bluuebunny/crossref_metadata_2025_split huggingface dataset:
Initial Perturbations Based on Ensemble Transform Kalman Filter with Rescaling Method for Ensemble Forecasting
Authors: Wang Jingzhuo , Chen Jing , Zhang Hanbin , Tian Hua , Shi Yining 
Published: March 2021

AbstractEnsemble forecasting is a method to faithfully describe initial and model uncertainties in a weather forecasting system. Initial uncertainties are much more important than model uncertainties in the short-range numerical prediction. Currently, initial uncertainties are described by the ensemble transform Kalman filter (ETKF) initial perturbation method in Global and Regional Assimilation and Prediction Enhanced System–Regional Ensemble Prediction System (GRAPES-REPS). However, an initial perturbation distribution similar to the analysis error cannot be yielded in the ETKF method of the GRAPES-REPS. To improve the method, we introduce a regional rescaling factor into the ETKF method (we call it ETKF_R). We also compare the results between the ETKF and ETKF_R methods and further demonstrate how rescaling can affect the initial perturbation characteristics as well as the ensemble forecast skills. The characteristics of the initial ensemble perturbation improve after applying the ETKF_R method. For example, the initial perturbation structures become more reasonable, the perturbations are better able to explain the forecast errors at short lead times, and the lower kinetic energy spectrum as well as perturbation energy at the initial forecast times can lead to a higher growth rate of themselves. Additionally, the ensemble forecast verification results suggest that the ETKF_R method has a better spread–skill relationship, a faster ensemble spread growth rate, and a more reasonable rank histogram distribution than ETKF. Furthermore, the rescaling has only a minor impact on the assessment of the sharpness of probabilistic forecasts. The above results all suggest that ETKF_R can be effectively applied to the operational GRAPES-REPS.
A focus on postpartum depression among Jordanian mothers
Authors: Taybeh Esra’ O 
Published: March 2021

Background: The magnitude of postpartum depression in Jordan is under documented, and little is known about its potential sociodemographic and clinical correlates. Purpose: The aim of this study was to explore the prevalence and risk factors associated with postpartum depression among Jordanian mothers in the first 18 months after delivery. Method: This descriptive cross-sectional study was carried out from April to June 2020 in Jordan. A web-based survey was used for recruiting eligible participants. An Arabic version of the validated self-administered Edinburgh Postnatal Depression Scale questionnaire was used to measure postpartum depression with a cut-off score of ⩾12 which indicates probable depression. Results: A total of 1,071 Jordanian women participated in the study. Of those, 567 women had postpartum depression (52.9%). Multivariate logistic regression analysis revealed that postpartum depression was significantly associated with marital conflict (OR: 4.91; 95% CI: 2.36–10.20), negative attitude from the pregnancy (OR: 0.67; 95% CI: 0.45–0.99), unplanned pregnancies (OR: 1.73; 95% CI: 1.16–2.60), lack of social support (OR: 1.93; 95% CI: 1.12–3.32), time from last delivery (OR: 0.99; 95% CI: 0.98–1.00), insomnia (OR: 0.53; 95% CI: 0.35–0.82), and depression during the pregnancy (OR: 0.51; 95% CI: 0.33–0.78). Most of the participants (65.7%) sought social support to avoid, reduce, or treat postpartum depression. Conclusions: Postpartum depression among Jordanian women was the highest in comparison to that of women in other countries in the region. Therefore, screening for the presence of depressive symptoms should be implemented during regular pregnancy care visits. Social support should be encouraged in order to avoid, reduce, or treat postpartum depression.
Tonsillectomy Outcomes for Coblation Versus Bipolar Diathermy Techniques in Adult Patients: A Systematic Review and Meta-Analysis
Authors: Alsaif Abdulmalik , Alazemi Mohammad , Kahlar Narvair , Karam Mohammad , Abul Ahmad , Al-Naseem Abdulrahman , Muhanna Abdulredha Al , Aldrees Turki 
Published: March 2021

Introduction and Aims: There is no consensus on the optimal tonsillectomy technique in adult patients. The study aims to identify all studies comparing the outcomes of coblation versus bipolar diathermy in adult patients undergoing tonsillectomy. Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Primary outcomes were hemorrhage and postoperative pain. Secondary outcome measures included return to theatre, analgesia, intraoperative bleeding, diet, tonsillar healing, and operation time. Fixed-effects modeling was used for the analysis. Results: Six studies were identified enrolling a total of 1824 patients. There were no significant differences in terms of reactionary hemorrhage (OR = 1.81, P = .51), delayed hemorrhage (OR = 0.72, P = .20), or postoperative pain (mean difference = −0.15, P = .45); however, there is a general trend favuring coblation. For secondary outcomes, no significant differences noted in terms of intraoperative bleeding, diet, and cases returning to theatre. Analgesia administration was either insignificant or higher in the coblation group. The coblation group had longer operation time and greater healing effect on tonsillar tissue. Conclusions: There were no significant differences in outcomes for coblation and bipolar diathermy for adult tonsillectomy patients in this systematic review and meta-analysis.
Factors Related to Ventilation Tube Extrusion Time in Children and Adults
Authors: Lin Yi-Chih , Kao Yi-Lin , Chen Yen-Chun , Chen Lung-Che , Dang Luong Huu , Hung Shih-Han 
Published: March 2021

Background and Objective: The aim of this study was to investigate the factors affecting extrusion time in both children and adults with ventilation tube (VT) insertion, providing useful information for clinicians for better decision-making, follow strategy, and potentially improve clinical outcomes for these patients. Methods: Data from patients receiving myringotomy with VT insertion from January 1, 2007, to June 30, 2012, were retrospectively collected and analyzed by the end of 2018. Various factors, including age, gender, history of VT insertion, tympanogram, size of VT used, local finding of tympanic membrane, hypertension, diabetes mellitus, hyperlipidemia, and postoperative ear infection, were included and analyzed to examine the effects of these factors on extrusion time. Results: A total of 447 patients were included in this study (Child group–Adult group = 237:210). The overall average extrusion time was 225.85 days. In the subgroup analysis, the average time was 221.3 days and 231.0 days for children and adults, respectively. The results showed that the VT extrusion time was significantly longer in participants without a history of VT insertion and in those where larger sized VTs were inserted in both age-groups. Male gender had an influence on extrusion time in children. In addition, a history of VT insertion and VT size were determined to be factors related to extrusion before 12 months in children. Conclusion: History of VT insertion and VT size were significantly related to VT extrusion time in both children and adults and defined as factors associated with extrusion before 12 months in children. The findings suggest avoiding VT with a diameter < 1 mm and considering an appropriately larger size in patients with a history of VT insertion to optimize VT retention.
Accuracy of pleural biopsy for the diagnosis of histologic subtype of malignant pleural mesothelioma: Necropsy-based study of 134 cases
Authors: Barbieri Pietro Gino , Consonni Dario , Schneider Manuela 
Published: March 2021

Background: Definition of histologic subtype of malignant pleural mesothelioma (MPM) is important for management of patients, because surgical treatment improves prognosis for patients with epithelioid but not biphasic or sarcomatoid MPM. In a series of necropsies performed in a hospital specialized for MPM diagnosis, we retrospectively investigated the accuracy of histologic diagnosis performed on pathologic specimens collected through pleural biopsies obtained at video-assisted thoracoscopic surgery (VATS) or surgery. Methods: We reviewed histologic records of an unselected series of autopsies performed in patients with MPM employed in the Monfalcone shipyards (Northeast Italy) or living with shipyard workers from 1999 through 2017. Using necropsy results as a gold standard, we calculated sensitivity, specificity, and positive and negative predictive values of histology from VATS or surgery after combining nonepithelioid subtypes. Results: We retrieved necropsy records for 134 patients: 62 (46.3%) with epithelioid, 51 (38.1%) with biphasic, and 21 (15.7%) with sarcomatoid MPM. We observed good sensitivity of VATS (0.94) and surgery (0.89) in diagnosing epithelioid MPM. Conversely, specificity was low (VATS: 0.46; surgery: 0.32). Therefore, positive predictive values were also low (VATS: 0.58; surgery: 0.60). Misclassification was particularly high for biphasic MPM (three-fourths of biphasic MPM at necropsy had been classified as epithelioid at VATS or surgery). Conclusions: We observed a substantial degree of misclassification between epithelioid and biphasic MPM for pleural biopsies performed during VATS. Our results suggest caution should be taken in using histologic subtype obtained from VATS in selecting patients with MPM for surgical treatment. We also observed substantial misclassification of biospecimens collected during MPM surgery.
The role of perioperative ureteral stenting for urologic complications in radical surgery of cervical cancer
Authors: Kovachev Stefan Miladinov , Kovachev Miladin Stefanov 
Published: March 2021

Introduction: This study aimed to establish the urologic complications of radical type C2 hysterectomy in cervical cancer patients with or without ureteral stenting. Methods: This prospective randomized study included 76 (100%) patients with clinically and pathologically established cervical cancer stages I and II treated with radical type C2 hysterectomy with pelvic lymph node dissection for the last 5 years (2014–2019). Patients were randomized into two groups (2:1 ratio): group II received perioperative ureteral stenting ( n = 24, 31.6%) and group I did not ( n = 52, 68.4%). Urologic complications observed during follow-up include intraoperative ureter and urinary bladder lesions and postoperative ureterovaginal and vesicovaginal fistulas. Results: Of the 52 patients in group I who underwent surgery for cervical cancer, urologic complications were observed in 8 (10.5%) patients, 2 (2.6%) of whom underwent preoperative radiation therapy. In group II, urologic complications were observed in 2 (2.6%) patients, of which 1 (1.3%) received preoperative radiation therapy. Intraoperative urologic complications in group I (6.6%) included 3 (3.9%) ureteral lesions cases and 2 (2.6%) cases of urinary bladder lesions, wherein 1 patient received preoperative radiation therapy. One case of (1.3%) urinary bladder lesion was observed in group II. Postoperative complications were observed in 3 patients (3.9%) in group I, including 2 (2.6%) ureterovaginal fistula cases, wherein 1 (1.3%) patient received preoperative radiation therapy, and 1 (1.3%) case of vesicovaginal fistula. In group II, 1 (1.3%) patient who received perioperative radiotherapy developed postoperative vesicovaginal fistula. Discussion: Urologic complications are extremely common during and after radical surgery (hysterectomy type C2) for cervical cancer. The cervical cancer stage had a significant effect on intra- and postoperative urologic complication rates in this study; however, no such effect was observed for preoperative radiation therapy and ureteral stenting, and significant differences were observed between the two study groups.
Warfarin Dose Requirements in Adults Hospitalized With COVID-19 Infection: A Retrospective Case Series
Authors: Irwin Madison N. , Adie Sarah , Sandison Katherine , Alsomairy Sarah A. , Brancaccio Adamo 
Published: March 2021

Purpose: To describe the impact of hospitalization with COVID-19 infection on warfarin dose requirements in adult inpatients. Summary: A retrospective chart review of 8 adults on warfarin admitted to Michigan Medicine with COVID-19 infection was conducted and reported as a case series. Outcomes of interest were difference in average daily dose of warfarin prior to admission (PTA) and while inpatient (IP), warfarin sensitivity, time in therapeutic range (TTR), confirmed or suspected thromboembolic event, any major or clinically significant bleeding episodes, and in-hospital mortality. IP average daily warfarin doses were lower when compared to PTA average daily doses [1.3 mg (1.3) vs. 6.2 mg (4.1)]. The mean percentage decrease in dose was 68.8% (23) and the mean absolute dose difference was 4.8 mg (4.3). Mean IP percentage tests in range was 30.8% (24.6) and mean IP warfarin sensitivity was 4.2 (3.8), both of which differed from PTA TTR and warfarin sensitivity for those with data available (n = 3, n = 6, respectively). One patient was treated for suspected acute pulmonary embolism while on warfarin and one patient experienced clinically relevant bleeding. In-hospital mortality was zero, mean length of stay (LOS) was 17 days (14.4), and mean intensive care unit (ICU) LOS for the 3 patients requiring ICU level care was 14.3 days (4.5). Conclusion: Decreased warfarin dose requirements were evident in this group of adults hospitalized with COVID-19 infection. These findings suggest lower doses of warfarin may be needed to achieve therapeutic anticoagulation while inpatient.
Day Care Surgery for Unilateral Alveolar Bone Grafting of Residual Clefts With Mandibular Symphyseal Bone—A Prospective Questionnaire Study
Authors: Saaby Martin , Nørholt Sven Erik , Küseler Annelise , Hartlev Jens 
Published: March 2021

Objective: To evaluate patients’ experiences of shortened hospitalization in relation to bone grafting of unilateral alveolar clefts with mandibular symphyseal bone grafts. Design: Prospective cohort questionnaire study. Setting: Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Denmark. Patients: Thirty-nine (male n = 26, female n = 13) patients with unilateral residual clefts after primary reconstruction, mean age 10.4 years. Interventions: All patients underwent a standardized procedure with closure of the alveolar defect using mandibular symphyseal bone grafts. Patients were discharged within a day after surgery. Within 24 hours after discharge from surgery, patients and their parents filled in a 14-item psychometric questionnaire assessing the quality of their recovery. For all questions, a visual analogue scale (VAS) (0-10) was used. Main Outcome Measure: Patients’ experience of shortened hospitalization in relation to secondary bone grafting of alveolar defects. Factors influencing the overall experience were measured using a VAS scale. Results: A significant correlation between “Information from the hospital” and feeling worried and anxious was found ( P = .04). Additionally, the ability to sleep correlated with pain ( P = .003) and with nausea ( P = .001). Conclusions: Although this study included a limited number of patients, the findings suggest that treatment of alveolar residual cleft with bone grafting from the mandibular symphyseal region in a day care surgery setting is characterized by very high patient satisfaction.
Evaluation of Delirium in Critically Ill Patients Prescribed Melatonin or Ramelteon
Authors: Romero Natasha , Dube Kevin M. , Lupi Kenneth E. , DeGrado Jeremy R. 
Published: March 2021

Background: An impaired sleep-wake cycle may be one factor that affects the development of delirium in critically ill patients. Several small studies suggest that exogenous melatonin or ramelteon may decrease the incidence and/or duration of delirium. Objective: To compare the effect of prophylactic administration of melatonin, ramelteon, or no melatonin receptor agonist on the development of delirium in the intensive care unit (ICU). Methods: This was a single-center, retrospective, observational cohort study of nondelirious patients in the ICU who received melatonin, ramelteon, or no melatonin receptor agonist. The primary end point was the incidence of delirium. Secondary end points included assessments of daily level of sedation and daily utilization of antipsychotic, sedative, and opioid agents. Results: No difference was observed in the incidence of delirium among the melatonin, ramelteon, and placebo cohorts (18.7% vs 14.3% vs 13.8%; P = 0.77). A difference was observed in the rate of agitation and sedation among the 3 groups, with the greatest observed in the melatonin cohort. Additionally, there was a difference in the use of propofol, dexmedetomidine, and opioids. Overall, there was no difference in clinical outcomes, including duration of mechanical ventilation and ICU or hospital length of stay. Conclusion and Relevance: Therapy with melatonin, ramelteon, and no melatonin receptor agonist resulted in similar rates of delirium in a mixed ICU population. Despite significant differences in agitation, sedation, and medication utilization, there was no differences in the clinical outcomes evaluated.
Evaluation of keratoconus progression and visual improvement after intrastromal corneal ring segments implantation: A retrospective study
Authors: Moscovici Bernardo Kaplan , Rodrigues Pablo Felipe , Rodrigues Renan Albert Mendonça , Rios Livia Cristina , Simoncelli Rosangela , Freitas Marcela Mara Silva , Torquetti Leonardo 
Published: March 2021

Objective: To investigate the role of ICRS in halting keratoconus progression in a large sample of patients. Methods: A retrospective, non-comparative, interventional study based on the review of medical records of patients diagnosed with keratoconus who underwent Ferrara corneal ring segment implantation. A retrospective chart analysis study of 123 operated eyes with follow-up ranging from 3 to 16 years (mean 5.3 ± 3.6 years) was performed. This study was carried out at Ocular Surgery Unit, São Paulo, Brazil. All topographic data were obtained from Pentacam (Oculus, Arlington, USA). The same surgeon performed all surgeries, and the Ferrara ICRS nomogram was used for ICRS selection in all cases. Results: Corrected distance visual acuity, keratometry, and topographic astigmatism improved in most cases, with statistical significance. In 42 eyes (53.8%), there was an increase in K1 or K2, and in 36 (46.2%), there was a reduction or maintenance in K1. Considering a difference higher than 1 D, between 3-month post-surgery and final visit (group 3), 32 eyes (41%) showed an increase, and 46 eyes (59%) ended equal or below this value. Conclusion: The implantation of ICRS showed improvement in visual and keratometric indexes. The majority of patients did not increase more than one diopter in keratometric values after ICRS implantation. ICRS may be effective for slowing disease progression, especially in older patients.
Intracameral r-tPA for the management of severe fibrinous reactions in TASS after cataract surgery
Authors: Osaadon Perach , Belfair Nadav , Lavy Itay , Walter Eyal , Levy Jaime , Tuuminen Raimo , Achiron Asaf , Knyazer Boris 
Published: March 2021

Background: To describe the use of intracameral recombinant tissue plasminogen activator (r-tPA) in the treatment of severe fibrinous reactions in toxic anterior segment syndrome (TASS) after cataract surgery. Methods: A case series of 59 eyes of 59 patients with severe fibrinous anterior chamber reaction following cataract surgery who received intracameral r-tPA (25 µg/0.1 ml). The main outcome measures after intracameral r-tPA were the incidence of complete fibrinolysis, time of maximal effect, visual acuity, and complications. Results: Severe fibrinous reactions appeared 11.5 ± 5.3 days after cataract surgery. Fibrinolysis was observed 2.33 ± 2.70 days after rtPA use and 36 eyes (61%) exhibited resolution of the fibrin by the end of the first day following injection ( p < 0.001). Transient corneal edema observed at 1-day after injection was the only complication reported during the injection of r-tPA or at follow-up. Eight eyes (13.6%) required a second r-tPA injection. Best-corrected visual acuity improved from 0.88 ± 0.67 logMAR units before rtPA injection to 0.48 ± 0.49 logMAR units at 1-month ( p < 0.001). Conclusions: The application of r-tPA was a quick and efficacious therapeutic approach for the management of severe fibrinous reactions in TASS after cataract surgery. In a clinical setting, intracameral r-tPA may be useful when rapid visual recovery is needed.
Retinal pigment epithelium aperture in acute central serous chorioretinopathy: Another novel possible pathological mechanism
Authors: Lei Chunyan , Hua Rui , Duan Jianan , Zhang Meixia 
Published: March 2021

Purpose: To present retinal pigment epithelium (RPE) aperture related to an avascular pigment epithelium detachment (PED) secondary to acute central serous chorioretinopathy (CSC). Methods: Case report. Results: A 47-year-old man diagnosed as acute CSC presented with RPE aperture in the superonasal area of the macula in his left eye during follow-up. At 2-week follow-up, his decimal best-corrected visual acuity (BCVA) was improved from 0.08 to 0.6 and subretinal fluid was partially absorbed. However, the near-infrared reflectance demonstrated a round mild hyperreflective lesion on the superonasal area of the macula. On spectral-domain optical coherence tomography (SD-OCT), RPE band of the round lesion discontinued but RPE fractured edges without shrinkage and curling. Fundus autofluorescence (FAF) showed RPE aperture appeared as round hypoautofluorescence and hyperautofluorescence outlined its borderline. OCT angiography demonstrated that no evidence of neovascularization within the sub-RPE space. En Face OCT confirmed that the RPE aperture developed at the edge of the PED lesion. At 8-month follow-up, his decimal BCVA was improved to 1.0 and SD-OCT demonstrated spontaneous resolution of subretinal fluid and restoration of RPE structure, with complete flattening of PED. However, FAF revealed hypoautofluorescence mingled with slight hyperautofluorescence within the lesion. Conclusions: To the best of our knowledge, this is the first report of an RPE aperture secondary to acute CSC. Our case indicated another novel possible pathological mechanism that in the relatively healthy RPE, increased hydrostatic pressure simply itself could contribute to RPE aperture.