bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association of workplace health education with smoking-related behaviour and unequal gains by job position in China: ABWMC programme findings
Authors: Lin Haoxiang , Chen Meijun , Zheng Yunting , Yun Qingping , Chang Chun 
Published: June 2021

Abstract
Background
Although the Chinese government has introduced a series of regulations to promote tobacco-related health education in workplaces, their implementation has been far from satisfactory. The aim of the present study was to explore the association of company-level tobacco-related health education and employee smoking behaviour.

Methods
Data from the 2018 Asia Best Workplace Mainland China programme were used to address these aims. This was a cross-sectional study that included 14,195 employees from 79 companies in mainland China. Spearman correlation tests were used to examine unadjusted correlations between the study variables, and binary logistic regression was used for multivariable analysis. The dependent variables included smoking-related variables or health information-seeking behaviour. The explanatory variable was the company-level tobacco-related health education.

Results
Tobacco-related health education was associated with better smoking harm awareness (OR = 2.23; 95% CI = 1.94–2.56), lower second-hand smoke exposure (OR = 0.73; 95% CI = 0.66–0.81), better perception of the workplace environment (OR = 2.04; 95% CI = 1.84–2.26) and positive health information-seeking behaviour (OR = 2.07; 95% CI = 1.86–2.30). Job position interacted with health education, suggesting that the positive association of health education was lower for general employees than employees who held an administrative position.

Conclusions
Tobacco-related health education is not only associated with lower SHS exposure but also related to more positive environmental perceptions and health attitudes, and these effects are significant for higher-ranking employees. Policy makers should recognize and reduce these potential health disparities.
Nuclear lamin A in rotator cuff tear margin tenocytes: an antiapoptotic and cell mechanostat factor
Authors: Gumina Stefano , Peruzzi Barbara , Leopizzi Martina , Porta Natale , Di Maio Valeria , Rocca Carlo Della , Candela Vittorio 
Published: June 2021

Abstract
Background
The network of intermediate filament proteins underlying the inner nuclear membrane forms the nuclear lamin. A- and B-type lamins are the major components of the nuclear lamina. Lamins function in many nuclear activities. The role of lamin A and transcription factors (NF-kB) as anti-apoptotic is well documented. Recently, lamin A has also been considered as a mechanosensor protein that is able to maintain nuclear integrity from mechanical insults.
We aimed to verify how lamin A expression varies in healthy cuff cells and in those with different-sized tears where various mechanical stresses are present.

Methods
Forty-three patients with rotator cuff tear (RCT) [23M–20F, mean age (SD): 63.5 (6.1)] were enrolled. Tissue samples excised from the most medial point of tear margins were analyzed for lamin A expression by immunohistochemistry. Controls were represented by samples obtained by normal supraspinatus tendons excised from patients submitted to reverse shoulder prosthesis implant [8M–7F, mean age (SD): 67.9 (7.1)]. The intensity of staining was graded, and an H-score was assigned. Statistical analysis was performed.

Results
Our study revealed a moderate intensity of lamin A in the healthy cuff tendons, a higher expression of this protein in the small tears, and a significant decrease of lamin A with increasing tear size (p < 0.0001).

Conclusions
Our study emphasizes the importance of early repair of small RCTs since nuclear stability is maintained, and the cellular function is protected by lamin A overexpression. High re-tear of massive cuff repair could be due to cellular apoptosis and nuclear modifications induced by lamin A lack.

Level of evidence
III
Prevalence of and factors associated with depression in the hill tribe population aged 40 years and older in northern Thailand
Authors: Singkhorn Onnalin , Apidechkul Tawatchai , Pitchalard Khanittha , Moonpanane Katemanee , Hamtanon Pawadee , Sunsern Rachanee , Leaungsomnapa Yosapon , Thepsaw Jintana 
Published: June 2021

Abstract
Background
Depression is globally recognized as a major mental health problem in all age categories, particularly among those living in poor economic conditions and with low levels of education, including the hill tribe people in northern Thailand.

Methods
This cross-sectional study aimed to estimate the prevalence of depression and determine the factors associated with depression in the hill tribe population aged 40 and over in northern Thailand. Hill tribe people who lived in the selected villages and met the inclusion criteria were invited to participate in the study. A validated questionnaire and the Patient Health Questionnaire-9 (PHQ-9) were used for data collection. An interview was conducted in a private and confidential room in the selected villages between January and April 2019. Logistic regression was used to determine the factors associated with depression at a significance level of α = 0.05.

Results
A total of 601 participants were recruited into the study. More than half (64.23%) were women, 46.76% were Akha, 61.90% were aged 40–59 years, and 76.37% were married. Half of the participants were Christian (57.07%) and had no monthly income (51.25%), and 85% were illiterate. The overall prevalence of depression was 39.10%: 75.74% had mild depression, 17.88% had moderate depression, and 6.38% had severe depression. In the multivariate model, three variables were found to be associated with depression: being female, having a history of substance abuse, and experiencing stress six months prior. Compared to men, women were 2.09 times (95% CI 1.30–3.35) more likely to have depression. Those who had a history of substance abuse were more likely to have depression than those who did not have a history of substance abuse (AOR = 1.97; 95% CI 1.25–3.10). Those who had a history of stress in the prior 6 months were more likely to have depression than those who did not (AOR = 6.43; 95% CI 4.20–9.85).

Conclusion
Public health screening programs to identify depression in the hill tribe population are urgently needed, particularly for women, those who have abused psychoactive substances, and those who have experienced stress.
A positive feedback loop between Periostin and TGFβ1 induces and maintains the stemness of hepatocellular carcinoma cells via AP-2α activation
Authors: Chen Gang , Wang Yi , Zhao Xin , Xie Xiao-zai , Zhao Jun-gang , Deng Tuo , Chen Zi-yan , Chen Han-bin , Tong Yi-fan , Yang Zhen , Ding Xi-wei , Guo Peng-yi , Yu Hai-tao , Wu Li-jun , Zhang Si-na , Zhu Qian-dong , Li Jun-jian , Shan Yun-feng , Yu Fu-xiang , Yu Zheng-ping , Xia Jing-lin 
Published: June 2021

Abstract
Background
Liver cancer stem cells (LCSCs) play key roles in the metastasis, recurrence, and chemotherapeutic resistance of hepatocellular carcinoma (HCC). Our previous research showed that the POSTN gene is closely related to the malignant progression and poor prognosis of HCC. This study aimed to elucidate the role of POSTN in generating LCSCs and maintaining their stemness as well as the underlying mechanisms.

Methods
Human HCC tissues and matched adjacent normal tissues were obtained from 110 patients. Immunohistochemistry, western blotting (WB), and RT-PCR were performed to detect the expression of POSTN and stemness factors. The roles of transforming growth factor (TGF)-β1 and AP-2α in the POSTN-induced stemness transformation of HCC cells were explored in vitro and in vivo using LCSCs obtained by CD133+ cell sorting.

Results
The high expression of POSTN was correlated with the expression of various stemness factors, particularly CD133, in our HCC patient cohort and in TCGA and ICGC datasets. Knockdown of POSTN expression decreased the abilities of HCC cell lines to form tumours in xenograft mouse models. Knockdown of POSTN expression also suppressed cell viability and clone formation, invasion, and sphere formation abilities in vitro. Knockdown of AP-2α attenuated the generation of CD133+ LCSCs and their malignant behaviours, indicating that AP-2α was a critical factor that mediated the POSTN-induced stemness transformation and maintenance of HCC cells. The role of AP-2α was verified by using a specific αvβ3 antagonist, cilengitide, in vitro and in vivo. Activation of POSTN could release TGFβ1 from the extracellular matrix and initiated POSTN/TGFβ1 positive feedback signalling. Furthermore, we found that the combined use of cilengitide and lenvatinib suppressed the growth of HCC cells with high POSTN expression more effectively than the use of lenvatinib alone in the patient-derived xenograft (PDX) mouse model.

Conclusions
The POSTN/TGFβ1 positive feedback pathway regulates the expression of stemness factors and the malignant progression of HCC cells by regulating the transcriptional activation of AP-2α. This pathway may serve as a new target for targeted gene therapy in HCC.
Ambulance deceleration causes increased intra cranial pressure in supine position: a prospective observational proof of principle study
Authors: Maissan Iscander M. , Vlottes Boris , Hoeks Sanne , Bosch Jan , Stolker Robert Jan , den Hartog Dennis 
Published: June 2021

Abstract
Background
Ambulance drivers in the Netherlands are trained to drive as fluent as possible when transporting a head injured patient to the hospital. Acceleration and deceleration have the potential to create pressure changes in the head that may worsen outcome. Although the idea of fluid shift during braking causing intra cranial pressure (ICP) to rise is widely accepted, it lacks any scientific evidence. In this study we evaluated the effects of driving and deceleration during ambulance transportation on the intra cranial pressure in supine position and 30° upright position.

Methods
Participants were placed on the ambulance gurney in supine position. During driving and braking the optical nerve sheath diameter (ONSD) was measured with ultrasound. Because cerebro spinal fluid percolates in the optical nerve sheath when ICP rises, the diameter of this sheath will distend if ICP rises during braking of the ambulance. The same measurements were taken with the headrest in 30° upright position.

Results
Mean ONSD in 20 subjects in supine position increased from 4.80 (IQR 4.80–5.00) mm during normal transportation to 6.00 (IQR 5.75–6.40) mm (p < 0.001) during braking. ONSD’s increased in all subjects in supine position.
After raising the headrest of the gurney 30° mean ONSD increased from 4.80 (IQR 4.67–5.02) mm during normal transportation to 4.90 (IQR 4.80–5.02) mm (p = 0.022) during braking. In 15 subjects (75%) there was no change in ONSD at all.

Conclusions
ONSD and thereby ICP increases during deceleration of a transporting vehicle in participants in supine position. Raising the headrest of the gurney to 30 degrees reduces the effect of breaking on ICP.
Early evidence of SARS-CoV-2 in Milan, Jan-Feb 2020
Authors: Milani Gregorio P. , Casazza Giovanni , Corsello Antonio , Marchisio Paola , Rocchi Alessia , Colombo Giulia , Agostoni Carlo , Costantino Giorgio 
Published: June 2021

Abstract
Background
A few studies have suggested that the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) was present in Northern Italy several weeks before its official detection on February 21, 2020. On the other hand, no clinical data have been provided so far to support such hypothesis. We investigated clinical-epidemiological evidence of SARS-CoV-2 infection among children and adults referring to emergency department (ED) in the main hospital of the center of Milan (Italy) before February 21, 2020.

Methods
A retrospective analysis of medical records of ED visits at the Fondazione Ca′ Granda Policlinico, Milan between January 11 and February 15 in 2017, 2018, 2019 and in 2020 was performed. The number of subjects referring with fever, cough or dyspnea was compared between the studied period of 2020 and the previous 3 years, by calculating a standardized referral ratio (SRR, number of observed cases in 2020 divided by the number of expected cases according to 2017–2019) and the corresponding 95% confidence interval (CI).

Results
In the pediatric ED, 7709 (average 2570/year) and 2736 patients were visited during the period 2017–2019 and in the 2020, respectively. Among adults, 13,465 (average 4488/year) and 4787 were visited during the period 2017–2019 and in the 2020, respectively. The SRR was 1.16 (95% CI 1.10–1.23) in children and 1.25 (95% CI 1.16–1.35) in adults. The ratio for the two (children and adults) SRRs was 0.93 (0.84–1.02), suggesting a trend towards a higher frequency in adults compared to children.

Conclusions
This study suggests that SARS-CoV-2 might have spread in Milan before February 21, 2020 with a minor trend among children.
Public access to protocols of contemporary cancer randomized clinical trials
Authors: Babu Christopher , Mell Loren , Lee Nancy , Zakeri Kaveh 
Published: June 2021

AbstractAccess to randomized clinical trial (RCT) protocols is necessary for the interpretation and reproducibility of the study results, but protocol availability has been lacking. We determined the prevalence of protocol availability for all published cancer RCTs in January 2020. We found that only 36.1% (48/133) of RCTs had an accessible protocol and only 11.3% of RCTs (15/133) had a publicly accessible protocol that was not behind a paywall. Only 18.0% (24/133) of RCTs were published in conjunction with the protocol on the journal website. In conclusion, few cancer RCTs have an accessible research protocol. Journals should require publication of RCT protocols along with manuscripts to improve research transparency.
A novel approach for the synthesis of nanostructured Ag3PO4 from phosphate rock: high catalytic and antibacterial activities
Authors: Dânoun Karim , Tabit Rida , Laghzizil Abdelaziz , Zahouily Mohamed 
Published: June 2021

Abstract
Background
Silver orthophosphate (Ag3PO4) has received enormous attention over the past few years for its higher visible light photocatalytic performance as well as for various organic pollutants degradation in aqueous media. Therefore, considerable efforts have been made to the synthesis of Ag3PO4 with high catalytic efficiency, long lifetime, and using low-cost inorganic precursors.

Results
This article describes our efforts to develop a novel approach to synthesize of nanostructured silver phosphate (Ag3PO4) using phosphate rock as alternative and natural source of PO43− precursor ions. The catalytic experimental studies showed that the nanostructured Ag3PO4 exhibited excellent catalytic activity for reduction of p-nitrophenol in the presence of NaBH4 at room temperature. Furthermore, the antibacterial studies revealed that the obtained Ag3PO4 possess significant effect against E. Coli and S. Aureus bacteria.

Conclusion
The obtained results make the nanostructured Ag3PO4 prepared from natural phosphate as a highly promising candidate to be used as efficient catalyst and antibacterial agent.

Graphic Abstract
Antiphospholipid antibodies and anticoagulant therapy: capillaroscopic findings
Authors: Ferrari Giorgia , Gotelli Emanuele , Paolino Sabrina , Pesce Giampaola , Nanni Luca , Colombo Barbara Maria , Pacini Greta , Schenone Carlotta , Pizzorni Carmen , Sulli Alberto , Smith Vanessa , Cutolo Maurizio 
Published: June 2021

Abstract
Background
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by specific vascular and obstetric manifestations and by antiphospholipid antibodies (aPL) positivity. Microvascular damage in the course of APS and “aPL carrier” patients without symptoms is poorly investigated.

Objectives
This study aims to compare nailfold videocapillaroscopy (NVC) microvascular parameters in APS patients and non-symptomatic "aPL carriers" and to investigate their possible correlations with different aPL subtypes.

Methods
NVC was performed during standard evaluations in 18 APS patients (mean age 50 ± 13.8 years), 24 "aPL carriers" without symptoms (mean age 46.4 ± 16.4 years), and 18 control patients (CTR) (mean age 74 ± 12.5 years) taking oral anticoagulants for non-immunological indications (i.e., cardiovascular accidents). All patients were investigated for the presence of dilated capillaries, giant capillaries, microhemorrhages, capillary loss, and further non-specific/specific abnormalities (i.e., branched “bushy” capillaries, sign of neoangiogenesis) by NVC. Every alteration was also classified according to a semi-quantitative score. Lupus anticoagulant, anticardiolipin antibodies, and antibeta2 glycoprotein I antibodies were tested in each patient.

Results
APS patients showed at NVC increased frequency of microhemorrhages (p = 0.039)—particularly a “comb-like” pattern (parallel hemorrhages) (p = 0.002)—than "aPL carriers". Of note, there were no significant differences concerning the isolated number of microhemorrhages between APS and the CTR group (p = 0.314), but “comb-like” hemorrhages were significantly more frequent in the APS group (p = 0.034). Not any significant correlation was found between the aPL subtypes and NVC parameters.

Conclusions
APS patients showed significantly a greater number of non-specific NVC abnormalities than "aPL carriers", particularly the “comb-like” NVC pattern. Oral anticoagulants may represent a confounding factor for isolated microhemorrhages. Not any correlation was found between aPL subtypes and NVC parameters. Further investigations are needed to better characterize the microvascular endothelium damage induced by aPL.
Swimming turn performance: the distinguishing factor in 1500 m world championship freestyle races?
Authors: Polach Marek , Thiel Dan , Kreník Jan , Born Dennis-Peter 
Published: June 2021

Abstract
Objective
Turn sections represent the second largest part of total race time in 1500 m freestyle races and may substantially affect race results. Therefore, the aim of the study was to investigate individual race strategies and compare the effect of start, swim, and turn performances between short-course and long-course races. Video footages were collected from all 16 male finalists at the 2018 short and 2019 long-course World swimming championships (age 23.06 ± 2.3 years, FINA points 941 ± 42) for subsequently analysis of start, turn, and swim performance.

Results
The larger number of turns in short-course races resulted in significantly faster race times (p = 0.004), but slower mean turn times compared to long-course races (p < 0.001). Total race velocity closely correlated with swim and turn but not start section velocity in short- (r ≥ 0.80, p ≤ 0.017) and long-course races (r ≥ 0.83, p ≤ 0.011). Analysis of individual race strategies showed that turn performance affected race results in 6 (75%) and 3 (37.5%) of the 8 world-best 1500 m swimmers in short-course and long-course races, respectively. Medal standing was improved for 1st, 3rd, and 4th ranked short- as well as 1st and 2nd ranked long-course finalist. Coaches, athletes, and performance analysts may carefully consider the importance of turn performance additionally to free-swimming skills.
Relationship between disease activity level and physical activity in rheumatoid arthritis using a triaxial accelerometer and self-reported questionnaire
Authors: Toyoshima Yoichi , Yajima Nobuyuki , Nemoto Tetsuya , Namiki Osamu , Inagaki Katsunori 
Published: June 2021

Abstract
Objective
This study evaluated the relationship between rheumatoid arthritis (RA) disease activity level and physical activity (PA) by using an accelerometer and self-reported questionnaire.

Results
The cross-sectional study was part of a cohort study designed to determine disease activity is associated with PA in RA patients. We classified patients with a Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) of less than and higher than 3.2 into the low-disease-activity (LDA) group and moderate/high-disease-activity (MHDA) group, respectively. We measured the wear time, time of vigorous-intensity PA, moderate-intensity PA, light-intensity PA, and sedentary behavior per day using a triaxial accelerometer. 34 patients were included in the study. The accelerometer-measured moderate-to-vigorous PA (MVPA) was 17.2 min/day and 10.6 min/day in the LDA group and MHDA group (p < 0.05), respectively. There was no significant association between RA disease activity level and accelerometer-measured PA with adjustment for age and Functional Assessment of Chronic Illness Therapy-Fatigue score. There was no correlation between accelerometer-measured MVPA and self-reported MVPA in the MHDA group, but these factors were correlated in the LDA group (rs = 0.57, p < 0.05). In conclusion, no significant association was noted between RA disease activity level and accelerometer-measured PA.
Patterns of financial incentives in primary healthcare settings in Nigeria: implications for the productivity of frontline health workers
Authors: Okereke Ekechi , Eluwa George , Akinola Akinwumi , Suleiman Ibrahim , Unumeri Godwin , Adebajo Sylvia 
Published: June 2021

Abstract
Objective
This study was designed to explore the patterns of financial incentives received by some frontline health workers (including nurses, midwives as well as community health workers in paid employment) and the implications for their productivity within rural settings in Nigeria. A cross-sectional quantitative design in two States in Nigeria was adopted. Structured interviews were conducted with 114 frontline health workers. Bivariate analysis and multivariate regression analysis were carried out to explore relationships between the satisfaction of frontline health workers with the financial incentives received and their productivity in rural settings as well as the extent of any such relationships.

Results
Bivariate analysis demonstrated a statistically significant relationship (P = 0.013) between satisfaction with incentives received by frontline health workers and their productivity in rural settings. When other predictors were controlled for within a multivariate regression model, those who received incentives and were satisfied with the incentives were about three times more likely to be more productive at work than those who were unsatisfied with incentives (AOR: 3.3; P = 0.009, 95% CI = 1.3–8.2). In conclusion, the determination of type and content of incentives should be done in consultation with all relevant stakeholders, including possibly a cross-section of health workers themselves.