bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations Between Clinical Outcomes and a Recently Proposed Adult Congenital Heart Disease Anatomic and Physiological Classification System
Authors: Lachtrupp Cara L. , Valente Anne Marie , Gurvitz Michelle , Landzberg Michael J. , Brainard Sarah B. , Wu Fred M. , Pearson Dorothy D. , Taillie Keith , Opotowsky Alexander R. 
Published: September 2021

Background
American Heart Association and American College of Cardiology consensus guidelines introduce an adult congenital heart disease anatomic and physiological (AP) classification system. We assessed the association between AP classification and clinical outcomes.

Methods and Results
Data were collected for 1000 outpatients with ACHD prospectively enrolled between 2012 and 2019. AP classification was assigned based on consensus definitions. Primary outcomes were (1) all‐cause mortality and (2) a composite of all‐cause mortality or nonelective cardiovascular hospitalization. Cox regression models were developed for AP classification, each component variable, and additional clinical models. Discrimination was assessed using the Harrell C statistic. Over a median follow‐up of 2.5 years (1.4–3.9 years), the composite outcome occurred in 185 participants, including 49 deaths. Moderately or severely complex anatomic class (class II/III) and severe physiological stage (stage D) had increased risk of the composite outcome (AP class IID and IIID hazard ratio, 4.46 and 3.73, respectively, versus IIC). AP classification discriminated moderately between patients who did and did not suffer the composite outcome (C statistic, 0.69 [95% CI, 0.67–0.71]), similar to New York Heart Association functional class and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide); it was more strongly associated with mortality (C statistic, 0.81 [95% CI, 0.78–0.84]), as were NT‐proBNP and functional class. A model with AP class and NT‐proBNP provided the strongest discrimination for the composite outcome (C statistic, 0.73 [95% CI, 0.71–0.75]) and mortality (C statistic, 0.85 [95% CI, 0.82–0.88]).

Conclusions
The addition of physiological stage modestly improves the discriminative ability of a purely anatomic classification, but simpler approaches offer equivalent prognostic information. The AP system may be improved by addition of key variables, such as circulating biomarkers, and by avoiding categorization of continuous variables.
Age at Menopause in Relationship to Lipid Changes and Subclinical Carotid Disease Across 20 Years: Study of Women's Health Across the Nation
Authors: Matthews Karen A. , Chen Xirun , Barinas‐Mitchell Emma , Brooks Maria M. , Derby Carol A. , Harlow Sioban , Jackson Elizabeth A. , Thurston Rebecca C. , El Khoudary Samar R. 
Published: September 2021

Background
Younger age at final menstrual period (FMP) is associated with increased risk for cardiovascular disease events. This paper evaluated whether older age at FMP is associated with more favorable patterns of lipid changes during the menopause transition and whether these changes are associated with less subclinical carotid disease in the postmenopausal years.

Methods and Results
Lipids and lipoproteins were measured repeatedly among 1554 premenopausal women who had a natural menopause during follow‐up years (median=18.8 years); a subset of 890 women also had measures of carotid intima media thickness, adventitial diameter, and plaque. Women who had an older FMP age had less adverse changes in cholesterol from 1 to 3 years after FMP, and in triglycerides from FMP to 3 years after FMP, but they had more adverse changes in ApoB and Apo A1 from 3 years before to 1 year after the FMP. Increasing cholesterol and ApoB from 1 to 3 years after FMP were associated with greater intima media thickness and adventitial diameter, and the greater likelihood of a plaque score >2 the older the age at FMP.

Conclusions
Despite the epidemiological literature showing early age at FMP is associated with elevated risk for cardiovascular disease events, older age at FMP had inconsistent associations with less adverse lipid changes in midlife, which did not translate into less risk for subclinical carotid disease and in some cases more risk. These findings are restricted to women who experience FMP in the normative age range for the menopausal transition.
On Theory Dependence of Truth in Measurement
Authors: Giordani Alessandro , Mari Luca 
Published: September 2021

Abstract
Measurement results are stated in terms of sentences ascribing measured values, as obtained via measurement processes, to measurands, as defined by measuring agents. Since both the definition of the measurands and the characterization of the processes depend on models constructed on the basis of relevant theories, the issue arises of the theory dependence of the truth of those sentences. This paper aims at assessing the question by introducing suitable distinctions about the sense and reference of the terms used to refer to individual and general quantities, in a framework where measurement is construed as an agent-dependent, model-based, purpose-driven activity.
Severe Clinical Outcomes Among Adults Hospitalized With Respiratory Syncytial Virus Infections, New York City, 2017-2019
Authors: Goldman Connor R. , Sieling William D. , Alba Luis R. , Silverio Francisco Raul A. , Vargas Celibell Y. , Barrett Angela E. , Phillips Matthew , Finelli Lyn , Saiman Lisa 
Published: September 2021

Objectives Respiratory syncytial virus (RSV) causes substantial morbidity and mortality in older adults. We assessed severe clinical outcomes among hospitalized adults that were associated with RSV infections. Methods We performed a nested retrospective study in 3 New York City hospitals during 2 respiratory viral seasons, October 2017–April 2018 and October 2018–April 2019, to determine the proportion of patients with laboratory-confirmed RSV infection who experienced severe outcomes defined as intensive care unit (ICU) admission, mechanical ventilation, and/or death. We assessed factors associated with these severe outcomes and explored the effect of RSV-associated hospitalizations on changes in the living situations of surviving patients. Results Of the 403 patients studied (median age, 69 years), 119 (29.5%) were aged ≥80. Severe outcomes occurred in 19.1% of patients, including ICU admissions (16.4%), mechanical ventilation (12.4%), and/or death (6.7%). Patients admitted from residential living facilities had a 4.43 times higher likelihood of severe RSV infection compared with patients who were living in the community with or without assistance from family or home health aides. At discharge, 56 (15.1%) patients required a higher level of care than at admission. Conclusions RSV infection was associated with severe outcomes in adults. Living in a residential facility at admission was a risk factor for severe outcomes and could be a proxy for frailty rather than an independent risk factor. Our data support the development of prevention strategies for RSV infection in older populations, especially older adults living in residential living facilities.
Whither Nicaragua Three Years On?
Authors: Cruz-Feliciano Héctor M. 
Published: September 2021

Since the violent events of April 2018, a kind of “normalcy” has returned to everyday life in Nicaragua, but the social and political atmosphere has seen a dramatic change. The government’s social programs have lent some credibility to its claim of reversing the neoliberal policies of its predecessors. However, after more than a decade in power it has become clear that this is not the case. Instead of a socialist transformation, it has pursued a populist model designed to contain and reduce extreme poverty while expanding its political control at the grassroots through clientelist mechanisms. National elections are scheduled to take place in November 2021, and the Ortega-Murillo regime is setting the stage to assure its reelection. Without agreement among the opposition on a single candidate to face off against the regime, Nicaragua is likely facing five more years of Sandinista government. One thing is certain: the April rebellion threw up numerous young leaders who are unaligned with the traditional parties and whose values and aspirations align with those for which Nicaraguans fought in the revolution yet involve a more inclusive, less partisan, and more wide-ranging approach. In time, April 19 is likely to go on record as the door leading to a new era of progressive change. Desde los violentos sucesos de abril de 2018, una especie de “normalidad” ha vuelto a la vida cotidiana en Nicaragua, pero la atmósfera social y política ha experimentado un cambio dramático. Los programas sociales del gobierno han dado cierta credibilidad a su pretensión de revertir las políticas neoliberales de sus predecesores. Sin embargo, después de más de una década en el poder, ha quedado claro que este no es el caso. En lugar de una transformación socialista, ha seguido un modelo populista diseñado para contener y reducir la pobreza extrema al tiempo que amplía su control político en las bases a través de mecanismos clientelistas. Las elecciones nacionales están programadas para noviembre de 2021, y el régimen de Ortega-Murillo está preparando el escenario para asegurar su reelección. Sin un acuerdo entre la oposición sobre un solo candidato para enfrentar al régimen, es probable que Nicaragua enfrente cinco años más de gobierno sandinista. Una cosa es cierta: la rebelión de abril arrojó a numerosos líderes jóvenes que no están alineados con los partidos tradicionales y cuyos valores y aspiraciones se alinean con aquellos por los que lucharon los nicaragüenses en la revolución, pero que involucran un enfoque más inclusivo, menos partidista y más amplio. Con el tiempo, es probable que el 19 de abril quede registrado como la puerta que conduce a una nueva era de cambio progresivo.
A Liberal Region in a World of Closed Borders? The Liberalization of Asylum Policies in Latin America, 1990–2020
Authors: Hammoud-Gallego Omar 
Published: September 2021

Recent scholarship has claimed that countries across Latin America have been adopting an increasingly liberal and more advanced legal framework for the protection of refugees. Yet little systematic cross-country evidence beyond case studies exists to back up this claim. To address this gap in the literature, I develop a new methodology — called the Asylum Policies in Latin America (APLA) Database — to measure policy outputs on asylum across Latin America over time. Applying this new methodology, I present the results of the codification of 19 Latin American countries, over a 31-year period (1990–2020), using 65 indicators to track the development of policy measures on asylum. The findings from this new database confirm the claim from existing research that countries across Latin America have developed an increasingly complex and more liberal legal framework for the protection of refugees. This liberal trend in asylum legislation stands in contrast to findings of increased restrictiveness over the same period across OECD countries. The APLA Database represents a unique contribution to the fields of migration and refugee studies, as it provides systematic data on the nature and development of asylum policies in Latin America through highly disaggregated data on policy outputs. Additionally, APLA demonstrates the existence of intra-regional variation. It also allows scholars to develop and test hypotheses in the field of asylum studies and provides a reference database for comparative analyses of asylum policies in Latin America, as well as a framework for the comparative study of asylum policies across the globe.
Electroclinical Features in MECP2 Duplication Syndrome: Pediatric Case Series
Authors: Lorenzo Jocelyn , Dolce Alison , Lowden Andrea 
Published: September 2021

Objective: MECP2 duplication syndrome (MECP2DS) is an x-linked recessive syndrome characterized by infantile hypotonia, severe neurodevelopmental delay, intellectual disability, progressive spasticity, recurrent infections, and seizures. More than 50% of cases have been associated with epilepsy. Seizure semiology and electroencephalogram (EEG) findings in these patients are poorly described. Methods: In this case series, the authors describe the electroclinical features of children with MECP2DS presenting to their institution. In addition, they reviewed seizure types and therapies used. Results: Eight out of 9 patients with MECP2DS developed epilepsy, with 56% having normal initial EEG. Generalized slowing with generalized and focal/multifocal discharges was the most common EEG pattern which is consistent with prior studies. Atonic seizure was the most common semiology. Majority were pharmacoresistant (63%). Conclusion: The goal of this case series is to better define the clinical and electrophysiological aspects of the epilepsy associated with MECP2 duplication syndrome and provide practical guidance regarding management.
Learning trajectories: Comparing the transitions of graduates of “Power Mechanical Engineering” and “Humanities and Social Sciences” programs
Authors: Chen Su-Yen , Wu Chyuan-Yuan , Chang Hsing-Yu 
Published: September 2021

This study investigates and compares the learning trajectories of nine Taiwanese university graduates from a Power Mechanical Engineering (PME) program and nine from a cross-disciplinary Humanities and Social Sciences (HSS) program. Participants had received their degrees 4–7 years prior to the study. The findings suggest the relative advantages and disadvantages of different models of educational design. Even though PME graduates complained about the abstract nature of what they had learned during the first part of their undergraduate study, most had successfully entered labor markets related to the PME industry, having obtained appropriate knowledge/skills for application in industry from the latter part of the program. While some prioritized their identity as a PME professional, others admitted that they liked the extrinsic reward of a comfortable living best. In contrast, even though most of the HSS graduates admired the generic curriculum of the program, with its transferability from one context to another and its close connection to the real world, and some deeply identified with the core value of being an agent of societal change once they had entered the labor market, many also admitted that it was difficult to find a suitable industry to enter unless they first acquired a Master’s degree with higher specificity.
A contextual needs assessment of families with home invasive mechanical ventilation patients: A qualitative study
Authors: Esmaeili Maryam , Asgari Parvaneh , Dehghan Nayeri Nahid , Bahramnezhad Fatemeh , Fattah Ghazi Samrand 
Published: September 2021

Objectives With the advancement of technology the number of patients surviving critical illness has increased. Home mechanical ventilation (HMV) is a growing option for patients requiring long-term mechanical ventilation. Caring for these patients is demanding and challenging. The aim of this study was to explore family caregivers’(carers) needs when providing care to adult patients under HMV from the perspective of nurses, home care attendants, and the caregivers themselves. Methods Overall, 15 participants (nine carers, three home nurses, and three home care attendants) were selected by purposive sampling. Data were collected by in-depth semi-structured interviews and structured observation. Finally, data were analyzed through conventional content analysis with MAXQDA software. Results Three categories of carers’needs were identified, including educational needs (basic and emergencies), psychological needs, and economic needs. In addition, since the needs, feelings, and views of caregivers change over time, the noted needs were divided into three periods: Pre-discharge preparation, initial transition from hospital to home, and appropriate long-term follow-up. Conclusion The study results showed that the families of patients under invasive HMV require a standard discharge plan based on their care needs, financial concerns, and psychological screening before discharge as well as a suitable long-term follow-up plan in collaboration with a multidisciplinary treatment team, insurance providers, and home care services.
Differentiation of Benign From Malignant Sinonasal Masses Using Diffusion Weighted Imaging and Dynamic Contrast Enhanced Magnetic Resonance Imaging
Authors: Daga Radhika , Kumar Jyoti , Pradhan Gaurav , Meher Ravi , Malhotra Vikas , Khurana Nita 
Published: September 2021

Background The sinonasal region is affected by a variety of neoplasms. A differentiation between benign and malignant masses is essential both for management and prognostication. Morphological analysis often does not allow this differentiation. Objectives This article aims to assess the value of advanced MRI (diffusion [DWI] and dynamic contrast enhanced MRI [DCE-MRI]) in differentiation of benign and malignant sinonasal masses. Methods This prospective study included 40 patients with sinonasal masses who underwent advanced MR on 3T MR scanner. The lesions were analyzed based on morphological characteristics, qualitative, quantitative diffusion parameters, and time signal intensity curves. Apparent diffusion coefficient (ADC) values were acquired using b values of 50 and 1000 s/mm2. The accuracy of DWI, DCE-MRI, and combined DWI/DCE-MRI in differentiating benign from malignant sinonasal masses were analyzed. Results Perineural extension and growth pattern of the tumor were the best morphological discriminators. Mean ADC values for benign and malignant lesions were 1.675  ±  0.561 and 0.903  ±  0.405  × 10−3 mm2/sec, ,respectively. ROC revealed that ADC cutoff value of 1.005  × 10−3 mm2/sec provided an accuracy of 92.5% in differentiating benign from malignant masses ( P value <.01). On excluding the benign vascular masses (Juvenile Nasopharyngeal Angiofibroma and hemangioma), the time signal intensity curve showed 78% accuracy ( P value <.001). The highest diagnostic performance was achieved by combining DWI and DCE-MRI (95% accuracy). Conclusion DWI has higher accuracy than DCE-MRI. Quantitative DWI is preferable over qualitative DWI. Accuracy of DCE-MRI can be increased by excluding vascular masses with characteristic imaging features. DWI and DCE-MRI have the highest accuracy when used in combination than either of them alone in differentiating benign from malignant sinonasal masses.
Dissection of the Genetic Basis of Rice Panicle Architecture Using a Genome-wide Association Study
Authors: Bai Shaoxing , Hong Jun , Li Ling , Su Su , Li Zhikang , Wang Wensheng , Zhang Fengli , Liang Wanqi , Zhang Dabing 
Published: September 2021

AbstractPanicle architecture is one of the major factors influencing productivity of rice crops. The regulatory mechanisms underlying this complex trait are still unclear and genetic resources for rice breeders to improve panicle architecture are limited. Here, we have performed a genome-wide association study (GWAS) to analyze and identify genetic determinants underlying three panicle architecture traits. A population of 340 rice accessions from the 3000 Rice Genomes Project was phenotyped for panicle length, primary panicle number and secondary branch number over two years; GWAS was performed across the whole panel, and also across the japonica and indica sub-panels. A total of 153 quantitative trait loci (QTLs) were detected, of which 5 were associated with multiple traits, 8 were unique to either indica or japonica sub-panels, while 37 QTLs were stable across both years. Using haplotype and expression analysis, we reveal that genetic variations in the OsSPL18 promoter significantly affect gene expression and correlate with panicle length phenotypes. Three new candidate genes with putative roles in determining panicle length were also identified. Haplotype analysis of OsGRRP and LOC_Os03g03480 revealed high association with panicle length variation. Gene expression of DSM2, involved in abscisic acid biosynthesis, was up-regulated in long panicle accessions. Our results provide valuable information and resources for further unravelling the genetic basis determining rice panicle architecture. Identified candidate genes and molecular markers can be used in marker-assisted selection to improve rice panicle architecture through molecular breeding.
Analysis of microbial populations in plastic–soil systems after exposure to high poly(butylene succinate-co-adipate) load using high-resolution molecular technique
Authors: Tanunchai Benjawan , Juncheed Kantida , Wahdan Sara Fareed Mohamed , Guliyev Vusal , Udovenko Maria , Lehnert Ann-Sophie , Alves Eliane Gomes , Glaser Bruno , Noll Matthias , Buscot François , Blagodatskaya Evgenia , Purahong Witoon 
Published: September 2021

AbstractBackgroundBio-based and biodegradable plastics are considered as plastics of the future owing to their ability to decompose under various environmental conditions. However, their effects on the soil microbiome are poorly characterised. In this study, we aimed to investigate the effects of an important bio-based and biodegradable plastic, polybutylene succinate-co-adipate (PBSA), on soil microbial diversity and community composition using high-resolution molecular technique (Illumina sequencing) targeting all three microbial domains: archaea, bacteria, and fungi.ResultsAdding high load of PBSA to soil (6% (w/w)) caused a significant decline in archaeal (13%) and fungal (45%) richness and substantial changes in both bacterial (Proteobacteria, Actinobacteria, and Acidobacteria) and fungal (Eurotiomycetes, Sordariomycetes, Leotiomycetes, and Dothideomycetes) community composition compared with no PBSA addition to soil. The combined effects of PBSA and (NH4)2SO4fertilisation on the soil microbiome were much greater than the effects of PBSA alone. We only detected opportunistic human pathogens in low abundance on PBSA and in the surrounding soil. However, some plant pathogenic fungi were detected and/or enriched on the PBSA films and in surrounding soil. Apart from plant pathogens, many potential microbial control agents and plant growth-promoting microorganisms were also detected/enriched owing to PBSA addition. Adding high load of PBSA together with (NH4)2SO4fertilisation can either eliminate some plant pathogens or enrich specific pathogens, especiallyFusarium solani, which is economically important.ConclusionsWe conclude that high load of bio-based and biodegradable PBSA plastic may negatively affect soil microbiome.
Pain expectation and avoidance in the social context: an electrophysiological study
Authors: Piedimonte Alessandro , Zamfira Denisa Adina , Guerra Giulia , Vighetti Sergio , Carlino Elisa 
Published: September 2021

AbstractContingent negative variation (CNV) is an informative electrophysiological measure of pain anticipation showing higher amplitudes when highly painful stimulation is expected while presenting lower amplitudes when low painful stimulation is expected. Two groups of participants were recruited: one group expected and received an electrical stimulation of different intensities while being alone in the room (i.e. without social context), while a second group performed the same experiment with an observer in the room (i.e. with social context). Lower pain ratings and slower reaction times were observed in the group with social context and these results were accompanied in this group by a lower amplitude in the early component of the CNV as well as a lower amplitude of the later component of the wave. These results show that CNV can be considered a precise measure of central elaboration of pain anticipation explaining both its perceptual and motor components.