Background: Colorectal cancer screening can detect colorectal cancer at an early stage and reduce mortality. None of the existing clinical practice guidelines provide specific recommendations for colorectal cancer screening in patients with Alzheimer’s disease and related dementias (ADRD). Limited studies have assessed the impacts of ADRD on colorectal cancer screening use and knowledge, and no studies have focused on the associated health disparities.Objectives: To examine the utilization, knowledge, and associated health disparities of colorectal cancer screening in older adults with ADRD.Methods: This study used the Medicare Current Beneficiary Survey from 2015 to 2018. Two types of colorectal cancer screening, including fecal occult blood test (FOBT) and colonoscopy/sigmoidoscopy, were measured. The colorectal cancer screening knowledge was evaluated by asking if the participants have heard of two screening methods and whether they knew Medicare pays for colorectal cancer screenings. Logistic regression models were used to examine the impact of ADRD diagnosis on the utilization and knowledge of colorectal cancer screening.Results: The overall colorectal cancer screening rate in older adults increased from 86.4% to 88.96% from 2015 to 2018. Patients with AD were 39% (OR: 0.61; 95% CI: 0.50–0.76) less likely and those with RD were 25% (OR: 0.75; 95% CI: 0.62–0.91) less likely to use any colorectal cancer screening when compared to older adults without ADRD. The rate of knowledge of colonoscopy/sigmoidoscopy remained high between 84.23% and 84.57% while the knowledge of FOBT increased from 64.32% to 78.69% during the study period. Compared to older adults without ADRD, those with AD were 77% (OR: 1.77; 95% CI: 1.12–2.81) more likely to hear of colonoscopy/sigmoidoscopy. The rate of knowledge of Medicare pay for colorectal cancer screening increased from 42.19% to 45.27% during the study period. Compared to older adults without ADRD, those with AD were 19% (OR: 0.81; 95% CI: 0.70–0.94) less likely to know that Medicare pays for colorectal cancer screening.Conclusion: ADRD was significantly associated with colorectal cancer screening utilization and knowledge. In addition, this study identified health disparities in race/ethnicity, gender, and urban/rural residence in colorectal cancer screening use and knowledge.

Introduction The aim of this retrospective study was to assess the clinical outcomes of cemented or uncemented total hip arthroplasty (CTHA or UTHA) following prior failed proximal femoral nail antirotation (PFNA) fixation in patients with intertrochanteric femur fractures (IFFs). Materials and methods Data from 244 patients with IFFs who experienced a conversion of PFNA to CTHA (n = 120) or to UTHA (n = 124) due to screw cut-out, mal/nonunion, or osteonecrosis during 2008-2018 were retrospectively analyzed. Follow-up occurred 1, 3, 6, and 12 months postoperatively and yearly thereafter. The primary outcome was the incidence of orthopedic complications; the secondary outcome was the Harris hip score (HHS). Results The median follow-up was 60 months (range, 50-67 months). The incidences of orthopedic complications were 10% in the PFNA to CTHA group and 19.3% in the PFNA to UTHA group (P = .040). Significant differences were also observed regarding the incidence of prosthesis revision (1.7% for PFNA to CTHA vs 7.2% for PFNA to UTHA, P = .036). From the three years after conversion surgery to the final follow-up, significant differences were detected in HHS between groups (each P < .05). At the final follow-up, a statistically significant difference was detected in the HHS (79.54±18.85 for PFNA to CTHA vs. 75.26±18.27 for PFNA to UTHA, P = .014). Conclusion The results of the study may demonstrate a significant statistical advantage with respect to the orthopedic complication rate and HHS in favor of CTHA compared to UTHA in patients with failed PFNA.

Objectives: Pharmacoeconomics evaluation (PE) is increasingly used in the healthcare decision-making process in China. Little is known about PE conducted in Chinese Herbal Medicines (CHMs). We aimed to systematically review trends, characteristics, and quality of PE of CHMS.Methods: We systematically searched both Chinese (CNKI, WanFang, and VIP) and English (Pubmed) databases. Studies were included if they were PE studies comparing both costs and outcomes between two or more interventions published in Chinese or English. Assessment of the quality of studies was conducted using the Quality of Health Economic Analyses (QHES) instrument. T-test and Chi-square tests were used to compare the studies before and after the first edition of China Guidelines for PE published in 2011, and between studies published in Chinese and English.Results: A total of 201 articles were included. There was an increasing trend of PE studies on CHMs during the study period. The top three studied diseases were central nervous system (CNS), mental, and behavioral disorders; cardiovascular diseases; and blood, immune and endocrine diseases. The average QHES score for the included studies was 63.37. Cost-effectiveness analysis (CEA) accounted for the majority (76.6%) of the included studies. Only a quarter of the articles (27.4%) were funded, and there were significantly more studies funded after the publication of China guidelines for PE. About 96.5% of studies did not specify evaluation perspectives and 89.6% of studies had a sample size of less than 300. Around half of the studies (55%) used incremental analysis, but only a few of them considered using a threshold. Half of the studies lacked sensitivity analysis. There was no significant improvement in the quality of studies published after the publication of China Guidelines for PE, and English articles had significantly higher quality than Chinese articles.Conclusion: This study identified several problems in PE studies on CHMs, including having small sample sizes, lacking necessary research elements, and using single evaluation methods. The quality of PE studies on CHMs was not sufficient. Researchers need to understand the standardized way to conduct PE studies and improve the quality and level of PE studies on CHMs.

Liver cancer is the main reason of cancer deaths globally, with an unfavorable prognosis. DNA methylation is one of the epigenetic modifications and maintains the right adjustment of gene expression and steady gene silencing. We aim to explore the novel signatures for prognosis by using DNA methylation-driven genes. To acquire the DNA methylation-driven genes, we perform the difference analysis from the gene expression data and DNA methylation data in TCGA or GEO databases. And we obtain the 31 DNA methylation-driven genes. Subsequently, consensus clustering analysis was utilized to identify the molecular subtypes based on the 31 DNA methylation-driven genes. So, two molecular subtypes were identified to perform those analyses: Survival, immune cell infiltration, and tumor mutation. Results showed that two subtypes were clustered with distinct prognoses, tumor-infiltrating immune cell and tumor mutation burden. Furthermore, the 31 DNA methylation-driven genes were applied to perform the survival analysis to select the 14 survival-related genes. Immediately, a five methylation-driven genes risk model was built, and the patients were divided into high and low-risk groups. The model was established with TCGA as the training cohort and GSE14520 as the validation cohort. According to the risk model, we perform the systematical analysis, including survival, clinical feature, immune cell infiltration, somatic mutation status, underlying mechanisms, and drug sensitivity. Results showed that the high and low groups possessed statistical significance. In addition, the ROC curve was utilized to measure the accuracy of the risk model. AUCs at 1-year, 3-years, and 5-years were respectively 0.770, 0.698, 0.676 in training cohort and 0.717, 0.649, 0.621 in validation cohort. Nomogram was used to provide a better prediction for patients’ survival. Risk score increase the accuracy of survival prediction in HCC patients. In conclusion, this study developed a novel risk model of five methylation-driven genes based on the comprehensive bioinformatics analysis, which accurately predicts the survival of HCC patients and reflects the immune and mutation features of HCC. This study provides novel insights for immunotherapy of HCC patients and promotes medical progress.

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