bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of a Peer-Based Intervention on Loneliness and Social Isolation of Older Chinese Immigrants in Canada: a Randomized Controlled Trial
Authors: Lai Daniel W.L. , Li Jia , Ou Xiaoting , Li Celia Y.P. 
Published: July 2020

Abstract
Background: Social isolation is a key concern for immigrant older adults. We examined the effectiveness of a peer-based intervention in reducing loneliness, social isolation, and improving psychosocial well-being with a sample of aging Chinese immigrants.Methods: Sixty community-dwelling older Chinese immigrants aged 65 and older were randomly assigned to an intervention group and a control group (n=30 each) in a randomized control parallel trial design. Intervention group participants received an eight-week peer support intervention. Twenty-four volunteers aged 48 to 76 engaged in two-on-one peer support through home visits and telephone calls to provide emotional support, problem-solving support, and community resource sharing. Social workers who are not blinded to the group assignment measured the changes of both the intervention group and the control group participants in a range of psychosocial outcomes including three primary outcomes (loneliness, social support, barriers to social participation) and five secondary outcomes (depressive symptoms, anxiety, life satisfaction, happiness, and purpose in life).Results: The 30 intervention group participants showed a statistically significant decrease in loneliness and increase in resilience when compared to the 30 control group participants. They reported fewer barriers to social participation, fewer depressive symptoms, increased life satisfaction, and happiness while no such improvements were observed in the control group.Conclusions: There is a need to further examine the use of peer-based interventions for both program effectiveness and delivery efficiency. In the era of population aging and increasing immigration, diverse aging adults can be trained to fill volunteer support roles via peer-based intervention approaches.Trial registration: ISRCTN, ISRCTN14572069, Registered 23 December 2019 – Retrospectively registered, https://doi.org/10.1186/ISRCTN14572069Funding: There are no external funding for this study.
Investigating the association between Physicians self-efficacy regarding communication skills and risk of "Burnout".
Authors: Messerotti Andrea , Banchelli Federico , Ferrari Silvia , Barbieri Emiliano , Bettelli Francesca , Bandieri Elena , Giusti Davide , Catellani Hillary , Borelli Eleonora , Colaci Elisabetta , Pioli Valeria , Morselli Monica , Forghieri Fabio , Galeazzi Gian Maria , Marasca Roberto , Bigi Sarah , D'Amico Roberto , Martin Peter , Efficace Fabio , Luppi Mario , Potenza Leonardo 
Published: July 2020

Abstract
Background: Breaking bad news (BBN) may be associated with increasing risk of burnout in practising physicians. However, there is little research on the association between the way bad news is broken and burnout. We investigated the association between physicians' self-efficacy regarding communication to patients and risk of burnout.Methods: We performed a cross-sectional study by proposing an ad-hoc survey exploring attitudes and practice regarding BBN and the Maslach Burnout Inventory - Human Service Survey to 379 physicians from two University Hospitals in Italy. Associations were assessed by multivariable logistic regression models.Results: Two-hundred twenty-six (60%) physicians returned the questionnaires. 76% of physicians acquired communication skills by observing mentors or colleagues, 64% considered BBN as discussing a poor prognosis, 56% reported discussing prognosis as the most difficult task, 38% and 37% did not plan a BBN encounter and considered it stressful. The overall burnout rate was 59%. Considering BBN a stressful task was independently associated with high risk of burnout (OR 3.01; p=0.013). Planning the encounter (OR=0.43, p=0.037), mastering communication skills (OR=0.19, p=0.034) and the self-evaluation as good or very good at BBN (OR 0.32; 0.15 to 0.71; p=0.0) were associated with low risk of burnout.Conclusions: Our findings suggest that some physicians' BBN attitudes and knowledge of conceptual frameworks may influence the risk of burnout and support the notion that increasing knowledge about communication skills may protect clinicians from burnout. Further research is needed in this area.
Large-scale production of recombinant miraculin protein in transgenic carrot callus supension cultures using air-lift bioreactors
Authors: Park Yun-Ji , Han Jong-Eun , Lee Hyoshin , Jung Yu-Jin , Murthy Hoskatte Niranjana , Park So-Young 
Published: July 2020

Abstract
Miraculin, derived from the miracle fruit ( Synsepalum dulcificum ), is a taste-regulating protein that interacts with human sweet-taste receptors and transforms sourness into sweet taste. Since miracle fruit is cultivated in West Africa, mass production of miraculin is limited by regional and seasonal constraints. Here, we investigated mass production of recombinant miraculin in carrot ( Daucus carota L.) callus cultures using an air-lift bioreactor. To increase miraculin expression, the oxidative stress-inducible SWAP2 promoter was used to drive the expression of miraculin gene under various stress treatments. An 8 h treatment of hydrogen peroxide (H 2 O 2 ) and salt (NaCl) increased the expression of miraculin gene by 5-fold compared with the untreated control. On the other hand, abscisic acid, salicylic acid, and methyl jasmonate treatments showed no significant impact on miraculin gene expression compared with the control. This shows that since H 2 O 2 and NaCl treatments induce oxidative stress, they activate the SWPA2 promoter and consequently up-regulate miraculin gene expression. Thus, the results of this study provide a foundation for industrial-scale production of recombinant miraculin protein using transgenic carrot cells as a heterologous host.
Experiential learning for children's dental anxiety: a cluster randomized trial
Authors: Zhu Minmin , Yu Hongbing , Xie Bo , Li Hongwen , He Qian , Li Huimin , Su Jing , Li Xueqi 
Published: July 2020

Abstract
Background: Dental anxiety (DA) has an impact on the quality of dental treatment and may have long-lasting implications for children. A recent study introducing experiential learning (EL) into children’s oral health promotion resulted in better oral hygiene. The purpose of the study is to evaluate whether EL can reduce children's DA. Methods: In September 2018, we recruited 988 children aged 7-8 years from 24 classes to participate in a cluster-randomized trial. Classes were randomly assigned to EL (in which children received a lively presentation on oral health and participated in a role play in a simulated dental clinic in the classroom) or the Tell-Show-Do (TSD) group (in which children received a conventional TSD behavior management). The primary outcome was the prevalence of high DA after the procedure of pit and fissure sealant (PFS), assessed by a modified Children's Fear Survey Schedule-Dental Subscale. Secondary outcomes were changes in blood pressures (BP) and pulse rates (PR) before and after the PFS procedure. The intervention effects were estimated by means of mixed effect models, which included covariates of gender and school (and baseline value for BP and PR only), and a random cluster effect.Results: In 396 children of the EL group who received the PFS treatment, the prevalence of high DA (score ≥ 38) was 18.5%, compared with 24.3% in 391 children of the TSD group (OR=0.65; 95% confidence interval, 0.46-0.93; P=0.019). The increases in BP and PR after the PFS were also significantly less in the EL group. Conclusion: School-based experiential learning intervention before a dental visit is feasible and effective in reducing children’s dental anxiety during PFS.Trial registration: The trial was registered in Chinese Clinical Trial Registry on 5 January 2020 (No.: ChiCTR2000028878, retrospectively registered), http://www.chictr.org.cn/edit.aspx?pid=47970&htm=4.
Barriers to Effective Prescribing in Older Adults: Applying the Theoretical Domains Framework in the Ambulatory Setting
Authors: Lau Sabrina , Lun Penny , Ang Wendy , Tan Keng Teng , Ding Yew Yoong 
Published: July 2020

Abstract
Background: As the population ages, potentially inappropriate prescribing (PIP) in the older adults may become increasingly prevalent. This undermines patient safety and creates a potential source of major morbidity and mortality. Understanding the factors that influence prescribing behaviour may allow development of interventions to reduce PIP. The aim of this study is to apply the Theoretical Domains Framework (TDF) to explore barriers to effective prescribing for older adults in the ambulatory setting. Methods: A scoping review was performed based on the five-stage methodological framework developed by Arksey and O’Malley. From 30 Aug 2018 to 5 Sep 2018, we conducted our search on PubMed, CINAHL, EMBASE, the Cochrane Database of Systematic Reviews, and Web of Science. We also searched five electronic journals, Google and Google Scholar to identify additional sources and grey literature. Two reviewers applied eligibility criteria to the title and abstract screening, followed by full text screening, before systematically charting the data. Results: A total of 5,731 articles were screened. 29 studies met the selection criteria for qualitative analysis. We mapped our results using the 14-domain TDF, eventually identifying 10 domains of interest for barriers to effective prescribing. Of these, significant domains include physician-related factors such as “Knowledge”, “Skills”, and “Social/Professional Role and Identity”; issues with “Environmental Context and Resources”; and the impact of “Social Influences” and “Emotion” on prescribing behaviour.Conclusion: The TDF elicited multiple domains which both independently and collectively lead to barriers to effective prescribing for older adults in the ambulatory setting. Changing the prescribing climate will thus require interventions targeting multiple stakeholders, including physicians, patients and hospital/clinic systems. Further work is needed to explore individual domains and guide development of frameworks to aid guide prescribing for older adults in the ambulatory setting.
Vibroarthrographic analysis of patellofemoral joint arthrokinematics during squats with increasing external loads
Authors: Ołowiana Ewelina , Selkow Noelle , Laudner Kevin , Puciato Daniel , Bączkowicz Dawid 
Published: July 2020

Abstract
Background: The patellofemoral joint (PFJ) provides extremely low kinetic friction, which results in optimal arthrokinematic motion quality. Previous research showed that these friction-reducing properties may be diminished due to the increase in articular contact forces. However, this phenomenon has not been analyzed in vivo during functional daily-living activities. The aim of this study was the vibroarthrographic assessment of changes in PFJ arthrokinematics during squats with variated loads. Methods: 114 knees from 57 asymptomatic subjects (23 females and 34 males) whose ages ranged from 19 to 26 years were enrolled in this study. Participants were asked to perform 3 trials: 4 repetitions of bodyweight squats (L0), 4 repetitions of 10 kg barbell back loaded squats (L10), 4 repetitions of 20 kg barbell back loaded squats (L20). During the unloaded and loaded (L10, L20) squats, vibroarthrographic signals were collected using an accelerometer placed on the patella and were described by the following parameters: variation of mean square (VMS), mean range (R4), and power spectral density for frequency of 50-250 Hz (P1) and 250-450 Hz (P2). Results: Obtained results showed that the lowest values were noted in the unloaded condition and that the increased applied loads had a significant concomitant increase in all the aforementioned parameters bilaterally (p<0.05). Conclusion: This phenomenon indicates that the application of increasing knee loads during squats corresponds to higher intensity of vibroacoustic emission, which might be related to higher contact stress and kinetic friction as well as diminished arthrokinematic motion quality.
Candida tropicalis distribution and drug resistance is correlated with ERG11 and UPC2 expression
Authors: Wang Dan , An Na , Yang Yuwei , Yang Xianggui , Fan Yingzi , Feng Jiafu 
Published: July 2020

Abstract
Objective

This study analyzed the distribution and drug resistance of Candida tropicalis ( C. tropicalis ) and the relationship between ERG11 and UPC2 expression and resistance to azole antifungal agents.

Methods

C. tropicalis was cultured and identified by Sabouraud Agar Medium, CHROM Agar Candida and ATB tests (Bio-Mérieux, France). Total RNA was extracted from the collected strains, and the ERG11 and UPC2 mRNA expression levels were analyzed by quantitative real-time PCR.

Results

In total, 2872 clinical isolates of Candida , including 319 strains of C. tropicalis , were analyzed herein; they were mainly obtained from the Departments of Respiratory Medicine and ICU. The strains were predominantly isolated from airway secretion samples, and the detection trend in four years was mainly related to the type of department and specimens. The resistance rates of C. tropicalis to fluconazole, itraconazole and voriconazole had been increasing year by year. The mRNA expression levels of ERG11 and UPC2 in the fluconazole-resistant group were significantly higher than they were in the sensitive group. In addition, there was a significant positive linear correlation between these two genes in the fluconazole-resistant group.

Conclusions

Overexpression of the ERG11 and UPC2 genes in C. tropicalis could increase resistance to azole antifungal drugs. The routine testing for ERG11 and UPC2 in high-risk patients in key departments would provide a theoretical basis for the rational application of azole antifungal drugs.
Left Atrial Spontaneous Echo Contrast Occurring in Patients with Low CHADS2 or CHA2DS2-VASc Scores
Authors: Akamatsu Kanako , Ito Takahide , Ozeki Michishige , Miyamura Masatoshi , Sohmiya Koichi , Hoshiga Masaaki 
Published: July 2020

Abstract
Background: Left atrial spontaneous echo contrast (LASEC) is common in patients with atrial fibrillation (AF), although scarce information exists on LASEC occurring in nonvalvular AF patients who have low thromboembolic risk scores. We therefore examined prevalence and determinants of LASEC under low CHADS2 or CHA2DS2-VASc scores in these patients.Methods: Among 713 patients who underwent transesophageal echocardiography, 349 with a CHADS2 score <2 (CHADS2 group) (93 women, mean age 65 years) and 221 with a CHA2DS2-VASc score <2 (CHA2DS2-VASc group) (39 women, mean age 62 years) were separately examined for clinical and echocardiographic findings.Results: LASEC was found in 77 patients of CHADS2 group (22%) and in 41 of CHA2DS2-VASc group (19%). Multivariate logistic regression analysis, adjusted for several parameters including non-paroxysmal AF, LA enlargement (LA diameter ≥50 mm), left ventricular (LV) hypertrophy, and an elevated B-type natriuretic peptide (BNP) (BNP ≥200 pg/mL) revealed that for CHADS2 group, non-paroxysmal AF (Odds ratio 5.65, 95%CI 3.08-10.5, P <0.001), BNP elevation (Odds ratio 3.42, 95%CI 1.29-9.06, P = 0.013), and LV hypertrophy (Odds ratio 2.26, 95%CI 1.19-4.28, P = 0.013) were significant independent determinants of LASEC, and that for CHA2DS2-VASc group, non-paroxysmal AF (Odds ratio 3.38, 95%CI 1.51-7.54, P = 0.003) and LV hypertrophy (Odds ratio 2.53, 95%CI 1.13-5.70, P = 0.025) were significant independent determinants of LASEC.　Conclusions: LASEC was present in a considerable proportion of patients with nonvalvular AF under low thromboembolic risk scores. Information on AF chronicity, BNP, and LV hypertrophy may help avoid transesophageal echocardiographic assessment of LASEC, but large-scale studies are necessary to confirm our observations. Information on AF chronicity, BNP, and LV hypertrophy might help identify patients at elevated risk for thromboembolism, although large-scale studies are necessary to confirm our observations.
Tissue mechanics and expression of TROP2 in oral squamous cell carcinoma with varying differentiation
Authors: Zhang Baoping , Gao Shuting , Li Yiting , Li Ruiping , Cao Rui , Cheng Jingyang , Guo Yumeng , Wang Errui , Huang Ying , Zhang Kailiang 
Published: July 2020

Abstract
Background Trophoblast cell surface antigen 2 (TROP2) is overexpressed in many squamous cell carcinomas and promotes tumor development and invasion. The association between TROP2 expression and occurrence and development of oral squamous cell carcinoma (OSCC) remains to be understood.Methods We investigated the role of TROP2 in OSCC patients using a combination of biophysical approaches. A total of 108 OSCC patient specimens with varying degrees of differentiation were subjected to hematoxylin and eosin staining, immunohistochemistry, Kaplan-Meier survival curve analysis, and atomic force microscopy to analyze TROP2 expression, morphology, and mechanical properties of OSCC tissues.Results TROP2 was overexpressed in 34% of poorly differentiated OSCC samples. High levels of TROP2 were associated with 10.2% survival rate lower than 45.4% and patient age (odds ratio [OR]=0.437, P=0.039, 95% confidence interval [CI, 0.198–0.966]), tumor size (OR=13.148, P=0.000, 95% CI [5.060–34.168]), and TNM stage (OR=0.141, P=0.000, 95% CI [0.082–0.244]). Average surface roughness of low, medium, and highly differentiated OSCC tissues were 448.9±54.8, 792.7±83.6, and 993.0±104.3 nm, respectively. The Pearson coefficient revealed a negative association between tumor stiffness and TROP2 expression (r=-0.84, P<0.01).Conclusion Overexpression of TROP2 negatively associated with patient survival, degree of tumor differentiation, and tissue mechanics. Taken together, our findings demonstrated that TROP2 may be an indicator of OSCC differentiation leading to the altered mechanical properties of OSCC tissues.
Staging Procedures Fail to Benefit Women with Borderline Ovarian Tumours Who Want to Preserve Fertility: A Retrospective Analysis of 448 cases
Authors: Li Na , Gou Jinhai , Li Lin , Ming Xiu , Hu Tingwenyi , Li Zhengyu 
Published: July 2020

Abstract
Background: To evaluate the effect of clinicopathologic factors on the prognosis and fertility outcomes of BOT patients.Methods: We performed a retrospective analysis of BOT patients who underwent surgical procedures in West China Second University Hospital from 2008 to 2015. The DFS outcomes, potential prognostic factors and fertility outcomes were evaluated.Results: 448 patients were included; 52 recurrences were observed. 92 patients undergoing FSS achieved pregnancy. No significant differences in fertility outcomes were found between the staging and unstaged surgery groups. Staging surgery was not an independent prognostic factor for DFS. Laparoscopy resulted in better prognosis than laparotomy in patients with stage I tumours and a desire for fertility preservation.Conclusion: Patients with BOT fail to benefit from surgical staging. Laparoscopy is recommended for patients with stage I disease who desire to preserve fertility. Physicians should pay more attention to risk of recurrence in patients who want to preserve fertility.
Medical education too: sexual harassment within the educational context of medicine – insights from undergraduates
Authors: Schoenefeld Eva , Marschall Bernhard , Paul Berit , Ahrens Helmut , Sensmeier Janina , Coles Jan , Pfleiderer Bettina 
Published: July 2020

Abstract
Background: Assessment of the presence and the characteristics of sexual harassment in academic medicine is a global issue. Only limited international data are available so far.Methods: Aim: To assess the extent of sexual harassment and to identify the perpetrators in the student population of the medical school of Münster, Germany.A survey was undertaken, using the Medical Womens’ International Association sexual harassment questionnaire translated into German. The anonymous online questionnaire was sent as a link to all medical undergraduates at Münster Medical School via a mailing list between 1st October and the 30th November 2018. Identifying and potentially identifying data was not collected.Data were analyzed by descriptive statistical methods such as categorical variables. Baseline characteristics, e.g. answers by male or female medical students, were correlated with their individual sexual harassing experiences and perpetrator groups by means of univariate analysis. Results: A total of 2162 medical students were asked to participate: 623 (28.8%) completed the survey. Sexual harassment is a significant issue among medical students at Münster, with 87.6% of female students experiencing some verbal and /or physical sexual harassment. The majority of perpetrators were patients, followed by medical superiors and educators, and less frequently by colleagues. All students who had experiences with forced sexual contact were females. Over half (58.9%) of all undergraduates were exposed to sexually harassing behaviour: 41.3% of those suffered from verbal harassment and 31.8% from unwanted physical sexual contact such as e.g. unwanted physical touch, while 8.5% of faced forced sexual contact e.g. such as oral, anal or vaginal penetration, intercourse and rape. Perpetrators were mostly male medical superiors (7.0%) and male patients (18.3%).Conclusions: Sexual harassment in medical education and the medical working place are a significant problem in a German medical school. The majority of students experiencing sexual harassment are females. Female students also experience the more serious forms of sexual harassment more often.
Inverse correlation between Interleukin-34 and gastric cancer, a potential biomarker for prognosis
Authors: Liu Qinghua , Zhang Ying , Zhang Jiwei , Tao Kun , Hambly Brett D , Bao Shisan 
Published: July 2020

Abstract
Background : Gastric cancer (GC) is a malignancy with high morbidity/mortality, partly due to a lack of reliable biomarkers for early diagnosis. It is important to develop reliable biomarker(s) with specificity, sensitivity and convenience for early diagnosis. The role of tumour-associated macrophages (TAMs) and survival of GC patients are controversial. Macrophage colony stimulating factor (MCSF) regulates monocytes/macrophages. Elevated MCSF is correlated with invasion, metastasis and poor survival of tumour patients. IL-34, a ligand of the MCSF receptor, acts as a “twin” to MCSF, demonstrating overlapping and complimentary actions. IL-34 involvement in tumours is controversial, possibly due to the levels of MCSF receptors. While the IL‑34/MCSF/MCSFR axis is very important for regulating macrophage differentiation, the specific interplay between these cytokines, macrophages and tumour development is unclear. Methods : A multi-factorial evaluation could provide more objective utility, particularly for either prediction and/or prognosis of gastric cancer. Precision medicine requires molecular diagnosis to determine the specifically mutant function of tumours, and is becoming popular in the treatment of malignancy. Therefore, elucidating specific molecular signalling pathways in specific cancers facilitates the success of a precision medicine approach. Gastric cancer tissue arrays were generated from stomach samples with TNM stage, invasion depth and the demography of these patients (n=185). Using immunohistochemistry/histopathology, MCSF, IL-34 and macrophages were determined. Results : We found that IL-34 may serve as a predictive biomarker, but not as an independent, prognostic factor in GC; MCSF inversely correlated with survival of GC in TNM III‑IV subtypes. Increased CD68 + TAMs were a good prognostic factor in some cases and could be used as an independent prognostic factor in male T3 stage GC. Conclusion : Our data support the potency of IL-34, MCSF, TAMs and the combination of IL‑34/TAMs as novel biological markers for GC, and may provide new insight for both diagnosis and cellular therapy of GC.