bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial/Ethnic and Socioeconomic Disparities in Hearing Care among Older Americans
Authors: Nieman Carrie L. , Marrone Nicole , Szanton Sarah L. , Thorpe Roland J. , Lin Frank R. 
Published: September 2014

Objectives:Although hearing impairment is prevalent in older adults and may carry implications for cognitive, social, and physical functioning, little is known about hearing care among older minority adults. The aims of this study were: (1) describe factors that are associated with disparities in hearing health care among older adults and (2) assess the current reach of hearing care delivery to older adults.Methods:We analyzed nationally‐representative, cross‐sectional data from 1544 older adults ≥70 years with audiometry and hearing health care data from the 2005‐2006, 2009‐2010 National Health and Nutritional Examination Surveys. The 2 primary outcomes were recent hearing screening (≤4 years) and, for those with hearing loss, regular hearing aid use (≥5 h/wk in the past 12 months). Disparities‐related covariates included demographics, insurance status, general health, and health care utilization.Results:Adjusting for age and better ear speech‐frequency (0.5‐4 kHz), pure tone average (PTA), race (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 1.21‐2.33, Blacks compared with Whites) and education (OR = 1.63, 95% CI: 1.05‐2.52 ≥college versus <high school), were associated with having a recent hearing screening. However, hearing aid use was associated with socioeconomic status (higher education, income, poverty‐to‐income ratios, having private insurance), and with race (Blacks OR = 0.42 [95% CI: 0.19‐0.91] and Mexican Americans OR = 0.22 [95% CI: 0.06‐0.74] versus Whites). In a multivariate analysis, adjusting for age, hearing loss, race/ethnicity, and socioeconomic status, Blacks were not more likely than Whites to use hearing aids despite higher levels of hearing screening (OR = 0.74, 95% CI: 0.28‐1.93).Conclusions:With increasing populations of older minority adults and growing evidence of the detrimental effects of hearing loss, disparities in hearing health care represent critical areas for research and intervention.
RNA‐Seq Analysis of Allele‐Specific Expression in the Mouse Cochlea
Authors: Ho Maria K. L. , Hasin Yehudit , Lusis Aldons J. , Friedman Rick A. 
Published: September 2014

Objectives:Age‐related hearing impairment or presbycusis is one of the most common sensory abnormalities in the world. Mouse models have been widely used in studies of hearing loss to separate genetic and environmental influences. We will describe novel cis‐ and trans‐regulation and dominance patterns in gene expression levels from cochlea of mice.Methods:Next‐generation sequencing (RNA‐Seq) data has been acquired from cochlea of three F1 mouse hybrid strains (n = 4) from parental strains C57BL/6J, DBA/2J, C3H/HeJ.Results:An analysis of allele‐specific expression will be reported and novel transcripts, isoforms, cis and trans‐regulation, long non‐coding RNAs, and dominance patterns will be discussed in relation to known genes.Conclusions:This will help to elucidate mechanisms and better understand the genetic backdrop of age related hearing impairment.
The Tuning Fork Examination: Are You Performing It Correctly?
Authors: Stevens Jayne R. , Pfannenstiel Travis J. 
Published: September 2014

Objectives:The tuning fork remains a useful diagnostic tool in modern otolaryngology practice. Two important variables help describe the sound generated by the tuning fork: frequency and amplitude. We sought to determine whether the manner in which a tuning fork is activated affects its vibrational response.Methods:A Polytec OFV‐5000 single point laser Doppler vibrometer was used to obtain direct velocity measurements after activation of 256 Hz, 512 Hz, and 1024 Hz tuning forks with several striking methods: striking the parietal bone, striking the pisiform bone, striking a wood table, and striking a metal surface. Each method was tested using three separate subjective intensities: softly, medium force, and significant force. Data were analyzed using the Polytec Vibrometer Software to produce a velocity spectrum and measurements of frequency and velocity amplitude.Results:The predominant frequency of motion of all tuning forks was their expected fundamental frequency. Additional nonharmonic frequencies were recorded when striking the 256 Hz and the 512 Hz tuning forks against metal or wood. The aberrant frequencies were of lower intensity relative to the fundamental frequency of the tuning fork.Conclusions:No additional frequencies were seen with activation on the head or pisiform bone or with the 1024 Hz fork using any method. For the 256 Hz and 512 Hz tuning forks, striking a hard surface produced additional and potentially misleading frequencies. As some providers use this test to guide surgical candidacy decisions in stapes surgery, this could have significant impact in clinical decisions.
Unilateral Cochlear Delivery of Virally Mediated Gene Therapy Demonstrates Bilateral Expression in VGLUT3 Knockout Mice
Authors: Kiringoda Ruwan , Akil Omar , Lustig Lawrence R. 
Published: September 2014

Objectives:(1) Examine whether unilateral round window membrane injection of adeno‐associated virus‐1 carrying vesicular glutamate transporter‐3 (AAV1‐VGLUT3) in congenitally deaf VGLUT3 knockout (KO) mice results in bilateral VGLUT3 expression. (2) Quantify hearing recovery in ipsilateral versus contralateral cochleae following VGLUT3 rescue.Methods:Five wild‐type (WT) and 7 VGLUT3 rescued KO mice were used; 2 VGLUT3 KO mice served as deaf controls. Postnatal‐day 1 (P1)‐P3 VGLUT3 KO mice to be rescued underwent left‐ear fixed‐volume round window injection of AAV1‐VGLUT3. On P21‐28, auditory brainstem responses (ABRs) were performed to determine bilateral hearing thresholds. Immunofluorescence was used to count inner hair cells (IHCs) expressing VGLUT3.Results:The 2 VGLUT3 KO mice were completely deaf and showed no IHC expression of VGLUT3. Rescued mice demonstrated VGLUT3 IHC expression in the injected side (85.8 ± 4.6% relative to WT) that was greater than the contralateral side (31.1 ± 22.7% relative to WT; P =. 03). ABR thresholds were 33.1 (±2.7) dB ipsilaterally and 46.0 (±14.1) dB contralaterally (P =. 03).Conclusions:The cochlea represents an attractive target for gene therapy due to its bony compartmentalization, but the extent of transfection outside the cochlea has yet to be fully studied. Our study suggests that hearing restoration and IHC transfection occurs bilaterally after unilateral injection, although contralateral changes are significantly less. This supports a model of extracochlear viral spread via cerebrospinal fluid and perilymph, and has important potential implications for future implementation of cochlear gene therapy. This preliminary study provides the basis for a larger, future project examining cochlear and brain expression following VGLUT3 rescue.
Acute Mastoiditis in the Pneumococcal Conjugate Vaccines Era
Authors: Tamir Sharon‐Ovnat , Roth Yehudah , Dalal Ilan , Goldfarb Abraham , Marom Tal 
Published: September 2014

Objectives:(1) Describe the changing trends in mastoiditis incidence and bacteriology in the pneumococcal conjugate vaccine (PCV) era.Methods:PCV‐7 and PCV‐13 have been gradually implemented in the Israeli national immunization program in 2009 and 2010, respectively. We retrospectively identified children aged 0‐6 years who had middle ear cultures obtained from “severe” acute otitis media (AOM) episodes, defined as AOM requiring tympanocentesis or presenting with spontaneous otorrhea, during the years 2008‐2013. Of those, we identified children with acute mastoiditis. Data were extracted for demographic, clinical and microbial information.Results:Data from 295 eligible AOM episodes reported in 279 children were collected. Of those, 56 children with 57 episodes of acute mastoiditis were identified. Of these 36 were boys (64%) and 37 (66%) were <2 years old. During the pre‐PCV and the PCV introduction period (January 2008‐November 2010), mastoiditis incidence rate was significantly higher than the post‐PCV introduction era (December 2010‐December 2013) incidence, 0.23 versus 0.16/“severe” AOM episode, respectively (P =. 04). Mastoiditis developed despite adequate systemic antibiotic therapy for AOM in 28 (49%) patients. Of the 21 (37%) positive cultures, Streptococcus pneumoniae was the most common bacteria, which was solely isolated in 17 (81%) episodes and in combination of Haemophilus influenzae in 1 (5%) episode. Notably, there were no isolates of S pneumoniae from mastoiditis patients following the first year after PCV‐13 introduction.Conclusions:Mastoiditis incidence complicating “severe” AOM decreased after the introduction of PCVs, which can be directly attributed to their effectiveness in reducing pneumococcal‐related AOM burden and complications.
Consultant Perceptions of Electronic Online Workplace‐Based Assessment Training for Surgical Trainees in the United Kingdom
Authors: Fu Bertram , Hampton Tom , Haarer Francesca , Das Prodip 
Published: September 2014

Objectives:(1) Describe the online electronic Work‐Based Assessments (WBAs) tools (run by Intercollegiate Surgical Curriculum Programme [ISCP]) used by consultant trainers in surgical training in the United Kingdom. (2) Describe the current perceptions and prior training (TrACE‐Training and Assessment in the Clinical Environment) received by consultant trainers of such training tool.Methods:An anonymous electronic survey was circulated to all surgical educational supervisors within a large southeast England university teaching hospital in the period of August‐December 2013.Results:Twenty‐one consultants were identified. Seventeen responded (81%), all using WBAs in ISCP. Only 1 supervisor had heard of TrACE, and 17% had received no formal training in verifying themselves as competent in their assessor role. Thirty‐five percent felt they would like to receive formal ISCP training, with the remainder happy to self‐certify their competency.Conclusions:The GMC specifies that trainers must be competent in the use of WBAs and the ISCP cites a need for systematic accreditation of supervisors. The RCSEng runs TrACE course, which explains roles/responsibilities of a trainer/supervisor with regard to the use of WBAs. Supplementary to the “Training the Trainers” course, it offers a structured forum to discuss recent changes in postgraduate training. We conducted this study to assess awareness/uptake/thought regarding changes in surgical supervision to identify whether the guidelines are being implemented. We recommend increased publicity for this and similar courses providing consultants for this training. The alternative is a more formal adoption of current status quo whereby consultants appointed as supervisors and assessors self‐certify their competency in supervising juniors.
Facial Plastic Surgery in Pediatric Otolaryngology: Outcomes and Satisfaction
Authors: Vincent Richard L. , Pereira Kevin D. , Ambro Bryan T. 
Published: September 2014

Objectives:Highlight the role of facial plastic and reconstructive surgery in the surgical management of pediatric head and neck lesions and assess cosmetic outcomes.Methods:Retrospective case series of 13 pediatric head and neck lesions managed at a tertiary care children's hospital. The charts of all patients were reviewed for clinical presentation, radiologic findings, surgical technique used for excision and reconstruction, preoperative and postoperative photography, pathology and cosmetic outcomes.Results:A total of 13 pediatric patients with ages ranging from 18 months to 12 years had adequate documentation for review. There were 4 naso‐frontal dermoids, 4 head and neck skin lesions, 3 midface/orbital bony lesions, and 2 parotid/facial soft tissue lesions. Six patients were managed by soft tissue advancement flaps, 2 required complex linear closure and 2 had a surgical exposure achieved with cosmetically placed incisions. Two patients needed a midface degloving approach for exposure, one required medial osteotomies and bone pate for reconstruction and 2 were managed with calvarial bone grafts. At last follow‐up cosmetically acceptable outcomes were photographically documented in all 13 patients. This was confirmed by parental satisfaction.Conclusions:The involvement of facial plastic and reconstructive surgery is an important adjunct in the management of pediatric head and neck lesions. It leads to better cosmetic outcomes that can be documented and confirmed by parental satisfaction.
Frequency‐Specific Hearing Outcomes after Use of a Powered Drill in Pediatric Type I Tympanoplasty
Authors: Kent David T. , Chi David H. , Wine Todd M. , Kisto Dennis 
Published: September 2014

Objectives:(1) Describe factors related to frequency‐specific hearing outcomes after type I tympanoplasty in pediatric patients. (2) Describe the effect of powered bone drilling on frequency‐specific hearing outcomes after type I tympanoplasty.Methods:Retrospective medical chart review (February 2006 to October 2011) of 492 consecutive pediatric otolaryngology patients undergoing type I tympanoplasty for tympanic membrane (TM) perforation of any etiology at a tertiary‐care pediatric otolaryngology practice. Data collected included air conduction at 250 to 8000 Hz, speech reception thresholds, bone conduction at 500 to 4000 Hz, and air‐bone gap at 500 to 4000 Hz. Demographic data obtained included sex, age, size, mechanism, location of perforation, and operative repair technique, as well as the use of a powered bone drill during surgery.Results:A downtrend in sensorineural hearing at 2000 and 4000 Hz was noted with the use of a powered drill during surgery, although no significant difference in sensorineural hearing or air‐bone gap was detected at 500, 1000, 2000, or 4000 Hz (P >. 05). No significant change was detected in conductive hearing at 1000, 2000, 4000 Hz, or 8000 Hz (P >. 05). Significant improvement was noted in lower‐frequency conductive hearing at 250 and 500 Hz (P <. 001).Conclusions:No correlation between high‐frequency hearing loss and use of a powered drill during type I tympanoplasty was found in this pediatric population. Surgery was found to significantly improve conductive hearing at 200 and 500 Hz. Based on these results, use of a powered bone drill is not contraindicated during type I tympanoplasty.
Dissolution of Salivary Calculi with Chemolysis and Ultrasound
Authors: Schatton Robert , Kempf Hans‐Georg , Schatton Helmut 
Published: September 2014

Objectives:(1) Investigate whether treatment with an ultrasound probe can reduce the weight of salivary calculi in vitro. (2) Determine the effect of ultrasound application on chemolysis of salivary gland stones with diluted acetic acid.Methods:Ten submandibular calculi (mean weight 159 ± 80.2 mg) were halved. After randomization these halves were each placed in a beaker containing saline solution (0.9%, pH5.3) or diluted acetic acid (0.6%, pH 2.78), respectively. An ultrasound probe (1‐mm diameter, 30 kHz) was dipped into the solution with a tip‐to‐calculi distance of 5mm. Ultrasound was applied in a continuous mode for 3 hours. To determine the extent of dissolution, the calculi were weighed and photographed before and after the treatment.Results:The mean weight reduction of salivary calculi after ultrasound treatment was 2 ± 1.1 mg in isotonic saline solution and 19.1 ± 13.7 mg in diluted acetic acid, respectively. The differences were statistically significant (P <. 005).Conclusions:A weight reduction of salivary calculi can be achieved by ultrasound application in vitro. Ultrasound treatment enhances the effect of chemolitholysis with diluted acetic acid. This could be helpful to diminish the size of salivary calculi within the scope of minimally invasive therapy of sialolithiasis.
National Trends in Pediatric Basilar Skull Fractures
Authors: Capra Gregory G. , Johnson Christopher M. , Wilson Justin D. , Brigger Matthew T. 
Published: September 2014

Objectives:(1) Identify the current public health burden of pediatric temporal bone fractures. (2) Determine if the introduction of bicycle helmet and child safety seat laws has resulted in a change in national patterns.Methods:The 2000 and 2009 Kids’ Inpatient Databases were used to gather data on a sample of all pediatric discharges in the United States during the years 2000 and 2009. Children diagnosed with basilar skull fractures were identified by corresponding ICD‐9 codes. Database analyses generated national estimates of summary statistics and comparison of trends over the 9‐year period.Results:The estimated prevalence of pediatric skull base fractures requiring hospitalization in the United States has remained essentially stable with 9641 (95% confidence interval [CI]: 8782, 10,501) admissions in 2000 and 10,581 (95% CI: 9532, 11,630) in 2009. Likewise, the mean age is unchanged from 10.02 (95% CI: 9.66, 10.38) years to 9.76 (95% CI: 9.44, 10.07). The proportion of female patients is the same (33%) (95% CI: 0.031, 0.34) and (95% CI: 0.0.32, 0.35) respectively. Total charges increased from $25,900,000 (95% CI: $22,200,000, $29,600,000) to $60,300,000 (95% CI: $53,100,000, $67,600,000) with a mean charge per admission increasing from $28,958 (95% CI: $26,302, $31,615) in 2000 to $57,596 (95% CI: $53,134, $62,058) in 2009. The mean length of stay remained stable at 6.04 (95% CI: 5.60, 6.48) to 5.31 (95% CI: 5.00, 5.62) hospital days.Conclusions:The public health impact of pediatric skull base fractures continues to be substantial. Despite the institution of bicycle helmet and child safety seat laws, national trends demonstrate a stable prevalence of hospital admissions, age at admission, sex distribution, and mean hospital stays with an increasing economic burden over the past decade.
Neonatal Tracheostomies: Changing Trends
Authors: Fisher Kelly , Isaiah Amal , Pereira Kevin D. 
Published: September 2014

Objectives:(1) Examine the current trends in neonatal tracheostomies and compare them to historic cohorts. (2) Determine and stratify the current risk factors for failed extubation in the neonatal intensive care unit (NICU).Methods:We conducted a retrospective review of 34 consecutive neonatal tracheostomies performed over a 5‐year period (2008‐2012) in a university‐based tertiary care hospital. Risk factors for failed extubation were identified and analyzed.Results:Sixty‐two percent of the infants had identifiable anatomic causes of airway obstruction, whereas the remaining (38%) had significant isolated pulmonary disease (P <. 05; χ2 test). The vast majority (95%) of the tracheostomies were performed at age ≥30 days (mean = 129d, SD = 101). Within anatomic risk factors, subglottic obstruction represented the largest group (33%). Risk of extubation failure was not systematically related to either birth weight (P =. 3 to. 9; n‐way analysis of variance) or age (P =. 1 to. 5) separately. Within a small group (n = 5) both anatomic causes as well as pulmonary disease were present. No procedure‐related complications were encountered.Conclusions:Neonatal tracheostomies are currently being performed for anatomic airway abnormalities more frequently than primary pulmonary disease as previously documented. It suggests that current respiratory therapies have lowered the burden of chronic lung disease. Even as more low‐birth‐weight neonates are being rescued, the presence of multiple concurrent risk factors did not appear to increase the chances of extubation failure or need for tracheostomy within this population.
Pain Control after Tonsillectomy: A Survey of Membership of the American Society of Pediatric Otolaryngologists
Authors: Jensen Daniel R. , Brown David J. , Thorne Marc C. 
Published: September 2014

Objectives:(1) Describe current prescribing practices and opinions of membership of the American Society of Pediatric Otolaryngologists (ASPO) regarding analgesia after pediatric adenotonsillectomy. (2) Understand prevailing opinions about opioids and nonsteroidal anti‐inflammatory drugs (NSAIDs) that influence medication selection in this setting.Methods:Pain management after pediatric adenotonsillectomy is controversial. We conducted a web‐based survey of ASPO membership to understand current post‐adenotonsillectomy prescribing practices, with emphasis on attitudes regarding opioids and NSAIDs.Results:A total of 110 responses were received. Seventy‐eight percent of respondents indicated that they sometimes or always prescribe an opioid as first line analgesic. A majority (74%) indicated they frequently prescribe NSAIDs, while 11% indicated they avoid them entirely. A total of 76% agreed or strongly agreed that opioids increase risk of respiratory events after tonsillectomy, versus 19% in regard to NSAIDs increasing risk of post‐tonsillectomy hemorrhage. More than 10 years in practice was associated with increased concern that NSAIDs increase bleeding risk (24% vs 4%, P =. 018), but was not associated with increased concerns about opioid‐related respiratory suppression. A slight majority (54%) indicated they believed NSAIDs to be either equally or more effective than opioids at controlling pain. Additional areas of inquiry included preferred medications, factors influencing medication choice, respondent confidence in their regimen, and influence of Food and Drug Administration warning on codeine use.Conclusions:Significant heterogeneity exists among pediatric otolaryngologists regarding optimal pain management after adenotonsillectomy. Most respondents indicated they frequently prescribe opioids, though most expressed concern about respiratory suppression. We also found broad support for NSAID use among respondents, with comparatively few expressing concern regarding bleeding risk.
Preliminary Study on the Application of Upper‐Airway Model Construction with 3DMIA in OSAHS of Children
Authors: Chao Cheng , Dabo Liu 
Published: September 2014

Objectives:Investigate the applicability of 3DMIA software to upper airway modeling in children with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods:A total of 12 children diagnosed with OSAHS by polysomnography were included in this study. Data regarding upper airway structure were collected via spiral computed tomography (CT) while sleeping and awake, from which a 3‐dimensional model of the upper respiratory tract from the nasopharynx to the supraglottic region using 3DMIA software was constructed. The upper airway volume and airway minimum cross‐sectional area were measured employing software algorithms.Results:The upper airway volume and airway minimum cross‐sectional area of the 12 children during sleep were significantly less than while awake (P <. 01).Conclusions:3DMIA software modeling and software algorithm measurement were more objective than traditional radiology with respect to evaluation of the extent of the upper airway narrowing in OSAHS children, and showed good applicability to studying upper airway morphology and function in children with OSAHS.