bluuebunny/crossref_metadata_2025_split huggingface dataset:
Better use of inhaled medication in asthma and COPD through training, preparation and counselling: the On TRACk study protocol for a cluster randomised controlled trial
Authors: Paske R te , van Dijk Liset , Linn Annemiek J , van Boven Job F M , Koster Ellen S , Vervloet Marcia 
Published: September 2022

IntroductionAbout 70% of patients with asthma and/or chronic obstructive pulmonary disease (COPD) use their inhaled medication incorrectly, leading to reduced disease control, higher healthcare use and costs. Adequate guidance from the pharmacy team from first dispense onwards can benefit patients in the long run. We propose an intervention (‘On TRACk’) to improve medication adherence and inhaler technique of adult patients with asthma and/or COPD. This intervention focuses on training pharmacy technicians (PTs) in patient-centred communication and inhalation instruction skills. In addition, patients are actively involved in refill consultations at the pharmacy. The aim of this study is to improve inhaler technique and better inhaled medication adherence among patients with asthma and/or COPD. This paper describes the study protocol.Methods and analysisA cluster randomised controlled trial (RCT) with an intervention and control group of 15 pharmacies each will be conducted. Per intervention pharmacy, two PTs will be trained online. Each PT will include five patients who will prepare their second and third dispense counselling sessions by selecting three topics they wish to discuss. Pharmacies in the control cluster provide usual care. In total, 300 patients (150 per group) will be included. Up to 12 months after inclusion, patients complete 3-monthly follow-up questionnaires. Both a process evaluation and a cost-effectiveness analysis will be performed alongside the trial. Trial effectiveness on the patient level will be evaluated after the 12-month follow-up period.Patient data will be collected through questionnaires and pharmacy refill data. Patients’ inhaler technique will be visually assessed by PTs. Semistructured interviews with PTs and patients will be conducted regarding implementation and fidelity. Direct and indirect health costs will be collected to assess cost-effectiveness.The primary outcome is adherence to inhalation maintenance medication measured with pharmacy refill data. Secondary outcomes are inhaler technique, persistence, patients’ attitudes towards medication, self-efficacy in medication use and communication with their PTs.Ethics and disseminationThe study was approved by the Vrije Universiteit Amsterdam Ethics Committee (number: 2020.358). Results will be presented at (inter)national conferences and published in peer-reviewed journals. If proven to be (cost-)effective, the intervention should be considered for reimbursement and implementation in Dutch community pharmacies.Trial registration numberNL9750.
Role of social comparison in preparedness for practice as a junior doctor in Singapore: a longitudinal qualitative study
Authors: Chen Shiwei , Smith Helen , Bartlam Bernadette , Low-Beer Naomi , Chow Aloysius , Rosby Lucy Victoria , Shelat Vishalkumar G , Cleland Jennifer 
Published: September 2022

ObjectivesTo date, most research on medical graduates’ preparedness for practice has conceptualised preparedness as something possessed by the individual. However, new doctors work within social settings with other people and, given this, we argue that preparedness has a social and comparative dimension. The aim of this paper is to explore medical students’/graduates’ self-assessments of their preparedness for practice using the lens of social comparison theory.SettingWe invited medical students from one of Singapore’s three medical schools who were in their final-year Student Assistantship Programme to participate in semi-structured interviews, and follow-up interviews 6 months later when they were working as junior doctors. Data was collected from two cohorts, in 2018 and 2019. Initial analysis of interview transcripts was inductive and thematic. Social comparison theory was used for subsequent theory-driven analysis.Participants31 participants took part, of whom 21 also engaged in follow-up interviews.ResultsWe identified three uses of social comparison: as coping strategy to manage uncertainties in transitions where there was no formal, objective testing of their performance; as a means to confirm their self-perceived preparedness (upwards or downwards, eg, being better or worse prepared than comparator others); and as the basis for decision-making (eg, changing career choices).ConclusionsSenior medical students and newly-graduated doctors compare themselves with peers and near-peers in terms of prior learning and current performance to evaluate and understand their own performance at work. Future studies need to examine further how the feeling of preparedness or unpreparedness generated from social comparisons may affect subsequent clinical performance and professional development.
Feasibility of a new electronic patient-reported outcome (ePRO) system for an advanced therapy clinical trial in immune-mediated inflammatory disease (PROmics): protocol for a qualitative feasibility study
Authors: Hughes Sarah E , McMullan Christel , Rowe Anna , Retzer Ameeta , Malpass Rebecca , Bathurst Camilla , Davies Elin Haf , Frost Chris , McNamara Gary , Harding Rosie , Price Gary , Wilson Roger , Walker Anita , Newsome Philip N , Calvert Melanie 
Published: September 2022

IntroductionThe use of electronic patient-reported outcome (ePRO) systems to capture PRO data in clinical trials is increasing; however, their feasibility, acceptability and utility in clinical trials of advanced therapy medicinal products (ATMPs) are not yet well understood. This protocol describes a qualitative study that aims to evaluate the feasibility and acceptability of ePRO data capture using a trial-specific ePRO system (the PROmics system) within an advanced therapy trial involving patients with immune-mediated inflammatory disease (rheumatoid arthritis, lupus, primary sclerosing cholangitis (PSC) and Crohn’s disease).Methods and analysisThis protocol for a remote, qualitative, interview-based feasibility study is embedded within the POLARISE trial, a single-arm, phase II, multisite ATMP basket trial in the UK. 10–15 patients enrolled in the POLARISE trial and 10–15 research team members at the trial sites will be recruited. Participants will take part in semistructured interviews which will be transcribed verbatim and analysed thematically according to the framework method. Data collection and analysis will occur concurrently and iteratively. Researcher triangulation will be used to achieve a consensus-based analysis, enhancing rigour and trustworthiness.Ethics and disseminationThis study was approved by the London—West London and GTAC Research Ethics Committee (Ref: 21/LO/0475). Informed consent will be obtained from all participants prior to data collection. The study findings will be published in peer-review journals and disseminated via conference presentations and other media. Our patient and public involvement and engagement group and ATMP stakeholder networks will be consulted to maximise dissemination and impact.Trial registration numberISRCTN80103507.
Pharmacy program to improve care for veterans with transient ischaemic attack: a pilot implementation evaluation
Authors: Rattray Nicholas , Damush Teresa M , Myers Laura , Perkins Anthony J , Homoya Barbara , Knefelkamp Christopher , Fleming Breanne , Kingsolver Andrea , Boldt Amy , Ferguson Jared , Zillich Alan , Bravata Dawn M 
Published: September 2022

BackgroundEarly evaluation and effective communication to manage transient ischaemic attacks (TIA) may lead to a reduction of up to 70% in recurrent events for patients with TIA/minor stroke, along with reduced costs and lengths of hospital stay.MethodsWe conducted a single site pilot evaluation of a clinical pharmacy programme to improve medication management among TIA patients. The programme included a structured protocol, online identification tool, and a templated discharge checklist. Primary effectiveness measures were change in systolic blood pressure (SBP) 90 days post discharge and prescription of high/moderate potency statins. Contextual aspects and clinical perspectives on the implementation process were evaluated through prospective semistructured interviews with key informants.ResultsThe analysis included 75 patients in the preimplementation group and 61 in the postimplementation group. The mean SBP at 90 days post discharge was significantly lower in the post implementation period (pre implementation, 133.3 mm Hg (SD 17.8) vs post implementation, 126.8 mm Hg (16.6); p=0.045). The change in SBP from discharge to 90 days post discharge was greater in the postimplementation period (15.8 mm Hg (20.5) vs 24.8 mm Hg (23.2); p=0.029). The prescription of high/moderate potency statins were similar across groups (pre implementation, 66.7% vs post implementation, 77.4%; p=0.229). Front-line clinicians involved in the pilot study reported positively on the acceptability, appropriateness and feasibility of implementing the protocol without additional cost and within current scope of practice.ConclusionsImplementation of a clinical protocol outlining medication management and provider communication to ensure rapid postdischarge treatment of TIA patients was associated with SBP improvements. The pilot evaluation demonstrates how clinical pharmacists may play a role in treating low frequency, high stakes cerebrovascular events where early treatment and follow-up are critical.
Financial stress during COVID-19: implications for parenting behaviour and child well-being
Authors: McGill Megan G , Purkey Eva , Davison Colleen M , Watson Autumn , Bayoumi Imaan 
Published: September 2022

BackgroundFamily financial stress and parenting behaviours are each associated with child behaviours. We sought to explore the association between parent financial stress and child socioemotional and behavioural difficulties during the COVID-19 pandemic and examine parenting behaviour, including overreactive and lax parenting approaches, as a potential mediator to this relationship.MethodsCross-sectional sample of parent and child data pairings in Ontario, Canada between April and November of 2020. Linear models were used to describe the relationships between financial worry, child Strengths and Difficulties Questionnaire (SDQ) total difficulties and parenting behaviours measured by the Parenting Scale 8-item (PS-8), which includes measures of both overreactive and lax parenting tendencies. Formal mediation testing was performed to assess the potential mediating role of parenting behaviour.Results528 parent and child pairs were enrolled from largely European ancestry (78%), female (93%) and varied household income levels. Analysis revealed increased financial worry during the COVID-19 pandemic was significantly associated with increased child SDQ total difficulties scores (β=0.23, SE=0.10, p=0.03). This relationship was mediated by reported parenting behaviour, independent of parent education, household income, parent age, parent sex, parent anxiety and child sex (total effect: β=0.69, p=0.02, average causal mediation effects: β=0.50, p=0.02, average direct effects: β=0.19, p=0.08).ConclusionFinancial stress during the COVID-19 pandemic was associated with poorer child social and emotional well-being. Parenting behaviours measured by the PS-8 significantly mediated these effects. This work supports the importance of policies aimed to alleviate family financial stresses and highlights the potential impact such policies have on child well-being.
TNF-α, IL-6 and hsCRP in patients with melancholic, atypical and anxious depression: an antibody array analysis related to somatic symptoms
Authors: Liu Hongmei , Wu Xiaohui , Wang Yun , Liu Xiaohua , Peng Daihui , Wu Yan , Chen Jun , Su Yun'ai , Xu Jia , Ma Xiancang , Li Yi , Shi Jianfei , Yang Xiaodong , Rong Han , Forti Marta Di , Fang Yiru 
Published: September 2022

BackgroundThe association between inflammation and major depressive disorder (MDD) remains poorly understood, given the heterogeneity of patients with MDD.AimsWe investigated inflammatory markers, such as interleukin (IL)-6, high-sensitivity C reactive protein (hsCRP) and tumour necrosis factor-α (TNF-α) in melancholic, atypical and anxious depression and explored whether baseline inflammatory protein levels could indicate prognosis.MethodsThe sample consisted of participants (aged 18–55 years) from a previously reported multicentre randomised controlled trial with a parallel-group design registered with ClinicalTrials.gov, including melancholic (n=44), atypical (n=37) and anxious (n=44) patients with depression and healthy controls (HCs) (n=33). Subtypes of MDD were classified according to the 30-item Inventory of Depressive Symptomatology, Self-Rated Version and the 17-item Hamilton Depression Rating Scale. Blood levels of TNF-α, IL-6 and hsCRP were assessed using antibody array analysis.ResultsPatients with MDD, classified according to melancholic, atypical and anxious depression subtypes, and HCs did not differ significantly in baseline TNF-α, IL-6 and hsCRP levels after adjustment. In patients with anxious depression, hsCRP levels increased significantly if they experienced no pain (adjusted (adj.) p=0.010) or mild to moderate pain (adj. p=0.038) compared with those with severe pain. However, the patients with anxious depression and severe pain showed a lower trend in hsCRP levels than patients with atypical depression who experienced severe pain (p=0.022; adj. p=0.155). Baseline TNF-α (adj. p=0.038) and IL-6 (adj. p=0.006) levels in patients in remission were significantly lower than those in patients with no remission among the participants with the atypical depression subtype at the eighth-week follow-up.ConclusionsThis study provides evidence of differences in inflammatory proteins in patients with varied symptoms among melancholic, atypical and anxious depression subtypes. Further studies on the immunoinflammatory mechanism underlying different subtypes of depression are expected for improved individualised therapy.Trial registration numberNCT03219008.
Nemvaleukin alfa, a novel engineered IL-2 fusion protein, drives antitumor immunity and inhibits tumor growth in small cell lung cancer
Authors: Pan Yuanwang , Hao Yuan , Han Han , Chen Ting , Ding Hailin , Labbe Kristen E , Shum Elaine , Guidry Kayla , Hu Hai , Sherman Fiona , Geng Ke , Stephens Janaye , Chafitz Alison , Tang Sittinon , Huang Hsin-Yi , Peng Chengwei , Almonte Christina , Lopes Jared E , Losey Heather C , Winquist Raymond J , Velcheti Vamsidhar , Zhang Hua , Wong Kwok-Kin 
Published: September 2022

BackgroundSmall cell lung cancer (SCLC) is a deadly disease with a 5-year survival of less than 7%. The addition of immunotherapy to chemotherapy was recently approved as first-line treatment; however, the improved clinical benefit is modest, highlighting an urgent need for new treatment strategies. Nemvaleukin alfa, a novel engineered interleukin-2 fusion protein currently in phase I–III studies, is designed to selectively expand cytotoxic natural killer (NK) cells and CD8+T cells. Here, using a novel SCLC murine model, we investigated the effects of a mouse version of nemvaleukin (mNemvaleukin) on tumor growth and antitumor immunity.MethodsA novelRb1−/−p53−/−p130−/−SCLC model that mimics human disease was generated. After confirming tumor burden by MRI, mice were randomized into four treatment groups: vehicle, mNemvaleukin alone, chemotherapy (cisplatin+etoposide) alone, or the combination of mNemvaleukin and chemotherapy. Tumor growth was measured by MRI and survival was recorded. Tumor-infiltrating lymphocytes and peripheral blood immune cells were analyzed by flow cytometry. Cytokine and chemokine secretion were quantified and transcriptomic analysis was performed to characterize the immune gene signatures.ResultsmNemvaleukin significantly inhibited SCLC tumor growth, which was further enhanced by the addition of chemotherapy. Combining mNemvaleukin with chemotherapy provided the most significant survival benefit. Profiling of tumor-infiltrating lymphocytes revealed mNemvaleukin expanded the total number of tumor-infiltrating NK and CD8+T cells. Furthermore, mNemvaleukin increased the frequencies of activated and proliferating NK and CD8+T cells in tumors. Similar immune alterations were observed in the peripheral blood of mNemvaleukin-treated mice. Of note, combining mNemvaleukin with chemotherapy had the strongest effects in activating effector and cytotoxic CD8+T cells. mNemvaleukin alone, and in combination with chemotherapy, promoted proinflammatory cytokine and chemokine production, which was further confirmed by transcriptomic analysis.ConclusionsmNemvaleukin, a novel cytokine-based immunotherapy, significantly inhibited murine SCLC tumor growth and prolonged survival, which was further enhanced by the addition of chemotherapy. mNemvaleukin alone, and in combination with chemotherapy, drove a strong antitumor immune program elicited by cytotoxic immune cells. Our findings support the evaluation of nemvaleukin alone or in combination with chemotherapy in clinical trials for the treatment of SCLC.
Utility of the ACR-1997, SLICC-2012 and EULAR/ACR-2019 classification criteria for systemic lupus erythematosus: a single-centre retrospective study
Authors: Lu Wentian , Zhong Ying , Weng Chenghua , Wang Qing , Tang Mei , Liu Zhichun , Xue Leixi 
Published: September 2022

Background and aimsSeveral different versions of classification criteria, including the American College of Rheumatology (ACR)-1997, Systemic Lupus International Collaborating Clinics (SLICC)-2012 and European Alliance of Associations for Rheumatology (EULAR)/ACR-2019 classification criteria, have been launched in the past decades. The current study aimed to investigate the performance of these three classification criteria for diagnosing patients with SLE in a Chinese cohort.Methods352 patients with SLE and 385 controls with other diseases who had the detection results of ANA were enrolled into the study. Various clinical parameters were estimated, such as demographics variables, clinical characteristics and other variables related to three criteria.ResultsThe current study demonstrated great diagnostic ability of the three criteria; and the receiver operating characteristic curve and the area under curve (AUC) were used to evaluate the diagnostic ability of three criteria: ACR-1997 (AUC=0.972), SLICC-2012 (AUC=0.986) and EULAR/ACR-2019 (AUC=0.983). Despite lower specificity of the SLICC-2012 and EULAR/ACR-2019 classification criteria, their sensitivity is significantly improved than ACR-1997. Of note, we also compared the median time interval between the appearance of the earliest item and fulfilment of the three sets of criteria, suggesting the SLICC-2012 and EULAR/ACR-2019 could achieve earlier diagnosis. Adjusting the thresholds of the EULAR/ACR-2019 criteria from 10 to 12, the specificity and accuracy significantly increased.ConclusionThe SLICC-2012 and EULAR/ACR-2019 performed well in Chinese patients with SLE and showed better early diagnosis ability. In addition, by adjusting the classification threshold, the accuracy of the EULAR/ACR-2019 classification criteria was improved.
Democratization of terrorism: an analysis of vehicle-based terrorist events
Authors: Houser Ryan Scott 
Published: September 2022

ObjectivesThe COVID-19 pandemic inspired social changes that promote outdoor activities including eating at restaurants, which may linger in a world hyperfocused on disease transmission prevention, increasing the vulnerabilities to vehicle-based terrorism. Vehicle ramming attacks started to transition from a relatively rare method of attack to one of the most lethal forms of terrorism in Western countries just prior to the emergence of SARS-CoV-2. This study aims to provide a historical analysis of the terrorism-based attacks using vehicles between 1970 and 2019.MethodsThis study uses the methodology suggested by Tinet alin which the Global Terrorism Database hosted by the National Consortium for the Study of Terrorism and Responses to Terrorism was searched retrospectively for data. Data was collected from the database using the internal search function for terror events between January 1, 1970 and December 31, 2019 which used a vehicle as a means of attack.ResultsThere were 257 recorded terror attacks that involved some type of vehicle between 1970 and 2019. The attacks resulted in 808 fatalities and 1715 injuries when excluding the September 11 attacks. 76 events occurred at the West Bank and Gaza Strip, 25 in the USA, 16 in Israel, and 14 in the UK. Of the 257 terror incidents, 71% (183) occurred within the last 6-year span of inquiry.ConclusionBy 2016, vehicle attacks were the most lethal form of attack comprising just over half of all terrorism-related deaths in that year. Large gatherings such as festivals, sporting events, and now outdoor seating at restaurants, leave a number of people highly vulnerable to a vehicle ramming attacks depending on established countermeasures. The increased prevalence of outdoor activities and gatherings in a post-COVID-19 world will further expose large numbers of people to the potential vulnerabilities of vehicle-based terrorism. The scale of the casualties from a vehicle-based terror attack can overwhelm traditional resources and strain the abilities of the healthcare sector. Counterterrorism and disaster medicine specialists are crucial players in educating first responders and emergency medicine providers, allowing them to adequately prepare for an evolving threat in a world devastated by COVID-19.Level of evidenceVI.
Momentum transport properties of a hot and dense QCD matter in a weak magnetic field
Authors: Rath Shubhalaxmi , Dash Sadhana 
Published: September 2022

AbstractWe have studied the momentum transport properties of a hot and dense QCD matter in the presence of weak magnetic field by determining the shear ($$\eta $$
η
) and bulk ($$\zeta $$
ζ
) viscosities in the relaxation time approximation of kinetic theory. The dependence of $$\eta $$
η
and $$\zeta $$
ζ
on the temperature has been explored in the presence of weak magnetic field (B-field) and finite chemical potential ($$\mu $$
μ
). It is observed that both shear and bulk viscosities get decreased in the presence of a weak magnetic field, whereas the finite chemical potential increases these viscosities, specifically at low temperatures. This study is important to understand the sound attenuation through the Prandtl number (Pr), the nature of the flow through the Reynolds number (Re), the fluidity and location of transition point of the matter through the ratios $$\eta /s$$

η
/
s

and $$\zeta /s$$

ζ
/
s

(s is the entropy density), respectively. The Prandtl number is observed to increase in the weak magnetic field, whereas the presence of a finite chemical potential reduces its magnitude as compared to the scenario of absence of B-field and $$\mu $$
μ
. However, Pr still remains larger than unity, indicating that the energy dissipation due to the sound attenuation is mostly governed by the momentum diffusion. It is noticed that the weak magnetic field makes the Reynolds number larger, whereas the chemical potential makes it smaller than that in the absence of B-field and $$\mu $$
μ
. We have observed that the ratio $$\eta /s$$

η
/
s

decreases in the weak magnetic field regime, whereas the finite chemical potential increases its value, but the ratio $$\zeta /s$$

ζ
/
s

is found to decrease in the presence of weak magnetic field as well as finite chemical potential.