bluuebunny/crossref_metadata_2025_split huggingface dataset:
Behavior of glulam timber beam strengthened with carbon fiber reinforced polymer strip for flexural loading
Authors: İşleyen Ümmü K , Ghoroubi Rahim , Mercimek Ömer , Anil Özgür , Erdem Recep Tuğrul 
Published: April 2021

In the last 20 years, the use of wooden structures and their dimensions have gradually increased. The wood application has increased in different structures such as multistory buildings, sports, industrial facilities, road and railway bridges, power transmission lines, and towers. The widespread use and size of wood structures have increased the research on developing special types of wood products supported by composite materials. Laminated wood elements are the leading composite wood materials. Laminated wooden beams allow making much larger openings than standard solid wood structural elements. The development of the sizes and usage areas of wooden structures has increased the capacity of glulam structural elements and reveals the need to improve their performance. Carbon fiber reinforced polymers (CFRPs) are the most suitable options for increasing the bearing capacity values of glulam beams and improving general load–displacement behaviors. In this study, the use of CFRP strips in different layouts to increase glulam wooden beams and the application of CFRP fan-type anchors in the CFRP strip endpoints are the studied variables. Anchored and non-anchored glulam wooden beams reinforced with CFRP strips with different layouts were tested using a three-point bending test. The ultimate load capacity, initial stiffness, displacement ductility ratio, energy dissipation capacity, failure mechanisms, and general load–displacement behavior of wooden beam test specimens were obtained and interpreted as a result of the experiments.
Uncoupled bone remodeling is characteristic of bone damage in premenopausal women with new-onset systemic lupus erythematosus
Authors: Zhu Li , Zhang Jing , wang Jing , Lv Xiaohong , Pu Dan , Wang Yanhua , Men Qian , He Lan 
Published: April 2021

Objective To investigate the mechanism underlying systemic lupus erythematosus (SLE)-related bone loss by evaluating the bone mineral density (BMD) and bone turnover markers (BTMs) in premenopausal patients with new-onset SLE without any treatment. Methods BMD and BTMs of 106 premenopausal patients with new-onset SLE and 64 gender-, age- and body mass index (BMI)-matched healthy controls were analyzed. BMD was determined using dual energy X-ray absorptiometry (DXA). Serum BTMs were measured. Results Hip and lumbar spine BMD in premenopausal patients with new-onset SLE was significantly decreased compared with healthy controls. Higher rate of osteoporosis was observed in new-onset SLE patients (25% vs. 1%). Moreover, uncoupled bone remodeling evidenced by an increase in bone resorption marker β-CTX (685.9 ± 709.6 pg/mL vs. 395.4 ± 326.0 pg/mL, P < 0.05) and decrease in bone formation markers PINP (37.4 ± 33.0 ng/mL vs. 46.1 ± 20.9 ng/mL, P < 0.05) and OC (11.4 ± 9.8 ng/mL vs. 18.2 ± 8.6 ng/mL, P < 0.05) was observed in premenopausal patients with new-onset SLE compared with healthy controls. Univariate correlation analyses showed negative correlations between OC and SLE Disease Activity Index (SLEDAI), and positive correlations between β-CTX and SLEDAI. SLE patients positive for dsDNA, nucleosome showed lower OC and higher β-CTX. Conclusion Premenopausal patients with new-onset SLE had decreased BMD and abnormal bone metabolism with increased β-CTX and decreased OC and P1NP levels, indicating uncoupled bone remodeling in new-onset SLE patients. Disease activity and abnormal immunity, especially the amount of antibodies in SLE patients, were strongly associated with abnormality of bone metabolism.
Paclitaxel-Coated Balloons for the Treatment of Symptomatic Central Venous Stenosis in Vascular Access: Results From a European, Multicenter, Single-Arm Retrospective Analysis
Authors: Kitrou Panagiotis M. , Steinke Tobias , El Hage Rami , Ponce Pedro , Lucatelli Pierleone , Katsanos Konstantinos , Spiliopoulos Stavros , Spinelli Alessio , Bisdas Theodosios , Stavroulakis Konstantinos , Jaffer Ounali , Mallios Alexandros , Zilahi de Gyurgyokai Simone , Cancellieri Roberto , Coscas Raphael , Karnabatidis Dimitrios 
Published: April 2021

Introduction: This was a European, multicenter, investigator-initiated and run, single-arm retrospective analysis to assess the safety and the clinical benefit of the use of paclitaxel-coated balloon (PCB) for the treatment of symptomatic central venous stenosis (CVS). Materials and Methods: Eleven centers from 7 countries across Europe, submitted 86 cases performed during the period between October 2015 and June 2018. Minimum follow-up was 6 months. Patient baseline demographics and procedural details were collected. Mean age was 62.6 years (SD 15.2 years). Median vascular access age was 3.0 years (IQR 1.2–4.8 years). A total of 55 were arteriovenous fistulas (64%) the rest arteriovenous grafts (31/86, 36%). Vessels treated were 43 subclavian veins, 42 brachiocephalic veins and 1 superior vena cava. Median drug-coated balloon diameter was 10 mm (IQR 8–12 mm). Primary outcome measures were clinically assessed intervention-free period (IFP) of the treated segment at 6 months and procedure-related minor and major complications. Secondary outcome measures included access circuit survival, patient survival, and the investigation of independent factors that influence the IFP. Results: IFP was 62.7% at 6 months. Median patient follow-up time was 1.0 year (IQR 0.5–2.2 years). There was 1 minor complication (1/86; 1.2%) and no major complications. Access circuit survival was 87.7% at 6 months. Patient survival was 79.7% at 2 years according to Kaplan-Meier survival analysis. Higher balloon diameters significantly favored IFP [HR 0.71 (0.55–0.92), p=0.006; 5–7 mm group vs 8–12 mm group, p=0.025]. Conclusion: In this analysis, use of PCBs for the treatment of symptomatic CVS was safe. Efficacy was comparable to previous trials. Increased balloon size had a significant effect on patency rates.
Preoperative Physical Activity Predicts Surgical Outcomes Following Lung Cancer Resection
Authors: Billé Andrea , Buxton James , Viviano Alessandro , Gammon David , Veres Lukacs , Routledge Tom , Harrison-Phipps Karen , Dixon Allison , Minetto Marco A. 
Published: April 2021

Objectives: To assess whether preoperative levels of physical activity predict the incidence of post-operative complications following anatomical lung resection. Methods: Levels of physical activity (daily steps) were measured for 15 consecutive days using pedometers in 90 consecutive patients (prior to admission). Outcomes measured were cardiac and respiratory complications, length of stay, and 30-day re-admission rate. Results: A total of 78 patients’ datasets were analysed (12 patients were excluded due to non-compliance). Based on steps performed they were divided into quartiles; 1 (low physical activity) to 4 (high physical activity). There were no significant differences in age, smoking history, COPD, BMI, percentage predicted FEV1 and KCO and cardiovascular risk factors between the groups. There were significantly fewer total complications in quartiles 3 and 4 (high physical activity) compared to quartiles 1 and 2 (low physical activity) (8 vs 22; P = .01). There was a trend ( P > .05) towards shorter hospital length of stay in quartiles 3 and 4 (median values of 4 and 5 days, respectively) compared to quartiles 1 and 2 (6 days for both groups). Conclusions: Preoperative physical activity can help to predict postoperative outcome and can be used to stratify risk of postoperative complications and to monitor impact of preoperative interventions, ultimately improving short term outcomes.
Clinical Outcomes and Complications of Primary Fingertip Reconstruction Using a Reverse Homodigital Island Flap: A Systematic Review
Authors: Xu Joshua , Cao Jacob Y. , Graham David J. , Lawson Richard D. , Sivakumar Brahman S. 
Published: April 2021

Background Reverse homodigital island flaps (RHIFs) are increasingly used to reconstruct traumatic fingertip injuries, but there is limited evidence on the efficacy of this technique. We performed a systematic review of the literature to establish the safety and functional outcomes of RHIF for traumatic fingertip injuries. Methods Electronic searches were performed using 3 databases (PubMed, Ovid Medline, Cochrane CENTRAL) from their date of inception to April 2020. Relevant studies were required to report on complications and functional outcomes for patients undergoing RHIF for primary fingertip reconstruction. Data were extracted from included studies and analyzed. Results Sixteen studies were included, which produced a total cohort of 459 patients with 495 fingertip injuries. The index and middle fingers were involved most frequently (34.6% and 34.1%, respectively), followed by the ring finger (22%), the little finger (6.7%), and the thumb (2.6%). The mean postoperative static and moving 2-point discrimination was 7.2 and 6.7 mm, respectively. The mean time to return to work was 8.4 weeks. The mean survivorship was 98.4%, with the pooled complication rate being 28%. The pooled complication rate of complete flap necrosis was 3.6%, of partial flap necrosis was 10.3%, of venous congestion was 14.6%, of pain or hypersensitivity was 11.5%, of wound infection was 7.2%, of flexion contractures was 6.3%, and of cold intolerance was 17.7%. Conclusions Reverse homodigital island flaps can be performed safely with excellent outcomes. To minimize complications, care is taken during dissection and insetting, with extensive rehabilitation adhered to postoperatively. Prospective studies assessing outcomes of RHIF compared with other reconstruction techniques would be beneficial.
WALANT Technique versus Sedation for Endoscopic Carpal Tunnel Release
Authors: Wellington Ian , Cusano Antonio , Ferreira Joel V. , Parrino Anthony 
Published: April 2021

Background This study sought to investigate complication rates/perioperative metrics after endoscopic carpal tunnel release (eCTR) via wide-awake, local anesthesia, no tourniquet (WALANT) versus sedation or local anesthesia with a tourniquet. Methods Patients aged 18 years or older who underwent an eCTR between April 28, 2018, and December 31, 2019, by 1 of 2 fellowship-trained surgeons at our single institution were retrospectively reviewed. Patients were divided into 3 groups: monitored anesthesia care with tourniquet (MT), local anesthesia with tourniquet (LT), and WALANT. Results Inclusion criteria were met by 156 cases; 53 (34%) were performed under MT, 25 (16%) under LT, and 78 (50%) under WALANT. The MT group (46.1 ± 9.7) was statistically younger compared with LT (56.3 ± 14.1, P = .007) and WALANT groups (53.5 ± 15.8, P = .008), F(2, 153) = 6.465, P = .002. Wide-awake, local anesthesia, no tourniquet had decreased procedural times (10 minutes, SD: 2) compared with MT (11 minutes, SD: 2) and LT (11 minutes, SD: 2), F(2, 153) = 5.732, P = .004). Trends favored WALANT over MT and LT for average operating room time (20 minutes, SD: 3 vs 32 minutes, SD: 6 vs 23 minutes, SD: 3, respectively, F(2, 153) = 101.1, P < .001), postanesthesia care unit time (12 minutes, SD: 7 vs 1:12 minutes, SD: 26 vs 20 minutes, SD: 22, respectively, F(2, 153) =171.1, P < .001), and door-to-door time (1:37 minutes, SD: 21 vs 2:51 minutes, SD: 40 vs 1:46 minutes, SD: 33, respectively, F(2, 153) = 109.3, P < .001). There were no differences in complication rates. Conclusions Our data suggest favorable trends for patients undergoing eCTR via WALANT versus MT versus LT.
Threaded Intramedullary Nails Are Biomechanically Superior to Crossed K-wires for Metacarpal Neck Fractures
Authors: Patel Midhat , Castañeda Paulo , Campbell David H. , Putnam Jill G. , McKee Michael D. 
Published: April 2021

Background Intramedullary nail (IMN) fixation of metacarpal fractures is an alternative to Kirschner wire (K-wire) fixation. The goal of this study was to compare the biomechanical properties of K-wire fixation with a threaded IMN (InNate; ExsoMed, Aliso Viejo, California). Methods The study design was based on previously described biomechanical models for evaluating metacarpal fractures. Sixteen fresh frozen small finger–matched and ring finger–matched pairs were randomized to either IMN or 0.045 in K-wire fixation after receiving a standardized neck osteotomy. Proper implant placement was confirmed with plain radiographs. Specimens then underwent loading in a 3-point bend configuration. Load to failure (LTF), stiffness, and fracture displacement were recorded. Mechanical failure was defined by a sharp change in the load-displacement curve. Results Age, sex, sidedness (left or right), and digit (ring or small finger) were evenly distributed between groups. The IMN had a significantly higher LTF than K-wires (546 N vs 154 N, P < .001). The K-wire fixation demonstrated plastic deformation between 75 and 150 N. Intramedullary nail stiffness was higher than that of K-wires (155.89 N/mm vs 59.28 N/mm, P < .001). Conclusions When surgical fixation is indicated for metacarpal neck and shaft fractures, the threaded IMN is biomechanically superior to crossed K-wires with the application of 3-point bend.
Capturing Stories of How Young Adults Experience Entry Into the Workforce: A Qualitative Research Protocol on Data Collection During the Ongoing Coronavirus Pandemic
Authors: Wall Erika , Jansson Anna Berg , Svensson Sven 
Published: April 2021

Background: In present research protocol, the project entitled “A sustainable working life for young adults—leadership, learning, and insecurity” is presented and discussed. The study which aims to describe and analyze the expectations of young adults in the retail workforce in terms of leadership, learning and development and how these aspects can be understood from a health promotion perspective. The project is limited to young adults (18–28 years) employed in a retail setting. Methods: The project is based on qualitative data collected through focus group interviews and individual interviews made during the ongoing coronavirus pandemic (COVID-19) in year 2020 what here will be reflected upon. Discussion: It is concluded data collection carried out during the ongoing spread of the coronavirus, may be significant to what interviewees highlighted in the interviews, but also to what was not discussed in the interviews. It may be the case that the increased focus on the coronavirus meant that other issues that are important to young adults as they establish themselves in the labor market were overshadowed.
Robot-assisted transthoracic first rib resection for venous thoracic outlet syndrome
Authors: Hoexum Frank , Jongkind Vincent , Coveliers Hans ME , Yeung Kak K , Wisselink Willem 
Published: April 2021

Background Venous thoracic outlet syndrome (vTOS) is caused by external compression of the subclavian vein at the costoclavicular junction. It can be subdivided in McCleery Syndrome and Paget-Schroetter Syndrome (PSS). To improve the venous outflow of the arm and to prevent recurrent thrombosis, first rib resection with venolysis of the subclavian vein can be performed. Open transaxillary, supraclavicular, infraclavicular or combined paraclavicular approaches are well known, but more recent robot-assisted techniques are introduced. We report our short- and long-term results of a minimal invasive transthoracic approach for resection of the anteromedial part of the first rib using the DaVinci surgical robot, performed through three trocars. Methods We analyzed all patients with vTOS who were scheduled to undergo robot-assisted transthoracic first rib resection in the period July 2012 to May 2016. Outcomes were: technical success, operation time, blood loss, hospital stay, 30-day complications and patency. Functional outcomes were assessed using the “Disability of the Arm, Shoulder and Hand” (DASH) questionnaire. Results Fifteen patients (8 male, 7 female; mean age 32.9 years, range 20–54 years) underwent robot-assisted transthoracic first rib resection. Conversion to transaxillary resection was necessary in three patients. Average operation time was 147.9 min (range 88–320 min) with a mean blood loss of 79.5 cc (range 10–550 cc). Mean hospital stay was 3.5 days (range 2–9). In three patients, complications were reported (Clavien-Dindo grade 2–3a). Patency was 91% at 15.5 months’ follow-up. DASH scores at one and three years showed excellent functional outcomes (7.1 (SD= 6.9, range 0–20.8) and 6.0 (SD= 6.4, range 0–25)) and are comparable to the scores of the normative general population. Conclusion Robot-assisted transthoracic first rib resection with only three trocars is a feasible minimal invasive approach for first rib resection in the management of vTOS. This technique enables the surgeon to perform venolysis under direct 3D vision with good patency and long-term functional outcome. Studies with larger cohort size are needed to compare the outcomes of this robot-assisted technique with other more established approaches.
Mental health experiences of mothers in Jos, Nigeria: An interpretative phenomenological analysis
Authors: Jidong Dung Ezekiel , Husain Nusrat , Francis Christopher , Murshed Maisha , Roche Ayesha , Ike Tarela J , Karick Haruna , Dagona Zubairu K , Pwajok Juliet Y , Nyam Pam P , Mwankon Shadrack B , Gumber Anil 
Published: April 2021

Objectives: There is an increasing mental health disease burden in mothers with infants and young children, especially in low- and middle-income countries such as Nigeria. Children of distressed mothers suffer early-life exposure from the effects of maternal distress which contributes to the risk of physical and mental health problems in their childhood and beyond. This study explored mental health lived experiences of mothers in Jos, Nigeria. Methods: Purposive and Snowball sampling techniques were adopted, and a total of 40 mothers participated with 8 to 11 participants in one of the four focus group discussions. Participants were between the ages of 18 and 43 years, self-identified as mothers with each having a child between the ages of 3 and 48 months. Each focus group lasted approximately 60 minutes and was audio-recorded. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. Results: Three overarching themes emerged from the data set such as (1) experience of persisting psychological distress from the time of labour/birth; (2) cultural practices that influence feelings; and (3) anxiety due to limited knowledge about childcare, access to support and healthy food. Conclusion: Maternal mental health in Nigeria is under-researched and distressed mothers have limited knowledge about evidence-based early child development. The study recommends developing and testing culturally appropriate parenting interventions in Jos, Nigeria. This is likely to be beneficial for the mother and may also improve child health outcomes.
Improved image quality in abdominal computed tomography reconstructed with a novel Deep Learning Image Reconstruction technique – initial clinical experience
Authors: Njølstad Tormund , Schulz Anselm , Godt Johannes C , Brøgger Helga M , Johansen Cathrine K , Andersen Hilde K , Martinsen Anne Catrine T 
Published: April 2021

Background A novel Deep Learning Image Reconstruction (DLIR) technique for computed tomography has recently received clinical approval. Purpose To assess image quality in abdominal computed tomography reconstructed with DLIR, and compare with standardly applied iterative reconstruction. Material and methods Ten abdominal computed tomography scans were reconstructed with iterative reconstruction and DLIR of medium and high strength, with 0.625 mm and 2.5 mm slice thickness. Image quality was assessed using eight visual grading criteria in a side-by-side comparative setting. All series were presented twice to evaluate intraobserver agreement. Reader scores were compared using univariate logistic regression. Image noise and contrast-to-noise ratio were calculated for quantitative analyses. Results For 2.5 mm slice thickness, DLIR images were more frequently perceived as equal or better than iterative reconstruction across all visual grading criteria (for both DLIR of medium and high strength, p < 0.001). Correspondingly, DLIR images were more frequently perceived as better (as opposed to equal or in favor of iterative reconstruction) for visual reproduction of liver parenchyma, intrahepatic vascular structures as well as overall impression of image noise and texture (p < 0.001). This improved image quality was also observed for 0.625 mm slice images reconstructed with DLIR of high strength when directly comparing to traditional iterative reconstruction in 2.5 mm slices. Image noise was significantly lower and contrast-to-noise ratio measurements significantly higher for images reconstructed with DLIR compared to iterative reconstruction (p < 0.01). Conclusions Abdominal computed tomography images reconstructed using a DLIR technique shows improved image quality when compared to standardly applied iterative reconstruction across a variety of clinical image quality criteria.
The efficacy of meniscus posterior root tears repair: A systematic review and meta-analysis
Authors: Wang Lifu , Zhang Kun , Liu Xuening , Liu Zhongcheng , Yi Qiong , Jiang Jin , Xia Yayi 
Published: April 2021

Purpose: To report of efficacy repair treatment for meniscus posterior root tears repair. Methods: We systematically searched databases including PubMed, Embase, and Cochrane Library for relevant articles. Coleman Methodology Score was used for a quality assessment of the included studies. A meta-analysis was performed to analyze for efficacy of MMPRTs repair. Results: Twenty-two studies, 14 level III and 8 level IV, were included in this systematic review, with a total of 926 cases. Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower progression of Kellgrene–Lawrence grade with meniscal repair. Decreased meniscus extrusion is beneficial to the prognosis of patients undergoing MMPRTs repair. As treatment efficacy, the Lysholm score increased 28.87 (P < 0.001), IKDC score increased 31.73. The overall pooled event rates of progression of K-L grade is 0.200. Difference of Lysholm score and IKDC score between repair and meniscectomy were 8.72 and 9.67. Conclusions: The clinical subjective score after MMPRT repair was significantly improved compared with the preoperative status. Considering the progression of joint K-L grade, it can prevent the progression of arthrosis to some extent, but not completely. Decreased meniscus extrusion is beneficial to the prognosis of patients undergoing MMPRTs repair. Based on these results, MMPRTs repair cloud result favorable outcomes.
Gender Pay Gap in India: A Reality and the Way Forward—An Empirical Approach Using Quantile Regression Technique
Authors: Sengupta Pooja , Puri Roma 
Published: April 2021

There is a growing body of empirical work on gender studies that mostly focus on the gender-wise representation of individuals in different sectors. One such study is the wage gap attributed to gender. In this article, we have tried to focus on a detailed study of the gender wage gap in the Indian context. The study was carried out on the most recent Employment–Unemployment Survey carried out by NSS for the year 2012. The study was based on the personal characteristics as well as the characteristics of the job undertaken by the employees. Ordinary least square regression and linear quartile regression model were used for analysis. In our study we have come up with a few interesting determinants of wage inequality based mostly on the personal traits. For women, personal characteristic like age was highly significant determinant of wage whereas in case of men more industry specific determinants were significant. JEL Classifications: C01, C10, J16, J31