bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a hybrid digital cognitive–behavioural therapy for insomnia and emotion regulation in the workplace (SLEEP): study protocol for a randomised waitlist control trial
Authors: Moukhtarian Talar Rita , Patel Krishane , Toro Carla , Russel Sean , Daly Guy , Walasek Lukasz , Tang Nicole K Y , Meyer Caroline 
Published: July 2022

IntroductionThis trial tests the efficacy of implementing a hybrid digital cognitive–behavioural therapy for insomnia (dCBT-I) and emotion regulation (ER) in the workplace. The study protocol follows the SPIRIT (Standard Protocol Items: Recommendations for Intervention Trials) 2013 recommendations.Methods and analysisThis is a mixed methods evaluation with a two-arm randomised waitlist control design of a 6-week dCBT-I+ER intervention through self-guided online platform and four videoconferencing therapy sessions. A process evaluation will examine the fidelity of delivery and experiences of the intervention. The primary outcomes are the Insomnia Severity Index, the Patient Health Questionnaire-9 and the Generalised Anxiety Disorder-7. The secondary outcomes are job productivity, job satisfaction, well-being, quality of life, self-reported (sleep diary data) and objective (actigraphy) sleep parameters, and usage of online intervention platform. Assessments take place at baseline (T0), week 8 post-treatment (T1) and week 12 postrandomisation (T2). We will recruit 156 workers with sleep and ER problems ranging from subclinical to clinical levels not engaged in treatment at the time of the trial.Ethics and disseminationFull approval was given by the University of Warwick Biomedical and Research Ethics Committee (BSREC 45/20-21). The current protocol version is 2.9_Dec21. Publication of results will inform the scientific, clinical and business communities through peer-reviewed articles, webinars, conferences and newsletters.Trial registration numberISRCTN13596153.
Emotional impact on healthcare providers involved in medical assistance in dying (MAiD): a systematic review and qualitative meta-synthesis
Authors: Dholakia Saumil Yogendra , Bagheri Alireza , Simpson Alexander 
Published: July 2022

BackgroundMedical assistance in dying (MAiD) traverses challenging and emotionally overwhelming territories: healthcare providers (HCPs) across jurisdictions experience myriad of affective responses secondary to possible tensions between normative and interwoven values, such as sanctity of life, dignity in death and dying and duty to care.ObjectiveTo determine the emotional impact on HCPs involved in MAiD.MethodsInclusion restricted to English language qualitative research studies from four databases (OVID Medline, EMBASE, CINAHL and Scopus), from beginning until 30 April 2021, and grey literature up to August 2021 were searched. Key author, citation and reference searches were undertaken. We excluded studies without rigorous qualitative research methodology. Included studies were critically appraised using the Joanna Briggs Institute’s critical appraisal tool. Analysis was conducted using thematic meta-synthesis. The cumulative evidence was assessed for confidence using the Confidence in the Evidence from Reviews of Qualitative Research approach.ResultsThe search identified 4522 papers. Data from 35 studies (393 physicians, 169 nurses, 53 social workers, 22 allied healthcare professionals) employing diverse qualitative research methodologies from five countries were coded and analysed. The thematic meta-synthesis showed three descriptive emotional themes: (1) polarised emotions including moral distress (n=153), (2) reflective emotions with MAiD as a ‘sense-making process’ (n=251), and (3) professional value-driven emotions (n=352).DiscussionThis research attempts to answer the question, ‘what it means at an emotional level’, for a MAiD practitioner. Legislation allowing MAiD for terminal illness only influences the emotional impact: MAiD practitioners under this essential criterion experience more polarised emotions, whereas those practising in jurisdictions with greater emphasis on allaying intolerable suffering experience more reflective emotions. MAiD practitioner’s professional values and their degree of engagement influence the emotional impact, which may help structure future support networks. English language literature restriction and absence of subgroup analyses limit the generalisability of results.
Effects of community family doctors-led intervention for self-management and medication adherence in type 2 diabetes mellitus patients: study protocol of a cluster randomised controlled trial
Authors: Ren Biqi , Wang Ningsheng , Lei Shuang , Lin Shuzhi , Chen Yue , Liu Lianye , Xiang Yufang , Feng Bianling 
Published: July 2022

IntroductionThe management of diabetes has become a critical public health issue in China. The development of community-based type 2 diabetes management in China has not yet reached an ideal state, and the most suitable management methods for diabetic patients are still being explored. Few studies have used community-based family doctors to perform interventions of appropriate intensity. This protocol describes a planned randomised controlled trial to evaluate the effectiveness of a family doctor-led intervention model for diabetes self-management and medication adherence in type 2 diabetes mellitus patients.Methods and analysisThis is a Standard Protocol Items: Recommendations for Interventional Trials-compliant cluster randomised controlled trial. The study will be conducted at four CHCs (community health centers). The control group will receive conventional medical services and health education. The intervention group will receive an intervention led by community family doctors based on the conventional medical services and health education. It will include five parts: usual care, a medication reminder, a 4-week plan, a weekly phone interview and a monthly interview. The primary outcomes are changes in fasting blood glucose, glycosylated haemoglobin, self-management knowledge and behaviour, and medication adherence from baseline to the 3rd and 6th months. The secondary outcome is the proportion of people whose blood sugar and glycosylated haemoglobin are under control in the 3rd and 6th months.Ethics and disseminationThe study proposal was approved by the Biomedical Ethics Committee of the Medical Department of Xi’an Jiaotong University (no. 2021-1371). The findings will be published in peer-reviewed journals and presented at scientific conferences.Trial registration numberChinese Clinical Trial Registry, ChiCTR2100051685.
Ethnic inequalities in mental and physical multimorbidity in women of reproductive age: a data linkage cohort study
Authors: Catalao Raquel , Dorrington Sarah , Pritchard Megan , Jewell Amelia , Broadbent Matthew , Ashworth Mark , Hatch Stephani , Howard Louise 
Published: July 2022

ObjectivesExplore inequalities in risk factors, mental and physical health morbidity in non-pregnant women of reproductive age in contact with mental health services and how these vary per ethnicity.DesignRetrospective cohort study.SettingData from Lambeth DataNet, anonymised primary care records of this ethnically diverse London borough, linked to anonymised electronic mental health records (‘CRIS secondary care database’).ParticipantsWomen aged 15–40 years with an episode of secondary mental health care between January 2008 and December 2018 and no antenatal or postnatal Read codes (n=3817) and a 4:1 age-matched comparison cohort (n=14 532).Main outcome measuresPreconception risk factors including low/high body mass index, smoking, alcohol, substance misuse, micronutrient deficiencies and physical diagnoses.ResultsWomen in contact with mental health services (whether with or without severe mental illness (SMI)) had a higher prevalence of all risk factors and physical health diagnoses studied. Women from minority ethnic groups were less likely to be diagnosed with depression in primary care compared with white British women (adjusted OR 0.66 (0.55–0.79) p<0.001), and black women were more likely to have a SMI (adjusted OR 2.79 (2.13–3.64) p<0.001). Black and Asian women were less likely to smoke or misuse substances and more likely to be vitamin D deficient. Black women were significantly more likely to be overweight (adjusted OR 3.47 (3.00–4.01) p<0.001), be diagnosed with hypertension (adjusted OR 3.95 (2.67–5.85) p<0.00) and have two or more physical health conditions (adj OR 1.94 (1.41–2.68) p<0.001) than white British women.ConclusionsOur results challenge the perspective that regular monitoring of physical health in primary care should be exclusively encouraged in people with a l diagnosis. The striking differences in multimorbidity for women in contact with mental health services and those of ethnic minority groups emphasise a need of integrative models of care.
Effectiveness–implementation hybrid-2 randomised trial of a collaborative Shared Care Model for Detecting Neurodevelopmental Impairments after Critical Illness in Young Children (DAISY): pilot study protocol
Authors: Long Debbie , Gibbons Kristen , Dow Belinda , Best James , Webb Kerri-Lyn , Liley Helen G , Stocker Christian , Thoms Debra , Schlapbach Luregn J , Wharton Carolyn , Lister Paula , Matuschka Lori , Castillo Maria Isabel , Tyack Zephanie , Bora Samudragupta 
Published: July 2022

IntroductionIn Australia, while paediatric intensive care unit (PICU) mortality has dropped to 2.2%, one in three survivors experience long-term neurodevelopmental impairment, limiting their life-course opportunities. Unlike other high-risk paediatric populations, standardised routine neurodevelopmental follow-up of PICU survivors is rare, and there is limited knowledge regarding the best methods. The present study intends to pilot a combined multidisciplinary, online screening platform and general practitioner (GP) shared care neurodevelopmental follow-up model to determine feasibility of a larger, future study. We will also assess the difference between neurodevelopmental vulnerability and parental stress in two intervention groups and the impact of child, parent, sociodemographic and illness/treatment risk factors on child and parent outcomes.Methods and analysisSingle-centre randomised effectiveness–implementation (hybrid-2 design) pilot trial for parents of children aged ≥2 months and <4 years discharged from PICU after critical illness or injury. One intervention group will receive 6 months of collaborative shared care follow-up with GPs (supported by online outcome monitoring), and the other will be offered self-directed screening and education about post-intensive care syndrome and child development. Participants will be followed up at 1, 3 and 6 months post-PICU discharge. The primary outcome is feasibility. Secondary outcomes include neurodevelopmental vulnerability and parental stress. An implementation evaluation will analyse barriers to and facilitators of the intervention.Ethics and disseminationThe study is expected to lead to a full trial, which will provide much-needed guidance about the clinical effectiveness and implementation of follow-up models of care for children after critical illness or injury. The Children’s Health Queensland Human Research Ethics Committee approved this study. Dissemination of the outcomes of the study is expected via publication in a peer-reviewed journal, presentation at relevant conferences, and via social media, podcast presentations and open-access medical education resources.Registration detailsThe trial was prospectively registered with the Australian New Zealand Clinical Trials Registry as ‘Pilot testing of a collaborative Shared Care Model for Detecting Neurodevelopmental Impairments after Critical Illness in Young Children’ (the DAISY Pilot Study).Trial registration numberACTRN12621000799853.
Understanding clinical decision-making in mesothelioma care: a mixed methods study
Authors: Henshall Catherine , Dawson Paul , Rahman Najib , Ball Hannah , Sundralingam Anand , Shahidi Mitra , McKeown Edward , Park John , Walthall Helen , Davey Zoe 
Published: July 2022

IntroductionMalignant pleural mesothelioma is a rare, incurable cancer arising from previous asbestos exposure; patients have a poor prognosis, with a median survival rate of 8–14 months. Variation in mesothelioma clinical decision-making remains common with a lack of multidisciplinary knowledge sharing, leading to inconsistencies in treatment decisions. The study aimed to explore which factors impacted on clinicians’ decision-making in mesothelioma care, with a view to optimising the mesothelioma care pathway.MethodsThis mixed methods study consisted of documentary analysis of local and national guidelines, policies or documents pertaining to mesothelioma care pathways, secondary analysis of mesothelioma patient data, and interviews with clinicians attending lung cancer and/or mesothelioma-specific multidisciplinary team meetings. The study took place at three National Health Service trusts in England. Documentations relating to patients’ treatment pathways were collated and reviewed qualitatively. Records of patients with mesothelioma were extracted from hospital patient records and data collected on diagnosis date, treatment, mortality rates, survival postdiagnosis, age and clinical care team. Data were statistically analysed. Interviews with clinicians explored influences on clinical decision-making, including challenges or barriers involved. Data were thematically analysed. The Strengthening the Reporting of Observational Studies in Epidemiology reporting checklist was used.ResultsThere were differences in the structure and delivery of mesothelioma treatment and care between trusts. Four main themes were identified: ‘collaboration and communication’, ‘evidence base and knowledge’, ‘role of the clinician’ and ‘role of the patient’. Two cross-cutting themes relating to the role of the mesothelioma nurse specialist and the impact of COVID-19 were identified.DiscussionThere is a need to review the structure of mesothelioma multidisciplinary team meetings to ensure patients are reviewed by clinicians with appropriate knowledge, expertise and understanding of how, why and when decisions should be made. There is a need for expert clinicians in mesothelioma care to promote an up-to-date evidence and knowledge base within the wider multidisciplinary team.
Lorentz invariance and the spinor-helicity formalism yield the U(1) and SU(3) fermion symmetry
Authors: Marsch Eckart , Narita Yasuhito 
Published: July 2022

AbstractIn this paper we use the so-called spinor-helicity formalism to represent three-vectors in terms of the Pauli matrices and derive a generalized relativistic wave equation for a massive fermion of spin one-half. We thus extend the Dirac equation by making use of the Pauli-Lubański operator that includes isospin explicitly. As a consequence, we get new degrees of freedom related to isospin helicity, in addition to the two standard ones of the Dirac equation that are associated with the kinetic spin-helicity doublet and the particle-antiparticle pair. Formally, isospin helicity has $$2(2s+1)$$

2
(
2
s
+
1
)

degrees of freedom for an arbitrary general isospin s and has the eigenvalues s and $$-(s+1)$$

-
(
s
+
1
)

, and thus it reveals a kind of hidden symmetry in any isospin field. The resulting four degrees of freedom for isospin 1/2 are interpreted as being associated with two independent subspaces of dimension 1 related to the U(1) and 3 related to SU(3) symmetry, i.e. to the leptons and quarks.
Lofoten Composite Tectono-Sedimentary Element, Norwegian Rifted Margin, Norwegian Sea
Authors: Tsikalas Filippos , Meza-Cala Juan Camilo , Abdelmalak Mohamed Mansour , Faleide Jan Inge , Brekke Harald 
Published: July 2022

Abstract
The Lofoten Rifted Margin is a composite tectono-sedimentary element (CTSE), located offshore northern Norway, and comprises the northernmost part of the Norwegian Sea margin at its transition to the West Barents Sea margin. We refine the late Paleozoic–early Cenozoic evolution of the margin with emphasis on the late Mesozoic–early Cenozoic rift phases, and we provide new and better-refined structural elements for the area. Distinct along-margin segmentation is evident and is imposed by transfer zones/systems that reflect the structural inheritance. These divide the study area into three main margin segments, namely the Lofoten, Vesterålen and Andøya segments, that are accounted for by observed along-margin tectonostratigraphic changes and are briefly viewed in a conjugate margin setting. Confirmed and potential plays within five main reservoir groups are also described and evaluated.
β2-Microglobulin Maintains Glioblastoma Stem Cells and Induces M2-like Polarization of Tumor-Associated Macrophages
Authors: Li Daqi , Zhang Qian , Li Lu , Chen Kexin , Yang Junlei , Dixit Deobrat , Gimple Ryan C. , Ci Shusheng , Lu Chenfei , Hu Lang , Gao Jiancheng , Shan Danyang , Li Yangqing , Zhang Junxia , Shi Zhumei , Gu Danling , Yuan Wei , Wu Qiulian , Yang Kailin , Zhao Linjie , Qiu Zhixin , Lv Deguan , Gao Wei , Yang Hui , Lin Fan , Wang Qianghu , Man Jianghong , Li Chaojun , Tao Weiwei , Agnihotri Sameer , Qian Xu , Shi Yu , You Yongping , Zhang Nu , Rich Jeremy N. , Wang Xiuxing 
Published: July 2022

Abstract

Glioblastoma (GBM) is a complex ecosystem that includes a heterogeneous tumor population and the tumor-immune microenvironment (TIME), prominently containing tumor-associated macrophages (TAM) and microglia. Here, we demonstrated that β2-microglobulin (B2M), a subunit of the class I major histocompatibility complex (MHC-I), promotes the maintenance of stem-like neoplastic populations and reprograms the TIME to an anti-inflammatory, tumor-promoting state. B2M activated PI3K/AKT/mTOR signaling by interacting with PIP5K1A in GBM stem cells (GSC) and promoting MYC-induced secretion of transforming growth factor-β1 (TGFβ1). Inhibition of B2M attenuated GSC survival, self-renewal, and tumor growth. B2M-induced TGFβ1 secretion activated paracrine SMAD and PI3K/AKT signaling in TAMs and promoted an M2-like macrophage phenotype. These findings reveal tumor-promoting functions of B2M and suggest that targeting B2M or its downstream axis may provide an effective approach for treating GBM.

Significance:
β2-microglobulin signaling in glioblastoma cells activates a PI3K/AKT/MYC/TGFβ1 axis that maintains stem cells and induces M2-like macrophage polarization, highlighting potential therapeutic strategies for targeting tumor cells and the immunosuppressive microenvironment in glioblastoma.
Hyperemesis Gravidarum and the Potential for Cancer: A Longitudinal Cohort Study over Three Decades
Authors: Marcoux Sophie , Leduc Valérie , Healy-Profitós Jessica , Bilodeau-Bertrand Marianne , Auger Nathalie 
Published: July 2022

Abstract

Background:
Our objective was to assess whether hyperemesis gravidarum is associated with the risk of endodermal, mesodermal, and ectodermal human chorionic gonadotropin (hCG) receptor+ cancer in women.

Methods:
We performed a longitudinal cohort study of 1,343,040 women who were pregnant between 1989 and 2019 in Quebec, Canada. We identified women with and without hyperemesis gravidarum and followed them over time to capture incident cancers, grouped by embryonic germ cell layer of origin and organ hCG receptor positivity. We used time-varying Cox regression to model hazard ratios (HR) and 95% confidence intervals (CI) for the association between hyperemesis gravidarum and cancer onset, adjusted for maternal age, comorbidity, multiple gestation, fetal congenital anomaly, socioeconomic deprivation, and time period.

Results:
Women with hyperemesis gravidarum had a greater risk of endodermal cancer compared with no hyperemesis gravidarum (5.8 vs. 4.8 per 10,000 person-years; HR, 1.36; 95% CI, 1.17–1.57), but not mesodermal or ectodermal cancer. Severe hyperemesis with metabolic disturbance was more strongly associated with cancer from the endodermal germ layer (HR, 1.97; 95% CI, 1.51–2.58). The association between hyperemesis gravidarum and endodermal cancer was driven by bladder (HR, 2.49; 95% CI, 1.37–4.53), colorectal (HR, 1.41; 95% CI, 1.08–1.84), and thyroid (HR, 1.43; 95% CI, 1.09–1.64) cancer.

Conclusions:
Women with hyperemesis gravidarum have an increased risk of cancers arising from the endodermal germ cell layer, particularly bladder, colorectal, and thyroid cancers.

Impact:
Future studies identifying the pathways linking hyperemesis gravidarum with endodermal tumors may help improve the detection and management of cancer in women.
Novel DNA Methylation Biomarker Panel for Detection of Esophageal Adenocarcinoma and High-Grade Dysplasia
Authors: Yu Ming , Moinova Helen R. , Willbanks Amber , Cannon Victoria K. , Wang Ting , Carter Kelly , Kaz Andrew , Reddi Deepti , Inadomi John , Luebeck Georg , Iyer Prasad G. , Canto Marcia I. , Wang Jean S. , Shaheen Nicholas J. , Thota Prashanti N. , Willis Joseph E. , LaFramboise Thomas , Chak Amitabh , Markowitz Sanford D. , Grady William M. 
Published: July 2022

Abstract

Purpose:
Current endoscopy-based screening and surveillance programs have not been proven effective at decreasing esophageal adenocarcinoma (EAC) mortality, creating an unmet need for effective molecular tests for early detection of this highly lethal cancer. We conducted a genome-wide methylation screen to identify novel methylation markers that distinguish EAC and high-grade dysplasia (HGD) from normal squamous epithelium (SQ) or nondysplastic Barrett's esophagus (NDBE).

Experimental Design:
DNA methylation profiling of samples from SQ, NDBE, HGD, and EAC was performed using HM450 methylation arrays (Illumina) and reduced-representation bisulfate sequencing. Ultrasensitive methylation-specific droplet digital PCR and next-generation sequencing (NGS)-based bisulfite-sequencing assays were developed to detect the methylation level of candidate CpGs in independent esophageal biopsy and endoscopic brushing samples.

Results:
Five candidate methylation markers were significantly hypermethylated in HGD/EAC samples compared with SQ or NDBE (P &lt; 0.01) in both esophageal biopsy and endoscopic brushing samples. In an independent set of brushing samples used to construct biomarker panels, a four-marker panel (model 1) demonstrated sensitivity of 85.0% and 90.8% for HGD and EACs respectively, with 84.2% and 97.9% specificity for NDBE and SQ respectively. In a validation set of brushing samples, the panel achieved sensitivity of 80% and 82.5% for HGD and EAC respectively, at specificity of 67.6% and 96.3% for NDBE and SQ samples.

Conclusions:
A novel DNA methylation marker panel differentiates HGD/EAC from SQ/NDBE. DNA-methylation–based molecular assays hold promise for the detection of HGD/EAC using esophageal brushing samples.
“Noite de almirante” de Machado de Assis: um povo de subúrbio
Authors: Silva Eufrida Pereira da 
Published: July 2022

"Noite de almirante", de Machado de Assis, foi publicado em 1884 na Gazeta de Notícias do Rio de Janeiro e em Histórias sem Data no mesmo ano. No conto, um triângulo amoroso é vivido por um povo de subúrbio como Genoveva, Deolindo e José Diogo. Deolindo, ao saber que foi traído, ele que fez juras de amor, passou a fazer promessas de morte. O caráter frívolo da moça, a farsa da noite de almirante e a vida imprevisível do mascate mundo afora formam um turbilhão que colide com os ideários dos discursos inaugurais de uma nação recém-independente com pretensões de unidade, civilização e ordem. A discussão é tratada segundo Schwarz (2000), DaMatta (1997), Candido (1970) e Schwarcz (2000).