bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motor and Physical Function Impairments as Contributors to Slow Gait Speed and Mobility Difficulty in Middle-Aged and Older Adults
Authors: Cai Yurun , Tian Qu , Gross Alden L , Wang Hang , E Jian-Yu , Agrawal Yuri , Simonsick Eleanor M , Ferrucci Luigi , Schrack Jennifer A 
Published: January 2022

Abstract

Background
Motor function affects ability to perform daily activities and maintain independence. Yet, the interrelatedness of upper and lower extremity motor impairments and the magnitude of their contribution to slow gait and mobility difficulty are not well investigated.

Methods
Participants in the Baltimore Longitudinal Study of Aging (N = 728, aged 50–99) completed motor and physical function tests including grip and knee extension strength, pegboard, finger tapping, standing balance, chair stands, fast-paced 400-m walk, and usual gait speed. Slow gait was defined as usual gait speed &lt;1.0 m/s. Mobility difficulty was defined as self-reported difficulty walking ¼ mile or climbing stairs. Structural equation modeling examined the interrelationships of motor measures and their contributions to slow gait and mobility difficulty, adjusting for demographics and comorbidities.

Results
Poorer manual dexterity (−0.571 standard deviation [SD] units, p &lt; .001) and lower muscle strength (upper and lower extremity; −0.447 SD units, p = .014) were most strongly associated with slow gait speed, followed by slower chair stand pace (−0.195 SD units, p = .002) and greater lap time variation (0.102 SD units, p = .028). Lower muscle strength (−0.582 SD units, p = .001) was most strongly associated with mobility difficulty, followed by slower chair stand pace (−0.322 SD units, p &lt; .001), slower gait speed (−0.247 SD units, p &lt; .001), and poorer standing balance (−0.190 SD units, p = .043).

Conclusions
Components of manual dexterity and strength were the strongest correlates of slow gait and mobility difficulty in mid-to-late life. Longitudinal studies examining relationships between changes in these motor parameters and mobility are needed to elucidate possible causal effects.
Preliminary Evidence of Differential Expression of Myogenic and Stress Factors in Skeletal Muscle of Older Adults With Low Muscle Strength
Authors: Dalle Sebastiaan , Dupont Jolan , Dedeyne Lenore , Verschueren Sabine , Tournoy Jos , Gielen Evelien , Koppo Katrien 
Published: January 2022

Abstract
The age-related loss of muscle strength and mass, or sarcopenia, is a growing concern in the aging population. Yet, it is not fully understood which molecular mechanisms underlie sarcopenia. Therefore, the present study compared the protein expression profile, such as catabolic, oxidative, stress-related, and myogenic pathways, between older adults with preserved (8 ♀ and 5 ♂; 71.5 ± 2.6 years) and low muscle strength (6 ♀ and 5 ♂; 78.0 ± 5.0 years). Low muscle strength was defined as chair stand test time more than 15 seconds and/or handgrip strength less than 16 kg (women) or less than 27 kg (men) according to the EWGSOP2 criteria. Catabolic signaling (ie, FOXO1/3a, MuRF1, MAFbx, LC3b, Atg5, p62) was not differentially expressed between both groups, whereas the mitochondrial marker COX-IV, but not PGC1α and citrate synthase, was lower in the low muscle strength group. Stress factors CHOP and p-ERK1/2 were higher (~1.5-fold) in older adults with low muscle strength. Surprisingly, the inflammatory marker p-p65NF-κB was ~7-fold higher in older adults with preserved muscle strength. Finally, expression of myogenic factors (ie, Pax7, MyoD, desmin; ~2-fold) was higher in adults with low muscle strength. To conclude, whereas the increased stress factors might reflect the age-related deterioration of tissue homeostasis, for example, due to misfolded proteins (CHOP), upregulation of myogenic markers in the low strength group might be an attempt to compensate for the gradual loss in muscle quantity and quality. These data might provide valuable insights into the processes that underlie sarcopenia.
Gene expression in the amygdala and hippocampus of cyclic and acyclic gilts
Authors: Wijesena Hiruni R , Nonneman Dan J , Keel Brittney N , Lents Clay A 
Published: January 2022

Abstract
Age at first estrus is the earliest phenotypic indicator of future reproductive success of gilts. Prebreeding anestrus is a major reason for reproductive failure leading to culling of replacement gilts. The two types of prebreeding anestrus are delay in attaining puberty (prepubertal anestrus, PPA) and silent ovulation (behavioral anestrus, BA). Neural tissues such as amygdala and hippocampus play a major role in regulating sexual behavior, social interactions, and receptivity to males. Differences in gene expression in the amygdala and hippocampus of gilts were analyzed in three comparisons: 1) PPA cases and cyclic controls at follicular phase of estrous cycle, 2) BA cases and cyclic controls at luteal phase of estrous cycle, and 3) gilts at different stages of the ovarian cycle (cyclic gilts at follicular phase and luteal phase of estrous cycle) to gain functional understanding of how these rarely studied tissues may differ between pubertal phenotypes and different stages of the estrous cycle of gilts. Differentially expressed genes (DEG) between PPA and BA cases and their respective cyclic controls were involved in neurological and behavioral disorders as well as nervous system functions that could directly or indirectly involved in development of behaviors related to estrus. The comparison between cyclic follicular and luteal phase control gilts identified the greatest number of DEG in the hippocampus and amygdala. These DEG were involved in adult neurogenesis and neural synapse (e.g., GABAergic, dopamine, cholinergic), suggesting that these tissues undergo structural changes and synaptic plasticity in gilts. This is the first report to demonstrate that the stage of estrous cycle is associated with dynamic changes in gene expression within porcine hippocampus and amygdala and indicates a role of gonadal steroids in regulating their biology.
Competition law and pricing among biologic drugs: the case of VEGF therapy for retinal diseases
Authors: Van de Wiele Victor L , Hammer Maximilian , Parikh Ravi , Feldman William B , Sarpatwari Ameet , Kesselheim Aaron S 
Published: January 2022

Abstract
Neovascular age-related macular degeneration (AMD) is a progressive eye disease and is a leading cause of vision loss in the Western world. Vascular endothelial growth factor inhibitors have become a mainstay of treatment for this disease. Currently, treatment options include three originator biologics with approvals for neovascular AMD (aflibercept, ranibizumab, and brolucizumab-dbll) and one biologic that is commonly used off-label for the condition (bevacizumab). In the USA, Medicare spending on these drugs consistently surpassed $4 billion per year between 2015 and 2019, driven by high prices and varying off-label use of bevacizumab, which is substantially cheaper than the other biologics used to treat neovascular AMD. In this article, we discuss how legal reform can improve market competition for biologic drugs, using AMD therapies as a case study. We chose this group of drugs for their significant contribution to Medicare spending, the price difference between approved therapies and intravitreal bevacizumab, and because there currently exists a large biosimilar pipeline with many drug candidates in the final stage of development. We propose mechanisms for anticipating and facilitating the market introduction of biosimilars, as well as changes to the pricing model in Medicare that can promote use of cost-effective therapies. Reforms such as empowering Medicare to negotiate drug prices may help ensure that introduction of new biologics and biosimilars for AMD will lower spending and increase patient access.
Professional flows: Lateral moves of law firm partners in Hong Kong, 1994–2018
Authors: Liu Sida , Blocq Daniel , Honari Ali , Au Anson 
Published: January 2022

Abstract
This article uses the case of law firms in Hong Kong to develop a processual approach for understanding lateral mobility in professional service firms. Based on the analysis of 1,461 lateral moves of law firm partners reported in 300 monthly issues of the official journal of the Law Society of Hong Kong during 1994–2018, as well as archival data and interviews conducted in Hong Kong, the article offers both a bird’s-eye view of the lateral mobility of partners across law firms of different jurisdictional origins and an in-depth investigation of how elite law firms in this market, namely the Magic Circle and Wall Street firms, are influenced by the dynamics of professional flows. Theoretically, the article reconceptualizes professional service firms as organizations connected by and transform through the flows of professionals between them, a dynamic process characterized by three key concepts: waves, cycles, and turning points. In addition to its theoretical contribution, the study has broader implications for understanding Hong Kong’s economic transformation since the 1990s, particularly after Hong Kong’s handover to China in 1997 and the global financial crisis in 2008.
Coming of Age in Postwar Germany: Young Women’s Search for New Emotional Subjectivities, 1946–50
Authors: Sahrakorpi Tiia , Watton Cherish 
Published: January 2022

Abstract
During the Allied occupation of Germany, educators asked students to write about their feelings and experiences of youth before and after the Second World War. This article uses Abitur and Reifeprüfung examination essays written by young German women, between the ages of fourteen and twenty-three, to explore how they performed and represented their emotional subjectivities in early postwar Berlin. First, it examines how young women used selective strategies of forgetting and remembering to repress their troubling emotional memories of the regime. Second it explores how women achieved some level of psychic comfort, through a selective remembering of their home lives and Bund Deutsche Mädel experiences by developing different emotional coping mechanisms. The article argues that young women’s emotional renegotiation was not a passive process as previously thought, but rather based on young women’s active and astute reading of the postwar emotional climate. Subjecting these emotional subjectivities to greater attention elucidates a key, but hitherto underexplored, stage in these young people’s lives.
Numerical simulations of the random angular momentum in convection: Implications for supergiant collapse to form black holes
Authors: Antoni Andrea , Quataert Eliot 
Published: January 2022

ABSTRACT
During the core collapse of massive stars that do not undergo a canonical energetic explosion, some of the hydrogen envelope of a red supergiant (RSG) progenitor may infall on to the newborn black hole (BH). Within the athena++ framework, we perform 3D, hydrodynamical simulations of idealized models of supergiant convection and collapse in order to assess whether the infall of the convective envelope can give rise to rotationally supported material, even if the star has zero angular momentum overall. Our dimension-less, polytropic models are applicable to the optically thick hydrogen envelope of non-rotating RSGs and cover a factor of 20 in stellar radius. At all radii, the specific angular momentum due to random convective flows implies associated circularization radii of 10–1500 times the innermost stable circular orbit of the BH. During collapse, the angular momentum vector of the convective flows is approximately conserved and is slowly varying on the time-scale relevant to forming discs at small radii. Our results indicate that otherwise failed explosions of RSGs lead to the formation of rotationally supported flows that are capable of driving outflows to large radii and powering observable transients. When the BH is able to accrete most of the hydrogen envelope, the final BH spin parameter is ∼ 0.5, even though the star is non-rotating. For fractional accretion of the envelope, the spin parameter is generally lower and never exceeds 0.8. We discuss the implications of our results for transients produced by RSG collapse to a black hole.
Early-stage Triple-negative Breast Cancer: Time to Optimize Personalized Strategies
Authors: Abuhadra Nour , Stecklein Shane , Sharma Priyanka , Moulder Stacy 
Published: January 2022

Abstract
Triple-negative breast cancer (TNBC) accounts for approximately 15%-20% of breast cancers diagnosed worldwide, which amounts to almost 200 000 cases each year. Although historically TNBC is considered difficult to treat with a poor prognosis, there is emerging evidence showing excellent response rates in a subset of TNBC patients. Attempts to de-escalate chemotherapy in hormone-receptor-positive (HR+) and HER2-neu amplified breast cancer subtypes have been successful. At present, robust strategies to personalize therapy in early-stage TNBC do not exist, and despite excellent response rates in a subset of patients, all patients are exposed to the same several cycles of cytotoxic chemotherapy. Personalizing therapy in TNBC represents a challenge due to the scarcity of treatment options outside of cytotoxic chemotherapy and limited predictive and prognostic biomarkers to tailor treatment. Recent developments in understanding TNBC biology have sparked interest in exploring treatment optimization and personalization with the goal of achieving excellent response rates and long-term clinical outcomes, while simultaneously reducing physical, psychological, and financial toxicities for select patients. Here, we provide an update on the current evidence to support future studies examining de-escalating chemotherapy in patients with low-risk TNBC and adjuvant intensification strategies to improve outcomes for patients who are at high risk for systemic failure despite current standard-of-care treatments.
The Impact of Tobamovirus Infection on Root Development Involves Induction of Auxin Response Factor 10a in Tomato
Authors: Vaisman Michael , Hak Hagit , Arazi Tzahi , Spiegelman Ziv 
Published: January 2022

Abstract
Plant viruses cause systemic diseases that severely impair plant growth and development. While the accumulation of viruses in the root system has long been established, little is known as to how viruses affect root architecture. Here, we examined how the emerging tobamovirus, tomato brown rugose fruit virus (ToBRFV), alters root development in tomato. We found that ToBRFV and tobacco mosaic virus both invaded root systems during the first week of infection. ToBRFV infection of tomato plants resulted in a significant decrease in root biomass and elongation and root-to-shoot ratio and a marked suppression of root branching. Mutation in RNA-dependent RNA polymerase 6 increased the susceptibility of tomato plants to ToBRFV, resulting in severe reduction of various root growth parameters including root branching. Viral root symptoms were associated with the accumulation of auxin response factor 10a (SlARF10a) transcript, a homolog of Arabidopsis ARF10, a known suppressor of lateral root development. Interestingly, loss-of-function mutation in SlARF10a moderated the effect of ToBRFV on root branching. In contrast, downregulation of sly-miR160a, which targets SlARF10a, was associated with constitutive suppression root branching independent of viral infection. In addition, overexpression of a microRNA-insensitive mutant of SlARF10a mimicked the effect of ToBRFV on root development, suggesting a specific role for SlARF10a in ToBRFV-mediated suppression of root branching. Taken together, our results provide new insights into the impact of tobamoviruses on root development and the role of ARF10a in the suppression of root branching in tomato.
Parkinson’s Disease Medication Administration During a Care Transition: The Impact of Interprofessional Team Simulation on Student Competency, Comfort, and Knowledge
Authors: Ellis Diane M. , Hickey Shelley , Prieto Patricia , McLaughlin Carlene , Felgoise Stephanie H. , Becker Michael , O’Connor Melissa , Puleo Madison , Reddy Tara , Markey Danielle , Kim Lydia , Bernhardt Paul W. 
Published: January 2022

Abstract

AIM
This study investigated the impact of an interprofessional mock code on students’ comfort and competency related to Parkinson’s disease (PD) medication administration during care transitions.

BACKGROUD
Patients with PD are at increased risk for medication errors during hospitalization. Individualization of PD medication creates vulnerability during care transitions.

METHOD
Four interprofessional groups took part in this study: baccalaureate degree senior nursing students (n = 113), master’s level nurse anesthesia students (n = 35), doctor of osteopathic medicine fourth-year students (n = 32), and doctor of clinical psychology fourth-year students (n = 22). Groups participated in an unfolding case study simulation involving a mock code with a focus on the omission of time-sensitive PD medication. Pre- and postsimulation test results were compared.

RESULTS
Findings indicated an increased understanding among three of the four groups relating to medication timing during care transitions.

CONCLUSION
All groups improved with respect to perceived comfort and competency.
A Pilot Randomized Controlled Trial of Virtual Reality Distraction to Reduce Procedural Pain During Subcutaneous Port Access in Children and Adolescents With Cancer
Authors: Hundert Amos S. , Birnie Kathryn A. , Abla Oussama , Positano Karyn , Cassiani Celia , Lloyd Sarah , Tiessen Petra Hroch , Lalloo Chitra , Jibb Lindsay A. , Stinson Jennifer 
Published: January 2022

Objectives:
We aimed to determine the feasibility of virtual reality (VR) distraction for children with cancer undergoing subcutaneous port (SCP) access. We also aimed to estimate preliminary treatment effects of VR compared with an active distraction control (iPad).

Materials and Methods:
A single-site pilot randomized controlled trial comparing VR to iPad distraction was conducted. Eligible children and adolescents were aged 8 to 18 years undergoing treatment for cancer with upcoming SCP needle insertions. Intervention acceptability was evaluated by child, parent, and nurse self-report. Preliminary effectiveness outcomes included child-reported pain intensity, distress, and fear. Preliminary effectiveness was determined using logistic regression models with outcomes compared between groups using preprocedure scores as covariates.

Results:
Twenty participants (mean age 12 y) were randomized to each group. The most common diagnosis was acute lymphocytic leukemia (n=23, 58%). Most eligible children and adolescents (62%) participated, and 1 withdrew after randomization to the iPad group. Nurses, parents, and children reported the interventions in both groups to be acceptable, with the VR participants reporting significantly higher immersion in the distraction environment (P=0.0318). Although not statistically significant, more VR group participants indicated no pain (65% vs. 45%) and no distress (80% vs. 47%) during the procedure compared with the iPad group. Fear was similar across groups, with ~60% of the sample indicating no fear.

Discussion:
VR was feasible and acceptable to implement as an intervention during SCP access. Preliminary effectiveness results indicate that VR may reduce distress and distress compared with iPad distraction. These data will inform design of a future full-scale randomized controlled trial.
Declining trends in Medicare physician reimbursements for surgical procedures in orthopaedic oncology from 2002 to 2018: a retrospective review of payment data
Authors: Malik Azeem Tariq , Alexander John H. , Voskuil Ryan T. , Khan Safdar N. , Scharschmidt Thomas J. 
Published: January 2022

Background:
As the United States (US) healthcare system evolves towards cost-containment and value-based approaches, evaluating trends in procedure reimbursements will be critical for assessing and ensuring financial stability of highly specialized fields, such as orthopaedic oncology.

Methods:
The Medicare Physician Fee Schedule (MPFS) look-up tool was accessed through the official Center for Medicaid and Medicare Services website and used to retrieve average reimbursement rates for 28 common orthopaedic oncologic procedures (radical resections of soft tumors, bone tumors, and prophylactic treatment, nailing, or pinning) from 2002 to 2018. All reimbursement data were adjusted for inflation to 2018 dollars. For each Current Procedural Terminology (CPT) code, average reimbursement percentage change from 2002 to 2018 was calculated.

Results:
Based on the included codes, physician payment data for 28 surgical procedures from 2002 to 2018 were retrieved from the MPFS database. After adjusting all data for inflation, the average reimbursement for all included procedures decreased by 9.9% from 2002 to 2018, representing an estimated average decrease of 1.1% every couple of years. Reimbursement percentage decreases were the most significant prior to the Medicare Access and CHIP Reauthorization Act (MACRA), with reimbursements decreasing by an average of 5.8% from 2002 to 2014. However, reimbursement rates still declined by an average of 4.3% from 2014 to 2018 (after MACRA).

Discussion:
Reimbursements for orthopaedic oncologic procedures have steadily decreased over time. With orthopaedic oncology being a highly specialized field with few practicing providers, health policy makers need to understand the financial implications of the declining reimbursement rates to ensure financial stability and viability of the specialty.

Level of Evidence:
Level III.