bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Adaptation of Management Philosophy and Mission Statement, and Work Engagement Among Japanese Workers
Authors: Eguchi Hisashi , Inoue Akiomi , Kachi Yuko , Tsutsumi Akizumi 
Published: June 2021

Objective:
To investigate the association between individual adaptation of management philosophy and mission statement, and work engagement among employees in a single Japanese company.

Methods:
We carried out a 1-year prospective cohort study on all workers aged 18 to 65 years in a Japanese electrical components manufacturer. Our cohort included 2044 men and 721 women. We used multiple regression analysis to examine associations between variables.

Results:
Higher individual adaptation of management philosophy and mission statement at baseline was significantly associated with better work engagement at follow-up after adjusting for potential confounders and work engagement at baseline (β = 0.085, 95% confidence interval 0.054 to 0.117).

Conclusions:
There is a positive association between higher individual adaptation of management philosophy and mission statement with work engagement.
Glenohumeral Internal Rotation Deficit in the Adolescent Overhead Athlete: A Systematic Review and Meta-Analysis
Authors: Gouveia Kyle , Kay Jeffrey , Memon Muzammil , Simunovic Nicole , Ayeni Olufemi R. 
Published: June 2021

Objective:
The objective of this review was to investigate the average glenohumeral internal rotation deficit (GIRD) in the dominant arm of adolescent overhead athletes and to examine the association with shoulder and elbow injuries.

Design:
Systematic review and meta-analysis.

Setting:
MEDLINE, Embase, and PubMed were searched from inception to August 1, 2020.

Participants:
Adolescent overhead athletes with glenohumeral range of motion (ROM) measurements.

Interventions:
Nonoperative treatments of GIRD.

Main Outcome Measures:
Glenohumeral ROM measurements comparing the dominant and nondominant extremities were pooled in a meta-analysis.

Results:
Twenty-five studies were included in this review, which involved 2522 overhead athletes. Pooled internal rotation (IR) deficit of the dominant arm was 9.60° (95% confidence interval [CI] 7.87°-11.32°, P < 0.00001), with an external rotation (ER) gain of 6.78° (95% CI 4.97°-8.59°, P < 0.00001) and a total ROM (TROM) deficit of 1.78° (95% CI -0.70° to 4.26°, P = 0.16). The association between GIRD and shoulder or elbow injury was not clearly defined. Two studies reported treatment, and both used nonoperative treatment in the form of physiotherapy and sleeper stretches.

Conclusions:
The adolescent overhead athlete has roughly 10° of IR deficit in their dominant arm, accompanied by nearly 7° of ER gain, with similar ROM measurements for injured and uninjured athletes. Those with pathological GIRD have a greater degree of IR deficit, but without an accompanying compensatory increase in ER, leading to a TROM deficit of nearly 15°. Surgical treatment in the absence of other indications is rare, whereas physiotherapy and sleeper stretches remain the first-line treatment.
Norm-Based Cutoffs as Predictors of Prolonged Recovery After Adolescent Sport-Related Concussion
Authors: Worts Phillip R. , Haider Mohammad N. , Mason Justin R. , Schatz Philip 
Published: June 2021

Objectives:
To identify predictors of prolonged recovery (ie, >28 days) using patient demographic factors and healthy, norm-based cutoffs on a multimodal test battery in adolescents after sport-related concussions (SRCs).

Design:
Retrospective cohort. Patients were deemed recovered after successful completion of return-to-play/school protocols and received medical clearance.

Setting:
Community concussion clinic.

Patients:
Male and female adolescent student athletes diagnosed with a SRC and evaluated within 1 week of injury.

Independent Variables:
Patient demographics, medical history, injury description, computerized neurocognitive testing, vestibular/ocular testing, and symptoms at initial clinical visit.

Main Outcome Measures:
Performance on clinical testing to predict recovery duration, classified as normal (<28 days) or prolonged (>28 days).

Results:
A total of 201 adolescent student athletes (age = 15.3 ± 1.4 years) were included (female 35%). Average recovery duration for the entire cohort was 22.3 ± 13.3 days, with 22% (n = 45) of adolescent student athletes taking >28 days to recover. The final model was 88.3% accurate in classifying normal and prolonged recovery. Predictor variables included sex, loss of consciousness, history of ocular disorder, history of concussion, performance on visual motor speed composite, visual motion sensitivity symptom provocation and near point of convergence distance, number-naming total time, and symptom count.

Conclusions:
These findings suggest that using norm-based cutoffs from cognitive, oculomotor, and vestibulo-ocular testing and symptom reporting, clinicians can accurately predict a prolonged recovery (sensitivity = 81%) and normal recovery (specificity = 83%) in an adolescent, SRC cohort.
Findings From Cardiovascular Evaluation of National Collegiate Athletic Association Division I Collegiate Student-Athletes After Asymptomatic or Mildly Symptomatic SARS-CoV-2 Infection
Authors: Hwang Calvin E. , Kussman Andrea , Christle Jeffrey W. , Froelicher Victor , Wheeler Matthew T. , Moneghetti Kegan J. 
Published: June 2021

Objective:
The risk of myocardial damage after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been controversial. The purpose of this study is to report the incidence of abnormal cardiovascular findings in National Collegiate Athletic Association (NCAA) Division I student-athletes with a history of SARS-CoV-2 infection.

Design:
This is a case series of student-athletes with SARS-CoV-2 infection and their subsequent cardiac work-up, including troponin level, electrocardiogram, and echocardiogram. Additional testing was ordered as clinically indicated.

Setting:
This study was conducted at a single NCAA Division I institution.

Participants:
Student-athletes were included if they tested positive for SARS-CoV-2 by PCR or antibody testing [immunoglobulin G (IgG)] from April 15, 2020 to October 31, 2020.

Intervention:
Cardiac testing was conducted as part of postinfection screening.

Main Outcome Measures:
This study was designed to quantify abnormal cardiovascular screening results and cardiac diagnoses after SARS-CoV-2 infection in Division I collegiate athletes.

Results:
Fifty-five student-athletes tested positive for SARS-CoV-2. Of these, 14 (26%) had a positive IgG and 41 (74%) had a positive PCR test. Eight abnormal cardiovascular screening evaluations necessitated further testing including cardiac magnetic resonance imaging (cMRI). Two athletes received new cardiac diagnoses, one probable early cardiomyopathy and one pericarditis, whereas the remaining 6 had normal cMRIs.

Conclusions:
These data support recent publications which recommend the de-escalation of cardiovascular testing such as cardiac MRI or echocardiogram for athletes who have recovered from asymptomatic or mildly symptomatic SARS-CoV-2 infection. Continued follow-up of these athletes for sequelae of SARS-CoV-2 is critical.
Visio-Vestibular Deficits in Healthy Child and Adolescent Athletes
Authors: Corwin Daniel J. , McDonald Catherine C. , Arbogast Kristy B. , Mohammed Fairuz N. , Grady Matthew F. , Master Christina L. 
Published: June 2021

Objective:
To determine the relationship between patient characteristics and performance on the visio-vestibular examination (VVE) in a cohort of healthy youth athletes and explore the potential association between the VVE and other standardized concussion batteries.

Design:
Cross-sectional.

Setting:
Suburban middle and high school.

Patients:
One hundred ninety subjects age 11 to 18 enrolled before their respective scholastic sport season between August 2017 and March 2020.

Assessment of Independent Variables:
Patient age, sex, concussion history, comorbidities, hours of weekly exercise, Sport Concussion Assessment Tool, 5th edition (SCAT-5), King–Devick (K–D), Postconcussion Symptom Inventory (PCSI).

Main Outcome Measures:
Visio-vestibular examination abnormalities (smooth pursuit, horizontal and vertical saccades, horizontal and vertical gaze stability, convergence, right and left monocular accommodation, complex tandem gait).

Results:
Overall, 29.5% of subjects had at least one of 9 VVE elements abnormal, 7.9% at least 2, and 3.2% at least 3. None of 72 comparisons of the VVE elements, when stratified by age, sex, concussion history, history of headaches, attention deficit hyperactivity disorder, learning issues, psychiatric problems, motion sickness, or weekly hours of exercise, reached significance using the Benjamini–Hochberg procedure at a false discovery rate of 5%. There were no significant associations between VVE elements and the SCAT-5, K–D, or PCSI.

Conclusions:
The VVE is robust across multiple patient characteristics. Although healthy subjects may have one abnormal element, multiple abnormal elements are a less common feature, making multiple abnormal elements more indicative of concussion, highlighting the use of this assessment in the setting of injury. The VVE tests unique domains when compared with the PCSI, SCAT-5, and K–D.
Sensorineural Hearing Loss and Tinnitus Characteristics in Patients With Idiopathic Intracranial Hypertension
Authors: Shim Timothy , Chillakuru Yeshwant , Moncada Paola , Kim Sunny , Sabetrasekh Parisa , Sparks Andrew , Mulcahy Collin F. , Monfared Ashkan 
Published: June 2021

Objectives:
To characterize patterns of sensorineural hearing loss (SNHL) and tinnitus in patients with idiopathic intracranial hypertension (IIH).

Study Design:
Retrospective chart review.

Setting:
Tertiary referral center.

Patients:
Adult patients diagnosed with IIH via lumbar puncture (LP) between 2010 and 2020 who had available audiograms. The study included a total of 40 patients; 33 women, and 7 men with a median age of 43.

Interventions:
Diagnostic LP and audiogram.

Main Outcome Measures:
Otologic symptoms, ophthalmologic signs, hearing thresholds, cerebrospinal fluid opening pressures.

Results:
The most commonly reported symptoms were tinnitus in 28 (70%, 23 pulsatile and 5 tonal), aural fullness in 11 (28%), and vertigo in 10 (25%). Twenty-nine patients had ophthalmologic examinations and 18 had evidence of papilledema. Twenty-five (63%) patients had hearing loss in at least one ear at one frequency range. Patients presented with both unilateral and bilateral hearing loss across low, middle, and high frequency ranges. No significant association was observed between hearing loss threshold and LP opening pressure except for 250 Hz in the left ear. After stratification by tinnitus group (pulsatile, tonal, and no tinnitus), no significant difference was found between mean hearing loss threshold at different frequencies. In addition, no significant mean age difference was identified in patients within each tinnitus group.

Conclusions:
There was no classic pattern or presentation for hearing loss in our IIH patients. They developed sudden, unilateral, or bilateral SNHL in low, middle, or high frequency range. The degree of hearing loss did not correlate with CSF opening pressure.
Management of Jugular Bulb Injury During Transcanal Endoscopic Tympanoplasty
Authors: Amorosa Luca , Molinari Giulia , Botti Cecilia , Presutti Livio 
Published: June 2021

Variable internal jugular vein anatomy is not rare. A high jugular bulb (JB) is reported in 6 to 34% of cases and, it can be jeopardized during middle ear surgery, especially if dehiscent. Its injury represents a threatening complication of ear surgery.
In recent years there has been an increasing trend in the use of endoscopic ear surgery for a wide range of otologic procedures, but being a one-hand technique, the management of bleeding still represents a challenge.
The aim of this video, http://links.lww.com/MAO/B280 is to report the endoscopic surgical management of internal jugular vein hemorrhage during endoscopic type I tympanoplasty.
From Galen to Eustachio: Discovering the Anatomy of the Facial Nerve
Authors: Maoz Sabrina Leah Levy , Canalis Rinaldo Fernando 
Published: June 2021

Objective:
To discuss the historical relevance of the original illustrations and descriptions of the facial nerve during the Italian Renaissance (ca. late 14th to early 17th centuries).

Material and Methods:
Graphic and textual information related to facial nerve discoveries were harvested from the works of the study period's anatomists, with special attention to those of Leonardo da Vinci, Andreas Vesalius, Gabrielle Falloppio, and Bartolomeo Eustachio. The importance of Galen's anatomical works as a guide to these discoveries is discussed.

Conclusion:
The reviewed texts and the illustrations therein contained provided sufficient information to establish a sequence of discoveries that resulted in a near-modern knowledge of the anatomy of the facial nerve and the basis to comprehend its function.
3D-reconstructions of Bast's Valve and Membranous Labyrinth: Insights for Vestibular Implantation and Meniere's Disease
Authors: Misra Shibalik , Cheng Kai , Curthoys Ian , Wong Christopher , Mukherjee Payal 
Published: June 2021

Hypothesis/Background:
Bast's valve is a poorly understood inner ear structure located at the junction between pars superior and inferior in the membranous labyrinth. Anatomically precise three-dimensional reconstructions (3D-reconstructions) of Bast's valve can help illuminate the morphology of the valve, and point toward its role in normal physiology and pathological states such as endolymphatic hydrops. This is of particular relevance to the development of a vestibular implant, a device intended to rehabilitate deficits in the vestibular system.

Methods:
Six postmortem human temporal bones from healthy donors were scanned using a micro-computed tomography (microCT) scanner. The microCT data allowed 3D-reconstructions of the membranous labyrinth, with a particular focus on Bast's valve, vestibule, and cochlear duct.

Results:
The microCT images of Bast's valve showed a rigid lip containing a core of soft tissue, opposing the thin membranous wall of the utricle. The maximum recorded length and width of the rigid lip were 440.4 μm and 88 μm, respectively. The 3D-reconstructions illustrated the slit-like opening of Bast's valve into the utricle, the twisting course of the basal turn of the cochlear duct, and the spatial orientation of utricle and saccule with respect to the stapes footplate.

Conclusions:
The present study provided a novel anatomical perspective on the microscopic structure of Bast's valve. The interplay between endolymphatic hydrops and Bast's valve is an ongoing area of research, but defining this anatomy in 3D will play a key role in furthering our understanding of the disease process. Implications for vestibular implantation are explored through the various 3D-reconstructions.
Canalplasty for Exostosis Removal Comparing Microscopic Versus Endoscopic Ear Surgery Techniques
Authors: Sayyid Zahra N. , Vaisbuch Yona , Sajjadi Autefeh , Sajjadi Hamed 
Published: June 2021

Objective:
To compare an endoscopic versus microscopic approach to removal of exostoses and osteomas in canalplasty procedures.

Study Design:
Retrospective case review.

Setting:
Private and tertiary referral centers.

Patients:
Adult patients requiring canalplasty procedures performed either microscopically or endoscopically for removal of exostosis or osteoma and/or canal stenosis.

Intervention:
Microscopic or endoscopic canalplasty.

Main Outcome Measure:
Major outcome measures included assessment of hearing improvement as well as rates of major and minor complications. Standard audiological data were collected before and after the operative procedure. Major complications queried included stenosis, perforation of the tympanic membrane, hearing loss, facial palsy, and osteomyelitis. Minor complications queried included signs of poor wound healing, graft failure, and bleeding or discharge.

Results:
Forty three canalplasties were performed on 36 patients. Audiometric tests did not significantly differ between endoscopic and microscopic surgeries. There was a moderate linear relationship between date of surgery and duration of surgery for the endoscopic technique, with more recent surgeries taking less time. No major complications were noted. However, significantly fewer endoscopic cases had evidence of minor postoperative complications relative to microscopic cases.

Conclusions:
An endoscopic approach to canalplasty is a safe and minimally invasive technique. Significantly fewer postoperative complications occurred after endoscopic canalplasty procedures as compared with microscopic procedures. Endoscopic repair may be preferred to microscopic repairs due to the improved view of the end of the instruments while maintaining a minimally invasive approach with what is likely a decreased operative time as well.
Notch Signaling in Acquired Middle Ear Cholesteatoma
Authors: Fukuda Atsushi , Kano Satoshi , Nakamaru Yuji , Morita Shinya , Hoshino Kimiko , Fujiwara Keishi , Homma Akihiro 
Published: June 2021

Hypothesis:
We hypothesized that an anomalous change of Notch signaling might be involved in the pathophysiology of cholesteatoma.

Background:
The Notch signaling pathway regulates integrated growth and differentiation control of keratinocytes. Its involvement in cholesteatoma proliferation has not been elucidated.

Methods:
We obtained cholesteatoma and external auditory canal (EAC) skin samples from patients with middle ear cholesteatoma who underwent tympanomastoid surgery. We performed polymerase chain reaction using the RT2 Profiler™ PCR Array Human Notch Signaling Pathway (Qiagen) in the cholesteatoma and EAC skin samples (n = 6 each). This was followed by immunohistochemical staining of Notch1, enhancer of split-1 (HES1), and p53 in 41 and 8 cholesteatoma and EAC skin samples, respectively.

Results:
The fold change of Notch1 gene expression was lowest in cholesteatoma, with a statistically significant difference (p = 0.0424). Moreover, the fold change of HES1 expression decreased (p = 0.272). The positive rates of Notch1 and HES1 protein expressions in the cholesteatoma (48.5 ± 32.4% and 44.9 ± 17.8%, respectively) were significantly lower than in the EAC skin (83.4 ± 17.5% and 55.7 ± 7.1%, respectively) (p < 0.001 and p < 0.01). In contrast, the positive rate of p53 expression in the cholesteatoma (8.5 ± 11.4%) was significantly higher than in the EAC skin (0.5 ± 0.7%) (p < 0.001).

Conclusion:
The decreases in Notch1 and HES1 protein expression might play an important role in the hyperproliferative character of the keratinizing squamous epithelium in cholesteatoma. An increase in p53 might reflect the reaction to cellular hyperproliferation.
Surgical Outcomes After Conservative Resection of Vestibular Schwannoma in the Elderly
Authors: Luryi Alexander L. , Babu Seilesh , Bojrab Dennis I. , Kveton John F. , Schutt Christopher A. 
Published: June 2021

Objective:
To assess outcomes after surgery for vestibular schwannoma in patients over 70 years of age.

Study Design:
Retrospective chart review.

Setting:
Two tertiary otology and neurotology centers.

Patients and Interventions:
Patients undergoing primary surgery for vestibular schwannoma between 2007 and 2018.

Main Outcome Measures:
Postoperative complications and surgical outcomes.

Results:
A total of 452 patients met inclusion criteria, 31 of whom (6.9%) were over 70 years of age. Age ranged from 18 to 90 years with a mean of 53 years. Elderly patients were more likely to have pre-existing hypertension (58.1% versus 34.0%, p = 0.007) and diabetes mellitus (19.4% versus 7.4%, p = 0.02). Elderly patients were less likely to undergo gross total resections of their tumors (35.5% versus 60.6%, p = 0.05) although they were not statistically significantly more likely to undergo subtotal (<95%) resections (25.8% versus 14.7%, p > 0.05). Elderly patients were also less likely to undergo second stage procedures (0% versus 9.5%, p = 0.04). There were no significant differences between elderly and non-elderly patients in the rates of any complications, ultimate facial nerve function, or duration of surgery. No patients over 70 years of age expired within 1 year of surgery.

Conclusions:
Conservative surgery for vestibular schwannoma in appropriately selected elderly patients is appropriate and safe, given adequate consideration to risk-benefit analysis and goals of care.
Spectral Composition of Body Sway in Persistent Postural-Perceptual Dizziness
Authors: Anagnostou Evangelos , Stavropoulou Georgia , Zachou Athena , Kararizou Evangelia 
Published: June 2021

Objective:
Previous studies in phobic postural vertigo patients showed characteristic frequency changes in body sway fluctuations, raising the question whether similar spectral changes can be also observed in the recently defined syndrome of persistent postural-perceptual dizziness (PPPD).

Study design:
Cross-sectional prospective study.

Setting:
Tertiary referral center.

Subjects:
Sixty-one PPPD patients and 41 healthy controls.

Interventions:
Static balance was assessed while standing on firm surface with eyes open or closed (conditions 1 and 2) and while standing on foam with eyes open or closed (conditions 3 and 4). Postural sway was analyzed by means of time (sway area and standard deviation) and frequency domain metrics. The latter was based on comparisons of the percentage of energy in each of three frequency bands: low (0–0.5 Hz), middle (0.05–2 Hz), and high frequency (2–20 Hz).

Main outcome measure:
Stabilometric time and frequency domain parameters.

Results:
Time domain metrics deteriorated significantly from conditions 1 through condition 4 in patients and controls. Spectral changes, however, were more abundant in PPPD subjects than in controls. Patients showed increased low frequency, but decreased high frequency spectral power in condition 3 as compared to condition 2. Dizziness Handicap Inventory score was positively correlated with middle frequency and negatively correlated with low frequency fluctuations.

Conclusions:
We conclude that PPPD patients exhibit a time domain sway pattern in different conditions which is grossly similar to that of controls. However, sensory feedback conditions with equal sway area show unique differences in their spectral content in PPPD patients. Moreover, perceived severity of dizziness is associated with greater body oscillations in the middle frequency band.