bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Maintained PhysicAl CaPacity 1-yr After Coronary Patient Cardiac Rehabilitation (EMAP)
Authors: Pavy Bruno , Kubas Sophie , Rocca Cécile , Merle Erick , Kerros Hélène , Tisseau Anne , Iliou Marie-Christine , Le Cunuder Anne , Cohen-Solal Alain , Carré François 
Published: April 2022

Purpose:
Data are scarce concerning the sustainable effects of cardiac rehabilitation (CR), on cardiorespiratory fitness (CRF) of patients with coronary artery disease (CAD). This study, carried out using data from a French multicenter study, aimed to clarify the evolution of the CRF of patients with CAD 1 yr after the end of a CR stay.

Methods:
Patients were included after an acute coronary syndrome (77%) and/or coronary revascularization, occurring <3 mo beforehand. All underwent a CR program with CRF evaluation by exercise testing (ET) on a cycle ergometer at the beginning of CR (ET1), at its end (ET2), and 1 yr later (ET3)—all ETs were performed with medication.

Results:
Two hundred fifty-nine patients were included (age 60 ± 10 yr, 89% male) in 16 French CR centers. Left ventricular ejection fraction was 55.3 ± 9%. Revascularization was complete (82%). Maximal workloads were 110 ± 37 (ET1), 139 ± 43 (ET2), and 144 ± 46 W (ET3) (P < .001). The estimated metabolic equivalents of the task (METs) were respectively 5.3 ± 1.4, 6.4 ± 1.6 (P < .001), and 6.6 ± 1.7 (P < .002). One year later, 163 patients (63%) improved or maintained their CRF (ET3 ≥ ET2), 73 (28%) decreased (ET1 < ET3 < ET2), and 23 (9%) lost the benefit of CR (ET3 ≤ ET1).

Conclusion:
Among completers who agreed to enroll in this study, most patients with CAD seem to maintain their CRF 1 yr after CR.
Association Between Meeting Physical Activity Time-Intensity Guidelines With Ambulation, Quality of Life, and Inflammation in Claudication
Authors: Gardner Andrew W. , Montgomery Polly S. , Wang Ming , Shen Biyi , Zhang Shangming , Pomilla William A. 
Published: April 2022

Purpose:
The aim of this investigation was to determine if meeting the 2018 physical activity (PA) time-intensity guidelines was associated with better ambulatory function, health-related quality of life (HRQoL), vascular function, and inflammation than failing to meet the guidelines in patients with peripheral artery disease and claudication. Second, we determined the optimal number of total steps/d and steps taken at moderate cadence needed to meet the PA time-intensity guidelines.

Methods:
Five hundred seventy-two patients were assessed on daily ambulatory activity for 1 wk with a step activity monitor, and were grouped according to whether they achieved <150 min of moderate-intensity PA/wk (group 1 = do not meet guidelines; n = 397) or whether they were above this threshold (group 2 = meet guidelines; n = 175).

Results:
Treadmill peak walking time (mean ± SD) was higher (P < .001) in group 2 (709 ± 359 sec) than in group 1 (427 ± 281 sec). The physical function HRQoL score was higher (P < .001) in group 2 (61 ± 22%) than in group 1 (44 ± 21%). High-sensitivity C-reactive protein was lower (P < .001) in group 2 (3.6 ± 4.5 mg/L) than in group 1 (5.9 ± 6.1 mg/L). Finally, ≥7675 total steps/d and ≥1660 steps/d at moderate cadence were optimal thresholds associated with meeting PA guidelines.

Conclusions:
Patients with claudication who meet the 2018 PA time-intensity guidelines for US adults had better ambulation, HRQoL, and vascular outcomes than those who failed to meet the PA guidelines. Patients with claudication best achieved the PA time-intensity guidelines by taking ≥7675 total steps/d, and ≥1660 steps/d at a moderate cadence.
Corneal Response to Scleral Contact Lens Wear in Keratoconus
Authors: Cagliari Cristina , Schor Paulo , Formentin Luiz , Lipener César , dos Santos Myrna Serapião , Oliveira Helena , Raulino Junior José Ney de Carvalho , de Freitas Denise 
Published: April 2022

Objective:
To verify corneal alterations in patients with keratoconus who wear scleral contact lenses (ScCLs), focusing on corneal endothelial assessment.

Methods:
Scleral contact lenses were fitted in 22 patients with keratoconus. During a 90-day follow-up, patients were assessed in three visits: at baseline, after 30 days, and after 90 days. Patients underwent visual acuity measurement, slitlamp biomicroscopy of the anterior segment, specular microscopy of the corneal endothelium, corneal pachymetry, measurement of the clearance between the cornea and the lens, and follow-up of ectasia.

Results:
Variables related to endothelial morphology and pachymetry values did not change significantly over time. Central clearance measurements decreased in the 90-day period. No progression of corneal ectasia was observed, neither were infectious or inflammatory processes in the same period.

Conclusion:
Daily wear of ScCLs in patients with keratoconus was not associated with adverse effects on the cornea or endothelium over a period of 90 days nor was there evidence of disease progression. Central clearance values diminished over that period, but the significance of this observation remains unclear.
Outcomes and Complications in Patients With Hypermobile Ehlers–Danlos Syndrome Who Have Undergone Laser In Situ Keratomileusis Surgery
Authors: Gauthier Angela C. , Bower Kraig S. , Singman Eric L. 
Published: April 2022

Purpose:
The purpose of this study was to determine the safety and outcomes of myopic laser in situ keratomileusis (LASIK) in patients who were secondarily diagnosed with hypermobile Ehlers–Danlos syndrome (EDS).

Methods:
We conducted a case series study on patients with hypermobile EDS who underwent myopic LASIK surgery. Visual acuity, manifest refraction, a full dilated eye examination, biometry measurements, and Scheimpflug imaging were performed in the Wilmer outpatient clinic.

Results:
There were 24 eyes of 12 patients included in this study. All participants were White women with a mean age of 46.58 years (SD 8.91 years). Participants were seen at an average of 13.83 years (SD 4.3 years, range 6–21 years) after undergoing LASIK. None of the patients in the series had a diagnosis of hypermobile EDS before LASIK surgery. Overall, 92% of patients were happy they got LASIK. The uncorrected distance visual acuity was 20/20 or better in 68% of eyes, and the best-corrected visual acuity was 20/20 or better in 92% of eyes. Manifest refraction was within 1 diopter of plano in 79% of patients. Dry eye symptoms were present in 83% of patients, and 46% of eyes had either punctate epithelial erosions or decreased tear break-up time. One of the 12 patients developed corneal ectasia in both eyes.

Conclusions:
Patients with hypermobile EDS are generally satisfied with myopic LASIK correction, with good visual acuity outcomes and low rates of myopic regression. However, the risk of corneal ectasia may prevent laser vision correction from being a viable treatment option in these patients. Further studies are needed to make a definitive recommendation.
Efficacy and Safety of Endoscopic Submucosal Dissection for Rectal Tumors Extending Versus Not to the Dentate Line
Authors: Zeng Qi-Shan , Zou Min , Nie Jiao , Yang Jia-Hui , Luo Zhen-Yi , Gan Hua-Tian 
Published: April 2022

Goals:
To evaluate the outcomes of endoscopic submucosal dissection (ESD) for rectal tumors extending to the dentate line (RTDLs) compared with rectal tumors not extending to the dentate line (non-RTDLs).

Background:
There is limited composite data on the outcomes of ESD for RTDLs versus non-RTDLs.

Study:
We performed a systematic review and meta-analysis of studies that reported the clinical outcomes of ESD for RTDLs and non-RTDLs. Main outcomes were pooled estimated rates of en bloc/complete/curative resection, local recurrence, and incidence of bleeding, perforation, stricture, anal pain, and fever.

Results:
Six studies were enrolled, including 265 cases of RTDLs and 788 cases of non-RTDLs. The en bloc resection rate was comparable for RTDLs and non-RTDLs [odds ratio (OR), 1.04; 95% confidence interval (CI), 0.55-1.95; P=0.90]. The complete resection rate was significantly lower for RTDLs (OR, 0.59; 95% CI, 0.41-0.83; P=0.003), as well as the curative resection rate (OR, 0.57; 95% CI, 0.38-0.87; P=0.010). The rates of stricture, postoperative anal pain and local recurrence were significantly higher for RTDLs than non-RTDLs (OR, 3.07; 95% CI, 1.01-9.31; P=0.05) (OR, 42.10; 95% CI, 4.73-374.97; P=0.0008) (OR, 3.00; 95% CI, 1.13-7.96; P=0.03), but the higher rates of postoperative bleeding and fever for RTDLs were not significantly (OR, 1.33; 95% CI, 0.53-3.30; P=0.54) (OR, 2.23; 95% CI, 0.55-9.07; P=0.26), as well as its lower perforation rate (OR, 0.85; 95% CI, 0.27-2.63; P=0.78).

Conclusions:
Despite its inferior outcomes than non-RTDLs, ESD is still a feasible and safe treatment for RTDLs if appropriate lesions are treated by experienced operators.
The Wet Suction Technique Enhances the Diagnostic Efficacy and Aspirate Quality of EUS-FNA for Solid Lesions
Authors: Chen Dafan , Ren Yingchun , Chen Sumin , Jin Yubiao , Xie Haoran , Yu Lanting , Peng Kui , Xia Youchen , Pan Dan , Lu Jiawei , Lu Lungen , Wan Xinjian , Hu Duanmin , Li Baiwen 
Published: April 2022

Goals:
To comprehensively compare the wet suction technique with the conventional dry suction technique for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in solid lesions.

Background:
Optimal suction techniques for EUS-FNA remain uncertain when approaching solid lesions.

Study:
We performed a retrospective study of EUS-FNA at 3 medical centers in China. A total of 203 patients were enrolled who received 2 passes of EUS-FNA with 22-G needles. If the first pass underwent dry suction, the second pass was wet suction. Otherwise, the order of suction technique is opposite. Diagnostic accuracy, sample quality (including cellularity and blood contamination), and sample quantity (including specimen adequacy, the maximum intact specimen length, and the total specimen length) were compared between wet-suction and dry-suction techniques.

Results:
The patients included 143 pancreatic lesions and 60 nonpancreatic lesions. Compared with the dry suction technique, the wet suction technique yielded a significantly higher diagnostic accuracy (85.22% vs. 72.41%, P=0.002), better specimen adequacy score and cellularity score (P<0.0001), and lower blood contamination score (P<0.0001). In the subgroup analysis, wet suction provided significantly higher diagnostic accuracy in pancreatic cancer without chronic pancreatitis (P<0.05), and better cellularity score and specimen adequacy score, lower blood contamination score, and longer maximum intact specimen length and total specimen length in various lesions than that in dry suction.

Conclusions:
The wet suction technique resulted in significantly higher diagnostic accuracy in pancreatic cancer without chronic pancreatitis, and better cellularity and histologic specimen in most of solid lesions.
Adherence to Surveillance Endoscopies Posteradication of Barrett’s Esophagus With High-grade Dysplasia or Carcinoma In Situ
Authors: Um Phoebe S. , Chan Megan Q. , Hinton Alice , Haisley Kelly , Perry Kyle A. , Balasubramanian Gokulakrishnan 
Published: April 2022

Goals:
We aimed to evaluate factors associated with patient adherence to recommended surveillance guidelines during the first 3 years after endoscopic eradication of Barrett’s esophagus (BE) with high-grade dysplasia (HGD) or T1a carcinoma in situ (CIS) and the relationship between adherence and detection of recurrence.

Background:
While surveillance endoscopies after treatment of BE with HGD or T1a CIS are an important component of therapy, it is unclear whether these high-risk patients are adhering to recommended surveillance guidelines.

Materials and Methods:
A total of 123 BE patients who underwent radiofrequency ablation±endoscopic mucosal resection for biopsy-proven HGD, or CIS between January 2010 and November 2018 underwent retrospective review for adherence to surveillance guidelines, patient factors related to adherence, and recurrence of dysplasia or CIS at 12, 24, and 36 months.

Results:
Of 123 BE patients (89 HGD and 34 CIS), adherence during the first year following treatment was 26.97% for HGD patients and 41.18% for CIS patients, with increasing adherence rates in subsequent years. Patients who received 3 to 4 surveillance endoscopies in the first year posttreatment had significantly higher rates of recurrence detection than patients who received 0 to 2 surveillance endoscopies over this interval (P=0.01). No patient factors were found to impact adherence significantly.

Conclusions:
Adherence to recommended surveillance intervals after endoscopic treatment of BE with HGD or CIS is low, with poor adherence during the first year associated with decreased detection of recurrence. Future studies are needed to evaluate risk factors and develop a potential intervention for poor adherence in this high-risk population.
Associations Between Mobility, Food Insecurity, and Transactional Sex Among Women in Cohabitating Partnerships: An Analysis From 6 African Countries 2016–2017
Authors: Khalifa Aleya , Findley Sally , Gummerson Elizabeth , Mantell Joanne E. , Hakim Avi J. , Philip Neena M. , Ginindza Choice , Hassani Ahmed Saadani , Hong Steven Y. , Jalloh Mohamed F. , Kirungi Wilford L. , Maile Limpho , Mgomella George S. , Miller Leigh Ann , Minchella Peter , Mutenda Nicholus , Njau Prosper , Schwitters Amee , Ward Jennifer , Low Andrea 
Published: April 2022

Background:
Mobile women are at risk of HIV infection in sub-Saharan Africa, although we lack evidence for HIV risk among women in mobile partnerships, especially in the context of household food insecurity, a growing concern in the region.

Setting:
Women aged 15–59 years with a cohabitating male partner who participated in population-based HIV impact assessment surveys in Eswatini, Lesotho, Namibia, Tanzania, Uganda, and Zambia.

Methods:
We evaluated the association between women's and their partner's mobility (being away from home for more than 1 month or staying elsewhere) and transactional sex (selling sex or receiving money or goods in exchange for sex). We examined associations for effect measure modification by food insecurity level in the household in the past month. We used survey-weighted logistic regression, pooled and by country, adjusting for individual, partner, and household-level variables.

Results:
Among women with a cohabitating male partner, 8.0% reported transactional sex, ranging from 2.7% in Lesotho to 13.4% in Uganda. Women's mobility [aOR 1.35 (95% CI: 1.08 to 1.68)], but not their partner's mobility [aOR 0.91 (0.74–1.12)], was associated with transactional sex. Food insecurity was associated with transactional sex independent of mobility [aOR 1.29 (1.10–1.52)]. Among those who were food insecure, mobility was not associated with increased odds of transactional sex.

Conclusion:
Food insecurity and women's mobility each increased the odds of transactional sex. Because transactional sex is associated with HIV risk, prevention programs can address the needs of mobile and food-insecure women, including those in cohabitating relationships.
Trans-border transfer of human biological materials in collaborative biobanking research: Perceptions and experiences of researchers in Uganda
Authors: Mwaka Erisa Sabakaki , Munabi Ian Guyton 
Published: April 2022

AbstractIntroductionThe study aimed to explore researchers’ perceptions and experiences on the transfer of human biological materials in international collaborative research.MethodsThis was a descriptive convergent parallel survey that randomly recruited 187 researchers involved in biobanking and/or genetics research. Data were collected using a self-administered tool that had both open and closed ended questions.ResultsMajority of respondents were male scientists (53.5%) with a mean research experience of 12.2 (SD 6.75) years. About 89% had ever worked in international collaborative research and 42% had ever participated in material transfer agreement (MTA) development. There were several areas of agreement in regard to the rights of local researchers and institution in collaborative biobanking research, and what details should be included in material transfer agreements. There was overwhelming support for collaborative partnership in biobanking research with 90.4% of researchers agreeing that local scientists should be involved in decisions making regarding the future use of samples. A majority (85.6%) opined that there should be fair sharing of research benefits with local researchers and populations or country from which the human biological materials were taken. Researchers felt that most MTAs tend to favour international collaborators. Several trust issues in the MTA development and implementation process were also highlighted and these included: lack of transparency and dishonesty of receiving scientists; lack of mechanisms to monitor the use of exported samples; ownership and intellectual property disputes; exploitation and inequitable sharing of research benefits; and authorship challenges. Several researchers seemed not to be conversant with the guidance provided by the Ugandan national ethics guidelines on the cross-border exchange of human biological specimens.ConclusionLocal researchers had a positive attitude towards the export of human biological materials in collaborative research. However, there were several governance and trust concerns. There is a need for collaborative partnership in biobanking research.
Deep learning-based prognosis models accurately predict the time to delivery among preeclampsia patients using health records at the time of diagnosis
Authors: Yang Xiaotong , Ballard Hailey K , Mahadevan Aditya D , Xu Ke , Garmire David G , Langen Elizabeth S , Lemas Dominick J , Garmire Lana X 
Published: April 2022

AbstractBackgroundPreeclampsia (PE) is one of the leading factors in maternal and perinatal mortality and morbidity worldwide with no known cure. Delivery timing is key to balancing maternal and fetal risk in pregnancies complicated by PE. Delivery timing of PE patients is traditionally determined by closely monitoring over a prolonged time. We developed and externally validated a deep learning models that can predict the time to delivery of PE patients, based on electronic health records (EHR) data by the time of the initial diagnosis, in the hope of reducing the need for close monitoring.MethodUsing the deep-learning survival model (Cox-nnet), we constructed time-to-delivery prediction models for all PE patients and early-onset preeclampsia (EOPE) patients. The discovery cohort consisted of 1,533 PE cases, including 374 EOPE, that were delivered at the University of Michigan Health System (UM) between 2015 and 2021. The validation cohort contained 2,172 PE cases (547 EOPE) from the University of Florida Health System (UF) in the same time period. We built clinically informative baseline models from 45 pre-diagnosis clinical variables that include demographics, medical history, comorbidity, PE severity, and initial diagnosis gestational age features. We also built full models from 60 clinical variables that include additional 15 lab tests and vital signs features around the time of diagnosis.ResultsThe 7-feature baseline models on all PE patients reached C-indices of 0.74 and 0.73 on UM hold-out testing and UF validation dataset respectively, whereas the 12-feature full model had improved C-indices of 0.79 and 0.74 on the same datasets. For the more urgent EOPE cases, the 6-feature baseline model achieved C-indices of 0.68 and 0.63, and its 13-feature full model counterpart reached C-indices of 0.76 and 0.67 in the same datasets.ConclusionsWe successfully developed and externally validated an accurate deep-learning model for time-to-delivery prediction among PE patients at the time of diagnosis, which helps to prepare clinicians and patients for expected deliveries.
Automated method to extract and purify RNA from wastewater enables more sensitive detection of SARS-CoV-2 markers in community sewersheds
Authors: West Nicholas W. , Vasquez Adrian A. , Bahmani Azadeh , Khan Mohammed , Hartrick James , Turner Carrie L. , Shuster William , Ram Jeffrey L. 
Published: April 2022

AbstractWastewater based epidemiology (WBE) has emerged as a strategy to identify, locate, and manage outbreaks of COVID19, and thereby possibly prevent surges in cases, which overwhelm local to global health care networks. The WBE process is based on assaying municipal wastewater for molecular markers of the SARS-CoV-2 virus. The standard process for sampling municipal wastewater is both time-consuming and requires the handling of large quantities of wastewater, which negatively affect throughput and timely reporting, and can increase safety risks. We report on a method to assay multiple sub-samples of a bulk wastewater sample. We document the effectiveness of this new approach by way of comparison of technologies for automating RNA purification from wastewater samples. We compared processes using the Perkin-Elmer Chemagic™ 360 to a PEG/NaCl/Qiagen protocol that is used for detection of N1 and N2 SARS-CoV-2 markers by the majority of 19 pandemic wastewater testing labs in the State of Michigan. Specifically, we found that the Chemagic™ 360 lowered handling time, decreased the amount of wastewater required by 10-fold, increased the amount of RNA isolated per µl of final elution product by approximately five-fold, and had no deleterious effect on subsequent ddPCR analysis. Moreover, for detection of markers on the borderline of detectability, we found that use of the Chemagic™ 360 enabled the detection of viral markers in a significant number of samples for which the result with the PEG/NaCl/Qiagen method was below the level of detectability. This improvement in detectability of the viral markers might be particularly important for early warning to public health authorities at the beginning of an outbreak.
Reactivating ordinal position information from auditory sequence memory in human brains
Authors: Fan Ying , Luo Huan 
Published: April 2022

AbstractRetaining a sequence of events in their order is a core ability of many cognitive functions, such as speech recognition, movement control, and episodic memory. Although content representations have been widely studied in working memory (WM), little is known about how ordinal position information of an auditory sequence is retained in the human brain as well as its coding characteristics. In fact, there is still a lack of an efficient approach to directly access the stored ordinal position code, since the neural activities enter a relatively ‘activity-silent’ WM state during WM retention. Here participants performed an auditory sequence WM task with their brain activities recorded using electroencephalography (EEG). We developed new triggering events that could successfully reactivate neural representations of ordinal position from the ‘activity-silent’ retention stage. Importantly, the rank reactivation is further related to recognition behavior, confirming its indexing of WM storage. Furthermore, the ordinal position code displays an intriguing ‘stable-dynamic’ format, i.e., undergoing the same dynamic neutral trajectory during both encoding and retention (whenever reactivated). Overall, our results provide an effective approach to access the behaviorally-relevant ordinal position information in auditory sequence WM and reveal its new temporal characteristics.