bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathological characteristics and fertility preserving treatment of atypical polypoid adenomyoma
Authors: Wang Qian , Shan Weiwei , Yang Bingyi , Xue Yu , Lou Yaochen , Chen Xiaojun 
Published: May 2024

ObjectiveAtypical polypoid adenomyoma (APA) is a rare benign tumor frequently diagnosed in young women that may coexist with or progress to atypical endometrial hyperplasia (EAH) or endometrioid endometrial carcinoma (EEC). This study aimed to investigate which subset of patients with APA are prone to concurrent or subsequent EAH or EEC, evaluate the necessity of progestin treatment in patients with APA only after achieving a complete response (CR) through hysteroscopic lesion resection, and assess the impact of concurrent APA on the fertility-preserving treatment of EAH or EEC.MethodsThis retrospective single-center study analyzed 86 patients with APA treated at the Obstetrics and Gynecology Hospital of Fudan University between January 2010 and October 2021. Patients with EAH or EEC only who underwent fertility-preserving treatment during the same period were matched in a 2:1 ratio with patients with concurrent APA and EAH or EEC. The clinicopathological characteristics, treatments, and prognosis were analyzed.ResultsThe median patient age was 31 years (range 21–47 years). Among the 86 included patients, nine underwent total hysterectomy, 62 received conservative treatment, and the remaining 15 were lost to follow-up. A comparison of the 16 patients with APA only versus the 58 patients with APA and concurrent or subsequent EAH or EEC revealed that a homeostasis model assessment of insulin resistance (HOMA-IR) of &gt; 2.2 (P = 0.047) and high-density lipoprotein (HDL) concentration of &lt; 1.2 mmol/L (P = 0.028) were independent risk factors for EAH or EEC in patients with APA. Among the 17 patients with APA only who received conservative treatment and achieved a CR after hysteroscopic lesion resection, 13 received hormone treatment for a median duration of 6.3 months. The median follow-up time for these 17 patients was 49.0 months, during which no recurrence of APA was observed, but six patients developed endometrial hyperplastic diseases. Regarding the impact of concurrent APA on fertility-preserving treatment for EAH or EEC, the median time to achieve a CR was 24.0 weeks (95% confidence interval [CI]: 23.0–40.4) in the APA group and 26.0 weeks (95% CI: 24.3–32.3) in the non-APA group (P = 0.424). There were no significant differences between the two groups in the outcomes of fertility-preserving treatment.ConclusionPatients with APA only may still develop endometrial hyperplastic diseases after complete resection of the lesion under hysteroscopy to achieve a CR, particularly those with a HOMA-IR of &gt; 2.2 or HDL concentration of &lt; 1.2 mmol/L. Concurrent APA did not affect the efficacy of fertility-preserving treatment in patients with EAH or EEC.
Avelumab maintenance therapy for node-positive muscle invasive bladder cancer: a report of two cases
Authors: Poon Darren M. C. , Ho Lap Yin , Kwong Yiu Ming 
Published: May 2024

BackgroundMuscle-invasive bladder cancer (MIBC) with nodal involvement is associated with poor prognosis and high mortality. Treatment of node-positive MIBC is complex due to disease heterogeneity and a lack of evidence-based treatment options, especially alternatives to radical cystectomy. We describe a bladder-sparing management approach involving systemic therapy followed by maintenance therapy, illustrated with two cases of node-positive MIBC.Case presentationTwo patients with node-positive MIBC received upfront gemcitabine/cisplatin chemotherapy, concurrent chemoradiotherapy (cCRT), and avelumab (immune checkpoint inhibitor) maintenance therapy. Both patients achieved complete remission without recurrence or distant metastasis post-avelumab maintenance therapy. At the last follow-up, Patient 1 (45-year-old male) was in remission for over two years, and Patient 2 (57-year-old male) was in complete remission for over one year post-chemotherapy. Avelumab treatment was well-tolerated, with no immune-related adverse events, and quality of life (QoL) was maintained.ConclusionBoth cases showed a good response and extended remission on avelumab maintenance, supporting its use in conjunction with local consolidation therapy as a bladder-preserving approach in node-positive MIBC. Further research, such as the ongoing INSPIRE trial, is required to refine treatment strategies for this patient group.
Laparoscopic nephron-sparing surgery for complex renal cystic lesions: a single-center experience
Authors: Dong Dexin , Zhang Yushi 
Published: May 2024

ObjectivesThis study aimed to explore the feasibility and safety of laparoscopic nephron-sparing surgery (LNSS) for complex renal cystic lesions.MethodsA retrospective study was conducted on 83 cases of complex renal cystic lesions treated with LNSS in our hospital. There were 32 men and 51 women, ranging in age from 24 to 73 years (average, 47.22 ± 9.03 years). The diameter of the cysts was 1.5–5.9 cm (average, 3.44 ± 0.86cm). According to the Bosniak classification, there were 15 cases of type II, 23 cases of type IIF, 29 cases of type III, and 16 cases of type IV complex renal cystic lesions. According to clinical classification based on the difficulty of laparoscopic partial nephrectomy and the depth of the lesion, the 83 complex renal cystic lesions were divided into 48 cases of the extra-renal type, 15 cases of the centrally located type, seven cases of the renal sinus type, and 13 cases of the renal hilum type.ResultsLaparoscopic partial nephrectomy was successful in all 83 patients. The surgical time was 35–102 min (average, 52.13 ± 14.38 min), the intraoperative bleeding volume was 10–200 ml (average, 27.25 ± 12.26 ml), and the renal artery occlusion time was 12–28 min (average, 12.46 ± 4.45 min). There was no significant change in creatinine before and after surgery. The postoperative pathological results showed 71 cases of renal clear cell carcinoma, five cases of low malignant potential multilocular cystic renal tumors, and seven cases of pure renal cysts with all margins negative.ConclusionsThere is potential for the malignant transformation of complex renal cysts into renal cell carcinoma. For complex renal cysts classified as Bosniak IIF or higher, surgical intervention is recommended, and LNSS is safe and effective. The complexity of the surgical procedure varies depending on the location classification of the complex renal cysts.
Clinical value of serum tumor markers in assessing the efficacy of neoadjuvant chemotherapy in advanced ovarian cancer: single-center prospective clinical study
Authors: Huang Jing , Du Danyi , Chen Hailong , Luo Deping , Wang Qi , Li Chan , Li Yuanxiang , Yu Ying 
Published: May 2024

ObjectiveThis study aimed to assess the clinical importance of various biomarkers, including NLR, CEA, CA199, CA125, CA153, and HE4, through dynamic testing to evaluate the effectiveness of neoadjuvant chemotherapy (NACT) for individuals facing advanced ovarian cancer. This provides valuable information for tailoring treatment plans to individual patients, thereby leading to a more personalized and effective management of individuals facing ovarian cancer.MethodsThe levels of NLR, CA125, CA199, CEA, CA153, and HE4 were detected before chemotherapy and after 3 courses of chemotherapy. Patients were categorized into ineffective and effective groups according to the effectiveness of NACT. To evaluate the factors influencing NACT’s effectiveness in individuals facing advanced ovarian cancer, receiver operating characteristic (ROC) curves, predictive modeling, and multifactorial regression analysis were employed.ResultsIn the effective group, the patients’ age, maximum tumor diameter, and CEA and HE4 levels of the patients were significantly higher compared to those in the ineffective group (P &lt;.05). Additionally, the difference in HE4 levels before and after treatment between the effective and ineffective groups was statistically significant (P&lt;.05). Multifactorial analysis showed that age and maximum tumor diameter were independent risk factors impacting the effectiveness of NACT in individuals facing advanced ovarian cancer (P&lt;.05). The ROC curve for predicting the effectiveness of NACT in individuals facing advanced ovarian cancer showed a sensitivity of 93.3% for NLR and a specificity of 92.3% for CA199. HE4 emerged as the most reliable predictor, demonstrating a specificity of 84.6% and a sensitivity of 75.3%. The area under the curve of the combined CA125 and HE4 assays for predicting the ineffectiveness of NACT in individuals facing advanced ovarian cancer was 0.825, showcasing a specificity of 74.2% and a sensitivity of 84.6%.ConclusionThe predictive capacity for the effectiveness of NACT in individuals facing advanced ovarian cancer is notably high when considering the sensitivity of NLR and the specificity of CA199. Additionally, the combination of CA125 and HE4 assays can obtain a better predictive effect, which can accurately select patients suitable for NACT, determine the appropriate timing of the interval debulking surgery (IDS) surgery, and achieve a satisfactory tumor reduction effect.
Tunable optical parametric oscillator based on ZnGeP2 crystal for greenhouse gas remote sensing systems
Authors: Yudin N. N. , Zinoviev M. M. , Podzyvalov S. N. , Kuznetsov V. S. , Slyunko E. S. , Lysenko A. B. , Kalsin A. Yu. , Gabdrakhmanov A. Sh. , Yakovlev S. V. , Sadovnikov S. A. , Romanovskii O. A. , Baalbaki H. 
Published: May 2024

This work is devoted to the development of a compact source of coherent radiation with frequency-energy characteristics and a spectral generation range that allows remote determination of background concentrations of greenhouse gases in the atmosphere. The aim of this work was to create a frequency parametric converter based on ZGP, pumped by Ho:YAG laser radiation. For use as a source in a mobile lidar for remote determination of the concentration of greenhouse gases in the atmosphere. In the course of the research, a layout of an Optical parametric oscillator OPO based on a ZGP crystal with Ho:YAG laser radiation pumping was developed. The system’s continuous failure-free operation time was 1.5 h at a pulse repetition rate of 10 kHz and a pulse energy of the generated radiation of 0.08 mJ. The tuning range of the OPO was from 3.3 to 5 μm when using a Lyot filter. The losses from the average generation power when the Lyot filter was introduced into the resonator were 30%. At the same time, it was possible to achieve a linewidth of the generated radiation of 0.7 nm. The divergence of the generated radiation did not exceed 1.5 mrad.The absorption spectrum of gases CO2, CH4, N2O, CO in a gas cell was simulated for the entire generation range of the ZnGeP2-based OPO. As a result of the simulation, the most intense absorption lines of gases CO2, CH4, N2O, CO in the OPO tuning range were revealed, the central wavelengths of the absorption lines and their spectral width were determined.
Exhausting, but necessary: the lived experience of participants in an intensive inpatient trauma treatment program
Authors: Vaage-Kowalzik Veronica , Engeset Jeanette , Jakobsen Marianne , Andreassen Wenche , Evensen Julie Horgen 
Published: May 2024

BackgroundIntensive inpatient treatment programs have shown robust results in the treatment of post-traumatic stress disorder (PTSD). How patients experience this treatment program and what changes they experience as a result of the treatment have, however, only scarcely been explored through qualitative studies.ObjectiveThis study aimed to explore the lived experience of participants in an intensive inpatient trauma treatment program. Our research questions were as follows: how do patients experience intensive trauma-focused treatment? How do they experience possible changes related to participating in the treatment program?MethodsSix patients diagnosed with PTSD with significant comorbidities, who recently participated in an intensive 2-week (4 + 4 days) inpatient trauma treatment program with prolonged exposure (PE), eye movement desensitization and reprocessing (EMDR), and therapist rotation (TR), were interviewed with a semi-structured qualitative interview. Transcripts were analyzed using a thematic analysis approach.ResultsOur analysis resulted in five main themes: (1) the need to feel safe; (2) the benefits of many and different therapeutic encounters; (3) variable experience with elements of treatment; (4) intensity; and (5) experienced change. Our results suggest that feeling safe within the framework of the treatment program facilitated the treatment process. Many and different therapeutic encounters, both through TR and with ward staff, contributed to experienced change. All participants described the intensity as facilitative to trauma processing. However, most participants also describe often feeling too overwhelmed to benefit from all elements of the treatment program.ConclusionsOur findings suggest that participants experience the overall treatment program as beneficial and contributing to experienced change. Participants described the intensity of the program as exhausting, but necessary. Most did, however, report at times of being too overwhelmed to benefit from elements of the program. Consequently, our results prompt us to question the optimal level of intensity.Trial registrationClinicalTrials.gov identifier: NCT05342480. Date of registration: 2022-04-22.
Comparison of the effect of teaching games for understanding, sport education, combined and linear pedagogy on motor proficiency of children with developmental coordination disorder
Authors: Ghorbanzadeh Behrouz , Kirazci Sadettin , Badicu Georgian 
Published: May 2024

IntroductionThe prevalence of developmental coordination disorder (DCD) is increasing and it has been shown that the main problem of children with DCD is their low motor proficiency. Therefore, it is important to find a way to improve motor skills in these children. Thus, this study aimed to compare the effect of teaching games for understanding (TGFU), sport education (SE), combined (TGFU and SE), and linear pedagogy (LP) on motor proficiency of children with DCD.MethodsIn this regard, among 7-year-old children in Turkey, 80 children were selected voluntarily and by evaluating the MABCD-2 test. These children were randomly placed in four-LP (control), SE, TGFU, and combined (SE-TGFU) groups and practiced futsal exercises for 16 sessions under the supervision of coaches specific to each method. BOT-2 short-form test was used to evaluate motor proficiency.ResultsThe results of the analysis of the covariance test showed that the group effect is significant, and the results of the post hoc LSD test showed a significant difference between the LP with SE, LP with TGFU, LP with combination, SE with TGFU, SE with combination and TGFU with combination groups (p = &lt;0.001).DiscussionBased on the results of this study, the combined method is the best compared to other methods. Generally, combining games as an important activity in childhood with SE that emphasizes improving the child’s self-esteem is a method that can solve the movement competence that is the main problem of DCD children and lead them to continue physical activity.
Exploring the concept and management strategies of caring stress among clinical nurses: a scoping review
Authors: Goudarzian Amir Hossein , Nikbakht Nasrabadi Alireza , Sharif-Nia Hamid , Farhadi Bahar , Navab Elham 
Published: May 2024

ObjectiveThe concept of caring stress and its specific management has received less attention than other dimensions of stress in nurses. Therefore, to clarify the concept of caring stress, a scoping review study was designed. This scoping review aimed to investigate the concept of caring stress among clinical nurses and examine the strategies used for its management.MethodsThis review employed a scoping review methodology to comprehensively map the essential concepts and attributes of the phenomenon by drawing on a wide range of sources. International databases including PubMed, Scopus, Web of Science, Google Scholar, and Scientific Information Database (SID) were searched to gather relevant studies published until October 1, 2023. MESH terms included “caring stress”, “care”, “stress”, “nurse”, and “stress management” were used. Two reviewers independently collected data from full-text papers, ensuring that each paper underwent assessment by at least two reviewers.ResultsOut of 104,094 articles initially searched, 22 articles were included in this study. High workloads, transmitting the infection, stressful thoughts, stressful emotions, and stressful communications were the significant concepts and factors of caring stress among nurses. Also, rest breaks during patient care shifts, playing music in the ward, and denial of critical situations were examples of positive and negative coping and management ways to reduce caring stress.ConclusionEffective stress management strategies can lead to better patient care and safety. Stressed nurses are more likely to make errors or become less vigilant in their duties, impacting patient outcomes. By addressing caring stress, clinical practice can prioritize patient well-being. Further research is required to delve deeper into this critical issue concerning nurses in the future.
Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: a randomized controlled pilot study
Authors: Rankins Ellen M. , Quinn Andrea , McKeever Kenneth H. , Malinowski Karyn 
Published: May 2024

IntroductionEquine-assisted services (EAS) has received attention as a potential treatment strategy for post-traumatic stress disorder (PTSD), as existing literature indicates that symptoms may decrease following EAS. Relatively little is known about the mechanisms at play during lessons and if physiological measures are impacted. The objectives of this pilot study were to 1) explore the effects of adaptive horsemanship (AH) lessons on symptoms of PTSD, hormone concentrations, and social motor synchrony; 2) determine if physiological changes occur as veterans interact with horses; and 3) explore if the interaction between veteran and horse changes over the 8-week session.MethodsVeterans with PTSD were randomly assigned to control (CON, n = 3) or AH (n = 6) groups for an 8-week period (clinical trial; NCT04850573; clinicaltrials.gov). Veterans completed the PTSD Checklist (PCL-5) and Brief Symptom Inventory (BSI) at pre-, post-, and 2- and 6-month follow-up time points. They also completed a social motor synchrony test (pendulum swinging) and blood draw at pre- and post-time points. In weeks 1, 4, and 8, blood samples were drawn at 0 min, 3 min, 5 min, 25 min, and 30 min during the 30-min AH lessons. Veterans completed the Human–Animal Interaction Scale (HAIS) after each lesson. Blood samples were assayed for plasma cortisol, epinephrine, norepinephrine, and oxytocin. Data were analyzed with repeated measure ANOVAs. Changes in PTSD symptoms from pre- to post-time point were analyzed with paired t-tests.ResultsChanges in PCL-5 scores tended to differ (p = 0.0989), and global BSI scores differed (p = 0.0266) between AH (−11.5 ± 5.5, mean ± SE; −0.5 ± 0.2) and CON (5.3 ± 5.4; 0.4 ± 0.2) groups. Social motor synchrony and hormone concentrations did not differ between groups or time points (p &gt; 0.05). Cortisol, norepinephrine, and oxytocin concentrations did not differ across sessions (p &gt; 0.05). Epinephrine concentrations tended (p = 0.0744) to decrease from week 1 to 4 of sessions. HAIS scores increased (p ≥ 0.0437) in week 3 and remained elevated as compared to week 1.DiscussionParticipant recruitment was the greatest challenge. These preliminary results agree with the literature suggesting that EAS can reduce symptoms of PTSD.
Menopausal wellbeing: navigating quality of life and osteoporosis risk
Authors: Nair Rajeesh R. , Joy Teena Mary , George Leyanna Susan , Ajay Aparna , Mathew Minu Maria , Raveendran Greeshma C. 
Published: May 2024

BackgroundMultifaceted dimensions influence the quality of life among post-menopausal women. Osteoporosis, a condition characterized by fragile bones, poses a significant risk, potentially leading to fractures and decreased wellbeing. This study aims to assess the quality of life of postmenopausal women, its determinants, and also the risk of osteoporosis among them.MethodsA cross-sectional study was done among 379 post-menopausal women residing in rural and urban areas of Ernakulam district, Kerala, India. They were selected by probability proportional to size sampling from 10 clusters. Quality of life was measured using MENQOL-I questionnaire and osteoporosis risk assessment was done using OSTA score.ResultsThe study participants had a mean age of 60 years, (standard deviation of 6.83 years). On average, menopause occurred at 50.58 years (standard deviation of 4.28 years). The most common symptoms impacting quality of life among postmenopausal women were psychosocial symptoms, followed by physical and vasomotor symptoms. Furthermore, a high proportion (63.6%) of participants were at risk for osteoporosis. History of fracture, concern of falling, marital status and having an insurance, are factors associated with various domains of quality of life.ConclusionThis study underscores the complex interplay of demographic factors, menopausal experiences, and their impact on the participants' quality of life. The prevalence of psychosocial symptoms and the significant risk of osteoporosis call for tailored healthcare interventions. Postmenopausal women with history of fracture, high concern of fall and single women require special attention. Encouraging women to take up selfcare practices will help during the menopausal transition to have a good quality of life.