bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comorbidity is associated with higher risk of financial burden in Medicare beneficiaries with cancer but not heart disease or diabetes
Authors: Jones Salene M.W. , Chennupati Shasank , Nguyen Trung , Fedorenko Catherine , Ramsey Scott D. 
Published: January 2019

Abstract
The aim of the study was to examine how multimorbidity influences the prevalence of financial burden among older adults with heart disease, diabetes, or cancer.
The study was a cross-sectional analysis of prospective observational cohort survey study.
Older adults (age 65 or older) who did not report 1/6 major chronic illnesses (n = 2773; reference group), reported 1/3 major chronic illnesses without comorbidity (heart disease n = 206; diabetes n = 460; cancer n = 417), and reported 1/3 major chronic illnesses with comorbidity (heart disease n = 232; diabetes n = 202; cancer n = 109).
The measures were presence of chronic diseases (heart disease, diabetes, cancer), comorbid chronic diseases (stroke, lung disease, dementia), medical-related financial burden (credit card debt due to medical costs, paying medical bills over time), and overall financial burden (financial help from family, credit card debt, help with food, utilities, and other necessities).
The proportion reporting financial burden ranged from 15% to 27% across samples. Heart disease was unrelated to medical or overall financial burden, regardless of comorbidity. Diabetes was unrelated to financial burden except diabetes without comorbidity was associated with lower odds of overall financial burden compared to healthy older adults (odds ratio [OR] = 0.655, 95% confidence interval [CI]: 0.468–0.917). Cancer with comorbidity, but not cancer without comorbidity, was associated with greater odds of medical related (OR = 1.678, 95% CI: 1.057–2.664) and overall financial burden (OR = 1.748, 95% CI: 1.064–2.872).
The association of multimorbidity with financial burden likely varies based on specific diseases. Future research on financial burden should focus on specific disease combinations such as cancer with comorbidity.
Novel EZH2 mutation in a patient with secondary B-cell acute lymphocytic leukemia after deletion 5q myelodysplastic syndrome treated with lenalidomide
Authors: Burgos Sebastian , Montalban-Bravo Guillermo , Fuente Lucia , Jabbour Elias J. , Kanagal-Shamanna Rashmi , Soltysiak Kelly A. , Garcia-Manero Guillermo , Mela-Osorio Maria J. 
Published: January 2019

Abstract

Rationale:
The gene deletion (5)(q22q35) is reported in 10–20% of myelodysplastic syndrome (MDS) cases and is associated with response to lenalidomide and favorable prognosis. The authors report here a clinical case of MDS transformation to B-cell acute lymphocytic leukemia (B-ALL) with an associated accrual of an additional mutation following treatment with lenalidomide.

Patient Concerns:
A 69-year-old man presented with progressive anemia, normal white blood cell count, and thrombocytopenia consistent with MDS. He was administered lenalidomide for 27 months, then developed acute B-cell lymphocytic leukemia and acquired a previously unreported mutation in the gene enhancer of zeste homolog 2 (EZH2).

Diagnoses:
After 27 months of therapy with lenalidomide, a surveillance bone marrow aspiration (BMA) revealed 90% cellularity with persistent multilineage dysplasia and a population of blasts comprising 54% of all bone marrow elements by morphology, consistent with B-ALL, even though the patient was asymptomatic. Conventional karyotype showed no signs of del(5)(q22q35) MDS, however bone marrow next–generation sequencing (NGS) demonstrated the accrual of a nonsense mutation (c.211del pL71∗) in exon 3 of EZH2. A confirmatory BMA yielded 70% blasts and clinical features indicative of B-ALL.

Interventions:
Mini-hyper-CVD (cyclophosphamide and dexamethasone at 50% dose reduction, no anthracycline, methotrexate at 75% dose reduction, cytarabine at 0.5 g/m2 × 4 doses) was administered for 21 days.

Outcomes:
A follow-up BMA was performed 2 months after mini-hyper-CVD therapy, showing dysplastic features with 25% ring sideroblasts, but no evidence of B-ALL. The patient is currently receiving monthly-low dose decitabine, ofatumumab, and dexamethasone, and is transfusion independent and asymptomatic after 7 cycles.

Lessons:
The present study shows an extremely rare progression of del(5)(q22q35) MDS to B-ALL with accompanying NGS data and a newly described acquisition of an EZH2 frameshift mutation. This case highlights the importance of NGS as a diagnostic and surveillance tool for MDS.
Multiple myeloma secondary to acute lymphoblastic leukemia
Authors: Hu Tonglin , Shen Jianping , Liu Wenbin , Zheng Zhiying 
Published: January 2019

Abstract

Rationale:
Acute lymphoblastic leukemia (ALL) secondary to multiple myeloma (MM) is rare. Here we report a rare case of secondary ALL transformed from MM.

Patient concerns:
A 64-year-old woman was diagnosed as MM IgG light chain type in 2001. She achieved complete remission after 2 cycles of therapy, and received maintenance therapy with thalidomide. The patient suffered from MM relapse in September 2011. Bone marrow examination showed that the percentage of primary lymphocytes was 59%, indicating ALL-L2 (Pre-B-ALL). The patient reached complete remission after 1 cycle of chemotherapy, and has been maintained for more than 6 years.

Diagnoses:
Immunophenotyping analysis revealed that the abnormal cell population accounted for approximately 66% which expressed HLA-DR, CD4, CD22, CD33, CD34, and cCD79a. These results indicated acute B lymphoblastic leukemia. Chromosome presented 47, XX, +5, −7, +19. Leukemia fusion gene analysis demonstrated positive EVI1 and negative IgH and TCR gene rearrangement.

Interventions:
The patient accepted 1 cycle of VDCLP chemotherapy and reached complete remission, followed with consolidation therapies with VDCLP, MA, CAG and other chemotherapy regimens.

Outcomes:
This patient has maintained CR1 of ALL for more than 6 years.

Lessons:
Even secondary lymphoblastic leukemia has been rarely reported in patients with MM, we still need perform bone marrow examination, flow cytology, and gene tests, especially during maintenance therapy.
Application of sedation–agitation scale in conscious sedation before bronchoscopy in children
Authors: Zhong Lin , Shen Kun , Zhai Songhui , Chen Ting , Tao Qingfen , Chen Lina , Tao Yuhong , Qiu Li 
Published: January 2019

Abstract
This retrospective study investigated the application of the sedation–agitation scale (SAS) in pediatric bronchoscopy by observing its effects on sedative dosages and adverse reactions.
Children who underwent sedation before bronchoscopy, during the period from January 2014 to June 2017, were divided into control and SAS groups. Patients in the control group were administered a single dose of 0.1 to 0.3 mg/kg midazolam, based on physicians’ clinical experience. The initial dose of midazolam in the SAS group was 0.1 mg/kg, and was adjusted based on the SAS score, as evaluated by physicians. Between-group comparisons were made of midazolam dose; adverse reactions of midazolam, such as agitation, delirium, excessive sedation, and respiratory depression; operating time of bronchoscopy; and number of participants.
No statistically significant differences in gender, age distribution, weight, or disease composition were observed between the groups. The midazolam dose, operating time, and number of participants at different ages were all lower in the SAS group than in the control group. Fewer adverse drug reactions, such as intraoperative agitation and delirium, were noted in the SAS group. Moreover, the overall number of participants was reduced, and the overall operating time was less than that in the control group.
Application of SAS for assessment of sedation during pediatric bronchoscopy can guide individualized administration of midazolam, reduce midazolam dose while achieving an ideal sedative effect, reduce adverse reactions, and improve operator experience. Hence, its use should be promoted for pediatric patients undergoing bronchoscopy under local anesthesia and conscious sedation.
Mistaken Asymptomatic Carinal Foreign Body in a Child
Authors: Scerbo Christina , Kilgar Jennifer , Lim Rodrick 
Published: January 2019

Abstract
Foreign body aspirations are commonly seen in emergency departments (EDs) worldwide, presenting with cough, dyspnea, wheeze, and decreased air entry. Chest radiographs are commonly utilized diagnostic tools to confirm foreign object aspiration. The following is a case report of a child who presented in the ED with a carinal push-pin aspiration and a lack of respiratory symptoms; an extremely rare ED presentation of foreign body aspirations masquerading as a foreign body ingestion. This attests to the importance of conducting a lateral chest radiograph for diagnostic purposes to accurately interpret an esophageal or tracheal foreign body placement.
Appendicitis
Authors: Mittal Manoj K. 
Published: January 2019

Abstract
The diagnosis of pediatric appendicitis can be difficult, with a substantial proportion misdiagnosed based on clinical features and laboratory tests alone. Accordingly, advanced imaging with ultrasound (US), computed tomography (CT), and/or magnetic resonance imaging has become routine for most children undergoing diagnostic evaluation for appendicitis. There is increasing interest in the use of US as the primary imaging modality and reserving CT as a secondary diagnostic modality in equivocal cases. Magnetic resonance imaging, using a rapid protocol, without contrast or sedation, has been found to be highly sensitive and specific in the evaluation of children with acute right lower quadrant pain in a number of studies. Because magnetic resonance imaging has the advantage over CT of not using contrast or ionizing radiation, it may replace CT in many instances, whether after US as part of a stepwise imaging algorithm or as a primary imaging modality. Accessibility and cost, however, limit its more widespread use currently.
Point-of-Care Ultrasound to Diagnose Pyomyositis in a Child
Authors: Levitt Danielle L. , Byer Robyn , Miller Andrew F. 
Published: January 2019

Abstract
We report a case of a patient presenting with fever, right lower leg swelling, and pain who was found to have a fluid collection between muscle planes noted on point-of-care ultrasound. Point-of-care ultrasound raised the clinician's concern for deep musculoskeletal infection, leading to prompt initiation of antibiotics and magnetic resonance imaging.
Point-of-Care Ultrasound in Pediatric Diagnostic Dilemmas
Authors: Sharma Priya , Al-Sani Faisal , Saini Sidharth , Sao Pedro Tais , Wong Peter , Etoom Yousef 
Published: January 2019

Abstract
Diagnostic dilemmas are ubiquitous in pediatric emergency medicine because of the varied and often insidious presentations of many pediatric conditions. Point-of-care ultrasound (POCUS) in emergency departments is being used for some of these diagnostic challenges and can often provide rapid and valuable information to supplement a physician's clinical assessment. Intussusception is a pediatric condition that may be challenging to recognize because of its subtle and varied presenting symptoms. An unrecognized or delayed diagnosis of intussusception can be catastrophic, with complications including bowel obstruction, bowel perforation, and death. Here we present two challenging cases of intussusception, one due to its atypical age of presentation and the other due to its unique symptoms. These cases demonstrate the benefits of point-of-care ultrasound for diagnostically challenging cases in the emergency department.
Usefulness of Cone-Bean Computed Tomography Exams to Detect Foramen of Huschke in Diverse Age Group
Authors: Tucunduva Rosana Mara Adami , Lopes Ivna Albano , Shinohara Andre Luis , Lauris Jose Roberto Pereira , Rubira-Bullen Izabel Regina Fischer 
Published: January 2019

Abstract
The foramen of Huschke (FH) is present in the early stages of the temporal bone tympanic portion development. The literature shows that FH may persist in adult individuals and several authors acknowledge its clinical importance, reporting being associated with the dissemination of diseases. Some authors believe that FH presents importance in archeology and forensic situations.
Considering that the identification of FH by conventional imaging methods is extremely impaired or impossible due to overlapping bone structures and that cone-bean computed tomography presents quality in the evaluation of this structure, the authors conducted this research to determine the FH prevalence and dimensions through the Invivo5 software, and correlated its size with age.
The foramen was present in 19 scans (12.7%), 6 (8.8%) were present among male and 13 (15.8%) among female. The χ
2 test was performed, with no statistically significant difference for gender and age. Considering the age, in individuals aged 7 to 18 years, 16.4% of persistent FH was found compared with 10.5% in individuals over 18 years of age. The diameter ranged from 2.58 to 3.28 mm. No correlation was found between size and age (p between 0.25 and 0.88).
The authors conclude that the cone-bean computed tomography is an examination that allows the correct evaluation of the FH and, although the persistence of this unusual anatomical variation presents different frequencies in the different populations and age groups, it can have clinical consequences, so that the professionals who work in the area must be aware of its existence.
The California environmental DNA “CALeDNA” program
Authors: Meyer Rachel S , Curd Emily E , Schweizer Teia , Gold Zack , Ramos Dannise Ruiz , Shirazi Sabrina , Kandlikar Gaurav , Kwan Wai-Yin , Lin Meixi , Freise Amanda , Moberg-Parker Jordan , Ramos Miroslava Munguia , Shapiro Beth , Sexton Jason P , Pipes Lenore , Vedrenne Ana Garcia , Mejia Maura Palacios , Aronson Emma L , Moore Tiara , Nielsen Rasmus , Lewin Harris , Barber Paul , Wall Jeff , Kraft Nathan , Wayne Robert K 
Published: January 2019

AbstractGlobal change is leading to habitat shifts that threaten species persistence throughout California’s unique ecosystems. Baseline biodiversity data provide opportunities for ecosystems to be managed for community complexity and connectivity. In 2017, the University of California Conservation Genomics Consortium launched the California Environmental DNA (CALeDNA) program, a community science initiative monitoring California’s biodiversity through environmental DNA (eDNA)—DNA shed from organisms through fur, mucus, spores, pollen, etc. Community scientists collect soil and sediment samples, then researchers analyze the eDNA in the samples and share results with the public. The results are catalogues of thousands of organisms per sample, ranging from microbes to mammals. The CALeDNA website presents biodiversity inventories in a platform designed for the public and researchers alike, as well as user-friendly analysis tools and educational modules. Here, we present CALeDNA as a scalable community science framework that can harmonize with future biodiversity research and education initiatives.
iDamage: a method to integrate modified DNA into the yeast genome
Authors: Masłowska Katarzyna , Laureti Luisa , Pagès Vincent 
Published: January 2019

AbstractIn order to explore the mechanisms employed by living cells to deal with DNA alterations, we have developed a method by which we insert a modified DNA into a specific site of the yeast genome. This is achieved by the site-specific integration of a modified plasmid at a chosen locus of the yeast genome, through the use of the Cre/lox recombination system.In the present work, we have used our method to insert a single UV lesion into the yeast genome, and studied how the balance between error-free and error-prone lesion bypass is regulated. We show that the inhibition of homologous recombination, either directly (by the inactivation ofrad51recombinase) or through its control by preventing the poly-ubiquitination of PCNA (ubc13mutant), leads to a strong increase in the use of TLS. Such regulatory aspects of the DNA damage tolerance could not have been observed with previous strategies using plasmid or randomly distributed lesions, which shows the advantage of our new method.The very robust and precise integration of any modified DNA at any chosen locus of the yeast genome that we describe here is a powerful tool that will allow exploration of many biological processes related to replication and repair of modified DNA.
Multiplexed, sequential secretion analysis of the same single cells reveals distinct effector response dynamics dependent on the initial basal state
Authors: Chen Zhuo , Lu Yao , Zhang Kerou , Xiao Yang , Lu Jun , Fan Rong 
Published: January 2019

AbstractThe effector response of immune cells dictated by an array of secreted proteins is a highly dynamic process, requiring sequential measurement of all relevant proteins from single cells. Herein we show a microchip-based, 10-plexed, sequential secretion assay on the same single cells and at the scale of ~5000 single cells measured simultaneously over 4 time points. It was applied to investigating the time course of single human macrophage response to Toll-like receptor 4 (TLR4) ligand lipopolysaccharide and revealed four distinct activation modes for different proteins in single cells. In particular, we observed that secreted factors regulated by transcription factor NFkB (e.g., TNF and CCL2) predominantly show on-off mode over off-on mode. The dynamics of all proteins combined classified the cells into two major activation states, which were found to be dependent on the basal state of each cell. Single-cell RNA-Seq was performed on the same samples at the matched time points and further demonstrated at the transcriptional level the existence of two major activation states, which are enriched for translation vs inflammatory programs, respectively. These results showed a cell-intrinsic heterogeneous response in phenotypically homogeneous cell population. This work demonstrated the longitudinal tracking of protein secretion signature in thousands of single cells at multiple time points, providing dynamic information to better understand how individual immune cells react to pathogenic challenges over time and how they together constitute a population response.
ToxoplasmaF-Box Protein 1 is Required for Daughter Cell Scaffold Function During Parasite Replication
Authors: Baptista Carlos Gustavo , Lis Agnieszka , Deng Bowen , Gas-Pascual Elisabet , Dittmar Ashley , Sigurdson Wade , West Christopher M. , Blader Ira J. 
Published: January 2019

ABSTRACTBy binding to the adaptor protein SKP1 and serving as substrate receptors for the Skp1, Cullin, F-box E3 ubiquitin ligase complex, F-box proteins regulate critical cellular processes including cell cycle progression and membrane trafficking. While F-box proteins are conserved throughout eukaryotes and are well studied in yeast, plants, and animals, studies in parasitic protozoa are lagging. We have identified eighteen putative F-box proteins in theToxoplasmagenome of which four have predicted homologs inPlasmodium. Two of the conserved F-box proteins were demonstrated to be important forToxoplasmafitness and here we focus on an F-box protein, named TgFBXO1, because it is the most highly expressed by replicative tachyzoites and was also identified in an interactome screen as aToxoplasmaSKP1 binding protein. TgFBXO1 interacts withToxoplasmaSKP1 confirming it as a bona fide F-box protein. In interphase parasites, TgFBXO1 is a component of the Inner Membrane Complex (IMC), which is an organelle that underlies the plasma membrane. Early during replication, TgFBXO1 localizes to the developing daughter cell scaffold, which is the site where the daughter cell IMC and microtubules form and extend from. TgFBXO1 localization to the daughter cell scaffold required centrosome duplication but occurred before segregation of the centrocone, which connects the spindle pole to the centrosomes. Daughter cell scaffold localization required TgFBXO1 N-myristoylation and was dependent on the small molecular weight GTPase, TgRab11b. Finally, we demonstrate that TgFBXO1 is required for parasite growth due to its function as a daughter cell scaffold effector. TgFBXO1 is the first F-box protein to be studied in apicomplexan parasites and represents the first protein demonstrated to be important for daughter cell scaffold function.AUTHOR SUMMARYToxoplasma gondiiis a protozoan parasite that can cause devastating and life-threatening disease in immunocompromised patients and in fetuses. Its replication is important to study because parasite growth is responsible for the pathology that develops in toxoplasmosis patients. The parasite replicates by a unique process named endodyogeny in which two daughter parasites develop within the mother cell. Early during this process the parasite creates a structure called the Daughter Cell Scaffold whose function is to mark the site from which daughter parasites will emerge. Here, we report the identification of one of the first proteins recruited to the Daughter Cell Scaffold and its importance in executing its function.
Investigating the influence of extraction methodology, and certain other experimental parameters on bacterial response to selected quorum-modulatory plant extracts
Authors: Patel Pooja , Joshi Chinmayi , Kothari Vijay 
Published: January 2019

AbstractIn context of the global threat of antimicrobial resistance (AMR), a large number of labs throughout the world are investigating plant extracts for their possible anti-pathogenic efficacy. Outcome of protocols employed for screening the plant extracts for such activities are influenced by multiple factors. Among them, this study has found the method used for extraction, size and volume of the assay system, to be important factors. Further we demonstrate the extracts prepared by microwave-and vacuum-assisted extraction methods to be stable with respect to their anti-pathogenic efficacy over a long period of storage.