bluuebunny/crossref_metadata_2025_split huggingface dataset:
“We bleed for our community:” A qualitative exploration of the implementation of a pragmatic weight gain prevention trial from the perspectives of community health center professionals
Authors: Berger Miriam B. , Chisholm Miriam , Miller Hailey N. , Askew Sandy , Kay Melissa C. , Bennett Gary G. 
Published: April 2023

AbstractBackgroundClinical trial implementation continues to shift toward pragmatic design, with the goal of increasing future adoption in clinical practice. Yet, few pragmatic trials within clinical settings have qualitatively assessed stakeholder input, especially from those most impacted by research implementation and outcomes, i.e., providers and staff. Within this context, we conducted a qualitative study of the implementation of a pragmatic digital health obesity trial with employees at a Federally qualified health center (FQHC) network in central North Carolina.MethodsParticipant recruitment was conducted through purposive sampling of FQHC employees from a variety of backgrounds. Two researchers conducted semi-structured qualitative interviews and collected demographic data. Interviews were digitally recorded, professionally transcribed and double-coded by two independent researchers using NVivo 12. Coding discrepancies were reviewed by a third researcher until intercoder consensus was reached. Responses were compared within and across participants to elucidate emergent themes.ResultsEighteen qualitative interviews were conducted, of whom 39% provided direct medical care to patients and 44% worked at the FQHC for at least seven years. Results illuminated the challenges and successes of a pragmatically designed obesity treatment intervention within the community that serves medically vulnerable patients. Although limited time and staffing shortages may have challenged recruitment processes, respondents described early buy-in from leadership; an alignment of organizational and research goals; and consideration of patient needs as facilitators to implementation. Respondents also described the need for personnel power to sustain novel research interventions and considerations of health center resource constraints.ConclusionsResults from this study contribute to the limited literature on pragmatic trials utilizing qualitative methods, particularly in community-based obesity treatment. To continue to merge the gaps between research implementation and clinical care, qualitative assessments that solicit stakeholder input are needed within pragmatic trial design. For maximum impact, researchers may wish to solicit input from a variety of professionals at trial onset and ensure that shared common goals and open collaboration between all partners is maintained throughout the trial.Trial RegistrationThis trial was registered with ClinicalTrials.gov (NCT03003403) on December 28, 2016.
Limited awareness of HIV Status hinders uptake of treatment among female sex workers and sexually exploited adolescents in Wau and Yambio, South Sudan
Authors: Bolo Alex , Ochira Patrick , Hakim Avi J. , Katoro Joel , Bunga Sudhir , Lako Richard , Anib Victoria , Arkangelo Golda Caesar , Lobojo Brenda Nyokani , Okiria Alfred G. 
Published: April 2023

Abstract
Background
Several factors determine uptake of HIV testing services (HTS) by female sex workers (FSW), including their knowledge of HIV and their awareness of services supporting people who are HIV-positive. HTS provided entry into the UNAIDS 90-90-90 cascade of care. We conducted a cross-sectional biobehavioural survey (BBS) to determine HIV prevalence and progress towards UNAIDS 90-90-90 cascade targets among this population in South Sudan.

Methods
Respondent-driven sampling (RDS) was used to recruit women and sexually exploited girls aged 13–18 years who exchanged sex for goods or money in the past 6 months and resided in the town for at least 1 month. Consenting participants were interviewed and tested for HIV and, if positive, they were also tested for their viral load (VL). Data were weighted in RDS Analyst and analyzed with Stata 13.

Results
A total of 1,284 participants were recruited. The overall HIV cascade coverages were 64.8% aware of their HIV-positive status; 91.0% of those aware of their positive status were on ART; and VL suppression among those on ART was 93.0%.

Conclusion
Being unaware of their HIV-positive status limits, the uptake of HIV treatment among FSW in South Sudan. This underscores the importance of optimized case-finding approaches to increase HTS among FSW and sexually exploited minors.
A case of subclinical immune checkpoint inhibitor-associated myocarditis in non-small cell lung cancer
Authors: Hu Yue , Liu Cuixia , Jin Shaojun , Yi Zihan , Wang Chao , Pan Xiaohong , Huang Huaqiong 
Published: April 2023

Abstract
Background
Immune checkpoint inhibitors (ICIs) have been widely used in the treatment of cancer. Moreover, immune-related adverse events (irAEs) have become a new clinical challenge. ICI-associated myocarditis is a rare but fatal condition among diverse organ injuries, and early recognition and effective interventions are critical for patients.

Case presentation
In this report, we present the case of a healthy 60-year-old male who was diagnosed with lung squamous cell carcinomas following chemotherapy and received ICIs. The patient presented with asymptomatic cardiac biomarker elevation followed by immune-related myocarditis. Fortunately, the patient achieved a good clinical result after receiving high-dose steroids. The treatment with ICIs was discontinued because of recurrent increases in troponin T.

Conclusion
ICI-mediated associated myocarditis is an uncommon but potentially life-threatening adverse event. The current data suggest that clinicians need to be cautious about reinitiation in low-grade patients; however, further study of the diagnosis and treatment is necessary.
Effect of the ethnic, profession, gender, and social background on the perception of upper dental midline deviations in smile esthetics by Chinese and Black raters
Authors: Musa Mazen , Awad Riham , Mohammed Abdalla , Abdallah Hibatalrahman , Elhoumed Mohamed , Al-waraf Leena , Qu Wanting , Alhashimi Najah , Chen Xi , Wang Shuang 
Published: April 2023

AbstractsBackgroundThe purpose of this study was to compare the perception of upper dental midline deviation on the attractiveness of a smile among raters from different ethnicities, professions, genders, and ages and measure to what extent the presence or absence of the associated smiling structures influence the raters' evaluations.MethodsA male subject (26 years of age) with adequate smile characteristics was selected by 3 experienced orthodontists, and 561 raters from 2 different ethnic groups (281 Chinese raters and 280 Black raters) rated the subject's smile after the subject's upper dental midline was digitally altered from 0 to 5 mm using a 5-point Likert scale on 12 smile photographs divided into two groups: group 1, in the presence of smile related structures, two-thirds of the nose, lips, and chin (NLC), and group 2, in the absence of smile related structures, the lips only (L).ResultsThere were statistically significant differences (p < 0.05) between the two ethnicities, in 2 mm and 4 mm in-group NLC and 5 mm in-group L, as well as the raters' profession to each midline shift of both groups (NLC) and (L) for both ethnicities except for 0 mm. Regarding the role of associated smile structures, the smile photos were observed in the presence of smile-associated structures, and in its absence (NLC × L), statistically significant differences (p < 0.05) were found when the deviation was 5 mm among the Chinese raters; in 1 mm, and 4 mm among the Black raters. Among different genders, statistical differences were only reported (p < 0.05) for Chinese raters for 5 mm in NLC, while statistical differences were observed for 2 mm and 3 mm in NLC for Black raters. For age categories, differences were observed (p < 0.05) for 4 mm, 5 mm in NLC and 4 mm, and 5 mm in L for Chinese raters, while 5 mm in NLC and 1 mm in L for Black raters.ConclusionPerception of the upper dental midline deviations was influenced by the factors of ethnicity, profession, presence or absence of smile-associated structures, as well as the gender and age of the raters.
Conflict resolution styles and skills and variation among medical students
Authors: Gunasingha Rathnayaka M. Kalpanee D. , Lee Hui-Jie , Zhao Congwen , Clay Alison 
Published: April 2023

Abstract
Background
Conflict is inevitable on healthcare teams, yet few professional school curricula teach or assess conflict resolution skills. Little is known about the variation in conflict resolution styles across medical students and how these styles might impact conflict resolution skills.

Methods
This is a prospective, single blinded, group randomized quasi experimental trial to assess the impact of knowing one’s own conflict resolution style on conflict resolution skills in a simulated encounter. Graduating medical students completed a mandatory conflict resolution session with standardized patients acting as nurses during a transition to residency course. Coaches reviewed videotapes of the simulation, focusing on students’ skills with negotiation and emotional intelligence. Retrospectively, we assessed the impact of the students knowing their conflict resolution style prior to simulation, student gender, race, and intended field of practice on conflict resolution skills as judged by coaches.

Results
One hundred and eight students completed the simulated conflict session. Sixty-seven students completed the TKI before the simulated patient (SP) encounter and 41 after. The most common conflict resolution style was accommodating (n = 40). Knowing one’s conflict resolution style in advance of the simulation and one’s identified race/ethnicity did not impact skill as assessed by faculty coaches. Students pursuing diagnosis-based specialties had higher negotiation (p = 0.04) and emotional quotient (p = 0.006) scores than those pursuing procedural specialties. Females had higher emotional quotient scores (p = 0.02).

Conclusions
Conflict resolution styles vary among medical students. Male gender and future practice in a procedural specialty impacted conflict resolution skills but knowing conflict resolution style did not.
Creation of an asynchronous faculty development curriculum on well-written narrative assessments that avoid bias
Authors: Clay Alison S. , Andolsek Kathryn M. , Niederhoffer Kira , Kandakatla Apoorva , Zhang Gloria , Price Meghan , Alagesan Priya , Jeffs Sydney , DeLaura Isabel , Nicholson C. Phifer , Chudgar Saumil M. , Narayan Aditee P. , Knudsen Nancy W. , Blazar Melinda , Edwards Pamela , Buckley Edward G. 
Published: April 2023

Abstract
Background
The COVID-19 pandemic in parallel with concerns about bias in grading resulted in many medical schools adopting pass/fail clinical grading and relying solely on narrative assessments. However, narratives often contain bias and lack specificity. The purpose of this project was to develop asynchronous faculty development to rapidly educate/re-educate > 2000 clinical faculty spread across geographic sites and clinical disciplines on components of a well-written narrative and methods to minimize bias in the assessment of students.

Methods
We describe creation, implementation, and pilot data outcomes for an asynchronous faculty development curriculum created by a committee of volunteer learners and faculty. After reviewing the literature on the presence and impact of bias in clinical rotations and ways to mitigate bias in written narrative assessments, the committee developed a web-based curriculum using multimedia learning theory and principles of adult learning. Just-in-time supplemental materials accompanied the curriculum. The Dean added completion of the module by 90% of clinical faculty to the department chairperson’s annual education metric.
Module completion was tracked in a learning management system, including time spent in the module and the answer to a single text entry question about intended changes in behavior. Thematic analysis of the text entry question with grounded theory and inductive processing was used to define themes of how faculty anticipate future teaching and assessment as a result of this curricula.

Outcomes
Between January 1, 2021, and December 1, 2021, 2166 individuals completed the online module; 1820 spent between 5 and 90 min on the module, with a median time of 17 min and an average time of 20.2 min. 15/16 clinical departments achieved completion by 90% or more faculty. Major themes included: changing the wording of future narratives, changing content in future narratives, and focusing on efforts to change how faculty teach and lead teams, including efforts to minimize bias.

Conclusions
We developed a faculty development curriculum on mitigating bias in written narratives with high rates of faculty participation. Inclusion of this module as part of the chair’s education performance metric likely impacted participation. Nevertheless, time spent in the module suggests that faculty engaged with the material. Other institutions could easily adapt this curriculum with provided materials.
Ten-year distant-recurrence risk prediction in breast cancer by CanAssist Breast (CAB) in Dutch sub-cohort of the randomized TEAM trial
Authors: Zhang Xi , Gunda Aparna , Kranenbarg Elma Meershoek-Klein , Liefers Gerrit-Jan , Savitha Badada Ananthamurthy , Shrivastava Payal , Serkad Chandra Prakash Vijay Kumar , Kaur Taranjot , Eshwaraiah Mallikarjuna Siraganahalli , Tollenaar Rob A. E. M. , van de Velde Cornelis J. H. , Seynaeve Caroline M. J. , Bakre Manjiri , Kuppen Peter J. K. 
Published: April 2023

Abstract
Background
Hormone receptor (HR)-positive, HER2/neu-negative breast cancers have a sustained risk of recurrence up to 20 years from diagnosis. TEAM (Tamoxifen, Exemestane Adjuvant Multinational) is a large, multi-country, phase III trial that randomized 9776 women for the use of hormonal therapy. Of these 2754 were Dutch patients. The current study aims for the first time to correlate the ten-year clinical outcomes with predictions by CanAssist Breast (CAB)—a prognostic test developed in South East Asia, on a Dutch sub-cohort that participated in the TEAM. The total Dutch TEAM cohort and the current Dutch sub-cohort were almost similar with respect to patient age and tumor anatomical features.

Methods
Of the 2754 patients from the Netherlands, which are part of the original TEAM trial, 592 patients’ samples were available with Leiden University Medical Center (LUMC). The risk stratification of CAB was correlated with outcomes of patients using logistic regression approaches entailing Kaplan–Meier survival curves, univariate and multivariate cox-regression hazards model. We used hazard ratios (HRs), the cumulative incidence of distant metastasis/death due to breast cancer (DM), and distant recurrence-free interval (DRFi) for assessment.

Results
Out of 433 patients finally included, the majority, 68.4% had lymph node-positive disease, while only a minority received chemotherapy (20.8%) in addition to endocrine therapy. CAB stratified 67.5% of the total cohort as low-risk [DM = 11.5% (95% CI, 7.6–15.2)] and 32.5% as high-risk [DM = 30.2% (95% CI, 21.9–37.6)] with an HR of 2.90 (95% CI, 1.75–4.80; P < 0.001) at ten years. CAB risk score was an independent prognostic factor in the consideration of clinical parameters in multivariate analysis. At ten years, CAB high-risk had the worst DRFi of 69.8%, CAB low-risk in the exemestane monotherapy arm had the best DRFi of 92.7% [vs CAB high-risk, HR, 0.21 (95% CI, 0.11–0.43), P < 0.001], and CAB low-risk in the sequential arm had a DRFi of 84.2% [vs CAB high-risk, HR, 0.48 (95% CI, 0.28–0.82), P = 0.009].

Conclusions
Cost-effective CAB is a statistically robust prognostic and predictive tool for ten-year DM for postmenopausal women with HR+/HER2−, early breast cancer. CAB low-risk patients who received exemestane monotherapy had an excellent ten-year DRFi.
Claudin-4-adhesion signaling drives breast cancer metabolism and progression via liver X receptor β
Authors: Murakami-Nishimagi Yuko , Sugimoto Kotaro , Kobayashi Makoto , Tachibana Kazunoshin , Kojima Manabu , Okano Maiko , Hashimoto Yuko , Saji Shigehira , Ohtake Tohru , Chiba Hideki 
Published: April 2023

Abstract
Background
Cell adhesion is indispensable for appropriate tissue architecture and function in multicellular organisms. Besides maintaining tissue integrity, cell adhesion molecules, including tight-junction proteins claudins (CLDNs), exhibit the signaling abilities to control a variety of physiological and pathological processes. However, it is still fragmentary how cell adhesion signaling accesses the nucleus and regulates gene expression.

Methods
By generating a number of knockout and rescued human breast cell lines and comparing their phenotypes, we determined whether and how CLDN4 affected breast cancer progression in vitro and in vivo. We also identified by RNA sequencing downstream genes whose expression was altered by CLDN4-adhesion signaling. Additionally, we analyzed by RT-qPCR the CLDN4-regulating genes by using a series of knockout and add-back cell lines. Moreover, by immunohistochemistry and semi-quantification, we verified the clinicopathological significance of CLDN4 and the nuclear receptor LXRβ (liver X receptor β) expression in breast cancer tissues from 187 patients.

Results
We uncovered that the CLDN4-adhesion signaling accelerated breast cancer metabolism and progression via LXRβ. The second extracellular domain and the carboxy-terminal Y197 of CLDN4 were required to activate Src-family kinases (SFKs) and the downstream AKT in breast cancer cells to promote their proliferation. Knockout and rescue experiments revealed that the CLDN4 signaling targets the AKT phosphorylation site S432 in LXRβ, leading to enhanced cell proliferation, migration, and tumor growth, as well as cholesterol homeostasis and fatty acid metabolism, in breast cancer cells. In addition, RT-qPCR analysis showed the CLDN4-regulated genes are classified into at least six groups according to distinct LXRβ- and LXRβS432-dependence. Furthermore, among triple-negative breast cancer subjects, the "CLDN4-high/LXRβ-high" and "CLDN4-low and/or LXRβ-low" groups appeared to exhibit poor outcomes and relatively favorable prognoses, respectively.

Conclusions
The identification of this machinery highlights a link between cell adhesion and transcription factor signalings to promote metabolic and progressive processes of malignant tumors and possibly to coordinate diverse physiological and pathological events.
Some inequalities related to Csiszár divergence via diamond integral on time scales
Authors: Bilal Muhammad , Khan Khuram Ali , Nosheen Ammara , Pečarić Josip 
Published: April 2023

AbstractIn this paper, Csiszár f-divergence via diamond integral is introduced and some inequalities related to Csiszár f-divergence involving diamond integrals are presented. Some examples are presented for different divergence measures by fixing time scales. Some divergence measures are estimated in terms of logarithmic, identric, geometric, and arithmetic means. The obtained results generalize some known results in the literature and provide new bounds for some divergence measures in q-calculus.
A Tseng-type algorithm for approximating zeros of monotone inclusion and J-fixed-point problems with applications
Authors: Adamu Abubakar , Kumam Poom , Kitkuan Duangkamon , Padcharoen Anantachai 
Published: April 2023

AbstractIn this paper, a Halpern–Tseng-type algorithm for approximating zeros of the sum of two monotone operators whose zeros areJ-fixed points of relativelyJ-nonexpansive mappings is introduced and studied. A strong convergence theorem is established in Banach spaces that are uniformly smooth and 2-uniformly convex. Furthermore, applications of the theorem to convex minimization and image-restoration problems are presented. In addition, the proposed algorithm is used in solving some classical image-recovery problems and a numerical example in a Banach space is presented to support the main theorem. Finally, the performance of the proposed algorithm is compared with that of some existing algorithms in the literature.
Depression and opinion of dental students regarding the hybrid learning model during the COVID-19 pandemic
Authors: Orozco Marco Felipe Salas , de González Wendy Yesenia Escobar , Marín Nuria Patiño , Hernández Jesús Ramón Castillo , Hernandez-Cabanillas Juan Carlos , Acosta Ivan Olivares , Rider Ricardo Martinez , Casillas Santana Miguel Angel 
Published: April 2023

Abstract
Background
The global spread of COVID-19 forced schools at all educational levels to close, which was repeated in more than 60 countries. In addition, the COVID-19 pandemic has affected the mental health of dental students world wide. This study hypothesizes that the prevalence of depression in dental students from El Salvador is higher than that reported in studies from Europe, Asia, and North America.

Methods
This study was an online cross-sectional survey performed at the Faculty of Dentistry of the University of Salvador. The PHQ-9 questionnaire was applied to know the level of depression of the students, and a questionnaire focused on learning the opinion of the students on the hybrid teaching model adopted. Approximately 450 students participated in both questionnaires.

Results
Regarding the levels of depression present in the students, 14% had minimal depression, 29% had medium depression, 23% had moderate depression and, 34% had severe depression. The students had an excellent opinion regarding the hybrid learning model.

Conclusions
The prevalence of depression in dental students in El Salvador seems to be higher than that reported in studies in non-Latin American countries. Therefore, universities must generate care plans for mental health to avoid these harmful effects on students during future contingencies.
Electrical conduction investigation of pre-stressed carbon/epoxy fabric laminates heated by ampere-level currents
Authors: Zhou Gang , Mikinka Ewa , Bao Xujin , Sun Weiwei 
Published: April 2023

AbstractA study on electrical conduction of carbon/epoxy laminates has so far been conducted in an ad hoc nature without a standardised method, involving many extrinsic factors. How these factors affect electrical conduction of carbon/epoxy laminates has not been well established. The objectives of this work are to ascertain the effects of electrical currents, temperatures, and clamping torques on the anisotropic electrical conduction of carbon/epoxy laminates. Two-probe method with solid electrodes was developed with machined carbon/epoxy laminate specimens of various dimensions. The contributions of elevated temperatures and clamping pressures to electrical conduction were investigated. Various contact conditions with or without conductive paint were examined. The relationship of electrical resistance correlating with temperature and clamping pressure was developed to aid an analysis of data trends. From the average test results of 18 groups, aided with qualitative predictions, the milliampere-to-ampere increases of current led to significant reductions in electrical conductivities in both in-plane and through-the-thickness directions. The rises of temperatures resulted in the similar reductions in electrical conductivity due to the increased resistance. The increase in clamping torque increased the electrical conductivity values in both directions. Applying conductive paint to the contact faces did not appear to affect the contact resistance. Thus, the enhanced values of electrical conductivity from the painted specimens were attributed to their lower body temperatures, as the conductive paint at the contact faces soaked up the substantial amount of the electrical energies.