bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uterine atony
Authors: Miller Hayley E. , Ansari Jessica R. 
Published: February 2022

Purpose of review
Postpartum hemorrhage (PPH) is the leading preventable cause of maternal morbidity and mortality worldwide. Uterine atony is identified as the underlying etiology in up to 80% of PPH. This serves as a contemporary review of the epidemiology, risk factors, pathophysiology, and treatment of uterine atony.

Recent findings
Rates of postpartum hemorrhage continue to rise worldwide with the largest fraction attributed to uterine atony. A simple 0–10 numerical rating score for uterine tone was recently validated for use during cesarean delivery and may allow for more standardized assessment in clinical and research settings. The optimal prophylactic dose of oxytocin differs depending on the patient population, but less than 5 units and as low as a fraction of one unit is needed for PPH prevention, with an increased requirements within that range for cesarean birth, those on magnesium, and advanced maternal age. Carbetocin is an appropriate alternative to oxytocin. Misoprostol shows limited to no efficacy for uterine atony in recent studies. Several uncontrolled case studies demonstrate novel mechanical and surgical interventions for treating uterine atony.

Summary
There is a critical, unmet need for contemporary, controlled studies to address the increasing threat of atonic PPH.
The Cutting Edge: Surface Texture Analysis following Resection of Nerve Stumps Using Various Instruments
Authors: Rose Ryan Adam , Bliss Ryan , Bromage Timothy , Hu Bin , Gopman Jared M. , Melamed Eitan 
Published: February 2022

Background:
Preparation of nerve ends is an essential part of nerve repair surgery. Multiple instruments have been described for this purpose; however, no consensus exists regarding which is the least traumatic for tissue handling. We believe that various instruments used for nerve-end excision will lead to different surface roughness.

Methods:
Median and ulnar nerves from fresh frozen cadavers were dissected, and 1–2 cm lengths were excised using a No. 11 blade, a razor blade, or a pair of scissors. Using electron microscopy, 3-dimensional surface analysis of roughness (Sa) for each specimen was performed using ZeeScan optical hardware and GetPhase software (PhaseView, Buisson, France). An ANOVA or Kruskal-Wallis test compared roughness measures among cutting techniques.

Results:
Forty nerves were included. Of these, 13 (32.5%) were cut using scissors, 15 (37.5%) using a razor blade, and 12 (30%) using a No. 11 blade. An ANOVA test showed statistical differences in Sa among the cutting techniques (P = 0.002), with the lowest mean Sa noted in the scissors group (7.2 µM, 95% CI: 5.34–9.06), followed by No. 11 blade (7.29 µM, 95% CI: 5.22–9.35), and razor blade (11.03 µM, 95% CI: 9.43–12.62). Median Ra (surface profile roughness) was 4.58 (IQR: 2.62–5.46). A Kruskal-Wallis test demonstrated statistical difference in Ra among techniques (P = 0.003), with the lowest by No. 11 blade (3 µM, IQR: 1.87–4.38), followed by scissors (3.29 µM, IQR: 1.56–4.96), and razor (5.41 µM, IQR: 4.95–6.21).

Conclusion:
This novel technique of 3-dimensional surface analysis found razor blade use demonstrated poor roughness, whereas a No. 11 blade or nerve-specific scissors led to equivocally smooth nerve ends.
Prospective Cohort Validation Study of a Novel Foot Offloading Device
Authors: Lubarsky Ryan , Gusenoff Beth , Gusenoff Jeffrey A. 
Published: February 2022

Summary:
Pressure offloading is often considered a crucial factor affecting healing after a foot injury. We have devised a novel foot offloading device (PopSole) which allows for immediate customization of the area where there is foot pain and allows for adjustable arch support and metatarsal pad height while maintaining patient stability. We hypothesize that pain and function outcomes will improve significantly after use of the device over a 1-month period. Ten participants with foot pain for longer than 6 months completed five validated outcome questionnaires during three visits (initial screening, at 2 weeks, and at 4 weeks). Devices were deflated in areas of pain specific for each patient. Validated patient reported outcomes measures showed significant improvement in pain and function from baseline to week two (r = 0.644, P < 0.05), (r = 0.43, P < 0.05), and (r = 0.552, P < 0.05), respectively, and the Foot & Ankle Ability Measure (FAAM) showed improved ability in activities of daily living (r = 0.58, P < 0.05) and sports (r = 0.69, P < 0.05). All 10 patients reported pain relief during at least one visit and/or an ability to return to standing-based activities that they previously were unable to do. PopSole rapidly improved pain and function, with sustained relief through 4 weeks. Current studies are in progress to assess long-term durability of the device and potential modifications to be made before future randomized studies to assess pressure and gait assessment, shear forces, and diabetic foot ulcer mitigation.
Abdominal Panniculectomy: An Analysis of Outcomes in 238 Consecutive Patients over 10 Years
Authors: Kuruoglu Doga , Salinas Cristina A. , Tran Nho V. , Nguyen Minh-Doan T. , Martinez-Jorge Jorys , Bite Uldis , Harless Christin A. , Sharaf Basel 
Published: February 2022

Background:
Panniculectomy is a commonly performed body contouring procedure to address skin laxity and its related complications. This study aimed to assess clinical outcomes of abdominal panniculectomy and identify predictors of complications at a tertiary academic healthcare center.

Methods:
A retrospective review of patients who underwent panniculectomy between January 2010 and January 2020 at our institution was performed. Exclusion criteria were a history of prior panniculectomy or abdominoplasty. Patient characteristics and clinical outcomes were collected. Univariate and multivariable analyses were performed to assess the risk factors of complications.

Results:
The mean age in the included 238 patients was 51.7 ± 12.7 years, and the mean body mass index (BMI) at the time of panniculectomy was 33 ± 7.5 kg/m2. Median resection weight was 2.7 kg (range: 0.15–14.6) and median length of hospital stay was 2 days (range: 0–24). Mean follow-up time was 50 ± 37 months. The rate of major complications was 22.3%. Revision surgery was performed in 3.4% of the cases. Multivariable analyses demonstrated that increase in BMI (P = 0.007) and active smoking (P = 0.026) were significantly associated with increased odds of major complication, and increase in BMI (P = 0.0004), history of venous thromboembolism (P = 0.034) and having a concomitant ventral hernia repair (P = 0.0044) were significantly associated with having a length of hospital stay of 3 days or more.

Conclusions:
Panniculectomy is generally safe to perform, with major postoperative complication rate of 22.3% in our series. Increase in BMI and active smoking were significantly associated with having a major complication. Higher BMI, concomitant hernia repair, and a history of venous thromboembolism were associated with length of hospital stay of 3 days or more.
Demographic Disparities amongst Patients Receiving Carpal Tunnel Release: A Retrospective Review of 92,921 Patients
Authors: Brodeur Peter G. , Patel Devan D. , Licht Aron H. , Loftus David H. , Cruz Aristides I. , Gil Joseph A. 
Published: February 2022

Background:
Despite strong evidence supporting the efficacy of surgical release for carpal tunnel syndrome (CTS), previous studies have suggested that surgery is not performed equally amongst races and sex. The purpose of this study was to investigate potential socioeconomic disparities in the surgical treatment for CTS.

Methods:
Adult patients (≥18) were identified in the New York Statewide Planning and Research Cooperative System database from 2011 to 2018 by diagnosis code for CTS. All carpal tunnel surgery procedures in the outpatient setting were identified using Current Procedural Terminology codes. Using a unique identifier for each patient, the diagnosis data were linked to procedure data. A multivariable logistic regression was performed to assess the impact of patient factors on the likelihood of receiving surgery.

Results:
In total, 92,921 patients with CTS were included in the analysis and 30,043 (32.3%) went on to have surgery. Older age and workers compensation insurance had increased the odds of surgery. Feminine gender had lower odds of surgery. Asian, African American, and other races had decreased odds of surgery relative to the White race. Patients of Hispanic ethnicity had decreased odds of surgery compared with non-Hispanic ethnicity. Patients with Medicare, Medicaid, or self-pay insurance were all less likely to undergo surgery relative to private insurance. Higher social deprivation was also associated with decreased odds of surgery.

Conclusions:
Surgical treatment of CTS is unequally distributed amongst gender, race, and socioeconomic status. Additional research is necessary to identify the cause of these disparities to improve equity in patient care.
Cardiovascular consequences of vaping
Authors: Echeagaray Oscar , Savko Clarissa , Gallo Andrea , Sussman Mark 
Published: February 2022

Purpose of review
Vaping activity continues to increase worldwide. Promoted as a ‘healthier’ alternative to traditional smoking, emerging evidence indicates ‘healthier’ should not be confused with ‘harmless’. Direct inhalation exposure of the respiratory tract in experimental research demonstrates pulmonary consequences of vaping. However, cardiovascular consequences of vaping are poorly characterized and are a priority area of research to reveal vaping-induced pathogenesis.

Recent findings:
Alterations in cardiovascular homeostasis, inflammation, and molecular changes following vaping exposure demonstrate vaping-related health concerns.

Summary:
This review summarizes cardiovascular consequences of vaping from cumulative research findings. Strategic application of emerging technologies to understand the impact of vaping upon the cardiovascular system will be essential for defining the true risks of vaping-associated injury.
Beyond traditional subjective refraction
Authors: Rodriguez-Lopez Victor , Dorronsoro Carlos 
Published: February 2022

Purpose of review
The evaluation of refractive error is probably the most important and common procedure in eye care. The gold standard method for evaluating refractive error is subjective refraction, a process that has not significantly changed in 200years. This article aims to review recent technologies and novel approaches attempting to improve this traditional procedure.

Recent findings
From laboratory prototypes to commercial instruments, the proposed methods aim to perform reliable and fast subjective refractions, following different approaches: using motorized phoropters in combination with automatic algorithms or even self-refraction, hybridizing objective and subjective measurements within the same instruments, or using new visual tasks beyond letter identification of blur estimation to obtain the refractive error subjectively.

Summary
The current trend in subjective refraction is to overcome the traditional manual blur reduction method, using automatic and self-refraction instruments, which can provide faster measurements with lower variability. Many of the technologies reported here are already in the market, and some have the potential of becoming the new standard in subjective refraction.
TIMP-1 expression in coronary thrombi associate with myocardial injury in ST-elevation myocardial infarction patients
Authors: Nordeng Jostein , Schandiz Hossein , Solheim Svein , Åkra Sissel , Hoffman Pavel , Roald Borghild , Bendz Bjørn , Arnesen Harald , Helseth Ragnhild , Seljeflot Ingebjørg 
Published: February 2022

Background
Matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) are considered important both in atherosclerosis and remodeling after acute myocardial infarction (AMI). We aimed to study genetic expression and presence of MMP-2, MMP-9, TIMP-1, TIMP-2 and the extracellular MMP-inducer (EMMPRIN) in coronary thrombi. Circulating levels and genetic expression in circulating leukocytes were also assessed, and relations to degree of myocardial injury measured by troponin T and time from symptom to PCI were explored. Expression of cell markers were also analyzed, indicating relations to cell types.

Methods
Intracoronary thrombi were aspirated from 33 patients with ST-elevation myocardial infarction (STEMI). Blood samples with Pax-gene tubes were drawn at end of PCI and the next day. RNA was isolated from thrombi and leukocytes, and genes were relatively quantified by RT-PCR. Each thrombus was preserved for histology and immunohistochemistry analyzes.

Results
Genes coding for the five markers were present in 84–100% of thrombi and immunohistochemically stained in 96–100%. Expression of TIMP-1 in thrombi and in leukocytes correlated significantly to peak troponin T (r = 0.393 P = 0.026, r = 0.469 P = 0.006, respectively). No significant correlations between genes expressed in thrombi and time from symptom to PCI were observed. TIMP-1 was connected mainly to monocytes/macrophages in the thrombi.

Conclusion
MMP-2, MMP-9, TIMP-1, TIMP-2 and EMMPRIN were highly expressed in human coronary thrombi. The correlation between troponin T and the expression of TIMP-1 both in thrombi and in leukocytes at time of PCI indicates that TIMP-1 plays a role in myocardial damage early post-MI.
Challenges in the hemodynamic management of acute nontraumatic neurological injuries
Authors: Messina Antonio , Villa Federico , Cecconi Maurizio 
Published: February 2022

Purpose of review
To appraise the evidence from the literature and suggest an integrated hemodynamic approach of early and delayed phases of acute ischemic stroke (AIS), subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH).

Recent findings
In AIS, the research aims to evaluate the optimal pressure control before, during and after the revascularization, to optimize the perfusion in the ischemic areas, minimizing the risk of hemorrhage or secondary damage to already infarcted areas. In the early phase of SAH, systemic pressure should be controlled to balance the risk of stroke, hypertension-related rebleeding, and maintenance of cerebral perfusion pressure. The late phase aims to minimize the risk of cerebral vasospasm by adapting systemic pressure and volemia to cerebral and systemic physiological hemodynamic targets. In the mild-to-moderate ICH, achieving SAP of less than 140 mmHg and greater than 110 mmHg may be considered as a beneficial target. Caution should be considered in lowering intensively SAP in severe ICH.

Summary
In nontraumatic brain injuries, the hemodynamic management is strictly related to fluctuating physiology of these diseases, needing a strict control of pressure and flow variable to ensure both cerebral and systemic homeostasis.
Respiratory viral infections in the immunocompromised
Authors: Ison Michael G. 
Published: February 2022

Purpose of review
During much of the COVID-19 pandemic, respiratory viruses other than SARS-CoV-2 did not infect immunocompromised patients. As mitigation strategies lighten, there has been a rapid resurgence of respiratory viruses globally. This review will summarize our current options for the management of the common respiratory viruses in transplant recipients.

Recent findings
Expansion of the availability and increased utilization of multiplex molecular assays have allowed the recognition of the scope of respiratory virus infections in the transplant populations. New antivirals for influenza, respiratory syncytial virus (RSV), parainfluenza virus (PIV) and adenovirus show promise to improve outcomes of these important infections.

Summary
Several new antiviral agents, including combination therapy of oseltamivir as well as baloxavir for influenza, fusion and nucleoprotein inhibitors for RSV, DAS181 for PIV and brincidofovir for adenovirus, hold promise to speed clearance of the virus, improve clinical outcomes and reduce the risk of resistance emergence.
Impact of social determinants of health on colorectal cancer screening and surveillance in the COVID reopening phase
Authors: Choy Alexa M , Lebwohl Benjamin , Krigel Anna 
Published: February 2022

Background/aims
Procedural delays due to the coronavirus disease 2019 (COVID-19) pandemic may exacerbate disparities in colorectal cancer (CRC) preventive care. We aimed to measure racial and socioeconomic disparities in the prioritization of CRC screening or adenoma surveillance during the COVID reopening period.

Methods
We identified CRC screening or surveillance colonoscopies performed during two time periods: (1) 9 June 2019–30 September 2019 (pre-COVID) and (2) 9 June 2020–30 September 2020 (COVID reopening). We recorded the procedure indication, patient age, sex, race/ethnicity, primary language, insurance status and zip code. Multivariable logistic regression was used to determine factors independently associated with undergoing colonoscopy in the COVID reopening era.

Results
We identified 1473 colonoscopies for CRC screening or adenoma surveillance; 890 occurred in the pre-COVID period and 583 occurred in the COVID reopening period. In total 342 (38.4%) pre-COVID patients underwent adenoma surveillance and 548 (61.6%) underwent CRC screening; in the COVID reopening cohort, 257 (44.1%) underwent adenoma surveillance and 326 (55.9%) underwent CRC screening (P = 0.031). This increased proportion of surveillance procedures in the reopening cohort was statistically significant on multivariable analysis [odds ratio (OR), 1.26; 95% confidence interval (CI), 1.001–1.58]. Black patients comprised 17.4% of the pre-COVID cohort, which declined to 15.3% (P = 0.613). There was a trend toward an inverse association between reopening phase colonoscopy and Medicaid insurance compared with commercial insurance (OR, 0.71; 95% CI, 0.49–1.04). No significant associations were found between reopening phase colonoscopy and the remaining variables.

Conclusions
During the COVID reopening period, colonoscopies for CRC fell by over one-third with significantly more surveillance than screening procedures. Nonwhite patients and non-English speakers comprised a shrinking proportion in the COVID reopening period.
The diagnostic accuracy of O-(2-18F-fluoroethyl)-L-tyrosine parameters for the differentiation of brain tumour progression from treatment-related changes
Authors: Diao Wei , Su Dunyan , Cao Yuan , Jia Zhiyun 
Published: February 2022

Background

18F-fluoro-ethyl-tyrosine (18F-FET) is recommended to distinguish brain tumours post-therapeutic true progression (including recurrent and metastatic brain tumours) and treatment-related change (TRC). However, many parameters of 18F-FET can be used for this differential diagnosis. Our purpose was to investigate the diagnostic accuracy of various 18F-FET parameters to differentiate true progression from TRC.

Methods
We performed a literature search using the following databases: the PubMed, Embase and Web of Science databases up to 29 November 2020. We included studies that reported the diagnostic test results of 18F-FET to distinguish true progression from TRC. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to evaluate the quality of the included studies. The diagnostic accuracy of various parameters was pooled using a random-effects model.

Results
We included 17 eligible studies (nine parameters). For static parameters of 18F-FET, the maximum and mean tumour-to-brain ratios (TBRmax and TBRmean) showed similar pooled sensitivities of 82% [95% confidence interval (CI), 80–85%) and 82% (95% CI, 78–85%), respectively. Among the three kinetic parameters (slope, time to peak and kinetic pattern), the kinetic pattern presented the optimal diagnostic value with a pooled sensitivity of 81% (95% CI, 75–86%). When combining the static and kinetic parameters, the diagnostic performance of 18F-FET was significantly improved, with a pooled sensitivity of 90% (95% CI, 84–94%) in the combination of TBR and kinetic patterns.

Conclusions

18F-FET static parameters alone showed a comparably high sensitivity in the differentiation between brain tumour true progression and TRC. Combining static and kinetic parameters provided improved diagnostic performance.
Update on surgical management of enteroatmospheric fistulae in intestinal failure patients
Authors: Nikoupour Hamed , Theodorou Alexis , Arasteh Peyman , Lurje Georg , Kalff Joerg C. , von Websky Martin W. 
Published: February 2022

Purpose of review
The surgical management of enteroatmospheric fistula (EAF) in patients with intestinal failure represents a major challenge for a surgical team and requires proficiency in sepsis management, nutritional support and prehabilitation, beside expertise in visceral and abdominal wall surgery. This review provides an update on the current recommendations and evidence.

Recent findings
Reconstructive surgery should be performed at a minimum of 6–12 months after last laparotomy. Isolation techniques and new occlusion devices may accelerate spontaneous EAF closure in selected cases. Chyme reinfusion supports enteral and parenteral nutrition. Stapler anastomosis and failure to close the fascia increase the risk of EAF recurrence. Posterior component separation, intraoperative fascial tension and biological meshes may be used to accommodate fascial closure.

Summary
Timing of reconstructive surgery and previous optimal conservative treatment is vital for favorable outcomes. Wound conditions, nutritional support and general patient status should be optimal before attempting a definitive fistula takedown. Single stage procedures with autologous gut reconstruction and abdominal wall reconstruction can be complex but well tolerated.
Chronic lung allograft dysfunction and restrictive allograft syndrome: are phenotypes robust and helpful?
Authors: Verleden Geert M. , Godinas Laurent , Vos Robin , Verleden Stijn E. 
Published: February 2022

Purpose of review
New chronic lung allograft dysfunction (CLAD) consensus documents were published in 2019, defining four phenotypes; bronchiolitis obliterans syndrome, restrictive allograft syndrome, mixed and undefined. Clearly, validation of these guidelines in a real life cohort is critical.

Recent findings
Indeed, validation has been performed recently, both after bilateral lung transplantation (LTx) and after single LTx illustrating that precise phenotyping based on pulmonary function alone can be difficult. Undertaking regular chest computed tomography scanning does appear very helpful in establishing the prognosis of the patients with CLAD.

Summary
Pulmonary function changes may not always identify the exact phenotype of CLAD and we provide further evidence for the important role of chest imaging at diagnosis and during the follow-up of patients with CLAD.