bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tissue tolerance mechanisms conferring salinity tolerance in a halophytic perennial species Nitraria sibirica Pall.
Authors: Tang Xiaoqian , Zhang Huilong , Shabala Sergey , Li Huanyong , Yang Xiuyan , Zhang Huaxin 
Published: December 2020

Abstract
Plant salt tolerance relies on a coordinated functioning of different tissues and organs. Salinity tissue tolerance is one of the key traits that confer plant adaptation to saline environment. This trait implies maintenance low cytosolic Na+/K+ ratio in metabolically active cellular compartments. In this study, we used Nitraria sibirica Pall., a perennial woody halophyte species, to understand the mechanistic basis of its salinity tissue tolerance. The results showed that the growth of seedlings was stimulated by 100–200 mM NaCl treatment. The ions distribution analysis showed that the leaves act as an Na+ sink, while the plant roots possess superior K+ retention. The excessive Na+ absorbed from the soil was mainly transported to the shoot and was eventuallysequestrated into mesophyll vacuoles in the leaves. As a result, N. sibirica could keep the optimal balance of K+/Na+ at a tissue- and cell-specific level under saline condition. To enable this, N. sibirica increased both vacuolar H+-ATPase and H+-PPase enzymes activities and up-regulated the expressions of NsVHA, NsVP1 and NsNHX1 genes. Vacuolar Na+ sequestration in the leaf mesophyll, mediated by NsVHA, NsVP1 and NsNHX1, reduced the Na+ concentration in cytosol and inhibited further K+ loss. Meanwhile, N. sibirica enhanced the Two Pore K+ expression at the transcriptional level to promote K+ efflux from vacuole into cytoplasm, assisting in maintaining cytosolic K+ homeostasis. It is concluded that the tissue tolerance traits such as vacuolar Na+ sequestration and intracellular K+ homeostasis are critical to confer adaptation of N. sibirica to soil salinity.
Genomic epidemiology of a densely sampled COVID-19 outbreak in China
Authors: Geidelberg Lily , Boyd Olivia , Jorgensen David , Siveroni Igor , Nascimento Fabrícia F , Johnson Robert , Ragonnet-Cronin Manon , Fu Han , Wang Haowei , Xi Xiaoyue , Chen Wei , Liu Dehui , Chen Yingying , Tian Mengmeng , Tan Wei , Zai Junjie , Sun Wanying , Li Jiandong , Li Junhua , Volz Erik M , Li Xingguang , Nie Qing 
Published: December 2020

AbstractAnalysis of genetic sequence data from the SARS-CoV-2 pandemic can provide insights into epidemic origins, worldwide dispersal, and epidemiological history. With few exceptions, genomic epidemiological analysis has focused on geographically distributed data sets with few isolates in any given location. Here, we report an analysis of 20 whole SARS- CoV-2 genomes from a single relatively small and geographically constrained outbreak in Weifang, People’s Republic of China. Using Bayesian model-based phylodynamic methods, we estimate a mean basic reproduction number (R0) of 3.4 (95% highest posterior density interval: 2.1–5.2) in Weifang, and a mean effective reproduction number (Rt) that falls below 1 on 4 February. We further estimate the number of infections through time and compare these estimates to confirmed diagnoses by the Weifang Centers for Disease Control. We find that these estimates are consistent with reported cases and there is unlikely to be a large undiagnosed burden of infection over the period we studied.
Organizational Commitment of Nurse Faculty Teaching in Accelerated Baccalaureate Nursing Programs
Authors: Donovan Laureen M. , Payne Camille L. 
Published: December 2020

ABSTRACT

AIM
The aim of the study was to examine organizational commitment by exploring experiences of faculty in Accelerated Bachelor of Science in Nursing (ABSN) programs.

BACKGROUND
ABSN faculty report that the curriculum is intense and fast-paced.

METHOD
A cross-sectional survey design was used to examine faculty organizational commitment. A 53-item self-reported survey with closed questions measured organizational commitment, global job satisfaction, and work conditions. ABSN programs were recruited using cluster random sampling from a five-region list of programs; 62 programs were recruited with total faculty participation of 104.

RESULTS
ABSN faculty were found to be affectively and normatively committed to their organizations. Significant predictor variables of work environment conditions were stress and experiences of shortcomings, professional development, managerial support, and global job satisfaction.

CONCLUSION
As ABSN programs continue to flourish, it is important to identify strategies for faculty success within the fast-paced curricula.
Multimodal Rehabilitation Following Gliosarcoma Resection: A Case Report
Authors: van Rij Stephen , Andrews A. Williams , Freund Jane , Bailey Stephen 
Published: December 2020

Background and Purpose:
Gliosarcoma is a highly malignant brain cancer with an exceptionally poor medical prognosis. Despite poor prognostic indicators, rehabilitation may improve quality of life and restore independence. Little research is available to guide physical rehabilitation in this population. Medical and rehabilitation prognoses are interdependent, yet distinct in terms of objective and elements of consideration.

Case Description:
The patient was a female in her 70s who was diagnosed with a grade IV gliosarcoma of the left frontoparietal region. The tumor was surgically resected and severe postoperative complications resulted. Following medical stabilization, she spent 2 weeks in inpatient rehabilitation, followed by 4 months of hospice care. She was discharged to skilled nursing for rehabilitation including physical, occupational, and speech-language therapy.

Interventions:
Multimodal rehabilitation included functional tasks, neuromotor, resistance, and gait training over 6 weeks to maximize motor function and independence.

Outcomes:
The minimal detectable change was met or exceeded for fast gait speed, Berg Balance Scale, Timed Up and Go test, and Dynamic Gait Index. The minimal clinically important difference was exceeded for comfortable gait speed, Six-Minute Walk Test, and grip strength dynamometry. She was discharged to an assisted living facility.

Discussion:
Little research is available to guide intervention parameters for those with highly malignant gliomas receiving palliative care. Despite an exceptionally poor medical prognosis, skilled rehabilitation improved independence in an individual following gliosarcoma resection and should be considered for similar patients.
Physical Mobility and Balance Performance Differs in Older Cancer Survivors With Impaired Executive Function
Authors: Blackwood Jennifer , Rybicki Kateri 
Published: December 2020

Background and Purpose:
Executive function (EF) is associated with falls and impaired gait in older adults. Performance on a measure of EF, the Trail Making Test Part B (TMT-B), may be able to differentiate between physical mobility and balance in older cancer survivors. The purpose of this study was to describe the demographic, disease-associated, and mobility differences in 2 groups of older cancer survivors based on the ability to complete TMT-B.

Methods:
Physical mobility and cognition was assessed in 50 older (aged 65+ years) cancer survivors. Group assignment was by TMT-B completion status (completers/noncompleters). Between-groups comparisons were performed on measures of physical mobility, balance, gait, and self-efficacy using nonparametric statistics.

Results:
Sixteen (32%) older cancer survivors were unable to complete TMT-B. Significant differences were found (P < .05) on all Timed Up and Go (TUG) measures in noncompleters versus completers: TUG (12.10 seconds vs 9.28 seconds), TUG-manual (12.81 seconds vs 10.88 seconds), TUG-cognitive (14.35 seconds vs 10.98 seconds). Noncompleters had significantly worse (P < .05) scores on the Short Physical Performance Battery, Fullerton Advanced Balance Scale, 30-second timed chair rise, balance confidence, falls self-efficacy, and all gait speed (usual, fast, dual-task) measures.

Discussion:
Older cancer survivors unable to complete TMT-B had worse performance in mobility, balance, strength, and dual-task activities that involve the increased demand of cognitive function. Executive function should be screened as a part of the falls risk management in older cancer survivors.

Conclusion:
Physical mobility, balance, and function are significantly more impaired in older cancers survivors who are unable to complete the TMT-B cognitive measure.
Position-related Change of Pelvic Incidence Depends on the Nonfused Sacroiliac Joint in Patients with Degenerative Spinal Diseases
Authors: Bao Hongda , Zhang Yuancheng , Shu Shibin , Zhang Tianyuan , Gu Qi , Jing Wenting , Liu Zhen , Sun Xu , Qiu Yong , Zhu Zezhang 
Published: December 2020

Study Design.
A retrospective cross-sectional study.

Objective.
This study aims to determine whether the sacroiliac (SI) joint motion correlated to pelvic incidence (PI) change from standing to supine position in patients with degenerative spinal diseases.

Summary of Background Data.
PI was found an unstable parameter after adolescence as the fixed nature of PI was challenged by several studies. The SI joint has been shown to have some motion, age-related degenerative changes of cartilage and SI ligaments contribute to SI joint instability.

Methods.
The study contains both specimen study and radiographic study. One human specimen was acquired, on which PI was measured with different sacrum-ilium positions. In radiographic study, patients with old thoracolumbar fracture, lumbar disc herniation, stenosis, and spondylolisthesis were included. Ankylosing spondylitis (AS) patients were also included as control group. PI was measured on standing x-rays and scanogram of computed tomography images in supine position.

Results.
Specimen study result revealed that SI motion would lead to the change of PI with fixed pelvic thickness. In radiographic study, 101 patients with different etiology and 30 AS patients were included. After stratifying into different age groups, standing PI was significantly larger than supine PI in each age groups (P = 0.002, <0.001, and <0.001, respectively). In patients with degenerative diseases, PI was significantly larger on standing position than that on supine position. ΔPI showed no significant difference across etiologies. However, in AS patients, standing PI and supine PI revealed no significant difference (P = 0.528).

Conclusion.
Mobile SI joint may be the cause of increased PI in the aging spine. The dynamic change of PI is etiology-independent if the SI joint was not fused. Older patients have greater position-related change of PI.

Level of Evidence: 4
Coagulation, Vascular Morphology, and Vasculogenesis in Spinal Ligament Ossification Model Mice
Authors: Ichikawa Nana , Kumagai Gentaro , Wada Kanichiro , Kudo Hitoshi , Tanaka Sunao , Asari Toru , Liu Xizhe , Sasaki Ayako , Furukawa Ken-Ichi , Ishibashi Yasuyuki 
Published: December 2020

Study Design.
In vivo studies of the vascular system in ossification of the posterior longitudinal ligament (OPLL) model mice.

Objective.
The aim of this study was to investigate blood coagulability, vascular morphology, and vasculogenesis capability, known as venous thromboembolism (VTE) risk factors in the ossification model, tiptoe walking (ttw) mice.

Summary of Background Data.
Patients with OPLL are more likely to develop VTE after spinal cord injury. Capillary mesh invasion of spinal ligaments precedes spinal ligament ossification in ttw mice. Investigation on vascular systems of ttw mice may contribute to clarifying its pathology.

Methods.
Coagulability of blood samples from ttw and C57BL/6 (WT) mice were evaluated at 8, 16, and 24 weeks of age. Vascular morphology was assessed from a Hematoxylin-Eosin stained section by measuring vessel area. A tube formation assay was performed with endothelial cells isolated from the aorta to assess vasculogenesis.

Results.
Prothrombin time was significantly shorter in ttw mice than in WT at 8 and 16 weeks. Fibrinogen had a greater increase in ttw mice than in WT at 16 weeks. The vascular area and vascular wall area were significantly smaller in ttw mice than in WT at all timepoints. The ratio of vascular wall area to vascular area was significantly smaller in ttw mice than in WT at 24 weeks. The endothelial cells from ttw mice formed significantly higher numbers of total branching points than WT cells.

Conclusion.
Ossification model mice had impaired blood coagulation and vascular morphology and high capacity for vasculogenesis. With regard to the pathogenesis of VTE, ttw mice harbor an environment that promotes the development of VTE.

Level of Evidence: N/A
Does the ACS NSQIP Surgical Risk Calculator Accurately Predict Complications Rates After Anterior Lumbar Interbody Fusion Procedures?
Authors: Narain Ankur S. , Kitto Alexander Z. , Braun Benjamin , Poorman Matthew J. , Curtin Patrick , Slavin Justin , Whalen Giles , DiPaola Christian P. , Connolly Patrick J. , Stauff Michael P. 
Published: December 2020

Study Design.
Clinical case series.

Objective.
The aim of this study was to determine the effectiveness of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) surgical risk calculator in the prediction of complications after anterior lumbar interbody fusion (ALIF).

Summary of Background Data.
Identifying at-risk patients may aid in the prevention of complications after spine procedures. The ACS NSQIP surgical risk calculator was developed to predict 30-day postoperative complications for a variety of operative procedures.

Methods.
Medical records of patients undergoing ALIF at our institution from 2009 to 2019 were retrospectively reviewed. Demographic and comorbidity variables were entered into the ACS NSQIP surgical risk calculator to generate percentage predictions for complication incidence within 30 days postoperatively. The observed incidences of these complications were also abstracted from the medical record. The predictive ability of the ACS NSQIP surgical risk calculator was assessed in comparison to the observed incidence of complications using area under the curve (AUC) analyses.

Results.
Two hundred fifty-three (253) patients were analyzed. The ACS NSQIP surgical risk calculator was a fair predictor of discharge to non-home facility (AUC 0.71) and surgical site infection (AUC 0.70). The ACS NSQIP surgical risk calculator was a good predictor of acute kidney injury/progressive renal insufficiency (AUC 0.81). The ACS NSQIP surgical risk calculator was not an adequate predictive tool for any other category, including: pneumonia, urinary tract infections, venous thromboembolism, readmission, reoperations, and aggregate complications (AUC < 0.70).

Conclusion.
The ACS NSQIP surgical risk calculator is an adequate predictive tool for a subset of complications after ALIF including acute kidney injury/progressive renal insufficiency, surgical site infections, and discharge to non-home facilities. However, it is a poor predictor for all other complication groups. The reliability of the ACS NSQIP surgical risk calculator is limited, and further identification of models for risk stratification is necessary for patients undergoing ALIF.

Level of Evidence: 3
Sepsis-Associated Mortality, Resource Use, and Healthcare Costs: A Propensity-Matched Cohort Study*
Authors: Farrah Kelly , McIntyre Lauralyn , Doig Christopher J. , Talarico Robert , Taljaard Monica , Krahn Murray , Fergusson Dean , Forster Alan J. , Coyle Doug , Thavorn Kednapa 
Published: December 2020

Objectives:
To examine long-term mortality, resource utilization, and healthcare costs in sepsis patients compared to hospitalized nonsepsis controls.

Design:
Propensity-matched population-based cohort study using administrative data.

Setting:
Ontario, Canada.

PATIENTS:
We identified a cohort of adults (≥ 18) admitted to hospitals in Ontario between April 1, 2012, and March 31, 2016, with follow-up to March 31, 2017. Sepsis patients were flagged using a validated International Classification of Diseases, 10th Revision-coded algorithm (Sepsis-2 definition), including cases with organ dysfunction (severe sepsis) and without (nonsevere). Remaining hospitalized patients were potential controls. Cases and controls were matched 1:1 on propensity score, age, sex, admission type, and admission date.

INTERVENTIONS:
None.

Measurements and Main Results:
Differences in mortality, rehospitalization, hospital length of stay, and healthcare costs were estimated, adjusting for remaining confounders using Cox regression and generalized estimating equations. Of 270,669 sepsis cases, 196,922 (73%) were successfully matched: 64,204 had severe and 132,718 nonsevere sepsis (infection without organ dysfunction). Over follow-up (median 2.0 yr), severe sepsis patients had higher mortality rates than controls (hazard ratio, 1.66; 95% CI, 1.63–1.68). Both severe and nonsevere sepsis patients had higher rehospitalization rates than controls (hazard ratio, 1.53; 95% CI, 1.50–1.55 and hazard ratio, 1.41; 95% CI, 1.40–1.43, respectively). Incremental costs (Canadian dollar 2018) in sepsis cases versus controls at 1-year were: $29,238 (95% CI, $28,568–$29,913) for severe and $9,475 (95% CI, $9,150–$9,727) for nonsevere sepsis.

Conclusions:
Severe sepsis was associated with substantially higher long-term risk of death, rehospitalization, and healthcare costs, highlighting the need for effective postdischarge care for sepsis survivors.
Sebaceous Carcinoma of the Eyelid: A Systematic Review and Meta-Analysis
Authors: Desiato Vincent M. , Byun Young Jae , Nguyen Shaun A. , Thiers Bruce H. , Day Terry A. 
Published: December 2020

BACKGROUND
Sebaceous carcinoma (SC) of the eyelid is a rare, aggressive malignancy associated with high rates of recurrence, metastasis, and tumor-related mortality.

OBJECTIVE
Provide a collective analysis of clinical presentations, management techniques, and outcomes, and compare outcomes of common treatment methods.

METHODS AND MATERIALS
Observational studies reporting management and outcomes of SC of the eyelid were included. Patient and clinical data were extracted, and meta-analysis of proportions was performed.

RESULTS
One thousand three hundred thirty-three subjects were included with a mean age of 65.2 years and 803 (60.2%) women. Of 647 initial diagnoses reported, 277 (42.8%) were correct, and the mean diagnostic delay was 14.7 months (range 8.5–34.8). The tumor location was reported in 1,246 subjects and involved the upper eyelid in 780 (62.6%), lower eyelid in 409 (32.8%), and 57 (4.8%) involved both. Overall rates of recurrence, metastasis, and tumor-related mortality were 15.9%, 12.1%, and 6.2%, respectively. There were no statistically significant differences in wide local excision (WLE) versus Mohs micrographic surgery (MMS) outcomes.

CONCLUSION
Sebaceous carcinoma of the eyelid is more common in women, on the upper eyelid, and is frequently misdiagnosed initially. Rate of recurrence, metastasis, and tumor-related mortality were similar in subjects managed with WLE versus MMS.
Prevalence, Clinical Factors, and Outcomes Associated With Myocardial Infarction With Nonobstructive Coronary Artery
Authors: Schmitz Katie , Groth Nicole , Mullvain Richard , Renier Colleen , Oluleye Oludamilola , Benziger Catherine 
Published: December 2020

Background:
Myocardial infarction with nonobstructive coronary arteries (MINOCA) is an underrecognized clinical problem in patients presenting with acute coronary syndrome. Various clinical disorders lead to MINOCA thus making treatment and diagnosis a challenge. We aimed to compare the clinical factors and outcomes of patients with MINOCA versus obstructive disease [myocardial infarction due to coronary artery disease (MI-CAD)] in a largely rural health system.

Methods:
Between May 1, 2009 and June 24, 2019, all consecutive ST-segment elevation myocardial infarction patients at Essentia Health were prospectively examined. We categorized patients into MI-CAD (obstructive plaque ≥ 50% with revascularization) or MINOCA (obstructive plaque < 50% with exclusion of other alternative cause). Outcomes included 30-day and 1-year all-cause mortality, 30-day all-cause readmission and 30-day cardiac readmission.

Results:
There were 2170 patients included in the study; 2097 (96.6 %) had MI-CAD and 73 (3.4%) met the definition of MINOCA. Within the MINOCA group, the 3 most common presentations were supply–demand mismatch (28.8%), spontaneous coronary artery dissection (9.6%), and other etiology (60.3%). Only 10 (13 %) MINOCA patients had cardiac magnetic resonance imaging studies obtained within 6 months. MINOCA patients were younger 61.6 versus 63.4 years with higher left ventricular function 51.6% versus 50.4% with less likelihood of prior myocardial infarction 4.1% versus 15.5% or congestive heart failure 2.7% versus 6.3% (P < 0.05). Compared with MI-CAD patients, MINOCA patients had similar 30-day mortality (7.1% vs. 8.2%; P = 0.70), 1-year mortality (10.4% vs. 8.2 %; P = 0.55), and 30-day cardiac readmission (8.7% vs. 9.6%; P = 0.29). MINOCA patients were less likely to be discharged on aspirin, betablockers, angiotensin-converting enzyme inhibitor/angiotensin receptor blockers, or statins (P < 0.05).

Conclusion:
Though there was no difference in readmission and mortality between MINOCA and MI-CAD; use of secondary prevention medications and cardiac rehabilitation referral was low in MINOCA patients. Prospective studies will be relevant to assess effective medical therapy to improve outcomes in MINOCA patients.
Atrial Fibrillation Patients on Warfarin and Their Transition to Direct Oral Anticoagulants
Authors: Collins Peter , Lewin Andrea , Vincze Irving Nicole , Sylvester Katelyn , Fanikos John , Goldhaber Samuel Z. , Connors Jean M. 
Published: December 2020

Background:
The standard of care for stroke prevention in nonvalvular atrial fibrillation (AF) is the use of direct oral anticoagulants (DOACs). However, many patients established on warfarin therapy have not been considered for a transition to a DOAC.

Objectives:
Assess the AF patient population of Brigham and Women’s Hospital (BWH) Anticoagulation Management Service (AMS) currently being treated with warfarin, transition eligible patients to a DOAC, and identify barriers to the transitional process.

Methods:
Patient characteristics were analyzed to describe the overall AF population and a systematic process was used to determine clinical candidacy for a transition from warfarin to a DOAC. After being deemed eligible by both the referring physician and the AMS pharmacist, each patient was contacted and offered the opportunity for DOAC transition. Endpoints included number of successful transitions and commonly encountered barriers.

Results:
Out of the 1407 total AF patients on warfarin managed by BWH AMS, there were 787 patients identified as candidates for DOAC transition and a successful transition was completed for 250 (31.8%) of them. Barriers to transition included patient preference for warfarin (n = 247, 31.4%), referring physician preference for warfarin (n = 112, 14.2%), cost (n = 88, 11.2%), AMS pharmacist preference for warfarin (n = 70, 8.9%), and previous DOAC intolerance (n = 20, 2.5%).

Conclusions:
Every institution or provider network that manages AF patients on warfarin should assess their population on a regular basis to identify candidates for DOAC therapy. Our initiative outlines a process for identifying and transitioning DOAC-eligible AF patients established on warfarin therapy and describes the most commonly encountered barriers to DOAC therapy.