bluuebunny/crossref_metadata_2025 huggingface dataset:
Obstructive Sleep Apnea Screening in Preoperative Patients
Authors: Kertes Steven S
Published: June 2020

Patients with the medical diagnosis of obstructive sleep apnea (OSA) and those with undiagnosed OSA have greater chances for adverse events during surgical procedures related to their medical condition. Early identification of at-risk OSA patients can help mitigate associated adverse events. The purpose of this project was to implement a preoperative process to provide early identification of at-risk OSA patients in the preadmission unit, at a large military level I trauma center in central Texas. The Population, Intervention, Comparison, Outcome, Time (PICOT) question for this project is: “In the adult surgical population, how does the routine use of the STOP-Bang Questionnaire compared to non-standardized assessment influence the identification of OSA during the preadmission processing in a military health care treatment facility?” Following the implementation of the standardized use of the STOP-Bang Questionnaire, the identification of early at-risk OSA patients increased from 23% (based on a medical diagnosis of OSA) to 54% with an intermediate and high-risk OSA. Early identification of OSA has an impact on the decisions made to augment and enhance the patient-specific tailored care for each at-risk OSA surgical patient. Potential adverse events may be diminished or eliminated with the early identification of OSA patients. Preoperative policies that support the utilization of preoperative screening for OSA will improve the overall quality and safety of care provided to surgical patients.
Nursing’s Role in Preventing and Managing Back Pain in Military Members: Proceedings of the First Back Pain Summit
Authors: Talbot Laura A , Wilson Candy , Nayback-Beebe Ann , Metter E Jeffrey , Hatzfeld Jennifer
Published: June 2020

This is a review of the proceedings of the first Military Nursing Back Pain Summit focusing on nursing’s role in preventing and managing back pain. The purpose of the summit was to present the state of the science in back pain and to identify key gaps in research, policy, education, and treatment that could be undertaken by military nurses, nurse leaders, nurse practitioners, and nurse scientists. Several key points were highlighted during the summit: (1) back pain is multifactorial and preventable; (2) military service members have unique risk factors for developing back pain; (3) both acute and chronic back pain impact readiness and sustaining readiness is the primary mission of military medicine; (4) back pain is most effectively managed with multiple treatment approaches; (5) military culture must pivot away from an attitude of ignoring persistent pain or “toughing it out” to prevent acute back pain from becoming chronic; (6) integrating military nurses within operational units will be important for effective prevention, education, screening, and treatment within dispersed Multi-Domain Operations; and (7) early self-management is an important area for nursing research and intervention to empower service members to maintain and sustain their back health. The various presentations and panels from the meeting are summarized.
Theory of ion holes in space and astrophysical plasmas
Authors: Aravindakshan Harikrishnan , Yoon Peter H , Kakad Amar , Kakad Bharati
Published: June 2020

Coherent bipolar electric field structures, ubiquitously found in various space and astrophysical plasma environments, play an important role in plasma transport and particle acceleration. Most of the studies found in the literature about them pertain to bipolar structures with positive potentials interpreted in terms of electron holes. Magnetospheric Multiscale spacecraft have recently observed a series of coherent electric field structures with negative potential in the Earth’s bow shock region, which are interpreted as ion holes. The existing theoretical models of ion holes are inadequate because they entail stringent conditions on the ratio of ion to electron temperature. This letter presents a new theory that provides a satisfactory explanation to these observations. A salient point is that this letter incorporates the electron dynamics in the theoretical formalism, which removes ambiguities associated with existing theories, thus showing that the new theory for ion holes may be widely applicable for space and astrophysical plasmas.
JAM-A functions as a female microglial tumor suppressor in glioblastoma
Authors: Turaga Soumya M , Silver Daniel J , Bayik Defne , Paouri Evi , Peng Sen , Lauko Adam , Alban Tyler J , Borjini Nozha , Stanko Sarah , Naik Ulhas P , Keri Ruth A , Connor James R , Barnholtz-Sloan Jill S , Rubin Joshua B , Berens Michael , Davalos Dimitrios , Lathia Justin D
Published: June 2020

Background

Glioblastoma (GBM) is the most aggressive primary brain tumor and has a dismal prognosis. Previously, we identified that junctional adhesion molecule A (JAM-A), a cell adhesion molecule, is highly elevated in human GBM cancer stem cells and predicts poor patient prognosis. While JAM-A is also highly expressed in other cells in the tumor microenvironment, specifically microglia and macrophages, how JAM-A expression in these cells affects tumor growth has yet to be determined. The goal of this study was to understand the role of microenvironmental JAM-A in mediating GBM growth.

Methods

Male and female wild-type (WT) and JAM-A–deficient mice were transplanted intracranially with the syngeneic glioma cell lines GL261 and SB28 and were assessed for differences in survival and microglial activation in tumors and in vitro. RNA-sequencing was performed to identify differentially regulated genes among all genotypes, and differences were validated in vitro and in vivo.

Results

We found that JAM-A–deficient female mice succumbed to GBM more quickly compared with WT females and JAM-A–deficient and male WT mice. Analysis of microglia in the tumors revealed that female JAM-A–deficient microglia were more activated, and RNA-sequencing identified elevated expression of Fizz1 and Ifi202b specifically in JAM-A–deficient female microglia.

Conclusions

Our findings suggest that JAM-A functions to suppress pathogenic microglial activation in the female tumor microenvironment, highlighting an emerging role for sex differences in the GBM microenvironment and suggesting that sex differences extend beyond previously reported tumor cell–intrinsic differences.
Tobacco-Specific Nitrosamines (NNAL, NNN, NAT, and NAB) Exposures in the US Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013–2014)
Authors: Xia Baoyun , Blount Benjamin C , Guillot Tonya , Brosius Christina , Li Yao , Van Bemmel Dana M , Kimmel Heather L , Chang Cindy M , Borek Nicolette , Edwards Kathryn C , Lawrence Charlie , Hyland Andrew , Goniewicz Maciej L , Pine Brittany N , Xia Yang , Bernert John T , De Castro B Rey , Lee John , Brown Justin L , Arnstein Stephen , Choi Diane , Wade Erin L , Hatsukami Dorothy , Ervies Gladys , Cobos Angel , Nicodemus Keegan , Freeman Dana , Hecht Stephen S , Conway Kevin , Wang Lanqing
Published: June 2020

Introduction

The tobacco-specific nitrosamines (TSNAs) are an important group of carcinogens found in tobacco and tobacco smoke. To describe and characterize the levels of TSNAs in the Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013–2014), we present four biomarkers of TSNA exposure: N′-nitrosonornicotine, N′-nitrosoanabasine, N′-nitrosoanatabine, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) which is the primary urinary metabolite of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone.

Methods

We measured total TSNAs in 11 522 adults who provided urine using automated solid-phase extraction coupled to isotope dilution liquid chromatography–tandem mass spectrometry. After exclusions in this current analysis, we selected 11 004 NNAL results, 10 753 N′-nitrosonornicotine results, 10 919 N′-nitrosoanatabine results, and 10 996 N′-nitrosoanabasine results for data analysis. Geometric means and correlations were calculated using SAS and SUDAAN.

Results

TSNA concentrations were associated with choice of tobacco product and frequency of use. Among established, every day, exclusive tobacco product users, the geometric mean urinary NNAL concentration was highest for smokeless tobacco users (993.3; 95% confidence interval [CI: 839.2, 1147.3] ng/g creatinine), followed by all types of combustible tobacco product users (285.4; 95% CI: [267.9, 303.0] ng/g creatinine), poly tobacco users (278.6; 95% CI: [254.9, 302.2] ng/g creatinine), and e-cigarette product users (6.3; 95% CI: [4.7, 7.9] ng/g creatinine). TSNA concentrations were higher in every day users than in intermittent users for all the tobacco product groups. Among single product users, exposure to TSNAs differed by sex, age, race/ethnicity, and education. Urinary TSNAs and nicotine metabolite biomarkers were also highly correlated.

Conclusions

We have provided PATH Study estimates of TSNA exposure among US adult users of a variety of tobacco products. These data can inform future tobacco product and human exposure evaluations and related regulatory activities.
Victor Edelberg: LSE’s forgotten econometrician
Authors: Thomas Jim
Published: June 2020

Given Lionel Robbins’s strong scepticism about the value of statistical analysis in economics, it is not surprising that early developments in Econometrics at LSE came from members of the Statistics Department at the School. However, Victor Edelberg, a graduate student in the Economics Department at LSE in the 1930s, published the second article in Econometrica with ‘Econometrics’ in the title and further econometric articles in the Review of Economic Studies. Despite these publications, his work has been forgotten and is not included in the history of econometrics at LSE, nor in the wider history of economics. This study has three objectives: (i) to provide information on the life of Victor Edelberg to explain why, despite his high academic achievements, he failed to establish an academic career, (ii) to evaluate his contributions to econometrics, given the standards of the time, and (iii) to suggest reasons why he would become LSE’s forgotten econometrician.
Rethinking ‘essential’ and ‘nonessential’: the developmental paediatrician’s COVID-19 response
Authors: Fung Alastair , Ricci M Florencia
Published: June 2020

While terms such as ‘essential’ and ‘nonessential’ used amidst the COVID-19 pandemic may serve a practical purpose, they also pose a risk of obstructing our view of the harmful indirect health consequences of this crisis. SARS-CoV-2 cases and deaths in children are minimal compared to adults, but the pandemic impacts other ‘essential’ aspects of children’s health including child development and the associated areas of paediatric behaviour, mental health, and maltreatment. Alongside the management of severe SARS-CoV-2 cases in emergency rooms and intensive care units, continuing to care for children with developmental disabilities must also be concurrently championed as ‘essential’ during this crisis. The potentially devastating lifelong effects of the pandemic and isolation on an already vulnerable population demand that action be taken now. Video conferences and phone calls are ‘essential’ instruments we can use to continue to provide quality care for our patients.
RUNX1T1 rs34269950 is associated with obesity and metabolic syndrome
Authors: Zhou Y , Hambly B D , Simmons D , McLachlan C S
Published: June 2020

Background

Runt-related transcription factor 1 (RUNX1T1) isoforms are involved in adipogenesis. RUNX1T1 is mediated by the fat mass and obesity-associated (FTO). However, the extent to which RUNX1T1 single-nucleotide polymorphisms (SNPs) are associated with obesity risk or metabolic abnormalities in a community population basis is unknown.

Methods

Samples were obtained from the Australian Crossroads study bio-bank. SNPs located in the coding region and 3′untranslated regions of RUNX1T1 with minor allele frequency ≥0.05 were analysed using Taqman genotyping assays.

Results

Eight candidate SNPs were genotyped successfully in 1440 participants. Of these SNPs only rs34269950 located in the ‘RRACH’ motif, the most common N6-methyladenosine (m6A) methylation modification site (recognized by FTO), was significantly associated with obesity risk and metabolic abnormalities. Specifically, compared to AA genotype, rs34269950 del/del genotype was associated with a 1.47 [95% confidence interval (CI): 1.01–2.14, P = 0.042] fold higher rate of obesity risk. Additionally, the del/del genotype was associated with a 60% increased risk of metabolic syndrome (MetS) [odds ratio (OR) = 1.60, 95% CI: 1.10–2.32, P = 0.015], in comparison to the AA genotype. Finally, rs34269950 del/del increased the risk of a larger waist circumference (OR = 1.65, 95% CI: 1.15–2.36, P = 0.007), but not other components of MetS.

Conclusion

Our study demonstrates that RUNX1T1 rs34269950, located in a potential FTO recognition motif, is significantly associated with waist circumference. This provides novel evidence to suggest SNPs located in RRACH motif may be involved in RNA m6A modification and mechanistic pathways that influence abdominal obesity.
The orbitofrontal cortex spontaneously encodes food health and contains more distinct representations for foods highest in tastiness
Authors: Londerée Allison M , Wagner Dylan D
Published: June 2020

The human orbitofrontal cortex (OFC) has long been associated with food reward processing and is thought to represent modality-independent signals of value. Food tastiness and health are core attributes of many models of food choice and dietary self-control. Here we used functional neuroimaging to examine the neural representation of tastiness and health for a set of 28 food categories selected to be orthogonal with respect to both dimensions. Using representational similarity analysis, in conjunction with linear mixed-effects modeling, we demonstrate that the OFC spontaneously encodes food health, whereas tastiness was associated with greater neural dissimilarity. Subsequent analyses using model dissimilarity matrices that encode overall tastiness magnitude demonstrated that the neural representation of foods grows more distinct with increasing tastiness but not with increasing health. In a separate study, we use lexical analysis of natural language descriptions of food to show that food tastiness is associated with more elaborate descriptions of food. Together these data show not only that the OFC spontaneously encodes the dimensions of health and tastiness when viewing appetitive food cues, but also that the neural and cognitive representations of food categories that are the highest in tastiness are more refined than those lower in tastiness.
Seasonal fluctuation of nonstructural carbohydrates reveals the metabolic availability of stemwood reserves in temperate trees with contrasting wood anatomy
Authors: Furze Morgan E , Huggett Brett A , Chamberlain Catherine J , Wieringa Molly M , Aubrecht Donald M , Carbone Mariah S , Walker Jennifer C , Xu Xiaomei , Czimczik Claudia I , Richardson Andrew D
Published: June 2020

Nonstructural carbohydrates (NSCs) play a critical role in plant physiology and metabolism, yet we know little about their distribution within individual organs such as the stem. This leaves many open questions about whether reserves deep in the stem are metabolically active and available to support functional processes. To gain insight into the availability of reserves, we measured radial patterns of NSCs over the course of a year in the stemwood of temperate trees with contrasting wood anatomy (ring porous vs diffuse porous). In a subset of trees, we estimated the mean age of soluble sugars within and between different organs using the radiocarbon (14C) bomb spike approach. First, we found that NSC concentrations were the highest and most seasonally dynamic in the outermost stemwood segments for both ring-porous and diffuse-porous trees. However, while the seasonal fluctuation of NSCs was dampened in deeper stemwood segments for ring-porous trees, it remained high for diffuse-porous trees. These NSC dynamics align with differences in the proportion of functional sapwood and the arrangement of vessels between ring-porous and diffuse-porous trees. Second, radial patterns of 14C in the stemwood showed that sugars became older when moving toward the pith. The same pattern was found in the coarse roots. Finally, when taken together, our results highlight how the radial distribution and age of NSCs relate to wood anatomy and suggest that while deeper, and likely older, reserves in the stemwood fluctuated across the seasons, the deepest reserves at the center of the stem were not used to support tree metabolism under usual environmental conditions.
Caloric Intake and Energy Expenditures in India
Authors: Eli Shari , Li Nicholas
Published: June 2020

Total energy expenditures for the Indian population between 1983 and 2012 are estimated to shed light on the debate concerning falling measured caloric intake during the period (A. Deaton and J. Drèze. 2009. “Food and Nutrition in India: Facts and Interpretations.” Economic and Political Weekly 44(7): 42–65). Anthropometric, time-use, and detailed employment surveys are used to estimate the separate components of total energy expenditure related to metabolism and physical activity levels. Despite a significant drop in adult physical activity levels, total energy expenditures are flat overall between 1983 and 2012. Rising metabolic requirements due to increases in weight dampened the effect of falling activity levels on total energy expenditure. In addition, the 10 percent decline in the population share of children in the period raised average total energy expenditures considerably as children have much lower metabolic requirements and activity levels than adults.
The Effect of Evaluator Training on Inter- and Intrarater Reliability in High-Stakes Assessment in Simulation
Authors: Holland Ann E. , Tiffany Jone , Blazovich Linda , Bambini Deborah , Schug Vicki
Published: June 2020

AIM

The aim of this study was to evaluate the effectiveness of a training intervention in achieving inter- and intrarater reliability among faculty raters conducting high-stakes assessment of clinical performance in simulation.

BACKGROUND

High-stakes assessment of simulation performance is being adopted in nursing education. However, limited research exists to guide best practices in training raters, which is essential to ensure fair and defensible assessment.

METHOD

A nationwide sample of 75 prelicensure RN program faculty participated in an experimental, randomized, controlled study.

RESULTS

Participants completing a training intervention achieved higher inter- and intrarater reliability than control group participants when using a checklist evaluation tool. Mixed results were achieved by participants when completing a global competency assessment.

CONCLUSION

The training intervention was effective in helping participants to achieve a shared mental model for use of a checklist, but more time may be necessary to achieve consistent global competence decisions.
The allergic eye: recommendations about pharmacotherapy and recent therapeutic agents
Authors: Kimchi Nofar , Bielory Leonard
Published: June 2020

Purpose of review

Ocular allergies affect an estimated 40% of the population, 98% of which are because of allergic conjunctivitis. With the current advent of both repurposed drugs for ocular allergies, as well as novel drugs and methods of administration, there is a need for an updated review of current available medications. A clear characterization of each treatment will ultimately allow treating physicians to restore patients’ quality of life and decrease burden of disease.

Recent findings

Currently, there are a number of reformulated antihistamines, with cetrizine being the most recent ophthalmic solution available. Nevertheless, there is ongoing research in the field of immunotherapy, steroids, flavonoids, cannabis, and drug-delivery systems.

Although dual-activity agents remain the keystone for treatment, newer drugs and drug-delivery systems offer other novel directions for delivering appropriate relief with minimal adverse effects.
Clinical Outcomes of Triplane Fractures Based on Imaging Modality Utilization and Management: A Systematic Review and Meta-analysis
Authors: Gaudiani Michael A. , Knapik Derrick M. , Liu Raymond W.
Published: June 2020

Background:

Because of the complex nature and relatively rare prevalence of triplane fractures, ideal imaging and optimal treatment remain controversial. The purpose of this investigation was to systematically review and compare clinical outcomes in skeletally immature patients with triplane fractures on the basis of imaging modalities [radiography alone vs. radiography+computed tomography (CT)] and fracture management (operative vs. nonoperative).

Methods:

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using a PRISMA checklist. All the literature related to skeletally immature patients with triplane fractures published from January 1988 to March 2020 were identified. Inclusion criteria consisted of skeletally immature patients with triplane fractures with reported imaging modality performed during diagnosis, fracture management, and postoperative outcomes on the basis of functional scores and the incidence of any complications.

Results:

A total of 11 articles met inclusion criteria, comprising a total of 203 skeletally immature patients with 203 documented triplane fractures. Male individuals were significantly older at the time of injury (14.2±0.6 y) when compared with female individuals (12.6±0.9 y) (P=0.006). Fracture diagnosis and management were evaluated using radiography+CT in 63% (128/203) of patients, whereas 37% (75/203) underwent radiography only. No significant differences in good/excellent Modified Weber Protocol scores were reported in patients treated nonoperatively versus those undergoing operative treatment (P=0.78), whereas Modified Weber Protocol scores were significantly higher in patients using radiography alone (P=0.02). No significant difference in complication incidence was reported on the basis of management type (nonoperative, 16%; operative, 15%; P=0.47).

Conclusions:

Patients undergoing operative management of triplane fractures achieved comparable functional outcomes scores without an increased incidence of complications when compared with patients undergoing nonoperative treatment. Further investigations analyzing outcomes at middle and long-term follow-up are necessary to determine the clinical utility of CT and various treatment modalities for the management of triplane fractures.

Level of Evidence:

Level IV—Systematic review.
Regression of liver fibrosis: evidence and challenges
Authors: Sun Ya-Meng , Chen Shu-Yan , You Hong
Published: June 2020

It has been reported that liver fibrosis could be reversed after eliminating liver injuries. This article systematically summarizes the evidence of fibrosis regression based on histology, liver stiffness, and serum biomarkers, and discusses several clinically relevant challenges. Evidence from liver biopsy has been regarded as the gold standard in the assessment of fibrosis regression. Semi-quantitative staging and grading systems are traditionally and routinely used to define regression. Recently, the predominantly regressive, indeterminate, and predominantly progressive score was proposed, based on the regressive features from “hepatic repair complex”, to provide additional information regarding the quality of fibrosis. For non-invasive assessment, although liver stiffness and serum biomarkers could be applied to reflect the dynamic changes of liver fibrosis, other confounding factors such as liver inflammation have to be considered. In conclusion, both histology and non-invasive methods can provide evidence regarding fibrosis regression. The predictive value of fibrosis regression in long-term prognosis warrants further investigation.
Establishment of endometriotic models: the past and future
Authors: Gu Zhi-Yue , Jia Shuang-Zheng , Leng Jin-Hua
Published: June 2020

Endometriosis is a prevalent chronic disease that affects approximately 6% to 10% of reproductive-aged women. Although numerous researchers have endeavored to explore the etiology of endometriosis over a century, its etiology still remains an enigma. The exploration of pathophysiologic mechanism and novel therapy for endometriosis depends on ideal endometriotic models. In the previous decade, various endometriotic models have been established; therefore, we made a conclusion for available information on these models. This review summarized the common experimental models used in endometriotic studies, including their origins, characteristics, applications, and limitations. Endometriotic models played an important role in studying etiologies and novel treatments of endometriosis during the last decades. Among them, animal models and endometriotic cell lines were viewed as most common studying tools to explore the intrinsic entities of endometriosis. In addition, endometrial organoid also emerged and was regarded as an ideal studying tool for endometriosis research. Different research models collectively complement each other to advance the endometriosis research. The successful establishment of endometrial organoids means that organoids are expected to become an ideal model for studying endometriosis in the future.
Mechanical Stability of Cryopreserved Split-Thickness Tectonic Corneal Grafts
Authors: Palko Joel R. , Ma Yanhui , Pan Xueliang , Liu James , Reppa Catherine , Dixon Maxwell W. , Clayson Keyton , Lubniewski Anthony , Liu Jun
Published: June 2020

Purpose:

To evaluate the influence of cryopreservation on the pressure-strain relationship of microkeratome dissected anterior stromal grafts (ASGs).

Methods:

Partial thickness ASGs were created from 7 pairs of human corneas and randomized to immediate grafting or grafting after 3 months of cryopreservation at −80°C into a whole globe ex vivo corneal perforation model. High frequency ultrasound speckle tracking was used to calculate the cross-sectional axial and lateral strains in each graft at increasing intraocular pressure (IOP) from 5 to 30 mm Hg. The mean axial and lateral strains were compared between the paired groups.

Results:

The mean axial and lateral strains were not significantly different between the cryopreserved and noncryopreserved ASGs. The mean lateral strains at 30 mm Hg in the noncryopreserved and cryopreserved grafts were 2.4% ± 2.1% and 1.4% ± 0.7% (P= 0.294), respectively. The mean axial strains at 30 mm Hg in the noncryopreserved and cryopreserved grafts were −7.8% ± 3.3% and −5.5% ± 3.0% (P= 0.198), respectively. A linear pressure-strain relationship was found for all grafts at physiologic IOP.

Conclusions:

ASGs cryopreserved at −80°C maintain their IOP-strain relationship compared with noncryopreserved ASGs at physiologic pressures, supporting the potential use of cryopreserved human corneal stroma for patch grafting procedures.
Studies on CRMP2 SUMOylation–deficient transgenic mice identify sex-specific Nav1.7 regulation in the pathogenesis of chronic neuropathic pain
Authors: Moutal Aubin , Cai Song , Yu Jie , Stratton Harrison J. , Chefdeville Aude , Gomez Kimberly , Ran Dongzhi , Madura Cynthia L. , Boinon Lisa , Soto Maira , Zhou Yuan , Shan Zhiming , Chew Lindsey A. , Rodgers Kathleen E. , Khanna Rajesh
Published: June 2020

The sodium channel Nav1.7 is a master regulator of nociceptive input into the central nervous system. Mutations in this channel can result in painful conditions and produce insensitivity to pain. Despite being recognized as a “poster child” for nociceptive signaling and human pain, targeting Nav1.7 has not yet produced a clinical drug. Recent work has illuminated the Nav1.7 interactome, offering insights into the regulation of these channels and identifying potentially new druggable targets. Among the regulators of Nav1.7 is the cytosolic collapsin response mediator protein 2 (CRMP2). CRMP2, modified at lysine 374 (K374) by addition of a small ubiquitin-like modifier (SUMO), bound Nav1.7 to regulate its membrane localization and function. Corollary to this, preventing CRMP2 SUMOylation was sufficient to reverse mechanical allodynia in rats with neuropathic pain. Notably, loss of CRMP2 SUMOylation did not compromise other innate functions of CRMP2. To further elucidate the in vivo role of CRMP2 SUMOylation in pain, we generated CRMP2 K374A knock-in (CRMP2K374A/K374A) mice in which Lys374 was replaced with Ala. CRMP2K374A/K374A mice had reduced Nav1.7 membrane localization and function in female, but not male, sensory neurons. Behavioral appraisal of CRMP2K374A/K374A mice demonstrated no changes in depressive or repetitive, compulsive-like behaviors and a decrease in noxious thermal sensitivity. No changes were observed in CRMP2K374A/K374A mice to inflammatory, acute, or visceral pain. By contrast, in a neuropathic model, CRMP2K374A/K374A mice failed to develop persistent mechanical allodynia. Our study suggests that CRMP2 SUMOylation–dependent control of peripheral Nav1.7 is a hallmark of chronic, but not physiological, neuropathic pain.
Subjective Hearing Impression and Quality of Life in Patients With Bilateral Active Middle Ear Implants
Authors: Seebacher Josef , Weichbold Viktor , Schörg Philipp , Koci Viktor , Magele Astrid , Zorowka Patrick , Sprinzl Georg
Published: June 2020

Objective:

This study compared the quality of life in patients with bilateral active middle ear implants to their quality of life when they were unilaterally implanted.

Design:

Twenty-one patients implanted sequentially with the Vibrant Soundbridge (VSB) active middle ear implant completed quality-of-life surveys. The patients were asked to rate whether and to what extent their quality of life has changed upon receiving a second VSB. Hearing-specific quality of life was assessed with the Speech, Spatial, and Qualities of Hearing Scale (SSQ12-B), and general quality of life was with the Glasgow Benefit Inventory (GBI). In addition, the patients completed a health-related quality-of-life questionnaire (AQoL-8D). Finally, the changes in hearing-related and general quality of life were correlated to the change in word recognition ability after implantation of the second VSB (Freiburg monosyllabic word test; unilateral VSB versus bilateral VSB at 65 dB SPL).

Results:

On the SSQ12, subjects scored a median of + 2.73 (p < 0.001; significantly different from zero) on a scale of −5 to + 5 where 0 indicates no change. All three subscores showed significant improvement. On the GBI, patients reached a median overall score of + 23.6 (p < 0.001; significantly different from zero) on a scale of −100 to + 100 where 0 indicates no change. Here, the improvement was mainly visible in the general subscore, whereas the social support and physical health subscores did not change due to the intervention. Both subjective benefit rating scores strongly correlated with the change in word recognition scores, suggesting that both hearing and general quality of life improved with increased word recognition due to bilateral VSB use. No significant correlation was found between the subjects’ general health (as measured by AQoL-8D utility scores) and SSQ12-B or GBI overall scores.

Conclusion:

Usage of a second active middle ear implant substantially improved our patients’ subjective hearing and general quality of life compared with unilateral use. The increase in quality of life may be linked to improved speech understanding due to bilateral use of a middle ear implant. Furthermore, these outcomes were not influenced by our patients’ general health state at the time of survey.
Noise Exposure on Human Cochlea During Cochleostomy Formation Using Conventional and a Hand Guided Robotic Drill
Authors: Du Xinli , Zhang Yu , Boulgouris Nikolaos , Brett Peter N. , Mitchell-Innes Alistair , Coulson Chris , Irving Richard , Begg Philip
Published: June 2020

Objective:

To investigate the disturbance induced in the cochlea during cochleostomy using conventional drill and a hand guided robotic drill.

Study Design:

The study is based on experimental measurements using the Laser Doppler Vibrometer during the drilling processes converted to Sound Pressure Levels (SPL) for comparison.

Setting:

The study is based on experimental results of three sets of cochleostomies on human cadaver heads.

Main Outcome Measure(s):

Robotic drilling, in comparison to the conventional drilling method, creates a consistently lower level of disturbance in cochlea across the hearing frequency range.

Results:

Robotic drilling, in comparison to the conventional drilling method, creates a consistently lower level of disturbance in cochlea across the hearing frequency range.

Conclusions:

It is reasonable to conclude that robotic drilling has a lower possibility of creating acoustic trauma in cochlea that endangers the residual hearing of patients.
Cochlear Implantation for Treatment of Tinnitus in Single-sided Deafness: A Systematic Review and Meta-analysis
Authors: Levy Dylan A. , Lee Joshua A. , Nguyen Shaun A. , McRackan Theodore R. , Meyer Ted A. , Lambert Paul R.
Published: June 2020

Objective:

Quantify the benefit of cochlear implantation (CI) for tinnitus relief among individuals with single-sided deafness (SSD).

Data Sources:

PubMed, Scopus, and Cochrane databases were searched through July 10, 2019. Search strategies used a combination of subject headings (e.g., MeSH in PubMed) and keywords for the following three concepts: single-sided deafness, cochlear implantation, and tinnitus.

Study Selection:

English articles that reported the preintervention (baseline) tinnitus-related patient-reported outcome measures (e.g., Tinnitus Handicap Inventory [THI] and Visual Analog Scale [VAS] for loudness) in patients with SSD that underwent CI were included.

Data Extraction:

Number of patients, mean age, etiology of hearing loss, duration of deafness, baseline and follow-up THI and VAS scores.

Data Synthesis:

A total of 17 studies met inclusion criteria encompassing 247 patients with SSD receiving a cochlear implant (mean age 50.2 yr, range 23–71). For THI, CI resulted in a mean difference of –35.4 points [95% CI –55.8 to –15.0, p < 0.001]. VAS decreased by –4.6 points [CI –6.0 to –3.3, p < 0.001]. A weighted proportion of 14.9% [CI 6.4–26.1] of patients experienced complete resolution of tinnitus, while 74.5% [CI 63.1–84.5] experienced partial improvement; 7.6% [CI 4.1–12.6] of patients had no change in severity, and 3.0% [CI 1.0–6.7] experienced worsening of their tinnitus.

Conclusions:

On both THI and VAS, patients reported significant reduction in their scores, representing an overall improvement in tinnitus severity while wearing the cochlear implant. Most patients with SSD will experience partial improvement or complete resolution of tinnitus with a cochlear implant.
Hearing Preservation With a New Atraumatic Lateral Wall Electrode
Authors: Lenarz Thomas , Buechner Andreas , Lesinski-Schiedat Anke , Timm Max , Salcher Rolf
Published: June 2020

Introduction:

Many individuals have some residual hearing which should be preserved with cochlear implantation. To achieve this goal electrode arrays must fulfil certain design requirements. A new thin lateral wall electrode array (HiFocus SlimJ) was systematically designed on the basis of μCT studies of human cochlea anatomy. The primary objective of this study was to report on initial retrospective hearing preservation results from a cohort of subjects consecutively implanted with this electrode. Secondary objectives were to report on insertion depth and speech perception results for this new array.

Methods:

Twenty subjects with considerable residual hearing in low frequencies were consecutively implanted with the SlimJ electrode array. The electrode was inserted slowly through the round window and the insertion process was controlled by intracochlear electrocochleography measuring cochlear microphonics through the cochlear implant.

Postoperative cone beam computed tomography was conducted and precise scalar location and angular insertion depth was estimated following image fusion with the preoperative images.

Results:

Low frequency hearing at 1 month postsurgery was preserved within 30 dB HL in 85% of subjects and within 15 dB HL in 50% of subjects. Mean angular insertion depth was 393 degrees (SD 62 degrees) with a range from 294 to 520 degrees. All electrode contacts in all subjects were identified within scala tympani.

Conclusion:

The SlimJ electrode array is easy to handle for atraumatic insertion through the round window, adjusted insertion depth controlled by electrocochleography measurements, and reliable fixation at the posterior tympanotomy. Hearing preservation rates are encouraging on the short term. We aim to further report on larger data sets and long-term outcomes.
OTOPLAN in Cochlear Implantation for Far-advanced Otosclerosis
Authors: Lovato Andrea , Marioni Gino , Gamberini Lisa , Bonora Chiara , Genovese Elisabetta , de Filippis Cosimo
Published: June 2020

Aim:

To evaluate OTOPLAN software in the surgical planning of far-advanced otosclerosis (FAO) candidates to cochlear implant (CI) were considered. We aimed to preliminarily investigate if this software could influence the electrode length choice, or predict surgical difficulties.

Methods:

We reviewed the outcome of five consecutive FAO patients that underwent unilateral CI. OTOPLAN was used to evaluate preoperative computed tomography imaging. A comparison was made with historical data (eight FAO patients).

Results:

The mean cochlear duct length estimated by OTOPLAN was 32.4 mm. Evaluating OTOPLAN reconstructed images, we ruled out cochlear lumen fibrosis/ossification in three FAO patients and the longest electrodes according to cochlear dimensions were preferred. We disclosed fibrosis in the middle and apical turns of two patients. These findings allowed us to change surgical plans, choosing a shorter electrode (24 and 28 mm instead of 31 mm) to avoid incomplete insertion due to cochlear fibrosis. OTOPLAN reconstructed images identified preoperatively the two patients with round window niche ossification that required additional drilling during surgery. In the present series, we experienced no incomplete insertion. In two cases out of eight historical FAO patients, array insertion (24 mm) was incomplete. One years after unilateral CI, the mean speech reception threshold and disyllabic word recognition score of the five considered FAO patients were 36 dB and 94%, respectively (39 dB and 84% for the eight historical patients). There was no facial nerve stimulation or any other complication during the 1-year follow-up.

Conclusion:

According to our preliminary results, OTOPLAN was useful for the appropriate choice of array length.
Necrotizing Otitis Externa: A Systematic Review and Analysis of Changing Trends
Authors: Byun Young Jae , Patel Jaimin , Nguyen Shaun A. , Lambert Paul R.
Published: June 2020

Objective:

To assess for changes in trends of the disease process, management, and outcomes of necrotizing otitis externa (NOE) over the last decade.

Data Sources:

Articles in English, published between January 2011 and June 2019, were searched in PubMed, Scopus, Web of Science, ScienceDirect, and the Cochrane Database.

Study Selection:

Inclusion criteria: 1) reported evidence of NOE, 2) details on patient demographic and underlying medical disorder, 3) details on treatments, 4) documented outcomes, and 5) greater than 10 cases.

Data Extraction:

Study demographics, underlying conditions, infectious etiology, treatments, signs and symptoms, and outcomes.

Data Synthesis:

Ten studies, totalling 284 patients with a mean age of 67.8 years, were included. The time period of collected patient data ranged from 2000 to 2018. Temporal subgroup analysis was conducted before and after 2009. Cure rate was lower in the post-2009 group (76.0 versus 94.1%, p < 0.01) while disease-specific mortality remained stable. Increases in proportions of diabetes and culture negative results (p < 0.01) were also observed in this latter group. Rate of extensive surgery and the use of ciprofloxacin decreased (p < 0.01), while the use of ceftazidime increased in the post-2009 group (p < 0.01).

Conclusion:

A decrease in cure rate of NOE patients was observed in the setting of an increase in prevalence of diabetes. Various antipseudomonal agents are being used and an increase in culture negative results is seen.
Early Feasibility Studies of Augmented Reality Navigation for Lateral Skull Base Surgery
Authors: Creighton Francis X. , Unberath Mathias , Song Tianyu , Zhao Zhuokai , Armand Mehran , Carey John
Published: June 2020

Hypothesis:

An augmented reality (AR) platform using a head mounted display (HMD) can successfully display and register virtual computerized tomography (CT) data to corresponding real world anatomy using fiducial markers.

Background:

AR is a growing field in surgical planning, and has been used by this group to aide in orthopedic surgery applications. Intraoperative AR registration of preoperative CT images could improve identification of critical anatomical structures during lateral skull base surgery.

Methods:

An AR based HMD platform was created to allow for virtual display and real time manipulation of a temporal bone phantom model. Four fiducial markers were incorporated into this model and used to allow manual alignment of surface markers in real-time. To test the accuracy of this platform virtual lines were created in the AR environment running through the visualized real-world fiducial marker points. Target registration error (TRE) was calculated by measuring the orthogonal distance between these virtual lines and the corresponding virtual fiducial marker for each of the four markers from varying angles. Ten consecutive experiments were performed.

Results:

The AR based platform successfully displayed CT renderings in the AR environment and allowed real time translation and rotation for manual alignment. A TRE of 10.62 ± 5.90 mm was found.

Conclusions:

Our results suggest that AR visualization of CT imaging can be registered to patient surface landmarks, but current limitations of AR hardware resulted in TREs too large to be used in the lateral skull base. Future advancements in AR technology will hopefully allow for reduction of registration error.
Insertion Depth for Optimized Positioning of Precurved Cochlear Implant Electrodes
Authors: Banalagay Rueben A. , Labadie Robert F. , Chakravorti Srijata , Noble Jack H.
Published: June 2020

Hypothesis:

Generic guidelines for insertion depth of precurved electrodes are suboptimal for many individuals.

Background:

Insertion depths that are too shallow result in decreased cochlear coverage, and ones that are too deep lift electrodes away from the modiolus and degrade the electro-neural interface. Guidelines for insertion depth are generically applied to all individuals using insertion depth markers on the array that can be referenced against anatomical landmarks.

Methods:

To normalize our measurements, we determined the optimal position and insertion vector where a precurved array best fits the cochlea for each patient in an IRB-approved, N = 131 subject CT database. The distances from the most basal electrode on an optimally placed array to anatomical landmarks, including the round window (RW) and facial recess (FR), was measured for all patients.

Results:

The standard deviations of the distance from the most basal electrode to the FR and RW are 0.65 mm and 0.26 mm, respectively. Owing to the high variability in FR distance, using the FR as a landmark to determine insertion depth results in >0.5 mm difference with ideal depth in 44% of cases. Alignment of either of the two most proximal RW markers with the RW would result in over-insertion failures for >80% of cases, whereas the use of the third, most medial marker would result in under-insertion in only 19% of cases.

Conclusions:

Normalized measurements using the optimized insertion vector show low variance in distance from the basal electrode position to the RW, thereby suggesting it as a better landmark for determining insertion depth than the FR.
Potential Ototopical Antiseptics for the Treatment of Active Chronic Otitis Media: An In Vitro Evaluation
Authors: van Straten Andries Francois , Blokland Rachel , Loock James William , Whitelaw Andrew
Published: June 2020

Objectives:

Primary: to compare, in vitro, the antimicrobial activity of different antiseptic agents versus quinolone drops, against the common organisms of chronic otitis media.

Secondary: to examine the possible role of pH on the antimicrobial activity of the antiseptic solutions.

Methods:

Three antiseptic powders (boric acid; iodine; and a 1:1 combination of these two) and four solutions (2% boric acid; 2% acetic acid; 3.25% aluminum acetate; and 5% povidone iodine) were tested against five bacteria and two fungi common in chronic otitis media, using both agar plates and the modified broth dilution method. These results were compared with the antimicrobial activity of quinolone drops.

The potential role of pH of solutions was tested by reducing the acidity of the agents and repeating the broth dilution.

Results:

Of the powders, iodine, and iodine/boric acid combined, are very effective against all organisms. Boric acid powder showed moderate effectiveness against all organisms. All solutions performed poorly on the agar plates. 5% povidone iodine has good effectivity when tested with the broth dilution method. 3.25% aluminum acetate had the best activity againstPseudomonas aeruginosa.

Conclusion:

Boric acid powder and 5% povidone iodine solution show promise for clinical use. Boric acid powder has proven clinical effectiveness. 5% povidone iodine requires further clinical research. Although very effective in vitro, iodine powder is toxic to tissues and cannot be recommended for clinical use. The pH of solutions does not seem to play a significant role in their antimicrobial activity in vitro.
The National Landscape of Acute Mastoiditis: Analysis of the Nationwide Readmissions Database
Authors: Schwam Zachary G. , Ferrandino Rocco , Kaul Vivian Z. , Omorogbe Aisosa , Bu Daniel , Faddoul Daniel-Georges , Cosetti Maura K. , Wanna George B.
Published: June 2020

Objective:

To determine risk factors for readmission, prolonged length of stay, and discharge to a rehabilitation facility in patients with acute mastoiditis. Trends in treatment and complication rates were also examined.

Study Design:

Retrospective cohort study.

Setting:

Nationwide Readmissions Database (2013, 2014).

Patients:

Pediatric and adult patients in the Nationwide Readmissions Database with a primary diagnosis of acute mastoiditis.

Interventions:

Medical treatment, surgical intervention.

Outcome Measures:

Rates of and risk factors for readmission, prolonged length of stay, and discharge to a rehabilitation facility. Procedure and complication rates were also examined.

Results:

Four thousand two hundred ninety-five pediatric and adult admissions for acute mastoiditis were analyzed. The overall rates of readmission, prolonged length of stay, and discharge to a rehabilitation facility were 17.0, 10.4, and 10.2%, respectively. Children 4 to 17 years of age had the highest rates of intracranial complications, and children ≤3 years were most likely to undergo operative intervention. Any procedure was performed in 31.2% of cases, and undergoing myringotomy or mastoidectomy was associated with lower rates of readmission but higher rates of prolonged length of stay. Those with intracranial complications and subperiosteal abscesses had the highest surgical intervention rates.

Conclusions:

Readmission, prolonged length of stay, and discharge to a rehabilitation facility are common in patients with acute mastoiditis with various sociodemographic and disease-related risk factors. While once a primarily surgical disease, a minority of patients in our cohort underwent procedures. Undergoing a surgical procedure was protective against readmission but a risk factor for prolonged length of stay.