Large Number Of Articles Research Articles

A Systematic Review of Alternative Service Delivery in Africa for Taming Wicked Risks

This research considers the role that alternative service delivery can play in addressing wicked problems. The aim of this research is, firstly, to determine which evidence and knowledge are available on alternative service delivery arrangements relevant to African countries to inform decisions about addressing wicked problems on the continent. Second, this research determines suitable mechanisms for an alternative service delivery model for mitigating wicked risks in Africa. This research is based on a systematic literature review. This systematic literature review reveals that most work on alternative service delivery has been done in developed countries, with developing African countries being left behind in research on alternative service delivery. Furthermore, most of the alternative service delivery efforts have not focused on addressing wicked problems. A large number of articles on alternative service delivery models show that alternative delivery is not a preferred approach in Africa. This research recommends an alternative service delivery model that is based on digital governance, service delivery innovation and partnerships. Robust governance responses are needed to mitigate these wicked risks, and alternative service delivery presents robust features to mitigate these risks given that it is more flexible, agile, adaptable, and decentralized in nature than simply relying on traditional government responses. Lastly, risk-informed decision-making should be placed at the center of the reform agenda for a smart and sustainable society.

Effectiveness of extracorporeal shock wave therapy in comparison with other methods of treatment of patients with plantar fasciitis: literature review

Plantar fasciitis (PF) is one of the most common causes of pain in the heel area, which is associated with the presence of inflammation in the plantar fascia and is most often localized in the medial part of the heel area. Extracorporeal shock wave therapy (ESWT) is a method of hardware treatment that has been used in orthopedics and traumatology for the past decades. One of the main diseases successfully treated with this method is plantar fasciitis. The aim of the work was to determine the effectiveness of extracorporeal shock wave therapy in the treatment of plantar fasciitis compared to other methods of conservative treatment based on the literature review. Research literary sources from scientific electronic databases PubMed, Medline and other sources of scientific and medical information were analyzed. A literature search was performed using search queries specifying the method under study and plantar fasciitis, namely: «Extracorporeal Shockwave Therapy», «Plantar Fasciitis», «Conservative Treatment», «Physiotherapy». During the search, 473 scien­tific articles devoted to the treatment of plantar fasciitis were selected. Given the large number of articles and the desire to present up-to-date data, the query was limited to the last 9 years (from 2015 to 2023) and 417 articles were selected. Articles devoted to other methods of treatment of PF (conservative and surgical) and articles devoted to the use of ESWT in orthopedic and traumatological diseases of other localizations were excluded from the search results. At the second stage of the search, articles devoted exclusively to the treatment of PF by the ESWT method were excluded, and sources comparing the effectiveness of ESWT treatment with other methods of conservative treatment were selected (31 articles). The main results – it was determined that extracorporeal shock wave therapy continues to remain one of the main methods of conservative treatment of PF, which has been used for the last decades. It has proven its high efficiency and safety in the treatment of PF. Compared with other methods of conservative treatment of PF, extracorporeal shock wave therapy remains one of the most effective, it is successfully used in the treatment of PF.

Bibliometric Analysis: Interactive Multimedia For Mathematics Learning

With the development of technology in the 5.0 era, it is possible for students to use technology-based learning media such as interactive multimedia which combines video, animation and audio, thus allowing users to interact and understand the material, as well as increasing learning that is more interesting and interactive. This research aims to see the trend of publication of interactive learning media in mathematics learning from 1993-2023 on Scopus, to see the most countries that study interactive multimedia articles in mathematics learning, to find out published journals regarding interactive multimedia in mathematics learning, and to find out the level of education who use interactive multimedia a lot in mathematics learning. The method used is descriptive research using bibliometrics for publication mapping with the help of VOS viewer. Data collection techniques use Scopus with the keyword’s interactive multimedia and mathematics. The amount of data retrieved from 359 articles to 38 articles regarding interactive multimedia in learning mathematics. Research results show development publication in 1993-2023 on search sqopus the highest in 2010 was 4 publications with 0.12%. Mathematics education for 29 years has increased every year. Malaysia is the country with the largest number of articles on interactive multimedia, namely 87 articles. The journal that publishes interactive multimedia articles is Educational Technology and Society with 79 articles. Writer article the highest of each is article written by (Goodwin, 2008). The level of education that often uses interactive multimedia is Junior High School (SMP) with 10 articles.

SUSTAINABLE ARCHITECTURE AND THE ROLE OF CYBER-PHYSICAL SYSTEMS: A BIBLIOMETRIC ANALYSIS

Cyber-Physical Systems are next-generation digital systems that focus on the intricate connections and integration between the physical and digital worlds. These systems have highly integrated physical, communication, control, and computing components. The study's purpose is to carry out a bibliometric analysis to explore the research trends, collaboration network, and thematic evaluation of papers on cyber-physical systems. The most prolific countries, authors, sources, highest citations received by authors, and co-occurrences in this research domain were identified. The bibliometric analysis method was employed to empirically analyze the research on CPS in architecture published between 2007 and 2022 in the Web of Science database. All retrieved records were initially filtered by excluding 364 non–non-peer-reviewed publications and another type of languages except English. After that, we excluded 8 records based on the criteria and scope, and again excluded records for duplicates 12 records. Finally, 1336 records met the eligibility criteria. The VOS viewer and biblioshiny software was used to construct the scientific maps. A total of 1336 publications were analyzed. The study results show that the highly cited papers have been published in 297 journals by 4520 authors from 1483 organizations in 83 countries. The most prolific journal was IEEE Access, with 104 publications, 3823 citations, and an h-index of 24. The number of documents progressively increased from 2010 to 2021. Further, 2009 has no publications, and the largest number of articles was published in 2021 (n=272). Furthermore, China led the way with the most publications, active organizations, prolific authors, and international collaborations. This is the first study to look at the global trends in research on CPS in architecture and provides valuable guidelines and motivations for further research. Future studies may also examine the main hazards connected with using cyber-physical systems to manage operations across various industries and sectors.

Energy efficiency of hydrogen production during dark fermentation

It is widely known that most of the world's energy is produced from non-renewable energy sources such as crude oil and coal. Hydrogen is an ideal fuel candidate with a high energy content and clean combustion product. Biohydrogen is an environmentally friendly, renewable biofuel with high energy density, making it a viable alternative to fossil fuels in the future. At the same time, despite the large number of articles on the intensification of both dark fermentation and anaerobic bioconversion in general, the operating costs of the proposed intensification methods are not well covered in the literature. The goal of the work was to estimate the conversion coefficient of thermal and electrical energy spent on the functioning of the process of dark fermentation of various organic wastes into the energy of produced hydrogen. A block diagram of the energy flows of the dark fermentation system and the structure of the energy consumption of the system were developed. The obtained literature and experimental data suggest that the conversion coefficient of energy into biohydrogen in the process of dark fermentation is less than 1, so to obtain 1 kWh of hydrogen it is necessary to expend more than 1 kWh of energy. At the same time, the use of a vortex layer apparatus for dark fermentation of the food waste model made it possible to increase the energy output of the process by more than 7 times, thereby bringing the values of the conversion coefficients of thermal and electrical energy closer to 1. Despite the fact that the energy efficiency of most known methods for producing hydrogen is higher than the energy efficiency of dark fermentation, it is worth noting that the raw material for producing hydrogen in the dark fermentation process is organic waste, and not high-energy fuel (natural gas, methane, coal) or water in the case of electrolysis. In addition, the use of a vortex layer apparatus for pre-treatment of the dark fermentation substrate made it possible to achieve electricity conversion coefficient values 40% higher than with water electrolysis.

Hundred Most Cited Articles in Actinic Keratosis: A Bibliometric Analysis

Abstract Many articles have been published on actinic keratosis. Bibliometric analysis helps identify the most influential studies in a particular field, Our article was to identify the 100 most frequently cited references on actinic keratosis through bibliometric analysis. As of March 1, 2020, actinic keratosis was searched in the Web of Science database and ranked in order of the total number of citations. The top 100 most cited articles in actinic keratosis were analysed. The top 100 most cited articles on actinic keratosis were published between 1982 and 2020. The largest number of articles were published in a single interval in 2001–2005. The average annual citations increased first and then decreased. The total citations were positively correlated with annual citations. The 100 articles were classified into different research focuses: pathogenesis (33%), treatment (24%), clinical features and diagnosis (15%), pathophysiology (8%), epidemiology (5%), associated diseases (2%) and others (13%). Among these 100 articles, 5 were clinical trials, 14 focused on the association between actinic keratosis and P53, and 9 reported the association between actinic keratosis and 5-aminolevulinic acid. The 100 articles were published in 38 journals by 87 different first corresponding authors from 15 different countries, mostly in the USA and Australia. Stockfleth, E from the University of Berlin published the most articles as the corresponding author. The top 100 cited references of actinic keratosis were identified and their bibliometric characteristics were analysed to lay a foundation for further research.

Indicators of scientific production on Health Policy

Introduction: health and its maintenance constitute one of the main assets of man at any stage of his history. The implementation of health policies is aimed at solving global health problems that affect the population.Objective: characterize the scientific production on Health Policy in SCOPUSMethod: an observational, descriptive, bibliometric study was developed. A total of 229,339 articles were worked on. The SCOPUS database was used to collect the information; especially the SciVal tool for the analysis of information and the study of indicators. Descriptive statistics were applied to analyze the information.Results: a total of 229,339 articles were analyzed; equivalent to 2,471,305 appointments in the study period. I highlight the year 2023 with the highest number of articles published (31,982; 13.94%). The United States stood out with the highest number of articles published with 79,708 investigations (34.75%). The articles published in the journal BMC Health Services Research stood out with 10,425 investigations (23%). The largest number of articles were located in the health and health services categoryConclusions: scientific production related to Health Policy showed heterogeneous but constant growth, in contrast to the number of citations. The publications were related to the largest centers of scientific production. The research topics were directed with greater interest towards the quality of health services and assistance according to age groups

Biosurfactant Production by Pseudomonas: a Systematic Review.

It is of fundamental interest to research and develop innovative biotechnologies, as well as bioproducts that replace or are alternatives to those of non-renewable origin, such as biosurfactants in relation to traditional surfactants used in various sectors. Consequently, there are a large number of experimental studies addressing different subjects, especially with the use of bacteria of the genus Pseudomonas; however, there is a lack of work that demonstrates the evaluation of this science produced to date. Therefore, this article discusses the production of biosurfactants by Pseudomonas with the aim of surveying and analyzing experimental articles on this topic. To realize this, a systematic search was carried out with well-defined temporal space, databases, and inclusion and exclusion criteria, based on metric studies that guided what information would be collected and the method of evaluation. Therefore, a large number of articles were selected, which demonstrated Pseudomonas aeruginosa as the bioagent mostly used in the tests, which aimed to improve the process in the area. Furthermore, interest in this field has increased over the years, predominantly in emerging market countries, where the most prominent authors on the topic are found. Therefore, it is necessary that there is an expansion of interest in the area to make the production of biosurfactants cheaper in areas that currently have greater development deficiencies, such as means of purifying the bioprocess and reducing foam formation in the bioprocess.

Dyadic Coping of Chronic Illness Patients and Their Spouses: A Bibliometric Analysis

Objective: To understand the research hotspots and development trends of binary coping in chronic disease patients and their spouses, and to provide ideas and references for future related research. Methods: Literature on binary coping in patients with chronic diseases and their spouses included in the Web of Science Core Collection database was analysed visually in terms of the number of articles, countries and keywords using CiteSpace software. Results: A total of 4138 valid articles were included, and the country with the largest number of articles was the United States. The main research populations were breast cancer, dementia, and prostate cancer patients and their spouses; and the research hotspots were quality of life, diabetes, stroke, and multimorbidity, etc. Conclusion: Most of the intervention studies on the dyadic coping of patients with chronic diseases and their spouses are in developed countries, and scholars in China can learn from the international research hotspots, combine with China's national conditions, and construct a management program suitable for the cultural needs and psychological needs of chronic disease patients and their spouses in China.

Coral restoration: a mapping review through a scientometric analysis

Reef restoration has gained attention as it has strategic actions and powerful means in sustaining and maintaining coastal ecosystem services. This scientometric study systematically analyzes the current trends and research hotspot in coral restoration across the last five decades (1971–2022). The metadata (12,667 articles with 652,860 cited references) were obtained from the Clarivate Web of Science platform through the Core Collection database, associated with the CiteSpace and R‐software for further analysis. The results indicated that the trend of coral restoration is increasing in paper/year, with the United States, Australia, and China as major contributors to the related research. Furthermore, James Cook University, Australia had the largest number of articles, and the Consortium of Research Libraries of the United Kingdom was the most influential institution on coral restoration. The highly cited keywords are “Great Barrier Reef,” “climate change,” and “coral reef,” while the most influential keywords are “coral,” “model,” and “Atlantic.” A total of 23 clusters in the field with “coral reef,” “phase shift,” “bacterial communities,” “coral restoration,” “symbiotic dinoflagellate,” “stony coral tissue loss disease,” “bleaching event,” “ocean acidification,” “oyster reef,” and “quantitative reconstruction” are among the top cluster size labeled. Early‐stage researcher may use both keywords and cluster analysis to find topics attractive to their future research projects. In addition, this study contributes toward evaluating recent scientific productivity about coral restoration as well as informing researchers and policymakers regarding funding, future strategic planning, and potential collaboration opportunities.

Global scientific trends on exosomes therapy for osteoporosis from 2004 to 2023: A bibliometric and visualized analysis.

Exosomes have emerged as pivotal mediators in modulating physiological and pathological processes implicated in osteoporosis (OP) through their distinctive mode of intracellular communication. The use of exosomes has evoked considerable interest, catalyzing a surge in research endeavors on a global scale. This study endeavors to scrutinize contemporary landscapes and burgeoning trends in this realm. The Web of Science Core Collection was used to retrieve publications on exosomes therapy for OP within the time frame of January 1, 2004 to December 31, 2023. The bibliometric methodology was applied to study and index the collected data. VOSviewer and citespace software were used to conduct visualization, co-authorship, co-occurrence, and publication trend analyses of exosome therapy in OP. A total of 610 publications (443 articles and 167 reviews) from 51 countries and 911 institutions were included in this study. Shanghai Jiao Tong University, Central South University, Sichuan University, and Zhejiang University are leading research institutions in this field. Stem Cell Research Therapy published the highest number of articles and has emerged as the most cited journal. Of the 4077 scholars who participated in the study, Xie, Hui, Zhang, Yan, Tan, and Yi-Juan had the largest number of articles. Furthermore, according to the cluster analysis of external keywords, future research hotspots can be categorized into 3 directions: research status of exosomes for the treatment of OP, treatment of OP through exosome-regulated signaling pathways, and exosomes as targeted drug delivery systems. This study suggests that the number of future publications on exosome therapy for OP will increase, with a focus on fundamental investigations into drug-loading capacities and molecular mechanisms. In summary, this study presents the first systematic bibliometric analysis of exosome therapy publications in OP, providing an objective and comprehensive overview of the field and a valuable reference for researchers in this domain.

Community participation in the Latin American context: Bibliometric Analysis

Introduction: community participation and outreach constitute one of the key work tools for each science. Despite the existence of previous studies on this topic, it is necessary to have an overview of the current state of knowledgeObjective: characterizes the scientific publications grouped in Scopus regarding community participation in the Latin American contextMethod: A bibliometric study was developed. 5,832 publications were analyzed as the research universe. Bibliometric indicators were applied from the Scopus database and the Scival tool.Results: Articles published in 2022 predominated with 988 investigations (16,94 %). The thematic areas of social sciences stood out (2,639 investigations; 45,25 %). The relationship between the different thematic areas was mostly heterogeneous, with greater participation from the medical sciences. Articles published in research article format stood out with 4,196 investigations, equivalent to 71,94 %. The largest number of articles was published in journals located in quartile 1 (Q1) with 2,407 investigations (41,27 %). The researches with authors from the United States (4,933 articles; 84,58 %) and Canada (885 works; 15,17 %) stood out.Conclusions: scientific production on community participation in the Latin American context was characterized by gradual growth. In turn, in correlation with a heterogeneous behavior of the branches of sciences involved in scientific activity. The center of the research responds to original articles located in the countries with the highest rate of scientific activity.

Global research trends in regulating gut microbiome to improve type 2 diabetes mellitus: bibliometrics and visual analysis.

Gut microbiome (GM) and type 2 diabetes mellitus (T2DM) have two-way effects. Improving T2DM by modulating GM in various ways, such as diet, exercise, and medication, is gradually becoming popular, and related studies have yielded positive results. However, there is still a lack of high-quality bibliometric analyses of research in this area. This study aims to systematize and comprehensively summarize the knowledge structure, research tropics, and research trends of GM and T2DM through bibliometric analysis. Publications related to GM and T2DM before January 9, 2024, in the Web of Science Core Collection (WOSCC) were searched in this study. Microsoft Excel 2019 was used to analyze publishing trends and CiteSpace (v.6.1.R6 Advanced) was used to analyze institutions, cited journals, references, and keywords.SCImago Graphica (v.1.0.39) was used to analyze countries/regions, institutions' collaborations, cited authors, and published journals. We finally included 1004 articles published from 2008 to 2023. The number of published articles showed an upward trend and reached its peak in 2022. China is the country with the largest number of articles, Univ Copenhagen is the institution with the largest number of articles, Fukui, Michiaki, Hamaguchi, Masahide are the scholars with the largest number of articles, and Cani and Patrice D. are the scholars with the largest number of citations. NUTRIENTS(Q1/5.9) published the most publications, while Nature (Q1/64.8; Cited 804 times) is the most frequently cited journal. Gut microbiota, Obesity, and insulin resistance are the most frequently used keywords. This study found that current researches focus on the effects of diet, exercise, and pharmacological modification of GM to improve T2DM and explores specific mechanisms. Future researches will focus on three areas: complications of T2DM and specific physiological processes, methods and measures to regulate GM, and new experimental techniques and assays. The current researches confirmed the effects and specific mechanisms of modulating GM to improve T2DM. Further exploration of the effects of modulating GM on T2DM complications and specific physiologic processes is a future trend of research. Exploring specific methods for regulating GM and developing new experimental techniques and assays are important for future research.

What makes an article a must read in medical education?

BackgroundThe dissemination of published scholarship is intended to bring new evidence and ideas to a wide audience. However, the increasing number of articles makes it challenging to determine where to focus one’s attention. This study describes factors that may influence decisions to read and recommend a medical education article.MethodsAuthors analyzed data collected from March 2021 through September 2022 during a monthly process to identify “Must Read” articles in medical education. An international team of health sciences educators, learners, and researchers voted on titles and abstracts to advance articles to full text review. Full texts were rated using five criteria: relevance, methodology, readability, originality, and whether it addressed a critical issue in medical education. At an end-of-month meeting, 3–4 articles were chosen by consensus as “Must Read” articles. Analyses were used to explore the associations of article characteristics and ratings with Must Read selection.ResultsOver a period of 19 months, 7487 articles from 856 journals were screened, 207 (2.8%) full texts were evaluated, and 62 (0.8%) were chosen as Must Reads. During screening, 3976 articles (53.1%) received no votes. BMC Medical Education had the largest number of articles at screening (n = 1181, 15.8%). Academic Medicine had the largest number as Must Reads (n = 22, 35.5%). In logistic regressions adjusting for the effect of individual reviewers, all rating criteria were independently associated with selection as a Must Read (p < 0.05), with methodology (OR 1.44 (95%CI = 1.23–1.69) and relevance (OR 1.43 (95%CI = 1.20–1.70)) having the highest odds ratios.ConclusionsOver half of the published medical education articles did not appeal to a diverse group of potential readers; this represents a missed opportunity to make an impact and potentially wasted effort. Our findings suggest opportunities to enhance value in the production and dissemination of medical education scholarship.

Interrelation between gut microbiota and bronchial asthma

Bronchial asthma is a chronic disease of the respiratory tract, and its etiology and pathogenesis have not been studied adequately. Many authors suggest that intestinal microbiota significantly contributed to its etiology. The existence of a gut–lung connection, through which bacterial metabolites influence airway sensibilization, has been proven. Certainly, the formation of this connection in childhood is important. This study provides a review of indigenous and foreign studies concerning the influence of the quantitative and qualitative compositions of intestinal microbiota and certain metabolites of commensals on the manifestation of bronchial asthma. This topic is relevant because of the widespread overuse of antibiotic therapy and the availability of possible ways to prevent the development of bronchial asthma if the influence of the microbiota on its pathogenesis is detected. This study also tried to examine the influence of antibiotic therapy on pregnant women and young children at risk of bronchial asthma, a relationship confirmed in many studies. Despite the large number of studies, the use of probiotics for the treatment and prevention of this disease is still debatable.

Molecular Aspects of Carrageenan in the Pharmaceutical and Food Industries

Abstract: Carrageenan is a gel-forming polysaccharide obtained by extracting certain species of red algae. This substance is used in several food groups due to carrageenan's ability to replace fat and combine easily with milk proteins to increase solubility and improve texture. Although the FDA (Food and Drug Administration) considers carrageenan safe for consumption, this point is still subject to intense scrutiny to investigate the potential health risks associated with human consumption. In view of this, the objective of this review was to address the consumption of carrageenan in the food and pharmaceutical industries and its possible toxic effects on health. One hundred and eleven articles were related to the objective of this review. Although carrageenan is widely used for consumption and several studies describe its beneficial effects, a large number of articles have already been bringing possible toxic effects that it can generate in the long term.

Research hotspot and frontiers in post-stroke dysphagia: A bibliometric study and visualisation analysis.

Dysphagia, a common complication after stroke, significantly hampers the recovery process of patients, both due to dysphagia itself and the additional complications it causes. Although a large number of articles have been published on post-stroke dysphagia (PSD), bibliometric analysis in this field is still lacking. This study aimed to provide a comprehensive understanding of the research hotspots and trends in PSD, thereby guiding future research efforts. The Web of Science Core Collection (WoSCC) database was searched for articles related to PSD from 2003 to 2022. Data were visualised and analysed using CiteSpace and VOSviewer. A total of 3102 publications were included in the scientometric analysis, with a gradual increase in the number of papers published each year. The United States emerged as the country with the highest number of publications (625 articles), while the University of Manchester led with the most publications among institutions (67 articles). Notably, Dysphagia was both the most published (254 articles) and the most cited journal (11,141 citations). Among authors, Hamdy S emerged as the most prolific (52 articles), with Martino R being the most cited (1042 citations). Based on our findings, we anticipate that research hotspots in PSD will mainly focus on complications due to PSD such as stroke-associated pneumonia, stroke-related sarcopenia. Additionally, exploration into the mechanisms and parameters of noninvasive brain stimulation techniques for the treatment of PSD, as well as the rehabilitation needs of patients with PSD, are expected to be key focal points in future research endeavours.

Juvenile language disorders and their interaction with dentistry: a bibliometric analysis.

To analyze the 100 most frequently cited articles on language disorders in children and adolescents and assess the interplay with dentistry by means of a bibliometric analysis. A search of the 100 most frequently cited articles up to December 2021 on language disorders was performed in the Web of Science Core Collection database. Four researchers extracted the data on number of citations, title, authors, country, year of publication, journals, study design, prevalent clinical conditions, and area of expertise. The analyses were performed using VOSviewer and Excel. The total number of citations ranged from 251 to 1,431. Four articles were cited more than 1,000 times. Bishop DVM (10 articles; 3,653 citations) and Tomblin JD (10 articles; 4,261 citations) were the most frequently cited authors. The institutions with the largest number of publications were the University of Oxford/England (11%) and the University of Kansas/USA (8%). Observational study design was the most frequent (77%). Autism spectrum disorder (18%) and dyslexia (14%) were the most broadly investigated clinical conditions. Speech-language pathology (32%) was the area of expertise with the largest number of articles, and none of the top 100 studies showed interplay with dentistry. The 100 most widely cited articles on language disorders are mostly observational, mainly address autism spectrum disorder, and are in the field of speech-language pathology No study reported interplay with dentistry.

Community Detection Methods Based on Exploiting Attributes and Interactions on Social Networks: A Survey and Future Directions

In recent years, community detection in social network analysis has been a hot research topic that has attracted much more attention in the scientific community and a large number of articles have already been published in the literature. Community detection problems focus on determining the subgraphs of the network that have dense edges and whose nodes are expected to have similar features. Community detection has significant applications in different domains of social network analysis such as sociology, business, criminal detection and recommendation systems. The computational complexity is hampered by the huge size and the dynamic nature of social networks. This paper introduces a comprehensive survey of community detection methods in social networks based on mining attributes and interactions of users. We divide the community detection approaches into three basic categories, namely (1) node content-based approaches, (2) edge content-based approaches, and (3) node- and edge content-based approaches. We also discuss in detail the main idea of each method that is suitable for social network data. Furthermore, to promote the study of community detection, we introduce the benchmark datasets from available sources. Last, we present further research directions as well as some open challenges for the community detection problem in social networks.

Failed distractional bone regeneration as a complication of distraction osteosynthesis: risk factors, preventive diagnosis, treatment

Introduction Despite the large number of articles on complications associated with surgical lengthening, information about such a complication of transosseous distraction osteosynthesis as failed bone regenerate (called hypoplastic in foreign literature) is extremely rare. There are no methods for predicting the restructuring of the regenerate and clinical recommendations for the management of patients at various stages of reconstruction of the distraction regenerate. This entails a long period of immobilization and severe complications.The objective of the work was to define the notion of inadequate (“ischemic”/hypoplastic) bone regeneration and the problem of its formation as a complication during surgical limb lengtheningMaterial and methods The PubMed database and the eLIBRARY scientific electronic library were used to select sources for a systematic literature review. The sources published between 1997 and 2020 were selectedResults and discussion Ineffective distraction bone regenerate is a complication of surgical segment lengthening with the shape and/or structure of the newly formed bone preventing functional load on the segment. There is a general tendency with bone elongations being greater than 15-20 % to significantly reduce biomechanical properties of the distractional regenerate bone. Patients' age at surgical lengthening is not reported as a risk factor for distraction regenerate fractures and a history of adverse events and complications is regarded as an additional risk factor. Inadequate (unstable) distraction regenerate bone includes morphotypes III-V and structural types 1, 5, 7 as classified by Ru Li. There are no clinical guidelines for operational strategy. Failed distraction bone regeneration as a complication of distraction osteosynthesis was reported by different authors between 1997 and 2020. There are conflicting statistically unreliable data regarding a risk for regenerate bone to develop into a less stable type. The surgical options presented have no statistical significance (occasional case reports) and do not describe all possible clinical scenarios.Conclusion The problem of failed distraction regeneration and impaired organotypic restructuring remains one of the most important problems in limb lengthening. Inadequate formation and restructuring of newly formed bone can be caused by many factors including anatomical, physiological and technological aspects that would require further comprehensive study.