bluuebunny/crossref_metadata_2025_split huggingface dataset:
Double Major for Slashing: Management of Blunt Popliteal Fossa Trauma in Ice Hockey in the Setting of Popliteal Artery Entrapment Syndrome
Authors: Singh Brij M. , Galimova Irina , Singh Tej M. 
Published: September 2021

Abstract:
Popliteal artery entrapment syndrome (PAES) is a rare condition that produces calf claudication in young patients. It is most commonly a result of aberrant anatomy of the popliteal fossa. If undiagnosed, PAES can lead to acute ischemia and a threatened limb as a result of complete arterial occlusion or embolism. Ice hockey is a contact sport, and slashing on the covered legs is well described as a strategy and contact point. We present a unique case that highlights a blunt popliteal artery injury in a young player with an underlying type 2 PAES. We discuss the initial diagnosis and endovascular/vascular surgical treatment, followed by the delayed management of the popliteal artery injury. We also provide considerations for popliteal fossa blunt trauma and need for future protection of the popliteal fossa for athletes.
A Direct Comparative Study of Bronchoscopic Navigation Planning Platforms for Peripheral Lung Navigation
Authors: Akulian Jason A. , Molena Daniela , Wahidi Momen M. , Chen Alex , Yu Diana , Maldonado Fabien , Lee Hans , Vachani Anil , Yarmus Lonny ,   on behalf of the Interventional Pulmonary Outcomes Group (IPOG)
Published: September 2021

Background:
The use of mapping to guide peripheral lung navigation (PLN) represents an advance in the management of peripheral pulmonary lesions (PPL). Software has been developed to virtually reconstruct computed tomography images into 3-dimensional airway maps and generate navigation pathways to target PPL. Despite this there remain significant gaps in understanding the factors associated with navigation success and failure including the cartographic performance characteristics of these software algorithms. This study was designed to determine whether differences exist when comparing PLN mapping platforms.

Methods:
An observational direct comparison was performed to evaluate navigation planning software packages for the lung. The primary endpoint was distance from the terminal end of the virtual navigation pathway to the target PPL. Secondary endpoints included distal virtual and segmental airway generations built to the target and/or in each lung.

Results:
Twenty-five patient chest computed tomography scans with 41 PPL were evaluated. Virtual airway and navigation pathway maps were generated for each scan/nodule across all platforms. Virtual navigation pathway comparison revealed differences in the distance from the terminal end of the navigation pathway to the target PPL (robotic bronchoscopy 9.4 mm vs. tip-tracked electromagnetic navigation 14.2 mm vs. catheter based electromagnetic navigation 17.2 mm, P=0.0005) and in the generation of complete distal airway maps.

Conclusion:
Comparing PLN planning software revealed significant differences in the generation of virtual airway and navigation maps. These differences may play an unrecognized role in the accurate PLN and biopsy of PPL. Further prospective trials are needed to quantify the effect of the differences reported.
Therapeutic Rigid Bronchoscopy Intervention for Malignant Central Airway Obstruction Improves Performance Status to Allow Systemic Treatment
Authors: Lee Edward Y.C. , McWilliams Annette M. , Salamonsen Matthew R. 
Published: September 2021

Background:
Malignant central airway obstruction may result in an Eastern Cooperative Oncology Group Performance Status (ECOG PS) that precludes treatment with systemic therapies. We sought to evaluate outcomes of patients undergoing rigid bronchoscopy for malignant central airways obstruction (MCAO) and its effect on access to systemic therapies including immunotherapy.

Patients and Methods:
We conducted a retrospective observational single-center study evaluating 77 consecutive patients who underwent rigid bronchoscopy from March 2015 to November 2019. Procedural details, preprocedural and postprocedural ECOG PS, complications, and proportions of patients receiving systemic therapy postprocedure were recorded.

Results:
The majority of patients were ECOG PS 2 to 3 at diagnosis (62%). The most common indication was MCAO due to squamous cell carcinoma (35.1%). MCAO was managed with a debulking/dilatation procedure alone (51.9%) or in combination with stenting (48.1%). The laser was unavailable, electrocautery was used for hemostasis only not tumor ablation. Significant improvement in ECOG PS postprocedure in the group with baseline ECOG PS 3 to 4 (P<0.0001) and in those with baseline ECOG PS 0 to 4 (P<0.00001) was observed. The main complication was bleeding, controlled bronchoscopically with mechanical compression with a rigid bronchoscope and/or electrocautery (68.8% of patients). No deaths occurred. Overall, 70% of those presenting with ECOG 3 to 4 went onto receive systemic therapies that would have been contraindicated due to poor baseline ECOG PS.

Conclusion:
Therapeutic rigid bronchoscopy is safe and efficacious in the management of MCAO, improving ECOG PS allowing for the administration of systemic therapies. This is especially important in the era of immunotherapy and directed therapies, which have been shown to provide significant survival benefit over conventional therapies alone.
Effect of cognitive behavioral active engagement training on test item construction skills among primary school teachers in Nigeria
Authors: Ede Moses Onyemaechi , Agah John J. , Okeke Chinedu Ifedi , Chuks Zudonu Onisoman , Oguguo Basil C.E. , Agu Patricia Uzoamaka , Ene Catherine U. , Ekesionye Ngozi E. , Nji Ifeyinwa Awele , Eze Chikodili , Manafa Ifeyinwa F. 
Published: September 2021

Abstract

Background:
Most classroom teachers are weak in constructing test items for assessment of students. This study examined the effects of cognitive behavioral active engagement training on test items construction skills among primary school teachers in Nigeria.

Methods:
We adopted a randomized pretest–posttest control group design. A total of 148 participants served as the study sample. One instrument was used for data collection. The participants were administered the instrument at 4 different times. Test construction guide was employed to implement the training. Data analysis was completed using analysis of covariance.

Results
The researchers found that cognitive behavioral active engagement training had a significant effect on participants’ test items construction scores as measured by test construction skills inventory at posttest, first and second follow-up stages.

Conclusion
The researchers concluded that cognitive behavioral active engagement training is efficacious in the improvement of test items construction skills among primary school teachers in Nigeria.
Two years outcomes of treating full-thickness macula hole associated with idiopathic macular telangiectasia type 2 by internal limiting membrane inverted flap technique
Authors: Nishiyama Shungo , Iwase Takeshi 
Published: September 2021

Abstract

Rational:
Macular telangiectasia (MacTel) is an uncommon ocular disorder that can lead to legal blindness. MacTel type 2 is characterized by a bilateral loss of macular transparency, the presence of white crystals on the retina, aberrant blood vessel growth, and neurodegeneration of the macula. Full-thickness macular holes (FTMHs) are a prominent cause of vision reduction in MacTel type 2, and the standard care for an FTMH is pars plana vitrectomy (PPV) to restore the FTMH and best-corrected visual acuity (BCVA). However, surgical outcomes in previous reports were not good, with a lack of closure or a reopening of the FTMH, compared with those with an idiopathic FTMH. Thus, this study aimed to determine the surgical outcomes of PPV with the inverted ILM flap technique for the treatment of FTMHs with a 2-year postoperative follow-up in three patients with MacTel type 2.

Patient concerns:
This study involved 3 patients who had been diagnosed with MacTel type 2 at a local eye clinic and who was subsequently referred to our department for a more detailed examination.

Diagnoses:
Three patients were diagnosed with MacTel type 2 using dilated ophthalmoscopy, fluorescein angiography, and optical coherence tomography (OCT) in both eyes. A FTMH was developed and visual acuity decreased during follow-up period in all of the patients.

Interventions:
Each patient underwent PPV in 1 eye using the inverted ILM-flap technique, gas tamponade, and prone positioning.

Outcomes:
The FTMH was successfully closed in the 3 cases after the surgery. OCT showed that the FTMH remained closed at the last follow-up examination in 2 patients and vision improved to 20/20 and 20/25. In the other patient, the hole was closed temporarily after surgery, but was reopened at 6 months. The vision had improved to 20/60 until the hole was reopened, and it was 20/100 at the final follow-up examination.

Lessons:
Although only 3 patients were examined, the inverted ILM-flap technique may be an effective and safe method to close an FTMH in patients with MacTel type 2. However, the surgery cannot prevent the reopening of the hole when the retinal atrophy progresses.
Removal of a catheter mount and heat-and-moisture exchanger improves hypercapnia in patients with acute respiratory distress syndrome
Authors: Shimoda Takaya , Sekino Motohiro , Higashijima Ushio , Matsumoto Sojiro , Sato Shuntaro , Yano Rintaro , Egashira Takashi , Araki Hiroshi , Naoya Iwasaki , Miki Suzumura , Koyanagi Ryo , Hayashi Makoto , Kurihara Shintaro , Hara Tetsuya 
Published: September 2021

Abstract
To avoid ventilator-associated lung injury in acute respiratory distress syndrome (ARDS) treatment, respiratory management should be performed at a low tidal volume of 6 to 8 mL/kg and plateau pressure of ≤30 cmH2O. However, such lung-protective ventilation often results in hypercapnia, which is a risk factor for poor outcomes. The purpose of this study was to retrospectively evaluate the effectiveness and safety of the removal of a catheter mount (CM) and using heated humidifiers (HH) instead of a heat-and-moisture exchanger (HME) for reducing the mechanical dead space created by the CM and HME, which may improve hypercapnia in patients with ARDS.
This retrospective observational study included adult patients with ARDS, who developed hypercapnia (PaCO2 > 45 mm Hg) during mechanical ventilation, with target tidal volumes between 6 and 8 mL/kg and a plateau pressure of ≤30 cmH2O, and underwent stepwise removal of CM and HME (replaced with HH). The PaCO2 values were measured at 3 points: ventilator circuit with CM and HME (CM + HME) use, with HME (HME), and with HH (HH), and the overall number of accidental extubations was evaluated. Ventilator values (tidal volume, respiratory rate, minutes volume) were evaluated at the same points.
A total of 21 patients with mild-to-moderate ARDS who were treated under deep sedation were included. The values of PaCO2 at HME (52.7 ± 7.4 mm Hg, P < .0001) and HH (46.3 ± 6.8 mm Hg, P < .0001) were significantly lower than those at CM + HME (55.9 ± 7.9 mm Hg). Measured ventilator values were similar at CM + HME, HME, and HH. There were no cases of reintubation due to accidental extubation after the removal of CM.
The removal of CM and HME reduced PaCO2 values without changing the ventilator settings in deeply sedated patients with mild-to-moderate ARDS on lung-protective ventilation. Caution should be exercised, as the removal of a CM may result in circuit disconnection or accidental extubation. Nevertheless, this intervention may improve hypercapnia and promote lung-protective ventilation.
Drugs in Focus
Authors: Mas Emmanuel , Borrelli Osvaldo , Broekaert Ilse , de‐Carpi J. Martin , Dolinsek Jernej , Miele Erasmo , Pienar Corina , Koninckx C. Ribes , Thomassen Ruth‐Anne , Thomson Mike , Tzivinikos Christo , Benninga Marc A. 
Published: September 2021

ABSTRACTOctreotide, a somatostatin analogue, has been used for more than 20 years in children with gastrointestinal bleeding, chylothorax or chylous ascites, intestinal lymphangiectasia, pancreatitis, intestinal dysmotility, and severe diarrhoea; however, until now, there is a lack of randomised clinical trials evaluating the efficacy of this compound in childhood. Hence, we aimed to review the literature in order to determine the evidence of its use and safety in children, using PubMed from 2000 to 2021 with the search terms “octreotide” and “children” and “bleeding or chylous ascites or chylothorax or acute pancreatitis or lymphangiectasia or diarrhoea or intestinal dysmotility”.
Health Promotion and Wellness in Neurologic Physical Therapy: Strategies to Advance Practice
Authors: Rafferty Miriam R. , Held Bradford Elissa C. , Fritz Stacy , Hutchinson Karen J. , Miczak Kimberly , Resnick Arielle , Billinger Sandra A. 
Published: September 2021

Background and Purpose:
Neurologic physical therapy (PT) can assist people with neurologic conditions and injuries to optimize their health and well-being by addressing barriers at the individual, relationship, community, and societal levels. The purpose of this special interest article is to provide consensus-driven strategies to address barriers to implementing health promotion and wellness (HPW)-related neurologic PT practice.

Summary of Key Points:
Environmental scan, literature review, and expert input were used to determine barriers and develop strategies. Barriers include lack of time; low knowledge, self-efficacy, and awareness; client complexity; and lack of HPW resources; as well as concerns regarding payment and scope of practice. Four key strategies emerged: (1) develop and disseminate a consensus-based scope of practice for HPW in neurologic PT; (2) increase knowledge of resources related to HPW; (3) promote delivery models for HPW-related neurologic PT; and (4) encourage advocacy, community building and partnership along the continuum of care.

Recommendations for Clinical Practice:
Clinicians should practice to their full scope of HPW-related PT practice. This includes optimizing movement, including physical activity and fitness, as well as reinforcing the importance of healthy sleep, nutrition, stress, and smoking cessation. These activities address primary, secondary, and tertiary prevention. Clinicians are encouraged to report their experiences with HPW-focused delivery models and outcomes. Additional research is needed to understand the full impact of HPW on PT practice (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A364).
Feasibility of Point-of-Care Ultrasound for Diagnosing Hypertrophic Pyloric Stenosis in the Emergency Department
Authors: Park Jun Sung , Byun Young-Hoon , Choi Seung Jun , Lee Jong Seung , Ryu Jeong-Min , Lee Jeong-Yong 
Published: September 2021

ObjectivesThis study aimed to investigate the feasibility of point-of-care ultrasound (POCUS) for diagnosing hypertrophic pyloric stenosis (HPS) in the emergency department (ED).MethodsA retrospective study was conducted in infants aged younger than 90 days who were brought to the ED due to vomiting between January 2015 and December 2019. Of these, infants who were clinically suspected of having HPS and underwent ultrasound were included and categorized into 3 groups: POCUS only, POCUS followed by radiologist-performed ultrasound (RADUS), and RADUS only. All confirmative diagnoses of HPS were made by RADUS. The diagnostic performance of POCUS was analyzed, and the ED patient flow was compared between the POCUS-performed (POCUS only or POCUS followed by RADUS) and RADUS-only groups.ResultsOverall, 171 patients with a median age of 34 days were included. Of these, 79 patients (46.2%) underwent POCUS only, and none had HPS; 50 patients (29.2%) underwent POCUS followed by RADUS; and 42 patients (24.5%) underwent RADUS only. Overall, 41 patients (24.0%) were diagnosed with HPS, and POCUS showed a sensitivity of 96.6% and specificity of 94.0%. In the total cohort, length of stay in the ED (EDLOS) was shorter in the POCUS-performed group than in the RADUS-only group (2.6 vs 3.8 hours,P= 0.015). Among non-HPS patients, time to disposition (1.8 vs 2.7 hours,P= 0.005) and EDLOS (2.0 vs 3.0 hours,P= 0.004) were shorter in the POCUS-performed group than in the RADUS-only group. Performing POCUS followed by RADUS did not significantly delay the treatment among HPS patients.ConclusionsPoint-of-care ultrasound is accurate and useful for diagnosing HPS and improved the ED patient flow by reducing EDLOS and door-to-disposition time in non-HPS patients.
Lessons Learned From Implementing Rehabilitation at a COVID-19 Field Hospital
Authors: McLaughlin Kevin H. , Simon Lauren , Friedman Michael , Siddiqui Zishan K. , Ficke James R. , Kantsiper Melinda E. ,   CONQUER COVID Consortium
Published: September 2021

Abstract
Rehabilitation experts play an important role in preventing hospital-acquired debility, increasing patients’ abilities to safely perform activities of daily living, and facilitating discharge to the home setting for patients with COVID-19. Surges in COVID-19 hospitalization rates combined with increases in length of hospital stay and decreases in postacute care placements have necessitated the opening of COVID-19 field hospitals around the country. Most field hospitals lack the resources to offer a full suite of rehabilitation services, but there are opportunities for small teams of rehabilitation experts to increase their reach by using innovative strategies. This article describes the implementation of a small team of rehabilitation experts in a COVID-19 field hospital and strategies used by this team to maximize patient activity and mobility, facilitate timely discharge, and maximize the number of patients discharged to the home setting. Strategies include training nonclinical staff to assist with activity and mobility promotion and using a rehabilitation triage system to determine needs of individual patients and facilitate efficient resource utilization. The authors reflect on successful aspects of these strategies, as well as barriers to rehabilitation implementation, and make recommendations for other field hospitals seeking to implement rehabilitation during the COVID-19 pandemic or future health crises.
Psychobiological Mechanisms in Somatic Symptom Disorder and Depressive Disorders: An Ecological Momentary Assessment Approach
Authors: Mewes Ricarda , Feneberg Anja C. , Doerr Johanna M. , Nater Urs M. 
Published: September 2021

ABSTRACT

Objective
Persistent somatic symptoms cause strong impairment in persons with somatic symptom disorder (SSD) and depressive disorders (DDs). Specific negative psychological factors (NPFs), such as catastrophizing, negative affectivity, and behavioral avoidance, are assumed to contribute to this impairment and may maintain symptoms via dysregulations of biological stress systems. We examined the associations between NPF and somatic symptoms in the daily life of women with SSD or DD and investigated the mediating role of psychobiological stress responses.

Methods
Twenty-nine women with SSD and 29 women with DD participated in an ecological momentary assessment study. For 14 days, intensity of and impairment by somatic symptoms, NPF, and stress-related biological measures (cortisol, alpha-amylase) were assessed five times per day using an electronic device and saliva samples. Multilevel models were conducted.

Results
The greater the number of NPF, the higher the concurrent and time-lagged intensity of and impairment by somatic symptoms in both groups (12.0%–38.6% of variance explained; χ2(12) p < .001 for all models). NPFs were associated with higher cortisol levels in women with DD and with lower levels in women with SSD (interaction NPF by group: B = −0.04, p = .042 for concurrent; B = −0.06, p = .019 for time-lagged). In women with SSD, lower cortisol levels were associated with higher intensity at the next measurement time point (group by cortisol: B = −1.71, p = .020). No mediation effects were found.

Conclusions
NPFs may be considered as transdiagnostic factors in the development and treatment of impairing somatic symptoms. Our findings will allow the development of new treatment strategies that use ecological momentary intervention approaches focusing on NPF.
Brief Report: Efficacy and Safety of Bictegravir/Emtricitabine/Tenofovir Alafenamide in Females Living With HIV: An Integrated Analysis of 5 Trials
Authors: Orkin Chloe , Ajana Faiza , Kityo Cissy , Koenig Ellen , Natukunda Eva , Gandhi-Patel Bhumi , Wang Hui , Liu Yapei , Wei Xuelian , White Kirsten , Makadzange Tariro , Pikora Cheryl , McNicholl Ian , Collins Sean E. , Brainard Diana , Chuck Susan K. 
Published: September 2021

Background:
We characterized the efficacy and safety of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in a broad population of pediatric/adolescent/adult/elderly females living with HIV (FWH).

Setting:
Integrated analysis.

Methods:
Available data from 5 trials were integrated. Week 48 virologic suppression (HIV-1 RNA <50 copies/mL), resistance, adverse events (AEs), and laboratory parameters were assessed.

Results:
Three hundred and seventy-three FWH [304 virologically suppressed; 69 antiretroviral therapy (ART)-naive] received B/F/TAF [data from comparator regimens available for 306 individuals (236 virologically suppressed and 70 ART-naive participants)]. Virologic suppression rates with B/F/TAF at week 48 were high regardless of age in participants virologically suppressed at baseline (≥95%) and in ART-naive participants (≥87%). Virologic suppression rates were similar in B/F/TAF and comparator regimens (both virologically suppressed and ART-naive groups). Treatment-emergent resistance was not detected in the B/F/TAF group. AEs considered related to study drugs were experienced by 9.2% (B/F/TAF) and 5.5% (comparator regimen) of virologically suppressed participants and 15.9% (B/F/TAF) and 31.4% (comparator regimen) of ART-naive participants. For virologically suppressed and ART-naive FWH combined, only 1 of the 373 B/F/TAF–treated and 2 of the 306 comparator-regimen participants discontinued because of AEs (none were bone/renal/hepatic AEs); grade 3/4 AEs were experienced by 5.1% (B/F/TAF) and 7.8% (comparator regimen); and grade 3/4 elevation of low-density lipoprotein/total cholesterol occurred in 2.7%/0.3% (B/F/TAF) and 5.9%/2.0% (comparator regimen). At week 48, median changes from baseline estimated glomerular filtration rate in adults were <5 mL/min; results were similar in B/F/TAF and comparator-regimen groups.

Conclusion:
B/F/TAF treatment was effective and well tolerated over 48 weeks, confirming B/F/TAF as an option for a broad population of FWH.