bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Preoperative Patient Expectations in Adult Cochlear Implant Outcomes
Authors: McRackan Theodore R. , Reddy Priyanka , Costello Mark S. , Dubno Judy R. 
Published: November 2020

Objective:
Preoperative expectations affect patient outcomes in many health conditions, but expectations are rarely assessed in adult cochlear implant (CI) users. This study is a first step in assessing the contribution of preoperative expectations to postoperative CI outcomes, including speech recognition, CI quality of life (CIQOL), and CI satisfaction.

Study Design:
Cross-sectional study.

Setting:
Tertiary medical center.

Patients:
Fourty one adult CI patients.

Interventions/Main Outcome Measures:
Preoperative expectation questionnaire results, pre- and postoperative speech recognition (CNC and AzBio) scores, postoperative CIQOL domain scores and global scores, and CI satisfaction scores using a visual analog scale (VAS). Cohen's d was used to express effect size.

Results:
Overall, patients with lower preoperative CI performance expectations showed higher postoperative QOL. This effect was large for the emotional, entertainment, and social domains (d = 0.85–1.02) of the CIQOL-35 and medium for the communication, listening effort domains, and the Global score (d = 0.55–0.63). Preoperative performance expectations showed minimal associations with preoperative versus postoperative change in CNC (d = –0.26; –0.69–0.18) or AzBio scores (d = –0.28; –0.72–0.15). Determining the extent to which preoperative expectations played a role in postoperative satisfaction with CIs was limited by the clustering of satisfaction scores in the upper range of the scale (VAS mean 81.1).

Conclusions:
This study provides preliminary evidence that patients’ expectations before cochlear implantation may influence their postoperative quality of life and other outcomes, but not postoperative speech recognition. This suggests that an increased emphasis should be placed on measuring and counseling expectations in CI candidates. This assumption needs to be confirmed with additional research with larger sample sizes, more sensitive satisfaction measures, and a prospective design.
Do Patients Benefit From a Cochlear Implant When They Qualify Only in the Presence of Background Noise?
Authors: Lundberg Emily M. H. , Strong Darcy , Anderson Melinda , Kaizer Alexander M. , Gubbels Samuel 
Published: November 2020

Objective:
To compare the difference in pre- to postoperative speech performance of patients qualifying for a cochlear implant (CI) in quiet, +10 dB signal-to-noise ratio (SNR), and +5 dB SNR.

Study Design:
Retrospective.

Setting:
Tertiary referral center.

Patients:
Fifty-eight post-lingually deafened, unilateral CI recipients from three Groups were included: 1) those who met CI candidacy criteria with AzBio sentences in quiet, 2) in noise at +10 dB SNR but not in quiet, 3) and in noise at +5 dB SNR but not in quiet or +10 dB SNR.

Intervention:
Unilateral CI.

Main Outcome Measures:
Pre- and 1 year postoperative speech recognition scores.

Results:
Best-aided AzBio speech recognition of individuals in Group 1 improved significantly for all test conditions and improved significantly for Groups 2 and 3 in the +10 and +5 dB SNR test conditions postoperatively. When tested with their CI alone however, while AzBio speech recognition of individuals in Group 1 and Group 2 improved significantly in the quiet and +10 dB SNR conditions, speech recognition was not significantly changed postoperatively under any testing condition for individuals in Group 3.

Conclusions:
While individuals qualifying for a CI only in the +5 dB SNR condition may derive significant benefit from implantation in best aided conditions, speech understanding outcomes can be more variable thus warranting additional counseling before implantation and case-by-case consideration of listening needs and goals.
Nystagmus and Vertigo in Acute Vestibular Migraine Attacks: Response to Non-Invasive Vagus Nerve Stimulation
Authors: Beh Shin C. 
Published: November 2020

Objective:
Vestibular migraine (VM) is the most common neurologic cause of vertigo in adults, but there are no currently-approved rescue therapies. This study describes the benefits of non-invasive vagus nerve stimulation (nVNS) on vertigo, headache, and nystagmus during VM attacks.

Methods:
Case series of four VM patients who were evaluated during acute VM episodes in a tertiary referral neurology clinic between February 2019 and January 2020. They underwent bedside neuro-otologic examination, and graded the severity of vertigo and headache using a 10-point visual-analog scale (VAS; 0—no symptoms, 10—worst ever symptoms), before and 15 minutes after nVNS.

Results:
Average vertigo severity was 5 (median 4.5) before, and 1.5 (median 0.5) after nVNS. Mean headache severity (three patients) before treatment was 4 (median 4), and 0.7 (median 0) after. Spontaneous right-beating nystagmus (Patient 1) nystagmus, upbeat nystagmus (Patient 2), and positional nystagmus (Patient 3) resolved with nVNS. Baseline left-beating nystagmus in Patient 4 from previous vestibular neuritis damped during acute VM but returned to baseline following nVNS. In all four patients, ictal nystagmus resolved, and examination findings returned to baseline.

Conclusions:
This study suggests nVNS may ameliorate vertigo and headache, as well as nystagmus associated with VM attacks. Larger, sham device-controlled studies are needed to elucidate the benefits of nVNS in VM.
Vestibular Screening Before Cochlear Implantation: Clinical Implications and Challenges in 409 Cochlear Implant Recipients
Authors: West Niels , Klokker Mads , Cayé-Thomasen Per 
Published: November 2020

Objective:
Cochlear implantation (CI) carries a risk of loss of vestibular function following surgery. Thus, vestibular assessment presurgery is used to identify vestibulopathy that may contraindicate implantation and guide in selecting the candidate ear. The aim of this study was to evaluate the clinical implications of preoperative vestibular assessment, and to identify challenges in performing vestibular testing in patients with profound hearing loss, i.e., CI candidates.

Study Design:
Retrospective study of all CI recipients implanted since the introduction of a vestibular screening program.

Setting:
Tertiary referral center in 2013.

Patients and Intervention:
CI candidates routinely underwent testing with the video head impulse test (VHIT) and the cervical vestibular evoked myogenic potential (cVEMP) test as a part of the CI work up.

Results:
Three hundred thirty-five individuals were screened before the first CI and 74 individuals before the second CI. In 301 cases (73.6%), the vestibular function was considered normal and consequently carried no contraindications for surgery or implications for choice of ear to be implanted. Bilateral vestibular loss was found in 43 cases (10.5%) and unilateral vestibular loss was found in 62 cases (15.2%). In the latter cases, evaluation of multiple variables was indicated to select candidate ear. In nine implanted patients (2.2%), a relative contraindication to operate based on an “only balancing” ear was overruled by other factors. Vestibular testing was challenged by various factors (e.g., neck immobility, eye tracking issues, communication, and other patient issues), limiting the vestibular data output. This resulted in omittance, testing failure, or interpretation uncertainty 24 times (5.9%) for VHIT and 65 times (15.9%) for cVEMP.

Conclusion:
Vestibular screening is an important part of the clinical workup with respect to selection of candidate ear for cochlear implantation, as 15.2% of CI candidates present with unilateral vestibulopathy. Challenges in performing the vestibular tests are not uncommon, as test failure occurred in 15.9% of cases for the cVEMP and 5.9% for the VHIT. The most common reasons for test failure were neck immobility, communication issues, and problems of pupil tracking.
Abnormal diurnal blood pressure profile and hypertension-mediated organ damage in nondiabetic chronic kidney disease G1-G3b patients
Authors: Stróżecki Paweł , Pluta Agnieszka , Donderski Rafał , Włodarczyk Zbigniew , Manitius Jacek 
Published: November 2020

Objective
Chronic kidney disease (CKD) is associated with high cardiovascular risk. Prevalence of hypertension and hypertension-mediated organ damage (HMOD) increases with CKD progression. Nocturnal blood pressure (BP) is a strong predictor of cardiovascular complications. This cross-sectional study investigated the link between the diurnal BP profile and HMOD in nondiabetic CKD G1-G3b patients.

Methods
We investigated 109 CKD patients and 41 apparently healthy persons as controls. All subjects underwent 24-ambulatory blood pressure monitoring (ABPM), echocardiography with left ventricular mass index (LVMI) calculation and pulse wave velocity (PWV) measurement.

Results
Hypertension was present in 84% of CKD patients. SBP-24 and DBP-24, SBP-day and DBP-day did not differ between CKD and controls. Significant differences were found in SBP-night and DBP-night. The nondipping BP profile (SBP-night/SBP-day ratio ≥0.9) was found in 62% of CKD patients and 32% of controls (P < 0.005). Nocturnal hypertension was found in 56% of CKD patients. LVMI was higher in CKD compared to controls, higher in nondipping than dipping CKD patients, and higher in patients with nocturnal hypertension than without nocturnal hypertension. Abnormal left ventricular geometry was found in 72% nondipping and 43% dipping CKD patients. PWV was higher in CKD than in controls, in patients with nocturnal hypertension than without nocturnal hypertension but did not differ between CKD nondippers and dippers.

Conclusion
The nondipping BP profile and nocturnal hypertension are associated with HMOD in G1-G3b CKD patients. Hence, there is a need for more extensive use of ABPM for individual risk assessment and personalization of antihypertensive treatment in CKD patients.
The impact of chronic kidney disease on long-term outcomes following semi-urgent and elective percutaneous coronary intervention
Authors: Soh Rodney Yu-Hang , Sia Ching-Hui , Lau Rui-Huai , Ho Pei-Ying , Timothy Ng Yi-Ming , Ho Jamie Sin-Ying , Kaur Harsharon , Sim Hui-Wen , Yeo Tiong-Cheng , Tan Huay-Cheem , Chan Mark Yan-Yee , Loh Joshua Ping-Yun 
Published: November 2020

Introduction
The effects of chronic kidney disease (CKD) on outcomes in patients undergoing semi-urgent and elective percutaneous coronary intervention (PCI) are unclear. This study aims to investigate impact of CKD on long-term outcomes of this population.

Methods
This was a retrospective cohort study of patients who underwent semi-urgent and elective PCI from 1 January 2014 to 31 December 2015 at a tertiary academic center. They were stratified into five groups – group 1 [estimated glomerular filtration rate (eGFR) ≥90 ml/min/1.73m2], group 2 (eGFR 60–89 ml/min/1.73m2), group 3 (eGFR 30–59 ml/min/1.73 m2), group 4 (eGFR <30 ml/min/1.73m2), and group 5 (dialysis). Demographics, risk factors in relation to endpoints of all-cause mortality, contrast-induced nephropathy (CIN), three-point major adverse cardiac events (MACE) (cardiac death, subsequent myocardial infarction, subsequent stroke), and four-point MACE (including target lesion revascularization) were analyzed.

Results
One thousand six hundred nine patients were included. Advanced CKD patients were more likely to be female and older, with higher prevalence of co-morbidities. Compared to group 1, group 4 patients were associated with increased risk of three-point [adjusted hazard ratio (aHR) 1.94, 95% confidence interval (CI): 1.06–3.55; P = 0.031] and four-point MACE (aHR 2.15, 95% CI: 1.21–3.80; P = 0.009). However, higher contrast volume usage [odds ratio (OR) 2.20, 95% CI: 1.04–4.68; P = 0.040) was associated with increased CIN risk but not reduced eGFR (OR 1.62, 95% CI: 0.57–4.65; P = 0.369).

Conclusion
Advanced CKD patients undergoing PCI were associated with higher co-morbid burden. Despite adjustments for co-morbidities, these patients had higher mortality and worse cardiovascular outcomes at 3 years following contemporary PCI.
Apolipoprotein B: the Rosetta Stone of lipidology
Authors: Glavinovic Tamara , Sniderman Allan D. 
Published: November 2020

Purpose of review
This review summarizes the evidence that apolipoprotein B (apoB) integrates the conventional lipid markers – total cholesterol, triglycerides, LDL-cholesterol, and non-HDL-cholesterol – into a single index that accurately and simply quantitates the atherogenic risk due to the apoB lipoprotein particles.

Recent findings
Marked hypertriglyceridemia remains the essential signal for hyperchylomicronemia and potential pancreatitis. However, with the exception of Lp(a) and the abnormal cholesterol-enriched remnant particles that are the hallmark of type III hyperlipoproteinemia, recent evidence from discordance analyses and Mendelian randomization indicate that apoB integrates the risk due to the atherogenic lipoprotein particles because all LDL particles are, within the limits of our ability to measure any differences, equally atherogenic and all, except the largest VLDL particles are, within the limits of our ability to measure any differences, equally atherogenic.

Summary
Measuring apoB as well as the conventional lipids is essential for accurate diagnosis. For almost all follow-up, however, apoB is all that need be measured. ApoB is the Rosetta Stone of lipidology because dyslipoproteinemia cannot be understood unless apoB is measured.
Content Validation of the Quality and Safety Framed Clinical Evaluation for Nurse Practitioner Students
Authors: Altmiller Gerry , Dugan Mary Ann 
Published: November 2020

Background
Clinical performance evaluation is a high-stakes assessment that requires a valid and reliable instrument. There appear to be no identified clinical evaluation instruments developed for nurse practitioner (NP) students that have undergone content validation.

Purpose
This study describes the process to develop, validate, and pilot a clinical evaluation instrument for NP students framed in the Quality and Safety Education of Nurses Competencies for advanced practice.

Methods
Six expert nurse educators were recruited for the purpose of rating items for relevance for inclusion in the Quality and Safety Framed Clinical Evaluation Instrument for NP Students using the content validity index. The instrument was pilot tested in a primary care clinical course.

Results
Two rounds of review yielded a 34-item content validated instrument.

Conclusions
Evidence suggests that the Quality and Safety Framed Clinical Evaluation for NP Students is a valid and reliable instrument to evaluate the clinical performance of NP students.
Virtual Education During COVID-19
Authors: Alqahtani Naji , Innab Adnan , Bahari Ghareeb 
Published: November 2020

Background
Because of the COVID-19 pandemic, education and learning processes have been shifted to a completely virtual, online format. Students' satisfaction has been linked to better learning outcomes.

Purpose
The purpose was to determine factors associated with students' satisfaction with e-learning among Saudi nursing students.

Methods
A cross-sectional, correlational descriptive study was conducted among 139 nursing students from different nursing programs in Saudi Arabia using a self-reported online survey.

Results
Previous experience with and readiness for e-learning influenced students' overall satisfaction with e-learning and satisfaction with assessment. Only readiness for e-learning was associated with satisfaction with teaching and generic skills and learning experiences.

Conclusions
This study may enhance faculty members' understandings of factors influencing students' satisfaction with e-learning. Therefore, the urgent national distance education plan may need further development to meet students' needs.
Prevalence of and Factors Associated With Genital and Extragenital Chlamydia and Gonorrhea Among Transgender Women in HIV Care in the United States, 2005 to 2016
Authors: Van Gerwen Olivia T. , Tamhane Ashutosh , Westfall Andrew O. , Mugavero Michael J. , Crane Heidi M. , Moore Richard D. , Karris Maile , Christopoulos Katerina , Dombrowski Julia C. , Mayer Kenneth H. , Marrazzo Jeanne , Dionne-Odom Jodie 
Published: November 2020

Background
Data on testing rates and prevalence of and factors associated with genital and extragenital chlamydia and gonorrhea among transgender women with HIV in the United States are limited.

Methods
This retrospective cohort analysis included transgender women living with HIV enrolled in the US Centers for AIDS Research Network of Integrated Clinical Systems cohort between January 2005 and December 2016 with chlamydia or gonorrhea testing performed in HIV clinic. The primary outcome was a positive test result for chlamydia or gonorrhea at urogenital or extragenital (rectal/pharyngeal) sites. Factors associated with infection were examined using logistic regression and generalized estimating equations to account for multiple tests per woman.

Results
Among 312 transgender women in HIV care, 252 (81%) were tested for chlamydia or gonorrhea at least once. Annual testing rates were low: 23% to 53% at genital sites and 24% to 47% at extragenital sites. A total of 88 infections were detected, and 22% of women (55/252) had at least one positive test result. Most infections occurred at extragenital sites (80% of chlamydia and 82% of gonorrhea positive test results). Factors associated with infection in an adjusted model were as follows: age 18 to 29 years compared with ≥50 years (adjusted odds ratio [aOR], 7.6; 95% confidence interval [CI], 1.8–31.2), CD4 count >350 compared with CD4 <200 (aOR, 5.5; 95% CI, 1.2–25.1), and higher engagement in HIV care (aOR, 2.2; 95% CI, 1.0–4.5).

Conclusions
Among transgender women living with HIV, testing rates for chlamydia and gonorrhea are inadequate, particularly at extragenital sites where most infections occur.
COVID-19 Case Investigation and Contact Tracing: Early Lessons Learned and Future Opportunities
Authors: Ruebush Elizabeth , Fraser Michael R. , Poulin Amelia , Allen Meredith , Lane J. T. , Blumenstock James S. 
Published: November 2020

Context:
Case investigation and contact tracing are fundamental public health strategies for controlling and preventing the spread of infectious diseases. Although the principles behind these strategies are not new, the capacity and operational requirements needed to support disease investigation during the SARS-CoV-2 (COVID-19) pandemic are unprecedented. This article analyzes the implementation of case investigation and contact tracing in controlling COVID-19 transmission during the early stages of the US pandemic response (January 20 through August 31, 2020).

Program Implementation:
Governmental public health agencies mobilized to expand case investigation and contact tracing programs in the early months of the pandemic. In doing so, they encountered a range of challenges that included rapidly scaling up the workforce; developing and subsequently revising guidance and protocols specific to COVID-19 as more was learned about the virus over time; defining job functions; encouraging public acceptance of and participation in case investigation and contact tracing; and assessing the utility of these activities during both the containment and mitigation phases of outbreak response. COVID-19 case investigation and contact tracing programs presented an array of opportunities for health departments to innovate, especially around technology to support public health efforts, as well as opportunities to address health equity and advance community resilience.

Conclusion:
Lessons learned from disease intervention specialists, guidance and resources from federal agencies and national partners, and peer-to-peer exchange of promising practices can support jurisdictions encountering early implementation challenges. Further research is needed to assess COVID-19 case investigation and contact tracing program models and innovations, as well as strategies for implementing these activities during containment and mitigation phases.
Crisis Decision-Making at the Speed of COVID-19: Field Report on Issuing the First Regional Shelter-in-Place Orders in the United States
Authors: Aragón Tomás J. , Cody Sara H. , Farnitano Christopher , Hernandez Lisa B. , Morrow Scott A. , Pan Erica S. , Tzvieli Ori , Willis Matthew 
Published: November 2020

Context:
In March, 2020, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causal agent of coronavirus disease 2019 (COVID-19), was spreading in the Bay Area, especially in Santa Clara County, causing increases in cases, hospitalizations, and deaths.

Program:
The Association of Bay Area Health Officials (ABAHO) represents 13 Bay Area health jurisdictions.

Implementation:
On March 15, 2020, the local health officers of 7 ABAHO members (counties of Alameda, Contra Costa, Marin, San Francisco, San Mateo, and Santa Clara and the city of Berkeley) decided to issue legal orders on March 16 for 6.7 million residents to shelter in place to prevent the spread of SARS-CoV-2, the causal agent of COVID-19. The Bay Area was the first region in the United States to shelter in place, and within days, other regions in the United States followed.

Evaluation:
Subsequent comparative analyses have confirmed that acting early in issuing shelter-in-place orders prevented a large number of cases, hospitalizations, and deaths in the Bay Area throughout the United States. The quality of a decision—in this case, for crisis decision making—cannot be judged by the outcome. A good decision can have a bad outcome, and a bad decision can have a good outcome. The quality of a decision depends only on the quality of the decision-making process at the time the decision was made.

Discussion:
In this Field Report, we review how we made this collective decision. With the benefit of hindsight and reflection, we recount our story through the lens of public health legal authority, meta-leadership, and decision intelligence. Our purpose is to improve the crisis decision-making skills of public health officials by improving how we make high-stakes decisions each day in our continuing fight to contain the SARS-CoV-2 pandemic, to save lives, and to eliminate COVID-19 racial/ethnic inequities.
Bilateral Complete Cleft Lip Repair: A Step-by-Step Video Series
Authors: Denadai Rafael , Pai Betty C. J. , Sato Nobuhiro , Lonic Daniel , Chou Pang-Yun , Lo Lun-Jou 
Published: November 2020

Summary:
Surgeons-in-training learning how to perform cleft surgery should not only acquire a broad repertoire of technical details but also master the proper execution of techniques based on the modern principles of bilateral cleft lip repair with synchronous reconstruction of cleft nose deformity. This article describes a bilateral complete cleft lip repair by adopting these principles, plus a modified composition of mucosal flaps for the nasal floor and intraoral linings, including the prolabial mucosal flap, C-flap mucosal flap, inferior turbinate mucosal flap, and lateral nasal mucosal flap. The accompanying four-part video series presents the step-by-step approach for design and execution of this alternative technique.