bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determining the optimum anatomical coverage of side plates for the VIRTUS body armour and load carriage system
Authors: Breeze Johno , Fryer R N , Lewis E 
Published: February 2020

IntroductionSide plates are worn by UK Armed Forces as part of the VIRTUS body armour and load carriage systems to protect the thorax and abdomen from high-velocity threats. The VIRTUS project has provided the impetus to objectively demonstrate the anatomical coverage provided by side plates.MethodCT scans of 120 male UK Armed Forces personnel were analysed to ascertain the vertical distance between the anterior axillary fold and iliac crest, and horizontal distance between anterior and posterior borders of the liver, delineating the boundaries of essential medical coverage from the side aspects. The percentage of shot-lines intersected by the existing Enhanced Combat Body Armour (ECBA) plates as well as an optimised plate based on the maximum potential dimensions of essential coverage was determined in the Coverage of Armour Tool.ResultsECBA plates were 101 mm shorter and 4 mm narrower than a plate with dimensions providing essential medical coverage for the 50th percentile subject (157×315 mm). Coverage increased by 35% when using two ECBA plates as side coverage in addition to using the front and rear OSPREY plates in the VIRTUS vest. Two side plates with dimensions providing essential medical coverage for the 50th percentile increased anatomical coverage by a further 16%.ConclusionsThis analysis has provided strong evidence that ECBA plates are already optimised for side protection, despite not being originally designed for this purpose. They are correctly positioned within the VIRTUS soft body armour vest and the width of the ECBA plate is only 3% less than what would be optimum size for the 50th percentile. Although the height of the plate could be increased to further enhance the anatomical coverage, it is unlikely that this would be acceptable in terms of the human factors, equipment integration or additional mass.
What constitutes a ‘successful’ recovery? Patient perceptions of the recovery process after a traumatic injury
Authors: Rosenberg Graeme , Zion Sean R , Shearer Emily , Bereknyei Merrell Sylvia , Abadilla Natasha , Spain David A , Crum Alia J , Weiser Thomas G 
Published: February 2020

BackgroundAs the number of patients surviving traumatic injuries has grown, understanding the factors that shape the recovery process has become increasingly important. However, the psychosocial factors affecting recovery from trauma have received limited attention. We conducted an exploratory qualitative study to better understand how patients view recovery after traumatic injury.MethodsThis qualitative, descriptive study was conducted at a Level One university trauma center. Participants 1–3 years postinjury were purposefully sampled to include common blunt-force mechanisms of injuries and a range of ages, socioeconomic backgrounds and injury severities. Semi-structured interviews explored participants’ perceptions of self and the recovery process after traumatic injury. Interviews were transcribed verbatim; the data were inductively coded and thematically analyzed.ResultsWe conducted 15 interviews, 13 of which were with male participants (87%); average hospital length of stay was 8.9 days and mean injury severity score was 18.3. An essential aspect of the patient experience centered around the recovery of both the body and the ‘self’, a composite of one’s roles, values, identities and beliefs. The process of regaining a sound sense of self was essential to achieving favorable subjective outcomes. Participants expressed varying levels of engagement in their recovery process, with those on the high end of the engagement spectrum tending to speak more positively about their outcomes. Participants described their own subjective interpretations of their recovery as most important, which was primarily influenced by their engagement in the recovery process and ability to recover their sense of self.DiscussionPatients who are able to maintain or regain a cohesive sense of self after injury and who are highly engaged in the recovery process have more positive assessments of their outcomes. Our findings offer a novel framework for healthcare providers and researchers to use as they approach the issue of recovery after injury with patients.Level of evidenceIII—descriptive, exploratory study.
High-resolution laser resonance ionization spectroscopy of $$^{143-147}$$Pm
Authors: Studer Dominik , Ulrich Jiri , Braccini Saverio , Carzaniga Tommaso Stefano , Dressler Rugard , Eberhardt Klaus , Heinke Reinhard , Köster Ulli , Raeder Sebastian , Wendt Klaus 
Published: February 2020

AbstractWe present the results of high-resolution laser spectroscopy of the long-lived radioactive isotopes $$^{143-147}$$143-147Pm. The hyperfine structures and isotope shifts in two different atomic ground-state transitions at 452 nm and 468 nm were probed by in-source laser spectroscopy at the RISIKO mass separator in Mainz, using the PI-LIST ion source. From the hyperfine coupling constants the nuclear magnetic dipole and electric quadrupole moments for $$^{143-147}$$143-147Pm were derived, and the measured isotope shifts allowed the extraction of changes in nuclear mean square charge radii.
Sensitivity on anomalous neutral triple gauge couplings via ZZ production at FCC-hh
Authors: Yilmaz A. , Senol A. , Denizli H. , Turk Cakir I. , Cakir O. 
Published: February 2020

AbstractWe study the sensitivity of anomalous neutral triple gauge couplings (aNTGC) via $$pp \rightarrow ZZ$$pp→ZZ production in the 4$$\ell $$ℓ channel at 100 TeV center of mass energy of future circular hadron collider, . The analysis including the realistic detector effects is performed in the mode where both Z bosons decay into same-flavor, oppositely charged lepton pairs. The sensitivities to the charge–parity (CP)-conserving couplings $$C_{{\tilde{B}}W} / \Lambda ^{4}$$CB~W/Λ4 and CP-violating couplings $$C_{WW} / \Lambda ^{4}$$CWW/Λ4, $$C_{BW} / \Lambda ^{4}$$CBW/Λ4 and $$C_{BB} / \Lambda ^{4}$$CBB/Λ4 obtained at 95% Confidence Level using the invariant mass distribution of the 4$$\ell $$ℓ system reconstructing the leading and sub-leading Z boson candidates are $$[-\,0.09, \,\, +\,0.09]$$[-0.09,+0.09], $$[-\,0.21, \,\, +\,0.21]$$[-0.21,+0.21], $$[-\,0.26, \,\, +\,0.26]$$[-0.26,+0.26], and $$[-\,0.10, \,\, +\,0.10]$$[-0.10,+0.10] in units of $$\hbox {TeV}^{-4}$$TeV-4, respectively.
Generating Digital Painting Lighting Effects via RGB-space Geometry
Authors: Zhang Lvmin , Simo-Serra Edgar , Ji Yi , Liu Chunping 
Published: February 2020

We present an algorithm to generate digital painting lighting effects from a single image. Our algorithm is based on a key observation: Artists use many overlapping strokes to paint lighting effects, i.e., pixels with dense stroke history tend to gather more illumination strokes. Based on this observation, we design an algorithm to both estimate the density of strokes in a digital painting using color geometry and then generate novel lighting effects by mimicking artists’ coarse-to-fine workflow. Coarse lighting effects are first generated using a wave transform and then retouched according to the stroke density of the original illustrations into usable lighting effects.
Our algorithm is content-aware, with generated lighting effects naturally adapting to image structures, and can be used as an interactive tool to simplify current labor-intensive workflows for generating lighting effects for digital and matte paintings. In addition, our algorithm can also produce usable lighting effects for photographs or three-dimensional rendered images. We evaluate our approach with both an in-depth qualitative and a quantitative analysis that includes a perceptual user study. Results show that our proposed approach is not only able to produce favorable lighting effects with respect to existing approaches, but also that it is able to significantly reduce the needed interaction time.
The Effects of Virtual Reality, Augmented Reality, and Mixed Reality as Training Enhancement Methods: A Meta-Analysis
Authors: Kaplan Alexandra D. , Cruit Jessica , Endsley Mica , Beers Suzanne M. , Sawyer Ben D. , Hancock P. A. 
Published: February 2020

Objective The objective of this meta-analysis is to explore the presently available, empirical findings on transfer of training from virtual (VR), augmented (AR), and mixed reality (MR) and determine whether such extended reality (XR)-based training is as effective as traditional training methods. Background MR, VR, and AR have already been used as training tools in a variety of domains. However, the question of whether or not these manipulations are effective for training has not been quantitatively and conclusively answered. Evidence shows that, while extended realities can often be time-saving and cost-saving training mechanisms, their efficacy as training tools has been debated. Method The current body of literature was examined and all qualifying articles pertaining to transfer of training from MR, VR, and AR were included in the meta-analysis. Effect sizes were calculated to determine the effects that XR-based factors, trainee-based factors, and task-based factors had on performance measures after XR-based training. Results Results showed that training in XR does not express a different outcome than training in a nonsimulated, control environment. It is equally effective at enhancing performance. Conclusion Across numerous studies in multiple fields, extended realities are as effective of a training mechanism as the commonly accepted methods. The value of XR then lies in providing training in circumstances, which exclude traditional methods, such as situations when danger or cost may make traditional training impossible.
Atypical infectious spondylitis with reduced bone marrow enhancement: “black vertebra sign”
Authors: Park Sung Eun , Yoo Hye Jin , Hong Sung Hwan , Choi Ja-Young , Chae Hee Dong 
Published: February 2020

Background A few patients suspected of having infectious spondylitis exhibited a reduced enhancement pattern on postcontrast T1-weighted (T1W) magnetic resonance imaging (MRI). Purpose To investigate the characteristics of infectious spondylitis patients who exhibited reduced vertebral enhancement. Material and Methods From January 2010 to November 2017, 456 patients with findings suspicious for infectious spondylitis on 706 postcontrast T1W imaging were retrospectively evaluated. When an affected vertebra exhibited markedly reduced enhancement compared to normal bone marrow (BM), the vertebra was termed a “black vertebra.” MRI and computed tomography (CT) imaging findings within two-week intervals and the patients’ clinical characteristics were reviewed. Results Ten patients (5 men, 5 women; mean age 66.4 years) whose MRI scans revealed the black vertebra sign were included. Among the 10 patients with black vertebrae, six patients exhibited signal voids in or around the affected vertebral bodies on T2-weighted (T2W) images. Eight patients showed air bubbles on CT images, suggestive of emphysematous infection. However, the typical image findings of infectious spondylitis were uncommon, namely, low BM signal intensity (SI) on T1W images (n=1) and intradiscal fluid-equivalent SI on T2W images (n=5) at an early stage. On follow-up MRI (average interval 7.2 weeks from initial MRI), available for five patients, marked progression of infection was evidenced by increased numbers of affected segments (n=3), low T1 SIs of the affected vertebrae (n=5), and increased contrast enhancement (n=3). Five patients underwent surgery to treat infections not controlled by antibiotics. Conclusion A black vertebra sign on postcontrast T1W imaging seems to reflect an early emphysematous infection.
Lumbar puncture rapidly improves olfaction in patients with idiopathic intracranial hypertension: A cohort study
Authors: Becker Nils J , Enge Sören , Kreutz Katharina Maria , Schmidt Felix , Harms Lutz , Wiener Edzard , Hoffmann Jan , Kronenberg Golo , Kunte Hagen 
Published: February 2020

Background A lumbar puncture constitutes an important diagnostic procedure in the evaluation of idiopathic intracranial hypertension. Chronic overflow of cerebrospinal fluid into the sheaths of the olfactory nerves appears to be related to olfactory impairment in these patients. Here, we asked whether cerebrospinal fluid drainage in idiopathic intracranial hypertension patients improves olfactory function. Methods Fourteen idiopathic intracranial hypertension patients and 14 neurologic control patients were investigated before and after lumbar puncture using the extended Sniffin’ Sticks procedure. We assessed odor threshold, discrimination, and identification. In idiopathic intracranial hypertension patients, cerebrospinal fluid was drained until cerebrospinal fluid pressure had normalized. In addition, a third group of 14 healthy controls participated in the two smell tests at similar intervals. Results Relative to healthy controls, threshold, discrimination, and identification composite scores before lumbar puncture were significantly lower in idiopathic intracranial hypertension patients and also in neurologic controls. Following lumbar puncture, threshold, discrimination, and identification scores for neurologic controls remained unchanged whereas idiopathic intracranial hypertension patients showed robust improvement on the composite score as well as on all three subscores (all changes: p < 0.003), quickly regaining olfactory function in the normal range. Cerebrospinal fluid opening pressure was significantly correlated with improvement in threshold, discrimination, and identification score upon cerebrospinal fluid drainage ( r = 0.609, p = 0.021). Conclusion Olfactory impairment is an important, yet underappreciated, clinical feature of idiopathic intracranial hypertension. Lowering of increased intracranial pressure improves hyposmia. Our findings shed new light on the pathophysiology of cerebrospinal fluid circulation in idiopathic intracranial hypertension.
Dying in the Neurointensive Care Unit After Withdrawal of Life-Sustaining Therapy: Associations of Advance Directives and Health-Care Proxies With Timing and Treatment Intensity
Authors: Stachulski Frank , Siegerink Bob , Bösel Julian 
Published: February 2020

Background and Purpose: Critically ill patients require a careful approach for prognosis and decision-making. The German health legislation aims to strengthen the role of advance directives (ADs) and health-care proxies (HCPs). Their impact within a dedicated neurocritical care setting is unknown. This study aimed to assess the practice of withdrawal or withholding of life-sustaining therapy (WOLST) in a German neurointensive care unit (NICU) focusing on whether AD or HCP is associated with timing and treatment intensity. Methods: Data on patients who died after WOLST at a dedicated NICU of a German university hospital, from 2010 to 2013, were retrospectively analyzed. Results: Of 400 deceased patients, 310 (77.5%) died after initiation of WOLST. Among them, 68 (21.9%) were identified to have AD or HCP or both (AD + HCP). WOLST patients with AD, HCP, or AD + HCP were older than those without (median age: 77 vs 72 years, P < .001) but did not show any other distinct baseline features. There was no difference in the specific neurocritical care measures between the groups. Poisson regression analysis showed no significant difference in the probability of time-dependent WOLST initiation between those with and without AD/HCP, after adjusting for age and sex (adjusted incidence rate ratio, 1.10; 95% confidence interval, 0.94-1.28; P = .244). Conclusions: In this single-center study of mainly cerebrovascular NICU patients, AD or HCP was neither associated with an earlier WOLST nor associated with a difference in treatment intensity before WOLST. Further prospective studies should assess the emerging concept of advance care planning in neurocritical care.
Influence of Plasticizer-Free CAPD Bags and Tubings on Serum, Urine, and Dialysate Levels of Phthalic Acid Esters in CAPD Patients
Authors: Mettang Thomas , Pauli–Magnus Christiane , Alscher Dominik Mark , Kirchgessner Judith , Wodarz Roman , Rettenmeier Albert W. , Kuhlmann Ulrich 
Published: February 2020

Objectives To evaluate the impact of a plasticizer-free device on exposure to di-(2-ethylhexyl) phthalate (DEHP) and its major metabolites in patients on continuous ambulatory peritoneal dialysis (CAPD). DEHP is the most commonly used plasticizer in polyvinyl chloride (PVC) products; it is added to CAPD bags in order to improve the flexibility of the material. Since DEHP leaches out of the plastic matrix, patients on CAPD are exposed to considerable amounts of DEHP and its metabolites. Design A prospective cross-over study. Setting Department of nephrology in a teaching hospital. Participants Six patients (4 female, 2 male) stable on peritoneal dialysis (PD) for at least 6 months. Interventions Patients were switched from a plasticizer-containing PVC CAPD system (A.N.D.Y. Plus, Fresenius Medical Care, Bad Homburg, Germany) to a polyolefine-made plasticizer-free system (stay-safe, Fresenius). Main Outcome Measures Prior to and 42 days after the switch, 24-hour effluent dialysate and urine collections were performed and 10 mL blood was drawn. Concentrations of DEHP, mono-(2-ethylhexyl) phthalate (MEHP), phthalic acid (PA), and 2-ethylhexanol (2-EH) in urine, dialysate, and serum were determined using gas chromatography/mass spectrometry. Results Complete data were obtained from 5 patients. Serum levels of PA decreased significantly during the study period (0.137 ± 0.078 mg/L vs 0.124 ± 0.049 mg/L, p = 0.04), and the respective levels of DEHP decreased insignificantly (0.097 ± 0.076 mg/L vs 0.069 ± 0.046 mg/L, p = 0.07), whereas the concentrations of MEHP and 2-EH remained unchanged. Urine concentrations of PA were high (0.81 ± 0.69 mg/L) but did not change substantially (0.70 ± 0.50 mg/L). Effluent dialysate concentrations of MEHP and PA decreased significantly (0.0176 ± 0.004 mg/L vs 0.0040 ± 0.0007 mg/L, p = 0.043 and 0.158 ± 0.056 mg/L vs 0.111 ± 0.051 mg/L, p = 0.043, respectively). Conclusions Although PD patients seem to be exposed to other sources of phthalates in addition to dialysis, use of plasticizer-free devices may help to reduce potentially immunosuppressive exposure to phthalate esters.
Peritoneal Kinetics and Mesothelial Markers in CCPD Using Icodextrin for Daytime Dwell for Two Years
Authors: Posthuma Nynke , Verbrugh Henri A. , Donker Ab J.M. , Van Dorp Wim , Dekker Hubertina A.Th. , Peers Elizabeth M. , Oe Po L. , Ter Wee Pieter M. 
Published: February 2020

Objective To evaluate the safety, efficacy, and biocompatibility of icodextrin (Ico), continuous cycling peritoneal dialysis (CCPD) patients were treated for 2 years with either Ico- or glucose (Glu)-containing dialysis fluid for their daytime dwell (14 – 15 hours). Prior to entry into the study, all patients used standard Glu solutions (Dianeal, Baxter BV, Utrecht, The Netherlands). Design Open, randomized, prospective two-center study. Setting University hospital and teaching hospital. Patients Both established patients and patients new to CCPD were included. A life expectancy of more than 2 years, a stable clinical condition, and written informed consent were necessary before entry. Patients aged under 18 years or with peritonitis in the previous month, and women of childbearing potential unless taking adequate contraceptive precautions, were excluded. Thirty-eight patients entered the study (19 Glu, 19 Ico). Main Outcome Measures Daytime dwell peritoneal effluents were collected every 3 months in combination with other study variables (clinical data, laboratory measurements, dialysis-related data, and urine collection). Peritoneal transport studies were carried out every 6 months. Results In Glu- and Ico-treated patients, peritoneal transport of low molecular weight solutes and protein clearances neither changed during follow-up nor differed between the two groups. Peritoneal membrane markers (CA125, interleukin-8, carboxyterminal propeptide of type I procollagen, and aminoterminal propeptide of type III procollagen) measured in effluents did not differ between the groups and did not change over time. All these markers showed a dialysate/plasma ratio of more than 1, suggesting local production. Residual renal function remained stable during follow-up and adverse clinical effects were not observed. Conclusions Peritoneal membrane transport kinetics and markers remained stable in both groups over a 2-year follow-up period. Membrane markers were higher in effluents than in serum, suggesting local production. No clinical side effects were demonstrated. Icodextrin was a well-tolerated effective treatment.
Relationship between Fill Volume, Intraperitoneal Pressure, Body Size, and Subjective Discomfort Perception in CAPD Patients
Authors: De Jesús Ventura María , Amato Dante , Correa–Rotter Ricardo , Paniagua Ramón ,   Mexican Nephrology Collaborative Study Group
Published: February 2020

Objective To determine changes in intraperitoneal pressure (IPP) when dialysate fill volume is increased from 2.0 L to 2.5 L to 3.0 L per exchange, and to evaluate the relationship with subjective discomfort perception. Design Cross-sectional survey. Setting Seven Mexican hospital-based dialysis centers. Patients Eighty-one adult patients on continuous ambulatory peritoneal dialysis (CAPD) without restriction criteria for age, gender, or time on dialysis, were studied. Patients seropositive for HIV or hepatitis B, and those with cancer or receiving immunosuppressive drugs were excluded. Participants were studied as outpatients. Main Measures Blindly and in random order, 2.0-, 2.5-, and 3.0-L volumes of dialysate were infused consecutively. Body surface area (BSA) was calculated from patient height and weight. IPP was assessed with the patient lying supine, measuring the height of the dialysate column inside the peritoneal dialysis bag tubing. Blood pressure and subjective discomfort perception (using a visual analog scale of 0 – -100 mm) were also evaluated and registered after each of the three exchanges. Results The IPP rose with each increase of dialysate volume and was higher in males than in females for each fill volume level. For males IPP was 18.9 ± 6.9, 20.8 ± 7.1, and 22.9 ± 7.5 cm H2O; and for females it was 16.5 ± 5.7, 18.4 ± 5.5, and 19.7 ± 6.2 cm H2O for 2.0-, 2.5-, and 3.0-L fill volumes respectively ( p < 0.01 among fill volumes and between genders). Intraperitoneal pressure showed significant negative correlation with the fill volume corrected for patient body size as reflected by the dialysate volume/ BSA ratio ( r = –0.393, p < 0.01; r = 0.319, p < 0.01; and r = –0.274, p < 0.02 for 2.0-, 2.5-, and 3.0-L fill volumes respectively). Discomfort score rose as fill volume rose, with a median of 0, 2.5, and 13.0 for 2.0-, 2.5-, and 3.0-L fill volumes respectively ( p < 0.001). It is interesting, however, that with 2.5-L and 3.0-L dialysate infusion volumes, 64% and 44% of the patients, respectively, had no discomfort at all. Conclusion Dialysate volume increase is associated with higher IPP, which is modulated by the gender and body size of the patients. Although the mean discomfort score was higher with larger dialysate volumes, there was no significant correlation between discomfort and IPP or the dialysate volume/BSA ratio. Many patients had no discomfort with 2.5-L or even with 3.0-L dialysate infusions; theoretically, they can be treated with larger volumes.