bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative process study to explore the perceived burdens and benefits of a digital intervention for self-managing high blood pressure in Primary Care in the UK
Authors: Morton Katherine , Dennison Laura , Bradbury Katherine , Band Rebecca Jane , May Carl , Raftery James , Little Paul , McManus Richard J , Yardley Lucy 
Published: May 2023

Objectives
Digital interventions can change patients’ experiences of managing their health, either creating additional burden or improving their experience of healthcare. This qualitative study aimed to explore perceived burdens and benefits for patients using a digital self-management intervention for reducing high blood pressure. A secondary aim was to further our understanding of how best to capture burdens and benefits when evaluating health interventions.

Design
Inductive qualitative process study nested in a randomised controlled trial.

Setting
Primary Care in the UK.

Participants
35 participants taking antihypertensive medication and with uncontrolled blood pressure at baseline participated in semistructured telephone interviews.

Intervention
Digital self-management intervention to support blood pressure self-monitoring and medication change when recommended by the healthcare professional.

Analysis
Data were analysed using inductive thematic analysis with techniques from grounded theory.

Results
Seven themes were developed which reflected perceived burdens and benefits of using the intervention, including worry about health, uncertainty about self-monitoring and reassurance. The analysis showed how beliefs about their condition and treatment appeared to influence participants’ appraisal of the value of the intervention. This suggested that considering illness and treatment perceptions in Burden of Treatment theory could further our understanding of how individuals appraise the personal costs and benefits of self-managing their health.

Conclusions
Patients’ appraisal of the burden or benefit of using a complex self-management intervention seemed to be influenced by experiences within the intervention (such as perceived availability of support) and beliefs about their condition and treatment (such as perceived control and risk of side effects). Developing our ability to adequately capture these salient burdens and benefits for patients could help enhance evaluation of self-management interventions in the future. Many participants perceived important benefits from using the intervention, highlighting the need for theory to recognise that engaging in self-management can include positive as well as negative aspects.

Trial registration number

NCT13790648
Providing psychological support to people in intensive care: development and feasibility study of a nurse-led intervention to prevent acute stress and long-term morbidity
Authors: Wade Dorothy , Als Nicole , Bell Vaughan , Brewin Chris , D’Antoni Donatella , Harrison David A , Harvey Mags , Harvey Sheila , Howell David , Mouncey Paul R , Mythen Monty , Richards-Belle Alvin , Smyth Deborah , Weinman John , Welch John , Whitman Chris , Rowan Kathryn M 
Published: May 2023

Objectives
Adverse psychological outcomes, following stressful experiences in critical care, affect up to 50% of patients. We aimed to develop and test the feasibility of a psychological intervention to reduce acute stress and prevent future morbidity.

Design
A mixed-methods intervention development study, using two stages of the UK Medical Research Council framework for developing and testing complex interventions. Stage one (development) involved identifying an evidence base for the intervention, developing a theoretical understanding of likely processes of change and modelling change processes and outcomes. Stage two comprised two linked feasibility studies.

Setting
Four UK general adult critical care units.

Participants
Stage one: former and current patients, and psychology, nursing and education experts. Stage two: current patients and staff.

Outcomes
Feasibility and acceptability to staff and patients of content and delivery of a psychological intervention, assessed using quantitative and qualitative data. Estimated recruitment and retention rates for a clinical trial.

Results
Building on prior work, we standardised the preventative, nurse-led Provision Of Psychological support to People in Intensive Care (POPPI) intervention. We devised courses and materials to train staff to create a therapeutic environment, to identify patients with acute stress and to deliver three stress support sessions and a relaxation and recovery programme to them. 127 awake, orientated patients took part in an intervention feasibility study in two hospitals. Patient and staff data indicated the complex intervention was feasible and acceptable. Feedback was used to refine the intervention. 86 different patients entered a separate trial procedures study in two other hospitals, of which 66 (80% of surviving patients) completed questionnaires on post-traumatic stress, depression and health 5 months after recruitment.

Conclusion
The ‘POPPI’ psychological intervention to reduce acute patient stress in critical care and prevent future psychological morbidity was feasible and acceptable. It was refined for evaluation in a cluster randomised clinical trial.

Trial registration number

NCT61088114
Feasibility of data linkage in the PARAMEDIC trial: a cluster randomised trial of mechanical chest compression in out-of-hospital cardiac arrest
Authors: Ji Chen , Quinn Tom , Gavalova Lucia , Lall Ranjit , Scomparin Charlotte , Horton Jessica , Deakin Charles D , Pocock Helen , Smyth Michael A , Rees Nigel , Brace-McDonnell Samantha J , Gates Simon , Perkins Gavin D 
Published: May 2023

Objectives
There is considerable interest in reducing the cost of clinical trials. Linkage of trial data to administrative datasets and disease-specific registries may improve trial efficiency, but it has not been reported in resuscitation trials conducted in the UK. To assess the feasibility of using national administrative and clinical datasets to follow up patients transported to hospital following attempted resuscitation in a cluster randomised trial of a mechanical chest compression device in out-of-hospital cardiac arrest.

Methods
Hospital data on trial participants were requested from Hospital Episode Statistics (HES), the Intensive Care National Audit and Research Centre, and Myocardial Ischaemia National Audit Project and National Audit of Percutaneous Coronary Interventions, using unique patient identifiers. Linked data were received between June 2014 and June 2015.

Results
Of 4471 patients randomised in the pre-hospital randomised assessment of a mechanical compression device in cardiac arrest (PARAMEDIC) trial, 2398 (53.6%) were not known to be deceased at emergency department arrival and were eligible for linkage. We achieved an overall match rate of 86.7% in the combined HES accident and emergency, inpatient and critical care dataset, with variable match rates (4.2%–80.4%) in individual datasets. Patient demographics, cardiac arrest-related characteristics and major outcomes were predominantly similar between HES matched and unmatched groups, in the linkage apart from location, response time and return of spontaneous circulation (ROSC) at handover.

Conclusions
This study shows that it is feasible to track patients from the prehospital setting through to hospital admission using routinely available administrative datasets with a moderate to high degree of success. This approach has the potential to complement the trial data with the demographic and clinical management information about the studied cohort, as well as to improve the efficiency and reduce the costs of follow-up in cardiac arrest trials.

Clinical trial registration

NCT08233942Post-results.
Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: a qualitative study with illustrative case studies
Authors: Tickell Alice , Byng Richard , Crane Catherine , Gradinger Felix , Hayes Rachel , Robson James , Cardy Jessica , Weaver Alice , Morant Nicola , Kuyken Willem 
Published: May 2023

Objectives
This study aimed to describe the recovery journeys of people with a history of recurrent depression who took part in a psychosocial programme designed to teach skills to prevent depressive relapse (mindfulness-based cognitive therapy (MBCT)), alongside maintenance antidepressant medication (ADM).

Design
A qualitative study embedded within a multicentre, single blind, randomised controlled trial (the PREVENT trial).

Setting
Primary care urban and rural settings in the UK.

Participants
42 people who participated in the MBCT arm of the parent trial were purposively sampled to represent a range of recovery journeys.

Interventions
MBCT involves eight weekly group sessions, with four refresher sessions offered in the year following the end of the programme. It was adapted to offer bespoke support around ADM tapering and discontinuation.

Methods
Written feedback and structured in-depth interviews were collected in the 2 years after participants undertook MBCT. Data were analysed using thematic analysis and case studies constructed to illustrate the findings.

Results
People with recurrent depression have unique recovery journeys that shape and are shaped by their pharmacological and psychological treatment choices. Their journeys typically include several over-arching themes: (1) beliefs about the causes of depression, both biological and psychosocial; (2) personal agency, including expectations about their role in recovery and treatment; (3) acceptance, both of depression itself and the recovery journey; (4) quality of life; (5) experiences and perspectives on ADM and ADM tapering-discontinuation; and (6) the role of general practitioners, both positive and negative.

Conclusions
People with recurrent depression describe unique, complex recovery journeys shaped by their experiences of depression, treatment and interactions with health professionals. Understanding how several themes coalesce for each individual can both support their recovery and treatment choices as well as health professionals in providing more accessible, collaborative, individualised and empowering care.

Trial registration number
Clinical trial numberNCT26666654; post results.
Impact of loneliness on suicidal ideation during the COVID-19 pandemic: findings from a cross-sectional online survey in Japan
Authors: Tachikawa Hirokazu , Matsushima Midori , Midorikawa Haruhiko , Aiba Miyuki , Okubo Ryo , Tabuchi Takahiro 
Published: May 2023

ObjectivesWe aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic.DesignCross-sectional online survey.SettingCommunity cohort study in Japan.ParticipantsThe second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20–59 years.Main outcome measuresThe prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis.Statistical methodsEstimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected.ResultsOverall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation.ConclusionLoneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.
Knowledge and practice of cervical cancer screening and its associated factors among women attending maternal health services at public health institutions in Assosa Zone, Benishangul-Gumuz, Northwest Ethiopia, 2022: a cross-sectional study
Authors: Gelassa Firaol Regea , Nagari Shalama Lekasa , Jebena Desalegn Emana , Belgafo Dabeli , Teso Daniel , Teshome Debela 
Published: May 2023

BackgroundCervical cancer ranks as the second most frequent cancer among all women in Ethiopia and the second most frequent cancer among women between 15 and 44 years of age, resulting in over 4884 moralities annually. Although there is a focus on health promotion through teaching and screening in Ethiopia’s intended transition toward universal healthcare, there is little information available on baseline levels of knowledge and screening uptake related to cervical cancer.ObjectivesThis study explored the levels of knowledge and screening rates of cervical cancer along with its associated factors among women of reproductive age in Assosa Zone, Benishangul-Gumuz, Ethiopia in 2022.MethodologyA facility-based cross-sectional study was conducted. A systematic sampling technique was used to select 213 reproductive-age women from selected health institutions, from 20 April 2022 to 20 July 2022. A validated and pretested questionnaire was used for data collection. Multi-logistic regression analyses were done to identify factors independently associated with cervical cancer screening. Adjusted OR with 95% CI was estimated to measure the strength of association. The level of statistical significance was declared at a p value of <0.05. The results were presented in tables and figures.ResultKnowledge of cervical cancer screening in this study was 53.5%, and 36% of respondents had practised cervical cancer screening. Family history of cervical cancer (AOR)=2.5, 95% CI (1.04 to 6.44)), place of residence (AOR=3.68, 95% CI (2.23, 6.54)) and availability of health services at nearby (AOR=2.03, 95% CI (1.134, 3.643)) were significantly associated with knowledge of cervical cancer screening, while educational status (AOR=2.811, 95% CI (1.038 to 7.610)), knowing someone diagnosed with cervical cancer (AOR=8.3, 95% CI (2.4, 28.69)), Knowledge of cervical cancer(AOR=2.17, 95%CI(1.077, 4.384) and feeling feeling at risk (AOR=3.26 95% CI (1.52, 5.04)) were associated with the practice of cervical cancer screening.Conclusion and recommendationKnowledge and practice of cervical cancer screening in this study were low. Therefore, the reproductive women must be encouraged to have early cervical cancer screening at precancerous stage by informing their susceptibility to cervical cancer.
Clinical study reports published by the European Medicines Agency 2016–2018: a cross-sectional analysis
Authors: Byrne David , Prendergast Ciaran , Fahey Tom , Moriarty Frank 
Published: May 2023

ObjectivesTo describe the characteristics of clinical study report (CSR) documents published by the European Medicines Agency (EMA), and for included pivotal trials, to quantify the timeliness of access to trial results from CSRs compared with conventional published sources.DesignCross-sectional analysis of CSR documents published by the EMA from 2016 to 2018.MethodsCSR files and medication summary information were downloaded from the EMA. Individual trials in each submission were identified using document filenames. Number and length of documents and trials were determined. For pivotal trials, trial phase, dates of EMA document publication and matched journal and registry publications were obtained.ResultsThe EMA published documents on 142 medications that were submitted for regulatory drug approval. Submissions were for initial marketing authorisations in 64.1%. There was a median of 15 (IQR 5–46) documents, 5 (IQR 2–14) trials and 9629 (IQR 2711–26,673) pages per submission, and a median of 1 (IQR 1–4) document and 336 (IQR 21–1192) pages per trial. Of all identified pivotal trials, 60.9% were phase 3 and 18.5% were phase 1. Of 119 unique submissions to the EMA, 46.2% were supported by a single pivotal trial, with 13.4% based on a single pivotal phase 1 trial. No trial registry results were identified for 26.1% trials, no journal publications for 16.7% and 13.5% of trials had neither. EMA publication was the earliest information source for 5.8% of pivotal trials, available a median 523 days (IQR 363–882 days) before the earliest publication.ConclusionsThe EMA Clinical Data website contains lengthy clinical trial documents. Almost half of submissions to the EMA were based on single pivotal trials, many of which were phase 1 trials. CSRs were the only source and a timelier source of information for many trials. Access to unpublished trial information should be open and timely to support decision-making for patients.
Dual receptor T cells mediate effective antitumor immune responses via increased recognition of tumor antigens
Authors: Jang Hyun J , Caron Christine , Lee Calvin K , Wang Lu , Jama Burhan , Bui Jack D , Morris Gerald P 
Published: May 2023

BackgroundDiscovery that ~16% of T cells naturally co-express two T-cell receptor (TCR) clonotypes prompts examining the role of dual TCR cells in immune functions.MethodsUsing TCRα-reporter transgenic mice, enabling unambiguous identification of single-TCR and dual-TCR cells, we tested the role of dual TCR cells in antitumor immune responses against immune-responsive syngeneic 6727 sarcoma and immune-resistant B16F10 melanoma.ResultsDual TCR cells were specifically increased among tumor-infiltrating lymphocytes (TILs) in both models, indicating selective advantage in antitumor responses. Phenotype and single-cell gene expression analyses identified dual TCR are predominant during the effective antitumor response, demonstrating selectively increased activation in the TIL compartment and skewing toward an effector memory phenotype. Absence of dual TCR cells impaired immune response to B16F10 but not 6727, suggesting that dual TCR cells may be more influential in responses against poorly immunogenic tumors. Dual TCR cells demonstrated an advantage in recognition of B16F10-derived neoantigens in vitro, providing a mechanistic basis for their antitumor reactivity.ConclusionsThese results discover an unrecognized role for dual TCR cells in protective immune function and identify these cells and their TCRs as a potential resource for antitumor immunotherapy.
In patients who had a stroke or TIA, enlarged perivascular spaces in basal ganglia may cause future haemorrhagic strokes
Authors: Tian Yu , Wang Mengxing , Pan Yuesong , Meng Xia , Zhao Xingquan , Liu Liping , Wang Yongjun , Wang Yilong 
Published: May 2023

IntroductionIt remains unclear whether enlarged perivascular spaces (EPVS) predict poor clinical outcomes in patients with acute ischaemic stroke (AIS) or transient ischaemic attack (TIA).MethodData were obtained from the Third China National Stroke Registry study. We estimated EPVS in basal ganglia (BG) and centrum semiovale (CSO) using a semiquantified scale (Grade from 0 to 4). Using Cox and logistic regression analyses, the associations of EPVS with 3-month and 1-year adverse outcomes (including recurrent stroke, ischaemic stroke, haemorrhagic stroke, combined vascular event, disability and mortality) were explored. Sensitivity analyses of any association of cerebral small vessel disease at baseline and development of a small arterial occlusion (SAO) were conducted.ResultAmong 12 603 patients with AIS/TIA, median age was 61.7±11.6 years, and 68.2% were men. After adjusting for all potential confounders, frequent-to-severe BG-EPVS was associated with a decreased risk of recurrent ischaemic stroke (HR 0.71, 95% CI 0.55 to 0.92, p=0.01) but an increased risk of haemorrhagic stroke (HR 1.99, 95% CI 1.11 to 3.58, p=0.02) at 1 year after AIS/TIA, compared with none-to-mild BG-EPVS. Patients with frequent-to-severe CSO-EPVS had a decreased risk of disability (OR 0.76, 95% CI 0.62 to 0.92, p=0.004) and all-cause death (HR 0.55, 95% CI 0.31 to 0.98, p=0.04) within 3-month but not 1-year follow-ups, compared with those with none-to-mild BG-EPVS. Sensitivity analyses showed that both BG-EPVS (HR 0.43, 95% CI 0.21 to 0.87, p=0.02) and CSO-EPVS (HR 0.58, 95% CI 0.35 to 0.95, p=0.03) were associated with a decreased risk of subsequent ischaemic stroke in patients with SAO during 1-year follow-up.ConclusionBG-EPVS increased the risk of haemorrhagic stroke in patients already with AIS/TIA within 1 year. Therefore, caution is recommended when selecting antithrombotic agents for secondary stroke prevention in patients with AIS/TIA and more severe BG-EPVS.
Effects of soil water and nitrogen on drought resilience, growth, yield, and grain quality of a spring wheat
Authors: Biswas Dilip , Gjetvaj Branimir , St. Luce Mervin , Liu Kui , Asgedom Haben 
Published: May 2023

Drought imposes a significant challenge for crop production. However, little is known about the impact of drought priming and nitrogen (N) application and their interactive effects on drought resilience, yield, and grain quality in wheat. Spring wheat (cv. Stettler) was grown in plastic pots (25 cm diameter) with high, moderate, and low soil water levels and received N (added N) or without N (no N added), and subjected to acute drought for 10 days, then rewatering at the tillering stage. Canopy temperature, maximum efficiency of photosystem II, and normalized difference vegetation index were measured at 3-day intervals during drought-recovery periods to quantify drought resistance and resilience. Above-ground dry matter, straw dry matter, seed dry matter, harvest index, and grain N, phosphorus (P), and zinc (Zn) concentrations were determined. Both moderate- and low-water-grown plants had higher drought resistance than high-water-grown plants. The addition of N alleviated acute drought stress in high- and moderate-water-grown plants but exacerbated drought stress in low-water-grown plants. Both high and moderate water resulted in higher grain yields, but had a lower harvest index than low water. The highest and lowest grain N were observed in the low- and high-water-grown plants, respectively. The addition of N increased N and N:P in grains but decreased grain Zn:N. This study showed that moderate drought priming along with N application can improve drought resistance, yield, and grain quality. The results also indicated that canopy thermal imaging is a useful tool for high-throughput quantification of the drought resistance of wheat.
Comparative Study of Spin Pumping in Epitaxial- and Polycrystalline-NiO/Ni80Fe20
Authors: Khan Kacho Imtiyaz Ali , Gupta Pankhuri , Agarwal Rekha , Chowdhury Niru , Muduli Pranaba Kishor 
Published: May 2023

We perform a comparative study of spin pumping in NiO/Ni[Formula: see text]Fe[Formula: see text] (Py) by altering the crystallinity of NiO. We simultaneously grow high-quality NiO/Py heterostructures on Si/SiO2 and Al2O3(0001) substrates. Although the growth on Si/SiO2 substrate produced polycrystalline NiO (Poly-NiO), the growth on Al2O3(0001) substrate produced epitaxial NiO (Epi-NiO). Our ferromagnetic resonance measurements reveal the presence of two-magnon scattering (TMS) in the measured linewidth for the Epi-NiO/Py system. By carefully considering the contribution of TMS, we found the effective spin mixing conductance, g[Formula: see text] to be comparable in both Poly-NiO/Py and Epi-NiO/Py, despite the different crystallinity of NiO. Our findings show that g[Formula: see text] of an optimized polycrystalline-NiO/Py system can reach the value for an epitaxial-NiO/Py system.