bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extrauterine leiomyomas in uncommon locations: two case reports and literature review
Authors: Yavuz Onur , Kula Ali Hakan , Bayramoğlu Zeynep , Aydin Nur Yağ mur , Mankan Kadir Alper , Akdöner Aslı 
Published: July 2024

ObjectivesThis study aims to provide an overview of the diagnosis, treatment, and follow-up management of vulvar and vaginal leiomyomas through the presentation of two rare cases.MethodsDetailed clinical presentations, surgical procedures, histopathological examinations, and follow-up outcomes of two cases of vulvar and vaginal leiomyomas are described. Relevant literature is also reviewed to contextualize the findings.ResultsBoth patients underwent successful surgical excision of the leiomyomas with no perioperative or postoperative complications. Histopathological examinations confirmed the diagnosis of leiomyoma based on characteristic microscopic features and immunohistochemical analyses.ConclusionVulvar and vaginal leiomyomas are rare benign tumors that require careful evaluation for accurate diagnosis and appropriate management. Surgical excision remains the primary treatment modality, and long-term follow-up is essential for monitoring recurrence and ensuring favorable outcomes.
A reference architecture for personal health data spaces using decentralized content-addressable storage networks
Authors: Klementi Toomas , Piho Gunnar , Ross Peeter 
Published: July 2024

IntroductionThis paper addresses the dilemmas of accessibility, comprehensiveness, and ownership related to health data. To resolve these dilemmas, we propose and justify a novel, globally scalable reference architecture for a Personal Health Data Space (PHDS). This architecture leverages decentralized content-addressable storage (DCAS) networks, ensuring that the data subject retains complete control and ownership of their personal health data. In today's globalized world, where people are increasingly mobile for work and leisure, healthcare is transitioning from episodic symptom-based treatment toward continuity of care. The main aims of this are patient engagement, illness prevention, and active and healthy longevity. This shift, along with the secondary use of health data for societal benefit, has intensified the challenges associated with health data accessibility, comprehensiveness, and ownership.MethodThe study is structured around four health data use case scenarios from the Estonian National Health Information System (EHIS): primary medical use, medical emergency use, secondary use, and personal use. We analyze these use cases from the perspectives of accessibility, comprehensiveness, and ownership. Additionally, we examine the security, privacy, and interoperability aspects of health data.ResultsThe proposed architectural solution allows individuals to consolidate all their health data into a unified Personal Health Record (PHR). This data can come from various healthcare institutions, mobile applications, medical devices for home use, and personal health notes.DiscussionsThe comprehensive PHR can then be shared with healthcare providers in a semantically interoperable manner, regardless of their location or the information systems they use. Furthermore, individuals maintain the autonomy to share, sell, or donate their anonymous or pseudonymous health data for secondary use with different systems worldwide. The proposed reference architecture aligns with the principles of the European Health Data Space (EHDS) initiative, enhancing health data management by providing a secure, cost-effective, and sustainable solution.
Single Neuroform Atlas stent: a reliable approach for treating complex wide-neck bifurcated aneurysms
Authors: Ahn Hong Suk , Jeon Hong Jun , Cho Byung Moon , Park Se Hyuck 
Published: July 2024

BackgroundTreating wide-neck bifurcated cerebral aneurysms (WNBAs) using various techniques and new devices has shown favorable outcomes. However, endovascular coiling can be technically challenging when the aneurysm neck is incorporated into the parent vessel. Furthermore, although recent research has reported favorable outcomes of Neuroform Atlas stent (NAS)-assisted coiling, broad inclusion criteria have hampered precise evaluations of their effectiveness and safety for treating complex WNBAs. Therefore, this study evaluated whether the use of a single NAS is a safe and effective approach for treating complex WNBAs.MethodsWe treated 76 complex WNBAs (unruptured, n = 49; ruptured, n = 27) using single NAS-assisted coil embolization and retrospectively analyzed the clinical and angiographic outcomes.ResultsIn a cohort of 68 patients (mean age, 58.3 ± 11.6 years; males n = 20, 29.4%; females, n = 48, 70.6%), 76 stents were successfully delivered to the target aneurysms, yielding a technical success rate of 98.6%. Complete occlusion was evident in 59 (77.6%) of 76 aneurysms, with neck remnants found in 16 (21.1%) and partial occlusion in 1 (1.3%). Treatment-related morbidities comprised one branch occlusion and one parenchymal hemorrhage. However, no new neurological symptoms of unruptured aneurysms were evident at discharge. The outcomes of 20 of the 27 ruptured aneurysms were favorable (Glasgow Outcome Scale scores of 4 or 5) at the final follow-up assessment (mean 12.2 [6–29] months), except for one initial subarachnoid hemorrhage. Post-treatment angiography revealed complete occlusion in 89.1%, neck remnants in 7.8%, and incomplete occlusion in 3.1% of the aneurysms. Approximately 88.2% of the patients were assessed at least once by follow-up diagnostic or magnetic resonance angiography (mean, 12.5 ± 4.3 [range, 6–29] months), with five (7.8%) minor and two (3.1%) major recurrences.ConclusionA single NAS is safe and effective for treating WNBAs incorporated into parent vessels.
Neoadjuvant targeted therapy versus targeted combined with chemotherapy for resectable EGFR-mutant non–small cell lung cancer: a retrospective controlled real-world study
Authors: Shao Weipeng , Liu Zhan , Li Bobo , Chen Feng , Liu Jie , Li Hui , Guo Hongbo 
Published: July 2024

BackgroundThis study aimed to assess the role and effect of neoadjuvant targeted therapy (TT) versus targeted combined with chemotherapy (TC) for resectable EGFR-mutant non–small cell lung cancer (NSCLC).MethodsBetween March 2021 and June 2023, 20 patients with stage IA3-IIIB NSCLC were enrolled in the study. Eleven patients received EGFR-TKIs in the TT group, while nine patients received EGFR-TKIs and two cycles of cisplatin-based doublet chemotherapy (TC group). We compare the differences between the two groups through the following variables, including age, sex, surgical approach, postoperative complications, neoadjuvant therapy adverse events, complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), objective response rate (ORR), major pathologic response (MPR), and pathologic complete response (pCR).ResultsPatients were predominantly female (75%) and never-smokers (95%). The average age was 59.2 years (range 46-79 years). Fifty-five percent harbored an exon 19 EGFR mutation and 45% an exon 21 mutation. The average targeted drug dosing time was 2.91 ± 1.7 (range 1-6) months in the TT group and 3.56 ± 3.54 (range 1-12) months in the TC group (P=0.598). The most common side effects were rash and diarrhea. No grade 5 events with neoadjuvant therapy were observed. The rate of R0 resection was 100% in all patients. Among the 11 patients in the TT group, 6 achieved a PR and 5 had SD, resulting in an ORR of 54.5%. Among the 9 patients in the TC group, 6 had PR and the remaining 3 had SD, resulting in an ORR of 66.6%. one patient (11.1%) in the TC group achieved pCR, while no patients in the TT group achieved pCR (P = 0.142). Two patients (18.2%) in the TT group reached MPR, and 2 patients (22.2%) in the TC group reached MPR (P = 0.257). The overall clinical downstage rate is 60%. Only 9 (45%) cases of yield clinical TNM (ycTNM) were consistent with yield pathologic TNM (ypTNM).ConclusionResults from this retrospective controlled research indicate that the neoadjuvant TT group is likely to be more effective outcomes and has safer profile in patients with EGFR-positive NSCLC than the neoadjuvant TC group. However, our results need to be validated in a multicenter, large sample prospective study.
Neurodivergent patient experience in a tertiary children's hospital-a qualitative analysis
Authors: Talley Michele , Brown Chelsea , Wingo Nancy , Conway Jennifer , Maha Julian , Kong Michele 
Published: July 2024

IntroductionSensory processing challenges are commonly encountered in pediatric patients, particularly in those who are neurodivergent. We previously developed a novel clinical pathway (named “Sensory Pathway”) which aimed at improving patient care for those with sensory barriers via staff training, provision of sensory toolkits and early integration of families throughout the hospital stay. We hypothesized that utilization of this pathway will result in improved patient experience and provide valuable feedback to improve care.MethodsA voluntary survey was made available to all patients who utilized this resource as part of our hospital wide patient satisfaction survey. Qualitative data was coded using open coding as part of the constant comparison method data using NVivo 12 for Windows software for analysis. Software was used to create word clouds and clusters for visualization, which confirmed the themes and patterns that were noted from initial open coding.ResultsBetween 2021 and 2022, surveys were obtained from 160 patients who utilized the Sensory Pathway. More than 50% reported that the most helpful components of the pathway were the approach by the staff and sensory tools. The three major themes identified from the survey were (1) Tools and techniques that benefited their children; (2) Positive interactions and communication with the hospital staff, and (3) Suggestions for future improvement.ConclusionThe survey results highlight the importance of having tools readily available to aid with sensory regulation and comfort of patients during healthcare encounters, the value of a positive patient and staff encounter, as well as opportunities for improvement.
Real-world evidence of characteristics and factors influencing herbal medicine use for weight loss in adults
Authors: Lee Boram , Yang Changsop , Yim Mi Hong 
Published: July 2024

BackgroundObesity imposes a significant socioeconomic burden owing to its high prevalence. In response to the adverse outcomes associated with conventional pharmacotherapy and the challenges of low adherence to lifestyle interventions, herbal medicine has surfaced as an actively utilized approach for weight loss. Therefore, this study aimed to analyze the characteristics and influencing factors of herbal medicine users for weight loss in adults.MethodsOverall, 22,080 participants were included based on data from the Korea National Health and Nutrition Examination Survey from 2010 to 2019. Simple logistic regression analyses were used to derive the associations between herbal medicine use for weight loss and individual characteristics. Three models were constructed utilizing multiple logistic regression analyses to assess the associations between herbal medicine use for weight loss and the combined characteristics of predisposing, enabling, and need factors according to Andersen’s model.ResultsIn the full adjustment model, women, younger adults, those with higher incomes, and individuals reporting higher levels of perceived stress were more prone to use herbal medicine for weight loss in the past year. Adults who identified body image as being fat/very fat, those who consumed alcohol, and those classified as severely obese by body mass index were also more prone to use herbal medicine for weight loss. In particular, adults with a higher rate and amount of weight loss in the past year were more likely to use herbal medicine for weight loss compared to those experiencing weight gain/no changes/loss of 0–3 kg.ConclusionOur study was the first to derive the characteristics and influencing factors of herbal medicine users for weight loss among adults. These findings hold significant promise for informing future research endeavors and policy decision-making for effective resource distribution for obesity treatment.
Optimism and mental health in college students: the mediating role of sleep quality and stress
Authors: Lai Yun-Ju , Tsai En-Yun , Jarustanaput Ploypapus , Wu Yi-Syuan , Chen Yi-Hau , O’Leary Samantha E. , Manachevakul Sumatchara , Zhang Yuan , Shen Jiabin , Wang Yan 
Published: July 2024

ObjectiveCollege students showed a high prevalence of stress, anxiety, and depression, with medical and nursing students experiencing particularly elevated levels of mental health challenges.Optimism significantly influences overall well-being by promoting a healthy lifestyle and cognitive responses. However, the association of optimism with sleep quality, stress, and mental health in college students remains unexplored. This study aimed to (1) explore the associations of optimism with sleep quality, stress, and mental health and (2) ascertain whether sleep quality and stress mediate the association between optimism and mental health among college students.MethodsA cross-sectional study was conducted using online surveys with students from health science majors at a public university in the northeast United States from September to December 2022. A total of 222 students participated in the study, providing data on sociodemographics, optimism, sleep quality, stress, anxiety, and depression. Parallel and serial mediation models were utilized to examine the potential mediating roles of sleep quality and stress in the association between optimism and mental health.ResultsThe study found that optimism influences anxiety and depression through both direct and indirect pathways. In line with predictions, the parallel mediation analysis revealed that the impact of optimism on anxiety (βtotal = −0.598, 95% confident interval [CI]: −0.778 to −0.392) and depression (βtotal = −0.724, 95% CI: −0.919 to −0.519) was mediated by stress and sleep quality. Furthermore, the serial mediation models revealed that stress and sleep quality co-mediated the relationship betweenoptimism and anxiety (indirect effect [IE] = −0.074, 95% CI: −0.135 to −0.029) or depression (IE = −0.084, 95% CI: −0.142 to −0.036) in a sequential manner.ConclusionOptimism was negatively correlated with poor sleep quality, stress, anxiety, and depression. Enhanced optimism was linked to high sleep quality and less stress, anxiety, and depression. These insights emphasize the potential for school-based optimism interventions to improve sleep quality, ameliorate stress-related concerns, and alleviate mental health challenges in college students.
Medical care for transgender individuals at a hospital in southern Brazil: why do they drop out from our service?
Authors: Guadagnin Fernanda , Schwarz Karine , Cardoso da Silva Dhiordan , Salati Leonardo Romeira , Kayser Vinicius , Lobato Maria Inês Rodrigues 
Published: July 2024

ObjectiveThe objective of the study was to investigate dropout rates and discern potential factors contributing to the discontinuation of treatment provided to transgender individuals by the Transdisciplinary Gender Identity Program at the Hospital de Clínicas de Porto Alegre (PROTIG).MethodologyThis study employs a descriptive, cross-sectional, retrospective design to analyze socio-demographic and clinical data obtained from medical records of patients treated at PROTIG between 2000 and 2018. A structured form, devised by PROTIG’s professional team, was utilized to extract and evaluate several variables including: age, gender, education level, diagnosis of F64 according to the International Classification of Diseases (ICD-10: Version: 2010), clinical comorbidities (coded by ICD-10), laboratory diagnosis of sexually transmitted infections, distance between patients’ residence and the hospital, and year of entry into PROTIG. The patient cohort was stratified into two categories based on their duration of attendance: dropout (defined as attendance for up to 365 days) and non-dropout (attendance exceeding 365 days). Categorical variables between dropout and non-dropout groups were compared using Pearson’s chi-square test. Additionally, Poisson regression analysis was utilized, employing a 95% confidence interval (CI) and setting the significance level at 0.05.ResultsThe study included a total of 888 patients accessing PROTIG, with 275 (31%) classified in the dropout group. Of the patient population, 65.5% (n = 582) self-identified as transgender women, while 34.5% (n = 306) identified as transgender men. Significant differences were noted between the dropout and non-dropout groups. Specifically, differences were noted among transgender women (p &lt; 0.001), individuals with lower levels of education (p &lt; 0.001), those with fewer diagnoses classified under ICD-10 as F64 (p &lt; 0.001), individuals exhibiting fewer clinical comorbidities recorded in ICD-10 (p &lt; 0.001), and those who commenced inclusion in PROTIG after 2010 (p &lt; 0.001).ConclusionThere exists a notable rate of treatment discontinuation among individuals receiving care at PROTIG, with statistically significant variances observed between groups. We posit potential rationales for this discontinuation, informed by care experiences and feedback from group attendees: Increased accessibility to outpatient services in our jurisdiction for Transgender Care, along with heightened societal awareness of gender identity fostering diverse gender expression avenues devoid of reliance on gender-affirming surgical interventions.
The association between physical fitness and mental health among college students: a cross-sectional study
Authors: Hong Yu , Shen Jiaqi , Hu Yue , Gu Yuxuan , Bai Zhongjiang , Chen Yu , Huang Siyi 
Published: July 2024

IntroductionPhysical inactivity and mental health disorders are emerging threats to public health in China. Previous research on links between exercise and mental wellbeing have focused on clinical populations, with little evidence from the general population, particularly younger adults. We aimed to investigate associations between physical fitness and mental health in Chinese college students.MethodsIn this series, of cross-sectional observational studies, we enrolled 7,468 Chinese college students aged 16–24 years in 199 classes at Changzhou Vocational Institute of Engineering between Sept 1, 2017, and Jun 30, 2018. Exposures of interest were the students’ physical fitness level, measured by the Chinese University Students Physique Test. The primary outcomes were mental health situations, measured by the University Personality Inventory (UPI). The multivariable linear regression models were used to assess the relationship between the levels of physical fitness and mental disorders symptoms.ResultsCompleted mental health and physical fitness data were available for 6,724 participants aged 16–24 years. Compared with the failed group, the corresponding levels of difference in overall UPI scores were − 1.45 scores (95% CI: −2.45, −0.46; p &lt; 0.01) for the passed group and − 2.95 scores (95% CI: −4.13, −1.77; p &lt; 0.01) for the good group. Similar results were observed in the four different aspects of psychotic disorder symptoms.DiscussionThere was a significantly negative correlation between the level of physical fitness and phycological situations among Chinese college students. Our findings highlight the psychological situations of students with low physical fitness levels should be concerned.
Transtheoretical model to predict the stages of changes in smoking cessation behavior among adolescents
Authors: Park Min Hee , Song Hye-Young 
Published: July 2024

IntroductionPrevious studies on adolescent smoking cessation behavior based on the transtheoretical model have primarily focused on the development of cessation programs. Attempting to quit smoking is a prerequisite for executing smoking cessation. Appropriate methods must be selected based on the characteristics and intentions of individuals to increase smokers’ satisfaction and success rates in quitting. Therefore, this study aimed to identify changing processes influencing the stages of change associated with successful smoking cessation among adolescents and examined the related factors. This descriptive study explored a transtheoretical model of different stages of changes in smoking cessation behavior among adolescent smokers.MethodsThe participants included 237 middle and high school students in South Korea. We examined the differences in stages of changes in smoking cessation behaviors based on general characteristics, smoking-related characteristics, smoking cessation change processes (cognitive and behavioral), smoking decisional balance (pros and cons of smoking), and self-efficacy.ResultsThe probability of reaching the preparation stage of smoking cessation was significantly lower among participants who did not know their father’s educational level than among those who knew their father’s educational level. Conversely, this probability was significantly higher among participants whose mothers had a college or higher education level and those who did not know their mother’s educational level than in those whose mothers had a high school or lower education level.ConclusionThese findings indicated that parental education is a significant predictor of the preparation stage of smoking cessation, highlighting the importance of the family environment in facilitating smoking cessation among adolescents. Accordingly, communication and support at home could help reinforce adolescents’ determination to quit smoking and make relevant plans. Thus, smoking cessation support should stress the need to enhance communication at home.
HYPSTAR: a hyperspectral pointable system for terrestrial and aquatic radiometry
Authors: Kuusk Joel , Corizzi Alexandre , Doxaran David , Duong Kim , Flight Kenneth , Kivastik Joosep , Laizans Kaspars , Leymarie Edouard , Muru Silvar , Penkerc’h Christophe , Ruddick Kevin 
Published: July 2024

Optical Earth observation satellites provide vast amounts of data on a daily basis. The top-of-atmosphere radiance measured by these satellites is usually converted to bottom-of-atmosphere radiance or reflectance which is then used for deriving numerous higher level products used for monitoring environmental conditions, climate change, stock of natural resources, etc. The increase of available remote sensing data impacts decision-making on both regional and global scales, and demands appropriate quality control and validation procedures. A HYperspectral Pointable System for Terrestrial and Aquatic Radiometry (HYPSTAR®) has been designed to provide automated, in-situ multiangular reflectance measurements of land and water targets. HYPSTAR-SR covers 380–1020 nm spectral range at 3 nm spectral resolution and is used at water sites. For land sites the HYPSTAR-XR variant is used with the spectral range extended to 1680 nm at 10 nm spectral resolution. The spectroradiometer has multiplexed radiance and irradiance entrances, an internal mechanical shutter, and an integrated imaging camera for capturing snapshots of the targets. The spectroradiometer is mounted on a two-axis pointing system with 360° range of free movement in both axes. The system also incorporates a stable light emitting diode as a light source, used for monitoring the stability of the radiometric calibration during the long-term unattended field deployment. Autonomous operation is managed by a host system which handles data acquisition, storage, and transmission to a central WATERHYPERNET or LANDHYPERNET server according to a pre-programmed schedule. The system is remotely accessible over the internet for configuration changes and software updates. The HYPSTAR systems have been deployed at 10 water and 11 land sites for different periods ranging from a few days to a few years. The data are automatically processed at the central servers by the HYPERNETS processor and the derived radiance, irradiance, and reflectance products with associated measurement uncertainties are distributed at the WATERHYPERNET and LANDHYPERNET data portals.