bluuebunny/crossref_metadata_2025_split huggingface dataset:
National charitable fundraising for the NHS, 1948–2023
Authors: Stewart Ellen , Cresswell Rosemary , Möller Christian 
Published: July 2024

AbstractWhether charitable fundraising might play a part in funding Britain's ostensibly tax‐funded NHS has been a longstanding dilemma, which until recently has received only occasional scholarly attention. In 1946, Aneurin Bevan argued that one of the main goals of the reformed health care system was to liberate health care from the ‘caprice of private charity’. Seven decades later, NHS Charities Together's Urgent Covid‐19 Appeal became a powerful societal rallying cry in the health emergency of the pandemic and raised £150 million in the process. This paper draws together findings from new archival research, a witness seminar with key actors in the NHS charity sector, and qualitative research based on interviews with NHS charity staff and trustees (N = 13), all conducted between 2021 and 2023. We investigate the way in which national appeals have been proposed, debated and implemented at different times in the NHS's history. We trace the recurrence of conflicting ideas about the acceptability of national fundraising for the NHS, about whether public loyalties are to their local services or the national ‘brand’ and about the introduction of national appeals into a complex ecology of local NHS charities. The history of charitable fundraising for the NHS is, we argue, neither a simple story of spontaneous public generosity, nor often of formal policy reform, but is an artefact of more complex dynamics between a changing cast of local and national actors over the last 75 years.
Belatacept‐based immunosuppression does not confer increased risk of BK polyomavirus‐DNAemia relative to tacrolimus‐based immunosuppression
Authors: Eichenberger Emily M. , Magua Wairimu , Rickert Joseph B. , Karadkhele Geeta , Fallahzadeh Mohammad Kazem , Vasanth Payaswini , Larsen Christian 
Published: July 2024

AbstractBackgroundThe effect of belatacept on BK polyomavirus (BKPyV) control remains largely unknown.MethodsThis is a propensity matched retrospective cohort study in adult kidney transplant recipients (KTR) transplanted between 2016–2020 who received a belatacept‐ versus tacrolimus‐based immunosuppression regimen. A continuous time multi‐state Markov model was used to evaluate BKPyV replication dynamics (BKPyV‐dyn). Three BKPyV‐dyn states were defined: BKPyV‐dyn1 (viral load <3 log10), BKPyV‐dyn2 (viral load ≥ 3 log10 and ≤4 log10), and BKPyV‐dyn3 (viral load >4 log10).ResultsTwo hundred eighty KTR on belatacept‐ and 280 KTR on tacrolimus‐based regimens were compared. The probability of transitioning between BKPyV‐dyn states and time spent in each state in both groups was comparable. Total duration in BKPyV‐dyn‐1 was 632.1 days (95% CI 612.1, 648.5) for belatacept versus 615.2 days (95% CI 592.5, 635.8) for tacrolimus, BKPyV‐dyn‐2 was 49.2 days (95% CI 41.3, 58.4) for belatacept versus 55.6 days (95% CI 46.5, 66.8) for tacrolimus, and BKPyV‐dyn‐3 was 48.7 days (95% CI 37.1, 363.1) for belatacept versus 59.2 days (95% CI 45.8, 73.5) for tacrolimus. BKPyV associated nephropathy (PyVAN) occurred in 3.9% in belatacept‐ and 3.9% tacrolimus‐treated KRT (P > .9).ConclusionsCompared with tacrolimus‐based immunosuppression, belatacept based immunosuppression was not associated with increased risk of BKPyV‐DNAemia or nephropathy.
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A noma case report: A warning message from Northern Uganda
Authors: Longo Bianca Maria , Merli Martina , Achana Bonny , Okao Maurice , Smart Okot Godfrey , Ribero Simone , Calcagno Andrea , Montrucchio Giorgia , Orlotti Carmen 
Published: July 2024

AbstractNoma, or Cancrum oris, is a severe and rapidly progressing gangrenous infection that primarily affects the face. It is most commonly observed in children living in impoverished conditions, especially in sub‐Saharan Africa. Rapid diagnosis and early management are crucial to prevent devastating consequences, such as functional limitations and serious psychological repercussions. Herein, we present a case of an 8‐month‐old child affected by noma, whose positive outcome is attributed to the prompt recognition by healthcare personnel. In our patient, the condition was likely related to malnutrition and the preceding extraction of a deciduous tooth reported by the mother and probably associated with a traditional Ugandan practice called Ebiino. This is the second case reported in Uganda, and given the limited healthcare access in most of the country, coupled with the high prevalence of poverty and other predisposing factors, it becomes evident that the incidence of noma is underestimated. Noma, as a neglected disease, requires greater awareness within communities and among healthcare professionals. A collective effort is needed to significantly reduce risk factors and promote prevention of this life‐threatening disease.
Study protocol for ADAPT-TDM: A beta-lactam antibiotic Dose AdaPtation feasibility randomised controlled Trial using Therapeutic Drug Monitoring
Authors: Pai Mangalore Rekha , Chai Ming Gene , Pope Jeffrey , Lee Sue J , Padiglione Alexander , Diehl Arne , Roberts Llyod , Sim Kirsty , Rawson-Harris Philip , Wicha Sebastian , Schneider Hans G , Peel Trish N , Jenney Adam , Ayton Darshini , Peleg Anton Y , Udy Andrew A 
Published: July 2024

IntroductionCritically ill patients are at risk of suboptimal beta-lactam antibiotic (beta-lactam) exposure due to the impact of altered physiology on pharmacokinetics. Suboptimal concentrations can lead to treatment failure or toxicity. Therapeutic drug monitoring (TDM) involves adjusting doses based on measured plasma concentrations and individualising dosing to improve the likelihood of improving exposure. Despite its potential benefits, its adoption has been slow, and data on implementation, dose adaptation and safety are sparse. The aim of this trial is to assess the feasibility and fidelity of implementing beta-lactam TDM-guided dosing in the intensive care unit setting.Methods and analysisA beta-lactam antibiotic Dose AdaPtation feasibility randomised controlled Trial using Therapeutic Drug Monitoring (ADAPT-TDM) is a single-centre, unblinded, feasibility randomised controlled trial aiming to enroll up to 60 critically ill adult participants (≥18 years). TDM and dose adjustment will be performed daily in the intervention group; the standard of care group will undergo plasma sampling, but no dose adjustment. The main outcomes include: (1) feasibility of recruitment, defined as the number of participants who are recruited from a pool of eligible participants, and (2) fidelity of TDM, defined as the degree to which TDM as a test is delivered as intended, from accurate sample collection, sample processing to result availability. Secondary outcomes include target attainment, uptake of TDM-guided dosing and incidence of neurotoxicity, hepatotoxicity and nephrotoxicity.Ethics and disseminationThis study has been approved by the Alfred Hospital human research ethics committee, Office of Ethics and Research Governance (reference: Project No. 565/22; date of approval: 22/11/2022). Prospective consent will be obtained and the study will be conducted in accordance with the Declaration of Helsinki. The finalised manuscript, including aggregate data, will be submitted for publication in a peer reviewed journal. ADAPT-TDM will determine whether beta-lactam TDM-guided dose adaptation is reproducible and feasible and provide important information required to implement this intervention in a phase III trial.Trial registration numberAustralian New Zealand Clinical Trials Registry, ACTRN12623000032651.
What is known about the role of external facilitators during the implementation of complex interventions in healthcare settings? A scoping review
Authors: Girard Ariane , Doucet Amélie , Lambert Mireille , Ouadfel Sarah , Caron Genève , Hudon Catherine 
Published: July 2024

ObjectiveTo synthesise current knowledge about the role of external facilitators as an individual role during the implementation of complex interventions in healthcare settings.DesignA scoping review was conducted. We reviewed original studies (between 2000 and 2023) about implementing an evidence-based complex intervention in a healthcare setting using external facilitators to support the implementation process. An information specialist used the following databases for the search strategy: MEDLINE, CINAHL, APA PsycINFO, Academic Search Complete, EMBASE (Scopus), Business Source Complete and SocINDEX.Results36 reports were included for analysis, including 34 different complex interventions. We performed a mixed thematic analysis to synthesise the data. We identified two primary external facilitator roles: lead facilitator and process expert facilitator. Process expert external facilitators have specific responsibilities according to their role and expertise in supporting three main processes: clinical, change management and knowledge/research management.ConclusionsFuture research should study processes supported by external facilitators and their relationship with facilitation strategies and implementation outcomes. Future systematic or realist reviews may also focus on outcomes and the effectiveness of external facilitation.
Comparing performance of primary care clinicians in the interpretation of SPIROmetry with or without Artificial Intelligence Decision support software (SPIRO-AID): a protocol for a randomised controlled trial
Authors: Doe Gillian , El-Emir Ethaar , Edwards George D , Topalovic Marko , Evans Rachael A , Russell Richard , Sylvester Karl P , Van Orshoven Karolien , Sunjaya Anthony P , Scott David A , Prevost A Toby , Harvey Jennifer , Taylor Stephanie JC , Hopkinson Nicholas S , Kon Samantha S , Jarrold Ian , Spain Nannette , Banya Winston , Man William D-C 
Published: July 2024

IntroductionSpirometry is a point-of-care lung function test that helps support the diagnosis and monitoring of chronic lung disease. The quality and interpretation accuracy of spirometry is variable in primary care. This study aims to evaluate whether artificial intelligence (AI) decision support software improves the performance of primary care clinicians in the interpretation of spirometry, against reference standard (expert interpretation).Methods and analysisA parallel, two-group, statistician-blinded, randomised controlled trial of primary care clinicians in the UK, who refer for, or interpret, spirometry. People with specialist training in respiratory medicine to consultant level were excluded. A minimum target of 228 primary care clinician participants will be randomised with a 1:1 allocation to assess fifty de-identified, real-world patient spirometry sessions through an online platform either with (intervention group) or without (control group) AI decision support software report. Outcomes will cover primary care clinicians’ spirometry interpretation performance including measures of technical quality assessment, spirometry pattern recognition and diagnostic prediction, compared with reference standard. Clinicians’ self-rated confidence in spirometry interpretation will also be evaluated. The primary outcome is the proportion of the 50 spirometry sessions where the participant’s preferred diagnosis matches the reference diagnosis. Unpaired t-tests and analysis of covariance will be used to estimate the difference in primary outcome between intervention and control groups.Ethics and disseminationThis study has been reviewed and given favourable opinion by Health Research Authority Wales (reference: 22/HRA/5023). Results will be submitted for publication in peer-reviewed journals, presented at relevant national and international conferences, disseminated through social media, patient and public routes and directly shared with stakeholders.Trial registration numberNCT05933694.
Bayesian inference of the mean power of several Gaussian data
Authors: Mana Giovanni , Palmisano Carlo 
Published: July 2024

Abstract
The uniform prior probability density for the means of normal data leads to inconsistent Bayesian inference of their mean power and jeopardizes the possibility of selecting among different models that explain the data. We reinvestigated the problem avoiding delivering unrecognised information and looking at it in a novel way. Namely, to consider a finite power, we used a normal prior minimally diverging from the uniform one, hyperparameterised by the mean and variance, and left the data to choose the most supported parameters. We also obtained an extended James–Stein estimator averaging the hyper-parameters and avoiding empirical Bayes techniques.

Graphical abstract
Targeted Bias: The Next Swing at IL2 Therapy
Authors: Kulhanek Kayla R. , Kalbasi Anusha 
Published: July 2024

Summary:Despite its long history of toxicity and limited efficacy, IL2 has re-entered the clinic as a companion to the recently FDA-approved tumor infiltrating lymphocyte therapy. In back-to-back articles, Moynihan and Kaptein introduce a new fusion protein that delivers a biased IL2 mutein to CD8 T cells.See related article by Moynihan et al., p. 1206 (6).See related article by Kaptein et al., p. 1226 (7).
Functional magnetic resonance imaging of the lumbosacral cord during a lower extremity motor task
Authors: Kündig Christian W. , Finsterbusch Jürgen , Freund Patrick , David Gergely 
Published: July 2024

Abstract
Blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) can be used to map neuronal function in the cervical cord, yet conclusive evidence supporting its applicability in the lumbosacral cord is still lacking. This study aimed to (i) demonstrate the feasibility of BOLD fMRI for indirectly mapping neural activity in the lumbosacral cord during a unilateral lower extremity motor task and (ii) investigate the impact of echo time (TE) on the BOLD effect size. Twelve healthy volunteers underwent BOLD fMRI using four reduced field-of-view single-shot gradient-echo echo planar imaging sequences, all with the same geometry but different TE values ranging from 20 to 42 ms. Each sequence was employed to acquire a single 6-min rest run and two 10-min task runs, which included alternating 15-s blocks of rest and unilateral ankle dorsi- and plantar flexion. We detected lateralized task-related BOLD activity at neurological levels L3-S2, centered at the ipsilateral (right) ventral spinal cord but also extending into the ipsilateral dorsal spinal cord. This pattern of activation is consistent with our current understanding of spinal cord organization, wherein lower motor neurons are located in the ventral gray matter horn, while interneurons neurons of the proprioceptive pathway, activated during the movement, are located in the dorsal horns and the intermediate gray matter. At the subject level, BOLD activity showed considerable variability but was lateralized in all participants. The highest BOLD effect size within the ipsilateral ventral spinal cord, as well as the highest split-half reliability, was observed at a TE of 42 ms. Sequences with a shorter TE (20 and 28 ms) also detected activity in the medioventral part of the spinal cord, likely representing large vein effects. In summary, our results demonstrate the feasibility of detecting task-related BOLD activity in the lumbosacral cord induced by voluntary lower limb movements. BOLD fMRI in the lumbosacral cord has significant implications for assessing motor function and its alterations in disease or after spinal cord injury.
A benchmark of individual auto-regressive models in a massive fMRI dataset
Authors: Paugam François , Pinsard Basile , Lajoie Guillaume , Bellec Pierre 
Published: July 2024

Abstract
Dense functional magnetic resonance imaging datasets open new avenues to create auto-regressive models of brain activity. Individual idiosyncrasies are obscured by group models, but can be captured by purely individual models given sufficient amounts of training data. In this study, we compared several deep and shallow individual models on the temporal auto-regression of BOLD time-series recorded during a natural video-watching task. The best performing models were then analyzed in terms of their data requirements and scaling, subject specificity, and the space-time structure of their predicted dynamics. We found the Chebnets, a type of graph convolutional neural network, to be best suited for temporal BOLD auto-regression, closely followed by linear models. Chebnets demonstrated an increase in performance with increasing amounts of data, with no complete saturation at 9 h of training data. Good generalization to other kinds of video stimuli and to resting-state data marked the Chebnets’ ability to capture intrinsic brain dynamics rather than only stimulus-specific autocorrelation patterns. Significant subject specificity was found at short prediction time lags. The Chebnets were found to capture lower frequencies at longer prediction time lags, and the spatial correlations in predicted dynamics were found to match traditional functional connectivity networks. Overall, these results demonstrate that large individual functional magnetic resonance imaging (fMRI) datasets can be used to efficiently train purely individual auto-regressive models of brain activity, and that massive amounts of individual data are required to do so. The excellent performance of the Chebnets likely reflects their ability to combine spatial and temporal interactions on large time scales at a low complexity cost. The non-linearities of the models did not appear as a key advantage. In fact, surprisingly, linear versions of the Chebnets appeared to outperform the original non-linear ones. Individual temporal auto-regressive models have the potential to improve the predictability of the BOLD signal. This study is based on a massive, publicly-available dataset, which can serve for future benchmarks of individual auto-regressive modeling.
Unfolding the dynamics of driving behavior: a machine learning analysis from Germany and Belgium
Authors: Roussou Stella , Michelaraki Eva , Katrakazas Christos , Afghari Amir Pooyan , Al Haddad Christelle , Alam Md Rakibul , Antoniou Constantinos , Papadimitriou Eleonora , Brijs Tom , Yannis George 
Published: July 2024

AbstractThe i-DREAMS project focuses on establishing a framework known as the ‘Safety Tolerance Zone (STZ)’ to ensure drivers operate within safe boundaries. This study compares Long-Short-Term-Memory Networks and shallow Neural Networks to assess participants’ safety levels during i-DREAMS on-road trials. Thirty German drivers’ trips and Forty-Three Belgian drivers were analyzed using these methods, revealing factors contributing to risky behavior. Results indicate i-DREAMS interventions significantly enhance driving behavior, with Neural Networks displaying superior performance among the algorithms considered.
Risk factors and predictors of recurrence of febrile seizures in children in Nantong, China: a retrospective cohort study
Authors: Shen Feifei , Lu Leijuan , Wu Youjia , Suo Guihai , Zheng Yuqin , Zhong Xiuli , Wang Xu , Li Haiying 
Published: July 2024

Abstract
Background
Although most children with febrile seizures (FS) have a favorable prognosis, some experience recurrence within 1–3 years. Age, peak temperature, and family history are now recognized as important risk factors for FS recurrence, yet studies in this area are lacking in China. This study aimed to investigate the risk factors for FS recurrence in children in Nantong, China, and to develop a prediction model.

Methods
This retrospective cohort study analyzed 463 children diagnosed with febrile seizures (FS) who presented to the Affiliated Hospital of Nantong University between January 2015 and June 2020. Basic information, disease characteristics, and laboratory and imaging data were collected. A follow-up survey was conducted one year post-discharge to assess the recurrence status of FS in children. Univariate logistic regression and random forest models were used to identify and rank the predictive ability of risk factors for recurrence.

Results
Of the 463 children with FS, 70 experienced recurrences within 1 year of discharge, resulting in a one-year recurrence rate of 15%. Age (OR = 0.61, 95% CI: 0.46, 0.80, P < 0.001), duration of the first episode (OR = 1.03, 95% CI: 1.00, 1.06, P = 0.040), and peak temperature (OR = 0.68, 95% CI: 0.47, 0.98, P = 0.036) were identified as independent risk factors for FS recurrence. Age had the highest relative importance in predicting FS recurrence, followed by the duration of the first episode, with an area under the ROC curve of 0.717.

Conclusion
Young age and duration of the first seizure are important independent risk factors for FS recurrence and are key considerations for predicting recurrence. Further research is needed to confirm the potential use of Neutrophil–lymphocyte ratio (NLR) as a predictor of FS recurrence.
A school-based food and nutrition education intervention increases nutrition-related knowledge and fruit consumption among primary school children in northern Ghana
Authors: Mogre Victor , Sefogah Promise Emmanuel , Adetunji Alaofin Wemimo , Olalekan Oni Opeyemi , Gaa Patience Kanyiri , Ayettey Anie Hannah N.G , Tayo Bamidele 
Published: July 2024

Abstract
Background
Providing children with the opportunity to learn about nutrition is critical in helping them establish a healthy lifestyle and eating behaviours that would remain with them till adulthood. We determined the effect of a school-based food and nutrition education (SFNE) intervention on the nutrition-related knowledge, attitudes, dietary habits, physical activity levels and the anthropometric indices (BMI-for-age z scores, %Body fat and waist circumference) of school-age children in northern Ghana.

Methods
Following a controlled before-and-after study design, we recruited school-age children in primary 4 and 5 from public and private schools and assigned them non-randomly to intervention and control groups (4 schools total). A SFNE intervention called ‘Eat Healthy, Grow Healthy (EHGH)’ was implemented in intervention schools. Components of the intervention included children, teachers, school officials, and the school environment. Nutrition education didactic sessions, active discussions, nutrition games, charades, art work, and physical activity sessions were among the teaching and learning activities implemented. At 0 and 6 months, primary (anthropometry) and secondary (fruit, vegetable, and breakfast consumption) outcomes were obtained.

Results
Mean BMI-for-age z-scores did not differ significantly between intervention and control groups (F1,261 = 0.45, P = 0.503, η2 = 0.01). However, significantly greater nutrition-related knowledge scores were recorded in the intervention group than in the control group at post-intervention (M = 6.07 SD = 2.17 vs. M = 5.22 SD = 1.92; p = 0.002). Mean number of days intervention children consumed fruits differed across time (F1, 263 = 33.04, p = 0.002, η2 = 0.04) but not between the control and intervention groups (F1, 263 = 0.28, p = 0.60, η2 = 0.00).

Conclusions
The EHGH intervention had positive effects on the nutrition-related knowledge and the consumption of fruits among children although it did not impact their anthropometric indices.