bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stabbing Spines: A review of the Biomechanics and Evolution of Defensive Spines
Authors: Crofts Stephanie B , Stankowich Theodore 
Published: May 2021

SynopsisSpines are ubiquitous in both plants and animals, and while most spines were likely originally used for defense, over time many have been modified in a variety of ways. Here we take an integrative approach to review the form, function, and evolution of spines as a defensive strategy in order to make new connections between physical mechanisms and functional behavior. While this review focuses on spines in mammals, we reference and draw ideas from the literature on spines in other taxa, including plants. We begin by exploring the biomechanics of defensive spines, their varied functions, and nondefensive modifications. We pay particular attention to the mechanics involved in passive puncture and the ways organisms have overcome limitations associated with the low energy input. We then focus on the ecological, physiological, and behavioral factors that promote the evolution of spiny defenses, including predator- and habitat-mediated hypotheses. While there is considerable evidence to support both, studies have generally found that (1) defensive spines are usually effective against one class of attacker (e.g., larger predators) but ineffective against or even facilitate predation by others and (2) species that are more visible or exposed to predators are under much stronger selection to evolve defensive spines or some other robust defense. What type of defensive morphology that evolves, however, is less predictable and probably strongly dependent on both the dominant source of predation and the habitat structure of the organism (e.g., arboreal, terrestrial, and fossorial). We then explore traits that often are correlated with defensive spines and armor, potentially forming armor syndromes, suites of traits that evolve together with body armor in a correlated fashion. In mammals, these include aposematic warning coloration, locomotion style, diet, metabolic rate, and relative brain size. Finally, we encourage integration of mechanistic, behavioral, and evolutionary studies of defensive spines and suggest future avenues of research in the biomechanics, evolution, and behavior of spines and spiny organisms.
Validation of neonatal and paediatric antimicrobial stewardship treatment algorithms in rapid diagnostic-detected bacteraemia
Authors: Kruger Howard Amy , Parbuoni Kristine A , Claeys Kimberly , Biggs Jessica M , Seung Hyunuk , Johnson Kristie , Campbell James , Morgan Jill A 
Published: May 2021

Abstract

Objectives
Blood culture rapid diagnostic testing (RDT) aids in early organism identification and resistance gene detection. This information allows quicker transition to tailored antimicrobial therapy, improved patient outcomes and prevention of antimicrobial resistance. An antimicrobial treatment algorithm based on RDT results and local antibiograms can serve as a valuable clinical decision-support tool. This study assessed the proportion of appropriate antibiotic therapy recommendations using a novel paediatric RDT-guided treatment algorithm compared with standard care (SC) in paediatric bacteraemia.

Methods
This was a retrospective, observational study of admitted paediatric patients who received antibiotics for RDT-confirmed bacteraemia. Appropriateness of SC was compared with algorithm-recommended treatment. Antimicrobial appropriateness was defined as in vitro susceptibility to the organism identified through traditional microbiology. Clinical appropriateness took into consideration the ability to tailor therapy within 12 h of RDT results. Appropriateness was evaluated by two blinded, independent reviewers.

Key findings
Eighty-six blood cultures were included with 15 unique Gram-positive and Gram-negative species or genus identified. Comparative antimicrobial appropriateness of SC and algorithm-recommended treatment was 94.2% (81/86) and 100% (86/86), respectively (P = 0.06). Clinical assessment determined 39.5% (34/86) of SC patients were on appropriate therapy within 12 h of RDT result. Algorithm-recommended therapy was clinically appropriate in 97.7% (84/86) of patients (P &lt; 0.001). There was a median time savings of 42.7 h (IQR 40.6, 49.4) for the patients able to be de-escalated as compared with waiting on final sensitivities.

Conclusions
Algorithm-guided treatment may allow most patients to be de-escalated to organism-tailored therapy earlier in their therapeutic course.
Observer analysis and design for nonlinear bounded Lipschitz systems
Authors: Alexandridis Antonio T , Papageorgiou Panos C 
Published: May 2021

Abstract
The design of dynamic observers for nonlinear Lipschitz systems has considered great attention in past decades. Instead of applying the standard strictly explicit designs or LMI-based heuristic solutions, in this paper, an efficient systematic method is deployed by considering the existence of some arbitrary bounds on the nonlinear Lipschitz terms. The method enables to relax the observer design from the conventional restrictions and it is easily solved analytically without needing the solution of LMIs. As proven in the paper by a detailed and rigorous analysis, its main advantage is that it guarantees global asymptotic stability and ensures the observer response with desired decay characteristics satisfying simultaneously the Lyapunov equation.
Additive Processes on the Unit Circle and Loewner Chains
Authors: Hasebe Takahiro , Hotta Ikkei 
Published: May 2021

AbstractThis paper defines the notion of generators for a class of decreasing radial Loewner chains that are only continuous with respect to time. For this purpose, “Loewner’s integral equation”, which generalizes Loewner’s differential equation, is defined and analyzed. The definition of generators is motivated by the Lévy–Khintchine representation for additive processes on the unit circle. Actually, we can and do introduce a homeomorphism between the above class of Loewner chains and the set of the distributions of increments of additive processes equipped with suitable topologies. On the other hand, from the viewpoint of non-commutative probability theory, the above generators also induce bijections with some other objects: in particular, monotone convolution hemigroups and free convolution hemigroups. Finally, the generators of Loewner chains constructed from free convolution hemigroups via subordination are computed.
Perspectives on Remote Glucose Monitoring in Youth With Type 1 Diabetes
Authors: Fremont Ettya R , Miller Victoria A 
Published: May 2021

Abstract

Objective
Continuous glucose monitoring (CGM) has become increasingly popular among youth with type 1 diabetes (T1D). Used with CGM, remote monitoring (RM) gives caregivers real-time access to patients’ glucose values. Whereas RM may safeguard against hypo- and hyperglycemic events, little is known about how older children and adolescents, who are striving for independence, and their parents view the RM aspect of CGM. The goal of this study was to describe and explore parent and youth perceptions of RM.

Methods
Youth with T1D and their parents participated separately in semi-structured interviews 2 months after starting CGM. Questions focused on decisions to use and experiences with RM.

Results
Analysis of 43 parents and 41 youth (13.79 years ± 2.82) interviews revealed four themes, with 10 subthemes. Seven subthemes emerged in parent and youth interviews, and three emerged exclusively in parent interviews. The overarching themes included the impact of RM on (1) peace-of-mind, (2) parental anxiety, (3) communication; and addressed (4) technological limitations that prevented some from using RM. Regardless of youth age, youth and parents found comfort in parental knowledge of glucose values and parental abilities to assist youth (e.g., giving reminders to eat). Whereas RM could lead to conflicts due to excessive communication (e.g., texting), conflicts could be resolved through iterative parent-youth conversations.

Conclusion
RM may facilitate youth independence by providing a way for them to stay connected to their support system while acquiring developmentally appropriate skills. However, families should have iterative discussions about boundaries to mitigate parental over-involvement.
Disparities in Incidence and Severity of Shigella Infections Among Children—Foodborne Diseases Active Surveillance Network (FoodNet), 2009-2018
Authors: Gharpure Radhika , Marsh Zachary A , Tack Danielle M , Collier Sarah A , Strysko Jonathan , Ray Logan , Payne Daniel C , Garcia-Williams Amanda G 
Published: May 2021

Abstract

Background
Shigella infections are an important cause of diarrhea in young children and can result in severe complications. Disparities in Shigella infections are well documented among US adults. Our objective was to characterize disparities in incidence and severity of Shigella infections among US children.

Methods
We analyzed laboratory-diagnosed Shigella infections reported to FoodNet, an active, population-based surveillance system in 10 US sites, among children during 2009-2018. We calculated the incidence rate stratified by sex, age, race/ethnicity, Shigella species, and disease severity. Criteria for severe classification were hospitalization, bacteremia, or death. The odds of severe infection were calculated using logistic regression.

Results
During 2009-2018, 10 537 Shigella infections were reported in children and 1472 (14.0%) were severe. The incidence rate was 9.5 infections per 100 000 child-years and the incidence rate of severe infections was 1.3 per 100 000 child-years. Incidence was highest among children aged 1-4 years (19.5) and lowest among children aged 13-17 years (2.3); however, children aged 13-17 years had the greatest proportion of severe infections (21.2%). Incidence was highest among Black (16.2 total; 2.3 severe), Hispanic (13.1 total; 2.3 severe), and American Indian/Alaska Native (15.2 total; 2.5 severe) children. Infections caused by non-sonnei species had higher odds of severity than infections caused by Shigella sonnei (adjusted odds ratio 2.58; 95% confidence interval 2.12-3.14).

Conclusions
The incidence and severity of Shigella infections among US children vary by age, race/ethnicity, and Shigella species, warranting investigation of unique risk factors among pediatric subpopulations.
Tremarctos ornatus(Carnivora: Ursidae)
Authors: Vela-Vargas I Mauricio , Jorgenson Jeffrey P , González-Maya José F , Koprowski John L 
Published: May 2021

AbstractTremarctos ornatus (F.G. Cuvier, 1825) is a tremarctine bear commonly known as the Andean bear. It is a medium-sized bear with black to dark red-brown pelage with dense, long, coarse fur; creamy white marks occur on the chin, neck, and chest, and often white to creamy marks occur on the face, around the muzzle, and eyes. It is distributed in the tropical Andes of Venezuela, Colombia, Ecuador, Perú, Bolivia, and northern Argentina in South America. T. ornatus is catalogued as “Vulnerable” (VU) by the International Union for Conservation of Nature and Natural Resources and is included in CITES Appendix I. Main threats include habitat loss and fragmentation, illegal killing, human–bear conflicts, and most likely climate change.
An international multicenter matched cohort analysis of incidental meningioma progression during active surveillance or after stereotactic radiosurgery: the IMPASSE study
Authors: Sheehan Jason , Pikis Stylianos , Islim Abdurrahman I , Chen Ching-Jen , Bunevicius Adomas , Peker Selcuk , Samanci Yavuz , Nabeel Ahmed M , Reda Wael A , Tawadros Sameh R , El-Shehaby Amr M N , Abdelkarim Khaled , Emad Reem M , Delabar Violaine , Mathieu David , Lee Cheng-Chia , Yang Huai-Che , Liscak Roman , Hanuska Jaromir , Alvarez Roberto Martinez , Patel Dev , Kondziolka Douglas , Moreno Nuria Martinez , Tripathi Manjul , Speckter Herwin , Albert Camilo , Bowden Greg N , Benveniste Ronald J , Lunsford Lawrence Dade , Jenkinson Michael D 
Published: May 2021

Abstract

Background
The optimal management of patients with incidental meningiomas remains unclear. The aim of this study was to characterize the radiologic and neurological outcomes of expectant and stereotactic radiosurgery (SRS) management of asymptomatic meningioma patients.

Methods
Using data from 14 centers across 10 countries, the study compares SRS outcomes to active surveillance of asymptomatic meningiomas. Local tumor control of asymptomatic meningiomas and development of new neurological deficits attributable to the tumor were evaluated in the SRS and conservatively managed groups.

Results
In the unmatched cohorts, 727 meningioma patients underwent SRS and were followed for a mean of 57.2 months. In the conservatively managed cohort, 388 patients were followed for a mean of 43.5 months. Tumor control was 99.0% of SRS and 64.2% of conservatively managed patients (P &lt; .001; OR 56.860 [95% CI 26.253-123.150]). New neurological deficits were 2.5% in the SRS and 2.8% of conservatively managed patients (P = .764; OR 0.890 [95% CI 0.416-1.904]). After 1:1 propensity matching for patient age, tumor volume, location, and imaging follow-up, tumor control in the SRS and conservatively managed cohorts was 99.4% and 62.1%, respectively (P &lt; .001; OR 94.461 [95% CI 23.082-386.568]). In matched cohorts, new neurological deficits were noted in 2.3% of SRS-treated and 3.2% of conservatively managed patients (P = .475; OR 0.700 [95% CI 0.263-1.863]).

Conclusions
SRS affords superior radiologic tumor control compared to active surveillance without increasing the risk of neurological deficits in asymptomatic meningioma patients. While SRS and active surveillance are reasonable options, SRS appears to alter the natural history of asymptomatic meningiomas including tumor progression in the majority of patients treated.
The phosphorylated pathway of serine biosynthesis links plant growth with nitrogen metabolism
Authors: Zimmermann Sandra E , Benstein Ruben M , Flores-Tornero María , Blau Samira , Anoman Armand D , Rosa-Téllez Sara , Gerlich Silke C , Salem Mohamed A , Alseekh Saleh , Kopriva Stanislav , Wewer Vera , Flügge Ulf-Ingo , Jacoby Richard P , Fernie Alisdair R , Giavalisco Patrick , Ros Roc , Krueger Stephan 
Published: May 2021

Abstract
Because it is the precursor for various essential cellular components, the amino acid serine is indispensable for every living organism. In plants, serine is synthesized by two major pathways: photorespiration and the phosphorylated pathway of serine biosynthesis (PPSB). However, the importance of these pathways in providing serine for plant development is not fully understood. In this study, we examine the relative contributions of photorespiration and PPSB to providing serine for growth and metabolism in the C3 model plant Arabidopsis thaliana. Our analyses of cell proliferation and elongation reveal that PPSB-derived serine is indispensable for plant growth and its loss cannot be compensated by photorespiratory serine biosynthesis. Using isotope labeling, we show that PPSB-deficiency impairs the synthesis of proteins and purine nucleotides in plants. Furthermore, deficiency in PPSB-mediated serine biosynthesis leads to a strong accumulation of metabolites related to nitrogen metabolism. This result corroborates 15N-isotope labeling in which we observed an increased enrichment in labeled amino acids in PPSB-deficient plants. Expression studies indicate that elevated ammonium uptake and higher glutamine synthetase/glutamine oxoglutarate aminotransferase (GS/GOGAT) activity causes this phenotype. Metabolic analyses further show that elevated nitrogen assimilation and reduced amino acid turnover into proteins and nucleotides are the most likely driving forces for changes in respiratory metabolism and amino acid catabolism in PPSB-deficient plants. Accordingly, we conclude that even though photorespiration generates high amounts of serine in plants, PPSB-derived serine is more important for plant growth and its deficiency triggers the induction of nitrogen assimilation, most likely as an amino acid starvation response.
The State of American Federalism, 2020–2021: Deepening Partisanship amid Tumultuous Times
Authors: Konisky David M , Nolette Paul 
Published: May 2021

Abstract
In this introductory article for the 2020–2021 Annual Review of American Federalism, we review notable developments in U.S. politics and policy during the last year, with an emphasis on their intersections with and consequences for federalism. We focus in particular on the 2020 elections and the COVID pandemic, along with policy developments in the areas of criminal justice and police reform, health care, environment, immigration, and equality and religious liberty. The events of the past year, especially those related to the pandemic and the fallout of the presidential election, led to a resurgence of public interest in federalism and a focus on the importance of government decision-making of state and local governments. Events during the last year have not only reinforced partisan polarization but have also deepened the existing divide of Americans along partisan lines and perhaps in new ways. Partisan differences have increasingly become cultural differences, so that political and policy differences have saturated American culture in notable ways.
Opioid use disorder and COVID-19
Authors: Mitchell Michaela , Shee Kameron , Champlin Kelly , Essary Alison C. , Evans Matthew 
Published: May 2021

ABSTRACT
Preliminary data suggest that opioid-related overdose deaths have increased subsequent to COVID-19. Despite national support for expanding the role of physician assistants (PAs) and NPs in serving patients with opioid use disorder, these clinicians are held to complex and stringent regulatory barriers. COVID-19 triggered significant changes from regulatory and federal agencies, yet disparate policies and regulations persist between physicians and PAs and NPs. The dual epidemics of COVID-19 and opioid use disorder highlight the inadequate infrastructure required to support patients, communities, and clinicians, and may serve as the catalyst for eliminating barriers to care.
Juvenile Batten disease
Authors: Niederer Kathryn 
Published: May 2021

ABSTRACT
This article describes the 6-year journey to diagnosis of twin girls with varying presentations of the same rare disease. Batten disease is a neurodegenerative disease caused by an autosomal recessive genetic mutation. In patients with juvenile Batten disease, the most common initial symptom is vision loss, and initial testing early in the disease process typically fails to find any indication of this fatal disease.
Increased Glucocorticoid Receptor Alpha Expression and Signaling in Critically Ill Coronavirus Disease 2019 Patients*
Authors: Vassiliou Alice G. , Athanasiou Nikolaos , Keskinidou Chrysi , Jahaj Edison , Tsipilis Stamatios , Zacharis Alexandros , Botoula Efthimia , Diamantopoulos Aristidis , Ilias Ioannis , Vassiliadi Dimitra A. , Tsagarakis Stylianos , Kotanidou Anastasia , Dimopoulou Ioanna 
Published: May 2021

OBJECTIVES:
Critical illness is characterized by increased serum cortisol concentrations and bioavailability resulting from the activation of the hypothalamic-pituitary-adrenal axis, which constitutes an essential part of the stress response. The actions of glucocorticoids are mediated by a ubiquitous intracellular receptor protein, the glucocorticoid receptor. So far, data on coronavirus disease 2019 and glucocorticoid receptor alpha expression are lacking.

DESIGN:
Prospective observational study.

SETTING:
One academic multidisciplinary ICU.

SUBJECTS:
Twenty-six adult coronavirus disease 2019 patients; 33 adult noncoronavirus disease 2019 patients, matched for age, sex, and disease severity, constituted the control group. All patients were steroid-free.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Glucocorticoid receptor alpha, glucocorticoid-inducible leucine zipper expression, and serum cortisol were measured on ICU admission. In coronavirus disease 2019 patients, glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper messenger RNA expression were upregulated (4.7-fold, p < 0.01 and 14-fold, p < 0.0001, respectively), and cortisol was higher (20.3 vs 14.3 μg/dL, p < 0.01) compared with the control group.

CONCLUSIONS:
ICU coronavirus disease 2019 patients showed upregulated glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper expression, along with cortisol levels, compared with ICU noncoronavirus disease 2019 patients. Thus, on ICU admission, critical coronavirus disease 2019 appears to be associated with hypercortisolemia, and increased synthesis of glucocorticoid receptor alpha and induced proteins.
Adherence to Child Attention-Deficit/Hyperactivity Disorder Treatment Guidelines in Medical Homes—Results from a National Survey
Authors: AlRasheed Rashed M. , Martin-Herz Susanne P. , Glidden David V. , Okumura Megumi J. 
Published: May 2021

ABSTRACT:

Objective:
Having primary care delivered through a medical home is believed to improve mental health care delivery to children. Children with attention-deficit/hyperactivity disorder (ADHD) are commonly treated in pediatric practices, yet little is known about ADHD treatment patterns in medical homes. Our objective was to assess for treatment variation depending on parent-perceived medical home (PPMH) status. We hypothesized that having a PPMH would be associated with receiving ADHD treatments recommended by clinical guidelines.

Methods:
We used the 2016 National Survey of Children's Health—a nationally representative cross-sectional survey of children in the United States. Analyses included an unweighted sample of 4,252, representing 5.4 million children aged 3 to 17 years with parent-reported ADHD. Child characteristics were analyzed using descriptive statistics. Associations between ADHD treatment types and PPMH status were assessed using a multinomial logistic regression, adjusting for child characteristics.

Results:
Having a PPMH was associated with increased prevalence odds of children's receipt of medications alone for ADHD (vs no treatment). The prevalence odds of receiving behavioral treatment alone (vs medications alone) for ADHD decreased by 43% when children had a PPMH (95% confidence interval, 0.38–0.85, p = 0.01). PPMH status was not associated with a statistically significant difference in prevalence odds of receiving combination treatment (vs medications alone) for pediatric ADHD.

Conclusion:
Having a PPMH was associated with children's receipt of ADHD medications alone, but not behavioral treatments. Our findings suggest that medical homes may need further improvement to ensure that children with ADHD receive treatments as recommended by clinical guidelines.