bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cochlear Implant Referral Criteria for the Spanish-Speaking Adult Population
Authors: Smeal Molly R. , Coto Jennifer , Prentiss Sandra , Stern Tina , VanLooy Lindsey , Holcomb Meredith A. 
Published: December 2023

Objective
To evaluate the effectiveness of the “60/60 Guideline” in a diverse patient population.

Study Design
Retrospective review.

Setting
Tertiary referral center.

Patients
Data were collected for adult patients (18 years and older) who underwent a cochlear implant evaluation (CIE) between January 2016 and March 2021.

Main Outcome Measure(s)
Development of the “60/60 Guideline” has provided better clarity on when to refer English-speaking patients for a CIE. Our study evaluated the effectiveness of this referral tool in the Spanish-speaking population.

Results
In our group of patients who underwent a traditional CIE (n = 402), 209 met unaided and aided traditional cochlear implant (CI) candidacy criteria. Of the 193 individuals who did not meet both components of traditional candidacy criteria, a majority met the aided component (86%) but only 4.6% met the unaided component. When applying the 60/60 Guideline to patients who met traditional criteria, there is a sensitivity rating of 84.7% and a specificity index of 50.3%. For English and Spanish speakers who met traditional criteria but did not meet the 60/60 Guideline, a majority (83.3% English, 87.5% Spanish) had a better ear word recognition score (WRS) greater than 60%, suggesting the unaided WRS is the more restrictive component of the “60/60 Guideline.”

Conclusion
Application of the “60/60 Guideline” is an effective method to identify potential CI candidates in the English-speaking population; however, it was less effective in the Spanish-speaking population. Spanish-speaking adults should be referred for a CIE when better ear pure tone average is greater than 60 dB hearing loss, regardless of their unaided WRS. This study highlights the need for inclusion of nonlinguistic test measures in the CI referral criteria and test battery to reduce CI access barriers for patients who speak a language other than English.
Educational Benefit of the Three-Dimensional Exoscope Versus Operating Microscope in Otologic Surgery
Authors: Tu Nathan C. , Doerfer Karl , Costeloe Anya , Sioshansi Pedrom C. , Babu Seilesh 
Published: December 2023

Objective
To compare observation of otologic surgery using a traditional operating microscope (OM) and a three-dimensional exoscope.

Study Design
Prospective, nonrandomized, noncontrolled study.

Setting
Tertiary care center.

Methods
Senior medical students and otolaryngology trainees observing otologic surgery performed with OM and exoscope were asked to complete a questionnaire comparing the two experiences. The key variables were image clarity, depth perception, observer's level of motion sickness during the surgery, the participant's understanding of middle ear anatomy, and their overall preference between OM and exoscope.

Results
Twenty-two observers participated in the study. Subjective clarity of the image was significantly better with the exoscope compared with the OM (9.7 ± 0.6 versus 6.9 ± 1.7, p = 0.0004) as well as the depth perception (9.25 ± 0.87 versus 5 ± 2.69, p = 0.0007). Observers subjectively had an improved understanding of middle ear anatomy after observing an exoscopic surgery, but not a microscopic surgery. All but one observer preferred the exoscope.

Conclusion
The three-dimensional exoscope may be a valuable educational tool for teaching trainees otologic surgery. More objective studies are needed in the future to assess the degree of improvement.
Effect of Cochlear Implantation on Social Life
Authors: Reddy Priyanka , Schneider Kara J. , Tamati Terrin N. , Moberly Aaron C. 
Published: December 2023

Objective
Explore the effects of hearing loss on social life and identify residual social life deficits that remain after cochlear implantation.

Study Design
Retrospective review of prospectively obtained data.

Setting
Tertiary care adult neurotology center.

Patients
Adults between the ages of 35 and 83 years were included with either normal hearing (NH) or a cochlear implant (CI).

Interventions
CI and non-CI–specific quality-of-life (QOL) surveys focused on social and overall QOL.

Main Outcome Measure(s)
(1) The difference in QOL survey responses between NH and CI participants. (2) The relationship between CI-specific global and social QOL responses and non–CI-specific social QOL responses in CI users.

Results
A total of 51 participants were included: 31 CI users and 20 NH participants. Of the social QOL questionnaires, CI users reported significantly poorer scores on Self-Efficacy in Social Interactions than NH peers (p = 0.049). Both Self-Efficacy in Social Interactions scores and Social Isolation Questionnaire scores were significantly correlated with the CI-specific social domain of QOL (r = 0.64 and −0.58, respectively). Only the Self-Efficacy in Social Interactions scores had a moderate association with global CI QOL (r = 0.47).

Conclusions
CI users self-report similar social life outcomes as their NH peers with the exception of poorer self-efficacy in social situations. Moreover, self-efficacy in social interactions and social isolation were associated with social QOL in CI users, and self-efficacy in social interactions was associated with broader CI-related QOL. Findings support the relevance of individuals' perception of social life to their overall QOL with a CI.
Cortisol Sensitizes Cochlear Hair Cells to Gentamicin Ototoxicity Via Endogenous Apoptotic Pathway
Authors: Li Cong , Chen Liang , Li Yingying , Li Mengxin , Zhang Xiaoling , Cui Limei , Sun Yan , Song Xicheng 
Published: December 2023

Hypothesis
The stress hormone cortisol affects aminoglycoside-induced ototoxicity.

Background
The widespread use of aminoglycosides is a prevalent cause of sensorineural hearing loss. Patients receiving aminoglycosides usually have elevated levels of circulating stress hormones due to disease or physiological stress; however, whether the stress hormone cortisol impacts aminoglycoside-mediated injury of cochlear hair cells has not been fully investigated.

Methods
House Ear Institute-Organ of Corti 1 (HEI-OC1) cells with or without cortisol pretreatment were exposed to gentamicin, we investigated the effect of cortisol pretreatment on gentamicin ototoxicity by assessing cell viability. Molecular pathogenesis was explored by detecting apoptosis and oxidative stress. Meanwhile, by inhibiting glucocorticoid receptors (GR) and mineralocorticoid receptors (MR), the potential roles of receptor types in cortisol-mediated sensitization were evaluated.

Results
Cortisol concentrations below 75 μmol/l did not affect cell viability. However, pretreatment with 50 μmol/l cortisol for 24 hours sensitized hair cells to gentamicin-induced apoptosis. Further mechanistic studies revealed that cortisol significantly increased hair cell apoptosis and oxidative stress, and altered apoptosis-related protein expressions induced by gentamicin. In addition, blockade of either GR or MR attenuated cortisol-induced hair cell sensitization to gentamicin toxicity.

Conclusion
Cortisol pretreatment increased mammalian hair cell susceptibility to gentamicin toxicity. Sensitization was related to the activation of the intrinsic apoptotic pathway and excessive generation of reactive oxygen species. Cortisol may exacerbate aminoglycoside ototoxicity.
The place of positive end expiratory pressure in ventilator-induced lung injury generation
Authors: Thornton Lauren T. , Kummer Rebecca L. , Marini John J. 
Published: December 2023

Purpose of review
Describe the rationale for concern and accumulating pathophysiologic evidence regarding the adverse effects of high-level positive end expiratory pressure (PEEP) on excessive mechanical stress and ventilator-induced lung injury (VILI).

Recent findings
Although the inclusion of PEEP in numerical estimates of mechanical power may be theoretically debated, its potential to increase stress, strain, and mean airway pressure are not. Recent laboratory data in a variety of animal models demonstrate that higher levels of PEEP coupled with additional fluids needed to offset its impediment of hemodynamic function are associated with increased VILI. Moreover, counteracting end-tidal hyperinflation by external chest wall pressure may paradoxically improve respiratory mechanics, indicating that lower PEEP helps protect the small ‘baby lung’ of advanced acute respiratory distress syndrome (ARDS).

Summary
The potentially adverse effects of PEEP on VILI can be considered in three broad categories. First, the contribution of PEEP to total mechanical energy expressed through mechanical power, raised mean airway pressure, and end-tidal hyperinflation; second, the hemodynamic consequences of altered cardiac loading, heightened pulmonary vascular stress and total lung water; and third, the ventilatory consequences of compromised carbon dioxide eliminating efficiency. Minimizing ventilation demands, optimized body positioning and care to avoid unnecessary PEEP are central to lung protection in all stages of ARDS.
Setting positive end-expiratory pressure: does the ‘best compliance’ concept really work?
Authors: Menga Luca S. , Subirà Carles , Wong Alfred , Sousa Mayson , Brochard Laurent J. 
Published: December 2023

Purpose of review
Determining the optimal positive end-expiratory pressure (PEEP) setting remains a central yet debated issue in the management of acute respiratory distress syndrome (ARDS).
The ‘best compliance’ strategy set the PEEP to coincide with the peak respiratory system compliance (or 2 cmH2O higher) during a decremental PEEP trial, but evidence is conflicting.

Recent findings
The physiological rationale that best compliance is always representative of functional residual capacity and recruitment has raised serious concerns about its efficacy and safety, due to its association with increased 28-day all-cause mortality in a randomized clinical trial in ARDS patients.
Moreover, compliance measurement was shown to underestimate the effects of overdistension, and neglect intra-tidal recruitment, airway closure, and the interaction between lung and chest wall mechanics, especially in obese patients. In response to these concerns, alternative approaches such as recruitment-to-inflation ratio, the nitrogen wash-in/wash-out technique, and electrical impedance tomography (EIT) are gaining attention to assess recruitment and overdistention more reliably and precisely.

Summary
The traditional ‘best compliance’ strategy for determining optimal PEEP settings in ARDS carries risks and overlooks some key physiological aspects. The advent of new technologies and methods presents more reliable strategies to assess recruitment and overdistention, facilitating personalized approaches to PEEP optimization.
Optimal positive-end expiratory pressure weaning in acute respiratory distress syndrome patients
Authors: McNamara Laura , Baedorf Kassis Elias 
Published: December 2023

Purpose of review
Positive-end expiratory pressure (PEEP) is a tool in managing acute respiratory distress syndrome (ARDS). In this review, we discuss the various approaches to weaning PEEP after the acute phase of ARDS.

Recent findings
There is a paucity of research specifically looking at the differences between PEEP weaning protocols. Data in some populations though, particularly those with elevated BMI, suggest that a physiologic approach to PEEP weaning may be helpful. Use of various tools to optimize PEEP prior to and during spontaneous breathing trials (SBTs) may allow for improved alveolar recruitment and respiratory outcomes.

Summary
Although further prospective studies are warranted, we should consider using a physiologic approach to PEEP weaning in ARDS rather than a one size fits all model, which is currently the standard used in many clinical trials and throughout many ICUs.
Casein glycomacropeptide in phenylketonuria: does it bring clinical benefit?
Authors: Daly Anne , Ilgaz Fatma , Pinto Alex , MacDonald Anita 
Published: December 2023

Purpose of review
Casein glycomacropeptide (CGMP) is a milk-derived bioactive sialyated phosphorylated peptide with distinctive nutritional and nutraceutical properties, produced during the cheese making process. It comprises 20–25% of total protein in whey products. CGMP is low in phenylalanine (Phe) and provides an alternative to Phe-free amino acids as a source of protein equivalent for patients with phenylketonuria (PKU). The amino acid sequence of CGMP is adapted by adding the amino acids histidine, leucine, tyrosine, arginine and tryptophan to enable its suitability in PKU. CGMP has potential antibacterial, antioxidative, prebiotic, remineralizing, digestion /metabolism and immune-modulating properties. The aim of this review is to assess the evidence for the role of CGMP in the management of PKU.

Recent findings
In PKU, there is no agreement concerning the amino acid composition of CGMP protein substitutes and consequently the nutritional composition varies between products. Although there is evidence in patients or animal models that CGMP has possible beneficial effects on gut microbiota and bone health, the results are inconclusive. Data on kinetic advantage is limited. Most studies report an increase in blood Phe levels with CGMP. Appropriate adaptations and reduction of dietary Phe intake should be made to compensate for the residual Phe content of CGMP, particularly in children. Data from short term studies indicate improved palatability of CGMP when compared to Phe-free amino acids.

Summary
In PKU, CGMP with supplementary amino acids, offers a safe low Phe nitrogen source. Current scientific evidence is unconvincing about its bioactive advantage in PKU. Further longitudinal research is necessary.
A Comparative Study of Two Topical Treatments for Photoaging of the Hands
Authors: Wyles Saranya , Jankov Laura Eaton , Copeland Karen , Bucky Louis P. , Paradise Chris , Behfar Atta 
Published: December 2023

Background:
Multiple effective treatments exist for correction of skin photoaging. Topical L-ascorbic acid (vitamin C), a well-known antioxidant and topical human platelet extract (HPE), is a novel off-the-shelf cosmetic ingredient that has shown positive results in recent clinical studies. HPE is a leukocyte-depleted allogeneic product derived from United States–sourced, pooled, apheresed platelets produced with consistent batch quality, purity, and effect. The authors sought to characterize the effect of topical HPE (plated) intense serum (Rion Aesthetics) compared with vitamin C (C E Ferulic with 15% L-ascorbic acid; SkinCeuticals) in skin rejuvenation of dorsal hands after 12 to 26 weeks of twice-daily use.

Methods:
This prospective, longitudinal study sought to compare the effectiveness of 2 known treatments for skin rejuvenation. Evaluations at baseline and 6, 12, and 26 weeks included photographic documentation to assess common skin concerns related to aging.

Results:
For age-related skin appearance on the dorsal hands, topical HPE was noninferior to topical vitamin C for improvement in brown spot fractional area, wrinkle fractional area, and improvement in luminosity at 12 weeks after twice-daily topical use.

Conclusions:
HPE performed as well as vitamin C to rejuvenate the skin on the dorsal hands after 12 to 26 weeks of twice-daily topical use. Both topical serums may yield similar or superior results versus invasive procedures, such as intense pulsed light, in reducing brown spots on the dorsal hands. These topical products work equally well in both sexes. Skin improvements lasted through 6 months.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Nationwide Outcome of Tailored Surgery for Symptomatic Chronic Pancreatitis based on Pancreatic Morphology
Authors: Van Veldhuisen Charlotte L. , Leseman Charlotte A , De Rijk Fleur E.M. , Dekker E. Nicole , Wellens Martine J. , Michiels Nynke , Stommel Martijn W.J. , Krikke Christina , Hofker H. Sijbrand , Mieog J. Sven D. , Bouwense Stefan A. , Van Eijck Casper H. , Groot Koerkamp Bas , Haen Roel , Boermeester Marja A. , Busch Olivier R. , Van Santvoort Hjalmar C. , Besselink Marc G. ,   for the Dutch Pancreatitis Study Group
Published: December 2023

Objective:
To determine the nationwide use and outcome of tailored surgical treatment for symptomatic chronic pancreatitis (CP) as advised by recent guidelines.

Summary background data:
Randomized trials have shown that surgery is superior to endoscopy in patients with symptomatic CP, although endoscopy remains popular Recent guidelines advice to “tailor surgery” based on pancreatic morphology meaning that the least extensive procedure should be selected based on pancreatic morphology. However, nationwide, and multicenter studies On tailored surgery for symptomatic CP are lacking.

Methods:
Nationwide multicenter retrospective analysis of consecutive patients undergoing surgical treatment for symptomatic CP in all seven Dutch university medical centers (2010-2020). Outcomes included volume trend, major complications, 90-day mortality, postoperative opioid use and clinically relevant pain relief. Surgical treatment was tailored based on the size of the main pancreatic duct and pancreatic head (e.g. surgical drainage for a dilated pancreatic duct, and normal size pancreatic head).

Results:
Overall, 381 patients underwent surgery for CP: 127 surgical drainage procedures ( 33%; mostly extended lateral pancreaticojejunostomy), 129 duodenum-preserving pancreatic head resections (DPPHR, 34%, mostly Frey), and 125 formal pancreatic resections (33%, mostly distal pancreatectomy). The annual surgical volume increased slightly (Pearson r=0.744). Mortality (90-day) occurred in 6 patients (2%), and was non-significantly lower after surgical drainage (0%, 3%, 2%; P=0.139). Major complications (12%, 24%, 26%; P=0.012), postoperative pancreatic fistula grade B/C (0%, 3%, 22%; P=0.038), surgical reintervention (4%, 16%, 12%; P=0.006), and endocrine insufficiency ( 14%, 21%, 43%; P<0.001) occurred less often after surgical drainage. After a median follow-up of 11 months [IQR 3-23] good rates of clinically relevant pain relief ( 83%, 69%, 80%; P=0.082) were observed and 81% of opioid users had stopped using (83%, 78%, 84%, P=0.496).

Conclusion:
The use of surgery for symptomatic CP increased over the study period. Drainage procedures were associated with the best safety profile and excellent functional outcome, highlighting the importance of tailoring surgery based on pancreatic morphology.
Revascularization of arterial occlusions in posterior circulation acute ischemic stroke
Authors: Salerno Alexander , Michel Patrik , Strambo Davide 
Published: December 2023

Purpose of review
This review highlights the latest advancements achieved in the revascularization of arterial occlusions associated with an acute ischemic stroke affecting the posterior circulation. It delves into the frequency and outcomes based on specific arterial segments and presents current evidence supporting revascularization treatments, including intravenous thrombolysis and endovascular thrombectomy.

Recent findings
Comprehensive evidence for treatment across major arterial segments of the posterior circulation -- vertebral artery, basilar artery, posterior cerebral artery, cerebellar arteries, and multilevel posterior occlusions -- is provided. Additionally, the latest findings from randomized clinical trials on basilar artery occlusion are explored alongside results from extensive retrospective analyses of isolated vertebral and posterior cerebral artery occlusions.

Summary
Current research supports the treatment decision in acute ischemic strokes of the posterior circulation using both intravenous thrombolysis and endovascular thrombectomy. This review also emphasizes existing knowledge gaps in the management of these strokes and advocates for more randomized clinical trials, notably concerning the posterior cerebral artery (currently ongoing), isolated vertebral artery, and multilevel posterior circulation occlusions.
RSYD-BASIC: a bioinformatics pipeline for Routine Sequence analYsis and Data processing of BActerial iSolates for clInical miCrobiology
Authors: Steinke Kat , Thomsen Karina Gravgaard , Hoegh Silje Vermedal , Larsen Sanne Løkkegaard , Kubel Vilhelmsen Karina , Jensen Thøger Gorm , Skov Marianne Nielsine , Sydenham Thomas Vognbjerg 
Published: December 2023

Background
Whole genome sequencing of bacterial isolates is increasingly becoming routine in clinical microbiology; however, subsequent analysis often needs to be started by a bioinformatician even for comprehensive pipelines. To increase the robustness of our workflow and free up bioinformatician work hours for development and advanced analysis, we aimed to produce a robust, customizable bioinformatic pipeline for bacterial genome assembly and routine analysis results that could be initiated by non-bioinformaticians.
Results
When tested on publicly available sequences, our pipeline yields comparable results in most cases. In routine use, it has already yielded clinically relevant results, allowing us to type a variety of bacterial pathogens isolated in our clinical laboratory and disprove a potential outbreak.
Conclusion
With the RSYD-BASIC pipeline, we present a reads-to-results analysis pipeline operated by non-expert users that greatly eases investigation of potential outbreaks. Results obtained with publicly available sequences are also promising, while underlining the importance of standardized methods.
Inhibition of KLK8 promotes pulmonary endothelial repair by restoring VE-cadherin/Akt/FOXM1 pathway
Authors: Zhao Ying , Ji Hui , Han Feng , Xu Qing-Feng , Zhang Hui , Liu Di , Wei Juan , Xu Dan-Hong , Jiang Lai , Du Jian-Kui , Xu Ping-Bo , Liu Yu-Jian , Zhu Xiao-Yan 
Published: December 2023

AbstractThe tissue kallikrein-related peptidases (KLKs) are secreted serine proteases deeply involved in angiogenesis. However, whether KLKs are involved in the regulation of endothelial regeneration during sepsis remains unknown. By comparing the mRNA levels of 15 KLKs, we found that KLK8 was the highest induced KLK member in lung tissues or primary isolated mouse lung vascular endothelial cells (MLVECs) exposed to lipopolysaccharide (LPS). Adenovirus-mediated overexpression of KLK8 caused endothelial hyperpermeability bothin vitroandin vivo. Inhibition of KLK8, by either gene knockout or KLK8 neutralizing antibodies, alleviated sepsis-induced endothelial hyperpermeability, acute lung injury and mortality. Mechanistically, transcription profiling of KLK8-overexpressed endothelial cells revealed a central role of forkhead box M1 (FOXM1) downregulation in mediating the pro-injury and anti-proliferation effects of KLK8. KLK8 cleaved VE-cadherin and consequently suppressed FOXM1 expression by inactivation of the VE-cadherin/Akt pathway. KLK8 deficiency or blockade rescued VE-cadherin/Akt/FOXM1 pathway, thus promoting endothelium regeneration. This study reveals a critical role for KLK8-induced inactivation of VE-cadherin/Akt/FOXM1 pathway in mediating the impairment of endothelial regeneration and the consequent lung vascular leakiness in response to sepsis.HighlightsUpregulated KLK8 mediates lung endothelial barrier dysfunction during sepsisKLK8 inactivates VE-cadherin/Akt/FOXM1, thus impairing endothelium regenerationKLK8 deficiency or blockade rescues VE-cadherin/Akt/FOXM1 signaling pathwayKLK8 deficiency or blockade promotes endothelium regeneration during sepsisKLK8 deficiency or blockade attenuates sepsis-induced acute lung injury and mortality