bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decompressive Craniectomy vs. Craniotomy Only for Traumatic Brain Injury: A Propensity-Matched Study of Long-Term Outcomes in Neuropsychology
Authors: Guo Zhengqian , Ding Wantao , Cao Dan , Chen Yong , Chen Jian 
Published: March 2022

BackgroundBoth decompressive craniectomy (DC) and craniotomy only (CO) are commonly performed to treat patients with traumatic brain injury (TBI) by evacuation of intracranial hemorrhage (ICH) and control intracranial pressure (ICP). The outcomes of these two procedures have been well-studied; however, most research studies have focused on physical functions. The purpose of our study is to assess long-term outcomes in neuropsychology after DC or CO in TBI patients.MethodsInformation was collected from patients with TBI who had undergone DC or CO and were then in the postoperative stable phase (6–24 months after injury). Propensity scoring matched the patients in a 1:1 ratio for demographics, cause of injury, TBI subtype, TBI severity, computed tomography (CT) findings, surgery side, and interval from TBI. We used Wechsler Adult Intelligence Scale-Chinese Revision (WAIS-RC), Wechsler Memory Scale-Chinese Revision (WMS-RC), Physical Self-maintenance Scale (PSMS), Instrumental Activities of Daily Living Scale (IADL), and Glasgow Outcome Scale-Extended (GOSE) to measure the long-term outcomes in TBI patients, especially in neuropsychology.ResultsThere were 120 TBI patients included in our study. After matching, 74 patients were paired into the DC group (n = 37) and the CO group (n = 37). There were no differences in the gender (P = 1.000), age at injury (P = 0.268), marital status (P = 0.744), pre-injury employment (P = 0.711), comorbidities (P = 1.000), education level (P = 0.969), cause of injury (P = 0.357), TBI subtype (P = 0.305), Glasgow Coma Scale (GCS) total score (P = 0.193), unconsciousness (P = 0.485), traumatic subarachnoid hemorrhage (tSAH) (P = 0.102), unresponsive pupil (P = 1.000), midline shift (P = 0.409), cisterns compressed or absent (P = 0.485), surgery side (P = 0.795), and interval from TBI (P = 0.840) between the two groups. The CO group was associated with better cognitive function in WAIS-RC OIQ (P = 0.030) and WAIS-RC FIQ (P = 0.021) and better daily function in IADL (P = 0.028) and ADL total (P = 0.030). The DC group also had a lower GOSE (P = 0.004) score compared to the CO group. No difference was observed in WAIS-VIQ (P = 0.062), WMS-RC MQ (P = 0.162), and PSMS (P = 0.319).ConclusionIn the matched cohort, patients who underwent CO had better long-term outcomes in cognitive and daily function compared with DC. Future randomized control trials are needed for intensive studies on physical and neuropsychological prognosis in TBI patients.
Functional Outcomes in Survivors of Pediatric Sepsis: A Scoping Review and Discussion of Implications for Low- and Middle-Income Countries
Authors: Ravikumar Namita , Sankar Jhuma , Das Rashmi Ranjan 
Published: March 2022

BackgroundPediatric sepsis is an important cause of mortality and morbidity in low- and middle-income countries (LMIC), where there is a huge burden of infectious diseases. Despite shortage of resources, adapting protocol-based care has reduced sepsis-related deaths but survivors of pediatric sepsis are at risk of poor functional outcomes.ObjectivesTo perform a scoping review of the literature on functional outcomes of pediatric sepsis survivors after discharge from the intensive care unit (ICU) and discuss the implications for patients in LMICs. The outcomes include prevalence of survival with reduced functional outcomes or quality of life (QoL) and changes over time during follow-up or recovery, and these outcomes were compared with other groups of children.MethodsWe searched major medical electronic databases for relevant literature from January 2005 until November 2021, including Medline (via PubMed), Embase, CINAHL, and Google Scholar databases. We included observational studies and follow-up data from clinical trials involving children/adolescents (≤18 years) who were admitted to pediatric intensive care unit (PICU) and got discharged finally. Major focus was on survivors of sepsis in LMIC. We followed PRISMA guidelines for scoping reviews (PRISM-ScR).ResultsWe included eight papers reporting data of functional outcomes in 2,915 children (males = 53%, and comorbidity present in 56.6%). All included studies were either a prospective or retrospective cohort study. Studies were classified as Level II evidence. Disabilities affecting physical, cognitive, psychological, and social function were reported in children following discharge. Overall disability reported ranged between 23 and 50% at hospital discharge or 28 days. Residual disability was reported at 1, 3, 6, and 12 months of follow-up with an overall improving trend. Failure to recover from a baseline HRQL on follow-up was seen in one-third of survivors. Organ dysfunction scores such as pSOFA, PeLOD, vasoactive inotrope score, neurological events, immunocompromised status, need for CPR, and ECMO were associated with poor functional outcome.ConclusionsThe research on functional outcomes in pediatric sepsis survivors is scarce in LMIC. Measuring baseline and follow-up functional status, low-cost interventions to improve management of sepsis, and multidisciplinary teams to identify and treat disabilities may improve functional outcomes.
Diurnal Variation of Real-Life Insulin Sensitivity Factor Among Children and Adolescents With Type 1 Diabetes Using Ultra-Long-Acting Basal Insulin Analogs
Authors: Hegab Ahmed M. 
Published: March 2022

BackgroundEstimation of insulin sensitivity factor (ISF) is essential for correction insulin doses calculation. This study aimed to assess real-life ISF among children and adolescents with type 1 diabetes using ultra-long-acting basal insulin analogs and to detect factors associated with ISF among those patients.MethodsThis prospective observational study was conducted at Sohag University Hospital, Egypt, and included 93 participants aged 6–18 years, diagnosed with T1DM for at least 1 year and using insulin glargine 300 Units/mL or insulin degludec 100 Units/mL as basal insulin. The ISF, insulin-to-carbohydrate ratio (ICR) and insulin doses were initially assessed then adjusted as required. The participants were regularly contacted throughout the follow-up period. Glycemic control parameters were assessed after 3 months.ResultsThe ISF showed diurnal variation with higher correction dose requirements for the morning than for the rest of the day (p &lt; 0.001). This pattern of diurnal variation was found in participants with different pubertal stages and in participants using either type of ultra-long acting basal insulin analogs. There was no significant difference between the ISF calculated according to the 1800 rule [1800/Total daily insulin dose (TDD)] and the morning ISF (p = 0.25). The 1800 rule-calculated ISF was significantly lower than the actual ISF for the afternoon (p &lt; 0.001) and the evening (p &lt; 0.001). ISF at different times of the day were significantly correlated with age, body mass index, pubertal stage, diabetes duration, TDD, and ICR. Multiple regression analysis revealed that ICR was the most significant factor associated with ISF. Linear regression analysis revealed that the ISF (in mg/dL) for any time of the day could be estimated as 5.14 × ICR for the same time of the day (coefficient = 5.14, 95% confidence interval: 5.10–5.19, R2 = 0.95, p &lt; 0.001).ConclusionDiurnal variation of ISF that had to be considered for proper calculation of correction doses. This diurnal variation was found in children and adolescents with different pubertal stages. The 1800 rule was appropriate for the morning correction doses but not in the afternoon or the evening. The TDD and the ICR could be used for ISF estimation.
The Impact of Qigong and Tai Chi Exercise on Drug Addiction: A Systematic Review and Meta-Analysis
Authors: Cui Jiabao , Liu Fang , Liu Xuan , Li Ru , Chen Xiaorong , Zeng Hongfa 
Published: March 2022

BackgroundPrevious preliminary studies have found that qigong exercises produced significant effects in healthy people and in various clinical populations. The purpose of this study was to systematically review the effects of qigong and tai chi exercise on individuals with drug addiction.MethodsA systematic search of seven English databases and three Chinese databases was conducted to identify randomized controlled trials (RCTs) and non-randomized comparative studies (NRS) assessing the effects of qigong and tai chi on drug addiction. Study quality was assessed using the Checklist for the Evaluation of Non-Pharmaceutical Trial Reports (CLEAR-NPT).ResultsTwo RCTs and nine NRS studies were included in this study, including a total of 1072 patients with drug addiction (age range, 27–43 years). The results showed that qigong and tai chi exercise had a significant overall effect on depression (SMD = −0.353, 95%CI [−0.548, −0.159]), anxiety (SMD = −0.541, 95%CI [−0.818, −0.264]), quality of life (SMD = 0.673, 95%CI [0.438, 0.907]), and sleep quality (SMD = −0.373, 95%CI [−0.631, −0.116]). The subgroup analysis found that qigong outperformed tai chi on the improving depression, anxiety, and sleep quality.ConclusionExisting studies suggest that qigong and tai chi are effective at improving depression, anxiety, and quality of life in drug users; however, the evidence from rigorous randomized controlled group trials is lacking.
Gender Difference and Correlates of Physical Activity Among Urban Children and Adolescents in Ethiopia: A Cross-Sectional Study
Authors: Biadgilign Sibhatu , Gebremichael Bereket , Abera Admas , Moges Tsedey 
Published: March 2022

BackgroundStudies indicate that children and adolescent populations in most countries show a low level of physical activity (PA) and an increasing prevalence of obesity. Addressing gender disparity in PA is the main element of public health programs. There is currently a paucity of studies, particularly, in developing countries that investigate gender differences and correlates of PA among children and adolescents.ObjectiveThe study is aimed to assess the gender difference and correlates of PA among children and adolescents in Ethiopia.MethodsAn observational population-based cross-sectional study was conducted in representative samples of children and adolescents in the capital city of Ethiopia, Addis Ababa. Multivariable logistic regression models with robust estimation of SEs were fitted to predict the odds ratios (ORs) and 95% CIs.ResultsA total of 632 children and adolescents-parent dyads were included in the study. More boys than girls (17.0 and 11.7%) were engaged in moderate intensity PA 3 days a week or more (p = 0.057). Age, mothers working in a private business, attending public schools, longer sleep duration, and being taught the benefits of PA were positively associated with meeting moderate-to-vigorous PA (MVPA) in both sexes combined and in a sub-sample of boys. Furthermore, an inverse association was found between overweight/obesity and MVPA in the overall children and girls as well. For moderate PA (MPA); the age of the children, maternal education and occupation, school type, overweight/obesity, and sleep duration on school nights were significant correlates among the studied children.ConclusionsThe present study provided evidence of several correlates identified associated with meeting MVPA and MPA in both sexes combined. Girls are less likely than boys to engage in PA. Therefore, there is a need to take into perspectives the provision of a comprehensive multifaceted health behavior modification and interventions, such as focused and regular physical education in schools.
Current Opinion and Practice on Peritoneal Carcinomatosis Management: The North African Perspective
Authors: Souadka Amine , Essangri Hajar , Makni Amin , Abid Mourad , Ayadi Mouna , Ksantini Feriel , Kordjani Zakia , Ballah Yousri , Bouka Jemila , Benkabbou Amine , Majbar Mohammed Anass , El Khannoussi Basma , Mohsine Raouf , Boutayeb Saber , Hubner Martin 
Published: March 2022

BackgroundThe status of peritoneal surface malignancy (PSM) management in North Africa is undetermined. The aim of this study was to assess and compare current practice and knowledge regarding PSM and examine satisfaction with available treatment options and need for alternative therapies in North Africa.MethodsThis is a qualitative study involving specialists participating in PSM management in North Africa. The survey analyzed demographic characteristics and current knowledge and opinions regarding PSM management in different institutions. We also looked at goals and priorities, satisfaction with treatment modalities and heated intraperitoneal chemotherapy (HIPEC) usefulness according to specialty, country, years of experience, and activity sector.ResultsOne-hundred and three participants responded to the survey (response rate of 57%), including oncologists and surgeons. 59.2% of respondents had more than 10 years experience and 45.6% treated 20–50 PSM cases annually. Participants satisfaction with PSM treatment modalities was mild for gastric cancer (3/10 [IQR 2–3]) and moderate for colorectal (5/10 [IQR 3–5]), ovarian (5/10 [IQR 3–5]), and pseudomyxoma peritonei (5/10 [IQR 3–5]) type of malignancies. Good quality of life and symptom relief were rated as main priorities for treatment and the need for new treatment modalities was rated 9/10 [IQR 8–9]. The perceived usefulness of systemic chemotherapy in first intention was described as high by 42.7 and 39.8% of respondents for PSM of colorectal and gastric origins, while HIPEC was described as highly useful for ovarian (49.5%) and PMP (73.8) malignancies.ConclusionsThe management of PSM in the North African region has distinct differences in knowledge, treatments availability and priorities. Disparities are also noted according to specialty, country, years of expertise, and activity sector. The creation of referral structures and PSM networks could be a step forward to standardized PSM management in the region.
Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis
Authors: Wang Jianjun , Cheng Liangwang , Liu Jing , Zhang Binyin , Wang Weijun , Zhu Wenxin , Guo Yan , Bao Chuanfei , Hu Yunli , Qi Shanxin , Wang Kai , Zhao Shuguang 
Published: March 2022

BackgroundThere is still no consensus regarding the role of laparoscopy in trauma cases. The purpose of this paper is to assess the value of diagnostic and therapeutic laparoscopy for patients with blunt or penetrating abdominal trauma by performing a systematic review and meta-analysis.MethodsPubMed, Embase, and the Cochrane library were systemically searched for the randomized controlled trials (RCTs) and non-RCT comparative studies on effectiveness and safety of laparoscopy vs. laparotomy for the two authors independently performed the search, data extraction, and quality assessment.ResultsA total of 5,517 patients were enrolled in 23 eligible studies that were published in English. Meta-analysis results suggest that there is no significant difference in the incidence of missed injury and mortality between abdominal trauma patients receiving laparoscopy and those receiving laparotomy. Concerning postoperative complications, compared with patients in the open surgery group, those in the laparoscopy group are at a similar risk of intra-abdominal abscesses, thromboembolism, and ileus, while there is a decreased incidence of wound infection and pneumonia. Besides, patients in the laparoscopy group experience shorter hospitalization times and procedure times. For most outcomes, the sensitivity analysis yielded similar results to the primary analysis.ConclusionLaparoscopic surgery is a practical alternative to laparotomy for appropriate patients. The decision to perform laparoscopy should be based on the experience of the surgeon and the resources available.
Charcot Neuroarthropathy: Current Surgical Management and Update. A Systematic Review
Authors: Bajuri Mohd Yazid , Ong Shir Lee , Das Srijit , Mohamed Isa Naina 
Published: March 2022

BackgroundCharcot neuroarthropathy of the ankle and the hindfoot is a complex clinical entity with a high risk of amputation. Charcot neuroarthropathy limb reconstruction has been proposed as a limb-salvaging procedure. However, there was a lack of information on the various available reconstruction methods, including the outcomes and complications. The present study aimed to evaluate the current literature and update on the trends regarding the surgical management of Charcot neuroarthropathy of the ankle and the hindfoot.MethodsAll data published from January 2010 to January 2020 that investigated the methods of fixation and their respective outcomes for the surgical reconstruction in Charcot neuroarthropathy were analyzed. The union rate, amputation rates, and complications associated with these techniques were taken for statistical analysis.ResultsA total of 16 studies fit the inclusion criteria of this study, with four Level-III studies and 12 Level-IV studies were included. Ten studies utilized internal fixation only; five used a combination of internal fixation and circular external fixator, whereby there are three comparative studies between internal and external fixations, and two studies applied combined technique of internal and external fixations (hybrid fixation). One study describes the usage of circular external fixation only.ConclusionsThe use of retrograde intramedullary nail as a treatment of choice in the reconstruction of Charcot neuroarthropathy ankle is recommended before an ulcer occurrence. Hydroxyapatite (HA)- coated screws are recommended for the locking mechanism to prevent migration in Charcot neuroarthropathy due to poor bony quality. Hybrid fixation is recommended for reconstruction in a condition of ulceration and more complex deformity as it provides a higher rate of limb salvage with less soft tissue irritation.
Special Considerations for Tympanoplasty Type I in the Oncological Pediatric Population: A Case-Control Study
Authors: Richard Celine , Baker Emily , Wood Joshua 
Published: March 2022

IntroductionAlthough cutting-edges antineoplastic therapies increase survival in children with malignancies, the optimal surgical strategy to address associated comorbidities such as chronic tympanic membrane perforation is still poorly documented. The aim of this study is to evaluate the outcomes of type I tympanoplasty in pediatric cancer survivors who received chemo and/or radiotherapy to the skull and to identify potential associated risk factors.MethodsThis case-control study included medical records review of oncologic patients (age &lt;21) treated at the same Academic medical oncologic center between March 2015 and July 2021 and referred for conductive hearing loss and chronic tympanic membrane perforation. Patients and middle ear status-related variables were analyzed, and outcomes were compared with matched peers without any history of malignancies.ResultsA total of seven pediatric cancer survivors and seven paired children without any history of malignancies were included in this report. The mean age at tympanoplasty type I surgery was 10.2 years (range = 4.3–19.9; median = 7.9 years) for the pediatric cancer survivors' group and 10.1 years (range = 5.5–19.2; median = 7.9 years) in the control group. Three pediatric cancer patients had received chemotherapy alone, one patient had radiotherapy to the skull base, and three patients had received chemoradiotherapy. On average, surgery was performed 3.9 years after chemo and/or radiotherapy termination, except for 1 patient for whom the tympanoplasty was performed during chemotherapy treatment. A retroauricular approach was used for one of the pediatric cancer patients, a transcanal approach was performed in one other and five patients benefited from an otoendoscopic approach. Tragal perichondrium with cartilage was used in most of the pediatric cancer survivor cases (four out seven cases) while xenograft (Biodesign) and Temporalis fascia without cartilage graft were used in five out of the seven control cases. Rate of tympanic membrane perforation recurrence was similar between groups (28.6%). Mean functional gain for air conduction Pure Tone Average (AC PTA) was 2.6 and 7.7 dB HL for the oncologic and control group, respectively. Mean postoperative air-bone gap (ABG) was 10.7 dB HL [median = 8.7; inter-quartile range (IQR) = 13.8] for the oncologic cohort and 10.1 dB HL (median = 10.7; IQR = 9.6) for the control group.DiscussionChemo- and chemoradiotherapy to the skull are associated with damages to the inner and middle ear structures with secondary eustachian tube dysfunction and chronic middle ear effusion. Although healing abilities and immunological defenses are compromised as part of the expected effects of antineoplastic therapies, type I tympanoplasty can be safe and effective in this population. While different approaches may be considered, otoendoscopy showed excellent results with less morbidity in this vulnerable population.
Aplicación del modelo didáctico 3D realidad aumentada en el aprendizaje colaborativo. Revisión sistemática
Authors: Caballero Garriazo Javier Alfredo , Lázaro Aguirre Alberto Frank , Rojas Huacanca Jaime Rolando 
Published: March 2022

Actualmente, la realidad aumentada (RA) ha ganado más relevancia y han producido cambios significativos en la educación, porque proporciona una forma diferente de aprendizaje significativo. Estas posibilidades de aplicación de modelo didáctico 3D en entornos de aprendizaje colaborativo de RA son infinitas y continúan en constante evolución. Estas herramientas tecnológicas proporcionan experiencias de aprendizaje de diseño a un nivel de inmersión altamente calificada. Por lo tanto, el presente artículo tuvo como objetivo revisar artículos publicados sobre la aplicación de modelo didáctico 3D de los entornos de aprendizaje colaborativo en RA, se realizó un enfoque de mapeo sistemático de la literatura científica mediante la extracción de información con palabras clave de artículos indexados en las bibliotecas digitales especializadas, se analizaron un total 567 artículos, de los cuales se seleccionaron 21 artículos para el desarrollo de esta investigación. En esta revisión se observó datos que indican la existencia de ventajas potenciales de las experiencias de realidad aumentada, motivando a los estudiantes a realizar nuevas experiencias. En conclusión, la herramienta de RA proporciona beneficios tanto cognitivos como también mejoran de manera significativa la creatividad en los estudios de diseño y en el desarrollo de la habilidad de percepción espacial.