bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bereavement and Mortality
Authors: Goldstein Mark A. , Goldstein Myrna Chandler 
Published: May 2024

Abstract
The death of a parent is probably the most traumatic event that may occur to an adolescent. Close to three percent of adolescents have lost a parent to death by age 18. This loss challenges adolescents with short-term grief and long-term emotional and economic support issues. Prolonged grief after the loss may increase an adolescent’s risk for anxiety, depression, suicidality, or substance use. Brief interventions may help prevent adolescents from developing more severe problems after the loss of a parent. The Family Bereavement Program, a 12-month intervention for parentally bereaved children and adolescents, demonstrated results in reducing internalizing and externalizing problems in females. The Writing for Recover intervention confirmed that writing about traumatic experiences might alleviate grief symptoms in bereaved adolescents.
Pain and Adverse Childhood Experiences
Authors: Katzman William G. , Fabbro Anilla Del 
Published: May 2024

Abstract
In this chapter, the effects of childhood trauma on mental and physical pain are explored. The chapter begins with a discussion regarding the relationship between physical and psychological pain in the context of trauma. Subsequently, a focus is given to adverse childhood experiences (ACEs) with regard to their defining principles, correlates with other social determinants of health, and their effects on psychological and physical pain. Within this discussion, it is clear that the effect of ACEs frequently leads to subsequent pain, which can manifest in a number of different disorders and diseases. This often stems from the way that these early traumas have effects on an individual’s biology, psychology, and social capacities. Finally, the chapter explores pain-based interventions, including primary, secondary, and tertiary strategies, and it highlights an array of interventions that health care providers must consider to improve the mental and physical health of individuals with both experiences of pain and childhood trauma.
Pain in Patients Living in Congregant Settings
Authors: Kalauokalani Donna , Budhwar Nitin 
Published: May 2024

Abstract
This chapter describes the challenges for assessing and treating pain in vulnerable populations who are in congregant settings, specifically in prison and in nursing homes. The unique circumstances surrounding incarceration and how those may mitigate considerations for assessment and selection of therapies are discussed. Understanding the relationship of prior trauma, adverse childhood experiences, co-occurring substance use disorder, and/or other mental health illness is explored. A stepwise, graduated approach is described to create an individualized treatment program. Compounding these challenges tied to long-term care settings are the unique medical risks of the older patient, including an increased susceptibility to acute injuries, a higher prevalence of chronic illness that may contribute to delayed recovery, and various forms and degrees of cognitive and physiologic decline. Systemic challenges such as staffing shortages, lack of standardized protocols, increasing cost of care, corporate priorities, and the interpretation and enforcement of rules and regulations add to the complexities one must navigate to provide optimal patient care.
Pain Related to Obesity
Authors: DeLateur Barbara 
Published: May 2024

Abstract
The most common definition of obesity is a body mass index (BMI) of 30 or greater, with subdivisions beyond that, and the term “morbid obesity” is applied to a BMI 40 or greater. Obesity has increased markedly, from 30.5% during the period of 1999–2000 to 41.9% during the period 2017–2020. Obesity increases the load on weight-bearing joints, especially the knee and hip. It also increases the load on the back, particularly when there is central adiposity. Visceral fat increases inflammation by sending out inflammatory cytokines. Obesity often leads to depression, which can lead to further obesity, especially by stress eating and inactivity. Obesity is often associated with sleep disorders, which lead to further obesity by decreasing the hormone leptin (fullness) and increasing ghrelin (the hunger hormone). Treatment strategies include getting good sleep; using canes and other load-bearing devices when needed; and weight-loss strategies based on the patient’s food and drink logs, examining content, frequency, and duration of eating. It is especially helpful to eliminate processed foods and eat whole, unprocessed foods such as fruits and vegetables, whole grains, legumes, and fish.
Pain and COVID-19
Authors: Han Andrew , Jolly Taranjeet S. , Cohen Steven P. 
Published: May 2024

Abstract
In late 2019 and early 2020, a global pandemic caused by severe acute respiratory syndrome coronavirus 2 occurred that as of April 2023 had cumulatively resulted in more than 760 million cases worldwide and nearly 7 million deaths. But although the mortality rate from the disease caused by the virus, COVID-19, has declined secondary to myriad preventative measures, vaccinations, and evolving viral strains, the impact continues to resound worldwide in terms of chronic pain, psychological morbidity, and reduced quality of life. Not only is COVID-19 more likely to affect vulnerable populations such as the elderly, underrepresented minorities, and impoverished people but also these individuals are more likely to suffer from both acute and chronic sequelae, including chronic pain. This chapter discusses epidemiology including in at-risk populations, acute and chronic pain sequelae, psychosocial sequelae that accompany active infection and its aftermath, and treatment.
Pain in Critically Ill Patients
Authors: Jaremko Kellie , Krish Brinda , Nikolic Katarina , Rayaz Hassan 
Published: May 2024

Abstract
This chapter discusses the unique vulnerabilities and risks for development of chronic pain in critically ill patients, as well as management for their acute post-traumatic, procedural, and postoperative pain. It describes pain prevalence, assessment, multicomponent treatment plans, and consequences to poorly controlled pain in the intensive care unit patient leading to chronicity, psychological distress, and poor long-term outcomes. It explores the specific vulnerabilities of these patients regarding communication barriers associated with sedation, delirium, and psychological distress. The chapter further addresses the known difficulties of assessing acute pain in critically ill patients and describes validated pain scales. Evidence-based and established national and international guidelines for sedation, delirium, and postoperative/post-traumatic analgesia optimization are reviewed. It expands on the use of opioids, multimodal analgesia, and regional anesthesia. The critical role of pain physicians is also highlighted, in addition to the importance of aggressive pain management in critically ill patients and the significant impact it has on patient outcomes.
Pain in Dental Settings and Facial Pain
Authors: Chavis Sydnee , Manrriquez Salvador L. , Reyes Marcela Romero 
Published: May 2024

Abstract
Dental pain is a significant contributor to decreased quality of life and disability throughout the life span. It usually derives from diseases of the teeth or oral tissues, but it can be caused by other local and systemic conditions. Dental pain is more prevalent and, often, more debilitating in vulnerable populations, such as people of minority groups, people of low socioeconomic status, people with special needs, and older adults. Dental pain is mostly preventable with routine oral health care. Other conditions, such as dry mouth, can put people at risk for caries and periodontal disease that can lead to dental pain and infection. Orofacial pain conditions of no-dental origin such as trigeminal neuralgia, and temporomandibular disorders can also affect greatly the quality of life of the sufferer. Awareness of the conditions and factors that lead to dental and orofacial pain as well as adequate access to dental and medical care and equitable treatment are imperative to address and manage pain among vulnerable people.
SBAs and EMQs for the MRCOG Part 2
Authors: Gnanasambanthan Sai , Datta Shree , Mahmood Tahir 
Published: May 2024

Abstract
Specifically designed for the MRCOG exam part 2, SBAs and EMQs for MRCOG Part 2 offers practical questions mapped closely to the Royal College of Obstetrics and Gynaecology curriculum to help candidates prepare for the newly adapted exam. This book features 300 Single Best Answers multiple-choice questions and 300 extended multiple-choice questions with explanations and sources for further reading. The aim of this book is not to provide another revision text to consult, but rather to tackle the common and difficult areas faced by candidates undertaking the exam. Questions have been compiled by junior doctors who have recently passed the exam, together with consultants who have a special interest in postgraduate education and training. The structure and content of the book matches the format of the exam. A detailed explanation is provided along with each answer, as well as appropriate references where relevant.
Ghrelin alleviates intestinal ischemia–reperfusion injury by activating the GHSR‐1α/Sirt1/FOXO1 pathway
Authors: Liao Shi‐shi , Zhang Le‐le , Zhang Yi‐guo , Luo Jie , Kadier Tulanisa , Ding Ke , Chen Rong , Meng Qing‐tao 
Published: May 2024

AbstractIschemia–reperfusion (IR) injury is primarily characterized by the restoration of blood flow perfusion and oxygen supply to ischemic tissue and organs, but it paradoxically leads to tissue injury aggravation. IR injury is a challenging pathophysiological process that is difficult to avoid clinically and frequently occurs during organ transplantation, surgery, shock resuscitation, and other processes. The major causes of IR injury include increased levels of free radicals, calcium overload, oxidative stress, and excessive inflammatory response. Ghrelin is a newly discovered brain‐intestinal peptide with anti‐inflammatory and antiapoptotic effects that improve blood supply. The role and mechanism of ghrelin in intestinal ischemia–reperfusion (IIR) injury remain unclear. We hypothesized that ghrelin could attenuate IIR‐induced oxidative stress and apoptosis. To investigate this, we established IIR by using a non‐invasive arterial clip to clamp the root of the superior mesenteric artery (SMA) in mice. Ghrelin was injected intraperitoneally at a dose of 50 μg/kg 20 min before IIR surgery, and [D‐Lys3]‐GHRP‐6 was injected intraperitoneally at a dose of 12 nmol/kg 20 min before ghrelin injection. We mimicked the IIR process with hypoxia‐reoxygenation (HR) in Caco‐2 cells, which are similar to intestinal epithelial cells in structure and biochemistry. Our results showed that ghrelin inhibited IIR/HR‐induced oxidative stress and apoptosis by activating GHSR‐1α. Moreover, it was found that ghrelin activated the GHSR‐1α/Sirt1/FOXO1 signaling pathway. We further inhibited Sirt1 and found that Sirt1 was critical for ghrelin‐mediated mitigation of IIR/HR injury. Overall, our data suggest that pretreatment with ghrelin reduces oxidative stress and apoptosis to attenuate IIR/HR injury by binding with GHSR‐1α to further activate Sirt1.
Exploring Decisional Conflict Experienced by Individuals Considering Metoidioplasty and Phalloplasty Gender-affirming Surgery
Authors: Otto-Moudry Reade , Kinney Linda M. , Butcher Rebecca L. , Blasdel Gaines , Brown Lee K. , Elwyn Glyn , Myers Jeremy B. , Turco John H. , Nigriny John F. , Moses Rachel A. 
Published: May 2024

Background:
Metoidioplasty and phalloplasty gender-affirming surgery (MaPGAS) is increasingly performed and requires patients to make complex decisions that may lead to decisional uncertainty. This study aimed to evaluate decisional conflict in individuals considering MaPGAS.

Methods:
We administered a cross-sectional survey to adult participants assigned female sex at birth and considering MaPGAS, recruited via social media platforms and community health centers. We collected data on demographics, medical and surgical history, MaPGAS type considered, and the Decisional Conflict Scale (DCS). DCS scores range from 0 to 100 (>37.5 indicates greater decisional conflict). Demographic characteristics and DCS scores were compared between subgroups, using descriptive and chi-square statistics. Participants commented on MaPGAS uncertainty, and their comments were evaluated and thematically analyzed.

Results:
Responses from 264 participants were analyzed: mean age 29 years; 64% (n = 168) trans men, 80% (n = 210) White, 78% (n = 206) nonrural, 45% (n = 120) privately insured, 56% (n = 148) had 4 or more years of college, 23% (n = 84) considering metoidioplasty, 24% (n = 87) considering phalloplasty, and 26% (n = 93) considering metoidioplasty and phalloplasty. DCS total scores were significantly higher (39.8; P < 0.001) among those considering both MaPGAS options, as were mean ratings on the Uncertainty subscale [64.1 (SD 25.5; P < 0.001)]. Concerns surrounding complications were the top factor contributing to uncertainty and decisional conflict.

Conclusions:
In a cross-sectional national sample of individuals seeking MaPGAS, decisional uncertainty was the highest for those considering both MaPGAS options compared with metoidioplasty or phalloplasty alone. This suggests this cohort would benefit from focused decision support.
Limbal stem cell therapy
Authors: Bonnet Clemence , Gonzalez Sheyla , Deng Sophie X. 
Published: May 2024

Purpose of review
To highlight the progress and future direction of limbal stem cell (LSC) therapies for the treatment of limbal stem cell deficiency (LSCD).

Recent findings
Direct LSC transplantation have demonstrated good long-term outcomes. Cultivated limbal epithelial transplantation (CLET) has been an alternative to treat severe to total LSCD aiming to improve the safety and efficacy of the LSC transplant. A prospective early-stage uncontrolled clinical trial shows the feasibility and safety of CLET manufactured under xenobiotic free conditions. Other cell sources for repopulating of the corneal epithelium such as mesenchymal stem cells (MSCs) and induced pluripotent stem cells are being investigated. The first clinical trials of using MSCs showed short-term results, but long-term efficacy seems to be disappointing. A better understanding of the niche function and regulation of LSC survival and proliferation will lead to the development of medical therapies to rejuvenate the residual LSCs found in a majority of eyes with LSCD in vivo. Prior efforts have been largely focused on improving LSC transplantation. Additional effort should be placed on improving the accuracy of diagnosis and staging of LSCD, and implementing standardized outcome measures which enable comparison of efficacy of different LSCD treatments for different severity of LSCD. The choice of LSCD treatment will be customized based on the severity of LSCD in the future.

Summary
New approaches for managing different stages of LSCD are being developed. This concise review summarizes the progresses in LSC therapies for LSCD, underlying mechanisms, limitations, and future areas of development.
Bioenergetics of human spermatozoa in patients with testicular germ cell tumour
Authors: Simonik Ondrej , Bryndova Barbora , Sur Vishma Pratap , Ded Lukas , Cockova Zuzana , Benda Ales , Qasemi Maryam , Pecina Petr , Pecinova Alena , Spevakova Daniela , Hradec Tomas , Skrobanek Pavel , Ezrova Zuzana , Kratka Zuzana , Kren Radomir , Jeseta Michal , Boublikova Ludmila , Zamecnik Libor , Büchler Tomas , Neuzil Jiri , Postlerova Pavla , Komrskova Katerina 
Published: May 2024

AbstractIn testicular germ cell tumour (TGCT) patients, sperm cryopreservation prior to anti-cancer treatment represents the main fertility preservation approach. However, it is associated with low sperm recovery rate after thawing. Since sperm is a high-energy demanding cell, which is supplied by glycolysis and oxidative phosphorylation (OXPHOS), mitochondrial dysfunctionality can directly result in sperm anomalies. In this study, we investigated the bioenergetic pattern of cryopreserved sperm of TGCT patients in comparison with normozoospermic samples using two state-of-the-art methods; the Extracellular Flux Analyzer (XF Analyzer) and Two-Photon Fluorescence Lifetime imaging (2P-FLIM), in order to assess the contributions of OXPHOS and glycolysis to energy provision. A novel protocol for combined measurement of OXPHOS (Oxygen Consumption Rate – OCR) and glycolysis (Extracellular Acidification Rate – ECAR) using the XF Analyzer was developed together with a unique customized AI-based approach for semiautomated processing of 2P-FLIM images. Our study delivers optimized Low-HEPES modified Human Tubal Fluid media (mHTF) for sperm handling during pre-analytical and analytical phases to maintain sperm physiological parameters and optimal OCR, equivalent of OXPHOS. The negative effect of cryopreservation was signified by deterioration of both bioenergetic pathways represented by modified OCR and ECAR curves and the derived parameters. This was true for normozoospermic as well as TGCT samples, which showed even a stronger damage within the respiratory chain compared to the level of glycolytic activity impairment. The impact of cryopreservation and pathology are supported by 2P-FLIM analysis showing a significant decrease in bound NADH in contrast to unbound NAD(P)H which reflects decreased metabolic activity in samples from TGCT patients. Our study provides novel insight into the impact of TGCT on sperm bioenergetics and delivers a verified protocol to be used for assessment of human sperm metabolic activity, which can be a valuable tool for further research and clinical andrology.Abstract Figure
Genealogical asymmetry under the IM model and a two-taxon test for gene flow
Authors: Mackintosh Alexander , Setter Derek 
Published: May 2024

AbstractMethods for detecting gene flow between populations often rely on asymmetry in the average length of particular genealogical branches, with the ABBA-BABA test being a well known example. Currently, asymmetry-based methods cannot be applied to a pair of populations and such analyses are instead performed using model-based methods. Here we investigate genealogical asymmetry under a two-population isolation-migration model. We focus on genealogies where the first coalescence event is between lineages sampled from different populations, as the external branches of these genealogies have equal expected length as long as there is no post-divergence gene flow. We show that unidirectional gene flow breaks this symmetry and results in the recipient population having longer external branches. We derive expectations for the probability of this genealogical asymmetry under the isolation-migration model and propose a simple statistic (Am) to detect it from genome sequence data.Amprovides a two-taxon test for gene flow that only requires a single unphased diploid genome from each population, with no outgroup information. We use analytic expectations and coalescent simulations to explore how recombination, unequal effective population sizes and bidirectional gene flow influenceAmand find that the statistic provides unambiguous evidence for gene flow under a continent-island history. We estimateAmfor genome sequence data fromHeliconiusbutterflies andOdocoileusdeer, generating results consistent with previous model-based analyses. Our work highlights a signal of gene flow overlooked to date and provides a method that complements existing approaches for investigating the demographic history of recently diverged populations.
Operating principles of interconnected feedback loops underlying cell fate decisions
Authors: Hegade Abhiram , Rashid Mubasher 
Published: May 2024

AbstractInterconnected feedback loops are prevalent across biological mechanisms including cell fate transitions enabled by epigenetic mechanisms driving phenotypic plasticity of carcinoma cells. However, the operating principles of these networks remain largely unexplored. Here, we identify numerous coupled feedback loops driving phenotypic transition in cancers and CD4+ T cell lineage decisions. These networks have three generic structures, serial type (ST), hub type (HT), and cyclic, which we discover to be the hallmarks of lower- and higher-order dynamics. While networks having ST or cyclic topology exhibit multiple alternative states, those having HT topology enable at most two states. We also show that topologically distinct networks with equal node or loop count exhibit different steady-state distributions, highlighting the crucial influence of network structure on emergent dynamics. Irrespective of the topology, networks with autoregulated genes exhibit multiple states thereby “liberating” network dynamics from absolute topological control. Finally, we identify precise gene interaction targets to restrict the multistable network dynamics to a unique state. Our results thus reveal design principles of coupled feedback loops in enabling multiple alternative states while also identifying perturbations to restrict it. These findings can serve as crucial inputs to comprehend multi-fate decisions of cells and phenotypic plasticity in carcinomas.
Responses of chlorophyll fluorescence to CO2elimination as an indicator of Crassulacean acid metabolism photosynthesis
Authors: Bekki Sae , Suetsugu Kenji , Kobayashi Koichi 
Published: May 2024

AbstractCrassulacean acid metabolism (CAM) is found in a wide variety of vascular plant species, mainly those inhabiting water-limited environments. Identifying and characterizing diverse CAM species enhances our understanding of the physiological, ecological, and evolutionary significance of CAM photosynthesis. In this study, we examined the effect of CO2elimination on chlorophyll fluorescence-based photosynthetic parameters in two constitutive CAMKalanchoespecies and six orchids. In CAM-performingKalanchoespecies, the effective quantum yield of photosystem II showed no change in response to CO2elimination during the daytime but decreased with CO2elimination at dusk. We applied this method to reveal the photosynthetic mode of epiphytic orchids and found thatGastrochilus japonicus,Oberonia japonica, andBulbophyllum inconspicuum, but notBulbophyllum drymoglossum, are constitutive CAM. AlthoughB. drymoglossumhad relatively high malate content in leaves, they did not depend on it to perform photosynthesis even under water deficient or high light conditions. Anatomical comparisons revealed a notable difference in the leaf structure betweenB. drymoglossumandB. inconspicuum;B. drymoglossumleaves possess the large water storage tissue internally, unlikeB. inconspicuumleaves, which develop pseudobulbs. Our data propose a novel approach to identify and characterize CAM plants without labor-intensive experimental procedures.HighlightResponses of chlorophyll fluorescence-based photosynthetic parameters to CO2elimination differ between Crassulacean acid metabolism (CAM) and C3metabolism, proposing a novel approach to identify and characterize CAM plants.