bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physically active primary care doctors are more likely to offer exercise counselling to patients with cardiovascular diseases: a cross-sectional study
Authors: Selvaraj Christine Shamala , Abdullah Nurdiana 
Published: March 2022

Abstract
Background
Regular physical activity had been shown to reduce morbidity and mortality from chronic diseases such as cardiovascular diseases, hypertension, type 2 diabetes mellitus, dyslipidaemia, obesity/metabolic syndrome, osteoarthritis, osteoporosis, bronchial asthma and chronic obstructive pulmonary disease. Research had shown that physically active doctors were more likely to offer exercise counselling to patients. However, few studies looked into this association with counselling practices to patients with specific chronic diseases. This study aims to determine the association between physical activity levels of primary care doctors (PCDs) in Malaysian private practice with physical activity counselling to patients with chronic diseases.

Methodology
A cross-sectional study involving PCDs in private practice in 3 states was done. Participants were recruited from members of the Malaysian Academy of Family Physicians and attendees of a conference. A self-administered questionnaire obtained information on sociodemography, initiation of exercise counselling to patients with chronic diseases as well as physical activity levels using the International Physical Activity Questionnaire (IPAQ).

Results
The response rate was 32.3% (272/842). 47.1% of the respondents were post-graduate holders. 50% of participants had a moderate level of physical activity and 24.3% a high level. Most respondents answered ‘always’ or ‘often’ for initiation of exercise counselling to patients with cardiovascular diseases (59.9%), hypertension (72.8%), type 2 diabetes mellitus (78.6%), obesity/metabolic syndrome (86.4%), dyslipidaemia (81.6%), osteoarthritis/osteoporosis (41.9%) and bronchial asthma/COPD (29.5%). PCDs being physically active and non-smokers were associated with a higher initiation of exercise counselling to patients with cardiovascular diseases. Doctors with post-graduate degrees were more likely to offer exercise counselling to hypertensive patients.

Conclusion
The association between PCDs’ physical activity levels and their physical activity counselling varies between different types of chronic diseases. Primary care doctors with higher physical activity levels were more likely to initiate physical activity counselling in patients with cardiovascular disease during chronic disease follow up visits.
Pneumatosis cystoides intestinalis associated with etoposide in hematological malignancies: a case report and a literature review
Authors: Yang Liqing , Zhong Xi , Yang Hao , Wu Qin , Gong Yuping , Wang Bo 
Published: March 2022

AbstractPneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of air collection within the subserosa and/or submucosa of the gastrointestinal wall. Due to the lack of specific symptoms, PCI is likely to be misdiagnosed or missed without the use of imaging techniques or gastrointestinal endoscopy. Here, we report a patient who complained of abdominal distention and constipation after chemotherapy for hematological malignancies, and was diagnosed with secondary PCI via computed tomography (CT) and exploratory laparotomy. Pneumoperitoneum was no longer observed after two weeks of conservative treatments. Notably, the possibility of intra-abdominal pressure (IAP) as a predictor for surgical intervention was proposed. Furthermore, we conducted a literature review on PCI after chemotherapy in hematological malignancies to raise awareness of etoposide-related PCI, while whether PCI could be identified as an adverse event of etoposide requires more evidence.
CD63-positive extracellular vesicles are potential diagnostic biomarkers of pancreatic ductal adenocarcinoma
Authors: Odaka Haruki , Hiemori Keiko , Shimoda Asako , Akiyoshi Kazunari , Tateno Hiroaki 
Published: March 2022

AbstractBackgroundPancreatic ductal adenocarcinoma (PDAC) is one of the deadliest gastrointestinal cancers with a 5-year survival rate of less than 10%. Biomarkers for early PDAC detection are useful in treating patients with PDAC. Extracellular vesicles (EVs) are lipid-bound vesicles that are potential biomarkers of various diseases such as PDAC. In this study, we quantitatively measured the serum levels of EVs (CD63+-EVs) or platelet-derived EVs (CD41+- and CD61+-EVs) and evaluated their potential use as biomarkers of PDAC.MethodsWe measured the serum levels of CD63+-, CD41+-, CD61+-EVs using sandwich enzyme-linked immunosorbent assay based on Tim4 with specificity for phosphatidylserine on EVs in age- and sex-matched healthy controls (HCs, n = 39) and patients with PDAC (n = 39). We also examined the effect of tumor burden on the serum EV levels after surgical resection (n = 28). CA19-9, a clinical PDAC biomarker, was also measured for comparison.ResultsSerum levels of CD63+-EVs, CD41+-EVs, and CD61+-EVs were significantly increased in patients with PDAC compared to HCs. Receiver operating characteristic analysis revealed that CD63+-EVs exhibited the highest diagnostic performance to discriminate patients with PDAC from HCs (area under the curve (AUC): 0.846), which was comparable to CA19-9 (AUC: 0.842). CA19-9 showed lower AUC values in early stages (I–II, AUC: 0.814) than in late stages (III–IV, AUC: 0.883) PDAC. Conversely, CD63+-EVs, CD41+-EVs, and CD61+-EVs showed comparable AUCs between early- and late-stage PDAC. The combined use of CA19-9 and CD63+-EVs showed a higher diagnostic performance for early-stage PDAC (AUC: 0.903) than CA19-9. The serum levels of CD63+-EVs, CD41+-EVs, CD61+-EVs, and CA19-9 decreased significantly after surgical resection, demonstrating that EVs are increased in sera of patients depending on the tumor burden.ConclusionsThe serum levels of CD63+-EVs and platelet-derived EVs (CD41+-EVs, CD61+-EVs) are increased in patients with PDAC than HCs. Since CD63+-EVs showed a high AUC to discriminate patients with PDAC from HCs; they might be useful as potential biomarkers for PDAC.
An assessment of Veterans attitudes and willingness to receiving the COVID-19 vaccine: a mixed methods study
Authors: Gardner Jessica , Brown Gabriel , Vargas-Correa Jadisha , Weaver Frances , Rubinstein Israel , Gordon Howard S. 
Published: March 2022

Abstract
Background
While several safe and effective COVID-19 vaccines have been available since December 2020, many eligible individuals choose to remain unvaccinated. This vaccine hesitancy is an important factor affecting our ability to combat the COVID-19 pandemic.

Methods
The objective of the study was to examine the attitudes and willingness among US Veterans toward receiving COVID-19 vaccination. The study used a quantitative qualitative mixed methods design with a telephone survey and then in-depth interviews in a subset of those surveyed. Participants were unvaccinated Veterans (N = 184) selected randomly from a registry of patients who had received VA healthcare during the pandemic and had a diagnostic test for COVID-19. The primary outcome was willingness to accept COVID-19 vaccination. Survey data collection and in-depth interviews were conducted by telephone. Analyses of the survey data compared the primary outcome with demographics, clinical data, and survey responses using bivariate and multiple regression analyses. A subset (N = 10) of those surveyed, participated in an in-depth interview. Interview transcripts were analyzed to derive themes using qualitative content analysis.

Results
Almost 40% of participants disagreed they would receive a COVID-19 vaccine. Participants who were younger, female, and had fewer comorbid conditions were more likely (P < 0.05) to disagree with COVID-19 vaccination. In multiple regression analysis, willingness to accept vaccination was associated with reliance on a doctor or family member’s recommendation and with a belief that vaccines are effective. In-depth interviews revealed several barriers to COVID-19 vaccination, including lack of trust in the government and vaccine manufacturers, concerns about the speed of vaccine development, fear of side effects, and fear the vaccine was a tool of racism.

Conclusions
This study illustrates the complexity of patients’ deliberation about COVID-19 vaccination and may help physicians and other health care providers understand patients’ perspectives about COVID-19 vaccination. The results highlight the importance of patients’ trust in physicians, healthcare organizations, pharmaceutical manufacturers and the government when making health decisions.
Incidence of acute otitis media in children in the United States before and after the introduction of 7- and 13-valent pneumococcal conjugate vaccines during 1998–2018
Authors: Hu Tianyan , Done Nicolae , Petigara Tanaz , Mohanty Salini , Song Yan , Liu Qing , Lemus-Wirtz Esteban , Signorovitch James , Sarpong Eric , Weiss Thomas 
Published: March 2022

Abstract
Background
Acute otitis media (AOM) is a leading cause of office visits and antibiotic prescriptions in children. Pneumococcal conjugate vaccines were introduced in the USA in 2000 (7-valent, PCV7) and 2010 (13-valent, PCV13). Expanded valency PCVs are currently under development. To describe the impact of PCVs and quantify the residual burden of AOM, this study estimated annual incidence rates (IRs) of AOM and AOM-related complications and surgical procedures in children < 18 years in the USA before and after the introduction of PCV7 and PCV13.

Methods
AOM episodes were identified in the IBM MarketScan® Commercial and Medicaid databases using diagnosis codes (ICD-9-CM: 382.x; ICD-10-CM: H66.xx and H67.xx). Annual IRs were calculated as the number of episodes per 1000 person-years (PYs) for all children < 18 years and by age group (< 2, 2–4, and 5–17 years). National estimates of annual AOM IRs were extrapolated using Census Bureau data. Interrupted time series analyses were used to assess immediate and gradual changes in monthly AOM IRs, controlling for seasonality.

Results
In the commercially insured population, AOM IRs declined between the pre-PCV7 period (1998–1999) and the late PCV13 period (2014–2018) from 1170.1 to 768.8 episodes per 1000 PY for children < 2 years, from 547.4 to 410.3 episodes per 1000 PY in children 2–4 years, and from 115.6 to 91.8 episodes per 1000 PY in children 5–17 years. The interrupted time series analyses indicated significant immediate or gradual decreases in the early PCV7 period (2001–2005), and gradual increases in the late PCV7 period (2006–2009) in children < 2 years; however, crude IRs trended downward in all time periods. In older children, IRs decreased in the early PCV7 and early PCV13 period (2011–2013), but gradually increased in the late PCV7 period. IRs of AOM-related surgical procedures decreased, and IRs of AOM-related complications increased during the study timeframe.

Conclusions
AOM disease burden remains high in children of all ages despite overall reductions in AOM IRs during 1998–2018 following the introduction of PCV7 and PCV13. The impact of investigational PCVs on the disease burden of AOM will likely depend on AOM etiology and circulating pneumococcal serotypes.
Effect of gender, age and vaccine on reactogenicity and incapacity to work after COVID-19 vaccination: a survey among health care workers
Authors: Nachtigall Irit , Bonsignore Marzia , Hohenstein Sven , Bollmann Andreas , Günther Rosita , Kodde Cathrin , Englisch Martin , Ahmad-Nejad Parviz , Schröder Alexander , Glenz Corinna , Kuhlen Ralf , Thürmann Petra , Meier-Hellmann Andreas 
Published: March 2022

Abstract
Background
The aim of our study was to assess the impact the impact of gender and age on reactogenicity to three COVID-19 vaccine products: Biontech/Pfizer (BNT162b2), Moderna (mRNA-1273) and AstraZeneca (ChAdOx). Additional analyses focused on the reduction in working capacity after vaccination and the influence of the time of day when vaccines were administered.

Methods
We conducted a survey on COVID-19 vaccinations and eventual reactions among 73,000 employees of 89 hospitals of the Helios Group. On May 19th, 2021 all employees received an email, inviting all employees who received at least 1 dose of a COVID-19 to participate using an attached link. Additionally, the invitation was posted in the group’s intranet page. Participation was voluntary and non-traceable. The survey was closed on June 21st, 2021.

Results
8375 participants reported on 16,727 vaccinations. Reactogenicity was reported after 74.6% of COVID-19 vaccinations. After 23.0% vaccinations the capacity to work was affected. ChAdOx induced impairing reactogenicity mainly after the prime vaccination (70.5%), while mRNA-1273 led to more pronounced reactions after the second dose (71.6%). Heterologous prime-booster vaccinations with ChAdOx followed by either mRNA-1273 or BNT162b2 were associated with the highest risk for impairment (81.4%). Multivariable analyses identified the factors older age, male gender and vaccine BNT162b as independently associated with lower odds ratio for both, impairing reactogenicity and incapacity to work. In the comparison of vaccine schedules, the heterologous combination ChAdOx + BNT162b or mRNA-1273 was associated with the highest and the homologue prime-booster vaccination with BNT162b with the lowest odds ratios. The time of vaccination had no significant influence.

Conclusions
Around 75% of the COVID-19 vaccinations led to reactogenicity and nearly 25% of them led to one or more days of work loss. Major risk factors were female gender, younger age and the administration of a vaccine other than BNT162b2. When vaccinating a large part of a workforce against COVID-19, especially in professions with a higher proportion of young and women such as health care, employers and employees must be prepared for a noticeable amount of absenteeism. Assuming vaccine effectiveness to be equivalent across the vaccine combinations, to minimize reactogenicity, employees at risk should receive a homologous prime-booster immunisation with BNT162b2.
Trial registration: The study was approved by the Ethic Committee of the Aerztekammer Berlin on May 27th, 2021 (Eth-37/21) and registered in the German Clinical Trials Register (DRKS 00025745). The study was supported by the Helios research grant HCRI-ID 2021-0272.
Cerebral nocardiosis in a patient treated with pembrolizumab: a first case report
Authors: Petitgas Paul , Lesouhaitier Mathieu , Boukthir Sarrah , Cattoir Vincent , Tattevin Pierre , Bénézit François 
Published: March 2022

Abstract
Background
Checkpoints inhibitors (CPIs) are increasingly used for the treatment of several malignancies. The most common side effects are Immune Related Adverse Events, while infectious complications are rare, especially cerebral nocardiosis.

Case presentation
Here, we report the first clinical case of a cerebral nocardiosis revealed after seizure in a patient treated by pembrolizumab for a metastatic lung cancer, in the absence of any additional immunosuppressive therapy or risk factors for cerebral nocardiosis. The extended evaluation including a brain CT-scan did not reveal any lesion before pembrolizumab. Nevertheless, the 3-month delay between the start of Pembrolizumab and the diagnosis of cerebral nocardiosis suggests that the infection occurred prior to the CPI. Unfortunately, the patient died during treatment for cerebral nocardiosis, while the lung cancer tumor mass had decreased by 80% after the sixth cycle of pembrolizumab.

Conclusions
This case report emphasizes that clinicians should consider diagnoses other than metastasis in a patient with a brain mass and metastatic cancer treated with CPI, such as opportunistic infections or IRAE.
Recipient and donor PTX3 rs2305619 polymorphisms increase the susceptibility to invasive fungal disease following haploidentical stem cell transplantation: a prospective study
Authors: Zhao Chen , Zhao Xiao-Su , Xu Lan-Ping , Zhang Xiao-Hui , Huang Xiao-Jun , Sun Yu-Qian 
Published: March 2022

Abstract
Background
Invasive fungal disease (IFD) is a severe complication after haploidentical stem cell transplantation (haplo-HSCT) and has a poor prognosis. It has been shown that genetic polymorphism may be one possible reason for the increased risk of IFD. This study aimed to assess the role of genetic polymorphism in the level of susceptibility to IFD after haplo-HSCT.

Methods
In this study, we prospectively enrolled 251 patients who received haplo-HSCT at the Peking University Institute of Hematology from 2016 to 2018. Forty-three single nucleotide polymorphisms (SNPs) of the genomic DNA were genotyped in blood samples from both recipient and donor.

Results
Twenty-two patients (8.8%) were diagnosed with proven or probable IFD. The independent risk factors for IFD were grades 3–4 acute graft-versus-host disease, cytomegalovirus reactivation, and recipient and donor rs2305619 (PTX3) (P < 0.05) in multivariate analysis. Meanwhile, we combined the variables to develop the IFD risk scoring system and stratified patients into low- (0–2) and high-risk (3–4) groups. The 30-day and 100-day cumulative incidence of IFD in the low- and high-risk groups were 2.1% and 10.2%, 4.2% and 20.3%, respectively (P = 0.015).

Conclusions
PTX3 rs2305619 polymorphism increase the susceptibility of IFD after haplo-HSCT in the Chinese Han population, and the IFD scoring system could be useful in risk stratification for IFD after HSCT.
Three-dimensional evaluation of soft tissues in hyperdivergent skeletal class II females in Guangdong
Authors: Zhang Xueqin , Zheng Jinxuan , Deng Jianqing , Wen Zhaoxiang , Chen Zhengyuan , Gan Liyi , Wu Liping 
Published: March 2022

Abstract
Objectives
To establish the three-dimensional facial soft tissue morphology of adolescent and adult females in the Guangdong population and to study the morphological characteristics of hyperdivergent skeletal class II females in Guangdong compared with that of normodivergent class I groups.

Materials and methods
The 3dMDface system was used to capture face scans of 160 patients, including 45 normal and 35 hyperdivergent skeletal class II adolescents (aged 11–14 years old) and 45 normal and 35 hyperdivergent skeletal class II adults (aged 18–30 years old). Thirty-two soft tissue landmarks were mapped, and 21 linear, 10 angular and 17 ratio measurements were obtained by 3dMDvultus analysis software. Data were assessed with a t-test of two independent samples between the normal adolescent and adult groups and between the normal and hyperdivergent skeletal class II groups.

Results
The linear measurements of the Guangdong adult females were larger than those of the adolescents in both Class I and Class II groups. However, the angular and ratio measurements had no significant difference. The vertical linear measurements were higher and the sagittal and transverse linear measurements were smaller in the hyperdivergent class II group (p < 0.05). The soft tissue ANB angle, chin-lip angle, and mandibular angle were significantly larger and the soft tissue facial convexity angle and nasal convexity angle were significantly smaller in the hyperdivergent class II group (p < 0.05). Additionally, there were significant differences in the ratio measurements between the hyperdivergent class II groups and the control groups (p < 0.05).

Conclusions
The three-dimensional facial morphology of Guangdong adolescent and adult females was acquired. The facial soft tissue measurements of the adults were higher in the three dimensions except for the facial convexity and proportional relationships which were similar, suggesting that the growth pattern remained the same. The three-dimensional facial soft tissue features of hyperdivergent skeletal class II were characterized by the terms “long, convex, and narrow”. Three-dimensional facial measurements can reflect intrinsic hard tissue characteristics.
Risk factors for twin pregnancy in women undergoing double cleavage embryo transfer
Authors: Chen Panpan , Hu Kai-Lun , Jin Jiani , Chen Ruixue , Xu Qiqi , Zhao Wei , Zhang Runju , Xing Lanfeng , Zhu Yimin , Zhang Dan 
Published: March 2022

Abstract
Background
Two or more embryo transfers have been used to increase the success rate of live birth in traditional in vitro fertilization (IVF) strategy at the expense of increased risks of multiple pregnancy and adverse perinatal outcomes. The decision regarding the elective single embryo transfer or double embryo transfer remains inconclusive. The aim of this study was to investigate the risk factors for twin pregnancy in IVF.

Methods
Participants who underwent their first fresh IVF cycle where two cleavage stage embryos were transferred in Women’s Hospital of Zhejiang University between January 2010 and December 2018 were included in this retrospective cohort study. The primary outcome was twin delivery. Secondary outcomes included preterm birth and low birth weight

Results
Fifteen thousand four hundred fifty-nine women were available for final analysis, in which 1511 women resulted in twin delivery and 4788 women had singleton delivery. Female age over 35 was associated with reduced rates of twin pregnancy compared with female age at or less than 35 (9.5% vs 25.1%, aRR = 0.38 (0.27. 0.55)). Poor-type endometrium was associated with reduced rates of twin pregnancy (19.2% vs 27.5%, aRR = 0.75 (0.58. 0.96)). Two good-quality embryos for transfer was associated with significantly higher rates of twin pregnancy compared with one good-quality or none good-quality embryo (26% vs 12.8% vs 9.3%, aRR = 0.56 (0.45. 0.70), aRR = 0.44(0.26. 0.74)). Female age over 35 and none or one good-quality embryo for transfer were associated with reduced rate of low birth weight and preterm birth.

Conclusion
Women with age over 35, poor-type endometrium, one good-quality embryo or none good-quality embryo were associated with reduced rate for twin pregnancy.
Evaluation of a breastfeeding promotion film among a racially minoritized sample
Authors: Blackman Kacie C. A. , Slama Derek S. , Pickering Trevor A. , Russell Aqueelah , Valentine Wenonah , Merchant Meridith A. , Saetermoe Carrie 
Published: March 2022

Abstract
Background
In Los Angeles County (LAC), disparities in breastfeeding rates vary by race and region. Black persons are more affected by social and environmental factors than other racial/ethnic groups, leading to lower breast/chestfeeding rates. This study aims to evaluate the community’s knowledge, perceptions, experiences, barriers, and solutions before and after an educational film about Black persons who are breast/chestfeeding.

Methods
Participant responses were collected anonymously through an online survey (via QR code) pre-and post-viewing a film with open- and closed-ended questions. There were 15 pre-screening questions and 24 post-screening questions discussed with a team of community experts. Questions included four main areas related to breast/chestfeeding: current/past experiences, support, awareness of laws, and solutions. Central tendency, variance, and paired differences were calculated from evaluation responses.

Results
There were 185 participants who completed the pre-screening evaluation and 57 participants who completed the post-screening evaluation. Racial/ethnic differences were found for stated reasons for attendance, and perceptions of breastfeeding being challenging after viewing the video. On a five-point Likert scale (1 = very relevant, 5 = not relevant), most participants felt the video was relevant (median response = “2-relevant”; IQR = “3-neutral”; “1-very relevant”), learned something new (81.4%) and knew how to access breast/chestfeeding support after viewing the video (93.2%).

Conclusions
Current media is a way to alter perceptions and opinions, and provides information. Additionally, it can be a way of increasing awareness of issues that Black breast/chestfeeding persons encounter. Strategic marketing efforts for future film screenings may increase attendance of those that can gain insight into breast/chestfeeding support (youth/young adults and males). Supportive breast/chestfeeding environments can also be a reality with readily accessible, unified, and encouraging personal and professional networks.