bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can remote testing for chronic kidney disease improve outcomes without widening existing health inequalities? A collaborative quality improvement project in primary care
Authors: Griffiths Kathryn , Taylor Sheila , Bramham Kate , Molokhia Mariam 
Published: June 2024

BackgroundIn the UK, chronic kidney disease (CKD) is a prevalent, silent and strong predictor of cardiovascular disease. Identification of CKD is poor in primary care, particularly in minority ethnic and socio-economically deprived groups.AimTo investigate feasibility of remote ACR testing to improve the detection and management of CKD in underserved groups.Method13 591 tests were sent out across South East London. Individuals with diabetes and no ACR in the past year were offered a remote ACR test to complete at home with a smartphone using a validated app (Healthy.io). We extracted data on demographics, medical comorbidities and medication. Analyses (Stata) describe who completed the test.ResultsTwenty-seven practices agreed to participate. Analyses of 6082 tests sent show the test completion rate was 46.8%. Adjusted odds ratios demonstrated that people were less likely to complete testing if over 70 years (OR 0.71, 95% CI 0.57 to 0.89) and over 80 (OR 0.43, CI 95% 0.33 to 0.56) compared to <40 years old; people from CORE20 groups (most deprived quintile) were also less likely to complete testing (OR 0.68, 95% CI 0.61 to 0.76) and those with missing data and those with no recorded healthcare interactions within the last 5 years were also less likely to complete testing.DiscussionRemote ACR testing presents an opportunity to diagnose early CKD but there is still inequity in who completes testing. Engagement with stakeholders is needed to explore innovative ways to implement remote ACR testing to achieve equitable CKD screening.
Gender incongruence in primary care: are GPs trained?
Authors: Ozoran Hakan , Amiry Jack 
Published: June 2024

BackgroundGP confidence and competence in relation to gender diversity and the discussion of related matters remains relatively unknown. Despite increasing demand on primary care in dealing with matters of gender identity; contention and confusion are unfortunately widely reported amongst doctors.AimWe sought to formally evaluate the level of GP training and gauge desire for further training in relation to the discussion of pronouns with patients.MethodWe used a structured questionnaire that was sent out to GPs in Oxfordshire, facilitated by a mailing list used by the Primary Care Undergraduate Teaching Department at the University of Oxford. Additionally, we performed structured individual interviews with GPs in Oxford, who provided their contact details and expressed interest when completing the questionnaire.ResultsFourty-four GPs responded and completed the questionnaire, five of whom agreed to participate in a structured interview. Most GPs (61%) had not received any formal training. Despite this, 68% of GPs did not want more formal training in the field of gender incongruence and pronoun usage. Only one GP routinely asked patients their pronouns (2%).ConclusionOur findings highlight that a significant proportion of GPs have no formal training in relation to discussing pronouns and gender incongruence. We believe GPs should have the skills necessary to appreciate, understand and provide structured support to those with concerns in relation to their gender identity. With waiting times for gender clinics frequently exceeding 2 years, our findings emphasise the increasing importance of GP specific training in the field of gender identity.
GP workforce sustainability to maximise effective and equitable patient care: a realist review of what works, for whom and in what circumstances?
Authors: Owen Emily , Burford Bryan , Cohen Tanya , Duddy Claire , Dunn Harry , Fadia Vacha , Goodman Claire , Henry Cecily , Lamb Elizabeth , Ogden Margaret , Rapley Tim , Rees Eliot , Vance Gillian , Wong Geoff , Park Sophie 
Published: June 2024

BackgroundUK general practice has been described as being in crisis. A shortage and exodus of GPs is an urgent and challenging problem, attracting significant media attention, widespread public debate, and policy action.AimOur review aims to examine which aspects of the healthcare system affect GP workforce sustainability, how, why, and for whom.MethodA realist review is an interpretive, theory-driven approach to evidence synthesis, that brings together data from quantitative, qualitative, mixed methods research, and the wider grey literature (e.g., policy documentation). Using this data allows us to examine a diverse range of evidence with a clear focus on understanding factors which support (or hinder) GP workforce sustainability, how these are shaped by contexts, and the mechanisms that underpin them. We identify important individual and system-level contexts that may be amenable to change.ResultsWe present our emerging findings in the form of a programme theory which explores human connection with patients, colleagues, and across organisations, gaining intellectual enrichment and learning systems comprising socially-situated knowledge. Relational continuity is key across these, supporting GP workforce sustainability. Challenges include standardisation, alienation and professional loneliness, inflexible organisation, and restrictive technologies.ConclusionOur research generates new knowledge about the interdependencies between contexts, mechanisms, and outcomes. The findings can inform strategies and interventions intended to support, facilitate, and assist the GP workforce in delivering equitable and effective patient care. We identify critical gaps in knowledge and prioritise the expectations for scope and nature of future GP work and retention strategies.
The negative spillover impact of the COVID-19 pandemic on Hong Kong diabetes patients’ mortality and cardiovascular disease
Authors: Hu Zhuoran , Youn Hin Moi , Jin Qiao , Quan Jianchao , Cindy  , Lam Lo Kuen , Eric  , Wan Yuk Fai 
Published: June 2024

BackgroundThe spillover impact from disrupted healthcare services for non-COVID-infected diabetes mellitus (DM) patients caused by the reshuffling of the manpower during the pandemic remains understudied, especially in Hong Kong where healthcare resources were already strained before the pandemic.AimTo evaluate the spill-over effect of the Pandemic on Hong Kong diabetes patients, we examined the change in all-cause mortality and the incidence of cardiovascular disease (CVD) from 2012 to 2021.MethodThis retrospective cohort study analyzed data from Hong Kong Hospital Authority healthcare records covering all publicly provided care. Adults diagnosed with DM on/before December 31, 2010, without CVD before January 2012 were included. The 2016–2019 average all-cause mortality and the incidence of CVD after age-standardization represented the pre-pandemic levels. Subjects would leave the cohort after being infected with COVID-19.ResultsA cohort of 159,693 patients with diabetes was identified and followed up for 10 years from January 2012 to December 2021. Compared to the pre-pandemic levels, 2020 saw a 12% increase in age-standardized mortality per 10,000 diabetic patients (incidence rate ratio [95% CI]: 1.12 [1.10 - 1.14]), but no significant change in age-standardized CVD incidence. However, in 2021, there were 11% (1.11[1.10 - 1.13]) and 13% (1.13 [1.11 - 1.15]) more new CVD cases and deaths, respectively, versus the pre-pandemic period.ConclusionThe COVID-19 outbreak in 2020 had negative spillover impacts on DM patients without COVID-19 in Hong Kong, with a higher mortality in 2020 and 2021 compared with the pre-pandemic level.
Implementing a digital rare disease case-finding tool in UK primary care: a qualitative study of health professionals’ experience
Authors: Yahia Reem , Rafi Imran , Evans Will 
Published: June 2024

BackgroundRare diseases affect millions of people globally, with a lifetime incidence of 1 in 17. They are complex, multisystem, severe disease, and patients experience a diagnostic delay averaging 5.6 years with associated misdiagnoses, inappropriate treatments, and anxiety. MendelScan is a digital case-finding tool that uses structured primary care data to identify patients at risk of being affected by one of a series of rare diseases. This qualitative study explored primary healthcare professionals’ experiences of implementing this technology.AimTo develop an understanding of primary healthcare professionals’ experiences of implementing MendelScan with a focus on their perception of the technology and its implementation, challenges and opportunities.MethodA qualitative appraisal of implementing MendelScan using descriptive analysis of surveys and semi-structured interviews with professionals.ResultsA total of 11 professionals from the two project areas participated. Participants included GPs, nurses, a genetic counsellor, and healthcare managers.Participants reported that they received adequate support, the project increased confidence in integrating genetics in primary care, and that it may improve inequity in rare disease diagnosis. Professionals’ reservations were related to knowledge, time commitments, primary care pressures, contacting patients, data sharing and confidentiality, and overcoming clinical resistance in sharing data with a non-NHS external body.ConclusionThis study provides a valuable insight into the experiences of primary care professionals using a novel tool to identify rare diseases. The potential of this tool is promising with benefits for skill development. Large-scale implementation faces challenges related to primary care capacity, data, and funding.
Communicating effectively to patients about a cancer referral
Authors: Black Georgia , Russell Jessica 
Published: June 2024

BackgroundThe UK’s National Institute for Health and Care Excellence (NICE) advises GPs to inform patients referred to the Urgent Suspected Cancer (USC) pathway about their impending service and expectations. However, little is known about patient experiences and information needs post-referral. GPs often grapple with conveying the urgency of referrals while offering reassurance.AimThis study explores GP communication regarding cancer and USC referrals.MethodA secondary analysis of 23 audio-recorded GP-patient consultations, selected from a larger dataset of 200 consultations in Surrey and London (2017–2018), was conducted, focusing on discussions related to cancer.ResultsWe found that most GPs informed patients that they might have cancer and engaged in reassurance about the patient’s low risk of cancer using personalised risk statements. Some GPs, however, avoided all mention of cancer, using symptom-led language instead. GPs tended to focus on communicating practical rather than support-based information when discussing the referral. While most GPs informed patients that they would be seen by a specialist within two weeks, few discussed patients’ support needs during the referral or specialist appointment.ConclusionThis presentation will offer language recommendations for clear communication about cancer referrals. This plays an important role in promoting shared decision-making and driving patient attendance for investigations. The study highlights the need for further research on communication practices around cancer referral to improve patient understanding and experience. Our recommendations for enhanced communication may improve patient outcomes by optimising routes to diagnosis via primary care.
DECIDE (Diverse experiences of End-of-Life Care for Dementia) establishing consensus and capacity for future research through collaboration and co-production
Authors: Poole Marie , Tomkow Louise , Tissa Faith , Ogden Margaret , Ngouala Malcolm , Karagiannidou Maria , Dixon Josie , Damisa Efioanwan , Hanratty Barbara , Knapp Martin , Dewhurst Felicity 
Published: June 2024

BackgroundDementia is a leading cause of death globally. However, end-of-life care is often poor or non-existent. People with dementia from ethnic minorities or socioeconomically deprived communities are even less likely to receive good palliative care. Despite this, research into end-of-life care often fails to include people from these populations.AimTo find out what research is required to improve end-of-life care for everyone with dementia and how to facilitate inclusivity.MethodA scoping review of the academic literature (Medline, CINAHL, EMBASE, PsycInfo and Scopus databases) published between Jan 2000 and April 2023 was conducted. Findings were shared with diverse key stakeholders through a series of workshops. Conclusions were subsequently used to provide evidence-based recommendations for inclusive end-of-life care and future research.ResultsThemes from the literature were evident in the personal and professional experiences of key stakeholders. Palliative care providers are often ignorant of the needs of those dying in the margins. Support services are scarce and unequal geographically. There is a lack of personalised and culturally appropriate care for those with dementia and their families. Themes from the stakeholder groups included a need for better communication between services, and more investment into dementia as a palliative condition, with avenues created to increase trust and facilitate engagement with services.ConclusionFuture research should focus on educational strategies, including how optimal end-of-life care differs for those with dementia compared to other life-limiting conditions, with appropriate models of inclusive, appropriately funded care needed.
Fidelity to and utility of a home blood pressure self-monitoring regime in people with pre-hypertension: results from the REVERSE study
Authors: Bray Emma , Hives Lucy , Spencer Joseph , Georgiou Rachel , Benedetto Valerio , Clegg Andrew , Rutter Paul , Watkins Caroline , Williams Nefyn 
Published: June 2024

IntroductionAround 40% of adults have pre-hypertension (120-139/80-89mmHg) increasing their risk of developing hypertension and associated cardiovascular conditions. Guidance on pre-hypertension management focuses on improving lifestyle. Self-monitoring may improve awareness and understanding of blood pressure (BP) for people with pre-hypertension, allowing them to modify their lifestyle risks.AimTo determine the fidelity to and utility of a home BP self-monitoring regime in people with pre-hypertension.MethodThis sub-study is part of a larger prospective, non-randomised feasibility study. Individuals with pre-hypertension were identified via GP records and pharmacy NHS Health Checks in Northwest England. Participants received training for home BP self-monitoring. They were asked to complete two readings (leaving a 5-minute interval) on the first three days of the month for six months, colour-code their readings and take action using a simple algorithm, then send them to the research team within 7 days.ResultsEighty participants (aged 40–79, mean=59) enrolled. The majority were female (n=45, 56%), White British (n=79, 99%), and had not previously monitored their BP (n=55, 69%). Seventy-five (94%) participants completed the training. Sixty-one (81%) received online training and 14 (19%) opted for a face-to-face session. Sixty-one (81%) completed all six months of readings, 51 (68%) also returned them on time. All in-person training participants completed all six months of readings on time. Reasons for non-compliance to the protocol included battery issues, forgetting, and struggling to find a consistent time for readings.ConclusionHome BP self-monitoring can be feasible and easily implementable for people with pre-hypertension – however, some barriers were identified.
برنامج إرشادي قائم على العلاج بالواقع لخفض حدة الضغوط النفسية لدى أمهات الأطفال ذوي الإعاقة
Authors: أشرف محمد شريت  
Published: June 2024

تهدف الدراسة الحالية إلى الكشف عن فعالية البرنامج الإرشادي القائم على استخدام أسلوب العلاج بالواقع لخفض الضغوط النفسية الناتجة عن الإعاقة لدى أمهات الأطفال المعاقين، وقد اتبعت الدراسة الحالية المنهج شبه التجريبي، وتكونت عينة الدراسة من (20) أماً من الأمهات اللاتي لديهن أطفال معاقين، وطبق عليهن مقياس الضغوط النفسية الناتجة عن الإعاقة لدى أمهات الأطفال المعاقين. (إعداد الباحث)، وبرنامج إرشادي قائم على العلاج بالواقع لخفض حدة الضغوط النفسية لدى أمهات الأطفال المعاقين. (إعداد الباحث)، وقد أسفرت الدراسة عن النتائج التالية:
1-	وجود فروق دالة إحصائياً عن مستوى (0,01) بين متوسطات رتب درجات القياسين­ القبلي، والبعدي في مقياس الضغوط النفسية الناتجة عن الإعاقة لدى أمهات الأطفال المعاقين والراجعة إلى الابن المعاق، لصالح القياس البعدي.
2-	وجود فروق دالة إحصائياً عند مستوى (0,01) بين متوسطات رتب درجات القياسين: القبلي، والبعدي في مقياس الضغوط النفسية الناتجة عن الإعاقة لدى أمهات الأطفال المعاقين والراجعة إلى الأم، لصالح القياس البعدي,
3-	عدم وجود فروق دالة إحصائياً بين متوسطات رتب درجات القياسين: القبلي، والبعدي في مقياس الضغوط النفسية الناتجة عن الإعاقة لدى أمهات الأطفال المعاقين والراجعة إلى الزوج لصالح القياس البعدي.
4-	وجود فروق دالة إحصائياً عند مستوى (0,01) بين متوسطات رتب درجات القياسين: القبلي، والبعدي في مقياس الضغوط النفسية الناتجة عن الإعاقة لدى أمهات الأطفال المعاقين والراجعة إلى المجتمع، لصالح القياس البعدي.
5-	عدم وجود فروق دالة إحصائياً بين متوسطات رتب درجات القياسين: البعدي، والتتبعي في مقياس الضغوط النفسية الناتجة عن الإعاقة لدى أمهات الأطفال المعاقين.
وقد قدمت الدراسة مجموعة من التوصيات التربوية لأمهات الأطفال المعاقين.
LOW-Q FILTERING IN WIRED TELEPHONY
Authors: Ясинский С.А. , Романенко П.Г. , Воробьев Л.В. , Репин Б.Г. , Аникеев А.И. 
Published: June 2024

В статье проведен анализ научных публикаций в области телефонной связи и аудиометрии, позволяющий установить отсутствие подхода к исследованиям в этих направлениях с позиции проявления добротностей электрических цепей в низкочастотной области. Представлена математическая модель для обоснования зависимостей между частотными параметрами полосового фильтра и проведено обоснование применения низкодобротных фильтров в проводной телефонной связи с последующим выполнением эксперимента по моделированию амплитудно-частотных характеристик низкодобротных фильтров.
The article analyzes scientific publications in the field of telephone communication and audiometry, which made it possible to establish a new approach to research in these areas from the position of demonstrating the Q-values of electrical circuits in the low-frequency region. A mathematical model is presented to substantiate the dependencies between the frequency parameters of a bandpass filter and a justification for the use of low-Q filters in wired telephone communications is carried out, followed by an experiment to simulate the amplitude-frequency characteristics of low-Q filters.
DEVELOPMENT OF THE METHOD FOR DETERMINING THE CHARACTERISTICS OF A RANDOM PROCESS REPRESENTED AS A STOCHASTIC NETWORK
Authors: Катанович А.А. , Попов П.В. , Привалов А.А. , Палехин Е.М. 
Published: June 2024

В статье рассматривается оптимизация процесса определения вероятностно-временных характеристик случайного процесса, основанного на методе топологического преобразования стохастических сетей. Разработан модифицированный метод определения вероятностно-временных характеристик случайного процесса, позволяющий снять выявленные ограничения применения метода топологического преобразования стохастических сетей, что приводит к существенному сокращению времени и снижению объема вычислений.
The article discusses the optimization of the process of determining the probabilistic-temporal characteristics of a random process based on the method of topological transformation of stochastic networks. A modified method for determining the probabilistic-temporal characteristics of a random process has been developed, which makes it possible to remove the identified limitations of using the method of topological transformation of stochastic networks, which leads to a significant reduction in the time and volume of calculations.
RESEARCH OF METHODS FOR REDUNDANCY OF STORAGE DEVICES AND INFORMATION PROCESSING OF DIGITAL DATA TRANSMISSION SYSTEMS
Authors: Павлов А.А. , Царьков А.Н. , Романенко Ю.А. , Пашинцев В.П. , Романенко А.Ю. , Макеев М.И. , Павлов Ф.А. 
Published: June 2024

Осуществлен анализ эксплуатации и выбор показателей надежности специализированных ЭВМ (СЭВМ) цифровых систем передачи данных. Сформулированы требования к методам резервирования СЭВМ. Проведена сравнительная оценка обнаруживающей способности и аппаратурных затрат при реализации мажоритарного метода резервирования, метода дублирования и использования корректирующих кодов. Обоснована целесообразность использования метода дублирования для повышения вероятности безотказной работы и живучести самовосстанавливаемых СЭВМ с использованием алгебраических линейных кодов для выявления неисправного резервного канала.
An analysis of the operation and selection of reliability indicators for specialized computers of digital data transmission systems was carried out. Requirements for computer backup methods are formulated. A comparative assessment of the detection capability and hardware costs was carried out when implementing the majority redundancy method, the duplication method, and the use of correcting codes. The expediency of using the duplication method is substantiated to increase the probability of failure-free operation and survivability of self-healing central computers, using algebraic linear codes to identify a faulty backup channel.
USING COATINGS WITH CONTROLLED PARAMETERS FOR TRANSMITTING INFORMATION ABOUT THE STATE OF ONBOARD SATELLITE SYSTEMS
Authors: Иванов А.А. , Алёшкин А.П. , Гусаков В.М. 
Published: June 2024

Предлагается способ передачи информации о состоянии бортовых систем космического аппарата в случае неисправности передатчика командной радиолинии за счет использования покрытия с управляемой резонансной частотой поглощения в качестве пространственного модулятора отраженного сигнала, система управления которого подключается к внутренней шине управления. Энергетические расчеты показывают применимость указанного способа на низких околоземных орбитах. Также приводится математическая модель определения размеров элементов предлагаемого покрытия и результаты моделирования его отражательных характеристик с использованием пакетов программ электродинамического моделирования.
A method is proposed for transmitting information about the state of the on-board systems of a spacecraft in the event of a malfunction of the command radio link transmitter by using a coating with a controlled resonant absorption frequency as a spatial modulator of the reflected signal, the control system of which is connected to the internal control bus. Energy calculations show the applicability of the method to LEO satellites. A mathematical model for determining the dimensions of the elements of the proposed coating and the results of modeling its reflective characteristics using electrodynamic modeling software packages are also provided.