bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Background Meridional Moisture Gradient on the Propagation of the MJO over the Maritime Continent
Authors: Kang Daehyun , Kim Daehyun , Ahn Min-Seop , An Soon-Il 
Published: May 2021

AbstractThis study investigates the role of the background meridional moisture gradient (MMG) on the propagation of the Madden–Julian Oscillation (MJO) across the Maritime Continent (MC) region. It is found that the interannual variability of the seasonal mean MMG over the southern MC area is associated with the meridional expansion and contraction of the moist area in the vicinity of the MC. Sea surface temperature anomalies associated with relatively high and low seasonal mean MMG exhibit patterns that resemble those of the El Niño–Southern Oscillation. By contrasting the years with anomalously low and high MMG, we show that MJO propagation through the MC is enhanced (suppressed) in years with higher (lower) seasonal mean MMG, though the effect is less robust when MMG anomalies are weak. Column-integrated moisture budget analysis further shows that sufficiently large MMG anomalies affects MJO activity by modulating the meridional advection of the mean moisture via MJO wind anomalies. Our results suggest that the background moisture distribution has a strong control over the propagation characteristics of the MJO in the MC region.
Observing and quantifying ocean flow properties using drifters with drogues at different depths
Authors: Rypina Irina I. , Getscher Timothy R. , Pratt Lawrence J. , Mourre Baptiste 
Published: May 2021

AbstractThis paper presents analyses of drifters with drogues at different depths – 1, 10, 30, 50 m – that were deployed in the Mediterranean Sea to investigate frontal subduction and upwelling. Drifter trajectories were used to estimate divergence, vorticity, vertical velocity, and finite-size Lyapunov exponents (FTLEs), and to investigate the balance of terms in the vorticity equation. The divergence and vorticity are O(f) and change sign along trajectories. Vertical velocity is O(1 mm/s), increases with depth, indicates predominant upwelling with isolated downwelling events, and sometimes changes sign between 1 and 50 m. Vortex stretching is one of, but not the only, significant term in the vorticity balance. 2D FTLEs are 2 × 10−51/s after 1 day, twice larger than in a 400-m-resolution numerical model. 3D FTLEs are 50% larger than 2D FTLEs and are dominated by the vertical shear of horizontal velocity. Bootstrapping suggests uncertainty levels of ~10% of the time-mean absolute values for divergence and vorticity. Analysis of simulated drifters in a model suggests that drifter-based estimates of divergence and vorticity are close to the Eulerian model estimates, except when drifters get aligned into long filaments. Drifter-based vertical velocity is close to the Eulerian model estimates at 1 m but differs at deeper depths. The errors in the vertical velocity are largely due to the lateral separation between drifters at different depths, and partially due to only measuring at 4 depths. Overall, this paper demonstrates how drifters, heretofore restricted to 2D near-surface observations, can be used to learn about 3D flow properties throughout the upper layer of the water column.
Hyaluronic Acid Concentration in Female Vocal Folds With Reinke’s Edema
Authors: de Melo Lins Cristiana Vanderlei , Maciel Martins João Roberto , Kobayashi Elsa Yoko , Korn Gustavo Polacow , Park Sung Woo , Mororó Welber Chaves , De Biase Noemi Grigoletto 
Published: May 2021

ObjectiveThe aim of the present study was to investigate hyaluronic acid (HA) concentrations in vocal folds among patients with Reinke’s edema.Study DesignProspective and experimental study.SettingSingle tertiary center.MethodsAn HA binding protein isolated from bovine nasal cartilage was used to identify and isolate the HA from samples. Plates coated with biotin‐conjugated binding protein and streptavidin‐europium conjugate were sequentially incubated with 18 Reinke’s edema samples and 11 female vocal fold cover samples from cadavers (the superficial layer of the lamina propria; control group). After the release of europium from streptavidin in enhancement solution, final fluorescence was measured in a fluorometer.ResultsThe mean HA concentration in Reinke’s edema vocal folds was significantly higher than that in the control vocal folds (9.2 × 103 vs 0.9 × 103µg/g).ConclusionVocal fold covers affected by Reinke’s edema present a higher concentration of HA than do vocal fold covers with no edema.
Critical Review and Consensus Statement for Neural Monitoring in Otolaryngologic Head, Neck, and Endocrine Surgery
Authors: Scharpf Joseph , Liu Jeffrey C. , Sinclair Catherine , Singer Michael , Liddy Whitney , Orloff Lisa , Steward David , Bonilla Velez Juliana , Randolph Gregory W. 
Published: May 2021

BackgroundEnhancing patient outcomes in an array of surgical procedures in the head and neck requires the maintenance of complex regional functions through the protection of cranial nerve integrity. This review and consensus statement cover the scope of cranial nerve monitoring of all cranial nerves that are of practical importance in head, neck, and endocrine surgery except for cranial nerves VII and VIII within the temporal bone. Complete and applied understanding of neurophysiologic principles facilitates the surgeon’s ability to monitor the at‐risk nerve.MethodsThe American Academy of Otolaryngology–Head and Neck Surgery (AAO‐HNS) identified the need for a consensus statement on cranial nerve monitoring. An AAO‐HNS task force was created through soliciting experts on the subject. Relevant domains were identified, including residency education, neurophysiology, application, and various techniques for monitoring pertinent cranial nerves. A document was generated to incorporate and consolidate these domains. The panel used a modified Delphi method for consensus generation.ResultsConsensus was achieved in the domains of education needs and anesthesia considerations, as well as setup, troubleshooting, and documentation. Specific cranial nerve monitoring was evaluated and reached consensus for all cranial nerves in statement 4 with the exception of the spinal accessory nerve. Although the spinal accessory nerve’s value can never be marginalized, the task force did not feel that the existing literature was as robust to support a recommendation of routine monitoring of this nerve. In contrast, there is robust supporting literature cited and consensus for routine monitoring in certain procedures, such as thyroid surgery, to optimize patient outcomes.ConclusionsThe AAO‐HNS Cranial Nerve Monitoring Task Force has provided a state‐of‐the‐art review in neural monitoring in otolaryngologic head, neck, and endocrine surgery. The evidence‐based review was complemented by consensus statements utilizing a modified Delphi method to prioritize key statements to enhance patient outcomes in an array of surgical procedures in the head and neck. A precise definition of what actually constitutes intraoperative nerve monitoring and its benefits have been provided.
Quality Improvement in Otolaryngology–Head and Neck Surgery: Developing Registry‐Enabled Quality Measures From Guidelines for Cerumen Impaction and Allergic Rhinitis Through a Transparent and Systematic Process
Authors: Michel Jeremy J. , Schwartz Seth R. , Dawson Douglas E. , Denneny James C. , Erinoff Eileen , Dhepyasuwan Nui , Rosenfeld Richard M. 
Published: May 2021

Background and SignificanceQuality measurement can drive improvement in clinical care and allow for easy reporting of quality care by clinicians, but creating quality measures is a time‐consuming and costly process. ECRI (formerly Emergency Care Research Institute) has pioneered a process to support systematic translation of clinical practice guidelines into electronic quality measures using a transparent and reproducible pathway. This process could be used to augment or support the development of electronic quality measures of the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO‐HNSF) and others as the Centers for Medicare and Medicaid Services transitions from the Merit‐Based Incentive Payment System (MIPS) to the MIPS Value Pathways for quality reporting.MethodsWe used a transparent and reproducible process to create electronic quality measures based on recommendations from 2 AAO‐HNSF clinical practice guidelines (cerumen impaction and allergic rhinitis). Steps of this process include source material review, electronic content extraction, logic development, implementation barrier analysis, content encoding and structuring, and measure formalization. Proposed measures then go through the standard publication process for AAO‐HNSF measures.ResultsThe 2 guidelines contained 29 recommendation statements, of which 7 were translated into electronic quality measures and published. Intermediate products of the guideline conversion process facilitated development and were retained to support review, updating, and transparency. Of the 7 initially published quality measures, 6 were approved as 2018 MIPS measures, and 2 continued to demonstrate a gap in care after a year of data collection.ConclusionDeveloping high‐quality, registry‐enabled measures from guidelines via a rigorous reproducible process is feasible. The streamlined process was effective in producing quality measures for publication in a timely fashion. Efforts to better identify gaps in care and more quickly recognize recommendations that would not translate well into quality measures could further streamline this process.
Cochlear Implantation Hearing Outcome in Ménière’s Disease
Authors: Chien Chen‐Yu , Kulthaveesup Anan , Herrmann Barbara S. , Rauch Steven D. 
Published: May 2021

ObjectiveThe aim of this study was to evaluate the hearing outcome of cochlear implantation in patients deafened by Ménière’s disease.Study DesignRetrospective single‐institution study.SettingTertiary medical center.MethodsOur institutional database of 1400 patients with cochlear implants was reviewed to identify cases with deafness due to Ménière’s disease. Twenty‐nine patients were identified: 24 with unilateral and 5 with sequential bilateral cochlear implants. Pre‐ and postoperative speech recognition scores and medical data were extracted from the medical record and analyzed.ResultsOverall the mean difference between pre‐ and postoperative speech recognition after >1 year was 56% (95% CI, 47.08%‐64.92%). The mean preoperative monosyllabic word score was 9.5%, and the mean postoperative scores at 1 month, 3 months, 6 months, 1 year, and >1 year were 37.1%, 46.1%, 54.1%, 59.1%, and 66.8%, respectively. Cochlear implantation resulted in improved word scores in all patients regardless of prior medical or surgical treatment (endolymphatic sac, labyrinthectomy). The mean postoperative hearing improvement in patients aged <70 and ≥70 years was 65.26% (95% CI, 54.79%‐75.73%) and 40.00% (95% CI, 27.22%‐52.77%). Postoperative word scores in patients with bilateral cochlear implants were not significantly different between the first and second implanted ears or between the monoaural and binaural testing conditions.ConclusionCochlear implant in patients deafened by Ménière’s disease significantly improves word recognition scores regardless of whether medical or surgical treatment is used prior to implantation. The potential improvement in word recognition scores decreases after age 70 years.
Real world coronary artery ostia full accessibility after last generation transcatheter aortic valve implantation
Authors: Rigatelli Gianluca , Zuin Marco , Roncon Loris , Nanjiundappa Aravinda , Daggubati Ramesh 
Published: May 2021

Aim We evaluate, performing a pooled meta-analysis, the current coronary artery accessibility rate in transcatheter aortic valve implantation (TAVI) patients during the follow-up. Full coronary artery accessibility after TAVI has not been adequately addressed by the current literature. Methods According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data on coronary artery access were obtained from the ratio between in the full coronary engagement (n) and the number of coronary angiography and/or percutaneous coronary intervention (N). Data were synthesized using random-effects meta-analyses. Results Out of 7048 TAVI patients, 276 (3.9%) (mean age 76.8 years, 111 (40.2%) females) were analysed. Full coronary artery accessibility for coronary angiographies and percutaneous coronary interventions were obtained in 83.0% (95% confidence interval (CI): 0.66–0.92, p = 0.001, I2: 88.2%) and 96.0% (95% CI: 0.90–0.98, p < 0.0001, I2: 0) of cases (p for difference  < .0.001). Left coronary artery (n = 219) was easily fully engaged compared to the right one (90.9% (95% CI: 0.80–0.96, p < 0.0001, I2: 58.4% and 82.0% (95% CI: 0.60–0.93, p = 0.006, I2: 83.2%), respectively, (p for difference  < 0.001). Using age as moderator variable, meta-regression revealed a positive and negative correlation with coronary artery accessibility in patients treated with Sapien-Edwards (p = 0.008) and CoreValve (p = 0.010) platforms, respectively. Conversely, a negative correlation (p = 0.01) was found between coronary artery accessibility and mean time after Sapien-Edwards platform implantation (p = 0.01). Conclusions Full coronary artery accessibility during coronary angiographies and/or percutaneous coronary interventions results suboptimal for both coronary artery ostia and worse for right compared to left coronary artery after TAVI.
Assessment tools for problematic opioid use in palliative care: A scoping review
Authors: Lau Jenny , Mazzotta Paolo , Fazelzad Rouhi , Ryan Suzanne , Tedesco Alissa , Smith Andrew J. , Sud Abhimanyu , Furlan Andrea D. , Zimmermann Camilla 
Published: May 2021

Background: Screening for problematic opioid use is increasingly recommended in patients receiving palliative care. Aim: To identify tools used to assess for the presence or risk of problematic opioid use in palliative care. Design: Scoping review. Data sources: Bibliographic databases (inception to January 31, 2020), reference lists, and grey literature were searched to find primary studies reporting on adults receiving palliative care and prescription opioids to manage symptoms from advanced cancer, neurodegenerative diseases, or end-stage organ diseases; and included tools to assess for problematic opioid use. There were no restrictions based on study design, location, or language. Results: We identified 42 observational studies (total 14,431 participants) published between 2009 and 2020 that used questionnaires ( n = 32) and urine drug tests ( n = 21) to assess for problematic opioid use in palliative care, primarily in US ( n = 38) and outpatient palliative care settings ( n = 36). The questionnaires were Cut down, Annoyed, Guilty, and Eye-opener (CAGE, n = 8), CAGE-Adapted to Include Drugs (CAGE-AID, n = 6), Opioid Risk Tool ( n = 9), Screener and Opioid Assessment for Patients with Pain (SOAPP; n = 3), SOAPP-Revised ( n = 2), and SOAPP-Short Form ( n = 5). Only two studies’ primary objectives were to evaluate a questionnaire’s psychometric properties in patients receiving palliative care. There was wide variation in how urine drug tests were incorporated into palliative care; frequency of abnormal urine drug test results ranged from 8.6% to 70%. Conclusion: Given the dearth of studies using tools developed or validated specifically for patients receiving palliative care, further research is needed to inform clinical practice and policy regarding problematic opioid use in palliative care.
Diagnosis of Menière’s disease on MRI: feasibility at 1.5 Tesla
Authors: Kenis Christoph , Crins Tom , Bernaerts Anja , Casselman Jan , Foer Bert De 
Published: May 2021

Background Menière’s disease (MD) is clinically characterized by the triad sensorineural hearing loss, tinnitus and/or aural fullness, and vertigo. Endolymphatic hydrops (EH) is the histopathological basis associated with MD, which can be demonstrated on magnetic resonance imaging (MRI). Currently, most studies are done on a 3-T MRI scanner and to date it is believed that EH can only be demonstrated on a 3-T magnet. We report the feasibility of demonstrating EH on a 1.5-T scanner using the standard 20-channel head and neck coil and the current standard 4-h delayed intravenous gadolinium-enhanced three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence. Purpose To investigate whether current standard 4-h delayed intravenous gadolinium-enhanced 3D-FLAIR imaging can demonstrate endolymphatic hydrops on a 1.5-T MRI scanner. Material and Methods The 3D-FLAIR sequence was taken from a 3-T MRI protocol and tested on a volunteer patient with clinically “definite” MD, after 4-h delayed intravenous contrast injection. Good image quality was obtained after reducing both the matrix and the bandwidth, with clear demonstration of EH. Subsequently, eight more patients with unilateral disease were imaged. Five patients had “definite” MD and four had “probable” MD. Results We imaged nine patients with unilateral disease and detected EH in eight of nine ears. One patient with “probable” MD did not show any abnormality, but the images were degraded by motion artifacts. Conclusion At a cost of 2 min extra scanning time compared to a 3-T scanner, EH can be confidently demonstrated with the current standard 3D-FLAIR sequence on a 1.5-T magnet.
PD-L1 SNPs as biomarkers to define benefit in patients with advanced NSCLC treated with immune checkpoint inhibitors
Authors: Minari Roberta , Bonatti Francesco , Mazzaschi Giulia , Dodi Alessandra , Facchinetti Francesco , Gelsomino Francesco , Cinquegrani Gloria , Squadrilli Anna , Bordi Paola , Buti Sebastiano , Bersanelli Melissa , Leonetti Alessandro , Cosenza Agnese , Ferri Leonarda , Rapacchi Elena , Quaini Federico , Ardizzoni Andrea , Tiseo Marcello 
Published: May 2021

Objective: To investigate the role of CTLA-4, PD-1 (programmed death-1), and PD-L1 (programmed death-ligand 1) single nucleotide polymorphisms (SNPs) in predicting clinical outcome of patients with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs). Methods: A total of 166 consecutive patients were included. We correlated SNPs with clinical benefit, progression-free survival, time to treatment failure, and overall survival and evaluated the incidence of SNPs in nonresponder and long clinical benefit groups. Results: Considering the entire cohort, no correlation was found between SNPs and clinical outcome; however, PD-L1 rs4143815 SNP and the long clinical benefit group showed a statistically significant association ( p = 0.02). The nonresponder cohort displayed distinctive PD-L1 haplotype ( p = 0.05). Conclusion: PD-L1 SNPs seem to be marginally involved in predicting clinical outcome of NSCLC treated with ICI, but further investigations are required.
Understanding the occupational identity of care-givers for people with mental health problems
Authors: Howes Megan L , Ellison Diane 
Published: May 2021

Introduction There is recognition within the literature that the role of care-giving can have a negative impact on care-givers’ general well-being. Less is understood about the role of care-giving on an individual’s occupational participation and in turn occupational identity. Occupational therapists have a unique understanding of the interplay between occupational participation and health, though this is an area that has been under researched in relation to mental health care-givers. Therefore, the current research aims to understand how the role of care-giving for an individual with a mental illness impacts on occupational participation and identity. Method A qualitative semi-structured interview the Occupational Performance and History Interview–Version 2 was utilised to understand life experiences. Six mental health care-givers were interviewed, and these interviews were transcribed for thematic analysis. Findings Three main themes were identified: being me, roles and responsibilities associated with care-giving and services. Conclusion The findings suggest being a mental health care-giver does have a detrimental impact on occupational participation and therefore occupational identity. As care-givers gained more experience in their role, they used occupational adaption as a positive coping mechanism that helped them achieve occupational balance. Using their unique understanding of occupational participation and occupational identity, occupational therapists are well placed to utilise their knowledge and skills to work in a systemic way supporting both the person with mental illness and their care-giver.
Examining Factors Related to the Food Insecurity–Obesity Paradox in Low-Income Mothers and Fathers
Authors: Taylor Emily A. , Foster Jaime S. , Mobley Amy R. 
Published: May 2021

Background: Prior research has indicated a varying relationship of food security and obesity risk between men and women yet factors affecting this relationship are unclear. Objective: The objective of this study was to examine factors related to the gender disparity in the food insecurity–obesity paradox within a sample of low-income parents. Methods: Low-income cohabiting mother and father pairs (n = 25) living with their child were interviewed individually using the United States Department of Agriculture Household Food Security Module, Center for Epidemiological Studies Depression Scale, and Coping Strategies Index to examine gendered factors related to the food insecurity–obesity paradox. Results: There was a significant ( P = .003) difference in report of adults in the household sacrificing consumption to feed young children between mothers (2.91 ± 0.92) and fathers (3.59 ± 0.73), with mothers reporting greater sacrifice and compromised diet quality to feed their children, but no significant correlation among body mass index, depression, and food insecurity was detected. Conclusions: Food insecure mothers may be more likely to compromise their diet quality to feed their children than fathers. This could help explain why the food insecurity–obesity paradox is significant only in women, and this work gives insights into gender-based differential consequences of food insecurity.
Effectiveness of Workplace Exercise Interventions on Body Composition: A Systematic Review and Meta-Analysis
Authors: de Sevilla Guillermo García Pérez , Vicente-Arche Fernando Cobo , Thuissard Israel John , Barcelo Olga , Perez-Ruiz Margarita 
Published: May 2021

Objective: The aim of this review was to analyze the effectiveness of workplace exercise interventions on body composition (BC). Data Source: Studies published in PubMed, Scopus, SPORTDiscus, Web of Science, CINAHL and PsycINFO, from the earliest time point until 8 July 2020. Study Inclusion and Exclusion Criteria: Inclusion criteria were worksite interventions, in adults, Randomized Controlled Trials (RCTs), real exercise practice, and measuring BC outcomes. Exclusion criteria were full-text non-available, abstract not in English, and exercise protocol missing. Data Extraction: 157 studies were retrieved and assessed for inclusion by 2 independent reviewers, who also used the Cochrane’s Collaboration Tool to assess study quality and risk of bias. Data Synthesis: We performed a meta-analysis to determine the effect size of the interventions on BC outcomes reported in at least 5 studies. Results: Twelve RCTs were included (n = 1270, 66% women), quality of studies being low to high (25% moderate, 67% high). Interventions achieved a statistically significant decrease in waist circumference (SMD = 0.24; 95% confidence interval (CI): 0.06 to 0.41; p = 0.008), total mass fat (SMD = 0.21; 95%CI: 0.00 to 0.41; p = 0.047), and body adiposity index (SMD = 0.20; 95%CI: 0.00 to 0.41; p = 0.049). No changes were observed in body weight (SMD = 0.08 95%CI: −0.02 to 0.18; p = 0.128). Additionally, muscle mass increased in interventions that included strength training. There were no adverse events reported. Conclusion: The most effective workplace exercise interventions to improve BC combined supervised, moderate-intensity aerobic and strength training, for at least 4 months.