bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring methodological frontiers in laminar fMRI
Authors: Chai Yuhui , Zhang Ru-Yuan 
Published: November 2024

Abstract
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

Abstract
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

Abstract
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.
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

AbstractCardiac 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.
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

Abstract:

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.

Summary
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.
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.