bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple Myeloma Course with Renal Insufficiency in Young Patient: Case Report
Authors: Ferreira Hugo Henrique de Freitas , Silva Alessandra Suelen Jardim , Júnior Lenilton Silva DA Silva , Oliveira Gustavo Henrique de Medeiros , Araujo Maria das Graças Pereira , Soares Victor lima , Bahia Frank , Oliveira Taissa Moura , Silva Dany GKC , Sales Valéria SF , Paiva Aldair Sousa , Cavalcanti Geraldo Barroso
Published: November 2020

Introduction: Multiple myeloma (MM) is a malignant neoplasm characterized by the clonal proliferation of abnormal plasma cells in the bone marrow (OM). The average age of patients diagnosed with MM is approximately 70 years, being relatively uncommon in younger individuals. Objective: To report a case of a young patient with multiple myeloma. Case Description: A 42-year-old male patient presented with continuous and progressive low back pain for 3 months, associated with adynamia, weight loss (10 kg), episodes of constipation and bleeding in the oral cavity in this period. Examinations at the first appointment revealed moderate anemia (Hb 7.4 g / dL), leukocytosis, thrombocytopenia, hypercalcemia, and altered renal function (Cr 5.9 and Ur 178), chest tomography indicating vertebral fracture in T6, T11, L2 and L4. Referred for specialized follow-up, he performed electrophoresis of serum proteins with the presence of a monoclonal peak in the gamma globulin fraction. The immunofixation test confirmed monoclonality for IgA isotype and Kappa light chain (IgA / Kappa). The myelogram showed plasmacytosis of more than 50% of mononuclear cells in the bone marrow. He developed renal failure (with dosage of creatinine of 10.1 mg/ dL. and urea of 208 mg/dL) and hypercalcemia requiring dialysis therapy on the third day of hospitalization, having undergone chemotherapy with Bortezomib, cyclophosphamide and dexamethasone. During this period, infection by the multisensitive S. aureus in catheter occurred and, despite being treated with specific antibiotic therapy, it evolved with clinical worsening and hemodynamic instability and was referred to the Intensive Care Unit, going to death after 2 days. Conclusion: Young patients with MM may study with more aggressive characteristics. Despite the use of new therapeutic agents, more effective treatment strategies need to be studied more for patients in this age group.

Disclosures

No relevant conflicts of interest to declare.
High-Grade B-Cell Lymphoma,NOS : Does Prognosis End with the Diagnosis? - a Retrospective Analysis
Authors: Karunakaran Parathan , Selvarajan Gangothri , PK Jayachandran , Mehra Nikita , Sundersingh Shirley , Dhanushkodi Manikandan , Rajan Arun Kumar , Kesana Sivasree , Sagar Tenali Gnana , Kannan Krishnarathinam , Radhakrishnan Venkatraman
Published: November 2020

Background

High-Grade B-cell Lymphoma (HGBL) was a new disease entity proposed in 2016 to define a particularly aggressive subset of DLBCL. It consisted of two entities - HGBL with double hit(DH)/ triple hit(TH) and HGBL,NOS. While the aggressive nature of HGBL with DH/TH is well described, the data on the other subset of HGBL - HGBL,NOS is lacking in literature. We conducted this analysis to study the clinical profile of HGBL,NOS versus DLBCL,NOS.

Methodology

Retrospective, registry-based, single centre analysis of all patients diagnosed between 1.1.2017 till 31.12.2019 with the histopathological diagnosis of (1) DLBCL (2) HGBL,NOS and (3) HGBL with DH/TH.

Results

One hundred and forty four cases were identified, including 109 DLBCL,NOS, 29 HGBL, NOS and 6 cases of HGBL with DH/TH. The comparison of these 3 aggressive lymphoma subsets has been shown in table 1. HGBL,NOS had worse outcome in comparison to DLBCL,NOS (median PFS 20months vs NR, p=0.12) with a median follow up of 19 months. But the multivariate Cox analysis confirmed that DLBCL vs HGBL significantly affected PFS(p<0.005). End of treatment complete remission showed significant(p<0.001) PFS benefit with respect to both subsets. GCB subtype and IPI score significantly(p=0.03) influenced PFS in DLBCL,NOS but not in HGBL NOS. The DA-EPOCH-R arm did significantly (p<0.05) worse than R CHOP arm with respect to DLBCL NOS. For HGBL,NOS the analysis failed to show any significant difference in PFS with respect to different chemotherapeutic regimen delivered (RCHOP/DA EPOCH R/R mini CHOP).

Conclusion

High-grade B-cell lymphoma, NOS is part of the spectrum of aggressive large B -cell lymphomas with prognosis intermediate to DLBCL, NOS and HGBL with DH/TH. The ideal therapeutic regimen for this aggressive lymphoma needs to be addressed prospectively in clinical trials.

Table

Disclosures

No relevant conflicts of interest to declare.
Integrated Analysis of Key Genes for FGFR1 Knockdown in Mantle Cell Lymphoma Cell Line (Z-138)
Authors: Wu Xue , Li Yuan , Chen Baoan
Published: November 2020

Background:Mantle cell lymphoma (MCL) is the secondary common B cell lymphoma subtype that comprises 6 to 8% of non-Hodgkin's lymphoma, and is closely related to the poor clinical outcomes. Previous studies have focussed on the mechanisms mediating ibrutinib resistance, the first-in-class oral covalent inhibitor of Bruton's tyrosine kinase (BTK). The aims of the this study is to identify key genes related to the FGFR1 Knockdown in Mantle cell lymphoma cell line (Z-138) that has been proved to play a vital role in MCL progression.

Methods:GSE138127 mRNA microarray datasets from Gene Expression Omnibus (GEO) were analysed to obtain differentially expressed genes (DEGs) between vector control and the Knockdown of FGFR1 charactered by ibrutinib resistance. The GO and GSEA were carried out by WEB-based GEne SeT AnaLysis Toolkit (WebGestalt) to do the functional enrichment analysis. The network analysis of protein-protein interactions (PPIs), TF-gene interaction were carried out by Network Analyst 3.0 to identify hub genes. And the main hub gene was probed using Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway analysis.

Results:In total, 175 DEGs were obtained, of which 87 and 88 were up- and down-regulated, respectively. Three hub genes (CDK1, CCND1) were identified and associated to cell cycle and DNA replication. FOXC1 were identified as the potential Transcription factors in the biological process.

Conclusion:CDK1, CCND1 may affect the cell cycle regulated by FOXC1, and represent the new candidate molecular markers of the occurrence of ibrutinib resistance.

Keywords: Mantle cell lymphoma (MCL), ibrutinib resistance, Network Analyst, Microarray, Protein-protein interactions, Molecular markers

Disclosures

No relevant conflicts of interest to declare.
Importance of Flow Cytometry in the Immunophenotyping Characterization of Mantle Cell Lymphoma in State of Rio Grande Do Norte, Brazil
Authors: Paiva Aldair Sousa , Silva Alessandra Suelen Jardim , Júnior Lenilton Silva DA Silva , Oliveira Gustavo Henrique de Medeiros , Ferreira Hugo Henrique de Freitas , Araujo Maria das Graças Pereira , Soares Victor lima , Bahia Frank , Freitas Rodrigo Villar , Oliveira Taissa Moura , Silva Dany GKC , Sales Valéria SF , Paiva Hugo Diogenes De Oliveira , Soares Rodolfo DA , Cavalcanti Geraldo Barroso
Published: November 2020

Introduction:Mantle Cell Lymphoma (MCL) is a disease of a neoplastic nature characterized by proliferation in lymphoid tissues, classified as non-Hodgkin's lymphoma of B lymphocytes (NHBL). The nomenclature derives from the specific pathophysiology of this disease, that proliferates in the marginal area of the mantle of the germinal center of the lymph nodes.Objective:Carry out a detailed assessment of the immunophenotypic profile using the flow cytometry (CF) technique in 26 patients, NHBL to confirm mantle lymphoma.Materials and Methods:Biological samples from 26 patients, these being from peripheral blood (SP) or bone marrow (MO), of patients with suspected MCL were marked with monoclonal antibodies conjugated to fluorochromes and subsequently analyzed by FC.Results:all patients with a confirmed diagnosis of LCM were positive for pan-B antigens CD19, CD20 (strong) and CD22 (strong), CD19+/CD5+ and ciclin-D1 in 100% of cases. In addition to these, CD23, CD56, CD38, CD79b, Ki-67, Bcl-2, FMC-7 and HLA-Dr also obtained positive staining, as well as the immunoglobulin heavy chain (IgH) in all cases, and isotypes of immunoglobulins, IgD, IgG and IgM in most cases, with a predominance of the heavy chain of the lambda light chain in 79% of cases. Antigens related to T lymphocytes such as CD1a, CD2, CD3, CD7, TCR alpha/beta, TCR gamma/delta, CD4 and CD8, as well as antigens related to NK cells (CD16-56) and lymphoid progenitor cells (CD10 and Terminal- deoxynucleotidyl-transferase) were negative, as were CD200, antigens related to hairy cell leukemia (CD103, CD11c and CD123) and multiple myeloma (CD138).Discussion:According to the expression of the antigens, the antibodies were positive for: Cyclin D, CD19, CD20, CD22, CD38, Ki-67, Bcl-2, FMC-7 and CD79b, which are relevant to the diagnosis of this disease. Conclusion: Flow cytometry immunophenotyping is the technique currently used to confirm the diagnosis of neoplasms, such as LCM, which, due to its specific phenotype, helps in the correct selection of treatment.

Disclosures

No relevant conflicts of interest to declare.
Characterization of Abnormal Hemoglobins in the Blood Center of Rio Grande Do Norte, Brazil By High Performance Liquid Chromatography
Authors: Oliveira Gustavo Henrique de Medeiros , Paiva Aldair Sousa , Silva Alessandra Suelen Jardim , Júnior Lenilton Silva DA Silva , Ferreira Hugo Henrique de Freitas , Araujo Maria das Graças Pereira , Soares Victor lima , Bahia Frank , Freitas Rodrigo Villar , Oliveira Taissa Moura , Silva Dany GKC , Sales Valéria SF , Soares Rodolfo DA , Paiva Hugo Diogenes De Oliveira , Cavalcanti Geraldo Barroso
Published: November 2020

INTRUDUCTION:In Brazil, blood donation is carried out by healthy people and meets the criteria established in the technical regulation of hemotherapy (Ordinance No. 2,712 / 20013 - Ministry of Health). METHODS It is mandatory to screen donors with hemoglobin S (HbS) and in the Blood Center of Rio Grande do Norte we use High Performance Liquid Chromatography (HPLC) VARIANT II. (Bio-Rad Laboratories, Hercules, CA). This method allows the screening of HbS and analysis of the levels of Glycated Hemoglobin (HbA1c), which is an important indicator of type 2 diabetes.RESULTS AND DISCUSSIONThe present study evaluated 29,098 donors, between 2018-2019, of both genders, aged between 18 and 69 years old. 22,754 (78.2%) are male and 451 (1.55%) have variant hemoglobins. The sickle cell trait (HbAS) was the most frequent among blood donors 372 (1.28%). For the analysis of HbA1c, donors with variant hemoglobins were excluded and we found that 26,910 (92, 48%) are in the normoglycemic group with HbA1c <6%. 1,379 blood donors were classified as pre-diabetic with HbA1c levels between 6 - 6.4%. 766 (2.63%) donors were considered diabetic with HbA1c levels> 6.5%.CONCLUSIONThe frequency of variant hemoglobins is lower in Rio Grande do Norte when compared to other Brazilian states. The prevalence of diabetes found in our study is in accordance with data from the International Diabetes Federation (IDF 2019). Brazilian blood centers could perform a large public health service by screening non-diagnosed cases of diabetes as well as assisting in monitoring donor HbA1c levels, however this notification is not mandatory.

Disclosures

No relevant conflicts of interest to declare.
Frequency of Thrombotic Events in Hospitalized Patients with Sickle Cell Disease
Authors: Inoue Susumu , Anagonye Christina
Published: November 2020

Background

Thrombosis is one of the most common complications described in patients with sickle cell disease. However, little is known about the prevalence, variety and severity of thrombus particularly in sickle cell patients hospitalized with vaso-occlusive crisis.

Methods

We made a retrospective chart review of patients (age 21 years or older) admitted with sickle cell disease at Hurley Medical Center (Flint, Michigan) and was diagnosed with a thrombotic event between April 2012 and April 2020. To obtain a logistic model, we identified all patients with the the final discharge diagnosis of thrombosis (ICD-9 or ICD-10 code indicating any thrombosis, such as DVT, arterial thrombosis, catheter-related thrombus, pulmonary embolism, and stroke), combined with the diagnosis of sickle cell disease.

Findings

37/137 (27%) sickle cell patients were found to have had at least one thrombotic event during their hospitalization. As predicted, patients with sickle cell disease appeared to have very high frequency of thrombotic complications, though we lack a control group to compare with. Genotypes of sickle cell disease was also measured in this study. Patients with the Hb-SS disease had a much higher rate of this complication(25/68=37%) compared with those with Hb SC disease patients (12/49=24%). There were no thrombotic events reported in patients with Hb S/beta thalassemia+, or 0 patients or in patients with Hb SS with HPFH.

Interpretation

The risk of a thromboembolic event in patients with SCD is high, Sickle cell anemia is a procoagulant condition, which is a risk factor for thrombosis. More research is required to determine if preventive modalities could reduce thrombotic risk.

Disclosures

No relevant conflicts of interest to declare.
Whole transcriptome sequencing detects a large number of novel fusion transcripts in patients with AML and MDS
Authors: Stengel Anna , Shahswar Rabia , Haferlach Torsten , Walter Wencke , Hutter Stephan , Meggendorfer Manja , Kern Wolfgang , Haferlach Claudia
Published: November 2020

Fusion transcripts are frequent genetic abnormalities in myeloid malignancies and are often the basis for risk stratification, minimal residual disease (MRD) monitoring, and targeted therapy. We comprehensively analyzed the fusion transcript landscape in 572 acute myeloid leukemia (AML) and 630 myelodysplastic syndrome (MDS) patients by whole transcriptome sequencing (WTS). Totally, 274 fusion events (131 unique fusions) were identified in 210/572 AML patients (37%). In 16/630 MDS patients, 16 fusion events (15 unique fusions) were detected (3%). In AML, 141 cases comprised entity-defining rearrangements (51% of all detected fusions) and 21 (8%) additional well-known fusions, all detected by WTS (control group). In MDS, only 1 fusion was described previously (NRIP1-MECOM, n = 2). Interestingly, a high number of so-far unreported fusions were found (41% [112/274] in AML, 88% [14/16] in MDS), all validated by cytogenetic and/or whole genome sequencing data. With 1 exception (CTDSP1-CFLAR, n = 2), all novel fusions were observed in 1 patient each. In AML, cases with novel fusions showed concomitantly a high frequency of TP53 mutations (67%) and of a complex karyotype (71%), which was also observed in MDS, but less pronounced (TP53, 26%; complex karyotype, 21%). A functional annotation of genes involved in novel fusions revealed many functional relevant genes (eg, transcription factors; n = 28 in AML, n = 2 in MDS) or enzymes (n = 42 in AML, n = 9 in MDS). Taken together, new genomic alterations leading to fusion transcripts were much more common in AML than in MDS. Any novel fusions might be of use for developing markers (eg, for MRD monitoring), particularly in cases without an entity-defining abnormality.
Four myriapod relatives – but who are sisters? No end to debates on relationships among the four major myriapod subgroups
Authors: Szucsich Nikolaus U. , Bartel Daniela , Blanke Alexander , Böhm Alexander , Donath Alexander , Fukui Makiko , Grove Simon , Liu Shanlin , Macek Oliver , Machida Ryuichiro , Misof Bernhard , Nakagaki Yasutaka , Podsiadlowski Lars , Sekiya Kaoru , Tomizuka Shigekazu , Von Reumont Björn M. , Waterhouse Robert M. , Walzl Manfred , Meng Guanliang , Zhou Xin , Pass Günther , Meusemann Karen
Published: November 2020

Background

Phylogenetic relationships among the myriapod subgroups Chilopoda, Diplopoda, Symphyla and Pauropoda are still not robustly resolved. The first phylogenomic study covering all subgroups resolved phylogenetic relationships congruently to morphological evidence but is in conflict with most previously published phylogenetic trees based on diverse molecular data. Outgroup choice and long-branch attraction effects were stated as possible explanations for these incongruencies. In this study, we addressed these issues by extending the myriapod and outgroup taxon sampling using transcriptome data.

Results

We generated new transcriptome data of 42 panarthropod species, including all four myriapod subgroups and additional outgroup taxa. Our taxon sampling was complemented by published transcriptome and genome data resulting in a supermatrix covering 59 species. We compiled two data sets, the first with a full coverage of genes per species (292 single-copy protein-coding genes), the second with a less stringent coverage (988 genes). We inferred phylogenetic relationships among myriapods using different data types, tree inference, and quartet computation approaches. Our results unambiguously support monophyletic Mandibulata and Myriapoda. Our analyses clearly showed that there is strong signal for a single unrooted topology, but a sensitivity of the position of the internal root on the choice of outgroups. However, we observe strong evidence for a clade Pauropoda+Symphyla, as well as for a clade Chilopoda+Diplopoda.

Conclusions

Our best quartet topology is incongruent with current morphological phylogenies which were supported in another phylogenomic study. AU tests and quartet mapping reject the quartet topology congruent to trees inferred with morphological characters. Moreover, quartet mapping shows that confounding signal present in the data set is sufficient to explain the weak signal for the quartet topology derived from morphological characters. Although outgroup choice affects results, our study could narrow possible trees to derivatives of a single quartet topology. For highly disputed relationships, we propose to apply a series of tests (AU and quartet mapping), since results of such tests allow to narrow down possible relationships and to rule out confounding signal.
Association between plasma leptin/adiponectin ratios with the extent and severity of coronary artery disease
Authors: Rahmani Asghar , Toloueitabar Yaser , Mohsenzadeh Yousef , Hemmati Roholla , Sayehmiri Kourosh , Asadollahi Khairollah
Published: November 2020

Background

Leptin can have a direct effect on endothelial and vascular smooth muscle cells and high level of leptin is involved in the pathogenesis of atherosclerosis. This study aimed to determine the relationship between leptin/adiponectin (L/A) ratio and the extent and severity of coronary artery disease (CAD).

Methods

This case-control study was conducted in an educational hospital in Ilam, Iran from June 2014 to September 2015. Totally 300 participants including 150 patients with CAD (case group) and 150 healthy individuals (control group) were selected and their plasma leptin, adiponectin and leptin/adiponectin ratio was measured. The extent and severity of coronary artery disease were assayed based on the number of involved vessels and Gensini score (GS) and the relation between scores and L/A findings were compared between cases and controls.

Results

Totally, 300 participants including 150 (42.7% male), mean age 59.5 ± 11.4 years as cases and 150 (50.7% male), mean age 59.8 ± 10.7 as controls were analyzed. Plasma level of leptin and L/A ratio were higher in cases compared to controls, but level of adiponectin was significantly lower in CAD patients than the control group. More number of involved coronary vessels was significantly correlated to higher level of plasma leptin, L/A ratio and lower level of adiponectin among case group. Moreover, adiponectin was negatively and leptin or L/A ratio were positively correlated with number of involved vessels. 7.3% of cases had only one involved vessel, 42.7% had two involved vessels, and 50% of total patients had involved vessels and the mean ± SD of GS in the case group was 23.6 ± 6.9.

Conclusions

Plasma levels of leptin, and adiponectin can indicate the extent of coronary artery diseases but leptin may be a better marker of extent of CAD than either L/A ratio or adiponectin separately.
Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly aged over 80 years old versus non-elderly: a retrospective cohort study
Authors: Ueda Yoshitake , Shiraishi Norio , Kawasaki Takahide , Akagi Tomonori , Ninomiya Shigeo , Shiroshita Hidefumi , Etoh Tsuyoshi , Inomata Masafumi
Published: November 2020

Background

Recently, colorectal cancer has increased in elderly patients worldwide, with laparoscopic colorectal surgery increasing in elderly patients with colorectal cancer. However, whether laparoscopic colorectal surgery is an optimal procedure for colorectal cancer in the elderly remains unclear. This study aimed to verify safety and curability of laparoscopic colorectal surgery in elderly patients ≥80 years old.

Methods

Patients undergoing curative colorectal surgery from 2006 to 2014 were enrolled and classified into the laparoscopic surgery in elderly patients aged ≥80 years (LAC-E) group, open surgery in elderly patients (OC-E) group, and laparoscopic surgery in non-elderly patients (LAC-NE) group. Short- and long-term outcomes were compared between these groups.

Results

The LAC-E, OC-E, and LAC-NE groups comprised 85, 25, and 358 patients, respectively. Intraoperative blood loss and incidence of postoperative complications were significantly lower in the LAC-E versus OC-E group (97 vs. 440 mL, p < .01 and 14% vs. 32%, p < .05, respectively). Long-term outcomes were not different between these two groups. Operation time was significantly shorter in the LAC-E versus LAC-NE group (249 vs. 288 min, p < .01). Intraoperative blood loss and postoperative complications were similar between the groups. Although the 5-year overall survival rate in the LAC-E group was lower than that in the LAC-NE group (64% vs. 80%, p < .01), there was no difference in 5-year disease-specific survival between the groups.

Conclusion

Laparoscopic colorectal surgery is technically and oncologically safe for colorectal cancer in the elderly as well as the non-elderly and can be an optimal procedure for colorectal cancer in the elderly.
Physician assistants in geriatric medical care
Authors: Kozikowski Andrzej , Honda Trenton , Segal-Gidan Freddi , Hooker Roderick S.
Published: November 2020

Background

The US population is maturing. As of 2020, over 52 million (16%) people are age 65 or older. With a citizenry that is increasingly “gray,” the nation is short of medical providers who specialize in geriatric medical care. For example, the number of geriatrician physicians per 10,000 adults 65 years and older has decreased since 2000, with approximately 5300 in 2018. Nurse practitioners in geriatric medical care numbered 598 in 2018. Considering that the projected needs by 2030 will be over 30,000, the trajectory of geriatricians is becoming increasingly inadequate for the aging population. Physician assistants (PA) are another class of providers that are filling this geriatric medical care role, although little has been published. To address this role of PAs a study was undertaken.

Methods

The National Commission on Certification of Physician Assistants databank provided the number and characteristics of PAs in geriatric medicine and compared them to all other certified PAs. Analyses included descriptive statistics, Chi-Square, and Wilcoxon Rank Sum tests for comparisons between PAs practicing in geriatric medical care vs. all other PA specialties. Where a comparison between PAs in geriatrics and other specialties was made, a P value of .05 or less was considered statistically significant.

Results

As of 2018, there were 794 certified PAs, or 0.8% of the certified PA workforce, in geriatric medical care. This cadre has grown significantly since 2013, both in total number (increasing over 373%) and as a percentage of the PA workforce. The median age of certified PAs in geriatrics is 45 years, and 79% are female. Almost half (46%) of PAs in geriatric medicine work in extended care facilities or nursing homes, which differs from PAs in non-geriatric care. Another 8% work in government facilities and 8% in rehabilitation facilities. In 2018, the mean annual income for this PA group was $106,680.

Conclusions

As the American population continues to age, the relative growth of PAs in geriatric medicine makes them a natural part of the solution to the projected physician geriatrician deficit. The role of PAs in geriatric medical care remains to be explored.
Association between tea consumption and cognitive impairment in middle-aged and older adults
Authors: Zhang Jia , Wang Anxin , Zhang Xiaoli , Chen Shuohua , Wu Shouling , Zhao Xingquan , Zhang Qian
Published: November 2020

Background

Biologic studies have suggested that tea may have neuroprotective activity. However, tea’s protective effect on cognitive function is controversial in human epidemiological studies, and no data, including the middle-aged, are available. The objective of this study was to investigate the association of habit, frequency, and types of tea consumption with incident cognitive impairment in middle-aged and older adults.

Methods

Data from the Asymptomatic Polyvascular Abnormalities in Community study were used (aged over 40y). We gathered information on tea consumption, including habit, frequency, and types, via a standardized questionnaire and assessed cognitive function by Mini-Mental State Examination (MMSE) and/or Montreal Cognitive Assessment (MoCA). Three thousand eight hundred sixty-eight and 806 participants were selected in MMSE and MoCA subgroups. Multivariate logistic regression models were utilized to examine associations between tea consumption and cognitive impairment in middle-aged and older participants.

Results

In MMSE analyses, after adjustment for potential confounding factors, habitual (odds ratio (OR) 0.47, [95% confidence interval (CI) 0.33–0.68], p < 0.001) and high frequency (p trend < 0.001) of tea intake were associated with a lower risk of cognitive impairment. The risk of cognitive impairment was lower in green tea consumption (OR 0.36, [95% CI 0.22–0.61], p < 0.001) than other types (OR 0.59, [95% CI 0.38–0.91], p = 0.017). In MoCA analyses, we got similar results.

Conclusions

Habitual tea consumption, especially high-frequency and green tea consumption, was significantly associated with a lower prevalence of cognitive impairment in middle-aged and older individuals.
Developing an assessment scale for long-term care reablement literacy in home care workers in Taiwan using a modified Delphi method
Authors: Yu Hsiao-Wei , Chiu Tzu-Ying , Chen Pin-Yuan , Liao Tai-Hsiang , Chang Wen-Hui , Wang Mei-Wen , Lin Pay-Shin
Published: November 2020

Background

Reablement is a philosophy of change in long-term care (LTC). Assessing the knowledge and competence of LTC professionals who provide reablement services is vital in LTC research. This study aimed to develop a scale for the assessment of long-term care reablement literacy (LTCRL) and employ this scale to assess the performance of home care workers in Taiwan.

Methods

To develop this scale, we employed the modified Delphi technique based on the theoretical framework of health literacy and the content of service delivery in reablement. Home care workers from northern, central, and southern Taiwan were selected through purposive sampling (N = 119). Participants answered a self-administered questionnaire that included items related to basic demographic characteristics and questions to assess LTCRL.

Results

Based on the experts’ consensus on the procedure of the modified Delphi technique, the LTCRL assessment sale consists of 29 questions on four aspects of knowledge acquisition: the abilities to access/obtain, understand, process/appraise, and apply/use. The results revealed that higher education levels and better Chinese language proficiency are associated with higher LTCRL outcomes among home care workers.

Conclusions

The LTCRL assessment scale based on a modified Delphi technique is useful and feasible for evaluating LTCRL in home care workers who provide reablement services in Taiwan.
Co-occurrence across time and space of drug- and cannabinoid- exposure and adverse mental health outcomes in the National Survey of Drug Use and Health: combined geotemporospatial and causal inference analysis
Authors: Reece Albert Stuart , Hulse Gary Kenneth
Published: November 2020

Background: Whilst many studies have linked increased drug and cannabis exposure to adverse mental health (MH) outcomes their effects on whole populations and geotemporospatial relationships are not well understood.

Methods

Ecological cohort study of National Survey of Drug Use and Health (NSDUH) geographically-linked substate-shapefiles 2010–2012 and 2014–2016 supplemented by five-year US American Community Survey. Drugs: cigarettes, alcohol abuse, last-month cannabis use and last-year cocaine use. MH: any mental illness, major depressive illness, serious mental illness and suicidal thinking. Data analysis: two-stage, geotemporospatial, robust generalized linear regression and causal inference methods in R.

Results

410,138 NSDUH respondents. Average response rate 76.7%. When drug and sociodemographic variables were combined in geospatial models significant terms including tobacco, alcohol, cannabis exposure and various ethnicities remained in final models for all four major mental health outcomes. Interactive terms including cannabis were related to any mental illness (β-estimate = 1.97 (95%C.I. 1.56–2.37), P <  2.2 × 10− 16), major depressive episode (β-estimate = 2.03 (1.54–2.52), P = 3.6 × 10− 16), serious mental illness (SMI, β-estimate = 2.04 (1.48–2.60), P = 1.0 × 10− 12), suicidal ideation (β-estimate = 1.99 (1.52–2.47), P <  2.2 × 10− 16) and in each case cannabis alone was significantly associated (from β-estimate = − 3.43 (− 4.46 − −2.42), P = 3.4 × 10− 11) with adverse MH outcomes on complex interactive regression surfaces. Geospatial modelling showed a monotonic upward trajectory of SMI which doubled (3.62 to 7.06%) as cannabis use increased. Extrapolated to whole populations cannabis decriminalization (4.26%, (4.18, 4.34%)), Prevalence Ratio (PR) = 1.035(1.034–1.036), attributable fraction in the exposed (AFE) = 3.28%(3.18–3.37%), P < 10− 300) and legalization (4.75% (4.65, 4.84%), PR = 1.155 (1.153–1.158), AFE = 12.91% (12.72–13.10%), P < 10− 300) were associated with increased SMI vs. illegal status (4.26, (4.18–4.33%)).

Conclusions

Data show all four indices of mental ill-health track cannabis exposure across space and time and are robust to multivariable adjustment for ethnicity, socioeconomics and other drug use. MH deteriorated with cannabis legalization. Cannabis use-MH data are consistent with causal relationships in the forward direction and include dose-response and temporal-sequential relationships. Together with similar international reports and numerous mechanistic studies preventative action to reduce cannabis use is indicated.
Knowledge of peri-menarcheal changes and a comparative analysis of the age at menarche among young adolescent school girls in urban and rural Cameroon
Authors: Ajong Atem Bethel , Tankala Nkengazem Nerry , Yakum Martin Ndinakie , Azenoi Ikei Solange , Kenfack Bruno
Published: November 2020

Background

Menarche is an expected event that occurs during the development of every normal young girl. We designed this study to evaluate the knowledge of young school girls on puberty, menarche, and menstruation, and to update data on the age at menarche in a rural and urban setting in Cameroon.

Methods

We conducted a cross-sectional survey from February to March 2017, targeting female students aged 9 to 16 years in Yaoundé (urban) and Bamougoum (rural). Participants were included using a randomised cluster sampling and data collected using an auto-administrable questionnaire. Student t-test or the Kruskal-Wallis test was used to compare means, and the odds ratio used as the measure of association between age at menarche and selected covariates.

Results

1157 participants were included in the study; 49.3% from an urban setting and 50.7% from a rural setting. Regarding the knowledge of our participants on puberty, menarche, and menstruation, 67.20% of rural participants had good knowledge, whereas only 46.00% had good knowledge in the urban setting. Mean age at menarche was 12.76 ± 1.33 years, with the mean age at menarche in the urban setting of 12.48 ± 1.12 years and the rural setting of 13.03 ± 1.46 years. Mean age at menarche was significantly lower in participants aged below 14 years (p-value = 0.000), those with both parents alive (p-value = 0.0461), those whose fathers had skilled occupations (p-value = 0.005), those of urban resident (p-value = 0.000), and those who watched TV everyday (p-value = 0.030). Urban residence and age below 14 years were significantly associated with an earlier onset of menarche.

Conclusion

Rural participants had better knowledge of puberty, menarche, and the menstrual cycle than their counterparts in the urban setting. The mean age at menarche over the last two decades has dropped by 7.4 and 4.2 months per decade in urban and rural Cameroon respectively. Mean age at menarche varies significantly with age group, urban/rural residence, state of both parents (both alive/at least one dead), occupation of the father, and frequency of watching TV. Age and urban/rural residence are associated with age at onset of menarche. The continually declining age at menarche is an alarm for future early menarche-linked morbidities.
Relationship between the atlantodental interval and T1 slope after atlantoaxial fusion in patients with rheumatoid arthritis
Authors: Ha Byeong Jin , Won Yu Deok , Ryu Je Il , Han Myung-Hoon , Cheong Jin Hwan , Kim Jae Min , Chun Hyoung-Joon , Bak Koang-Hum , Bae In-Suk
Published: November 2020

Background

Atlantoaxial fusion has been widely used for the treatment of atlantoaxial instability (AAI). However, atlantoaxial fusion sacrifices the motion of atlantoaxial articulation, and postoperative loss of cervical lordosis and aggravation of cervical kyphosis are observed. We investigated various factors under the hypothesis that the atlantodental interval (ADI) and T1 slope may be associated with sagittal alignment after atlantoaxial fusion in patients with rheumatoid arthritis (RA).

Methods

We retrospectively investigated 64 patients with RA who underwent atlantoaxial fusion due to AAI. Radiological factors, including the ADI, T1 slope, Oc-C2 angle, cervical sagittal vertical axis, and C2–C7 angle, were measured before and after surgery.

Results

The various factors associated with atlantoaxial fusion before and after surgery were compared according to the upper and lower preoperative ADIs. There was a significant difference in the T1 slope 1 year after surgery (p = 0.044) among the patients with lower preoperative ADI values. The multivariate logistic regression analysis showed that the preoperative ADI (> 7.92 mm) defined in the receiver-operating characteristic curve analysis was an independent predictive factor for the increase in the T1 slope 1 year after atlantoaxial fusion (odds ratio, 4.59; 95% confidence interval, 1.34–15.73; p = 0.015).

Conclusion

We found an association between the preoperative ADI and difference in the T1 slope after atlantoaxial fusion in the patients with RA. A preoperative ADI (> 7.92 mm) was an independent predictor for the increase in the T1 slope after atlantoaxial fusion. Therefore, performing surgical treatment when the ADI is low would lead to better cervical sagittal alignment.
Efficacy evaluation of photodynamic therapy for oral lichen planus: a systematic review and meta-analysis
Authors: He Yuqing , Deng Jiaxin , Zhao Yi , Tao Huiqian , Dan Hongxia , Xu Hao , Chen Qianming
Published: November 2020

Background

Photodynamic therapy (PDT) is a new option for oral lichen planus (OLP) management; however, there are different opinions on the efficacy of PDT for OLP. The aim of this study was to comprehensively assess the efficacy of PDT in the treatment of OLP and compare PDT with steroid therapy.

Methods

A systematic review and meta-analysis were conducted to assess the curative effect of PDT. Five electronic databases were searched, PubMed, Web of Science, the Cochrane Library, Embase, and EBSCO up to 1 December, 2019. Random and fixed effects models for pooled estimates calculation were used and the Meta package of R was applied.

Results

Pooled estimates revealed that, after PDT, the lesion size decreased by 1.53 cm2 (95% confidence interval (CI): 0.71–2.35) after PDT and the partial response (PR) was 0.77 (95% CI: 0.65–0.85). The visual analogue scale (VAS) score decreased by 3.82 (95% CI: 2.80–4.85) and the Thongprasom sign score decreased by 1.33 (95% CI: 0.56–2.10) after PDT. Subgroup analyses revealed that the 5-aminolevulinic acid (5-ALA) was more effective than methylene blue (MB), with a PR of 0.87 (95% CI: 0.80–0.91). The topical use of 5-ALA yielded a better response than gargling methylene blue. In terms of VAS, the diode laser showed a better clinical PR in the treatment of OLP. In terms of changes in lesion size, the efficacy of the semiconductor laser was higher than that of the diode laser. PDT had a similar efficacy to topical corticosteroids, as shown by pooled estimates of five randomised controlled trials with 139 lesions.

Conclusion

This systematic review indicates that PDT is an effective treatment modality for the management of OLP. PDT is as effective as topical corticosteroid in the treatment of OLP and could be used for cases resistant to steroids or when steroids are contraindicated.
Evaluation of the quality of fixed prosthesis impressions in private laboratories in a sample from Yemen
Authors: Al-Odinee Nusaiba M. , Al-Hamzi Mohsen , Al-shami Ibrahim Z. , Madfa Ahmed , Al-Kholani Abdulwahab I. , Al-Olofi Yazeed M.
Published: November 2020

Background

Fixed prosthodontics require an accurate impression for the teeth and the area to be restored for the laboratory to fabricate the desired restoration without mistakes. This study evaluated the quality of impressions received by private laboratories for the fabrication of fixed prosthesis by describing the frequency of clinically detectable errors and by analyzing association between the various factors involved.

Methods

165 impressions were collected from four dental laboratories. Jaw involved, type of tray, size of tray, number of prepared units, type of impression materials, techniques and viscosity in case of elastomeric impressions and type of prosthesis requested were recorded. Data referring to errors and visible defects including errors in finish line, in preparation area, in silicone impression technique and blood in impression were also documented. Factors affecting errors present were also assessed. Association between dentist gender and experience years and impression errors was assessed. Chi square and Fisher exact tests used to examine the association between categorical variables and outcomes.

Results

The total of error considering not immediately pouring as an error. Alginate was the most impression used. of impressions evaluated (50.9%), 97% were have at least one visible error; 92.1% had errors in finish line, 53.9% had errors in preparation area and (72.8%) of elastomeric impressions were have at least one error in technique. Blood in impression was detected in 52.1% of impressions. Significant association was found between material type and errors in finishing line and preparation area. Significant relationships were found between gender and errors in silicone impression technique (p < 0.05).

Conclusion

Within the limitations of this study, high frequency of detectable errors was found in fixed prosthesis impressions received by private dental laboratories. This high frequency is of serious concern, as this will result in poor fitted fixed prosthesis provided to patients.
Associated factors to caries experience of children undergoing general anaesthesia and treatment needs characteristics over a 10 year period
Authors: Bekes Katrin , Steuber Antonia , Challakh Nadia , Schmidt Jana , Haak Rainer , Hraský Valentina , Ziebolz Dirk
Published: November 2020

Background

Aim of this study was to describe the characteristics of 1- to 6-year-old children who underwent general anesthesia (GA) in a German specialized pediatric dental institution between 2002 and 2011, and to evaluate the risk factors (age, migration background, nutritional status) for caries experience (dmf-s) in these children.

Methods

A cross-sectional study with retrospective data collection was designed. Children who underwent comprehensive dental treatment under GA were enrolled in the study. The data were collected from patient records and included personal background: age, sex, dmf-s, nutritional status, reasons for GA and treatments provided. Mann–Whitney-U test, Chi-square tests, and linear regression modelling were applied for statistical analyses.

Results

652 children (median age: 3 years [IQR: 2–4], 41.6% female) were treated under GA between 2002 and 2011. Of these, 30.8% had migration background, 17.3% were underweight and 14.8% overweight. The median dmf-s was 28 (IQR: 19–43.5). Univariate, only age and migration showed a significant association with dmf-s (p < 0.01) up to the age of 5 years. In the linear regression analysis, this association of dmf-s with age (OR: 4.04/CI: 2.81–5.27;p < 0.01) and migration (OR: 4.26/CI: 0.89–7.62;p = 0.013) was confirmed. At the patient level, tooth extraction was the most chosen option in both time periods, however, more restorative approaches were taken between 2007 and 2011 including pulp therapy and the use of strip and stainless steel crowns compared to 2002–2006.

Conclusions

Children aged 1–6 years treated under GA showed a high caries experience (dmf-s), whereby age as well as migration, but not BMI, were relevant risk factors. Although tooth extraction is the first choice in most cases in the first time period, more conservative procedures were performed in the second half of the follow-up period.
Medical students’ affective reactions to workplace experiences: qualitative investigation in a Chinese cultural context
Authors: Yeh Huei-Ming , Chien Wan-Hsi , Tsai Daniel Fu-Chang , Dornan Tim , Lai Ling-Ping , Chu Chun-Lin
Published: November 2020

Background

Compassion fatigue, unprofessional behavior, and burnout are prompting educators to examine medical students’ affective reactions to workplace experiences. Attributes of both students and learning environments are influenced by their socio-cultural backgrounds. To prevent ‘educational cultural hegemony’, opinion leaders have advocated research in under-represented cultural contexts, of which Asia is a prime example. This study aimed to broaden the discourse of medical education by answering the question: how do students react affectively to workplace experiences in a Chinese cultural context?

Methods

In 2014, the authors recruited five female and seven male Taiwanese clerkship students to make 1–2 audio-diary recordings per week for 12 weeks describing affective experiences, to which they had consciously reacted. The authors analyzed transcripts of these recordings thematically in the original Mandarin and prepared a thick description of their findings, including illustrative extracts. An English-speaking education researcher helped them translate this into English, constantly comparing the interpretation with the original, untranslated data.

Results

(Mis) matches between their visions of future professional life and clerkship experiences influenced participants’ affective reactions, thoughts, and behaviors. Participants managed these reactions by drawing on a range of personal and social resources, which influenced the valence, strength, and nature of their reactions. This complex set of interrelationships was influenced by culturally determined values and norms, of which this report provides a thick description.

Conclusion

To avoid educational cultural hegemony, educators need to understand professional behavior in terms of complex interactions between culturally-specific attributes of individual students and learning environments.

Trial registration

The ethics committee of the National Taiwan University (NTU) Hospital gave research ethics approval (20130864RINB).
The mediation effects of coping style on the relationship between social support and anxiety in Chinese medical staff during COVID-19
Authors: Zhu Wei , Wei Yi , Meng Xiandong , Li Jiping
Published: November 2020

Background

The COVID-19 has been a pandemic around the world, which affirmatively brought mental health problems to medical staff. We aimed to investigate the prevalence of anxiety in Chinese medical staff and examine the mediation effects of coping styles on the relationship between social support and anxiety.

Methods

A cross-sectional study via internet survey was conducted from 15 March to 30 March, 2020. The social demographic data, Self-rated Anxiety Scale, Social Support Rate Scale and Trait Coping Style Scale were collected. Pearson correlation and a structural equation model were performed to examine the relationships of these variables. The bootstrap analysis was conducted to evaluate the mediation effects.

Results

A total of 453 medical staff participated in this study. The mean score of SAS was 46.1 (SD = 10.4). Up to 40.8% of the participants had anxiety symptoms. The participants lived with family members had lower SAS score (45.1 ± 9.8 vs 49.6 ± 11.8). Social support was negatively associated with anxiety, mediated by positive coping and negative coping partially significantly with an effect size of − 0.183.

Conclusions

Chinese medical staff had a high level of anxiety during the COVID-19 pandemic. Coping styles had effects on the association between social support and anxiety. Sufficient social support and training on positive coping skills may reduce anxiety in medical staff.