bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Status and Associated Factors of Early Childhood Caries among 3- to 5-year-old Children in Guangdong, Southern China: A Provincial Cross-sectional Survey
Authors: Li Jianbo , Fan Weihua , Zhou Yueshan , Wu Linmei , Liu Wei , Huang Shaohong 
Published: June 2020

Abstract
Background: Dental caries of deciduous teeth (Early Childhood Caries, ECC) has become a crucial oral health problem over the decades in China. The aim of this study was to examine the prevalence and severity of ECC among preschool children from Guangdong Province, Southern China. In addition, to assess the association of ECC with reported oral health-related behaviors.Methods: A cross-sectional survey was carried out in Guangdong Province by means of an equal-sized, stratified, multistage random sampling method. According to the standard for clinical dentition examination of the WHO 2013 criteria, the presence of ECC was determined by the dmft (decayed-missing-filled tooth) index using a CPI (Community Periodontal Index) probe. A questionnaire about caries-related factors was completed by each of the participants’ parents or grandparents through a face-to-face and one-on-one interview. Then, t-test, Chi2 tests, One-Way ANOVA served for statistical analysis, and logistic regression analysis as well as covariance analysis were executed to identify potential associated factors for ECC.Results: There were 2592 3- to 5-year-old preschool children. The prevalence (% dmft >0) of ECC was 68.3 (95% CI: 66.5-70.1), the mean dmft was 4.36 (95% CI: 4.17-4.55), and the filled rate was 1.2%. In multivariable modeling, associated factors for both prevalence and mean dmft were older age, rural areas, consumption of sweets before sleep, dental visit history, low household income, and low parental education level. Initiating toothbrushing after 3 years of age and being exclusively/ predominantly breastfed indicated only the prevalence; being female and frequently consuming sweetened milk/powdered milk indicated only the mean dmft.Conclusions: The preschool children in Guangdong Province experienced a significant amount of ECC. More attention should be given to children’s dental health for deciduous teeth. Associated factors for ECC included demographics, oral health measures, dietary factors, and socioeconomic factors.
Use of MicroRNA Expression Profile For The Discrimination of Multiple Primary Lung Cancers From Intrapulmonary Metastasis
Authors: Zhou Xudong , Huang Jian , Xia Jie 
Published: June 2020

Abstract
Background: The increasing number of patients with multifocal lung cancers (MFLCs) complicates tumor, node, and metastasis (TNM) staging and treatment assignments. Clinical guidelines, comprehensive histologic subtyping (CHS) and molecular analyses are available to help distinguish multiple primary lung cancers (MPLCs) from intrapulmonary metastasis (IPM). However, these guidelines and criteria are difficult to apply and often lead to conflicting results. Methods: We enrolled 44 patients with MFLCs, 32 of whom had tumors with the same histology. We assessed their statuses using existing guidelines, which led to integrated results. Twelve patients with lymph-node metastasis (LNM) were selected for comparison. Results: The sum of the differences of five microRNAs (miRNAs) in matched tumors was evaluated by quantitative real-time polymerase chain reaction (RT-qPCR). All 12 patients with LNM showed a sum of differences of < 9 in terms of miRNA expression between primary tumors and LNM. According to the integrated analysis, seven patients were diagnosed with definite MPLCs, which were newly classified as MPLCs according to the miRNA criteria. Four patients with “no definite conclusion” according to the integrated analysis were newly classified by the miRNA criteria. The results between the integrated analysis and the miRNA criteria were contradictory in 7 patients and consistent in 14 patients. Conclusions: A gold standard has yet to be developed for MPLCs. However, currently, an analysis of the miRNA expression profile is a useful way to distinguish MPLCs from intrapulmonary metastasis.
Using the Delphi Technique to Determine Objectives and Topical Outline for a Pharmaceutical Care Course: An Experience from the Cuban Higher Education System
Authors: Martínez-Sánchez Alina M. 
Published: June 2020

Abstract
Background: How implement pharmaceutical care in pharmacy curriculum remains a recurring question at the pharmacy education setting. The purpose was to define course objectives and topic outline for a pharmaceutical care course in a pharmacy curriculum. Methods: A two-round modified Delphi process was used to obtain opinions from assessment experts on the objectives and topic outline for a pharmaceutical care course in a pharmacy curriculum. Pharmacy Professors from Cuban, European, Latin American and North American universities were invited to participate in the study. A number of 15 experts was considered. Issues addressed included: about the theoretical program foundation; recommended for teaching literature; instructional and educational objectives of the programme; teaching methods; knowledge, skills and professional values considered; and students performance assessment. Results: Responses were received from 15 panel experts. The experts made ​​recommendations regarding the relation between the topic and objectives, and referred to the literature, suggesting that texts in the Spanish language should be included in the program. Consensus was achieved for 100% of the proposed items. The final list was composed of 10 objectives for three subjects. The added items included a basic text in Spanish and some papers published in this language were considered as part of the complementary bibliography. The design objectives were updated to ensure that they correspondent to the topics designed for each course. Suggestions related to the relationship between objectives and topics were identified. Conclusion: The process identified a consensus for course objectives and topics for a pharmaceutical care course. The Delphi method can be an effective means for the definition and validation of objectives and topics outline to implement pharmaceutical care in a pharmacy curriculum
15-year Follow-up of Comparing Mastoscopic and Conventional Axillary Dissection in Breast Cancer: A Multicentres, Randomized Controlled Trial
Authors: Luo Chengyu , Cao Guang , Guo wenbin , Yang Jie , Sun Qiuru , Wei Wei , Wu Suhua , Fang Shubing , Zeng Qingliang , Zhao Zhensheng , Meng Fanjie , Huang Xuandong , Zhang Xianlan , Li Ruihua , Ma Xiufeng , Luo Chaoying , Yang Yun 
Published: June 2020

Abstract
Backgroud: Longer follow-up was necessary to testify the exact value of mastoscopic axillary lymph node dissection (MALND).Methods：From January 1, 2003 to December 31, 2005,1027 patients with operable breast cancer were randomly assigned to two groups: MALND and CALND. 996 eligible patients were enrolled. The end points are disease free survival and overall survival.Results：The final cohort of 996 patients was followed for an average of 184 months. The distribution of all events was fairly similar between two groups of patients. The incidence of local in-breast events did not differ in a significant manner between two cohorts. Similarly, the rate of distant metastases was not significantly different with 30.0% in MLND and 32.6% in CALND. And no significant difference was observed in other primary tumor between two groups (p=0.46). Patients who remain alive with no event comprise a total of 37.2% in MALND and 35.4% in CALND. Other primary cancers and deaths from other causes were distributed equally between two groups. The 15-year disease-free survival rates were41.1 percent for the MALND group and 39.6 percent for the CALND group (p=0.79). MALND was found to be not inferior for overall survival (P =0.54). The 15-year overall survival rates were 49.5 percentafter MALND and 51.2 percentafter CALND (p=0.86). Probability of overall survival was not significantly different between two groups.Conclusions：MALND does not increase unfavorable events, and also does not affect the long-term survival of patients. Therefore, MALND should be one of the preferred approaches for breast cancer surgery.
Effect of Sterilized Rumen Fluid Supplementation Ways in Lactation Period on Rumen Microflora of Calves after Weaning
Authors: Lin Xueyan , Zhang Tian , Jiang Yue , Hou Qiuling , Wang Yun , Hu zhiyong , Wang zhonghua 
Published: June 2020

Abstract
Background: The presence of the rumen makes the ruminant special, and the rumen flora has an important influence on the ruminant. The rumen is not fully developed in young ruminants. The purpose of this study was to investigate the effects of supplemental feeding of rumen fluid from high-yielding dairy cows with suckling calves on rumen microflora after weaning. For the experiment, 12 newborn Holstein male calves with the same feeding environment and similar ages were selected. They were randomly divided into 3 groups, with 4 in each group. The three treatments were: addition of sterilized rumen fluid to milk (Group M), addition of sterilized rumen fluid to starter feed (Group S), and a normal fed control group (Group C). The growth performance indices and blood indices were measured, and rumen fluid samples were collected after weaning. Furthermore, 16S rDNA sequencing and LC-MS metabolome detection were performed.Results: Compared with the control group, the growth performance of group S was significantly increased, and the difference between group M and group C was not significant. For the immune indicators in the blood, group M showed a greater difference from group C; the blood-related and energy-related indicators were less different between the two test groups and the control group. For the rumen fluid microbiome and metabolome detection, both groups M and S showed significant differences from group C.Conclusions: The microflora and metabolites were different due to different supplementary feeding methods. Metabolites with differential levels were mainly involved in metabolic pathways such as amino acid metabolism, nucleotide metabolism, and carbohydrate metabolism.
Identification of a metabolism-related gene expression prognostic model in endometrial carcinoma patients
Authors: Jiang Pinping , Sun Wei , Shen Ningmei , Huang Xiaohao , Fu Shilong 
Published: June 2020

Abstract
Background: Metabolic abnormalities have recently been widely studied in various cancer types. This study aims to explore the expression profiles of metabolism-related genes (MRGs) in endometrial cancer (EC). Methods: We analyzed the expression of MRGs using The Cancer Genome Atlas (TCGA) data to screen differentially expressed MRGs (DE-MRGs) significantly correlated to EC patients’ prognosis. Functional pathway enrichment analysis of DE-MRGs were investigated. LASSO algorithm and Cox regression analysis were performed to select MRGs closely related to EC patients’ outcomes. A prognostic signature was developed and the efficacy were validated in part of and the entire TCGA EC cohort. Moreover, we developed a comprehensive nomogram including the risk model and clinical features to predict EC patients' survival probability.Results: Forty-seven differentially expressed MRGs (DE-MRGs) were significantly correlate to EC patients’ prognosis. Functional enrichment analysis showed these MRGs were highly enriched in amino acid, glycolysis, and glycerophospholipid metabolism. Nine MRGs were screened out to closely relate to EC patients’ outcomes, which are CYP4F3, CEL, GPAT3, LYPLA2, HNMT, PHGDH, CKM, UCK2 and ACACB. Based on nine DE-MRGs, we developed a prognostic signature and its efficacy in part of and the entire TCGA EC cohort was validated. The nine-MRGs signature was independent of other clinical features, and could effectively distinguish high- or low-risk EC patients and predicted patients' OS. The nomogram showed excellent consistency between prediction and actual survival observation. Conclusions: The MRG prognostic model and the comprehensive nomogram could guide for precise outcom predicting and rational therapy in clinical practice.
Fidelity Evaluation of the Compared Procedures for Conducting the PREDIAPS Implementation Strategy to Optimize Diabetes Prevention in Primary Care
Authors: Sanchez Alvaro , Rogers Heather Lynn , Pablo Susana , García Esther , Rodríguez Inmaculada , Flores Mª Antonia , Galarza Olga , Gaztañaga Ana B. , Martínez Pedro A. , Alberdi Eider , Resines Elena , Llarena Ana I. , Grandes Gonzalo , Group PREDIAPS 
Published: June 2020

Abstract
Background:Assessing the fidelity of an implementation strategy is important to understand why and how the strategy influences the uptake of evidence-based interventions. The present study aims to assess the fidelity of the two procedures for engaging primary care (PC) professionals and for the deployment of an implementation strategy for optimizing type 2 diabetes prevention in routine PC within the PREDIAPS randomized cluster implementation trial. Method:We conducted an observational descriptive fidelity evaluation study of the PREDIAPS implementation strategy. Nine PC centers from the Basque Health Service (Osakidetza) were allocated to two different procedures to engage physicians and nurses and deploy a implementation strategy to model and adapt the clinical intervention and its implementation to their specific contexts: a Global procedure, promoting the cooperation of all healthcare professionals from the beginning; or a Sequential procedure, centered first on nurses who then pursued the pragmatic cooperation of physicians. Process indicators of the delivery and receipt of implementation strategy actions among centers and groups compared and the comparison of documented modifications to the planned implementation strategy were used to assess the following components of fidelity: adherence, dose, quality of delivery, professionals’ responsiveness and program differentiation. Results:Generally, the procedures compared for professionals engagement and deployment of the implementation strategy were carried out with the planned differentiation. Nonetheless, some unexpected between-group differences were observed,the initial rate of collaboration of nurses being higher in the Sequential (93%) than in the Global (67%) groups. Exposure rate to the programed implementation actions (% of hours received out of those delivered) were similar in both groups by professional category, with nurses (86%) having a higher rate of exposure than physicians (75%). Professionals identified half of the planned discrete strategies and their rating of strategies’perceived usefulness was overwhelmingly positive, with few differences between Sequential and Global centers. DiscussionThe PREDIAPS implementation strategy has been implemented with high fidelity and minor unplanned reactive modifications. Professionals’ exposure to the implementation strategy was high in both groups. The centers’ organizational context (i.e., work overload) led to small mismatches between groups in participation and exposure of professionals to implementation actions.TRIAL REGISTRATIONClinicaltrials.gov identifier: NCT03254979. Registered 16 August 2017, https://www.clinicaltrials.gov/ct2/show/NCT03254979
Fabrication of Polylactic Acid/Paclitaxel Nano Fibers by Electrospinning for Cancer Therapeutics
Authors: Yu C. H. , Chan Vincent , Li Chuan , Hsieh J. H. , Lin P. H. , Tsai Ya-Hui , Chen Yun 
Published: June 2020

Abstract
Background: Polylactic acid (PLA) is a thermoplastic and biodegradable polyester, largely derived from renewable resources such as corn starch, cassava starch and sugarcane. However, PLA is only soluble in a narrow range of solvents such as tetrahydrofuran, dioxane, chlorinated solvents and heated benzene. The limited choices of solvent for PLA dissolution have imposed singificant challenges in the development of specifically engineered PLA nanofibers with electrospinning techniques.Methods: Generally, the electrospun polymeric materials have been rendered with unique properties such as high porosity and complex geometry while maintaining its biodegradability and biocompatibility for emerging biomedical applications. In this study, a new drug delivery system composed of PLA nanofibers with encapsulated paclitaxel was developed by the electrospinning of the respective nanofibers on top of a spin-coated thin film with the same chemical compositions. Our unique approach is meant for promoting strong bonding between PLA-based nanofibers and their respective films in order to improve the prolonged release properties and composite film stability within a fluctuative phyiochemical environment during cell culture.Results: PLA/paclitaxel nanofiber supported on respective polymeric films were probed by scanning electronic microscope, Fourier transform infrared spectrometer and water contact measurement for determining their surface morphologies, fibers’ diameters, molecular vibrational modes, and wettability, respectively. Moreover, PLA/paclitaxel nanofibers supported on respective spin-coated films at different loadings of paclitaxel were evaluated for their abilities in killing human colorectal carcinoma cells (HCT-116). More importantly, MTT assays showed that regardless of the concentrations of paclitaxel, the growth of HCT-116 was effectively inhibited by the prolonged release of paclitaxel from PLA/paclitaxel nanofibers.Conclusions: An effective prolonged delivery system based on PLA nanofiber has demonstrated exciting potentials for emerging applications in cancer therapeutics.
Effectiveness of Securing Central Venous Catheters with Topical Tissue Adhesive in Patients Undergoing Cardiac Surgery: A Randomized Controlled Pilot Study
Authors: Prachanpanich Naruemol , Morakul Sunthiti , Kiatmongkolkul Napanont 
Published: June 2020

Abstract
Background: Central venous catheters (CVCs) play an important role during cardiac surgery. Topical tissue adhesives form a thin film of coating that becomes bound to the keratin in the epidermis. The advantage of this “super glue” lies in its antimicrobacterial activity. This study aimed to evaluate fixation of CVCs with topical tissue adhesive in patients (prone to bleed) undergoing cardiac surgery, regarding its ability to reduce the incidence of pericatheter leakage.Methods: This randomized controlled trial included 150 patients >15 years of age who were (1) scheduled to undergo elective cardiac surgery, (2) required CVC insertion at the internal jugular vein, and (3) were scheduled for transfer postoperatively to the cardiac intensive care unit. We randomly assigned patients to a topical tissue adhesive group (TA) or a standard control group (SC). The primary outcome was a change of dressing immediately postoperatively due to pericatheter blood oozing. Secondary outcomes were the number of dressings, total dressings per catheter-day, and composite outcome of catheter failure within 3 days. Both intention-to-treat and per-protocol analyses were performed. Seven patients violated the protocol (three TA patients, and four SC patients).Results: Regarding the primary outcome, the SC group had a significantly higher incidence of dressing change immediately postoperatively due to pericatheter leakage than the TA group in both the intention-to-treat analysis (5.33% vs 18.67%, RR 0.25 [95%CI 0.08 to 0.79], P = 0.012) and the per-protocol analysis (5.56% vs 16.90%, RR 0.289 [95%CI 0.09 to 0.95], P = 0.031). There were no significant differences between the two groups for the number of dressings, total dressings per catheter-day, or composite outcome of catheter failure within 3 days. Multiple logistic regression analysis was performed to adjust baseline characteristics which were different in the per-protocol analysis. The result showed that the risk ratios of immediate postoperative dressing change in TA patients were 0.25 compared to the SC group ([95%CI 0.07 to 0.87], P = 0.029) in the per-protocol analysis.Conclusion: Use of a topical tissue adhesive can reduce the incidence of immediate postoperative pericatheter blood oozing.Trial registration: TCTR20180608004, retrospectively registered on June 06, 2018. http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=3610
A Multi-Method Exploratory Study of Health Professional Students’ Experiences with Compliance Behaviours
Authors: Violato Efrem , King Sharla , Bulut Okan 
Published: June 2020

Abstract
Research in healthcare, including with students, has begun to document experiences with negative compliance, specifically conformity and obedience. There is a growing body of experimental work however, the majority of literature on negative compliance is anecdotal and theoretical. Currently lacking is a direct measure of the frequency at which health professional students have negative experiences with conformity and obedience integrated with psychological factors, the outcomes of negative compliance, and students’ perceptions. To develop empirical knowledge about the frequency of negative compliance and student perceptions during health professional education a multi-methods survey approach was used. The survey was administered to health professional students across ten disciplines at four institutions. The results indicated students regularly experience obedience and conformity and are influenced by impression management and displacement of responsibility. Moral distress was identified as a consistent negative outcome. Student self-reported experiences aligned with the empirical findings. The findings of the present study demonstrate the pervasiveness of experiences with negative compliance during health professional’s education. The findings have educational and practical implications, as well as pointing to the need for further integration of social and cognitive psychology in explaining compliance in healthcare. The results are likely generalizable to a population level however replication is encouraged to better understand the true frequency of negative compliance at a population level.