bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Training System Based on the Discovery of Subperiosteal Transmission of Pressures Between Joint Capsules
Authors: Pitkin Mark 
Published: January 2021

ABSTRACTBackgroundA new training and rehabilitation methodology called Sanomechanics® is presented based on a recent discovery of the anatomical system called Floating Skeleton System (FSS) responsible for redistributing contact pressures in the joint capsules and thus minimizing the loads on joint cartilages.Materials and MethodsThe main idea behind the Sanomechanics® methodology (SMM) is that when this system of subperiosteal pressure transmission is disrupted, the overloading of cartilages may occur leading to trauma, osteoarthritis and other related pathologies. Conversely, if functioning of the FSS is adequately restored and continuously maintained, the pathological developments can be effectively stopped.ResultsAnalysis of existing training systems using mind-body approach revealed that they are lacking the understanding of a physiological mechanism of their success or failure in training. It is postulated that maintaining/restoration of transmission of pressure between the joint capsules is necessary component of preventing overloading of joint cartilages occurring in military training and operations and in civilian life. Visualization of this concept has been suggested as a key element to the SMM training system.ConclusionsThe FSS provides for a guidance for development of scientific approaches to the training and rehabilitation techniques. The SMM is balanced mind-body training system, which can help U.S. Servicemen and Servicewomen be better prepared for extreme load during their service.
A Pilot Study to Examine Psychological and Neuropsychological Outcomes and a Novel Detoxification Program for Gulf War Illness
Authors: Graves Donald F , Morse Gayle S , Kerr Kathleen , Carpenter David O 
Published: January 2021

ABSTRACT

Introduction
Exposures to environmental toxins have been associated with severe health problems for approximately one-quarter of the nearly 700,000 U.S. soldiers who served in the Gulf War between the years 1990 and 1991. Gulf War illness still affects about 30% of Gulf War veterans (GWV), causing reduced psychological wellness and neuropsychological function.

Method and Materials
This pilot study used a randomized wait-list control design to explore the feasibility and efficacy of a novel detoxification method for GWV exposed to toxicants such as pesticides, nerve gases, and pyridostigmine bromide. Our study included 32 GWV (67% male), with a mean age of 51 (range: 43-70, SD = 6.97), who participated in a 4- to 5-week treatment that was hypothesized to reduce the reported psychological and neuropsychological symptoms. Psychological measures used included tests given for the evaluation of neurocognitive function, including motor function for a dominant hand with the grooved pegboard test; verbal and visual immediate and delayed memory with the Wechsler Memory Scale III abbreviated subtests; executive function domains of attention, speed, and mental flexibility with trail making test parts A and B and Stroop color and word test. Psychological status was measured using the nine subscales of the Symptom Checklist-90-Revised.

Results
Primary outcomes included between-group differences in self-reported psychological measures and a neuropsychological battery at 7-day and 3-month assessments. Baseline comparison revealed improvements in 16 of 19 psychological and neuropsychological measures at 7-day assessment and that 13 remained stable at 3-month assessment.

Conclusions
We conclude that the detoxification procedure provided improvement in psychological and cognitive function for GWV and that future study is warranted.
Efficacy of Cognitive Training When Translated From the Laboratory to the Real World
Authors: Young Leanne R , Zientz Jennifer E , Spence Jeffrey S , Krawczyk Daniel C , Chapman Sandra B 
Published: January 2021

ABSTRACT

Introduction
Research shows that cognitive performance and emotional well-being can be significantly strengthened. A high-performance brain training protocol, Strategic Memory Advanced Reasoning Training (SMART), was developed by cognitive neuroscientists at The University of Texas at Dallas Center for BrainHealth based on 25-plus years of scientific study. Randomized controlled trials with various populations have shown that training and use of nine “SMART” strategies for processing information can improve cognitive performance and psychological health. However, the multi-week intensive training used in the laboratory is not practical for widespread use outside the laboratory. This article examines the efficacy of SMART when translated outside the laboratory to two populations (military/veterans and law enforcement) that received SMART in condensed time frames.

Materials and Methods
In two translation studies with healthy military personnel and veterans, 425 participants received between 6 and 10 hours of SMART over 2 days. In a third translation study, 74 healthy police officers received 9 hours of SMART over 3 days. Training was conducted by clinicians who taught the nine “SMART” strategies related to three core areas—strategic attention, integrated reasoning, and innovation—to groups of up to 25 participants. In all three translation studies, cognitive performance and psychological health data were collected before and immediately following the training. In one of the military/veteran studies, psychological health data were also collected 1 and 4 months following the training.

Results
In both translations to military personnel and veterans, there were improvements in the complex cognitive domains of integrated reasoning (P &lt; .0001) and innovation (P &lt; .0001) immediately after undergoing SMART. In the translation to police officers, there were improvements in the cognitive domains of innovation (P = .02) and strategic attention (P = .005). Participants in all three translations saw statistically significant improvements in self-reported symptoms of psychological health. The improvements continued among a subset of participants who responded to the later requests for information.

Conclusions
The results of translating to these two populations provide evidence supporting the efficacy of SMART delivered in an abbreviated time frame. The improvements in two major domains of cognitive function demonstrate that strategies can be taught and immediately applied by those receiving the training. The immediate psychological health improvements may be transient; however, the continued improvements in psychological health observed in a subset of the participants suggest that benefits may be sustainable even at later intervals.
A high-contrast search for variability in HR 8799bc with VLT-SPHERE
Authors: Biller Beth A , Apai Dániel , Bonnefoy Mickaël , Desidera Silvano , Gratton Raffaele , Kasper Markus , Kenworthy Matthew , Lagrange Anne-Marie , Lazzoni Cecilia , Mesa Dino , Vigan Arthur , Wagner Kevin , Vos Johanna M , Zurlo Alice 
Published: January 2021

ABSTRACT
The planets HR8799bc display nearly identical colours and spectra as variable young exoplanet analogs such as VHS 1256-1257ABb and PSO J318.5-22, and are likely to be similarly variable. Here we present results from a 5-epoch SPHERE IRDIS broadband-H search for variability in these two planets. HR 8799b aperture photometry and HR 8799bc negative simulated planet photometry share similar trends within uncertainties. Satellite spot lightcurves share the same trends as the planet lightcurves in the August 2018 epochs, but diverge in the October 2017 epochs. We consider Δ(mag)b − Δ(mag)c to trace non-shared variations between the two planets, and rule out non-shared variability in Δ(mag)b − Δ(mag)c to the 10–20 ${{\ \rm per\ cent}}$ level over 4–5 h. To quantify our sensitivity to variability, we simulate variable lightcurves by inserting and retrieving a suite of simulated planets at similar radii from the star as HR 8799bc, but offset in position angle. For HR 8799b, for periods &lt;10 h, we are sensitive to variability with amplitude $\gt 5{{\ \rm per\ cent}}$. For HR 8799c, our sensitivity is limited to variability $\gt 25{{\ \rm per\ cent}}$ for similar periods.
Structure-based analyses ofSalmonellaRcsB variants unravel new features of the Rcs regulon
Authors: Huesa Juanjo , Giner-Lamia Joaquín , Pucciarelli M Graciela , Paredes-Martínez Francisco , Portillo Francisco García-del , Marina Alberto , Casino Patricia 
Published: January 2021

AbstractRcsB is a transcriptional regulator that controls expression of numerous genes in enteric bacteria. RcsB accomplishes this role alone or in combination with auxiliary transcriptional factors independently or dependently of phosphorylation. To understand the mechanisms by which RcsB regulates such large number of genes, we performed structural studies as well as in vitro and in vivo functional studies with different RcsB variants. Our structural data reveal that RcsB binds promoters of target genes such as rprA and flhDC in a dimeric active conformation. In this state, the RcsB homodimer docks the DNA-binding domains into the major groove of the DNA, facilitating an initial weak read-out of the target sequence. Interestingly, comparative structural analyses also show that DNA binding may stabilize an active conformation in unphosphorylated RcsB. Furthermore, RNAseq performed in strains expressing wild-type or several RcsB variants provided new insights into the contribution of phosphorylation to gene regulation and assign a potential role of RcsB in controlling iron metabolism. Finally, we delimited the RcsB box for homodimeric active binding to DNA as the sequence TN(G/A)GAN4TC(T/C)NA. This RcsB box was found in promoter, intergenic and intragenic regions, facilitating both increased or decreased gene transcription.
Peasants, Market Exchange and Economic Agency in North-Western Iberia, c.850–c.1050
Authors: Portass Robert 
Published: January 2021

Abstract
Our understanding of the economic foundations of rural society in early medieval north-western Iberia remains wedded to explanations that emphasize the structural limitations that framed human activity while seeking to attenuate the economic agency of non-elite groups and individuals. This article argues that the early medieval peasantry of north-western Iberia was not the staid caricature presented by much of the historiography, but a much more economically dynamic section of society. To demonstrate this dynamism, it uses charters to analyse peasant productive strategies that went beyond subsistence. These reveal that peasants not only dabbled in the land market but invested in non-movable capital goods, with the result that some peasants produced surpluses for the express purpose of exchange by the tenth century, fundamentally altering the contours of their communities from within. By examining the evidence concerning peasant ownership of watermills, the article sheds new light on causal explanations for phenomena as diverse as social mobility, the possibilities of commercial integration, and the logic of market exchange. It concludes by contending that narratives focused on uncovering the beginnings of growth must more readily concede that its origins are to be found both beyond as well as within seigneurial contexts.
Implementing the PREP2 Algorithm to Predict Upper Limb Recovery Potential After Stroke in Clinical Practice: A Qualitative Study
Authors: Connell Louise A , Chesworth Brigit , Ackerley Suzanne , Smith Marie-Claire , Stinear Cathy M 
Published: January 2021

Abstract

Objective
Predicting motor recovery after stroke is a key factor when planning and providing rehabilitation for individual patients. The Predict REcovery Potential (PREP2) prediction tool was developed to help clinicians predict upper limb functional outcome. In parallel to further model validation, the purpose of this study was to explore how PREP2 was implemented in clinical practice within the Auckland District Health Board (ADHB) in New Zealand.

Methods
In this case study design using semi-structured interviews, 19 interviews were conducted with clinicians involved in stroke care at ADHB. To explore factors influencing implementation, interview content was coded and analyzed using the consolidated framework for implementation research. Strategies identified by the Expert Recommendations for Implementing Change Project were used to describe how implementation was undertaken.

Results
Implementation of PREP2 was initiated and driven by therapists. Key factors driving implementation were as follows: the support given to staff from the implementation team; the knowledge, beliefs, and self-efficacy of staff; and the perceived benefits of having PREP2 prediction information. Twenty-six Expert Recommendations for Implementing Change strategies were identified relating to 3 areas: implementation team, clinical/academic partnerships, and training.

Conclusions
The PREP2 prediction tool was successfully implemented in clinical practice at ADHB. Barriers and facilitators to implementation success were identified, and implementation strategies were described. Lessons learned can aid future development and implementation of prediction models in clinical practice.

Impact
Translating evidence-based interventions into clinical practice can be challenging and slow; however, shortly after its local validation, PREP2 was successfully implemented into clinical practice at the same site in New Zealand. In parallel to further model validation, organizations and practices can glean useful lessons to aid future implementation.
Monitoring in Originate-to-Distribute Lending: Reputation versus Skin in the Game
Authors: Winton Andrew , Yerramilli Vijay 
Published: January 2021

Abstract
Banks face liquidity and capital pressures that favor selling off the loans they originate, but loan sales undermine their monitoring incentives. A bank’s loan default history is a noisy measure of its past monitoring choices, which can serve as a reputation mechanism to incentivize current monitoring. In equilibrium, higher reputation banks monitor (weakly) more intensively; if retention is credible, they generally retain less of the loans they originate. Monitoring is difficult to sustain in periods with uncommonly large spikes in loan demand (“booms”), especially for low-reputation banks, which are more likely to accommodate boom demand and forgo monitoring.
Associations between fluorescence optical imaging and magnetic resonance imaging and symptoms in hand osteoarthritis
Authors: Maugesten Øystein , Ohrndorf Sarah , Slatkowsky-Christensen Barbara , Kvien Tore K , Uhlig Till , Haugen Ida Kristin 
Published: January 2021

Abstract

Objectives
To investigate whether Fluorescence Optical Imaging (FOI) enhancement and MRI-defined synovitis are associated with pain and physical function in hand OA patients.

Methods
Bilateral FOI scans and MRI of the dominant hand were available for 221 patients. Finger joints were examined for tenderness on palpation. Pain in individual finger joints during the last 24 h and last 6 weeks and hand pain intensity by the Australian/Canadian hand index and Numeric Rating Scale were self-reported. On joint level, we applied logistic regression with generalized estimating equations to examine whether FOI enhancement and MRI-defined synovitis were associated with pain in the same joint. On subject level, we applied linear regression to assess whether FOI and MRI sum scores were associated with pain intensity and physical function.

Results
Metacarpophalangeal and thumb base joints were excluded from analyses due to little/no FOI enhancement. Finger joints with FOI enhancement on the composite image had higher odds (95% CI) of pain during the last 6 weeks [grade 1: 1.4 (1.2–1.6); grade 2–3: 2.1 (1.7–2.6)]. Similar results were found for joint pain during the last 24 h and joint tenderness in fingers. Numerically stronger associations were found between MRI-defined synovitis and finger joint pain/tenderness. FOI and MRI sum scores demonstrated no/weak associations with hand pain and physical function.

Conclusion
FOI enhancement and MRI-defined synovitis were associated with pain in the same finger joint. None of the imaging modalities demonstrated consistent associations with pain, stiffness and physical function on subject level.
Genetic and biochemical changes in liver and kidney of Channa punctatus after treatment with 2-naphthalene sulfonate
Authors: Mehra Sukanya , Chadha Pooja 
Published: January 2021

Abstract
2-Naphthalene sulfonate (2NS) is a sulfonated aromatic compound and a momentous intermediate involved in the synthesis of dyes and surfactants. Thus, the present experiment was undertaken to evaluate the variation in biochemical constituents in liver and kidney of fresh water fish, Channa punctatus, after 2NS intoxication. After determination of lethal dose (LD) two sublethal doses, i.e. 0.33 mg/15 g body weight (one-half of LD50) and 0.16 mg/15 g b.w. (one-fourth of LD50) were selected for analyzing oxidative stress, genotoxicity and bioaccumulative potential of 2NS. Highest significant increase in oxidative stress and DNA damage in the exposed groups as compared with control group (P ≤ 0.05) was observed at 96 h. However, decreased values of all the studied parameters after 30 days indicate repair capacity of fish. In order to study the alterations observed in biomolecules including lipids, proteins and nucleic acids, histopathology along with spectroscopic analysis using attenuated total reflection-Fourier transform infrared was also performed for 96 h exposed group. In addition, protein secondary structure analysis was focused in this study, which reveals alterations in α-helix and β-sheet structure after 2NS intoxication. Furthermore, the bioaccumulative potential of 2NS was revealed using high-performance liquid chromatography showing 1.83 and 45.54 μg/ml concentration of 2NS in liver and kidney homogenate, respectively. As the study revealed 2NS as the potential health hazard to aquatic organisms, it entails the augmentation and adoption of pertinent policies regarding the management of such toxic compounds.
Is Resident-Driven Inpatient Care More Expensive? Challenging a Long-Held Assumption
Authors: Weinstein Debra F. , Choi Jin G. , Mercaldo Nathaniel D. , Stump Natalie N. , Paras Molly L. , Berube Rhodes A. , Hur Chin 
Published: January 2021

Purpose
The financial impact of graduate medical education (GME) on teaching hospitals remains poorly understood, while calls for increased federal support continue alongside legislative threats to reduce funding. Despite studies suggesting that residents are more “economical” than alternative providers, GME is widely believed to be an expensive investment. Assumptions that residents increase the cost of patient care have persisted in the absence of convincing evidence to the contrary. Thus, the authors sought to examine resident influence on patient care costs by comparing costs between a resident-driven service (RS) and a nonresident-covered service (NRS), with attention to clinical outcomes and how potential cost differences relate to the utilization of resources, length of stay (LOS), and other factors.

Method
This prospective study compared costs and clinical outcomes of internal medicine patients admitted to an RS versus an NRS at Massachusetts General Hospital (July 1, 2016–June 30, 2017). Total variable direct costs of inpatient admission was the primary outcome measure. LOS; 30-day readmission rate; utilization related to diagnostic radiology, pharmaceuticals, and clinical labs; and other outcome measures were also compared. Linear regression models quantified the relationship between log-transformed variable direct costs and service.

Results
Baseline characteristics of 5,448 patients on the 2 services (3,250 on an RS and 2,198 on an NRS) were similar. On an RS, patient care costs were slightly less and LOS was slightly shorter than on an NRS, with no significant differences in hospital mortality or 30-day readmission rate detected. Resource utilization was comparable between the services.

Conclusions
These findings undermine long-held assumptions that residents increase the cost of patient care. Though not generalizable to ambulatory settings or other specialties, this study can help inform hospital decision making around sponsorship of GME programs, especially if federal funding for GME remains capped or is subject to additional reductions.
Targeting Causes of Burnout in Residency: An Innovative Approach Used at Hennepin Healthcare
Authors: Quirk Rosemary , Rodin Holly , Linzer Mark 
Published: January 2021

Problem
Rates of burnout are high in physicians in the United States. While others have reported on the success of burnout-reduction strategies on practicing physicians and residents, few strategies have approached the problem longitudinally in residents.

Approach
From 2014 to 2019, the authors used a previously developed survey to assess factors related to resident burnout, including sleep, personal time, professional fulfillment, effects on relationships, program recognition, and peer support. At Hennepin Healthcare, a safety-net hospital in Minneapolis, Minnesota, the authors created a reproducible process for collecting data from internal medicine residents annually, and for using evidence-based conceptual frameworks to develop a continuous improvement method to address worklife across training years. Interventions included jeopardy coverage for essential life events, a newsletter celebrating resident achievements, removal of after-hours consult pager call, an extra day off for senior residents on the wards, and care packages distributed to night teams.

Outcomes
Annually from 2014 to 2019, 40/66 (60.6%) to 62/73 residents (84.9%) completed the survey (average response rate was 72.1% over 6 years). Survey results were shared with residents in multiple formats, and feedback was requested, demonstrating that burnout reduction is a priority for program leadership. High professional fulfillment scores were documented every year. Self-reported rates of burnout were between 25% and 35%. Significant improvements were seen in perception of empathy, sleep impairment, and peer support.

Next Steps
The authors developed a plan for minimizing burnout, which includes the following evidence-based domains: workload, control, balance in effort and reward, work–life balance, fairness, values, support, gender equity, moral distress, and moral injury. Additional interventions include protected time for didactics, trauma-informed care training, and addressing workplace racism. The authors aspire to achieve an integrated culture of well-being for residents and faculty; foster an efficient, effective, and fair learning environment; and reduce—and ultimately eliminate—burnout.