bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Recent Standing, Moving, or Sitting on Daytime Ambulatory Blood Pressure
Authors: Barone Gibbs Bethany , Muldoon Matthew F. , Conroy Molly B. , Paley Joshua L. , Shimbo Daichi , Perera Subashan 
Published: August 2023

Background
There are no recommendations for being seated versus nonseated during ambulatory blood pressure (BP) monitoring (ABPM). The authors examined how recent standing or moving versus sitting affect average daytime BP on ABPM.

Methods and Results

This analysis used baseline assessments from a clinical trial in desk workers with office systolic BP (SBP) 120 to 159 mm Hg or diastolic BP (DBP) 80 to 99 mm Hg. ABPM was measured every 30 minutes with a SunTech Medical Oscar 2 monitor. Concurrent posture (standing or seated) and moving (steps) were measured via a thigh‐worn accelerometer. Linear regression determined within‐person BP variability explained (
R
2
) by standing and steps before ABPM readings. Mean daytime BP and the prevalence of mean daytime BP >135/85 mm Hg from readings after sitting (seated) or after recent standing or moving (nonseated) were compared with all readings. Participants (n=266, 59% women; age, 45.2±11.6 years) provided 32.5±3.9 daytime BP readings. Time standing and steps before readings explained variability up to 17% for daytime SBP and 14% for daytime DBP. Using the 5‐minute prior interval, seated SBP/DBP was lower (130.8/79.7 mm Hg,
P
<0.001) and nonseated SBP/DBP was higher (137.8/84.3 mm Hg,
P
<0.001) than mean daytime SBP/DBP from all readings (133.9/81.6 mm Hg). The prevalence of mean daytime SBP/DBP ≥135/85 mm Hg also differed: 38.7% from seated readings, 70.3% from nonseated readings, and 52.6% from all readings (
P
<0.05).

Conclusions
Daytime BP was systematically higher after standing and moving compared with being seated. Individual variation in activity patterns could influence the diagnosis of high BP using daytime BP readings on ABPM.
Enclosing the Open Fields
Authors: Gehrke Louisa-Dorothea 
Published: August 2023

Abstract
Early modern natural history was both characterized by naturalists collecting jointly on excursions and by the employment of paper technologies in the exchange of information and objects. Evaluating a sample of Matthias Ernst Boretius’s correspondence with Johann Philipp Breyne (Gotha research library) as well as Jacob Breyne’s 1659 herbarium as a gift to Hieronymus van Beverningh (Naturalis Biodiversity Center Leiden), this paper argues that naturalists made creative use of those technologies as substitutes for joint outings. It analyzes the specific characteristics of the letter and the herbarium as instruments for both distance interaction and self-presentation, considering the relationship between sender and addressee, and the aims the authors pursued with their respective media. As the herbarium has not been fully considered before this background yet, the paper contributes to its understanding as a means of naturalist communication.
Differential Forgiveness Perspectives and Their Implications on Bangsamoro-Christian Conflict Resolution
Authors: Labor Paul Danielle P. , Gastardo-Conaco Maria Cecilia C. 
Published: August 2023

Abstract
The article explored intergroup perspectives among Bangsamoro and Christian group members to determine their impact on forgiveness-based peace initiatives and conflict resolution. It adopts a qualitative approach by analyzing thematically four (4) focus group discussions. Bangsamoro participants’ themes on Intergroup Forgiveness as a Process of Negotiation and Pride as Key Factor in the Process of Intergroup Forgiveness stress socio-religious and political leaders’ roles including that of cultural values such as maratabat (honor) and sabar (silent forbearance). Christian participants’ Intergroup Forgiveness as an Outcome through Discussion/Communication theme emphasizes understanding and pride’s impact on the forgiveness process. These findings bring to awareness the complexity of integrating intergroup forgiveness in current peacebuilding interventions.
The Poetics of Persianate Disaffiliation: Recusative Gestures for a Royal Genre
Authors: Hodgkin Samuel 
Published: August 2023

Abstract
Across the Persianate regions of late-nineteenth and early-twentieth-century Eurasia, the discourse of modernization had a deep, perhaps even dominant aesthetic dimension. Apparently disparate anxieties about oriental indolence, homosexuality and unmanliness, flattery and unmeaning speech, and submission to despots all may be understood as elements of a coherent critique of a single literary mode: taghazzul. Insofar as ghazal was a “royal genre” (Ireneusz Opacki), it provided the formal-aesthetic framing for numerous literary and speech genres, and thus for the social and political order. In case studies from across the Persianate zone, this article considers how writers’ refusal of taghazzul, or its excision from their texts, became a recognizable gesture of disaffiliation from the Persianate. In the resulting reordering of the literary field, taghazzul took on new functions in relation to the Western category of lyric.
Bacterial Vaginosis Treatment Patterns, Associated Complications, and Health Care Economic Burden of Women With Medicaid Coverage in the United States
Authors: Watkins Eren , Chow Clifton M. , Lingohr-Smith Melissa , Lin Jay , Yong Candice , Tangirala Krishna , Collins Kevin , Li James , Brooks Roy , Amico Jennifer 
Published: August 2023

Background Bacterial vaginosis (BV) is a highly prevalent vaginal infection. Objectives Primary objectives of this study were to examine treatment patterns among female patients with Medicaid coverage who were diagnosed with incident BV, the frequency of BV-associated complications, and health care resource utilization (HCRU) and associated costs of incident BV and its recurrence. Secondary objectives were to identify predictors of total all-cause health care costs and number of treatment courses. Methods Female patients aged 12-49 years with an incident vaginitis diagnosis and ≥1 pharmacy claim for a BV medication were selected from the Merative MarketScan Medicaid database (2017-2020). Additional treatment courses were evaluated during a ≥12-month follow-up period, in which new cases of BV-associated complications and HCRU and the associated costs were also measured. Generalized linear models were used to identify baseline predictors of total all-cause health care costs and number of treatment courses. Results An incident vaginitis diagnosis and ≥1 BV medication claim were present in 114 313 patients (mean age: 28.4 years; 48.6% black). During the follow-up, 56.6% had 1 treatment course, 24.9% had 2, 10.2% had 3, and 8.3% had ≥4; 43.4% had BV recurrence. Oral metronidazole (88.5%) was the most frequently prescribed medication. Nearly 1 in 5 had a new occurrence of a BV-associated complication; most (76.6%) were sexually transmitted infections (STIs). Total all-cause and BV-related costs averaged $5794 and $300, respectively, per patient; both increased among those with more treatment courses. Older age, pregnancy, comorbidity, any STIs, postprocedural gynecological infection (PGI), and infertility were predictive of higher total all-cause health care costs, while race/ethnicity other than white was predictive of lower costs. Older age, black race, any STIs, pelvic inflammatory disease, and PGI were predictive of >1 treatment courses. Conclusion and Relevance The high recurrence of BV represents an unmet need in women’s health care and better treatments are necessary.
Identification of CDK gene family and functional analysis of CqCDK15 under drought and salt stress in quinoa
Authors: Wang Wangtian , Liu Wenyu , Wang Baoqiang 
Published: August 2023

Abstractas one of the oldest cultivated crops in the world, quinoa has been widely valued for its rich nutritional value and green health. In this study, 22 CDK genes (CqCDK01-CqCDK22) were identified from quinoa genome using bioinformatics method. The number of amino acids was 173–811, the molecular weight was 19,554.89 Da-91,375.70 Da, and the isoelectric point was 4.57–9.77. The phylogenetic tree divided 21 CqCDK genes into six subfamilies, the gene structure showed that 12 (54.5%) CqCDK genes (CqCDK03, CqCDK04, CqCDK05, CqCDK06, CqCDK07, CqCDK11, CqCDK14, CqCDK16, CqCDK18, CqCDK19, CqCDK20 and CqCDK21) had UTR regions at 5’ and 3’ ends. Each CDK protein had different motifs (3–9 motifs), but the genes with the same motifs were located in the same branch. Promoter analysis revealed 41 cis-regulatory elements related to plant hormones, abiotic stresses, tissue-specific expression and photoresponse. The results of real-time fluorescence quantitative analysis showed that the expression level of some CDK genes was higher under drought and salt stress, which indicated that CDK genes could help plants to resist adverse environmental effects. Subcellular localization showed that CqCDK15 gene was localized to the nucleus and cytoplasm, and transgenic plants overexpressing CqCDK15 gene showed higher drought and salt tolerance compared to the controls. Therefore, CDK genes are closely related to quinoa stress resistance. In this study, the main functions of quinoa CDK gene family and its expression level in different tissues and organs were analyzed in detail, which provided some theoretical support for quinoa stress-resistant breeding. Meanwhile, this study has important implications for further understanding the function of the CDK gene family in quinoa and our understanding of the CDK family in vascular plant.
Aberrant activation of five embryonic stem cell-specific genes robustly predicts a high risk of relapse in breast cancers
Authors: Jacquet Emmanuelle , Chuffart Florent , Vitte Anne-Laure , Nika Eleni , Mousseau Mireille , Khochbin Saadi , Rousseaux Sophie , Bourova-Flin Ekaterina 
Published: August 2023

AbstractBackgroundIn breast cancer, as in all cancers, genetic and epigenetic deregulations can result in out-of-context expressions of a set of normally silent tissue-specific genes. The activation of some of these genes in various cancers empowers tumours cells with new properties and drives enhanced proliferation and metastatic activity, leading to a poor survival prognosis.ResultsIn this work, we undertook an unprecedented systematic and unbiased analysis of out-of-context activations of a specific set of tissue-specific genes from testis, placenta and embryonic stem cells, not expressed in normal breast tissue as a source of novel prognostic biomarkers. To this end, we combined a strict machine learning framework of transcriptomic data analysis, and successfully created a new robust tool, validated in several independent datasets, which is able to identify patients with a high risk of relapse. This unbiased approach allowed us to identify a panel of five biomarkers, DNMT3B, EXO1, MCM10, CENPF and CENPE, that are robustly and significantly associated with disease-free survival prognosis in breast cancer. Based on these findings, we created a new Gene Expression Classifier (GEC) that stratifies patients. Additionally, thanks to the identified GEC, we were able to paint the specific molecular portraits of the particularly aggressive tumours, which show characteristics of male germ cells, with a particular metabolic gene signature, associated with an enrichment in pro-metastatic and pro-proliferation gene expression.ConclusionsThe GEC classifier is able to reliably identify patients with a high risk of relapse at early stages of the disease. We especially recommend to use the GEC tool for patients with the luminal-A molecular subtype of breast cancer, generally considered of a favourable disease-free survival prognosis, to detect the fraction of patients undergoing a high risk of relapse.
A survey of surgical patients’ perspectives and preferences towards general anesthesia techniques and shared-decision making
Authors: Pennington Bethany R. Tellor , Politi Mary C , Abdallah Arbi Ben , Janda Allison M. , Eshun-Wilsonova Ingrid , deBourbon Nastassjia G. , Siderowf Lilly , Klosterman Heidi , Kheterpal Sachin , Avidan Michael S. 
Published: August 2023

Abstract
Background
The decision about which type of general anesthetic to administer is typically made by the clinical team without patient engagement. This study examined patients’ preferences, experiences, attitudes, beliefs, perceptions, and perceived social norms about anesthesia and about engaging in the decision regarding general anesthetic choice with their clinician.

Methods
We conducted a survey in the United States, sent to a panel of surgical patients through Qualtrics (Qualtrics, Provo, UT) from March 2022 through May 2022. Questions were developed based on the Theory of Planned Behavior and validated measures were used when available. A patient partner who had experienced both intravenous and inhaled anesthesia contributed to the development and refinement of the questions.

Results
A total of 806 patients who received general anesthesia for an elective procedure in the last five years completed the survey. 43% of respondents preferred a patient-led decision making role and 28% preferred to share decision making with their clinical team, yet only 7.8% reported being engaged in full shared decision making about the anesthesia they received. Intraoperative awareness, pain, nausea, vomiting and quickly returning to work and usual household activities were important to respondents. Waking up in the middle of surgery was the most commonly reported concern, despite this experience being reported only 8% of the time. Most patients (65%) who searched for information about general anesthesia noted that it took a lot of effort to find the information, and 53% agreed to feeling frustrated during the search.

Conclusions
Most patients prefer a patient-led or shared decision making process when it comes to their anesthetic care and want to be engaged in the decision. However, only a small percentage of patients reported being fully engaged in the decision. Further studies should inform future shared decision-making tools, informed consent materials, educational materials and framing of anesthetic choices for patients so that they are able to make a choice regarding the anesthetic they receive.
T2-weighted imaging and dynamic contrast‑enhanced imaging in predicting the prognosis in patients with acute-on-chronic liver failure
Authors: Du Yan Ni , Guan Chun Shuang , Lv Zhi Bin , Xue Ming , Xing Yu Xue , Xie Ru Ming 
Published: August 2023

Abstract
Background
Acute-on-chronic liver failure (ACLF) is a syndrome with high 28- and 90-day mortality rates. Magnetic resonance imaging (MRI) has been widely used to diagnose and evaluate liver disease. Our purpose is to determine the value of the imaging features derived from Gd-DTPA-enhanced MRI for predicting the poor outcome of patients with ACLF and develop a clinically practical radiological score.

Methods
This retrospective study comprised 175 ACLF patients who underwent Gd-DTPA-enhanced abdominal MRI from January 2017 to December 2021. The primary end-point was 90-day mortality. Imaging parameters, such as diffuse hyperintense of the liver on T2WI, patchy enhancement of the liver at the arterial phase, uneven enhancement of the liver at the portal vein phase, gallbladder wall edema, periportal edema, ascites, esophageal and gastric varix, umbilical vein patefac, portal vein thrombosis, and splenomegaly were screened. Cox proportional hazard regression models were used to evaluate prognostic factors and develop a prediction model. The accuracy of the model was evaluated by receiver operating characteristic (ROC) curves.

Results
During the follow-up period, 31 of the 175 ACLF patients died within 90 days. In the multivariate analysis, three imaging parameters were independently associated with survival: diffuse hyperintense on T2WI (p = 0.007; HR = 3.53 [1.40–8.89]), patchy enhancement at the arterial phase (p = 0.037; HR = 2.45 [1.06–5.69]), moderate ascites (vs. mild) (p = 0.006; HR = 4.12 [1.49–11.36]), and severe ascites (vs. mild) (p = 0.005; HR = 4.29 [1.57–11.71]). A practical radiological score was proposed, based on the presence of diffuse hyperintense (7 points), patchy enhancement (5 points), and ascites (6, 8, and 8 points for mild, moderate, and severe, respectively). Further analysis showed that a cut-off at 14 points was optimum to distinguish high-risk (score > 14) from the low-risk group (score ≤ 14) for 90-day survival and demonstrated a mean area under the ROC curve of 0.774 in ACLF patients.

Conclusions
Gd-DTPA-enhanced MR imaging features can predict poor outcomes in patients with ACLF, based on which we proposed a clinically practical radiological score allowing stratification of the 90-day survival.
An exploration of health workers’ experiences in providing bereavement care to mothers following a stillbirth: results from a subnational level health system in Uganda
Authors: Ssegujja Eric , Ddumba Isaac , Andipatin Michelle 
Published: August 2023

Abstract
Background
Stillbirth is a profound emotion-laden event to the mothers and health workers who provide care due to its sudden and unexpected occurrence. Health workers offering support in regions shouldering the highest-burden experience providing support to a stillbirth mother in their professional lifetime. However, their experiences seldom get documented as much of the focus is on mothers causing a dissonance between parental and clinical priorities. This study aimed to explore the health worker’s experiences in the provision of bereavement care to mothers following a stillbirth.

Methods
An exploratory cross-sectional qualitative study was undertaken on a purposively selected sample of key informants drawn from frontline health workers and health systems managers providing maternal health services at a subnational level health system in Uganda. An interview guide was used to collect data with the audio-recorded interviews transcribed using Microsoft office word. Atlas. ti a qualitative data management software aided in coding with analysis following a thematic content analysis technique.

Results
There was no specialised bereavement care provided due to inadequate skills, knowledge of content, resources and support supervision for the same. However, health workers improvised within the available resources to comfort mothers upon news of a stillbirth. Disclosure to mothers about the stillbirth loss often took the form of forewarnings, direct and sometimes delayed disclosure. A feeling of unpreparedness to initiate the disclosure process to the mother was common while the whole experience had an emotional effect on the health workers when establishing the cause, particularly for cases without clear risk factors. The emotional breakdown was often a reflexive response from the mothers which equally affected the care providers. Health workers engaged in comforting and rebuilding the mothers to transition through the loss and validate the loss. Efforts to identify the skills and health systems gaps for address were a common response targeted at improving the quality of maternal healthcare services to avert similar occurrences in the future.

Conclusion
Providing care to mothers after stillbirth was an emotional and challenging experience for health workers requiring different approaches to disclosure and provision of emotional support. The aspect of specialised bereavement care was lacking within the current response. Reflection of unpreparedness to handle the tasks demonstrates a deficit in the required skills. It is a critical gap missing hence calling for dedicated efforts to address it. Targeting efforts to improve health workers’ competencies and preparedness to manage grieving mothers is one way to approach it.
“I would not want the mechanic to direct me to an engine repair manual”: a qualitative analysis of provider perspectives on low-intensity treatments for patients on waiting lists
Authors: Peipert Allison , Adams Sydney , Lorenzo-Luaces Lorenzo 
Published: August 2023

AbstractBackgroundLow-intensity treatments (LITs), such as bibliotherapy or online self-help, have the potential to reach more individuals than traditional face-to-face care by circumventing many of the common barriers to mental health treatment. Despite substantial research evidence supporting their usability and efficacy across several clinical presentations, prior work suggests that mental health providers rarely recommend LITs for patients waiting for treatment.MethodsThe present study analyzed provider open responses to a prompt asking about perceived barriers, thoughts, and comments related to additional treatment resources for patients on treatment waiting lists. We surveyed 141 practicing mental health providers, 65 of whom responded to an open text box with additional thoughts on using LITs for patients on treatment waiting lists. Responses were qualitatively coded using a thematic coding process.ResultsQualitative outcomes yielded 11 codes: patient appropriateness, research evidence, feasibility, patient barriers, liability, patient personal contact, additional resources, positive attitudes, trust in programs, systemic problems, and downplaying distress.ConclusionsResults suggest providers are predominantly concerned about the potential of suggesting a LIT that would be ultimately inappropriate for their patient due to a lack of assessment of the patient’s needs. Furthermore, providers noted ambiguity around the legal and ethical liability of recommending a LIT to someone who may not yet be a patient. Guidelines and standards for recommending LITs to patients on treatment waiting lists may help address ambiguity regarding their use in routine care.