bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rate of Initial Hearing Loss During Early Observation Predicts Time to Non-Serviceable Hearing in Patients With Conservatively Managed Sporadic Vestibular Schwannoma
Authors: Carlson Matthew L. , Dowling Eric M. , Lohse Christine M. , O’Connell Brendan P. , Driscoll Colin L. W. , Haynes David S. , Link Michael J. , Hunter Jacob B. 
Published: October 2019

Objective:
To date, prediction models for estimating risk of acquiring non-serviceable hearing in subjects with observed vestibular schwannoma (VS) have evaluated outcomes primarily based on features at initial diagnosis. Herein, we evaluate the association of rate of hearing decline during the initial period of observation with time to non-serviceable hearing. If significant, rate of hearing decline may inform decision making after an introductory period of observation.

Setting:
Two tertiary care centers.

Patients:
VS patients with serviceable hearing who underwent at least three audiograms and two magnetic resonance imaging (MRI) studies before intervention or being lost to follow-up. The rate of change in pure-tone average (PTA) and word recognition score (WRS) was calculated as the score from the second audiogram minus the score from the first audiogram, divided by the duration in months between the two.

Main Outcome Measure(s):
Serviceable hearing, defined as PTA ≤50 dB HL and WRS ≥50%.

Results:
Among 266 patients meeting inclusion criteria, 52 developed non-serviceable hearing at last follow-up. Kaplan–Meier estimated rates of maintaining serviceable hearing (95% CI; number still at risk) at 1, 3, 5, 7, and 10 years were 97% (95–100; 206), 78% (72–85; 98), 68% (60–77; 39), 60% (50–73; 17), and 44% (29–67; 2), respectively. In a univariable setting, each 1 dB increase per month in the rate of initial PTA change was associated with a 96% increased likelihood of acquiring non-serviceable hearing (hazard ratio [HR] 1.96; 95% CI 1.44–2.68; p < 0.001). Each 1% increase per month in the rate of initial WRS change was associated with a decreased likelihood of acquiring non-serviceable hearing (hazard ratio [HR] 0.79; 95% confidence interval [CI] 0.66–0.94; p = 0.009). After multivariable adjustment, both rate of PTA change (HR 2.42; 95% CI 1.72–3.41; p < 0.001) and rate of WRS change (HR 0.81; 95% CI 0.67–0.99; p = 0.043) remained statistically significantly associated with time to non-serviceable hearing.

Conclusion:
Rate of early PTA and WRS decline during the initial period of observation are significantly associated with time to development of non-serviceable hearing. This information may facilitate accurate patient counseling and inform decision-making regarding prospective disease management.
Transcanal Endoscopic Ear Surgery for Congenital Middle Ear Anomalies
Authors: Ito Tsukasa , Kubota Toshinori , Furukawa Takatoshi , Matsui Hirooki , Futai Kazunori , Kakehata Seiji 
Published: October 2019

Objective:
To demonstrate the efficacy of transcanal endoscopic ear surgery (TEES) for congenital middle ear anomalies.

Study Design:
Retrospective case review.

Setting:
Tertiary referral center.

Patients:
Twenty-one patients ranging in age from 4 to 62 years old (median: 15 yr) who underwent TEES between 2011 and 2017 were compared with 19 patients ranging in age from 3 to 49 years old (median: 11 yr) who underwent microscopic ear surgery (MES) between 2000 and 2011.

Intervention:
Ossiculoplasty or stapes surgeries were performed with TEES or MES. TEES was performed using a rigid endoscope with an outer diameter of 2.7-mm coupled with a full high-definition video system. MES was performed via a transcanal approach with a retroauricular incision.

Main Outcome Measure:
Middle ear anomaly classification, operating time, and hearing outcomes based on the American Academy of Otolaryngology and Head and Neck Surgery criteria were evaluated and compared between the TEES and MES groups.

Results:
For Teunissen and Cremers class III anomalies, defined as ossicular chain malformations with a mobile stapes footplate, postoperative air-bone gap closure to 10 dB or less was achieved in 50% of the TEES group and 47% of the MES group. Postoperative air-bone gap closure to 20 dB or less was achieved in 86% of the TEES group and 100% of the MES group. No significant difference was found in the operating time between the two groups. All MES procedures required a retroauricular incision.

Conclusion:
Our results indicate that TEES has similar auditory outcomes compared with MES while avoiding a retroauricular incision.
Evaluation of Cochlear Duct Length Measurements From a 3D Analytical Cochlear Model Using Synchrotron Radiation Phase-Contrast Imaging
Authors: Helpard Luke W. , Rohani Seyed A. , Ladak Hanif M. , Agrawal Sumit K. 
Published: October 2019

Hypothesis:
Evaluating the accuracy of cochlear duct length (CDL) measurements from a published three-dimensional (3D) analytical cochlear model using Synchrotron Radiation Phase–Contrast Imaging (SR-PCI) data will help determine its clinical applicability and allow for model adjustments to increase accuracy.

Background:
Accurate CDL determination can aid in cochlear implant sizing for full coverage and frequency map programming, which has the potential to improve hearing outcomes in patients. To overcome problems with the currently available techniques for CDL determination, a novel 3D analytical cochlear model, dependent on four basal turn distances, was proposed in the literature.

Methods:
SR-PCI data from 11 cadaveric human cochleae were used to obtain reference measurements. CDL values generated by the analytical cochlear model were evaluated in two conditions: when the number of cochlear turns (NCT) were automatically predicted based on the four input distances, and when the NCT were manually specified based on SR-PCI data.

Results:
When the analytical cochlear model automatically predicted the NCT, the mean absolute error was 2.6 ± 1.6 mm, with only 27% (3/11) of the samples having an error in the clinically acceptable range of ±1.5 mm. When the NCT were manually specified based on SR-PCI data, the mean absolute error was reduced to 1.0 ± 0.6 mm, with 73% (8/11) of the samples having a clinically acceptable error.

Conclusion:
The 3D analytical cochlear model introduced in the literature is effective at modeling the 3D geometry of individual cochleae, however tuning in the NCT estimation is required.
NF2-Related Intravestibular Schwannomas: Long-Term Outcomes of Cochlear Implantation
Authors: Jia Huan , Nguyen Yann , Hochet Baptiste , Smail Mustapha , Mosnier Isabelle , Wu Hao , Sterkers Olivier , Kalamarides Michel , Bernardeschi Daniele 
Published: October 2019

Objective:
Intravestibular schwannomas (IVS) are uncommon tumors in Neurofibromatosis type 2 (NF2) and are mainly associated with multiple internal auditory meatus (IAM) and cerebellopontine angle (CPA) tumors. They usually induce profound hearing loss which can be rehabilitated by cochlear implantation (CI). The aim of this study was to analyze the long-term outcomes of CI during the unpredictable evolution of NF2 disease.

Study Design:
Retrospective case review.

Setting:
Tertiary referral center.

Patients:
Three adults with neurofibromatosis type 2 and intravestibular schwannomas, and who were cochlear implant recipients.

Interventions:
Periodic radiologic follow-up, tumor resection, and hearing rehabilitation.

Main Outcome Measures:
Audiological evolution, tumor evolution, surgical outcome, cochlear implant outcome.

Results:
Three NF2 patients (mean age at diagnosis, 26.3 ± 3.2 yr) were identified with IVS in the period between 2000 and 2017. IVS were first observed by serial MRI and profound hearing loss occurred in this ear after 4 ± 1.5 years of follow-up. IVS were removed via a translabyrinthine approach, and ipsilateral cochlear implantations were simultaneously performed. In two patients, large contralateral CPA tumors had previously been removed without hearing preservation, whereas in the third patient, a small, growing contralateral VS was excised via a retrosigmoid approach 6 months after IVS removal/cochlear implantation with serviceable hearing preservation. In all cases, CI provided good hearing outcomes. In two cases, hearing outcomes were even better for more than 5 years when ipsilateral intracanalicular vestibular schwannomas were removed in either the same or subsequent procedures.

Conclusions:
Rehabilitation of hearing with CI provides a favorable long-term outcome in patients with NF2-related IVS which could be altered by the occurrence of other intracanalicular and/or CPA NF2-related tumors.
Helicobacter pylori Infection and the Development of Advanced Colorectal Neoplasia
Authors: Ryoo Si Kyong , Kim Tae Jun , Kim Eun Ran , Hong Sung Noh , Kim Young-Ho , Chang Dong Kyung 
Published: October 2019

Background:
An association between Helicobacter pylori infection and colorectal neoplasia has been reported in cross-sectional studies.

Goals:
We examined the association between H. pylori infection and the development of advanced colorectal neoplasia (AN) in a screening cohort.

Study:
We identified 3753 adults, who underwent screening and subsequent surveillance colonoscopies. The primary outcome was the development of metachronous AN, as confirmed by surveillance colonoscopy. H. pylori infection status was assessed by an H. pylori-specific immunoglobulin G antibody test. Sensitivity analysis was also performed by H. pylori infection status on the basis of histology.

Results:
During a median follow-up of 41 months, the incidence of AN was 3.2% and 1.7% in participants with and without H. pylori infection, respectively. In multivariable analysis adjusted for age, body mass index, smoking status, alcohol intake, family history of colorectal cancer, and baseline adenoma characteristics, the hazard ratio [95% confidence interval (CI)] for metachronous AN was 1.74 (1.11-2.73) in participants with H. pylori seropositivity, compared with those without H. pylori seropositivity. The association was consistent with H. pylori infection status on the basis of histology (adjusted hazard ratio, 3.51; 95% CI, 1.64-7.51). In the subgroup analysis, the positive association was observed in both no-adenoma and adenoma removal subgroups.

Conclusions:
In a cohort study, H. pylori infection was associated with an increased risk of AN development. This association was consistent in both the serological and histologic assessment of H. pylori infection. Prospective studies are necessary to determine whether H. pylori eradication can reduce the risk of colorectal neoplasia.
Prognostic significance of middle paraesophageal lymph node metastasis in resectable esophageal squamous cell carcinoma
Authors: Hong Huang , Jie Hou , Liyu Rao , Zerui Chen , Borong Shu , Hongwei Liang 
Published: October 2019

Abstract
Lymph node metastasis (LNM) of esophageal squamous cell carcinoma (ESCC) has important prognostic significance. In this study, we examined the correlations between lymph node metastatic sites and prognosis in patients with resectable ESCC.
A total of 960 patients who received curative esophagectomy with systemic lymphadenectomy between 1996 and 2014 were included in the retrospective analysis. The Kaplan-Meier method and log-rank test were used to perform the survival analysis. The prognostic significance of LNM site was evaluated by Cox regression analysis.
The LNM in middle paraesophageal (P < .001), subcarinal (P < .001), lower paraesophageal (P < .001), recurrent laryngeal nerve (P = .012), paratracheal (P = .014), and perigastric (P < .001) sites were associated with poor prognosis in univariate analysis. In multivariate analysis, only middle paraesophageal LNM (MPLNM, P = .017; HR, 1.33; 95%CI, 1.05–1.67) was the independent factor for worse prognosis. Additionally, patients with MPLNM had a lower 5-year survival rate (15.6%) than those with LNM at other sites. Furthermore, upper or middle tumor location and relatively late pN stage were associated with increased risk of MPLNM.
Our findings suggested MPLNM could be a characteristic indicating the worst prognosis. Preoperative examinations should identify the existences of MPLNM, especially on patients with risk factors. And patients with MPLNM should be considered for more aggressive multidisciplinary therapies.
Evidence of altered cardiac autonomic regulation in myalgic encephalomyelitis/chronic fatigue syndrome
Authors: Nelson Maximillian J. , Bahl Jasvir S. , Buckley Jonathan D. , Thomson Rebecca L. , Davison Kade 
Published: October 2019

Abstract

Background:
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex condition with no reliable diagnostic biomarkers. Studies have shown evidence of autonomic dysfunction in patients with ME/CFS, but results have been equivocal. Heart rate (HR) parameters can reflect changes in autonomic function in healthy individuals; however, this has not been thoroughly evaluated in ME/CFS.

Methods:
A systematic database search for case-control literature was performed. Meta-analysis was performed to determine differences in HR parameters between ME/CFS patients and controls.

Results:
Sixty-four articles were included in the systematic review. HR parameters assessed in ME/CFS patients and controls were grouped into ten categories: resting HR (RHR), maximal HR (HRmax), HR during submaximal exercise, HR response to head-up tilt testing (HRtilt), resting HR variability (HRVrest), HR variability during head-up tilt testing (HRVtilt), orthostatic HR response (HROR), HR during mental task(s) (HRmentaltask), daily average HR (HRdailyaverage), and HR recovery (HRR) Meta-analysis revealed RHR (MD ± 95% CI = 4.14 ± 1.38, P < .001), HRtilt (SMD ± 95% CI = 0.92 ± 0.24, P < .001), HROR (0.50 ± 0.27, P < .001), and the ratio of low frequency power to high frequency power of HRVrest (0.39 ± 0.22, P < .001) were higher in ME/CFS patients compared to controls, while HRmax (MD ± 95% CI = –13.81 ± 4.15, P < .001), HR at anaerobic threshold (SMD ± 95% CI = –0.44 ± 0.30, P = 0.005) and the high frequency portion of HRVrest (–0.34 ± 0.22, P = .002) were lower in ME/CFS patients.

Conclusions:
The differences in HR parameters identified by the meta-analysis indicate that ME/CFS patients have altered autonomic cardiac regulation when compared to healthy controls. These alterations in HR parameters may be symptomatic of the condition.
Palliative and Hospice Care in Correctional Facilities
Authors: Burles Meridith , Holtslander Lorraine , Peternelj-Taylor Cindy 
Published: October 2019

Background
The need for palliative and hospice care for persons with life-limiting conditions who are incarcerated is increasingly common in correctional facilities worldwide.

Objective
Through a family nursing lens, we critically analyze the unique challenges experienced by those requiring palliative care while incarcerated. Key concerns and implications for nursing are illustrated through the discussion of a representative case scenario.

Methods
The case scenario was developed based on the findings of a scoping review of academic and gray literature (such as policy documents and editorials) about palliative, hospice, and end-of-life care in corrections.

Results
The case scenario highlights multilevel barriers that were identified, including the individual, relational, institutional, and sociocultural contexts of palliative care in correctional facilities. Evidence is presented of how integration of a family nursing perspective can enhance specialized palliative and hospice care services in correctional settings.

Conclusions
By applying a family nursing approach, nurses practicing with correctional populations can ensure persons with life-limiting illnesses are not denied their right to appropriate end-of-life care by playing a key role in addressing barriers to palliative and hospice care access in corrections. Specific attention to relational issues and holistic care can contribute to enhanced palliative and hospice care, greater dignity in dying, and improved family and peer outcomes, which have benefits for individuals, families, communities, and society.

Implications for Practice
Through the case scenario, we illustrate real issues emerging in correctional contexts and offer evidence of how family nursing relational principles can be applied to promote adequate palliative and hospice care.
Work Values of Generation Z Nurses
Authors: Hampton Debra , Welsh Darlene 
Published: October 2019

OBJECTIVESTo determine the work values of Generation Z nurses, a new generation in the current workforce.BACKGROUNDA new generation of nurses is now part of the nursing workforce. Generation Z nurses, born in 1995 (aged ≤24 years), will bring new expectations and ideals about life and work into healthcare work settings.METHODSA descriptive, cross-sectional survey design was used to assess the work values of traditional baccalaureate Generation Z nursing students using the Lyons Work Values Survey.RESULTSThe work value component ranked most important by participants was social/altruistic, followed by instrumental/extrinsic, cognitive/intrinsic, and prestige.CONCLUSIONHelping people and having a job that is interesting and engaging while also offering job security and good benefits were the most important future Generation Z nurse work values.
Epidemiological Impact of Expedited Partner Therapy for Men Who Have Sex With Men: A Modeling Study
Authors: Weiss Kevin M. , Jones Jeb S. , Katz David A. , Gift Thomas L. , Bernstein Kyle , Workowski Kimberly , Rosenberg Eli S. , Jenness Samuel M. 
Published: October 2019

Background
Expedited partner therapy (EPT) is an intervention for patients with gonorrhea or chlamydia, providing index patients with prescriptions or medication to give to their partners. Expedited partner therapy is recommended for heterosexuals but not for men who have sex with men (MSM), partially due to concerns about overtreatment of uninfected partners and missed opportunities for human immunodeficiency virus (HIV) diagnosis.

Methods
We extended our stochastic network-based mathematical model of HIV, gonorrhea, and chlamydia among MSM to include EPT. The EPT implementation was simulated for 10 years. Counterfactual scenarios varied EPT coverage, provision, uptake, and partnership window duration. We estimated sexually transmitted infection (STI) incidence, proportion of infections averted, and process outcomes under each scenario.

Results
Delivery of EPT to 20% of eligible MSM index patients (coverage) reduced cumulative STI incidence by 27% (interquartile range, 13%–39%) over 10 years compared with current estimated STI screening levels. A 20% increase in providing medication to non–index partners (provision) averted 32% (interquartile range, 20%–41%) of STI infections compared with estimated STI screening levels. When targeted by partnership type, EPT solely to casual partners maximized the population-level infections averted. The proportion of partners given medication who had no current STI varied from 52% to 63%, depending on coverage level. The proportion of partners given medication with undiagnosed HIV infection was 4% across scenarios.

Conclusions
Expedited partner therapy could reduce bacterial STI incidence for MSM. However, this intervention could result in missed opportunities for HIV/STI prevention and a substantial increase in use of antimicrobials by STI-uninfected MSM, raising concerns about cost and antimicrobial resistance.
Probable Posttraumatic Stress Disorder and Lower Respiratory Symptoms Among Rescue/Recovery Workers and Community Members After the 9/11 World Trade Center Attacks—A Longitudinal Mediation Analysis
Authors: Wyka Katarzyna , Friedman Stephen M. , Jordan Hannah T. 
Published: October 2019

ABSTRACTObjectivePosttraumatic stress disorder (PTSD) and lower respiratory symptoms (LRS) often coexist among survivors of the September 11, 2001 (9/11) World Trade Center (WTC) attacks. Research in police and nontraditional responders suggests that PTSD mediates the relationship between 9/11 physical exposures and LRS, but not vice versa. We replicated these findings in WTC rescue/recovery workers (R/R workers), extended them to exposed community members, and explored the interplay between both physical and psychological 9/11 exposures, probable PTSD, and LRS over a 10-year follow-up.MethodsParticipants were 12,398 R/R workers and 12,745 community members assessed in three WTC Health Registry surveys (2003–2004, 2006–2007, and 2011–2012). LRS and 9/11 exposures were self-reported. Probable PTSD was defined as a PTSD Checklist score ≥44.ResultsProbable PTSD predicted LRS (R/R workers: β = 0.88–0.98,p< .001; community members: β = 0.67–0.86,p< .001) and LRS predicted PTSD (R/R workers: β = 0.83–0.91,p< .001; community members: β = 0.68–0.75,p< .001) at follow-ups, adjusting for prior symptoms and covariates. In both R/R workers and community members, probable PTSD mediated the relationship between 9/11 physical exposures (dust cloud, long duration of work) and LRS (indirect effects,p= .001–.006), and LRS mediated the physical exposure-PTSD relationship (indirect effects,p= .001–.006). In R/R workers, probable PTSD mediated the psychological exposure (losing friends or loved ones, witnessing horrific events)–LRS relationship (indirect effect,p< .001), but LRS did not mediate the psychological exposure-PTSD relationship (indirect effect,p= .332). In community members, high 9/11 psychological exposure predicted both probable PTSD and LRS at follow-ups; probable PTSD mediated the psychological exposure-LRS relationship (indirect effect,p< .001), and LRS mediated the psychological exposure-PTSD relationship (indirect effect,p= .001).ConclusionsProbable PTSD and LRS each mediated the other, with subtle differences between R/R workers and community members. A diagnosis of either should trigger assessment for the other; treatment should be carefully coordinated.
Genetic clustering analysis for HIV infection among MSM in Nigeria: implications for intervention
Authors: Li Yuruo , Liu Hongjie , Ramadhani Habib O. , Ndembi Nicaise , Crowell Trevor A. , Kijak Gustavo , Robb Merlin L. , Ake Julie A. , Kokogho Afoke , Nowak Rebecca G. , Gaydos Charlotte , Baral Stefan D. , Volz Erik , Tovanabutra Sodsai , Charurat Man 
Published: October 2019

Background:
The HIV epidemic continues to grow among MSM in countries across sub-Saharan Africa including Nigeria. To inform prevention efforts, we used a phylogenetic cluster method to characterize HIV genetic clusters and factors associated with cluster formation among MSM living with HIV in Nigeria.

Methods:
We analyzed HIV-1 pol sequences from 417 MSM living with HIV enrolled in the TRUST/RV368 cohort between 2013 and 2017 in Abuja and Lagos, Nigeria. A genetically linked cluster was defined among participants whose sequences had pairwise genetic distance of 1.5% or less. Binary and multinomial logistic regressions were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors associated with HIV genetic cluster membership and size.

Results:
Among 417 MSM living with HIV, 153 (36.7%) were genetically linked. Participants with higher viral load (AOR = 1.72 95% CI: 1.04–2.86), no female partners (AOR = 3.66; 95% CI: 1.97–6.08), and self-identified as male sex (compared with self-identified as bigender) (AOR = 3.42; 95% CI: 1.08–10.78) had higher odds of being in a genetic cluster. Compared with unlinked participants, MSM who had high school education (AOR = 23.84; 95% CI: 2.66–213.49), were employed (AOR = 3.41; 95% CI: 1.89–10.70), had bacterial sexually transmitted infections (AOR = 3.98; 95% CI: 0.89–17.22) and were not taking antiretroviral therapy (AOR = 6.61; 95% CI: 2.25–19.37) had higher odds of being in a large cluster (size > 4).

Conclusion:
Comprehensive HIV prevention packages should include behavioral and biological components, including early diagnosis and treatment of both HIV and bacterial sexually transmitted infections to optimally reduce the risk of HIV transmission and acquisition.