bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Experience and Early Outcomes With a Slim Perimodiolar Electrode
Authors: Friedmann David R , Kamen Emily , Choudhury Baishakhi , Roland J. Thomas 
Published: February 2019

Introduction:
In 2016 the Cochlear CI532 received FDA approval and has since been the primary full-length electrode from this manufacturer implanted at our center. Our experience to date including surgical technique and early patient outcomes are reviewed here.

Methods:
Since 2016, this array was used as our standard full length Cochlear array, including children with normal anatomy, with 237 total implantations. Surgical experience and clinical outcomes including low frequency hearing preservation and speech perception on CNC words were analyzed in those with at least 6 months follow-up implanted through June 2017 (n = 94).

Results:
Speech perception scores are improving over clinical follow-up in accord with other electrode arrays. Hearing preservation is possible with a number of patients utilizing acoustic low frequency hearing in conjunction with electric stimulation from their CI. Tip fold overs were infrequent (4.6%) and always identified on intraoperative x-ray. No patients left the operating room with a tip fold over.

Conclusions:
Speech perception outcomes with the CI532 slim periomodiolar array are similar to other full length arrays with the added potential for at least short term preservation of residual acoustic hearing. There is a learning curve to its use and intraoperative x-rays are valuable to ensure optimal placement.
The Natural History of Hearing Loss in Pendred Syndrome and Non-Syndromic Enlarged Vestibular Aqueduct
Authors: Mey Kristianna , Bille Michael , Rye Rasmussen Stig Hebbelstrup , Tranebjærg Lisbeth , Cayé-Thomasen Per 
Published: February 2019

Introduction:
The aim was to investigate the progress of hearing loss over time in a cohort of pendred syndrome and non-syndromic enlarged vestibular aqueduct (PS/NSEVA) with one or two confirmed pathogenic variations in SLC26A4.

Study Design:
Retrospective cohort study.

Subjects and Methods:
At our tertiary referral center, a retrospective search of all patients with enlarged vestibular aqueduct, hearing loss and SLC26A4 mutations yielded 103 individuals by March 2017, 96 of whom had records of hearing levels; both an early audiometry and the latest between 3 and 668 months follow-up. Pure-tone average (PTA; average of thresholds at 0.5, 1, 2 and 4 kHz) was calculated for both ears at time 1 and time 2. Neonatal screening results were retrieved.

Results:
Eighty-seven (87) individuals had biallelic (M2) and 16 had monoallelic alterations (M1) in their SLC26A4. On average, the PTA progressed to 80 dB HL by the age of 6 years for the entire cohort, and 3.2 years for the biallelic (M2) affected individuals. 25% of the cohort was screened in the neonatal screening program; of these 42% had “passed” at least monaurally. Audiometric profiles related to age show faster deterioration in high frequencies than in low frequencies.

Conclusion:
In patients with PS/NSEVA and SLC26A4 mutations, the average hearing loss progresses to 80 dB HL by the age of 6 years. For biallelic (M2) affected individuals it was 3.2 years. Although hearing levels reached severe to profound during childhood, almost 1/2 had passed neonatal hearing screening, at least monaurally, emphasizing the need for close follow-up.
Revision Stapes Surgery: A Novel Technique of Overcoming Erosion of the Long Process of Incus Using Hydroxylapatite Cement and Shape Memory Piston
Authors: Rouhani Maral J. , Lavy Jeremy 
Published: February 2019

Background:
Stapes surgery is performed to treat hearing loss in patients with otosclerosis. Erosion of the long process of incus can occur postoperatively and requires demanding revision surgery to further improve the hearing. The authors describe a novel method of performing revision stapes surgery where there is erosion of the long process of incus.

Methods:
A retrospective case series analysis of a database of revision stapes operations performed by one surgeon between July 2013 and December 2017 at a tertiary center was carried out. 26 cases were identified where there was significant erosion of long process of incus. The ossicular chain in these cases was reconstructed using a novel technique of using cement to fix the piston prosthesis to the incus remnant. The full technique is described herein. The pre- and postoperative audiometric data were analyzed.

Results:
Mean preoperative air bone gap (ABG) was 29.3 dB and mean postoperative ABG was 9.9 dB. Of the 22 patients with recorded postoperative masked bone conduction thresholds, 16 had ABG closure to < 10 dB (72.7%).

Conclusion:
We have shown highly favorable outcomes using this novel technique in addressing erosion of the long process of incus in revision cases for patients with otosclerosis.
Sequential versus Combination Treatment Using Steroids and Diuretics for Acute Low-Frequency Sensorineural Hearing Loss: A Noninferiority Trial
Authors: Yakunina Natalia , Lee Woo Hyun , Ryu Yoon-Jong , Nam Eui-Cheol 
Published: February 2019

Objective:
Acute low-frequency hearing loss (ALHL) is typically treated with combination therapy, including steroids and diuretics. To avoid unnecessary use of steroids we proposed a method of sequential administration using these two drugs, and compared the efficacy of our protocol with that of existing combination treatments.

Methods:
A prospective, randomized, open-label, single-blind, noninferiority clinical trial was conducted to investigate whether the effectiveness of sequential treatment is noninferior to that of combination treatment for ALHL. Ninety-two patients with ALHL received either steroids and diuretics simultaneously for 2 weeks (combination group), or diuretics for 2 weeks followed by steroids for another 2 weeks if they did not respond to diuretic treatment (sequential group). The primary outcome measure was a change in mean hearing threshold at three frequencies (125, 250, and 500 Hz) at 4 weeks after treatment.

Results:
The mean hearing threshold of the low frequencies improved 20.0 and 17.2 dB in the combination and the sequential group, respectively. The 95% lower confidence interval was −8.0 dB and noninferiority was established at p < 0.05. At 4 weeks after treatment, the complete recovery rate was 80.5 and 82.9% in the combination and sequential groups, respectively.

Conclusion:
This is the first study on ALHL treatment following the establishment of Consolidated Standards of Reporting Trials (CONSORT). The sequential treatment is not inferior to combination treatment for ALHL, and therefore may be a better treatment guideline for ALHL considering that patients receive less steroid exposure and smaller restrictions in diuretic use compared with steroids.
Use of Direct Oral Anticoagulants in the Treatment of Left Ventricular Thrombus: Systematic Review of Current Literature
Authors: Kajy Marvin , Shokr Mohamed , Ramappa Preeti 
Published: February 2019

Background:
Left ventricular thrombus (LVT) is an important complication in the setting of systolic dysfunction, particularly after acute myocardial infarction. Current guidelines recommend the vitamin-K antagonist, warfarin, for the treatment of LVT.

Area of Uncertainty and Study Question:
The direct oral anticoagulants (DOACs) are being increasingly used for the management of this entity, despite lack of randomized trials in support of it or knowledge about their efficacy. We aimed to assess the frequency of use and the efficacy of DOACs in the treatment of LVT.

Data Sources:
We searched published articles in Google Scholar, PubMed, MEDLINE, and Embase from the introduction of DOACs in any therapy until April 2018. Reports describing patients diagnosed with LVT and who were treated with a DOAC were examined. Patient characteristics, comorbidities, pharmacologic treatments, and outcomes were collected. The primary end points of this study were thrombus resolution and time to resolution. Other end points were bleeding and thromboembolic events.

Results:
Thirty articles describing 41 patients were analyzed. The most common risk factors for LVT formation were male gender, ischemic heart disease, and low ejection fraction. Most patients were treated with rivaroxaban (51.2%), followed by apixaban (26.8%) and dabigatran (22%). Patients were treated with DOAC alone (46.3%), DOAC and aspirin (12.2%), DOAC and clopidogrel (2.4%), and triple therapy (39%). Thrombus resolution success rate was 81%, 100%, and 88.9% for rivaroxaban, apixaban, and dabigatran, respectively. The median time of thrombus resolution was 40 days, 36 days, and 24 days for rivaroxaban, apixaban, and dabigatran, respectively. One nonfatal bleeding event and one stroke event were reported while on a DOAC.

Conclusions:
The use of DOACs is a reasonable alternative to vitamin-K antagonists in the management of LVT.
Design and Implementation of a Face-to-Face Peer Feedback Program for Ambulatory Nursing
Authors: Ryiz-Semmel Jennifer , France Monique , Bradshaw Robin , Khan Marjorie , Mulholland Barbara , Meucci Joanne , McGrath Jacqueline 
Published: February 2019

BACKGROUND/PURPOSE
Ongoing dissatisfaction with anonymous peer feedback led to problem solving to equip nurses to provide and receive respectful and meaningful feedback during face-to-face peer review.

PROBLEM
Giving and receiving feedback about other's performance and collaboration are a vital aspect of teambuilding; yet, no programmatic training existed to prepare and equip nurses to feel confident and comfortable in providing or receiving face-to-face peer feedback. A search of the literature demonstrated a dearth of evidence related to developing these teambuilding relationships. The facilitator role appeared in some literature outside nursing but was poorly articulated and yet appeared important to the process.

METHODS
This was a quality improvement project that utilized online surveys with both multiple-choice and open-ended questions for data collection across 3 time points for 2 different cohorts over a 2-year implementation period. Strategies included education related to providing feedback with positive intent regardless of feedback type. A facilitator role was used to ensure effective communication and provide support to the peers during the process.

RESULTS
Nurse participants described increased comfort and knowledge related to providing/receiving face-to-face feedback. Training and use of a facilitator provided the necessary support; 75% of participants reported comfort with giving face-to-face feedback. However, the greater majority, 80% to 92%, of participants reported increased comfort with receiving face-to-face feedback.

CONCLUSIONS
Using active peer-to-peer support has become an accepted standard for face-to-face peer feedback as an aspect of the annual review process.
A Mechanical Intermittent Abdominal Pressure Ventilator
Authors: Bach John R. , Radbourne Mark , Potpally Nikhil , Chiou Michael 
Published: February 2019

Abstract
Pneumatically driven intermittent abdominal pressure ventilators were a popular means of daytime ventilatory support until the late 1960s paradigm shift to invasive (tracheostomy) mechanical ventilation. However, although many patients still use intermittent abdominal pressure ventilators, currently available turbine-driven portable home care ventilators are not powerful enough to always successfully operate them. We describe a new mechanically driven intermittent abdominal pressure ventilator operated by a 1-pound motor that provided a depth of abdominal compression of almost 2 in in 1.05 to 1.13 secs to normalize alveolar ventilation for a 72-yr-old postpolio survivor. It increased her autonomous 200- to 320-ml tidal volumes by greater than 300 ml to normalize her respiratory rate, relieve her dyspnea, and maintain normal oxyhemoglobin saturation levels throughout daytime hours for a 9-mo period of continuous ventilatory support.
Balance and Gait Alterations Observed More Than 2 Weeks After Concussion
Authors: Wood Tyler A. , Hsieh Katherine L. , An Ruopeng , Ballard Randy A. , Sosnoff Jacob J. 
Published: February 2019

ObjectiveThe aim of the study was to systematically review and quantitatively synthesize the existing evidence of balance and gait alterations lasting more than 2 wks after concussion in adults.DesignA systematic review was conducted through PubMed, CINAHL, SPORTDiscus, and Web of Science. Investigations must include adult participants with at least one concussion, were measured for 14 days after injury, and reported balance or gait measures. Balance error scoring system scores, center of pressure sway area and displacement, and gait velocity were extracted for the meta-analysis.ResultsTwenty-two studies were included. Balance alterations were observed for 2 wks after concussion when participants were tested with eyes closed, for longer durations of time, and with nonlinear regulatory statistics. The meta-analysis of center of pressure sway area with no visual feedback indicated that concussed individuals had greater sway area (P< 0.001). Various gait alterations were also observed, which may indicate that concussed individuals adopt a conservative gait strategy. The meta-analysis revealed that concussed participants walked 0.12 m/sec (P< 0.001) and 0.06 m/sec (P= 0.023) slower in single and dual-task conditions, respectively.ConclusionsSubtle balance and gait alterations were observed after 2 wks after a concussion. Understanding these alterations may allow clinicians to improve concussion diagnosis and prevent subsequent injury.
Interventions to Teach Medical Students About Disability
Authors: Ioerger Michael , Flanders Reed M. , French-Lawyer Jeremy R. , Turk Margaret A. 
Published: February 2019

Abstract
Historically, medical students have received little training about working with patients with disability, but there is now a greater recognition of the need to educate medical students in this domain. The aims of this review were to define the body of literature and to determine effective strategies for teaching medical students about disability. A systematic search protocol executed across six databases identified journal articles reporting interventions implemented to teach disability to medical students. Seventy-seven articles spanning 1960–2018 met inclusion criteria. Most articles reported objectives related to increasing knowledge and skills or changing attitudes. However, only half included evaluations for all of their stated objectives in those domains. In addition, few articles used longitudinal evaluations, resulting in most articles basing conclusions on immediate posttest evaluations. Overall, the reported interventions exhibit a high risk of potential bias, with only 10% of the articles receiving a global quality rating of “good.” Thus, although several articles have reported educational interventions to teach medical students about disability, the high risk of bias, incomplete reporting, and limitations of the evaluations prevent evidence-based determinations of effective strategies for teaching medical students about disability. The findings highlight ways to improve future studies in this domain.
How to Deal With Temporal Relationships Between Biopsychosocial Variables: A Practical Guide to Time Series Analysis
Authors: Stadnitski Tatjana , Wild Beate 
Published: February 2019

ABSTRACT

Objective
Longitudinal data allow for conclusions about the temporal order of events and interactional dynamics between several processes. The aim of this article is to provide a concise and pragmatic description of time series analyses (TSAs) of patient samples with numerous (or daily) repeated biological, behavioral, or psychological measurements. In addition, the article demonstrates how to implement the described analyses with the software R.

Methods
To illustrate the concrete application of the time series method, we use two case series of patients with anorexia nervosa. Upon awakening, the patients collected salivary cortisol on a daily basis and answered several questions on a handheld computer (electronic diary) regarding psychosocial variables at the time of salivary collection.

Results
Basic concepts of time series analysis such as stationarity, auto- and cross-correlation, Granger causality, impulse response function, and variance decomposition are presented. In addition, we demonstrate vector autoregressive analyses with three variables. For Patient 1, we demonstrate how TSA is used to detect cortisol and anxiety decreases during inpatient treatment and also how TSA can be used to show that an increase in cortisol is followed by a next-day increase in anxiety. For Patient 2, TSA was used to show higher salivary cortisol upon awakening on the days the patient was weighed compared with other days. In addition, we show how interdependencies of depressive feelings, positive anticipations, and cortisol values can be quantified using TSA.

Conclusions
Time series designs enable modeling of temporal relationships and bidirectional associations between biopsychosocial variables within individuals. These individual patterns cannot be derived from traditional group-based statistical analyses. This article provides accessible research tools for conducting TSA relevant to psychosomatic and biobehavioral research.
Results of a Couples-Based Randomized Controlled Trial Aimed to Increase Testing for HIV
Authors: Darbes Lynae A. , McGrath Nuala M. , Hosegood Victoria , Johnson Mallory O. , Fritz Katherine , Ngubane Thulani , van Rooyen Heidi 
Published: February 2019

Background:
Although couples HIV testing and counseling (CHTC) is effective for facilitating mutual disclosure and linkage to HIV care, uptake remains low. Using a randomized controlled design, we tested the efficacy of a behavioral couples-based intervention aimed to increase CHTC.

Setting:
The Vulindlela district of KwaZulu-Natal, South Africa.

Methods:
Couples were recruited from the community (eg, markets and community events). Couples were excluded if mutual HIV serostatus disclosure had occurred. Both partners had to report being each other's primary partner and relationship length was at least 6 months. Assessments occurred at baseline, and 3, 6, and 9 months after intervention. Eligible couples attended a group session (3–4 hours) after which randomization occurred. Intervention couples additionally received: one couples-based group session followed by 4 couples' counseling sessions (1–2 hours). Intervention topics included communication skills, intimate partner violence, and HIV prevention. Our primary outcomes were CHTC and sexual risk behavior.

Results:
Overall, 334 couples were enrolled. Intervention couples were significantly more likely to have participated in CHTC [42% vs. 12% (P ≤ 0.001)]. In addition, their time to participate in CHTC was significantly shorter (logrank P ≤ 0.0001) (N = 332 couples). By group, 59% of those who tested HIV-positive in intervention and 40% of those who tested in control were new HIV diagnoses (P = 0.18). There were no group differences in unprotected sex.

Conclusions:
Our intervention improved CHTC uptake—a vehicle for mutual serostatus disclosure and entrée into HIV treatment, both of which exert a significant public health impact on communities substantially burdened by HIV.
Female Genital Schistosomiasis and HIV: Research Urgently Needed to Improve Understanding of the Health Impacts of This Important Coinfection
Authors: O'Brien Daniel P. , Ford Nathan , Djirmay Amadou G. , Calmy Alexandra , Vitoria Marco , Jensen Tomas O. , Christinet Vanessa 
Published: February 2019

Abstract:Evidence suggests that there are important interactions between HIV and female genital schistosomiasis (FGS) that may have significant effects on individual and population health. However, the exact way they interact and the health impacts of the interactions are not well understood. In this article, we discuss what is known about the interactions between FGS and HIV, and the potential impact of the interactions. This includes the likelihood that FGS is an important health problem for HIV-positive women inSchistosoma-endemic areas potentially associated with an increased risk of mortality, cancer, and infertility. In addition, it may be significantly impacting the HIV epidemic in sub-Saharan Africa by making young women more susceptible to HIV. We call for immediate action and argue that research is urgently required to address these knowledge gaps and propose a research agenda to achieve this.
Big Data Research in Neuro-Ophthalmology: Promises and Pitfalls
Authors: Moss Heather E. , Joslin Charlotte E. , Rubin Daniel S. , Roth Steven 
Published: February 2019

Background:
Big data clinical research involves application of large data sets to the study of disease. It is of interest to neuro-ophthalmologists but also may be a challenge because of the relative rarity of many of the diseases treated.

Evidence Acquisition:
Evidence for this review was gathered from the authors' experiences performing analysis of large data sets and review of the literature.

Results:
Big data sets are heterogeneous, and include prospective surveys, medical administrative and claims data and registries compiled from medical records. High-quality studies must pay careful attention to aspects of data set selection, including potential bias, and data management issues, such as missing data, variable definition, and statistical modeling to generate appropriate conclusions. There are many studies of neuro-ophthalmic diseases that use big data approaches.

Conclusions:
Big data clinical research studies complement other research methodologies to advance our understanding of human disease. A rigorous and careful approach to data set selection, data management, data analysis, and data interpretation characterizes high-quality studies.
Regulation of sexual differentiation is linked to invasion in malaria parasites
Authors: Josling Gabrielle A. , Venezia Jarrett , Orchard Lindsey , Russell Timothy J. , Painter Heather J. , Llinás Manuel 
Published: February 2019

SummaryIn the malaria parasite Plasmodium falciparum, the switch from asexual multiplication to sexual differentiation into gametocytes is essential for transmission to mosquitos. One of the key determinants of sexual commitment is the transcription factor PfAP2-G, which has been proposed to orchestrate this crucial cell fate decision by driving expression of gametocyte genes. We show conclusively that PfAP2-G is a transcriptional activator of gametocyte genes and identify the earliest known markers expressed during commitment. Remarkably, we also find that in sexually committed cells, PfAP2-G is associated with the promoters of genes important for red blood cell invasion and activates them through its interactions with a second transcription factor. We thus demonstrate an intriguing transcriptional link between the apparently opposing processes of red blood cell invasion and gametocytogenesis that is coordinated by the master regulator PfAP2-G. This finding has important implications for the development of new anti-malarial drugs that block the invasion of red blood cells by sexually committed cells, thereby preventing parasite transmission.