bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aerosol Generation During Bronchoscopy
Authors: Reddy Chakravarthy , Sethi Jaskaran , Balwan Akshu , Iravani Aidin , Ansari Sikandar , Kelly Kerry 
Published: September 2021

Background:
Bronchoscopy is an aerosol-generating procedure and can place the health care providers at risk for exposure to viral pathogens. The pattern of aerosol generation during different aspects of bronchoscopy are poorly understood. The goal of this study is to characterize the pattern of aerosol generation during flexible and rigid bronchoscopy performed under moderate sedation or general anesthesia (GA). The inhalable mass concentration of aerosol generated during the procedures was measured continuously.

Methods:
The aerosol concentration in the endoscopy room at baseline and while the procedures were performed was measured. Procedures included flexible bronchoscopies with moderate sedation, flexible bronchoscopies performed through endotracheal tube under GA and rigid bronchoscopies under GA. Changes from the baseline were measured continuously during the bronchoscopy.

Results:
Measurements obtained during the procedure were compared with the baseline reading. For flexible bronchoscopy under moderate sedation, the inhalable aerosol fraction was significantly higher (P=0.036) during atomization of lidocaine. For Flexible bronchoscopy through endotracheal tube, inhalable aerosol fraction was significantly higher (P<0.001) during intubation and extubation. For rigid bronchoscopy done under GA with jet ventilation, inhalable aerosol fraction was significantly higher during both the bronchoscopy (P=0.01) and recovery (P=0.012).

Conclusion:
Elevated levels of aerosol were generated during all aspects of bronchoscopy. However, atomization of lidocaine, intubation, extubation, and recovery generated the most aerosol.
Diagnostic value of combined serological markers in the detection of acute cerebral infarction
Authors: Zhao Xiaowen , Zhao Min , Pang Baojun , Zhu Yingnan , Liu Jizhu 
Published: September 2021

Abstract
To evaluate the value of the combination schemes of 10 serological markers in the clinical diagnosis of acute cerebral infarction.
The level of total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, homocysteine (HCY), lipoprotein-related phospholipase A2, ischemia-modified albumin, complement C1q, and lipoprotein a were analyzed in 154 patients with acute ischemic cerebral infarction. The optimized diagnostic combination for acute cerebral infarction was explored by calculating the maximum area under the receiver operating characteristic curves (AUC).
The levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, HCY, lipoprotein-related phospholipase A2, ischemia-modified albumin, complement C1q, and lipoprotein a were significantly higher in the patient vs the control group. Moreover, the positive rate of HCY reached 89.9%. The analysis of the receiver operating characteristic curve of each index and their combinations showed that the minimum AUC of HDL-C alone was 0.543, while the maximum AUC of HCY was 0.853. A multiple logistic regression analysis indicated that HDL-C was a slightly significant variate in the diagnosis of acute cerebral infarction.
The value of individual serological markers in the diagnosis of acute cerebral infarction was slightly significant, while the combination of the markers significantly improved the efficiency of its diagnosis.
Postoperative complications observed with robotic versus laparoscopic surgery for the treatment of rectal cancer
Authors: Liu Chengkui , Li Xiaoqing , Wang Qingfeng 
Published: September 2021

Abstract

Background:
This is an updated meta-analysis comparing the postoperative complications observed with robotic versus laparoscopic surgery (LS) for the treatment of rectal cancer.

Methods:
Cochrane central, MEDLNE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica dataBASE), Google Scholar, Web of Science and http://www.ClinicalTrials.gov were searched for studies (published after the year 2015), comparing robotic versus LS for the treatment of rectal cancer. The postoperative outcomes were considered as the endpoints in this analysis. RevMan 5.4 was used to carry out the statistical analysis. Risk ratio (RR) with 95% confidence intervals (CI) were used to represent the results following data analysis.

Results
A total number of 22,744 participants were included in this study whereby 9178 participants were assigned to the robotic surgery and 13,566 participants were assigned to the LS group. The time period of patients’ enrollment varied from years 2007 to 2017. Our results showed that overall complications (RR: 0.91, 95% CI: 0.71–1.17; P = .45), wound complications (RR: 0.81, 95% CI: 0.64–1.04; P = .09), anastomotic leak (RR: 1.12, 95% CI: 0.88–1.42; P = .37), anastomotic bleeding (RR: 0.88, 95% CI: 0.29–2.64; P = .82), stoma-related complications (RR: 0.88, 95% CI: 0.24–3.21; P = .85), intra-abdominal abscess (RR: 0.53. 95% CI: 0.22–1.31; P = .17), urinary tract infection (RR: 0.94, 95% CI: 0.53–1.66; P = .83), enterocolitis (RR: 1.35, 95% CI: 0.38–4.71; P = .64), reoperation (RR: 0.85, 95% CI: 0.46–1.54; P = .58), and mortality (RR: 0.75, 95% CI: 0.34–1.62; P = .46) were not significantly different between robotic-assisted versus LS for rectal cancer. Postoperative ileus (RR: 1.21, 95% CI: 0.81–1.81; P = .34), readmission (RR: 1.17, 95% CI: 0.75–1.83; P = .48), and urinary retention (RR: 0.51, 95% CI: 0.21–1.23; P = .14) were also similarly manifested.

Conclusions:
In this updated meta-analysis, both robotic and laparoscopic surgeries were equally effective for the treatment of rectal cancer. Similar postoperative complications were observed. However, our analysis was restricted only to postoperative outcomes, parameters such as duration of surgery were not taken into consideration.
Robotic sacrocolpopexy in pelvic organ prolapse: a review of current literature
Authors: Pushkar Dmitry Y. , Kasyan George R. , Popov Alexander A. 
Published: September 2021

Purpose of review
Recently, robotic sacrocolpopexy has become the gold standard for treating genital prolapse. Despite this, there is still much interest in this procedure, and many questions remain unanswered. This review focuses on the most critical articles on this issue that have been published in the last 2 years.

Recent findings
A summary of 23 articles is provided. There were no differences in total postoperative complications, postoperative stress incontinence, mesh erosion, and the success of the two surgical techniques in long-term investigations. Obesity modestly increases robotic approach difficulty and does not raise the mesh erosion rate or prolapse recurrence rate. Ultra-light and preprepared meshes with alternative fixation techniques can be applied with these procedures. Another emerging trend is alternative robotic approaches and the use of single-port surgery.

Summary
For women with pelvic organ prolapse, especially the elderly and obese, robotic sacrocolpopexy is well tolerated and effective. Despite highly restricted and heterogeneous data, recent investigations have included single incision methods and new mesh/fixation materials. Randomized trials with large sample size and excellent quality are necessary before the practical implementation of new techniques.
Symmetry Is Associated With Interlimb Coordination During Walking and Pedaling After Stroke
Authors: Cleland Brice T. , Schindler-Ivens Sheila 
Published: September 2021

Background and Purpose:
Asymmetry during walking may be explained by impaired interlimb coordination. We examined these associations: (1) propulsive symmetry with interlimb coordination during walking, (2) work symmetry with interlimb coordination during pedaling, and (3) work symmetry and interlimb coordination with clinical impairment.

Methods:
Nineteen individuals with chronic stroke and 15 controls performed bilateral, lower limb pedaling with a conventional device and a device with a bisected crank and upstroke assistance. Individuals with stroke walked on a split-belt treadmill. Measures of symmetry (%Propulsionwalk, %Workped) and interlimb phase coordination index (PCIwalk, PCIped) were computed. Clinical evaluations were the lower extremity Fugl-Meyer (FMLE) and walking speed. Associations were assessed with Spearman's rank correlations.

Results:
Participants with stroke displayed asymmetry and impaired interlimb coordination compared with controls (P ≤ 0.001). There were significant correlations between asymmetry and impaired interlimb coordination (walking: R
2 = 0.79, P < 0.001; pedaling: R
2 = 0.62, P < 0.001) and between analogous measures across tasks (%Workped, %Propulsionwalk: R
2 = 0.41, P = 0.01; PCIped, PCIwalk: R
2 = 0.52, P = 0.003). Regardless of task, asymmetry and interlimb coordination were correlated with FMLE (R
2 ≥ 0.48, P ≤ 0.004) but not walking speed. There was larger within group variation for %Propulsionwalk than %Workped (Z = 2.6, P = 0.005) and for PCIped than PCIwalk (Z = 3.6, P = 0.003).

Discussion and Conclusions:
Pedaling may provide useful insights about walking, and impaired interlimb coordination may contribute to asymmetry in walking. Pedaling and walking provide distinct insights into stroke-related impairments, related to whether the task allows compensation (walking > pedaling) or compels paretic limb use (pedaling > walking). Pedaling a device with a bisected crank shaft may have therapeutic value.

Video Abstract available for more insight from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A365).
Providers PrEP: Identifying Primary Health care Providers' Biases as Barriers to Provision of Equitable PrEP Services
Authors: Hull Shawnika J. , Tessema Hanna , Thuku Jeri , Scott Rachel K. 
Published: September 2021

Background:
Despite their disparately high HIV incidence and voiced willingness to use pre-exposure prophylaxis (PrEP), Black cisgender women's knowledge and uptake of PrEP are low, especially relative to White cisgender women and men who have sex with men. Mounting evidence demonstrates that health care provider recommendations are a critical factor in women's awareness, willingness, and ability to uptake PrEP. Health care providers may make clinical judgments about who is (not) a good candidate for PrEP based on unconscious and conscious stereotypes and prejudice.

Setting:
We conducted an online experiment among N = 160 health care providers with prescribing privileges in the 48 HIV hotspot counties.

Method:
Providers received 1 of 4 vignettes about a PrEP eligible woman. Vignettes varied by patient race and substance use status. Then, providers reported their willingness to discuss PrEP with the patient and willingness to prescribe PrEP to her.

Results:
We tested 2 models predicting providers (1) willingness to discuss and (2) willingness to prescribe PrEP, contingent on their racial attitudes. Providers who scored high on a modern racism measure were less willing to discuss and prescribe PrEP to the Black patient. These effects were mediated by provider perceptions of patients' abilities to adhere to PrEP, but not their expectations of risk compensatory behaviors.

Conclusions:
Our findings highlight the importance of applying an intersectional lens in documenting the processes that exacerbate inequities in PrEP use. This study provides evidence to support the development of interventions that address the mechanisms that work to thwart optimal care.
18F-FDG PET/CT of Malignant Presacral Masses in Currarino Syndrome
Authors: Nguyen Ba D. 
Published: September 2021

Abstract
The Currarino syndrome is characterized by 3 main features: anorectal malformation, presacral lesion, and dysgenesis of the sacrum and coccyx. The presacral lesion is usually benign with a rare occurrence of malignant degeneration. The author presents 2 cases of Currarino syndrome with presacral mucinous adenocarcinoma and neuroendocrine tumor depicted by 18F FDG PET/CT.
Malignant Lymphoma Diagnosed as Gallbladder Carcinoma on 18F-FDG PET/CT
Authors: Xu Lian , Yu Xiaofeng , Chen Yumei , Liu Jianjun 
Published: September 2021

Abstract
Extranodal primary lymphoma of gallbladder is extremely rare. We report a 48-year-old woman initially diagnosed as gallbladder carcinoma with lymph nodes metastases by contrast-enhanced CT and MRI. Meanwhile the images of 18F-FDG PET/CT highly suggested gallbladder carcinoma due to the necrosis in one of the enlarged lymph nodes. However, it was proved to be diffuse large B-cell lymphoma by the histopathological diagnosis.
Increased 68Ga-FAPI Activity in Malignant Melanoma of the Nasal Cavity
Authors: Ou Lei , Yang Xiao , Liu Huipan , Gong Weidong , Zhang Chunyin 
Published: September 2021

Abstract
We report the case of a 56-year-old man who presented with a 1-month history of recurrent right-sided epistaxis. Nasal endoscopy revealed a mass in the right nasal cavity, and CT scans showed a nasal space-occupying lesion. 68Ga-FAPI PET/CT demonstrated a high FAPI uptake of the mass in the right nasal cavity. Biopsy revealed a malignant melanoma.
123I Scintigraphy Mirror Image of Graves Disease Induced by Radioiodine Treatment for Toxic Adenoma
Authors: Lugat Alexandre , Drui Delphine , Bach-Ngohou Kalyane , Guillot Pascale , Mourrain-Langlois Emmanuelle , Kraeber-Bodéré Françoise , Ansquer Catherine 
Published: September 2021

Abstract
A 61-year-old woman presenting with hyperthyroidism received 131I therapy for a toxic adenoma diagnosed by 123I scintigraphy. Six months later, the patient had a relapse of hyperthyroidism, and 123I scintigraphy showed a mirror image of the first scintigraphy: a high and diffuse uptake in the thyroid gland except for the previously treated nodule. Graves disease was confirmed by elevated thyrotropin receptor antibodies. The patient was cured by a second radioiodine therapy. Radioiodine-induced Graves disease may occur within 6 months of 131I treatment of toxic adenoma and can be treated with a second line of 131I.
68Ga-FAPI PET/CT Imaging of Multiple Muscle Metastases of Pancreatic Cancer
Authors: Gong Weidong , Yang Xiao , Wu Junhao , Ou Lei , Zhang Chunyin 
Published: September 2021

Abstract
A 67-year-old man presented with generalized muscle pain for 2 months. A potential malignancy was suspected. The patient was subsequently enrolled in the clinical trial of 68Ga-FAPI. Increased activity of FAPI and FDG was observed in muscle lesions. Moreover, 68Ga-FAPI PET/CT showed intense FAPI uptake in the pancreas. Finally, pancreas and left iliopsoas muscle biopsies confirmed the diagnosis of pancreatic cancer with multiple muscle metastases.
Anti-microbial effect of filtered 222nm excimer lamps in a hospital waiting area
Authors: Thyrsted Jacob , Helbo Skaarup Søren , Fløe Hvass Andreas , Joensen Sara Moeslund , Nielsen Stine Y. , Bendstrup Elisabeth , Hauschildt Pernille , Holm Christian K. 
Published: September 2021

SummaryBackgroundHospital aquired infections is a considerable challenge for vulnerable patients. Ultraviolet light based on the excitation of mercury emit light at 254nm and has well established antimicrobial effects but the use hereof in populated areas is hindered by the carcinogenic properties of 254nm. This is in contrast to the recently developed excimer lamps based on krypton chloride (KrCl). These lamps emit light with a peak intensity at a wavelength of 222nm and have recently been demonstrated to have broad bactericidal and viricidal effects including efficient inactivation of SARS-CoV2. It is, however, unclear how efficiently 222nm lamps perform in a real-life setting such as a hospital waiting area. In this study we aimed to assess the antimicrobial efficacy of filtered 222nm excimer lamps in a real-world setting at an out-patient pulmonology clinic.MethodsFiltered KrCl 222nm excimer lamps (UV222 lamps) were installed in a densely populated waiting room at the out-patient waiting area at Department of Respiratory Diseases and Allergy at Aarhus University Hospital, Aarhus, Denmark. Furniture sufaces were sampled and analyzed for bacterial load in a single arm interventional longitudinal study with and without exposure to filtered 222nm UVC-light. Furthermore, bacterial species were identified using MALDI-ToF mass-spectrometry.FindingsThe exposure to filtered 222nm UVC-light significantly reduced the number of colony-forming-units, and patches with high desity of bacteria. Pathogenic bacteria such as Staphylococcus Aureus and Staphylococcus Epidermidis were detected only in the non-exposed areas suggesting that these species are highly sensitive to inactivation by 222nm UVC-light.ConclusionFiltered 222nm UVC-light is highly anti-microbial in a real-world clinical setting reducing bacterial load and eradicating clinically relevant bacteria species. Filtered 222nm UVC-light has the potential to become an important part of current and future anti-microbial prevention in the clinic.
Network Meta-Analysis Comparing the Short and Long-Term Outcomes of Alternative Access for Transcatheter Aortic Valve Replacement
Authors: Ranka Sagar , Lahan Shubham , Chhatriwalla Adnan K. , Allen Keith B. , Verma Sadhika , Villablanca Pedro 
Published: September 2021

AbstractObjectivesThis study aimed to compare short- and long-term outcomes following various alternative access routes for transcatheter aortic valve replacement (TAVR).MethodsThirty-four studies with a pooled sample size of 30,986 records were selected by searching PubMed and Cochrane library databases from inception through 11thJune 2021 for patients undergoing TAVR via 1 of 6 different access sites: Transfemoral (TF), Transaortic (TAO), Transapical (TA), Transcarotid (TC), Transaxillary/Subclavian (TSA), and Transcaval (TCV). Data extracted from these studies were used to conduct a frequentist network meta-analysis with a random-effects model using TF access as a reference group.ResultsCompared with TF, both TAO [RR 1.91, 95% CI (1.46–2.50)] and TA access [RR 2.12, 95%CI (1.84–2.46)] were associated with an increased risk of 30-day mortality. No significant difference was observed for stroke, myocardial infarction, major bleeding, conversion to open surgery, and major adverse cardiovascular or cerebrovascular events in the short-term (≤ 30 days). Major vascular complications were lower in TA [RR 0.43, (95% CI, 0.28-0.67)] and TC [RR 0.51, 95% CI (0.35-0.73)] access compared to TF. The 1-year mortality was higher in the TAO [RR of 1.35, (95% CI, 1.01–1.81)] and TA [RR 1.44, (95% CI, 1.14–1.81)] groups.ConclusionNon-thoracic alternative access site utilization for TAVR implantation (TC, TSA and TCV) is associated with similar outcomes to conventional TF access. Thoracic TAVR access (TAO and TA) is associated with increased short and long-term mortality.
Neuromuscular risk factors for non-contact knee injury: a systematic review and meta-analysis
Authors: McGuire Bonar , King Ben 
Published: September 2021

ABSTRACTObjectivesIdentify neuromuscular risk factors for non-contact knee injury, using a systematic review and meta-analysis, to inform the development of preventive strategies.MethodsMedline, Web of Science and SCOPUS were searched from inception until November 2020. Prospective and nested case-control studies that analysed baseline neuromuscular characteristics as potential risk factors for subsequent non-contact knee injuries were included. Two reviewers independently appraised methodological quality using a modified Newcastle–Ottawa Scale. Meta-analysis was performed where appropriate, with standardised mean differences calculated for continuous scaled data.ResultsSeventeen studies were included, comprising baseline data from 5,584 participants and 415 non-contact knee injuries (heterogeneous incidence = 7.4%). Protocols and outcome measures differed across studies, limiting data pooling. Twenty-one neuromuscular variables were included in the meta-analysis. Three were identified as risk factors. For patellofemoral pain, among military recruits: reduced non-normalised quadriceps strength at 60º/s (SMD −0.66; 95% CI −0.99, −0.32); reduced quadriceps strength at 240º/s (normalised by body mass) (SMD −0.53; CI −0.87, −0.20). For PFP/ACL injury among female military recruits: reduced quadriceps strength at 60º/s (normalised by body mass) (SMD −0.50; CI −0.92, −0.08).ConclusionsQuadriceps weakness is a risk factor for PFP among military recruits, and for PFP/ACL injury among female military recruits. However, the effect sizes are small, and the generalisability of these findings is limited. The effectiveness of quadriceps strengthening interventions for preventing PFP and ACL injury merits evaluation in prospective randomised trials.
Plotgardener: Cultivating precise multi-panel figures in R
Authors: Kramer Nicole E , Davis Eric S , Wenger Craig D , Deoudes Erika M , Parker Sarah M , Love Michael I , Phanstiel Douglas H 
Published: September 2021

The R programming language is one of the most widely used programming languages for transforming raw genomic data sets into meaningful biological conclusions through analysis and visualization, which has been largely facilitated by infrastructure and tools developed by the Bioconductor project. However, existing plotting packages rely on relative positioning and sizing of plots, which is often sufficient for exploratory analysis but is poorly suited for the creation of publication-quality multi-panel images inherent to scientific manuscript preparation. We present plotgardener, a coordinate-based genomic data visualization package that offers a new paradigm for multi-plot figure generation in R. Plotgardener allows precise, programmatic control over the placement, aesthetics, and arrangements of plots while maximizing user experience through fast and memory-efficient data access, support for a wide variety of data and file types, and tight integration with the Bioconductor environment. Plotgardener also allows precise placement and sizing of ggplot2 plots, making it an invaluable tool for R users and data scientists from virtually any discipline.AvailabilityPackage:https://bioconductor.org/packages/plotgardenerCode:https://github.com/PhanstielLab/plotgardenerDocumentation:https://phanstiellab.github.io/plotgardener/