Acute Care Utilization After Recovery Coaching Linkage During Substance-Related Inpatient Admission: Results of Two Randomized Controlled Trials.

Background: For patients with substance use disorder (SUD), a peer recovery coach (PRC) intervention increases engagement in recovery services; effective support services interventions have occasionally demonstrated cost savings through decreased acute care utilization.

Objective: Examine effect of PRCs on acute care utilization.

Design: Combined results of 2 parallel 1:1 randomized controlled trials.

Incidental Diagnosis of Adult Beta-Thalassemia With Point-of-Care Ultrasound in the Emergency Department: A Case Report.

Beta-thalassemia is an autosomal recessive hemoglobinopathy that can result in microcytic hypochromic anemia, splenomegaly, hypercoagulability, and long-term sequelae. Beta-thalassemia intermedia, specifically, is diagnosed based on the moderate severity of illness, which does not carry the early symptomatic urgency of beta-thalassemia major, although patients of both often become chronically or intermittently transfusion-dependent. A presenting symptom may be splenomegaly, which is most efficiently detected with a combination of physical examination and point-of-care ultrasound (POCUS).

Clear cell carcinoma of the pelvic side wall arising from endometriosis.

Endometriosis is a condition wherein an ectopic layer of endometrial tissue arises in an extra-uterine location, often effecting significant pelvic pain and infertility. While very uncommon, there have been reported cases of endometriosis undergoing malignant transformation, frequently involving the ovaries and seldom in extra-gonadal regions. We recount a case depicting a 63 year-old woman who presented with an apparent inguinal hernia in 2017; she was ultimately diagnosed with a pelvic side wall clear cell carcinoma and attendant metastatic disease to the medial groin, which emanated from endometriosis.

Point-of-Care Ultrasound in Established Settings.

The original and most widely accepted applications for point-of-care ultrasound (POCUS) are in the settings of trauma, shock, and bedside procedures. Trauma was the original setting for the introduction of POCUS and has been standardized under the four-plus view examination called the Focused Assessment with Sonography in Trauma (FAST). This examination was found to be especially practice changing for achieving rapid diagnoses in critically ill patients who are too unstable for the delays and transportation inherent in more advanced imaging with computed tomography.

Analysis of Factors Associated With In-hospital Mortality in Lung Cancer Chemotherapy Patients With Neutropenia.

Lung cancer, compared with other solid tumors, is associated with high mortality rates from febrile neutropenia. The risk factors associated with in-hospital mortality were identified and compared for patients with lung cancer and patients with other solid tumors. Hospitalization data from the University Health Consortium database inclusive of 2004 to 2012 were analyzed.

Nurses' Perceptions of Self as Role Models of Health.

This study purposed to determine the relationship between nurses' personal health practices and their perceptions of themselves as role models for health promotion, and assess the relationship of personal and professional characteristics both on perception of self as role model and on the practice of healthy behaviors. In this study of 804 Tennessee registered nurses, 4% report smoking, 24.9% drink alcohol, 34% are overweight, and 30% are obese.

Using a Radial Diffusion Method to Investigate the Role of Plasmin Degradation of Fibrin in a Physical Model of an Early-phase Wound.

Background: Fibrin clot formation, which acts to stabilize a wound following injury, is among the key early aspects of dermal wound healing. This preliminary matrix is eventually degraded via a process known as fibrinolysis and replaced with a collagen-rich matrix that continues to be remodeled to minimize scarring. Disruptions in these carefully coordinated events lead to certain undesirable conditions such as fibrosis and the formation of abnormal scars that are associated with excess amounts of collagen.

Versatile, Reusable, and Inexpensive Ultrasound Phantom Procedural Trainers.

We have constructed simple and inexpensive models for ultrasound-guided procedural training using synthetic ballistic gelatin. These models are durable, leak resistant, and able to be shaped to fit a variety of simulation scenarios to teach procedures. They provide realistic tactile and sonographic training for our learners in a safe, idealized setting.

Slashing the timelines: Opting to generate high-titer clonal lines faster via viability-based single cell sorting.

Chinese hamster ovary (CHO) cell line development (CLD) is a long and laborious process, which requires up to 5 - 6 months in order to generate and bank CHO lines capable of stably expressing therapeutic molecules. Additionally, single cell cloning of these production lines is also necessary to confirm clonality of the production lines. Here we introduce the utilization of viability staining dye in combination with flow cytometer to isolate high titer clones from a pool of selected cells and single cell deposit them into the wells of culture plates.

Management of axillary disease.

The presence of nodal metastases is the most important prognostic indicator in breast cancer, making accurate assessment of the axillary nodal basin critical to delivering optimal therapy in breast cancer. Clinically node-negative women can be reliably staged in a minimally invasive manner using sentinel lymph node dissection (SLND). In node-negative patients receiving neoadjuvant chemotherapy, SLND can be performed after chemotherapy, allowing for a single surgical procedure and a decreased probability of requiring axillary lymph node dissection (ALND).

Minireview: DNA replication in plant mitochondria.

Higher plant mitochondrial genomes exhibit much greater structural complexity compared to most other organisms. Unlike well-characterized metazoan mitochondrial DNA (mtDNA) replication, an understanding of the mechanism(s) and proteins involved in plant mtDNA replication remains unclear. Several plant mtDNA replication proteins, including DNA polymerases, DNA primase/helicase, and accessory proteins have been identified.

Multidisciplinary treatment of pelvic and cardiac intravenous leiomyosarcomatosis.

•Intravenous leiomyosarcomatosis is a rare condition in which malignant myometrial tissue metastasizes to the heart.•We discuss the complicated diagnosis and treatment of a patient afflicted with intravenous leiomyosarcomatosis.•To ensure a favorable prognosis, therapy should comprise comprehensive and multi-disciplinary treatment.

A very rare case of synchronous carcinomas of the endometrium and ovary with peritoneal keratin granulomatous involvement.

► Peritoneal keratin granulomas infrequently manifest themselves in conjunction with gynecologic cancer. ► We report on a patient with synchronous ovarian and uterine cancers that contained extensive keratin granulomas. ► Comprehensive pathologic sampling may be essential to conferring optimal patient management.

Host genetic background impacts modulation of the TLR4 pathway by RON in tissue-associated macrophages.

Toll-like receptors (TLRs) enable metazoans to mount effective innate immune responses to microbial and viral pathogens, as well as to endogenous host-derived ligands. It is understood that genetic background of the host can influence TLR responsiveness, altering susceptibility to pathogen infection, autoimmunity and cancer. Macrophage stimulatory protein (MSP), which activates the receptor tyrosine kinase recepteur d'origine nantais (RON), promotes key macrophage functions such as motility and phagocytic activity.

The Arabidopsis At1g30680 gene encodes a homologue to the phage T7 gp4 protein that has both DNA primase and DNA helicase activities.

Background: The Arabidopsis thaliana genome encodes a homologue of the full-length bacteriophage T7 gp4 protein, which is also homologous to the eukaryotic Twinkle protein. While the phage protein has both DNA primase and DNA helicase activities, in animal cells Twinkle is localized to mitochondria and has only DNA helicase activity due to sequence changes in the DNA primase domain. However, Arabidopsis and other plant Twinkle homologues retain sequence homology for both functional domains of the phage protein.

A rare case of primary retroperitoneal mucinous adenocarcinoma: a case report.

Background: Primary retroperitoneal mucinous adenocarcinomas are very rare tumors that resemble ovarian mucinous cystadenocarcinomas.

Case: A 39-year-old woman presented with a 20-cm cystic lesion. Following surgery final pathology revealed mucinous adenocarcinoma consistent with a primary retroperitoneal process.

Arabidopsis thaliana organellar DNA polymerase IB mutants exhibit reduced mtDNA levels with a decrease in mitochondrial area density.

Plant organelle genomes are complex and the mechanisms for their replication and maintenance remain unclear. Arabidopsis thaliana has two DNA polymerase genes, DNA polymerase IA (polIA) and polIB, that are dual targeted to mitochondria and chloroplasts and are differentially expressed in primary plant tissues. PolIB gene expression occurs at higher levels in tissues not primary for photosynthesis.

Primary small cell neuroendocrine carcinoma of the endometrium.

Background: Small cell neuroendocrine carcinoma is very rarely encountered within the endometrium.

Case Study: A patient underwent a hysterectomy and salpingo-oophorectomy for a suspicious gynecologic condition. Pathology revealed invasive small cell neuroendocrine carcinoma of the endometrium; the neoplasm exhibited positive immunoreactivity for synaptophysin, pancytokeratin and CD56 but was negative for CD3 and CD20.

Phosphorylation of NLRC4 is critical for inflammasome activation.

NLRC4 is a cytosolic member of the NOD-like receptor family that is expressed in innate immune cells. It senses indirectly bacterial flagellin and type III secretion systems, and responds by assembling an inflammasome complex that promotes caspase-1 activation and pyroptosis. Here we use knock-in mice expressing NLRC4 with a carboxy-terminal 3×Flag tag to identify phosphorylation of NLRC4 on a single, evolutionarily conserved residue, Ser 533, following infection of macrophages with Salmonella enterica serovar Typhimurium (also known as Salmonella typhimurium).

Effect of introducing hematoma ultrasound-guided lumpectomy in a surgical practice.

Background: Preoperative needle localization (NL) is the gold standard for lumpectomy of nonpalpable breast cancer. Hematoma ultrasound-guided (HUG) lumpectomy can offer several advantages. The purpose of this study was to compare the use of HUG with NL lumpectomy in a single surgical practice.

Recurrent lymphatic ascites in a patient cured of cervical carcinoma.

► Lymphatic ascites is a rare complication attributed to abdominal or thoracic trauma. ► We report on a patient who developed two prolonged bouts of recurrent lymphatic ascites. ► The patient's lymphatic ascites occurring 20 years later is very unusual.

Complex retrieval of embedded IVC filters: alternative techniques and histologic tissue analysis.

Purpose: We evaluated the safety and effectiveness of alternative endovascular methods to retrieve embedded optional and permanent filters in order to manage or reduce risk of long-term complications from implantation. Histologic tissue analysis was performed to elucidate the pathologic effects of chronic filter implantation.

Methods: We studied the safety and effectiveness of alternative endovascular methods for removing embedded inferior vena cava (IVC) filters in 10 consecutive patients over 12 months.

Pannexin-1 is required for ATP release during apoptosis but not for inflammasome activation.

Apoptotic cell death is important for embryonic development, immune cell homeostasis, and pathogen elimination. Innate immune cells also undergo a very rapid form of cell death termed pyroptosis after activating the protease caspase-1. The hemichannel pannexin-1 has been implicated in both processes.

Psychological health in patients with ALS is maintained as physical function declines.

Although quality of life (QoL) in patients with ALS has been shown to be independent of physical function and to be maintained over time, the status of psychological health over the disease course has not been studied using an ALS-specific instrument. It is also uncertain how three common interventions - antidepressants, percutaneous endoscopic gastrostomy (PEG), and non-invasive ventilatory support (NIPPV) - influence psychological health. We performed a retrospective review of the Negative Emotion subscale (NES) score, a measure of psychological health within the ALS-Specific QoL Instrument.

The excimer laser sheath technique for embedded inferior vena cava filter removal.

An inferior vena cava (IVC) filter became embedded within the IVC of a 45-year-old man after prolonged implantation. Because of incorporation of the filter legs within the caval endothelium, the filter was densely adherent and could not be sheathed using standard retrieval methods. In this patient, the authors performed percutaneous filter retrieval using an excimer laser sheath technique for circumferential ablation of dense fibrotic tissue between the filter and IVC.