The effect of nomophobic behaviors among nurses on their clinical decision-making perceptions.

AIM: This study aimed to explore the impact of nomophobic behaviors among hospital nurses on their clinical decision-making perceptions. This understanding can offer insights to enhance the work environment, improve the clinical decision-making ability of nurses and guide medical institutions in the management of related equipment and policy development. BACKGROUND: The term "nomophobia" refers to the anxiety and fear individuals experience when they cannot use their smartphones or when smartphones are not accessible. Nursing clinical decision-making is a complex process, including a meticulous assessment of the patient's pathological condition and medical history, alongside the application of nursing knowledge and experiential learning rooted in critical thinking. The concept of clinical decision-making perceptions is defined as a deliberate cognitive understanding of one's decision-making processes, which significantly influences the clinical decision-making capabilities of healthcare professionals, thereby impacting the quality of patient care. The factors influencing these clinical decision-making perceptions have been the subject of extensive research. However, there is no Chinese research on the impact of nurses ' nomophobic behaviors on their clinical decision-making perception. DESIGN: A cross-sectional descriptive survey using online-based delivery modes was used. METHODS: A descriptive cross-sectional survey design was employed. Using convenience sampling, we surveyed the nurses from a tertiary hospital in Nanjing in May 2023. Data were gathered using a sociodemographic data form, the Nomophobia Questionnaire and the Clinical Decision-Making in Nursing Scale. Techniques including the independent sample t-test, one-way ANOVA, Pearson correlation analysis and linear regression analysis were employed to probe the degree of nomophobia and its effects on their perception of clinical decision-making. Out of 284 questionnaires gathered, 272 were deemed valid, resulting in a 95.8% effective response rate. RESULTS: The data revealed that participants exhibited a medium level of nomophobia (54.01 ± 24.09) and clinical decision-making perceptions (144.94 ± 20.08). A robust negative correlation was discerned between nomophobia and clinical decision-making perceptions (r: -0.365, P<0.001). This study highlighted that as the degree of nomophobia intensified, nurses' clinical decision-making perceptions decreased with the increase in nomophobia. CONCLUSION: Nomophobic behaviors can hamper nurses' perception of clinical decision-making, potentially leading to inaccuracies or errors. Nurses must use mobile phones judiciously, practice self-regulation and mitigate the disruptive effects of nomophobia on their decision-making. In addition, medical institutions should foster relevant education or craft policies to regularize mobile phone use, augmenting nurses' efficiency and decision-making prowess, enhancing patient care quality, diminishing medical errors and ensuring patient health and safety.

[Recent progress in vestibular prosthesis].

Bilateral vestibulopathy（BVP） is one of the common diseases in the vestibular nervous system, with an incidence rate of about 4%-7% in the population, which can lead to a variety of body dysfunctions. At present, there are two main treatment methods for BVP. One is vestibular rehabilitation. However, only part of BVP patients can finally benefit from vestibular rehabilitation, and most patients will remain with permanent vestibular dysfunction. Benefiting from the maturity of cochlear implant technology, European and American countries took the lead in the development of vestibular prosthesis（VP） technology to restore the vestibular function in patients with BVP. This review will focus on the development history, principles, future applications and the related research progress of VP in China.

[Otitis media with antineutrophil cytoplasmic antibody-associated vasculitis].

Objective:To analyze clinical features, diagnosis and treatment of otitis media with antineutrophil cytoplasmic antibody（ANCA） -associated vasculitis（OMAAV）. Methods:This study reported three OMAAV patients and discussed the diagnosis and treatment of OMAAV combined with the recent literature. Results:Two males and one female were included. The age of these three patients ranged from 56 to 72 years. Their characteristics were as follows: ①tympanic membrane with granulation and bloody secretions in two patients; ②progressive bone-conducted hearing loss within a short period of time; ③facial palsy in two patients; ④the laboratory test of ANCA is positive; ⑤conventional treatment of otitis media is ineffective, while glucocorticoid combined with immunosuppressive therapy is effective. Conclusion:OMAAV is a rare disease and prone to misdiagnosis. Early diagnosis and treatment with corticosteroids and immunosuppressants are critical. Invasive tests and surgery during the active phase of OMAAV may aggravate symptoms and should be avoided.

[Characteristics of air-conducted and bone-conducted vibration cervical vestibular-evoked myogenic potential in preschool children].

Objective: To investigate the characteristics of air-conducted sound cervical vestibular evoked myogenic potential （ACS-cVEMP） and bone-conducted vibration cervical vestibular evoked myogenic potential （BCV-cVEMP） in healthy preschool children, and to provide the normal reference range of VEMP for preschool children in China. Methods:Forty-four normal-hearing children （88 ears） aged 3-7 years were recruited to undergo ACS-cVEMP and BCV-cVEMP determination. These children were divided into two groups according to age: 3-4 years old group （ 17 cases, 34 ears） and 5-7 years old group （ 27 cases, 54 ears）. The response rates and waveform parameters were recorded and analyzed statistically using SPSS 18.0 software. Results:The response rates of ACS-cVEMP, BCV-cVEMP in 44 normal-hearing children （88 ears） were 96.59％（85/88） and 97.73％（86/88） respectively, and there was no significant difference between the two groups （P > 0.05）. The response rates of ACS-cVEMP in 3-4 year old group and 5-7 year old group were 94.12% （32/34） and 98.15% （53/54） respectively, and there was no significant difference between the two groups（P>0.05）; The response rates of BCV-cVEMP in 3-4 year old group and 5-7 year old group were 94.12% （32/34） and 100.00%（54/54） respectively, and there was no significant difference between the two groups （P>0.05）. Compared with the 5-7 year old group, the latency of p1 and n1 in the 3-4 year old group was shorter （P<0.05） and the amplitude was higher （P<0.05）, and there was no significant difference in other parameters （P>0.05）. There was no statistical difference in threshold, n1, p1 latency, n1-p1 wave interval, n1-p1 amplitude, and amplitude asymmetry ratio of BCV-cVEMP between the two groups （P>0.05）. Conclusion:ACS-cVEMP and BCV-cVEMP can be elicited in most preschool children, and cVEMP is a feasible method to detect vestibular function in children.

B81 Bone Vibrator-Induced Vestibular-Evoked Myogenic Potentials: Normal Values and the Effect of Age.

Objective: To define the normal values and examine the influence of aging on B81 bone vibrator-induced cervical vestibular-evoked myogenic potentials (B81-cVEMPs) and ocular vestibular-evoked myogenic potentials (B81-oVEMPs). Methods: Seventy healthy subjects, divided into seven groups according to their ages, were enrolled in this study. The 4-9-, 10-19-, 20-29-, 30-39-, 40-49-, 50-59-, and 60-70-year-old participants were divided into groups I-VII, respectively. B81-cVEMP and B81-oVEMP were recorded in each group. Results: The B81-cVEMP response rates for groups I-VII were 100, 100, 100, 100, 95, 95, and 75%, respectively, with significant differences only between groups I-VI and group VII (p = 0.047, p < 0.05). The B81-oVEMP response rates for groups I-VII were 100, 100, 100, 100, 70, 65, and 40%, respectively, with significant differences only between groups I-IV and groups V-VII (p = 0.020, p = 0.008, p = 0.000; p < 0.05). The threshold, P13, and N23 latencies of B81-cVEMP positively correlated with age (r = 0.756, p = 0.000; r = 0.357, p = 0.003; r = 0.316, p = 0.009; p < 0.05). The raw amplitudes and corrected amplitudes negatively correlated with age (r = -0.641, p = 0.000; r = -0.609, p = 0.000, p < 0.05). For B81-oVEMP, the corrected amplitudes negatively correlated with age (r = -0.638, p = 0.000, p<0.05), but the threshold and N10 latency positively correlated with age (r = 0.768, p = 0.000; r = 0.334, p = 0.009, p < 0.05). Moreover, the interaural asymmetry ratio did not significantly correlate with age for B81-cVEMP and B81-oVEMP. Conclusion: As age increased, the B81-cVEMP response rate decreased, the thresholds increased, P13 and N23 latencies were prolonged, and the raw amplitude and corrected amplitude decreased. The B81-oVEMP response rate and corrected amplitude decreased, the thresholds increased, and N10 latency was prolonged with age. These changes are probably due to the occurrence of morphological and functional changes in the vestibular system with aging. Therefore, we suggest establishing different reference values according to different age groups when evaluating the VEMP results in patients with vestibular diseases.

Association Analysis of HIMP and SHIMP Quantitative Parameters in Patients With Vestibular Neuritis and Healthy Participants.

Background: The Head Impulse Paradigm (HIMP) and Suppression Head Impulse Paradigm (SHIMP) are objective, quantitative methods that directly test the vestibulo-ocular reflex (VOR) and are increasingly becoming a standard in evaluating patients with vestibular disorders. Objective: The main objective was to assess the correlations between HIMP and SHIMP parameters in patients with superior vestibular neuritis (VN) and healthy participants. Additionally, the correlations between the parameters of each method were analyzed. Methods: A retrospective cohort, non-randomized study was designed. HIMP and SHIMP were performed on 40 patients with VN and 20 healthy participants (40 ears). HIMP and SHIMP parameters were measured and calculated. Pearson's or Spearson's correlations were used to establish the associations among them. Results: A strong positive correlation was found between HIMP and SHIMP gain (Pearson's r = 0.957, p = 0.000), while strong negative correlations were detected between HIMP and SHIMP saccade amplitudes (r = -0.637, p = 0.000) and percentages of overt saccades (r = -0.631, p = 0.000). In HIMP, strong and moderate positive correlations were identified between gain and saccade amplitude (R 2 = 0.726, p = 0.000) and gain and saccade percentage (R 2 = 0.558, p = 0.000), respectively. By contrast, an extremely weak positive correlation was observed between gain and latency (R 2 = 0.053, p = 0.040). In SHIMP, strong and moderate positive correlations were found between gain and saccade percentage (R 2 = 0.723, p = 0.000) and gain and saccade amplitude (R 2 = 0.525, p = 0.000), respectively, but no correlation was detected between gain and latency (R 2 = 0.006, p = 0.490). Conclusions: HIMP and SHIMP-related parameters were highly correlated (inter-method). Within each method (intra-method), moderate to strong correlations in VOR assessment were observed. These results further contribute to our understanding of the relationship between HIMP and SHIMP as well as to the diagnosis.

Retro-labyrinthine Lesion Site Detected by Galvanic Vestibular Stimulation Elicited Vestibular-evoked Myogenic Potentials in Patients with Auditory Neuropathy.

OBJECTIVE: Auditory neuropathy (AN) is a unique pattern of hearing loss with preservation of hair cell function. The condition is characterized by the presence of otoacoustic emissions (OAE) or cochlear microphonic (CM) responses with severe abnormalities of the auditory brainstem response (ABR). The vestibular branches of the VIII cranial nerve and the structures innervated by it can also be affected. However, the precise lesion sites in the vestibular system are not well characterized in patients with AN. METHODS: The air-conducted sound (ACS) vestibular-evoked myogenic potentials (VEMPs) and galvanic vestibular stimuli (GVS)-VEMPs were examined in 14 patients with AN. RESULTS: On examination of VEMPs (n=14, 28 ears), the absent rates of ACS-cervical VEMP (cVEMP), ACS-ocular VEMP (oVEMP), GVS-cVEMP, GVS-oVEMP and caloric test were 92.9% (26/28), 85.7% (24/28), 67.9% (19/28), 53.6% (15/28), and 61.5% (8/13), respectively. Impaired functions of the saccule, inferior vestibular nerve, utricle, superior vestibular nerve, and horizontal semicircular canal were found in 25.0% (7/28), 67.9% (19/28), 32.1% (9/28), 53.6% (15/28) and 61.5% (8/13) patients, respectively. On comparing the elicited VEMPs parameters of AN patients with those of normal controls, both ACS-VEMPs and GVS-VEMPs showed abnormal results in AN patients (such as, lower presence rates, elevated thresholds, prolonged latencies, and decreased amplitudes). CONCLUSION: The study suggested that patients with AN often have concomitant vestibular disorders. Retro-labyrinthine lesions were more frequently observed in this study. GVS-VEMPs combined with ACS-VEMPs may help identify the lesion sites and facilitate detection of areas of vestibular dysfunction in these patients.

[Methods and advances in clinical application of vestibular evoked myogenic potentials in children].

Vestibular dysfunction, which may lead to delayed motor development and reduced quality of life, is an overlooked entity among children and adolescents. Vestibular evoked myogenic potential （VEMPs） is a common, safe diagnostic tool in adults for vestibular disorders. However, there is no related data for children and adolescents. We aimed to collect and assess normative VEMP data for adolescents. In this article , we analyzed the results of VEMPs in children in recent years, and summarized the common detection methods of VEMPs in children, the detection rate and variability characteristics of VEMPs in children of different ages, and the current status of clinical application of VEMPs in children.

[Outcome of otolith organ function after treatment of sudden sensorineural hearing loss].

Objective:This study aimed to assess the clinical practice value of ocular vestibular evoked myogenic potential（oVEMP） and cervical vestibular evoked myogenic potential（cVEMP） in monitoring the rehabilitation of vestibular function in patients with suddensen sorineural hearing loss（SSHL）. Method:Twenty-four patients with SSHL were retrospectively enrolled， showing no VEMP response on the affected side but exhibiting VEMP responses after therapies We analyzed the improvement and the restoration of hearing and the parameters of VEMP response. Result:After treatment, seven patients showed VEMP recovery, including three cases with both oVEMP and cVEMP recovery, three cases with oVEMP recovery, and one case with cVEMP recovery. Between VEMP recoved group and VEMP unrecoved group, before treatment, no significant difference was found in the thresholds of pure-tone audiometry（PTA）. However, after treatment, VEMP recoved group exhibited lower PTA thresholds and better PTA shift （P<0.01）. Multivariate analysis revealed that recovery of VEMP was the independent risk factor for the therapeutic effect of SSHL. Conclusion:The Combination of oVEMP and cVEMP is an objective tool for assessing vestibular otolithic end organ function during dynamic functional recovery in SSHL and the recovery of VEMP could predict the auditory improvement.