bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-traumatic stress syndromes following childbirth influenced by birth mode—is an emergency cesarean section worst?
Authors: Hüner Beate , Friedl Thomas , Schütze Sabine , Polasik Arkadius , Janni Wolfgang , Reister Frank 
Published: July 2023

Abstract
Purpose
The experience of birth is an emotional challenge for women. Traumatic birth experiences can cause psychological stress symptoms up to post-traumatic stress disorders (PTSD), with impact on women’s wellbeing. Primarily unplanned interventions can trigger birth-mode-related traumatization. The aim of the study was to evaluate whether an emergency cesarean section (ECS) is the most traumatizing.

Methods
A retrospective case–control study was undertaken. Therefore, data were collected by standardized questionnaires (Impact of Event Scale-Revised and City Birth Trauma Scale) that were sent to women with singleton pregnancies > 34 weeks of gestation who either give birth by ECS (case group, n = 139), unplanned cesarean section (UCS), operative vaginal birth (OVB), or natural birth (NB) (three control groups, n = 139 each). The investigation period was 5 years.

Results
Overall, 126 of 556 (22%) sent questionnaires were returned and could be analyzed (32 ECS, 38 UCS, 36 OVB, and 20 NB). In comparison to other birth modes, women with ECS were associated with a higher degree of traumatization as revealed by statistically significant differences regarding the DSM-5 criteria intrusion and stressor. In addition, women who underwent ECS declared more frequently a demand for professional debriefing compared to other birth modes.

Discussion
ECS is associated with more post-traumatic stress symptoms compared to other birth modes. Therefore, early interventions are recommended to reduce long-term psychological stress reactions. In addition, outpatient follow-ups by midwives or emotional support programs should be implemented as an integral component of postpartum debriefings.
Determining ICU EEG periodic patterns and why it matters
Authors: Gélisse Philippe , Tatum William O. , Crespel Arielle , Jallon Pierre , Kaplan Peter W. 
Published: July 2023

AbstractHistorically, periodic EEG patterns were described as any pattern with stereotyped paroxysmal complexes occurring at regular intervals, i.e., the period (T). T is the sum of the duration of the waveform (t1) and, eventually, the duration of the interval between two consecutive waves (t2). The American Clinical Neurophysiology Society introduced the concept of a clearly discernible inter-discharge interval between consecutive waveforms (i.e., t2). As this definition was not applied to what have previously been termed triphasic waves and in some cases of lateralized periodic discharges, we propose reconsideration of terminology that includes historical use of definitions. This will allow the development and usage of the concept for periodic EEG patterns as any runs of stereotyped paroxysmal waveforms separated by nearly identical intervals and prolonged repetitive complexes on the EEG. Prolonged expression means EEG is recorded for a sufficient period of time to prove that the pattern is repetitive, thus resulting in a monomorphic/monotonous pattern. More important than the inter-discharge interval (t2), periodic EEG patterns occur at time regular intervals (T). As a result, periodic EEG activity should be considered along a continuum and not the opposite of rhythmic EEG activity where no interval activity exists between consecutive waveforms.
The relationship of diabetic retinopathy severity scales with frequency and surface area of diabetic retinopathy lesions
Authors: Esmaeilkhanian Houri , Liu Henry , Fasih-Ahmed Sohaib , Gnanaraj Ramya , Verma Aditya , Oncel Deniz , He Ye , Nittala Muneeswar Gupta , Attiku Yamini , Kadomoto Shin , Corradetti Giulia , Velaga Swetha Bindu , Tsui Irena , Prasad Pradeep , Li Xiaorong , Li Xiao , Jiang Shangjun Collier , Choudhry Netan , Jayadev Chaitra , Sadda SriniVas 
Published: July 2023

Abstract

Purpose
To assess the relationship between qualitative diabetic retinopathy (DR) scales with the precise numbers and surface area of DR lesions within the Early Treatment Diabetic Retinopathy Study (ETDRS) standard seven field (S7F) region on ultrawide-field (UWF) color fundus images.

Methods
In this study, we collected UWF images from adult patients with diabetes. Poor-quality images and eyes with any pathology precluding assessment of DR severity were excluded. The DR lesions were manually segmented. DR severity was graded according to the International Clinical Diabetic Retinopathy (ICDR) and AA protocol by two masked graders within the ETDRS S7F. These lesions’ numbers and surface area were computed and correlated against the DR scores using the Kruskal–Wallis H test. Cohen’s Kappa was performed to determine the agreement between two graders.

Results
One thousand five hundred and twenty eyes of 869 patients (294 females, 756 right eyes) with a mean age of 58.7 years were included. 47.4% were graded as no DR, 2.2% as mild non-proliferative DR (NPDR), 24.0% as moderate NPDR, 6.3% as severe NPDR, and 20.1% as proliferative DR (PDR). The area and number of DR lesions generally increased as the ICDR level increased up to severe NPDR, but decreased from severe NPDR to PDR. There was perfect intergrader agreement on the DR severity.

Conclusion
A quantitative approach reveals that DR lesions’ number and area generally correlate with ICDR-based categorical DR severity levels with an increasing trend in the number and area of DR lesions from mild to severe NPDR and a decrease from severe NPDR to PDR.
Multiple-point statistical modeling of three-dimensional glacial aquifer heterogeneity for improved groundwater management
Authors: Kawo Nafyad Serre , Korus Jesse , Gulbrandsen Mats Lundh 
Published: July 2023

AbstractQuaternary glacial aquifers are important water sources for irrigation in many agricultural regions, including eastern Nebraska, USA. Quaternary glacial aquifers are heterogeneous, with juxtaposed low-permeability and high-permeability hydrofacies. Managing groundwater in such aquifers requires a realistic groundwater-flow model parameterization, and characterization of the aquifer geometry, spatial distribution of aquifer properties, and local aquifer interconnectedness. Despite its importance in considering uncertainty during decision-making, hydrofacies probabilities generated from multiple-point statistics (MPS) are not widely applied for groundwater model parameterization and groundwater management zone delineation. This study used a combination of soft data, a cognitive training image, and hard data to generate 100 three-dimensional (3D) conditional aquifer heterogeneity realizations. The most probable model (probability of hydrofacies) was then computed at node spacing of 200 × 200 × 3 m and validated using groundwater-level hydrographs. The resulting hydrofacies probability grids revealed variations in aquifer geometry, locally disconnected aquifer systems, recharge pathways, and hydrologic barriers. The profiles from hydrofacies probability at various locations show spatial variability of the streambed and aquifer connectivity. Groundwater-level hydrographs show evidence of these aquifer characteristics, verifying the general structure of the model. Using the MPS-generated 3D hydrofacies probability and hydrologic data, a novel workflow was developed in order to better define high-resolution groundwater management zones and strategies. In general, the conditional probability of hydrofacies helps improve the understanding of glacial aquifer heterogeneity, the characterization of aquifer-to-aquifer and streambed-aquifer connections, and the delineation of groundwater management zones. This MPS workflow can be adapted to other areas for modeling 3D aquifer heterogeneity using multisource data.
How do native and non-native speakers recognize emotions in the instructor’s voice in educational videos? Exploring the first step of the cognitive-affective model of e-learning for international learners
Authors: Sajinčič Nežka , Sandak Anna , Simmons Amy , Istenič Andreja 
Published: July 2023

AbstractThe emotional stance of the instructor in an educational video can influence the learning process. For this reason, we checked the first link of the cognitive-affective model of e-learning, namely, whether learners can recognize emotions that an instructor expresses only with their voice. Since English is not the native language for many learners and most instructional videos are produced in English, we tested for possible differences in emotion recognition between native and non-native speakers. We focused on positive emotions typically conveyed in such videos — enthusiasm and calmness. Native and non-native English speakers watched 12 short video clips about wood as a building material spoken by an instructor in different emotional tones — five videos expressed enthusiasm, five calmness, one boredom and one frustration. Participants rated the extent to which they thought the narrator expressed a specific emotion, the valence and activation level of the narration and solved an English vocabulary test. Both native and non-native speakers recognized the correct emotions (except for frustration), demonstrating the power of voice prosody to convey emotion in a multimedia learning scenario. Native speakers rated the enthusiastic videos more positively than non-native speakers, indicating a subtle difference in the way the two groups perceive emotions expressed through voice.
Cytotoxic NK cells phenotype and activated lymphocytes are the main characteristics of patients with alcohol-associated liver disease
Authors: Zurera-Egea Coral , Teniente-Serra Aina , Fuster Daniel , Martínez-Cáceres Eva , Muga Roberto , Zuluaga Paola 
Published: July 2023

AbstractT cells, natural killer (NK) and NKT cells have opposing actions in the development of alcohol-associated liver fibrosis. We aimed to evaluate the phenotype of NK cells, NKT cells and activated T cells in patients with alcohol use disorder (AUD) according to the presence of advanced liver fibrosis (ALF). Totally, 79 patients (51-years, 71% males) were admitted to treatment of AUD. ALF was defined as FIB4-score > 2.67. Immunophenotyping of NK cells (CD3−CD56+CD16+, CD3−CD56+CD16−, CD3−CD56−CD16+), NKT-like (CD3+CD56+), and the activation status of CD4+, CD8+ and regulatory T cells (Tregs) were evaluated according to the HLA-DR expression. Patients had an AUD duration of 18 ± 11 years with a daily alcohol consumption of 155 ± 77 gr/day prior to hospital admission. The values of absolute cells were 2 ± 0.9 cells/L for total lymphocytes, 1054 ± 501 cells/µL for CD4+, 540 ± 335 cells/µL for CD8+, 49.3 ± 24.8 cells/µL for Tregs, 150.3 ± 97.5 cells/µL for NK cells and 69.8 ± 78.3 cells/µL for NKT-like. The percentage of total NK cells (11.3 ± 5.5% vs. 7 ± 4.3%, p < 0.01), CD3−CD56+CD16+ regarding total lymphocytes (9.7 ± 5.1% vs. 5.8 ± 3.9%, p < 0.01), activated CD4+ cells (5.2 ± 3.2% vs. 3.9 ± 3%, p = 0.04) and activated CD8+ cells (15.7 ± 9.1% vs. 12.2 ± 9%, p = 0.05) were significantly higher in patients with ALF. The percentage of CD3−CD56+CD16− regarding NK cells (5.1 ± 3.4% vs. 7.6 ± 6.2%, p = 0.03) was significantly lower in patients with ALF. Activated Tregs (39.9 ± 11.5 vs. 32.4 ± 9.2, p = 0.06) showed a tendency to be higher in patients with ALF. The proportion of activated CD4+ cells (r = 0.40, p < 0.01) and activated CD8+ cells (r = 0.51, p < 0.01) was correlated with the proportion of NKT-like in patients without ALF. Patients with ALF presented an increased NK cytotoxic phenotype and activated T cells concomitant with a decreased NK cytokine-secreting phenotype.
Sex- and age-dependent breeding plumage acquisition in monomorphic species, the Black-headed Gull Chroicocephalus ridibundus
Authors: Meissner Włodzimierz , Czaplewska Emilia , Ożarowska Agnieszka 
Published: July 2023

AbstractIn monomorphic species, like in the Black-headed Gull, both sexes look alike in breeding plumage. With large sets of data on captured and photographed birds and using the Underhill–Zucchini moult model, we provided a detailed pattern of breeding plumage development in this species by age and sex. This study, similar to other studies, documented first adults with the initial stage of head moult at the beginning of January, yet the mean start date of nuptial moult in adults was the end of February. Half of adults acquired full breeding plumage about mid-March and almost all of them before mid-April. The start date of nuptial moult was more variable in immatures. The mean start of head moult in immatures was 19th April, which is 52 days later than in adults, and the majority, i.e., 70%, did not complete moult until the end of May. We showed for the first-time sex-dependent breeding plumage acquisition in monomorphic species. According to the Underhill–Zucchini moult model, males started to moult on average 7 days earlier than females and their moult lasted 7 days longer. Hence, the final date of completed head moult was the same in both sexes. A fully developed hood is an important part of the status signalling during pairing; therefore, completing the moult before mating is important for both sexes.
Exploring adaptive expertise in residency: the (missed) opportunity of uncertainty
Authors: Gamborg Maria Louise , Mylopoulos Maria , Mehlsen Mimi , Paltved Charlotte , Musaeus Peter 
Published: July 2023

AbstractPreparing novice physicians for an unknown clinical future in healthcare is challenging. This is especially true for emergency departments (EDs) where the framework of adaptive expertise has gained traction. When medical graduates start residency in the ED, they must be supported in becoming adaptive experts. However, little is known about how residents can be supported in developing this adaptive expertise. This was a cognitive ethnographic study conducted at two Danish EDs. The data comprised 80 h of observations of 27 residents treating 32 geriatric patients. The purpose of this cognitive ethnographic study was to describe contextual factors that mediate how residents engage in adaptive practices when treating geriatric patients in the ED. Results showed that all residents fluidly engaged in both adaptive and routine practices, but they were challenged when engaging in adaptive practices in the face of uncertainty. Uncertainty was often observed when residents’ workflows were disrupted. Furthermore, results highlighted how residents construed professional identity and how this affected their ability to shift between routine and adaptive practices. Residents reported that they thought that they were expected to perform on par with their more experienced physician colleagues. This negatively impacted their ability to tolerate uncertainty and hindered the performance of adaptive practices. Thus, aligning clinical uncertainty with the premises of clinical work, is imperative for residents to develop adaptive expertise.
Adolescent Girls and Young Women’s Experiences with Disclosing Oral PrEP or Dapivirine Vaginal Ring Use: a Multi-Country Qualitative Analysis
Authors: Young Alinda M. , Mancuso Noah , Atujuna Millicent , Tenza Siyanda , Chitukuta Miria , Kemigisha Doreen , Ngure Kenneth , van der Straten Ariane , Garcia Morgan , Szydlo Danny , Soto-Torres Lydia , Roberts Sarah T. 
Published: July 2023

AbstractEffective use of oral pre-exposure prophylaxis (PrEP) has been low among adolescent girls and young women (AGYW) in Eastern and Southern Africa, partly due to stigma and opposition from key influencers. Understanding AGYW’s experiences of disclosure of different PrEP modalities to key influencers may inform strategies to motivate uptake and adherence. We analyzed qualitative in-depth interviews and focus group discussions data from 119 participants in the MTN-034/REACH (Reversing the Epidemic in Africa with Choices in HIV Prevention) study of oral PrEP and the dapivirine vaginal ring (ring) to explore AGYW’s disclosure experiences. We found that AGYW disclosure experiences varied across influencers and product type. The ring was disclosed less often to most influencers, except partners, because it was discreet. Oral PrEP was disclosed more often, because pills were more common and to avoid HIV stigma given that oral PrEP resembled HIV treatment. Ultimately, disclosure typically led most key influencers to support product use through reminders and encouragement. While disclosure yielded positive support from influencers, further community awareness of both PrEP products is essential to reduce potential opposition and perceived stigma.Clinical Trial Number: NCT03593655.
Worst-case analysis of heuristic approaches for the temporal bin packing problem with fire-ups
Authors: Martinovic John , Strasdat Nico 
Published: July 2023

AbstractWe consider the temporal bin packing problem with fire-ups (TBPP-FU), a branch of operations research recently introduced in multi-objective cloud computing. In this scenario, any item is equipped with a resource demand and a lifespan meaning that it requires the bin capacity only during that time interval. We then aim at finding a schedule minimizing a weighted sum of the total number of bins required and the number of switch-on processes (so-called fire-ups) caused during operation. So far, research on the TBPP-FU has mainly focused on exact approaches and their improvement by valid cuts or variable reduction techniques. Although these studies have revealed the problem considered here to be very difficult to cope with, theoretical contributions to heuristic solution methods have not yet been presented in the available literature. Hence, in this article we investigate the worst-case behavior of some approximation algorithms, ranging from classic online algorithms to a more sophisticated look-ahead heuristic specifically designed for the TBPP-FU. In addition, we theoretically study three heuristics the ideas of which are inspired by solution methods for generalized bin packing problems in the field of logistics. As a main contribution, we constructively show that the feasible solutions obtained by all these approaches can be arbitrarily bad. By doing so, we (i) identify a new open problem in cutting and packing, and (ii) establish another previously unknown difference between the classical TBPP and the extended problem with fire-ups, rendering the latter the more difficult problem even from a heuristic point of view.
Induction of multiple defense responses in wheat plants against stripe rust using mycorrhizal fungi and Streptomyces viridosporus HH1
Authors: El-Sharkawy Hany H. A. , Rashad Younes M. , Elazab Nahla T. 
Published: July 2023

AbstractStripe rust, caused by Puccinia striiformis f. sp. tritici, is one of the most devastating diseases of wheat worldwide. This study dealt with investigating the biocontrol activity of mycorrhizal colonization and/or application of Streptomyces viridosporus HH1 against stripe rust of wheat. In vitro, data showed that S. viridosporus HH1 had a strong anti-spore germination effect on uredospores of P. striiformis (90% reduction). A 84.2% reduction in the disease severity was achieved in the infected wheat plants, which were colonized with mycorrhizal fungi and were sprayed with S. viridosporus HH1. Molecular investigation revealed that mycorrhizal colonization and application of S. viridosporus HH1 upregulated the defensive genes ethylene response factor protein 3 (JERF3) by 20.7-fold, chitinase II (13.6-fold), and β-1,3-glucanase (9.8-fold). Furthermore, mycorrhizal colonization and application of S. viridosporus HH1 led to a significant increase in the activity of the antioxidant enzymes peroxidase (52.3%), polyphenol oxidase (106.9%), and catalase (87.9%). The phenolic content also increased due to mycorrhizal colonization and application of S. viridosporus HH1, while the lipid peroxidation decreased in the infected wheat leaves. A mitigation in the adverse effects of infection on the photosynthetic pigments in wheat leaves was noticed. Observations from transmission electron microscopy showed that different hypersensitivity reactions were induced on the ultrastructural level in the infected wheat cells due to this treatment. In addition, a significant growth-promoting effect was also reported. It can be concluded that mycorrhizal colonization and spraying with S. viridosporus HH1 have a promising biocontrol activity against stripe rust in wheat. Field evaluation is necessary in the future studies before the use recommendation.
Discordance of PIK3CA mutational status between primary and metastatic breast cancer: a systematic review and meta-analysis
Authors: Rosin Justus , Svegrup Ella , Valachis Antonios , Zerdes Ioannis 
Published: July 2023

Abstract
Introduction
In light of the clinically meaningful results of the PI3K inhibitors in PIK3CA-mutated metastatic breast cancer (BC) patients, the reliable identification of PIK3CA mutations is of outmost importance. However, lack of evidence on the optimal site and timing of assessment, presence of temporal heterogeneity and analytical factors pose several challenges in clinical routine. We aimed to study the discordance rates of PIK3CA mutational status between primary and matched metastatic tumors.

Methods
A systematic literature search was performed in three different databases (Embase, Pubmed, Web of Science) and—upon screening—a total of 25 studies reporting PIK3CA mutational status both on primary breast tumors and their matched metastases were included in this meta-analysis. The random-effects model was used for pooled analyses of discordance of PIK3CA mutational status.

Results
The overall discordance rate of PIK3CA mutational status was 9.8% (95% CI, 7.0–13.0; n = 1425) and did not significantly differ within BC subtypes or metastatic sites. The change was bi-directional, more commonly observed from PIK3CA mutated to wild-type status (14.9%, 95% CI 11.8–18.2; n tumor pairs = 453) rather than the opposite direction (8.9%, 95% CI 6.1–12.1; n tumor pairs = 943).

Conclusions
Our results indicate the need of obtaining metastatic biopsies for PIK3CA-mutation analysis and the possibility of testing of the primary tumor, in case a re-biopsy deemed non-feasible.
Clinical relevance of biomarker discordance between primary breast cancers and synchronous axillary lymph node metastases
Authors: Janeva Slavica , Parris Toshima Z. , Krabbe Ellen , Sundquist Marie , Karlsson Per , Audisio Riccardo A. , Olofsson Bagge Roger , Kovács Anikó 
Published: July 2023

AbstractClinical decision-making for patients with breast cancer (BC) is still primarily based on biomarker characteristics of the primary tumor, together with the evaluation of synchronous axillary lymph node metastasis (LNM). In this study, we investigated the prevalence of discordance in the biomarkers and surrogate subtyping between the primary BC and the LNM, and whether subsequent changes would have altered clinical treatment recommendations. In this retrospective study, 94 patients treated for unifocal primary BC and synchronous LNM at Sahlgrenska UniversityHospital during 2018 were included. Estrogen (ER) and progesterone (PR) receptor, Ki67, and HER2 status were assessed in the primary tumor and LNM using immunohistochemistry. Discordances between the primary tumor and the LNM were analyzed for each individual biomarker and surrogate subtyping. The concordance between the primary tumor and the LNM for ER, PR, Ki67, and HER2 status was 98.9%, 89.4%, 72.3%, and 95.8%, respectively. Discordance in surrogate subtyping was found in 28.7% of the tumors and matched LNMs, the majority (81.5%) of which changed to a more favorable subtype in the LNM; most commonly from Luminal B to Luminal A (48.6%). No changes in surrogate subtyping were detected where ER or HER2 status changed from negativity in the BC to positivity in the LNM, thereby showing no additional value in performing immunohistochemistry on the LNM from a treatment decision-making perspective. However, large studies need to be performed that test both the primary BCs and synchronous LNMs for more accurate diagnostics.