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OBJECTIVES: The objective of this study was to report on the development of neuroinvasive West Nile virus (WNV) infection in the context of anti-CD20 monotherapy for multiple sclerosis (MS). METHODS: This is a case series study. RESULTS: In 2021-2022, we observed 4 cases of neuroinvasive WNV infection in our patient population of 2009 patients with MS on ocrelizumab, compared with a total of 46 cases of neuroinvasive WNV infection reported in Pennsylvania and 40 in New Jersey. Odds were 258 times that of the general population (95% confidence interval 97-691), χ2 p < 0.0001). All were women aged 41-61 years with variable disease duration, level of disability, and duration of anti-CD20 therapy. All presented in summer/early fall with fever, headache, and encephalopathy consistent with meningoencephalitis. Three patients had acute cerebellitis. Two had anterior nerve root involvement progressing to quadriparesis, and 1 developed refractory nonconvulsive status epilepticus. All required intubation and experienced significant morbidity. All had CSF pleocytosis. Two patients were WNV IgM positive in both the serum and CSF, 1 patient had positive serum IgM and CSF metagenomic next-generation sequencing (mNGS), while 1 had positive CSF mNGS with negative serum and CSF antibodies. DISCUSSION: Neuroinvasive WNV infection can develop with anti-CD20 monotherapy in the absence of additional immunosuppression. WNV serologies may be negative in the setting of anti-CD20 treatment; in the appropriate clinical context, one should consider direct detection methods such as PCR or mNGS-based testing.

BackgroundLiquid biopsies have become an integral part of cancer management as minimally invasive options to detect molecular and genetic changes. However, current options show poor sensitivity in peritoneal carcinomatosis (PC). Novel exosome-based liquid biopsies may provide critical information on these challenging tumors. In this initial feasibility analysis, we identified an exosome gene signature of 445 genes (ExoSig445) from colon cancer patients, including those with PC, that is distinct from healthy controls.MethodsPlasma exosomes from 42 patients with metastatic and non-metastatic colon cancer and 10 healthy controls were isolated and verified. RNAseq analysis of exosomal RNA was performed and differentially expressed genes (DEGs) were identified by the DESeq2 algorithm. The ability of RNA transcripts to discriminate control and cancer cases was assessed by principal component analysis (PCA) and Bayesian compound covariate predictor classification. An exosomal gene signature was compared with tumor expression profiles of The Cancer Genome Atlas.ResultsUnsupervised PCA using exosomal genes with greatest expression variance showed stark separation between controls and patient samples. Using separate training and test sets, gene classifiers were constructed capable of discriminating control and patient samples with 100% accuracy. Using a stringent statistical threshold, 445 DEGs fully delineated control from cancer samples. Furthermore, 58 of these exosomal DEGs were found to be overexpressed in colon tumors.ConclusionsPlasma exosomal RNAs can robustly discriminate colon cancer patients, including patients with PC, from healthy controls. ExoSig445 can potentially be developed as a highly sensitive liquid biopsy test in colon cancer.

Nonprofit organizations (NPOs) are significant contributors culturally, socially, and economically, but little research has focused on their management of organizational crises. Research has been quickly documenting impacts of the COVID-19 crisis on different sectors, but again less so for NPOs. This is significant because research and recommendations developed in one sector (such as for-profit corporations) may not translate to others (such as NPOs). NPOs are particularly vulnerable due to their dependence on public financial support and demands on their resource during crises. We report on a unique and unfortunate opportunity to assess response dynamics from a half year before (2019) and a half year after (2020) the beginning of the COVID-19 pandemic in the United States. We draw on a unique dataset (combining surveys at two points in time, Twitter use data, and financial information, from 578 NPOs) to develop a general model (grounded in the discourse of renewal theory) of five sources of influence (communication, organizational resources, crisis experience, crisis management, crisis impacts) on three types of strategic responses by nonprofits (retrenchment, persevering, and innovating) to COVID-19. Higher levels of communication, crisis experience, and crisis management all predicted greater tendencies for persevering and innovating in response to COVID-19. The implications for research and practice include extending crisis communication research to the nonprofit sector and demonstrating how NPOs can strengthen themselves to recover from COVID-19 or the next crisis.

This study examines coverage of the 2008-2009 negotiations between the Screen Actors Guild and the Alliance for Motion Picture and Television Producers, through 148 articles published in the Hollywood Reporter, the Los Angeles Times, and the New York Times. News coverage tended to focus on actions, strategies, and procedures; unions' actions against management, rather than management's actions against unions; intra- and inter-union conflict rather than conflict within management; and economic consequences only in a broad sense. © 2014 AEJMC.