bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions and practices of general practitioners on providing oral health care to people with diabetes - A qualitative study
Authors: Poudel Prakash , Griffiths Rhonda , Wong Vincent W , Flack Jeff R , Arora Amit , Khoo Chee L , George Ajesh 
Published: December 2019

Abstract
Background Poorly controlled diabetes leads to multiple complications including oral health problems. General practitioners (GPs) are at the forefront of management of chronic diseases in primary health care. Diabetes guidelines encourage a proactive role for GPs in oral health complications management in people with diabetes, yet little is known about this area of care. This study aimed to explore current practices, perceptions and barriers of GPs towards oral health care for people with diabetes.Methods We employed a qualitative research method utilising telephone interviews. Purposive/snowball sampling was used to recruit 12 GPs from Greater Sydney region. A thematic analysis involving an inductive approach was used to identify and analyse contextual patterns and themes.Results A majority of participants were males (n=10), working in group practices (n=11) with a mean±SD age of 55±11.4 years and 25±13.6 years work experience. Three major themes emerged: oral health care practices in general practice settings; barriers and enablers to oral health care; and role of diabetes care providers in promoting oral health. Most GPs acknowledged the importance of oral health care for people with diabetes, identifying their compromised immune capacity and greater risks of infections as risk factors. GPs reported 20-30% of their patients having oral health problems, however their current oral health care practices relating to education, risk assessment and referrals were reported as very limited. GPs identified several barriers including time constraints, absence of referral pathways, and limited knowledge and training in promoting oral health care. They also reported patient barriers including oral health care costs and lower oral health awareness. GPs perceived that resources such as education/training, a standardised assessment tool and patient education materials could support them in promoting oral health care. GPs also perceived that other diabetes care providers such as diabetes educators could play an important role in promoting oral health.Conclusions Despite current recommendations, GPs' current oral health care practices among people with diabetes are limited. Further strategies including capacity building GPs by developing appropriate oral health training programs and simple risk assessment tools along with accessible referral pathways are needed to address the current barriers.
Diagnostic and Predictive Value of Speckle Tracking Echocardiography in Cardiac Sarcoidosis
Authors: Stefano Cristina Di , Bruno Giulia , Calle Maria Arciniegas , Acharya Gayatri A. , Fussner Lynn M. , Ungprasert Patompong , Cooper Leslie T. , Blauwet Lori A. , Ryu Jay H. , Pellikka Patricia A. , Porquera Eva Carmona , Villarraga Hector R. 
Published: December 2019

Abstract
Background: Sarcoidosis is a systemic granulomatous disease that may affect the myocardium. This study evaluated the diagnostic and prognostic value of 2-dimensional speckle tracking echocardiography in cardiac sarcoidosis (CS).

Methods: Eighty-three patients with extracardiac, biopsy-proven sarcoidosis and definite/probable diagnosis of cardiac involvement diagnosed from January 2005 through December 2016 were included. Strain parameters in early stages of CS, in a subgroup of 23 CS patients with left ventricular ejection fraction (LVEF) within normal limits (LVEF>52% for men: >54% for women, mean value: 57.3%±3.8%) and no wall motion abnormalities was compared with 97 controls (1:4) without cardiac disease. LV and right ventricular (RV) global longitudinal (GLS), circumferential (GCS), and radial (GRS) strain and strain rate (SR) analyses were performed with TomTec software and correlated with cardiac outcomes (including heart failure and arrhythmias). This study was approved by the Mayo Clinic Institutional Review Board, and all patients gave informed written consent to participate.

Results: Mean age of CS patients was 53.6±10.8 years, and 34.9% were women. Mean LVEF was 43.2%±12.4%; LV GLS, -12.4%±3.7%; LV GCS, -17.1%±6.5%; LV GRS, 29.3%±12.8%; and RV wall GLS, 14.6%±6.3%. In the 23 patients with early stage CS with normal LVEF and RV systolic function, strain parameters were significantly reduced when compared with controls (respectively: LV GLS, -15.9%±2.5% vs -18.2%±2.7% [ P =.001]; RV GLS, -16.9%±4.5% vs -24.1%±4.0% [ P <.001]). A LV GLS value of -16.3% provided 82.2% sensitivity and 81.2% specificity for the diagnosis of CS (AUC 0.91), while a RV value of -19.9% provided 88.1% sensitivity and 86.7% specificity (AUC 0.93). Hospital admission and heart failure significantly correlated to impaired LV GLS (> -14%).

Conclusion: Reduced strain values in the LV GLS and RV GLS can be used in the diagnostic algorithm in patients with suspicion of cardiac sarcoidosis. These values also correlate with adverse cardiovascular events.
Layer-specific speckle tracking analysis of left ventricular systolic function and synchrony in maintenance hemodialysis patients
Authors: Liu Chang , Yan Zining , Fan Li , Huang Jun , Shen Dan , Song Xiangting 
Published: December 2019

Abstract
Background: This study investigated the value of layer-specific strain analysis by twodimensional speckle tracking echocardiography (2D-STE) for evaluating left ventricular (LV) systolic function and synchrony in maintenance hemodialysis (MHD) patients. Methods: A total of 34 MHD patients and 35 healthy controls were enrolled in this study. Dynamic images were collected at the LV apical long-axis, the four- and twochamber, and the LV short-axis views at the basal, middle, apical segments. The layerspecific speckle tracking (LST) was used to analyze the longitudinal strain (LS) and circumferential strain (CS) of LV sub-endocardium, mid-myocardium, subepicardium, global longitudinal strain (GLS), global circumferential strain (GCS), the LV 17 segment time to peak LS (TTP), the peak strain dispersion (PSD). The differences in these parameters were compared between control and MHD, and the correlation between PSD and each LS parameter was examined. The receiver operator characteristic curve was used to evaluate the efficacy of three myocardial layer LS and CS in the assessment of LV systolic dysfunction in MHD. Results: MHD had comparable left ventricular ejection fraction (LVEF), but significantly smaller GLS, GCS, and three-layer LS and CS compared to the control. The three layer LS of the basal segment, middle segment, and apex segment was significantly reduced in the MHD compared to the normal, while the three myocardial layer CS of the basal segment, middle segment, and apex segment was significantly reduced in the MHD compared to the normal, except for the sub-endocardium of middle and apex segment. MHD had significantly higher TTP of LV 17 segments and PSD compared to controls, and had delayed peak time in most segments. In addition, PSD of MHD was positively correlated with subendocardial and mid-myocardial LS and GLS, but not with subepicardial LS. The area under the curves (AUCs) of sub-endocardial, midmyocardial, and sub-epicardial LS in MHD were 0.894, 0.852, and 0.870, respectively; the AUCs of sub-epicardial, midmyocardial, and sub-endocardial CS were 0.852, 0.837, and 0.669, respectively. Conclusion: LST may detect the early changes of all three-layer LS and CS and PSD in MHD, and is a valuable tool to diagnose LV systolic dysfunction in MHD.
IL-1-conferred gene expression pattern in ERα+ BCa and AR+ PCa cells is intrinsic to ERα- BCa and AR- PCa cells and promotes cell survival
Authors: Nawas Afshan F. , Kanchwala Mohammed , Thomas-Jardin Shayna E. , Dahl Haley , Daescu Kelly , Bautista Monica , Anunobi Vanessa , Wong Ally , Meade Rachel Katherine , Mistry Ragini , Ghatwai Nisha , Bayerl Felix , Xing Chao , Delk Nikki 
Published: December 2019

Abstract
Background Breast (BCa) and prostate (PCa) cancers are hormone receptor (HR)-driven cancers. Thus, BCa and PCa patients are given therapies that reduce hormone levels or directly blocks HR activity; but most patients eventually develop treatment resistance. We have previously reported that interleukin-1 (IL-1) inflammatory cytokine downregulates ERα and AR mRNA in HR-positive (HR+) BCa and PCa cell lines, yet the cells can remain viable. Additionally, we identified pro-survival proteins and processes upregulated by IL-1 in HR+ BCa and PCa cells, that are basally high in HR- BCa and PCa cells. Therefore, we hypothesize that IL-1 confers a conserved gene expression pattern in HR+ BCa and PCa cells that mimics conserved basal gene expression patterns in HR- BCa and PCa cells to promote HR-independent survival and tumorigenicity.Methods We performed RNA sequencing (RNA-seq) for HR+ BCa and PCa cell lines exposed to IL-1 and for untreated HR- BCa and PCa cell lines. We confirmed expression patterns of select genes by RT-qPCR and used siRNA and/or drug inhibition to silence select genes in HR- BCa cell lines. Finally, we performed Ingenuity Pathway Analysis (IPA) and used the gene ontology web-based tool, GOrilla, to identify signaling pathways encoded by our RNA-seq data set.Results We identified 350 genes in common between BCa and PCa cells that are induced or repressed by IL-1 in HR+ cells that are, respectively, basally high or low in HR- cells. Among these genes, we identified Sequestome-1 (SQSTM1/p62) and SRY (Sex-Determining Region Y)-Box 9 (SOX9 ) to be essential for survival of HR- BCa and PCa cell lines. Analysis of publicly available data indicates that p62 and SOX9 expression are elevated in HR-independent BCa and PCa sublines generated in vitro, suggesting that p62 and SOX9 have a role in acquired hormone receptor independence and treatment resistance. We also assessed HR- cell line viability in response to the p62-targeting drug, verteporfin, and found that verteporfin is cytotoxic for HR- cell lines. Conclusions Our 350 gene set can be used to identify novel therapeutic targets and/or biomarkers conserved among acquired (e.g. due to inflammation) or intrinsic HR-independent BCa and PCa.
Bioinformatic Analysis of Peripheral Blood miRNA of Breast Cancer Patients in Relation With Anthracycline Cardiotoxicity
Authors: Yadi Wang , Shurui Chen , Tong Zhang , Suxian Chen , Qing Tong , Dongning He 
Published: December 2019

Abstract
The current diagnostic methods and treatments still fail to lower the incidence of anthracycline-induced cardiotoxicity effectively. In this study, we aimed to (1) analyze the cardiotoxicity-related genes after breast cancer chemotherapy in gene expression database and (2) carry out bioinformatic analysis to identify cardiotoxicity-related abnormal expressions, the biomarkers of such abnormal expressions, and the key regulatory pathways after breast cancer chemotherapy. Cardiotoxicity-related gene expression data (GSE40447) after breast cancer chemotherapy was acquired from the GEO database. The biomarker expression data of women with chemotherapy-induced cardiotoxicity (group A), chemotherapy history but no cardiotoxicity (group B), and confirmatory diagnosis of breast cancer but normal ejection fraction before chemotherapy (group C) were analyzed to obtain the mRNA with differential expressions and predict the miRNAs regulating the differential expressions. The miRanda formula and functional enrichment analysis were used to screen abnormal miRNAs. Then, the gene ontology (GO) analysis was adapted to further screen the miRNAs related to cardiotoxicity after breast cancer chemotherapy. The data of differential analysis of biomarker expression of groups A, B, and C using the GSE40447-related gene expression profile database showed that there were 30 intersection genes. The differentially expressed mRNAs were predicted using the miRanda and TargetScan software, and a total of 2978 miRNAs were obtained by taking the intersections. Further, the GO analysis and targeted regulatory relationship between miRNA and target genes were used to establish miRNA-gene interaction network to screen and obtain 7 cardiotoxicity-related miRNAs with relatively high centrality, including hsa-miR-4638-3p, hsa-miR-5096, hsa-miR-4763-5p, hsa-miR-1273g-3p, hsa-miR6192, hsa-miR-4726-5p and hsa-miR-1273a. Among them, hsa-miR-4638-3p and hsa-miR-1273g-3p had the highest centrality. The PCR verification results were consistent with those of the chip data. There are differentially expressed miRNAs in the peripheral blood of breast cancer patients with anthracycline cardiotoxicity. Among them, hsa-miR-4638-3p and hsa-miR-1273g-3p are closely associated with the onset of anthracycline cardiotoxicity in patients with breast cancer. Mining, integrating, and validating effective information resources of biological gene chips can provide a new direction for further studies on the molecular mechanism of anthracycline cardiotoxicity.
Clinical study of Endoscopic treatment of a sellar pituitary adenomas with sellar diaphragm defect
Authors: Jin Zhuoru , Wu Xinyu , Wang Yibao 
Published: December 2019

Abstract
Purpose: Invasive growth of pituitary macroadenomas to the suprasellar region occurs commonly. Pituitary adenomas show varying growth patterns when the sellar diaphragm is absent, and they are often confused with other common tumors in the sellar region. This article explores the clinical features of suprasellar pituitary adenomas with defects of the sellar diaphragm (SPADSD) and evaluates the efficacy of the endoscopic endonasal approach (EEA) for treatment of such tumors. Methods: We performed a detailed examination of records from 19 patients collected prior to surgery. After relevant diseases were excluded, the tumor properties were evaluated according to imaging characteristics. Diagnoses were verified using EEA surgery. The concept of SPADSD was put forward. Postoperative recovery was followed to determine whether EEA is suitable for the treatment of such tumors. Results: In the 19 patients with SPADSD, we found that the tumors were less stressed on the pituitary, and tumors in the suprasellar region often had irregular shapes. During surgery, we took extended supra-saddle approaches and confirmed that unrestricted growth of the tumor was caused by defects in the diaphragm of the sella turcica to the suprasellar region. Recovery was good after surgery, confirming the efficacy of EEA for treatment of these tumors. Conclusion: SPADSD has different clinical features from those of other pituitary tumors and requires careful screening prior to surgery. Endoscopic surgery is the preferred procedure for this type of tumor.
Effect Of Maternal Growth Monitoring Knowledge On Stunting, Wasting And Underweight Among Children 0-18 Months In Tamale Metropolis Of Ghana
Authors: Bukari Mohammed , Abubakari Muzamil Mohammed , Majeed Mohammed , Abizari Abdul-Razak , Wemakor Anthony , Atosona Ambrose 
Published: December 2019

Abstract
This study sought to assess maternal growth monitoring knowledge and its effect on stunting, wasting and underweight among children 0-18 months in the Tamale Metropolis. An analytical cross-sectional study design, involving 340 mother-child pairs randomly selected from 4 health facilities in the Tamale Metropolis, was used. A structured questionnaire was used to collect information on socio-demographic characteristics and maternal growth monitoring knowledge. Weight and length of children were taken to assess nutritional status (stunting, underweight and wasting). Chi-square/Fisher’s exact test was used to determine the association between maternal growth monitoring knowledge level and child nutritional status.This study sought to assess maternal growth monitoring knowledge and its effect on stunting, wasting and underweight among children 0-18 months in the Tamale Metropolis. An analytical cross-sectional study design, involving 340 mother-child pairs randomly selected from 4 health facilities in the Tamale Metropolis, was used. A structured questionnaire was used to collect information on socio-demographic characteristics and maternal growth monitoring knowledge. Weight and length of children were taken to assess nutritional status (stunting, underweight and wasting). Chi-square/Fisher’s exact test was used to determine the association between maternal growth monitoring knowledge level and child nutritional status.
Suppression of behavioral activity and hippocampal noradrenaline caused by surgical stress in type 2 diabetes model mice
Authors: Nishimura Momoka , Nomura Yuki , Egi Moritoki , Obata Norihiko , Tsunoda Makoto , Mizobuchi Satoshi 
Published: December 2019

Abstract
Background: There has been much discussion recently about the occurrence of neuropsychological complications during the perioperative period. Diabetes is known to be one of the metabolic risk factors. Although the number of patients with diabetes mellitus (DM) has been increasing, the pathophysiology of postoperative neuropsychological dysfunction in DM patients is still unclear. Recently, a deficiency of neurotransmitters, such as monoamines, was reported to be associated with mental disorders. Therefore, we investigated the effects of surgical stress on behavioral activity and hippocampal noradrenaline (NA) level in type 2 diabetes mellitus model (T2DM) mice.
Methods: Eighty-four 6-week-old male C57BL/6J mice were divided into four groups (non-diabetes, non-diabetes with surgery, T2DM, and T2DM with surgery groups). T2DM mice were established by feeding a high-fat diet (HFD) for 8 weeks. At 14 weeks of age, fifteen mice in each group underwent a series of behavioral tests including an open field (OF) test, a novel object recognition (NOR) test and a light-dark (LD) test. In the surgery groups, open abdominal surgery with manipulation of the intestine was performed 24 hours before the behavioral tests as a surgical stress. Hippocampal noradrenaline (NA) concentration was examined in six mice in each group by high-performance liquid chromatography. The data were analyzed by the Mann-Whitney U test, and p values less than 0.05 were considered significant.
Results: The T2DM group showed significantly increased explorative activity in the NOR test (P = 0.0016) and significantly increased frequency of transition in the LD test (P = 0.043) compared with those in the non-diabetic group before surgery. In T2DM mice, surgical stress resulted in decreased total distance in the OF test, decreased explorative activity in the NOR test, and decreased frequency of transition in the LD test (OF: P = 0.015, NOR: P = 0.009, LD: P = 0.007) and decreased hippocampal NA (P = 0.015), but such differences were not observed in the non-diabetic mice.
Conclusions: Mice with T2DM induced by feeding an HFD showed increased behavioral activities, and surgical stress in T2DM mice caused postoperative hypoactivity and reduction of the hippocampal NA level.
Prediction of pre-eclampsia in nulliparous women using routinely collected maternal characteristics: A model development and validation study
Authors: Al-Rubaie Ziad TA , Hudson H Malcolm , Jenkins Gregory , Mahmoud Imad , Ray Joel G , Askie Lisa M , Lord Sarah J 
Published: December 2019

Abstract
Background Guidelines recommend identifying in early pregnancy women at elevated risk of pre-eclampsia. The aim of this study was to develop and validate a pre-eclampsia risk prediction model for nulliparous women attending routine antenatal care “the Western Sydney (WS) model”; and to compare its performance with the National Institute of Health and Care Excellence (NICE) risk factor-list approach for classifying women as high-risk. Methods This retrospective cohort study included all nulliparous women who gave birth in three public hospitals in the Western-Sydney-Local-Health-District, Australia 2011-2014. Using births from 2011-2012, multivariable logistic regression incorporated established maternal risk factors to develop and internally validate the WS model. The WS model was then externally validated using births from 2013-2014, assessing its discrimination and calibration. We fitted the final WS model for all births from 2011-2014, and compared its accuracy in predicting pre-eclampsia with the NICE approach. Results Among 12,395 births to nulliparous women in 2011-2014, there were 293 (2.4%) pre-eclampsia events. The WS model included: maternal age, body mass index, ethnicity, multiple pregnancy, family history of pre-eclampsia, autoimmune disease, chronic hypertension and chronic renal disease. In the validation sample (6201 births), the model c-statistic was 0.70 (95% confidence interval 0.65–0.75). The observed:expected ratio for pre-eclampsia was 0.91, with a Hosmer-Lemeshow goodness-of-fit test p-value of 0.20. In the entire study sample of 12,395 births, 374 (3.0%) women had a WS model-estimated pre-eclampsia risk ≥8%, the pre-specified risk-threshold for considering aspirin prophylaxis. Of these, 54 (14.4%) developed pre-eclampsia (sensitivity 18% (14–23), specificity 97% (97–98)). Using the NICE approach, 1173 (9.5%) women were classified as high-risk, of which 107 (9.1%) developed pre-eclampsia (sensitivity 37% (31-42), specificity 91% (91–92)). The final model showed similar accuracy to the NICE approach when using lower risk-threshold of ≥4% to classify women as high-risk for pre-eclampsia. Conclusion The WS risk model that combines readily-available maternal characteristics achieved modest performance for prediction of pre-eclampsia in nulliparous women. The model did not outperform the NICE approach, but has the advantage of providing individualised absolute risk estimates, to assist with counselling, inform decisions for further testing, and consideration of aspirin prophylaxis.