bluuebunny/crossref_metadata_2025_split huggingface dataset:
“We Are Here”: Race, Gender, and Spaces of “Common Ground” in the Works of John Edgar Wideman, bell hooks, and Jesmyn Ward
Authors: Wendland-Liu Joel 
Published: September 2021

AbstractBlack-authored self-writing serves as a tool of cultural self-determination and anticipates the concept of “placemaking.” Scholars regard “placemaking” as a process by which people of color struggle to transform space into place, to alter racially segregated spaces into sites of joy, freedom, and political mobilization. This essay evaluates these claims through an exploration of spatial themes in three memoirs: John Edgar Wideman–s Fatheralong (1994), bell hooks’s Where We Stand (2000), and Jesmyn Ward’s Men We Reaped (2013). The contemporary constructions of black place in these narratives destabilize ideological impressions of linear racial progress, individualism, dominant narratives of “colorblind” white supremacy, and neoliberal political economy. These texts record a process by which black people create a self-determined space of “common ground” despite white supremacist, capitalist dominance.
Topological gapless points in superconductors: From the viewpoint of symmetry
Authors: Sumita Shuntaro , Yanase Youichi 
Published: September 2021

Abstract
Searching for topological insulators/superconductors is a central subject in recent condensed matter physics. As a theoretical aspect, various classification methods of symmetry-protected topological phases have been developed, where the topology of a gapped Hamiltonian is investigated from the viewpoint of its onsite/crystal symmetry. On the other hand, topological physics also appears in semimetals, whose gapless points can be characterized by topological invariants. Stimulated by this background, we shed light on the topology of nodal superconductors. In this paper, we review our modern topological classification theory of superconducting gap nodes in terms of symmetry. The classification method elucidates nontrivial gap structures arising from nonsymmorphic symmetry or angular momentum, which cannot be predicted by a conventional theory.
Mortality in Cardiogenic Shock Patients Is Predicted by Pao 2/Fio 2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation
Authors: Scherer Clemens , Lüsebrink Enzo , Joskowiak Dominik , Feuchtgruber Vanessa , Petzold Tobias , Hausleiter Jörg , Peterss Sven , Massberg Steffen , Hagl Christian , Orban Martin 
Published: September 2021

OBJECTIVES:
Venoarterial extracorporeal membrane oxygenation treatment in patients with severe cardiogenic shock can cause or aggravate acute lung injury. In our retrospective analysis, we aimed at identifying markers for acute lung injury after arrival on ICU, which predict mortality of those patients.

DESIGN:
Observational, monocentric, retrospective analysis.

SETTING:
Cardiac ICU of Ludwig Maximilian University Hospital, Munich, Germany.

PATIENTS:
Two-hundred eleven patients undergoing venoarterial extracorporeal membrane oxygenation treatment for severe cardiogenic shock were included into this analysis. Patients who died within 24 hours after venoarterial extracorporeal membrane oxygenation implantation were excluded.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
To determine lung injury, we investigated the influence of Pao2/Fio2 ratio (Horowitz index). The lowest Horowitz index was measured on ICU 6–12 hours after venoarterial extracorporeal membrane oxygenation implantation. An optimal cutoff value of less than 126 for Horowitz index to predict mortality was identified via receiver operating characteristic analysis (area under the curve, 0.62). Patients with Horowitz index less than 126 had a 30-day mortality rate of 67.5% compared to 37.5% with a Horowitz index greater than or equal to 126 (p < 0.001). Multivariate analysis identified Horowitz index less than 126 as an independent risk factor of ICU mortality (odds ratio, 3.6; 95% CI, 1.8–7.3; p < 0.001).

CONCLUSIONS:
In this hypothesis-generating analysis, a Horowitz index less than 126 is associated with increased mortality in patients with cardiogenic shock and venoarterial extracorporeal membrane oxygenation, which may serve as a threshold for further therapeutic interventions.
Impact of Disclosure over Time on the Emotional Well-Being of Children with Perinatally Acquired HIV Infection in South Africa
Authors: Buckley Janice , Otwombe Kennedy , Joyce Celeste , Leshabane Given , Galvin Lisa , Ramsammy Candice , Lebotsa Moshoko Emily , Liberty Afaaf , Violari Avy 
Published: September 2021

ABSTRACT:

Objective:
The aim of this study was to describe the disclosure process in children with perinatally acquired HIV infection (PHIV+) and its impact on their emotional well-being and adherence to antiretroviral therapy (ART) in South Africa.

Methods:
This prospective cohort study followed PHIV+ children aged 7 to 13 years attending counseling over 18 months. Standardized disclosure tools were used by a counselor with both child and caregiver present. Assessments included the Child Behavior Checklist (CBCL), Vineland Adaptive Behavior Scale (VABS), Child Depression Inventory (CDI), and Revised Children's Manifest Anxiety Scale (RCMAS). Adherence to ART was recorded through pharmacy pill returns. Changes over time and their differences from baseline were assessed by linear mixed models.

Results:
Thirty children with median age 10 years (interquartile range [IQR]: 9.0–11.0) were enrolled. The median time to disclosure was 48 weeks (IQR: 48.0–54.6). There was a significant decrease from baseline (p < 0.0001) and over time (p = 0.0037) in the total CDI score. A positive trend in the changes from baseline and over time was observed for internalizing (p values < 0.0001) and externalizing (p values < 0.0001) CBCL scales and Total Anxiety score of the RCMAS (p < 0.0001 and p < 0.0002, respectively). Only the Defensiveness median T-score increased during the follow-up (p = 0.004) and in the change from baseline (p = 0.0005). The adaptive (p = 0.0092) and maladaptive (p < 0.0001) scores of the VABS showed a decrease from baseline. ART adherence remained high throughout this study.

Conclusion:
Disclosure does not worsen the child's emotional well-being and adherence to ART over time. This study adds to research from low- and middle-income countries to alleviate fears that disclosure may have an adverse outcome on children with PHIV+.
Pregnancy After Concussion: A Clarion Call for Attention?
Authors: Anto-Ocrah Martina , Cafferky Virginia , Lewis Vivian 
Published: September 2021

Objective:
Emerging research shows that women who sustain a mild traumatic brain injury, also termed concussion, have a higher risk of menstrual irregularities and sexual dysfunctions. However, no research exists on how these reproductive disruptions affect women's subsequent pregnancies. The objective of this study was to evaluate pregnancy outcomes after concussion in a cohort of reproductive-aged women (aged 18-45 years), 24 months post-injury. We hypothesized that, compared with their extremity-injured peers in the same cohort, women with concussion will have lower incidence of pregnancies.

Setting:
Emergency department of a level 1 trauma center.

Participants:
Women of reproductive age (aged 18-45 years) seeking care for concussion or extremity injury.

Design:
Longitudinal cohort study that used data collected at 3 distinct time points: t0, baseline: an original cohort of 245 women recruited in January to July 2017 for exposure assessment; t1, 6(+4) weeks post-injury: evaluation of self-reported postinjury menstrual and sexual changes for subgroup analyses—data collected in March to September 2017 (n = 135); t2, 24 months post-injury: March 2020 chart review for documentation of pregnancies/pregnancy-related events (N = 245).

Main Measure:
Poisson regression estimates used to model the incidence rate (IR) of pregnancies, comparing concussion with extremity injury.

Results:
We reviewed the charts of 254 women from the t0 cohort. After excluding 9 patients who were either deceased or missing relevant data, we had the 245 (96.5%) charts of 102 concussed and 143 extremity-injured study participants. After adjusting for race and obstetric history, women with concussion had 80% lower incidence of pregnancies than their extremity-injured peers (adjusted [adj] IR = 0.20; 95% CI: 0.07-0.59; P = .003). When we excluded women who were using birth control, the IR of pregnancy for women with concussions was 76% lower than for those who had sustained extremity injuries (adj IR = 0.24; 95% CI: 0.07-0.81; P = .02). Pregnancy incidence remained consistently lower for concussed women in additional sensitivity analyses excluding assault/domestic violence victims and those with a prior/new concussion at t0 and t2. Subgroup analyses of the 135 women who had experienced menstrual and/or sexual dysfunctions at t1 showed 84% reduced incidence of pregnancy for women with concussions compared with those who had sustained an extremity injury (adj IR = 0.16; 95% CI: 0.04-0.73; P = .02).

Conclusion and Relevance:
Our study potentially serves as a clarion call to understand the long-term reproductive effects of female concussions.
Associations Between Sleep Quality and 10-Year Cardiovascular Disease Risk Among Female Nurses in Hong Kong
Authors: Yan Lin Jia , Xie Yao Jie 
Published: September 2021

Background
Sleep problems are common among nurses compared with the general population. Poor sleep quality increases the risk of developing cardiovascular disease (CVD). The relationship between sleep quality and CVD risk has not been previously investigated among Hong Kong female nurses.

Objective
The authors of this study explored the association between sleep quality and CVD risk among Hong Kong female nurses.

Methods
Data were collected from the Hong Kong Women's Health Study cross-sectional survey between 2019 and 2020. Questionnaires were sent to female nurses (≥aged 30 years). Ten-year CVD risk was measured using the Framingham 10-year risk score, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Relationships were evaluated using adjusted multiple linear regression and binary logistic regression.

Results
In 1344 respondents, the mean age was 46.12 ± 10.47 years, average PSQI score was 6.02 (3.35), and 52.4% reported poor sleeping quality (global PSQI score > 5). The mean 10-year CVD risk was 3.6% (3.3%). The 10-year CVD risk was significantly associated with sleep disturbance (β = 0.006) and daytime dysfunction (β = −0.002) (both Ps < .01). Participants who reported sleep disturbance had a higher CVD risk (odds ratio, 1.82; 95% confidence interval, 1.04–3.18). High daytime dysfunction decreased CVD risk (odds ratio, 0.63; 95% confidence interval, 0.46–0.85). Subgroup analysis showed stronger associations between sleep quality and Framingham 10-year risk score among those unemployed, undergoing postmenopause, or with a family history of CVDs.

Conclusions
Sleep disturbance and daytime dysfunction were associated with the 10-year CVD risk among Hong Kong female nurses. Nurses who were unemployed, were undergoing postmenopause, or with a family history of CVD were those with the highest risk.
Personality Traits, Media Exposure, and Deterioration of Psychological Wellbeing in Japan During the COVID-19 Pandemic
Authors: Yamauchi Takashi , Suka Machi , Yanagisawa Hiroyuki 
Published: September 2021

Abstract
This study examined the associations among personality traits, media exposure regarding COVID-19, and deterioration of mental wellbeing among the public in Japan. We conducted a cross-sectional Web-based questionnaire survey among 8000 Japanese men and women aged 25 to 64 years. Approximately half of participants reported deterioration of mental wellbeing. Nearly 20% of participants reported “constant/excessive” exposure to media information regarding COVID-19. As compared with those with low “extraversion” and “less frequent” exposure to media information about COVID-19, those with high “extraversion” and “more frequent” media exposure reported significantly less deterioration of mental wellbeing. In addition, as compared with those with low “neuroticism” and media exposure, those with high “neuroticism” and “constant/excessive” exposure to COVID-19–related information significantly more frequently reported deterioration of mental wellbeing. Under the ongoing pandemic of COVID-19, measures for the promotion and maintenance of mental wellbeing should be implemented considering the interaction between personality traits and media exposure.
Exercise Training and Cognitive Function in Kidney Disease
Authors: Bronas Ulf G. , Hannan Mary , Lash James P. , Ajilore Olu , Zhou Xiaohong Joe , Lamar Melissa 
Published: September 2021

Background
Chronic kidney disease (CKD) is extremely common in older adults and is associated with cognitive impairment. It is hypothesized that accelerated cognitive decline in CKD results from a vascular dysfunction-induced reduction in the integrity of the brain white matter.

Objective
The aim of this study was to describe the protocol for a study to evaluate whether exercise training provides a cerebroprotective effect by improving cerebrovascular health.

Methods
This is a randomized controlled trial investigating feasibility and effect size.

Results
Participants will be randomized to either a 24-week, home-based, walking program or a usual care group. Participants will undergo evaluation of cognitive function, brain structure via magnetic reasoning imaging, physical function, physical activity, and vascular function. The primary outcome is change in cognitive function.

Discussion
The findings of this study will help determine whether exercise training influences cognitive function during a therapeutic window in the disease process of cognitive impairment in older adults with CKD.

Conclusion
This protocol describes a study to evaluate cognition and brain structure following a home-based exercise program to an at-risk population.
Focused Cardiac Ultrasound Findings in Children Presenting With Shock to a Tertiary Care Hospital in Rwanda
Authors: Chen Lei , Mutabandama Yves , McCall Natalie , Umuhoza Christian 
Published: September 2021

Objectives
Shock remains a leading proximate cause of death in children. Children in sub-Saharan African (SSA) countries present with shock from a wide range of pathologies. Routine physiologic parameters may not reflect underlying physiology. No previous work has systematically described ultrasound findings in children with shock in an SSA country. We set out to perform focused cardiac ultrasound (FOCUS) on children with shock in Rwanda and describe the findings in this pilot study.

Methods
In a prospective descriptive study, we trained pediatric residents to perform FOCUS on children presenting with shock to an urban tertiary care pediatric emergency department in Kigali, Rwanda. Images were transmitted via cellphone network and reviewed by experts. Primary outcome was expert's description of the FOCUS findings. Secondary outcomes included mortality at 48-hour, change in assessment and treatment after FOCUS, and agreement of FOCUS findings between residents and experts.

Results
Between January 2020 and April 2020, 25 subjects were enrolled by 8 residents. Eleven of 25 (44%) were newly diagnosed with acquired or congenital heart disease. The 48-hour mortality rate was higher in this group compared with those without heart disease (8 of 11 vs 1 of 14). The resident reported changing assessment and treatment based on FOCUS findings in 60% of patients (15 of 25). There was good to excellent agreements between residents and FOCUS experts on left ventricle function, pericardial effusion, and intravascular volume.

Conclusions
In children presenting with signs and symptoms of shock in SSA, one could perform a screening FOCUS to distinguish between hypovolemic and cardiogenic shock.
The Voice of the Patient: Patient Roles in Antibiotic Management at the Hospital-to-Home Transition
Authors: Sharara Sima L. , Arbaje Alicia I. , Cosgrove Sara E. , Gurses Ayse P. , Dzintars Kathryn , Ladikos Nicholas , Qasba Sarojini Sonjia , Keller Sara C. 
Published: September 2021

Objective
Our objective was to characterize tasks required for patient-performed antibiotic medication management (MM) at the hospital-to-home transition, as well as barriers to and strategies for patient-led antibiotic MM. Our overall goal was to understand patients’ role in managing antibiotics at the hospital-to-home transition.

Methods
We performed a qualitative study including semistructured interviews with health care workers and contextual inquiry with patients discharged home on oral antibiotics. The setting was one academic medical center and one community hospital. Participants included 37 health care workers and 16 patients. We coded interview transcripts and notes from contextual inquiry and developed themes.

Results
We identified 6 themes involving barriers or strategies for antibiotic MM. We identified dissonance between participant descriptions of the ease of antibiotic MM at the hospital-to-home transition and their experience of barriers. Similarly, patients did not always recognize when they were experiencing side effects. Lack of access to follow-up care led to unnecessarily long antibiotic courses. Instructions about completing antibiotics were not routinely provided. However, patients typically did not question the need for the prescribed antibiotic.

Conclusions
There are many opportunities to improve patient-led antibiotic MM at the hospital-to-home transition. Mismatches between patient perceptions and patient experiences around antibiotic MM at the hospital-to-home transition provide opportunities for health system improvement.
Influence of Psychological Safety and Organizational Support on the Impact of Humiliation on Trainee Well-Being
Authors: Appelbaum Nital P. , Santen Sally A. , Perera Robert A. , Rothstein William , Hylton Jordan B. , Hemphill Robin R. 
Published: September 2021

Objectives
To develop physicians who can practice safely, we need better understanding of how the clinical learning environment affects trainee well-being. Two psychosocial constructs may help us understand the context: psychological safety (belief one can speak up without concerns) and perceived organizational support (degree to which members feel that their organization cares for them and values their contributions). The objective of this study is to test a moderated mediation model to determine how humiliation (X) impacts trainees’ well-being (Y) while taking into account psychological safety (mediator) and organizational support (moderator).

Methods
Between May and June 2018, a single health system recruited resident physicians across 19 programs to complete an anonymous electronic survey to assess facets of the clinical learning environment, well-being, and experiences of humiliation. In a moderated mediation analysis, mediation helps explain how a predictor variable (X) impacts an outcome variable (Y) through a mediating variable, whereas moderation helps explain under what conditions such a relationship exists.

Results
Of 428 residents, 303 responded (71%) to the survey across 19 training programs. The effects of humiliation on well-being were mitigated by psychological safety, which varied depending on the levels of perceived organizational support. Environments rated 1 SD below the mean on perceived organization support by residents had a stronger negative impact of public humiliation on psychological safety.

Conclusions
The findings suggest that humiliation is associated with well-being through the effects of psychological safety and influenced by organizational support. Further work might explore the relationship by investing resources (e.g., faculty development, mentorship) to increase psychological safety and reduce humiliation during training, especially within environments prone to be perceived as unsupportive of trainees.
Computed Tomography Imaging Characteristics: Potential Indicators of Epidermal Growth Factor Receptor Mutation in Lung Adenocarcinoma
Authors: Wang Bin , Yu Nan , Han Dong , Ren Zhanli , Jia Yongjun , Zhang Xirong , He Taiping 
Published: September 2021

Purpose
The purpose of this study was to investigate the correlation between computed tomography imaging characteristics in lung adenocarcinoma and epidermal growth factor receptor (EGFR) mutations.

Methods
A total of 124 patients with lung adenocarcinoma and known EGFR mutation status were collected in this retrospective study. Computed tomography quantitative parameters of each tumor, including total volume, total surface, surface-to-volume ratio (SVR), average diameter, maximum diameter, and average density, were determined using computer-aided detection software. The correlation between the EGFR mutation status and imaging characteristics was assessed. The predictive value of these imaging characteristics for EGFR mutation was calculated using the area under the receiver operating characteristic curve.

Result
Fifty-eight of 124 patients showed EGFR mutations. Patients who are female (P < 0.001) and nonsmokers (P < 0.001) and those with serum carcinoembryonic antigen (CEA) level of ≥5 (P = 0.035) were likely to have EGFR mutation. Computed tomography features including air bronchogram (P = 0.035), absence of cavitation (P = 0.010), and absence of pulmonary emphysema (P = 0.002) and quantitative parameters, such as smaller total surface (P = 0.002), smaller total volume (P = 0.001), higher SVR (P = 0.003), and smaller average diameter (P = 0.001), were associated with EGFR mutation. Logistic regression analysis revealed that the most significant independent prognostic factors of EGFR mutation for the model were nonsmoking (P = 0.035), CEA level of ≥5 (P = 0.004), presence of air bronchogram (P = 0.040), absence of cavitation (P = 0.021), and high SVR (P = 0.014). The area under the receiver operating characteristic curve, sensitivity, and specificity of the model for predicting EGFR mutation were 0.827, 75.8%, and 82.8%, respectively.

Conclusions

EGFR-mutated adenocarcinoma showed significantly increased CEA level, presence of air bronchogram, absence of cavitation, and higher quantitative parameter SVR than those with wild-type EGFR.
Magnetic Resonance Elastography of the Liver: A Single-Institution Review of Cases Performed in a 5-Year Interval
Authors: Morillo-Hernandez Carlos , Catania Roberta , Grosse Philip J. , Bollino Gideon , Borhani Amir A. , Furlan Alessandro 
Published: September 2021

Objective
This study aimed to assess the diagnostic accuracy of magnetic resonance elastography (MRE) in detecting hepatic fibrosis and determining clinically relevant stiffness cutoff values per stage of fibrosis.

Methods
This retrospective study assessed 1488 hepatic MRE evaluations performed at a single institution for 5 years. Mean liver stiffness measurements were collected from 282 patients who had an MRE study within 1 year of histopathologic analysis. Areas under receiver operating characteristic curves were calculated for each stage of fibrosis with nonparametric ordinal measures of accuracy, and Youden Index was determined.

Results
Mean liver stiffness measurement values were as follows: F0, 2.5± 0.55 kPa; F1, 3.1± 0.80 kPa; F2, 3.4±0.95 kPa; F3, 4.7±1.44 kPa; and F4, 7.9± 2.64 kPa. Nonparametric ordinal measures of accuracy per fibrosis stage were as follows: F0: 0.934, P < 0.001; F0–F1: 0.917, P < 0.001; F0–F2: 0.944, P < 0.001; and F0–F3: 0.941, P < 0.001. Youden Index values for fibrosis stages F2, F3, and F4 were 3.9, 4.0, and 4.5 kPa, respectively.

Conclusions
Magnetic resonance elastography is an accurate diagnostic tool in assessing liver fibrosis.