bluuebunny/crossref_metadata_2025 huggingface dataset:
Rhythm and Meter
Authors: Maler Anabel
Published: November 2024

Existing theories of musical rhythm and meter take sound as a given, but many pieces of sign language music do not include any sounding elements. This chapter applies the notions of rhythm and meter to the visual domain, drawing on existing literature on music theory, sign language poetry, and the perception and cognition of rhythm. It explores entrainment, pulse, rhythm, and meter in sign language music, arguing that signers present visual rhythms using four movement types: hold emphasis, movement emphasis, movement size, and movement duration. The chapter further shows how visual rhyme impacts the creation of metrical structures, investigates the complex metrical situations that arise when spoken and signed languages interact, and defines the concept of phrase rhythm in sign language music. It uses varied examples, from percussion songs, to Deaf hip hop, to translated songs, to reveal the resiliency of rhythm in human musical life.
Meaning and Form
Authors: Maler Anabel
Published: November 2024

This chapter asks how sign language music creates musical meaning for its performers and audiences, acting as a site of affective engagement. In order to show how sign language music creates specifically musical meaning for its perceivers, the chapter draws on fundamental parameters of sign language music: aspects of vocal production; pulse, rhythm, and meter; and aspects of melody. It reveals how music and language interact to create musical meaning, and how signing musicians structure their performances formally. Finally, the chapter uses two case studies, Rosa Lee Timm’s “River Song” and Jesse Jones III’s “One World, Two Hands,” to reveal how each song conveys meaning through simulations of dynamic processes, out of which emerges musical structure.
Lester B. Pearson and the Domestic Implications of Canadian Foreign Policy, 1963–1968
Authors: Chapnick Adam , McKercher Asa
Published: November 2024

This chapter examines Canadian foreign policy under Liberal Prime Minister Lester Pearson during a period of consecutive minority parliaments. The Liberals governed with support from the New Democratic Party, whose influence on foreign policy was evident. The chapter includes the foreign policy implications of Quebec’s Quiet Revolution, the impact of economic nationalism on relations with the United States, the negotiation of the Columbia River Treaty and the Auto Pact, the posture of Canada at the UN, and the decline of the British connection. The cases deal with the federal government’s response to the promulgation of the Gérin-Lajoie doctrine in Quebec, and Lester Pearson’s controversial speech at Temple University about American policy in Vietnam. The Beyond the Book case examines Ottawa’s response to Time and Reader’s Digest when they produced split-run magazines to benefit from tax credits intended to promote Canadian companies.
How to Participate in Early Childhood Music Experiences
Authors: Huisman Koops Lisa
Published: November 2024

Music is important for young children. There are many ways to experience music in early childhood. Formal early childhood music classes work for some families and not for others. Decisions about whether to go to an early childhood music class, when to begin, and which class to choose all depend on multiple factors. Young children demonstrate a wide range of participation in early childhood music classes. There are many other ways to engage in music with a young child. For those who choose to attend an early childhood music class, be attentive and open-minded about how one’s child is participating. Incorporate early childhood music activities regularly at home. Sample activities for an at-home early childhood music class are described.
Souvenirs of Cicero
Authors: Martelli Francesca K. A.
Published: November 2024

Cicero’s letters have figured prominently in some of Western modernity’s most cherished illusions about the immediacy of its encounter with classical antiquity. Celebrated since their discovery in the Renaissance for their intimate mode of self-expression, they have been prized since then for the unparalleled proximity they appear to give us to the events and leading figures of the late Republic. Yet they are also the product of a later era. Only organized into books and collections and published as such by unidentified editors after Cicero’s death, the transmitted letters are also inescapably imperial and post-imperial texts. This book is a study of the narratives that the letter collections plot in their transmitted formats and, in particular, of the belated, post-republican perspectives that shape these narratives. Focusing on the Epistulae ad Familiares, the collection that incorporates Cicero’s widest cast of correspondents, it traces the social, political, and technological agencies that shaped this letter collection in antiquity, and elucidates the interests that these editorial interventions serve both for ancient readers and for our interpretation of the letters today. This study draws on the work of cultural and media theorists to classify Cicero’s letters as residual media, which haunt subsequent history with the Republic’s lost futures as they circulate beyond their own era.
Before oil, we were poor. now, we’re miserable
Authors: Behrends Andrea
Published: November 2024

The focus then moves back from the capital to the largest city of the Chad-Sudan borderlands, Abéché. Linking how the inhabitants imagine the state and how they perceive actual governing practices, the author recapitulates some reactions to the rebellion in Abéché and N’Djamena. The chapter shows how rumors of rebellion and speculations about who will win trigger the population to instantly switch their definitions of belonging, for instance, by showing support for rebels instead of the national army, and vice versa, depending on whom they assume to be victorious. In this chapter, the long-distance effect of oil production comes into focus, relating to both images and practical effects.
What about the English?
Authors: Kenny Michael
Published: November 2024

The establishment of devolved governments outside England inadvertently raised questions about what devolution meant for the largest part of the UK. This was a period in which questions of nationhood and identity were becoming prominent in England, and, separately, a growing seam of disenchantment with the political and governing system developed outside its largest cities. Both of these trends eroded the stock of English consent for the Union. And in 2014 debates about England’s governance broke into the open in the aftermath of the Scottish referendum. Brexit temporarily quelled these debates but the grievances underlying them have persisted. Historically, the British constitutional tradition has assumed that the English are content with Britain's governing structures, but there are signs of a growing sense of English distinctiveness and a latent demand for national recognition. The chapter considers the implications of these changes, and also explores the parallel debates over sub-national devolution which resulted in successive attempts to establish a middle layer of governance sitting between local councils and central state.
Movement Parties of the Far Right
Authors: Castelli Gattinara Pietro , Pirro Andrea L. P.
Published: November 2024

In an era of traditional political party decline, Movement Parties of the Far Right explores a new phase of nativist mobilization, in which street politics holds an increasingly important role. Pietro Castelli Gattinara and Andrea L. P. Pirro delve into the hybrid and transitional nature of far-right movement parties, i.e. collective actors that contest elections like political parties and mobilize in the protest arena like social movements. Movement parties offer an exceptional object of study since they challenge the conventional distinction between institutional and non-institutional politics. Examining the ‘production structure’ of ten movement parties across nine European countries, the authors identify key factors affecting their engagement in protest activity. They address the internal organization, decision-making processes, and external mobilization of these collective actors using unique empirical material, including quantitative data on far-right protest mobilization spanning over a decade, protest network visualizations, and qualitative interviews with high-ranking officials. The book provides fresh insights into how the far right spreads its influence and relates to non-institutional politics, making it essential reading for anyone concerned about the way in which nativist collective actors transform society from the ground up. A compelling study looking at the relationship between electoral politics and grassroots activism, Movement Parties of the Far Right illuminates the complex organizational and strategic choices underlying far-right mobilization.
Gautrot or ‘the Most Relentless Fighting Spectacle between Makers’
Authors: Diago Ortega José-Modesto
Published: November 2024

This chapter focuses on Pierre-Louis Gautrot (the most important wind instrument maker in France), one of the businessmen who were attacked by Sax at the Paris Exposition of 1855. Gautrot’s strategy was to delay the process in order to financially undermine his rival, who had not yet recovered from the bankruptcy of 1852. Gautrot only had to hang on, as the main patent blocking most of these brasswinds (saxotromba) would soon fall into the public domain (1860). The dispute became heated—blocking of economic provisions, different interpretations of the statute of limitations, etc.—and the case went several times to the Courts of Appeal and Cassation. These procedural ups and downs ceased when the two contenders reached (1859) a financial settlement of more than half a million francs and Gautrot accepted an (abusive) licensing agreement for as long as the saxotromba patent was active, presumably only for another year.
Masterstroke
Authors: Diago Ortega José-Modesto
Published: November 2024

This chapter contains the unprecedented episode in which late modern France passed a state law for a private individual (Adolphe Sax) to enjoy a five-year extension to prolong the validity of his patents (saxotromba and saxophone) and, ultimately, for that entrepreneur to continue to enjoy a double monopoly. Although this was a contingency provided for in the legislation, it was remote because it required strong involvement of the Executive, approval by the Council of State, passage through committees, procedures, and debates in both the Parliament and Senate, and ratification by the Emperor. Moreover, such an exception was highly controversial in a system of theoretically free competition; moreover, in this case, the stakes were enormous, including huge amounts of money. This chapter captures the reasons for and against such a concession, as well as the debates—and sharp commentaries—of the representatives of the French people and sovereignty.
CRISPR CLIP: comprehensive reviews on interventional studies using precision recombinant technologies: clinical landmarks, implications, and prospects
Authors: Chodnekar Swarali Yatin , Tsetskhladze Zurab
Published: November 2024

To consolidate clinical trials that utilized the CRISPR technology to synthesise cures for various genetic diseases as a means to provide a window into the progress made so far while paving the way forward for future research and practices. Systematic review (PROSPERO CRD42023479511). Trials from seven databases’ (ClinicalTrials.gov, European Union Clinical Trials Registry, ISRCTN registry, ICTRP/trialsearch.who.int, ChiCTR.org.cn, Clinical Trial Registry India, and Cochrane Library/Trials) inception to 9 March 2024, were considered. Exclusion criteria were unrelated, duplicated, non-English, unavailable full texts, diagnostic studies, correlational studies, observational studies, abstract-only papers, reviews or conference papers. Included studies were appraised using the ten-item CASP tool to assess methodological quality. The review identified 82 RCTs utilizing CRISPR and revealed four main themes: Diseases targeted, Countries of Clinical trials, Type of interventions, and Trial trends over the years. Geographically, the United States and China lead in the number of CRISPR clinical trials, followed by the European Union. However, Africa, Asia, and South America have very few trials. Among disease classes, cancer is the most prevalent focus with 39 studies, followed by monogenetic blood diseases, like Thalassemia and sickle cell anaemia. The biological agent CTX001 and Cyclophosphamide each feature in 11 studies. The peak year for clinical trials was 2018, marked by a significant increase with 16 studies conducted. Despite conducting a comprehensive search, the majority of trials were concentrated in the United States and China. Additionally, potential oversights due to vague titles, English-only studies, and indexing issues may have occurred. Nonetheless, by incorporating data from seven distinct databases, this review significantly contributes to understanding CRISPR's utilization in therapeutic clinical trials, paving the way for future research directions. The review underscores the burgeoning interest in CRISPR-based interventions. Current trials barely tap CRISPR's potential for treating genetic diseases.
Exploring methodological frontiers in laminar fMRI
Authors: Chai Yuhui , Zhang Ru-Yuan
Published: November 2024

This review examines the methodological challenges and advancements in laminar functional magnetic resonance imaging (fMRI). With the advent of ultra-high-field MRI scanners, laminar fMRI has become pivotal in elucidating the intricate micro-architectures and functionalities of the human brain at a mesoscopic scale. Despite its profound potential, laminar fMRI faces significant challenges such as signal loss at high spatial resolution, limited specificity to laminar signatures, complex layer-specific analysis, the necessity for precise anatomical alignment, and prolonged acquisition times. This review discusses current methodologies, highlights typical challenges in laminar fMRI research, introduces innovative sequence and analysis methods, and outlines potential solutions for overcoming existing technical barriers. It aims to provide a technical overview of the field's current state, emphasizing both the impact of existing hurdles and the advancements that shape future prospects.
A call for rigorous research investment in women’s health
Authors: Su Zhaohui , Zhang Ruijie , Kaburu Francis Mungai , Tong Chaojun , Intizar Mehak , Kudiza Abdulswabul , Kuang Qiang , Chen Ruru , Yu Xin , Jiang Jianlin , McDonnell Dean , Cheshmehzangi Ali , Šegalo Sabina , Ahmad Junaid , da Veiga Claudimar Pereira , Xiang Yu-Tao
Published: November 2024

Worldwide, women face a disproportionately heavier health burden than their male counterparts. Yet, there is a chronic lack of research attention and investment in women’s health, which may explain the absence of women-inclusive, let alone women-centered, understanding of the causes, consequences and confounding factors that shape individuals’ health and quality of life. In this article, by analyzing the US National Health Expenditure data, we show how ingrained the issue of poor investment in women’s health even in the 0–18 years age group in terms of per capita health expenditure. We hope this article sheds light on how early-life poor health investment in women’s health might be a potential cause for women’s poor health in adulthood, and in turn, underscores the importance of investing resources into better understanding and improving women’s health.
The politics of directionality in innovation policy through the lens of policy process frameworks
Authors: de Graaff Sabine , Wanzenböck Iris , Frenken Koen
Published: November 2024

Different interpretations of “directionality” in innovation policy and sustainability transitions literature streams suggest the need for distinguishing between actors “giving direction” contributing to transformative change, and “systemic directionality” emerging through transformative change required to address societal challenges. As an initiation toward bridging these understandings, we emphasize the process-oriented and political nature of directionality and mobilize political theory to conceptualize the politics of directionality. The questions who gives direction, where and how is direction given, which direction is given, and when and why does a direction change (or not) are employed to explore the politics of directionality in an integrative literature review of five policy process frameworks: Multiple Streams Framework, Punctuated Equilibrium Theory, Policy Feedback Theory, Advocacy Coalition Framework, and the Narrative Policy Framework. We propose an integrated conceptual framework for the analysis of the politics of directionality involving giving direction and processes of systemic directionality.
Allelopathic effects of sorghum/sorghum-sudangrass hybrids against Rotylenchulus reniformis
Authors: Paudel Roshan , Balkwill Landon , Wang Koon-Hui
Published: November 2024

Reniform nematode (Rotylenchulus reniformis) is a damaging and difficult-to-manage pest on many agricultural crops. Sorghum and sorghum-sudangrass hybrids (SSgH) have shown potential in managing plant-parasitic nematodes by releasing toxic hydrogen cyanide gas through the hydrolysis of dhurrin, a cyanogenic glucoside found in leaf epidermal cells. The objectives of this study were to evaluate the effect of different SSgH varieties and their age on the suppression of R. reniformis and to quantify their dhurrin contents. Shoot biomass of seven SSgH varieties was harvested at 1, 2, and 3 months of growth and used as a soil amendment in two greenhouse cowpea bioassay trials. Dhurrin concentration was analyzed using high-performance liquid chromatography (HPLC) from 2-month-old tissues. The results indicated that energy sorghum ‘NX-D-61’ and SSgH ‘Latte’ exhibited the highest dhurrin concentrations (P ≤ 0.05) and suppressed R. reniformis development in cowpea roots (P ≤ 0.05). In Trial I, 2-month-old amendments showed the greatest suppression, while in Trial II, 1-month-old amendments were more suppressive (P ≤ 0.05). Potential effect of environmental stress on dhurrin concentration in SSgH tissue was discussed. Nonetheless, dhurrin concentrations were negatively related to the number of R. reniformis infecting cowpea roots (r2 =0.69; P = 0.02). These findings suggest that high dhurrin SSgH varieties can be integrated into reniform nematode management plans as a cover crop and terminated no more than 2 months after planting.
Development and Validation of a Mechanistic, Weather-Based Model for Walnut Blight Caused by Xanthomonas arboricola pv. juglandis
Authors: Ji Tao , Caffi Tito , Fedele Giorgia , Liu Ran , Rossi Vittorio
Published: November 2024

Walnut blight, caused by Xanthomonas arboricola pv. juglandis (Xaj), occurs worldwide in almost all areas where the Persian walnut (Juglans regia) is grown, causing significant reductions in nut yield via defoliation and fruit drop. The disease control relies on the calendar-based, repeated use of chemical bactericides, negatively impacting economic and environmental sustainability and potentially inducing Xaj resistance to chemicals. This study developed and validated a mechanistic model incorporating the main stages of the pathogen’s life cycle and the influence of weather under orchard conditions to improve the scheduling of disease control interventions. The model can simulate: i) the mobilization of primary inoculum; ii) the infection caused by bacteria; and iii) the lesion formation and production of secondary inoculum. We evaluated the model against 21 independent walnut blight epidemics in Italy (nine epidemics on leaves in five orchards) and the USA (12 epidemics on fruit in six orchards). Overall, the model provided accurate predictions for both the occurrence and non-occurrence of infection, with a precision and F1-score of 0.866 and 0.844, respectively. The model could accurately predict disease progression across the season, with a concordance correlation coefficient between observed and predicted disease severities of 0.951, a root mean square error of 0.069, and a coefficient of residual mass of 0.024. After further validation, the model can serve as a decision-making tool for the risk-based timing of chemical sprays in walnut blight management.
A Diagnostic Guide for Fusarium Root Rot of Sweetpotato
Authors: Bhatta Usha , Krasnow Charles , Ziv Carmit , Quesada-Ocampo Lina
Published: November 2024

Fusarium solani is an ascomycete fungal pathogen causing economically important diseases in a wide range of hosts worldwide including Convolvulaceae, Cucurbitaceae, Solanaceae, Brassicaceae, Poaceae, and Fabaceae. Fusarium root rot, caused by F. solani f. sp. batatas, is a destructive postharvest disease of sweetpotato. The disease primarily develops two to five months after harvest when the pathogen infects through wounds, leading to the development of dark sunken lesions and dry rot in stored roots. This diagnostic guide provides a comprehensive review of Fusarium root rot, covering symptoms, pathogen biology and taxonomy, geographic distribution, isolation, identification, storage, and pathogenicity testing. Molecular methods, morphological characteristics, culture media, inoculation methods, and the importance of wounding in the infection process are discussed for accurate diagnosis.
Cardiomyocyte‐derived small extracellular vesicle‐transported let‐7b‐5p modulates cardiac remodeling via TLR7 signaling pathway
Authors: Zhang Yanan , Cui Hongtu , Zhao Mingming , Yu Haiyi , Xu Wenli , Wang Zhanli , Xiao Han
Published: November 2024

Cardiac remodeling is the major pathological change of heart failure. And let‐7 family has been implicated in the development and pathogenesis of cardiovascular diseases. However, the mechanisms underlying let‐7b‐5p‐mediated cellular pathogenesis of cardiac remodeling are not well understood. The present study aimed to explore the effects of let‐7b‐5p on cardiac remodeling and the corresponding regulatory mechanism. In vivo results indicated that cardiac let‐7b‐5p was upregulated in the mouse model of Angiotensin II (Ang II)‐induced cardiac remodeling. Additionally, let‐7b‐5p knockdown ameliorated the effects of Ang II‐induced cardiac remodeling, whereas let‐7b‐5p overexpression facilitated cardiac remodeling. In vitro, let‐7b‐5p mimics induced cardiomyocyte hypertrophy, fibroblast transdifferentiation, and the expression of inflammatory factors in neonatal mouse cardiomyocytes (NMCMs), neonatal mouse cardiac fibroblasts (NMCFs), and bone marrow‐derived macrophages (BMDMs), respectively. Furthermore, let‐7b‐5p exerted its cardiac pro‐remodeling effects at least partially through a small extracellular vesicle (SEV)‐based delivery strategy. We found that let‐7b‐5p was enriched in SEVs derived from Ang II‐treated NMCMs (NMCM‐SEV) but not from Ang II‐treated NMCFs (NMCF‐SEV). Mechanistic analyses revealed that NMCM‐SEV promoted TLR7 and MyD88 expression, which increased NF‐κB phosphorylation levels. Knockdown of let‐7b‐5p, TLR7 or MyD88 in NMCMs, NMCFs, and BMDMs abolished the cardiac pro‐remodeling effects of NMCM‐SEV. These results uncover that let‐7b‐5p‐containing NMCM‐SEVs promote cardiac remodeling via the TLR7/MyD88/NF‐κB pathway, implicating let‐7b‐5p as a potential therapeutic target for heart failure.
Maternal Characteristics and Rates of Unexpected Complications in Term Newborns by Hospital
Authors: Glazer Kimberly B. , Zeitlin Jennifer , Boychuk Natalie , Egorova Natalia N. , Hebert Paul L. , Janevic Teresa , Howell Elizabeth A.
Published: November 2024

(Abstracted from JAMA Network Open 2024;7(5):e2411699)

The Joint Commission’s Patient Care Core measure PC-06, Unexpected Complications in Term Newborns, standardizes how newborn complications are tracked in otherwise-healthy births ≥37 weeks of gestation. The PC-06 measure is designed to characterize newborn morbidity that could be associated with labor and delivery care.
Neurodevelopmental Outcomes After Late Preterm Antenatal Corticosteroids: The ALPS Follow-up Study
Authors: Gyamfi-Bannerman Cynthia , Clifton Rebecca G. , Tita Alan T.N. , Blackwell Sean C. , Longo Monica , de Voest Jessica A. , O’Shea T. Michael , Bousleiman Sabine Z. , Ortiz Felecia , Rouse Dwight J. , Metz Torri D. , Saade George R. , Rood Kara M. , Heyborne Kent D. , Thorp John M. , Swamy Geeta K. , Grobman William A. , Gibson Kelly S. , El-Sayed Yasser Y. , Macones George A. ,   For the Eunice Kennedy Shriver Maternal-Fetal Medicine Units Network
Published: November 2024

(Abstracted from JAMA 2024;331:1629–1637)

The antenatal late preterm steroids (ALPSs) randomized trial found that antenatal exposure to betamethasone decreased short-term neonatal respiratory morbidity compared with placebo. But the trial also found an increased risk of neonatal hypoglycemia, which, when prolonged and persistent, is associated with adverse childhood neurodevelopment.
Herbal Supplement Use Among Adolescent and Young Adult Women in a Family Planning Clinic
Authors: Friedman Julie C. , Sheeder Jeanelle , Polotsky Alex Joel , Lazorwitz Aaron
Published: November 2024

(Abstracted from J Pediatr Adolesc Gynecol 2024;37:323–329)

A large percentage of those who use herbal supplements are reproductive-aged women, and research has shown that many of these individuals also consume prescription medications; there is some research regarding herbal supplement and drug interactions, but information is limited depending on the supplement and the drug. Because of this lack of information, the risks associated with interactions between supplements and drugs are higher, as unintended adverse events can arise such as thrombotic thrombocytopenic purpura with oral contraceptives or cardiac arrhythmias or gastrointestinal illness with diabetic or depression medications.
Transcutaneous Electric Nerve Stimulation for Analgesia During Outpatient Endometrial Biopsy
Authors: Wu Jenny , Lim Stephanie , Scott Amelia , Hayes Taylor , Unnithan Shakthi , Erkanli Alaattin , Havrilesky Laura J. , Swartz Jonas J.
Published: November 2024

OBJECTIVE:

To evaluate whether transcutaneous electric nerve stimulation (TENS) decreases pain at the time of outpatient endometrial biopsy.

METHODS:

We conducted a randomized, double-blind trial of active TENS compared with placebo TENS at the time of endometrial biopsy. The primary outcome was pain measured on a 0- to 100-mm visual analog scale immediately after biopsy, with secondary outcomes including satisfaction and tolerability of TENS and pain scores at other procedural time points. To detect a 15-mm reduction in pain with a 30-mm SD, 80.0% power, and a significance level of 0.05, 64 participants were required in each arm.

RESULTS:

From December 2022 to December 2023, 135 participants were randomized with 67 in the placebo TENS arm and 68 in the active TENS arm. Baseline demographic and clinical characteristics were similar between groups. The median (interquartile range) pain score immediately after biopsy was 50 mm (20–80 mm) in the active TENS group and 60 mm (40–100 mm) in the placebo TENS group (P=.039). Pain scores at other time intervals were not statistically significantly different. In a subset analysis, participants with higher-than-median baseline anxiety had postprocedural pain scores (interquartile range) of 50 mm (40–80 mm) in the active TENS group compared with 80 mm (50–100 mm) in the placebo TENS group. Overall satisfaction (interquartile range) with pain control (with 100 mm representing completely satisfied) was 87.5 mm (60–100 mm) for active TENS and 70 mm (41–100 mm) for placebo TENS; 85.3% of active TENS participants would use TENS in a future endometrial biopsy. Minimal side effects were associated with TENS, with one participant reporting itching at the pad sites.

CONCLUSION:

Despite a statistical difference in pain scores, a clinical difference was not seen between active and placebo TENS for pain during endometrial biopsy. Satisfaction was higher in the active TENS group, and there were overall minimal side effects associated with TENS.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT05472740.
Self-efficacy Through Digital Care Plan Participation
Authors: Smith Justin M. , Christopherson Laura A. , Harper Sarah B. , Harmsen William S.
Published: November 2024

The concept of self-care is a foundational construct of individual health and wellness. Facilitated self-care is the next logical step in society’s uptake of technology for previously high-touch clinical activities, such as patient education and frequent biometric data tracking. This retrospective study aimed to assess whether participation in a digital interactive care plan correlated with an increase in participants’ perceived self-efficacy as measured by a change in the Shortened Perceived Medical Condition Self-management Scale score from baseline to end-of-care plan. We included adult patients who were enrolled in at least one of 15 different interactive care plans at our institution between October 21, 2021, and December 30, 2022. Among 3196 patients included, 48.7% of participants did not complete the Shortened Perceived Medical Condition Self-management Scale assessment at baseline, and 73.5% did not complete it at end-of-care plan. For those who completed both assessments (n = 848), 52.2% had no change in their reported self-efficacy on completion of care plan. Similar percentages of patients had increased and decreased scores (25.6% vs 21.9%). The low completion rates were not sufficient to answer the research questions and generalize results. They also underscore the importance of patient engagement for understanding health outcomes associated with implementation of digital health solutions.
Fostering Development in Children With Congenital Heart Disease
Authors: Butler Samantha , Shade Catherine Ullman , Wood Laura , Roseman Alexandra , Berry Emily , Walecka Erin , Engstler Katherine , Dickinson Hope , Sadhwani Anjali
Published: November 2024

Children with complex congenital heart defects often show delays and deficits in cognitive, language, motor, and social-emotional functioning. As such, the American Academy of Pediatrics and the American Heart Associated recommend ongoing monitoring and support of development. In conjunction with the formal therapeutic supports frequently recommended for young children with CHD, caregivers are instrumental in providing an enriching environment to enhance development in the hospital, at home, and in early childhood settings. In this article, we review the common developmental sequelae associated with CHD, underlying causes, and ways in which parents, family members, and professional caregivers can support development for children with CHD from birth to three years old.
Grenfell Tower Fire: Firefighters’ Activities and Their Exposure to Fire Smoke and Heat
Authors: Stec Anna A. , Purser David A. , Hull T Richard
Published: November 2024

Objective: To characterise the smoke exposure of firefighters who attended the Grenfell Tower fire during the initial 20 hours.

Methods: As no compilation of exposure data exists, data was compiled from nine unconnected sources, including the Grenfell Tower Inquiry, firefighters’ statements, incident logs and the UK Firefighter Cancer and Disease Registry.

Results: Of the 628 firefighters who attended, information was available from 524. 89% reported exposure to smoke without respiratory protection equipment (RPE), of whom 23% also reported exposure to excessive heat. Common reasons for smoke exposure were assisting casualties (18%), running out of air (15%) and climbing stairs without activating RPE to conserve air (17%).

Conclusions: A significant proportion of firefighters reported inhaling smoke during the incident with potentially debilitating health effects.
Work-Related Fatigue
Authors: Schmitz Amber N. , Giuliani-Dewig Hayden K. , Laffan Megan R. , Trivisonno Abigail J. , Gerstner Gena R. , Mota Jacob A. , Buoncristiani Nicholas A. , Ryan Eric D.
Published: November 2024

Objective

The purpose of this study was to (1) examine the relationship between perceived work-related fatigue and performance fatigability, and (2) assess the impact of percent body fat (%BF) on perceived fatigue constructs in career firefighters.

Methods

Thirty-nine career firefighters completed body composition testing, the Occupational Fatigue Exhaustion Recovery (OFER15) scale assessing three subscales of work-related fatigue (acute fatigue, chronic fatigue, and inter-shift recovery), and maximal leg extensor isometric strength testing prior to and following an isotonic fatiguing protocol.

Results

Performance fatigability was not associated with any of the OFER15 perceived work-related fatigue variables (P ≥ 0.513). Greater %BF was associated with greater %∆ peak torque (r = −0.41, P = 0.010) but none of the OFER15 perceived work-related fatigue variables (P ≥ 0.638).

Conclusions

Performance fatigability was not associated with OFER15 perceived work-related fatigue, and greater adiposity negatively impacted performance fatigability but not perceived fatigability.
Power exercises with elastic bands combined with endurance training improve pulse pressure, systolic blood pressure, and functional parameters in older adults
Authors: Costa Chaves Luiz Filipe , Bavaresco Gambassi Bruno , Cadore Eduardo Lusa , Sotão Samir , Sousa Thiago Matheus , Dias Danielle da Silva , Schwingel Paulo Adriano , Mostarda Cristiano
Published: November 2024

Objective

This study aimed to investigate the effects of power training (PT) using elastic bands combined with endurance training (ET) on pulse pressure (PP), systolic (SBP) and diastolic blood pressures (DBP), autonomic response (AR), and functional parameters in older adults.

Methods

Thirty participants were randomly assigned to the control group (n = 15) and the intervention group (IG) (n = 15). IG participants performed PT with elastic bands combined with ET twice weekly for 8 weeks. PP, SBP, DBP, AR, and functional parameters were assessed before and after 8 weeks.

Results

PP, SBP, and functional parameters significantly improved after 8 weeks in the IG (P < 0.05). The study also found a clinically significant reduction in the SBP (Δ = −16.5 mmHg; η
2

p
 = 0.36) and DBP (Δ = −4.3 mmHg; η
2

p
 = 0.26), and a clinical reduction in the 5-Repetition Sit-To-Stand test (η
2

p
 = 0.63) and the elbow flexion test (η
2

p
 = 0.51).

Conclusion

Our findings indicate that PT with elastic bands combined with ET improves PP, SBP, and functional parameters in older adults. Hence, our combined training protocol can be an easily accessible, low-cost, nonpharmacological strategy for strength, and conditioning professionals to prescribe as an exercise intervention to older adults.
Pediatrics leading the way: co-enrollment as the next step in health-related social needs screening and referral
Authors: Ettinger de Cuba Stephanie , Ruemmele Carley , Poblacion Ana
Published: November 2024

Purpose of review

To contextualize how pediatrics led the field in developing and implementing tools to screen for social determinants of health in clinical care as well as in creating innovative interventions to mitigate them, and to summarize where the evidence points as the next frontier.

Recent findings

The evidence showed that health-related social needs (HRSN), like food insecurity, energy insecurity, and housing instability, continue to drive poor health outcomes across the lifespan; patients and healthcare providers are open to discussing HRSN in clinical settings, though some providers feel ill-equipped to do so; to mitigate HRSN, healthcare plays a unique role in ensuring patients’ HRSN are understood, referring to effective resources through building strong, lasting relationships with community partners, embedding services in the healthcare setting across all departments, and empowering patient families to participate in programs and services; and administrative burden hinders families from getting all the benefits to which they are entitled, which streamlined co-enrollment processes can address.

Pediatric providers can add a unique and credible voice to seeking changes to the safety-net, including co-enrollment, that could reduce administrative burden, address patients’ HRSN, and improve health starting in the prenatal period through later adulthood.
Plasma Exchange and N-Acetylcysteine Therapy in a Case of Congenital Thrombotic Thrombocytopenic Purpura Presenting With Acute Renal Failure
Authors: Coşkun Çağri , Aksu Tekin , Gülhan Bora , Düzova Ali , Ünal Şule
Published: November 2024

Congenital thrombotic thrombocytopenic purpura (cTTP), which is associated with mutations in the gene for a disintegrin and metalloproteinase with a thrombospondin type 1 motif member 13 (ADAMTS13), is a chronic and lifelong disease. The clinical course is variable. Regularly using ADAMTS13-containing products such as fresh frozen plasma (FFP) for long-term prophylaxis is the most important treatment to prevent thrombotic microangiopathy (TMA) episodes. Here, we identified novel pathogenic mutations of ADAMTS13 in our patients who experienced severe acute renal failure. Infections can trigger acute hemolytic episodes, and if the initiation of FFP therapy is delayed, this leads to severe organ dysfunction, as in our case. We have shown that regular use of products containing ADAMTS13 can reverse TMA episodes and long-term morbidity and mortality. When severe acute renal failure occurs, daily plasma exchange and N-acetylcysteine (NAC) are useful.
Disparities in Genetic Management of Breast and Ovarian Cancer Patients
Authors: Duyar-Ayerdi Susan , Summey Rebekah M. , Uyar Denise
Published: November 2024

Importance

Hereditary breast and ovarian cancer syndrome (HBOC) is most often caused by pathogenic variants in the BRCA1 or BRCA2 genes. Guidelines exist for genetic testing in patients at high risk, yet significant disparities in genetic testing and management remain. These disparities result in missed opportunities for cancer prevention and treatment.

Objective

This review details the multiple layers of disparities in genomic knowledge, testing referral, completion, and posttesting risk reduction for at-risk populations.

Evidence Acquisition

A comprehensive search of the PubMed database was conducted in September 2023 for studies addressing disparities at all points of HBOC risk assessment and risk reduction.

Results

Disparities in genomic knowledge, referral and testing, and in cancer risk reduction exist by race, ethnicity, insurance status, socioeconomic status, age, and care setting in the United States. Many mitigation strategies have been explored with some success.

Conclusion

Each component contributes to a “leaky pipe” in BRCA testing and management whereby patients eligible for intervention trickle out of the pipe due to inequities at each step. Implementation of proven strategies aimed at disparity reduction in this setting is essential, as well as additional strategy development.

Relevance

This review provides clinicians with a comprehensive understanding of disparities in the identification and management of individuals at risk for or diagnosed with HBOC and strategies to reduce disparities in their own practice.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objectives

After participating in this activity, the learners should be better able to discuss disparities in the testing for and risk-reducing management of patients with pathogenic variants of BRCA1/2; describe populations in which these disparities are greatest; and explain proven strategies for practice change to mitigate these disparities.
Frequency and Distribution of Perinatal Arterial Ischemic Stroke in a Cohort of Patients With Cerebral Palsy Using Delayed MRI
Authors: Jalloul Mohammad , Venkatakrishna Shyam Sunder B. , Alves Cesar Augusto P. , Curic Jelena , Andronikou Savvas
Published: November 2024

Purpose

This study examined the occurrence and MRI characteristics of perinatal arterial ischemic stroke (PAIS) in children with cerebral palsy (CP) and suspected term hypoxic-ischemic injury (HII).

Methods

A retrospective review of brain MRI scans was conducted on children with CP and suspected term HII in South Africa.

Results

Out of 1620 children with CP included in the study, 15 (0.9%) had PAIS. The most common site of infarct was the left middle cerebral artery. The majority of infarcts were unilateral, and 67% of cases exhibited cystic changes. Among children with PAIS, 47% exhibited concurrent HII, with the predominant patterns being basal-ganglia-thalamus (BGT) and watershed (WS). In cases of isolated PAIS (53%), network injuries were prevalent in 88% of children, most commonly involving the posterior limbs of the internal capsule, cerebral peduncles, thalami, and corpus callosum.

Conclusions

The study highlights that PAIS is a relatively rare condition in children with CP, predominantly occurring in the left middle cerebral artery.
Clinical Impact of Pancreatic and Peripancreatic Hemorrhage Associated With Acute Pancreatitis
Authors: Richter Benjamin I. , Weissbrot Joseph H. , Chung Frank R. , Gonda Tamas A. , Huang Chenchan
Published: November 2024

Purpose

The significance of pancreatitis-associated hemorrhage outside the context of a ruptured pseudoaneurysm remains unclear. This study aims to characterize the clinical significance of pancreatic hemorrhage during acute pancreatitis (AP).

Methods

This retrospective study included adult patients diagnosed with hemorrhagic pancreatitis (HP) from 2010 to 2021. HP was defined as a clinical diagnosis of AP and the presence of pancreatic or peripancreatic hemorrhage on cross-sectional imaging. Two radiologists assessed the pancreatitis type, degree of necrosis, hemorrhage location, peripancreatic collections, and peripancreatic vessels. Demographic and disease data, AP severity, and treatment decisions from admission to 3 months after discharge were extracted from hospital electronic health records.

Results

The study included 36 patients, stratified by AP severity into 12 (33.3%) mild, 13 (36.1%) moderate-severe, and 11 (30.6%) severe cases. Six (16.6%) of the patients experienced clinically significant bleeding, which led to changes in clinical management such as further imaging, modifications to anticoagulation regimens, or both. Among these, 50% (3 of 6) demonstrated active bleeding on further imaging, with 33% (2 of 6) of the bleeding being intrapancreatic. In contrast, 83% (30 of 36) of HP patients did not have clinically significant bleeding, and all but one did not require changes in clinical management. AP-associated splanchnic vein thrombosis occurred in 30.6% (11 of 36) of patients, and anticoagulation in these patients did not result in clinically significant bleeding.

Conclusions

HP without clinically significant bleeding does not necessitate changes in clinical management. However, hemorrhage may indicate more severe disease and is associated with a higher incidence of splanchnic vein thrombosis.
Evaluation of Amide Proton Transfer Imaging Combined With Serum Squamous Cell Carcinoma Antigen for Grading Cervical cancer
Authors: Zhang Xiao-yan , Xu Chen , Wu Xing-chen , Qu Qian-qian , Deng Kai
Published: November 2024

Objective

The aim of the study is to investigate the efficacy of amide proton transfer-weighted (APT) imaging combined with serum squamous cell carcinoma antigen (SCC-Ag) in grading cervical cancer.

Methods

Sixty-three patients with surgically confirmed cervical SCC were enrolled and categorized into 3 groups: highly differentiated (G1), moderately differentiated (G2), and poorly differentiated (G3). The diagnostic efficacies of APT imaging and serum SCC-Ag, alone or in combination, for grading cervical SCC were compared.

Results

The APT values measured by the 2 observers were in excellent agreement (intraclass correlation coefficient >0.75). Mean (± standard deviation) APT values for the high, moderate, and poor differentiation groups were 2.542 ± 0.215% (95% confidence interval [CI]: 2.423–2.677), 2.784 ± 0.175% (95% CI: 2.701–2.856), and 3.120 ± 0.221% (95% CI: 2.950–3.250), respectively. APT values for groups G2 and G3 were significantly higher than those for G1 (P < 0.05). APT values for identifying cervical SCC in groups G1 and G2, G2 and G3, and G1 and G3, had areas under the receiver operating characteristic curve, sensitivities, and specificities of 0.815 (95% confidence interval [CI]: 0.674–0.914), 82.1%, and 72.2%, 0.882 (95% CI: 0.751–0.959), 70.6%, and 92.7%, and 0.961 (95% CI: 0.835–0.998), 94.1%, and 94.4%, respectively. APT values were significantly and positively correlated with the histological grade of cervical SCC (Spearman's correlation [r
s] = 0.731, P < 0.01). Serum SCC-Ag levels for the high, moderate, and poor differentiation groups were 1.60 (0.88–4.63) ng/mL, 4.10 (1.85–6.98) ng/mL, and 26.10 (9.65–70.00) ng/mL, respectively. The differences were statistically significant only between groups G1 and G3 and G2 and G3 (P < 0.05), whereas the differences between groups G1 and G2 were not statistically significant (P > 0.05). Spearman's analysis revealed a positive correlation between SCC-Ag levels and the histological grade of cervical SCC (r
s = 0.573, P < 0.01). The diagnostic efficacy of APT imaging for the histological grading of cervical SCC was better than that of serum SCC-Ag, and the discriminatory efficacy of the combination of the 2 parameters was better than that of either alone.

Conclusions

The diagnostic efficacy of APT imaging was better than that of serum SCC-Ag, and the combined diagnostic utility of APT and SCC-Ag was better than that of the individual parameters.
FDG PET/CT Scan Still Can Help in Evaluation of Prostate Cancer
Authors: Doroudinia Abtin , Wolfe Taylor
Published: November 2024

Although 18F-FDG PET/CT scan is not the preferred modality to evaluate prostate cancer patients due to generally low uptake of FDG in prostate cancer cells, it can still be helpful in some selected cases with diagnostic dilemma. Here we are presenting an unusual prostate cancer case, status post radical prostatectomy, with heterogenous uptake in osseous lesions on 68Ga-PSMA PET/CT scan and low PSA values. He was referred for further evaluation with 18F-FDG PET/CT scan, revealing widely metastatic lesions in bone and liver, in addition to mildly avid recurrence in prostatectomy surgical bed and also metastasis in the spleen.
“Hot Tongue and Mouth” on 18F-FDG PET/CT Due to Buccolingual Masticatory Syndrome, Caused by Metoclopramide Antiemetic Treatment
Authors: Jochumsen Mads Ryø , Kramer Stine Maria Jentoft
Published: November 2024

We present a case of a 66-year-old man, where 18F-FDG PET/CT revealed intense FDG uptake in the tongue, lips, cheeks, and chewing musculature and distinct activation of the somatosensory and motor cortex corresponding to the mouth and tongue. The patient suffered from buccolingual masticatory syndrome, characterized by tardive dyskinesia, meaning uncontrollable, repetitive movements of the tongue, lips, cheeks, and masticatory musculature. In this case, the buccolingual masticatory syndrome was caused by metoclopramide antiemetic treatment. “Hot tongue” was previously described on 18F-FDG PET/CT in patients with tardive dyskinesia due to antipsychotic treatment, but the distinct activation of the lower facial motor cortex makes the present case stand out.
Norepinephrine Transporter–Targeted Cancer Theranostics—New Horizons
Authors: Higuchi Takahiro , Klimek Konrad , Groener Daniel , Chen Xinyu , Werner Rudolf A.
Published: November 2024

In the evolving landscape of precision oncology, this review delineates the role of radiopharmaceuticals targeting the norepinephrine transporter (NET), with a particular focus on the current clinical application of 123I-MIBG diagnostic imaging and 131I-MIBG therapeutics, in particular for pheochromocytoma, neuroblastoma, or paraganglioma. We will also highlight recently introduced 18F-labeled NET targeting imaging radiotracers, which would offer unparalleled resolution, enhanced tumor localization, and staging properties. Complementing these novel second-generation PET agents in a theranostic approach, astatine-211 meta-astatobenzylguanidine (211At-MABG) would leverage the advantages of alpha-particles to selectively target and eradicate NET-expressing tumor cells with minimal off-target effects.