Miracle-dz/UniFAR-FTUs huggingface dataset:
Mindfulness-Based Cognitive Therapy for Chronic Tinnitus: Evaluation of Benefits in a Large Sample of Patients Attending a Tinnitus Clinic

Objectives: Mindfulness-based approaches may benefit patients with chronic tinnitus, but most evidence is from small studies of nonstandardized interventions, and there is little exploration of the processes of change. This study describes the impact of mindfulness-based cognitive therapy (MBCT) in a “real world” tinnitus clinic, using standardized MBCT on the largest sample of patients with chronic tinnitus to date while exploring predictors of change. Design: Participants were 182 adults with chronic and distressing tinnitus who completed an 8-week MBCT group. Measures of tinnitus-related distress, psychological distress, tinnitus acceptance, and mindfulness were taken preintervention, postintervention, and at 6-week follow-up. Results: MBCT was associated with significant improvements on all outcome measures. Postintervention, reliable improvements were detected in tinnitus-related distress in 50% and in psychological distress in 41.2% of patients. Changes in mindfulness and tinnitus acceptance explained unique variance in tinnitus-related and psychological distress postintervention. Conclusions: MBCT was associated with significant and reliable improvements in patients with chronic, distressing tinnitus. Changes were associated with increases in tinnitus acceptance and dispositional mindfulness. This study doubles the combined sample size of all previously published studies. Randomized controlled trials of standardized MBCT protocols are now required to test whether MBCT might offer a new and effective treatment for chronic tinnitus.
Multiple imputation for estimating the risk of developing dementia and its impact on survival

Dementia, Alzheimer's disease in particular, is one of the major causes of disability and decreased quality of life among the elderly and a leading obstacle to successful aging. Given the profound impact on public health, much research has focused on the age‐specific risk of developing dementia and the impact on survival. Early work has discussed various methods of estimating age‐specific incidence of dementia, among which the illness‐death model is popular for modeling disease progression. In this article we use multiple imputation to fit multi‐state models for survival data with interval censoring and left truncation. This approach allows semi‐Markov models in which survival after dementia depends on onset age. Such models can be used to estimate the cumulative risk of developing dementia in the presence of the competing risk of dementia‐free death. Simulations are carried out to examine the performance of the proposed method. Data from the Honolulu Asia Aging Study are analyzed to estimate the age‐specific and cumulative risks of dementia and to examine the effect of major risk factors on dementia onset and death.
Left-Right Asymmetry in Hearing Loss Following Cisplatin Therapy in Children—The Left Ear is Slightly but Significantly More Affected

Objectives: Bilateral symmetric high frequency hearing loss is regarded as one of the main characteristics of cisplatin-induced ototoxicity. Hair-cell damage because of cisplatin is discussed as the leading cause of hearing loss. Our observations in long-term audiological follow-up of children treated with cisplatin did not always show the anticipated symmetry of hearing loss. Design: Pure-tone audiograms of 55 (34 m, 21 f) children receiving chemotherapy with cisplatin at Muenster university hospital were analyzed. We compared pure tone hearing thresholds, transient evoked otoacoustic emissions levels and distortion product otoacoustic emissions levels before and after chemotherapy with cisplatin. Results: After therapy, the 55 children showed slightly higher average hearing levels in the range 2000 to 8000 Hz in the left ear. The side difference was significant at 4000, 6000, and 8000 Hz. In girls, the effect was less pronounced than in boys. Conclusions: This result, on the one hand, indicates that the auditory system is already responding asymetrically at the cochlear level, on the other hand it underscores the need for further research into the pathophysiology of platinum ototoxicity. There are parallels with stronger effects to the left ear in oiseinduced hearing loss as described in literature. Special attention should be given to possible supracochlear pathways of damage. Clinicians should consider that cisplatin associated hearing loss is not necessarily symmetric.
Tumor de Abrikossoff: revisión de la literatura y presentación de tres casos

espanolEl tumos de celulas granulares (TCG) es una le3sion benigna e infrecuente, que se suele presentar como una masa asintomatica de menos de dos centimetros de diametro. Aunque su origen todavia permanece desconocido, se sospecha que es neural (celula de Schwann), debido a estudios inmunohistoquimicos. Puede aparecer en cualquier parte del cuerpo, pero la region de la cabeza y el cuello es la mas habitual (50%). En la cabeza y cuello, la lengua es la localizacion mas comun del TCG, seguida por la piel, la laringe, y los sistemas respiratorio y digestivo. En el estudio histologico, es caracteristica la presencia de hiperplasia pseudos-epiteliomatosa, y el epitelio superficial esta preservado normalmente. El analisis inmunohistoquimico revela reaccion positiva a la proteina S-100, enolasa neuronal y proteinas mielinicas como P0 y P2. Presentamos tres casos de TCG y un resumen breve de la literatura existente. El primer caso fue diagnosticado en una mujer de 36 anos de edad, el segundo en un hombre de 45 anos, y el tercero en otro hombre de 55 anos. Las lesiones estaban localizadas en el borde lateral, la superficie ventral y la superficie dorsal de la lengua. El tratamiento fue quirurgico en los tres casos y no hay evidencia de recurrencia del tumor despues de un periodo de seguimiento que varia desde los 8 meses a los 2 anos. EnglishGranular cell tumor (GCT) is an uncommon bening lession, pressenting as an asymptomatic mass, less than two centimeters in diameter. The origin is still unknown, althougt it's suspected to be neural (Schann cell), because of immunohistochemical studies. It can appear in any part of the body, but the head and the neck region is the most common (50%). In the head and neck, the tongue is the most usual location for GCT, followed by the skin, larynx, respiratory and digestive system. In the histological study is caracteristic the presence of pseudo-epitheliomatous hyperplasia, and the overlyng ephitelium is ususally preserved. Immunohistochemical analisis reveals positive reaction to S-100 protein, neuronal enolase, mielinic protein as P0 and P2. We present three cases of GCT of the tongue and a brief review of the literature. The first case was found in a 36 year old woman, the second in a 45 year old man and the third one in a 55 year old man. The lesions were placed in the lateral border, the ventral surface and the dorsal surface of the tongue. The treatment was surgycal, and three was no evidence of recurrence after a period from eight months to two years of follow up.
The Association Between Hearing Status and Psychosocial Health Before the Age of 70 Years: Results From an Internet-Based National Survey on Hearing

Objective: There is a substantial lack of knowledge of the impact of reduced hearing on psychosocial functioning in adults younger than 70 yr. The aim of this study was to examine the association between hearing status and psychosocial health in adults aged between 18 and 70 yr. Design: This was a cross-sectional cohort study. Baseline data of the National Longitudinal Study on Hearing are analyzed using regression models. The cohort consisted of 1511 participants. Hearing status was determined using the National Hearing test, a recently launched speech-in-noise screening test over the Internet. We assessed self-reported psychosocial health using a set of online questionnaires. Results: Adjusting for confounding variables, significant adverse associations between hearing status and distress, somatization, depression, and loneliness are found. For every decibel signal to noise ratio (dB SNR) reduction of hearing status, both the distress and somatization scores increased by 2% [distress: b = 0.02, 95% confidence interval (CI) = 0.00 to 0.03, p = 0.03; somatization: b = 0.02, 95% CI = 0.01 to 0.04, p < 0.001]. The odds for developing moderate or severe depression increase by 5% for every dB SNR reduction in hearing (odds ratio = 1.05, 95% CI = 1.00 to 1.09, p = 0.03). The odds for developing severe or very severe loneliness significantly increase by 7% for every dB SNR reduction in hearing (odds ratio = 1.07, 95% CI = 1.02 to 1.12, p = 0.004). Different age groups exhibit different associations between hearing status and psychosocial health, with loneliness being an issue particularly in the youngest age group (18 to 30 yr). In the group of middle-aged adults (40 to 50 yr), the number of significant associations is highest. Conclusions: Hearing status is negatively associated with higher distress, depression, somatization, and loneliness in young and middle-aged adults. The associations are different in different age groups. The findings underline the need to seriously address the adverse effects of limited hearing among young and middle-aged adults both in future research and in clinical practice.
Book Review: Wound Care

hensive textbooks of coloproctology but there has been a real need for a practical and usable book on outpatient rectal clinic practice. This book seems to fill that need. The first thing that strikes one is how readable it is. It seems short but, through a simple and economical style, manages to cover a large field in considerable detail. Clear, practical guidance is given on setting up and running a rectal clinic, on diagnostic methods and on the detailed management of anal conditions. Further chapters deal with colorectal disease and pelvic floor problems in a more general way. In a book concentrating on anal lesions the lack of coloured illustrations might seem a serious omission; however, the clarity ofthe many line drawings makes them far more instructive than any photograph. There are good references for further reading and a particularly good pharmacopoeia, although this already needs updating to include the newer sulphasalazine derivatives and to take account of the ravages of limited prescribing legislation. This excellent book should not be on the library shelf, but rather open on the surgeon's desk. JEREMY WILSON Consultant Surgeon Queen Mary's Hospital, Sidcup
Effects of Audibility and Multichannel Wide Dynamic Range Compression on Consonant Recognition for Listeners with Severe Hearing Loss

Objective: This study examined the effects of multichannel wide-dynamic range compression (WDRC) amplification and stimulus audibility on consonant recognition and error patterns. Design: Listeners had either severe or mild to moderate sensorineural hearing loss. Each listener was monaurally fit with a wearable hearing aid using typical clinical procedures, frequency-gain parameters, and a hybrid of clinically prescribed compression ratios for desired sensation level (Scollie et al., 2005) and NAL-NL (Dillon, 1999). Consonant-vowel nonsense syllables were presented in soundfield at multiple input levels (50, 65, 80 dB SPL). Test conditions were four-channel fast-acting WDRC amplification and a control compression limiting (CL) amplification condition. Listeners identified the stimulus heard from choices presented on an on-screen display. A between-subject repeated measures design was used to evaluate consonant recognition and consonant confusion patterns. Results: Fast-acting WDRC provided a considerable audibility advantage at 50 dB SPL, especially for listeners with severe hearing loss. Listeners with mild to moderate hearing loss received less audibility improvement from the fast-acting WDRC amplification, for conversational and high level speech, when compared with listeners with severe hearing loss. Analysis of WDRC benefit scores revealed that listeners had slightly lower scores with fast-acting WDRC amplification (relative to CL) when WDRC provided minimal improvement in audibility. The negative effect was greater for listeners with mild to moderate hearing loss compared with their counterparts with severe hearing loss. Conclusions: All listeners, but particularly the severe loss group, benefited from fast-acting WDRC amplification for low-level speech. For conversational and higher speech levels (i.e., when WDRC does not confer a significant audibility advantage), fast-acting WDRC amplification seems to slightly degrade performance. Listeners’ consonant confusion patterns suggest that this negative effect may be partly due to fast-acting WDRC-induced distortions, which alter specific consonant features. In support of this view, audibility accounted for a greater percentage of the variance in listeners’ performance with CL amplification compared with fast-acting WDRC amplification.
Lexical Effects on Spoken-Word Recognition in Children with Normal Hearing

Objectives: This study is the first in a series designed to develop and norm new theoretically motivated sentence tests for children. The purpose was to examine the independent contributions of word frequency (i.e., how often words occur in language) and lexical density (the number of similar sounding words or “neighbors” to a target word) to the perception of key words in the new sentence set. Design: Twenty-four children with normal hearing aged 5 to 12 yrs served as participants; they were divided into four equal age-matched groups. The stimuli consisted of 100 semantically neutral sentences that were 5 to 7 words in length. Each sentence contained 3 key words that were controlled for word frequency and lexical density. Words with few neighbors come from sparse neighborhoods, whereas words with many neighbors come from dense neighborhoods. The key words within a sentence belonged to one of the four lexical categories: (1) high-frequency sparse, (2) low-frequency dense, (3) high-frequency dense, and (4) low-frequency sparse. Participants were administered the sentence list and the 300 key words in isolation at 65 dB SPL. Each participant group was tested in spectrally matched noise at one of the four signal-to-noise ratios (SNRs −2, 0, 2, and 4 dB). The percent of words correctly identified was calculated as a function of SNR, key word context (sentences vs. words), and key word lexical category. Results: SNR had a significant effect on the recognition of key words in sentences and in isolation; performance improved at higher SNRs. There were significant main effects of word frequency and lexical density as well as a significant interaction between the two lexical factors. In isolation, high-frequency words were recognized more accurately than low-frequency words. In both word and sentence contexts, sparse words yielded greater accuracy than dense words, irrespective of word frequency. There was a modest but significant negative correlation between lexical density and the recognition of words in isolation and in sentences. Conclusions: Word frequency and lexical density seem to influence word recognition independently in children with normal hearing. This is similar to earlier results in adults with normal hearing. In addition, there seems to be an interaction between the two factors, with lexical density being more heavily weighted than word frequency. These results give us further insight into the way children organize and access words from long-term lexical memory in a relational way. Our results showed that lexical effects were most evident at poorer SNRs. This may have important implications for assessing spoken-word recognition performance in children with sensory aids because they typically receive a degraded auditory signal.
Slight-Mild Sensorineural Hearing Loss in Children: Audiometric, Clinical, and Risk Factor Profiles

Objectives: Slight or mild hearing loss has been posited as a factor affecting speech, language, learning, and academic outcomes, but the risk factors for slight-mild sensorineural hearing loss (SNHL) have not been ascertained. The two specific aims for this research were (1) to describe the audiometric and clinical characteristics of children identified with slight-mild bilateral SNHL and (2) to compare children with slight-mild SNHL with those with normal hearing (NH) with respect to potential risk factors for congenital or acquired for hearing loss. Design: A cross-sectional cluster sample survey of 6581 children enrolled in years 1 and 5 of Australian elementary school was completed. Children were screened for slight-mild SNHL, defined as a low- and/or high-frequency pure-tone average of 16 to 40 dB HL in the better ear, with air-bone gaps <10 dB. Children who did not pass the screen received air and bone conduction threshold and tympanometry tests to determine the type and degree of hearing loss. The parents of every child who participated in this study completed a questionnaire, before the hearing screening, to ascertain possible risk indicators. The questionnaire included items regarding the family's demographics, hearing status of family members, the presence of risk factors, and parental concern regarding the child's hearing. Results: Fifty-five children with slight-mild SNHL and 5490 with NH were identified. Of the group with SNHL, 39 children had a slight loss (16 to 25 dB HL) and 16 had a mild loss (26 to 40 dB HL). The majority of the losses were bilateral and symmetrical, and the mean pure-tone average for the better ear for all 55 children was 22.4 dB HL (SD, 5.2). The most prevalent risk factor was “neonatal intensive care unit/special care nursery admission,” which was reported for 12.5% of the SNHL and 8.4% of the NH group. Reported use of personal stereos was a significant risk factor with an odds ratio of 1.7 (95% confidence interval = 1.0 to 3.0, p = 0.05). The questions relating to parental concern for their child's hearing had low sensitivity (<30%) and very low positive predictive values (<3%) for detecting slight-mild SNHL. Conclusions: Slight-mild SNHL had a prevalence of 0.88% among the school-aged population sampled, with the majority of these children exhibiting bilateral, symmetrical audiometric configurations. Conventional risk factors for hearing loss were not strongly predictive of slight-mild SNHL nor were parental concerns about the child's hearing ability. The association between slight-mild SNHL and the parent report of personal stereo use suggests that this type of noise exposure may be a risk factor for acquired hearing loss. This seems to be the first documentation of such an association in a large sample of young children.
Cumulative disease progression models for cross‐sectional data: A review and comparison

A better understanding of disease progression is beneficial for early diagnosis and appropriate individual therapy. Many different approaches for statistical modelling of cumulative disease progression have been proposed in the literature, including simple path models up to complex restricted Bayesian networks. Important fields of application are diseases such as cancer and HIV. Tumour progression is measured by means of chromosome aberrations, whereas people infected with HIV develop drug resistances because of genetic changes of the HI‐virus. These two very different diseases have typical courses of disease progression, which can be modelled partly by consecutive and partly by independent steps.
Prevalência de bactérias potencialmente patogênicas em espécimes respiratórios de fibrocísticos do Recife

Of 147 respiratory specimens (114 sputum and 33 pharyngeal swabs) collected from 36 cystic fibrosis patients during routine visits or exacerbation of their respiratory symptoms, from December 2000 to December 2002, the following bacterial species were recovered: Pseudomonas aeruginosa (65.3%), Staphylococcus aureus (29.9%), Burkholderia cepacia (29.2%), and Haemophilus influenzae (20.4%). Among the S. aureus and H. influenzae isolates, 6.8% were oxacillin resistant and 6.7% were b-lactamase producers, respectively. Of 96 isolates of P. aeruginosa, 59.4% belonged to the mucoid phenotype. Both mucoid and non-mucoid morphotypes were simultaneously found in 12 specimens. Emerging gram-negative bacteria, such as Stenotrophomonas maltophilia and Achromobacter xylosoxidans, were present at a low number. H. influenzae was more prevalent in the cystic fibrosis children between six and 12 years old. Concerning the other bacterial species there was not preference for age groups.
Sample size calculations for noninferiority trials with Poisson distributed count data

Clinical trials with Poisson distributed count data as the primary outcome are common in various medical areas such as relapse counts in multiple sclerosis trials or the number of attacks in trials for the treatment of migraine. In this article, we present approximate sample size formulae for testing noninferiority using asymptotic tests which are based on restricted or unrestricted maximum likelihood estimators of the Poisson rates. The Poisson outcomes are allowed to be observed for unequal follow‐up schemes, and both the situations that the noninferiority margin is expressed in terms of the difference and the ratio are considered. The exact type I error rates and powers of these tests are evaluated and the accuracy of the approximate sample size formulae is examined. The test statistic using the restricted maximum likelihood estimators (for the difference test problem) and the test statistic that is based on the logarithmic transformation and employs the maximum likelihood estimators (for the ratio test problem) show favorable type I error control and can be recommended for practical application. The approximate sample size formulae show high accuracy even for small sample sizes and provide power values identical or close to the aspired ones. The methods are illustrated by a clinical trial example from anesthesia.
Congenital cystic adenomatoid malformation of the lung (CCAM), a retrospective clinical audit and literature review in a tertiary centre in Scotland over a period of 14 years

Abstract This work was a retrospective audit of CCAM – 1994 to 2008. A total of 26 cases were identified. Mean gestational age at diagnosis was 20 weeks. All were unilateral and had serial scans. In 31% the lesion resolved, 8% decreased, 42% were unchanged and 4% increased in size. Only one foetus developed hydrops. All were born alive. Of 8 foetuses where the CCAM was thought to have resolved, 6 had persistent lesions (overall sensitivity and PPV of US 64% and 69%, respectively). Computerised tomography performed better than chest X-ray in detecting lesions postnatally (sensitivity 100% vs 88%, PPV 95% vs 78%). Seventeen cases required surgery, 4 conservative management and 2 were discharged following negative CXR; 12% had associated anomalies. Four babies had recurrent chest infections. CCAMs have a good overall prognosis. CT scan rather than CXR should be performed to confirm the resolution of antenatally diagnosed lesions. Surgical management is the preferred option over conservative management.