bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe liver dysfunction complicating course of COVID-19 in the critically ill: multifactorial cause or direct viral effect?
Authors: Roedl Kevin , Jarczak Dominik , Drolz Andreas , Wichmann Dominic , Boenisch Olaf , de Heer Geraldine , Burdelski Christoph , Frings Daniel , Sensen Barbara , Nierhaus Axel , Lütgehetmann Marc , Kluge Stefan , Fuhrmann Valentin 
Published: March 2021

Abstract
Background
SARS-CoV-2 caused a pandemic and global threat for human health. Presence of liver injury was commonly reported in patients with coronavirus disease 2019 (COVID-19). However, reports on severe liver dysfunction (SLD) in critically ill with COVID-19 are lacking. We evaluated the occurrence, clinical characteristics and outcome of SLD in critically ill patients with COVID-19.

Methods
Clinical course and laboratory was analyzed from all patients with confirmed COVID-19 admitted to ICU of the university hospital. SLD was defined as: bilirubin ≥ 2 mg/dl or elevation of aminotransferase levels (> 20-fold ULN).

Results
72 critically ill patients were identified, 22 (31%) patients developed SLD. Presenting characteristics including age, gender, comorbidities as well as clinical presentation regarding COVID-19 overlapped substantially in both groups. Patients with SLD had more severe respiratory failure (paO2/FiO2: 82 (58–114) vs. 117 (83–155); p < 0.05). Thus, required more frequently mechanical ventilation (95% vs. 64%; p < 0.01), rescue therapies (ECMO) (27% vs. 12%; p = 0.106), vasopressor (95% vs. 72%; p < 0.05) and renal replacement therapy (86% vs. 30%; p < 0.001). Severity of illness was significantly higher (SAPS II: 48 (39–52) vs. 40 (32–45); p < 0.01). Patients with SLD and without presented viremic during ICU stay in 68% and 34%, respectively (p = 0.002). Occurrence of SLD was independently associated with presence of viremia [OR 6.359; 95% CI 1.336–30.253; p < 0.05] and severity of illness (SAPS II) [OR 1.078; 95% CI 1.004–1.157; p < 0.05]. Mortality was high in patients with SLD compared to other patients (68% vs. 16%, p < 0.001). After adjustment for confounders, SLD was independently associated with mortality [HR3.347; 95% CI 1.401–7.999; p < 0.01].

Conclusion
One-third of critically ill patients with COVID-19 suffer from SLD, which is associated with high mortality. Occurrence of viremia and severity of illness seem to contribute to occurrence of SLD and underline the multifactorial cause.
Instructor strategies to aid implementation of active learning: a systematic literature review
Authors: Nguyen Kevin A. , Borrego Maura , Finelli Cynthia J. , DeMonbrun Matt , Crockett Caroline , Tharayil Sneha , Shekhar Prateek , Waters Cynthia , Rosenberg Robyn 
Published: March 2021

AbstractBackgroundDespite the evidence supporting the effectiveness of active learning in undergraduate STEM courses, the adoption of active learning has been slow. One barrier to adoption is instructors’ concerns about students’ affective and behavioral responses to active learning, especially student resistance. Numerous education researchers have documented their use of active learning in STEM classrooms. However, there is no research yet that systematically analyzes these studies for strategies to aid implementation of active learning and address students’ affective and behavioral responses. In this paper, we conduct a systematic literature review and identify 29 journal articles and conference papers that researched active learning, affective and behavioral student responses, and recommended at least one strategy for implementing active learning. In this paper, we ask: (1) What are the characteristics of studies that examine affective and behavioral outcomes of active learning and provide instructor strategies? (2) What instructor strategies to aid implementation of active learning do the authors of these studies provide?ResultsIn our review, we noted that most active learning activities involved in-class problem solving within a traditional lecture-based course (N= 21). We found mostly positive affective and behavioral outcomes for students’ self-reports of learning, participation in the activities, and course satisfaction (N= 23). From our analysis of the 29 studies, we identified eight strategies to aid implementation of active learning based on three categories. Explanation strategies included providing students with clarifications and reasons for using active learning. Facilitation strategies entailed working with students and ensuring that the activity functions as intended. Planning strategies involved working outside of the class to improve the active learning experience.ConclusionTo increase the adoption of active learning and address students’ responses to active learning, this study provides strategies to support instructors. The eight strategies are listed with evidence from numerous studies within our review on affective and behavioral responses to active learning. Future work should examine instructor strategies and their connection with other affective outcomes, such as identity, interests, and emotions.
Longitudinal multi-omics transition associated with fatality in critically ill COVID-19 patients
Authors: Sun Chaoyang , Sun Yuzhe , Wu Ping , Ding Wencheng , Wang Shiyou , Li Jiafeng , Liang Langchao , Chai Chaochao , Fu Yu , Li Zhiming , Zhu Linnan , Ju Jia , Liao Xin , Huang Xiaoyuan , Feng Ling , Ma Ding , He Liang , Chen Dongsheng , Chen Gang , Jin Xin , Wu Peng 
Published: March 2021

Abstract
Purpose
Critically ill COVID-19 patients have significantly increased risk of death. Although several circulating biomarkers are thought to be related to COVID-19 severity, few studies have focused on the characteristics of critically ill patients with different outcomes. The objective of this study was to perform a longitudinal investigation of the potential mechanisms affecting the prognosis of critically ill COVID-19 patients.

Methods
In addition to clinical data, 113 whole blood samples and 85 serum samples were collected from 33 severe and critical COVID-19 patients without selected comorbidities. Multi-omics analysis was then performed using longitudinal samples.

Results
Obvious transcriptional transitions were more frequent in critical survivors than in critical non-survivors, indicating that phase transition may be related to survival. Based on analysis of differentially expressed genes during transition, the erythrocyte differentiation pathway was significantly enriched. Furthermore, clinical data indicated that red blood cell counts showed greater fluctuation in survivors than in non-survivors. Moreover, declining red blood cell counts and hemoglobin levels were validated as prognostic markers of poor outcome in an independent cohort of 114 critical COVID-19 patients. Protein–metabolite–lipid network analysis indicated that tryptophan metabolism and melatonin may contribute to molecular transitions in critical COVID-19 patients with different outcomes.

Conclusions
This study systematically and comprehensively depicted the longitudinal hallmarks of critical COVID-19 patients and indicated that multi-omics transition may impact the prognosis.

Take home message
Frequent transcriptional phase transitions may contribute to outcome in critically ill COVID-19 patients. Furthermore, fluctuation in red blood cell and hemoglobin levels may relate to poor prognosis. The biological function of melatonin was suppressed in COVID-19 non-survivors, which may provide a potential theoretical basis for clinical administration.
Korea hypertension fact sheet 2020: analysis of nationwide population-based data
Authors: Kim Hyeon Chang , Cho So Mi Jemma , Lee Hokyou , Lee Hyeok-Hee , Baek Jongmin , Heo Ji Eun ,   for the Korean Society of Hypertension (KSH) – Hypertension Epidemiology Research Working Group, Kim Hyeon Chang , Ahn Song Vogue , Jee Sun Ha , Park Sungha , Lee Hae-Young , Shin Min Ho , Ihm Sang-Hyun , Lee Seung Won , Lee Hokyou , Park Jong Ku , Suh Il , Lee Tae-Yong , Cho So Mi Jemma , Lee Hyeok-Hee , Baek Jongmin , Heo Ji Eun 
Published: March 2021

Abstract
Background
The Korean Society of Hypertension has published the Korea Hypertension Fact Sheet 2020 to provide an overview of the magnitude and management status of hypertension and their recent trends.

Methods
The Fact Sheets were based on the analyses of Korean adults aged 20 years or older of the 2007–2018 Korea National Health and Nutrition Examination Survey (KNHANES) and the 2002–2018 National Health Insurance Big Data (NHI-BD).

Results
Currently, the population average of systolic/diastolic blood pressure was 118/76 mmHg in Korean adults aged 20 years or older showing little change in the recent decade. However, the number of people with hypertension increased steadily, exceeding 12.0 million. Indeed, the number of people diagnosed with hypertension increased from 3.0 million in 2002 to 9.7 million in 2018. During the same period, the number of people using antihypertensive medication increased from 2.5 million to 9.0 million, and the number of people adherent to treatment increased from 0.6 million to 6.5 million. Hypertension awareness, treatment, and control rates increased rapidly until 2007, but showed plateaued thereafter. In 2018, the awareness, treatment, and control rates of hypertension among all adults were 67, 63, and 47%, respectively. However, the awareness and treatment rates were only 17 and 14% among adults aged 20 to 39 years old with hypertension. Among patients treated for hypertension, 61% of them were also using glucose-lowering or lipid-lowering drugs. Among antihypertensive prescriptions, 41% of the patients received monotherapy, 43% received dual therapy, and 16% received triple or more therapy. The most commonly prescribed antihypertensive medication was angiotensin receptor blockers, followed by calcium channel blockers and diuretics.

Conclusion
To achieve further improvement in management of hypertension, we need to encourage awareness and treatment in young adults. It is required to develop tailored prevention and management strategies that are appropriate for and inclusive of various demographics.
The biosynthesis of the cannabinoids
Authors: Tahir M. Nazir , Shahbazi Fred , Rondeau-Gagné Simon , Trant John F. 
Published: March 2021

Abstract
Cannabis has been integral to Eurasian civilization for millennia, but a century of prohibition has limited investigation. With spreading legalization, science is pivoting to study the pharmacopeia of the cannabinoids, and a thorough understanding of their biosynthesis is required to engineer strains with specific cannabinoid profiles. This review surveys the biosynthesis and biochemistry of cannabinoids. The pathways and the enzymes’ mechanisms of action are discussed as is the non-enzymatic decarboxylation of the cannabinoic acids. There are still many gaps in our knowledge about the biosynthesis of the cannabinoids, especially for the minor components, and this review highlights the tools and approaches that will be applied to generate an improved understanding and consequent access to these potentially biomedically-relevant materials.

Graphical abstract
Post-COVID-19 encephalomyelitis
Authors: Kim Ji-Won , Abdullayev Nuran , Neuneier Janina , Fink Gereon R. , Lehmann Helmar C. 
Published: March 2021

AbstractSince the outbreak of coronavirus disease 2019 (COVID-19), a growing number of cases of acute transverse myelitis associated with COVID-19 have been reported. Here, we present the case of a patient who developed sensory ataxia after COVID-19 with MR lesions suggestive for longitudinal myelitis and in the splenium of the corpus callosum. The patient was successfully treated with immunoadsorption.
The cyclase-associated protein UvCap1 is required for mycelial growth and pathogenicity in the rice false smut fungus
Authors: Cao Hui-Juan , Zhang Jin-Jin , Yong Ming-Li , Yu Mi-Na , Song Tian-Qiao , Yu Jun-Jie , Pan Xia-Yan , Liu Yong-Feng 
Published: March 2021

AbstractRice false smut caused by Ustilaginoidea virens is one of the widespread rice diseases across the globe in recent years, however, we know little about its molecular mechanism of infection. The cAMP signaling pathway functions directly in the development and formation of infectious structures to regulate the infection process in many pathogenic fungi. In order to investigate the role of the cAMP signaling pathway in U. virens, UvCap1, a cyclase-associated-protein homologous to Saccharomyces cerevisiae Srv2 was identified. Three targeted deletion mutants of the UvCAP1 gene were obtained with gene replacement strategy assisted with CRISPR-Cas9 system. The UvCAP1 deletion mutants showed defects in mycelial growth and conidial production. Inoculation experiments demonstrated that ΔUvcap1 exhibited defects in pathogenicity. Compared with the wild-type strain, ΔUvcap1 showed decreased tolerance to sorbitol and H2O2, and increased tolerance to NaCl, CFW and SDS, and the intracellular cAMP level was significantly reduced in ΔUvcap1. Yeast two-hybrid assay identified the interactions of UvCap1 with UvAc1 (adenylase cyclase), two Ras proteins (UvRas1 and UvRas2) and UvSte50. Taken together, as a component of cAMP signaling pathway, UvCap1 plays important roles in the development and pathogenicity of U. virens.
Recent advances in skin collagen: functionality and non-medical applications
Authors: Han Yanting , Hu Jinlian , Sun Gang 
Published: March 2021

Abstract
During nature evolution process, living organisms have gradually adapted to the environment and been adept in synthesizing high performance structural materials at mild conditions by using fairly simple building elements. The skin, as the largest organ of animals, is such a representative example. Conferred by its intricate organization where collagen fibers are arranged in a randomly interwoven network, skin collagen (SC), defined as a biomass derived from skin by removing non-collagen components displays remarkable performance with combinations of mechanical properties, chemical-reactivity and biocompatibility, which far surpasses those of synthetic materials. At present, the application of SC in medical field has been largely studied, and there have been many reviews summarizing these efforts. However, the generalized view on the aspects of SC as smart materials in non-medical fields is still lacking, although SC has shown great potential in terms of its intrinsic properties and functionality. Hence, this review will provide a comprehensive summary that integrated the recent advances in SC, including its preparation method, structure, reactivity, and functionality, as well as applications, particularly in the promising area of smart materials.

Graphical abstract
Synthesis and application of non-bioaccumulable fluorinated surfactants: a review
Authors: Zhou Rong , Jin Yong , Shen Yichao , Zhao Peng , Zhou Yutang 
Published: March 2021

AbstractDue to negative effects of conventional fluorinated surfactants with long perfluorocarbon chain (CxF2x+ 1, x≥7) like perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), these conventional long perfluorocarbon chain surfactants have been restricted in many industrial applications. Nowadays, their potential non-bioaccumulable alternatives have been developed to meet the requirements of environmental sustainable development. In this paper, the recent advances of potential non-bioaccumulable fluorinated surfactants with different fluorocarbon chain structures, including the short perfluorocarbon chain, the branched fluorocarbon chain, and the fluorocarbon chain with weak points, are reviewed from the aspects of synthesis processes, properties, and structure-activity relationships. And their applications in emulsion polymerization of fluorinated olefins, handling membrane proteins, and leather manufacture also are summarized. Furthermore, the challenges embedded in the current non-bioaccumulable fluorinated surfactants are also highlighted and discussed with the hope to provide a valuable reference for the prosperous development of fluorinated surfactants.Graphical abstract
Multi-grade fuzzy assessment framework for software professionals in work-from-home mode during and post-COVID-19 era
Authors: Suresh M. , Gopakumar Kavya 
Published: March 2021

AbstractThe pandemic novel Coronavirus disease and the resulting lockdowns have contributed to major economic disturbances around the world, forcing organisations to extend the work-from-home (WFH) option to their employees wherever feasible. The current major challenge of this option is maintaining the efficiency and productivity of the employees across the organisations. It is therefore important to understand the impact of this make-shift arrangement of WFH policy and their underlying effects that may affect the efficiency of employees and hence their output levels. This is a distinctive approach to develop a unique framework for efficiency index computation by evaluating the efficiency levels of WFH mode in software organisations using multi-grade fuzzy approach and importance–performance analysis. In turn, this would help to determine the crucial attributes that require improvement to increase the efficiency levels of employees concerned. In this study, a case project has been assessed and it was observed that the efficiency index of WFH accounts to 4.92, which is in between the range of (4.01–6) specified as ‘Efficient’. The framework can be used on a periodic basis to help software organisations to continuously improve their WFH efficiency level.
Scholarly Activity of Radiation Oncologists in High-Income Developing Countries: Saudi Arabia as an Example
Authors: Alghamdi Majed A. , Alghamdi Suliman M. , Bahadur Yasir A. , Asiri Mushabbab A. , AlHussain Hussain A. , Alhebshi Adnan S. , Alothman Majid O. , Al-omair Ameen S. , Alghamdi Abdulaziz A. , Qanat Ahmed S. , Aqeeli Mohammed O. , Alsuhaibani Abdullah A. , Alshehri Salem M. , Alotain Ibrahim M. , Mail Noor K. , Alhashemi Hashem H. , Alassaf Hossam A. 
Published: March 2021

PURPOSETo examine the trends and quality metrics of publications by radiation oncologists in Saudi Arabia.METHODSPubMed was searched using names of all Saudi radiation oncologists to retrieve published articles between January 2010 and December 2019. International collaboration, journal impact factor and country of origin, and number of citations were collected. Each article was assessed for epidemiologic type and independently assigned a level of evidence (LOE) by two authors. The trend in publications was examined and compared in the first and second 5-year periods (2010-2014 and 2015-2019) using relevant parameters.RESULTSA total of 186 publications were found and included. The most common type of research was cohort studies followed by case reports and case series in 24%, 14%, and 13% of all publications, respectively. Dosimetry, clinical, and preclinical studies formed 7%, 8.6%, and 7.5% of the total publications, respectively. The LOE was I, II, III, IV, and not applicable in 8.6%, 22%, 25.8%, 29%, and 14.5% of the included publications, respectively. Comparing the first and second 5-year periods, there was an increase in international collaboration ( P < .001) in the second period. The number of citations ( P < .001) and journal impact factor ( P = .028) were lower in the second period. LOE and publications in international journals were not statistically different between the two periods.CONCLUSIONAlthough radiation oncology research activity in Saudi Arabia has gained momentum in terms of volume and international collaboration over time, the LOE has not improved. This calls for a national effort to make the contribution to the literature a priority, allocate adequate resources, and apply appropriate measures to enhance research productivity and quality.
Never Enough Time: Mixed Methods Study Identifies Drivers of Temporal Demand That Contribute to Burnout Among Physicians Who Care for Pediatric Hematology-Oncology Patients
Authors: Blazin Lindsay J. , Terao Michael A. , Spraker-Perlman Holly , Baker Justin N. , McLaughlin Crabtree Valerie , Mandrell Belinda N. , Gattuso Jami , Sellers Janet , Dunn Tyler J. , Lu Zhaohua , Hoffman James M. , Burlison Jonathan D. 
Published: March 2021

PURPOSE: Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment because of chronic occupational stress. Approximately one third of pediatric hematology-oncology physicians experience burnout. The goal of this mixed methods study was to determine the prevalence and drivers of burnout among physicians caring for pediatric hematology-oncology patients at our institution. MATERIALS AND METHODS: This mixed methods, cross-sectional study was conducted at a large academic cancer center. Validated survey instruments were used to measure burnout, job demands, experience with patient safety events, and workplace culture. Quantitative data informed development of a semistructured interview guide, and physicians were randomly selected to participate in individual interviews. Interviews were transcribed and analyzed via content analysis based on a priori codes. RESULTS: The survey was distributed to 132 physicians, and 53 complete responses were received (response rate 40%). Of the 53 respondents, 15 (28%) met criteria for burnout. Experiencing burnout was associated with increased temporal demand. Twenty-six interviews were conducted. Qualitative themes revealed that frequent meetings, insufficient support staff, and workflow interruptions were key drivers of temporal demand and that temporal demand contributed to burnout through emotional exhaustion and reduced personal accomplishment. CONCLUSION: Nearly one-third of participating physicians met criteria for burnout, and burnout was associated with increased temporal demand. Qualitative interviews identified specific drivers of temporal demand and burnout, which can be targeted for intervention. This methodology can be easily adapted for broad use and may represent an effective strategy for identifying and mitigating institution-specific drivers of burnout.
Deiodinases and the Metabolic Code for Thyroid Hormone Action
Authors: Russo Samuel C , Salas-Lucia Federico , Bianco Antonio C 
Published: March 2021

Abstract
Deiodinases modify the biological activity of thyroid hormone (TH) molecules, ie, they may activate thyroxine (T4) to 3,5,3′-triiodothyronine (T3), or they may inactivate T3 to 3,3′-diiodo-L-thyronine (T2) or T4 to reverse triiodothyronine (rT3). Although evidence of deiodination of T4 to T3 has been available since the 1950s, objective evidence of TH metabolism was not established until the 1970s. The modern paradigm considers that the deiodinases not only play a role in the homeostasis of circulating T3, but they also provide dynamic control of TH signaling: cells that express the activating type 2 deiodinase (D2) have enhanced TH signaling due to intracellular build-up of T3; the opposite is seen in cells that express type 3 deiodinase (D3), the inactivating deiodinase. D2 and D3 are expressed in metabolically relevant tissues such as brown adipose tissue, skeletal muscle and liver, and their roles have been investigated using cell, animal, and human models. During development, D2 and D3 expression customize for each tissue/organ the timing and intensity of TH signaling. In adult cells, D2 is induced by cyclic adenosine monophosphate (cAMP), and its expression is invariably associated with enhanced T3 signaling, expression of PGC1 and accelerated energy expenditure. In contrast, D3 expression is induced by hypoxia-inducible factor 1α (HIF-1a), dampening T3 signaling and the metabolic rate. The coordinated expression of these enzymes adjusts TH signaling in a time- and tissue-specific fashion, affecting metabolic pathways in health and disease states.