bluuebunny/crossref_metadata_2025_split huggingface dataset:
Otology-Neurotology 2020 US Workforce Distribution
Authors: Casazza Geoffrey C. , Kesser Bradley W. , Strumpf Andrew M. , Gurgel Richard K. , Hashisaki George T. 
Published: August 2022

Objective:
Determine the geographic and per capita distribution of otology-neurotology physician-surgeons within the United States.

Study Design:
National database review.

Setting:
United States.

Methods:
The American Neurotology Society and ENThealth.org membership databases were queried to identify otology-neurotology physician-surgeons within the United States. Physician-surgeons were divided by regional national census areas, state, and by largest population statistical area based on 2019 US Census population estimates. The number of otology-neurotology physician-surgeons per 1 million persons was calculated for each population designation.

Results:
Four-hundred eighty-two physician-surgeons were identified, representing 49 states and the District of Columbia. The New England division (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island) was the most concentrated region (1.89), whereas the West-South-Central (Texas, Oklahoma, Arkansas, Louisiana) was the least concentrated region (1.23) per million persons. The highest concentration of physician-surgeons by state is within the District of Columbia (4.25), Vermont (3.21), North Dakota (2.62), Massachusetts (2.61), and New York (2.21) (per million), whereas Mississippi (0.67), Georgia (0.66), Idaho (0.56), New Mexico (0.48), and Wyoming (0.0) were the least concentrated per million persons. Increasing number of physician-surgeons was significantly correlated by state (r
2 = 0.9; P < 0.0001), largest statistical area (r
2 = 0.88; P < 0.0001), and census region (r
2 = 0.95; P < 0.0005).

Conclusions:
Otology-neurotology physician-surgeons are evenly distributed across the United States; however, certain areas are likely underrepresented. Variability in clinical practice may account for under or overrepresentation not captured in this analysis.
Incidence of Concomitant Semicircular Canal Dehiscence With Otosclerosis
Authors: Walker Brian A. , Thorwarth Ryan M. , Stull Lindsey L. , Hoxworth Joseph M. , Deep Nicholas L. , Weisskopf Peter A. 
Published: August 2022

Objective:
The concurrence of otosclerosis and superior semicircular canal dehiscence (SSCD) presents a diagnostic challenge and failure to differentiate between these 2 diagnoses results in mischaracterization and unsuccessful surgery. The objective of this study is to identify the incidence of SSCD in patients who have computed tomography (CT) evidence of otosclerosis.

Study Design:
Retrospective chart review.

Setting:
Tertiary referral hospital.

Patients:
Adults with CT scan of the temporal bone diagnosed with radiological unilateral or bilateral fenestral otosclerosis from January 1995 to April 2018.

Methods:
Retrospective review of patient imaging from a multi-center tertiary-referral health system from January 1995 to April 2018. Imaging was reviewed to quantify the incidence of SSCD among patients with CT-diagnosed bilateral fenestral otosclerosis. Poor quality imaging was excluded from review.

Results:
One-thousand two-hundred eight patients (1214 CT scans) were identified with otosclerosis, of which 373 were diagnosed with fenestral otosclerosis (663 ears) with imaging of sufficient quality for review. This population was predominantly female (57.2%) with bilateral fenestral otosclerosis (78%). Of these, 23 ears (3.5%) had definitive evidence of SSCD, with an additional 15 ears (2.3%) with possible radiographic evidence of SSCD. There was no significant difference in laterality between the SSCD and otosclerosis.

Conclusions:
Among 373 patients with fenestral otosclerosis per CT temporal bone imaging at a tertiary referral hospital, as many as 8.3% of patients had radiographic evidence of SSCD. Given this incidence, it continues to be important to consider SSCD when diagnosing and treating otosclerosis.
Rationally Designed Magnetic Nanoparticles for Cochlear Drug Delivery: Synthesis, Characterization, and In Vitro Biocompatibility in a Murine Model
Authors: Goyal Mukund M. , Zhou Nancy J. , Vincent Philippe F. Y. , Hoffman Elina S. , Goel Shiv , Wang Chao , Sun Daniel Q. 
Published: August 2022

Hypothesis:
Magnetic nanoparticles (MNPs) for cochlear drug delivery can be precisely engineered for biocompatibility in the cochlea.

Background:
MNPs are promising drug delivery vehicles that can enhance the penetration of both small and macromolecular therapeutics into the cochlea. However, concerns exist regarding the application of oxidative, metal-based nanomaterials to delicate sensory tissues of the inner ear. Translational development of MNPs for cochlear drug deliver requires specifically tuned nanoparticles that are not cytotoxic to inner ear tissues. We describe the synthesis and characterization of precisely tuned MNP vehicles, and their in vitro biocompatibility in murine organ of Corti organotypic cultures.

Methods:
MNPs were synthesized via 2-phase ligand transfer process with precise control of nanoparticle size. Core and hydrodynamic sizes of nanoparticles were characterized using electron microscopy and dynamic light scattering, respectively. In vitro biocompatibility was assayed via mouse organ of Corti organotypic cultures with and without an external magnetic field gradient. Imaging was performed using immunohistochemical labeling and confocal microscopy. Outer hair cell, inner hair cell, and spiral ganglion neurites were individually quantified.

Results:
Monocore PEG-MNPs of 45 and 148 nm (mean hydrodynamic diameter) were synthesized. Organ of Corti cultures demonstrated preserved outer hair cell, inner hair cell, and neurite counts across 2 MNP sizes and doses, and irrespective of external magnetic field gradient.

Conclusion:
MNPs can be custom-synthesized with precise coating, size, and charge properties specific for cochlear drug delivery while also demonstrating biocompatibility in vitro.
Immediate Improvement in Subjective Visual Vertical and Disequilibrium Predicts Resolution of Benign Paroxysmal Positional Vertigo Following Single Canalith Repositioning Maneuver
Authors: Little Christine C. , Schwam Zachary G. , Campo Marc , Gurley James , Hujsak Bryan , Cosetti Maura K. , Kelly Jennifer 
Published: August 2022

Objective:
To evaluate whether immediate post-canalith repositioning maneuver (CRM) vestibular changes are predictive of benign paroxysmal positional vertigo (BPPV) resolution.

Study Design:
Retrospective cohort study.

Setting:
Tertiary referral center.

Patients:
Adults (n = 27) with posterior canal BPPV.

Interventions:
Single CRM with Frenzel goggles.

Main Outcome Measures:
The Visual Analog Scale (VAS) for disequilibrium, the subjective visual vertical (SVV), the subjective visual horizontal (SVH), and the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) were administered pre- and immediately following single CRM. Dix-Hallpike was performed 1–3 weeks after CRM to assess for BPPV resolution. Pre- and post-treatment vestibular assessments were compared between groups to determine if post-CRM vestibular changes could predict BPPV resolution.

Results:
The change in VAS score following CRM treatment was statistically different between patients who responded to CRM treatment (n = 15) and those who did not (n = 12), (–0.07 points versus –2.40 points, respectively; P = 0.03). Likewise, a significantly greater improvement in SVV score was observed for CRM responders compared with CRM nonresponders (0.92° versus –0.06°, respectively; P = 0.02). Change in SVH and mCTSIB scores did not differ significantly between groups. Additionally, patient age was found to predict outcome of CRM treatment, with older patients more likely to experience persistent BPPV (P ≤ 0.01).

Conclusions:
Immediate improvement in VAS and SVV scores following CRM may be useful in predicting resolution of BPPV and may assist in directing the timing and need for future interventions. Younger age may have a favorable predictive value for improvement following single CRM.
Single-dose radiation therapy without additional surgery as a treatment for heterotopic ossification developing after transfemoral amputation, a case report
Authors: Zorn Devon , Lombardo Joseph , Poiset Spencer , Gutman Michael , Cappelli Louis , Hurwitz Mark , Ankam Nethra 
Published: August 2022

Abstract
Heterotopic ossification (HO) is the development of mature lamellar bone in soft tissues. HO can occur in up to 23% of patients after amputation. HO is often painful, causing significant dysfunction. While radiotherapy is used to prevent HO prior to formation, there is a dearth of literature on using radiotherapy to treat existing HO. This case report describes the use of late radiotherapy for the management of existing HO that developed after a transfemoral amputation. A 61-year-old female with peripheral artery disease of her bilateral lower extremities status post stenting and ultimately left transfemoral amputation was diagnosed with symptomatic HO limiting her function. Another surgery was not felt to be warranted. She was not improving with medical therapy and was prescribed 800 cGy in one fraction. Following treatment, she experienced significant relief in her pain, allowing her to resume physical therapy and use of her prosthesis. There are no other published examples of using radiation alone for treatment of HO formation after transfemoral amputation without surgical revision of the bone formation. Our case shows possible utility in single-dose radiation as a treatment to prevent progression of HO, especially when limiting functional progress.
Optimized Camera-Based Patient Positioning in CT
Authors: Manava Panagiota , Galster Marco , Ammon Josefin , Singer Julian , Lell Michael M. , Rieger Vera 
Published: August 2022

Objective
The aim of this study was to evaluate whether a 3-dimensional (3D) camera can outperform highly trained technicians in precision of patient positioning and whether this transforms into a reduction in patient exposure.

Materials and Methods
In a single-center study, 3118 patients underwent computer tomography (CT) scans of the chest and/or abdomen on a latest generation single-source CT scanner supported with an automated patient positioning system by 3D camera. One thousand five hundred fifty-seven patients were positioned laser-guided by a highly trained radiographer (camera off) and 1561 patients with 3D camera (camera on) guidance. Radiation parameters such as effective dose, organ doses, CT dose index, and dose length product were analyzed and compared. Isocenter accuracy and table height were evaluated between the 2 groups.

Results
Isocenter positioning was significantly improved with the 3D camera (P < 0.001) as compared with visual laser-guided positioning. Absolute table height differed significantly (P < 0.001), being higher with camera positioning (165.6 ± 16.2 mm) as compared with laser-guided positioning (170.0 ± 20.4 mm). Radiation exposure decreased using the 3D camera as indicated by dose length product (321.1 ± 266.6 mGy·cm; camera off: 342.0 ± 280.7 mGy·cm; P = 0.033), effective dose (3.3 ± 2.7 mSv; camera off: 3.5 ± 2.9; P = 0.053), and CT dose index (6.4 ± 4.3 mGy; camera off: 6.8 ± 4.6 mGy; P = 0.011). Exposure of radiation-sensitive organs such as colon (P = 0.015) and red bone marrow (P = 0.049) were also lower using the camera.

Conclusions
The introduction of a 3D camera improves patient positioning in the isocenter of the scanner, which results in a lower and also better balanced dose reduction for the patients.
Brachial Plexus Magnetic Resonance Neurography
Authors: Davidson Emily J. , Tan Ek T. , Pedrick Emily G. , Sneag Darryl B. 
Published: August 2022

Abstract
Magnetic resonance neurography of the brachial plexus (BP) is challenging owing to its complex anatomy and technical obstacles around this anatomic region. Magnetic resonance techniques to improve image quality center around increasing nerve-to-background contrast ratio and mitigating imaging artifacts. General considerations include unilateral imaging of the BP at 3.0 T, appropriate selection and placement of surface coils, and optimization of pulse sequences. Technical considerations to improve nerve conspicuity include fat, vascular, and respiratory artifact suppression techniques; metal artifact reduction techniques; and 3-dimensional sequences. Specific optimization of these techniques for BP magnetic resonance neurography greatly improves image quality and diagnostic confidence to help guide nonoperative and operative management.
Training Program for Orthopedic Residents in Forefoot Osteotomy Skills
Authors: Ledermann Gerardo , Kuroiwa Aron , González Nicolas , Silva Isadora , Villa Andres 
Published: August 2022

Introduction
An effective simulation program allows both the acquisition of surgical skills on the simulated model and the transfer of these skills to a surgical scenario. We designed a forefoot osteotomy training program and sought to determine the transferability to a cadaveric surgical scenario.

Methods
Eleven orthopedic residents and 2 foot and ankle surgeons were included. A foot simulator was used. All residents were instructed on the surgical techniques of Chevron, Akin, and triple Weil osteotomies. Eight junior residents (trainees) were enrolled in a supervised simulation program. Baseline assessment was performed on the simulator with the Objective Structured Assessment of Technical Skills (OSATS) and the Imperial College Surgical Assessment Device (ICSAD). After baseline, trainees completed a training program and had a final evaluation of proficiency on the simulator and on cadaveric specimens. Three senior residents with no simulated training (controls) and experts were assessed for comparison.

Results
All trainees improved from a baseline OSATS score of 11 points (9–20) to a final score of 35 points (33–35) in the simulator and 34 points (32–34) in the cadaveric specimen (P < 0.01). Compared with baseline, the ICSAD results improved in path length (391 [205–544] to 131 [73–278] meters, P < 0.01) and number of movements (2756 [1258–3338] to 992 [478–1908], P < 0.01). The final OSATS and ICSAD scores did not differ from experts (P = 0.1) and were significantly different from untrained residents (P = 0.02).

Conclusions
Simulated training of Chevron, Akin, and triple Weil osteotomies in orthopedic residents improved procedural proficiency, enabling successful skill transfer to a surgical scenario in cadavers.

Level of Evidence
II (Prospective Cohort Study)
Long-Term Oncological Outcomes After Colorectal Anastomotic Leakage
Authors: Arron Melissa N.N. , Greijdanus Nynke G. , Bastiaans Sarah , Vissers Pauline A.J. , Verhoeven Rob H.A. , ten Broek Richard P.G. , Verheul Henk M.W. , Tanis Pieter J. , van Goor Harry , de Wilt Johannes H.W. 
Published: August 2022

Objective:
The aim was to evaluate the impact of anastomotic leak (AL) after colon cancer (CC) and rectal cancer (RC) surgery on 5-year relative survival, disease-free survival (DFS), and disease recurrence.

Background:
AL after CC and RC resection is a severe postoperative complication with conflicting evidence whether it deteriorates long-term outcomes.

Methods:
Patients with stage I to IV CC and RC who underwent resection with primary anastomosis were included from the Netherlands Cancer Registry (2008–2018). Relative survival, measured from day of resection, and multivariable relative excess risks (RERs) were analyzed. DFS and recurrence were evaluated in a subset with stage I to III patients operated in 2015. All analyses were performed with patients who survived 90 days postoperatively.

Results:
A total of 65,299 CC and 22,855 RC patients were included. Five-year relative survival after CC resection with and without AL was 95% versus 100%, 89% versus 94%, 66% versus 76%, and 28% versus 25% for stage I to IV disease. AL was associated with a significantly higher RER for death in stage II and III CC patients. Stage-specific 5-year relative survival in RC patients with and without AL was 97% versus 101%, 90% versus 95%, 74% versus 83%, and 32% versus 41%. AL was associated with a significantly higher RER for death in stage III and IV RC patients. DFS was significantly lower in CC patients with AL, but disease recurrence was not associated with AL after colorectal cancer resection.

Conclusion:
AL has a stage-dependent negative impact on survival in both CC and RC, but no independent association with disease recurrence.
Poorly Cohesive Gastric Cancers Showing the Transcriptomic Hallmarks of Epithelial-Mesenchymal Transition Behave Aggressively
Authors: Bencivenga Maria , Simbolo Michele , Ciaparrone Chiara , Vicentini Caterina , Torroni Lorena , Piredda Maria Liliana , Sacco Michele , Alloggio Mariella , Castelli Claudia , Tomezzoli Anna , Scarpa Aldo , De Manzoni Giovanni 
Published: August 2022

Hypothesis:
Poorly cohesive (PC) gastric cancer (GC) exhibits variable clinical behavior, being extremely aggressive in most cases but more indolent at times. We hypothesized that the integrative genomic and gene expression characterization of a PC GC series could help identifying molecular subtypes with potential clinical implications.

Materials and Methods:
64 PC GCs were assessed for alterations in 409 genes and 30 cases were subjected to transcriptomic profiling of 20,815 genes.

Results:
A median of 8.2 mutations per Mb (interquartile range 6.9–10.4) was found and a tumor mutational load >10 muts/Mb was significantly associated with patients’ worse survival (P=0.0024). The most frequent mutated genes were CDH1 and TP53 (each 32.8%) followed by PIK3CA (10.9%). In 15 samples (23.4%), at least 1 chromatin remodeling gene was mutated: KMT2D (5 cases); ARID1A and BAP1 (4 cases each); EZH2, KMT2A, PBRM1 (1 case each). Eight samples (12.5%) had fusion genes involving CLDN18 gene. Gene expression profiling identified 4 different clusters: cluster A associated with epithelial to mesenchymal transition (EMT) signature; cluster B associated to proliferative signature and EMT; cluster C correlated to hedgehog signaling; cluster D showing no enrichment for any of the previous signatures. Notably, cluster A and B showed a worse prognosis compared with clusters C and D (P=0.0095).

Conclusion:
integrated genomic and transcriptomic analysis suggest the existence of 4 molecular subtypes of PC GC with prognostic significance where EMT features are associated with a worse outcome.
Ocular Biomarkers of Riboflavin Transporter Deficiency
Authors: Bulas Sabrina , Bedoukian Emma C. , O'Neil Erin C. , Krantz Ian D. , Yum Sabrina W. , Liu Grant T. , Aleman Tomas S. 
Published: August 2022

Background:
To describe the clinical presentation with a focus on ocular manifestations and response to riboflavin supplementation of 3 patients with riboflavin transporter deficiency (RTD) caused by mutations in SLC52A2 (SLC52A2-RTD).

Methods:
This is a retrospective review of records of 3 children (aged 18, n = 2 and age = 8, n = 1) with SLC52A2-RTD. Patients underwent comprehensive ophthalmic evaluations including color vision testing, pattern visual-evoked potentials (pVEPs, 1 patient) and spectral domain optical coherence tomography (SD-OCT) imaging. Patients received riboflavin supplements from the time of the molecular diagnosis of RTD.

Results:
Two unrelated 18-year-old patients with SLC52A2-RTD had a symptomatic onset with sensorineural hearing loss and auditory neuropathy/dys-synchrony since age 3 and 11, respectively. On examination 7 years after symptomatic onset, they showed subnormal visual acuities (20/30 and 20/60, both eyes, respectively), preserved color vision, and a thin but measurable retinal ganglion cell layer (GCL) and nerve fiber (RNFL). The inner and outer nuclear layers were normal. The asymptomatic SLC52A2-positive brother of one of these patients started riboflavin supplementation right after the molecular diagnosis and had normal vision and SD-OCTs 7 years later. Onset of riboflavin supplementation in one of the 2 symptomatic cases resulted in acute improvement of the pattern visual-evoked potential and vision.

Conclusions:
Retinal ganglion cells and their axons are uniquely susceptible to RTD compared with other highly energy-dependent retinal neurons, such as photoreceptors, raising the possibility for alternative mechanisms of disease or protection. Riboflavin supplementation results in acute functional improvement of vision and long-term preservation of GCL and RNFL if initiated early.
Improvement of Retinal Capillary Function After High-Speed Circuit Resistance Training in Healthy Older Adults
Authors: Jiang Hong , Signorile Joseph F. , Simms Ava-Gaye , Wang Jianhua 
Published: August 2022

Background:
To determine the retinal capillary function (RCF, the efficiency of blood flow transferring in the capillary network) and its relation to cognitive function in healthy older people without known cognitive impairment following an 8-week high-speed circuit resistance training program (HSCT).

Methods:
Eleven subjects in the HSCT group and 7 age-matched nontraining controls (CON) were recruited. The HSCT group trained 3 times per week for 8 weeks, whereas CON performed no formal training. One eye of each subject from both groups was imaged at baseline and 8-week follow-up. Retinal blood flow (RBF) was measured using a retinal function imager, and retinal capillary density (RCD, expressed as fractal dimension Dbox) was measured using optical coherence tomography angiography. RCF was defined as the ratio of RBF to RCD. Cognitive function was assessed during both visits using the NIH Toolbox Fluid Cognition Battery.

Results:
RCF was 2.07 ± 0.64 nL⋅s−1·Dbox−1 (mean ± SD) at baseline, and significantly increased to 2.59 ± 0.54 nL⋅s−1·Dbox−1 after training (P = 0.0003) in the HSCT group, reflecting an increase of 25%. The changes of RBF were not related to the changes of RCD in the HSCT group (r = −0.18, P = 0.59). There was no significant change of RCF in the CON group (P = 0.58). In the HSCT group, the Pattern Comparison Processing Speed Test and Fluid Cognition Composite Score were significantly increased after HSCT (P = 0.01). Furthermore, the changes in Flanker Inhibitory Control and Attention Test (FLNK) were positively correlated to increases in RCF (r = 0.77, P = 0.005).

Conclusions:
This is the first prospective study to demonstrate that the increased RCF after HSCT was related to improved cognition in cognitively normal older adults.
Parasphingorhabdus cellanae sp. nov., isolated from the gut of a Korean limpet, Cellana toreuma
Authors: Yoo Ji-Ho , Han Jeong Eun , Lee June-Young , Jeong Su-Won , Jeong Yun-Seok , Lee Jae-Yun , Lee So-Yeon , Sung Hojun , Tak Euon Jung , Kim Hyun Sik , Kim Pil Soo , Choi Jee-Won , Kim Do-Yeon , Jeong In Chul , Gim Do-Hun , Kang Seo Min , Bae Jin-Woo 
Published: August 2022

A novel bacterium, designated strain JHSY0214T, was isolated from the gut of a Korean limpet, Cellana toreuma. Cells of strain JHSY0214T were Gram-stain-negative, strictly aerobic, yellow-pigmented, non-spore-forming, non-motile and showed a rod–coccus growth cycle. Phylogenetic analysis based on 16S rRNA gene sequences indicated that the strain belonged to the genus

Parasphingorhabdus

, and was most closely related to

Parasphingorhabdus litoris

KCTC 12764T (98.71 %). Strain JHSY0214T had two fluoroquinolone-resistance genes and seven multidrug-resistance efflux pump genes, but did not have beta-lactamase genes and zinc resistance genes compared with

P. litoris

KCTC 12764T. Strain JHSY0214T grew optimally at 30 °C, pH 7.0 and in the presence of 2 % (w/v) NaCl. The predominant cellular fatty acids of strain JHSY0214T were summed feature 8 (C18 : 1
ω6c and/or C18 : 1
ω7c; 41.2 %), summed feature 3 (C16 : 1
ω7c and/or C16 : 1
ω6c; 21 %) and C16 : 0 (18.9 %). The major isoprenoid quinone was ubiquinone-10. The major polar lipids were sphingoglycolipid and phosphatidylethanolamine. The genomic DNA G+C content was 52.8 mol%. Based on phylogenetic, genotypic and phenotypic data, strain JHSY0214T represents a novel species of the genus

Parasphingorhabdus

, for which the name Parasphingorhabdus cellanae is proposed. The type strain is JHSY0214T (=KCTC 82387T=DSM 112279T).