SLIDES: So What if It’s Called “All-American”

Presenter: Melissa Hathaway McKeith, Lewis Brisbois Bisgaard & Smith LLP. Respondent on US-Mexico Issues and Other Lower Basin Matters: Bob Johnson, US Bureau of Reclamation. 15 slides and 12 pages. Contains references

The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29

Enhanced Wound Documentation with Inclusion of Photography

The concept of wound photography (WP) has been described in the literature for use in home care and long term management, however there is limited research related to the acute care setting. Current evidence suggests that the use of WP in conjunction with written documentation can be beneficial in the management and treatment of wounds. In my observation of D6B, there lacks a consistency in both the communication of wound assessment during bedside report and also wound documentation within the electron medical record (EMR). There is no current standard practice in place. In patients on D6B, I seek to determine if the use of WP in conjunction with a wound documentation tool to communicate wound assessment during bedside report by D6B nursing staff, compared to no standard reporting practice, improves the accuracy and consistency in wound care documentation. I plan to educate RNs in the use of WP and the documentation tool using the current best evidence. In addition, I will introduce a format for communicating this information during bedside report. To evaluate the effectiveness of this process I will conduct chart reviews to assess the accuracy and consistency of the documentation. Without sufficient documentation, the resulting cost of a hospital acquired wound can be imposed upon our unit. Implementing a standard reporting process can improve the accuracy of wound documentation and in turn decrease cost, improve patient care, and ultimately outcomes.https://scholarlycommons.libraryinfo.bhs.org/nursing_artof_innovation/1009/thumbnail.jp

Cyberspace policy review

With the broad reach of a loose and lightly regulated digital infrastructure, great risks threaten nations, private enterprises, and individual rights, according to this report of the 60-day review on cybersecurity in the United States

Capnography: The Ventilation Vital Sign

https://scholarlycommons.libraryinfo.bhs.org/nursing_artof_questioning/1044/thumbnail.jp

Germline Variants Incidentally Detected via Tumor-Only Genomic Profiling of Patients with Mesothelioma

Importance: Patients with mesothelioma often have next-generation sequencing (NGS) of their tumor performed; tumor-only NGS may incidentally identify germline pathogenic or likely pathogenic (P/LP) variants despite not being designed for this purpose. It is unknown how frequently patients with mesothelioma have germline P/LP variants incidentally detected via tumor-only NGS. Objective: To determine the prevalence of incidental germline P/LP variants detected via tumor-only NGS of mesothelioma.Design, Setting, and Participants: A series of 161 unrelated patients with mesothelioma from a high-volume mesothelioma program had tumor-only and germline NGS performed during April 2016 to October 2021. Follow-up ranged from 18 months to 7 years. Tumor and germline assays were compared to determine which P/LP variants identified via tumor-only NGS were of germline origin. Data were analyzed from January to March 2023.Main Outcomes and Measures: The proportion of patients with mesothelioma who had P/LP germline variants incidentally detected via tumor-only NGS.Results: Of 161 patients with mesothelioma, 105 were male (65%), the mean (SD) age was 64.7 (11.2) years, and 156 patients (97%) self-identified as non-Hispanic White. Most (126 patients [78%]) had at least 1 potentially incidental P/LP germline variant. The positive predictive value of a potentially incidental germline P/LP variant on tumor-only NGS was 20%. Overall, 26 patients (16%) carried a P/LP germline variant. Germline P/LP variants were identified in ATM, ATR, BAP1, CHEK2, DDX41, FANCM, HAX1, MRE11A, MSH6, MUTYH, NF1, SAMD9L, and TMEM127.Conclusions and Relevance: In this case series of 161 patients with mesothelioma, 16% had confirmed germline P/LP variants. Given the implications of a hereditary cancer syndrome diagnosis for preventive care and familial counseling, clinical approaches for addressing incidental P/LP germline variants in tumor-only NGS are needed. Tumor-only sequencing should not replace dedicated germline testing. Universal germline testing is likely needed for patients with mesothelioma.</p