bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two atypical ANGUSTIFOLIA without a plant‐specific C‐terminus regulate gametophore and sporophyte shapes in the moss Physcomitrium (Physcomitrella) patens
Authors: Takechi Katsuaki , Nagase Hiroaki , Furuya Tomoyuki , Hattori Koro , Sato Yoshikatsu , Miyajima Kensuke , Higuchi Tomofumi , Matsuda Ryuya , Takio Susumu , Tsukaya Hirokazu , Takano Hiroyoshi 
Published: December 2020

SummaryANGUSTIFOLIA (AN) is a plant‐specific subfamily of the CtBP/BARS/AN family, characterized by a plant‐specific C‐terminal domain of approximately 200 amino acids. Previously, we revealed that double knockout (DKO) lines of Physcomitrium (Physcomitrella) patens ANGUSTIFOLIA genes (PpAN1‐1 and PpAN1‐2) show defects in gametophore height and the lengths of the seta and foot region of sporophytes, by reduced cell elongation. In addition to two canonical ANs, the genome of P. patens has two atypical ANs without a coding region for a plant‐specific C‐terminus (PpAN2‐1 and PpAN2‐2); these were investigated in this study. Similar to PpAN1s, both promoters of the PpAN2 genes were highly active in the stems of haploid gametophores and in the middle‐to‐basal region of young diploid sporophytes that develop into the seta and foot. Analyses of PpAN2‐1/2‐2 DKO and PpAN quadruple knockout (QKO) lines implied that these four AN genes have partially redundant functions to regulate cell elongation in their expression regions. Transgenic strains harboring P. patens α‐tubulin fused to green fluorescent protein, which were generated from a QKO line, showed that the orientation of the microtubules in the gametophore tips in the PpAN QKO lines was unchanged from the wild‐type and PpAN1‐1/1‐2 DKO plants. In addition to both PpAN2‐1 and PpAN2‐2, short Arabidopsis AN without the C‐terminus of 200 amino acids could rescue the Arabidopsis thaliana an‐1 phenotypes, implying AN activity is dependent on the N‐terminal regions.
Surgical Treatment of Epiblepharon Effectively Alleviates Keratopathy but Not Astigmatism: A Case-Control Study Utilizing Vector Analysis in East Asian Children
Authors: Ma Shang-Te , Liu Yao-Lin , Hsieh Ching-Ju , Chen Yo-Shen , Tsai Tzu-Hsun 
Published: December 2020

Purpose. To identify an appropriate surgical indication of epiblepharon by comparing keratopathy and astigmatism outcomes after surgical and medical treatments for epiblepharon in Asian children. Methods. Children diagnosed with epiblepharon (n = 82, age 5.93 ± 2.76 years) with >6 months of follow-up were enrolled. The clinical presentations and cycloplegic refractive status at the baseline and 3 and 6 months after treatment were compared between surgical (91 eyes from 47 children) and nonsurgical (67 eyes from 35 children) groups. The refractive and keratometric astigmatism at each time point were evaluated with vector analysis methods. For Thibos and Horner’s method, the astigmatic power vector was decomposed into horizontal and oblique meridians (J0 and J45). However, the treatment-induced astigmatism (TIA) vectors were calculated by Alpins’ method and depicted by the AstigMATIC software. Results. In the surgical and nonsurgical groups, the baseline astigmatism magnitude was similar (2.22 ± 1.39 and 2.26 ± 1.46 D,

p

= 0.87). The rate of complete resolution of keratopathy at 6 months was 71.4% and 11.5%. The astigmatism magnitude in the surgical group differed among baseline and 3 months (2.25 ± 1.23 D) and 6 months postoperatively (1.97 ± 1.28 D) (

p

= 0.001). Power vector analyses confirmed a nuanced against-the-rule shift in the surgical group. This trend was especially observed in the subgroup of baseline astigmatism >2.0 D. However, the difference in the astigmatism magnitude between surgical and nonsurgical groups, even in highly astigmatic children, was not significant at 6 months. Conclusions. The improvement of keratopathy in the surgical group was greater than that in the nonsurgical group in consideration of the more advanced severity in the surgery group at baseline. Decreased with-the-rule astigmatism can be observed at 6 months postoperatively, particularly among those with greater baseline astigmatism. However, the amount of change is small, and the outcome does not differ significantly from the nonsurgical treatment. Therefore, surgical indications should majorly base on the severity of symptoms and keratopathy.
Patterns of Resistance Differ in Patients with Acute Myeloid Leukemia Treated with Type I versus Type II FLT3 Inhibitors
Authors: Alotaibi Ahmad S. , Yilmaz Musa , Kanagal-Shamanna Rashmi , Loghavi Sanam , Kadia Tapan M. , DiNardo Courtney D. , Borthakur Gautam , Konopleva Marina , Pierce Sherry A. , Wang Sa A. , Tang Guilin , Guerra Veronica , Samra Bachar , Pemmaraju Naveen , Jabbour Elias , Short Nicholas J. , Issa Ghayas C. , Ohanian Maro , Garcia-Manero Guillermo , Bhalla Kapil N. , Patel Keyur P. , Takahashi Koichi , Andreeff Michael , Cortes Jorge E. , Kantarjian Hagop M. , Ravandi Farhad , Daver Naval 
Published: December 2020

Abstract

Despite promising results with FLT3 inhibitors (FLT3i), response durations remain short. We studied pretreatment and relapse bone marrow samples from patients with FLT3-mutated acute myeloid leukemia (AML) treated with FLT3i-based therapies (secondary resistance cohort), and pretreatment bone marrow samples from patients with no response to FLT3i-based therapies (primary resistance cohort). Targeted next-generation sequencing (NGS) at relapse identified emergent mutations involving on-target FLT3, epigenetic modifiers, RAS/MAPK pathway, and less frequently WT1 and TP53. RAS/MAPK and FLT3-D835 mutations emerged most commonly following type I and II FLT3i-based therapies, respectively. Patients with emergent mutations at relapse had inferior overall survival compared with those without emergent mutations. Among pretreatment RAS-mutated patients, pretreatment cohort-level variant allelic frequencies for RAS were higher in nonresponders, particularly with type I FLT3i-based therapies, suggesting a potential role in primary resistance as well. These data demonstrate distinct pathways of resistance in FLT3-mutated AML treated with type I versus II FLT3i.

Significance:
Sequential NGS-based mutational analysis at relapse after FLT3i-based therapies showed distinct pathways of secondary resistance between type I and II FLT3i. FLT3 mutations may be lost at relapse after FLT3i-based therapies. Pretreatment RAS/MAPK mutations may also be associated with primary resistance in patients treated with type I FLT3i.
See related commentary by Shastri et al., p. 113.
Understanding FLT3 Inhibitor Resistance to Rationalize Combinatorial AML Therapies
Authors: Shastri Aditi , Gonzalez-Lugo Jesus , Verma Amit 
Published: December 2020

Summary:

Patients treated with Fms-like tyrosine kinase 3 (FLT3) inhibitor–based acute myeloid leukemia therapies nearly always develop resistance. In this issue, Alotaibi and colleagues describe the patterns of mutations that emerge upon relapse after FLT3 inhibitor therapy after initial response, as well as in treatment-refractory disease in a single-institution study; the findings offer insights for sequential therapies targeting the dominant clone at the time of relapse.
See related article by Alotaibi et al., p. 125.
Associations Between Burnout and Mental Disorder Symptoms Among Nurses in Canada
Authors: Stelnicki Andrea M. , Jamshidi Laleh , Angehrn Andréanne , Hadjistavropoulos Heather D. , Carleton R. Nicholas 
Published: December 2020

Background Nurses appear to be at a greater risk of burnout compared to other medical professionals. Higher levels of burnout are significantly associated with higher levels of anxiety, stress, and depression symptoms. Purpose The current study was designed to estimate levels of burnout among Canadian nurses, examine the association between burnout and mental disorder symptoms, and identify characteristics that may increase the risk for reporting symptoms of burnout. Method Canadian nurses ( n = 3257; 94.3% women) were surveyed online in both English and French. The survey assessed current symptoms of burnout and mental disorders (i.e., Posttraumatic Stress Disorder, Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder). Results Most nurses (63.2%) reported at least some symptoms of burnout and many (29.3%) reported clinically significant levels of burnout. Age and years of service were the only demographic variables that explained burnout rates. Participants reporting clinically significant levels of burnout were significantly more likely than participants with no burnout to screen positive for all mental disorders, but particularly for Major Depressive Disorder. Conclusions Monitoring burnout may be an effective way to identify nurses at risk of developing symptoms of mental disorders. Younger and early-career nurses are an important group to target for prevention programs.
Effects of Rurality and Geographical Distance on Unplanned Emergency Department Utilization for Children With Asthma: A Population Level Retrospective Cohort Study
Authors: Wilson Jennifer , Gedcke-Kerr Laurie , Woo Kevin , Plazas Pilar Camargo , Tranmer Joan 
Published: December 2020

Background Asthma is a highly prevalent chronic disease among Ontario children; however, the extent to which rural status and distance are associated with unplanned emergency department (ED) use by this population is largely unknown. Objective To explore the impact of rurality and geographical distance to primary and specialist care services on healthcare utilization by analyzing the use of unplanned ED services. Methods A population level retrospective cohort study of Ontario children ages 5–14 with newly diagnosed asthma was conducted using health administrative data from Institute for Clinical Evaluative Sciences (ICES). Adjusted logistic regression models were used to analyze the association between unplanned ED use with rural status and distance to general practitioner/family physician (GP/FP) and specialist healthcare services, while controlling for confounders. Results In total, 19,732 individuals met the inclusion criteria. Individuals who lived in rural locations (OR 2.00, 95% CI 1.64–2.44) and travelled >50 km to a GP/FP (OR 1.25, 95% CI 1.06–1.48) or specialist (OR 1.20, 95% CI 1.05–1.38) were more likely to utilize an ED. Conclusion Children with asthma utilize healthcare services differently based on rural status and distance to services. To ensure equitable access to care, there is a need to accommodate for these factors in the planning and provision of asthma healthcare services.
Do Gaming Simulations Substantiate That We Know More Than We Can Tell?
Authors: van Haaften M. A. , Lefter I. , Lukosch H. , van Kooten O. , Brazier F. 
Published: December 2020

Background. Revealing tacit knowledge often is seen as very valuable for organizations, although it is usually challenging to enunciate and share this type of knowledge. Methods. This study uses a participatory design and the application of a board gaming simulation as instruments to extract tacit knowledge. To illustrate this application, the gaming simulation is played with entrepreneurs from horticulture. Horticulture represents a complex social system where tacit knowledge plays a major role in the trade process. A participatory design process is used to explore whether the design and play of gaming simulations enable participants to explicate their tacit knowledge. Participants’ participation in designing the gaming simulation explicated that reconstructing reality was a prerequisite for their commitment. Results. The results from playing simulation sessions show that participants were able to: (1) narrow down the anecdotic behaviour to a few factors; (2) to structure these factors; (3) explore how these factors relate to trade barriers and (4) to explain which tactics are applied to foster trade. Conclusion. The educational value of this study is that it helped entrepreneurs in understanding complex real-life situations.
End-to-side versus side-to-side anastomosis with distal vein ligation for arteriovenous fistula creation
Authors: ElKassaby Mohammed , Elsayed Nashaat , Mosaad Ahmed , Soliman Mosaad 
Published: December 2020

Introduction There is lack of compelling evidence about the best technique to carry out the anastomosis between the artery and the vein: end to side or side to side. This issue was addressed by very few randomized controlled studies. This topic has recently re-emerged with the advent of the endovascular fistula creation using the side-to-side technique. Objectives: To compare the results of both surgical techniques for the creation of arteriovenous anastomosis. Methods This is a randomized controlled prospective study. All renal failure patients, 18 years and older, referred to our institution requiring creation of a new arm arteriovenous fistulas, including distal radio-cephalic, ulno-basilic, proximal brachio-cephalic or brachio-basilic configurations were included. Results Between February 2018 and October 2018, 378 patients underwent creation of permanent haemodialysis access. A total of 100 patients were randomized equally into the end-to-side and side-to-side groups. Follow-up for the study purpose continued until May 2019 (mean = 9 months, range 1–12). Patients’ age ranged from 19 to 68 years. Sevety-seven arteriovenous fistulas were created at the elbow (37 brachio-basilic and 40 brachio-cephalic). Radio-cephalic fistulae were 23, created at wrist and in the forearm. Primary technical success was 97%, and 35 (70%) and 17 (34%) cases achieved functionally maturation in the end-to-side and side-to-side groups, respectively (P = 0.0001). Primary and secondary patency rates at 12 months were 76% end to side versus 78% STS (P = 0.381) and 84% end to side versus 86% STS (P = 0.225), respectively. Conclusion End-to-side technique should be used in all instances of arteriovenous fistulas creation.
Diagnostic value of miR-637 in patients with atherosclerosis and its predictive significance for the future cardiovascular events
Authors: Xu Yuxia , Zhao Lixiang , Liu Hai , Sun Bin , Zhao Xinxiang 
Published: December 2020

Objectives Atherosclerosis is a common vascular disease. MiR-637 has been demonstrated to be low-expressed in hypertensive patients, and atherosclerosis is closely related to hypertension. Therefore, this study speculated that miR-637 may play an important role in the development of atherosclerosis. In brief, this study examined the expression level of miR-637 in patients with atherosclerosis and further analyzed its clinical value in patients with atherosclerosis. Methods The expression level of miR-637 was detected in serum from 86 patients with atherosclerosis and 75 healthy controls by using quantitative reverse transcription-polymerase chain reaction. The receiver operating characteristic curve was used to assess the diagnostic value of miR-637 in atherosclerosis. Pearson’s correlation analysis was performed to evaluate the relationship between serum miR-637 and different clinical parameters. The prognostic value of miR-637 in atherosclerosis was analyzed by the Kaplan–Meier survival curve and multivariate cox regression analysis. Results Compared with healthy individuals, miR-637 was downregulated in the serum of atherosclerosis patients. The receiver operating characteristic curve suggested the high diagnostic value of miR-637 for atherosclerosis, with the AUC of 0.853, specificity of 77.9%, and sensitivity of 80.0%. The expression level of miR-637 was negatively correlated with CIMT (r = –0.8101, P <  0.0001) and CRP (r = –0.6154, P <  0.0001), respectively. Survival analysis indicated that miR-637 was also found to be an independent prognostic factor for atherosclerosis. Conclusions MiR-637 is a potential noninvasive diagnostic marker of atherosclerosis and has important predictive value for the occurrence of future cardiovascular events.
COVID-19 – Changes in the presentation and management of shoulder and elbow trauma in a UK district general hospital orthopaedic department
Authors: Faria Giles , Virani Siddharth , Shaeir Mohammed , Velazquez-Ruta Patricia , Tadros Baha John , Arealis Georgios , Dhinsa Baljinder Singh , Relwani Jai 
Published: December 2020

Introduction COVID-19 has had a significant impact on healthcare systems. We aim to quantify the impact of this outbreak on shoulder and elbow trauma in our institution. Methods We prospectively collected data on patients presenting to our hospital with shoulder and elbow injuries during COVID-19. This included the number of attendances to the emergency department, fracture clinic, inpatient admissions and operative treatments. This was compared to a pre-COVID-19 period. We also assessed the efficacy of telephone clinics. Results There has been a noticeable decrease in the number of emergency department and fracture clinic attendances with upper limb complaints. The number of in-person fracture clinic reviews also decreased, with a reciprocal exponential increase in telephone consultations. We recorded a decrease in the number of shoulder and elbow trauma procedures performed. There was a small increase in the proportion of injuries treated conservatively during COVID-19. Our telephone clinics yielded a diagnosis and management plan in many cases and patient perspective appeared favourable. Conclusion We have noted significant change in the upper limb caseload. Certain injuries have reduced, likely due to COVID-19 lockdown. Moreover, we consider several changes to current practices could be taken forward after the pandemic.
Arthroscopic management of synovial chondromatosis of the shoulder: a systematic review of literature
Authors: Park J Patrick , Marwan Yousef , Alfayez Saud M , Burman Mark L , Martineau Paul A 
Published: December 2020

Background Synovial chondromatosis (SC) of the shoulder is rare, with limited literature on its management. This systematic review of literature aimed to characterize common arthroscopic techniques for the treatment of shoulder SC and patient outcomes. We hypothesized that arthroscopy is an effective operative modality for the management of shoulder SC. Methods PubMed and Embase databases were searched for articles on arthroscopic management of shoulder SC, published before 6 August 2020. All articles meeting inclusion criteria received an independent full-text review by two authors. Results An initial search found 64 articles. Following duplicate removal and title, abstract, and full-text reviews, 27 articles (48 patients) remained eligible. The mean age of patients was 33.0 years, with 2:1 male-to-female ratio. The mean follow-up was 41.8 months. SC was found to affect various intra- and extra-articular locations of the shoulder. Overall, arthroscopic treatment of shoulder SC was successful in 70.8%. Treatment failure was common in SC involving the bicipital tendon sheath. Disease recurrence was seen in 14.7%. Conclusion Literature on arthroscopic management of shoulder SC is limited, and significant heterogeneity in arthroscopic techniques was observed. Although arthroscopic management of shoulder SC is effective, further optimization is necessary to minimize treatment failure and disease recurrence.
Sinonasal Anatomic Variants in Allergic Fungal Rhinosinusitis
Authors: Makary Chadi A. , Parman Brock , Gill Brittany , Unsal Aykut , Holmes Thomas , Reyes Camilo , Kountakis Stilianos E. 
Published: December 2020

Background The pathophysiology of allergic fungal rhinosinusitis (AFRS) is not well understood. Objectives To study the incidence of sinonasal anatomic variants (AVs) in AFRS. Methods Retrospective cohort study. Patients with AFRS presenting to our clinic from 2008 to 2018 were reviewed for laterality of the disease. Patients with unilateral involvement were further studied for AV presence by reviewing their preoperative sinus CT scan at original presentation. Each patient’s uninvolved side served as its own control. AVs studied include agger nasi (AN), Haller’s cells (HC), concha bullosa (CB) and supraorbital ethmoid cells (SOEC). Results A total of 155 patients with AFRS were identified. 30 patients (19.3%) had unilateral disease involvement. Of these, 16 patients had left sided and 14 patients had right sided disease. AV were present in 26 of the 30 AFRS sides (86.7%) and in 21 of the 30 healthy sides (70%), (chi squared = 2.45, p = 0.117). CB were present in 12 of 30 AFRS sides (40%) and only in 1 of 30 healthy sides (3%), (chi squared = 11.88, p = 0.0006). The presence of HC was more common in the AFRS vs healthy sides (7 of 30, 23.3% vs 2 of 30, 6.7%, respectively, p = 0.071). AN and SOEC presence was similar in both AFRS and healthy sides (p = 0.598 and p = 0.718 respectively). Conclusion AV are more common on the sides with AFRS compared to healthy sides, with the presence of CB reaching unquestionable statistical significance. Further study is needed to determine the possible association of AV, especially concha bullosa, with the pathophysiology of AFRS.
Multidisciplinary approach to enhancing provider well-being in a metropolitan medical group in the United States
Authors: Shields Lisa B. E. , Jennings James T. , Honaker Joshua T. 
Published: December 2020

Abstract
Background
Physician burnout refers to depersonalization, emotional exhaustion, and a sense of lower personal accomplishment. Affecting approximately 50% of physicians in the United States, physician burnout negatively impacts both the physician and patient. Over a 3-year-period, this prospective study evaluated the multidisciplinary approach to decreasing provider burnout and improving provider well-being in our metropolitan community.

Methods
A multidisciplinary Well-Being Task Force was established at our Institution in 2017 to assess the myriad factors that may play a role in provider burnout and offer solutions to mitigate the stressors that may lead to decreased provider well-being. Four multifaceted strategies were implemented: (1) provider engagement & growth; (2) workflow/office efficiencies; (3) relationship building; and (4) communication. Providers at our Institution took the Mayo Clinic’s well-being index survey on 3 occasions over 3 years. Their scores were compared to those of providers nationally at baseline and at 1 and 2 years after implementing organizational and individualized techniques to enhance provider well-being. Lower well-being index scores reflected better well-being.

Results
The average overall well-being index scores of our Institution’s providers decreased from 1.76 at baseline to 1.32 2 years later compared to an increase in well-being index scores of physicians nationally (1.73 to 1.85). Both male and female providers’ average well-being index scores at our Institution decreased over the 3 years of this study, from 1.72 to 1.58 for males and 1.78 to 1.21 for females, while physicians’ scores nationally increased for both genders. The average well-being index scores were highest for providers at our Institution who graduated from medical school less than 5 years earlier (2.0) and who graduated 15–24 years earlier (2.3), whereas the average lowest scores were observed in providers who graduated ≥25 years earlier (1.37). Obstetricians/gynecologists and internal medicine physicians had the highest average well-being index scores (2.48 and 2.4, respectively) compared to other medical specialties. The turnover rate of our Institution’s providers was 5.6% in 2017 and 3.9% in 2019, reflecting a 30% decrease.

Conclusion
This study serves as a model to reduce provider burnout and enhance well-being through both organizational and individual interventions.