bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of collegial midwifery assistance during second stage of labour on women’s experience: a follow-up from the Swedish Oneplus randomised controlled trial
Authors: Häggsgård Cecilia , Edqvist Malin , Teleman Pia , Tern Helena , Rubertsson Christine 
Published: July 2024

ObjectiveTo compare experiences of the second stage of labour in women randomised to assistance by one or by two midwives to reduce severe perineal trauma (SPT).DesignAnalysis of a secondary outcome within the Swedish Oneplus multicentre randomised trial.SettingFive obstetric units in Sweden between December 2018 and March 2020.ParticipantsInclusion criteria in the Oneplus trial were women opting for their first vaginal birth from gestational week 37+0 with a singleton pregnancy and a live fetus in the vertex presentation. Further inclusion criteria were language proficiency in Swedish, English, Arabic or Farsi. Exclusion criteria were multiple pregnancies, intrauterine fetal demise and planned caesarean section. Of the 3059 women who had a spontaneous vaginal birth, 2831 women had consented to participate in the follow-up questionnaire.InterventionsWomen were randomly assigned (1:1) to assistance by two midwives (intervention group) or one midwife (standard care) when reaching the second stage of labour.Outcome measuresData were analysed by intention to treat. Comparisons between intervention and standard care regarding experiences of the second stage of labour were evaluated with items rated on Likert scales. The Student’s t-test was used to calculate mean differences with 95% CIs.ResultsIn total 2221 (78.5%) women responded to the questionnaire. There were no statistically significant differences regarding women’s experiences of being in control, feelings of vulnerability or pain. Women randomised to be assisted by two midwives agreed to a lesser extent that they could handle the situation during the second stage (mean 3.18 vs 3.26, 95% CI 0.01 to 0.15). Conducted subgroup analyses revealed that this result originated from one of the study sites.ConclusionsThe intervention’s lack of impact on the experience of the second stage is of importance considering the reduction in SPT when being assisted by two midwives.Trial registration numberNCT03770962.
Effectiveness and cost-effectiveness of radiofrequency denervation versus placebo for chronic and moderate to severe low back pain: study protocol for the RADICAL randomised controlled trial
Authors: Ashton Kate E , Price Cathy , Fleming Leah , Blom Ashley W , Culliford Lucy , Evans Rebecca Nicole , Foster Nadine E , Hollingworth William , Jameson Catherine , Jeynes Nouf , Moore Andrew J , Orpen Neil , Palmer Cecily , Reeves Barnaby C , Rogers Chris A , Wylde Vikki 
Published: July 2024

IntroductionLow back pain (LBP) is the leading global cause of disability. Patients with moderate to severe LBP who respond positively to a diagnostic medial nerve branch block can be offered radiofrequency denervation (RFD). However, high-quality evidence on the effectiveness of RFD is lacking.Methods and analysisRADICAL (RADIofrequenCy denervAtion for Low back pain) is a double-blind, parallel-group, superiority randomised controlled trial. A total of 250 adults listed for RFD will be recruited from approximately 20 National Health Service (NHS) pain and spinal clinics. Recruitment processes will be optimised through qualitative research during a 12-month internal pilot phase. Participants will be randomised in theatre using a 1:1 allocation ratio to RFD or placebo. RFD technique will follow best practice guidelines developed for the trial. Placebo RFD will follow the same protocol, but the electrode tip temperature will not be raised. Participants who do not experience a clinically meaningful improvement in pain 3 months after randomisation will be offered the alternative intervention to the one provided at the outset without disclosing the original allocation. The primary clinical outcome will be pain severity, measured using a pain Numeric Rating Scale, at 3 months after randomisation. Secondary outcomes will be assessed up to 2 years after randomisation and include disability, health-related quality of life, psychological distress, time to pain recovery, satisfaction, adverse events, work outcomes and healthcare utilisation. The primary statistical analyses will be by intention to treat and will follow a prespecified analysis plan. The primary economic evaluation will take an NHS and social services perspective and estimate the discounted cost per quality-adjusted life-year and incremental net benefit of RFD over the 2-year follow-up period.Ethics and disseminationEthics approval was obtained from the London—Fulham Research Ethics Committee (21/LO/0471). Results will be disseminated in open-access publications and plain language summaries.Trial registration numberISRCTN16473239.
Study protocol of the HessenKohorte2042: a prospective, longitudinal cohort study characterising quality of life in people with Parkinson’s disease and their caregivers using a bio-psycho-social approach
Authors: Kleinholdermann Urs , Thieken Franziska , Ruppert-Junck Marina Christine , van Munster Marlena , Pedrosa Anna Julia , Stümpel Johanne , Hammes Vincent , Timmermann Lars , Woopen Christiane , Schmitz-Luhn Björn , Storms Anna , Golla Heidrun , Nater Urs M , Skoluda Nadine , Pfefferle Petra Ina , Pedrosa David José 
Published: July 2024

IntroductionQuality of life (QoL) is of paramount importance as an outcome to monitor and guide therapies for people with Parkinson’s disease (PwPD). In particular, due to the heterogeneous symptoms that PwPD may experience during their disease course, QoL can deteriorate not only in patients but also in their caregivers, with a variety of psychosocial consequences. However, there is a lack of longitudinal studies that explore how QoL evolves over time and what factors are significant. Furthermore, holistic approaches that consider bio-psycho-social determinants are rare. In the worst cases, these gaps can lead to suboptimal care and therefore unmet needs for patients and their caregivers, resulting in unnecessary symptom burden and increased healthcare costs for society.Methods and analysisThis prospective, longitudinal study will follow 1000 PwPD along with their caregivers for 20 years, with up to 40 semi-annual assessments. Patient data and sample collection will include clinical assessments, self-reported outcome measures focusing on QoL, biospecimen collection and MRI. Caregiver burden will be systematically assessed through self-administered questionnaires. The use of digitised surveys will allow efficient data collection and convenient assessment at home. Our primary objective is to attain a holistic understanding of QoL in PwPD and establish a tool to measure it. The secondary objective is to explore the psycho-social and biological variables associated with QoL of patients and caregivers over the progression of the disease. This will provide key information for diagnostic and prognostic prediction, therapeutic patient stratification and adaptation of therapy in the future.Ethics and disseminationThe study was approved by the local ethics committee of the University Hospital of Marburg (study number: 209/19). The results will be disseminated by means of publication in peer-reviewed journals, international conference contributions, annual patient meetings and a dedicated website.Trial registration numberGerman Clinical Trials Register (DRKS00023598).
Primary healthcare in the aftermath of the COVID-19 pandemic: a qualitative interview study in Sweden
Authors: Fernemark Hanna , Hårdstedt Maria , Skagerström Janna , Seing Ida , Karlsson Elin , Nilsen Per , Schildmeijer Kristina Görel Ingegerd 
Published: July 2024

ObjectiveTo explore how primary healthcare workers in Sweden experienced and perceived the long-term impact of the pandemic on their work.DesignThis is a descriptive qualitative study with individual semistructured interviews conducted 2 years after the onset of COVID-19. Data were analysed using an inductive thematic approach.SettingSwedish primary healthcare units in rural and urban locations.Participants29 healthcare providers (6 registered nurses, 7 assistant nurses, 8 physicians and 8 managers) in Swedish primary healthcare.ResultsData analysis yielded three overarching themes: (1) primary healthcare still affected by the pandemic; (2) primary healthcare changes made permanent; and (3) lessons learnt for handling future crises affecting primary healthcare. The participants experienced a high workload, even after the pandemic, and concluded that it would take years to catch up both mentally and workwise. Four lessons were learnt for future handling of crises that might affect primary healthcare: the importance of creating a cohesive primary healthcare management system to provide clarity regarding recommendations for how primary healthcare personnel should work, the need for management support at all levels, restricting and adapting the flow of information for primary healthcare and ascertaining the necessary resources if primary healthcare is to take on additional tasks.ConclusionTwo years after the onset of the COVID-19 pandemic, primary healthcare workers in Sweden experienced that their work was still affected by the pandemic. Our findings highlight the importance of ensuring sufficient recovery time and providing opportunities for reflection on the experiences of primary healthcare personnel. This also includes preparedness for managing the heavy workload and strained energy levels of healthcare workers in the aftermath of a crisis.
Timely integration of specialist palliative home care (SPHC) for patients with congestive heart failure, chronic obstructive pulmonary disease and dementia: qualitative evaluation of the experiences of SPHC physicians in the KOPAL trial
Authors: Schade Franziska , Hüttenrauch Danica , Schwabe Sven , Mueller Christiane A , Pohontsch Nadine Janis , Stiel Stephanie , Scherer Martin , Marx Gabriella , Nauck Friedemann 
Published: July 2024

ObjectiveChronic non-malignant diseases (CNMDs) are under-represented in specialist palliative home care (SPHC). The timely integration of SPHC for patients suffering from these diseases can reduce hospitalisation and alleviate symptom burdens. An intervention of an SPHC nurse–patient consultation followed by an interprofessional telephone case conference with the general practitioner (GP) was tested in the KOPAL trial (‘Concept for strengthening interprofessional collaboration for patients with palliative care needs’). As part of the trial, the aim of this study was to gain in-depth insights into SPHC physicians’ perspective on care with and without the KOPAL intervention for patients with congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and dementia (D).DesignQualitative evaluation of the KOPAL intervention from the perspective of SPHC physicians as part of the KOPAL trial. Thematic-focused narrative interviews analysed with grounded theory.SettingWe conducted the KOPAL study and its qualitative evaluation in Lower Saxony and the greater Hamburg area, Germany.Participants11 physicians from 14 SPHC teams who participated in the trial were interviewed.ResultsA grounded theory of the necessity of collaboration between GPs and SPHC teams for patients with CHF, COPD and dementia was developed. From the perspective of SPHC physicians, patients with CNMD are generally difficult to manage in GP care. The timing of SPHC initiation is patient-specific, underscoring the need for collaboration between SPHC physicians and GPs. However, the primary mandate for healthcare should remain with GPs. SPHC physicians actively seek collaboration with GPs (eg, through the KOPAL intervention), viewing themselves as advisors for GPs and aspiring to collaborate as equal partners.ConclusionEffective communication and the negotiation of future interprofessional collaboration are essential for SPHC teams.Trial registration numberDRKS00017795.
Improving Miscarriage Prevention Research: a survey exploring the expectations of service users and stakeholders (IMPRESS) – a study protocol for a UK-based survey
Authors: Black Naomi , Quenby Siobhan , Odendaal Joshua 
Published: July 2024

IntroductionInterventional clinical trials in recurrent miscarriage use varying expected effect sizes to inform their sample size calculations. Often these are not informed by what stakeholders consider a meaningful treatment effect. Adaptive trial designs may integrate stakeholder views on trial success and futility but the criteria to inform this is lacking. This study aims to understand relevant stakeholder views of what is considered a worthwhile treatment effect for miscarriage prevention interventions and what is acceptable stopping criteria in miscarriage clinical trials.Methods and analysisThe study is designed as a cross-sectional online anonymous survey. The survey presents different scenarios to respondents relating to varying target differences and probability thresholds and explores success and futility criteria for clinical trials. The survey was developed with personal and public involvement (PPI) through focus groups and a PPI partner. Eligible participants will be those with a personal history of miscarriage, including partners, and healthcare professionals who manage patients who experience a miscarriage. Convenience, snowball and purposive sampling techniques will be employed to invite eligible participants to complete the survey. The survey will be accepting responses for an initial 2-week pilot to check validity, prior to being open for a further 12 weeks. Descriptive analyses and linear regression analyses will synthesise the survey results.Ethics and disseminationEthical approval was obtained from the NHS Research Ethics Committee North West—Greater Manchester East (23/NW/0322) on 30 January 2024. Informed consent will be obtained prior to survey completion. No personal identifying information will be collected. The results will be published in a relevant scientific journal and communicated through our institutional website.
Application of speaking valves in adult patients with tracheostomy: a protocol for a systematic review and meta-analysis
Authors: Duan Dan , Cui Wenyao , Liu Wenjie , Xie Jingying 
Published: July 2024

IntroductionTracheostomy is a common emergency procedure for critically ill patients to secure their airway. The speaking valve is a one-way ventilation valve that is attached to the end of the tracheostomy tube to help the patient remodel subglottic pressure. However, the efficacy and safety of speaking valves in adult patients with tracheostomy remain controversial. The purpose of this protocol is to describe and evaluate the effectiveness, safety and impact on the quality of life of speaking valves in adult patients with tracheostomy.Methods and analysisWe will search four English databases (PubMed, Embase, Cochrane Library and Web of Science), grey literature websites and reference lists of original studies to screen for studies that might meet the criteria. The two authors will independently screen the literature, extract data and assess the quality and risk of bias of the included studies. The primary outcomes will focus on the patients’ swallowing function, vocalisation and quality of life. We will use a fixed effects model or a random effects model based on heterogeneity testing or a descriptive analysis only. The quality of evidence on the effects of interventions will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation.Ethics and disseminationThis study is based on the literature in the database and does not require the approval of the ethics committee. The results will be disseminated through a peer-reviewed journal and conferences.PROSPERO registration numberCRD42024502906.
Incidents and patterns ofcommotio cordisamong athletes in the USA from 1982 to 2023
Authors: Shore Erin , Moseley Garrett A , DeLong Randi , Register-Mihalik Johna , Drezner Jonathan A , Dickey Grant James , Mao Haojie , Cantu Robert C , Kucera Kristen L 
Published: July 2024

IntroductionCommotio cordisis a rare event that occurs following blunt, non-penetrating trauma to the chest, precipitating a ventricular arrhythmia.Commotio cordisrequires immediate medical attention through cardiopulmonary resuscitation and defibrillation, often resulting in death.Commotio cordisis most common condition among young male athletes. The purpose of this study was to describe the incidents and patterns ofcommotio cordisamong young athletes participating in organised sports in the USA from academic years 1982-1983 through 2022-2023.MethodsThis was a retrospective, descriptive epidemiology study using surveillance data from the National Center for Catastrophic Sport Injury Research. The study included allcommotio cordisincidents captured in the database. We calculated descriptive statistics (counts and proportions) overall and stratified by outcome and athlete sport.ResultsOver the study period, 64 incidents of commotio cordis were captured. The majority occurred among males (n=60) and were caused by contact with an object/apparatus (n=39) or contact with another player (n=20). The most common sports were baseball (n=20), lacrosse (n=17) and football (n=13). Over half of these incidents resulted in death (n=34), although survival fromcommotio cordisincreased over the study period. A higher proportion of fatal incidents occurred among football athletes and were caused by contact with another player.ConclusionsCommotio cordisremains most common among young male athletes who participate in organised baseball, lacrosse and football. Although survival has improved over time, greater awareness and emergency preparedness forcommotio cordisin an organised sport are needed to facilitate prompt recognition and intervention.
POSTN+cancer-associated fibroblasts determine the efficacy of immunotherapy in hepatocellular carcinoma
Authors: Wang Hao , Liang Yuan , Liu Zheng , Zhang Rui , Chao Jiashuo , Wang Mingming , Liu Mu , Qiao Lei , Xuan Zhengfeng , Zhao Haitao , Lu Ling 
Published: July 2024

ObjectiveHepatocellular carcinoma (HCC) poses a significant clinical challenge because the long-term benefits of immune checkpoint blockade therapy are limited. A comprehensive understanding of the mechanisms underlying immunotherapy resistance in HCC is imperative for improving patient prognosis.DesignIn this study, to systematically investigate the characteristics of cancer-associated fibroblast (CAF) subsets and the dynamic communication among the tumor microenvironment (TME) components regulated by CAF subsets, we generated an HCC atlas by compiling single-cell RNA sequencing (scRNA-seq) datasets on 220 samples from six datasets. We combined spatial transcriptomics with scRNA-seq and multiplexed immunofluorescence to identify the specific CAF subsets in the TME that determine the efficacy of immunotherapy in HCC patients.ResultsOur findings highlight the pivotal role of POSTN+CAFs as potent immune response barriers at specific tumor locations, as they hinder effective T-cell infiltration and decrease the efficacy of immunotherapy. Additionally, we elucidated the interplay between POSTN+CAFs and SPP1+macrophages, whereby the former recruits the latter and triggers increased SPP1 expression via the IL-6/STAT3 signaling pathway. Moreover, we demonstrated a spatial correlation between POSTN+CAFs and SPP1+macrophages, revealing an immunosuppressive microenvironment that limits the immunotherapy response. Notably, we found that patients with elevated expression levels of both POSTN+CAFs and SPP1+macrophages achieved less therapeutic benefit in an immunotherapy cohort.ConclusionOur research elucidates light on the role of a particular subset of CAFs in immunotherapy resistance, emphasizing the potential benefits of targeting specific CAF subpopulations to improve clinical responses to immunotherapy.
NAD+metabolism enzyme NNMT in cancer-associated fibroblasts drives tumor progression and resistance to immunotherapy by modulating macrophages in urothelial bladder cancer
Authors: Yang Meihua , Wang Bo , Hou Weibin , Zeng Honghui , He Wang , Zhang Xin-Ke , Yan Dong , Yu Hao , Huang Long , Pei Lu , Li Kaiwen , Qin Haide , Lin Tianxin , Huang Jian 
Published: July 2024

BackgroundThis study comprehensively investigates the association between the expression of nicotinamide N-methyltransferase (NNMT) and clinical outcomes of urothelial bladder cancer (UBC), as well as the molecular mechanisms by which NNMT in cancer-associated fibroblast (CAF) modulates tumor progression and immunotherapy resistance in UBC.MethodsSingle-cell transcriptomic analyses, immunohistochemical and immunofluorescence assays were performed on bladder cancer samples to validate the relationship between NNMT expression and clinical outcomes. A series of experiments, including chromatin immunoprecipitation assay, liquid chromatography tandem mass spectrometry assay, and CRISPR‒Cas9 (Clustered Regularly Interspaced Short Palindromic Repeats and CRISPR-associated protein 9) knockout, together within vivomodels, have been established to determine the molecular functions of NNMT in CAFs in UBC.ResultsWe demonstrated that elevated expression of the nicotinamide adenine dinucleotide (NAD+) metabolism enzyme NNMT in CAFs (NNMT+CAFs) was significantly associated with non-response to programmed death-ligand 1 (PD-L1) blockade immunotherapy in patients with UBC and predicted the unfavorable prognosis of UBC in two independent large cohorts. Targeting NNMT using the inhibitor 5-Amino-1-methylquinolinium iodide significantly reduced tumor growth and enhanced the apoptotic effects of the anti-PD-L1 antibody in UBC mouse models. Mechanistically, NNMT+CAFs recruit tumor-associated macrophages via epigenetic reprogramming of serum amyloid A (SAA) to drive tumor cell proliferation and confer resistance to programmed death-1/PD-L1 blockade immunotherapy.ConclusionsNNMT+CAFs were significantly associated with non-response to PD-L1 blockade immunotherapy in patients with UBC. Elevated NNMT, specifically in CAFs, upregulates SAA expression and enhances the recruitment and differentiation of macrophages in the tumor microenvironment, thereby directly or indirectly promoting tumor progression and conferring resistance to immunotherapies in bladder cancer.
Study of the effects of external imaginary electric field and chiral chemical potential on quark matter
Authors: Yang Ji-Chong , Zhang Xin , Chen Jian-Xing 
Published: July 2024

AbstractThe behavior of quark matter with both external electric field and chiral chemical potential is theoretically and experimentally interesting to consider. In this paper, the case of simultaneous presence of imaginary electric field and chiral chemical potential is investigated using the lattice QCD approach with $$N_f=1+1$$

N
f

=
1
+
1

dynamical staggered fermions. We find that overall both the imaginary electric field and the chiral chemical potential can exacerbate chiral symmetry breaking, which is consistent with theoretical predictions. However we also find a non-monotonic behavior of chiral condensation at specific electric field strengths and chiral chemical potentials. The behavior of Polyakov loop in the complex plane is not significantly affected by chiral chemical potential in the region of the parameters considered.
A simple dirac prescription for two-loop anomalous dimension matrices
Authors: Aebischer Jason , Pesut Marko , Polonsky Zachary 
Published: July 2024

AbstractA novel method to treat effects from evanescent operators in next-to-leading order (NLO) computations is introduced. The approach allows, besides further simplifications, to discard evanescent-to-physical mixing contributions in NLO calculations. The method is independent of the treatments of $$\gamma _5$$

γ
5

and can therefore be combined with different renormalization schemes. We illustrate the utility of this result by reproducing literature results of two-loop anomalous dimension matrices for both $$|\Delta F| = 1$$

|
Δ
F
|
=
1

and $$|\Delta F| = 2$$

|
Δ
F
|
=
2

transitions.