bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of EPclin on adjuvant therapeutic decision making and comparison of EPclin to the PREDICT tool
Authors: Bourien Héloïse , Quillien Véronique , Godey Florence , Perrin Christophe , Le Du Fanny , Guillermet Sophie , Blanchot Jérôme , Lavoué Vincent , Campillo-Gimenez Boris , Brunot Angélique , Crouzet Laurence , De la Motte Rouge Thibault , Diéras Véronique , Lefeuvre-Plesse Claudia 
Published: May 2021

Purpose: Genomic signatures, such as EndoPredict®, may help clinicians to decide which adjuvant treatment is the most appropriate. Methods: We propose the EndoPredict® assay for unclear cases of adjuvant treatment in patients treated in our comprehensive cancer center. We prospectively and retrospectively report the decision of adjuvant treatment before and after the EndoPredict® assay, respectively, compared to the PREDICT’s tool scores. Results: From November 2016 to March 2019, 159 breast cancer tumors were analyzed and presented before and after the EndoPredict® assay. Before the EndoPredict® results, clinicians recommended chemotherapy for 57 patients (57/159, 36%). A total of 108 patients (108/159, 68%) were classified as EPclin high-risk score. There was only a slight agreement between clinicians’ decisions and EPclin risk score. The EPclin score led to 37% changes in treatment (59/159); chemotherapy was favored in 80% of cases (47/59). The PREDICT tool recommended chemotherapy for 16 high-risk patients (16/159, 10%). Conclusion: Although genomic tests were developed in order to de-escalate adjuvant treatment, in our comprehensive cancer center the use of the EndoPredict® assay led to an increase in prescribed chemotherapy.
Treatment expectations as a possible prognostic factor for DMARD response in rheumatoid arthritis: a prospective cohort study
Authors: Mucke Johanna , Brinks Ralph , Dimitriou Argyri , Richter Jutta G. , Schneider Matthias 
Published: May 2021

Background: The prediction of the individual’s response to disease modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA) is challenging and often limited. Here we evaluated the influence of patients’ expectations towards a change in treatment with DMARD on clinical outcome in RA. Methods: One hundred patients (74 female) with RA (2010 ACR/EULAR classification criteria) and an upcoming change in DMARD treatment due to non-response or adverse effects were included. Patients’ treatment beliefs, health-related quality of life and treatment expectations were measured using the Beliefs about Medicines Questionnaire (BMQ), the Short Form 36, and self-designed questions about expectations before treatment initiation (T0), and DAS28-CRP was calculated at T0 and after 4 months (T4). Associations between patients’ beliefs and expectations and changes in DAS28-CRP (T0 to T4, ΔDAS28-CRP) were explored by regression analyses after multiple imputation. Results: A total of 99 patients were included, of whom 84 completed all questionnaires. Thirty-six percent of all variability in treatment response (ΔDAS28-CRP) was explained by expectations assessed with the questionnaires and the C-reactive protein (CRP)-value at T0. Among these, the expected improvement rate, with 10.5%, as well as the CRP-value at T0, with 10.6%, had the greatest positive effect whereas the fear of adverse effects, with 11.4%, and the BMQ.concern scale, with 9.0%, had the greatest negative impact on ΔDAS28. Conclusion: Patients’ expectations towards newly induced DMARD therapies influence clinical response and may serve as possible explanatory factors for treatment response affecting subjective and objective outcome parameters. Clinical trial registration number: DRKS00017005
Game Mechanisms in Serious Games That Teach Children with Type 1 Diabetes How to Self-Manage: A Systematic Scoping Review
Authors: Nørlev Jannie , Sondrup Katrine , Derosche Christina , Hejlesen Ole , Hangaard Stine 
Published: May 2021

Introduction: The use of serious games is a popular approach to help children with Type 1 diabetes (T1D) learn how to self-manage. Many different game mechanisms exist. However, it is unclear which game mechanisms a serious game should include to teach self-management to children with T1D. Therefore, the aim of this scoping review is to map and describe the game mechanisms used in serious games that teach children with T1D how to self-manage and explain how they contribute to teaching self-management. Methods: A systematic scoping review was conducted to map and describe the important game mechanisms published before 23 September 2020. A comprehensive search was performed in the PubMed, CINAHL, Embase, PsycINFO, Scopus, and Education Database. Relevant literature was selected, synthesized, and reported. Results: Of the 800 articles identified, 18 were included in this systematic scoping review. The game mechanisms used in serious games that teach self-management included narrative contexts, feedback, avatars, simulations, goals, levels, and social interactions. Discussion: This review identified 7 game mechanisms used in serious games that teach children how to self-manage. A serious game is most effective in teaching self-management when it is T1D-oriented and when multiple game mechanisms are combined. However, the most effective combination of game mechanisms has yet to be determined.
Wealth index and other behavioral and sociodemographic characteristics associated with body mass index in Ethiopia
Authors: Tesfaw Lijalem Melie , Muluneh Essey Kebede 
Published: May 2021

Background: Nowadays, the burden of non-communicable diseases including obesity has been an increasing public health concern. This menace can be monitored using indexing method like body mass index. Studies indicate that socioeconomic indicators such as income, biology, behavior, and demographic factors associated with body mass index. In Ethiopia, few studies associate wealth index with body mass index in people of ages between 15 and 49. This study was aimed to assess the association of body mass index with wealth index, and behavioral and sociodemographic population characteristics. Methods: A cross-sectional population-based study was conducted using the 2016 Ethiopian Demographic and Health Survey population of ages 15–49. A total of 10,245 individuals were considered to detect the effect of socioeconomic, biological, behavioral, and demographic factors on body mass index using logistic regression. Results: The prevalence of underweight, overweight, and obesity among men are 23.8%, 6.6%, and 2.0%, respectively, which is lower than that of women (underweight 25.3%, overweight 9.1%, and obesity 2.9%). The poorest men had higher odds of being underweight (adjusted odds ratio = 2.395%; 95% confidence interval = 2.020–3.544) as compared to the richest men. Merchants and government employees have lower odds (adjusted odds ratio = 0.744; 95% confidence interval = 0.588–0.899) compared to men whose occupation is farming and labor, indicating that merchants and government employees are more likely to become overweight and obese compared to men who are farmers and laborers. Conclusion: It is concluded that wealth index is an important socioeconomic determinant of body mass index among men and women of age 15–49 in Ethiopia. A high prevalence of underweight, and overweight, and obesity is observed, which increases instances of non-communicable diseases. Effects of socioeconomic, biological, behavioral, and demographic indicators on body mass index differed according to sex.
“Sometimes I don’t have a pulse … and I’m still alive!” Interviews with healthcare professionals to explore their experiences of and views on population-based digital health technologies
Authors: Tomasella Flavio , Morgan Heather May 
Published: May 2021

Background Digital technologies are increasingly becoming an integral part of our daily routine and professional lives, and the healthcare field is no exception. Commercially available digital health technologies (DHTs – e.g. smartphones, smartwatches and apps) may hold significant potential in healthcare upon successful and constructive implementation. Literature on the topic is split between enthusiasm associated with potential benefits and concerns around privacy, reliability and overall effectiveness. However, little is known about what healthcare professionals (HCPs) have experienced so far with patients and what they perceive as the main advantages and disadvantages of adoption. This study therefore aims to investigate current perceptions of HCPs towards self-tracked health-related outputs from devices and apps available to the public. Methods Nine HCPs volunteered to take part in semi-structured interviews. Related data were thematically analysed, following a deductive approach with the construction of a framework based on expected themes from the relevant literature, and themes identified from the first two interviews. Findings The following main themes in relation to DHTs were identified and explored in detail: HCPs’ experience, knowledge and views; advantages and disadvantages; barriers towards healthcare implementation and potential solutions; future directions. While most participants were adopters of DHTs and held positive views about them, their overall experience with patients and the technology was limited. Potential reasons for this were explored, including factors such as time/resources; colleagues’ mindset; lack of evidence of effectiveness for practice; data security concerns. Conclusions The potential advantages of DHTs’ adoption in healthcare are substantial, e.g. patient autonomy, time/resources saving, health and behaviour change promotion, but are presently premature. Therefore, future research is warranted, focussing on addressing barriers, minimising disadvantages, and assessing the clinical value of commercially available DHTs.
Building MedVenture – A mobile health application to improve adolescent medication adherence – Using a multidisciplinary approach and academic–industry collaboration
Authors: Mehta Pooja , Moore Susan L , Bull Sheana , Kwan Bethany M 
Published: May 2021

Objective Mobile health (mHealth) tools are increasingly used to support medication adherence yet few have been designed specifically for the pediatric population. This paper describes the development of a medication adherence application ( MedVenture) using the integration of patient and healthcare provider input, health behavior theory, and user engagement strategies for adolescents with chronic gastrointestinal disease. Methods MedVenture was created by a multidisciplinary research team consisting of a gastroenterologist, a social health psychologist, software developers, and digital health researchers. Healthcare providers and adolescent patients were interviewed to identify barriers to medication adherence, explore ways that technologies could best support medication adherence for both patients and providers, and determine user requirements and core design features for a digital health tool. Intervention mapping was used to match themes from qualitative content analysis to known efficacious adherence strategies, according to a conceptual framework based on self-determination theory. Iterative design with review by the research team and two rounds of user testing informed the final prototype. Results Three themes were identified from content analysis: 1) lack of routine contributes to nonadherence, 2) adolescents sometimes purposefully forgo medications, and 3) healthcare providers would prefer a tool that promotes patient self-management rather than one that involves patient-provider interaction. These findings, combined with evidence-based adherence and user engagement strategies, resulted in the development of MedVenture – a game-based application to improve planning and habit formation. Conclusions Academic-industry collaboration incorporating stakeholders can facilitate the development of mobile health tools designed specifically for adolescents with chronic disease.
Seeking Help in the “Perfect Storm”: Why Residents and Faculty Access an On-Site Wellness Program
Authors: Ey Sydney , Ladd Benjamin , Soller Marie , Moffit Mary 
Published: May 2021

Background In the face of significant distress among physicians, access to counseling is critical. Objective An on-site wellness program for physicians-in-training and faculty was assessed by examining (a) were participants representative of those eligible for services and (b) demographic and trainee vs. faculty differences in burnout, distress, suicide risk, and presenting concerns of participants who utilized services. Methods From 2013–2018, 73% (N = 468; 316 residents/fellows, 152 faculty) of individuals seeking services also consented to research. At intake, participants completed a distress measure (ACORN) and two items from the Maslach Burnout Inventory (MBI), and clinicians categorized presenting concerns and suicide risk. Using Chi-square analyses, participants’ characteristics were compared to physicians eligible for treatment. The association between demographics, faculty vs. trainee status, specialty, and distress, burnout, suicide risk, and presenting concerns was evaluated with ANOVAs and logistic regressions. Results Women, trainees, and primary care physicians were more likely to access services. On the ACORN, 63% were in the clinical range (M =1.7, SD =0.6). On the MBI, 36% scored in the clinical range. Clinicians rated 9% of participants with suicide risk. Neither gender, racial/ethnic minority status, nor specialty were associated with distress, burnout or suicide risk. Trainees reported greater distress than faculty ( F (1,447) = 8.42, P =  .004, [Formula: see text] = .018). Participants reported multiple presenting concerns (M = 3.0, SD = 1.18) with faculty more commonly endorsing work-related issues. Trainees more commonly reported new or worsening psychological symptoms, performance and family concerns. Conclusions Two physician groups which often report higher levels of burnout and distress when surveyed, women physicians and residents/fellows, were the most likely to get professional help in an on-site wellness program. Physician wellness programs need to be prepared to address work and personal stressors and different levels of distress and risk.
Effects of Defocus Distance on Three-Beam Laser Internal Coaxial Wire Cladding
Authors: Ji Shaoshan , Liu Fan , Shi Tuo , Fu Geyan , Shi Shihong 
Published: May 2021

AbstractThree-beam laser internal coaxial wire feeding cladding is regarded as a promising additive manufacturing technique because it is highly efficient and controllable. In this study, the effects of the defocus distance on cladding using a three-beam laser with internal wire feeding are experimentally and numerically studied. A process map indicating the surface characteristics at different defocus distances with various parameter combinations was developed. The transmission characteristics including laser intensity, beam size, and laser spot distance of the three-beam laser at different defocus distances were analyzed using TracePro software. Based on the TracePro results as heat source, a three-dimensional transient finite element (FE) thermal model was formulated to predict the thermal field, temperature history and molten pool shape at different defocus distances. A molten pool with a flat bottom and low melting depth is generated when the defocus distance is − 2.5 mm, whereas when this distance is − 1.5 mm, a pool with a valley-shaped bond and high melting depth is formed. The simulated results of the temperature cycle and clad geometry are both validated and found to well agree with experimental measurements. The influence of the defocus distance on the microstructure and microhardness are discussed based on the temperature history and cooling rate. With the increase in the absolute defocus distance, the height and dilution of the clad decreased, whereas the width increased. In addition, the effects of defocus distance with various parameter combinations on clad geometry were explored using the formulated FE model.
Clinical, psychological, and sensory characteristics associated with headache attributed to temporomandibular disorder in people with chronic myogenous temporomandibular disorder and primary headaches
Authors: Tchivileva Inna E. , Ohrbach Richard , Fillingim Roger B. , Lin Feng-Chang , Lim Pei Feng , Arbes Samuel J. , Slade Gary D. 
Published: May 2021

AbstractBackgroundHeadache attributed to Temporomandibular Disorder (HATMD) is a secondary headache that may have features resulting in diagnostic overlap with primary headaches, namely, tension-type (TTH) or migraine. This cross-sectional study of people with both chronic myogenous TMD and primary headaches evaluated characteristics associated with HATMD.MethodsFrom a clinical trial of adults, baseline data were used from a subset with diagnoses of both TMD myalgia according to the Diagnostic Criteria for TMD (DC/TMD) and TTH or migraine according to the International Classification of Headache Disorders, 3rd edition. HATMD was classified based on the DC/TMD. Questionnaires and examinations evaluated 42 characteristics of facial pain, headache, general health, psychological distress, and experimental pain sensitivity. Univariate regression models quantified the associations of each characteristic with HATMD (present versus absent), headache type (TTH versus migraine), and their interaction in a factorial design. Multivariable lasso regression identified the most important predictors of HATMD.ResultsOf 185 participants, 114 (61.6%) had HATMD, while the numbers with TTH (n = 98, 53.0%) and migraine (n = 87, 47.0%) were similar. HATMD was more likely among migraineurs (61/87 = 70.1%) than participants with TTH (53/98 = 54.1%; odds ratio = 2.0; 95%CL = 1.1, 3.7). In univariate analyses, characteristics associated with HATMD included pain-free jaw opening and examination-evoked pain in masticatory muscles and temporomandibular joints (TMJ) as well as frequency and impact of headache, but not frequency or impact of facial pain. Lowered blood pressure but not psychological or sensory characteristics was associated with HATMD. Multiple characteristics of facial pain, headache, general health, and psychological distress differed between TTH or migraine groups. Few interactions were observed, demonstrating that most characteristics’ associations with HATMD were consistent in TTH and migraine groups. The lasso model identified headache frequency and examination-evoked muscle pain as the most important predictors of HATMD.ConclusionsHATMD is highly prevalent among patients with chronic myogenous TMD and headaches and often presents as migraine. In contrast to primary headaches, HATMD is associated with higher headache frequency and examination-evoked masticatory muscle pain, but with surprisingly few measures of facial pain, general health, and psychological distress. A better understanding of HATMD is necessary for developing targeted strategies for its management.Trial identification and registrationSOPPRANO;NCT02437383. Registered May 7, 2015.
MiR-501 promotes tumor proliferation and metastasis by targeting HOXD10 in endometrial cancer
Authors: Sun Xiaomei , Hou Lingtong , Qiu Chunping , Kong Beihua 
Published: May 2021

Abstract
Background
Several studies have shown the crucial role of miR-501 in regulating cellular pathology in various cancers. However, the function and expression of miR-501 in endometrial cancer (EC) remain obscure.

Methods
The expression of miR-501 was determined using quantitative real-time PCR. MTT assay, colony formation assay and cell cycle analysis were used to evaluate the proliferation ability. Migration and invasion were assessed using transwell assay. Tumor formation in nude mice was used to observe the effects of miR-501 on cell proliferation and migration in vivo. Luciferase assay, quantitative real-time PCR and western blot were applied to determine that HOXD10 was the target gene of miR-501.

Results
In this study, we observed significantly up-regulated expression of miR-501 in endometrial cancer, which correlated with higher pelvic lymph node metastasis and shorter overall survival in high-grade endometrial cancer. High expression of miR-501 was also found in the copy-number-high group than other groups. Moreover, in vitro and in vivo assay showed that overexpression of miR-501 can promote proliferation and metastasis. Mechanistically, we found that miR-501 promotes tumor progression by directly targeting HOXD10. Further study also indicated that miR-501 overexpression can activate the AKT/mTOR pathway.

Conclusions
MiR-501, which functions as an oncomir in endometrial cancer, might be a potential therapeutic target in high grade endometrial cancer.
Distance-Dependent Plasmon-Enhanced Fluorescence of Submonolayer Rhodamine 6G by Gold Nanoparticles
Authors: Bian Yajie , Liu Shikang , Zhang Yuyi , Liu Yiting , Yang Xiaoyu , Lou Shitao , Wu E. , Wu Botao , Zhang Xiaolei , Jin Qingyuan 
Published: May 2021

AbstractWe investigate the fluorescence from submonolayer rhodamine 6G molecules near gold nanoparticles (NPs) at a well-controlled poly (methyl methacrylate) (PMMA) interval thickness from 1.5 to 21 nm. The plasmonic resonance peaks of gold NPs are tuned from 530 to 580 nm by the PMMA spacer of different thicknesses. Then, due to the plasmonic resonant excitation enhancement, the emission intensity of rhodamine 6G molecules at 562 nm is found to be enhanced and shows a decline as the PMMA spacer thickness increases. The variation of spectral intensity simulated by finite-difference time-domain method is consistent with the experimental results. Moreover, the lifetime results show the combined effects to rhodamine 6G fluorescence, which include the quenching effect, the barrier effect of PMMA as spacer layer and the attenuation effect of PMMA films.