bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Outcomes of Additional Surgery After Noncurative Endoscopic Resection in Patients with Early Gastric Cancer: A Meta-Analysis
Authors: Jiao Jian , Li Han , Shang Liang , Wu Hao , Zhang Ronghua , Xiao Kun , Dong Kangdi , Du Fengying , Ren Huicheng , Liu Jin , Li Leping 
Published: July 2021

Abstract
BackgroundThe influence of additional surgery on the prognosis of early gastric cancer who underwent noncurative endoscopic resection was controversial. Different results were observed in different studies. Therefore, this meta-analysis was conducted to evaluate whether additional surgery could produce survival benefits for these patients.MethodsA systematic search was conducted in the PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure and Wanfang databases for relevant articles published until 31 March 2021 to investigate the differences in long-term results between the additional surgery group and the observation group. ResultsSixteen studies including 3877 patients were included in this meta-analysis. The results had shown that the surgery group were younger and more male, higher undifferentiated type, higher rate of SM2, lymphatic and vascular invasion, lower recurrence and metastasis than the observation group. Good survival benefits were observed in additional surgery group with obvious significant differences in the 5-year OS, 5-year DSS and 5-year DFS. Similar results were obtained in the subgroup analysis, such as elderly patients (aged ≥70 years) in 5-year OS. ConclusionThis meta-analysis illustrated that significant survival benefits, including 5-year OS, 5-year DSS and 5-year DFS, could be obtained with additional gastrectomy in patients with EGC after noncurative ER, and patients ≥70 years could also benefit from surgery.
Quadriceps Physiological Response During the 1-minute Sit-to-stand Test in People with Severe COPD and Healthy Controls
Authors: Gephine Sarah , Mucci Patrick , Bielmann Mathieu , Martin Mickael , Bouyer Laurent , Saey Didier , Maltais François 
Published: July 2021

Abstract
We compared quadriceps oxygenation and surface electromyography (sEMG) responses during the 1-min sit-to-stand (1STS) in 14 people with severe COPD and 12 controls, in whom cardiorespiratory response, near-infrared spectroscopy signals (oxy [Hb-Mb], deoxy [Hb-Mb], total [Hb-Mb], and SmO2) and sEMG signals of the quadriceps were recorded. Time duration of each sit-to-stand cycle and the total work performed during the 1STS were measured. The quadriceps oxygenation parameters were normalized by reporting their values according to the total work during 1STS. The rate of sit-to-stand maneuvers decelerated in people with COPD leading to smaller total work compared with controls. The pattern of quadriceps oxygenation response during 1STS was similar between groups. However, in COPD, the recovery after 1STS was characterized by larger overshoots in oxy [Hb-Mb], total [Hb-Mb], and SmO2. When corrected for the cumulative total work, the increase in muscle O2 extraction (deoxy [Hb-Mb]) during the first 30 seconds of recovery was greater in people with COPD compared to controls. Quadriceps sEMG changes suggestive of a fatiguing contraction pattern was observed only in people with COPD. All together, these results highlighted physiological misadaptation of people with severe COPD to the 1STS.
Effects of COVID-19 Pandemic on Behavior, Perception of Threat, Stress and Training Patterns of Olympic and Paralympic Athletes
Authors: Martínez-Patiño María José , Lopez Francisco Javier Blas , Dubois Michel , Vilain Eric , Fuentes-García Juan Pedro 
Published: July 2021

Abstract
Objective Analyze the effect of the COVID-19 pandemic and its subsequent confinement on Olympic and Paralympic level athletes’ behaviors, perception of threat, stress, state of mind and training patterns.Methods All variables were modulated by gender, academic training, and sport discipline on a population composed of 447 Olympic (25.97 ± 7.46 years) and 64 Paralympic athletes (28.44 ± 10.50 years).Results Most of the athletes recognize that their best athletic performance diminished due to the COVID-19 confinement but that will recover after the pandemic and its confinements. Almost half of the athletes declared they were more tired than normal and had difficulty sleeping, while more than half eat more or less as usual. Paralympic athletes report they felt more capable to cope with personal problems and feeling more frequently that life events where going well and less lonely during the confinement than the Olympians. The athletes from team sports disrupted their training routine more significantly than athletes of individual sports, seeing their athletic performance more affected. Athletes in individual sports felt more capable to cope with personal problems than athletes in team sports. Female athletes were significantly more tired and reported more difficulty sleeping than male.Conclusions The situation caused by COVID-19 has had significant effects on the behavior, perception of threat, stress and training patterns of Olympic and Paralympic athletes facing the 2020 Tokyo Olympiad. It is necessary that sports institutions to reinforce mechanisms of help to athletes during future situations of confinement.
Effectiveness of Innovative Instructional Module for Professional Competence in Health Literacy in Medical Students
Authors: Yang Hui-Fang , Chang Chia-Chen , Tseng Pei-Ling , Lai Hsiang-Ru , Tasi Jaw-Shiun , Huang Wei-Hsin , Fan Yu-Hao , Weng Ci-Xiang , Tung Chen-Yin 
Published: July 2021

Abstract
BackgroundsPhysicians in medical environments should be equipped with abilities to acquire better understanding, strengthen autonomy, and support their self-management of patients, which will in turn enhance their health literacy. In this study, we developed an innovative instructional module that targeted medical students and measured their professional competence in terms of health literacy. We then implemented the module to investigate whether the intervention helped medical students improve their professional competence in health literacy.MethodsWe adopted a quasi-experimental design and selected three medical schools from northern Taiwan. For the intervention group (n = 98), we assigned fifth-year medical students serving internship at the department of family medicine. Students received a three-hour innovative teaching intervention including teaching materials such as medical simulation videos, role playing, and board games. For the control group (n = 99), we recruited same-level fifth-year medical students from other medical schools. Both groups answered pre-test and post-test questions, and then applied generalized estimating equation (GEE) to measure the effect of teaching intervention.ResultsIn comparing progress margin, there was significant difference (p = 0.001) between the intervention and control groups for knowledge questions, with the intervention group improving 12% more than the control group. In attitude questions, the progress difference was also significant (p = 0.007), with the intervention group improving on average 0.27 more points per question than the control group. In skill questions, the progress difference was likely significant (p = 0.001), with the intervention group improving on average 0.35 more points per question than the control group. The study indicates that the innovative instructional module intervention had significant effect on professional competence in health literacy in all three aspects.ConclusionThe proposed innovative instructional module significantly improved fifth-year medical students’ professional competence in health literacy, which should in turn benefit their future medical practice.
Effects of Rare Earth Elements on Bacteria in Rhizosphere, Root, Phyllosphere and Leaf of Soil-Rice Ecosystem
Authors: Zhang Xinzhuan , Hu Zhongjun , Pan Huahua , Bai Yijun , Hu Ying , Jin Shulan 
Published: July 2021

Abstract
The effects of rare earth mining on rice biomass, rare earth element(REE) content and bacterial community structure was studied by pot experiment. The research showed that the REE content in rice roots, shoots and grains was significantly positive correlated with that in soil, and the dry weight of rice roots, shoots and grains was highly correlated with soil physical and chemical properties, nutrient elements and REE contents; The exploitation of rare earth minerals inhibited a-diversity of endophytic fungi in rhizosphere, root, phyllosphere and leaf of rice, significantly reduced the abundance index, OTU number, Chao, Ace index and also significantly reduced the diversity index-Shannon index and Inv-Simpson index, also reduced uniformity index: Pielou’s evenness index, Simpson’s evenness index, etc, which caused β-diversity of bacteria to be quite different. The exploitation of rare earth minerals reduces the diversity of bacteria, but forms dominant bacteria, such as Burkholderia, Bacillus, Buttiauxella, Acinetobacter, Bradyrhizobium, Candida koribacter, which can degrade the pollutants formed by exploitation of rare earth minerals, alleviate the compound pollution of rare earth and ammonia nitrogen, and also has the function of fixing nitrogen and resisting rare earth stress; The content of soil available phosphorus in non mining area is low, forming the dominant bacteria of Pantoea, which has the function of improving soil phosphorus availability. Rare earth elements and physical and chemical properties of soil affect the community structure of bacteria in rhizosphere and phyllosphere of rice, promote the parallel movement of some bacteria in rhizosphere, root, phyllosphere and leaf of rice, promote the construction of community structure of bacteria in rhizosphere and phyllosphere of rice, give full play to the growth promoting function of Endophytes, and promote the growth of rice. The results showed that the rice biomass in mining area was guaranteed due to the growth promoting effect of endophytic bacteria, However, the mining of mineral resources causes the compound pollution of rare earth and ammonia nitrogen, which makes REE content of rice in mining area significantly higher than that in non mining area.
Number of fiber bundles in the fetal anterior talofibular ligament
Authors: Edama Mutsuaki , Takabayashi Tomoya , Yokota Hirotake , Hirabayashi Ryo , Sekine Chie , Maruyama Sae , Togashi Ryoya , Syakawa Mayuu , Yamada Yuki , Otani Hiroki 
Published: July 2021

Abstract
Background

For the anterior talofibular ligament (ATFL), a three-fiber bundle has recently been suggested to be weaker than a single or double fiber bundle in terms of ankle plantarflexion and inversion braking function. However, the studies leading to those results all used elderly specimens. Whether the difference in fiber bundles is a congenital or an acquired morphology is important when considering methods to prevent ATFL damage. The purpose of this study was to classify the number of fiber bundles in the ATFL of fetuses.
Methods

This study was conducted using 30 legs from 15 Japanese fetuses (mean weight, 1764.6 ± 616.9 g; mean crown-rump length, 283.5 ± 38.7 mm; 8 males, 7 females). The ATFL was then classified by the number of fiber bundles: Type I, one fiber bundle; Type II, two fiber bundles; and Type III, three fiber bundles.
Results

Ligament type was Type I in 5 legs (16.7%), Type II in 21 legs (70%), and Type III in 4 legs (13.3%).
Conclusions

The present results suggest that the three fiber bundles of the structure of the ATFL may be an innate structure.
Women's strategies for managing domestic violence in pregnancy: A qualitative study in Iran
Authors: Barez Malikeh Amel , Babazadeh Raheleh , Roudsari Robab Latifnejad , Bazaz Mojtaba Mousavi , Najmabadi Khadijeh Mirzaii 
Published: July 2021

Abstract
Background Domestic violence in pregnancy is a severe public health problem. Victimized pregnant women are confronted with the threats posed by domestic violence. Pregnancy and protection of the unborn child could affect maternal strategies for managing violence. The purpose of this study was to explore Iranian women's strategies for managing domestic violence in pregnancy.Methods This was a qualitative descriptive study, which was conducted in October 2019 to June 2021 in Mashhad, Iran. Data were collected through Individual semi structured interviews with 13 women who experienced perinatal domestic violence, two relatives and 24 related specialists as well as two focus group discussion with attendance of 20 victimized mothers until the data saturation was achieved. Data were analyzed by the conventional content analysis approach of Graneheim & Lundman.Results The main themes "adopting escape strategies" and "applying situation improvement strategies" were emerged as the result of data analysis. Adopting escape strategies was comprised of three categories including concealment, passive dysfunctional behaviors and neutral behaviors to control maternal emotional distress. Applying situation improvement strategies was comprised of three categories including active self-regulation, protecting family privacy and help seeking to control violence.Conclusion Understanding the experience of managing domestic violence among pregnant women is essential to design evidence based violence prevention programs, which enable supportive healthcare and social systems to encourage victimized mothers to use more effective strategies and seeking help to overcome domestic violence.
BMP-2 Promotes Bone Formation in Bone Defects in Which Bone Remodeling Is Suppressed by Long-term and High-dose Zoledronic Acid
Authors: Moon Young Jae , Jeong Seongyup , Lee Kwang-Bok 
Published: July 2021

Abstract
Background: The use of long-term and high-dose bisphosphate is associated with severely suppressed bone turnover and the delayed union of fractures. However, therapeutic methods to overcome the negative effects of bisphosphonate use are lacking. Bone morphogenetic proteins (BMPs) are powerful osteoinductive proteins. We hypothesized that BMPs had similar effects as autografts in patients with decreased bone healing potential due to long-term bisphosphonate treatment. The purpose of this study was to compare BMPs with demineralized freeze-dried bone grafts and autografts in a rat femoral bone defect model with long-term and high-dose bisphosphonate treatment. Methods: Forty rats were divided into the following four groups depending upon the materials implanted into the femoral defect after ten weeks of bisphosphonate (zoledronic acid) injections: Group I: absorbable collagen sponge (control); group II: demineralized freeze-dried bone graft; group III: autogenous bone graft; and group IV: rhBMP-2 with an absorbable collagen sponge. Radiographic union, micro computed tomography (CT) analysis, manual palpation, and histologic analysis were evaluated. Results: The radiographic union rate, manual union rate, and micro-CT bone volume in groups III and IV were significantly higher than those in groups I and II. Groups III and IV showed similar results to each other. Although the amount of immature bone in the BMP-treated group was large, the effect was similar to that of autografts in the bone defect model in which bone turnover was severely reduced by bisphosphonate treatment. Conclusion: BMP might be a good substitute for autografts in patients with decreased bone healing potential due to long-term bisphosphonate treatment.
Parkin Dependent Mitophagy Protects Macrophage Against Oxidative Injury And Inflammation During Atherogenesis
Authors: Liu Xiaopeng , Zhen Yanan , Zheng Xia , Han Yongxin , Nie Qiangqiang , Wang Feng , Wang He , Liu Peng 
Published: July 2021

Abstract
Mitochondrial oxidative injury induces macrophage inflammatory activation and apoptosis during atherogenesis. Timely clearance of dysfunctional mitochondria may therefore be beneficial for the survival of macrophages. Based on these principles, our working hypothesis was therefore that mitophagy mediated by the E3 ubiquitin ligase Parkin could have an important role in reducing both oxidative injury and the apoptosis of macrophages under atherogenic conditions. To examine this proposal, in the present study oxidative low-density lipoprotein (ox-LDL) treated THP-1 macrophages were used for the in vitro experiments, and high-cholesterol-fed male apolipoprotein E knockout (ApoE−/−) mice were used for the in vivo investigations. The results demonstrated that mitophagy was activated both in oxidatively stimulated THP-1 macrophages and in aortic plaque macrophages of high-cholesterol-fed ApoE−/− mice. In ox-LDL treated THP-1 macrophages, both the expression level and mitochondrial translocation of Parkin were increased following oxidative stimulation, whereas silencing Parkin led to impaired mitophagy, which exacerbated macrophage oxidative injury, NF-κB activation and apoptosis. Taken together, these results have demonstrated that mitophagy exerts a protective role in macrophages under atherogenic conditions, and that Parkin is a key mediator in this process.
Micro-EDM Machining With Copper Foil
Authors: Mouralova Katerina , Bednar Josef , Benes Libor , Prokes Tomas , Fries Jiri 
Published: July 2021

Abstract
Electrical discharge die-sinking machining (EDM) is one of the indispensable unconventional technologies enabling the machining of all materials that are at least minimally electrically conductive. Due to the clear trend of miniaturization of products, it is necessary to ensure their quality and accurate production, also with the help of micro-EDM. It is the optical instruments used for testing car lights that contain these miniaturized parts necessary for the correct functioning of the device. For this reason, this study was performed, which focused on the production of a precise slot measuring 5000x170 µm in a copper foil with a thickness of 125 µm. The same copper foil was used as a tool, which represents an advance in the production of micro-parts. A design of experiment Box and Behnken Response Surface Design was performed for a total of 15 rounds, monitoring the effect of machine setting parameters (Pulse current, Pulse on time and Voltage) on responses in the form of Erosion rate, corner radius, slot length and width. Using multi-criteria optimization, the optimal setting of the machine parameters for the production of a given slit was determined, which is Pulse current = 2.1 A, Pulse on time = 40 µs and Voltage = 238.8 V.
Evaluating the Structural Reform of Outpatient Psychotherapy in Germany (ES-Rip Trial) - A Qualitative Study of Provider Perspectives
Authors: Regina Poß-Doering , Martin Hegelow , Milena Borchers , Mechthild Hartmann , Johannes Kruse , Hanna Kampling , Gereon Heuft , Spitzer Carsten , Wild Beate , Szecsenyi Joachim , Friederich Hans-Christoph 
Published: July 2021

Abstract
Background: Access to outpatient mental healthcare can be challenging for patients. In Germany, a national structural reform was implemented in 2017 to accelerate and enhance access to outpatient psychotherapy and reduce waiting times. During the first phase of the study ’Evaluation of a structural reform of the outpatient psychotherapy guideline (ES-RiP)’ and embedded into a process evaluation, the implementation was to be evaluated through assessing general practitioners’ (GPs) and psychotherapists’ (PTs) perspectives regarding utilization of provided new measures, and perceived potential for optimization. Particular focus was on patients with a comorbidity of mental disorders and chronic physical conditions (cMPs). Methods: This exploratory cross-sectional qualitative study used on-site and online focus group discussions and semi-structured open-ended telephone interviews with GPs and outpatient PTs. Generated data were analyzed using thematic framework analysis. Descriptive statistics were used to analyze participant characteristics collected via a socio-demographic questionnaire. Results: Perspectives on the structural reform were heterogenous. GPs and PTs considered the component of timely initial psychotherapeutic assessment consultations beneficial. GPs disapproved of their deficits in detailed information about the structural reform and exchange with outpatient PTs. Improvement suggestions included structured short information exchange and joint quality circles. The overall number of available outpatient PTs in rural areas was perceived as insufficient. For patients with cMPs, GPs saw patient barriers for therapy access and continuity in low intrinsic motivation, physical impediments and older age. PTs also saw patient challenges regarding low intrinsic motivation and keeping scheduled appointments. They considered post-reform administrative efforts to be high and reported that the regulations (conformity) lead to planning difficulties and financial losses. Reform elements were tailored to fit in with PTs key therapy areas. Stronger networking and joint lectures were suggested as remedy for the currently still limited exchange with GPs. Unlike the GPs, PTs emphasized that accepting patients into psychotherapeutic treatment was independent of a possibly present chronic physical disease.Conclusions: The findings contribute to understanding the integration of the delivered structural reform into daily care processes and provides an indication about reached targets and potential improvements. Further phases of the ES-RiP study can build on the findings and broaden insights. Trial registration: Registration-ID DRKS00020344 (DRKS German Register of Clinical Trials; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020344)
Selectively Targeting Breast Cancer Stem Cells by 8-Quinolinol and Niclosamide
Authors: Cámara-Sánchez Patricia , Díaz-Riascos Zamira V. , García-Aranda Natalia , Gener Petra , Seras-Franzoso Joaquin , Giani-Alonso Micaela , Royo Miriam , Vázquez Esther , Schwartz Simó , Abasolo Ibane 
Published: July 2021

Abstract
Background Cancer maintenance, metastatic dissemination and drug-resistance are sustained by cancer stem cells (CSCs). Triple negative breast cancer (TNBC) is the breast cancer subtype with the highest numbers of CSCs and poorest prognosis. Here, we aimed to identify potential drugs targeting CSCs to be further employed in combination with standard chemotherapy in TNBC treatment. Methods The anti-CSC efficacy of up to 17 small-drugs was tested in TNBC cell lines using cell viability assays on differentiated cancer cells and CSCs. Then, the effect of 2 selected drugs (8-quinolinol -8Q- and niclosamide -NCS-) in the cancer stemness hallmarks were evaluated using mammosphere growth, cell invasion, migration and anchorage-independent growth assays. Changes in the expression of stemness genes upon 8Q or NCS treatment were also evaluated. Moreover, the potential synergism of 8Q and NCS with PTX on the CSC proliferation and on stemness-related signaling pathways was evaluated using TNBC cell lines, CSC-reporter sublines, and CSCenriched mammospheres. Finally, the efficacy of the NCS in combination with PTX was analyzed in vivo using an orthotopic mice model of MDA-MB-231 cells. Results Among all tested drug candidates, 8Q and NCS showed remarkable specific anti-CSC activity in terms of CSC viability, migration, invasion and anchorage independent growth reduction in vitro. Moreover, specific 8Q/PTX and NCS/PTX ratios at which both drugs displayed a synergistic effect in different TNBC cell lines were identified. The solely use of PTX increased the relative presence of CSCs in TNBC cells, whereas the combination with 8Q and NCS counteracted this pro-CSC activity of PTX whilst significantly reducing cell viability. In vivo, the combination of NCS with PTX reduced tumor growth, and limited the dissemination of the disease by reducing the circulating tumor cells and the incidence of lung metastasis. Conclusions The combination of 8Q and NCS with PTX at established ratios inhibits both, the proliferation of differentiated cancer cells and the viability of CSCs, opening a way to more efficacious TNBC treatments.