bluuebunny/crossref_metadata_2025 huggingface dataset:
Intracytoplasmic Filamentous Inclusions in the Peripheral Blood of a Patient With Chronic Lymphocytic Leukemia
Authors: Dorion R. Patrick , Shaw John H.
Published: January 2021

Intracellular inclusions in lymphoproliferative disorders are not common. Multiple different types of inclusions have been reported in chronic lymphocytic leukemia (CLL), including vacuoles, crystals, and pseudocrystals. Most of the reported cases were seen in the bone marrow lymphocytes, and the majority of these on electron microscopy. We report a case of long-standing CLL with no therapy that had filamentous cytoplasmic inclusions in the peripheral blood that were readily seen by light microscopy. Electron microscopy demonstrated dilated cisternae of the rough endoplasmic reticulum filled with amorphous electron-dense material. By immunofluorescence, the material proved to be immunoglobulin G-λ deposits. The immunophenotype had the typical CLL pattern with positive staining with CD19, CD5, and CD23, and low-density CD20 staining; however, it also had unusual staining with CD25 and intermediate-intensity staining with CD22.
Innate Immune-Related Receptors in Normal and Psoriatic Skin
Authors: Curry Jonathan L. , Qin Jian-Zhong , Bonish Brian , Carrick Ryan , Bacon Patricia , Panella Jeffrey , Robinson June , Nickoloff Brian J.
Published: January 2021

Context.—A precise role for the innate immune system in psoriasis remains to be determined. Surface receptors, including Toll-like receptors (TLRs) that recognize bacterial ligands and CD91, which recognizes heat shock proteins (HSPs), are implicated in both innate and adaptive immunity.

Objective.—Since skin is exposed to various exogenous stimuli, which can provoke or exacerbate psoriasis, we characterized expression and function of TLRs, CD91, and HSPs in normal and psoriatic skin.

Design.—A variety of skin-derived cells and blood-derived cells were analyzed both in vivo and in vitro; samples were obtained from 24 different individuals for innate immune-related receptor expression and function. By comparing and contrasting individuals with healthy skin and psoriatic patients, several specific differences were identified.

Results.—Immunohistochemistry-based expression profiling revealed TLR1 expression in epidermal dendritic cells (DCs) and dermal dendritic cells (DDCs) in normal skin, as well as in pre-psoriatic skin and psoriatic plaques, with enhanced basal layer keratinocyte (KC) expression in pre-psoriatic and psoriatic plaques compared with normal skin; TLR2 expression primarily by DDCs; and TLR4 expression by epidermal DCs and DDCs, with mid-epidermal-layer KCs displaying cell surface staining. No TLR9 or CD14 was detected on DCs or KCs, although psoriatic plaques contained CD14-positive macrophages. Analysis of psoriatic epidermis revealed HSPs 27, 60, and 70. Keratinocytes were CD91 negative, but CD91 was expressed by fibroblasts and DDCs in normal and pre-psoriatic skin, with prominent accumulation of CD91-positive DDCs in psoriatic plaques. Cultured KCs revealed no surface expression of TLR2, TLR4, TLR9, or CD91. Exposure of fibroblasts, but not KCs, to lipopolysaccharide or HSPs triggered nuclear factor (NF)-κB activation. Heat shock proteins did induce maturation of blood-derived DCs accompanied by increased interleukin-12 production and enhanced antigen-presenting function.

Conclusions.—These data demonstrate distinctive patterns of innate immune-related receptors by specific subsets of cells in normal and psoriatic skin, suggesting functional roles for HSPs and DCs in psoriasis.
Lack of Specificity of Cyclosporine Immunoassays
Authors: Soldin Steven J. , Steele Bernard W. , Witte David L. , Wang Edward , Elin Ronald J.
Published: January 2021

Objective.—To evaluate the cross-reactivity of the 6 most abundant cyclosporine A (CsA) metabolites in commonly used assays for CsA.

Design.—Whole blood samples containing either only 62 ng/mL CsA (A) or 62 ng/mL CsA and between 49 and 86 ng/mL of 1 of the 6 most abundant CsA metabolites (B) were lyophilized. One sample of A and 1 of B were mailed to each of the laboratories participating in the College of American Pathologists Proficiency Testing Program quarterly during a 3-year period (1999–2001). Method means and coefficients of variation were calculated for each mailing.

Results.—The study showed significant cross-reactivity of metabolites in all the immunoassay systems studied. Overall degree of interference decreased from Abbott TDx polyclonal > Abbott TDx monoclonal > DiaSorin > Syva EMIT. High-performance liquid chromatography methods gave results close to those found using mass spectrometric techniques.

Conclusions.—Significant metabolite interference was found to occur with the immunoassay systems studied.
Incidence and Significance of Cytoplasmic Thyroid Transcription Factor-1 Immunoreactivity
Authors: Bejarano Pablo A. , Mousavi Fathema
Published: January 2021

Context.—The immunohistochemical identification of thyroid transcription factor-1 (TTF-1) is regarded as the presence of a nuclear pattern of staining and is used to identify tumors of thyroid or pulmonary origin. Although there have been reports of cytoplasmic expression of TTF-1, the significance of this pattern has not been studied in detail.

Objectives.—To determine the incidence at which cytoplasmic immunostaining for TTF-1 occurs and to analyze the diagnostic value of this pattern of immunoreactivity.

Design.—Histologic sections of 361 consecutive cases of neoplasms stained for TTF-1 were reviewed, and those showing cytoplasmic staining in the tumor cells or in nonneoplastic cells were selected. Clinical correlation was obtained on the latter cases regarding the origin of the tumor.

Setting.—An immunohistochemistry laboratory in a tertiary-care institution.

Results.—The 361 tumors were obtained from 29 organ sites and corresponded to primary and metastatic neoplasms. Twenty-three (6.3%) tumors showed cytoplasmic staining for TTF-1. In 13 of these, the primary site of origin was established with certainty: 7 were lung carcinomas (3 primary lung adenocarcinomas, 1 primary large cell carcinoma, 1 metastatic small cell carcinoma to the liver, 1 metastatic adenocarcinoma to a neck lymph node, and 1 metastatic adenocarcinoma to thigh soft tissue), 3 colonic adenocarcinomas (2 metastases to vertebrae and 1 to lung), 1 metastatic breast ductal adenocarcinoma to femur, 1 metastatic laryngeal squamous cell carcinoma to liver, and 1 meningioma involving the orbit bone. There were 3 lung carcinomas with concomitant nuclear immunostaining. Nonneoplastic liver tissue was the most frequent nontumoral tissue in which the cytoplasm stained with TTF-1 antibody.

Conclusion.—Occasional cytoplasmic staining for TTF-1 in tumors is seen, but it is a nonspecific finding; when present, it should be disregarded for diagnostic purposes.
Large Cell Neuroendocrine Carcinoma of the Ampulla of Vater
Authors: Cavazza Alberto , Gallo Marco , Valcavi Roberto , De Marco Loredana , Gardini Giorgio
Published: January 2021

We report a large cell neuroendocrine carcinoma arising in the ampulla of Vater. The patient, a 74-year-old woman, presented with a 3-cm ulcerated mass located in the ampullary region. She died of disease 8 months after surgery. Microscopically, the tumor was extensively necrotic. It was composed of islands and trabeculae irregularly infiltrating the muscular wall of the duodenum. Neoplastic cells were large and had a high mitotic index. Immunohistochemically, they expressed cytokeratin, chromogranin, synaptophysin, and neuron-specific enolase. Large cell neuroendocrine carcinoma is very rare in the ampulla of Vater, and it shares with its more common pulmonary counterpart the same morphology and probably the same poor prognosis.
Pathologic Review of Atypical Hyperplasia Identified by Image-Guided Breast Needle Core Biopsy
Authors: Yeh I-Tien , Dimitrov Diana , Otto Pamela , Miller Alexander R. , Kahlenberg Morton S. , Cruz Anatolio
Published: January 2021

Context.—Management of breast needle core biopsies diagnosed as atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ is controversial. Current recommendations involve excisional biopsy to rule out ductal carcinoma in situ and/or invasive carcinoma, which have been reported in more than 50% of cases in some series.

Objective.—To determine how frequently these diagnoses made on needle core biopsy are ultimately found to represent in situ or invasive carcinoma based on excisional biopsy specimens, in order to identify predictive factors.

Design.—One thousand eight hundred thirty-six image-guided needle core biopsies were performed between January 1, 1995 and May 1, 2001. Fifty-four (2.9%) patients diagnosed with atypical ductal hyperplasia (n = 36), atypical lobular hyperplasia (n = 12), atypical ductal hyperplasia + atypical lobular hyperplasia (n = 3), or lobular carcinoma in situ (n = 3) subsequently underwent breast excisions. Pathologic features were reviewed in each of the needle core biopsies using Page's criteria and were then correlated with excision specimens.

Setting.—University medical center.

Results.—Review of the needle core biopsy cases with either ductal carcinoma in situ or invasive carcinoma + ductal carcinoma in situ on final excision showed that nucleoli were evident in most of the needle core cases, with foci of nuclear pleomorphism and individual cell necrosis or apoptosis.

Conclusion.—A more precise diagnosis can be made by using strict criteria for atypical ductal hyperplasia versus ductal carcinoma in situ on needle core biopsy. Cytologic atypia, even if in a small area, particularly when there is apoptosis/individual cell necrosis, correlates with the finding of a more serious lesion on excision.
Prevalence and Incidence of Cytoplasmic Yellow Bodies in Thyroid Neoplasms
Authors: Rothenberg Harold J. , Goellner John R. , Carney J. Aidan
Published: January 2021

Context.—Cytoplasmic yellow bodies are a common and frequent histologic finding in hyalinizing trabecular adenoma of the thyroid gland, a morphologically distinctive neoplasm, and are visible in fine-needle aspiration biopsy of the tumor.

Objective.—To determine the prevalence and frequency of cytoplasmic yellow bodies in common thyroid tumors.

Design.—Microscopic slides of random cases of papillary carcinoma (61 cases), follicular adenoma (27 cases), and Hürthle cell adenoma (12 cases) were searched for cytoplasmic yellow bodies.

Setting and Patients.—Slides were from patients who had undergone surgery at Mayo Clinic, Rochester, Minn, and were obtained from the Mayo Clinic Tissue Registry.

Main Outcome Measure.—Presence or absence of cytoplasmic yellow bodies.

Results.—Cytoplasmic yellow bodies were found in papillary carcinoma (62%), follicular carcinoma (22%), and Hürthle cell adenoma (83%) but were very infrequent numerically in each tumor type.

Conclusions.—Cytoplasmic yellow bodies may be present in papillary carcinoma and in follicular and Hürthle cell adenomas, but because they are uncommon in these tumors, they are unlikely to be found in fine-needle aspiration biopsy smears. Therefore, cytoplasmic yellow bodies are a useful cytomorphologic indicator of hyalinizing trabecular adenoma of the thyroid gland.
Automation of Gross Photography Using a Remote-Controlled Digital Camera System
Authors: Park Rae-Woong , Eom Joon-Hoe , Byun Ho-Yong , Park Peom , Lee Kyi-Beom , Joo Hee-Jae
Published: January 2021

Context.—Conventional gross photography requires a series of tedious and time-consuming steps, including taking, developing, labeling, sorting, filing, and tracking numerous photographs.

Objective.—To describe how to automate the gross photographic process by way of controlling a digital camera remotely.

Design.—After defining the requirements of automation regarding gross photography, a remote control board, foot switch, barcode system, and image retrieval system were devised.

Setting.—The surgical pathology laboratory of a university medical center with a commercially available megapixel digital camera.

Results.—The digital camera zoom and shutter were controlled remotely by a foot switch. A large portion of the gross photographic process, including specimen number labeling, image downloading, labeling, sorting, filing, and tracking, were automated. In addition, the elimination of several manual specimen-processing steps, along with not having to wait for the developing and mounting of conventional 35-mm film, reduced the entire time span required in conventional gross photography from 2 to 5 days, to a few minutes. It was also possible to review the gross images at the time of microscopic sign-out.

Conclusions.—The automation of gross photography using a remote-controlled digital camera changes the conventional gross workflow markedly. We found use of a remote-controlled gross photography system to be practical, convenient, and efficient.
Gastric Toxoplasmosis in a Patient With Acquired Immunodeficiency Syndrome
Authors: Ganji Masoud , Tan Ailyn , Maitar Michael I. , Weldon-Linne C. Michael , Weisenberg Elliot , Rhone Douglas P.
Published: January 2021

Toxoplasmosis is a common opportunistic pathogen in patients with acquired immunodeficiency syndrome (AIDS). It usually presents with ocular, central nervous system, or pulmonary disease. Gastric toxoplasmosis is uncommon in AIDS patients, especially in the absence of central nervous system manifestations. In the few reported cases, patients have presented with abdominal pain and other digestive complaints that usually are attributed to the more common gastrointestinal manifestations of human immunodeficiency virus infection. We describe a 49-year-old man with AIDS who presented with abdominal pain, diarrhea, dry cough, and systemic symptoms and was diagnosed with toxoplasmosis by a gastric biopsy.
Diffuse Fibrous Pseudotumor of the Testicular Tunics Associated With an Inflamed Hydrocele
Authors: Seethala Raja R. , Tirkes A. Temel , Weinstein Susan , Tomaszewski John E. , Malkowicz S. Bruce , Genega Elizabeth M.
Published: January 2021

Fibrous pseudotumors of the testicular tunics and paratesticular soft tissue are uncommon lesions. They typically arise as painless scrotal masses that may be associated with a hydrocele or history of trauma or infection. Although these lesions are clinically worrisome for a malignant neoplasm, they are thought to be reactive in nature, since they are composed of dense fibrous tissue with interspersed bland fibroblasts and myofibroblasts and mixed inflammatory cells. Once excised, these lesions behave in a benign fashion. Typically, these masses are multinodular, but in rare cases they are diffuse, bandlike myofibroblastic proliferations that encase the testis and are termed fibromatous periorchitis. Herein, we describe a 57-year-old man with a diffuse fibrous pseudotumor/fibromatous periorchitis that encased the left testis and adnexa and arose in close apposition to an inflamed hydrocele.
Giant Blastoconidia of Candida albicans
Authors: Alasio Teresa M. , Lento Patrick A. , Bottone Edward J.
Published: January 2021

We describe a patient with extranodal non-Hodgkin lymphoma who developed systemic candidiasis after treatment with a cyclophosphamide-based chemotherapy regimen. Histologically, the fungal organisms demonstrated markedly enlarged blastoconidia with a variety of morphologic forms, mimicking other mycotic organisms, such as Cryptococcus neoformans, Blastomyces dermatitidis, and Paracoccidioides brasiliensis. The in vivo occurrence of such giant forms is rare, and when observed histologically may result in an erroneous diagnosis or a diagnosis of multiple mycotic organisms.
Postirradiation Angiosarcoma of the Prostate
Authors: Chandan Vishal S. , Wolsh Loren
Published: January 2021

Angiosarcomas are high-grade sarcomas of vascular origin that rarely arise in the prostate. We describe a unique case of angiosarcoma arising in the prostate 10 years after radiotherapy for adenocarcinoma of the prostate. A review of literature regarding angiosarcomas of prostate is also discussed.
Lymphangitic Spread of Hepatocellular Carcinoma
Authors: Molina D. Kimberley , Valente Philip T.
Published: January 2021

Pulmonary lymphangitic carcinomatosis is a well-documented phenomenon caused by spread of carcinoma to the pulmonary vasculature and lymphatics, often resulting in respiratory failure and cor pulmonale. It has been described in numerous types of carcinoma, most commonly occurring with carcinomas of the breast and stomach and with choriocarcinoma. We report the case of a patient who presented with increasing shortness of breath and dyspnea on exertion. Autopsy findings revealed diffuse pulmonary vascular spread of a hepatocellular carcinoma to the lungs. To our knowledge, this is the first reported case of lymphangitic spread of a hepatocellular carcinoma causing respiratory compromise (lymphangitic carcinomatosis).
Sclerosing Adenosis of the Prostate
Authors: Luque Rafael J. , Lopez-Beltran Antonio , Perez-Seoane Carlos , Suzigan Sueli
Published: January 2021

Sclerosing adenosis of the prostate is a pseudoneoplastic lesion that can mimic prostate cancer. Because the lesion is more common in the transition zone, which is only rarely sampled in needle biopsy, it is uncommon to see examples of this lesion in biopsy specimens. Because sampling of the transition zone of the prostate is likely to become more frequent, practicing surgical pathologists must be aware of the morphologic features of sclerosing adenosis of the prostate in needle biopsy specimens, in order to avoid misinterpretation of sclerosing adenosis of the prostate, a benign lesion, as prostate adenocarcinoma. We report the morphologic findings of sclerosing adenosis of the prostate in 3 needle biopsy specimens from 2 patients diagnosed as having sclerosing adenosis. We found a combination of histologic (mainly a cellular myxoid stroma and a double-cell population of acinar cells) and immunohistochemical features demonstrating a continuous basal cell layer with myoepithelial differentiation to be diagnostic.
Secondary Tumors in Mammary Adenolipomas: A Report of 2 Unusual Cases
Authors: Harigopal Malini , Mudrovich Steven A. , Hoda Syed A. , Rosen Paul Peter
Published: January 2021

Two unusual examples of secondary tumors arising in adenolipomas were diagnosed in a 16-year-old girl and a 27-year-old woman, each of whom presented with asymmetric enlargement of the right breast. In both instances, a significant secondary lesion was associated with the adenolipoma. In the first case, a cyst appeared to have arisen in a fibroadenoma within the adenolipoma, which had apparently undergone infarction during a recent pregnancy and postpartum period. There was micropapillary duct epithelial hyperplasia of the cyst lining epithelium. In the second case, an adenofibroma with atypical lobular hyperplasia was present within the adenolipoma.
A Parathyroid Hormone–Related Protein–Secreting Metastatic Epithelioid Leiomyosarcoma
Authors: Tang Shou-jiang , Geevarghese Sunil , Saab Sammy , Martinez Dorothy , Van Herle Andre , Wallace William D. , Cortina Galen R. , Dry Sarah , Busuttil Ronald W.
Published: January 2021

A diagnosis of parathyroid hormone–related protein (PTH-rP)–secreting metastatic uterine epithelioid leiomyosarcoma was made in a 61-year-old woman with humoral hypercalcemia of malignancy. A primary uterine tumor had been removed 10 years previously, which had been associated with a short history of hypercalcemia. The original uterine tumor was diagnosed as a smooth muscle tumor of uncertain malignant potential. To the best of our knowledge, this is the first reported case of a PTH-rP–secreting uterine leiomyosarcoma. We demonstrate the dramatic changes in serum calcium, phosphorus, PTH, and PTH-rP levels after tumor resection. Extensive biochemical analysis and detailed immunohistochemical and ultrastructural characterization demonstrate several features of this tumor.
SYT-SSX2 Variant of Primary Pulmonary Synovial Sarcoma With Focal Expression of CD117 (c-Kit) Protein and a Poor Clinical Outcome
Authors: Boroumand Nahal , Raja Vinay , Jones Dennie V. , Haque Abida K.
Published: January 2021

Pulmonary synovial sarcoma is a rare neoplasm recently recognized as a distinct entity and characterized by t(X;18) translocation and production of at least 2 fusion genes, SYT-SSX1 and SYT-SSX2. We report a case of primary pulmonary synovial sarcoma with the SYT-SSX2 phenotype and a rapidly progressive downhill course. Previous reports have suggested that the soft tissue synovial sarcomas with SYT-SSX2 phenotype have a favorable clinical outcome. To the best of our knowledge, this is also the first report of CD117 (c-Kit) expression in a pulmonary synovial sarcoma. A 45-year-old woman presented with left chest pain and was found to have a left lower lobe tumor that was originally diagnosed as a sarcomatoid carcinoma. After the patient underwent chemotherapy and brachytherapy, the specimen from a left pneumonectomy showed a large spindle cell tumor, which was reclassified as a synovial sarcoma based on the results of immunophenotyping and molecular genetic studies. Differentiation between sarcoma and carcinosarcoma is crucial for implementing appropriate therapy. Furthermore, if the tumor expresses c-Kit, it may respond to target-based therapy.
Carcinoid Tumors of the Urinary Bladder
Authors: Martignoni Guido , Eble John N.
Published: January 2021

We report the clinical, histopathologic, and immunophenotypic features of 2 carcinoid tumors of the urinary bladder and review the literature. Both tumors were located in the bladder neck, presented with hematuria, were small, and appeared to be completely excised cystoscopically. The tumors were smooth-surfaced sessile polypoid nodules covered by urothelium. Both tumors had glandular architecture. One tumor had regular bland nuclei, and the other had focal moderate nuclear pleomorphism. Neuroendocrine differentiation was readily confirmed by the immunohistochemical markers chromogranin, synaptophysin, and neural cell adhesion molecule (CD56/NCAM). In 1 of the tumors, 20% of the cells were positive for the β subunit of human chorionic gonadotropin, and 20% were positive for thyroid transcription factor 1.
Intraosseous Epidermoid Inclusion Cyst in a Great Toe
Authors: Wang Beverly Y. , Eisler Jesse , Springfield Dempsey , Klein Michael J.
Published: January 2021

Epidermoid inclusion cysts are benign lesions that occasionally occur in the distal phalanges of the fingers but are less frequently identified and underreported in the toes. We describe a 55-year-old man with a history of work-related trauma followed by painful expansion of his right great toe, resulting in great anxiety. Imaging studies revealed a radiolucent lesion in the distal phalanx of his right hallux. Clinical differential diagnoses included the possibility of an intramedullary inclusion cyst and other various radiolucent lesions. During surgery, a cystic lesion that contained creamy material was discovered. Frozen section diagnosis of the lesion was an intraosseous epidermoid inclusion cyst. The lesion was removed and the patient recovered uneventfully. Although it has been reported that an unduly large number of phalangeal cysts have been treated by amputation, the judicious use of intraoperative frozen sections can prevent this scenario.
Synchronous Adenocarcinoma and Mantle Cell Lymphoma of the Colon
Authors: Padmanabhan Vijayalakshmi , Trainer Thomas D.
Published: January 2021

Synchronous occurrence of malignant lymphoma and carcinoma, both located in the intestinal tract, is unusual. We report a unique case of an adenocarcinoma of the cecum and a simultaneous mantle cell lymphoma of the colon, terminal ileum, and regional lymph nodes in an 85-year-old man. Grossly, the adenocarcinoma was identified as a cecal mass. Lymphomatous involvement of the gastrointestinal tract was evident only on microscopic examination. The terminal ileum and colon showed microscopic disseminated multiple mucosal nodules, with involvement of the regional lymph nodes. There was no involvement of distant organs, suggesting that the mantle cell lymphoma was early in its evolution without formation of polyps or a mass lesion. To our knowledge, this is the fourth reported case with this association and the second case that showed early involvement of the gastrointestinal tract with mantle cell lymphoma without polyp formation.
Composite Thymoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Involving the Anterior Mediastinum
Authors: Khoury Joseph D. , Amin Hesham M. , Jorgensen Jeffrey L. , Ostrowski Mary L. , Bloom M. G. Kim , Medeiros L. Jeffrey
Published: January 2021

Simultaneous involvement of the anterior mediastinum by thymoma and B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), to our knowledge, has not been previously reported. We describe a composite tumor composed of thymoma and CLL/SLL incidentally discovered in a 62-year-old man who had no history of malignant diseases or immunologic disorders. The preoperative peripheral blood specimen showed a normal complete blood cell count and differential count. The diagnosis was established by histologic examination and immunophenotypic studies of the surgically excised anterior mediastinal mass. Postoperatively, bone marrow aspiration and biopsy specimens showed morphologic evidence of CLL/SLL, and the presence of neoplastic cells in peripheral blood and bone marrow was confirmed by flow cytometry immunophenotypic analysis.
Renal Cell Carcinoma With Intratumoral Calcium Oxalate Crystal Deposition in Patients With Acquired Cystic Disease of the Kidney
Authors: Rioux-Leclercq Nathalie C. , Epstein Jonathan I.
Published: January 2021

We describe 2 cases of renal cell carcinoma arising in acquired cystic disease of the kidney (ACDK) in patients with end-stage renal disease undergoing hemodialysis for more than 5 years and provide a brief review of the complications of ACDK. In both cases, abundant calcium oxalate crystals were observed within the tumors. Histologically, one of the tumors was a conventional (clear cell) renal cell carcinoma. The other tumor was a bilateral papillary renal cell carcinoma. Both tumors were high-grade carcinomas with extensive oncocytic (acidophilic) features. Also noted within the kidneys were cysts with atypical papillary hyperplasia. The clinicopathologic findings along with review of the literature suggest a relationship between tumor growth and calcium oxalate crystal deposition in patients undergoing hemodialysis with ACDK.
The Unpaid Internship: Benefits, Drawbacks, and Legal Issues
Authors: Rothschild Philip , Rothschild Connor
Published: January 2021

This article hopes to clear up some of the confusion surrounding unpaid internships by discussing who participates in such internships, the merits and drawbacks relative to paid internships, and the relevant legal issues. This summary of existing research provides several key insights, which are of interest to potential interns as well as educators. For students, the literature suggests that unpaid internships are different from their paid counterparts in a variety of ways and pose certain risks that paid internships do not. On an institutional level, this paper documents the unique legal environment surrounding the unpaid internship and notes the unique liabilities program administrators may face if they fail to act with caution.
Influence of a synchronized human dynamic load on vibrations of machine structures
Authors: Radoičić Goran , Jovanović Miomir
Published: January 2021

This paper contributes to the research of rhythmic behavior of a group of people, which, more or less synchronized, moves or jumps on a thin and elastic plate, thus performing a dynamically variable load. The analysis of the rhythmic behaviour of the crowd carried out on the basis of the experimental testing on the special steel test platform. The experiment consisted of sixteen measurements of live force and acceleration of the test platform. The dynamic loads caused by the mass of the human crowd and individuals had different intensities. The measurements of acceleration of the test platform were performed in order to estimate how the live human force influences on vibrations of machine structures. This research allows us to gain a picture of how serious the threats are from some human actions on the support structure of machines that are handled when performing works in industry, construction or mining. On the basis of these experiments, the mathematical models of the equivalent excitation forces were developed. The measured accelerations of the test platform tread surface and calculated dynamic coefficients of human force indicate that similar actions can seriously endanger balance of the support structure of some machine, and even, for example, can cause the main girder of the bridge crane to fall out. This and similar experiments allow us to formulate appropriate models of excitation loads by human force, which can then be used in simulation analyses in order to develop future systems of electronic protection of machines structures from adverse events.
On the Complexity of Some Geometric Problems With Fixed Parameters
Authors: Schaefer Marcus
Published: January 2021

The following graph-drawing problems are known to be complete for the existential theory of the reals (${\exists \mathbb{R}}$-complete) as long as the parameter $k$ is unbounded. Do they remain ${\exists \mathbb{R}}$-complete for a fixed value $k$?

Do $k$ graphs on a shared vertex set have a simultaneous geometric embedding?
Is $G$ a segment intersection graph, where $G$ has maximum degree at most $k$?
Given a graph $G$ with a rotation system and maximum degree at most $k$, does $G$ have a straight-line drawing which realizes the rotation system?

We show that these, and some related, problems remain ${\exists \mathbb{R}}$-complete for constant $k$, where $k$ is in the double or triple digits. To obtain these results we establish a new variant of Mnëv's universality theorem, in which the gadgets are placed so as to interact minimally; this variant leads to fixed values for $k$, where the traditional variants of the universality theorem require unbounded values of $k$.
Del suicidio de Judas al salto de Pármeno: codicia, traición y caídas mortales en La Celestina
Authors: Beltrán Rafael
Published: January 2021

El artículo se propone el estudio de las influencias de los motivos de la traición y suicidio de Judas Iscariote en las caídas mortales de cuatro personajes principales de La Celestina. Judas encarna, mejor que ningún otro personaje bíblico, la trayectoria del pecador, desde la lealtad y la traición hasta la desesperación y la muerte suicida. Se examina la figura literaria e iconográfica de la codicia, traición y suicidio de Judas en la Edad Media, centrándonos en los dos tipos de suicidio que refleja la Biblia. Se analizan las caídas accidentales (Calisto), los saltos mortales al  vacío (Sempronio y Pármeno) y el suicidio (Melibea); las imágenes de representación de la traición (la bolsa de las monedas); y, finalmente, la trayectoria de Pármeno, que va, como la de Judas, desde fidelidad del buen criado, pasando por la codicia y la traición, hasta el salto mortal hacia el vacío desesperado.
La Segunda Celestina de Feliciano de Silva a la luz de nuevos datos sobre su biografía
Authors: Cáseda Teresa Jesús Fernando
Published: January 2021

Este estudio aporta un buen número de documentos desconocidos que dan luz sobre la biografía de Feliciano de Silva, localizados en el Archivo Histórico de la Nobleza. Da noticia de su fecha de nacimiento (1479), asunto que tanto debate ha suscitado a lo largo de los años, y desvela muchos aspectos relativos a su familia, a su situación económica, etc. Establece el origen de diversos personajes de su continuación de La Celestina a partir de su biografía: su primo el «arcediano» o el «arcediano el viejo», Polandria —su esposa Gracia Fe—, Celestina —probable-mente Catalina Maldonado—, etc. Estudia algunas curiosas relaciones onomásticas de la obra con los nombres que aparecen en otras obras de sus amigos judeo-conversos portugueses o de Núñez de Reinoso. Y sitúa el origen de otros muchos personajes de su comedia: por ejemplo el juego onomástico con su propio nombre en el caso de Félides o Filínides, que ocultan en ambos casos a Feliciano de Silva.
«Muchos días son passados...». Magia y concepción del tiempo en La Celestina
Authors: Ferrera-Lagoa Alberto
Published: January 2021

En este artículo se analizan las referencias textuales de La Celestina que evidencian tanto la existencia del elemento mágico en la obra como su importancia estructural. Para ello, se ofrecen nuevos datos en favor de la hipótesis del enamoramiento de Melibea como consecuencia del conjuro celestinesco y se realiza un análisis comparativo entre los dos amantes y la retórica del amor cortés para descartar la hipótesis del tiempo implícito y aportar una nueva interpretación del amor entre Calisto y Melibea.
Fernando de Rojas y La Celestina a través de la novela histórica: autoría y ascendencia judía
Authors: Huertas Morales Antonio
Published: January 2021

El presente artículo analiza las novelas históricas publicadas desde 1990 y protagonizadas por Fernando de Rojas para discernir qué contenidos se divulgan sobre La Celestina y su supuesto autor. Pretendemos demostrar que el género sigue, a pesar de la fabulación literaria, la versión de su doble paternidad, actualmente la más aceptada, pero no la única. Sin embargo, estas novelas también popularizan una de las tesis más controvertidas hoy: la de que Rojas sea descendiente directo de un condenado a la hoguera. En este caso la elección parece consecuencia no solo de la vigencia de los trabajos de Stephen Gilman como fuente, sino de la recepción de la obra a partir del siglo XX, tanto por la relevancia que adquiere el elemento inquisitorial como de la lectura más crítica de la Tragicomedia y la superposición del imaginario de la narrativa histórica.
El proceso de amores de Calisto y Melibea frente a la tradición
Authors: Matos Kevin
Published: January 2021

La historia de los dos amantes Calisto y Melibea sigue en muchos aspectos los códigos amatorios repetidos una y otra vez en la literatura medieval, aunque, por momentos, tales códigos no se adecúan del todo a la realidad de los enamorados. Para aquilatar sus singularidades, este trabajo explora al detalle el proceso de amores que siguen los protagonistas, desde su primer encuentro hasta llegar al tálamo venéreo, siempre teniendo en cuenta la tradición o el contexto en el que se enmarcan. Será en el tálamo venéreo donde el lector halle el culmen de la rebeldía erótica de Melibea, quien rechaza una tradición de siglos y propone a viva voz nada menos que nuevos modos de hacer el amor.
Crimen y castigo en la Tercera Celestina de Gaspar Gómez de Toledo: ¿la visión moralizadora de un médico?
Authors: Gernert Folke
Published: January 2021

El presente artículo estudia la Tercera Celestina de Gaspar Gómez de Toledo como obra escrita posiblemente por un médico haciendo particular hincapié en las textualizaciones del saber curativo desde una perspectiva de la historia de la ciencia. Una comparación con La Lozana Andaluza del médico Francisco Delicado muestra paralelismos con la obra de Gómez de Toledo, quien, al igual que el galeno andaluz, emite juicios moralizantes a través de la metáfora de la enfermedad y de la minusvalía física.
Materialización del dolor de Celestina en la Tercera parte de la Tragicomedia de Celestina
Authors: García Álvarez Juan Pablo Mauricio
Published: January 2021

En este artículo se analiza el dolor de Celestina como un elemento configurador del personaje en el texto escrito por Gómez de Toledo. Las heridas físicas y emocionales se convierten en una materialización de los valores morales y sociales de la vieja, mostrando con ello un tratamiento original. El análisis del dolor nos permite construir una cultura emocional representada en la celestinesca.
Nanoscopic anatomy of dynamic multi-protein complexes at membranes resolved by graphene-induced energy transfer
Authors: Füllbrunn Nadia , Li Zehao , Jorde Lara , Richter Christian P , Kurre Rainer , Langemeyer Lars , Yu Changyuan , Meyer Carola , Enderlein Jörg , Ungermann Christian , Piehler Jacob , You Changjiang
Published: January 2021

Insights into the conformational organization and dynamics of proteins complexes at membranes is essential for our mechanistic understanding of numerous key biological processes. Here, we introduce graphene-induced energy transfer (GIET) to probe axial orientation of arrested macromolecules at lipid monolayers. Based on a calibrated distance-dependent efficiency within a dynamic range of 25 nm, we analyzed the conformational organization of proteins and complexes involved in tethering and fusion at the lysosome-like yeast vacuole. We observed that the membrane-anchored Rab7-like GTPase Ypt7 shows conformational reorganization upon interactions with effector proteins. Ensemble and time-resolved single-molecule GIET experiments revealed that the HOPS tethering complex, when recruited via Ypt7 to membranes, is dynamically alternating between a ‘closed’ and an ‘open’ conformation, with the latter possibly interacting with incoming vesicles. Our work highlights GIET as a unique spectroscopic ruler to reveal the axial orientation and dynamics of macromolecular complexes at biological membranes with sub-nanometer resolution.
Genotyping tools and resources to assess peanut germplasm: smut-resistant landraces as a case study
Authors: Massa Alicia N. , Bressano Marina , Soave Juan H. , Buteler Mario I. , Seijo Guillermo , Sobolev Victor S. , Orner Valerie A. , Oddino Claudio , Soave Sara J. , Faustinelli Paola C. , de Blas Francisco J. , Lamb Marshall C. , Arias Renee S.
Published: January 2021

Peanut smut caused by Thecaphora frezii is a severe fungal disease currently endemic to Argentina and Brazil. The identification of smut resistant germplasm is crucial in view of the potential risk of a global spread. In a recent study, we reported new sources of smut resistance and demonstrated its introgression into elite peanut cultivars. Here, we revisited one of these sources (line I0322) to verify its presence in the U.S. peanut germplasm collection and to identify single nucleotide polymorphisms (SNPs) potentially associated with resistance. Five accessions of Arachis hypogaea subsp. fastigiata from the U.S. peanut collection, along with the resistant source and derived inbred lines were genotyped with a 48K SNP peanut array. A recently developed SNP genotyping platform called RNase H2 enzyme-based amplification (rhAmp) was further applied to validate selected SNPs in a larger number of individuals per accession. More than 14,000 SNPs and nine rhAmp assays confirmed the presence of a germplasm in the U.S. peanut collection that is 98.6% identical (P < 0.01, bootstrap t-test) to the resistant line I0322. We report this germplasm with accompanying genetic information, genotyping data, and diagnostic SNP markers.
Glen Gallic Mallee (Eucalyptus dealbata subsp. aperticola, Myrtaceae), a new taxon from the sandstone escarpment of the Hunter Valley, New South Wales
Authors: Bell Stephen , Nicolle Dean
Published: January 2021

Eucalyptus dealbata subsp. aperticola S.A.J. Bell & D. Nicolle, a new mallee red gum from Triassic aged sandstone benches in the northern part of Wollemi National Park north-west of Sydney, is described and illustrated, and notes on affinities, distribution, ecology and conservation status provided.
DNA sequencing supports the reinstatement of Pycnolejeunea glauca from synonymy of Cheilolejeunea intertexta, as Cheilolejeunea glauca comb. nov.
Authors: Beveridge Peter , Glenny David , Shepherd Lara
Published: January 2021

Pycnolejeunea glauca, originally described by Stephani based on a collection in New Zealand by William Colenso, was placed by Grolle into the synonymy of the paleotropical species Cheilolejeunea intertexta with a type from Micronesia. In this study, we generated DNA sequences from a recently-collected sample of P. glauca and compared them with published sequences of C. intertexta from China. Pycnolejeunea glauca was recovered in the phylogenetic analyses as sister to C. nipponica, whereas C. intertexta grouped in another clade with C. vittata and C. streimannii. The analysis justifies the reinstatement of P. glauca as the new combination Cheilolejeunea glauca, a New Zealand endemic. Descriptions and illustrations are provided of key features of this species together with data on its position in the phylogeny of the genus.
Emotional Salespeople: customer orientation and emotional intelligence
Authors: Dos Santos Agnaldo Antonio , Dornelles Marcos , Crispim Sergio Feliciano
Published: January 2021

Customer orientation is recurrent in academic research because it enables more effective value creation for customers and shareholders. In this context, this research investigates an unexplored topic, which is the relationship between the emotional intelligence of salespeople and their customer orientation. In a sample of 167 Brazilian salespeople, two validated scale were used, but rarely applied together: (a) Saxe and Weitz Sales Orientation and Customer Orientation Scale (SOCO); (b) Wong and Law Emotional Intelligence Scale (WLEIS). It was concluded with the structural equation model developed that the percentage of customer orientation variability explained by the model is 12% and that for each increase in standard deviation of total emotional intelligence, customer orientation increases by .35 standard deviation, that emotional intelligence is greater in older salespeople, and that emotional intelligence varies according to the economic sectors of salespeople.
The impact of activism on the performance of publicly-traded companies
Authors: Xavier Wlamir Goncalves , Cesar Silva Melo Lauro , Oliveira Camilo Silvio Parodi , Greene Frederick
Published: January 2021

Institutional investors hold the largest volume of financial resources in the world. The role of the institutional investor as a shareholder has evolved, and now institutional investors are engaged with increasing participation in companies. This active positioning, or activism, is defined as an increase of direct involvement by the investors in the management of companies and influence over corporate executives by vastly increased corporate governance. This paper proposes to analyze the impact of institutional investors' activism on the performance of publicly-traded companies in Brazil. The final sample composed of economic data from 351 companies. The financial and market performance was measured in the years from 2006 to 2015. For data analysis, a panel data effects model was chosen. Results suggest that the governance index moderates the effect of activism on performance, especially in companies where governance practices are not very developed.
Seeing the Bigger Picture: A Lesson for Accessible Treatment Design
Authors: VanDyke David J. , Zimmerman Tammy , Vanrooy Tammy , Milanovic Melissa , Bowie Christopher R.
Published: January 2021

A cognitive remediation group therapy was adapted to accommodate a participant with acquired blindness in an early psychosis intervention program. The modifications facilitated group inclusion and self-reported positive outcomes. This case highlights the need to consider accessibility during treatment design and transitioning therapies from research settings into clinical environments.
Uptake of circulating extracellular vesicles from rectal cancer patients and differential responses by human monocyte cultures
Authors: Bjørnetrø Tonje , Steffensen Lilly Alice , Vestad Beate , Brusletto Berit Sletbakk , Olstad Ole Kristoffer , Trøseid Anne‐Marie , Aass Hans Christian Dalsbotten , Haug Kari Bente Foss , Llorente Alicia , Bøe Stig Ove , Lång Anna , Samiappan Rampradeep , Redalen Kathrine Røe , Øvstebø Reidun , Ree Anne Hansen
Published: January 2021

Extracellular vesicles (EVs) released by tumor cells can directly or indirectly modulate the phenotype and function of the immune cells of the microenvironment locally or at distant sites. The uptake of circulating EVs and the responses by human monocytes in vitro may provide new insights into the underlying biology of the invasive and metastatic processes in cancer. Although a mixed population of vesicles is obtained with most isolation techniques, we predominantly isolated exosomes (small EVs) and microvesicles (medium EVs) from the SW480 colorectal cancer cell line (established from a primary adenocarcinoma of the colon) by sequential centrifugation and ultrafiltration, and plasma EVs were prepared from 22 patients with rectal adenoma polyps or invasive adenocarcinoma by size‐exclusion chromatography. The EVs were thoroughly characterized. The uptake of SW480 EVs was analyzed, and small SW480 EVs were observed to be more potent than medium SW480 EVs in inducing monocyte secretion of cytokines. The plasma EVs were also internalized by monocytes; however, their cytokine‐releasing potency was lower than that of the cell line‐derived vesicles. The transcriptional changes in the monocytes highlighted differences between adenoma and adenocarcinoma patient EVs in their ability to regulate biological functions, whereas the most intriguing changes were found in monocytes receiving EVs from patients with metastatic compared with localized cancer.
Move to eliminate x‐waiver gathers steam, aimed at federal legislation
Authors: Knopf Alison
Published: January 2021

The ripples toward deregulating buprenorphine became a tsunami last week. This time, it's aiming straight for Congress, as the Trump administration's clumsy attempt to steer it through the last days of the previous administration failed. Among the new voices added to the debate: patient advocacy group NAMA Recovery, and the American Association for Addiction Medicine (ASAM).
HHS proceeds with weakening of HIPAA, including for SUD
Authors: Knopf Alison
Published: January 2021

The federal Department of Health and Human Services (HHS), which under former President Donald Trump threatened to open up patient record protections under the Health Insurance Portability and Accountability Act (HIPAA; see “In case you haven't heard,” ADAW, Jan. 11, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32940), has made good on its threat. The HHS Office for Civil Rights (OCR) published its notice of proposed rulemaking (NPRM), the “Standards for the Privacy of Individually Identifiable Health Information (Privacy Rule),” in the Jan. 21 Federal Register — a day after President Joe Biden was inaugurated (and a day after the new administration placed a freeze on rulemakings).
H2 In Situ Inducing Strategy on Pt Surface Segregation Over Low Pt Doped PtNi5 Nanoalloy with Superhigh Alkaline HER Activity
Authors: Zhang Cong , Liang Xin , Xu Ruinian , Dai Chengna , Wu Bin , Yu Gangqiang , Chen Biaohua , Wang Xiaolei , Liu Ning
Published: January 2021

Surface segregation constitutes an efficient approach to enhance the alkaline hydrogen evolution reaction (HER) activity of bimetallic PtxNiy nanoalloys. Herein, a new strategy is proposed by utilizing the small gas molecule of H2 as the structure directing agent (SDA) to in situ induce Pt surface segregations over a series of PtNi5‐n samples with extremely low Pt doping (Pt/Ni = 0.2). Impressively, the sample of PtNi5‐0.3 synthesized under 0.3 MPa H2 delivers an extremely low overpotential of 26.8 mV (−10 mA cm−2) and Tafel slope of 19.2 mV dec−1, which is superior to most of the previously reported PtxNiy electrocatalysts. This is substantially related to the strong H2 in situ inducing effect to generate Pt‐rich@Ni‐rich core‐shell nanostructure of PtNi5‐0.3 with an ultrahigh Pt surface content of 46%. The specific mechanistic effects of H2 during the PtNi5‐n synthesis process are well illustrated based on the combined experimental and theoretical studies. The density functional theory mechanism simulations further unravel that the evolved active site of PtNi5‐n can efficiently reduce the reaction Gibbs free energies; especially for the scenario of PtNi5‐0.3, the downward‐shifted d band center of the Pt active site significantly reduces the PtH bond strength, eventually resulting in the lowest absolute value of ΔGH.