bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative Electrocochleography Correlates to Outcomes in Transmastoid and Middle Cranial Fossa Superior Semicircular Canal Dehiscence Repair
Authors: Ellsperman Susan E. , Telian Steven A. , Kileny Paul R. , Welch Christopher M. 
Published: September 2021

Objective:
To determine the degree to which electrocochleography (ECoG) correlates with auditory and vestibular outcomes after repair of superior semicircular canal dehiscence (SSCD) via transmastoid (TM) and middle cranial fossa (MCF) approaches.

Study Design:
Retrospective review.

Setting:
Academic tertiary referral center.

Patients:
Adults with SSCD who underwent repair between 2005 and 2019.

Intervention:
Pre-, intra-, and postoperative ECoG.

Main Outcome Measures:
Patient-reported vestibular and auditory symptoms; pre-, intra-, and postoperative ECoG measures, dizziness handicap inventory (DHI) scores.

Results:
Forty-six patients underwent SSCD repair (40 unilateral, six bilateral) between 2005 and 2019, including 24 MCF and 28 TM approaches. There were no differences in preoperative, intraoperative, or postrepair ECoG SP/AP values between the MCF and TM groups (p 0.12, 0.77, 0.58). Patients had subjective improvement in vestibular symptoms (or stable vestibular function in patients operated for predominantly auditory manifestations) with both approaches (MCF: 87.5%; TM: 92.3%; p 0.64). A successful outcome correlated with intraoperative SP/AP ratio normalization (p 0.0005). Similarly, DHI scores were similar in both groups preoperatively (p 0.66) and returned to their preoperative baseline postoperatively with both (p 0.52). Reported vestibular symptoms persisted or worsened more often in patients with migraine (66.6% vs. 28.9%, p 0.03), and with persistently abnormal ECoG measures, though the latter was not statistically significant in this population (38% vs. 15%, p 0.10). Patients had subjective improvement or stability in auditory symptoms using either approach (MCF: 96%; TM: 100%; p 0.62), also correlating with SP/AP ratio normalization (p 0.008).

Conclusions:
Correction of abnormal preoperative ECoG reliably correlates to patient symptom improvement after SSCD repair. No significant differences in postoperative outcomes were noted between patients undergoing TM versus MCF repair. Circumspection regarding the likelihood of an ideal outcome after SSCD repair should be exercised when counseling patients with concomitant migraine.

Define Professional Practice Gap and Educational Need:
It is not certain whether outcomes differ between the two dominant approaches for SSCD repair. Surgeons and patients would benefit from an intraoperative metric that reflects satisfactory plugging of SSCD.

Learning Objective:
To highlight the reliability and unique utility of intraoperative ECoG and demonstrate the correlation between ECoG correction and symptom improvement for SSCD repair.

Desired Result:
To report subjective and objective outcomes following SSCD repair and encourage adoption of intraoperative ECoG monitoring.

Level of Evidence:
Level V.

Indicate IRB or IACUC:
IRB review considers this study exempt (HUM00169949).
The Effect of Supervision in Vestibular Rehabilitation in Patients with Acute or Chronic Unilateral Vestibular Dysfunction: A Systematic Review
Authors: Lilios Andreas , Chimona Theognosia , Nikitas Christos , Papadakis Chariton , Chatziioannou Ioannis , Skoulakis Charalambos 
Published: September 2021

Objective:
The investigation of supervised vestibular rehabilitation treatment role for individuals with dizziness and imbalance due to peripheral, unilateral vestibular disorders.

Databases Reviewed:
Cochrane, PubMed, and Physiotherapy Evidence Database (PEDro) were utilized to identify relevant studies.

Methods:
The key search terms used were “Vestibular Rehabilitation and Unilateral Vestibular Hypofunction,” “Vestibular Rehabilitation and Unilateral Vestibular Loss,” and “Vestibular Rehabilitation and Supervision.” A manual search was performed by exploring the references of included articles to identify studies not captured through the computer-based searches. The quality of the studies was assessed according to the PEDro scale. Inclusion criteria were: 1) studies with patients, aged from 18 to 80 years, with acute or chronic dizziness and disequilibrium due to unilateral vestibular dysfunction, 2) randomized control trials (RCTs), 3) studies comparing supervised vestibular rehabilitation program with an unsupervised vestibular rehabilitation program or home-based training or standard care or placebo, and 4) articles written in the English language. Studies reporting cases of vertigo and imbalance due to possible recurrent pathologies, acute benign paroxysmal positional vertigo, or central neurological/orthopedic deficits, were excluded.

Results:
A total of 448 articles were retrieved from the systematic database search strategy. Five of them were included in the systematic review after full-text analysis, plus one more after manual searching of their references. All studies involved supervised vestibular rehabilitation treatment programs compared with unsupervised home training, the performance of daily activities and, standard care. Based on PEDro's scoring system, one study rated as high-quality RCT, three studies were considered of fair quality and one scored as low-quality RCT.

Conclusions:
Although most RCTs report better outcomes with a supervised vestibular rehabilitation treatment program regarding the emotional status, dizziness, and balance improvement, this systematic review failed to provide a strong evidence that supervision is superior to unsupervised protocols in patients with UNH. The self-reported subjective measures used by the included RCTs represent a serious limitation of their results.
Utilizing Single Cell RNA-Sequencing to Implicate Cell Types and Therapeutic Targets for SSNHL in the Adult Cochlea
Authors: Nelson Lacey , Johns J. Dixon , Gu Shoujun , Hoa Michael 
Published: September 2021

Objective:
To identify genes implicated in sudden sensorineural hearing loss (SSNHL) and localize their expression in the cochlea to further explore potential pathogenic mechanisms and therapeutic targets.

Study Design:
Systematic literature review and bioinformatics analysis.

Data Sources:
The following sources were searched from inception through July 2, 2020: PubMed-NCBI, MEDLINE, Embase, CINAHL, Cochrane Library, ClinicalTrials.gov, OpenGrey, GreyNet, GreyLiterature Report, and European Union Clinical Trials Registry. PubMed-NCBI and MEDLINE were additionally searched for human temporal bone histopathologic studies related to SSNHL.

Methods:
Literature review of candidate SSNHL genes was conducted according to PRISMA guidelines. Existing temporal bone studies from SSNHL patients were analyzed to identify the most commonly affected inner ear structures. Previously published single-cell and single-nucleus RNA-Seq datasets of the adult mouse stria vascularis, as well as postnatal day 7 and 15 mouse cochlear hair cells and supporting cells, were utilized for localization of the SSNHL-related genes curated through literature review.

Conclusions:
We report 92 unique single nucleotide polymorphisms (SNPs) in 76 different genes that have been investigated in relation to SSNHL in the literature. We demonstrate that a subset of these genes are expressed by cell types in the adult mouse stria vascularis and organ of Corti, consistent with findings from temporal bone studies in human subjects with SSNHL. We highlight several potential genetic targets relevant to current and possible future SSNHL treatments.
Heterogeneity of Treatment Effects Among Patients With Type 2 Diabetes and Elevated Body Mass Index in a Study Comparing Group Medical Visits Focused on Weight Management and Medication Intensification
Authors: Kobe Elizabeth A. , Crowley Matthew J. , Jeffreys Amy S. , Yancy William S. , Zervakis Jennifer , Edelman David , Voils Corrine I. , Maciejewski Matthew L. , Coffman Cynthia J. 
Published: September 2021

Background:
Illuminating heterogeneity of treatment effect (HTE) within trials is important for identifying target populations for implementation.

Objective:
The aim of this study was to examine HTE in a trial of group medical visits (GMVs) for patients with type 2 diabetes and elevated body mass index.

Research Design and Measures:
Participants (n=263) were randomized to GMV-based medication management plus low carbohydrate diet-focused weight management (WM/GMV; n=127) or GMV-based medication management alone (GMV; n=136) for diabetes control. We used QUalitative INteraction Trees, a tree-based clustering method, to identify subgroups with greater improvement in hemoglobin A1c (HbA1c) and weight from either WM/GMV or GMV. Subgroup predictors included 32 baseline demographic, clinical, and psychosocial factors. Internal validation was conducted to estimate bias in the range of mean outcome differences between arms.

Results:
QUalitative INteraction Trees analyses indicated that for patients who had not previously attempted weight loss, WM/GMV resulted in better glycemic control than GMV (mean difference in HbA1c improvement=1.48%). For patients who had previously attempted weight loss and had lower cholesterol and blood urea nitrogen, GMV was better than WM/GMV (mean difference in HbA1c improvement=1.51%). No treatment-subgroup effects were identified for weight. Internal validation resulted in moderate corrections in mean HbA1c differences between arms; however, differences remained in the clinically significant range.

Conclusion:
This work represents a novel step toward targeting care approaches for patients to maximize benefit based on individual patient characteristics.
Can Nurses Self-Assess Fatigue?
Authors: Cochran Karen R. , Letvak Susan A. , McCoy Thomas P. , Bacon Cynthia , Karper William B. 
Published: September 2021

OBJECTIVE
The aims of this study were to describe nurses' self-perceptions of fatigue and to examine nurses' acceptance of specific fatigue countermeasures.

BACKGROUND
The work of nurses places them at a high risk of fatigue. Evidence suggests 75% to 80% of nurses in the United States experience high levels of fatigue.

METHODS
This descriptive, cross-sectional correlational study surveyed 279 nurses.

RESULTS
Results suggest that almost half of nurses (46%) are not able to accurately self-assess fatigue. Nurses expressed acceptance of several workplace fatigue reduction strategies.

CONCLUSIONS
It may be unrealistic to expect nurses to self-assess fatigue levels and make decisions about their ability to safely provide patient care. Reliable methods for assessing fatigue in the workplace are needed. Several strategies exist that may be used to alleviate fatigue, and many were acceptable to nurses. Nurse leaders are well positioned to implement changes that impact the occurrence of nurse fatigue and thereby the quality of patient care.
In Vitro Antibiotic Resistance among Bacteria from the Cornea in the Antibiotic Resistance Monitoring in Ocular MicRoorganisms Surveillance Study
Authors: Thomas Randall K. , Melton Ron , Vollmer Patrick M. , Asbell Penny A. 
Published: September 2021

PURPOSE
This study aimed to report on in vitro susceptibility patterns among corneal isolates collected in the Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) study.

METHODS
Each year, from 2009 to 2019, Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae isolates cultured from patients with ocular infections at participating ARMOR sites were submitted to a central laboratory for species confirmation and antibiotic susceptibility testing. In this analysis of corneal isolates, odds ratios for concurrent resistance were based on sample proportions, one-way ANOVA was used to evaluate resistance by patient age, and Cochran-Armitage tests were used to examine changes in antibiotic resistance over time.

RESULTS
A total of 1499 corneal isolates were collected from 61 sites over the 11-year period. Overall, 34.5% (148 of 429) of S. aureus and 41.9% (220 of 525) of CoNS isolates were methicillin resistant and had higher odds ratios for concurrent resistance to azithromycin (17.44 and 5.67), ciprofloxacin (39.63 and 12.81), and tobramycin (19.56 and 19.95), respectively, relative to methicillin-susceptible isolates (P < .001, all); also, a high proportion of methicillin-resistant S. aureus (85.1%) and methicillin-resistant CoNS (81.8%) were multidrug resistant (at least three classes of antibiotics). Resistance among S. pneumoniae isolates was highest for azithromycin (33.1%), whereas P. aeruginosa and H. influenzae isolates demonstrated low resistance overall. Among staphylococci, antibiotic resistance differed by patient age (S. aureus: F = 6.46, P < .001; CoNS: F = 4.82, P < .001), and few small changes in resistance (≤3.60% per year), mostly decreases, were observed over time.

CONCLUSIONS
Although rates of in vitro antibiotic resistance among presumed keratitis isolates obtained in ARMOR seemed stable between 2009 and 2019, resistance among staphylococci and pneumococci remains high (and should be considered when treating keratitis).
Computer Vision Syndrome in the Spanish Population during the COVID-19 Lockdown
Authors: Galindo-Romero Caridad , Ruiz-Porras Alberto , García-Ayuso Diego , Di Pierdomenico Johnny , Sobrado-Calvo Paloma , Valiente-Soriano Francisco J. 
Published: September 2021

SIGNIFICANCE
After 6 to 8 weeks of mandatory lockdown due to coronavirus disease 2019 (COVID-19) in Spain, the encouraged change in daily habits resulted in a significant increase in electronic device use. Computer vision syndrome–related symptoms were reported more often in participants who used electronic device for more time and spent less time outdoors.

PURPOSE
The main purpose of this study was to evaluate computer vision syndrome–related eye symptoms due to the use of electronic devices during COVID-19 lockdown decreed in Spain in 2020.

METHODS
After 6 to 8 weeks of strict lockdown, a total of 730 participants (18 to 73 years old) filled in a customized questionnaire divided into three sections: (1) general demographics, (2) usage habits of electronic devices during this period, and (3) computer vision syndrome–related ocular and visual symptoms associated with their use and with ergonomic practices.

RESULTS
The daily duration of use of electronic devices increased an average of 3.1 ± 2.2 h/d during the lockdown, with computer use increasing the most. The main symptoms reported by the participants were headache (36.7%), dry eye (31.1%), irritation (24.1%), blurred vision (21.2%), and ocular pain (14.9%). There was a significant relationship between computer vision syndrome–related symptoms and age (greater in participants between 18 and 30 years old than in those older than 45 years, P < .001), primary activity (greater in studying from home and remote working, P < .001), and extended periods of electronic device use (greater when used more than 10 h/d, P = .05). Symptoms were also associated with time spent outdoors (greater in participants with <1 h/d, P = .02).

CONCLUSIONS
The lockdown due to COVID-19 showed an increase in the electronic device use. Participants who spent more time with electronic devices and less time outdoors reported more computer vision syndrome–related eye symptoms.
Correlation between Contrast Sensitivity and Modulation Transfer Functions
Authors: Leroux Charles E. , Bouchet Elise , Espinasse Pauline , Fontvieille Christophe , Bardin Fabrice 
Published: September 2021

SIGNIFICANCE
Previous studies found no correlation between visual acuity and optical quality in a population of young subjects with good vision. Using sinusoidal gratings, we systematically investigate the correlation between contrast sensitivity and optical quality as a function of spatial frequency.

PURPOSE
This study describes the correlation between the contrast sensitivity function (CSF) and the modulation transfer function (MTF) in a sample of young and informed subjects. Our results are compared with prior studies on the correlation between visual acuity and metrics of image quality. We also compare our results with previous studies that compare the CSF, the MTF, and the neural contrast sensitivity function (NCSF).

METHODS
The CSF of 28 informed subjects is measured in photopic conditions. The polychromatic MTF is computed from the measurements of monochromatic aberrations. The (CSF, MTF) correlation is estimated as the Pearson correlation coefficient, at each spatial frequency. The NCSF of each subject is estimated as the ratio of CSF to MTF.

RESULTS
We obtain high correlation coefficients (0.8) in the range of spatial frequencies of 3 to 6 cycles per degree, which also corresponds to high NCSF. Correlation decreases with increasing spatial frequency in the range of 6 to 18 cycles per degree (down to 0.0 at 18 cycles per degree). In that range, optical and neural contrast sensitivities are both approximately reduced by factor 4.

CONCLUSIONS
In our sample of young subjects with good vision, the CSF with sinusoidal gratings better differentiates eyes of good optical quality at intermediate spatial frequencies (3 to 6 cycles per degree) than at higher spatial frequencies (12 to 18 cycles per degree). At the highest tested spatial frequency of sinusoidal gratings (18 cycles per degree), there is no significant correlation between optical quality and contrast sensitivity.
Ultraviolet and Visible Transmittance of Soft Contact Lenses with and without Ultraviolet Blockers
Authors: Kapfelsberger Andrea , Eckstein Julia , von Ahrentschildt Anke , Bischoff Jürgen , Marx Sebastian , Sickenberger Wolfgang 
Published: September 2021

SIGNIFICANCE
Ultraviolet (UV) and visible light transmittance of soft contact lenses (SCLs) was measured. A significant difference in UV transmittance has been found between SCLs with a positive and negative back vertex power (BVP). It can be shown that thicker SCLs absorb more UV radiation.

PURPOSE
This study aimed to determine UV and visible light transmittance of different SCLs with and without UV protection filters.

METHODS
Twenty-one lens brands were investigated in the BVP range of −12.00 to +6.00 D. Three SCLs were measured per BVP 25 times. Three hundred thirty-nine SCLs with UV filter (stenfilcon A, somofilcon A, narafilcon A, senofilcon A, senofilcon C, etafilcon A, nesofilcon A) and 489 SCLs without UV filter (delefilcon A, lotrafilcon A, lotrafilcon B, comfilcon A, balafilcon A, samfilcon A, asmofilcon A, nelfilcon A, omafilcon A, hilafilcon B, ocufilcon D, hioxifilcon A, omafilcon B) have been examined. The measurement setup was created according to ISO 18369-3.

RESULTS
All UV-absorbing labeled test SCLs meet UV protection class 2. senofilcon A, senofilcon C, and narafilcon A meet the higher UV protection class 1 level. A statistically significant difference in UV transmittance (280 to 380 nm) has been found between SCLs with a positive BVP (+1.00 to +6.00 D) and SCLs with a negative BVP (−1.00 to −12.00 D), both without (P = .04) and with UV filters (P = .02).

CONCLUSIONS
With the ISO-conforming, diopter-independent measurement setup, the UV-absorbing test contact lenses that meet the current international standards, regardless of their BVP, were identified. Lenses with increased center thickness absorb more UV radiation. Further studies may use a modified measurement setup with a larger aperture than 10 mm. It would also be worthwhile to examine the UV absorption of the contact lens over the complete corneal area and limbal area because UV radiation may damage inner ocular tissues like the crystalline lens as well as limbal stem cells.
Case Report: Postpartum Purtscher-like Retinopathy
Authors: Fairbanks Jennifer L. , Lloyd Rachael E. , Dempsey Sean P. 
Published: September 2021

SIGNIFICANCE
This case highlights various clinical features and resolution of Purtscher-like retinopathy after childbirth.

PURPOSE
This study aimed to present a case report of postpartum Purtscher-like retinopathy and subsequent resolution after oral and intravitreal treatment.

CASE REPORT
A 30-year-old woman presented with subjective visual disturbance and transient scotoma in her right eye 7 days after giving birth. Vision measured 20/20 in her right eye and 20/20 in her left eye. Clinical examination revealed optic disc edema, retinal ischemia, and retinal hemorrhage in the right eye with a grossly normal appearance of the left eye. A diagnosis of Purtscher-like retinopathy was made. Neuroimaging and bloodwork were noncontributory to the diagnosis. Approximately 1 month after treatment with rapidly tapered oral methylprednisolone and a single intravitreal bevacizumab (Avastin; Genentech, San Francisco, CA) injection, the retinopathy had resolved with subjective visual improvement.

CONCLUSIONS
Purtscher-like retinopathy can occur after childbirth, usually within 1 to 2 days postpartum and occasionally associated with preeclampsia. Clinical course and visual improvement vary, but novel treatments may aid in visual recovery.
Case Report: Ipilimumab-induced Multisystem Autoimmune-like Toxicities Suggestive of Vogt-Koyanagi-Harada–like Syndrome
Authors: Monferrer-Adsuara Clara , Hernández-Bel Laura , Hernández-Garfella María Luisa , Remolí-Sargues Lidia , Ortiz-Salvador Miguel , Castro-Navarro Verónica , Cervera-Taulet Enrique 
Published: September 2021

SIGNIFICANCE
The emergence of new cancer therapies has dramatically improved outcomes in metastatic melanoma. Immune checkpoint inhibitors have been the most effective treatment. Although, as a direct consequence of the immune dysregulation induced by them, adverse effects termed immune-related adverse events are observed in more than 60% of the patients.

PURPOSE
We describe the clinical presentation of Vogt-Koyanagi-Harada–like syndrome in a patient with concomitant systemic melanoma treatment with ipilimumab, a cytotoxic T lymphocyte–associated antigen 4 blocker.

METHODS
This study aimed to report a case of ipilimumab-induced vitritis, papillitis, and skin and auditory signs suggestive of Vogt-Koyanagi-Harada–like syndrome.

CASE REPORT
A 64-year-old woman with metastatic melanoma presented with bilateral blurred vision and hearing loss upon completion of three cycles of treatment with ipilimumab. Ophthalmologic examination revealed a bilateral granulomatous uveitis with intense vitritis and papillitis. The result of optical coherence tomography was normal, and fluorescein angiography confirmed the bilateral papillary edema. Ipilimumab was withdrawn, and treatment with oral and systemic steroids led to a rapid improvement in the ophthalmologic and auditory manifestations. Three months after initial presentation, the patient developed vitiligo and poliosis.

CONCLUSIONS
Vogt-Koyanagi-Harada–like syndrome can develop in the process of immunological deregulation by ipilimumab in the treatment of metastatic melanoma and can correlate temporally with the efficacy of the drug in tumor regression. These observations may help elucidate the underlying mechanism of Vogt-Koyanagi-Harada syndrome as well as the relation between tumor-associated tolerance and autoimmunity.