Combined Solid Organ Transplant and Transfusion-Associated Graft-Versus-Host Disease in a Lung Transplant Recipient: An Uncertain Culprit With Lethal Complications.

Although graft-versus-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation, it is rare after solid organ transplantation (SOT) or blood transfusion. We present a rare case of SOT-derived and/or transfusion-associated graft-versus-host disease (TA-GVHD) in a 66-year-old man with interstitial lung disease who underwent bilateral lung transplantation (LT) from a 12-year-old female donor and required three units of packed red blood cells intraoperatively. He presented with signs and symptoms consistent with GVHD, and a bone marrow biopsy revealed an XX karyotype.

Diagnostic accuracy of telestroke consultation: a Louisiana based tele-network experience.

Background And Purpose: Telestroke has grown significantly since its implementation. Despite growing utilization, there is a paucity of data regarding the diagnostic accuracy of telestroke to distinguish between stroke and its mimics. We aimed to evaluate diagnostic accuracy of telestroke consultations and explore the characteristics of misdiagnosed patients with a focus on stroke mimics.

Toward an Integrated Context-Based Design Approach for Dementia Residential Care Homes: A Review of Key Operational Design Problems.

Objectives, Purpose, Or Aim: This article seeks to develop a context-based management system focusing on assessing key operational and design problems and affecting wayfinding in dementia residential care homes.

Background: Dementia is multifaceted neurocognitive impairments largely attributed to cognitive deterioration manifested in memory loss and visuospatial deficit which have wider practical implications to both environmental safety and wayfinding and navigation of dementia user. Two key questions were addressed in this context: (1) How can cognitively facilitating assistive technology (AT) be made more user-focused to mitigate the impacts of cognitive impairments on environmental safety and wayfinding? (2) How can design intervention and changes in design topology, colors and texture, and internal finishing aid wayfinding, navigation, and orientation in dementia residential care homes?

Method: A systematic literature review and analysis was undertaken to assess the efficacy of key cognitively-related AT to support activities of daily living and environmental safety of dementia sufferers in a care home and aid wayfinding, navigation, and orientation.

Detectability of Hibiscus Mealybug, Nipaecoccus viridis (Hemiptera: Pseudoccocidae), DNA in the Mealybug Destroyer, Cryptolaemus montrouzieri (Coleoptera: Coccinellidae), and Survey of Its Predators in Florida Citrus Groves.

The Hibiscus mealybug, Nipaecoccus viridis (Newstead), has recently established in Florida citrus and become a pest of concern given secondary pest outbreaks associated with management of citrus greening disease. Chemical controls used to manage other citrus arthropod pests are not as effective against N. viridis due to its waxy secretions, clumping behavior, and induced cellular changes to host plant tissue which increase microhabitats.

Provider perspectives and reach of an evidence-based intervention in community services for toddlers.

Expert recommendations for toddlers who are likely to develop autism include caregivers being actively involved in the services children receive. However, many services available in the community may not follow these recommendations. Evidence suggests that an intervention named Project ImPACT for Toddlers demonstrates positive parent and child outcomes for families in the community.

Through the Lens: Youth Experiences with Cancer in Rural Appalachian Kentucky Using Photovoice.

Rural Appalachian Kentucky experiences disproportionately high cancer incidence and mortality rates. This cancer burden is due to social determinants of health and cultural factors prominent in the region. The firsthand experiences of community members-especially young people-can highlight these factors and identify areas for improvement.

A Blueprint for the Conduct of Large, Multisite Trials in Telemedicine.

Recent literature supports the efficacy and efficiency of telemedicine in improving various health outcomes despite the wide variability in results. Understanding site-specific issues in the implementation of telemedicine trials for broader replication and generalizability of results is needed. Lessons can be learned from existing trials, and a blueprint can guide researchers to conduct these challenging studies using telemedicine more efficiently and effectively.

Ecological half-life of radiocesium in white-tailed deer on the Department of Energy's Savannah River Site: What can a half century of field monitoring tell us?

This paper estimates the Cs ecological half-life of white-tailed deer inhabiting the Department of Energy's Savannah River Site (SRS) based on sex and age using data collected over a 51-year time-period. With a physical half-life of 30.2 yr, the biological half-life for the deer herd is considerably shorter because of the isotope's biochemical mimicry of K+ inside the body.

Information Transfer and Multifractal Analysis of EEG in Mild Blast-Induced TBI.

Mild, blast-induced traumatic brain injury (mbTBI) is a common combat brain injury characterized by typically normal neuroimaging findings, with unpredictable future cognitive recovery. Traditional methods of electroencephalography (EEG) analysis (e.g.

Get SET Early to Identify and Treatment Refer Autism Spectrum Disorder at 1 Year and Discover Factors That Influence Early Diagnosis.

Objectives: To examine the impact of a new approach, Get SET Early, on the rates of early autism spectrum disorder (ASD) detection and factors that influence the screen-evaluate-treat chain.

Study Design: After attending Get SET Early training, 203 pediatricians administered 57 603 total screens using the Communication and Symbolic Behavior Scales Infant-Toddler Checklist at 12-, 18-, and 24-month well-baby examinations, and parents designated presence or absence of concern. For screen-positive toddlers, pediatricians specified if the child was being referred for evaluation, and if not, why not.

Thrombolytic therapy for wake-up stroke: A systematic review and meta-analysis.

Background And Purpose: According to evidence-based clinical practice guidelines, patients presenting with disabling stroke symptoms should be treated with intravenous tissue plasminogen activator (IV tPA) within 4.5 h of time last known well. However, 25% of strokes are detected upon awakening (i.

Patient Perspectives With Telehealth Visits in Cardiology During COVID-19: Online Patient Survey Study.

Background: The rise of COVID-19 and the issue of a mandatory stay-at-home order in March 2020 led to the use of a direct-to-consumer model for cardiology telehealth in Kentucky. Kentucky has poor health outcomes and limited broadband connectivity. Given these and other practice-specific constraints, the region serves as a unique context to explore the efficacy of telehealth in cardiology.

REPRINT OF: The Behavioral Risk Factor Surveys: I. State-Specific Prevalence Estimates of Behavioral Risk Factors.

Editor's Note: This article is a reprint of a previously published article. For citation purposes, please use the original publication details: Marks JS, Hogelin GC, Gentry EM, et al. The Behavioral Risk Factor Surveys: I.

Pediatric Scurvy: How an Old Disease Is Becoming a New Problem.

Ascorbic acid (vitamin C) functions as a cofactor and antioxidant within the human body that enables tissue growth and repair, but vitamin C is not intrinsically produced. Scurvy, or ascorbic acid deficiency, has traditionally been viewed as a historical disease. With the incidence of autism spectrum disorder and food restriction on the rise, children's hospitals may see increasing cases of scurvy.

Exposure to 17β estradiol causes erosion of sexual dimorphism in Bluegill (Lepomis macrochirus).

Estrogenic compounds including 17β estradiol (or E2) are known to negatively affect the reproductive system of many animals, including fish, leading to feminization, altered sex ratio, reduced fecundity, and decreased gonadosomatic index. The objective of this study was to evaluate the effects of varying concentrations of water-soluble 17β estradiol exposure on the external morphology of Bluegill. An experiment was set up where fish were individually maintained in 10-g tanks and exposed to 17β estradiol concentrations of 40 and 80 ng/L or no 17β estradiol exposure (the control).

Physical Function Measured Prior to Lung Transplantation Is Associated With Posttransplant Patient Outcomes.

Introduction: The primary objective of this study was to determine whether pretransplant physical function is correlated with posttransplantation outcomes.

Methods: We performed a retrospective study of patients that participated in pretransplantation screening and subsequently underwent lung transplantation. Pretransplant variables of interest included demographics, muscle mass, body composition, physical function, and physical frailty.

The fifth vital sign? Nurse worry predicts inpatient deterioration within 24 hours.

Introduction: Identification of hospitalized patients with suddenly unfavorable clinical course remains challenging. Models using objective data elements from the electronic health record may miss important sources of information available to nurses.

Methods: We recorded nurses' perception of patient potential for deterioration in 2 medical and 2 surgical adult hospital units using a 5-point score at the start of the shift (the Worry Factor [WF]), and any time a change or an increase was noted by the nurse.

Targeting the High-Mobility Group Box 3 Protein Sensitizes Chemoresistant Ovarian Cancer Cells to Cisplatin.

Chemotherapeutic regimens for ovarian cancer often include the use of DNA interstrand crosslink-inducing agents (e.g., platinum drugs) or DNA double-strand break-inducing agents.

The Physiological Impact of Window Murals on Pediatric Patients.

Objectives: To examine the magnitude of impact of two nature-themed window murals on physiological processes, as measured by heart rate and blood pressure, of pediatric patients.

Background: Many children and adolescents find at least one aspect of the hospitalization process frightening or anxiety provoking. One physical feature linked to stress reduction is access to positive distractions.

The development and use of a spatially explicit model for river otters to evaluate environmental hazards: a case study on the Department of Energy's Savannah River Site.

The Department of Energy's (DOE) Savannah River Site (SRS) faces a legacy of radionuclide and metal contamination from industrial processes that occurred throughout the site. Northern river otters (Lontra canadensis) are appropriate receptors for studying the effects of long-term, low-level contamination because they are long-lived, higher trophic level organisms susceptible to accumulating high levels of pollutants. The purpose of this study was to use latrine surveys to examine patterns of wetland latrine usage; explicitly model northern river otter resource selection on the landscape level; and utilize the model results within an ecological risk assessment (ERA) framework to assess potential effects of metals and radiocesium (Cs) on the population for the SRS as a case study.

Patient-reported distress and survival among patients receiving definitive radiation therapy.

Objective: Patient-reported distress (PRD) has not been well assessed in association with survival after radiation therapy (RT). The aims of this study were to evaluate the association between PRD level and survival after definitive RT and to identify the main causes of distress in definitive RT patients.

Methods And Materials: A total of 678 consecutive patients receiving definitive RT at our institution from April 2012 through May 2015 were included.

Microbial community structure of a freshwater system receiving wastewater effluent.

Despite our dependency on treatment facilities to condition wastewater for eventual release to the environment, our knowledge regarding the effects of treated water on the local watershed is extremely limited. Responses of lotic systems to the treated wastewater effluent have been traditionally investigated by examining the benthic macroinvertebrate assemblages and community structure; however, these studies do not address the microbial diversity of the water systems. In the present study, planktonic and benthic bacterial community structure were examined at 14 sites (from 60 m upstream to 12,100 m downstream) and at two time points along an aquatic system receiving treated effluent from the Charleston Wastewater Treatment Plant (Charleston, IL).

Neuropsychological assessment of executive functions following pediatric traumatic brain injury.

Assessment of executive functions in the adult is best captured at the stage where full maturation of brain development occurs. Assessment of executive functions of children, however, is considerably more complicated. First, assessment of executive functioning in children represents a snapshot of these developing functions at a particular time linked stage, which may have implications for further development.

Characteristics and Patterns of Rare Malignancies Published in Rare Tumors.

Rare Tumors is an international peer-reviewed medical journal established in 2009. The journal is focused on rare cancers and aims to expand upon current knowledge on their presentation, diagnosis, management, and outcomes. We reviewed the 335 case reports published from 2009 to 2015.