bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrative Medicine in General Practice in Australia: A Mixed-Methods Study Exploring Education Pathways and Training Needs
Authors: Ee Carolyn , Templeman Kate , Forth Amy , Kotsirilos Vicki , Singleton Gillian , Deed Gary , Dubois Shamieka , Pirotta Marie , Harnett Joanna , Myers Stephen , Hunter Jennifer 
Published: August 2021

Background Globally, a substantial proportion of general practitioners (GPs) incorporate integrative medicine (IM) into their clinical practice. Objective This study aimed to map the IM education and training pathways and needs of a cohort of Australian GPs who are members of the Royal Australian College of General Practitioners’ IM Specific Interest Network, which is a group of GPs with interest in IM. Methods We conducted a mixed-methods study comprising of an online, cross-sectional survey supplemented with in-depth semi-structured interviews. Data from the survey and interviews were initially analysed separately and then combined. Results Eighty-three (83) of 505 eligible GPs/GPs in training (16.4%) participated in the survey, and 15 GPs were interviewed. Results from the two datasets either converged or were complementary. Almost half (47%) of survey respondents had undertaken formal undergraduate or postgraduate IM education, a short course (63%), informal education (71%) or self-education (54%), in at least one of 20 IM modalities listed. Interviewees affirmed there was no single education pathway in IM. Survey respondents who identified as practicing IM were significantly more likely to have IM education, positive attitudes towards IM, particularly natural products, and higher self-rated IM knowledge and competencies. However, knowledge gaps were identified in professional skills domains of population health and context, and organisational and legal dimensions of applied IM practice. Interviewees also highlighted a range of professional and systemic barriers to the practice of IM, education, and training. There was broad support for recognition of IM as a sub-specialty through formalised post-graduate training and accreditation. Most survey respondents (62%) expressed interest in post-fellowship recognition of GPs with advanced skills in IM. Conclusion Our findings demonstrate that it is important to define best practice in IM for GPs in Australia and provide a standardised pathway towards recognition of advanced skills in IM.
Comparison of Pelvis and Trunk Kinematics Between Youth and Collegiate Windmill Softball Pitchers
Authors: Wasserberger Kyle W. , Friesen Kenzie B. , Downs Jessica L. , Bordelon Nicole M. , Oliver Gretchen D. 
Published: August 2021

Background: The windmill softball pitch is a dynamic sporting movement that places softball pitchers at high risk of injury. Unlike baseball, there is limited research into the mechanical differences between softball pitchers of varying skill levels. Purpose/Hypothesis: The purpose of this study was to compare pelvis and trunk kinematics between youth and collegiate softball pitchers. It was hypothesized that there would be significant differences in pelvis and trunk kinematics between these 2 groups. Study Design: Descriptive laboratory study. Methods: The pelvic and trunk kinematics of 90 softball pitchers were collected during full-effort pitching using a 3-dimensional motion capture system. Participants were grouped based on their age at the time of data collection (35 youth [mean age, 11 ± 1 years]; 55 collegiate [mean age, 20 ± 2 years]). We compared between-group differences in pelvic posterior tilt, lateral tilt, axial rotation, and axial rotation velocity as well as trunk extension, lateral flexion, axial rotation, and axial rotation velocity during the pitching phase between start of pitch and ball release (BR) using 1-dimensional statistical parametric mapping. Statistical significance was determined using Holmes-Šidák stepdown correction–adjusted P values ( P ′). Results: Compared with youth pitchers, collegiate pitchers exhibited a more posteriorly tilted pelvis from the moment of start of pitch until 94% of the way between start of pitch and BR ( P ′ = .002) and a more laterally flexed trunk toward the glove side from the moment of start of pitch until 71% of the way between start of pitch and BR ( P ′ = .010). Conclusion: Collegiate pitchers displayed a more posteriorly tilted pelvis and more laterally flexed trunk toward the glove side during the windmill pitching motion when compared with youth pitchers. Clinical Relevance: These findings add to the growing body of softball research and help elucidate mechanical differences between youth and collegiate softball pitchers.
Management of Suprachoroidal Hemorrhage in a Patient With Boston Type I Keratoprosthesis
Authors: Wagley Sushant , Brandner Dieter D. , Hou Joshua H. , Montezuma Sandra R. 
Published: August 2021

Purpose: Suprachoroidal hemorrhage (SCH) is a rare but vision-threatening complication in patients with keratoprosthesis devices (KPro), particularly in the setting of concurrent glaucoma tube shunts. Although there are many approaches to draining an SCH, surgery can be especially challenging in these patients because a crowded anterior chamber, and frequent anterior extension of the SCH. Methods: A case report is discussed. Results: We describe a novel approach to surgical drainage of SCH in a 64-year-old monocular patient with a Type I Boston KPro, an Ahmed valve, and aphakia. Conclusion: Successful repair of appositional SCH in the context of KPro can be safely and effectively achieved by injecting viscoelastic through the backplate holes of the KPro, thereby providing internal tamponade within the vitreous compartment while liquefied hemorrhage is drained by sclerotomy.
Tildrakizumab Inadequate Responders Switching to an Alternative IL-23 Inhibitor: A Case Series
Authors: Song Eingun James , Wong Audrey Jia Shin 
Published: August 2021

Background: Biologic switching is not uncommon in the treatment of psoriasis and is most often due to inadequate response of adverse events. Staying within or switching out of the class is still based on expert opinion but there are published data on intra-class switching with TNF-alpha and IL-17 inhibitors. Less is known about the IL-23 inhibitors because of their limited time in the market. We would like to present our experience with inadequate responders to tildrakizumab, a selective IL23 inhibitor, who were switched to an alternative IL-23 inhibitor. Case Description: This is a case series of 6 patients at a single institution considered inadequate responders to tildrakizumab, which included primary failures, secondary failures, and intermediate responders, who were subsequently switched to another IL-23 inhibitor. Conclusion: All 6 patients who were inadequate responders to tildrakizumab showed significant improvement after switching to another IL-23 inhibitor, with 5/6 reaching IGA 0/1 after 16 weeks of treatment.
Genotypes of European and Iranian patients with type 3 von Willebrand disease enrolled in 3WINTERS-IPS
Authors: Baronciani Luciano , Peake Ian , Schneppenheim Reinhard , Goodeve Anne , Ahmadinejad Minoo , Badiee Zahra , Baghaipour Mohammad-Reza , Benitez Olga , Bodó Imre , Budde Ulrich , Cairo Andrea , Castaman Giancarlo , Eshghi Peyman , Goudemand Jenny , Hassenpflug Wolf , Hoorfar Hamid , Karimi Mehran , Keikhaei Bijan , Lassila Riitta , Leebeek Frank W. G. , Lopez Fernandez Maria Fernanda , Mannucci Pier Mannuccio , Marino Renato , Nikšić Nikolas , Oyen Florian , Santoro Cristina , Tiede Andreas , Toogeh Gholamreza , Tosetto Alberto , Trossaert Marc , Zetterberg Eva M. K. , Eikenboom Jeroen , Federici Augusto B. , Peyvandi Flora 
Published: August 2021

Abstract
Type 3 von Willebrand disease (VWD3) is a rare and severe bleeding disorder characterized by often undetectable von Willebrand factor (VWF) plasma levels, a recessive inheritance pattern, and heterogeneous genotype. The objective of this study was to identify the VWF defects in 265 European and Iranian patients with VWD3 enrolled in 3WINTERS-IPS (Type 3 Von Willebrand International Registries Inhibitor Prospective Study). All analyses were performed in centralized laboratories. The VWF genotype was studied in 231 patients with available DNA (121 [115 families] from Europe [EU], and 110 [91 families] from Iran [IR]). Among 206 unrelated patients, 134 were homozygous (EU/IR = 57/77) and 50 were compound heterozygous (EU/IR = 43/7) for VWF variants. In 22 patients, no or only one variant was found. A total of 154 different VWF variants (EU/IR = 101/58 [5 shared]) were identified among the 379 affected alleles (EU/IR = 210/169), of which 48 (EU/IR = 18/30) were novel. The variants p.Arg1659*, p.Arg1853*, p.Arg2535*, p.Cys275Ser, and delEx1_Ex5 were found in both European and Iranian VWD3 patients. Sixty variants were identified only in a single allele (EU/IR = 50/10), whereas 18 were recurrent (≥3 patients) within 144 affected alleles. Nine large deletions and one large insertion were found. Although most variants predicted null alleles, 21% of patients carried at least 1 missense variant. VWD3 genotype was more heterogeneous in the European population than in the Iranian population, with nearly twice as many different variants. A higher number of novel variants were found in the Iranian VWD3 patients.
Anti-inflammatory effect of essential oil extracted from Pinus densiflora (Sieb. et Zucc.) wood on RBL-2H3 cells
Authors: Yang Jiyoon , Choi Won-Sil , Jeung Eui-Bae , Kim Ki-Joong , Park Mi-Jin 
Published: August 2021

AbstractThe aim of this study is to identify the active compounds of the essential oil extracted from the Pinus densiflora (Sieb. et Zucc.) wood using the hydrodistillation method and evaluate their anti-inflammatory activity. The chemical composition of the oil was identified by GC–MS analysis, and its anti-inflammatory activity was assessed by investigating its effect on the expression of interleukin-4 (IL-4), interleukin-13 (IL-13), and β-hexosaminidase in lipopolysaccharide (LPS)-stimulated RBL-2H3 cells. Treatment of the LPS-stimulated RBL-2H3 cells with the oil and its fractions downregulated the production of pro-inflammatory cytokines such as IL-4 and IL-13 and further attenuated the secretion of β-hexosaminidase out of the cells to a significant level. Among the five obtained fractions, fraction E exhibited the best anti-inflammatory activity, and its main constituent, longifolene, was considered as the active compound. Moreover, the inhibitory effect of longifolene on the expression levels of IL-4 and IL-13 and the β-hexosaminidase secretion was similar to that of the P. densiflora wood oil, indicating longifolene as the active constituent of the P. densiflora wood oil with immunosuppressive effects on inflammation.
The transcriptomic blueprint of molt in rooster using various tissues from Ginkkoridak (Korean long-tailed chicken)
Authors: Charton Clémentine , Youm Dong-Jae , Ko Byung June , Seol Donghyeok , Kim Bongsang , Chai Han-Ha , Lim Dajeong , Kim Heebal 
Published: August 2021

AbstractBackgroundAnnual molt is a critical stage in the life cycle of birds. Although the most extensively documented aspects of molt are the renewing of plumage and the remodeling of the reproductive tract in laying hens, in chicken, molt deeply affects various tissues and physiological functions. However, with exception of the reproductive tract, the effect of molt on gene expression across the tissues known to be affected by molt has to date never been investigated. The present study aimed to decipher the transcriptomic effects of molt in Ginkkoridak, a Korean long-tailed chicken. Messenger RNA data available across 24 types of tissue samples (9 males) and a combination of mRNA and miRNA data on 10 males and 10 females blood were used.ResultsThe impact of molt on gene expression and gene transcript usage appeared to vary substantially across tissues types in terms of histological entities or physiological functions particularly related to nervous system. Blood was the tissue most affected by molt in terms of differentially expressed genes in both sexes, closely followed by meninges, bone marrow and heart. The effect of molt in blood appeared to differ between males and females, with a more than fivefold difference in the number of down-regulated genes between both sexes. The blueprint of molt in roosters appeared to be specific to tissues or group of tissues, with relatively few genes replicating extensively across tissues, excepted for the spliceosome genes (U1,U4)and the ribosomal proteins (RPL21,RPL23). By integrating miRNA and mRNA data, when chickens molt, potential roles of miRNA were discovered such as regulation of neurogenesis, regulation of immunity and development of various organs. Furthermore, reliable candidate biomarkers of molt were found, which are related to cell dynamics, nervous system or immunity, processes or functions that have been shown to be extensively modulated in response to molt.ConclusionsOur results provide a comprehensive description at the scale of the whole organism deciphering the effects of molt on the transcriptome in chicken. Also, the conclusion of this study can be used as a valuable resource in transcriptome analyses of chicken in the future and provide new insights related to molt.
Hemodynamic, renal and hormonal effects of lung protective ventilation during robot-assisted radical prostatectomy, analysis of secondary outcomes from a randomized controlled trial
Authors: Høyer Sidse , Mose Frank H. , Ekeløf Peter , Jensen Jørgen B. , Bech Jesper N. 
Published: August 2021

Abstract
Background
Lung protective ventilation with low tidal volume (TV) and increased positive end-expiratory pressure (PEEP) can have unfavorable effects on the cardiovascular system. We aimed to investigate whether lung protective ventilation has adverse impact on hemodynamic, renal and hormonal variables.

Methods
In this randomized, single-blinded, placebo-controlled study, 24 patients scheduled for robot-assisted radical prostatectomy were included. Patients were equally randomized to receive either ventilation with a TV of 6 ml/IBW and PEEP of 10 cm H2O (LTV-h.PEEP) or ventilation with a TV of 10 ml/IBW and PEEP of 4 cm H2O (HTV-l.PEEP). Before, during and after surgery, hemodynamic variables were measured, and blood and urine samples were collected. Blood samples were analyzed for plasma concentrations of electrolytes and vasoactive hormones. Urine samples were analyzed for excretions of electrolytes and markers of nephrotoxicity.

Results
Comparable variables were found among the two groups, except for significantly higher postoperative levels of plasma brain natriuretic peptide (p = 0.033), albumin excretion (p = 0.012) and excretion of epithelial sodium channel (p = 0.045) in the LTV-h.PEEP ventilation group compared to the HTV-l.PEEP ventilation group. In the combined cohort, we found a significant decrease in creatinine clearance (112.0 [83.4;126.7] ml/min at baseline vs. 45.1 [25.4;84.3] ml/min during surgery) and a significant increase in plasma concentrations of renin, angiotensin II, and aldosterone.

Conclusion
Lung protective ventilation was associated with minor adverse hemodynamic and renal effects postoperatively. All patients showed a substantial but transient reduction in renal function accompanied by activation of the renin-angiotensin-aldosterone system.

Trial registration
ClinicalTrials, NCT02551341. Registered 13 September 2015.
Predictors of COVID-19 vaccine hesitancy among Egyptian healthcare workers: a cross-sectional study
Authors: El-Sokkary Rehab H. , El Seifi Omnia S. , Hassan Hebatallah M. , Mortada Eman M. , Hashem Maiada K. , Gadelrab Mohamed Rabie Mohamed Ali , Tash Rehab M. Elsaid 
Published: August 2021

Abstract
Background
Coronavirus disease 2019 (COVID-19) vaccination has raised concerns about vaccine hesitancy in general and COVID-19 vaccine hesitancy in particular. Understanding the factors driving the uncertainty regarding vaccination against COVID-19 is crucial.

Methods
This cross-sectional study was designed to identify the perceptions and attitudes of healthcare workers (HCWs) towards COVID-19 vaccines and determine the predictive factors that affect their willingness to receive the COVID-19 vaccine. An online survey was distributed among HCWs to collect data assessing demographic and general characteristics of the participants and vaccine-related characteristics, including source of information about the vaccine. In addition to items assessing the perception of COVID-19, there were items on COVID-19 vaccines and attitude towards vaccination in general and towards COVID-19 vaccines in particular.

Results
The participants were classified according to their willingness to take the COVID-19 vaccine as follows: hesitant (41.9%), refusing (32.1%), and willing (26%). Statistically significant differences were observed among the three groups for the perception of COVID-19 vaccines, attitude towards vaccination in general, and COVID-19 vaccines in particular (p < 0.01).

Conclusions
Although the participants adequately perceived COVID-19 severity, prevention, and COVID-19 vaccine safety, they were widely hesitant or refused to be vaccinated. A multidimensional approach is required to increase the vaccine acceptability rate. Higher income and increased years of work experience are positive predictors of willingness to receive a vaccine. Thus, further studies addressing the scope of COVID-19 vaccine hesitancy are warranted as an initial step to build trust in COVID-19 vaccination efforts with continuous monitoring of attitudes and practices of HCWs towards COVID-19 vaccines in the future.
The associations between fasting blood glucose levels and mortality of SFTS in patients
Authors: Zhang Yin , Zhang Yu , Xu Yuanhong , Huang Ying 
Published: August 2021

Abstract
Objective
To identify the correlation between the level of at-admission fasting blood glucose (FBG) with poor outcomes in hospitalized patients suffering from severe fever with thrombocytopenia syndrome (SFTS).

Methods
Between April 1 and December 1, 2020, the list of hospitalized patients affected with SFTS infection was provided by the Infectious Disease Department at First Affiliated Hospital of Anhui Medical University, followed by the collection of information I.e., gender, age, diabetic history and the level of FBG on admission.

Results
In this study, a total of 77 patients were included and were categorized into three groups (< 5.6, 5.6–6.9, and ≥ 7.0 mmol/l) on the basis of their glucose level in the blood. The obtained results revealed that among three groups considerable variations were observed in leukocytes, FBG, D-Dimer, aspartate aminotransferase (AST), tumor necrosis factor-α (TNF-α), fibrin degradation products (FDP), and interleukin (IL)-10 level. Correlation analysis indicated a linear negative correlation between PLT and FBG (r = − 0.28, P = 0.01), however, a linear positive correlation was observed between AST, IL10, D-Dimer, and FDP levels and FBG (P-value < 0.05). Multivariate statistical analysis results shown that there was significant difference between group comparison (F = 17.01, P < 0.001) and interaction between group and time (F = 8.48, P < 0.05); but there was no significant difference between time point comparison (F = 0.04, P = 0.96). With the prolongation of time, the changes of FBG were different between survivor group and non-survivor group. The FBG in survival group shown a downward trend; The non-survivor group shown an upward trend.

Conclusions
Elevated level of FBG has been correlated with hypercoagulability, inflammation, and lower PLT in SFTS patients. The measurement of FBG level can help in evaluating the inflammatory process, hypercoagulability, and prognosis of patients suffering from SFTS. FBG can predict the prognosis of SFTS. It is necessary to pay attention to the role of FBG in the process of treatment in patients with SFTS.
Factors associated with development of symptomatic disease in Ethiopian COVID-19 patients: a case-control study
Authors: Leulseged Tigist W. , Alemahu Degu G. , Hassen Ishmael S. , Maru Endalkachew H. , Zewde Wuletaw C. , Chamiso Negat W. , Yegele Kalkidan T. , Abebe Daniel S. , Abdi Firaol M. , Minyelshewa Etsegenet Y. , Gerbi Tegenu G. , Hagos Helen T. 
Published: August 2021

Abstract
Background
Studies show that having some symptoms seems to be associated with more severe disease and poor prognosis. Therefore, knowing who is more susceptible to symptomatic COVID-19 disease is important to provide targeted preventive and management practice. The aim of the study was to assess factors associated with the development of symptomatic disease among COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia.

Methods
A case-control study was conducted from August to September 2020 among a randomly selected 730 COVID-19 patients (337 Asymptomatic and 393 Symptomatic patients). Chi-square test and independent t-test were used to detect the presence of a statistically significant difference in the characteristics of the cases (symptomatic) and controls (asymptomatic), where p-value of < 0.05 considered as having a statistically significant difference. Multivariable binary logistic regression was used to assess a statistically significant association between the independent variables and developing symptomatic COVID-19 where Adjusted Odds ratio (AOR), 95% CIs for AOR, and P-values were used for testing significance and interpretation of results.

Results
The result of the multivariable binary logistic regression shows that age group (AOR = 1.89, 95% CI = 1.25, 2.87, p-value = 0.002 for 30–39 years; AOR = 1.69, 95% CI = 1.06, 2.73, p-value = 0.028 for 40–49 years and AOR = 4.42, 95% CI = 2.75, 7.12, p-value = 0.0001 for ≥50 years), sex (AOR = 1.76, 95% CI = 1.26, 2.45, p-value = 0.001) and history of diabetes mellitus (AOR = 3.90, 95% CI = 1.92, 7.94, p-value = 0.0001) were found to be significant factors that determine the development of symptomatic disease in COVID-19 patients.

Conclusions
Developing a symptomatic COVID-19 disease was found to be associated with exposures of old age, male sex, and being diabetic. Therefore, patients with the above factors should be given enough attention in the prevention and management process, including inpatient management, to pick symptoms earlier and to manage accordingly so that these patients can have a favorable treatment outcome.