bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal Spinous‐Splitting Laminoplasty with Coral Bone for the Treatment of Cervical Adjacent Segment Degenerative Disease: A 5‐Year Follow‐up Study
Authors: He Wei , He Da , Wang Qi‐long , Tian Wei , Liu Bo , Liu Ya‐jun , Sun Yu‐qing , Xing Yong‐gang , Yuan Ning , Yuan Qiang , Xiao Bin , Han Bing , Wang Yu‐mei , Ma Teng‐fei , Liu Ming‐ming 
Published: December 2021

This study was designed to analyze the causes of cervical adjacent segment degenerative disease (ASDis), evaluate the surgical outcomes of longitudinal spinous‐splitting laminoplasty with coral bone (SLAC) during cervical reoperation, and accumulate data on reoperation with SLAC in a primary hospital. Based on the inclusion and exclusion criteria, we conducted a retrospective study involving 52 patients who underwent cervical reoperation for ASDis using SLAC at the spinal surgery department of the Beijing Jishuitan Hospital from 1998 to 2014. Among them, 39 were treated with anterior cervical fusion and internal fixation during the first operation (anterior cervical corpectomy with fusion [ACCF], n = 24; anterior cervical discectomy and fusion [ACDF], n = 11; and cervical disc arthroplasty [CDA], n = 4). Outcomes were the Japanese Orthopaedic Association (JOA) score, neck disability index (NDI) score, upper limb/neck and shoulder evaluated using a visual analogue scale (VAS), and rates of ASDis. In patients who underwent an anterior cervical approach in the first instance, the incidence of ASDis was significantly higher in the C3/4 gap than in the other gaps. In the ACCF group, the lateral radiograph of the cervical spine revealed that the distance between the anterior cervical plate and the adjacent segment disc was <5 mm in 15 (62.5%) cases and five (12.8%) cases, respectively, the internal fixation screws broke into the annulus of the adjacent segment. After the first SLAC, ASDis developed at C2/3 and C3/4 in four (30.8%) and eight (61.5%) cases, respectively. After reoperation, all cases were followed up for >5 (average, 6.2) years. The pre‐reoperation and last follow‐up values were as follows: mean Japanese Orthopaedic Association score, 10.2 ± 1.5 vs 15.5 ± 0.7 (P = 0.03); neck disability index, 26.2 vs 13.6 points (P = 0.01); upper‐limb visual analog scale (VAS) score, 6.1 vs 2.6 points (P = 0.04); and neck and shoulder VAS score, 6.6 vs 2.1 points (P = 0.03). SLAC is a simple technique in which the local anatomy is clearly visible and satisfactory clinical outcomes are obtained.
Statistical Inference of the Value Function for Reinforcement Learning in Infinite-Horizon Settings
Authors: Shi Chengchun , Zhang Sheng , Lu Wenbin , Song Rui 
Published: December 2021

AbstractReinforcement learning is a general technique that allows an agent to learn an optimal policy and interact with an environment in sequential decision-making problems. The goodness of a policy is measured by its value function starting from some initial state. The focus of this paper was to construct confidence intervals (CIs) for a policy’s value in infinite horizon settings where the number of decision points diverges to infinity. We propose to model the action-value state function (Q-function) associated with a policy based on series/sieve method to derive its confidence interval. When the target policy depends on the observed data as well, we propose a SequentiAl Value Evaluation (SAVE) method to recursively update the estimated policy and its value estimator. As long as either the number of trajectories or the number of decision points diverges to infinity, we show that the proposed CI achieves nominal coverage even in cases where the optimal policy is not unique. Simulation studies are conducted to back up our theoretical findings. We apply the proposed method to a dataset from mobile health studies and find that reinforcement learning algorithms could help improve patient’s health status. A Python implementation of the proposed procedure is available at https://github.com/shengzhang37/SAVE.
Real-Time Prediction of Severe Influenza Epidemics Using Extreme Value Statistics
Authors: Thomas Maud , Rootzén Holger 
Published: December 2021

AbstractEach year, seasonal influenza epidemics cause hundreds of thousands of deaths worldwide and put high loads on health care systems. A main concern for resource planning is the risk of exceptionally severe epidemics. Taking advantage of recent results on multivariate Generalized Pareto models in extreme value statistics we develop methods for real-time prediction of the risk that an ongoing influenza epidemic will be exceptionally severe and for real-time detection of anomalous epidemics and use them for prediction and detection of anomalies for influenza epidemics in France. Quality of predictions is assessed on observed and simulated data.
The best of both worlds – entering the nursing profession with support of a transition programme
Authors: Berglund Mia , Kjellsdotter Anna , Wills Joanne , Johansson Anita 
Published: December 2021

AbstractBackgroundTransition into clinical practice for newly graduated nurses is a difficult time, with high stress levels defined by a demanding period of personal and professional acclimatisation. Transitions are complicated and multi‐dimensional, and to understand this process, it is crucial to identify the factors that facilitate or stand in the way of a healthy transition.AimThe phenomenological study aimed to describe newly graduated nurses’ expectations of transitioning into the nursing profession at the start of a clinical nursing introduction programme, including education, supervision, and critical reflection with peers.MethodThe study was based on seven group interviews with newly graduated nurses. The interviews utilised open‐ended and follow‐up questions and were carried out as a dialogue to enable reflection on the phenomenon of interest. This was explored and illuminated using the reflective lifeworld research approach, based on phenomenological epistemology.Findings“Expectations of transition into the nursing profession via the Clinical Nursing Introduction Programme” is signified by an oscillating movement between uncertainty, security, challenge, and growth on the threshold of a new identity. The phenomenon is constituted by the courage to grow, responsibility and fear, belonging and vulnerability, and support and challenge.ConclusionTransitioning into the nursing profession via the Clinical Nursing Introduction Programme means having the best of both worlds. Newly graduated nurses have the opportunity to receive education and structured support at the same time as they work independently in clinical practice.
How Intrusive Are Accelerometers for Measuring Nonlinear Vibrations? A Case Study on a Compressor Blade Subjected to Vibro-Impact Dynamics
Authors: Woiwode Lukas , Müller Florian , Groß Johann , Scheel Maren , Krack Malte 
Published: December 2021

Abstract
A characteristic feature of nonlinear vibrations is the energy transfer among different parts or modes of a mechanical system. Moreover, nonlinear vibrations are often non-periodic, even at steady state. To analyze these phenomena experimentally, the vibration response must be measured at multiple locations in a time-synchronous way. For this task, piezoelectric accelerometers are by far the most popular technology. While the effect of attached sensors on linear vibration properties is well-known (mass loading in particular), the purpose of the present work is to assess their intrusiveness on nonlinear vibrations. To this end, we consider a compressor blade that undergoes impacts near the tip for sufficiently large vibrations. We consider two configurations, one in which five triaxial piezoelectric accelerometers are glued to the blade surface and one without sensors attached. In both configurations, the vibration response is measured using a multi-point laser Doppler vibrometer. In the linear case without impacts, the lowest-frequency bending mode merely sees the expected slight frequency shift due to mass loading. In the nonlinear vibro-impact case, unexpectedly, the near-resonant response to harmonic base excitation changes severely both quantitatively and qualitatively. In particular, pronounced strongly modulated responses and period doubling are observed only in the case without attached sensors. We conjecture that this is due to a considerable increase of damping, caused by the sensor cables, affecting mainly the higher-frequency modes.
Volcano distribution and tectonics: A planetoidic perspective
Authors: Cañón-Tapia* Edgardo 
Published: December 2021

ABSTRACT
Volcanic activity is ultimately controlled by processes that take place many kilometers beneath the surface of a planet. The deeper processes are unlikely to reach the surface without some degree of modification at shallower levels. Nevertheless, traces of those deeper processes may still be found when examining the final products at the surface. In this work, it is shown that it is possible to gain insights concerning the integrated contribution of deep structures through the study of the spatial distribution of volcanic vents at the surface. The method here described relies on the systematic use of increasing smoothing factors in Gaussian kernel estimations. The sequences of probability density functions thus generated are equivalent to images obtained with an increasing wavelength, which therefore have the power to penetrate deeper below the surface. Although the resolution of this method is much smaller than the resolution provided by seismic or other geophysical surveys, it has the advantages of ease of implementation, extremely low cost, and remote application. Thus, the reported method has great value as a first-order exploration tool to investigate the deep structure of a planet, and it can make important contributions to our understanding of the volcano-tectonic relationship, not only on Earth, but also across the various bodies of the solar system where volcanic activity has been documented.
Quantifying the growth of continental crust through crustal thickness and zircon Hf-O isotopic signatures: A case study from the southern Central Asian Orogenic Belt
Authors: Wang Yujian , Zhu Dicheng , Lin Chengfa , Hu Fangyang , Liu Jingao 
Published: December 2021

Abstract
Accretionary orogens function as major sites for the generation of continental crust, but the growth model of continental crust remains poorly constrained. The Central Asian Orogenic Belt, as one of the most important Phanerozoic accretionary orogens on Earth, has been the focus of debates regarding the proportion of juvenile crust present. Using published geochemical and zircon Hf-O isotopic data sets for three belts in the Eastern Tianshan terrane of the southern Central Asian Orogenic Belt, we first explore the variations in crustal thickness and isotopic composition in response to tectono-magmatic activity over time. Steady progression to radiogenic zircon Hf isotopic signatures associated with syn-collisional crustal thickening indicates enhanced input of mantle-derived material, which greatly contributes to the growth of the continental crust. Using the surface areas and relative increases in crustal thickness as the proxies for magma volumes, in conjunction with the calculated mantle fraction of the mixing flux, we then are able to determine that a volume of ~14–22% of juvenile crust formed in the southern Central Asian Orogenic Belt during the Phanerozoic. This study highlights the validity of using crustal thickness and zircon isotopic signatures of magmatic rocks to quantify the volume of juvenile crust in complex accretionary orogens. With reference to the crustal growth pattern in other accretionary orogens and the Nd-Hf isotopic record at the global scale, our work reconciles the rapid crustal growth in the accretionary orogens with its episodic generation pattern in the formation of global continental crust.
Case–control study on clinical characteristics of child and adolescent psychiatric outpatients with child-to-parent violence
Authors: Sasaki Yoshinori , Usami Masahide , Sasaki Shoko , Sunakawa Hikaru , Toguchi Yusuke , Tanese Shuichi , Saito Kiyoshi , Shinohara Rena , Kurokouchi Toshinari , Sugimoto Kaori , Hakoshima Yuki , Inazaki Kumi , Yoshimura Yuta , Mizumoto Yuki , Okada Takayuki 
Published: December 2021

ObjectivesTo the best of our knowledge, no case–control study on child and adolescent psychiatric outpatients has investigated the clinical characteristics of patients with child-to-parent violence (CPV). The current study aimed to evaluate the clinical characteristics of child and adolescent psychiatric patients with CPV.Setting and participantsThis research included child and adolescent psychiatric patients who were aged 10–15 years during their initial consultation. The participants were allocated to one of two groups: children with CPV (CPV group, n=109) and without CPV (non-CPV group, n=713).Outcome measuresThis study analysed data including age, sex, diagnostic classification of the primary diagnosis, antisocial behaviour, suicidal attempt or self-harm and refusal to attend school. Moreover, a history of abuse by parents was investigated. Psychological rating scales such as the Spence Children’s Anxiety Scale, Depression Self-Rating Scale for Children, Tokyo Autistic Behavior Scale, Attention-deficit/Hyperactivity Disorder-Rating Scale and Oppositional Defiant Behavior Inventory were used.ResultsOf 822 patients who sought consultation in our department, 109 (13.26%) were included in the CPV group during the first consultation. Compared with the non-CPV group, the CPV group had significantly higher proportions of patients who experienced physical abuse, psychological abuse and who witnessed violence between parents. Meanwhile, the proportion of patients with neurodevelopmental disorders was significantly higher in the CPV group than in the non-CPV group. Regarding developmental characteristics, impulsivity might be correlated with CPV. Moreover, violence and behavioural problems outside of home were associated with CPV.ConclusionsIn patients with CPV who sought consultation, the findings of the current study should be considered to understand invisible side and to facilitate the use of appropriate treatment approaches. However, a prospective study should be performed to investigate the causality between CPV and clinical characteristics.
What do people with lung cancer and stroke expect from patient navigation? A qualitative study in Germany
Authors: Fügemann Hella , Goerling Ute , Gödde Kathrin , Desch Anke Kristin , Müller-Nordhorn Jacqueline , Mauckisch Verena , Siegerink Bob , Rieckmann Nina , Holmberg Christine 
Published: December 2021

ObjectiveThis qualitative study investigated patients’ needs and wishes in relation to patient navigation.DesignA qualitative interview study was conducted. Participants were invited to take part in three in-depth interviews over a period of 6–12 months. Thematic analysis was used.SettingInterviewees were sought in the Berlin metropolitan area of Germany in academic university hospitals, in rehabilitation clinics and through self-help organisations.ParticipantsThe sample consisted of individuals diagnosed with lung cancer (n=20) or stroke (n=20).ResultsFrom the perspective of interviewees, patient navigators should function as consistent contact persons, present during the whole care trajectory. Their role would be to guide patients through an often confusing healthcare landscape, offering practical, advisory and emotional assistance corresponding to patients’ needs. The study shows that—independent of the disease—participants had similar expectations and needs regarding support from navigators.ConclusionFor chronic and complex diseases—as is the case with lung cancer and stroke—it appears less important for navigators to fulfil disease-specific tasks. Rather, they should ensure that patients’ more general needs, in relation to social, practical and emotional support, are met in a way that suits their individual wishes. Following these results, patient navigation programmes might be designed to include generic elements, which should then be adapted to the infrastructure in a particular healthcare region and to the particularities of a specific healthcare system.
Development and external validation of a dynamic nomogram for delayed cerebral ischaemia after aneurysmal subarachnoid hemorrhage: a study protocol for a multicentre retrospective cohort study
Authors: Hu Ping , Li Yuntao , Zhang Hongbo , Su Zhongzhou , Xu Shancai , Li Xuesong , Gao Xu , Liu Yangfan , Deng Gang , Xu Yang , Ye Liguo , Chen Qianxue 
Published: December 2021

IntroductionDelayed cerebral ischaemia (DCI) caused by aneurysmal subarachnoid haemorrhage (aSAH) is the most frequent complication and typically contributes to poor neurological outcome or deterioration of patients’ condition. Therefore, early accurate and effective prediction of DCI is urgently needed. This study aims to construct a dynamic nomogram for precisely calculating the risk of DCI in patients with aSAH. Internal validation of this tool is conducted using the training cohort, and independent external validation is completed by using other medical centre datasets.Methods and analysisThis study is a multicentre, retrospective, observational cohort study using data from patients with aSAH. The participants include all adult patients who received surgical treatment in neurosurgery of multiple medical centres from 1 September 2019 to 1 April 2021, including Renmin Hospital of Wuhan University, Huzhou Central Hospital, First Affiliated Hospital of Harbin Medical University, General Hospital of Northern Theatre Command and Affiliated Hospital of Panzhihua University. Clinical information is collected via the electronic medical record system, including demographic data, clinical state on admission and serum laboratory tests. Modified Fisher grade at admission, admission subarachnoid clot and cerebral oedema density, and residual postoperative subarachnoid clot density are determined using the electronic imagine record software. The primary outcome is DCI.Ethics and disseminationThis study protocol was reviewed and approved by the Medical Ethics Committee of Renmin Hospital of Wuhan University, which is the principal affiliation of this study (approval number: WDRM2021-K022). The other Ethics Committees, including Huzhou Central Hospital (approval number: 202108005–01), First Affiliated Hospital of Harbin Medical University (approval number: H202156), General Hospital of Northern Theater Command (approval number: Y2021060) and Affiliated Hospital of Panzhihua University (approval number: 202105002), also approved the protocol. The results of this research will be published in a peer-reviewed medical journal.Trial registration numberChiCTR2100044448.
Exploring two distinct gentamicin prescribing protocols in UK hospitals: a mixed-methods realist evaluation
Authors: Dyar Nadine , Mattick Karen , Bethune Rob 
Published: December 2021

ObjectivesGentamicin is the aminoglycoside antibiotic of choice in the UK. It has a narrow therapeutic index: underdosing results in inefficacy while overdosing is characterised by nephrotoxicity and ototoxicity. To improve patient safety, hospitals have protocols for the prescription of gentamicin, which vary in complexity and approach. This study aimed to explore two distinct protocols for prescribing gentamicin in hospital settings, in order to understand the mechanisms they trigger and the outcomes they achieve.SettingA mixed-methods realist evaluation explored gentamicin prescribing protocols in two hospital surgical admissions units in South West England between January and August 2018. Site 1 had a traditional, complex protocol, while site 2 took a simplified protocol.ParticipantsTesting the initial programme theory (IPT) involved semi-structured audio-recorded interviews of a volunteer sample of healthcare professionals (HCPs) involved in the prescribing and administering process, alongside a clinical audit reviewing accuracy of gentamicin prescribing.Outcome measuresThree sequential phases were used to identify factors in a successful protocol: IPT generation; testing; refinement of the IPT. The IPT was generated by literature search and analysis of existing protocols of sites 1 and 2. Refinement of the IPT synthesised the results of the quantitative and qualitative research to identify the key characteristics of a successful protocol.ResultsOne hundred gentamicin prescriptions were reviewed, with a mean accuracy of gentamicin prescribing at site 1 of 65.67% and at site 2 of 78.79% (p<0.01). Thirty HCPs were interviewed. Key contexts were identified including prescriptiveness, experience and availability of patient information. These triggered hidden mechanisms including uncertainty, fear, confidence and frustration leading to both intended outcomes but also unintended outcomes such as deviation from protocol and unnecessary gentamicin levels.ConclusionsA simplified prescribing protocol for gentamicin is better accepted by prescribers, leading to better adherence to protocol and more accurate prescribing.
Evidence-based recommendations for economic evaluations in spine surgery: study protocol for a Delphi consensus
Authors: Droeghaag Ruud , Schuermans Valérie N E , Hermans Sem M M , Smeets Anouk Y J M , Caelers Inge J M H , Hiligsmann Mickaël , van Hemert Wouter L W , Evers Silvia , van Santbrink Henk 
Published: December 2021

IntroductionConsidering the rising global healthcare expenses, economic evaluations are more important than ever. Even though the number of studies regarding costs and cost-effectiveness is increasing, the quality of these studies remains relatively low. This is mainly caused by abundant heterogeneity in methods used for determining, calculating and reporting cost data, despite current general guidelines for the conduct of economic evaluations. Disease-specific recommendations for the conduct of economic evaluations in the field of spine surgery, as complement to existing general guidelines, will ameliorate overall research quality, comparability and interpretability and thus, the overall quality. We aim to provide expert-based recommendations for the design, conduct, and reporting of economic evaluations in spine surgery.Methods and analysisA modified Delphi study will be conducted to formulate expert-based recommendations. The following steps will be taken:(1) The conduct of a systematic review to identify relevant publications and identify relevant authors. Formation of an expert group and a Delphi-panel. (2) Drafting of statements based on articles included in the systematic literature review. Validation of drafted statements by the expert group. Step 2 can be repeated up to three times, statements can be discarded and adjusted in these rounds. Statements with more than 75% agreement will be accepted as consensus statements. (3) Validation of statements by the Delphi-panel. (4) Final recommendations.Ethics and disseminationThe underlying work is based on existing literature and published data and does not include participation of patients, and thus does not require ethical review approval. The final recommendations are intended for (clinical) researchers in the field of cost-effectiveness in spine surgery. The Delphi method ensures that the final output reflects the opinions of international participants and gives insight in the adherence level to the recommendations. The aim is to reach uniformity in design, conduct and reporting of these studies, as is currently lacking. This will provide a solid basis to determine cost-effectiveness of spine surgeries and consequently aid to limit the rising healthcare costs. The findings of this study and the final recommendations will be disseminated in conferences and seminars and will be published in an international peer-reviewed journal.