bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burden of orofacial pain in a socially deprived and culturally diverse area of the United Kingdom
Authors: Joury Easter , Bernabe Eduardo , Gallagher Jennifer E. , Marcenes Wagner 
Published: March 2018

Abstract
Little is known about the burden and impact of orofacial pain in deprived areas, and whether it mediates the relationship between socioeconomic position and impacts on daily life. We analysed data from a representative sample of 2168 adults, aged 16 to 65 years, from the East London Oral Health Inequality study. Participants completed a validated questionnaire on demographics, socioeconomic position (area deprivation), orofacial pain (by anatomical site) in the past month, and impacts related to oral conditions on daily life. Negative binomial regression models with robust variance estimator were fitted. The prevalence of orofacial pain was high (30.2%). The most common subset of orofacial pain was intraoral pain (27.5%). The prevalence of pain related to temporomandibular disorders was 6.8%. The most common subsets of intraoral pain were tooth (20.4%) and gingival (11.4%) pain. Orofacial pain, its subsets (intraoral and temporomandibular disorder–related pain), and intraoral pain subsets (tooth and gingival pain) consistently showed associations with all dimensions of impacts on daily life that were highly statistically significant: functional limitation, psychological discomfort, disabilities, and handicap. Socioeconomic inequalities were present in orofacial pain and some dimensions of impacts on daily life. Orofacial pain did not mediate the relationship between area deprivation and impacts on daily life. Our study demonstrated a substantial burden and impact of orofacial pain in a socially deprived and culturally diverse area of the United Kingdom. To address this burden, interventions that lie within the remit of health services are needed to improve access to dental care for adults with orofacial pain.
Sustained and repeated mouth opening leads to development of painful temporomandibular disorders involving macrophage/microglia activation in mice
Authors: Wang Guan Yun Frances , Shi Xiang Qun , Wu Wenjia , Gueorguieva Maria , Yang Mu , Zhang Ji 
Published: March 2018

Abstract
Temporomandibular disorder (TMD) is a set of heterogeneous musculoskeletal conditions involving the temporomandibular joint (TMJ) and/or the masticatory muscles. Up to 33% of the population has had at least 1 symptom of TMD with 5% to 10% of them requiring treatment. Common symptoms include limited jaw movement, joint sound, and pain in the orofacial area. Once TMD becomes chronic, it can be debilitating with comorbidities that greatly reduce one's overall quality of life. However, the underlying mechanism of TMD is unclear because of the multicausative nature of the disease. Here, we report a novel mouse model of TMD where a bite block was placed in between the upper and lower incisors such that the mouth was kept maximally open for 1.5 hours per day for 5 days. After sustained mouth opening, mice developed persistent orofacial mechanical allodynia and TMJ dysfunction. At the cellular level, we found masseter muscle dystrophy, and increased proteoglycan deposition and hypertrophic chondrocytes in the mandibular condyle. Increased F4/80+ macrophages were also observed in the masseter muscles and the TMJ posterior synovium. We also found ATF3+ neuronal injury and increased F4/80+ macrophages in the trigeminal ganglia. Microglia activation was observed in the trigeminal subnucleus caudalis. Inhibiting macrophage and microglia activation with a colony stimulating factor-1 receptor inhibitor prevented the development of orofacial mechanical allodynia, but not TMJ dysfunction. This study suggests that mouth opening for an extended period during dental treatments or oral intubations may risk the development of chronic TMD and inflammation associated with macrophage and microglia in the tissue and trigeminal system contributes to the development of TMD pain.
Radiosurgery of Glomus Tumors of Temporal Bone: a Meta-analysis
Authors: Sahyouni Ronald , Mahboubi Hossein , Moshtaghi Omid , Goshtasbi Khodayar , Sahyouni Sammy , Lin Harrison W. , Djalilian Hamid R. 
Published: March 2018

Objective:
1) Perform a meta-analysis of the available data on the outcomes of stereotactic radiosurgery (SRS) for the treatment of temporal bone glomus tumors (GT), and 2) evaluate the collective outcomes of SRS treatment with respect to tumor control.

Data Sources:
A thorough literature search of the published English-language literature from 2011 to 2016 was performed in PubMed, Ovid, and Cochrane databases using the keywords (“Gamma Knife” or “CyberKnife” or “linear accelerator” or “radiosurgery”) and (“glomus jugulare” or “jugular paraganglioma” or “glomus tympanicum”).

Study Selection:
Studies reporting outcomes of SRS for temporal bone GT were included.

Data Extraction:
Of 45 articles found, 15 studies met our inclusion and exclusion criteria and were selected for qualitative and quantitative analyses totaling 511 patients.

Data Synthesis:
Average margin dose, modality, isodose line, volume decrease, follow-up duration, and tumor control rate data were extracted and analyzed.

Conclusion:
Gamma Knife was the most commonly implemented radiosurgery modality and was used in eight studies. The mean marginal dose varied between 13.2 and 20 Gy. The pooled tumor control rate was 95.4% (95% CI: 93.6–97.2%) over a median follow-up duration ranging between 27.4 and 148 months. Clinical data on outcomes of SRS for the treatment of GTs are sparse and primarily limited to single institutional analyses, with considerable variation in tumor volume and follow-up duration. This meta-analysis provides an in-depth analysis of the available data in the literature and reviews the reported outcomes. Future studies on SRS for GT should include data on tumor growth before radiation as well as follow-up periods sufficiently long to identify true tumor control.
Early Fitting in Cochlear Implantation: Benefits and Limits
Authors: Günther Stefanie , Baumann Uwe , Stöver Timo 
Published: March 2018

Objective:
Evaluation of a shortened delay time between surgical placement of the cochlear implant (CI) device and processor activation to less than 8 days (early CI fitting). Assessment of benefits and limits of early fitting in terms of medical, technical, audiological, and subjective outcome.

Study Design:
Prospective.

Setting:
Tertiary referral center.

Patients:
Forty-one patients scheduled for cochlear implant surgery divided into early fit (EF, n = 21) and control group (CG, n = 19).

Main Outcome Measures:
Questionnaires were used to evaluate technical, medical, and subjective outcomes associated with early fitting. Additional, electrode impedance and speech recognition scores were measured. These data, collected preoperative, at first activation and after 3 months were compared with the CG with standard fitting.

Results:
The medical and audiological status of the EF subjects allowed early fitting in nearly all patients (20/21). Evidence of pain, delayed wound healing, or other compromises was equal in both study groups. Speech recognition scores show comparable development over time for EF and CG. Average electrode impedance was significantly higher in the CG at first activation.

Conclusions:
Early fitting of the sound processor is feasible and did not compromise wound healing or generates additional pain. During the first month following surgery, reduction of wound swelling can be expected. Hence, regular inspection of magnet strength is recommended at follow-ups. Over all, early activation of their CI device was highly appreciated by nearly all patients.
Speech Perception in Quiet and Noise With an Off the Ear CI Processor Enabling Adaptive Microphone Directionality
Authors: Wesarg Thomas , Voss Bettina , Hassepass Frederike , Beck Rainer , Aschendorff Antje , Laszig Roland , Arndt Susan 
Published: March 2018

Objective:
To investigate the impact of the wearing position of an off-the-ear-processor (OTE) on speech perception in quiet and noise.

Patients:
The study group consisted of 16 adult subjects with bilateral severe-to-profound sensorineural hearing loss, 2 of them unilaterally, and 14 bilaterally provided with cochlear implants.

Main Outcome Measures:
Speech perception in quiet and noise was measured for frontal presentation with the recipients behind-the-ear processor CP810 or CP910 and the OTE processor Kanso (Cochlear Limited, Sydney, Australia). Additionally, speech performance in noise with the OTE for spatially separated signal and noise sources was assessed.

Results:
The recipients showed monosyllabic word recognition scores in quiet between 65 and 95% and speech reception thresholds in noise between 2.4 and −5.5 dB SNR with the OTE. For frontal presentation of speech and noise, application of the adaptive directional microphone (Beam) yielded a slight median decrement of 0.6 dB for the speech reception threshold compared with standard directionality. However, huge median improvements, ranging from −3.7 to −11.6 dB, for the three tested conditions with spatially separated sources (S0NIL, S0NCL, S0N180) were observed.

Conclusion:
The beamforming algorithm in the investigated OTE processor provides similar benefits as described in previous studies for behind-the-ear processors in conditions with spatially separated speech and noise sources. Adaptive microphone directionality can be successfully implemented in an OTE processor. The OTE processor's potential to increase usability, comfort, and cosmetics might not be compromised by a deterioration of speech performance.
Video Head Impulse Test (vHIT): The Role of Corrective Saccades in Identifying Patients With Vestibular Loss
Authors: Janky Kristen L. , Patterson Jessie , Shepard Neil , Thomas Megan , Barin Kamran , Creutz Tom , Schmid Kendra , Honaker Julie A. 
Published: March 2018

Objective:
1) Characterize corrective saccades (CS) in normal controls, and 2) examine the sensitivity of the video head impulse test (vHIT) for identifying vestibular loss using both gain and CS.

Study Design:
Prospective combined with retrospective review.

Setting:
Tertiary referral center.

Patients:
Seventy subjects with normal vestibular function served as controls (mean age, 44.1 yr; range, 10–78) and data from 49 patients with unilateral and bilateral vestibular loss was retrospectively reviewed (mean age, 50; range, 7–81).

Intervention:
vHIT; individual horizontal head impulses were then analyzed in MATLAB.

Main Outcome Measures:
Horizontal vHIT gain, CS peak velocity, frequency, and latency.

Results:
There was not an age effect for CS velocity or latency, and only a weak relationship between CS frequency and age in the control group. Gain and CS latency were the only parameters affected by impulse side, demonstrating higher gain and longer latency on the right. The group with vestibular loss had significantly lower mean vHIT gain, higher mean CS frequency, higher mean CS velocity, earlier CS latency, and smaller mean CS standard deviations of the latency compared with the control group.
When all factors were analyzed separately by logistic regression, vHIT gain provided the best classification (83.8%), closely followed by CS frequency (83.1%). Using a two variable approach (both gain and CS frequency) yielded the best diagnostic accuracy (overall classification = 84.6%).

Conclusions:
Along with gain, incorporating CS frequency in interpreting vHIT improves diagnostic accuracy. A repeatable CS (>81.89%) and/or low gain (<0.78) indicate vestibular loss.
Picosecond Infrared Laser (PIRL) Application in Stapes Surgery—First Experience in Human Temporal Bones
Authors: Petersen Hannes , Gliese Alexandra , Stober Yannick , Maier Stephanie , Hansen Nils-Owe , Kruber Sebastian , Eggert Dennis , Tóth Miklós , Gosau Tobias , Schlüter Hartmut , Püschel Klaus , Schumacher Udo , Miller Robert John Dwayne , Münscher Adrian , Dalchow Carsten 
Published: March 2018

Objective:
Using a contact-free laser technique for stapedotomy reduces the risk of mechanical damage of the stapes footplate. However, the risk of inner ear dysfunction due to thermal, acoustic, or direct damage has still not been solved. The objective of this study was to describe the first experiences in footplate perforation in cadaver tissue performed by the novel Picosecond-Infrared-Laser (PIRL), allowing a tissue preserving ablation.

Patients and Intervention:
Three human cadaver stapes were perforated using a fiber-coupled PIRL. The results were compared with footplate perforations performed with clinically applied Er:YAG laser. Therefore, two different laser energies for the Er:YAG laser (30 and 60 mJ) were used for footplate perforation of three human cadaver stapes each.

Main Outcome Measure:
Comparisons were made using histology and environmental scanning electron microscopy (ESEM) analysis.

Results:
The perforations performed by the PIRL (total energy: 640–1070 mJ) revealed a precise cutting edge with an intact trabecular bone structure and no considerable signs of coagulation. Using the Er:YAG-Laser with a pulse energy of 30 mJ (total energy: 450–600 mJ), a perforation only in the center of the ablation zone was possible, whereas with a pulse energy of 60 mJ (total energy: of 195–260 mJ) the whole ablation zone was perforated. For both energies, the cutting edge appeared irregular with trabecular structure of the bone only be conjecturable and signs of superficial carbonization.

Conclusion:
The microscopic results following stapes footplate perforation suggest a superiority of the PIRL in comparison to the Er:YAG laser regarding the precision and tissue preserving ablation.
Right Ear Advantage of Speech Audiometry in Single-sided Deafness
Authors: Wettstein Vincent G. , Probst Rudolf 
Published: March 2018

Background:
Postlingual single-sided deafness (SSD) is defined as normal hearing in one ear and severely impaired hearing in the other ear. A right ear advantage and dominance of the left hemisphere are well established findings in individuals with normal hearing and speech processing. Therefore, it seems plausible that a right ear advantage would exist in patients with SSD.

Methods:
The audiometric database was searched to identify patients with SSD. Results from the German monosyllabic Freiburg word test and four-syllabic number test in quiet were evaluated. Results of right-sided SSD were compared with left-sided SSD. Statistical calculations were done with the Mann–Whitney U test.

Results:
Four hundred and six patients with SSD were identified, 182 with right-sided and 224 with left-sided SSD. The two groups had similar pure-tone thresholds without significant differences. All test parameters of speech audiometry had better values for right ears (SSD left) when compared with left ears (SSD right). Statistically significant results (p < 0.05) were found for a weighted score (social index, 98.2 ± 4% right and 97.5 ± 4.7% left, p < 0.026), for word understanding at 60 dB SPL (95.2 ± 8.7% right and 93.9 ± 9.1% left, p < 0.035), and for the level at which 100% understanding was reached (61.5 ± 10.1 dB SPL right and 63.8 ± 11.1 dB SPL left, p < 0.022) on a performance-level function.

Conclusion:
A right ear advantage of speech audiometry was found in patients with SSD in this retrospective study of audiometric test results.
Reflections on the Last 25 Years of the American Otological Society and Thoughts on its Future
Authors: Welling D. Bradley , Jackler Robert K. 
Published: March 2018

Purpose:To review contributions of the American Otological Society (AOS) over the most recent quarter century (1993–2018) and to comment on possible future evolution of the field during the quarter century to come.Methods:Retrospective review of selected topics from the AOS transactions, distinguished lectureships over the past 25 years, and selective reflection by the authors. Speculation on potential advances of the next quarter century derived from emerging topics in the current literature and foreseeable trends in science and technology are also proffered for consideration (and possible future ridicule).Results:Integration of multiple disciplines including bioengineering, medical imaging, genetics, molecular biology, physics, and evidence based medicine have substantially benefitted the practice of otology over the past quarter century. The impact of the contributions of members of the AOS in these developments cannot be over estimated.Conclusions:Further scientific advancement will certainly accelerate change in the practice of otologic surgery and medicine over the coming decade in ways that will be marvelous to behold.
Pharmacological cognitive enhancement in pediatrics
Authors: Colaneri Natalie , Sheldon Mark , Adesman Andrew 
Published: March 2018

Purpose of review
Given the pervasiveness of psychotropic medication in the youth population and an increasingly competitive culture regarding educational performance, children, teenagers, and/or their parents may increasingly seek psychotropic substances in an effort to enhance a student's cognitive abilities and/or academic performance. Physicians must become aware of this very important and clinically relevant issue and work to ensure that medications remain in the hands of patients seeking wellness and not enhancement.

Recent findings
The current article highlights findings on the pervasiveness of stimulant misuse and diversion in youth, the motivations and effects of stimulant use, health and legal consequences associated with use, and physician perceptions and preventive practices. Ethical concerns regarding pharmacological cognitive enhancement in pediatrics are also outlined – including coercion for nonusers, inequities in access, and threats to an individual's sense of self with regard to authenticity and autonomy.

Summary
Pharmacological cognitive enhancement in pediatrics will become a larger, clinically relevant issue in the coming years. Physicians who care for children and adolescents must become more aware of this issue. Given the myriad health, legal, and ethical concerns, clinicians should discourage use of pharmaceuticals for enhancement purposes in the pediatric population.
Acute concussion: making the diagnosis and state of the art management
Authors: Eisenberg Matthew , Mannix Rebekah 
Published: March 2018

Purpose of reviewConcussion is an increasingly common injury in children. We aim to review the basic epidemiology and management of acute concussion and highlight recent studies that have contributed to our understanding of care for this injury.Recent findingsWhile concussion is considered a ‘mild’ form of traumatic brain injury, recent evidence suggests that as many as 30% of children are still symptomatic 1 month after injury. Although there is increasing interest in finding objective measures of injury and recovery, emerging imaging and serum biomarkers are not ready for routine clinical use. Identification of children at risk for prolonged symptoms is vital. Prolonged rest after injury may worsen outcomes.SummaryConcussion is a common injury in children. Objective measures of injury and recovery are needed, as are targeted therapies to mitigate the risk of prolonged recovery after injury.
Mothers and Fathers Experience Stress of Congenital Heart Disease Differently: Recommendations for Pediatric Critical Care*
Authors: Sood Erica , Karpyn Allison , Demianczyk Abigail C. , Ryan Jennie , Delaplane Emily A. , Neely Trent , Frazier Aisha H. , Kazak Anne E. 
Published: March 2018

Objective:
To inform pediatric critical care practice by examining how mothers and fathers experience the stress of caring for a young child with congenital heart disease and use hospital and community supports.

Design:
Qualitative study of mothers and fathers of young children with congenital heart disease.

Setting:
Tertiary care pediatric hospital in the Mid-Atlantic region of the United States.

Subjects:
Thirty-four parents (20 mothers, 14 fathers) from diverse backgrounds whose child previously underwent cardiac surgery during infancy.

Interventions:
Subjects participated in semi-structured, individual interviews about their experiences and psychosocial needs at the time of congenital heart disease diagnosis, surgical admission, and discharge to home after surgery. Qualitative interview data were coded, and consistent themes related to emotional states, stressors, and supports were identified.

Measurements and Main Results:
Fathers experience and respond to the stressors and demands of congenital heart disease in unique ways. Fathers often described stress from not being able to protect their child from congenital heart disease and the associated surgeries/pain and from difficulties balancing employment with support for their partner and care of their congenital heart disease child in the hospital. Fathers were more likely than mothers to discuss support from the work environment (coworkers/managers, flexible scheduling, helpful distraction) and were less likely to describe the use of hospital-based resources or congenital heart disease peer-to-peer supports.

Conclusions:
This study highlights the importance of understanding the paternal experience and tailoring interventions to the unique needs of both mothers and fathers. Opportunities for critical care practice change to promote the mental health of mothers and fathers following a diagnosis of congenital heart disease are discussed.
Depressive Symptoms, Exercise Capacity, and Clinical Outcomes After Lung Transplantation
Authors: Smith Patrick J. , Byrd Rebecca , Lusby Megan , Clausen Emily , Snyder Laurie D. 
Published: March 2018

ABSTRACTObjectiveDepressive symptoms are common among lung transplant recipients and have been associated with worse clinical outcomes. However, few studies have examined the association between depressive symptoms assessed at multiple time points or behavioral mechanisms by which posttransplant depressive symptoms may confer greater clinical risk. We therefore examined the associations between depressive symptoms, exercise capacity, chronic lung allograft dysfunction (CLAD), and mortality prospectively in a large sample of lung transplant recipients.MethodsBetween July 2009 and February 2016, 251 lung transplant recipients were assessed before transplantation and again approximately 3 weeks and 3 months after transplant. Depressive symptoms were assessed using the Centers for Epidemiologic Studies of Depression scale. Functional exercise capacity was assessed using the 6-minute walk test. Cox proportional hazards models were used to examine the associations between depressive symptoms, exercise capacity, CLAD, and mortality.ResultsDuring a median (range) follow-up of 4.5 (0.1 to 6.3) years, 53 participants (21%) died. Greater depressive symptoms (hazard ratio [HR] = 1.39 [95% CI = 1.05 to 1.84],p= .021) and poorer exercise capacity (HR = 0.58 [95% CI = 0.38 to 0.90],p= .021) assessed 3 months after transplant were both independently associated with mortality. Although greater depressive symptoms were associated with lower exercise capacity (β = −0.14,p= .039), exercise capacity did not mediate the association between depressive symptoms and mortality. In secondary analyses, depressive symptoms were independently predictive of CLAD (HR = 1.29 [95% CI = 1.01 to 1.65],p= .045) and the composite outcome of CLAD and mortality in a clustered event model (HR = 1.30 [1.09 to 1.56],p= .005).ConclusionsDepressive symptoms are associated with mortality and CLAD after lung transplantation, independent of exercise capacity.