Short Message Research Articles

Smart Approaches to Efficient Text Mining for Categorizing Sexual Reproductive Health Short Messages into Key Themes

Smart Approaches to Efficient Text Mining for Categorizing Sexual Reproductive Health Short Messages into Key Themes

Pclf: Parallel cnn-lstm fusion model for sms spam filtering

Short Message Service (SMS) is widely used for its accessibility, simplicity, and cost-effectiveness in communication, bank notifications, and identity confirmation. The increase in spam text messages presents significant challenges, including time waste, potential financial scams, and annoyance for users and carriers. This paper proposes a novel deep learning model based on parallel structure in the feature extraction step to address this challenge, unlike the traditional models that only enhance the classifier. This parallel model fuses local and temporal features to enhance feature representation by combining convolutional neural networks (CNN) and long short-term memory networks (LSTM). The performance of this model has been evaluated on the UCI SMS Collection V.1 dataset, which comprises both spam and ham messages. The model achieves an accuracy of 99.28% on this dataset. Also, the model demonstrates good precision, recall, and F1 score. This paper aims to provide the best protection from unwanted messages for mobile phone users.

Professional Quality of Life among Iranian Clinical Nurses at the Forefront of the Fight against COVID-19: A Multicenter Cross-Sectional Study.

With the prolonged COVID-19 disease control time, concerns about the caring ability of clinically exposed nurses have increased. This study aimed to investigate Compassion Satisfaction (CS), Burnout (BO), and Secondary Traumatic Stress (STS) as elements of Professional Quality of Life among nurses in COVID-19 settings. In this descriptive online national survey, 427 clinical nurses who had worked in the COVID-19 wards from all Iran provinces answered the Persian version of the Professional Quality of Life Scale as the profile tool with three subscales, including CS, BO, and STS. Data were collected using email, Short Message Service (SMS), and social networks from December 2020 to February 2021. The mean (SD) score of CS was 38.86 (9.00), the mean (SD) score of BO was 18.60 (4.08), and STS was 34.74 (7.02). STS was substantially more prevalent among married nurses whose Polymerase Chain Reaction (PCR) tests were positive for themselves or at least one family member (p < 0.05). Clinical nurses who respond to the COVID-19 crisis are at risk of STS and BO. In pandemic situations like COVID-19, it is necessary to consider supportive interventions to increase satisfaction and reduce burnout and secondary traumatic stress in nurses.

Mobile health technologies in the prevention and management of hypertension: A scoping review.

An estimated one billion people globally are currently suffering from hypertension. Prevention and management of hypertension are suboptimal especially in low- and middle-income countries leading to increased complications and deaths. With increased mobile phone coverage globally, this study aims to review mobile health technologies used for the prevention and management of hypertension. We conducted a literature search on electronic databases using identified keywords involving "hypertension", "mobile health technology" and their synonyms. Snowballing technique was also used. Papers were screened at two levels by independent reviewers. The targets were studies published in peer-reviewed journals reporting mobile health interventions for hypertension prevention and management. Only primary research studies published in English from January 2017 to April 2024 were included. Google Forms were used to extract the data along with other characteristics, and selected articles were categorised into: mobile application, web-based solutions, and Short Message Service (SMS) and other offline solutions. The search yielded 184 articles, and 44 studies were included in the review. Most (n = 26) were randomised control trials. Twenty-two studies (22) focused only on mobile applications solutions, 12 on SMS and other offline mHealth, 5 web-based solutions, and 5 combined more than one type of mobile health technology. The United States of America had the majority of studies (n = 17), with 6 studies from other American countries, 11 from Asia and nine from Europe, while only one from Africa. A total of 36 studies reported that mobile health technology significantly improved hypertension care through reduced blood pressure, improved adherence to follow-up visits and medications, and lifestyle changes. SMS and offline mHealth strategies have also demonstrated effectiveness in promoting self-management and reducing racial disparities in hypertension care. Mobile health technology has the potential to play a significant role in the prevention and management of hypertension. However, there is a need for mobile health solutions for hypertension prevention and management in African countries and other developing countries. Integrating mHealth into primary healthcare delivery would also go a long way in strengthening patient care and reducing the burden on healthcare systems.

Active Surveillance for Safety Monitoring of XBB.1.5-Containing COVID-19 mRNA Vaccines in Korea.

The emergence of the omicron variant and its sub-lineages has necessitated vaccine updates for coronavirus disease 2019. In September 2023, the U.S. Food and Drug Administration approved an updated BNT162b2 vaccine targeting the omicron XBB.1.5 variant, which was initiated in Korea in October 2024. This study demonstrates the adverse events reported through active nationwide surveillance after XBB.1.5 vaccination in Korea. Since October 19, 2023, the Korea Disease Control and Prevention Agency has conducted daily Short Message Service surveys to collect data on health issues, fever, vaccination site reactions, systemic symptoms, impact on daily life, and healthcare visits. Among 20,180 respondents, 27.9% reported health issues. Adverse reactions peaked on day 1 (28.7%), including pain at the vaccination site, muscle pain, fatigue, and fever. These findings elucidate the short-term safety of the XBB.1.5 vaccine and support its co-administration with the influenza vaccine, reducing vaccine hesitancy and achieving herd immunity.

Technology acceptance and users’ satisfactions with telecommunication services

Technological innovation and advancement have augmented the space of productivity in terms of quality and quantity, goods and services delivery and the removal of overall stress embedded in jobs. This achievement also comes with the challenge of technology acceptance as well as user satisfaction with the technology, especially in the telecommunication industry in Nigeria. Hence, the objectives of this research are to determine the extent of users’ satisfaction in the telecommunication industry and examine the technology acceptance of telecommunication products. Two thousand participants were selected for the study in the Ibadan metropolis and Pearson Product Moment Correlation (PPMC) was used in analysing the information gathered from respondents. The result of the analysis (r = .713, n= 2000, P (.003) &lt; 0.05) revealed that participants considered factors such as availability of the network, network coverage, quality of service and call rate before choosing a network provider or telecommunication brand in the studied area. It was concluded in this study that participants considered factors such as availability of service, novelty technology, service availability, call rate and data rate before choosing a brand of telecommunication service in the study area. The research showed that service availability, call rate and data rate are factors considered by customers before choosing a brand of telecommunication service. The research also revealed that telecommunication service is an accepted technology in the studied area with some inherent challenges. Going by the outcomes of this study, it can be concluded that there is a correlation between the users’ satisfaction and technological acceptance in telecommunication industries in Nigeria. It is therefore recommended that telecommunication providers should enhance the quality of service and minimize the call rate, especially on phone calls and short message services (SMS) in other to satisfy their customers and win more patronage.

Responsibility of the Radiologists as a Clinician: RCRT Perspective and Short Message of the ESR International Forum 2023, Vienna, Austria

The European Society of Radiology (ESR) internal forum is held in the European Congress of Radiology (ECR) every year and this year, under the theme "Responsibility of the Radiologists as a Clinician", on March 3, 2023. The representatives of twenty-two international societies were invited to present their perspectives and discussions as ESR's global society stakeholders.

Developing a Centralized Receipt Service to Streamline Restaurant Operations and Reduce Costs

The fast food industry, which the restaurant industry falls under, has several challenges, including receipt management. Conventional document management means are ineffective, expensive, and inconducive to the best performance of restaurants and the satisfaction of consumers. This article discusses the challenges arising from the decentralized receipt service and how they have developed and deployed the Centralised Receipt Service to solve these issues with modern technologies like Go Gin framework and AWS lambda. The service thus factors in cloud architecture to improve the receipt data storage, retrievals, management, and less paper use. It also improves customer satisfaction through digital receipts through Short Messaging Service and mobile responsive web front end. Receiving centralized services helps enhance performance by cutting operational costs, reducing paperwork, and increasing record-keeping. Besides, it helps the business reduce paper usage, positively contributing to environmental conservation. It provides a potential growing scale for all forms of businesses; restaurants can use it to address expanding customers’ demands for digital services. It also exposes future possibilities for using AI for predictive analysis and customized client communications. Therefore, by consolidating restaurant receipt management, they can enhance customer satisfaction with less spending and set the business up for success in the dynamic digital space. This study supports that this centralized method for receipt services is feasible and fundamental in today’s restaurant businesses since it comes with a package of effectiveness, sustainability, and customer appeal opportunities.

Review of Sentiment Analysis Techniques in Social Networks

This article develops a review of the techniques used for sentiment analysis applied to messages on social networks. Sentiment analysis is a task from the field of Artificial Intelligence known as Natural Language Processing and seeks to detect the sentiment polarity expressed by a person in a short message or in a document. Currently there are three types of techniques from which the proposed sentiment analysis models are derived: Lexicons, traditional machine learning and deep learning – in addition to hybrid approaches that combine at least two of these techniques to improve classification performance. Sentiment analysis is a currently-valid task and its importance has grown along with the massification of social networks, which allow a massive generation of text that can be classified.

Assessment of relationship between different communication methods and treatment compliance in orthodontic patients during Covid-19 pandemics

Objective: The aim of this study was to minimize impairment in oral hygiene and failure of brackets; therefore, effects of pandemic on treatment duration, by communicating our patients using 4 different methods during Covid-19 pandemic. &#x0D; &#x0D; Methods: In the study, 227 patients undergoing fixed orthodontic treatment were included. Five groups were designed: WhatsApp group, short message service (SMS) group, Teledentistry group, e-mail group and control group. During quarantine period, patients were contacted for 4 times and same text was sent to patients. After pandemics, the patients were assessed using mucogingival index (MGI), orthodontic plaque index (OPI) and failure of brackets was determined.&#x0D; &#x0D; Results: In MGI, percentage of patients with healthy result were as follows: WhatsApp group, 83.7%; SMS group, 87.8%; Teledentistry group, 83.7%; E-mail group, 77.5%; control group, 72.2% and no significant difference was found (p&gt;0.05). The OPI scores were as follows: 1.12±1.24 in WhatsApp group; 1.27±1.28 in SMS group; 1.24±1.38 in Teledentistry group; 1.00±1.22 in E-mail group; and 1.61±1.25 in the control group and no significant difference was found (p&gt;0.05). The mean number of brackets broken was 0.47±0.88 in WhatsApp group, 0.39±0.83 in SMS group, 0.51±1.00 in Teledentistry group, 0.40±0.67 in E-mail group and 0.44±0.86 in the control group and no significant difference was found (p&gt;0.05).&#x0D; &#x0D; Conclusion: It was determined that communicating with patients in different ways did not make any difference in terms of the subjects investigated in the study. It was concluded that it would be more appropriate to conduct new studies including social and psychological evaluations.

Interventions of eHealth technologies integrated with non-physician health workers for improving management of hypertension: Systematic review and meta-analysis

Hypertension is a major public health problem, accounting for 7.5 million deaths and 57 million disability-adjusted life years annually worldwide. The majority of hypertension-related deaths occur in low- and middle-income countries (LMICs). Despite the escalating prevalence of hypertension in many LMICs, only one-third of those affected are aware of their hypertension status. The rapid proliferation of eHealth technologies presents an opportunity to improve the detection and management of hypertension. Many LMICs face a critical shortage of physicians, and their services often come at a considerable cost to the health system. Non-physician health workers could be a cost-effective alternative to improve the detection and management of hypertension, particularly in LMICs. In this systematic review, we aim to synthesize and evaluate the effectiveness of interventions that integrated eHealth technologies with non-physician health workers to reduce blood pressure. A diverse range of eHealth technologies, such as mobile-based applications, telemonitoring, short text messaging and electronic decision support systems, are being used by non-physician health workers for the management of hypertension. We found that eHealth technologies integrated with non-physician health workers reduced overall mean systolic blood pressure by -4.09 mmHg (95%CI: -5.87 to -2.32) compared to usual care. Similarly, such an integrated approach also reduced diastolic blood pressure by -1.25 mmHg (-2.31 to -0.81) in the intervention group than usual care. Therefore, leveraging the use of cost-effective eHealth technologies to support task-sharing with non-physicians presents an effective strategy for enhancing blood pressure management, applicable to both high- and low-income countries.

The Information Needs and Seeking Behavior of Elderly Patients in Educational and Therapeutic Hospitals: Unveiling Barriers to Information Accessibility

Background: With the aging population on the rise, it becomes increasingly important for healthcare providers and policymakers to grasp the preferences of elderly patients when it comes to seeking health information. Such understanding can pave the way for tailored interventions aimed at enhancing health literacy and encouraging healthy behaviors among older adults. Objectives: This study sought to investigate the information needs and seeking behavior of elderly patients in educational and therapeutic hospitals while also identifying the barriers that hinder these patients’ access to relevant information sources. Methods: A cross-sectional study was conducted involving 200 older adults who were hospitalized in educational and therapeutic hospitals in Sari, located in northern Iran, within 2018 to 2020. The data collection tool consisted of a researcher-made questionnaire with four sections: demographic information, health information needs, health information-seeking behavior (HISB), and barriers to finding information. The questionnaire’s reliability was validated, and the chi-square test was employed to explore the association between demographic variables and barriers to information retrieval. Data analysis was performed using SPSS software (version 24). Results: The key demographic characteristics influencing HISB among older patients included age (70 - 79 years), gender (female), educational level (illiterate), and employment status (housewife). The primary health information needs of older patients encompassed staying updated with current health news, seeking information from nurses and allied healthcare staff, and encountering obstacles in accessing information due to a lack of internet literacy. The most pronounced associations between demographics and HISB among older patients were observed in educational level, employment status, and reliance on newspapers and magazines. Moreover, significant associations existed between age groups and seeking support from groups, family, relatives, and friends in addition to using brochures, books, internet resources, short message service (SMS), and radio/television. Conclusions: Elderly patients often encounter challenges in accessing health information due to their limited internet skills. To assist older adults in navigating and utilizing the Internet more effectively, it is crucial to identify trustworthy online sources and bolster their confidence in using the Internet. Healthcare professionals can contribute to the well-being of older adult patients by providing access to current health news, delivering educational programs tailored to individuals with lower levels of education, and offering alternative sources of information for patients who lack internet access.

Design of electrical power telemetering system using microcontroller device via GSM

"Traditionally, reading of energy meters is done by human operators who move from house to house collecting readings. This exercise requires huge labor operator numbers and a lot of time to achieve complete reading of meters in a particular area. This paper endeavors to do away with this problem by using a telemetering system. With this system, power can be measured from a remote site. To achieve this, readings from an energy meter on site are processed by a microcontroller device that then sends the energy consumption information to a Global System Mobile (GSM) module. The GSM module then sends this information using microwaves to a particular mobile subscriber who receives it in the form of an Short Message Service (SMS). The reading is also transmitted to a web based telemetering system through a server. In the remote site, a remote computer which can access the internet is able to obtain data from the server through the internet. The microcontroller is developed in such a way that it achieves communication between the energy meter and the particular server using Transmission Control Protocol(TCP) protocol. Software programs are also developed to facilitate transfer of data to the user at remote site. With the web based telemetering system connected to the internet, electrical energy measurements can be accessed globally. The efficiency of the transmission channel is important for the success of both SMS and web based telemetering systems. Keywords: Telemetering system, remote sites, GSM "

Increasing bowel cancer screening using SMS in general practice: the SMARTscreen cluster randomised trial.

Australia has one of the highest incidences of colorectal cancer (CRC) worldwide. The Australian National Bowel Cancer Screening Program (NBCSP) is a best-practice, organised screening programme, but uptake is low (40.9%) and increasing participation could reduce morbidity and mortality associated with CRC. Endorsement by GPs is strongly associated with increasing screening uptake. This study (SMARTscreen) aimed to test whether a multi-intervention short message service (SMS) sent by general practices to 50-60-year-old patients who were due to receive the NBCSP kit would increase NBCSP uptake, by comparing it with usual care. A stratified cluster randomised controlled trial was undertaken, involving 21 Australian general practices in Western Victoria, Australia. For intervention practices, people due to receive the NBCSP kit within a 6-month study period were sent an SMS just before receiving the kit. The SMS included a personalised message from the person's general practice endorsing the kit, a motivational narrative video, an instructional video, and a link to more information. Control practices continued with usual care, comprising at-home testing with a faecal immunochemical test (FIT) through the NBCSP. The primary outcome was the between-arm percentage difference in uptake of FIT screening within 12 months from randomisation, which was estimated using generalised linear model regression. In total, 39.2% (1143/2914) of people in 11 intervention practices and 23.0% (583/2537) of people in 10 control practices had a FIT result in their electronic health records - a difference of 16.5% (95% confidence interval = 2.02 to 30.9). The SMS intervention increased NBCSP kit return in 50-60-year-old patients in general practice. This finding informed a larger trial - SMARTERscreen - to test this intervention in a broader Australian population.

Legal Protection For Third Parties Who Are Provided As Individual Guarantees By Fintech Peer-To-Peer Lending

The emergence of fintech companies is increasingly receiving attention from the public and regulators, namely the financial services authority (OJK) and Bank Indonesia (BI). This is stated in Financial Services Authority Regulation Number 77/POJK.01/2016 concerning Information Technology-Based Money Lending and Borrowing Services. This regulation regulates information technology-based money lending and borrowing services or what is called peer to peer money lending. As of May 24 2021, the total number of fintech peer to peer lending or fintech lending providers registered and licensed with the OJK was 131 companies. In the case of a loan recipient applying for a loan on an online loan platform, the borrower will usually be asked to include an emergency contact as a condition for applying for a loan, but this is done without the permission of the third party who is used as an emergency contact. This resulted in losses for the emergency contact party due to terror from the lender as a result of the loan recipient experiencing late payments. LBH Jakarta received 1330 reports of loan victims from 25 provinces in Indonesia. One of them is Dian Siregar, who was a victim who was terrorized by an online loan where he received a short message from one of the KSP Rupiah Petir Pro loan applications after being made a guarantor by his friend without prior approval or confirmation.

Impact of a pharmacist-led patient-centred care intervention along with textmessage reminders, on the management of newly diagnosed tubercular patients: A protocol for a randomized controlled trial.

Non-adherence to tuberculosis (TB) treatment is the leading cause of the increase in drug resistance cases. This study will determine the effectiveness of pharmaceutical-care-based interventions coupled with short messages delivered by a pharmacist on treatment outcomes and adherence among TB patients. The study will be conducted in TB Control Center of Pakistan Institute of Medical Sciences Hospital, Islamabad and District Bannu TB Control Center time period will be from August 2019 to September 2021. The patients will be included into the control group (usual care) or the intervention group pharmaceutical care and SMS reminder. The primary outcome includes a change in mean score from baseline in treatment outcomes and adherence, measured by Morisky Medication Adherence Scale, and clinic appointment attendance registration. Secondary outcomes include health-related quality of life of patients, disease knowledge, and patient satisfaction with the intervention. The major issues in patients with TB are cure rate and medication adherence. The method anticipated in this manuscript could set the foundation of pharmaceutical care and mobile SMS for the future provision of care to improve TB treatment outcomes. The study will make available fundamental information about the influence of the patient centered program on the adherence and clinical outcomes of patients with TB.Trial status and registration: Clinical Trials.gov assigned Identifier NCT04645836.

Utilizing RoBERTa Model for Churn Prediction through Clustered Contextual Conversation Opinion Mining

In computational study and automatic recognition of opinions in free texts, certain words in sentences are used to decide its sentiments. While analysing each customer’s opinion per time in churn management will be effective for personalised recommendations. Oftentimes, the opinion is not sufficient for contextualised content mining. While personalised recommendations are time consuming, it also does not provide complete picture of an overall sentiment in the business community of customers. To help businesses identify widespread issues affecting a large segment of their customers towards engendering patterns and trends of different customer churn behaviour, here, we developed a clustered contextualised conversation as opinions set for integration with Roberta Model. The developed churn behavioural opinion clusters disambiguated short messages while charactering contents collectively based on context beyond keyword-based sentiment matching for effective mining. Based on the predicted opinion threshold, customer churn category for group-based personalised decision support was generated, with matching concepts. The baseline RoBERTa model on the contextually clustered opinions, trained with a batch size of 16, a learning rate of 2e-5, over 8 epochs, using a maximum sequence length of 128 and standard hyperparameters, achieved an accuracy of 92%, Precision of 88%, Recall of 86% and F1 score of 84% over a test set of 30%.

The trial of sending short message service multidrug-resistant tuberculosis patients in Indonesia: the chance to increase knowledge and motivation.

Multidrug-Resistant Tuberculosis (MDR TB) is a threat for the future control of TB disease. In Indonesia, the success rate of MDR TB patient recovery is still very low, following the still low recovery rate of TB patients. This paper aims to discuss the trial result of message delivery containing knowledge and motivation to the MDR TB sufferers. There are about 34 MDR TB patients participating in this research. During the research, everyone received a message in their handphone or the handphone of their family members every day, contained information on medication and motivation to comply with the medication. At the end of the research, the measurement on knowledge and attitude, on the compliance with medication, and on the compliance with laboratory examinations was conducted. The results were compared with the assessment before this intervention was conducted. Out of 32 patients that managed to complete the intervention, the average means of their knowledge and attitude increased significantly. The average mean of knowledge before the intervention was 9.74 to become 10.94, and the average mean of attitude was from 7.06 to become 18.47 (P<0.05). Meanwhile, the medication compliance score and the laboratory examination compliance score also changed significantly (P<0.05). SMS delivery routinely even in a short period of time managed to change knowledge and motivation of MDR TB sufferers. To conclude, it is necessary to develop recent technology effort in order to scaling-up MDR TB patients. Existing social channels in the community must be used intensively to reduce this disease negative impact.

A Review of Research on Mobile-Assisted Vocabulary Learning

More academics are concentrating on the topic of mobile-assisted language learning (MALL) on account of the advancement of mobile technology and the widespread use of mobile electronics in modern culture, and mobile-assisted vocabulary learning (MAVL) as a hot topic in MALL has attracted a large number of scholars. The study reviews some representative literatures during 2010-2023, including the impact of using mobile Short Message Service (SMS)/Multimedia Message Service (MMS) on Second Language (L2) word learning and the effectiveness of using mobile learning applications. Moreover, this study analyses the research methods used by previous researchers and summarises the results of the studies, finding that most of the experiments focused on vocabulary enhancement and retention, the effect on motivation, and learners perceptions and satisfaction. The results of many studies show that MAVL as a learning approach is better than the traditional vocabulary learning approach. Also, researches on MAVL has many pedagogical impacts on teaching of second and foreign languages in the future. However, researches have also shown that MAVL has some drawbacks that will hopefully be addressed in the future.

Multifaceted Strategy Based on Automated Text Messaging After a Recent Heart Failure Admission

Readmissions after an index heart failure (HF) hospitalization are a major contemporary health care problem. To evaluate the feasibility and efficacy of an intensive telemonitoring strategy in the vulnerable period after an HF hospitalization. This randomized clinical trial was conducted in 30 HF clinics in Brazil. Patients with left ventricular ejection fraction less than 40% and access to mobile phones were enrolled up to 30 days after an HF admission. Data were collected from July 2019 to July 2022. Participants were randomly assigned to a telemonitoring strategy or standard care. The telemonitoring group received 4 daily short message service text messages to optimize self-care, active engagement, and early intervention. Red flags based on feedback messages triggered automatic diuretic adjustment and/or a telephone call from the health care team. The primary end point was change in N-terminal pro-brain natriuretic peptide (NT-proBNP) from baseline to 180 days. A hierarchical win-ratio analysis incorporating blindly adjudicated clinical events (cardiovascular deaths and HF hospitalization) and variation in NT-proBNP was also performed. Of 699 included patients, 460 (65.8%) were male, and the mean (SD) age was 61.2 (14.5) years. A total of 352 patients were randomly assigned to the telemonitoring strategy and 347 to standard care. Satisfaction with the telemonitoring strategy was excellent (net promoting score at 180 days, 78.5). HF self-care increased significantly in the telemonitoring group compared with the standard care group (score difference at 30 days, -2.21; 95% CI, -3.67 to -0.74; P = .001; score difference at 180 days, -2.08; 95% CI, -3.59 to -0.57; P = .004). Variation of NT-proBNP was similar in the telemonitoring group compared with the standard care group (telemonitoring: baseline, 2593 pg/mL; 95% CI, 2314-2923; 180 days, 1313 pg/mL; 95% CI, 1117-1543; standard care: baseline, 2396 pg/mL; 95% CI, 2122-2721; 180 days, 1319 pg/mL; 95% CI, 1114-1564; ratio of change, 0.92; 95% CI, 0.77-1.11; P = .39). Hierarchical analysis of the composite outcome demonstrated a similar number of wins in both groups (telemonitoring, 49 883 of 122 144 comparisons [40.8%]; standard care, 48 034 of 122 144 comparisons [39.3%]; win ratio, 1.04; 95% CI, 0.86-1.26). An intensive telemonitoring strategy applied in the vulnerable period after an HF admission was feasible, well-accepted, and increased scores of HF self-care but did not translate to reductions in NT-proBNP levels nor improvement in a composite hierarchical clinical outcome. ClinicalTrials.gov Identifier: NCT04062461.