Use of a neoprene binding to reduce giant omphaloceles followed by delayed closure
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Bibliographic record
Abstract
Omphaloceles occur in about 1 in 5000 births and are the second most common congenital abdominal wall defects.1 Repair remains a surgeon’s preference with early closure only attempted for small-to-medium omphaloceles, while delayed closure is used for giant omphaloceles.2–4 In recent years, novel techniques that aim at reducing the disproportion between the abdominal cavity and the volume of the extra-abdominal viscera have been described to manage giant omphaloceles.4–17 Although less commonly associated with genetic abnormalities, giant omphaloceles are associated with adverse neurodevelopmental outcome at 2 years.18 In addition to gestational age, birth weight, associated malformation, resuscitation and hypoxia, other factors including prolonged stay in the neonatal intensive care unit (NICU), time on ventilation, infections, and delayed establishment of enteral nutrition are likely contributory factors.19 This is a case study of two infants with giant omphaloceles treated in our institution with a novel neoprene binder preoperatively. The binder allows for gradual reduction of the viscera below the level of the skin followed by early fascia closure. Families were contacted for a follow-up survey about parental experience and satisfaction in March–July 2020. A summary of the demographic and outcomes is reported in table 1. View this table: Table 1 Summary of patient’s demographic and outcomes Both infants had giant omphaloceles2 3 larger than 5 cm with most of the liver and bowel in the sac. Neither had other major abnormalities nor genetic disorders. After delivery, infants were wrapped in a plastic bag to protect the omphalocele sac and were transferred to NICU for initial care. Infants did not require sedation or intubation, and enteral feeds were started on day 1 of life, with 5 and 11 days, respectively, of concomitant parenteral nutrition until full enteral feeds were established. Immediately postnatally, the intact sac was cleaned and dressed with Restore silver dressing …
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it