bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Is My Heart Healing?” A Meta-synthesis of Patients' Experiences After Acute Myocardial Infarction
Authors: Dreyer Rachel P. , Pavlo Anthony J. , Hersey Denise , Horne Anna , Dunn Robert , Norris Colleen M. , Davidson Larry 
Published: August 2020

Background
Recovery from acute myocardial infarction (AMI) has been primarily understood in a narrow medical sense. For patients who survive, secondary prevention focuses largely on enhancing clinical outcomes. As a result, there is a lack of descriptive accounts of patients' experiences after AMI and little is known about how people go about the challenge of recovering from such an event.

Objective
We conducted a meta-synthesis of the available literature on qualitative accounts of patients' experiences after AMI.

Methods
We searched for relevant papers that were descriptive, qualitative accounts of participants' experiences after AMI across 4 electronic databases (April 2016). Using an adapted meta-ethnography approach, we analyzed the findings by translating studies into one another and synthesizing the findings from the studies.

Results
After a review of titles/abstracts, reading each article twice in full, and cross-referencing articles, this process resulted in 17 studies with 224 participants (48% women) aged 23 to 90 years. All participants provided a first-person account of an AMI within the 3-day to 25-year time frame. Two major themes emerged that characterized patients' experiences: navigating lifestyle changes and navigating the emotional reaction to the event—consisting of various subthemes.

Conclusion
Although AMI tends to be seen as a discrete event, participants are left with little professional guidance as to how to negotiate significant, and often discordant, psychosocial changes that have long-lasting effects on their lives, similar to persons with chronic illnesses but without research in place to figure out how to best support them.
Vitamin D Mediates the Relationship Between Depressive Symptoms and Quality of Life Among Patients With Heart Failure
Authors: Ruz Mohannad Eid Abu , Momani Aaliyah , Shajrawi Abed Almajeed 
Published: August 2020

Background
Depressive symptoms are common among patients with heart failure and are associated with poor quality of life. Vitamin D plays a role in the regulation of mood and depressive symptoms levels. Patients with heart failure can have lower levels of vitamin D.

Objective
The aim of this study was to explore the relationship between vitamin D deficiency, depressive symptoms, and quality of life among patients with heart failure in Jordan.

Methods
A cross-sectional correlational comparative design was used in this study. Depressive symptoms were measured by the Arabic subscale of the Hospital Anxiety and Depression Scale, quality of life was measured by the 36-item Short Form Health Survey questionnaire, and vitamin D was measured in plasma. Data were analyzed by independent-sample t test and multiple regression.

Results
A total of 220 patients participated in this study, 70.5% of whom were men, and 57.3% had vitamin D deficiency (<30 ng/mL). Patients with vitamin D deficiency had higher levels of depressive symptoms compared with those with normal levels (mean [SD], 16.2 [4.3] vs 6.3 [2.3]; P ≤ .001). In multiple regression, according to the Baron and Kenny approach, depressive symptoms predicted quality of life and vitamin D levels. Vitamin D deficiency and higher levels of depressive symptoms were associated with poor quality of life.

Conclusions
Vitamin D levels partially mediated the relationship between depressive symptoms and quality of life. Therefore, further research is needed to better understand the nature of the relationship between vitamin D deficiency, depressive symptoms, and quality of life among patients with heart failure.
Prognostic Value of Braden Scale in Patients With Acute Myocardial Infarction
Authors: Jia Yu , Li Hong , Li Dongze , Li Fanghui , Li Qin , Jiang Ying , Gao Yongli , Wan Zhi , Cao Yu , Zeng Zhi , Zeng Rui 
Published: August 2020

Background
The Braden Scale (BS) is a routine nursing measure used to predict pressure ulcer events; it is recommended as a frailty identification instrument.

Objective
We aimed to evaluate the predictive utility of the BS in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention.

Methods
We enrolled 2285 patients with AMI from the Retrospective Multicenter Study for Early Evaluation of Acute Chest Pain. The patients were divided into 3 groups (B1, B2, and B3) according to their BS score (≤12 vs 13–14 vs ≥15). The primary endpoint was all-cause death.

Results
There were 264 (12.0%) all-cause deaths during the median follow-up period of 10.5 (7.9–14.2) months. In-hospital and midterm mortality and other adverse outcomes increased with decreases in the BS score. The Kaplan-Meier survival analysis showed that patients with a lower BS score had a lower cumulative survival rate (P < .001). The multivariate Cox regression analysis showed that a decreased BS score was an independent predictor for all-cause mortality (B2 vs B1: hazard ratio, 0.610; 95% confidence interval, 0.440–0.846; P = .003; B3 vs B1: hazard ratio, 0.345; 95% confidence interval, 0.241–0.493; P < .001).

Conclusions
The BS at admission may be a useful routine nursing measure to evaluate the prognosis of patients with AMI. The BS may be used to stratify risk at early stages and to identify those who may benefit from further assessment and intervention due to frailty syndrome.
Exercise Training in Patients With Heart Failure With Preserved Ejection Fraction
Authors: Bean Glenn , Mou Jin , Pflugeisen Bethann , Olsen Lindsay , Hoag Stephanie , Silva Angela , Ball Andrea L. , Lee Tobias 
Published: August 2020

Background
Patients with heart failure with preserved ejection fraction (HFpEF) experience poor exercise tolerance and quality of life. Little is known about the feasibility or effects of HFpEF exercise training (ET) in a community hospital setting.

Objective
The aim of this study was to examine the feasibility and pilot data of a community-based HFpEF ET intervention.

Methods
This was a single-group (n = 16), pretest-posttest, 9-week ET intervention. The Minnesota Living With Heart Failure Questionnaire, Patient Health Questionnaire-9, cardiopulmonary exercise test (peak VO2), and 6-minute walk test were used for evaluation.

Results
Participants (n = 16) attended 88% of prescribed ET sessions and 94% completed all pretest-posttest assessments. Significant improvements in Minnesota Living With Heart Failure Questionnaire (P = .01), Patient Health Questionnaire-9 (P ≤ .01), exercise test time (P = .01) and 6-minute walk test (P = .001), but not in peak VO2 (P = .16), were found.

Conclusions
The ET intervention was feasible and safe, and findings support improved quality of life, depressive symptoms, and exercise tolerance. Larger controlled trials are warranted.
COVID-19 Is a Catalyst for Future Changes in Stroke Nursing Care
Authors: Paletz Laurie 
Published: August 2020

ABSTRACT

INTRODUCTION: During the COVID-19 pandemic, hospitals still have to meet external regulations while delivering compassionate patient care. This reflections article provides a solution for certified stroke programs to continue to meet stroke certification requirements. One area of focus, in this article, is stroke education. Because of “shelter-in-place orders,” there were no visitors permitted at the bedside, yet we know that high-quality poststroke education is important to improve outcomes. The purpose of this reflections article is to share what has worked at my institution. INNOVATIONS: We found that calling family members to engage them in stroke education was a great option. They seemed engaged, took notes, and asked questions. Nurses document details from these phone encounters in the patient's medical record. Many people placed the call on speaker so other family members could listen to the education session. While family members were at home, telehealth nursing has its own set of challenges. Although telehealth is not a perfect solution, it was one we found most reasonable and found it to work well through this unprecedented time. SUMMARY: These strategies are being shared to promote dissemination of innovative nursing interventions that will help to continue providing loved ones with the information and education they deserve to receive even during the COVID-19 pandemic.
Hearing Outcomes of Treatment for Acute Noise-induced Hearing Loss: A Systematic Review and Meta-analysis
Authors: Koochakzadeh Sina , Gupta Avigeet , Nguyen Shaun A. , McRackan Theodore R. , Kil Jonathan , Bhenswala Prashant N. , Lambert Paul R. 
Published: August 2020

Objective:
To determine the efficacy of various treatment modalities used for acute noise-induced hearing loss (aNIHL) from acute acoustic trauma (AAT) via a systematic review and meta-analysis.

Data Sources:
PubMed, Cochrane, and Scopus databases.

Study Selection:
The scientific literature was searched up to October 2018 for articles evaluating hearing outcomes after treatment of aNIHL.

Data Extraction:
The following were extracted: Oxford level of evidence, number of patients, mean age, time to presentation, source of noise exposure, method of treatment/intervention, baseline hearing threshold, posttreatment hearing threshold, hearing gain, proportion of patients with no recovery, partial recovery, or complete recovery, and treatment complications.

Data Synthesis:
Sixteen studies with 932 patients met inclusion criteria for systematic review and four studies with 187 patients were included in the meta-analysis.

Conclusions:
Treatment modalities identified were steroids, vascular agents, nootropics, antioxidants, vitamins, cell apoptosis inhibitors, and hyperbaric oxygen therapy. Meta-analysis demonstrated significant improvement in mean hearing threshold for patients with high-frequency hearing loss, those treated within 48 hours, and those receiving treatment with a nootropic agent. Significant heterogeneity was present in experimental design among included studies and many were of lower levels of evidence. More prospective, large scale, randomized, double-blinded, placebo-controlled clinical trials are required to determine optimal treatment regimens for patients suffering from aNIHL caused by AAT.
Endoscopic Stapedectomy: Collective Experience From a Large Australian Center
Authors: Vaughan Casey , Fox Richard , Jufas Nicholas , Kong Jonathan H. K. , Patel Nirmal P. , Saxby Alexander J. 
Published: August 2020

Introduction:
Endoscopic stapes surgery is a technically demanding procedure that is increasing in popularity. Surgical outcomes and complication rates have been demonstrated to be comparable to traditional microscopic techniques. The surgical outcomes for patients undergoing stapes surgery performed by the Sydney Endoscopic Ear Surgery Research Group are presented.

Study Design:
Retrospective review from prospectively gathered database.

Setting:
Tertiary referral centers.

Patients:
A retrospective case review of patients undergoing endoscopic stapes surgery performed by four surgeons between February 2015 and July 2019 was carried out. Sixty nine patients were identified, and assessed for demographics, functional results, and postoperative complications.

Intervention:
Endoscopic stapedotomy.

Main Outcome Measure:
Postoperative hearing results.

Results:
Sixty eight of 69 patients (98.6%) achieved an air-bone gap (ABG) closure of less than 20 dB. Sixty of 69 patients (87%) achieved and ABG closure of less than 10 dB. The average improvement of the ABG over four frequencies achieved was 26.5 dB (range, 0–61). Postoperative complications were infrequent and self-limiting. Six patients experienced dysgeusia without obvious chorda tympani injury, four patients developed short lived vertigo, and two patients experienced tinnitus.

Conclusions:
Endoscopically assisted stapes surgery represents a safe alternative to traditional microscopic techniques, with similar morbidity and audiological outcomes.
Immune Response of Macrophage Population to Cochlear Implantation: Cochlea Immune Cells
Authors: Noonan Kathryn Y. , Lopez Ivan A. , Ishiyama Gail , Ishiyama Akira 
Published: August 2020

Hypothesis:
The presence and distribution of ionized calcium binding adaptor 1 and CD68 macrophages in the human cochlea is altered in cochlear implantation (CI) compared with the normative or nonimplanted cochlea.

Background:
It has been hypothesized that CI induces an immunological response in macrophages leading to implant failure or reduced hearing. Macrophages are resident immune cells in human cochlea and have been shown to phagocytize implant material. In animal models, macrophage populations increase with surgical stress and with the introduction of a foreign body. However, the function and response of inner ear macrophages to CI are only beginning to be understood. This study seeks to investigate the inflammatory response to CI by comparing cochlear macrophages in implanted and nonimplanted human temporal bones.

Methods:
Nineteen temporal bones from nine implanted ears, seven contralateral controls, and three normal control ears were evaluated for the presence and distribution of CD68 and Iba1 expressing positive macrophages.

Results:
Three types of macrophage populations were detected 1) CD68 positive macrophages, 2) Iba1 positive macrophages, and 3) CD68 and Iba1 colocalizing macrophages. Macrophage distribution was ubiquitous: the stria vascularis, Rosenthal canal, and the mid-modiolus intermingled in the spiral ganglia. Iba1 and CD68 macrophages were found in the CI and non-CI contralateral and normal human cochlea. Most ionized calcium binding adaptor 1 expressing macrophages were ramified/amoeboid cells, while CD68 expressing macrophages were round shaped with foamy appearance in some areas. In the CI cochlea, both types of macrophages were detected in the fibrous sheath surrounding the CI path and within fibrotic areas within the scala tympani and the scala vestibuli in the case of CI translocation. In four cases, the density of macrophages was unchanged in the CI compared with the contralateral nonimplanted side, and in three cases, there was an increased number of macrophages in the implanted CI side compared with the nonimplanted side.

Conclusion:
Multiple populations of macrophages exist within the cochlea which are present at baseline and in response to trauma from CI. These results further support evidence for a macrophage response to cochlear implantation. Further studies are indicated to evaluate whether these macrophages have a beneficial, detrimental, or a mixed effect in CI patients.
Are There Real-world Benefits to Bimodal Listening?
Authors: Nyirjesy Sarah , Rodman Cole , Tamati Terrin N. , Moberly Aaron C. 
Published: August 2020

Objective:
To assess the benefits of bimodal listening (i.e., addition of contralateral hearing aid) for cochlear implant (CI) users on real-world tasks involving high-talker variability speech materials, environmental sounds, and self-reported quality of life (quality of hearing) in listeners’ own best-aided conditions.

Study Design:
Cross-sectional study between groups.

Setting:
Outpatient hearing clinic.

Patients:
Fifty experienced adult CI users divided into groups based on normal daily listening conditions (i.e., best-aided conditions): unilateral CI (CI), unilateral CI with contralateral HA (bimodal listening; CIHA), or bilateral CI (CICI).

Intervention:
Task-specific measures of speech recognition with low (Harvard Standard Sentences) and high (Perceptually Robust English Sentence Test Open-set corpus) talker variability, environmental sound recognition (Familiar Environmental Sounds Test-Identification), and hearing-related quality of life (Nijmegen Cochlear Implant Questionnaire).

Main Outcome Measures:
Test group differences among CI, CIHA, and CICI conditions.

Results:
No group effect was observed for speech recognition with low or high-talker variability, or hearing-related quality of life. Bimodal listeners demonstrated a benefit in environmental sound recognition compared with unilateral CI listeners, with a trend of greater benefit than the bilateral CI group. There was also a visual trend for benefit on high-talker variability speech recognition.

Conclusions:
Findings provide evidence that bimodal listeners demonstrate stronger environmental sound recognition compared with unilateral CI listeners, and support the idea that there are additional advantages to bimodal listening after implantation other than speech recognition measures, which are at risk of being lost if considering bilateral implantation.
A 3D-printed Lateral Skull Base Implant for Repair of Tegmen Defects: A Case Series
Authors: VanKoevering Kyle Keith , Gao Rebecca Weiwei , Ahmed Sameer , Green Glenn Edward , Arts Henry Alexander 
Published: August 2020

Objective:
To determine the feasibility of a patient-specific, three-dimensionally (3D)-printed reconstruction plate for repair of lateral skull base defects.

Study Design:
Prospective case series and cadaveric study.

Setting:
A university-based, tertiary care hospital.

Patients:
Three patients with lateral skull base defects and five cadavers.

Main Outcome Measure(s):
Caliper gauge fit testing was performed in the cadaver temporal bones to determine the fit of the tegmen plate in engaging the tegmen defect. Additionally, three patients underwent standard of care reconstruction of their middle fossa floor using autografts or allografts. Temporary plate insertion during standard operative repair was performed to gauge feasibility and fit. Operative time required for standard grafting compared with placement of the tegmen plate was examined.

Results:
Real-time, intraoperative placement of the tegmen plate in our patients under 1 minute compared with nearly 60 minutes for standard surgical repair. Tegmen plates covered the defects and locked into place from contour matching without impinging on critical structures. Fit testing revealed flush-fitting plates to the cadaveric temporal bone surface with all gaps less than 500 μm.

Conclusions:
Computer modeling and 3D printing can design custom fitted tegmen reconstruction plates for temporal bone defects. Versatility in prefabrication and 3D modeling shows potential in allowing the construct to avoid critical structures and adequately cover defects with high precision to the tegmen surface.
Comparing Cochlear Duct Lengths Between CT and MR Images Using an Otological Surgical Planning Software
Authors: George-Jones Nicholas A. , Tolisano Anthony M. , Kutz J. Walter , Isaacson Brandon , Hunter Jacob B. 
Published: August 2020

Objective:
We sought to examine the intra- and interobserver variability in measuring the cochlear duct length (CDL) from magnetic resonance imaging (MRI) images versus computed tomography (CT) images using an otological surgical planning software that uses measurements of the basal turn diameter and cochlear width to estimate the CDL.

Patients:
Twenty-one adult cochlear implant patients with preoperative MRI and CT images.

Intervention:
Three fellowship-trained neurotologists served as the raters in the study. One rater measured the CDL using preoperative CT scans to serve as the benchmark. Two of the raters measured the CDL on preoperative MRI scans. One rater also remeasured the scans using MRI images after a period of 1 week to assess intraobserver variability.

Main Outcome Measure:
Intraclass correlational coefficients were calculated to assess for intra- and interobserver agreement.

Results:
The mean CDL measured from the CT scans was 32.7 ± 2.0 mm (range 29.4 – 37.6 mm). The mean difference between the raters when measuring the CDL using MRI scans was −0.15 ± 2.1 mm (range −3.2 to 4.3 mm). The intraclass correlational coefficients for inter-rater reliability of CDL determination using MRI scans was judged as fair to excellent (0.68; 95% CI 0.41–0.84). The intrarater reliability of CDL determination using MRI scans was judged at fair to excellent (0.73; 95% CI 0.491–0.866).

Conclusion:
We demonstrate that a validated otological surgical planning software for estimating the CDL preoperatively had comparable performance using MRI scans versus the gold-standard CT scans.
Congenital Hearing Loss Is Associated With a High Incidence of Central Nervous System Abnormalities
Authors: Sayyid Zahra N. , Boldt Brian , Mokhtari Tara E. , Schoppy Krista , Yeom Kristen W. , Cheng Alan G. 
Published: August 2020

Objective(s):
To assess the incidence of central nervous system abnormalities in pediatric subjects with sensorineural hearing loss (SNHL).

Methods:
One hundred forty-three pediatric subjects evaluated for SNHL at a single academic center from 2007 to 2014 were included and divided into eight diagnosis groups based on etiology of SNHL. One hundred forty-three age- and gender-matched control subjects with no known brain-related pathology or history of hearing loss were included as healthy controls for comparison. Two neuroradiologists independently evaluated magnetic resonance imaging (MRI) and computed tomography (CT) scans for each subject. Comparison of abnormal cerebral development was performed using an ordinal logistic regression model. Concordance between CT and MRI of the temporal bone was assessed using the kappa statistic.

Results:
The etiologies of hearing loss in our cohort were 37.8% genetic, 12.6% infectious, 1.4% ototoxin-induced, and 48.3% idiopathic. Brain MRI revealed cerebral developmental abnormalities in defined regions in >30% of the SNHL cohort, significantly more than in normal-hearing pediatric controls. The Sylvian fissure, Virchow-Robin spaces, and lateral ventricles were most commonly affected. In the temporal bone, the percentage of subjects with concordant findings on CT and MRI was ≥92% across all anatomical structures.

Conclusion:
MRI revealed a high incidence of intracranial abnormalities, suggestive of aberrant development of auditory and nonauditory neural structures associated with SNHL. CT and MRI share a high degree of concordance in detecting temporal bone anomalies. Inclusion of MRI as part of the workup of congenital SNHL may facilitate the detection of developmental anomalies of the brain associated with SNHL.
When Opposites Attract: Pediatric Cochlear Implantation in the Setting of Cerebrospinal Fluid Shunts
Authors: Selleck Anne Morgan , Park Lisa R. , Brown Kevin D. 
Published: August 2020

Objective:
The Food and Drug Administration (FDA) has recently raised concern regarding the safety of cochlear implantation in the setting of programmable cerebrospinal fluid shunts. The purpose of this study was to evaluate the outcomes and complications of cochlear implantation in children who have a cerebrospinal fluid shunt.

Study Design:
Retrospective chart review.

Setting:
Tertiary academic referral center.

Patients:
Twenty pediatric subjects with a cerebrospinal fluid shunt and cochlear implant (CI).

Intervention:
Cochlear implantation in the setting of a cerebrospinal fluid shunt.

Main Outcome Measures:
Primary outcome measures included descriptive data regarding age at implantation, etiology of hearing loss, medical management, complications, and speech perception outcomes.

Results:
The average age of CI candidacy was 30 months with an average 21.5 months delay to implantation. In 45% of cases the laterality of the shunt determined the ear to be implanted. Three of the subjects required a surgical intervention on the shunt before cochlear implantation. Three subjects had a concurrently programmable shunt and activated CI. Two of the three subjects had no complications as a result of the two devices; however, the third subject had significant interactions requiring multiple revision surgeries. For those with the cognitive ability to perform open set, recoded speech perception, the average postoperative Consonant Nucleus Consonant word score in the best aided condition was 65.2% (n = 5).

Conclusions:
Children with a cerebrospinal fluid shunt are viable candidates for cochlear implantation, although they often require additional procedures and considerations before and after implantation.