bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Age and Alberta Stroke Program Early Computed Tomography Score 0 to 5 on Mechanical Thrombectomy Outcomes: Analysis From the STRATIS Registry
Authors: Zaidat Osama O. , Liebeskind David S. , Jadhav Ashutosh P. , Ortega-Gutierrez Santiago , Nguyen Thanh N. , Haussen Diogo C. , Yavagal Dileep R. , Froehler Michael T. , Jahan Reza , Nogueira Raul G. , Yao Tom L. , Alenzi Bader A. , Bushnaq Saif , Mueller-Kronast Nils H. 
Published: June 2021

Background and Purpose:
This study investigates clinical outcomes after mechanical thrombectomy in adult patients with baseline Alberta Stroke Program Early CT Score (ASPECTS) of 0 to 5.

Methods:
We included data from the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) from patients who underwent mechanical thrombectomy within 8 hours of symptom onset and had available ASPECTS data adjudicated by an independent core laboratory. Angiographic and clinical outcomes were collected, including successful reperfusion (modified Thrombolysis in Cerebral Infarction ≥2b), functional independence (modified Rankin Scale score 0–2), 90-day mortality, and symptomatic intracranial hemorrhage at 24 hours. Outcomes were stratified by ASPECTS scores and age.

Results:

Of the 984 patients enrolled, 763 had available ASPECTS data. Of these patients, 57 had ASPECTS of 0 to 5 with a median age of 63 years (interquartile range, 28–100), whereas 706 patients had ASPECTS of 6 to 10 with a median age of 70 years of age (interquartile range, 19–100). Ten patients had ASPECTS of 0 to 3 and 47 patients had ASPECTS of 4 to 5 at baseline. Successful reperfusion was achieved in 85.5% (47/55) in the ASPECTS of 0 to 5 group. Functional independence was achieved in 28.8% (15/52) in the ASPECTS of 0 to 5 versus 59.7% (388/650) in the 6 to 10 group (
P
<0.001). Mortality rates were 30.8% (16/52) in the ASPECTS of 0 to 5 and 13.4% (87/650) in the 6 to 10 group (
P
<0.001). sICH rates were 7.0% (4/57) in the ASPECTS of 0 to 5 and 0.9% (6/682) in the 6 to 10 group (
P
<0.001). No patients aged >75 years with ASPECTS of 0 to 5 (0/12) achieved functional independence versus 44.8% (13/29) of those age ≤65 (
P
=0.005).

Conclusions:
Patients <65 years of age with large core infarction (ASPECTS 0–5) have better rates of functional independence and lower rates of mortality compared with patients >75 years of age.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02239640.
Mechanical Characterization of Thrombi Retrieved With Endovascular Thrombectomy in Patients With Acute Ischemic Stroke
Authors: Boodt Nikki , Snouckaert van Schauburg Philip R.W. , Hund Hajo M. , Fereidoonnezhad Behrooz , McGarry J. Patrick , Akyildiz Ali C. , van Es Adriaan C.G.M. , De Meyer Simon F. , Dippel Diederik W.J. , Lingsma Hester F. , van Beusekom Heleen M.M. , van der Lugt Aad , Gijsen Frank J.H. 
Published: June 2021

Background and Purpose:
Mechanical properties of thromboemboli play an important role in the efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke. However, very limited data on mechanical properties of human stroke thrombi are available. We aimed to mechanically characterize thrombi retrieved with EVT, and to assess the relationship between thrombus composition and thrombus stiffness.

Methods:

Forty-one thrombi from 19 patients with acute stroke who underwent EVT between July and October 2019 were mechanically analyzed, directly after EVT. We performed unconfined compression experiments and determined tangent modulus at 75% strain (E
t75
) as a measure for thrombus stiffness. Thrombi were histologically analyzed for fibrin/platelets, erythrocytes, leukocytes, and platelets, and we assessed the relationship between histological components and E
t75
with univariable and multivariable linear mixed regression.

Results:

Median E
t75
was 560 (interquartile range, 393–1161) kPa. In the multivariable analysis, fibrin/platelets were associated with increased E
t75
(aβ, 9 [95% CI, 5 to 13]) kPa, erythrocytes were associated with decreased E
t75%
(aβ, −9 [95% CI, −5 to −13]) kPa. We found no association between leukocytes and E
t75
. High platelet values were strongly associated with increased E
t75
(aβ, 56 [95% CI, 38–73]).

Conclusions:
Fibrin/platelet content of thrombi retrieved with EVT for acute ischemic stroke is strongly associated with increased thrombus stiffness. For thrombi with high platelet values, there was a very strong relationship with thrombus stiffness. Our data provide a basis for future research on the development of next-generation EVT devices tailored to thrombus composition.
Adaptive foraging strategy of an insular snake (Lycodon semicarinatus, Colubridae) feeding on patchily distributed nests of sea turtles
Authors: Matsumoto Kazumasa , Mori Akira 
Published: June 2021

Abstract
Foraging tactics of predators generally include two major modes, active searching and ambushing. A colubrid snake, Lycodon semicarinatus, is a typical example of a predator, which uses both tactics to forage on sea turtles on islands of the Kerama Group in the Central Ryukyu Archipelago, Japan. To investigate factors that determine the foraging mode of this snake, we conducted a four-year field survey on its foraging behaviour on sea turtles on another island, Okinawa Island. We found that the snake performs only active searching at our study site. Snakes visited a small area exactly above the nest of sea turtles and attempted to burrow a tunnel to feed on eggs and hatchlings in the sand. Tunnels leading from the surface of the beach to the inside of the nest were formed only by large snakes. Many other snakes used the already made tunnels to capture eggs and hatchlings in the nest. When the snakes caught a hatchling, they brought the hatchling away into the nearby bush area without swallowing it above the nest (taking-away behaviour). When snakes failed to find food on a nest, they terminated the intensive search above the nest in approximately 5 minutes irrespective of snake body size, season, and the condition of the nest. Subsequently, they left the nest and resumed extensive searching for other nests. Our findings showed that L. semicarinatus has a different foraging strategy depending on populations. Two environmental traits, diversity of available prey animals other than sea turtles and characteristics of sand that beaches consist of, were considered as factors that might cause the difference in the foraging strategy. The fine sand of our study site enables snakes to form a sturdy tunnel in nests. We presume that such an environment facilitates the use of active searching by the snakes to find the nest with tunnels suitable for exploitation. The taking-away behaviour may be effective to reduce excessive contact with other conspecifics under the situation that the nest with tunnels attracts many visitors. Furthermore, the observation that the snake left the nest site after a consistent duration of unprofitable searching supports the giving-up time rule, which has been predicted by a theoretical model concerning the optimal time for predators to leave a patch.
Maritime Autonomous Vehicles and Drug Trafficking by Sea: Some Legal Issues
Authors: McLaughlin Rob , Klein Natalie 
Published: June 2021

Abstract
Among the new technologies being deployed at sea, maritime autonomous vehicles (MAV) are of increasing interest to States to enhance their intelligence, surveillance and reconnaissance capabilities to improve their maritime security. This article analyses the international law implications of this use of MAV to support maritime law enforcement efforts in response to drug trafficking and other crimes at sea. The use of MAV for criminal purposes, especially smuggling goods, also holds international law consequences. The article assesses how these different operations of MAV fit within existing legal regimes, highlighting emerging legal questions for resolution and setting out recommendations for law reform to enhance counter-smuggling operations at sea.
Changes in the characteristics of North Pacific Jet as a Conduit for U. S. surface air temperature in boreal winter across the late 1990s
Authors: Song Se-Yong , Yeh Sang-Wook , Jo Hyun-Su 
Published: June 2021

AbstractThe leading modes of the North Pacific Jet (NPJ) variability include intensity changes and meridional shifts in jet position on the low frequency timescales. These leading modes of NPJ variability are closely associated with weather and climate conditions spanning from Asia to the United States (US). In this study, we investigated changes in the NPJ’s role as a conduit for US surface air temperature (SAT) anomalies during the boreal winter across the late 1990s. We found that the leading mode of NPJ variability changed from the NPJ intensity changes to meridional shifts in NPJ position across the late 1990s. It leads to the change in the role of NPJ as a conduit for US SAT anomalies. Before the late 1990s, the variability of NPJ’s intensity significantly impacted western US SAT anomalies related to the anomalous surface cyclonic circulation over the North Pacific. After the late 1990s, however, the variability of NPJ’s meridional shift significantly influenced on the eastern US SAT anomalies in association with the anomalous surface cyclonic circulation over the northern North Pacific. Further analysis and model experiments revealed that the western to central North Pacific Ocean has been warming since the late 1990s and modulates atmospheric baroclinicity. This phenomenon mainly leads to a northward NPJ shift and implies that the eddy driven mechanism on the NPJ’s formation, which acts to enhance the meridional variability of NPJ position, becomes dominant. We conclude that this northward shift of NPJ could have contributed to enhancing the NPJ’s meridional shift variability, significantly influencing the eastern US SAT anomalies since the late 1990s.
Response of Regional Asian Summer Monsoons to the Effect of Reduced Surface Albedo in Different Tibetan Plateau Domains in Idealized Model Experiments
Authors: LU MENGMENG , YANG SONG , WANG JUNBIN , WU YUTING , JIA XIAOLONG 
Published: June 2021

AbstractThe thermal effect of entire Tibetan Plateau (TP) tends to strengthen the South Asian summer monsoon (SASM); however, how does this monsoon component respond to the thermal conditions of different TP domains? How do the thermal condition of entire TP influences other monsoons including the East Asian summer monsoon (EASM) and the Southeast Asian summer monsoon (SEASM)? These questions are addressed by conducting an experiment with the CESM, which is forced by reducing the surface albedo over the plateau by half, from a TP-averaged 0.20 to 0.10, from May to September, and similar experiments for different TP domains. Both observation and model results show that the entire-TP heating intensifies the large-scale Asian monsoon, the SASM, and the EASM, but surprisingly weakens the SEASM. It is also surprising that the TP heating exerts a stronger effect on the EASM than on the SASM. The southern TP (south of 35°N) does not show the strongest impact on the SASM compared to other TP domains and it exerts a weakest impact on the EASM, which is most strongly influenced by the thermal effect of eastern (east of 90°E) and northern TP. The western TP weakens the SEASM as the other domains, while it strengthens other monsoon components. The thermal condition of southern and eastern TP are accompanied by signals of tropical atmospheric response at relatively broader spatial scales, while that of northern TP more apparently leads to a significant wave train extending eastward from the TP to western Eurasia over the higher latitudes.
Exploring the Interaction Between Head-Supported Mass, Posture, and Visual Stress on Neck Muscle Activation
Authors: Le Peter , Weisenbach Charles A. , Mills Emily H. L. , Monforton Lanie , Kinney Micah J. 
Published: June 2021

Objective Assess neck muscle activity for varying interactions between helmet, posture, and visual stress in a simulated “helo-hunch” posture. Background Military aviators frequently report neck pain (NP). Risk factors for NP include head-supported mass, awkward postures, and mental workload. Interactions between these factors could induce constant low-level muscle activation during helicopter flight and better explain instances of NP. Method Interactions between physical loading (helmet doffed/donned), posture (symmetric/asymmetric), and visual stress (low/high contrast) were studied through neck muscle electromyography (EMG), head kinematics, subjective discomfort, perceived workload, and task performance. Subjects ( n = 16) performed eight 30-min test conditions (varied physical loading, posture, and visual stress) while performing a simple task in a simulated “helo-hunch” seating environment. Results Conditions with a helmet donned had fewer EMG median frequency cycles (which infer motor unit rotation for rest/recovery, where more cycles are better) in the left cervical extensor and left sternocleidomastoid. Asymmetric posture (to the right) resulted in higher normalized EMG activity in the right cervical extensor and left sternocleidomastoid and resulted in less lateral bending compared with neutral across all conditions. Conditions with high visual stress also resulted in fewer EMG cycles in the right cervical extensor. Conclusion A complex interaction exists between the physical load of the helmet, postural stress from awkward postures, and visual stress within a simulated “helo-hunch” seating environment. Application These results provide insight into how visual factors influence biomechanical loading. Such insights may assist future studies in designing short-term administrative controls and long-term engineering controls.
Needs and Procedures for a National Anthropometry Study of Law Enforcement Officers
Authors: Hsiao Hongwei , Whisler Richard , Bradtmiller Bruce 
Published: June 2021

Objectives This research aims to determine the need and extent for a national anthropometry survey of law enforcement officers (LEOs) via an exploratory investigation of anthropometric changes of LEOs in four decades and comparisons of the LEO data with three existing military and civilian anthropometry sources. Background The best available anthropometric dataset of LEOs is 45 years old and has largely become outdated due to demographic changes. Assessing the extent of anthropometric changes of LEOs through a sample and evaluating the differences of the sample against existing anthropometric datasets is a step toward ascertaining the necessity for a national LEO anthropometry study. Method Thirty-two body dimensions of 67 regional male LEOs and seven female LEOs were measured, and the data of males were compared with the best available LEO anthropometry data from 1975 and three recent non-LEO anthropometry databases. Results Anthropometric dimensions were significantly different between this LEO study and existing data sources, especially in chest circumference and body weight. Most of the significant differences are important differences for LEO protective gear and vehicle design. Conclusion The study confirmed that the existing 45-year-old LEO dataset and recent Army and civilian datasets would not be suitable for armor and equipment design for the current LEO population. Application The study results are useful in supporting the decision of investing in a national LEO anthropometry survey and for equipment manufacturers to recognize the distinctiveness of LEO anthropometry from other populations and the magnitude of anthropometry changes of LEOs over the past 45 years.
Efficiency of Cournot and Bertrand Equilibria with Non-cooperative and Cooperative R&D in Presence of Product Differentiation
Authors: Ghosh Satyajit 
Published: June 2021

Strategic cooperative and non-cooperative R&D decisions are analysed in the presence of R&D spillover and product differentiation. Using a two-stage game it is shown that in both Cournot and Bertrand duopolies, R&D and output levels are larger and prices are lower under cooperative R&D agreements compared to non-cooperative R&D. For complementary and independent goods, these results are valid for any degree of R&D spillover and may hold for substitute goods even for sufficiently small R&D spillover. In terms of social welfare, cooperative R&D agreements dominate non-cooperation for both Cournot and Bertrand duopolies. As for relative efficiency of Cournot and Bertrand equilibria, it is shown that the traditional efficiency ranking may be reversed and Cournot equilibrium may dominate Bertrand equilibrium if the degree of product differentiation is low and the products are reasonably close substitutes for high degree of R&D spillover provided that R&D productivity is high. This result is stronger for cooperative R&D decision. JEL Codes: D21, D43, L13
Psychopathy and Occurrence of Gambling Problems: The Role of Gambling Protective Strategies and Urgency
Authors: Kramer Matthew P. , Peterson Roselyn , Leary Angelina V. , Wilborn Dexter D. , Magri Tatiana , Dvorak Robert D. 
Published: June 2021

Background Psychopathy has been an increasing area of clinical and personality research and is associated with numerous problematic outcomes, including pathological gambling, though this area of research is limited. The most common conceptualization of psychopathy is a two-factor model of primary and secondary psychopathy, with primary psychopathy comprising more interpersonal traits and secondary psychopathy encompassing more antisocial behaviors. Previous research has linked psychopathy to greater urgency and lower utilization of harm reduction strategies. Objectives The current study examines the relationship between primary psychopathy, secondary psychopathy, and problematic gambling, as well as the possible mechanisms of these relationships. Method College student gamblers ( n = 308) completed surveys on psychopathy, impulsivity, protective behavioral strategies regarding gambling, and possible gambling problems. Results Primary psychopathy was inversely related to gambling protective behavioral strategies (PBS) and secondary psychopathy was positively associated with higher levels of urgency. Secondary psychopathy, via urgency, was a strong predictor of whether an individual will experience gambling problems, while primary psychopathy via PBS better predicts the number of gambling problems one experiences. Conclusion This study extends an overall under-researched area of gambling and personality and highlights the importance of delineating different factors of psychopathy regarding problematic gambling outcomes.
Initial experience with del Nido cardioplegia solution at a Pediatric and Congenital Cardiac Surgery Program in Brazil
Authors: Caneo Luiz Fernando , Matte Gregory S , R Turquetto Aida Luiza , Pegollo Luana Marques de Carvalho , Amato Miglioli Maria Clara , T de Souza Gisele , Amato Luciana Patrick , Miana Leonardo A , B Massoti Maria Raquel , Penha Juliano G , Tanamati Carla , Jatene Marcelo B , Jatene Fabio B 
Published: June 2021

Objective: The aim of this study was to evaluate outcome measures between our standard multidose cardioplegia protocol and a del Nido cardioplegia protocol in congenital heart surgery patients. Methods: Retrospective single-center study including 250 consecutive patients that received del Nido cardioplegia (DN group) with a mandatory reperfusion period of 30% of cross clamp time and 250 patients that received a modified St. Thomas’ solution (ST group). Groups were matched by age, weight, gender, and Risk Adjustment for Congenital Heart Surgery (RACHS-1) scores. Preoperative hematocrit and oxygen saturation were also recorded. Outcomes analyzed were the vasoactive inotropic score (VIS), lactate, ventilation time, ventricular dysfunction with low cardiac output syndrome (LCOS), intensive care unit (ICU) length of stay (LOS), hospital LOS, bypass and aortic cross-clamp times, and in-hospital mortality. Results: Both groups were comparable demographically. Statistically significant differences (p ⩽ 0.05) were noted for cardiac dysfunction with LCOS, hematocrit at end of surgery (p = 0.0038), VIS on ICU admission and at end of surgery (p = 0.0111), and ICU LOS (p = 0.00118) with patients in the DN group having more desirable values for those parameters. Other outcome measures did not reach statistical significance. Conclusion: In our congenital cardiac surgery population, del Nido cardioplegia strategy was associated with less ventricular dysfunction with LCOS, a lower VIS and decreased ICU LOS compared with patients that received our standard myocardial protection using a modified St. Thomas’ solution. Despite the limitation of this study, including its retrospective nature and cohort size, these data supported our transition to incorporate del Nido cardioplegia solution with a mandatory reperfusion period as the preferred myocardial protection method in our program.
The Relationship of Staged, Bilateral Arthroscopic Primary Rotator Cuff Repair Timing and Postoperative Complications
Authors: Cancienne Jourdan M. , Denard Patrick J. , Garrigues Grant E. , Werner Brian C. 
Published: June 2021

Background: Although previous studies have reported acceptable clinical outcomes after simultaneous, single-stage bilateral and staged bilateral rotator cuff repair (RCR), few studies have been adequately powered to compare postoperative complication rates at various time intervals between procedures. Purpose: To examine the relationship between the timing of bilateral arthroscopic RCR and complications. Study Design: Descriptive epidemiology study. Methods: Patients from the Medicare data set within the PearlDiver database who underwent bilateral RCR between 2005 and 2014 were identified. These patients were then stratified by time between surgeries into cohorts: (1) single stage, (2) <3 months, (3) 3 to 6 months, (4) 6 to 9 months, (5) 9 months to 1 year, and (6) 1 to 2 years. Surgical and medical complications of these cohorts were compared with those of a control cohort of patients who underwent bilateral RCR >2 years apart using a regression analysis. Results: A total of 11,079 patients who underwent bilateral RCR were identified. Patients who underwent single-stage bilateral arthroscopic RCR experienced higher rates of revision RCR (odds ratio [OR], 2.1; P < .0001), reverse total shoulder arthroplasty (RTSA) (OR, 2.47; P < .0001), and postoperative infection (OR, 2.18; P = .007) in addition to higher rates of venous thromboembolism (VTE) (OR, 1.78; P = .031) and emergency department visits (OR, 1.51; P = .002) compared with the control group. Patients who underwent bilateral RCR with a <3-month interval had higher rates of revision surgery (OR, 1.56; P = .003), RTSA (OR, 1.89; P = .002), and lysis of adhesions (OR, 2.31; P < .0001) in addition to increased rates of VTE (OR, 1.92; P = .015) and emergency department visits (OR, 1.62; P < .0001) compared with the control group. There were no differences in any surgical or medical complications when surgeries were staged by ≥3 months compared with controls. Conclusion: Patients with Medicare undergoing single-stage and staged bilateral RCR who had the second repair within 3 months had significantly higher rates of multiple medical and surgical complications compared with patients waiting >2 years between procedures.