bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early employment after childbirth: a cross-sectional analysis using data from a national maternity survey in England
Authors: Wyatt Rose , Fellmeth Gracia , Quigley Maria A , Alderdice Fiona , Harrison Sian 
Published: December 2024

Abstract

Background
Participation in paid work after childbirth may have important health and socioeconomic impacts on women and their families. We investigated women's employment patterns at six months postpartum and the factors that influence them.

Methods
Using data from a 2018 population-based national maternity survey in England, employment status at six months postpartum was assessed. Logistic regression was used to explore sociodemographic and pregnancy- and birth-related factors associated with being in paid work by six months postpartum. Descriptive analysis was used to explore employment characteristics and motivations of women in paid work.

Results
Of the 4313 participants included, 7.7% were in paid work by six months postpartum. Factors associated with being in paid work were age ≥35 years [(adjusted odd ratios (aOR):1.37, 95% confidence interval (CI):1.02–1.84], not living with a partner (aOR:0.50, 95%CI:0.28–0.90), and pre-term birth (aOR:0.38, 95%CI:0.20–0.69). The most frequently reported motivation was financial need (76%), followed by wanting to work (41%). Financial need was associated with younger age, living in a more socioeconomically disadvantaged area, not living with a partner, and lower education level.

Conclusion
Postpartum employment patterns and motivations for working vary according to sociodemographic characteristics. These findings have important implications for parental leave and childcare policies, which should be equitable across different groups.
Local conditions have greater influence than provenance on sugar maple (Acer saccharum Marsh.) frost hardiness at its northern range limit
Authors: Mura Claudio , Charrier Guillaume , Buttò Valentina , Delagrange Sylvain , Surget-Groba Yann , Raymond Patricia , Rossi Sergio , Deslauriers Annie 
Published: December 2024

Abstract
In temperate and boreal ecosystems, trees undergo dormancy to avoid cold temperatures during the unfavorable season. This phase includes changes in frost hardiness, which is minimal during the growing season and reaches its maximum in winter. Quantifying frost hardiness is important to assess the frost risk and shifts of species distribution under a changing climate. We investigate the effect of local conditions and intra-specific variation on frost hardiness in sugar maple (Acer saccharum Marsh.). Seedlings belonging to seven provenances from the northern area of the species’ range were planted at two sites in Quebec, Canada. LT50, i.e. the lethal temperature for 50% of the cells, was measured monthly with the relative electrolyte leakage method on branches and buds from September 2021 to July 2022. LT50 varied between −4 °C in summer (July) and −68 °C in winter (February). Autumnal acclimation rates (September to early December) and mid-winter frost hardiness (December to early March) were similar in both sites. Samples in the southern site deacclimated faster than in the northern site between March and July because of a warmer and earlier spring. No difference in frost hardiness was detected between provenances. Our results suggest that the frost hardiness trait is similar within the northern part of the sugar maple distribution, with local weather conditions having a greater influence than provenance. We demonstrate that LT50 in sugar maple can exceed −55 °C, far below the minimum temperatures occurring in winter at the northern limit of the species. In order to minimize the risk of damage from extreme frost events exceeding tree frost hardiness, a careful evaluation of site characteristics is more important than provenance selection. Other factors should also be considered within the context of changing climate, in particular, the phenology of maple and avoidance of late frost in spring.
Effects of Age on the Bone-Conduction Amplitude-Modulated cVEMP Temporal Modulation Transfer Function
Authors: Jha Raghav H. , Piker Erin G. , Clinard Christopher G. 
Published: December 2024

Objectives:
Cervical vestibular evoked myogenic potentials (cVEMPs) reflect saccular stimulation that results in an inhibitory muscle reflex recorded over the sternocleidomastoid muscle. These responses are utilized to study basic vestibular functions and are also applied clinically. Traditionally, cVEMPs have utilized transient stimuli such as clicks and tonebursts to evoke onset responses. Recently, amplitude-modulated tones have been used to elicit cVEMPs (AMcVEMPs). These AMcVEMP responses can provide information about the magnitude, phase synchrony, and nonlinearities from the vestibulo-collic reflexes that cannot be captured using other existing testing techniques. Although temporal modulation transfer functions (TMTFs) of AMcVEMPs for young, healthy adults have been established using different analysis techniques, there is currently no information regarding the effects of age on these responses. Thus, the current study aimed to examine the effects of age on AMcVEMPs across a broad range of modulation frequencies (MFs) using various AMcVEMP metrics including amplitude, signal to noise ratio (SNR), and phase coherence (PC).

Design:
The study included 16 (aged 20 to 39 years) young, 17 (aged 40 to 59 years) mid-age, and 16 (60 to 75 years) older adults with no history of neurological, vestibular, or middle-ear complaints. The stimuli consisted of amplitude-modulated tones with a carrier frequency of 500 Hz and 10 MFs ranging from 11 to 397 Hz. These stimuli were presented using a B81 transducer at 123 dB FL. AMcVEMPs were recorded from the sternocleidomastoid muscle (ipsilateral to the stimulating mastoid) using surface electrodes. Response analysis was performed using an FFT-based approach with analyses including amplitude, SNR, and PC.

Results:
AMcVEMP waveforms exhibited periodicity corresponding to the stimulus MF, consistent with previous observations. Furthermore, significant age-related degradation in AMcVEMP amplitude, SNR, and PC measures were observed across a broad range of MFs. While AMcVEMPs were elicited across a wide range of MFs (11 to 263 Hz) for young adults, in mid-age and older adults, these metrics were robust only across a narrower range of MFs, resulting in a reduced TMTF. In addition, the MF eliciting the most robust AMcVEMP varied across different AMcVEMP analysis metrics and age groups.

Conclusions:
A significant decline in the AMcVEMP response is seen as an effect of aging; however, the effect of aging is not uniform across measures or across MFs. The TMTF of AMcVEMP gets flatter, and the overall range is reduced as an effect of aging. Results from this study enhance our understanding of age-related changes in the vestibular system. Expansion of AMcVEMP to clinical populations may lead to a deeper understanding of the pathophysiology of vestibular disorders.
Higher Versus Lower Protein Delivery in Critically Ill Patients: A Systematic Review and Bayesian Meta-Analysis
Authors: Heuts Samuel , Lee Zheng-Yii , Lew Charles Chin Han , Bels Julia L. M. , Gabrio Andrea , Kawczynski Michal J. , Heyland Daren K. , Summers Matthew J. , Deane Adam M. , Mesotten Dieter , Chapple Lee-anne S. , Stoppe Christian , van de Poll Marcel C. G. 
Published: December 2024

Objectives:
Recent multicenter trials suggest that higher protein delivery may result in worse outcomes in critically ill patients, but uncertainty remains. An updated Bayesian meta-analysis of recent evidence was conducted to estimate the probabilities of beneficial and harmful treatment effects.

Data Sources:
An updated systematic search was performed in three databases until September 4, 2024. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and the protocol was preregistered in PROSPERO (CRD42024546387).

Study Selection:
Randomized controlled trials that studied adult critically ill patients comparing protein doses delivered enterally and/or parenterally with similar energy delivery between groups were included.

Data Extraction:
Data extraction was performed by two authors independently, using a predefined worksheet. The primary outcome was mortality. Posterior probabilities of any benefit (relative risk [RR] < 1.00) or harm (RR > 1.00) and other important beneficial and harmful effect size thresholds were estimated. Risk of bias assessment was performed using the risk of bias 2.0 tool. All analyses were performed using a Bayesian hierarchical random-effects models, under vague priors.

Data Synthesis:
Twenty-two randomized trials (n = 4164 patients) were included. The mean protein delivery in the higher and lower protein groups was 1.5 ± 0.6 vs. 0.9 ± 0.4 g/kg/d. The median RR for mortality was 1.01 (95% credible interval, 0.84–1.16). The posterior probability of any mortality benefit from higher protein delivery was 43.6%, while the probability of any harm was 56.4%. The probabilities of a 1% (RR < 0.99) and 5% (RR < 0.95) mortality reduction by higher protein delivery were 38.7% and 22.9%, respectively. Conversely, the probabilities of a 1% (RR > 1.01) and 5% (RR > 1.05) mortality increase were 51.5% and 32.4%, respectively.

Conclusions:
There is a considerable probability of an increased mortality risk with higher protein delivery in critically ill patients, although a clinically beneficial effect cannot be completely eliminated based on the current data.
Prevalence and impact of vasomotor symptoms due to menopause among women in Canada: A subgroup analysis from an international cross-sectional survey of Women with Vasomotor Symptoms Associated with Menopause (WARM Study)
Authors: Yuksel Nese , Todorova Lora , Scrine Ludmila , Rea Carol , Bouchard Céline 
Published: December 2024

Abstract

Objective
The aim of the study was to assess the prevalence of postmenopausal vasomotor symptoms (VMS) and the impact of VMS and related treatment patterns among perimenopausal and postmenopausal Canadian women.

Methods
A subgroup analysis of data from a cross-sectional online survey of women aged 40-65 years conducted November 4, 2021, through January 17, 2022, evaluated the prevalence of moderate/severe VMS among postmenopausal Canadian women. The analysis also assessed survey responses from perimenopausal and postmenopausal Canadian women with moderate/severe VMS who completed the Menopause-Specific Quality of Life questionnaire, Work Productivity and Activity Impairment questionnaire, and the Patient-Reported Outcomes Measurement Information System Sleep Disturbances-Short Form 8b and answered questions about treatment patterns and attitudes toward treatments.

Results
Of 2,456 Canadian postmenopausal women, 360 (14.7%; primary analysis) reported moderate/severe VMS in the previous month. Perimenopausal and postmenopausal women with moderate/severe VMS (n = 400; secondary analysis) reported negative impact on overall quality of life (mean total Menopause-Specific Quality of Life questionnaire score: 4.3/8). VMS impaired overall work and daily activities by 30.2% and 35.7%, respectively. Overall mean (SD) Patient-Reported Outcomes Measurement Information System Sleep Disturbance-Short Form 8b score (scale 8-40) was 28.5 (6.9), confirming sleep disturbances in this population. The majority of women (88% of the total cohort) sought advice, but about half were never treated. Most women had positive or neutral attitudes toward menopause.

Conclusions
In a survey conducted in Canada, moderate/severe VMS were reported by 14.7% of postmenopausal women and were associated with impairment in quality of life, work productivity, daily activities, and sleep in perimenopausal and postmenopausal women.
A cultural adaptation and testing on the reliability and validity of the Chinese version of the Menopause Symptom Assessment Scale
Authors: Hou Jie , Wang Diya , Su Jing 
Published: December 2024

Abstract

Objective
The aim of this study was to modify the Chinese version of the Menopause Symptom Assessment Scale (MSAS) and evaluate its validity and reliability.

Methods
An expert panel from the gynecology and nursing domain determined items that should remain or be revised, and 30 participants were selected for the pilot study. A total of 255 women who met the criteria for inclusion were enrolled in the investigation. SPSS 25.0 and AMOS 25.0 were used to analyze data. The internal and external reliability of the scale was evaluated using Cronbach's α coefficient, split-half reliability, and test-retest reliability, respectively. Expert review, exploratory factor analysis, and confirmatory factor analysis were used to evaluate the scale's validity, which encompasses both its content validity and structural validity.

Results
The Chinese version of the MSAS contains 43 items with 5 dimensions, including sexual function, psychological status, interpersonal anxiety, autonomic balance, and other subjective symptoms. The correlation coefficient (r value) between individual items and the total scale ranged from 0.49 to 0.67 (P < 0.05); the Item-Content Validity Index range from 0.80 to 1.00, and Scale-Content Validity Index was 0.91; the Cronbach's α coefficient was 0.85, and the test-retest reliability was 0.93; exploratory factor analysis revealed a cumulative variance contribution of 76.98%; the fitting index of the scale structure model was good.

Conclusions
The updated Chinese version of the MSAS presented good reliability and validity and could be applied in assessing menopausal symptoms in Chinese women.
Comparison between virtual reality and traditional lecture methods in educating respiratory therapy students on pediatric difficult airway diseases
Authors: Hsu Wen-Jing , Tang Yi-Hsuan , Chen Wei-Chih , Lee Yu-Sheng , Tsao Pei-Chen , Chen Wei-Yu , Yang Ying-Ying , Ko Hsin-Kuo , Pan Sheng-Wei , Ting Yu-Fen , Yang Shih-Hsing , Jeng Mei-Jy 
Published: December 2024

Background:
Pediatric airway diseases are associated with complex challenges because of smaller and more dynamic airway structures in children. These conditions, along with specialized management by medical care staff, should be immediately and precisely recognized to prevent life-threatening obstructions and long-term respiratory complications. Recently, virtual reality (VR) has emerged as an innovative approach to clinical medical education. To evaluate and compare the effectiveness of VR-based education and traditional lectures in enhancing knowledge retention, clinical reasoning, and motivation among senior respiratory therapy students.

Methods:
This experimental research was conducted between November 2020 and September 2022, involving 54 students from a School of Respiratory Therapy, with 43 completing a pre-test and undergoing random assignment into either a VR or a traditional education (non-VR) group. Samsung Gear VR Oculus headsets were used by the VR group for instructions on conditions such as laryngeal malacia, subglottic stenosis, and tracheomalacia. Theoretical exams, objective structured clinical examinations (OSCE), and instructional material motivation survey (IMMS) were used to evaluate participants’ knowledge retention, clinical reasoning, and application capabilities, followed by statistical analysis comparing both study groups.

Results:
No significant differences in pre-test scores were observed between the two groups. However, the VR group outperformed the non-VR group in OSCE scores significantly (p = 0.003) and demonstrated greater learning motivation and satisfaction based on IMMS scores. No notable difference in immediate post-education theoretical examination scores was observed between the groups.

Conclusion:
VR-based education markedly improved the clinical reasoning and application skills of respiratory therapy students over traditional lecture methods. VR learning also increased students’ motivation and satisfaction, indicating a more immersive and effective educational experience. These findings reveal that VR may be best utilized as a supplemental educational tool in clinical training programs. Future studies with larger samples and longer follow-up are warranted to further explore the optimal integration of VR in education.
Iron deficiency promotes intra-leaflet hemorrhage-induced aortic valve calcification: an experimental study
Authors: Liu Huiruo , Yang Zeyu , Sun Hourong , Wang Zerui , Xu Feng , Chen Yuguo , Li Chuanbao 
Published: December 2024

Background:
Intra-leaflet hemorrhage (IH) plays a well-recognized detrimental role in calcified aortic valve disease (CAVD). However, IH-induced fibro-osteogenic responses in valvular interstitial cells (VICs) appear to be triggered under specific pathological conditions. Iron deficiency (ID), a common co-morbidity in CAVD, may influence these responses. This study investigated the relationship between ID and pathological changes associated with CAVD, and its effects on IH-mediated fibro-osteogenic differentiation of VICs.

Methods and results:
Two independent studies were conducted, including 2495 patients in the discovery study and 34 in the validation study. Our data demonstrated that ID was associated with CAVD severity and progression, particularly in an age-dependent manner. Based on these clinical findings, immunofluorescence and Western blot analyses revealed that TFR1, a key iron import transporter, was significantly upregulated in human calcified aortic valves. Concurrently, iron accumulation was detected by Perl’s staining in both calcific and non-calcific valve sections. In vitro, VICs cultured with human serum from ID patients showed red blood cell lysis-induced iron overload and fibro-calcific differentiation.

Conclusions:
ID triggers TFR1-mediated intracellular iron overload, leading to fibrosis and calcification in human VICs, thereby contributing to IH-mediated valve remodeling and calcification. These findings supported the potential role of monitoring and correcting ID to slow or prevent the progression of valvular calcification.
A bibliotherapy intervention to improve emotional wellbeing during cancer treatment: a pilot study
Authors: Wells Elizabeth , Gunn Kate , Velasquez Diane , Kaeding Jo , Hutchinson Amanda 
Published: December 2024

Abstract

Background:
Bibliotherapy, or reading for therapy, has been shown to help with a variety of mental health conditions, yet reading can be difficult for those undergoing treatment due to cancer-related cognitive impairment (CRCI). Listening is likely to be easier than reading when experiencing CRCI and fatigue. Currently, no studies examine the potential impact of read-aloud programs on the emotional wellbeing of people undergoing cancer treatment.

Methods:
To explore a way to introduce or reinstate reading and the benefits it can bring, a new bibliotherapy model was developed and delivered to 38 people who were undergoing or had recently completed treatment. Most participants (97%) were older than 45 years, 34% were palliative, and 13% had incurable but treatable cancer, while 95% self-reported symptoms of CRCI. The bibliotherapy model was personalized in its approach to book selection and delivery (one-on-one in-person or via Zoom). Using a pragmatic, mixed-methods framework, participant wellbeing was measured preintervention to postintervention and qualitative interviews were conducted to explore psychosocial effects from participants' (n = 35) and family members' (n = 17) perspectives and were analyzed using reflexive thematic analysis.

Results:
Stress, anxiety, and depression decreased (as measured by DASS-21, P = .004, P = .000 and P = .015, respectively), and wellbeing increased (as measured by Warwick-Edinburgh Mental Wellbeing Scale [WEMWBS], P = .001) preintervention to postintervention. Qualitative analyses highlighted the aspects of the program participants valued: relaxation, mood lift, increased self-efficacy, time out, and feelings of warmth/nurturing. Distraction/escapism was viewed by participants as having benefits to their mood, pain, and nausea. Human interaction was also highly valued: the sense of connection with the reader was important. Family members expressed feelings of comfort and respite.

Conclusions:
Findings suggest a tailored bibliotherapy program may be associated with increases in the emotional wellbeing of people undergoing or recently completed cancer treatment, and comfort and respite for their family members. While further research using a randomized controlled trial design is needed, these findings suggest this model is eminently suitable as an offering in integrative cancer centers and palliative settings, with no negative unintended consequences being observed.
A Case of NTRK Fusion Corpus Sarcoma With Pseudobiphasic Growth Pattern and Literature Review
Authors: Zhang Xiao-Ying , Jiang Han-Wen , Wen Xiao-Bo , Yu Qian , Li Ying , Wang Hao , Han Jing , Yang Shi-Cong 
Published: December 2024

The incidence of neurotrophic tyrosine kinase receptor (NTRK) fusion uterine sarcoma is extremely low, and reports have been mostly focused on cases localized to the cervix. So far, only 4 cases have been reported of the uterine corpus. In this study, we reported a case of NTRK fusion corpus sarcoma. This study aimed to expand the morphologic spectrum of this tumor, which showed adenosarcoma-like features not previously described. The tumor was confined to the uterine corpus, polypoid growth, comprised predominantly of a fascicular proliferation of spindle cells, entrapping benign endometrial glands, and exhibited a pseudo-biphasic growth pattern. The tumor showed coexpression of S-100, CD34, and pan-Trk by immunohistochemistry, DNA-sequencing identified TPR-NTRK1 gene fusion and AKT1(E17K) mutation. Four cases of NTRK fusion corpus sarcoma were reviewed. The clinicopathologic features, immunohistochemical phenotype, molecular testing, and prognosis of 5 cases including this one were summarized and analyzed. Most cases exhibited an infiltrative g	rowth pattern and showed mild or moderate cytologic atypia. The potential for these tumors to be misclassified as uterine adenosarcoma or other uterine mesenchymal tumors. The diagnosis relies on pan-Trk, S-100, CD34 immunohistochemistry, and molecular testing. Surgical resection is the mainstay of treatment for most patients. Distinguishing these tumors from morphologic mimics is significant because patients with advanced-stage disease may be treated with TRK inhibitors.