Age-Adjusted Modified Frailty Index Predicts 30-Day Complications and Mortality in Aseptic Revision Total Hip and Knee Arthroplasty.

BACKGROUND: The age-adjusted modified frailty index (aamFI) has been demonstrated to effectively predict postoperative complications and healthcare resource utilization in patients undergoing primary total joint arthroplasty. The purpose of this study was to evaluate the applicability of aamFI in patients undergoing aseptic revision total hip (rTHA) and knee arthroplasty (rTKA). METHODS: A national database was queried for patients undergoing aseptic rTHA and rTKA from 2015 to 2020. A total of 13,307 rTHA and 18,762 rTKA cases were identified. The aamFI was calculated by adding 1 additional point for age ≥73 years to the previously described 5-item modified frailty index (mFI-5). The area under the curve was calculated and compared to compare predictive accuracy between mFI-5 and aamFI. Logistic regression was used to investigate the relationship between aamFI and 30-day complications. RESULTS: The incidence of incurring any (≥1) complication increased from 15% for aamFI 0 to 45% for aamFI ≥5 after rTHA and from 5 to 55% after rTKA. Patients who had an aamFI ≥3 (reference aamFI = 0) had increased odds (rTHA: odds ratio (OR) 3.5, 95% confidence interval (CI) 2.9 to 4.1, P < .001; rTKA: OR 4.2, 95% CI 4.4 to 5.1, P < .001) of incurring at least 1 complication. The aamFI, compared to mFI-5, was a more accurate predictor of any complication (rTHA P < .001; rTKA P < .001) and 30-day mortality (rTHA P < .001; rTKA P < .003). CONCLUSION: The aamFI is an excellent predictor of complications in patients undergoing rTHA and rTKA. The addition of chronological age to the previously described mFI-5 improves the predictive value of this simple metric.

A Transgenic Line That Reports CSF1R Protein Expression Provides a Definitive Marker for the Mouse Mononuclear Phagocyte System.

The proliferation, differentiation, and survival of cells of the mononuclear phagocyte system (MPS; progenitors, monocytes, macrophages, and classical dendritic cells) are controlled by signals from the M-CSF receptor (CSF1R). Cells of the MPS lineage have been identified using numerous surface markers and transgenic reporters, but none is both universal and lineage restricted. In this article, we report the development and characterization of a CSF1R reporter mouse. A FusionRed (FRed) cassette was inserted in-frame with the C terminus of CSF1R, separated by a T2A-cleavable linker. The insertion had no effect of CSF1R expression or function. CSF1R-FRed was expressed in monocytes and macrophages and absent from granulocytes and lymphocytes. In bone marrow, CSF1R-FRed was absent in lineage-negative hematopoietic stem cells, arguing against a direct role for CSF1R in myeloid lineage commitment. It was highly expressed in marrow monocytes and common myeloid progenitors but significantly lower in granulocyte-macrophage progenitors. In sections of bone marrow, CSF1R-FRed was also detected in osteoclasts, CD169+ resident macrophages, and, consistent with previous mRNA analysis, in megakaryocytes. In lymphoid tissues, CSF1R-FRed highlighted diverse MPS populations, including classical dendritic cells. Whole mount imaging of nonlymphoid tissues in mice with combined CSF1R-FRed/Csf1r-EGFP confirmed the restriction of CSF1R expression to MPS cells. The two markers highlight the remarkable abundance and regular distribution of tissue MPS cells, including novel macrophage populations within tendon and skeletal muscle and underlying the mesothelial/serosal/capsular surfaces of every major organ. The CSF1R-FRed mouse provides a novel reporter with exquisite specificity for cells of the MPS.

Acceleration Profile of Elite Gaelic Football With Special Reference to Position of Play.

Ryan, M, Malone, S, Donnellan, A, and Collins, K. Acceleration profile of elite Gaelic football with special reference to position of play. J Strength Cond Res 34(6): 1750-1758, 2020-The current study aimed to characterize the positional match-play demands of elite Gaelic football players with special reference to acceleration using predetermined 5-minute periods (epochs). Thirty-five male Gaelic players (mean ± SD, age: 24 ± 6 years; height: 180 ± 7 cm; mass: 81 ± 7 kg) across 5 playing positions (full-back, half-back, midfield, half-forward, and full-forward) were monitored during the investigation. Player movement was recorded during 19 matches using 4-Hz global positioning system technology (VXSport, New Zealand) resulting in 154 player observations. Global positioning system was used to record total distance (m), (high-speed running; m; ≥17 km·h), (very high-speed running distance; m; ≥22 km·h), the number of accelerations (n), duration of accelerations (s), peak acceleration (m), and distance of accelerations (m). Acceleration profiles were position dependent with midfielders found to have a high accumulation of acceleration movements when compared with all other positions (p ≤ 0.05). Declines of -2 to -32% for acceleration distance (m) depending on positional line of play were observed during match-play. Less high-speed running and very high-speed running distance was performed by the full-back line (high-speed running; -39% and very high-speed running; -36%) and full-forward line (-35%; -29%) when compared with half-back, midfielders, and half-forwards (p = 0.01, d = 1.35-1.77). Similar trends were reported for peak acceleration distance (p = 0.01, d = 1.15-1.93). The current investigation provides a greater understanding of temporal differences in acceleration profiles of playing position. We show that half-back, midfield, and half-forwards have the highest acceleration movements; these data can assist coaches in appropriately preparing players for the required acceleration distances required during match-play.

"Therapeutic applications of the 'NPGP' family of viral 2As".

Oligopeptide "2A" and "2A-like" sequences ("2As"; 18-25aa) are found in a range of RNA virus genomes controlling protein biogenesis through "recoding" of the host-cell translational apparatus. Insertion of multiple 2As within a single open reading frame (ORF) produces multiple proteins; hence, 2As have been used in a very wide range of biotechnological and biomedical applications. During translation, these 2A peptide sequences mediate a eukaryote-specific, self-"cleaving" event, termed "ribosome skipping" with very high efficiency. A particular advantage of using 2As is the ability to simultaneously translate a number of proteins at an equal level in all eukaryotic systems although, naturally, final steady-state levels depend upon other factors-notably protein stability. By contrast, the use of internal ribosome entry site elements for co-expression results in an unbalanced expression due to the relative inefficiency of internal initiation. For example, a 1:1 ratio is of particular importance for the biosynthesis of the heavy-chain and light-chain components of antibodies: highly valuable as therapeutic proteins. Furthermore, each component of these "artificial polyprotein" systems can be independently targeted to different sub-cellular sites. The potential of this system was vividly demonstrated by concatenating multiple gene sequences, linked via 2A sequences, into a single, long, ORF-a polycistronic construct. Here, ORFs comprising the biosynthetic pathways for violacein (five gene sequences) and ß-carotene (four gene sequences) were concatenated into a single cistron such that all components were co-expressed in the yeast Pichia pastoris. In this review, we provide useful information on 2As to serve as a guide for future utilities of this co-expression technology in basic research, biotechnology, and clinical applications.

Seasonal Changes in Gaelic Football Match-Play Running Performance.

Mangan, S, Ryan, M, Shovlin, A, McGahan, J, Malone, S, O'Neill, C, Burns, C, and Collins, K. Seasonal changes in Gaelic football match-play running performance. J Strength Cond Res 33(6): 1686-1692, 2019-Time of season influences performance in many team sports; however, the anomaly has not yet been examined with regards to elite Gaelic football. Global positioning systems (4 Hz; VX Sport, Lower Hutt, New Zealand) were used to monitor 5 elite Gaelic football teams over a period of 5 years (2012-2016). In total, 95 matches equated to 780 full player data sets. Running performance was characterized by total distance (m) and high-speed distance (≥17 km·h; m). High-speed distance was further categorized into 4 match quarters. Time of season was determined by month of the year. Time of season had a significant effect on total distance (p ≤ 0.001 partial η = 0.148) and high-speed distance (p ≤ 0.001 partial η = 0.105). August and September were significantly different from every other month for total distance (p ≤ 0.001) and high-speed distance (p ≤ 0.002). Month of season and match quarter had a significant interaction with high-speed distance (p ≤ 0.001 partial η = 0.106). High-speed distances run in the fourth quarter in August (478 ± 237 m) and in September (500 ± 219 m) were higher than any other quarter in any other month. This is the first study to show that time of season influences running performance in Gaelic football. The findings have major implications for training practices in Gaelic football.

'2A-Like' Signal Sequences Mediating Translational Recoding: A Novel Form of Dual Protein Targeting.

We report the initial characterization of an N-terminal oligopeptide '2A-like' sequence that is able to function both as a signal sequence and as a translational recoding element. Owing to this translational recoding activity, two forms of nascent polypeptide are synthesized: (i) when 2A-mediated translational recoding has not occurred: the nascent polypeptide is fused to the 2A-like N-terminal signal sequence and the fusion translation product is targeted to the exocytic pathway, and, (ii) a translation product where 2A-mediated translational recoding has occurred: the 2A-like signal sequence is synthesized as a separate translation product and, therefore, the nascent (downstream) polypeptide lacks the 2A-like signal sequence and is localized to the cytoplasm. This type of dual-functional signal sequence results, therefore, in the partitioning of the translation products between the two sub-cellular sites and represents a newly described form of dual protein targeting.

Acceleration Profile of Elite Gaelic Football Match Play.

Ryan, M, Malone, S, and Collins, K. An acceleration profile of elite Gaelic football match play. J Strength Cond Res 32(3): 812-820, 2018-The use of global positioning system (GPS) technology in Gaelic football is the primary source of quantifying game demands. The aim of this study was to quantify the acceleration profile of elite Gaelic football. Thirty-six elite male Gaelic football players (mean ± SD, age: 24 ± 6 years; height: 180 ± 7 cm; mass: 81 ± 7 kg) across 5 playing positions took part in a multiple study (n = 154 observations). Player movement was recorded during 19 (n = 19) competitive games over 2 seasons using 4-Hz GPS (VXSport, New Zealand). The average total distance (m), high-speed running distance (m; ≥17 km·h), and very high-speed running distance (m; ≥22 km·h) were recorded. In addition, the number (n), distance (m), and the duration of accelerations were quantified. Accelerations were subdivided into 14 equal parts of 5-minute epochs (E1 = 0-5 minutes, E2 = 5-10 minutes, E3 = 10-15 minutes etc). Players performed 166 ± 41 accelerations. High-speed running distance and very high-speed running distance was 1563 ± 605 and 524 ± 190 m, respectively. The mean acceleration distance was 267 ± 45 m distributed between 12 ± 5 accelerations per 5-minute epoch. The maximum acceleration epoch classified as the greatest distance covered accelerating during a predetermined 5-minute epoch was 296 ± 134 m. The PEAK epoch resulted in a significant reduction of acceleration distance covered in the period before and in the subsequent epoch. An understanding of the acceleration profile in Gaelic football can inform the prescription of appropriate training regimen.

Influence of Team Rating on Running Performance in Elite Gaelic Football.

Mangan, S, Malone, S, Ryan, M, Mc Gahan, J, Warne, J, Martin, D, O'Neill, C, Burns, C, and Collins, K. Influence of team rating on running performance in elite Gaelic football. J Strength Cond Res 32(9): 2584-2591, 2017-It is currently unknown how team rating influences running performance in Gaelic football. Global positioning system technologies were used to quantify match-running performance within 5 elite Gaelic football teams over a period of 5 years (2012-2016). In total 780 player data sets were collected over 95 matches. Running performance variables included total distance, high-speed distance (≥17 km·h), and the percentage of high-speed distance. Team ratings were determined objectively using the Elo rating system for Gaelic football. Reference team rating had trivial effects on total distance (p = 0.011, partial η = 0.008) and high-speed distance (p = 0.011, partial η = 0.008). Opposition team rating had small effects on total distance (p = 0.005, partial η = 0.016) and high-speed distance (p = 0.001, partial η = 0.020). Top-tier teams cover greater total distances and high-speed distance than lower tier teams. Players cover considerably less total distance and high-speed distance against tier-3 and tier-4 teams. Tier-1 players ran a significantly higher percentage of distance at high speed than players who played for tier-2 teams (p = 0.020). The competitive advantage of top-tier Gaelic football teams is closely linked with their ability to demonstrate a higher physical intensity than lower tier teams.

A Retrospective Comparative Analysis of the Use of Implantable Bone Stimulators in Nonunions.

This study details the use of implantable bone stimulators in the setting of nonunion. A retrospective comparative analysis was used to evaluate the efficacy of implantable bone stimulators in achieving union in the setting of atrophic or oligotrophic nonunion by two fellowship-trained orthopaedic trauma surgeons. Initially, 72 patients underwent surgical intervention for nonunion. Twenty-one patients had an implantable bone stimulator placed at the time of nonunion surgery. Thirty-eight patients had a minimum of 1-year follow-up. An implantable bone stimulator was used in 13 patients and 25 patients did not have a bone stimulator. The use of implantable bone stimulators was found to be significantly associated with increased union rates (p = .042). (Journal of Surgical Orthopaedic Advances.

APE-type non-LTR retrotransposons of multicellular organisms encode virus-like 2A oligopeptide sequences, which mediate translational recoding during protein synthesis.

2A oligopeptide sequences ("2As") mediate a cotranslational recoding event termed "ribosome skipping." Previously we demonstrated the activity of 2As (and "2A-like sequences") within a wide range of animal RNA virus genomes and non-long terminal repeat retrotransposons (non-LTRs) in the genomes of the unicellular organisms Trypanosoma brucei (Ingi) and T. cruzi (L1Tc). Here, we report the presence of 2A-like sequences in the genomes of a wide range of multicellular organisms and, as in the trypanosome genomes, within non-LTR retrotransposons (non-LTRs)-clustering in the Rex1, Crack, L2, L2A, and CR1 clades, in addition to Ingi. These 2A-like sequences were tested for translational recoding activity, and highly active sequences were found within the Rex1, L2, CR1, and Ingi clades. The presence of 2A-like sequences within non-LTRs may not only represent a method of controlling protein biogenesis but also shows some correlation with such apurinic/apyrimidinic DNA endonuclease-type non-LTRs encoding one, rather than two, open reading frames (ORFs). Interestingly, such non-LTRs cluster with closely related elements lacking 2A-like recoding elements but retaining ORF1. Taken together, these observations suggest that acquisition of 2A-like translational recoding sequences may have played a role in the evolution of these elements.

Inhibition of the foot-and-mouth disease virus subgenomic replicon by RNA aptamers.

We have previously documented the inhibitory activity of RNA aptamers to the RNA-dependent RNA polymerase of foot-and-mouth disease virus (3D(pol)). Here we report their modification and use with a subgenomic replicon incorporating GFP (pGFP-PAC replicon), allowing replication to be monitored and quantified in real-time. GFP expression in transfected BHK-21 cells reached a maximum at approximately 8 h post-transfection, at which time change in morphology of the cells was consistent with a virus-induced cytopathic effect. However, transfection of replicon-bearing cells with a 3D(pol) aptamer RNA resulted in inhibition of GFP expression and maintenance of normal cell morphology, whereas a control aptamer RNA had little effect. The inhibition was correlated with a reduction in 3D(pol) (detected by immunoblotting) and shown to be dose dependent. The 3D(pol) aptamers appeared to be more effective than 2'-C-methylcytidine (2'CMC). Aptamers to components of the replication complex are therefore useful molecular tools for studying viral replication and also have potential as diagnostic molecules in the future.

2A peptides provide distinct solutions to driving stop-carry on translational recoding.

Expression of viral proteins frequently includes non-canonical decoding events ('recoding') during translation. '2A' oligopeptides drive one such event, termed 'stop-carry on' recoding. Nascent 2A peptides interact with the ribosomal exit tunnel to dictate an unusual stop codon-independent termination of translation at the final Pro codon of 2A. Subsequently, translation 'reinitiates' on the same codon, two individual proteins being generated from one open reading frame. Many 2A peptides have been identified, and they have a conserved C-terminal motif. Little similarity is present in the N-terminal portions of these peptides, which might suggest that these amino acids are not important in the 2A reaction. However, mutagenesis indicates that identity of the amino acid at nearly all positions of a single 2A peptide is important for activity. Each 2A may then represent a specific solution for positioning the conserved C-terminus within the peptidyl-transferase centre to promote recoding. Nascent 2A peptide:ribosome interactions are suggested to alter ribosomal fine structure to discriminate against prolyl-tRNA(Pro) and promote termination in the absence of a stop codon. Such structural modifications may account for our observation that replacement of the final Pro codon of 2A with any stop codon both stalls ribosome processivity and inhibits nascent chain release.

Preferred analysis methods for single genomic regions in RNA sequencing revealed by processing the shape of coverage.

The informational content of RNA sequencing is currently far from being completely explored. Most of the analyses focus on processing tables of counts or finding isoform deconvolution via exon junctions. This article presents a comparison of several techniques that can be used to estimate differential expression of exons or small genomic regions of expression, based on their coverage function shapes. The problem is defined as finding the differentially expressed exons between two samples using local expression profile normalization and statistical measures to spot the differences between two profile shapes. Initial experiments have been done using synthetic data, and real data modified with synthetically created differential patterns. Then, 160 pipelines (5 types of generator × 4 normalizations × 8 difference measures) are compared. As a result, the best analysis pipelines are selected based on linearity of the differential expression estimation and the area under the ROC curve. These platform-independent techniques have been implemented in the Bioconductor package rnaSeqMap. They point out the exons with differential expression or internal splicing, even if the counts of reads may not show this. The areas of application include significant difference searches, splicing identification algorithms and finding suitable regions for QPCR primers.

The Dangers of Distracted Driving: A substudy of Patient Perception Data from the DRIVSAFE Observational Study.

OBJECTIVE: To determine how fracture clinic patients perceive the dangers of distracted driving. METHODS: Design: Analysis of patient perception subset data from the original DRIVSAFE study; a large, multi-center cross-sectional study, surveying fracture clinic patients about distracted driving. SETTING: Four level 1 Canadian trauma center fracture clinics. PATIENT SELECTION CRITERIA: English-speaking patients with a valid Canadian driver's license and a traumatic musculoskeletal injury sustained in the past six months. OUTCOME MEASURES AND COMPARISONS: Primary outcome was patients' safety ratings of driving distractions. As per the original DRIVSAFE study, patients were categorized as distraction-prone or distraction-averse using their questionnaire responses and published crash-risk odds ratios (OR). A regression analysis was performed to identify associations with unsafe driving perceptions. RESULTS: The study included 1378 patients, 749 (54.3%) male and 614 (44.6%) female. The average age was 45.8 years old ± 17.0 (range 16-87). Sending electronic messages was perceived as unsafe by 92.9% (1242/1337) of patients, while reading them was seen as unsafe by 81.2% (1086/1337). Approximately three-quarters of patients viewed making (78.9%, 1061/1344) and accepting (74.8%, 998/1335) calls on handheld mobile phones as unsafe. However, 31.0% (421/1356) of patients believed they had no differences in their driving ability when talking on the phone while 13.1% (175/1340) reported no driving differences when texting. Younger age (OR, 0.93 [95% CI 0.90-0.96], p<0.001), driving experience (OR, 1.06 [95% CI 1.02-1.09], p<0.001), and distraction-prone drivers (OR, 3.79 [95% CI 2.91-4.94], p<0.001) were associated with unsafe driving perceptions. CONCLUSIONS: There is a clear association between being prone to distractions and unsafe driving perceptions, with distraction-prone drivers being 3.8 times more likely to perceive driving distractions as safe. This information could potentially influence the appropriate delivery and content of future educational efforts to change the perception of driving distractions and thereby reduce distracted driving. LEVEL OF EVIDENCE: Level III. See Instructions for Authors for a complete description of levels of evidence.

Optimisation of the foot-and-mouth disease virus 2A co-expression system for biomedical applications.

BACKGROUND: Many biomedical applications require the expression or production of therapeutic hetero-multimeric proteins/protein complexes: in most cases only accomplished by co-ordinated co-expression within the same cell. Foot-and-mouth disease virus 2A (F2A) and '2A-like' sequences are now widely used for this purpose. Since 2A mediates a co-translational 'cleavage' at its own C-terminus, sequences encoding multiple proteins (linked via 2As) can be concatenated into a single ORF: a single transgene. It has been shown that in some cases, however, the cleavage efficiency of shorter versions of F2A may be inhibited by the C-terminus of certain gene sequences immediately upstream of F2A. This paper describes further work to optimise F2A for co-expression strategies. RESULTS: We have inserted F2A of various lengths in between GFP and CherryFP 'reporter' proteins (in reciprocal or tandem arrangements). The co-expression of these proteins and cleavage efficiencies of F2As of various lengths were studied by in vitro coupled transcription and translation in rabbit reticulocyte lysates, western blotting of HeLa cell lysates and fluorescence microscopy. CONCLUSIONS: Optimal and suboptimal lengths of F2A sequences were identified as a result of detailed 'fine-tuning' of the F2A sequence. Based on our data and the model according to which 2A activity is a product of its interaction with the exit tunnel of the ribosome, we suggest the length of the F2A sequence which is not 'sensitive' to the C-terminus of the upstream protein that can be successfully used for co-expression of two proteins for biomedical applications.

Girl with xanthogranulomatous pyelonephritis and bronchiectasis: case report.

Xanthogranulomatous pyelonephritis (XGP) is a rare chronic inflammatory disorder of the kidney. Infiltration to lung and liver can occur. We present a rare complication of locally invasive XGP extending beyond the diaphragm to the lung to cause bronchiectasis in an adolescent girl with chronic productive cough, weight loss and no urinary symptoms. The patient underwent open left radical nephrectomy, where it was noted that the left kidney lay very high with significant perinephric inflammation and was densely adherent to the diaphragm and partially adherent to the spleen. XGP was confirmed on histology.

Magnesium implants in orthopaedic surgery create a diagnostic conundrum: A radiology case series and literature review.

During a routine post-operative orthopaedic radiograph reading session, repeated unusual radiographic soft tissue and bone appearances became evident. It was discovered that these patients had received biodegradable magnesium implants which have recently been introduced into orthopaedic clinical practice. To the untrained eye, the combination of peri-metallic bone resorption with associated soft tissue gas, could easily be mistaken for post-operative infection. The aim of this study is to properly characterise the radiographic post-operative appearances of biodegradable magnesium orthopaedic hardware. We retrospectively evaluated radiographs of all patients who underwent magnesium screw implantation for fractures over a 6 month period. Four patients, mean age of 9.75 (range: 6-15) years who underwent magnesium screw fixation following fracture were included in the study. Follow up duration was 100 days (range: 75-122) with a mean of 2.5 postoperative radiographs being performed per patient during this period. All cases demonstrated post-operative peri-metallic radiolucency which developed around the magnesium screws on x-ray, which subsequently resorbed over time. Peri-metallic soft tissue gas was observed in all patients. In two cases, magnesium implants fractured. As the use of biodegradable metal implants becomes more common, it is important for radiologists to be aware of their imaging characteristics. Prior to reporting a case, it would be prudent to know if biodegradable screws have been utilised and whether there exists a clinical concern for post-operative infection in patients with these particular implants, in which case it would be critical not to dismiss peri-prosthetic radiolucencies and soft tissue gas as merely a sequela of the natural metal degradation process.

Immunogenicity of a secreted, C-terminally truncated, form of bovine viral diarrhea virus E2 glycoprotein as a potential candidate in subunit vaccine development.

Both current live, attenuated, and killed virus vaccines for bovine viral diarrhea virus (BVDV) have their limitations. Here, we report the development of a BVDV subunit vaccine by (i) the expression of a secreted form of a recombinant E2 glycoprotein using BHK21 cells and (ii) determination of the immune responses in mice. The E2 glycoprotein was modified by deletion of the C-terminal transmembrane anchor domain and fusion to a V5 epitope tag. This allowed detection using anti-V5 monoclonal antibodies together with simple purification of the expressed, secreted, form of E2 from the cell media. Furthermore, we genetically fused green fluorescent protein (GFP) linked to E2 via a Thosea asigna virus 2A (T2A) ribosome skipping sequence thereby creating a self-processing polyprotein [GFP-T2A-BVDV-E2trunk-V5], producing discrete [GFP-T2A] and [E2trunk-V5] translation products: GFP fluorescence acts, therefore, as a surrogate marker of E2 expression, BALB/c mice were inoculated with [E2trunk-V5] purified from cell media and both humoral and cellular immune responses were observed. Our antigen expression system provides, therefore, both (i) a simple antigen purification protocol together with (ii) a feasible strategy for further, large-scale, production of vaccines.

Colorectal Cancer Screening with Mailed Fecal Immunochemical Tests and Telephone Outreach at a Community Health Center during the COVID-19 Pandemic.

Colorectal cancer (CRC) is a common cause of cancer death and disproportionately affects non-Hispanic Black patients. Routine screening with the fecal immunochemical test (FIT) decreases CRC incidence and mortality, and previous literature suggests pairing FIT with live outreach. Screening delays due to the COVID-19 pandemic will likely increase CRC incidence and mortality, especially in underserved communities. We implemented a quality improvement (QI) project at an urban community health center (CHC) in which FIT was paired with live telephone outreach. The intervention increased CRC screening at the CHC by five percentage points. Fecal immunochemical test completion rates significantly increased with successful contact (24.6% for at least one vs. 3.0% for none, p < .0001) and ordering a FIT kit during a patient interaction (28.4% vs. 15.7%, p < .001). This intervention addressed disparities in CRC screening, and the report may have general implications for addressing systemic racism in preventive medicine.