bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interprofessional care of patients with type 2 diabetes mellitus in primary care: family physicians’ perspectives
Authors: Torti Jacqueline M. I. , Szafran Olga , Kennett Sandra L. , Bell Neil R. 
Published: April 2022

Abstract
Background
There is a lack of understanding of the team processes and factors that influence teamwork and medication management practices in the care of patients with type 2 diabetes mellitus (T2DM). The purpose of the study was to explore physicians’ perspectives of barriers and facilitators to interprofessional care of patients with T2DM within team-based family practice settings.

Methods
This was a qualitative, descriptive study. Participants included physicians affiliated with a primary care network providing care to patients with T2DM in an interprofessional team-based primary care setting in Edmonton, Alberta, Canada. Participants’ contact information was obtained from the publicly available College of Physicians and Surgeons of Alberta and respective primary care network websites. Interview questions addressed physicians’ perspectives on factors or processes that facilitated and hindered the care and medication management of adult patients with T2DM in primary care team-based clinical practice. Interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis and a constant comparative approach.

Results
A total of 15 family physicians participated in individual interviews. Family physicians identified facilitators of interprofessional team-based care and medication management of patients with T2DM in three theme areas—access to team members and programs, knowledgeable and skilled health professionals, and provision of patient education by other health professionals. Two themes emerged as barriers to interprofessional care – lack of provider continuity and the loss of skills from delegation of tasks.

Conclusion
Family physicians perceive both benefits and risks to interprofessional team-based care in caring for patients with T2DM. Successful functioning of team-based care in family practice will require overcoming traditional professional roles.
Is diabetic striatopathy the culprit of seizures in a patient with ketotic hyperglycemia-induced hemichorea–hemiballismus?
Authors: Safan Abeer Sabry , Sharma Omna , Almasri Muna , D’Souza Ashton Ian , Suliman Omer 
Published: April 2022

Abstract
Background
Diabetic striatopathy is a rare neurological manifestation of nonketotic hyperglycemia that presents with contralateral hemichorea-hemiballismus. Presentation with concurrent seizures is rarely reported.

Clinical presentation
We report a case of diabetic striatopathy presenting with focal and generalized tonic-clonic seizures (GTCS) with right hemichorea-hemiballismus induced by a ketotic hyperglycemic state. Head MRI showed high T1-weighted signal intensity in the left lentiform nucleus with no significant diffusion restriction or postcontrast enhancement. The patient’s condition gradually improved, with seizure control on AEDs. Hemichorea-hemiballismus significantly improved with adequate blood sugar control and resolved with low-dose haloperidol.

Conclusions
Diabetic striatopathy presenting with hemichorea-hemiballismus and concurrent GTCS has been reported previously in two cases; however, it has never been reported in ketotic hyperglycemia. To the best of our knowledge, we herein report the first case report of focal and generalized seizures in a ketotic hyperglycemic state and mesial temporal sclerosis.
Antibiotic use by backyard food animal producers in Ecuador: a qualitative study
Authors: Waters William F. , Baca Martin , Graham Jay P. , Butzin-Dozier Zachary , Vinueza Lenin 
Published: April 2022

Abstract
Background
Antibiotics are increasingly used throughout the world in food animal production for controlling and preventing disease and for promoting growth. But this trend also has the potential for promoting antibiotic resistance, which represents a threat to human, animal, and environmental health. The use of antibiotics and the potential effects of antibiotic dependence has often been associated with large-scale food animal production. But rural households also engage in small-scale production, often operating literally in backyards. While some small-scale producers use veterinary antibiotics, many do not. This paper examines knowledge, attitudes, beliefs, and agricultural practices (KAP) that represent an alternative to dependence on antibiotics.

Methods
Qualitative field research was based on four focus group discussions (FGDs) with non-indigenous backyard food animal producers in four communities near Quito, Ecuador and two FGDs with veterinarians. FGDs were supplemented by structured observations and key informant interviews. They were recorded with digital audio devices and transcriptions were analyzed independently by two researchers using a three-stage coding procedure. Open coding identifies underlying concepts, while axial coding develops categories and properties, and selective coding integrates the information in order to identify the key dimensions of the collective qualitative data.

Results
Backyard food animal producers in the Ecuadorian highlands generally do not use antibiotics while rearing small batches of animals and poultry for predominantly non-commercial household consumption. Instead, they rely on low cost traditional veterinary remedies. These practices are informed by their Andean history of agriculture and a belief system whereby physical activity is a holistic lifestyle through which people maintain their health by participating in the physical and spiritual environment.

Conclusions
Backyard food animal producers in the Ecuadorian highlands implement complex strategies based on both economic calculations and sociocultural underpinnings that shape perceptions, attitudes, and practices. They use traditional veterinary remedies in lieu of antibiotics in most cases because limited production of food animals in small spaces contributes to a predictable household food supply, while at the same time conforming to traditional concepts of human and environmental health.
Evaluation of a new developed disposable and portable bronchoscopy system
Authors: Liang Zhixin , Zhou Guanzhou , Li Yi , Pan Fei , Zeng Jiaqi , Luan Zhe , Zhu Qiang , Xu Yi , Zhang Nana , Xiang Lei , Jia Yunxiao , Sun Gang , Yang Yunsheng 
Published: April 2022

Abstract
Background
Bronchoscopy is critical in the treatment of patients with coronavirus disease (COVID-19), and its use is associated with the challenges of stringent sterilization and virus transmission risk. We developed a disposable and portable bronchoscope (YunSendo-R) and compared its safety and function with those of current reusable and single-use bronchoscopes using an animal model.

Methods
We compared the YunSendo-R system with a commercially available reusable bronchoscope (Olympus, BF-H290) and single-use bronchoscope (Ambu, Ambu® aScope3™). Eight physicians used the three types of bronchoscopes to operate on Guangxi Bama mini pigs. Each operator performed bronchoscopy and completed a 10-point Likert scale questionnaire for evaluating visual ability and manoeuvrability. Operation time and scores were collected.

Results
Operation time had no significant differences among the three bronchoscopes. In visual ability, the YunSendo-R bronchoscope showed superior performance to the Ambu bronchoscope in image clarity, colour contrast, and illumination (P < 0.05) and no significant difference in performance compared with the Olympus bronchoscope (P > 0.05). The YunSendo-R bronchoscope had similar manoeuvrability to the Olympus bronchoscope and better scope tip flexibility than the Ambu bronchoscope (P > 0.05). No relevant complications were reported.

Conclusion
We have developed a new bronchoscopy system with the advantages of disposability and portability, which was effective and safe in an animal model. It has better visual ability than the Ambu bronchoscope and similar visual ability and manoeuvrability to the Olympus bronchoscope. The YunSendo-R bronchoscope is a promising device for clinical practice, especially in reusable-endoscope-transmitted infectious diseases such as COVID-19.
Scoliosis in dysplastic spondylolisthesis: a clinical survey of 50 young patients
Authors: Guo Xinhu , Guo Zhaoqing , Li Weishi , Chen Zhongqiang , Zeng Yan , Zhong Woquan , Li Zihe 
Published: April 2022

Abstract
Background
Dysplastic spondylolisthesis is a rare spinal deformity that occurs mainly in young patients. Although its sagittal parameters had been well stated, coronal abnormalities in these patients were poorly studied. The purposes of this study were: (1) to investigate the prevalence of scoliosis in dysplastic spondylolisthesis;(2) to assess scoliosis resolution or persistence after surgery; and (3) to propose a modified classification of scoliosis associated with dysplastic spondylolisthesis.

Methods
Fifty patients (average age 14.9 ± 5.6 years) diagnosed with dysplastic spondylolisthesis who underwent surgical treatment were followed up and their data were analyzed. Standing posteroanterior and lateral full spine radiographs were used to measure the coronal and sagittal parameters. Patients with scoliosis, which was defined as a coronal Cobb angle greater than 10°, were divided into three groups according to their curve characteristics: “independent” scoliosis (IS) group, spasm scoliosis (SS) group, and olisthetic scoliosis (OS) group. SS and OS were spondylolisthesis-induced scoliosis. The radiographic parameters and patient-reported outcomes were collected before and after surgery and compared between groups.

Results
The average slip percentage was 62.8% ± 23.1% and the average follow-up time was 51.5 ± 36.4 months (range 3–168 months). Twenty-eight of the 50 (56%) dysplastic spondylolisthesis patients showed scoliosis, of which 8 were IS (24.7° ± 15.2°), 11 were SS (13.9° ± 3.0°), and 9 were OS (12.9° ± 1.9°). By the last follow-up, no scoliosis resolution was observed in the IS group whereas all SS patients were relieved. Of the nine patients with OS, four (44.4%) had scoliosis resolution after surgery.

Conclusion
Distinguishing different types of scoliosis in dysplastic spondylolisthesis patients may help surgeons to plan treatment and understand prognosis. For patients with significant scoliosis, whether “independent” or spondylolisthesis-induced, treatment of spondylolisthesis should be performed first and scoliosis should be observed for a period of time and treated according to the corresponding principles.
C/EBP homologous protein promotes Sonic Hedgehog secretion from type II alveolar epithelial cells and activates Hedgehog signaling pathway of fibroblast in pulmonary fibrosis
Authors: Yang Xiaoyu , Sun Wei , Jing Xiaoyan , Zhang Qian , Huang Hui , Xu Zuojun 
Published: April 2022

Abstract
Background
Endoplasmic reticulum (ER) stress is involved in the pathological process of pulmonary fibrosis, including IPF. It affects a broad scope of cellular types during pulmonary fibrosis but the role in epithelial-mesenchymal crosstalk has not been fully defined. The present study aimed to investigate the effects of Shh secretion by ER stress-challenged type II alveolar epithelial cells (AECII) on fibroblast and pulmonary fibrosis.

Methods
Conditioned medium (CM) from tunicamycin (TM)-treated AECII was collected and incubated with fibroblast. Short hairpin RNA (shRNA) was used for RNA interference of C/EBP homologous protein (CHOP). The effects of CHOP and HH signaling were evaluated by TM administration under the background of bleomycin-induced pulmonary fibrosis in mice.

Results
Both expression of CHOP and Shh in AECII, and HH signaling in mesenchyme were upregulated in IPF lung. TM-induced Shh secretion from AECII activates HH signaling and promotes pro-fibrotic effects of fibroblast. Interfering CHOP expression reduced ER stress-induced Shh secretion and alleviated pulmonary fibrosis in mice.

Conclusions
Our work identified a novel mechanism by which ER stress is involved in pulmonary fibrosis. Inhibition of ER stress or CHOP in epithelial cells alleviated pulmonary fibrosis by suppressing Shh/HH signaling pathway of fibroblasts.
Auxora vs. placebo for the treatment of patients with severe COVID-19 pneumonia: a randomized-controlled clinical trial
Authors: Bruen Charles , Al-Saadi Mukhtar , Michelson Edward A. , Tanios Maged , Mendoza-Ayala Raul , Miller Joseph , Zhang Jeffrey , Stauderman Kenneth , Hebbar Sudarshan , Hou Peter C. 
Published: April 2022

Abstract
Background
Calcium release-activated calcium (CRAC) channel inhibitors block proinflammatory cytokine release, preserve endothelial integrity and may effectively treat patients with severe COVID-19 pneumonia.

Methods
CARDEA was a phase 2, randomized, double-blind, placebo-controlled trial evaluating the addition of Auxora, a CRAC channel inhibitor, to corticosteroids and standard of care in adults with severe COVID-19 pneumonia. Eligible patients were adults with ≥ 1 symptom consistent with COVID-19 infection, a diagnosis of COVID-19 confirmed by laboratory testing using polymerase chain reaction or other assay, and pneumonia documented by chest imaging. Patients were also required to be receiving oxygen therapy using either a high flow or low flow nasal cannula at the time of enrolment and have at the time of enrollment a baseline imputed PaO2/FiO2 ratio > 75 and ≤ 300. The PaO2/FiO2 was imputed from a SpO2/FiO2 determine by pulse oximetry using a non-linear equation. Patients could not be receiving either non-invasive or invasive mechanical ventilation at the time of enrolment. The primary endpoint was time to recovery through Day 60, with secondary endpoints of all-cause mortality at Day 60 and Day 30. Due to declining rates of COVID-19 hospitalizations and utilization of standard of care medications prohibited by regulatory guidance, the trial was stopped early.

Results
The pre-specified efficacy set consisted of the 261 patients with a baseline imputed PaO2/FiO2≤ 200 with 130 and 131 in the Auxora and placebo groups, respectively. Time to recovery was 7 vs. 10 days (P = 0.0979) for patients who received Auxora vs. placebo, respectively. The all-cause mortality rate at Day 60 was 13.8% with Auxora vs. 20.6% with placebo (P = 0.1449); Day 30 all-cause mortality was 7.7% and 17.6%, respectively (P = 0.0165). Similar trends were noted in all randomized patients, patients on high flow nasal cannula at baseline or those with a baseline imputed PaO2/FiO2 ≤ 100. Serious adverse events (SAEs) were less frequent in patients treated with Auxora vs. placebo and occurred in 34 patients (24.1%) receiving Auxora and 49 (35.0%) receiving placebo (P = 0.0616). The most common SAEs were respiratory failure, acute respiratory distress syndrome, and pneumonia.

Conclusions
Auxora was safe and well tolerated with strong signals in both time to recovery and all-cause mortality through Day 60 in patients with severe COVID-19 pneumonia. Further studies of Auxora in patients with severe COVID-19 pneumonia are warranted.
Trial registration NCT04345614.
Association between timing of speech and language therapy initiation and outcomes among post-extubation dysphagia patients: a multicenter retrospective cohort study
Authors: Hongo Takashi , Yamamoto Ryohei , Liu Keibun , Yaguchi Takahiko , Dote Hisashi , Saito Ryusuke , Masuyama Tomoyuki , Nakatsuka Kosuke , Watanabe Shinichi , Kanaya Takahiro , Yamaguchi Tomoya , Yumoto Tetsuya , Naito Hiromichi , Nakao Atsunori 
Published: April 2022

AbstractBackgroundPost-extubation dysphagia (PED) is recognized as a common complication in the intensive care unit (ICU). Speech and language therapy (SLT) can potentially help improve PED; however, the impact of the timing of SLT initiation on persistent PED has not been well investigated. This study aimed to examine the timing of SLT initiation and its effect on patient outcomes after extubation in the ICU.MethodsWe conducted this multicenter, retrospective, cohort study, collecting data from eight ICUs in Japan. Patients aged ≥ 20 years with orotracheal intubation and mechanical ventilation for longer than 48 h, and those who received SLT due to PED, defined as patients with modified water swallowing test scores of 3 or lower, were included. The primary outcome was dysphagia at hospital discharge, defined as functional oral intake scale score < 5 or death after extubation. Secondary outcomes included dysphagia or death at the seventh, 14th, or 28th day after extubation, aspiration pneumonia, and in-hospital mortality. Associations between the timing of SLT initiation and outcomes were determined using multivariable logistic regression.ResultsA total of 272 patients were included. Of them, 82 (30.1%) patients exhibited dysphagia or death at hospital discharge, and their time spans from extubation to SLT initiation were 1.0 days. The primary outcome revealed that every day of delay in SLT initiation post-extubation was associated with dysphagia or death at hospital discharge (adjusted odds ratio (AOR), 1.09; 95% CI, 1.02–1.18). Similarly, secondary outcomes showed associations between this per day delay in SLT initiation and dysphagia or death at the seventh day (AOR, 1.28; 95% CI, 1.05–1.55), 14th day (AOR, 1.34; 95% CI, 1.13–1.58), or 28th day (AOR, 1.21; 95% CI, 1.07–1.36) after extubation and occurrence of aspiration pneumonia (AOR, 1.09; 95% CI, 1.02–1.17), while per day delay in post-extubation SLT initiation did not affect in-hospital mortality (AOR, 1.04; 95% CI, 0.97–1.12).ConclusionsDelayed initiation of SLT in PED patients was associated with persistent dysphagia or death. Early initiation of SLT may prevent this complication post-extubation. A randomized controlled study is needed to validate these results.
HIV serostatus disclosure to sexual partner: a survey among women in Tehran, Iran
Authors: Pashaei Zahra , Oskouie Fatemeh , Moradi-Lakeh Maziar , Jahanfar Shayesteh , Haghani Shima 
Published: April 2022

Abstract
Background
Disclosure of HIV-positive status in women is associated with many factors. Consequently, status disclosure remains a challenge for Iranian women living with HIV. This study aimed to assess the prevalence, related factors, and reflections of HIV-positive status disclosure to a sexual partner(s) among Iranian women living with HIV.

Methods
A cross-sectional study was conducted on 170 HIV-seropositive women. Participants were selected from patients registered in the largest HIV clinic and HIV-positive club of Iran. The “HIV disclosure” questionnaire had 38-items and all the interviews were administered by the researcher. Data were analyzed using SPSS version 21.0 software. We used a logistic regression method to calculate the crude odds ratio (COR) and the adjusted odds ratio (AOR) for self-disclosure as the independent predictor variable and the dependent variable, respectively.

Results
One hundred and seventy HIV-positive women were enrolled. Most of them had disclosed their HIV status to at least one person (94.1%) and their sexual partners (86.5%). In the univariate analysis, being married (COR = 18.66, 95% CI 5.63–61.87), living with a sexual partner (COR = 4.72, 95% CI 1.92–11.62), being aware of sexual partners’ HIV status (COR = 6.20, 95% CI 1.79–21.49), and gaining the support of sexual partner (COR = 9.08, 95% CI 3.48–23.64) were associated with higher odds of HIV status disclosure. In the multivariate analysis, being aware of sexual partners’ HIV status, and gaining the support of sexual partners remained associated with HIV status disclosure. Most women reported a positive reflection from their sexual partners after disclosure, however, negative reflections from society were more common compared to sexual partners and family members.

Conclusion
This study shows high overall HIV disclosure proportions. It should be noted that a large number of women were infected by their sexual partners, especially by their spouses. The high rate of transmission in married people indicates an urgent need for more emphasis on appropriate prevention behaviors by infected partners.
Determination of professional job burnout and temperament (Mizaj) from the viewpoint of Traditional Persian Medicine and work-related variables among Iranian dentists: a cross-sectional study
Authors: Noori Fereshteh , Kazemeini Seyed-Kazem , Owlia Fatemeh 
Published: April 2022

AbstractBackgroundDentists are prone to professional burnout due to the nature of their work but this phenomenon could be prevented. Professional burnout has a great impact on different aspects of human life. No study has been published on determination of professional job burnout and temperament (Mizaj) from the viewpoint of Traditional Persian Medicine (TPM). The current study intends to touch upon this issue for the first time.MethodsIn order to conduct this Cross-Sectional study based on a randomized sampling method, 145 dentists completed the 22-item Maslach Burnout Inventory questionnaires (MBI), and the 20-item Salmannejad Mizaj questionnaire. The study started since February, 2020 and ended in August, 2020 in Yazd, Iran. A total of 120 valid questionnaires were collected, with a response rate of 82.76%. Data analysis was performed using descriptive statistics, mean and standard deviation, analytical tests (including student t-test, one-way analysis of variance) by Spss17 (Chicago, USA) software.ResultsOverall, 8.3% of responders had high emotional exhaustion, while 65.8% and 33.3% had moderate depersonalization and reduced personal accomplishment, respectively. With respect to the results, dentists with cold and dry temperaments experienced a higher level of burnout in emotional exhaustion while dentists with warm and wet temperaments had a higher level of burnout in depersonalization and reduced personal accomplishment dimensions. There was an insignificant difference between age, gender, work experience, number of working days per week, number of patients per day with the dimensions of burnout. Pearson correlation coefficient indicated there was a positive correlation between avoidance job and emotional exhaustion (r = − 0.22,p = 0.016).ConclusionBased on the findings, it may conclude there was no significant difference in professional burnout between different temperaments among dentists.
Maximising Grip on Deception and Disguise: Expert Sports Performance During Competitive Interactions
Authors: Ramsey Harry , Dicks Matt , Hope Lorraine , Reddy Vasu 
Published: April 2022

AbstractExpert performers in fast-ball and combat sports continuously interact with their opponents and, if they are to be successful, adapt behaviour in order to gain an advantage. For example, disguise and deception are recognised as skilful behaviours that are employed to disrupt an opponent’s ability to successfully anticipate their actions. We contend that such skilled behaviour unfolds during the interaction between opposing players, yet typical research approaches omit and/or artificially script these interactions. To promote the study of skilled behaviour as it emerges during competitive interactions, we offer an account informed by contemporary ecological perspectives for shaping investigation into how deception and disguise can be used to gain an advantage over an opponent and the challenges it poses to anticipation. We propose that each player attempts to develop maximum grip on the interaction through exploiting information across multiple timescales to position themselves as to facilitate openness to relevant affordances. The act of deception can be understood as offering a misleading affordance that an opponent is invited to act on, imposing a significant challenge to an opponent’s ability to attain grip by manipulating the information available. Grounded in our ecological perspective, we emphasise the need for future investigation into: (1) the role of disguise for disrupting anticipation; (2) how deception can be employed to gain an advantage by manipulating information on multiple timescales, before detailing; (3) how opposing performers go beyond merely exploiting information and actively elicit information to deal with deception and disguise during an interaction.