bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonverbal Reasoning as a Contributor to Sentence Recognition Outcomes in Adults With Cochlear Implants
Authors: Mattingly Jameson K. , Castellanos Irina , Moberly Aaron C. 
Published: November 2018

Hypothesis:
Significant variability in speech recognition persists among postlingually deafened adults with cochlear implants (CIs). We hypothesize that scores of nonverbal reasoning predict sentence recognition in adult CI users.

Background:
Cognitive functions contribute to speech recognition outcomes in adults with hearing loss. These functions may be particularly important for CI users who must interpret highly degraded speech signals through their devices. This study used a visual measure of reasoning (the ability to solve novel problems), the Raven's Progressive Matrices (RPM), to predict sentence recognition in CI users.

Methods:
Participants were 39 postlingually deafened adults with CIs and 43 age-matched normal-hearing (NH) controls. CI users were assessed for recognition of words in sentences in quiet, and NH controls listened to eight-channel vocoded versions to simulate the degraded signal delivered by a CI. A computerized visual task of the RPM, requiring participants to identify the correct missing piece in a 3×3 matrix of geometric designs, was also performed. Particular items from the RPM were examined for their associations with sentence recognition abilities, and a subset of items on the RPM was tested for the ability to predict degraded sentence recognition in the NH controls.

Results:
The overall number of items answered correctly on the 48-item RPM significantly correlated with sentence recognition in CI users (r = 0.35–0.47) and NH controls (r = 0.36–0.57). An abbreviated 12-item version of the RPM was created and performance also correlated with sentence recognition in CI users (r = 0.40–0.48) and NH controls (r = 0.49–0.56).

Conclusions:
Nonverbal reasoning skills correlated with sentence recognition in both CI and NH subjects. Our findings provide further converging evidence that cognitive factors contribute to speech processing by adult CI users and can help explain variability in outcomes. Our abbreviated version of the RPM may serve as a clinically meaningful assessment for predicting sentence recognition outcomes in CI users.
Feasibility Study of a Mechanical Real-Time Feedback System for Optimizing the Sound Transfer in the Reconstructed Middle Ear
Authors: Neudert Marcus , Bornitz Matthias , Mocanu Horia , Lasurashvili Nicoloz , Beleites Thomas , Offergeld Christian , Zahnert Thomas 
Published: November 2018

Objective:
To evaluate electromechanical excitation as an alternative excitation mode for middle ear transfer function (METF) measurements as well as real-time feedback in prosthetic ossicular reconstruction.

Method:
In eight human cadaveric temporal bones, the ossicular chain was excited using acoustic and mechanical (floating mass transducer, FMT) stimulation to determine the METF. After disconnecting the ossicular chain and reconstruction with partial or total prosthesis the METFs were measured again. Continuous FMT stimulation was then applied to improve the prosthesis’ position using real-time feedback of the METF.

Results:
Mechanical stimulation of ossicular vibration showed characteristic differences to acoustic excitation resulting from the force characteristics of the FMT. Furthermore, the interspecimen METF variability was greater with electromechanical than acoustic stimulation because of interspecimen variability in the FMT coupling conditions. When the METF with FMT excitation was used as a real-time feedback tool, a measurable improvement in the quality of ossicular reconstruction could be achieved.

Conclusions:
Mechanical excitation is an effective and suitable alternative stimulation method in experimental METF measurements. The system provides real-time feedback for ossicular reconstruction in the experimental setting. Some influencing factors still need to be distinguished for reliable measurements. However, the method does not yet meet the requirements for clinical application as an intraoperative, real-time monitoring tool. However, the system could be an excellent model for high-end cadaveric temporal bone training in ossiculoplasty.
The Insertion Results of a Mid-scala Electrode Assessed by MRI and CBCT Image Fusion
Authors: Sipari Sini , Iso-Mustajärvi Matti , Löppönen Heikki , Dietz Aarno 
Published: November 2018

Objectives:
To investigate the results of clinical surgical insertions with a Mid-scala array (HIFocus Mid-Scala Electrode, HFms).

Study Design:
Consecutive retrospective case study.

Settings:
Tertiary referral center.

Patients:
Analyses of imaging data of 26 consecutive patients (31 insertions) implanted with the HFms.

Intervention (s):
The evaluation of insertion trauma evoked by a previously validated image fusion technique. Electrode reconstructions from postoperative cone-beam computed tomography (CBCT) were overlaid onto preoperative magnetic resonance imaging (MRI) scans to create artifact-free images.

Main Outcome Measures:
The electrode position was quantified in relation to the basilar membrane. Trauma scaling adopted from Eshraghi was used for evaluating insertion trauma. The results of the visual assessment of the postoperative CBCT were compared to those obtained with the fusion technique.

Results:
Three insertions had to be excluded due to incompatibility of the imaging data with the fusion software. We found consistent peri- to mid-modiolar placement of the HFms with a mean insertion depth angle of 376°. According to the medical records, a visual examination of the postoperative CBCT indicated that there had been no scala dislocations but when assessed by the image fusion technique, five scala dislocations (17.8%) were found. Additionally, one tip fold-over was detected in the postoperative CBCT even though this was not evident in any intraoperative measurements.

Conclusion:
HFms showed atraumatic surgical insertion results with consistent mid-modiolar placement. Image fusion enhances the accuracy of the insertion trauma assessment. Routine postoperative imaging is recommended for identifying tip fold-over as well as for quality control and documentation.
Epidemiology of atrial fibrillation in patients with cirrhosis and clinical significance: a meta-analysis
Authors: Chokesuwattanaskul Ronpichai , Thongprayoon Charat , Bathini Tarun , O’Corragain Oisin A , Sharma Konika , Preechawat Somchai , Wijarnpreecha Karn , Kröner Paul T. , Ungprasert Patompong , Cheungpasitporn Wisit 
Published: November 2018

ObjectiveThe epidemiology of atrial fibrillation (AF) in patients with cirrhosis and its clinical significance remain unclear. This study aimed (i) to investigate the pooled prevalence and/or incidence of AF in patients with cirrhosis and (ii) to assess the mortality risk of AF in patients with cirrhosis.Patients and methodsA literature search for studies that reported incidence of AF in patients with cirrhosis was carried out using Medline, Embase, and Cochrane Database from inception through July 2018. Pooled incidence with 95% confidence interval (CI) was calculated using a random-effect model. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42018102664).ResultsSeven cohort studies including 385 866 patients with cirrhosis were identified. The pooled estimated prevalence of AF in patients with cirrhosis was 5.0% (95% CI: 2.8–8.6%). When studies that solely assessed patients undergoing transplant evaluation or on transplant waiting list were excluded, the pooled estimated prevalence of AF in patients with cirrhosis was 7.4% (95% CI: 3.5–15.2%). There was a significant association between AF and increased mortality risk in cirrhotic patients with a pooled odds ratio of 1.44 (95% CI: 1.36–1.53).ConclusionThe overall estimated prevalence of AF among patients with cirrhosis is 5.0%. Our study demonstrates a statistically significant increased mortality risk in cirrhotic patients with AF.
Neutropenia in Barth syndrome: characteristics, risks, and management
Authors: Steward Colin G. , Groves Sarah J. , Taylor Carolyn T. , Maisenbacher Melissa K. , Versluys Birgitta , Newbury-Ecob Ruth A. , Ozsahin Hulya , Damin Michaela K. , Bowen Valerie M. , McCurdy Katherine R. , Mackey Michael C. , Bolyard Audrey A. , Dale David C. 
Published: November 2018

Purpose of review
Barth syndrome (BTHS) is an X-linked disease characterized by defective remodeling of phospholipid side chains in mitochondrial membranes. Major features include neutropenia, dilated cardiomyopathy, motor delay and proximal myopathy, feeding problems, and constitutional growth delay. We conducted this review of neutropenia in BTHS to aid in the diagnosis of this disease, and to improve understanding of both the consequences of neutropenia and the benefits of treatment with granulocyte colony-stimulating factor (G-CSF).

Recent findings
In 88 patients with BTHS, neutropenia, that is, at least one count below 1.5 × 109/l, was detected in 74 (84%) and 44% had severe chronic neutropenia, with multiple counts below 0.5 × 109/l. The pattern of neutropenia varied between intermittent and unpredictable, chronic and severe, or cyclical with mathematically regular oscillations. Monocytosis, that is, monocytes more than 1.0 × 109/l, was observed at least once in 64 of 85 (75%) patients. G-CSF was administered to 39 of 88 patients (44%). Weekly average G-CSF doses ranged from 0.12 to 10.92 μg/kg/day (mean 1.16 μg/kg/day, median 1.16 μg/kg/day). Antibiotic prophylaxis was additionally employed in 21 of 26 neutropenic patients. Pretreatment bone marrow evaluations predominantly showed reduced myeloid maturation which normalized on G-CSF therapy in seven of 13 examined. Consistent clinical improvement, with reduced signs and symptoms of infections, was observed in response to prophylactic G-CSF ± prophylactic antibiotics. However, despite G-CSF and antibiotics, one adult patient died with multiple infections related to indwelling medical devices and gastrostomy site infection after 15.5 years on G-CSF and a pediatric patient required gastrostomy removal for recurrent abdominal wall cellulitis.

Summary
BTHS should be considered in any men with neutropenia accompanied by any of the characteristic features of this syndrome. Prophylaxis with G-CSF ± antibiotics prevents serious bacterial infections in the more severe neutropenic patients although infections remain a threat even in patients who are very compliant with therapy, especially in those with indwelling devices.
Associations Among Nurse Fatigue, Individual Nurse Factors, and Aspects of the Nursing Practice Environment
Authors: Knupp Amy M. , Patterson Emily S. , Ford Jodi L. , Zurmehly Joyce , Patrick Thelma 
Published: November 2018

OBJECTIVE
This study examined the relationships among nurse fatigue, individual nurse factors, and the practice environment in the inpatient setting.

BACKGROUND
Nurse fatigue affects the quality of care provision on inpatient units. Scant literature exists regarding how aspects of the practice environment relate to nurse fatigue.

METHODS
A cross-sectional, correlational design was used in this survey study of 175 neonatal intensive care unit nurses from multiple hospitals. Data were collected using the Checklist Individual Strength questionnaire and the Practice Environment Scale of the Nursing Work Index. Hierarchical regression analysis was performed to examine the relationships.

RESULTS
Higher fatigue was significantly associated with more hours worked, fewer hours of sleep, a physical or mental contributor to fatigue, and a recent distressing patient event. Lower fatigue was significantly associated with better nurse manager ability, leadership, and support.

CONCLUSIONS
Nurse fatigue may be diminished with organizational and individual strategies. Developing tactics for nurse managers to better support staff members after a recent distressing patient event is indicated.
Does Information Become Actual Knowledge in Surgical Spine Patients? A Qualitative Study
Authors: Bidstrup Christina Alstrup , Morthorst Karen Rud , Laursen Malene , Jørgensen Lene Bastrup , Høybye Mette Terp 
Published: November 2018

BACKGROUND:
It is seldom questioned, if information delivered (to a patient) actually produces knowledge. There is a lack of understanding of how patients in general, surgical patients in particular, perceive, process, and translate clinical information in their everyday lives. The objective of this study was to elucidate how patients undergoing spinal fusion surgery manage and assimilate information provided by clinicians and how they adapt and embrace this information pre- and postsurgery.

METHODS:
The study employed qualitative methods of ethnographic observation and semistructured interview with a total of 14 individuals, that is, spinal fusion patients (n = 6) and clinicians (n = 8) over a 4-month period in 2014.

RESULTS:
The results highlight that in the course of treatment, patients embrace or reject information on the basis of their previous experience, expectations, and confidence in their own ability. Overall, patients adjusting to everyday life after spinal fusion surgery used 4 strategies of information processing about their individual life situation. Patients do not use just one of these strategies but may use a number of strategies depending on the situation. Such production of knowledge is pivotal to the behavior of patients through their treatment trajectory.

CONCLUSIONS:
This study points to the challenges of supporting patients to assimilate information and affect health-related behaviors, recognizing that knowledge and behavior change are emergent processes in patients and not a linear outcome of information.
Repeatability of Anterior Curvature Metrics in Healthy and Keratoconic Eyes with a Portable Handheld Topographer
Authors: Fernández-Velázquez Fernando José 
Published: November 2018

SIGNIFICANCE
This is a prospective observational investigation that studies the repeatability of several outcomes obtained with the Keratron Scout in healthy and keratoconic corneas. In addition, we have been able to determine the “noise” values of the instrument, which can be very useful when evaluating possible progression in keratoconus (KCN).

PURPOSE
The purpose of this study was to evaluate the repeatability of several anterior curvature metrics provided by a portable and handheld Placido disk–based topographer in healthy and keratoconic eyes.

METHODS
One eye from 50 keratoconic patients and 50 eyes from healthy patients were included in this prospective observational study. Two consecutive sessions (with three scans per session) were performed, and the following parameters were analyzed with a Keratron Scout topographer: flat keratometry, steep keratometry, flat corneal axis, corneal astigmatism, and flat and steep asphericities. In addition, in the KCN cohort, indices derived from the Cone Location and Magnitude Index were also recorded. Intrasession (first session, all three measurements) and intersession (one measurement from each session, selected randomly) statistics were calculated. The following variables were calculated: within-subject standard deviation, coefficient of repeatability (R), coefficient of variation, and intraclass correlation coefficient (ICC).

RESULTS
In healthy eyes, the intrasession and intersession ICCs were high (0.947 to 0.999), and for both flat keratometry and steep keratometry, the within-subject standard deviation was 0.08 and R was 0.24 diopters. Repeatability was slightly lower in the KCN group, but the ICC was greater than 0.95, whereas the R for flat keratometry was 0.41 diopters.

CONCLUSIONS
The Keratron Scout provides repeatable measures for the studied metrics in healthy and keratoconic eyes.
Accuracy of a Smartphone-based Autorefractor Compared with Criterion-standard Refraction
Authors: Jeganathan V. Swetha E. , Valikodath Nita , Niziol Leslie M. , Hansen Sean , Apostolou Hannah , Woodward Maria A. 
Published: November 2018

SIGNIFICANCE
Uncorrected refractive error is a prevalent problem throughout the world especially among the low-income population who have limited access to professional eye care and cannot afford eyeglasses.

PURPOSE
The purpose of this study was to evaluate the accuracy and usability of a low-cost, portable, smartphone-based autorefractor (Netra, EyeNetra Inc., Somerville, MA) in adults.

METHODS
A cross-sectional study was conducted to compare the portable refractor with subjective (manifest and cycloplegic) refraction for sequential adult participants with best-corrected visual acuity of 20/40 or greater. For each method of refraction, the spherical equivalent was calculated. Differences between methods were tested with linear mixed regression models. A validated usability questionnaire was administered regarding ease of use (100-point scale, higher scores better) for the portable autorefractor.

RESULTS
Eighty-seven subjects (152 eyes) were studied (age range, 20 to 90 years; mean ± standard deviation, 51.9 ± 18.3 years). Mean spherical equivalent by the portable device was −2.76 D (range, −14.75 to 3.63 D) compared with −2.49 D (range, −15.25 to 4.25 D) by manifest refraction. The mean relative difference in spherical equivalent between methods was −0.27 D (P = .001, significantly different than 0 D). The mean absolute difference between methods was 0.69 D (P < .001, significantly different than 0.5-D absolute difference). Similar results were found when comparing spherical equivalent between Netra and cycloplegic refraction methods. Subjects reported average ease of use for the Netra of 75.4 ± 19.8.

CONCLUSIONS
The portable autorefractor had small but clinically significant differences from subjective refraction. The device's scores on the usability scale indicate good overall patient acceptance. The device may be valuable for use where there is limited access to a trained refractionist.
Comparison of the Ultraviolet Light Filtering across Different Intraocular Lenses
Authors: García-Domene Mari Carmen , Pérez-Vives Caridad , Peris-Martínez Cristina , Artigas José María 
Published: November 2018

SIGNIFICANCE
We have analyzed the ultraviolet transmittance of some commercial intraocular lenses (IOLs). The results show differences of wavelength cutoff among them.

PURPOSE
The purpose of this study was to measure and compare the ultraviolet light transmittance of different IOLs made out of acrylic hydrophobic, hydrophilic, and hydrophilic with hydrophobic surface materials from different manufacturers.

METHODS
The spectral transmission curves of eight monofocal IOLs with the same dioptric power of +20.0 diopters were measured using a PerkinElmer Lambda 35 ultraviolet/visible spectrometer. Two IOLs of each type were tested three times. The ultraviolet cutoff wavelength at 10% transmission and the mean values were calculated.

RESULTS
All lenses prevented transmission of ultraviolet C (200 to 280 nm) and B radiation (280 to 315 nm). However, not all IOLs provided the same filtering properties in ultraviolet A (315 to 380 nm). Within the ultraviolet A range, the ultraviolet radiation cutoff wavelength of 10% ranges from approximately 360 to 400 nm. HOYA iSert 250 provided a cutoff wavelength of 398.4 nm; AcrySof SA60AT, 396.2 nm; AcrySof SA60WF, 395.7 nm; CT Asphina 404, 378.34 nm; Tecnis ZCB00, 377.70 nm; CT Lucia 601P, 379 nm; C-Flex 570C, 377 nm; and enVista MX60, 360 nm.

CONCLUSIONS
Intraocular lenses of different materials and manufacturers have different ultraviolet transmission characteristics. AcrySof (SA60AT and SA60WF) and HOYA iSert 250 provided the highest ultraviolet radiation transmission; the cutoff wavelength of 10% is close to 400 nm. In contrast, enVista IOL showed the lowest ultraviolet radiation cutoff.
Visual Performance of Daily-disposable Multifocal Soft Contact Lenses: A Randomized, Double-blind Clinical Trial
Authors: Sha Jennifer , Tilia Daniel , Kho Danny , Amrizal Hamdy , Diec Jennie , Yeotikar Nisha , Jong Monica , Thomas Varghese , Bakaraju Ravi C. 
Published: November 2018

SIGNIFICANCE
The present study highlights the differences between modern daily-disposable multifocal soft contact lenses to assist eye care practitioners in fitting presbyopic contact lens wearers.

PURPOSE
The purpose of this study was to compare visual performance of three daily-disposable multifocal contact lenses.

METHODS
Presbyopes (n = 72) wore 1-Day Acuvue Moist Multifocal, BioTrue ONEday for Presbyopia, and Dailies AquaComfort Plus Multifocal for 1 week in a prospective, randomized, double-blind, crossover clinical trial. After 1 week, high- and low-contrast visual acuities (HCVA, LCVA) were measured between 6 m and 40 cm and stereopsis at 40 cm. Subjective performance was assessed with 1- to 10-point rating scales for clarity, ghosting, driving vision, vision stability, ease of focusing, overall vision satisfaction, and ocular comfort. Willingness to purchase was reported with categorical responses. Linear mixed models and χ2 tests were used for analysis, and level of significance was set at 5%.

RESULTS
BioTrue provided better HCVA and LCVA at distance than did Acuvue Moist (P ≤ .03). Subjectively, Acuvue Moist was rated lowest for distance clarity, distance ghosting, and driving vision (P ≤ .05). Acuvue Moist provided better HCVA at 70 to 40 cm and LCVA at 1 m to 40 cm than did BioTrue (P ≤ .01) and better LCVA at 1 m to 50 cm than did AquaComfort Plus (P ≤ .02). AquaComfort Plus also provided better HCVA and LCVA at 50 and 40 cm than did BioTrue (P ≤ .03). Acuvue Moist provided better stereopsis than did BioTrue (P = .02). Subjectively, BioTrue was rated lowest for near clarity (P ≤ .007) and lower than Acuvue Moist for intermediate clarity and near ghosting (P ≤ .04). No other differences were found between lenses (P > .05).

CONCLUSIONS
BioTrue had better distance performance compared with near, whereas Acuvue Moist performed conversely. AquaComfort Plus performed reasonably overall.
Optimizing antiretroviral regimens in chronic kidney disease
Authors: Hamzah Lisa , Jones Rachael , Post Frank A. 
Published: November 2018

Purpose of review
To identify recent data that inform the management of individuals with HIV and chronic kidney disease.

Recent findings
Several nonnucleoside reverse transcriptase, protease, and integrase strand transfer inhibitors inhibit tubular creatinine secretion resulting in stable reductions in creatinine clearance of 5–20 ml/min in the absence of other manifestations of kidney injury. Progressive renal tubular dysfunction is observed with tenofovir disoproxil fumarate in clinical trials, and more rapid decline in estimated glomerular filtration rate in cohort studies of tenofovir disoproxil fumarate and atazanavir, with stabilization, improvement or recovery of kidney function upon discontinuation. Results from clinical trials of tenofovir alafenamide (TAF) in individuals with chronic kidney disease suggest that TAF is well tolerated in those with mild to moderate renal impairment (creatinine clearance >30 ml/min) but results in very high tenofovir exposures in those on haemodialysis.

Summary
Standard antiretroviral regimens remain appropriate for individuals with normal and/or stable, mildly impaired kidney function. In those with chronic kidney disease or progressive decline in estimated glomerular filtration rate, antiretrovirals with nephrotoxic potential should be avoided or discontinued. Although TAF provides a tenofovir formulation for individuals with impaired kidney function, TAF is best avoided in those with severe or end-stage kidney disease.