bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between smokeless tobacco use and oral cavity cancer risk in women compared with men: a systematic review and meta-analysis
Authors: Mu Guangyan , Wang Jiayi , Liu Zhiyan , Zhang Hanxu , Zhou Shuang , Xiang Qian , Cui Yimin 
Published: August 2021

Abstract
Background
The impact of smokeless tobacco (SLT) use on the risk of oral cavity cancer (OCC) has been confirmed; however, the sex-based difference in this association remains inconclusive. Therefore, this study aimed to estimate the association between SLT use and OCC risk in women and compared it to that in men.

Methods
PubMed, Embase, and Cochrane Library databases were systematically searched for eligible studies from their inception up to August 2020. Studies reporting the effect estimates of SLT use on OCC risk in men and women, were eligible for inclusion. The relative risk ratio (RRR) was applied to calculate the sex-based difference in the relationship between SLT use and OCC risk, and pooled analysis was conducted using a random-effects model with inverse variance weighting.

Results
Nineteen studies reporting a total of 6593 OCC cases were included in the final meta-analysis. The pooled relative risk (RR) suggested that SLT use was associated with an increased risk of OCC in both men (RR, 2.94; 95% confidence interval [CI], 2.05–4.20; P < 0.001) and women (RR, 6.39; 95%CI, 3.16–12.93; P < 0.001). Moreover, the SLT-use-related risk of OCC was higher in women than that in men (RRR,1.79; 95%C, 1.21–2.64; P = 0.003). The risk of OCC related to SLT use in women was still significantly higher than that in men (RRR, 1.75; 95%CI, 1.15–2.66; P = 0.008) after excluding indirect comparison results. Finally, a subgroup analysis suggested significant sex-based differences only in individuals who received chewed smokeless products, regardless of the control definition. Pooled analysis of studies with high design quality confirmed the notably higher risk of OCC in women than in men.

Conclusions
This study found that SLT use was associated with a higher risk of OCC in women than in men. Further large-scale prospective cohort studies should be conducted to verify sex-based differences in the association between use of specific smokeless products and OCC risk.
Trends in food insecurity rates at an academic primary care clinic: a retrospective cohort study
Authors: Montez Kimberly , Brown Callie L. , Garg Arvin , Rhodes Scott D. , Song Eunyoung Y. , Taxter Alysha J. , Skelton Joseph A. , Albertini Laurie W. , Palakshappa Deepak 
Published: August 2021

Abstract
Background
Healthcare organizations are increasingly screening and addressing food insecurity (FI); yet, limited data exists from clinic-based settings on how FI rates change over time. The objective of this study was to evaluate household FI trends over a two-year period at a clinic that implemented a FI screening and referral program.

Methods
In this retrospective cohort study, data were extracted for all visits at one academic primary care clinic for all children aged 0–18 years whose parents/guardians had been screened for FI at least once between February 1, 2018 to February 28, 2019 (Year 1) and screened at least once between March 1, 2019 to February 28, 2020 (Year 2). Bivariate analyses tested for differences in FI and demographics using chi-square tests. Mixed effects logistic regression was used to assess change in FI between Years 1 and 2 with random intercept for participants controlling for covariates. The interaction between year and all covariates was evaluated to determine differences in FI change by demographics.

Results
Of 6182 patients seen in Year 1, 3691 (59.7%) were seen at least once in Year 2 and included in this study. In Year 1, 19.6% of participants reported household FI, compared to 14.1% in Year 2. Of those with FI in Year 1, 40% had FI in Year 2. Of those with food security in Year 1, 92.3% continued with food security in Year 2. Compared to Hispanic/Latinx participants, African American/Black (OR: 3.53, 95% CI: 2.33, 5.34; p < 0.001) and White (OR: 1.88, 95% CI: 1.06, 3.36; p = 0.03) participants had higher odds of reporting FI. African American/Black participants had the largest decrease in FI between Years 1 and 2 (− 7.9, 95% CI: − 11.7, − 4.1%; p < 0.0001).

Conclusions
Because FI is transitional, particularly for racial/ethnic minorities, screening repeatedly can identify families situationally experiencing FI.
Ultrasound-guided single popliteal sciatic nerve block is an effective postoperative analgesia strategy for calcaneal fracture: a randomized clinical trial
Authors: Li Yanan , Zhang Qi , Wang Ying , Yin Chunping , Guo Junfei , Qin Shiji , Zhang Yahui , Zhu Lian , Hou Zhiyong , Wang Qiujun 
Published: August 2021

Abstract
Objectives
The aim of this study was to evaluate the postoperative analgesia effect of ultrasound-guided single popliteal sciatic nerve block for calcaneal fracture.

Methods
A total of 120 patients scheduled for unilateral open reduction and internal fixation of calcaneal fracture were enrolled in this prospective randomized study. Patients in group B received ultrasound-guided single popliteal sciatic nerve block after operation, but Patients in group A did not. All patients received patient-controlled intravenous analgesia (PCIA) after operation. The time to initiation of PCIA, the time of first pressing the analgesia pump, duration of analgesia pump use and the total number of times the patient pressed the analgesia pump were recorded. The time of rescue analgesia and the adverse reactions were recorded. Pain magnitude of the patients immediately after discharge from operating room (T1), and at 4th (T2), 8th (T3), 12th (T4), 16th (T5), 24th (T6) and 48th (T7) h after the operation were assessed with visual analog scale (VAS). In addition, patient, surgeon and nurse satisfaction were recorded.

Results
The VAS scores at T2 ~ T5, the time of rescue analgesia and the adverse reactions, the total number of times the patient pressed the analgesia pump were significantly declined in group B (p < 0.001). The time to initiation of PCIA, the time of first pressing the analgesia pump, duration of analgesia pump use were prolonged and patient surgeon and nurse satisfaction were improved in group B (p < 0.05).

Conclusion
Ultrasound-guided single popliteal sciatic nerve block is an effective postoperative analgesia strategy for calcaneal fracture.

Trial registration
ChiCTR, ChiCTR2100042340. Registered 19 January 2021, URL of trial registry record: http://www.chictr.org.cn/showproj.aspx?proj=66526.
Field note use in family medicine residency training: learning needs revealed or avoided?
Authors: Zaki Nicole , Cavett Teresa , Halas Gayle 
Published: August 2021

Abstract
Background
Field notes (FNs) are used in Family Medicine residency programs to foster reflective learning and facilitate formative assessment. Residents assess their strengths and weaknesses and develop action plans for further improvement. This study explored the use of FNs in the University of Manitoba’s Family Medicine residency program 5 years after their implementation.

Methods
This multi-method study examined 520 FNs from 16 recent graduates from the University of Manitoba Family Medicine residency program. Quantitative analysis (frequencies and means) enabled descriptions and comparisons between training sites. Four themes emerged from inductive content analysis highlighting common ideas reflected upon.

Results
Residents displayed cyclical variation in the FN generation over 2 years. Eight of the 99 Priority Topics (addressing complex psychosocial issues) were not captured in this data set. The domains of Care of First Nations, Inuit, and Metis; Care of the Vulnerable and Underserved; and Behavioural Medicine and the CanMEDS-FM roles of FM – Procedural Skill, Leader/Manager, and Professional were less frequently reflected upon. Four themes (Patient-Centered Care, Patient Safety, Achieving Balance, and Confidence) were identified from qualitative analysis of residents’ narrative notes.

Conclusions
Vygotsky’s Sociocultural Theory of Cognitive Development was proposed as a lens through which to examine factors influencing resident learning. Residents’ discomfort with certain topics may lead to avoidance in reflecting upon certain competencies in FNs, impacting skill acquisition. Further research should explore factors influencing residents’ perceptions FNs and how to best assist residents in becoming competent, confident practitioners.
The risks and benefits of using social media to engage consumers in service design and quality improvement in Australian public hospitals: findings from an interview study of key stakeholders
Authors: Walsh Louisa , Hyett Nerida , Howley Jayne , Juniper Nicole , Li Chi , MacLeod-Smith Belinda , Rodier Sophie , Hill Sophie J. 
Published: August 2021

AbstractBackgroundEngaging consumers - patients, families, carers and community members who are current or potential service users - in the planning, design, delivery, and improvement of health services is a requirement of public hospital accreditation in Australia. There is evidence of social media being used for consumer engagement in hospitals internationally, but in Australia this use is uncommon and stakeholders’ experiences have not been investigated. The aim of the study was to explore the experiences and beliefs of key Australian public hospital stakeholders around using social media as a consumer engagement tool. This article focuses on the study findings relating to methods, risks, and benefits of social media use.MethodsSemi-structured interviews were conducted with Australian public hospital stakeholders in consumer representative, consumer engagement/patient experience, communications or quality improvement roles. Qualitative data were analysed using a deductive content analysis method. An advisory committee of consumer and service provider stakeholders provided input into the design and conduct of this study.ResultsTwenty-six Australian public hospital service providers and consumers were interviewed. Participants described social media being used to: recruit consumers for service design and quality improvement activities; as an online space to conduct consultations or co-design; and, to gather feedback and patient experience data. The risks and benefits discussed by interview participants were grouped into five themes: 1)overcoming barriers to engagement, 2)consumer-initiated engagement; 3) breadthvsdepth of engagement,4)organisational transparencyvscontroland 5)users causing harm.ConclusionsSocial media can be used to facilitate consumer engagement in hospital service design and quality improvement. However, social media alone is unlikely to solve broader issues commonly experienced within health consumer engagement activities, such as tokenistic engagement methods, and lack of clear processes for integrating consumer and patient feedback into quality improvement activities.
Bacterial factors required for Streptococcus pneumoniae coinfection with influenza A virus
Authors: Chen Yi-Yin , Huang Ching-Tai , Li Shiao-Wen , Pan Yi-Jiun , Lin Tzu-Lung , Huang Ya-Yu , Li Ting-Hsuan , Yang Yu-Ching , Gong Yu-Nong , Hsieh Yu-Chia 
Published: August 2021

AbstractBackgroundStreptococcus pneumoniaeis a common cause of post-influenza secondary bacterial infection, which results in excessive morbidity and mortality. Although 13-valent pneumococcal conjugate vaccine (PCV13) vaccination programs have decreased the incidence of pneumococcal pneumonia, PCV13 failed to prevent serotype 3 pneumococcal disease as effectively as other vaccine serotypes. We aimed to investigate the mechanisms underlying the co-pathogenesis of influenza virus and serotype 3 pneumococci.MethodsWe carried out a genome-wide screening of a serotype 3S. pneumoniaetransposon insertion mutant library in a mouse model of coinfection with influenza A virus (IAV) to identify the bacterial factors required for this synergism.ResultsDirect, high-throughput sequencing of transposon insertion sites identified 24 genes required for both coinfection and bacterial infection alone. Targeted deletion of the putative aminotransferase (PA) gene decreased bacterial growth, which was restored by supplementation with methionine. The bacterial burden in a coinfection with thePAgene deletion mutant and IAV in the lung was lower than that in a coinfection with wild-type pneumococcus and IAV, but was significantly higher than that in an infection with thePAgene deletion mutant alone. These data suggest that IAV infection alters host metabolism to benefit pneumococcal fitness and confer higher susceptibility to pneumococcal infection. We further demonstrated that bacterial growth was increased by supplementation with methionine or IAV-infected mouse lung homogenates.ConclusionsThe data indicates that modulation of host metabolism during IAV infection may serve as a potential therapeutic intervention against secondary bacterial infections caused by serotype 3 pneumococci during IAV outbreaks in the future.
Cyclin G2 reverses immunosuppressive tumor microenvironment and potentiates PD-1 blockade in glioma
Authors: Li Sen , Zhao Chenyang , Gao Jinlan , Zhuang Xinbin , Liu Shuang , Xing Xuesha , Liu Qi , Chen Chen , Wang Shusen , Luo Yang 
Published: August 2021

Abstract
Background
Expression of aberrant cyclin G2 is a key factor contributing to cancer biological processes, including glioma. However, the potential underlying mechanisms of cyclin G2 in the glioma tumor immune microenvironment remain unclear.

Methods
Co-immunoprecipitation (co-IP), in situ proximity ligation assay (PLA), and in vitro kinase assay were conducted to reveal the underlying mechanism by which cyclin G2 regulates Y10 phosphorylation of LDHA. Further, the biological roles of cyclin G2 in cell proliferation, migration, invasion capacity, apoptosis, glycolysis, and immunomodulation were assessed through in vitro and in vivo functional experiments. Expressions of cyclin G2 and Foxp3 in glioma specimens was determined by immunohistochemistry.

Results
In this study, we found that cyclin G2 impeded the interaction between LDHA and FGFR1, thereby decreasing Y10 phosphorylation of LDHA through FGFR1 catalysis. Cyclin G2 inhibited proliferation, migration, invasion capacity, and glycolysis and promoted apoptosis glioma cells via suppressing Y10 phosphorylation of LDHA. Moreover, we further verified that cyclin G2 reversed the immunosuppressive to antitumor immune microenvironment through inhibiting lactate production by glioma cells. Besides, cyclin G2 potentiated PD-1 blockade and exerted strong antitumor immunity in the glioma-bearing mice model.

Conclusions
Cyclin G2 acts as a potent tumor suppressor in glioma and enhances responses to immunotherapy. Our findings may be helpful in selecting glioma patients for immunotherapy trials in the future.
Socio-economic and demographic impacts on the full awareness of the methods for controlling/preventing the spread of COVID-19 among social media users in some African countries at the onset of the pandemic
Authors: Okorie Idika E. , Afuecheta Emmanuel , Alaebo Chinonso G. , Nadarajah Saralees 
Published: August 2021

Abstract
Objective
In Africa, most countries continue to battle COVID-19 with cases of newly infected still being recorded. In this note, we investigate how socioeconomic and demographic factors affected individuals awareness on the methods for controlling/preventing the spread of COVID-19 in some parts of Africa at the onset of the pandemic.

Results
Based on regression modelling, we find that having full awareness does not depend on religious affiliation. Men, urban dwelling, holding bachelors or higher degrees, operating multiple social media accounts or being employed are associated with having full awareness of the recommended practices for the prevention and control of COVID-19 at the early stage of the pandemic. No occupation, business or older people are associated with not having full awareness.
DNA methyltransferase inhibitors combination therapy for the treatment of solid tumor: mechanism and clinical application
Authors: Hu Chunhong , Liu Xiaohan , Zeng Yue , Liu Junqi , Wu Fang 
Published: August 2021

AbstractDNA methylation, an epigenetic modification, regulates gene transcription and maintains genome stability. DNA methyltransferase (DNMT) inhibitors can activate silenced genes at low doses and cause cytotoxicity at high doses. The ability of DNMT inhibitors to reverse epimutations is the basis of their use in novel strategies for cancer therapy. In this review, we examined the literature on DNA methyltransferase inhibitors. We summarized the mechanisms underlying combination therapy using DNMT inhibitors and clinical trials based on combining hypomethylation agents with other chemotherapeutic drugs. We also discussed the efficacy of such compounds as antitumor agents, the need to optimize treatment schedules and the regimens for maximal biologic effectiveness. Notably, the combination of DNMT inhibitors and chemotherapy and/or immune checkpoint inhibitors may provide helpful insights into the development of efficient therapeutic approaches.
Who buys certified firewood? Individual determinants of clean fuel adoption for promoting the sustainable energy transition in southern Chile
Authors: Álvarez Boris , Boso Àlex , Rodríguez Ignacio , Hofflinger Álvaro , Vallejos-Romero Arturo 
Published: August 2021

AbstractBackgroundTemuco and Padre Las Casas, Chile, have severe problems of air pollution due to the extensive use of firewood for heating. The local authorities have made various efforts to improve fuel quality and introduce greater regulation into the market. Certified firewood guarantees low levels of humidity (< 25%) and has better combustion, but its distribution is still limited and the variables that determine its purchase have scarcely been studied. The aim of this study is to identify the determinants of certified firewood consumption in urban southern Chile.MethodsThis study was conducted with a cross-sectional non-experimental design. Following a non-probability sampling by convenience, we applied 355 surveys to participants who use a firewood system. Nonparametric comparisons analyses were made to identify differences in the use of certified wood by socio demographic variables. In addition, an Ordinal Logistic Regression was used to analyze the relation between the use of certified firewood and various psycho-social variables.ResultsHalf of the users of wood-burning stoves participating in the study declared that they “never” (38%) or “almost never” (12%) used certified firewood to heat their home. Situational and product-related variables, such as price, availability, convenience and time are fundamental to people’s purchase behavior, partially explaining the low public interest shown in this product. On the other hand, the results indicate the influence of socio-demographic variables such as income level and the presence of older adults at home, as well as psycho-social variables which include how much participants pay attention to air quality, the information level they have about it, the feelings of discomfort due to air pollution and concern for its effects on health.ConclusionsFirst, increasing information levels and awareness among the population through communication campaigns is necessary to promote the sustainable urban energy transition in southern Chile. Second, information strategies may be complemented by boosting employment, driving investment, improving income, and strengthening the mechanisms of social protection, especially for the most vulnerable groups, to be effective. Finally, protecting and stimulating the formal trade in firewood could increase the points of sale of certified firewood, which would facilitate user access to cleaner fuels.
Mental health outcomes in communities exposed to Armed Conflict Experiences
Authors: Trujillo Sandra , Giraldo Luz Stella , López José David , Acosta Alberto , Trujillo Natalia 
Published: August 2021

Abstract
Background
Populations exposed to Armed Conflict Experiences (ACE) show different levels of impact in their mental health (i.e. clinical and positive components); however, there is limited evidence related to mental health of general population (civilians not classified as victims) exposed to ACE. Government guided mental health assessments exclude this population. The use of a newly validated Extreme Experiences Scale (EX2) seems appropriate to classify victims, ex-combatants, and civilians for their mental health assessment.

Methods
Here, we propose a novel approach to identify relationships between individuals classified with different levels of ACE exposure—independent of their legal role in the armed conflict, and mental health outcomes. According to the cut-off points derived from the scores of EX2, we classified the sample in low and high exposure to ACE.

Results
The high-level ACE group (scores > 2.5) included 119 subjects, and the low-level ACE was constituted by 66 subjects. Our results evidence that people with high exposure to ACE experiment higher odds to present anxiety disorders, risk of suicide, or post-traumatic stress disorder, as well as increased cognitive empathy (i.e., fantasy dimension).

Conclusion
These findings allowed us to identify the influence of ACE on mental health outcomes beyond the conventional frame (victim or ex-combatant), and to discuss effective interventions and implementation of mental health strategies in these communities. We expect to help the health system to focus on key vulnerable subjects by including civilians not recognized as victims, which are neglected from most of the public health screening, assessment, and interventions.
Secretory expression of cyclohexanone monooxygenase by methylotrophic yeast for efficient omeprazole sulfide bio-oxidation
Authors: Li Ya-Jing , Zheng Yu-Cong , Geng Qiang , Liu Feng , Zhang Zhi-Jun , Xu Jian-He , Yu Hui-Lei 
Published: August 2021

AbstractProchiral pyrmetazole can be asymmetrically oxidized into (S)-omeprazole, a proton pump inhibitor that is used to treat gastroesophageal reflux, by an engineered cyclohexanone monooxygenase (CHMOAcineto-Mut) that has high stereoselectivity. CHMOAcineto-Mut is produced by heterologous expression in Escherichia coli, where it is expressed intracellularly. Thus, isolating this useful biocatalyst requires tedious cell disruption and subsequent purification, which hinders its use for industrial purposes. Here, we report the extracellular production of CHMOAcineto-Mut by a methylotrophic yeast, Pichia pastoris, for the first time. The recombinant CHMOAcineto-Mut expressed by P. pastoris showed a higher flavin occupation rate than that produced by E. coli, and this was accompanied by a 3.2-fold increase in catalytic efficiency. At a cell density of 150 g/L cell dry weight, we achieved a recombinant CHMOAcineto-Mut production rate of 1,700 U/L, representing approximately 85% of the total protein secreted into the fermentation broth. By directly employing the pH adjusted supernatant as a biocatalyst, we were able to almost completely transform 10 g/L of pyrmetazole into the corresponding (S)-sulfoxide, with  >  99% enantiomeric excess.