bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiences
Authors: Woodman Jenny , Mc Grath-Lone Louise , Clery Amanda , Weatherly Helen , Jankovic Dina , Appleton Jane V , Kirman Jennifer , Barlow Jane , Kendall Sally , Bennett Samantha , Gilbert Ruth , Harron Katie 
Published: September 2022

IntroductionExposure to adverse childhood experiences (ACEs) is associated with poorer health outcomes throughout life. In England, health visiting is a long-standing, nationally implemented service that aims to prevent and mitigate the impact of adversity in early childhood, including for children exposed to ACEs. A range of health visiting service delivery practices exist across England (from the minimum five recommended contacts to tailored intensive interventions), but there is a lack of evidence on who receives what services, how this varies across local authorities (LAs) and the associated outcomes.Methods and analysisThis study will integrate findings from analysis of individual-level, deidentified administrative data related to hospital admissions (Hospital Episode Statistics (HES)) and health visiting contacts (Community Services Data Set (CSDS)), aggregate LA-level data, in-depth case studies in up to six LAs (including interviews with mothers), a national survey of health visiting services, and workshops with stakeholders and experts by experience. We will use an empirical-to-conceptual approach to develop a typology of health visiting service delivery in England, starting with a data-driven classification generated from latent class analysis of CSDS-HES data, which will be refined based on all other available qualitative and quantitative data. We will then evaluate which models of health visiting are most promising for mitigating the impact of ACEs on child and maternal outcomes using CSDS-HES data for a cohort of children born on 1 April 2015 to 31 March 2019.Ethics and disseminationThe University College London Institute of Education Research Ethics Committee approved this study. Results will be submitted for publication in a peer-reviewed journal and summaries will be provided to key stakeholders including the funders, policy-makers, local commissioners and families.
Visual acuity outcome of stable proliferative diabetic retinopathy following initial complete panretinal photocoagulation
Authors: Fu Dun Jack , Thottarath Sridevi , Faes Livia , Balaskas Konstantinos , Keane Pearse A , Sim Dawn , Sivaprasad Sobha 
Published: September 2022

BackgroundRecent clinical trials on proliferative diabetic retinopathy (PDR) show that presenting visual acuity can be stabilised with panretinal photocoagulation (PRP) within 2 years despite the need for supplementary PRP or anti-vascular endothelial growth factor therapy for concomitant diabetic macular oedema (DMO). It is unclear whether similar results can be obtained in daily clinical practice. Here, we query the probability of vision loss in patients with treatment-naïve PDR who have attained stability after PRP and its predictors.MethodsRetrospective cohort study at a tertiary eye centre between 01 January 2015 and 31 December 2019, wherein 2336 eyes met study criteria with first record of stable PRP-treated PDR in at least one eye. Kaplan-Meier and Cox proportional hazards modelling were used to report the probability of vision loss of at least five Early Treatment Diabetic Retinopathy Study (ETDRS) letters.ResultsThe probability of losing at least five ETDRS letters was 50% at 3.32 (95% CI, 2.94 to 3.78) years after achieving first stability post PRP in treatment-naïve PDR. The mean decrease at this event was 14.2 (SD 13.0) ETDRS letters irrespective of the presence of DMO. The strongest risk factor for vision loss was a history of DMO at baseline (HR 1.62 (95% CI, 1.34 to 1.95), p<0.001).DiscussionOne in two patients with stable treated PDR lose a line of vision by 3.5 years. This resulted in 15% of patients losing their eligibility to drive. Notably, 13% of the cohort died during the follow-up period.
Factors affecting decision-making in children with complex care needs: a consensus approach to develop best practice in a UK children’s hospital
Authors: Birchley Giles , Thomas-Unsworth Sadie , Mellor Charlotte , Baquedano Mai , Ingle Susanne , Fraser James 
Published: September 2022

BackgroundChildren with complex care needs are a growing proportion of the sick children seen in all healthcare settings in the UK. Complex care needs place demands on parents and professionals who often require many different healthcare teams to work together. Care can be both materially and logistically difficult to manage, causing friction with parents. These difficulties may be reduced if common best practice standards and approaches can be developed in this area.ObjectiveTo develop a consensus approach to the management of complexity among healthcare professionals, we used a modified Delphi process. The process consisted of a meeting of clinical leaders to develop candidate statements, followed by two survey rounds open to all professionals in a UK children’s hospital to measure and establish consensus recommendations.ResultsNinety-nine professionals completed both rounds of the survey, 69 statements were agreed. These pertained to seven thematic areas: standardised approaches to communicating with families; processes for interprofessional communication; processes for shared decision-making in the child’s best interests; role of the multidisciplinary team; managing professional–parental disagreement and conflict; the role of clinical psychologists; and staff support. Overall, the level of consensus was high, ranging from agreement to strong agreement.ConclusionsThese statements provide a consensus basis that can inform standardised approaches to the management of complexity. Such approaches may decrease friction between parents, children and healthcare professionals.
Bridging thrombolysis improves survival rates at 90 days compared with direct mechanical thrombectomy alone in acute ischemic stroke due to basilar artery occlusion: a systematic review and meta-analysis of 1096 patients
Authors: Lee Keng Siang , Siow Isabel , Zhang John JY , Syn Nicholas L , Gillespie Conor S , Yuen Linus ZH , Anil Gopinathan , Yang Cunli , Chan Bernard PL , Sharma Vijay Kumar , Teoh Hock-Luen , Mingxue Jing , Teo Kevin Soon Hwee , Myint May Zin , Bhogal Pervinder , Meyer Lukas , Schob Stefan , Sia Ching-Hui , Mpotsaris Anastasios , Maus Volker , Andersson Tommy , Arnberg Fabian , Gontu Vamsi Krishna , Lee Tsong-Hai , Tan Benjamin Y Q , Yeo Leonard LL 
Published: September 2022

BackgroundMechanical thrombectomy (MT) is an effective treatment for patients with acute ischemic stroke (AIS) from basilar artery occlusion (BAO).ObjectiveTo compare the clinical outcomes of MT, with and without bridging intravenous thrombolysis (IVT), in acute BAO through a systematic review and meta-analysis of the current literature.MethodsSystematic searches of Medline, EMBASE, and Cochrane Central were undertaken on August 1, 2022. Good functional outcome defined as 90-day modified Rankin Scale score 0–2 was the primary outcome measure. Secondary outcome measures were 90-day mortality, successful post-thrombectomy recanalization (modified Thrombolysis in Cerebral Infarction score ≥2b), symptomatic intracranial hemorrhage (sICH), and subarachnoid hemorrhage (SAH).ResultsThree studies reporting 1096 patients with BAO AIS were included in the meta-analysis. No significant differences in good functional outcome were detected between the two groups (RR=1.28 (95% CI 0.86 to 1.92); p=0.117). However, specifically patients with large artery atherosclerosis (LAA) benefited from bridging IVT (OR=2.52 (95% CI 1.51 to 4.22); p<0.001) with better functional outcomes. There was a significantly lower 90-day mortality rate for patients who underwent bridging IVT compared with MT alone (RR=0.70 (95% CI 0.62 to 0.80); p=0.008). No significant differences were detected in rates of post-treatment recanalization (RR=1.01 (95% CI 0.35 to 2.91); p=0.954), sICH (RR=0.96 (95% CI 0.66 to 1.42); p=0.724), and SAH (RR=0.93 (95% CI 0.31 to 2.83); p=0.563).ConclusionsIn patients with AIS due to BAO, bridging IVT was associated with lower mortality rates at 90 days, compared with direct MT. There were no improved functional outcomes or increased sICH or SAH between both arms, However, patients with LAA benefited from bridging IVT, with better functional outcomes.
Evolution of military evacuation activity in French Guiana over 10 years: a retrospective observational study
Authors: Vial Valentin , Egmann G , Jost D , Ilcinkas C , Manot C , Astrié P-M , Arrivé K , Travers S , André N 
Published: September 2022

BackgroundThree permanent military operations are established in French Guiana. The Cayenne medical unit is a French military search and rescue unit and provides MEDEVAC and CASEVAC for ill and injured soldiers. The main objective of this study was to describe the temporal trends of its evacuation missions over 10 years. The secondary purpose was to document the means used for these missions.MethodsThis retrospective observational study included patients who were evacuated for a medical reason or an injury during military operations in French Guiana. We collected the data from the computerised registers the medical department had stored.ResultsFrom 1 January 2010 to 31 December 2019, 1070 patients were included, representing a median annual incidence of 115 (IQR 91–122) evacuations. Of these, 602 (59%) were evacuated by helicopter, 214 (21%) by airplane, 182 (18%) by ambulance and 19 (2%) by pirogue.Reasons for evacuation were diseases in 664 (62%) patients, non-battle injuries in 389 (36%) patients and battle injuries in 17 (2%) patients. Finally, 286 (29%) evacuations were MEDEVAC and 712 (71%) were CASEVAC.Over the years, the increasing number of evacuations reached a maximum of 183 in 2018. Helicopter evacuations, once the primary mode of evacuation, have declined proportionately in favour of other means of evacuation.ConclusionEvacuation missions by the Cayenne medical unit increased over the 10-year study period, while helicopter use decreased. This evolution is a response to the constraints of adapting military operations to fight against illegal gold mining in the Amazonian Forest. Improvement of the means and procedures allows provision of the best care to patients while ensuring the ongoing conduct of military operations.
A meta-analysis of extended ECG monitoring in detection of atrial fibrillation in patients with cryptogenic stroke
Authors: Jiang Haowen , Tan Shyn Yi , Wang Jeremy King , Li Jiaqi , Tu Tian Ming , Tan Vern Hsen , Yeo Colin 
Published: September 2022

ObjectiveThe aim of this systematic review is to evaluate the various modalities available for extended ECG monitoring in the detection of atrial fibrillation (AF) following a cryptogenic stroke.MethodsMEDLINE (Ovid), EMBASE (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL) were searched from January 2011 to November 2021. All randomised controlled trials and prospective cohort studies including the use of extended ECG monitoring >24 hours with a minimum duration of AF of 30 s in patients with either cryptogenic strokes or transient ischaemic attacks were included. A random-effects model was used to pool effect estimates of AF detection rates from different ECG modalities.Results3924 studies were identified, of which 47 were included reporting on a pooled population of 6448 patients with cryptogenic stroke. The pooled AF rate for implantable loop recorders (ILRs) increased from 4.9% (3.0%–7.9%) at 1 month to 38.4% (20.4%–60.2%) at 36 months. Mobile cardiac outpatient telemetry (MCOT) had a significantly higher pooled AF detection rate of 12.8% (8.9%–17.9%) versus 4.9% (3.0%–7.9%) for ILR at 1 month (p<0.0001). Predictors for AF detection include duration of monitoring (p<0.0001) and age (p<0.0001) for ILRs, but only age for MCOTs (p<0.020).ConclusionMCOT has a higher rate of detection at 1 month and is less invasive. Beyond 1 month, compliance becomes a significant limitation for MCOT. MCOT may be a reasonable alternative AF screening tool for patients with cryptogenic stroke if ILR is not available.PROSPERO registration numberCRD42022297782.
Use of multibiomarker disease activity scores in biosimilarity studies for the treatment of patients with rheumatoid arthritis
Authors: Kay Jonathan , Bock Amy E , Rehman Muhammad , Zhang Wuyan , Zhang Min , Iikuni Noriko , Alvarez Daniel F 
Published: September 2022

ObjectivesThis exploratory analysis investigated the potential use of the multibiomarker disease activity (MBDA) score to support biosimilarity assessments using data from two randomised controlled trials (RCTs) of biosimilar infliximab (IFX-qbtx) and biosimilar adalimumab (ADL-afzb) versus EU-sourced infliximab (Remicade; IFX-EU) and adalimumab (Humira; ADL-EU) reference products, respectively, both conducted in adult patients with active rheumatoid arthritis.MethodsIn one study, patients (N=650) were randomised 1:1 to IFX-qbtx or IFX-EU (3 mg/kg intravenous at weeks 0, 2 and 6, then every 8 weeks). In the other, patients (N=597) were randomised 1:1 to ADL-afzb or ADL-EU (40 mg subcutaneous every other week). All treatments were given with MTX. Mean values of MBDA scores were calculated at baseline (BL), based on the concentrations of 12 serum proteins using the Vectra disease activity algorithm, and at timepoints throughout treatment period 1 (TP1) of the IFX (weeks 6, 14, 30) and ADL (weeks 6, 12, 26) studies. Data were summarised using descriptive statistics for the intent-to-treat population, without imputation for missing data.ResultsAt BL, mean (±SD) MBDA scores were 61.3 (±12.5) and 58.8 (±13.2) for IFX-qbtx (n=236) and IFX-EU (n=248), respectively, and 57.2 (±14.44) and 58.3 (±15.34) for ADL-afzb (n=292) and ADL-EU (n=293), respectively. Mean MBDA scores were highly comparable between IFX-qbtx and IFX-EU and between ADL-afzb and ADL-EU at all measured timepoints during TP1 in each study.ConclusionsThese RCTs are the first to incorporate MBDA score as an exploratory assessment of biosimilarity. MBDA scores may provide objective, quantitative evidence of biosimilarity using an assessment of disease activity that is independent of the potential subjectivity inherent in joint counts, or in patient or physician global assessments.Trial registration numbersNCT02222493 and NCT02480153.
Web-based physical activity promotion in young people with CF: a randomised controlled trial
Authors: Cox Narelle S , Eldridge Beverley , Rawlings Sarah , Dreger Julianna , Corda Jennifer , Hauser Jennifer , Button Brenda M , Bishop Jennifer R , Nichols Amanda , Middleton Anna , Ward Nathan , Dwyer Tiffany , Dentice Ruth , Lazarus Raynuka , O'Halloran Paul , Lee Joanna Y T , Mellerick Christie , Mackintosh Kelly , McNarry Melitta , Williams Craig Anthony , Holland Anne E 
Published: September 2022

BackgroundPhysical activity levels are known to decline following hospitalisation for people with cystic fibrosis (pwCF). However, optimal physical activity promotion strategies are unclear. This study investigated the effect of a web-based application (ActivOnline) in promoting physical activity in young pwCF.MethodsMulticentre randomised controlled trial with assessor blinding and qualitative evaluation. People with CF (12–35 years) admitted to hospital for a respiratory cause were eligible and randomised to the 12-week ActivOnline intervention (AO) or usual care (UC). The primary outcome was change in device-based time spent in moderate-to-vigorous physical activity (MVPA) from baseline to post-intervention. Follow-up was at 6 months from hospital discharge when qualitative evaluation was undertaken.Results107 participants were randomised to AO (n=52) or UC (n=55). Sixty-three participants (59%) contributed to the intention-to-treat analysis. Mean (SD) age was 21 (6) years (n=46, <18 years). At baseline, physical activity levels were high in both groups (AO 102 (52) vs UC 127 (73) min/day). There was no statistically significant difference in MVPA between groups at either timepoint (post-intervention mean difference (95% CI) −14 mins (−45 to 16)). Uptake of the intervention was low with only 40% (n=21) of participants accessing the web application.ConclusionA web-based application, including individualised goal setting, real-time feedback and motivation for behavioural change, was no better than usual care at promoting physical activity in young pwCF following hospital discharge. High levels of baseline physical activity levels in both groups, and limited engagement with the intervention, suggest alternative strategies may be necessary to identify and support young pwCF who would benefit from enhanced physical activity.Trial registration numberACTRN12617001009303, 13 July 13 2017.
Reconstruction of complex network from time series data based on graph attention network and Gumbel Softmax
Authors: Wang Zhitao , Jiang Weinuo , Wu Wenkai , Wang Shihong 
Published: September 2022

It is a challenging practical problem to infer the network structure from measurable time series data. Recently, with the rapid development of graph deep learning, Zhang et al. [Appl. Netw. Sci. 4, 110 (2019)] applied graph neural network to the field of network reconstruction and proposed Gumbel Graph Network. In this paper, a graph deep learning network reconstruction method based on graph attention network and Gumbel Softmax (GAT-GS) is proposed, which can realize high accuracy network reconstruction and node state prediction of discrete and continuous systems. The GAT-GS model is designed based on the dynamic equation of nodes. It consists of two parts: a network structure learner to reconstruct a more real rather than functionally connected networks, based on Gumbel Softmax sampling to generate network structures; and a node state learner using graph attention networks to learn the state evolution of nodes, with the introduction of Laplacian matrix and adjacency matrix for better adaptation to diffusion coupling and unidirectional coupling systems. This model is trained to dynamically adjust the network adjacency matrix and attention coefficients to obtain the network structure and predict the node state. Experimental results show that the GAT-GS model has high reconstruction accuracy, strong robustness and high universality. It can be applied to various kinds of dynamic systems, including Coupled Map Lattice model and Lorenz system, can deal with time series data from regular to complete chaos, can reconstruct various kinds of complex networks, including regular network, Barabási–Albert network and Watts–Strogatz small world network, and it can also reconstruct networks from small scale to large scale with higher computational efficiency.
Image scrambler based on novel 4-D hyperchaotic system and magic square with fast Walsh–Hadamard transform
Authors: Zghair Hayder Kadhim , Ismael Hussein Ali , Al-Shamery Ameer Al-Haq 
Published: September 2022

A novel 4-D hyperchaotic system that have seven positive parameters in third order with thirteen terms is proposed,in this paper, the proposed chaotic behavior is proved by analysis of the Lyapunov's exponent, fractional dimension, zero-one test, sensitivity dependent on initial condition (SDIC), phase portraits, and waveform analysis, this study offers an innovative designed image encryption algorithm depending on a 4-D chaotic system using fast discrete Walsh-Hadamard transform and magic matrix that is both effective and simple for image encryption and gives it a higher level of security. This new 4-D hyperchaotic system is used to produce a random key in this algorithm. The implemented and simulated results using mathematica programs and MATLAB programs were supplied qualitatively and in figures. The proposed system is hyperchaotic, according to testing results, because it possesses two Lyapunov positive exponents.
Impact of Intracoronary Imaging‐Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups
Authors: Mohamed Mohamed O. , Kinnaird Tim , Wijeysundera Harindra C. , Johnson Thomas W. , Zaman Sarah , Rashid Muhammad , Moledina Saadiq , Ludman Peter , Mamas Mamas A. 
Published: September 2022

Background
Intracoronary imaging (ICI) has been shown to improve survival after percutaneous coronary intervention (PCI). Whether this prognostic benefit is sustained across different indications remains unclear.

Methods and Results
All PCI procedures performed in England and Wales between April, 2014 and March 31, 2020, were retrospectively analyzed. The association between ICI use and in‐hospital major acute cardiovascular and cerebrovascular events; composite of all‐cause mortality, stroke, and reinfarction and mortality was examined using multivariable logistic regression analysis for different imaging‐recommended indications as set by European Association for Percutaneous Cardiovascular Interventions consensus. Of 555 398 PCI procedures, 10.8% (n=59 752) were ICI‐guided. ICI use doubled between 2014 (7.8%) and 2020 (17.5%) and was highest in left main PCI (41.2%) and lowest in acute coronary syndrome (9%). Only specific European Association for Percutaneous Cardiovascular Interventions imaging‐recommended indications were associated with reduced major acute cardiovascular and cerebrovascular events and mortality, including left main PCI (odds ratio [OR], 0.45 [95% CI, 0.39–0.52] and 0.41 [95% CI, 0.35–0.48], respectively), acute coronary syndrome (OR, 0.76 [95% CI, 0.70–0.82] and 0.70 [95% CI, 0.63–0.77]), and stent length >60 mm (OR, 0.75 [95% CI, 0.59–0.94] and 0.72 [95% CI, 0.54–0.95]). Stent thrombosis and renal failure were associated with lower mortality (OR, 0.69 [95% CI, 0.52–0.91]) and major acute cardiovascular and cerebrovascular events (OR, 0.77 [95% CI, 0.60–0.99]), respectively.

Conclusions
ICI use has more than doubled over a 7‐year period at a national level but remains low, with <1 in 5 procedures performed under ICI guidance. In‐hospital survival was better with ICI‐guided than angiography‐guided PCI, albeit only for specific indications.