RELX Group (Netherlands)

This working paper reports on six pilot projects conducted as part of the UK Reproducibility Network’s Open Research Programme (ORP) to explore the feasibility of developing automated indicators for monitoring open research practices across UK universities. The pilots examined data quality, metadata standards, and automated extraction methods across six areas: FAIR data, open data, data availability statements, downstream effects of data sharing, pre-registration, and the use of the CRediT taxonomy. The findings highlight areas of promise, particularly pre-registration and elements of FAIRness, while also identifying major challenges related to inconsistent metadata, terminology, and workflows. The report outlines key recommendations for improving interoperability, enhancing data standards, and supporting the responsible development of future monitoring infrastructure.

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Postamputation pain in amputees is a major cause of morbidity. Studies have highlighted the impact of preemptive surgical intervention of the amputated nerves for treatment of postamputation pain. The study aimed to analyze the role of targeted muscle reinnervation (TMR) at the time of limb loss in addressing both residual limb pain and phantom limb pain. A randomized controlled trial (RCT) in acutely injured patients undergoing above-knee amputation (AKA) (n = 97) were randomized into two groups with equal allocation, i.e., group A with TMR (intervention) and group B with conventional stump formation (control) at the time of amputation using mixed block randomization. The timeframe for the outcome analysis was 48 hours and 12 weeks postamputation. The psychological well-being was assessed using the Hospital Anxiety and Depression Scale (HADS), McGill Pain Questionnaire (MPQ), and functionality using Patient Reported Outcomes Measurement Information System (PROMIS) pain questionnaires. The anatomical evaluation of the severed nerve was done at 12 weeks with high-frequency ultrasonography. The majority of the patients were males (n = 92, 94.8%) with a mean age of 32.5 years. The mean Mangled Extremity Severity Score (MESS) was comparable (p = 0.98) between the groups. The difference of the mean NRS of the residual limb pain (1.8 vs. 3.3) and phantom limb pain (1.2 vs. 2.6) was statistically significant between the two groups (p = 0.001). The psychological scores HADS, MPQ, and PROMIS were statistically significant. The neuroma size measured using ultrasound at 12 weeks was statistically significant between the groups (p < 0.05). The preemptive surgical intervention of amputated nerve at the time of amputation by TMR techniques significantly reduces the postoperative residual limb pain and phantom limb pain at 3 months follow up. Randomized Controlled Trial with no negative criteria; Level I.

Artificial intelligence (AI) is transforming healthcare by equipping clinicians and patients with tools that support more efficient, patient-centered care. In pediatrics, however, the implementation of AI demands a higher threshold for responsibility, transparency, and family-centered engagement. This perspective explores the opportunities and challenges of AI in pediatric healthcare, highlighting the unique ethical and developmental considerations that distinguish children’s care from adult medicine. Drawing on Kaiser Permanente’s seven principles for responsible AI, the article emphasizes the importance of augmentation over automation, the need for pediatric-specific validation, and the necessity of trustworthiness and fairness in clinical deployment. It outlines how AI can support primary care providers through enhanced decision support, early screening for developmental and behavioral disorders, including the potential for AI to create personalized developmental trajectories, moving beyond static population norms to provide earlier, more precise insights into a child’s neurodevelopmental progress, improved electronic health record usability, and risk prediction models. However, without careful governance, AI poses risks of bias, inequity, and erosion of clinician judgment. Policy recommendations include redesigning family consent models, ensuring robust clinician training, and mandating pediatric-specific testing of AI systems with diverse, representative datasets. Ultimately, AI should function as a supportive tool that strengthens, not replaces, human empathy, clinical expertise, and family-centered values. Responsible innovation is essential to ensure that children benefit equitably from AI while maintaining trust, safety, and compassion in pediatric healthcare.

This study assessed the validity of a widely used standardized exit exam (E2) as a predictor of Next Generation NCLEX (NGN) and examined the relationship between policies governing E2 use in programs and success on the NGN. A total of 32 programs across the United States and Canada provided NGN outcome information for 1,753 students who took the E2 in April to December 2023, and 36 programs provided information about their policies. Students who achieved an average E2 score of 850 and above had an NGN first-time pass rate (FTPR) of 98%, significantly higher than those with average scores under 850. Policies such as test preparation requirements and remediation for the E2 were associated with significantly higher student E2 benchmark attainment. This study presents updated evidence on the validity of the E2 and expands research in the ways specific policies can support student success on the E2 and, by extension, potentially the NGN.

Recent studies have proposed revising the conventional airway-breathing-circulation (ABC) sequence to a circulation-airway-breathing (CAB) approach. We evaluated the potential benefit of the CAB sequence, emphasizing the timing of blood transfusion in trauma resuscitation. We retrospectively analyzed data from the trauma registry and electronic medical records at our institution between March 2016 and February 2024. Adult trauma patients with systolic blood pressure of <90 mm Hg in the resuscitation room who underwent both endotracheal intubation and blood transfusion within 1 hour of arrival were included. To control for confounding factors, including demographics, vital signs, Injury Severity Score, and head/neck Abbreviated Injury Scale, logistic regression analysis was performed after propensity score matching. A total of 690 patients met the inclusion criteria: 244 received transfusion before intubation (CAB group), and 446 were intubated before transfusion (ABC group). After propensity score matching, 231 patients were included in each group. Intubation occurred 14 minutes earlier, and transfusion occurred 11 minutes later in the ABC group than in the CAB group. Postintubation hypotension was more frequent in the ABC group (73% vs. 64%; p = 0.046), whereas unplanned intensive care unit admission was higher in the CAB group. The median hospital stay was shorter in the ABC group (25 [7-50] days) than in the CAB group (30 [14-50] days) ( p = 0.014). In multivariable analysis, CAB resuscitation was independently associated with reduced 30-day mortality (adjusted odds ratio, 0.57; 95% confidence interval, 0.33-0.99; p = 0.045). This study demonstrated that transfusion-first resuscitation (CAB) improved hemodynamic stability and 30-day survival compared with the conventional ABC sequence. Prioritizing circulation before airway management may reduce postintubation hypotension and guide future trauma resuscitation strategies. Further prospective multicenter studies are warranted to validate these findings. Therapeutic/Care Management; Level III.