bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Education in Oral Health Competencies in Physician Assistant Education Programs Translate to Delivery of Oral Health Services in Clinical Practice?
Authors: Langelier Margaret , Surdu Simona 
Published: May 2021

Purpose
The purpose of this study was to determine the extent to which physician assistants (PAs) are educated in oral health competencies and the relationship of education to providing oral health services to patients.

Methods
The study was conducted in 2016 by administering an Internet-based survey to a nationwide sample of 2014 graduates of programs accredited by the Accreditation Review Commission on Education for the Physician Assistant. The survey response rate was 12.7% (N = 304).

Results
More than half of the PAs who received education in oral health in their professional education programs indicated that oral health curricula were either integrated into one or several topical areas in the base curriculum or delivered in stand-alone lectures. The majority of PA respondents rated their educational preparation as good or excellent in helping them provide oral health education to their patients (54.8%), make appropriate referrals to oral health providers (53.7%), and provide preventive oral health services (51.2%), while more than 40% rated their preparation as good or excellent in helping them identify oral diseases, conditions, and intervention strategies. More than one-third (35.7%) of all PA respondents reported that they provided oral health services in their clinical practices. PAs who received instruction in oral health competencies through the PA education curriculum or from other sources were 2.82 times more likely to provide oral health assessment and screening services to their patients (95% confidence interval, 1.19–6.67). The PA respondents' provision of oral health services was also significantly associated with working in primary medicine or urgent care practice specialties but not with the work setting.

Conclusions
PAs educated in oral health competencies are more likely to provide such services to patients, especially in primary medicine or urgent care settings.
Agreement between blood pressure from research study visits versus electronic medical records and associations with hypertensive disorder diagnoses in pregnant women with overweight/obesity
Authors: Lane-Cordova Abbi D , Wilcox Sara , Fernhall Bo , Liu Jihong 
Published: May 2021

Objectives
Blood pressure (BP) abstracted from electronic medical records (EMR) is moderately correlated to BP in nonpregnant adults with limited agreement. Little is known about the agreement of research versus EMR BP measured during pregnancy or associations of EMR BP with hypertensive disorder of pregnancy (HDP) diagnoses.

Methods
BP was measured according to guidelines at in-person research study visits in 214 women with prepregnancy overweight or obesity (44.4% African American, mean age = 29.8 ± 4.8 years) at weeks 16 and 32 of pregnancy. Clinic BP readings that occurred within 1 week of the study visits were abstracted from the EMR. We assessed correlations between sources using Pearson’s coefficients; the agreement was evaluated with Bland–Altman plots. We compared differences in the proportion of women with an HDP diagnosis in the EMR between women with versus without a hypertensive EMR BP measurement.

Results
SBP and DBP from study visits and the EMR were modestly moderately correlated at both time points; 0.20 < r < 0.44; P < 0.05 for all. The average mean difference was 10.5 mmHg for SBP and <1 mmHg for DBP in early and 7.3 mmHg for SBP and −1.7 mmHg for DBP in late pregnancy. Women with at least one hypertensive BP reading in the EMR were more likely to have an HDP diagnosis recorded in the EMR; 43.5 versus 3.3%; P < 0.01.

Conclusion
EMR SBP was higher but moderately correlated with research quality BP in early and late pregnancy. Women with a hypertensive EMR BP measurement were more likely to have an HDP diagnosis in the EMR.
Comparison of invasive fungal diseases between patients with acute myeloid leukemia receiving posaconazole prophylaxis and those not receiving prophylaxis
Authors: Yang Eunmi , Choi Eun-Ji , Park Han-Seung , Lee Sang-Oh , Choi Sang-Ho , Kim Yang Soo , Lee Jung-Hee , Lee Je-Hwan , Lee Kyoo-Hyung , Kim Sung-Han 
Published: May 2021

Abstract
Posaconazole prophylaxis is effective in decreasing the incidence of invasive fungal diseases (IFDs) in patients with acute myeloid leukemia (AML). However, the use of antifungal prophylaxis varies in real-life practice, and only a small number of studies have compared the incidence of IFDs between those receiving posaconazole prophylaxis and those without prophylaxis. We compared the clinical characteristics and outcomes of IFDs between patients with AML who received posaconazole prophylaxis and those without antifungal prophylaxis.
We reviewed the medical records of adult AML patients who underwent induction chemotherapy between June 2016 and October 2019 at Asan Medical Center (Seoul, South Korea), where posaconazole prophylaxis is not administered in patients with gastrointestinal symptoms that may hinder sufficient absorption of oral prophylactic agents, and in patients with abnormal liver functions considering the possible exacerbation of adverse events. Patients who received posaconazole prophylaxis for ≥7 days were included in the prophylaxis group. Clinical characteristics and outcomes including the incidence of IFDs were compared between the 2 groups.
Of the 247 patients with AML who underwent induction chemotherapy, 162 (66%) received posaconazole prophylaxis and 85 (34%) did not receive any prophylaxis. The incidence of proven/probable IFD was significantly higher in the no prophylaxis group than in the prophylaxis group (9.4% [8/85] vs 2.5% [4/162], P = .03). Of the 8 cases of IFDs in the no prophylaxis group, 7 were mold infections and 1 was invasive candidiasis. Of the 4 cases of IFDs in the prophylaxis group, 3 were mold infections and 1 was invasive candidiasis. Patients with posaconazole prophylaxis less frequently received therapeutic antifungal therapy (2.5% vs 9.4%, P = .03) and had a longer median, duration from chemotherapy to antifungal therapy compared with the no prophylaxis group (18 vs 11 days, P < .01). The rate of IFD-related mortality was similar between the 2 groups (0.6% vs 0%, P > .99).
Patients with AML who received posaconazole prophylaxis had a lower incidence of breakthrough IFDs compared with those who did not receive any prophylaxis. Invasive mold infection was the most common IFD regardless of antifungal prophylaxis.
The analgesic evaluation of gabapentin for arthroscopy
Authors: Huang Feiri , Yang Zhifang , Su Zhongliang , Gao Xiaosheng 
Published: May 2021

Abstract

Introduction:
The efficacy of gabapentin for pain management of arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of gabapentin versus placebo on the postoperative pain intensity of arthroscopy.

Methods:
We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through April 2020 for randomized controlled trials assessing the effect of gabapentin versus placebo on pain control of arthroscopy. This meta-analysis is performed using the random-effect model.

Results:
Five randomized controlled trials are included in the meta-analysis. Overall, compared with control group for arthroscopy, gabapentin remarkably decreases pain scores at 24 hour (standard mean difference [SMD]=-0.68; 95% confidence interval [CI]=-1.15 to -0.02; P = .21), analgesic consumption (SMD = -18.24; 95% CI=-24.61 to -11.88; P < .00001), nausea and vomiting (OR = 0.42; 95% CI = 0.21 to 0.84; P = .01), but has no obvious influence on pain scores at 6 h (SMD = −1.30; 95% CI = −2.92 to 0.31; P = .11) or dizziness (OR = 1.12; 95% CI = 0.56 to 2.24; P = .75).

Conclusions:
Gabapentin is effective for pain control after arthroscopy.
Thymosin alpha-1 therapy improves postoperative survival after curative resection for solitary hepatitis B virus-related hepatocellular carcinoma
Authors: Linye He , Zijing Xia , Wei Peng , Chao He , Chuan Li , Tianfu Wen 
Published: May 2021

Abstract
Thymosin alpha-1 (Tα1) is an immunomodulatory and antiviral agent with potential effects on chronic hepatitis B and liver cancer. Its impact on solitary hepatocellular carcinoma (HCC) remains controversial, so we aimed to investigate the efficacy of Tα1 in solitary HBV-related HCC patients after curative resection.
Between May 2010 and April 2016, 468 patients with solitary HBV-related HCC after curative resection were analyzed. Propensity score matching (PSM) was used to minimize confounding variables. Risk factors were identified by the Cox proportional hazards model. Recurrence-free survival (RFS) rates, overall survival (OS) rates, immunological, and virologic response were compared.
The median follow up was 60.0 months. Immunological response improved in the Tα1 group compared with the control group (P < .001) but the virologic response was similar between 2 groups after 24 months. Patients with Tα1 therapy had better RFS and OS before (P = .018 and P < .001) and after (P = .006 and P < .001) propensity matching. Multivariate analysis revealed that Tα1 therapy was an independent prognostic factor for both OS (P < .001, HR = 0.308, 95% CI: 0.175–0.541) and RFS (P < .001, HR = 0.381, 95% CI: 0.229–0.633).
Tα1 as an adjuvant therapy improves the prognosis of solitary HBV-related HCC patients after curative liver resection.
Association between gastroesophageal reflux disease and vocal fold polyps
Authors: Zou Yazhu , Deng Dan , Li Xia , Yang Zhaoxia 
Published: May 2021

Abstract
The aim of this study is to explore the relationship between gastroesophageal reflux disease (GERD) and vocal fold polyps (VFPs).
This is a Case-Control study and was performed with the help of The Second Affiliated Hospital of Chongqing Medical University.
Twenty-seven patients with VFP and 20 controls without VFP were recruited between May and October 2018. All the subjects underwent a saliva pepsin test, completed the GerdQ questionnaire and 24-hour multichannel intraluminal impedance with pH (24-h MII-pH) monitoring. Twenty-five resected VFP specimens were examined with immunohistochemical (IHC) and double immunofluorescence (IF) staining.
The incidence of GERD in the VFP group was significantly higher than that in the control group (P = .003). Patients with VFP had significantly higher GerdQ scores, pepsin concentrations, and pepsin-positive rates (P < .05). Moreover, the number of proximal and upright reflux events was significantly higher in the VFP group (P < .05). The pepsin concentration in saliva showed a significant positive correlation with the pepsin levels in tissues (r

2
= 0.50, P = .011). Pepsin and TGF-β1-positive cells were colocalized with CD45RO-positive cells. IHC staining showed that the majority of VFP patients had a positive expression of pepsin (20/25, 80%) and pepsin-positive cells were found in both the squamous epithelium and mesenchymal tissues. IHC staining of TGF-β1 in VFP revealed findings similar to those of pepsin staining.
GERD is an important risk factor for VFP. Pepsin may promote the aggregation of immune cells, increase the local cytokines, and promote inflammatory reaction, suggesting a potential new pathogenesis for VFP. The saliva pepsin test is a reliable method for GERD diagnosis.
Risk factors of postpartum stress urinary incontinence in primiparas
Authors: Gao Jiejun , Liu Xinru , Zuo Yan , Li Xiaocui 
Published: May 2021

Abstract
Stress urinary incontinence (SUI) is a common clinical postpartum complication. It is necessary to explore the risk factors of postpartum SUI in primiparas to provide evidence support for preventing and reducing the occurrence of SUI.
Primiparas who were delivered in our hospital from March 2019 to October 2020 were identified, the personal information and related treatment details of SUI and no-SUI primiparas were collected and analyzed. Logistic regression analyses were conducted to identify the risk factors of postpartum SUI in primiparas.
A total of 612 primiparas were included, the incidence of SUI in primiparas was 32.03%. There were significant differences in the body mass index (BMI) before pregnancy, diabetes, abortion, delivery method, newborn's weight, epidural anesthesia, and duration of second stage of labor (all P < .05) between SUI and no-SUI group, and there were no significant differences in the age, BMI at admission, hypertension and hyperlipidemia SUI and no-SUI group (all P > .05). Logistic regression analyses indicated that BMI before pregnancy ≥24 kg/m2 (odds ratio [OR]: 2.109, 95% confidence interval [CI]: 1.042–4.394), diabetes (OR: 2.250, 95% CI: 1.891–3.544), abortion history (OR: 3.909, 95% CI: 1.187–5.739), vaginal delivery (OR: 2.262, 95% CI: 1.042–4.011), newborn's weight ≥3 kg (OR: 1.613, 95% CI: 1.095–2.316), epidural anesthesia (OR: 2.015, 95% CI: 1.226–3.372), and duration of second stage of labor ≥90 minutes (OR: 1.726, 95% CI: 1.084–2.147) were the risk factors of postpartum SUI in primiparas (all P < .05).
The clinical incidence of SUI in primiparas is relatively high. In clinical practice, medical staff should conduct individualized early screening for those risk factors, and take prevention measures to reduce the occurrence of SUI.
The best thickness of cornea graft from SMILE surgery as patch graft in glaucoma drainage implant surgery
Authors: Wang Yuhong , Liu Jinkun , Huang Weiyi , Xu Yazhang , Cheng Meizhu , Shen Zhengwei 
Published: May 2021

Abstract

Objective:
The aim of this study was to determine the best thickness of corneal slices acquired from femtosecond laser surgery—small incision lenticule extraction (SMILE surgery) as patch graft in glaucoma drainage implantation surgery.

Methods:
This study is a prospective randomized study. Patients who received glaucoma drainage implantation from September 2016 to November 2018 were observed. The patients were randomly divided into 3 groups. Group A included 102 cases (104 eyes), receiving 1 layer (120–150 μm) of allogeneic lamellar corneal tissue as the graft. Group B included 117 cases (120 eyes), receiving 2 layers of lamellar corneal tissue from one donor. Group C included 109 cases (111 eyes), using 3 layers of lamellar corneal tissue from 2 donors. The intraocular pressure, corneal graft, conjunctiva stromalysis, drainage tube exposure, and drainage plate were observed.

Results:
Patients were followed up for 6 to 33 months. The intraocular pressure was significantly reduced after surgery in all three groups. Conjunctiva stromalysis and drainage tubes were exposed in 3 eyes (3%) in group A and 1 eye (0.8%, a special case which has nystagmus and the plate was placed infratemporally) in group B, whereas no conjunctiva stromalysis or tube exposure was reported in group C.

Conclusions:
The corneal graft acquired from SMILE surgery can effectively prevent drainage tube exposure and give patients a better cosmetic appearance. Two layers of lamellar corneal tissue (240–300 μm) may be the best suitable thickness because it can effectively reduce tube exposure and rejection. In some special cases, 3 layers of lamellar corneal tissue are needed.
Risk factors of infection after transarterial chemoembolization for hepatocellular carcinoma
Authors: Shi Zhipeng , Yang Wen , Tang Hao , Li Xiuhong 
Published: May 2021

Abstract

Background:
Transarterial chemoembolization (TACE) has the characteristics of minimally invasive, strong repeatability, and good curative effect, so it is commonly used in the nonoperative treatment of hepatocellular carcinoma (HCC). However, infection will occur after TACE, which not only increases the hospitalization time and medical expenses, but also affects the efficacy of TACE treatment. At present, there is a lack of analysis of the risk factors of infection after TACE of patients with HCC. In this study, meta-analysis was used to further explore the risk factors of postoperative infection in patients with HCC after TACE, and to provide strategies for infection prevention and intervention.

Methods:
To search the literatures about the influencing factors of post-TACE infection in patients with HCC published from the establishment of PubMed, Embase, The Cochrane Library, Web of Science, China Biology Medicine Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and WANFANG to April 2021. Screening was carried out according to inclusion criteria and exclusion criteria. A meta-analysis was performed using RevMan 5.3 software.

Results:
We disseminated the findings of this systematic review and meta-analysis via publications in peer-reviewed journals.

Conclusion:
This study systematically reviewed the existing evidence and determined the incidence and predictors of infection after TACE of patients with HCC.

Ethics and dissemination:
The private information from individuals will not be published. This systematic review also should not damage participants’ rights. Approval from an ethics committee is not required for this study. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration number:
DOI 10.17605/OSF.IO/26P5X
Quality of life in chronic pain treated through pulsed radiofrequency therapy
Authors: Lo Buono Viviana , De Cola Maria Cristina , Di Cara Marcella , Floridia Daniela , Bonanno Lilla , De Salvo Simona , Cerra Francesco , Cannistraci Cecilia , Maresca Giuseppa , Bramanti Placido , Marino Silvia , Corallo Francesco 
Published: May 2021

Abstract
Anxiety and depression are often symptoms present in people who suffer from chronic pain, compromising the quality of life of these individuals. The objective of this study was to assess whether a pulsed radiofrequency (PRF) treatment, in addition to psychological support intervention, can decrease chronic pain, thereby improving quality of life and restoring psychological well-being.
Fifty outpatients with a diagnosis of chronic pain, without any benefit from traditional drug therapies, were selected to perform a PRF treatment in combination with a psychological intervention. They were evaluated before and after the intervention through the Hamilton Anxiety Rating Scale and the Beck Depression Inventory-II for anxiety and depression symptomatology, respectively, the Short Form Health Survey 36 (SF-36) was used to assess the subject's quality of life, and the Numerical Rating Scale was used for pain assessment.
The Wilcoxon signed-rank test showed a significant difference in Beck Depression Inventory-II (P < .001), Hamilton Anxiety Rating Scale (P < .01), and Numerical Rating Scale (P = .004). In the SF-36 scores, we observed a significant difference between T0 and T1 in both mental (P < .001) and physical (P < .001) dimensions.
This study shows that a chronic pain reduction leads to a decrease of anxiety-depressive symptoms and an improvement in quality of life. PRF seems to be an appropriate method to reduce the chronic pain that influences psychological well-being and quality of life.
Exercise interventions for older people at risk for frailty
Authors: Zhang Jianna , Liu Zhixi , Liu Yi , Ye Lei 
Published: May 2021

Abstract

Background:
Frailty is a state of age-related reduced physiological reserve characterized by an increased risk of adverse clinical outcomes. Studies have shown that exercise can improve frailty in older people. However, it remains to be seen which exercises will most improve the fitness of older people with frailty or those at the risk for frailty.
Objective: This protocol aims to determine whether physical exercise can improve frailty in older people, and if which methods are most effective.

Methods:
We searched the following databases for relevant articles published between January 1, 2012 and January 1, 2021: PubMed, EMBASE, the Cochrane Library, Wanfang, the China National Knowledge Infrastructure, Clinical Trials Database, and the Science Network. Two independent reviewers will carry out data extraction, discuss and resolve differences, and obtain consensus from the third author. We will select randomized control trials (RCTs) according to the preformulated inclusion criteria. The main outcomes in this study are scores from Fried Frailty Phenotype Criteria; the Frailty Trait Scale–short form; the SHARE Frailty Instrument; the FRAIL scale; the Gérontopôle Frailty Screening Tool; the Clinical Frailty Scale, the Rockwood and Mitnitsky Frailty Index; the Study of Osteoporotic Fractures Index; the Edmonton Frailty Scale; the Fatigue, Resistance, Ambulation, Illness and Loss of Weight Index; the Multidimensional Prognostic Index; the Tilburg Frailty Indicator; PRISMA-7; the Groningen Frailty Indicator; the Sherbrooke Postal Questionnaire; and the Kihon Checklist. Secondary outcomes are muscle strength, gait velocity, stair-climbing power, and level of spontaneous physical activity. If the heterogeneity test shows slight or no statistical heterogeneity, a fixed effects model will be used for data synthesis; otherwise, a random effects model will be used. We will develop a unified data extraction table that includes a number of parameters. The Cochrane Cooperative Bias Risk Tool will be used to evaluate the methodological quality of the selected RCTs. RevMan Manager 5.3 and STATA 14.0 will be used for data analysis if enough RCTs (more than 10) are identified and selected.

Result:
The final results will provide information on the effectiveness of intervention programs for frail older adul and further demonstrate which exercise programs are more effective and which methods can significantly improve frailty.

Conclusion:
This protocol will contribute to the development of more effective interventions for elderly individuals with frailty.

Ethics and dissemination:
This study applies existing literature references; therefore, ethical approval is not required.

INPLASY registration number:
INPLASY202130107
m6A regulators are associated with osteosarcoma metastasis and have prognostic significance
Authors: Zhang Wenpeng , Wang Lina , Zhang Ping , Zhang Quanbin 
Published: May 2021

Abstract

Background:
Osteosarcoma represents the most common malignant bone tumor with high metastatic potential and inferior prognosis. RNA methylation (N6-methyladenosine [m6A]) is a prevalent RNA modification that epigenetically influences numerous biological processes including tumorigenesis. This study aims to determine that m6A regulators are significant biomarkers for osteosarcoma, and establish a prognostic model to predict the survival of patients.

Methods:
In this study, we comprehensively analyzed the underlying associations between m6A regulators’ mRNA expressions and metastasis as well as prognosis of osteosarcoma patients in the Cancer Genome Atlas. Multivariate Cox-regression analysis was used to screen regulators that were significantly associated with overall survival of osteosarcoma patients. Least absolute shrinkage and selection operator (LASSO) Cox-regression analysis was used for constructing m6A regulator-based osteosarcoma prognostic signature.

Results:
Some of the regulators exhibited aberrant mRNA levels between osteosarcoma samples with and without metastasis. Multivariate Cox-regression analysis identified several regulators with potential prognostic significance. A risk score formula consisted of methyltransferase-like 3, YTH domains of Homo sapiens, and fat mass and obesity-associated protein was obtained through which patients could be prognostically stratified independently of potential confounding factors. The signature was also significantly associated with the metastatic potential of osteosarcoma. All the analyses could be well reproduced in another independent osteosarcoma cohort from the Gene Expression Omnibus.

Conclusions:
In conclusion, this study first revealed potential roles of m6A regulators in osteosarcoma metastasis and prognosis, which should be helpful for its clinical decision-making.