bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptome Analysis of Oleaginous Fungus Mucor circinelloides WJ11 in Response to Exogenous Soybean Oil as Carbon Source
Authors: Sun Caili , Shah Aabid Manzoor , Yang Junhuan , Wang Zongmin , Zhu Lanlan , Song Yuanda
Published: June 2021

Mucor circinelloides is an oleaginous fungus that utilizes a wide variety of carbon substrates for its growth. The different sources of carbon strongly influence the total lipid content of the fungus. These different carbon substrates are assimilated and dissimilated through different metabolic pathways before entering into the TAG synthesis pathway. In the present study, we attempted to explore the mechanism of ex-novo lipid biosynthesis in M. circinelloides WJ11 in response to exogenous plant oil as a carbon source through transcriptomic analysis. The lipid content of WJ11 grown in a media containing mixed soybean oil with glucose as a carbon source was up to 43.8%, an increase of 13.9% as compared to glucose alone as the carbon source. RNA-Seq analysis was performed to investigate global gene expression patterns in the oil-treated WJ11. Based on RNA-seq analysis, among the 4646 differentially expressed genes (DEGs), 2379 were up-regulated and 2267 down-regulated. The expression of acetyl-CoA synthetase, 6-phosphofructokinase, alcohol dehydrogenase (NADP+), fructose-bisphosphate aldolase, and pyruvate kinase was down-regulated while genes related to triglyceride synthesis were up-regulated. The majority of genes and pathways related to lipid biosynthesis were up-regulated indicating a diversion of metabolic pathways towards lipid biosynthesis. The data generated advance the genomic resources and provide insights into the mechanisms of ex-novo lipid accumulation in fungi that use exogenous oil as a carbon source.
An Essay on the Challenges of Doing Education Research in Canada
Authors: Robson Karen
Published: June 2021

In this essay, I discuss the challenges faced by Canadian researchers in trying to undertake research, particularly in the area of education. I begin by focusing on the issue of data availability (with focus on the lack of race data in Canada) and the extreme limitations that these issues place on the potential for research on important Canadian education issues and then discuss what I regard as hypervigilant data access protocols for Canadian data sets. I then turn to practical issues that arise when comparing education data across cities and countries and the process of “harmonizing” the data. I address the compromises that must be made when attempting to make data comparable across different sites. I conclude by discussing how the larger context in which education occurs must be considered when understanding observed comparative differences between educational outcomes.
Species-Area Relationships Induced by Forest Habitat Fragmentation Apply Even to Rarely Detected Organisms
Authors: Palmeirim Ana Filipa , Fraga Rafael de , Vieira Marcus V. , Peres Carlos A.
Published: June 2021

Neotropical snakes have extremely low detection rates, hampering our understanding of their responses to habitat loss and fragmentation. We addressed this gap using a limited sample (50 individuals, 16 species) across 25 variable-size insular forest fragments within a hydroelectric lake and four adjacent mainland continuous forest sites, in Central Brazilian Amazonia. The number of species recorded on forest islands (1.55 [Formula: see text] 0.78) was much lower than that at continuous forest sites (5.0 [Formula: see text] 3.1), with no snakes being recorded at twelve islands smaller than 30 ha. As such, snake assemblages were positively affected by forest area, explaining 48% of the number of species, and negatively affected by island isolation. The markedly higher number of species recorded across continuous forest sites likely results from the availability of riparian habitats, which have virtually disappeared from the archipelagic landscape given the widespread inundation of lowland areas. To prevent further severe biodiversity loss, including those of poorly known rare taxa, conservation policies should avert the additional construction of mega-dams that create myriad of small islands, in addition to extensive reservoir lakes from which all riparian habitats are eliminated.
An Economic Evaluation of Disallowing Body Checking in 11- to 12-Year-Old Ice Hockey Leagues
Authors: Currie Gillian R. , Lee Raymond , Black Amanda M. , Palacios-Derflingher Luz , Hagel Brent E. , Emery Carolyn A. , Marshall Deborah A.
Published: June 2021

Background:

After a national policy change in 2013 disallowing body checking in Pee Wee ice hockey games, the rate of injury was reduced by 50% in Alberta. However, the effect on associated health care costs has not been examined previously.

Hypothesis:

A national policy removing body checking in Pee Wee (ages 11-12 years) ice hockey games will reduce injury rates, as well as costs.

Study Design:

Cost-effectiveness analysis alongside cohort study.

Level of Evidence:

Level 3.

Methods:

A cost-effectiveness analysis was conducted alongside a cohort study comparing rates of game injuries in Pee Wee hockey games in Alberta in a season when body checking was allowed (2011-2012) with a season when it was disallowed after a national policy change (2013-2014). The effectiveness measure was the rate of game injuries per 1000 player-hours. Costs were estimated based on associated health care use from both the publicly funded health care system and privately paid health care cost perspectives. Probabilistic sensitivity analysis was conducted using bootstrapping.

Results:

Disallowing body checking significantly reduced the rate of game injuries (−2.21; 95% CI [−3.12, −1.31] injuries per 1000 player-hours). We found no statistically significant difference in public health care system (−$83; 95% CI [−$386, $220]) or private health care costs (−$70; 95% CI [−$198, $57]) per 1000 player-hours. The probability that the policy of disallowing body checking was dominant (with both fewer injuries and lower costs) from the perspective of the public health care system and privately paid health care was 78% and 92%, respectively.

Conclusion:

Given the significant reduction in injuries, combined with lower public health care system and private costs in the large majority of iterations in the probabilistic sensitivity analysis, our findings support the policy change disallowing body checking in ice hockey in 11- and 12-year-old ice hockey leagues.
Evaluation of the Quality and Readability of Online Sources on the Diagnosis and Management of Osteochondral Lesions of the Ankle
Authors: Alshaikh Lamees , Shimozono Yoshiharu , Dankert John F. , Ubillus Hugo , Kennedy John G.
Published: June 2021

Objective:

Patients frequently use the internet as a source to obtain health information. The purpose of this study was to evaluate the quality and readability of online resources on the diagnosis and treatment of ankle osteochondral lesions (OCLs).

Design:

Three search terms (“ankle cartilage defect,” “cartilage injury,” “ankle cartilage damage”) were entered into 3 search engines (Google, Yahoo, and Bing). The first 20 websites from each search was collected excluding websites intended for health care providers. The quality of the websites were evaluated using the DISCERN instrument, JAMA benchmark, and a Quality rating criteria specific to ankle OCL. The readability was assessed using Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL). Statistical analysis was performed using one-way analysis of variance.

Results:

A total of 41 websites were reviewed. The mean quality ratings were poor across the assessment tools: DISCERN = 38.5 ± 9.0 (range, 23.7-56.7) out of 80; JAMA = 1.0 ± 1.1 (range, 0-3.3) out of 4; and Quality rating criteria = 11.3 ± 4.6 (range, 4-20.7) out of 24. The mean FRE and FKGL were 40.7 ± 32.0 (range, −152.3 to 60.2) and 13.5 ± 10.8 (range, 8.4-80.7), respectively; higher than the recommended reading level for patients (fifth grade).

Conclusions:

The quality and readability of credible sources for ankle OCL were poor, which could lead to misinformation. This study should guide the improvement of online information on ankle OCL.
Sweet Revenge Feels Less Bitter: Spontaneous Affective Reactions After Revenge Taking
Authors: Eder Andreas B. , Krishna Anand , Mitschke Vanessa
Published: June 2021

Previous studies suggested that people feel better after revenge taking, while other studies showed that they feel worse. The interpretation of this research is however ambiguous due to its extensive reliance on self-report measures. The present research examined spontaneous affective responses after retaliatory punishments in a laboratory task using an indirect measure of affect (affect misattribution procedure). Experiment 1 showed positive reactions after noise punishments of a provocateur compared to a control person, but only in revenge-seeking participants. Experiment 2 replicated this finding and revealed that punishing either individual led to less positive responses than not punishing anyone. It is suggested that revenge taking is associated with brief pleasurable responses that can ameliorate negative affective consequences of retaliatory action. Revenge is sweet because it makes one feel better about one’s punitive action.
A practical review study on shaped charge in the last two decades (2000–2020)
Authors: Mehmannavaz Hossein , Ramezani Ali , Nabakhteh Mohammad Amin , Liaghat Gholamhossein
Published: June 2021

Shaped charges are devices used for cutting or penetrating different aerial, on land, and underwater targets, based on the concentration of the explosion energy to the liner. The purpose of this study is to present a practical review of the studies related to shaped charges in the last twenty years (2000–2020). In this regard, these studies have been reviewed in two different categories for ordinary and advanced shaped charges. In the case of ordinary shaped charges, different aspects including shaped charges against different targets, different types of shaped charges (such as linear shaped charge and explosively formed penetrators), and theoretical advancements are presented. On the other hand, the new kinds of shaped charges developed for a specific purpose are introduced in the case of advanced shaped charges. The survey of the literature indicates that different concepts such as cut-off velocity and theoretical applicability of hydrodynamics theory in shaped charge penetration still Requires effort. Also, few studies have been focused on new shaped charges, such as hyper-velocity shaped charges, annular and dual-mode ones; and the field is still open for further progress. Besides, some of these new shaped-charges, such as double-layer shaped charges, are not realistic enough to be produced for practical purposes or the market.
The efficacy of nintedanib in 158 patients with idiopathic pulmonary fibrosis in real-world settings: A multicenter retrospective study
Authors: Dobashi Masaki , Tanaka Hisashi , Taima Kageaki , Itoga Masamichi , Ishioka Yoshiko , Shiratori Toshihiro , Okumura Fumihiko , Tabe Chiori , Tanaka Yoshihito , Morimoto Takeshi , Hasegawa Yukihiro , Yasugahira Hideo , Okudera Koichi , Takanashi Shingo , Tasaka Sadatomo
Published: June 2021

Background:

The INPULSIS trials revealed that nintedanib reduced the decline in lung function in patients with idiopathic pulmonary fibrosis. We aimed to evaluate the efficacy and safety of nintedanib in Japanese idiopathic pulmonary fibrosis patients in real-world settings.

Method:

Medical records of idiopathic pulmonary fibrosis patients, who received treatment with nintedanib in five institutions between July 2015 and June 2017, were reviewed. Patients with % forced vital capacity ⩾50% and % predicted diffusing capacity of the lung carbon monoxide ⩾30% were classified as the moderate group and those with more impaired lung functions as the severe group.

Result:

Among 158 patients analyzed, 132 (84.6%) were classified as the moderate group and 26 (15.4%) as the severe group. In the moderate group, changes in forced vital capacity in 12 months were significantly different between before and after nintedanib administration (−253 ± 163 vs −125 ± 235 mL; p = 0.0027). In contrast, changes in forced vital capacity in 12 months were not significantly changed by nintedanib treatment in the severe group (−353 ± 250 vs −112 ± 341 mL; p = 0.2374). Incidence of acute exacerbation was higher in the severe group than in the moderate group (30.8% vs 18.9%). The overall survival of the moderate and the severe groups was 17.2 and 10.1 months.

Conclusion:

In real-world practice, nintedanib showed comparable efficacy to those observed in previous trials. In the severe group, the efficacy of nintedanib might be limited.
Palliative Opioids May Be a Bridge to Care for Rural Long-Term Care Facility Residents with Severe COVID-19 Symptoms
Authors: Crocetti Emily , Assadzandi Shauna , Pilkerton Courtney S. , Ashcraft Amie M. , Shrader Carl D.
Published: June 2021

Purpose

Long term care facility (LTCF) residents are at high risk for severe COVID-19 symptoms, but those in rural and resource-limited areas, such as West Virginia (WV) and the larger Appalachian region, may experience delays in obtaining higher levels of medical care due to isolated geography and limited transportation. The study examined the outcomes between residents from 1 LCTF in WV who were moved to a hospital as compared to those remaining in the facility.

Methods

This cohort study compares mortality outcomes among severely symptomatic residents desiring hospitalization and those electing to stay at the facility receiving palliative opioids with supplemental oxygen.

Findings

Forty residents tested positive for COVID-19 with 11 developing severe respiratory symptoms. Eight residents elected to receive care at the LTCF while 3 desired hospitalization. Mortality was assessed at 4 time points and was not statistically different between those who were hospitalized versus those who received palliative opioids at the LTCF. Although not significant, the difference in mortality between those hospitalized (66.7%) and those receiving opioids at the LTCF (12.5%) in the acute phase trended toward significance ( P = .072). Overall mortality at the 6-month time point among all residents who developed severe respiratory symptoms at this LTCF was 54.5%.

Conclusions

LTCF residents choosing different levels of therapeutic intervention for severe COVID-19 symptoms had no mortality difference. Palliative opioids may be an effective treatment for LTCF residents with severe COVID-19 and also a bridge to care in rural areas with limited resources until more advanced treatments can be accessed.
An Exploratory Mixed Methods Study of Experiences of Interprofessional Teams Who Received Coaching to Simultaneously Redesign Primary Care Education and Clinical Practice
Authors: Carney Patricia A. , Dickinson W. Perry , Fetter Jay , Warm Eric J. , Zierler Brenda , Patton Jill , Kirschner Greg , Crane Steven D. , Shrader Sarah , Eiff M. Patrice
Published: June 2021

Introduction/Objectives:

Coaching is emerging as a form of facilitation in health professions education. Most studies focus on one-on-one coaching rather than team coaching. We assessed the experiences of interprofessional teams coached to simultaneously improve primary care residency training and interprofessional practice.

Methods:

This three-year exploratory mixed methods study included transformational assistance from 9 interprofessional coaches, one assigned to each of 9 interprofessional primary care teams that included family medicine, internal medicine, pediatrics, nursing, pharmacy and behavioral health. Coaches interacted with teams during 2 in-person training sessions, an in-person site visit, and then as requested by their teams. Surveys administered at 1 year and end study assessed the coaching relationship and process.

Results:

The majority of participants (82% at end of Year 1 and 76.6% at end study) agreed or strongly agreed that their coach developed a positive working relationship with their team. Participants indicated coaches helped them: (1) develop as teams, (2) stay on task, and (3) respond to local context issues, with between 54.3% and 69.2% agreeing or strongly agreeing that their coaches were helpful in these areas. Cronbach’s alpha for the 15 coaching survey items was 0.965. Challenges included aligning the coach’s expertise with the team’s needs.

Conclusions:

While team coaching was well received by interprofessional teams of primary care professionals undertaking educational and clinical redesign, the 3 primary care disciplines have much to learn from each other regarding how to improve inter- and intra-professional collaborative practice among clinicians and staff as well as with interprofessional learners rotating through their outpatient clinics.
Cardio-Pulmonary Sequelae in Recovered COVID-19 Patients: Considerations for Primary Care
Authors: Sarfraz Zouina , Sarfraz Azza , Barrios Alanna , Garimella Radhika , Dominari Asimina , KC Manish , Pandav Krunal , Pantoja Juan C. , Retnakumar Varadha , Cherrez-Ojeda Ivan
Published: June 2021

Background:

Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care.

Methods:

Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords “COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication.” We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, while making healthcare considerations for primary care workers.

Results:

We identified 29 studies across 9 countries including 37.9% Chinese and 24.1% U.S. studies, comprising 655 patients (Mean Age = 45) with various ethnical backgrounds including Asian and European. Based on the WHO COVID-19 severity classification scale, initial disease severity was mild for 377 patients and severe for 52 patients. Treatments during primary infection included corticosteroids, oxygen support, and antivirals. The mean value (in days) for complication onset after acute recovery was 28 days. Complete blood counts and RT-PCR tests were the most common laboratory results described. In 22 of the studies, patients showed signs of clinical improvement and were prescribed medications such as anticoagulants or corticosteroids.

Conclusion:

Post-recovery infectious complications are common in long-COVID-19 patients ranging from mild infections to life-threatening conditions. International thoracic and cardiovascular societies need to develop guidelines for patients recovering from COVID-19 pneumonia, while focused patient care by the primary care physician is crucial to curb preventable adverse events. Recommendations for real-time and lab-quality diagnostic tests are warranted to establish point-of-care testing, detect early complications, and provide timely treatment.
Assessing Primary Care Contributions to Behavioral Health: A Cross-sectional Study Using Medical Expenditure Panel Survey
Authors: Jetty Anuradha , Petterson Stephen , Westfall John M. , Jabbarpour Yalda
Published: June 2021

Objectives

To assess primary care contributions to behavioral health in addressing unmet mental healthcare needs due to the COVID-19 pandemic.

Methods

Secondary data analysis of 2016 to 2018 Medical Expenditure Panel Survey of non-institutionalized US adults. We performed bivariate analysis to estimate the number and percentage of office-based visits and prescription medications for depression and anxiety disorders, any mental illness (AMI), and severe mental illness (AMI) by physician specialty (primary care, psychiatry, and subspecialty) and medical complexity. We ran summary statistics to compare the differences in sociodemographic factors between patients with AMI by seeing a primary care physician versus those seeing a psychiatrist. Binary logistic regression models were estimated to examine the likelihood of having a primary care visit versus psychiatrist visit for a given mental illness.

Results

There were 394 023 office-based visits in the analysis sample. AMI patients seeing primary care physician were thrice as likely to report 1 or more chronic conditions compared to those seeing psychiatrist. Among patients with a diagnosis of depression or anxiety and AMI the proportion of primary care visits ([38% vs 32%, P < .001], [39% vs 34%, P < .001] respectively), and prescriptions ([50% vs 40%, P < .001], [47% vs 44%, P < .05] respectively) were higher compared to those for psychiatric care. Patients diagnosed with SMI had a more significant percentage of prescriptions and visits to a psychiatrist than primary care physicians.

Conclusion

Primary care physicians provided most of the care for depression, anxiety, and AMI. Almost a third of the care for SMI and a quarter of the SMI prescriptions occurred in primary care settings. Our study underscores the importance of supporting access to primary care given primary care physicians’ critical role in combating the COVID-19 related rise in mental health burden.
Don’t Wait, Communicate: Rural School Counselors and Disaster Mental Health
Authors: Crumb Loni , Appling Brandee , Jones Shenika
Published: June 2021

This study explored rural school counselors’ experiences regarding their preparation and response to natural disasters. Using descriptive phenomenology, we examined the perspectives of 10 school counselors and identified four themes that captured their experiences: (a) the need for disaster mental health training, (b) the value of rural community collaboration, (c) the influence of multiple roles, and (d) personal reactions to disaster response. We provide implications and recommendations about expanding crisis training to include disaster mental health.
Linguistic Capital in the University and the Hegemony of English: Medieval Origins and Future Directions
Authors: Abrar-ul-Hassan Shahid
Published: June 2021

As the institution of university has evolved into a highly diverse educational community, the language of communication (or linguistic capital) in higher education plays a vital role. Therefore, English as a medium of instruction (EMI) became the dominant characteristic of academia in many parts of a (globalized) world. This growing influence of EMI has affected the scope of both higher education and academic research. Being a linguistic form of capital, the significance of English as a major linguistic resource can be analyzed historically since the institution of university was founded. In fact, EMI seems to have challenged the linguistic diversity and accessibility to higher education in the contemporary world. The case of Canadian higher education highlights new directions in the exploitation of the linguistic capital at university, and the emerging concept of a multilingual university could offer some unique opportunities for knowledge mobilization and access to higher education. Thus, the issue of linguistic capital at the current (globalized) university needs to be re-examined.
New Localism in the Neoliberal Era: Local District Response to Voluntary Open-School Markets in Ohio
Authors: Lee Jin
Published: June 2021

Local education governance has allowed neighborhood schools to offer community-oriented curricula and activities, and public schools have been operated to serve only residents’ children within the defined areas. The rise of neoliberalism may, however, undermine political foundations of the traditional political systems. This article explores how self-governed local education authorities function and evolve under neoliberalism by revisiting core values in localism and neoliberalism. By looking into the voluntary open-enrollment policy in Ohio, this study finds that the local governments surrounded by dissimilar neighborhoods are more likely to depend on the mechanism of localism to protect local authorities and locational privileges. This research argues that neoliberal policies safeguard community interests by deeply engaging with interchanging resources across their borders in regional market environments.
The Role of Katara Cultural Village in Enhancing and Marketing the Image of Qatar: Evidence From TripAdvisor
Authors: Abaalzamat Khalid Hamad , Al-Sulaiti Khalid Ibrahim , Alzboun Nidal Mohammed , Khawaldah Hamzah Ali
Published: June 2021

The aim of this study was to examine the extent to which Katara Cultural Village enhances the image of Qatar, based on reviewers’ posts on TripAdvisor. It also sought to analyze the current situation of Katara from the managers’ perspective. A total of 2,342 comments about Katara on the TripAdvisor website were analyzed using content analysis. Three focus group meetings with eight divisional managers in Katara were also conducted and analyzed using thematic analysis. The results show a high level of overall satisfaction among TripAdvisor reviewers from different nationalities and backgrounds. A word frequency count presents Katara positively as a good destination for cultural experience, with amazing and attractive features. According to the comments, Katara contributes to enhancing the image of Qatar and Qatari culture worldwide. The Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis based on the focus group meetings with managers provided a clear and in-depth understanding of Katara’s current strengths, weaknesses, opportunities, and threats. This analysis can be important to planners and policy makers in Katara in developing and adopting suitable policies and strategies.
Distal Junctional Kyphosis after Posterior Spinal Fusion in Lenke 1 and 2 Adolescent Idiopathic Scoliosis-Exploring Detailed Features of the Sagittal Stable Vertebra Concept
Authors: Wang Po-Yao , Chen Chih-Wei , Lee Yuan-Fuu , Hu Ming-Hsiao , Wang Ting-Ming , Lai Po-Liang , Yang Shu-Hua
Published: June 2021

Study Design:

A retrospective cohort study.

Objective:

To investigate the factors contributing to the development of postoperative distal junctional kyphosis (DJK) in adolescent idiopathic scoliosis (AIS) patients who underwent posterior spinal fusion (PSF) with lowest instrumented vertebrae (LIV) at or above L1.

Methods:

Patients with Lenke type 1 or 2 curves who underwent PSF with LIV at or above L1 with a minimum follow-up of 2 years were evaluated. The primary outcome measure was the occurrence of postoperative DJK. Radiographic parameters of sagittal alignment and inclusion/exclusion of sagittal stable vertebra (SSV) in PSF were analyzed to determine their associations with the occurrence of postoperative DJK.

Results:

Overall, 122 patients (mean age: 15.1 ± 3.2 years) were included. The overall incidence of postoperative DJK was 6.6%. DJK was observed in 19.0% (8/42) of patients whose SSV was not included in PSF and not in patients with SSV included in PSF (n = 80). In the SSV-excluded group, univariate analysis found two significant risk factors for DJK: postoperative thoracic kyphosis (TK, T5-12) and postoperative thoracolumbar kyphosis (TLK, T11-L2). The ROC curve revealed that postoperative TK ≥ 25° and TLK ≥ 10° best predicted the occurrence of postoperative DJK in the SSV-excluded group. The incidence was significantly higher in cases with postoperative TK ≥ 25° or TLK ≥ 10° (7/13 = 53.8%) than in those with postoperative TK < 25° and TLK < 10° (1/29 = 3.4%).

Conclusions:

The current study revealed that postoperative TK ≥ 25° or postoperative TLK ≥ 10° with SSV excluded from PSF were related to DJK after PSF for Lenke type 1 and type 2 AIS. When the SSV is intended to be spared from PSF to save more motion segments, TK and TLK should be carefully evaluated and attained in a lesser magnitude (TK < 25°, TLK < 10°) after surgery.
Association Between Rotator Cuff Tears and Superior Migration of the Humeral Head: An MRI-Based Anatomic Study
Authors: Siow Matthew Y. , Mitchell Brendon C. , Hachadorian Michael , Wang Wilbur , Bastrom Tracey , Kent William T. , Huang Brady K. , Edmonds Eric W.
Published: June 2021

Background:

Superior humeral migration has been established as a component of rotator cuff disease, as it disrupts normal glenohumeral kinematics. Decreased acromiohumeral interval (AHI) as measured on radiographs has been used to indicate rotator cuff tendinopathy. Currently, the data are mixed regarding the specific rotator cuff pathology that contributes the most to humeral head migration.

Purpose:

To determine the relationship between severity of rotator cuff tears (RCTs) and AHI via a large sample of magnetic resonance imaging (MRI) shoulder examinations.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A search was performed for 3-T shoulder MRI performed in adults for any indication between January 2010 and June 2019 at a single institution. Three orthopaedic surgeons and 1 musculoskeletal radiologist measured AHI on 2 separate occasions for patients who met the inclusion criteria. Rotator cuff pathologies were recorded from imaging reports made by fellowship-trained musculoskeletal radiologists.

Results:

A total of 257 patients (mean age, 52 years) met the inclusion criteria. Of these, 199 (77%) had at least 1 RCT, involving the supraspinatus in 174 (67.7%), infraspinatus in 119 (46.3%), subscapularis in 80 (31.1%), and teres minor in 3 (0.1%). Full-thickness tears of the supraspinatus, infraspinatus, or subscapularis tendon were associated with significantly decreased AHI (7.1, 5.3, and 6.8 mm, respectively) compared with other tear severities ( P < .001). Having a larger number of RCTs was also associated with decreased AHI (ρ = –0.157; P = .012). Isolated infraspinatus tears had the lowest AHI (7.7 mm), which was significantly lower than isolated supraspinatus tears (8.9 mm; P = .047).

Conclusion:

Although various types of RCTs have been associated with superior humeral head migration, this study demonstrated a significant correlation between a complete RCT and superior humeral migration. Tears of the infraspinatus tendon seemed to have the greatest effect on maintaining the native position of the humeral head. Further studies are needed to determine whether early repair of these tears can slow the progression of rotator cuff disease.
Predictive Analytics for the KMAP-O Model in Design and Evaluation of Diabetes Care Management Research
Authors: Wan Thomas T.H.
Published: June 2021

This is a commentary on methodological challenges and analytical requirements in designing an evaluation of the knowledge, motivation, attitude, preventive practice-outcome (KMAP-O) model for selfcare management of diabetes. Critical issues pertaining to an investigation of the dose-response relationship between the intervention program and outcomes, the comparative effectiveness evaluation, and the lengths of observation were noted. Although numerous publications on factors influencing diabetes care and control were systematically reviewed and documented in the literature, scientific results on artificial intelligence research remain to be uncovered. To optimizing the knowledge and clinical practice in selfcare management, specific methodological approaches to predictive analytics are suggested for future clinical studies, using a comprehensive behavioral system such as the KMAP-O model.
Measuring Entrepreneurial Self-efficacy: A Comprehensive Scale
Authors: Taneja Chawla Neha , Bhatia Hitesh
Published: June 2021

With the increasing popularity of entrepreneurship education programs across the world, the impact assessment of such programs has gathered considerable interest of the researchers. Growing number of studies are including entrepreneurial self-efficacy (ESE) as a key predictor of future entrepreneurial behaviour and hence the scale for measuring ESE is central to majority of studies pertaining to entrepreneurship education and entrepreneurial behaviour. This study attempts to refine the existing instruments for measuring ESE by extensively reviewing the notable scales of ESE in literature and develops a comprehensive scale of ESE relevant in the Indian context. The additional components are added to the existing scales through expert discussions with the academicians as well as entrepreneurs. The scale is further verified for its reliability and validity by using appropriate statistical methods.
Clinical Characteristics and HealthCare Resource Utilization in Patients With Generalized Pustular Psoriasis: Real-World Evidence From a Large Claims-Based Dataset
Authors: Crowley Jeffrey , Golembesky Amanda K. , Kotowsky Nirali , Gao Ran , Bohn Rhonda L. , Garry Elizabeth M. , Pisc Julia A. , Valdecantos Wendell C. , Feldman Steven R. , Menter Alan
Published: June 2021

Background:

Generalized pustular psoriasis (GPP) is a rare, severe neutrophilic skin disease with significant unmet clinical need. Historically, GPP has not been well characterized; however, the advent of the International Classification of Diseases, 10th revision, has made it possible to more accurately characterize patients with GPP.

Objective:

To describe the characteristics and estimate the burden of disease in patients with GPP compared with those with plaque psoriasis.

Methods:

A retrospective study was conducted using a US administrative claims database, Optum® Clinformatics® Data Mart, between October 1, 2015, and March 31, 2019. Patients with at least 1 inpatient or 2 outpatient diagnosis codes for GPP (L40.1) or psoriasis vulgaris (L40.0) were included. The main outcome measures included the percentage of individuals with comorbidities, medication use, and healthcare resource utilization (HCRU), which were compared between patients with GPP and those with plaque psoriasis and a general population comparator control cohort.

Results:

Overall, 1,669 patients with GPP were identified at baseline; most patients were female (67.6%). Patients with GPP had more comorbidities than those with plaque psoriasis, specifically metabolic disorders: hyperlipidemia and type 2 diabetes. Medication use for patients with GPP differed from those with plaque psoriasis—patients with GPP required more frequent use of antihypertensives and antibiotics than those with plaque psoriasis. Patients with GPP also had higher HCRU than those with plaque psoriasis.

Conclusion:

Although this study has limitations, it shows that patients with GPP have a high burden of illness that differs from patients with plaque psoriasis.
A Critical Assessment and Review of Artificial Intelligence in Facial Paralysis Analysis: Uncovering the Truth
Authors: Mitchell David T. , Allen David Z. , Greives Matthew R. , Nguyen Phuong D.
Published: June 2021

Machine learning is a rapidly growing subset of artificial intelligence (AI) which involves computer algorithms that automatically build mathematical models based on sample data. Systems can be taught to learn from patterns in existing data in order to make similar conclusions from new data. The use of AI in facial emotion recognition (FER) has become an area of increasing interest for providers who wish to quantify facial emotion before and after interventions such as facial reanimation surgery. While FER deep learning algorithms are less subjective when compared to layperson assessments, the databases used to train them can greatly alter their outputs. There are currently many well-established modalities for assessing facial paralysis, but there is also increasing interest in a more objective and universal measurement system to allow for consistent assessments between practitioners. The purpose of this article is to review the development of AI, examine its existing uses in facial paralysis assessment, and discuss the future directions of its implications.
Evolution of CT findings after anticoagulant treatment for acute pulmonary embolism in patients with and without an ultimate diagnosis of chronic thromboembolic pulmonary hypertension
Authors: Braams Natalia J. , Boon Gudula J.A.M. , de Man Frances S. , van Es Josien , den Exter Paul L. , Kroft Lucia J.M. , Beenen Ludo F.M. , Huisman Menno V. , Nossent Esther J. , Boonstra Anco , Vonk Noordegraaf Anton , Ruigrok Dieuwertje , Klok Frederikus A. , Bogaard Harm Jan , Meijboom Lilian J.
Published: June 2021

Introduction

The pulmonary arterial morphology of patients with pulmonary embolism (PE) is diverse and it is unclear how the different vascular lesions evolve after initiation of anticoagulant treatment. A better understanding of the evolution of computed tomography pulmonary angiography (CTPA) findings after the start of anticoagulant treatment may help to better identify those PE patients prone to develop chronic thromboembolic pulmonary hypertension (CTEPH). We aimed to assess the evolution of various thromboembolic lesions on CTPA over time after the initiation of adequate anticoagulant treatment in individual acute PE patients with and without an ultimate diagnosis of CTEPH.

Methods

We analysed CTPA at diagnosis of acute PE (baseline) and at follow-up in 41 patients with CTEPH and 124 patients without an ultimate diagnosis of CTEPH, all receiving anticoagulant treatment. Central and segmental pulmonary arteries were scored by expert chest radiologists as normal or affected. Lesions were further subclassified as 1) central thrombus, 2) total thrombotic occlusion, 3) mural thrombus, 4) web or 5) tapered pulmonary artery.

Results

Central thrombi resolved after anticoagulant treatment, while mural thrombi and total thrombotic occlusions either resolved or evolved into webs or tapered pulmonary arteries. Only patients with an ultimate diagnosis of CTEPH exhibited webs and tapered pulmonary arteries on the baseline scan. Moreover, such lesions always persisted after follow-up.

Conclusions

Webs and tapered pulmonary arteries at the time of PE diagnosis strongly indicate a state of chronic PE and should raise awareness for possible CTEPH, particularly in patients with persistent dyspnoea after anticoagulant treatment for acute PE.
R-scale for pulmonary fibrosis: a simple, visual tool for the assessment of health-related quality of life
Authors: Scallan Ciaran , Strand Lauren , Hayes Jennifer , Kadura Suha , Collins Bridget , Ho Lawrence , Spada Carolyn , Canestaro Will , Kolb Martin , Raghu Ganesh
Published: June 2021

Rationale

Patients with idiopathic pulmonary fibrosis (IPF) experience impaired health-related quality of life (HRQoL). Several tools have been developed to objectively assess HRQoL in this patient population, but none are in use in routine clinical practice.

Objectives

To develop a rapid, specific tool that can be used for patients with IPF during routine clinic visits.

Methods

A novel and simple five-item numerical rating scale was developed and compared with two other previously validated tools. 100 consecutive patients with IPF managed at a centre for interstitial lung disease were recruited to complete the Raghu scale for pulmonary fibrosis (R-Scale-PF), King's Brief Interstitial Lung Disease questionnaire (K-BILD), and the EuroQol Five-Dimensional Five-Level questionnaire (EQ-5D-5L) in addition to pulmonary function and 6-min walk tests.

Measurements and main results

All 100 patients successfully completed the three HRQoL tools with 53 completing them again at follow-up visits. Internal consistency was high (Cronbach's α 0.825) with minimal floor/ceiling effect. Concurrent validity of the R-Scale-PF was moderate to high compared with the K-BILD (r=−0.713) and the EQ-5D-5L (r=−0.665). Concurrent validity was moderate with physiologic measures (forced vital capacity,r=−0.307, 6-min walking distance,r=−0.383). The R-Scale-PF demonstrated good known-groups validity when comparing scores across stages of disease severity.

Conclusions

The R-Scale-PF correlates well with the K-BILD and EQ-5D-5L. It is hoped that this novel simple numerical rating scale tool, subject to validation in patients from other centres, will provide an opportunity to objectively measure HRQoL in routine clinical practice for patients with IPF.
Mesenchymal stromal (stem) cell therapy modulates miR-193b-5p expression to attenuate sepsis-induced acute lung injury
Authors: dos Santos Claudia C. , Amatullah Hajera , Vaswani Chirag M. , Maron-Gutierrez Tatiana , Kim Michael , Mei Shirley H.J. , Szaszi Katalin , Monteiro Ana Paula T. , Varkouhi Amir K. , Herreroz Raquel , Lorente Jose Angel , Tsoporis James N. , Gupta Sahil , Ektesabi Amin , Kavantzas Nikolaos , Salpeas Vasileios , Marshall John C. , Rocco Patricia R.M. , Marsden Philip A. , Weiss Daniel J. , Stewart Duncan J. , Hu Pingzhao , Liles W. Conrad
Published: June 2021

Although mesenchymal stromal (stem) cell (MSC) administration attenuates sepsis-induced lung injury in pre-clinical models, the mechanism(s) of action and host immune system contributions to its therapeutic effects remain elusive. We show that treatment with MSCs decreased expression of host-derived microRNA (miR)-193b-5p and increased expression of its target gene, the tight junctional protein occludin (Ocln), in lungs from septic mice. Mutating the Ocln 3′ untranslated region miR-193b-5p binding sequence impaired binding to Ocln mRNA. Inhibition of miR-193b-5p in human primary pulmonary microvascular endothelial cells prevents tumour necrosis factor (TNF)-induced decrease in Ocln gene and protein expression and loss of barrier function. MSC-conditioned media mitigated TNF-induced miR-193b-5p upregulation and Ocln downregulationin vitro. When administeredin vivo, MSC-conditioned media recapitulated the effects of MSC administration on pulmonary miR-193b-5p and Ocln expression. MiR-193b-deficient mice were resistant to pulmonary inflammation and injury induced by lipopolysaccharide (LPS) instillation. Silencing of Ocln in miR-193b-deficient mice partially recovered the susceptibility to LPS-induced lung injury.In vivoinhibition of miR-193b-5p protected mice from endotoxin-induced lung injury. Finally, the clinical significance of these results was supported by the finding of increased miR-193b-5p expression levels in lung autopsy samples from acute respiratory distress syndrome patients who died with diffuse alveolar damage.
Manipulation of the Magnetic Properties of Janus WSSe Monolayer by the Adsorption of Transition Metal Atoms
Authors: Chen Kai , Tang Weiqing , Fu Mingming , Li Xu , Ke Congming , Wu Yaping , Wu Zhiming , Kang Junyong
Published: June 2021

Two-dimensional Janus materials have great potential for the applications in spintronic devices due to their particular structures and novel characteristics. However, they are usually non-magnetic in nature. Here, different transition metals (TMs: Co, Fe, Mn, Cr, and V) adsorbed WSSe frameworks are constructed, and their structures and magnetic properties are comprehensively investigated by first-principles calculations. The results show that the top of W atom is the most stable absorption site for all the TM atoms, and all the systems exhibit magnetism. Moreover, their magnetic properties significantly depend on the adsorbed elements and the adsorbent chalcogens. A maximal total magnetic moment of 6 μB is obtained in the Cr-adsorbed system. The induced magnetism from S-surface-adsorption is always stronger than that for the Se-surface-adsorption due to its larger electrostatic potential. Interestingly, the easy magnetization axis in the Fe-adsorbed system switches from the in-plane to the out-of-plane when the adsorption surface changes from Se to S surface. The mechanism is analyzed in detail by Fe-3d orbital-decomposed density of states. This work provides a guidance for the modification of magnetism in low-dimensional systems.
Genotype-determined EGFR-RTK heterodimerization and its effects on drug resistance in lung Cancer treatment revealed by molecular dynamics simulations
Authors: Zhu Mengxu , Wang Debby D. , Yan Hong
Published: June 2021

Background

Epidermal growth factor receptor (EGFR) and its signaling pathways play a vital role in pathogenesis of lung cancer. By disturbing EGFR signaling, mutations of EGFR may lead to progression of cancer or the emergence of resistance to EGFR-targeted drugs.

Results

We investigated the correlation between EGFR mutations and EGFR-receptor tyrosine kinase (RTK) crosstalk in the signaling network, in order to uncover the drug resistance mechanism induced by EGFR mutations. For several EGFR wild type (WT) or mutated proteins, we measured the EGFR-RTK interactions using several computational methods based on molecular dynamics (MD) simulations, including geometrical characterization of the interfaces and conventional estimation of free energy of binding. Geometrical properties, namely the matching rate of atomic solid angles in the interfaces and center-of-mass distances between interacting atoms, were extracted relying on Alpha Shape modeling. For a couple of RTK partners (c-Met, ErbB2 and IGF-1R), results have shown a looser EGFR-RTK crosstalk for the drug-sensitive EGFR mutant while a tighter crosstalk for the drug-resistant mutant. It guarantees the genotype-determined EGFR-RTK crosstalk, and further proposes a potential drug resistance mechanism by amplified EGFR-RTK crosstalk induced by EGFR mutations.

Conclusions

This study will lead to a deeper understanding of EGFR mutation-induced drug resistance mechanisms and promote the design of innovative drugs.
The role of SARC-F scale in predicting progression risk of COVID-19 in elderly patients: a prospective cohort study in Wuhan
Authors: Ma Yao , He Min , Hou Li-Sha , Xu Shen , Huang Zhi-Xin , Zhao Na , Kang Yan , Yue Ji-Rong , Wu Chenkai
Published: June 2021

Background

Since the outbreak of COVID-19, it has been documented that old age and underlying illnesses are associated with poor prognosis among COVID-19 patients. However, it is unknown whether sarcopenia, a common geriatric syndrome, is associated with poor prognosis among older COVID-19 patients. The aim of our prospective cohort study is to investigate the association between sarcopenia risk and severe disease among COVID-19 patients aged ≥60 years.

Method

A prospective cohort study of 114 hospitalized older patients (≥60 years) with confirmed COVID-19 pneumonia between 7 February, 2020 and 6 April, 2020. Epidemiological, socio-demographic, clinical and laboratory data on admission and outcome data were extracted from electronic medical records. All patients were assessed for sarcopenia on admission using the SARC-F scale and the outcome was the development of the severe disease within 60 days. We used the Cox proportional hazards model to identify the association between sarcopenia and progression of disease defined as severe cases in a total of 2908 person-days.

Result

Of 114 patients (mean age 69.52 ± 7.25 years, 50% woman), 38 (33%) had a high risk of sarcopenia while 76 (67%) did not. We found that 43 (38%) patients progressed to severe cases. COVID-19 patients with higher risk sarcopenia were more likely to develop severe disease than those without (68% versus 22%, p < 0.001). After adjustment for demographic and clinical factors, higher risk sarcopenia was associated with a higher hazard of severe condition [hazard ratio = 2.87 (95% CI, 1.33–6.16)].

Conclusion

We found that COVID-19 patients with higher sarcopenia risk were more likely to develop severe condition. A clinician-friendly assessment of sarcopenia could help in early warning of older patients at high-risk with severe COVID-19 pneumonia.