bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Time to Receipt of Prosthesis on Total Healthcare Costs 12 Months Postamputation
Authors: Miller Taavy A. , Paul Rajib , Forthofer Melinda , Wurdeman Shane R. 
Published: May 2020

Objective
The objective was to assess the impact of a prosthesis and the timing of prosthesis receipt on total direct healthcare costs in the 12-mo postamputation period.

Design
Data on patients with lower limb amputation (n = 510) were obtained from a commercial claims database for retrospective cohort analysis. Generalized linear multivariate modeling was used to determine differences in cost between groups according to timing of prosthesis receipt compared with a control group with no prosthesis.

Results
Receipt of a prosthesis between 0 and 3 mos post lower limb amputation yielded a reduced total cost by approximately 0.23 in log scale within 12 mos after amputation when compared with the no-prosthesis group. Despite the included costs of a prosthesis, individuals who received a prosthesis either at 4–6 mos postamputation or 7–9 mos postamputation incurred costs similar to the no-prosthesis group.

Conclusion
Earlier receipt of a prosthesis is associated with reduced spending in the 12 mos postamputation of approximately $25,000 compared with not receiving a prosthesis. The results of this study suggest that not providing or delaying the provision of a prosthesis increases costs by about 25%.
COVID-19 Guide for the Rehabilitation Clinician
Authors: Lopez Marielisa , Bell Kathleen , Annaswamy Thiru , Juengst Shannon , Ifejika Nneka 
Published: May 2020

Abstract
Severe acute respiratory syndrome coronavirus 2—also known as COVID-19—is primarily known for respiratory illness. Although it is clear that patients with moderate to severe cases of COVID-19 will require pulmonary rehabilitation, physiatrists will need to consider effective management plans for COVID-19 survivors with extrapulmonary involvement. This report will summarize key nonpulmonary considerations to guide rehabilitation clinicians who may be involved in the care of COVID-19 survivors with the best available early evidence.
Neck Imaging Reporting and Data System: What Does Radiologist Want to Know?
Authors: Abdel Razek Ahmed Abdel Khalek , Abdelaziz Tougan Taha 
Published: May 2020

Abstract
The aim of this work was to review Neck Imaging Reporting and Data System (NI-RADS) that was designed for reporting and surveillance of head and neck cancer after therapy and their subsequent management. The categories of NI-RADS can be designated as belonging in 1 of the 4 categories: negative; low suspicion; high suspicion; and definite recurrence. Lexicon of NI-RADS-1 shows nonmass-like distortion of soft tissues, NI-RADS-2 lesions divided into mucosal (2A) versus deep (2B) abnormalities, NI-RADS-3 primary site can either be a submucosal or deep lesion, and NI-RADS-4 is a biopsy-proven residual or recurrent disease. The NI-RADS Lexicon of radiology reporting categories linked to management protocols and surveillance for these patients. Neck Imaging Reporting and Data System is to provide guidance for next-imaging decisions either a follow-up period, biopsy, or surgery.
How Do Standardized Patients Form Their Complex Identities? The Impact of Interactions With Medical Students
Authors: Starr Samantha A. , Plack Margaret M. , Lewis Karen L. , Blatt Benjamin 
Published: May 2020

Introduction
Little is known about the nature of standardized patient (SP) identity and its formation. Understanding identity and formation can have important implications for recruiting, working with, and retaining SPs. Social relational theory explains how identity is formed in a social context in relationship with others. In keeping with social relational theory, this study explored SP identity formation through the SP experience with one of the most important elements of their social context—medical students.

Methods
Using qualitative methods, we conducted four 1-hour semistructured focus group interviews with SPs (N = 18). Interviews were audio recorded and transcribed verbatim. We used a constant comparative approach and consensus development to analyze the data and identify codes, categories, and ultimately themes. We used multiple methods to ensure credibility and trustworthiness of the study, as well as transparency of methods and thick rich descriptions to enable readers to judge transferability of the findings and conclusions.

Results
We identified 4 major themes. Through their interactions, SPs experienced: (1) identity transformation toward a new professional identity; (2) self-actualization toward their maximum potential; (3) judgmental reactions to medical student behaviors; and (4) simulation-reality interaction between their simulated and real selves.

Conclusions
Through their interactions with medical students, SPs experienced a transformation into a complex identity composed of multiple roles. Within this identity, they found purpose, fulfillment, and self-actualization through fostering students', as well as their own, personal, and professional growth and through developing a higher sense of social responsibility. Within this identity, they also encountered the challenges of navigating between judging and supporting medical students, and toggling between their real and simulated selves. Guided by the SPs' perspectives, and in conjunction with professional organizational standards, we provide recommendations for training, recruitment, and retention of SPs.
Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures
Authors: Schuster Kevin M. , Sanghvi Mansi , O'Connor Rick , Becher Robert , Maung Adrain A. , Davis Kimberly A. 
Published: May 2020

BACKGROUND
Geriatric patients with rib fractures are at risk for developing complications and are often admitted to a higher level of care (intensive care units [ICUs]) based on existing guidelines. Forced vital capacity (FVC) has been shown to correlate with outcomes in patients with rib fractures. Complete spirometry may quantify pulmonary capacity, predict outcome, and potentially assist with admission triage decisions.

METHODS
We prospectively enrolled 86 patients, 60 years or older with three or more isolated rib fractures presenting after injury. After informed consent, patients were assessed with respect to pain (visual analog scale), grip strength, FVC, forced expiratory volume 1 second (FEV1), and negative inspiratory force on hospital days 1, 2, and 3. Outcomes included discharge disposition, length of stay (LOS), pneumonia, intubation, and unplanned ICU admission.

RESULTS
Mean age was 77.4 (SD, 10.2) and 43 (50.0%) were female. Forty-five patients (55.6%) were discharged home, median LOS was 4 days (interquartile range, 3–7). Pneumonias (2), unplanned ICU admissions (3), and intubation (1) were infrequent. Spirometry measures including FVC, FEV1, and grip strength predicted discharge to home and FEV1, and pain level on day 1 moderately correlated with the LOS. Within each subject, FVC, FEV1, and negative inspiratory force did not change for 3 days despite pain at rest and pain after spirometry improving from day 1 to 3 (p = 0.002, p < 0.001 respectively). Change in pain also did not predict outcomes and pain level was not associated with respiratory volumes on any of the 3 days. After adjustment for confounders, FEV1 remained a significant predictor of discharge home (odds ratio, 1.03; 95% confidence interval, 1.01–1.06) and LOS (p = 0.001).

CONCLUSION
Spirometry measurements early in the hospital stay predict ultimate discharge home, and this may allow immediate or early discharge. The impact of pain control on pulmonary function requires further study.

LEVEL OF EVIDENCE
Diagnostic test, level IV.
Therapeutic anticoagulation in patients with traumatic brain injuries and pulmonary emboli
Authors: Chipman Amanda M. , Radowsky Jason , Vesselinov Roumen , Chow David , Schwartzbauer Gary , Tesoriero Ronald , Stein Deborah 
Published: May 2020

BACKGROUND
Patients with traumatic intracranial hemorrhage (ICH) and concomitant pulmonary embolus (PE) have competing care needs and demand a careful balance of anticoagulation (AC) versus potential worsening of their ICH. The goal of this study is to determine the safety of therapeutic AC for PE in patients with ICH.

METHODS
This is a retrospective single-center study of patients older than 16 years with concomitant ICH and PE occurring between June 2013 and December 2017. Early AC was defined as within 7 days of injury or less; late was defined as after 7 days. Primary outcomes included death, interventions for worsening ICH following AC, and pulmonary complications. Multivariate logistic regression was used to evaluate for clinical and demographic factors associated with worsening traumatic brain injury (TBI), and recursive partitioning was used to differentiate risk in groups.

RESULTS
Fifty patients met criteria. Four did not receive any AC and were excluded. Nineteen (41.3%) received AC early (median, 4.1; interquartile range, 3.1–6) and 27 (58.7%) received AC late (median, 14; interquartile range, 9.7–19.5). There were four deaths in the early group, and none in the late cohort (21.1% vs. 0%, p = 0.01). Two deaths were due to PE and the others were from multi-system organ failure or unrecoverable underlying TBI. Three patients in the early group, and two in the late, had increased ICH on computed tomography (17.6% vs. 7.4%, p = 0.3). None required intervention.

CONCLUSION
This retrospective study failed to find instances of clinically significant progression of TBI in 46 patients with computed tomography–proven ICH after undergoing AC for PE. Therapeutic AC is not associated with worse outcomes in patients with TBI, even if initiated early. However, two patients died from PE despite AC, underlining the severity of the disease. Intracranial hemorrhage should not preclude AC treatment for PE, even early after injury.

LEVEL OF EVIDENCE
Care management, Level IV.
The Association Between Vena Cava Implantation Technique and Acute Kidney Injury After Liver Transplantation
Authors: Hannon Vivienne , Kothari Rishi P. , Zhang Li , Bokoch Michael P. , Hill Rachel , Roll Garrett R. , Mello Anna , Feiner John R. , Liu Kathleen D. , Niemann Claus U. , Adelmann Dieter 
Published: May 2020

Background.
Acute kidney injury (AKI) after liver transplantation is associated with increased morbidity and mortality. It remains controversial whether the choice of vena cava reconstruction technique impacts AKI.

Methods.
This is a single-center retrospective cohort of 897 liver transplants performed between June 2009 and September 2018 using either the vena cava preserving piggyback technique or caval replacement technique without veno-venous bypass or shunts. The association between vena cava reconstruction technique and stage of postoperative AKI was assessed using multivariable ordinal logistic regression. Causal mediation analysis was used to evaluate warm ischemia time as a potential mediator of this association.

Results.
The incidence of AKI (AKI stage ≥2) within 48 h after transplant was lower in the piggyback group (40.3%) compared to the caval replacement group (51.8%, P < 0.001). Piggyback technique was associated with a reduced risk of developing a higher stage of postoperative AKI (odds ratio, 0.49; 95% confidence interval, 0.37-0.65, P < 0.001). Warm ischemia time was shorter in the piggyback group and identified as potential mediator of this effect. There was no difference in renal function (estimated glomerular filtration rate and the number of patients alive without dialysis) 1 y after transplant.

Conclusions.
Piggyback technique, compared with caval replacement, was associated with a reduced incidence of AKI after liver transplantation. There was no difference in long-term renal outcomes between the 2 groups.
A unique small molecule pair controls the plant circadian clock
Authors: Uehara Takahiro N , Takao Saori , Matsuo Hiromi , Saito Ami N. , Ota Eisuke , Ono Azusa , Itami Kenichiro , Kinoshita Toshinori , Yamaguchi Junichiro , Nakamichi Norihito 
Published: May 2020

SummaryCircadian clocks are the biological time keeping systems that coordinate genetic, metabolic, and physiological behaviors with the external day-night cycle. Previous studies have suggested possible molecular mechanisms for the circadian clock inArabidopsis thaliana(Arabidopsis), but there might be additional mechanisms that have been hidden due to genetic redundancy.A clock reporter line of Arabidopsis was screened against the 10,000 chemicals in the Maybridge Hitfinder10K chemical library, and a structure-activity relationship study of hit compounds was conducted. Clock mutants were treated with two of the small molecules to gain insight into their mode of action.The screening identified 5-(3,4-dichlorophenyl)-1-phenyl-1,7-dihydro-4H-pyrazolo[3,4-d]pyrimidine-4,6(5H)-dione (TU-892) as a period lengthening molecule. From a structure-activity relationship study, we found that a molecule possessing 2,4-dichlorophenyl instead of a 3,4-dichlorophenyl group (TU-923) had period shortening activity. The period shortening activity ofTU-923was reversed to a lengthening activity in double mutants lackingPSEUDO-RESPONSE REGULATOR 9(PRR9) andPRR7(prr9-10 prr7-11).Our study provides a unique small molecule pair that regulates the pace of the clock in opposite ways, likely by targeting unknown factors. Small differences at the atomic level can reverse the period tuning activities.PRR9andPRR7are essential for the activity ofTU-923in period shortening.
Defense versus growth in a hostile world – Lessons from phage and bacteria
Authors: Eriksen Rasmus Skytte , Krishna Sandeep 
Published: May 2020

AbstractBacterial communities are often highly diverse with several closely related species (or strains) coexisting together. These bacteria compete for resources and the competitive exclusion principle predicts that all but the fastest-growing bacteria will go extinct. When exposed to phage, it is predicted that bacterial strains with restriction-modification (RM) systems can circumvent the competitive exclusion principle and reach diversity on the order of the phage burst size. We show that with a trade-off between bacterial growth rates and the strength of their RM systems, the diversity of such an ecosystem can further increase several fold beyond the burst size limit. Moreover, we find that the ratio of the growth rate of a bacterial strain to the imperfection of its RM system is an excellent predictor of (i) whether the strain will go extinct or not, and (ii) the biomass of the strain if it survives. In contrast, the growth rate alone is not a determinant of either of these properties. Our work provides a quantitative example of a model ecosystem where the fitness of a species is determined not by growth rate, but by a trade-off between growth and defence against predators.
Discovery of novel haplotypes for complex traits in landraces
Authors: Mayer Manfred , Hölker Armin C. , González-Segovia Eric , Presterl Thomas , Ouzunova Milena , Melchinger Albrecht E. , Schön Chris-Carolin 
Published: May 2020

AbstractGenetic variation is of crucial importance for selection and genetic improvement of crops. Landraces are valuable sources of diversity for germplasm improvement, but for quantitative traits efficient strategies for their targeted utilization are lacking. Here, we propose a genome-based strategy for making native diversity accessible for traits with limited genetic variation in elite germplasm. We generated ~ 1,000 doubled-haploid (DH) lines from three European maize landraces, pre-selected based on molecular and phenotypic information. Using GWAS, we mapped haplotype-trait associations for early development traits at high resolution in eleven environments. Molecular haplotype inventories of landrace derived DH libraries and a broad panel of 65 breeding lines based on 501,124 SNPs revealed novel variation for target traits in the landraces. DH lines carrying these novel haplotypes outperformed breeding lines not carrying the respective haplotypes. Most haplotypes associated with target traits showed stable effects across populations and environments and only limited correlated effects with undesired traits making them ideal for introgression into elite germplasm. Our strategy was successful in linking molecular variation to meaningful phenotypes and identifying novel variation for quantitative traits in plant genetic resources.
LETR1 is a lymphatic endothelial-specific lncRNA that governs cell proliferation and migration through KLF4 and SEMA3C
Authors: Ducoli Luca , Agrawal Saumya , Sibler Eliane , Kouno Tsukasa , Tacconi Carlotta , Hon Chung-Chao , Berger Simone D. , Müllhaupt Daniela , He Yuliang , D’Addio Marco , Dieterich Lothar C. , Carninci Piero , de Hoon Michiel J. L. , Shin Jay W. , Detmar Michael 
Published: May 2020

AbstractRecent studies have revealed the importance of long noncoding RNAs (lncRNAs) as tissue-specific regulators of gene expression. There is ample evidence that distinct types of vasculature undergo tight transcriptional control to preserve their structure, identity, and functions. We determined, for the first time, the global lineage-specific lncRNAome of human dermal blood and lymphatic endothelial cells (BECs and LECs), combining RNA-Seq and CAGE-Seq. A subsequent genome-wide antisense oligonucleotide-knockdown screen of a robust set of BEC- and LEC-specific lncRNAs identified LETR1 as a critical gatekeeper of the global LEC transcriptome. Deep RNA-DNA, RNA-protein, and phenotype rescue analyses revealed that LETR1 acts as a nucleartrans-acting lncRNA modulating, via key epigenetic factors, the expression of essential target genes, including KLF4 and SEMA3C, governing the growth and migratory ability of LECs. Together, our study provides new evidence supporting the intriguing concept that every cell type expresses precise lncRNA signatures to control lineage-specific regulatory programs.
IMiDs induce FAM83F degradation via an interaction with CK1α to attenuate Wnt signalling
Authors: Dunbar Karen , Macartney Thomas J. , Sapkota Gopal P. 
Published: May 2020

ABSTRACTImmunomodulatory imide drugs (IMiDs) bind CRBN, a substrate receptor of the Cul4A E3 ligase complex, enabling neo-substrate recruitment and degradation via the ubiquitin-proteasome system. Here, we report FAM83F as such a neo-substrate. We recently showed that the eight FAM83 proteins (A-H) interact with members of the serine/threonine protein kinase CK1 family, to regulate their subcellular distribution and distinct biological roles. CK1α is a well-established IMiD neo-substrate and we demonstrate here that IMiD-induced FAM83F degradation requires its association with CK1α. Despite all FAM83 proteins interacting with CK1α, no other FAM83 protein is degraded by IMiDs. FAM83F is localised to the plasma membrane, and consistent with this, IMiD treatment results in depletion of both FAM83F and CK1α levels from the plasma membrane. We have recently identified FAM83F as a mediator of the canonical Wnt signalling pathway. The IMiD-induced degradation of FAM83F attenuated Wnt signalling in colorectal cancer cells and removed CK1α from the plasma membrane, mirroring the phenotypes observed with genetic ablation of FAM83F. Intriguingly, in many cancer cell lines, IMiD-induced degradation of CK1α is only modest and incomplete. In line with this observation, the expression of FAM83G, which also binds to CK1α, appears to attenuate the IMiD-induced degradation of CK1α, suggesting a protective role for FAM83G on CK1α. Our findings reveal that the efficiency of target protein degradation by IMiDs, and perhaps other degraders such as PROTACs, relies on the nature of the inherent multiprotein complex in which the target protein exists. Our findings unearth opportunities for developing degraders to target specific protein complexes.
Fast in vivo23Na imaging and T2*mapping using accelerated 2D-FID magnetic resonance spectroscopic imaging at 3 T: Proof of concept and reliability study
Authors: Alhulail Ahmad A. , Xia Pingyu , Shen Xin , Nichols Miranda , Volety Srijyotsna , Farley Nicholas , Thomas M. Albert , Nagel Armin M , Dydak Ulrike , Emir Uzay E. 
Published: May 2020

AbstractPurposeTo implement an accelerated MR-acquisition method allowing to map sodium T2*relaxation and absolute concentration within skeletal muscles at 3T.MethodsA fast-2D density-weighted concentric-ring-trajectory23Na-MRSI technique was used to acquire 64 time-points of FID with a spectral bandwidth of 312.5 Hz from a 2.5 x 2.5 mm2in-plane resolution within about 15 minutes. The fast relaxing23Na signal was localized with a single-shot, inversion-recovery based, non-echo (SIRENE) OVS method. The sequence was verified using simulation and phantom studies before implementing it in human calf muscles. Within two same-day sessions, 2D-SIRENE-MRSI (UTE = 0.55 ms) and 3D-MRI (UTE = 0.3 ms) data were acquired. The T2*values were fitted voxel-by-voxel using a bi-exponential model for the 2D-MRSI data. Within-subject coefficients of variation were estimated for both acquisition methods.ResultsThe MRSI-FID data allowed for fast and slow T2*mapping of the calf muscles in vivo with minimal sensitivity reduction. The spatial-distributions of23Na concentration for both in vivo MRSI and 3D-MRI acquisitions were significantly correlated (r = 0.7,P<0.001). The test-retest results rendered high reliability for both MRSI (CV = 5%) and 3D MRI (CV = 6%). The meanin calf muscles was 0.7 ± 0.1 (contribution fraction = 37%), whilewas 13.2 ± 0.2 ms (63%). The mean absolute muscle23Na concentration calculated from the T2*-corrected data was 28.6 ± 3.3 mM.ConclusionThe proposed MRSI technique is a reliable technique to map sodium’s absolute concentration and T2*within a clinically acceptable scan time at 3T.
Neutrophils Mediate Kidney Inflammation Following Acute Skin Exposure to UVB Light
Authors: Skopelja-Gardner Sladjana , Tai Joyce , Sun Xizhang , Tanaka Lena , Kuchenbecker James A. , Snyder Jessica M. , Kubes Paul , Mustelin Tomas , Elkon Keith B. 
Published: May 2020

AbstractPhotosensitivity to ultraviolet (UV) light affects up to ~80% of lupus patients and can exacerbate local skin disease as well as systemic disease, including lupus nephritis. While neutrophils have been implicated in local tissue injury in lupus in response to immune complex deposition, whether and how they play a role in photosensitivity induced systemic disease is unknown. Here, we show that following skin exposure to UV light, neutrophils migrate not only to the skin, but also to the kidney, in an IL-17A-dependent manner. Kidney infiltrating neutrophils produced reactive oxygen species and their presence was associated with upregulation of endothelial adhesion molecules and inflammatory cytokines as well as the induction of kidney injury markers, including transient proteinuria. Neutrophils were responsible for inflammation and renal injury as demonstrated by experiments that inhibited neutrophil mobilization. Exploiting a mouse model containing photoactivatable immune cells, we observed that a subset of neutrophils found in the kidney had transited through UV light-exposed skin suggesting reverse transmigration. These findings demonstrate that neutrophils mediate transient kidney injury following skin exposure to UV light and, coupled with observations identifying similar neutrophil phenotypes in human lupus, could provide a mechanistic link to explain sun-induced systemic lupus flares.