bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Mixed Methods Study of the Association of Non-Veterans Affairs Care With Veterans’ and Clinicians’ Experiences of Care Coordination
Authors: Benzer Justin K. , Gurewich Deborah , Singer Sara J. , McIntosh Nathalie M. , Mohr David C. , Vimalananda Varsha G. , Charns Martin P. 
Published: July 2020

Background:
Poor coordination between the Department of Veterans Affairs (VA) and non-VA care may negatively impact health care quality. Recent legislation is intended to increase Veterans’ access to care, in part through increased use of non-VA care. However, a possible consequence may be diminished patient experiences of coordination.

Objective:
The objective of this study was to determine VA patients’ and clinicians’ experiences of coordination across VA and non-VA settings.

Design:
Observational mixed methods using patient surveys and clinician interviews. Sampled patients were diagnosed with type 2 diabetes mellitus and either cardiovascular or mental health comorbidities.

Participants and Measures:
Patient perspectives on coordination were elicited between April and September 2016 through a national survey supplemented with VA administrative records (N=5372). Coordination was measured with the 8-dimension Patient Perceptions of Integrated Care survey. Receipt of non-VA care was measured through patient self-report. Clinician perspectives were elicited through individual interviews (N=100) between May and October 2017.

Results:
Veterans who received both VA and non-VA care reported significantly worse care coordination experiences than Veterans who only receive care in VA. Clinicians report limited information exchange capabilities, which, combined with bureaucratic and opaque procedures, adversely impact clinical decision-making.

Conclusions:
VA is working through a shift in how Veterans receive health care by increasing access to care from non-VA providers. Study findings suggest that VA should prioritize coordination of care in addition to access. This could include requiring monitoring of patient-experienced care coordination, surveys of referring and consulting clinicians, and pilot testing and evaluation of interventions to improve coordination.
Pediatric nail disorders: a review
Authors: Smith Robert J. , Rubin Adam I. 
Published: July 2020

Purpose of review
Nail disorders represent an uncommon subset of complaints seen in pediatric dermatology. There is a wide array of disorders that can affect the nail unit in children, including infectious, inflammatory, neoplastic, congenital, and traumatic processes. In order to enhance familiarity with pediatric nail conditions, we review the background and treatment of the more common entities seen in pediatric onychology, including onychomycosis, onychomadesis, nail psoriasis, trachyonychia, longitudinal melanonychia, onychophagia, and onychocryptosis.

Recent findings
Nail involvement in pediatric patients with psoriasis may indicate increased risk for both overall disease severity and the development psoriatic arthritis. In the evaluation of longitudinal melanonychia, the clinical findings that raise concern for subungual melanoma in adults are often found in benign nail unit nevi in children. In the systemic treatment of pediatric onychomycosis, new data raises the possibility that laboratory monitoring may be approached differently. In the approach to onychophagia, emerging pharmacotherapies include N-acetylcysteine.

Summary
Most nail disorders in pediatric patients have an overall favorable prognosis. However, nail abnormalities can lead to patient and parental anxiety, decreased quality of life, pain, and functional impairment. Clinicians should be aware of these more common diverse entities in order to identify them and apply state of the art management for these issues. Additionally, the reader will learn factors related to these nail disorders, which may require systemic work-up and/or specialist referral.
Alloimmunity in pancreas transplantation
Authors: Aziz Fahad , Mandelbrot Didier , Parajuli Sandesh , Al-Qaoud Talal , Redfield Robert , Kaufman Dixon , Odorico Jon S. 
Published: July 2020

Purpose of reviewDespite significant improvement in pancreas allograft survival, rejection continues to be a major clinical problem. This review will focus on emerging literature related to the impact of pretransplant and de-novo DSA (dnDSA) in pancreas transplant recipients, and the diagnosis and treatment of T-cell-medicated rejection (TCMR) and antibody-mediated rejection (ABMR) in this complex group of patients.Recent findingsRecent data suggest that pretransplant DSA and the emergence of dnDSA in pancreas transplant recipients are both associated with increased risk of ABMR. The pancreas allograft biopsy is essential for the specific diagnosis of TCMR and/or ABMR, distinguish rejection from other causes of graft dysfunction, and to guide-targeted therapy. This distinction is important especially in the setting of solitary pancreas transplants but also in simultaneous pancreas-kidney transplants where solid evidence has now emerged demonstrating discordant biopsy findings. Treatment of rejection in a functioning pancreas can prolong allograft survival.SummaryThe accurate and timely diagnosis of active alloimmune destruction in pancreas transplant recipients is paramount to preserving graft function in the long term. This review will discuss new, rapidly evolving information that is valuable for the physician caring for these patients to achieve optimal immunological outcomes.
Impulsiveness and Emotional Dysregulation as Stable Features in Borderline Personality Disorder Outpatients Over Time
Authors: Martino Francesca , Gammino Lorenzo , Sanza Michele , Berardi Domenico , Pacetti Monica , Sanniti Alice , Tangerini Giulia , Menchetti Marco 
Published: July 2020

Abstract
Large-scale longitudinal studies show that specific borderline personality disorder (BPD) symptoms are more likely to remit over time, suggesting that clinical features of BPD may vary between younger patients and older ones. The objective of the present report is to provide a direct comparison between younger (age 18–25 years; n = 44) and older (age 40–59 years; n = 49) BPD patients on the nine DSM-4 BPD criteria (self-harm, emotional dysregulation, impulsiveness, and work and social functioning). Younger and older patients reported similar levels of impulsiveness, emotional dysregulation, and work and social functional impairment. Younger adults were more likely to show anger and self-damaging behaviors compared with older patients, which in turn were more likely to endorse chronic emptiness. In conclusion, older patients with BPD are still impaired in impulsiveness, emotional regulation, and social functioning; treatments for older BPD population should be long term and focused on emotion dysregulation and impulsive behaviors.
Structural imaging of the retina in psychosis spectrum disorders: current status and perspectives
Authors: Jerotic Stefan , Ignjatovic Zora , Silverstein Steven M. , Maric Nadja P. 
Published: July 2020

Purpose of review
Structural changes of the retina in schizophrenia and other psychotic disorders seem plausible as these conditions are accompanied by widespread morphological abnormalities of the brain. Advances in structural retinal imaging have led to the possibility of precise quantification of individual retinal layers, using optical coherence tomography (OCT) scanners.

Recent findings
The aggregation of information related to OCT findings in schizophrenia has resulted in three metaanalyses, which are currently described. Areas where retinal changes were reported include retinal nerve fiber layer (RNFL), ganglion cell layer complex (GCC), macular volume, and macular thickness, but findings on affected retinal segments vary to some extent across studies. Discrepancies in individual studies could be because of small samples, heterogeneity within schizophrenia (phase of the illness, illness duration, predominant symptomatology), inconsistent reporting of antipsychotic therapy, insufficient control of confounding variables (somatic comorbidities, smoking, and so on), and use of the different types of OCT scanners.

Summary
Exploration of potential disturbances in retinal architecture could provide new insights into neuronal changes associated with psychosis spectrum disorders, with potential to elucidate the nature and timing of developmental, progressive, inflammatory, and degenerative aspects of neuropathology and pathophysiology, and to assist with characterizing heterogeneity and facilitating personalized treatment approaches.
Improving the physical health of the mentally ill: recent advances
Authors: Stanley Susanne H. 
Published: July 2020

Purpose of review
This review of the literature examines the most recent advances in the battle to improve the physical health of people with severe mental illness. Covering the 2018/2019 time period, the article offers a glance of future healthcare models and research directions.

Recent findings
A systematic search of the PubMed and Cochrane databases, along with additional journal articles available online but not yet allocated to a journal edition, produced a total of 24 journal articles suitable for review. The review period was from January 2018 to December 2019. The four main themes of investigation, intervention, integration and training emerged.

Summary
The uptake and integration of primary care into mental health services for people with SMI is still facing many barriers. Healthy lifestyle and physical activity interventions need to run alongside medical treatment for both mental and physical health in order to provide holistic care. To do this, clarification of professional roles and responsibility need to be defined and adhered to, along with additional training for staff and coordination of services.
Human first-order tactile neurons can resolve spatial details on the scale of single fingerprint ridges
Authors: Jarocka Ewa , Pruszynski J Andrew , Johansson Roland S 
Published: July 2020

AbstractFast-adapting type 1 (FA-1) and slow-adapting type 1 (SA-1) first-order tactile neurons provide detailed spatiotemporal tactile information when we touch objects with fingertips. The distal axon of these neuron types branches in the skin and innervates many receptor organs associated with fingerprint ridges (Meissner corpuscles and Merkel cell neurite complexes, respectively), resulting in heterogeneous receptive fields that include many highly sensitive zones or ‘subfields’. Using raised dots that tangentially scanned a neuron’s receptive field, here we examined the spatial resolution capacity of FA-1 and SA-1 neurons afforded by their heterogeneous receptive fields and its constancy across scanning speed and direction. We report that the resolution of both neuron types on average corresponds to a spatial period of ∼0.4 mm and provide evidence that a subfield’s spatial selectivity arises because its associated receptor organ measures mechanical events limited to a single fingerprint ridge. Accordingly, the sensitivity topography of a neuron’s receptive fields is quite stable over repeated mappings and over scanning speeds representative of real-world hand use. The sensitivity topography is substantially conserved also for different scanning directions, but the subfields can be relatively displaced by direction-dependent shear deformations of the skin surface.Significance StatementThe branching of the distal axon of first-order tactile neurons with receptor-organs associated with fingerprint ridges (Meissner and Merkel end-organs) results in cutaneous receptive fields composed of several distinct subfields spread across multiple ridges. We show that the spatial selectivity of the subfields typically corresponds to the dimension of the ridges (∼0.4 mm) and that neurons’ subfield layout is well preserved across tangential movement speeds and directions representative of natural use of the fingertips. We submit that the receptor-organ underlying a subfield essentially measures mechanical events at an individual ridge. That neurons receive convergent input from multiple subfields does not preclude the possibility that spatial details can be resolved on the scale of single fingerprint ridges by a population code.
Development and Validation of a Web-based Prediction Model for Acute Kidney Injury after surgery
Authors: Woo Sang H. , Zavodnick Jillian , Ackermann Lily , Maarouf Omar , Zhang Jingjing , Cowan Scott W. 
Published: July 2020

AbstractBackground and objectivesAcute kidney injury after surgery is associated with high mortality and morbidity. The purpose of this study is to develop and validate a risk prediction tool for the occurrence of postoperative acute kidney injury requiring renal replacement therapy.Design, setting, participants, measurementsThis retrospective cohort study had 2,299,502 surgical patients over 2015-2017 from the American College of Surgeons National Surgical Quality Improvement Program Database (ACS-NSQIP). Eleven predictors were selected for the predictive model: age, history of congestive heart failure, diabetes, ascites, emergency surgery, preoperative serum creatinine, hematocrit, sodium, preoperative sepsis, preoperative acute renal failure and surgery type. The predictive model was trained using 2015-2016 data (n=1,487,724) and further tested using 2017 data (n=811,778). A risk model was developed using multivariate logistic regression and machine learning methods.Main outcomesThe primary outcome was postoperative 30-day acute kidney injury requiring renal replacement therapy(AKI-D)ResultsThe unadjusted 30-day postoperative mortality rate associated with AKI-D was 37.5%. The renal risk prediction model had high AUC (area under the receiver operating characteristic curve, training cohort: 0.89, test cohort: 0.90) for postoperative AKI-D.ConclusionsThis model provides a clinically useful bedside predictive tool for postoperative acute kidney injury requiring dialysis.
N and O glycosylation of the SARS-CoV-2 spike protein
Authors: Sanda Miloslav , Morrison Lindsay , Goldman Radoslav 
Published: July 2020

ABSTRACTCovid-19 pandemic outbreak is the reason of the current world health crisis. The development of effective antiviral compounds and vaccines requires detailed descriptive studies of the SARS-CoV-2 proteins. The SARS-CoV-2 spike (S) protein mediates virion binding to the human cells through its interaction with the ACE2 cell surface receptor and is one of the prime immunization targets. A functional virion is composed of three S1 and three S2 subunits created by furin cleavage of the spike protein at R682, a polybasic cleavage sites that differs from the SARS-CoV spike protein of 2002. We observe that the spike protein is O-glycosylated on a threonine (T678) near the furin cleavage site occupied by core-1 and core-2 structures. In addition, we have identified eight additional O-glycopeptides on the spike glycoprotein and we confirmed that the spike protein is heavily N-glycosylated. Our recently developed LC-MS/MS methodology allowed us to identify LacdiNAc structural motives on all occupied N-glycopeptides and polyLacNAc structures on six glycopeptides of the spike protein. In conclusion, our study substantially expands the current knowledge of the spike protein’s glycosylation and enables the investigation of the influence of the O-glycosylation on its proteolytic activation.
The severity of microstrokes depends on local vascular topology and baseline perfusion
Authors: Schmid Franca , Conti Giulia , Jenny Patrick , Weber Bruno 
Published: July 2020

1AbstractCortical microinfarcts are caused by blood flow disturbances and are linked to pathologies like cerebral amyloid angiopathy and dementia. Despite their relevance for disease progression, microinfarcts often remain undetected and the smallest scale of disturbance has not yet been identified. We employ blood flow simulations in realistic microvascular networks from the mouse cortex to quantify the impact of single capillary occlusions. We reveal that the severity of a microstroke is strongly affected by the local vascular topology and the baseline flow rate in the occluded capillary. The largest changes in flow rate are observed in capillaries with two in- and two outflows. Interestingly, this specific topological configuration only occurs with a frequency of 8%, while the majority of capillaries are likely designed to efficiently supply oxygen and nutrients. Taken together, microstrokes likely induce a cascade of local disturbances in the surrounding tissue, which might accumulate and impair energy supply locally.
Effect of Systemic Inflammatory Response to SARS-CoV-2 on Lopinavir and Hydroxychloroquine Plasma Concentrations
Authors: Marzolini Catia , Stader Felix , Stoeckle Marcel , Franzeck Fabian , Egli Adrian , Bassetti Stefano , Hollinger Alexa , Osthoff Michael , Weisser Maja , Gebhard Caroline E. , Baettig Veronika , Geenen Julia , Khanna Nina , Tschudin-Sutter Sarah , Mueller Daniel , Hirsch Hans H. , Battegay Manuel , Sendi Parham 
Published: July 2020

AbstractBackgroundCoronavirus disease 2019 (COVID-19) leads to inflammatory cytokine release, which can downregulate the expression of metabolizing enzymes. This cascade affects drug concentrations in the plasma. We investigated the association between lopinavir (LPV) and hydroxychloroquine (HCQ) plasma concentrations and the values of acute phase inflammation marker C-reactive protein (CRP).MethodsLPV plasma concentrations were prospectively collected in 92 patients hospitalized at our institution. Lopinavir/ritonavir was administered 12-hourly, 800/200 mg on day 1, and 400/100 mg on day 2 until day 5 or 7. HCQ was given at 800 mg, followed by 400 mg after 6, 24 and 48 hours. Hematological, liver, kidney, and inflammation laboratory values were analyzed on the day of drug level determination.ResultsThe median age of study participants was 59 (range 24–85) years, and 71% were male. The median duration from symptom onset to hospitalization and treatment initiation was 7 days (IQR 4–10) and 8 days (IQR 5–10), respectively. The median LPV trough concentration on day 3 of treatment was 26.5 μg/mL (IQR 18.9–31.5). LPV plasma concentrations positively correlated with CRP values (r=0.37, p<0.001), and were significantly lower when tocilizumab was preadministrated. No correlation was found between HCQ concentrations and CRP values.ConclusionsHigh LPV plasma concentrations were observed in COVID-19 patients. The ratio of calculated unbound drug fraction to published SARS-CoV-2 EC50 values indicated insufficient LPV concentrations in the lung. CRP values significantly correlated with LPV but not HCQ plasma concentrations, implying inhibition of cytochrome P450 3A4 (CYP3A4) metabolism by inflammation.
Partial Prediction of the Virus COVID-19 Spread in Russia Based on SIR and SEIR Models
Authors: Tomchin Dmitry , Fradkov Alexander 
Published: July 2020

AbstractThe possibility to predict the spread of COVID-19 in Russia is studied. Particular goal is to predict the time instant when the number of infected achieves its maximum (peak). Such a partial prediction allows one to use simple epidemoics models: SIR and SEIR. Simplicity and small number of parameters are significant advantages of SIR and SEIR models under conditions of a lack of numerical initial data and structural incompleteness of models. The prediction is carried out according to public WHO datasets from March 10 to April 20, 2020. Comparison of forecast results by SIR and SEIR models are given. In both cases, the peak number of infected persons while maintaining the current level of quarantine measures is forecasted at the end of May 2020 or later. It coincides with the real data obtained in May-June, 2020. The results confirm usefulness of simple nonlinear dynamical models for partial prediction of complex epidemic processes.
Cardioids reveal self-organizing principles of human cardiogenesis
Authors: Hofbauer Pablo , Jahnel Stefan , Papai Nora , Giesshammer Magdalena , Penc Mirjam , Tavernini Katherina , Grdseloff Nastasja , Meledeth Christy , Deyett Alison , Schmidt Clara , Ctortecka Claudia , Šalic Šejla , Novatchkova Maria , Mendjan Sasha 
Published: July 2020

SUMMARYOrganoids that self-organize into tissue-like structures have transformed our ability to model human development and disease. To date, all major organs can be mimicked using self-organizing organoids with the notable exception of the human heart. Here, we established self-organizing cardioids from human pluripotent stem cells that intrinsically specify, pattern and morph into chamber-like structures containing a cavity. Cardioid complexity can be controlled by signaling that instructs the separation of cardiomyocyte and endothelial layers, and by directing epicardial spreading, inward migration and differentiation. We find that cavity morphogenesis is governed by a mesodermal WNT-BMP signaling axis and requires its target HAND1, a transcription factor linked to human heart chamber cavity defects. In parallel, a WNT-VEGF axis coordinates myocardial self-organization with endothelial patterning and specification. Human cardioids represent a powerful platform to mechanistically dissect self-organization and congenital heart defects, serving as a foundation for future translational research.Highlights- Cardioids form cardiac-like chambers with inner endothelial lining and interact with epicardium- Cardioid self-organization and lineage complexity can be controlled by signaling- WNT-BMP signaling directs cavity formation in self-organized cardioids via HAND1- WNT-VEGF coordinate endothelial patterning with myocardial cavity morphogenesis
Cotranslational folding of alkaline phosphatase in the periplasm ofEscherichia coli
Authors: Elfageih Rageia , Karyolaimos Alexandros , Kemp Grant , de Gier Jan-Willem , von Heijne Gunnar , Kudva Renuka 
Published: July 2020

AbstractCotranslational protein folding studies using Force Profile Analysis, a method where the SecM translational arrest peptide is used to detect folding-induced forces acting on the nascent polypeptide, have so far been limited mainly to small domains of cytosolic proteins that fold in close proximity to the translating ribosome. In this study, we investigate the cotranslational folding of the periplasmic, disulfide bond-containingE. coliprotein alkaline phosphatase (PhoA) in a wild-type strain background and a strain background devoid of the periplasmic thiol:disulfide interchange protein DsbA. We find that folding-induced forces can be transmittedviathe nascent chain from the periplasm to the polypeptide transferase center in the ribosome, a distance of ~160 Å, and that PhoA appears to fold cotranslationallyviaat least two disulfide-stabilized folding intermediates. Thus, Force Profile Analysis can be used to study cotranslational folding of proteins in an extra-cytosolic compartment, like the periplasm.