bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolutionary medical insights into the SARS-CoV-2 pandemic
Authors: Crespi Bernard
Published: September 2020

The author apply concepts and tools from evolutionary medicine to understanding the SARS-CoV-2 pandemic. The pandemic represents a mismatched conflict, with dynamics and pathology apparently driven by three main factors: (i) bat immune systems that rely on low inflammation but high efficacy of interferon-based defenses; (ii) viral tactics that differentially target the human interferon system, leading to substantial asymptomatic and pre-symptomatic transmission; and (ii) high mortality caused by hyper-inflammatory and hyper-coagulatory phenotypes, that represent dysregulated tradeoffs whereby collateral immune-induced damage becomes systemic and severe. This framework can explain the association of mortality with age (which involves immune life-history shifts towards higher inflammation and coagulation and reduced adaptive immunity), and sex (since males senesce faster than females). Genetic-risk factors for COVID-19 mortality can be shown, from a phenome-wide association analysis of the relevant SNPs, to be associated with inflammation and coagulation; the phenome-wide association study also provides evidence, consistent with several previous studies, that the calcium channel blocking drug amlodipine mediates risk of mortality.

Lay Summary: SARS-CoV-2 is a bat virus that jumped into humans. The virus is adapted to bat immune systems, where it evolved to suppress the immune defenses (interferons) that mammals use to tell that they are infected. In humans, the virus can apparently spread effectively in the body with a delay in the production of symptoms and the initiation of immune responses. This delay may then promote overactive immune responses, when the virus is detected, that damage the body as a side effect. Older people are more vulnerable to the virus because they are less adapted to novel infectious agents, and invest less in immune defense, compared to younger people. Genes that increase risk of mortality from SARS-CoV-2 are functionally associated with a drug called amlodipine, which may represent a useful treatment.
Social Engagement and Cognitive Function of Older Adults in Mexico and the United States: How Universal Is the Interdependence in Couples?
Authors: Howrey Bret , Avila Jaqueline C , Downer Brian , Wong Rebeca
Published: September 2020

Objectives

Increased social engagement in older adults has been linked to positive cognitive outcomes; however, it is unclear if the social engagement of husbands and wives influences their own cognition as well as each other’s cognition. Moreover, it is unknown if any such patterns persist in different country contexts.

Methods

Data from the 2001 Mexican Health and Aging Study (MHAS) and the 2000 Health and Retirement Study (HRS) were combined, and comparable samples of married couples without cognitive impairment at baseline were drawn. Follow-up cognition data was obtained from the 2012 MHAS and the 2012 HRS. Structural equation models (SEM) were used to test the actor–partner interdependence model with moderating effect of country on the association of social engagement with cognition.

Results

Significant actor effects were observed for wives in both countries. Actor effects for husbands were observed in the United States only. In Mexico, a significant partner effect was observed where wives’ social engagement benefited their own cognition as well as their husbands’, but not vice versa. Partner effects were not observed in the United States. No moderation effects of country were observed.

Discussion

Our results suggest asymmetric patterns of actor–partner interdependence in Mexico, which may be reflective of the more traditional social role of women, and codependence within the couple. On the other hand, our results for the United States, where each spouse had significant actor effects but no partner effects, may suggest more independence within the couple.
Passive Investments
Authors: Ho Jean
Published: September 2020

Passive investments are a phenomenon in investment treaty arbitration. Arbitral jurisprudence is divided over the eligibility of investments represented by claimants who played little or no part in their establishment or nurturing for treaty protection. This note attributes the emergence of passive investments as a category of protected investments to a jurisdictional loophole present in the vast majority of investment treaties. It then considers the extent to which this loophole can be addressed by ‘denial of benefits’ clauses in applicable treaties, by reading an ‘action of investing’ jurisdictional condition into applicable treaties, and by the award of nominal damages when a claim arising from a passive investment prevails on the merits. This note concludes that so long as investment treaties continue to hold sway as regulatory tools, passive investments, for better or for worse, are protected investments.
Genomics of Ocular Chlamydia trachomatis After 5 Years of SAFE Interventions for Trachoma in Amhara, Ethiopia
Authors: Pickering Harry , Chernet Ambahun , Sata Eshetu , Zerihun Mulat , Williams Charlotte A , Breuer Judith , Nute Andrew W , Haile Mahteme , Zeru Taye , Tadesse Zerihun , Bailey Robin L , Callahan E Kelly , Holland Martin J , Nash Scott D
Published: September 2020

Background

To eliminate trachoma as a public health problem, the World Health Organization recommends the SAFE (surgery, antibiotics, facial cleanliness, and environmental improvement) strategy. As part of the SAFE strategy in the Amhara Region, Ethiopia, the Trachoma Control Program distributed >124 million doses of antibiotics between 2007 and 2015. Despite this, trachoma remained hyperendemic in many districts and a considerable level of Chlamydia trachomatis (Ct) infection was evident.

Methods

We utilized residual material from Abbott m2000 Ct diagnostic tests to sequence 99 ocular Ct samples from Amhara and investigated the role of Ct genomic variation in continued transmission of Ct.

Results

Sequences were typical of ocular Ct at the whole-genome level and in tissue tropism–associated genes. There was no evidence of macrolide resistance in this population. Polymorphism around the ompA gene was associated with village-level trachomatous inflammation–follicular prevalence. Greater ompA diversity at the district level was associated with increased Ct infection prevalence.

Conclusions

We found no evidence for Ct genomic variation contributing to continued transmission of Ct after treatment, adding to evidence that azithromycin does not drive acquisition of macrolide resistance in Ct. Increased Ct infection in areas with more ompA variants requires longitudinal investigation to understand what impact this may have on treatment success and host immunity.
Detection of Cannabinoids by LC–MS-MS and ELISA in Breast Milk
Authors: Sempio Cristina , Wymore Erica , Palmer Claire , Bunik Maya , Henthorn Thomas K , Christians Uwe , Klawitter Jost
Published: September 2020

Cannabis is the most commonly used drug of abuse in pregnancy and after delivery. However, little is known regarding the disposition of cannabinoids in breast milk, although delta-9-tetrahydrocannabinol (THC), the main psychoactive component, is highly lipophilic. Quantification of cannabinoids in breastmilk is essential for clinical monitoring and research studies and breastmilk banks mainly rely on enzyme-linked immunosorbent assay (ELISA) in terms of screening for cannabinoids. To support clinical studies on disposition of cannabinoids in breastmilk, we validated a high-performance liquid chromatography–tandem mass spectrometry (LC–MS-MS) assay for the simultaneous quantification of 12 cannabinoids and their metabolites in human breast milk. Said assay was based upon a simple one-step protein precipitation, online column extraction and detection in the positive multiple reaction monitoring mode. After successful validation, the assay was used to analyze 30 samples from a clinical research study that had tested negative using an ELISA kit that is commonly used by breastmilk banks. In human breast milk, depending on the analyte, the lower limits of quantification of the LC–MS-MS assay ranged from 0.39 to 7.81 ng/mL. Acceptance criteria for intra- and inter-batch accuracy (85–115%) and imprecision (<15%) were met for all compounds. Mean extraction efficiencies were above 60% for all analytes. Mean matrix effect ranged from −12.5% to 44.5% except of THC-glucuronide for which significant matrix effects were noted. No carry-over was detected. Although cannabinoid-negative based on the ELISA, all 30 samples tested positive for THC using LC–MS-MS (0.8–130 ng/mL) and several also for 11-hydroxy-THC (11-OH-THC), 11-nor-9-carboxy-THC (THCCOOH), cannabidiol (CBD) and cannabigerol (CBG). We validated a sensitive and specific assay for the quantification of 12 cannabinoids in human breastmilk that outperformed an ELISA commonly used by breastmilk banks.
A study of the hard X-ray spectral tails in Scorpius X-1 using RXTE observations
Authors: Ding G Q , Chen T T , Qu J L
Published: September 2020

Using all the data of the High Energy X-ray Timing Experiment (HEXTE) on board the Rossi X-ray Timing Explorer for Scorpius X-1 from 1996 February to 2012 January, we systematically search for hard X-ray tails in the X-ray spectra in 20–220 keV and, together with the data of the Proportional Counter Array (PCA), investigate the evolution of the detected hard X-ray tails along the Z-track on its hardness-intensity diagram (HID). The hard X-ray tails are detected in 30 observations and their presence is not confined to a specific position on the HID. Our analysis suggests that from the horizontal branch (HB), through the normal branch (NB), to the flaring branch (FB) on the HID, the hard X-ray tail becomes hard and its flux decreases. Jointly fitting the PCA+HEXTE spectra in 3–220 keV, it is found that the Bulk-Motion Comptonization (BMC) could be an alternative mechanism for producing the hard X-ray tails on the HB and the NB of this source. The temperature of the seed photons for the BMC spans in the range of ∼(2.4–2.6) keV, indicating that the seed photons might come from the surface of the neutron star (NS) or the boundary layer and, therefore, the BMC process could take place around the NS or in the boundary layer. Some possible mechanisms for producing the hard X-ray tails on the FB are given.
LncSEA: a platform for long non-coding RNA related sets and enrichment analysis
Authors: Chen Jiaxin , Zhang Jian , Gao Yu , Li Yanyu , Feng Chenchen , Song Chao , Ning Ziyu , Zhou Xinyuan , Zhao Jianmei , Feng Minghong , Zhang Yuexin , Wei Ling , Pan Qi , Jiang Yong , Qian Fengcui , Han Junwei , Yang Yongsan , Wang Qiuyu , Li Chunquan
Published: September 2020

Long non-coding RNAs (lncRNAs) have been proven to play important roles in transcriptional processes and various biological functions. Establishing a comprehensive collection of human lncRNA sets is urgent work at present. Using reference lncRNA sets, enrichment analyses will be useful for analyzing lncRNA lists of interest submitted by users. Therefore, we developed a human lncRNA sets database, called LncSEA, which aimed to document a large number of available resources for human lncRNA sets and provide annotation and enrichment analyses for lncRNAs. LncSEA supports >40 000 lncRNA reference sets across 18 categories and 66 sub-categories, and covers over 50 000 lncRNAs. We not only collected lncRNA sets based on downstream regulatory data sources, but also identified a large number of lncRNA sets regulated by upstream transcription factors (TFs) and DNA regulatory elements by integrating TF ChIP-seq, DNase-seq, ATAC-seq and H3K27ac ChIP-seq data. Importantly, LncSEA provides annotation and enrichment analyses of lncRNA sets associated with upstream regulators and downstream targets. In summary, LncSEA is a powerful platform that provides a variety of types of lncRNA sets for users, and supports lncRNA annotations and enrichment analyses. The LncSEA database is freely accessible at http://bio.liclab.net/LncSEA/index.php.
CRISP-view: a database of functional genetic screens spanning multiple phenotypes
Authors: Cui Yingbo , Cheng Xiaolong , Chen Qing , Song Bicna , Chiu Anthony , Gao Yuan , Dawson Tyson , Chao Lumen , Zhang Wubing , Li Dian , Zeng Zexiang , Yu Jijun , Li Zexu , Fei Teng , Peng Shaoliang , Li Wei
Published: September 2020

High-throughput genetic screening based on CRISPR/Cas9 or RNA-interference (RNAi) enables the exploration of genes associated with the phenotype of interest on a large scale. The rapid accumulation of public available genetic screening data provides a wealth of knowledge about genotype-to-phenotype relationships and a valuable resource for the systematic analysis of gene functions. Here we present CRISP-view, a comprehensive database of CRISPR/Cas9 and RNAi screening datasets that span multiple phenotypes, including in vitro and in vivo cell proliferation and viability, response to cancer immunotherapy, virus response, protein expression, etc. By 22 September 2020, CRISP-view has collected 10 321 human samples and 825 mouse samples from 167 papers. All the datasets have been curated, annotated, and processed by a standard MAGeCK-VISPR analysis pipeline with quality control (QC) metrics. We also developed a user-friendly webserver to visualize, explore, and search these datasets. The webserver is freely available at http://crispview.weililab.org.
Predicting Treatment Success with Facet Syndrome: An Algorithm to Predict Lumbar Radiofrequency Ablation Responders in a Military Population
Authors: Hughey Scott , Cole Jacob , Booth Gregory , Moore Jeffrey , McDowell Benjamin , DeYoung Henry , Hosig Anna , Moran Thomas , Stedje-Larsen Eric
Published: September 2020

Objective

Radiofrequency ablation (RFA) of the medial branch nerve is a commonly performed procedure for patients with facet syndrome. RFA has previously been demonstrated to provide long-term functional improvement in approximately 50% of patients, including those who had significant pain relief after diagnostic medial branch block. We sought to identify factors associated with success of RFA for facet pain.

Design

Active-duty military patients who underwent lumbar RFA (L3, L4, and L5 levels) over a 3-year period were analyzed. Defense and Veterans Pain Rating Scale (DVPRS) and Oswestry Disability Index (ODI) scores were assessed the day of procedure and at the 2-month and 6-month follow-up. These data were analyzed to identify associations between patient demographics, pain, and functional status and patients’ improvement after RFA, with a primary outcome of ODI improvement and a secondary outcome of pain reduction.

Results

Higher levels of starting functional impairment (starting ODI scores of 42.9 vs. 37.5; P = 0.0304) were associated with a greater likelihood of improvement in functional status 6 months after RFA, and higher starting pain scores (DVPRS pain scores of 6.1 vs. 5.1; P < 0.0001) were associated with a higher likelihood that pain scores would improve 6 months after RFA. A multivariate logistic regression was then used to develop a scoring system to predict improvement after RFA. The scoring system generated a C-statistic of 0.764, with starting ODI, pain scores, and both gender and smoking history as independent variables.

Conclusions

This algorithm compares favorably to that of diagnostic medial branch block in terms of prediction accuracy (C-statistic of 0.764 vs. 0.57), suggesting that its use may improve patient selection in patients who undergo RFA for facet syndrome.
Changes in Brain Glutamate on Switching to Clozapine in Treatment-Resistant Schizophrenia
Authors: McQueen Grant , Sendt Kyra-Verena , Gillespie Amy , Avila Alessia , Lally John , Vallianatou Kalliopi , Chang Nynn , Ferreira Diogo , Borgan Faith , Howes Oliver D , Barker Gareth J , Lythgoe David J , Stone James M , McGuire Philip , MacCabe James H , Egerton Alice
Published: September 2020

It has been suggested that the antipsychotic clozapine may modulate brain glutamate, and that this effect could contribute to its efficacy in treatment-resistant schizophrenia (TRS). The aim of this study was to examine the effects of clozapine on brain glutamate in TRS longitudinally. This study examined individuals with TRS before and 12 weeks after switching from a non-clozapine antipsychotic to treatment with clozapine as part of their normal clinical care. Proton magnetic resonance spectroscopy (1H-MRS) measured concentrations, corrected for voxel tissue content, of glutamate (Glucorr), and glutamate plus glutamine (Glxcorr) in the anterior cingulate cortex (ACC) and right caudate nucleus. Symptoms were monitored using the Positive and Negative Syndrome Scale (PANSS). Of 37 recruited patients (27 men, 39.30 years old, 84% clozapine naïve), 25 completed 1H-MRS at both timepoints. 12 weeks of clozapine was associated with a longitudinal reduction in Glucorr in the caudate (n = 23, F = 7.61 P = .01) but not in the ACC (n = 24, F = 0.02, P = .59). Percentage reduction in caudate Glucorr was positively correlated with percentage improvement in symptoms (total PANSS score, n = 23, r = .42, P = .04). These findings indicate that reductions in glutamate in the caudate nucleus may contribute to symptomatic improvement during the first months of clozapine treatment.
Controlling Brain State Prior to Stimulation of Parietal Cortex Prevents Deterioration of Sustained Attention
Authors: Edwards Grace , Contò Federica , Bucci Loryn K , Battelli Lorella
Published: September 2020

Sustained attention is a limited resource which declines during daily tasks. Such decay is exacerbated in clinical and aging populations. Inhibition of the intraparietal sulcus (IPS), using low-frequency repetitive transcranial magnetic stimulation (LF-rTMS), can lead to an upregulation of functional communication within the attention network. Attributed to functional compensation for the inhibited node, this boost lasts for tens of minutes poststimulation. Despite the neural change, no behavioral correlate has been found in healthy subjects, a necessary direct evidence of functional compensation. To understand the functional significance of neuromodulatory induced fluctuations on attention, we sought to boost the impact of LF-rTMS to impact behavior. We controlled brain state prior to LF-rTMS using high-frequency transcranial random noise stimulation (HF-tRNS), shown to increase and stabilize neuronal excitability. Using fMRI-guided stimulation protocols combining HF-tRNS and LF-rTMS, we tested the poststimulation impact on sustained attention with multiple object tracking (MOT). While attention deteriorated across time in control conditions, HF-tRNS followed by LF-rTMS doubled sustained attention capacity to 94 min. Multimethod stimulation was more effective when targeting right IPS, supporting specialized attention processing in the right hemisphere. Used in cognitive domains dependent on network-wide neural activity, this tool may cause lasting neural compensation useful for clinical rehabilitation.
Manganese exposure induces permeability in renal glomerular endothelial cells via the Smad2/3-Snail–VE-cadherin axis
Authors: Gao Peng , Tian Yutian , Xie Qi , Zhang Liang , Yan Yongjian , Xu Dongmei
Published: September 2020

Manganese (Mn) is an essential micronutrient. However, it is well established that Mn overexposure causes nervous system diseases. In contrast, there are few reports on the effects of Mn exposure on glomerular endothelium. In the present study, the potential effects of Mn exposure on glomerular endothelium were evaluated. Sprague Dawley rats were used as a model of Mn overexposure by intraperitoneal injection of MnCl2·H2O at 25 mg/kg body weight. Mn exposure decreased expression of vascular endothelial-cadherin, a key component of adherens junctions, and increased exudate from glomeruli in Sprague Dawley rats. Human renal glomerular endothelial cells were cultured with different concentration of Mn. Exposure to 0.2 mM Mn increased permeability of human renal glomerular endothelial cell monolayers and decreased vascular endothelial-cadherin expression without inducing cytotoxicity. In addition, Mn exposure increased phosphorylation of mothers against decapentaplegic homolog 2/3 and upregulated expression of zinc finger protein SNAI1, a negative transcriptional regulator of vascular endothelial-cadherin. Our data suggest Mn exposure may contribute to development of glomerular diseases by inducing permeability of glomerular endothelium.
Genome Sequence Resource for the Ramie Oomycete Pathogen Phytopythium vexans HF1
Authors: Yu Yongting , Gao Chunsheng , Wang Tuhong , Chen Yikun , Cheng Yi , Li Zhimin , Chen Jia , Guo Litao , Sun Xiangping , Xu Jianping
Published: September 2020

The oomycete Phytopythium vexans is a causative agent of patch canker, damping-off, and crown, stem, and root rot in many economically important plants. P. vexans HF1 was isolated in China, where it caused brown root rot of ramie, a fiber crop broadly cultivated in Asia. The genome of HF1 was sequenced by a combination of technologies producing short (Illumina HiSeq X) and long (PacBio RS) reads. The genome is 41.73 Mbp long, assembled into 44 contigs. It has a GC content of 58.17% and contains 13,051 predicted coding genes, including 1,461 putative virulence genes and 220 putative antimicrobial resistance genes. This genome sequence provides a resource for determining the molecular mechanisms of disease development in this pathosystem.
The Complete Genome Sequence of Xanthomonas theicola, the Causal Agent of Canker on Tea Plants, Reveals Novel Secretion Systems in Clade-1 Xanthomonads
Authors: Koebnik Ralf , Burokiene Daiva , Bragard Claude , Chang Christine , Saux Marion Fischer-Le , Kölliker Roland , Lang Jillian M. , Leach Jan E. , Luna Emily K. , Portier Perrine , Sagia Angeliki , Ziegle Janet , Cohen Stephen P. , Jacobs Jonathan M.
Published: September 2020

Xanthomonas theicola is the causal agent of bacterial canker on tea plants. There is no complete genome sequence available for X. theicola, a close relative of the species X. translucens and X. hyacinthi, thus limiting basic research for this group of pathogens. Here, we release a high-quality complete genome sequence for the X. theicola type strain, CFBP 4691T. Single-molecule real-time sequencing with a mean coverage of 264× revealed two contigs of 4,744,641 bp (chromosome) and 40,955 bp (plasmid) in size. Genome mining revealed the presence of nonribosomal peptide synthases, two CRISPR systems, the Xps type 2 secretion system, and the Hrp type 3 secretion system. Surprisingly, this strain encodes an additional type 2 secretion system and a novel type 3 secretion system with enigmatic function, hitherto undescribed for xanthomonads. Four type 3 effector genes were found on complete or partial transposons, suggesting a role of transposons in effector gene evolution and spread. This genome sequence fills an important gap to better understand the biology and evolution of the early-branching xanthomonads, also known as clade-1 xanthomonads.
High-risk surgical procedures and semi-emergent surgical procedures for ambulatory surgery
Authors: Skues Mark A.
Published: September 2020

Purpose of review

This review evaluates more complex surgical procedures to see whether they might be suitable for ambulatory surgery. Operations that have shown an increasing daycase rate in England include thyroidectomy, joint arthroplasty, spinal surgery and hysterectomy, and these procedures are evaluated. Similarly, there have been recent developments in the management of nonelective ambulatory surgery with more timely throughput and home discharge for suitable patients.

Recent findings

Caveats on patient selection with the development of focussed educational programmes about the proposed operation have assisted with the development of shorter discharge times. Strict antiemetic guidelines, multimodal analgesic protocols and postoperative multidisciplinary follow-up are core components of the pathway for effective ambulatory management. Communication after discharge should include phone calls from the Ambulatory Unit and easy access to the medical staff who conducted their operation.

There should be no reason why more complex surgical operations could not be included in a day surgery armamentarium. Similarly, the evidence for more effective use of timely emergency care with shortened length of stay is increasing.
Enhanced recovery pathways for ambulatory surgery
Authors: Joshi Girish P.
Published: September 2020

Purpose of review

Implementation of enhanced recovery pathways have allowed migration of complex surgical procedures from inpatient setting to the outpatient setting. These programs improve patient safety and patient-reported outcomes. The present article discusses the principles of enhanced recovery pathways in adults undergoing ambulatory surgery with an aim of improving patient safety and postoperative outcomes.

Recent findings

Procedure and patient selection is one of the key elements that influences perioperative outcomes after ambulatory surgery. Other elements include optimization of comorbid conditions, patient and family education, minimal preoperative fasting and adequate hydration during the fasting period, use of fast-track anesthesia technique, lung-protective mechanical ventilation, maintenance of fluid balance, and multimodal pain, nausea, and vomiting prophylaxis.

Implementation of enhanced recovery pathways requires a multidisciplinary approach in which the anesthesiologist should take a lead in collaborating with surgeons and perioperative nurses. Measuring compliance with enhanced recovery pathways through an audit program is essential to evaluate success and need for protocol modification. The metrics to assess the impact of enhanced recovery pathways include complication rates, patient reported outcomes, duration of postoperative stay in the surgical facility, unplanned hospital admission rate, and 7-day and 30-day readmission rates.
Measuring and monitoring perioperative patient safety: a basic approach for clinicians
Authors: Wacker Johannes
Published: September 2020

Purpose of review

Recent research points to considerable rates of preventable perioperative patient harm and anaesthesiologists’ concerns about eroding patient safety. Anaesthesia has always been at the forefront of patient safety improvement initiatives. However, factual local safety improvement requires local measurement, which may be afflicted by barriers to data collection and improvement activities. Because many of these barriers are related to mandatory reporting, the focus of this review is on measurement methods that can be used by practicing anaesthesiologists as self-improvement tools, even independently from mandatory reporting, and using basic techniques widely available in most institutions.

Recent findings

Four mutually complementary measurement approaches may be suited for local patient safety learning: incident and rate-based measurements, staff surveys and patient surveys. Reportedly, individual methods have helped to tailor problem solutions and to reduce patient harm, morbidity, and mortality.

Considering the potential for perioperative patient safety measurements to improve patient outcomes, the absence of a generally accepted measurement standard and manifold barriers to reporting, a pragmatic approach to locally measuring patient safety appears advisable.
Fostering Effective Mentoring Relationships in Qualitative Research
Authors: Cypress Brigitte S.
Published: September 2020

Conducting a qualitative research study is a long, arduous, and laborious endeavor. The novice and early-career researchers, including graduate students, can be overwhelmed by the complexity of the methods used in conducting a naturalistic inquiry. Despite the recognized importance of mentoring in different fields, a research supervisor is almost always used to guide the neophytes in their pursuit of completing a research investigation in nursing. Supervising is task-oriented, whereas mentoring involves caring, role-modeling, emotional support, and guidance including the long-term development of the mentee. Research mentoring relationships are critical to the satisfaction of both the mentor and the mentee that leads to a successful completion of a qualitative inquiry and, eventually, for their academic and professional advancement. Mentees are advised to seek mentors and to establish formal mentoring relationships with them. It is also suggested that institutions support the value and work of mentors. Future studies must address failed mentoring liaisons, and assess and use different strategies for effective mentorship for both the mentor and the mentee. The purpose of this article is to discuss the role of mentoring in successfully completing a scholarly inquiry that will help in equipping novices with the knowledge, skills, and confidence that will empower them to navigate the difficult and long journey of a qualitative investigation.
Thyroid Doses to French Polynesians Resulting from Atmospheric Nuclear Weapons Tests: Estimates Based on Radiation Measurements and Population Lifestyle Data
Authors: Drozdovitch Vladimir , Bouville André , Taquet Marc , Gardon Jacques , Xhaard Constance , Ren Yan , Doyon Françoise , de Vathaire Florent
Published: September 2020

Thyroid doses were estimated for the subjects of a population-based case-control study of thyroid cancer in a population exposed to fallout after atmospheric nuclear weapons tests conducted in French Polynesia between 1966 and 1974. Thyroid doses due to (1) intake of 131I and of short-lived radioiodine isotopes (132I, 133I, 135I) and 132Te, (2) external irradiation from gamma-emitting radionuclides deposited on the ground, and (3) ingestion of long-lived 137Cs with foodstuffs were reconstructed for each study subject. The dosimetry model that had been used in 2008 in Phase I of the study was substantially improved with (1) results of radiation monitoring of the environment and foodstuffs, which became available in 2013 for public access, and (2) historical data on population lifestyle related to the period of the tests, which were collected in 2016–2017 using focus-group discussions and key informant interviews. The mean thyroid dose among the study subjects was found to be around 5 mGy while the highest dose was estimated to be around 36 mGy. Doses from 131I intake ranged up to 27 mGy, while those from intake of short-lived iodine isotopes (132I, 133I, 135I) and 132Te ranged up to 14 mGy. Thyroid doses from external exposure ranged up to 6 mGy, and those from internal exposure due to 137Cs ingestion did not exceed 1 mGy. Intake of 131I was found to be the main pathway for thyroid exposure accounting for 72% of the total dose. Results of this study are being used to evaluate the risk of thyroid cancer among the subjects of the epidemiologic study of thyroid cancer among French Polynesians.
Predominance of Infection With Blastocystis hominis in Patients With Colorectal Cancer and Its Association With High Mucin Content, Infiltration of Inflammatory Cells and Elevated Serum Tumor Necrosis Factor α
Authors: Hawash Yousry A. , Ismail Khadiga Ahmed , Saber Taisir , Eed Emad M. , Khalifa Amany S. , Alsharif Khalaf F. , Alghamdi Saleh A. , Dahlawi Haytham A. , Alsanie Walaa , Khalifa Ahmed M. , Khalifa Osama Mahmoud
Published: September 2020

Background

Blastocystis hominis is a unicellular protozoan parasite with a worldwide distribution. It was hypothesized that the infection with B. hominis plays a role in the pathogenesis of colorectal cancer in humans.

Objective

We aimed to test this hypothesis in a 1-year study using patients from Saudi Arabia with colorectal cancer.

Subjects and Methods

Colorectal cancer patients with various stages were enrolled in the study as cases (n = 75) along with a noncolorectal cancer patients as controls (n = 25). All participants in the study were subjected to history taking and investigated for B. hominis infection by microscopy and molecular-based tests applied to their fecal samples. Also, the tumor necrosis factor α in serum collected from both patients and controls was calculated in our study.

Results

The B. hominis were identified more in cases (20/75; 26.6%) than in controls (2/25; 8%), with significant difference (P < 0.05). Marked inflammatory cells infiltrate and mucin contents were demonstrated more in colorectal cancer patients infected with B. hominis, particularly those with stage 3 and stage 4 cancers. In patients with stage 4 colorectal cancer, there was a significantly higher level of mucin content and serum level of tumor necrosis factor α compared with colorectal cancer patients with less advanced stages (P < 0.05). In colorectal cancer cases, a statistically significant higher serum level of tumor necrosis factor α was observed compared with the controls (P < 0.05).

Conclusions

The findings of our study support the hypothesis that the infection with B. hominis has a possible role in the pathogenesis of colorectal cancer because it increases inflammatory cells infiltration and proinflammatory cytokines (tumor necrosis factor α) in the study's setting. This possibility demands future cohort prospective studies to prove whether the infection induces the colonic tissue to form a tumor or exacerbates the existing tumor. After this, we suggest that the study's population be screened for B. hominis, especially those suffering from colorectal cancers.
Outcomes of Central Nervous System Infections Treated by an Outpatient Parenteral Antimicrobial Therapy Program in a Public Teaching Hospital
Authors: Cummins Sarah A. , Beeler Cole , Muloma Eva , Erdman Sharon M.
Published: September 2020

Background

Outpatient parenteral antimicrobial therapy (OPAT) has been safely used to treat a variety of infections. However, limited data are available on the safety and efficacy of OPAT for central nervous system (CNS) infections.

Methods

This was a retrospective, single-center study evaluating the safety and efficacy of OPAT in patients with CNS infections between July 1, 2009, and May 31, 2016. Demographic, medical, infection-specific, and drug-specific data were collected for each patient. Patients were categorized as clinical cure, probable cure, or treatment failure based on resolution or recurrence of infection for up to 1 year after OPAT completion. Safety of OPAT was evaluated through adverse drug event (ADE) and line complication (LC) monitoring. Readmission rates from OPAT-related ADE and LC were also recorded.

Results

Forty-seven patients with CNS infections (mean age, 45.3 years; 70.2% male) received OPAT for a median duration of 12 days (range, 2–144 days); 1 patient was excluded from efficacy analysis because of hospice transition. Thirty-seven patients (80.4%) achieved clinical cure, 7 patients (15.2%) had probable cure, and 2 patients (4.3%) experienced treatment failure. Three patients (6.4%) experienced ADE and 4 patients (8.5%) experienced LC during OPAT. Five patients (10.6%) required rehospitalization because of worsening infection (n = 1), LC (n = 2), cerebrospinal fluid leak repair (n = 1), and insurance issues (n = 1). Six patients (12.8%) required a therapy change because of ADE or LC.

Conclusions

Treating CNS infections with OPAT seems to be safe and effective based on the low failure and complication rates observed in this study.
Multisystem Inflammatory Syndrome in an Adult After COVID-19
Authors: Shan Yizhi , Dalal Vishal , Nahass Ronald G. , Rodricks Michael B. , Teichman Amanda L.
Published: September 2020

We describe the first case of multisystem inflammatory syndrome in an adult patient after coronavirus disease-19 (COVID-19). A 34-year-old Hispanic man, who tested positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) 1 month before presentation, was admitted for fever, abdominal pain, headache, and myalgia. The patient deteriorated, developing multisystem organ failure. He required intensive care unit admission, mechanical ventilation, vasopressors, and continuous renal replacement therapy. Laboratory workup showed depletion of serum complement levels. After immunosuppressive therapy with intravenous immunoglobulin and corticosteroids, complement levels improved, and the patient made a full recovery.
Nursing Professional Development Specialist’s Role in Adapting Education, Onboarding, and Just-in-Time Education During the COVID-19 Pandemic
Authors: Weiss Rebecca L. , Kennell Jamilyn , Lakdawala Linda , Anzio Nicole , Klamut Kimberly A. , Lucas Wendy , Antinori-Lent Kellie , Mininni Nicolette C.
Published: September 2020

The COVID-19 pandemic impacted every aspect of the personal and professional lives of healthcare providers. Nursing professional development practitioners are challenged with ongoing classroom education, new hire onboarding, and just-in-time education for staff. This article is intended to present the unique challenges that the COVID-19 pandemic placed on nursing professional development practitioners in a large academic medical center and how opportunities presented to revise old education practices.
Molecular Profiling of Salivary Oncocytic Mucoepidermoid Carcinomas Helps to Resolve Differential Diagnostic Dilemma With Low-grade Oncocytic Lesions
Authors: Skálová Alena , Agaimy Abbas , Stanowska Olga , Baneckova Martina , Ptáková Nikola , Ardighieri Laura , Nicolai Piero , Lombardi Davide , Durzynska Monika , Corcione Luigi , Laco Jan , Koshyk Olena , Žalud Radim , Michal Michal , Vanecek Tomáš , Leivo Ilmo
Published: September 2020

Oncocytic mucoepidermoid carcinoma (OMEC) is a rare but diagnostically challenging variant of mucoepidermoid carcinoma (MEC). OMEC is notable for differential diagnostic considerations that are raised as a result of overlap with other benign and low-grade oncocytic salivary gland tumors. Diffuse and strong immunoreactivity of p63 protein may be useful in distinguishing OMEC from its mimics. However, focal p63 staining can be present in benign oncytomas. Presence of mucin-containing cells, mucinous cystic formation, and foci of extravasated mucin are considered a hallmark of MEC. True mucocytes may be, however, very few and hardly discernable in OMECs. Recent evidence has shown that most MECs harbor gene fusions involving MAML2. A retrospective review of archived pathology files and the authors’ own files was conducted to search for “low-grade/uncertain oncocytic tumor,” “oncocytoma,” and “oncocytic carcinoma” in the period from 1996 to 2019. The tumors with IHC positivity for p63 and/or p40, and S100 negativity, irrespective of mucicarmine staining, were tested by next-generation sequencing using fusion-detecting panels to detect MAML2 gene rearrangements. Two index cases from consultation practice (A.S. and A.A.) of purely oncocytic low-grade neoplasms without discernible mucinous cells showed a CRTC1-MAML2 fusion using next-generation sequencing, and were reclassified as OMEC. In total, 22 cases of oncocytic tumors, retrieved from the authors’ files, and from the Salivary Gland Tumor Registry, harbored the MAML2 gene rearrangements. Presence of mucocytes, the patterns of p63 and SOX10 immunopositivity, and mucicarmine staining were inconsistent findings. Distinguishing OMEC devoid of true mucinous cells from oncocytoma can be very challenging, but it is critical for proper clinical management. Diffuse and strong positivity for p63 and visualization of hidden mucocytes by mucicarmine staining may be misleading and does not always suffice for correct diagnosis. Our experience suggests that ancillary studies for the detection of MAML2 rearrangement may provide useful evidence in difficult cases.
Immunotherapy and Thyroid Dysfunction
Authors: Gregorio Maria Laura , Gomez Juan Sebastian , Arora Surender , Ramachandran Anil , Takalkar Amol
Published: September 2020

We report a case of a 66-year-old woman with small cell lung cancer (stage IIB, T2N1M0), who received immunotherapy with nivolumab monthly for 2 months and then presented with thyrotoxic symptoms associated with suppressed thyroid-stimulating hormone levels and elevated free thyroid hormone levels, although previous thyrotropin performed 1 month ago was normal. Thyroid uptake and scan demonstrated diffusely decreased uptake in both thyroid lobes. The 4-hour percentage uptake was 0.7%, and the 24-hour percentage uptake was 0.3%. This was followed by development of hypothyroidism within few weeks. Findings suggested drug-induced thyroiditis secondary to nivolumab therapy.
Quality and Safety in Healthcare, Part LXXIII
Authors: Harolds Jay A.
Published: September 2020

Disruptive behavior in the healthcare system is costly because it has an adverse effect on patient outcomes, staff morale, and referrals to a healthcare organization, and it increases staff turnover. A small proportion of medical providers exhibit disruptive behavior, but those individuals may exhibit this behavior frequently in some healthcare institutions so that this type of conduct is not uncommonly there. Each healthcare institution should have policies and procedures to address disruptive behavior and decrease the frequency of this type of conduct.
Cavernosal Metastasis From Prostate Cancer on 18F-Fluciclovine PET/CT
Authors: Nguyen Ba D.
Published: September 2020

Uncommon penile metastasis from prostate cancer has been reported on PET/CT imaging with 18F-FDG, 18F-fluorocholine, 11C-choline, and 68Ga-PSMA. The author presents an additional case of 18F-fluciclovine PET/CT depiction of proximal and distal cavernosal metastases from prostate cancer with corresponding contrast-enhanced CT findings.
Pitfalls in the Detection of Insulinomas With Glucagon-Like Peptide-1 Receptor Imaging
Authors: Antwi Kwadwo , Hepprich Matthias , Müller Natasha A. , Reubi Jean Claude , Fani Melpomeni , Rottenburger Christof , Nicolas Guillaume , Kaul Felix , Christ Emanuel R. , Wild Damian
Published: September 2020

Purpose

Physiological pancreaticoduodenal uptake of radiolabeled exendin-4 in Brunner glands of the proximal duodenum is the most common pitfall for false interpretation of glucagon-like peptide-1 receptor (GLP-1R) imaging. The aim of this study was to analyze the pancreaticoduodenal uptake in GLP-1R PET/CT and SPECT/CT images and to identify additional potential reading pitfalls in patients with suspected insulinoma.

Methods

A post hoc analysis of a prospective study, including 52 consecutive patients, was performed. All patients underwent 1 68Ga-exendin-4 PET/CT and 2 111In-exendin-4 SPECT/CT scans (4 and 72 hours postinjection) in a randomized crossover order. Three board-certified nuclear medicine physicians read all scans independently. They were unaware of other results. Reference standard was surgery with histopathological confirmation of an insulinoma/nesidioblastosis and normalization of blood glucose levels after surgery.

Results

There were no false-positive readings. However, there were a number of false-negative PET/CT and SPECT/CT readings, respectively: (1) due to false interpretation of uptake in the pancreaticoduodenal region (falsely interpreted as physiological uptake in Brunner glands instead of an insulinoma in 0.6% vs 9.0%), (2) due to ectopic insulinoma (0% vs 2.6%), (3) due to small insulinoma (1.9% vs 5.1%), (4) due to insulinoma overlap with kidneys (1.9% vs 4.5%), and (5) due to nesidioblastosis (0.6% and 1.9%). Pitfalls were identified in all GLP-1R PET/CT and SPECT/CT scans.

Conclusions

Peripancreatic uptake, small size of an insulinoma, insulinoma overlap with kidneys, and presence of nesidioblastosis are potential pitfalls in GLP-1R imaging, which can lead to false reading results.
Clinical Impact of PET Imaging in Patients With Metastatic Prostate Cancer
Authors: Tuncel Murat , Tuncalı Meltem Çağlar , Telli Tuğçe , Erman Mustafa
Published: September 2020

Prostate cancer (Pca) is the most common cancer and the second leading cause of death among men. Although conventional bone scans and abdominal CT are preferred in most of the guidelines and clinical trials, PET/CT has already started to become the inevitable part of Pca management because of its higher sensitivity and specificity. Radiotracers used for PET imaging show different molecular aspects of the disease process. Although 68Ga–prostate-specific membrane antigen offers the highest sensitivity and specificity, other PET radiotracers such as 18F-FDG and 68Ga-DOTATATE still have a role in patients with prostate-specific membrane antigen–negative diseases such as Pca with neuroendocrine differentiation. In this pictorial essay, we have presented a series of patients with metastatic Pca who had PET images with different radiotracers and discussed the clinical role of this imaging modality in patient management.
99mTc-MDP Bone Scintigraphy in Gaucher Disease
Authors: Kesim Selin , Turoglu Halil Turgut , Tutar Engin , Ozguven Salih , Erdil Tanju Yusuf
Published: September 2020

In this case report, we present the bone scintigraphic findings of a 9-year-old boy with Gaucher disease who has a history of fractures to evaluate the extent of his osseous lesions. Gaucher disease is a genetic deficiency of lysosomal enzyme glucocerebrosidase, which results in the accumulation of glucocerebroside in the macrophages in the reticuloendothelial cells of the spleen, liver, and bone marrow. Most patients with type 1 Gaucher disease present a clinical or radiographic evidence of infiltrative bone disease. Lipid-filled macrophages called Gaucher cells infiltrate the bone marrow, leading to medullary expansion, diffuse osteoporosis, ischemic necrosis, and fractures.
Multimodality Imaging Features of a Misleading Sacral Giant Cell Tumor in 18F-FDG PET/CT, Bone Scan, and MRI
Authors: Dejust Sebastien , Jallerat Pascaline , Soibinet-Oudot Pauline , Jouannaud Christelle , Morland David
Published: September 2020

We report the case of an asymptomatic 66-year-old woman referred for initial staging of an invasive ductal breast carcinoma. Initial workup incidentally revealed a bone tumor of right sacral wing corresponding to a giant cell tumor (GCT). We present the imaging characteristics of GCT on 99mTc-HDP bone scan (doughnut sign), 18F-FDG PET/CT (intense and heterogeneous uptake of a prominent geographic lytic lesion with partial rupture of cortical), and MRI (hyposignal with gadolinium enhancement on T1-weighted images and heterogeneous hypersignal on T2-weighted images). GCT is a benign but locally aggressive primary bone tumor, constituting a pitfall and diagnostic challenge.
Quality and Safety in Healthcare, Part LXXV
Authors: Harolds Jay A. , Miller Laura B.
Published: September 2020

The Magnet Recognition Program® and the Pathway to Excellence® program of the American Nurses Credentialing Center are not only designed to improve the working conditions of nurses, but also to elevate nursing as a profession and ultimately increase quality, safety, and outcomes for patients. There is much overlap in the programs but the Magnet Recognition Program® specifically addresses outcomes and the Pathway to Excellence® program specifically addresses the well-being of nurses.
Non-Hodgkin Lymphoma With an Atypical Presentation
Authors: Shen Guohua , Kuang Anren
Published: September 2020

An 81-year-old woman was admitted with chest tightness and shortness of breath. Chest CT revealed massive pleural effusion on the right side as well as a right paravertebral soft tissue mass at the T8 to T10 level, showing intense enhancement. Her symptoms were successfully relieved by thoracentesis catheter drainage. On PET/CT, the paravertebral lesion demonstrated increased FDG uptake with an SUVmax of 7.5, indicating a suspected diagnosis of malignancy. Eventually, a CT-guided needle biopsy was performed, which confirmed the diagnosis of non-Hodgkin lymphoma.