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Responsible Generative AI for SMEs in UK and Africa (RAISE): An Education AI Case Study
Get PDFThis report presents a series of case studies developed under the Responsible Generative AI for SMEs in the UK and Africa (RAISE) project, examining how small and medium-sized enterprises (SMEs) understand, adopt, and operationalise generative AI in practice. Drawing on in-depth qualitative engagement with participating organisations across diverse sectors, the case studies explore anticipated benefits, technical and organisational challenges, and the ethical, legal, and social considerations shaping AI integration. The RAISE case studies demonstrate how responsible AI principles are interpreted pragmatically by SMEs and illustrate the value of context-sensitive, actionable guidance in supporting responsible adoption. Collectively, the cases provide empirical insight into the realities of generative AI use in resource-constrained environments and inform the development of practical frameworks for responsible AI implementation in SMEs
Identification and Characterisation of Canine Osteosarcoma Biomarkers and Therapeutic Targets
Get PDFBackground: Osteosarcoma (OSA) is the most common type of bone cancer in canines. Novel therapies are required to prevent the growth, survival, and metastatic progression of this cancer, to increase life expectancy of patients. Immunohistochemical (IHC) studies and RNA sequencing help us gain a deeper understanding into the molecular mechanisms of the disease. Methods: We previously compared canine OSA tissues with patient matched non-tumour tissues, revealing 442 overexpressed genes within the samples. The present research used IHC staining for four of these genes in OSA tissues: G protein-coupled receptor 64 (GPR64), TOX High Mobility Group Box Family Member 3 (TOX3), Matrix Metallopeptidase 12 (MMP-12), and Forkhead Box F1 (FOXF1). H-scoring was performed to quantitatively assess protein expression and qualitatively contextualise staining locations. Additional analyses addressed whether gender or anatomical location of lesions (axial or appendicular tumours) affected protein expression. cBioPortal was employed to analyse expression and genetic alterations in patients. Results:GPR64, TOX3, MMP-12, and FOXF1 showed high mRNA expression and genetic alterations in people with OSA. GPR64, TOX3, MMP-12, and FOXF1 were all expressed in canine OSA with novel findings regarding cellular expression. Additionally, differential sex expression was revealed for GPR64 and TOX3. Potential biomarkers or therapeutic targets were identified. Conclusions: These studies, and subsequent analysis, have provided insights into the molecular mechanisms associated with OSA progression and revealed potential biomarkers for diagnostic and prognostic purposes. A deeper understanding of genetic and protein interactions will support and progress novel pathways towards diagnostic, prognostic, and treatment interventions for OSA in both veterinary and human medicine
Distinguishing AKI from CKD: outcomes and characteristics of patients with abnormal serum creatinine and no known baseline
Get PDFBackground: Comparison of a patient’s abnormal serum creatinine result to an earlier value is fundamental to differentiating Acute Kidney Injury (AKI) from Chronic Kidney Disease (CKD), and is the first step in electronic AKI detection systems. For those patients in whom a baseline serum creatinine is unavailable, some systems generate a warning message to highlight the elevated serum creatinine but without distinguishing AKI from CKD (a “?AKI?CKD” warning). We aimed to determine demographic characteristics of this group, the proportion who had a first presentation of AKI, their clinical outcomes, and how these alert messages translate into subsequent biochemical testing and follow-up. Methods: We performed a retrospective cohort analysis of adult patients with serum creatinine testing at University Hospitals of Leicester during 2019. Using the NHS England AKI detection algorithm, we identified patients with AKI Warning Test Scores (WTS) and “?AKI?CKD” warnings. The “?AKI?CKD” cohort was classified as probable AKI, probable CKD, or no follow-up result, based on subsequent serum creatinine measurements. Survival (90-day and 1-year) was analysed with Kaplan–Meier methods. Results: Among 3,464 patients with “?AKI?CKD” warnings, 8.5% were probable AKI, 59.4% probable CKD, and 32.0% had no follow-up test. Probable AKI patients were younger (median age 71 versus 76 years) and more often hospitalised at warning time (56% versus 15%). One-year survival was lower in probable AKI (72%) compared to probable CKD (88%) or no follow-up (89%). Probable AKI survival was similar to AKI WTS stage 1 but better than stages 2–3. Extending baseline serum creatinine look-back to 426 days changed categorisation minimally (≤ 2%). Conclusions: These findings highlight that the major feature of the “?AKI?CKD” classification is not simply misclassification between AKI and CKD, but the variability of clinical response, with one-third of patients receiving no subsequent serum creatinine test. Most patients flagged as “?AKI?CKD” likely have CKD rather than AKI, and this, coupled with comparable outcomes of the probable AKI group to early-stage AKI, suggests minimal missed population-level AKI detection. However, one-third lacked follow-up testing, highlighting missed opportunities to identify CKD. Clinical trial number: Not applicable
Investigating the applicability of the SAFER-YCL care bundle for transitions from CAMHS Crisis and Liaison services: the barriers and enablers
Get PDFBackground: Crisis and Liaison teams in Child and Adolescent Mental Health Services (CAMHS) offer intensive, short-term support to young people experiencing mental health crisis in the community (Crisis) or admitted to acute hospitals (Liaison). There is no evidence-based model for how these teams operate. The SAFER care bundle, designed to improve discharges from acute hospitals, has been adapted for use in mental health inpatient discharges for adults (SAFER-MH) and young people (SAFER-YMH). This study took a care bundle designed to improve discharges from CAMHS inpatient care (SAFER-YMH) and used stakeholder feedback to adapt it for use in CAMHS Crisis and Liaison teams. Design: Focus groups were carried out with healthcare professionals (HCPs), young people and parents/carers to present the SAFER care bundle and discuss necessary adaptations for use in CAMHS Crisis and Liaison teams. Analysis of transcripts followed a Normalisation Process Theory (NPT) framework to identify barriers and facilitators to implementation and necessary adaptations. Results: Participants expressed that integrating the SAFER-YCL care bundle into the electronic patient record, automatically pulling information from other forms, and providing a template for discharge letters and safety plans could serve as an aide-memoire and potentially replace current discharge documents. It would need to avoid increasing documentation burden for staff and have flexibility to be administered by different staff members and at an appropriate time. Conclusions: The SAFER-YCL care bundle has been successfully developed for implementation in CAMHS Crisis and Liaison services, demonstrating potential to enhance transition experiences. Feasibility testing will be crucial to validate its effectiveness and facilitate successful integration into clinical practice. Patient or Public Contribution: This study was initially presented at the Nottinghamshire Healthcare NHS Foundation Trust's Involvement group of young people to gather their thoughts on it. They were supportive of the study design and gave constructive feedback on the study. A PPI representative with lived experience was part of the study team who was involved in developing and reviewing all study materials, was part of monthly reviews of the study's progress and supported data collection, analysis and write-up of the study results
Beyond the classroom: a commentary on overcoming the challenges with conducting research in schools by using public engagement as a novel approach to data collection
Get PDFRecruiting participants for psychological research is a well-known and frequently reported challenge associated with the research process. This is especially challenging when recruiting younger populations, often leading researchers to rely on educational settings for recruitment and data collection. This commentary explores the challenges of conducting research in schools, the potential drawbacks of this reliance, and proposes an alternative approach to address these challenges. We propose an alternative recruitment method utilising public engagement sessions with established groups, such as Scouting and Girlguiding communities, to facilitate data collection. This recruitment model has the potential to transform recruitment dynamics, overcome many of the barriers associated with school-based testing and offer researchers an alternative pathway to optimise data collection in psychological research with young people
30-day postoperative mortality and the effects of hospital preparedness during the COVID-19 pandemic: a pooled analysis of prospective international cohort studies
Get PDFBackgroundSurgical services were poorly prepared for the COVID-19 pandemic, leading to widescale disruption to elective activity. This study aimed to identify actionable priorities to strengthen pandemic preparedness of surgical and hospital systems.MethodsThis study pooled data from three international, prospective cohort studies including patients who had a positive SARS-CoV-2 test result in the seven days before or within 30 days after surgery. Patients were included across four pandemic time periods: Period 1 (January–May 2020), Period 2 (June–July 2020), Period 3 (October 2020), and Period 4 (December–March 2022). The primary outcome measure was 30-day postoperative mortality. Hierarchical logistic regression models were developed to explore association between pandemic periods (primary analysis) and hospital-level preparedness (secondary analysis) on 30-day postoperative mortality. Hospital preparedness was classified in to poorly-, moderately-, and highly-prepared tertiles based on Surgical Preparedness Index (SPI) score.FindingsA total of 31,751 patients were included from 1589 hospitals and 102 countries. From Period 1 through to Period 4 there was a decrease in the proportion of patients aged ≥70 years and with ASA grades 3–5.30-day postoperative mortality fell from Period 1 (18.4% [1378/7502]), Period 2 (9.9% [219/2234], adjusted odds ratio (aOR) 0.65, 95% confidence interval (CI) 0.53–0.78), Period 3 (10.5% [246/2427], aOR 0.60, 95% CI 0.50–0.71), through to Period 4 (5.8% [1132/19,588], aOR 0.33, 95% CI 0.30–0.37). During Period 4, SARS-CoV-2 vaccinated patients had lower mortality compared to unvaccinated patients (4.9% [603/12,361] versus 7.4% [529/7178], aOR 0.49, 95% CI 0.42–0.57). Compared to poorly-prepared hospitals (11.2% [1019/9071]), moderately-prepared (9.4% [857/9071], aOR 0.84, 95% CI 0.75–0.94) and highly-prepared hospitals (5.8% [530/9071], aOR 0.70, 95% CI 0.62–0.80) had lower mortality.InterpretationPostoperative mortality decreased over the course of the COVID-19 pandemic and was lower in better prepared hospitals. Hospitals are critical national infrastructure and strengthening their preparedness by developing formal pandemic plans, establishing patient and procedure prioritisation protocols, and ring-fencing surgical beds would ensure safer surgical care during future pandemics
Understanding the role of executive functions in academic skills: A primer on measurement and study design
Get PDFResearch across multiple fields and a broad range of study designs demonstrates that executive function (EF) serves a critical role in cognitive and academic development. Given the extent of the literature on the topic, the variety of EF models, and the various methods of investigating it, EF can be a challenging topic to navigate. With this article, we aim to provide a primer for researchers new to the field of EF on how to navigate the literature, articulate a study design, and choose EF tasks that align with this study design, specifically when investigating the role of EF in the context of developing academic skills such as reading and mathematics. We first provide a targeted onramp to the wide literature on existing models of EF. Then, we detail specific issues concerning the measurement of EF across different environmental/cultural and cognitive contexts. Lastly, we lay out a practical guide, with heuristics and examples, of how this research can be conducted effectively
Care and support needs of families in the first 9 months after PICU discharge: A multi-center, longitudinal, qualitative study
Get PDFAimTo explore the experiences, associated care and support needs of families in the 9-months following a child’s Pediatric Intensive Care Unit (PICU) discharge, using the Post-Intensive Care Syndrome in Pediatrics (PICS-p) framework.MethodsAn embedded qualitative study within the OCEANIC longitudinal mixed-methods study was conducted across seven PICUs in England. Forty families were purposively sampled and interviewed at two time points (1–3 and 6–9 months post-discharge). Semi-structured interviews with children, parents, and siblings were analysed using Framework Analysis, informed by both deductive and inductive approaches.FindingsA total of 57 participants (45 parents; 11 children; 1 sibling) were interviewed from May 2020 − November 2022. Themes in care and support revealed multifaceted and interdependent needs across physical, cognitive, emotional, and social health domains. Unmet needs in one domain often exacerbated challenges in others, and across family members. Key concerns included lack of coordinated follow-up care, psychological distress, cognitive burden related to life administration, and financial strain. The COVID-19 pandemic intensified these challenges, particularly through restricted hospital access and disrupted healthcare services.ConclusionsIn the nine months following discharge from the PICU, families experience complex, evolving needs post-PICU discharge, many of which remain unmet and interlinked across PICS-p domains. The pandemic context amplified these needs, highlighting systemic gaps in post-discharge support and continuity of care.Implications for clinical practiceFindings illuminate the necessity for integrated, family-centred follow-up services that address physical recovery, psychological support, and social determinants of health. Routine screening for PICS-p morbidity, improved interprofessional communication, and accessible mental health services are essential. Tailored interventions should be developed and tested to support families at risk, ensuring equitable recovery and long-term wellbeing
Behavioural drivers of on-farm biosecurity implementation in livestock: A literature overview with insights for research
Get PDFGlobal livestock intensification heightens disease risks, making effective biosecurity crucial. However, the inconsistent adoption of biosecurity measures and the behavioural drivers behind this variability are not fully understood. This review assessed the current state of knowledge and identified evidence gaps regarding drivers influencing stakeholders’ decision-making and the implementation of biosecurity practices, to clarify why well-established measures are not consistently applied and to guide research addressing the factors shaping biosecurity implementation.Following PRISMA 2020 guidelines, a systematic search up to October 2023 was conducted across PubMed, Web of Science, and Scopus. Using a literature overview methodology, we retrieved relevant review articles on biosecurity decision-making (first phase), from which we identified relevant original research cited within them (second phase). Thematic analysis used the Capability, Opportunity and Motivation Behaviour (COM-B) model, with the Theoretical Domains Framework (TDF) guiding the coding procedure.Of 811 reviews initially retrieved, 37 were included. From these, 205 original research articles were identified, of which 78 were included. Most original studies originated from Europe and Central Asia (n = 38), highlighting geographical biases. Research mainly targeted farmers (n = 78), with few studies targeting veterinarians (n = 6). While 45 articles addressed all three COM-B components, beyond half (n = 46) reported four or fewer TDF domains, suggesting important knowledge gaps in the literature.Future studies should target understudied regions, TDF domains (e.g. Skills, Goals and Reinforcement) and stakeholders (e.g. farmers) to effectively implement biosecurity measures. This will help the livestock sector adopt evidence-based biosecurity and adhering to it, improving animal health and resilience worldwide
Imagine Yourself to Wellness: Harnessing the Power of Imagination
Get PDFBackground: Guided imagery, a technique that harnesses imagination to promote relaxation and well-being, has shown benefits in chronic illness. However, its role in vasculitis remains unexplored.Objective: To co-design and evaluate a 10-week online guided imagery programme with patient partners, led by the RECORDER Team at the University of Nottingham and informed by Rossman (2000).Methods: Three patients contributed to programme development, and thirteen individuals with vasculitis participated. Sessions were delivered online, with feedback obtained through discussions about the imagery exercises and an anonymous questionnaire.Findings: All participants found at least some guided imagery exercises helpful, though engagement varied. Challenges included initial difficulty creating sensory images and discomfort with certain exercises, but group support and facilitator guidance encouraged continued participation.Conclusion: While not a universal solution, guided imagery is an accessible, low-cost self-management tool. All participants believed it could help others with chronic illness and supported further research into its role in vasculitis care
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