bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cochlear Implantation for Single‐Sided Deafness: Early Outcomes for 12 Patients
Authors: Frisch Christopher D. , Sladen Douglas P. , Driscoll Colin , Zeitler Daniel M. 
Published: September 2014

Objectives:(1) Summarize hearing status in the nonimplant ear. (2) Report audiometric and subjective outcomes.Methods:Multi‐institutional retrospective chart review. We report outcomes of cochlear implantation in 12 patients with single‐sided deafness. Hearing status in the nonimplant ear included: 6 patients with American Academy of Otolaryngology—Head and Neck Surgery Class A, 4 with Class B, and 2 with Class C (1 with WRS 90%). Five of 12 (42%) patients had normal hearing in the nonimplanted ear. There were 6 male and 6 female patients. Average age was 51.5 years (range, 9‐75 years). Average preoperative word recognition score in the nonimplanted ear was 82% (range, 52%‐100%). Average preoperative pure tone average was 30.4 dB (range, 2‐60 dB).Results:Average post‐implantation follow‐up was 8 months (range, 1‐36 months). Etiologies of deafness included 5 idiopathic sudden‐sensorineural, 3 Ménière's Disease, 2 idiopathic progressive, 1 labyrinthitis, and 1 iatrogenic. Audiometric results for the implant‐only condition demonstrated mean consonant‐nucleus‐consonant score of 67% (range, 10%‐88%) and mean AzBio score of 83% (range, 73%‐97%). Objective testing in noise also showed substantial improvement compared to the preoperative condition. All are daily users.Conclusions:Although cochlear implantation for asymmetric hearing loss and single‐sided deafness is not Food and Drug Administration approved in the United States, our patients report a high level of satisfaction. Early audiometric data indicate that these patients score similarly to standard implant users in the CI only condition. In addition, they show substantial improvement in noise since preoperative testing. More data are needed to determine future candidacy for this intervention.
Management of Pediatric Patients with X‐Linked Stapes Gusher Syndrome
Authors: Merwin William H. , Buchman Craig A. , Adunka Oliver F. , Iseli Claire E. 
Published: September 2014

Objectives:Present outcomes of children with X‐linked stapes gusher (XLSG) syndrome managed at a single institution.Methods:A retrospective evaluation of children with radiographically confirmed XLSG was undertaken. Additionally, an analysis of surgical complications and speech perception outcomes in the published literature was carried out.Results:Eight male children with XLSG identified in the first year of life were included in the single institutional review. All demonstrated varying levels of mixed hearing loss with present acoustic reflexes. There was no associated medical comorbidities or intellectual disability. The average pure tone average (PTA) at initiation of care was 90 ± 14 dB HL. All patients were initially managed with conventional amplification and 4 went on to receive cochlear implants (mean age 7 years). Speech perception abilities were variable amongst the implanted children (PBK range = 8‐84%) despite radiographically confirmed electrode placement. One patient was too young to test. Children using amplification alone (n = 4) also demonstrated variable results. Literature review identified 21 other XLSG patients with cochlear implants (1 bilateral). Surgical complications included 4 postoperative cerebrospinal fluid leaks, 4 electrodes placed into the internal auditory canal, 2 electrode extrusions, and one device failure. Speech perception testing revealed 12 patients with open set abilities, 3 with closed set abilities, and 5 with only sound detection.Conclusions:Some children with XLSG can be managed with amplification alone. Cochlear implantation, while possible, presents issues with electrode placement, cerebrospinal fluid management and variable outcomes. Careful planning is needed in children with XLSG to minimize risk and optimize outcomes.
Middle Ear Implant versus Hybrid Cochlear Implant for High‐Frequency Sensorineural Hearing Loss
Authors: Glasscock Michael E. 
Published: September 2014

Objectives:Profound SNHL responds well to a standard cochlear implant (CI) with rewarding results. However, if the individual has residual hearing in the low frequencies there is a reasonable chance that the pure tones will be lost. Hybrid cochlear implants have been suggested as a solution for this problem. Unfortunately, there continues to be a loss of the low frequency pure tones in a large number of these patients.Methods:One solution would be to use a middle ear implant instead of a hybrid CI. The Maxum middle ear implant has the advantage of being a minimally invasive surgical procedure that can be performed under local anesthesia. A small magnet is attached to the stapes through a transcanal approach.Results:After 3 weeks an integrated processor coil (IPC) is inserted into the external auditory canal. The IPC has an electromagnet driver. By driving the stapes directly it is possible to obtain as much as 60 dB of functional gain in the high frequencies without distortion, acoustic feedback, or the sensation of occlusion.Conclusions:For these reasons the author believes a Maxum should be considered in these patients before a Hybrid Cochlear Implant. If the SNHL progresses, then a CI can still be performed at a later date. This sequence of events delays the invasion of the cochlea and in some cases prevents the need for a CI altogether.
Rescuing Noise‐Induced Permanent Threshold Shift by D‐Methionine in Guinea Pigs
Authors: Cheng Po‐Wen , Lo Wu C. , Wang Chi‐Te 
Published: September 2014

Objectives:This study examined the effectiveness of D‐methionine (D‐met) in rescuing a noise‐induced permanent threshold shift (PTS) and cochlear biochemistry following noise exposure.Methods:One hour after being exposed to continuous white noise at 105 ± 2 dB SPL for 6 hours, guinea pigs were treated 5 times at 12‐hour intervals with 200, 400, or 600 mg/kg D‐met or sterile 0.9% saline by intraperitoneal injection. Auditory brainstem responses were examined before and 14 days after noise exposure. Six guinea pigs with normal hearing that were not exposed to noise served as control animals. The level of D‐met in rescuing noise‐induced hearing loss and the changes in cochlear biochemistry, including membranous Na+, K+‐ATPase, and Ca2+‐ATPase, lipid peroxidation, and nitric oxide, were evaluated.Results:Hearing acuity had no significant differences before and 14 days after noise exposure for the animals treated with 600 mg/kg D‐met, compared with the control animals, whereas significant differences occurred among the animals in the other treatment groups. The level of rescue from noise‐induced PTS following treatment with D‐met was dose‐dependent. No significant differences in the mean enzyme activities were observed between the controls and the D‐met 600 mg/kg treatment group. The attenuation of the noise‐induced decreases in the enzyme activities was dose‐dependent. Likewise, D‐met‐dose‐dependent decreases in oxidative stress were observed in the D‐met treated groups.Conclusions:Treatment with D‐met significantly rescued noise‐induced PTS in a dose‐dependent manner. Significant attenuation of increased oxidative stress and decreased ATPase activities were concurrent with the D‐met‐mediated improvements in noise‐induced auditory dysfunction.
Obstructive Sleep Apnea during Pregnancy and Morbidity Outcome
Authors: Pinyopornpanish Poj , Sonsuwan Nuntigar , Sirichotiyakul Supatra 
Published: September 2014

Objectives:Obstructive sleep apnea (OSA) is increasingly a concern for a risk factor of poor pregnancy outcomes. However, to date, most research studies have relied on subjective research such as Epworth Sleepiness Scale (ESS). Therefore, our research design used polysomnography, which is an objective measurement to define OSA in pregnancy. The study aimed to measure the incidence of OSA in pregnancy, to reveal clinical examination which will be objective screening tool for OSA in pregnancy, and prove that OSA is a risk factor of poor pregnancy outcomes.Methods:Fifty healthy pregnant women who received antenatal care at Chiangmai University Hospital during October 2012 through April 2013 were measured by physical examination and polysomnography at GA 28th to 32nd weeks, and followed until the end of pregnancy to see the difference of poor pregnancy outcomes in OSA and non‐OSA group.Results:The incidence of OSA in pregnancy was 12%. OSA related to more overall poor pregnancy outcomes (relative risk [RR] = 5.86 [2.16‐15.96], P =. 007), more preterm labor (RR = 19.33 [3.89‐220.79], P <. 001), and more preeclampsia (RR = n/a, P =. 012). Friedman tongue position (FTP) equal or more than gr III was considered the screening tool for OSA in pregnancy, which yielded 66.7% sensitivity and 84.1% specificity.Conclusions:OSA could lead to a high‐risk pregnancy, which should be screened by multidisciplinary teams, to establish diagnosis and treatment for maternal and child health.
Spectral material characterization with dual-energy CT: comparison of commercial and investigative technologies in phantoms
Authors: Gabbai Michal , Leichter Isaac , Mahgerefteh Samuel , Sosna Jacob 
Published: September 2014

Background Dual-energy computed tomography (DECT) enables tissue discrimination based on the X-ray attenuations at different photon energies emitted by the tube. The spectral dependencies of net X-ray attenuation can be analyzed and used to characterize specific materials. Purpose To evaluate the capability of DECT to characterize and differentiate high-density materials, using spectral analysis. Material and Methods Images of phantoms containing iodine, barium, gadolinium, and calcium solutions in five concentrations were obtained from three DECT scanners and with sequential scanning at different kV values from three conventional MDCT devices. DECT studies were performed with commercial dual-source and rapid kV-switching systems, and a spectral-detector CT (SDCT) prototype based on dual-layer detector technology. Spectral maps describing Hounsfield Units (HU) in low- versus high-energy images were calculated and characterizing curves for all materials were compared. Results Spectral low- to- high energy maps yielded linear curves (R2 = 0.98–0.999) with increasing slopes for calcium, gadolinium, barium, and iodine, respectively. Slope differences between all material pairs were highest (reaching 45%) for DECT with dual-source (140/80 kV) and rapid kV-switching (60/80 keV), reaching statistical significance ( P < 0.05) with most techniques. Slope differences between all material pairs for sequential scanning were lower (reaching 32%). Slope differences lacked statistical significance for iodine-barium with two sequential-acquisition techniques and the dual-source DECT scanner, and the calcium-gadolium pair with the dual-source scanner. Conclusion All designated techniques for dual-energy scanning provide robust and material-specific spectral characterization and differentiation of barium, iodine, calcium, and gadolinium, though to varying degrees.
Timing of recanalization and outcome in ischemic-stroke patients treated with recombinant tissue plasminogen activator
Authors: Wei Xiao-Er , Zhao Yu-Wu , Lu Jing , Li Ming-Hua , Li Wen-Bin , Zhou Ya-Jun , Li Yue-Hua 
Published: September 2014

Background Intravenous administration of recombinant tissue plasminogen activator (rtPA) is approved treatment for acute ischemic stroke <3 h of symptom onset. Purpose To determine the impact of the timing and degree of recanalization on clinical outcome after rtPA infusion in patients. Material and Methods Seventy-five patients with ischemic stroke in the middle cerebral artery territory treated with intravenous rtPA within 3 h were studied consecutively. Magnetic resonance imaging (MRI), including magnetic resonance angiography (MRA), before, 6 h, and 24 h after thrombolytic therapy was undertaken. Depending on the MRA results acquired 6 h after rtPA infusion, recanalization was graded as: early recanalization (ER), delayed recanalization (DR), and no recanalization (NR). Clinical outcome was assessed using the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Results Of patients in the ER, DR and NR groups, 71.4% (15/21), 13.3% (2/15), and 30.7% (12/39), respectively, showed dramatic improvement in NIHSS score 7 days after rtPA administration compared with those scores upon hospital admission. The 6-h and 24-h NIHSS scores and 3-month mRS scores of ER patients were significantly lower than those of the other two groups ( P < 0.05). The 24-h, 7-d NHISS and mRS scores of DR patients were significantly higher than NR patients ( P = 0.001, 0.002, 0.049, respectively). Three patients in the DR group died during follow-up. Conclusion These data suggest that DR is associated with clinical deterioration. Patients treated with rtPA thrombolysis should be under close observation for 6–24 h. Corresponding treatment should be considered once DR appears.
Assessment of myocardial edema and area at risk in a rat model of myocardial infarction with a faster T2 mapping method
Authors: Xia Rui , Lu Xi , Zhang Bing , Wang Yuqing , Liao Jichun , Zheng Jie , Gao Fabao 
Published: September 2014

Background The common T2 mapping is not suitable for the use in rat heart with high heart rate, unless data are acquired in multiple cardiac cycles. Purpose To evaluate a simplified T2 mapping method for faster assessment of myocardial edema and area at risk in a rat model of myocardial infarction. Material and Methods The simplified T2 mapping method (TR/TE, 1500 ms/10, 20, 30 ms) was implemented at a 7.0T MRI system. The accuracy of T2 mapping was compared with a standard T2 mapping method (TR, 2500 ms, 16 TEs equally spaced from 11 ms to 176 ms) in thigh muscles in rats ( n = 6) and a phantom. This method was further evaluated in normal rats ( n = 8) and rats with myocardial infarction ( n = 8). Late gadolinium enhancement images were also acquired in the rats with myocardial infarction. Results T2 values of simplified T2 mapping in the muscles and phantom were 27.3 ± 2 ms and 26.5 ± 1.1 ms, which were similar to the T2 values obtained by the standard T2 mapping method (28.1 ± 1.4 ms, P > 0.05; 26.9 ± 1.7 ms). No significant difference in T2 distribution (different segments and slices from base to apex) in the whole heart was found in normal rats (25.6 ± 3.3 ms, P > 0.05). The mean T2 value in the myocardial edema regions of myocardial infarction rats (37 ± 4.9 ms) was significantly higher than that of the normal rats (25.6 ± 3.3 ms, P < 0.001). The T2 value in the myocardial infarction core of myocardial infarction rats (39.9 ± 3.6 ms) was significantly higher than that of area at risk (34.7 ± 2.9 ms, P < 0.001). Conclusion The simplified myocardial T2 mapping is technically feasible and accurate, and can readily detect myocardial edema and area at risk in rats with high heart rate.
Statins Enhance Rotator Cuff Healing by Stimulating the COX2/PGE2/EP4 Pathway
Authors: Dolkart Oleg , Liron Tamar , Chechik Ofir , Somjen Dalia , Brosh Tamar , Maman Eran , Gabet Yankel 
Published: September 2014

Background: Statins are lipid-lowering drugs with many beneficial pleiotropic effects. Cyclooxygenase (COX2) selective inhibitors that are commonly prescribed in orthopaedic patients may effect healing. Evidence indicates that statins stimulate COX2 activity. Hypothesis: Atorvastatin (ATV) administration will enhance tendon healing by stimulating the acute inflammatory phase via increasing the production of prostaglandin E2 (PGE2). Study Design: Controlled laboratory study. Methods: After experimental rotator cuff (RC) tearing and suturing, 48 Wistar rats were randomly allocated into 4 groups: (1) ATV (20 mg/kg), (2) celecoxib (CEL; COX2 inhibitor) (10 mg/kg), (3) ATV + CEL (20 mg/kg + 10 mg/kg), and (4) saline alone. Animals were sacrificed 3 weeks after RC tears and repair, and tendon integrity was tested biomechanically in tension. To further evaluate the underlying mechanism of action, human and rat primary tenocytes were obtained from the supraspinatus tendon. Cultures were treated with a therapeutic dosage of 5 commonly used statins: CEL, ATV + CEL, PGE2, and a selective antagonist of PGE2 receptor 4 (EP4). Cell proliferation (thymidine incorporation), migration (wound healing assay), and adhesion (iCELLigence) were evaluated. The expression of all PGE2 receptors (EPs) was determined by quantitative reverse transcription polymerase chain reaction. Results: Tension testing of healed tendons demonstrated significantly higher maximal loading and stiffness in the ATV group as compared with the saline (+30% and +20%, respectively; P < .001) and CEL groups (+33% and +50%, respectively; P < .005). Celecoxib alone did not affect tendon healing ( P = .88). In line with these in vivo results, tenocytes treated with statins demonstrated significantly higher proliferation rates; CEL abrogated this effect, and PGE2 treatment stimulated tenocyte proliferation even in the presence of CEL. Also, ATV stimulated the migration (wound healing) and adhesion of tenocytes. Among all PGE2 receptors, tenocytes mainly express EP4, and an EP4 selective antagonist blocked the effect of ATV. Conclusion: Results indicate that ATV enhances tendon healing by stimulating tenocyte proliferation, migration, and adhesion via increased COX2 activity and autocrine/paracrine PGE2 signaling. Findings also demonstrate that this effect is mediated by EP4 signaling. Clinical Relevance: Although chronic inflammation contributes to the development of tendinopathy, study results advocate for a positive role of PGE2 in tendon healing during the acute inflammatory phase that follows tendon surgical repair. It is therefore suggested that ATV should be further investigated as a possible modality to improve tendon healing.
Body size and the risk of multiple sclerosis in Norway and Italy: The EnvIMS study
Authors: Wesnes Kristin , Riise Trond , Casetta Ilaria , Drulovic Jelena , Granieri Enrico , Holmøy Trygve , Kampman Margitta T , Landtblom Anne-Marie , Lauer Klaus , Lossius Andreas , Magalhaes Sandra , Pekmezovic Tatjana , Bjørnevik Kjetil , Wolfson Christina , Pugliatti Maura , Myhr Kjell-Morten 
Published: September 2014

Background: Obesity may be a risk factor for developing multiple sclerosis (MS). Objective: We examined if body size influences the risk of MS in a population-based, case control study. Methods: A total of 953 cases and 1717 controls from Norway and 707 cases and 1333 controls from Italy reported their body size by choosing a silhouette 1 to 9 (largest) every fifth year from age 5 to 30 and at time of study. The body size-related MS risk was defined by odds ratios (ORs) in logistic regression analyses adjusting for age, smoking and outdoor activity. Results: In Norway a large body size (silhouettes 6–9) compared to silhouette 3 increased the risk of MS, especially at age 25 (OR 2.21; 95% CI 1.09–4.46 for men and OR 1.43; 95% CI 0.90–2.27 for women). When comparing silhouette 9 to 1, we found a significant dose-response from age 10 until age 30 peaking at age 25 (sex-adjusted OR 2.83; 95% CI 1.68–4.78). The association was present for at least 15 years prior to disease onset. No significant associations were found in Italy. Conclusions: Obesity from childhood until young adulthood is a likely risk factor for MS with a seemingly stronger effect in Norway than in Italy.
Closed fifth metacarpal neck fractures: Do they need to be seen in fracture clinic? An emergency department pathway for assessment, management and criteria for fracture clinic referral
Authors: Abdelmalek Amir , Harrison Emily , Scott Sharon 
Published: September 2014

Background In our institution patients with fifth metacarpal neck fractures used to be referred to fracture clinic. The first audit aimed to assess if the referral changes management. This resulted in implementation of new practice, followed by the re-audit and follow up. Methods We looked at 6 months data retrospectively, followed by prospective data collection for 6 months after initiation of new practice and electronic monitoring of re-referrals. Local systems were used for data extraction. Fracture assessment included angulation, rotational deformity and whether it was an open injury. The financial department assessed the cost of each fracture clinic. Results Thirty-six patients included in the first audit compared to 27 in the re-audit, referral rate is 97% and 78%, respectively. All injuries were closed and there was no rotational deformity. Two patients had volar angulation more than 50° in the second sample but none in the first one. All patients were treated with neighbour strapping for one to two weeks and subsequent mobilisation. There were no instances of change of management with attendance at fracture clinic. Sixty percent got discharged in first appointment, compared to 50% after re-auditing. Re-referral rate is 0%. Each fracture clinic costs just over £700. Conclusions Patients with fifth metacarpal neck fractures should be managed in the ED through an agreed pathway, unless they have rotational deformity, are open or angled beyond 50° in which case they should be referred to the fracture clinic or on call orthopaedic team as appropriate. This will not only avoid an unnecessary attendance at fracture clinic, but also provide cost saving.
Reactive and proactive aggression in mainland Chinese secondary school students
Authors: Li Xiang , Fung Annis Lai-chu 
Published: September 2014

Summary As there has been little research in mainland China on the distinction between reactive and proactive aggression, the country’s educators and social workers work with an oversimplified definition of aggression that fails to consider different subtypes, thereby preventing the development of effective interventions. There is a pressing need to learn more about the particular subtypes of reactive and proactive aggression that prevail among mainland Chinese students. Here we report the validation and generalization in China of a well-designed assessment tool, the Reactive-Proactive Aggression Questionnaire (RPQ), which is widely used in the West to measure students’ reactive and proactive aggression. Our twofold objective is to determine 1) whether reactive and proactive aggression can be distinguished; and 2) whether the two-factor structure of the reactive and proactive aggression model is appropriate in a non-Western setting. This is a pioneering study designed to develop a reliable reactive/proactive aggression assessment instrument for the mainland Chinese context. Findings Consistent with the findings of previous validation studies on the RPQ, our findings indicate that reactive and proactive aggression are distinguishable in mainland China, but the factor structure differs slightly from the prior findings. Applications With modification of its factor structure, the RPQ can be considered a valid scale to measure the two dimensions of aggression in mainland China. An understanding of the distinction between them will facilitate effective treatment for aggressive students in this region.