bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathophysiology of Facial Nerve Stimulation and Its Implications for Electrical Stimulation in Cochlear Implants
Authors: Saoji Aniket A. , DeJong Melissa D. , Bertsch Natasha J. , Graham Madison K. , Goulson Kayla R. , Wernsman Pease Megan L. , Gruenwald Jill M. , Bross Abigail E. , Dornhoffer James R. , Neff Brian A. , Driscoll Colin L. W. , Carlson Matthew L. , Lane John I. , Pesch Joerg , Vanpoucke Filiep J. 
Published: January 2024

Objectives
A small number of cochlear implant (CI) users experience facial nerve stimulation (FNS), which can manifest as facial twitching. In some patients, this can be resolved by adjusting the electrical stimulation parameters. However, for others, facial stimulation can significantly impair CI outcomes or even prevent its use. The exact mechanisms underlying FNS are unclear and may vary among patients.

Design
Transimpedance measurements were used to assess lateral and longitudinal spread of current within 15 cochlea of nucleus CI recipients with FNS (13 unilateral recipients and 1 bilateral recipient). We compared the transimpedance measurements with programming parameters from clinical visits and pre- and postoperative temporal bone computed tomography (CT) scans to identify factors that may contribute to FNS in each CI ear.

Results
In nine ears, transimpedance curves showed inflection, which suggests a localized current sink within the cochlea. This indicates a low-impedance pathway through which current exits the cochlea and stimulates the labyrinthine segment of the facial nerve canal. Electrodes near this current sink were disabled or underfit to minimize facial stimulation. In the other seven ears, current flow peaked toward the basal end of the cochlea, suggesting that current exits through the round window or other structures near the basal end of the cochlea, stimulating the tympanic segment of the facial nerve.

Conclusions
Objective transimpedance measurements can be used to elucidate the mechanisms of FNS and to develop strategies for optimizing electrical stimulation parameters and speech coding to minimize or eliminate FNS in a small subset of CI users.
Assessment of Central Auditory Processing in Children Using a Novel Tablet-Based Platform: Application for Low- and Middle-Income Countries
Authors: Lee Torri , Rieke Catherine , Niemczak Christopher , Kobrina Anastasiya , Clavier Odile , Gonzalez Julian , Fuente Adrian , Alvarez Karen Mojica , Gonzalez-Quiroz Marvin , Buckey Jay , Saunders James 
Published: January 2024

Objective
Evaluate whether a portable, tablet-based central auditory processing (CAP) test system using native language training videos and administered by minimally trained community health workers can produce CAP results comparable to previously published norms. Our secondary aim was to determine subject parameters that influence test results.

Study Design
Cross-sectional study.

Setting
Community-based settings in Chontales, Nicaragua, New Hampshire, and Florida.

Patients
English- and/or Spanish-speaking children and adolescents (n = 245; average age, 12.20 yr; range, 6–18 yr)

Main Outcome Measures
Completion of the following tests with responses comparable to published norms: Pure-tone average (PTA), gap detection threshold (GDT), fixed-level frequency threshold, masking level difference (MLD), Hearing in Noise Test (HINT), Dichotic Digits Test (DDT), and Frequency Pattern Recognition (FPR) test.

Results
GDT, HINT, and DDT had comparable results to previously published normative values. MLD and FPR results differed compared with previously published normative values. Most CAP tests (MLD, GDT, HINT) results were independent of age and PTA (p = 0.1–0.9). However, DDT was associated with age and PTA (p < 0.0001)

Conclusions
Pediatric CAP testing can be successfully completed in remote low- and middle- income country environments using a tablet-based platform without the presence of an audiologist. Performance on DDT improved with age but deteriorated with hearing loss. Further investigation is warranted to assess the variability of FPR.
Speech Understanding and Subjective Listening Effort in Noise With Different OTEs and Sound Processing Technologies
Authors: Wesarg Thomas , Wiebe Konstantin , Galindo Guerreros Julio Cesar , Arndt Susan , Aschendorff Antje , Voß Bettina 
Published: January 2024

Objective
To determine speech reception thresholds (SRTs) in noise and subjective listening effort (LE) in cochlear implant (CI) recipients for application of three sound processing (SP) technologies with two off-the-ear (OTE) CI sound processors, a fixed moderately directional microphone (Standard), an adaptive directional microphone (Beam), and the spatial noise-reduction setting ForwardFocus, with the Kanso 2 (OTE2), and Beam with the Kanso (OTE1).

Study Design
Prospective repeated measures, within-subject design.

Setting
Single tertiary-referral center.

Patients
Twenty CI recipients with bilateral severe-to-profound sensorineural hearing loss.

Main Outcome Measures
SRTs were assessed in two spatial configurations with frontal speech and noise from 90–180–270 degrees (S0N90–180–270) or from the CI side (S0NCI). SRTs were obtained for sentences of the Oldenburg sentence test presented in International Collegium of Rehabilitative Audiology (ICRA) noise ICRA5-250. LE for speech understanding in noise was evaluated in S0N90–180–270 and assessed in effort scale categorical units (ESCUs) by using Adaptive Categorical Listening Effort Scaling (ACALES). LEs at 5-dB signal-to-noise ratio (SNR) were calculated from fitted psychometric curves.

Results
With OTE2 in S0N90–180–270, SRT with ForwardFocus (−4.28 dB SNR) was better than with Beam (−3.13 dB SNR) and Standard (0.43 dB SNR). ForwardFocus showed lower LE5dB (2.61 ESCU) compared with Beam (4.60 ESCU) and Standard (5.32 ESCU). In a comparison of both OTEs in S0N90–180–270 regarding best-performing SP technology, ForwardFocus with OTE2 yielded a better SRT and better LE5dB than Beam with OTE1 (SRT: −1.70 dB SNR; LE5dB: 4.00 ESCU). With OTE2 in S0NCI, SRT was improved with ForwardFocus (−2.78 dB SNR) compared with Beam (−1.23 dB SNR) and Standard (1.83 dB SNR).

Conclusion
With respect to SP technology and OTE, CI recipients experience best SRT and lowest LE in S0N90–180–270 when using ForwardFocus with OTE2. ACALES is feasible for assessing subjective LE in CI recipients.
Clearing the air: a review of the effects of air pollution on dialysis outcomes
Authors: Spencer Annika , Lavenburg Linda-Marie , Sanders Alison P. , Shah Ankur D. 
Published: January 2024

Purpose of review
An evolving body of literature indicates exposure to air pollutants is associated with adverse health outcomes in dialysis patients. As the prevalence of kidney disease increases, understanding the role of environmental agents on the health of dialysis patients is critical to reducing global morbidity and mortality.

Recent findings
We identified 16 publications that investigated associations between pollutants including particulate matter (PM2.5 and PM10), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) and health outcomes among dialysis patients. Eight studies examined the effects of particulate matter (PM) and four studies examined the effects CO exposure on dialysis patients. Exposure to PM was consistently associated with outcomes including all-cause mortality and a smaller body of literature suggested relationships with subclinical outcomes. Exposure to CO was associated with all-cause mortality, generalized inflammation, and uremic pruritus. An additional four studies examined multiple pollutant exposures including NO2, SO2, and O3 and reported associations with all-cause mortality in dialysis patients.

Summary
This review emphasized the nascent literature that demonstrates consistent relationships between air pollutant exposure and adverse outcomes among dialysis patients. Further research is needed to assess the impact of air pollutants, including how co-exposures will impact dialysis patient health.
Implementing a Clinical Decision Support Tool to Improve Physical Activity
Authors: McCarthy Margaret M. , Szerencsy Adam , Taza-Rocano Leslie , Hopkins Stephanie , Mann Devin , D’Eramo Melkus Gail , Vorderstrasse Allison , Katz Stuart D. 
Published: January 2024

Background
Currently, only about half of U.S. adults achieve current physical activity guidelines. Routine physical activity is not regularly assessed, nor are patients routinely counseled by their healthcare provider on achieving recommended levels. The three-question physical activity vital sign (PAVS) was developed to assess physical activity duration and intensity and identify adults not meeting physical activity guidelines. Clinical decision support provided via a best practice advisory in an electronic health record (EHR) system can be triggered as a prompt, reminding healthcare providers to implement the best practice intervention when appropriate. Remote patient monitoring of physical activity can provide objective data in the EHR.

Objectives
This study aimed to evaluate the feasibility and clinical utility of embedding the PAVS and a triggered best practice advisor into the EHR in an ambulatory preventive cardiology practice setting to alert providers to patients reporting low physical activity and prompt healthcare providers to counsel these patients as needed.

Methods
Three components based in the EHR were integrated for the purpose of this study: Patients completed the PAVS through their electronic patient portal prior to an office visit, a best practice advisory was created to prompt providers to counsel patients who reported low levels of physical activity, and remote patient monitoring via Fitbit synced to the EHR provided objective physical activity data. The intervention was pilot-tested in the Epic EHR for 1 year (July 1, 2021 to June 30, 2022). Qualitative feedback on the intervention from both providers and patients was obtained at the completion of the study.

Results
Monthly assessments of the use of the PAVS and best practice advisory and remote patient monitoring were completed. Patients’ completion of the PAVS varied from 35% to 48% per month. The best practice advisory was signed by providers between 2% and 65% and was acknowledged by 2%–22% per month. The majority (58%) of patients were able to sync a Fitbit device to their EHR for remote monitoring.

Discussion
Although uptake of each component needs improvement, this pilot demonstrated the feasibility of incorporating a physical activity promotion intervention into the EHR. Qualitative feedback provided guidance for future implementation.
Safety and real-world dosing of onabotulinumtoxinA for the treatment of adult spasticity: post hoc analysis of the Adult Spasticity International Registry study
Authors: Bavikatte Ganesh , Esquenazi Alberto , Dimyan Michael A. , Dashtipour Khashayar , Feng Wuwei , Mayadev Angeli , Fanning Kristina , Musacchio Tiziana , Zuzek Aleksej , Francisco Gerard E. 
Published: January 2024

Abstract

Objective
To evaluate the safety of onabotulinumtoxinA treatment for spasticity across dose ranges in real-world practice.

Design
Adult Spasticity International Registry (ASPIRE) was a multicenter, prospective, observational study (NCT01930786) of onabotulinumtoxinA treatment for adult spasticity over 2 years. Adverse events (AEs), serious AEs (SAEs), treatment-related AEs (TRAEs), and TRSAEs were sorted into 5 categories (≤200 U, 201-400 U, 401-600 U, 601-800 U, ≥801 U) based on cumulative dose per session.

Results
In 3103 treatment sessions (T), 730 patients received ≥1 dose of onabotulinumtoxinA. Dose categories included: ≤200 U (n = 312; t = 811), 201-400 U (n = 446, t = 1366), 401-600 U (n = 244, t = 716), 601-800 U (n = 69, t = 149), ≥801 U (n = 29, t = 61). Of these patients, 261 reported 827 AEs, 94 reported 195 SAEs, 20 reported 23 TRAEs, and 2 patients treated with 201-400 U onabotulinumtoxinA reported 3 TRSAEs. TRAEs reported: ≤200 U (8 TRAEs/811, 0.9%); 201-400 U (7/1366, 0.5%); 401-600 U (6/716, 0.8%); 601-800 U (1/149, 0.7%); ≥801 U (1/61, 1.6%).

Conclusions
In this post hoc analysis, most treatment sessions were performed with 201-400 U onabotulinumtoxinA. Patients treated with 201-400 U onabotulinumtoxinA had an AE profile consistent with onabotulinumtoxinA package inserts globally (eg, United States, European Union, United Kingdom, Canada). No new safety signals were identified.
Influence of verbal instruction on gait training in Parkinson’s disease: a randomized controlled trial
Authors: Li Ming-Hao , Tai Chun-Hwei , Luh Jer-Junn , Chen Yu-Jen , Hsu Wei-Li , Lee Ya-Yun 
Published: January 2024

Abstract

Objective
Verbal instruction is one of the most commonly used methods that therapists use to correct walking pattern for people with Parkinson’s disease (PD). This study aimed to compare the long-term training effects of two different verbal instructions that either asked the participants to ‘take big steps’ or ‘strike the ground with the heel’ on walking ability in individuals with PD.

Design
Forty-five participants with PD were randomized into the big-step (BIG) or heel strike (HS) group. The participants underwent 12 sessions of treadmill and overground gait training. Throughout the interventions, the BIG group received an instruction to ‘take big steps,’ while the HS group received an instruction to ‘strike the ground with your heel.’ The primary outcome was gait performance, including velocity, stride length, cadence, and heel strike angle. The participants were assessed before, immediately after, and 1-month after training.

Results
Both groups showed significant improvements in gait performance after training. The HS group showed continuous improvements in velocity and stride length during the follow-up period; however, the BIG group showed slightly decreased performance.

Conclusion
A verbal instruction emphasizing heel strike can facilitate long-term retention of walking performance in people with PD.
Transition From Pediatric to Adult Rheumatology Care
Authors: Borgia R. Ezequiel , De Cunto Carmen L. , Terreri Maria Teresa , Guerini L. Lorena , Espada Graciela 
Published: January 2024

Background/Purpose
Adequate transition from pediatric to adult care is associated with better adherence to treatment and better outcomes in pediatric patients with chronic diseases. There are little data on transition programs, outcomes, use of transition guidelines, and available tools in pediatric rheumatology centers from Latin America (LATAM). In this study, we described the characteristics of transition programs from 3 pediatric rheumatology centers. We also introduced results of the first survey examining the transition experience in countries from LATAM.

Methods
The experience and implementation process of transition programs from 3 pediatric rheumatology centers are described. A survey based on a questionnaire created by Chira et al (J Rheumatol. 2014;41:768–779) from the Childhood Arthritis and Rheumatology Research Alliance was also administrated to pediatric rheumatology centers from LATAM.

Results
A total of 49 (68%) pediatric rheumatologists answered the survey. Most centers do not have an official and written transition program and reported a need for more tools and resources in their services to facilitate the transition experience.

Conclusions
Transition guidelines culturally tailored to developing countries are needed in LATAM.
Frail Patients Undergoing Optimization Before Surgery: Preliminary Results
Authors: Hui Lauren T , St Pierre Diane , Miller Richard S 
Published: January 2024

BACKGROUND:
It is estimated that 10% or more of patients older than 65 years are affected by frailty, a mental and physical state of vulnerability to adverse surgical outcomes. Frailty can be assessed using the Edmonton Frailty Scale: a reliable and convenient multidimensional assessment before surgery. The correlation between frailty score, presurgical optimization, and surgical outcomes was investigated in this preliminary pilot study.

STUDY DESIGN:
A retrospective study was performed on patients referred to the surgical optimization clinic and assessed for frailty from September 2020 to May 2023. Patients received presurgical optimization for reasons including diabetes, smoking cessation, prehabilitation and nutrition, and/or cardiopulmonary issues. Outcomes were evaluated whether they proceeded to surgery, were referred to the High-Risk Surgical Committee, surgical case canceled, or not scheduled. For those who proceeded to surgery, infection rates, complications, and 30-day emergency department (ED) and readmission rates were evaluated.

RESULTS:
Of 143 unique patients, 138 (men = 61, women = 77) were evaluated for this study. The average Edmonton frailty score for patients who proceeded to surgery was 7.013 (n = 78) vs 9.389 with cancelation and 9.600 for not scheduled or not optimized for surgery. Postoperative infection rates were <3%. However, 30-day ED and readmission rate was 21% (16 of 78).

CONCLUSIONS:
Patients with lower average Edmonton frailty scores were more likely to proceed to surgery, whereas those with higher average Edmonton frailty scores were more likely to have surgery canceled or delayed. Frail patients cleared for surgery were found to have a high 30-day ED and readmission rate.
Pilot study of a high-intensity interval training program in older adults: Safety, feasibility, functional fitness and cognitive effects
Authors: Anderson Vanessa R. , Kakuske Katherine , Thompson Christian , Ivanova Maria V. 
Published: January 2024

AbstractExercise can boost physical and cognitive health in older adults. However, there are a lack of accessible exercise programs that foster adherence among older adults. In this study, we aimed to establish the safety and feasibility of APEX, a new exercise program designed to optimize fitness and cognitive gains for older adults, in addition to evaluating its acute physiological effects, and assessing its possible effects on functional fitness and cognition among healthy older adults. APEX utilizes a multimodal progressive high-intensity interval training (HIIT) design, with high-intensity intervals focused on enhancing cardiovascular fitness and muscle strength, and recovery intervals that incorporate balance and mobility exercises. The APEX training was tested in healthy older adults (n=4) over the course of four weeks. Ultimately, APEX was found to be safe and feasible, with no adverse events and high adherence. Participants met heart rate targets for all of the high-intensity exercises, and all intervals had a significant difference in heart rates between high-intensity and recovery periods in linear effects models (p<0.001). Improvements in functional fitness were observed in aerobic endurance, lower body strength, and balance. The intervention was also associated with positive trends in the cognitive domains of information processing, working memory, executive control, and attention. APEX offers a promising alternative to traditional cardiovascular exercise modalities for older adults with additional benefits for functional fitness and cognition. These results encourage further testing of the APEX program in older adults and different clinical populations.
Oral Baricitinib in the Treatment of Cutaneous Lichen Planus
Authors: Hwang Angelina , Kechter Jacob , Do Tran , Hughes Alysia , Zhang Nan , Li Xing , Wasikowski Rachael , Brumfiel Caitlin , Patel Meera , Boudreaux Blake , Bhullar Puneet , Nassir Shams , Yousif Miranda , DiCaudo David J , Fox Jennifer , Gharaee-Kermani Mehrnaz , Xing Xianying , Zunich Samantha , Branch Emily , Kahlenberg J. Michelle , Billi Allison C. , Plazyo Olesya , Tsoi Lam C. , Pittelkow Mark R , Gudjonsson Johann E. , Mangold Aaron R 
Published: January 2024

ABSTRACTBackgroundCutaneous lichen planus (LP) is a recalcitrant, difficult-to-treat, inflammatory skin disease characterized by pruritic, flat-topped, violaceous papules on the skin. Baricitinib is an oral Janus kinase (JAK) 1/2 inhibitor that interrupts the signaling pathway of interferon (IFN)-γ, a cytokine implicated in the pathogenesis of LP.MethodsIn this phase II trial, twelve patients with cutaneous LP received baricitinib 2 mg daily for 16 weeks, accompanied by in-depth spatial, single-cell, and bulk transcriptomic profiling of pre-and post-treatment samples.ResultsAn early and sustained clinical response was seen with 83.3% of patients responsive at week 16. Our molecular data identified a unique, oligoclonal IFN-γ, CD8+, CXCL13+ cytotoxic T-cell population in LP skin and demonstrate a rapid decrease in interferon signature within 2 weeks of treatment, most prominent in the basal layer of the epidermis.ConclusionThis study demonstrates the efficacy and molecular mechanisms of JAK inhibition in LP.Trial Registration Number:NCT05188521
Refining the Prothrombotic State and Prognosis in Atrial Fibrillation With Left Atrial Appendage 3D Echocardiography
Authors: Soulat-Dufour Laurie , Lang Sylvie , Simon Théo , Ederhy Stephane , Adavane-Scheuble Saroumadi , Droit Marion Chauvet , Capderou Elodie , Arnaud Camille , Sotto Eleonore , Cohen Raphael , Gargas Thibault d’Izarny , Scheuble Aliocha , Hammoudi Nadjib , Beraud Anne-Sophie , Addetia Karima , Boccara Franck , Lang Roberto M. , Cohen Ariel 
Published: January 2024

BACKGROUNDLeft atrial (LA) volume is an echocardiographic marker of remodeling, thromboembolic risk, and prognosis in atrial fibrillation (AF); limited data are available on LA appendage (LAA) characterization beyond morphology. We sought to evaluate LAA characteristics in 2-dimensional (2D) and 3-dimensional (3D) transesophageal echocardiography (TEE) and the correlation with LA/LAA prothrombotic state and prognosis.METHODSWe prospectively studied 206 hospitalized patients with AF using 2D transthoracic echocardiography (TTE) and 2D/3D TEE of the LAA ≤24 hours from admission. Patients were divided according to the presence or absence of LAA sludge and/or thrombus. Data on clinical events were collected for 2 years.RESULTSPatients with LAA sludge/thrombus (n=35) on admission had higher LA volumes, lower left ventricular ejection fraction, lower LAA emptying and filling flow velocity, larger 2D LAA measurements (2D LAA ostium diameter, 2D LAA area) as well as larger 3D LAA measurements (higher 3D LAA volumes (LAAV), higher 3D end-systolic [ES] LAA ostium area), and more frequently non-chicken wing morphology. On multivariable logistic regression analysis, LAA filling flow velocity and 3D ES LAAV were associated with the presence of LAA sludge/thrombus at admission (P=0.031 andP<0.0001 respectively). Receiver operating characteristic curve analysis revealed the optimal cut-off for 3D ES LAAV to discriminate patients at risk of death within 2 years was 9.3 mL. Kaplan–Meier curves demonstrated a significant difference in survival at 2-year follow-up according to this value: 3 deaths occurred in the group with 3D ES LAAV <9.3mL and 11 in those with volume ≥9.3 mL (P=0.02).CONCLUSIONS3D characterization of LAAV depicts a degree of LAA remodeling in AF that appears associated with LA/LAA thrombogenicity and mid-term prognosis.CONDENSED ABSTRACTLimited data are available on left atrial appendage (LAA) remodeling in atrial fibrillation (AF). We hypothesized that 3-dimensional (3D) evaluation of the LAA volume in AF could help to refine the prothrombotic state and prognosis in AF. Patients with LAA sludge and/or thrombus exhibited lower LAA filling and emptying flow velocities, and higher 2-dimensional (2D) and 3D LAA measurements. On multivariable analysis, LAA filling flow velocity and 3D end-systolic LAA volume were associated with the presence of LAA sludge/thrombus at admission (respectively,P=0.031 andP<0.0001). Kaplan–Meier curves demonstrated a significant difference in survival at 2 years according to 3D ES LAA volume (P=0.02). Three dimensional LAA volume reflects the degree of LAA remodeling in AF and is associated with prothrombotic state and prognosis.