bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differentiation in stem and leaf traits among sympatric lianas, scandent shrubs and trees in a subalpine cold temperate forest
Authors: Zhang Ke-Yan , Yang Da , Zhang Yun-Bing , Ellsworth David S , Xu Kun , Zhang Yi-Ping , Chen Ya-Jun , He Fangliang , Zhang Jiao-Lin 
Published: April 2021

Abstract
The scandent shrub plant form is a variant of liana that has upright and self-supporting stems when young but later becomes a climber. We aimed to explore the associations of stem and leaf traits among sympatric lianas, scandent shrubs and trees, and the effects of growth form and leaf habit on variation in stem or leaf traits. We measured 16 functional traits related to stem xylem anatomy, leaf morphology and nutrient stoichiometry in eight liana, eight scandent shrub and 21 tree species co-occurring in a subalpine cold temperate forest at an elevation of 2600–3200 m in Southwest China. Overall, lianas, scandent shrubs and trees were ordered along a fast–slow continuum of stem and leaf functional traits, with some traits overlapping. We found a consistent pattern of lianas &gt; scandent shrubs &gt; trees for hydraulically weighted vessel diameter, maximum vessel diameter and theoretical hydraulic conductivity. Vessel density and sapwood density showed a pattern of lianas = scandent shrubs &lt; trees, and lianas &lt; scandent shrubs = trees, respectively. Lianas had significantly higher specific leaf area and lower carbon concentration than co-occurring trees, with scandent shrubs showing intermediate values that overlapped with lianas and trees. The differentiation among lianas, scandent shrubs and trees was mainly explained by variation in stem traits. Additionally, deciduous lianas were positioned at the fast end of the trait spectrum, and evergreen trees at the slow end of the spectrum. Our results showed for the first time clear differentiation in stem and leaf traits among sympatric liana, scandent shrub and tree species in a subalpine cold temperate forest. This work will contribute to understanding the mechanisms responsible for variation in ecological strategies of different growth forms of woody plants.
Burn Survivors’ Experiences of the Ongoing Challenges after Discharge in South Korea: A Qualitative Study
Authors: Kim Kyung Ja , Boo Sunjoo , Oh Hyunjin 
Published: April 2021

ABSTRACT

OBJECTIVE
To help burn survivors during the recovery time after discharge, healthcare professionals need to understand their experiences and care requirements. However, little is known about the experience of burn survivors after discharge in South Korea. This study aims to explore their experiences in a community setting.

METHODS
Using a qualitative descriptive format, data were collected by semistructured interview from 10 patients who had sustained major burns. Each interview was based on a protocol of 60 to 90 minutes’ duration and used a qualitative content analysis.

RESULTS
Three themes were identified in the analysis: (1) ongoing distressing symptoms and the unpredictability of hypertrophic scars, (2) difficulties in reintegration into society, and (3) burden of health expenditure.

CONCLUSIONS
Several participants expressed consistent difficulties with distressing symptoms such as wound pain, pruritus, sleep disturbances, and unpredictable scar and symptom changes. Survivors further described the financial burden associated with high expenditures from nonreimbursable rehabilitation expenses, and the high cost incurred with consistent skin care. By providing support based on their needs, appropriate interventions would be more readily available for burn survivors.
Mother–Infant Dyadic Synchrony in the NICU Context
Authors: Neugebauer Christine , Oh Wonjung , McCarty Michael , Mastergeorge Ann M. 
Published: April 2021

Background:
Dyadic synchrony is a co-constructed social process relating to the back and forth interactions between mothers and infants that are strongly associated with neurodevelopment, self-regulation, and attachment. In the neonatal intensive care unit (NICU), this process may become interrupted because of the physiological state of the infant, the emotional state of the mother, and the physical environment of the NICU.

Purpose:
In applying Feldman's Biobehavioral Model of Synchrony, this empirical review deconstructs the process of dyadic synchrony in the NICU context and provides a conceptual approach to guide both research and clinical practice.

Methods:
First, we examine the theoretical and empirical literature to explicate the primary structural and biophysiological components of synchrony and relate these constructs to the extant research on premature infants. Next, we synthesize the maternal, infant, and contextual factors that facilitate or inhibit the ontogenesis of dyadic synchrony in the NICU. The final section highlights the state of the science in dyadic synchrony in the NICU including gaps and recommendations for future research.

Findings:
An empirical review synthesis presents a visual conceptual framework to illustrate multiple processes that depict maternal, infant, and contextual influences of mother–infant synchrony in the NICU.

Implications for Practice/Research:
Despite the challenges posed to mother–infant relationships in the NICU, high-quality mother–infant interactions are possible, dyadic synchrony can emerge, and premature infants can develop secure attachments. Clinicians and researchers can apply this conceptual framework of mother–infant dyadic synchrony in the NICU to promote evidence-based research and clinical practice.
Review of the Reliability and Validity of the Apgar Score
Authors: Michel Alexandra 
Published: April 2021

Background:
The Apgar score is the most common score used to quantify neonatal status after birth. It is routinely used in clinical practice and research. However, since its introduction there have been significant changes in peripartum and neonatal management, our understanding of neonatal physiology, and changes in data analysis capabilities.

Purpose:
To assess the Apgar score's reliability and validity in the context of today's clinical and research environments.

Method:
PubMed was searched using the term “Apgar.” Just over 22,000 titles were identified. Full-text articles were obtained if they addressed the Apgar score's use, reliability, and validity, or if the score was a primary outcome measure. This was followed by a hand search using the same criteria. The 505 identified articles build the basis for this discussion of the Apgar score's reliability and validity.

Findings:
Multiple positive and negative aspects of the Apgar score's reliability and validity were identified. Some facets needed to evaluate reliability and validity do not seem to have been addressed in the literature. Overall, the identified concerns can introduce bias into outcomes obtained via the use of the Apgar score in both clinical practice and research.

Implications for Practice:
The Apgar score is no longer used to determine neonatal management in the delivery room.

Implications for Research:
The use of the Apgar score in research may introduce bias into outcomes. As discussed in the Video Abstract, researchers need to address and improve the score's weaknesses or consider developing a new tool better suited to today's research needs.

Video Abstract available at:

https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=45
Sound-level Monitoring Earphones With Smartphone Feedback as an Intervention to Promote Healthy Listening Behaviors in Young Adults
Authors: Knoetze Megan , Mahomed-Asmail Faheema , Manchaiah Vinaya , Swanepoel De Wet 
Published: April 2021

Objectives:
More than a billion adolescents and youngsters are estimated to be at risk of acquiring recreational noise-induced hearing loss (RNIHL) due to the unsafe use of personal audio systems. RNIHL is preventable; therefore, the present study aimed to determine (i) the accuracy and reliability of dbTrack (Westone) sound-level monitoring earphones and (ii) the effect of sound-level monitoring earphones with smartphone feedback and hearing-health information as an intervention to promote healthy listening behaviors in young adults.

Design:
The study consisted of two phases: the first phase investigated the accuracy and reliability of dbTrack sound-level monitoring earphones. Accuracy was determined by comparing earphone measurements to sound level meter measurements. Intradevice reliability was determined by comparing earphone measurements during test-retest conditions. Nineteen participants were recruited through convenience sampling to determine within-subject reliability by comparing in-ear sound levels measured by the earphones during test-retest conditions. For the second phase of the study, a single-group pretest-posttest design was utilized. Forty participants, recruited through snowball sampling, utilized the sound-level monitoring earphones with the accompanying dbTrack smartphone application for 4 weeks. The application’s smartphone feedback was disabled during the first 2 weeks (pretest condition) and enabled during the last 2 weeks (posttest condition). Average daily intensities, durations, and sound dosages measured during pre- and posttest conditions were compared.

Results:
Phase 1 dbTrack earphone measurements were within 1 dB when compared with sound level meter measurements. Earphones were also within 1 dB in repeated measures across earphones and across participants. Phase 2 posttest average daily intensity decreased by 8.7 dB (18.3 SD), duration decreased by 7.6 minutes (46.6 SD), and sound dose decreased by 4128.4% (24965.5% SD). Differences in intensity and sound dose were significantly lower with a small and medium effect size, respectively.

Conclusions:
This study’s preliminary data indicate that dbTrack (Westone) sound-level monitoring earphones with a calibrated in-ear microphone can reliably and accurately measure personal audio systems sound exposure. Preliminary results also suggest that feedback on sound exposure using the accurate sound-level monitoring earphones with the accompanying dbTrack application can potentially promote safe listening behavior in young adults and reduce the risk of acquiring an RNIHL.
The Sensitivity of the Electrically Stimulated Auditory Nerve to Amplitude Modulation Cues Declines With Advanced Age
Authors: Riggs William J. , Vaughan Chloe , Skidmore Jeffrey , Conroy Sara , Pellittieri Angela , Carter Brittney L. , Stegman Curtis J. , He Shuman 
Published: April 2021

Objectives:
This study aimed to investigate effects of aging and duration of deafness on sensitivity of the auditory nerve (AN) to amplitude modulation (AM) cues delivered using trains of biphasic pulses in adult cochlear implant (CI) users.

Design:
There were 21 postlingually deaf adult CI users who participated in this study. All study participants used a Cochlear Nucleus device with a full electrode array insertion in the test ear. The stimulus was a 200-ms pulse train with a pulse rate of 2000 pulses per second. This carrier pulse train was sinusodially AM at four modulation rates (20, 40, 100, 200 Hz). The peak amplitude of the modulated pulse train was the maximum comfortable level (i.e., C level) measured for the carrier pulse train. The electrically evoked compound action potential (eCAP) to each of the 20 pulses selected over the last two AM cycles were measured. In addition, eCAPs to single pulses were measured with the probe levels corresponding to the levels of 20 selected pulses from each AM pulse train. There were seven electrodes across the array evaluated in 16 subjects (i.e., electrodes 3 or 4, 6, 9, 12, 15, 18, and 21). For the remaining five subjects, 4 to 5 electrodes were tested due to impedance issues or time constraints. The modulated response amplitude ratio (MRAR) was calculated as the ratio of the difference in the maximum and the minimum eCAP amplitude measured for the AM pulse train to that measured for the single pulse, and served as the dependent variable. Age at time of testing and duration of deafness measured/defined using three criteria served as the independent variables. Linear Mixed Models were used to assess the effects of age at testing and duration of deafness on the MRAR.

Results:
Age at testing had a strong, negative effect on the MRAR. For each subject, the duration of deafness varied substantially depending on how it was defined/measured, which demonstrates the difficulty of accurately measuring the duration of deafness in adult CI users. There was no clear or reliable trend showing a relationship between the MRAR measured at any AM rate and duration of deafness defined by any criteria. After controlling for the effect of age at testing, MRARs measured at 200 Hz and basal electrode locations (i.e., electrodes 3 and 6) were larger than those measured at any other AM rate and apical electrode locations (i.e., electrodes 18 and 21)

Conclusions:
The AN sensitivity to AM cues implemented in the pulse-train stimulation significantly declines with advanced age. Accurately measuring duration of deafness in adult CI users is challenging, which, at least partially, might have accounted for the inconclusive findings in the relationship between the duration of deafness and the AN sensitivity to AM cues in this study.
Longer Cochlear Implant Experience Leads to Better Production of Mandarin Tones for Early Implanted Children
Authors: Tang Ping , Yuen Ivan , Xu Rattanasone Nan , Gao Liqun , Demuth Katherine 
Published: April 2021

Objectives:
Children with cochlear implants (CIs) face challenges in acquiring tones, since CIs do not transmit pitch information effectively. It has been suggested that longer CI experience provides additional benefits for children implanted early, enabling them to achieve language abilities similar to that of normal-hearing (NH) children (Colletti 2009). Mandarin is a tonal language with four lexical tones and a neutral tone (T0), characterized by distinct pitch and durational patterns. It has been suggested that early implantation (i.e., before 2 years) greatly benefits the acquisition of Mandarin tones by children with CIs (Tang et al. 2019c). In this study, we extend those findings to investigate the effect of CI experience on the acquisition of Mandarin tones for children implanted early. We asked the extent to which they were able to produce distinct pitch and durational patterns of both lexical tones and T0 as a function of CI experience, and the extent to which their tonal productions were acoustically like that of NH children.

Design:
Forty-four NH 3-year olds and 28 children implanted with CIs between 1 and 2 years, aged 3 to 7, were recruited. The children with CIs were grouped according to the length of CI experience: 3 to 6 years, 2 to 3 years, and 1 to 2 years. Lexical tone and T0 productions were elicited using a picture-naming task. Tonal productions from the children with CIs were acoustically analyzed and compared with those from the NH children.

Results:
Children with 3 to 6 years of CI experience were able to produce distinct pitch and durational patterns for both lexical tones and T0, with NH-like acoustic realizations. Children with 2 to 3 years of CI experience were also able to produce the expected tonal patterns, although their productions were not yet NH-like. Those with only 1 to 2 years of CI experience, however, were not yet able to produce the distinct acoustic patterns for either lexical tones or T0.

Conclusions:
These results provide acoustic evidence demonstrating that, when Mandarin-speaking children are implanted before the age of 2, only those with 3 to 6 years of experience were able to produce NH-like tones, including both lexical tone and T0. Children with shorter CI experience (less than 3 years) were unable to produce distinct acoustic patterns for the different tones. This suggests that at least 3 years of CI experience is still needed for early implanted children to acquire tonal distinctions similar to those of NH 3-year olds.
Association Between the Right Ear Advantage in Dichotic Listening and Interaural Differences in Sensory Processing at Lower Levels of the Auditory System in Older Adults
Authors: Ianiszewski Alejandro , Fuente Adrian , Gagné Jean-Pierre 
Published: April 2021

Objective:
Current evidence suggests that an enhanced right ear advantage (REA) in dichotic listening (DL) among older adults may originate from age-related structural changes in the corpus callosum and age-related decline in cognitive processes. Less is known about the effect of information processing at lower portions of the auditory system on DL performance. The present study investigates whether interaural differences (ID) in sensory processing at lower levels of the auditory system are associated with the magnitude of the REA in DL among older adults.

Design:
Sixty-eight older adults participated in the study. Participants were assessed with a DL test using nonforced (NF) and forced attention paradigms. Hearing sensitivity, transient-evoked otoacoustic emission (TEOAE), contralateral suppression of TEOAE, a proxy measure of medial olivocochlear activation, and auditory brainstem response to speech stimuli (speech-ABR) were tested in both ears separately. The ID in sensory processing at lower levels of the auditory system was derived by calculating the difference between the RE and LE for each auditory measure. Bivariate and multivariate regression models were performed. One multivariate model for each DL paradigm (NF and forced attention) was independently constructed. Measures of cognitive speed of processing and cognitive flexibility were accounted for in the regression models.

Results:
For both multivariate regression models, ID in pure-tone thresholds and ID in MOC suppression of TEOAE were significantly associated with the magnitude of the REA for DL among older adults. Cognitive measures of speed of processing and cognitive flexibility also contributed to the magnitude of the REA.

Conclusion:
These results suggest that ID in sensory processing at lower levels of the auditory system account, at least in part, for the increased magnitude of the REA in DL among older adults.
Tinnitus and Its Central Correlates: A Neuroimaging Study in a Large Aging Population
Authors: Oosterloo Berthe C. , Croll Pauline H. , Goedegebure André , Roshchupkin Gennady V. , Baatenburg de Jong Robert J. , Ikram M. Arfan , Vernooij Meike W. 
Published: April 2021

Objectives:
To elucidate the association between tinnitus and brain tissue volumes and white matter microstructural integrity.

Design:
Two thousand six hundred sixteen participants (mean age, 65.7 years [SD: 7.5 years]; 53.9% female) of the population-based Rotterdam Study underwent tinnitus assessment (2011 to 2014) and magnetic resonance imaging of the brain (2011 to 2014). Associations between tinnitus (present versus absent) and total, gray, and white matter volume and global white matter microstructure were assessed using multivariable linear regression models adjusting for demographic factors, cardiovascular risk factors, depressive symptoms, Mini-Mental State Examination score, and hearing loss. Finally, potential regional gray matter density and white matter microstructural volume differences were assessed on a voxel-based level again using multivariable linear regression.

Results:
Participants with tinnitus (21.8%) had significantly larger brain tissue volumes (difference in SD, 0.09; 95% confidence interval, 0.06 to 0.13), driven by larger white matter volumes (difference, 0.12; 95% confidence interval, 0.04 to 0.21) independent of hearing loss. There was no association between tinnitus and gray matter volumes nor with global white matter microstructure. On a lobar level, tinnitus was associated with larger white matter volumes in each lobe, not with gray matter volume. Voxel-based results did not show regional specificity.

Conclusions:
We found that tinnitus in older adults was associated with larger brain tissue volumes, driven by larger white matter volumes, independent of age, and hearing loss. Based on these results, it may be hypothesized that tinnitus potentially has a neurodevelopmental origin in earlier life independent of aging processes.
The Presence of Another Individual Influences Listening Effort, But Not Performance
Authors: Pielage Hidde , Zekveld Adriana A. , Saunders Gabrielle H. , Versfeld Niek J. , Lunner Thomas , Kramer Sophia E. 
Published: April 2021

Objectives:
The aim of this study was to modify a speech perception in noise test to assess whether the presence of another individual (copresence), relative to being alone, affected listening performance and effort expenditure. Furthermore, this study assessed if the effect of the other individual’s presence on listening effort was influenced by the difficulty of the task and whether participants had to repeat the sentences they listened to or not.

Design:
Thirty-four young, normal-hearing participants (mean age: 24.7 years) listened to spoken Dutch sentences that were masked with a stationary noise masker and presented through a loudspeaker. The participants alternated between repeating sentences (active condition) and not repeating sentences (passive condition). They did this either alone or together with another participant in the booth. When together, participants took turns repeating sentences. The speech-in-noise test was performed adaptively at three intelligibility levels (20%, 50%, and 80% sentences correct) in a block-wise fashion. During testing, pupil size was recorded as an objective outcome measure of listening effort.

Results:
Lower speech intelligibility levels were associated with increased peak pupil dilation (PPDs) and doing the task in the presence of another individual (compared with doing it alone) significantly increased PPD. No interaction effect between intelligibility and copresence on PPD was found. The results suggested that the change of PPD between doing the task alone or together was especially apparent for people who started the experiment in the presence of another individual. Furthermore, PPD was significantly lower during passive listening, compared with active listening. Finally, it seemed that performance was unaffected by copresence.

Conclusion:
The increased PPDs during listening in the presence of another participant suggest that more effort was invested during the task. However, it seems that the additional effort did not result in a change of performance. This study showed that at least one aspect of the social context of a listening situation (in this case copresence) can affect listening effort, indicating that social context might be important to consider in future cognitive hearing research.