bluuebunny/crossref_metadata_2025_split huggingface dataset:
First Generation Osseointegrated Steady State Implant Benefits in Children With Hearing Loss
Authors: Gordon Karen A. , Papsin Blake C. , Feness MaryLynn , Negandhi Jaina , Cushing Sharon L. 
Published: December 2021

Objective:
To assess outcomes of a new Osseointegrated Steady State Implant (OSSI) for bone conduction in adolescents.

Method:
In an initial trial, 14 adolescents (14.5 years of age, SD = 2.22) were provided with an OSSI; unilateral OSSI (n = 13), bilateral OSSI in sequential surgeries (n = 1). Outcomes measured were surgical duration, complications, hearing thresholds, speech perception and self-reported hearing benefits using the Speech and Spatial Quality of Hearing Questionnaire.

Results:
The surgical times were mean 93.6 minutes (SD = 33.3). Surgery was slightly longer in three adolescents who required skin flap reduction (n = 1) or significant bone polishing (n = 2) (121.33 minutes, SD = 8.14). Adverse events occurred in two adolescents post-implant poor external device retention in one child requiring revision flap reduction and inflammation at the incision site due to magnet overuse in another. The “Digital Link Calibration” measure was a good proxy predictor of the strength of magnet required for external device adherence (p = 0.002). The OSSI increased audibility in the implanted ear by mean 31.48 dB HL (SE = 1.58). Aided thresholds were best at 1 kHz (mean 25.33 dB HL, SD = 22.60) and only slightly poorer at 3000 and 4000 Hz (estimate decrease = 8.33 dB HL, SE = 3.54), reflecting good auditory sensitivity even at high frequencies. Speech perception when using the new device alone was good (89.67%, SD = 7.84%) and self-reported hearing by participants and parents improved in all domains assessed by the Speech and Spatial Quality of Hearing Questionnaire (estimate = 1.90 points, SE = 0.25, p < 0.0001).

Conclusion:
The OSSI provides hearing benefits with surgical safety in a carefully selected cohort of adolescents.
Characterization of Sensorineural Hearing Loss in Patients With MYH9-Related Disease: A Systematic Review
Authors: Peddu Dhiraj , Amin Sahil , Ying Yu-Lan Mary 
Published: December 2021

Objectives:
To review the characteristics and progression of hearing loss in MYH9-related disease (MYH9-RD) patients and present a unique case of bilateral non-simultaneous sudden sensorineural hearing loss (SNHL) in an MYH9-RD patient. MYH9-RD is a rare autosomal dominant platelet disorder. Patients with this disorder have a variable risk of developing SNHL.

Methods:
A comprehensive literature search for scientific articles in PubMed, Scopus, and Web of Science that reported hearing loss outcomes in MYH9-RD patients.

Results:
Initial search yielded 270 studies. Eight studies with a total of 23 patients met inclusion criteria and were used for data analysis. MYH9-RD patients typically present with progressive bilateral SNHL affecting predominantly the high frequencies. Mean age of hearing loss onset was 17.1 years, progressing to severe—profound SNHL over a mean period of 14.4 years. Seventeen of the 23 patients received cochlear implant (CI) at a mean age of 37.9 years. In comparison, the study patient presented initially with bilateral progressive SNHL as a teenager and developed bilateral non-simultaneous sudden SNHL, first in her right ear at the age of 31 and 7 months later in her left ear at the age of 32. She is now a successful bilateral CI user.

Conclusions:
This is the first systematic investigation of the relationship between MYH9-RD patients and SNHL. Hearing loss in MYH9-RD patients is generally characterized as progressive SNHL. However, the study patient presented with the unique feature of bilateral non-simultaneous sudden SNHL, potentially expanding the hearing loss sequela associated with this disorder.
Predictive Effect of Bone Conduction Pattern on Hearing Outcomes of Stapes Surgery
Authors: Shapiro Scott B. , Grojean Meghan , Hong Michael , Lipschitz Noga , Breen Joseph T. , Pensak Myles L. , Samy Ravi N. 
Published: December 2021

Objective:
Examine the effect of preoperative bone conduction pattern on outcomes of stapedotomy/stapedectomy.

Study Design:
Retrospective case series.

Setting:
Tertiary-care academic medical center.

Patients:
Patients who underwent stapedotomy or stapedectomy from 2013 to 2019.

Interventions:
Primary small-fenestra stapedotomy or partial stapedectomy.

Main Outcome Measures:
Association between preoperative bone conduction patterns and hearing after stapes surgery.

Results:
Complete audiometric data were available for 137 patients who had surgery. The mean preoperative air-bone gap (ABG) was 26.8 dBHL. The ABG was closed to less than 20 and 10 dBHL in 88.7 and 65.2% of patients, respectively. A notch at 2000 Hz was present in 32.1% of operated ears and was rarely found at other frequencies. There was no statistically significant association between the presence of a notch and hearing outcomes. The slope of the bone conduction line had no association with hearing outcomes, though an increased bone conduction PTA compared with the contralateral ear was associated with ABG closure less than 10 dBHL and overclosure (odds ratio: 2.14, p = 0.027 and odds ratio: 2.20, p = 0.04).

Conclusion:
In properly selected otosclerosis patients, depressions in bone conduction other than near 2000 Hz are rare and hearing outcomes are generally favorable regardless of the preoperative bone conduction pattern. Despite the association with otosclerosis, the presence of a notch at 2000 Hz is not associated with better hearing outcomes with surgery.
A Case–Case Analysis of Intralabyrinthine Schwannoma Versus Intracanalicular Vestibular Schwannoma
Authors: Selleck Anne Morgan , Hicks Kelli L. , Brown Kevin D. 
Published: December 2021

Objectives:
Determine the differences in presentation of intracanalicular and intralabyrinthine schwannomas.

Study Design:
Retrospective chart review at a single center.

Setting:
Tertiary academic referral center.

Patients:
Eighteen subjects with an intralabyrinthine schwannoma (ILS) and 216 patients with an intracanalicular vestibular schwannoma (VS).

Main Outcome Measures:
Variables collected included age at diagnosis, gender, presenting signs and symptoms, imaging findings, treatment modality, pure-tone average (PTA), and word recognition scores (WRS) at presentation and at follow-up visits.

Results:
Incidence of subjective hearing loss was 100% in the ILS group and 80.6% in the intracanalicular VS group. The degree of hearing loss was significantly worse in the ILS group (average PTA of 83.9 dB; average WRS of 46.9%) compared with the VS group (average PTA of 38.7 dB; average WRS of 71.8%) (PTA p = 0.000006; WRS p = 0.007). Other subjective signs and symptoms, including vestibular symptoms, did not differ significantly between the two groups. Approximately one-third of both groups underwent microsurgical resection. 22.2% of ILSs were missed on initial imaging by radiologists.

Conclusion:
Intralabyrinthine schwannomas differ from intracanalicular schwannomas in the severity of hearing loss at presentation. Otherwise, these two tumors present in a very similar fashion—age at presentation, presenting signs and symptoms—and are treated comparably. Otolaryngologists should maintain a high degree of suspicion for ILS in patients presenting with an asymmetric hearing loss, vertigo, and tinnitus.
Cochlear Implantation Can Improve Auditory Skills, Language and Social Engagement of Children With Autism Spectrum Disorder
Authors: Jenks Carolyn M. , Hoff Stephen R. , Haney Jennifer , Tournis Elizabeth , Thomas Denise , Young Nancy M. 
Published: December 2021

Objective:
To review outcomes of cochlear implantation (CI) in children diagnosed with autism spectrum disorder (ASD).

Study Design:
Retrospective case review and parent survey.

Setting:
Tertiary care children's hospital.

Patients:
Thirty children with ASD who underwent CI between 1991 and 2018. Mean age at CI = 3.5 years (0.8–11.8), mean age at diagnosis of ASD = 5.1 years (2.0–15.0) (22/30 diagnosed after CI), mean follow-up = 10.5 years (1.4–21.6). Parents of 7 children returned a survey.

Intervention:
Unilateral or bilateral cochlear implantation.

Main Outcome Measures:
Speech perception; expressive communication mode; educational placement; social engagement; consistency of CI use; parent survey of child behavior change.

Results:
Thirty-three percent of all and 45% of the 22 consistent device users developed measurable open-set speech perception by an average of 4.5 years of device use. Educational placement at last follow-up included 13% mainstreamed without interpreter, 50% Special Education programs, 10% therapeutic residential or day programs, 23% total communication programs, and one home schooled. Spoken language alone was used by 31% and spoken plus sign by 14%, with the remainder using sign alone, augmentative communication devices or no mode of communication. By parent report, 86% showed improvement in social engagement compared to pre-CI. Survey results showed the behaviors most frequently ranked as most affected by CI were communication and attention, while awareness of environment had the lowest (most affected) mean ranking.

Conclusions:
Findings support a growing body of literature that cochlear implantation has the potential to improve auditory skills, language, and enhance social engagement in some deaf children with autism spectrum disorder.
Use of unattended automated office blood pressure in Utah primary care clinics
Authors: Stuligross John , Hoj Taylor H. , Brown Brittany , Woolsey Sarah , Stults Barry 
Published: December 2021

Aim
Unattended automated office blood pressure (BP) measurement (u-AOBP) improves office BP measurement accuracy and reduces white-coat BP elevation. u-AOBP is recommended as the preferred office BP measurement technique by multiple hypertension guidelines. This study examines utilization, performance, and potential barriers to implementation of u-AOBP in Utah primary care clinics following 5 years of promotional efforts by the Utah Million Hearts Coalition (UMHC).

Methods
An online questionnaire was administered to 285 Utah primary care clinics to evaluate self-reported use of u-AOBP and u-AOBP technique, interpretation of results, and perceived barriers to implementation.

Results
Seventy-nine of 285 clinics (27.7%) completed the full questionnaire. Fifty-nine clinics (74.7%) use u-AOBP. Nearly 65% first learned about u-AOBP through UMHC promotional efforts rather than from the medical literature. One-half of these clinics noted no significant barriers to u-AOBP implementation, and over 80% noted no reduction in medical staff productivity. However, important knowledge deficits concerning correct u-AOBP performance and interpretation of results were apparent from answers to the questionnaire.

Conclusion
After 5 years of UMHC promotional efforts, at least 20% of the 285 Utah primary care clinics invited to take the questionnaire and 75% of the 79 clinics completing the survey have incorporated u-AOBP and found it feasible in a primary care setting. Ongoing promotion of u-AOBP implementation at the local and regional level is required to extend its utilization. Effective, accessible educational materials and local technical assistance from public health and community partners are needed to correct knowledge and performance deficits to optimize u-AOBP utilization in primary care.
Lipidomics in diabetes
Authors: Kim Eun Ji , Ramachandran Radha , Wierzbicki Anthony S. 
Published: December 2021

Purpose of review
Multiple studies have shown a strong association between lipids and diabetes. These are usually described through the effects of cholesterol content of lipid particles and in particular low-density lipoprotein. However, lipoprotein particles contain other components, such as phospholipids and more complex lipid species, such as ceramides and sphingolipids. Ceramides, such as sphingolipids are also produced intracellularly and have signalling actions in regulating cell metabolism including effects on inflammation, and potentially have a mechanistic role in the development of insulin resistance.

Recent findings
Recently, techniques have been developed to analyse detailed molecular profiles of lipid particles – lipidomics. Proteomics has confirmed the different proteins associated with different particles but far less is known about the relationship of individual lipid species with diabetes and cardiovascular risk. A number of studies have now shown that the plasma lipidome, and in particular, ceramides and sphingolipids may predict the development of diabetes.

Summary
Lipidomics had identified ceramides and sphingolipids as potential mediators of cellular dysfunction in diabetes. Further work is required to ascertain whether they have clinical utility.
The association of biological sex and long-term outcomes in patients with acute dyspnea at the emergency department
Authors: Vaittinada Ayar Prabakar , Motiejūnaitė Justina , Čerlinskaitė Kamilė , Deniau Benjamin , Blet Alice , Kavoliūnienė Aušra , Mebazaa Alexandre , Čelutkienė Jelena , Azibani Feriel 
Published: December 2021

Background and importance
Marked differences have been described between women and men in disease prevalence, clinical presentation, response to treatment and outcomes. However, such data are scarce in the acutely ill. An awareness of differences related to biological sex is essential for the success of clinical care and outcomes in patients presenting with acute dyspnea, the most frequent cause of emergency department (ED) admission.

Objectives
The aim of the present study was to assess the effect of biological sex on 1-year all-cause mortality in patients presenting with acute dyspnea to the ED.

Design, settings and participants
Consecutive adult patients presenting with acute dyspnea in two Lithuanian EDs were included. Clinical characteristics, laboratory data and medication use at discharge were collected. Follow-up at 1 year was performed via national data registries.

Outcomes measure and analysis
The primary outcome of the study was 1-year all-cause mortality. Hazard ratios (HRs) for 1-year mortality according to biological sex were calculated using a Cox proportional hazards regression model, with and without adjustment for the following confounders: age, systolic blood pressure, creatinine, sodium and hemoglobin.

Main results
A total of 1455 patients were included. Women represented 43% of the study population. Compared to men, women were older [median (interquartile range [IQR]) age 74 (65–80) vs. 68 (59–77) years, P < 0.0001]. The duration of clinical signs before admission was shorter for women [median (IQR) duration 4 (1–14) vs. 7(2–14) days, P = 0.006]. Unadjusted 1-year all-cause mortality was significantly lower in women (21 vs. 28%, P = 0.001). Adjusted HR of 1-year all-cause mortality was lower in women when compared to men [HR 0.68 (0.53–0.88), P = 0.0028]. Additional sensitivity analyses confirmed the survival benefit for women in subgroups including age greater and lower than 75 years, the presence of comorbidities and causes of dyspnea (cardiac or noncardiac).

Conclusion
Women have better 1-year survival than men after the initial ED presentation for acute dyspnea. Understanding the biological sex-related differences should lead toward precision medicine, and improve clinical decision-making to promote gender equality in health.
Accuracy of Emergency Severity Index in older adults
Authors: Kemp Kirsi , Alakare Janne , Kätkä Minna , Lääperi Mitja , Lehtonen Lasse , Castrén Maaret 
Published: December 2021

Background and importance
Emergency Severity Index is a five-level triage tool in the emergency department that predicts the need for emergency department resources and the degree of emergency. However, it is unknown whether this is valid in patients aged greater than or equal to 65 years.

Objective
The aim of the study was to compare the accuracy of the Emergency Severity Index triage system between emergency department patients aged 18–64 and greater than or equal to 65 years.

Design, settings, and participants
This was a retrospective observational cohort study of adults who presented to a Finnish emergency department between 1 February 2018 and 28 February 2018. All data were collected from electronic health records.

Outcome measures and analysis
The primary outcome was 3-day mortality. The secondary outcomes were 30-day mortality, hospital admission, high dependency unit or ICU admission, and emergency department length of stay. The area under the receiver operating characteristic curve and cutoff performances were used to investigate significant associations between triage categories and outcomes. The results of the two age groups were compared.

Main results
There were 3141 emergency department patients aged 18–64 years and 2370 patients aged greater than or equal to 65 years. The 3-day mortality area under the curve in patients aged greater than or equal to 65 years was greater than that in patients aged 18–64 years. The Emergency Severity Index was associated with high dependency unit/ICU admissions in both groups, with moderate sensitivity [18–64 years: 61.8% (50.9–71.9%); greater than or equal to 65 years: 73.3% (63.5–81.6%)] and high specificity [18–64 years: 93.0% (92.0–93.8%); greater than or equal to 65 years: 90.9% (90.0–92.1%)]. The sensitivity was high and specificity was low for 30-day mortality and hospital admission in both age groups. The emergency department length of stay was the longest in Emergency Severity Index category 3 for both age groups. There was no significant difference in accuracy between age groups for any outcome.

Conclusion
Emergency Severity Index performed well in predicting high dependency unit/ICU admission rates for both 18–64 years and greater than or equal to 65-year-old patients. It predicted the 3-day mortality for patients aged greater than or equal to 65 years with high accuracy. It was inaccurate in predicting 30-day mortality and hospital admission for both age groups.
Factors that lead to dialysis as the preferred treatment modality for patients with chronic kidney disease
Authors: Bleyer Anthony J. 
Published: December 2021

Purpose of review
To describe forces that lead to dialysis as the preferred treatment modality for patients with chronic kidney disease.

Recent findings
Although chronic dialysis is life-saving and the only option available for many individuals, treatment of the underlying causes of kidney disease and transplantation may be preferable options for many patients. Factors that favor dialysis instead of treatment of underlying kidney disease or transplantation include lack of proper diagnosis, lack of proper treatment of underlying kidney disease, poor compliance, lack of consideration for transplantation, early initiation of dialysis therapy, and financial incentives. New developments that may reverse this trend include genetic panels that improve diagnosis of kidney disease, new methods of transplantation, and legislation that will encourage kidney transplantation.

Summary
By recognizing factors that favor dialysis over other therapies, nephrologists may be better able to provide care to their patients and prevent dialysis, researchers may be able to focus on research that will prevent the need for dialysis, and professional societies may work to prevent unneeded dialysis.
Can chronic kidney disease lead to chronic heart failure, and does worsening chronic heart failure lead to chronic kidney disease progression
Authors: Leon Silvia J. , Tangri Navdeep 
Published: December 2021

Purpose of review
The objective of this review is to discuss if chronic kidney disease (CKD) leads to chronic heart failure (CHF), and does worsening CHF lead to CKD progression and how a new medication class can modify the risk of both outcomes.

Recent findings
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are similarly effective on cardiovascular (CV) - and kidney-related outcomes in the presence of CV and CKD.

Summary
SGLT2 inhibitors can reduce the risk of CHF events and CKD progression, and may have synergistic effects in patients with cardiorenal syndrome.
Lung adenocarcinoma: development of nomograms based on PET/CT images for prediction of epidermal growth factor receptor mutation status and subtypes
Authors: Huang Lele , Cao Yuntai , Zhou Fei , Li Jicheng , Ren Jialiang , Zhang Guojin , Luo Yongjun , Liu Jiangyan , He Jiangping , Zhou Junlin 
Published: December 2021

Objective
To develop nomograms that combine clinical characteristics, computed tomographic (CT) features and 18F-fluorodeoxyglucose PET (18F-FDG PET) metabolic parameters for individual prediction of epidermal growth factor receptor (EGFR) mutation status and exon 19 deletion mutation and exon 21 point mutation (21 L858R) subtypes in lung adenocarcinoma.

Methods
In total 124 lung adenocarcinoma patients who underwent EGFR mutation testing and whole-body 18F-FDG PET/CT were enrolled. Each patient’s clinical characteristics (age, sex, smoking history, etc.), CT features (size, location, margins, etc.) and four metabolic parameters (SUVmax, SUVmean, MTV and TLG) were recorded and analyzed. Logistic regression analyses were performed to screen for significant predictors of EGFR mutation status and subtypes, and these predictors were presented as easy-to-use nomograms.

Results
According to the results of multiple regression analysis, three nomograms for individualized prediction of EGFR mutation status and subtypes were constructed. The area under curve values of three nomograms were 0.852 (95% CI, 0.783–0.920), 0.857 (95% CI, 0.778–0.937) and 0.893 (95% CI, 0.819–0.968) of EGFR mutation vs. wild-type, 19 deletion mutation vs. wild-type and 21 L858R vs. wild-type, respectively. Only calcification showed significant differences between the EGFR 19 deletion and 21 L858R mutations.

Conclusion
EGFR 21 L858R mutation was more likely to be nonsolid texture with air bronchograms and pleural retraction on CT images. And they were more likely to be associated with lower FDG metabolic activity compared with those wild-types. The sex difference was mainly caused by the 19 deletion mutation, and calcification was more frequent in them.
Semiautomatic assessment of whole-body tumor burden with 18F-PSMA-1007 in biochemical recurrent prostate cancer
Authors: Cardoza-Ochoa David R. , Cristancho-Rojas Cesar , Pérez David J. , Moreno-Izaguirre Paola , Guzman Melissa , Gutiérrez-Rivera María C. , Gaxiola-Mascareño Aarón P. , Avila-Rodríguez Miguel A. , Rivera-Bravo Belén 
Published: December 2021

Objective
The aim of the study was to evaluate the 18F-PSMA-1007 PET/computed tomography (CT) semiautomatic volumetric parameters to assess the whole-body tumor burden and its correlation with prostate-specific antigen (PSA) and Gleason score in patients with biochemically recurrent prostate cancer (PCa).

Materials and methods
A total of 110 patients referred for 18F-PSMA-1007 PET/CT due to biochemical recurrence were retrospectively analyzed. Whole-body total lesion prostate-specific membrane antigen (wbTl-PSMA) and whole-body PSMA-derived tumor volume (wbPSMA-TV) metrics on 18F-PSMA-1007 were obtained semiautomatically in dedicated software. A Spearman test was performed to explore the correlation of volumetric imaging parameters with PSA levels and Gleason score. To analyze the association between volumetric measures and PSA subgroups, we used a Kruskal–Wallis test and a Dunn’s test to identify each group causing an observed difference.

Results
A total of 492 metastatic lesions were analyzed, and a significant correlation was found between wbTL-PSMA (R = 0.63, P < 0.0001) and wbPSMA-TV (R = 0.49, P < 0.0001) with serum PSA. A statistically significant difference with wbTL-PSMA was found in patients with a PSA less than or equal 0.5 ng/ml and PSA in the range of 0.51–1.0 ng/ml.

Conclusion

18F-PSMA-1007 PSMA volumetric parameters can provide a quantitative imaging biomarker for whole-body tumor burden.