RESUMO
Patient knowledge of risk factors, signs and symptoms associated with oral cancers is crucial for increasing the likelihood of patient presentation for opportunistic screening and reducing delay in patient appraisal for early detection. This study aimed to assess the knowledge of oral cancer and to ascertain socio-demographic factors that influence knowledge amongst adult dental patients attending public clinics in Brisbane, Australia. A convenience sample of 213 adult dental patients who attended the Herston and Stafford public health clinics in Brisbane, Australia, between July and August 2019 participated in the self-administered questionnaire. Multivariate analyses were performed to identify predictors for oral cancer knowledge. Patients were well informed of smoking as a risk factor (n = 135; 84.4%), whereas only 53.8% (n = 82) of participants agreed that heavy alcohol consumption was a risk factor. A larger proportion of participants identified difficulty of moving the tongue (n = 79; 49.4%) and pain on swallowing (n = 72; 45.0%) compared to the proportion who identified fixed red patches (n = 61; 38.1%) and fixed white patches (n = 57; 35.6%) as a sign or symptom. Education level and gender were significant knowledge predictors for alcohol (p = 0.01), old age (p = 0.008) and family history (p = 0.004) as a risk factors for oral cancer. Those with a family history of cancer were more likely to identify a red patch (p = 0.02), bleeding gums (p = 0.001) and altered sensation (p = 0.023) as a sign or symptom of oral cancer. Overall, patient knowledge was greater for risk factors than for signs and symptoms for oral cancer. Symptoms associated with later stages of cancer were recognised by a greater proportion of patients compared to early stages of oral cancer. These results indicate the need for targeted public health initiatives to improve patient knowledge.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Bucais , Adulto , Austrália , Humanos , Neoplasias Bucais/diagnóstico , Queensland , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
Biological nitrogen (N) fixation is an important source of N in terrestrial ecosystems, but the response of soil microbial N fixation rate to N deposition in different forest ecosystems still remains uncertain. We conducted a field N addition experiment to simulate atmosphere N deposition in subtropical Pinus taiwanensis and Castanopsis faberi forests. We set up three levels of nitrogen addition using urea as the N source: 0 (control), 40 (low N), and 80 g N·hm-2·a-1(high N) to examine the chemical properties, microbial biomass C, enzyme activities, and nifH gene copies of top soils (0-10 cm). We also measured the microbial N fixation rate using the 15N labeling method. Results showed that N addition significantly reduced the soil microbial N fixation rate in the P. taiwanensis and C. faberi forests by 29%-33% and 10%-18%, respectively. Nitrogen addition significantly reduced N-acquiring enzyme (i.e., ß-1, 4-N-acetylglucosaminidase) activity and nifH gene copies in both forest soils. There was a significant positive correlation between the microbial N fixation rate and soil dissolved organic C content in the P. taiwanensis forest, but a significant negative relationship between the rate of soil microbial nitrogen fixation and NH4+-N content in the C. faberi forest. Overall, soil microbial N fixation function in the P. taiwanensis forest was more sensitive to N addition than that in the C. faberi forest, and the factors affecting microbial N fixation varied between the two forest soils. The study could provide insights into the effects of N addition on biological N fixation in forest ecosystems, and a theoretical basis for forest management.
Assuntos
Florestas , Fixação de Nitrogênio , Nitrogênio , Pinus , Microbiologia do Solo , Nitrogênio/metabolismo , Nitrogênio/análise , Pinus/crescimento & desenvolvimento , Pinus/metabolismo , Solo/química , Fagaceae/crescimento & desenvolvimento , China , Clima TropicalRESUMO
OBJECTIVE: To compare the safety and nail placement accuracy of fluoroscopy-assisted and robot-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of single-space lumbar disc herniation. METHODS: The clinical data of 52 patients with single-space lumbar disc herniation treated by MIS-TLIF from March 2019 to February 2020 were retrospectively analyzed. Among them, 24 patients were treated by robot-assisted MIS-TLIF(group A) and 28 patients were treated by fluoroscopy-assisted MIS-TLIF (group B). The intraoperative blood loss, operation time, intraoperative fluoroscopy times, preoperative and postoperative visual analogue scale(VAS), Japanese Orthopaedic Association(JOA) scores and operation-related complications were recorded in two groups. Gertzbein-Robbins grade according to CT scan was used to evaluate the nail placement after operation. Grade A and B were evaluated as satisfactory nail placement, and grade C, D, and E were evaluated as error placement. Babu's method was used to evaluate the screw's invasion to the superior articular process. RESULTS: The operation time, intraoperative blood loss and intraoperative fluoroscopy times in group A were less than those in group B(P<0.05).VAS and JOA scores of all patients at the final follow-up were significantly improved compared with those before operation(P<0.05), but there was no statistically significant difference between the groups(P>0.05). There were 96 and 112 screws in group A and group B, respectively. Three days after operation, according to the Gertzbein-Robbins grade to evaluate the nail placement accuracy, there were 90 screws of grade A, 5 of grade B, 1 of grade C, no grade D and E in group A;there were 84 screws of grade A, 16 of grade B, 8 of grade C, 4 of grade D, no grade E in group B;the difference between two groups was statistically significant(Z=-3.709, P=0.000). The satisfactory rate of screw placement in group A was 98.96% (95/96), and that of group B was 89.29% (100/112), the difference between two groups was statistically significant (χ2=8.254, P=0.004). Three days after operation, the invasion of superior facet joints by pedicle screws was evaluated according to Babu's method, including 90 screws in grade 0, 4 in grade 1, 2 in grade 2, and 0 in grade 3 in group A;86 in grade 0, 12 in grade 1, 10 in grade 2 and 4 in grade 3 in group B, and the difference was statistically significant(Z=-3.433, P=0.001). There were no serious spinal cord, nerve and vascular injuries and other operation-related complications caused by screw implantation failure in both groups. All patients were followed up from 6 to 12(9.06±1.60) months. The neurological symptoms improved well after operation. During the follow-up period, there was no recurrence of symptoms, loosening or breakage of the internal fixation. CONCLUSION: Compared with the traditional fluoroscopy-assisted MIS-TLIF, the spinal robot-assisted MIS-TLIF not only has more minimally invasive and safer, but also has higher accuracy in nail placement, lower incidence of upper articular process invasion, and more accurate decompression targets, which can be used for minimally invasive treatment of single-space lumbar disc herniation.