bluuebunny/crossref_metadata_2025 huggingface dataset:
Eating Disorder Examination Questionnaire (EDE-Q-13): Expanding on The Short Form
Authors: Lev-Ari Lilac , Bachner-Melman Rachel , Zohar Ada H
Published: November 2020

Objective: The Eating Disorders Examination–Questionnaire (EDE-Q) is widely used but is time-consuming to complete. In recent years, the advantages and disadvantages of several brief versions have therefore been investigated. A seven-item scale (EDE-Q-7) has excellent psychometric properties but excludes items on bingeing and purging. This study aimed to evaluate a thirteen-item scale (EDE-Q-13) including items on bingeing and purging. Method: Participants were 1,160 (188; 11.4% males) community volunteers aged 28.79±9.92. They completed the full EDE-Q and measures of positive body experience, social and emotional connection, life satisfaction, positive and negative affect and positive eating. The six EDE-Q items about bingeing and purging, recoded to correspond to the response categories of the other EDE-Q questions, were added to the EDE-Q-7, resulting in the EDE-Q-13. Results: Confirmatory factor analysis confirmed the hypothesized EDE-Q-13 structure, including the bingeing and purging subscales. Strong positive correlations were found between the EDE-Q-13 and the original EDE-Q scores. The EDE-Q-13 showed convergent validity with related measures. Conclusions: The EDE-Q-13 is a brief version of the EDE-Q that includes bingeing and purging subscales and has satisfactory psychometric properties. Its use in clinical and research contexts is encouraged.
Improved Agrobacterium Tumefaciens-Mediated Transformation of Cucumber via Modified use of Antibiotics and Acetosyringone
Authors: Chai Li'ang , Du Changxia , Fan Huaifu , Liu Chen , Si Yuyang
Published: November 2020

Background: Cucumber (Cucumis sativus) is one of the most important vegetable crops in the world. As conventional breeding of cucumber is very challenging, genetic engineering is an alternative option to introduce important traits such as enhanced stress resistance and nutritional value. However, the efficiency of the transformation system depends on genotypes, transformation conditions, selection agents, etc. This study aims to speed up the process of Agrobacterium-mediated transformation of cucumber. ‘Xintaimici’, a very popular and typical north China-type cucumber variety, was transformed with Agrobacterium GV3101. The strain carried the pCAMBIA2300s plasmid, a double vector with the marker gene neomycin phosphotransferase II (npt II). Results: The research results indicated that cefotaxime sodium was suitable for inhibiting Agrobacterium in the screening and bud elongation stages. Timentin was best used during the rooting stage. Furthermore, 25 mg/L kanamycin was used in the early stage of screening and increased to 50 mg/L for further screening. At the bud elongation and rooting stages, 75 and 100 mg/L kanamycin was used, respectively, to improve the screening efficiency. To obtain the highest regeneration frequency of resistant buds, 50, 150, and 100 μM acetosyringone was added in the pre-culture medium, infection solution, and co-culture medium, respectively. To confirm the presence of the transgenes, DNA from npt II transgenic cucumber plants was analysed by polymerase chain reaction after transplanting resistant regenerated plants. Conclusions: We finally achieved an 8.1% conversion, which is among the highest values reported to date using the cucumber ‘Xintaimici’. Thus, an effective protocol for Agrobacterium tumefaciens-mediated genetic transformation of cucumber was optimized.
The Evolution of Medical Students’ Preparedness for Clinical Practice During the Transition of Graduation: A Longitudinal Study from the Undergraduate to Postgraduate Periods
Authors: Chaou Chung－Hsien , Yu Shiuan-Ruey , Chang Yu-Che , Ma Shou-De , Tseng Hsu-Min , Hsieh Ming-Ju , Fang Ji-Tseng
Published: November 2020

Background Graduating from medical school and beginning independent practice appears to be a major transition for medical students across the world. It is often reported that medical graduates are underprepared for independent practice. Most previous studies on undergraduates’ preparedness are cross-sectional. This study aimed to understand the development and trend of medical students’ preparedness and its association with other objective and subjective indicators from the undergraduate to postgraduate periods.MethodsThis was a prospective longitudinal cohort study. The participants were recruited and followed from 2 years before graduation to the postgraduate period. The preparedness for independent practice, professional identity, and teamwork experience were biannually measured using previously validated questionnaires. The participants’ basic demographic information, clinical learning marks from the last two years, and national board exam scores were also collected.Results A total of 85 participants completed 403 measurements in the 5 sequential surveys. The mean age at recruitment was 23.6, and 58% of participants were male. The overall total preparedness score gradually increased from 157.3 (SD=21.2) at the first measurement to 175.5 (SD=25.6) at the fifth measurement. The serial individual preparedness scores revealed both temporal differences within the same learner and individual differences across learners. Despite the variations, a clear steady increase in the overall average score was observed. Participants were least prepared in the domain of patient management at first, but the score increased in the subsequent measurements. The participants with better final preparedness had better professional identity (p<0.01), better teamwork experience (p<0.01), and higher average clinical rotation marks (p<0.05). ConclusionsThe preparedness for practice of medical students from the undergraduate to postgraduate periods is associated with their professional identity, teamwork experience, and objective clinical rotation endpoint. Although preparedness generally increases with time, educators must understand that there are temporal fluctuations and individual differences in learners’ preparedness.
Acupuncture Treatment Compensated the Altered Functional Connectivity in the Pain Modulation System on Primary Dysmenorrhea: A Pilot Study
Authors: Tu Cheng-Hao , Lee Yu-Chen , Chen Ying-Yu , Chen Chun-Ming , Lu Wen-Chi , Chen Yi-Hung , Yang Su-Tso
Published: November 2020

BackgroundPrimary dysmenorrhea (PDM) is the most commonly encountered gynecological problem in reproductive-age women. We previously reported altered functional connectivity between periaqueductal gray matter and other pain-related brain regions in women with PDM, indicating a maladaptation in the descending pain modulation system. Clinically, acupuncture has been suggested as an effective treatment of PDM. Previous animal studies revealed that acupuncture on specific acupoint can produced analgesic effect via descending pain modulation system. In the present study, we used resting-state functional magnetic resonance imaging to investigate possible changes in descending pain modulation after acupuncture treatment in women with PDM. MethodsThirty-four right-handed adult women with PDM participated in this randomized, single-blinded, sham-controlled study. Each patient was randomly allocated to an 8-week verum or sham acupuncture intervention on the bilateral acupoint Sanyinjiao (SP6). Resting-state functional magnetic resonance imaging was conducted before, during, and after the intervention session to measure the spontaneous activity in brain. The functional connectivity maps between periaqueductal gray matter and other pain-related brain regions were generated to reveal the status of descending pain modulation systems.ResultsAfter 8 weeks, both groups reported decreased menstrual pain. However, the patterns of functional connectivity changes in descending pain modulation system were different after the verum or sham intervention. The effect of the verum acupuncture intervention may be underpinned by compensatory and/or resilience changes in descending pain modulation systems, whereas that of the sham acupuncture intervention may be underpinned by cognitive reappraisal of painConclusionsThe dissimilar pattern of the FC alterations after the verum and sham acupuncture indicating that different brain mechanisms may be responsible for the menstrual pain relief in verum or sham acupuncture intervention. These results may contribute to the discussion of whether acupuncture treatment induces therapeutic physiological alterations or its benefit is attributable to the placebo effect.
How Design Can Impact the Performance of a Healthcare Application, Affect Users’ Decisions and Contribute to Patient’s Well-Being: A Scoping Review Protocol.
Authors: Souza Jose George Dias de , Bublitz Frederico M. , Scherer Daniel
Published: November 2020

Background: Pregnancy is an important phase in a woman's life, the gestational period however is accompanied by fears and apprehension, especially for women who are experiencing this phase for the first time. Prenatal care is essential to prevent diseases and reduce risk for pregnant women, thus enabling healthy development for the baby. Nowadays many women find it difficult to make an adequate prenatal care, for the most varied reasons. Taking into account that the world is increasingly connected to the internet, it is important to understand, analyzing a set of health applications, which are the best decisions from the design point of view, usability to become a useful application for pregnant women, another relevant point is to understand how the architecture of these solutions were designed to be scalable. Thus, a well-defined systematic review is needed to identify the impacts of architectural, design and performance decisions on health applications, reducing risks and minimizing human errors.Methods/Design: This study will follow a well-defined methodological structure. The methodology is separated into the following sections: Research question identification; Extraction of relevant studies; Selection criteria; Charting the data; Collating, summarizing, and reporting the results. The research question aims to analyze the approaches used to build health applications aiming at design decisions, architecture and the impacts that are generated for the end user. The researchers will use the following electronic databases for data extraction: PubMed (Medline); IEEE Xplore Digital Library; ACM Digital Library; Web of Science; and Scopus Document Search. The search for research will consist of a set of terms and keywords.Discussion: This work has the interest of presenting a model, a standard, a guide for creating a health software interface, always aiming at the quality of the interface, the user experience and the possible gain with the performance of the application, considering that users will have more security to make decisions.Systematic review registration: Submitted on October 11, 2020 Open Science Framework.
The Impact of Personal Values and Justifications on Academic Cheating for Business vs. Non-Business Students
Authors: Parks-Leduc Laura , Guay Russell P. , Mulligan Leigh
Published: November 2020

In this study we examine college cheating behaviors of business students compared to non-business students, and investigate possible antecedents to cheating in an effort to better understand why and when students cheat. We specifically examine power values; we find that they are positively related to academic cheating in our sample, and that choice of major (business or non-business) partially mediates the relationship between power values and cheating. We also consider the extent to which students are able to provide justifications for their cheating, and find that business students are more likely to justify (rationalize) their cheating behaviors. Finally, we update the literature in terms of the ways students cheat. We assess newer forms of academic cheating, as increased accessibility to information via the Internet and smartphones may have changed the ways (and ease with which) students cheat – a particularly relevant topic currently, as many classes have moved online during the COVID-19 pandemic. In our study, cheating was especially prevalent when taking quizzes or tests (or completing homework) online. We found that only 10% of participants reported never engaging in any of the cheating behaviors we examined.
Cardiac Arrests after Eating Raw Grass Carp Gall Bladders: A Case Report
Authors: Han Jiayan , Sun Yan , Zhuo Luo , Chen Dongmei , Li Fan , Huang Shouqiu , Chen Xiaobing , Wang Yanli , Luo Jiye , Li Xiaoming
Published: November 2020

BACKGROUND: Cases of poisoning by eating raw fish gallbladder occur mainly in Asia. These cases have been reported mainly with acute liver and kidney damage. We found that the ingestion of carp gallbladder also caused myocardial damage and lead to frequent cardiac arrest in patients with subclinical long QT interval syndrome. Patient concerns: We report a 57-year-old woman with an unexplained Long QT syndrome history who developed arrhythmia sudden death two times following ingestion of raw fish gall bladder.Fish bile poisoning, toxic hepatitis, acute renal failure, cardiac arrest, postoperative cardiopulmonary resuscitation, long QT syndrome were diagnosed. As in this case, myocardial injury caused by fish bile poisoning further leads to cardiac arrest related to LQTS.The patient underwent continued renal replacement therapy (CRRT) and other supportive treatments to manage symptoms, promote detoxing, protect liver and myocardium in our hospital. Then she completed a cardiac pacemaker placement in local hospital.Her liver enzymes profile returned to normal after 18 days, and kidney injury index returned to normal after more than one month. On follow up after three months, her renal as well as the liver parameters were found normal and she never attack malignant arrhythmia again.Conclusion: Eating fish bile can lead to MODS, not merely to liver and kidney damage. Some of the LQTS patients usually have no clinical symptoms. Clinicians should be aware of changes in low-risk LQTS patients when something special happens to them.
WITHDRAWN: Associations of ultrasound-based inflammation patterns with peripheral innate lymphoid cell populations, serum cytokine/chemokines, and treatment response to methotrexate in rheumatoid arthritis and spondyloarthritis
Authors: Kato Manami , Ikeda Kei , Sugiyama Takahiro , Tanaka Shigeru , Iida Kazuma , Suga Kensuke , Nishimura Nozomi , Mimura Norihiro , Kasuya Tadamichi , Kumagai Takashi , Furuya Hiroki , Iwamoto Taro , Iwata Arifumi , Furuta Shunsuke , Suto Akira , Suzuki Kotaro , Kawakami Eiryo , Nakajima Hiroshi
Published: November 2020

Background: We aimed to clarify the associations of musculoskeletal inflammation patterns with peripheral blood innate lymphoid cell (ILC) populations, serum cytokine/chemokines, and treatment response to methotrexate in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA).Methods: We enrolled patients with either RA or SpA who had peripheral symptoms and performed comprehensive ultrasound to evaluate power Doppler signals for synovitis (52 joint regions), tenosynovitis (20 tendons), and enthesitis (44 sites). We performed clustering analysis using unsupervised random forest based on the multi-axis ultrasound information and classified the patients into groups. We identified and counted ILC1-3 populations in the peripheral blood by flow cytometry and also measured the serum levels of 20 cytokine/chemokines. We also determined the American College of Rheumatology 20% improvement (ACR20) response at 3 months in 38 patients who initiated treatment with methotrexate after baseline assessment. Results: We enrolled a total of 100 patients with RA (n=66) or SpA (n=34). Synovitis was more prevalent and severer in RA than in SpA, whereas tenosynovitis and enthesitis were comparable between RA and SpA. Patients were classified into two groups which represented synovitis-dominant and synovitis-nondominant inflammation patterns, respectively. While peripheral ILC counts were not significantly different between RA and SpA, they were significantly higher in the synovitis-nondominant group than in the synovitis-dominant group (ILC1-3 p=0.0007, p=0.0061, p=0.0002, respectively). On the other hand, clustering of patients based on serum cytokine/chemokines did not clearly correspond either to clinical diagnoses or to synovitis-dominant/nondominant patterns. The synovitis-nondominant pattern was the factor that predicted no clinical response to methotrexate most significantly (p=0.0065).Conclusions: Ultrasound-detected musculoskeletal inflammation is clustered into synovitis-dominant and nondominant patterns. These patterns are associated with peripheral ILC counts and could predict treatment response to methotrexate. These data suggest that ultrasound-based inflammation patterns can be utilized to establish more individualized treatment for both RA and SpA. Trial registration: The study has been registered in UMIN Clinical Trial Registry (UMIN ID: 000033797, date of registration: 18th of August, 2018).
Effects of magnesium biotinate supplementation on serum insulin, glucose, and lipid parameters along with liver protein levels of intermediary metabolism in rats
Authors: Sahin Kazim , Orhan Cemal , Kucuk Osman , Erten Fusun , Tuzcu Mehmet , Sahin Nurhan , Ojalvo Sara Perez , Komorowski James Richard
Published: November 2020

Background: The objective of this study was to investigate the effects of a novel form of biotin (magnesium biotinate) on serum glucose, lipid profile, and hepatic lipid metabolism-related genes in rats. Methods: Forty-two rats were divided into six groups and fed a standard diet-based egg white powdered diet supplemented with either d-biotin at 0.01, 1 or 100 mg/kg BW or magnesium biotinate at 0.01, 1, or 100 mg/kg BW. Results: Serum total cholesterol and triglyceride decreased with biotin by both sources (P < 0.05). Concentrations were lower with magnesium biotinate when comparing the 1 mg/kg dose groups (P < 0.05). Serum, liver, and brain biotin, and liver cyclic guanosine monophosphate (cGMP) concentrations were greater when rats were treated with magnesium biotinate versus d-biotin, particularly when comparing the 1 mg/kg and 100 mg/kg dose groups (P < 0.05). Both forms of biotin decreased the liver SREBP‐1c and FAS and increased AMPK-α1, ACC-1, ACC-2, PCC, and MCC levels (P < 0.05). The magnitudes of responses were more emphasized with magnesium biotinate. Conclusions: Magnesium biotinate, compared with a commercial d-biotin, is more effective in reducing serum lipid concentrations and in regulating gene levels of intermediary metabolism-related biomarkers.
Public Trust in Healthcare System and Its Correlates during the COVID-19 Epidemic in Iran
Authors: Vardanjani Hossein Molavi , Imanieh Mohammad-Hadi , Hassani Amir-Hossein , Bagheri-Lankarani Kamran
Published: November 2020

Background: Public trust in the healthcare system is a critical necessity of management in public health crises such as the COVID-19 pandemic. To rapidly assess the public trust in the healthcare system during the COVID-19 epidemic and its correlates in Iran.Methods: A cross-sectional rapid assessment was conducted in Iran during the COVID-19 epidemic in the country. A probability proportional to size multistage random sampling was applied. Sampling was done in 15 provinces. We collected data on public perceived fear, public trust in health system and socio-demographics. Ordinary least square regression modeling was applied to identify correlates of public trust.Results: A total of 5250 adults (response rate: 76%) were participated in the study. Mean of reported trust scores was 50.3±22.8, and of fear scores was 72.0±17.8. Being male (p=0.006), higher levels of education (p<0.001) and socio-economic status (p<0.001), and higher fear scores (p<0.001) were independently correlated with trust in healthcare system. Conclusion: At the time of the COVID-19 epidemic in Iran, public trust in healthcare system is low. A dynamic public epidemic communication with appropriate strategies to communicate with higher social classes is urgent in Iran. Rapid assessments to identify appropriate strategies are needed. These results might be generalizable to the other similar countries during the COVID-19 pandemic.
Analysis of IgM, IgA, and IgG Isotype Antibodies Directed Against SARS‑CoV‑2 Spike Glycoprotein and ORF8 in the Course of COVID‑19.
Authors: Meinberger Denise , Koch Manuel , Roth Annika , Hermes Gabriele , Stemler Jannik , Cornely Oliver A. , Streichert Thomas , Klatt Andreas R.
Published: November 2020

Immunoassays are a standard diagnostic tool assessing immunity in severe acute respiratory syndrome coronavirus type 2 (SARS‑CoV‑2) infection. However, immunoassays do not provide information about contaminating antigens or cross‑reaction and might exhibit inaccurate high sensitivity and low specificity. We aimed to gain insight into the serological immune response of SARS‑CoV‑2 patients by immunoblot analysis. We analyzed serum immunoglobulins IgM, ‑A, and ‑G directed against SARS‑CoV‑2 proteins by immunoblot analysis from 12 infected patients. We determined IgG isotype antibodies by commercially available ELISA, and assessed clinical parameters of inflammation status, kidney, and liver injury. We found evidence for antibody cross‑reactivity, which calls into question a reliable assessment of serum samples tested negative for anti‑SARS‑CoV‑2 antibodies by immunoassays. Nevertheless, for the detection of IgG anti‑SARS‑CoV‑2 antibodies, our data suggest that the use of the spike glycoprotein in immunoassays should be sufficient to identify positive patients. Using a combination of the spike glycoprotein and the open reading frame 8 protein could prove to be the best for the detection of patients positive for anti‑SARS‑CoV‑2 IgM antibodies. We found that the antibody response alone is not decisive for the course of the disease but the inflammation parameters are promising indicators.
Management of chlamydia and gonorrhoea infections diagnosed in primary care using a centralised nurse-led telephone-based service: mixed methods evaluation
Authors: Horwood Jeremy , Brangan Emer , Manley Petra , Horner Paddy , Muir Peter , North Paul , MacLeod John
Published: November 2020

Background: Up to 18% of genital Chlamydia infections and 9% of Gonorrhoea infections in England are diagnosed in Primary Care. Evidence suggests that a substantial proportion of these cases are not managed appropriately in line with national guidelines. With the increase in sexually transmitted infections and the emergence of antimicrobial resistance, their timely and appropriate treatment is a priority. We investigated feasibility and acceptability of extending the National Chlamydia Screening Programme’s centralised, nurse-led, telephone management (NLTM) as an option for management of all cases of chlamydia and gonorrhoea diagnosed in Primary Care. Methods: Randomised feasibility trial in 11 practices in Bristol with nested qualitative study. In intervention practices patients and health care providers (HCPs) had the option of choosing NLTM or usual care for all patients tested for Chlamydia and Gonorrhoea. In control practices patients received usual care.Results: 1154 Chlamydia/gonorrhoea tests took place during the 6-month study, with a chlamydia positivity rate of 2.6% and gonorrhoea positivity rate of 0.8%. The NLTM managed 335 patients. Interviews were conducted with sixteen HCPs (11 GPs, 5 nurses) and 12 patients (8 female). HCPs were positive about the NLTM, welcomed the partner notification service, though requested more timely feedback on the management of their patients. Explaining the NLTM to patients didn’t negatively impact on consultations. Patients found the NLTM acceptable, more convenient and provided greater anonymity than usual care. Patients appreciated getting a text message regarding a negative result and valued talking to a sexual health specialist about positive results.Conclusion: Extension of this established NLTM intervention to a greater proportion of patients was both feasible and acceptable to both patients and HCP, could provide a better service for patients, whilst decreasing primacy care workload. The study provides evidence to support the wider implementation of this NLTM approach to managing chlamydia and gonorrhoea diagnosed in primary care.
Anti-inflammatory protein TNFα-stimulated gene-6 (TSG-6) reduces inflammatory response after brain injury in mice
Authors: Mutoji Kazadi Nadine , Sun Mingxia , Nash Amanda , Puri Sudan , Hascall Vincent , Coulson-Thomas Vivien J
Published: November 2020

Background: Current research suggests that the glial scar surrounding penetrating brain injuries is instrumental in preserving the surrounding uninjured tissue by limiting the inflammatory response to the injury site. We recently showed that tumor necrosis factor (TNF)-stimulated gene-6 (TSG-6), a well-established anti-inflammatory molecule, is present within the glial scar. In the present study we investigated the role of TSG-6 within the glial scar. Methods: TSG-6 null and littermate control mice were subjected to penetrating brain injuries (2 mm puncture wound to the frontal cortex), after which both the injury site and remaining injured hemisphere were analyzed. The presence of activated astrocytes, inflammatory markers and glial scar components was evaluated by real-time PCR and immunofluorescence. Results: Our findings show that mice lacking TSG-6 present a more severe inflammatory response after injury, which was correlated with an enlarged area of astrogliosis beyond the injury site. Conclusion: Our data provides evidence that TSG-6 has an anti-inflammatory role within the glial scar.
Prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte zone, southern Ethiopia
Authors: Muze Mohammed , Yesse Mubarek , Kedir Shemsu , Mustefa Abdilmejid
Published: November 2020

Background: Maternal undernutrition is highly prevalent in underdeveloped countries. Hence, this study was intended to determine the prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte Zone..Method: Facility-based cross-sectional study was conducted from July to January 2019. Systematic random sampling technique was used to select 422 study participants from 11 randomly selected health facilities. Data was collected by using a structured-interviewer administered questionnaire. Mid upper arm circumference (MUAC) was measured by standard non stretchable MUAC tape. Data was entered into a computer using Epi data 3.1 and edited, cleaned, and analyzed using SPSS version 20. Both bivariate and multiple logistic regression analyses were employed to identify factors associated with maternal undernutrition.Result: In this study, the overall prevalence of undernutrition among study subjects was 21.8%. Age greater than 31 years of women (AOR=0.15; 95% CI: 0.03, 0.93), Birth intervals > 2 years (AOR= 0.18; 95% CI: 0.04, 0.76), good nutritional knowledge (AOR=0.34; 95% CI: 0.17, 0.67), and having no dietary change as a result of current pregnancy AOR=6.02; 95% CI: 2.99, 12.14) were significantly associated with undernutrition.Conclusions: The prevalence of undernutrition among pregnant women was 21.8 %. Current estimate is lower than previously reported in the study area but higher than reported in developed country. Age of women, Birth intervals, and Dietary change as a result of current pregnancy and Nutrition knowledge were important risk factors/ predictors of undernutrition (MUAC < 23 cm). Interventions targeting maternal nutrition education and child spacing with giving special emphasis to adolescent pregnant women are recommended.
Clinico-pathologic determinants of non-e-curative outcome following en-bloc endoscopic submucosal dissection in patients with early gastric neoplasia
Authors: Embaye Kidane Siele , Zhang Chao , Ghebrehiwet Matiwos Araya , Wang Zhihao , Zhang Fengdi , Liu Liwei , Qin Shenghui , Qin Lingzhi , Wang Jun , Wang Xi
Published: November 2020

Background: Endoscopic submucosal dissection (ESD) is gaining enormous popularity in the treatment of early gastric cancers (EGCs) across many institutions in the world. However, appropriate selection of patients for endoscopic resection is crucial to sufficiently mitigate non-e-curative (NEC) resection. This study aims at identifying the various clinico-pathologic factors that independently predict the depth of submucosal invasion and NEC resection following ESD in patients with EGCs.Methods: Multiple logistic regression analysis was applied to investigate factors that independently predict the level of submucosal invasion and NEC resection in patients with early gastric neoplasia. Statistical Packages for the Social Sciences version 23 was used for analysis.Results: A total of 162 EGCs underwent en-bloc ESD for which the rate of complete resection and non-e-curative outcomes were 95% and 22.2%, correspondingly. Multivariate analysis depicted that tumor location in the upper two third of stomach (odds ratio [OR] 5.46, confidence interval [CI] 95%, 1.65-18.12, p = 0.006), tumor size > 2 cm (OR 7.63, CI 95%, 2.29-25.42, p = 0.001), histologically undifferentiated tumor (OR 15.54, CI 95%, 1.65-146.22, p = 0.001), and tumors with 0-IIa/0-IIc or their mixed variants with predominant 0-IIa/0-IIc (OR 9.77, CI 95%, 1.23-77.65, p = 0.031) were all independent predictors of NEC resection for early gastric tumors. Additionally, location in the upper two third of stomach (OR 8.88, CI 95%, 2.90-27.17, p < 0.001), ulcerated lesions (OR 3.70, CI 95%, 1.15-11.90, p = 0.028), lesions with > 2 cm (OR 2.94, CI 95%, 1.08-8.02, p = 0.036) and those with poor differentiation (OR 6.51, CI 95%, 2.23-18.98, p = 0.001) were found to have significant association with submucosal invasion.Conclusions: Tumors located in the upper two third of stomach having larger size (> 2 cm), poor histo-differentiation and a gross type of 0-IIa/0-IIc or their mixed variants with predominant 0-IIa/0-IIc are significantly associated with a risk of NEC after ESD procedure. Thus, early gastric tumors displaying these features need to be handled carefully during endoscopic resection. Our findings may provide some insights about the factors that determine non-curability in patients with EGC in relation to ESD procedure.
Quick BSI Score to Identify Bloodstream Infection at the Emergency Department
Authors: Phungoen Pariwat , Lerdprawat Nunchalit , Sawanyawisuth Kittisak , Chotmongkol Verajit , Ienghong Kamonwon , Sumritrin Sumana , Apiratwarakul Korakot
Published: November 2020

Background: Bloodstream infection (BSI) is a common and urgent condition at the emergency department (ED). In order to diagnose BSI, the current guideline fails to mention the juncture at which blood cultures ought to be taken. The decision whether or not to obtain hemoculture is solely based upon clinical judgment and outcomes pertaining to inappropriately ordered blood culture. This study aimed to develop predictive bloodstream infection scoring at the ED employing only clinical factors presented on ED arrival.Methods: This study was conducted retrospectively at the ED, Khon Kaen University Hospital, Thailand. Inclusion criteria encompassed adult patients suspected of infection defined by blood culture collection presented at the ED with intravenous antibiotics initiated during ED visits. Independent positive predictors for positive blood culture were used to create the Quick Bloodstream Infection score (qBSI score) through logistic regression analysis.Results: A total of 169578 patients visited the ED during the study period. Of those, 12556 patients (7.40%) were suspected of infection. 8177 cases met the study criteria and were categorized according to positive blood culture results, i.e. bloodstream infection (741 patients; 9.06%). Probability of positive blood culture was calculated via aged over 55 years + moderate to severe CKD + solid organ tumor + (2 x liver disease) + (2 x history of fever with chills) + (2 x body temperature of over 38.3oC). A score of 1 or over rendered 92.98% sensitivity, 15.40% specificity, 9.87% positive predictive value, 95.66% negative predictive value, positive likelihood ratio of 1.10, and negative likelihood ratio of 0.46.Conclusions: The qBSI score may be a helpful tool to perform blood culture in patients at the ED suspected of infection. Employing this score may facilitate in the determining of those needing blood culture at the ED.
The Impact of COVID-19 Pandemic on Dental Practice in Iran: A questionnaire-based report
Authors: Ahmadi Hanie , Ebrahimi Alireza , Ghorbani Farhad
Published: November 2020

Background: The highly contagious nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), besides the fact that dental procedures commonly generate blood and saliva droplets that could lead to the contagion have resulted in the closure of many dental clinics. In the present study, we aimed to evaluate the impact of coronavirus disease 2019 (COVID-19) pandemic on dental practice by conducting an online questionnaire among the Iranian dental practitioners and finding their perspectives on the subject.Methods: This report is based on a questionnaire that was conducted among Iranian dentists. The survey included questions that evaluate the dentists’ perceptions and attitudes toward the COVID-19 pandemic and its effect on their personal life, financial status, and the quality of dental services for patients.Results: Overall, 240 dentists contributed to this study (214 general dentists and 26 specialists). The majority of the participants (n=170, 70%) did not perform non-emergency procedures during the pandemic. The dental practitioners have suggested several strategies to decrease the risk of contagion, such as reducing treatment sessions (n=90, 37%), strict triage of patients (n=156, 64%), and using personal protective equipment (n=108, 45%). However, most of the dentists (n=210, 87%) had problems, providing personal protective equipment during the pandemic. Moreover, 97% (n=234) of the participants reported that they encountered a decrease in their financial income since the eruption of the pandemic.Conclusion: Dental health care workers are at the highest risk of contracting COVID-19. Thus dental practioners ought to execute the standard protocols more cautiously during the pandemic. They could also lower their work hours and limit dental procedures to emergency treatments to reduce the risk of COVID-19 transmission. Besides, the public organizations should provide proper equipment for the dental practitioners to decrease the risk of contagion.
One-year results of half-dose versus one-third-dose photodynamic therapy in chronic or recurrent central serous chorioretinopathy
Authors: Jirarattanasopa Pichai , Vanchalerm Banchasakjaroen , Mansing Ratanasukon
Published: November 2020

Background: Central serous chorioretinopathy (CSC) is characterized by an accumulation of subretinal fluid (SRF) in the macula. It is usually treated by laser photocoagulation or photodynamic therapy (PDT) with different doses and power. This study is to compare the efficacy of half-dose PDT and one-third-dose PDT in chronic or recurrent CSC.Methods: A retrospective review of patients with chronic or recurrent CSC who were treated with half-dose or one-third-dose PDT and followed for 12 months afterwards. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and resolution of subretinal fluid (SRF) at baseline and 1, 3, 6 and 12 months post-PDT were assessed.Results: Forty-six eyes and 20 eyes received half-dose and one-third-dose PDT, respectively. The study showed efficacy of the one-third-dose PDT compared with half-dose PDT in BCVA improvement (0.10±0.04 logMAR for one-third-dose versus 0.17±0.04 for half-dose, P=0.148) and CRT improvement (125.6±24.6 µm for one-third-dose versus 139.1±16.54 for half-dose, P=0.933) at 12 months. The SRF recurrence rate was significantly higher in the one-third-dose PDT group compared with the half-dose PDT group (40.0% versus 15.2%, P=0.027) at 12-months.Conclusion: At 12 months, the one-third-dose PDT was effective in term of BCVA and CRT improvement, when compared with half-dose PDT. However, this study showed that one-third-dose PDT had a higher recurrence rate of SRF.
Decontamination methods for respiratory protection mask model N95: a rapid review
Authors: Probst Livia Fernandes , Guerrero Ana Tereza Gomes , Cardoso Andréia Insabralde de Queiroz , Grande Antônio José , Croda Mariana Garcia , Venturini James , Fonseca Maria Cristina de Camargo , Paniago Anamaria Mello Miranda , Barreto Jorge Otávio Maia , de Oliveira Sandra Maria do Valle Leone
Published: November 2020

Background: N95 respiratory protection masks are used by healthcare professionals to prevent contamination with infectious microorganisms transmitted by droplets or aerosols.Methods: We conducted a rapid review of the literature analyzing the effectiveness of decontamination methods for mask reuse. The review was carried out in September 2020 using a simplification of the formal systematic review process, which simplified the stages of a complete systematic review, including the exclusion of an assessment of study methodology.Results: A total of 563 articles were retrieved of which 48 laboratory-based studies were selected. Fifteen decontamination methods were included in the studies. Hydrogen peroxide was evaluated by 19 laboratory studies, ultraviolet germicidal irradiation by 21, ethylene oxide by 4, dry heat by 11, moist heat by 9, ethanol by 5, isopropanol solution by 2, microwave oven by 11, sodium hypochlorite by 10, autoclave by 7, electric rice cooker by 3, cleaning wipes by 1, bar soap and water 1, multi-Purpose High-Level Disinfection Cabinet by 1 and chlorine dioxide by 1. Five methods appear promising: hydrogen peroxide vapor, ultraviolet irradiation, dry heat, wet heat/pasteurization, and microwave ovens.Conclusions: Positive results should be considered with caution as they represent a small number of studies, reflect ideal laboratory conditions, and may have limited applicability in realistic situations and for health systems.
Analysis of the expression and potential molecular mechanism of interleukin-1 receptor antagonist (IL1RN) in papillary thyroid cancer via bioinformatics methods
Authors: Xie Zhenyu , Li Xin , He Yuzhen , Wu Song , Wang Shiyue , Sun Jianjian , He Yuchen , Lun Yu , Xin Shijie , Zhang Jian
Published: November 2020

Background: Interleukin-1 receptor antagonist (IL1RN) has been reported as a biomarker of many cancers. However, the biological function of IL1RN in papillary thyroid carcinoma (PTC) remains undetermined.Methods: We obtained IL1RN expression data from The Cancer Genome Atlas (TCGA) database. Enrichment analysis of coexpressed genes and IL1RN methylation analysis were performed via LinkedOmics. The correlations between IL1RN and immune infiltrates were investigated via ESTIMATE, TIMER and TISIDB. We analyzed the association of IL1RN expression with pancancer overall survival (OS) via Gene Expression Profiling Interactive Analysis (GEPIA).Results: IL1RN showed higher expression levels and lower methylation levels in PTC tissues than in normal tissues. Higher IL1RN expression was significantly associated with shorter progression-free survival (PFS), advanced tumor stage, tumor metastasis, increased incidence of BRAF mutations, and decreased incidence of N-RAS and H-RAS mutations. Genes coexpressed with IL1RN participate primarily in immune-related pathways. IL1RN expression positively correlated with immune infiltration, tumor progression and poor OS for all cancers.Conclusions: IL1RN is a good prognostic and diagnostic biomarker for PTC. IL1RN may promote thyroid cancer progression through immune-related pathways. Methylation may act as an upstream regulator of IL1RN expression and biological function. Additionally, IL1RN was shown to have broad prognostic value in a pancancer cohort.
COVID-TRACK: WORLD AND USA SARS-COV-2 TESTING AND COVID-19 TRACKING
Authors: Zohner Ye Emma Mariam , Morris Jeffrey S
Published: November 2020

Background: The COVID-19 pandemic has caused major health and socio-economic disruptions worldwide. Accurate investigation of emerging data is crucial to inform policy makers as they construct viral mitigation strategies. Complications such as variable testing rates and time lags in counting cases, hospitalizations and deaths make it challenging to accurately track and identify true infectious surges from available data, and requires a multi-modal approach that simultaneously considers testing, incidence, hospitalizations, and deaths. Although many websites and applications report a subset of these data, none of them provide graphical displays capable of comparing different states or countries on all these measures as well as various useful quantities derived from them. Here we introduce a freely available graphical application that allows the user to simultaneously assess time trends in these measures and compare various states or countries, equipping them with a tool to investigate the potential effects of the different mitigation strategies and timelines used by various jurisdictions. Findings: COVID-TRACK is a Python based web-application that provides a platform for tracking testing, incidence, hospitalizations, and deaths related to COVID-19 along with various derived quantities. Our application makes the comparison across states or countries in the world easy to explore, with useful transformation options including per capita, log scale, and/or moving averages. We illustrate its use by assessing various viral trends in the USA and Europe. Conclusion: The COVID-TRACK web-application is a user-friendly analytical tool to compare data and trends related to the COVID-19 pandemic across areas in the United States and worldwide. Our tracking tool provides a unique platform where trends can be monitored across geographical areas in the coming months to watch how the pandemic waxes and wanes throughout the summer and into a potential second wave in the fall.
A controlled study on the diagnostic accuracy of panoramic and peri-apical radiography for detecting furcation involvement
Authors: Berghuis Gijsbrecht Jan , Cosyn Jan , De Bruyn Hugo , Hommez Geert , Dierens Melissa , Christiaens Véronique
Published: November 2020

Background: The aim of this study was to determine diagnostic accuracy, sensitivity and specificity of panoramic and peri-apical radiography for detecting furcation involvement (1) and to evaluate the possible impact of clinical experience on these diagnostic parameters (2).Methods: Periodontitis patients in need of an implant were retrospectively selected. Inclusion criteria were the presence of a CBCT, panoramic and peri-apical radiograph of the site of interest within a one-year time frame. All furcation sites were classified on the basis of CBCT using Hamp’s index (1975). These data were considered gold standard. Ten experienced examiners and 10 trainees were asked to assess furcation involvement for the same defects on the basis of corresponding panoramic and peri-apical radiographs. Absolute agreement, Cohen’s weighted kappa, sensitivity and specificity were calculated. In addition, ROC-curves were constructed.Results: The study sample included 60 furcation sites in 29 multi-rooted teeth from 17 patients (10 females; mean age 62). On average 20/60 furcations were correctly classified on the basis of panoramic radiography, corresponding to weighted kappa of 0.209 indicative of slight agreement. Respective data for peri-apical radiography were 19/60 and 0.221. When recategorizing FI Grades into ‘no to limited FI’ (FI Grade 0 and I) and ‘advanced FI’ (FI Grade II and III), panoramic and peri-apical radiography showed low sensitivity (0.558 and 0.441, respectively), yet high specificity (0.791 and 0.790, respectively) for identifying advanced FI. Both showed diagnostic value given the area under the ROC-curve amounting to 0.79 and 0.69 for panoramic and peri-apical radiography, respectively. There was no significant difference between experienced periodontists and trainees (P = 0.257 versus P = 0.880).Conclusion: Panoramic and peri-apical radiography are relevant in the diagnosis of FI given high specificity. These are best combined with furcation probing showing high sensitivity. Clinical experience does not seem to improve the accuracy of a radiological diagnosis of furcation sites.Trial Registration: Patients were retrospectively registered.
A multilevel analysis of the importance of oral health instructions for preventing tooth loss: The 8020 Promotion Foundation Study of Japanese Dental Patients
Authors: Saito Mizuki , Shimazaki Yoshihiro , Fukai Kakuhiro , Furuta Michiko , Aida Jun , Ando Yuichi , Miyazaki Hideo , Kambara Masaki
Published: November 2020

Background: Many studies have reported risk factors for tooth loss. Oral health instruction is considered effective at improving oral health behavior and oral health. However, few studies have examined the relationship of dental clinic factors, such as the number of dental hygienists and implementation of oral health instructions, with tooth loss. Here, we conducted a multilevel analysis to clarify the dental clinic risk factors associated with tooth loss.Methods: Baseline surveys were conducted at 1,216 dental clinics in 46 prefectures in Japan, and 12,399 dental patients aged 20 years and over underwent oral examinations and completed a questionnaire. The dental clinics also completed a questionnaire at baseline. A 3-year follow-up survey included 2,488 patients in 585 dental clinics. Multilevel multivariate logistic regression analysis was used to examine the risk of tooth loss at the patient and clinic levels.Results: Of the patient variables, older age, higher mean probing pocket depth, current or past smoking, and bleeding during tooth brushing were associated with higher risks of tooth loss. Individuals with many teeth who visited dental clinics for maintenance were at significantly lower risk of tooth loss. Of the clinic variables, patients attending dental clinics with four or more dental hygienists had a significantly lower risk of tooth loss (OR 0.68, 95% CI 0.50–0.99). Patients attending dental clinics that provide oral health instructions for 20 min or more had a significantly lower risk of tooth loss (OR 0.69, 95% CI 0.50–0.96).Conclusions: In addition to individual risk factors for tooth loss, dental clinic factors such as length of oral health instruction and number of dental hygienists are associated with tooth loss. In dental clinics, ensuring sufficient time for dental hygienists to provide oral health instructions can help prevent tooth loss in dental patients.