bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upstream and downstream implementation arrangements in two‐level games. A focus on administrative simplification in the Italian National Recovery and Resilience Plan
Authors: Di Mascio Fabrizio , Natalini Alessandro , Profeti Stefania 
Published: January 2024

AbstractThe onset of the European NGEU program represented for European member states a formidable opportunity for post‐pandemic recovery and yet a significant challenge at the same time: to receive and retain EU funds, each state had to promptly draw up a National Recovery and Resilience Plan—NRRP) and commit to a pressing timetable for its implementation. Regarding this challenge, the Italian government's response is a case in point: first, Italy is by far the largest beneficiary of NGEU funds; second, it has long had a reputation for being laggard in both the implementation of European directives and the spending of cohesion policy structural funds; and the formulation of the NRRP, the design of the governance in charge of its implementation, and implementation itself, occurred at a particular moment in the country's political life. Based on these premises, the article examines the upstream process by which the Italian government designed the implementation arrangements for the adoption of simplification policies under the NRRP and their downstream recalibration in the first two years, taking the implementation arrangements as the dependent variable. Analytically, the focus is on the interplay between the pressures of EU timetables and internal political dynamics, be they the legacy or strategic political considerations on the part of national policymakers, in determining the design and eventual re‐design of implementation arrangements as the plan unfolds.
Oral candida lesions and Candida tropicalis: Potential prognostic markers in end‐of‐life cancer patients
Authors: Shimosato Maiko , Kada Shinpei , Yase Eriko , Sakane Naoki 
Published: January 2024

AbstractAimsOral candidosis is common in patients with end‐of‐life cancer; however, its prognosis is unclear. We aimed to assess oral candidosis and Candida species as prognostic indicators in palliative care for these patients.MethodsWe consecutively included palliative care patients, assessed for candidosis via microbiological techniques, and classified into three groups by the extent of oral lesions. The association between oral candidosis and overall survival was assessed using a Cox proportional hazards model adjusted by performance status (PS).ResultsWe studied 142 patients (median age 77; 52.8% women) with a 76.1% oral candidosis prevalence. Candida albicans (80.6%) was the most common species. Oral lesions were classified as none, grade 1 (28.7%), or ≥ grade 2 (14.8%). During follow‐up, Cox models identified ≥grade 2 lesions (aHR = 2.04; 95% CI: 1.18–3.54; p = .011) and Candida tropicalis (aHR = 2.38; 95% CI: 1.03–5.55; p = .044) as predictors.ConclusionThe extent of oral candidosis lesions or the presence of C. tropicalis may serve as prognostic indicator in patients with end‐of‐life cancer. Therefore, solely concentrating on the prevalence and frequency of fungal species may be insufficient for predicting life prognosis; it is advisable to assess these parameters through both visual examination and culture.
Exemplar or facilitator: An exploration of the lived experience of nurse mentors supporting the adaptation of internationally educated nurses
Authors: Smith Carly , Cantillon Peter 
Published: January 2024

AbstractIntroductionDeficits in nursing workforces have led to major increases in overseas recruitment in many countries. Internationally educated nurses recruited within Ireland must complete an adaptation programme before they can practice nursing, a process contingent on the support from nurse mentors. However, it is becoming progressively difficult to identify nurses willing to act as mentors, threatening viability of overseas nurse recruitment. This research set out to address this problem by exploring the lived experiences of nurse mentors during the adaptation programme.MethodsAn interpretative phenomenological analysis research design was utilised to explore the experiences of nurse mentors. Semi‐structured interviews were conducted with a maximum variance sample of 11 nurse mentors. The data were subjected to an Interpretive Phenomenological Analysis (IPA) sequential analytical approach yielding integrative themes.ResultsThe lived experiences of participants coalesced into three conceptual themes, mentor identity, sustainability, and learner socialisation. Participants who self‐identified as ‘mentor exemplars’ expressed more negative perceptions of the role when compared with nurses who positioned themselves as ‘mentor facilitators’. Nurse mentors were challenged by the complexities of intercultural dissonance and insufficient time and training for their mentoring role because of the pressures of clinical service.ConclusionAlthough mentorship is essential for the integration of internationally educated nurses, the sustainability of the mentorship role is contingent on how it is supported through training and protected within busy clinical environments. Critically, nurse mentors need to learn how to conceptualise their role as one of facilitating the development of others rather than presenting themselves as exemplary role models.
Differentiating patient characteristics between platelet refractory patients with and without antibodies to human leukocyte antigens
Authors: Liu Kelsey , Stephens Laura , Nedelcu Elena , Bakhtary Sara 
Published: January 2024

AbstractBackgroundPredicting whether a patient's platelet refractoriness (PR) is due to immune or nonimmune causes can be challenging. This study compared the demographics and clinical history of PR patients with human leukocyte antigen (HLA) antibodies (HLA‐PR) versus PR patients without HLA antibodies.Materials and MethodsA retrospective review of all patients with PR consults at a single institution over a 3‐year period was performed. Patient charts were reviewed for all patients with confirmed PR, and demographic information (e.g., sex, race and ethnicity, preferred language) and clinical history (e.g., pregnancy, transfusion, primary diagnosis) were collected. Patient characteristics were compared among the HLA and non‐HLA cohorts.ResultsA total of 295 patients with confirmed PR were identified, of whom approximately 70% did not have HLA antibodies and 30% did. Approximately 84% of the HLA‐PR cohort was female. A history of transfusions was not associated with HLA‐PR (p = .1). A history of pregnancy was strongly associated with the occurrence of HLA‐PR (p < .001). Splenomegaly was associated with PR in the absence of HLA alloimmunization whereas infection, fever, bleeding, and disseminated intravascular coagulation were not.ConclusionIn this single‐institution retrospective review, a history of pregnancy was strongly associated with HLA‐PR, whereas a history of transfusion was not.
Quantifying Offense and Defense Workloads in Professional Rugby Union
Authors: Stevens Luke J. , Hopkins Will G. , Chittenden Jessica A. , Koper Bianca Z. , Smith Tiaki Brett 
Published: January 2024

Purpose: Rugby union is a contact team sport demanding high levels of physical capacity, and understanding the match workloads can be useful to inform training. In this study, the factors influencing locomotion and contact workloads for offensive and defensive ball-in-play periods are quantified. Methods: Locomotion and contact metrics were collected from global positioning system units and videos for 31 professional players of a Super Rugby team across 14 games in the 2021 season. Data were analyzed with a generalized mixed-model procedure that included effects for type of play, playing position, match outcome, and ball-in-play time. Magnitudes were assessed with standardization, and evidence for substantial magnitudes was derived from sampling uncertainty. Results: When offense was compared to defense, most metrics showed decisively substantial increases (small to moderate) for forwards and backs. There was decisive evidence that locomotion metrics were substantially lower (large differences) and contact metrics were higher (very large differences) when comparing forwards to backs on offense and defense. When winning was compared to losing, there was good evidence that forwards experienced small increases in overall workload on defense, and backs experienced a small increase in high-speed running and a moderate decrease in contacts on offense. Match-to-match changes associated with ball-in-play time, attributed to fatigue, were decisive (moderate to very large) across most metrics for forwards and backs in offense and defense. Conclusions: The increased locomotion and contact workloads in offensive periods and the differing physical requirements between positions and match outcomes for both types of play are novel findings that should aid practitioners in designing effective training.
AlmA involved in the long-chain
n
-alkane degradation pathway in
Acinetobacter baylyi
ADP1 is a Baeyer–Villiger monooxygenase
Authors: Yin Chao-Fan , Nie Yong , Li Tao , Zhou Ning-Yi 
Published: January 2024

ABSTRACT

Many
Acinetobacter
species can grow on
n
-alkanes of varying lengths (≤C40). AlmA, a unique flavoprotein in these
Acinetobacter
strains, is the only enzyme proven to be required for the degradation of long-chain (LC)
n
-alkanes, including C32 and C36 alkanes. Although it is commonly presumed to be a terminal hydroxylase, its role in
n
-alkane degradation remains elusive. In this study, we conducted physiological, biochemical, and bioinformatics analyses of AlmA to determine its role in
n
-alkane degradation by
Acinetobacter baylyi
ADP1. Consistent with previous reports, gene deletion analysis showed that
almA
was vital for the degradation of LC
n
-alkanes (C26–C36). Additionally, enzymatic analysis revealed that AlmA catalyzed the conversion of aliphatic 2-ketones (C10–C16) to their corresponding esters, but it did not conduct
n
-alkane hydroxylation under the same conditions, thus suggesting that AlmA in strain ADP1 possesses Baeyer–Villiger monooxygenase (BVMO) activity. These results were further confirmed by bioinformatics analysis, which revealed that AlmA was closer to functionally identified BVMOs than to hydroxylases. Altogether, the results of our study suggest that LC
n
-alkane degradation by strain ADP1 possibly follows a novel subterminal oxidation pathway that is distinct from the terminal oxidation pathway followed for short-chain
n
-alkane degradation. Furthermore, our findings suggest that AlmA catalyzes the third reaction in the LC
n
-alkane degradation pathway.

IMPORTANCE

Many microbial studies on
n
-alkane degradation are focused on the genes involved in short-chain
n
-alkane (≤C16) degradation; however, reports on the genes involved in long-chain (LC)
n
-alkane (>C20) degradation are limited. Thus far, only AlmA has been reported to be involved in LC
n
-alkane degradation by
Acinetobacter
spp.; however, its role in the
n
-alkane degradation pathway remains elusive. In this study, we conducted a detailed characterization of AlmA in
A. baylyi
ADP1 and found that AlmA exhibits Baeyer–Villiger monooxygenase activity, thus indicating the presence of a novel LC
n
-alkane biodegradation mechanism in strain ADP1.
Kefir4All, a citizen science initiative to raise awareness of the roles that microbes play in food fermentation
Authors: Walsh Liam H. , Breselge Samuel , Martin José Guilherme Prado , Coakley Mairéad , Ferguson Eimear , Stapleton Aimee , Crispie Fiona , O'Toole Paul W. , Cotter Paul D. 
Published: January 2024

ABSTRACTMicroorganisms are ubiquitous in nature and are central to human, animal, environmental, and planetary health. They play a particularly important role in the food chain and the production of high-quality, safe, and health-promoting foods, especially fermented foods. This important role is not always apparent to members of the public. Here, we describe Kefir4All, a citizen science project designed to provide the general public with an opportunity to expand their awareness, knowledge, and practical skills relating to microbiology, introduced through the medium of producing fermented food, i.e., milk kefir or water kefir. During the course of Kefir4All, 123 citizen scientists, from second-level school and non-school settings, participated in a study to track changes in the microbial composition of kefirs, by performing and recording details of milk kefir or water kefir fermentations they performed in their homes or schools over the 21-week project. At the start of the study, the citizen scientists were provided with milk or water kefir grains to initiate the fermentations. Both types of kefir grain are semi-solid, gelatinous-like substances, composed of exopolysaccharides and proteins, containing a symbiotic community of bacteria and yeast. The experimental component of the project was complemented by a number of education and outreach events, including career talks and a site visit to our research center (Kefir Day). At the end of the study, a report was provided to each citizen scientist, in which individualized results of their fermenting activities were detailed. A number of approaches were taken to obtain feedback and other insights from the citizen scientists. Evaluations took place before and after the Kefir4All project to gauge the citizen scientist’s self-reported awareness, knowledge, and interest in microbiology and fermented foods. Further insights into the level of citizen science participation were gained through assessing the number of samples returned for analysis and the level of participation of the citizen scientists throughout the project. Notably, the survey results revealed a self-reported, increased interest in, and general knowledge of, science among the Kefir4All citizen scientists after undertaking the project and a willingness to take part in further citizen science projects. Ultimately, Kefir4All represents an example of the successful integration of citizen science into existing education and research systems.
Building-level wastewater surveillance localizes interseasonal influenza variation
Authors: Germano Emma R. , Flores Tiffany , Freed Grace S. , Kim Kang , Tulinsky Grace H. , Yang Annie , Rose Oliver J. , Ray Caroline A. , Autry April , Catallozzi Marina , Mailloux Brian J. , Miranda JJ L. 
Published: January 2024

ABSTRACT

Influenza virus poses a recurring threat to public health and infects many populations in annual waves of generally unpredictable magnitude and timing. We aimed to detect the arrival and estimate the case magnitude of seasonal influenza A in urban New York City college dormitory buildings. Our wastewater-based surveillance (WBS) program measured viral RNA in the sewage outflow of three dormitories at Barnard College in 2021 and 2022. Wastewater test positivity strongly correlated with New York County clinical cases (Kendall’s τ = 0.58). Positive wastewater samples are also associated with campus clinical cases. The 2022 data stand in stark contrast to the 2021 results by revealing the more frequent and earlier presence of influenza A. The increase in positive tests is significant (
P
< 0.01). It is further noteworthy that positive samples were not evenly distributed among buildings. Surveillance additionally identified the influenza A H3 subtype but did not detect any influenza B. We also systematically analyzed our viral purification protocol to identify in which fraction influenza can be found. While virus can be found in solid fractions, a substantial quantity remains in the final liquid fraction. Our work focuses on individual buildings rather than larger sewersheds because buildings may localize interseasonal influenza variation to specific subpopulations. Our results highlight the potential value of building-level WBS in measuring influenza incidence to help guide public health intervention.

IMPORTANCE
Seasonal influenza remains a major public health burden. We monitored influenza A in dormitory wastewater of a New York City college in 2021 and 2022. Longitudinal samples acquired over consecutive years allowed measurement of individual buildings between seasons. We uncovered building-level changes in the magnitude and timing of test positivity concordant with clinical cases. Surveillance also localized the heterogeneity of influenza variation during the large 2022 seasonal surge. The ability to detect such changes could be leveraged as part of a public health response.
TransFAIR study: a European multicentre experimental comparison of EHR2EDC technology to the usual manual method for eCRF data collection
Authors: Ammour Nadir , Griffon Nicolas , Djadi-Prat Juliette , Chatellier Gilles , Lewi Martine , Todorovic Marija , Gómez de la Cámara Augustín , García Morales Maria Teresa , Testoni Sara , Nanni Oriana , Schindler Christoph , Sundgren Mats , Garvey Almenia , Victor Tomothy , Cariou Manon , Daniel Christel 
Published: January 2024

PurposeRegulatory authorities including the Food and Drug Administration and the European Medicines Agency are encouraging to conduct clinical trials using routinely collected data. The aim of the TransFAIR experimental comparison was to evaluate, within real-life conditions, the ability of the Electronic Health Records to Electronic Data Capture (EHR2EDC) module to accurately transfer from EHRs to EDC systems patients’ data of clinical studies in various therapeutic areas.MethodsA prospective study including six clinical trials from three different sponsors running in three hospitals across Europe has been conducted. The same data from the six studies were collected using both traditional manual data entry and the EHR2EDC module. The outcome variable was the percentage of data accurately transferred using the EHR2EDC technology. This percentage was calculated considering all collected data and the data in four domains: demographics (DM), vital signs (VS), laboratories (LB) and concomitant medications (CM).ResultsOverall, 6143 data points (39.6% of the data in the scope of the TransFAIR study and 16.9% when considering all data) were accurately transferred using the platform. LB data represented 65.4% of the data transferred; VS data, 30.8%; DM data, 0.7% and CM data, 3.1%.ConclusionsThe objective of accurately transferring at least 15% of the manually entered trial datapoints using the EHR2EDC module was achieved. Collaboration and codesign by hospitals, industry, technology company, supported by the Institute of Innovation through Health Data was a success factor in accomplishing these results. Further work should focus on the harmonisation of data standards and improved interoperability to extend the scope of transferable EHR data.
Adoption of electronic health record systems to enhance the quality of healthcare in low-income countries: a systematic review
Authors: Woldemariam Misganaw Tadesse , Jimma Worku 
Published: January 2024

BackgroundElectronic health record (EHR) systems are mentioned in several studies as tools for improving healthcare quality in developed and developing nations. However, there is a research gap in presenting the status of EHR adoption in low-income countries (LICs). Therefore, this study systematically reviews articles that discuss the adoption of EHR systems status, opportunities and challenges for improving healthcare quality in LICs.MethodsWe used Preferred Reporting Items for Systematic Reviews and Meta-Analyses in articles selected from PubMed, Science Direct, IEEE Xplore, citations and manual searches. We focused on peer-reviewed articles published from January 2017 to 30 September 2022, and those focusing on the status, challenges or opportunities of EHR adoption in LICs. However, we excluded articles that did not consider EHR in LICs, reviews or secondary representations of existing knowledge. Joanna Briggs Institute checklists were used to appraise the articles to minimise the risk of bias.ResultsWe identified 12 studies for the review. The finding indicated EHR systems are not well implemented and are at a pilot stage in various LICs. The barriers to EHR adoption were poor infrastructure, lack of management commitment, standards, interoperability, support, experience and poor EHR systems. However, healthcare providers’ perception, their goodwill to use EMR and the immaturity of health information exchange infrastructure are key facilitators for EHR adoption in LICs.ConclusionMost LICs are adopting EHR systems, although it is at an early stage of implementation. EHR systems adoption is facilitated or influenced by people, environment, tools, tasks and the interaction among these factors.
Navigating the machine learning pipeline: a scoping review of inpatient delirium prediction models
Authors: Strating Tom , Shafiee Hanjani Leila , Tornvall Ida , Hubbard Ruth , Scott Ian A. 
Published: January 2024

ObjectivesEarly identification of inpatients at risk of developing delirium and implementing preventive measures could avoid up to 40% of delirium cases. Machine learning (ML)-based prediction models may enable risk stratification and targeted intervention, but establishing their current evolutionary status requires a scoping review of recent literature.MethodsWe searched ten databases up to June 2022 for studies of ML-based delirium prediction models. Eligible criteria comprised: use of at least one ML prediction method in an adult hospital inpatient population; published in English; reporting at least one performance measure (area under receiver-operator curve (AUROC), sensitivity, specificity, positive or negative predictive value). Included models were categorised by their stage of maturation and assessed for performance, utility and user acceptance in clinical practice.ResultsAmong 921 screened studies, 39 met eligibility criteria. In-silico performance was consistently high (median AUROC: 0.85); however, only six articles (15.4%) reported external validation, revealing degraded performance (median AUROC: 0.75). Three studies (7.7%) of models deployed within clinical workflows reported high accuracy (median AUROC: 0.92) and high user acceptance.DiscussionML models have potential to identify inpatients at risk of developing delirium before symptom onset. However, few models were externally validated and even fewer underwent prospective evaluation in clinical settings.ConclusionThis review confirms a rapidly growing body of research into using ML for predicting delirium risk in hospital settings. Our findings offer insights for both developers and clinicians into strengths and limitations of current ML delirium prediction applications aiming to support but not usurp clinician decision-making.