bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating qualitative research within a clinical trials unit: developing strategies and understanding their implementation in contexts
Authors: Segrott Jeremy , Channon Sue , Lloyd Amy , Glarou Eleni , Henley Josie , Hughes Jacqueline , Jacob Nina , Milosevic Sarah , Moriarty Yvonne , Pell Bethan , Robling Mike , Strange Heather , Townson Julia ,   Qualitative Research Group, Drew C. , Gillespie D. , Hale R. , Latchem-Hastings J. , Milton R. , Pell B. , Prout H. , Shepherd V. , Smallman K. , Stanton H. , Brookes-Howell Lucy 
Published: May 2024

Abstract
Background/aims
The value of using qualitative methods within clinical trials is widely recognised. How qualitative research is integrated within trials units to achieve this is less clear. This paper describes the process through which qualitative research has been integrated within Cardiff University’s Centre for Trials Research (CTR) in Wales, UK. We highlight facilitators of, and challenges to, integration.

Methods
We held group discussions on the work of the Qualitative Research Group (QRG) within CTR. The content of these discussions, materials for a presentation in CTR, and documents relating to the development of the QRG were interpreted at a workshop attended by group members. Normalisation Process Theory (NPT) was used to structure analysis. A writing group prepared a document for input from members of CTR, forming the basis of this paper.

Results
Actions to integrate qualitative research comprised: its inclusion in Centre strategies; formation of a QRG with dedicated funding/roles; embedding of qualitative research within operating systems; capacity building/training; monitoring opportunities to include qualitative methods in studies; maximising the quality of qualitative research and developing methodological innovation. Facilitators of these actions included: the influence of the broader methodological landscape within trial/study design and its promotion of the value of qualitative research; and close physical proximity of CTR qualitative staff/students allowing sharing of methodological approaches. Introduction of innovative qualitative methods generated interest among other staff groups. Challenges included: pressure to under-resource qualitative components of research, preference for a statistical stance historically in some research areas and funding structures, and difficulties faced by qualitative researchers carving out individual academic profiles when working across trials/studies.

Conclusions
Given that CTUs are pivotal to the design and conduct of RCTs and related study types across multiple disciplines, integrating qualitative research into trials units is crucial if its contribution is to be fully realised. We have made explicit one trials unit’s experience of embedding qualitative research and present this to open dialogue on ways to operationalise and optimise qualitative research in trials. NPT provides a valuable framework with which to theorise these processes, including the importance of sense-making and legitimisation when introducing new practices within organisations.
Comparison of apixaban versus aspirin for the prevention of latent bioprosthetic aortic valve thrombosis: study protocol for a prospective randomized trial
Authors: Kopjar Tomislav , Gasparovic Hrvoje , Paar Maja Hrabak , Lovric Daniel , Cerina Petra , Tokic Tomislav , Milicic Davor 
Published: May 2024

Abstract
Background
The optimal antithrombotic strategy early after aortic valve replacement surgery with a biological valve remains controversial due to lack of high-quality evidence. Either oral anticoagulants or acetylsalicylic acid should be considered for the first 3 months. Hypo-attenuated leaflet thickening on cardiac computed tomography has been associated with latent bioprosthetic valve thrombosis and may be prevented with anticoagulation. We hypothesize that anticoagulation with apixaban is superior to single antiplatelet therapy with acetylsalicylic acid in reducing hypo-attenuated leaflet thickening of bioprosthetic aortic valve prostheses.

Methods
In this prospective, open-label, randomized trial, patients undergoing isolated aortic valve replacement surgery with rapid deployment bioprosthetic valves will be randomized. The treatment group will receive 5 mg of apixaban twice a day for the first 3 months and 100 mg of acetylsalicylic acid thereafter. The control group will be administered 100 mg of acetylsalicylic acid once a day, indefinitely. After the 3-month treatment period, a contrast-enhanced electrocardiogram-gated cardiac computed tomography will be performed to identify hypo-attenuated leaflet thickening of the bioprosthetic valve. The primary objective of the study is to assess the impact of apixaban on the prevention of hypo-attenuated leaflet thickening at 3 months. The secondary and exploratory endpoints will be clinical outcomes and safety profiles of the two strategies.

Discussion
Antithrombotic therapy after aortic valve replacement is used to prevent valve thrombosis and systemic thromboembolism. Latent bioprosthetic valve thrombosis is a precursor of clinically significant prosthetic valve dysfunction or thromboembolic events. The hallmark feature of latent bioprosthetic valve thrombosis is hypo-attenuated leaflet thickening on cardiac computed tomography. Subclinical leaflet thrombosis occurs frequently in bioprosthetic aortic valves, more commonly in transcatheter than in surgical valves. There is no evidence on the effect of direct oral anticoagulants on the incidence of hypo-attenuated leaflet thickening after surgical aortic valve replacement with rapid deployment bioprostheses.

Trial registration
ClinicalTrials.gov NCT06184113. Registered on December 28, 2023
Enabling resilient UAV swarms through multi-hop wireless communications
Authors: Clerigues David , Wubben Jamie , Calafate Carlos T. , Cano Juan-Carlos , Manzoni Pietro 
Published: May 2024

AbstractIn the last decade, the popularity of UAVs, colloquially known as drones, has increased tremendously. Nowadays, drones are used in a wide range of use-cases, such as precision agriculture, surveillance, and photography. Many of these use-cases can be made more efficient if multiple UAVs are used cooperatively (i.e., in a swarm). To achieve this, communication between the UAVs is paramount. To ensure communication, many works rely on the existing infrastructure (e.g., 4G). However, in many rural areas, this infrastructure does not exist. In those cases, an ad hoc (Wi-Fi) network is the most adequate alternative. Yet, due to the limited communication range of Wi-Fi, it is not possible to let UAVs in a swarm to communicate over a long distance. To solve this issue a relay approach is necessary. Despite general solutions to relay messages between (mobile) nodes already exist, many UAV swarms rely on master–slave communication. Thus, a specific solution for this type of communication might be more efficient. Hence, in this work, we propose a strategy to efficiently relay messages for UAV swarms adopting the master–slave communication paradigm. Our approach seeks to introduce a very small message overhead to avoid congestion of the network, and to provide more bandwidth for the actual applications of the UAV swarm. We tested our approach using a realistic UAV simulator called ArduSim. Our results show that our approach is capable of detecting all the nodes in the network within a few seconds. Furthermore, we applied our message relay approach on an existing swarm application (where a swarm of UAVs had to follow a mission), and our results show that, now, the communication range of the UAVs can be much larger, without impacting other aspects of the mission (such as flight time).
Procrastination, depression and anxiety symptoms in university students: a three-wave longitudinal study on the mediating role of perceived stress
Authors: Jochmann Anna , Gusy Burkhard , Lesener Tino , Wolter Christine 
Published: May 2024

Abstract
Background
It is generally assumed that procrastination leads to negative consequences. However, evidence for negative consequences of procrastination is still limited and it is also unclear by which mechanisms they are mediated. Therefore, the aim of our study was to examine the harmful consequences of procrastination on students’ stress and mental health. We selected the procrastination-health model as our theoretical foundation and tried to evaluate the model’s assumption that trait procrastination leads to (chronic) disease via (chronic) stress in a temporal perspective. We chose depression and anxiety symptoms as indicators for (chronic) disease and hypothesized that procrastination leads to perceived stress over time, that perceived stress leads to depression and anxiety symptoms over time, and that procrastination leads to depression and anxiety symptoms over time, mediated by perceived stress.

Methods
To examine these relationships properly, we collected longitudinal data from 392 university students at three occasions over a one-year period and analyzed the data using autoregressive time-lagged panel models.

Results
Procrastination did lead to depression and anxiety symptoms over time. However, perceived stress was not a mediator of this effect. Procrastination did not lead to perceived stress over time, nor did perceived stress lead to depression and anxiety symptoms over time.

Conclusions
We could not confirm that trait procrastination leads to (chronic) disease via (chronic) stress, as assumed in the procrastination-health model. Nonetheless, our study demonstrated that procrastination can have a detrimental effect on mental health. Further health outcomes and possible mediators should be explored in future studies.
Dissecting wheat above-ground architecture for enhanced water use efficiency and grain yield in the subtropics
Authors: Hakeem Sadia , Ali Zulfiqar , Saddique Muhammad Abu Bakar , Habib-ur-Rahman Muhammad , Wiehle Martin 
Published: May 2024

Abstract
Background
Growing wheat under climate change scenarios challenges, scientists to develop drought and heat-tolerant genotypes. The adaptive traits should therefore be explored and engineered for this purpose. Thus, this study aimed to dissect surface traits and optimizing the leaf architecture to enhance water use efficiency (WUE) and grain yield. Twenty-six wheat genotypes were assessed for five novel leaf traits (NLTs: leaf prickle hairs, groove type, rolling, angle and wettability) under normal, drought and heat conditions following triplicated factorial randomized complete block design (RCBD). The data for NLTs, physiological traits (stomatal conductance, WUE, transpiration, and photosynthesis), and standard morphological and yield traits were recorded. Leaves were sampled at the stem elongation stage (Zadoks 34) to measure the leaf water content (%), contact angle, and to obtain pictures through scanning electron microscopy (SEM). The air moisture harvesting efficiency was evaluated for five selected genotypes. The ideotype concept was applied to evaluate the best-performing genotypes.

Results
The correlation analysis indicated that long leaf prickle hairs (> 100 μm), short stomatal aperture and density (40–60 mm− 2), inward to spiral leaf rolling, medium leaf indentation, low contact angle hysteresis (< 10°), and cuticular wax were positively associated with WUE. This, in turn, was significantly correlated to grain yield. Thus, the genotypes (E-1) with these traits and alternate leaf wettability had maximum grain yield (502 g m− 2) and WUE supported with high photosynthesis rate, and relative water content (94 and 75% under normal and stress conditions, respectively). However, the genotype (1-hooded) with dense leaf hairs on edges but droopy leaves, spiral leaf rolling, and lighter groove, also performed better in terms of grain yield (450 g m− 2) under heat stress conditions by maintaining high photosynthesis and WUE with low stomatal conductance and transpiration rate.

Conclusion
The SEM analysis verified that the density of hairs on the leaf surface and epicuticular wax contributes towards alternate wettability patterns thereby increasing the water-use efficiency and yield of the wheat plant. This study paves a way towards screening and and developing heat and drought-tolerant cultivars that are water-saving and climate-resilient.
The role of collectivist cultural practices in supporting a hybrid payment system among small and medium enterprises (SMEs) in Pakistan
Authors: Khan Khan Burhan , Jaafar Noor Ismawati , Zakaria Shamshul Bahri 
Published: May 2024

AbstractDespite having to rely on hybrid payment systems that combine manual and electronic methods, less developing countries such as Pakistan still manage to perform business transactions successfully. This success is partly due to the indigenous collectivist cultural practices in Pakistan society. However, an explanation of how indigenous culture supports information systems in general, and in particular payment systems, is scarce. This study adds to the knowledge of culture and information systems by exploring how indigenous culture in Pakistan enables hybrid payment systems to flourish. A case study was conducted in the marble industry of KPK Pakistan where qualitative data were collected through semi-structured interviews with the industry’s participants. The findings highlight the role of the indigenous collectivist cultural practice of Pakhtunwali in successfully implementing the hybrid payment system in SMEs in Pakistan. The study makes a theoretical contribution to knowledge about culture and payment systems by examining the role of collectivist cultural practices in supporting the hybrid payment system in Pakistan. The study highlights the role of collectivist cultural practices in overcoming the limitations of the hybrid payment system. The study also informs SME owners/managers about the importance of local cultural practices in Pakistan and how these can be utilized and maintained to improve the transactional practices of businesses.
Clinicopathologic Profile and Treatment Outcomes of Colorectal Cancer in Young Adults: A Multicenter Study From India
Authors: Sehrawat Amit , Khanna Mridul , Kayal Smita , Sundriyal Deepak , Tiwari Shraddha , Cyriac Sunu , Ravishankaran Praveen , Raphael Jomon , Mathew Dominic , Panda Soumya Surath , Moharana Laltendu , Mohanty Sumit Subhadarshi , Mohanty Swati Sucharita , Philips Ashwin , Jain Deepak , Jeyaraj Pamela , David Parvez Haque , Patil Jaineet , Saju S.V. , Rathnam Krishnakumar , Sharma Neha , Dheva Kaaviya , Jinkala Sree Rekha , Raja Kalyarasaran , Penumadu Prasanth , Ganesan Prasanth 
Published: May 2024

PURPOSE Colorectal cancer (CRC) in young adults is a rising concern in developing countries such as India. This study investigates clinicopathologic profiles, treatment patterns, and outcomes of CRC in young adults, focusing on adolescent and young adult (AYA) CRC in a low- and middle-income country (LMIC). METHODS A retrospective registry study from January 2018 to December 2020 involved 126 young adults (age 40 years and younger) with CRC. Patient demographics, clinical features, tumor characteristics, treatment modalities, and survival outcomes were analyzed after obtaining institutional ethics committees' approval. RESULTS Among 126 AYA patients, 62.70% had colon cancer and 37.30% had rectal cancer. Most patients (67%) were age 30-39 years, with no significant gender predisposition. Females had higher metastatic burden. Abdominal pain with obstruction features was common. Adenocarcinoma (65%) with signet ring differentiation (26%) suggested aggressive behavior. Limited access to molecular testing hindered mutation identification. Capecitabine-based chemotherapy was favored because of logistical constraints. Adjuvant therapy showed comparable recurrence-free survival in young adults and older patients. For localized colon cancer, the 2-year median progression-free survival was 74%, and for localized rectal cancer, it was 18 months. Palliative therapy resulted in a median overall survival of 33 months (95% CI, 18 to 47). Limited access to targeted agents affected treatment options, with only 27.5% of patients with metastatic disease receiving them. Chemotherapy was generally well tolerated, with hematologic side effect being most common. CONCLUSION This collaborative study in an LMIC offers crucial insights into CRC in AYA patients in India. Differences in disease characteristics, treatment patterns, and limited access to targeted agents highlight the need for further research and resource allocation to improve outcomes in this population.
Group consensus under asymmetric voting behavior
Authors: Yu Hao , Xu Zhehang , Wen Youjin , Yang Pingle , Zhang Jianlin , Meng Fanyuan 
Published: May 2024

Abstract
In this study, we propose a group formation model by assuming voters hold asymmetric irrationality, namely the probability of accepting a candidate with whom they disagree with. Moreover, we utilize a non-Markovian function by introducing a rationality decay rate to represent that agents’ rationality decays as their contributed admissions on the candidate increase. We have systematically explored the impact of non-Markovian asymmetric irrationality, voter selection mechanisms, voter number, and group size on the degree of consensus. Our findings indicate that, with only one voter, as the group size increases, the degree of consensus converges to a value determined by the irrationality ratio. Remarkably, even in scenarios with significant asymmetry in irrationality, a substantial degree of consensus can still be maintained. Furthermore, for multiple voters, the relationship between the degree of group consensus and rationality decay rate exhibits non-monotonic behaviors. In summary, this research offers new theoretical insights into group dynamics and provides implications for enhancing consensus in real-world social groups.
Prostate Risk and Monitoring During Testosterone Replacement Therapy
Authors: Bhasin Shalender , Thompson Ian M 
Published: May 2024

Abstract

Abstract
Men with hypogonadism have reduced risk of prostate cancer mortality; whether testosterone treatment increases the risk of prostate safety events in men with hypogonadism remains controversial. Several studies including 4 larger randomized trials—the Testosterone Trials, TEstosterone and Atherosclerosis Progression in Aging Men (TEAAM) trial, Testosterone for Diabetes Mellitus trial, and Testosterone Replacement therapy for Assessment of long-term Vascular Events and efficacy ResponSE in hypogonadal men (TRAVERSE) trial—treated men with testosterone or placebo for 1 year or longer and reported prospectively ascertained prostate safety data. The TRAVERSE Trial, because of its large size, longer duration, and adjudication of prostate events, has provided comprehensive data on the risk of adverse prostate events during testosterone replacement therapy (TRT). Among men with hypogonadism, carefully screened to exclude those at high risk of prostate cancer, the incidences of high-grade or any prostate cancer, acute urinary retention, surgical procedure for benign prostatic hyperplasia, prostate biopsy, or new pharmacologic therapy for lower urinary tract symptoms were low and did not differ between the testosterone and placebo groups. Testosterone did not worsen lower urinary tract symptoms. TRT was associated with a greater increase in prostate-specific antigen than placebo in the first year of treatment.

Conclusion
Testosterone treatment of men with hypogonadism, screened to exclude those at high risk of prostate cancer, is associated with low risk of adverse prostate events. Baseline evaluation of prostate cancer risk and a standardized monitoring plan can minimize the risk of unnecessary prostate biopsy while enabling the detection of high-grade prostate cancers in men receiving TRT.
Smad4 is essential for epiblast scaling and morphogenesis after implantation, but nonessential before implantation
Authors: Kruger Robin E. , Frum Tristan , Brumm A. Sophie , Hickey Stephanie L. , Niakan Kathy K. , Aziz Farina , Shammami Marcelio A. , Roberts Jada G. , Ralston Amy 
Published: May 2024

ABSTRACT
Bone morphogenic protein (BMP) signaling plays an essential and highly conserved role in embryo axial patterning in animal species. However, in mammalian embryos, which develop inside the mother, early development includes a preimplantation stage, which does not occur in externally developing embryos. During preimplantation, the epiblast is segregated from extra-embryonic lineages that enable implantation and development in utero. Yet, the requirement for BMP signaling is imprecisely defined in mouse early embryos. Here, we show that, in contrast to previous reports, BMP signaling (SMAD1/5/9 phosphorylation) is not detectable until implantation when it is detected in the primitive endoderm – an extra-embryonic lineage. Moreover, preimplantation development appears to be normal following deletion of maternal and zygotic Smad4, an essential effector of canonical BMP signaling. In fact, mice lacking maternal Smad4 are viable. Finally, we uncover a new requirement for zygotic Smad4 in epiblast scaling and cavitation immediately after implantation, via a mechanism involving FGFR/ERK attenuation. Altogether, our results demonstrate no role for BMP4/SMAD4 in the first lineage decisions during mouse development. Rather, multi-pathway signaling among embryonic and extra-embryonic cell types drives epiblast morphogenesis postimplantation.
Eye-specific detection and a multi-eye integration model of biological motion perception
Authors: De Agrò Massimo , Rößler Daniela C. , Shamble Paul S. 
Published: May 2024

ABSTRACT
‘Biological motion’ refers to the distinctive kinematics observed in many living organisms, where visually perceivable points on the animal move at fixed distances from each other. Across the animal kingdom, many species have developed specialized visual circuitry to recognize such biological motion and to discriminate it from other patterns. Recently, this ability has been observed in the distributed visual system of jumping spiders. These eight-eyed animals use six eyes to perceive motion, while the remaining two (the principal anterior medial eyes) are shifted across the visual scene to further inspect detected objects. When presented with a biologically moving stimulus and a random one, jumping spiders turn to face the latter, clearly demonstrating the ability to discriminate between them. However, it remains unclear whether the principal eyes are necessary for this behavior, whether all secondary eyes can perform this discrimination, or whether a single eye-pair is specialized for this task. Here, we systematically tested the ability of jumping spiders to discriminate between biological and random visual stimuli by testing each eye-pair alone. Spiders were able to discriminate stimuli only when the anterior lateral eyes were unblocked, and performed at chance levels in other configurations. Interestingly, spiders showed a preference for biological motion over random stimuli – unlike in past work. We therefore propose a new model describing how specialization of the anterior lateral eyes for detecting biological motion contributes to multi-eye integration in this system. This integration generates more complex behavior through the combination of simple, single-eye responses. We posit that this in-built modularity may be a solution to the limited resources of these invertebrates' brains, constituting a novel approach to visual processing.