bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Developmental Dental Anomalies, Early Childhood Caries And Oral Hygiene Status Of 3-5-Year-Old Children In Ile-Ife, Nigeria
Authors: Folayan Morenike Oluwatoyin , Alade Michael , Adeniyi Abiola , Tantawi Maha El , Finlayson Tracy L 
Published: December 2019

Abstract
Objectives: To determine the association between developmental dental anomalies (DDA), early childhood caries (ECC) and oral hygiene status of 3-5-year-old children resident in Ile-Ife, Nigeria.
Methods: This was a cross-sectional study. We analyzed data for 3-5-year-olds extracted from the dataset of a household survey collected to determine the association between ECC and maternal psychosocial wellbeing in children 0-5-year-olds. The outcome variables for the study were ECC and poor oral hygiene. The explanatory variable was the presence of developmental dental anomalies (supernumerary, supplemental, mesiodens, hypodontia, macrodontia, microdontia, peg-shaped lateral, dens evaginatus, dens invaginatus, talons cusp, fusion/germination, hypoplasia, hypomineralized second molar, fluorosis, amelogenesis imperfecta). The prevalence of each anomaly was determined. Poisson regression analysis was conducted to determine the association between presence of developmental dental anomalies, ECC and oral hygiene status. The model was adjusted for sex, age and socioeconomic status.
Results: Of the 918 children examined, 75 (8.2%) had DDA, 43 (4.7%) had ECC, and 38 (4.1%) had poor oral hygiene. The most prevalent DDA was enamel hypoplasia (3.9%). Of the 43 children with ECC, 6 (14.0%) had enamel hypoplasia and 3 (7.6%) had hypomineralized second primary molar. There was a significant association between ECC and enamel hypoplasia (p<0.001) and a borderline association between ECC and hypomineralized second primary molars (p=0.05). The proportion of children with poor oral hygiene (PR: 2.03; 95% CI: 0.91-4.56; p=0.09) and ECC (PR: 2.02; 95% CI: 0.92-4.46; p=0.08) who had DDA was twice that of children with good oral hygiene and without ECC respectively, although the differences did not reach statistical significance.
Conclusion. Enamel hypoplasia and hypomineralized second primary molars are DDA associated with ECC. DDA also increases the probability of having poor oral hygiene in the population studied.
Integrin α7 knockdown suppresses cell proliferation, migration, invasion and endothelium-mesenchymal transformation in hepatocellular carcinoma
Authors: Wu Zhiyong , Kong Xiaoyu , Wang Zhihui 
Published: December 2019

Abstract
Background The aim was to investigate whether integrin α7 (ITGA7) influenced hepatocellular carcinoma (HCC) progression, and explore its effect on regulating endothelium-mesenchymal transformation (EMT).Methods ITGA7 mRNA and protein expressions in human normal liver epithelial cell line and HCC cell lines were determined by reverse transcription polymerase chain reaction (RT-qPCR) and western blot. ITGA7 siRNA (ITGA7-KD group) and nonsense siRNA (control group) were transfected into Huh7 cells and SUN449 cells. After transfection, ITGA7 mRNA and protein expressions (RT-qPCR and western blot), cell proliferation (Cell Counting Kit-8), apoptosis (Annexin V/Propidium Iodide assay), migration (Wound scratch assay) and invasion (Transwell assay) were determined. E-cadherin and α-SMA expressions (RT-qPCR and western blot) were determined.Results ITGA7 mRNA and protein expressions were increased in Li7, Huh7, SKHEP1 and SNU449 cells compared to THLE-3 cells. In both Huh7 and SNU449 cells, ITGA7 mRNA and protein expressions were decreased in ITGA7-KD group than control group after plasmids transfection, indicating the successful transfection. Then, cell proliferation was decreased at 48h and 72h; cell apoptosis rate was increased at 48h; cell migration rate was reduced at 24h; cell invasive count was decreased at 24h in ITGA7-KD group compared to control group. Furthermore, increased E-cadherin but decreased α-SMA mRNA and protein expressions were discovered in ITGA7-KD group than control group at 24h.Conclusions ITGA7 knockdown suppresses HCC progression and inhibits EMT process in HCC, indicating that ITGA7 might be a potential novel treatment target for HCC therapy.
Correlation between optic disc deformation and retinal vasculature in non-pathological high myopia
Authors: Sun Jiao , Wang Jialin , Wang Yanling 
Published: December 2019

Abstract
Background: The aim of this study was to investigate the correlation between optic disc deformation and retinal vasculature in high myopia.Methods: One hundred and thirty eyes with non-pathological high myopia were included in this cross-sectional study. The optic disc tilt ratio, and horizontal and vertical disc diameters were analyzed using fundus color photography. A 3 × 3 mm2 grid and a 4.5 × 4.5 mm2 grid were used to scan parafoveal and peripapillary regions, respectively, using optical coherence tomography angiography. Vessel flow density (VFD) and fractal dimension of the retina and the foveal avascular zone (FAZ) were analyzed and quantified using en face projection images. Optic disc parameters that were associated with vascular changes were determined using multiple linear regression analysis.Results: Results from the multivariate analysis revealed that the tilt ratio (β = -2.291, p = 0.025) was negatively correlated with three sectors in the deep layer. Age was negatively correlated with the VFD of the retina (β = -2.161; p < 0.034). Additionally, FAZ was not significantly correlated with any factors in the current study. Further, there was a positive correlation between retinal nerve fiber layer thickness and VFD of the optic nerve head (β = -2.146, p = 0.035).Conclusions: Overall, our results demonstrated that optic disc deformation was negatively correlated with the retinal microvasculature in non-pathological high myopia. Therefore, optic disc deformation may be used to predict the retinal vasculature in high myopia.
The reliability and validity of PHQ-9 in patients with major depressive disorder in psychiatric hospital
Authors: Sun Yue , Fu Zhaoyan , Bo Qijing , Mao Zhen , Ma Xin , Wang Chuanyue 
Published: December 2019

Abstract
Background: To assess the reliability and validity of Patient Health Questionnaire-9 (PHQ-9) for patients with major depressive disorder (MDD) and to assess the feasibility of its use in psychiatric hospitals in China. Methods: 109 outpatients or inpatients with MDD who qualified the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria completed PHQ-9 and Hamilton Depression Scale (HAMD-17). Two weeks after the initial evaluation, 54 randomly selected patients underwent repeat assessment using PHQ-9. For validity analysis, the construct validity and criterion validity were assessed. The internal concordance coefficient and the test-retest correlation coefficients were used for reliability analysis. The correlation between total score and scores for each item and the correlation between scores for various items were evaluated using Spearman correlation coefficient. Results: Principal components factor analysis showed good construct validity of the PHQ-9. PHQ-9 total score showed a positive correlation with HAMD-17 total score (r=0.610, P<0.001). With HAMD as the standard, PHQ-9 depression scores of 7, 15, and 21 points were used as cut-offs for mild, moderate, and severe depression, respectively. Consistency assessment was conducted between the depression severity as assessed by PHQ-9 and HAMD (Kappa=0.229, P<0.001). Intraclass correlation coefficient between PHQ-9 total score and HAMD total score was 0.594 (95% confidence interval: 0.456–0.704, P<0.001). The Cronbach's α coefficient of PHQ-9 was 0.892. Correlation coefficients between each item score and the total score ranged from 0.567–0.789 (P<0.01); the correlation coefficient between various item scores ranged from 0.233–0.747. The test-retest correlation coefficient for total score was 0.737. Conclusions: PHQ-9 showed good reliability and validity, and high adaptability for patients with MDD in psychiatric hospital. It is a simple, rapid, effective, and reliable tool for screening and evaluation of the severity of depression.
Sex-specific Longitudinal Comparison of CES-D and PHQ-9 Depression Scales. A Concordance Analysis using data from the population-based Heinz Nixdorf Recall Study
Authors: Engel Miriam , Peternel Markus , Jöckel Karl-Heinz , Schramm Sara , Slomiany Uta , Moebus Susanne 
Published: December 2019

Abstract
Background: To measure depressive symptoms (DS) in population-based studies, there are two the well-established questionnaires: the Center for Epidemiologic Studies Depression Scale (CES-D) and the Patient Health Questionnaire-9 (PHQ-9). So far, comparisons between both instruments have only been performed using cross-sectional data, and in specific patient groups. Furthermore, comparisons for population-based studies are missing as well as sex-specific analyses. The aim is to evaluate the psychometric properties and concordance of the longitudinal results of CES-D and PHQ-9 in the German population-based Heinz Nixdorf Recall (HNR) study. Methods: We used data of n=3,084 participants (48.8% men, mean age: 66.8 years). CES-D and PHQ-9 were assessed in the 8th (t8) and 9th (t9) annual postal follow up within two years via questionnaires. DS were defined as CES-D score ≥ 17 and PHQ-9 score ≥ 10. Internal consistency reliability, convergent validity, and agreement between PHQ-9 and CES-D were assessed using respectively Cronbach’s alpha, Pearson’s correlation, and Cohen’s kappa. To analyse DS differences between t8 and t9 we used McNemar’s test. Sex-stratified results are presented. Results: The prevalence of DS at t8 was higher for CES-D (7.8%) than for PHQ-9 (4.4%). The prevalence slightly increased for CES-D (8.1%), as well as for PHQ-9 to 4.5% at t9. Internal consistency of the PHQ-9 and CES-D was good at both times (Cronbach’s alpha: CES-D t8 & t9: 0.89, PHQ-9 t8: 0.84; t9: 0.85). Cohen’s kappa of agreement between CES-D and PHQ-9 was moderate at both time points (t8: k=0.57; 95% CI: 0.51, 0.63; t9; k=0.58; 95% CI: 0.52, 0.64). For both instruments, the McNemar’s test revealed no differences in the proportion of depressives between t8 and t9. We could not observe sex-specific differences of psychometric characteristics, whereas the agreement between the CES-D and PHQ-9 performed slightly higher in men than in women (t8: k=0.61, resp. k=0.55). Conclusion: The results do not support the superiority of one of the scales. Both scales perform well in this population-based cohort in both sexes and longitudinal approach. The decision, which scale to use may depend on characteristics other than the accuracy of the scale, including feasibility and clinical usability.
Reported prevalence of suicidal ideation and suicide attempts among men who have sex with men in China: A systematic review and meta-analysis
Authors: Fu Hanlin , Yang Tubao , Wu Xiaobing , Cai Yumao , feng tiejian 
Published: December 2019

Abstract
Background: Men who have sex with men(MSM) in China are at high risk for suicidality but often overlooked. Several studies have reported the prevalence of suicidal ideation and suicide attempts. However, the estimates varies substantially between studies. This systematic review aimed to establish pooled prevalence of suicidal ideation and suicide attempts among MSM in China, in order to arouse the attention of the public.Methods: The relevant studies up to April 2019 were systematically searched via several electronic databases. Studies were screened according to inclusion and exclusion criterion and the random-effects meta-analyses were adopted to calculate the pooled prevalence estimates of suicidal ideation and suicide attempts. Heterogeneity between studies and publication bias was also assessed.Results: A total of 23 articles were eligible for the meta-analysis. The pooled prevalence estimate of suicidal ideation and suicide attempts was 20.1% (95%CI: 16.7%-23.7%) and 6.8%(95%CI: 5.0%-8.9%), respectively. Significant heterogeneity was found for both combined effects. Heterogeneity in the estimates could be partially explained by survey points, HIV infection and average age.Conclusions: The prevalence of suicidal ideation and suicide attempts among MSM in China was moderate high, suggesting that more attention should be paid to the subgroup and effective psychological interventions need to be established and implemented to reduce the suicide-related problems among Chinese MSM.
Magnitude of Problematic Anger and its Predictors in the Millennium Cohort
Authors: Adler Amy , LeardMann Cynthia A. , Roenfeldt Kimberly , Forbes David , Jacobson Isabel 
Published: December 2019

Abstract
Background In military personnel and veterans, problematic anger is associated with heightened risk of mental health problems and difficulty functioning, although previous studies have been limited by sample size and cross-sectional data. Methods The current study used Millennium Cohort survey data (N = 90,266) from two time points (2013 and 2016 surveys) to assess the association of baseline demographics, military factors, mental health, self-mastery, and posttraumatic growth with problematic anger levels reported several years later.ResultsOverall, 17.3% of respondents reported problematic anger. In the fully adjusted logistic regression model, greater risk of problematic anger was predicted by male sex, younger age, current or formerly marital status, being black non-Hispanic or other (vs. white), less educational attainment, childhood trauma, and financial problems. Service members who were in the Army or Marines, active duty (vs. reserve), and previously deployed with high levels of combat had increased risk for problematic anger. Veterans were also more likely to report problematic anger. Mental health predictors included major depressive disorder (MDD), posttraumatic stress disorder (PTSD) and comorbid PTSD/MDD. Higher levels of self-mastery and post-traumatic growth were associated with decreased risk of problematic anger.Conclusion Not only did 1 in 6 respondents report problematic anger, but risk factors were significant even after adjusting for MDD and PTSD, suggesting that problematic anger is more than an expression of these mental health problems. Results identify potential points of early intervention and clinical treatment for addressing problematic anger.
“To be lonely in your own loneliness” – The interplay between self-perceived loneliness and rheumatoid arthritis in everyday life: A qualitative study
Authors: Bay Laila Twisttmann , Ellingsen Torkell , Giraldi Annamaria , Graugaard Christian , Nielsen Dorthe 
Published: December 2019

Abstract
Background: Loneliness has a negative impact on physical health, and rheumatoid arthritis symptoms can lead to social isolation. However, there is a lack of research exploring patients’ perspectives on self-perceived loneliness in everyday life with rheumatoid arthritis. The purpose of this study was to gain insight into the meaning and importance of self-perceived loneliness among adult patients diagnosed with rheumatoid arthritis.Methods: Semi-structured interviews analyzed within a narrative thematic framework.Results: Three themes emerged during the analysis: explanations of loneliness in everyday life with rheumatoid arthritis, disclosing or disguising loneliness, and feelings of loneliness in social life.Conclusion: The findings from this study show that loneliness can be burdensome when living with RA. Narratives of loneliness can be hard for patients to disclose, so health care practitioners should take responsibility for legitimizing this subject. A narrative approach in consultations may be helpful to support patients and to encourage a dialogue about loneliness in everyday life with RA.
Earthquake Preparedness of Households and Its Predictors Based on Health Belief Model
Authors: Rostami-Moez Masoumeh , Rabiee-Yeganeh Mohammad , Shokouhi Mohammadreza , Dosti-Irani Amin , Rezapur-Shahkolai Forouzan 
Published: December 2019

Abstract
Background: Earthquakes are one of the most destructive natural disasters in which many people are injured, disabled, or dead each year. Although Iran has only one percent of the world's population, its earthquake-related deaths are six percent. Therefore, this study aimed to determine the level of earthquake preparedness of households and its predictors using the Health Belief Model (HBM).Methods: This study was conducted on 933 households in Hamadan province, located in the west of Iran, in 2019. Multistage random cluster sampling was used for selecting the participants. The inclusion criteria were having at least 18 years old and being able to answer the questions. A questionnaire was used for data collection including earthquake preparedness, awareness of earthquake response, predictors of earthquake preparedness based on the HBM, and demographic information. Analysis of variance, independent t-test, and a linear regression model were used.Results: The mean age of participants was approximately 38.29 ±12.80 years. Furthermore, 60.83% of participants had less than post-secondary education. Earthquake preparedness was poor and about 30%. There was a significant relationship between earthquake preparedness and gender, home ownership, marriage status, and previous earthquake experience (p <0.001). Regarding the HBM constructs, perceived benefits, cues to action, and self-efficacy had significant predictors of earthquake preparedness (p <0.01).Conclusions: Regarding the low earthquake household preparedness, community intervention for improving households' preparedness for earthquake based on the HBM is recommended. Intervention can be designed considering cues to action, self-efficacy, and perceived benefits.
Is natural (6S)-5-methyltetrahydrofolic acid as effective as synthetic folic acid in increasing serum and red blood cell folate concentrations during pregnancy? A proof-of-concept pilot study
Authors: Cochrane Kelsey M , Mayer Chantal , Devlin Angela M , Elango Rajavel , Hutcheon Jennifer A , Karakochuk Crystal D 
Published: December 2019

Abstract
Background: Health Canada recommends 0.4 mg/day folic acid before conception and throughout pregnancy to reduce the risk of neural tube defects. Folic acid is a synthetic form of folate that must be reduced by dihydrofolate reductase and then further metabolized in the small intestine. Recent evidence suggests that the maximal capacity for this process is limited and unmetabolized folic acid has been detected in circulation. The biological effects of unmetabolized folic acid are not fully understood. A natural form of folate, (6S)-5-methyltetrahydrofolic acid (Metafolin®), may be a superior alternative because it does not need to be reduced in the small intestine. Metafolin® is currently used in some prenatal multivitamins, however it has yet to be evaluated during pregnancy. Methods: This double-blind randomized trial will recruit 60 pregnant women aged 19-42 years. Women will receive either 0.6 mg/day folic acid or an equimolar dose (0.625 mg/day) of (6S)-5-methyltetrahydrofolic acid for 16-weeks. The trial will be initiated at 8-21 weeks gestation (after neural tube closure) to reduce the risk of harm should (6S)-5-methyltetrahydrofolic acid prove less effective. All women will also receive a prenatal multivitamin (not containing folate) to ensure adequacy of other nutrients. Baseline and endline blood samples will be collected to assess primary outcome measures, including serum folate, red blood cell folate and unmetabolized folic acid. Change in primary outcomes from baseline to endline in each group will be calculated using a paired-t-test. Discussion: This proof-of-concept trial is needed to obtain estimates of the effect of (6S)-5-methyltetrahydrofolic acid compared to folic acid on circulating biomarkers of folate status during pregnancy. These estimates will inform the design of a definitive trial which will be powered to assess whether (6S)-5-methyltetrahydrofolic acid is as effective as folic acid in raising blood folate concentrations during pregnancy. Ultimately, these findings will inform folate supplementation policies for pregnant women.
Standardising Care in the ICU: A Protocol for a Scoping Review of Tools used to Improve Care Delivery
Authors: Allum laura , Apps Chloe , Hart Nicholas , Pattison Natalie , Connolly Bronwen , Rose Louise 
Published: December 2019

Abstract
Background: Increasing numbers of critically ill patients experience a prolonged intensive care unit stay contributing to greater physical and psychological morbidity, strain on families, and cost to health systems. Healthcare providers report dissatisfaction with provision of care for these longer stay patients due to competing demands from higher acuity patients. Quality improvement tools such as checklists concisely articulate best practices with the aim of improving quality and safety. However, these tools have not been designed for the specific needs of patients with prolonged ICU stay. The objective of this review is to generate data to inform development and implementation of quality improvement tools for patients with prolonged ICU stay, namely: the content, design and effect of multicomponent tools designed to standardise or improve ICU care. Secondary objectives are to understand how these tools were developed and implemented in clinical practice.Methods: We will search the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, MEDLINE, PsycINFO, Web of Science, OpenGrey, NHS evidence and Trial Registries from 1999 to August 2019. We will include primary research studies recruiting more than 10 adult participants admitted to ICUs, high dependency units and weaning centres regardless of length of stay, describing quality improvement measures such as structured care plans or checklists designed to standardize more than one aspect of care delivery. Two authors will independently screen citations for eligible studies and perform data extraction. We will use a narrative synthesis to describe review findings.Discussion: The findings will be used to guide development of tools for use with prolonged ICU stay. Our group will use experience-based co-design methods to identify the most important actionable processes of care to include in quality improvement tools for patients with prolonged ICU stay. Such tools are needed to standardise practice and thereby improve quality of care for patients with prolonged ICU stay and their families. Illustrating the development and implementation methods used for such tools will help to guide translation for similar tools in ICU and future research.Systematic Review Registration: This protocol is registered on the Open Science Framework, https://osf.io/ , DOI 10.17605/OSF.IO/Z8MRE