Rationale and Objectives: The coronavirus disease of 2019 (COVID-19) pandemic has challenged the educational missions of academic radiology departments nationwide. We describe a novel cloud-based HIPAA compliant and accessible education platform which simulates a live radiology workstation for continued education of first year radiology (R1) residents, with an emphasis on call preparation and peer to peer resident learning. Materials and Methods: Three tools were used in our education model: Pacsbin (Orion Medical Technologies, Baltimore, MD, pacsbin. com), Zoom (Zoom Video Communications, San Jose, CA, zoom.us), and Google Classroom (Google, Mountain View, CA, classroom.google.com). A senior radiology resident (R2-R4) (n = 7) driven workflow was established to provide scrollable Digital Imaging and Communications in Medicine (DICOM) based case collections to the R1 residents (n = 9) via Pacsbin. A centralized classroom was created using Google Classroom for assignments, reports, and discussion where attending radiologists could review content for accuracy. Daily case collections over an 8-week period from March to May were reviewed via Zoom video conference readout in small groups consisting of a R2-R4 teacher and R1 residents. Surveys were administered to R1 residents, R2-4 residents, and attending radiologist participants. Results: Hundred percent of R1 residents felt this model improved their confidence and knowledge to take independent call. Seventyeight percent of the R1 residents (n = 7/9) demonstrated strong interest in continuing the project after pandemic related restrictions are lifted. Based on a Likert "helpfulness" scale of 1-5 with 5 being most helpful, the project earned an overall average rating of 4.9. Two R2-R4 teachers demonstrated increased interest in pursuing academic radiology. Conclusion: In response to unique pandemic circumstances, our institution implemented a novel cloud-based distance learning solution to simulate the radiology workstation. This platform helped continue the program's educational mission, offered first year residents increased call preparation, and promoted peer to peer learning. This approach to case-based learning could be used at other institutions to educate residents.

BACKGROUND Since the identification of xenotropic murine leukemia virus–related virus (XMRV) in prostate cancer patients in 2006 and in chronic fatigue syndrome patients in 2009, conflicting findings have been reported regarding its etiologic role in human diseases and prevalence in general populations. In this study, we screened both plasma and peripheral blood mononuclear cells (PBMNCs) collected in Africa from blood donors and human immunodeficiency virus Type 1 (HIV-1)-infected individuals to gain evidence of XMRV infection in this geographic region. STUDY DESIGN AND METHODS A total of 199 plasma samples, 19 PBMNC samples, and 50 culture supernatants from PBMNCs of blood donors from Cameroon found to be infected with HIV-1 and HIV-1 patients from Uganda were screened for XMRV infection using a sensitive nested polymerase chain reaction (PCR) or reverse transcription (RT)-PCR assay. RESULTS Using highly sensitive nested PCR or RT-PCR and real-time PCR assays capable of detecting at least 10 copies of XMRV plasmid DNA per reaction, none of the 268 samples tested were found to be XMRV DNA or RNA positive. CONCLUSIONS Our results failed to demonstrate the presence of XMRV infection in African blood donors or individuals infected with HIV-1. More studies are needed to understand the prevalence, epidemiology, and geographic distribution of XMRV infection worldwide.

Cameroon is a West African country where high genetic diversity of HIV-1 has been reported. The predominant CRF02_AG is involved in the emergence of more complex intersubtype recombinants. In this study, we sequenced the full-length genome of a novel unique recombinant form (URF) of HIV-1, 02CAMLT04 isolated in blood donors in urban Cameroon. Phylogenetic tree and bootscan analysis showed that 02CAMLT04 was complex and appeared to be a secondary recombinant derived from CRF02_AG and CRF22_01A1. The genomic composition of 02CAMLT04 strain showed that it is composed of three segments; twenty four percent of the genome is classified as CRF02_AG, spanning most of the envelope gene. The remaining seventy six percent of the genome is classified as CRF22_01A1. In addition, the sequence analysis of 13 full-length sequences from HIV-1 positive specimens received from Cameroon between 2002 and 2010 indicated that five specimens are pure CRF22_01A1 viruses, and six others have homology with CRF22_01A1 sequences in either gag, pol or env region where as 6% of strains contain portions of CRF22_01A1. Further study demonstrated that CRF22_01A1 is a primary prevalence strain co-circulating in Cameroon and is involved in complex intersubtype recombination events with subtypes (D or F), subsubtypes (A1 or F2) and CRFs (CRF01_AE or CRF02_AG). Our studies show that novel recombinants between CRF22_01A1 and other clades and recombinant forms may be emerging in Cameroon that could contribute to the future global diversity of HIV-1 in this region and world wide.

BackgroundXMRV is a gammaretrovirus first identified in prostate tissues of Prostate Cancer (PC) patients and later in the blood cells of patients with Chronic Fatigue Syndrome (CFS). Although XMRV is thought to use XPR1 for cell entry, it infects A549 cells that do not express XPR1, suggesting usage of other receptors or co-receptors.MethodsTo study the usage of different receptors and co- receptors that could play a role in XMRV infection of lymphoid cells and GHOST (GFP- Human osteosarcoma) cells expressing CD4 along with different chemokine receptors including CCR1, CCR2, etc., were infected with XMRV. Culture supernatants and cells were tested for XMRV replication using real time quantitative PCR.ResultsInfection and replication of XMRV was seen in a variety of GHOST cells, LNCaP, DU145, A549 and Caski cell lines. The levels of XMRV replication varied in different cell lines showing differential replication in different cell lines. However, replication in A549 which lacks XPR1 expression was relatively higher than DU145 but lower than, LNCaP. XMRV replication varied in GHOST cell lines expressing CD4 and each of the co- receptors CCR1-CCR8 and bob. There was significant replication of XMRV in CCR3 and Bonzo although it is much lower when compared to DU145, A549 and LNCaP.ConclusionXMRV replication was observed in GHOST cells that express CD4 and each of the chemokine receptors ranging from CCR1- CCR8 and BOB suggesting that infectivity in hematopoietic cells could be mediated by use of these receptors.

BackgroundPreliminary studies in chronic fatigue syndrome (CFS) patients and XMRV infected animals demonstrated plasma viremia and infection of blood cells with XMRV, indicating the potential risk for transfusion transmission. XMRV and MLV-related virus gene sequences have also been detected in 4–6% of healthy individuals including blood donors in the U.S. These results imply that millions of persons in the U.S. may be carrying the nucleic acid sequences of XMRV and/or MLV-related viruses, which is a serious public health and blood safety concern.Methodology/Principal FindingsTo gain evidence of XMRV or MLV-related virus infection in the U.S. blood donors, 110 plasma samples and 71 PBMC samples from blood donors at the NIH blood bank were screened for XMRV and MLV-related virus infection. We employed highly sensitive assays, including nested PCR and real-time PCR, as well as co-culture of plasma with highly sensitive indicator DERSE cells. Using these assays, none of the samples were positive for XMRV or MLV-related virus.Conclusions/SignificanceOur results are consistent with those from several other studies, and demonstrate the absence of XMRV or MLV-related viruses in the U.S. blood donors that we studied.

No abstract

Bilateral renal infarction is a rare phenomenon which can be difficult to diagnose because the symptoms may often mimic renal calculi, infection, muscle inflammation, genital diseases, myocardial infarction, or ischemia. We present the case of a 55-year-old male patient who presented with non-radiating, left-sided flank pain associated with nausea and vomiting. A computed tomography (CT) scan of the abdomen and pelvis with contrast demonstrated bilateral renal infarction. A thorough workup was initiated, and the thrombus formation due to left atrial enlargement from hypertrophic obstructive cardiomyopathy was considered as the cause of the bilateral renal infarction in this patient. The patient's renal function improved with treatment, and she was discharged on an anticoagulant, considering her left atrial enlargement and renal infarction.

This is a single axial contrast-enhanced MRI image through the upper abdomen...umm...it looks like there is a mass arising from the right kidney, although I can't really tell whether it could be arising from the adrenal gland...umm...I would like to look at the coronals, if there are any available....I guess differentials for a patient this age could include neuroblastoma and Wilms tumor. Anonymous radiology resident