bluuebunny/crossref_metadata_2025_split huggingface dataset:
REtrieving thrombi and Separated Coils/catheters Unexpectedly detached during Endovascular therapy: RESCUE – the use of thrombectomy devices for rescue therapy in interventional neuroradiology
Authors: Herlihy Darragh , Singh Sneha , Nicholson Patrick , Griffin Emma , O’Hare Alan , Brennan Paul , Thornton John , Power Sarah 
Published: December 2024

Purpose Intraprocedural complications during intracranial embolisation include thromboembolic vessel occlusion, catheter tip detachment and coil migration. Stentrievers and aspiration catheters are valuable devices for the management of these complications. We present our experience with the use of these devices. We describe the devices and techniques used, case details and clinical outcomes. Currently there is no standardised approach for the management of the above intraprocedural complications. Methods We performed a retrospective review of our interventional neuroradiology database of patients who underwent endovascular treatment in our institution from January 2012 to January 2019 and identified embolisation procedures during which either stentrievers or aspiration catheters were utilised. Results We present a case series of 24 cases in which these devices were utilised as rescue devices over a period of 7 years. We provide three illustrative cases. Conclusion Stentrievers and aspiration catheters can be used safely and effectively as adjunctive or rescue devices during embolisation procedures.
The relationship between social media use and pregnancy-related body image
Authors: Rosenbaum Diane L , Gillen Meghan M , Hutson David J 
Published: December 2024

Background: Social media negatively affects body image, but few have investigated its impact on pregnancy-related body image. Pregnancy represents a vulnerable period for body image, and poor body image has negative implications for health. Objectives: We aimed to (1) understand relations of social media and pregnancy-related body image variables, (2) examine differences in social media use and body image based on demographic characteristics, and (3) evaluate whether type of social media use (i.e., active versus passive) was differentially related with body image based on time spent on social media. Design: This was a cross-sectional study. Methods: We recruited an online sample of women ( N = 154) experiencing early motherhood, as defined by giving birth within the past 5 years. We examined social media use (e.g., amount of time, type of use) on Facebook, Instagram, and Twitter in relation to pregnancy-related body image questionnaires. Results: Passive use (e.g., viewing others’ content rather than creating original content) and greater time on Facebook were independently related to lower positive body image. Those who passively used Facebook for the longest amount of time had the lowest positive body image. No significant effects were found for Instagram or Twitter. Conclusion: Spending more time passively viewing others’ content may facilitate social comparison, reducing positive feelings about one’s own body. Social media may constitute a source of pressure and scrutiny for women, resulting in lowered pregnancy-related body image.
Immuno-combined treatment versus radio-combined treatment in limited-stage small-cell lung cancer
Authors: Tong Li , Li Xiaomi , Hu Mingming , Zhang Minghang , Wang Yishuo , Zhang Kai , Wang Qunhui , Zhang Tongmei , Li Baolan 
Published: December 2024

Background: Although the approval of immunotherapy in patients with extensive-stage small-cell lung cancer (ES-SCLC) has significantly improved the patient’s prognosis, synchronous chemoradiotherapy has always been the standard treatment for limited-stage small-cell lung cancer (LS-SCLC). Objectives: Immuno-combined and radio-combined therapy in LS-SCLC has been applied in clinical practice, but what is the best for LS-SCLC? Design: This was a retrospective cohort study. Methods: Patients with LS-SCLC from January 2019 to December 2023 were retrospectively screened and divided into three groups according to the initial treatment regimen whether included immune-combined and radio-combined treatment. Univariate and multivariate Cox regression were used to analyze the predictors affecting the survival of LS-SCLC, and the progression pattern of patients and the occurrence of adverse events (AEs) were also recorded. Results: In this study, the median overall survival (OS) was 15.8 months, not yet reached (NR) and NR, and the median progression-free survival (PFS) was 11.7, 20.9, and 18.9 months in the immunotherapy combined chemotherapy ( N = 34), immune combined chemoradiotherapy ( N = 26), and chemoradiotherapy ( N = 53) groups, respectively. OS and PFS were significantly prolonged in the radio-combined groups compared with the non-radio-combined group, and there was no significant difference between the radio-combined groups, namely immunotherapy combined chemoradiotherapy and chemoradiotherapy groups. In this study, we also constructed some indexes to predict prognosis for LS-SCLC, derived neutrophil and lymphocyte ratios were significantly associated with worse survival, and systemic inflammatory index and neuron-specific enolase (NSE) levels were significantly associated with shorter PFS. The primary organs of progression remained the lung and brain, the main immune-related AE was hypothyroidism, and the radiation-related AE was pneumonia. Conclusion: Radiation-combined therapy still plays an important role in LS-SCLC in the era of immunotherapy, and clinicians cannot abandon the use of radiation therapy in the initial treatment plan for LS-SCLC.
Infrahyoid Myocutaneous Flaps with Common Wall of Hypopharyngeal and Esophageal Serosas for Voice Rehabilitation After Total Laryngectomy
Authors: Lu Zhiyan , Li Changjiang , Chen Jian , Shu Min , Wang Yimiao , Li Dan , Chen Siyi , Ma Shuaichi , Cheng Lei , Wu Haitao , He Peijie 
Published: December 2024

Importance Patients who undergo total laryngectomy lose the voice function permanently. It is important to reconstruct the voice function of the patients after total laryngectomy. Objective To explore a novel method for voice rehabilitation by suturing infrahyoid myocutaneous flaps to the hypopharyngeal and esophageal serosas after total laryngectomy and investigate its clinical efficacy. Design Clinical study (retrospective study). Participants Twenty patients with advanced laryngocarcinoma who underwent total laryngectomy. Methods Following total laryngectomy, the pharyngeal cavity was formed via layer-by-layer suturing, and the infrahyoid myocutaneous flap was sutured to the common wall of hypopharyngeal and esophageal serosas to create a voice tube. Results Flap failure was not observed in any patient. All patients were able to vocalize after surgery. The voice after the reconstruction was smooth and natural. However, 3 patients were unable to vocalize gradually. Two patients experienced aspiration, requiring the removal of the voice tube, while 3 patients exhibited mild aspiration, which could be overcome by pressing the larynx on the voice tube surface. Conclusions Using infrahyoid myocutaneous flaps with the common wall of the hypopharyngeal and esophageal serosas was effective in rehabilitating voice after total laryngectomy. Future clinical studies are necessary to validate the effectiveness of this technology for voice rehabilitation.
Service quality evaluation of integrated health and social care for older Chinese adults in residential settings based on factor analysis and machine learning
Authors: Liu Zhihan , Ouyang Caini , Gu Nian , Zhang Jiaheng , He Xiaojiao , Feng Qiuping , Chang Chunguyu 
Published: December 2024

Objective To evaluate the service quality of integrated health and social care institutions for older adults in residential settings in China, addressing a critical gap in the theoretical and empirical understanding of service quality assurance in this rapidly expanding sector. Methods This study employs three machine learning algorithms—Backpropagation Neural Networks (BPNN), Feedforward Neural Networks (FNN), and Support Vector Machines (SVM)—to train and validate an evaluative item system. Comparative indices such as Mean Squared Error, Mean Absolute Error (MAE), Mean Absolute Percentage Error (MAPE), and predictive performance metrics were employed to assess the models. Results The service quality evaluation model, enhanced by factor analysis and fuzzy BPNN, demonstrated reduced error rates and improved predictive performance metrics. Key factors influencing service quality included daily care, medical attention, recreational activities, rehabilitative services, and psychological well-being, listed in order of their impact. Conclusion The BPNN-based model provides a comprehensive and unified framework for assessing service quality in integrated care settings. Given the pressing need to match service supply with the complex demands of older adults, refining the service delivery architecture is essential for enhancing overall service quality.
Feasibility of using an artificially intelligent chatbot to increase access to information and sexual and reproductive health services
Authors: Bull Sheana , Hood Shakari , Mumby Sara , Hendrickson Anna , Silvasstar Joshva , Salyers Adam 
Published: December 2024

Background Following the US Supreme Court decision overturning Roe v. Wade, there is evidence of limitations in access to safe abortion care. Artificially intelligent (AI)-enabled conversational chatbots are becoming an appealing option to support access to care, but generative AI systems can misinform and hallucinate and risk reinforcing problematic bias and stigma related to sexual and reproductive healthcare. Method A single arm pilot study describing the development of an AI chatbot focused on sexual and reproductive health and its deployment in a clinic setting and community-based organization over a nine-month period. Results We adjusted chatbot content based on feedback from the medical director and clients of organizations where the system was deployed given updated medical guidelines and preferred language related to gender-affirming care. We deployed the system in two organizations and tracked use over nine months. In that time, there were 1749 queries from 425 unique users. One-tenth of users of the clinic based chatbot went on to schedule an appointment for care. Conclusions Ongoing challenges in accessing sexual and reproductive health suggest having diverse mechanisms to facilitate access to accurate and updated medical information is warranted. Using an AI chatbot is feasible to accomplish this goal and shows promise in increasing opportunities to access care.
Navigating “Promising Victimhood:” Discretionary Practices of UNHCR Caseworkers in Rwanda’s Refugee Resettlement Process
Authors: Bækkevold Kine Marie , Bjørkhaug Ingunn , Irankunda Jerome , Divon Shai André 
Published: December 2024

Executive Summary As the global refugee population continues to expand, resettlement opportunities remain scarce, accessible only to a select few. Scholarly literature has increasingly drawn attention to the opaque bureaucratic processes, often referred to as “black boxes,” that govern resettlement selection, revealing that the decision-making practices determining which refugees are chosen for resettlement are still not well understood. This study addresses a critical gap concerning the implementation of selection criteria within UNHCR’s operations in the Global South, with a specific focus on caseworkers in Rwanda. It examines how these criteria are applied in practice, providing new empirical insights into the concept of “promising victimhood” — the contradictory demands placed on refugees to simultaneously demonstrate both vulnerability and integration potential to qualify for asylum or resettlement. The study explores how caseworkers navigate their roles amidst the complex and often conflicting demands imposed on refugees during the selection process. The analysis is grounded in interviews with sixteen caseworkers involved in resettlement selection, employing street-level bureaucracy theory alongside the concepts of refugee deservingness and promising victimhood. As key actors in the selection process, caseworkers exercise bottom-up power as policy implementers, while simultaneously adhering to the top-down directives established by resettlement states. The findings reveal that caseworkers employ a range of discretionary practices to reconcile the demands of resettlement states’ admission criteria with their advocacy for refugees deemed most vulnerable by the UNHCR. This research enhances our understanding of UNHCR’s operations at the street level, shedding light on how the practices of caseworkers influence perceptions of refugee eligibility and ultimately influence who is granted resettlement.
HotBENT experiment on quality control of bentonites used for granular bentonite material backfilling and block production
Authors: Kaufhold Stephan , Dohrmann Reiner , Ufer Kristian , Gröger-Trampe Jens , Kober Florian , Schneeberger Raphael , Weber Christian 
Published: December 2024

Abstract
The maximum temperature that a geotechnical bentonite barrier in a deep geological repository for radioactive waste can withstand while maintaining its integrity and meeting safety requirements is still an open question. Therefore, an international consortium set up an in situ heater test (HotBENT experiment) at the Grimsel Test Site (GTS) in Switzerland at relevant scales and gradients with temperatures ranging from 175°C to 200°C at the heater/canister surface. After dismantling (5 and 20 years, respectively), the identification of bentonite alteration processes of (clay) minerals has to be based on the comparison of data with reference values determined before the heating started. The experiment was set up using ~150 tons of two different clays (Wyoming and BCV from the Czech Republic) provided in different batches. The bentonites were used both as compacted bentonite blocks and as granular bentonite material (GBM). The determination of representative mineralogical and geochemical bentonite reference values must be based on a significant number of samples taken from all parts of the experiment, which is presented here. Most of the compositional variability was close to the accuracy of the methods used. However, chemical, mineralogical and exchangeable cation analyses showed that different raw materials were used to produce the BCV top blocks. The Wyoming bentonite used is similar to MX80 bentonite in that it is dominated by Na-rich smectite, but the HotBENT material contains slightly more feldspar and zeolite and slightly less smectite. Overall, 55 samples were analysed from different parts of the experiment, providing a statistical basis for post-excavation investigations.
Approaching hypercalcemia in monoclonal gammopathy of undetermined significance: insights from the iStopMM screening study
Authors: Jónsdóttir Ástrún Helga , Sigurjónsdóttir Helga Ágústa , Thorsteinsdóttir Sigrun , Long Thorir Einarsson , Sverrisdóttir Ingigerður Sólveig , Eythorsson Elias , Óskarsson Jón Þórir , Palsson Runolfur , Indridason Olafur Skuli , Viðarsson Brynjar , Onundarson Pall Torfi , Ólafsson Ísleifur , Þorsteindóttir Ingunn , Agnarsson Bjarni A. , Sigurðardóttir Margrét , Jónsson Ásbjörn , Hultcrantz Malin , Durie Brian G. M. , Harding Stephen , Landgren Ola , Love Thorvardur Jon , Kristinsson Sigurður Yngvi , Rögnvaldsson Sæmundur 
Published: December 2024

Abstract
Hypercalcemia in monoclonal gammopathy of undetermined significance (MGUS) presents a clinical challenge because it may indicate progression to multiple myeloma (MM) but could also be due to a multitude of unrelated disorders. To inform the approach to this clinical challenge, we conducted a nested cohort study within the Iceland Screens, Treats, or Prevents Multiple Myeloma screening study. Of the 75 422 Icelanders aged 40 years and above who underwent screening for MGUS, we included 2546 with MGUS who were in active follow-up, including regular serum calcium measurements. In total, 191 individuals (7.5%) had hypercalcemia detected at least once, of whom 93 had persistent hypercalcemia (48.7%). MM was found in 3 participants with persistent hypercalcemia (3.2%); all had concurrent bone disease and other end-organ damage. The most common causes of hypercalcemia were primary hyperparathyroidism (56.0%) and malignancies other than MM (16.0%). In this first comprehensive study on hypercalcemia in MGUS, we observed that hypercalcemia rarely indicated MGUS progression and never in the absence of other symptoms of MM. More than half of hypercalcemia cases were transient, and the underlying causes were similar to those in the general population. We conclude that hypercalcemia in MGUS should be approached in the same way as in those without MGUS.
How I treat quantitative fibrinogen disorders
Authors: Casini Alessandro 
Published: December 2024

Abstract
Quantitative fibrinogen disorders, including afibrinogenemia and hypofibrinogenemia, are defined by the complete absence or reduction of fibrinogen, respectively. The diagnosis is based on the measurement of fibrinogen activity and antigen levels, which define the severity of this monogenic disorder. Afibrinogenemia is the result of homozygosity or combined heterozygosity for the causative mutations, whereas monoallelic mutations lead to hypofibrinogenemia. The bleeding phenotype varies in accordance with fibrinogen levels, ranging generally from frequent and often life-threatening bleeding in afibrinogenemia to the absence of symptoms, or mild bleeding symptoms in mild hypofibrinogenemia. The main treatment for quantitative fibrinogen disorders is fibrinogen supplementation. Despite low fibrinogen levels, a tendency for thrombosis is a characteristic of these disorders and may be exacerbated by fibrinogen supplementation. The management of surgery and pregnancy presents significant challenges regarding the amount of fibrinogen replacement and the need for thromboprophylaxis. The objective of this article is to present 4 clinical scenarios that illustrate common clinical challenges and to propose strategies for managing bleeding, thrombosis, surgery, and pregnancy.
Space, time, and presence in video consultations: an interview study in Danish general practice
Authors: Kofod Frida Greek , Christensen Anne-Marie Søndergaard , Hvidt Elisabeth Assing , Arreskov Anne Beiter , Guassora Ann Dorrit 
Published: December 2024

Abstract
Background
The purpose of this interview study was to explore patients’ and general practitioners’ (GPs’) experiences of space, time, and presence in video consultation in general practice in Denmark.

Methods
The study included six GPs and seven patients from the Copenhagen area, with different experience of video consultations. The data consisted of semi-structured interviews with all participants including recordings from their video consultations. The transcribed interviews were analyzed by Interpretative Phenomenological Analysis (IPA). The theoretical analysis was inspired by philosopher K.E. Løgstrup’s writings about time, space, presence and sensation.

Results
Both the patients and the GPs experienced a lack, or a different form, of presence in video consultations, comparing it to face-to-face consultations. Patients felt more secure in their own homes and the GPs found some of them to be more relaxed during the video consultation than in the face-to-face consultation taking place in the surgery. However, the consultation felt more superficial, with the GPs and patients experiencing an alteration in their sensory access to one another. The video consultation was also perceived as purpose-driven and action-oriented.
Both patients and GPs felt that time was saved. According to K.E. Løgstrup, our experience is always composed of spatiality and temporality; the space is where we sense one another and experience duration, while time is the awareness of change and action. The theoretical analysis points to the experience of presence as spatial and, owing to the changed space in video consultations, the experience of presence and time is changed.

Conclusion and Implications
The balance between space and time is altered in the video consultation. GPs and patients lack certain sensory impressions, owing to the changed spatiality. The changed spatiality, sensation and experiences of presence lead the participants to eliminate the expendable elements to make the consultation more efficient.
Video consultations allow some issues to be handled quickly, but the option for physical consultations still needs to be available, as we believe we now can argue that the physical consultation room has importance for the experience of presence and time.
Factors associated with functional health literacy and the quality of life of riverside residents served by the primary care network in the Brazilian amazon: a cross-sectional study
Authors: Pinheiro Ana Kedma Correa , Raymundo Carlos Eduardo , da Silva Santos Eliene do Socorro , Saldanha dos Santos Marcio Yrochy , de Oliveira Sarefino Adriana , do Nascimento Souza Maria Helena , Lima Ingrid Bentes , da Silva Raquel Gomes , Nogueira Laura Maria Vidal 
Published: December 2024

Abstract
Background
the riverside population lives in a vulnerable social situation, shaped by geographical, economic, social, and educational aspects that have repercussions on health literacy, the limitations of which can compromise Quality of Life. These specificities influence the actions of Primary Health Care, especially in the rural context. This study aimed to assess the factors associated with Functional Health Literacy and Quality of Life among riverside residents of the Brazilian Amazon who use Primary Health Care.

Methods
a cross-sectional study with 312 users of a riverside Family Health Team, using the Health Literacy Test, classified as adequate, limited, and inadequate, and the Study Short Form 12 Health Survey questionnaire, analyzing the physical and mental components in isolation. A theoretical model was built to assess the associations between sociodemographic and environmental variables and the Functional Health Literacy and Quality of Life outcomes. The Functional Health Literacy outcome was considered as two dichotomous variables (inadequate versus adequate; limited versus adequate), while the Quality of Life outcomes were considered as counts, with a Poisson distribution. Thus, a structural equation model was used to adjust the proposed theoretical model.

Results
there was a worsening in inadequate Functional Health Literacy, associated with females, aged over 40, elementary school education, living close to the health service, and using only a cell phone for communication. Factors that compromised physical Quality of Life: livelihood problems; inadequate literacy; age range 40–59; and having two children or more. And those that worsened mental Quality of Life: age over 40; having a family allowance; and being in control of their medication.

Conclusions
sociodemographic, environmental, and economic factors and adherence to medication by river communities have been shown to be associated with Health Literacy and Quality of Life. Knowing these implications is fundamental for health provision. These findings can support the formulation of strategies in health services to improve Health Literacy and Quality of Life.