bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Systematic Review of Primary Temporal Bone Mucosal Melanoma
Authors: Young Kurtis , Arkfeld Daniel V. , Ogasawara Christian T. , Squires Lane D. 
Published: February 2023

Objective
Temporal bone mucosal melanomas (MMs) are rare, and patients may experience delays in diagnosis and treatment. Our objective was to better characterize the presentation, diagnosis, treatment modalities, and outcomes of this process.

Data Sources
PubMed/Medline, CINAHL (EBSCOhost), and Web of Science databases were searched in all languages without restriction of publication dates.

Study Selection
Inclusion criteria included that the article was either a case report or a case series with individual case data. All non-English articles were excluded if the corresponding abstract lacked data on demographics, initial presentation, and clinical management.

Data Extraction
After full-text analysis, data pertaining to demographics, diagnosis, medical and surgical management modalities, and outcomes were extracted.

Data Synthesis
Data were qualitatively synthesized, and means and averages were obtained for all continuous variables. Overall survival was measured by the Kaplan-Meier method, and significance was measured through log-rank testing.

Conclusions
Clinicians should suspect temporal bone MM in the differential diagnosis of patients with bloody otorrhea in the context of a chronic serous otitis media or an associated cranial nerve palsy. If suspected, physicians should not delay the acquisition of a biopsy or imaging studies. Management is highly variable and must be decided on a case-by-case basis. Outcomes remain poor because of the high propensity for MM to metastasize.
Quality of Life Impact of Cochlear Implantation for Single-Sided Deafness: Assessing the Interrelationship of Objective and Subjective Measures
Authors: Tolisano Anthony M. , Pillion Elicia M. , Dirks Coral E. , Ryan Matthew T. , Bernstein Joshua G. W. 
Published: February 2023

Objective
To determine the effect on quality of life (QOL) of cochlear implantation (CI) for single-sided deafness (SSD) and asymmetric hearing loss (AHL) using the first psychometrically developed CI-specific QOL tool for English-speaking patients and to assess its relationship to objective perceptual measures.

Study Design
Retrospective cohort study.

Setting
Tertiary-care medical center.

Patients
English-speaking adults with SSD or AHL.

Interventions
Unilateral CI.

Main Outcome Measures
Cochlear Implant Quality of Life (CIQOL) score, CI-alone speech-in-quiet (SIQ) score (CNC and AzBio), binaural speech-in-noise (SIN) threshold, binaural azimuthal sound localization (SL) error.

Results
At the most recent postoperative evaluation (median, 9.3 months postimplantation), 25 of 28 subjects (89%) had a CIQOL improvement, with the improvement considered clinically beneficial (>3 points) for 18 of 28 subjects (64%). Group-mean CIQOL improvement was observed at the first postoperative visit and did not change significantly thereafter. Objective perceptual measures (SL, SIQ, SIN) continued to improve over 12 months after implantation. Linear mixed-model regression analyses showed a moderate positive correlation between SIN and SIQ improvements (r = 0.50 to 0.59, p < 0.0001) and a strong positive correlation between the improvement in the two SIQ measures (r = 0.89, p < 0.0001). No significant relationships were observed (p > 0.05) among QOL or the objective perceptual measures.

Conclusions
QOL improved for the majority of subjects implanted for SSD and AHL. Different time courses for improvement in QOL and audiologic tests, combined with the lack of significant relationships among them, suggest that QOL outcomes reflect different aspects of the CI experience than those captured by speech-understanding and localization measures. SIQ may substitute for SIN when clinical constraints exist.
Older Adults with Vestibular Disorders and Hip Fractures Have High Rates of Meclizine Use
Authors: Curry Steven D. , Carotenuto Alessandro , Huang Ye , Maar Dennis J. , DeLuna Devin A. , Siebler Justin C. , Hatch Jonathan L. 
Published: February 2023

Objectives
To examine the risk factors for hip fracture in patients with vestibular disorders and the association between antihistamine use and hip fracture in patients with vestibular disorders.

Study Design
Retrospective case series with chart review.

Setting
Tertiary academic medical center.

Methods
A retrospective review of adult patients with hip fracture based on International Classification of Diseases, Tenth Revision (ICD-10) code S72 from January 2013 to December 2019 who had previously been diagnosed with a vestibular disorder based on ICD-10 codes H81–83, A88.1, and R42.

Results
A total of 201 patients were identified meeting the inclusion criteria. The average age at the time of hip fracture was 78.8 years and the majority were female (64.7%). Most patients were diagnosed with nonspecific dizziness (60.2%) or vertigo (23.9%). Those with a peripheral vestibular disorder included benign paroxysmal positional vertigo (BPPV) in 13.4% and Ménière’s disease in 2.5%. Overall, meclizine was prescribed to 38.3% of patients, including 29.9% of patients before hip fracture. Meclizine was prescribed to 66.7% of patients with BPPV. Patients were seen for vestibular symptoms 0.67 ± 2.51 years before hip fracture, and 98 patients (48.8%) presented with vestibular concerns within 1 year prior.

Conclusion
Patients with vestibular disorders who sustain a ground level fall resulting in hip fracture are a vulnerable population of predominantly older adults with multiple comorbidities. Patients were frequently diagnosed with dizziness or vertigo rather than more specific causes being identified. Multifactorial interventions to prevent hip fractures in older adults have been recommended; however, this study suggests that meclizine use was common among patients diagnosed with dizziness, vertigo, or BPPV before hip fracture.
Video Head Impulse Test Demonstrates a Residual Function after Plugging of Dehiscent Superior Semicircular Canal
Authors: Renteria Axel E. , Elblidi Ahlem , Altamami Nasser , Alhabib Salman , Saliba Issam 
Published: February 2023

Objective
Plugging a symptomatic dehiscent superior semicircular canal (SSCC) often leads to a nonfunctional postoperative canal. However, in some instances, a residual function has been described. This study attempts to describe what factors may lead to such residual function.

Study design
Retrospective study.

Setting
Tertiary referral center.

Patients
Thirty-five patients with confirmed SSCC dehiscence.

Intervention
Video head impulse test was conducted pre- and postoperatively to assess any difference in the function of the SSCC.

Main Outcome measures
Mean gain and pathological saccades were recorded according to well-established thresholds along with dehiscence length and location to evaluate any associations to residual canal function.

Results
When comparing preoperative to postoperative SSCC abnormal gains, a significant increase was observed after plugging (p = 0.023). This also held true when abnormal gain and pathologic saccades were taken together (p < 0.001). Interestingly, 55.3% of patients were observed to remain with a residual SSCC function 4 months postoperatively even with a clinical improvement. Of these, 47.6% had normal gain with pathologic saccades, 38.1% had an abnormal gain without pathologic saccades, and 14.3% had normal gain without pathologic saccades (normal function). Preoperatively, SSCC abnormal gain was associated with a larger dehiscence length mean (p = 0.002). Anterosuperior located dehiscences were also associated with a larger dehiscence length mean (p = 0.037). A residual SSCC function after plugging was associated with a shorter dehiscence length regardless of location (p = 0.058).

Conclusion
Dehiscence length and location may be useful in predicting disease symptomatology preoperatively and canals function recovery after plugging. These factors could be used as indicators for preoperative counseling and long-term management.
Management of Already Inserted Ventilation Tubes During Pediatric Cochlear Implantation: To Remove or Leave the Tube?
Authors: Tobe Yota , Yamazaki Hiroshi , Shirakawa Chigusa , Shinohara Shogo , Fujiwara Keizo , Naito Yasushi 
Published: February 2023

Objective
Ventilation tube (VT) insertion is usually recommended before cochlear implantation (CI) in pediatric cochlear implant candidates with recurrent acute otitis media (AOM) or chronic otitis media with effusion (OME). However, there is no consensus on whether the VT is beneficial even after CI, that is, whether the tube should be removed or left in place during CI. This study aimed to assess the effect of tube placement after CI, especially on the incidence of post-CI AOM, in pediatric cochlear implant recipients who had undergone VT insertion before CI because of recurrent AOM or chronic OME.

Study Design
A retrospective medical record review.

Setting
A tertiary referral cochlear implant center.

Patients
This study recruited 58 consecutive ears of children who underwent VT insertion followed by CI at age 7 years or younger between 2004 and 2021. Before October 2018, we removed the VT simultaneously with CI (removed group, 39 ears), while since then, the tube has remained in place during CI (retained group, 19 ears).

Intervention
Therapeutic.

Main Outcome Measure
The primary outcome was the proportion of ears that developed AOM at post-CI 6 months in the removed and retained groups.

Results
The age at CI was significantly higher in the removed group than in the retained group (mean [standard deviation]: the removed group, 2.9 [1.2] yr; the retained group: 1.5 [0.8] yr; p < 0.001). The removed group showed a significantly higher proportion of ears with post-CI AOM (8 of 39 ears; 20.5%) than the retained group (none of 19 ears; 0%) 6 months after CI (p = 0.044). The AOM-free proportion at post-CI 12 months was 76.9% in the removed group and 83.3% in the retained group, demonstrating no significant difference (p = 0.49), probably because the VT was spontaneously extruded in the retained group at a median of 6.5 months after CI. Throughout the study period, 17 ears (13 from the removed group) were affected by post-CI AOM. Of these, three ears in the removed group and two in the retained group after spontaneous extrusion of the VT were hospitalized and treated with intravenous antibiotics for AOM that had failed to respond to oral antibiotic therapy. Only one ear in the removed group required an explanation of the infected implant. None suffered from chronic perforation of the tympanic membrane or secondary cholesteatoma after VT insertion or meningitis associated with post-CI AOM.

Conclusion
Our results suggest that in CI for children who already have a VT because of a recurrent AOM or chronic OME, retaining the tube in position, rather than removing the tube, may decrease the incidence of AOM at least within 6 months after CI, during which most cochlear implant device infection was reported in the pediatric population.
Effects of Age at Implantation on Outcomes of Cochlear Implantation in Children with Short Durations of Single-Sided Deafness
Authors: Gordon Karen A. , Alemu Robel , Papsin Blake C. , Negandhi Jaina , Cushing Sharon L. 
Published: February 2023

Objective
Children with single-sided deafness (SSD) show reduced language and academic development and report hearing challenges. We aim to improve outcomes in children with SSD by providing bilateral hearing through cochlear implantation of the deaf ear with minimal delay.

Study Design
Prospective cohort study of 57 children with SSD provided with cochlear implant (CI) between May 13, 2013, and June 25, 2021.

Setting
Tertiary children’s hospital.

Participants
Children with early onset (n = 40) or later onset of SSD (n = 17) received CIs at ages 2.47 ± 1.58 years (early onset group) and 11.67 ± 3.91 years (late onset group) (mean ± SD). Duration of unilateral deafness was limited (mean ± SD = 1.93 ± 1.56 yr).

Intervention
Cochlear implantation of the deaf ear.

Main Outcomes/Measures
Evaluations of device use (data logging) and hearing (speech perception, effects of spatial release from masking on speech detection, localization of stationary and moving sound, self-reported hearing questionnaires).

Results
Results indicated that daily device use is variable (mean ± SD = 5.60 ± 2.97, range = 0.0–14.7 h/d) with particular challenges during extended COVID-19 lockdowns, including school closures (daily use reduced by mean 1.73 h). Speech perception with the CI alone improved (mean ± SD = 65.7 ± 26.4 RAU) but, in the late onset group, remained poorer than in the normal hearing ear. Measures of spatial release from masking also showed asymmetric hearing in the late onset group (t
13 = 5.14, p = 0.001). Localization of both stationary and moving sound was poor (mean ± SD error = 34.6° ± 16.7°) but slightly improved on the deaf side with CI use (F
1,36 = 3.95, p = 0.05). Decreased sound localization significantly correlated with poorer self-reported hearing.

Conclusions and Relevance
Benefits of CI in children with limited durations of SSD may be more restricted for older children/adolescents. Spatial hearing challenges remain. Efforts to increase CI acceptance and consistent use are needed.
Dynamic Behavior and Insertional Forces of a Precurved Electrode Using the Pull-Back Technique in a Fresh Microdissected Cochlea
Authors: Smetak Miriam R. , Riojas Katherine E. , Whittenbarger Noah , Noble Jack H. , Labadie Robert F. 
Published: February 2023

Hypothesis
This study evaluated the utility of the pull-back technique in improving perimodiolar positioning of a precurved cochlear implant (CI) electrode array (EA) with simultaneous insertion force profile measurement and direct observation of dynamic EA behavior.

Background
Precurved EAs with perimodiolar positioning have improved outcomes compared with straight EAs because of lowered charge requirements for stimulation and decreased spread of excitation. The safety and efficacy of the pull-back technique in further improving perimodiolar positioning and its associated force profile have not been adequately demonstrated.

Methods
The bone overlying the scala vestibuli was removed in 15 fresh cadaveric temporal bones, leaving the scala tympani unviolated. Robotic insertions of EAs were performed with simultaneous force measurement and video recording. Force profiles were obtained during standard insertion, overinsertion, and pull-back. Postinsertion CT scans were obtained during each of the three conditions, enabling automatic segmentation and calculation of angular insertion depth, mean perimodiolar distance (M
avg), and cochlear duct length.

Results
Overinsertion did not result in significantly higher peak forces than standard insertion (mean [SD], 0.18 [0.06] and 0.14 [0.08] N; p = 0.18). Six temporal bones (40%) demonstrated visibly improved perimodiolar positioning after the protocol, whereas none worsened. M
avg significantly improved after the pull-back technique compared with standard insertion (mean [SD], 0.34 [0.07] and 0.41 [0.10] mm; p < 0.01).

Conclusions
The pull-back technique was not associated with significantly higher insertional forces compared with standard insertion. This technique was associated with significant improvement in perimodiolar positioning, both visually and quantitatively, independent of cochlear size.
Role of basal autonomic functions in patients with increased morning blood pressure surge
Authors: Akbay Ertan , Akinci Sinan 
Published: February 2023

Background
Morning blood pressure (BP) surge (MS) is associated with cardiovascular events. The autonomic nervous system plays an active role in the regulation of BP and its function can be evaluated by heart rate variability (HRV) analysis. This study aimed to evaluate autonomic nervous system functions in patients with increased MS.

Methods
Patients who underwent ambulatory BP monitoring (ABPM) and 24-h rhythm Holter in our hospital during the same period between 2017 and 2022 were evaluated. HRV parameters were obtained from 24-h rhythm Holter recordings. MS values of the patients were calculated from ABPM records and patients were divided into four groups according to the MS quartiles. HRV parameters and other parameters were compared between the groups.

Results
A total of 129 patients were included in the study. The mean age of the patients was 57.2 ± 18.2 years, and 63 (48.8%) were male. HF, the square root of the mean squared differences of successive normal-to-normal intervals (rMSSD), and the proportion of adjacent RR intervals differing by >50 ms in the 24-h recording (pNN50) were statistically significant between the groups (P = 0.039, P = 0.013, P = 0.011, respectively). In univariate regression analysis, low-frequency/high-frequency ratio was positively associated with MS and HF, SDNNi, rMSSD, and pNN50 were negatively associated (β = 0.207, P = 0.019; β = −0.272, P = 0.002; β = −0.201, P = 0.022; β = −0.265, P = 0.002; β = −0.278, P = 0.001, respectively). Multiple linear regression analysis showed an independent association between HF, low-frequency/high-frequency ratio, rMSSD, pNN50, and MS (β = −0.247, P = 0.005; β=0.206, P = 0.017; β = −0.209, P = 0.005; β = −0.227, P = 0.008, respectively).

Conclusion
We found an independent association between HRV parameters associated with vagal tone and MS. The findings of our study suggest that the increased sympathetic activity detected in patients with high MS in previous studies may be due to a decrease in basal vagal tone.
Update on the management of acute pancreatitis
Authors: van den Berg Fons F. , Boermeester Marja A. 
Published: February 2023

Purpose of review
This review provides insight into the recent advancements in the management of acute pancreatitis.

Recent findings
Moderate fluid resuscitation and Ringer's lactate has advantages above aggressive fluid resuscitation and normal saline, respectively. A normal “on-demand” diet has a positive effect on recovery from acute pancreatitis and length of hospital stay. A multimodal pain management approach including epidural analgesia might reduce unwarranted effects of opiate use. A more targeted use of antibiotics is starting to emerge. Markers such as procalcitonin may be used to limit unwarranted antibiotic use. Conversely, many patients with infected necrotizing pancreatitis can be treated with only antibiotics, although the optimal choice and duration is unclear. Delay of drainage as much as is possible is advised since it is associated with less procedures. If drainage is required, clinicians have an expanding arsenal of interventional options to their disposal such as the lumen-apposing metal stent for transgastric drainage and (repeated) necrosectomy. Immunomodulation using removal of systemic cytokines or anti-inflammatory drugs is an attractive idea, but up to now the results of clinical trials are disappointing. No additional preventive measures beside non-steroidal anti-inflammatory drugs (NSAIDs) can be recommended for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.

Summary
More treatment modalities that are less invasive became available and a trend towards less aggressive treatments (fluids, starvation, interventions, opiates) of acute pancreatitis is again emerging. Despite recent advancements, the pathophysiology of specific subgroup phenotypes is still poorly understood which reflects the disappointing results of pharmacological and immunomodulatory trials.
Metachronous Colorectal Adenomas Occur Close to the Index Lesion
Authors: Rosser Ria , Corfe Bernard M. , Chapple Keith S. 
Published: February 2023

Goals:
The aim of this study is to assess the spatial relationship between index and metachronous colorectal adenoma location.

Background:
After the complete excision of a human sporadic colorectal adenoma, patients are at elevated risk of developing a further metachronous adenoma. Data regarding the occurrence site of a metachronous colorectal adenoma relative to the index adenoma are scarce.

Study:
Prospectively maintained databases were interrogated to identify all colonoscopies and adenoma excisions performed over a 10-year period at a single university teaching hospital. Data for the colonic segments at which adenoma removal were reported at index and all subsequent colonoscopies were extracted and 2 allied data sets merged.

Results:
A total of 15,121 colonoscopies and 4759 polyp events were recorded. Four hundred fifty-two patients [296 male, 156 female, median (range) age 75 (32 to 100) y] developed at least 1 metachronous adenoma at follow-up colonoscopy. When single index events only are considered (ie, synchronous adenoma cases excluded), over 61% of metachronous adenomas were recorded in the same or an adjacent colonic segment. When the full span of the colon is considered, metachronous adenomas were more likely to occur in a section of the colon proximal to that of the index adenoma (41%±5%) than the same (39%±5%) or distal segment (20%±5%; P=0.006; 1-way χ2 test).

Conclusions:
A metachronous human sporadic colorectal adenoma is more likely to be found in the same colonic segment to that of the index adenoma or 1 immediately adjacent. These data suggest a shared origin of metachronous adenoma with preceding lesions, supporting the existence of precancerous fields.
Pneumococcal Vaccination Recommendation and Completion Rates Among Patients With Inflammatory Bowel Disease and Barriers to Vaccination
Authors: Dasharathy Sonya S. , May Folasade P. , Myint Anthony , Yang Liu , Rahal Harman K. , Cusumano Vivy , Kozan Philip A. , Lowe Sarina C. , Beah Peter Y. , Limketkai Berkeley N. , Sauk Jenny S. 
Published: February 2023

Background:
Guidelines for inflammatory bowel disease (IBD) patients receiving immunosuppression encouraged both the pneumococcal polysaccharide vaccine (PPSV23) and the pneumococcal conjugate vaccine (PCV13). We aimed to evaluate which pneumococcal vaccines are recommended and administered, and to understand provider and IBD patient knowledge regarding pneumococcal vaccinations.

Methods:
We performed a retrospective, cross-sectional analysis of 357 adult IBD patients on immunosuppression in our health care system. Patient demographics and clinical characteristics were collected. The primary outcome was rate of documented vaccinations recommended by providers; the secondary outcome was rate of receipt of the vaccines. We identified factors associated with receipt of any pneumococcal vaccine through multivariable logistic regression. We also performed provider and IBD patient surveys to understand provider and patient knowledge regarding pneumococcal vaccines. We used χ2 and Fisher exact tests to assess survey responses.

Results:
Fifty seven percent of IBD patients had any pneumococcal vaccination recommended and 35% had recommendations for both PPSV23 and PCV13. Forty percent received any pneumococcal vaccine and 18% received both vaccines. In multivariable analyses, increasing age (adjusted odds ratio: 1.03, 95% CI: 1.01-1.05) was associated with receipt of any pneumococcal vaccine, after adjusting for gender, race, insurance, disease activity, and time seen in our gastroenterology clinics. In the survey study, on average, 59% of providers correctly answered questions regarding pneumococcal vaccination indications.

Conclusion:
In our health care system, while recommendation for any pneumococcal vaccination was >50%, receipt of both PPSV23 and PCV13 was low. Simplified vaccine regimens (ie, PCV20) will likely improve vaccination rates.