bluuebunny/crossref_metadata_2025_split huggingface dataset:
Missing Data in the Field of Otorhinolaryngology and Head & Neck Surgery: Need for Improvement
Authors: Netten Anouk P. , Dekker Friedo W. , Rieffe Carolien , Soede Wim , Briaire Jeroen J. , Frijns Johan H. M. 
Published: August 2016

Objective:
Clinical studies are often facing missing data. Data can be missing for various reasons, for example, patients moved, certain measurements are only administered in high-risk groups, and patients are unable to attend clinic because of their health status. There are various ways to handle these missing data (e.g., complete cases analyses, mean substitution). Each of these techniques potentially influences both the analyses and the results of a study. The first aim of this structured review was to analyze how often researchers in the field of otorhinolaryngology/head & neck surgery report missing data. The second aim was to systematically describe how researchers handle missing data in their analyses. The third aim was to provide a solution on how to deal with missing data by means of the multiple imputation technique. With this review, we aim to contribute to a higher quality of reporting in otorhinolaryngology research.

Design:
Clinical studies among the 398 most recently published research articles in three major journals in the field of otorhinolaryngology/head & neck surgery were analyzed based on how researchers reported and handled missing data.

Results:
Of the 316 clinical studies, 85 studies reported some form of missing data. Of those 85, only a small number (12 studies, 3.8%) actively handled the missingness in their data. The majority of researchers exclude incomplete cases, which results in biased outcomes and a drop in statistical power.

Conclusions:
Within otorhinolaryngology research, missing data are largely ignored and underreported, and consequently, handled inadequately. This has major impact on the results and conclusions drawn from this research. Based on the outcomes of this review, we provide solutions on how to deal with missing data. To illustrate, we clarify the use of multiple imputation techniques, which recently became widely available in standard statistical programs.
Screening, Education, and Rehabilitation Services for Hearing Loss Provided to Clients with Low Vision: Measured and Perceived Value Among Participants of the Vision-Hearing Project
Authors: McMahon Catherine M. , Schneider Julie , Dunsmore Moira , Gopinath Bamini , Kifley Annette , Mitchell Paul , Wang Jie-Jin , Leeder Stephen R. 
Published: August 2016

Objectives:
Combined vision and hearing impairment, termed dual sensory impairment (DSI), is associated with poorer health outcomes compared with a single sensory loss alone. Separate systems of care exist for visual and hearing impairment which potentially limit the effectiveness of managing DSI. To address this, a Hearing Screening Education Model (HSEM) was offered to older adults attending a low-vision clinic in Australia within this pilot study. The present study aimed to evaluate the benefits of seeking help on hearing handicap, self-perceived health, and use of community services among those identified with unmet hearing needs after participation in the HSEM.

Design:
Of 210 older adults (>55 years of age) who completed the HSEM and were referred for follow-up, 169 returned for a follow-up interview at least 12 months later. Of these, 68 (40.2%) sought help, and the majority were seen by a hearing healthcare provider (89.7%). Changes in hearing handicap, quality of life, and reliance on community services between the baseline and 12-month follow-up were compared between those who sought help and those who did not. In addition, the perceived value of the HSEM was assessed.

Results:
Results showed that there was no significant difference in hearing handicap between those who sought help (mean change −1.02 SD = 7.97, p = 0.3) and those who did not (mean change 0.94 SD = 7.68, p = 0.3), p = 0.18. The mental component of the SF-36 worsened significantly between baseline and follow-up measures across the whole group (mean change −2.49 SD = 9.98, p = 0.002). This was largely driven by those not seeking help, rather than those seeking help, but was not significantly different between the two groups. Those who sought help showed a significant reduction in the use of community services compared with those who did not. Further, all participants positively viewed the HSEM’s underlying principle of greater integration between vision and hearing services.

Conclusions:
These findings suggest a need to further develop and evaluate integrated models of healthcare for older adults with DSI. It also highlights the importance of using broader measures of benefit, other than use of hearing aids to evaluate outcomes of hearing healthcare programs.
The Benefits of Increased Sensation Level and Bandwidth for Spatial Release From Masking
Authors: Jakien Kasey M. , Kampel Sean D. , Gordon Samuel Y. , Gallun Frederick J. 
Published: August 2016

Objective:
Spatial release from masking (SRM) can increase speech intelligibility in complex listening environments. The goal of the present study was to document how speech-in-speech stimuli could be best processed to encourage optimum SRM for listeners who represent a range of ages and amounts of hearing loss. We examined the effects of equating stimulus audibility among listeners, presenting stimuli at uniform sensation levels (SLs), and filtering stimuli at two separate bandwidths.

Design:
Seventy-one participants completed two speech intelligibility experiments (36 listeners in experiment 1; all 71 in experiment 2) in which a target phrase from the coordinate response measure (CRM) and two masking phrases from the CRM were presented simultaneously via earphones using a virtual spatial array, such that the target sentence was always at 0 degree azimuth angle and the maskers were either colocated or positioned at ±45 degrees. Experiments 1 and 2 examined the impacts of SL, age, and hearing loss on SRM. Experiment 2 also assessed the effects of stimulus bandwidth on SRM.

Results:
Overall, listeners’ ability to achieve SRM improved with increased SL. Younger listeners with less hearing loss achieved more SRM than older or hearing-impaired listeners. It was hypothesized that SL and bandwidth would result in dissociable effects on SRM. However, acoustical analysis revealed that effective audible bandwidth, defined as the highest frequency at which the stimulus was audible at both ears, was the best predictor of performance. Thus, increasing SL seemed to improve SRM by increasing the effective bandwidth rather than increasing the level of already audible components.

Conclusions:
Performance for all listeners, regardless of age or hearing loss, improved with an increase in overall SL and/or bandwidth, but the improvement was small relative to the benefits of spatial separation.
Gender Identification Using High-Frequency Speech Energy: Effects of Increasing the Low-Frequency Limit
Authors: Donai Jeremy J. , Halbritter Rachel M. 
Published: August 2016

Objective:
The purpose of this study was to investigate the ability of normal-hearing listeners to use high-frequency energy for gender identification from naturally produced speech signals.

Design:
Two experiments were conducted using a repeated-measures design. Experiment 1 investigated the effects of increasing high-pass filter cutoff (i.e., increasing the low-frequency spectral limit) on gender identification from naturally produced vowel segments. Experiment 2 studied the effects of increasing high-pass filter cutoff on gender identification from naturally produced sentences. Confidence ratings for the gender identification task were also obtained for both experiments.

Results:
Listeners in experiment 1 were capable of extracting talker gender information at levels significantly above chance from vowel segments high-pass filtered up to 8.5 kHz. Listeners in experiment 2 also performed above chance on the gender identification task from sentences high-pass filtered up to 12 kHz.

Conclusions:
Cumulatively, the results of both experiments provide evidence that normal-hearing listeners can utilize information from the very high-frequency region (above 4 to 5 kHz) of the speech signal for talker gender identification. These findings are at variance with current assumptions regarding the perceptual information regarding talker gender within this frequency region. The current results also corroborate and extend previous studies of the use of high-frequency speech energy for perceptual tasks. These findings have potential implications for the study of information contained within the high-frequency region of the speech spectrum and the role this region may play in navigating the auditory scene, particularly when the low-frequency portion of the spectrum is masked by environmental noise sources or for listeners with substantial hearing loss in the low-frequency region and better hearing sensitivity in the high-frequency region (i.e., reverse slope hearing loss).
Indices of Effortful Listening Can Be Mined from Existing Electroencephalographic Data
Authors: Wisniewski Matthew G. 
Published: August 2016

Objectives:
Studies suggest that theta (~4 to 7 Hz), alpha (~8 to 12 Hz), and stimulus-evoked dynamics of the electroencephalogram index effortful listening. Numerous auditory event-related potential datasets exist, without thorough examination of these features. The feasibility of mining those datasets for such features is assessed here.

Design:
In a standard auditory-oddball paradigm, 12 listeners heard deviant high-frequency tones (10%) interspersed among low-frequency tones (90%) “near” or “far” separated in frequency.

Results:
During active listening (deviance detection; experiment 1), sustained frontal midline theta power, and gamma-band inter-trial phase coherence, were greater for the near condition. No significant “near”/“far” differences were observable during passive exposure to the same sounds (experiment 2).

Conclusions:
Increased theta power likely reflects increased utilization of cognitive-control processes (e.g., working memory) that rely on frontal cortical networks. Inter-trial phase coherence differences may reflect differences in attention-modulated stimulus encoding. Reanalysis of existing datasets can usefully inform future work on listening effort.
Neurovascular injury in acute knee dislocation: evaluation of an algorithm for selective arteriography
Authors: Roberson Troy A. , Throckmorton Thomas W. , Miller Robert H. , Smith Richard A. , Azar Frederick M. 
Published: August 2016

Background:
The role of arteriography in acute knee dislocations has evolved from routine use to most authors advocating selective arteriography. Further refining and education are necessary to identify patients at increased risk of popliteal artery injury and avoid missing serious injuries while at the same time avoiding unnecessary arteriography. Our hypothesis was that selective arteriography algorithm would identify all flow-limiting popliteal artery injuries, and patients with a body mass index (BMI) over 40 will have higher rates of popliteal artery and peroneal nerve injuries than nonobese patients.

Methods:
Fifty-three patients treated for an acute knee dislocation over a 5-year period (2007-2012) were included. Patients with a normal neurovascular examination or ankle-brachial indices (ABI) greater than 0.9 were clinically observed. Those with abnormal ABI (<0.9) but palpable pulses had an arteriogram at the discretion of the attending physician, while patients with pulse discrepancy compared to the contralateral side had arteriography. Missed injuries were defined as worsening clinical examination resulting in further diagnostic evidence of vascular injury prior to discharge.

Results:
The rate of popliteal artery injury was 17% (9 of 53) and peroneal nerve injury 38% (20 of 53). There were no missed vascular injuries using the selective arteriography algorithm. Morbid obesity (BMI>40) was significantly associated with popliteal artery injury and the mean BMI was significantly higher (40 vs. 33) in patients with popliteal artery injury. Time to reduction of more than 6 hr trended toward association with popliteal artery injury while transfer from another facility was not significant. Falls from a standing height were not significantly associated with popliteal artery injury, while peroneal nerve injury was significantly higher with this ultra-low-velocity mechanism.

Conclusions:
There were no missed vascular injuries with the use of a selective arteriography algorithm. Morbid obesity and an ultra-low-velocity mechanism were associated with an increased risk of neurovascular injury in acute knee dislocations, but arteriography was not found to be mandatory in this population.
Efficiency and Safety of an Early Dose Adjustment of Ribavirin in Patients Infected With Hepatitis C Underexposed to the Drug and Treated With Peginterferon Ribavirin
Authors: Loustaud-Ratti Véronique , Maynard Marianne , Thevenon Sylvie , Pradat Pierre , Rousseau Annick , Alain Sophie , Deny Paul , Gagnieu Marie-Claude , Tran Albert , Dao Thông , Silvain Christine , Lunel-Fabiani Françoise , Picard Nicolas , Zublena Irène , Marquet Pierre , Trepo Christian ,   the RIBAJUSTE Group
Published: August 2016

Background:
Ribavirin exposure after the first dose (D0AUC0–4h) >1755 mcg·h−1·L−1 is predictive of sustained virological response (SVR) in patients with hepatitis C treated with peginterferon and ribavirin. The aim of this study was to test the benefit of ribavirin early dose adjustment based on this target in naïve patients infected with genotype 1.

Methods:
A multicenter randomized controlled trial with two parallel groups; fixed-dose (FD) group: standard of care in 2010–2011, ie, peginterferon-α2a 180 mcg·wk−1 and weight-based ribavirin 1000–1200 mg/d during 48 weeks; adapted-dose (AD) group: increase of ribavirin dose if D0AUC0–4h <1755 mcg·h−1·L−1.

Results:
A total of 221 patients were included, 110 in the AD group and 111 in the FD group with similar baseline characteristics. In the perprotocol analysis, SVR was higher in the AD group (55.1% versus 40.4%; P = 0.042), especially in patients with D0AUC0–4h <1755 mcg·h−1·L−1 (54.3% versus 31.9%; P = 0.029). In the intention-to-treat analysis, the difference was not significant (50% versus 41%; P = 0.197). Ribavirin trough concentrations (C0s) at week 4 of treatment (intention-to-treat analysis) were higher in patients achieving SVR (2.06 versus 1.72 mg/L, P = 0.003). In the subgroup of patients with AUC0–4h <1755 mcg·h−1·L−1, 46% of patients with AD achieved a C0 >2.0 mg/L versus 22% of patients with FD (P = 0.013). Grade 1 anemia (but not other grades) was more frequent in the AD group (70% versus 48%, P = 0.001). The number of dose reductions or discontinuation of ribavirin was similar in both groups.

Conclusions:
Early ribavirin dose adjustment increases SVR in patients underexposed to ribavirin without increasing grade II-IV anemia. Such a strategy could be useful in patients with no access to new antiviral drugs.
Dosage Adjustment of Dabigatran Etexilate Based on Creatinine Clearance in Patients With Cardioembolic Stroke or Atrial Fibrillation
Authors: Matsuda Shohei , Imazu Tomoko , Kimura Ryuji , Nakamura Mamoru , Matsumoto Atsushi , Murakami Teruo , Maeda Yorinobu 
Published: August 2016

Background:
A recommendation for dosage adjustment of dabigatran etexilate, a prodrug of dabigatran, seems to be desirable based on creatinine clearance to avoid bleeding and stroke.

Methods:
Outpatients and inpatients having a history of cardioembolic stroke or atrial fibrillation were included. After taking dabigatran etexilate orally (75–150 mg twice daily) for at least 1 week, plasma trough concentration (Ctrough, ng/mL) of dabigatran and creatinine clearance (CLcr, mL/min) of patients according to Cockcroft and Gault equation were determined.

Results:
Among the 38 patients studied, Ctrough of dabigatran and CLcr were scattered in a range from 31.4 to 329.5 ng/mL and 15.4–133.4 mL/min, respectively. Temporal CLtotal (Temp-CLtotal) of dabigatran, estimated by dividing the daily absorbed amount of dabigatran etexilate with Ctrough of dabigatran, was linearly correlated with CLcr of patients (P = 0.0018). Based on the findings, the daily dose of dabigatran etexilate that provides Ctrough of dabigatran at approximately 70 ng/mL was estimated.

Conclusions:
A linear relationship was found between Temp-CLtotal of dabigatran and CLcr of patients. Depending on CLxr of patients, we recommend 4 different dosages of dabigatran etexilate to obtain Ctrough of dabigatran at approximately 70 ng/mL.
ACUTE MACULAR NEURORETINOPATHY AFTER RANIBIZUMAB INJECTION IN A DIABETIC PATIENT
Authors: Wheatley H. Matthew , Sarraf David 
Published: August 2016

Purpose:
To report a case of acute macular neuroretinopathy occurring after intravitreal ranibizumab injection for diabetic macular edema.

Methods:
Observational clinical case report.

Results:
The patient received an intravitreal ranibizumab (0.3 mg) injection for diabetic macular edema. Three days later, he had a decline in vision associated with a central and paracentral scotoma. Optical coherence tomography (OCT) demonstrated bandlike hyperreflectivity of the outer nuclear and plexiform layers corresponding to the patient's scotoma, consistent with the diagnosis of acute macular neuroretinopathy. There was spontaneous resolution of the abnormalities observed in optical coherence tomography, but only partial resolution of the scotoma was observed 4 months after presentation.

Conclusion:
Diabetic retinopathy may be associated with acute macular neuroretinopathy. The temporal relationship between ranibizumab injection and the onset of acute macular neuroretinopathy in this case report raises the possibility of a causal relationship.
Visual Outcome and Patient Satisfaction of Low-Power-Added Multifocal Intraocular Lens
Authors: Kim Kyeong Hwan , Kim Wan Soo 
Published: August 2016

Purpose:
To evaluate visual outcome and patient satisfaction following implantation of multifocal intraocular lenses (IOLs) with a +1.5 diopters (D) addition compared with monofocal IOLs.

Methods:
This prospective, nonrandomized, comparative case series involved 48 eyes (24 patients) who underwent cataract surgery with implantation of low-power-added multifocal IOLs (LS313-MF15; multifocal group) and 48 eyes (24 patients) with conventional monofocal IOLs (CTS204; monofocal group). Visual acuity (VA), defocus curves, refraction, contrast sensitivity, glare, ocular optical quality, and scores in questionnaire were assessed 6 months postoperatively.

Results:
Uncorrected VA at intermediate and near distance tended to be better in the multifocal group, with significant differences at 50 cm (P=0.03). The defocus curve showed significantly different VA at vergences of −1.5 and −2.0 D (P=0.02 and P=0.03, respectively). Results of postoperative refraction, contrast sensitivity, glare, and optical quality were similar (P>0.05), although coma-like aberration was higher in the multifocal group (P=0.04). Despite of similar levels of visual disturbances (P>0.05), disturbances in activities and spectacle use at intermediate working distance were significantly less frequent in the multifocal group (P=0.03 and P=0.04, respectively). Multifocal group showed significantly greater overall satisfaction (P=0.02).

Conclusions:
Low-power-added multifocal IOLs yielded better intermediate and near vision without increasing optical phenomena compared with monofocal IOLs.
Differences in Ocular Blood Flow Between People of African and European Descent With Healthy Eyes
Authors: Kaskan Betül , Ramezani Koosha , Harris Alon , Siesky Brent , Olinde Carine , WuDunn Darrell , Eikenberry Jennifer , Tobe Leslie A. , Racette Lyne 
Published: August 2016

Purpose:
To investigate differences in ocular blood flow between people of African descent (AD) and European descent (ED) with healthy eyes.

Materials and Methods:
Retrobulbar and retinal capillary blood flow was assessed in 1 eye of 58 participants (24 AD, 34 ED) with healthy eyes with systemic blood pressure lower than 140/90. Retrobulbar blood flow was measured in the ophthalmic artery (OA), central retinal artery (CRA), nasal posterior ciliary artery (NPCA) and temporal posterior ciliary artery (TPCA). Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) were assessed. Retinal capillary blood flow was assessed using mean retinal flow and avascular space defined as the percent of area measured with no blood flow. Groups were compared using t tests and Pearson correlations were compared using Fisher r-to-z transformation.

Results:
Compared with people of ED, people of AD had significantly lower EDV in the NPCA (P=0.01), and higher RI in the CRA (P=0.04) and TPCA (P=0.01). No significant differences were observed in mean retinal capillary flow or avascular area. In the CRA, a significant negative correlation was observed between pattern standard deviation and peak systolic velocity (P=0.02) in the AD group and this correlation was significantly different from that observed in the ED group (P=0.01). A significant correlation was also observed between pattern standard deviation and EDV (0.04) in the AD group.

Conclusions:
This study suggests that retrobulbar blood flow is lower in healthy eyes in persons of AD compared with ED. This may provide a mechanism through which people of AD are at increased risk for ophthalmic diseases such as glaucoma.
Comprehensive systematic review of long-term opioids in women with chronic noncancer pain and associated reproductive dysfunction (hypothalamic–pituitary–gonadal axis disruption)
Authors: Wersocki Emily , Bedson John , Chen Ying , LeResche Linda , Dunn Kate M. 
Published: August 2016

AbstractA comprehensive systematic literature review of reproductive side effects in women aged 18 to 55 years treated with opioids for 1 month or longer for chronic noncancer pain. A search of 7 databases including EMBASE and Medline was undertaken (October 2014 and a limited rerun April 2016). The search contained key words for opioids (generic and specific drug names) and side effects (generic and specific reproductive). Titles were screened using predefined criteria by a single reviewer and abstracts and full texts by 2 independent reviewers. A total of 10,684 articles were identified and 12 full texts (cohort [n = 1], case–control [n = 4], cross-sectional [n = 4], case series [n = 1], and case report [n = 2] with a maximum of 41 cases in 1 article) were included covering 3 different modes of administration: oral (n = 6), intrathecal (n = 5), and transdermal (n = 1). Amenorrhoea occurred in 23% to 71% of those receiving oral or intrathecal opioids. Decreased libido was seen in 61% to 100%. Of the 10 studies that undertook hormonal assays, only 2 studies showed a statistically significant decrease in hormone levels. This review supports the view that there is a potential relationship between the use of long-term opioids in women and reproductive side effects. The evidence is however weak and the mode of administration, duration, type, and dose of opioid might influence associations. Although hormone levels were statistically significant in only 2 studies, women exhibited clinically important symptoms (decreased libido and altered menstrual cycle). Further investigation is required with larger cohorts and analysis of different delivery methods.