bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy and Progression of Cardiomyopathy in Women With LMNA Genotype‐Positive
Authors: Castrini Anna I. , Skjølsvik Eystein , Estensen Mette E. , Almaas Vibeke M. , Skulstad Helge , Lyseggen Erik , Edvardsen Thor , Lie Øyvind H. , Picard Kermshlise C. I. , Lakdawala Neal K. , Haugaa Kristina H. 
Published: April 2022

Background
We aimed to assess the association between number of pregnancies and long‐term progression of cardiac dysfunction, arrhythmias, and event‐free survival in women with pathogenic or likely pathogenic variants of gene encoding for Lamin A/C proteins ( LMNA+).

Methods and Results
We retrospectively included consecutive women with LMNA+ and recorded pregnancy data. We collected echocardiographic data, occurrence of atrial fibrillation, atrioventricular block, sustained ventricular arrhythmias, and implantation of cardiac electronic devices (implantable cardioverter defibrillator/cardiac resynchronization therapy defibrillator). We analyzed retrospectively complications during pregnancy and the peripartum period.

We included 89 women with LMNA+ (28% probands, age 41±16 years), of which 60 had experienced pregnancy. Follow‐up time was 5 [interquartile range, 3–9] years. We analyzed 452 repeated echocardiographic examinations. Number of pregnancies was not associated with increased long‐term risk of atrial fibrillation, atrioventricular block, sustained ventricular arrhythmias, or implantable cardioverter defibrillator/cardiac resynchronization therapy defibrillator implantation. Women with previous pregnancy and nulliparous women had a similar annual deterioration of left ventricular ejection fraction (−0.5/year versus −0.3/year,
P
=0.37) and similar increase of left ventricular end‐diastolic diameter (0.1/year versus 0.2/year,
P
=0.09). Number of pregnancies did not decrease survival free from death, left ventricular assist device, or need for cardiac transplantation. Arrhythmias occurred during 9% of pregnancies. No increase in maternal and fetal complications was observed.

Conclusions
In our cohort of women with LMNA+, pregnancy did not seem associated with long‐term adverse disease progression or event‐free survival. Likewise, women with LMNA+ generally well‐tolerated pregnancy, with a small proportion of patients experiencing arrhythmias.
Contributions to the Lichen flora of Turkey: New records from Eastern Anatolia (Van province)
Authors: Karagöz Yalçin , Aslan Ali , Yazici Kenan 
Published: April 2022

Abstract
Our field research in Van province during 2008–2009 resulted in collection of 3766 lichen samples from 55 sites, and identification of 229 lichen taxa, including two subspecies and three varieties, in 108 genera of Ascomycota. We found 182 new records for Van province. These include four new records for Turkey, namely Bibbya ruginosa, Buellia subalbula, Caloplaca tenuatula and Rimularia gibbosa. Lists of species and collection sites are provided. Acarospora (11 species), Lecidea (9 species), Verrucaria (8 species), Caloplaca, Physcia and Rinodina (7 species for each), and Aspicilia, Lecanora and Polyozosia (6 species for each) are the genera richest in species in the study area. Of the identified species, 163 are crustose, 43 are foliose, 7 are fruticose, 13 are squamulose and 3 are leprose. 101 species colonise on calcareous rocks, 86 on siliceous rocks, 23 on various trees (epiphytic), 10 on soil, 12 on moss and 17 on other lichens (lichenicolous). Sites 16, 19 are the richest with 55 identified taxa, followed by sites 52, 34, and 6 with 51, 49 and 44 taxa, respectively. The poorest sites are 40 and 42 with 6 identified taxa, followed by sites 5, 7, and 21 with 8, 8, and 9 taxa, respectively.
Diagnostic Inaccuracies Using Extended Focused Assessment With Sonography in Trauma for Traumatic Pneumothorax
Authors: Butts C. Caleb , Cline David , Pariyadath Manoj , Avery Martin D. , Nunn Andrew M. , Miller Preston R. 
Published: April 2022

Background Traumatic pneumothorax (PTX) can be deadly, and rapid diagnosis is vital. Ultrasound (US) is rapidly gaining acceptance as an accurate bedside diagnostic tool. While making the diagnosis is important, not all PTX require tube thoracostomy. Our goal was to evaluate the predictive ability of ultrasound in identifying clinically significant PTX. Methods Over 13 months, data was collected on patients undergoing evaluation for trauma. Patients were included if they underwent US, radiograph chest X-ray (CXR), and computed tomography of the chest. Predictive ability of ultrasound was evaluated in identifying clinically significant PTX. Results Ninety-four patients received evaluation by all 3 modalities. Of these, 32% were diagnosed with PTX. Sixteen patients (17%) had a clinically significant PTX. Chest X-ray and US both had a sensitivity of 75%; however, US had more than twice as many false positives, resulting in a much lower positive predictive value (63% vs 80%). Conclusions While US can reliably rule out PTX, it may be overly sensitive diagnosing clinically significant PTX. Ultrasound alone should not be used in determining the need for tube thoracostomy as many patients will not require acute intervention.
Extreme Sawtooth-Sign in Motor Neuron Disease (MND) suggests Laryngeal Resistance to Forced Expiratory Airflow
Authors: Britton Deanna , Kain Alexander , Chen Yu-Wen , Wiedrick Jack , Benditt Joshua O. , Merati Albert L. , Graville Donna 
Published: April 2022

Objective: The impact of laryngeal dysfunction on airflow has not been well characterized in motor neuron disease (MND). This study aimed to detect and characterize extreme airflow oscillations informally observed during volitional cough and forced vital capacity (FVC) tasks in individuals with MND who demonstrated neurolaryngeal impairments including reduced speed and extent of vocal fold abduction compared to healthy controls during volitional cough expulsion. The extreme airflow oscillations in the MND group, when viewed as a flow-volume loop, appeared similar to the “sawtooth-sign.” If the airflow oscillations are periodic in a range similar to phonation, they may reflect reduced laryngeal patency. Methods: Volitional cough and FVC airflow data (3 trials each) from 12 participants with MND with bulbar/laryngeal involvement (3 F; ages 45-76) and 12 healthy controls (6 F; ages 41-68) were analyzed for periodicity. Percent and absolute durations of periodicity of the flow oscillations were calculated by an algorithm applied to the airflow signals. In addition, the frequency, magnitude, and kurtosis of the periodic airflow oscillations were described and compared between groups. Results: In both volitional cough and FVC trials, the percent of airflow periodicity during forced expiration was significantly higher ( z = 3.54) in individuals with MND, adjusted for age and sex. Periodic airflow accounted for on average 28% of the total time in participants with MND and was within a frequency range similar to phonation. Magnitude of the airflow oscillations was also larger for participants with MND ( z = 3.46), and kurtosis of airflow was smaller ( z = −4.70) during forced expiration, indicating persistent airflow oscillations throughout exhalation. Conclusions: The significantly larger-magnitude, lower-kurtosis, and more prominent presence of sawtooth-like airflow periodicity within a frequency range similar to phonation observed in individuals with MND with neurolaryngeal impairments suggests glottic airflow resistance during forced expiration.
“I Called us the Sacrificial Lambs”: Experiences of Nurses Working in Border City Hospitals During the First Wave of the COVID-19 Pandemic
Authors: Ménard A. Dana , Soucie Kendall , Freeman Laurie A. , Ralph Jody , Chang Yiu-Yin , Morassutti Olivia 
Published: April 2022

Background The first wave of the COVID-19 pandemic had a significant impact on the personal and professional lives of frontline nurses. Purpose The purpose of this descriptive phenomenological study was to explore the experiences of Canadian Registered Nurses (RNs) working in Ontario or United States hospitals during the first wave of the COVID-19 pandemic. Methods Semi-structured interviews were conducted with 36 RNs living in Ontario and employed either at an Ontario or United States hospital. Three main themes were identified across both healthcare contexts. Results 1) The Initial Response to the pandemic included a rapid onset of chaos and confusion, with significant changes in structure and patient care, often exacerbated by hospital management. Ethical concerns arose (e.g., redeployment, allocation of resources) and participants described negative emotional reactions. 2) Nurses described Managing the Pandemic by finding new ways to nurse and enhanced teamwork/camaraderie; they reported both struggle and resiliency while trying to maintain work and home life balance. Community responses were met with both appreciation and stigma. 3) Participants said they were Looking Forward to a “new normal”, taking pride in patient improvements, accomplishments, and silver linings, with tempered optimism about the future. Many expressed a reaffirmation of their identities as nurses. Differences between participants working in the US and those working in Ontario were noted in several areas (e.g., initial levels of chaos, ethical concerns, community stigma). Conclusions The COVID-19 pandemic has been very difficult for nursing as a profession. Close attention to post-pandemic issues is warranted.
Self-Regulatory Coping Behaviors and Stress Reactivity: Exploring the Environmental Affordance Model of Health Disparities
Authors: Mezuk Briana , Kalesnikava Viktoryia , Spears Erica , Kirk Keri , Rafferty Jane , Del Toro Juan 
Published: April 2022

Objectives To explore the relationship between self-regulatory coping behaviors (SRCB) and hypothalamic pituitary adrenal (HPA) stress reactivity. Methods Data came from the Richmond Stress and Sugar Study (n=125, median age: 57 years, 46% non-Hispanic White, 48% African American). The relationships between 11 SRCB (“health-harming” [e.g., smoking] and “health-promoting” [e.g., exercising]) with HPA stress reactivity, indicated by salivary cortisol response to the Trier Social Stress Test, was assessed using multi-level modeling. Results Health-harming and health-promoting SRCB were positively correlated (+0.33, p<0.001). Several individual behaviors were related to HPA stress reactivity, for example, smoking and meditation were associated with shallower increases in cortisol (smoking: −13.0%, 95%CI: −20.9% to −4.3%; meditation: −14.0%, 95%CI: −22.0% to −5.1%). However, SRCB summary measures were unrelated to stress reactivity. Discussion Health-harming and health-promoting SRCB are inter-related. Specific behaviors, rather than groupings as health-harming versus -promoting, are related to HPA stress reactivity.
Effect of multi-layer graphene on microstructure and mechanical properties of titanium-based composites
Authors: Sharma Deepak , Singla Vinod Kumar , Singh Sachin 
Published: April 2022

To achieve the enhanced mechanical properties of the titanium grade 5 (Ti64) alloy, multi-layer graphene (MLG) reinforced Ti64 nanocomposites were successfully fabricated by using spark plasma sintering process. Spherical Ti64 particles with an average diameter of 25 μm, MLG with an average diameter of 5 μm, and an average thickness of 2.5 nm were used in the present study. Microstructure study reveals the in-suit reaction between Ti (matrix) and C (reinforcement) that leads to the formation of TiC along the interface. Further, it was observed that a maximum grain refinement of 32.56% occurs in the Ti64/1.2 wt% MLG nanocomposite. Strengthening along the Ti64 and MLG interface and grain refinement are the primary reasons for the enhanced mechanical properties of the nanocomposites. Nanocomposites with 1.2 wt% MLG exhibit nanohardness of 5.29 GPa, elastic modulus of 119.8 GPa which is 68.4% and 140.5% higher compared with that of Ti64 sintered alloy. The results showed that MLG reinforcement plays an important role in improving the mechanical properties of Ti64 nanocomposites.
Economic Policy Uncertainty Versus Sector Volatility: Evidence from India Using Multi-scale Wavelet Granger Causality Analysis
Authors: Ambatipudi Vamsidhar , Kumar Dilip 
Published: April 2022

The present study examines the relationship between Indian economic policy uncertainty (IEPU) and the different sector volatilities (SVs) of the Indian economy over the period 2006–2021. The relationship is studied using a multi-scale correlation framework, combining wavelet coherence analysis with the Granger causality test. The findings indicate a stronger relationship between the IEPU and SV for all sectors during COVID-19, primarily in the medium term. While IEPU led to SV during the global financial crisis (GFC), the SVs led to the IEPU during the COVID-19. However, the Granger causality test provides evidence that, in the long term, the SVs cause the IEPU while the IEPU leads to SV in the short term. The IT sector is crucial as its volatility leads to IEPU across all scales. These results have substantial implications for policymakers and portfolio managers. JEL Codes: G10, G17, G32
A Study on Clinico-Pathological Profile of Breast Cancer Patients and Their Correlation With Uterine Fibroids Using Hormone Level and Receptor Status Assessment
Authors: Mohan Anjaly , Kumar Vinay , Brahmachari Swagata , Pandya Bharati 
Published: April 2022

Purpose: To study the clinico-pathological profile of breast cancer patients and the prevalence of uterine fibroids in them, their hormonal levels and hormone receptor status. Patients and methods: 52 patients with breast cancer who attended AIIMS Bhopal from November 2018 to January 2020 were selected, with their clinical details, triple assessment and other investigations for further management being performed and recorded. The presence of uterine fibroids was assessed using ultrasound of the abdomen, and for patients who had undergone hysterectomy, previous medical records were examined to ascertain the history of uterine fibroids. Serum levels of estrogen and progesterone were assessed using chemi-luminescent micro-particle immune assay (CMIA). Results: The mean age of patients was 50.35 ± 10.87 years. 36.54% of our patients had uterine fibroids, of whom 15.38% had undergone hysterectomy for the same, and 21.15% was detected on ultrasound of the abdomen during evaluation. Among patients with uterine fibroids, 84.2% were hormone receptor-positive, while in patients without uterine fibroids, only 57.6% had positive receptors. ( P = 0.049). Among premenopausal patients, there was a statistically significant difference in serum progesterone values between patients with and without uterine fibroids. Conclusion: The prevalence of uterine fibroids in our study group of breast cancer patients was found to be high. The role of estrogen and progesterone in the pathophysiology of both diseases and the common risk factors involved may biologically explain this finding. Breast cancer and other estrogen associated disorders may hold future research prospects.
Clinicopathological Features of Papillary Renal Cell Carcinoma With Venous Tumor Thrombus: Case Series from a Large Chinese Center
Authors: Liu Zhuo , Ge Liyuan , Zhao Xun , Lu Min , Aili Abudureyimujiang , Li Yuxuan , Zhu Guodong , Hong Peng , Tian Xiaojun , Wang Shumin , Zhang Hongxian , Liu Cheng , Ding Zhenshan , Zhang Shudong , Ma Lulin 
Published: April 2022

Background: Few studies have reported the influence of the histological classification of type-2 papillary renal cell carcinoma (PRCC), which may differ from that of clear cell renal carcinoma (ccRCC), on the prognosis of renal cell carcinoma with tumor thrombus. We investigated the clinicopathological features and prognosis of type-2 PRCC associated with venous tumor thrombi (PRCC-TT). Methods: We retrospectively analyzed 163 patients with renal cell carcinoma with venous tumor thrombus (RCC-TT) admitted to Peking University Third Hospital between June 2016 and June 2020. Twenty-five patients had type-2 PRCC-TT and 138 had ccRCC combined with tumor thrombus; there were 125 males and 38 females. All the included patients underwent radical nephrectomy and thrombectomy under either complete laparoscopic surgery or open surgery. Univariate and multivariate Cox regression analysis were performed to evaluate the prognostic significance of each variable on cancer-specific survival (CSS). Cancer-specific survival was calculated from the date of surgery to death or the last follow-up using the Kaplan–Meier method. Results: The blood vessels of type-2 PRCC-TT presented on CT images were not as abundant as those of ccRCC-TT. Slight enhancement was observed in the corticomedullary phase. While wash-out symptoms were observed, contrast agent extinction was not obvious in the nephrographic and excretory phases. We compared the macroscopic and microscopic appearances of the 2 cohorts. Compared to the ccRCC-TT cohort, lymph node invasion was more prevalent in the PRCC-TT cohort (88.0% vs. 60.9%, P = .009). Multivariate analysis revealed that sarcomatoid differentiation, distant metastasis, and pathological type were the independent predictors of poor CSS. The Kaplan–Meier analysis showed that the CSS of type-2 PRCC-TT and ccRCC-TT were 23.5 and 38.4 months, respectively, with statistical significance ( P = .002). Conclusion: Type-2 PRCC-TT varies with common ccRCC-TT in imaging manifestation and pathological characteristics. The prognosis of type-2 PRCC-TT patients was worse than that of ccRCC-TT patients.
‘That’s my dumb husband’: Wild things, battle bears and heteronormative responses in an afterschool reading club
Authors: Skrlac Lo Rachel , Wiseman Angela 
Published: April 2022

In this paper, we analyse a group of 6 and 7 year olds’ interactions during a literacy event. We explore the complexities of their meaning-making following a read aloud of Where the Wild Things Are (Sendak 1963). Our focus is on discourses of gender/sex/uality, a term that acknowledges the complex relationship between gender, sex and sexuality, and how these discourses are enacted. Our guiding question was: How did discourses of gender/sex/uality circulate in this group of young children’s multimodal and playful responses to a literacy event? By considering the relationship between reader response, play and gender/sex/uality, we gained insight into how children’s responses to texts are connected to their own identities and lived experiences. We used critical multimodal discourse analysis to understand the children’s meaning-making processes. This revealed how the children were drawing from varying scripts to inform their play and creative processes. The children referenced gender/sex/uality to collaborate, to compete and to seek inclusion or status in the group. We discuss four children who drove this collective dialogue and who guided the group’s interactions. Another child’s responses pushed against and evolved in tandem with the emerging consensus. This study deepened and expanded our consciousness of children’s enactments of gender/sex/uality and how such enactments reinforced heteronormativity. The children’s artefacts, actions and talk are testimony of dominant discourses that guided and ultimately led them to adopt storylines that aligned with heteronormative scripts. Our analysis of how the children’s responses unfolded revealed how power asymmetries were reinforced and hegemonic ideologies persisted. Understanding the influences of social norms during interactive literacy events may help educators create opportunities for all learners to write themselves into these events and classroom interactions more broadly.
Randomized Pilot Trial Using External Yarrow Liver Compress Applications With Metastatic Cancer Patients Suffering From Fatigue: Evaluation of Sympathetic Modulation by Heart Rate Variability Analysis
Authors: Foucré Clara , Schulz Steffen , Stritter Wiebke , von Mackensen Irina , Luchte Jacqueline , Ivaki Pune , Voss Andreas , Ghadjar Pirus , Seifert Georg 
Published: April 2022

Background: Liver compresses are commonly applied in complementary medicine during cancer treatment and are believed to have an energizing effect. We conducted a pilot study to investigate the influence of external application of yarrow liver compresses on the autonomous nervous system by analyzing the heart rate variability (HRV) in metastatic cancer patients undergoing radiation therapy and suffering from cancer-related fatigue (CRF). Methods: A randomized pilot trial was undertaken with patients suffering from CRF receiving palliative radiation therapy for bone or brain metastasis over 2 weeks. CRF patients were randomized into an intervention group receiving yarrow liver compresses and a control group receiving no external application. HRV was analyzed at the beginning (T1) and end (T2) period of the study during daytime (d) and nighttime (n) in both groups and quantified using time-, frequency-, and nonlinear dynamics domains. Results: A total of 39 patients were randomized between September 2017 and August 2019 and a total of 20 patients (10 per group) were available for analysis. For both groups, significant differences in HRV analyses were found in the comparison over the timeline between the first and second measurement (T1d→T2d) during daytime. Specifically, the intervention group showed decreased HRV and complexity of heart rate regulation, indicating increased sympathetic activity at time T2d, whereas the control group showed increased HRV and complexity of heart rate regulation, indicating increased vagal activity at time T2d. Furthermore, the observed HRV analyses showed almost no significant differences between the 2 groups in a direct comparison at the beginning and the end of the study (exception: T2d). Conclusions: Yarrow liver compresses led to increased sympathetic activity during daytime in the intervention group, whereas in the control group, which did not receive any external application, increased parasympathetic activity was observed.