bluuebunny/crossref_metadata_2025_split huggingface dataset:
“I liked school, but school didn’t like me”: Autistic young adults’ reflections on their mainstream primary school experiences
Authors: Billington Jo , Loucas Tom , Knott Fiona 
Published: December 2024

A substantial literature indicates that autistic children and young people are much more likely than their non-autistic peers to have difficult school experiences and poor educational outcomes. However, how autistic people describe and make sense of their school experiences has received less attention from researchers, especially in relation to primary school, the period of formal state education in the United Kingdom for children from the age of five to eleven years old. Furthermore, little is known about how early school experiences impact on the lives of autistic adults, particularly in terms of identity development. Using thematically analysed data collected from focus group and one-to-one interviews, this study aimed to contribute towards this gap in the literature by documenting the subjective accounts of six autistic young adults. The findings show that the participants’ primary school experiences were characterised by routine invalidations and hostilities from peers and school staff which led to anxiety about social acceptability. These early negative experiences had long lasting implications in terms of self-concept and general wellbeing. Recommendations for teacher training and education policy are discussed. Lay Abstract We know from previous research that lots of autistic children and young people have difficult school experiences. But we know less about what these experiences feel like for autistic people, especially in relation to the primary school years. We also know very little about what autistic adults remember about their primary school experiences and how such experiences affect their sense of identity. Our study aimed to address this gap in the research by asking a group of 6 autistic young adults about their experiences of mainstream primary school. We held a focus group discussion for 5 participants and 1 participant chose to be interviewed instead. They told us that they were regularly bullied by peers and teachers for being different. They also told us that the impact of these early negative experiences was still being felt in adulthood. These findings suggest that autistic children's school experiences may be improved by focusing on changing school cultures and attitudes to be more welcoming and accepting of autistic ways of being. We briefly discuss ways in teacher training and educational policy might play a role in this.
Staff and Providers’ Perceptions of Patients’ PrEP Candidacy, Acceptability, and Adherence in Methadone Clinic Settings
Authors: Jaiswal Jessica , Grin Benjamin , Gagnon Kelly , John Tejossy , Walters Suzan , Griffin Marybec , Kay Emma 
Published: December 2024

Background: People who use drugs and patients in substance use treatment may be placed at high risk for HIV due to mixing sex and drugs, potential engagement in sex work, and injection drug use. However, pre-exposure prophylaxis (PrEP) adoption among these populations remains low. Methadone clinics, a main point of contact with the healthcare system for this population, are a missed opportunity to offer biomedical HIV prevention. Understanding provider and staff perceptions of patients’ PrEP-related candidacy, acceptability, and adherence is a critical first step to informing PrEP implementation in substance use treatment settings. Methods: Thirty semistructured interviews were conducted at 2 methadone clinics in Northern New Jersey between January and April 2019. Participants included methadone counselors, medical providers, front desk staff, intake coordinators, and other clinic staff members. Results: Three major themes were identified: (1) provider and staff’s perceptions of who would benefit most from PrEP, (2) perceptions of patients’ acceptability of PrEP, and (3) perceptions of patients’ ability to take a pill every day. Broadly, staff perceived younger patients to be better PrEP candidates than older patients, expressed cautious optimism that PrEP would be acceptable to their patient populations, and were mixed in terms of their perceptions of patients’ ability to adhere to PrEP. Notably, staff largely did not mention patients who inject drugs as potential PrEP candidates, suggesting a missed opportunity. Conclusion: To promote PrEP implementation in methadone clinics, staff and providers should receive training around screening for PrEP eligibility in order to maximize the benefits of PrEP for various subpopulations, especially those who inject. Importantly, discussions around sexual behavior and injection drug use must be approached in an open, non-stigmatizing manner. These findings can be used to inform future interventions to integrate PrEP services into substance use treatment settings.
Impact of a Web-Based Curriculum on Internal Medicine Resident Use of Stigmatizing Language for Substance Use Disorder
Authors: Samberg Diana , Spinella Sara , Rothenberger Scott , Tetrault Jeanette M. , Childers Julie 
Published: December 2024

Background: Addiction is a chronic, treatable disorder, yet it carries considerable stigma. Stigmatizing language biases how clinicians view patients with substance use disorders (SUDs) and negatively affects patient care. While national medical organizations have recommended educational initiatives to reduce the stigma associated with SUDs, studies of initiatives are lacking. We aimed to improve documentation of SUDs and reduce measured stigma by teaching standardized, non-stigmatizing language. Methods: We created an online, 25-minute interactive curriculum about vocabulary for addiction and why language matters. Before and 8 weeks after completing the curriculum, internal medicine residents viewed a video encounter between a physician and a “challenging” simulated patient with opioid use disorder, then completed a case write-up and a SUD stigma survey. We analyzed the frequency of usage of stigmatizing terms and quantified participants’ stigma levels. Results: During the fall of 2020, UPMC Internal Medicine residents completed the curriculum. In all, 98 participants (out of ~150) completed the pre-curriculum assessment, and 39 completed the entire course. In pre-curriculum write-ups, stigmatizing terminology was used 4 times more often than clinical terminology (30 terms per 100 write-ups versus 7.6, P = .032). Clinical terminology was used 134% more often post-curriculum than pre-curriculum (24 terms per 100 write-ups vs 7.6), but this result was not significant. There was no difference between measured stigma levels pre- and post-curriculum. In total, 34/45 (75.6%) participants who completed the post-curriculum survey said that they learned new information, and 32/45 (71.1%) would recommend it to others. Conclusions: There were trends toward improvement in language, including decreased use of stigmatizing terminology and increased usage of clinical terminology, though not statistically significant. The curriculum was well-received, but the study was limited in participation by the COVID-19 pandemic. However, the simple design of the curriculum—a short, web-based module—allows for easy delivery to workers across the healthcare sector.
Work participation after receiving multidisciplinary treatment or acceptance and commitment therapy intervention for return to work: long-term follow-up of a randomized controlled trial among sick-listed individuals with mental disorders and/or chronic pain
Authors: Berglund Erik , Anderzén Ingrid , Helgesson Magnus , Lytsy Per , Andersén Åsa 
Published: December 2024

Abstract
Background
The return-to-work (RTW) process for individuals on long-term sick leave can be complex. Vocational rehabilitation may facilitate RTW; however, many intervention studies often have relatively short follow-up periods. The purpose of this study was to assess long-term work participation 2–7 years after the initiation of a three-armed randomized controlled trial aimed at RTW for individuals on long-term sick leave because of mental disorders and/or chronic pain.

Methods
This study followed 220 participants out of 402 (response rate 55%, 205 female) who had previously participated in a randomized controlled trial. They were allocated to one of three groups: multidisciplinary team assessment and individualized treatment (MDT), acceptance and commitment therapy (ACT) or a control group. The participants were followed up at two, three, four, five, six, and seven years after inclusion. The outcome, work participation, was assessed using registry data and defined as having the main source of annual income from paid work during the follow-up years.

Results
Participants in the MDT intervention group were, to a larger extent, in paid work during follow-up in years four (9.0% points), five (2.5% points), six (7.6% points), and seven (4.1% points) after inclusion, compared to the control group. Participants in the ACT intervention group were, to a larger extent, in paid work during follow-up in years four (14.8% points), six (17.6% points), and seven (13.9% points) after inclusion, compared to the control group.

Conclusion
This study, primarily involving female individuals on long-term sick leave, suggests that both MDT and ACT interventions can improve long-term work participation. The results also indicate some time-lag effect of the interventions.

Trial registration
The original randomized study was registered at the Clinicaltrials.gov Register Platform (ID NCT03343457); registered on November 15, 2017 (retrospectively registered).
Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves’ disease: role of TRAbs
Authors: Kalra Sanjay , Selim Shahjada , Shrestha Dina , Somasundaram Noel , Raza Syed Abbas , Baruah Manash P. , Bhattacharya Saptarshi , Gadve Sharvil , Bantwal Ganapathi , Sahay Rakesh 
Published: December 2024

AbstractGraves' disease (GD) is an autoimmune disorder characterized by activation of the TSH receptor by stimulatory autoantibodies (TSH Receptor Antibodies, or TRAbs), leading to unregulated thyroid hormone production. Diagnosis is largely based on the typical clinical picture and laboratory thyroid panel. Establishment of elevated serum levels of TRAbs by competitive binding assay or cell-binding assay has its unique role in diagnosis and management of GD, especially in the differential diagnosis, therapy selection, prognostication, evaluation of thyroid function during pregnancy, peri-conceptional and neonatal thyroid workup, and in certain special situation. Inclusion of TRAbs in GD diagnostic algorithm can improve cost-effectiveness of GD management. The current best practice guidelines were developed to provide evidence-based recommendations in the use of TRABs in GD management for healthcare providers in South Asia. A panel of endocrinologists with minimum 10 years of clinical experience in thyroid disorders reviewed existing literature and their quality, and after deliberation and discussion, developed 21 recommendations surrounding the best practices surrounding the role of TRAbs in GD management.
Decision-making about palliative sedation for patients with cancer: a qualitative study in five European countries linked to the Palliative sedation project
Authors: Van der Elst Michael , Payne Sheila , Arantzamendi Maria , Preston Nancy N. , Koper Ian , Belar Alazne , Brunsch Holger , Surges Séverine M. , Adile Claudio , Grassi Yasmine , Cockshott Zoe , Hasselaar Jeroen , Menten Johan ,   Palliative Sedation Consortium
Published: December 2024

Abstract
Background
Palliative sedation refers to the proportional use of titrated medication which reduces consciousness with the aim of relieving refractory suffering related to physical and psychological symptoms and/or existential distress near the end of life. Palliative sedation is intended to be an end of life option that enables healthcare professionals to provide good patient care but there remains controversy on how it is used. Little is known about decision-making processes regarding this procedure. The aim of this study was to explore decision-making processes in palliative sedation based on the experiences and perceptions of relatives and healthcare professionals.

Methods
We conducted a qualitative interview study with dyads (a bereaved relative and a healthcare professional) linked to 33 deceased patient with cancer who had palliative sedation, in seven in-patient palliative care settings in five countries (Belgium, Germany, Italy, the Netherlands, and Spain). A framework analysis approach was used to analyse the data.

Results
Two main themes are defined: 1) Decision-making about palliative sedation is a complex iterative process, 2) Decision-making is a shared process between the patient, healthcare professionals, and relatives. Decision-making about palliative sedation appears to follow an iterative process of shared information, deliberation, and decision-making. The patient and healthcare professionals are the main stakeholders, but relatives are involved and may advocate for, or delay, the decision-making process. Starting palliative sedation is reported to be an emotionally difficult decision for all parties.

Conclusions
As decision-making about palliative sedation is a complex and iterative process, patients, relatives and healthcare professionals need time for regular discussions. This requires a high level of engagement by healthcare professionals, that takes into account patients’ wishes and needs, and helps to facilitate decision-making.
A generation at risk: the unseen consequences of Nepal’s nursing shortage on undergraduate nursing students clinical education
Authors: Ghimire Animesh , Neupane Mamata 
Published: December 2024

Abstract
Background
The global nursing shortage has particularly severe consequences in resource-constrained countries like Nepal, where a significant outflow of healthcare professionals exacerbates the crisis. While the impact on patient care, workforce dynamics, and organizational challenges within healthcare settings have been extensively researched, the profound implications of this crisis for nursing education remain underexplored. This qualitative study sheds light on the often-unseen consequences of the nursing shortage on undergraduate nursing students’ clinical education.

Methods
Data were collected from three focus group discussions involving eighteen final-year nursing students from two tertiary institutions. The first two discussions took place in June 2024, with the third one in July 2024. Thematic analysis was employed to identify and interpret the key themes.

Results
Four overarching themes emerged: (1) Compromised Learning, highlighting the detrimental impact on skill acquisition and student preparedness; (2) Abandoned in the Field, revealing the emotional toll of isolation, with students describing themselves as “ghosts, silently observing from the sidelines”; (3) Forging Ahead, showcasing the unintended resilience and resourcefulness of students seeking alternative knowledge sources; and (4) Digital Mentors, spotlighting the innovative use of Artificial Intelligence (AI) as a supplementary learning tool in overburdened clinical settings.

Conclusion
The nursing shortage in Nepal has created a challenging and often isolating clinical learning environment (CLE) for students. While their resilience and adaptability are commendable, these qualities are not substitutes for nurse staffing shortages and inadequate mentorship. This study underscores the urgent need for systemic change, including increased investment in the nursing workforce, cultivating a supportive learning environment, and integrating technology into nursing education. These findings have implications for Nepal and other resource-constrained settings grappling with the challenges of a nursing shortage.
DNA methylation models of protein abundance across the lifecourse
Authors: Waterfield Scott , Yousefi Paul , Suderman Matt 
Published: December 2024

Abstract
Background
Multiple studies have shown that DNA methylation (DNAm) models of protein abundance can be informative about exposure, phenotype and disease risk. Here we investigate and provide descriptive details of the capacity of DNAm to capture non-genetic variation in protein abundance across the lifecourse.

Methods
We evaluated the performance of 14 previously published DNAm models of protein abundance (episcores) in peripheral blood from a large adult population using the Avon Longitudinal Study of Parents and Children (ALSPAC) at ages 7–24 and their mothers antenatally and in middle age (N range = 145–1464). New age-specific episcores were trained in ALSPAC and evaluated at different ages. In all instances, episcore–protein associations were evaluated with and without adjustment for genetics. The association between longitudinal protein stability and longitudinal episcore projection was also evaluated, as was sex-specificity of episcores derived solely in female participants.

Findings
Of the 14 Gadd episcores, 10 generated estimates associated with abundance in middle age, 9 at age 24, and none at age 9. Eight of these episcores explained variation beyond genotype in adulthood (6 at age 24; 7 at midlife). At age 9, the abundances of 22 proteins could be modelled by DNAm, 7 beyond genotype of which one trained model generated informative estimates at ages 24 and in middle age. At age 24, 31 proteins could be modelled by DNAm, 19 beyond genotype, of which 5 trained models generated informative estimates at age 9 and 8 in middle age. In middle age, 23 proteins could be modelled, 13 beyond genotype, of which 3 were informative at age 9 and 7 at age 24.

Interpretation
We observed that episcores performed better at older ages than in children with several episcores capturing non-genetic variation at all ages.
In vitro and ex vivo evaluation of preclinical models for FAP-targeted theranostics: differences and relevance for radiotracer evaluation
Authors: van der Heide Circe D. , Campeiro Joana D. , Ruigrok Eline A. M. , van den Brink Lilian , Ponnala Shashikanth , Hillier Shawn M. , Dalm Simone U. 
Published: December 2024

Abstract
Background
Fibroblast activation protein (FAP) is an attractive target for cancer theranostics. Although FAP-targeted nuclear imaging demonstrated promising clinical results, only sub-optimal results are reported for targeted radionuclide therapy (TRT). Preclinical research is crucial in selecting promising FAP-targeted radiopharmaceuticals and for obtaining an increased understanding of factors essential for FAP-TRT improvement. FAP is mainly expressed by cancer-associated fibroblasts in the tumor stroma and less on cancer cells themselves. Therefore, other (complex) factors impact FAP-TRT efficacy compared to currently clinically applied TRT strategies. For accurate evaluation of these aspects, selection of a representative preclinical model is important. Currently mainly human cancer cell lines transduced to (over)express FAP are applied, lacking clinical representation. It is unclear how these and more physiological FAP-expressing models compare to each other, and whether/how the model influences the study outcome. We aimed to address this by comparing FAP tracer behavior in FAP-transduced HT1080-huFAP and HEK293-huFAP cells, and endogenous FAP-expressing U-87 MG cancer cells and PS-1 pancreatic stellate cells. [111In]In-FAPI-46 and a fluorescent FAP-targeted tracer (RTX-1370S) were used to compare tracer binding/uptake and localization in vitro and ex vivo. Additionally, FAP expression was determined with RT-qPCR and anti-FAP IHC.

Results
Although FAP expression was highest in HEK293-huFAP cells and cell line derived xenografts, this did not result in the highest tracer uptake. [111In]In-FAPI-46 uptake was highest in HT1080-huFAP, closely followed by HEK293-huFAP, and a 6-10-fold lower uptake for U-87 MG and PS-1 cells. However, ex vivo U-87 MG xenografts only showed a 2-fold lower binding compared to HT1080-huFAP and HEK293-huFAP xenografts, mainly because the cell line attracts murine fibroblasts as demonstrated in our RT-qPCR and IHC studies.

Conclusions
The interaction between FAP and FAP-targeted tracers differs between models, indicating the need for appropriate model selection and that comparing results across studies using different models is difficult.
Simulation analysis of the damage and recovery process in natural disasters: a case study of high-speed railways in Sichuan Province, China
Authors: Wu Junyi , Ishiro Taku 
Published: December 2024

AbstractThis study employs a dynamic input–output model to simulate the recovery process of a high-speed railway and the subsequent regional economic recovery following an earthquake. The analysis considers the impact of earthquakes of varying magnitudes on Sichuan Province, its neighboring areas, and the entire nation of China. The simulation is conducted against the backdrop of the restoration and reconstruction efforts in Sichuan Province post-earthquake. The findings reveal that the recovery speed of the high-speed railway transportation sector is influenced not only by the established recovery time, but also by the pace of recovery in adjacent industrial sectors and external inputs. Accelerated recovery in adjacent industrial sectors contributes to a faster recovery of the high-speed railway transportation sector. Furthermore, once the adjacent industrial sectors return to normal levels of recovery, the high-speed railway transportation sector follows suit, reaching the established recovery rate. In terms of regional economic recovery, provinces with smaller economies experience higher rates of economic reduction due to earthquakes. Conversely, provinces with a significant proportion of high-speed railways in their economies witness higher rates of economic reduction following seismic events. The insights derived from this study hold practical significance for guiding regional economic and transportation recovery and reconstruction efforts post-major earthquakes.