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lly protected by this H1N1 vaccine against a lethal H5 or H3 virus challenge. Our work demonstrates a new strategy for using a single influenza virus strain to induce broadly cross-reactive immune responses against different influenza virus subtypes. Copyright © 2020 Yan et al.Endoscopic ultrasonography (EUS) has been used since the mid-1980s. Initially a diagnostic tool, it has since evolved into a therapeutic, minimally invasive surgical tool with significant impact on the diagnosis and management of a range of benign and malignant conditions. The authors review current indications, safety, and efficacy of EUS for diseases of the upper and lower gastrointestinal tract, posterior mediastinum, pancreas, bile duct, gallbladder, retroperitoneum, liver, adrenal glands, and kidneys. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Eating disorders are common in adolescents and young adults, including those with a history of overweight or obesity, and are associated with numerous systemic sequelae. Understanding the differences in presentation between these patients and those who have a more classic anorexia nervosa phenotype is critical to ensuring timely recognition and treatment. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Megaloblastic anemia causes macrocytic anemia from ineffective red blood cell production and intramedullary hemolysis. The most common causes are folate (vitamin B9) deficiency and cobalamin (vitamin B12) deficiency. Megaloblastic anemia can be diagnosed based on characteristic morphologic and laboratory findings. However, other benign and neoplastic diseases need to be considered, particularly in severe cases. Therapy involves treating the underlying cause-eg, with vitamin supplementation in cases of deficiency, or with discontinuation of a suspected medication. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Community-acquired pneumonia significantly contributes to patient morbidity and healthcare costs. As our understanding of this common infection grows, collaborative efforts among researchers and clinical societies provide new literature and updated guidelines informing its management. This review discusses diagnostic methods, empiric treatment, and infection prevention strategies for patients with suspected community-acquired pneumonia. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Purpose An aging population, combined with increasing tooth retention, could significantly impact the dental care delivery system. VX-445 molecular weight The purpose of this study was to assess self-reported oral health and the factors associated with oral health outcomes among a random sample of older adults in Washington State.Methods A telephone survey of adults 55+ years was used to collect information on factors associated with oral health, plus four outcome variables; substantial tooth loss (6+ teeth lost), oral problems, oral pain, and poor health of teeth. Data were weighted to reflect the state's age and gender statistics.Results A total of 2,988 older adults completed the survey during 2017. Substantial tooth loss (18%), oral problems (17%) and oral pain (13%) were the most frequently reported issues. Of the adults with teeth, 17% reported fair/poor health of teeth. Compared to adults with an income of $75,000 or more, adults with an income less than $25,000 were twice as likely to have substantial tooth loss and oral problems (OR=2.1 and 2.2, respectively) and were three times more likely to report oral pain and poor health of teeth (OR=3.1 and 3.3, respectively). The oldest old (adults 75+ years), as compared to those 55-64 years, were significantly more likely to have substantial tooth loss (OR=2.6) but were less likely to report oral problems (OR=0.6), pain (OR=0.3), or poor health of teeth (OR=0.5).Conclusions Although the majority of Washington's older adults report having good oral health, a small subgroup has oral problems which may have a negative impact on quality of life. Copyright © 2020 The American Dental Hygienists’ Association.Purpose Education reflecting current knowledge is required for competent health care providers but the number of educators and/or lecture/clinical contact hours are often limited. The purpose of this study was to evaluate the learning outcomes and practicality of interactive simulation modules developed for a computerized learning system in dental hygiene education.Methods Twenty-nine Japanese fourth-year dental hygiene undergraduates were given access to five interactive modules, delivered via a learning management system (LMS), for one month. The modules provided virtual clinical settings to take learners through decision-making processes for explaining procedures and treatments, and making appointments in English. Pre- and post-tests and a questionnaire were used to evaluate the knowledge gained and to receive learner's feedback. Participants were classified into two groups (study group and non-study group), based on their use/non-use of modules made available during the five-week period for statistical analysis.Results Post-test scores were significantly higher in the study group (n = 22) than in the non-study group (n = 6), (p = 0.024). Post-test scores were also significantly higher than the pre-test scores in the study group (p = 0.001). No significant differences in the post- versus pre-test scores were found in the non-study group. The questionnaire response rate of 100% (n = 29) indicated that participants considered the interactive modules, including the system operation, as convenient and beneficial.Conclusion Modules made available via a LMS for self-study were beneficial for Japanese undergraduate dental hygiene students in the acquisition of knowledge and skills for clinical decision-making in English. Copyright © 2020 The American Dental Hygienists’ Association.Purpose Dental hygienists have increased opportunities as work-force models expand opportunities for the profession. The purpose of this study was to identify entry-level dental hygiene program directors' perceptions regarding advancing accreditation standards in dental hygiene education.Methods An electronic questionnaire was distributed via three mailings during the spring semester of 2019 to the 332 entry-level dental hygiene program directors across the United States for this exploratory, descriptive study. The survey instrument addressed the various dimensions related to changing the accreditation standard for the entry-level dental hygienists to the baccalaureate degree. Descriptive statistics and chi-square tests of association were used to analyze results.Results A total of 178 responses were received (n=178) for a response rate of 53.6%. Most program directors agreed students complete three years of college education (n=152, 85.4%), and should be educated to understand current and emerging workforce delivery models (n=166, 93.