bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Mother’s Voice: The Construction of Maternal Identity Following Perinatal Loss
Authors: Rossen Larissa , Opie Jessica E. , O’Dea Gypsy 
Published: October 2023

Background Maternal identity, a mother’s internalized view of self as mother, has not been studied in relation to perinatal loss. This study aimed to investigate how women construct a sense of maternal identity after the loss of a baby. Methods We interviewed 10 mothers who had experienced perinatal loss. A Listening Guide framework for narrative analysis was used to identify patterns of giving voice to the mother’s own story. Results We identified 12 overarching voices which fell within three distinct groupings: voices of motherhood, voices of grief, and voices of growth. Although bereaved mothers grappled with constructing their maternal identity, they also demonstrated how maternal identity is individually and intuitively created through an honouring and remembering of the child that was lost, resulting in significant growth. Conclusions There is need for a broader definition of what constitutes motherhood to encapsulate diverse mothering experiences, including perinatal loss.
The Lure of Beauty: People Select Representations of Statistical Information Largely Based on Attractiveness, Not Comprehensibility
Authors: Gaissmaier Wolfgang , Tiede Kevin E. , Garcia-Retamero Rocio 
Published: October 2023

Objective People differ in whether they understand graphical or numerical representations of statistical information better. However, assessing these skills is often not feasible when deciding which representation to select or use. This study investigates whether people choose the representation they understand better, whether this choice can improve risk comprehension, and whether results are influenced by participants’ skills (graph literacy and numeracy). Methods In an experiment, 160 participants received information about the benefits and side effects of painkillers using either a numerical or a graphical representation. In the “no choice” condition, the representation was randomly assigned to each participant. In the “choice” condition, participants could select the representation they would like to receive. The study assessed gist and verbatim knowledge (immediate comprehension and recall), accessibility of the information, attractiveness of the representation, as well as graph literacy and numeracy. Results In the “choice” condition, most (62.5%) chose the graphical format, yet there was no difference in graph literacy or numeracy (nor age or gender) between people who chose the graphical or the numerical format. Whereas choice slightly increased verbatim knowledge, it did not improve gist or overall knowledge compared with random assignment. However, participants who chose a representation rated the representation as more attractive, and those who chose graphs rated them as more accessible than those without a choice. Limitations The sample consisted of highly educated undergraduate students with higher graph literacy than the general population. The task was inconsequential for participants in terms of their health. Conclusions When people can choose between representations, they fail to identify what they comprehend better but largely base that choice on how attractive the representation is for them. Highlights People differ systematically in whether they understand graphical or numerical representations of statistical information better. However, assessing these underlying skills to get the right representation to the right people is not feasible in practice. A simple and efficient method to achieve this could be to let people choose among representations themselves. However, our study showed that allowing participants to choose a representation (numerical v. graphical) did not improve overall or gist knowledge compared with determining the representation randomly, even though it did slightly improve verbatim knowledge. Rather, participants largely chose the representation they found more attractive. Most preferred the graphical representation, including those with low graph literacy. It would therefore be important to develop graphical representations that are not only attractive but also comprehensible even for people with low graph literacy.
Establishment of reference intervals for ultrasonographically derived caudal vena cava parameters from 110 healthy, lightly sedated cats
Authors: Hultman Tove M , Rosanowski Sarah M , Jalava Steffi M , Boysen Søren R , Yozova Ivayla D 
Published: October 2023

Objectives The present study aimed to establish reference intervals (RIs) for ultrasonographically derived caudal vena cava (CVC) parameters in healthy cats. Methods A prospective, observational, experimental single-centre study involving 110 cats was conducted. Two trained operators scanned all cats in a randomised order. Two sets of cine loops per cat were conducted by each operator from the subxiphoid view with cats in lateral recumbency. Two blinded raters measured the narrowest inspiratory (CVCinsp) and widest expiratory (CVCexp) diameter over two separate respiratory cycles for each operator (four measurements in total for each rater) at the point the CVC crosses the diaphragm. The CVC collapsibility index (CVCCI) was calculated. Reference intervals and limits were calculated for CVC parameters with outliers removed to include the central 95% of CVC values and the non-parametric 90% confidence intervals (90% CIs). The CVCCI interval included the central 95th (2.5th and 97.5th) centiles bounded by the 90% CI. Intra- and inter-rater and intra- and inter-operator reliabilities were calculated for each parameter using a two-way random-effects model. A Bland–Altman plot was used to visualise the CVCCI between the two raters. Results In total, 880 measurements were included for each diameter and 440 CVCCI values were calculated. The CVC diameters were normally distributed, whereas the CVCCI was not. The calculated RIs were 1.4–6.1 mm for CVCinsp and 2.2–6.7 mm for CVCexp. The median (range) CVCCI was 23% (11–36%) with 2.5th and 97.5th centiles of 2% and 67%, respectively. There was a moderate to good intra-rater and intra-operator reliability for CVC diameter. The intra-rater reliability for the CVCCI was moderate. The inter-rater and inter-operator reliabilities for the CVCCI were poor. Conclusions and relevance The CVC RIs determined from the subxiphoid site in cats appear to be wider than those reported in dogs, and rater and operator variability is present. Whether precise measurements of CVC parameters are suitable to guide clinical decisions remains to be determined.
Association between optic atrophy 1 polymorphisms and primary open angle glaucoma risk: Based on a meta-analysis
Authors: Liu Yue-Feng , Luo Xiang-Yu , Zhao Zhi-Cai , Zheng Wu , Lv Hai-Yang , Luo Wei-Min 
Published: October 2023

BackgroundEmerging evidence suggested a significant association between optic atrophy 1 (OPA1) polymorphisms and primary open angle glaucoma (POAG) risk. However, the current data are inconsistent or even contradictory. Given these, we conducted a meta-analysis to examine the precise association between OPA1 polymorphisms and POAG risk.Materials and MethodsOnline databases were retrieved, and the related studies were reviewed from inception to December 1, 2022. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated to examine the statistical power of each genetic model. In addition, heterogeneity, sensitivity, cumulative analysis, and publication bias were analyzed to guarantee statistical power.ResultOverall, 14 studies within 11 publications (involving 2,413 POAG patients and 1,904 controls) were included and some significant association between OPA1 rs166850 C/T (T vs. C: OR = 1.24, 95%CI = 1.06–1.45, P = 0.01, I2 = 39.0%; CT vs. CC: OR = 1.37, 95%CI = 1.05–1.79, P = 0.02, I2 = 41.6%; CT + TT vs. CC: 1.37, 95%CI = 1.06–1.77, P = 0.02, I2 = 41.6%), rs10451941T/C (TC + CC vs. TT: OR = 1.79, 95%CI = 1.41–2.28, P < 0.01, I2 = 71.9%) polymorphisms and POAG susceptibility. In addition, further significant associations were also observed in the stratified analysis, especially in normal tension glaucoma groups and Caucasian descendants.ConclusionThe observed evidences suggest that OPA1 polymorphisms may be associate with POAG susceptibility significantly.
Out-of-hours decision-making in deteriorating patients by foundation year doctors: Relationship to moral distress
Authors: Geddes Justin C , MacDougall Margaret , Taylor Robin D 
Published: October 2023

Background: Moral distress (MD) refers to psychological unease when healthcare professionals identify morally correct actions to take but are constrained in their ability to take those actions. Methods: This study evaluated the relationship between out-of-hours decisions and MD among 40 Foundation Year 2 (FY2) doctors. They were asked to choose the ‘expected’ and the ‘right’ management options for five out-of-hours scenarios and complete an adapted Measure of Moral Distress for Health Professionals (MMD-HP) questionnaire. Results: 28/40 (70%) reported discordance between ‘expected’ and ‘right’ options more frequently than concordance. The mean total MMD-HP score was low: 64.9 ( SD = 26.9), range 13–143, maximum 288. The association between decision-making discordance and MMD-HP score was weak. Conclusion: Out-of-hours decisions by FY2 doctors were characterised by doing what is ‘expected’ rather than what is perceived to be ‘right’. Providing guidance regarding decision-making in deteriorating patients is needed for patient safety and staff well-being.
Efficacy and safety of anti-PD-1 monotherapy versus anti-PD-1 antibodies plus lenvatinib in patients with advanced hepatocellular carcinoma: a real-world experience
Authors: Liu Qingyan , Li Rong , Li Lingling , Wang Gaokun , Ji Shiyu , Zheng Xuan , Jia Xiaodong , Tao Haitao , Hu Yi 
Published: October 2023

Background: The efficacy of anti-programmed cell death (PD)-1 monotherapy in advanced hepatocellular carcinoma (aHCC) is limited, and combination therapy with lenvatinib and pembrolizumab has shown promising results. However, comparative studies between immune monotherapies and combination therapies are lacking. Objectives: To investigate the efficacy and safety of anti-PD-1 monotherapy (PD-1) and anti-PD-1 plus lenvatinib (PD-1 + L) in patients with aHCC to guide clinical treatment decisions. Design: A retrospective study was conducted on a cohort of patients with aHCC who received either PD-1 monotherapy or PD-1 + L combination therapy between January 2018 and January 2020. Methods: The study retrospectively reviewed the medical records of 94 eligible patients with aHCC, with 39 in the PD-1 group and 55 in the PD-1 + L group. The efficacy outcomes, including objective response rate (ORR), disease control rate (DCR), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety, were assessed. Results: With a median follow-up of 30.1 months, the PD-1 + L group demonstrated a significantly higher ORR (32.7% versus 10.3%, p = 0.013), better DCR (80.0% versus 53.8%, p = 0.012), longer median PFS (10.6 versus 4.4 months, p < 0.001) and longer median OS (18.4 versus 8.5 months, p = 0.013) than PD-1 group. For the responders, the efficacy of the two groups was durable (DOR was 11.6 versus 3.5 months, p = 0.009). Subgroup analyses based on prior tyrosine kinase inhibitor (TKI) treatment and the presence or absence of macrovascular tumor thrombosis or extrahepatic metastases favored the PD-1 + L group. The combination therapy was a good predictor of PFS and OS in multivariate analysis. Grade 3/4 treatment-related adverse events were more common in PD-1 + L group, with higher incidences of hypertension and hand–foot skin reactions. Conclusions: PD-1 monotherapy and PD-1 plus lenvatinib combination therapy were well-tolerated in patients with aHCC. PD-1 + L showed significantly better survival benefits than PD-1 monotherapy.
Uncertainty’s impact on adaptive performance in the post-COVID era: The moderating role of perceived leader’s effectiveness
Authors: Junça-Silva Ana , Caetano António 
Published: October 2023

This study builds upon existing research on daily adaptive performance by focusing on two main aspects: (1) the fluctuations within individuals concerning uncertainty in relation to daily negative affect and daily adaptive performance and (2) the variations between individuals in the perceived effectiveness of their leaders as a relevant boundary condition of these relationships. Data were gathered during a post-COVID phase from a sample of 176 Portuguese working adults, for 10 days, resulting in a total of 1,760 measurement occasions. The results of the multilevel analysis revealed a positive correlation between fluctuations in daily uncertainty and daily negative affect. Notably, this relationship was influenced by the perceived effectiveness of leaders. Specifically, the presence of an effective leader mitigated the heightened negative affect caused by increased uncertainty. In addition, the findings demonstrated a positive link between daily negative affect and daily adaptive performance. Moreover, a statistically significant indirect effect was observed, indicating that uncertainty led to fluctuations in adaptive performance through its impact on daily negative affect. Essentially, higher levels of uncertainty contributed to increased negative affect among employees, subsequently influencing their daily adaptive performance. It is important to note that this pathway was further influenced by the perceived effectiveness of leaders. In cases where employees perceived their leaders as less effective, the connection between negative affect and adaptive performance was more pronounced. This study underscores the significance of perceived effective leadership, particularly in unique contexts such as the post-COVID era: an effective leader is always good for affective regulation, but a less effective leader is not always bad regarding adaptive performance. This complexity prompts discussions on implications for both theoretical understanding and practical application. JEL CLASSIFICATION M0
Biology of factor XI
Authors: Moellmer Samantha A. , Puy Cristina , McCarty Owen J. T. 
Published: October 2023

AbstractUnique among coagulation factors, the coagulation factor XI (FXI) arose through a duplication of the gene KLKB1, which encodes plasma prekallikrein. This evolutionary origin sets FXI apart structurally because it is a homodimer with 2 identical subunits composed of 4 apple and 1 catalytic domain. Each domain exhibits unique affinities for binding partners within the coagulation cascade, regulating the conversion of FXI to a serine protease as well as the selectivity of substrates cleaved by the active form of FXI. Beyond serving as the molecular nexus for the extrinsic and contact pathways to propagate thrombin generation by way of activating FIX, the function of FXI extends to contribute to barrier function, platelet activation, inflammation, and the immune response. Herein, we critically review the current understanding of the molecular biology of FXI, touching on some functional consequences at the cell, tissue, and organ level. We conclude each section by highlighting the DNA mutations within each domain that present as FXI deficiency. Together, a narrative review of the structure-function of the domains of FXI is imperative to understand the etiology of hemophilia C as well as to identify regions of FXI to safely inhibit the pathological function of activation or activity of FXI without compromising the physiologic role of FXI.
Circular and L50-like leaderless enterocins share a common ABC-transporter immunity gene
Authors: Teso-Pérez Claudia , Martínez-Bueno Manuel , Peralta Sánchez Juan Manuel , Valdivia Eva , Fárez-Vidal María Esther , Martín-Platero Antonio Manuel 
Published: October 2023

AbstractMicrobes live within complex communities of interacting populations, either free-living in waters and soils or symbionts of animals and plants. Their interactions include the production of antimicrobial peptides (bacteriocins) to antagonize competitors, and these producers must carry their own immunity gene for self-protection. Whether other coexisting populations are sensitive or resistant to the bacteriocin producer will be key for the population dynamics within the microbial community. The immunity gene frequently consists of an ABC transporter to repel its own bacteriocin but rarely protects against a nonrelated bacteriocin. A case where this cross-resistance occurs mediated by a shared ABC transporter has been shown between enterocins MR10A/B and AS-48. The first is an L50-like leaderless enterocin, while AS-48 is a circular enterocin. In addition, L50-like enterocins such as MR10A/B have been found in E. faecalis and E. faecium, but AS-48 appears only in E. faecalis. Thus, using the ABC transporter of the enterocin MR10A/B gene cluster of Enterococcus faecalis MRR10-3 as a cross-resistance model, we aimed to unravel to what extent a particular ABC transporter can be shared across multiple bacteriocinogenic bacterial populations. To this end, we screened the MR10A/B-ABC transporters in available microbial genomes and analyzed their sequence homologies and distribution. Overall, our main findings are as follows: (i) the MR10A/B-ABC transporter is associated with multiple enterocin gene clusters; (ii) the different enterocins associated with this transporter have a saposin-like fold in common; (iii) the Mr10E component of the transporter is more conserved within its associated enterocin, while the Mr10FGH components are more conserved within the carrying species. This is the least known component of the transporter, but it has shown the greatest specificity to its corresponding enterocin. Bacteriocins are now being investigated as an alternative to antibiotics; hence, the wider or narrower distribution of the particular immunity gene should be taken into account for clinical applications to avoid the selection of resistant strains. Further research will be needed to investigate the mechanistic interactions between the Mr10E transporter component and the bacteriocin as well as the specific ecological and evolutionary mechanisms involved in the spread of the immunity transporter across multiple bacteriocins.
Financial satisfaction, food security, and shared meals are foundations of happiness among older persons in Thailand
Authors: Phulkerd Sirinya , Gray Rossarin Soottipong , Chamratrithirong Aphichat , Pattaravanich Umaporn , Thapsuwan Sasinee 
Published: October 2023

AbstractThe objective of this study was to investigate the association between happiness and food-related behaviours and other potential factors among older persons in Thailand. This was a cross-sectional study with multistage random sampling. In total, 1,197 older (age 60 + years) persons participated in this study. Face-to-face interviews were conducted to obtain information about socio-demographic characteristics, health status, household chores, home gardening, financial situation, family meals, and food security. Descriptive and multivariate regression analyses were performed for data analysis. The analysis found that age, health status, household chores, and home gardening were found to be significantly associated with happiness. Statistically-significant associations of financial situation, family meals, and food insecurity with happiness were also observed. People who were not dissatisfied with their financial situation were happier than people who were unhappy with their financial situation. Older people who ate every meal with a family member(s) were happiest. People who had severe food insecurity were less happy than those with food security. The findings suggest the need for investment priorities on food and nutrition with a long-term policy to ensure financial self-sufficiency and food security among older persons and their family.
“I had given up on being a mother”: a survey of 183 women’s experience of transabdominal cerclage (TAC)
Authors: Carter Jenny , Deery Joanne , Chandiramani Manju , Shennan Andrew 
Published: October 2023

Abstract
Background
Transabdominal cerclage (TAC) is a relatively uncommon intervention for preventing preterm birth. This study aimed to investigate the experience of women who had undergone this procedure.

Methods
The survey was designed in collaboration with a preterm birth studies public and patient involvement (PPI) group and ethical approval was granted by KCL BDM Research Ethics Panel (LRS-19/20-13205). Members of closed Facebook group, UK TAC Support, were invited to complete an online questionnaire about their experience of TAC, and pregnancies before and after having it placed. The survey was open between December 2019 and May 2020. Open and closed questions provided both qualitative and quantitative data for analysis, which was carried out using NVivo Pro 2020 v.1.4.1 qualitative data management software and SPSS Statistics 27 (IBM).

Results
One hundred eighty-three participants completed the survey, having had TAC procedures carried out in 36 hospitals. Altogether, participants had experienced 287 preterm births (PTB) and late miscarriages (LM), equating to an average of 1.6 each (range 0–5), including 18 stillbirths. TAC was indicated in 123 (67%) for previous PTB and/or LM, 29 (16%) for cervical surgery and 31 (17%) for both. 151 (83%) TAC procedures were open, 32 (17%) laparoscopic. 86% (n = 157) were placed outside pregnancy. Of those placed in pregnancy, gestation at TAC ranged from 7 to 16 weeks. When comparing earliest pre- and post-TAC pregnancy gestation (excluding first trimester losses), median gestational weeks gained following TAC was 15.5 weeks (SD 6.89). Qualitative themes included: the struggle to get treatment; lack of TAC knowledge amongst clinicians; gratitude, hope and feeling protected; possible detrimental effects of TAC.

Conclusions
This very high-risk group found having a TAC gave great reassurance and hope, and were very grateful to have found the care they needed. However, they often struggled to get this support, frequently due to lack of clinician awareness. This may improve following roll-out of NHS England’s Saving Babies Live Care Bundle and NHS commissioning guidelines for care of women at risk of PTB.