for certain conditions associated with sudden cardiac arrest (SCA) and sudden cardiac death (SCD). What constitutes the most effective strategy for PPCS of young athletes remains a topic of considerable debate. The addition of the electrocardiogram (ECG) to the medical history and physical examination undoubtedly enhances early detection of disease, which meets the primary objective of PPCS. The benefit of enhanced sensitivity must be carefully balanced against the risk of potential harm through increased false-positive findings, costly downstream investigations, and unnecessary restriction/disqualification from competitive sports. To mitigate this risk, it is essential that ECG-based PPCS programs are implemented by institutions with a strong infrastructure and by physicians appropriately trained in modern ECG standards with adequate cardiology resources to guide downstream investigations.