bluuebunny/crossref_metadata_2025 huggingface dataset:
Drivers and distribution of forest fires in Sikkim Himalaya: A maximum entropy-based approach to spatial modelling.
Authors: Banerjee Polash
Published: October 2020

The recent episodes of forest fire in Brazil and Australia of 2019 are tragic reminders of the hazards of the forest fire. Globally incidents of forest fire events are in the rise due to human encroachment into wilderness and climate change. Sikkim with a forest cover of more than 47%, suffers seasonal instances of frequent forest fire during the dry winter months. To address this issue, a GIS-aided and MaxEnt machine learning-based forest fire prediction map has been prepared using forest fire inventory database and maps of environmental features. The study indicates that amongst the environmental features, climatic conditions and proximity to roads are the major determinants of the forest fire. Model validation criteria like ROC curve, correlation coefficient and Cohen’s Kappa show a good predictive capability (AUC = 0.95, COR = 0.78, κ = 0.78). The outcomes of this study in the form of a forest fire prediction map can aid the stakeholders of the forest in taking informed mitigation measures.
Adolescent and non-consensual anal sexual debut among Chinese men who have sex with men: a cross-sectional study
Authors: Tang Weiming , Wang Yehua , Huang Wenting , Wu Dan , Yang Fan , Xu Yongshi , Ong Jason J. , Fu Hongyun , Yang Bin , Wang Cheng , Ma Wei , Wei Chongyi , Tucker Joseph D.
Published: October 2020

Background: Adolescent sexual debut and non-consensual sex have been linked to higher sexual risk and STI infection in adulthood among men who have sex with men (MSM) in high-income countries. This study aimed to examine adolescent and non-consensual anal sexual debut among Chinese MSM and to evaluate factors associated with adolescent sexual debut and non-consensual anal sex.Methods: A cross-sectional study was conducted recently among Chinese men assigned male sex at birth, ≥18 years old, and who had ever engaged in anal sex with a man. Participants answered questions regarding socio-demographics, condomless sex, age at anal sexual debut with a man, and whether the first anal sex was consensual. Factors associated with an adolescent sexual debut (<18 years old) and non-consensual sex at sexual debut were evaluated. We defined adolescent sexual debut as having anal sex with another man at 17 years old or younger, and the participants were asked whether their first male-to-male anal sex was non-consensual.Results: Overall, 2031 eligible men completed the survey. The mean age of sexual debut was 20.7 (SD=4.3) years old. 17.6% (358/2031) of men reported adolescent sexual debut, and 5.0% (101/2031) reported a non-consensual sexual debut. The adolescent sexual debut was associated with having more male sexual partners (adjusted OR 1.10, 95% CI 1.06–1.15) and condomless anal sex in the last three months (AOR=1.71, 95% CI 1.34-2.18). MSM whose sexual debut was non-consensual were more likely to have condomless anal sex (AOR=1.76, 95% CI 1.17-2.66), and to have reported an adolescent sexual debut (AOR=2.72, 95% CI 1.75-4.21).Conclusions: Many Chinese MSM reported adolescent sexual debut and non-consensual sex, both of which are associated with sexual risk behaviors and drive STI transmission. These findings highlight the need for designing tailored interventions for MSM who experienced adolescent sexual debut and non-consensual sex at debut.
Genomic profile of MYCN non-amplified neuroblastoma and potential for immunotherapeutic strategies in neuroblastoma
Authors: Lee Eunjin , Lee Ji Won , Lee Boram , Park Kyunghee , Shim Joonho , Yoo Keon Hee , Koo Hong Hoe , Sung Ki Woong , Park Woong-Yang
Published: October 2020

Background: MYCN amplification is the most important genomic feature in neuroblastoma (NB). However, limited studies have been conducted on the MYCN non-amplified NB including low- and intermediate-risk NB. Here, the genomic characteristics of MYCN non-amplified NB were studied to allow for the identification of biomarkers for molecular stratification.

Methods: Fifty-eight whole exome sequencing (WES) and 48 whole transcriptome sequencing (WTS) samples of MYCN non-amplified NB were analysed. Forty-one patients harboured WES and WTS pairs .

Results: In the MYCN non-amplified NB WES data, maximum recurrent mutations were found in MUC4 (26%), followed by RBMXL3 (19%), ALB (17%), and MUC16 and SEPD8 (14% each). Two gene fusions, CCDC32 - CBX3 (10%) and SAMD5 - SASH1 (6%), were recurrent in WTS analysis, and these fusions were detected mostly in non-high-risk patients with ganglioneuroblastoma histology. Analysis of risk-group-specific biomarkers showed that several genes and gene sets were differentially expressed between the risk groups, and some immune-related pathways tended to be activated in the high-risk group. Mutational signatures 6 and 18, which represent DNA mismatch repair (MMR) associated mutations, were commonly detected in 60% of the patients. In the tumour mutation burden (TMB) analysis, four patients showed high TMB (> 3 mutations/Mb), and had mutations in genes related to either MMR or homologous recombination. Excluding four outlier samples with TMB > 3 Mb, high-risk patients had significantly higher levels of TMB compared with the non-high-risk patients.

Conclusions: This study provides novel insights into the genomic background of MYCN non-amplified NB. Activation of immune-related pathways in the high-risk group and the results of TMB and mutational signature analyses collectively suggest the need for further investigation to discover potential immunotherapeutic strategies for NB.
Transcriptomic and metabolomic profiling reveals the effect of LED light quality on morphological traits, and phenylpropanoid-derived compounds accumulation in Sarcandra glabra seedlings
Authors: Xie Dejin , Chen Lingyan , Zhou Chengcheng , Tarin Muhammad Waqqas Khan , Yang Deming , Ren Ke , He Tianyou , Rong Jundong , Zheng Yushan
Published: October 2020

Background: Sarcandra glabra is an evergreen and traditional Chinese herb with anti-oxidant, anti-bacterial, anti-inflammatory, and anti-tumor effects. Light is one of the most influential factor affecting the growth and quality of herbs. In recent times, the introduction of Light Emission Diode (LED) technology has been widely used for plants in greenhouse. However, the impact of such lights on plant growth and the regulatory mechanism of phenylpropanoid-derived compounds in S. glabra remain unclear. Results: The red LED light (RL) substantially increased the plant height and decreased the stem diameter and leaf area relative to the white LED light (WL), while the blue LED light (BL) significantly reduced the height and leaf area of S. glabra. According to transcriptomic profiling, 861, 378, 47, 10,033, 7917, and 6379 differentially expressed genes (DEGs) were identified among the groups of leaf tissue under BL (BY) vs. leaf tissue under RL (RY), BY vs. leaf tissue under WL (WY), RY vs. WY, root tissue under WL (WG) vs. WY, stem tissue under WL (WJ) vs. WG, and WJ vs. WY, respectively. We identified 46 genes encoding for almost all known enzymes involved in phenylpropanoid biosynthesis, e.g., phenylalanine ammonia lyase (PAL), chalcone synthase (CHS), and flavonol synthase (FLS). We found 53 genes encoding R2R3-MYB proteins and bHLH proteins, respectively, where several were related to flavonoids biosynthesis. A total of 454 metabolites were identified based on metabolomic profiling, of which 44, 87, and 296 compounds were differentially produced in WY vs. RY, WY vs. BY, and WY vs. WG. In BY there was a substantial reduction in the production of esculetin, caffeic acid, isofraxidin, and fraxidin, while the yields of quercitrin and kaempferol were significantly up-regulated. In RY, the contents of cryptochlorogenic acid, cinnamic acid, and kaempferol decreased significantly. Besides, in WG, the production of metabolites (e.g. chlorogenic acid, cryptochlorogenic acid, and scopolin) declined, while their yields increased significantly (e.g. esculetin, fraxetin, isofraxidin, and fraxidin).Conclusion: These results provide further insight into the regulatory mechanism of accumulation patterns of phenylpropanoid-derived compounds in S. glabra under various light conditions, allowing optimum breeding conditions to be developed for this plant.
Determinants of participation in a post-hospitalization physical exercise program for older adults
Authors: Urquiza Miriam , Echeverria Iñaki , Besga Ariadna , Amasene Maria , Labayen Idoia , Rodriguez Ana , Barroso Julia , Aldamiz Mikel , Irazusta Jon
Published: October 2020

BACKGROUND: Older patients often experience a decline in physical function and cognitive status after hospitalization. Although interventions involving physical exercise are effective in improving functional performance, participation in physical exercise interventions among older individuals is low. We aimed to identify factors that contribute to exercise refusal among post-hospitalized older patients.METHODS: A cross-sectional study of recruitment data from a randomized controlled trial was conducted involving 495 hospitalized people ≥70 years old. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We determined physical function with the Short Physical Performance Battery (SPPB), nutritional status with the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U, or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model.RESULTS: Among the analyzed patients, 88.8% declined participation in the physical exercise program. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.07 - 1.19), poor nutritional status (OR: 0.81; 95% CI: 0.69 - 0.95), and reduced home accessibility (OR: 0.27; 95% CI: 0.08 - 0.94) were predictors of participation refusal. Moreover, patients who declined participation had worse performance on the SPPB (P < 0.05) and its tests of balance, leg strength, and walking speed (P < 0.05). No differences were found between groups in other variables. CONCLUSIONS: This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with increased age, poor nutritional status, and reduced home accessibility. Our findings support the need for intervention design that accounts for these factors to increase older patient participation in beneficial exercise programs.TRIAL REGISTRATION: ACTRN12619000093189 (retrospectively registered): Registered January 22, 2019.
Multilevel modelling of the risk of malaria among children aged under five years in Nigeria
Authors: Oguoma Victor M , Anyasodor Anayochukwu E , Adeleye Adeniyi O , Eneanya Obiora A , Mbanefo Evaristus C
Published: October 2020

Background:Malaria is still a major cause of morbidity and mortality among children under five (U5) years. This study assessed individual, household, and community risk factors for malaria in Nigerian children U5 years of age.Methods:Data from the Nigerian Malaria Health Indicator Survey 2015 were pooled for analyses. This comprised of national survey of 329 clusters. Children aged 6-59 months who were tested for malaria using microscopy were retained. Multilevel logit model accounting for sampling design was used to assess individual, household and community factors associated with malaria parasitaemia. Results:A total of 5742 children were assessed for malaria parasitaemia with overall prevalence of 27% (95% CI 26-28%). Plasmodium falciparum constituted 98% of the Plasmodium species. There was no significant difference in parasitaemia between older children, and those ≤12 months. In adjusted analyses, rural living, Northwest region, household size of >7, dependence on river and rain water as primary water source were associated with higher odds of parasitaemia; while higher wealth index, all U5s who slept under bed net and dependence on packaged water were associated with lower odds of parasitaemia.Conclusion:Despite sustained investment in malaria control and prevention, a quarter of the overall study population of U5s suffer from malaria. Across the six geopolitical zones, the highest burden was in children living in poorest rural households.
The impact of COL1A1 and COL6A1 expression on hypospadias and penile curvature severity
Authors: yuri prahara , Gunadi . , Lestari Rahmadani Puji , Fardilla Firly Putri , Setyaningsih Wiwit Ananda Wahyu , Arfian Nur , Dachlan Ishandono
Published: October 2020

Background : Hypospadias, the most frequent congenital male external genitalia abnormality, is usually associated with curvature of the ventral penis, i.e. chordee. Abnormality of darto tissue has been suggested as the pathophysiology of chordees. Collagen is one of the most abundant fibrous proteins within the extracellular matrix. In this study, we determined the expression of collagen 1 (COL1A1) and COL6A1 in patients with hypospadias and associated them with the severity of penile curvature.
Methods : We included 60 children <18 years old, consisting of 20 distal hypospadias, 20 proximal hypospadias patients, and 20 controls in our institution from 2017 – 2020. The expression of COL1A1 and COL6A1 in darto tissue was determined by reverse-transcriptase polymerase chain reaction (qPCR). The penile curvature severity was classified as mild (<30 degrees), moderate (30-60 degrees), and severe (>60degrees).
Results : qPCR showed that COL1A1 and COL6A1 expression was significantly downregulated in the distal (0.88 (0.38-2.53) and 0.54 (0.16-4.35), respectively) and proximal 0.76 (0.33-2.57) and 0.57 (0.18-1.38), respectively) hypospadias groups compared to controls (1.85 (0.24-4.61) and 0.93 (0.17-4.06), respectively) with p -values of 0.024 and 0.018, respectively. Furthermore, there was a moderate correlation between COL1A1 and COL6A1 expression ( r= 0.458, p< 0.0001). Interestingly, COL1A1 and COL6A1 were also significantly downregulated in the moderate and severe chordee groups compared to the mild chordee groups, with p -values of 0.003 and 0.037, respectively.
Conclusions : Aberrant COL1A1 and COL6A1 expression might affect abnormalities in darto tissue and penile curvature severity in hypospadias patients.
Keywords: chordee; COL1A1 ; COL6A1 ; expressions; hypospadias; penile curvature severity; qPCR
The Impact of Dementia and Language on Hospitalizations. A Retrospective Cohort of Long-Term Care Residents.
Authors: Riad Karine , Webber Colleen , Batista Ricardo , Reaume Michael , Rhodes Emily , Knight Braden , Prud’homme Denis , Tanuseputro Peter
Published: October 2020

Background: Hospitalizations carry considerable risks for frail, elderly patients; this is especially true for patients with dementia, who are more likely to experience delirium, falls, functional decline, iatrogenic complications, and infections when compared to their peers without dementia. Since up to two thirds of patients in long-term care (LTC) facilities have dementia, there is interest in identifying factors associated with transitions from LTC to hospitals. The purpose of this study was to investigate the association between dementia status and incidence of hospitalization among residents in LTC in Ontario, Canada, and to determine whether this association is modified by linguistic factors.
Methods: We used linked administrative databases to establish a prevalent cohort of 81,188 residents in 628 LTC facilities from April 1 st 2014 to March 31, 2017. Diagnoses of dementia were identified with a previously validated algorithm; all other patient characteristics were obtained from in-person assessments. Residents’ primary language was coded as English or French; facility language (English or French) was determined using language designation status according to the French Language Services Act . We identified all hospitalizations within 3 months of the first assessment performed after April 1 st 2014. We performed multivariate logistic regression analyses to determine the impact of dementia and resident language on the incidence of hospitalization; we considered interactions between dementia and both resident language and resident-facility language discordance.

Results: The odds of hospitalization were 39% lower for residents with dementia compared to residents without dementia (OR 0.61, 95% CI 0.57–0.65). Francophones had lower odds of hospitalization than Anglophones, but this difference was not statistically significant (OR 0.91, 95% CI 0.81 – 1.03). However, Francophones without dementia were significantly less likely to be hospitalized compared to Anglophones without dementia (OR 0.71, 95% CI 0.53 – 0.94). Resident-facility language discordance did not significantly affect hospitalizations.

Conclusions: Residents in LTC facilities were generally less likely to be hospitalized if they had dementia, or if their primary language was French and they did not have dementia. These findings could be explained by differences in end-of-life care goals; however, they could also be the result of poor patient-provider communication.
Knowledge among the rural parents about the vaccinations and vaccination coverage of children in the first year of life in Papua New Guinea – analysis of data provided by Christian Health Services.
Authors: Gowin Ewelina , Kuzma Jerzy , Januszkiewicz-Lewandowska Danuta
Published: October 2020

Background: This analysis aimed to assess rural parents' knowledge about the diseases prevented by vaccinations and establish vaccination coverage in PNG. Methods: Knowledge on vaccinations was checked through a standard questionnaire (five open questions). We analyzed data on vaccination coverage from 2016 to 2018 from all Catholic health facilities. Analyzed vaccinations were the pentavalent vaccine (DTaP-HiB-HepB) and measles vaccine given in the first year of life. Coverage was calculated based on the number of vaccines used compared to the number of eligible children. Results: 56 parents, including 52 mothers and four fathers, participated in the interview. The majority of parents (46%) understood that the vaccine prevents the child from the sick. During the analyzed period, a total of 25,502 doses of measles vaccine was given, 31,428 children were vaccinated with the pentavalent vaccine. In 2016, the coverage rate for the measles vaccine was 26.6% and 33.4% for the pentavalent vaccine. In 2017, the coverage rate for measles and pentavalent vaccines was 12.5% and 16.6%, respectively. There were significant differences in immunization coverage between provinces. A decreasing trend in the number of administered vaccinations was observed. Conclusion: The results of this analysis demonstrate that in PNG, the majority of children are not fully immunized. There are big differences in vaccination coverage between provinces. The problem is the lack of public understanding of the need for vaccinations. Lack of patient vaccination records makes it difficult to establish individual vaccination history.
Natural hybridization between two butterfly bushes in Tibet: dominance of F1 hybrids promotes strong reproductive isolation   
Authors: Liao Rongli , Sun Weibang , Ma Yongpeng
Published: October 2020

Background: F1 hybrids acting as a bridgehead for producing later generation hybrids can have evolutionary significance through strengthening reproductive isolation or facilitating gene flow between parental species, depending on whether backcrossing can occur. It had been suggested that the Tibetan plant Buddleja wardii was a hybrid species between B. alternifolia and B. crispa based on their sympatric distributions and the morphological characters in last century. Till now however, we still have limited evidence to prove key issues to B. wardii, like if it is of hybrid origin indeed and whether it is currently a true hybrid species already.Results: In the present study, two sympatric populations of these three taxa were examined and compared using four nuclear genes and three chloroplast intergenic spacers, as well as with 10 morphological characters. Our results suggest that at both sites B. × wardii was likely to be a hybrids between B. alternifolia and B. crispa, and moreover, most of the hybrids present were confirmed to be F1s. This was further supported by morphology as no transgressive characters were detected. B. crispa was found to be the maternal parent in one population (BH), while in the second population (TJ), it was difficult to distinguish the hybridization direction due to shared haplotypes of cpDNA between B. alternifolia and B. crispa. Conclusions: These results provide evidence that the natural hybrids between B. alternifolia and B. crispa mainly comprise F1 hybrids, which have subsequently been given the name B. wardii. The F1 hybrids have also contributed to strong reproductive isolation between parental species.
Degradation and sorption of the herbicides 2,4-D and quizalofop-P-ethyl and their metabolites in soils from railway tracks
Authors: Buerge Ignaz J , Pavlova Pavlina , Hanke Irene , Bächli Astrid , Poiger Thomas
Published: October 2020

Background Broad spectrum of activity and low potential for leaching to groundwater are important arguments for the application of the herbicide glyphosate on railway tracks. Nevertheless, certain weeds are insufficiently controlled or develop resistance, and there is also an ongoing controversial discussion about possible carcinogenicity of glyphosate. Alternatives are thus strongly desired. 2,4-D and quizalofop-P-ethyl (QE) are two selective herbicides with a complementary spectrum of activity. When used in agriculture, the compounds and their metabolites exhibit low groundwater contamination potential. Uses on railway tracks may, however, be more critical since degradation likely is slower and mobility higher than in agricultural soils. In this study, we investigated degradation and sorption of the two active substances as well as five metabolites in three soils collected from railway tracks and in a crushed sand, used for construction works.Results In these railway materials, the compounds were indeed degraded slower than in agricultural soils (mean half-lives differed by a factor of 1.4-26, depending on the substance) and mobility was higher (mean sorption coefficients differed by a factor of 3-19). Half-lives and sorption coefficients were also estimated by extrapolation of data from agricultural soils, considering the organic carbon content of railway soils and agricultural soils. Estimated values were more conservative than measured values. Conclusions Based on our experimental data, possible leaching to groundwater is predicted to be highest for 2,4-D and quizalofop-acid, the primary metabolite of QE, moderate for 2,4-dichlorophenol, the primary metabolite of 2,4-D, but low for QE. Secondary and tertiary metabolites were formed in only low quantities. For herbicides, for which no measured parameters are available for railway soils, estimated values may also be a viable alternative for a first tier groundwater assessment.
Reductive dissolution of biogenic magnetite
Authors: Yamazaki Toshitsugu
Published: October 2020

Reductive dissolution of magnetite is known to occur below the Fe-redox boundary in sediments. In this study detailed processes associated with biogenic magnetite dissolution are documented. A sediment core from the Japan Sea was used for this purpose, in which reductive dissolution of magnetic minerals is known to start at depths of about 1.15 m and is mostly complete within a depth interval of about 0.35 m. Using first-order reversal curve diagrams, preferential dissolution of biogenic magnetite within this interval is estimated from the observation that a narrow peak that extends along the coercivity axis (central ridge), which is indicative of biogenic magnetite, diminishes downcore. Transmission electron microscopy is used to demonstrate that the sediments contain three magnetofossil morpho-types: octahedra, hexagonal prisms, and bullet-shaped forms. Within the reductive dissolution zone, partially etched crystals are commonly observed. With progressive dissolution, the proportion of bullet-shaped magnetofossils decreases, whereas hexagonal prisms become more dominant. This observation can be explained by the differences in resistance to dissolution among crystal planes of magnetite and the differences in surface area to volume ratios. Magnetofossil morphology may reflect the preference of magnetotactic bacterial lineages for inhabiting specific chemical environments in sediments. However, it could also reflect alteration of the original morphological compositions during reductive diagenesis, which should be considered when using magnetofossil morphology as a paleoenvironmental proxy.
Long interspersed nuclear element 1 hypomethylation has novel prognostic value and potential utility in liquid biopsy for oral cavity cancer
Authors: Misawa Kiyoshi , Yamada Satoshi , Mima Masato , Nakagawa Takuya , Kurokawa Tomoya , Imai Atsushi , Mochizuki Daiki , Shinmura Daichi , Yamada Taiki , Kita Junya , Ishikawa Ryuji , Yamaguchi Yuki , Misawa Yuki , Kanazawa Takeharu , Kawasaki Hideya , Mineta Hiroyuki
Published: October 2020

Background: New biomarkers are urgently needed to improve personalized treatment approaches for head and neck squamous cell carcinoma (HNSCC). Global DNA hypomethylation has wide-ranging functions in multistep carcinogenesis, and the hypomethylation of long interspersed nucleotide element-1 (LINE-1) has been generally considered to be related with increased retrotransposon activity and induced genome instability. However, little information is available regarding LINE-1 hypomethylation and its prognostic implications in HNSCC. Methods: In this study, we analyzed LINE-1 hypomethylation levels in a well-characterized dataset of 317 matched pairs of HNSCC tissues and oral cavity cancer (OCC) circulating tumor DNA (ctDNA) using quantitative real-time methylation and unmethylation PCR. This analysis was performed according to various clinical characteristics and prognostic implications. Results: Our results demonstrated that LINE-1 hypomethylation levels were significantly higher in HNSCC tissues than in corresponding normal tissues from the same individuals (P < 0.001). Univariate analysis revealed that high levels of LINE-1 hypomethylation were correlated with poor disease-free survival (DFS; log-rank test, P = 0.038), whereas multivariate analysis demonstrated that it is a significant independent prognostic factor for DFS (hazard ratio: 2.10, 95% confidence interval: 1.02–4.36; P = 0.045). Moreover, patients with high LINE-1 hypomethylation levels exhibited the greatest decrease in 5-hydroxymethylcytosine (5-hmC) levels and increase in tumor-suppressor gene methylation index (P = 0.006 and P < 0.001, respectively). Further ctDNA studies also showed that LINE-1 hypomethylation had high predictive ability for OCC. Conclusions: LINE-1 hypomethylation is associated with a higher risk of early OCC relapse, and is hence, a potential predictive biomarker for OCC. Furthermore, 5-hmC levels also exhibited predictive potential in OCC, based on its inverse correlation with LINE-1 hypomethylation levels. LINE-1 hypomethylation analysis, therefore, has applications in determining patient prognosis and real-time surveillance for disease recurrence, and could serve as an alternative method for OCC screening.
Effects of immediate and delayed loading protocols on marginal bone loss around implants in unsplinted mandibular implant-retained overdentures: A systematic review and meta-analysis
Authors: Liu Wei , Cai He , Zhang Junjiang , Wang Jian , Sui Lei
Published: October 2020

Background: Immediate loading has recently been introduced into unsplinted mandibular implant-retained overdentures for the management of edentulous patients due to their increasing demand on immediate aesthetics and function. However, there is still a scarcity of meta-analytical evidence on the efficacy of immediate loading compared to delayed loading in unsplinted mandibular implant-retained overdentures. The purpose of this study was to compare the marginal bone loss (MBL) around implants between immediate and delayed loading of unsplinted mandibular implant-retained overdentures.
Methods: Randomized controlled trials (RCTs), controlled clinical trials (CCTs), and cohort studies quantitatively comparing the MBL around implants between immediate loading protocol (ILP) and delayed loading protocol (DLP) of unsplinted mandibular overdentures were included. A systematic search was carried out in PubMed, EMBASE, and CENTRAL databases on April 28, 2020. “Grey” literature was also searched. A meta-analysis was conducted to compare the pooled MBL of two different loading protocols of unsplinted mandibular overdentures through weighted mean differences with 95% confidence intervals. The subgroup analysis was performed between different attachment types ( i.e. Locator attachment vs. ball anchor). The risk of bias within and across studies were assessed using the Cochrane Collaboration’s tool, the Newcastle-Ottawa scale, and Egger's test.
Results: Of 305 records, five RCTs and two cohort studies were included and evaluated, which totally contained 191 participants with a follow-up of no less than 12 months. The MBL of ILP group showed no significant difference with that of DLP group (WMD0.04, CI -0.13 to 0.21, P > .05). Subgroup analysis revealed similar results between the two different loading groups restored with Locator attachments or ball anchors ( P > .05). Apart from one RCT (20%) with a high risk of bias, four RCTs (80%) showed a moderate risk of bias. Two prospective cohort studies were proved with acceptable quality. Furthermore, the Egger's test indicated no significant bias among seven included studies ( P > .05).
Conclusions: For unsplinted mandibular implant-retained overdentures, the MBL around implants after ILP seems comparable to that of implants after DLP. Immediate loading may be a promising alternative to delayed loading for the management of unsplinted mandibular implant-retained overdentures.
Clinical and MRI features of sacral insufficiency fractures after radiotherapy in patients with cervical cancer
Authors: Zhong Xi , Zhang Linqi , Dong Tianfa , Mai Hui , Lu Bingui , Huang Lu , Li Jiansheng
Published: October 2020

Background

To determine the incidence, clinical and MRI features of sacral insufficiency fracture (SIF) after radiotherapy (RT) in patients with cervical cancer.
Methods

Our study included 167 patients with cervical cancer after radiotherapy that underwent pelvic MRI for follow-up. MRIs included pre-enhanced T1-weighted, coronal fat-Suppressed T2-weighted (FS-T2W) and enhanced T1-weighted imaging. The clinical and MRI dates were reviewed. The gold standard of SIF was based on radiologic findings, clinical data and follow-up at least 12 months.
Results

28 patients (10.8%) with 47 sites were diagnosed with SIFs, including 9 patients with unilateral SIF and 19 patients with bilateral SIFs. The median age was 60 years (range 41–72 years), and 89.3% (25/28) of patients were postmenopausal. 64.3% (18/28) of patients were symptomatic, and 53.6% of patients (15/28) had concomitant pelvic fractures. The median interval time from RT to SIFs was 10 months (range 3 − 34 months). For the lesion-wise analysis based on all MR images, all lesions were detected by visualizing bone marrow edema patterns, and fracture lines were detected in 64.6% (31/47) of SIFs. No soft-tissue tumors were founded. For each MRI sequence analysis, coronal FS-T2WI detected the most bone marrow edema pattern and fracture line than T1WI or enhanced T1WI.
Conclusion

SIF is a common complication in cervical cancer after radiotherapy, which has some certain clinical and MRI features. Coronal FS-T2WI may be more useful to detect and characterize these fractures than other imaging sequences.
Exosomal microRNAs in Human Breast Milk: Potential Effect on Neonatal Breast Milk Jaundice
Authors: YANG Lifei , Hu Rui , Li Jing , Mo Xi , Xu Liqing , Shen Nan , Sheng Wangtao , Li Yaxuan
Published: October 2020

Background: The pathogenesis of breast milk jaundice (BMJ) remains unrevealed. While UGT1A1 gene has been extensively investigated in neonatal BMJ cases, the reason for down-regulation of UGT1A1 gene in neonatal BMJ has not been completely elucidated. In this research, the authors attempt to speculate whether there was some gene regulatory substance exist in human milk and result in BMJ, such as miRNA. This research aims to demonstrate the association between the profile of exosomal miRNA in human milk and the occurrence of neonate breast milk jaundice.Methods: A previous study conducted by Shanghai Children’s Medical Center of the Shanghai Jiao Tong University School of Medicine and the UIB International Maternity Care Center regarding 12 mother-infant dyads were recruited from September 2016 to December 2016. The subjects were divided into two groups (BMJ and control) for exosomal miRNA screening. Four methods of transmission electron microscopy (TEM), a nanoparticle tracking analyzer (NTA), flow cytometry (FCM), and Western blotting were used to identify the exosome in human milk. Based on the previous study, this research determines the expression profile of miRNA in human milk exosomes by small RNA sequencing. Based on the biological information analysis, the authors not only screen the differentially expressed miRNA but also predict the target genes. Then, another 20 mother-infant dyads were recruited for realtime PCR assay to verify the difference of predicted microRNAs expression in breast milk exosomes and to explore the correlation between differentially expressed microRNAs in breast milk and neonatal breast milk jaundice. Results: Human milk exosomes are rich in various types of microRNA, especially let-7g-5p, let-7b-5p, has-miR-21-5p, has-miR-375, has-miR-99a-5p, et al. The predicted target genes of miR-127-3p are statistically significantly overexpressed in BMJ group, including the gene of UGT1A1 which expresses key enzyme in process of bilirubin metabolism. Conclusions: Exosomal miRNA-127-3p plays a potential effect on neonatal breast milk jaundice.
A Qualitative Study of Healthcare Experiences Among Chinese Homebound Adults Receiving Home Health Care Services
Authors: Zhou Rui , Cheng Joyce , Wang Shuangshuang , Yao Nengliang (Aaron)
Published: October 2020

Background: Home health care services (HHC) are emerging in China to meet increased healthcare needs among the homebound population, but research examining the efficiency and effectiveness of this new care model is rare. This study aimed to investigate care recipients’ experiences with HHC and areas for improvement in China.Methods: This research was a qualitative study based on semi-structured interviews. Qualitative data were collected from homebound adults living in Jinan, Zhangqiu, and Shanghai, China. A sample of 17 homebound participants aged 45 or older (mean age = 76) who have received home-based clinical care were recruited. Colaizzi’s descriptive phenomenological method was used to generate qualitative codes and identify themes.Results: The evaluations of participants’ experiences with HHC yielded both positive and negative aspects. Positive experiences included: 1) the healthcare delivery method was convenient for homebound older adults; 2) health problems could be detected in a timely manner because doctors visited regularly; 3) home care providers had better bedside manners and technical skills than did hospital-based providers; 4) medical insurance typically covered the cost of home care services. Areas that could potentially be improved included: 1) the scope of HHC services was too limited to meet all the needs of homebound older adults; 2) the visit time was too short; 3) healthcare providers’ technical skills varied greatly.Conclusions: Findings from this study suggested that the HHC model benefited Chinese older adults, primarily homebound adults, in terms of convenience and affordability. There are opportunities to expand the scope of home health care services and improve the quality of care. Policymakers may consider providing more resources and incentives to enhance HHC in China. Educational programs may be created to train more HHC providers and improve their technical skills.Trial registration: Not applicable
β-glucan from Lentinula Edodes Prevents Cognitive Impairments in High-Fat Diet-Induced Obese Mice: Involvement of Colon-Brain Xxis
Authors: Pan Wei , Jiang Pengfei , Zhao Jinxiu , Shi Hongli , Zhang Peng , Yang Xiaoying , Biazik Joanna , Hu Minmin , Hua Hui , Ge Xing , Huang Xufeng , Yu Yinghua
Published: October 2020

Background: Long-term high fat (HF) diet intake can cause neuroinflammation and cognitive decline through the gut-brain axis. (1, 3)/(1, 6)-β-glucan, an edible polysaccharide isolated from medical mushroom, Lentinula edodes (L. edodes), has the potential to remodel gut microbiota. However, the effects of L. edode derived β-glucan against HF diet-induced neuroinflammation and cognitive decline remain unknown. This study aimed to evaluate the neuroprotective effect and mechanism of dietary L edodes β-glucan supplementation against the obesity-associated cognitive decline in mice fed by a HF diet. Methods: C57BL/6J male mice were fed with either a lab chow (LC), HF or HF with L. edodes β-glucan supplementation diets for 7 days (acute) or 15 weeks (chronic). Cognitive behavior was examined; blood, cecum content, colon and brain were collected to evaluate metabolic parameters, endotoxin, gut microbiota, colon, and brain pathology.Results: We reported that acute L. edodes β-glucan supplementation prevented the gut microbial composition shift induced by the HF diet. Chronic L. edodes β-glucan supplementation prevented the HF diet-induced recognition memory impairment assessed by behavioral tests (the temporal order memory, novel object recognition and Y-maze tests). In the prefrontal cortex and hippocampus, the β-glucan supplementation ameliorated the alteration of synaptic ultrastructure, neuroinflammation and brain-derived neurotrophic factor (BDNF) deficits induced by HF diet. Furthermore, the β-glucan supplementation increased the mucosal thickness, upregulated the expression of tight junction protein occludin, decreased the plasma LPS level, and inhibited the proinflammatory macrophage accumulation in the colon of mice fed by HF diet. Conclusions: This study revealed that L. edodes β-glucan prevents cognitive impairments induced by the HF diet, which may occur via colon-brain axis improvement. The finding suggested that dietary L. edodes β-glucan supplementation may be an effective nutritional strategy to prevent obesity-associated cognitive decline.
Impact of Immune Checkpoint Inhibitor Therapy on The Overall Survival in Elderly Patients With Non-Small Cell Lung Cancer
Authors: Inomata Minehiko , Azechi Kenji , Takata Naoki , Hayashi Kana , Tokui Kotaro , Taka Chihiro , Okazawa Seisuke , Kambara Kenta , Imanishi Shingo , Miwa Toshiro , Hayashi Ryuji , Matsui Shoko , Tobe Kazuyuki
Published: October 2020

Purpose: We analyzed the relationship between a history of immune checkpoint inhibitor and overall survival in patients with non-small cell lung cancer (NSCLC) aged ≥ 70 years. Methods: We conducted a retrospective analysis of the data of patients with NSCLC aged ≥70 years old who had received systemic anticancer therapy at our institution between 2015 and 2019. Results: The analysis included the data of a total of 63 patients, including 36 patients who had received immune checkpoint inhibitor therapy and 27 patients who had not received treatment with an immune checkpoint inhibitor. Univariate analysis revealed a longer overall survival in patients who had received treatment with an immune checkpoint inhibitor as compared to those who had not received treatment with an immune checkpoint inhibitor (median: 17.2 vs. 9.8 months; p = 0.026, log-rank test). Multivariate analysis revealed a significant association between a history of treatment with immune checkpoint inhibitors and the overall survival (hazard ratio, 95% confidence interval: 0.42, 0.20-0.86; p = 0.019, Cox proportional hazards model). A significant interaction was also observed between a history of treatment with an immune checkpoint inhibitor and the tumor histology (p = 0.006), the association between the overall survival and a history of immune checkpoint inhibitor therapy being stronger in the non-small cell lung cancer patients with squamous cell carcinoma than in those with adenocarcinoma. Conclusion: A significant association between history of immune checkpoint inhibitor therapy and the overall survival was detected in elderly NSCLC patients aged ≥70 years old in a clinical practice setting. Our results also suggested that the impact of immune checkpoint inhibitor therapy on the survival differed depending on the tumor histology.
Clinical Significance of Systemic Inflammation Response Index and Platelet–lymphocyte Ratio in Patients with Adenocarcinoma of The Esophagogastric Junction and Upper Gastric Cancer
Authors: Yin Xin , Fang Tianyi , Lin Xuan , Cong Xiliang , Wang Yimin , Li Chunfeng , Ma Yan , Xue Yingwei
Published: October 2020

Background: Tumor immunity plays an important role in assessing the tumor progression. The purpose of this study was to investigate the prognostic value of combined systemic inflammation response index (SIRI) and platelet–lymphocyte ratio (PLR) for treatment of gastroesophageal junction cancer (AEG) and upper gastric cancer (UGC).Methods: In this study, patients from 2003 to 2014 were divided into training and validation sets. The prognostic accuracy of each variable was compared using time-independent ROC analysis. The scoring system was calculated by cut-off values of SIRI and PLR in 5-year. Kaplan-Meier and Log-rank tests were used to analyze overall survival (OS). Chi-square test was used to analyze the association between clinical characteristics and the scoring system. Univariate and multivariate analyses based on the competitive risk regression model were used to analyze independent predictors of death due to AGC and UGC. R software was used to construct the Nomogram model of risk assessment.Results: Patients with SIRI–PLR=2 had worse survival time than those with 0 and 1 (P<0.001) and more suitable for postoperative adjuvant chemotherapy (P=0.002). High PLR patients were more suitable for proximal gastrectomy (P=0.049). SIRI and PLR were independent predictors in training set (P=0.036, P=0.045), which could be combined with age and pTNM to construct Nomogram for predicting OS. Conclusions: Preoperative SIRI–PLR score was an independent predictor for patients with AEG and UGC. The Nomogram model constructed by age, SIRI, PLR and pTNM can correctly predict the prognosis of patients.
High Fidelity Simulation Is Associated With Good Discriminability In Emergency Medicine Residents’ In-Training Examinations
Authors: Chen Shou-Yen , Chaou Chung-Hsien , Yu Shiuan-Ruey , Chang Yu-Che , Ng Chip-Jin , Liu Pin
Published: October 2020

BackgroundIn-training examinations (ITEs), arranged during residency training, evaluate the residents' performances periodically. The ITE usually consists of written and oral forms. There is limited literature focusing on the effectiveness of emergency medicine (EM) resident ITEs in the format of simulation-based examinations, as compared to traditional oral or written tests. Our primary objective is to compare high fidelity simulation with written and oral tests in the evaluation of the residents with different seniority in EM training programs. MethodsDuring the 5-year study period, 8 ITEs were administered to 68 EM residents, and 253 ITE scores were collected. Different ITE scores were calculated and presented as mean and standard deviation. Discrimination of ITE scores between different training years of residency was examined using one-way ANOVA test. ResultsThe high fidelity simulation scores correlated to the EM training year, and residents in their fourth training year (R4) had the highest scores consistently, followed by R3, R2, and then R1. The oral test scores had similar results but not as consistent as the high fidelity simulation tests. The written test scores distribution failed to discriminate the residents' seniority. The high fidelity simulation test had the best discriminative ability and better correlation between different EM residency training years comparing to oral or written forms.ConclusionsHigh fidelity simulation tests had a good discriminative ability and were well correlated to the EM training year. We suggest high-fidelity simulation should be a part of ITE of EM training programs and maybe adopted in EM board certification examination in the future.
Clinical study on decreasing occurance of Alzheimer's Disease through intervention on amnestic Mild Cognitive Impairment with Di-Huang-Yi-Zhi formula in Shigatse, Tibet
Authors: Zhang Liming , Shen Ting , An Hongmei , Yuan Canxing , Yan Jianwen , Gu Chao
Published: October 2020

Background

Mild cognitive impairment (MCI) is generally considered a transitional stage between normal aging and AD dementia. This study aimed to analyze the efficacy of Di-Huang-Yi-Zhi (DHYZ) formula in treating amnestic Mild Cognitive Impairment (aMCI) for the patients in high altitude area (Qinghai Tibet Plateau).
Method:

A total of 106 patients in Shigatse, Tibet were randomly allocated into two groups. One group were to receive DHYZ decoction (150 ml each time, twice a day), the other group were to have aniracetam capsule (200 mg each time, three times a day) ,with 53 patients in each group. Changes in neuropsychological scales including mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), the Barthel Index for activities of daily living (ADL) and TCM symptoms were detected during a 12-month treatment period. After one year follow-up, the conversion rate of AD was observed.
Result

There was no significant difference between the two groups in baseline characteristics and scale scores (P > 0.05). Compared with the aniracetam group, the DHYZ group showed statistically higher MMSE and MoCA score and lower TCM score at the 9-month and 12-month. In addition, the ADAS-Cog and ADL scores in DHYZ group at 12-month were lower than that in the aniracetam control group. After one year follow-up, the conversion rate of AD in DHYZ group was 10% (5/50), and aniracetam group was 15.69% (8/51). The conversion rate of AD in DHYZ group was significantly lower than that in aniracetam group.
Conclusion

DHYZ formula can improve the cognition behavior and global function of patients with aMCI, it can also delay the conversion to AD. This is represents a new treatment option for the patients.