bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary care physicians’ electronic health record proficiency and efficiency behaviors and time interacting with electronic health records: a quantile regression analysis
Authors: Nguyen Oliver T , Turner Kea , Apathy Nate C , Magoc Tanja , Hanna Karim , Merlo Lisa J , Harle Christopher A , Thompson Lindsay A , Berner Eta S , Feldman Sue S 
Published: November 2021

Abstract

Objective
This study aimed to understand the association between primary care physician (PCP) proficiency with the electronic health record (EHR) system and time spent interacting with the EHR.

Materials and Methods
We examined the use of EHR proficiency tools among PCPs at one large academic health system using EHR-derived measures of clinician EHR proficiency and efficiency. Our main predictors were the use of EHR proficiency tools and our outcomes focused on 4 measures assessing time spent in the EHR: (1) total time spent interacting with the EHR, (2) time spent outside scheduled clinical hours, (3) time spent documenting, and (4) time spent on inbox management. We conducted multivariable quantile regression models with fixed effects for physician-level factors and time in order to identify factors that were independently associated with time spent in the EHR.

Results
Across 441 primary care physicians, we found mixed associations between certain EHR proficiency behaviors and time spent in the EHR. Across EHR activities studied, QuickActions, SmartPhrases, and documentation length were positively associated with increased time spent in the EHR. Models also showed a greater amount of help from team members in note writing was associated with less time spent in the EHR and documenting.

Discussion
Examining the prevalence of EHR proficiency behaviors may suggest targeted areas for initial and ongoing EHR training. Although documentation behaviors are key areas for training, team-based models for documentation and inbox management require further study.

Conclusions
A nuanced association exists between physician EHR proficiency and time spent in the EHR.
Let Me Show You What I Did versus What I Have: Sharing Experiential versus Material Purchases Alters Authenticity and Liking of Social Media Users
Authors: Valsesia Francesca , Diehl Kristin 
Published: November 2021

AbstractSocial media may encourage novel ways of signaling that involve different purchase types (experiential vs. material), signaling frequencies (multiple vs. single signals), and other features unique to social media (e.g., hashtags). This work examines how purchase signals are received on social media and how these signaling variations affect signal receivers’ perceptions of the authenticity of social media posts as well as the overall impressions receivers form of the signal sender. Data collected across six experiments show multiple material purchase signals lead to more negative impressions compared to multiple experiential purchase signals. Signal receivers perceive multiple material purchase posts as less authentic, which dampens their impressions of the signal sender. In line with this mechanism, the impression premium of experiential purchase signals disappears when receivers use other cues (monetary mentions, other users’ comments, and marketer associations via hashtags) to infer a signal’s lack of authenticity. Additional data also document downstream consequences on engagement. This work contributes theoretically to research in both signaling and social media and improves the understanding of substantive situations in which consumers’ objectives of curating a positive image and creating engagement with their posts, collide with marketers’ objectives of encouraging user-generated content and word of mouth.
What makes elk tick: winter tick (Dermacentor albipictus) grooming behavior in wild elk (Cervus canadensis)
Authors: Normandeau Jacalyn , Cassady St. Clair Colleen , Kutz Susan J , Hebblewhite Mark , Merrill Evelyn H 
Published: November 2021

Abstract
Ungulates groom to remove ectoparasites but grooming may interfere with foraging, vigilance, and rumination, and it is possible that these effects differ among migratory tactics due to differences in parasite infestations. We compared the effects of grooming for winter ticks (Dermacentor albipictus) on winter foraging behavior by migrating and resident elk (Cervus canadensis) in the partially migratory population at the Ya Ha Tinda, adjacent to Banff National Park, Canada. We used hair loss on the dorsal shoulder area (“withers”) measured from photographic images as an index of tick infestation of individual elk. We conducted 594 focal observations on 48 radio-collared and 18 uncollared individuals that were uniquely identifiable from ear-tags (N = 66) in 2019 to assess whether grooming for ticks in winter reduced time spent foraging, ruminating, or being vigilant. Because rubbing or hair loss from radio-collars may influence tick infestations and behavior, we controlled for whether elk were collared or uncollared in our analyses. Neck hair loss was 3−5% greater in collared elk than uncollared elk, but neither withers hair loss nor time spent grooming differed. Grooming occurred during 42% of the observations but grooming comprised only ~1% of observation time. Nevertheless, 40% of all grooming was observed during resting, and grooming interrupted vigilance behavior ~8 times more than foraging. We found no differences among elk following different migratory tactics in time spent grooming or in other behaviors, but one of the two groups of migrant elk had higher withers hair loss. Our results suggest winter ticks may have slight effects on elk relative to other ungulates, particularly moose (Alces alces), in North America.
The flip-flop configuration of the PABP-dimer leads to switching of the translation function
Authors: Gu Sohyun , Jeon Hyung-Min , Nam Seung Woo , Hong Ka Young , Rahman Md Shafiqur , Lee Jong-Bong , Kim Youngjin , Jang Sung Key 
Published: November 2021

Abstract
Poly(A)-binding protein (PABP) is a translation initiation factor that interacts with the poly(A) tail of mRNAs. PABP bound to poly(A) stimulates translation by interacting with the eukaryotic initiation factor 4G (eIF4G), which brings the 3′ end of an mRNA close to its 5′ m7G cap structure through consecutive interactions of the 3′-poly(A)–PABP-eIF4G-eIF4E-5′ m7G cap. PABP is a highly abundant translation factor present in considerably larger quantities than mRNA and eIF4G in cells. However, it has not been elucidated how eIF4G, present in limited cellular concentrations, is not sequestered by mRNA-free PABP, present at high cellular concentrations, but associates with PABP complexed with the poly(A) tail of an mRNA. Here, we report that RNA-free PABPs dimerize with a head-to-head type configuration of PABP, which interferes in the interaction between PABP and eIF4G. We identified the domains of PABP responsible for PABP–PABP interaction. Poly(A) RNA was shown to convert the PABP–PABP complex into a poly(A)–PABP complex, with a head-to-tail-type configuration of PABP that facilitates the interaction between PABP and eIF4G. Lastly, we showed that the transition from the PABP dimer to the poly(A)–PABP complex is necessary for the translational activation function.
Cancer cell heterogeneity and plasticity: A paradigm shift in glioblastoma
Authors: Yabo Yahaya A , Niclou Simone P , Golebiewska Anna 
Published: November 2021

Abstract
Phenotypic plasticity has emerged as a major contributor to intra-tumoral heterogeneity and treatment resistance in cancer. Increasing evidence shows that glioblastoma (GBM) cells display prominent intrinsic plasticity and reversibly adapt to dynamic microenvironmental conditions. Limited genetic evolution at recurrence further suggests that resistance mechanisms also largely operate at the phenotypic level. Here we review recent literature underpinning the role of GBM plasticity in creating gradients of heterogeneous cells including those that carry cancer stem cell (CSC) properties. A historical perspective from the hierarchical to the nonhierarchical concept of CSCs towards the recent appreciation of GBM plasticity is provided. Cellular states interact dynamically with each other and with the surrounding brain to shape a flexible tumor ecosystem, which enables swift adaptation to external pressure including treatment. We present the key components regulating intra-tumoral phenotypic heterogeneity and the equilibrium of phenotypic states, including genetic, epigenetic, and microenvironmental factors. We further discuss plasticity in the context of intrinsic tumor resistance, where a variable balance between preexisting resistant cells and adaptive persisters leads to reversible adaptation upon treatment. Innovative efforts targeting regulators of plasticity and mechanisms of state transitions towards treatment-resistant states are needed to restrict the adaptive capacities of GBM.
Phosphatidic acid modulates MPK3- and MPK6-mediated hypoxia signaling in Arabidopsis
Authors: Zhou Ying , Zhou De-Mian , Yu Wei-Wei , Shi Li-Li , Zhang Yi , Lai Yong-Xia , Huang Li-Ping , Qi Hua , Chen Qin-Fang , Yao Nan , Li Jian-Feng , Xie Li-Juan , Xiao Shi 
Published: November 2021

Abstract
Phosphatidic acid (PA) is an important lipid essential for several aspects of plant development and biotic and abiotic stress responses. We previously suggested that submergence induces PA accumulation in Arabidopsis thaliana; however, the molecular mechanism underlying PA-mediated regulation of submergence-induced hypoxia signaling remains unknown. Here, we showed that in Arabidopsis, loss of the phospholipase D (PLD) proteins PLDα1 and PLDδ leads to hypersensitivity to hypoxia, but increased tolerance to submergence. This enhanced tolerance is likely due to improvement of PA-mediated membrane integrity. PA bound to the mitogen-activated protein kinase 3 (MPK3) and MPK6 in vitro and contributed to hypoxia-induced phosphorylation of MPK3 and MPK6 in vivo. Moreover, mpk3 and mpk6 mutants were more sensitive to hypoxia and submergence stress compared with wild type, and fully suppressed the submergence-tolerant phenotypes of pldα1 and pldδ mutants. MPK3 and MPK6 interacted with and phosphorylated RELATED TO AP2.12, a master transcription factor in the hypoxia signaling pathway, and modulated its activity. In addition, MPK3 and MPK6 formed a regulatory feedback loop with PLDα1 and/or PLDδ to regulate PLD stability and submergence-induced PA production. Thus, our findings demonstrate that PA modulates plant tolerance to submergence via both membrane integrity and MPK3/6-mediated hypoxia signaling in Arabidopsis.
Revealed Heuristics: Evidence from Investment Consultants’ Search Behavior
Authors: Chava Sudheer , Kim Soohun , Weagley Daniel 
Published: November 2021

Abstract
Using proprietary data from a major fund data provider, we analyze the screening activity of investment consultants (ICs). We find that ICs frequently shortlist funds using threshold screens clustered at $500MM for AUM, 0% for benchmark-adjusted return, and quartiles for return percentile rank screens. Funds just above the $500MM AUM threshold get 14%–18% more page views and 5–9 pp greater flows over the next year compared to similar funds just below the threshold. Our results are consistent with ICs using a two-stage consider-then-choose decision-making process and cognitive reference numbers in selecting screening thresholds. (JEL G41, G11, G14, G29)
Received January 8, 2021; editorial decision September 3, 2021. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Retraction in the online world—Shall we rethink the policy?
Authors: Rzymski Piotr 
Published: November 2021

Abstract
In case of scientific misconduct, the papers can be retracted at the request of the journal’s editors and/or authors. However, the retracted articles continue to be fully available through online resources, including journals websites. This paper argues that a classical retraction is insufficient to mitigate the adverse effect some retracted papers continue to have on critical issues, e.g. public health. The more strict approach, ‘Hard Retraction’, is presented for consideration. Its implementation would lead to (1) complete deletion of the full text of the retracted paper, (2) substitution of the original abstract with a detailed retraction notice, (3) removal of the paper from the citation databases, (4) deposition of the retracted paper in the dedicated repository accessible for registered members. The benefits and risks of such an approach are discussed. Nevertheless, it should only be reserved for cases of fraud or grave errors with broad impacts.
Newborn Hearing Screening Results of Infants Born To Mothers Who Had COVID-19 Disease During Pregnancy: A Retrospective Cohort Study
Authors: Oskovi-Kaplan Z. Asli , Ozgu-Erdinc A. Seval , Buyuk Gul Nihal , Sert-Dinc U. Yasemin , Ali-Algan Cavide , Demir Bariş , Sahin Dilek , Keskin H. Levent , Tayman Cüneyt , Moraloglu-Tekin Özlem 
Published: November 2021

Objective:
Viral infections are known to be a risk factor for neonatal hearing loss. COVID-19 infection has been reported to affect hearing test results in one small sample sized study. We aimed to investigate the incidence the risk of neonatal hearing loss in infants of mothers who had COVID-19 infection during pregnancy, regarding their trimesters, by evaluating the neonatal hearing screening results.

Design:
In this retrospective case-control study, neonatal hearing test results of 458 women with a history of COVID-19 infection in pregnancy were compared with 339 women who gave birth before the pandemic. Data of pregnant women who attended the COVID-19 outpatient clinic of the emergency service of a tertiary pandemic hospital and who had confirmed infection with a reverse transcriptase–polymerase chain reaction (RT-PCR) test were determined from the hospital’s records and their neonatal hearing screening results were analyzed from the national database. Neonates born before <34 weeks, and with reported risk factors in the database such as congenital anomaly or known TORCH infection during pregnancy were excluded. The screening tests, Automated Auditory Brainstem Response or Transient Evoked Otoacoustic Emission (TEOAE), were used for screening, and patients who failed the first screening were reevaluated at least 2 weeks apart with a second screening.

Results:
The incidence of failed second screening was 1.3% in the COVID-19 group and 2.9% in controls, and no significant difference was observed between the two groups according to the final screening results on the second test. Among the 458 mothers, 8 were infected in first trimester, 126 in second trimester, 127 in third trimester but did not deliver within 15 days after infection and 197 were positive at birth. Six neonates in the infected group failed the second screening (3 [2.4%] in the second trimester, 1 [0.8%] third trimester, and 2 [1.0%] positive at birth).

Conclusions:
COVID-19 infection during pregnancy was not found to be a risk factor for hearing loss, according to the newborn hearing screening results.
When the World Changes, Opportunities for Growth Come Forward
Authors: Sutton Bob , Clark Thomas A. 
Published: November 2021

Summary
Nothing will ever be the same. The idea of returning to pre-COVID-19 conditions seems less plausible every day. Nearly every business model has had to transform seemingly overnight, and hospitals and health systems are at center stage in the real-time drama that will change the way we promote, deliver, finance, and engage in healthcare for years to come.
This is the next normal, the starting point for the future. Planning for Avera Health’s future has taken on a new level of excitement. Emerging from the COVID-19 crisis, we are finding opportunities. We are learning how to do our work differently and better. We are exploring new partnerships and areas of business that will add to our mission work. We are focusing on the patient–consumer experience. We are shaping a new future. The notion of a new future terrifies some people—they would rather hold on to the past. At Avera, we see this as our chance to create a future to our specifications. All we have to do is let go of yesterday and dream about what tomorrow can be.
Our first action was to reassess our five-year strategic plan, unveiled shortly before the pandemic. We initially thought that the plan had been stymied. What we discovered is that it has actually been accelerated. Our organization has become more agile, focused, and sustainable. Growth has been redefined as deepening our relationship with patients to increase lifetime loyalty and creating efficiencies to bend the cost curve for patients and allow Avera to expand services and service areas. This strategy puts people first, makes healthcare more affordable, and modernizes the doctor–patient relationship.
Productivity Efforts and Service Line Development Sustain Margin Improvement
Authors: White Patty 
Published: November 2021

SUMMARY
How can healthcare organizations best attain sound financial results and, in turn, sustain market growth? Leaders at St. Joseph’s Hospital and Medical Center, part of Dignity Health Arizona, realized that they could not cut their way to success. They needed a plan for strategic growth that fit their corporate mission and expanded their market. They moved forward with a proven productivity process that would engage stakeholders at all levels of the organization. Supported by commitments to the necessary financial investment and the patience to see the plans through, their efforts have paid off with substantial improvements in margin. Similar financial growth success stories are playing out in other markets, including Froedtert Health in Wisconsin and Avera Health in South Dakota.
Descemet Membrane Endothelial Transfer (DMET) in Pseudophakic Bullous Keratopathy After DSEK—A Case Report and Review of Literature
Authors: Anitha Venugopal , Swarup Rishi , Ravindran Meenakshi 
Published: November 2021

Purpose:
The purpose of this study was to report a Descemet membrane endothelial transfer (DMET) in a patient with pseudophakic bullous keratopathy (PBK) who developed graft dislocation after manual Descemet stripping endothelial keratoplasty.

Methods:
A 60-year-old man presented with defective vision in the left eye; after Descemet stripping endothelial keratoplasty, graft dislocation was noted 1 month after surgery.

Results:
Corneal clarity was improving slowly over 3 months without any secondary surgical intervention. The mechanism of DMET and the review of literature were enunciated.

Conclusions:
DMET occurs commonly in eyes with Fuch endothelial dystrophy and rarely in patients with PBK. The mechanism of DMET in PBK probably occurs because of migration of the donor endothelial cells from partially attached Descemet stripping endothelial keratoplasty grafts to the host stroma, in contrast to Fuch endothelial dystrophy, where the endothelial cells from the periphery migrate to the center. Hence, waiting for spontaneous corneal clarity is pivotal because of DMET even in patients with PBK for at least 3 months.
Repeated loco-regional therapies for hepatocellular carcinoma is associated with inferior outcome after living donor liver transplantation in cirrhotic patients
Authors: Tsou Yi-Fan , Lin Niang-Cheng , Hsia Cheng-Yuan , Loong Che-Chuan , Tsai Hsin-Lin , Chen Cheng-Yen , Lei Hao-Jan , Chou Shu-Cheng , Chung Meng-Hsuan , Kuo Fang-Cheng , Liu Chin-Su 
Published: November 2021

Background:
Liver transplantation is the definitive treatment for defined stage hepatocellular carcinoma (HCC) in cirrhotic patients. Loco-regional therapy (LRT) may be considered before transplantation to prevent the disease progression and the patient from dropping out of the waiting list. This study aims to evaluate the impact of repeated pretransplant LRTs on the long-term outcomes in HCC liver transplant recipients.

Methods:
Between 2004 and 2019, living donor liver transplantation (LDLT) recipients with viable HCC on the explant livers were enrolled. Uni- and multivariate analysis was performed with the Cox regression model to stratify the risk factors associated with HCC recurrence and patent survival after LDLT.

Results:
A total of 124 patients were enrolled, in which 65.3% (n = 81) were Barcelona Clinic Liver Cancer classification stage B or D and 89% (n = 110) had advanced fibrosis or cirrhosis on the explanted livers. After a median follow-up of 41 months (IQR: 24–86.5), there were 18 cases (13.7%) of HCC recurrence. Univariate analysis showed that the model of end-stage liver disease and Child-Turcotte-Pugh score, pretransplant alpha-fetoprotein value (>500 ng/ml), repeated pretransplant LRTs (N > 4), increased tumor numbers and maximal size, presence of microvascular invasion, and the histological grading of the tumors are risk factors of inferior outcomes. In multivariate analysis, only repeated pretransplant LRTs (N > 4) had a significant impact on both the overall- and recurrence-free survival. The impact of pretransplant LRT was consistently significant among subgroups based on their LRT episodes (N = 0, 1–4, >4 respectively).

Conclusion:
Repeated LRT for HCC can be associated with the risk of tumor recurrence and inferior patient survival after LDLT in cirrhotic patients. Early referral of those eligible for transplantation may improve the treatment outcomes in these patients.
Good response to pulmonary arterial hypertension-targeted therapy in 2 pulmonary veno-occlusive disease patients
Authors: Zhang Li , Wang Yao , Zhang Ruifeng 
Published: November 2021

Abstract

Rationale:
Pulmonary veno-occlusive disease (PVOD) is a kind of rare and fatal pulmonary arterial hypertension (PAH). Different from other subtypes of PAH, PVOD patients have a very poor prognosis because of the progressive nature of pulmonary vascular involvement and fatal pulmonary edema induced by PAH-targeted drugs. Lung transplantation is the only choice for these patients.

Patient concerns:
We reported 2 cases of PVOD which was misdiagnosed as idiopathic pulmonary arterial hypertension initially due to the lack of typical findings of PVOD. Right heart catheterization was done. The results showed severe PAH with mean pulmonary artery pressure at 76 mmHg and 68 mmHg.

Diagnosis:
The diagnosis of idiopathic pulmonary arterial hypertension was corrected by eukaryotic translation initiation factor 2 alpha kinase 4 (EIF2AK4) mutation screening. Biallelic mutations (c.1387delT (p. Arg463fs); c.989-990 delAA (p. Lys330fs)) were detected by next-generation sequencing for whole exome from blood sample. The presence of biallelic EIF2AK4 mutation was sufficient to confirm the diagnosis of PVOD.

Interventions:
The 2 patients had good response to PAH-targeted therapy (Ambrisentan 10 mg once a day and tadalafil 20 mg once a day) in the following 1 year.

Outcomes:
Because the patients had a good response to targeted drugs, the treatment of the 2 cases was unchanged. Over 1-year period, they still have a good response to PAH-targeted drugs. There was no sign of pulmonary edema.

Lessons:
All these results may indicate that PVOD is not so rare and typical findings of PVOD are lacking in some patients. EIF2AK4 mutation screening by next-generation sequencing maybe useful to differentiate PVOD from other PAH subtypes. PVOD is a heterogeneity population and different patients have different characteristics including response to PAH-targeted therapy. How to pick off this portion of patients timely is the core issue. Further study is necessary to answer this question.