Rainfall-runoff models are used for efficient management, distribution, planning, and design of water resources in accordance with the process of hydrologic cycle. The models simplify the transition of rainfall to runoff as rainfall through different processes including evaporation, transpiration, interception, and infiltration. As the models simplify complex physical processes, gaps between the models and actual rainfall events exist. For more accurate simulation, appropriate models that suit analysis goals are selected and reliable long-term hydrological data are collected. However, uncertainty is inherent in models. It is therefore necessary to evaluate reliability of simulation results from models. A number of studies have evaluated uncertainty ingrained in rainfall-runoff models. In this paper, Meta-Gaussian method proposed by Montanari and Brath(2004) was used to assess uncertainty of simulation outputs from rainfall-runoff models. The model, which estimates upper and lower bounds of the confidence interval from probabilistic distribution of a model's error, can quantify global uncertainty of hydrological models. In this paper, Meta-Gaussian method was applied to analyze uncertainty of simulated runoff outputs from $Vflo^{TM}$, a physically-based distribution model and HEC-HMS model, a conceptual lumped model.
Ricci, Joseph A.;Vargas, Christina R.;Ho, Olivia A.;Lin, Samuel J.;Lee, Bernard T.
Archives of Plastic Surgery
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v.46
no.3
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pp.198-203
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2019
Background Professional affiliation between medical centers and professional sports teams can be mutually beneficial in the provision of healthcare and marketing strategy. Anecdotal evidence suggests a link between trauma volume and sporting events; however, there is limited data. This study aims to characterize the incidence of operative hand and facial trauma during professional baseball home games. Methods A retrospective review of surgical cases for traumatic hand or facial injuries at a level 1 center between 1999 and 2012 was performed. Demographic information including date of injury, admission status, and operative repair were collected. Patients were grouped based on whether their trauma occurred on the date of a home game. Results Operative hand and facial trauma occurred at a rate of 33.4 injuries per 100 days with home games, compared to 22.2 injuries per 100 days (incidence rate ratios, 1.50; 95% confidence interval, 1.34-1.69). When home games were played, patients were more likely to present as a result of motorcycle accidents (3.1% vs. 1.5%; P=0.04) or bicycle accidents (5.0% vs. 2.6%; P=0.01). Other mechanisms of trauma were not statistically different. There was an increase incidence of injuries during home games in August; weekly variability showed an increased incidence during the weekends. Conclusions There was an increased rate of operative hand and facial injuries on dates with professional home games. The incidence of injuries during home games was higher in the late summer and on the weekends. Further analysis may allow improved resource allocation and strategies for injury prevention and treatment.
Purpose: The use of direct oral Xa inhibitors (DXaIs) to prevent venothrombotic events is increasing. However, gastrointestinal bleeding, including that related to endoscopic resection, is a concern. In this study, we evaluated bleeding and coagulation times during the perioperative period of gastric endoscopic submucosal dissection (ESD). Materials and Methods: Patients who consecutively underwent gastric ESD from August 2016 to December 2018 were analyzed. Bleeding rates were compared among the 3 groups (antiplatelet, DXaIs, and control). DXaI administration was discontinued on the day of the procedure. Prothrombin time (PT), activated partial thromboplastin time, and the ratio of inhibited thrombin generation (RITG), which was based on dilute PT, were determined before and after ESD. Results: During the study period, 265 gastric ESDs were performed in 239 patients, where 23 and 50 patients received DXaIs and antiplatelets, respectively. Delayed bleeding occurred in 17 patients (7.4%) and 21 lesions (7.1%). The bleeding rate in the DXaI group was significantly higher than that in the other groups (30.4%, P<0.01), and the adjusted odds ratio of bleeding was 5.7 (95% confidence interval, 1.4-23.7; P=0.016). In patients using DXaIs, there was a significant (P=0.046) difference in the median RITG between bleeding cases (18.6%) and non-bleeding cases (3.8%). Conclusions: A one-day cessation of DXaIs was related to a high incidence of bleeding after gastric ESD, and monitoring of residual coagulation activity at trough levels might enable the predicted risk of delayed bleeding in patients using DXaIs.
Kim, Chan Hyeong;Kang, Yoonjin;Kim, Ji Seong;Sohn, Suk Ho;Hwang, Ho Young
Journal of Chest Surgery
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v.55
no.3
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pp.189-196
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2022
Background: This study investigated the predictive value of the frailty index calculated using laboratory data and vital signs (FI-L) in patients who underwent coronary artery bypass grafting (CABG). Methods: This study included 508 patients (age 67.3±9.7 years, male 78.0%) who underwent CABG between 2018 and 2021. The FI-L, which estimates patients' frailty based on laboratory data and vital signs, was calculated as the ratio of variables outside the normal range for 32 preoperative parameters. The primary endpoints were operative and medium-term all-cause mortality. The secondary endpoints were early postoperative complications and major adverse cardiac and cerebrovascular events (MACCEs). Results: The mean FI-L was 20.9%±10.9%. The early mortality rate was 1.6% (n=8). Postoperative complications were atrial fibrillation (n=148, 29.1%), respiratory complications (n=38, 7.5%), and acute kidney injury (n=15, 3.0%). The 1- and 3-year survival rates were 96.0% and 88.7%, and the 1- and 3-year cumulative incidence rates of MACCEs were 4.87% and 8.98%. In multivariable analyses, the FI-L showed statistically significant associations with medium-term all-cause mortality (hazard ratio [HR], 1.042; 95% confidence interval [CI], 1.010-1.076), MACCEs (subdistribution HR, 1.054; 95% CI, 1.030-1.078), atrial fibrillation (odds ratio [OR], 1.02; 95% CI, 1.002-1.039), acute kidney injury (OR, 1.06; 95% CI, 1.014-1.108), and re-operation for bleeding (OR, 1.09; 95% CI, 1.032-1.152). The minimal p-value approach showed that 32% was the best cutoff for the FI-L as a predictor of all-cause mortality post-CABG. Conclusion: The FI-L was a significant prognostic factor related to all-cause mortality and postoperative complications in patients who underwent CABG.
Purpose: This systematic review and meta-analysis aimed to compare endoscopy as primary versus secondary prophylaxis to prevent future bleeding in children with esophageal varices. Methods: A systematic literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was conducted using the Scopus, PubMed, and Cochrane databases for relevant studies on the outcome of rebleeding events after endoscopy in primary prophylaxis compared to that in secondary prophylaxis. The following keywords were used: esophageal varices, children, endoscopy, primary prophylaxis and bleeding. The quality of eligible articles was assessed using the Newcastle-Ottawa Scale and statistically analyzed using RevMan 5.4 software. Results: A total of 174 children were included from four eligible articles. All four studies were considered of high-quality based on the Newcastle-Ottawa Quality Assessment Scale. Patients who received primary prophylaxis had 79% lower odds of bleeding than those who received secondary prophylaxis (odds ratio, 0.21; 95% confidence interval [CI], 0.07-0.66; I2=0%, p=0.008). Patients in the primary prophylaxis group underwent fewer endoscopic procedures to eradicate varices than those in the secondary prophylaxis group, with a mean difference of 1.73 (95% CI, 0.91-2.56; I2=62%, p<0.0001). Conclusion: Children with high-risk varices who underwent primary prophylaxis were less likely to experience future bleeding episodes and required fewer endoscopic procedures to eradicate the varices than children who underwent secondary prophylaxis.
Background: Along with the increase in the elderly population, concerns about polypharmacy, which can cause medication-related problems, are increasing. This study aimed to find out the association between drug-related factors and readmission in elderly patients within 30 days after discharge. Methods: Data of patients aged ≥65 years who were discharged from the respiratory medicine ward of a tertiary hospital between January and March 2016 were retrospectively obtained. The medication regimen complexity at discharge was calculated using the medication regimen complexity index (MRCI) score, comorbidity status was assessed using the Charlson comorbidity index (CCI), potentially inappropriate medications (PIMs) were evaluated based on the Beer 2019 criteria, and adverse drug events (ADEs) were examined using the ADE reporting system. Multivariable logistic regression analysis was used to evaluate the effect of medication-related problems on hospital readmission after controlling for other variables. Results: Of the 206 patients included, 84 (40.8%) used PIMs, 31 (15%) had ADEs, and 32 (15.5%) were readmitted. The mean age, total medications, MRCI, CCI, and PIMs in the readmission group were significantly higher than those in the non-readmission group. Age significantly decreased the risk of readmission (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.84-0.96) after adjusting for sex, length of hospital stay, and ADEs. The use of PIMs (OR, 2.38; 95% CI, 1.10-5.16) and increased CCI (OR, 1.50; 95% CI, 1.16-1.93) and MRCI (OR, 1.04; 95% CI, 1.01-1.07) were associated with an increased occurrence of readmission. Conclusion: PIMs were associated with a significantly greater risk for readmission than MRCI.
Background/Aims: Data on the incidence of adverse respiratory events during recovery from gastrointestinal endoscopy are limited. The aim of this study was to investigate the incidence of these complications. Methods: In this retrospective cohort study, data were obtained from the electronic records of 657 consecutive patients, who underwent gastroenterological procedures under sedation. Results: Pulse oximetry oxygen saturation (SpO2) <90% for <60 seconds occurred in 82 patients (12.5%), and in 11 patients (1.7%), SpO2 of <90% for >60 seconds occurred in 79 patients (12.0%) and in 14 patients (2.1%), and SpO2 <75% occurred in four patients (0.6%) and in no patients during the procedure and recovery period, respectively. No major complications were noted. The occurrence of desaturation during recovery was correlated with desaturation during the procedure (p<0.001). Higher American Society of Anesthesiologists score (odds ratio [OR], 1.867; 95% confidence interval [CI], 1.008-3.458), ischemic heart disease (OR, 1.815; 95% CI, 0.649-5.080), hypertension (OR, 1.289; 95% CI, 0.472-3.516), and diabetes mellitus (OR, 2.406; 95% CI, 0.950-6.095) increased the occurrence of desaturation during recovery. Conclusions: We found no major complications during recovery after balanced propofol-based sedation administered by a gastroenterologist-nurse team. Patients with the identified risk predictors must be monitored carefully.
Soo-Han Choi;Su-Yeon Yu;Jimin Kim;Miyoung Choi;Youn Young Choi;Jae Hong Choi;Ki Wook Yun;Young June Choe
Pediatric Infection and Vaccine
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v.31
no.1
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pp.12-24
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2024
The number of pediatric coronavirus disease 2019 (COVID-19) cases worldwide are increasing compared to the early phase of the pandemic, along with highly transmissible severe acute respiratory syndrome coronavirus variant and the increase in adult COVID-19 vaccination. We conducted a rapid systematic review and meta-analysis of published randomized clinical trials (RCTs) of the COVID-19 vaccines and the observational retrospective studies on adverse events after COVID-19 vaccination in adolescents. Seventeen studies were finally included in this systematic review. Meta-analysis showed that although vaccination in adolescents was significantly effective to prevent COVID-19 infection in retrospective studies (risk ratio [RR], 0.29; 95% confidence interval [CI], 0.22-0.37; I2 =100%), however the effect of preventing COVID-19 infection was lower than in RCTs (RR, 0.05; 95% CI, 0.01-0.27). In five retrospective studies, the pooled estimated proportion of participants with myocarditis and/or pericarditis was 2.33 per 100,000 of the population (95% CI, 0.97-5.61 per 100,000). Sub-group analysis with sex and vaccine doses showed that male (5.35 per 100,000) and the second dose (9.71 per 100,000) had significantly higher incidence of myocarditis and/or pericarditis than female (1.09 per 100,000) and the first dose (1.61 per 100,000), respectively. Our study showed that mRNA COVID-19 vaccines in adolescent recipients were favorable and effective against COVID-19 in RCT as well as observational studies. The safety findings of BNT162b2 vaccine in adolescents were explored and we found the difference of safety according to sex and vaccine doses. The occurrence of adverse events after mRNA COVID-19 vaccination should be monitored.
We investigate the signaling effect of repurchase preceding new equity issue using Korean data. In a short time span, firms announce stock repurchases and equity offerings. The proximity of two events in Korean firms indicates that those are not independent of each other. In this paper, we test the signaling effect of repurchase on equity offerings on the two measures. One is announcement effect, which is measured as CAR(0, +2). The other is the effectiveness which is measured as CAR(0, +30) because the price movement during this window influences on the price of new issues. Previous studies that stock repurchase convey positive signal to equity offerings-Billet and Xue(2004) and Jung(2004)-construct sample without the limit of time interval between two events. This causes the unclear relation between those because of the long time interval. In this study we consider only samples of being within one year each other to reduce this problem and clarify the signal of repurchase on equity offerings. Korean firms are allowed to repurchase own shares with two different method. One is direct repurchase as same as open market repurchase. The other is stock stabilization fund and stock trust fund which trust company or bank buy and sell their shares on the behalf of firms. Generally, the striking different characteristic between direct repurchase and indirect repurchase is following. Direct repurchase is applied by more strict regulation than indirect repurchase. Therefore, the direct repurchase is more informative signal to the equity offering than the indirect repurchase. We construct two sample firms- firms with direct repurchase preceding-equity offerings and indirect repurchase-preceding equity offering, and one control firms-equity offerings only firms-to investigate the announcement effect and the effectiveness of repurchases. Our findings are as follows. Direct repurchase favorably affect the price of new issues favorably. CAR(0, +2) of firms with direct repurchase is not different from that of equity offerings only firms but CAR(0, +30) is higher than that of equity offerings only firms. For firms with indirect repurchase and equity offerings, Both the announcement effect and the effectiveness does not exist. Jung(2004) suggest the possibilities of how indirect stock repurchase can be regarded as one of unfair trading practices on based on the survey results that financial managers of some of KSE listed firms have been asked of their opinion on the likelihood of the stock repurchase being used in unfair trading. This is not objective empirical evidence but opinion of financial managers. To investigate whether firms announce false signal before equity offerings to boost the price of new issues, we calculate the long-run performance following equity offerings. If firms have announced repurchase to boost the price of new issues intentionally, they would undergo the severe underperformance. The empirical results do not show the severer underperformance of both sample firms than equity offerings only firms. The suggestion of false signaling of repurchase preceding equity offerings is not supported by our evidence.
The hypocenter distribution of microseismic events generated by hydraulic fracturing for shale gas development provides essential information for understanding characteristics of fracture network. In this study, we evaluate how inaccurate velocity models influence the inversion results of two widely used location programs, hypoellipse and hypoDD, which are developed based on an iterative linear inversion. We assume that 98 stations are densely located inside the circle with a radius of 4 km and 5 artificial hypocenter sets (S0 ~ S4) are located from the center of the network to the south with 1 km interval. Each hypocenter set contains 25 events placed on the plane. To quantify accuracies of the inversion results, we defined 6 parameters: difference between average hypocenters of assumed and inverted locations, $d_1$; ratio of assumed and inverted areas estimated by hypocenters, r; difference between dip of the reference plane and the best fitting plane for determined hypocenters, ${\theta}$; difference between strike of the reference plane and the best fitting plane for determined hypocenters, ${\phi}$; root-mean-square distance between hypocenters and the best fitting plane, $d_2$; root-mean-square error in horizontal direction on the best fitting plane, $d_3$. Synthetic travel times are calculated for the reference model having 1D layered structure and the inaccurate velocity model for the inversion is constructed by using normal distribution with standard deviations of 0.1, 0.2, and 0.3 km/s, respectively, with respect to the reference model. The parameters $d_1$, r, ${\theta}$, and $d_2$ show positive correlation with the level of velocity perturbations, but the others are not sensitive to the perturbations except S4, which is located at the outer boundary of the network. In cases of S0, S1, S2, and S3, hypoellipse and hypoDD provide similar results for $d_1$. However, for other parameters, hypoDD shows much better results and errors of locations can be reduced by about several meters regardless of the level of perturbations. In light of the purpose to understand the characteristics of hydraulic fracturing, $1{\sigma}$ error of velocity structure should be under 0.2 km/s in hypoellipse and 0.3 km/s in hypoDD.
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