bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Trauma-Informed Approach for Care of a Postpartum Patient With Provoked-Localized Vulvodynia: A Case Report
Authors: Parr Rebecca E. 
Published: October 2024

Introduction:
Vulvodynia is a chronic pelvic pain condition affecting at least 10% of individuals with a vulva. Its complex and multifactorial etiology can be exacerbated by adverse childhood events (ACEs), which intensify pain symptoms and complicate treatment. This case report outlines a comprehensive trauma-informed treatment strategy for addressing persistent vulvodynia in a patient with a history of traumatic ACEs.

Case Description:
This case report describes a 30-year-old female with provoked localized vulvodynia, and a history of multiple ACEs. A trauma-informed plan of care was created which emphasized consent, control, emotional safety, and compassionately listening to avoid re-traumatization. The patient was seen for 15 physical therapy visits over six months. Her pain reduced from 9/10 to 3/10 on the NRPS, exceeding the minimally clinically important difference. The Marinoff dyspareunia scale reduced from 3 to 1. She was able to return to previously painful activities, such as wearing underwear and blue jeans, and unlimited sitting, standing, and walking.

Discussion:
ACEs can adversely affect the pelvic floor and the nervous system. Adopting trauma-informed practices can assist patients in overcoming effects of trauma, and improve communication, plan of care adherence, and overall outcomes. Trauma-informed practice should be standard of care with all patients, as it encourages empowerment, choice, collaboration, and safety.
Efficacy of Mindfulness Exercises for Primary Osteoporosis Pain and Balance
Authors: Lyu Fang Fei , Ramoo Vimala , Chui Ping Lei , Ng Chong Guan 
Published: October 2024

Mindfulness exercise has shown great benefits for patients with osteoporosis. However, there are various types of mindfulness exercises and no studies have compared their efficacy. The aim of this study was to compare the efficacy of mindfulness exercises on pain and balance in patients with primary osteoporosis. Articles published in 10 English and three Chinese language databases from January 1, 2003, to December 31, 2022, were systematically searched. Twenty-two studies (N = 1,603) of five types of mindfulness exercises (Pilates, Ba Duan Jin, Wu Qin Xi, Tai Chi, and Yi Jin Jing) were eligible for this meta-analysis. Evidence from this review indicated that all five of the mindfulness exercises included in this study effectively reduced pain and improved balance for patients with primary osteoporosis. Pilates had the highest value of surface under the cumulative ranking as the best intervention. Future studies could consider developing a standard guideline for mindfulness exercise to be incorporated into osteoporosis rehabilitation.
Minimally Invasive Surgery for the Management of Ovarian Cancer
Authors: Nezhat Farr , Briskin Camille , Lakhi Nisha , Fu Rongwei , Pejovic Tanja 
Published: October 2024

OBJECTIVE:
To examine perioperative and survival outcomes of patients with ovarian cancer managed by minimally invasive surgery compared with laparotomy in the context of 1) early-stage epithelial ovarian cancer, 2) primary cytoreduction for advanced disease, and 3) interval debulking after neoadjuvant chemotherapy.

DATA SOURCES:
A literature search was conducted PubMed, MEDLINE and ClinicalTrials.gov, Web of Science, Cochrane Library, and meeting abstract libraries (International Gynecological Cancer Society, Society of Gynecologic Oncology, American Society of Clinical Oncology) from 1994, the year of the first published laparoscopic clinical study in ovarian cancer, to May 2024. Studies that compared minimally invasive surgery with laparotomy for staging of ovarian cancer and reported perioperative or survival outcomes data were included. Single-arm studies, case studies, meeting abstracts, and studies involving borderline tumors, fertility-sparing surgery, or management of recurrent disease were excluded.

METHODS OF STUDY SELECTION:
Three authors independently screened citations for relevance and inclusion and exclusion criteria and assessed the risk of bias of individual studies using the methodologic index for nonrandomized studies criteria for nonrandomized studies.

TABULTATION, INTEGRATION, AND RESULTS:
From a total of 2,777 identified citations, 36 nonrandomized studies were included: 21 early-stage, five primary debulking for advanced stages, seven interval debulking after neoadjuvant chemotherapy, and three with heterogeneous populations. No randomized studies were identified. For early-stage cancer, nine studies found no difference in progression-free survival (risk ratio [RR] 1.05, 95% CI, 1.00–1.10, I
2=34.7%, P=.151), and 12 studies found no difference in overall survival (RR 1.00, 95% CI, 0.98–1.03, I
2=49.7%, P=.025). For primary debulking of advanced disease, rate of optimal debulking (five studies) (RR 1.11, 95% CI, 1.00–1.25, I
2=41.5%, P=.144) slightly favored minimally invasive techniques. For interval debulking, there was no difference in rates of optimal debulking (five studies) (RR 1.03, 95% CI, 0.96–1.11, I
2=54.6%, P<.051) between the two surgical modalities.

CONCLUSION:
The inclusion of observational studies in this analysis with a fair amount of bias warrants caution in the interpretation of the findings. However, minimally invasive surgery may offer some perioperative advantages over laparotomy and may be an acceptable alternative for selected patients. For early-stage disease, there was no difference in survival outcomes between minimally invasive surgery and laparotomy. For those with advanced disease, rates of optimal debulking were similar.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO, CRD42022359051.
Diagnostic Safety: Needs Assessment and Informed Curriculum at an Academic Children’s Hospital
Authors: Congdon Morgan , Rasooly Irit R. , Toto Regina L. , Capriola Danielle , Costello Anna , Scarfone Richard J. , Weiss Anna K. 
Published: October 2024

Background:
Diagnostic excellence is central to healthcare quality and safety. Prior literature identified a lack of psychological safety and time as barriers to diagnostic reasoning education. We performed a needs assessment to inform the development of diagnostic safety education.

Methods:
To evaluate existing educational programming and identify opportunities for content delivery, surveys were emailed to 155 interprofessional educational leaders and 627 clinicians at our hospital. Educational leaders and learners were invited to participate in focus groups to further explore beliefs, perceptions, and recommendations about diagnostic reasoning. The study team analyzed data using directed content analysis to identify themes.

Results:
Of the 57 education leaders who responded to our survey, only 2 (5%) reported having formal training on diagnostic reasoning in their respective departments. The learner survey had a response rate of 47% (293/627). Learners expressed discomfort discussing diagnostic uncertainty and preferred case-based discussions and bedside learning as avenues for learning about the topic. Focus groups, including 7 educators and 16 learners, identified the following as necessary precursors to effective teaching about diagnostic safety: (1) faculty development, (2) institutional culture change, and (3) improved reporting of missed diagnoses. Participants preferred mandatory sessions integrated into existing educational programs.

Conclusions:
Our needs assessment identified a broad interest in education regarding medical diagnosis and potential barriers to implementation. Respondents highlighted the need to develop communication skills regarding diagnostic errors and uncertainty across professions and care areas. Study findings informed a pilot diagnostic reasoning curriculum for faculty and trainees.
miR-374 family is a key regulator of chronic primary pain onset
Authors: Hernandez Nathaniel P. , Rawls Ashleigh , Chen Jiegen , Zhang Xin , Wang Yaomin , Gao Xianglong , Parisien Marc , Karaky Mohamad , Meloto Carolina Beraldo , Montagna Francesca , Dang Hong , Pan Yue , Zhao Ying , McLean Samuel , Linnstaedt Sarah , Diatchenko Luda , Nackley Andrea G. 
Published: October 2024

Abstract

Introduction:
Chronic primary pain conditions (CPPCs) are linked to catecholamine activation of peripheral adrenergic receptors. Yet, catecholamine-dependent epigenetic mechanisms, such as microRNA (miRNA) regulation of mRNA transcripts, remain largely unknown.

Objectives:
We sought to identify RNA species correlated with case status in 3 pain cohorts, to validate RNAs found to be dysregulated in a mouse model of CPPC onset, and to directly test the role of adrenergic receptors in miRNA regulation. Furthermore, we tested antinociceptive effects of miR-374 overexpression.

Methods:
We used RNA-seq and quantitative reverse transcription polymerase chain reaction to measure RNA expression in 3 pain cohorts. Next, we validated identified RNAs with quantitative reverse transcription polymerase chain reaction in a mouse model of CPPC onset, measuring expression in plasma, peripheral (adipose, muscle, dorsal root ganglia [DRG]), and central (spinal cord) tissues. Then, we stimulated adrenergic receptors in primary adipocyte and DRG cultures to directly test regulation of microRNAs by adrenergic signaling. Furthermore, we used in vitro calcium imaging to measure the antinociceptive effects of miR-374 overexpression.

Results:
We found that one miRNA family, miR-374, was downregulated in the plasma of individuals with temporomandibular disorder, fibromyalgia syndrome, or widespread pain following a motor vehicle collision. miR-374 was also downregulated in plasma, white adipose tissue, and spinal cord from mice with multisite mechanical sensitivity. miR-374 downregulation in plasma and spinal cord was female specific. Norepinephrine stimulation of primary adipocytes, but not DRG, led to decreased miR-374 expression. Furthermore, we identified tissue-specific and sex-specific changes in the expression of predicted miR-374 mRNA targets, including known (HIF1A, NUMB, TGFBR2) and new (ATXN7, CRK-II) pain targets. Finally, we demonstrated that miR-374 overexpression in DRG neurons reduced capsaicin-induced nociceptor activity.

Conclusions:
Downregulation of miR-374 occurs between adrenergic receptor activation and mechanical hypersensitivity, and its adipocyte source implicates adipose signaling in nociception. Further study of miR-374 may inform therapeutic strategies for the millions worldwide who experience CPPCs.
The Status of Liver Margin in Perihilar Cholangiocarcinoma
Authors: Jin Shuo , Lin Ming-Yu , Xiang Can-Hong , Liu Zhi-Peng , Wang Si-Yuan , Jiang Nan , Li Li , Shan Si-Qiao , Zeng Jian-Ping , Yin Hai-Xin , Zhang Tao , Yang Chang-Zhen , Yang Dong-Liang , Zhou Hu , Chen Zhi-Yu , Dong Jia-Hong 
Published: October 2024

Objective:
This study aimed to investigate the prevalence and distribution of carcinoma in the liver margin (LM) of resected perihilar cholangiocarcinoma (pCCA) and establish a method for LM examination.

Background:
LM is the largest margin in resected pCCA with undefined status and assessment method.

Methods:
227 pCCA cases underwent major hepatectomy were divided into a discovery cohort (n=101) assessed using serial whole-mount digital large sections (WDLS) combined with small sections, and a control cohort (n=126) assessed using only small sections.

Results:
The LM R1 resection rate was 38.6% (39/101) in the discovery cohort and 5.6% (7/126) in the control cohort. WDLS identified more LM R1 cases compared to the small section in the discovery cohort (38.6% vs. 5.9%, P<0.001). R0 patients in the discovery cohort had better overall survival and recurrence-free survival than those in the control cohort (both P<0.05). Additionally, 95% of carcinoma was found within 20 mm of the proximal ductal margin (DM). A proximal DM distance of<5 mm was an independent risk factor for LM R1 resection. Patients with which are more likely to experience R1 compared to those with ≥ 5 mm (P<0.001).

Conclusions:
Positive LM was the significant cause for R1 resection of pCCA and the utilization of WDLS improved the diagnostic accuracy of LM. An examination methodology was established, highlighting the necessity of examining LM within a 20 mm radius around the proximal DM, especially in patients with a proximal DM of<5 mm.
Dosing Balance Training for Older Adults
Authors: Espy Debbie , Lyon Marissa F. 
Published: October 2024

The physical processes that contribute to balance may decline as humans age. In exercise-based balance training, the most effective intervention for improving balance and falls-reduction among older adults, the type of exercise is set first, then intensity, then time. Clinical decision making about type of exercise program is based on examination and assessment of the person, including their goals and contributing impairments. Intensity is poorly reported, but 2 tools to measure and modulate intensity have been developed. Time component recommendations vary: most common are 2 to 3 times per week for 30-45 min for 12 weeks.
Neurorights in the Constitution: from neurotechnology to ethics and politics
Authors: Ruiz Sergio , Valera Luca , Ramos Paulina , Sitaram Ranganatha 
Published: October 2024

Neuroimaging technologies such as brain–computer interfaces and neurofeedback have evolved rapidly as new tools for cognitive neuroscience and as potential clinical interventions. However, along with these developments, concern has grown based on the fear of the potential misuse of neurotechnology. In October 2021, Chile became the first country to include neurorights in its Constitution. The present article is divided into two parts. In the first section, we describe the path followed by neurorights that led to its inclusion in the Chilean Constitution, and the neurotechnologies usually involved in neurorights discussions. In the second part, we discuss two potential problems of neurorights. We begin by pointing out some epistemological concerns regarding neurorights, mainly referring to the ambiguity of the concepts used in neurolegislations, the difficult relationship between neuroscience and politics and the weak reasons for urgency in legislating. We then describe the dangers of overprotective laws in medical research, based on the detrimental effect of recent legislation in Chile and the potential risk posed by neurorights to the benefits of neuroscience development. This article aims to engage with the scientific community interested in neurotechnology and neurorights in an interdisciplinary reflection of the potential consequences of neurorights.
This article is part of the theme issue ‘Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation’.
Neurofeedback: potential for abuse and regulatory frameworks in the United States
Authors: Furnari Fiona , Park Haesoo , Yaffe Gideon , Hampson Michelle 
Published: October 2024

Neurofeedback is a brain-training technique that continues to develop via ongoing innovations, and that has broadening potential impact. Once confined primarily to clinical and research settings, it is increasingly being used in the general population. Such development raises concerns about the current regulatory mechanisms and their adequacy in protecting patterns of economic and political decision-making from the novel technology. As studies have found neurofeedback to change subjects’ preferences and mental associations covertly, there is a possibility it will be abused for political and commercial gains. Current regulatory practices (including disclaimer requirements, unfair and deceptive trade practice statutes and undue influence law) may be avenues from which to regulate neurofeedback influence. They are, however, limited. Regulating neurofeedback will face the line-drawing problem of determining when it induces an unacceptable level of influence. We suggest experiments that will clarify how the parameters of neurofeedback training affect its level of influence. In addition, we assert that the reactive nature of the traditional models of regulation will be inadequate against this and other rapidly transforming technologies. An integrated and proactive regulatory system designed for flexibility must be adopted to protect society in this era of modern technological advancement.
This article is part of the theme issue ‘Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation’.
SMC modulates ParB engagement in segregation complexes inStreptomyces
Authors: Pawlikiewicz Katarzyna , Strzałka Agnieszka , Majkowski Michał , Duława-Kobeluszczyk Julia , Szafran Marcin , Jakimowicz Dagmara 
Published: October 2024

ABSTRACTParB is long established chromosome segregation protein in bacteria. Due to the recently demonstrated CTPase activity of ParB, formation of its nucleoprotein complexes was unrevealed. ParB homodimers bound to CTP are loaded onto DNA atparSsites, where they recruit condensin (SMC), thereby facilitating chromosome organization and segregation. Whether SMC modulates ParB complexes has remained unknown. Here, we generatedStreptomyces venezuelaestrains producing ParB-HaloTag in the presence or absence of SMC and used single-cell time-lapse fluorescence microscopy, single molecule tracking and fluorescence recovery after photobleaching analysis to explore ParB dynamics. Additionally, we performed chromatin immunoprecipitation to examine ParB interactions with DNA in the presence or absence of SMC. We reveal that SMC modulates ParB complex stability on DNA. We find that the absence of SMC results in faster ParB complex disassembly, and promotes non-specific DNA binding. Additionally, we show that SMC reduces ParB CTPase activityin vitro. Taken together our data provide evidence of SMC positive feedback on the ParB nucleoprotein complex, offering new insight into the nature of ParB complex regulation.
Packed Red Blood Cell and Whole Blood Perfusates during an Ex-vivo Normothermic Perfusion for Assessment of High-Risk Donor Kidneys
Authors: Ahmadi Armin , Yang Heiko , Jen Kuang-Yu , Fan Sili , Palma Ivonne , Sageshima Junichiro , Goussous Naeem , Roshanravan Baback , Perez Richard V. 
Published: October 2024

AbstractBackgroundEx-vivo normothermic perfusion (EVNP) with a blood based perfusate has the potential to both assess viability of and repair high-risk organs prior to transplantation. However, the optimal perfusate is yet to be established.MethodsEight paired high-risk human kidneys were placed on three hours of pressure dependent EVNP at 37°C. Kidneys were perfused with either a leukocyte-depleted packed red blood cell (PRBC) with crystalloid perfusate or a whole blood (WB) perfusate. Continuous hemodynamic and functional parameters were assessed. Core needle tissue biopsies were taken for untargeted metabolomics and lipidomics profiling. At testwas used to assess group differences in functional and hemodynamics outcomes.ResultsAfter a mean cold ischemia time (CIT) of 54 hours, all kidneys showed high renal blood flow (RBF) through perfusion. Renal resistance (RR) increased for both groups during the first hour and then decreased to similar terminal values. The kidneys perfused with PRBC had 55 ml/min greater RBF (95% CI of 21 to 89; P=0.004) and higher total urine output (UO) (145 vs 25 ml, P= 0.002) compared to the WB group. Urinary acute kidney biomarkers of NGAL and KIM-1 were also significantly lower (mean differences of 281 and 2.1 ng/ml respectively; P<0.01) in the PRBC perfused kidneys. Compared to PRBC, within group tissue metabolic profiling revealed a similar (23% vs 18%) but a more pronounced alteration predominantly involving (branched chain) amino acid and mitochondrial energy metabolism in the WB group. Similarly, lipid profile temporal changes showed WB group were highlighted by elevation of plasma membrane and structure lipids including glycerolipids, sphingolipids, and steroids. The PRBC group had minimal temporal tissue lipid profile changes.ConclusionCompared to WB, PRBC perfusion is superior in mitigating post-ischemia damage and facilitating function and metabolic recovery of high-risk kidneys subjected to long CITs during a three-hour ENVP.Key points-Kidneys perfused with packed red blood cells (PRBC) exhibited more favorable hemodynamics and functional outcomes during ex vivo normothermic perfusion (ENVP).-Tissue metabolic profiling showed an overlapping but a more drastic metabolic aberration in the whole blood (WB) group involving amino acid, carbohydrate, and mitochondrial energy metabolism over time.-Compared to the PRBC groups, WB perfused kidneys were associated with accumulation of tissue membrane/structure components including TGs, ceramides, and cholesteryl esters post perfusion.
Substantia Nigra MRI markers are lower in Alzheimer’s disease and are linked to novelty and memory
Authors: Krohn Friedrich , Sarkar Mousumi , Schütze Hartmut , Iliopoulos Panagiotis , Penalba-Sánchez Lucía , Hämmerer Dorothea , Yakupov Renat , Lüsebrink Falk , Spottke Annika , Schneider Anja , Roy Nina , Incesoy Enise I. , Heneka Michael , Kilimann Ingo , Kleineidam Luca , Teipel Stefan J , Brosseron Frederic , Goerss Doreen , Glanz Wenzel , Schmid Matthias , Rostamzadeh Ayda , Wagner Michael , Fliessbach Klaus , Jessen Frank , Düzel Emrah , Betts Matthew 
Published: October 2024

AbstractIndividuals with Alzheimer’s disease dementia (ADD) show Alzheimer’s disease (AD) pathology in and heterogeneous degeneration of the Substantia Nigra (SN) postmortem. However, it is unclear how the SN degeneration is related to cognitive dysfunction across the ADD continuum. In this study, using data from a prospective dementia study (DELCODE), we investigated if in-vivo SN MRI measures are lower in cases with clinically defined ADD than in healthy control subjects (HC) and associated with functional activity during the processing of novel visual stimuli and subsequent recognition memory.161 DELCODE participants (69 years ±6 years, 88 men), including 79 Healthy Controls, 71 individuals with subjective cognitive impairment (SCD), 17 individuals with mild cognitive impairment (MCI), and 10 individuals with ADD, completed a scene novelty and encoding task and a 3T neuromelanin (NM)-sensitive MRI scan, from which in-vivo measures of SN MRI contrast and SN volume were calculated. For 71 individuals, CSF levels of phospoTau, total tau, and amyloid beta 42/40 ratio (Aß42/40) were available. All individuals completed a neuropsychological task battery from which a global cognitive score was calculated.SN volume but not SN MRI contrast was lower in individuals with clinical ADD (One- way ANOVA: F(3,156)=4,13, N=160, p=0.0056, Tukey posthoc test: p=0.003) and SN MRI contrast and and volume were not associated with Aß42/40, ptau, and ttau CSF levels (all p<0.1). SN MRI contrast was positively associated with anterior hippocampal functional activity during the presentation of novel stimuli in individuals with Aß42/40 ratio levels below a pathological threshold of 0.08 (Aß42/40 positive, (p(FWE)=0.002, 157 voxels, n=28) but not in Aß42/40 negative individuals. Moreover, SN volume was positively associated with recognition memory (N=160, p=0.017, r2=0.11) and global cognition (p<0.0001, N=160, r2=0.221) across the ADD continuum.Our study emphasizes the potential of using in-vivo SN MRI markers to understand the impact of AD pathology-independent SN degeneration on recognition memory and novelty processing dysfunction in ADD. Our results motivate future longitudinal studies exploring how SN volume and SN contrast change over time, how these differentially associate with cognitive decline and how the SN volume and SN contrast might be associated with other dopamine-dependent cognitive functions.