bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge of PEP and PrEP among people living with HIV/aids in Brazil
Authors: Sousa Laelson Rochelle Milanês , Elias Henrique Ciabotti , Fernandes Nilo Martinez , Gir Elucir , Reis Renata Karina
Published: January 2021

Background: Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) are key to preventing sexual transmission of HIV, whose sexual partners are at high risk of acquiring HIV. We aimed to determine the factors associated with PrEP and PEP's knowledge as secondary prevention among people living with HIV/AIDS.Method: Cross-sectional analytical study carried out among people living with HIV/AIDS treated at five specialized services in the city of Ribeirão Preto, São Paulo, Brazil. Data were collected from July 2016 to July 2017. Individual interviews were conducted. We used multivariable logistic regression to determine factors associated with knowing PrEP and PEP. Results: Of the 397 participants, 140 (35.26%) were heterosexual women aged 40 to 49 years (36.2%).Participants with less than 11 years of study (adjusted odds: 0.29; 95% CI: 0.13-0.60); who did not have a low viral load or did not know their viral load (adjusted odds: 0.29; 95% CI: 0.09-0.83) and those with casual partners (adjusted odds: 0.29; 95% CI: 0.09- 0.83) were less likely to know about the PrEP. MSM (adjusted odds: 2.88; 95% CI: 1.59-5.3) and those who used alcohol during sexual intercourse (adjusted odds: 1.7; 95% CI: 1.0-2.8) were more likely to know about the PEP.Conclusions: The knowledge about PEP and PrEP is low in Brazil. This may undermine secondary prevention efforts. Educational interventions to raise awareness of these prevention methods are needed among people living with HIV and who have HIV-negative sexual partners.
Chronic pain after breast surgery: incidence, associated factors and impact on quality of life, an observational prospective study
Authors: Villa Gianluca , Mandarano Raffaele , Calabrisotto Caterina Scirè , Rizzelli Valeria , Duca Martina Del , Montin Diego Pomarè , Paparella Laura , De Gaudio A. Raffaele , Romagnoli Stefano
Published: January 2021

Background. Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients’ function and quality of life is also described. Methods. Women aged 18+ undergoing oncological or reconstructive breast surgery from Jan until Apr 2018 at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Postoperative pain was measured at 0hrs, 3hrs, 6hrs, 12hrs, 24hrs, 48hrs, and 3 months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis. Results. Among the 307 patients considered in this study, the incidence of CPBS was 28% [95%CI 23.1%-33.4%]. Results from the logistic regression analysis suggest that axillary surgery (OR [95%CI], 2.99 [1.13-7.87], p=0.03), preoperative use of pain medications (OR [95%CI], 2.04 [1.20-3.46], p=0.01), and higher dynamic NRS values at 6 hours postoperatively (OR [95%CI], 1.28 [1.05-1.55], p=0.01) were all independent predictors for CPBS. Conclusions. Chronic pain after breast surgery is a frequent complication. In our cohort, long-term use of analgesics for pre-existing chronic pain, axillary surgery, and higher dynamic NRS values at 6 hours postoperatively were all factors associated with increased risk of developing CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicisation.Trial registration: clinicalTrials.gov registration NCT04309929
Oral Cancer patient’s profile and time to treatment initiation in the public health system in Rio de Janeiro, Brazil
Authors: Conceição Manoela Garcia Dias , Emmerick Isabel Cristina Martins , Figueiró Ana Claudia , Luiza Vera Lucia
Published: January 2021

Background: This paper aims to describe the profile of oral cancer (OC) patients, their risk classification and identify the time between screening and treatment initiation in Rio de Janeiro Municipality.Method: Data were obtained from the healthcare Regulation System (SISREG) regarding the period January 2013 to September 2015. Descriptive, bivariate and multivariate analysis were performed identifying the factors associates with a diagnosis of OC as well as the time to treatment initiation (TTI) differences between groups.Results: From 3,862 individuals with a potential OC lesion, 6.9% had OC diagnosis. OC patients were 62.3 y.o. (mean), 64.7% male, 36.1% were white and 62.5% of the records received a red/yellow estimated risk classification. Being older, male, white and receiving a high-risk classification was associated with having an OC diagnosis. OC TTI was in average 59.1 days and median of 50 days significantly higher than non-OC individuals (p=0.007). TTI was higher for individuals older than 60 years old, male, and white individuals and for risk classification red and yellow, nevertheless while in average none of these differences were statistically significant, the median of individuals classified as low risk was significantly (p=0.044) lower than those with high risk.Conclusions: Time to treatment initiation (TTI) was higher for OC patients related to non OC. Despite OC confirmed was associated with risk at screening classified as urgent or emergent, a high percentage of OC patients had their risk classified for elective care when specialized care was requested.
Patient involvement to inform the design of a clinical trial in postbariatric hypoglycaemia
Authors: Hepprich Matthias , Donath Marc Y , Hemkens Lars G
Published: January 2021

Background: Bariatric surgery may lead to symptomatic postprandial hypoglycaemia as a major side effect without established therapy so far. We aimed to develop an evidence-based study design of a clinical trial that tests treatment options and can provide useful patient-relevant evidence.Methods: We searched systematically for guidance of core outcome sets to determine the most relevant types of outcomes and duration of such a trial. Our search comprised literature databases, a database of core outcome sets and self-help organizations. We then developed a simple online questionnaire based on interviews with German-speaking patients with postprandial hypoglycaemia after bariatric surgery. We recruited participants by reaching out to all German speaking endocrinologists in Switzerland and large Swiss bariatric centres. We asked for preferences regarding outcome types and acceptable duration of being included in a corresponding clinical trial.Results: The literature search did not identify evidence-based guidance for informing our study design. Experience of clinical and research routine as well as patient interviews helped in identifying potential outcomes and the design of an online questionnaire. Therein, a total of 29 persons started the questionnaire and 22 answered questions related to the primary outcome. Of these, 17 (77.3%) deemed quality of life more relevant as primary outcome than the rate of hypoglycaemic episodes. A trial length of four weeks or longer was regarded as acceptable for 19 of 21 respondents to this question (91.4 %) and of six months or longer for 12 respondents (56 %). Conclusions: In situations with no other guidance, a simple questionnaire may help to inform trial design decisions. This study identifies a patient preference for “quality of life” as a primary outcome and supports the evidence-based conception of a patient-centred clinical trial in postbariatric hypoglycaemia.
Effectiveness of Oral Health Education Intervention among 12-15-Year-Old School Children in Dharan, Nepal: A Randomized Controlled Trial
Authors: Subedi Krishna , Shrestha Ashish , Bhagat Tarakant , Baral Dharanidhar
Published: January 2021

Background: School aged adolescents are in particular need of preventive program to ensure positive long-term oral health and hygiene. The objective of this study was to assess the effectiveness of an oral health education intervention on oral hygiene knowledge, attitude and practices (KAP), plaque control and gingival health among 12-15 years old school children in Dharan sub-metropolitan city, Nepal.Methods: A randomized controlled trial was conducted with parallel study groups, comprising 12-15-year-old school children, 120 in each group (experimental and control group). Oral health education was given to the experimental group at baseline, third and sixth months. Oral health education was given after completion of the study to the control group. Interview of the participants were done using a 23-item questionnaire for assessment of oral hygiene knowledge, attitude and practices (KAP). Oral examination was done using mouth mirror and WHO probe to record Turesky-Gilmore-Glickman modification of the Quigley-Hein plaque index (1970), Gingival index (Loe H and Silness J 1963) and Dentition status and treatment needs at baseline and third and sixth months of the study period. Analysis was done using chi-square test for categorical data and Independent t test, repeated ANOVA, Kruskal-Wallis test, Friedman test, Mann-Whitney U test for quantitative data. The level of significance was set at p<0.05.Results: There was 54.58% improvement in overall oral hygiene KAP in experimental group (p=0.001) whereas no improvement was seen in control group after 6 months of intervention. The mean plaque score was improved by 57.67% (p=0.001) in experimental group in comparison to 4.56% in control group. Gingival index was improved by 49.90% (p=0.001) in experimental group in comparison to 0.7% (p=0.05) in control group. Caries experience was increased in both groups but no significant difference was seen.Conclusions: The study concluded that oral health education was effective in improving oral hygiene KAP, plaque control and gingival health.Trial registrationThe trial was retrospectively registered with Clinical Trial Registry India (CTRI) with identifier no. CTRI/2018/05/013985, registered on 05/21/2018. (http://www.ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=23651&EncHid=&modid=&compid=%27,%2723651det%27). Institutional Review Committee, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal provided the ethical approval (Ref. No.: 292/074/075-IRC).
The use of internet platforms for oral health information and associated factors among adolescents from Jakarta: a cross sectional study
Authors: Maharani Diah Ayu , Tantawi Maha El , Yoseph Marsha Griselda , Rahardjo Anton
Published: January 2021

Background: The growth of the internet has increased its use to obtain health information including oral health information (OHI). This study assessed Indonesian adolescents’ use of different internet platforms to obtain OHI and factors associated with this use.Methods: A cross-sectional study surveyed middle school students in five regions in Jakarta in 2019. Participants completed a questionnaire that assessed demographics, oral health practices (toothbrushing and dental visits), the presence of dental pain, using internet platform to obtain OHI and type of information searched for. Multinomial logistic regression was used to assess the association between using the internet for OHI (Google, Social Media (SM), both or none) and the independent factors: demographics, oral health practice, dental pain and whether participants search for causes, symptoms, prevention or treatment of oral diseases (ODs). Results: Most of the 521 participants were female (55.7%) with mean age= 13.4 years. Almost all of them (93.7%) searched the internet for OHI through Google (40.7%) or Google with SM (36.1%). Searching for OHI over SM was significantly associated with toothbrushing (OR= 4.12, 95%CI= 1.43, 11.89) and less dental visits (OR= 0.16, 95%CI= 0.05, 0.60). Searching Google for OHI was significantly associated with looking for information about causes (OR= 3.69, 95%CI= 1.33, 10.26) and treatment (OR= 6.17, 95%CI= 2.23, 17.03) of ODs. Conclusions: Most adolescents used Google to seek OHI. Oral health practices and types of OHI searched for differed by internet platform. Dental health professionals should consider using internet-based interventions to promote oral health to this age group.
The attenuation of insulin-like growth factor signaling may be responsible for the relative reduction in matrix synthesis in degenerated areas of osteoarthritc cartilage
Authors: Tanaka Nobuho , Tsuno Hirotaka , Ohashi Satoru , Iwasawa Mitsuyasu , Furukawa Hiroshi , Kato Tomohiro , Fukui Naoshi
Published: January 2021

Background: In osteoarthritis (OA), cartilage matrix is lost gradually despite enhanced matrix synthesis by chondrocytes. This paradox may be explained, at least partly, by reduced chondrocyte anabolism in degenerated area of OA cartilage. However, to date, it is not known why chondrocyte anabolism is suppressed in those areas.Methods: Cartilage was obtained from control knees and end-stage OA knees in macroscopically preserved areas and degenerated areas, and gene expression was analyzed in respective regions of cartilage using laser capture microdissection and qPCR. For the cartilage protein analysis, cartilage was obtained from preserved areas and degenerated areas of OA knees in pairs, and proteins were extracted using urea buffer. Protein concentrations were determined by Luminex and compared between the areas. Cartilage explants prepared from preserved areas and degenerated areas of OA knees were cultured in the presence or absence of an AKT inhibitor, and the gene expression was evaluated by qPCR. Finally, the expression of SP1 was evaluated in OA and control cartilage, and the significance of Sp1 on the expression of IGF1R and IRS1 was investigated in experiments using primary cultured chondrocytes.Results: Within OA cartilage, the expression of IGF-1, IGF-2, IGF1R and IRS1 was reduced in degenerated areas compared to preserved areas, while the expression of all six IGF-binding protein genes examined was enhanced in the former areas. Consistent results were obtained by a protein analysis. In explant culture, the inhibition of AKT signaling abrogated the abundant matrix gene expression in the preserved areas over the degenerated areas, indicating that suppressed matrix synthesis in degenerated areas may be ascribed, at least partly, to attenuated IGF signaling. Within OA cartilage, the expression of Sp1 was considerably reduced in severely degenerated areas compared to preserved areas, which correlated well with the expression of IGF1R and IRS1. In experiments using primary cultured chondrocytes, the expression of IGF1R and IRS1 was enhanced by the induction of Sp1 expression and reduced by the suppression of Sp1 expression. Conclusions: The results of this study suggest that attenuated IGF signaling may be responsible, at least partly, for the reduced matrix synthesis in degenerated areas of OA cartilage.
Change in the plasma proteome associated with canine cognitive dysfunction syndrome (CCDS) in Thailand
Authors: Phochantachinda Sataporn , Chantong Boonrat , Reamtong Onrapak , Chatchaisak Duangthip
Published: January 2021

Background: Canine cognitive dysfunction syndrome (CCDS) is a progressive neurodegenerative disorder found in senior dogs. Due to the lack of biological markers, CCDS is commonly underdiagnosed. The aim of this study was to identify potential plasma biomarkers using proteomics techniques and to increase our understanding of the pathogenic mechanism of the disease. Plasma amyloid beta 42 (Aβ42) has been seen to be a controversial biomarker for CCDS. Proteomics analysis was performed for protein identification and quantification.Results: Within CCDS, ageing, and adult dogs, 87 proteins were identified specific to Canis spp. in the plasma samples. Of 87 proteins, 48 and 41 proteins were changed in the ageing and adult groups, Several distinctly expressed plasma proteins identified in CCDS were involved in complement and coagulation cascades and the apolipoprotein metabolism pathway. Plasma Aβ42 levels considerably overlapped within the CCDS and ageing groups. In the adult group, the Aβ42 level was low compared with that in the other groups. Nevertheless, plasma Aβ42 did not show a correlation with the Canine Cognitive Dysfunction Rating scale (CCDR) score in the CCDS group (p=0.131, R2=0.261).Conclusions: Our present findings suggest that plasma Aβ42 does not show potential for use as a diagnostic biomarker in CCDS. The nano-LC-MS/MS data revealed that the predictive underlying mechanism of CCDS was the co-occurrence of inflammation-mediated acute phase response proteins and complement and coagulation cascades that partly functioned by apolipoproteins and lipid metabolism. Some of the differentially expressed proteins may serve as potential predictor biomarkers along with Aβ42 in plasma for improved CCDS diagnosis. Further study in larger population-based cohort study is required in validation to define the correlation between protein expression and the pathogenesis of CCDS.
De novo transcriptome in roots of switchgrass (Panicum virgatum L.) reveals gene expression dynamic and act network under alkaline salt stress
Authors: Zhang Pan , Duo Tianqi , Wang Fengdan , Zhang Xunzhong , Yang Zouzhuan , Hu Guofu
Published: January 2021

Background: Soil salinization is a major limiting factor for crop cultivation. Switchgrass is a perennial rhizomatous bunchgrass that is considered an ideal plant for marginal lands, including sites with saline soil. Here we investigated the physiological responses and transcriptome changes in the roots of Alamo (alkaline-tolerant genotype) and AM-314/MS-155 (alkaline-sensitive genotype) under alkaline salt stress.Results: Alkaline salt stress significantly affected the membrane, osmotic adjustment and antioxidant systems in switchgrass roots, and the ASTTI values between Alamo and AM-314/MS-155 were divergent at different time points. A total of 108,319 unigenes were obtained after reassembly, including 73,636 unigenes in AM-314/MS-155 and 65,492 unigenes in Alamo. A total of 10,219 DEGs were identified, and the number of upregulated genes in Alamo was much greater than that in AM-314/MS-155 in both the early and late stages of alkaline salt stress. The DEGs in AM-314/MS-155 were mainly concentrated in the early stage, while Alamo showed greater advantages in the late stage. These DEGs were mainly enriched in plant-pathogen interactions, ubiquitin-mediated proteolysis and glycolysis/gluconeogenesis pathways. We characterized 1,480 TF genes into 64 TF families, and the most abundant TF family was the C2H2 family, followed by the bZIP and bHLH families. A total of 1,718 PKs were predicted, including CaMK, CDPK, MAPK and RLK. WGCNA revealed that the DEGs in the blue, brown, dark magenta and light steel blue 1 modules were associated with the physiological changes in roots of switchgrass under alkaline salt stress. The consistency between the qRT-PCR and RNA-Seq results confirmed the reliability of the RNA-seq sequencing data. A molecular regulatory network of the switchgrass response to alkaline salt stress was preliminarily constructed on the basis of transcriptional regulation and functional genes.Conclusions: Alkaline salt tolerance of switchgrass may be achieved by the regulation of ion homeostasis, transport proteins, detoxification, heat shock proteins, dehydration and sugar metabolism. These findings provide a comprehensive analysis of gene expression dynamic and act network induced by alkaline salt stress in two switchgrass genotypes and contribute to the understanding of the alkaline salt tolerance mechanism of switchgrass and the improvement of switchgrass germplasm.
Association of Neuroimaging Markers of Cerebral Small Vessel Disease With Short-Term Outcomes in Patients With Minor Cerebrovascular Events
Authors: Chen Xuemei , Wang Lin , Jiang Junying , Gao Yuanyuan , Zhang Rui , Zhao Xiaoyuan , Shen Tingwen , Dai Qi , Li Junrong
Published: January 2021

Background: Increasing evidences have showed that neuroimaging markers of SVD can predict the short-term outcome of acute ischemic stroke (AIS).It is unclear that whether neuroimaging markers of SVD are also associated with short-term outcomes of minor cerebrovascular events. In the present study, we investigate neuroimaging markers of SVD in order to explore their roles in prediction of short-term outcome in patients with minor cerebrovascular events. Methods: Consecutive first-ever stroke patients (n=546) from the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled. A total of 388 patients were enrolled according to minor cerebrovascular events definition（National Institutes of Health Stroke Scale Score≤3）and exclusion criteria. MRI scans were performed within seven days of stroke onset, and then neuroimaging markers of SVD including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS) , SVD burden scores were assessed. We completed baseline characteristics and evaluated the relationships of short-term outcomes to SVD neuroimaging markers and SVD scores. The 90-day modified Rankin Scale (mRS) was thought as primary outcome and was dichotomized as good functional outcome (mRS 0-1) and poor outcome (mRS 2-6). Secondary outcomes were stroke progression and stroke recurrence. Results: Higher age, National Institutes of Health Stroke Scale (NIHSS) upon admission, lipoprotein-associated phospholipase A2 (LP-PLA2) and lacunes, Fazekas score were correlated with poor functional outcome (P<0.05), But after adjusting for confounding variables, among the neuroimaging markers of cerebral small vessel disease, only Fazekas score (OR, 1.343; 95% confidence interval, 1.020-1.770; P=0.036) was found to be associated with poor outcome at 90 days. Higher Fazekas and SVD scores were not associated with stroke progression or stroke recurrence. Conclusion: WMH can predict the poor functional outcome of minor cerebrovascular events. Adding other neuroimaging markers of SVD and total SVD burden score, however, does not improve the prediction, which indicated WMH can as neuroimaging markers for guiding the treatment of minor cerebrovascular events.
Biofilm reduction potential of 0.02% polyhexanide irrigation solution in several types of urethral catheters
Authors: Brill Florian H. H. , Hambach Julia , Utpatel Christian , Mogrovejo Diana , Gabriel Henrik , Klock Jan-Hendrik , Steinmann Joerg , Arndt Andreas
Published: January 2021

Background Long-term use of urethral catheters is associated with high risk of urinary tract infection (UTI) and blockage. Microbial biofilms are a common cause of catheter blockage, reducing their lifetime and significantly increasing morbidity of UTIs. A 0.02% polyhexanide irrigation solution developed for routine mechanical rinsing shows potential for bacterial decolonization of urethral catheters and has the potential to reduce or prevent biofilm formation.Methods Using an in vitro assay with standard market-leading types of catheters artificially contaminated with clinically relevant bacteria, assays were carried out to evaluate the biofilm reduction and prevention potential of a 0.02% polyhexanide solution vs. no intervention (standard approach) and irrigation with saline solution (NaCl 0.9%). The efficiency of decolonization was measured through microbial plate count and membrane filtration.Results Irrigation using a 0.02% polyhexanide solution is suitable for the decolonization of a variety of transurethral catheters. The effect observed is significant compared to irrigation with 0.9% saline solution (p = 0.001) or no treatment (p = 0.018). No significant difference was found between irrigation with 0.9% saline solution and no treatment (p = 0.94). Conclusions The polyhexanide and standard saline solutions are able to reduce bacterial biofilm from urinary catheters, showing a combination of mechanical and antibacterial effects. The data supports a prevention strategy to reduce thick biofilms, which are characteristically difficult to be efficiently removed. Further research is required to evaluate the long-term tolerability and efficacy of polyhexanide in clinical practice.
Text Classification Models for the Automatic Detection of Nonmedical Prescription Medication Use from Social Media
Authors: Al-Garadi Mohammed , Yang Yuan-Chi , Cai Haitao , Ruan Yucheng , O’Connor Karen , Graciela Gonzalez-Hernandez , Perrone Jeanmarie , Sarker Abeed
Published: January 2021

BackgroundPrescription medication (PM) misuse/abuse has emerged as a national crisis in the United States, and social media has been suggested as a potential resource for performing active monitoring. However, automating a social media-based monitoring system is challenging—requiring advanced natural language processing (NLP) and machine learning methods. In this paper, we describe the development and evaluation of automatic text classification models for detecting self-reports of PM abuse from Twitter.MethodsWe experimented with state-of-the-art bi-directional transformer-based language models, which utilize tweet-level representations that enable transfer learning (e.g., BERT, RoBERTa, XLNet, AlBERT, and DistilBERT), proposed fusion-based approaches, and compared the developed models with several traditional machine learning, including deep learning, approaches. Using a public dataset, we evaluated the performances of the classifiers on their abilities to classify the non-majority “abuse/misuse” class.ResultsOur proposed fusion-based model performs significantly better than the best traditional model (F1-score [95% CI]: 0.67 [0.64-0.69] vs. 0.45 [0.42-0.48]). We illustrate, via experimentation using differing training set sizes, that the transformer-based models are more stable and require less annotated data compared to the other models. The significant improvements achieved by our best-performing classification model over past approaches makes it suitable for automated continuous monitoring of nonmedical PM use from Twitter.ConclusionsBERT, BERT-like and fusion-based models not only outperform traditional machine learning and deep learning models, but also show substantial improvements over many years of past research on the topic of prescription medication misuse/abuse classification from social media, which had been shown to be a complex task due to the unique ways in which information about nonmedical use is presented. Several challenges, such as lack of complete context and the nature of social media language, need to be overcome to further improve BERT and BERT-like models. These experimental driven challenges are represented as potential future research directions.
Effects of immediate and delayed loading protocols on marginal bone loss around implants in unsplinted mandibular implant-retained overdentures: A systematic review and meta-analysis
Authors: Liu Wei , Cai He , Zhang Junjiang , Wang Jian , Sui Lei
Published: January 2021

Background: Immediate loading has recently been introduced into unsplinted mandibular implant-retained overdentures for the management of edentulous patients due to their increasing demand on immediate aesthetics and function. However, there is still a scarcity of meta-analytical evidence on the efficacy of immediate loading compared to delayed loading in unsplinted mandibular implant-retained overdentures. The purpose of this study was to compare the marginal bone loss (MBL) around implants between immediate and delayed loading of unsplinted mandibular implant-retained overdentures.Methods: Randomized controlled trials (RCTs), controlled clinical trials (CCTs), and cohort studies quantitatively comparing the MBL around implants between immediate loading protocol (ILP) and delayed loading protocol (DLP) of unsplinted mandibular overdentures were included. A systematic search was carried out in PubMed, EMBASE, and CENTRAL databases on December 02, 2020. “Grey” literature was also searched. A meta-analysis was conducted to compare the pooled MBL of two different loading protocols of unsplinted mandibular overdentures through weighted mean differences (WMDs) with 95% confidence intervals (95% CIs). The subgroup analysis was performed between different attachment types (i.e. Locator attachment vs. ball anchor). The risk of bias within and across studies were assessed using the Cochrane Collaboration’s tool, the Newcastle-Ottawa scale, and Egger’s test. Results: Of 328 records, five RCTs and two cohort studies were included and evaluated, which totally contained 191 participants with a follow-up of no less than 12 months. The MBL of ILP group showed no significant difference with that of DLP group (WMD 0.04, CI -0.13 to 0.21, P > .05). The subgroup analysis revealed similar results with Locator attachments or ball anchors (P > .05). Apart from one RCT (20%) with a high risk of bias, four RCTs (80%) showed a moderate risk of bias. Two prospective cohort studies were proved with acceptable quality. Seven included studies have reported ten implant failures in ILP groups and two implant failures in DLP groups in total.Conclusions: For unsplinted mandibular implant-retained overdentures, the MBL around implants after ILP seems comparable to that of implants after DLP. Immediate loading may be a promising alternative to delayed loading for the management of unsplinted mandibular implant-retained overdentures. PROSPERO registration number: CRD42020159124
Pattern of cortical thinning in logopenic progressive aphasia patients in Thailand
Authors: Thanprasertsuk Sekh , Likitjaroen Yuttachai
Published: January 2021

Background: Logopenic progressive aphasia (LPA) is an uncommon neurodegenerative disorder primarily characterized by word-finding difficulties and sentence repetition impairment. Prominent cortical atrophy around left temporo-parietal junction (TPJ) is a classical imaging feature of LPA. This study investigated cortical thinning pattern in clinically diagnosed LPA patients using non-demented subjects as a control group. We also aimed to explore whether there was prominent thinning of other cortical area additional to the well-recognized left TPJ.Methods: Thicknesses of all cortical regions were measured from brain magnetic resonance images using an automated command on Freesurfer software. Cortical thickness of the LPA and control groups were compared by two methods: 1) using a general linear model (GLM) in SPSS software; and 2) using a vertex-by-vertex GLM, performed with Freesurfer’s QDEC interface. Results: Besides the well-recognized left TPJ, cortical regions that were significantly thinner in the LPA group by both comparison methods included left caudal middle frontal gyrus (CMFG) (p=0.006 by SPSS, p=0.0003 by QDEC), left rostral middle frontal gyrus (p=0.001 by SPSS, p=0.0001 by QDEC), left parahippocampal gyrus (p=0.008 by SPSS, p=0.005 by QDEC) and right CMFG (p=0.005 by SPSS, p=0.0001 by QDEC).Conclusions: Our results demonstrated that thinning of middle frontal gyri may be an additional feature in clinically diagnosed LPA patients. Involvement of left parahippocampal gyrus may reflect the underlying neuropathology of Alzheimer’s disease in majority of the LPA patients.
Advanced care planning during the COVID-19 pandemic: ceiling of care decisions and their implications for observational data
Authors: Straw Sam , McGinlay Melanie , Drozd Michael , Slater Thomas A , Cowley Alice , Kamalathasan Stephe , Maxwell Nicholas , Bird Rory , Koshy Aaron O , Prica Milos , Patel Peysh A , Relton Samuel D , Gierula John , Cubbon Richard M , Kearney Mark T , Witte Klaus K
Published: January 2021

BackgroundObservational studies investigating risk factors in coronavirus disease 2019 (COVID-19) have not considered the confounding effects of advanced care planning, such that a valid picture of risk for elderly, frail and multi-morbid patients is unknown. We aimed to report ceiling of care and cardiopulmonary resuscitation (CPR) decisions and their association with demographic and clinical characteristics as well as outcomes during the COVID-19 pandemic.MethodsRetrospective, observational study conducted between 5th March and 7th May 2020 of all hospitalised patients with COVID-19. Ceiling of care and CPR decisions were documented using the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process. Unadjusted and multivariable regression analyses were used to determine factors associated with ceiling of care decisions and death during hospitalisation.ResultsA total of 485 patients were included, of whom 409 (84·3%) had a documented ceiling of care; level one for 208 (50·9%), level two for 75 (18·3%) and level three for 126 (30·8%). CPR decisions were documented for 451 (93·0%) of whom 336 (74·5%) were ‘not for resuscitation’. Advanced age, frailty, White-European ethnicity, a diagnosis of any co-morbidity and receipt of cardiovascular medications were associated with ceiling of care decisions. In a multivariable model only advanced age (odds 0·89, 0·86-0·93 p<0·001), frailty (odds 0·48, 0·38-0·60, p<0·001) and the cumulative number of co-morbidities (odds 0·72, 0·52-1·0, p=0·048) were independently associated. Death during hospitalisation was independently associated with age, frailty and requirement for level two or three care.ConclusionCeiling of care decisions were made for the majority of patients during the COVID-19 pandemic, broadly in line with known predictors of poor outcomes in COVID-19, but with a focus on co-morbidities suggesting ICU admission might not be a reliable end-point for observational studies where advanced care planning is routine.
Chinese forest fire occurrence prediction based on machine learning methods
Authors: Li yudong , Feng Zhongke , Zhao Ziyu , Ma Wenyuan , Chen Shilin , Zhang Hanyue
Published: January 2021

Forest fires can cause serious harm. Scientifically predicting forest fires is an important basis for preventing them. Currently, there is little research on the prediction of long time-series forest fires in China. Choosing a suitable forest fire prediction model and predicting the probability of Chinese forest fire occurrence are of great importance to China’s forest fire prevention and control work. Based on fire hotspot, meteorological, terrain, vegetation, infrastructure, and socioeconomic data collected from 2003 to 2016, we used a random forest model as a feature-selection method to identify 13 major drivers of forest fires in China. The forest fire prediction models developed in this study are based on four machine-learning algorithms: an artificial neural network, a radial basis function network, a support-vector machine, and a random forest. The models were evaluated using the five performance indicators of accuracy, precision, recall, f1 value, and area under the curve. We used the optimal model to obtain the probability of forest fire occurrence in various provinces in China and created a spatial distribution map of the areas with high incidences of forest fires. The results showed that the prediction accuracy of the four forest fire prediction models was between 75.8% and 89.2%, and the area under the curve value was between 0.840 and 0.960. The random forest model had the highest accuracy (89.2%) and area under the curve value (0.96); thus, it was used as the optimal model to predict the probability of forest fire occurrence in China. The prediction results indicate that the areas with high incidences of forest fires are mainly concentrated in north-eastern China (Heilongjiang Province and northern Inner Mongolia Autonomous Region) and south-eastern China (including Fujian Province and Jiangxi Province). In areas at high risk of forest fire, management departments can improve forest fire prevention and control by establishing watch towers and using other monitoring equipment. This study helps in understanding the main drivers of forest fires in China, provides a reference for the selection of high-precision forest fire prediction models, and provides a scientific basis for China’s forest fire prevention and control work.
Posterior fixation can further improve the segmental alignment of lumbar degenerative spondylolisthesis with Oblique Lumbar Interbody Fusion
Authors: WU JINGYE , Ge Tenghui , Zhang Ning , Li Jianing , Tian Wei , Sun Yuqing
Published: January 2021

Background: For patients with degenerative spondylolisthesis, whether additional posterior fixation can further improve segmental alignment is unknown, compared with stand-alone cage insertion in oblique lumbar interbody fusion (OLIF) procedure. The aim of this study was to compare changes of the radiographical segmental alignment following stand-alone cage insertion and additional posterior fixation in the same procedure setting of OLIF for patients with degenerative spondylolisthesis.Methods: A retrospective observational study. Selected consecutive patients with degenerative spondylolisthesis underwent OLIF procedure from July 2017 to August 2019. Five radiographic parameters of disc height (DH), DH-Anterior, DH-Posterior, slip ratio and segmental lordosis (SL) were measured on preoperative CT scans and intraoperative fluoroscopic images. Comparisons of those radiographic parameters prior to cage insertion, following cage insertion and following posterior fixation were performed.Results: A total of thirty-three patients including six males and twenty-seven females, with an average age of 66.9±8.7 years, were reviewed. Totally thirty-six slipped levels were assessed with thirty levels at L4/5, four at L3/4 and two at L2/3. Intraoperatively, with only anterior cage support, DH was increased from 8.2±1.6mm to 11.8±1.7mm (p<0.001), DH-Anterior was increased from 9.6±2.3mm to 13.4±2.1mm (p<0.001), DH-Posterior was increased from 6.1±1.9mm to 9.1±2.1mm (p<0.001), the slip ratio was reduced from 11.1±4.6% to 8.3±4.4% (p=0.020) with the slip reduction ratio 25.6±32.3%, and SL was slightly changed from 8.7±3.7° to 8.3±3.0°(p=1.000). Following posterior fixation, the DH was unchanged (from 11.8±1.7mm to 11.8±2.3mm, p=1.000), DH-Anterior and DH-Posterior were slightly changed from 13.4±2.1mm and 9.1±2.1mm to 13.7±2.3mm and 8.4±1.8mm respectively (P=0.861, P=0.254), the slip ratio was reduced from 8.3±4.4% to 2.1±3.6 % (p<0.001) with the slip reduction ratio 57.9±43.9%, and the SL was increased from 8.3±3.0° to 10.7±3.6° (p=0.008). Conclusions: Compared with stand-alone cage insertion, additional posterior fixation provides better segmental alignment improvement in terms of slip reduction and segmental lordosis in OLIF procedures in the treatment of lumbar degenerative spondylolisthesis.
HDL-Cholesterol Efflux Capacity and Lipid Profile in Patients with Systemic Sclerosis.
Authors: Ferraz-Amaro Iván , Delgado-Frías Esmeralda , Hernández-Hernández Vanesa , Sánchez-Pérez Hiurma , de Armas-Rillo Laura , Armas-González Estefanía , Machado José David , Diaz-Gonzalez Federico
Published: January 2021

Objective. It is well established that patients with systemic sclerosis (SSc) have a disrupted lipid profile and an increased cardiovascular risk. Cholesterol efflux capacity (CEC), the ability of high-density lipoprotein (HDL)-cholesterol to accept cholesterol from macrophages has been linked to cardiovascular events. The aim of this study was to establish whether CEC and lipid profile were impaired in SSc patients respect to controls and whether these changes were associated with disease-related data.Methods. Cross-sectional study encompassed 188 individuals: 73 SSc patients and 115 controls. CEC, using an in vitro assay, and lipoprotein serum concentrations were assessed in patients and controls. A multivariable analysis was performed to study the differences in CEC between patients and controls, and if SSc-related data could explain such differences. Results. The multivariable analysis adjusted for demographic characteristics, cardiovascular risk factors and lipid-related molecules showed that total cholesterol (beta coefficient: -22 [95%CI -37- -7], p=0.004), triglycerides (beta coefficient: 24 [95%CI 2-47], p=0.033), lipoprotein A (beta coefficient: 22 [95%CI 2-43], p=0.033) and CEC (beta coefficient: -6 [95%CI -10- -2]%,p=0.002) were significantly differences between patients and controls. Skin thickness, as assessed by modified Rodnan skin score, was independently associated with a lower CEC (beta coefficient: -0.21 [95%CI -0.37- -0.05]%, p=0.011) after multivariable adjustment.Conclusion: SSc patients show an abnormal lipid profile with respect to controls including CEC. Skin thickness is independent and inversely associated with CEC in SSc patients.
Genome evolution during bread wheat formation unveiled by the distribution dynamics of SSR sequences on chromosomes using FISH
Authors: Zhang Yingxin , Fan Chengming , Chen Yuhong , Wang Richard R.-C. , Zhang Xiangqi , Han Fangpu , Hu Zanmin
Published: January 2021

Background: During the bread wheat speciation by polyploidization, a series of genome rearrangement and sequence recombination occurred. Simple sequence repeat (SSR) sequences, predominately located in heterochromatic regions of chromosomes, are the effective marker for tracing the genomic DNA sequence variations. However, to date the distribution dynamics of SSRs on chromosomes of bread wheat and its donors, including diploid and tetraploid Triticum urartu, Aegilops speltoides, Ae. tauschii, T. turgidum ssp. dicocoides, reflecting the genome evolution events during bread wheat formation had not been comprehensively investigated.Results: The genome evolution was studied by comprehensively comparing the distribution patterns of (AAC)n, (AAG)n, (AGC)n and (AG)n in bread wheat Triticum aestivum var. Chinese Spring and its progenitors T. urartu, A. speltoides, Ae. tauschii, wild tetroploid emmer wheat T. dicocoides, and cultivated emmer wheat T. dicoccum. Results indicated that there are specific distribution patterns in different chromosomes from different species for each SSRs. They provided efficient visible markers for identification of some individual chromosomes and SSR sequence evolution tracing from the diploid progenitors to hexaploid wheat. During wheat speciation, the SSR sequence expansion occurred predominately in the centromeric and pericentromeric regions of B genome chromosomes accompanied by little expansion and elimination on other chromosomes. This result indicated that the B genome might be more sensitive to the “genome shock” and more changeable during wheat polyplodization.Conclusions: During the bread wheat evolution, SSRs including (AAC)n, (AAG)n, (AGC)n and (AG)n in B genome displayed the greatest changes (sequence expansion) especially in centromeric and pericentromeric regions during the polyploidization from Ae. speltoides S genome, the most likely donor of B genome. This work would enable a better understanding of the wheat genome formation and evolution and reinforce the viewpoint that B genome was originated from S genome.
Effects of Baduanjin on Essential Hypertension: A Study Protocol for a Randomized Controlled Trial
Authors: Guan Yuanyuan , Hao Yang , Guan Yun , Wang Dongjun , Sun Xuan , Tian Chunying , Tian Zhikui , Bu Huaien , Wang Hongwu
Published: January 2021

Background: Clinical treatment of hypertension recommends the use of drugs to reduce the incidence and mortality of cardiovascular diseases in hypertensive patients. However, the side effects of long-term medication and economic pressure have increased the medical community's interest in Baduanjin as a method of exercise therapy. Clinical studies have shown that Baduanjin can be used to treat various diseases, and it can also regulate physical and mental factors such as tension and anxiety. This study aims to evaluate the antihypertensive effect of Baduanjin on patients with essential hypertension. Methods/design: In this study, 92 patients with essential hypertension were randomly divided into the Baduanjin group and the routine care group, using a randomized, active control, evaluator blind method, and two parallel control methods, with 46 cases in each group, signed informed Subjects with the consent form will manage their blood pressure by limiting salt intake, losing weight, drinking moderately, exercising, and adjusting dietary intake during the first visit. In addition to self-management, the Baduanjin group will also conduct 30-minute Baduanjin training three times a week for a total of 8 weeks. The main result is the measurement of blood pressure. In addition, body composition will be measured as a secondary result.Discussion: This study is a randomized controlled Baduanjin trial and is not currently widely used. It may provide valuable data on the impact of Baduanjin on essential hypertension, which will inform non-drug treatment options for this disease.Trial registration: Chinese Clinical Trial Registration Center, ChiCTR200003570. Register on August 16, 2020.
Three-month outcomes from a patient-centered program to treat opioid use disorder in Iowa, USA
Authors: Lynch Alison C. , Weber Andrea N. , Hedden Suzy , Sabbagh Sayeh , Arndt Stephan , Acion Laura
Published: January 2021

Background: Opioid use disorder (OUD), a chronic disease, is a major public health problem. Despite availability of effective treatment, too few people receive it and treatment retention is low. Understanding barriers and facilitators of treatment access and retention is needed to improve outcomes for people with OUD.Objectives: To assess 3-month outcomes pilot data from a patient-centered OUD treatment program in Iowa, USA, that utilized flexible treatment requirements and prioritized engagement over compliance. Methods: Forty patients (62.5% female: mean age was 35.7 years, SD 9.5) receiving medication, either buprenorphine or naltrexone, to treat OUD were enrolled in an observational study. Patients could select or decline case management, counseling, and peer recovery groups. Substance use, risk and protective factors, and recovery capital were measured at intake and 3 months. Results: Most participants reported increased recovery capital. The median Assessment of Recovery Capital (ARC) score went from 37 at enrollment to 43 (p<0.01). Illegal drug use decreased, with the median days using illegal drugs in the past month dropping from 10 to 0 (p<0.001). Cravings improved: 29.2% reported no cravings at intake and 58.3% reported no cravings at 3 months (p<0.001). Retention rate was 92.5% at 3 months. Retention rate for participants who were not on probation/parole was higher (96.9%) than for those on probation/parole (62.5%, p=0.021). Conclusion: This study shows preliminary evidence that a care model based on easy and flexible access and strategies to improve treatment retention improves recovery capital, reduces illegal drug use and cravings, and retains people in treatment.