bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Impact of Glucagon-Like Peptide-1 Receptor Agonists on Metabolic Changes in Patients With Type 2 Diabetes on High-Dose Insulin
Authors: Rentsch Tiffany , Awad Magdi , Moorman John M. , Gothard Michael David 
Published: January 2021

Background:
Studies involving the glucagon-like peptide-1 receptor agonist (GLP-1 RA) liraglutide have shown reductions in hemoglobin A1c (HbA1c), weight, and insulin requirements in patients with type 2 diabetes mellitus (DM2) requiring high-dose insulin therapy. The effect of the class of GLP-1 RAs on these parameters is unknown.

Data Sources:
A retrospective cohort analysis was conducted in patients with DM2 where a GLP-1 RA was added to high-dose insulin therapy. The primary composite outcome was the change from baseline to 9 months in HbA1c, weight, and insulin dose.

Results:
GLP-1 RA therapy was associated with a significant reduction in HbA1c from baseline (−0.9%; P = 0.022). Weight and insulin dose were not significantly reduced from baseline. There was a moderate effect of individual agents on these outcomes, but no significant reductions were seen due to the small sample size.

Limitations:
Generalizability of these findings may be limited by the characteristics and size of the study population.

Therapeutic Opinion:
The effect of GLP-1 RA therapy on HbA1c may be attributed to the medication class. The effect of individual agents on weight and insulin requirements needs further investigation.
Quality of Life, Resilience, and Related Factors of Nursing Students During the COVID-19 Pandemic
Authors: Keener Tina Antill , Hall Katherine , Wang Kesheng , Hulsey Tara , Piamjariyakul Ubolrat 
Published: January 2021

Background
COVID-19 and the associated measures to mitigate the spread of the virus have significantly disrupted nursing education.

Purpose
The purpose of this study was to examine the relationship between quality of life (QoL), resilience, and associated factors among nursing students during the unprecedented COVID-19 pandemic and subsequent social distancing requirements.

Methods
A cross-sectional study using an anonymous survey with nursing students (n = 152) was conducted at a public university in rural Appalachia in April 2020. Instruments included World Health Organization Quality of Life-BREF, Connor Davidson Resilience Scale, demographics and school-related questionnaires, and an open-ended question. Data were analyzed using descriptive, bivariate, and multiple linear regression analyses.

Results
Resilience, having online experience, and being well prepared for online learning were associated with each QoL domain. Remarkably, 21% to 54% of nursing student QoL scores indicated poor QoL.

Conclusions
Cultivating resilience among nursing students may improve QoL, help with academic success, and prepare students to sustain the demands associated with the nursing profession.
Do Pediatric Emergency Physicians Comply With Guideline Recommendations in Management of Patients With Acute Urticaria?
Authors: Yiğit Ramazan Emre , Cavkaytar Ozlem , Besli Gulser Esen , Arga Mustafa 
Published: January 2021

Objectives
To determine the level of knowledge and practical preferences of pediatricians regarding acute urticaria (AU) management and to assess the effects of training provided in accordance with the current urticaria guideline recommendations on pediatricians who work in the pediatric emergency department (PED).

Methods
A theoretical training was provided to pediatricians regarding the diagnosis and treatment of AU in line with current urticaria guideline recommendations. Before the training, pediatricians completed a 10-item questionnaire. This prospective study assesses their treatment approaches in patients admitted to PED because of AU during the 6-month period before and the 1-year period after training.

Results
Four hundred seventeen children in the pretraining and 1085 children in the posttraining periods were treated for AU in PED. Forty-eight pediatricians participated in the training. According to their questionnaire responses, 35% of them used only H1 antihistamine (AH) treatment, 50% used second-generation H1 AH (2nd-GAH) as AHs, 75% preferred the oral route of administration, and 85.4% did not administer systemic corticosteroid (sCS) to all patients. Comparing the practice approaches of the pediatricians in the pretraining and posttraining periods, first-generation H1 antihistamine (1st-GAH) preference rate decreased from 68.4% to 30.3% and the sCS preference rate decreased from 58.5% to 25.7%, while the 2nd-GAH preference rate increased from 31.7% to 69.7% (P < 0.001 for all). No treatments were prescribed for 10.8% of patients before the training and 3% after the training during discharge at home (P < 0.05). Comparing the home treatment choices of the pediatricians in the pretraining and posttraining periods, 1st-GAH preference rate decreased from 11.5% to 5%, while the 2nd-GAH preference rate increased from 78.7% to 91.5% (for both parameters, P < 0.001).

Conclusions
Practical treatment preferences of pediatricians in the treatment of children with AU differ considerably from both current guideline recommendations and their own theoretical knowledge, and training can enhance pediatricians' compliance with current guideline recommendations.
Physical Therapy Management of Wiedemann-Steiner Syndrome From Birth to 3 Years
Authors: Mendoza Carmel 
Published: January 2021

Purpose:
To investigate Wiedemann-Steiner syndrome (WSS), its correlation to hypotonia and developmental delay, and to determine the relative intervention strategies that may be useful during early intervention from birth to 3 years.

Methods:
A literature search using PEDro and PubMed was conducted using key words “Wiedemann-Steiner syndrome,” “hypotonia,” and “developmental delay” and a case study is presented.

Results:
A 36-month-old child with WSS received PT intervention beginning at 2 months old. Addition of orthotics and treadmill walking was added at 13 and 19 months, respectively. The child progressed through developmental sequences from rolling, sitting, standing, and walking although consistently scored with motor delay of −2 SD.

Conclusions:
Fifty-seven percent of children diagnosed with WSS have hypotonia, and 90% have developmental delay. The diagnosis of WSS should require physical therapy services through early intervention programs due to its high correlation with motor developmental delay and disability. Determination of progress should be measured with achievement of function rather than norm-referenced outcome measures.

Video Abstract: For more insights from the authors, access Supplemental Digital Content 1, available at: http://links.lww.com/PPT/A292
Outcome of First-admission Depression Treated in a Specialized Mood Disorders Service
Authors: THEKISO THEKISO B. , MCLOUGHLIN DECLAN M. , HARTNETT YVONNE , CASEY SARAH , ORJI AZUBIKE , HERON ELIZABETH A. , RUSH GAVIN , KENNEDY NOEL 
Published: January 2021

Objective:
Few studies have described the treatment or outcome of depression in specialized mood disorders units (MDUs). Previous studies have focused on cohorts of patients with highly treatment-resistant illness who are likely to have a poor prognosis even with intensive treatment. This study describes the treatment and medium-term outcomes of a cohort of first-admission depressed patients with less treatment-resistant illness treated in a specialized MDU.

Methods:
A cohort of 137 consecutive first-admission depressed patients, referred to an MDU over 2 years, were interviewed using standardized schedules and followed up prospectively from admission for ∼18 months to describe baseline characteristics, treatment, outcome, and predictors of outcome. Times to recovery and recurrence were evaluated using survival analyses and predictors of outcome were examined using bivariate and multivariate regression analyses.

Results:
On admission, 75% of the 137 patients had depression that had been found to be resistant to pharmacological treatment, and 34% had been chronically depressed (>2 y). Over half of the patients had likely maladaptive personality traits and one third had at least 1 comorbid psychiatric disorder. By discharge, a significantly higher proportion of the patients were being prescribed very high (P<0.01) or high doses (P<0.05) of antidepressants, augmentation therapy (P<0.001), or a combination of antidepressants (P<0.001) or were engaged in individual psychotherapy (P<0.001), compared with baseline. With intensive treatment, 62% of the patients recovered by 6 months and 76% by 12 months, with 83% overall recovering and patients found to be asymptomatic during almost 60% of the follow-up period. However, 48% suffered a recurrence over the course of the follow-up. Chronicity of mood episodes (P<0.01) and the presence of psychiatric comorbidity (P<0.05) predicted recurrence.

Conclusions:
This prospective, naturalistic, medium-term study describes better outcomes, in terms of recovery and symptomatology over time, in a cohort of first-admission depressed patients than previous first-admission studies after continuous, intensive treatment, although the proportion of patients who experienced recurrences remained high.
Role or oritavancin and dalbavancin in acute bacterial skin and skin structure infections and other potential indications
Authors: Bassetti Matteo , Labate Laura , Vena Antonio , Giacobbe Daniele R. 
Published: January 2021

Purpose of review
To discuss the currently available evidence about the use oritavancin and dalbavancin for the treatment of acute bacterial skin and skin structure infections (ABSSSI) and for other potential indications.

Recent findings
In this review, we briefly summarize the available data on efficacy (from randomized controlled trials) and on effectiveness and cure rates (from observational studies) pertaining to the use of oritavancin and dalbavancin either for ABSSSI or for other indications.

Summary
Oritavancin and dalbavancin are valid options for outpatient therapy and early discharge in patients with ABSSSI, especially when adherence to oral therapy cannot be guaranteed or no oral choices are available. Furthermore, it is worth noting that a non-negligible portion (sometimes the majority) of oritavancin and dalbavancin use in available real-life experiences is for indications other than ABSSSI, especially for Gram-positive osteomyelitis and endocarditis. The number of studies on the use of long-acting lipoglycopeptides for these currently off-label indications is rapidly increasing and will help to further optimize the use of these peculiar antibiotics in the forthcoming future.
Morphometry of Asterion and its Proximity to Dural Venous Sinuses in Northwest Ethiopian Adult Skulls
Authors: Muche Abebe 
Published: January 2021

Introduction:The asterion is a craniometric point in the norma lateralis of skull situated at the confluence of parietal, temporal, and occipital bones. The aim of this study is to determine the type and mapping of asterion and its relation with transverse-sigmoid venous sinus junction (TSSJ).Materials and Methods:Sixty-one dry and intact adult human skulls of unknown sex and age were used. The measurements were implemented using stainless steel sliding vernier caliper. The data were analyzed using SPSS version-20 and independentt-test analysis was implemented.P < 0.05 was considered as statistically significant.Results:In the study, type II was found to be the predominant asterion type. There was statistically significant difference in measurements of central thickness of right and left sides of asterion (P = 0.04, Eta squared = 0.025). Besides, the TSSJ was situated above the asterion and at the level of asterion in 39.34% and 60.66 of the cases, respectively.Conclusions:The Northwest Ethiopian population has a high incidence of type II asterion. In most of the cases, the TSSJ is situated at the level of the asterion. The finding of the present study may be useful to neurosurgeons to reduce the risk during posterior cranial fossa surgeries. This work may also offer worthy information to radiologists, anthropologists, anatomists, and forensic scientists.
A Role for Artificial Intelligence in the Classification of Craniofacial Anomalies
Authors: Geisler Emily L. , Agarwal Saloni , Hallac Rami R. , Daescu Ovidiu , Kane Alex A. 
Published: January 2021

Abstract
Development of an objective algorithm to diagnose and assess craniofacial conditions has the potential to facilitate early diagnosis, especially for care providers with limited craniofacial expertise. Deep learning, a branch of artificial intelligence, can automatically analyze and categorize disease without human assistance. Convolutional neural networks (CNN) have excelled in utilizing medical images to automatically classify disease. In this study, the authors developed CNN models to detect and classify non-syndromic craniosynostosis (CS) using 2D images. The authors created an annotated data set of labeled CS (normal, metopic, sagittal, and unicoronal) conditions using standard clinical photography from the image repository at our center. The authors extended this dataset set by adding photographic images of children with craniofacial conditions from the internet. A total of 1076 images were used in this study. The authors developed a CNN model using a pre-trained ResNet-50 model to classify the data as metopic, sagittal, and unicoronal. The testing accuracy for the CS ResNet50 model achieved an overall testing accuracy of 90.6%. The sensitivity and precision were: 100% and 100% for metopic, 93.3% and 100% for sagittal, and 66.7% and 100% for unicoronal, respectively. The CNN model performed with promising accuracy. These results support the idea that deep learning has a role in diagnosis of craniofacial conditions. Using standard 2D clinical photography, such systems can provide automated screening and detection of these conditions. In the future, ML may be applied to prediction and assessment of surgical outcomes, or as an open-source remote diagnostic resource.
Comparison of Donor Site Morbidity Between Anterolateral Thigh and Radial Forearm Free Flaps for Head and Neck Reconstruction: A Systematic Review and Meta-Analysis
Authors: Niu Zehao , Chen Youbai , Li Yan , Tao Ran , Lei Yonghong , Guo Lingli , Zhang Fugui , Zhang Haizhong , Zhang Qixu , August Meredith , Han Yan 
Published: January 2021

Abstract
This meta-analysis aimed to provide an up-to-date comparison of donor site morbidity (DSM) between patients who underwent head and neck reconstruction with Anterolateral thigh (ALT) and radial forearm free (RFF) flaps. We searched the PubMed, Web of Science, EMBASE, and Cochrane Library databases to identify studies that compared DSM between ALT and RFF patients. Study quality was assessed using the Newcastle-Ottawa Scale. The pooled odds ratio (OR) of each DSM between ALT and RFF patients was estimated using a random- or fixed-effect model depending on the degree of interstudy heterogeneity. Sensitivity and subgroup analyses were performed if substantial heterogeneity was detected. Eighteen cohort studies with 1,018 patients (535 ALT and 483 RFF patients) were included. Compared with RFF, ALT were associated with lower risks of wound dehiscence (OR = 0.2, 95%CI: 0.10-0.42, P < 0.01), strength impairment (OR = 0.18, 95%CI: 0.07-0.47, P < 0.01), and movement impairment (OR = 0.19, 95%CI:0.07-0.49, P < 0.01). A subgroup analysis showed that ALT were associated with a lower risk of donor site numbness among patients undergoing tongue reconstruction (OR = 0.05, 95%CI: 0.01-0.25, P < 0.01), but not among all patients undergoing head and neck reconstruction. The pooled ORs of other DSMs demonstrated no significant difference between ALT and RFF patients. ALT are superior to RFF for head and neck reconstruction in terms of donor site wound dehiscence, strength impairment, movement impairment, and for tongue reconstruction specifically in terms of donor site numbness. No significant differences in the incidence of donor site hematoma/seroma, infection, or dissatisfaction with donor site appearance were identified between ALT and RFF patients.
Cadaveric Costal Cartilage Grafts in Rhinoplasty and Septorhinoplasty: A Systematic Review and Meta-Analysis of Patient-Reported Functional Outcomes and Complications
Authors: Pfaff Miles J. , Bertrand Anthony A. , Lipman Kelsey J. , Malapati Sri Harshini , Kim Daniel H. , Rezzadeh Kameron S. , Roostaeian Jason 
Published: January 2021

Abstract
Irradiated cadaveric costal cartilage (CC) has been utilized as an alternative to autologous cartilage (AC) in functional and aesthetic nasal surgery. The impact of graft choice between AC and CC on functional outcomes in rhinoplasty has yet to be studied. A systematic review was performed in PubMed, Embase, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify comparative studies evaluating the efficacy and safety of CC in nasal surgery. Functional and aesthetic outcomes and complications were reviewed and compared between AC and CC. Meta-analytic comparisons were performed when appropriate using data from comparative studies using a random-effects model. Four studies met inclusion criteria. The indication for surgery was functional in the majority of cases, and 34.6% of cases were revision rhino- or septorhinoplasties. Disparate data across studies prevented meta-analysis on functional outcomes; however, qualitative review of function outcomes demonstrated comparable outcomes between the CC and AC groups. No differences in graft infection, warping, and resorption rates were detected. Analysis of all graft-related complications was higher in the CC group (P = 0.02); however, when AC donor site-related complications were included, no significance between the two groups was observed. In conclusion, limited, high quality data was available for analysis. Of the available studies, this systematic review suggest that the use of AC or CC may lead to comparable results in terms of functional outcomes. More long-term studies directly comparing AC and CC functional outcomes would be welcomed.
Effect of Autogenous Dentin Graft on New Bone Formation
Authors: Yüceer-Çetiner Ezgi , Özkan Nilüfer , Önger Mehmet Emin 
Published: January 2021

Abstract
The aim of this study is to analyze the effects of autogenous dentin graft and mixture of autogenous dentin graft and platelet-rich fibrin (PRF) applied to the tooth extraction sockets on bone healing process. A total of 57 extraction sockets in 9 patients who were planned to be treated with dental implant after tooth extraction were evaluated in this study. Extraction sockets were divided randomly into 3 groups for each patient. In the first group, sockets were filled with autogenous dentin graft (Group D). In the second group, sockets were filled with the mixture of PRF and autogenous dentin graft (Group DP). In the third group, sockets were left empty as the control group (Group C). After 3 months, histological and immunohistochemical evaluations were performed on the samples taken during the implant surgery. Additionally, samples obtained from each group were examined by scanning electron microscopy. According to the histopathological findings, when the groups were compared in terms of new bone formation there was a significant difference between Group DP, both Group C, and Group D (P = 0.00), (P = 0.001). These findings supported by immunohistochemical results that showing increased bone morphogenetic protein-2 and Runt-related transcription factor-2 expression in Group DP. It has been concluded that undemineralized autogenous dentin graft has bone formation capacity on early period of bone healing. It can be used as bone graft material in augmentation procedures and its combined use with PRF accelerates new bone formation.
Evaluation of Alveolar Bone Quality: Correlation Between Histomorphometric Analysis and Lekholm and Zarb Classification
Authors: Oliveira Marina Reis , Gonçalves Andréa , Gabrielli Marisa Aparecida Cabrini , de Andrade Cleverton Roberto , Vieira Eduardo Hochuli , Pereira-Filho Valfrido Antonio 
Published: January 2021

Objectives:This study evaluated the bone quality of the maxilla and mandible by using the classification proposed by Lekholm and Zarb (L & Z) and histomorphometry.Methods:Sixty edentulous areas were evaluated. The classification by L & Z was obtained through the evaluation of periapical and panoramic radiographs associated with the surgeon's tactile perception during milling and implant installation. Before implant installation, bone biopsies of standardized sizes were performed for histological evaluation.Results:Type III bone quality was more frequent in the posterior (73.33%) and anterior (73.33%) maxilla, whereas type II bone quality was more frequent in the posterior (53.33%) and anterior (60.00%) mandible. Through histometry, statistical difference was observed for the amount of bone tissue of the posterior region of the maxilla in relation to the anterior and posterior regions of the mandible (P≤ 0.043). However, there was no difference in osteocyte counts between alveolar regions (P = 0.2946). In the female gender, the age showed a low positive correlation with the L & Z classification (rho = 0.398;P = 0.006) and in the male gender, a moderate negative correlation was observed (rho = –0.650,P = 0.016).Conclusions:Both methods detected differences in the bone quality of the alveolar regions of the maxilla/mandible and that the classification by L & Z is a reliable method, since it was consistent with histomorphometry, considered the “gold standard” method for the evaluation of bone quality and greater bone density was observed in older men.
One-Half Wedge Osteotomy Genioplasty for Correction of Chin Deviation Based on Three-Dimensional Computed Tomography Measurements and Simulation
Authors: Jiang Yerong , Yang Bin , Yang Fan , Li Binghang , Ma Hengyuan , Huang Qinghua , Sun Tiecheng , Lei Bowen , Shuang Kun 
Published: January 2021

Abstract
Conventional operations correcting chin deviations mainly rely on the observation and experience of the surgeons during the operation. We have created a new surgical method, one-half wedge osteotomy genioplasty (1/2WOG), that combines three-dimensional computed tomography measurements and simulation. This study evaluated the clinical effect of chin deviation correction with the 1/2WOG method. A total of 38 patients (15 men and 23 women) who underwent 1/2WOG between October 2019 and October 2014 were evaluated. The chin deviation angle and distance, and partial chin deformity were measured preoperatively using three-dimensional computed tomography data. Precise calculations and osteotomy lines were achieved by preoperative simulation. All patients underwent the same surgery by the same surgical team. The clinical effect of 1/2WOG was evaluated according to the preoperative and postoperative data and patient satisfaction. All 38 patients achieved satisfactory aesthetic results without major complications such as chin nerve injury or bone nonunion. Eight patients occured numbness of the lower lip after surgery; at 6-month follow-up, the numbness was reduced in 2 patients and disappeared in 6 patients. Compared with preoperative data, the chin deviation angle, chin deviation distance, and gonion-menton difference were significantly reduced postoperatively. During the 12-month follow-up, the patient satisfaction rate reached 90%. We conclude that chin deviation can be improved by 1/2WOG. The combination of digital technology measurements and simulation can increase the accuracy of the osteotomy line design, thus reducing surgical trauma and increasing patient satisfaction, which is worthy of clinical promotion.