bluuebunny/crossref_metadata_2025_split huggingface dataset:
An overview of oral health status, socio-economic and behavioral risk factors, and the pattern of tooth loss in a sample of Egyptian rural population
Authors: Moussa Amani , Ibrahim Eman , Esmat Ahmed , Eissa Sherihan , Ramzy Magda 
Published: January 2020

Abstract
Background
The lack of adequate data on the oral health status among the Egyptians is a challenging barrier for the assessment and improvement of oral health needs.

Objectives
The aim of this study was to collect data on oral health status among a sample of Egyptian rural population and to assess the possible role of the socio-demographic, socio-economic, and behavioral risk factors on the status of the present dentition (the pattern of tooth loss and edentulism).

Materials and methods
Data was collected from 530 patients with age ranged from 20 to 70 years using a modified World Health Organization (WHO) questionnaire. The questionnaire included information about oral health status, socio-demographic (age and sex), socio-economic (educational levels and income), and behavioral factors (smoking and oral hygiene measures). A complete intra- and extraoral examination and free dental health care services were provided by a team of qualified dental specialists from National Research Centre (NRC). Data was analyzed using chi-square and Spearman’s correlation tests, and the significance level was validated at p < 0.05.

Results
Females comprised 79% while males were 21% of the surveyed rural sample. Concerning socio-economic aspects including the level of education and income, it was found that 50% of the individuals completed their secondary educational levels, followed by illiterates 35.5% and preparatory levels, while college graduates were minority 4.7%. On the other hand, only 27.5% of rural had income while 72.5% of them had no income. Assessment of behavioral risk factors (oral hygiene procedures and smoking) showed that only 34.3% of the individuals claimed to brush their teeth and only a minority were male smokers (13.8%). The results demonstrated poor oral health status and increased incidence of partial edentulism (45%), where Kennedy class III was the most common type (34.6%).

Conclusions

Lack of oral hygiene measures specifically tooth brushing is the most significant behavioral risk factor for the poor oral health status and tooth loss in this survey.

Sociodemographic and socio-economic factors are influential risk factors for tooth loss.

Cigarette smoking was not a main behavioral risk factor that impacts the oral health status in the present survey
Effects of subjective feeling of environmental temperature on appetite and food intake in Chinese sociodemographic and ethnic groups
Authors: Halawa Abdelhadi 
Published: February 2020

AbstractBackgroundA better understanding of the effect of environmental temperature variation on appetite and food intake may inform the public of adopting appropriate prophylactic eating behaviors. Seasonal weather temperature variation has been shown to have adverse effects on appetite and food intake in humans. The main purpose of this study was to examine the effect of environmental temperature variation on the appetite and eating patterns in Chinese adults.MethodsCross-sectional analysis of data obtained from 1297 Chinese adults, including two Chinese ethnic groups, Han (N= 897) and Hui (N= 400). Participants responded to a modified paper-and-pencil self-administered dietary habits and food intake survey. In addition to sociodemographic factors and ethnic group affiliation questions, the survey included a question regarding the effect of the subjective feeling of environmental temperature variation (SFETV) on appetite and food intake as an independent variable.ttests and chi-square analyses were performed to analyze the parametric and nonparametric variables respectively.ResultsNo significant difference was found in the effect of SFETV between the following dependent variables: male and female respondents (p< .998), married and single respondents (p< .281), full-time and part-time employed or retired participants (p< .187). Although it has not affected their SFETV responses, there was a statistically significant difference in the education level between the married and single respondents (p< .001). The single respondents were more likely to be college educated with a rate of (68.48%) compared with their married counterparts with a rate of 30.2%. There was a statistically significant difference between the eight cities and one rural town (p< .001). The appetite and food intake of the respondents from these cities were more likely to be affected by the SFETV. The appetite and food intake of the Han ethnic group were more likely to be affected by the SFETV with a rate of 28.09% juxtaposed to the Hui ethnic group with a rate of 12.64%.ConclusionsThe findings suggest that exposure to outdoor temperature variation (hot or cold) has a limited effect on the appetite and food intake of Chinese adults. However, the appetite and food intake of the permanent residents of the eight cities and one rural town were more likely to be affected by the exposure to outdoor temperature variation (hot or cold).
Unmasking lymphoma immune reconstitution inflammatory syndrome in a patient with pyrexia of unknown origin: a case report
Authors: Mahajan Mansi , Venkatesulu Bhanu Prasad , Sallam Omar , Taneja Kanika , Scott Megan , Brar Indira 
Published: January 2020

Abstract
Background
Immune reconstitution inflammatory syndrome (IRIS) is a constellation of inflammatory disorders that are unmasked after the initiation of anti-retroviral therapy (ART) in Human immunodeficiency virus (HIV) infected patients. Unmasking lymphoma IRIS is a relatively rare manifestation after initiation of anti-retroviral therapy.

Case presentation
We report a 44-year-old male with HIV on 4 months of ART presenting with pyrexia of unknown origin with a diagnosis of unmasking Hodgkin’s lymphoma IRIS stage IV with B symptoms. This case portrays the importance of recognizing the possibility of Hodgkin’s lymphoma as a possible manifestation of IRIS within the first 6 months of initiation of ART.

Conclusion
Patients presenting with pyrexia of unknown origin and lymphadenopathy within the first 6 months of initiation of ART, lymphoma diagnosis should be on the high threshold of suspicion as portrayed by our case.
Phthalates and Sex Steroid Hormones Among Men From NHANES, 2013–2016
Authors: Woodward Miriam J , Obsekov Vladislav , Jacobson Melanie H , Kahn Linda G , Trasande Leonardo 
Published: January 2020

Abstract

Context
Phthalates are commonly found in commercial packaging, solvents, vinyl, and personal care products, and there is concern for potential endocrine-disrupting effects in males. The commonly used di-2-ethylhexyl phthalate (DEHP) has progressively been replaced by seldom studied compounds, such as bis-2-ethylhexyl terephthalate and 1,2-cyclohexane dicarboxylic acid di-isononyl ester (DINCH).

Objective
To investigate the associations between the urinary phthalate metabolites and serum sex steroid hormone concentrations in a nationally representative sample of adult males.

Design, Setting, Participants, and Intervention
This was a cross-sectional analysis of data from the 2013–2016 National Health and Nutrition Examination Survey among 1420 male participants aged ≥20 years.

Main Outcome Measures
Serum levels of total testosterone, estradiol, SHBG, and derived sex hormone measurements of free testosterone, bioavailable testosterone, and free androgen index were examined as log-transformed continuous variables.

Results
Phthalate metabolites were not statistically significantly associated with sex hormone concentrations among all men. However, associations varied by age. High molecular weight phthalates were associated with lower total, free, and bioavailable testosterone among men age ≥60. Specifically, each doubling of ΣDEHP was associated with 7.72% lower total testosterone among older men (95% confidence interval, -12.76% to -2.39%). Low molecular phthalates were associated with lower total, free, and bioavailable testosterone among men age 20 to 39 and ∑DINCH was associated with lower total testosterone among men age ≥40.

Conclusions
Our results indicate that males may be vulnerable to different phthalate metabolites in age-specific ways. These results support further investigation into the endocrine-disrupting effects of phthalates.
CTG Expansion in the DMPK Gene: Semen Quality Assessment and Outcome of Preimplantation Genetic Diagnosis
Authors: Puy Vincent , Mayeur Anne , Levy Alexandre , Hesters Laetitia , Raad Jade , Monnot Sophie , Steffann Julie , Frydman Nelly 
Published: January 2020

Abstract

Context
Myotonic dystrophy (DM) is an autosomal dominant disorder characterized mainly by myotonia but also by primary hypogonadism. No study has reported on fertility management of patients affected by DM type 1 (DM1).

Objective
This study investigates the impact of CTG repeats in the DMPK gene on semen quality and preimplantation genetic diagnosis (PGD) outcome.

Design
This is a monocentric retrospective observational study conducted from January 2003 to January 2019.

Setting
Antoine Béclère University Hospital, Clamart, France.

Patients
Three groups were compared in this study: male DM1 patients (Group A, n = 18), unaffected partners of DM1 female patients (Group B, n = 30), and proven fertile men (Group C, n = 33). Reproductive outcomes after PGD were compared between groups A and B.

Results
Sperm volume was reduced in group A (2.0 mL) when compared with groups B (3.0 mL; P &lt; 0.01) and C (3.5 mL; P &lt; 0.01). Progressive motility in raw sperm was also decreased in group A (30%) as compared to group C (40%; P &lt; 0.01). The median number of progressive spermatozoa retrieved after sperm preparation was 2.7 million (M) in group A, which was significantly less than those of groups B (10.0 M; P &lt; 0.01) and C (62.2 M; P &lt; 0.01). Sperm motility was inversely correlated to the number of CTG repeats (Spearman r2 = 0.48, Pearson r2 = 0.35). Cumulative live birth rate per transfer was similar between groups, with 32.2% in group A versus 26.8% in group B.

Conclusions
As a precautionary measure, we advise physicians to perform regular monitoring of semen quality in affected males, which would allow sperm cryopreservation should semen parameters fall. PGD allows good reproductive outcomes without disease transmission.
The Impact of Obesity On Insulin Sensitivity and Secretion During Pubertal Progression: A Longitudinal Study
Authors: Kelsey Megan M , Pyle Laura , Hilkin Allison , Severn Cameron D , Utzschneider Kristina , Van Pelt Rachael E , Nadeau Kristen J , Zeitler Philip S 
Published: January 2020

Abstract

Context
Physiologic changes in glucose metabolism are well-described to occur during puberty. However, there are important gaps in understanding the interaction between obesity and the normal physiologic changes during puberty, as well as how these changes could contribute to the increased risk of comorbidities, such as type 2 diabetes and dyslipidemia, in youth with obesity.

Objective
The objective of this study was to compare longitudinal changes in insulin sensitivity (Si) and secretion during pubertal progression in youth with obesity versus those with normal weight.

Design
Longitudinal observational study evaluating youth from early puberty (Tanner [T]2-T3) until puberty completion (T5).

Setting
Pediatric academic hospital Clinical Translational Research Center.

Participants
Pubertal youth with normal weight (n = 47; 22 female, 25 male) and obesity (n = 37; 23 female, 14 male)

Main Outcome Measures
Si, insulin response (acute insulin response to glucose, AIRg) and disposition index (DI) by intravenous glucose tolerance test at baseline (T2-T3), T4, and T5

Results
Youth with obesity had significantly lower Si and higher AIRg at each time point (P &lt; 0.001), but DI was similar between the groups. There were no group differences in trajectory of Si, AIRg or DI over time. Leptin, insulin-like growth factor-1, and obesity were most strongly associated with Si and AIRg at all time points.

Conclusions
Obesity significantly impacts Si during puberty, even at the earliest stages. However, in general, obese youth have adequate β-cell compensation for the significantly reduced Si of puberty. Future studies are needed to better predict the subset of youth who fail to maintain β-cell compensation during puberty.
High Molecular Diagnosis Rate in Undermasculinized Males with Differences in Sex Development Using a Stepwise Approach
Authors: Jacobson Jill D , Willig Laurel K , Gatti John , Strickland Julie , Egan Anna , Saunders Carol , Farrow Emily , Heckert Leslie L 
Published: February 2020

Abstract
Differences of sex development (DSDs) are a constellation of conditions that result in genital ambiguity or complete sex reversal. Although determining the underlying genetic variants can affect clinical management, fewer than half of undermasculinized males ever receive molecular diagnoses. Next-generation sequencing (NGS) technology has improved diagnostic capabilities in several other diseases, and a few small studies suggest that it may improve molecular diagnostic capabilities in DSDs. However, the overall diagnostic rate that can be achieved with NGS for larger groups of patients with DSDs remains unknown. In this study, we aimed to implement a tiered approach to genetic testing in undermasculinized males seen in an interdisciplinary DSD clinic to increase the molecular diagnosis rate in this group. We determined the diagnosis rate in patients undergoing all clinically available testing. Patients underwent a stepwise approach to testing beginning with a karyotype and progressing through individual gene testing, microarray, panel testing, and then to whole-exome sequencing (WES) if no molecular cause was found. Deletion/duplication studies were also done if deletions were suspected. Sixty undermasculinized male participants were seen in an interdisciplinary DSD clinic from 2008 to 2016. Overall, 37/60 (62%) of patients with Y chromosomes and 46% of those who were 46XY received molecular diagnoses. Of the 46,XY patients who underwent all available genetic testing, 18/28 (64%) achieved molecular diagnoses. This study suggests that the addition of WES testing can result in a higher rate of molecular diagnoses compared to genetic panel testing.
Autonomic History, Examination, and Laboratory Evaluation
Authors: Cheshire William P. 
Published: January 2020

ABSTRACT

PURPOSE OF REVIEW
Autonomic disorders offer a fascinating view of the complexity of the nervous system. Their impact on human health ranges from benign to severe. Deciphering autonomic symptoms and signs draws on the cognitive skills and personal interest in the plight of patients that first attracted many physicians to the field of neurology. This article provides tools to sharpen those skills.

RECENT FINDINGS
Autonomic neuroscience and accumulated clinical knowledge have led to the categorization of autonomic disorders into specific syndromes that can be identified on the basis of clinical phenotypes and physiologic responses to standardized stimuli in the autonomic laboratory. A key development has been the ability to distinguish neurogenic orthostatic hypotension from other causes of hypotension. Quantification of sudomotor responses has proven valuable in the diagnosis of thermoregulatory disorders and small fiber neuropathies such as those related to diabetes mellitus. Increasing attention has focused on autonomic failure as a defining feature of neurodegenerative α-synucleinopathies, especially multiple system atrophy. As awareness of autonomic disorders has increased, the once obscure term dysautonomia has entered into common parlance.

SUMMARY
With appropriate knowledge and experience, neurologists can diagnose autonomic dysfunction accurately and with confidence. The opportunity to play an important role in caring for patients with autonomic disorders is worth the effort.
Synucleinopathies
Authors: Coon Elizabeth A. , Singer Wolfgang 
Published: January 2020

ABSTRACTPURPOSE OF REVIEWThis article reviews the α-synucleinopathies pure autonomic failure, multiple system atrophy, dementia with Lewy bodies, and Parkinson disease with respect to autonomic failure.RECENT FINDINGSThe pattern and severity of autonomic involvement in the synucleinopathies is related to differences in cellular deposition and neuronal populations affected by α-synuclein aggregation, which influences the degree and manifestation of autonomic failure. Clinical and laboratory autonomic features distinguish the different synucleinopathies based on pattern and severity. These features also determine which patients are at risk for evolution from pure autonomic failure to the synucleinopathies with prominent motor involvement, such as multiple system atrophy, dementia with Lewy bodies, or Parkinson disease.SUMMARYAutonomic failure is a key feature of the synucleinopathies, with varying type and degree of dysfunction from predominantly peripheral involvement in the Lewy body disorders to central involvement in multiple system atrophy.
The Mechanics of Seated and Nonseated Cycling at Very-High-Power Output: A Joint-Level Analysis
Authors: WILKINSON ROSS D. , LICHTWARK GLEN A. , CRESSWELL ANDREW G. 
Published: January 2020

ABSTRACT
Cyclists frequently use a nonseated posture when accelerating, climbing steep hills, and sprinting; yet, the biomechanical difference between seated and nonseated cycling remains unclear.

Purpose
This study aimed to test the effects of posture (seated and nonseated) and cadence (70 and 120 rpm) on joint power contributions, effective mechanical advantage, and muscle activations within the leg during very-high-power output cycling.

Methods
Fifteen male participants rode on an instrumented ergometer at 50% of their individualized instantaneous maximal power (10.74 ± 1.99 W·kg−1; above the reported threshold for seated to nonseated transition) in different postures (seated and nonseated) and at different cadences (70 and 120 rpm) while leg muscle activity, full-body motion capture, and crank radial and tangential forces were recorded. A scaled, full-body model was used to solve inverse kinematics and inverse dynamics to determine joint displacements and net joint moments. Statistical comparisons were made using a two-way repeated-measures ANOVA (posture–cadence).

Results
There were significant main effects of posture and cadence on joint power contributions. A key finding was that the nonseated posture increased negative power at the knee, with an associated significant decrease of net power at the knee. The contribution of knee power decreased by 15% at both 70 and 120 rpm (~0.8 W·kg−1) when nonseated compared with seated. Subsequently, hip power and ankle power contributions were significantly higher when nonseated compared with seated at both cadences. In both postures, knee power was 9% lower at 120 rpm compared with 70 rpm (~0.4 W·kg−1).

Conclusion
These results evidenced that the contribution of knee joint power to leg power was reduced by switching from a seated to nonseated posture during very-high-power output cycling; however, the size of the reduction is cadence dependent.
Radiology for medical students (1925–2018): an overview
Authors: Chew Cindy , Cannon Paul , O'Dwyer Patrick J 
Published: January 2020

Objective: Radiology has been espoused as an excellent tool for educating medical students since 1925. Advances in technology and PACS mean it has never been easier to demonstrate living anatomy and clinical pathology in exquisite detail to students. The aim of this study was to provide an overview of radiologic publications related to teaching medical students and its evolution through time. Methods A literature search was performed from inception to November 2018. The search strategies used both text words and relevant indexing related to “radiology”, “medical students” and “curriculum”. Results: 3589 records were identified of which 377 were included. There was a 100 fold increase in rate of publication over time—most were expository or surveys (60%), with few truly experimental articles. Radiology was used in clinical teaching (67%) and anatomy (33%). Almost half of radiologic anatomy teaching was conducted without the input of a Radiologist. Compulsory clinical clerkships/blocks in radiology was offered infrequently (35%). Female first authorship had increased in the last decade (47%). Conclusion: There is a significant increase in articles published on the role of radiology in medical student teaching in the last decade. Research in this area is required in order to investigate the role of radiology in improving the modern medical students’ education.
In vitro human stem cell derived cultures to monitor calcium signaling in neuronal development and function
Authors: Sharma Yojet , Saha Sankhanil , Joseph Annu , Krishnan Harini , Raghu Padinjat 
Published: February 2020

The development of the human brain involves multiple cellular processes including cell division, migration, and dendritic growth. These processes are triggered by developmental cues and lead to interactions of neurons and glial cells to derive the final complex organization of the brain. Developmental cues are transduced into cellular processes through the action of multiple intracellular second messengers including calcium. Calcium signals in cells are shaped by large number of proteins and mutations in several of these have been reported in human patients with brain disorders. However, the manner in which such mutations impact human brain developmentin vivoremains poorly understood. A key limitation in this regard is the need for a model system in which calcium signaling can be studied in neurons of patients with specific brain disorders. Here we describe a protocol to differentiate human neural stem cells into cortical neuronal networks that can be maintained as live cultures up to 120 days in a dish. Our protocol generates a 2Din vitroculture that exhibits molecular features of several layers of the human cerebral cortex. Using fluorescence imaging of intracellular calcium levels, we describe the development of neuronal activity as measured by intracellular calcium transients during developmentin vitro. These transients were dependent on the activity of voltage gated calcium channels and were abolished by blocking sodium channel activity. Using transcriptome analysis, we describe the full molecular composition of such cultures following differentiationin vitrothus offering an insight into the molecular basis of activity. Our approach will facilitate the understanding of calcium signaling defects during cortical neuron development in patients with specific brain disorders and a mechanistic analysis of these defects using genetic manipulations coupled with cell biological and physiological analysis.