bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health and social care use, costs, and satisfaction among key workers accessing Resilience Hub support during the COVID-19 pandemic
Authors: Rowlandson Aleix , Varese Filippo , Davies Linda M. , French Paul , Allsopp Kate , Carter Lesley-Anne , Hind Daniel , McGuirk Katherine , Barrett Alan , Bhutani Gita , Huntley Fay , Jordan Joanne , Sarsam May , Cate Hein Ten , Walker Holly , Watson Ruth , Wilkinson Jack , Willbourn Jenni , Shields Gemma E. 
Published: February 2025

Abstract
Key workers are vulnerable to adverse mental health. To ensure service sustainability during COVID-19, Resilience Hubs were established across England offering outreach, screening, and mental health support. This evaluation aimed to describe wider service use, associated costs, and satisfaction among Hub clients (key workers) accessing Hub support. Clients accessing support across four Hubs were invited to complete a service use questionnaire, between 5 and 8 months post referral, collecting satisfaction, wider service use and cost data. Exploratory linear regression assessed the relationship between demographic variables and service use. Most Hub clients reported Hub contact post referral (219/299, 73.2%), with many accessing mental health support (171/299, 57.2%) or on waitlists (34/299, 11.4%). Satisfaction was high, with median helpfulness rated 92 (out of 100), and many stating that Hubs either fully (148/299, 49.5%) or partially (54/299, 18.1%) met their needs. Mental health support accounted for most service use, with higher total service use and costs when including Hub services (£514 versus £213). Key workers have complex needs. Hub services helped clients to access support, with high reported satisfaction indicating that Hubs met clients needs. Further research is required to assess how service use varies according to occupation or demographic characteristics, and whether Hubs are clinically and cost-effective.
Moments that matter: childhood pain treatment shapes pain for life—we can do better every time in every child
Authors: Slater Rebeccah , Walker Suellen , Eccleston Christopher , Bellieni Carlo , Hirekodi Tanvi , Carbajal Ricardo , Smart Lucinda , Laughey William , Cobo Maria M. , Friedrichsdorf Stefan 
Published: February 2025

Abstract

Background
Needle procedures, such as vaccinations, blood draws, and intravenous cannulation, are the most frequent source of childhood pain, causing fear and reducing the uptake of medical procedures. Every child has the right to expect pain relief, and we have evidence-based tools to reduce needle procedure-related pain. Therefore, the lack of analgesic provision for needle pain is not justified. We argue that better informed and motivated healthcare professionals and families can advocate for appropriate pain relief in every child, every time.

Observations
Engaging communication campaigns are needed to educate our healthcare professionals. Evidence-based modalities such as topical anaesthesia, sucrose or breastfeeding, comfort positioning, and age-appropriate distractions should be available for every child during needle procedures. However, high-quality information is not enough to change behaviour—healthcare professionals need to be motivated, encouraged, and inspired. Parents and carers should be empowered to advocate for their children and be aware that their child has the right to receive pain relief during these procedures.

Conclusions and relevance
This is a call to action—we need collaboration between academics, healthcare professionals, industry and charities, to expedite behavioural change and parental advocacy through high-quality communication strategies. Effective pain management in infants and children can play a crucial role in promoting the uptake of vaccinations and medical procedures and can influence future attitudes to pain.
Visceral adipose tissue area and proportion provide distinct reflections of cardiometabolic outcomes in weight loss; pooled analysis of MRI-assessed CENTRAL and DIRECT PLUS dietary randomized controlled trials
Authors: Klein Hadar , Zelicha Hila , Yaskolka Meir Anat , Rinott Ehud , Tsaban Gal , Kaplan Alon , Chassidim Yoash , Gepner Yftach , Blüher Matthias , Ceglarek Uta , Isermann Berend , Stumvoll Michael , Shelef Ilan , Qi Lu , Li Jun , Hu Frank B. , Stampfer Meir J. , Shai Iris 
Published: February 2025

Abstract

Background
Visceral adipose tissue (VAT) is well established as a pathogenic fat depot, whereas superficial subcutaneous adipose tissue (SAT) is associated with either an improved or neutral cardiovascular state. However, it is unclear to what extent VAT area (VATcm2) and its proportion of total abdominal adipose tissue (VAT%) are distinguished in predicting cardiometabolic status and clinical outcomes during weight loss.

Methods
We integrated magnetic resonance imaging (MRI) measurements of VAT, deep-SAT, and superficial-SAT from two 18-month lifestyle weight loss clinical trials, CENTRAL and DIRECT PLUS (n = 572).

Results
At baseline, the mean VATcm2 was 144.8cm2 and VAT% = 28.2%; over 18 months, participants lost 28cm2 VATcm2 (− 22.5%), and 1.3 VAT% units. Baseline VATcm2 and VAT% were similarly associated with metabolic syndrome, hypertension, and diabetes status, while VAT% better classified hypertriglyceridemia. Conversely, higher VATcm2 was associated with elevated high-sensitivity C-reactive protein (hsCRP), while VAT% was not. After 18 months of lifestyle intervention, both VATcm2 and VAT% loss were significantly associated with decreased triglycerides, HbA1c, ferritin, and liver enzymes, and increased HDL-c levels beyond weight loss (FDR < 0.05). Only VATcm2 loss was correlated with decreased HOMA-IR, chemerin, and leptin levels.

Conclusions
MRI follow-up of 572 participants over 18 months of weight loss intervention suggests that although increased VATcm2 and VAT% exhibit similar clinical manifestations, it might be preferable to examine VAT% when exploring lipid status, while VATcm2 may better reflect inflammatory and glycemic states.

Trial registration
CENTRAL (Clinical-trials-identifier: NCT01530724); DIRECT PLUS (Clinical-trials-identifier: NCT03020186).
Exploration of treatment burden through examination of workload and patient capacity during transition onto kidney replacement therapy: a systematic review of qualitative research
Authors: Jones Catrin , Cairns Ross , Walker Heather , Welsh Silje , Edgar Benjamin , Stevenson Karen , Jani Bhautesh D. , Mark Patrick B. , Kingsmore David , Gallacher Katie I. 
Published: February 2025

Abstract

Background
Patients with advanced chronic kidney disease requiring initiation of kidney replacement therapy (KRT) are frequently asked to enact complex management plans. Treatment burden has been defined as the effect of healthcare workload and the capacity a person has to manage this workload has on wellbeing. The aim of this review is to examine the experience of healthcare workload and the factors that affect capacity to meet that workload for people transitioning onto KRT for the first time, using a framework synthesis of published literature informed by normalisation process theory (NPT) and theory of patient capacity (TPC).

Methods
Medline, Scopus and CINAHL were systematically searched with manual citation and reference searching. Studies were included if meeting the criteria of adults aged 18 or over transitioning for the first time onto any modality of KRT (haemodialysis, peritoneal dialysis or kidney transplantation), using qualitative methodologies to describe any aspect of experiences of healthcare workload or any factors that affect capacity to manage workload were included. Abstracts and full papers were independently screened by two reviewers and data extraction and quality appraisal were also independently conducted by two reviewers. Qualitative data were analysed using framework synthesis informed by NPT and TPC.

Results
A total of 24,380 studies were screened, 406 full texts were reviewed and 18 studies were included. There were four broad categories of workload described: making sense of KRT, working out what to do and how to do it, meeting the challenges of KRT, and reflecting on work done. Patient capacity influenced the experience of all types of workload and the treatment burden generated by the work.

Conclusions
Transitioning onto KRT is a period of very high healthcare workload and potentially high treatment burden. The relationship between healthcare workload and capacity to handle workload is complex, multifactorial and changes over time. By better understanding workload, capacity and burden during transition, we can develop better ways of measuring these important aspects of care and develop interventions to reduce treatment burden in those transitioning onto KRT.
PhantomAR: gamified mixed reality system for alleviating phantom limb pain in upper limb amputees—design, implementation, and clinical usability evaluation
Authors: Prahm Cosima , Eckstein Korbinian , Bressler Michael , Wang Zhixing , Li Xiaotong , Suzuki Takashige , Daigeler Adrien , Kolbenschlag Jonas , Kuzuoka Hideaki 
Published: February 2025

Abstract

Background
Phantom limb pain (PLP) is a restrictive condition in which patients perceive pain in a limb that is no longer present, greatly reducing their quality of life. Mirror Therapy, wherein patients observe a mirror reflection of their intact limb, has demonstrated efficacy in alleviating PLP. However, its unilateral and seated nature presents limitations. To address these constraints while still reducing PLP, and evaluating the impact of different virtual limb representations (anthropomorphic vs. non-anthropomorphic) on the user’s sense of ownership, agency, and embodiment, PhantomAR was developed. Leveraging wearable first-person augmented reality (AR) technology, PhantomAR extends traditional Mirror Therapy by enabling users to move freely and engage in bimanual tasks.

Methods
The assistive mixed reality game application PhantomAR was deployed on the Microsoft HoloLens 2 and augmented the user’s residual limb by superimposing a virtual arm or tentacle that was controlled via residual muscles on their stump using an EMG electrode array. This setup allowed patients to engage in a first-person perspective and manipulate virtual objects with both the healthy and augmented limbs, free from the confines of a seated position. The study enrolled 10 able-bodied individuals and 8 individuals with unilateral, transradial amputation. All amputees experienced PLP. The usability of the PhantomAR application was evaluated using the System Usability Scale (SUS) and a user-centric survey. Additionally, the Game Experience was assessed on a 5-point Likert questionnaire (GEQ). Participants rated their phantom sensations using the Numerical Rating Scale and McGill Pain Questionnaire before, during, and after interaction with PhantomAR. The embodiment and agency of the virtual superimposed arm were evaluated with an altered Prosthesis Embodiment Scale. The study protocol included two sessions of 30 min each, during which participants experienced PhantomAR.

Results
Participants (n = 18) rated PhantomAR highly usable (SUS m = 90.8%, SD = 6.88). Feedback on the Game Experience Questionnaire was overwhelmingly positive, showing high immersion (m = 4.46, SD = 0.08) and positive affect (m = 4.97, SD = 0.05). PLP (n = 8) significantly decreased post-intervention (NRS and McGill Pain Questionnaire, p < .001). Skin temperature in the residual limb increased significantly post-intervention (p < .01) but did not correlate with PLP (r = − 0.08, p = 0.83). Tentacle overlay yielded mixed ownership but high agency ratings.

Conclusion
PhantomAR leverages mixed reality to significantly reduce Phantom Limb Pain, enhance user engagement, and alter perceptions of ownership and agency of their augmented limb through bi-manual, dynamic, full-body interactions.

Trial registration DRKS00033208 (Jan. 5th 2024)
UAV rice panicle blast detection based on enhanced feature representation and optimized attention mechanism
Authors: Lin Shaodan , Huang Deyao , Wu Libin , Cheng Zuxin , Ye Dapeng , Weng Haiyong 
Published: February 2025

Abstract

Background
Rice blast is one of the most destructive diseases in rice cultivation, significantly threatening global food security. Timely and precise detection of rice panicle blast is crucial for effective disease management and prevention of crop losses. This study introduces ConvGAM, a novel semantic segmentation model leveraging the ConvNeXt-Large backbone network and the Global Attention Mechanism (GAM). This design aims to enhance feature extraction and focus on critical image regions, addressing the challenges of detecting small and complex disease patterns in UAV-captured imagery. Furthermore, the model incorporates advanced loss functions to handle data imbalances effectively, supporting accurate classification across diverse disease severities.

Results
The ConvGAM model, leveraging the ConvNeXt-Large backbone network and the Global Attention Mechanism (GAM), achieves outstanding performance in feature extraction, crucial for detecting small and complex disease patterns. Quantitative evaluation demonstrates that the model achieves an overall accuracy of 91.4%, a mean IoU of 79%, and an F1 score of 82% on the test set. The incorporation of Focal Tversky Loss further enhances the model's ability to handle imbalanced datasets, improving detection accuracy for rare and severe disease categories. Correlation coefficient analysis across disease severity levels indicates high consistency between predictions and ground truth, with values ranging from 0.962 to 0.993. These results confirm the model’s reliability and robustness, highlighting its effectiveness in rice panicle blast detection under challenging conditions.

Conclusion
The ConvGAM model demonstrates strong qualitative advantages in detecting rice panicle blast disease. By integrating advanced feature extraction with the ConvNeXt-Large backbone and GAM, the model achieves precise detection and classification across varying disease severities. The use of Focal Tversky Loss ensures robustness against dataset imbalances, enabling accurate identification of rare disease categories. Despite these strengths, future efforts should focus on improving classification accuracy and adapting the model to diverse environmental conditions. Additionally, optimizing model parameters and exploring advanced data augmentation techniques could further enhance its detection capabilities and expand its applicability to broader agricultural scenarios.
Synthetic CT generation from CBCT and MRI using StarGAN in the Pelvic Region
Authors: Wongtrakool Paritt , Puttanawarut Chanon , Changkaew Pimolpun , Piasanthia Supakiet , Earwong Pareena , Stansook Nauljun , Khachonkham Suphalak 
Published: February 2025

Abstract

Rationale and objectives
This study evaluated StarGAN, a deep learning model designed to generate synthetic computed tomography (sCT) images from magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) data using a single model. The goal was to provide accurate Hounsfield unit (HU) data for dose calculation to enable MRI simulation and adaptive radiation therapy (ART) using CBCT or MRI. We also compared the performance and benefits of StarGAN to the commonly used CycleGAN.

Materials and methods
StarGAN and CycleGAN were employed in this study. The dataset comprised 53 cases of pelvic cancer. Evaluation involved qualitative and quantitative analyses, focusing on synthetic image quality and dose distribution calculation.

Results
For sCT generated from CBCT, StarGAN demonstrated superior anatomical preservation based on qualitative evaluation. Quantitatively, CycleGAN exhibited a lower mean absolute error (MAE) for the body (42.8 ± 4.3 HU) and bone (138.2 ± 20.3), whereas StarGAN produced a higher MAE for the body (50.8 ± 5.2 HU) and bone (153.4 ± 27.7 HU). Dosimetric evaluation showed a mean dose difference (DD) within 2% for the planning target volume (PTV) and body, with a gamma passing rate (GPR) > 90% under the 2%/2 mm criteria. For sCT generated from MRI, qualitative evaluation also favored the anatomical preservation provided by StarGAN. CycleGAN recorded a lower MAE (79.8 ± 14 HU for the body and 253.6 ± 30.9 HU for bone) compared with StarGAN (94.7 ± 7.4 HU for the body and 353.6 ± 34.9 HU for bone). Both models achieved a mean DD within 2% in the PTV and body, and GPR > 90%.

Conclusion
While CycleGAN exhibited superior quantitative metrics, StarGAN was better in anatomical preservation, highlighting its potential for sCT generation in radiotherapy.
Intravenous leiomyomatosis presenting as Budd–Chiari syndrome: a case report and literature review
Authors: Gan Jingwen , Ma Xiao , Shao Jiang , Wang Jinhui , Cao Dongyan 
Published: February 2025

Abstract

Background
Budd–Chiari syndrome (BCS) caused by intravenous leiomyomatosis (IVL) is rare. Further reports and thorough evaluation are needed to identify and manage this disease.

Method
We described the case of a 49-year-old lady, exhibiting features of BCS secondary to IVL, and reviewed three other previous cases of BCS caused by IVL.

Results
The mean onset age of these four patients was 54.8 years. All but one (Patient No. 2) had a history of myoma, myomectomy, or hysterectomy. Abdominal pain, bloating or increasing abdominal circumference, and bilateral lower extremity edema were common symptoms. The establishment of clinical diagnoses of IVL and BCS mainly depends on clinical presentations and imaging, such as ultrasonography, computed tomography, and magnetic resonance imaging. Surgical intervention to alleviate the hepatic veins outflow obstruction is the most important treatment.

Conclusions
BCS caused by IVL should be considered when the inferior vena cava and right atrium lesions were detected in a patient with characteristics of BCS and a history of uterine myoma or hysterectomy. Complete tumor resection is the only curative treatment and should be performed as soon as possible.
The effect of GM-CSF and predictors of treatment outcome in pediatric septic shock patients
Authors: Yu Zhen-Hao , Tian Gui-Xiang , Wang Yao-Dong , Liu Ting-Yan , Shi Peng , Ying Jia-Yun , Chen Wei-Ming , Zhou Yu-Feng , Lu Guo-Ping , Zhang Cai-Yan 
Published: February 2025

Abstract

Background
Pediatric septic shock is a critical condition associated with high mortality rates, largely due to sepsis-induced immunosuppression. Granulocyte-macrophage colony-stimulating factor (GM-CSF) has been explored as a therapeutic intervention to counteract this immunosuppression. Despite its potential, the efficacy of GM-CSF in pediatric septic shock has not been clearly established. This study aims to investigate the impact of GM-CSF administration on survival rates and to identify key predictors of treatment outcomes in pediatric septic shock patients.

Methods
We conducted a retrospective cohort study at the Pediatric Intensive Care Unit (PICU) of Children’s Hospital of Fudan University, Shanghai, from January 1, 2019, to December 31, 2023. The study included pediatric patients diagnosed with septic shock, analyzing their demographic data, GM-CSF and adjunctive therapies, laboratory results, and clinical outcomes. We employed univariate and multivariate logistic regression models to assess the influence of GM-CSF on 28-day mortality and identify significant predictors of treatment outcomes.

Results
The study included 200 pediatric patients, with 66 receiving GM-CSF treatment and 134 not treated with GM-CSF. The initial comparison showed a higher 28-day mortality in the GM-CSF group (59.1%) compared to the non-GM-CSF group (35.1%, P = 0.001). Notably, after adjustment for confounding factors, multivariate analysis revealed that the effect of GM-CSF treatment on 28-day mortality among pediatric septic shock patients did not reach statistical significance, with an odds ratio (OR) of 0.472 and a 95% confidence interval (CI) ranging from 0.153 to 1.457 (P = 0.192). However, the analysis indicated a potential trend suggesting that GM-CSF treatment may contribute to a reduction in 28-day mortality. In addition, significant predictors of treatment outcomes included hematopoietic stem cell transplantation (HSCT), lactic acid (LAC) levels, hospital-acquired septic shock (HASS), red blood cell (RBC) count, and platelet (PLT) count.

Conclusions
GM-CSF treatment may benefit pediatric septic shock patients, especially those with higher lactic acid, and lower RBC and platelet counts. These factors, which are significant predictors of outcomes, should be monitored during therapy.
Quantifying the tumour vasculature environment from CD-31 immunohistochemistry images of breast cancer using deep learning based semantic segmentation
Authors: Whitmarsh Tristan , Cope Wei , Carmona-Bozo Julia , Manavaki Roido , Sammut Stephen-John , Woitek Ramona , Provenzano Elena , Brown Emma L. , Bohndiek Sarah E. , Gallagher Ferdia A. , Caldas Carlos , Gilbert Fiona J. , Markowetz Florian 
Published: February 2025

Abstract

Background
Tumour vascular density assessed from CD-31 immunohistochemistry (IHC) images has previously been shown to have prognostic value in breast cancer. Current methods to measure vascular density, however, are time-consuming, suffer from high inter-observer variability and are limited in describing the complex tumour vasculature morphometry.

Methods
We propose a method for automatically measuring a range of vascular parameters from CD-31 IHC images, which together provide a detailed description of the vasculature morphology. We first used a U-Net based convolutional neural network, trained and validated using 36 partially annotated whole slide images from 27 patients, to segment vessel structures and tumour regions from which the measurements are taken. The model also segments the vascular smooth muscle, benign epithelium, adipose tissue, stroma, lymphocyte clusters, nerves and CD-31 positive leukocytes, and we applied it to an additional 21 images from 15 patients. Using these segmentations, we investigated the relationship between the various tissue types and the vasculature and studied the relationship of various vascular parameters with clinical parameters. We also performed a 3D histology analysis on a separate tumour sample as a proof of principle, providing a more comprehensive visualization of vasculature morphology compared to the standard 2D cross-section of a tissue sample.

Results
Using two-way cross-validation, we show that vessels were accurately segmented, with Dice scores of 0.875 and 0.856, and were accurately identified, with F1 scores of 0.777 and 0.748. All vascular parameters exhibit strong (

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) and significant (p<0.001) correlations with measurements taken from the manual ground truth vessel segmentations. A significant relationship between the major/minor axis ratio, a measure of elongation, and the tumour grade was found.

Conclusion
Our proposed method shows promise as a tool for studying the tumour vasculature and its relationship with surrounding cells and tissue types. Furthermore, the correlation with tumour grade highlights the clinical relevance of our approach. These findings suggest that our method could have substantial implications for improving prognostic assessments and personalizing therapeutic strategies in breast cancer treatment.