bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can You Hear Me Now? The Impact of Hearing Loss on Patient Health Literacy
Authors: Tolisano Anthony M. , Fang Lilly B. , Isaacson Brandon , Kutz Joe Walter , Hunter Jacob B. 
Published: June 2020

Objective:
To elucidate the impact of hearing loss on patient health literacy.

Study Design:
Prospective, cross-sectional study.

Setting:
Academic otology practice at a university hospital.

Patients:
Consecutive, adult, English-speaking patients.

Main Outcome Measures:
Inadequate health literacy, defined as a composite score of less than or equal to nine on the brief health literacy screen (BHLS), was compared with patient hearing data utilizing the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) hearing classification. Secondary outcome measures included comparisons of inadequate BHLS scores according to patient demographic and clinical information.

Results:
There were 300 consecutive adult (>18 years old) patients evaluated with the BHLS at a university otology practice between February and March 2019. The median patient age was 60-years (range, 18–91 yr), a slight majority (160, 53.3%) were women, and most patients were White (241, 86.7%) and non-Hispanic (260, 91.6%). Overall, 9.7% of patients were found to have inadequate health literacy. Men had higher rates of inadequate health literacy as compared with women (13.6% versus 6.3%, odds ratio [OR] = 2.35, 95% confidence interval [CI] 1.06–5.25). Audiometric data was available for 284 (95%) patients, of which 235 (82.7%) had class A or B hearing and 49 (17.3%) had class C or D hearing. Patients with Class C or D hearing had a lower median composite BHLS score compared with patients with Class A or B hearing (11.6 versus 13.6, p < 0.0001) and an increased rate of inadequate health literacy (28.6% versus 4.7%, OR = 8.15, 95% CI 3.42–19.37). Increased age, female sex, and better hearing were independent predictors of higher BHLS scores on multivariable analysis.

Conclusions:
Hearing loss is an independent risk factor for inadequate health literacy. Providers should be aware of this risk and consider implementing strategies to improve counseling for this at-risk group of patients.
A Structural Analysis of Tympanic Compartments of the Middle Ear in Patients With Down's Syndrome: A Temporal Bone Study
Authors: Nogaki Taketoshi , Paparella Michael M. , Cureoglu Sebahattin 
Published: June 2020

Hypothesis: There may be findings peculiar to the temporal bones of children with Down's syndrome (DS). The purpose of this study is to investigate the temporal bone histopathology of the children with DS.Background: Otitis media with effusion is a highly prevalent condition with DS. Knowledge of the volume of the tympanic compartments and the area of the tympanic isthmus might be important to find out the pathogenesis of highly prevalent otitis media with effusion in those patients.Methods:We compared the volume of the epitympanum, mesotympanum, and the areas of the tympanic isthmus and tympanic orifice of eustachian tube in temporal bones from patients with DS. We also investigated the eustachian tube histopathologically.Results:The mean volume of the epitympanum and the mesotympanum was significantly smaller in the DS group than the control group. We found no significant difference in the mean diameter of the protympanic opening and tympanic orifice between the two groups. The mean narrowest area of the aerated and bony tympanic isthmus also was not significantly different between the two groups. An immature development of eustachian tube and cartilage was seen. We found mesenchyme remaining at the epitympanum and/or mesotympanum in all specimens in the DS group, and in five specimens in the control group.Conclusion:In the presence of the small middle ear, poorly developed eustachian tube, and tensor muscle, a vicious circle occurs, making otitis media with effusion difficult to resolve.
Intraoperative Observational Real-time Electrocochleography as a Predictor of Hearing Loss After Cochlear Implantation: 3 and 12 Month Outcomes
Authors: O’Leary Stephen , Briggs Robert , Gerard Jean-Marc , Iseli Claire , Wei Benjamin P.C. , Tari Sylvia , Rousset Alex , Bester Christo 
Published: June 2020

Objective:
A decrease in intracochlear electrocochleographic (ECochG) amplitude during cochlear implantation has been associated with poorer postoperative hearing preservation in several short-term studies. Here, we relate the stability of ECochG during surgery to hearing preservation at 3- and 12-months.

Methods:
Patients with hearing ≤80-dB HL at 500 Hz were implanted with a slim-straight electrode array. ECochG responses to short, high-intensity, 500-Hz pure tones of alternating polarity were recorded continuously from the apical-most electrode during implantation. No feedback was provided to the surgeon. ECochG amplitude was derived from the difference response, and implantations classified by the presence (“ECochG drop”) or absence (“no drop”) of a ≥30% reduction in ECochG amplitude during insertion. Residual hearing (relative and absolute) was reported against the ECochG class.

Results:
ECochG was recorded from 109 patients. Of these, interpretable ECochG signals were recorded from 95. Sixty-six of 95 patients had an ECochG drop during implantation. Patients with an ECochG drop had poorer preoperative hearing above 1000 Hz. Hearing preservation (in decibels, relative to preoperative levels and functionally) was significantly poorer at 250-, 500-, and 1000-Hz at 3 months in patients exhibiting an ECochG drop. Twelve-month outcomes were available from 85 patients, with significantly poorer functional hearing, and greater relative and absolute hearing loss from 250 to 1000 Hz, when an ECochG drop had been encountered.

Conclusion:
Patients exhibiting ECochG drops during implantation had significantly poorer hearing preservation 12 months later. These observational outcomes support the future development of surgical interventions responsive to real-time intracochlear ECochG. Early intervention to an ECochG drop could potentially lead to prolonged improvements in hearing preservation.
A novel method: can stapedial acoustic reflex have a role in the diagnosis of minimal hepatic encephalopathy?
Authors: Yazici Alper , Emre Yildirim Abdullah , Konduk BuğraTolga , Aytaç İsmail , Barutçu Sezgin 
Published: June 2020

Objective
Stapedial acoustic reflex is an easily accessible and applicable test which is also valuable for the clinical conditions which affect the various locations of the central nervous system. Searching the diagnostic value of stapedial acoustic reflex at minimal hepatic encephalopathy is the aim of this research.

Methods
Diagnosis of minimal hepatic encephalopathy was conducted by mini-mental state and critical flickered frequency tests. Minimal hepatic encephalopathy diagnosed patients were established in the first group. Cirrhosis (without minimal hepatic encephalopathy or overt hepatic encephalopathy) diagnosed patients were created the control group. The stapedial acoustic reflex test was applied for minimal hepatic encephalopathy and the control group by audiologists in a soundproof room.

Results
In total, 221 patients were screened and 97 patients meet the inclusion criterions. Out of 97 patients, 52 were the minimal hepatic encephalopathy patients and the remaining patients were the control group. Acoustic reflex tests battery includes the evaluation of two pathways called ipsilateral and contralateral. Ipsilateral way test results were found positive in all minimal hepatic encephalopathy patients and 95% positive in the control group. Contralateral acoustic reflex test results were found 36% positive in minimal hepatic encephalopathy patients and 95% positive in the control group, respectively. A comparison of ipsilateral and contralateral acoustic reflex test results was displayed a statistical significance.

Conclusion
Stapedial acoustic reflex test results of cirrhosis patients may cover additional parameters for the diagnosis of minimal hepatic encephalopathy.
Increased rates of spinal fusion surgery in patients with hereditary hemochromatosis: a five-year propensity matched cohort analysis
Authors: Kesler Alex M. , Kröner Paul T. , Wijarnpreecha Karn , Palmer William C. 
Published: June 2020

Object
Spinal arthropathy is associated with hereditary hemochromatosis and has been linked to calcium pyrophosphate dehydrate crystal deposition (CPPD) which resembles ankylosing spondylitis on radiograph, yet lacks clinical findings of inflammatory spinal arthritis. The aim of our study was to assess the use of spinal surgery and its outcomes in the US inpatient population with hereditary hemochromatosis from 2012 to 2016 by using the US Nationwide Inpatient Sample (NIS) database.

Methods
The observational retrospective cohort study uses the NIS 2012 to 2016. All patients with hereditary hemochromatosis were included using International Classification of Diseases 9th and 10th revisions, Clinical Modification codes. The cohort was stratified according to having undergone spinal surgery and substratified by the type of surgery. The primary outcome was determining the use of spinal surgery in patients with hereditary hemochromatosis. Secondary outcomes were determining length of hospital stay and total hospital charges and costs.

Results
A total of 39 780 patients with hereditary hemochromatosis were identified and propensity matched to nonhereditary hemochromatosis controls. The mean patient age was 61 years, and 65% were females. For the primary outcome patients with hereditary hemochromatosis underwent significantly more spinal fusion surgery compared to patients without hereditary hemochromatosis odds of 2.13 (P = 0.05). While there was no difference in mean LOS, or costs, patients with hereditary hemochromatosis had higher hospital charges.

Conclusion
Hereditary hemochromatosis is associated with higher odds of spinal fusion. It is a major complication not improved by phlebotomy, and there are currently no therapies to prevent this joint disease.
A 7-Year-Old Boy With Recurring Episodes of Abdominal Pain
Authors: Noble Jennifer , Ledrick David 
Published: June 2020

Abstract
Recurrent abdominal pain is a relatively common complaint in children who present to the emergency department. The etiology is often thought to be psychogenic, with an underlying organic cause present in less than 10% of patients. Intermittent ureteropelvic junction obstruction is usually not considered in the differential diagnosis of recurrent acute abdominal pain in children, which can cause a significant delay in diagnosis. In this condition, intermittent obstruction of the flow of urine from the renal pelvis to the proximal ureter occurs, which causes intermittent acute colicky abdominal pain and vomiting. This acute event, often referred to as a Dietl's crisis, either subsides after several hours or prompts a visit to the emergency department. Management often focuses on the identification of psychosocial issues or constipation, and routine abdominal imaging is not a common practice. The frequency of these events over time and the duration of each acute event are 2 components that factor into determining the loss of function in the affected kidney. The purpose of this case report is to increase awareness of intermittent ureteropelvic junction obstruction as a cause of recurring episodes of acute abdominal pain in children. Emphasis in this case report is on Dietl's crisis, how it presents, and how it is diagnosed and managed.
Outcomes Among HIV-Positive Patients Hospitalized With COVID-19
Authors: Karmen-Tuohy Savannah , Carlucci Philip M. , Zervou Fainareti N. , Zacharioudakis Ioannis M. , Rebick Gabriel , Klein Elizabeth , Reich Jenna , Jones Simon , Rahimian Joseph 
Published: June 2020

Background:
SARS-CoV-2 infection continues to cause significant morbidity and mortality worldwide. Preliminary data on SARS-CoV-2 infection suggest that some immunocompromised hosts experience worse outcomes. We performed a retrospective matched cohort study to characterize outcomes in HIV-positive patients with SARS-CoV-2 infection.

Methods:
Leveraging data collected from electronic medical records for all patients hospitalized at NYU Langone Health with COVID-19 between March 2, 2020, and April 23, 2020, we matched 21 HIV-positive patients with 42 non-HIV patients using a greedy nearest-neighbor algorithm. Admission characteristics, laboratory test results, and hospital outcomes were recorded and compared between the 2 groups.

Results:
Although there was a trend toward increased rates of intensive care unit admission, mechanical ventilation, and mortality in HIV-positive patients, these differences were not statistically significant. Rates for these outcomes in our cohort are similar to those previously published for all patients hospitalized with COVID-19. HIV-positive patients had significantly higher admission and peak C-reactive protein values. Other inflammatory markers did not differ significantly between groups, although HIV-positive patients tended to have higher peak values during their clinical course. Three HIV-positive patients had superimposed bacterial pneumonia with positive sputum cultures, and all 3 patients died during hospitalization. There was no difference in frequency of thrombotic events or myocardial infarction between these groups.

Conclusions:
This study provides evidence that HIV coinfection does not significantly impact presentation, hospital course, or outcomes of patients infected with SARS-CoV-2, when compared with matched non-HIV patients. A larger study is required to determine whether the trends we observed apply to all HIV-positive patients.
Magnesium sulfate ameliorates sepsis-induced diaphragm dysfunction in rats via inhibiting HMGB1/TLR4/NF-κB pathway
Authors: Jiang Jihong , Chen Qi , Chen Xia , Li Jinbao , Li Shitong , Yang Bin 
Published: June 2020

Background
Diaphragm dysfunction could be induced by sepsis with subsequent ventilatory pump failure that is associated with local infiltration of inflammatory factors in the diaphragm. It has been shown that the administration of anticonvulsant agent, magnesium sulfate (MgSO4) could decrease systematic inflammatory response. We recently reported that MgSO4 could inhibit macrophages high mobility group box 1 (HMGB1) secretion that confirms its anti-inflammatory properties. Toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signal pathway appears to be involved in the pathology of septic experimental animal’s inflammatory response and involve in the pathogenic mechanisms of sepsis-induced diaphragm dysfunction. Thus, in this study, we are aiming to explore whether MgSO4 could ameliorate sepsis-induced diaphragm dysfunction via TLR4/NF-κB pathway in a rodent model with controlled mechanical ventilation (CMV) and subsequent septic challenge.

Methods
Rats were randomly assigned into (1) control group: having an identical laparotomy but without ligation or puncture in the cecum; (2) CLP group: cecal ligation and puncture (CLP) with continuous saline infusion; (3) CLP + MgSO4 group: CLP with continuous MgSO4 administration; and (4) MgSO4 group: a sham surgery with MgSO4 administration. After surgery, all rats were submitted to CMV for 18 h. After completion of the study protocol, blood inflammatory cytokine/chemokine was detected by ELISA, as well as diaphragm contractility, TLR4, NF-κB (p65), phospho-NF-κB (p65) and HMGB1 protein expression.

Results
The level of inflammatory cytokine/chemokine includes interleukin-6, monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-2 (MIP-2) and HMGB1 in blood were significantly increased at 18-h post-CLP compared with the control group. We found that rats in the CLP group had substantial diaphragm dysfunction with a distinct downshift of the force–frequency curve. Furthermore, expression of HMGB1, TLR4, NF-κB (p65) and phospho-NF-κB (p65) in diaphragm were significantly increased in the CLP group. In contrast, MgSO4 attenuated the septic inflammation reaction in diaphragm and serum and preserved diaphragm function.

Conclusion
MgSO4 protects against sepsis-induced diaphragm dysfunction. This may be associated with its anti-inflammatory effect on HMGB1/TLR4/NF-κB signal pathway
Risk factors and protective factors of mental health during COVID-19 outbreak and lockdown in adult Indian population- A cross-sectional study
Authors: Saikarthik Jayakumar , Saraswathi Ilango , Siva Thirusangu 
Published: June 2020

AbstractBackgroundThe novel Corona virus has derailed the entire world and various steps have been taken by the health authorities to tackle this pandemic. Nationwide lockdown has been imposed to control the spread of COVID-19 outbreak in India, which could have psychological impact on the population.AimOur study aims to study the effect of the COVID-19 outbreak & subsequent lockdown on mental health status of adult Indian population along with identifying the high-risk groups.MethodologyAn online survey was conducted during 3rd phase of lockdown gathering details about sociodemographic variables, practice of precautionary measures, awareness and concerns regarding COVID-19 and mental health status of the participants through DASS21 questionnaire from 873 adults.ResultsThe prevalence of depression, anxiety and stress were 18.56%, 25.66%, and 21.99% respectively including higher number of participants with mild depression (15.1%) and stress (14.5%) and moderate anxiety (16.3%). Female gender, age <25 years, unemployment, self-business, employed in private sector, lack of formal education, larger household size, parenthood (>2 kids) were associated with increased likelihood of negative mental health. Confidence in physician’s ability to diagnose COVID-19 infection, decreased self-perceived likelihood of contracting COVID-19, lesser frequency of checking for information on COVID-19 and satisfaction of information received were protective against negative mental health.ConclusionThis landmark study identified the protective and risk factors of mental health during COVID-19 pandemic, to help authorities and mental health workers to strategize and deliver interventional methods to maintain psychosocial wellbeing of the population.
Limited genetic parallels underlie convergent evolution of quantitative pattern variation in mimetic butterflies
Authors: Bainbridge Hannah E. , Brien Melanie N. , Morochz Carlos , Salazar Patricio A. , Rastas Pasi , Nadeau Nicola J. 
Published: June 2020

AbstractMimetic systems allow us to address the question of whether the same genes control similar phenotypes in different species. Although widespread parallels have been found for major effect loci, much less is known about genes that control quantitative trait variation. In this study, we identify and compare the loci that control subtle changes in the size and shape of forewing pattern elements in twoHeliconiusbutterfly co-mimics. We use quantitative trait locus (QTL) analysis with a multivariate phenotyping approach to map the variation in red pattern elements across the whole forewing surface ofHeliconius eratoandHeliconius melpomene. These results are compared to a QTL analysis of univariate trait changes, and show that our resolution for identifying small effect loci is improved with the multivariate approach. QTL likely corresponding to the known patterning geneoptixwere found in both species but otherwise, a remarkably low level of genetic parallelism was found. This lack of similarity indicates that the genetic basis of convergent traits may not be as predictable as assumed from studies that focus solely on Mendelian traits.
Does Gender or Religion Contribute to the Risk of COVID-19 in Hospital Doctors in the UK?
Authors: Daga Sunil , Jafferbhoy Sadaf , Menon Geeta , Ali Mansoor , Chakravorty Subarna , Ghani Saqib , Burney Amir , Bamrah JS , Mehta Ramesh , Chakravorty Indranil 
Published: June 2020

AbstractThe novel coronavirus pandemic is posing significant challenges to healthcare workers (HCWs) in adjusting to redeployed clinical settings and enhanced risk to their own health. Studies suggest a variable impact of COVID-19 based on factors such as age, gender, comorbidities and ethnicity. Workplace measures such as personal protective equipment (PPE), social distancing (SD) and avoidance of exposure for the vulnerable, mitigate this risk. This online questionnaire-based study explored the impact of gender and religion in addition to workplace measures associated with risk of COVID-19 in hospital doctors in acute and mental health institutions in the UK.The survey had 1206 responses, majority (94%) from BAME backgrounds. A quarter of the respondents had either confirmed or suspected COVID-19, a similar proportion reported inadequate PPE and 2/3 could not comply with SD. One third reported being reprimanded in relation to PPE or avoidance of risk. In univariate analysis, age over 50 years, being female, Muslim and inability to avoid exposure in the workplace was associated with risk of COVID-19. On multivariate analysis, inadequate PPE remained an independent predictor with a twofold (OR 2.29, (CI - 1.22-4.33), p=0.01) risk of COVID-19.This study demonstrates that PPE, SD and workplace measures to mitigate risk remain important for reducing risk of COVID-19 in hospital doctors. Gender and religion did not appear to be independent determinants. It is imperative that employers consolidate risk reduction measures and foster a culture of safety to encourage employees to voice any safety concerns. (240 words)
Genome-wide analyses of behavioural traits biased by misreports and longitudinal changes
Authors: Xue Angli , Jiang Longda , Zhu Zhihong , Wray Naomi R. , Visscher Peter M. , Zeng Jian , Yang Jian 
Published: June 2020

AbstractGenome-wide association studies (GWAS) have discovered numerous genetic variants associated with human behavioural traits. However, behavioural traits are subject to misreports and longitudinal changes (MLC) which can cause biases in GWAS and follow-up analyses. Here, we demonstrate that individuals with higher disease burden in the UK Biobank (n =455,607) are more likely to misreport or reduce their alcohol consumption (AC) levels, and propose a correction procedure to mitigate the MLC-induced biases. The AC GWAS signals removed by the MLC corrections are enriched in metabolic/cardiovascular traits. Almost all the previously reported negative estimates of genetic correlations between AC and common diseases become positive/non-significant after the MLC corrections. We also observe MLC biases for smoking and physical activities in the UK Biobank. Our findings provide a plausible explanation of the controversy about the effects of AC on health outcomes and a caution for future analyses of self-reported behavioural traits in biobank data.