bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structure-guided protein engineering of human cathepsin L for efficient collagenolytic activity
Authors: Choudhury Debi , Biswas Sampa 
Published: February 2021

Abstract
Engineering precise substrate specificity of proteases advances the potential to use them in biotechnological and therapeutic applications. Collagen degradation, a physiological process mediated by collagenases, is an integral part of extracellular matrix remodeling and when uncontrolled, implicated in different pathological conditions. Lysosomal cathepsin-K cleaves triple helical collagen fiber, whereas cathepsin-L cannot do so. In this study, we have imparted collagenolytic property to cathepsin-L, by systematically engineering proline-specificity and glycosaminoglycans (GAG)-binding surface in the protease. The proline-specific mutant shows high specificity for prolyl-peptidic substrate but is incapable of cleaving collagen. Engineering a GAG-binding surface on the proline-specific mutant enabled it to degrade type-I collagen in the presence of chondroitin-4-sulfate (C4-S). We also present the crystal structures of proline-specific (1.4 Å) and collagen-specific (1.8 Å) mutants. Finally docking studies with prolyl-peptidic substrate (Ala-Gly-Pro-Arg-Ala) at the active site and a C4-S molecule at the GAG-binding site enable us to identify key structural features responsible for collagenolytic activity of cysteine cathepsins.
Current status of space gravitational wave antenna DECIGO and B-DECIGO
Authors: Kawamura Seiji , Ando Masaki , Seto Naoki , Sato Shuichi , Musha Mitsuru , Kawano Isao , Yokoyama Jun’ichi , Tanaka Takahiro , Ioka Kunihito , Akutsu Tomotada , Takashima Takeshi , Agatsuma Kazuhiro , Araya Akito , Aritomi Naoki , Asada Hideki , Chiba Takeshi , Eguchi Satoshi , Enoki Motohiro , Fujimoto Masa-Katsu , Fujita Ryuichi , Futamase Toshifumi , Harada Tomohiro , Hayama Kazuhiro , Himemoto Yoshiaki , Hiramatsu Takashi , Hong Feng-Lei , Hosokawa Mizuhiko , Ichiki Kiyotomo , Ikari Satoshi , Ishihara Hideki , Ishikawa Tomohiro , Itoh Yousuke , Ito Takahiro , Iwaguchi Shoki , Izumi Kiwamu , Kanda Nobuyuki , Kanemura Shinya , Kawazoe Fumiko , Kobayashi Shiho , Kohri Kazunori , Kojima Yasufumi , Kokeyama Keiko , Kotake Kei , Kuroyanagi Sachiko , Maeda Kei-ichi , Matsushita Shuhei , Michimura Yuta , Morimoto Taigen , Mukohyama Shinji , Nagano Koji , Nagano Shigeo , Naito Takeo , Nakamura Kouji , Nakamura Takashi , Nakano Hiroyuki , Nakao Kenichi , Nakasuka Shinichi , Nakayama Yoshinori , Nakazawa Kazuhiro , Nishizawa Atsushi , Ohkawa Masashi , Oohara Kenichi , Sago Norichika , Saijo Motoyuki , Sakagami Masaaki , Sakai Shin-ichiro , Sato Takashi , Shibata Masaru , Shinkai Hisaaki , Shoda Ayaka , Somiya Kentaro , Sotani Hajime , Takahashi Ryutaro , Takahashi Hirotaka , Akiteru Takamori , Taniguchi Keisuke , Taruya Atsushi , Tsubono Kimio , Tsujikawa Shinji , Ueda Akitoshi , Ueda Ken-ichi , Watanabe Izumi , Yagi Kent , Yamada Rika , Yokoyama Shuichiro , Yoo Chul-Moon , Zhu Zong-Hong 
Published: February 2021

Abstract
The Deci-hertz Interferometer Gravitational Wave Observatory (DECIGO) is a future Japanese space mission with a frequency band of 0.1 Hz to 10 Hz. DECIGO aims at the detection of primordial gravitational waves, which could have been produced during the inflationary period right after the birth of the Universe. There are many other scientific objectives of DECIGO, including the direct measurement of the acceleration of the expansion of the Universe, and reliable and accurate predictions of the timing and locations of neutron star/black hole binary coalescences. DECIGO consists of four clusters of observatories placed in heliocentric orbit. Each cluster consists of three spacecraft, which form three Fabry–Pérot Michelson interferometers with an arm length of 1000 km. Three DECIGO clusters will be placed far from each other, and the fourth will be placed in the same position as one of the other three to obtain correlation signals for the detection of primordial gravitational waves. We plan to launch B-DECIGO, which is a scientific pathfinder for DECIGO, before DECIGO in the 2030s to demonstrate the technologies required for DECIGO, as well as to obtain fruitful scientific results to further expand multi-messenger astronomy.
Effectiveness of Telerehabilitation in Physical Therapist Practice: An Umbrella and Mapping Review With Meta–Meta-Analysis
Authors: Suso-Martí Luis , La Touche Roy , Herranz-Gómez Aida , Angulo-Díaz-Parreño Santiago , Paris-Alemany Alba , Cuenca-Martínez Ferran 
Published: February 2021

Abstract

Objective
Telerehabilitation is an option that should be adapted as soon as possible to face the crisis caused by coronavirus disease 2019. An umbrella and mapping review with meta–meta-analysis (MMA) of the available scientific evidence was performed to determine whether telerehabilitation could be an effective alternative to conventional rehabilitation in physical therapist practice.

Methods
A systematic review of reviews and a synthesis of the findings of all systematic evidence published to date with a visual map and a meta–meta-analysis (MMA) were performed. A systematic search was realized in Cochrane Database of Systematic Reviews, MEDLINE (PubMed), and Google Scholar. Two independent reviewers performed a data analysis and assessed the quality of the included reviews, assessing the risk of bias using ROBIS.

Results
Twenty-nine articles that met the inclusion criteria were selected and divided according to the type of patient targeted for rehabilitation (patients with cardiorespiratory, musculoskeletal, and neurological conditions). The MMA regarding physical function between telerehabilitation and usual care rehabilitation did not reveal a statistically significant difference for patients with cardiorespiratory and musculoskeletal conditions. For patients with neurological conditions, the MMA revealed a statistically significant but negligible effect size in 6 reviews in favor of telerehabilitation (standardized mean difference = 0.18; 95% CI = 0.03–0.34).

Conclusion
The results of the present review showed that telerehabilitation offers positive clinical results, even comparable to conventional face-to-face rehabilitation approaches.

Impact
The advantages of lower cost and less interference by the rehabilitation processes in patients’ daily life could justify implementing telerehabilitation in clinical settings in the coronavirus disease 2019 era.
The need for mass testing and the proper post-COVID-19 test behavior in the Philippines
Authors: Mendoza Abelardo Jose M , dela Cruz Moriah Dianne M , Gozum Ivan Efreaim A , Galang Joseph Renus F 
Published: February 2021

Abstract
In a recent article, the researcher asked if people’s behavior after receiving negative COVID-19 tests contribute to the spread of the virus. It was discussed that even though testing mitigated the coronavirus spread, false confidence among those who have negative results contributed to the spread of the virus. This article, then, proposes that there is a need for mass testing for new virus variants and a foundation for proper behavior after testing.
Goths, Huns, and The Dream of the Rood
Authors: Neidorf Leonard 
Published: February 2021

Abstract
This article argues that two poems concerned with legends of Goths and Huns, the Old Norse Hlǫðskviða and the Old High German Hildebrandslied, provide an illuminating literary context for The Dream of the Rood. The critical utility of these poems inheres in their ability to delineate more precisely the intertextual relationship that obtains between The Dream of the Rood and the vernacular tradition of heroic poetry. When the poem is read in this context, Christ appears not to be vaguely heroic, but to be modelled on a specific type of hero: the intransigent youth who compels his unwilling adversary to fight him and ultimately take his life. The figures of Hlǫð and Hadubrand are shown to constitute the most relevant extant realizations of this type, while related examples from Waltharius and the Finnsburg fragment are adduced in order to confirm that the type was both traditional and widespread.
An Application of the Resource-Based Dynamic Process Model in the Context of Retirement Planning
Authors: Noone Jack , Earl Joanne , Stephens Christine , Rafalski Julia , Allen Joanne , Alpass Fiona , Topa Gabriela 
Published: February 2021

AbstractRetirement planning is a widely promoted activity to enhance wellbeing for aging populations. However, there is limited follow-up data to understand the antecedents of multi-dimensional retirement planning activities, the resources such activities produce or the explanatory mechanisms. This research draws on recent theorizing, which suggests that retirement planning may play a mediating role in explaining how pre-retirement antecedents are transformed into retirement resources. Antecedents, planning and retirement resources were examined using 3 waves of follow-up data collected in 2006, 2008, and 2014. Four hundred thirty-five people originally employed in 2008 and retired by 2014 participated in the study. Health, income, and a positive retirement attitude (T1) were the strongest predictors of retirement planning (T2), but job satisfaction and occupation also played smaller predictive roles. Financial planning (T2) predicted health, psychosocial, and financial resources in retirement (T3). However, health, lifestyle, and psychosocial planning played a minimal role in explaining retirement resources, and only financial planning demonstrated noteworthy evidence of mediation. Findings can help to inform policy decisions by identifying those at greatest risk of not planning, and to isolate the factors most likely to explain the longer-term effects of planning. Understanding which resources are predicted by different domains of planning will also help inform the targeting of interventions.
Comparing health care system and physician practice influences on social risk screening
Authors: Frehn Jennifer L. , Brewster Amanda L. , Shortell Stephen M. , Rodriguez Hector P. 
Published: February 2021

Background
Health care systems can support dissemination of innovations, such as social risk screening in physician practices, but to date, no studies have examined the association of health system characteristics and practice-level adoption of social risk screening.

Purpose
The aim of the study was to examine the association of multilevel organizational capabilities and adoption of social risk screening among system-owned physician practices.

Methodology
Secondary analyses of the 2018 National Survey of Healthcare Organizations and Systems were conducted. Multilevel linear regression models examined physician practice and system characteristics associated with practice adoption of screening for five social risks (food insecurity, housing instability, utility needs, interpersonal violence, and transportation needs), accounting for clustering of practices within systems using random effects.

Results
System-owned practices screened for an average of 1.7 of the five social risks assessed. The intraclass correlation indicated 16% of practice variation in social risk screening was attributable to differences between their health systems owners, with 84% attributable to differences between individual practices. Practices owned by systems with multiple hospitals screened for an additional 0.44 social risks (p = .046) relative to practices of systems without hospitals. Practice characteristics associated with social risk screening included health information technology capacity (β = 0.20, p = .005), innovation culture (β = 0.26, p < .001), and patient engagement strategies (β = 0.57, p < .001).

Conclusions
Health care system capabilities account for less variation in physician practice adoption of social risk screening compared to practice-level capabilities.

Practice Implications
Efforts to expand social risk screening among system-owned physician practices should focus on supporting practice capabilities, including enhancing health information technology, promoting an innovative organizational culture, and advancing patient engagement strategies.
Representation of Minority Groups in Key Pelvic Floor Disorder Trials
Authors: Mckay Elishia R. , Davila Jonathan L. , Lee Justin A. , Rolston Renee , Agalliu Ilir , Abraham Nitya E. 
Published: February 2021

Background
Multicenter randomized clinical trials on pelvic floor disorders (PFDs) support evidence-based care. However, many of these studies include homogenous study populations lacking diversity. Heterogeneous sampling allows for greater generalizability while increasing knowledge regarding specific subgroups. The racial/ethnic makeup of key pelvic floor disorder (PFD) trials has not been examined.

Objective
This study aimed to investigate racial/ethnic representation in major PFD clinical trials in comparison to racial/ethnic distribution of PFD in the National Health and Nutritional Examination Survey (NHANES).

Methods
Demographic data were extracted from completed PFD Network (PFDN) and Urinary Incontinence Treatment Network studies, which have resulted in nearly 200 publications. Prevalence of PFD by race/ethnicity was obtained from the NHANES. A representative index (Observed “n” by PFD study/Expected “n” based on the NHANES-reported prevalence) was calculated as a measure of representation. Meta-analyses were performed for each outcome and overall with respect to race/ethnicity.

Results
Eighteen PFDN/Urinary Incontinence Treatment Network studies were analyzed. White women comprised 70%–89% of PFD literature; Black women, 6%–16%; Hispanic women, 9%–15%; Asians, 0.5%–6%; and American Indians, 0%–2%. Representation of White women was higher in 13 of 18 PFDN studies compared with the NHANES prevalence data. Representation of Black women was either decreased or not reported in 10 of 18 index studies compared with the NHANES prevalence data. Hispanic women were absent or underrepresented in 7 of 18 PFDN studies compared with the prevalence data.

Conclusions
Our examination of PFDN and other landmark trials demonstrates inconsistent reporting of minority subgroups, limiting applicability with respect to minority populations. Our study suggests that PFD research would benefit from targeted sampling of minority groups.
Pelvic Organ Prolapse Surgery in the Elderly and Frail: Safety of a Reconstructive Versus Obliterative Approach
Authors: Chapman Graham C. , Slopnick Emily A. , Roberts Kasey , Sheyn David , El-Nashar Sherif A. , Mangel Jeffrey M. , Hijaz Adonis K. 
Published: February 2021

Objectives
The aim of this study was to compare the risk of complications associated with obliterative surgery versus reconstructive surgery in elderly and frail patients undergoing surgery for pelvic organ prolapse.

Methods
We performed a retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program Database from 2010 to 2017. We compared characteristics and perioperative complications in patients aged 80 years or older who underwent obliterative surgery versus reconstructive surgery. Multivariate logistic regression and propensity score matching were used to control for confounding. A subanalysis was performed that included patients who were considered frail as defined by the National Surgical Quality Improvement Program Modified Frailty Index 5.

Results
Of 1,654 total patients, reconstructive surgery was performed in 56.9% of patients, and obliterative surgery was performed in 43.1%. The respective composite complication rates were 9.2% and 9.8% (P = 0.69), whereas severe complications were experienced by 1.9% in the reconstructive group versus 0.8% in the obliterative group (P = 0.07). On multivariate logistic regression, reconstructive surgery was not significantly associated with the composite complication rate (adjusted odds ratio, 1.0; 95% confidence interval, 0.7–1.4; P = 0.80). After propensity score matching, composite complications did not differ between groups, but the rate of severe complications was significantly higher in patients who underwent reconstructive surgery compared with obliterative surgery (2.1% vs 0.8%; odds ratio, 2.53; 95% confidence interval, 1.01–6.36; P = 0.05). In frail patients only, complication rates did not differ between groups.

Conclusions
In patients aged 80 years or older, the overall rate of complications did not differ between those who underwent reconstructive surgery versus obliterative surgery. However, propensity score matching identified an increased risk of the most severe complications in patients who underwent reconstructive surgery.
Evaluating social and spatial inequalities of large scale rapid lateral flow SARS-CoV-2 antigen testing in COVID-19 management: An observational study of Liverpool, UK (November 2020 to January 2021)
Authors: Green Mark A. , García-Fiñana Marta , Barr Ben , Burnside Girvan , Cheyne Christopher P. , Hughes David , Ashton Matthew , Sheard Sally , Geddes Andrew , Rankin John , Buchan Iain E. 
Published: February 2021

AbstractObjectiveTo explore social and spatial inequalities in uptake and case-detection of rapid lateral flow SARS-CoV-2 antigen tests (LFTs) offered to people without symptoms of COVID-19.DesignObservational study.SettingLiverpool, UK.Participants496 784 residents.InterventionFree LFTs to all people living and working in Liverpool (6th November 2020 to 31st January 2021).Main outcome measuresResidents who received a LFT, residents who had multiple LFTs, and positive test results.Results214 525 residents (43%) received a LFT identifying 5557 individuals as positive cases of COVID-19 (1.3%) between 6th November 2020 and 31st January 2021. 89 047 residents had more than one test (18%). Uptake was highest in November when there was military assistance. High uptake was observed again in the week preceding Christmas and was sustained into a national lockdown. Overall uptake and repeat testing were lower among males (e.g. 40% uptake over the whole period), Black Asian and other Minority Ethnic groups (e.g. 27% uptake for ‘Mixed’ ethnicity) and in the most deprived areas (e.g. 32% uptake in most deprived areas). These population groups were also more likely to have received positive tests for COVID-19. Spatial regression models demonstrated that uptake and repeat testing were lower in areas of higher deprivation, areas located further from test sites and areas containing populations less confident in the using Internet technologies. Positive tests were spatially clustered in deprived areas.ConclusionsLarge-scale voluntary asymptomatic community testing saw social, ethnic, and spatial inequalities in an ‘inverse care’ pattern, but with an added digital exclusion factor. COVID-19 testing and support to isolate need to be more accessible to the vulnerable communities most impacted by the pandemic, including non-digital means of access.What is already known on this topicTesting asymptomatic individuals with rapid lateral flow SARS-CoV-2 antigen devices detects the most infectious individuals who otherwise would have been unaware they were likely to infect others.Liverpool (UK) conducted the world’s first whole population, open-access, voluntary asymptomatic testing programme for COVID-19 management.The impacts of such testing on inequalities are unknown.What this study addsTesting uptake was lower, and test positivity was higher, among deprived populations, Black Asian and other Minority Ethnic groups and areas classified as having low Internet use.Population-wide asymptomatic testing programmes need to account for social, spatial, and digital access issues in their design, communication and delivery to minimise inequalities in outcomes.
Digital cognitive behavioural therapy for insomnia and primary care costs in England: an interrupted time series analysis
Authors: Sampson Chris , Bell Eleanor , Cole Amanda , Miller Christopher B. , Rose James 
Published: February 2021

AbstractBackgroundSleepio is an automated digital programme that delivers cognitive behavioural therapy for insomnia. Sleepio has been proven effective in improving sleep difficulties. However, evidence for the possible impact of Sleepio use on health care costs in the United Kingdom has not previously been developed. In this study, we assessed the effect of a population-wide rollout of Sleepio in terms of primary care costs in the National Health Service (NHS) in England.MethodsThe study was conducted in the Thames Valley region of England, where access to Sleepio was made freely available to all residents between October 2018 and January 2020. We use primary care data for people with relevant characteristics from nine general practices in Buckinghamshire. The study relies on a quasi-experimental design, using an interrupted time series to compare the trend in primary care costs before and after the rollout of Sleepio. Primary care costs include general practice contacts and prescriptions. Segmented regression analysis was used to estimate primary and secondary outcomes.ResultsFor the 10,704 patients included in our sample, the total saving over the 65-week follow-up period was £71,027. This corresponds to £6.64 per person in our sample or around £70.44 per Sleepio user. Secondary analyses suggest that savings may be driven primarily by reductions in prescriptions.ConclusionSleepio rollout reduced primary care costs. National adoption of Sleepio may reduce primary care costs by £20 million in the first year. The expected impact on primary care costs in any particular setting will depend on the uptake of Sleepio.
Vagus nerve cross-sectional area in patients with Parkinson’s Disease – an ultrasound case-control study
Authors: Horsager Jacob , Walter Uwe , Fedorova Tatyana D , Andersen Katrine B. , Skjærbæk Casper , Knudsen Karoline , Okkels Niels , Weitzel-Mudersbach Paul von , Dyrskog Stig Eric , Bergholt Bo , Borghammer Per 
Published: February 2021

AbstractBackgroundVagal parasympathetic neurons are prone to degeneration in Parkinson’s disease (PD). High-resolution ultrasound can precisely estimate the cross-sectional area (CSA) of peripheral nerves. Here, we tested the hypothesis that vagus CSA is reduced in PD.MethodsWe included 56 healthy controls (HCs) and 63 patients with PD. Using a high-end ultrasound system equipped with a high-frequency transducer, five images were obtained of each nerve. The hypoechoic neuronal tissue was delineated offline with dedicated software and the CSA extracted.ResultsIn the initial PD vs. HC comparison, no statistically significant differences were observed in mean left vagus CSA (HC: 1.97mm2, PD: 1.89mm2, P=0.36) or in mean right vagus CSA (HC: 2.37mm2, PD: 2.23mm2, P=0.17). The right vagus CSA was significantly larger than the left vagus CSA in both groups (P<0.0001). Females were overrepresented in the HC group and presented with generally smaller vagus CSAs. Consequently, sex-adjusted CSA was significantly smaller for the right vagus nerve of the PD group (P=0.041), but not for the left.ConclusionA small but significant reduction in sex-adjusted right vagus CSA was observed in patients with PD. The left vagus CSA was not significantly reduced in patients with PD. Ultrasound may not be a suitable method to detecting vagal axonal loss in individual patients.