bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are parents’ education levels associated with either their oral health knowledge or the children’s oral health behaviors? a survey of 8446 families in Wuhan
Authors: Chen Liangwen , Hong Jialan , Xiong Dian , Zhang Luyi , Li Yuhong , Huang Shengfu , Hua Fang 
Published: April 2020

Abstract
Background: Children aged 6-7 years are in the early mixed dentition, which is a period of high prevalence of dental caries and other dental diseases and a critical period for the formation of oral health behaviors. Therefore, good oral hygiene habits of children and oral health knowledge of parents are very important. This study sought to explore the relationship between children’s oral health behaviors, parental oral health knowledge, parental choices of pit and fissure sealants, and parents’ education levels based on a large-scale sample size for the first time, and to compare the influences of parental education levels between parents. Methods: Families of the first and second graders of primary schools in Wuhan Hongshan District were included in this study. A total of 8446 questionnaires were collected to obtain comprehensive information on children’s oral health behaviors, parents’ oral health knowledge and parents’ pit and fissure sealants-related choices. The relationship between these outcome variables and parents’ education levels were studied using logistic regression analysis and chi-square test. Results: Parents who reported good educational background had more favorable oral health knowledge than those of other parents, and their children had better oral hygiene behaviors. Four indicators of five measures to children’s oral health behaviors were significantly associated with mother’s education level (P< 0.05), and three of them were related to father’s education level (P≤ 0.01). Moreover, seven indicators of eight measures to parents’ oral health knowledge were significantly related to mother’s education level (P< 0.05) and four of them were affected by the father’s (P< 0.05) . In addition, parents with higher educational attainments paid more attention to the completeness of medical facilities , the environment of dental practice, the distance to treatment sites, and took less concern of children’s willingness when choosing the pit and fissure sealants sites. Conclusions: In families with children at the early mixed dentition stage, parents with higher education levels tend to have better oral health knowledge and more oral health care needs, such as pit and fissure sealants. In addition, children of parents who have better educated parents tend to perform better oral hygiene practices.
Effect of high-intensity interval training in young heart transplant recipients: results from two randomized controlled trials
Authors: Nytrøen Kari , Rolid Katrine , Yardley Marianne , Gullestad Lars 
Published: April 2020

Abstract
Background Little is known about the effect of exercise in young heart transplant recipients, and results on group level is lacking. This study summarizes the findings of the youngest participants in two previous randomized controlled trials. Method This is a hypothesis-generating study reporting the main results from the youngest participants in two larger randomized controlled trials investigating the effect of high-intensity interval training (HIT). The article summarizes the main results from 28 young participants (< 40 year of age) who have participated in two previous studies which evaluated the effect of HIT vs. controls in adult heart transplant recipients. One of the studies included de novo heart transplant recipients and the other included maintenance heart transplant recipients. All study tests were performed in-hospital, in the specialist health care setting, but the exercise intervention was carried out locally, in cooperation with the primary health care. In both studies the exercise intervention lasted for 9-12 months. In one study, HIT (85%-95% of peak effort) was compared to controls (no specific intervention), and in the other study HIT was compared to moderate, continuous exercise (MICT , 60-70% of peak effort). The main outcome measure was peak oxygen uptake (VO 2peak ) and a secondary endpoint was muscle strength. Results The summarized findings from the youngest heart transplant recipients in these two studies demonstrated mainly that the improvement in peak oxygen uptake among the younger recipients (< 40 years) was much larger (4.7 vs. 1.2 ml/kg/min and 7.0 vs. 2.2 ml/kg/min) compared to the improvement among the older recipients (≥ 40 years), and in accordance with results from adult heart transplant populations: HIT, compared to MICT, induced the largest improvement in peak oxygen consumption, also in the younger heart transplant recipients. Conclusions These results suggest that young heart transplant recipients have a greater effect of HIT than of MICT and may also suggest that younger recipients benefit more from high-intensity interval training than their older co-patients. However, larger randomized studies focusing on the young heart transplant population is strongly needed to confirm this hypothesis.
Reinvestigation of the origins of pineal meningiomas based on its related veins and arachnoid membranes
Authors: Yu Lei , Orazmyradov Berdimyrat , Qi Songtao , Song Ye , Fang Luxiong 
Published: April 2020

Abstract
Background : A series of patients harboring pineal region meningiomas were respectively analyzed to explore the origin of these tumors and the true meaning of the term "velum interpositum (VI) meningiomas". Methods: 21 patients with pineal meningiomas underwent operation in Nanfang Hospital of Southern Medical University from January 2005 to December 2016 were retrospectively included to analyze the clinical features, imaging findings and surgical video data of these patients. According to the method of literature, the data of this group were also divided into falcotentorial (FT) meningiomas and VI meningiomas, and the differences between the two types of tumors were compared. Results: Among the 21 cases of tumor, there were 12 cases of FT meningiomas, including 4 cases originating from cerebral falx, 4 cases from tentorium of cerebellum and 4 cases from straight sinus; there were 9 cases of VI meningiomas, 7 of which originated from the arachnoid sleeve of the Galen vein, 1 from the posterior part of the internal cerebral vein and 1 from the posterior surface of the pineal gland. Postoperative pathological examination showed meningiomas in all the 21 patients, including 16 cases of total resection and 5 cases of subtotal resection. Postoperatively limitation of binocular vertical motion was found in 3 cases, homotropic hemianopia in 7 cases, hemiplegia in 1 case and death in 1 case. Conclusions : This study suggests that pineal meningiomas are more suitable to be described by FT meningioma and meningiomas of the arachnoid of the pineal region by analyzing the origin of tumors. The term "VI meningiomas" can only reflect a part of meningiomas of the arachnoid of the pineal region. Before the removal of pineal meningiomas, more attention should be paid to the effects of the two types of tumors on the Galen vein and the straight sinus, and the establishment of venous collateral circulation.
Clinical Implications of Pachyvessels in Polypoidal Choroidal Vasculopathy
Authors: Ijuin Nobuo , Tsujinaka Hiroki , Hirai Hiromasa , Jimura Hironobu , Nakao Shigeya , Yamashita Mariko , Nishi Tomo , Ueda Tetsuo , Ogata Nahoko 
Published: April 2020

Abstract
Purpose: Polypoidal choroidal vasculopathy (PCV) is one of the disorders within the pachychoroid spectrum diseases. The presence of pachyvessels is one of the characteristics of pachychoroid disorders. However, the relationship between the presence of pachyvessels and the clinical characteristics of PCV eyes has not been determined. The purpose of this study was to determine the relationship between the presence of choroidal pachyvessels and the clinical characteristics of eyes with PCV. Methods: The medical records of patients who were diagnosed with PCV and were treatment-naïve were reviewed. Fluorescein and indocyanine green angiography, fundus photography, spectral domain optical coherence tomography (SD-OCT), and enhanced depth imaging OCT (EDI-OCT) were used to obtain images of the choroid. The presence of pathologically dilated outer choroidal vessels, pachyvessels, was determined by ICGA images. These pachyvessels were confirmed to correspond with the large choroidal vessels in the EDI OCT images. The PCV eyes were divided into two groups based on the presence or absence of pachyvessels and clinical features and subfoveal choroidal thickness (SFCT) were evaluated between the two groups. Results: Eighty-six eyes of 84 patients with PCV were evaluated. Pachyvessels were detected in 48 eyes (55.8％). The mean SFCT was 203.9 ± 83.9 μm in all 86 eyes, and it was significantly thinner in eyes with pachyvessels (+) than without pachyvessels (-) (183.2 ± 58.4 μm vs 230.2 ± 103.1 μm; P =0.01). The differences in the incidence of subretinal fluid, pigment epithelial detachments, and hemorrhages between the two groups were not significant. However, the PCV eyes in pachyvessels (+) group with hemorrhage had the thinnest choroid ( P =0.047). The choroidal features of the fellow eyes were similar to those of the PCV affected eyes, that is, the fellow eyes in pachyvessels (+) group had pachyvessels and the fellow eyes in pachyvessels (-) group did not have pachyvessels. Conclusions: Pachyvessels were presented 55.8% in eyes with PCV, and these eyes had the thin SFCT. The presence of pachyvessels and attenuation of the inner choroid were probably due to the pathological changes in the eyes with PCV.
Active constituents of Zanthoxylum nitidum from Yunnan Province against leukemia
Authors: Deng Ying , Ding Tongtong , Deng Lulu , Hao Xiaojiang , Mu Shu Zhen 
Published: April 2020

Abstract
Zanthoxylum nitidium (Roxb.) DC (Rutaceae) is well known for inhibiting the proliferation of human gastric, liver, kidney and lung cancer cells, whereas research on its potential use in treating leukaemia is relatively rare. 26 compounds were isolated from the chloroform and petroleum ether extracts of the roots and leaves of Z. nitidium. The structures of four compounds (4-6 and 16) were confirmed and attributed firstly by UV-visible spectroscopy, 1D and 2D NMR and HR-ESI-MS. Compounds 1-2 and11 were isolated from Z. nitidium for the first time. Of the assayed compounds, compounds 14 and24 showed inhibitory activities against leukaemia HEL cells with IC50 values of 3.59 and 15.95 µM. In addition, to further investigate the possible mechanism, the cell cycle and apoptosis assays were investigated, which indicated that compound14 caused obvious S phase arrest in HEL cells and induced cell apoptosis, but compound 24 induced only cell apoptosis of HEL cells. These results suggested that compounds 14 and 24 were the potential candidates for anti-leukaemia drug for the first time.
Effect of antimicrobial activity of Teucrium polium on oral Streptococcus mutans: a randomized cross-over clinical trial study
Authors: Tusi Somayeh Khoramian , Jafari Ahmad , Marashi Seyed Mahmoud Amin , Niknam Salomeh Faramarzi , Farid Malihe , Ansari Mehdi 
Published: April 2020

Abstract
Background : The purpose of this study was to determine the effect of a mouthwash containing Teucrium polium herb on Streptococcus mutans in mouth. Methods : This study was a randomized, crossover, double-blind clinical trial, where twenty-two volunteer dental students were randomly divided into two groups. The study had two phases. In each phase, one group was chosen as the intervention group, while the other one was the control group. Both the intervention and control groups were given the mouthwash with and without Teucrium polium , respectively. S. mutans of saliva were measured before and after each phase to compare the effects of the mouthwashes. A three-week washout period was considered between the two phases. An independent two-sample t-test was used to compare the mean number of S. mutans colonies. Additionally, a standard AB/BA crossover model was used to find the results of the treatment and the carryover effect on the residual biological effects. The significance level was considered 0.05 in this experiment. Results : There was no significant difference between the two groups in the number of S. mutans before using the mouthwashes. Using the mouthwash containing Teucrium polium extract significantly decreased the number of S. mutans colonies in both phases (P = 0.002). Conclusion : The results of this study showed that the mouthwash containing aqueous extract of Teucrium polium can significantly reduce the colonization of S. mutans in human saliva. Trial registration : Ethical issues approved by the Ethics Committee of the Rafsanjan University of Medical Sciences with the approval number of 937/9/31 and IRCT code No. IRCT2013121815842N1, approved in 06.16.2014. The study was done in September till November 2014.
Recent Trends and Variations in General Practitioners’ Involvement in Accident Care in Switzerland: an Analysis of Claims Data
Authors: Höglinger Marc , Knöfler Fabio , Stosch Rita Schaumann-von , Scholz Stefan M. , Eichler Klaus 
Published: April 2020

Abstract
BACKGROUND As in other countries, there is concern that GPs’ central role in the Swiss healthcare system as the primary provider of care might be changing or even be in decline. Our study gives a systematic account of GPs’ involvement in accident care from 2008 to 2016 and identifies changes in GPs’ involvement in this typical field of primary care: how frequently GPs were involved along the care pathway, to what extent they figured as initial care provider, and what their role in the care pathway was. METHODS Using a claims dataset from the largest Swiss accident insurer with two million accident cases, we constructed individual care pathways, i.e., when and from which providers patients received care. We calculated probabilities for the involvement of various care provider groups, for initial care provision, and for the role of GPs in patients’ care pathways, adjusted for injury and patient characteristics using multinomial regression. RESULTS In 2014, GPs were involved in 70% of all accident cases requiring outpatient care but no inpatient stay, and provided initial care in 56%. While involvement stayed at about the same level for accidents occurring from 2008 to 2014, the share of accidents where GPs provided initial care decreased by 4 percentage points. The share of cases where GPs acted as sole care provider decreased by 7 percentage points down to 44%. At the same time, accident cases involving care from an ED at any point in time increased from 38% to 46% and the share receiving initial care from an ED from 30 to 35 percentage points – apparently substituting for the declining involvement of GPs in initial care. GPs’ involvement in accident care is higher in rural compared to urban regions, among elderly compared to younger patients, and among Swiss compared to non-Swiss citizens. CONCLUSIONS GPs play a key role in accident care with considerable variation depending on region and patient profile. From 2008 to 2014, there is a remarkable decline in GPs’ provision of initial care after an accident. This is a strong indication that the GPs’ role in the Swiss healthcare system is changing.
Risk management-based security evaluation model for telemedicine systems
Authors: Kim Dong-won , Choi Jin-young , Han Keun-hee 
Published: April 2020

Abstract
Background: Infectious diseases that can cause epidemics, such as COVID-19, SARS-CoV, and MERS-CoV, constitute a major social issue, with healthcare providers fearing secondary, tertiary, and even quaternary infections. To alleviate this problem, telemedicine is increasingly being viewed as an effective means through which patients can be diagnosed and medications prescribed by doctors via untact (i.e., non-face-to-facemedical services. Thus, concomitant with developments in information and communication technology (ICT), medical institutions have actively analyzed and applied ICT to medical systems to provide optimal medical services. However, with the convergence of these diverse technologies, various risks and security threats have emerged. To protect patients and improve telemedicine quality for patient safety, it is necessary to analyze these risks and security threats comprehensively and institute appropriate countermeasures. Methods: The security threats likely to be encountered in each of seven telemedicine service areas were analyzed, and related data were collected directly through on-site surveys by a medical institution. Subsequently, an attack tree, the most popular reliability and risk modeling approach for systematically characterizing the potential risks of telemedicine systems, was examined and utilized with the attack occurrence probability and attack success probability as variables to provide a comprehensive risk assessment method. Results: In this study, the most popular modelling method, an attack tree, was applied to the telemedicine environment, and the security concerns for telemedicine systems were found to be very large. Risk management and evaluation methods suitable for the telemedicine environment were identified, and their benefits and potential limitations were assessed. Conclusion: This research should be beneficial to security experts who wish to investigate the impacts of cybersecurity threats on remote healthcare and researchers who wish to identify new modeling opportunities to apply security risk modeling techniques.
Treatment patterns and survival outcomes of advanced hypopharyngeal squamous cell carcinoma
Authors: Tsai Yao-Te , Chen Wen-Cheng , Chien Chih-Yen , Hsu Cheng-Ming , Lee Yi-Chan , Tsai Ming-Shao , Lin Meng-Hung , Lai Chia-Hsuan , Chang Kai-Ping 
Published: April 2020

Abstract
Background: This study evaluated the treatment outcomes of the primary surgery (PS) or concurrent chemoradiotherapy (CCRT) as the initial treatment for hypopharyngeal squamous cell carcinoma (HPSCC).Methods: This retrospective cohort study included patients with stage III-IV HPSCC from four tertiary referral centers consecutively enrolled from 2003 to 2012; of them, 213 (32.6%) and 439 (67.4%) had received PS and CCRT as their primary treatments, respectively. The 5-year overall survival (OS) and disease-free survival (DFS) rates were analyzed using the Kaplan-Meier method and Cox regression models.Results: In patients undergoing PS and CCRT, OS rates were 45.0% and 33.1% (p < 0.001), respectively, and DFS rates were 36.2% and 28.9% (p = 0.003), respectively. In subgroup analysis, in patients with stage IVA HPSCC, PS was associated with higher OS rate (p = 0.002), particularly in those with T4 or N2 classification (p = 0.021 and 0.002, respectively). Multivariate analysis indicated that stages IVA HPSCC, stage IVB HPSCC, and CCRT were independent adverse prognostic factors for OS rate (p = 0.004, <0.001, and 0.014, respectively). Furthermore, in patients with stage IVA HPSCC aged ≥ 65 years and with N2 classification, CCRT was significantly associated with lower OS rates than was PS (p = 0.027 and 0.010, respectively).Conclusions: In patients with advanced HPSCC, PS was significantly associated with better prognosis than CCRT. PS could be a favorable primary treatment modality for the management of patients with stage IVA HPSCC, particularly those aged ≥ 65 years and with T4 and N2 classification.
miR-128-3p enhances the protective effect of dexmedetomidine on acute lung injury in septic mice by targeted inhibition of MAPK14
Authors: Ding Li , Gao Xiang , Yu Shenghui , Sheng Liufang 
Published: April 2020

Abstract
Background: To investigate the mechanism of miR-128-3p and MAPK14 on the protective effect of dexmedetomidine on acute lung injury in septic mice. Methods: SPF C57BL/6 mice were divided into 8 groups. The pathological changes and wet/dry weight ratio (W/D), PaO2, PaCO2, MDA, SOD and MPO levels in lung tissue and the serum levels of inflammation factors were observed. Dual luciferase reporter assay was used to verify the targeting relationship between miR-128-3p and MAPK14. qPCR and WB were used to detect the expression of miR-128-3p and MAPK14. Results: Compared with the Normal group, other groups had lower MDA, MPO, inflammatory factors levels and the expression level of MAPK14, while the content of SOD and the expression level of miR-128-3p was significantly decreased. DEX treatment and up-regulation of miR-128-3p could significantly decrease the contents of MDA, MPO, inflammatory factor levels and significantly increase the SOD content in model mice, however, MAPK14 over-expression had opposite effects. miR-128-3p up-regulation enhanced the changes of above indicators caused by DEX treatment and MAPK14 over-expression could block the protective effect of DEX on acute lung injury in septic mice. miR-128-3p up-regulation reversed the effects of MAPK14 over-expression in model mice. Conclusion: miR-128-3p can further enhance the protective effect of dexmedetomidine on acute lung injury in septic mice by targeting and inhibiting MAPK14 expression.
Agreement between Original and Rasch-Approved Neck Disability Index
Authors: LU ZE , MacDermid Joy C. , Nazari Goris 
Published: April 2020

Abstract
Background: The neck disability index (NDI) has been used widely to monitor the treatment outcomes from patients’ perspective, given that neck pain is a notable social burden with a high prevalence (33%) within the adult population. Previous researchers have examined its psychometric properties and latent construct. Uptake of modified versions of NDI have been limited, however, the traditional/original NDI is still commonly administered. Examining the extent of agreement between traditional and Rasch-based versions using Bland-Altman (B&A) plots will inform our understanding of score differences. Therefore, the objective of current study was to describe the extent of agreement between different versions of NDI.Methods: The current study was a secondary data analysis where the study data was compiled from two prospectively collected data source. We performed a comprehensive literature search to identify Rasch analyses of the NDI within four databases including Embase, Medline, PubMed, and Google Scholar. Modified version with associate score transformation solution was obtained if they meet the predefined criteria. We established B&A plot by the mean difference and the 95% limits of agreement (LoA; ±1.96 times the standard deviation).Results: Two Rasch approved versions (8- and 5- item) that met the study criteria were identified from 303 publications. We analyzed 201 (43 males and 158 females) patients attending community clinics for neck pain. We found that the mean difference was approximately 10% of the total score between the 10-item and 5-item (-4.6 points), whereas the 10-item versus 8-item and 8-item versus 5-item had similar mean differences that were about half (-2.3 points). The B&A plots displayed wider 95% LoA for the agreement between 10-item and 8-item (LoA: -12.0, 7.4) and 5-item (LoA: -14.9, 5.8) compared with the agreement of 8-item and 5-item (LoA: -7.8, 3.3). Conclusion: Our study is the first to examine the agreement between each versions of NDI. Due to the unpredictable bias and wide 95% LoA, the traditional 10-item version should not be used interchangeably with other two Rasch-approved versions even with a small magnitude of bias. Different coverage of content should be considered during the decision of 8- and 5-item NDI.