bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Acoustic Environments in Which Older Adults Wear Their Hearing Aids: Insights From Datalogging Sound Environment Classification
Authors: Humes Larry E. , Rogers Sara E. , Main Anna K. , Kinney Dana L. 
Published: September 2018

Purpose
This report presents data on the acoustic environments in which older adults with age-related hearing loss wear their hearing aids.

Method
This is an observational study providing descriptive data from 2 primary datasets: (a) 128 older adults wearing hearing aids for an average of 6 weeks and (b) 65 older adults wearing hearing aids for an average of 13 months. Acoustic environments were automatically and continuously classified about every 4 s, using the hearing aids' signal processing, into 1 of 7 acoustic environment categories.

Results
For both groups, older adults wore their hearing aids about 60% of the time in quiet or speech-only conditions. The automatic classification of sound environments was shown to be reliable over relatively short (6-week) and long (13-month) durations. Moreover, the results were shown to have some validity in that the obtained acoustic environment profiles matched a self-reported measure of social activity administered prior to hearing aid usage. For a subset of 56 older adults with data from both the 6-week and 13-month wear times, the daily amount of hearing aid usage diminished but the profile of sound environments frequented by the wearers remained stable.

Conclusions
Examination of the results from the automatic classification of sound environments by the hearing aids of older adults provides reliable and valid environment classifications. The present data indicate that most such wearers choose generally favorable acoustic environments for hearing aid use.
The Effect of Intraoperative Glove Choice on Carpal Tunnel Pressure
Authors: Jernigan Edward W. , Smetana Brandon S. , Rummings Wayne A. , Dineen Hannah A. , Patterson J. Megan M. , Draeger Reid W. 
Published: September 2018

Abstract
Introduction The aim of this study was to quantify the effect of surgical gown and glove wear on carpal tunnel pressure. The authors hypothesized that gowning and gloving is associated with an increase in carpal tunnel pressure in cadaveric specimens wearing appropriately sized gloves. Furthermore, they hypothesized that increased glove thickness, double gloving, and smaller-than-appropriately sized gloves would all serve to increase carpal tunnel pressure.
Materials and Methods Baseline carpal tunnel pressure measurements were obtained in 11 cadaveric specimens. Each specimen was subsequently gowned and gloved. Carpal tunnel pressures were obtained for each specimen fitted with four different types of gloves in four scenarios: (1) appropriately sized gloves, (2) one full-size smaller, (3) one full-size larger, and (4) double gloved.
Results Mean carpal tunnel baseline value was 3.5 mm Hg. Appropriately sized single-glove wear more than doubled baseline carpal tunnel pressure. Double gloving and smaller-than-appropriately sized glove wear more than tripled baseline values. Among the single-glove subgroup, the thickest gloves (ortho) were associated with the highest increase in pressure from baseline values.
Conclusion Glove selection can have repercussions related to carpal tunnel pressure. Susceptible surgeons should consider these factors when making decisions regarding intraoperative glove wear.
Is There a Place for Thoracoscopic Enucleation of Esophageal Gastrointestinal Stromal Tumors?
Authors: Cohen Charlotte , Pop Daniel , Icard Philippe , Berthet Jean-Philippe , Venissac Nicolas , Mouroux Jérome 
Published: September 2018

Background Esophageal gastrointestinal stromal tumors (E-GISTs) represent less than 1% of all GISTs. The rarity of this lesion precludes the realization of randomized studies, and its treatment remains a matter of debate. We aimed to evaluate the feasibility of enucleation by video-assisted thoracic surgery (VATS) for low- to intermediate-risk E-GIST.
Methods We performed a retrospective review of patients treated by enucleation through VATS between January 2004 and January 2014 and reviewed the literature.
Results We included five patients (four men and one woman). Mean age was 53 years (range: 49–79). Three patients were diagnosed because of dysphagia and two others incidentally. The diagnosis was made by immunostaining demonstrating CD117 expression on tumor cells. The mitotic index of all E-GISTs was low (≤ 5 per 50 high-power field). Median postoperative follow-up was 5.5 years, and there was no recurrence.
Conclusion Thoracoscopic enucleation of E-GIST seems to represent a valuable option as the postoperative morbidity/mortality is low and the oncological outcome is good for low-to-intermediate grade of malignity tumors.This is a retrospective study focused on minimally invasive treatment of E-GIST. We evaluated the feasibility of VATS enucleation of low-to-medium grade of malignity E-GIST.
Antioxidants the Powerful New Weapons in the Fight Against Periodontal Diseases
Authors: Singh Baljeet , Bhickta Shivani , Gupta Rajesh , Goyal Sachin , Gupta Ram 
Published: September 2018

AbstractThe human inflammatory periodontal diseases are amongst the most common of chronic diseases. The predominant inflammatory cell (96%) within the healthy connective tissue and epithelium of the gingiva is polymorphonuclear leucocyte (PMNL). Periodontopathic bacteria in the gingivomucosal tissue may functionally activate PMNLs leading to an increased production of reactive oxygen species (ROS). Chronic inflammation subjects the nearby cells to elevated levels of free radicals (ROS) due to extracellular release from phagocytic cells. Antioxidants block the process of oxidation by neutralizing free radicals. In doing so, the antioxidant themselves become oxidized. Because of this, there is a constant need to replenish our antioxidant resources.
Geographic Tongue in A 6 Year Old Child: A Case Report with Review of Literature
Authors: Bajaj Punnet , Kapoor Charu , Garg Deepti , P.K Rajeesh , Sabharwal Robin , Vaidya Sharad 
Published: September 2018

AbstractGeographic tongue is an inflammatory disorder characterized by asymptomatic erythematoud patched with serpiginous borders. Clinically the appearance is of multifocal, circinate, irregular patches bonded by slightly elevated, white colored keratotic bands. Several etiological factors have been proposed. The conditions may remain asymptomatic or patients may present with complains of pain and burning sensation. We report a case of geographic tongue in a 6 year old boy with review of current concept in causes and management.
Assessing the Efficacy of Deoxycholic Acid for the Treatment of Submental Fat: A Three-Dimensional Study
Authors: Grow Jacob Nathaniel , Holding Julie , Korentager Richard 
Published: September 2018

Abstract

Background
Deoxycholic acid is used for the treatment of excess submental fat, offering a potential alternative to more invasive surgical procedures. However, there is currently an absence of high-level evidence in the literature outside of Phase 3 clinical trials.

Objectives
The aim of this study was to evaluate the efficacy of deoxycholic acid for the treatment of submental adiposity by correlating objective 3-dimensional (3D) data with subjective patient assessment scores.

Methods
Thirteen patients were prospectively enrolled into the study. 3D images were obtained prior to initial treatment, at 4-week intervals, and in the acute recovery period. Volumetric changes were calculated using Vectra software. Corresponding subjective surveys using the FACE-Q tool evaluated the perceived treatment results and side effects.

Results
Objectively, there was a significant reduction in submental volume following treatment (P = 0.004), with total rounds of treatment averaging 3.4 (SD: 1.19). During the immediate recovery period, there was a statistically significant increase in submental volume, with an average increase of 8.68% (P = 0.0003). Subjectively, patient satisfaction scores improved significantly for both the aesthetics of the area under the chin and jawline (P &lt; 0.005). Self-resolving paresthesia following treatment occurred in all study participants. There were no major complications. Participant scores of early treatment recovery also improved significantly with subsequent treatments (P &lt; 0.005).

Conclusions
This study validates the use of deoxycholic acid for reducing supraplatysmal adiposity in the submental area. Objective volume changes showed positive correlation with subjective improvements in patient satisfaction scores. Recovery and side effect profiles were also described and may aid in future patient education and management.

Level of Evidence: 4
Heritability of Gray Matter Structural Covariation and Tool Use Skills in Chimpanzees (Pan troglodytes): A Source-Based Morphometry and Quantitative Genetic Analysis
Authors: Hopkins William D , Latzman Robert D , Mareno Mary Catherine , Schapiro Steven J , Gómez-Robles Aida , Sherwood Chet C 
Published: September 2018

AbstractNonhuman primates, and great apes in particular, possess a variety of cognitive abilities thought to underlie human brain and cognitive evolution, most notably, the manufacture and use of tools. In a relatively large sample (N = 226) of captive chimpanzees (Pan troglodytes) for whom pedigrees are well known, the overarching aim of the current study was to investigate the source of heritable variation in brain structure underlying tool use skills. Specifically, using source-based morphometry (SBM), a multivariate analysis of naturally occurring patterns of covariation in gray matter across the brain, we investigated (1) the genetic contributions to variation in SBM components, (2) sex and age effects for each component, and (3) phenotypic and genetic associations between SBM components and tool use skill. Results revealed important sex- and age-related differences across largely heritable SBM components and associations between structural covariation and tool use skill. Further, shared genetic mechanisms appear to account for a heritable link between variation in both the capacity to use tools and variation in morphology of the superior limb of the superior temporal sulcus and adjacent parietal cortex. Findings represent the first evidence of heritability of structural covariation in gray matter among nonhuman primates.
Changes in Objectively Measured Activity Behavior Among Women Undergoing Breast Cancer Treatment: Longitudinal Cohort Study
Authors: Forbes Cynthia C. , Keats Melanie , Rainham Daniel , Younis Tallal , Blanchard Chris M. 
Published: September 2018

Purpose:
Activity behaviors of breast cancer survivors (BCSs) during treatment are unlikely to be at levels sufficient enough to gain health benefits. Previous activity research among BCSs has been mainly posttreatment and generally cross-sectional. This study aimed to determine the prevalence and changes in objectively measured moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and sedentary behavior (SED) among BCSs undergoing adjuvant/palliative therapy.

Methods:
Participants completed baseline surveys and wore accelerometers to measure activity during waking hours during treatment and again 6 months later. Hierarchal linear modeling (HLM) was used to determine changes.

Results:
In total, 77 BCSs participated. Ninety-one percent provided physical activity (PA) data for 3 or more valid days at baseline (T
1) and 72% at 6 months (T
2); 29% met PA guidelines at T
1 and 41% at T
2. Daily LPA and SED did not change from T
1 to T
2 (133 vs 138 minutes; 595 vs 597 minutes). Controlling for body mass index at the intercept, HLM revealed that MVPA significantly increased from T
1 to T
2 (+5.62; P = .015).

Conclusion:
An increase in objectively measured total daily MVPA over 6 months was found, at which time, fewer BCSs were currently receiving chemo- or radiotherapy and may theoretically be feeling better. However, fewer T
2 measures may bias and artificially inflate the results. Although total MVPA minutes increased at T
2, less than half BCSs were meeting guidelines and had high amounts of LPA/SED during treatment, with insignificant change over time (71% at T
1; 59% at T
2). Practitioner intervention may help reduce SED while increasing LPA and MVPA behavior among those currently undergoing treatment.
Hospital-, Anesthesiologist-, and Patient-level Variation in Primary Anesthesia Type for Hip Fracture Surgery
Authors: McIsaac Daniel I. , Wijeysundera Duminda N. , Bryson Gregory L. , Huang Allen , McCartney Colin J. L. , van Walraven Carl 
Published: September 2018

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Manuscript Tells Us That Is New

Background
Substantial variation in primary anesthesia type for hip fracture surgery exists. Previous work has demonstrated that patients cared for at hospitals using less than 20 to 25% neuraxial anesthesia have decreased survival. Therefore, the authors aimed to identify sources of variation in anesthesia type, considering patient-, anesthesiologist-, and hospital-level variables.

Methods
Following protocol registration (NCT02787031), the authors conducted a cross-sectional analysis of a population-based cohort using linked administrative data in Ontario, Canada. The authors identified all people greater than 65 yr of age who had emergency hip fracture surgery from April 2002 to March 2014. Generalized linear mixed models were used to account for hierarchal data and measure the adjusted association of hospital-, anesthesiologist-, and patient-level factors with neuraxial anesthesia use. The proportion of variation attributable to each level was estimated using variance partition coefficients and the median odds ratio for receipt of neuraxial anesthesia.

Results
Of 107,317 patients, 57,080 (53.2%) had a neuraxial anesthetic. The median odds ratio for receiving neuraxial anesthesia was 2.36 between randomly selected hospitals and 2.36 between randomly selected anesthesiologists. The majority (60.1%) of variation in neuraxial anesthesia use was explained by patient factors; 19.9% was attributable to the anesthesiologist providing care and 20.0% to the hospital where surgery occurred. The strongest patient-level predictors were absence of preoperative anticoagulant or antiplatelet agents, absence of obesity, and presence of pulmonary disease.

Conclusions
While patient factors explain most of the variation in neuraxial anesthesia use for hip fracture surgery, 40% of variation is attributable to anesthesiologist and hospital-level practice. Efforts to change practice patterns will need to consider hospital-level processes and anesthesiologists’ intentions and behaviors.
Quality Anesthesia
Authors: Fleisher Lee A. 
Published: September 2018

Abstract
Quality has been defined by six domains: effective, equitable, timely, efficient, safe, and patient centered. Quality of anesthesia care can be improved through measurement, either through local measures in quality improvement or through national measures in value-based purchasing programs. Death directly related to anesthesia care has been reduced, but must be measured beyond simple mortality. To improve perioperative care for our patients, we must take shared accountability for all surgical outcomes including complications, which has traditionally been viewed as being surgically related. Anesthesiologists can also impact public health by being engaged in improving cognitive recovery after surgery and addressing the opiate crisis. Going forward, we must focus on what patients want and deserve: improved patient-oriented outcomes and satisfaction with our care. By listening to our patients and being engaged in the entire perioperative process, we can make the greatest impact on perioperative care.
Nurse-Initiated Mobilization Practices in 2 Community Intensive Care Units
Authors: Stolldorf Deonni P. , Dietrich Mary S. , Chidume Tiffani , McIntosh Marie , Maxwell Cathy A. 
Published: September 2018

Background
Critical-care nurses play a vital role in promoting safe early mobilization in intensive care unit (ICU) settings to reduce the risks associated with immobility in ICUs, including the risk of delirium, ICU-acquired weakness, and functional decline.

Objective
The purposes of this study were to describe nurse-led mobilization practices in 2 community hospital ICUs and to report differences and similarities between the 2 settings.

Methods
This was a cross-sectional exploratory study of 18 nurses (ICU A: n = 12, ICU B: n = 6) and 124 patients (ICU A: n = 50, ICU B: n = 74). Patient-specific therapeutic intervention needs and nurse-initiated mobilization practices were tracked over a 1-month period.

Results
Differences in patient characteristics and nurse-led mobilization activities were observed between ICUs. After controlling for patient characteristics, we found statistically significant differences in nurse-led mobilization activities between the 2 units, suggesting that factors other than patient characteristics may explain differences in nurse-led mobilization practices.
Cumulative Human Immunodeficiency Viremia, Antiretroviral Therapy, and Incident Myocardial Infarction
Authors: Delaney Joseph A. , Nance Robin M. , Whitney Bridget M. , Crane Heidi M. , Williams-Nguyen Jessica , Feinstein Mathew J. , Kaplan Robert C. , Hanna David B. , Budoff Matthew J. , Drozd Daniel R. , Burkholder Greer , Mugavero Michael J. , Mathews William C. , Moore Richard D. , Eron Joseph J. , Hunt Peter W. , Geng Elvin , Saag Michael S. , Kitahata Mari M. , Heckbert Susan R. 
Published: September 2018

Background:
People living with HIV are at risk of increased myocardial infarction (MI). Cumulative HIV viral load (VL) has been proposed as a better measure of HIV inflammation than other measures of VL, like baseline VL, but its associations with MI are not known.

Methods:
The multisite Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort includes clinical data and centrally adjudicated MI with distinction between atheroembolic MI (type 1) and MI related to supply–demand mismatch (type 2). We examined CNICS participants who were not on antiretroviral therapy (ART) at enrollment. Cumulative VL (copy-days of virus) from 6 months after enrollment was estimated with a time-weighted sum using the trapezoidal rule. We modeled associations of cumulative and baseline VL with MI by type using marginal structural Cox models. We contrasted the 75% percentile of the VL distribution with the 25% percentile.

Results:
Among 11,324 participants, 218 MIs occurred between 1996 and 2016. Higher cumulative VL was associated with risk of all MI (hazard ratio [HR] = 1.72; 95% confidence interval [CI] = 1.26, 2.36), type 1 MI (HR = 1.23; 95% CI = 0.78, 1.96), and type 2 MI (HR = 2.52; 95% CI = 1.74, 3.66). While off ART, cumulative VL had a stronger association with type 1 MI (HR = 2.13; 95% CI = 1.15, 3.94) than type 2 MI (HR = 1.25; 95% CI = 0.70, 2.25). Baseline VL was associated with all MI (HR = 1.60; 95% CI = 1.28, 2.01), type 1 MI (HR = 1.73; 95% CI = 1.26, 2.38), and type 2 MI (HR = 1.51; 95% CI = 1.10, 2.08).

Conclusions:
Higher cumulative and baseline VL is associated with all MI, with a particularly strong association between cumulative VL and type 2 MI.
Differences in Obesity Among Black and White Children, Adolescents, and Adults With Congenital Heart Disease
Authors: Jackson Jamie L. , Harrison Tondi , Keim Sarah A. 
Published: September 2018

Background:
Congenital heart disease (CHD) survivors have an elevated risk for obesity-related comorbidities, but little is known about racial differences in obesity rates for this population.

Objective:
The authors aimed to compare rates of obesity in CHD survivors to national estimates using National Health and Nutrition Examination Assessment Survey (NHANES) and to characterize racial disparities in obesity among CHD survivors across age ranges.

Methods:
Retrospective chart review included 4496 CHD survivors (4050 white and 446 black) with a range of lesion severities from a pediatric and an adult medical center.

Results:
White children with CHD had a higher prevalence of obesity compared with NHANES estimates. In contrast, white young adults with CHD had a lower prevalence of obesity compared with NHANES. Blacks with CHD had a 58% increased risk of obesity in young adulthood and a 33% increased risk in late adulthood compared with whites with CHD.

Conclusions:
Obesity interventions are needed among CHD survivors across the lifespan, particularly among adult non-Hispanic blacks.
Psychosocial Adjustment and Quality of Life in Patients With Peripartum Cardiomyopathy
Authors: Rosman Lindsey , Salmoirago-Blotcher Elena , Cahill John , Sears Samuel F. 
Published: September 2018

Background:
Psychological distress can adversely affect heart failure prognosis, yet the immediate and ongoing challenges faced by women diagnosed with peripartum cardiomyopathy (PPCM) are not well studied.

Objective:
We examined psychological distress and quality of life in a large, national sample of patients with PPCM and evaluated whether these characteristics differ among newly diagnosed (0–1 year), short-term (2–4 years), and long-term (5–10 years) survivors.

Methods:
One hundred forty-nine patients with PPCM (mean age, 33.9 ± 5.0 years) recruited from a web-based registry completed questionnaires about generalized anxiety (Generalized Anxiety Disorder-7), cardiac anxiety (Cardiac Anxiety Questionnaire [CAQ]), health status (Medical Outcomes Study Short-Form 12 [SF-12] Health Survey), and PPCM-specific quality-of-life concerns. Group differences were evaluated using multivariate statistics with adjustments for disease severity and psychiatric history.

Results:
Generalized anxiety symptoms higher than the clinical cutoff were reported by 53% of patients with PPCM. Mean scores on the CAQ (1.9 ± 0.7) and CAQ subscale scores (cardiac-specific fear [2.1 ± 0.8], avoidance [1.7 ± 0.9], and heart-focused attention [1.6 ± 0.8]) were elevated in the overall sample. Psychological symptoms and quality-of-life concerns were generally similar across patients except for cardiac avoidance, which was significantly higher in newly diagnosed women after adjustments for disease severity (P = .05) and psychiatric history (P = .01). Peripartum cardiomyopathy–specific quality-of-life concerns were also prevalent; however, group differences were nonsignificant (P = .07).

Conclusions:
Generalized anxiety, cardiac anxiety, and quality-of-life concerns are prevalent among patients with PPCM at all stages of recovery. Psychological issues may be an underrecognized aspect of women’s recovery from PPCM.