bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathological correlations in 38 cases of gastroenteropancreatic high-grade neuroendocrine neoplasms
Authors: Li Na , Hu Yanping , Wu Linguo , An Jianduo 
Published: October 2024

ObjectiveDiagnosis and treatment of gastroenteropancreatic high-grade neuroendocrine neoplasms (GEP-HG-NENs), particularly G3 well-differentiated neuroendocrine tumours (NETs) and poorly differentiated neuroendocrine carcinomas (NECs) relies on histopathological morphology, immunohistochemistry, and molecular biological markers, which are lacking especially in cases with ambiguous histomorphology. In this study to contribute to the development of more targeted treatment strategies, we examined various immunohistochemical and molecular biological markers and their association with clinicopathological features in GEP-HG-NENs.MethodsWe included 38 patients with GEP-HG-NENs in this study, with their retrospective follow-up data. The expression of tumour protein p53 (TP53), RB transcriptional corepressor 1 (RB1), somatostatin receptor 2 (SSTR2), clusterin (CLU), and marker of proliferation Ki-67 (MKI67) was immunohistochemically analysed. KRAS proto-oncogene, GTPase (KRAS) and B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E expression was evaluated using quantitative real-time polymerase chain reaction (qRT-PCR). The relationships between immunohistochemical and molecular biological markers and clinicopathological characteristics were examined using a Cox risk regression model, receiver operating characteristic (ROC) curve, and Kaplan–Meier survival analyses.ResultsSSTR2, RB, TP53, and CLU expression differed between NET G3 and NECs, with variations among the NET G3 and small- and large-cell NEC (SCNEC and LCNEC, respectively) groups (p &lt; 0.05). The median MKI67 proliferative index was approximately 40% and 70% in G3 NETs and NECs, respectively. The NET G3 group exhibited a median survival of 25 months, indicating a relatively better prognosis than that of the NECs group (median survival, 11 months). Both Kaplan–Meier survival analysis and the Cox risk regression model indicated a statistical correlation among treatment methods, CLU expression, and prognosis (p &lt; 0.05). The BRAF V600E mutation rate was 32.4% in G3 NETs and SCNEC, demonstrating a significant difference between both types (p = 0.0086). Furthermore, ROC curve analysis highlighted the diagnostic significance of the positive expression of the immunohistochemical markers CLU, SSTR2, and RB in identifying NET G3.ConclusionTo guide more suitable treatment strategies, it is essential to develop and apply valuable and more targeted immunohistochemical and molecular pathological markers for a comprehensive analysis.
Implementation of an automated transition readiness assessment in a pediatric rheumatology clinic
Authors: Argraves Melissa , Murray Elizabeth , Taxter Alysha , Wise Kelly , Jensen Paul T. , Goldstein-Leever Alana , Thomas Bethanne , Scott Alexa , Gallup James , Leone Ashlee , Ardoin Stacy P. , Sivaraman Vidya 
Published: October 2024

BackgroundFailure of successful transition to adult care for adolescents and young adults with chronic rheumatic diseases negatively impacts their health and wellbeing. Transition of care is a vital and complex process within pediatric rheumatology that can be difficult to execute. Use of quality improvement (QI) and clinical informatics (CI) can help implement transition programs.Local problemDespite efforts to improve transition of care within our pediatric rheumatology clinic, it has been difficult to implement and sustain good transition practices including assessment of transition readiness. Using QI methodology and CI, this study aimed to improve transition readiness assessment from 12 to 30% and sustain for one year by surveying transitioning patients yearly.MethodsA transition-focused QI team utilized methods endorsed by the Institute for Healthcare Improvement and leveraged CI to improve survey completion. Control charts of survey completion rates were tracked monthly. Descriptive statistics were used to analyze survey responses.InterventionsInterventions focused on automation of patient surveys at regularly scheduled clinic visits.Results1,265 questionnaires were administered to 1,158 distinct patients. Survey completion rose from a baseline of 12% to greater than 90% and was sustained over 18 months. Identified educational needs included health insurance, scheduling appointments, obtaining care outside of rheumatology clinic business hours, Electronic Health Record messaging, and refilling medications.ConclusionsBy leveraging CI and QI methodology, we were able to assess transition readiness in more than 90% of our patients and identify gaps in self-management. Process automation can create sustainable transition practices.
Loneliness, online learning and student outcomes in college students living with disabilities: results from the National College Health Assessment Spring 2022
Authors: Bevens William , Stoeckl Sarah E. , Schueller Stephen M. , Kim Jeongmi , Cha Biblia S. , Chwa Cindy , Stadnick Nicole A. , Best Nakia C. , Sorkin Dara H. 
Published: October 2024

BackgroundPeople with disabilities face many health, economic and social disparities. Loneliness is recognized as a significant issue for this group however, its impact on students with disabilities (SWDs) remains a critically underexplored area of research. Importantly, as higher education continues its transition to the digital space, the potential to entrench social isolation and loneliness within this population has not been examined. This research seeks to explore the associations between SWDs, loneliness, online learning, and academic outcomes in a national survey of university students.MethodsUsing the National College Health Assessment from Spring 2022, this study compared multiple outcomes between different groups of SWDs and students without disabilities. Two ordinal regression models were used to estimate associations between loneliness, disability type and learning mode (online vs. in-person), as well as cumulative grade average (CGA) with disability type.ResultsAll disability types included within this study were positively associated with increased odds of loneliness for those engaged in online learning compared to students without disabilities. Interactions indicate a significant effect of in-person learning compared with online learning for deaf or hard of hearing students, and those with multiple disabilities. Several disability groups reported decreased odds of higher CGA compared to students without disabilities.ConclusionLoneliness is a significant issue for all SWD groups reported in this study. The impact of disability on academic outcomes is reported herein; however, its impact on medium-to-long term outcomes for these individuals remains unknown. To address inequities in higher education for SWDs, universities must invest more resources to holistically support these students.
When end of treatment situations challenge patient-centered care: a discussion paper proposing new theoretical insights
Authors: Bonazza Federica , Lamiani Giulia , Borghi Lidia , Del Negro Silvia , Leone Daniela , Vegni Elena 
Published: October 2024

IntroductionAccording to the Institute of Medicine patient-centered medicine is one of the six crucial dimensions of health care quality. Although the patient-centered care model is widely recognized for its ethical underpinnings and effectiveness, its practical implementation still raises challenges, especially in end-of-treatment situations. This discussion paper offers an overview of the challenges facing the physician-patient relationship in end-of-treatment situations.MethodsWe developed three clinical vignettes and made some theoretical considerations about ethical issues related to the decision-making process leading to the end of treatment.ResultsWe identified two main challenges that end-of-treatment situations pose to patient-centered care: (1) when the patient’s autonomy challenges the best clinical treatment; and (2) when the proposed treatment (discontinuation of treatment) challenges the patient’s preferences.DiscussionsPatient-centered care supports personalized decision-making, in which the physician’s approach varies according to the patient’s situation and individuality. The idea of beneficence may change during care, because of acceptance of the patient’s principles or a change in the primary goal of care.
Machine learning’s effectiveness in evaluating movement in one-legged standing test for predicting high autistic trait
Authors: Ohmoto Yoshimasa , Terada Kazunori , Shimizu Hitomi , Kawahara Hiroko , Iwanaga Ryoichiro , Kumazaki Hirokazu 
Published: October 2024

IntroductionResearch supporting the presence of diverse motor impairments, including impaired balance coordination, in children with autism spectrum disorder (ASD) is increasing. The one-legged standing test (OLST) is a popular test of balance. Since machine learning is a powerful technique for learning predictive models from movement data, it can objectively evaluate the processes involved in OLST. This study assesses machine learning’s effectiveness in evaluating movement in OLST for predicting high autistic trait.MethodsIn this study, 64 boys and 62 girls participated. The participants were instructed to stand on one leg on a pressure sensor while facing the experimenter. The data collected in the experiment were time-series data pertaining to pressure distribution on the sole of the foot and full-body images. A model to identify the participants belonging to High autistic trait group and Low autistic trait group was developed using a support vector machine (SVM) algorithm with 16 explanatory variables. Further, classification models were built for the conventional, proposed, and combined explanatory variable categories. The probabilities of High autistic trait group were calculated using the SVM model.ResultsFor proposed and combined variables, the accuracy, sensitivity, and specificity scores were 1.000. The variables shoulder, hip, and trunk are important since they explain the balance status of children with high autistic trait. Further, the total Social Responsiveness Scale score positively correlated with the probability of High autistic trait group in each category of explanatory variables.DiscussionResults indicate the effectiveness of evaluating movement in OLST by using movies and machine learning for predicting high autistic trait. In addition, they emphasize the significance of specifically focusing on shoulder and waist movements, which facilitate the efficient predicting high autistic trait. Finally, studies incorporating a broader range of balance cues are necessary to comprehensively determine the effectiveness of utilizing balance ability in predicting high autistic trait.
Predicting COVID-19 booster intentions among college students using the health belief model: advancing health promotion strategies for uptake
Authors: Catalano Hannah Priest , Christofora Julianne , Richards Keith , Hyatt Hawkins Shaw Katherine , Kiser Kevin 
Published: October 2024

BackgroundCOVID-19 remains a significant public health threat. The primary purpose of this study was to test the health belief model (HBM) constructs in predicting COVID-19 booster intentions of college students.MethodsA total of 285 students enrolled at large public university in the Southeastern U.S., who were 18 years and older, completed an online survey to assess COVID-19 vaccination status, prior or current COVID-19 infection, demographics, and HBM constructs.ResultsOver three quarters of the sample (81.4%, n = 232) was fully vaccinated, 2.1% (n = 6) was partially vaccinated, and 16.5% (n = 47) was unvaccinated. Furthermore, 53.4% (n = 124) of students who self-reported being fully vaccinated also reported receiving the booster vaccine. Nearly half of the sample (49.1%, n = 140) self-reported previously or currently testing positive for COVID-19. Results of the stepwise multiple regression indicated the HBM constructs of perceived benefits (β =0.596; p &lt; 0.001) and cues to action (β =0.275; p &lt; 0.001) were significant predictors of respondents’ behavioral intention to receive the COVID-19 booster in the next 6 months. The significant predictors at step 2 accounted for 64.6% [R2 = 0.646, F (2, 111 = 101.331, p &lt; 0.001)] of the variance in behavioral intention to get the COVID-19 booster in the next 6 months.ConclusionPractitioners developing HBM-based interventions to enhance COVID-19 booster intentions among college students should tailor health promotion strategies that target perceived benefits and cues to action. Although some of the HBM constructs were not statistically significant in the prediction model, they should not be entirely discounted in health promotion practice. Instead, practitioners should focus on supplemental strategies to improve those domains in college students.
Knowledge, attitude, and practice toward sleep hygiene and cardiovascular health: a cross-sectional survey among healthcare workers
Authors: Sun Weixin , Pan Renyou , Song Xiaolong , Gu Tingting , Ni Qimeng , Gu Yuexing 
Published: October 2024

BackgroundHealthcare workers grapple with distinct challenges, inherent to their profession, making them susceptible to irregular sleep patterns and insufficient sleep, which may further impact their cardiovascular health. This study aimed to investigate the knowledge, attitude and practice (KAP) of healthcare workers concerning sleep hygiene and cardiovascular health.MethodsA cross-sectional survey was conducted at Yancheng TCM Hospital Affiliated with Nanjing University of Chinese Medicine between July, 2023 and September, 2023. Demographic characteristics, KAP scores, sleep health awareness and habits, and sleep quality were assessed through the questionnaires.ResultsA total of 423 valid questionnaires were included in the study. Among these, 215 (50.83%) were aged 35 or below, and 128 (30.26%) reported suffering from chronic insomnia. The mean knowledge, attitude, and practice scores were 43.23 ± 5.67 (possible range: 10–50), 24.53 ± 4.59 (possible range: 9–45), and 20.22 ± 4.46 (possible range: 6–30), respectively. Multivariate analyses indicated that attitude score (OR = 0.890, 95% CI: [0.807–0.981], p = 0.019), sleep health awareness &amp; habits score (OR = 1.847, 95% CI: [1.284–2.656], p = 0.001), experienced chest tightness or heart palpitations (OR = 6.084, 95% CI: [2.172–17.042], p = 0.001), and the presence of chronic insomnia (OR = 5.017, 95% CI: [2.428–10.368], p &lt; 0.001) were independently associated with sleep quality.ConclusionHealthcare workers had adequate knowledge, negative attitude and moderate practice toward sleep hygiene and cardiovascular health. The findings highlight the need for targeted interventions to address the observed gaps in attitudes and practices, aiming to enhance overall awareness and promote healthier sleep habits among healthcare professionals.
Investigation of hospital-acquired infections prevalence and analysis of influencing factors: a case study of a specialized infectious disease hospital in Chongqing, 2017–2023
Authors: Deng Bing , Li Peilin , Liu Yalan , Xie Juan , Huang Yaling , Sun Qingyun , Su Shifang , Deng Wenwen 
Published: October 2024

ObjectiveThis study aimed to investigate the prevalence of hospital-acquired infections (HAIs) and their main influencing factors in a specialized infectious disease hospital in Chongqing from 2017 to 2023, providing reference for the formulation of precise infection control measures.MethodsA retrospective cross-sectional survey method was employed, combining bedside investigations with medical record reviews. Surveys were conducted on all hospitalized patients on a certain day of the last week of October each year from 2017 to 2023. Data collected included patients’ basic information, diagnosis, and hospital infection status. Statistical analysis, including retrospective case–control and multivariable logistic regression analysis, was performed to identify the risk factors for hospital infections.ResultsThe investigation compliance rate for the prevalence of HAIs in the specialized infectious disease hospital in Chongqing from 2017 to 2023 was greater than 96% each year. The prevalence rate of HAIs ranged from 0.89 to 2.52%. Hospital infection departments were mainly concentrated in general internal medicine, tuberculosis, and HIV/AIDS departments, accounting for 31.25, 26.25, and 23.75%, respectively. The most common infection site was the lower respiratory tract (54.22%), followed by bloodstream and urinary tract infections, each accounting for 9.64%. The predominant pathogens of hospital infections were Klebsiella pneumoniae and fungi. The utilization rate of antimicrobial drugs ranged from 20.75 to 33.25%, primarily for monotherapy. The rate of pathogen testing for therapeutic antimicrobial drug use was 82.84%, meeting national requirements. Multivariable logistic regression analysis revealed that the use of antibiotic (OR = 7.46, 95%CI 2.54–21.89, p &lt; 0.001) and the presence of cardiovascular diseases (OR = 26.69, 95%CI 6.69–106.54, p &lt; 0.001) increased the risk of HAIs.ConclusionThe prevalence of HAIs in specialized infectious disease hospitals remains stable, primarily concentrated in departments such as general internal medicine, tuberculosis, and HIV/AIDS. The lower respiratory tract is the main infection site, and comorbid cardiovascular diseases and antibiotic use are risk factors for HAIs. Therefore, to reduce the risk of hospital infections, it is necessary to strengthen the daily monitoring of key departments and the care of key patients. Further implementation of precise and effective infection control measures, including rational antibiotic use, regular infection monitoring and pathogen culture is warranted.
Association of physical activity, screen time and sleep with substance use in children and adolescents: a large sample cross-sectional study
Authors: Su Huadong , Lyu Dongye , Huang Ke , Yan Jin 
Published: October 2024

Background24-h movement guidelines (24-HMG) play an important role in various demographics such as early years, children, youth, and the older adult. Nevertheless, most existing research exploring the links between socioeconomic factors, dietary intake, and substance use with sleep patterns, physical activity (PA), and sedentary behavior (SB) has been conducted in high-income Western countries.PurposeHence, this study seeks to investigate the relationship between adherence to the 24-HMG and smoking and alcohol use behaviors among children and adolescents in China.MethodsA comprehensive survey, in collaboration with the Municipal Education Commission, was carried out across primary and middle schools in Shenzhen, China. Sleep duration was gauged using the Pittsburgh Sleep Quality Index (PSQI), screen time was assessed with items adapted from the Health Behavior of School-aged Children (HBSC) survey, and PA was measured using a single item adapted from the HBSC survey. Results were presented as odds ratios (ORs) with 95% confidence intervals (CIs), considering p-values below 0.05 as statistically significant.ResultsAmong the sample, 51.9% were boys and 48% were girls. Those who did not meet any guidelines had a higher probability of smoking (OR = 1.62 [95% CI: 1.03, 2.56], p = 0.037) among children and adolescents. Conversely, meeting one (OR = 0.94 [95% CI: 0.61, 1.52], p = 0.874) or two guidelines (OR = 0.84 [95% CI: 0.52, 1.34], p = 0.459) showed no significant impact. The data displayed an inverse correlation between the number of guidelines adhered to and the likelihood of alcohol use among children and adolescents: none (OR = 2.07, p &lt; 0.001), one guideline (OR = 1.40, p = 0.006), and two guidelines (OR = 1.22, p = 0.106).ConclusionNot meeting guidelines elevates smoking and alcohol use risks in children and adolescents, whereas following more guidelines lowers these risks, highlighting the importance of guideline adherence in reducing substance use.
A hybrid self-supervised model predicting life satisfaction in South Korea
Authors: Nguyen Hung Viet , Byeon Haewon 
Published: October 2024

ObjectiveLife satisfaction pertains to an individual’s subjective evaluation of their life quality, grounded in their personal criteria. It stands as a crucial cognitive aspect of subjective wellbeing, offering a reliable gauge of a person’s comprehensive wellbeing status. In this research, our objective is to develop a hybrid self-supervised model tailored for predicting individuals’ life satisfaction in South Korea.MethodsWe employed the Busan Metropolitan City Social Survey Data in 2021, a comprehensive dataset compiled by the Big Data Statistics Division of Busan Metropolitan City. After preprocessing, our analysis focused on a total of 32,390 individuals with 51 variables. We developed the self-supervised pre-training TabNet model as a key component of this study. In addition, we integrated the proposed model with the Local Interpretable Model-agnostic Explanation (LIME) technique to enhance the ease and intuitiveness of interpreting local model behavior.ResultsThe performance of our advanced model surpassed conventional tree-based ML models, registering an AUC of 0.7778 for the training set and 0.7757 for the test set. Furthermore, our integrated model simplifies and clarifies the interpretation of local model actions, effectively navigating past the intricate nuances of TabNet’s standard explanatory mechanisms.ConclusionOur proposed model offers a transparent understanding of AI decisions, making it a valuable tool for professionals in the social sciences and psychology, even if they lack expertise in data analytics.
The Mellow Babies parenting programme: role of group processes and interpersonal change mechanisms
Authors: Tanner Jessica , Wilson Philip , Wight Daniel , Thompson Lucy 
Published: October 2024

IntroductionGroup-based parenting programmes have specific mechanisms of change compared to individual delivery. The Mechanisms of Action in Group-based Interventions framework (MAGI); distinguishes between interpersonal and intrapersonal mechanisms of change. This paper articulates a theory of change for Mellow Babies, a 14-week attachment-based group parenting programme for mothers of infants aged under 18 months, identifying the inter and intrapersonal change processes.MethodsThirty-two semi-structured interviews were conducted with mothers and practitioners who participated in Mellow Babies, including twenty post-group interviews and nine telephone fidelity checks. Data were analysed using Deductive Qualitative Analysis based on the components identified within the MAGI framework.ResultsKey interpersonal change mechanisms included: 1. Normalisation through social comparisons; 2. Validation and cognitive reframing through group feedback; 3. Peer support, offering accountability for the implementation of new habits, and providing opportunities to give and receive advice; and 4. Social and experiential learning, including internalisation of group responses leading to increased self-compassion. Intrapersonal change mechanisms were: 1. Developing new self-insight, including parenting self-awareness; 2. Increasing parenting knowledge and understanding of infant development; 3. Having time and space for self; 4. Motivation to implement new habits. Interpersonal change mechanisms had a moderating role on intrapersonal change mechanisms and subsequent programme outcomes.DiscussionThe contribution of group processes and interpersonal mechanisms of change are often overlooked within programme evaluations. Findings from this study implicate their mediating role on intrapersonal change mechanisms and subsequent programme outcomes. It is important for programme deliverers and evaluators to understand the interrelationships between group processes, change mechanisms and programme outcomes to optimise efficacy and ensure cross-contextual replicability.