bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factor Effects in Numerical Simulations
Authors: Cleveland Judah L. , Smith Jeffrey A. , Collins James P. 
Published: May 2020

AbstractNumerical simulations allow users to adjust factor settings in experimental runs to understand how changes in those factors affect the output. However, it is not straightforward to analyze these outputs when multiple input factors are changed, especially simultaneously. For the atmospheric sciences, Stein and Alpert introduced a method they termed “factor separation” in order to separate the “pure contribution” of a factor from “pure interactions” of combinations of factors. Although factor separation appears to be used exclusively within the atmospheric sciences, other communities achieve a similar result by computing “main effects” via design of experiments methods. While both methods yield different estimates for the factor effects or contributions, we show that factor separation effects are identical to “simple effects” in the design of experiments literature. We demonstrate how both factor separation effects and design of experiments main effects correspond to multiple linear regression coefficients with different coding methods; thus, effect estimates produced by each method are equivalent through a variable transformation. We illustrate the application of both methods using a shallow-water simulation. This connection between factor separation and the design of experiments discipline extends factor separation to more applications by making available design of experiments methods for decreasing the computational cost and calculating effects for factors with more than two settings, both of which are limitations of factor separation.
Spatial Bias in Medium-Range Forecasts of Heavy Precipitation in the Sacramento River Basin: Implications for Water Management
Authors: Brodeur Zachary P. , Steinschneider Scott 
Published: May 2020

AbstractForecasts of heavy precipitation delivered by atmospheric rivers (ARs) are becoming increasingly important for both flood control and water supply management in reservoirs across California. This study examines the hypothesis that medium-range forecasts of heavy precipitation at the basin scale exhibit recurrent spatial biases that are driven by mesoscale and synoptic-scale features of associated AR events. This hypothesis is tested for heavy precipitation events in the Sacramento River basin using 36 years of NCEP medium-range reforecasts from 1984 to 2019. For each event we cluster precipitation forecast error across western North America for lead times ranging from 1 to 15 days. Integrated vapor transport (IVT), 500-hPa geopotential heights, and landfall characteristics of ARs are composited across clusters and lead times to diagnose the causes of precipitation forecast biases. We investigate the temporal evolution of forecast error to characterize its persistence across lead times, and explore the accuracy of forecasted IVT anomalies across different domains of the North American west coast during heavy precipitation events in the Sacramento basin. Our results identify recurrent spatial patterns of precipitation forecast error consistent with errors of forecasted synoptic-scale features, especially at long (5–15 days) leads. Moreover, we find evidence that forecasts of AR landfalls well outside of the latitudinal bounds of the Sacramento basin precede heavy precipitation events within the basin. These results suggest the potential for using medium-range forecasts of large-scale climate features across the Pacific–North American sector, rather than just local forecasts of basin-scale precipitation, when designing forecast-informed reservoir operations.
Control of Bering Strait Transport by the Meridional Overturning Circulation
Authors: Cessi Paola 
Published: May 2020

AbstractIt is well established that the mean transport through Bering Strait is balanced by a sea level difference between the North Pacific and the Arctic Ocean, but no mechanism has been proposed to explain this sea level difference. It is argued that the sea level difference across Bering Strait, which geostrophically balances the northward throughflow, is associated with the sea level difference between the North Pacific and the North Atlantic/Arctic. In turn, the latter difference is caused by deeper middepth isopycnals in the Indo-Pacific than in the Atlantic, especially in the northern high latitudes because there is deep water formation in the Atlantic, but not in the Pacific. Because the depth of the middepth isopycnals is associated with the dynamics of the upper branch of the meridional overturning circulation (MOC), a model is formulated that quantitatively relates the sea level difference between the North Pacific and the Arctic/North Atlantic with the wind stress in the Antarctic Circumpolar region, since this forcing powers the MOC, and with the outcropping isopycnals shared between the Northern Hemisphere and the Antarctic circumpolar region, since this controls the location of deep water formation. This implies that if the sinking associated with the MOC were to occur in the North Pacific, rather than the North Atlantic, then the Bering Strait flow would reverse. These predictions, formalized in a theoretical box model, are confirmed by a series of numerical experiments in a simplified geometry of the World Ocean, forced by steady surface wind stress, temperature, and freshwater flux.
Resource Utilization and Billing in a Resident‐Managed Inpatient Consult Service
Authors: Chiao Jonathan , Dowdall Jayme R. , Pate Samuel K. 
Published: May 2020

ObjectivePatient care delivered by residents is an educational opportunity to foster autonomy. These services, however, may not be billed without direct faculty supervision. This quality improvement project analyzes descriptive data, procedures, and billing from an academic otolaryngology–head and neck surgery department’s inpatient consult service.MethodsThis prospective cohort study collected descriptive and billing data on all consults over 30 consecutive days. Data collected described bedside procedures and operative interventions. Encounters were Current Procedural Terminology coded and equivalent work relative value unit (wRVU) calculated. Codes submitted for billing were reviewed to identify opportunities for inpatient billing improvement.ResultsNinety‐eight new consults were included, and 105 bedside procedures were performed. Flexible laryngoscopy (n = 27), I&D (incision and drainage; n = 11), and suturing (n = 11) were the most performed bedside procedures. Operative intervention was required in 15 encounters. The inpatient consult team provided the equivalent of 391.39 wRVU. Seventy‐three percent of operative compared to 3% of bedside procedures were submitted for billing.DiscussionThe productivity of our team approximated 61.8% of a full‐time general otolaryngologist but with decreased billing submissions. Balance between resident autonomy, education, quality patient care, and the ability to capture service revenue is complex. Strategies other institutions have used to capture missed billing opportunities have included a hospitalist model, mid‐level providers, and resident billing.Implications for PracticeThis study characterizes an academic inpatient consult service. Results describe a case for improving the structure of the inpatient consult service, caution that studies collecting data via department billing may underrepresent services, and suggest alternative service structures to overcome identified billing limitations.
Algorithm‐Based Pediatric Otolaryngology Management During the COVID‐19 Global Pandemic: A Children’s Hospital of Philadelphia Clinical Consensus
Authors: Chorney Stephen R. , Elden Lisa M. , Giordano Terri , Kazahaya Ken , Rizzi Mark D. , Zur Karen B. , Dedhia Kavita 
Published: May 2020

ObjectiveThe coronavirus disease 2019 (COVID‐19) pandemic requires clinicians to explore alternatives to routine patient management. Otolaryngologists caring for children commonly depend on physical examination, laboratory data, and ambulatory surgical procedures. Limiting patient care, mindful allocation of resources, and concern for safety have challenged all aspects of our health care system. This evidence‐based clinical consensus is designed to guide practitioners of pediatric otolaryngology for common scenarios during this time.Data SourcesPeer‐reviewed literature, published reports, institutional guidelines, and expert consensus.Review MethodsA clinical consensus on 6 common scenarios in pediatric otolaryngology developed with evidence‐based strategies.ConclusionsProviders should suspend all in‐person nonessential office visits and elective surgical procedures. An emphasis on medical management and caregiver education will provide reasonable approaches to many of the common outpatient concerns. Surgery for chronic otitis media, obstructive sleep apnea, and acute rhinosinusitis should occur only in response to severe complications or failure of medical regimens. The approach to the pediatric neck mass focuses on timely management for oncologic etiologies and cautious surgical intervention for abscess drainage or tissue sampling. Finally, epistaxis and otorrhea must be triaged and addressed without the usual ambulatory procedures.Implications for PracticeAdaptation of practice patterns during this unprecedented moment for our health care system requires thoughtful planning. The strategies described allow for safe handling of common pediatric otolaryngology diagnoses. Ultimately, otolaryngologists must be stewards of our global health community while advocating for the care of individual pediatric patients.
Weight Gain in Infants With Pierre Robin Sequence in the First Year of Life
Authors: Li Leo , Scott Andrew R. 
Published: May 2020

ObjectiveTo compare growth trends among infants with Pierre Robin sequence (PRS) to normal World Health Organization (WHO) growth standards.Study DesignCase series with chart review.Subjects and MethodsTwenty‐four infants with syndromic and nonsyndromic PRS (54% male) treated at an urban academic medical center between 2009 and 2017 were included. Infants with symptomatic hypoventilation underwent mandibular distraction osteogenesis (71%). Weights were recorded at roughly 1‐ to 3‐month intervals from birth to 12 months, with ages adjusted for prematurity. The 50th percentile (P50) for this cohort was calculated and compared to WHO standards.ResultsIn total, 135 weight entries for 24 subjects were included. The birth weight P50 was similar to the WHO standard (females: 0.09 kg above WHO [95% CI, –0.25 to +0.43; z score = 0.19]; males: 0.38 kg below WHO [95% CI, –0.77 to 0.00; z score = −0.79]). A slower growth rate was noted among female and male infants with PRS: in month 5, the PRS P50 among females was 1.42 kg below the WHO standard (95% CI, –1.77 to −1.07; z score = −1.64). Among males in month 3, the PRS P50 was 1.68 kg below the WHO standard (95% CI, –2.12 to −1.24; z score = −2.19). By month 12, weight deficiencies had resolved in both groups.ConclusionNewborns with and without PRS may have similar birth weights, but the growth rate among male and female infants with PRS may lag behind that of unaffected infants, even when upper airway obstruction has been addressed in early infancy.
Impact of AAO‐HNS Guideline on Obtaining Polysomnography Prior to Tonsillectomy for Pediatric Sleep‐Disordered Breathing
Authors: Banik Grace L. , Empey Rebecca M. , Lam Derek J. 
Published: May 2020

ObjectiveTo assess the impact of the 2011 American Academy of Otolaryngology–Head and Neck Surgery (AAO‐HNS) guideline on practice patterns in obtaining preadenotonsillectomy (AT) polysomnography (PSG) for pediatric sleep‐disordered breathing (SDB).Study DesignRetrospective cohort study.SettingTertiary children’s hospital.Subject and MethodsThe study population included all patients referred to our pediatric otolaryngology clinic for consideration of AT for SDB during two 12‐month time periods: before (2010‐2011) and after (2015‐2016) publication of the 2011 AAO‐HNS guideline. Demographic, insurance, comorbidity, and Pediatric Sleep Questionnaire (PSQ) variables were assessed for association with pre‐AT PSG using bivariate and multivariate logistic regression analysis.ResultsA greater percentage of patients underwent pre‐AT PSG in 2015‐2016 vs 2010‐2011 (30% vs 22%, P =. 001). On multivariate analysis, presence of neuromuscular disorder was the only predictor associated with pre‐AT PSG in 2010 to 2011 (odds ratio [OR], 3.00; 95% CI, 1.10, 8.06; P =. 03). Presence of neuromuscular disorder (OR, 2.54; 95% CI, 1.51, 4.29; P <. 0001), craniofacial anomaly (OR, 2.32; 95% CI, 1.20, 4.50; P =. 013), or Down syndrome (OR, 3.45; 95% CI, 1.54, 7.72; P =. 003) was associated with pre‐AT PSG in 2015 to 2016. Positive PSQ screen was significantly associated with decreased odds of pre‐AT PSG in both time periods.ConclusionAfter publication of the 2011 AAO‐HNS guideline, there was a significant but modest increase in pre‐AT PSG utilization in children with SDB and high‐risk comorbidities at our institution, consistent with AAO‐HNS guideline recommendations. However, overall guideline adherence remains low and may reflect limitations in PSG testing capacity.
Subjective Changes in Smell and Taste During the COVID‐19 Pandemic: A National Survey—Preliminary Results
Authors: Coelho Daniel H. , Kons Zachary A. , Costanzo Richard M. , Reiter Evan R. 
Published: May 2020

Since the COVID‐19 pandemic began, many individuals have noted acute loss of smell and/or taste, although not all patients with these symptoms are tested for COVID‐19. To better characterize all patients with these rare symptoms, a national survey was created. Over 13 days in April 2020, a total of 220 people completed the survey in its entirety, representing a wide geographic distribution across the United States. Of the 220 respondents, 93 (42%) were diagnosed with COVID‐19, and 127 (58%) were not. A total of 37.7% of respondents reported changes in smell/taste as the initial or sole presentation of their condition. Most but not all patients had other symptoms suggestive of COVID‐19 at the time of chemosensory loss. Despite its inclusion as a major symptom of COVID‐19 by the CDC (Centers for Disease Control and Prevention), respondents with additional CDC‐defined symptoms associated with COVID‐19 were statistically more likely to be tested/diagnosed than those without.
Cadaveric Simulation of Otologic Procedures: An Analysis of Droplet Splatter Patterns During the COVID‐19 Pandemic
Authors: Sharma Dhruv , Rubel Kolin E. , Ye Michael J. , Campiti Vincent J. , Carroll Aaron E. , Ting Jonathan Y. , Illing Elisa A. , Burgin Sarah J. 
Published: May 2020

ObjectiveThe otolaryngology community has significant concerns regarding the spread of SARS‐CoV‐2 through droplet contamination and viral aerosolization during head and neck examinations and procedures. The objective of this study was to investigate the droplet and splatter contamination from common otologic procedures.Study DesignCadaver simulation series.SettingDedicated surgical laboratory.MethodsTwo cadaver heads were prepped via bilateral middle cranial fossa approaches to the tegmen (n = 4). Fluorescein was instilled through a 4‐mm burr hole drilled into the middle cranial fossa floor, and presence in the middle ear was confirmed via microscopic ear examination. Myringotomy with ventilation tube placement and mastoidectomy were performed, and the distribution and distance of resulting droplet splatter patterns were systematically evaluated.ResultsThere were no fluorescein droplets or splatter contamination observed in the measured surgical field in any direction after myringotomy and insertion of ventilation tube. Gross contamination from the surgical site to 6 ft was noted after complete mastoidectomy, though, when performed in standard fashion.ConclusionOur results show that there is no droplet generation during myringotomy with ventilation tube placement in an operating room setting. Mastoidectomy, however, showed gross contamination 3 to 6 ft away in all directions measured. Additionally, there was significantly more droplet and splatter generation to the left of the surgeon when measured at 1 and 3 ft as compared with all other measured directions.
Effect of coronavirus infection on the human heart: A scoping review
Authors: Ho Jamie SY , Tambyah Paul A , Ho Andrew FW , Chan Mark YY , Sia Ching-Hui 
Published: May 2020

BackgroundThe global coronavirus disease 2019 pandemic has highlighted the importance of understanding the cardiovascular implications of coronavirus infections, with more severe disease in those with cardiovascular co-morbidities, and resulting cardiac manifestations such as myocardial injury, arrhythmias, and heart failure.DesignA systematic review of the current knowledge on the effects of coronavirus infection on the cardiovascular system in humans was performed and results were summarized.MethodsDatabases such as MEDLINE, EMBASE, CENTRAL, Scopus, Web of Science, ClinicalTrials.gov, Chinese Knowledge Resource Integrated Database and Chinese Clinical Trial Registry were searched on 20 March 2020.ResultsIn total, 135 studies were included, involving severe acute respiratory syndrome, Middle East respiratory syndrome, coronavirus disease 2019 and other coronaviruses. Most were case reports, case series and cohort studies of poor to fair quality. In post-mortem examinations of subjects who died from infection, around half had virus identified in heart tissues in severe acute respiratory syndrome, but none in Middle East respiratory syndrome and coronavirus disease 2019. Cardiac manifestations reported include tachycardia, bradycardia, arrhythmias, and myocardial injury, secondary to both systemic infection and treatment. Cardiac injury and arrhythmias are more prevalent in coronavirus disease 2019, and elevated cardiac markers are associated with intensive care unit admission and death. In severe acute respiratory syndrome, Middle East respiratory syndrome, and coronavirus disease 2019, comorbidities such as hypertension, diabetes mellitus, and heart disease are associated with intensive care unit admission, mechanical ventilation, and mortality. There were cases of misdiagnosis due to overlapping presentations of cardiovascular diseases and coronavirus infections, leading to hospital spread and delayed management of life-threatening conditions.ConclusionThis review highlighted the ways in which coronaviruses affect cardiovascular function and interacts with pre-existing cardiovascular diseases.
Total hip arthroplasty for high-riding hips: A retrospective analysis of 79 cases and proposal of a new classification
Authors: Demirkale İsmail , Yaradılmış Yüksel Uğur , Ateş Ahmet , Altay Murat 
Published: May 2020

Purpose: Total hip arthroplasty (THA) for high-riding hips is a complex procedure and the requirement for subtrochanteric osteotomy (STO) is an important decision that needs to be taken preoperatively. STO renders this complex surgery even more complicated and there are no guidelines to determine the STO requirement. In this study, the outcomes of THA for patients with high-riding hips were evaluated and a practical classification system is proposed to predict any osteotomy requirement. Methods: A retrospective evaluation was made of 79 hips of 76 patients who underwent THA for high-riding hip dysplasia. The amount of shortening in patients with STO and in patients without STO was compared. All patients were evaluated in respect of Harris hip score, operating time, erythrocyte suspension need, and actual limb length discrepancy. Preoperative radiographs were classified into four types according to the ratio of the distance between the lesser trochanter and the ischial tuberosity with pelvic height (LT-IT/P) to grade the degree of dislocation. Results: The mean follow-up was 30 ± 6.54 months. STO was applied to 47 (60%) hips and not to 32 (40%). There was no statistically significant difference between the groups in respect of the functional scores. STO prolonged the operating time and increased the need for blood transfusion ( p = 0.026, p < 0.001, respectively). When the LT-IT/P index was <0.19 (type 1), no additional surgical approach was required for reduction, at 0.19–0.29 (type 2), the head can be safely reduced with additional reduction methods, and when >0.3 (type 3), a shortening osteotomy will most likely be required. The rate of complications is increased if LT-IT/P is >0.4 (type 4). Conclusion: STO adjunct to THA increases the rate of complications. This practical classification system may guide the surgeon in the decision of whether an STO should be added to the procedure or not. Level of evidence: Level III, clinical trial
How the World’s Children Hear: A Narrative Review of School Hearing Screening Programs Globally
Authors: Yong Michael , Panth Neelima , McMahon Catherine M. , Thorne Peter R. , Emmett Susan D. 
Published: May 2020

ObjectiveSchool hearing screening may mitigate the effects of childhood hearing loss through early identification and intervention. This study provides an overview of existing school hearing screening programs around the world, identifies gaps in the literature, and develops priorities for future research.Data SourcesA structured search of the PubMed, Embase, and Cochrane Library databases.Review MethodsA total of 65 articles were included according to predefined inclusion criteria. Parameters of interest included age groups screened, audiometric protocols, referral criteria, use of adjunct screening tests, rescreening procedures, hearing loss prevalence, screening test sensitivity and specificity, and loss to follow‐up.ConclusionsSchool hearing screening is mandated in few regions worldwide, and there is little accountability regarding whether testing is performed. Screening protocols differ in terms of screening tests included and thresholds used. The most common protocols included a mix of pure tone screening (0.5, 1, 2, and 4 kHz), otoscopy, and tympanometry. Estimates of region‐specific disease prevalence were methodologically inaccurate, and rescreening was poorly addressed. Loss to follow‐up was also a ubiquitous concern.Implications for PracticeThere is an urgent need for standardized school hearing screening protocol guidelines globally, which will facilitate more accurate studies of hearing loss prevalence and determination of screening test sensitivity and specificity. In turn, these steps will increase the robustness with which we can study the effects of screening and treatment interventions, and they will support the development of guidelines on the screening, diagnostic, and rehabilitation services needed to reduce the impact of childhood hearing loss.
Bilateral retinal detachment after chimeric antigen receptor T-cell therapy
Authors: Denton Christopher C. , Gange William S. , Abdel-Azim Hisham , Jodele Sonata , Kapoor Neena , Oberley Matthew J. , Wong Kenneth , Kim Jonathan , Vercio Abby , Moghaddampour Parisah , Chalam K. V. , Sierpina David , Gardner Rebecca A. , Pulsipher Michael A. , Jensen Michael C. , Nagiel Aaron 
Published: May 2020

Key Points
CAR T-cell targeting of leukemic infiltrates in the optic nerve and retina caused retinal detachment as a presentation of pseudoprogression. Treatment of this intraocular inflammation with intravitreal triamcinolone and orbital radiation led to marked improvement in visual acuity.