bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards measuring food insecurity stigma: development and validation of the Food Insecurity Self-stigma Scale and the Food Support Experiences Scale
Authors: Taylor Natalie , Boyland Emma , Christiansen Paul , Southern Alan , Hardman Charlotte A. 
Published: November 2024

Abstract
Background
Within high income countries, individuals experiencing food insecurity have become increasingly reliant on food support to satisfy household food needs. However, experiencing food insecurity and accessing food support are highly stigmatised, negatively impacting psychological and emotional wellbeing. Being able to quantify this stigma may contribute towards reducing these impacts. This study aimed to develop and validate two novel scales enabling the quantification of stigma concepts within the food insecurity and food support context: (1) the Food Insecurity Self-stigma Scale (FISS), which measures the level of self-stigma (and related constructs) that individuals experiencing food insecurity feel regarding their food insecure status; and (2) the Food Support Experiences Scale (FSES), which measures the psycho-social experiences (including the experience of self-stigma) when individuals access a food support service.

Methods
English speaking participants who identified as experiencing food insecurity completed the new FISS (N = 211) and FSES (N = 123) measures, alongside other validation measures. Exploratory (EFA) and confirmatory factor analysis (CFA) were carried out for both scales. Regressions using latent variables derived from the CFA were used to test convergent and divergent validity. McDonald’s Omega was used to assess internal reliability and intra-class correlations between initial and retest FISS and FSES scores of a small number of participants (FISS: N = 14; FSES: N = 8) were used to assess test-retest reliability.

Results
EFA indicated three-factor structures best fit both scales. CFA revealed a good fit of the model for the FISS (15 items; 3 factors: righteous anger, non-disclosure, and stereotype endorsement). Meanwhile, an acceptable-to-poor fit of the model was revealed for the FSES (23 items; 3 factors: self-approval and disclosure, dietary and interpersonal satisfaction, and perceived effectiveness and impact). Importantly, convergent validity was only found for the non-disclosure subscale of the FISS and the self-approval and disclosure subscale of the FSES.

Conclusions
The FISS and FSES provide valid tools for quantifying aspects of stigma relating to the experience of food insecurity and accessing food support respectively. Development of these two scales may provide an important first step towards measuring stigma. developing interventions which reduce this psychological burden, and working to promote psychological wellbeing within populations experiencing food insecurity.
Systematic review—understanding the barriers and facilitators experienced by healthcare professionals in providing care for tics: a mixed methods systematic review of clinical knowledge, attitudes, and practices
Authors: Parker Adam , French Blandine , Groom Madeline J. , Hall Charlotte L. 
Published: November 2024

AbstractTic disorders (TDs) have a prevalence of approximately 1%, and while various therapies have demonstrated effectiveness, people with tics and their families report a lack of understanding by healthcare professionals (HCPs). This systematic review included 13 papers featuring HCPs, people with tics, and their families about their experiences of either delivering or accessing care for tics, which were then divided into three themes. The first theme, Need for Education and Effective Implementation, suggested that while HCPs demonstrated good knowledge of tics, patient experiences indicated that this did not always translate to the care they received, potentially due to low confidence and a lack of formal training. The second theme, Misinterpretation, Misdiagnosis and Stigma, suggested that HCPs held incorrect beliefs about tics and would misinterpret tic symptoms, while caregiver responsibility for their child’s tics would both positively and negatively impact care-seeking behaviour, partly depending on their cultural belief system. Finally, the Communication between Healthcare Professionals and Families revealed that poor communication of a tic disorder diagnosis can exacerbate anxiety within the family. The themes of this review were demonstrated universally, demonstrating that HCPs around the world should be encouraged to understand tics and tic disorders confidently to improve the healthcare outcomes and experiences of those living with tics.
Risk factors for deep surgical site infections following orthopedic trauma surgery: a meta-analysis and systematic review
Authors: Liu Huan , Wang Yanan , Xing Hao , Chang Zhengqi , Pan Junlin 
Published: November 2024

Abstract
Objective
We conducted this meta-analysis to explore the risk factors and incidence of deep surgical site infections (DSSIs) after orthopaedic trauma surgery.

Methods
A systematic search was conducted across various databases, including MEDLINE, Embase, Cochrane Library, and Web of Science, for studies examining risk factors associated with DSSIs after bone trauma procedures. The search concluded on September 1, 2024. Data analysis was performed using Stata 15.0.

Results
Among 2,722 publications screened, 16 studies that met the eligibility criteria were included in the analysis, involving a total of 22,318 patients, of whom 894 experienced DSSIs. The meta-analysis revealed a combined incidence of deep infections after orthopedic trauma surgery at [ES = 6.7%, 95% CI (5.1%–8.2%)]. Risk factors identified included male gender [OR = 1.99, 95% CI (1.39, 2.86), p < 0.0001], current smoking status [OR = 2.60, 95% CI (1.85, 3.65), p < 0.0001], open injuries [OR = 3.17, 95% CI (1.72, 5.85), p < 0.0001], a BMI greater than 26.0 kg/m2 [OR = 1.95, 95% CI (1.24, 3.07), p = 0.004], wound class ≥ 2 [OR = 2.40, 95% CI (1.56, 3.70), p < 0.0001], and a surgery duration of 60 min or more [OR = 2.41, 95% CI (1.63, 3.55), p < 0.0001]. These factors significantly contribute to the risk of developing DSSIs post-surgery. However, age did not exhibit a significant difference.

Conclusion
This study identifies key risk factors for DSSI following orthopedic trauma surgery, addressing a gap in the existing literature and offering some insights for clinical decision-making. To mitigate the risk of DSSI, clinical practice should encourage patients to lose weight and quit smoking prior to surgery, optimize surgical procedures, and improve wound management strategies. Future research should aim to standardize follow-up durations and further refine the classification of risk factors, in order to validate and expand on the conclusions of this study.
The challenges of hepatic epithelioid hemangioendothelioma: the diagnosis and current treatments of a problematic tumor
Authors: Atyah Manar Mikhail , Sun Yongliang , Yang Zhiying 
Published: November 2024

Abstract
Background
Hepatic epithelioid hemangioendothelioma (HEHE) is a malignant vascular tumor known for its rarity. The different types of this hepatic tumor (single, multiple-nodular or diffused) indicate different prognosis and treatment plans. However, the heterogenic clinical manifestation creates a dilemma and a wide range of challenges when attending to HEHE patients. This review addresses the unique profile and clinical challenges that complicate the diagnosis and treatment of HEHE while focusing on current therapeutic strategies and their limitations.

Main text
The unclear etiology is a challenging feature of HEHE. The exact involvement of potential risk factors and mechanism of development are still undefined. Relevant genetic alterations like WWTR1–CAMTA1 fusion have been investigated; however, they are only applicable as diagnostic markers and their influence on therapeutic efficacy is largely unknown. Other characteristics include asymptomatic manifestation, lack of unique hepatic functional alterations, high rates of misdiagnosis and late-stage identification when metastases already exist. Currently, tissue biopsy is the main tool to establish a definite diagnosis but is challenged with the limited awareness to suspect HEHE at early stages and the lack of relevant guidelines due to the rarity and the insufficiency of relevant research. The absence of treatment guidelines is the greatest challenge of HEHE. Generally, Surgical approaches are recommended due to the benefits of prolonged survival and enhanced prognosis. Nonetheless, only a minority of patients are eligible for resections while liver transplants are faced with severe insufficiency of donor organs and long wait-lists. On the other hand, a variety of non-surgical treatments (like anti-angiogenic agents, interferon alpha-2B and sirolimus) are presented with a promising potential. However, relevant studies are challenged with limited sample-sizes and lack of prospective designs.

Conclusion
Regardless to decades passing since its discovery, HEHE still creates a dilemma due to its challenging clinical profile and lack of treatment guidelines. Raising awareness of HEHE in clinical practices improves the ability to diagnose this rare tumor at early stages and develop stronger research strategies and treatment guidelines to regulate the medical care provided to HEHE patients.
Quality of life and caregiving burden associated with parenting a person with Duchenne/Becker muscular dystrophy in Poland
Authors: Domaradzki Jan , Walkowiak Dariusz 
Published: November 2024

Abstract
Background
Duchenne and Becker muscular dystrophies (DBMD) are rare progressive, X-linked diseases of muscle wasting characterised by the early onset and prognosis of premature death. The aim of this study was to evaluate the impact of providing care for a person with DBMD on caregivers’ quality of life, perceived burden and financial well-being.

Results
202 Polish caregivers of a person with DBMD were included and completed a self-administered, computer-assisted online survey. Results show that DBMD affects the quality of life of caregivers who score significantly lower than the national average in every domain: 85.1% of DBMD caregivers scored below the national average in the physical health domain; in the environmental domain 83.7%; in the social relationships domain 82.2%; and in the psychological domain 72.3%. It also demonstrates that DBMD is a source of severe burden (mean score of 35.3). Finally, we report that while some dimensions of respondents’ quality of life and perceived burden were associated with patients’ age and caregivers’ educational status, financial well-being was the most important predictor of respondents’ quality of life and caregiving burden.

Conclusions
To improve DBMD caregivers’ quality of life and alleviate their burden, future intervention programs should promote resiliency and active coping and develop a social support system and respite care. Additionally, it is crucial to provide caregivers with adequate financial resources to fulfil their needs.
Pre-hospital management of penetrating neck injuries: derivation of an algorithm through a National Modified Delphi
Authors: Simpson Christopher , Tucker Harriet , Griggs Joanne , Gavrilovski Maja , Lyon Richard , Hudson Anthony ,   Air Ambulance Charity Kent Surrey Sussex, Breeze John , Hughes Michael , Leech Caroline , Watts Adam , Omeara Matt , Scurr Cosmo , Cowley Alan , ter Avest Ewoud , Brown Vicki , Russell Malcolm , Barnard Ed , Cowburn Phil , Hurst Tom , Dunne Andy , Walmsley Jim , Moore Fionna , Charlton Will , Lewis Simon , Hardy Pam , Edwards Tim , Yates James , Lang Nigel , Ingram Gordon , Bell Steve , Fitchett Clare , Curran Andy , Boylan Matthew , Battaloglu Emir , Nutbeam Tim , Taylor Matt , Smith Carl , Ley Erica , James Alex 
Published: December 2024

Abstract
Background
Timely and effective pre-hospital management of penetrating neck injuries (PNI) is critical to improve patient outcomes. Pre-hospital interventions in patients with PNI can be especially challenging due to the anatomical injury site coupled with a resource-limited environment. Nationally, in the United Kingdom, no consensus statement or expert agreed guidance exists on how to best manage PNI in the pre-hospital setting.

Method
We conducted a national modified e-Delphi study with subject matter experts (SMEs) from multiple professional specialities with experience in the management of PNI. Pre-identified SMEs were contacted and consented prior to participation allowing for a remotely conducted Delphi using REDCap and Microsoft Teams. In Round 1, statements drawn from the literature base were distributed to all SMEs. Round 2 comprised a facilitated and structured discussion of the statements and then an online survey provided final ratification in Round 3. Of the participating SMEs consensus was set a priori at 70%.

Results
Of the 67 pre-identified SMEs, 28 participated, resulting in a response rate of 42%. From the first two rounds, 19 statements were derived with every statement achieving consensus in Round 3. Subsequently, an algorithm for the pre-hospital management of PNI was developed and agreed with SME consensus.

Conclusion
Curation of national consensus statements from SMEs aims to provide principles and guidance for PNI management in a complicated patient group where pre-hospital evidence is lacking. Multi-professional national consensus on the best approach to manage these injuries alongside a novel PNI management algorithm aims to optimise time critical care and by extension improve patient outcomes.
EpiCHAOS: a metric to quantify epigenomic heterogeneity in single-cell data
Authors: Kelly Katherine , Scherer Michael , Braun Martina Maria , Lutsik Pavlo , Plass Christoph 
Published: December 2024

Abstract
Epigenetic heterogeneity is a fundamental property of biological systems and is recognized as a potential driver of tumor plasticity and therapy resistance. Single-cell epigenomics technologies have been widely employed to study epigenetic variation between—but not within—cellular clusters. We introduce epiCHAOS: a quantitative metric of cell-to-cell heterogeneity, applicable to any single-cell epigenomics data type. After validation in synthetic datasets, we apply epiCHAOS to investigate global and region-specific patterns of epigenetic heterogeneity across diverse biological systems. EpiCHAOS provides an excellent approximation of stemness and plasticity in development and malignancy, making it a valuable addition to single-cell cancer epigenomics analyses.
A multi-scene deep learning model for automated segmentation of acute vertebral compression fractures from radiographs: a multicenter cohort study
Authors: Zhang Hao , Yuan Genji , Zhang Ziyue , Guo Xiang , Xu Ruixiang , Xu Tongshuai , Zhong Xin , Kong Meng , Zhu Kai , Ma Xuexiao 
Published: December 2024

Abstract
Objective
To develop a multi-scene model that can automatically segment acute vertebral compression fractures (VCFs) from spine radiographs.

Methods
In this multicenter study, we collected radiographs from five hospitals (Hospitals A–E) between November 2016 and October 2019. The study included participants with acute VCFs, as well as healthy controls. For the development of the Positioning and Focus Network (PFNet), we used a training dataset consisting of 1071 participants from Hospitals A and B. The validation dataset included 458 participants from Hospitals A and B, whereas external test datasets 1–3 included 301 participants from Hospital C, 223 from Hospital D, and 261 from Hospital E, respectively. We evaluated the segmentation performance of the PFNet model and compared it with previously described approaches. Additionally, we used qualitative comparison and gradient-weighted class activation mapping (Grad-CAM) to explain the feature learning and segmentation results of the PFNet model.

Results
The PFNet model achieved accuracies of 99.93%, 98.53%, 99.21%, and 100% for the segmentation of acute VCFs in the validation dataset and external test datasets 1–3, respectively. The receiver operating characteristic curves comparing the four models across the validation and external test datasets consistently showed that the PFNet model outperformed other approaches, achieving the highest values for all measures. The qualitative comparison and Grad-CAM provided an intuitive view of the interpretability and effectiveness of our PFNet model.

Conclusion
In this study, we successfully developed a multi-scene model based on spine radiographs for precise preoperative and intraoperative segmentation of acute VCFs.

Critical relevance statement
Our PFNet model demonstrated high accuracy in multi-scene segmentation in clinical settings, making it a significant advancement in this field.

Key Points

This study developed the first multi-scene deep learning model capable of segmenting acute VCFs from spine radiographs.

The model’s architecture consists of two crucial modules: an attention-guided module and a supervised decoding module.

The exceptional generalization and consistently superior performance of our model were validated using multicenter external test datasets.

Graphical Abstract
Embracing sex-specific differences in engineered kidney models for enhanced biological understanding of kidney function
Authors: Veser Charlotte , Carlier Aurélie , Dubois Vanessa , Mihăilă Silvia M. , Swapnasrita Sangita 
Published: December 2024

AbstractIn vitro models serve as indispensable tools for advancing our understanding of biological processes, elucidating disease mechanisms, and establishing screening platforms for drug discovery. Kidneys play an instrumental role in the transport and elimination of drugs and toxins. Nevertheless, despite the well-documented inter-individual variability in kidney function and the multifaceted nature of renal diseases—spanning from their origin, trigger and which segment of the kidney is affected—to presentation, progression and prognosis, few studies take into consideration the variable of sex. Notably, the inherent disparities between female and male biology warrants a more comprehensive representation within in vitro models of the kidney. The omission of sex as a fundamental biological variable carries the substantial risk of overlooking sex-specific mechanisms implicated in health and disease, along with potential differences in drug responsiveness and toxicity profiles between sexes. This review emphasizes the importance of incorporating cellular, biological and functional sex-specific features of renal activity in health and disease in in vitro models. For that, we thoroughly document renal sex-specific features and propose a strategic experimental framework to integrate sex-based differences into human kidney in vitro models by outlining critical design criteria to elucidate sex-based features at cellular and tissue levels. The goal is to enhance the accuracy of models to unravel renal mechanisms, and improve our understanding of their impact on drug efficacy and safety profiles, paving the way for a more comprehensive understanding of patient-specific treatment modalities.
Exemplar Hospital Initiation Trial to Enhance Treatment Engagement (EXHIT ENTRE): protocol for CTN-0098 an open-label randomized comparative effectiveness trial of extended-release buprenorphine versus treatment as usual on post-hospital treatment engagement for hospitalized patients with opioid use disorder
Authors: Bart Gavin , Barth Kelly S. , Baukol Paulette , Enns Eva , Ghitza Udi E. , Harris Jacklyn , Jelstrom Eve , Liebschutz Jane M. , Magane Kara M. , Voronca Delia , Weinstein Zoe M. , Korthuis P. Todd 
Published: December 2024

Abstract
Background
Hospitalizations involving opioid use disorder (OUD) are increasing. Addiction consultation services (ACS) initiate medications for opioid use disorder (MOUD) in hospital settings and arrange post-hospital follow-up for ongoing MOUD care. Engagement in MOUD following hospital discharge is hampered by challenges in timely access to MOUD. This protocol describes an open-label randomized comparative effectiveness trial comparing ACS treatment as usual (TAU) to a single injection of a 28-day formulation extended-release buprenorphine (XR-BUP) on MOUD engagement 34-days following hospital discharge.

Methods
Six U.S. hospitals with ACS capable of prescribing all MOUD (i.e., methadone, buprenorphine, and extended-release naltrexone) recruit and randomize hospitalized patients with OUD who have not been on MOUD in the fourteen days prior to hospitalization. TAU may consist of any MOUD other than XR-BUP. Participants randomized to XR-BUP may receive any MOUD throughout their hospital stay and receive a 28-day XR-BUP injection within 72-hours of anticipated hospital discharge. There is no intervention beyond hospital stay. Participants are followed 34-, 90-, and 180-days following hospital discharge. The primary outcome is engagement in any MOUD 34-days following hospital discharge, which we hypothesize will be greater in the XR-BUP group. Randomizing 342 participants (171 per arm) provides 90% power to detect difference in the primary outcome between groups with an odds ratio of 2.1. Safety, secondary, and exploratory outcomes include: adverse events, MOUD engagement on days 90 and 180, opioid positive urine drug tests, self-reported drug use, hospital readmissions and emergency department visits, use of non-opioid drugs, fatal and non-fatal opioid overdose, all-cause mortality, quality of life, and cost-effectiveness. Data are analyzed by intention-to-treat, with pre-planned per-protocol and other secondary analyses that examine gender as an effect modifier, differences between groups, and impact of missingness.

Discussion
Engagement in MOUD care following hospitalization in individuals with OUD is low. This randomized comparative effectiveness trial can inform hospital ACS in medication selection to improve MOUD engagement 34-days following hospital discharge.

Trial registration
NCT04345718.
Regaining control over alcohol intake but not abstinence on disulfiram medication, as a harm reduction approach: 2 case reports
Authors: Schallenberg Max , Pilhatsch Maximilian , Petzold Johannes , Vogel-Blaschka Diana , Zimmermann Ulrich S. , Spreer Maik 
Published: December 2024

Abstract
Background
Alcohol use disorder (AUD) poses severe health risks, yet many affected individuals opt out of complete abstinence. Therefore, harm reduction strategies have become more prominent in treatment guidelines for AUD. Our two case reports illustrate how disulfiram, initially intended to enforce abstinence, was repurposed to support reduced drinking.

Case Presentations
A 41-year-old patient with a history of severe AUD successfully reduced his alcohol consumption to a low-risk level by leveraging the effects of the disulfiram-alcohol aversive reaction. Another patient, a 63-year-old woman with long histories of AUD and major depressive disorder, experienced fewer depressive episodes and hospitalizations with disulfiram therapy despite periodically intentional discontinuation of medication.

Conclusion
Individualized treatment strategies are critical in optimizing outcomes for patients with AUD. Continuous disulfiram therapy, despite its limitations in directly reducing alcohol intake, might offer a new avenue for harm reduction in exceptional cases even if alcohol consumption continues. The cases suggest that maintaining therapy, aiming at reduced drinking, can enhance the therapeutic alliance and help manage comorbid conditions. Regular medical monitoring is essential for safety and efficacy, warranting further study of possible long-term consequences and psychotropic effects of elevated acetaldehyde levels related to the disulfiram-alcohol interaction.