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FOXR2 activation is not exclusive of CNS neuroblastoma
No full textBackground:FOXR2 activation is regarded as pathognomonic for CNS neuroblastoma (NB). However, a comprehensive understanding of the landscape for CNS tumors exhibiting FOXR2 activation is lacking.
Methods:Histopathologic, molecular, imaging, and clinical data of 42 CNS tumors with FOXR2 overexpression identified through screening institutional datasets and published institutional cases were analyzed.
Results:Among the 42 tumors, 21 (50.0%) were high-grade gliomas (HGGs), and 18 (42.9%) were embryonal tumors. The HGGs included ten H3 K27M-mutant diffuse midline gliomas (DMGs) and eight radiation-associated tumors. The embryonal tumors included 11 CNS NBs and six pineoblastomas (PBs). FOXR2 expression was similar between CNS NB and other tumor types (P = 0.82). HGGs with FOXR2 overexpression, unlike NBs and PBs, displayed diverse concomitant genetic alterations. The most common mechanisms of FOXR2 activation involved structural alterations causing promoter donation and enhancer hijacking from active genes essential for brain development, followed by alternative promoter activation or truncated LINE-1 retrotransposition. The preferential activation mechanism varied by tumor type. All but two aberrant FOXR2 transcripts incorporated non-canonical, non-coding exons. Gene set enrichment analysis demonstrated shared downstream effects of FOXR2 activation at the epigenome and transcriptome levels across tumor types. DMGs and PBs with FOXR2 overexpression were aggressive, with 0% 2-year overall survival, whereas CNS NBs responded well to combined chemotherapy and radiation.
Conclusions:CNS tumors with FOXR2 overexpression manifest significant histological, molecular, imaging, and clinical diversity. While HGGs and PBs with FOXR2 overexpression demonstrated inferior prognosis, CNS NBs showed favorable outcomes. Integrating histologic and molecular diagnostic approaches is imperative for accurate prognostication and optimal therapeutic decision-making
Strengthening nursing research communication: Implementing R-SBAR in Magnet® hospitals
No full textThe SBAR (situation, background, assessment, recommendation) tool is effective for clear communication in healthcare settings. This article discusses adapting SBAR for research dissemination in Magnet® hospitals. A pilot at 2 Magnet™ sites evaluated the Research SBAR\u27s effectiveness, with the majority of nurses agreeing on its utility as a research communication tool
Results of the 2020-2023 Association of Residents in Radiation Oncology graduating resident survey: Job search experience and satisfaction
No full textPurpose:To better understand radiation oncology (RO) resident experiences navigating the job market, responses from the 2020-2023 Association of Residents in Radiation Oncology Graduating Resident Surveys were analyzed and compared.
Methods and materials:All identified postgraduate year 5 RO residents in the United States were sent a 50 to 58 question survey in May of their respective graduating year. Responses were collected in a deidentified database. Descriptive statistics were generated. Univariable and multivariable logistic regression analyses (MVA) were performed to identify predictors of overall satisfaction/dissatisfaction with accepted positions and agreement that the job market was tough.
Results:The aggregate response rate was 86.9%. Very few (0%-1.8%) respondents did not have a signed offer at survey completion. The percentage who strongly agreed or agreed that the job market was tough was 39.3% in 2020, 69.9% in 2021, 25.7% in 2022, and 16.2% in 2023. The percentage of respondents who were strongly dissatisfied or dissatisfied with their accepted job position was 6.2% in 2020, 3.6% in 2021, 1.4% in 2022, and 0.6% in 2023. In MVA, significant predictors of feeling that the job search was not tough included the year of job search (2020 [reference]; 2021 [odds ratio {OR}, 0.31; CI, 0.17-0.57; P \u3c .01]; 2022 [OR, 2.68; CI, 1.66-4.33; P \u3c .01]; 2023 [OR, 3.23; CI, 2.02-5.17; P \u3c .01]) and satisfaction with one\u27s residency program\u27s mentorship in the job search (OR, 1.69; CI, 1.08-2.64; P = .02). In MVA, predictors of overall satisfaction with an accepted position included mentorship during the job search (OR, 4.93; CI, 2.45-9.93; P \u3c .01) and practice setting (urban [reference]; rural [OR, 0.29; CI, 0.11-0.74; P \u3c .01]).
Conclusions:The vast majority of graduating RO residents from 2020 to 2023 were satisfied with their accepted job offer. Perceptions of job market toughness declined precipitously over time after 2021. Residents who have strong mentorship and accepted positions in urban settings were more likely to report accepted position satisfaction
Erysipelothrix rhusiopathiae: Blood, bones, and the beating heart
No full textErysipelothrix rhusiopathiae, a Gram-positive bacillus, infrequently causes human infections. While localized cutaneous infections are most common, they can also lead to septicemia and/or endocarditis. In this case report, we discuss a patient initially presenting with back pain, confusion, and forgetfulness worsening over the month preceding admission. She was found to have a complex E. rhusiopathiae infection involving bacteremia complicated by bioprosthetic aortic valve endocarditis, native mitral valve endocarditis, lumbar discitis and osteomyelitis, and an abscess. The patient was noted to have a penicillin allergy, so ceftriaxone was chosen for appropriate coverage. The patient was not deemed a candidate for surgical or procedural interventions, so treatment with a six-week course of intravenous ceftriaxone was initiated, and she was noted to have resolved her infection with no further complications. This case not only adds to the sparse data on E. rhusiopathiae infections involving endocarditis and osteomyelitis but also prompts reconsideration of management strategies in the aging population with multiple comorbidities and implanted devices
