bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of a Traditional Practical-Based Identification for Microscopic Image Examination with a Microsoft PowerPoint Examination in the Influence of Dental and Medical Students’ Learning Outcome and Motivation in a Histology Laboratory Course at NDMC in Taiwan
Authors: Lan Hsin-Chieh , Cheng Chia-Pi , Chen Jang-Yi , Yin Fon-Yi , Chiang Ming-Hsien , Huang Shing-Hwa , Lin Gu-Jiun 
Published: August 2019

Abstract
Background: Histology laboratory courses are morphologic study in the structure of the cells, tissues, and organs of the body that are mainly examined with a microscope. There are two types of examinations to assess learning outcomes in Taiwan. The first is a traditional practical-based identification for microscopic image (PBIMI) examination, and the second is Microsoft PowerPoint (MS PPT) examination. Whether these two types of examinations exhibit different influences on students’ learning motivation has not been evaluated.
Methods: In this study, we compared the grades of dental students and medical students in the National Defense Medical Center who completed PBIMI or MS PPT examinations and investigated the influence of the type of examination on the students’ learning outcomes and motivation. We also conducted a survey among the medical students to confirm the hypothesis concluded from the grade analysis.
Results: There was a significant decrease in the percentage of students scoring 61 to 80 in the MS PPT group compared to that in the PBIMI group in the midterm examination of dental students. The average score on the MS PPT examination was significantly higher than that on the PBIMI examination among medical students who completing both examinations. The average failing scores on the midterm examination among the students tested with the PBIMI examination were significantly lower than the scores among the students tested with the MS PPT examination. The results of the survey also showed that the MS PPT examination is easier for students and that they will spend less time learning the material when the MS PPT examination is utilized for assessment.
Conclusion: This study suggests that the type of examination affects learning motivation in less self-demanding students. The MS PPT test is easier for the students and leads to less time spent studying for the histology laboratory course, especially among the students with fewer self-demands or less interest in the course.
Evolutionary history of two cryptic species of Northern African jerboas
Authors: Moutinho Ana Filipa , Serén Nina , Paupério Joana , Silva Teresa Luísa , Martínez-Freiría Fernando , Sotelo Graciela , Faria Rui , Mappes Tapio , Alves Paulo Célio , Brito José Carlos , Boratyński Zbyszek 
Published: August 2019

Abstract
Background

Complex paleo-climatic and geological events shape species distributions, thus affecting their evolutionary history. In Sahara-Sahel, climatic oscillations shifted the desert extent during the Pliocene-Pleistocene interval, triggering the diversification of several species. Here, we investigated how these biogeographical and ecological events have shaped patterns of genetic diversity and divergence in African Jerboas, desert specialist’s species. We focused on two closely-related and cryptic species, Jaculus jaculus and J. hirtipes, where we (1) evaluated their genetic differentiation, (2) reconstructed their evolutionary and demographic history; (3) tested the level of gene flow between them and (4) assessed their ecological niche divergence.

Results

The analyses based on 321 individuals sampled throughout North Africa, 8 sequence fragments (including one mitochondrial and seven single copy nuclear DNA), 6 microsatellite markers and ecological modelling revealed: (1) a deep genetic divergence between J. jaculus and J. hirtipes, despite their overlapping distribution, (2) low levels of gene flow and strong species delimitation, in agreement with their classification as different taxa, (3) high genetic diversity but no apparent geographic population structure within species, suggesting large-distance migration between remote locations, concordant with putative demographic expansions, and (4) low level of large-scale ecological divergence between the two taxa, suggesting species micro-habitat specialization.

Conclusions

Overall, our results suggest a speciation event during the Pliocene-Pleistocene transition followed by the colonization of most of the Northern Africa by both evolutionary units. The contemporary distribution of genetic variation might reflect an ongoing expansion, demonstrating the ability of these species for fast and long-range colonization. Despite the largely overlapping distribution at a macrogeographic scale, our genetic results suggest that the two species remain reproductively isolated with only negligible levels gene flow being observed. The overlapping ecological preferences at a macro-geographic scale and the ecological divergence at a micro-habitat scale suggest that local adaptation might have played a crucial role in the speciation process of these species.
The prevalence of undiagnosed age-related sight threatening diseases in self-proclaimed healthy individuals
Authors: Lemmens Sophie , Breda João Barbosa , Keer Karel Van , Jacobs Tine , Landeghem Ruben Van , De Boever Patrick , Stalmans Ingeborg 
Published: August 2019

Abstract
Background Age-related conditions such as glaucoma, age-related macular degeneration (AMD), diabetic retinopathy (DRP) and cataract have become the major cause of visual impairment and blindness in high-income countries and carry a major socio-economic burden. The aim of the current study is to investigate the prevalence of age-related eye diseases such as glaucoma, age-related macular degeneration, diabetic retinopathy and cataract in a cohort of self-proclaimed healthy elderly, and thus get a rough estimation of the prevalence of undiagnosed age-related eye conditions in the Belgian population.Methods Individuals aged 55 and older without ophthalmological complaints were asked to fill in a general medical questionnaire and underwent an ophthalmological examination, which included a biomicroscopic examination, intraocular pressure measurement, axial length measurement, and acquisition of fundus pictures and Optical Coherence Tomography scans. Information regarding follow-up was collected in the subset of participants who received the advice of referral to an ophthalmologist or the advice to have more frequent follow-up visits, based on the ophthalmological changes detected in their evaluation.Results The cohort included 102 people and comprised 46% men (median age 70 years, range 57-85 years). Referral for additional examinations based on clinical findings, was made in 26 participants (25%). The advice to have more regular follow-up ophthalmologist visits was given to nine additional participants (9%). No significant correlations between baseline characteristics, including eye care consumption, and the need for referral could be identified. Follow-up information was available for 25 out of 26 referred volunteers (96%). Out of these, four (16%) underwent a therapeutical intervention based on study referral, up until 18 months after study participation. All four interventions took place in the age group 65 - 74 years.Conclusions This study shows that even in an elderly population with self-proclaimed healthy eyes and good general health, a significant proportion of subjects showed ocular findings that need regular follow up and/or intervention. Moreover, the frequency of prior ophthalmological examinations does not seem to be relevant to this proportion, meaning that everyone above 55 years old needs a routine ophthalmological evaluation.
Evaluation of ultrasound-guided Freka-Trelumina enteral nutrition tube placement in the treatment of acute pancreatitis
Authors: Liu Zhijun , Guo Jintao , Ren Weidong , Tang Shaoshan , Huang Ying , Huang Liping , Sun Siyu , Lin Lianjie 
Published: August 2019

Abstract
Background Enteral nutrition should be implemented as early as possible in patients with moderate or severe acute pancreatitis. This study was designed to evaluate the feasibility and effectiveness of ultrasound-guided Freka-Trelumina tube placement for enteral nutrition in acute pancreatitis.Methods Patients with severe acute pancreatitis admitted to Shengjing Hospital of China Medical University who needed Freka-Trelumina tube placement for enteral nutrition and gastrointestinal decompression were included in the current study. The relevant evaluation indicators of tube placement include the success rate of tube placement, tube placement time, tube shift rate, and blocking rate. In addition, the evaluation indicators of ultrasound-guided tube placement (from 1 January 2018 to 31 July 2019) was compared with those of previously endoscope-guided placement (from 1 January 2015 to 31 December 2017) by analysed the data from electronic medical record system.Results The success rate of ultrasound-guided tube placement was 90.7% (49/54). All 49 patients tolerated the Freka-Trelumina feeding tube. The average ultrasound-guided tube placement time for the 49 patients was 18.4 ± 12.8 min (range, 5-36 min). The Freka-Trelumina feeding tube had a shift rate of 10.2% (5/49). The blocking rate of the Freka-Trelumina feeding tube was 12.2% (6/49). The success rate of tube placement, tube shift rate and blocking rate for the endoscope-guided tube placement were 100% (62/62), 11.3% (7/62), 12.9% (8/62). The average endoscope-guided tube placement time for the 62 patients was 16.5 ± 5.7 min (range, 12-31 min).Conclusion The ultrasound-guided method can be operated non-invasively at the bedside, which is safe and convenient, and place the Freka-Trelumina feeding tube in time to achieve the goal of early enteral nutrition and gastrointestinal decompression.
Outcomes evaluation after application of multidisciplinary protocol of shared hospital care in patients aged 65 years and older and operated for hip fracture
Authors: Marín Jorge Salvador , Martínez Francisco Javier Ferrández , Ripoll José Miguel Seguí , Rico José Antonio Quesada , Beltrán Domingo Orozco , Carratala-Munuera Concepcion , López José Fernando Martínez , Campos Juan Carlos Marzo 
Published: August 2019

Abstract
Purpose

In geriatric patients, hip fracture is considered the greatest complication of osteoporosis in terms of morbidity, mortality, and cost. The aim of this study is to assess the effects of a multidisciplinary shared care protocol (trauma services, internal medicine, emergencies, anesthesia, nursing, hematology, pharmacy, rehabilitation, home hospitalization unit, and social services) on hospital stay and in-hospital mortality in inpatients aged 65 years or older and operated for hip fracture.

Methods

Retrospective cohort study between January 2011 and December 2017. The unexposed group was made up of patients who did not receive care according to the multidisciplinary protocol, while the exposed group did. We excluded patients with polytrauma, conservative treatment, bilateral hip fracture, pathological fracture, or previous fracture already included in the series. Variables analyzed were demographic data, medical comorbidities, Charlson index, hemoglobin levels, hematocrit and blood transfusion, antiplatelet drugs, length of surgical delay, length of hospital stay, in-hospital mortality, and a composite risk outcome considering in-hospital mortality and/or hospital stay of more than 10 days. We fit a multivariable logistic regression model to calculate the odds ratio (OR) of experiencing outcomes.

Results

The cohort included 681 patients: 310 were unexposed and 371, exposed. Compared to the unexposed group, patients receiving protocolized multidisciplinary care showed significantly lower in-hospital mortality (3.5% versus 7.7%; p = 0.015) and were less likely to have a hospital stay of more than 10 (16.4% versus 24.2%; p = 0.012). Mean length of hospital stay was 0.7 fewer days in the exposed group. Multivariable analysis showed the composite risk outcome was 51% lower in the exposed group, after adjusting for age, sex, heart failure, days to surgery, blood transfusion after surgery, and postoperative hemoglobin levels.

Conclusion

Implementing the multidisciplinary shared care protocol halved the risk of in-hospital mortality and/or a hospital admission of more than 10 days in patients over 65 years with proximal femur fracture. It also reduced mean length of hospital stay.
Is Romosozumab better than Teriparatide for the treatment of osteoporosis? A meta-analysis through a grade analysis of evidence
Authors: Liu Zhao-hui , Ma Jian-xiong , Sun Xiao-lei , Zhang Shun , Kuang Ming-jie , Ma Xin-long 
Published: August 2019

Abstract
Background

Osteoporosis is a common systemic skeletal disease. With an ageing population, the socioeconomic effect of osteoporosis will remarkably improve. Romosozumab (EVENITYTM) is a new osteoanabolic drug, which is a humanised monoclonal antibody against sclerostin, and received its first global approval for the treatment of osteoporosis in patients at high risk of fracture in Japan on January 8, 2019. Teriparatide is the first osteoanabolic drug. However, there is no comprehensive analysis and systematic review about the efficacy and safety of the two treatment.

Method

Randomized controlled trials (RCTs) about our analysis were searched from electronic database, including Pubmed (1996 to June 2019), Embase (1980 to June 2019), Cochrane Library (CENTRAL, June 2019), Web of Science (1998 to June 2019) and others. Four studies were included in our meta-analysis.

Results

Four studies containing 1304 patients meet our selection criteria. Our result of analysis indicated that Romosozumab showed better effects in improving BMD of lumbar spine (month 6: MD=3.54, 95% CI [3.13, 3.94], P<0.00001; month 12: MD=4.93, 95% CI [4.21, 5.64], P<0.00001), total hip (month 6: MD=2.27, 95% CI [0.62, 3.91], P=0.007; month 12: MD=3.17, 95% CI [2.68, 3.65], P<0.00001) and femoral neck (month 6: MD=2.30, 95% CI [0.51, 4.08], P=0.01; month 12: MD=3.04, 95% CI [2.29, 3.78], P<0.00001). And the injection-site reaction was fewer (month 12: RR=2.84, 95% CI [1.22, 6.59], P=0.02).But there were no significant differences in the incidence of serious adverse events (month 12: RR=0.78, 95% CI [0.46, 1.33], P=0.37), and death (month 12: RR=0.61, 95% CI [0.08, 4.62], P=0.63).

Conclusion

Based on the available studies, our current results demonstrated that Romosozumab was better than Teriparatide both in terms of efficacy and side effects.
Validation of the Clinical Frailty Score (CFS) in French language
Authors: ABRAHAM PAUL , COURVOISIER Delphine S. , ANNWEILER Cedric , LENOIR Cliff , MILLIEN Thomas , DALMAZ Francoise , FLATTEN Hans , MORENO Rui , CHRISTENSEN Steffen , GUIDET Bertrand , Bendjelid Karim , WALDER Bernhard , PINTO Bernardo BOLLEN 
Published: August 2019

Abstract
Background
The number of elderly patients admitted to the ICU is increasing. To better understand the magnitude of the challenges involved in intensive care practice for this ageing population and discuss a rational allocation of resources (admission, triage and level of care), healthcare practitioners need a reliable evaluation of frailty. In order to promote the adequate use of the clinical frailty Scale (CFS) in French-speaking countries, we aimed to develop, validate and characterise a French (FR) version from the original English (EN) CFS.

Methods
Translation and back translation method was used to developed and validate a FR version for CFS. Then every patient was assessed by a Doctor a Nurse with another evaluation being perform to evaluate intra inter operator variabilities; We then estimate and compared psychometric properties of the CFS both in FR and EN.

Results
Inter-rater reliability was 0.87 (95%CI: 0.76-0.93) between doctors for the original CFS-EN version and 0.76 (95%CI: 0.57-0.87) between nurses for the FR version. Inter-rater variability between doctor and nurse was 0.75 (95%CI: 0.56-0.87) for the original version, and 0.73 (95%CI: 0.52-0.85) for the FR version.
Test-retest (stability) with the original vs the FR version was 0.86 (95%CI: 0.72-0.93) for doctors and 0.87 (95%CI: 0.76-0.93) for nurses.
Differences between the evaluations of the CFS-EN and CSF-FR were not different from 0, with a mean difference of 0.06 (95%CI -0.24, 0.36) for the EN version and -0.03 (95%CI -0.47, 0.41) for the FR version. Agreement between the FR and the EN version for doctors was similar. Average original version ratings were slightly lower than FR version ratings, though this difference did not reach significance: -0.29 (95%CI -0.54, 0.04).

Conclusion
The CFS-FR version developed and validated in the present study has adequate psychometric properties for doctors or nurses to evaluate frailty in very old intensive care patients.
Prevalence and Associated Factors for Frailty among Elder Patients in China: A multicenter cross-sectional study
Authors: Jiao Jing , Wang Yu , Zhu Chen , Li Fangfang , Zhu Minglei , Wen Xianxiu , Jin Jingfen , Wang Hui , Lu Dongmei , Zhao Shengxiu , Wu Xinjuan , Xu Tao 
Published: August 2019

Abstract
Background: Up to date, most of previous studies of frailty among hospitalized elder Chinese patients were conducted based on a small sample, which could not represent the elder patient population. The aim of this study is to identify the prevalence and the risk factors for frailty among elder patients in China.
Study Design and Setting: This is a cross-sectional study, 9996 elder patients from 6 tertiary level hospitals in China were surveyed. The prevalence of frailty among patients from selected wards was surveyed by trained investigators. Mixed-effect Poisson regression model were used to analyze the associated factors of frailty among elder patients.
Results:
The mean age of all subjects was72.47±5.77years. The prevalence rate of frailty in this study was 18.02%. After controlling the confounding effect of hospital wards clustering effect, Mixed-effect Poisson regression model showed that the associated factors of frailty included: age(OR:1.016, 95% CI:1.012 -1.020), patients with BMI < 18.5(OR: 1.248, 95% CI:1.171-1.330), female(OR:1.058, 95% CI:1.004 -1.115), ethnic minorities(OR: 1.152, 95% CI: 1.073-1.236), admission to hospital by the emergency department(OR: 1.104, 95% CI:1.030 -1.184),the former drinker(OR: 1.094, 95% CI:1.022 -1.171),fall history in past 12 month(OR:1.257, 95%CI:1.194-1.323),vision dysfunction(OR:1.144 , 95% CI:1.080 -1.211),cognition impairment(OR:1.182 , 95% CI:1.130 -1.237),sleeping dysfunction(OR:1.215, 95% CI:1.215 -1.318),urinary dysfunction(OR: 1.175, 95% CI:1.104 -1.251),defecation dysfunction(OR:1.286 , 95% CI:1.217 -1.358).
Conclusion: We identified a relatively high prevalence of frailty among elder patients, and there are several associate factors among the population derived from an investigation of a large-scale, multicenter, nationwide representative Chinese elderly inpatient population.
Trial registration: Chinese clinical Trial registry, ChiCTR1800017682, Registered 09 August 2018
Keywords: Frailty; Elder patients; Prevalence; Associate factors
Effect of Continuation of Antiplatelet Therapy on Survival in Patients Receiving Physician Home Visits
Authors: Osugi Yasuhiro , Ino Teruo , Kobayashi Daiki , Iwata Mitzunaga , Asai Kanici 
Published: August 2019

Abstract
Background

Little is known about the effects of continued antiplatelet therapy in patients who receive physician home visits. This study aimed to evaluate the association of survival with the continuation of antiplatelet drugs in patients who received physician home visits.

Methods

A retrospective cohort study was conducted in a teaching hospital in Toyota, Japan, from April 2015 to October 2018. All patients who received home visits by physicians from the department of Family Medicine of the hospital were included. The primary outcome was the difference in all-cause mortality between patients who were taking antiplatelet drugs and those who were not. The Cox proportional hazards model was applied, adjusted for the patient’s demographic features, activities of daily living, comorbidities, and primary disease requiring home care.

Results

A total of 833 patients were included, of whom 61 received antiplatelet drugs (n = 42 for aspirin, n = 17 for clopidogrel, and n = 8 for cilostazol) and 772 received no antiplatelet drugs. The mean age of the patients was 78.3 years, 409 (49.1%) were male, and 314 (37.7%) had end-stage cancer. During a median follow-up period of 120 days (interquartile range, 29–364), 54.3% of the patients died. Compared with patients not taking antiplatelet drugs, patients taking antiplatelet drugs had a better outcome (p < 0.01, log-rank test) and a significantly lower hazard ratio (0.34; 95% confidence interval, 0.17–0.65; Cox proportional hazards regression).

Conclusions

The continuous prescription of antiplatelet drugs may have beneficial effects on mortality among patients who receive physician home visits.
A model for predicting carotid instability plaque in high risk group of stroke individuals
Authors: Yin Junxiong , Yu Chuanyong , Liu Hongxing , Du Mingyang , Sun Feng , Yu Cheng , Wei Lixia , Wang Chongjun , Wang Xiaoshan 
Published: August 2019

Abstract
Objective: To establish a predictive model of carotid vulnerable plaque through systematic screening of high-risk population for stroke.Patients and methods: All community residents who participated in the screening of stroke high-risk population by the China National Stroke Screening and Prevention Project (CNSSPP). A total of 19 risk factors were analyzed. Individuals were randomly divided into Derivation Set group and Validation Set group. According to carotid ultrasonography, the derivation set group patients were divided into instability plaque group and non-instability plaque group. Univariate and multivariable logistic regression were taken for risk factors. A predictive model scoring system were established by the coefficient. The AUC value of both derivation and validation set group were used to verify the effectiveness of the model.Results: A total of 2841 high-risk stroke patients were enrolled in this study, 266 (9.4%) patients were found instability plaque. According to the results of Doppler ultrasound, Derivation Set group were divided into instability plaque group (174 cases) and non-instability plaque group (1720 cases). The independent risk factors for carotid instability plaque were: male (OR 1.966, 95%CI 1.406-2.749)，older age (50-59, OR 6.012, 95%CI 1.410-25.629; 60-69, OR 13.915, 95%CI 3.381-57.267;≥70, OR 31.267, 95%CI 7.472-130.83) , married(OR 1.780, 95%CI 1.186-2.672)，LDL-c(OR 2.015, 95%CI 1.443-2.814), and HDL-C(OR 2.130, 95%CI 1.360-3.338). A predictive scoring system was created, range 0-10. The cut-off value of prediction model score is 6.5. The AUC value of derivation and validation set group were 0.738 and 0.737.Conclusion：For a high risk group of stroke individual, We provide a model that could distinguishing those who have a high probability of having carotid instability plaque. When resident’s predictive model score exceeds 6.5, the incidence of carotid instability plaque is high, carotid artery Doppler ultrasound would be checked immediately. This model can be helpful in the primary prevention of stroke.