bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative and Qualitative Perspectives of Siblings of Children With Cochlear Implants
Authors: Warner-Czyz Andrea D. , Wiseman Kathryn B. , Nelson Jackie A. 
Published: June 2021

Purpose
The sibling relationship teaches children to navigate social interactions with their peers. However, the presence of an exceptionality, such as hearing loss, in one child can affect the dynamic of this relationship. This article examines quantitative and qualitative effects of having a brother or sister with a cochlear implant (CI) on siblings with typical hearing (TH) to determine how children with TH perceive their sibling with a CI and how having a CI user in the family affects the sibling's activities, emotions, and parental attention.

Method

Participants include 36 siblings with TH (
M
age
= 11.6 years) of CI users (
M
age
= 11.9 years) who completed quantitative measures of their perspectives of their brother/sister with CIs and the effect of hearing loss on themselves. Siblings with TH also could express their opinions via open-ended prompts.

Results
Overall, siblings with TH express positive perspectives of their brother/sister with CIs and report having a CI user in the family does not affect them much, particularly if the CI user has adequate communication skills. Responses to both quantitative and qualitative items converge on the close relationship between siblings but diverge relative to differential attention from parents (i.e., open-ended responses suggest parents spend more time with the CI user than the sibling with TH). Additionally, siblings acknowledge the presence of social communication deficits of the CI user in real-world situations.

Conclusion
This nuanced look at relationships among the parent, CI user, and sibling with TH highlights the importance of understanding the family system when working with children with hearing loss.
Restoration Strategies Following Short-Term Vocal Exertion in Healthy Young Adults
Authors: Fujiki Robert Brinton , Huber Jessica E. , Sivasankar M. Preeti 
Published: June 2021

PurposeThis study aims to investigate the effects of a 10-min vocal exertion task on voice and respiratory measures, to determine whether restorative strategies can mitigate these effects after cessation of exertion, and to assess whether these strategies continue to reduce these detrimental effects when vocal exertion is resumed.MethodA prospective, repeated-measures design was used. On consecutive days, 20 participants (equal men and women) completed two vocal exertion tasks separated by 10 min of restoration strategies: vocal rest or controlled phonation (low-level tissue mobilization using straw phonation). Voice and respiratory data were collected at baseline, following the first exertion task, after restoration strategies, and after the second exertion task. Outcome measures included (a) vocal effort, (b) phonation threshold pressure, (c) maximum and minimum fundamental frequencies, (d) cepstral peak prominence of connected speech, (e) lung volume initiation and termination, (f) percent vital capacity expended per syllable, and (g) number of syllables per breath group.ResultsA worsening of phonation threshold pressure (p< .001), vocal effort (p< .001), and increase of minimum fundamental frequency (p= .007) were observed after vocal exertion. Lung volume initiation (p< .001) and lung volume termination (p< .001) increased. These changes were largely reversed by restoration strategies, but only controlled phonation prevented exertion-induced changes in respiratory kinematic measures on a subsequent vocal exertion task.ConclusionsExertion-induced voice changes occur rapidly and may be mitigated by either controlled phonation or vocal rest. Controlled phonation is recommended as a superior strategy due to evidence of a protective effect on a successive vocal exertion task.
Low‐voltage linear bootstrapped sampling switch with a‐InGaZnO TFTs
Authors: Tiwari Bhawna , Bahubalindruni Pydi Ganga , Pedda Sujit 
Published: June 2021

AbstractThis letter presents a novel linear bootstrapped sampling switch using amorphous indium‐gallium‐zinc‐oxide thin‐film transistors, which is designed using all enhancement n‐type transistors. The switch is simulated at a low supply voltage and a small transistor channel length of 2V and 2m, respectively. The simulation results across the process corners have shown a maximum variation of 2.2% in the on‐resistance of the switch. Moreover, the worst‐case signal to‐noise‐and‐distortion‐ratio, spurious‐free‐dynamic‐range, and total‐harmonic‐distortion across the process corners have been observed as 66, 70 and −68dB, respectively, at a sampling frequency of 50 kHz. This circuit finds potential applications in implementing an analogue‐to‐digital converter with oxide thin‐film transistors technology, which is an essential block in flexible sensing systems.
Trip destination prediction based on a deep integration network by fusing multiple features from taxi trajectories
Authors: Tang Jinjun , Liang Jian , Yu Tianjian , Xiong Yong , Zeng Guoliang 
Published: June 2021

AbstractTrip destination prediction plays an important role in exploring urban travel patterns. Accurate prediction can improve the efficiency of traffic management and the quality of location‐based services. Here, a deep learning structure that contains three components: travel information extraction, classification learning mechanism, and output module is proposed. Three types of information (the partial trajectory of on‐going trips, historical trajectories, and related external information) are extracted in the first component. Then, the classification learning mechanism chooses different methods (i.e. Long Short‐Term Memory network and Embedding technology) according to the characteristic of variables. Finally, an output layer that integrates the prior information about destinations is constructed. Two open‐source trajectory datasets are used to validate the effectiveness of the proposed model. Results show that the proposed model outperforms benchmark models using only part of the information or using all of the information but ignore the classification learning mechanism. The performance of the proposed model under different call types and travel durations is further explored. The result of this study will help understand travel behaviour in urban cities.
The performance of in‐building measurement‐based path loss modelling using kriging
Authors: Diago‐Mosquera M. E. , Aragón‐Zavala A. , Vargas‐Rosales C. 
Published: June 2021

AbstractAn accuracy evaluation analysis of a novel in‐building measurement‐based path loss prediction narrowband model is presented here, comparing the performance of Kriging‐aided shadowing prediction against the most traditional assumption of slow fading as a random variable and a classical estimation derived from linear interpolation. Extensive radio measurements were employed using distinct samples to calibrate (tuning dataset) and validate (testing dataset) the model. Path loss predictions are made over the testing dataset locations to compare it against the measured values, thus obtaining an error in the prediction from the difference between measurements and predictions. The results in the seven buildings evaluated show the potential of Kriging‐aided channel modelling with a higher level of confidence than other modelling approaches compared hereafter.
Primary Bone Lymphoma: An Experience of a Regional Cancer Center from India
Authors: Mahajan Rohit , Yadav Budhi Singh , Sharma Suresh Chander , Gupta Ankita , Kumar Shikhar 
Published: June 2021

Abstract
Background Primary bone lymphoma (PBL) is a rare disease, representing <5% of all extranodal non-Hodgkin’s lymphomas (NHLs). The optimal treatment strategy is still unclear. Here, we report our institutional outcome analysis of patients diagnosed with PBL.
Materials and Methods From 2007 to 2014, the medical records of 22 patients with PBL were reviewed. Analysis was done for symptom-, patient-, disease-, and treatment-related characteristics. All patients were treated with chemotherapy with or without radiotherapy. Treatment response and impact of different prognostic factors on clinical outcome were analyzed.
Results The median age of presentation was 44 years (range: 18–70 years). A total of 19 (86.4%) patients were ≤60 years of age and 3 (13.6%) patients were >60 years. Out of all, 18 were males and 4 were females. Ann Arbor clinical staging at diagnosis was Stage I in 13 (59.1%), Stage II in 3 (13.6%), Stage III in 2 (9.1%), and Stage IV in 4 (18.2%) patients. Spine was the most common site of involvement seen in 12 (54.5%) patients. Diffuse large B cell lymphoma histology was seen in 8 (36.4%) patients and 8 (36.4%) had high-grade NHL. Chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone was given to 20 (90.9%) patients, whereas 2 (9.1%) patients received cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab. Radiotherapy (30-40 Gy) was delivered to 19 (86.4%) patients. The median follow-up period was 40 months (range: 8–105 months). The overall response rate was 86.3% with complete response (CR) in 15 (68.1%) and partial response in 4 (18.2%) patients. Relapses were seen in three (13.5%) patients: two nodal, and one in the bone. Disease-free survival (DFS) and overall survival (OS) at 5 years were 56.6 and 72.7%, respectively. CR after initial treatment was associated with a significant better OS, 80 and 25%, respectively (p < 0.0001). Age, sex, stage, International Prognostic Index, histologic subtype, and number of sites had no significant influence on OS. Combining radiation therapy with chemotherapy (with or without rituximab) also did not improve the OS or DFS of patients.
Conclusion In spite of small number of patients reported in this study, conventional chemotherapy remains an effective treatment option for patients with PBL. OS was found to be affected by the initial response to treatment.
Role of Maintenance Gemcitabine in Advanced Carcinoma Gallbladder
Authors: Sharma Manish , Talwar Vineet , Maheshwari Udip , Koyyala Venkata Pradeep Babu , Goel Varun , Goyal Sumit , Dash Prasanta Kumar , Batra Ullas , Bajaj Rajat , Yadav Abhishek , Goyal Pankaj , Doval Dinesh Chandra 
Published: June 2021

Abstract
Objective The aim of this study is to investigate the effects of gemcitabine maintenance on progression-free survival (PFS) in patients with metastatic gallbladder cancer (GBC).
Materials and Methods Sixty patients with unresectable or metastatic GBC having ongoing response to treatment with initial six cycles of gemcitabine and a platinum-based doublet chemotherapy were prospectively randomized on day 21 of the 6th cycle in 1:1 fashion to receive either maintenance gemcitabine 1 g/m2 intravenously on day 1 and day 8 of three weekly cycle or observation. Survival analysis was performed using the Kaplan–Meier method and comparisons by the log-rank test. A p-value < 0.05 was considered as statistically significant.
Results Of 60 patients, a total of 56 were available for final analysis. The median PFS was 4.7 months (3.1–6.3) in gemcitabine arm and 2.6 months (2.4–2.8) in observation arm, hazard ratio (HR) 0.196 (95% confidence interval [CI]: 0.1–0.39), p < 0.001. Median overall survival in gemcitabine arm was 12.4 months (9.15–15.6) as opposed to 9.9 months (8.29–11.5) in observation arm, HR 0.76 (95% CI: 0.43–1.35), p = 0.354. The grade 3 or 4 side effects in maintenance arm were transaminitis (17.9%), thrombocytopenia (17.8%), neutropenia (14.2%), and febrile neutropenia (7.1%).
Conclusions Maintenance gemcitabine therapy in unresectable/metastatic GBC patients responding to first-line gemcitabine and platinum treatment contributes to increase PFS with minimal and manageable side effects.
Tuberculosis Coexistence in Pediatric Hodgkin’s Lymphoma: A Tropical Country Experience
Authors: Padma Maneya , Kumar Nuthan , Munireddy Jyothi , Kumar Arun , Gujjal Pooja Chebbi , Premalata S. Chennagiri 
Published: June 2021

AbstractIntroduction Hodgkin’s lymphoma (HL), being one of the common cancers among children, may occasionally masquerade as an infectious illness. Similarly, an underlying infection like tuberculosis (TB) may be missed in cases of HL because of similarity in clinical and radiological features. Here, we present our data of association of HL with histopathologically proven TB lymph node, their clinical presentation, treatment details, and outcome.Materials and Methods A retrospective review of all the cases of HL diagnosed between January 2007 and December 2016 was done. The cases which had an association of TB, based on the histopathology, were reviewed separately.Results A total of 262 children with HL were treated at our institute from January 2007 to December 2016. Of these cases, 42 children had received empirical antitubercular therapy (ATT) (due to suspicion of TB) before presenting to us, and only five cases had histopathologically proven TB lymph node. Ziehl–Neelsen (ZN) stain for acid-fast bacilli (AFB) was positive in the biopsy specimen of all the five cases, proving TB lymph node coexistence with HL. They were treated with six-drug ATT as per the Revised National Tuberculosis Control Program (RNTCP) guidelines along with chemotherapy with adriamycin, bleomycin, vinblastine, and dacarbazine regimen. All the five patients are healthy and disease free until their last follow-up.Conclusion A high-end suspicion for concomitant TB and HL is needed, especially in our country where TB is still rampant. Biopsy with immunohistochemistry and demonstration of AFB can enable a definite diagnosis of both the entities.
Violence against Health Care Professionals and Facilities—Local Insights about a Global Malady
Authors: Nagpal Neeraj , Nagpal Nimisha , Kataria Nilanshu , Parikh Purvish 
Published: June 2021

AbstractActs of violence against health care professionals (especially doctors) as well as facilities are a growing global problem. In our country, it has taken an unfortunate dramatic turn of the involvement of a mob—a ragtag group of persons who organize and perpetrate the crime based on community, caste, religion, or political affiliations. This crucial factor is the fundamental difference in what we face as compared with the so-called Yi Nao phenomenon of China. In India, the mob gathers and indulges in acts of violence, intimidation, and blackmail at the behest of its “leader,” often having no direct relationship with the deceased patient. It is premeditated and systematic vandalism. Often it is also associated with financial gain to the perpetrators through extortion and blackmail, adding to the woes of the health care professionals and hospital facility. We discuss what is the primary goal and what is a byproduct in this cycles of violence against the people who are doing their best to save the lives of patients. Unless the governments and the courts take this matter seriously as well as follow-up with corrective measures, the future looks bleak for all stakeholders.
Presentation and Outcomes with First-Line Chemotherapy in Advanced Cholangiocarcinomas—A Relatively Rare Component of Biliary Tract Cancers in India
Authors: Bhargava Prabhat G. , Kumar Amit , Simha Vijai , Shah Minit , Patkar Shraddha , Goel Mahesh , Ostwal Vikas , Ramaswamy Anant 
Published: June 2021

Abstract
Background Biliary tract cancers (BTCs) are a rare group of cancers with limited data with respect to advanced unresectable cholangiocarcinoma (CCA).
Materials and Methods The study is a retrospective study of patients with advanced unresectable/metastatic CCA, who received first-line palliative chemotherapy (CT1) from January 2014 to March 2019 at the Tata Memorial Hospital, Mumbai. Baseline clinical characteristics, chemotherapeutic regimens, and toxicities were evaluated.
Results One hundred and forty patients satisfied criteria for evaluation. Median age of the entire cohort was 57 years (range: 32–80). There were 87 patients (62.1%) with intrahepatic CCA, 35 patients (25%) with perihilar CCA, and 14 patients (10%) with distal CCA. One hundred and twelve patients (80%) had metastatic disease at presentation. Commonest CT1 regimens were gemcitabine–cisplatin (GC) in 89 patients (63.5%) and gemcitabine–oxaliplatin (GO) in 34 patients (24.3%). Sixty-three patients (45%) received second-line chemotherapy. With a median follow-up of 27 months, median progression-free survival for the entire cohort was 7.56 months (95% confidence interval [CI]: 6.23–8.88), and median OS was 12.16 months (95% CI: 10.08–14.24). Common chemotherapy-related grade 3/4 side effects included vomiting in 25 patients (17.9%), diarrhea in 23 patients (16.4%), and thrombocytopenia in 22 patients (15.7%).
Conclusion The current study in advanced CCAs is the largest of its nature from India. The common regimens used as first line were GC and GO. Tolerance and overall survival appear similar to previously published data.
Post-cochlear implant surgery Alopecia Areata in ophiasis pattern
Authors: Dalton-Petillo Stephen , Volsky Peter 
Published: June 2021

Background:
Alopecia Areata is a form of relapsing nonscarring hair loss, which is a poorly understood autoimmune phenomenon characterized by T-cell inflammation as a result of environmental and genetic factors.

Aims and Methods:
There are numerous types of alopecia areata, but in this article we describe a case of a patient with alopecia in the post-operative setting of bilateral cochlear implantation in an ophiasis pattern.

Results:
While the patient was lost to follow up and a biopsy could not be obtained for confirmation, the physical exam and clinical scenario point to a diagnosis of alopecia areata ophiasis.

Conclusions:
This autoimmune condition, especially in the ophiasis pattern, is quite rare and carries a rather variable clinical course and response rate to treatment. As genetic predisposition and environmental factors such as stress from surgery can contribute, it is likely a rare post-operative condition but one to keep in mind.
435 THE IMPACT OF COMPREHENSIVE GERIATRIC ASSESSMENT IN THE OUTCOMES OF OLDER ACUTE NEUROSURGICAL PATIENTS
Authors: Soutter L , Yordanov S , Uff C , Sivapathasuntharam D 
Published: June 2021

Abstract

Introduction
As the population ages, an increasing proportion of the neurosurgical caseload is comprised of older patients. This trend is reinforced by technical advances and anaesthetic considerations within the field, allowing a higher proportion of patients eligible for surgery. Comprehensive geriatric assessment (CGA) is the gold standard clinical approach for evaluating older patients. Peri-operative care of older people (POPS) has provided strong evidence that CGA services can result in fewer post-operative complications. However, this evidence stems largely from trauma and orthopaedic surgery. Currently, there is little evidence of the impact CGA has on older neurosurgical patients. The study aimed to investigate whether CGA for older neurosurgical patients improved outcomes such as thirty-day mortality and length of stay.

Methods
A control group was established by collecting retrospective data for all acute neurosurgical patients over the age of 65. This was then compared with an intervention group who received CGA in the form of regular geriatric consultant reviews. 49 patients were recruited into each group.

Results
Analysis showed that the interventional group had a significantly higher mean age and level of frailty. They also had more confirmed complications with a significant difference in the diagnosis of pneumonia (p = 0.05) and hyponatremia (p = 0.015). Despite this, the thirty-day mortality was lower and average length of stay was on average two days shorter compared to the control group, although this did not reach statistical significance (p = 0.701). The study showed that more patients who received a CGA were discharged home (p = 0.209).

Conclusion
Our findings suggest that CGA input for older neurosurgical patients improves outcomes and should be incorporated routinely into neurosurgical clinical pathways.
460 THE IMPACT OF THE BONE MDT: EXPLORING CHANGES IN BONE PROTECTION DECISIONS BETWEEN 2015 AND 2018
Authors: Brooks S , Harper A , Pack L , Wheatley T 
Published: June 2021

Abstract

Introduction
The Hip fracture Multidisciplinary metabolic bone Team (MDT) was developed in June 2016 as a collaboration between Orthogeriatricians and the Metabolic Bone Team. The objective was to improve the quality of bone protection treatment decisions. This audit aimed to assess the impact of the new MDT by reviewing treatment decisions prior to and post its introduction. Data collection and.

Methodology
Case notes were reviewed for admissions from September to October 2015 and from September to November 2018. For both time periods the inpatient list, discharge summary and blood tests were reviewed in order to collect data regarding demographics, type of surgery, co-morbidities, calcium and vitamin D levels, bone protection prior to admission and bone protection decisions at discharge.

Results
In 2015, 83% of patients were admitted with no form of bone protection. Around 6% of patients were admitted on a bisphosphonate and 36% were discharged on a bisphosphonate. Less than 2% of people received denosumab prior to their admission, with this number rising to 9.4% at discharge. In 2018, 77% of patients were admitted on no form of bone protection. 5.4% were admitted on a bisphosphonate rising to 16% on discharge. No patients were admitted on denosumab, but 27% were discharged having received it in hospital, or with a plan to receive it from their GP.

Conclusions
There was a fall in bisphosphonate use and a significant increase in the frequency of denosumab prescription after the introduction of the Bone MDT. This MDT facilitated better decision-making through access to the further specialist skills from the endocrinologist and specialist nurses. Individual case discussion enhanced the delivery of personalised medicine.
463 THE USE OF FERINJECT TO MANAGE IRON DEFICIENCY ANAEMIA IN PATIENTS WITH NECK OF FEMUR FRACTURES
Authors: Meakin O , Adejumo S 
Published: June 2021

Abstract

Introduction
Iron-deficiency anaemia is a condition that is regularly seen in patients admitted with neck of femur fractures (NOFF) and is associated with increased morbidity peri-operatively. Intravenous ferinject is a method of iron replacement that leads to a more rapid increase in haemoglobin than oral replacement, therefore is often more favourable in this patient group, leading to better patient outcomes.

Method
A quality improvement project was undertaken. An initial audit was conducted to analyse the demographic of patients with NOFF and to assess the current practice of the orthogeriatric team when managing iron deficiency anaemia. This reviewed NOFF patients admitted in July 2017. The indications and benefits of ferinject were distributed to the medical team, encouraging use clinically, and a further audit was performed 2 years later to compare outcomes and practice, reviewing patients with NOFF admitted July–September 2019.

Results
It was found that 87% of patients with NOFF are iron-deficient on admission, and that introducing the use of ferinject meant that 50% fewer blood transfusions were required. Additionally, it highlighted that those who received ferinject during their admission had a smaller range of discharge haemoglobin levels than those who did not. Finally, it was found that the use of ferinject did not affect the rates of readmission in the assessed patient cohort.

Conclusions
The introduction of the use of ferinject in NOFF patients with iron-deficiency anaemia leads to a reduction in the requirement of blood transfusions required and to a reduction of the range of discharge haemoglobin levels. Ferinject therefore aids in improved recovery of NOFF patients. It does not, however, appear to have any effect on readmission rates in this patient group. Further education is required amongst the orthogeriatric team about the indications and benefits of ferinject to ensure that all eligible patient receive ferinject, improving their recovery.