Impact of putatively beneficial genomic loci on gene expression in little brown bats (, Le Conte, 1831) affected by white-nose syndrome.

Genome-wide scans for selection have become a popular tool for investigating evolutionary responses in wildlife to emerging diseases. However, genome scans are susceptible to false positives and do little to demonstrate specific mechanisms by which loci impact survival. Linking putatively resistant genotypes to observable phenotypes increases confidence in genome scan results and provides evidence of survival mechanisms that can guide conservation and management efforts.

Impacts of coyote colonization on coastal mammalian predators.

Extreme ecosystem modification by humans has caused drastic reductions in populations and ranges of top mammalian predators, while simultaneously allowing synanthropic mesopredator species to expand. These conditions often result in inflated local densities of highly adaptable mesopredators that disrupt trophic dynamics and place unsustainable predation pressure on native prey populations. Colonization of a dominant predator may lead to top-down control of mesopredators and restore trophic balance.

Genomic signatures of selection in bats surviving white-nose syndrome.

Rapid evolution of advantageous traits following abrupt environmental change can help populations recover from demographic decline. However, for many introduced diseases affecting longer-lived, slower reproducing hosts, mortality is likely to outpace the acquisition of adaptive de novo mutations. Adaptive alleles must therefore be selected from standing genetic variation, a process that leaves few detectable genomic signatures.

"Save the Vein" Initiative in Children With CKD: A Quality Improvement Study.

Rationale & Objective: The preferred vascular access for hemodialysis recipients is an arteriovenous fistula in the nondominant arm. Prior placement of a peripheral intravenous (PIV) catheter can lead to vascular injury and limit options for arteriovenous fistula creation, a particular problem for children, who may need hemodialysis for their entire lifetime. We instituted an initiative to increase the frequency of PIV catheter placement in the dominant arm for hospitalized pediatric patients with advanced chronic kidney disease (CKD).

Conversion to Prepectoral Breast Implant Reconstruction after Chest Wall Resection for Desmoid Tumor.

Supplemental Digital Content is available in the text.

A Community Hospital's Response to the COVID-19 Pandemic.

The novel coronavirus 2019-nCoV (COVID-19) has disrupted and altered the way health care is delivered in the United States and across the world. Patient care guidelines and isolation recommendations continue to hastily change, demonstrating the key role of nursing professional development practitioners in educating and preparing frontline staff to provide safe patient care during the COVID-19 pandemic. This article describes a community hospital's strategic educational response to a highly contagious respiratory pandemic.

Primary Mediastinal Small Cell Neuroendocrine Carcinoma Presenting with Superior Vena Cava Syndrome.

A mediastinal small cell neuroendocrine carcinoma (MSCNC) is a rare form of neuroendocrine malignancy. Diagnosis is challenging and requires pathological identification and imaging studies. These tumors are aggressive and recurrence and metastases frequently complicate patient management.

Evaluation and management of an unusual congenital nevus.

Abnormal findings on routine skin exams are common and can be a source of unnecessary medical workup if a clinician is unfamiliar with the finding. Sebaceous nevi are rare skin lesions that are most often benign but may be associated with a multiorgan syndrome or local skin cancer. Dermatologists and primary care physicians may encounter these on routine exams and thus must be comfortable with diagnosis and management.

Chirosurveillance: The use of native bats to detect invasive agricultural pests.

Invasive insect pests cost the agricultural industry billions of dollars annually in crop losses. Timely detection of pests is critical for management efficiency. Innovative pest detection strategies, such as environmental DNA (eDNA) techniques, combined with efficient predators, maximize sampling resolution across space and time and may improve surveillance.

Lymphoma of prosthetic aortic graft presenting as recurrent embolization.

We describe the case of a patient who presented with transient ischemic attack 4 years after bicuspid aortic valve repair, ascending aorta, and hemiarch replacement. Workup included cross-sectional imaging consistent with thrombus in the ascending aorta graft. Warfarin was initiated, but another episode of cerebral ischemia occurred despite therapeutic anticoagulation.

Avoidance of lower-limb amputation by surgical implantation of autologous stem cells.

A 69-year-old Caucasian man was referred to Baylor University Medical Center at Dallas with resting lower-extremity pain and a nonhealing sore above his right ankle (Rutherford chronic ischemia stage 5 of 6) after having failed multiple attempts at revascularization. He was enrolled in a clinical research trial using adult autologous stem cells for treatment of critical limb ischemia. Autologous stem cells from the patient's pelvic bone marrow were harvested, concentrated in the operating room, and reinjected into the lower leg along the vasculature below the level of complete occlusion of the popliteal artery and around the ulcer.

The role of the Internet in improving healthcare quality.

The Internet is a tool that has the potential to greatly affect and improve the quality of healthcare. This article discusses the ways in which the Internet is being utilized by healthcare administrators, physicians, and healthcare consumers to enhance the quality of care. Despite the Internet's growing popularity and use, several barriers remain that prevent its full implementation in the healthcare field.

The clinical manifestations of Degos' syndrome.

Pathologic mechanisms underlying Degos' syndrome are poorly characterized. Thrombosis, either as a consequence of a postulated vasculitis or as a primary defect, is often a clinical complication of this syndrome. We have studied multiple coagulation parameters, including potential defects in fibrin assembly and other adhesive proteins, in a patient with Degos' syndrome and found no specific abnormality to explain the pathologic features of this syndrome.