bluuebunny/crossref_metadata_2025 huggingface dataset:
Can we safely reduce the administration of 131-iodine in patients with differentiated thyroid cancer? – experience of the Brugmann hospital in Brussels
Authors: Iconaru Laura , Baleanu Felicia , Taujan Georgiana , Duttmann Ruth , Spinato Linda , Karmali Rafik , Bergmann Pierre , Hambye Anne-Sophie
Published: August 2020

Background 131-iodine (131I) administration after surgery remains a standard practice in differentiated thyroid cancer (DTC). In 2014, the American Thyroid Association presented new guidelines for the staging and management of DTC, including no systematic 131I in patients at low-risk of recurrence and a reduced 131I activity in intermediate risk. The present study aims at evaluating the rate of response to treatment following this new therapeutic management compared to our previous treatment strategy in patients with DTC of different risks of recurrence. Methods Patients treated and followed up for DTC according to the 2014-ATA guidelines (Group 2) were compared to those treated between 2007 and 2014 (Group 1) in terms of general characteristics, risk of recurrence (based on the 2015-ATA recommendations), preparation to 131I administration, cumulative administered 131I activity and response to treatment. Results In total, 136 patients were included: 78 in Group 1 and 58 in Group 2. The two groups were not statistically different in terms of clinical characteristics nor risk stratification: 42.3% in Group 1 and 31% in Group 2 were classified as low risk, 38.5% and 48.3% as intermediate risk and 19.2% and 20.7% as high risk (P=0.38). Two patients (one in each group) with distant metastases were excluded from the analysis. Preparation to 131I administration consisted in rhTSH stimulation in 23.4% of the patients in Group 1 and 100% in Group 2 (p<0.001). 131I was administered to 46/77 patients (59.7%) in Group 1 (5 at low risk of recurrence) and 38/57 patients (66.7%) in Group 2 (0 with a low risk). Among the patients treated by 131I, median cumulative activity was significantly higher in Group 1 (3.70GBq [100mCi] range 1.11-11.1 GBq [30-300 mCi]) than in Group 2 (1.11 GBq [30 mCi], range 1.11-7.4 GBq [30-200 mCi], P<0.001). Complete response was found in 90.9% in Group 1 vs. 96.5% in Group 2 (P=0.20). Conclusions Using the 2015-ATA evidence-based guidelines for the management of DTC, meaning no 131I administration in low-risk patients, a low activity in intermediate and even high risk patients, and a systematic use of rhTSH stimulation before 131I therapy allowed us to reduce significantly the median administered 131I activity, with a similar rate of complete therapeutic response.
Application of ultrasound artificial intelligence in the differential diagnosis between benign and malignant breast lesions of BI-RADS 4A
Authors: Niu Sihua , Huang Jianhua , Li Jia , Liu Xueling , Wang Dan , Zhang Ruifang , Wang Yingyan , Shen Huiming , Qi Min , Xiao Yi , Guan Mengyao , Liu Haiyan , Li Diancheng , Liu Feifei , Wang Xiuming , Xiong Yu , Gao Siqi , Wang Xue , Zhu Jiaan
Published: August 2020

Background: The classification of Breast Imaging Reporting and Data System 4A (BI-RADS 4A) lesions is mostly based on the personal experience of doctors and lacks specific and clear classification standards. The development of artificial intelligence (AI) provides a new method for BI-RADS categorisation. We analysed the ultrasonic morphological and texture characteristics of BI-RADS 4A benign and malignant lesions using AI, and these ultrasonic characteristics of BI-RADS 4A benign and malignant lesions were compared to examine the value of AI in the differential diagnosis of BI-RADS 4A benign and malignant lesions.Methods: A total of 206 lesions of BI-RADS 4A examined using ultrasonography were analysed retrospectively, including 174 benign lesions and 32 malignant lesions. All of the lesions were contoured manually, and the ultrasonic morphological and texture features of the lesions, such as circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, margin lobulation, energy, entropy, grey mean, internal calcification and angle between the long axis of the lesion and skin, were calculated using grey level gradient co-occurrence matrix analysis. Differences between benign and malignant lesions of BI-RADS 4A were analysed.Results: Significant differences in margin lobulation, entropy, internal calcification and ALS were noted between the benign group and malignant group (P=0.013, 0.045, 0.045, and 0.002, respectively). The malignant group had more margin lobulations and lower entropy compared with the benign group, and the benign group had more internal calcifications and a greater angle between the long axis of the lesion and skin compared with the malignant group. No significant differences in circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, energy, and grey mean were noted between benign and malignant lesions.Conclusions: Compared with the naked eye, AI can reveal more subtle differences between benign and malignant BI-RADS 4A lesions. These results remind us carefully observation of the margin and the internal echo is of great significance. With the help of morphological and texture information provided by AI, doctors can make a more accurate judgment on such atypical benign and malignant lesions.
Long non-coding RNA H19 deficiency ameliorates bleomycin-induced pulmonary inflammation and fibrosis
Authors: WAN XIAOYU , TIAN XINBEI , DU JUN , LU YING , XIAO YONGTAO
Published: August 2020

Background: The poor understanding of pathogenesis in idiopathic pulmonary fibrosis (IPF) impaired development of effective therapeutic strategies. The aim of the current study is to investigate the roles of long non-coding RNA H19 (lncRNA H19) in the pathogenesis of IPF. Methods: Bleomycin was used to induce pulmonary inflammation and fibrosis in mice. The mRNAs and proteins expression in lung tissues was determined by quantitative real-time polymerase chain reaction and western blot. H19 knockout (H19-/-) mice were generated by CRISPR/Cas9 and used to investigate the roles of H19 in the pulmonary inflammation and fibrosis in vivo.Results: The expression of H19 mRNA was up-regulated in fibrotic lungs patients with IPF as well as in lungs tissues that obtained from bleomycin-treated mice. H19-/- mice suppressed bleomycin-mediated pulmonary inflammation and inhibited the Il6/Stat3 signaling. H19 deficiency ameliorated bleomycin-induced pulmonary fibrosis and repressed the activation of TGF-β/Smad and S1pr2/Sphk2 in the lungs of bleomycin-treated mice. Conclusions: Our data suggests that H19 is a profibrotic lncRNA and a potential therapeutic target for pulmonary fibrosis.
Determinants of Maternal and Neonatal Outcomes of Oligohydramnios After 37+0 Weeks of Gestation in Mekelle Public Hospitals, Northern Ethiopia
Authors: Teka Hale , Gidey Hagos , Gebreezgabher Tesfay , Yemane Awol , Ebuy Hiluf , Berhe Yibrah , Abate Ermias
Published: August 2020

Background Oligohydramnios is a state of deficient amniotic fluid defined objectively using ultrasound measurements as single deepest vertical pocket less than 2 centimeters and/or amniotic fluid index less than 5 centimeters. It has been correlated with conditions that threaten both maternal and fetal health. The aim of this stuy is to assess determinants of adverse maternal and perinatal outcome in women with oligohydramnios after 37+0 weeks in Ayder Comprehensive Specialized Hospital and Mekelle General Hospital from April 1, 2018 – March 31, 2019.Methods This was prospective observational study. Total population purposive sampling method was employed to collect data prospectively. Result During the study period, there were a total of 10,451 deliveries, of which 273 were complicated with oligohydramnios, making the prevalence of term oligohydramnios 2.6%. The composite adverse perinatal and maternal outcomes were 38.1% and 89.4% respectively. Primigravidity, degree of oligohydramnios, presence of intrauterine growth restriction and postterm pregnancy were associated with adverse perinatal outcome. Degree of oligohydramnios and hypertensive disorders of pregnancy were found to be predictor of composite adverse maternal outcome. Conclusion Appreciation of determinants of composite adverse maternal and neonatal outcome can aid prompt interventions and mobilization of resources for resuscitation and early transfer to neonatal intensive care unit. Knowledge of determinants of maternal outcome can serve as a tool for patient counseling and for anticipation of maternal complications.
A randomized-controlled pilot study on the effects of naproxen for the treatment of bleeding and spotting among new Copper T 380A IUD users
Authors: Godfrey Emily M , Andrilla C. Holly A. , Odem-Davis Katherine
Published: August 2020

Background: The most common reason women report discontinued use of the Copper T 380A (TCu380A) IUD is because of bleeding irregularities after method initiation. The objective of this study was to determine whether an over-the-counter NSAID, naproxen sodium, reduces the number of bleeding and spotting days and heavy or prolonged bleeding episodes among new users of the TCu380A IUD compared to placebo.Methods: In this double-blind pilot trial, we randomized 28 new TCu380A IUD users who reported menstrual cycle changes within 4-6 weeks after IUD placement to either naproxen 440 mg or placebo twice daily for 7 days for three consecutive 28-day cycles and one additional 28-day cycle without treatment. Participants completed a daily bleeding and other symptom diary, and monthly questionnaires. Results: Although not statistically significant, participants in the naproxen arm reported more mean number of spotting-only days during the three treatment cycles compared those in the placebo group (13.5 days (SE 5.1) vs.7.5 days (SE 1.7), respectively). Otherwise, the mean number of bleeding-only days during treatment and post-treatment and spotting-only post-treatment were similar between the groups. During each treatment cycle, fewer participants in the treatment group reported heavy bleeding compared to placebo group (30.7% fewer in cycle 2; 5.4% fewer in cycle 3). More women in the treatment group, however, reported prolonged menstrual bleeding of greater than 7 days for each cycle, although the percentage reporting prolonged bleeding decreased each consecutive treatment and post-treatment cycle (+27.5%, +19.8%, +9.1%, +4.5%, cycles 1-4 respectively). Other symptoms experienced by new TCu380A users did not differ between the study arms.Conclusions: Treatment with naproxen did not significantly reduce the number of bleeding or spotting days among new TCu380A users. Although not statistically different, proportionally fewer participants in the naproxen group reported moderate-heavy or heavy periods, but more reported prolonged menstrual bleeding compared to placebo. Participants tolerated oral naproxen use well.Trial registration: ClinicalTrials.gov: NCT02519231. Registered on August 10 2015.
Can the act of sexual intercourse before embryo transfer improve IVF treatment outcome? A Randomized Clinical Trial
Authors: Sun Zhen-Gao , Yuan Li Hua , Cao Xian Ling
Published: August 2020

Background: Exposure of the female reproductive tract to either seminal plasma or fluid component of the ejaculate is beneficial to achieving successful embryo implantation and normal embryo development. Can the act of sexual intercourse during the peri-transfer period have any influence on pregnancy outcome? Methods: We conducted a randomized trial that included 300 patients undergoing IVF treatment at a University-affiliated reproductive center from 19 July to 20 August 2018. Enrolled patients undergoing IVF treatment were randomized either to engage sexual intercourse using the barrier contraception (n=116) or to abstain (n=107) one night before FET. The follow-up parameters included biochemical pregnancy, clinical pregnancy, early abortion, implantation rate and pregnancy rate. Results: Patients having intercourse had higher pregnancy rate (51.72% vs. 37.07%, P=0.045) and implantation rate (38.31% vs. 24.77%, P=0.005) compared to those did not engage intercourse. However, there was no significant difference of the spontaneous abortion rate between two groups (11.67% vs. 14.63%, P=0.662). Conclusions: Sexual intercourse before the day of embryo transfer can improve the clinical pregnancy and implantation rates during the frozen-thawed embryo transfer (FET) cycle. But it's important to note that the selected time of coitus for patients was only once, the night before the embryo transfer. Our interpretation of the results obtained in the present study has been too brief an interval to show beneficial effects. In general, we do not recommend that patients undergoing IVF have sexual intercourse after embryo transfer, because this may lead to uterine contractions or introduce infection sources into the uterine cavity.TRIAL REGISTRATION NUMBER: This study was registered at the China Clinical Trial Registration Center, with the registration number ChiCTR1800017209（http://www.chictr.org）
Tinnitus in Noise Exposed Workers
Authors: Bai Lu , Yu Jianping , Du Hong , Shen Zhuang , Yang Hongyan
Published: August 2020

Background: Tinnitus in noise exposed workers is worse, which seriously affects the normal life and work. Workers with tinnitus often complain that even going to see the doctor is ineffective. They think tinnitus is caused by occupational noise exposure, which makes tinnitus worse. To find the truth the investigation and analysis of tinnitus including reason, treatment and effect and hearing level was proceeded among all noise-exposed workers in railway transportation mechanical manufacturers in Beijing in 2015. Methods: Cross-section study was conducted. 519 noise-exposed workers were selected as exposed group, 515 non noise-exposed workers were selected as control group. Self-designed questionnaire was used in the way of face-to-face to get subjects’ information including social statistical data, occupational history, past history and living habits. Results: The incidence of tinnitus was 36.6% among noise-exposed workers, which was significantly higher than that in the control group (c2= 40.725, P < 0.05). Meanwhile the incidence of seeing the doctor was 15.8%. The incidence of tinnitus was significantly different in different subgroups of exposed group (c2= 6.072, P < 0.05). There was no significant difference between using earphones and tinnitus (P > 0.05). In the exposed group the incidence of hearing abnormal in workers with tinnitus was significantly higher than those without tinnitus (c2= 18.570, P < 0.05). Conclusions: Right knowledge, attitude and practice (KAP) would be helpful for workers with tinnitus. Occupational health education and supervision of noise-exposed workers should be further strengthened in this industry. Personal protection should be enhanced so as to improve occupational health.
Non-Linear Relationships Between Maternal Pre-Pregnancy Body Mass Index, Gestational Weight Gain and Duration of Breastfeeding
Authors: Zhang Yijing , Lin Yanfen , Xu Jian , Luo Zhong-cheng , Cao Sirui , Liu Zhiwei , Huang Jun
Published: August 2020

Background:Considering the potential inappropriateness of the 2009 Institute-of-Medicine criteria to Chinese women, we investigated the associations between pre-pregnancy body-mass-index (BMI), gestational-weight-gain (GWG) and breastfeeding-duration among Chinese women.Methods:This birth-cohort study included 225 mother-child pairs in Shanghai from 2010 to 2012. Mothers were interviewed during mid-to-late pregnancy and at 24-36 months postpartum. Information on pre-pregnancy BMI/GWG and breastfeeding-duration was collected during pregnancy and at 24-36 months postpartum, respectively. Using a data-driven approach based on spline-smoothing-fitting of the data, two-piecewise linear regression models were used to assess the relations between pre-pregnancy BMI, GWG and breastfeeding-duration. Results:Mothers being younger, longer daily working hours, and less time living with children per week were associated with shorter duration (P<0.05). The "inverted-U"-shaped and "flat-then-declining"-shaped associations between pre-pregnancy BMI, GWG and breastfeeding-duration were observed, respectively. Adjusting for related confounders, the increases in pre-pregnancy BMI below and above 22.5 kg/m2 were associated with an increase (P=0.044) and a marginal decrease (P=0.077) in breastfeeding-duration, respectively. One-kilogram increase in GWG was associated with 0.4-month decrease (95% CI: -0.7, -0.1) in breastfeeding-duration when GWG ≥ 17.5 kilograms, however, with nonsignificant changes when GWG <17.5 kilograms. Conclusion:Appropriate pre-pregnancy BMI (around 22.5 kg/m2) and GWG (< 17.5 kilograms) were favorable to sustained breastfeeding.
Evidence for ABL Amplification in Multiple Myeloma and Its Role in Treatment
Authors: Huang He , Guo Wenjian , He Licai , Yao Ronxin , Lin Ying , Yu Kang , Li Qian
Published: August 2020

Background: The cytogenetic abnormalities are considered as initiating events in the pathogenesis of multiple myeloma (MM) and were assumed to be clinical significance. A number of defined cytogenetic lesions have been reported by genetic analysis techniques, while ABL gene, known as the therapeutic target in chronic myelogenous leukemia (CML), its expression in myeloma has not been deeply explored.Methods: We used publically available method FISH to analyze the chromosomal architecture, clinic features and overall survival of 101 MM patient samples. Additionally, we examined ABL expression in MM cell lines (NCI-H929, LP-1 and U266) through FISH and western blot. After culturing with ABL kinase inhibitor STI571, we analyzed MM cell proliferation by CCK8 assay and detected ABL protein levels by western blot.Results: Together with reported chromosomal abnormalities, we found ABL gene exhibited not as BCR-ABL fusion gene in CML, but its amplification was prevalent, 67 patients (66.3%) had cytogenetic abnormalities with ABL amplification. And the patients with ABL gene amplification indicates no significance with clinical features, adverse cytogenetics (C-MYC amplification, IGH rearrangement, RB1 deletion, P53 deletion and 1q21 amplification) and overall survival comparing to patients with normal ABL expression. Moreover, we revealed ABL amplification in MM cell lines (LP-1 and U266) by FISH, and ABL protein was easy to detect in MM cell lines and some tumor cells. According to CML cells, the cytotoxicity of STI571to MM cells was definitely limited.Conclusions: Our study first discussed ABL gene amplification in MM cells, and we believe ABL gene would potentially be a useful target in the treatment of combination strategy for MM with ABL amplification in future.
circVAR Database: Genome-Wide Archive of Genetic Variants for Human Circular RNAs
Authors: Zhao Min , Qu Hong
Published: August 2020

Background: Circular RNAs (circRNAs) play important roles in regulating gene expression through binding miRNAs and RNA binding proteins. Genetic variation of circRNAs may affect complex traits/diseases by changing their binding efficiency to target miRNAs and proteins. There is a growing demand for investigations of the functions of genetic changes using large-scale experimental evidence. However, there is no online genetic resource for circRNA genes. Results: We performed extensive genetic annotation of 295,526 circRNAs integrated from circBase, circNet and circRNAdb. All pre-computed genetic variants were presented at our online resource, circVAR, with data browsing and search functionality. We explored the chromosome-based distribution of circRNAs and their associated variants. We found that, based on mapping to the 1000 Genomes and ClinVAR databases, chromosome 17 has a relatively large number of circRNAs and associated common and health-related genetic variants. Following the annotation of genome wide association studies (GWAS)-based circRNA variants, we found many non-coding variants within circRNAs, suggesting novel mechanisms for common diseases reported from GWAS studies. For cancer-based somatic variants, we found that chromosome 7 has many highly complex mutations that have been overlooked in previous research.Conclusion: We used the circVAR database to collect SNPs and small insertions and deletions (INDELs) in putative circRNA regions and to identify their potential phenotypic information. To provide a reusable resource for the circRNA research community, we have published all the pre-computed genetic data concerning circRNAs and associated genes together with data query and browsing functions at http://soft.bioinfo-minzhao.org/circvar.
Clinical Features and Surgical Outcomes of Subretinal Proliferation in Proliferative Diabetic Retinopathy
Authors: Wu Chan , Rongping Dai , Chen Youxin , Zhang Xiao , Chen Zhe
Published: August 2020

Background: To investigate the clinical characteristics, treatments and prognosis of subretinal proliferation (SRP) in patients with proliferative diabetic retinopathy (PDR).Methods: 154 patients (182 eyes) who received vitrectomy for PDR were retrospectively reviewed. Patients with SRP were enrolled as the study group, and those without SRP served as the control group. The following data were collected from their medical records: demographics, systemic and ophthalmologic findings, and treatment given specifically for SRP. The main outcome measures included the visual acuity, funduscopic examination and final anatomic success. The association between SRP and other systemic involvement of PDR was also analyzed. Results: There were 9 eyes (9 patients) in the study group and 145 eyes (145 patients) in the control group. The average fasting blood glucose was 11.48 ± 3.52 mmol/L and 8.72 ± 3.05 mmol/L, respectively (P = .048). The study group had a significantly higher proportion of tractional retinal detachment (TRD) (P < .0001) and a significantly lower proportion of vitreous hemorrhage (VH) (P = .0006). The rate of silicone oil usage was higher in the study group (P < .0001). No retinal break was found preoperatively or intraoperatively. Only one eye (11.1%) had undergone subretinal band removal procedure intraoperatively, and the final anatomical success rate was 100%. Conclusion: SRP in PDR was associated with higher blood sugar levels and TRD. The retina could reattach successfully after vitrectomy without removal or transection of the subretinal bands in most eyes.
Expression Patterns of Ciliopathy Genes ARL3 and CEP120 Reveal Roles in Multisystem Development
Authors: Powell L , Barroso-Gil M , Clowry Gavin J , Devlin Laura A , Molinari Elisa , Ramsbottom Simon A , Miles Colin G , Sayer John
Published: August 2020

Joubert syndrome and related disorders (JSRD) and Jeune syndrome are multisystem ciliopathy disorders with overlapping phenotypes. There are a growing number of genetic causes for these rare syndromes, including the recently described genes ARL3 and CEP120. We sought to explore the developmental expression patterns of ARL3 and CEP120 in humans to gain additional understanding of these genetic conditions. We used an RNA in situ detection technique called RNAscope to characterise ARL3 and CEP120 expression patterns in human embryos and foetuses in collaboration with the MRC-Wellcome Trust Human Developmental Biology Resource. This study provides insights into the potential pathogenesis of JSRD by uncovering the spatial expression of two JSRD-causative genes during normal human development.
Development and Validation of An Immune-Related Gene Pair Signature in Skin Cutaneous Melanoma
Authors: Xie Ran , Dong Suwei , Jiang Jie , Yang Conghui , Li Lanjiang , Zhao Sheng , Li Yunlei , Wang Chun , Li Shujuan , Xiao Yanbin , Chen Long
Published: August 2020

Skin cutaneous melanoma (SKCM) is a common skin malignancy worldwide, and its metastasis and mortality rates are high. The molecular characteristics exhibited by tumor-immune interactions have drawn the attention from researchers. Therefore, increased knowledge and new strategies to identify effective immune-related biomarkers may improve the clinical management of SKCM by providing more accurate prognostic information. In this study, we established a prognostic immune-related gene pair (IRGP) signature for predicting the survival of SKCM patients. The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases provided gene expression profiles together with clinical information, and the samples were randomly divided into three groups including the training, testing, and validation datasets. The regression model of least absolute shrinkage and selection operator (LASSO) helped to identify a 13-IRGP signature with a significant relation to the survival of SKCM patients. The training, TCGA, and independent sets have an average value of area under the curve of 0.79, 0.76, and 0.82, respectively. In addition, this 13-IRGP signature can noticeably divide SKCM patients into high-risk group and low-risk group with significantly different prognoses. Many biological activities such as gene family were enriched among the genes in our IRGP signature. While analyzing the risk signature and clinical characteristics, there was a large difference in the risk score between T stage and tumor stage grouping. Finally, we constructed a nomogram and forest plots of the risk score and clinical features. In summary, we developed a robust 13-IRGP prognostic signature in SKCM, which can identify and provide new insights into immunological biomarkers.
Anthropometry of the Coracoid Process: Surgical Considerations in Arthroscopic Coracoclavicular Ligament Reconstruction
Authors: Kuptniratsaikul Somsak , Prasertkul Natavut , Itthipanichpong Thun
Published: August 2020

Purposed: The purpose of this study was to measure the dimensions of the coracoid process from MRI imaging to find a safe area for drilling in arthroscopic coracoclavicular ligament reconstruction.Materials and methods: A retrospective study of patients who underwent MRI of the shoulder in our hospital between July 1, 2016 and June 31, 2018. Inclusion criteria included patients aged 20–60 years, BMI < 35 and height > 150 cm. Exclusion criteria included patients with a history of coracoid surgery, coracoid fracture or bone diseases affecting the coracoid bone. Measurement of the coracoid size was done in T1 MRI sagittal, coronal and axial views. Safe zone was defined as an area far from the medial and lateral base of the coracoid process, at least 5 mm each. Safe zone was then compared with the size of the drill hole to find an appropriately sized drill that would not violate the peripheral cortical coracoid bone.Results: Overall, 100 (male = 55, female = 45) patients were included in this study. Mean age, BMI and height of the patients were 48.5 years (range 22–58), 22.5 kg/m2 (range 18.5–28.4) and 164.5 cm (range 155–182), respectively. Mean safe area was 167.45 mm2 with males being slightly larger than females (male = 190.34 mm2, female = 140.99 mm2). The drill hole area was calculated by the radius (r) of the drill ( compared with the safe area. The maximum drill size for the men was 7 mm (154 mm2) and 6 mm (113.14 mm2) for women. However, we recommended a smaller drill size to account for any errors in position and technique.Conclusion: The safe area at the coracoid base was slightly larger in males as compared to females and the proper drill bit size was suggested to be less than 7 mm in males and 6 mm in females.
Cultural Competence of Australian Dental Students
Authors: Mariño Rodrigo , Satur Julie , Tuncer Eren , Tran Megan , Milford Elizabeth , Tran Vivien , Tran Phuong , Tsai Richard
Published: August 2020

Background: Australia possesses a highly multicultural demographic, and thus dental practitioners are likely to encounter culturally and linguistically diverse individuals regularly. It is important for dental practitioners to be culturally competent, however, cultural competency education is highly variable in the curricula of dentistry and oral health courses in Australia, and research is largely limited to dentistry students. This study aims to investigate and compare perceived attitudes, beliefs and practices of cultural competence amongst first and final year Doctor of Dental Surgery (DDS) and Bachelor of Oral Health (BOH) students at the University of Melbourne Dental School.Methods: Following ethics approval, anonymous questionnaires were completed by 213 participants. The questionnaire was adapted from Schwarz’s Healthcare Provider Cultural Competence Instrument (HPCCI) and consisted of five scales. Data was analysed using SPSS V 24.0 software.Results: A total of 213 students participated in this study (response rate = 88%) The majority of participants were female (n=114, 53.5%) and the mean age of 23.5 years (range 18 - 40). The majority of participants were Australian born (n=110) with 74.6 percent (n=159) first generation Australians. Participants who identified as Australian represented 35.7 percent (n=76) with 66.1 percent (n=141) identified as partly Australian. Multivariate analysis indicated that, after controlling for other independent variables in the model, those who had the highest cultural competence score were female, who self-identify as “Australian”, who were in the final year. Furthermore, those who were in the final BOH year scored significatively higher than final year DDS students.Conclusion: The findings of this study suggest that there is a significant difference in students self-reported cultural competence at different stages of their education. This may be attributed to differences in cultural competence education, scope of practice and the type of patient encounters that students may experience. Future research should involve follow up to create longitudinal data, as well as research at other dental schools in Australia and overseas.
Time trends in hospital admissions in very elderly patients (≥85 years-old) in Spain: data from the Spanish National Discharge Database (2000 - 2015)
Authors: Fernández Sergio Palacios , Salcedo Mario , Gonzalez-Alcaide Gregorio , Ramos-Rincon Jose-Manuel
Published: August 2020

BackgroundThe aging population is an increasing concern in Western hospital systems. The aim of this study was to describe the main characteristics and hospitalization patterns in very elderly inpatients (≥ 85 years) in Spain from 2000 to 2015.MethodsRetrospective observational study analyzing data from the minimum basic data set, an administrative registry recording each hospital discharge in Spain since 1997. We collected administrative, economic and clinical data for all discharges between 2000 and 2015 in patients aged 85 years and older, reporting results in three age groups and four time periods to assess differences and compare trends.ResultsThere were 4,387,326 admissions in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total admissions in 2000–2003 and 10.42% in 2012–2015. The pace of growth was faster in older age groups, with an annual percentage increase of 6% in patients aged 85–89 years, 7.79% in those aged 90–94 years, and 8.06% in those aged 95 and older. The proportion of men also rose (37.3–39.7%, p < 0.001), and they had a higher incidence of hospitalization than women (385 discharges/1000 men versus 280 discharges/1000 women in 2012–2015).There were 4,387,326 admissions in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total admissions in 2000–2003 and 10.42% in 2012–2015. The pace of growth was faster in older age groups, with an annual percentage increase of 6% in patients aged 85–89 years, 7.79% in those aged 90–94 years, and 8.06% in those aged 95 and older. The proportion of men also rose (37.3% to 39.7%, p<0.001), and they had a higher incidence of hospitalization than women (385 discharges/1000 men versus 280 discharges/1000 women in 2012–2015).Mortality decreased from 14.64% in 2000–2003 to 13.83% in 2012–2015 (p<0.001), and mean length of stay from 9.98 days in 2000–2003 to 8.34 days in 2012–2015. Costs per hospital stay increased from 2000 to 2011, from EUR 4611 in 2000–2003 to EUR 5212 in 2008–2011, before dropping to EUR 4824 in 2012–2015. The 10 most frequent discharge diagnoses in the period 2000-2003 were: femoral neck fracture (8.07%), heart failure (7.84%), neoplasms (7.65%), ischemic encephalopathy (6.97%), pneumonia (6.36%), chronic obstructive pulmonary disease (4.23%), ischemic cardiomyopathy (4.2%), other respiratory diseases (3.87%), other alterations of urethra and the urinary tract (3.08%), and cholelithiasis (3.07%). ConclusionsThe very elderly population is growing in Spanish hospitals, and within this group, patients are getting older and more frequently male. The mean length of stay, cost of stay, and mortality are decreasing. Decompensation of chronic diseases, neoplasms and infections are the most common causes of admission.
Effects of vibration on chronic leg edema in chair-bound older adults: A randomized pilot trial
Authors: Tsuchiya Sayumi , Sato Aya , Ueda Terumi , Dai Misako , Okuwa Mayumi , Nakatani Toshio , Sugama Junko
Published: August 2020

BackgroundElderly individuals can easily develop leg edema that can become chronic, which may result in various problems. Therefore, appropriate care for the edema should be provided. In some cases, chronic leg edema among elderly individuals cannot be controlled by the standard care such as leg elevation or compression. A previous study reported that vibration benefited upper limb lymphedema; however, its effects on chronic leg edema are not yet clarified. Therefore, this study aimed to clarify the effects of vibration for reducing chronic leg edema among chair-bound elderly individuals.MethodsFor participant allocation, a computer-generated list of random numbers was used. Nursing home residents aged ≥65 years with chronic leg edema who spent more time sitting than standing or lying during the day were randomly assigned to the intervention (n = 7) or control group (n = 7). The intervention group underwent vibration therapy three times a day for 2 weeks at 47 Hz and 1.78 m/s2 frequency and horizontal vibration acceleration, respectively. The pitting test was performed at 22 sites, and participants’ pitting scores were calculated based on the pitting depth. Pitting score changes at pre- and post-intervention were compared between the intervention and control groups. Both participants and investigators were not blinded to group assignment.ResultsThe median age of the intervention and control groups was 86 and 84 years, respectively. Participants’ characteristics and edema severity at baseline were not significantly different. The median total pitting score change in the intervention group was −0.4 (interquartile range: −5.3–1.8), which was significantly lower than that of the control group (2.0 [interquartile range: 1.0－5.3], P = 0.01). The intervention group was more likely to have controlled edema (64.3%) than the control group (21.4%) (χ2 (1) = 5.25, P = 0.02).ConclusionsThe intervention group was more likely to have controlled edema than the control group, suggesting that vibration could prevent the worsening of chronic leg edema in chair-bound elderly individuals.Trial registration: UMIN Clinical Trials Registry, UMIN000017716. Registered 1 July 2015, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000020522
Morphology, Ontogeny and Molecular Phylogeny of a New Urostylid Ciliate, Bakuella (Pseudobakuella) Guangdongica n. sp. (Protista, Ciliophora, Hypotrichia) from Southern China
Authors: Wang Jingyi , Li Jingbao , Wang Yurui , Al-Farraj Saleh A. , Shao Chen
Published: August 2020

Background: Spirotrich ciliates are one of the most diverse groupsin the phylum Ciliophora and are widely distributed in marine, freshwater, and terrestrial biotopes. Many nominal species are, however, poorly known and their systematic positions remain uncertain due to the lack of information concerning their infraciliature, morphogenesis, and gene sequences. In this paper, the morphology and morphogenesis of Bakuella (Pseudobakuella) guangdongica n. sp. were studied, in addition, genomic DNA was extracted in order to sequence the small subunit rDNA. Results: Bakuella (Pseudobakuella) guangdongica n. sp. is characterized by 150–225 µm in vivo; 35–42 adoral membranelles; three to five buccal, two frontoterminal and eight to 13 transverse + pretransverse cirri; midventral complex comprised of 10–20 midventral pairs and two midventral rows extending to transverse cirri; posterior part of marginal rows slightly overlapped; colorless cortical granules about 1 μm across, arranged in small groups; soil habitat. Its main ontogenetic features are: (1) in the proter, the parental adoral zone of membranelles is completely renewed by new structures; (2) in the opisthe, the oral primordium originates apokinetally, some old midventral cirri join the formation of frontoventral-transverse cirral anlagen; (3) the anlagen for marginal rows and dorsal kineties develop intrakinetally; and (4) the numerous macronuclear nodules fuse into a single mass before dividing. Phylogenetic analyses based on the SSU rDNA sequence suggests the non-monophyly of the genus Bakuella. Conclusions: The morphology, morphogenesis and molecular phylogeny of the new hypotrichous ciliate, Bakuella (Pseudobakuella) guangdongica n. sp. were studied, the phylogenetic analyses show that the Bakuella is polyphyletic in the SSU rDNA.
The lower methylation of RANK is associated with osteoporosis in male aged general population of Xinjiang: A Case-Control Study
Authors: Shang Junjing , xiang Hong , Bai Xue , Halan Buluhan , Wang Hongmei
Published: August 2020

Background

RANK is a candidate gene for osteoporosis on both functional and genetic grounds. The study is to investigate the relationships between the methylation of RANK and osteoporosis in aged general population.
Methods

On the basis of an epidemiological investigation, we detect for methylation CpGs in promoter of RANK in 32 aged subjects (16 males and 16 females) firstly. Secondly, after considering the relationships among osteoporosis and the methylation rate of identified CpGs in male and female subjects, the selected representatives CpGs were detected in 90 male aged general subjects (43 controls and 47 cases) by bisulfite sequencing. Then a case-control study is conducted.
Results

Age and the prevalence of diabetes were significantly difference between the case patients and control individuals (P = 0. 025, P = 0. 005)., There was no statistical significance between the case group and the control group for the following values: systolic blood pressure, diastolic blood pressure, body mass index, 25-dihydroxyvitaminD3, folic acid, testosterone, creatinine, serum calcium concentration, and the prevalence of smoking, drinking and hypertension (P > 0.05). The methylation rate of RANK in control group was significant higher than that in osteoporosis group (P < 0.001). In addition, by covariance analysis to adjust age, prevalence of smoking, drinking, hypertension, and diabetes, the methylation rate of RANK in control group was significant higher than that in osteoporosis group in male aged general population of Xinjiang (P = 0.001). After adjusting for confounding factors (age, smoking, drinking, and diabetes), multivariate logistic regression analysis also showed that lower methylation of RNAK gene were significantly associated with osteoporosis (OR = 0.930, 95% CI = 0.886–0.976)
Conclusions

The lower methylation rate of RANK was associated with osteoporosis in male aged general population of Xinjiang. This confirms that lower methylation of RANK might be involved in the pathogenesis of osteoporosis
Effect of APOE ε4 genotype on amyloid-β and tau accumulation in Alzheimer’s disease
Authors: Baek Min Seok , Cho Hanna , Lee Hye Sun , Lee Jae Hoon , Ryu Young Hoon , Lyoo Chul Hyoung
Published: August 2020

Background: To assess effects of apolipoprotein E (ApoE) ε4 genotype on Aβ and tau burden and their longitudinal changes in Alzheimer’s disease (AD) spectrum.Methods: Among 272 individuals who underwent PET scans (18F-florbetaben for Aβ and 18F-flortaucipir for tau) and ApoE genotyping, 187 individuals completed 2-year follow-up PET scans. After correcting for partial-volume effect, we compared the standardized uptake value ratio (SUVR) for Aβ and tau burden between the ε4+ and ε4- groups. By using a linear mixed-effect model, we measured changes in SUVR in the ApoE ε4+ and ε4- groups.Results: The ε4+ group showed greater baseline Aβ burden in the diffuse cortical regions and greater tau burden in the lateral, and medial temporal, cingulate, and insula cortices. Tau accumulation rate was higher in the parietal, occipital, lateral, and medial temporal cortices in the ε4+ group. In Aβ+ individuals, baseline tau burden was greater in the medial temporal cortex, while Aβ burden was conversely greater in the ε4- group. Tau accumulation rate was higher in the ε4+ group in a small region in the lateral temporal cortex. The effect of ApoE ε4 on enhanced tau accumulation persisted even after adjusting for the global cortical Aβ burden.Conclusions: Progressive tau accumulation may be more prominent in ε4 carriers, particularly in the medial and lateral temporal cortices. ApoE ε4 allele has differential effects on Aβ burden depending on the existing amyloidosis and enhances vulnerability to progressive tau accumulation in the AD spectrum independent of Aβ.
Stability and Clinical Outcomes of A New One Piece Toric Intraocular Lens with Anchor-wing Haptics
Authors: Sugita Iichiro , Ogawa Tomoichiro , Ichikawa Kazuo , Okita Takahide , Negishi Kazuno , Nakano Tadashi , Tsuneoka Hiroshi
Published: August 2020

Background: To evaluate the safety and efficacy of a new toric intraocular lens (IOL) with anchor-wing haptics.Methods: The new toric IOL with anchor-wing haptics (NS60YT, NIDEK Co., Ltd.) was implanted in eligible patients with age-related cataracts with preoperative corneal astigmatism of 1.0 D or greater at one university hospital and two private hospitals in Japan. Four cylinder powers of the IOL were evaluated as follows: 1.50 D (NS60YT3), 2.25 D (NS60YT4), 3.00 D (NS60YT5) and 4.50 D (NS60YT7). All patients were assessed out to 12 months postoperatively. The primary endpoint was uncorrected visual acuity (UCVA) with spherical addition 6 months postoperatively, and the primary analysis calculated the proportion of UCVA with spherical addition of 0.8 or better. The magnitude of rotation was compared to the intended axis of IOL implantation at each postoperative examination. Adverse events were evaluated for the safety analysis. Results: The study enrolled 64 eyes of 53 patients. At 6 months postoperatively, for all models, mean UCVA with spherical addition of 0.8 or better was achieved in 90% [95% confidence interval (CI): 80-96] of eyes. The mean IOL rotation was 5.3±4.3° 12 months after surgery. Between each postoperative examination from 1 day to 12 months, the mean magnitude of rotation ranged between 1.9° to 2.5°.There were no vision threatening intraoperative or postoperative complications for the duration of the study.Conclusions: The NS60YT IOL remained stable after implantation and was efficacious for treating 1.00 D or greater astigmatism in patients with senile cataracts.Trial registration: This study was registered at ClinicalTrials.gov (NCT03242486) on August 8, 2017 - Retrospectively registered. (https://clinicaltrials.gov/ct2/show/NCT03242486)
Development of the Labor Pain Relief Attitude Questionnaire for Pregnant Women (LPRAQ-p)
Authors: Hulsbosch Lianne P , Nyklíček Ivan , Potharst Eva S , Boekhorst Myrthe GBM , Pop Victor JM
Published: August 2020

Background: Receiving epidural analgesia during labor can possibly have negative consequences for mother and child. Yet, the use of epidural analgesia rapidly increased in the Netherlands over the last decade. Since antenatal plans for labor pain relief have been related to epidural analgesia use during labor, the aim of the current study was to develop a Labor Pain Relief Attitude Questionnaire for pregnant women. Methods: Three focus groups interviews were conducted with pregnant women, new mothers and caregivers and 13 candidate items were derived. Psychometric properties were tested with explorative factor analysis in sample I (N = 429) and a subsequent confirmatory factor analysis in a different sample II (N = 432). Results: The explorative factor analysis suggested a two-factor seven-item solution: a ‘women’s perception’ and ‘social environment’ subscale. The confirmatory factor analysis confirmed an excellent six-item model fit with appropriate internal consistency. Two-tailed t-tests showed that depressed women, women with pregnancy-related distress, nulliparous women and multiparous women with complications during previous delivery were more willing to use labor pain relief during pregnancy. Conclusions: This study showed the Labor Pain Relief Attitude Questionnaire for pregnant women to be a valid instrument to evaluate attitude towards labor pain relief in pregnant women. Since high scores suggest low self-efficacy towards labor, this instrument may be a valuable screening instrument to indicate the women who may benefit from extra help and support during pregnancy and labor.
Professional Commitment and Career Maturity of Full-Time Nursing Postgraduates in China: A Cross-Sectional Study
Authors: sunzi kejimu , lei cheng , pan jun , ju mei
Published: August 2020

Background: Nursing is becoming ever more demanding, and is regarded as a stressful occupation because of manpower shortages and various other challenges associated with nursing practice.This article describes the students’ professional commitment and career maturity, and students establish their career objectives during the early stages of their graduate study. Methods: A cross sectional，survey design was conducted at universities in China. A sample of 184 students was selected using the professional commitment scale and career maturity scale to investigate the status quo of professional commitment and career maturity of full-time nursing postgraduates. Data was collected using self-designed demographic characteristics of the student, professional commitment scale, career maturity scale in 2019.Data was analyzed using correlation coefficient test(α < 0.05 ).Results: Participants returned 184 surveys (response rate, 100%) . Career maturity (105.12±11.13), Specialty commitment(90.0 ±12.09),Career maturity was positively correlated with Professional Commitment (r=0.20).Conclusions: The career maturity and professional commitments of full-time nursing postgraduates were of an average level. Career planning courses could be useful to strengthen the vocational education of the post-graduate students.