bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of Unsupervised Learning Techniques to Identify Atlantic Tropical Cyclone Rapid Intensification Environments
Authors: Mercer Andrew E. , Grimes Alexandria D. , Wood Kimberly M. 
Published: January 2021

AbstractTropical cyclone (TC) track forecasts have improved in recent decades while intensity forecasts, particularly predictions of rapid intensification (RI), continue to show low skill. Many statistical methods have shown promise in predicting RI using environmental fields, although these methods rely heavily upon supervised learning techniques such as classification. Advances in unsupervised learning techniques, particularly those that integrate nonlinearity into the class separation problem, can improve discrimination ability for difficult tasks such as RI prediction. This study quantifies separability between RI and non-RI environments for 2004–16 Atlantic Ocean TCs using an unsupervised learning method that blends principal component analysis with k-means cluster analysis. Input fields consisted of TC-centered 1° Global Forecast System analysis (GFSA) grids (170 different variables and isobaric levels) for 3605 TC samples and five domain sizes. Results are directly compared with separability offered by operational RI forecast predictors for eight RI definitions. The unsupervised learning procedure produced improved separability over operational predictors for all eight RI definitions, five of which showed statistically significant improvement. Composites from these best-separating GFSA fields highlighted the importance of mid- and upper-level relative humidity in identifying the onset of short-term RI, whereas long-term, higher-magnitude RI was generally associated with weaker absolute vorticity. Other useful predictors included optimal thermodynamic RI ingredients along the mean trajectory of the TC. The results suggest that the orientation of a more favorable thermodynamic environment relative to the TC and midlevel vorticity magnitudes could be useful predictors for RI.
ENSO Diversity in a Tropical Stochastic Skeleton Model for the MJO, El Niño, and Dynamic Walker Circulation
Authors: Yang Qiu , Majda Andrew J. , Chen Nan 
Published: January 2021

AbstractEl Niño–Southern Oscillation (ENSO) diversity has a significant impact on global climate and seasonal prediction. However, it is still a challenging problem for present-day global climate models to simulate different types of ENSO events with realistic features simultaneously. In this paper, a tropical stochastic skeleton model for the interactions among wind bursts and the Madden–Julian oscillation (MJO), the El Niño, and the Walker circulation is developed to reproduce both dynamical and statistical features of the ENSO diversity. In this model, the intraseasonal component with state-dependent noise captures general features of wind bursts and the MJO, both of which play important roles in triggering the El Niño. The thermocline feedback is the dominant mechanism for generating the eastern Pacific (EP) El Niño, while a nonlinear zonal advection is incorporated into the model that contributes to the central Pacific (CP) El Niño. Besides, a simple but effective stochastic process describing the multidecadal variation of the background Walker circulation modulates the spatial patterns and occurrence frequency of the EP and CP El Niño. This model succeeds in simulating the quasi-regular moderate EP El Niño, the super El Niño, and the CP El Niño as well as the La Niña simultaneously. It also captures the observed non-Gaussian characteristics of sea surface temperature anomalies in different Niño regions. Individual case studies highlight the outstanding skill of the model in reproducing the observed El Niño episodes and their underlying mechanisms.
WRF Model Moisture Adjustment Method: A Case Study with Wintertime Cloudy Biases in Xinjiang, China
Authors: Song Guiting , Huva Robert , Xing Yu , Zhong Xiaohui 
Published: January 2021

AbstractFor most locations on Earth the ability of a numerical weather prediction (NWP) model to accurately simulate surface irradiance relies heavily on the NWP model being able to resolve cloud coverage and thickness. At horizontal resolutions at or below a few kilometers NWP models begin to explicitly resolve convection and the clouds that arise from convective processes. However, even at high resolutions, biases may remain in the model and result in under- or overprediction of surface irradiance. In this study we explore the correction of such systematic biases using a moisture adjustment method in tandem with the Weather Research and Forecasting (WRF) Model for a location in Xinjiang, China. After extensive optimization of the configuration of the WRF Model we show that systematic biases still exist—in particular for wintertime in Xinjiang. We then demonstrate the moisture adjustment method with cloudy days for January 2019. Adjusting the relative humidity by 12% through the vertical led to a root-mean-square error (RMSE) improvement of 57.8% and a 90.5% reduction in bias for surface irradiance.
Laryngeal Force Sensor for Suspension Microlaryngoscopy: A Prospective Controlled Trial
Authors: Feng Allen L. , Puka Elefteria , Ciaramella Alex , Rao Vishwanatha M. , Wang Tiffany V. , Naunheim Matthew R. , Song Phillip C. 
Published: January 2021

ObjectivesThe laryngeal force sensor (LFS) provides real‐time force data for suspension microlaryngoscopy. This study investigates whether active use of the LFS can prevent the development of complications.Study DesignProspective controlled trial.SettingAcademic tertiary center.MethodsThe LFS and custom software were developed to track intraoperative force metrics. A consecutive series of 100 patients had force data collected with operating surgeons blinded to intraoperative readings. The subsequent 100 patients had surgeons actively use the LFS monitoring system. Patients were prospectively enrolled, completing pre‐ and postoperative surveys to assess the development of tongue pain, paresthesia, paresis, dysgeusia, or dysphagia.ResultsOn univariate analysis, the active monitoring group had lower total impulse (P <. 001) and fewer extralaryngeal complications (P <. 01). On multiple logistic regression, maximum force (odds ratio [OR], 1.08; 95% CI, 1.01‐1.16; P =. 02) was a significant predictive variable for the development of postoperative complications. Similarly, active LFS monitoring showed a 29.1% (95% CI, 15.7%‐42.4%; P <. 001) decrease in the likelihood of developing postoperative complications. These effects persisted at the first postoperative visit for maximum force (P =. 04) and active LFS monitoring (P =. 01). Maximum force (OR, 1.11; 95% CI, 1.04‐1.18; P <. 01) and active LFS monitoring (16.6%; 95% CI, 2.7%‐30.5%; P =. 02) were also predictive for the development of an abnormal 10‐item Eating Assessment Tool score. These effects also persisted at the first postoperative visit for maximum force (P =. 01) and active LFS monitoring (P =. 01).ConclusionMaximum force is predictive of the development postoperative complications. Active monitoring with the LFS is able to mitigate these forces and prevent postoperative complications.Level of Evidence2.
Long‐term Oncologic Outcomes of 1188 Tis‐T2 Glottic Cancers Treated by Transoral Laser Microsurgery
Authors: Piazza Cesare , Paderno Alberto , Del Bon Francesca , Lancini Davide , Fior Milena , Berretti Giulia , Bosio Paolo , Deganello Alberto , Peretti Giorgio 
Published: January 2021

ObjectiveTo evaluate long‐term disease‐specific survival (DSS) and organ preservation (OP) rates in patients affected by Tis‐T2 glottic squamous cell carcinoma (SCC) treated by carbon dioxide transoral laser microsurgery (CO2 TOLMS).Study DesignSingle‐center retrospective cohort study.SettingTertiary academic hospital.MethodsThe study included patients treated by CO2 TOLMS for Tis‐T2 glottic SCC at the Department of Otorhinolaryngology–Head and Neck Surgery of the University of Brescia, Italy, from 1988 to 2018. The male:female ratio was 11.2:1, and the mean age was 64 years (range, 31‐95). T categories were distributed as follows: 124 (10%) Tis, 646 (54%) T1a, 172 (15%) T1b, and 246 (21%) T2.ResultsTen‐ and 20‐year DSS rates were 97.6% and 96.3%, respectively, and 10‐ and 20‐year OP rates were 94.7% and 93%. During the follow‐up, 91% of patients were treated by CO2 TOLMS alone, while the remaining needed adjunctive treatments. Assessing the impact of multiple sessions of CO2 TOLMS, DSS showed no significant difference in terms of patients treated by 1, 2, or >2 procedures. Conversely, patients treated by >2 sessions of CO2 TOLMS showed a significantly worse OP rate.ConclusionsOur series validates CO2 TOLMS as a long‐term treatment strategy for early glottic SCC. Salvage CO2 TOLMS provided optimal results in terms of DSS and OP in patients with recurrence after previous transoral surgery.
Expert Consensus Statement: Pediatric Drug‐Induced Sleep Endoscopy
Authors: Baldassari Cristina M. , Lam Derek J. , Ishman Stacey L. , Chernobilsky Boris , Friedman Norman R. , Giordano Terri , Lawlor Claire , Mitchell Ron B. , Nardone Heather , Ruda James , Zalzal Habib , Deneal Adrienne , Dhepyasuwan Nui , Rosenfeld Richard M. 
Published: January 2021

ObjectiveTo develop an expert consensus statement on pediatric drug‐induced sleep endoscopy (DISE) that clarifies controversies and offers opportunities for quality improvement. Pediatric DISE was defined as flexible endoscopy to examine the upper airway of a child with obstructive sleep apnea who is sedated and asleep.MethodsDevelopment group members with expertise in pediatric DISE followed established guidelines for developing consensus statements. A search strategist systematically reviewed the literature, and the best available evidence was used to compose consensus statements regarding DISE in children 0 to 18 years old. Topics with significant practice variation and those that would improve the quality of patient care were prioritized.ResultsThe development group identified 59 candidate consensus statements, based on 50 initial proposed topics, that focused on addressing the following high‐yield topics: (1) indications and utility, (2) protocol, (3) optimal sedation, (4) grading and interpretation, (5) complications and safety, and (6) outcomes for DISE‐directed surgery. After 2 iterations of the Delphi survey and removal of duplicative statements, 26 statements met the criteria for consensus; 11 statements were designated as no consensus. Several areas, such as the role of DISE at the time of adenotonsillectomy, were identified as needing further research.ConclusionExpert consensus was achieved for 26 statements pertaining to indications, protocol, and outcomes for pediatric DISE. Clinicians can use these statements to improve quality of care, inform policy and protocols, and identify areas of uncertainty. Future research, ideally randomized controlled trials, is warranted to address additional controversies related to pediatric DISE.
Exploring implicit bias in the perceived consequences of prematurity amongst health care providers in North Queensland – a constructivist grounded theory study
Authors: Ireland Susan , Ray Robin , Larkins Sarah , Woodward Lynn 
Published: January 2021

Abstract
Background
A study was done to explore the attitudes of relevant health care professionals (HCP) towards the provision of intensive care for periviable and extremely premature babies.

Methods/design
Applying a constructivist grounded theory methodology, HCP were interviewed about their attitudes towards the provision of resuscitation and intensive care for extremely premature babies. These babies are at increased risk of death and neurodisability when compared to babies of older gestations. Participants included HCP of varying disciplines at a large tertiary centre, a regional centre and a remote centre. Staff with a wide range of experience were interviewed.

Results
Six categories of i) who decides, ii) culture and context of families, iii) the life ahead, iv) to treat a bit or not at all, v) following guidelines and vi) information sharing, emerged. Role specific implicit bias was found as a theoretical construct, which depended on the period for which care was provided relative to the delivery of the baby. This implicit bias is an underlying cause for the negativity seen towards extreme prematurity and is presented in this paper. HCP caring for women prior to delivery have a bias towards healthy term babies that involves overestimation of the risks of extreme prematurity, while neonatal staff were biased towards suffering in the neonatal period and paediatricians recognise positivity of outcomes regardless of neurological status of the child. The implicit bias found may explain negativity towards intensive care of periviable neonates.

Conclusion
Understanding the presence and origins of role specific implicit bias may enable HCP to work together to improve care for parents preparing for the delivery of extremely premature babies.
Reduced intensity of early intensification does not increase the risk of relapse in children with standard risk acute lymphoblastic leukemia - a multi-centric clinical study of GD-2008-ALL protocol
Authors: Li Xin-Yu , Li Jia-Qiang , Luo Xue-Qun , Wu Xue-Dong , Sun Xin , Xu Hong-Gui , Li Chang-Gang , Liu Ri-Yang , Sun Xiao-Fei , Chen Hui-Qin , Lin Yu-Deng , LI Chi-kong , Fang Jian-Pei 
Published: January 2021

Abstract
Background
The prognosis of childhood acute lymphoblastic leukemia (ALL) is optimistic with a 5-year event-free survival (EFS) rate of 70–85%. However, the major causes of mortality are chemotherapy toxicity, infection and relapse. The Guangdong (GD)-2008-ALL collaborative protocol was carried out to study the effect of reduced intensity on treatment related mortality (TRM) based on Berlin-Frankfurt-Münster (BFM) 2002 backbone treatment. The study was designed to elucidate whether the reduced intensity is effective and safe for children with ALL.

Methods
The clinical data were obtained from February 28, 2008 to June 30, 2016. A total of 1765 childhood ALL cases from 9 medical centers were collected and data were retrospectively analyzed. Patients were stratified into 3 groups according to bone marrow morphology, prednisone response, age, genotype, and karyotype information: standard risk (SR), intermediate risk (IR) and high risk (HR). For SR group, daunorubicin was decreased in induction IA while duration was reduced in Induction Ib (2 weeks in place of 4 weeks). Doses for CAM were same in all risk groups - SR patients received one CAM, others got two CAMs.

Results
The 5-year and 8-year overall survival (OS), event-free survival (EFS) and cumulative incidence of relapse (CIR) were 83.5±0.9% and 83.1±1.0%, 71.9±1.1% and 70.9±1.2%, and 19.5±1.0% and 20.5±1.1%, respectively. The 2-year treatment-related mortality (TRM) was 5.2±0.5%. The 5-year and 8-year OS were 90.7±1.4% and 89.6±1.6% in the SR group, while the 5-year and 8-year EFS were 81.5±1.8% and 80.0±2.0%. In the SR group, 74 (15.2%) patients measured minimal residual disease (MRD) on Day 15 and Day 33 of induction therapy. Among them, 7 patients (9.46%) were MRD positive (≥ 0.01%) on Day 33. The incidence of relapse in the MRD Day 33 positive group (n=7) was 28.6%, while in the MRD Day 33 negative group (n=67) was 7.5% (p=0.129).

Conclusions
The results of GD-2008-ALL protocol are outstanding for reducing TRM in childhood ALL in China with excellent long term EFS. This protocol provided the evidence for further reducing intensity of induction therapy in the SR group according to the risk stratification. MRD levels on Day 15 and Day 33 are appropriate indexes for stratification.
The effect of the integration of health services on health care usage among patients with type 2 diabetes in North Karelia, Finland
Authors: Wikström Katja , Lamidi Marja-Leena , Rautiainen Päivi , Tirkkonen Hilkka , Kivinen Petri , Laatikainen Tiina 
Published: January 2021

AbstractBackgroundThe need to improve the care of people with complex care requirements has been driving the reforms integrating care processes. This study examines the effect of the integration of health services on health care usage and the processes and outcomes of care among type 2 diabetes patients.MethodsData include all type 2 diabetes patients who lived in North Karelia, Finland, between 2014 and 2018. Health care contacts and glycated haemoglobin (HbA1c) measurements were obtained from the electronic health records. Logistic, Poisson and linear models with generalised estimating equations and the Friedman test were used to study the differences between years.ResultsThe health care usage was highest in 2017, the first year of a new organisation, and smallest in the following year. Before the new organisation, the health care usage was lowest in 2014, being slightly higher compared with 2018. Between the last two years, the mean number of contacts per person declined from 3.25 to 2.88 (-0.37,p < 0.001). The decreasing pattern seen in total health care usage was most obvious among contacts with primary health care nurses. The number of contacts increased only among specialised care nurses between the last two years. The number of HbA1c measurements was also in its lowest in 2018 but in its highest in 2015. Between the years 2014 and 2018, the difference in the mean number of contacts was − 0.05 (p = 0.011) for those not measured, -0.02 (p = 0.225) for those measured and within the target level of HbA1c, and 0.12 (p = 0.001) for those measured and not at the target level of HbA1c.ConclusionsHealth care integration first increased the health care usage but then brought it to a slightly lower level than before. The changes were most obvious in primary health care nurses’ appointments, and no decline was observed in secondary-level care. Even though the numbers of HbA1c measurements and the proportion measured declined, measurements increased among those with poor glycaemic control. The observed changes might reflect the better targeting and more concordant services in different service units.
Cholangiogenic potential of human deciduous pulp stem cell-converted hepatocyte-like cells
Authors: Yuniartha Ratih , Yamaza Takayoshi , Sonoda Soichiro , Yoshimaru Koichiro , Matsuura Toshiharu , Yamaza Haruyoshi , Oda Yoshinao , Ohga Shouichi , Taguchi Tomoaki 
Published: January 2021

Abstract
Background
Stem cells from human exfoliated deciduous teeth (SHED) have been reported to show the in vivo and in vitro hepatic differentiation, SHED-Heps; however, the cholangiogenic potency of SHED-Heps remains unclear. Here, we hypothesized that SHED-Heps contribute to the regeneration of intrahepatic bile duct system in chronic fibrotic liver.

Methods
SHED were induced into SHED-Heps under cytokine stimulation. SHED-Heps were intrasplenically transplanted into chronically CCl4-treated liver fibrosis model mice, followed by the analysis of donor integration and hepatobiliary metabolism in vivo. Immunohistochemical assay was examined for the regeneration of intrahepatic bile duct system in the recipient liver. Furthermore, SHED-Heps were induced under the stimulation of tumor necrosis factor alpha (TNFA).

Results
The intrasplenic transplantation of SHED-Heps into CCl4-treated mice showed that donor SHED-Heps behaved as human hepatocyte paraffin 1- and human albumin-expressing hepatocyte-like cells in situ and ameliorated CCl4-induced liver fibrosis. Of interest, the integrated SHED-Heps not only expressed biliary canaliculi ATP-binding cassette transporters including ABCB1, ABCB11, and ABCC2, but also recruited human keratin 19- (KRT19-) and KRT17-positive cells, which are considered donor-derived cholangiocytes, regenerating the intrahepatic bile duct system in the recipient liver. Furthermore, the stimulation of TNFA induced SHED-Heps into KRT7- and SRY-box 9-positive cells.

Conclusions
Collectively, our findings demonstrate that infused SHED-Heps showed cholangiogenic ability under the stimulation of TNFA in CCl4-damaged livers, resulting in the regeneration of biliary canaliculi and interlobular bile ducts in chronic fibrotic liver. Thus, the present findings suggest that SHED-Heps may be a novel source for the treatment of cholangiopathy.
Maximum likelihood-based adaptive iteration algorithm design for joint CFO and channel estimation in MIMO-OFDM systems
Authors: Cheng Nan-Hung , Huang Kai-Chieh , Chen Yung-Fang , Tseng Shu-Ming 
Published: January 2021

AbstractIn this paper, we present a joint time-variant carrier frequency offset (CFO) and frequency-selective channel response estimation scheme for multiple input-multiple output-orthogonal frequency-division multiplexing (MIMO-OFDM) systems for mobile users. The signal model of the MIMO-OFDM system is introduced, and the joint estimator is derived according to the maximum likelihood criterion. The proposed algorithm can be separated into three major parts. In the first part of the proposed algorithm, an initial CFO is estimated using derotation, and the result is used to apply a frequency-domain equalizer. In the second part, an iterative method is employed to locate the fine frequency peak for better CFO estimation. An adaptive process is used in the third part of the proposed algorithm to obtain the updated CFO estimation and track parameter time variations, including the time-varying CFOs and time-varying channels. The computational complexity of the proposed algorithm is considerably lower than that of the maximum likelihood-based grid search method. In a simulation, the mean squared error performance of the proposed algorithm was close to the Cramer-Rao lower bound. The simulation results indicate that the proposed novel joint estimation algorithm provides a bit error rate performance close to that in the perfect channel estimation condition. The results also suggest that the proposed method has reliable tracking performance in Jakes’ channel models.
A case of idiopathic myointimal hyperplasia of the mesenteric veins presenting with small bowel obstruction
Authors: Yamada Kohei , Hiraki Masatsugu , Tanaka Toshiya , Mori Daisuke , Tanaka Futoshi , Manabe Tatsuya , Aibe Hitoshi , Kitahara Kenji , Noshiro Hirokazu 
Published: January 2021

Abstract
Background
Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare ischemic bowel disease with venous occlusion resulting from the proliferation of smooth muscles in the venous intima. In most patients, the disease affects rectosigmoid colon and causes persistent abdominal pain and hematochezia, which is similar to inflammatory bowel disease (IBD). In addition, it is difficult to make a precise diagnosis of IMHMV without surgery.

Case presentation
An 81-year-old woman was admitted to our hospital with mild abdominal pain, nausea and vomiting. Repeated adhesive ileus was suspected due to the previous open and laparoscopic surgeries. Surgery was planned to treat small bowel obstruction. Intraoperatively no adhesive lesions were observed. However, a mass lesion was seen at the terminal ileum, which was suspected to have caused her bowel obstruction. Partial resection of the small intestine was performed. Macroscopic and histopathological examinations of the excised specimen showed circumferential ulceration with scarring, a thickened venous wall with active inflammation, and fibrotic changes that consequently produced stenosis and obstruction of the venous lumen in the subserosa. Additionally, Elastica van Gieson staining demonstrated thickening of the venous intima. The final diagnosis was IMHMV. At two years and 8 months after the operation, the patient was well without any additional medication.

Conclusion
IMHMV of the small intestine is rare. We described a case of IMHMV that was associated with ileus.