bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimating extreme level ice and ridge thickness for offshore wind turbine design: Case study Kriegers Flak
Authors: Tikanmäki Maria , Heinonen Jaakko 
Published: October 2021

AbstractWhen designing offshore wind turbines in ice‐covered seas, site‐specific ice conditions present crucial input for the structural design. In this study, methods of estimating the maximum level ice thickness occurring once in 50 years and parameters of a design ice ridge in an area where no direct ice thickness measurements exists are presented. The site of Kriegers Flak at the Southern Baltic Sea is taken as a case study. Rather than just applying basic equations found from the standards, the method gives more detailed estimates by utilizing available ice chart information, ice reports and atlases together with measured air temperature data to estimate the starting and ending date of ice growth. The maximum level ice thickness occurring once in 50 years at the site of Kriegers Flak wind farm was estimated to be between 0.26 and 0.44 m depending on the assumptions. The effect of the studied history length, the utilized weather station and the use of snow thicknesses to the 50‐year ice thickness estimates are compared and discussed. Interaction with ice ridges was found to be a relevant but infrequent, load scenario for the site of Kriegers Flak. For this reason, a representative ridge for determining ice ridge loads is presented. The most important parameter in a ridge, the thickness of the consolidated layer, was found based on scenario analyses to be in a range between 0.43 and 0.67 m can be used to calculate ice loads against the wind turbine substructures.
Learning to isolate muons
Authors: Collado Julian , Bauer Kevin , Witkowski Edmund , Faucett Taylor , Whiteson Daniel , Baldi Pierre 
Published: October 2021

Abstract
Distinguishing between prompt muons produced in heavy boson decay and muons produced in association with heavy-flavor jet production is an important task in analysis of collider physics data. We explore whether there is information available in calorimeter deposits that is not captured by the standard approach of isolation cones. We find that convolutional networks and particle-flow networks accessing the calorimeter cells surpass the performance of isolation cones, suggesting that the radial energy distribution and the angular structure of the calorimeter deposits surrounding the muon contain unused discrimination power. We assemble a small set of high-level observables which summarize the calorimeter information and close the performance gap with networks which analyze the calorimeter cells directly. These observables are theoretically well-defined and can be studied with collider data.
Schwerverletztenversorgung durch Notärzte aus unterschiedlichen Fachgebieten
Authors: Gäßler Michael , Ruppert Matthias , Lefering Rolf , Bouillon Bertil , Wafaisade Arasch ,   TraumaRegister DGU
Published: October 2021

Zusammenfassung
Hintergrund und Ziel
Die S3-Leitlinie Polytrauma/Schwerverletzten-Behandlung stellt den definierten Rahmen für eine leitliniengerechte Erstversorgung des schwer verletzten Patienten dar. Mutmaßlich werden diagnostische und therapeutische Entscheidungsfindungen in der Präklinik durch die klinische Expertise aus dem Fachgebiet des Notarztes mitbeeinflusst.

Material und Methoden
Retrospektive, multizentrische Studie aus Daten der ADAC (Allgemeiner Deutscher Automobil-Club e. V.) Luftrettung und des TraumaRegister der Deutschen Gesellschaft für Unfallchirurgie®. Im Untersuchungszeitraum von 2011 bis 2015 konnten 11.019 schwer verletzte Patienten eingeschlossen und der Versorgung durch Notärzte aus den Fachgebieten Anästhesie (ANÄ), innere Medizin (INN) und Chirurgie (CHIR) zugeordnet werden.

Ergebnisse
Durch ANÄ wurden 81,9 %, durch INN 7,6 % und durch CHIR 10,5 % versorgt. Präklinisch wurden 40,5 % der Patienten intubiert (ANÄ 43,0 %, INN 31,2 %, CHIR 28,3 %; p < 0,001), 5,5 % haben eine Thoraxdrainage (ANÄ 5,9 %, INN 4,2 %, CHIR 2,8 %; p = 0,004) und 10,8 % eine Katecholamintherapie erhalten (ANÄ 11,3 %, INN 8,3 %, CHIR 8,3 %; p = 0,022). Bewusstlose Patienten wurden in 96,0 % intubiert (ANÄ 96,1 %, INN 97,7 %, CHIR 93,9 %; p = 0,205). Die Mortalität wurde nicht durch die fachliche Herkunft des Notarztes beeinflusst.

Diskussion
In diesem Kollektiv aus dem Bereich der Luftrettung zeigten sich in den Gruppen Unterschiede bei der Indikationsstellung zu invasiven Maßnahmen, die möglicherweise durch die jeweilige klinische Expertise bedingt sind. Am Beispiel der Intubation konnte gezeigt werden, dass Leitlinienempfehlungen in hohem Maße – unabhängig von der Fachgebietszugehörigkeit des Notarztes – umgesetzt werden.
Predictors of Left Ventricular Outflow Tract Obstruction After Conventional Repair for Patients with Interrupted Aortic Arch or Coarctation of the Aorta, Combined with Ventricular Septal Defect: A Single-Center Experience
Authors: Szaflik Katarzyna , Goreczny Sebastian , Ostrowska Katarzyna , Kazmierczak Piotr , Moll Maciej , Moll Jadwiga A. 
Published: October 2021

AbstractLeft ventricular outflow tract obstruction (LVOTO) affects survival and reoperation rates after surgical treatment of patients with interruption of the aortic arch (IAA) or coarctation of the aorta (CoA) with ventricular septal defect (VSD). The aim of the study was to determine predictors of LVOTO and to evaluate the relationship between aortic valve (AoV) morphology and the re-intervention rate. Retrospective review of patients, who underwent a conventional repair for IAA/CoA with VSD at a tertiary referral center between 1996 and 2017. The preoperative demographic data as well as pre- and post-operative echocardiographic parameters and re-interventions were reviewed. In the median follow-up of 8.3 years (range of 6.15–10.27) 5 patients (11.9%) from a total of 47 patients included in the study presented with a significant LVOTO. Four of them required reoperation after median period of 2.3 years (range of 0.3–7.9) after the initial surgery. Multivariable logistic regression identified AoV z-score (OR 0.44, p = 0.017) as predictor of LVOTO. The mean AoV z-score before the primary repair was significantly smaller in those with LVOTO as compared to those with unobstructed flow from the LV (− 3.58 ± 1.96 vs. − 1.44 ± 1.55; p = 0.0016). At 1-year follow-up, both groups showed an increase in the AoV z-score (p = 0.98). The re-intervention rate after primary repair (both surgical procedures and percutaneous interventions), either for LVOTO or reCoA, was higher in patients with AoV z-score ≤  − 3 (p = 0.007 vs. p = 0.46) and those, whose aortic annulus was less or equal than patient’s weight (kg) + 1.5 mm as compared to those with larger aortic annulus (p = 0.03 vs. p = 0.16). In patients after surgical treatment of IAA/CoA with VSD, the AoV z-score at diagnosis is a significant risk factor for reoperation for LVOTO. With age, AoV growth and z-score improvement is expected. Small AoV at diagnosis is correlated with increased rate of re-intervention for LVOTO and reCoA.
Innate immune genes of the chicken MHC and related regions
Authors: Kaufman Jim 
Published: October 2021

AbstractCompared to the major histocompatibility complex (MHC) of typical mammals, the chicken BF/BL region is small and simple, with most of the genes playing central roles in the adaptive immune response. However, some genes of the chicken MHC are almost certainly involved in innate immunity, such as the complement component C4 and the lectin-like receptor/ligand gene pair BNK and Blec. The poorly expressed classical class I molecule BF1 is known to be recognised by natural killer (NK) cells and, analogous to mammalian immune responses, the classical class I molecules BF1 and BF2, the CD1 homologs and the butyrophilin homologs called BG may be recognised by adaptive immune lymphocytes with semi-invariant receptors in a so-called adaptate manner. Moreover, the TRIM and BG regions next to the chicken MHC, along with the genetically unlinked Y and olfactory/scavenger receptor regions on the same chromosome, have multigene families almost certainly involved in innate and adaptate responses. On this chicken microchromosome, the simplicity of the adaptive immune gene systems contrasts with the complexity of the gene systems potentially involved in innate immunity.
Reproducibility of Novel Soft-Tissue Landmarks on Three-Dimensional Human Facial Scan Images in Caucasian and Asian
Authors: Li Zhouxiao , Giunta Riccardo Enzo , Frank Konstantin , Schenck Thilo Ludwig , Koban Konstantin Christoph 
Published: October 2021

Abstract
Background
Three-dimensional surface imaging is established in many disciplines for objective facial acquisition regarding anthropometry. Former studies addressed the validation of landmark-based measurements for single race. In order to distinguish racial difference, the reproducibility of the landmark measurements must first be validated.

Objectives
Our purpose is to validate the reproducibility of 46 facial soft-tissue landmarks on x, y, z axes to prove their reliability as 3D reference points.

Methods
The study included 80 European Caucasian and 80 Chinese volunteers. Standardized 3D surface imaging was performed using Vectra 3D system. Two raters identified and defined 46 landmarks (138 coordinates), then repeatedly 3D-imaged volunteers' facial region in separate sessions. Coordinates' reproducibility of landmarks is divided into three categories (< 0.5 mm, < 1 mm, and >1 mm) for intra- and inter-rater reproducibility assessments.

Results
Coordinates' reproducibility of 160 samples was distributed as follows: Intra-rater: < 0.5 mm (45%), < 1 mm (42%), >1 mm (13%); inter-rater: < 0.5 mm (31.2%), < 1 mm (42%), > 1 mm (26.8%). The reproducibility of landmarks in nasal tip region differs slightly between Caucasians and Asians. Compared to females, males typically have higher landmark reproducibility in lip and chin region. However, there were no differences in the reproducibility ranking of landmarks by gender.

Conclusion
The majority of the 46 landmarks in the 3D plane are reproducible to 1 mm, which is clinically acceptable. All selected landmarks showed strong consistency across race and gender, suggesting their potential use as reference points in prospective clinical practice.

Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Indigenous Influence and Engagement in Mining Permitting in British Columbia, Canada: Lessons for Sweden and Norway?
Authors: Allard Christina , Curran Deborah 
Published: October 2021

AbstractMine developments in Indigenous territories risk disrupting Indigenous cultures and their economies, including spiraling already high levels of conflict. This is the situation in Canada, Sweden, and Norway, as elsewhere, and is fostered by current state legal framework that reflect historical trajectories, although circumstances are gradually changing. Promising institutional changes have taken place in British Columbia (BC), Canada, with respect to new legislative reforms. Notably, new legislation from 2019 intends to implement the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) in the province, by promoting consent-based and collaborative decision-making mechanisms. New environmental assessment legislation is another example; this legislation includes early engagement, collaborative decision-making, and Indigenous-led assessments. The article’s aim is, first, to analyze how Indigenous communities can influence and engage in the mining permitting system of BC, and, secondly, to highlight the positive features of the BC system using a comparative lens to identify opportunities for Sweden and Norway regarding mining permitting and Indigenous rights. Applying a legal-scientific and comparative analysis, the article analyzes traditional legal sources. The article concludes that the strong points that the BC regime could offer the two Nordic countries are: the concept of reconciliation, incorporation of UNDRIP, the spectrum of consultation and engagement approaches, and the structure of environmental assessments. All three jurisdictions, however, struggle with balancing mine developments and securing Indigenous authority and influence over land uses in their traditional territories.
Burnout Among Surgeons in the UK During the COVID‐19 Pandemic: A Cohort Study
Authors: Houdmont Jonathan , Daliya Prita , Theophilidou Elena , Adiamah Alfred , Hassard Juliet , Lobo Dileep N. ,   the East Midlands Surgical Academic Network (EMSAN) Burnout Study Group, Ahmed Jamil , Babu Victor , Baker Daryll , Bartlett David , Beckingham Ian , Bhatti Imran , Brooks Adam , Brown Steven , Burke Josh , Byrne Hannah , Chetter Ian , Cook Hannah , Coulston James , Cruddas Lucinda , Dias Richard , Dor Frank , Dube Mukul , Grant Katherine , Hammond John , Hargest Rachel , Joachim Theophilus , Joseph Annie , Kara Naveed , Karavias Dimitrios , Kotecha Sita , Kushairi Anisa , Lal Roshan , Lam Kit , Lasrado Irwin , Lee Rachel , Mann Gurminder , Mannu George , Maxwell‐Armstrong Charles , McCaslin James , McDermot Frank , Miller Andrew , Miller Sarah , Morgan Jenna , Nandhra Sandip , Narayanasamy Sangara , O'Brien Patrick , Parry Laura , Peters Kizzie , Pitsika Marina , Psaltis Emmanouil , Sargen Kevin , Sarmah Panchali , Shyamsundar Murali , Reddy Chinnappa , Rollins Katie , Roslan Farah , Shalhoub Joseph , Stanislas Matt , Tan Benjamin , Tewari Nilanjana , Thomas Pradeep , Thomas Tony , Tiernan Jim , Toogood Giles , Trimble Karl , Vauhan Peter , Wheldon Luke , White Steven , White Tim , Wijetunga Imeshi , Wilson Michael , Winterborn Rebecca , Wyld Lynda , Young Lora 
Published: October 2021

AbstractBackgroundSurgeon burnout has implications for patient safety and workforce sustainability. The aim of this study was to establish the prevalence of burnout among surgeons in the UK during the COVID‐19 pandemic.MethodsThis cross‐sectional online survey was set in the UK National Health Service and involved 601 surgeons across the UK of all specialities and grades. Participants completed the Maslach Burnout Inventory and a bespoke questionnaire. Outcome measures included emotional exhaustion, depersonalisation and low personal accomplishment, as measured by the Maslach Burnout Inventory‐Human Services Survey (MBI‐HSS).ResultsA total of 142 surgeons reported having contracted COVID‐19. Burnout prevalence was particularly high in the emotional exhaustion (57%) and depersonalisation (50%) domains, while lower on the low personal accomplishment domain (15%). Burnout prevalence was unrelated to COVID‐19 status; however, the greater the perceived impact of COVID‐19 on work, the higher the prevalence of emotional exhaustion and depersonalisation. Degree of worry about contracting COVID‐19 oneself and degree of worry about family and friends contacting COVID‐19 was positively associated with prevalence on all three burnout domains. Across all three domains, burnout prevalence was exceptionally high in the Core Trainee 1–2 and Specialty Trainee 1–2 grades.ConclusionsThese findings highlight potential undesirable implications for patient safety arising from surgeon burnout. Moreover, there is a need for ongoing monitoring in addition to an enhanced focus on mental health self‐care in surgeon training and the provision of accessible and confidential support for practising surgeons.
Evaluation of the absolute oral bioavailability of the anaplastic lymphoma kinase/c-ROS oncogene 1 kinase inhibitor lorlatinib in healthy participants
Authors: Hibma Jennifer E. , O’Gorman Melissa , Nepal Sunil , Pawlak Sylvester , Ginman Katherine , Pithavala Yazdi K. 
Published: October 2021

Abstract
Purpose
Lorlatinib is a third-generation tyrosine kinase inhibitor currently approved for the treatment of anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer. This open-label, phase 1, randomized two-sequence, two-treatment, two-period, crossover study investigated the absolute oral bioavailability of lorlatinib in healthy participants.

Methods
Eligible participants were randomized to receive two treatments in one of two sequences: lorlatinib 100 mg single oral dose followed by lorlatinib 50 mg intravenous (IV) dose, or lorlatinib IV dose followed by lorlatinib oral dose, each with at least a 10-day washout between successive lorlatinib doses. Blood samples for pharmacokinetics were collected for up to 144 hours (h) after dosing. Validated liquid chromatographic-tandem mass spectrometry was used to determine plasma concentrations of lorlatinib and its benzoic acid metabolite PF-06895751.

Results
In total, 11 participants were enrolled (mean age 37.6 years, all male). The adjusted geometric mean (90% confidence interval) for the absolute oral bioavailability was 80.78% (75.73–86.16%). Using non-compartmental analysis, the estimated arithmetic mean elimination plasma half-life of lorlatinib was 25.5 and 27.0 h after the oral and IV doses, respectively. No deaths, serious adverse events (AEs), or severe AEs were reported, and most treatment-emergent AEs were mild in severity, with two events of transaminase increase of moderate severity. All treatment-emergent AEs were resolved by the end of the study.

Conclusion
Both oral and IV lorlatinib were well-tolerated in healthy participants and oral lorlatinib is highly bioavailable after oral administration.
Spatial distribution of cerebral microbleeds reveals heterogeneous pathogenesis in CADASIL
Authors: Chen Ya-Fang , Chen Chih-Hao , Wu Wen-Chau , Lee Bo-Ching , Tsai Hsin-Hsi , Tang Sung-Chun 
Published: October 2021

AbstractObjectivesRadiological diagnosis of subtypes of cerebral small vessel diseases remains challenging. This study aimed to explore the spatial distribution of cerebral microbleeds (CMBs) in cerebral autosomal dominant arteriopathy with subcortical infarct and leukoencephalopathy (CADASIL) in contrast to cerebral amyloid angiopathy (CAA) in the lobar regions.MethodsThirty-two patients with CADASIL and 33 patients with probable CAA were prospectively and consecutively included. On 3-Tesla susceptibility-weighted magnetic resonance images, CMBs were analyzed for incidence and volume within atlas-based regions of interest, followed by voxel-wise analysis using risk mapping. The distribution of CMBs was correlated with the status of hypertension. Correlation and group differences with ap-value less than 0.05 were considered to be significant.ResultsAs compared with the CAA group, the CADASIL group presents a larger CMB volume in hippocampus/amygdala and white matter (nonparametric analysis of covariance,p = 0.014 and 0.037, respectively), a smaller CMB volume in parietal lobe (p = 0.038), and a higher incidence in hippocampus/amygdala, white matter, and insula (logistic regression,p = 0.019, 0.024, and 0.30, respectively). As part of the exclusion criteria of probable CAA, thalamus, basal ganglia, and pons exhibit greater CMB volume/incidence in the CADASIL group. In CADASIL patients, hot spots of CMBs are identified in the putamen and posteromedial thalamus; hypertension is associated with larger CMB volumes in insula, basal ganglia, and pons.ConclusionsThe spatial distribution of CMBs is differentiable between CADASIL and CAA in lobar regions. In CADASIL patients, hypertension has a region-dependent mediating effect on the CMB volume.Key Points•The topological distribution of lobar CMBs is differentiable between CADASIL and CAA.•In CADASIL patients, hypertension mediates CMB volume and the mediation is region dependent.•CMB risk mapping allows for voxel-wise exploration of CMB distribution and reveals hot spots in the putamen and posteromedial thalamus in CADASIL.
A novel augmented reality-based surgical guidance system for total knee arthroplasty
Authors: Fucentese Sandro F. , Koch Peter P. 
Published: October 2021

Abstract
Introduction
Many of the functional complications that arise after total knee arthroplasty (TKA) are caused by a non-optimal balance of the knee after surgery. Over the past 20 years, technology has been used in the Operating Room (OR) to help improve precision and balance. The results of Computer-Assisted Surgery (CAS) and robotic systems show improved accuracy regarding implant positioning but a relatively small improvement in patient-reported outcomes and implant survival compared to conventional TKA. Recently, Augmented Reality (AR) has been proposed as a technology that could improve accuracy in orthopaedic surgery, providing a more efficient and cost-effective solution.

Materials and methods
This article describes a novel AR-based surgical guidance system that measures intra-operatively the effect of prosthesis alignment and positioning on soft tissue balance. The system is integrated in a pair of smart glasses and two small sensors and displays surgical targets directly in the field of view of the surgeon.

Results
The system has been used in a limited number of cases. While the preliminary experience has been positive, clinical research is ongoing to confirm to confirm the performance of the system and the impact on clinical outcomes.

Conclusion
Augmented Reality can be a valuable tool to improve accuracy in TKA. The use of smart glasses and integrated sensors improves the efficiency of the procedure, particularly when coupled with single-use instrumentation. A novel protocol for soft tissue assessment allows for a 3-dimensional evaluation of the ligaments and a better measurement of the effect of tibial rotation.
Nonradiation-to-endoscopist ERCP is non-inferior to standard ERCP
Authors: Zeng Wei , Hu Jie , Pan Yanglin , Zhang Mingqing , Xu Li 
Published: October 2021

Abstract
Background
Radiation exposure is inherently involved in endoscopic retrograde cholangiopancreatography (ERCP), which could cause radiation-induced injury to endoscopists with long-term exposure. Nonradiation ERCP has been applied to pregnant patients. Conceivably, the same techniques could be used to benefit endoscopists. This study was designed to evaluate the effectiveness and safety of nonradiation-to-endoscopist (NRE) ERCP, compared with standard ERCP.

Methods
A retrospective, single-center study was conducted from August 2010 to December 2015. Patients aged 18–90 years and with choledocholithiasis (< 15 mm) or distal biliary stricture were eligible. Pre-ERCP evaluation with magnetic resonance cholangiopancreatography was mandatory. To overcome selection bias, we performed 1:2 match using propensity score matching (PSM) between NRE and standard groups. The primary endpoint was overall ERCP success rate. Secondary endpoints were cannulation success rate, stone clearance rate, complication rate, and duration of hospitalization.

Results
A total of 329 patients met inclusion criteria. After PSM, 73 patients were included in the NRE group and 146 in the standard group. The ERCP overall success rate for NRE and standard groups was equivalent (94.5% vs. 93.2%, P = 0.70). There was no difference in cannulation success rates between the two groups (95.6% vs. 97.8%, P = 0.39). A total of 88.3% of patients in the NRE group and 93.9% of patients in the standard group had stones cleared at initial ERCP (P = 0.57). No difference in overall stone clearance rate between the two groups (95.0% vs. 93.9%, P = 0.77) was found after second ERCP. The complication rate (1.4% vs. 1.4%, P = 1.00) and hospital duration (8.3 ± 5.1 vs. 10.2 ± 8.8 days, P = 0.07) were not different between the two groups.

Conclusion
Although technically demanding, NRE-ERCP is both safe and feasible in selected patients compared with standard ERCP.