bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of immediate and delayed loading protocols on marginal bone loss around implants in unsplinted mandibular implant-retained overdentures: A systematic review and meta-analysis
Authors: Liu Wei , Cai He , Zhang Junjiang , Wang Jian , Sui Lei 
Published: October 2020

Abstract
Background: Immediate loading has recently been introduced into unsplinted mandibular implant-retained overdentures for the management of edentulous patients due to their increasing demand on immediate aesthetics and function. However, there is still a scarcity of meta-analytical evidence on the efficacy of immediate loading compared to delayed loading in unsplinted mandibular implant-retained overdentures. The purpose of this study was to compare the marginal bone loss (MBL) around implants between immediate and delayed loading of unsplinted mandibular implant-retained overdentures.
Methods: Randomized controlled trials (RCTs), controlled clinical trials (CCTs), and cohort studies quantitatively comparing the MBL around implants between immediate loading protocol (ILP) and delayed loading protocol (DLP) of unsplinted mandibular overdentures were included. A systematic search was carried out in PubMed, EMBASE, and CENTRAL databases on April 28, 2020. “Grey” literature was also searched. A meta-analysis was conducted to compare the pooled MBL of two different loading protocols of unsplinted mandibular overdentures through weighted mean differences with 95% confidence intervals. The subgroup analysis was performed between different attachment types ( i.e. Locator attachment vs. ball anchor). The risk of bias within and across studies were assessed using the Cochrane Collaboration’s tool, the Newcastle-Ottawa scale, and Egger's test.
Results: Of 305 records, five RCTs and two cohort studies were included and evaluated, which totally contained 191 participants with a follow-up of no less than 12 months. The MBL of ILP group showed no significant difference with that of DLP group (WMD0.04, CI -0.13 to 0.21, P > .05). Subgroup analysis revealed similar results between the two different loading groups restored with Locator attachments or ball anchors ( P > .05). Apart from one RCT (20%) with a high risk of bias, four RCTs (80%) showed a moderate risk of bias. Two prospective cohort studies were proved with acceptable quality. Furthermore, the Egger's test indicated no significant bias among seven included studies ( P > .05).
Conclusions: For unsplinted mandibular implant-retained overdentures, the MBL around implants after ILP seems comparable to that of implants after DLP. Immediate loading may be a promising alternative to delayed loading for the management of unsplinted mandibular implant-retained overdentures.
Clinical and MRI features of sacral insufficiency fractures after radiotherapy in patients with cervical cancer
Authors: Zhong Xi , Zhang Linqi , Dong Tianfa , Mai Hui , Lu Bingui , Huang Lu , Li Jiansheng 
Published: October 2020

Abstract
Background

To determine the incidence, clinical and MRI features of sacral insufficiency fracture (SIF) after radiotherapy (RT) in patients with cervical cancer.
Methods

Our study included 167 patients with cervical cancer after radiotherapy that underwent pelvic MRI for follow-up. MRIs included pre-enhanced T1-weighted, coronal fat-Suppressed T2-weighted (FS-T2W) and enhanced T1-weighted imaging. The clinical and MRI dates were reviewed. The gold standard of SIF was based on radiologic findings, clinical data and follow-up at least 12 months.
Results

28 patients (10.8%) with 47 sites were diagnosed with SIFs, including 9 patients with unilateral SIF and 19 patients with bilateral SIFs. The median age was 60 years (range 41–72 years), and 89.3% (25/28) of patients were postmenopausal. 64.3% (18/28) of patients were symptomatic, and 53.6% of patients (15/28) had concomitant pelvic fractures. The median interval time from RT to SIFs was 10 months (range 3 − 34 months). For the lesion-wise analysis based on all MR images, all lesions were detected by visualizing bone marrow edema patterns, and fracture lines were detected in 64.6% (31/47) of SIFs. No soft-tissue tumors were founded. For each MRI sequence analysis, coronal FS-T2WI detected the most bone marrow edema pattern and fracture line than T1WI or enhanced T1WI.
Conclusion

SIF is a common complication in cervical cancer after radiotherapy, which has some certain clinical and MRI features. Coronal FS-T2WI may be more useful to detect and characterize these fractures than other imaging sequences.
Exosomal microRNAs in Human Breast Milk: Potential Effect on Neonatal Breast Milk Jaundice
Authors: YANG Lifei , Hu Rui , Li Jing , Mo Xi , Xu Liqing , Shen Nan , Sheng Wangtao , Li Yaxuan 
Published: October 2020

Abstract
Background: The pathogenesis of breast milk jaundice (BMJ) remains unrevealed. While UGT1A1 gene has been extensively investigated in neonatal BMJ cases, the reason for down-regulation of UGT1A1 gene in neonatal BMJ has not been completely elucidated. In this research, the authors attempt to speculate whether there was some gene regulatory substance exist in human milk and result in BMJ, such as miRNA. This research aims to demonstrate the association between the profile of exosomal miRNA in human milk and the occurrence of neonate breast milk jaundice.Methods: A previous study conducted by Shanghai Children’s Medical Center of the Shanghai Jiao Tong University School of Medicine and the UIB International Maternity Care Center regarding 12 mother-infant dyads were recruited from September 2016 to December 2016. The subjects were divided into two groups (BMJ and control) for exosomal miRNA screening. Four methods of transmission electron microscopy (TEM), a nanoparticle tracking analyzer (NTA), flow cytometry (FCM), and Western blotting were used to identify the exosome in human milk. Based on the previous study, this research determines the expression profile of miRNA in human milk exosomes by small RNA sequencing. Based on the biological information analysis, the authors not only screen the differentially expressed miRNA but also predict the target genes. Then, another 20 mother-infant dyads were recruited for realtime PCR assay to verify the difference of predicted microRNAs expression in breast milk exosomes and to explore the correlation between differentially expressed microRNAs in breast milk and neonatal breast milk jaundice. Results: Human milk exosomes are rich in various types of microRNA, especially let-7g-5p, let-7b-5p, has-miR-21-5p, has-miR-375, has-miR-99a-5p, et al. The predicted target genes of miR-127-3p are statistically significantly overexpressed in BMJ group, including the gene of UGT1A1 which expresses key enzyme in process of bilirubin metabolism. Conclusions: Exosomal miRNA-127-3p plays a potential effect on neonatal breast milk jaundice.
A Qualitative Study of Healthcare Experiences Among Chinese Homebound Adults Receiving Home Health Care Services
Authors: Zhou Rui , Cheng Joyce , Wang Shuangshuang , Yao Nengliang (Aaron) 
Published: October 2020

Abstract
Background: Home health care services (HHC) are emerging in China to meet increased healthcare needs among the homebound population, but research examining the efficiency and effectiveness of this new care model is rare. This study aimed to investigate care recipients’ experiences with HHC and areas for improvement in China.Methods: This research was a qualitative study based on semi-structured interviews. Qualitative data were collected from homebound adults living in Jinan, Zhangqiu, and Shanghai, China. A sample of 17 homebound participants aged 45 or older (mean age = 76) who have received home-based clinical care were recruited. Colaizzi’s descriptive phenomenological method was used to generate qualitative codes and identify themes.Results: The evaluations of participants’ experiences with HHC yielded both positive and negative aspects. Positive experiences included: 1) the healthcare delivery method was convenient for homebound older adults; 2) health problems could be detected in a timely manner because doctors visited regularly; 3) home care providers had better bedside manners and technical skills than did hospital-based providers; 4) medical insurance typically covered the cost of home care services. Areas that could potentially be improved included: 1) the scope of HHC services was too limited to meet all the needs of homebound older adults; 2) the visit time was too short; 3) healthcare providers’ technical skills varied greatly.Conclusions: Findings from this study suggested that the HHC model benefited Chinese older adults, primarily homebound adults, in terms of convenience and affordability. There are opportunities to expand the scope of home health care services and improve the quality of care. Policymakers may consider providing more resources and incentives to enhance HHC in China. Educational programs may be created to train more HHC providers and improve their technical skills.Trial registration: Not applicable
β-glucan from Lentinula Edodes Prevents&nbsp;Cognitive Impairments in&nbsp;High-Fat Diet-Induced Obese Mice: Involvement of Colon-Brain Xxis
Authors: Pan Wei , Jiang Pengfei , Zhao Jinxiu , Shi Hongli , Zhang Peng , Yang Xiaoying , Biazik Joanna , Hu Minmin , Hua Hui , Ge Xing , Huang Xufeng , Yu Yinghua 
Published: October 2020

Abstract
Background: Long-term high fat (HF) diet intake can cause neuroinflammation and cognitive decline through the gut-brain axis. (1, 3)/(1, 6)-β-glucan, an edible polysaccharide isolated from medical mushroom, Lentinula edodes (L. edodes), has the potential to remodel gut microbiota. However, the effects of L. edode derived β-glucan against HF diet-induced neuroinflammation and cognitive decline remain unknown. This study aimed to evaluate the neuroprotective effect and mechanism of dietary L edodes β-glucan supplementation against the obesity-associated cognitive decline in mice fed by a HF diet. Methods: C57BL/6J male mice were fed with either a lab chow (LC), HF or HF with L. edodes β-glucan supplementation diets for 7 days (acute) or 15 weeks (chronic). Cognitive behavior was examined; blood, cecum content, colon and brain were collected to evaluate metabolic parameters, endotoxin, gut microbiota, colon, and brain pathology.Results: We reported that acute L. edodes β-glucan supplementation prevented the gut microbial composition shift induced by the HF diet. Chronic L. edodes β-glucan supplementation prevented the HF diet-induced recognition memory impairment assessed by behavioral tests (the temporal order memory, novel object recognition and Y-maze tests). In the prefrontal cortex and hippocampus, the β-glucan supplementation ameliorated the alteration of synaptic ultrastructure, neuroinflammation and brain-derived neurotrophic factor (BDNF) deficits induced by HF diet. Furthermore, the β-glucan supplementation increased the mucosal thickness, upregulated the expression of tight junction protein occludin, decreased the plasma LPS level, and inhibited the proinflammatory macrophage accumulation in the colon of mice fed by HF diet. Conclusions: This study revealed that L. edodes β-glucan prevents cognitive impairments induced by the HF diet, which may occur via colon-brain axis improvement. The finding suggested that dietary L. edodes β-glucan supplementation may be an effective nutritional strategy to prevent obesity-associated cognitive decline.
Impact of Immune Checkpoint Inhibitor Therapy on The Overall Survival in Elderly Patients With Non-Small Cell Lung Cancer
Authors: Inomata Minehiko , Azechi Kenji , Takata Naoki , Hayashi Kana , Tokui Kotaro , Taka Chihiro , Okazawa Seisuke , Kambara Kenta , Imanishi Shingo , Miwa Toshiro , Hayashi Ryuji , Matsui Shoko , Tobe Kazuyuki 
Published: October 2020

Abstract
Purpose: We analyzed the relationship between a history of immune checkpoint inhibitor and overall survival in patients with non-small cell lung cancer (NSCLC) aged ≥ 70 years. Methods: We conducted a retrospective analysis of the data of patients with NSCLC aged ≥70 years old who had received systemic anticancer therapy at our institution between 2015 and 2019. Results: The analysis included the data of a total of 63 patients, including 36 patients who had received immune checkpoint inhibitor therapy and 27 patients who had not received treatment with an immune checkpoint inhibitor. Univariate analysis revealed a longer overall survival in patients who had received treatment with an immune checkpoint inhibitor as compared to those who had not received treatment with an immune checkpoint inhibitor (median: 17.2 vs. 9.8 months; p = 0.026, log-rank test). Multivariate analysis revealed a significant association between a history of treatment with immune checkpoint inhibitors and the overall survival (hazard ratio, 95% confidence interval: 0.42, 0.20-0.86; p = 0.019, Cox proportional hazards model). A significant interaction was also observed between a history of treatment with an immune checkpoint inhibitor and the tumor histology (p = 0.006), the association between the overall survival and a history of immune checkpoint inhibitor therapy being stronger in the non-small cell lung cancer patients with squamous cell carcinoma than in those with adenocarcinoma. Conclusion: A significant association between history of immune checkpoint inhibitor therapy and the overall survival was detected in elderly NSCLC patients aged ≥70 years old in a clinical practice setting. Our results also suggested that the impact of immune checkpoint inhibitor therapy on the survival differed depending on the tumor histology.
Clinical Significance of Systemic Inflammation Response Index and Platelet–lymphocyte Ratio in Patients with Adenocarcinoma of The Esophagogastric Junction and Upper Gastric Cancer
Authors: Yin Xin , Fang Tianyi , Lin Xuan , Cong Xiliang , Wang Yimin , Li Chunfeng , Ma Yan , Xue Yingwei 
Published: October 2020

Abstract
Background: Tumor immunity plays an important role in assessing the tumor progression. The purpose of this study was to investigate the prognostic value of combined systemic inflammation response index (SIRI) and platelet–lymphocyte ratio (PLR) for treatment of gastroesophageal junction cancer (AEG) and upper gastric cancer (UGC).Methods: In this study, patients from 2003 to 2014 were divided into training and validation sets. The prognostic accuracy of each variable was compared using time-independent ROC analysis. The scoring system was calculated by cut-off values of SIRI and PLR in 5-year. Kaplan-Meier and Log-rank tests were used to analyze overall survival (OS). Chi-square test was used to analyze the association between clinical characteristics and the scoring system. Univariate and multivariate analyses based on the competitive risk regression model were used to analyze independent predictors of death due to AGC and UGC. R software was used to construct the Nomogram model of risk assessment.Results: Patients with SIRI–PLR=2 had worse survival time than those with 0 and 1 (P<0.001) and more suitable for postoperative adjuvant chemotherapy (P=0.002). High PLR patients were more suitable for proximal gastrectomy (P=0.049). SIRI and PLR were independent predictors in training set (P=0.036, P=0.045), which could be combined with age and pTNM to construct Nomogram for predicting OS. Conclusions: Preoperative SIRI–PLR score was an independent predictor for patients with AEG and UGC. The Nomogram model constructed by age, SIRI, PLR and pTNM can correctly predict the prognosis of patients.
High Fidelity Simulation Is Associated With Good Discriminability In Emergency Medicine Residents’ In-Training Examinations
Authors: Chen Shou-Yen , Chaou Chung-Hsien , Yu Shiuan-Ruey , Chang Yu-Che , Ng Chip-Jin , Liu Pin 
Published: October 2020

Abstract
BackgroundIn-training examinations (ITEs), arranged during residency training, evaluate the residents' performances periodically. The ITE usually consists of written and oral forms. There is limited literature focusing on the effectiveness of emergency medicine (EM) resident ITEs in the format of simulation-based examinations, as compared to traditional oral or written tests. Our primary objective is to compare high fidelity simulation with written and oral tests in the evaluation of the residents with different seniority in EM training programs. MethodsDuring the 5-year study period, 8 ITEs were administered to 68 EM residents, and 253 ITE scores were collected. Different ITE scores were calculated and presented as mean and standard deviation. Discrimination of ITE scores between different training years of residency was examined using one-way ANOVA test. ResultsThe high fidelity simulation scores correlated to the EM training year, and residents in their fourth training year (R4) had the highest scores consistently, followed by R3, R2, and then R1. The oral test scores had similar results but not as consistent as the high fidelity simulation tests. The written test scores distribution failed to discriminate the residents' seniority. The high fidelity simulation test had the best discriminative ability and better correlation between different EM residency training years comparing to oral or written forms.ConclusionsHigh fidelity simulation tests had a good discriminative ability and were well correlated to the EM training year. We suggest high-fidelity simulation should be a part of ITE of EM training programs and maybe adopted in EM board certification examination in the future.
Clinical study on decreasing occurance of Alzheimer's Disease through intervention on amnestic Mild Cognitive Impairment with Di-Huang-Yi-Zhi formula in Shigatse, Tibet
Authors: Zhang Liming , Shen Ting , An Hongmei , Yuan Canxing , Yan Jianwen , Gu Chao 
Published: October 2020

Abstract
Background

Mild cognitive impairment (MCI) is generally considered a transitional stage between normal aging and AD dementia. This study aimed to analyze the efficacy of Di-Huang-Yi-Zhi (DHYZ) formula in treating amnestic Mild Cognitive Impairment (aMCI) for the patients in high altitude area (Qinghai Tibet Plateau).
Method:

A total of 106 patients in Shigatse, Tibet were randomly allocated into two groups. One group were to receive DHYZ decoction (150 ml each time, twice a day), the other group were to have aniracetam capsule (200 mg each time, three times a day) ,with 53 patients in each group. Changes in neuropsychological scales including mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), the Barthel Index for activities of daily living (ADL) and TCM symptoms were detected during a 12-month treatment period. After one year follow-up, the conversion rate of AD was observed.
Result

There was no significant difference between the two groups in baseline characteristics and scale scores (P > 0.05). Compared with the aniracetam group, the DHYZ group showed statistically higher MMSE and MoCA score and lower TCM score at the 9-month and 12-month. In addition, the ADAS-Cog and ADL scores in DHYZ group at 12-month were lower than that in the aniracetam control group. After one year follow-up, the conversion rate of AD in DHYZ group was 10% (5/50), and aniracetam group was 15.69% (8/51). The conversion rate of AD in DHYZ group was significantly lower than that in aniracetam group.
Conclusion

DHYZ formula can improve the cognition behavior and global function of patients with aMCI, it can also delay the conversion to AD. This is represents a new treatment option for the patients.
Metabonomic Study on the Plasma of High-Fat Diet-Induced Dyslipidemia Rats Treated With Ge Gen Qin Lian Decoction By Ultra High Performance Liquid Chromatography–Mass Spectrometry
Authors: Xu Ziwei , Sheng Yixuan , Zeng Guowei , Zeng Zhijun , Li Bingtao , Jiang Li , Xu Guoliang , Zhang Qiyun 
Published: October 2020

Abstract
Background: Gegen Qinlian decoction(GGQLD) has a definite effect on T2DM in clinic, and it has the effect of lowering blood sugar, improving insulin resistance, and improve the blood lipid level of rats with dyslipidemia, but the intervention mechanism of GGQLD on dyslipidemia has not been clarified. Methods: Based on ultra high performance liquid chromatography coupled with quadrupole-time-of-flight tandem mass spectrometry (UHPLC-Q-TOF-MS), the metabolic profiles of rat serum samples were collected. The rat model of dyslipidemia was induced by 60% fat-fed high-fat diet. After feeding the rats with high-fat diet for 4 weeks, the dyslipidemia appeared. After 5 weeks of GGQLD(14.85g•kg-1) administration, the metabonomics of rats plasma samples in normal group, model group and administration group were analyzed. Mass profiler professional (MPP), SIMCA-P 14.1 and Graphpad prism 6.0 software were used combined with METLIN biological database and human metabolite database HMDB to screen and identify endogenous biomarkers. Metaboanalyst 4.0 software was used by combining with HMDB and KEGG databases, the enrichment and metabolic pathway of biomarkers were analyzed to explore the metabolic mechanism of dyslipidemia rats induced by high-fat diet and the intervention mechanism of Gegen Qinlian decoction.Results: After 5 weeks of administration of GGQLD, the levels of serum TC and TG were significantly decreased (P < 0.05, P < 0.01), while HDL-C and LDL-C were not significantly affected. After administration, the food intake of rats in administration group decreased gradually, and the change trend of body weight gradually slowed down. The metabonomics of rat plasma samples results showed that 23 potential biomarkers including α - linolenic acid, arachidonic acid and lysophosphatidylcholine were significantly changed in positive ion mode.Conclusion: Studies have shown that GGQLD has significant lipid-lowering effect on dyslipidemia rats induced by high-fat diet, and its preventive mechanism is related to tryptophan metabolism, fatty acid biosynthesis, α - linolenic acid metabolism, arachidonic acid, glycerophosphatidyl metabolism pathway.