bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Climatological Analysis of Ambient Deep-Tropospheric Vertical Wind Shear Impacts upon Tornadoes in Tropical Cyclones
Authors: Schenkel Benjamin A. , Edwards Roger , Coniglio Michael 
Published: August 2020

AbstractThe cyclone-relative location and variability in the number of tornadoes among tropical cyclones (TCs) are not completely understood. A key understudied factor that may improve our understanding is ambient (i.e., synoptic-scale) deep-tropospheric (i.e., 850–200-hPa) vertical wind shear (VWS), which impacts both the symmetry and strength of deep convection in TCs. This study conducts a climatological analysis of VWS impacts upon tornadoes in TCs from 1995 to 2018, using observed TC and tornado data together with radiosondes. TC tornadoes were classified by objectively defined VWS categories, derived from reanalyses, to quantify the sensitivity of tornado frequency, location, and their environments to VWS. The analysis shows that stronger VWS is associated with enhanced rates of tornado production—especially more damaging ones. Tornadoes also become localized to the downshear half of the TC as VWS strengthens, with tornado location in strongly sheared TCs transitioning from the downshear-left quadrant in the TC inner core to the downshear-right quadrant in the TC outer region. Analysis of radiosondes shows that the downshear-right quadrant in strongly sheared TCs is most frequently associated with sufficiently strong near-surface speed shear and veering aloft, and lower-tropospheric thermodynamic instability for tornadoes. These supportive kinematic environments may be due to the constructive superposition of the ambient and TC winds, and the VWS-induced downshear enhancement of the TC circulation among other factors. Together, this work provides a basis for improving forecasts of TC tornado frequency and location.
A Bayesian Representation of the Storm Approach Probability Based on Operational Track Forecast Errors
Authors: Kang Namyoung 
Published: August 2020

AbstractThis study provides a statistical review on the forecast errors of tropical storm tracks and suggests a Bayesian procedure for updating the uncertainty about the error. The forecast track errors are assumed to form an axisymmetric bivariate normal distribution on a two-dimensional surface. The parameters are a mean vector and a covariance matrix, which imply the accuracy and precision of the operational forecast. A Bayesian method improves quantifying the varying parameters in the bivariate normal distribution. A normal-inverse-Wishart distribution is employed to determine the posterior distribution (i.e., the weights on the parameters). Based on the posterior distribution, the predictive probability density of track forecast errors is obtained as the marginal distribution. Here, “storm approach” is defined for any location within a specified radius of a tropical storm. Consequently, the storm approach probability for each location is derived through partial integration of the marginal distribution within the forecast storm radius. The storm approach probability is considered a realistic and effective representation of storm warning for communicating the threat to local residents since the location-specific interpretation is available on a par with the official track forecast.
Robotic Versus Laparoscopic Approach to Hiatal Hernia Repair: Results After 7 Years of Robotic Experience
Authors: O’Connor Sean C. , Mallard Matthew , Desai Shivani S. , Couto Francisco , Gottlieb Matthew , Ewing Alex , Cobb William S. , Carbonell Alfredo M. , Warren Jeremy A. 
Published: August 2020

Introduction Robotic hiatal hernia repair offers potential advantages over traditional laparoscopy, most notably enhanced visualization, improved ergonomics, and articulating instruments. The clinical outcomes, however, have not been adequately evaluated. We report outcomes of laparoscopic and robotic hiatal hernia repairs. Methods A retrospective observational cohort study was performed of all hiatal hernia repairs performed from 2006 through 2019. Operative, demographic, and outcomes data were compared between laparoscopic and robotic groups. Discrete variables were analyzed with Chi-square of Fisher’s exact test. Continuous variables were analyzed with Student’s t test (mean) or Wilcoxon rank sum (medians). All analyses were performed using R statistical software. Results Laparoscopic repair was performed in 278 patients and robotic repair in 114. More recurrent hernias were repaired robotically (24.5% vs 12.9%, P = .08). Operative times were no different between groups (175 vs 179 minutes; P = .681). Robotic repair resulted in significantly shorter length of stay (LOS; 2.3 vs 3.3 days; P = .003). Rate of readmission was no different, and there were no differences in acute complications. For patients with at least 1 year of follow-up, recurrence rates were lower after robotic repair (13.3% vs 32.8%; P = .008); however, mean follow-up is significantly longer after laparoscopic repair (23.7 ± 28.4 vs 15.1 ± 14.9 months; P < .001). Discussion Robotic hiatal hernia repair offers technical advantages over laparoscopic repair with similar clinical outcomes.
Biological Plausibility of Arm Postures Influences the Controllability of Robotic Arm Teleoperation
Authors: Mick Sébastien , Badets Arnaud , Oudeyer Pierre-Yves , Cattaert Daniel , De Rugy Aymar 
Published: August 2020

Objective We investigated how participants controlling a humanoid robotic arm’s 3D endpoint position by moving their own hand are influenced by the robot’s postures. We hypothesized that control would be facilitated (impeded) by biologically plausible (implausible) postures of the robot. Background Kinematic redundancy, whereby different arm postures achieve the same goal, is such that a robotic arm or prosthesis could theoretically be controlled with less signals than constitutive joints. However, congruency between a robot’s motion and our own is known to interfere with movement production. Hence, we expect the human-likeness of a robotic arm’s postures during endpoint teleoperation to influence controllability. Method Twenty-two able-bodied participants performed a target-reaching task with a robotic arm whose endpoint’s 3D position was controlled by moving their own hand. They completed a two-condition experiment corresponding to the robot displaying either biologically plausible or implausible postures. Results Upon initial practice in the experiment’s first part, endpoint trajectories were faster and shorter when the robot displayed human-like postures. However, these effects did not persist in the second part, where performance with implausible postures appeared to have benefited from initial practice with plausible ones. Conclusion Humanoid robotic arm endpoint control is impaired by biologically implausible joint coordinations during initial familiarization but not afterwards, suggesting that the human-likeness of a robot’s postures is more critical for control in this initial period. Application These findings provide insight for the design of robotic arm teleoperation and prosthesis control schemes, in order to favor better familiarization and control from their users.
Response to oxygen therapy using oxygen concentrators run off solar power in children with respiratory distress in remote primary health facilities in Papua New Guinea
Authors: Pulsan Francis , Duke Trevor 
Published: August 2020

Oxygen therapy reduces mortality and morbidity from hypoxaemia in children. There are no published studies assessing individual patient responses to oxygen when delivered by oxygen concentrators in primary healthcare facilities. Ours was a prospective observational study in remote health facilities over three years. A data recording form was used for children who required oxygen. Oxygen saturation (SpO2) was recorded before administration of oxygen, at 30 min and then daily. We assessed the primary diagnosis and the outcome. The common primary diagnoses needing oxygen were pneumonia: moderate (39%) and severe (37%). The median SpO2 before administration of oxygen in 913 patients was 80% (interquartile range [IQR] 66%–88%), and by five days, for the 121 patients who were recorded, SpO2 was 97% (IQR 93%–98%). Of the 745 patients with a recorded outcome, 99% had an uneventful recovery. We conclude that oxygen concentrators are effective in treating children in rural health facilities in Papua New Guinea.
Comparative Study of Endoscopic and Microscopic Type I Tympanoplasty in Terms of Delayed Facial Palsy
Authors: Li Kuan‐Hui , Chan Leong‐Perng , Chen Chin‐Kuo , Kuo Shin‐Huei , Wang Ling‐Feng , Chang Ning‐Chia , Wang Hsun‐Mo , Ho Kuen‐Yao , Chien Chen‐Yu 
Published: August 2020

ObjectiveDelayed facial palsy is a complication of otologic surgery. Tympanoplasty is commonly employed in chronic otitis media. We compared the incidence and characteristics of delayed facial palsy and hearing restoration between endoscopic and microscopic tympanoplasty for the treatment of simple chronic otitis media.Study DesignRetrospective cohort study.SettingTertiary medical center.Subjects and MethodsWe retrospectively analyzed 468 patients who underwent type I tympanoplasty from January 2009 to April 2017. Patients were divided into transcanal endoscopic ear surgery and microscopic ear surgery groups. Their epidemiological profiles were reviewed and the outcomes of tympanoplasty were analyzed. Blood sample tests for herpes simplex virus and varicella‐zoster virus immunoglobulin M and immunoglobulin G were arranged in patients with delayed facial palsy.ResultsTranscanal endoscopic ear surgery exhibited similar benefits to microscopic ear surgery in graft‐taking rate and hearing restoration but had a shorter operation time (P <. 01). Eight patients (1.71%) developed delayed facial palsy, but no statistically significant difference was observed between the 2 surgical approaches. All patients tested negative for varicella‐zoster virus and herpes simplex virus immunoglobulin M and positive for immunoglobulin G of the same viruses; however, the titer did not exhibit a 4‐fold increase, implying that patients did not have active viral infections.ConclusionTranscanal endoscopic ear surgery is an ideal alternative for simple tympanoplasty. The incidence of delayed facial palsy was not significantly different between the 2 approaches. Because of the favorable prognosis and the absence of direct serological evidence supporting viral reactivation, treatment with antivirals may not be required.
Nonopioid, Multimodal Analgesia as First‐line Therapy After Otolaryngology Operations: Primer on Nonsteroidal Anti‐inflammatory Drugs (NSAIDs)
Authors: Cramer John D. , Barnett Michael L. , Anne Samantha , Bateman Brian T. , Rosenfeld Richard M. , Tunkel David E. , Brenner Michael J. 
Published: August 2020

ObjectiveTo offer pragmatic, evidence‐informed advice on nonsteroidal anti‐inflammatory drugs (NSAIDs) as first‐line therapy after surgery. This companion to the American Academy of Otolaryngology–Head & Neck Surgery (AAO‐HNS) clinical practice guideline (CPG), “Opioid Prescribing for Analgesia After Common Otolaryngology Operations,” presents data on potency, bleeding risk, and adverse effects for ibuprofen, naproxen, ketorolac, meloxicam, and celecoxib.Data SourcesNational Guidelines Clearinghouse, CMA Infobase, National Library of Guidelines, NICE, SIGN, New Zealand Guidelines Group, Australian National Health and Medical, Research Council, TRIP database, PubMed, Guidelines International Network, Cochrane Library, EMBASE, CINAHL, BIOSIS Previews, ISI Web of Science, AHRQ, and HSTAT.Review MethodsAAO‐HNS opioid CPG literature search strategy, supplemented by PubMed/MEDLINE searches on NSAIDs, emphasizing systematic reviews and randomized controlled trials.ConclusionNSAIDs provide highly effective analgesia for postoperative pain, particularly when combined with acetaminophen. Inconsistent use of nonopioid regimens arises from common misconceptions that NSAIDs are less potent analgesics than opioids and have an unacceptable risk of bleeding. To the contrary, multimodal analgesia (combining 500 mg acetaminophen and 200 mg ibuprofen) is significantly more effective analgesia than opioid regimens (15 mg oxycodone with acetaminophen). Furthermore, selective cyclooxygenase‐2 inhibition reliably circumvents antiplatelet effects.Implications for PracticeThe combination of NSAIDs and acetaminophen provides more effective postoperative pain control with greater safety than opioid‐based regimens. The AAO‐HNS opioid prescribing CPG therefore prioritizes multimodal, nonopioid analgesia as first‐line therapy, recommending that opioids be reserved for severe or refractory pain. This state‐of‐the‐art review provides strategies for safely incorporating NSAIDs into acute postoperative pain regimens.
Effect of Tai Chi on post-stroke non-motor disorders: a systematic review and meta-analysis of randomized controlled trials
Authors: Lyu Diyang , Wang Jichen , Yang Fan , Zhang Yong , Zhang Weijiao , Liu Hongwei , Lyu Xuanxin , Fang Boyan 
Published: August 2020

Objective: To evaluate the state of evidence for the beneficial and harmful effects of Tai Chi on non-motor disorders in post-stroke patients. Design: Systematic review and meta-analysis of published studies. Subjects: Stroke survivors who received conventional rehabilitation therapy or Tai Chi training. Data sources: We searched seven electronic literature databases and one clinical registry platform to collect data from randomized controlled trials published up to July 26, 2020. Results: A total of 11 randomized controlled trials with 723 stroke survivors met the inclusion criteria, of which six were included in the meta-analysis. Among the 11 studies, one was assessed as “low”, eight were assessed as “moderate”, and only two were assessed as “high” for the assessment of methodologic quality. Compared to patients who received conventional rehabilitation therapy, those who received Tai Chi training showed greater improvement in scores of depression (standardized mean difference (SMD) [95% confidence interval (CI)] = 0.36 [0.10, 0.61], Grading of Recommendations Assessment, Development, and Evaluation [GRADE]: very low). There were no differences in the improvements in post-stroke global mental disorders (mean difference (MD [95% CI] = 6.15 [−3.05, 15.36], GRADE: moderate) or sleep disorders (MD [95% CI] = 0.33 [−1.51, 1.81], GRADE: low) between Tai Chi and control groups. Conclusion: Tai Chi may alleviate post-stroke depression in stroke survivors but has no clear effects on post-stroke cognitive and sleep disorders.
Quantified small bowel motility in patients with ulcerative colitis and gastrointestinal symptoms: a pilot study
Authors: Tufvesson Hanna , Dreja Julia , Ekberg Olle , Leander Peter , Månsson Sven , Ohlsson Bodil 
Published: August 2020

Background Gastrointestinal (GI) symptoms are common in patients with ulcerative colitis (UC), even when the disease is in remission, possibly due to abnormalities in GI motility. Small bowel motility can be assessed globally and in specific intestinal regions during magnetic resonance enterography (MRE) using a displacement mapping technique. Purpose To investigate whether small bowel motility in MRE differs between patients with UC and controls, and if altered motility correlates with GI symptoms. Material and Methods In 2016–2018, patients who were admitted for MRE, regardless of clinical indication, were consecutively invited to the study. Healthy volunteers were recruited. The participants completed a questionnaire regarding GI symptoms and relevant clinical data were reviewed in the medical records. The dynamic imaging series obtained during MRE were sent for motility mapping and a motility index (MI) was calculated in jejunum, ileum and terminal ileum in all participants. Results In total, 224 patients and healthy volunteers were enrolled in the study. Fifteen were diagnosed with UC and 22 were considered healthy controls. In UC, the prevalence of GI symptoms was higher than in controls ( P < 0.001), both in remission and in active disease. There was no correlation between GI symptoms and small bowel motility in UC. Jejunal motility was lower in UC than in controls ( P = 0.049). Conclusion Jejunal motility is decreased in UC compared with healthy controls, but there is no relationship between small bowel motility and GI symptoms in UC.
Secondary Injuries After Pediatric Anterior Cruciate Ligament Reconstruction: A Systematic Review With Quantitative Analysis
Authors: Zacharias Anthony J. , Whitaker John R. , Collofello Brandon S. , Wilson Benjamin R. , Unger R. Zackary , Ireland Mary Lloyd , Johnson Darren L. , Jacobs Cale A. 
Published: August 2020

Background: In the skeletally mature anterior cruciate ligament (ACL) reconstruction population, patients aged <25 years are at significantly increased risk of graft failure and injury to the contralateral ACL. Skeletal immaturity often affects graft selection and reconstruction technique. Purpose: To examine the incidence of ipsilateral graft failure and contralateral ACL injury in the skeletally immature patient population. Study Design: Systematic review and meta-analysis. Methods: Using the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines, we reviewed all literature that involved ACL reconstruction performed on skeletally immature patients between May 1976 and May 2019. Patient demographics, surgical technique, and the prevalence of ipsilateral graft failure or subsequent contralateral ACL injury were recorded. Ipsilateral, contralateral, and secondary ACL injuries were then compared between sexes via chi-square tests. Results: A total of 24 articles (1254 children; 1258 knees) met inclusion criteria for analysis. Ipsilateral graft failures occurred in 105 of 1258 patients (8.3%), and there were no statistically significant sex differences in the prevalence of graft failures (female, 9.7%; male patients, 7.1%; P = .14). The prevalence of contralateral ACL injury was significantly greater in female (29/129; 22.5%) than male (18/206; 8.7%; P = .0004) patients in the 9 studies that reported contralateral injury. Skeletally immature female patients were at significantly increased risk of contralateral ACL injury (odds ratio = 3.0; P = .0006) when compared with their male counterparts. Conclusion: In the literature to date, 1 in 3 female skeletally immature patients experienced an ipsilateral graft failure or contralateral ACL injury. Regardless of sex, the 24% prevalence of secondary injury after pediatric ACL reconstruction is almost identical to previously published secondary injury rates in skeletally mature patients <25 years old. As such, skeletal maturity alone does not seem to be a determinant of secondary injury; however, there is a clear need to improve postoperative rehabilitation, activity progression, and return-to-play testing to allow a safe return to sports that protects the long-term health of the reconstructed and contralateral limbs, especially for female patients.
Ulnar Collateral Ligament Tear Location May Affect Return-to-Sports Rate but Not Performance Upon Return to Sports After Ulnar Collateral Ligament Reconstruction Surgery in Professional Baseball Players
Authors: Erickson Brandon J. , Carr James , Chalmers Peter N. , Vellios Evan , Altchek David W. 
Published: August 2020

Background: The number of ulnar collateral ligament (UCL) tears in professional baseball players is increasing. UCL reconstruction (UCLR) is the treatment of choice in players with failed nonoperative treatment who wish to return to sports (RTS). It is unknown if UCL tear location influences the ability of players to RTS or affects their performance upon RTS. Purpose/Hypothesis: The purpose was to compare the RTS rate and performance upon RTS in professional baseball players who underwent UCLR based on UCL tear location (proximal vs distal). It was hypothesized that no difference in RTS rate or performance upon RTS will exist between players with proximal or distal UCL tears. Study Design: Cohort study; Level of evidence, 3. Methods: All professional baseball players who underwent primary UCLR by a single surgeon between 2016 and 2018 were eligible for inclusion. Players with purely midsubstance tears or revision UCLR were excluded. Tear location was determined based on preoperative magnetic resonance imaging (MRI) and intraoperative findings. RTS rate and performance were compared between players with proximal versus distal UCL tears. Results: Overall, 25 pitchers (15 proximal and 10 distal tears) and 5 position players (2 proximal and 3 distal) underwent primary UCLR between 2016 and 2018. Of the 25 pitchers, 84% were able to RTS. Of the 5 position players, 80% were able to RTS. Among the total cohort of pitchers and position players, 12 out of 17 (71%) players with proximal tears were able to RTS, while of the 13 distal tears, 13 out of 13 (100%) players were able to RTS ( P = .05). With regard to performance data, pitchers with distal tears had higher utilization postoperatively and, as such, allowed statistically more hits ( P = .03), runs ( P = .015), and walks ( P = .021) postoperatively. However, the WHIP ([walks + hits]/innings pitched) was not different between players with proximal or distal tears, indicating that efficacy in games was not significantly different between groups. Conclusion: Professional baseball players who sustain a distal UCL tear and undergo UCLR may be more likely to RTS than those who sustain a proximal UCL tear and undergo UCLR. Players with distal UCL tears who underwent UCLR saw higher utilization postoperatively than those with proximal UCL tears. Further work is needed in this area to confirm this result.
An Active In-Home Physician Model of Palliative Care and Its Resulting Performance Indicators Related to Home Deaths, Unplanned Emergency Department Visits and Unplanned Hospital Admissions
Authors: Webber Colleen , Valiulis Aurelia Ona , Tanuseputro Peter , Schulz Valerie , Apramian Tavis , Schreier Gil , Hamilton Kirk 
Published: August 2020

Background: Limited research has characterized team-based models of home palliative care and the outcomes of patients supported by these care teams. Case presentation: A retrospective case series describing care and outcomes of patients managed by the London Home Palliative Care Team between May 1, 2017 and April 1, 2019. Case management: The London Home Palliative Care (LHPC) Team care model is based upon 3 pillars: 1) physician visit availability 2) active patient-centered care with strong physician in-home presence and 3) optimal administrative organization. Case outcomes: In the 18 month study period, 354 patients received care from the London Home Palliative Care Team. Most significantly, 88.4% ( n = 313) died in the community or at a designated palliative care unit after prearranged direct transfer; no comparable provincial data is available. 21.2% ( n = 75) patients visited an emergency department and 24.6% ( n = 87) were admitted to hospital at least once in their final 30 days of life. 280 (79.1%) died in the community. These values are better than comparable provincial estimates of 62.7%, 61.7%, and 24.0%, respectively. Conclusion: The London Home Palliative Care (LHPC) Team model appears to favorably impact community death rate, ER visits and unplanned hospital admissions, as compared to accepted provincial data. Studies to determine if this model is reproducible could support palliative care teams achieving similar results.