bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Inter-Phase Gap Offset Effect as a Measure of Neural Health in Cochlear Implant Users With Residual Acoustic Hearing
Authors: Sijgers Leanne , Röösli Christof , Bertschinger Rahel , Epprecht Lorenz , Veraguth Dorothe , Dalbert Adrian , Huber Alexander , Pfiffner Flurin 
Published: July 2024

Objectives:
The inter-phase gap (IPG) offset effect is defined as the dB offset between the linear parts of electrically evoked compound action potential (ECAP) amplitude growth functions for two stimuli differing only in IPG. The method was recently suggested to represent neural health in cochlear implant (CI) users while being unaffected by CI electrode impedances. Hereby, a larger IPG offset effect should reflect better neural health. The aims of the present study were to (1) examine whether the IPG offset effect negatively correlates with the ECAP threshold and the preoperative pure-tone average (PTA) in CI recipients with residual acoustic hearing and (2) investigate the dependency of the IPG offset effect on hair cell survival and intracochlear electrode impedances.

Design:
Seventeen adult study participants with residual acoustic hearing at 500 Hz undergoing CI surgery at the University Hospital of Zurich were prospectively enrolled. ECAP thresholds, IPG offset effects, electrocochleography (ECochG) responses to 500 Hz tone bursts, and monopolar electrical impedances were obtained at an apical, middle, and basal electrode set during and between 4 and 12 weeks after CI surgery. Pure-tone audiometry was conducted within 3 weeks before surgery and approximately 6 weeks after surgery. Linear mixed regression analyses and t tests were performed to assess relationships between (changes in) ECAP threshold, IPG offset, impedance, PTA, and ECochG amplitude.

Results:
The IPG offset effect positively correlated with the ECAP threshold in intraoperative recordings (p < 0.001) and did not significantly correlate with the preoperative PTA (p = 0.999). The IPG offset showed a postoperative decrease for electrode sets that showed an ECochG amplitude drop. This IPG offset decrease was significantly larger than for electrode sets that showed no ECochG amplitude decrease, t(17) = 2.76, p = 0.014. Linear mixed regression analysis showed no systematic effect of electrode impedance changes on the IPG offset effect (p = 0.263) but suggested a participant-dependent effect of electrode impedance on IPG offset.

Conclusions:
The present study results did not reveal the expected relationships between the IPG offset effect and ECAP threshold values or between the IPG offset effect and preoperative acoustic hearing. Changes in electrode impedance did not exhibit a direct impact on the IPG offset effect, although this impact might be individualized among CI recipients. Overall, our findings suggest that the interpretation and application of the IPG offset effect in clinical settings should be approached with caution considering its complex relationships with other cochlear and neural health metrics.
The Dangers of Distracted Driving: A Substudy of Patient Perception Data From the DRIVSAFE Observational Study
Authors:   The DRIVSAFE Team
Published: July 2024

OBJECTIVE:
To determine how fracture clinic patients perceive the dangers of distracted driving.

METHODS:

Design:
Analysis of patient perception subset data from the original DRIVSAFE study; a large, multicenter cross-sectional study, surveying fracture clinic patients about distracted driving.

Setting:
Four Level 1 Canadian trauma center fracture clinics.

Patient Selection Criteria:
English-speaking patients with a valid Canadian driver's license and a traumatic musculoskeletal injury sustained in the past 6 months.

Outcome Measures and Comparisons:
Primary outcome was patients' safety ratings of driving distractions. As per the original DRIVSAFE study, patients were categorized as distraction-prone or distraction-averse using their questionnaire responses and published crash-risk odds ratios (ORs). A regression analysis was performed to identify associations with unsafe driving perceptions.

RESULTS:
The study included 1378 patients, 749 (54.3%) male and 614 (44.6%) female. The average age was 45.8 ± 17.0 years (range 16–87). Sending electronic messages was perceived as unsafe by 92.9% (1242/1337) of patients, while reading them was seen as unsafe by 81.2% (1086/1337). Approximately three-quarters of patients viewed making (78.9%, 1061/1344) and accepting (74.8%, 998/1335) calls on handheld mobile phones as unsafe. However, 31.0% (421/1356) of patients believed that they had no differences in their driving ability when talking on the phone while 13.1% (175/1340) reported no driving differences when texting. Younger age (OR, 0.93 [95% confidence interval (CI) 0.90–0.96], P < 0.001), driving experience (OR, 1.06 [95% CI 1.02–1.09], P < 0.001), and distraction-prone drivers (OR, 3.79 [95% CI 2.91–4.94], P < 0.001) were associated with unsafe driving perceptions.

CONCLUSIONS:
There is a clear association between being prone to distractions and unsafe driving perceptions, with distraction-prone drivers being 3.8 times more likely to perceive driving distractions as safe. This information could potentially influence the appropriate delivery and content of future educational efforts to change the perception of driving distractions and thereby reduce distracted driving.

LEVEL OF EVIDENCE:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Exposure to Ambient Heat and Risk of Spontaneous Abortion: A Case–Crossover Study
Authors: Wesselink Amelia K. , Gause Emma L. , Spangler Keith D. , Hystad Perry , Kirwa Kipruto , Willis Mary D. , Wellenius Gregory A. , Wise Lauren A. 
Published: July 2024

Background:
Few epidemiologic studies have examined the association of ambient heat with spontaneous abortion, a common and devastating pregnancy outcome.

Methods:
We conducted a case–crossover study nested within Pregnancy Study Online, a preconception cohort study (2013–2022). We included all participants reporting spontaneous abortion (N = 1,524). We defined the case window as the 7 days preceding the event and used time-stratified referent selection to select control windows matched on calendar month and day of week. Within each 7-day case and control window, we measured the mean, maximum, and minimum of daily maximum outdoor air temperatures. We fit splines to examine nonlinear relationships across the entire year and conditional logistic regression to estimate odds ratios (ORs) and 95% confidence interval (CI) of spontaneous abortion with increases in temperature during the warm season (May–September) and decreases during the cool season (November–March).

Results:
We found evidence of a U-shaped association between outdoor air temperature and spontaneous abortion risk based on year-round data. When restricting to warm season events (n = 657), the OR for a 10-percentile increase in the mean of lag 0–6 daily maximum temperatures was 1.1 (95% CI: 0.96, 1.2) and, for the maximum, 1.1 (95% CI: 0.99, 1.2). The OR associated with any extreme heat days (>95th county-specific percentile) in the preceding week was 1.2 (95% CI: 0.95, 1.5). Among cool season events (n = 615), there was no appreciable association between lower temperatures and spontaneous abortion risk.

Conclusion:
Our study provides evidence of an association between high outdoor temperatures and the incidence of spontaneous abortion.
A Counterfactual Analysis of Impact of Cesarean Birth in a First Birth on Severe Maternal Morbidity in the Subsequent Birth
Authors: Bane Shalmali , Snowden Jonathan M. , Simard Julia F. , Odden Michelle , Kan Peiyi , Main Elliott K. , Carmichael Suzan L. 
Published: July 2024

Background:
It is known that cesarean birth affects maternal outcomes in subsequent pregnancies, but specific effect estimates are lacking. We sought to quantify the effect of cesarean birth reduction among nulliparous, term, singleton, vertex (NTSV) births (i.e., preventable cesarean births) on severe maternal morbidity (SMM) in the second birth.

Methods:
We examined birth certificates linked with maternal hospitalization data (2007–2019) from California for NTSV births with a second birth (N = 779,382). The exposure was cesarean delivery in the first birth and the outcome was SMM in the second birth. We used adjusted Poisson regression models to calculate risk ratios and population attributable fraction for SMM in the second birth and conducted a counterfactual impact analysis to estimate how lowering NTSV cesarean births could reduce SMM in the second birth.

Results:
The adjusted risk ratio for SMM in the second birth given a prior cesarean birth was 1.7 (95% confidence interval: 1.5, 1.9); 15.5% (95% confidence interval: 15.3%, 15.7%) of this SMM may be attributable to prior cesarean birth. In a counterfactual analysis where 12% of the California population was least likely to get a cesarean birth instead delivered vaginally, we observed 174 fewer SMM events in a population of individuals with a low-risk first birth and subsequent birth.

Conclusion:
In our counterfactual analysis, lowering primary cesarean birth among an NTSV population was associated with fewer downstream SMM events in subsequent births and overall. Additionally, our findings reflect the importance of considering the cumulative accrual of risks across the reproductive life course.
Synthetic Simulators for Microsurgery Training: A Systematic Review
Authors: Sapino Gianluca , Gonvers Stephanie , Cherubino Mario , Ballestín Alberto , di Summa Pietro Giovanni 
Published: July 2024

Background:
Microsurgery has a steep learning curve. Synthetic simulators have proven to be useful training tools for the initial learning stages, as well as being ethically sound, viable, safe, and cost-effective. The objective of this review was to determine the quality, effectiveness, and validity of these simulators as well as to assess their ability to evaluate microsurgical skills.

Methods:
A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. We searched databases (Web of Science, Scopus, and PubMed) to identify original articles describing synthetic training models for microsurgery. Three reviewers evaluated articles for inclusion following predefined selection criteria. Data were extracted from full-texts of included articles.

Results:
Thirty-nine studies met the inclusion criteria. A total of 38 different devices have been recorded. Microsurgical training devices offer a low-cost, fast, and consistent method to concretely quantify and assess the initial microsurgical skills of trainees using standardized exercises that can be scored by the examiner. According to the authors, the outcomes were satisfactory, with a tangible improvement in microsurgical abilities, despite the lack of a common comparison scale.

Conclusions:
Thanks to their availability, cost, and effectiveness, synthetic models are the recommended option to train basic, intermediate and advanced procedures before executing them on in vivo models.
COMPLEX MACULAR HOLE CLOSURE BY TEMPORAL INTERNAL LIMITING MEMBRANE FLAP WITHOUT ENDOTAMPONADE
Authors: Szeto Simon K. H. , Yu Amy H. Y. , Tsang Chi Wai , Mohamed Shaheeda , Chen Li Jia , Lai Timothy Y. Y. 
Published: July 2024

Purpose:
To evaluate the safety, efficacy, and imaging features of a novel surgical technique without endotamponade in repairing complex macular hole (MH).

Methods:
Retrospective review of consecutive cases with complex MH underwent pars plana vitrectomy with temporal internal limiting membrane flap, which was stabilized using perfluorocarbon liquid and viscoelastics. At the conclusion of surgery, perfluorocarbon liquid was removed, and no endotamponade agent would be used. Complex MH was defined as a basal linear diameter of ≥400 µm and/or associated with high myopia. Visual acuity, pattern of MH closure on optical coherence tomography, formation of epiretinal membrane, and operative complications were reported.

Results:
Twenty-four eyes were included, and the mean basal linear diameter was 988.3 µm. MH closure was achieved in 24 (100%), of which, 8 (33%) achieved type 1A closure. The mean postoperative logarithm of the minimum angle of resolution visual acuity improved from 0.93 at baseline to 0.74, 0.51, 0.55, and 0.52 at 1-month, 3-month, 6-month, and last follow-up, respectively. Foveal gliosis was observed in 3 eyes (12.5%), and 10 (41.7%) developed nasal epiretinal membrane. One eye developed vitreous hemorrhage, which resolved spontaneously.

Conclusion:
This novel surgical technique that requires no endotamponade is effective in achieving complex MH closure. A substantial proportion of patients developed epiretinal membrane, and its clinical significance requires further investigation.
Clinical Characteristics of Four Cases of Presumed Chloroquine Retinopathy
Authors: Hall Brian P. , Thomas Joanne , Yan Jiong , Jain Nieraj 
Published: July 2024

Background:
Chloroquine (CQ), primarily used in the management of malaria and autoimmune diseases, has long been known to cause retinal toxicity. However, modern literature with multimodal fundus imaging findings remains limited. This retrospective study explores presumed CQ retinopathy cases at a tertiary United States referral center with an emphasis on multimodal fundus imaging characteristics.

Methods:
Retrospective series of cases of presumed CQ toxicity seen at the Emory Eye Center between 2015-2022.

Results:
Four males were identified with presumed CQ retinopathy, with median age of 57 years (range 50-59 years). CQ use occurred in malaria-endemic regions in each case, and the medication was self-administered in three cases. Optical coherence tomography consistently revealed outer band loss and varying degrees of foveal sparing. Fundus autofluorescence imaging demonstrated symmetric bull’s eye pattern of AF abnormality with hyperautofluorescence along the rim of diseased tissue. One case exhibited para-vascular hyperautofluorescence in the setting of repeated intravenous CQ exposure.

Discussion:
Multimodal retinal imaging revealed distinct yet diverse patterns of degeneration not readily visible on clinical examination. More generally, these findings raise public health concerns regarding self-administration of CQ in malaria-endemic regions.
How is age at menopause and reproductive lifespan associated with chronic pain outcomes in postmenopausal women?
Authors: Lund Charlotte Indre , Rosseland Leiv Arne , Steingrímsdóttir Ólöf Anna , Engdahl Bo Lars , Stubhaug Audun , Furberg Anne-Sofie , Nielsen Christopher Sivert 
Published: July 2024

Abstract
Female sex is a prominent risk factor for chronic pain, although the underlying mechanisms are not fully understood. This cross-sectional study aimed to investigate the relationship between age at menopause, reproductive lifespan, and chronic pain in a sample of postmenopausal women aged 40 to 93 years. Data were collected from the Tromsø study conducted in Norway between 2015 and 2016 (Tromsø7). Chronic pain was assessed using a single question, which formed a sample size of 5741 participants. Chronic widespread pain was evaluated using the more comprehensive Graphical Index of Pain, resulting in a sample size of 5920 women. Premenopausal women and those who experienced menstrual cessation due to chemotherapy/radiation or hormonal intrauterine devices were excluded from the analysis. Adjusted relative risk ratios with 95% confidence intervals were calculated to determine associations. The results showed that early menopause was associated with a 1% increase in the prevalence of chronic pain for each year of earlier onset at menopause (0.992, CI 95% 0.985-0.998). This association was also observed in women who experienced natural menopause only. However, the association between menopause and chronic widespread pain did not reach statistical significance in the fully adjusted analysis (0.996, CI 95% 0.975-1.017). There were no significant associations found between reproductive lifespan and either outcome. In conclusion, the findings suggest that early menopause in postmenopausal women is linked to a higher prevalence of chronic pain. However, reproductive lifespan does not appear to have a significant impact on chronic pain or chronic widespread pain.
Effects of nonimmersive virtual reality using Wii-Fit exercises on balance and cognition in Parkinson disease: A meta-analysis
Authors: Hussain Fouzia , Farooqui Sumaira , Khan Amna Aamir , Khan Muhammad Usman , Khan Muhammad Abid , Hasan Ahad 
Published: July 2024

Background:
Patients’ compliance and receptivity to nonimmersive virtual reality (NIVR) can enhance their long-term exercise therapy compliance for neurological illnesses. Patients with Parkinson disease (PD) have age-standardized rates of disability, death, and prevalence that are rising the fastest; several researches have revealed that there is no known cure for PD at this time. Thus, the current study investigates how NIVR affects patients with PD using Wii-Fit exercises. Therefore, the present study investigates the effects of NIVR using Wii-Fit exercises among patients with PD.

Materials and Methods:
The population, intervention, comparison, outcome approach was used to select the research studies. Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, PubMed, Physiotherapy Evidence Database, and ProQuest were checked for citations from 2012 to 2022. RevMan was used to analyze data. A fixed and random effects model was used to analyze the pooled effect size in terms of mean and standard deviation. The heterogeneity was calculated using the I2 statistic. Cochrane examined for bias in randomized controlled trials.

Results:
This review comprised 12 trials in total. Using the Berg Balance Scale, the pooled analysis showed statistically significant effects on the NIVR group (pooled standardized mean difference = 0.61 [95% confidence interval, 0.28–0.95]; I2 = 53%; P = .0003). The pooled effects of cognition showed nonsignificant effects of NIVR (pooled standardized mean difference = 0.15 [95% confidence interval, −0.21 to 0.51]; I2 = 0%; P = .41).

Conclusions:
The review suggests that NIVR is effective for balance rehabilitation but ineffective for cognitive improvement in patients with PD aged >18 to 85 years.
Women`s sexual function during the postpartum period: A systematic review on measurement tools
Authors: Rezaei Nazanin , Behboodi Moghadam Zahra , Tahmasebi Atbin , Taheri Safoura , Namazi Masoumeh 
Published: July 2024

Background:Sexual health is a critical component of overall well-being, yet discussions around sexual function, especially in the context of postpartum recovery, are often taboo or sidelined. The aim was to review measurement tools assessing women’s sexual function/health during the postpartum period.Methods:We did a systematic search according to preferred reporting items for systematic reviews and meta-analyses 2020 guidelines in different databases, including PubMed, Web of Science, Scopus, Embase, ProQuest and Open Access Thesis and Dissertations, and Google scholar search engine until June 2023. Also, the reference list of the related reviews has been screened. Eligible studies included observational studies or clinical trials that evaluated women`s sexual function during the postpartum period using existing tools. Data extraction covered study characteristics, measurement tools, and their validity and reliability.Results:From 3064 retrieved records, after removing duplicates and excluding ineligible studies, and reviewing the reference list of the related reviews, 41 studies were included in this review. Tools measuring sexual function were developed from 1996 to 2017. Sexual activity questionnaire, female sexual function index (FSFI), sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, and sexual function questionnaire’s medical impact scale and Carol scale.Conclusion:Sexual activity questionnaire, FSFI, sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, sexual function questionnaire’s medical impact scale, and Carol scale are valid and reliable measuring tools to assess sexual function or sexual health during postpartum period, which can be used in primary studies according to the study aim and objectives.
Concomitant rapidly growing aneurysm of intracavernous carotid artery and cavernous sinus thrombosis: Case report and review of the literature
Authors: Shen Yaoyao , Hu Fan , Wu Lingfeng , Nie Hongbing 
Published: July 2024

Rationale:
Intracavernous infectious aneurysm (ICIA), represents a rare entity that is always described in the form of case reports in the literature. The coexistence of ICIA and cavernous sinus thrombosis (CST) is extremely rare and poorly understood.

Patient concerns:
A 53-year-old female patient presented to our hospital with headache, nausea and fatigue for 3 weeks. She complained of blurry vision and drooping eyelids before admission. Neurological examination revealed bilateral decreased visual acuity, limitation of extraocular movements and decreased sensation of forehead. Brain magnetic resonance imaging (MRI) showed mixed signal intensities in both cavernous sinuses and expansion of right superior ophthalmic vein, suggesting the formation of CST. One month later, computed tomography angiography (CTA) confirmed a large aneurysm was attached to the left intracavernous carotid artery (ICCA).

Diagnoese:
This patient was diagnosed with ICIA and CST.

Interventions:
She was administered with intravenous meropenem and vancomycin and subcutaneous injection of low molecular heparin for 4 weeks.

Outcomes:
One month later, her extraocular movement had significantly improved, without ptosis and conjunctival congestion. At 1-year follow-up, her ophthalmoplegia fully recovered. Fortunately, such large aneurysm did not rupture in spite of slight broadening.

Lessons:
The coexistence of ICIA and CST is extremely rare. Contiguous infection from adjacent tissues is the foremost cause of ICIA. A repeated angiographic examination is recommended under enough anti-infective treatment due to the characteristics of rapid emergence and fast growth of infectious aneurysms.