bluuebunny/crossref_metadata_2025 huggingface dataset:
The localization of PHRAGMOPLAST ORIENTING KINESIN1 at the division site depends on the microtubule-binding proteins TANGLED1 and AUXIN-INDUCED IN ROOT CULTURES9 in Arabidopsis
Authors: Mills Alison M , Morris Victoria H , Rasmussen Carolyn G
Published: August 2022

Proper plant growth and development require spatial coordination of cell divisions. Two unrelated microtubule-binding proteins, TANGLED1 (TAN1) and AUXIN-INDUCED IN ROOT CULTURES9 (AIR9), are together required for normal growth and division plane orientation in Arabidopsis (Arabidopsis thaliana). The tan1 air9 double mutant has synthetic growth and division plane orientation defects, while single mutants lack obvious defects. Here we show that the division site-localized protein, PHRAGMOPLAST ORIENTING KINESIN1 (POK1), was aberrantly lost from the division site during metaphase and telophase in the tan1 air9 mutant. Since TAN1 and POK1 interact via the first 132 amino acids of TAN1 (TAN11–132), we assessed the localization and function of TAN11–132 in the tan1 air9 double mutant. TAN11–132 rescued tan1 air9 mutant phenotypes and localized to the division site during telophase. However, replacing six amino-acid residues within TAN11–132, which disrupted the POK1–TAN1 interaction in the yeast-two-hybrid system, caused loss of both rescue and division site localization of TAN11–132 in the tan1 air9 mutant. Full-length TAN1 with the same alanine substitutions had defects in phragmoplast guidance and reduced TAN1 and POK1 localization at the division site but rescued most tan1 air9 mutant phenotypes. Together, these data suggest that TAN1 and AIR9 are required for POK1 localization, and yet unknown proteins may stabilize TAN1–POK1 interactions.
Caring for a Person Living with Pain
Authors: Young Heather M. , Choula Rita B. , Reinhard Susan C.
Published: August 2022

Nurses play a key role in supporting family caregivers.
New Oral Form for ALS Drug
Authors: Aschenbrenner Diane S.
Published: August 2022

The Food and Drug Administration has approved an oral suspension form of edaravone (Radicava ORS) for the treatment of amyotrophic lateral sclerosis.

Edaravone should be taken on an empty stomach in the morning either by mouth or through a feeding tube. Feeding tubes should be flushed before and after drug administration.
Interrupting Biases in the Experience and Management of Pain
Authors: Booker Staja Q. , Baker Tamara A. , Epps Fayron , Herr Keela A. , Young Heather M. , Fishman Scott
Published: August 2022

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.

The articles in this new installment of the series provide practical information nurses can share with family caregivers of persons living with pain. To use this series, nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet—Information for Family Caregivers—and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.
Loss from Nurse Attrition Goes Deeper Than Numbers
Authors: Sato Hui-wen (Alina)
Published: August 2022

Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely—and often more personal—perspectives on professional, policy, and clinical issues. Best of the Blog is a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.
Improving Student Perceptions of Simulation Effectiveness With Co-Facilitation From Prebriefing Through Debriefing
Authors: de Rosa Cristina , Frost Erica , Ziegler Erin , Spies Martha
Published: August 2022

Co-facilitation (combining presence and expertise of clinical faculty and simulationists during all stages of simulation) presents an opportunity to improve student perceptions of effectiveness. Using a retrospective before and after comparison, data on students’ perceptions were collected from baccalaureate nursing students in clinical courses after each simulation experience. Mean differences in Simulation Effectiveness Tool-Modified scores for pre- and post-implementation were compared, as well as scores between levels of students. Statistically significant improvements in student-rated simulation effectiveness were found with co-facilitation. The authors recommend future studies expanding this methodology and considering co-facilitation where feasible.
End-of-Semester Report-Out: A Curriculum Evaluation Strategy
Authors: Lanz Amelia S. , Adams Marsha Howell , Frith Karen H.
Published: August 2022

An end-of-semester course -reporting strategy serves as one component of an overall curriculum evaluation plan. A framework specifying reporting criteria is used to guide the process. Report elements include integration of concepts in clinical, descriptions of active classroom learning strategies, testing data on concept performance, and exam statistics. Grade distribution and standardized testing scores are also reported. The report-out strategy has helped identify curricular strengths and weaknesses, encouraged instructional collaboration among faculty, informed decision-making, and contributed significantly to a successful curriculum transformation. The strategy has supported improved program outcomes in standardized testing scores and licensure pass rates.
A Systematic Approach to Nursing Curriculum Review Made Easier
Authors: Trent Peggy
Published: August 2022

The Nursing Curriculum Committee has a critical role in improving the quality of nursing programs and ensuring that standards from accreditation agencies and professional organizations are met. The work of the committee also presents opportunities for faculty to confirm that programs meet the needs of the community and address current trends. A systematic schedule for review helps with organization and ensures that all courses and programs are reviewed. Developing a systematic approach and sharing this information with faculty allows for a transparent method of reviewing courses and programs, as well as preparing faculty for their role in this process.
Caring for adults with hip pain
Authors: Munger Larry , Moore Amy Karen , Kearns Gary A. , Seth Shelly
Published: August 2022

This article discusses the pathophysiology, assessment techniques, and management of hip pain in adults and the role of nurses in caring for patients with hip pain.
A Call to Improve Health by Achieving the Learning Health Care System
Authors: Collard Harold R. , Grumbach Kevin
Published: August 2022

The learning health care system is an aspirational operational model for improving health care by learning from the care being delivered. The model, which has been endorsed by the National Academy of Medicine, aligns naturally with academic health systems, which have a mission to improve care for their communities through research and education. In this scholarly perspective, the authors define the learning health care system concept and its historical relationship to academic health systems; explore opportunities for and barriers to realizing the learning health care system; and propose actions to achieve the learning health care system at the local, regional, and national levels. The authors argue that the learning health care system model is essential to academic medicine’s evolution and to achieving the foundational societal mission of academic health systems to advance health through research and education.
Factors Associated With Perioperative Hospital Acquired Pressure Injury in Patients Undergoing Spine Surgery in the Prone Position: A Prospective Observational Study
Authors: Choi Seungeun , Kim Yoon Jung , Oh Hyongmin , Yuh Woon Tak , Lee Chang-Hyun , Yang Seung Heon , Kim Chi Heon , Chung Chun Kee , Park Hee-Pyoung
Published: August 2022

Background:

Hospital acquired pressure injury (HAPI) is associated with poor clinical outcomes and high medical costs. Patients undergoing surgery in the prone position are particularly vulnerable to perioperative HAPI. This prospective observational study investigated the factors associated with HAPI in patients undergoing elective spine surgery in the prone position.

Methods:

Two hundred eighty-seven patients undergoing elective spine surgery participated in this study. Demographics, perioperative vital signs, laboratory findings, surgical data, and intraoperative data were prospectively recorded. The sites and stages of HAPI were investigated on postoperative day 2. The stages of HAPI were evaluated using the pressure injury staging system of the National Pressure Ulcer Advisory Panel.

Results:

Perioperative HAPI was observed in 71 (24.7%) patients (stage 1, 40; stage 2, 31). The most frequent site (number) of HAPI was the upper extremities (33), followed by the chest (32), lower extremities (20), face (18), pelvis (10), and abdomen (9). In multivariate analysis, the duration of prone positioning per hour (odds ratio [95% confidence interval], 1.48 [1.25-1.74]; P<0.001) and intraoperative pH ≤7.35 (1.98 [1.05-3.76]; P=0.036) were associated with perioperative HAPI.

Conclusions:

The incidence of perioperative HAPI was 24.7% in patients undergoing elective spine surgery in the prone position. Long duration of prone positioning and intraoperative acidosis were associated with increased development of perioperative HAPI.
Predicting Aided Outcome With Aided Word Recognition Scores Measured With Linear Amplification at Above-conversational Levels
Authors: Fereczkowski Michal , Neher Tobias
Published: August 2022

Objectives:

Many hearing aid (HA) users receive limited benefit from amplification, especially when trying to understand speech in noise, and they often report hearing-related residual activity limitations. Current HA fitting strategies are typically based on pure-tone hearing thresholds only, even though suprathreshold factors have been linked to aided outcomes. Furthermore, clinical measures of speech perception such as word recognition scores (WRSs) are performed without frequency-specific amplification, likely resulting in suboptimal speech audibility and thus inaccurate estimates of suprathreshold hearing abilities. Corresponding measures with frequency-specific amplification (“aided”) would likely improve such estimates and enable more accurate aided outcome prediction. Here, we investigated potential links between either unaided WRSs or aided WRSs measured at several above-conversational levels and two established HA outcome measures: The Hearing-In-Noise Test (HINT) and the International Outcome Inventory for Hearing Aids (IOI-HA).

Design:

Thirty-seven older individuals with bilateral hearing impairments participated. Two conditions were tested: unaided and aided, with all stimuli presented over headphones. In the unaided condition, the most comfortable level (MCL) for the presented speech stimuli, WRS at MCL+10 dB as well as uncomfortable levels (UCLs) for narrowband noise stimuli were measured. In the aided condition, all stimuli were individually amplified according to the “National Acoustic Laboratories—Revised, Profound” fitting rule. Aided WRSs were then measured using an Interacoustics Affinity system at three above-conversational levels, allowing for the maximum aided WRS as well as the presence of “rollover” in the performance-intensity function to be estimated. Multivariate data analyses were performed to examine the relations between the HINT (measured using a simulated HA with the NAL-RP amplification) or IOI-HA scores (for the participants’ own HAs) and various potential predictors (age, pure-tone average hearing loss, unaided WRS, aided WRS, rollover presence [ROp], and UCL).

Results:

Aided WRSs predicted the HINT scores better than any other predictor and were also the only significant predictor of the IOI-HA scores. In addition, UCL and ROp in the aided WRSs were significant predictors of the HINT scores and competed for variance in the statistical models. Neither age nor pure-tone average hearing loss could predict the two aided outcomes.

Conclusions:

Aided WRSs can predict HA outcome more effectively than unaided WRSs, age or pure-tone audiometry and could be relatively easily implemented in clinical settings. More research is necessary to better understand the relations between ROp, UCL and speech recognition at above-conversational levels.
Trends in Outcomes of a Prospective Consecutively Enrolled Single-Center Adult Cervical Deformity Series
Authors: Passias Peter G. , Passfall Lara , Imbo Bailey , Williamson Tyler , Joujon-Roche Rachel , Krol Oscar , Tretiakov Peter , Kummer Nicholas A. , Lanre-Amos Tomi , Schoenfeld Andrew J. , De La Garza Rafael , Janjua Muhammad Burhan , Sagoo Navraj , Vira Shaleen , Diebo Bassel , Lafage Renaud , Protopsaltis Themistocles , Lafage Virginie
Published: August 2022

Study Design.

Retrospective cohort.

Objective.

To describe the 2-year outcomes for patients undergoing surgical correction of cervical deformity.

Background.

Adult cervical deformity (CD) has been shown to compromise health-related quality of life. While advances in spinal realignment have shown promising short-term clinical results in this parameter, the long-term outcomes of CD corrective surgery remain unclear.

Methods.

Operative CD patients >18 years with 2-year (2Y) HRQL/radiographic data were included. Improvement in radiographic, neurologic and HRQL outcomes were reported. Patients with a prior cervical fusion and patients with the greatest and smallest change based on NDI, NRS neck, mJOA were compared using multivariable analysis controlling for age, and frailty, and invasiveness.

Results.

158 patients were included in this study. By 2Y, 96.3% of patients improved in Ames cSVA modifier, 34.2% in TS-CL, 42.0% in Horizontal gaze modifier, and 40.9% in SVA modifier. Additionally, 65.5% of patients improved in Passias CL modifier, 53.3% in TS-CL modifier, 100% in C2-T3 modifier, 88.9% in C2S modifier, and 81.0% in MGS modifier severity by 2Y. The cohort significantly improved from BL to 2Y in NDI, NRS Neck, and mJOA, all P<0.05. 59.3% of patients met MCID for NDI, 62.3% for NRS Neck, and 37.3% for mJOA. 97 patients presented with at least one neurologic deficit at BL and 63.9% no longer reported that deficit at follow-up. There were 45 (34.6%) cases of DJK (∆DJKA>10° between LIV and LIV-2), of which 17 were distal junctional failure (DJF−DJK requiring reoperation). Patients with the greatest beneficial change were less likely to have had a complication in the 2-year follow-up period.

Conclusion.

Correction of cervical deformity results in notable clinical and radiographic improvement with most patients achieving favorable outcomes after two years. However, complications including distal junctional kyphosis or failure remain prevalent.
Wide Spectrum of Cardiac Phenotype in Myofibrillar Myopathy Associated With a Bcl-2-Associated Athanogene 3 Mutation: A Case Report and Literature Review
Authors: Akaba Yuichi , Takeguchi Ryo , Tanaka Ryosuke , Makita Yoshio , Kimura Takashi , Yanagi Kumiko , Kaname Tadashi , Nishino Ichizo , Takahashi Satoru
Published: August 2022

Myofibrillar myopathy is a clinically and genetically heterogeneous group of muscle disorders characterized by myofibrillar degeneration. Bcl-2-associated athanogene 3 (BAG3)-related myopathy is the rarest form of myofibrillar myopathy. Patients with BAG3-related myopathy present with early-onset and progressive muscle weakness, rigid spine, respiratory insufficiency, and cardiomyopathy. Notably, the heterozygous mutation (Pro209Leu) in BAG3 is commonly associated with rapidly progressive cardiomyopathy in childhood. We describe a male patient with the BAG3 (Pro209Leu) mutation. The patient presented at age 7 years with muscle weakness predominantly in the proximal lower limbs. Histologic findings revealed a mixture of severe neurogenic and myogenic changes. His motor symptoms progressed rapidly in the next decade, becoming wheelchair-dependent by age 17 years; however, at the age of 19 years, cardiomyopathy was not evident. This study reports a case of BAG3-related myopathy without cardiac involvement and further confirmed the wide phenotypic spectrum of BAG3-related myopathy.
Patient-Reported Symptom Burden of Charcot–Marie–Tooth Disease Type 1A: Findings From an Observational Digital Lifestyle Study
Authors: Thomas Florian P. , Saporta Mario A. , Attarian Shahram , Sevilla Teresa , Sivera Rafael , Fabrizi Gian M. , Genovese Filippo , Gray Amy J. , Bull Simon , Tanesse Daniel , Rego Manuel , Moore Allison , Hollett Courtney , Paoli Xavier , Sénéchal Thomas , Day Laura , Ouyang Chengyu , Llewellyn Samuel , Larkin Mark , Boutalbi Youcef
Published: August 2022

Objectives:

This study aims to explore the impact of Charcot–Marie–Tooth disease type 1A (CMT1A) and its treatment on patients in European (France, Germany, Italy, Spain, and the United Kingdom) and US real-world practice.

Methods:

Adults with CMT1A (n = 937) were recruited to an ongoing observational study exploring the impact of CMT. Data were collected via CMT&Me, an app through which participants completed patient-reported outcome measures.

Results:

Symptoms ranked with highest importance were weakness in the extremities, difficulty in walking, and fatigue. Almost half of participants experienced a worsening of symptom severity since diagnosis. Anxiety and depression were each reported by over one-third of participants. Use of rehabilitative interventions, medications, and orthotics/walking aids was high.

Conclusions:

Patient-reported burden of CMT1A is high, influenced by difficulties in using limbs, fatigue, pain, and impaired quality of life. Burden severity appears to differ across the population, possibly driven by differences in rehabilitative and prescription-based interventions, and country-specific health care variability.
Iodine-125 plaque brachytherapy for diffuse choroidal hemangioma
Authors: Azarcon Corrina P. , Qiu Richard L.J. , Sobol Ethan K. , Hubbard G. Baker , Craven Caroline M. , Bergstrom Chris S. , Wells Jill R.
Published: August 2022

Purpose:

To report 6 cases of diffuse choroidal hemangioma (DCH) in children treated with iodine-125 plaque brachytherapy at a single tertiary care center.

Methods:

Retrospective case series.

Results:

Six pediatric patients diagnosed with DCH were included in the study. Pre-plaque visual acuity (VA) ranged from 20/150 to no light perception (NLP). All patients had extensive serous retinal detachment at presentation. An iodine-125 radioactive plaque was placed on the affected eye to administer a dose of 34.2-42.1 Gy to the tumor apex over a median of 4 days. Tumor regression and subretinal fluid resolution were observed in all eyes within 17 months of treatment. Visual acuity improved in 2 patients. Radiation-induced cataract and subretinal fibrosis were documented in 1 case, and 1 patient developed radiation retinopathy. No patients developed neovascular glaucoma within a follow-up range of 12-65 months.

Conclusion:

Iodine-125 plaque radiotherapy is an effective option for DCH, although there is a risk for radiation-induced complications.
CENTRAL RETINAL VEIN OCCLUSION ASSOCIATED WITH USE OF AMYL NITRITE “POPPERS”
Authors: Lam Andrew , Gulati Shilpa , Foster Bradley S. , Lally David R.
Published: August 2022

Purpose:

To report a case of central retinal vein occlusion in a young patient after the use of amyl nitrate “poppers.”

Methods:

Description of the patient's clinical history, ophthalmic examination, retinal imaging, and treatment.

Results:

A 38-year-old man presented with a central retinal vein occlusion in his right eye after inhaling amyl nitrite “poppers.” There appeared to be a definitive temporal association between poppers use and both the onset of the vein occlusion and the patient's visual scotomata, which recurred immediately after drug use multiple times. Optical coherence tomography displayed cystic macular edema, which was treated with intravitreal bevacizumab. The patient's hypercoagulable laboratory workup was negative.

Conclusion:

This is the first report of a central retinal vein occlusion associated with poppers inhalation. A high index of suspicion for poppers use should be maintained in young patients who present with retinal vein occlusion, particularly in homosexual patients with a normal laboratory workup that fails to reveal a hypercoagulable etiology.
Paracentral Acute Middle Maculopathy with Sickle Cell Trait
Authors: Baker Mikayla , Neuhouser Adam , Nazari Hossein
Published: August 2022

Purpose:

To report a case of paracentral acute middle maculopathy in a pediatric patient with sickle cell trait.

Methods:

The patient was evaluated with a comprehensive ophthalmic examination, optical coherence tomography (OCT), optical coherence tomography angiography, and fluorescein angiography.

Results:

Acute loss of vision occurred immediately after an uneventful scleral buckling procedure for retinal detachment in a 16-year-old female. Retinal imaging studies confirmed the occurrence of paracentral acute middle maculopathy (PAMM), an ischemic condition characterized by infarction of the inner nuclear layer of the retina caused by hypoperfusion of the intermediate and deep capillary plexuses. Laboratory evaluation was only remarkable for sickle cell trait. Over a course of 3 months after the loss of vision, visual acuity improved from 20/1000 to 20/20, and OCT lesion resolved to a parafoveal area of inner and middle retinal layer thinning. Paracentral scotoma corresponding to the atrophic area persisted.

Conclusion:

Dehydration due to the presurgical non-per-os (NPO) status and transient increase in intraocular pressure during the buckling surgery may have predisposed this patient with sickle cell trait to a sickling event that caused localized ischemia in the middle retina’s end-capillaries. Avoiding long NPO status, being mindful of transient intraocular pressure elevation during scleral buckling procedures, and presurgical hemoglobin electrophoresis in at-risk populations are recommended to prevent sickling attacks during retinal surgeries in individuals with sickle cell trait.
The value of the SUV ratio between lymph node and bone marrow in predicting pelvic lymphatic metastasis of patients with locally advanced cervical cancer: an integrated PET/CT study
Authors: Liu Ying , Hua Jun , Liu Lisheng , Zhang Wei , Xu Shufan , Chen Xiaoliang
Published: August 2022

Purpose

This study aimed to evaluate the value of the standardized uptake value (SUV) ratio between lymph nodes and bone marrow (BM) measured by Fluorine-18-fluorodeoxyglucose PET and computed tomography (18F-FDG PET/CT) for predicting pelvic lymph node (PLN) metastasis in patients with locally advanced cervical cancer (LACC).

Materials and methods

A total of 62 patients with pathological stage Ib-IVa cervical cancer who underwent 18F-FDG PET/CT before treatment were reviewed retrospectively. We measured the metabolic and morphological parameters of lymph nodes and primary tumors, bone marrow SUV (SUVBM) and calculated the ratio of lymph nodes maximum SUV (SUVmax) to bone marrow SUV (SUVLN/BM) and the ratio of short-axis diameter to long-axis diameter (Ds/l) of lymph nodes. A receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic efficacy of each parameter.

Results

There were 180 lymph nodes with pathological evidence included in the study. Our results indicated that Ds/l, SUVmax of lymph nodes (SUVLN) and SUVLN/BM were independent risk factors for PLN metastasis in LACC (P < 0.05), and SUVLN/BM showed the best diagnostic performance by ROC curve analysis. The SUVBM in the anemia group was significantly higher than that in the nonanemia group (3.05 vs. 2.40, P < 0.05); furthermore, false-positive cases decreased when the SUVLN/BM was used as the diagnostic criterion instead of SUVLN, especially in the anemia group. ROC curve analysis showed that the area under the curve value of the combination of SUVLN/BM and Ds/l was 0.884 (P < 0.05), which was higher than Ds/l or SUVLN/BM alone.

Conclusions

SUVLN/BM could improve the ability to predicting PLN metastasis in patients with LACC, and the diagnostic efficacy of the combination of SUVLN/BM and Ds/l might be better than that of a single parameter.
The posterior tibial artery free flap for head and neck reconstruction
Authors: Kejner Alexandra E.
Published: August 2022

Purpose

The posterior tibial artery free flap (PTAFF) has been a mainstay of lower extremity reconstruction. Over the past 30 years, it has been intermittently used for head and neck reconstruction with recent renewed interest given its versatility.

Recent findings

Use of the PTAFF in head and neck reconstruction is expanding along with the continued evolution of microvascular techniques. Differences in overall health, incidence of smoking, and body habitus can impact the utility of this flap and should be taken into consideration when choosing to use it.

The PTAFF for head and neck reconstruction is a useful tool for the head and neck/reconstructive surgeon. Understanding the potential pitfalls and caveats to use of the PTAFF is important for successful use of this versatile flap.
Clinicopathologic Features and Genomic Signature of De Novo CD5+ Diffuse Large B-Cell Lymphoma
Authors: Sang Wei , Ma Yuhan , Wang Xiangmin , Ma Yuanyuan , Shen Ziyuan , Gu Weiying , Wang Fei , Ye Jingjing , Zhang Cuijuan , Miao Yuqing , Xu Chuanhai , Liu Qinhua , Li Bingzong , Tu Jian , Wang Chunling , Shi Yuye , Sun Su’an , Yan Dongmei , Song Xuguang , Sun Cai , Shao Yang , Xu Linyan , Li Zhenyu , Ma Dongshen , Xu Kailin , Young Ken H. , Liu Hui
Published: August 2022

De novo CD5+ diffuse large B-cell lymphoma (DLBCL) has poor survival in the era of immunochemotherapy. Accurate gene-based typing and prognostic stratification can enhance the development of effective individualized treatments. Therefore, we conducted a multicenter retrospective study to evaluate the clinicopathologic characteristics, genomic profiles, and prognostic parameters of 61 patients with CD5+ DLBCL and 60 patients with CD5− DLBCL, with the goal of facilitating accurate prognostic stratification and potential individualized treatment strategies. Compared with patients with CD5− DLBCL, older age, advanced stage, higher incidence of central nervous system involvement, and MYC/BCL-2 and p53 overexpression were more prevalent in CD5+ DLBCL. Most patients with CD5+ DLBCL had lymph nodes with non–germinal center B-cell–like or activated B-cell–like subtype according to immunohistochemistry or Lymph2Cx assay. Next-generation sequencing showed that the proportion of MCD subtype (based on the co-occurrence of MYD88 and CD79B mutations) in the CD5+ DLBCL cohort was higher than that in the CD5− DLBCL cohort (54.2% vs. 13.0%, P=0.005). Compared with the CD5− cohort, CD5+ DLBCL patients showed poor 5-year overall survival (70.9% vs. 39.0%, P<0.001). Kaplan-Meier survival analysis indicated that cell of origin, MYC/BCL-2, p53, and BCL-6 expression did not have a prognostic impact on patients with CD5+ DLBCL. Multivariate analysis showed that age above 76 years, advanced stage, higher incidence of central nervous system involvement, and hypoalbuminemia were independent factors for poor prognosis in CD5+ DLBCL patients. In summary, CD5+ DLBCL displays poor prognosis, distinctive clinicopathologic characteristics and predominant genetic features of activated B-cell–like and MCD subtypes with worse survival outcome.
Endoscopic Ultrasound for Diagnosis and Management of Pediatric Gastrointestinal Stromal Tumor
Authors: Krol Bridget C. , Rabinovich Hannah , Wichelt Natalie , Petty John , Linden Michael , McLean Thomas W. , Costa Peter
Published: August 2022

Gastrointestinal (GI) stromal tumors arise from the interstitial cells of Cajal and are rare in the pediatric population. The most common clinical manifestation is anemia secondary to GI bleeding. Endoscopy is commonly used for diagnostic and therapeutic interventions of an obstructing mass or gastrointestinal bleed, while experience with endoscopic ultrasound (EUS) and EUS fine needle aspiration (EUS-FNA) for pediatric patients with suspected gastric tumors is limited. We report 2 cases, a 14-year-old male and an 11-year-old female, who presented with symptomatic anemia. Both patients were diagnosed with GI stromal tumors of the stomach using EUS and EUS-FNA. This report shows that EUS and EUS-FNA are safe and effective diagnostic tools for pediatric patients.
Radial Nerve Paralysis in Diaphyseal Fractures of the Humerus
Authors: Ortega-Yago Amparo , Ferràs-Tarragó Joan , Jover-Jorge Nadia , Baixauli-Garcia Francisco
Published: August 2022

One of the most common complications associated with a diaphyseal humeral fracture is the development of a radial nerve injury. We conducted a study to analyze the degree of recovery and prognostic factors associated with radial nerve palsy in patients with diaphyseal humerus fractures. We retrospectively analyzed 28 patients who presented to the Hospital La Fe, Valencia, Spain, with a diaphyseal humerus fracture associated with radial nerve injury between 2010 and 2020. A total of 14.3% (n = 4) of the patients in our cohort had open fractures and 85.7% (n = 24) had closed fractures. There were no statistically significant differences between the type of treatment and the type of fracture (p = .13). There were also no significant differences between the type of treatment and recovery time (p = .42). There was a statistically significant difference (p = .04) in the mean recovery time for patients with preoperative radial nerve injuries (11.9 months) compared with patients who sustained a radial nerve injury secondary to surgical repair of the fracture (8.6 months). The difference in recovery time between patients with open and closed fractures was not statistically significant (p = .3). Results of the study showed that the type of fracture (i.e., open or closed) did not affect radial nerve palsy recovery time. Patients who sustain radial nerve injuries secondary to a surgical repair have a shorter recovery time than patients who sustain primary radial nerve injuries.
Connecting With the Untapped Millennial Market: Simple Strategies to Boost Conversion, Loyalty, and Per-Patient Spend in Your Aesthetic Practice
Authors: Neff Audrey M.
Published: August 2022

In 2020, it was forecast that the global medical aesthetic industry would grow at 14.9% CAGR (compound annual growth rate) and be worth $22.5 billion by the end of 2025 (Medical Insight Inc., 2021a). Within the total addressable aesthetics market, millennials represent the largest consumer group with full purchasing power, as well as the only generation expected to gain market share through 2025 (Medical Insight Inc., 2021b). This article discusses effective strategies aesthetic nurses can implement to connect with, convert, and build lifetime trust with the modern millennial patient, and to help fuel the growth and sustainability of the modern cash-pay aesthetic practice.
Where Are the Questions About Firearms?
Authors: Donelan Karen , Guzikowski Sophia , Buonomo Giancarlo , Galls Alexandra , Sacks Chana A. , Masiakos Peter T.
Published: August 2022

Objective:

To evaluate existing federal survey data infrastructure pertaining to firearms and firearm-related violence.

Background:

Firearm-related violence results in >40,000 deaths in the United States each year. Limited federal investments over the past 25 years have restricted a systematic approach to federal data collection related to firearms.

Methods:

We conducted a systematized review of the 22 continuously administered public health surveys in the US Federal Statistical System conducted between 1995 and 2020. Surveys were included if they addressed 1 of 4 areas of inquiry: (1) firearms; (2) exposure to or experience of firearm-related, intimate partner, or other interpersonal violence; (3) substance use and substance use disorder; (4) behavioral health. Descriptive statistics were used to report the frequency of relevant questions.

Results:

Nine of 22 surveys were focused on one of these domains and included in this analysis, 7 focused on adults (total 128 survey administrations over the study period) and 2 on youth and adolescents (total 30 administrations). Among all adult surveys, questions related to firearm use were asked 20% of the time, firearm-related violence 4%, firearm ownership 23%; in youth surveys, firearm use was addressed 0 times, firearm-related violence 57%, and firearm ownership 90%.

Conclusions:

Reliable national data are critical to understanding firearm-related violence as well as to developing, implementing, and evaluating public health measures to address it. Improving the consistency of questions pertaining to firearm access and experiences of violence in federal surveys offers an opportunity to improve national data infrastructure.
Bacillus circulans septicemia in a premature infant: a case report
Authors: Kundu Aditya , Maurya Kriti , Relhan Nidhi , Tak Vibhor , Gupta Neeraj , Nathan Thanigai , Chaudhary Sushil kumar , Singh Arun Kumarendu
Published: August 2022

In immunocompromised patients, Bacillus circulans is primarily regarded an opportunistic pathogen. This is a case report of septicaemia caused by Bacillus circulans in an extremely low birth weight preterm baby with respiratory distress. Although a laboratory contaminant but in immunocompromised host isolation of B. circulans should not be overlooked.
Whole-genome analysis of Haemophilus influenzae strains isolated from persons with cystic fibrosis
Authors: Fluit Ad C. , Bayjanov Jumamurat R. , Benaissa-Trouw Barry J. , Rogers Malbert R.C. , Díez-Aguilar María , Cantón Rafael , Tunney Michael M. , Elborn J. Stuart , Ekkelenkamp Miquel B.
Published: August 2022

Introduction.

Haemophilus influenzae

is a commensal of the respiratory tract that is frequently present in cystic fibrosis (CF) patients and may cause infection. Antibiotic resistance is well described for CF strains, and virulence factors have been proposed.

Hypothesis/Gap. The genetic diversity of

H. influenzae

strains present in the lungs of persons with CF is largely unknown despite the fact that this organism is considered to be a pathogen in this condition. The aim was to establish the genetic diversity and susceptibility of

H. influenzae

strains from persons with CF, and to screen the whole genomes of these strains for the presence of antibiotic resistance determinants and proposed virulence factors.

Methods. A total of 67 strains, recovered from respiratory samples from persons with CF from the UK (n=1), Poland (n=2), Spain (n=24) and the Netherlands (n=40), were subjected to whole-genome sequencing using Illumina technology and tested for antibiotic susceptibility. Forty-nine of these strains (one per different sequence type) were analysed for encoded virulence factors and resistance determinants.

Results. The 67 strains represented 49 different sequence types. Susceptibility testing showed that all strains were susceptible to aztreonam, ciprofloxacin, imipenem and tetracycline. Susceptibility to ampicillin, ampicillin/sulbactam, amoxicillin/clavulanic acid, cefuroxime, cefixime, ceftriaxone, cefepime, meropenem, clarithromycin, co-trimoxazole and levofloxacin ranged from 70.2–98.5%. Only 6/49 strains (12.2%) harboured acquired resistance genes. Mutations associated with a ß-lactamase-negative ampicillin-resistant phenotype were present in four strains (8.2 %). The potential virulence factors, urease, haemoglobin- and haptoglobin-binding protein/carbamate kinase, and OmpP5 (OmpA), were encoded in more than half of the strains. The genes for HMW1, HMW2,

H. influenzae

adhesin, a IgA-specific serine endopeptidase autotransporter precursor, a TonB-dependent siderophore, an ABC-transporter ATP-binding protein, a methyltransferase, a BolA-family transcriptional regulator, glycosyltransferase Lic2B, a helix–turn–helix protein, an aspartate semialdehyde dehydrogenase and another glycosyltransferase were present in less than half of the strains.

Conclusion. The

H. influenzae

strains showed limited levels of resistance, with the highest being against co-trimoxazole. Sequences encoding a carbamate kinase and a haemoglobin- and haemoglobin–haptoglobin-binding-like protein, a glycosyl transferase and an urease may aid the colonization of the CF lung. The adhesins and other identified putative virulence factors did not seem to be necessary for colonization.
Tracheostomy in children promotes persistent neutrophilic airway inflammation
Authors: Powell Jason , Powell Steven , Mather Michael W , Beck Lauren , Nelson Andrew , Palmowski Pawel , Porter Andrew , Coxhead Jonathan , Hedley Ann , Scott Jonathan , Rostron Anthony J , Hellyer Thomas P , Zaidi Fatima , Davey Tracey , Garnett James P , Agbeko Rachel , Ward Chris , Stewart Christopher J , Taggart Clifford C , Brodlie Malcolm , Simpson A John
Published: August 2022

Background

Tracheostomies in children are associated with significant morbidity, poor quality of life, excess healthcare costs, and excess mortality. The underlying mechanisms facilitating adverse outcomes in tracheostomised children are poorly understood. We aimed to characterise airway host defence in tracheostomised children using serial molecular analyses.

Methods

Tracheal aspirates, tracheal cytology brushings, nasal swabs and stool samples were prospectively collected from children with a tracheostomy and controls. Transcriptomic, proteomic, and metabolomic methods were applied to characterise the impact of tracheostomy on host immune response and the airway microbiome.

Results

Children followed up serially from the time of tracheostomy up to three months post-procedure (n=9) were studied. A validation cohort of children with a long-term tracheostomy was also enrolled (n=24). Controls (n=13) comprised children without a tracheostomy undergoing bronchoscopy. Tracheostomy was associated with new, rapidly emergent and sustained airway neutrophilic inflammation, superoxide production and evidence of proteolysis when compared with controls. In contrast, reduced airway microbial diversity was established pre-tracheostomy and sustained thereafter.

Conclusions

Childhood tracheostomy is associated with rapidly emergent and persistent airway neutrophil recruitment and activation, with sustained proteolysis and superoxide generation. These findings suggest neutrophil recruitment and activation as potential exploratory targets in seeking to prevent recurrent airway complications in this vulnerable group of patients.

Key message

The effect tracheostomy has on children is not described. Tracheostomy in children results in persistent local airway neutrophilic inflammation, proteolysis, superoxide production and dysbiosis.
Phenotype and genetic analysis of data collected within the first year of NeuroDev
Authors: Kipkemoi Patricia , Kim Heesu Ally , Christ Bjorn , O’Heir Emily , Allen Jake , Austin-Tse Christina , Baxter Samantha , Brand Harrison , Bryant Sam , Buser Nick , de Menil Victoria , Eastman Emma , Murugasen Serini , Galvin Alice , Kombe Martha , Ngombo Alfred , Mkubwa Beatrice , Mwangi Paul , Kipkoech Collins , Lovgren Alysia , MacArthur Daniel G. , Melly Brigitte , Mwangasha Katini , Martin Alicia , Nkambule Lethukuthula L. , Sanchis-Juan Alba , Singer-Berk Moriel , Talkowski Michael E. , VanNoy Grace , van der Merwe Celia ,   The NeuroDev Project, Newton Charles , O’Donnell-Luria Anne , Abubakar Amina , Donald Kirsten A , Robinson Elise
Published: August 2022

Genetic association studies have made significant contributions to our understanding of the aetiology of neurodevelopmental disorders (NDDs). However, the vast majority of these studies have focused on populations of European ancestry, and few include individuals from the African continent. The NeuroDev project aims to address this diversity gap through detailed phenotypic and genetic characterization of children with NDDs from Kenya and South Africa. Here we present results from NeuroDev’s first year of data collection, including phenotype data from 206 cases and clinical genetic analysis of 99 parent-child trios. The majority of the cases met criteria for global developmental delay/intellectual disability (GDD/ID, 80.3%). Approximately half of the children with GDD/ID also met criteria for autism, and 14.6% met criteria for autism alone. Analysis of exome sequencing data identified a pathogenic or likely pathogenic variant in 13 (17%) of the 75 cases from South Africa and 9 (38%) of the 24 cases from Kenya, as well as 7 total cases with suspicious variants of uncertain significance (VUS) in emerging disease genes that were matched through the MatchMaker Exchange. Data from the trio pilot cases has already been made publicly available, and the NeuroDev project will continue to develop resources for the global genetics community.
Expanding the Phenotypic spectrum ofNAA10-related neurodevelopmental syndrome andNAA15-related neurodevelopmental syndrome
Authors: Lyon Gholson J. , Vedaie Marall , Besheim Travis , Park Agnes , Marchi Elaine , Gottlieb Leah , Hsieh Tzung-Chien , Klinkhammer Hannah , Sandomirsky Katherine , Cheng Hanyin , Starr Lois J. , Preddy Isabelle , Tseng Marcellus , Li Quan , Hu Yu , Wang Kai , Carvalho Ana , Martinez Francisco , Caro-Llopis Alfonso , Gavin Maureen , Amble Karen , Krawitz Peter , Marmorstein Ronen , Herr-Israel Ellen
Published: August 2022

Amino-terminal (Nt-) acetylation (NTA) is a common protein modification, affecting 80% of cytosolic proteins in humans. The human essential gene,NAA10,encodes for the enzyme NAA10, which is the catalytic subunit in the N-terminal acetyltransferase A (NatA) complex, also including the accessory protein, NAA15. The full spectrum of human genetic variation in this pathway is currently unknown. Here we reveal the genetic landscape of variation inNAA10andNAA15in humans. Through a genotype-first approach, one clinician interviewed the parents of 56 individuals withNAA10variants and 19 individuals withNAA15variants, which were added to all known cases (N=106 forNAA10and N=66 forNAA15). Although there is clinical overlap between the two syndromes, functional assessment demonstrates that the overall level of functioning for the probands withNAA10variants is significantly lower than the probands withNAA15variants. The phenotypic spectrum includes variable levels of intellectual disability, delayed milestones, autism spectrum disorder, craniofacial dysmorphology, cardiac anomalies, seizures, and visual abnormalities (including cortical visual impairment and microphthalmia). One female with the p.Arg83Cys variant and one female with anNAA15frameshift variant both have microphthalmia. The frameshift variants located toward the C-terminal end ofNAA10have much less impact on overall functioning, whereas the females with the p.Arg83Cys missense in NAA10 have substantial impairment. The overall data are consistent with a phenotypic spectrum for these alleles, involving multiple organ systems, thus revealing the widespread effect of alterations of the NTA pathway in humans.
Model Choice Metrics to Optimize Profile-QSAR Performance
Authors: He Stewart , Kim Sookyung , McLoughlin Kevin S. , Ranganathan Hiranmayi , Shi Da , Allen Jonathan E.
Published: August 2022

Background

Predicting molecular activity against protein targets is difficult because of the paucity of experimental data. Approaches like multitask modeling and collaborative filtering seek to improve model accuracy by leveraging results from multiple targets, but are limited because different compounds are measured with different assays, leading to sparse data matrices. Profile-QSAR (pQSAR) 2.0 addresses this problem by fitting a series of partial least squares models for each target, using as features the predictions from single-task models on the remaining targets. This method has been shown to produce better results than single task and multitask models. However, the factors determining the success of pQSAR 2.0 have as yet not been characterized.

In this paper we examine the experimental conditions that lead to better pQSAR models. We limit the amount of data available to the method by retraining with decreasing amounts of data and explore the model’s ability to generalize to compounds that have never been assayed. Finally, we look at the properties of training data needed to demonstrate pQSAR improvement.

Results

We apply pQSAR 2.0 on a collection of GPCR and safety targets collected from Drug Target Commons, ExcapeDB, and ChEMBL. We found that pQSAR improved models on 34 of the 149 assays selected. In the other 115 assays, single task random forests offered better performance. There are many factors that contribute to an increase in performance, but the main factor is compound assay coverage. The pQSAR model improves when more compounds are measured in multiple assays.

Conclusion

It is necessary to consider the available data before applying pQSAR. Successful pQSAR models require a profile made of correlated targets that share compounds with other assays. This technique is best used when experimental data is available as random forest regressors often do not generalize well enough for virtual drug search applications.