bluuebunny/crossref_metadata_2025 huggingface dataset:
GENETICS OF LARGE PIGMENT EPITHELIAL DETACHMENTS IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Mouallem-Beziere Alexandra , Blanco-Garavito Rocio , Richard Florence , Miere Alexandra , Jung Camille , Rozet Jean-Michel , Souied Eric H.
Published: February 2019

Purpose:

We hypothesized that severe forms of neovascular age-related macular degeneration (AMD) such as large pigment epithelial detachments poorly responding to anti–vascular endothelial growth factor therapy might present a distinct genotype compared with overall series of neovascular AMD.

Methods:

This is a multicenter genetic association study. Sixty-eight patients presenting pigment epithelial detachments resistant to ranibizumab (issued from ARI2 study, register number NCT02157077 on clinicaltrials.gov) were compared with two series of patients derived from previously published clinical studies, presenting neovascular AMD (NAT2 study n = 300 and PHRC study n = 1,127), and with healthy controls (n = 441). The phenotype of neovascular AMD groups was based on visual acuity measurement, fundus examination, spectral-domain optical coherence tomography, and angiographic data. All samples were genotyped for three single-nucleotide polymorphisms: CFH (rs1061170), ARMS2 (rs10490924), and C3 (rs2230199). Significant difference in allele frequency between participants with neovascular AMD and control was the main outcome measurement.

Results:

The GG genotype of the C3 rs2230199 was significantly more frequent in the ARI2 group (55.9%) than the PHRC group (6.0%, P < 0.0001; odds ratio = 24.0 [95% confidence interval 10.4–55.0]) and the NAT2 group (5.1%, P < 0.0001; odds ratio = 16.1 [95% confidence interval 5.0–51.9]). The repartition of patients carrying a T allele of the ARMS2 (rs10490924) or patients carrying a C allele of the CFH (rs1061170) was similar in the ARI2 group when compared with the NAT2 and PHRC groups.

Conclusion:

In our series, the genotype GG of C3 rs2230199 was more significantly associated with the phenotype of large vascularized pigment epithelial detachment poorly responding to anti–vascular endothelial growth factor therapy than in global AMD series.
ONE-YEAR OUTCOMES OF A NOVEL SURGICAL APPROACH FOR FIXATION OF A POSTERIOR CHAMBER INTRAOCULAR LENS USING GORE-TEX SUTURE
Authors: Bonnell Alyssa C. , Mantopoulos Dimosthenis , Fine Howard F. , Shah Sumit P. , Wheatley H. Matthew , Prenner Jonathan L.
Published: February 2019

Purpose:

To report the 1-year outcomes of a novel surgical technique for the fixation of a CZ70BD intraocular lens with Gore-Tex suture using cow-hitch knots.

Methods:

A retrospective chart review of 15 patients (13 men and 2 women) who underwent fixation of a posterior chamber intraocular lens with Gore-Tex suture was performed. Short- and long-term outcomes data were collected 1 month and 1 year after surgery, respectively.

Results:

Fourteen of the 15 patients met inclusion criteria and were included in the analysis. Mean visual acuity improved significantly from Snellen 20/491 preoperatively to Snellen 20/59 at postoperative month 12 (P = 0.002). The most common short-term complications included increased intraocular pressure (n = 6) and cystoid macular edema (n = 4). The most common long-term complications included increased intraocular pressure (n = 2) and iris capture of the intraocular lens (n = 2).

Conclusions:

One-year outcome data suggest that this technique is a reasonable surgical option for secondary intraocular lens placement in patients who lack capsular support.
OPTICAL COHERENCE TOMOGRAPHY LEAKAGE IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Farinha Cláudia , Santos Torcato , Santos Ana Rita , Lopes Marta , Alves Dalila , Silva Rufino , Cunha-Vaz José
Published: February 2019

Purpose:

To test optical coherence tomography leakage in the identification and quantification of choroidal neovascularization–related fluid, its change after anti–vascular endothelial growth factor therapy in neovascular age-related macular degeneration eyes and its relation to functional outcome.

Methods:

Prospective analysis of a cohort of neovascular age-related macular degeneration cases treated with 2.0-mg intravitreal aflibercept. Eyes included were analyzed before, 1-week, and 1-month after one injection. Best-corrected visual acuity was assessed using Early Treatment Diabetic Retinopathy Study method. Optical coherence tomography leakage maps depicting low optical reflectivity (LOR) sites were acquired with OCT Cirrus AngioPlex (Zeiss, Dublin, CA). The LOR area ratio was correlated to retinal thickness and best-corrected visual acuity. Optical coherence tomography angiography was simultaneously performed.

Results:

Twenty-two eyes of 18 patients with neovascular age-related macular degeneration were included. The LOR ratio of the full retina scan and retinal pigment epithelium–Bruch layer decreased from baseline to Month 1 (P < 0.05). Changes in retinal thickness and LOR ratio were positively correlated (P < 0.05). Best-corrected visual acuity change correlated with the outer segment layer LOR change (rho = −0.53, P = 0.014), and LOR was inferior in better responders (P = 0.021). Optical coherence tomography leakage identified eyes with recurrent fluid in the external layers.

Conclusion:

Optical coherence tomography leakage identified and quantified the fluid related to choroidal neovascularization activity. Low optical reflectivity change in the outer segment layer correlates with functional outcome and increasing LOR in the external layers may be a marker of early recurrence. Combining optical coherence tomography angiography and optical coherence tomography leakage allows both for choroidal neovascularization morphology and activity analysis.
Cervical Vestibular Evoked Myogenic Potentials in Menière's Disease: A Comparison of Response Metrics
Authors: Noij Kimberley S. , Herrmann Barbara S. , Guinan John J. , Rauch Steven D.
Published: February 2019

Objective:

The cervical vestibular evoked myogenic potential (cVEMP) has been used to evaluate patients with Menière's disease (MD). Studied cVEMP metrics include: amplitude, threshold, frequency tuning, and interaural asymmetry ratio (IAR). However, few studies compared these metrics in the same set of MD patients, and methodological differences prevent such a comparison across studies. This study investigates the value of different cVEMP metrics in distinguishing one set of MD patients from age-matched controls.

Study Design:

Prospective study.

Setting:

Tertiary care center.

Patients:

Thirty patients with definite unilateral MD and 23 age-matched controls were prospectively included. All underwent cVEMP testing at 500, 750, 1000, and 2000 Hz on each side. Ears were separated into three groups: affected MD, unaffected MD, and control.

Main Outcome Measures:

Sound level functions were obtained at each frequency, and normalized peak-to-peak amplitude (VEMPn), VEMP inhibition depth (VEMPid), threshold, frequency-tuning ratio, and IAR were calculated. For all metrics, the differentiation between MD and control ears was compared using receiver operating characteristic (ROC) curves.

Results:

500 Hz cVEMP threshold, VEMPn, and VEMPid were similarly good at distinguishing affected MD ears from healthy ears, with ROC area under the curves (AUCs) of more than 0.828 and optimal sensitivities and specificities of at least 80 and 70%. Combinations of these three metrics yielded slightly larger AUCs (>0.880). Tuning ratios and IAR were less effective in separating healthy from affected ears with AUCs ranging from 0.529 to 0.720.

Conclusion:

The cVEMP metrics most useful in distinguishing MD patients from healthy controls are threshold, VEMPn, and VEMPid, using 500 Hz stimuli.
Isolated Traumatic Fracture of the Malleus Handle Causing Hearing Fluctuation
Authors: Cavada Marina Neves , Patel Nirmal
Published: February 2019

Introduction:

Handle of malleus fracture is a rare condition with <100 cases having been reported. The clinical presentation is conductive hearing loss following a history of trauma, typically, during manipulation of the external auditory canal. The diagnosis of the condition is clinical and radiological. The options for treatment are either a hearing aid or ossiculoplasty. We describe an isolated case of malleus handle fracture after trauma associated with manipulation of the external auditory canal.

Case report:

A 56-year-old female, reported a right ear trauma. She suffered immediate otalgia, hearing loss and nonpulsatile tinnitus. An indistinct umbo was identified on endoscopic inspection and a hypermobile right tympanic membrane during Valsalva. Clinical testing of hearing revealed a mild-to-moderate conductive hearing loss. Computed Tomography scan revealed a fracture of the right malleus handle. A decision for surgical treatment was made based on continuing symptomatology as well as audiology and CT findings. A tragal composite cartilage graft was harvested and placed over the remaining superior part of the malleus and under the inferior fragment of the malleus attached to the tympanic membrane. The patient had immediate improvement of fluctuating hearing loss and tinnitus in the postoperative period.

Conclusion:

A fracture of the malleus handle should be included in the etiologies of conductive hearing loss after trauma. A careful history, thorough otology examination, and a meticulous analysis of the CT will usually confirm this rare condition and exclude other ossicular abnormalities.
Remote Programming of Cochlear Implants
Authors: Slager Heidi K. , Jensen Jamie , Kozlowski Kristin , Teagle Holly , Park Lisa R. , Biever Allison , Mears Megan
Published: February 2019

Objective:

This study investigated the safety and efficacy of remote programming of cochlear implants.

Study Design:

Single-subject design

Setting:

Four North American clinical sites

Patients:

Forty cochlear implant recipients aged 12 years or older

Intervention:

Subjects had their cochlear implants programmed at a location that was remote from their audiologist using telecommunication with and without the support of a facilitator.

Main Outcome Measures:

Consonant-Nucleus-Consonant (CNC) word scores and the Speech, Spatial, and Qualities of Hearing Scale-C (SSQ-C) were compared using the subject's in-office MAP (program) and MAPs programmed remotely with and without the assistance of a facilitator. Additional subjective preference data were gathered from subjects and audiologists via questionnaires.

Results:

MAPs programmed via the three different models did not yield significantly different group mean CNC word scores. No device/procedure-related adverse events occurred. SSQ-C questionnaire results indicated that recipients received similar subjective benefit from familiar in-office, remote-facilitated, and remote-unassisted MAPs.

Conclusions:

Remote programming is an effective means of cochlear implant service delivery. The practice was approved by the FDA on November 17, 2017 supported by the results of this study.
Hearing Preservation in Pediatric Recipients of Cochlear Implants
Authors: Selleck A. Morgan , Park Lisa R. , Choudhury Baishakhi , Teagle Holly F. B. , Woodard Jennifer S. , Gagnon Erika B. , Brown Kevin D.
Published: February 2019

Objective:

To determine factors that influence low-frequency hearing preservation following pediatric cochlear implantation and compare hearing preservation outcomes between 20 and 24 mm depth lateral wall electrodes.

Study Design:

Retrospective chart review.

Setting:

Tertiary academic referral center.

Patients:

Pediatric cochlear implant recipients (under the age of 18) who presented preoperatively with a low-frequency pure tone average (LFPTA; 125, 250 and 500 Hz) ≤ 70 dB HL.

Intervention:

Cochlear implantation

Main Outcome Measures:

Multiple logistic regression evaluating the influence of variables on change in LFPTA including preoperative low-frequency hearing, lateral wall or perimodiolar electrode, progressive vs stable hearing, side, time from surgery, and the presence or the absence of enlarged vestibular aqueduct. A second analysis reviews the 12-month postactivation hearing preservation of a subset of subjects implanted with modern lateral wall electrodes.

Results:

A total of 105 subjects were included from the last 10 years for our multiple logistic regression analysis. This demonstrated a significant correlation of poorer preoperative low-frequency hearing with change in LFPTA. A significant negative effect of electrode type, specifically perimodiolar electrodes was also seen. Forty-five subjects from the last 3 years undergoing cochlear implantation with a lateral wall electrode demonstrated an overall 12-month preservation rate (LFPTA < 90 dB) of 82%. Differences in preservation rates existed between different electrodes.

Conclusion:

Preservation of low-frequency hearing following cochlear implantation is predicted both by preoperative low-frequency hearing as well as type of electrode implanted. Consistent low-frequency hearing preservation is possible in pediatric subjects receiving lateral wall electrodes, although differences exist between electrode types.
Bilateral Cochlear Implants Using Two Electrode Lengths in Infants With Profound Deafness
Authors: Dunn Camille C. , Walker Elizabeth A. , Gogel Stephanie , Van Voorst Tanya , Hansen Marlan , Gantz Bruce J.
Published: February 2019

Objective:

The goal of this investigation was to determine if a short electrode in one ear and standard electrode in the contralateral ear could be an option for infants with congenital profound deafness to theoretically preserve the structures of the inner ear. Similarities in performance between ears and compared with a control group of infants implanted with bilateral standard electrodes was evaluated.

Study Design:

Repeated-measure, single-subject experiment.

Setting:

University of Iowa—Department of Otolaryngology.

Participants:

Nine infants with congenital profound bilateral sensorineural hearing loss.

Intervention(s):

Short and standard implants.

Main Outcome Measure(s):

Early speech perception test (ESP), children's vowel, phonetically balanced-kindergarten (PB-K) word test, and preschool language scales-3 (PLS-3).

Results:

ESP scores showed performance reaching a ceiling effect for the individual short and standard ears and bilaterally. The children's vowel and PB-K word results indicated significant (both p < 0.001) differences between the two ears. Bilateral comparisons to age-matched children with standard bilateral electrodes showed no significant differences (p = 0.321) in performance. Global language performance for six children demonstrated standard scores around 1 standard deviation (SD) of the mean. Two children showed scores below the mean, but can be attributed to inconsistent device usage. Averaged total language scores between groups showed no difference in performance (p = 0.293).

Conclusions:

The combined use of a short electrode and standard electrode might provide an option for implantation with the goal of preserving the cochlear anatomy. However, further studies are needed to understand why some children have or do not have symmetric performance.
Relationship Between Objective and Behavioral Audiology for Young Children Being Assessed for Cochlear Implantation: Implications for CI Candidacy Assessment
Authors: Leigh Jaime , Farrell Rebecca , Courtenay Denise , Dowell Richard , Briggs Robert
Published: February 2019

Objective:

This study aimed to evaluate the feasibility of making cochlear implant recommendations based on diagnostic ABR and ASSR results. The goal was to challenge the need for behavioral audiometry as part of the standard cochlear implant assessment battery for infants with profound hearing loss and to reduce the age at which cochlear implant recommendation was made.

Study Design:

A retrospective review of 123 patient files for children referred to the pediatric cochlear implant service before 3 years of age over a 3-year period was undertaken. Results for click-ABR, ASSR, and behavioral audiology at 500, 1k, 2k and 4k Hz, and tympanometry were collected and relationships were investigated for 64 children who met the inclusion criteria. Data were excluded for 59 children due to the presence of auditory neuropathy findings, middle ear pathology at the time of testing, if ASSR was not assessed at intensity levels >85 dB, and/or behavioral testing was judged to be unreliable by two experienced clinicians.

Setting:

Primary care pediatric cochlear implant program located within a hospital setting.

Patients:

Pediatric patients referred for cochlear implant evaluation before 3 years of age.

Interventions(s):

Children were assessed using ABR, ASSR, and behavioral audiometry for identification and confirmation of hearing loss.

Main Outcome Measures(s):

Correlation between diagnostic click-ABR and ASSR thresholds and subsequently obtained behavioral hearing thresholds.

Results:

Results for objective measures (click-ABR and ASSR) were significantly correlated with behavioral results. The correlations, however, were poorer than expected with limited predictive value. For 6 of the 64 children click-ABR and/or ASSR suggested profound hearing loss and corresponding behavioral hearing threshold was found to be in the severe hearing loss range.

Conclusions:

Findings of this study do not support making cochlear implant recommendations based on the findings of diagnostic click-ABR and ASSR alone. Investigating ways to reduce the average age children with severe-to-profound hearing loss receive a cochlear implant is a priority for the study institution. An alternate evaluation pathway for infants which incorporates a multifaceted assessment is warranted and will be the focus of future work at the study institution.
Hybrid Music Perception Outcomes: Implications for Melody and Timbre Recognition in Cochlear Implant Recipients
Authors: Parkinson Aaron J. , Rubinstein Jay T. , Drennan Ward R. , Dodson Christa , Nie Kaibao
Published: February 2019

Objective:

To examine whether or not electric–acoustic music perception outcomes, observed in a recent Hybrid L24 clinical trial, were related to the availability of low-frequency acoustic cues not present in the electric domain.

Study Design:

Prospective, repeated-measures, within-subject design.

Setting:

Academic research hospital.

Subjects:

Nine normally hearing individuals.

Intervention:

Simulated electric–acoustic hearing in normally hearing individuals.

Main Outcomes Measures:

Acutely measured melody and timbre recognition scores from the University of Washington Clinical Assessment of Music Perception (CAMP) test.

Results:

Melody recognition scores were consistently better for listening conditions that included low-frequency acoustic information. Mean scores for both acoustic (73.5%, S.D. = 15.5%) and electric–acoustic (67.9%, S.D. = 21.2%) conditions were significantly better (p < 0.001) than electric alone (39.2%, S.D. = 18.1%). This was not the case for timbre recognition for which scores were more variable across simulated listening modes with no significant differences found in mean scores across electric (36.1%, S.D. = 17.7%), acoustic (38.0%, S.D. = 20.4%), and electric–acoustic (40.7%, S.D. = 19.7%) conditions (p > 0.05).

Conclusion:

Recipients of hybrid cochlear implants demonstrate music perception abilities superior to those observed in traditional cochlear implant recipients. Results from the present study support the notion that electric–acoustic stimulation confers advantages related to the availability of low-frequency acoustic hearing, most particularly for melody recognition. However, timbre recognition remains more limited for both hybrid and traditional cochlear implant users. Opportunities remain for new coding strategies to improve timbre perception.
Training of Speech Perception in Noise in Pre-Lingual Hearing Impaired Adults With Cochlear Implants Compared With Normal Hearing Adults
Authors: Bugannim Yossi , Roth Daphne Ari-Even , Zechoval Doreen , Kishon-Rabin Liat
Published: February 2019

Background:

Speech perception in noise remains a significant challenge for cochlear implant (CI) users in everyday life. It has been argued that training to use the information provided by the CI is as important as technological advances. So far, however, only few studies have trained speech perception in noise, most (if not all) included postlingually deafened CI adult users using non-sentence training material.

Objective:

To assess the effect of training on a speech perception in noise task in prelingually hearing-impaired CI users with years of CI experience, as compared with normal-hearing (NH) young adults, following single- and multi-session training using the same training protocol.

Methods:

Participants included 22 CI users with prelingual hearing loss and 30 NH. The Hebrew version of the Matrix sentence-in-noise test was used for training. All participants took part in a single training session. Six NH and seven CI continued training for four additional training sessions. All seven CI users trained for additional 5 days, totaling 10 training sessions. Generalization and retention of learning gains were assessed.

Results:

Following single-session training, CI users showed speech reception thresholds in noise (SRTn) that were 9 to 10 dB higher than NH. After 5 first days of training, five of seven CI users reduced this disadvantage by half. After 10 days of training the CI improved performance by 4.1 dB SNR. No generalization and partial retention of learning were demonstrated.

Conclusions:

The present study is the first to demonstrate the course of learning and improvements in SRTn following training speech perception in noise in CI users with prelingual hearing loss.
Cross-cultural Adaption and Validation of the Zurich Chronic Middle Ear Inventory Translated Into Italian (ZCMEI-21-It)—a Prospective Multicenter Study
Authors: Ralli Massimo , Quaranta Nicola , Canale Andrea , Röösli Christof , Milella Claudia , De Robertis Valentina , De Soccio Giulia , Greco Antonio , Ralli Giovanni , Albera Roberto , de Vincentiis Marco , Huber Alexander M. , Bächinger David
Published: February 2019

Objective:

There are no instruments available to comprehensively assess health-related quality of life (HRQoL) in chronic otitis media (COM) in Italian-speaking countries. The Zurich chronic middle ear inventory (ZCMEI-21) is a well-established instrument for the assessment of HRQoL in COM. The objective of this study was to translate and cross-culturally adapt the ZCMEI-21 into Italian and validate this questionnaire for measuring HRQoL in patients with COM.

Study Design:

Prospective multicenter study.

Setting:

Three University hospitals (northern Italy, central Italy, southern Italy).

Patients:

Adult patients suffering from COM (n = 128).

Intervention:

Following international guidelines, the ZCMEI-21 was translated into Italian (ZCMEI-21-It). Validation was performed by psychometric test statistics. Moreover, ZCMEI-21-It total and subscale scores were compared and correlated with 1) the scores of the original validation study, 2) to a question that directly addresses HRQoL, and 3) to the scores of the EQ-5D-5L, a generic questionnaire assessing HRQoL.

Results:

From three study centers, a total of 128 patients with COM were included. Cronbach's α was 0.86 indicating a high reliability. Between the ZCMEI-21-It total score and the question that directly addresses HRQoL, we found a strong correlation (r = 0.62, p < 0.0001). Between the ZCMEI-21-It total score and the EQ-5D-5L scores, we expectedly found moderate correlations (descriptive system score: r = 0.39, p < 0.0001; visual analog scale: r = 0.30, p = 0.008).

Conclusion:

We translated the ZCMEI-21 questionnaire into Italian and validated the ZCMEI-21-It in a prospective multicenter study. The ZCMEI-21-It is the first instrument that comprehensively assesses relevant dimensions of HRQoL in Italian-speaking patients affected by COM.
Impact of Microphone Configuration on Speech Perception of Cochlear Implant Users in Traffic Noise
Authors: Weissgerber Tobias , Bandeira Mariana , Brendel Martina , Stöver Timo , Baumann Uwe
Published: February 2019

Objective:

The aim of this study was to investigate the impact of microphone configuration and noise reduction algorithm on speech perception of cochlear implant (CI) users in a moving noise setup.

Method:

Eleven CI users provided with Advanced Bionics implant systems participated in this study. All tests were conducted with three different microphone settings: (a) omnidirectional behind the ear (BTE), (b) inside the pinna (ITP), and (c) adaptive directional microphone (adaptive beamformer, ABF). Speech reception thresholds (SRTs) were measured using the Oldenburg sentence test in a moving noise source condition. Furthermore, the effect of a noise reduction algorithm on speech perception was measured in a condition with an additional static noise source.

Results:

The ABF setting significantly improved SRT by 5.7 dB compared with the BTE microphone, and by 4.7 dB compared with the ITP microphone in the moving noise condition. In the presence of an additional static noise source, there was a significant improvement in SRT of 0.9 dB with the use of NR in addition to ABF.

Conclusion:

Adaptive beamforming can significantly improve speech perception in moving noise. Depending on the noise condition, the combination of ABF with NR can provide additional benefit.
Partial Ossiculoplasty: Malafronte's Double Cartilage Block Versus Incus
Authors: Filosa Barbara , Previtero Giorgio , Novia Generoso , Trusio Antonio , Malafronte Giuseppe
Published: February 2019

Objectives:

To describe the outcomes of Malafronte's double cartilage block (mDCB) and incus autograft protheses, and to determine which prosthesis gives better and lasting hearing results.

Study Design:

Prospective study.

Setting:

ENT Department of AORN “S.G. Moscati” Avellino, Italy

Materials and Methods:

Partial columellar ossiculoplasties were performed on 102 patients. Malafronte's DCB was used on 58 patients (group 1). The reshaped autologous incus was used on 44 patients (group 2). The main follow-up for the whole study group was 4.5 years.

Main Outcome Measures:

Mean postoperative air-bone gap (ABG) closure to < 20 dB, incidences of prosthesis availability, prosthesis displacement from the tympanic membrane, and prothesis fixation to the middle ear walls.

Results:

The hearing results and incidences of prosthesis availability, prosthesis slippage, and prosthesis fixation between groups 1 and 2 were significantly different. At the end of follow-up, a postoperative ABG of 20 dB or less occurred in 87.9% (n = 51) of patients in the group 1 and in 54.5% (n = 24) of patients in group 2. The Malafronte's DCB was always usable. While in 13.7% of cases, the incus was not usable. Prosthesis displacement and prothesis fixation were not observed in group 1. However, they were observed in 15 (34%) and 5 (11.3%) group 2 patients, respectively.

Conclusion:

The Malafronte's DCB gives more consistent hearing results.

Level of Evidence:

1b
An Assessment of the Change in Compliance of Observational Otology and Audiology Studies With the STROBE Statement Guidelines: A Systematic Review
Authors: Swords Chloe , Bhargava Eishaan Kamta , Meghji Sheneen , Smith Matthew E. , Tysome James R.
Published: February 2019

Objectives:

Observational studies often represent the best available evidence for surgical practice. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations were generated in 2007 with the aim of improving the quality of reporting. This study was designed to assess whether publication of STROBE guidelines has improved the quality of reporting in observational otology and audiology studies.

Data Sources:

EMBASE and MEDLINE were searched using a comprehensive keyword search developed in conjunction with a scientific librarian.

Study Selection:

English language papers from six Otorhinolaryngology journals during two 6-month periods (2005 and 2016) were evaluated.

Data Extraction:

Two reviewers independently analyzed papers according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data Synthesis:

Percentage scores for the two periods were compared using Mann–Whitney U test.

Conclusions:

Forty and 42 studies were returned for the 2005 and 2016 periods, respectively. The mean percentage of STROBE items that were met improved between 2005 and 2016 (58, 76%, respectively; p < 0.0001). Analysis indicated that improvements were greater in journals that endorsed STROBE guidelines (p = 0.02). This data suggests that STROBE has increased the reporting quality of observational studies; however, there are still significant further improvements to be met.
Involvement of the Internal Auditory Canal in Subjects With Cochlear Otosclerosis: A Less Acknowledged Third Window That Affects Surgical Outcome
Authors: Shim Ye Ji , Bae Yun Jung , An Gwang Seok , Lee Kyogu , Kim Yoonjoong , Lee Sang-Youp , Choi Byung Yoon , Choi Byung Se , Kim Jae Hyoung , Koo Ja-Won , Song Jae-Jin
Published: February 2019

Objective:

To investigate the effects of cavitating lesions involving the internal auditory canal (IAC) in subjects with cochlear otosclerosis with regard to poststapedotomy hearing outcome.

Study Design:

Retrospective study.

Setting:

Tertiary referral center.

Patients:

A retrospective chart review of 134 subjects with otosclerosis treated from January 2011 to June 2017 at Seoul National University Bundang Hospital was conducted. Sixteen subjects (23 ears) with temporal bone computed tomography (TBCT)-confirmed cochlear otosclerosis who underwent stapedotomy were included in the study.

Main Outcome Measures:

Pure tone audiometry (PTA) (i.e., air and bone conduction; AC and BC, respectively) thresholds and air–bone gap (ABG), measured at 6 months postoperatively were compared between cochlear otosclerosis with and without IAC involvement (IAC group and non-IAC group, respectively).

Results:

A total of 14 of 23 ears showed involvement of the IAC. There were no significant differences in age, side of otosclerosis, or preoperative hearing threshold between the two groups. The mean postoperative AC and BC thresholds and ABG of the IAC group were significantly poorer (45.7 dB, 33.8 dB, and 11.8 dB, respectively) than those of the nonIAC group (24.1 dB, 20.0 dB, and 4.1 dB, respectively).

Conclusions:

Cochlear otosclerosis with cavitating lesions involving the IAC showed significantly poorer postoperative audiological outcomes than those without any cavitating lesion. Cavitation extending to the IAC may act as a third window providing a route for sound energy shunting, and thus precluding successful hearing outcome in some subjects with cavitating otosclerosis after stapedotomy.
Longitudinal Analysis of “Window Shade” Tympanoplasty Outcomes for Anterior Marginal Tympanic Membrane Perforations
Authors: Bluher Andrew E. , Mannino Elizabeth A. , Strasnick Barry
Published: February 2019

Objectives:

Although many techniques have been proposed for the repair of tympanic membrane perforations, few address the unique challenges presented by anterior marginal perforations. In these circumstances, traditional underlay and overlay techniques are often complicated by issues including blunting of the anterior tympanomeatal angle, graft lateralization, delayed healing, and reduced graft take rates. The “window shade” tympanoplasty technique described in this paper incorporates several aspects of the underlay and overlay techniques to address these issues.

Study Design and Setting:

A retrospective chart review was conducted at an academic medical center, of all patients who underwent window shade tympanoplasty from 1994 to 2016 by a single surgeon.

Patients:

A total of 412 patients aged 6 to 76 years old were included in the study. Patients who had undergone concomitant ossicular chain reconstruction were excluded from the hearing outcome portion of the analysis.

Main Outcome Measures:

Any patients observed to have residual postoperative perforations within the first 6 months after surgery were considered to have graft failure. Complications such as otorrhea, serous otitis media, epithelial pearls, and post-auricular infection were tabulated. Air-bone gap closure was also assessed.

Results:

Postoperative outcomes of 412 patients were assessed including graft take rate, complication rates, and air-bone gap closure. The graft take success rate was 94.2%. Overall complication rate was 4.6%. 82.6% of patients achieved air-bone gap closure within 10 dB.

Conclusions:

The results of this study further reinforce the success of the window shade technique in repairing anterior marginal tympanic membrane perforations.
Phosphodiesterase-5 (PDE-5) Inhibitors and Ototoxicity: A Systematic Review
Authors: Manna Sayan , Gray Mingyang Liu , Kaul Vivian F. , Wanna George
Published: February 2019

Objective:

This study explores the current literature regarding associations between phosphodiesterase-5 (PDE-5) inhibitors and ototoxicity and provides a detailed summary and discussion of the findings.

Data Sources:

A comprehensive electronic search of PubMed/MEDLINE, Scopus, and Cochrane Library for studies published from database inception through March 21, 2018.

Study Selection:

Basic science articles, epidemiological studies, randomized controlled trials, cohort studies, case reports, reviews, meta-analyses, press releases, and newsletters were included. The PRISMA search strategy was used to select papers. Search terms are included in the appendix (http://links.lww.com/MAO/A733).

Results:

Twenty-two articles met the inclusion criteria. Among case reports, there were a total of nine patients, all male, with an average age of 57.4 years (37–79 years, SD = 13.87 years). Of the cases of hearing loss, 25% (2/8 cases) were bilateral and 75% (6/8) were unilateral; 22% (2/9) were associated with tinnitus; and 33% (3/9) had accompanying vestibular symptoms (including vertigo and dizziness). Among multipatient studies, all prospective studies failed to find a significant association between ototoxicity and PDE-5 inhibitor use. Results of the retrospective studies were also heterogeneous. Many key molecules in the PDE-5 inhibition pathway have been demonstrated to exist in the cochlea. However, mirroring the clinical studies, the basic science mechanisms have suggested both ototoxic and otoprotective effects.

Conclusions:

Currently, the literature is inconclusive regarding the interaction between PDE-5 inhibitor use and ototoxicity. Future study such as a double-blinded placebo controlled randomized trial with audiometric assessment would provide more sound evidence. Similarly, a unified molecular model is necessary.
The Biomechanics of Lesion Formation in Endolymphatic Hydrops: Single and Double Hit Mechanisms
Authors: Pender Daniel J.
Published: February 2019

Background:

The vestibular membranes of the cochlea and saccule are subject to two simultaneous constraints as they deform in endolymphatic hydrops. Boundary tethers impose a bulge-type constraint during pressure-induced transverse membrane displacement, while inherent elasticity imposes a stretch-type constraint during stress-induced longitudinal membrane distention.

Objective:

The aim of this study is to reconcile the effect of these dual constraints on membrane deformation. It is hypothesized that it is the interaction of these constraints that determines whether a stable membrane configuration can be achieved or progression to endolymphatic hydrops will occur.

Methods:

Reissner's membrane was modeled as a flat elastic ribbon that was bound along its lateral edges and subject to trans-mural pressure. The bulge and stretch constraints on membrane deformation were formulated mathematically. A graphic solution of the constraint functions was used to examine the nature of the interaction and determine how pressure and elasticity influence the hydropic process.

Results:

The graphic analysis shows how bulge and stretch phenomena interact to achieve an equilibrium point that satisfies both physical requirements. Nominal values of pressure and elasticity are projected to result in a stable membrane equilibrium in the precritical zone with the modest isolated increases in either parameter alone compatible with stability. However, a sufficiently large increase in either pressure or elasticity alone can constitute a single hit mechanism to exceed the critical point and destabilize the membrane. Moreover, simultaneous modest increases in both pressure and elasticity, neither of which would be sufficient in its own right, can be additive and constitute a double hit mechanism to destabilize the membranes as well. Finally, extreme values of pressure and elasticity that fail to intersect imply that no solution is feasible and that the affected membranes will fail immediately.

Conclusions:

Sufficiently large increases in either endolymphatic pressure or membrane elasticity alone can destabilize the membranes and constitute single hit mechanisms for inducing hydrops. Combined moderate increases in both trans-mural pressure and membrane elasticity can also destabilize the membranes and constitute a double hit mechanism for hydrops induction.
Thirty Years of Lactobacillus rhamnosus GG
Authors: Capurso Lucio
Published: February 2019

Lactobacillus rhamnosusGG (LGG) was the first strain belonging to the genusLactobacillusto be patented in 1989 thanks to its ability to survive and to proliferate at gastric acid pH and in medium containing bile, and to adhere to enterocytes. Furthermore LGG is able to produces both a biofilm that can mechanically protect the mucosa, and different soluble factors beneficial to the gut by enhancing intestinal crypt survival, diminishing apoptosis of the intestinal epithelium, and preserving cytoskeletal integrity. Moreover LGG thanks to its lectin-like protein 1 and 2 inhibits some pathogens such asSalmonellaspecies. Finally LGG is able to promote type 1 immune-responsiveness by reducing the expression of several activation and inflammation markers on monocytes and by increasing the production of interleukin-10, interleukin-12 and tumor necrosis factor-α in macrophages. A large number of research data onLactobacillusGG is the basis for the use of this probiotic for human health. In this review we have considered predominantly randomized controlled trials, meta-analysis, Cochrane Review, guide lines of Scientific Societies and anyway studies whose results were evaluated by means of relative risk, odds ratio, weighted mean difference 95% confidence interval. The effectiveness of LGG in gastrointestinal infections and diarrhea, antibiotic andClostridium difficileassociated diarrhea, irritable bowel syndrome, inflammatory bowel disease, respiratory tract infections, allergy, cardiovascular diseases, nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, cystic fibrosis, cancer, elderly end sport were analyzed.
A Survey of Nurse Leaders to Explore the Relationship Between Grit and Measures of Success and Well-being
Authors: Seguin Claire
Published: February 2019

OBJECTIVE

The aim of this study was to explore how a personality quality termed grit impacts the well-being and success of nurses who serve in positions of healthcare leadership.

BACKGROUND

As the responsibilities of nurse leaders become increasingly complex, there is concern that job satisfaction is becoming more difficult, and burnout and attrition more common. Grit, perseverance, and passion for long-term goals are associated with reduced burnout and predictable success in other industries, but less is known about its impact on nurse leaders.

METHODS

Surveys measuring grit and well-being were completed by nurses who identified as leaders.

RESULTS

Grit was significantly related to an increased sense of personal accomplishment, increased longevity in leadership roles, and reduced burnout.

CONCLUSIONS

Grit contributes to longevity and associates with both higher educational attainment and lower scores for burnout among a large group of nurse leaders surveyed across the United States.
Brief Report: Syphilis Coinfection Is Not Associated With an Increased Risk of Virologic Failure Among HIV-Positive Men Who Have Sex With Men on Antiretroviral Therapy
Authors: Grewal Ramandip , Allen Vanessa G. , Bayoumi Ahmed M. , Gardner Sandra L. , Kaul Rupert , Mazzulli Tony , Moravan Veronika , O'Neill Tyler , Raboud Janet , Rourke Sean B. , Tan Darrell H. S. , Burchell Ann N. ,   in collaboration with the OHTN Network Cohort Study Research Team
Published: February 2019

Background:

Incidence of syphilis continues to increase among HIV-positive men who have sex with men (MSM) in Ontario. Our objective was to determine the effect of acute syphilis on virologic failure (VF) among virally suppressed HIV-positive MSM taking antiretroviral therapy (ART) and determine if the relationship is confounded by drug use.

Setting:

The OHTN Cohort Study is a voluntary cohort of people receiving HIV care in Ontario. Syphilis and viral load (VL) data were retrieved via linkage with the provincial laboratory.

Methods:

Analyses included 2632 MSM from 2008 to 2015, on ART, with ≥1 questionnaire and 2 consecutive VL of <50 copies per milliliter 6 months apart. VF was defined as (1) VL of ≥1000 copies per milliliter or (2) 2 consecutive VLs of ≥200 copies per milliliter ≥1 month apart. We modeled acute syphilis as a time-varying covariate on VF using Poisson regression. Time-varying drug use was assessed for confounding using an iterative process where potential confounders were removed and then reintroduced into the model. Our model allowed for repeat observations using generalized estimating equations.

Results:

VF incidence was 3.5 per 100 person-years [95% confidence interval (CI): 3.4 to 4.2]. The rate ratio for VF for acute syphilis was 1.5 (95% CI: 0.9 to 2.4) in the unadjusted model; 1.6 (95% CI: 1.0 to 2.4) in the model adjusted for age, education, region, and income; and 1.2 (95% CI: 0.7 to 1.9) in the final model with additional adjustment for drug use.

Conclusions:

Acute syphilis was not associated with VF among virologically suppressed MSM on ART. Consequently, ART may still reduce HIV transmission risk to sexual partners.
Brief Report: Cocaine Use and Pre-exposure Prophylaxis: Adherence, Care Engagement, and Kidney Function
Authors: Hojilla Jose Carlo , Satre Derek D. , Glidden David V. , McMahan Vanessa M. , Gandhi Monica , Defechereux Patricia , Guanira Juan V. , Mehrotra Megha , Grant Robert M. , Carrico Adam W.
Published: February 2019

Background:

Concomitant use of cocaine and HIV pre-exposure prophylaxis (PrEP) raises important clinical questions around adherence, retention in care, and renal toxicity.

Methods:

We assessed the associations of confirmed cocaine use with PrEP adherence (both ascertained through objective measures), care engagement, and renal function in the iPrEx open-label extension. Cocaine use was measured in scalp hair samples and categorized as light (500–3000 pg/mg) and moderate to heavy (>3000 pg/mg). PrEP adherence in the first 3 months was measured through plasma tenofovir concentrations. Disengagement from PrEP care was defined as a gap in follow-up greater than 4 months. Serum creatinine was assessed at baseline and quarterly visits.

Results:

Of the 400 participants included in this analysis, 90% were men who have sex with men, 10% transgender women, 74% Hispanic/Latino; 21% tested positive for cocaine use in the last 3 months. In adjusted analysis, light cocaine use [adjusted odds ratio 2.10 (95% confidence interval: 1.07 to 4.14)] and moderate to heavy use [adjusted odds ratio 2.32 (1.08 to 5.00)] were associated with greater odds of having plasma tenofovir concentrations below the level of quantitation. Participants with moderate to heavy use had a nearly 3-fold higher rate of disengagement from PrEP care compared with nonusers (adjusted hazard ratio 2.90 [1.48 to 5.66]). We found no statistically or clinically significant differences in creatinine clearance and serum creatinine between participants who tested positive for cocaine and those who did not.

Conclusions:

Cocaine use decreases PrEP adherence and care engagement. Comprehensive approaches are needed to reduce cocaine use and enhance engagement along the PrEP care continuum.
A compilation of and typology for abundance-, phylogenetic- and functional-based diversity metrics
Authors: Scheiner Samuel M.
Published: February 2019

Ecologists are faced with an over-abundance of ways to measure biodiversity. In this paper, I provide a compilation of and guide through this ticket of diversity metrics. I present a typology for diversity metrics that encompasses the three commonly considered categories of information: abundance, phylogenetic relationships, and traits (i.e., function). I update and expand previous summaries of diversity metrics. The formulas of those 117 metrics are presented in a standard notation and format that makes it easy to see the mathematical similarities and differences among the metrics. Finally, I propose a standard set of symbols for many of the metrics that makes their properties immediately obvious. This compilation will make it easier for researchers to identify the metric(s) most suited to their needs and will help guide future metric development.

Disclaimer

This manuscript is based on work done while serving at (and furloughed from) the U.S. National Science Foundation. The views expressed in this paper do not necessarily reflect those of the National Science Foundation or the United States Government.
Improving Proteinuria Screening with Mailed Smartphone Urinalysis Testing in Previously Unscreened Patients with Hypertension: a Randomized Controlled Trial
Authors: Leddy Julia , Green Jamie A. , Yule Christina , Molecavage Juliann , Coresh Josef , Chang Alex R
Published: February 2019

Background

Proteinuria screening is recommended for patients with hypertension to screen for kidney disease and identify those at elevated risk for cardiovascular disease. However, screening rates among hypertensive patients are low. Home testing strategies may be useful in improving proteinuria screening adherence.

Methods

We conducted an individual-level, randomized trial at 55 primary care clinic sites in the Geisinger Health System to evaluate the effectiveness of a strategy using home smartphone urinalysis test (Dip.io) to complete proteinuria screening in previously unscreened non-diabetic patient portal users with hypertension. All patients received an educational letter and a standing urinalysis lab order, and then were randomized to control (usual care) or intervention. Intervention arm participants were invited to complete proteinuria screening with a mailed home smartphone urinalysis test. Co-primary outcomes were completion of proteinuria screening and number of albuminuria cases (albumin/creatinine ratio [ACR] ≥ 30 mg/g or protein/creatinine ratio ≥ 150 mg/g) at the end of 3 months. We also evaluated patient satisfaction with the home test, and compliance with recommendations for patients with newly detected albuminuria.

Results

A total of 999 patients were randomized to intervention or control. Out of 499 patients assigned to the intervention arm, 253 were reached by phone, and 69/97 (71.1%) consented patients completed the home test. Overall, the intervention increased proteinuria screening completion (28.9% vs. 18.0%; p<0.001) with no effect on the number of albuminuria cases (4 vs. 4) although only 6/57 (10.5%) patients with trace or 1+ urine dipstick protein had a follow-up quantitative test. Among the 55 patients who completed a survey after the home test, 89% preferred testing at home rather than the physician’s office.

Conclusions

A strategy using a home urinalysis smartphone test increased proteinuria screening rates in previously unscreened patients with hypertension and may be useful in increasing rates of proteinuria screening compliance. Future studies are needed to determine whether improving early detection of kidney disease can improve future kidney health.

Trial Registration

Clinical Trial Registry: NCT03470701

https://clinicaltrials.gov/ct2/show/NCT03470701