bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isotemporal substitution of sedentary behavior for physical activity on cardiorespiratory fitness in children and adolescents
Authors: Sun Yi , Yin Xiaojian , Li Yuqiang , Bi Cunjian , Li Ming , Yang Xiaofang , Zhang Ting , Zhang Feng , Cao Junfang , Guo Yaru , Yang Ting , Song Ge 
Published: July 2020

Abstract
Both sedentary behavior (SB) and physical activity (PA) are associated with cardiorespiratory fitness (CRF) and independent of each other. Due to the limited time during school for children and adolescents, it is necessary to explore the isotemporal substitution of SB for PA on CRF.
A total 536 eligible participants selected from the 7 traditional administrative regions of China were included in this study. The outcome was CRF, determined using a 20-meter shuttle run test, and exposures were SB, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) measured with accelerometers. We analyzed the cross-sectional associations of substituting SB with LPA, MVPA, and combinations of LPA and MVPA with CRF, using an isotemporal substitution model.
Reallocating SB into MVPA was associated with higher CRF for male (P < .01) and female (P < .01) children and female adolescents (P < .05). In the mixed redistribution, the ratio of LPA to MVPA for male children and female adolescents started from 16:4 and 14:6, respectively, tended toward improvements in CRF. For female children, regardless of the ratio of LPA to MVPA, it was always associated with higher CRF.
Reallocating SB into MVPA isotemporally was positively associated with CRF for male and female children and female adolescents but not for male adolescents. MVPA is the key factor to improve CRF when combinations of LPA and MVPA replace SB. The combined approach can provide basis for the selection of target and monitoring variables in intervention studies, and has more flexible choices for improving CRF that are more consistent with the daily PA habits of children and adolescents.
Acupuncture for post-stroke insomnia
Authors: Xiang Jie , Li Honglian , Xiong Jun , Hua Fanghui , Huang Shouqiang , Jiang Yunfeng , Zhou Xiaohong , Liao Kai , Xu Lingling 
Published: July 2020

Abstract

Background:
Post-stroke insomnia (PSI) is a significant complication of stroke, which often affects patients in various aspects. Acupuncture has fewer side effect and is increasingly used to treat PSI. The purpose of this study is to summarize the efficacy and safety of acupuncture for PSI.

Methods:
We will perform a comprehensive electronic searching, including PubMed, Embase, Cochrane Library, WangFang Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, from inception to July 2020. We will also manually retrieve references, and contact lead authors. Randomized clinical trials (RCTs) of acupuncture for PSI will be included, regardless of whether blind method and allocation concealment are used. The outcomes of interest include: Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), efficacy standards of Chinese medicine, relapse rate after follow-up, adverse events, quality of life. To assess the risk of bias, we will use the Cochrane risk assessment tool. RevMan 5.3 software will be used to conduct data synthesis. The evidence quality of each outcome will be appraised according to Grades of Recommendation, Assessment, Development, and Evaluation (GRADE).

Results:
The results will be published in a peer-reviewed journal.

Conclusion:
This study will provide a high-quality evidence to evaluate the efficacy and adverse reactions of acupuncture for PSI.

PROSPERO registration number:
CRD42020157865.
Optical coherence tomographic findings of ocular siderosis following intraocular foreign body removal
Authors: Lee You Hyun , Kim Yu Cheol 
Published: July 2020

Abstract

Rationale:
Ocular siderosis is arrested by the removal of intraocular foreing body (IOFB). The progression of ocular siderosis is very rare and few reports demonstrate the optical coherence tomographic (OCT) findings.

Patient concerns:
A 55-year-old Asian man presented to our clinic with the chief complaint of decreased vision in his left eye for 5 months. On slit lamp examination of the left eye, the corneal stroma had a rust-colored hue, and the retina was not visible due to vitreous opacity. An orbital computed tomography was ordered considering the possibility of left IOFB, which confirmed the presence of a vitreous IOFB. On the next day, he had a continuous curvilinear capsulorrhexis with phacoemulsification and intraocular lens implantation, pars plana vitrectomy, and removal of IOFB in the left eye. Six years later, he revisited our clinic. On slit lamp examination, the corneal haziness had worsened, and the iris showed heterochromia resembling the spokes of a wheel in the left eye.

Diagnosis:
Ocular siderosis.

Intervention:
Anterior and posterior segment OCT was performed.

Outcomes:
The anterior segment OCT showed linear hyperreflectivity on the anterior corneal stroma just beneath the Bowman's layer. The posterior segment OCT showed inner retinal degeneration observed at the parafoveal area.

Lessons:
Ocular siderosis progression can happen after the removal of IOFB. The swept source OCT might be useful to assess the cornea and retina in ocular siderosis patient with corneal haziness.
Anesthesia for pulmonary veno-occlusive disease: the dilemma and what we should know as anesthesiologists
Authors: Foong Theng Wai , Tan Pei Shan , Thampi Swapna , Balakrishnan Ashokka 
Published: July 2020

Abstract

Introduction:
Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension. It is often underdiagnosed or misdiagnosed as idiopathic pulmonary arterial hypertension (PAH). Inappropriate treatment may cause worsening of symptoms which may lead to fatal outcomes. Anesthetic considerations and management for pulmonary hypertension are well described, but few anesthesiologists are aware of the entity of PVOD and its management.

Patient concerns:
We report a case of PVOD in a 73-year-old female who was on concurrent aspirin and anagrelide, requiring emergent open femoral hernia repair.

Diagnosis:
PVOD and incarcerated femoral hernia

Intervention:
Combined spinal-epidural (CSE) was performed to enable the surgery.

Outcome:
Surgery was completed successfully under central neuraxial anesthesia and the patient remained stable and comfortable throughout, avoiding the need for general anesthesia. Due to the concurrent aspirin and anagrelide therapy, significant bleeding from the CSE puncture site was observed immediately post-operatively. This was resolved with external manual compression and withholding the aspirin and anagrelide. Patient remained well without neurological deficit and was discharged postoperative day seven.

Lessons:
It is important to differentiate PVOD from PAH due to the controversial use of pulmonary vasodilators in PVOD. Pulmonary vasodilator is commonly used to treat acute pulmonary hypertension in PAH but its usage may lead to pulmonary edema in patients with PVOD. Hence, with no ideal treatment available, the avoidance of general anesthesia is crucial to prevent acute pulmonary hypertensive crisis in patient with PVOD. However, this needs to be weighed against the elevated risk of central neuraxial bleeding when performing a CSE in a patient on concurrent aspirin and anagrelide therapy. Calculated decision-making considering the risks and benefits of all alternatives should be carried out in such a scenario, and measures should be taken in anticipation of the potential consequences of the eventual decision.

Conclusion:
It is important to differentiate PVOD from PAH. PVOD has unique anesthetic considerations due to the controversial use of pulmonary vasodilators. This case also emphasizes the importance of active anticipation of potential issues and adequate follow up.
Validation protocol for current good manufacturing practices production of [15O]water for hybrid PET/MR studies
Authors: Cockburn Neil , Corsaut Jeffrey , Kovacs Michael S. , St. Lawrence Keith , Hicks Justin W. 
Published: July 2020

Introduction
Oxygen-15 (15O; t½ = 122.4 s) has been used for nuclear imaging experiments since the beginning of the field. With the advent of simultaneous hybrid PET/MR technology, [15O]water has seen a resurgence and remains the gold standard method for quantitative blood flow studies. The short half-life presents a nontrivial challenge to applying current good manufacturing practices production methods to maintain patient safety.

Methods
A two-vial production method was devised to ensure adequate mixing of [15O]water vapour into buffered isotonic saline. For production validation, six batches of [15O]water were prepared: sterility, quality control testing and four patient doses. The final dose also underwent quality tested. Routine quality control testing included the following: radiochemical identity and purity, radionuclidic identity and purity, appearance, pH, pyrogenicity, and filter integrity. Sterility was retrospectively confirmed. For validation, breakthrough Pt concentration was also measured.

Results
Consistent yields of 10–12 GBq (270–325 mCi) were obtained 3 min after bombardment. Overall, 26 [15O]water batches underwent quality control testing under this protocol and all met or exceeded release specifications for clinical use.

Conclusion
The multiple batch protocol proved to be a safe and effective means for producing [15O]water. Furthermore, this protocol could be readily adapted by any facility attempting to produce [15O]water for clinical studies. Compared with previous attempts at our site, the protocol outlined here was more consistent and reliable, improved production workflow and led to more available radioactivity for participant injection and QC testing.
Feasibility and Acceptability of a Self-Management Program for Patients With Rheumatoid Arthritis
Authors: Shao Jung-Hua , Yu Kuang-Hui , Chen Su-Hui 
Published: July 2020

BACKGROUND:
Joint activity and protection are key components in the management of rheumatoid arthritis (RA). Despite a shift from care in health settings to empowering patients to play an active role in the day-to-day management of their own chronic conditions, there is little evidence on RA self-management, especially for Chinese patients.

PURPOSE:
This pilot study sought to determine the feasibility and acceptability of a self-management program for patients with RA in Taiwan.

METHODS:
Participants were recruited at a medical center in northern Taiwan. The intervention group participated in a 6-week self-management program; the control group received standard rheumatology care. Both groups underwent baseline assessments before the intervention and at 12 weeks.

RESULTS:
A total of 32 participants were recruited: 15 in the intervention group and 17 in the control group. Patients in the intervention group found the self-management protocol beneficial to their joint protection and activity behaviors and reported higher motivation to perform RA self-management. The posttest score for joint protection and activity self-management behavior were significantly greater for the intervention group than for the control group (p = .02).

CONCLUSIONS:
Participants in the intervention group were highly satisfied with home visits (which included peer story-telling and goal setting) and telephone calls to support their daily home-based joint protection and self-management activities (which included self-monitoring and self-evaluation). To mitigate the fear of scammers, researchers should begin by building a trust relationship with participants.
Sustained, Low Prevalence of Undiagnosed HIV Among Gay and Bisexual Men in Sydney, Australia Coincident With Increased Testing and Pre-exposure Prophylaxis Use: Results From Repeated, Bio-Behavioral Studies 2014–2018
Authors: Keen Phillip , Lee Evelyn , Grulich Andrew E. , Prestage Garrett , Guy Rebecca , Stoové Mark A. , Bavinton Benjamin R. , Asselin Jason , Hammoud Mohamed A. , Broady Tim , Duck Tim , Holt Martin ,   on behalf of the NSW HIV Prevention Partnership Project
Published: July 2020

Background:
Gay and bisexual men with undiagnosed HIV contribute disproportionately to HIV transmission in Australia.

Methods:
In 2014 and 2018, we recruited men at gay venues and events in Sydney. Participants self-completed surveys and provided oral fluid samples for HIV testing. We calculated the prevalence of HIV and undiagnosed infection, and assessed changes in behavior, HIV testing, and the use of pre-exposure prophylaxis. We weighted the samples to adjust for differences in where participants were recruited between rounds. Two-sample tests of proportion were used to compare prevalence estimates and χ2 tests to assess differences between the samples.

Results:
In 2014, 944 men were recruited, and 890 men were recruited in 2018. In 2014, the weighted estimate of HIV prevalence was 6.1% [95% confidence intervals (CI): 4.6 to 7.6], of which 13.8% (95% CI: 5.0 to 22.7) was undiagnosed. In 2018, weighted HIV prevalence was 6.4% (95% CI: 4.8 to 8.0), of which 5.3% (95% CI: 0.5 to 11.1) was undiagnosed. Between 2014 and 2018 among all participants, men reporting at least 10 recent casual partners increased from 22.3% to 27.7% (P = 0.008), condomless anal intercourse with casual partners in the previous 6 months increased from 23.9% to 37.3% (P < 0.001), and sexually transmitted infection diagnoses in the previous year increased from 14.4% to 27.5% (P < 0.001). HIV testing and the use of pre-exposure prophylaxis in the previous 6 months increased from 49.6% to 56.3% (P = 0.004) and 2.0%–21.0% (P < 0.001), respectively.

Conclusions:
Repeated, bio-behavioral surveillance suggests the prevalence of undiagnosed HIV remains low in Sydney, despite gay and bisexual men reporting more casual sex partners, condomless sex, and sexually transmitted infections.
Composite Face Lifting
Authors: Sterodimas Aris , Nicaretta Beatriz , Boriani Filippo 
Published: July 2020

Background
Face rejuvenation is increasingly challenging because patients request minimally invasive surgery; rapid surgical course and recovery; and fast, tangible, and long-term results. Rejuvenation of face often requires surgery to multiple areas, that is, the lateral face, the midface, the neck, and periorbital areas, in addition to the emerging procedures of face volumizing and biostimulation through fat injection. At our institution, a systematic approach comprising all of these procedures has been developed, with consistent results.

Objective
The aim of this study was to describe the combination of blepharoplasty, minilift, and Stromal Enriched Lipograft (SEL) for thorough rejuvenation of face and neck regions.

Methods
A prospective study was performed to evaluate outcomes and patient satisfaction with composite face lifting, comprising upper and lower blepharoplasties, minilift, and SEL in 210 patients between 2009 and 2018. Overall improvement after the procedure was rated on a scale of 1 to 5, where 1 is “poor,” 2 is “fair,” 3 is “good,” 4 is “very good,” and 5 is “excellent.” The evaluation was expressed at 6 months postoperatively by the patient.

Results
The amount of SEL transplanted varied from 22 to 56 mL per side (mean, 41). There were no cases of liponecrosis, infection of the grafted area, or pulmonary embolism. More than 85% of patients expressed a very good to excellent evaluation of the result obtained. No one expressed a degree of satisfaction less than good.

Conclusions
Composite face lifting seems as a safe and effective combined procedure for the rejuvenation of face. Face harmony not only depends on redraping tissues toward a more natural, tense, and young conformation, but also on restoring volumes and improving the quality of the redraped tissues. More research is necessary, but the preliminary encouraging impression is that the composite face lifting is capable of addressing all issues, the necessity of correcting laxity, filling volumes, and improving the quality of cutaneous tissues.
Maxillofacial Trauma in Geriatric Population
Authors: Aytaç Ismail , Yazici Alper , Tunç Orhan 
Published: July 2020

Background/Aim:
The worldwide population is increasingly aging. Maxillofacial fractures of the geriatric population have been increased. Evaluation of the demographic variables, causes and the patterns of maxillofacial traumas in the elderly population is the main aim of this study.

Materials and Methods:
Seven hundred thirteen maxillofacial tomography images which were scanned between 2010 and 2019 were evaluated. Data from 50 patients aged 65 years old and/or older, who were treated for maxillofacial fracture at the Department of Otorhinolaryngology, Gaziantep University, were retrospectively analyzed. Two groups were created according to the facial fracture pattern. Facial fractures were reclassified into 2 groups; mandibula, orbital, zygomaticomaxillary complex group fractures and the other group of frontal, naso-orbito-ethmoid fractures and were used as a comparison.

Results:
The mean age of the patients was 72.5 (min 65- max 93). The gender distribution was 17 females (34%) and 33 males (66%). The most common fractured bone was the nasal bone and the least one is the frontal bone. Approximately one-quarter of 50 fractures were seen in 70 to 79 years old. Falling is more common in females and men are more prone to work-related accidents than home-related accidents.

Conclusion:
Facial fractures in the elderly often seen in midface location. Falling is the common etiology of facial fracture in all genders at elderly. However, male dominance is seen in other etiological factors. Additional diseases in the elderly seem to increase the severity of facial fracture.
African Americans Struggle With the Current COVID-19
Authors: Kandil Emad , Attia Abdallah S. , Youssef Mohanad R. , Hussein Mohammad , Ibraheem Kareem , Abdelgawad Mohamed , Al-Qurayshi Zaid , Duchesne Juan 
Published: July 2020

Objectives:
Our study aims to explore the differential impact of this pandemic on clinical presentations and outcomes in African Americans (AAs) compared to white patients.

Background:
AAs have worse outcomes compared to whites while facing heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, and HIV/AIDS. However, there is no current study to show the impact of COVID-19 pandemic on the AA communities.

Methods:
This is a retrospective study that included patients with laboratory-confirmed COVID-19 from 2 tertiary centers in New Orleans, LA. Clinical and laboratory data were collected. Multivariate analyses were performed to identify the risk factors associated with adverse events.

Results:
A total of 157 patients were identified. Of these, 134 (77%) were AAs, whereas 23.4% of patients were Whites. Interestingly, AA were younger, with a mean age of 63 ± 13.4 compared to 75.7 ± 23 years in Whites (P < 0.001). Thirty-seven patients presented with no insurance, and 34 of them were AA. SOFA Score was significantly higher in AA (2.57 ± 2.1) compared to White patients (1.69 ± 1.7), P = 0.041. Elevated SOFA score was associated with higher odds for intubation (odds ratio = 1.6, 95% confidence interval = 1.32–1.93, P < 0.001). AA had more prolonged length of hospital stays (11.1 ± 13.4 days vs 7.7 ± 23 days) than in Whites, P = 0.01.

Conclusion:
AAs present with more advanced disease and eventually have worse outcomes from COVID-19 infection. Future studies are warranted for further investigations that should impact the need for providing additional resources to the AA communities.
Impact of Prolonged Neoadjuvant Treatment–surgery Interval on Histopathologic and Operative Outcomes in Patients Undergoing Total Mesorectal Excision for Locally Advanced Rectal Cancer
Authors: Akbaba Ata C. , Zenger Serkan , Aytac Erman , Yozgatli Tahir K. , Bengür Fuat B. , Esen Eren , Bilgin Ismail A. , Sahin Bilgehan , Atalar Banu , Sezen Duygu , Erdamar Sibel , Kapran Yersu , Ozben Volkan , Baca Bilgi , Balik Emre , Hamzaoglu Ismail , Bugra Dursun , Karahasanoglu Tayfun 
Published: July 2020

Background:
This study primarily aimed to assess the impact of prolonged neoadjuvant treatment–surgery interval (PNSI) on histopathologic and postoperative outcomes. Impacts of the mode of neoadjuvant treatment (NT) and surgery on the outcomes were also evaluated in the same patient population.

Patients and Methods:
Between February 2011 and December 2017, patients who underwent NT and total mesorectal excision for locally advanced rectal cancer were included. PNSI was defined as >4 and >8 weeks after short-course and long-course NT modalities, respectively.

Results:
A total of 44 (27%) patients received short-course NT (standard interval: n=28; PNSI: n=16) and 122 (73%) patients received long-course NT (standard interval: n=39; PNSI: n=83). Postoperative morbidity was similar between the standard interval and PNSI in patients undergoing short-course [n=3 (11%) vs. n=3 (19%), P=0.455] and long-course [n=6 (15%) vs. n=16 (19%), P=0.602] NT. PNSI was associated with increased complete pathologic response in patients receiving short-course NT [0 vs. n=5 (31%), P=0.002]. Compared with short-course NT, long-course NT was superior in terms of tumor response based on the Mandard [Mandard 1 to 2: n=6 (21%) vs. 6 (38%), P=0.012] and the College of American Pathologists (CAP) [CAP 0 to 1: n=13 (46%) vs. n=8 (50%), P=0.009] scores. Postoperative morbidity was similar after open, laparoscopic, and robotic total mesorectal excision [n=1 (14.2%) vs. n=21 (21%) vs. n=6 (12.5%), P=0.455] irrespective of the interval time to surgery and the type of NT.

Conclusions:
PNSI can be considered in patients undergoing short-course NT due to its potential oncological benefits. The mode of surgery performed at tertiary centers has no impact on postoperative morbidity after both NT modalities.
Perioperative Outcomes of Minimally Invasive Esophagectomy Versus Open Esophagectomy: A Meta-Analysis of Randomized Controlled Trials
Authors: Memon Muhammed A. , Yunus Rossita M. 
Published: July 2020

Background:
To explore the perioperative outcomes, safety, and effectiveness of minimally invasive esophagectomy (MIE) versus open esophagectomy (OE).

Materials and Methods:
Randomized controlled comparing MIE versus OE were searched from PubMed and other electronic databases between January 1991 and March 2019. Thirteen outcome variables were analyzed. Random effects model was used to calculate the effect size. The meta-analysis was prepared in accordance with PRISMA guidelines.

Results:
Four randomized controlled trials totaling 569 patients were analyzed. For MIE, there was a significantly reduction of 67% in the odds of pulmonary complications. For operating time, MIE was nonsignificantly 29 minutes longer. MIE was associated with nonsignificantly less blood loss of 443.98 mL. There was nonsignificant 60% reduction in the odds of total complications and 51% reduction in the odds of medical complications favoring MIE group. For delayed gastric emptying, there was a nonsignificant reduction of 75% in the odds ratio favoring the MIE group. For postoperative anastomotic leak, there was a nonsignificant increase of 48% in the odds ratio for MIE group. For gastric necrosis, chylothorax, reintervention and 30-day mortality, no difference was observed for both groups. There was a nonsignificant reduction in the length of hospital stay of 7.98 days and intensive care unit stay of 2.7 days favoring MIE.

Conclusions:
MIE seems to be superior to OE for only pulmonary complications. All the other perioperative variables were comparable however, the trend is favoring the MIE. Therefore, the routine use of MIE presently may only be justifiable in high volume esophagogastric units.