bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of rectal chloral hydrate for pediatric procedural sedation: A systematic review and meta-analysis
Authors: Chen Zhe , Qin Fang , Zeng Linan , Zhang Lingli 
Published: August 2024

Background:
To evaluate the efficacy and safety of rectal chloral hydrate (CH) in pediatric procedural sedation.

Methods:
Seven electronic databases and 3 clinical trials registry platforms were searched, and the deadline was August 2022. Randomized controlled trials evaluating the efficacy and safety of rectal CH in pediatric procedural sedation were included by 2 reviewers. The extracted outcomes included the success rate of sedation, sedation latency, sedation duration, and adverse events. The Cochrane risk of bias tool was used to assess the risk of bias. The outcomes were analyzed using Review Manager 5.3 software.

Results:
Forty-four randomized controlled trials with 8007 children were included in the meta-analysis. The success rate of sedation in the rectal CH group was significantly higher than that in the placebo group (risk ratio [RR], 2.60 [95% confidence interval [CI], 1.74–3.89]; P < .01; RR, 1.24 [95% CI, 1.01–1.54]; P = .04), oral CH group (RR, 1.12 [95% CI, 1.09–1.14]; I2 = 36%; P < .001; number needed to treat [NNT] = 10), diazepam group (RR, 1.21 [95% CI, 1.10–1.33]; I2 = 0%; P < .001; NNT = 6), phenobarbital group (RR, 1.24 [95% CI, 1.13–1.35]; I2 = 12%; P < .001; NNT = 6), and ketamine group (RR, 1.39 [95% CI, 1.20–1.60]; I2 = 20%; P < .001; NNT = 5). There was no significant difference in the success rate of sedation between the rectal CH group and the midazolam group (RR, 0.98 [95% CI, 0.86–1.11]; I2 = 51%; P > .05). The sedation latency was significantly shorter in rectal CH group than that in the oral CH group (mean difference [MD], −6.36 [95% CI, −7.04 to −5.68]; I2 = 49%; P < .001) and the phenobarbital group (MD, −7.64 [95% CI, −9.12 to −6.16]; P < .00001). The sedation duration in the rectal CH group was significantly longer than in the oral CH group (MD, 6.43 [95% CI, 4.39–8.47]; I2 = 0%; P < .001). The overall incidence of adverse events was significantly lower with rectal CH than with oral CH (RR, 0.21 [95% CI, 0.16–0.29]; I2 = 45%; P < .001) and ketamine (RR, 0.26 [95% CI, 0.12–0.60]; I2 = 0%; P = .001). There was no significant difference in the overall incidence of adverse events with rectal CH compared with intramuscular midazolam (RR, 0.55 [95% CI, 0.23–1.28]; P = .17) and intranasal midazolam (RR, 3.00 [95% CI, 0.66–13.69]; P = .16).

Conclusion:
The available evidence suggests that rectal CH cloud be an effective and safe sedative agent for pediatric procedural sedation.
Changes of oxidative stress in 3D film to be prepared for echocardiography: A randomized controlled study
Authors: Demir Emel , Duzguner Vesile , Yilmaz Nuh , Yengil Erhan 
Published: August 2024

Background:
Echocardiography (ECHO) is a nonprocedure that causes acute stress in children. Fear, anxiety, and fluctuations in children’s blood pressure and heart rate can potentially lead to alterations in echocardiographic measurements. The insufficient research on virtual reality pediatric preparation applications, particularly in the context of echocardiographic procedures, underscores the necessity for additional studies focusing on pediatric patients. This study sought to assess the impact of virtual reality applications tailored explicitly for ECHO on children’s oxidative stress levels.

Methods:
This was a prospective, randomized, controlled experimental study. Forty-eight children (experimental/24, control/24) aged 7 to 12 years who had an ECHO appointment in the pediatric cardiology outpatient clinic in the 3 months from June to August 2019 participated in the study. Participants whose blood analyses showed hemolysis were eliminated, and the study was completed with 37 children in total: 16 children in the experiment and 21 children in the control. Post hoc power analysis was performed for sample adequacy, and the power of the study was found to be 0.99. A 3D film was prepared for the research and applied to the experimental group before the procedure. All children’s oxidative stress levels (cortisol, malondialdehyde, nitric oxide) and glutathione levels were checked after ECHO.

Results:
The stress hormone cortisol and malondialdehyde levels were lower in the 3D-applied experimental group than in the control group. As another crucial anti-stress antioxidant factor, glutathione level increased in the experimental group compared to the control group (P < .05).

Conclusion:
The research revealed that the 3D film used to prepare ECHO reduces the stress parameters associated with heart risk and may affect the ECHO measurements. At the same time, the study also proved the positive effect of 3D film preparation by increasing the anti-stress factor.
Resection of uterine arteriovenous fistula with temporary occlusion of the internal iliac arteries: Case series and literature review
Authors: Chen Jianmin , Huang Dong , Yang Jie , Zhang Songying 
Published: August 2024

Rationale:
Uterine arteriovenous fistula (UAVF) is a rare vascular abnormality that can cause severe and potentially life-threatening hemorrhage. Uterine artery embolization is a common treatment that may affect ovarian and uterine perfusion and cause fertility problems. We herein report our experience treating 2 patients with UAVF who underwent resection after temporary occlusion of both internal iliac arteries.

Patient concerns:
Both patients presented with a large UAVF after incomplete miscarriages in the second trimester. Magnetic resonance imaging revealed a UAVF measuring 3.6 × 2.6 × 2.1 cm over the myometrium of the posterior uterine in case 1, and a UAVF of 7.1 × 4.1 × 4.5 cm was identified in case 2.

Diagnosis:
Uterine arteriovenous fistula, retained products of conception.

Interventions:
The patients underwent resection of UAVF with temporary occlusion of the internal iliac arteries and hysteroscopic removal of the retained products of conception.

Outcomes:
Intraoperative bleeding were minimal. Neither patient exhibited abnormal uterine bleeding at the 6-month follow-up. Follow-up ultrasonography and magnetic resonance imaging showed normal uterine myometrium and endometrium and no residual disease.

Lessons:
UAVF resection after temporary occlusion of the internal iliac arteries is a promising treatment approach for UAVF. This technique can reduce intraoperative bleeding and remove the potential hemorrhage-related lesion while preserving fertility.
Physical exercise on cortical brain activity in patients with mild cognitive impairment: A meta-analysis
Authors: Li Xiaomei , Cai Hejia , Li Fangcun , Tang Ke , Tang Gangjian 
Published: August 2024

Background:
Physical exercise is recognized as a potential strategy to mitigate the cognitive decline associated with mild cognitive impairment (MCI). This systematic review aims to examine the specific effects of physical exercise on cortical brain activity in patients with MCI, an area that has not been thoroughly explored.

Methods:
We conducted a search across 9 electronic databases for randomized controlled trials assessing the impact of physical exercise on the cortical activity of patients with MCI. The search covered the period from database inception to September 2023. Literature screening, data extraction, and quality assessments were carried out by 2 independent researchers. Meta-analyses were conducted using RevMan 5.3, and publication bias was evaluated using STATA 17.0. This study primarily assessed P300 latency and amplitude, alongside cognitive evaluations using the mini-mental state examination and Montreal Cognitive Assessment.

Results:
Six high-quality randomized controlled trials, involving a total of 360 participants, were included. Compared to the control group, significant enhancements were observed in the amplitude of central midline electrode (mean difference [MD] = 1.64 [95% confidence interval [CI], 0.92–2.36]; P < .00001), frontal midline electrode (MD = 2.70 [95% CI, 2.02–3.38]; P < .00001), and parietal midline electrode (MD = 2.42 [95% CI, 0.44–4.41]; P = .02). Latency periods of the central midline electrode (MD = −32.40 [95% CI, −40.27 to −24.54]; P < .00001), frontal midline electrode (MD = −12.57 [95% CI, −30.83 to 5.69]; P = .18), and parietal midline electrode (MD = −12.57 [95% CI, −30.83 to 5.69]; P = .81) were also notably influenced. Moreover, overarching cognitive functions as measured by mini-mental state examination (MD = 1.02 [95% CI, 0.61–1.43]; P < .00001) and Montreal Cognitive Assessment (MD = 1.39 [95% CI, 0.67–2.12]; P = .0002) exhibited marked improvement.

Conclusion:
This meta-analysis suggests that physical exercise can augment the P300 amplitude, reduce the P300 latency period, and, overall, enhance cognitive functionality in individuals with MCI.
Acute effects of manual breathing assist technique on lung volume and dyspnea in individuals with severe chronic obstructive pulmonary disease: A quasi-experimental study
Authors: Tanaka Takako , Reid W. Darlene , Nonoyama Mika Laura , Kozu Ryo 
Published: August 2024

Background:
Manual breathing assist technique (MBAT) is a common physical therapy technique used to facilitate airway clearance and improve ventilation and oxygenation. The effects during and immediately after intervention in individuals with chronic obstructive pulmonary disease (COPD) are unknown. This study aimed to investigate the acute effects and potential mechanisms of MBAT on lung volume, dyspnea, and oxygenation in individuals with COPD.

Methods:
This non-randomized quasi-experimental pre-test/post-test study included participants from pulmonary rehabilitation programs at Tagami Hospital (COPD group) and a community exercise program (Healthy group). During a single session, MBAT was applied during the expiration of every breath for 10 minutes. Dyspnea and lung volumes (tidal volume; V

T
, inspiratory capacity; IC, inspiratory reserved capacity; IRV, expiratory reserve capacity; ERV) were collected at baseline and after MBAT. Pulse oximetry (SpO2), skeletal muscle oxygenation (SmO2), and oxy- and deoxy-hemoglobin (O2Hb and HHb) using near-infrared spectroscopy (NIRS) were collected at baseline, during, and after MBAT. Between-group comparisons were conducted using the Mann-Whitney U-test and chi-square analyses. Within-group changes before and after MBAT were analyzed using the Wilcoxon signed-rank test. The Kruskal-Wallis test was used to detect differences in NIRS variables in each phase and over time.

Results:
Thirty participants with COPD, matched for age and sex, were included, with 15 individuals per group. The difference scores of V

T
, IRV, and IC were significantly higher in the Healthy group than in the COPD group, but improvements in dyspnea and SpO2 were significantly higher in the COPD group. Compared to baseline, ERV decreased significantly in both groups, with dyspnea and SpO2 improving significantly only in the COPD group. Inspiratory accessory muscle ΔO2Hb and ΔHHb were significantly higher and lower (respectively) during MBAT in the COPD group compared to the Healthy group. Additionally, only the COPD group had increased SmO2 during and after MBAT compared to baseline.

Conclusions:
MBAT in patients with COPD had acute physiological effects in reducing dyspnea by facilitating expiration and decreasing the recruitment of accessory respiratory muscles. MBAT may help individuals with COPD reduce dyspnea before exercise therapy in a pulmonary rehabilitation program.
Purse-string versus linear closure of the skin wound following stoma reversal: A meta-analysis with RCT and systematic review
Authors: Luo Jinlong , Liu Dan , Wu Junmei , Jiang Huaiwu , Chen Jin , Yang Hua , Yang Lie 
Published: August 2024

Background:
Linear closure (LC) following stoma reversal is associated with a high risk of surgical site infection (SSI). Purse-string closure and LC were both positive for the closure of the skin wound following stoma reversal, and it was not yet possible to distinguish which one was more beneficial to the patient’s prognosis.

Methods:
We conducted a search in Embase, PubMed, Web of Science, and Cochrane Library and conducted a randomized controlled experiment from the inception of each database to July 2024. Among them, the SSI within 30 days, operation time, hospitalization time, incisional hernia, and wound healing time were all outcome indicators.

Results:
Eleven studies were included in this meta-analysis (506 patients in the purse-string closure group and 489 patients in the LC group). The pooled data showed that the SSI rate was significantly lower in the purse-string closure group than in the LC group (odds ratio, 0.15; 95% confidence interval, 0.09–0.24; P < .00001; I2 = 0%). The differences in operative time, hospitalization time, incision hernia, and wound healing time were not statistically significant.

Conclusion:
Overall, purse-string closure had a significantly lower SSI rate following stoma reversal than LC.
Challenging treatment of severe hypotension following tracheal intubation in a patient with primary hyperparathyroidism: A case report
Authors: Koyama Yuhei , Hamaguchi Shinsuke 
Published: August 2024

Rationale:
Primary hyperparathyroidism (PHPT), which is characterized by increased parathyroid hormone secretion, typically manifests as hypercalcemia and hypertension. Here, we report a case of severe hypotension following tracheal intubation during anesthesia induction in a patient with PHPT, in contrast to the expected hypertensive response.

Patient concerns:
A 52-year-old man presented with nausea after eating, leg pain when walking, and headaches.

Diagnosis:
Based on the blood test and computed tomography results, he was diagnosed with PHPT.

Interventions:
The patient underwent parathyroidectomy under general anesthesia. After induction anesthesia and tracheal intubation, severe acute hypotension and tachycardia suddenly developed. To treat hypotensive shock, we immediately administered ephedrine and phenylephrine and infused Ringer solution.

Outcomes:
The symptoms of hypotensive shock were alleviated by this intervention.

Lessons:
We speculate that the cause of his severe hypotension was vasodilation due to the transient release of parathyroid hormone from mechanical stimulation by anesthetic procedures, such as tracheal intubation, combined with hypercalcemia-induced severe dehydration. Moreover, we speculate that fluid resuscitation stabilized his condition and helped achieve a successful surgical outcome. The possibility of severe hypotension after anesthesia induction should be anticipated, and management of cases with severe dehydration should be optimized during the anesthetic management of patients with PHPT.
Clinical features and genetic analysis of 5 cases of infantile-type glycogen storage disease type II: Case reports
Authors: Feng Qi , Zhang Meng Qiao , Ba Chun Xiao , Zhang Ying Qian 
Published: August 2024

Objective:
Clinical and genetic mutation analysis was performed on 5 infantile glycogen storage disease type II children in Chinese mainland.

Methods:
Clinical data of 5 children with infantile-type glycogen storage disease type II due to the acidic α-glucosidase (GAA) gene variants diagnosed and treated at Hebei Provincial Children’s Hospital from January 2018 to April 2020 were retrospectively analyzed.

Results:
Among the 5 cases, 1 was female and 4 were male, and the age at first diagnosis was from 2 months to 7 months. The first symptoms of all 5 cases showed progressive muscle weakness, hypotonia, and motor developmental backwardness, and all of them had abnormally elevated creatine kinase, and the echocardiograms suggested different degrees of myocardial hypertrophy, with ejection fractions ranging from 44% to 67%. Analysis of GAA gene variations: all 5 cases were compound heterozygous, and a total of 12 variant loci were detected, of which c.2024_2026delACA, c.2853G > A, c.1124G > T, c.574G > A, c.2509C > T, and c.2013G > A were new mutations that had not been reported.

Follow-up:
All 5 children died before 1 year of age, and the age of death ranged from 7 months to 11.5 months, with a mean survival time of 9.8 months.

Conclusion:
Peripheral blood GAA gene testing and alpha-glucosidase enzyme activity testing is an effective method for diagnosing this disease.
Evaluation of blood evacuation efficiency using 99mTc-RBC imaging: a comparative study of exsanguination tourniquet rings and Esmarch bandages
Authors: Liu Ninghu , Sun Binbin , Xu Jianjie , Xu Jianqiao , Zhao Keqi , Xu Shaonan , Su Xinhui , Zhou Weifeng 
Published: August 2024

Objective
The objective of this study is to compare the effectiveness of the Esmarch bandage and exsanguination tourniquet rings (ETRs) in blood evacuation procedures using a controlled intra-subject design involving healthy volunteers.

Methods
A total of 20 healthy adult volunteers (12 males, 8 females) were recruited from the community. Participants underwent blood evacuation procedures on both legs, using the Esmarch bandage on one leg and the ETR on the other. The order of the procedures was randomized. Blood evacuation time, overall blood evacuation rate, and calf blood evacuation rate were measured using 99mTc-labeled red blood cell imaging. Paired t-tests were conducted to compare the effectiveness of the two methods.

Results
The ETRs demonstrated a significantly faster blood evacuation time compared to the Esmarch bandage (mean difference = −41.72 s, P < 0.0001). The overall blood evacuation rate was slightly higher for the ETRs (mean difference = 1.717%), though not statistically significant (P = 0.3680). The calf blood evacuation rate was significantly higher for the ETRs (mean difference = 6.86%, P = 0.0225). No significant discomfort or adverse reactions were reported by any participants.

Conclusion
ETRs are more efficient in terms of blood evacuation time and calf blood evacuation rate compared to the Esmarch bandage, without causing significant discomfort or adverse reactions. These findings suggest that ETRs could be a preferable option in clinical settings for blood evacuation procedures.
International ISPRM Congress in Cartagena 2023: topics and recommendations
Authors: Lugo-Agudelo Luz Helena , Gimigliano Francesca , Fransisco Gerard E. , Gutiérrez-Godoy Jorge-Eduardo , Escobar-Giraldo Luz Marina , Giraldo-Prieto Mario 
Published: August 2024

Background:
The International Society of Physical and Rehabilitation Medicine—ISPRM—is the pre-eminent scientific and educational society for medical specialists in rehabilitation. Its mission is to optimize functioning and health-related quality of life and minimize disability in persons with medical problems. The World Congress remains the society’s face-to-face meeting to update topics related to disability and rehabilitation. This manuscript describes the academic proposals and abstracts submitted and accepted after peer review, sorting them out according to the Standardized Abstract Topic List of the ISPRM World Congress bidding guidelines. It also aims to give recommendations for future congresses.

Methods:
This study is a cross-sectional descriptive study of academic proposals and abstracts submitted to the ISPRM2023 Congress in Cartagena. To structure the academic program, the Congress Scientific Committee (CSC) opened 2 calls for wide-open international participation: one for academic proposals (Scientific sessions and workshops led by top experts) and another for abstract submissions inviting rehabilitation professionals in general, according to the ISPRM Congress classification of topics. Six members of the CSC assessed the academic proposals to ensure the representation of diverse topics and geographic areas. The abstracts were peer-reviewed following predefined quality criteria and assigned to 3 international juries according to their expertise.

Results:
Participants submitted 142 proposals in English and 42 in Spanish from 6 continents: North and South America, Europe, Africa, Asia, and Oceania. The Clinical Sciences category (58.7%) out of 138 accepted proposals was the most common. Of 703 submitted abstracts, 692 got accepted to present their work, but only 418 were presented on-site: 127 (30.4%) oral and 291 poster presentations. The distribution of the submitted abstracts showed substantial interest in clinical science and therapeutics (73.9%), followed by engineering and technology (9.1%), biomedical sciences (4.5%), and health policy and systems (4.5%).

Conclusions:
We made 8 recommendations for future congresses. It will be essential to review the topics involving emerging ones in physical and rehabilitation medicine that are gaining relevance, such as infectious diseases (COVID-19), cardiopulmonary disorders, metabolic diseases (obesity, osteoporosis), diagnostic and therapeutic ultrasound, and electrodiagnosis.
Using A Disentangled Neural Network to Objectively Assess the Outcomes of Midfacial Surgery in Syndromic Craniosynostosis
Authors: Rickart Alexander J , Foti Simone , van de Lande Lara S , Wagner Connor , Schievano Silvia , Jeelani Noor ul Owase , Clarkson Matthew J , Ong Juling , Swanson Jordan W , Bartlett Scott P , Taylor Jesse A , Dunaway David J 
Published: August 2024

Background:
Advancements in artificial intelligence and the development of shape models that quantify normal head shape and facial morphology provide frameworks by which the outcomes of craniofacial surgery can be compared. In this work, we will demonstrate the use of the Swap Disentangled Variational Autoencoder (SD-VAE) to objectively assess changes following midfacial surgery.

Materials and Methods:
Our model is trained on a dataset of 1405 3D meshes of healthy and syndromic patients which was augmented using a technique based on spectral interpolation. Patients with a diagnosis of Apert and Crouzon syndrome who had undergone sub- or trans-cranial midfacial procedures utilising rigid external distraction were then interpreted using this model as the point of comparison.

Results:
A total of 56 patients met our inclusion criteria, 20 with Apert and 36 with Crouzon syndrome. By using linear discriminant analysis to project the high-dimensional vectors derived by SD-VAE onto a 2D space, the shape properties of Apert and Crouzon syndrome can be visualised in relation to the healthy population. In this way, we are able to show how surgery elicits global shape changes in each patient. To assess the regional movements achieved during surgery, we use a novel metric derived from the Malahanobis distance to quantify movements through the latent space.

Conclusion:
Objective outcome evaluation, which encourages in-depth analysis and enhances decision making, is essential for the progression of surgical practice. We have demonstrated how artificial intelligence has the ability to improve our understanding of surgery and its effect on craniofacial morphology.