Unmet Dental Care Need and Associated Barriers by Race/Ethnicity among US Adults

INTRODUCTION

Ability to access needed dental care may vary among population subgroups. We assessed 1) the differences in the proportions of adults who reported unmet dental care needs in the past 12 months and the associated barriers (structural, financial, and cognitive) in 2015 to 2016 versus 2003 to 2004 by race/ethnicity and 2) the subgroups that are more likely to report unmet dental care needs.

METHODS

Data of 10,029 respondents aged ≥19 y from the 2003-2004 and 2015-2016 National Health and Nutrition Examination Surveys were used. Chi-square tests assessed the differences in the proportions of adults who reported not getting the needed dental care between the periods. A multiple logistic regression model was run to identify characteristics that were significantly associated with unmet need after adjusting for other factors.

RESULTS

Overall, 19.4% of the adults reported an unmet dental care need in 2015 to 2016, as compared with 21% in 2003 to 2004. The overall unmet dental care need decreased only in the Hispanic groups (34% to 28%, P = 0.045) between 2003-2004 and 2015-2016. Between the periods, unmet need decreased among Hispanics aged 19 to 64 y (35% to 28%, P = 0.02), Hispanics with some college education or above (33.5% to 21.0%, P = 0.008), and nonpoor Hispanic adults (29.8% to 20.4%, P = 0.048). No significant differences were observed in the proportions of adults reporting structural (P = 0.09), financial (P = 0.86), or cognitive (P = 0.07) barriers between the periods. When compared with their counterparts, nonelderly adults, women, Hispanics, adults with a high school education, those with less than a high school education, and poor adults were significantly more likely to report unmet dental care needs.

CONCLUSIONS

Racial and ethnic disparities in accessing and receiving the needed dental care still exist. Financial barriers to dental care are the most commonly cited reasons for not getting the needed dental care.

KNOWLEDGE TRANSFER STATEMENT

The results of the study will inform policy makers, public health planners, and dental professionals about subgroups that still face difficulty in receiving the dental care they need. Policy makers should develop new policies to mitigate the financial barriers that are still prevalent. Dental professionals can mitigate the public's cognitive and financial barriers by educating the community through outreach programs and by providing services to low-income populations at reduced charges or through alternative payment plans.

Neuropsychiatric Symptoms and Risk Factors in Mild Cognitive Impairment: A Cohort Investigation of Elderly Patients

BACKGROUND

Neuropsychiatric symptoms (NPS) have been shown to affect the progression and development of Alzheimer's disease (AD) in the elderly. However, the published data are still controversial and limited in large cohort-based NPS study.

AIM

To explore the potential relationship between NPS and mild cognitive impairment (MCI) among the elderly of Chinese community.

METHODS

A total of 465 Chinese community-dwelling elderly (age ≥ 60 years) with mild cognitive impairment (MCI) were recruited into this investigation. At baseline, enrolled participants were assessed for Clinical Dementia Rating (CDR), mini-psychiatric examination. They were also subjected to categorical language fluency test, list learning and delayed recall. We assessed the NPS severity by Neuropsychological Inventory (NPI). The global cognitive status (GCS) of the participants at the end of the 3-year study period were measured with the CDR.

RESULTS

Approximately 41.6% of subjects had 1 or more NPS (total NPI score ≥ 1) at baseline. The most common NPSs were nocturnal behavior (20.8%), depression (17.3%), apathy (12.7%) and anxiety (13.2%). At the end of 3-year follow-up, 26.9% of baseline depressed patients developed AD, while 15.2% of baseline non-depressed patients developed AD (χ2 = 4.86, P=0. 04). Abnormal motor behavior was significantly correlated with cognitive deterioration as well (χ2 = 5.75, P=0. 03). Logistic regression analysis revealed that depression was considered as a risk factor for AD progression at baseline (95% CI: 1.12-5.67, OR=2.37, P=0.03).

CONCLUSIONS

Depression may be an independent factor representing early neurodegeneration in elder patients with MCI. Further studies are warranted to assess whether effective management of NPS promotes the cognitive functions.

Residual behavior and risk assessment of butralin in peanut fields

Butralin is widely used to control single-leaf weeds and some dicotyledons. The application of butralin in the environment may cause residue beyond regulation criteria and residual toxicity. Therefore, it is important to detect and supervise the dissipation behavior of butralin in edible raw food and in the environment. The aim of this study was to monitor butralin in peanuts and soil under farmland conditions and examine the likely dietary risk assessment of butralin for Chinese people on the basis of residual concentrations. A method for the analysis of butralin residue and its dissipation in peanut plants and soil under field conditions was investigated. The results show that an analytical method for the quantization of butralin in peanuts and soil utilizing gas chromatography with electron capture detection (GC-ECD) was developed. Standard recovery experiments using three different butralin spiking levels of 0.01, 0.1, and 1.0 mg kg^-1 in different samples (i.e., peanut kernels, shell, seedling, stalk, and soil) were conducted. The recoveries of butralin from all matrices ranged from 86 to 108% with relative standard deviations from 3 to 6% (n = 5). The limit of quantification (LOQ) of the method was 0.01 mg kg^-1. After storage at - 20 °C for 365 days, the degradation rate of residues of butralin in peanut kernels was less than 30%, which met the storage stability test criteria for pesticide residues in stored commodities of plant origin. The dissipation half-lives of butralin ranged from 4.2 to 6.6 days and 4.6 to 6.6 days in peanut seedlings and soil, respectively, in farmland ecosystems. At the normal harvest time, the final residue concentrations of butralin in peanuts and soil were all below the LOQ. The final total risk quotient (RQ) values were much lower than RQ = 100%, which indicated that the long-run fitness risk associated with butralin residue in different groups of registered crops is correspondingly low for people in China. The current research results could offer guidance for the rational use of butralin and provide data support for the building of maximum residue limits (MRLs) in China.

miR-186-5p targeting SIX1 inhibits cisplatin resistance in non-small-cell lung cancer cells (NSCLCs)

miR-186-5p has been reported to be implicated in tumorigenesis and paclitaxel resistance in non-small-cell lung cancer cells (NSCLCs). However, it remains undisclosed whether miR-186-5p takes a part in chemoresistance against diaminodichloroplatinum (cisplatin, DDP) in lung cancers, including NSCLC. Expression of miR-186-5p and sine oculis homeobox 1 (SIX1) was detected using RT-qPCR and western blot. In vitro, 50% inhibitory concentration (IC50) of DDP and cell proliferation were measured by MTT assay. The rate of apoptosis and abilities of migration and invasion were evaluated with flow cytometry and Transwell assay. The target binding between miR-186-5p and SIX1 was predicted on Diana tools software and confirmed by dual-luciferase reporter assay and RNA immunoprecipitation. In vivo experiments, xenogeneic transplantation was conducted to monitor the tumor growth. Expression of miR-186-5p was downregulated in DDP resistant NSCLC tissues and cells (A549/DDP and H1299/DDP). Functionally, miR-186-5p overexpression could inhibit cell proliferation, migration and invasion, and promoted apoptosis rate in A549/DDP and H1299/DDP cells. Mechanically, SIX1 was identified as a downstream target for miR-186-5p and was highly expressed in A549/DDP and H1299/DDP cells. Similarly, SIX1 knockdown could also suppress DDP resistant NSCLC cell proliferation, migration and invasion, and promote apoptosis rate, which was reversed by miR-186-5p downregulation. Moreover, xenograft tumors induced by A549/DDP cells exerted cisplatin resistance, and miR-186-5p overexpression could inhibit tumor growth under DDP treatment. In conclusion, upregulation of miR-186-5p suppresses cisplatin resistance in DDP resistant NSCLC cells both in vitro and in vivo presumably by targeting SIX1.

[Impact of oxidative stress on renal dopamine D(1) receptor dysfunction in offspring of diabetic rat dams]

Objective: To explore the effects of oxidative stress on renal dopamine D(1) receptor dysfunction in offspring of diabetic rat dams. Methods: The pregnant Sprague Dawley (SD) rats (n=10) were randomly divided into the diabetic group (a single intraperitoneal injection of 35 mg/kg streptozotocin on day 0 of gestation) and control group (injected with the equal volume of 0.9% saline on day 0 of gestation) according to the random number table (n=5 each group). The offspring rats were divided into 4 groups including offspring of control dams treated with vehicle, offspring of control dams treated with antioxidant, offspring of diabetic dams treated with vehicle and offspring of diabetic dams treated with antioxidant (n=10 each group). After birth, the offspring rats were treated with normal drinking water or antioxidant (tempol, 1.0 mmol/L) from the age of 4 weeks until the end of the study (20 weeks). The blood pressure was monitored continuously by non-invasive tail-cuff method. The renal oxidative markers including superoxide dismutase (SOD) and malondialdehyde (MDA) activity and D(1) receptor agonist (fenoldopam)-mediated urinary and sodium excretion were detected. Furthermore, the protein expression of renal G protein-coupled receptor kinase 2 (GRK2), GRK4, dopamine D(1) receptor and the phosphorylation level of D(1) receptor were detected. Results: The mean arterial pressure of offspring from the diabetic dams treated with vehicle was significantly higher than that of offspring from control dams treated with vehicle (P=0.013), while the mean arterial pressure of offspring from diabetic dams treated with antioxidant was significantly lower than that of offspring from the diabetic dams treated with vehicle (P=0.038). The fenoldopam-mediated urinary flow and urinary sodium excretion rate were significantly lower in offspring of diabetic dams treated with vehicle than those in offspring of control dams treated with vehicle (P<0.01), which were significantly higher in offspring of diabetic dams treated with antioxidant as compared to offspring of diabetic dams treated with vehicle (both P<0.01). There was no significant difference in fenoldopam-mediated urinary flow and urinary sodium excretion rate in offspring of control dams treated with antioxidant or vehicle (urinary flow: P=0.772; urinary sodium excretion rate: P=0.716). Compared with offspring of control dams treated with vehicle, the renal MDA activity was significantly increased, while the SOD activity was significantly decreased in offspring of diabetic dams treated with vehicle (MDA: P<0.01; SOD: P=0.013). The renal MDA activity was significantly decreased, while the SOD activity was significantly increased in offspring of diabetic dams treated with antioxidant in comparison with offspring of diabetic dams treated with vehicle (MDA: P<0.01; SOD: P=0.035).The renal GRK2 and GRK4 protein expression in offspring of diabetic dams treated with vehicle were significantly higher than those in offspring of control dams treated with vehicle (P<0.01), while the expression levels of renal GRK2 and GRK4 in offspring of diabetic dams treated with antioxidant were significantly downregulated compared with offspring of diabetic dams treated with vehicle (P<0.01). There was no significant difference in the protein expression of dopamine D(1) receptor among 4 groups (P=0.735). The level of dopamine D(1) receptor phosphorylation in offspring of diabetic dams treated with vehicle was significantly higher than that in offspring of control dams treated with vehicle (P<0.01), while the dopamine D(1) receptor phosphorylation level was significantly lower in offspring of diabetic dams treated with antioxidant compared to that in offspring of diabetic dams treated with vehicle (P<0.01). Conclusion: Oxidative stress is involved in the dopamine D(1) receptors dysfunction in the offspring of diabetic dams.

Bone mineral density from early to middle adulthood in persons with Down syndrome

BACKGROUND

While accelerated ageing is recognised among individuals with Down syndrome (DS), the trajectory of their bone health across adulthood remains poorly understood.

METHODS

This study aimed to determine the age-related loss of bone mineral density (BMD) of the lumbar spine in 128 adults with DS aged 18 to 54 years compared with 723 counterparts without DS.

RESULTS

Men and women with DS had lower level of BMD than counterparts without DS across age groups. Magnitude of decrement in BMD as reflected in the z-scores was similar between younger and older men with DS. Older women with DS, on the contrary, showed greater decrement in older ages especially in their fourth decade of life. Osteopenia and osteoporosis as defined using age-specific and gender-specific T-scores affected greater number of men with DS (38% and 25%) than women (17% and 17%) aged 40-49 years.

CONCLUSIONS

Findings supported adults with DS, especially men, to have early bone mineral testing.

[Clinical research progression of molecular-targeted drugs and PD-1 inhibitors for advanced hepatocellular carcinoma]

Since sorafenib has been first-line molecular-targeted drug for advanced hepatocellular carcinoma (HCC), clinical studies in the last 10 years failed to confirm that a new molecular-targeted drug or immune checkpoint inhibitor was superior or non-inferior to sorafenib, or approved second-line treatment for patients with the failure of sorafenib. However, many clinical studies published in 2017 have changed people's previous understanding. REFLECT trial showed that as the first-line treatment of advanced HCC, lenvatinib was non-inferior than sorafenib. In addition, RESORCE trial and CheckMate-040 trial confirmed respectively that regorafenib and PD-1 inhibitor nivolumab were options of second-line treatment for patients with advanced HCC after sorafenib treatment. The development of these drugs will bring a new prospect for advanced HCC patients.

Biochar as An Effective Material on Sediment Remediation for Polycyclic Aromatic Hydrocarbons Contamination

The mechanism of biochar as capping materials on polycyclic aromatic hydrocarbons (PAHs) removal in river sediments was investigated. When biochar was amended, pyrene was decreased through strengthened aging effects (1.6 times), which was attributed to high adsorption capacity of the biochar. While biochar did not alter the main microbial community, it provided a stable niche for PAHs degradation microorganisms, which attributed to the porosity and biological affinity of biochar. According to the results, biochar increased the opportunity for PAH-degraders to contact PAHs in sediments. When electron acceptors were available, the pyrene-degraders in biochar pore degraded the adsorbed pyrene rapidly (+103%). Therefore, biochar could be an effective material on PAHs removal in sediments.

A meta-analysis of the association between poultry and egg consumption and the risk of brain cancer

Poultry consumption, as well as egg consumption for brain cancer risk remains an important topic. The objective of this meta-analysis is to investigate the role of poultry and egg consumption for brain cancer risk. All articles about poultry and egg consumption for brain cancer were retrieved from PubMed, Web of knowledge and Wan Fang Med Online. The data was analyzed using Stata 12.0 software. Ten articles (6 articles for poultry and 5 articles for egg) were included. For poultry consumption, the summarized relative risk (RR) was 0.901 (95%CI= 0.703-1.154) for brain cancer risk, with high between-study heterogeneity (I2= 60.7%, P=0.018). Four studies reported the association between poultry consumption and glioma risk, yielding a RR of 0.873 (95%CI= 0.737-1.034, I2= 0.0%, P=0.838). The association between egg consumption and brain cancer risk was not significant (RR= 0.998, 95%CI= 0.552-1.805), with significant heterogeneity (I2= 82.6%, P&lt; 0.001). The pooled RR for glioma risk was 1.472 (95%CI= 0.935-2.316). In summary, our results concluded that poultry and egg consumption may be not associated with the risk of brain cancer. Due to the limited quality of evidence currently available, more studies related to poultry and egg consumption for brain cancer is necessary.

A meta-analysis of the association between poultry and egg consumption and the risk of brain cancer

Poultry consumption, as well as egg consumption for brain cancer risk remains an important topic. The objective of this meta-analysis is to investigate the role of poultry and egg consumption for brain cancer risk. All articles about poultry and egg consumption for brain cancer were retrieved from PubMed, Web of knowledge and Wan Fang Med Online. The data was analyzed using Stata 12.0 software. Ten articles (6 articles for poultry and 5 articles for egg) were included. For poultry consumption, the summarized relative risk (RR) was 0.901 (95%CI= 0.703-1.154) for brain cancer risk, with high between-study heterogeneity (I2= 60.7%, P=0.018). Four studies reported the association between poultry consumption and glioma risk, yielding a RR of 0.873 (95%CI= 0.737-1.034, I2= 0.0%, P=0.838). The association between egg consumption and brain cancer risk was not significant (RR= 0.998, 95%CI= 0.552-1.805), with significant heterogeneity (I2= 82.6%, P< 0.001). The pooled RR for glioma risk was 1.472 (95%CI= 0.935-2.316). In summary, our results concluded that poultry and egg consumption may be not associated with the risk of brain cancer. Due to the limited quality of evidence currently available, more studies related to poultry and egg consumption for brain cancer is necessary.

Genetic analysis of skinfold thickness and its association with body condition score and milk production traits in Chinese Holstein population

The skin has many important roles in dairy cattle, and skinfold thickness could be used as an indicator of body fat deposition. The objectives of this study were to estimate genetic parameters of skinfold thickness and to explore its association with body condition score (BCS) and milk production traits in a Chinese Holstein population. Skinfold thicknesses over the neck (STN) and the last rib (STR), BCS, and test-day records of milk production traits were available for 6,416 lactating Holstein cows in the summers of 2015 and 2016 in Beijing, China. Multi-trait animal models were used to estimate variance and covariance components using the DMU software. The average STN was 7.15 ± 1.28 mm, and the average STR was 11.76 ± 1.95 mm (mean ± standard deviation). Estimated heritability was 0.13 ± 0.03 for STN and 0.26 ± 0.04 for STR. We detected a high genetic correlation (0.79 ± 0.08; heritability ± standard error) between STN and STR. Genetic correlations between skinfold thickness and BCS were low to moderate: 0.18 between STR and BCS, and 0.33 between STN and BCS. Genetic correlations between skinfold thickness and milk yield, milk fat percentage, and milk protein percentage were negligible, ranging from -0.02 to 0.15. Collectively, skinfold thickness is characterized as a trait with moderate heritability. Skinfold thickness is sensitive to changes in body condition or fat deposition across parities and lactation stages in milking cows, and we confirmed the complementary nature of skinfold thickness and BCS genetically as well as phenotypically by comparing their changing trends throughout lactation and across lactations. The use of skinfold thickness, together with BCS, can assist in the monitoring of changes in body fat deposition to achieve higher management precision.

Boron carbide composites with highly aligned graphene nanoplatelets: light-weight and efficient electromagnetic interference shielding materials at high temperatures

B₄C-based ceramic composites containing 0-2 vol% highly aligned graphene nanoplatelets (GNPs) are fabricated. The electromagnetic interference (EMI) shielding properties of the obtained composites are investigated at X-band (8.2-12.4 GHz) frequency range from room-temperature up to 800 °C. All composites exhibit outstanding EMI shielding properties with satisfactory frequency- and thermal-stability. The shielding effectiveness (SE) of GNP/B₄C composites increases monotonically with increasing GNP loading. Superior room-temperature SE close to 40 dB is achieved with only 2 vol% GNPs and high SE around 35 dB still persists at 800 °C. Considering their relatively low density, GNP/B₄C composites possess a high specific shielding effectiveness (SSE) of 16 dB cm³ g^-1 which is among the highest values in reported ceramic-based shielding composites. Especially, the GNP/B₄C composite with 2 vol% GNPs exhibits the highest SSE/t (SSE divided by thickness) values at temperatures above 200 °C for all reported shielding composites, indicating that GNP/B₄C composites belong to the most promising high-temperature shielding composites. The excellent shielding properties of GNP/B₄C composites arise mainly from the high electrical conductivity, high dielectric loss and the multiple reflections by the highly aligned and large-sized GNP layers.

[Correlation between fetal borderline ventriculomegaly and chromosomal abnormalities]

Objective: To assess the association between fetal borderline ventriculomegaly (VM) diagnosed by prenatal ultrasound and chromosomal abnormality. Methods: Sonographic manifestation and chromosome of 129 cases with borderline VM diagnosed by prenatal sonography were analyzed retrospectively. All subjects were divided into 3 groups, 80 cases (62.0%, 80/129) in isolated VM (IVM) group, 27 cases (20.9%, 27/129) of VM with no additional structural abnormality group (including ultrasonic soft marker, abnormal volume of amniotic fluid and fetal growth restriction) and 22 cases (17.1%, 22/129) of VM with structural abnormality. Furthermore, the IVM group was sub-grouped according to fetal sex, lesion position and degree of expansion. The results of chromosome detection in different sub-group were analyzed statistically. Results: (1) Overall situation: in 129 enrolled cases of borderline VM, 8 cases of chromosomal abnormality were detected by CMA and the positive detection rate was 6.2% (8/129) , of which 2 cases were abnormal karyotype and 6 cases were pathologic copy number variation (p-CNV) . (2) The results of fetal chromosomal abnormalities detected in 3 groups: there were no case of abnormal karyotype and 4 cases of p-CNV in IVM group, the detection rate of chromosome abnormalities was 5.0% (4/80) . One case of abnormal karyotype and 2 cases of p-CNV in VM with no additional structural abnormality group, the detection rate was 11.1% (3/27) . One case of abnormal karyotype and no case of p-CNV in VM with structural abnormality group, the detection rate was 4.5% (1/22) . There were no significant difference among 3 groups (all P>0.05) . Conclusions: The risk of chromosomal abnormaliy increases in fetus with borderline VM. When the fetal VM is found by ultrasound, it is necessary to perform comprehensive scanning and regular follow-up. Fetal chromosomes examination is recommended.