bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mass Spectrometry Analysis of SARS-CoV-2 Nucleocapsid Protein Reveals Camouflaging Glycans and Unique Post-Translational Modifications
Authors: Sun Zeyu , Zheng Xiaoqin , Ji Feiyang , Zhou Menghao , Su Xiaoling , Ren Keyi , Li Lanjuan 
Published: August 2021

Abstract
The devastating coronavirus disease 2019 (COVID-19) pandemic has prompted worldwide efforts to study structural biological traits of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its viral components. Compared to the Spike protein, which is the primary target for currently available vaccines or antibodies, knowledge about other virion structural components is incomplete. Using high-resolution mass spectrometry, we report a comprehensive post-translational modification (PTM) analysis of nucleocapsid phosphoprotein (NCP), the most abundant structural component of the SARS-CoV-2 virion. In addition to phosphoryl groups, we show that the SARS-CoV-2 NCP is decorated with a variety of PTMs, including N-glycans and ubiquitin. Based on newly identified PTMs, refined protein structural models of SARS-CoV-2 NCP were proposed and potential immune recognition epitopes of NCP were aligned with PTMs. These data can facilitate the design of novel vaccines or therapeutics targeting NCP, as valuable alternatives to the current vaccination and treatment paradigm that is under threat of the ever-mutating SARS-CoV-2 Spike protein.
Comparing Serum Levels of Vitamin D and Zinc in Novel Coronavirus–Infected Patients and Healthy Individuals in Northeastern Iran, 2020
Authors: Hosseini Seyed Javad , Moradi Bagher , Marhemati Mahmood , Firouzian Ali Asghar , Ildarabadi Eshagh , Abedi Ali , Firooz Mahbobeh 
Published: August 2021

Background
COVID-19 infection has recently become a pandemic disease around the world, and its risk factors have not fully evaluated. This study aimed to compare the serum vitamin D (Vit D) and zinc levels in patients infected with novel coronavirus and healthy volunteers (HVs).

Methods
This was a single-center, cross-sectional study conducted on 56 patients (32 severe cases and 24 nonsevere) admitted to the COVID-19 ward and 46 HVs living in Esfarayen City, North Khorasan Province of Iran. Serum levels of Vit D and zinc in admitted patients to the COVID-19 ward and HVs were measured.

Results
The average levels of serum Vit D in severe cases, nonsevere cases, and HVs were 31.03 ± 15.49, 37.25 ± 18.49, and 39.33 ± 14.83, respectively (P = 0.05). Moreover, the average concentrations of serum zinc in severe cases, nonsevere cases, and HVs were 31.03 ± 15.49, 37.25 ± 18.49, and 39.33 ± 14.83, respectively (P = 0.01). Mortality rate, reinfection (for 5 months), and length of hospital stay in severe cases were higher than in nonsevere cases (P > 0.05).

Conclusions
Results showed that severe cases had lower levels of Vit D than did other groups and were marginally significant. Also, severe cases had a significantly low level of zinc when compared with nonsevere cases and HVs. Levels of Vit D and zinc can affect the incidence of COVID-19 infection.
Primary Subcutaneous Phaeohyphomycosis Caused by Cladosporium cladosporioides
Authors: Viola Kelly Scapin , Ricci Giannina , D'Elia Maria Paula Barbieri , Pott-Junior Henrique 
Published: August 2021

Abstract
Here, we report a rare case of a 48-year-old female immunocompetent patient who presented with a subcutaneous phaeohyphomycosis caused by Cladosporium cladosporioides. Diagnostic confirmation was established by molecular analysis of the biopsy sample, and the patient was successfully treated with itraconazole monotherapy. This case should raise the clinician's awareness of such condition and point to molecular analysis as an important diagnostic tool.
Neurobiological antecedents of multisite pain in children
Authors: Kaplan Chelsea M. , Schrepf Andrew , Mawla Ishtiaq , Ichesco Eric , Boehnke Kevin F. , Beltz Adriene , Foxen-Craft Emily , Puglia Michael P. , Tsodikov Alexandre , Williams David A. , Hassett Afton L. , Clauw Daniel J. , Harte Steven E. , Harris Richard E. 
Published: August 2021

Abstract
Altered brain structure and function is evident in adults with multisite chronic pain. Although many such adults trace their pain back to childhood, it has been difficult to disentangle whether central nervous system alterations precede or are consequences of chronic pain. If the former is true, aberrant brain activity may identify children vulnerable to developing chronic pain later in life. We examined structural and functional brain magnetic resonance imaging metrics in a subset of children from the first 2 assessments of the Adolescent Brain and Cognitive Development Study. Children (aged 9-10) who were pain free at baseline and then developed multisite pain 1 year later (n = 115) were matched to control children who were pain free at both timepoints (n = 230). We analyzed brain structure (cortical thickness and gray matter volume) and function (spontaneous neural activity and functional connectivity). Results were deemed significant at the cluster level P < 0.05 false discovery rate corrected for multiple comparisons. At baseline, children who subsequently developed multisite pain had increased neural activity in superior parietal /primary somatosensory and motor cortices and decreased activity in the medial prefrontal cortex. They also exhibited stronger functional connectivity between the salience network, somatosensory, and default mode network regions. No significant differences in the brain structure were observed. Increased neural activity and functional connectivity between brain regions, consistent to that seen in adults with chronic pain, exist in children before developing multisite pain. These findings may represent a neural vulnerability to developing future chronic pain.
Correlations between bladder wall thickness and clinical manifestations in female patients with detrusor underactivity and detrusor overactivity–with–detrusor underactivity
Authors: Yu Ping-Hsuan , Lin Chih-Chieh , Fan Yu-Hua , Lin Alex T. L. , Huang William J. S. 
Published: August 2021

Background:
Among female patients with lower urinary tract symptoms, detrusor underactivity (DU), and detrusor overactivity–with–detrusor underactivity (DO-DU) are two common diagnoses. Here, we investigated the correlations between bladder wall thickness (BWT) and clinical manifestations of the two diagnoses.

Methods:
From 2011 to 2016, female patients with DU or DO-DU, diagnosed at our institute, were recruited. We analyzed their urodynamic parameters and collected three questionnaires (IPSS, UDI-6, OABSS). Using transabdominal sonography, the BWT was recorded. DU was defined as follows: maximum free flow rate (Q
max) ≤ 15 cc/s; detrusor pressure at maximum flow (P
detQmax) ≤ 20 cmH2O; bladder capacity > 150 cc. DO-DU was defined as follows: Q
max ≤ 15 cc/s; P
detQmax ≤ 20 cmH2O; bladder capacity ≤ 150 cc. The BWTs of the two groups were compared using the Mann–Whitney U test; the correlations among the BWTs and the results of three questionnaires were analyzed using Spearman’s rank correlation coefficient.

Results:
Forty-eight female patients with DU and 13 with DO-DU were recruited. Demographic data revealed no differences between the two groups. The mean BWT of the DO-DU patients was significantly larger than that of the DU patients (4.11 vs 3.42 mm; p = 0.001). In the DO-DU group, a high correlation existed between the BWT and some of the UDI-6 items (urgency incontinence: r = 0.831, p = 0.006; incontinence related to activity: r = 0.884, p = 0.002; small amounts of leakage: r = 0.809, p = 0.008). The BWT of the DO-DU patients also exhibited a moderate correlation with the urgency incontinence from the OABSS questionnaire (r = 0.679; p = 0.044). No correlations existed between the BWT of the DU patients and any of the data from the three questionnaires.

Conclusion:
The BWT in the DO-DU patients was significantly thicker than that in the DU patients. The DO-DU patients with thicker bladder walls also had higher UDI-6 scores for both urgency and urgency incontinence.
Adaptive Challenges, Adaptive Work, and Adaptive Leadership Among Women Living With HIV in the Southern United States: Findings From a Qualitative Study
Authors: Bailey Donald E. , Caiola Courtney , Adimora Adaora A. , Ramirez Catalina , Holt Lauren , Johnson Ragan , Koch Amie , McGee Kara , McMillian-Bohler Jacquelyn M. , Randolph Schenita D. , Ritchwood Tiarney D. , Relf Michael V. 
Published: August 2021

Abstract
Women living with HIV have a higher burden of non-AIDS comorbidities and prevalence of chronic conditions. The Adaptive Leadership Framework for Chronic Illness clarifies living with complex health challenges by delineating the technical work of health care providers as well as the adaptive work and leadership behaviors of patients and their providers. We conducted a descriptive, qualitative study of women residing in the Southern United States who were participating in the Women's Interagency HIV Study in North Carolina. Twenty-two participants (mean age = 52.2 years; 90.9% self-identifying as Black or African American) completed semi-structured qualitative interviews. We identified adaptive challenges (e.g., affective and disclosure challenges) and adaptive work and leadership behaviors. Women learned skills to care for their health and support their families and to work with their providers to manage their care. Findings support the importance of identifying leadership behaviors for the purpose of developing person-centered interventions.
Developing Clinical Reasoning in a Physician Assistant Curriculum: The University of Sheffield approach
Authors: Gray James , Darling-Pomranz Claire , Jackson Ben 
Published: August 2021

Abstract
Clinical reasoning remains a key area for development amongst clinical students across the world. Physician assistant (PA) roles (physician associate in the United Kingdom) are rapidly expanding, and there is a need to ensure that this core skill is reflected in course curricula. This article presents how the University of Sheffield has integrated clinical reasoning into the curriculum for its PA course. This includes recognizing the need to consider different approaches to reasoning and how they are taught, the assessment of reasoning across Miller's pyramid, and other considerations that contribute to embedding reasoning within the course. We discuss the implications of our approach and comment on issues that we may need to consider in the future.
Efficacy of Platelet-Rich Plasma Versus Placebo in the Treatment of Tendinopathy: A Meta-analysis of Randomized Controlled Trials
Authors: Dai Wenli , Yan Wenqiang , Leng Xi , Wang Jian , Hu Xiaoqing , Cheng Jin , Ao Yingfang 
Published: August 2021

Objective:
To evaluate the efficacy of platelet-rich plasma (PRP) injections versus placebo in the treatment of tendinopathy.

Data Sources:
We performed a systematic literature search in MEDLINE, Embase, Scopus, CINAHL, Cochrane Library, and ClinicalTrials.gov through November 2020 to identify randomized controlled trials (RCTs) that evaluated the clinical efficacy of PRP versus placebo for the treatment of tendinopathy. Outcomes were analyzed on an intention-to-treat basis with random-effects models.

Main Results:
A total of 13 RCTs were included in this meta-analysis. The pooled analysis showed no significant difference in pain relief at 4 to 6 weeks (standard mean difference [SMD]: −0.18, 95% confidence intervals [CI]: −0.62 to 0.26), 12 weeks (SMD: −0.14, 95% CI: −0.55 to 0.26), and ≥24 weeks (SMD: −0.56, 95% CI: −1.16 to 0.05) or function improvement at 4 to 6 weeks (SMD: 0.11, 95% CI: −0.13 to 0.35), 12 weeks (SMD: 0.18, 95% CI: −0.13 to 0.49), and ≥24 weeks (SMD: 0.26, 95% CI: −0.14 to 0.66) for PRP compared with placebo in the treatment of tendinopathy. The sensitivity analysis indicated no significant difference in pain relief or function improvement at 12 weeks between PRP and placebo for different types of tendinopathies, treatment regimens, leukocyte concentrations, or cointerventions.

Conclusions:
Platelet-rich plasma injection was not found to be superior to placebo in the treatment of tendinopathy, as measured by pain relief and functional improvement at 4 to 6, 12, and ≥24 weeks.
Individualized Prediction of Acute Pancreatitis Recurrence Using a Nomogram
Authors: Hu Xuehai , Yang Bo , Li Jie , Bai Xuesong , Li Shilin , Liu Honglan , Zhang Hongyu , Zeng Fanxin 
Published: August 2021

Objectives
The objective of this study was to develop and validate a model, based on the blood biochemical (BBC) indexes, to predict the recurrence of acute pancreatitis patients.

Methods
We retrospectively enrolled 923 acute pancreatitis patients (586 in the primary cohort and 337 in the validation cohort) from January 2014 to December 2016. Aiming for an extreme imbalance between recurrent acute pancreatitis (RAP) and non-RAP patients (about 1:4), we designed BBC index selection using least absolute shrinkage and selection operator regression, along with an ensemble-learning strategy to obtain a BBC signature. Multivariable logistic regression was used to build the RAP predictive model.

Results
The BBC signature, consisting of 35 selected BBC indexes, was significantly higher in patients with RAP (P < 0.001). The area under the curve of the receiver operating characteristic curve of BBC signature model was 0.6534 in the primary cohort and 0.7173 in the validation cohort. The RAP predictive nomogram incorporating the BBC signature, age, hypertension, and diabetes showed better discrimination, with an area under the curve of 0.6538 in the primary cohort and 0.7212 in the validation cohort.

Conclusions
Our study developed a RAP predictive nomogram with good performance, which could be conveniently and efficiently used to optimize individualized prediction of RAP.
Impact of Postoperative Glycemic Control on Postoperative Morbidity in Patients Undergoing Open Pancreaticoduodenectomy
Authors: Yun Regina , Javed Ammar A. , Jarrell Andrew S. , Crow Jessica , Wright Michael J. , Burkhart Richard A. , Rybny Joseph , Wolfgang Christopher L. , Kruer Rachel M. 
Published: August 2021

Objective
To evaluate the impact of postoperative glycemic control on postoperative morbidity in patients undergoing a pancreaticoduodenectomy.

Methods
A retrospective study was performed on patients at The Johns Hopkins Hospital between April 2015 and April 2016. Data were collected on postoperative insulin regimens, blood glucose, rates of hyperglycemia and hypoglycemia, and postoperative complications and were evaluated.

Results
Out of 244 patients, 114 (46.7%) experienced at least 1 hyperglycemic (>180 mg/dL) episode and 16 (6.6%) experienced at least 1 hypoglycemic episode (<70 mg/dL) during the first postoperative 24 hours. Early postoperative hyperglycemia (>180 mg/dL) was associated with a significantly higher rate of surgical site infections (15.7% vs 7%; P = 0.031). Late postoperative hyperglycemia (>180 mg/dL) was associated with a significantly higher rate of fistulas (4.3% vs 14.6%; P = 0.021).

Conclusions
Early hyperglycemia (>180 mg/dL) is associated with a higher risk of surgical site infections while late hyperglycemia is associated with a higher risk of fistulas. Intensive glucose control (<150 mg/dL) was not demonstrated to decrease the risk of postoperative complications. Similar to other critically ill populations, targeting a glucose goal of <180 mg/dL may be an appropriate target to reduce morbidity without increasing the risk of hypoglycemia.
Endoscopic Versus Laparoscopic Treatment for Pancreatic Pseudocysts
Authors: Hao Wenzhen , Chen Yunli , Jiang Yu , Yang Aiming 
Published: August 2021

Objective
The aim of the study was to evaluate the efficacy and safety of endoscopic treatment for pancreatic pseudocysts (PPCs) compared with laparoscopic treatment.

Methods
The Embase, Medline, Cochrane Library, Web of Science databases, China National Knowledge Infrastructure Chinese citation database, and WANFANG database were systematically searched to identify all comparative trials investigating endoscopic versus laparoscopic treatment for PPC. The main outcome measures included treatment success rate, adverse events, recurrence rate, operation time, intraoperative blood loss, and hospital stay.

Results
Six studies with 301 participants were included. The results suggested that there was no difference in rates of treatment success (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.40–2.01; P = 0.79), adverse events (OR, 0.80, 95% CI, 0.38–1.70; P = 0.57), or recurrence (OR, 0.55, 95% CI, 0.22−1.40; P = 0.21) between endoscopic and laparoscopic treatments. However, the endoscopic group exhibited reduced operation time (weighted mean difference [WMD], −67.11; 95% CI, −77.27 to −56.96; P < 0.001), intraoperative blood loss (WMD, −65.23; 95% CI, −103.38 to −27.08; P < 0.001), and hospital stay (WMD, −2.45; 95% CI, −4.74 to −0.16; P = 0.04).

Conclusions
Endoscopic treatment might be suitable for PPC patients.
North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure
Authors: Squires James E. , Alonso Estella M. , Ibrahim Samar H. , Kasper Vania , Kehar Mohit , Martinez Mercedes , Squires Robert H. 
Published: August 2021

ABSTRACTPediatric acute liver failure (PALF) is a rare, rapidly progressive clinical syndrome with significant morbidity and mortality. The phenotype of PALF manifests as abrupt onset liver dysfunction, which can be brought via disparate etiology. Management is reliant upon intensive clinical care and support, often provided by the collaborative efforts of hepatologists, critical care specialists, and liver transplant surgeons. The construction of an age‐based diagnostic approach, the identification of a potential underlying cause, and the prompt implementation of appropriate therapy can be lifesaving; however, the dynamic and rapidly progressive nature of PALF also demands that diagnostic inquiries be paired with monitoring strategies for the recognition and treatment of common complications of PALF. Although liver transplantation can provide a potential life‐saving therapeutic option, the ability to confidently determine the certainness that liver transplant is needed for an individual child has been hampered by a lack of adequately tested clinical decision support tools and accurate predictive models. Given the accelerated progress in understanding PALF, we will provide clinical guidance to pediatric gastroenterologists and other pediatric providers caring for children with PALF by presenting the most recent advances in diagnosis, management, pathophysiology, and associated outcomes.
Use of Job Classifications, Career Ladders, and the Applied Epidemiology Competencies to Support Recruitment, Retention, and Practice of State Health Department Epidemiologists
Authors: Daly Elizabeth R. , Arrazola Jessica , Umble Karl 
Published: August 2021

Context:
State health departments report that recruitment and retention of qualified epidemiologists is a significant challenge to ensuring epidemiology capacity to support essential public health services.

Objective:
To collect information on the use of epidemiology job classifications, career ladders, and professional competencies in state health departments to inform workforce development activities that improve epidemiology capacity.

Design:
Electronic survey of the designated state epidemiologist.

Setting:
Fifty state health departments and the District of Columbia.

Participants:
State epidemiologists working in state health departments.

Main Outcome Measures:
Use and perceived benefit of epidemiology job classifications, career ladders, and professional competencies.

Results:
All 50 states and the District of Columbia responded to the survey. Most state health departments reported having epidemiology-specific job classifications (n = 44, 90%) and career ladders (n = 36, 71%) in place. State epidemiologists strongly agreed or agreed that having an epidemiology-specific classification positively contributed to recruitment (n = 37, 84%) and retention (n = 29, 66%) of epidemiologists in their agency. State epidemiologists strongly agreed or agreed that having an epidemiology-specific career ladder positively contributed to recruitment (n = 24, 69%) and retention (n = 23, 66%) of epidemiologists in their agency. Only 10 (29%) state epidemiologists reported using the applied epidemiology competencies to develop or revise their jurisdiction's epidemiology career ladder.

Conclusions:
State health departments should implement well-maintained epidemiology-specific job classifications and career ladders that are based on current epidemiology competencies. Career ladders should be supported with opportunities for competency-based training to support career progression.
Patient Safety Strategies in Psychiatry and How They Construct the Notion of Preventable Harm: A Scoping Review
Authors: Svensson Jakob 
Published: August 2021

Objectives
The literature on patient safety in psychiatry has not been explored systematically in terms of what interventions are used, how they are used, and what type of (preventable) harm is targeted. The aims of this scoping review are to explore patient safety strategies used in psychiatry and determine how they construct the notion of preventable harm.

Method
A scoping review of literature on patient safety in psychiatry published in English between 2000 and 2019 was conducted using Scopus, MEDLINE, PsycInfo, and CINAHL. Keywords of patient safety strategies and possible outcomes were coded from the results, discussion, or conclusion. Patient safety strategies were inductively categorized into themes according to the focus of the strategy.

Results
The review introduces 7 focus areas of patient safety strategies identified within the psychiatric literature: “risk management,” “healthcare practitioners,” “patient observation,” “patient involvement,” “computerized methods,” “admission and discharge,” and “security.” The result shows that patient safety strategies mainly aim to reduce suicide, self-harm, violence, and falls and present a large diversity of measures, often aimed at reducing variability while increasing standardization.

Conclusions
The strategies that are supported in the literature to achieve safer psychiatry mainly arise from linear cause-effect models and rely on staff performance, competence, and compliance. Contemporary safety science acknowledges the performance variability of everyday normal work and sees risk as the dynamic migration of these daily activities. The field of psychiatry has not yet included this view of safety in the strategic actions to reduce preventable harm.
Utility and Clinical Implications of Appendicular Skeleton Magnetic Resonance Imaging in Multiple Myeloma: A Single-Institutional 15-Year Experience
Authors: Shieh Alice C. , Faraji Navid , Smith Daniel , Parikh Keval , Ramaiya Nikhil H. 
Published: August 2021

Objective
The aim of this study was to evaluate the utility of appendicular skeleton magnetic resonance imaging (MRI) in the management of multiple myeloma over 15 years.

Methods
A total of 107 appendicular MRIs were obtained from 67 patients. Variables including age, sex, diagnosis, stage, indication, transplant status, MRI result, and treatment course were analyzed.

Results
The most common indication was pain (76.6%). The most commonly affected bone groups were the proximal lower (54.3%) and upper extremity (47.6%). Most (83%) positive examinations demonstrated focal disease. Advanced Durie-Salmon stage was associated with increase in appendicular disease (P = 0.0056). Increasing age and prior negative positron emission tomography/computed tomography were associated with a decrease in appendicular disease (P = 0.0036 and 0.0011). When neoplasm was seen, 58.5% underwent management alteration. Advanced stage and history of relapse were associated with treatment alterations (P = 0.0096 and 0.0031).

Conclusion
Appendicular MRIs comprised 9.6% of MRIs ordered. Appendicular MRI elucidates both neoplastic and nonneoplastic causes of pain. Most examinations with MRI positive for myeloma had subsequent skeletal disease and resulted in altered management.