bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age Differences in Racial/Ethnic Disparities in Preventable Hospitalizations for Heart Failure in Connecticut, 2009-2015: A Population-Based Longitudinal Study
Authors: Doshi Riddhi P. , Yan Jun , Aseltine Robert H. 
Published: November 2019

Objective: Preventable hospitalizations for heart failure result in a large proportion of hospitalizations. The primary objective of this study was to describe longitudinal trends in the association of race/ethnicity with preventable hospitalizations for heart failure in Connecticut and differences in disparities by age. Methods: We analyzed data on hospitalizations in all civilian acute-care hospitals in Connecticut during a 7-year period, 2009 through 2015. We used raking methodology to weight the nonhospitalized population to create a reference population representative of the state’s general population. Multivariate regression models examined racial/ethnic disparities among adults aged 35-64, controlling for age, sex, and type of health insurance. For adults aged ≥65, regression models controlled for age and sex. Results: After controlling for age and sex, the non-Hispanic black to non-Hispanic white odds ratio for preventable hospitalizations for heart failure ranged from 5.2-6.4 during the study period among adults aged 35-64. Among adults aged ≥65, non-Hispanic black adults had significantly higher odds (range, 1.2-1.8) of preventable hospitalizations than non-Hispanic white adults. Rates among Hispanic adults were significantly higher than rates among non-Hispanic adults after controlling for age and sex among adults aged ≥65 in 2014 and 2015. Conclusions: This research provides information for clinical and population-based interventions targeting racial/ethnic gaps in heart failure hospitalizations. Demonstrating the persistent black–white disparity and age differences in racial/ethnic disparities, this study emphasizes the need for focused prevention among vulnerable populations. Raking methodology is an innovative approach to eliminating selection bias in hospital discharge data.
Repeatability and reproducibility of corneal biomechanical parameters derived from Corvis ST
Authors: Serbecic Nermin , Beutelspacher Sven , Markovic Lovro , Roy Abhijit Sina , Shetty Rohit 
Published: November 2019

Introduction: The aim of this study was to evaluate repeatability and reproducibility of newly calculated biomechanical parameters of the cornea, developed by our research group. Methods: One eye from each of the 23 healthy subjects was measured three times consecutively, three times at different daytimes and on three different days. The within-subject standard deviation and coefficient of variation, as well as the intraclass correlation coefficient, were calculated for every parameter in each group. Results: Excellent repeatability and reproducibility (coefficient of variation < 5%, intraclass correlation coefficient > 0.75) was found for corrected values measured at A1, HC, and A2 time points (2nd A2 Time, 2nd A1 Time, 2nd HC Time, 2nd HC Def Amp and 2nd A1 Def Amp). Corneal-specific stiffness parameters, which showed good repeatability and reliability, were DA_cor (coefficient of variation = 4.02%, intraclass correlation coefficient = 0.919), KcLinear (coefficient of variation = 4.03%, intraclass correlation coefficient = 0.895), areaForceCornea (coefficient of variation = 3.34%, intraclass correlation coefficient = 0.853) and E2 (coefficient of variation = 4.1%, intraclass correlation coefficient = 0.78). Overall, most parameters fell into the category of good reliability (high intraclass correlation coefficient) and poor reproducibility (low coefficient of variation), including all the parameters describing extraocular deformation (DA_ext, AEPvED, AUC EDef, areaForceExtra, Kg and μg). Comparing the coefficient of variation values for intrasession, intersession and daytime measurements, there were no indices for diurnal changes. Conclusion: Most parameters showed good repeatability and reliability. The extraocular stiffness parameters showed poor reproducibility. KcLinear can serve as a very reliable and repeatable indicator of corneal stiffness.
Paracentral acute middle maculopathy associated with hypoperfusion of the cilioretinal artery and impending central retinal vein occlusion
Authors: da Fonseca Maria Luisa Gois , Souza Amanda , Pereira Mauricio Bastos , Vianna Raul Nunes Galvarro , Cravo Leonardo Midleg , Demori Erika 
Published: November 2019

Background: Paracentral acute middle maculopathy is defined as ischemia of the deep retinal layers. We report an unusual case of paracentral acute middle maculopathy associated with hypoperfusion of the cilioretinal artery and impending central retinal vein occlusion in a young male with no previous comorbidities. Case Report: The patient was a 22-year-old male complaining about a sudden loss of vision in his right eye upon awakening. Fundus examination showed optic disk edema, and increased tortuosity of the retinal veins and a few retinal hemorrhages. Swept-source optical coherence tomography found a hyperreflective band that was more pronounced at the level of the inner nuclear layer of the retina. These findings led us to a diagnosis of paracentral acute middle maculopathy associated with hypoperfusion of the cilioretinal artery. Conclusion: The finding of paracentral acute middle maculopathy on optical coherence tomography demands a proper investigation of its cause, because it has an intimate association with vascular diseases and is not an isolated entity. In our case, we could not identify the etiology of the unilateral event in this young male, although dehydration due to alcohol consumption and subsequent hypotension might have played a role in this ischemic event.
Patient-reported outcomes at hospital discharge among patients with arrhythmia: Results from the national DenHeart survey
Authors: Thrysoee Lars , Thorup Charlotte Brun , Rasmussen Trine Bernholdt , Borregaard Britt , Christensen Anne Vinggaard , Juel Knud , Ekholm Ola , Vamosi Marianne , Banke Ann , Berg Selina Kikkenborg 
Published: November 2019

Background: Patient-reported outcomes are important predictors of mortality, cardiovascular events and hospitalisation in patients with cardiac diseases, but differences in patient-reported outcomes between groups of patients with arrhythmia have not yet been investigated. Aims: To describe and compare patient-reported outcomes at discharge among patients with different types of cardiac arrhythmia and to examine the associations between demographic characteristics, inhospital factors and patient-reported outcomes. Methods: Data were derived from the national DenHeart study including patient-reported outcomes from the following questionnaires: the hospital anxiety and depression scale (HADS), HeartQoL, short form 12 (SF-12), current health status (EQ-5D), brief illness perception questionnaire (B-IPQ) and the Edmonton symptom assessment scale (ESAS). Clinical and demographic data were obtained from national registers. Multiple linear and logistic regression models were used to investigate the associations between the potential risk factors and the patient-reported outcomes. Results: A total of 4251 patients diagnosed with arrhythmia completed the questionnaire. Across the arrhythmia subgroups, some differences were observed. In general, patient-reported outcome scores were worst among patients with ‘ventricular arrhythmia’ (e.g. highest depression scores and highest prevalence of feeling unsafe at discharge). Regression analysis revealed that longer hospital stay, female gender, being unmarried and having a short education were significantly associated with poor health for almost all arrhythmia subgroups. Conclusion: Differences exist in self-reported health, quality of life and symptom burden across arrhythmia groups with patients with ventricular arrhythmia reporting poorer patient-reported outcomes. Longer hospital stay, female gender, being unmarried and having a low level of education were significantly associated with worse outcomes among the total population.
Utility of Daily Laboratories in Patients with Lymphoma Admitted for Inpatient Chemotherapy
Authors: Anscher Daniel , El-Far Ahmad , Baidas Said M 
Published: November 2019

Background: Daily CBC (Complete blood count) and CMP (Complete metabolic profile) have been drawn on our patients with high-grade lymphoma admitted for inpatient chemotherapy with R-EPOCH (Rituximab, Prednisone, Vincristine, Cyclophosphamide, Doxorubicin) which is given over 5 days and R-ICE (Rituximab, Ifosfamide, Carboplatin, Etoposide) which is given over 3 day period. We conducted a retrospective study at our center looking to find if daily laboratory, other than day 1 laboratory, will have an impact on decisions regarding 1) change in chemotherapy dose or schedule 2) requirement of Blood products transfusion 3) cost effectiveness.
Methods: We did retrospective review of 101 admissions between 2010-2017. We documented how frequent CBC and CMP were obtained during patient admissions. We documented any change in chemotherapy schedule or dose, or any need for blood product transfusion based on results of laboratory obtained starting day 2 of cycle 2. We excluded day 1 given that its results are required to proceed with chemotherapy. Also we excluded induction cycle 1. We documented cost of laboratory obtained other than day 1.
Results: Daily CBC and CMP did not lead to any significant changes in plan of care of chemotherapy regimen and only lead to blood transfusions in 4.1% of patients on R-EPOCH and 6% of patients on R-ICE regimens. The cost associated with daily CBC and CMP was $1725 for R-EPOCH regimen and $1339 for R-ICE regimen.
Conclusion: We recommend only day 1 CBC/CMP for patients admitted for R-EPOCH and R-ICE chemotherapy starting cycle 2. Daily CBC/CMP didn't lead to any significant changes on the plan of care and added more cost.
Table

Disclosures
No relevant conflicts of interest to declare.
Parents' Views on Preimplantation Genetic Testing for Sickle Cell Disease after Education in Clinic
Authors: Kripalani Shawn , Attia Monica , Darbari Isha , Nickel Robert Sheppard 
Published: November 2019

Background: Preimplantation genetic testing (PGT) used in conjunction with in-vitro fertilization can help parents of a child with sickle cell disease (SCD) have another child who will not have SCD and also be an HLA match. Parents' views on this reproductive option are not well known and little work has been done regarding educating parents about this option. This study sought to describe parents' opinions on PGT after a clinic-based educational intervention.
Methods: A 5-page educational handbook was created on PGT for SCD. During certain clinic days, all parents of children with SCD were given this handbook in the waiting room and encouraged to read it and ask their provider questions during their clinic visit. After this visit, parents were then requested to complete a brief, anonymous survey via REDCap. Non-biological parents and other guardians were excluded. An IRB waiver of consent was granted as no personal health information was collected.
Results: Between May and July 2019, 83 biologic parents of children with SCD were approached in the clinic and 67 (81%) of these parents completed the questionnaire. This group had a median age of 34 years and included 52 mothers and 15 fathers. While 53 (79%) indicated that they had previously heard of bone marrow transplant for SCD before today, only 16 (24%) answered that they had heard of PGT for SCD (p<0.0001). When asked about their opinion on informing parents of SCD about PGT: 45 (67%) stated this information was "very important," 20 (30%) "important," 1 (2%) "a little important," and 1 (2%) "not important." The majority (69%) of parents indicated that education on PGT should occur "at the very first hematology clinic visit." Only 9 (13%) parents responded that they could pay $20,000 for PGT, while 65 (97%) answered that they think it should be covered by health insurance. Among parents who indicated that they might want to have more children (n=32), 29 (91%) answered that they would be interested in using PGT if covered by insurance.
Conclusion: Most parents of children with SCD seen in the hematology clinic do not know about PGT, but when educated about this option, viewed this knowledge as important. Routine hematology clinic appointments in early childhood may be opportune times to educate patients about PGT. Cost may be a major barrier, but providers should discuss PGT with parents of children with SCD to help ensure access to this option.

Disclosures
No relevant conflicts of interest to declare.
Wdr26 regulates nuclear condensation in developing erythroblasts
Authors: Zhen Ru , Moo Chingyee , Zhao Zhenzhen , Chen Mengying , Feng He , Zheng Xiaojun , Zhang Liang , Shi Jiahai , Chen Caiyong 
Published: November 2019

Abstract
Mammalian red blood cells lack nuclei. The molecular mechanisms underlying erythroblast nuclear condensation and enucleation, however, remain poorly understood. Here we show that Wdr26, a gene upregulated during terminal erythropoiesis, plays an essential role in regulating nuclear condensation in differentiating erythroblasts. Loss of Wdr26 induces anemia in zebrafish and enucleation defects in mouse erythroblasts because of impaired erythroblast nuclear condensation. As part of the glucose-induced degradation-deficient ubiquitin ligase complex, Wdr26 regulates the ubiquitination and degradation of nuclear proteins, including lamin B. Failure of lamin B degradation blocks nuclear opening formation leading to impaired clearance of nuclear proteins and delayed nuclear condensation. Collectively, our study reveals an unprecedented role of an E3 ubiquitin ligase in regulating nuclear condensation and enucleation during terminal erythropoiesis. Our results provide mechanistic insights into nuclear protein homeostasis and vertebrate red blood cell development.
Improvement in Follicular Non Hodgkin Lymphoma Survival among VA Patients.
Authors: Desai Shaili , Safa Malek M. , Komrokji Rami S. 
Published: November 2019

Abstract
Background: Follicular non Hodgkin lymphoma (FL) remains uncurable disease for majority of patients. Natural history of follicular lymphoma is changing with inroduction of new treatments. We examined outcome of FL among VA patients in the era of monoclonal antibodies.
Methods: This was a retrospective analysis. The VA Central Cancer Registry (VACCR) database was used to identify patients with FL diagnosed between 1995 and 2005. There are approximately 120 VA medical centers diagnosing and/or treating patients with cancer. Data were analyzed using bio-statistical software SPSS. Variables included age, sex, stage of disease, histology subtype, date of diagnosis, date of last contact, vital status.
Results: There were1338 patients with FL at the VACCR database between 1995 and 2005, 283 (88%) were white, 128 (10%) black patients, and 39 (2%) patients from other racial groups. The mean age at diagnosis was to 64 years. Four hundred twelve (31%) were grade I FL, 312 (23%) Grade II, 215 (16%) Grade III, and 399 (30%) FL, NOS. Four hundred twelve (30%) patients were early stage (I,II), 600 (45%) were advanced stage (III,IV) and 331 (25%) missing or unkown. No FLIPI score data were available. Median overall survival (OS) was 7 years. The median OS for early stage was 8.6 years compared to 5.5 years for advanced stage. The median OS for patients diagnosed 1995–2000 was 5.9 years compared to 9.7 years for patients diagnosed between 2001–2005. (log rank test, P value 0.025). The two groups were balanced regarding stage, race and chemotherapy.
Conclusions: The survival of FL patients has improved in the VA system in the era of rituximab.
Figure Figure
Motexafin Gadolinium (MGD) Induces Oxidant Stress and Downregulates Both Pro and Anti-Oxidant Genes in the Ramos Lymphoma Cell Line: Signaling through p53 Mediated Pathways.
Authors: Singh Amareshwar T.K. , Evens Andrew M. , Haque Qudsia , Prachand Sheila N. , Singh Karthik T.K. , Gordon Leo I. 
Published: November 2019

Abstract
We have reported that MGd, an expanded porphyrin and redox stress inducer, lowers p53 protein but not message in lymphoma cell lines. These results suggested that there is post-translational modification of p53 induced by MGd, and that this effect depends on the presence of ascorbate (Asc) or zinc (Zn). To expand these earlier studies, we measured the expression of oxidant and antioxidant genes in Ramos (Burkitt’s) cells. We incubated Ramos cells for 5 hours with MGd 100μM with or without Zn acetate (Zn, 100μM), Asc 100μM, and Nutlin-3 15μM. Following incubation, total RNA was isolated by the Qiagen method and dissolved in RNase-free water. 1.0 μg RNA was used for reverse transcription using the Taq DNA polymerase system. PCR amplification was performed at 94°C for 30 sec (denaturation), 55°C (annealing) and 72°C (extension) for 35 cycles. This was followed by an extension at 72°C for 10 minutes. Anti-sense primers and sense primers for SESN1(T2), SESN2, GPX1, CDKN1A, and PP1A were used and DNA was identified by 1% agarose gel electrophoresis. The T2 transcript of SESN1 gene was absent in these cells. Co-treatment of MGd/Zn/Asc notably decreased GPX1, SESN2, and CDKN1A transcripts. To determine the role of p53 in the regulation of downstream redox targets, we added the MDM2 inhibitor, Nutlin-3. We found that GPX1, SESN2, and CDKN1A were restored with Nutlin-3. In addition, we measured another downstream target of p53, PUMA, in both Ramos and HF-1 cells (a follicular lymphoma cell line) by immunoblot after MGd, Zn, and Asc exposure in the presence or absence of Nutlin-3. PUMAα and PUMAβ isoforms returned to near baseline levels in the presence of Nutlin-3. The restoration of PUMA was more pronounced in HF-1 cells than in Ramos. In summary, then, we have shown that:
the MDM2 inhibitor, Nutlin-3 reversed the downregulation of SESN2, GPX1, and CDKN1A genes that occurred as a result of MGd/Zn/Asc in Ramos cells and similarly, PUMAα and β isoforms were restored with Nutlin-3 after decreased expression following exposure to MGd, zinc, and ascorbate.
These data indicate that some MGd-mediated signaling events in lymphoma cells are mediated through p53-dependent pathways.
Reduced Dose of Non-Pegylated Liposomal Doxorrubicin with Cyclophosphamide, Vincristine and Prednisone ± Rituximab for Elderly Patients with Aggressive Lymphoma Non Candidates to Standard Chemotherapy.
Authors: Gimeno Eva , Alvarez Alberto , Pedro Carme , Abella Eugenia , Gomez Miquel , Comin Josep , Besses Carles , Salar Antonio 
Published: November 2019

Abstract
BACKGROUND: CHOP± Rituximab regimen is the standard regimen for elderly patients with aggressive lymphoma. However, many of these patients present formal contraindication for this type of treatment due to severe associated comorbidities. The aim of the study is to retrospectively evaluate the safety and clinical profile of a modified CHOP (with low dose non-pegylated liposomal doxorrubicin) ± Rituximab in elderly patients with clinically aggressive lymphoma which are not tributary to standard chemotherapy.
PATIENTS AND METHODS. Retrospective analysis of 15 consecutively patients (pts) with previously untreated aggressive lymphoma. Gender: 9 men/6 women; median age: 76 years (62–85y). 6 pts had stage I–II (IPI=1–2) and 9 pts stage IV (IPI=2–5). Median baseline left ventricular ejection fraction (LVEF) was 60.2% (31–80%). Comorbidities: active chronic liver disease (1 pt), severe chronic obstructive pulmonary disease (3 pts), severe cardiomiopathy (4 pts) and others (7 pts). Schedule: non pegylated liposomal doxorubicin 30 mg/m2, cyclophosphamide 750 mg/m2, vincristine 1.4 mg/m2, prednisone 100 mg/d d1-5 ± rituximab 375mg/m2 d1) every 21 days, as a first line therapy. Pegfilgrastim was used on day 2 at standard dose.
RESULTS. Nine pts are evaluable for efficacy at the time of this report (2 pts died early due to infectious complications and are not evaluable for response). Median number of cycles was 4 (range 4–6). Total number of cycles administered was 43. A complete response (CR) was achieved in 8 pts (88.8%) and partial response in 1 pt (11.1%) after chemotherapy. CR was achieved in this last patient after involved field radiotherapy. Two pts have relapsed during follow-up, all dying with active disease. OS at 12 months: 70% (CI95%: 42–98%) and PFS at 12 months: 60% (CI95%: 30–90%), with a median time of follow-up for surviving pts of 18 months (4–35 m). Treatment was well tolerated with grade III–IV neutropenia was 39.5% with 14% episodes of febrile neutropenia. No other relevant toxicities were observed. Of note, median LVEF was not significantly different between before and after treatment with one patient showing a clinical significant improve in his LVEF.
CONCLUSION. This preliminary data indicate that low dose non-pegylated liposomal doxorubicin in modified CHOP regimen was active and well tolerated in patients with formal contraindications to standard therapy due to severe comorbidities. Further exploration of this regimen administered every 14 days is warranted.