bluuebunny/crossref_metadata_2025_split huggingface dataset:
Speech Understanding in Noise for Adults With Cochlear Implants: Effects of Hearing Configuration, Source Location Certainty, and Head Movement
Authors: Gifford René H. , Loiselle Louise , Natale Sarah , Sheffield Sterling W. , Sunderhaus Linsey W. , S. Dietrich Mary , Dorman Michael F. 
Published: May 2018

PurposeThe primary purpose of this study was to assess speech understanding in quiet and in diffuse noise for adult cochlear implant (CI) recipients utilizing bimodal hearing or bilateral CIs. Our primary hypothesis was that bilateral CI recipients would demonstrate less effect of source azimuth in the bilateral CI condition due to symmetric interaural head shadow.MethodSentence recognition was assessed for adult bilateral (n= 25) CI users and bimodal listeners (n= 12) in three conditions: (1) source location certainty regarding fixed target azimuth, (2) source location uncertainty regarding roving target azimuth, and (3) Condition 2 repeated, allowing listeners to turn their heads, as needed.Results(a) Bilateral CI users exhibited relatively similar performance regardless of source azimuth in the bilateral CI condition; (b) bimodal listeners exhibited higher performance for speech directed to the better hearing ear even in the bimodal condition; (c) the unilateral, better ear condition yielded higher performance for speech presented to the better ear versus speech to the front or to the poorer ear; (d) source location certainty did not affect speech understanding performance; and (e) head turns did not improve performance. The results confirmed our hypothesis that bilateral CI users exhibited less effect of source azimuth than bimodal listeners. That is, they exhibited similar performance for speech recognition irrespective of source azimuth, whereas bimodal listeners exhibited significantly poorer performance with speech originating from the poorer hearing ear (typically the nonimplanted ear).ConclusionsBilateral CI users overcame ear and source location effects observed for the bimodal listeners. Bilateral CI users have access to head shadow on both sides, whereas bimodal listeners generally have interaural asymmetry in both speech understanding and audible bandwidth limiting the head shadow benefit obtained from the poorer ear (generally the nonimplanted ear). In summary, we found that, in conditions with source location uncertainty and increased ecological validity, bilateral CI performance was superior to bimodal listening.
Does the solar granulation change with the activity cycle?
Authors: Muller R. , Hanslmeier A. , Utz D. , Ichimoto K. 
Published: May 2018

Context. Knowledge of the variation of the solar granulation properties (contrast and scale) with the 11-yr activity cycle is useful for a better understanding of the interaction between magnetic field and convection at global or local scales. A varying granulation may also contribute to irradiance variations and affect the p-mode damping rates and lifetimes.
Aims. HINODE/SOT blue continuum images taken in the frame of the synoptic program at the disk center on a daily basis between November 2006 and February 2016 are used. This period covers the minimum of activity between cycles 23 and 24 and the maximum of cycle 24.
Methods. The sharpness of a significant number of images was reduced because of instrumental aberrations or inaccurate focusing. Only the sharpest images were selected for this investigation.
Results. To be detectable with HINODE/SOT images, the variation of the granulation contrast and of the granulation scale at the disk center should have been larger than 3%. As it is not the case, it is concluded that they varied by less than 3% through the weak cycle 24.
Surgical Treatment for Spasticity: Selective Dorsal Rhizotomy – Technique and Literature Review
Authors: Teixeira Marcos Paulo dos Santos , Monaco Bernardo Assumpção de , Navarro Jessie Medeiros de , Vazquez Emmanuel Alejandro , Lopes Arthur José Maia , Melo Thais Cristina de Souza , Teixeira Manoel Jacobsen 
Published: May 2018

AbstractSpasticity is a motor disorder that leads to a resistance to passive joint movement. Cerebral palsy is the most important cause of spasticity and can be caused by several factors, including multiple gestations, alcoholism, infections, hemorrhages, drowning, and traumatic brain injuries, among others. There are many scales that help to measure and monitor the degree of impairment of these patients. The initial treatment should focus on the causal factor, such as tumors, inflammation, degenerative diseases, hydrocephalus, etc. Subsequently, the treatment of spastic musculature includes oral or intrathecal myorelaxants, spinal cord electrostimulation, neurotomies, Lissauer tract lesion, dentatotomy and selective dorsal rhizotomy. The latter is a safe technique, possible to be performed in most centers with neurosurgical support, and it is effective in the treatment of severe spasticity. In this article, the authors describe the surgical technique and conduct a review the literature.
Tocolysis among Women with Preterm Birth: Associated Factors and Outcomes from a Multicenter Study in Brazil
Authors: Dias Tabata Zumpano , Fava Mariana Lacerda , Passini Júnior Renato , Cecatti Jose Guilherme , Tedesco Ricardo Porto , Lajos Giuliane Jesus , Rehder Patricia Moretti , Nomura Marcelo Luis , Oliveira Paulo Fanti , Costa Maria Laura 
Published: May 2018

Objective To evaluate the use of tocolysis in cases of preterm birth due to spontaneous preterm labor in a Brazilian sample.
Methods A sample of 1,491 women with preterm birth due to spontaneous preterm labor were assessed, considering treatment with tocolysis or expectant management, according to gestational age at birth (< 34 weeks and 34 to 36 + 6 weeks) and drugs prescribed. The study took place in 20 Brazilian hospitals from April 2011 to July 2012. Bivariate analyses were conducted to evaluate associations with sociodemographic and obstetric characteristics and odds ratios with their respective 95% confidence intervals were estimated for maternal and neonatal outcomes.
Results A total of 1,491 cases of preterm birth were considered. Tocolysis was performed in 342 cases (23%), 233 of which (68.1%) were delivered before 34 weeks. Within the expectant management group, 73% was late preterm and with more advanced labor at the time of admission. The most used drugs were calcium channel blockers (62.3%), followed by betamimetics (33%). Among the subjects in the tocolysis group, there were more neonatal and maternal complications (majority non-severe) and an occurrence of corticosteroid use that was 29 higher than in the expectant management group.
Conclusion Tocolysis is favored in cases of earlier labor and also among those with less than 34 weeks of gestation, using preferably calcium channel blockers, with success in achieving increased corticosteroid use. Tocolysis, in general, was related to higher maternal and neonatal complication rates, which may be due to the baseline difference between cases at admission. However, these results should raise awareness to tocolysis use.
Natural History, Multimodal Management, and Quality of Life Outcomes of Trigeminal Schwannomas
Authors: Ye Vincent , Akagami Ryojo , Makarenko Serge 
Published: May 2018

Background Trigeminal schwannomas are the second most common among intracranial schwannomas. These can arise from anywhere between the root and the distal extracranial branches of the trigeminal nerve. Clinical presentation depends on location and size, including but not limited to facial hypesthesia or pain, headaches, dizziness, ataxia, and diplopia. Literature is strikingly scant discussing the natural history of these lesions, while the treatment goals are heavily dependent on tumor presentation. Management decisions must be individualized to each tumor and each patient, while attempting to maximize the quality of life. We present the natural history of these lesions as well as their management by surgical resection or radiation therapy, and report long-term quality of life outcomes.
Methods Between 2001 and 2015, 24 patients (66.7% female) with trigeminal schwannomas were diagnosed and managed at Vancouver General Hospital. We analyzed the clinical presentation, surgical results, resection rates, patient quality of life, and complications. To complete the evaluation, we prospectively collected 36-Item Short Form Health Survey (SF-36) quality of life assessments for comparison.
Results We identified 12 patients treated with a craniotomy and surgical resection, 4 were treated with radiation therapy, while 8 patients were followed by observation. Mean age of study cohort was 49.2 years (range, 23–79 years), and most patients presented with facial hypesthesia (54.2%) and headaches (37.5%), while 37.5% were incidental findings. There were no major differences in patient demographics between the three groups. Patients offered surgery had larger lesions (mean diameter, 3.4 ± 1.1 cm) when compared with those that were irradiated or observed, and were more likely to have extracranial extension. Overall patient quality of life improved following treatment (ΔSF-36 + 12.9) at 3.9 years.
Conclusions The treatment goals of trigeminal schwannomas focus on improvement in neurologic symptoms, relief of mass effect, and preservation of cranial nerve function. We demonstrate that smaller lesions found incidentally with minimal symptoms can be followed safely with serial imaging, with 1 of 9 (11.1%) progressing to require treatment over the course of 7.1 years. Management of trigeminal schwannomas should be individualized with an involvement of a multidisciplinary skull base team.
An accurate estimation of the horizontal acceleration of a rower's centre of mass using inertial sensors: a validation
Authors: Lintmeijer Lotte L. , Faber Gert S. , Kruk Hessel R. , van Soest A. J. “Knoek” , Hofmijster Mathijs J. 
Published: May 2018

AbstractFor a valid determination of a rower's mechanical power output, the anterior–posterior (AP) acceleration of a rower's centre of mass (CoM) is required. The current study was designed to evaluate the accuracy of the determination of this acceleration using a full‐body inertial measurement units (IMUs) suit in combination with a mass distribution model. Three methods were evaluated. In the first two methods, IMU data were combined with either a subject‐specific mass distribution or a standard mass distribution model for athletes. In the third method, a rower's AP CoM acceleration was estimated using a single IMU placed at the pelvis.Experienced rowers rowed on an ergometer that was placed on two force plates, while wearing a full‐body IMUs suit. Correspondence values between AP CoM acceleration based on IMU data (the three methods) and AP CoM acceleration obtained from force plate data (reference) were calculated. Good correspondence was found between the reference AP CoM acceleration and the AP CoM accelerations determined using IMU data in combination with the subject‐specific mass model and the standard mass model (intraclass correlation coefficients [ICC] > 0.988 and normalized root mean square errors [nRMSE] 3.81%). Correspondence was lower for the AP CoM accelerations determined using a single pelvis IMU (0.877 < ICC < 0.960 and 6.11% < nRMSE < 13.61%).Based on these results, we recommend determining a rower's AP CoM acceleration using IMUs in combination with the standard mass model. Finally, we conclude that accurate determination of a rower's AP CoM acceleration is not possible on the basis of the pelvis acceleration only.
HealthStart: An Innovative Pilot Model Promoting Diversity in Nursing Education
Authors: Vignato Julie A. , Guinon Teresa 
Published: May 2018

Abstract
This article describes a pilot model for promoting diversity in prelicensure nursing education. The National League for Nursing calls on nursing education leadership to recruit, retain, and graduate diverse students to promote nursing diversity and decrease health disparities. Scaffolding contextualized learning through a learning community and “The Puente Project” bicultural and bilingual outreach guidelines were combined to create HealthStart. Retention rates increased by 23.5 percent in a predominately low socioeconomic, racially and ethnically diverse population. It was found that multiple modalities promote student success and diversity in prelicensure nursing education.
New Graduate Nurse Experiences in Clinical Judgment: What Academic and Practice Educators Need to Know
Authors: Lusk Monagle Janet , Lasater Kathie , Stoyles Sydnee , Dieckmann Nathan 
Published: May 2018

Abstract

AIM
The aim of the study was to determine if use of a structured reflection exercise using a clinical judgment framework would result in more practice-ready new graduate nurses (NGNs).

BACKGROUND
Clinical judgment is a critical skill for all nurses, yet it is identified as a deficit in NGNs.

METHOD
Seventy-four NGNs in two groups participated in this mixed-methods study in their first year in practice. Scores from two quantitative measures were collected for all participants. The Lasater Clinical Judgment Rubric framed the structured intervention.

RESULTS
Although the quantitative data showed no significant differences between the groups, use of the reflection exercise indicated a positive impact on NGNs. Qualitative data revealed four themes that present challenges for preparation of NGNs: enhancing communication, finding interprofessional support, responding to complexity of care, and appreciating the role of the nurse.

CONCLUSION
Implications provide guidance for academic and practice educators to smooth the transition into practice.
Interactive Versus Passive Distraction and Parent Psychoeducation as Pain Management Techniques During Pediatric Venepuncture
Authors: Newell Anna , Keane Jennifer , McGuire Brian E. , Heary Caroline , McDarby Vincent , Dudley Bernie , Moran Josh , Francis Kady , Caes Line 
Published: May 2018

Objectives:
The aim of the current research was to compare the relative efficacy of interactive and passive distraction, with or without parental psychoeducation, on child pain and distress during a venepuncture. We also compared the effect of parental psychoeducation on parental distress, knowledge of distraction strategies, and engagement in distraction.

Materials and Methods:
This cross-sectional study included 213 children scheduled for a venepuncture, and one of their parents, who were randomly allocated to 1 of 4 conditions; interactive distraction, passive distraction, interactive distraction with parent psychoeducation, and passive distraction with parent psychoeducation. Analyses of covariances were used to investigate the impact of distraction type and the use of parent psychoeducation on child and parent pain-related outcome variables.

Results:
Statistical analyses revealed no significant differences between groups for child-reported pain and distress. The parents of children who received interactive distraction reported significantly higher levels of distress than the parents of children who received passive distraction. Parents who received parent psychoeducation had a significantly higher level of knowledge than parents who did not receive psychoeducation, but did not engage in more effective pain management behavior.

Conclusions:
The results indicated that distraction type did not have a significantly different influence on child pain-related outcome variables. In addition, while psychoeducation was demonstrated to be effective in increasing parental knowledge, it was not sufficient to change parental behavior.
Factor Structure and Psychometric Properties of the Neonatal Eating Assessment Tool—Bottle-Feeding (NeoEAT—Bottle-Feeding)
Authors: Pados Britt Frisk , Thoyre Suzanne M. , Estrem Hayley H. , Park Jinhee , McComish Cara 
Published: May 2018

Background:
Feeding difficulties are common in infancy. There are currently no valid and reliable parent-report measures to assess bottle-feeding in infants younger than 7 months. The Neonatal Eating Assessment Tool (NeoEAT)—Bottle-feeding has been developed and content validated.

Purpose:
To determine the factor structure and psychometric properties of the NeoEAT—Bottle-feeding.

Methods:
Parents of bottle-feeding infants younger than 7 months were invited to participate. Exploratory factor analysis was used to determine factor structure. Internal consistency reliability was tested using Cronbach α. Test-retest reliability was tested between scores on the NeoEAT—Bottle-feeding completed 2 weeks apart. Construct validity was tested using correlations between the NeoEAT—Bottle-feeding, the Infant Gastroesophageal Reflux Questionnaire—Revised (I-GERQ-R), and the Infant Gastrointestinal Symptoms Questionnaire (IGSQ). Known-groups validation was tested by comparing scores between healthy infants and infants with feeding problems.

Results:
A total of 441 parents participated. Exploratory factor analysis revealed a 64-item scale with 5 factors. Internal consistency reliability (α= .92) and test-retest reliability (r = 0.90; P < .001) were both excellent. The NeoEAT—Bottle-feeding had construct validity with the I-GERQ-R (r = 0.74; P < .001) and IGSQ (r = 0.64; P < .001). Healthy infants scored lower on the NeoEAT—Bottle-feeding than infants with feeding problems (P < .001), supporting known-groups validity.

Implications for Practice:
The NeoEAT—Bottle-feeding is an available assessment tool for clinical practice.

Implications for Research:
The NeoEAT—Bottle-feeding is a valid and reliable measure that can now be used in feeding research.

Video Abstract Available at
https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx.
Outcomes of Hysterectomy Performed by Very Low-Volume Surgeons
Authors: Ruiz Maria P. , Chen Ling , Hou June Y. , Tergas Ana I. , St. Clair Caryn M. , Ananth Cande V. , Neugut Alfred I. , Hershman Dawn L. , Wright Jason D. 
Published: May 2018

OBJECTIVE:
To perform a population-based analysis to first examine the changes in surgeon and hospital procedural volume for hysterectomy over time and then to explore the association between very low surgeon procedural volume and outcomes.

METHODS:
All women who underwent hysterectomy in New York State from 2000 to 2014 were examined. Surgeons were classified based on the average annual procedural volume as very low-volume surgeons if they performed one procedure per year. We used multivariable models to examine the association between very low-volume surgeon status and morbidity, mortality, transfusion, length of stay, and cost.

RESULTS:
Among 434,125 women who underwent hysterectomy, very low-volume surgeons accounted for 3,197 (41.0%) of the surgeons performing the procedures and operated on 4,488 (1.0%) of the patients. The overall complication rates were 32.0% for patients treated by very low-volume surgeons compared with 9.9% for those treated by other surgeons (P<.001) (adjusted relative risk 1.97, 95% CI 1.86–2.09). Specifically, the rates of intraoperative (11.3% vs 3.1%), surgical site (15.1% vs 4.1%) and medical complications (19.5% vs 4.8%), and transfusion (38.5% vs 11.8%) were higher for very low-volume compared with higher volume surgeons (P<.001 for all). Patients treated by very low-volume surgeons were also more likely to have a prolonged length of stay (62.0% vs 22.0%) and excessive hospital charges (59.8% vs 24.6%) compared with higher volume surgeons (P<.001 for both). Mortality rate was 2.5% for very low-volume surgeons compared with 0.2% for higher volume surgeons (P<.001) (adjusted relative risk 2.89, 95% CI 2.32–3.61).

CONCLUSION:
A substantial number of surgeons performing hysterectomy are very low-volume surgeons. Performance of hysterectomy by very low-volume surgeons is associated with increased morbidity, mortality, and resource utilization.
A Simulator for Breech Extraction of the Second Twin
Authors: Birsner Meredith L. 
Published: May 2018

BACKGROUND:
Breech extraction of a second twin is a skill useful for any health care provider planning on undertaking vaginal delivery of twins. However, training opportunities in this skill may be limited.

METHOD:
Using readily available supplies, a reusable model neoprene uterus can be constructed, as can a balloon model to simulate a fetus in the amniotic cavity.

EXPERIENCE:
The model allowed demonstration of skills expected of trainees and is easy to construct. A simulated vagina addition increased extraction difficulty and increased the probability of balloon (amniotic sac) rupture during simulation. A hysterotomy addition enhanced model applicability for use at simulated cesarean delivery of the breech fetus.

CONCLUSION:
This educational device for simulation of breech extraction realistically simulates a fetus suspended in an amniotic cavity and challenges learners to use tactile cues for prompt and proper identification, grasping, and delivery of the fetal foot or feet.
Delivery of the Nonpresenting Twin First
Authors: Weiner Eran , Barrett Jon , Ram Maya , Lipworth Hayley , Mizrachi Yossi , Bas Lando Maayan , Melamed Nir 
Published: May 2018

OBJECTIVE:To estimate the rate of delivery of the nonpresenting twin first and to identify risk factors for such an event by using a cohort of opposite-sex twins for whom the intrauterine order was well documented with ultrasonography before delivery.METHODS:We conducted a retrospective cohort study of all opposite-sex dichorionic twins in a single tertiary center between 2002 and 2016. Reports of ultrasonograms performed less than 2 weeks before birth were reviewed for information on twins' presenting order in relation to fetal sex. Intrauterine labeling was compared with labeling at the time of birth. Multivariable regression analysis was used to identify factors associated with delivery of the nonpresenting twin first.RESULTS:Of 1,746 women with dichorionic twin pregnancies, 942 (53.9%) had opposite-sex twins and 617 had recent data on ultrasonographic twin labeling. In 456 of 617 (73.9%) pregnancies, both twins were delivered by cesarean delivery and in 161 of 617 (26.1%) pregnancies, one or both twins were delivered vaginally. The overall rate of delivery of the nonpresenting twin first was 6.8% (95% CI 4.5–9.1%, 31/456) in the cesarean group; there were no deliveries (95% CI 0.0–2.3%, 0/161) of the nonpresenting twin first in the vaginal group (P=.001). The following factors were independently associated with delivery of the nonpresenting twin first at cesarean delivery: discordance greater than 25% in birth weights (17.5%, adjusted odds ratio [OR] 4.0, 95% CI 1.7–9.1), nonvertex presentation of the presenting twin (11.6%, adjusted OR 3.8, 95% CI 1.7–8.3), and gestational age less than 32 0/7 weeks (14.9%, adjusted OR 3.6, 95% CI 1.6–7.8).CONCLUSIONS:Delivery of the nonpresenting twin first in dichorionic, opposite-sex twins at the time of birth occurs in 6.8% of cesarean deliveries. Clinicians and researchers should be aware of this phenomenon because it has implications for neonatal care and long-term outcome.