bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of early mortality after primary decompressive craniectomy in patients with severe traumatic brain injury
Authors: Abouhashem Safwat , Albakry Amr , El-Atawy Shawkat , Fawzy Faten , Elgammal Sahar , Khattab Omar 
Published: April 2021

Abstract
Objectives
Traumatic brain injury (TBI) is a worldwide major health problem associated with a high rate of morbidity and mortality. Intracranial hypertension following TBI is the main but not the only cause of early mortality. Decompressive craniectomy (DC) is used to decrease the intracranial pressure (ICP) and prevent brain herniation following TBI; however, the clinical outcome after DC for patients with TBI generates continuous debate. Prediction of early mortality after DC will help in making the surgery decision.
The aim of this study is to predict early mortality after DC based on the initial clinical and radiological findings.

Methods
In this study, 104 patients with severe traumatic brain injury have been treated by decompressive craniectomy and were retrospectively analyzed. Patients were divided into two groups; group I involved 32 patients who died within 28 days while group II involved 72 patients who survived after 28 days. The relationship between initial Glasgow Coma Scale score (GCS), pupil size and reactivity, associated injuries, and radiological findings were analyzed as predictor factors for early mortality.

Results
A total of 104 patients with severe TBI have been treated by DC and were analyzed; the early mortality occurred in 32 patients, 30.77%. There is a significant difference between groups in gender, mean GCS, Marshall scale, presence of isochoric pupils, and lung injury.
After stratification, odds of early mortality increases with the lower GCS, higher Marshall scale, lung injury, and abdominal injury while male gender and the presence of isochoric pupils decrease the odds of mortality. After univariate regression, the significant impact of GCS disappears except for GCS-8 which decreases the odds of mortality in comparison to other GCS scores while higher Marshall scale, presence of isochoric pupils, and lung injury increase the odds of mortality, but most of these effects disappear after multiple regressions except for lung injury and isochoric pupils.

Conclusion
Prediction of early mortality after DC is multifactorial, but the odds of early mortality after decompressive craniectomy in severe traumatic brain injury are progressively increased with the lower GCS, higher Marshall scale, and the presence of lung or abdominal injury.
Oral acute toxicity and antimalarial potentials of aqueous and methanolic extracts of roots, leaves and stem of Dictyandra arborescens (Welw.) on Plasmodium berghei infected mice
Authors: Enenebeaku Uchechi E. , Ukwandu Nnamdi C. , Mgbemena Ifeyinwa C. , Nwigwe Harriet C. , Enenebeaku Conrad K. , Duru Chidi E. , Ogidi Odangowei I. 
Published: April 2021

AbstractBackgroundMalaria is one of the tropical diseases of universal concern particularly with continuous appearance of resistant strains ofP.falciparum. This calls for continous screening of traditional plants such that new and effective antimalarial agents will be developed. This study therefore explored the oral acute toxicity and antimalarial potentials of aqueous and methanolic extracts of roots, leaves and stem ofDictyandra arborescensonPlasmodium bergheiinfected mice.ResultsNo mortality was recorded in any of the experimental animal groups even at the highest tested dose (5000 mg/kg b.wt) of the extract after monitoring them for 4hrs and subsequently for 7 days. Out of the six extracts, methanolic extracts of the roots and leaves exhibited more antimalarial activity than others. A significant difference (P < 0.05) was statistically observed in the parasite count of groups that received methanol extracts of roots and leaves ofD. arborescens. This observation was made when these two extracts were compared with other groups as well as the negative control. However, activity of the standard antimalarial drug (artesunate) was higher (p˂0.05) than those of the extracts. Phytochemicals such as tannins, alkaloids, saponins, terpenoids, flavonoids etc. were present in the extracts in varying quantities. GC–MS analysis of methanol extract of the root of this plant showed different chemical compounds.ConclusionAdministration of aqueous and methanol extracts of roots, leaves and stem ofD. arborescensin mice is not harmful at any dose less than or equal to 5000 mg/kg. Methanol extracts exhibited more antimalarial activity than aqueous extracts suggesting that antimalarial activity of the plant parts could be affected by the solvent used for extraction and antimalarial activity may be more in a particular part of a plant. The presence of different bioactive compounds identified in phytochemical and GC–MS analysis could be the fundamental scientific evidence for the antimalarial activity exhibited by this plant especially in the root.
Classic Cornelia de Lange syndrome with variant of unknown significance detected in NIPBL gene mutation: a case report
Authors: Desai Jay J. , Nair Sreelata B. , Pappachan S. 
Published: April 2021

AbstractBackgroundCornelia de Lange syndrome is a relatively uncommon disorder associated with multiple congenital anomalies/mental retardation of unknown etiology with its incidence varying from 1:10,000 to 1:50,000 live births in different population groups without any known racial predilections. Main clinical features of this syndrome consist of distinctive dysmorphic facial appearance, growth retardation, developmental delay, mental retardation, hirsutism, and skeletal formation anomaly.Case presentationThis case presents a variation of unknown significance in theNIPBLgene-exon 39, chr5:37048649T>A c.6635T>A (p.Val2212Glu) with clinical phenotype of Cornelia de Lange syndrome. Our patient belonged to South Indian origin with clinical features of synophrys, micrognathia, long smooth philtrum, and clinodactyly with bilateral simian crease.ConclusionCornelia de Lange syndrome is a rare but well-characterized disorder, in which multiple systems of the body are affected. It is important that the treating physician ensures coordination of the diversiform aspects of care in both childhood and adulthood. Proper and timely diagnosis using next generation sequencing helps in management and possibility of prenatal diagnosis.
Pharmacological comparison of four biopolymeric natural gums as hemostatic agents for management of bleeding wounds: preliminary in vitro and in vivo results
Authors: Kushwah Himanshu , Sandal Nidhi , Chauhan Meenakshi , Mittal Gaurav 
Published: April 2021

Abstract
Background
Uncontrolled bleeding is one of the primary reasons for preventable death in both civilian trauma and military battle field. This study evaluates in vitro and in vivo hemostatic potential of four biopolymeric natural gums, namely, gum tragacanth, guar gum, xanthan gum, and gum acacia. In vitro evaluation of whole blood clotting time and erythrocyte agglutination assay were carried out. In vitro cytotoxicity studies with respect to each gum were done in human lymphocytes to ascertain percent cell viability. In vivo hemostatic potential of each gum (as sponge dressing and powder form) was evaluated in Sprague Dawley rats using tail bleeding assay and compared with commercially available hemostatic sponge. Other important parameters like (a) time taken for complete hemostasis, (b) amount of blood absorbed, (c) adherence strength of developed hemostatic dressing(s), (d) incidence of re-bleeding, and (e) survival of animals were also studied.

Results
Of the four test gums studied, xanthan gum (@3mg/ml of blood) and gum tragacanth (@35mg/ml of blood) were able to clot blood in least time (58.75±6.408 s and 59.00±2.082 s, respectively) and exhibited very good hemostatic potential in vitro. Except for xanthan gum, all other test gums did not exhibit any significant cytotoxicity at different time points till 24 h. In rat tail bleeding experiments, gum tragacanth sponge dressing and powder achieved hemostasis in least time (156.2±12.86 s and 76±12.55 s, respectively) and much earlier than commercially available product (333.3±38.84 s; p˂0.01).

Conclusion
Results indicate potential of gum tragacanth to be developed into a suitable hemostatic product.
Role and efficacy of music therapy in learning disability: a systematic review
Authors: Mina Feeby , Darweesh Mohammed El Sayed , Khattab Ahmed Nabil , Serag Shaimaa Mohammed 
Published: April 2021

Abstract
Background
Kids with learning disabilities can succeed in school and improve their educational level with the help of a correct rehabilitation program; one of the most effective rehabilitation programs is music therapy. As there was little proof educating us knowledge regarding the function of music treatment in the improvement of learning incapacitated kids in this way, it was imperative to gather these bits of studies in a systematic review study to feature the role of music treatment in the restoration of learning disabilities.
The aim of this work is to study the relation between music therapy and learning disabilities, to define the music therapy role and efficacy in the enhancement of learning disabled children to be able to delineate an efficient program therapy later on.
This study is a systematic review and was carried out according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol.

Main text
The reviewed included studies were intervention studies that used different groups of cases (learning disabled, dyslexic, or with mathematical problems children) which received the music therapy versus different control groups (normal or dyslexic) receiving normal reading program, cognitive or placebo therapy; also they applied different methods and programs of music therapy. Most of the included studies reported that music therapy is a useful aiding factor in rehabilitation therapy of reading and phonological awareness disorders, however little evidence for positive effectiveness regarding spelling, arithmetic, writing, cognitive abilities, working memory, auditory attention, and rapid auditory processing.

Conclusion
Music therapy (with or without cognitive therapy) has an important and augmenting role in improving reading skills and phonological awareness problems in dyslexic children but does not replace the current methods of rehabilitation. There is little evidence found that music therapy (with or without cognitive therapy) is an effective aiding factor in rehabilitation therapy regarding spelling, arithmetic, writing, cognitive abilities, working memory, auditory attention, and rapid auditory processing in learning disabled children.
PARP Inhibitor in Platinum-Resistant Ovarian Cancer: Single-Center Real-World Experience
Authors: Agarwal Amit , Baghmar Saphalta , Dodagoudar Chandragouda , Qureshi Suhail , Khurana Aseem , Vaibhav Vikas , Kumar Guresh 
Published: April 2021

PURPOSE Poly (ADP-ribose) polymerase inhibitors (PARPi) have proven efficacy in treatment of BReast CAncer ( BRCA) gene mutation-positive platinum-sensitive ovarian cancers. There is paucity of data for their role in platinum-resistant ovarian cancer (PROC). We report here retrospective analysis of outcome of PARPi treatment in a group of patients including those of PROC. PATIENTS AND METHODS We analyzed all consecutive patients who received PARPi. The efficacy of PARPi monotherapy was assessed in patients with relapsed high-grade serous ovarian carcinoma with g BRCAm. The drug was procured through compassionate program. Drugs (olaparib and talazoparib) were provided in capsule form. RESULTS Between July 1, 2015, and June 30, 2019, 28 patients with ovarian cancer received PARPi. At the time of data censoring (September 30, 2019), four (14.3%) patients are still on treatment. Median age was 54.5 years (range, 39-75 years). Median number of previous lines of chemotherapy received was three (range, 1-6). Eleven platinum-sensitive patients received the drug as maintenance (five in complete response and six in partial response after chemotherapy), whereas 17 (60.7%) had platinum-resistant progressive disease while starting the drug. In PROC, objective response rate (complete response plus partial response) was 47%, median progression-free survival was 8.2 months (5.3-11.3), and overall survival was 14.9 months (11.2-18.5). No new side effects were observed. CONCLUSION This is the first study from India evaluating PARPi in platinum-resistant ovarian cancer. This study suggests that PARPi is a viable treatment option in patients with PROC with gBRCAm. This should be further evaluated in randomized clinical trial.
Disparities Between Provider Assessment and Documentation of Care Needs in the Care of Adolescent and Young Adult Patients With Sarcoma
Authors: McKay Grace E. , Zakas Anna L. , Osman Fauzia , Lee-Miller Cathy , Pophali Priyanka , Parkes Amanda 
Published: April 2021

PURPOSE: Given the occurrence of cancer during a complex developmental time, adolescent and young adult (AYA) patients have unique psychosocial needs that necessitate supportive care, which is optimally provided using National Comprehensive Cancer Network (NCCN) AYA guidelines. We sought to explore compliance with NCCN AYA guidelines and compare with oncology providers' perceptions of AYA care needs. METHODS: Retrospective chart reviews of AYA patients (15-39 years at time of cancer diagnosis) with sarcoma seen at least once in 2019 at the University of Wisconsin identified documentation of discussions deemed critical per NCCN AYA guidelines. As per the ASCO Quality Oncology Practice Initiative certification, we considered a threshold of these factors being discussed 75% of the time or higher to be compliant. Compliance was compared with an electronic survey of University of Wisconsin oncology providers regarding AYA patient needs, with items determined to have adequate resources if noted sufficient by at least 75% of providers. RESULTS: We identified 43 AYA patients with sarcoma. Less than 75% of patients had documentation of discussion of contraception, sexual health, fertility, finances, genetics, social work referral, and clinical trials indicating noncompliance with NCCN guidelines. Surveys, completed by 38 oncology providers, showed significant discordance between providers' perceptions of AYAs' access to resources and providers' documented discussions of supportive care resources. CONCLUSION: Disparities between oncology provider assessment of AYA care needs and documentation of critical components of AYA patient care demonstrate the need for novel tools to evaluate AYA care needs beyond provider assessments.
Impact of a G-CSF Policy to Reduce Low-Value Care on Guideline Adherence and Mortality
Authors: Orji Chinelo C. , Brown Carolyn M. , Hoverman J. Russell , Richards Kristin M. , Garey Jody , He Bo 
Published: April 2021

PURPOSE: Practice guidelines recommend the prophylactic use of granulocyte colony–stimulating factors (G-CSFs) in patients with high risk of febrile neutropenia, but evidence suggests that G-CSFs are frequently overused. The objectives of this study were (1) to determine the prevalence and prescribing patterns of G-CSF and (2) to evaluate the impact of a program initiative on G-CSF prescribing patterns, adherence to guidelines, and mortality. METHODS: In this retrospective cohort study, data were used from the electronic health records of patients with metastatic colorectal cancer who received care at a multicenter oncology practice network during two time periods: July 01, 2013, to December 31, 2014, and July 01, 2017, to December 31, 2017. Beginning 2016, a site-wide program initiative that involved educational materials, appropriate nonuse recommendations, and prior authorization was introduced in the oncology practice network with an aim of reducing G-CSF overutilization. Descriptive statistics, t tests, and chi-squared tests were employed to analyze program impact. RESULTS: There were 3,426 chemotherapy regimens corresponding to 2,968 patients. There were a total of 387 (11.3%) G-CSF–treated patients and 3,095 G-CSF administrations during the study period. G-CSF use was significantly lower in the postperiod, compared with the preperiod ( P < .0001). Adherence to guidelines was significantly higher in the postperiod, compared with the preperiod ( P < .0001). Mortality rates did not significantly differ between the two time periods. CONCLUSION: This study demonstrates that policy initiatives have the potential to positively affect G-CSF prescription patterns and promote guideline adherence. These findings could help prescribers adopt a cost-effective approach in patients with metastatic colorectal cancer, leading to enhanced clinical practice and value-based care.
Impact of a Virtual Multidisciplinary Sarcoma Case Conference on Treatment Plan and Survival in a Large Integrated Healthcare System
Authors: Pan Minggui , Yu Jeanette , Sidhu Manpreet , Seto Tiffany , Fang Andrew 
Published: April 2021

PURPOSE: Quantifying the impact of a multidisciplinary cancer case conference on patient outcome and care quality remains challenging. PATIENTS AND METHODS: We prospectively investigated the impact of our virtual multidisciplinary sarcoma case conference (VMSCC) on treatment plan in patients presented to the VMSCC from July to October 2020 (prospective cohort) and retrospectively in patients with metastatic or locally advanced high-grade soft-tissue sarcoma (STS) reviewed in the VMSCC in 2016 and 2017 (high-grade STS cohort). We also investigated the factors related to the nonadherence to the VMSCC-recommended plan in both cohorts. RESULTS: In both cohorts, approximately 28% of the patients were referred to the VMSCC for review without a treatment plan. In significantly more cases, referring physicians outside of the sarcoma group did not have a plan formulated before the VMSCC review compared with the referring physicians within the sarcoma group. In 28.2% (prospective cohort) and 19.5% (high-grade STS cohort) of the patients, VMSCC recommended a different plan. The adherence to the VMSCC-recommended plan was 87.9% and 83.1%, respectively. The causes of the nonadherence were primarily due to disease progression or patient’s decision against recommended therapy. The median overall survival for the high-grade STS cohort was 26 months. CONCLUSION: VMSCC affected the treatment plan in approximately 50% of the patients in both cohorts. The median overall survival of the patients with high-grade STS reviewed by the VMSCC in our cohort is comparable with the literature.
Prácticas de ocio y tiempo libre de los adolescentes en Galicia: análisis y reflexiones en clave socioeducativa
Authors: De Valenzuela Bandín Ángela L. , Martínez García Rubén , Escobar Arias Diana Morela 
Published: April 2021

INTRODUCCIÓN. Desde hace décadas diversos estudios han revelado el potencial del tiempo de ocio para el desarrollo personal y social. Un tiempo que, no en pocas ocasiones, queda relegado a un segundo plano en detrimento de otros considerados socialmente prioritarios. El objetivo de este trabajo es identificar las actividades de ocio que practican los estudiantes gallegos de Educación Secundaria Obligatoria (ESO), tanto entre semana como en fines de semana, y analizar la influencia del nivel de estudios de los progenitores en las actividades lúdicas que los adolescentes más realizan. MÉTODO. La metodología es de corte cuantitativo. Se ha aplicado un cuestionario elaborado ad hoc al alumnado de 1.º a 4.º de la ESO de centros educativos públicos y privados/concertados de Galicia, obteniendo 1.890 cuestionarios válidos. RESULTADOS. El ocio digital, ver la televisión y practicar deporte son las actividades que los adolescentes practican en mayormedida. Contrariamente, participar en asociaciones y voluntariado, así como asistir a actos culturalesson las actividades menos practicadas. En general, se evidencia que los adolescentes dedican más tiempo al ocio los fines de semana. En cuanto a la influencia del nivel de estudios de los progenitores, se constata que cuanto más alto es su nivel académico, menos tiempo dedican sus hijos/as al ocio digital y más al deporte y a la actividad física. Esta misma tendencia se observa en la lectura, actividad de ocio estudiada por su relación con el capital cultural. DISCUSIÓN. En líneas generales, los datos obtenidos coinciden con la literatura existente. Así, se presentan datos de otras investigaciones que reafirman, y en algún caso contradicen, estos resultados. En conclusión, la educación del ocio tiene un papel clave a la hora de alfabetizar el ocio de los adolescentes a fin de que transiten de la mera ocupación del tiempo libre al desarrollo de experienciasde ocio valiosas.
Routine group and save screening prior to emergency laparoscopic surgery
Authors: Alyacoubi S , Taj T , Raza I 
Published: April 2021

Introduction Two group and save (G&S) samples are routinely collected from patients undergoing diagnostic laparoscopy and/or emergency appendicectomy. We aimed to identify the necessity of this practice by looking at the perioperative transfusion rates. Methods Data were obtained from our electronic theatre system for all patients who underwent emergency laparoscopic surgery (specifically diagnostic laparoscopy and/or laparoscopic appendicectomy) between January 2017 and December 2018. Records were reviewed for the number of G&S samples sent and perioperative transfusion rates. Results A total of 451 patients were included in the study. The numbers of procedures performed in 2017 and 2018 were 202 (44.8%) and 249 (55.2%), respectively. The total number of samples sent was 930. Only 786 (84.5%) samples were processed and the rest were rejected for various reasons. Of the 451 patients included in the study, 308 (68.3%) had two G&S samples sent, whereas 41 patients (9.1%) had only one G&S sample sent. Fifty-six (12.4%) and 20 (4.4%) patients had three and four G&S samples sent, respectively. Only two patients required transfusion perioperatively (0.4%), and the indication in both was irrelevant to the primary operation. Conclusions These results demonstrate a near-zero transfusion rate in this patient cohort. Omitting G&S is safe and potentially saves time and resources.
The role of simulation in training breast surgeons: a systematic review
Authors: Kankam HKN , Lenti L , Razai MS , Hourston GJM , Khatib M 
Published: April 2021

Background As surgical education has evolved, most curricula have favoured a competency-based approach over traditional apprenticeship models. Surgical simulation can be a useful aide in the training of both oncological and reconstructive breast surgery trainees. This review investigates the extent to which simulation of breast surgery procedures has been validated as a training tool. Methods A comprehensive literature search for studies evaluating the objective validity of breast surgery simulators was performed, using MEDLINE, EMBASE and the Cochrane Library databases. Studies assessing construct, concurrent or predictive validity were included, as well as those demonstrating skill acquisition. Findings The initial literature search returned 1,625 hits, with only five articles meeting the inclusion criteria. Simulators were designed to train procedures such as breast augmentation, lesion biopsy and excision. Of these, breast biopsy was the most simulated procedure (three studies). Two studies evaluated animal models, two evaluated synthetic models and one study assessed both a synthetic and animal model. Construct validity was confirmed in two studies, concurrent validity in one study and a learning curve demonstrated in another study. No association between experience and performance was seen in the remaining study. The quality of the evidence presented in each article was low due to numerous limitations. Despite the abundance of breast surgery simulators created for trainees, few have been objectively validated and they only cover a narrow range of breast procedures. Although early results are promising, further studies are required before routine use of simulators is considered in breast surgery curricula.