bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postpartum readmission for hypertension and pre‐eclampsia: development and validation of a predictive model
Authors: Venkatesh Kartik Kailas , Jelovsek J. Eric , Hoffman Matthew , Beckham A. Jenna , Bitar Ghamar , Friedman Arielle M. , Boggess Kim A. , Stamilio David M. 
Published: June 2023

AbstractObjectiveTo develop a model for predicting postpartum readmission for hypertension and pre‐eclampsia at delivery discharge and assess external validation or model transportability across clinical sites.DesignPrediction model using data available in the electronic health record from two clinical sites.SettingTwo tertiary care health systems from the Southern (2014–2015) and Northeastern USA (2017–2019).PopulationA total of 28 201 postpartum individuals: 10 100 in the South and 18 101 in the Northeast.MethodsAn internal‐external cross validation (IECV) approach was used to assess external validation or model transportability across the two sites. In IECV, data from each health system were first used to develop and internally validate a prediction model; each model was then externally validated using the other health system. Models were fit using penalised logistic regression, and accuracy was estimated using discrimination (concordance index), calibration curves and decision curves. Internal validation was performed using bootstrapping with bias‐corrected performance measures. Decision curve analysis was used to display potential cut points where the model provided net benefit for clinical decision‐making.Main outcome measuresThe outcome was postpartum readmission for either hypertension or pre‐eclampsia <6 weeks after delivery.ResultsThe postpartum readmission rate for hypertension and pre‐eclampsia overall was 0.9% (0.3% and 1.2% by site, respectively). The final model included six variables: age, parity, maximum postpartum diastolic blood pressure, birthweight, pre‐eclampsia before discharge and delivery mode (and interaction between pre‐eclampsia × delivery mode). Discrimination was adequate at both health systems on internal validation (c‐statistic South: 0.88; 95% confidence interval [CI] 0.87–0.89; Northeast: 0.74; 95% CI 0.74–0.74). In IECV, discrimination was inconsistent across sites, with improved discrimination for the Northeastern model on the Southern cohort (c‐statistic 0.61 and 0.86, respectively), but calibration was not adequate. Next, model updating was performed using the combined dataset to develop a new model. This final model had adequate discrimination (c‐statistic: 0.80, 95% CI 0.80–0.80), moderate calibration (intercept −0.153, slope 0.960, Emax 0.042) and provided superior net benefit at clinical decision‐making thresholds between 1% and 7% for interventions preventing readmission. An online calculator is provided here.ConclusionsPostpartum readmission for hypertension and pre‐eclampsia may be accurately predicted but further model validation is needed. Model updating using data from multiple sites will be needed before use across clinical settings.
Laryngeal edema in drug reaction with eosinophilia and systemic symptoms syndrome due to sulfasalazine
Authors: Shimada Yusuke , Suyama Yasuhiro , Koizumi Megumi , Hagiwara Kiyofumi 
Published: June 2023

AbstractWe present a case of a 47‐year‐old man with drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. The patient had been diagnosed with rheumatoid arthritis and sulfasalazine was prescribed 4 weeks before admission. Initial symptoms with fever and rash worsened even after a discontinuation of the medication, and concomitant symptoms developed including typical manifestations of facial rash and edema sparing the periorbital area, as well as atypical laryngeal edema. Rheumatologists should be aware that sulfasalazine is derived from sulfonamide and can possibly induce DRESS syndrome, one of the life‐threatening drug eruptions.
The effectiveness of Tier 1 digital interventions for early reading: A meta‐analysis
Authors: Vanbecelaere Stefanie , Said‐Metwaly Sameh , Van den Noortgate Wim , Reynvoet Bert , Depaepe Fien 
Published: June 2023

AbstractReading is a fundamental skill to acquire during children's school career. The present meta‐analysis examined research on the effectiveness of digital technologies to foster early reading skills during Tier‐1 interventions (ie, high‐quality core reading instruction which is intended to promote learning for all children). Unlike previous meta‐analyses, this meta‐analysis investigated the effectiveness in a broad way, taking into account cognitive versus non‐cognitive learning outcomes, near versus far transfer outcomes and immediate versus delayed outcomes. Furthermore, different study characteristics were taken into account including participant characteristics, the targeted reading subskills, duration of intervention, type of technology and the level of integration. A total of 568 effect sizes from 72 studies encompassing 60,890 participants were analysed using a meta‐analytic three‐level model. A Hedges'g effect size of 0.37 was obtained, suggesting that using digital technologies generally have a positive, albeit small, effect compared to traditional teaching methods. Moderator analyses indicated that this effect was robust to cognitive and non‐cognitive outcomes, near and far transfer outcomes, and immediate and delayed outcomes, but differed by participants' age and study quality. Recommendations are formulated to push forward research on how digital interventions can be effectively implemented in the classroom.
Practitioner notesWhat is already known about this topic

Digital technologies can foster (early) reading skills.
Meta‐analyses to date focus only on the effect of digital reading interventions in terms of cognitive outcomes.
Unclear how different factors moderate the effectiveness of digital reading interventions (eg, type of technology, trained content, level of integration).
What this paper adds

Results corroborate previous findings indicating a positive but small effect compared to traditional teaching methods.
This study provides some evidence that this effect was robust to cognitive and non‐cognitive outcomes, near and far transfer outcomes, and immediate and delayed outcomes.
The effect differed by participants' age and study quality.
Game elements, adaptivity and whether the intervention was well integrated made little difference to the effectiveness of the intervention.
Implications for practice and/or policy

The results confirm that digital reading interventions are effective in fostering cognitive, non‐cognitive and efficiency outcomes.
Call for more intervention studies investigating how game characteristics and the level of integration of a digital tool moderate the effectiveness.
There is a need for reports of pilot studies investigating the effectiveness of recent digital technologies such as AR and VR.
Discursive delegitimization of Rouhani's nuclear diplomacy and the Iran nuclear deal by Iranian conservatives on Twitter
Authors: Nourani Hossein , Mohammadian Mohammad , Sarhaddi Reza , Danesh Afsaneh , Latifi Farzaneh 
Published: June 2023

AbstractThe reformist‐moderate and the conservative discourses have co‐existed and contended for primacy in the Iranian foreign policy since the 1979 revolution. The 2015 Joint Comprehensive Plan of Action (JCPOA), also known as the Iran nuclear deal, has been at the core of this discursive contest in recent years. This article investigates how Iranian conservative tweeters delegitimized the JCPOA and President Rouhani's nuclear diplomacy. We use Van Leeuwen's discursive construction of legitimacy (2008) to analyze three popular conservative Twitter accounts. Findings show that the Iranian conservatives used the strategies of authorization, moral evaluation, and rationalization for legal and political criticism of the JCPOA, offending Rouhani's administration and allies, and questioning their political competence. This research partly reveals the conservatives' anti‐negotiation and anti‐West logic and their refusal to offer a diplomatic alternative to the JCPOA.
Incubation with porcine urinary bladder matrix yields a late‐stage wound transcriptome in endothelial cells and keratinocytes isolated from both diabetic and non‐diabetic subjects
Authors: Paige John T. , Lightell Daniel J. , Douglas Hunter F. , Klingenberg Natasha C. , Pham Thaidan , Woods T. Cooper 
Published: June 2023

AbstractProper wound closure requires the functional coordination of endothelial cells (ECs) and keratinocytes. In the late stages of wound healing, keratinocytes become activated and ECs promote the maturation of nascent blood vessels. In diabetes mellitus, decreased keratinocyte activation and impaired angiogenic action of ECs delay wound healing. Porcine urinary bladder matrix (UBM) improves the rate of wound healing, but the effect of exposure to UBM under diabetic conditions remains unclear. We hypothesized that keratinocytes and ECs isolated from both diabetic and non‐diabetic donors would exhibit a similar transcriptome representative of the later stages of wound healing following incubation with UBM. Human keratinocytes and dermal ECs isolated from non‐diabetic and diabetic donors were incubated with and without UBM particulate. RNA‐Seq analysis was performed to identify changes in the transcriptome of these cells associated with exposure to UBM. While diabetic and non‐diabetic cells exhibited different transcriptomes, these differences were minimized following incubation with UBM. ECs exposed to UBM exhibited changes in the expression of transcripts suggesting an increase in the endothelial–mesenchymal transition (EndoMT) associated with vessel maturation. Keratinocytes incubated with UBM demonstrated an increase in markers of activation. Comparison of the whole transcriptomes with public datasets suggested increased EndoMT and keratinocyte activation following UBM exposure. Both cell types exhibited loss of pro‐inflammatory cytokines and adhesion molecules. These data suggest that application of UBM may accelerate healing by promoting a transition to the later stages of wound healing. This healing phenotype is achieved in cells isolated from both diabetic and non‐diabetic donors.
The surface and internal features of pubic hair: A comparative study with those of scalp hair
Authors: Ryu Soo Ryeon , Suh Jungwoo , Kim Hyeyoung , Shin Kwanwoo 
Published: June 2023

AbstractAlthough pubic hair has been a subject of public interest, little is known about its structure or characteristics beyond its curly and coarse appearance. In this study, we investigated the surface and internal features of pubic hair from Korean males and compared them to those of scalp hair from the same donors. Our findings indicate that the cuticle layer of pubic hair has a greater number of scales than that of scalp hair, resulting in a thicker cuticle layer overall. Fourier‐transform infrared (FT‐IR) spectroscopy analysis showed that the protein in the cortex layer of pubic hair was less affected by exposure to urine or ammonia than the protein in the cortex layer of scalp hair. This suggests that the cuticle layer of pubic hair, which is thicker and composed of more scales, acts as a physical barrier that protects the hair's internal structure. Furthermore, we observed that the secondary and tertiary structures of keratin in the pubic hair cuticle layer are essentially different from those in scalp hair. Based on these findings, we hypothesize that the thickened cuticle layer in pubic hair may have evolved as a defence mechanism against chemical damage from urine, urea and ammonia.
Communication about children's origins among same‐gender adoptive parent families in Belgium, France, and Spain
Authors: Messina Roberta , Farr Rachel H. , Tasker Fiona 
Published: June 2023

AbstractObjectiveThis study explored communication about children's origins among same‐gender parent adoptive families.BackgroundAlthough this topic has been widely researched among different‐gender parent adoptive families, communication about origins among those with same‐gender parents, as well as sexual minority identity dynamics relevant to this crucial task, remain unexplored.MethodA sample of same‐gender adoptive couples (N = 31) from Belgium, France, and Spain with children aged between 4 and 18 years (Mage = 8.9 years) participated in a semistructured interview and a graphic projective test aimed at explore their feelings and communication process about their adopted child's birth family.ResultsInductive thematic analysis yielded a continuum of three main stances conveyed by adoptive parents regarding their child's origins: (a) critical/minimization, (b) cautious/uncertainty, and (c) open/validation. The first (critical/minimization) was associated with experiences of sexual minority stigma and poorer communication about children's origins and sexual minority family‐related issues, while the second (cautious/uncertainty) was characterized by mixed feelings (i.e., at times open, at times critical) in communicating about origins and parents' sexual minority experiences. The third (open/validation) was associated with positive feelings toward adoptive and sexual minority family statuses, as well as identity integration as a lesbian or gay parent and low internalized sexual stigma.ConclusionOur findings underline the importance of sexual minority identity issues in relation to communication about children's origins in same‐gender parent adoptive families.ImplicationsThese findings have important implications for both adoption assessment and therapeutic work with same‐gender adoptive parent families.
Comparing the Fried frailty phenotype versus the Veterans Affairs frailty index among dialysis dependent patients
Authors: Hamiduzzaman Anum , Wu Ruoxue , Murray Victoria , Kalantar‐Zadeh Kamyar , Streja Elani , Sy John 
Published: June 2023

AbstractIntroductionFrailty in dialysis patients is a modifiable disease state which can increase mortality if left untreated but remains underdiagnosed as frailty evaluations can be arduous or time consuming. We evaluate the agreement between a clinical frailty construct (Fried frailty phenotype, FFP) against and an electronic health record‐based Veterans Affairs Frailty Index (VAFI) and their association with mortality.MethodsA retrospective cohort analysis of 764 participants from the ACTIVE/ADIPOSE study was performed. Frailty as measured by VAFI and FFP was obtained and Kappa statistic estimating concordance between the two scores were calculated. Differences in mortality risk were analyzed according to presence or absence of frailty.FindingsWhen assessing agreement between the VAFI and FFP, the kappa statistic was 0.09 (95% confidence interval [CI] 0.02–0.16) suggesting a low level of agreement. Frailty was independently associated with higher mortality risk (hazards ratio [HR] 1.40–1.42 in fully adjusted models depending upon frailty construct). Discordantly frail patients by construct had a higher risk of mortality though this was not statistically significant after adjustment. However, concordantly frail patients had much higher mortality risk compared to concordantly nonfrail (adjusted HR 2.08, 95% CI 1.44–3.01).DiscussionPoor agreement between constructs is likely reflective of the multifactorial definition of frailty. While further longitudinal studies are needed to determine if the VAFI would be beneficial in the reassessment of frailty, it may be beneficial as a cue for further frailty testing (e.g., with FFP) with the combination of multiple frail constructs providing improved prognostic information.
The poor antitumor effect of pembrolizumab in advanced upper urothelial carcinoma with renal parenchymal invasion
Authors: Hara Takuto , Furukawa Junya , Okamura Yasuyoshi , Bando Yukari , Terakawa Tomoaki , Harada Kenichi , Takahashi Satoru , Nakano Yuzo , Fujisawa Masato 
Published: June 2023

ObjectivesWe investigated poor prognosticators in advanced or unresectable urothelial carcinoma, focusing on renal parenchymal invasion (RPI).MethodsThis study included 48 bladder cancer (BC) and 67 upper tract urothelial carcinoma (UTUC) patients treated with pembrolizumab from December 2017 to September 2022 at Kobe University Hospital. Medical records were retrospectively reviewed for clinical characteristics, objective response rate (ORR), progression‐free survival (PFS), and overall survival (OS). Multivariate analyses were performed using the Cox proportional hazard regression model to identify parameters associated with either PFS or OS.ResultsOf 67 UTUC patients, 23 had RPI and 41 patients did not, while 3 cases could not be evaluated. Patients with RPI were predominantly elderly and had liver metastases. ORR for patients with RPI was 8.7%, while it was 19.5% for those without RPI. PFS was significantly shorter for patients with RPI compared with those without RPI. Patients with RPI had significantly shorter OS than those without RPI. On multivariate analysis, performance status (PS) ≥ 2, neutrophil‐lymphocyte ratio (NLR) ≥ 3, C‐reactive protein ≥0.3 mg/dL and RPI were independent prognostic factors for PFS. PS ≥ 2, NLR ≥ 3, visceral metastasis and RPI were independent prognostic factors for OS. UTUC patient OS was significantly shorter than BC patient OS, while no significant difference in PFS or OS was observed between BC patients and UTUC patients without RPI.ConclusionsRPI was a poor prognostic factor in advanced urothelial carcinoma treated with pembrolizumab, possibly resulting in a poorer prognosis for UTUC compared with BC.
Realization of diversity in physical properties of Zr2Se(B1‐xSex) MAX phases through DFT approach
Authors: Hadi Mohammad A. , Akhter Mehnaj , Ahasan Mohammad Shamim , Ahmed Istiak , Kashem Mohammad A. 
Published: June 2023

AbstractThe discovery of a series of MAX phases, Zr2Se(B1‐xSex), with Se at both A‐ and X‐sites, drives a new chemical diversity to the MAX family. Here, we employed the density functional theory (DFT) approach to realize the diversity in physical properties of Zr2Se(B1‐xSex). All compositions of Zr2Se(B1‐xSex) are mechanically stable and the dynamical stability of the end member Zr2SeSe is confirmed. The elastic constant C33 and bulk moduli B show a decrease almost monotonically with Se‐content x while other constants and moduli change irregularly. All elastic constants and moduli except C12 and C13 are highest for the end member Zr2SeB. Additionally, the Vickers hardness, Debye temperature, minimum thermal conductivity, and lattice thermal conductivity are highest for Zr2SeB. The increase of Se‐content x at X‐site reduces most of the properties of Zr2Se(B1‐xSex). The electronic band structures change drastically with increasing Se‐content x. This diversity in electronic band structures is mainly the reason for the diversity in physical properties of Zr2Se(B1‐xSex). All compositions of Zr2Se(B1‐xSex) have the potential to be thermal barrier coating materials, and Zr2SeB has the potential to be etched into 2D MXene, Zr2B.
A detailed look at the European Medicines Agency's recommendations for use of Janus kinase inhibitors in patients with atopic dermatitis
Authors: Wollenberg Andreas , Thyssen Jacob P. , Bieber Thomas , Chan Gary , Kerkmann Urs 
Published: June 2023

AbstractBackgroundOral Janus kinase inhibitors (JAKi) have been approved for the treatment of several chronic inflammatory conditions, including rheumatoid arthritis (RA) and atopic dermatitis (AD). Prompted by new evidence, the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) recently reassessed the benefit–risk balance of oral JAKi. The PRAC recommended that oral JAKi should be used only if no suitable alternatives are available in patients ≥65 years of age, or who have a history of atherosclerotic cardiovascular (CV) disease, other CV risk factors (e.g. history of long‐term smoking) or have malignancy risk factors, and used with caution in patients at risk of pulmonary embolism or deep vein thrombosis. The European Commission's final decision was issued in March 2023.ObjectivesOur goal was to highlight the PRAC recommendations, especially in the context of oral JAKi use in AD.MethodsAuthors summarized the PRAC recommendations, the new clinical evidence on oral JAKi safety and key differences between patients with RA and AD.ResultsRisk of developing adverse events of special interest (e.g. cardiovascular events, malignancy) is higher in patients with RA than in patients with AD, because of the higher prevalence of the underlying risk factors.ConclusionsThe benefit–risk profile of JAKi approved for AD remains favourable, including use as first‐line systemic therapy for patients with AD <65 years of age and without CV or malignancy risk factors.
Evaluating a web‐based personalized decision report for total knee or hip replacement: Lessons learned from patients
Authors: Pila Sarah , Stern Brocha Z. , Rothrock Nan E. , Franklin Patricia D. 
Published: June 2023

AbstractRationalePatient‐reported outcomes (PROs) are increasingly used in the context of clinical care, but evaluation of patients' perspectives of PRO‐based applications in routine care remains limited.Aims and ObjectivesThis paper investigates patients' acceptability of a personalized web‐based decision report for total knee or hip replacement and identifies opportunities to refine the report.MethodThis qualitative evaluation was embedded in a pragmatic cluster randomized trial of the report. We interviewed 25 patients with knee and hip osteoarthritis about their experiences using the personalized decision report in the context of a surgical consultation. The web‐based report contained current descriptive PRO scores of pain, function and general physical health; tailored predicted postoperative PRO scores (i.e., personalized likely outcomes based on actual knee or hip replacement outcomes of similar patients in a national registry); and information about alternative nonoperative treatments. Two trained researchers analysed the interview data qualitatively using a combination of inductive and deductive coding.ResultsWe identified three major categories for evaluation: content of report, presentation of data in report and engagement with report. Patients generally liked the report overall but specifically valued different pages of the report based on where they were in the surgical decision‐making process. Patients identified areas of confusion in data presentation related to graph orientation, terminology and interpretation of T‐scores. Patients also highlighted support needs to meaningfully engage with the information in the report.ConclusionOur findings highlight areas of opportunity to further refine this personalized web‐based decision report and similar patient‐facing PRO applications for routine clinical care. Specific examples include additional tailoring of reports via filterable web‐based dashboards and scalable educational supports to facilitate more independent patient understanding and use.