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The loss of a spouse is a common and natural life event for older adults. Adenosine Cyclophosphate Nearly one of four older bereaved spouses experience prolonged grief, impaired function or chronic depression. Mechanisms underlying these and other long-term health risks are not well understood. We conducted a scoping literature review to examine the interventions and outcomes that have been studied for late-life spousal bereavement to date. We identified 22 studies of group and individual-level interventions with most studies concerning grief processes within the first year. Nearly all studies evaluated emotional and psychological symptoms of loss and a small number evaluated the restoration of adaptive functioning. Four interventions addressed the treatment of complicated grief or grief with major depressive disorder. Qualitative studies explored themes of spirituality and mindfulness. There were 17 controlled studies, including 13 randomized controlled trials. Findings were eclectic, with evidence supporting mindfulness techniques in a group format for emotional and life satisfaction outcomes; an individual, function-based therapy addressing sleep to improve emotion and function; an individual, writing-based emotional expression therapy for short-term improvement in emotion and function; nortriptyline for the treatment of bereavement-related major depressive disorder; a group-based, complicated grief therapy for this condition; an internet-based CBT intervention for prolonged grief; and pharmacotherapy for cardiovascular changes during bereavement. These findings highlight the small literature of methodologically strong intervention studies addressing spousal bereavement in older adults and the need for greater exploration of relevant biological, social, cognitive and behavioral factors to improve short and long term health outcomes.Cysteiniphilum litorale is a Gram-negative coccobacillus first isolated from the seawater of Wailingding Island near the estuary of Pearl River in southern China. This organism was previously not considered to cause disease in animals or humans. We report a case of a 19-year-old female patient infected with abscess caused by C. litorale in the middle digit of her right hand after minor trauma during the handling of estuarine shrimps at home. C. litorale was cultured from the wound exudate of the patient and identified by 16S rRNA gene sequencing. Whether C. litorale may be transmitted to humans via other channels requires further exploration.

Immune checkpoint inhibitor monotherapy in metastatic castration-resistant prostate cancer (mCRPC) has produced modest results. High-dose radiotherapy may be synergistic with checkpoint inhibitors.

To evaluate the efficacy and safety of the PD-L1 inhibitor avelumab with stereotactic ablative body radiotherapy (SABR) in mCRPC.

From November 2017 to July 2019, this prospective phase 2 study enrolled 31 men with progressive mCRPC after at least one prior androgen receptor-directed therapy. Median follow-up was 18.0 mo.

Avelumab 10mg/kg intravenously every 2 wk for 24 wk (12 cycles). A single fraction of SABR (20Gy) was administered to one or two disease sites within 5 d before the first and second avelumab treatments.

The primary endpoint was the disease control rate (DCR), defined as a confirmed complete or partial response of any duration, or stable disease/non-complete response/non-progressive disease for ≥6 mo (Prostate Cancer Clinical Trials Working Group 3-modified Response Evaluation Criteria inctivity and acceptable toxicity in treatment-refractory mCRPC. This combination warrants further investigation.

In this study of men with advanced and heavily pretreated prostate cancer, combining stereotactic radiotherapy with avelumab immunotherapy was safe and resulted in nearly half of patients experiencing cancer control for 6 months or longer. Stereotactic radiotherapy may potentially improve the effectiveness of immunotherapy in prostate cancer.

In this study of men with advanced and heavily pretreated prostate cancer, combining stereotactic radiotherapy with avelumab immunotherapy was safe and resulted in nearly half of patients experiencing cancer control for 6 months or longer. Stereotactic radiotherapy may potentially improve the effectiveness of immunotherapy in prostate cancer.

Predict Prostate is a freely available online personalised risk communication tool for men with nonmetastatic prostate cancer. Its accuracy has been assessed in multiple validation studies, but its clinical impact among patients has not hitherto been assessed.

To assess the impact of the tool on patient decision-making and disease perception.

A multicentre randomised controlled trial was performed across eight UK centres among newly diagnosed men considering either active surveillance or radical treatment. A total of 145 patients were included between 2018 and 2020, with median age 67yr (interquartile range [IQR] 61-72) and prostate-specific antigen 6.8ng/ml (IQR 5.1-8.8).

Participants were randomised to either standard of care (SOC) information or SOC and a structured presentation of the Predict Prostate tool.

Validated questionnaires were completed by assessing the impact of the tool on decisional conflict, uncertainty, anxiety, and perception of survival.

Mean Decisional Conflict Scale scores wstic perceptions about survival outcomes and prognosis.

The use of an individualised risk communication tool, such as Predict Prostate, reduces patient decisional conflict and uncertainty when deciding about treatment for nonmetastatic prostate cancer. The tool leads to more realistic perceptions about survival outcomes and prognosis.Background Hair-thread tourniquet syndrome (HTTS) is the constriction of an appendage or tissue by a hair thread, which can cause ischemia and necrosis of distal tissues. Depilatory agents have the potential to release the hair tourniquet without exposing the patient to the risks of surgery.

This review aims to evaluate the effectiveness, benefits, complications, and contraindications of depilatory agents in HTTS.

Relevant terms to HTTS and depilatory agents were used to search for articles on MEDLINE and EMBASE databases using the NHS Healthcare Databases Advanced Search engine.

In total, 19 of the 295 articles identified in the primary search were included in the final review. Articles described the benefits of depilatory agents as painless, well tolerated, and non-invasive. Contraindications described include use on mucosal membranes, non-hair tourniquet, and allergy. Sixty-four percent (n=55) of patients had resolution of their HTTS after one or two cycles of depilatory agent treatment.

The use of depilatory agents has multiple potential benefits. The authors propose a treatment algorithm for the use of depilatory agents in HTTS and recommend that all acute centers should store and train staff in their use.

The use of depilatory agents has multiple potential benefits. The authors propose a treatment algorithm for the use of depilatory agents in HTTS and recommend that all acute centers should store and train staff in their use.

Early in the coronavirus disease 2019 (COVID-19) pandemic, before severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines became available, it was hypothesized that BCG (Bacillus Calmette-Guérin), which stimulates innate immunity, could provide protection against SARS-CoV-2. Numerous ecological studies, plagued by methodological deficiencies, revealed a country-level association between BCG use and lower COVID-19 incidence and mortality. We aimed to determine whether BCG administered in early life decreased the risk of SARS-CoV-2 infection in adulthood and the severity of COVID-19.

This case-control study was conducted in Quebec, Canada. Cases were patients with a positive SARS-CoV-2 nucleic acid amplification test performed at two hospitals between March-October 2020. Controls were identified among patients with non-COVID-19 samples processed by the same microbiology laboratories during the same period. Enrolment was limited to individuals born in Quebec between 1956 and 1976, whose vaccine status was accessible in a computerized registry of 4.2 million BCG vaccinations.

We recruited 920 cases and 2123 controls. Fifty-four percent of cases (n=424) and 53% of controls (n=1127) had received BCG during childhood (OR 1.03; 95% CI 0.89-1.21), while 12% of cases (n=114) and 11% of controls (n=235) had received two or more BCG doses (OR 1.14; 95% CI 0.88-1.46). After adjusting for age, sex, material deprivation, recruiting hospital and occupation there was no evidence of protection conferred by BCG against SARS-CoV-2 (AOR 1.01; 95% CI 0.84-1.21). Among cases, 77 (8.4%) needed hospitalization and 18 (2.0%) died. The vaccinated were as likely as the unvaccinated to require hospitalization (AOR 1.01, 95% CI 0.62-1.67) or to die (AOR 0.85, 95% CI 0.32-2.39).

BCG does not provide long-term protection against symptomatic COVID-19 or severe forms of the disease.

BCG does not provide long-term protection against symptomatic COVID-19 or severe forms of the disease.

Waning of immunity after vaccination with the acellular Pertussis (aP) vaccine has been proposed as one of the main reasons for pertussis resurgence in the US. In this study, we estimated time-varying vaccine effectiveness after 5 doses of aP vaccine.

We conducted a retrospective cohort study among children 5-9years old (born between 2008 and 2012) living in King County, Washington, USA, who participated in the Washington State Immunization Information System. We estimated time-varying vaccine effectiveness after 5 doses of aP using smoothed scaled Schoenfeld residuals obtained from fitting Cox proportional hazards models to the data as well as piecewise constant Poisson regression.

There were 55 pertussis cases in this cohort, of whom 22 (40%) were fully-vaccinated and 33 (60%) were under-vaccinated. Vaccine effectiveness (VE) remained high for up to 42months after the fifth dose (VE(t)=89%; 95% CI 64%, 97%) as estimated using survival analysis methods and up to 4years (VE(t)=93%; 95% CI 67%, 98%) as estimated using Poisson regression.

We did not find evidence for waning of vaccine effectiveness for up to four years after 5 doses of aP among 5 -9years old children in King County, WA.

We did not find evidence for waning of vaccine effectiveness for up to four years after 5 doses of aP among 5 -9 years old children in King County, WA.

Schools are the primary setting for the delivery of adolescent HPV vaccination in Australia. Although this strategy has achieved generally high vaccination coverage, gaps persist for reasons that are mostly unknown. This study sought to identify school-level correlates of low vaccination course initiation and completion in New South Wales, Tasmania, and Western Australia to inform initiatives to increase uptake.

Initiation was defined as the number of first doses given in a school in 2016 divided by vaccine-eligible student enrolments. Completion was the number of third doses given in a school in 2015-2016 divided by the number of first doses. Low initiation and completion were defined as coverage≤25thpercentile of all reporting schools. We investigated correlations between covariates using Spearman's rank correlation coefficients. Due to multicollinearity, we used univariable logistic regression to investigate associations between school characteristics and low coverage.

Median initiation was 84.7% (IQR 75.