bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Lamb Waves to Predict Current Damaged State of Mortar
Authors: Keller Michael S. , Kundu Tribikram , Desai Chandrakant S. 
Published: November 2021

Abstract
This paper describes the experimental and analytical results for the development of a methodology for predicting the current state of simulated concrete (mortar) in infrastructure. The nondestructive Lamb wave technique is used to experimentally identify the disturbance (damage) before and after mechanical testing of mortar specimens, which is used in the initial research as a substitute for concrete. The mortar specimens are tested to measure their stress-strain response under uniaxial compression and tension loading. The results of the nondestructive and mechanical stress-strain testing are correlated to develop the model based on the Disturbed State Concept (DSC), a unified approach for modeling material behavior. This model can allow evaluation of the deformation moduli, strength and degradation (damage) at a given state during the life of the material. This information can be used to design rehabilitation strategies. It can also lead to the development of new computer based equipment that can be used in the field for defining the remaining life. At this time, the research involved one-dimensional testing. The proposed methodology can, however, be extended and improved by conducting two- and three-dimensional testing of concrete specimens.
Epinephrine before defibrillation in patients with shockable in-hospital cardiac arrest: propensity matched analysis
Authors: Evans Erin , Swanson Morgan B , Mohr Nicholas , Boulos Nassar , Vaughan-Sarrazin Mary , Chan Paul S , Girotra Saket 
Published: November 2021

AbstractObjectiveTo determine the use of epinephrine (adrenaline) before defibrillation for treatment of in-hospital cardiac arrest due to a ventricular arrhythmia and examine its association with patient survival.DesignPropensity matched analysis.Setting2000-18 data from 497 hospitals participating in the American Heart Association’s Get With The Guidelines-Resuscitation registry.ParticipantsAdults aged 18 and older with an index in-hospital cardiac arrest due to an initial shockable rhythm treated with defibrillation.InterventionsAdministration of epinephrine before first defibrillation.Main outcome measuresSurvival to discharge; favorable neurological survival, defined as survival to discharge with none, mild, or moderate neurological disability measured using cerebral performance category scores; and survival after acute resuscitation (that is, return of spontaneous circulation for >20 minutes). A time dependent, propensity matched analysis was performed to adjust for confounding due to indication and evaluate the independent association of epinephrine before defibrillation with study outcomes.ResultsAmong 34 820 patients with an initial shockable rhythm, 7054 (20.3%) were treated with epinephrine before defibrillation, contrary to current guidelines. In comparison with participants treated with defibrillation first, participants receiving epinephrine first were less likely to have a history of myocardial infarction or heart failure, but more likely to have renal failure, sepsis, respiratory insufficiency, and receive mechanical ventilation before in-hospital cardiac arrest (standardized differences >10% for all). Treatment with epinephrine before defibrillation was strongly associated with delayed defibrillation (median 4 minutesv0 minutes). In propensity matched analysis (6569 matched pairs), epinephrine before defibrillation was associated with lower odds of survival to discharge (22.4%v29.7%; adjusted odds ratio 0.69; 95% confidence interval 0.64 to 0.74; P<0.001), favorable neurological survival (15.8%v21.6%; 0.68; 0.61 to 0.76; P<0.001) and survival after acute resuscitation (61.7%v69.5%; 0.73; 0.67 to 0.79; P<0.001). The above findings were consistent in a range of sensitivity analyses, including matching according to defibrillation time.ConclusionsContrary to current guidelines that prioritize immediate defibrillation for in-hospital cardiac arrest due to a shockable rhythm, one in five patients are treated with epinephrine before defibrillation. Use of epinephrine before defibrillation was associated with worse survival outcomes.
How often will midwives and obstetricians experience obstetric emergencies or high-risk deliveries: a national cross-sectional study
Authors: Høgh Stinne , Thellesen Line , Bergholt Thomas , Rom Ane Lilleøre , Johansen Marianne , Sorensen Jette Led 
Published: November 2021

ObjectiveTo estimate how often midwives, specialty trainees and doctors specialised in obstetrics and gynaecology are attending to specific obstetric emergencies or high-risk deliveries (obstetric events).DesignA national cross-sectional study.SettingAll hospital labour wards in Denmark.ParticipantsMidwives (n=1303), specialty trainees (n=179) and doctors specialised in obstetrics and gynaecology (n=343) working in hospital labour wards (n=21) in Denmark in 2018.MethodsCategories of obstetric events comprised of Apgar score <7/5 min, eclampsia, emergency caesarean sections, severe postpartum haemorrhage, shoulder dystocia, umbilical cord prolapse, vaginal breech deliveries, vaginal twin deliveries and vacuum extraction. Data on number of healthcare professionals were obtained through the Danish maternity wards, the Danish Health Authority and the Danish Society of Obstetricians and Gynaecologists. We calculated the time interval between attending each obstetric event by dividing the number of events occurred with the number of healthcare professionals.Outcome measuresThe time interval between attending a specific obstetric event.ResultsThe average time between experiencing obstetric events ranged from days to years. Emergency caesarean sections, which occur relatively frequent, were attended on average every other month by midwives, every 9 days for specialty trainees and every 17 days by specialist doctors. On average, rare events like eclampsia were experienced by midwives only every 42 years, every 6 years by specialty trainees and every 11 years by specialist doctors.ConclusionsSome obstetric events occur extremely rarely, hindering the ability to obtain and maintain the clinical skills to manage them through clinical practice alone. By assessing the frequency of a healthcare professionals attending an obstetric emergency, our study contributes to assessing the need for supplementary educational initiatives and interventions to learn and maintain clinical skills.
Effect of dexmedetomidine on postoperative delirium in patients undergoing brain tumour resections: study protocol of a randomised controlled trial
Authors: Wang Dexiang , Li Ruowen , Li Shu , Wang Juan , Zeng Min , Dong Jia , Liu Xiaoyuan , Lin Nan , Peng Yuming 
Published: November 2021

IntroductionPostoperative delirium (POD) is a common complication. The incidence of POD is about 25% in non-cardiac surgery and ranges from 10% to 30% in neurological procedures. A lot of trials show that dexmedetomidine might help to reduce the incidence of delirium in patients undergoing non-cardiac surgery. However, the impact of dexmedetomidine on POD for patients undergoing craniotomy and tumour resections remains unclear.Methods and analysisThe study is a prospective, single-centre, randomised, double-blinded, paralleled-group controlled trial. Patients undergoing elective frontotemporal tumour resections will be randomly assigned to the dexmedetomidine group and the control group. After endotracheal intubation, patients in the dexmedetomidine group will be administered with a loading dose of dexmedetomidine 0.6 µg/kg in 10 min followed by continuous infusion at a rate of 0.4 µg/kg/hour until the start of dural closure. In the control group, patients will receive the identical volume of normal saline in the same setting. The primary outcome will be the cumulative incidence of POD within 5 days. The delirium assessment will be performed by using the confusion assessment method in the first 5 consecutive days after surgery. Secondary outcomes include the pain severity assessed by Numerical Rating Scale pain score, quality of postoperative sleep assessed by the Richards Campbell sleep questionnaire and postoperative quality of recovery from anaesthesia by the Postoperative Quality Recovery Scale.Ethics and disseminationThe protocol (V.1.0, 10 November 2020) has been approved by the Ethics Review Committee of the Chinese Clinical Trial Registry (number ChiECRCT-20200436). The findings of the study will be disseminated in a peer-reviewed journal and at a scientific conference.Trial registration numberNCT04674241.
Longitudinal Outcomes of Gender Identity in Children (LOGIC): study protocol for a retrospective analysis of the characteristics and outcomes of children referred to specialist gender services in the UK and the Netherlands
Authors: Kennedy Eilis , Lane Chloe , Stynes Hannah , Ranieri Veronica , Spinner Lauren , Carmichael Polly , Omar Rumana , Vickerstaff Victoria , Hunter Rachael , Senior Robert , Butler Gary , Baron-Cohen Simon , de Graaf Nastasja , Steensma Thomas D , de Vries Annelou , Young Bridget , King Michael 
Published: November 2021

IntroductionSpecialist gender services for children and young people (CYP) worldwide have experienced a significant increase in referrals in recent years. As rates of referrals increase, it is important to understand the characteristics and profile of CYP attending these services in order to inform treatment pathways and to ensure optimal outcomes.Methods and analysisA retrospective observational study of clinical health records from specialist gender services for CYP in the UK and the Netherlands. The retrospective analysis will examine routinely collected clinical and outcome measures data including demographic, clinical, gender identity-related and healthcare resource use information. Data will be reported for each service and also compared between services. This study forms part of a wider programme of research investigating outcomes of gender identity in children (the Longitudinal Outcomes of Gender Identity in Children study).Ethics and disseminationThe proposed study has been approved by the Health Research Authority and London—Hampstead Research Ethics Committee as application 19/LO/0181. The study findings will be published in peer-reviewed journals and presented at both conferences and stakeholder events.
Stratigraphic and sedimentological characterization of the Late Cretaceous post-rift intra Lange Sandstones of the Gimsan Basin and Grinda Graben (Halten Terrace, Norwegian Sea)
Authors: Chiarella Domenico , Joel Daniel 
Published: November 2021

Abstract
Deep-marine gravity-driven deposits represent one of the more investigated depositional systems owing to their potential interest as targets for exploration and carbon capture and storage activities, as well as an important record of the depositional history of a basin through time. Although the Halten Terrace (Norwegian Sea) is one of the main successful exploration areas, we still have poor understanding of the post-rift Cretaceous interval. Here, 3D seismic reflection and borehole data are integrated to investigate the stratigraphic distribution and sedimentological characteristics of the Cenomanian–Turonian intra Lange Sandstones in the Gimsan Basin and Grinda Graben. The Lange Fm records the deposition in a deep-marine environment of a 1000 m-thick shale unit punctuated by gravity-driven coarse-grained sandstone intervals that are tens of metres-thick and sourced from the Norwegian mainland. The presence of gravity-driven deposits and the deep-marine setting are supported by seismic interpretation, architectural elements and the facies analysis of cored material acquired within the studied stratigraphic interval. Borehole data indicate the presence of both turbidites and hybrid-event beds rich in mud content. The results of this study have implications for understanding the distribution and reservoir potentiality of the Late Cretaceous Lange Fm in the Halten Terrace.
Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study
Authors: Bano Arjola , Rodondi Nicolas , Beer Jürg H. , Moschovitis Giorgio , Kobza Richard , Aeschbacher Stefanie , Baretella Oliver , Muka Taulant , Stettler Christoph , Franco Oscar H. , Conte Giulio , Sticherling Christian , Zuern Christine S. , Conen David , Kühne Michael , Osswald Stefan , Roten Laurent , Reichlin Tobias ,   of the Swiss‐Investigators
Published: November 2021

Background
Diabetes is a major risk factor for atrial fibrillation (AF). However, it remains unclear whether individual AF phenotype and related comorbidities differ between patients who have AF with and without diabetes. This study investigated the association of diabetes with AF phenotype and cardiac and neurological comorbidities in patients with documented AF.

Methods and Results
Participants in the multicenter Swiss‐AF (Swiss Atrial Fibrillation) study with data on diabetes and AF phenotype were eligible. Primary outcomes were parameters of AF phenotype, including AF type, AF symptoms, and quality of life (assessed by the European Quality of Life‐5 Dimensions Questionnaire [EQ‐5D]). Secondary outcomes were cardiac (ie, history of hypertension, myocardial infarction, and heart failure) and neurological (ie, history of stroke and cognitive impairment) comorbidities. The cross‐sectional association of diabetes with these outcomes was assessed using logistic and linear regression, adjusted for age, sex, and cardiovascular risk factors. We included 2411 patients with AF (27.4% women; median age, 73.6 years). Diabetes was not associated with nonparoxysmal AF (odds ratio [OR], 1.01; 95% CI, 0.81–1.27). Patients with diabetes less often perceived AF symptoms (OR, 0.74; 95% CI, 0.59–0.92) but had worse quality of life (β=−4.54; 95% CI, −6.40 to −2.68) than those without diabetes. Patients with diabetes were more likely to have cardiac (hypertension [OR, 3.04; 95% CI, 2.19–4.22], myocardial infarction [OR, 1.55; 95% CI, 1.18–2.03], heart failure [OR, 1.99; 95% CI, 1.57–2.51]) and neurological (stroke [OR, 1.39, 95% CI, 1.03–1.87], cognitive impairment [OR, 1.75, 95% CI, 1.39–2.21]) comorbidities.

Conclusions
Patients who have AF with diabetes less often perceive AF symptoms but have worse quality of life and more cardiac and neurological comorbidities than those without diabetes. This raises the question of whether patients with diabetes should be systematically screened for silent AF.

Registration

URL:
https://www.clinicaltrials.gov
; Unique Identifier: NCT02105844.
Radiographic Characteristics of Mild Ischemic Stroke Patients With Visible Intracranial Occlusion: The INTERRSeCT Study
Authors: Lau H. Lee , Gardener Hannah , Coutts Shelagh B. , Saini Vasu , Field Thalia S. , Dowlatshahi Dar , Smith Eric E. , Hill Michael D. , Romano Jose G. , Demchuk Andrew M. , Menon Bijoy K. , Asdaghi Negar 
Published: November 2021

Background and Purpose:
Early neurological deterioration occurs in one-third of mild strokes primarily due to the presence of a relevant intracranial occlusion. We studied vascular occlusive patterns, thrombus characteristics, and recanalization rates in these patients.

Methods:
Among patients enrolled in INTERRSeCT (Identifying New Approaches to Optimize Thrombus Characterization for Predicting Early Recanalization and Reperfusion With IV Alteplase and Other Treatments Using Serial CT Angiography), a multicenter prospective study of acute ischemic strokes with a visible intracranial occlusion, we compared characteristics of mild (National Institutes of Health Stroke Scale score, ≤5) to moderate/severe strokes.

Results:
Among 575 patients, 12.9% had a National Institutes of Health Stroke Scale score ≤5 (median age, 70.5 [63–79]; 58% male; median National Institutes of Health Stroke Scale score, 4 [2–4]). Demographics and vascular risk factors were similar between the two groups. As compared with those with a National Institutes of Health Stroke Scale score >5, mild patients had longer symptom onset to assessment times (onset to computed tomography [240 versus 167 minutes] and computed tomography angiography [246 versus 172 minutes]), more distal occlusions (M3, anterior cerebral artery and posterior cerebral artery; 22% versus 6%), higher clot burden score (median, 9 [6–9] versus 6 [4–9]), similar favorable thrombus permeability (residual flow grades I–II, 21% versus 19%), higher collateral flow (9.1 versus 7.6), and lower intravenous alteplase treatment rates (55% versus 85%). Mild patients were more likely to recanalize (revised arterial occlusion scale score 2b/3, 45%; 49% with alteplase) compared with moderate/severe strokes (26%; 29% with alteplase). In an adjusted model for sex, alteplase, residual flow, and time between the two vessel imagings, intravenous alteplase use (odds ratio, 3.80 [95% CI, 1.11–13.00]) and residual flow grade (odds ratio, 8.70 [95% CI, 1.26–60.13]) were associated with successful recanalization among mild patients.

Conclusions:
Mild strokes with visible intracranial occlusions have different vascular occlusive patterns but similar thrombus permeability compared with moderate/severe strokes. Higher thrombus permeability and alteplase use were associated with successful recanalization, although the majority do not recanalize. Randomized controlled trials are needed to assess the efficacy of new thrombolytics and endovascular therapy in this population.
Obesity Does Not Protect From Subarachnoid Hemorrhage: Pooled Analyses of 3 Large Prospective Nordic Cohorts
Authors: Rautalin Ilari , Kaprio Jaakko , Ingebrigtsen Tor , Jousilahti Pekka , Løchen Maja-Lisa , Romundstad Pål Richard , Salomaa Veikko , Vik Anne , Wilsgaard Tom , Mathiesen Ellisiv B. , Sandvei Marie , Korja Miikka 
Published: November 2021

Background:
Several population-based cohort studies have related higher body mass index (BMI) to a decreased risk of subarachnoid hemorrhage (SAH). The main objective of our study was to investigate whether the previously reported inverse association can be explained by modifying effects of the most important risk factors of SAH—smoking and hypertension.

Methods:
We conducted a collaborative study of three prospective population-based Nordic cohorts by combining comprehensive baseline data from 211 972 adult participants collected between 1972 and 2012, with follow-up until the end of 2018. Primarily, we compared the risk of SAH between three BMI categories: (1) low (BMI<22.5), (2) moderate (BMI: 22.5–29.9), and (3) high (BMI≥30) BMI and evaluated the modifying effects of smoking and hypertension on the associations.

Results:

We identified 831 SAH events (mean age 62 years, 55% women) during the total follow-up of 4.7 million person-years. Compared with the moderate BMI category, persons with low BMI had an elevated risk for SAH (adjusted hazard ratio [HR], 1.30 [1.09–1.55]), whereas no significant risk difference was found in high BMI category (HR, 0.91 [0.73–1.13]). However, we only found the increased risk of low BMI in smokers (HR, 1.49 [1.19–1.88]) and in hypertensive men (HR, 1.72 [1.18–2.50]), but not in nonsmokers (HR, 1.02 [0.76–1.37]) or in men with normal blood pressure values (HR, 0.98 [0.63–1.54]; interaction HRs, 1.68 [1.18–2.41],
P
=0.004 between low BMI and smoking and 1.76 [0.98–3.13],
P
=0.06 between low BMI and hypertension in men).

Conclusions:
Smoking and hypertension appear to explain, at least partly, the previously reported inverse association between BMI and the risk of SAH. Therefore, the independent role of BMI in the risk of SAH is likely modest.
Internal Fixation of Lateral Trochlear Groove Osteochondritis Dissecans With Simultaneous Lateral Retinacular Lengthening in Adolescent Athletes
Authors: Lee Dhong Won , Lee Joon Kyu , Cho Young Chang , Yang Sang Jin , Cho Seung Ik , Kim Jin Goo 
Published: November 2021

Background: The goals of operative treatment for the adolescent athlete with unstable osteochondritis dissecans (OCD) lesion are rigid fixation and prevention of recurrence. Purpose: To evaluate clinical and radiological outcomes of internal fixation of lateral trochlear groove OCD with simultaneous lateral retinacular lengthening. Study Design: Case series; Level of evidence, 4. Methods: Adolescent athletes who had undergone internal fixation and simultaneous lateral retinacular lengthening for an unstable OCD lesion of the lateral trochlear groove were retrospectively reviewed. Subjective assessments included the Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Tegner activity scale, and an athletic questionnaire. Functional tests included isokinetic muscle strength, single-leg hop for distance, single-leg vertical jump, and Y-balance. Pre- and postoperative radiographs and magnetic resonance images were reviewed. Results: The mean ± SD age of the 17 patients included in this study was 15.9 ± 0.9 years; last clinical follow-up duration was 37.7 ± 8.1 months. At the last follow-up, the Lysholm score improved from 68.7 ± 15.3 to 93.4 ± 12.4 and the IKDC subjective score from 60.2 ± 14.7 to 88.7 ± 12.7 ( P < .001). The mean Tegner activity scale score was 9.4 ± 0.5 before injury and 8.9 ± 1.2 at the last follow-up ( P = .059). The limb symmetry indices of isokinetic muscle strength, single-leg hop for distance, single-leg vertical jump, and Y-balance improved at the last follow-up; the mean limb symmetry index was ≥85% in each functional test. Regarding the athletic questionnaire, 16 (94.1%) patients were satisfied with the surgery. At the last follow-up, 2 patients had higher ability after returning to sports, 11 had the same ability, and 3 had lower ability than the preinjury level. Postoperative magnetic resonance imaging at 12-month follow-up showed that the OCD lesion appeared healed in 7 (41.2%) patients and partially healed in 9 (52.9%). Conclusion: Internal fixation of lateral trochlear groove OCD with simultaneous lateral retinacular lengthening in adolescent athletes achieved satisfactory clinical and radiological outcomes. Therefore, this combined surgical technique could be considered an effective treatment for lateral trochlear groove OCD, with a high rate of return to sport.
Parent Perceptions in Choosing Treatment for Infants With Spinal Muscular Atrophy Diagnosed Through Newborn Screening
Authors: Deng Stella , Lee Bo Hoon , Ciafaloni Emma 
Published: November 2021

Objective: To identify factors parents considered in treatment decision making for children diagnosed with spinal muscular atrophy on newborn screening. Methods: Participants were recruited through the University of Rochester or through flyers and Cure SMA social media outreach and asked to complete a telephone or online survey. Data were analyzed through mixed methods using descriptive statistics and theme identification in narrative responses. Results: Eighteen parents with children diagnosed with spinal muscular atrophy on newborn screening participated. Thirteen of 18 chose onasemnogene abeparvovec, 2 of 18 chose risdiplam, 1 of 18 chose nusinersen, and 2 of 18 did not receive treatment. The most commonly reported factors impacting treatment choice included treatment frequency and administration method. Seventeen (94.4%) parents felt that inclusion of spinal muscular atrophy on newborn screening was positive because it could allow for better outcomes with earlier treatment. Conclusion: Treatment frequency and administration method were the most important factors for parents in determining spinal muscular atrophy treatment. Parents felt positively about newborn screening due to opportunity for earlier treatment.