bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the efficacy of a fatigue management therapy in schizophrenia: study protocol for a randomized, controlled multi-centered study (ENERGY)
Authors: Raffard Stéphane , Rainteau Nicolas , Bayard Sophie , Laraki Yasmine , Norton Joanna , Capdevielle Delphine 
Published: July 2020

Abstract
Background Fatigue is a well-known common clinical feature of numerous chronic diseases including various forms of cancer, neurological disorders such as multiple sclerosis, and psychiatric disorders. A significant proportion of people with schizophrenia (30-60%) reportedly experience fatigue, which impacts negatively on participation in various activities, including work, study, leisure and social pursuits. Causes of fatigue in schizophrenia are poorly understood and there are no established treatments. Several evidence-based interventions for fatigue syndrome including psychoeducation, cognitive behavioral therapy, and graded exercise therapy have been shown to be effective in other medical conditions and could be adapted to address fatigue in schizophrenia patients. As there are no psychosocial or pharmacological interventions with proved efficacy for fatigue in schizophrenia, there is an urgent need for the development of strategies to improve fatigue management in schizophrenia.The aim of this project is to evaluate in a single blind randomized clinical trial the efficacy of a cognitive-behavioral therapy (CBT) intervention compared to treatment as usual (TAU) on fatigue as the main outcome in schizophrenia patients. Clinical symptoms, physical functioning, major cognitive functions, quality of life and functioning, treatment dosage, daily motor activity, biological markers with inflammatory markers are also considered as secondary outcomes. Methods/design 200 patients meeting the inclusion criteria will be randomized to either of the study arms (intervention or TAU). The ENERGY intervention will be delivered according to a standardized treatment manual comprising six modules addressing fatigue and sleep over 14 individual therapy sessions. The treatment encompasses core CBT principles of psycho-education, behavioral activation, behavioral experiments, cognitive restructuring, problem-solving and relapse prevention. Sessions will follow the traditional CBT structure of agenda setting, review of homework tasks, and introduction of a new concept/technique with collaborative discussions on how to implement such strategies in the participant’s day-to-day environment. Our primary endpoint will be the severity of fatigue assessed at baseline and at the 9-month follow-up using the “Multidimensional Fatigue Inventory” (MFI).Discussion The trial will provide the first test of CBT intervention for fatigue for patients with schizophrenia. This study will also test to what extent the treatment can be implemented in everyday practice.Trial Registration : ClinicalTrials.gov Identifier: NCT04332601. Registered on April 10, 2020
UGT1A1 polymorphism has a prognostic effect in patients with stage IB or II uterine cervical cancer and one or no metastatic pelvic nodes receiving irinotecan chemotherapy
Authors: Matsuoka Hideki , Murakami Ryusuke , Abiko Kaoru , Yamaguchi Ken , Horie Akihito , Hamanishi Junzo , Baba Tsukasa , Mandai Masaki 
Published: July 2020

Abstract
Background: Uridine diphosphate glucuronosyltransferase 1 family polypeptide A1 (UGT1A1) is a predictive biomarker for the side-effects of irinotecan; irinotecan chemotherapy reduces the volume of tumors harboring UGT1A1 polymorphisms. We aimed to determine whether UGT1A1 polymorphisms can predict progression-free survival in patients with local cervical cancer treated with irinotecan. Methods: We retrospectively analyzed the data of 51 patients with cervical cancer treated at a single institution between 2010 and 2015. All patients were diagnosed with the 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IB1, IB2, IIA, or IIB squamous cell carcinoma, underwent radical hysterectomy, and received irinotecan chemotherapy as neoadjuvant and/or adjuvant treatment. All patients were examined for irinotecan side effects using UGT1A1 tests. Conditional inference tree and survival analyses were performed considering stage, age, UGT1A1 status, and the number of metastatic lymph nodes to determine primary factors associated with progression-free survival.Results: The tree-structured survival model determined high recurrence-risk factors related to progression-free survival. The most relevant factor was ≥2 metastatic lymph nodes (p = 0.004). The second most relevant was UGT1A1 genotype (p = 0.024). Among patients with ≤1 metastatic lymph node, those with UGT1A1 polymorphisms benefited from irinotecan chemotherapy and demonstrated significantly longer progression-free survival (p = 0.020) than those with wild-type UGT1A1.Conclusion: Irinotecan chemotherapy has the potential to benefit patients with cervical cancer, UGT1A1 polymorphism, and ≤1 metastatic lymph nodes.
Rat epidermal stem cells promote the angiogenesis of full-thickness wound
Authors: Huang Shaobin , Hu Zhicheng , Wang Peng , zhang Yi , Cao Xiaoling , Dong Yunxian , Cheng Pu , Xu Hailin , Zhu Wenkai , Tang Bing , Zhu Jiayuan 
Published: July 2020

Abstract
Background: Full-thickness wounds severely affect patients’ life quality and become challenging problems for clinicians. Stem cells have great prospects in the treatment of wounds. Our previous study confirmed that autologous basal cell suspension could promote wound healing, and epidermal stem cells (ESCs) were detected in the basal cell suspension. Herein, this study aimed to explore the effect of ESCs on full-thickness wounds. Methods: Rat ESCs were isolated and expanded, and then were transfected with lentivirus to stably express enhanced green fluorescent protein. The experimental rats were randomly divided into 2 groups: in the ESC group, the rat ESCs were sprayed on the full-thickness wounds of rats; in the control group, phosphate-buffered saline was sprayed the on the wounds. Next, wound healing and neovascularization were evaluated. Colonization, division and differentiation of ESCs on the wound were analyzed by immunofluorescence. Results: The rat ESCs colonized, divided and proliferated in the wound. Additionally, rat ESCs around blood vessels differentiated into vascular endothelial cells and formed a lumen-like structure. Compared with the control group, the ESC group showed enhanced angiogenesis and accelerated wound healing. Conclusions: Our study confirmed that rat ESCs are safe and effective for treating full-thickness wounds . Additionally, under certain conditions, ESCs can differentiate into vascular endothelial cells to promote angiogenesis and wound healing.
A Health Care Professionals Training Needs Assessment for Oncology in Uganda
Authors: Byamugisha Josaphat , Munabi Ian G , Mubuuke Aloysius G. , Mwaka Amos D. , Kagawa Mike , Okullo Isaac , Niyonzima Nixon , Lusiba Pastan , Ainembabazi Peruth , Kankunda Caroline , Muhumuza Dennis D. , Orem Jackson , Atwine Diana , Ibingira Charles 
Published: July 2020

Abstract
Background Cancer incidence and mortality in sub-Saharan Africa are increasing and do account for significant premature death. The expertise of the health care providers is critical to down staging cancer at diagnosis and improving survival in low- and middle-income countries. We set out to determine the training needs of health care providers for a comprehensive oncology services package in selected hospitals in Uganda, in order to inform capacity development intervention to improve cancer outcomes in the East African region. Methods This was a cross-sectional survey using the WHO Hennessey-Hicks questionnaire to identify the training needs of health workers involved in cancer care, across 22 hospitals in Uganda. Data were captured in real time using the open data kit platform from which the data was exported to Stata Version 15 for analysis using the Wilcoxon sign rank test and Somers-Delta. Results There were 199 respondent health professionals who were predominately female (146/199, 73.37%), with an average age of 38.97 years. There were 158/199 (79.40%) nurses, 24/199 (12.06%) medical doctors and 17/199 (8.54%) allied health professionals. Overall the research and audit domain had the highest ranking for all the health workers (Somers-D=0.60). The respondent’s level of education had a significant effect on the observed ranking (P-value =0.03). Most of the continuing medical education (CME) topic suggested by the participants were in the clinical task related category. Conclusion The “research and audit” domain was identified as the priority area for training interventions to improve oncology services in Uganda. There are opportunities for addressing the identified training needs with an expanded cancer CME program content, peer support networks and tailored training for the individual health care provider.
Analysis of 4 imaging features in patients with COVID-19
Authors: JIN JUN , Gao De-hong , Mo Xin , Tan Si-ping , Kou Zhen-xia , Chen Yi-bo , Cao Jin-bo , Chen Wen-jing , Zhang Ya-ming , Li Bing-qing , Huang Kuan-long , Xu Bing-ren , Tang Xiao-li , Wang Yu-li 
Published: July 2020

Abstract
Background: The aim of this was to analyze 4 chest CT imaging features of patients with coronavirus disease 2019 (COVID-19) in Shenzhen, China so as to improve the diagnosis of COVID-19.Methods: Chest CT of 34 patients with COVID-19 confirmed by the nucleic acid test (NAT) were retrospectively analyzed. Analyses were performed to investigate the pathological basis of four imaging features(“feather sign”,“dandelion sign”,“pomegranate sign”, and “rime sign”) and to summarize the follow-up results.Results: There were 22 patients (65.2 %) with typical “feather sign”and 18 (52.9%) with “dandelion sign”, while few patients had “pomegranate sign” and “rime sign”. The “feather sign” and “dandelion sign” were composed of stripe or round ground-glass opacity(GGO), thickened blood vessels, and small-thickened interlobular septa. The “pomegranate sign” was characterized as follows: the increased range of GGO, the significant thickening of the interlobular septum, complicated with a small amount of punctate alveolar hemorrhage. The “rime sign” was characterized by numerous alveolar edemas. Microscopically, the wall thickening, small vascular proliferation, luminal stenosis, and occlusion, accompanied by interstitial infiltration of inflammatory cells, as well as numerous pulmonary interstitial fibrosis and partial hyaline degeneration were observed. Repeated chest CT revealed the mediastinal lymphadenectasis in one patient. Re-examination of the NAT showed another positive anal swab in two patients.Conclusion: “Feather sign” and “dandelion sign” were typical chest CT features in patients withCOVID-19; “pomegranate sign” was an atypical feature, and “rime sign” was a severe feature. In clinical work, accurate identification of various chest CT signs can help to improve the diagnostic accuracy of COVID-19 and reduce the misdiagnosis or missed diagnosis rate.
ANGPTL4 Overexpression Inhibits Tumor Cell Adhesion and Migration and Predicts Favorable Prognosis of Triple-Negative Breast Cancer
Authors: Cai Yu-Chen , Yang Hang , Wang Ke-Feng , Chen Tan-Huan , Jiang Wen-Qi , Shi Yan-Xia 
Published: July 2020

Abstract
Background: Triple-negative breast cancer (TNBC) patients have relatively poor clinical outcomes. A marker predicting the prognosis of patients with TNBC could help guide treatment. Extensive evidence demonstrates that angiopoietin-like 4 (ANGPTL4) is involved in the regulation of cancer growth, metastasis and angiogenesis. Therefore, its role in TNBC is of interest.Methods: We tested the ANGPTL4 expression level in tumor tissues by immunohistochemistry (IHC) and detected its association with the clinical features of TNBC patients. Next, the effects and mechanisms of ANGPTL4 on TNBC cell migration and adhesion were investigated.Results: We found that ANGPTL4 overexpression was associated with favorable outcomes in TNBC patients. ANGPTL4 upregulation inhibited cell adhesion, migration and invasion in vitro. Further analyses demonstrated that the possible mechanism might involve suppression of TNBC progression by interacting with extracellular matrix-related genes.Conclusions: The present findings demonstrated that enhancement of ANGPTL4 expression might inversely correlate with TNBC progression. ANGPTL4 is a promising marker of TNBC and should be evaluated in further studies. Trial registration: Retrospectively registered.
Active Learning of Medical Students in Taiwan: Arealist Evaluation
Authors: Huang Chien-Da , Tseng Hsu-Min , Jenq Chang-Chyi , Ou Liang-Shiou 
Published: July 2020

Abstract
BackgroundActive learning is defined as any instructional method that engages students in the learning process. Cultural differences in learning patterns can play an important role in engagement with active learning. We aimed to examine process models of active learning to understand what works, for whom and why.MethodsForty-eight sixth- and seventh-year medical students with experience of active learning methods were purposively selected to participate in ten group interviews. Interactions around active learning were analysed using a realist evaluation framework to unpack the ‘context-mechanism-outcome’ (CMO) configurations.ResultsThree core CMO configurations including cultural, training and individual domains were identified. In the cultural context of a strong hierarchical culture, the mechanisms of fear prompted students to be silent (outcome), daring not to share their opinions. In the training context of teacher-student familiarity alongside teachers’ guidance, the mechanisms of learning motivation, self-regulation and enthusiasm are triggered, prompting positive learning outcomes and competencies (outcome). In the individual context of learning how to learn actively at an early stage within the medical learning environment, the mechanisms of internalisation, professional identity and stress, resulted in recognised active learning and advanced preparation (outcomes).ConclusionsWe identified three CMO configurations of Taiwanese medical students’ active learning. The connections between hierarchical culture, fear, teachers’ guidance, motivation, the medical environment and professional identity have been shown to affect the complex interactions of learning outcomes. Fear derived from a hierarchical culture is a concern as it is a significant and specific contextual factor, often sparking fear with negative outcomes.
Ibudilast for Alcohol Use Disorder: Study protocol for a phase II randomized clinical trial
Authors: Burnette Elizabeth M. , Baskerville Wave-Ananda , Grodin Erica N. , Ray Lara A. 
Published: July 2020

Abstract
Background Alcohol use disorder (AUD) is a chronic and relapsing condition for which current pharmacological treatments are only modestly effective. The development of efficacious medications for AUD remains a high research priority with recent emphasis on identifying novel molecular targets for AUD treatment and to efficiently screen new compounds aimed at those targets. Ibudilast, a phosphodiesterase inhibitor, has been advanced as a novel addiction pharmacotherapy that targets neurotrophin signaling and neuroimmune function. Methods This study will conduct a 12-week, double-blind, placebo controlled randomized clinical trial of ibudilast (50mg BID) for AUD treatment. We will randomize 132 treatment-seeking men and women with current AUD. We will collect a number of alcohol consumption outcomes. Primary among these is percent heavy drinking days (PHDD); secondary drinking outcomes include drinks per day, drinks per drinking day, percent days abstinent, percent subjects with no heavy drinking days, and percent subjects abstinent, as well as measures of alcohol craving and negative mood. Additionally, participants will have the option to opt-in to a neuroimaging session in which we examine the effects of ibudilast on neural activation to psychosocial stress and alcohol cues. Finally, we will also collect plasma levels of proinflammatory markers, as well as subjective and biological (salivary cortisol) markers of stress response.Discussion This study will further develop ibudilast, a safe and promising novel compound with strong preclinical and clinical safety data for AUD, and will probe biological mechanisms underlying the effects of Ibudilast on stress, neuroinflammation, and alcohol cue-reactivity and craving. If ibudilast proves superior to placebo in this study, it will set the stage for a confirmatory multi-site trial leading to FDA approval of a novel AUD treatment. Trial Registration ClinicalTrials.gov, NCT03594435 “Ibudilast for the Treatment of Alcohol Use Disorder”, registered July 20, 2018.
Evaluation of Transition to Distance Education in COVİD-19 Pandemic
Authors: Kolcu Giray , Demir Sadettin , Gülle Kanat , Atay Tolga , Kolcu Mukadder İnci Başer , Koşar Alim 
Published: July 2020

Abstract
Background: As in the rest of the world, distance education methods have been introduced in higher education in our country. The aim of the study is to evaluate the satisfaction of the learning management system.Methods: The study was designed as a cross-sectional study with mixed research design. 467 students stated their opinions for the questionnaire (n: 467).Results: In the evaluation of the scale total scores, the mean was calculated as 17.72 ± 5.49 (min: 5, max: 25). Between the preclinical term and the clinical term, t-test was performed in independent groups, and there was a statistically significant difference between the averages.In the qualitative component of the study, students were asked to express their views on the positive and aspects that should be improved regarding distance education. In the content analysis of the open-ended question, 4 themes (LMS, Learning Process, Student-educator interaction, Assessment and evaluation).Conclusions: Our faculty evaluated distance education as an opportunity for change during the pandemic process and quickly adapted to the process. This reaction was positively perceived by students and expressed as satisfaction. In line with this satisfaction and effectiveness, we believe that the experience of pandemics can bring educational programs closer to blended learning by enriching with distance learning.
Evaluation of Patients' Satisfaction on Booking Appointment System in Dental School of Isfahan During 2018
Authors: Nilchian Firouzeh , ataie zahra , Jamshidian Hamid 
Published: July 2020

Abstract
Background: With the development of technology in recent years, booking appointment software systems have gained special and significant popularity among physicians and patients. For this purpose, this study aimed to improve the queuing services of Isfahan School of Dentistry, examine the types of booking systems of the School of Dentistry and report the level of patient satisfactionMethods: The study was descriptive and cross-sectional. The questionnaire was prepared using Zhang study in 2014 and the standard Forward-Backward translation method. In order to investigate the validity, the opinions of the professors of Isfahan Dental School were taken and the professional opinions of the individuals were applied. The questionnaire was distributed among patients referring to the dental school who had undergone the initial examination. After completing the data, SPSS software version 20 and descriptive and analytical statistical tests were used to analyze the data (a = 0.05).Results: In this study, independent t-test, Kruscal-Wallis test and Pearson correlation test were used to investigate the data. The Kruscal-Wallis test showed that overall satisfaction was significantly higher in patients who booked appointment online than in other patients (P = 0.003). The independent t-test showed that the mean scores of patient satisfaction with staff behavior (P = 0.03) and satisfaction with the waiting time (P = 0.01) were significantly different between native, non-native and passenger patients.Conclusion: Most of the people surveyed were generally relatively satisfied with the booking appointment services. Most of them surveyed came in person to queue. Most people cited cheap services as the main reason for their visits. Most people cited telephone busy signal as the reason for not using the telephone booking system.
Comparison of Molecular, Clinicopathological, and Pedigree Differences Between Lynch-like and Lynch Syndromes
Authors: Xu Yun , Li Cong , Guo Tian'an , Zhang Yuqin , Liu Fangqi , Xu Ye 
Published: July 2020

Abstract
Background: In this study, we compared the molecular, clinical, and pathological characteristics, as well as pedigrees, between patients with Lynch-like syndrome (LLS) and confirmed Lynch syndrome (LS) to develop appropriate management strategies for patients with LLS and their affected family members. Methods: Between June 2008 and September 2018, 81 patients with LLS and 47 patients with LS who developed colorectal cancer (CRC) were enrolled in this study. Multigene panel testing included 139 genes and was performed for all patients. The variants identified in each group were described, and clinicopathological characteristics and pedigrees were compared between the two groups. Results: In the LLS group, a total of 52 variants were detected in 44 (54.3%) patients. Among the 52 variants, 17 were variants of unknown significance in mismatch repair genes, and the other most frequently mutated genes were MUYTH, POLE, BRCA2, and GJB2. The proportion of early-onset patients was significantly higher among the LS probands than among the LLS probands (74.5% and 53.1%, respectively; χ2 = 5.712, P = 0.017). On the other hand, the proportion of primary CRC developed in the rectum was higher in the LLS group than in the LS group (25.9% and 10.6%, respectively; χ2 = 2.358, P = 0.046). There were no significant differences in the occurrence of metachronous CRC (P = 0.632) and extra-CRC (P = 0.145) between the two groups. However, analysis of pedigrees showed that more patients developed CRC in the LS families (P = 0.013), whereas more patients with extra-CRC were observed in the LLS families (P = 0.045). A higher prevalence of male patients was observed in the LLS families (P = 0.036). Conclusions: LLS should be classified as a mixed entity, containing cases of true LS, other hereditary cancer syndromes, and sporadic CRC. The high risks of CRC and extra-CRC, found in our study, suggest that aggressive surgical management should be performed for LLS probands. In addition, we recommend a stringent surveillance protocol that should involve regular follow-ups of the intestine and other organs for probands and affected family members.