bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of Brain-Derived Neurotrophic Factor in Human Spiral Ganglia Neurons after Cochlear Implantation
Authors: Wong Emily C. , Lopez Ivan A. , Ishiyama Akira , Ishiyama Gail 
Published: January 2024

Background
Brain-derived neurotrophic factor (BDNF) is an important factor in the development and neuroprotection of afferent auditory pathways. In this study, we investigated the expression of BDNF in the afferent auditory pathway after cochlear implantation (CI), hypothesizing that electrical stimulation after CI stimulates BDNF expression in the afferent auditory pathway.

Methods
Archival human temporal bones from eight patients with a history of CI and five patients with normal hearing (ages 65–93 years old) were studied. Temporal bone specimens were immunoreacted with rabbit polyclonal antibodies against BDNF and mouse monoclonal antibodies against pan-neurofilaments. In cases of unilateral CI, the BDNF expression was compared with the contralateral unimplanted ear and normal temporal bones without hearing loss.

Results
BDNF immunoreactivity (IR) localized to the spiral ganglion neurons (SGNs) somata and the surrounding satellite cells. BDNF-IR in the spiral ganglia was similar in the apical, middle, and basal hook regions. Neurofilament IR localized to SGN nerve fibers in both implanted and unimplanted cochleae. BDNF-IR in the SGN and satellite cells was significantly increased in the implanted specimens compared with the unimplanted specimens (p < 0.05) and the normal hearing specimens (p < 0.05). BDNF-IR expression was similar in the unimplanted cochlea and in the normal cochlea. BDNF protein expression was increased despite complete loss of the organ of Corti hair cells and supporting cells. Even in the cases of CI with a 6-mm first-generation electrode, BDNF expression was upregulated throughout the cochlea.

Conclusions
BDNF expression in the SGN appears to be upregulated by the electrical stimulation from CI. This study provides evidence that the electrical stimulation from CI may stimulate the expression of BDNF, playing a neuroprotective role in the rehabilitation of hearing in the deafened ear.
The genetics of cystinuria – an update and critical reevaluation
Authors: Abad Baucells Clàudia , Schönauer Ria , Halbritter Jan 
Published: January 2024

Purpose of review
We aimed to critically evaluate how the establishment of genotype-based treatment for cystinuria has been hampered due to the large number of variants of unknown significance (VUS) within the disease causing genes as well as challenges in accessing a large enough sample size for systematic analysis of endpoint parameters that truly reflect disease severity. This review further discusses how to overcome these hurdles with the establishment of a cystinuria-specific refinement of the current American College of Medical Genetics and Genomics (ACMG)-criteria of variant interpretation.

Recent findings
Novel tools such as AlphaMissense combined with the establishment of a refined ACMG criterion will play a significant role in classifying VUS within the responsible disease genes SLC3A1 (rBAT) and SLC7A9 (BAT1). This will also be essential in elucidating the role of promising candidate genes, such as SLC7A13 (AGT1), which have been derived from murine model systems and still need further research to determine if they are involved in human cystinuria.

Summary
Cystinuria was one of the first disorders to receive a gene-based classification, nonetheless, the clinically actionable implications of genetic diagnostics is still minor. This is due to poorly characterized genotype-phenotype correlations which results in a lack of individualized (genotype-) based management and metaphylaxis.
A case report of postcardioversion device-related thrombus in a patient with left atrial appendage occlusion device on apixaban
Authors: Ahmed Hasaan , Ismayl Mahmoud , Palicherla Anirudh , Heppler Miranda , Petraskova Terezia , Kousa Omar , Vargha Jalal 
Published: January 2024

Background:
Current guidelines recommend proceeding with cardioversion, without the explicit need for preprocedural transesophageal echocardiography (TEE), in patients compliant with oral anticoagulation for at least 3 weeks. The relevance of these guidelines remains unclear in those undergoing repeat cardioversion.

Case summary:
A 66-year-old male with a history of atrial fibrillation (AF) and a left atrial appendage occlusion (LAAO) device, compliant with apixaban, presented with dyspnea and lightheadedness. He was cardioverted into sinus rhythm, 10 days before symptom onset, with TEE unremarkable at the time. An ECG revealed that the patient converted back into AF and a repeat cardioversion was scheduled. At the patient’s request, a TEE was obtained, revealing a new 2 cm×1 cm thrombus in the left atrium above the WATCHMAN device. Cardioversion was canceled and the patient was hospitalized for AF management.

Discussion:
Cardioverted patients are at risk for thrombus formation due to atrial stunning, a transitory dysfunction of the atrial appendage and atrium, which occurs immediately after cardioversion and can persist for several weeks. The likelihood of a thrombus is further propagated by individual risk factors for stroke.

Conclusion:
Anticoagulation does not eliminate the risk of thrombus formation in those with increased risk factors for stroke. Further studies are warranted to assess the need for routine TEE, after cardioversion, in those with stroke risk factors on anticoagulation or who have LAAO.
Compassionate Care
Authors: Segre Lisa S. , Davila Rebecca Chuffo , Banks Erika , Hohmann Kayla , Vlasich Maureen , Hein Maria L. , Beck Cheryl Tatano 
Published: January 2024

Abstract

Purpose:
Although mothers of infants hospitalized in a neonatal intensive care unit (NICU) often experience clinically significant levels of depression symptoms, accessing mental-health treatment may be difficult. NICU mothers need emotional support that is conveniently delivered at the infant's point-of-care by a trusted professional who is knowledgeable about the medical and nursing care in the NICU. Listening Visits are an effective and accessible, nurse-delivered depression intervention, yet little is known about what mothers discuss during these sessions. This analysis of sessions recorded during the randomized controlled trial evaluation of Listening Visits in the NICU provides a glimpse into NICU mothers' concerns and experiences.

Study Design and Methods:
This is a secondary, qualitative case analysis of the recorded Listening Visits sessions of four depressed NICU mothers as indicated by a score of 12 or above on the Edinburgh Postnatal Depression Scale. The mothers, who were all White, varied in their economic resources, educational level, availability of support, and infant illness severity.

Results:
Mothers discussed similar concerns and experiences, often at analogous temporal points in the six Listening Visit sessions, as well as one common concern they voiced throughout: family and friends do not understand what it is like to have an infant in the NICU.

Clinical Implications:
For mildly to moderately depressed mothers of infants hospitalized in the NICU, Listening Visits provide a way for bedside nurses to deliver compassionate care by listening to mothers' concerns and experiences.
Barriers and Facilitators of Parent Presence in the Neonatal Intensive Care Unit
Authors: Nist Marliese Dion , Spurlock Elizabeth J. , Pickler Rita H. 
Published: January 2024

AbstractPurpose:The purpose of this study was to describe system-level and personal factors influencing parent presence in the neonatal intensive care unit (NICU) and identify differences in factors by sociodemographic characteristics.Study Design and Methods:In a cross-sectional national survey study using social media recruitment, participants rated the frequency of 13 potential barriers and 12 potential facilitators using a 5-point Likert scale. Experiences of discrimination and parent–staff engagement were also measured.Results:Valid responses were analyzed from 152 participants. Uncomfortable facilities and home responsibilities were the most highly reported system-level and personal barriers, respectively. Encouragement to participate in caregiving and social support were the most highly reported system-level and personal facilitators, respectively. Participants reported low to moderate levels of discrimination and moderate levels of parent–staff engagement. Latent class analysis revealed three sociodemographic clusters. Differences in barriers, facilitators, discrimination, and engagement were found among clusters.Clinical Implications:NICU facilities are uncomfortable and may discourage parent presence. Allowing support persons to accompany parents, providing comfortable facilities, and engaging parents in caregiving may promote greater parent presence and improved parent and child outcomes. Studies of potential bias toward parents with lower education and income and effects on parent presence and infant outcomes are needed.
Expedited surgery does not increase transfusion rates for patients with geriatric hip fracture taking factor Xa inhibitors
Authors: Wang Juntian , Nilssen Paal , Stone Julia , Breda Kathleen , Little Milton , Moon Charles , Lin Carol 
Published: January 2024

Abstract

Objectives:
Geriatric patients who sustain hip fractures and are taking factor Xa inhibitors (Xa-I) experience surgical delay. Our institution developed a pharmacokinetic protocol to formally guide and expedite surgical timing for these patients. The protocol is based on the patient's renal function and timing of last Xa-I dose. For patients with impaired renal function, longer wait times are recommended. The purpose of this study was to determine the effects of this protocol for patients with geriatric hip fracture taking Xa-I.

Design:
Retrospective cohort study.

Setting:
Level 1 trauma center.

Patients/Participants:
A total of 164 patients aged 65 and older who were taking Xa-I before admission and underwent hip fracture surgery; 68 patients in the Standard group (2014–2018) and 96 patients in the Expedited group (2020–2022, after protocol implementation).

Intervention:
Hip fracture surgery.

Main Outcome Measurements:
Time to surgery (TTS), transfusion rate, blood loss, 90-day complication rates.

Results:
The median TTS was significantly shorter in the Expedited group (28.6 hours, interquartile range 21.3 hours) than in the Standard group (44.8 hours, interquartile range 21.1 hours) (P < .001). There were no differences in overall transfusion rates. Multivariable regression analysis demonstrated that time to surgery was not predictive of transfusion rate in all patients (OR 1.00, 95% CI 0.99–1.02, P = .652). There were no differences in blood loss or rates of 90-day complications.

Conclusion:
Geriatric patients with hip fractures and taking factor Xa inhibitors may warrant earlier surgery without an increased risk of transfusion or bleeding.

Level of Evidence:
Therapeutic Level III.
Resuscitation With Vitamin C, Hydrocortisone, and Thiamin in Children With Septic Shock: A Multicenter Randomized Pilot Study
Authors: Schlapbach Luregn J. , Raman Sainath , Buckley David , George Shane , King Megan , Ridolfi Roberta , Harley Amanda , Cree Michele , Long Debbie , Erickson Simon , Singh Puneet , Festa Marino , Gibbons Kristen , Bellomo Rinaldo ,   on behalf of the Resuscitation in Paediatric Sepsis Randomized Controlled Pilot Platform in the Paediatric Intensive Care Unit (RESPOND PICU) Study Investigators and the Australian and New Zealand Intensive Care Society Paediatric Study Group
Published: January 2024

OBJECTIVES:
Adjunctive therapy with vitamin C, hydrocortisone, and thiamin has been evaluated in adults, but randomized controlled trial (RCT) data in children are lacking. We aimed to test the feasibility of vitamin C, hydrocortisone, and thiamin in PICU patients with septic shock; and to explore whether the intervention is associated with increased survival free of organ dysfunction.

DESIGN:
Open-label parallel, pilot RCT multicenter study. The primary endpoint was feasibility. Clinical endpoints included survival free of organ dysfunction censored at 28 days and nine secondary outcomes, shock reversal, and two proxy measures of intervention efficacy.

SETTING:
Six PICUs in Australia and New Zealand.

PATIENTS:
Children of age between 28 days and 18 years requiring vasoactive drugs for septic shock between August 2019 and March 2021.

INTERVENTIONS:
Patients were assigned 1:1 to receive 1 mg/kg hydrocortisone every 6 hours (q6h), 30 mg/kg ascorbic acid q6h, and 4 mg/kg thiamin every 12 hours (n = 27), or standard septic shock management (n = 33).

MEASUREMENTS AND MAIN RESULTS:
Sixty of 77 (78%) eligible patients consented with 91% of approached parents providing consent. The median time from randomization to intervention was 44 (interquartile range [IQR] 29–120) min. Seventy of seventy-seven (28%) patients had received IV steroids before randomization. Median survival alive and free of organ dysfunction was 20.0 (0.0–26.0) days in the intervention and 21.0 (0.0–25.0) days in the standard care group. Median PICU length of stay was 5.3 (2.5–11.3) days in the intervention group versus 6.9 (3.0–11.5) days in the control group. Shock reversal occurred at a median of 35.2 (14.6–101.2) hours in the intervention group versus 47.3 (22.4–106.8) hours in the standard care group (median difference –12 hr; 95% CI, –56.8 to 32.7 hr).

CONCLUSIONS:
In children requiring vasopressors for septic shock, a protocol comparing adjunctive treatment with high-dose vitamin C, hydrocortisone, and thiamin versus standard care was feasible. These findings assist in making modifications to the trial protocol to enable a better-designed larger RCT.
Perinatal outcomes of frozen-thawed embryo transfer following blastocyst-stage embryo transfer compared to those of cleavage-stage embryo transfer: analysis of 9408 singleton newborns using propensity score analysis
Authors: Zhong Hu-Cen , Wan Qi , Hu Yu-Ling , Li Tian , Huang Li-Juan , Wang Mao , Hu Xin-Yue , Wang Meng-Di , Zhong Zhao-Hui 
Published: January 2024

Objective:
Regarding frozen-thawed embryo transfer (FET), there is limited consensus on whether extending embryo culture from the cleavage stage to the blastocyst stage affects perinatal outcomes. This study aimed to compare perinatal outcomes of singletons between blastocyst-stage embryo transfer (BT) and cleavage-stage embryo transfer (CT) in FET.

Methods:
A total of 9408 FET cycles that met the inclusion criteria were included in this retrospective cohort study between 2019 and 2022. Blastocyst-stage embryo transfers were performed in the BT group, and cleavage-stage embryo transfers were performed in the CT group. Multivariate logistic regression analyses were performed, as well as propensity score matching (PSM) to adjust for confounders.

Results:
After PSM, a higher risk of pre-term birth (PTB; odds ratio [OR]: 1.23, 95% confidence interval [CI]: 1.00–1.50, P = 0.048) and being large for gestational age (LGA; OR: 1.16, 95% CI: 1.00–1.35, P = 0.050) was observed in the BT group compared to that in the CT group. After stratified PSM, in the subgroup under 35 years of age, only an increased risk of LGA was observed in the BT group compared to the CT group. Perinatal outcomes in the double-embryo transfer subgroup were similar to those in the unstratified group. However, in the subgroup beyond 35 years of age and the single embryo transfer subgroup, perinatal outcomes were not statistically different between the BT and CT groups (P >0.05).

Conclusions:
In FET, prolonged embryo culture to the blastocyst stage increased the risk of PTB and LGA in single fetuses. However, stratified analysis based on age and the number of transferred embryos yielded different results, necessitating further mechanistic studies.
Effects of Simulation Fidelity on Health Care Providers on Team Training—A Systematic Review
Authors: Mitchell Sally , Blanchard Erin , Curran Vernon , Hoadley Theresa , Donoghue Aaron , Lockey Andrew ,   on behalf of the Society for Simulation in Healthcare
Published: January 2024

Abstract
This systematic review, following PRISMA standards, aimed to assess the effectiveness of higher versus lower fidelity simulation on health care providers engaged in team training. A comprehensive search from January 1, 2011 to January 24, 2023 identified 1390 studies of which 14 randomized (n = 1530) and 5 case controlled (n = 257) studies met the inclusion criteria. The certainty of evidence was very low due to a high risk of bias and inconsistency. Heterogeneity prevented any metaanalysis. Limited evidence showed benefit for confidence, technical skills, and nontechnical skills. No significant difference was found in knowledge outcomes and teamwork abilities between lower and higher fidelity simulation. Participants reported higher satisfaction but also higher stress with higher fidelity materials. Both higher and lower fidelity simulation can be beneficial for team training, with higher fidelity simulation preferred by participants if resources allow. Standardizing definitions and outcomes, as well as conducting robust cost-comparative analyses, are important for future research.
Does Extended Reality Simulation Improve Surgical/Procedural Learning and Patient Outcomes When Compared With Standard Training Methods?
Authors: Woodall William J. , Chang Eugene H. , Toy Serkan , Lee Deborah R. , Sherman Jonathan H. 
Published: January 2024

Introduction
The use of extended reality (XR) technologies, including virtual, augmented, and mixed reality, has increased within surgical and procedural training programs. Few studies have assessed experiential learning- and patient-based outcomes using XR compared with standard training methods.

Methods
As a working group for the Society for Simulation in Healthcare, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and a PICO strategy to perform a systematic review of 4238 articles to assess the effectiveness of XR technologies compared with standard training methods. Outcomes were grouped into knowledge, time-to-completion, technical proficiency, reactions, and patient outcomes. Because of study heterogeneity, a meta-analysis was not feasible.

Results
Thirty-two studies met eligibility criteria: 18 randomized controlled trials, 7 comparative studies, and 7 systematic reviews. Outcomes of most studies included Kirkpatrick levels of evidence I–III (reactions, knowledge, and behavior), while few reported level IV outcomes (patient). The overall risk of bias was low. With few exceptions, included studies showed XR technology to be more effective than standard training methods in improving objective skills and performance, shortening procedure time, and receiving more positive learner ratings. However, XR use did not show significant differences in gained knowledge.

Conclusions
Surgical or procedural XR training may improve technical skill development among trainees and is generally favored over standard training methods. However, there should be an additional focus on how skill development translates to clinically relevant outcomes. We recommend longitudinal studies to examine retention and transfer of training to clinical settings, methods to improve timely, adaptive feedback for deliberate practice, and cost analyses.
Educational and Patient Care Impacts of In Situ Simulation in Healthcare
Authors: Calhoun Aaron W. , Cook David A. , Genova Gina , Motamedi Seyed Mohammad Kalantar , Waseem Muhammad , Carey Rob , Hanson Amy , Chan Jacky C.K. , Camacho Cheryl , Harwayne-Gidansky Ilana , Walsh Barbara , White Marjorie , Geis Gary , Monachino Anne Marie , Maa Tensing , Posner Glenn , Li David Li , Lin Yiqun 
Published: January 2024

Abstract
This systematic review was performed to assess the effectiveness of in situ simulation education. We searched databases including MEDLINE and Embase for studies comparing in situ simulation with other educational approaches. Two reviewers screened articles and extracted information. Sixty-two articles met inclusion criteria, of which 24 were synthesized quantitatively using random effects meta-analysis. When compared with current educational practices alone, the addition of in situ simulation to these practices was associated with small improvements in clinical outcomes, including mortality [odds ratio, 0.66; 95% confidence interval (CI), 0.55 to 0.78], care metrics (standardized mean difference, −0.34; 95% CI, −0.45 to −0.21), and nontechnical skills (standardized mean difference, −0.52; 95% CI, −0.99 to −0.05). Comparisons between in situ and traditional simulation showed mixed learner preference and knowledge improvement between groups, while technical skills showed improvement attributable to in situ simulation. In summary, available evidence suggests that adding in situ simulation to current educational practices may improve patient mortality and morbidity.
Evaluation of Forward Head Posture, Balance, and Risk for Falls in Community-Dwelling Older Adults
Authors: Migliarese Sara , Wendt Christopher , Anastopoulos John , Anastopoulos Jessica , White Emma 
Published: January 2024

Objective:
This study investigated the influence of fear of falling, forward head posture (FHP), cervical proprioception, dynamic balance, and sensory integration on fall risk in older adults.

Methods:
Thirty-one participants were evaluated using tests designed to detect fall risk. FHP was assessed using a cervical range of motion device and craniovertebral angle (CVA) measurement.

Results:
Independent t tests were significant for Sensory Organization Test conditions 2 (P = .031) and 5 (P = .043) for FHP versus non-FHP groups. Regression analysis revealed that CVA could predict 16.7% variance in fall risk.

Conclusion:
CVA is a practical measure for measuring FHP and identifying fall risk in older adults.
Otago Exercise Program Improves Physical Functional Performance and Reduces Falling Risk in Elderly Korean Women
Authors: Kang Minjeong , Kang Hyunsik 
Published: January 2024

Aims:
To determine the effects of the Otago exercise program (OEP) on physical functional capacity and fear of falling.

Methods:
Elderly Korean women aged 75 to 84 years (n = 40) were nonrandomly assigned to the control (n = 12) or exercise (n = 36) group. The exercise group underwent a 6-month group-based OEP.

Results:
The exercise group had significant pre- to postintervention improvements in muscle quality index, walking speed, handgrip strength, 30-second chair stand test, 8-ft Timed Up and Go test, and short physical performance battery in conjunction with reduced fear of falling compared with the control group.

Conclusion:
The OEP is an effective fall prevention tool for elderly Korean women who are afraid of falling.