bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Impact of Hydroxyapatite on the Outcome of Skull Base Reconstruction for Intraoperative High-Flow CSF Leak: A Propensity Score Matching Analysis
Authors: Lee Shin Heon , Ha Chang-Min , Hong Sang Duk , Choi Jung Won , Seol Ho Jun , Nam Do-Hyun , Lee Jung-Il , Kong Doo-Sik 
Published: May 2022

BackgroundDespite recent advances in skull base reconstructive techniques, including the multilayer technique during the last decade, complete reconstruction of grade 3 intraoperative high-flow cerebrospinal fluid (CSF) leak remains challenging. This study was designed to investigate the role of injectable hydroxyapatite (HXA) used in the multilayer technique on the clinical outcome of skull base reconstruction for intraoperative high-flow CSF leak.Materials and MethodsThis study enrolled 187 patients who experienced intraoperative high-flow CSF leak after endoscopic endonasal surgery for anterior skull base or suprasellar pathologies between January 2014 and July 2021. All skull base defects were reconstructed using the conventional multilayer technique including a vascularized naso-septal flap (NSF, n = 141) and the combined use of HXA with the conventional multilayer technique (HXA group, n = 46). We retrospectively evaluated the efficacy of the HXA group by 1:2 propensity score matching analysis.ResultsOverall, 17 of 187 patients (9.1%) showed postoperative CSF leaks, resulting in second reconstruction surgery. There were no statistical differences in patient age, sex, body mass index, tumor location, tumor type, and degree of resection, except for the follow-up period between the two groups. The HXA group showed a significantly lower incidence of postoperative CSF leak than the control group (0% vs. 12.1%, p &lt; 0.05). Postoperative lumbar drain (LD) was performed in 8.7% of the HXA group compared to 46.1% of the control group (p &lt; 0.01). CSF leak-related infection rates showed a decreasing tendency in the HXA group compared to the control group (0 vs. 7.1%, p = 0.06). A total of 46 patients in the HXA group were well matched with the control group (92 patients) at a 1:2 ratio. In the propensity score-matched control group, there were higher rates of postoperative CSF leaks than in the HXA group.ConclusionThe use of HXA combined with the conventional multilayer technique completely reduced postoperative CSF leaks in this study. This technique resulted in reduced CSF leakage, even without postoperative LD, and decreased infection rates. Further randomized comparative studies are required to confirm our findings.
Is Undernutrition Associated With Deterioration of Outcomes in the Pediatric Intensive Care Unit (PICU): Systematic and Meta-Analysis Review
Authors: Albadi Maram S. , Bookari Khlood 
Published: May 2022

Background and aimUndernutrition (UN) may negatively impact clinical outcomes for hospitalized patients. The relationship between UN status at pediatric intensive care unit (PICU) admission and clinical outcomes is still not well-reported. This systematic meta-analysis review evaluated the impact of UN at admission to PICU on clinical outcomes, including mortality incidence, length of stay (LOS), and the need for and length of time on mechanical ventilation (MV).MethodsA search was conducted using relevant and multi-medical databases from inception until January 2022. We considered studies that examined the link between UN at PICU admission and clinical outcomes in patients aged 18 years or younger. Pooled risk difference estimates for the PICU outcomes were calculated using a random-effects model.ResultThere were a total of 10,638 patients included in 17 observational studies; 8,044 (75.61%) and 2,594 (24.38%) patients, respectively, were normal-nourished (NN) and undernourished (UN). In comparison to NN patients, UN patients had a slightly higher risk of mortality (RD = 0.02, P = 0.05), MV usage (RD = 0.05, P = 0.02), and PICU LOS (RD = 0.07, P = 0.007). While the duration of MV was significantly longer in UN than in NN (RD = 0.13, P &lt; 0.0001). Sensitivity analysis of UN classification cohorts with a z-score &lt; -2 or in the 5%, patetints age up to 18 years, and mixed diagnose for PICU admission demonstrated a 6-fold increase in the probability of PICU LOS in UN patients compared to NN patients (RD = 0.06, 95% CI = 0.01, 0.12). UN patients have a higher risk of MV usage RD = 0.07, 95% CI = 0.00, 0.14) in studies involving cohorts with a mixed primary diagnosis for PICU admission.ConclusionIn PICU, UN is linked to mortality incidence, longer PICU stay, MV usage, and duration on MV. The primary diagnosis for PICU admission may also influence clinical outcomes. Determining the prevalence of UN in hospitalized patients, as well as the subgroups of patients diagnosed at the time of admission, requires more research. This may help explain the relationship between nutritional status and clinical outcomes in PICU patients.
Prevalence, Predictive Factors, and Outcomes of Respiratory Failure in Children With Pneumonia Admitted in a Developing Country
Authors: Shaima Shamsun Nahar , Alam Tahmina , Bin Shahid Abu Sadat Mohammad Sayeem , Shahrin Lubaba , Sarmin Monira , Afroze Farzana , Parvin Irin , Nuzhat Sharika , Jahan Yasmin , Mamun Gazi Md. Salahuddin , Saha Haimanti , Ackhter Mst. Mahmuda , Islam Md. Zahidul , Shahunja K. M. , Islam Sufia , Ahmed Tahmeed , Chisti Mohammod Jobayer 
Published: May 2022

BackgroundPneumonia has been the leading infectious cause of morbidity and mortality in children under 5 years of age for the last several decades. Although most of these deaths occur due to respiratory failure, published data are limited regarding predicting factors and outcomes of respiratory failure in children hospitalized with pneumonia or severe pneumonia.ObjectiveThis study aimed to explore the prevalence, predicting factors, and outcomes of respiratory failure in children under-five with pneumonia or severe pneumonia.MethodsIn this retrospective chart analysis, we enrolled children under 5 years of age hospitalized with pneumonia or severe pneumonia in the Dhaka Hospital of International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) between August 2013 and December 2017. Comparisons were made between children with respiratory failure (n = 212) and those without respiratory failure (n = 4,412). Respiratory failure was defined when the oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) was &lt;315.ResultsA total of 4,625 children with pneumonia or severe pneumonia were admitted during this study period. Among them, 212 (4.6%) children developed respiratory failure and formed the case group. A total of 4,412 (95.3%) children did not develop respiratory failure and formed the comparison group. In logistic regression analysis, after adjusting with potential confounders, severe sepsis [adjusted odds ratio (aOR): 12.68, 95% CI: 8.74–18.40], convulsion (aOR: 4.52, 95% CI: 3.06–6.68), anemia (aOR: 1.76, 95% CI: 1.20–2.57), and severe underweight (aOR: 1.97, 95% CI: 1.34–2.89) were found to be independently associated with respiratory failure. As expected, children with respiratory failure more often had fatal outcome than without respiratory failure (74, 1%, p &lt; 0.001).ConclusionThe results of our analyses revealed that prevalence of respiratory failure was 4.6% among under-five children hospitalized for pneumonia or severe pneumonia. Severe sepsis, convulsion, anemia, and severe underweight were the independent predictors for respiratory failure in such children and their case-fatality rate was significantly higher than those without respiratory failure. Early recognition of these predicting factors of respiratory failure may help clinicians imitating prompt treatment that may further help to reduce deaths in such children, especially in resource-limited settings.
TCR Coexpression Signature Predicts Immunotherapy Resistance in NSCLC
Authors: Wang Yuntao , Liu Yi , Li Xiaohua , Li Weiming , Xue Zhihong , He Xiaoqian , Xiong Weijie , He Lang , Bai Yifeng 
Published: May 2022

Background: Lung cancer has the highest morbidity and mortality rate among types of malignant tumors, and as such, research into prolonging the survival time of patients is vital. The emergence of immune checkpoint inhibitors (ICIs) has greatly improved the survival of patients with non-small cell lung cancer (NSCLC), however, the lack of effective biomarkers to predict the prognosis of immunotherapy has made it difficult to maximize the benefits. T cell receptor (TCR) is one of the most important components for recognizing tumor cells, and with this study we aim to clarify the relationship between TCR coexpression and the prognosis of NSCLC patients receiving immunotherapy.Methods: Univariate COX regression, logistics regression, and KM survival analysis were used to evaluate the relationship between TCR coexpression and the prognosis of immunotherapy. Additionally, CIBERSORT, Gene Set Enrichment Analysis (GSEA), and single-sample GSEA (ssGSEA) algorithms were used to evaluate the tumor immune microenvironment (TIME) of NSCLC patients.Results: Univariate Cox regression analysis showed that the TCR coexpression signature can be used as a clinical prognostic indicator for NSCLC patients receiving immunotherapy (p = 0.0205). In addition, those in the NSCLC group with a high TCR coexpression signature had significantly improved progression-free survival (PFS) (p = 0.014). In the ICI treatment cohort (GSE35640). In addition, there was a high infiltration of CD8+T cells, activated memory CD4+T cells, and M1 macrophages in the TIME of those with a high TCR coexpression signature. The results of pathway enrichment analysis showed that patients with a high TCR coexpression signature had significantly activated signal pathways such as lymphocyte proliferation and activation, chemokine binding, and inflammatory cytokine production. Also, we found that patients with a high TCR coexpression signature had an elevated T cell inflammation gene expression profile (GEP).Conclusion: We show that the TCR coexpression signature may be useful as a new biomarker for the prognosis of NSCLC patients undergoing immunotherapy, with high signatures indicating better treatment response. Additionally, we found that patients with a high TCR coexpression signature had tumor immune microenvironments with beneficial anti-tumor characteristics.
Long-Term Hypercaloric Diet Consumption Exacerbates Age-Induced Dysmetabolism and Carotid Body Dysfunction: Beneficial Effects of CSN Denervation
Authors: Melo Bernardete F. , Sacramento Joana F. , Capucho Adriana M. , Sampaio-Pires Dinis , Prego Cláudia S. , Conde Silvia V. 
Published: May 2022

Carotid bodies (CBs) are metabolic sensors whose dysfunction is involved in the genesis of dysmetabolic states. Ageing induces significant alterations in CB function also prompting to metabolic deregulation. On the other hand, metabolic disease can accelerate ageing processes. Taking these into account, we evaluated the effect of long-term hypercaloric diet intake and CSN resection on age-induced dysmetabolism and CB function. Experiments were performed in male Wistar rats subjected to 14 or 44 weeks of high-fat high-sucrose (HFHSu) or normal chow (NC) diet and subjected to either carotid sinus nerve (CSN) resection or a sham procedure. After surgery, the animals were kept on a diet for more than 9 weeks. Metabolic parameters, basal ventilation, and hypoxic and hypercapnic ventilatory responses were evaluated. CB type I and type II cells, HIF-1α and insulin receptor (IR), and GLP-1 receptor (GLP1-R)-positive staining were analyzed by immunofluorescence. Ageing decreased by 61% insulin sensitivity in NC animals, without altering glucose tolerance. Short-term and long-term HFHSu intake decreased insulin sensitivity by 55 and 62% and glucose tolerance by 8 and 29%, respectively. CSN resection restored insulin sensitivity and glucose tolerance. Ageing decreased spontaneous ventilation, but short-term or long-term intake of HFHSu diet and CSN resection did not modify basal ventilatory parameters. HFHSu diet increased hypoxic ventilatory responses in young and adult animals, effects attenuated by CSN resection. Ageing, hypercaloric diet, and CSN resection did not change hypercapnic ventilatory responses. Adult animals showed decreased type I cells and IR and GLP-1R staining without altering the number of type II cells and HIF-1α. HFHSu diet increased the number of type I and II cells and IR in young animals without significantly changing these values in adult animals. CSN resection restored the number of type I cells in HFHSu animals and decreased IR-positive staining in all the groups of animals, without altering type II cells, HIF-1α, or GLP-1R staining. In conclusion, long-term hypercaloric diet consumption exacerbates age-induced dysmetabolism, and both short- and long-term hypercaloric diet intakes promote significant alterations in CB function. CSN resection ameliorates these effects. We suggest that modulation of CB activity is beneficial in exacerbated stages of dysmetabolism.
Reflections on Reflection: Clarifying and Promoting Use in Experienced Coaches
Authors: Nash Christine , MacPherson Alan C. , Collins Dave 
Published: May 2022

BackgroundWe draw on the work of established scholars in the field of reflective practice who highlight its importance as a key cognitive skill for professionals to hold. While the substantive effect of engaging in reflective practice is emphasised in the literature, apparently coaches only spend a limited time learning about and engaging with it.ObjectivesThis study was conducted in two parts: Part 1 examined coaches’ knowledge of reflective practice and ascertained their perceived lack of value and use of reflective practice within their coaching. In response to the unexpected findings in Part 1, in Part 2, we instituted an educational intervention to further these participant coaches’ knowledge of Reflective Practice (RP) and facilitate its integration into their coaching practice.DesignThe present study utilised a mixed method design with semi-structured interviews being conducted in Part 1. A coach development reflective programme inspired by Stimulated Recall approach was implemented in Part 2.ParticipantsTwelve high level coaches were interviewed about their reflective practices in Part 1. In Part 2, the same coaches agreed to participate in the educational intervention for the duration of the project.ResultsFindings from Part 1 revealed an interesting paradox: coaches demonstrated a lack of appreciation for reflective practice yet recounted the positive influence that specific events and individuals had on their practice. In Part 2, to fully develop RP with the present cohort, an educational intervention was conducted. While watching videos of their own practice, coaches initially required lots of prompts from the lead interviewer to facilitate a deep and meaningful discussion of their practice. During the latter stages of the intervention, however, participants were less dependent on questions and prompts.ConclusionIn part 1, the coaches in this study did employ reflection, although they did not label it as such. The qualitative evidence we have gathered enables us to suggest that it is the combination of how to reflect, and against what criteria that makes RP a powerful tool to develop expertise which it has the potential to be. Importantly, however, additional coach education input is necessary for these benefits to be fully realised.
Social Media Support and Funding Assistance for Psychological Injuries in Social Work
Authors: Hu Xiaowu , Tang Caiyi , Wang Dongmei 
Published: May 2022

IntroductionPsychological injuries in social work are on the rise in complex modern society. Some individuals are incurring both physical and psychological injuries. Often, psychological injuries are more miserable than physical injuries. To combat the psychological injury suffered by individuals involved in social work, authorities should mobilize support via social media and raise funds by this and other feasible means to cover the cost of care for these individuals. This study focuses on social media support and funding assistance that could play useful roles in helping to treat psychological injuries among social workers and their clients in China.MethodsA scoping review of academic and gray literature was undertaken to identify the different injuries involved in social work. Semi-structured interviews were carried out with 7 experts, including social workers, social media professionals, and social fund directors. Empirical studies on psychological injuries in social work provided examples in support of the policy advocacy reported in this paper.ResultsThe scoping review found diverse literature on the subject of psychological injury in social work over the past decade in China. Semi-structured interviews with experts indicate that social media support can alleviate psychological suffering and that funding assistance has a positive influence on assisting individuals coping with psychological injuries. The empirical cases support the plan to encourage more support from social media and funding sources.ConclusionPsychological injury is greatly influenced by social bias and discrimination. According to cases and actions are taken to mitigate the harm done, supportive social media strategies could greatly diminish the psychological injuries to social workers and their clients and help them avoid much suffering. This study finds that funding organizations could provide a new treatment mechanism—social media marketing strategies and functional activities—to help a large number of individuals with psychological injuries out of the disease trap in China.
Anxiety Symptoms and Associated Factors Among Chronic Low Back Pain Patients in China: A Cross-Sectional Study
Authors: Hu Yueming , Yang Zechuan , Li Yong , Xu Yong , Zhou Xuan , Guo Ningfeng 
Published: May 2022

BackgroundThis study aimed to investigate the prevalence of anxiety symptoms among patients with chronic low back pain and explore its related factors.MethodsA cross-sectional study was conducted on patients with chronic low back pain from two general hospitals in China. Anxiety symptoms were assessed by the Generalized Anxiety Disorder-7. Binary logistic regression was used to examine the association between demographic characteristics, pain severity, pain self-efficacy, family functioning and anxiety symptoms.ResultsThis study involved 1,172 chronic low back pain patients, with an effective rate of 94.67%. The prevalence of anxiety symptoms among patients with chronic low back pain in China was 23.89%. In the binary logistic regression, patients with more severe pain (OR = 1.15, 95%CI: 1.11–1.18) and pain duration between 1~5 years (1~3 years: OR = 2.45, 95%CI: 1.38–4.36; 3~5 years: OR = 2.99, 95%CI: 1.49–6.00) had a higher risk to anxiety symptoms. In contrast, patients with higher monthly income (OR = 0.62, 95%CI: 0.39–0.98), better family functioning (highly functional family: OR = 0.22, 95% CI: 0.13–0.37; moderately dysfunctional family: OR = 0.44, 95% CI: 0.27–0.72) and higher pain self-efficacy (OR = 0.95, 95%CI: 0.94–0.96) had a lower risk to anxiety symptoms.ConclusionThe prevalence of anxiety symptoms among chronic low back pain patients was high in China. Targeted intervention measures should be taken to reduce anxiety symptoms levels of chronic low back pain patients.
Prediction and Diagnosis of Respiratory Disease by Combining Convolutional Neural Network and Bi-directional Long Short-Term Memory Methods
Authors: Li Li , Ayiguli Alimu , Luan Qiyun , Yang Boyi , Subinuer Yilamujiang , Gong Hui , Zulipikaer Abudureherman , Xu Jingran , Zhong Xuemei , Ren Jiangtao , Zou Xiaoguang 
Published: May 2022

ObjectiveBased on the respiratory disease big data platform in southern Xinjiang, we established a model that predicted and diagnosed chronic obstructive pulmonary disease, bronchiectasis, pulmonary embolism and pulmonary tuberculosis, and provided assistance for primary physicians.MethodsThe method combined convolutional neural network (CNN) and long-short-term memory network (LSTM) for prediction and diagnosis of respiratory diseases. We collected the medical records of inpatients in the respiratory department, including: chief complaint, history of present illness, and chest computed tomography. Pre-processing of clinical records with “jieba” word segmentation module, and the Bidirectional Encoder Representation from Transformers (BERT) model was used to perform word vectorization on the text. The partial and total information of the fused feature set was encoded by convolutional layers, while LSTM layers decoded the encoded information.ResultsThe precisions of traditional machine-learning, deep-learning methods and our proposed method were 0.6, 0.81, 0.89, and F1 scores were 0.6, 0.81, 0.88, respectively.ConclusionCompared with traditional machine learning and deep-learning methods that our proposed method had a significantly higher performance, and provided precise identification of respiratory disease.
Clinical Evaluation of an Innovative Metal-Artifact-Reduction Algorithm in FD-CT Angiography in Cerebral Aneurysms Treated by Endovascular Coiling or Surgical Clipping
Authors: Eisenhut Felix , Schmidt Manuel Alexander , Kalik Alexander , Struffert Tobias , Feulner Julian , Schlaffer Sven-Martin , Manhart Michael , Doerfler Arnd , Lang Stefan 
Published: May 2022

Treated cerebral aneurysms (IA) require follow-up imaging to ensure occlusion. Metal artifacts complicate radiologic assessment. Our aim was to evaluate an innovative metal-artifact-reduction (iMAR) algorithm for flat-detector computed tomography angiography (FD-CTA) regarding image quality (IQ) and detection of aneurysm residua/reperfusion in comparison to 2D digital subtraction angiography (DSA). Patients with IAs treated by endovascular coiling or clipping underwent both FD-CTA and DSA. FD-CTA datasets were postprocessed with/without iMAR algorithm (MAR+/MAR−). Evaluation of all FD-CTA and DSA datasets regarding qualitative (IQ, MAR) and quantitative (coil package diameter/CPD) parameters was performed. Aneurysm occlusion was assessed for each dataset and compared to DSA findings. In total, 40 IAs were analyzed (ncoiling = 24; nclipping = 16). All iMAR+ datasets demonstrated significantly better IQ (pIQ coiling < 0.0001; pIQ clipping < 0.0001). iMAR significantly reduced the metal-artifact burden but did not affect the CPD. iMAR significantly improved the detection of aneurysm residua/reperfusion with excellent agreement with DSA (naneurysm detection MAR+/MAR−/DSA = 22/1/26). The iMAR algorithm significantly improves IQ by effective reduction of metal artifacts in FD-CTA datasets. The proposed algorithm enables reliable detection of aneurysm residua/reperfusion with good agreement to DSA. Thus, iMAR can help to reduce the need for invasive follow-up in treated IAs.