bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Central Auditory Processing Dysfunction With Preclinical Alzheimer's Disease
Authors: Byun Min Soo , Chang Munyoung , Yi Dahyun , Ahn Hyejin , Han Dongkyun , Jeon Seulki , Jang Hyunsook , Lee Dong Young , Oh Seung Ha ,   For the KBASE Research Group
Published: January 2023

AbstractObjectiveTo investigate whether central auditory processing dysfunction measured by the dichotic digit test‐1 digit (DDT1) is present in preclinical Alzheimer's disease (AD) individuals who are cognitively normal (CN) older adults with the cerebral beta‐amyloid (Aβ) deposition and to explore the potential of the DDT1 as a screening test for preclinical AD.Study DesignCross‐sectional design.SettingA prospective observational cohort study.MethodsCN older adults with a global clinical dementia rating score of 0 were included. The hearing test battery including pure‐tone audiometry, speech audiometry, distortion product otoacoustic emission, and DDT1 was administered to participants.ResultsFifty CN older adults were included. Among them, 38 individuals were included in the Aβ deposition negative (AN) group and 12 were included in the Aβ deposition positive (AP) group. The DDT1 scores of both the better and worse ears were significantly lower in the AP group than in the AN group (p = .008 andp = .015, respectively). No significant differences were observed between the groups in tests of the peripheral auditory pathways. In multivariable logistic regression analysis adjusted for apolipoprotein E4 positivity, the DDT1 better ear score predicted the AP group (p = .036, odds ratio = 0.892, 95% confidence interval: 0.780‐0.985) with relatively high diagnostic accuracy.ConclusionOur findings suggest that Aβ deposition may affect the central auditory pathway even before cognitive decline appears. DDT1, which can easily be applied to the old‐age population, may have the potential as a screening tool for preclinical AD.
Multimodal Analgesia and Patient Education Reduce Postoperative Opioid Consumption in Otology
Authors: Butkus Joann M. , Awosanya Samiat , Scott Elizabeth Reilly , Perlov Natalie , Hannikainen Paavali , Tekumalla Sruti , Armache Maria , Stewart Matthew , Willcox Thomas , Chiffer Rebecca 
Published: January 2023

AbstractObjectiveThis study sought to validate alternative pain management strategies that can reduce reliance on opioids for postoperative pain management in otology.Study DesignProspective cohort study.SettingSingle tertiary‐care facility.MethodsAdult patients who underwent outpatient otologic surgery from September 2021 to July 2022 were randomized into treatment cohorts. The opioid monotherapy cohort received a standard opioid prescription. The multimodal analgesia cohort received the same opioid prescription, prescriptions for acetaminophen and naproxen, and additional pain management education with a flyer on discharge. All patients completed a questionnaire 1 week after surgery to evaluate opioid usage and pain scores.ResultsEighty‐six patients completed the study. The opioid monotherapy cohort (n = 42) and multimodal analgesia cohort (n = 44) were prescribed an average of 42.1 ± 20.4 morphine milligram equivalents (MME) and 38.4 ± 5.7 MME, respectively (p = 0.373). Four patients (9.52%) in the opioid monotherapy cohort required opioid refills compared to 1 patient (2.27%) in the multimodal analgesia cohort (p = 0.156). Multivariate analysis demonstrated that the multimodal analgesia cohort consumed significantly fewer opioids on average than the opioid monotherapy cohort (11.9 ± 15.9 MME vs 22.8 ± 28.0 MME, respectively). There were no significant differences in postoperative rehospitalizations (p = 0.317) or Emergency Department visits (p = 0.150). Pain scores on the day of surgery, postoperative day (POD) 1, POD3, and POD7 were not significantly different between cohorts (p = 0.395, 0.896, 0.844, 0.765, respectively).ConclusionThe addition of patient education, acetaminophen, and naproxen to postoperative opioid prescriptions significantly reduced opioid consumption without affecting pain scores, refill rates, or complication rates after otologic surgery.
Endoscopic Management of Rhinolithiasis: A Systematic Review
Authors: Nguyen Julia , Omiunu Ariel , Patel Rushi , Patel Prayag , Fang Christina H. , Eloy Jean Anderson 
Published: January 2023

AbstractObjectiveThis study reviews the presentation, management, and outcomes of patients with rhinolithiasis.Data SourcesAn electronic database search of PubMed, SCOPUS, CINAHL, and the Cochrane Library was performed in accordance with the PRISMA 2020 updated guidelines for reporting systematic reviews.Review MethodsCase reports and case series published from 2004 to 2020 were included. Data collected included patient demographics, clinical symptoms at presentation, diagnosis, treatment, complications, and follow‐up. Relevant descriptive statistics were computed using Microsoft Excel 2013 (Microsoft Corp).ResultsFifty‐five case reports and five case series were included (n = 122). The majority were female (60.7%). The mean age was 29.4 years (range, 4‐80 years). The most common symptoms were rhinorrhea (81.1%), nasal obstruction (79.5%), nasal malodor (38.5%), and headache (27.9%). Computed tomography imaging was obtained in 109 (91.5%) cases. Concurrent rhinosinusitis (35.2%) and deviated nasal septum (28.7%) were commonly identified. Rhinoliths were commonly found in the right nostril (52.5%) and in between the inferior turbinate and nasal septum (26.9%). All rhinoliths were fully excised using endoscopic sinonasal surgery, accompanied by a septoplasty (9.2%). The nidus was identified in 27 (22.2%) patients. There were no recurrences or complications over an average follow‐up of 8.5 months (range, 0.25‐36 months).ConclusionRhinolithiasis is an uncommon entity of the nasal cavity and should be suspected in patients with long‐standing unilateral nasal obstruction, rhinorrhea, and nasal malodor. Rigid nasal endoscopy and endoscopic sinonasal surgery are the most important methods for diagnosis and treatment, respectively.
Preoperative Predictors of Severe Respiratory Events After Tonsillectomy: Consideration for Pediatric Intensive Care Admission
Authors: Kirkham Erin M. , Puglia Michael P. , Haydar Bishr , Jewell Elizabeth S. , Leis Aleda M. , Peddireddy Nithin , Chervin Ronald D. 
Published: January 2023

AbstractObjectiveFew data are available to guide postadenotonsillectomy (AT) pediatric intensive care (PICU) admission. The aim of this study of children with a preoperative polysomnogram (PSG) was to assess whether preoperative information may predict severe respiratory events (SRE) after AT.Study DesignRetrospective cohort study.SettingSingle tertiary center.MethodsChildren aged 6 months to 17 years who underwent AT with preoperative polysomnography (2012‐2018) were identified by billing codes. Data were extracted from medical records. SRE were defined as any 1 or more of desaturations <80% requiring intervention; newly initiated positive airway pressure; postoperative intubation; pneumonia/pneumonitis; respiratory code, cardiac arrest, or death. We hypothesized that SRE would be associated with age <24 months, major medical comorbidity, obesity (>95th percentile), apnea‐hypopnea index (AHI) ≥ 30, and O2 nadir <70% on PSG. Analysis was performed with multivariable logistic regression.ResultsOf 1774 subjects, 28 (1.7%) experienced SRE. Compared to those without, children with SRE were on average younger (3 vs 5 years, p < .01) with a greater probability of medical comorbidities (59% vs 18%, p < .001). After adjustment for sex, black race, obesity, and age <24 months, children with major medical comorbidity were more likely than other children to have SRE (odds ratio [OR]: 14.2; 95% confidence interval [CI]: [5.7, 35.2]), as were children with AHI ≥ 30 (OR: 7.7 [3.0, 19.9]), or O2 nadir <70% (OR 6.1 [2.1, 17.9]). Age, obesity, sex, and black race did not independently predict SRE.ConclusionPICU admission may be most prudent for children with complex medical co‐morbidities, high AHI (>30), and/or low O2 nadir (<70%).
Integrated Health Maintenance Reminders for Improved HPV Vaccine Administration: Toward Improvements in Completion Disparities
Authors: Rames Jess D. , Frisco Nicholas A. , Jiang Rong , Shah Kevin P. , Kahmke Russel R. , Puscas Liana , Osazuwa‐Peters Nosayaba , Rocke Daniel J. 
Published: January 2023

AbstractObjectiveTo evaluate the effect of a health maintenance reminder (HMR) on human papillomavirus (HPV) vaccine administration and completion across different age, insurance, and race cohorts.Study DesignRetrospective pre‐post analysis.SettingAcademic primary care.MethodsPatients aged 9 to 26 who had initiated the HPV vaccine series from 2016 to 2021 were analyzed, based on current age‐based standards. The cohort was divided based on vaccine uptake before and after the implementation of the HMR program in February 2020. The multivariate analysis estimated the odds of vaccine completion based on sociodemographic factors, and variable interactions were investigated to determine independent associations between sociodemographic factors and HMR implementation.ResultsThere were 7654 individual patients (mean age was 15.8 years; 46.7 were males; and 50.7% were white). HPV vaccine completion rates increased post‐HMR implementation by 59.2% (37% pre‐, and 58.9% post‐HMR; p < .001) in the entire cohort. Overall, black patients (adjusted odds ratio [aOR] = 0.68; 95% confidence interval [CI]: 0.60, 0.70) and patients ≥18 years (aOR = 0.13; 95% CI: 0.11, 0.15) were significantly less likely to complete their vaccine series; however, this improved significantly following HMR in these groups (p < .001). Post‐HMR, race, and insurance status were not independently associated with disparate vaccine completion rates, however, age was, and patients ≤14 or younger had higher odds of vaccine completion (aOR = 3.54; 95% CI: 2.91, 4.32).ConclusionThe implementation of an HMR was associated with increased HPV vaccine uptake across age and race groups in this single‐institution study. Future research should explore barriers to implementing HMRs in different health care settings.
Speech Perception and Sound Localization Skills in Inner Ear Malformations: Children With Incomplete Partition Type‐II
Authors: Kocabay Aysun Parlak , Batuk Merve Ozbal , Sennaroglu Gonca , Sennaroglu Levent 
Published: January 2023

AbstractObjectiveThe present study aimed to evaluate binaural auditory skills in bimodal and bilateral pediatric cochlear implant (CI) users with incomplete partition type‐II (IP‐II) and to reveal the effect of IP‐II on performance by comparing the results to pediatric CI users with normal cochlear morphology.Study DesignCross‐sectional study.SettingTertiary referral center.MethodsForty‐one CI users (mean age 8.8 ± 1.9) were grouped as bimodal (BIM‐IP) and bilateral (BIL‐IP) users with IP‐II; bimodal (BIM‐N) and bilateral (BIL‐N) users with normal cochlear anatomy. Speech perception in noise and sound localization skills were compared under 2 conditions; binaural (bilateral or bimodal) and monaural (first CI alone).ResultsBIM‐IP and BIL‐IP showed no performance difference in binaural tasks. The BIM‐N group showed remarkably poor performance in comparison to the groups of BIL‐IP (p = .007), BIM‐IP (p < .001), and BIL‐N (p = .004) in terms of speech‐in‐noise skills. In sound localization abilities, similar significant differences were found between the group of BIM‐N and the groups of BIL‐IP (p = .001), BIM‐IP (p < .001), and BIL‐N (p = .004). All groups showed statistically significant improvements in binaural condition on both tasks (p < .05).ConclusionWe revealed that bilateral and bimodal pediatric CI users with IP‐II benefitted from implantation as much as bilateral users with normal anatomy. Differences in residual hearing between groups may explain the poor performance of bimodal users with normal cochlear morphology. To the best of our knowledge, it is the first study to unveil binaural performance characteristics in children diagnosed with a specific inner ear malformation subgroup.
Relationship Between Alcohol Intolerance and Aspirin‐Exacerbated Respiratory Disease (AERD): Systematic Review
Authors: Candelo Estephania , McCalla Monet , Valderrama Oriana A. , Avila‐Castano Karol , Chelf Cynthia , Olomu Osarenoma , Donaldson Angela M. 
Published: January 2023

AbstractObjectivePrevious studies have suggested that patients with aspirin‐exacerbated respiratory disease (AERD) have a high likelihood of alcohol intolerance. The purpose of this systematic review is to identify if there is sufficient evidence to confirm this correlation and the impact of medical therapy on subsequent alcohol tolerance.Data SourcesPubMed, EMBASE, SCOPUS, EBSCO, Google Scholar, Cochrane Library, and Grey literature. We also performed snowballing on the identified observational studies (OS) for additional data.Review MethodsA systematic review was conducted from 1968 to 2022 to identify those studies describing AERD symptomatology triggered by alcohol intake. The primary outcome was to analyze the current literature for the association between alcohol intolerance and AERD symptoms. The secondary outcome looked for improvement in alcohol tolerance after aspirin desensitization or biological therapy.ResultsA total of 775 studies were identified and 40 abstracts were evaluated. From these, 5 studies met the inclusion criteria. Of the 5 manuscripts, there was 1 case‐control, 2 cohort, and 2 cross‐sectional studies. A total of 522 participants with AERD and a history of alcohol consumption were included, with 52.8% reporting at least 1 sinopulmonary exacerbation after alcohol intake. One of 3 studies noted improvement in alcohol tolerance after medical therapy with aspirin desensitization.ConclusionThe current literature suggests that patients with AERD have a high risk of alcohol intolerance. Additionally, aspirin desensitization may improve alcohol tolerance in this patient population.
Providing Evidence for Dogma: Risk of Epistaxis After COVID‐19 Nasal‐Screening Swab
Authors: Block‐Wheeler Nikolas R. , Wei Julia , Weintraub Miranda R. , Liang Jonathan 
Published: January 2023

AbstractObjectiveThere is anecdotal evidence SARS‐CoV‐2 (COVID) RT‐PCR screening nasal swabs confer an elevated epistaxis risk. We aimed to assess the association between epistaxis and exposure to a COVID nasal swab.Study DesignA matched pairs design was used.SettingThe study was performed in a single, integrated health care system.MethodsAll patients who received a single COVID nasal swab at our institution between April 2020 and March 2021 were included. McNemar's test was used to compare rates of epistaxis between the 7 days following the index COVID swab (hazard period), and the 7 days preceding the index COVID swab (control period). Conditional logistic regression was used to evaluate sociodemographic and clinical risk factors for epistaxis.ResultsA total of 827,987 participants were included, with 1047 epistaxis encounters. The prevalence of epistaxis during the hazard and control periods were 0.08% and 0.04%, respectively. Swab exposure was associated with 1.92‐fold odds of epistaxis during the hazard period (95% confidence interval [1.73, 2.12]). Older age, Asian/Pacific Islander (PI) (compared to white), male sex, hypertension, prior facial trauma, and warfarin or direct‐acting oral anticoagulant use were also associated with significantly increased odds of epistaxis (p ≦ 0.01).ConclusionCOVID nasal swabs are associated with increased odds of epistaxis. Physicians should counsel patients, particularly those at the highest risk, including a history of prior facial trauma, anticoagulants/antiplatelets, or hypertension.
Objective Pharyngeal Phenotyping in Obstructive Sleep Apnea With High‐Resolution Manometry
Authors: Kent David T. , Scott William C. , Ye Cheng , Fabbri Daniel 
Published: January 2023

AbstractObjectiveDrug‐induced sleep endoscopy (DISE) is a commonly used diagnostic tool for surgical procedural selection in obstructive sleep apnea (OSA), but it is expensive, subjective, and requires sedation. Here we present an initial investigation of high‐resolution pharyngeal manometry (HRM) for upper airway phenotyping in OSA, developing a software system that reliably predicts pharyngeal sites of collapse based solely on manometric recordings.Study DesignProspective cross‐sectional study.SettingAn academic sleep medicine and surgery practice.MethodsForty participants underwent simultaneous HRM and DISE. A machine learning algorithm was constructed to estimate pharyngeal level‐specific severity of collapse, as determined by an expert DISE reviewer. The primary outcome metrics for each level were model accuracy and F1‐score, which balances model precision against recall.ResultsDuring model training, the average F1‐score across all categories was 0.86, with an average weighted accuracy of 0.91. Using a holdout test set of 9 participants, a K‐nearest neighbor model trained on 31 participants attained an average F1‐score of 0.96 and an average accuracy of 0.97. The F1‐score for prediction of complete concentric palatal collapse was 0.86.ConclusionOur findings suggest that HRM may enable objective and dynamic mapping of the pharynx, opening new pathways toward reliable and reproducible assessment of this complex anatomy in sleep.
Experience With the New Active Transcutaneous Bone‐Conduction Implant With Smaller Dimensions
Authors: Brkic Faris F. , Baumgartner Wolf‐Dieter , Schlott Melina , Liu David T. , Thurner Thomas , Riss Dominik , Gstöttner Wolfgang , Vyskocil Erich 
Published: January 2023

AbstractObjectiveRecently, the Bonebridge 602 implant was introduced. Its smaller dimensions facilitate implantation even in surgically demanding cases. However, in extreme anatomical conditions, implant lifts are still required. We intended to report on the medical and audiological outcomes of all patients implanted with the implant with a secondary focus on the safety, efficacy, and feasibility of the use of 1‐mm lifts.Study DesignRetrospective cohort study.SettingTertiary academic center.MethodsWe retrospectively analyzed all patients implanted with the Bonebridge 602. Patient demographics and surgically‐specific data were collected from the medical charts. Furthermore, audiological results were assessed. Outcomes were compared between implantations with versus without lifts.ResultsTwenty‐one devices were implanted during the study period. Satisfactory audiological results were observed, while no intra‐ or postoperative adverse events occurred. The majority of patients were daily users at the end of the observation period (n = 20/21, 95.2%), and one patient (n = 1/21, 4.8%) was a nonuser after 6 months of use because of subjective dissatisfaction. Due to anatomical considerations, 1‐mm lifts were used in 4 implantations (19.0%). The application of lifts did not result in prolonged surgical times, complications, or shorter time of use, nor did it negatively affect audiometric results.ConclusionImplantations with the new and smaller Bonebridge were associated with gratifying medical and audiological outcomes. Still, in extreme anatomical conditions, 1‐mm lifts are necessary. Nonetheless, surgical placement with the help of lifts seems safe, effective, and feasible, and is a viable option in cases with challenging anatomies due to previous surgeries or anomalies.
Radiotherapy of early‐stage breast cancer
Authors: Yu Cedric X. 
Published: January 2023

AbstractBreast cancer is the most prevalent disease for women. With advances in breast cancer screening, most breast cancers are now diagnosed in the early stages. With knowledge of different subtypes and their behavior, breast cancer treatment has become more individualized. Radiation therapy as one of the mainstays of breast cancer treatment has also been evolving. This review attempts to provide a summary of the most influential clinical studies that have driven the technological advances in radiation therapy for early‐stage breast cancer.
Recent trends in the spatial distribution of human capital: Are skill levels converging across regions in England and Wales?
Authors: Azpitarte Francisco 
Published: January 2023

AbstractIn modern knowledge‐based societies human capital is the single most important determinant of regional inequalities in productivity and standards of living. Using a newly constructed data set that allows the analysis of educational attainments at different levels of geography, this paper evaluates spatial inequalities and the degree of convergence in the distribution of human capital across areas in England and Wales during the second decade of the 21st century. Our results show this was a period characterised by a large increase in educational attainment and skill intensity. However, the growth in skill intensity was far from uniform across space. In particular, we find strong evidence of both absolute σ‐divergence and β‐convergence in the distribution of skills. Thus, even if low‐skill areas grew on average more than other areas with higher skill intensity at the start of the period, the stochastic dominance analyses provide strong evidence of an unambiguous increase in absolute inequalities so that by end of the decade the skill gap between low‐ and high‐skill areas had significantly widened. We present new spatial and aspatial evidence that sheds light on those inequalities and the changes in the spatial configuration of human capital over the last decade. Despite the implementation of policies aimed at reducing regional inequalities, many low skill areas struggled to attract talent so that the gap with most skilled areas widened over that period likely contributing to the persistence of the well‐documented large spatial economic inequalities in this country.
Estimating county level health indicators using spatial microsimulation
Authors: Seamon Erich , Megheib Mohamed , Williams Christopher J. , Murphy Christopher F. , Brown Helen F. 
Published: January 2023

AbstractGiven the importance of understanding health outcomes at fine spatial scales, iterative proportional fitting (IPF), a form of small area estimation, was applied to a fixed number of health‐related variables (obesity, overweight, and diabetes) taken from regionalised 2019 survey responses (n = 5474) from the Idaho Behavioral Risk Factor Surveillance System (BRFSS). Using associated county‐level American Community Survey (ACS) census data, a set of constraints, which included age categorisation, race, sex, and education level, were used to create county‐level weighting matrices for each variable, for each of the seven (7) Idaho public health districts. Using an optimised modeling construction technique, we identified significant constraints and grouping splits for each variable/region, resulting in estimates that were internally and externally validated. Externally validated model results for the most populated counties showed correlations ranging from 0.79 to 0.85, with p‐values all below 0.05. Estimates indicated higher levels of obesity and overweight individuals for midsouth and southwestern Idaho counties, with a cluster of higher diabetes estimates in the center of the state (Gooding, Lincoln, Minidoka, and Jerome counties). Alternative external sources for health outcomes aligned extremely well with our estimates, with wider confidence intervals in more rural counties with sparse populations.