bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Integrated Geometric and Topological Approach for the Identification and Visual Analysis of Rossby Wave Packets
Authors: Pandey Karran , Monteiro Joy Merwin , Natarajan Vijay 
Published: June 2020

AbstractA new method for identifying Rossby wave packets (RWPs) using 6-hourly data from the ERA-Interim is presented. The method operates entirely in the spatial domain and relies on the geometric and topological properties of the meridional wind field to identify RWPs. The method represents RWPs as nodes and edges of a dual graph instead of the more common envelope representation. This novel representation allows access to both RWP phase and amplitude information. Local maxima and minima of the meridional wind field are collected into groups. Each group, called a υ-max cluster or υ-min cluster of the meridional wind field, represents a potential wave component. Nodes of the dual graph represent a υ-max cluster or υ-min cluster. Alternating υ-max clusters and υ-min clusters are linked by edges of the dual graph, called the RWP association graph. Amplitude and discrete gradient-based filtering applied on the association graph helps identify RWPs of interest. The method is inherently robust against noise and does not require smoothing of the input data. The main parameters that control the performance of the method and their impact on the identified RWPs are discussed. All filtering and RWP identification operations are performed on the association graph as opposed to directly on the wind field, leading to computational efficiency. Advantages and limitations of the method are discussed and are compared against (transform-based) envelope methods in a series of experiments.
Applicant-to-Residency Program Communication: Does It Matter?
Authors: Solis Roberto N. , Quesada Pompeyo R. , Ma Cheng , Olinde Lindsay M. , Diaz Rodney C. 
Published: June 2020

Objectives: To elucidate the frequency and types of pre- and post-interview communication that applicants engage with programs, to garner the perceptions of both applicants and program directors (PDs), and determine if communication influences outcomes. Subjects and Methods: Electronic surveys were distributed to otolaryngology residency applicants, and to PDs of ACGME-accredited otolaryngology programs after the 2018 to 2019 application cycle. Results: 93 of 324 applicants (28.7%) and 33 of 106 PDs (31.3%) responded. In the pre-interview period, 58.1% of applicants sent emails of interest, and 41.9% had a mentor initiate communication. In the post-interview period, the majority of applicants (82.8%) sent notes of intent to their number one choice, and 32.3% had a faculty mentor communicate this on their behalf. The majority of PDs (84.8%) were undecided or did not believe that emails of interest influence decisions to offer an interview, whereas 81.8% believed that communication initiated by an applicant’s mentor has an impact on interview offers. No PD agreed that declarations of intent from applicants have an impact on their rank lists, while only 33.3% of PDs believed that a mentor communicating this for an applicant has some impact. Our statistical findings are in agreement with these perceptions as neither applicant-initiated pre-interview ( P = .54), mentor-initiated pre-interview ( P = .62), applicant-initiated post-interview ( P = .11) nor mentor-initiated post-interview ( P = .78) communications influenced the number of interviews received or ultimate match outcome. Conclusion: Pre- and post-interview communication practices vary widely among otolaryngology applicants. Applicant-initiated communication has no impact on outcomes, while mentor-initiated communication is perceived to have more benefit, despite not impacting interview or match outcomes in this study.
Functional vitamin B12 deficiency in phenylketonuria patients and healthy controls: An evaluation with combined indicator of vitamin B12 status as a biochemical index
Authors: Akış Merve , Kant Melis , Işık İshak , Kısa Pelin Teke , Köse Engin , Arslan Nur , İşlekel Hüray 
Published: June 2020

Background Vitamin B12 deficiency frequently appears in phenylketonuria patients having a diet poor in natural protein. The aims of this study were to evaluate vitamin B12 status in phenylketonuria patients by using combined indicator of vitamin B12 status (cB12) as well as methylmalonic acid and homocysteine, more specific and sensitive markers, in comparison with healthy controls. Methods Fifty-three children and adolescents with phenylketonuria under dietary treatment and 30 healthy controls were assessed cross-sectionally. Serum vitamin B12 and folate concentrations were analysed by chemiluminescence immunoassay. Plasma methylmalonic acid and total homocysteine concentrations were measured by liquid chromatography-tandem mass spectrometry and liquid chromatography, respectively. cB12 was calculated by using a formula involving blood parameters. Results Methylmalonic acid and folate concentrations in phenylketonuria group were higher compared with controls. Methylmalonic acid concentrations were high in 56.5% of the patients and 26.7% of the controls with normal vitamin B12 concentrations. Based on cB12, a significant difference within the normal values was detected between the groups. However, although 24.5% of phenylketonuria patients and 13.3% of controls had decreased vitamin B12 status according to cB12, there was no significant difference. Conclusion Children and adolescents with phenylketonuria having a strict diet can be at risk of functional vitamin B12 deficiency. This deficiency can be accurately determined by measuring methylmalonic acid concentrations. Calculation of cB12 as a biochemical index did not provide additional information compared with the measurement of methylmalonic acid alone, but may be helpful for classification of some patients with increased methylmalonic acid as having adequate vitamin B12 status.
Measurement of faecal haemoglobin with a faecal immunochemical test can assist in defining which patients attending primary care with rectal bleeding require urgent referral
Authors: Digby Jayne , Strachan Judith A , McCann Rebecca , Steele Robert JC , Fraser Callum G , Mowat Craig 
Published: June 2020

Background Current guidelines document persistent rectal bleeding as an alarm symptom in patients presenting to primary care. We studied whether a faecal immunochemical test could assist in their assessment. Methods From December 2015, faecal immunochemical tests were routinely available to primary care when assessing patients with new-onset bowel symptoms: general practitioners were encouraged to include faecal haemoglobin concentration (f-Hb) within any referral to secondary care. Results with f-Hb ≥10  μg Hb/g faeces were defined as positive. The incidence of significant bowel disease (SBD: colorectal cancer [CRC], higher-risk adenoma [HRA: any ≥1 cm, or three or more] and inflammatory bowel disease [IBD]) at subsequent colonoscopy, referred symptoms and f-Hb were recorded. Results Of 1447 patients with a faecal immunochemical test result and colonoscopy outcome, SBD was diagnosed in 296 patients (20.5%; 95 with CRC, 133 with HRA, and 68 with IBD). Four hundred and sixty-two patients (31.9%) reported rectal bleeding: 294 had f-Hb ≥10  μg Hb/g faeces. At colonoscopy, 105/294 had SBD versus 14/168 with rectal bleeding and f-Hb <10  μg Hb/g faeces ( P < 0.0001), comprising one case of CRC (0.6%), 12 HRA (7.1%) and one new case of IBD (0.6%); further, the single cancer and 8 of the 12 HRA were located in the descending colon. Conclusion Patients with rectal bleeding and f-Hb <10  μg Hb/g faeces are unlikely to have SBD and could be investigated by sigmoidoscopy alone. Using the faecal immunochemical test to guide investigation of patients with rectal bleeding is a rational and practical way forward.
Tympanostomy Tube Innovation: Advances in Device Material, Design, and Office-Based Technology
Authors: Whelan Rachel L. , Maguire Raymond C. 
Published: June 2020

Objectives: With tympanostomy tube insertion remaining the most common procedure performed in children to date, growing interests in minimizing both procedural costs and anesthetic exposure in the pediatric population have inspired innovation with respect to tympanostomy tubes. As such, we aim to discuss the current state of tympanostomy tube innovation including insertion devices, tube material, and design. Methods: Computerized literature review. Results: (1) Numerous single-use devices consisting of a myringotomy knife and preloaded tympanostomy tube offer potential advantages of decreasing or eliminating operating room time and may be performed under moderate instead of a general anesthetic. (2) Innovation with respect to tympanostomy tube material and design may offer enhanced ototopical drug delivery, decreased rates of tube occlusion, and/or the ability to dissolve “on-command” with application of a novel ototopical material. (3) These technologies currently remain in various phases of preclinical and clinical testing. Conclusions: While clinical testing for a number of new technologies is preliminary and ongoing, tympanostomy tube-related innovations hold exciting promise to supplement or potentially replace the present-day armamentarium of tympanostomy tube design and insertion moving forward.
Association Between Helicobacter pylori Infection and Otitis Media With Effusion Risk in Children: A Systematic Review and Meta‐analysis
Authors: Wu Xiaohui , Zheng Yun , Gao Xingqiang , Li Gang , Cao Qiuxue 
Published: June 2020

ObjectiveTo investigate the potential correlation between Helicobacter pylori infection and otitis media with effusion (OME) risk in children.Data SourcesElectronic databases were searched, including Cochrane Library, PubMed, Embase, China Biology Medicine disc, China Science and Technology Journal Database, Wanfang Database, and China National Knowledge Infrastructure Database.Review MethodsA systematic review and meta‐analysis were conducted with Revman 5.3 software. Combined odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate infection‐disease association.ResultsIn total, 11 studies from 9 articles regarding H pylori infection and OME risk were enrolled in this meta‐analysis. A significant association between H pylori infection and OME was detected for both adenoid samples from the case group (OR, 2.75; 95% CI, 1.43‐5.30; P =. 002) and middle ear fluid samples from the case group (OR, 4.45; 95% CI, 2.52‐7.88; P <. 00001). Subgroup analyses suggested a stronger correlation in African and Asian populations.ConclusionThis study indicated the correlation between H pylori infection and increased risk of OME in children, especially in African and Asian populations. Further well‐designed studies regarding the white population are strongly recommended in the future.
Eustachian Tube Balloon Dilation: A Systematic Review and Meta‐analysis of Treatment Outcomes
Authors: Froehlich Michael H. , Le Phong T. , Nguyen Shaun A. , McRackan Theodore R. , Rizk Habib G. , Meyer Ted A. 
Published: June 2020

ObjectiveTo examine the effectiveness of eustachian tube balloon dilation for the treatment of eustachian tube dysfunction.Data SourcesPubMed, Scopus, and Google Scholar.Review MethodsA systematic review of eustachian tube balloon dilation for the treatment of eustachian tube dysfunction was conducted following Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines to identify randomized control trials and prospective and retrospective studies published prior to January 31, 2019. Meta‐analysis of proportions evaluated 7‐item Eustachian Tube Dysfunction Questionnaire (ETDQ7) scores, tympanometry, otoscopy findings, and the ability to perform a Valsalva maneuver.ResultsThe systematic review identified 35 studies. Twelve studies met inclusion for meta‐analysis (448 patients). Mean ETDQ7 scores decreased by 2.13 from baseline to 6 weeks (95% CI, –3.02 to −1.24; P <. 001). From baseline to 6 weeks, 53.0% of patients had improvement in tympanograms (P <. 001). At the long‐term point (3‐12 months), 50.5% of patients had improved tympanograms from baseline (P <. 001). There was no significant difference in the proportion of improved tympanograms at 6 weeks compared to long term (P =. 535). Normal otoscopy exams at baseline increased by 30.0% at 6 weeks (P <. 001) and 55.4% in the long term (P <. 001). There was a 67.8% increase in proportion of patients able to perform a Valsalva maneuver in the long term compared to baseline (P <. 001).ConclusionEustachian tube balloon dilation appears to be associated with improvement in subjective and objective treatment outcome metrics. The improvement appears stable at 3 to 12 months after dilation. Patients with eustachian tube dysfunction are likely to benefit from balloon dilation, particularly those with medication‐refractory disease.
Immediate Voice and Swallowing Complaints Following Revision Anterior Cervical Spine Surgery
Authors: Strohl Madeleine P. , Choy Winward , Clark Aaron J. , Mummaneni Praveen V. , Dhall Sanjay S. , Tay Bobby K. , Loftus Patricia A. , El‐Sayed Ivan H. , Russell Matthew S. 
Published: June 2020

ObjectiveTo report on the incidence of dysphagia, dysphonia, and acute vocal fold motion impairment (VFMI) following revision anterior cervical spine surgery, as well as to identify risk factors associated with acute VFMI in the immediate postoperative period.Study DesignRetrospective cohort study.SettingTertiary care center.Subjects and MethodsAll patients who underwent 2‐team reoperative anterior cervical discectomy and fusion (ACDF) were retrospectively reviewed. Incidence of dysphonia, dysphagia, and acute VFMI was noted. Patient and operative factors were evaluated for association with risk of acute VFMI.ResultsThe incidence of postoperative dysphonia and dysphagia was 25% (18/72) and 52% (37/72), respectively. The incidence of immediate VFMI was 21% (15/72). Subjective postoperative dysphonia (odds ratio, [OR] 8; 95% CI, 2.2‐28; P =. 001) and dysphagia (OR, 22; 95% CI, 2.5‐168; P =. 005) were significantly associated with increased risk of VFMI. Three patients with VFMI required temporary injection medialization for voice complaints and/or aspiration. Infection (OR, 14; 95% CI, 1.4‐147, P =. 025) and level C7/T1 (OR, 5.5; 95% CI, 1.3‐23, P =. 02) were significantly associated with an increased risk of acute VFMI on multivariate logistic regression analysis. Number of prior surgeries, laterality of approach, side of approach relative to prior operations, and number of levels exposed were not significant.ConclusionEarly involvement of an otolaryngologist in the care of a patient undergoing revision ACDF can be helpful to the patient in anticipation of voice and swallowing changes in the postoperative period. This may be particularly important in those being treated at C7/T1 or those with spinal infections.
Alternations of Blood Pressure Before and After OSA Surgery
Authors: Tsai Ming‐Hsien , Lin Pei‐Wen , Lin Hsin‐Ching , Friedman Michael , Salapatas Anna M. , Lu Yu‐Hao , Su Mao‐Chang , Lin Meng‐Chih 
Published: June 2020

ObjectiveTo investigate the changes of blood pressure (BP) on patients with obstructive sleep apnea/hypopnea syndrome (OSA) before and after upper airway surgery.DesignCase series with chart review.SettingTertiary academic medical center.Subjects and MethodsPatients with OSA who underwent upper airway surgery were enrolled. We retrospectively investigated the nighttime and daytime BP before and at least 3 months after OSA surgery. Paired t test was used to compare the changes of BP before and after surgery. Generalized estimating equation was used to examine the prognostic significance of the variables in predicting the changes of postoperative BP.ResultsIn total, 176 patients with OSA (149 men, 27 women; mean age, 42.9 years; mean apnea/hypopnea index, 43.1/h) were enrolled in this study. The overall nighttime and daytime BP decreased significantly before and after OSA surgery (daytime systolic BP was reduced from 137.3 ± 14.0 mm Hg to 132.7 ± 17.0 mm Hg, P <. 01; nighttime systolic BP was reduced from 138.7 ± 16.0 mm Hg to 133.7 ± 15.3 mm Hg, P <. 01; daytime diastolic BP was reduced from 87.7 ± 14.7 mm Hg to 84.9 ± 10.6 mm Hg, P =. 01; nighttime diastolic BP was reduced from 85.4 ± 12.9 mm Hg to 83.1 ± 11.1 mm Hg, P =. 02). The changes of nighttime systolic and diastolic BP were significantly associated with the improvement of percentage of O2 saturation <90% during polysomnography.ConclusionSurgical modifications of the upper airways for patients with OSA could benefit blood pressure.
Predicting COVID‐19 Incidence Using Anosmia and Other COVID‐19 Symptomatology: Preliminary Analysis Using Google and Twitter
Authors: Panuganti Bharat A. , Jafari Aria , MacDonald Bridget , DeConde Adam S. 
Published: June 2020

ObjectiveTo determine the relative correlations of Twitter and Google Search user trends concerning smell loss with daily coronavirus disease 2019 (COVID‐19) incidence in the United States, compared to other severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) symptoms. To describe the effect of mass media communications on Twitter and Google Search user trends.Study DesignRetrospective observational study.SettingUnited States.Subjects and MethodsGoogle Search and “tweet” frequency concerning COVID‐19, smell, and nonsmell symptoms of COVID‐19 generated between January 1 and April 8, 2020, were collected using Google Trends and Crimson Hexagon, respectively. Spearman coefficients linking each of these user trends to COVID‐19 incidence were compared. Correlations obtained after excluding a short timeframe (March 22 to March 24) corresponding to the publication of a widely read lay media publication reporting anosmia as a symptom of infection was performed for comparative analysis.ResultsGoogle searches and tweets concerning all nonsmell symptoms (0.744 and 0.761, respectively) and COVID‐19 (0.899 and 0.848) are more strongly correlated with disease incidence than smell loss (0.564 and 0.539). Twitter users tweeting about smell loss during the study period were more likely to be female (52%) than users tweeting about COVID‐19 more generally (47%). Tweet and Google Search frequency pertaining to smell loss increased significantly (>2.5 standard deviations) following a widely read media publication linking smell loss and SARS‐CoV‐2 infection.ConclusionsGoogle Search and tweet frequency regarding fever and shortness of breath are more robust indicators of COVID‐19 incidence than anosmia. Mass media communications represent important confounders that should be considered in future analyses.
Effect of Implementing Simulation Education on Health Care Worker Comfort With Nasopharyngeal Swabbing for COVID‐19
Authors: Mark Michelle E. , LoSavio Phillip , Husain Inna , Papagiannopoulos Peter , Batra Pete S. , Tajudeen Bobby A. 
Published: June 2020

ObjectiveTo determine if rapid implementation of simulation training for the nasopharyngeal swab procedure can increase provider confidence regarding procedure competency.MethodsA simulation training exercise was designed as a departmental initiative to improve competency performing nasopharyngeal swabs during the COVID‐19 pandemic. Sixty‐one health care workers attended teaching sessions led by the Department of Otorhinolaryngology on proper nasopharyngeal swab technique. After a brief lecture, participants practiced their swab technique using a high‐fidelity airway simulation model. Pre‐ and postintervention self‐evaluations were measured via standardized clinical competency questionnaires on a 5‐point Likert scale ranging from “No knowledge, unable to perform” up to “Highly knowledgeable and confident, independent.”ResultsForty‐six participants in this study submitted pre‐ and postintervention self‐assessments. Postintervention scores improved on average 1.41 points (95% CI, 1.10‐1.73) out of 5 from a mean score of 3.13 to 4.54 (P <. 0001). This reflects a large effect size with a Glass’s delta value of 1.3.DiscussionLecture coupled with simulation‐based teaching can significantly improve health care workers’ confidence in performing nasopharyngeal swabs. Proper training for frontline workers performing swabs for COVID‐19 is essential to improving testing accuracy and can be achieved in a simple and timely manner.Implications for PracticeTo meet the testing needs of the growing pandemic, many health care workers who are unfamiliar with nasopharyngeal swabs have been asked to perform this test. Simulation‐based teaching sessions may improve health care workers’ confidence and help prevent false‐negative results. This intervention is easily reproducible in any setting where frequent nasopharyngeal swab testing occurs.Level of Evidence/Study DesignProspective cohort study.
Respiratory Dysfunction and Sleep-Disordered Breathing in Children With Myasthenia Gravis
Authors: Katzberg Hans D. , Vajsar Jiri , Vezina Kevin , Qashqari Heba , Selvadurai Sarah , Chrestian Nicholas , Khayat Abdullah , Ryan Clodagh M. , Narang Indra 
Published: June 2020

Objectives: The purpose of this study was to prospectively evaluate sleep patterns and the presence of sleep-disordered breathing in children with myasthenia gravis. We further aimed to examine the relationship between sleep and daytime respiratory function using spirometry tests including upright and supine forced vital capacity, sniff nasal inspiratory pressure, and maximal inspiratory pressure. Methods: Eleven children between 3 and 18 years old with confirmed myasthenia gravis were recruited from The Hospital for Sick Children Neuromuscular Clinic in this prospective observational study. After informed consent was obtained, patients underwent a comprehensive clinical assessment with collection of anthropometric data. Following this, all subjects performed pulmonary function tests, overnight polysomnography and completed the Epworth Sleepiness Scale questionnaire. Results: Two of eleven children who reported no symptoms of sleep disordered breathing were diagnosed with mild to moderate obstructive sleep apnea. Pulmonary function tests showed abnormal maximal inspiratory pressure in 6 of 11 patients, whereas seated forced vital capacity as well as seated to supine forced vital capacity ratios were normal in the entire group. Conclusions: In our small group of pediatric myasthenia gravis subjects, there was an unexpected finding of obstructive sleep apnea in 2 of the 11 patients studied. Maximal inspiratory pressure appears to be a more sensitive method of detecting abnormalities compared to upright or seated forced vital capacity. A larger multicenter study is needed to validate our findings and to determine the impact of obstructive sleep apnea in the pediatric myasthenia gravis population as well as risk factors associated with sleep disordered breathing.
Private metropolitan telepsychiatry in Australia during Covid-19: current practice and future developments
Authors: Looi Jeffrey CL , Pring William 
Published: June 2020

Objective: This paper discusses issues arising from the rapid implementation of metropolitan telepsychiatry in private practice during the Covid-19 public health emergency. Conclusions: The relatively rapid uptake of private practice metropolitan telepsychiatry may further increase flexibility of the options for appointments through ongoing broad telepsychiatry access after the Covid-19 crisis. Telepsychiatry can be used to facilitate the temporary provision of psychiatric care, and has benefits and risks, but is not a longer-term replacement for the interpersonal richness of face-to-face consultations.