bluuebunny/crossref_metadata_2025_split huggingface dataset:
Remote Intraoperative Neural Response Telemetry: Technique and Results in Cochlear Implant Surgery
Authors: Kouhi Ali , Swanson Austin , Fitzgerald Matthew B. , Blevins Nikolas H. 
Published: June 2022

Objective
Present results with remote intraoperative neural response telemetry (NRT) during cochlear implantation (CI) and its usefulness in overcoming the inefficiency of in person NRT.

Study Design
Case series.

Setting
Tertiary academic otology practice.

Patients
All patients undergoing primary or revision CI, both adult and pediatric, were enrolled.

Interventions
Remote intraoperative NRT performed by audiologists using a desktop computer to control a laptop in the operating room. Testing was performed over the hospital network using commercially available software. A single system was used to test all three FDA-approved manufacturers’ devices.

Main Outcome Measures
Success rate and time savings of remote NRT.

Results
Out of 254 procedures, 252 (99.2%) underwent successful remote NRT. In two procedures (0.7%), remote testing was unsuccessful, and required in-person testing to address technical issues.
Both failed attempts were due to hardware failure (OR laptop or headpiece problems). There was no relation between success of the procedure and patient/surgical factors such as difficult anatomy, or the approach used for inner ear access. The audiologist time saved using this approach was considerable when compared with in-person testing.

Conclusions
Remote intraoperative NRT testing during cochlear implantation can be performed effectively using standard hardware and remote-control software. Especially important during the Covid-19 pandemic, such a procedure can reduce in-person contacts, and limit the number of individuals in the operating room. Remote testing can provide additional flexibility and efficiency in audiologist schedules.
Changes in Measures of Vestibular and Balance Function and Hippocampus Volume in Alzheimer’s Disease and Mild Cognitive Impairment
Authors: Cohen Helen S. , Lincoln Christie M. , Pavlik Valory N. , Sangi-Haghpeykar Haleh 
Published: June 2022

Objective
To test the hypotheses that people with Alzheimer’s disease and mild cognitive impairment have increased frequency of vestibular impairments and decreased hippocampal volume compared with healthy age-matched controls.

Study Design
Retrospective, with some historical controls.

Setting
Out-patient, tertiary care center.

Subjects
People with mild to moderate dementia diagnosed with Alzheimer’s disease and with mild cognitive impairment. Main Outcome Measures: A standard clinical battery of objective tests of the vestibular system, and screening for balance; available clinical diagnostic magnetic resonance imaging (MRIs) were reviewed and postprocessed to quantify the left and right hippocampal volumes utilizing both manual segmentation and computer automated segmentation.

Results
Study subjects (N = 26) had significantly more vestibular impairments, especially on Dix-Hallpike maneuvers and cervical vestibular evoked myogenic potentials (cVEMP), than historical controls. No differences were found between mild and moderate dementia subjects. Independence on instrumental activities of daily living in subjects with age-normal balance approached statistical differences from subjects with age-abnormal balance. MRI data were available for 11 subjects. Subjects with abnormal cVEMP had significantly reduced left hippocampal MRIs using manual segmentation compared with subjects with normal cVEMP.

Conclusion
The data from this small sample support and extend previous evidence for vestibular impairments in this population. The small MRI sample set should be considered preliminary evidence, and suggests the need for further research, with a more robust sample and high-resolution MRIs performed for the purpose of hippocampal analysis.
Impact of gastroesophageal reflux disease on idiopathic pulmonary fibrosis and lung transplant recipients
Authors: Reddy Chanakyaram A. , Wakwaya Yosafe T. 
Published: June 2022

Purpose of review
Idiopathic pulmonary fibrosis (IPF) is a prevalent subset of interstitial lung disease (ILD) that often progresses to require lung transplantation. Gastroesophageal reflux disease (GERD) is common in the IPF population, and GER-related micro-aspiration appears to be an important risk factor for IPF pathogenesis and for the deterioration of transplanted lung function.

Recent findings
Many patients with IPF have elevated esophageal acid exposure on reflux testing despite having no or minimal symptoms. Studies on the effects of medical GERD therapy on IPF-related outcomes have had mixed results. Antireflux surgery is safe in appropriately selected IPF patients, and appears to have potential for slowing the decline of lung function. GERD can persist, improve or develop after lung transplantation, and the presence of GERD is associated with allograft injury and pulmonary function decline in lung transplant recipients.

Summary
Clinicians should have a low threshold to assess for objective evidence of GERD in IPF patients. Antireflux surgery in IPF patients with GERD appears to improve lung function, but further studies are needed before surgical treatment can be recommended routinely in this setting. In lung transplant recipients, reflux testing after transplant is the most accurate way to guide GERD treatment decisions.
Refractory eosinophilic esophagitis: what to do when the patient has not responded to proton pump inhibitors, steroids and diet
Authors: Strauss Alexandra L. , Falk Gary W. 
Published: June 2022

Purpose of review
Management for patients with refractory eosinophilic esophagitis (EoE) remains a clinical challenge. This review aims to define refractory EoE, explore rates and reasons for nonresponse, and discuss the evidence that informs the approach to these patients.

Recent findings
Many patients will fail first-line therapies for EoE. Longer duration of therapy can increase response rates, and initial nonresponders may respond to alternative first-line therapies. There are ongoing clinical trials evaluating novel therapeutics that hold promise for the future of EoE management. Increasingly, there is recognition of the contribution of oesophageal hypervigilance, symptom-specific anxiety, abnormal motility and oesophageal remodelling to ongoing clinical symptoms in patients with EoE.

Summary
For refractory EoE, clinicians should first assess for adherence to treatment, adequate dosing and correct administration. Extending initial trials of therapy or switching to an alternative first-line therapy can increase rates of remission. Patients who are refractory to first-line therapy can consider elemental diets, combination therapy or clinical trials of new therapeutic agents. Patients with histologic remission but ongoing symptoms should be evaluated for fibrostenotic disease with EGD, barium esophagram or the functional luminal imaging probe (FLIP) and should be assessed for the possibility of oesophageal hypervigilance.
Functional luminal imaging probe in the evaluation of esophago-gastric junction outflow obstruction
Authors: Ellison Ashton , Nguyen Anh D. 
Published: June 2022

Purpose of review
Esophagogastric junction outflow obstruction (EGJOO) comprises a heterogeneous group of conditions that demonstrate impaired deglutitive relaxation of the esophagogastric junction (EGJ) with intact esophageal peristalsis on high-resolution manometry. Functional luminal imaging probe (FLIP) panometry is a powerful tool that can help to clarify the etiology of this manometric diagnosis. The aim of this review is to summarize the use of FLIP for the evaluation and management of EGJOO.

Recent findings
FLIP panometry provides measures of esophageal compliance at the EGJ and information on esophageal body contractile responses to balloon distention that have important implications for the management of patients with EGJOO. After excluding anatomic causes of impaired EGJ distensibility, FLIP panometry is useful in differentiating true lower esophageal sphincter dysfunction from manometric artifact. FLIP panometry has been shown to be useful in determining the need for invasive treatment in patients with EGJOO, and in intraoperative tailoring of myotomy procedures.

Summary
FLIP panometry is easy to perform during endoscopy and provides useful information for characterizing the EGJOO population. FLIP panometry can be used to guide treatment and improve outcomes in the management of patients with EGJOO.
The future of telemedicine and wearable technology in IBD
Authors: Rowan Catherine , Hirten Robert 
Published: June 2022

Purpose of review
Telemedicine has quickly become an essential part of modern healthcare, particularly in the management of chronic conditions like inflammatory bowel disease. The purpose of this review is to describe the current use of telehealth, mobile applications and wearable devices in inflammatory bowel disease and potential future applications.

Recent findings
Telemedicine was increasingly used during the Coronavirus Disease 2019 pandemic. Virtual consultations allowed clinical care to continue despite pandemic-related restrictions without compromising the quality of care for patients with inflammatory bowel disease (IBD). It also benefits patients who would not have access to care due to financial or geographical barriers. Mobile applications allow patients with IBD to record disease activity among other metrics, allowing for earlier healthcare provider intervention. Wearable devices are increasingly being explored to monitor physiological indicators of disease activity and flare.

Summary
Telehealth and remote patient monitoring has been successfully integrated into the care of IBD patients. The advantages of these modalities include better access to specialist care and remote noninvasive disease monitoring. Careful consideration must be given to patient privacy, data protection and equitable access. These modalities have enormous potential to improve patient care through accurate consistent data collection and even the prediction of disease activity.
Precision medicine: how multiomics will shape the future of inflammatory bowel disease?
Authors: Borren Nienke Z. , Ananthakrishnan Ashwin N. 
Published: June 2022

Purpose of review
In this article, we provide an overview of studies examining multiomic profiling in various clinical scenarios in the management of inflammatory bowel diseases (IBDs).

Recent findings
IBD arises as a result of an interplay between genetic, environmental, microbial and immunologic perturbations. The access to high throughput technology as well as the decrease in costs associated with such studies has led to a growing wealth of literature examining the utility of single or multiomic profiles in the management of IBD. Such studies have commonly examined the genome (and less frequently the epigenome), transcriptome, metabolome, proteome and the gut microbial metagenome in the context of overall IBD status or specific clinical scenarios, including the disease progression or response to treatment. The findings have provided important insight into how each of these compartments reflect underlying disease pathophysiologic processes and, in turn, can influence stratification of patients for clinical management.

Summary
Multiomic profiling in IBD has the potential to advance the field of personalized precision medicine in the management of IBDs.
Management of refractory inflammatory bowel disease
Authors: Gergely Maté , Prado Eric , Deepak Parakkal 
Published: June 2022

Purpose of review
Nearly one-third of patients with inflammatory bowel disease (IBD) do not achieve remission despite our best therapies. When this happens, it is critical to understand the reason for treatment failure. Once nonresponse is confirmed, these patients should be referred to an IBD centre for multidisciplinary care. This review will discuss the remaining treatment options, including escalation of biologics to unlicensed doses, combination biologics, nonvalidated therapies and surgical options. It will additionally provide updates in the management of acute severe ulcerative colitis (ASUC).

Recent findings
There is an increasing interest in combination biologics to treat refractory IBD, although data supporting its safety and effectiveness are limited. The use of hyperbaric oxygen, mesenchymal stem cell therapy and dietary interventions also show early promise in this area. Studies have additionally focused on personalized therapy to identify aggressive phenotypes and predict treatment response in these challenging patients. In ASUC, infliximab and cyclosporine remain mainstays of treatment, and tofacitinib shows promise as a salvage therapy.

Summary
Refractory IBD is common, yet large knowledge gaps remain. Recent and ongoing studies have focused on medical, surgical and dietary approaches with mixed success. Larger prospective studies are desperately needed to address this complex issue.
Inflammatory bowel disease in underserved populations: lessons for practice
Authors: Odufalu Florence-Damilola , Aboubakr Aiya , Anyane-Yeboa Adjoa 
Published: June 2022

Purpose of review
The incidence of inflammatory bowel disease (IBD) is increasing in minority groups across the USA. There are racial and ethnic disparities in IBD care and outcomes that are rooted in historical injustice and inequities in the social determinants of health.

Recent findings
Current literature has identified racial, ethnic and sociodemographic disparities in therapeutics and outcomes for IBD, including disease severity, morbidity and mortality.

Summary
Strategies to achieve equity in IBD include tackling structural racism as a driver of health disparities and making actionable changes against multilevel barriers to care.
Clinical decision support systems to guide healthcare providers on HIV testing
Authors: Smit Mikaela , Jordans Carlijn C.E. , Reinhard Jitte M. , Bramer Wichor M. , Verbon Annelies , Rokx Casper , Calmy Alexandra 
Published: June 2022

Objective:
To understand the impact of clinical decision support systems (CDSSs) on improving HIV testing and diagnosis.

Design:
An original global systematic review (PROSPERO Number: CRD42020175576) of peer-reviewed articles reporting on electronic CDSSs that generate triggers encouraging healthcare providers to perform an HIV test.

Methods:
Medline, Embase, Cochrane CENTRAL and CINAHL EBSCOhost were searched up to 17 November 2020 and reference lists of included articles were checked. Qualitative and quantitative syntheses (using meta-analyses) of identified studies were performed.

Results:
The search identified 1424 records. Twenty-two articles met inclusion criteria (19 of 22 non-HIV endemic settings); 18 clinical and four laboratory-driven reminders. Reminders promoted ‘universal’ HIV testing for all patients without a known HIV infection and no recent documented HIV test, or ‘targeted’ HIV testing in patients with clinical risk-factors or specific diagnostic tests. CDSSs increased HIV testing in hospital and nonhospital setting, with the pooled risk-ratio amongst studies reporting comparable outcome measures in hospital settings (n = 3) of 2.57 [95% confidence interval (CI) 1.53–4.33, random-effect model] and in nonhospital settings (n = 4) of 2.13 (95% CI 1.78–4.14, random effect model). Results of the clinical impact of CDSSs on HIV diagnosis were mixed.

Conclusion:
CDSSs improve HIV testing and may, potentially, improve diagnosis. The data support the broader study of CDSSs in low- and high prevalent HIV settings to determine their precise impact on UNAIDS goals to reach universal HIV testing and treatment coverage.
Effectiveness of an Interactive, Highly Tailored “Video Doctor” Intervention to Suppress Viral Load and Retain Patients With HIV in Clinical Care: A Randomized Clinical Trial
Authors: Lewis Megan A. , Harshbarger Camilla , Bann Carla , Marconi Vincent C. , Somboonwit Charurut , Piazza Michelle Dalla , Swaminathan Shobha , Burrus Olivia , Galindo Carla , Borkowf Craig B. , Marks Gary , Karns Shawn , Zulkiewicz Brittany , Ortiz Alexa , Abdallah Iddrisu , Garner Bryan R. , Courtenay-Quirk Cari ,   for the Positive Health Check Study Team
Published: June 2022

Background:
To determine whether Positive Health Check, a highly tailored video doctor intervention, can improve viral suppression and retention in care.

Setting:
Four clinics that deliver HIV primary care.

Methods:
A hybrid type 1 effectiveness-implementation randomized trial design was used to test study hypotheses. Participants (N = 799) who were not virally suppressed, were new to care, or had fallen out of care were randomly assigned to receive Positive Health Check or the standard of care alone. The primary endpoint was viral load suppression, and the secondary endpoint was retention in care, both assessed at 12 months, using an intention-to-treat approach. A priori subgroup analyses based on sex assigned at birth and race were examined as well.

Results:
There were no statistically significant differences between Positive Health Check (N = 397) and standard of care (N = 402) for either endpoint. However, statistically significant group differences were identified from a priori subgroup analyses. Male participants receiving Positive Health Check were more likely to achieve suppression at 12 months than male participants receiving standard of care adjusted risk ratio [aRR] [95% confidence interval (CI)] = 1.14 (1.00 to 1.29), P = 0.046}. For retention in care, there was a statistically significant lower risk for a 6-month visit gap in the Positive Health Check arm for the youngest participants, 18–29 years old [aRR (95% CI) = 0.55 (0.33 to 0.92), P = 0.024] and the oldest participants, 60–81 years old [aRR (95% CI) = 0.49 (0.30 to 0.81), P = 0.006].

Conclusions:
Positive Health Check may help male participants with HIV achieve viral suppression, and younger and older patients consistently attend HIV care.

Registry Name:
Positive Health Check Evaluation Trial. Trial ID: 1U18PS004967-01. URL: https://clinicaltrials.gov/ct2/show/NCT03292913.
Pediatric Cases of Recurrent Skull Giant Osteoma Misdiagnosed as Fibrous Dysplasia
Authors: Kim Yumin , Kim Byungjun 
Published: June 2022

Abstract:
Osteomas are benign mature bone tumors that typically arise in the skull. Osteomas larger than 3 cm in diameter are considered giant osteomas. Giant osteomas of the skull vault are very rare, especially in children; therefore, only a few cases have been reported in the literature. Although osteomas are usually asymptomatic, a large skull mass can cause headache, as well as esthetic disfigurement of the forehead. it can be misdiagnosed as other conditions, such as fibrous dysplasia, ossifying cephalhematoma, or other malignant bone tumors. Herein, the authors report 2 rare pediatric cases of giant osteomas mimicking fibrous dysplasia and their successful surgical excision. These cases showed good results without recurrence or complications on long-term follow-up after complete excision.
Prognosis of Continuous Positive Airway Pressure Treatment to Velopharyngeal Insufficiency: Preliminary Study
Authors: Kim Jong Seong , Lee Seung Eun , Ryu Jeong Yeop , Lee Joon Seok , Yang Jung Dug , Chung Ho Yun , Cho Byung Chae , Choi Kang Young 
Published: June 2022

Background:
Cleft palate is a congenital malformation that causes hypernasality and decreases the intelligibility of pronunciation and leads to velopharyngeal insufficiency. It causes difficulty in language development. Many studies and treatments have been conducted to reduce this problem, but there are limitations. In this study, the effect obtained through continuous positive airway pressure (CPAP) treatment was analyzed by statistical methods.

Methods:
From May 2012 to December 2018, using patient demographics, computed tomography (CT) scan, and nasalance test was performed on 25 patient groups treated with CPAP devices for 8 weeks to confirm the effect after 6 months.

Results:
After CPAP treatment in a total of 25 patients, 13 patients had a therapeutic effect. The average age of the patient group with treatment effect (effective group [EG]) was 51.2months, and the patient group with no treatment effect (ineffective group [iG]) was 73.6 months. (P < 0.05). In CT data analysis, the highest palatal arch point was 6.31 mm in EG and 7.36 mm in IG, which was lower in EG (P < 0.01), and the distance from incisive foramen to posterior pharyngeal wall was 41.39 mm in EG and 49.07 mm in IG (P < 0.05).

Conclusions:
Through the statistical analysis, the group of patients who were effective in treatment had a low age at the beginning of treatment, the height of highest palatal arch point was low on CT data, and the length of distance from incisive foramen to posterior pharyngeal wall was short. It will be helpful to set the CPAP treatment patient group with respect to the results and age and CT data when treating VPI patients.
Two Pre-Expanded Free Flaps Used for Auricular Reconstruction and Ipsilateral Facial Scar Release
Authors: Pei Jiaomiao , Zhang Juan , Song Baoqiang , Li Yang , Guo Shuzhong 
Published: June 2022

Objectives:
Auricular reconstruction is a great challenge for surgeons to achieve good aesthetic outcomes when adjacent tissues were burned. Compared with pedicle flap therapies, there are some advantages of pre-expanded free flaps for ear rebuilding, such as thinner layer tissues for aesthetic requirements of delicate auricular structures and less donor site deformity. In this study, the authors introduced 6 sequential surgical procedures for total auricular reconstruction with severe ipsilateral facial scar.

Methods:
Pre-expanded deltopectoral flap was used to release periauricular contracture and repair facial scar. The injured ear was restored by expanded forearm flap including autologous cartilage framework. The surgical procedures were lasted more than 2 years. An 8 and half year's follow-up was performed from November 2012 to April 2021. The clinical data and surgical techniques were recorded and analyzed.

Results:
The patient was satisfied with the aesthetic outcomes of the new ear. The skin texture and color of the grafts were approximately matched to the recipient sites. Facial expression was not affected severely. Sensations of the transferred flap and new ear had partially recovered. The donor sites were recovered without severe complication.

Conclusions:
The pre-expanded free forearm flap is a feasible method for total ear reconstruction when local flap therapies could not be applied. Repair of ipsilateral facial scar is beneficial for auricular procedures.