bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enteral Nutrition in Pediatric High-risk Head and Neck Cancer Patients Receiving Proton Therapy: Identifying Risk Factors and Quality of Life Concerns to Optimize Care
Authors: Bechtel Allison S. , Indelicato Daniel J. , Sandler Eric 
Published: November 2018

Background:
Radiotherapy for pediatric head and neck tumors often results in mucositis and pain, limiting oral intake and compromising patients’ nutrition. There are little pediatric data available regarding enteral tube use and risk factors. Our objective was to estimate nutrition needs, identify risk factors contributing to nutritional decline and explore quality of life measures regarding enteral nutrition during proton radiotherapy.

Procedure:
Nutritional metrics and status were collected throughout radiation treatment for 32 patients. We surveyed patients/caregivers about their perceptions of enteral nutrition. Risk factors for progression to non–oral nutrition or >5% weight loss were evaluated using univariate analysis.

Results:
Patients who received any esophageal radiation or >30 Gy mean dose to the pharyngeal constrictors were more likely to experience >5% weight loss. These patients, as well as those who received a mean dose >30 Gy to the oropharynx or concurrent chemotherapy, were also more likely to require non–oral supplementation. Patients expressed the importance of maximizing nutrition and feared pain associated with a tube placement.

Conclusions:
Pediatric patients with head and neck cancer can be risk-stratified based on clinical and dosimetric factors. This data, combined with parent and patient perceptions, is key to the development of rational guidelines.
Glanzmann Thrombasthenia in Children: Experience From a Tertiary Care Center in Southern India
Authors: Kongalappa Smitha , Reddy Jyothi Muni , Durugappa Tarangini , D’Souza Fulton , Subramanian Sitalakshmi , Prakash Anand 
Published: November 2018

Background:
Glanzmann thrombasthenia (GT) is a globally rare inherited disorder of hemostasis.

Objectives:
To describe the clinical profile of GT in a tertiary care center in Southern India.

Methods:
A retrospective chart review of all children with GT was performed between January 2005 and August 2017 in the Department of Paediatrics.

Results:
A total of 48 patients (representing 43 families) were included. Median age at diagnosis was 2.75 years (interquartile range: 1.5 to 6.75). Two thirds had an onset of bleeding within the first 2 years of life. Sixty-seven percent were born out of consanguineous marriage. The common symptoms were epistaxis, gingival bleeding, and ecchymoses. Neonatal onset of bleeding manifested as purpura, epistaxis, and intracranial hemorrhage. Postsurgical bleeding and menorrhagia were unique presentations in adolescence. About 25% had life-threatening hemorrhage while 50% had growth retardation due to chronic anemia.

Conclusions:
GT is relatively more common in areas of Southern India due to the higher prevalence of consanguinity. Chronic anemia can contribute to growth stunting in these patients.
Cell Phone and Computer Use Among Parents Visiting an Urban Pediatric Emergency Department
Authors: Shields Wendy C. , Omaki Elise , McDonald Eileen M. , Rosenberg Ruth , Aitken Mary , Stevens Martha Wood , Gielen Andrea C. 
Published: November 2018

Objectives
The objectives of this study were to estimate the prevalence of cell phone and computer use among urban families bringing their children to an emergency department and to determine which technologies parents prefer to use to receive health information.

Methods
We visited 2 pediatric emergency departments in Baltimore, Md, and Little Rock, Ark. A convenience sample of parents of children 8 years old or younger completed a self-administered survey in the waiting area.

Results
Two hundred thirty-eight surveys were completed. Respondents were primarily female (83%), less than 35 years old (74%), and had at least a high school diploma or General Educational Development (94%). Forty-three percent were employed full time. A majority (95%) of respondents reported owning a cell phone, with most (88%) owning a smartphone and 96% reported having some internet access. Of cell phone owners, 91% reported daily text messaging activity. Over half (63%) of respondents reported having computer internet access at home; 31% reported having internet access at work. Patterns of behavior and preferences emerged for both cell phone and computer use. Respondents were more likely to check their email (75% vs 50%, P < 0.0001) and access the internet (78% vs 67%, P = 0.002) with a smartphone rather than their computer.

Conclusions
Both cell phones and computers are prevalent and used among urban families seen in pediatric emergency departments, offering new ways to deliver health information to these often underserved populations. Providers aiming to deliver health information should consider smartphone applications, text message–based programs, and email to communicate with their patients.
The Flint Water Crisis: A Coordinated Public Health Emergency Response and Recovery Initiative
Authors: Ruckart Perri Zeitz , Ettinger Adrienne S. , Hanna-Attisha Mona , Jones Nicole , Davis Stephanie I. , Breysse Patrick N. 
Published: November 2018

Context:
The City of Flint was already distressed because of decades of financial decline when an estimated 140 000 individuals were exposed to lead and other contaminants in drinking water. In April 2014, Flint's drinking water source was changed from Great Lakes' Lake Huron (which was provided by the Detroit Water and Sewerage Department) to the Flint River without necessary corrosion control treatment to prevent lead release from pipes and plumbing. Lead exposure can damage children's brains and nervous systems, lead to slow growth and development, and result in learning, behavior, hearing, and speech problems. After the involvement of concerned residents and independent researchers, Flint was reconnected to the Detroit water system on October 16, 2015. A federal emergency was declared in January 2016.

Program:
The Centers for Disease Control and Prevention provided assistance and support for response and recovery efforts including coordinating effective health messaging; assessing lead exposure; providing guidance on blood lead screening protocols; and identifying and linking community members to appropriate follow-up services.
In response to the crisis in Flint, Congress funded the Centers for Disease Control and Prevention to establish a federal advisory committee; enhance Childhood Lead Poisoning Prevention Program activities; and support a voluntary Flint lead exposure registry. The registry, funded through a grant to Michigan State University, is designed to identify eligible participants and ensure robust registry data; monitor health, child development, service utilization, and ongoing lead exposure; improve service delivery to lead-exposed individuals; and coordinate with other community and federally funded programs in Flint. The registry is also collaborating to make Flint “lead-free” and to share best practices with other communities.

Discussion:
The Flint water crisis highlights the need for improved risk communication strategies, and environmental health infrastructure, enhanced surveillance, and primary prevention to identify and respond to environmental threats to the public's health. Collecting data is important to facilitate action and decision making to prevent lead poisoning. Partnerships can help guide innovative strategies for primary lead prevention, raise awareness, extend outreach and communication efforts, and promote a shared sense of ownership.
Emerging concepts in HIV-associated cryptococcal meningitis
Authors: Lawrence David S. , Boyer-Chammard Timothée , Jarvis Joseph N. 
Published: November 2018

Purpose of review
HIV-associated cryptococcal meningitis remains a significant contributor to AIDS-related mortality despite widened access to antiretroviral therapy. Even in clinical trial settings 10-week mortality is roughly 40%. A number of important clinical trials have either recently concluded or are actively recruiting.

Recent findings
Global burden of disease estimates suggest cryptococcal meningitis causes 181 100 deaths annually. Screening blood for cryptococcal antigen in HIV-infected individuals with CD4 cell counts less than 100 cells/μl and preemptive antifungal treatment for those with detectable cryptococcal antigen reduces the incidence of cryptococcal meningitis and is likely to reduce mortality. Cryptococcal meningitis treatment with conventional 14-day courses of amphotericin are associated with high toxicity and mortality and can be reduced to 7 days if given alongside flucytosine. Flucytosine is a significantly superior adjunct to amphotericin treatment compared with fluconazole. In settings without amphotericin B dual oral antifungal combinations of flucytosine and fluconazole offer an effective alternative treatment. A single, high-dose of liposomal amphotericin is effective at reducing fungal burden and is being tested in a phase III trial.

Summary
Recently completed and ongoing clinical trials are increasing our understanding of how to optimize induction therapy for cryptococcal meningitis. Advocacy efforts are needed to broaden access to amphotericin formulations and flucytosine.
The lived experience of breathlessness for people diagnosed with heart failure: a qualitative synthesis of the literature
Authors: Walthall Helen , Floegel Theresa 
Published: November 2018

Purpose of review
The experience of breathlessness in patients with heart failure is understudied. This review was aimed at evaluating the most recent qualitative findings regarding the experience of breathlessness in persons diagnosed with heart failure.

Recent findings
A literature search was conducted using Pubmed, Psycinfo, BNI, Cinahl and Google Scholar including studies on breathlessness experience in patients with heart failure, published between 2017 and 2018. Only three studies were identified, and findings were categorized into five themes: acknowledgment of breathlessness, prevailing consequences of breathlessness, breathlessness in daily life, recognising when breathlessness is a problem and communicating breathlessness. Understanding the experience of breathlessness was different before and after heart failure diagnosis. Patients experienced similar physical and emotional consequences of breathlessness but varied in strategies to manage the symptom. Patients often do not report breathlessness symptom, or are not asked to describe their symptom by the provider.

Summary
Recent studies show those at risk for and those who have heart failure need appropriate education to recognize breathlessness as a critical symptom. In addition, adequate communication between patients and providers of the breathlessness symptom is needed to support management.
Structural heart disease: one valve does not fit all
Authors: German Konstantin S. , Kalra Ankur 
Published: November 2018

Purpose of review
Highlight the difficulties patients, physicians, and the global economy face in relation to treatment of structural heart diseases. It is easy to be carried away by the excitement of medical advancement; however, it is difficult to demonstrate restraint. Transcatheter aortic valve replacement (TAVR) is a modern marvel that can help many patients when utilized appropriately. This article highlights the work that has been done to facilitate decision-making in this challenging patient population.

Recent findings
Patient selection is of paramount importance as TAVR remains a costly intervention. Currently, our gold standards for preprocedural patient evaluation are inadequate. Apropos, several objective tools are being developed to help clinicians evaluate frailty. Giving patients a more accurate postprocedure prognosis allows them to make informed decisions on whether this intervention is appropriate for their respective goals.

Summary
In order for us to fully embrace shared decision-making and cost-effectiveness, we must continue to work on our prognostic tools and have honest conversations with patients and their families to formulate individualized treatment plans. This becomes even more important when factors like economic impact of intervention are considered. In an era where cost-effective care has garnered more attention than ever before, we must do our best to make sure our interventions are in line with patient goals and offer the maximum amount of benefit, given the current cost of TAVR.
A lipid-free and insulin-supplemented medium supportsde novofatty acid synthesis gene activation in melanoma cells
Authors: Wu Su , Näär Anders M. 
Published: November 2018

AbstractWhile investigating the role played byde novolipid (DNL) biosynthesis in cancer cells, we sought a medium condition that would support cell proliferation without providing any serum lipids. Here we report that a defined serum free cell culture medium condition containing insulin, transferrin and selenium (ITS) supports controlled study of transcriptional regulation ofde novofatty acid (DNFA) production andde novocholesterol synthesis (DNCS) in melanoma cell lines. This lipid-free ITS medium is able to support continuous proliferation of several melanoma cell lines that utilize DNL to support their lipid requirements. We show that the ITS medium stimulates gene transcription in support of both DNFA and DNCS, specifically mediated by SREBP1/2 in melanoma cells. We further found that the ITS medium promoted SREBP1 nuclear localization and occupancy on DNFA gene promoters. Our data show clear utility of this serum and lipid-free medium for melanoma cancer cell culture and lipid-related areas of investigation.
Cell-free DNA Reveals Potential Zoonotic Reservoirs in Non-Human Primates
Authors: Kowarsky Mark , Vlaminck Iwijn De , Okamoto Jennifer , Neff Norma F , LeBreton Matthew , Nwobegabay Julius , Tamoufe Ubald , Ledoux Joseph Diffo , Tafon Babila , Kiyang John , Saylors Karen , Wolfe Nathan D , Quake Stephen R 
Published: November 2018

Abstract:The microbiome of non-human primates is relatively neglected compared with humans, and yet it is a source of many zoonotic diseases. We used high throughput sequencing of circulating cell-free DNA to identify the bacteria, archaea, eukaryotic parasites and viruses from over 200 individual non-human primates across 17 species from Africa. Many of the assembled sequences have low or no homology to previously sequenced microorganisms, while those that do have homology support prior observations of specific taxa present in primate microbiomes. The structure of the total microbiome is correlated with geographic location, even between distinct primate species which are co-located. However, we find that viruses have a particularly notable association with host taxa independent of geography. Numerous potentially zoonotic taxa were discovered in an unbiased manner, thereby expanding knowledge of host species diversity and strengthening the case for monitoring wildlife reservoirs.One Sentence SummaryBlood from non-human primates provides insight into potential pathogens which might eventually infect humans.
Simulation of Karyotype Evolution and Biodiversity in Asexual and Sexual Reproduction
Authors: Ying Andrew Y. , Ye Christine J. , Jiang Hui , Horne Steven D. , Abdallah Batoul Y. , Liu Guo , Ying Hao , Heng Henry H.Q. 
Published: November 2018

AbstractWhether sexual reproduction increases biodiversity remains controversial. Traditionally, sex within a species has been thought to increase genetic diversity, inferring an acceleration of macro-evolution, promoting biodiversity. Recently, it was suggested that the main function of sex is to maintain genome integrity, rather than increase genetic diversity or purify deleterious genes within populations, as the karyotype encodes/safeguards the genomic blueprint. As such, the contribution of sex to biodiversity needs to be re-examined. Since many simulation studies focus only on gene-level selection, it is important to investigate how sexual and asexual reproduction differentially impact patterns of genome-level evolution and biodiversity. Based on the key difference between sexual and asexual reproduction, that sexual individuals are required to mate with a partner of the same genome for successful reproduction, we have performed a simulation to illustrate how such differences impact genome-mediated biodiversity. Asexual populations displayed high genome-level diversity whereas sexual populations evidenced low genome-level diversity. Further analysis demonstrated that the requirement of finding a partner possessing a compatible genome prevents new sexual species from emerging, which may explain why geographic isolation can promote speciation: by increasing mating and survival-domination opportunities. This study challenges the traditional concepts of speciation and the function of sex.
A novel polyphasic identification system for genus Trichoderma
Authors: Dou Kai , Lu Zhixiang , Wu Qiong , Ni Mi , Yu Chuanjin , Wang Meng , Li Yaqian , Wang Xinhua , Xie Huilan , Chen Jie 
Published: November 2018

AbstractAs the rapid-changing inTrichodermataxonomy, an efficient identification ofTrichodermaspecies is an urgent issue forTrichoderma-based research. In this study, based on the current taxonomy ofTrichoderma, we constructed curated databases including 338 ITS sequences, 435 TEF1 sequences, 415 RPB2 sequences and 28 phenotypic characters. In addition, a polyphasic identification system (PIST) was developed. Within PIST, the resolution ability of molecular and phenotype characters could be combined for species identification in a step-by-step way. Compared with other identification systems, the involvedTrichodermaspecies were extended from 88 to 252 species and 175 from 188 testedTrichodermaspecies could be identified within PIST. In most tested cases, three nucleotide markers and phenotypic characters showed improved identification performance. The TEF1 sequences have superior resolution than other characters.ImportanceThe genusTrichodermais important to human society with a wide application in industry, agriculture and environment bio-remediation. Thus, a quick and accurate identification ofTrichodermaspp. is paramount since it is usually the first step to conduct aTrichoderma-based scientific research and is an obstruction especially for those researchers as nematologist, chemists, nutritionist and the like, lacking of taxonomic knowledge of fungi.
Eye-movements as a signature of age-related differences in global planning strategies for spatial navigation
Authors: Tartaglia Elisa M. , Boucly Celine , Tatur Guillaume , Arleo Angelo 
Published: November 2018

AbstractThe ability to efficiently find alternatives routes when faced with unexpected obstacles along our path is among the most compelling evidence of the flexibility of human behaviour. Although a plethora of plausible computations have been put forward to elucidate how the brain accomplishes efficient goal-oriented navigation, the mechanisms that guide an effective re-planning when facing obstructions are still largely undetermined. There is a fair consensus in postulating that possible alternatives routes are internally replayed sampling from past experiences, however, there is currently no account of the criterion according to which those memories are replayed. Here, we posit that paths, which are expected to be more rewarding are replayed more often and that eye movements are the explicit manifestation of this re-planning strategy. In other words, the visual sampling statistics reflects the retrieval of available routes on a mental representation of the environment.To test our hypothesis, we measured the ability of both young and old human subjects to solve a virtual version of the Tolman maze, while we recorded their eye movements. We used reinforcement learning (RL) to corroborate that eye movements statistics was crucially subtending the decision making process involved in re-planning and that the incorporation of this additional information to the algorithm was necessary to reproduce the behavioral performance of both screened populations.
Detecting HTS Barcode Contamination
Authors: Clark Mallory A. , Stankiewicz Sara H. , Barronette Vincent , Ricke Darrell O. 
Published: November 2018

AbstractDNA barcoding enables multiple samples to be characterized in parallel with high throughput sequencing (HTS) experiments for cost efficiencies. Cross-contamination of DNA barcode reagents can result in the detection of HTS sequences for barcodes that were not originally added to a particular sample. Cross-contamination of data between multiplexed samples can also occur. Avoidance and detection of contaminated barcodes is relevant for DNA forensic samples analysis, accurate cancer diagnosis, clinical research applications, metagenomic analysis, etc. We present recommendations for the avoidance of contamination and a tool, TallyBarcodes, to aid in the detection of DNA barcode contamination.
PUMA: A tool for processing 16S rRNA taxonomy data for analysis and visualization
Authors: Mitchell Keith , Dao Christopher , Freise Amanda , Mangul Serghei , Parker Jordan Moberg 
Published: November 2018

AbstractMicrobial community profiling and functional inference via 16S rRNA analysis is quickly expanding across various areas of microbiology due to improvements to technology. There are numerous platforms for producing 16S rRNA taxonomic data which often vary in file and sequence formatting, creating a common barrier in microbiome studies. Additionally, many of the methods for analyzing and visualizing this sequencing data each require their own specific formatting. As a result, efficient and reproducible comparative analysis of taxonomic data and corresponding metadata in multiple programs remains a challenge in the investigation of microbial communities. PUMA, the Program for Unifying Microbiome Analysis, alleviates this problem in microbiome studies by allowing users to take advantage of numerous 16S rRNA taxonomic identification platforms and analysis tools in an efficient manner. PUMA accepts sequencing results from several taxonomic identification platforms and then automates configuration of data and file types for analysis and visualization via many popular tools. The protocol accomplishes this by producing a variety of properly configured, annotated, and altered files for both analysis and visualization of taxonomic community profiles and inferred functional profiles. PUMA provides an easy and flexible interface to accommodate for a variety of users to produce all files needed for all-inclusive analysis of targeted amplicon sequencing studies. PUMA is an unprecedented open-source solution for unifying multiple microbiome analysis softwares and uses an adaptable implementation with the potential to improve and consolidate the state of microbiome research.Body/Findings