bluuebunny/crossref_metadata_2025_split huggingface dataset:
Train-Track-Bridge coupling vibration and train running safety under vessel impact
Authors: Zhang Jingfeng , Zhang Zhichao , Zhu Zhihui , Liu Dejun , Li Xiaozhen 
Published: November 2023

Accidental vessel collisions pose a threat to the safety of train operations on navigable bridges. The CRH2 high-speed train, operating on a four-span continuous girder bridge, is selected as a research prototype to study the effects of vessel impact loads on the responses of the train-track-bridge (TTB) system and train running safety. The TTB model subjected to vessel collision is developed using the finite element software ANSYS and the multi-body system software SIMPACK. The influences of load intensity and train speed on the critical indicators of train running safety are discussed. Safety thresholds based on train running speed are proposed through comprehensive parametric analysis. The results indicate that the impact load has a significant effect on the dynamic responses of both bridge and track structures. The interaction between piles and soil (PSI) has a significant impact on the dynamic responses of the TTB system. The track structure undergoes significant overall deformation under the vessel impact load. The train running safety indices ascend with the increase in impact load intensity and train speed. As the impact load intensity increases from 0 to 24.25 MN, the speed limit for ensuring train running safety decreases from 350 km/h to 250 km/h.
Psychostimulant Misuse Among American Indian, Alaskan Native, or Native Hawaiian College Students in the U.S. From 2015 to 2019
Authors: Qeadan Fares , Ross Sydney , Barbeau William A , Madden Erin F , Venner Kamilla L , English Kevin 
Published: November 2023

Introduction: This study examines factors associated with psychostimulant misuse, including polysubstance use and social factors, among the understudied American Indian/Alaska Native/Native Hawaiian (AI/AN/NH) college student population. Methods: Data were from the 2015 to 2019 American College Health Association-National College Health Assessment IIc (ACHA-NCHA IIc) survey. Multivariable logistic regression models and odds ratios were used to estimate associations between psychostimulant misuse and potential risk and protective factors among AI/AN/NH college students, including licit and illicit substance use, social support, relationship factors, exposure to violence or abuse, mental health symptoms, drug and alcohol education, and sample demographics. Results: Opioid misuse among AI/AN/NH college students significantly increased the odds of using psychostimulants. Specifically, for cocaine use, the adjusted odds ratio (aOR) was 3.17 with a 95% confidence interval (C.I.) of 2.17 to 4.63; for methamphetamine use, the aOR was 38.87 (95% C.I. 19.24-78.52). For amphetamine misuse among non-Tobacco users, the aOR was 5.47 (95% C.I. 3.49-8.55), while among Tobacco users, the aOR was 2.65 (95% C.I. 2.07-3.41). For cocaine and other stimulant misuse, the aOR was 3.64 (95% C.I. 2.30-5.67). Additionally, the use of other types of licit and illicit substances was associated with greater odds of psychostimulant use and misuse. Conversely, factors such as age, living on campus, and residing in parental/guardian housing were linked with lower odds of psychostimulant use and misuse. Conclusion: Substance use prevention and treatment interventions targeting AI/AN/NH college students should address polysubstance use, including the combined use of opioids and psychostimulants. Substance use interventions should not be siloed to focus narrowly on single substances but rather should leverage potential protective factors against substance use, such as promoting supportive campus and family living conditions and other social support networks, in broad efforts to reduce multiple forms of substance use among AI/AN/NH students.
Assessment of Pathological Complete Response Using Vacuum-Assisted Biopsy in Breast Cancer Patients Who Have Clinical and Radiological Complete Response After Neo-Adjuvant Chemotherapy
Authors: Khare Siddhant , Santosh Irrinki , Laroiya Ishita , Singh Tulika , Bal Amanjit , Singh Gurpreet 
Published: November 2023

Background: Any treatment protocol that leads to complete elimination of surgery may lead to a better patient acceptance of breast cancer treatments. Objectives: We conducted this study to assess the feasibility of preoperative vacuum-assisted biopsies in identifying pathological complete response (pCR) and its accuracy in correlation to final histopathology report (HPR), in an Indian setting. Methods: This was a prospective study conducted between October 1, 2019, and March 31, 2021. Patients with early breast cancer, estrogen and progesterone receptors negative and either Her2 positive or negative, and who were fit to undergo marker placement at the centre of the tumour and to receive third-generation chemotherapy (4 cycles of 3 weekly doxorubicin and cyclophosphamide followed by 4 cycles of 3 weekly docetaxel) were included in the study. Following the enrolment, a tissue marker was placed at the centre of the tumour and appropriate chemotherapy was started. Patients who achieved clinical complete response were subjected to ultrasound-guided vacuum-assisted biopsy (VAB) from the tumour bed before surgery. Pathology results of the VAB and resected specimen were then compared. Descriptive statistics were used in the study. Results: Eighteen patients were enrolled in the study, with a mean age of 43.6 ± 9.8 years. However, only 10 were eligible for VAB procedure, and sensitivity and specificity were calculated based on the results of these 10 patients only. Vacuum-assisted biopsy showed sensitivity of 50% and specificity of 100% in identifying pCR. Combination of mammography, ultrasonography, and VAB showed sensitivity of 77.8% and specificity of 66.7% in identifying pCR. Conclusion: Vacuum-assisted biopsy of tumour bed may not be sensitive enough to eliminate surgery even in patients who have had exceptional response to neo-adjuvant chemotherapy.
Prevalence, Species Identification, and Associated Risk Factor Ixodid Tick Infestation of Cattle in Selamago District Southern Ethiopia
Authors: Belete Worku , Mekuria Solomon 
Published: November 2023

Background: Ticks are blood-sucking external parasites of livestock and humans; and can transmit pathogens beyond their direct effect during biting. Ticks are distributed in different agro-ecological zones. The study’s objectives were to determine the species of ixodid ticks, estimate prevalence, and link the presumptive risk variables. Material and methods: A cross-sectional study was conducted from November 2022 to June 2023 in Selamago district, Southern Ethiopia. A total of 384 cattle managed under extensive grazing systems were selected proportionally based on cattle population, from 3 kebeles, which is the lowest administrative structure of government, and individual animals were selected using systematic random sampling techniques at an interval of 5 animals; as the results, 153, 128, and 103 cattle were selected from Hana, Marsiyo, and Geyo kebeles, respectively. Results: 262 animals (68.2%) were found to be infested with one or more tick species. In this study, there was a statistically significant difference in prevalence between sexes and age groups ( P < .05). A higher prevalence was recorded in female and adult cattle than respective group. A total of 579 ticks were collected; 4 genera and 7 tick species were identified. As a result, Ambylomma variegatum, Amblyomma gemma, Amblyomma lepidum, Rhipicephalus (Boophilus) decoloratus, Rhipicephalus pulchellus, Rhipicephalus evertsi evertsi, and Hyalomma truncatum were observed. Among the species identified in the study area, Ambylomma variegatum was the most abundant tick (32.3%) and Hy. truncatum was the least prevalent (4.3%). Ticks on animals’ body were recovered more dominantly around the perineum region, udder, scrotum, and dewlap, followed by the belly, head, and neck. Male ticks were more frequently encountered than females. Conclusion: The finding shows a high tick infestation, and adult age groups were more affected and had a serious problem. Hence, prompt control measures are required to rescue the livelihood of the community and economic loss.
A 10-year review of pain management practices for rib fractures at a lead trauma hospital: Are we adopting all multimodal pain management strategies?
Authors: Naveed Asad , Adams-McGavin R. Chris , Ladha Karim , Chan Stephen , Beckett Andrew , Rezende-Neto Joao , Ahmed Najma , Nauth Aaron , Gomez David 
Published: November 2023

Objective Rib fractures lead to altered breathing mechanics, impaired gas exchange, and in some patients to respiratory failure. Multimodal analgesia has become one of the pillars of management; however, barriers toward widespread adoption remain. We reviewed the trends in multimodal pain management strategies and their drivers over a 10-year period at a lead trauma hospital in Canada. Methods This is a cross-sectional study in which demographic, injury, pharmacological, as well as outcome data were collected for all adult patients admitted with rib fractures. Data were collected retrospectively and the study period was divided into three eras (2011–2014; 2015–2018; 2019–2022). Multimodal pain management was defined as either patient-controlled (PCA) or regional analgesia (epidural or continuous plane block) in combination with acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). All patients received pro re nata (PRN) narcotics. Data were stratified based on rib fracture severity, age, and intubation on arrival. Results We identified 2586 patients with rib fractures (mild non-flail 32.6%; moderate non-flail 50.2%; flail 17.2%). The use of standing acetaminophen and NSAIDs increased over time for all groups. Regional analgesia use increased while PCA use reduced, particularly in the flail group. Only 7% of flail patients intubated on arrival received regional analgesia. Among those not intubated on arrival, only 35% of flail and 23% of non-flail patients received multimodal pain management. Over time, multimodal pain management decreased in the non-flail group due to a reduction in PCA use without an equal rise in regional anesthesia. Those without multimodal pain management were older and the mechanism of injury was more likely a fall. Among those with a flail, who were non-intubated at presentation, only 31% of those aged >65 received multimodal pain regimens compared to 45% in those ≤65y. Conclusions Although multimodal pain management strategies have improved over time, a large proportion of patients, even among those with flail chest, still do not receive multimodal pain management. Elderly patients, at highest risk of adverse outcomes, were less likely to receive multimodal pain management strategies and should be the target of performance improvement initiatives.
Patient perspectives of recovery following major musculoskeletal trauma: A systematic review and qualitative synthesis
Authors: Norris Sarah , Graham Laura , Wilkinson Lynne , Savory Sinead , Robinson Lisa 
Published: November 2023

Background Improved survival following major trauma has resulted in an increased number of patients with complex physical, functional and psychosocial needs requiring specialist multidisciplinary rehabilitation. A key challenge in modern trauma care is to deliver rehabilitation interventions that translate into improved outcomes. This study aimed to synthesise patient perceptions of recovery following major musculoskeletal trauma. Methods A pre-planned literature search (CINAHL, Medline, Embase, PsychInfo, and other sources) was performed 28/02/22–03/03/22 (updated 29/3/23–17/4/23 prior to submission) to capture all available qualitative or mixed methods studies describing major musculoskeletal trauma recovery from the patient perspective. Quality assessment was performed using the Joanna Briggs evaluation tool and the mixed methods appraisal tool. The qualitative data was thematically analysed. Findings Of 5648 distinct studies, 18 studies met the criteria for inclusion totalling 637 participants. Thematic analysis of the qualitative data found that recovery following major musculoskeletal trauma has physical, psychological and socio-functional dimensions. Successful recovery involves ‘crafting a new normal’ and is both a process and an outcome. Three major themes were identified: vulnerability; learning to manage; adaptation and adjustment. Patients do not experience each theme in a linear way; instead, they move through the recovery process in an individualised and cyclical manner. Conclusion This review highlights the individual experience of recovery, which requires flexible and holistic care to facilitate an occupational (or socio-functional) perspective on major musculoskeletal trauma recovery. Therefore, organisationally, an effective multi-disciplinary team model of care is essential to support survival as a long-term condition.
Endovascular Coil Embolization of an Enlarging Gastroduodenal Artery Aneurysm
Authors: Rahman Naveed A. , Lieb Kayla R. , Choudhry Asad , Chihade Deena B. , Feghali Anthony 
Published: November 2023

Gastroduodenal artery aneurysms are a rare type of visceral aneurysm that can lead to rupture and death. We present a 75-year-old male with history of hypertension, diabetes, and hyperlipidemia with an incidental finding of a 3.2 × 3.7 cm gastroduodenal aneurysm found on abdominal computed tomography angiography (CTA). After refusing surgical intervention, he was seen two years later and presented with an enlarged gastroduodenal aneurysm, now 5.0 × 5.1 cm, visible on a repeat abdominal CTA. Upon his continued refusal for an open surgery, we elected for endovascular repair of this GDA aneurysm via coil embolization.
A retrospective analysis of complications associated with postpartum hemorrhage up to 1 year postpartum in mothers with and without a pre-existing mental health diagnosis
Authors: Endres Kodi , Razavi Nina , Tian Zizhong , Zhou Shouhao , Krawiec Conrad , Jasani Sona 
Published: November 2023

Background/objectives: There is limited research on the associated immediate and long-term outcomes of postpartum hemorrhage. Mothers with a pre-existing psychiatric disease prior to delivery may be especially vulnerable to postpartum hemorrhage outcomes but little is known on this topic. Barriers to studying this population exist and add to knowledge gaps. The goal of this study is to determine the clinical characteristics and frequency of complications within 1 year of a postpartum hemorrhage diagnosis and the psychiatric sequelae within 7 days of a postpartum hemorrhage diagnosis in mothers with a pre-existing mental health diagnosis prior to delivery versus those without. Methods/design: This is a multicenter retrospective observational cohort study using TriNetX, a de-identified electronic health record database. The following electronic health record data were collected and evaluated in postpartum females who were billed for either a vaginal or cesarean delivery: age, race, ethnicity, diagnostic codes, medication codes, and number of deaths. Results: We included 10,649 subjects (6994 (65.7%) no mental health diagnosis and 3655 (34.3%) pre-existing mental health diagnosis). Haloperidol administration (118 (3.2%) versus 129 (1.8%), p < 0.001) was more prevalent in subjects with a pre-existing mental health diagnosis. Adjusting for demographics, pre-existing mental health diagnoses were associated with complications within 1 year after postpartum hemorrhage diagnosis (OR = 1.39, 95% CI: 1.26–1.52, p < 0.001). Conclusion: Having a mental health disorder history is associated with a higher odds of developing subsequent complications within 1 year of postpartum hemorrhage diagnosis. Mothers with a pre-existing mental health disorder have a significantly higher frequency of certain severe postpartum hemorrhage sequelae, including acute respiratory distress syndrome, retained placenta, sickle cell crisis, and need for mechanical ventilation/tracheostomy up to 1 year after delivery. Medications such as haloperidol were ordered more frequently within 7 days of a postpartum hemorrhage diagnosis in these mothers as well. Further research is needed to understand and manage the unique consequences of postpartum hemorrhage in this vulnerable maternal population.
Effects of 16-weeks of strength training on jump height and anthropometric variables in U19 semi-professional male soccer players
Authors: González-Fernández Francisco Tomás , Clemente Filipe Manuel , Rodríguez-García Lorena , Castillo-Rodriguez Alfonso 
Published: November 2023

Purpose The aim of our study was to examine the effect of 16 weeks of strength training on anthropometric characteristics and jump height in semi-professional male players after a pre-season period. Methods A parallel two-group, longitudinal (pre, post) design was used with physical tests performed before (preintervention) and after (postintervention) the 16-week intervention period. The soccer players were assigned and matched into two groups, an experimental group (EG) and a control group (CG), based on the team of which they were a part. Results A two-way ANOVA was performed with group and time as factors. The results of a two-way ANOVA revealed no time×group interaction for body composition or jump height. Nevertheless, a paired measures t-test of weight, fat mass, lean mass, and countermovement jump (CMJ) test metrics (pre-post) and group (CG and EG) showed an improvement in all measures ( p < 0.01). Discussion The 16-week intervention program resulted in an improvement in the EG both at the level of body composition and in CMJ performance. Conclusions Despite the benefits of the 16-week intervention program, a combination of training methods that includes power, agility-coordination, speed, and strength can enhance such improvements. It is important to take this strength-specific capacity into account in training, due to the importance outlined in the sport of soccer both for its transfer to both linear and COD sprints and specific strength skills and mainly to vertical jump.
Improvement in severe asthma patients receiving biologics and factors associated with persistent insufficient control: a real-life national study
Authors: Guilleminault Laurent , Camus Claire , Raherison-Semjen Chantal , Capdepon Audrey , Bourdin Arnaud , Bonniaud Philippe , Fry Stéphanie , Devouassoux Gilles , Blanc François-Xavier , Pison Christophe , Dupin Clairelyne , Khayath Naji , Courdeau Joelle , Valcke-Brossollet Judith , Nocent-Ejnaini Cécilia , Rolland Fabien , Lamandi Carmen , Proust Alain , Ozier Anaig , Portel Laurent , Gaspard Wanda , Roux-Claude Pauline , Beurnier Antoine , Martinez Stéphanie , Dot Jean-Marc , Hennegrave Florence , Vignal Guillaume , Auvray Etienne , Paleiron Nicolas , Just Nicolas , Miltgen Jean , Russier Maud , Olivier Cécile , Taillé Camille , Didier Alain 
Published: November 2023

Background: Biological therapies have revolutionized the treatment of severe asthma with type 2 inflammation. Although such treatments are very effective in reducing exacerbation and the dose of oral steroids, little is known about the persistence of symptoms in severe asthma patients treated with biologics. Purpose: We aim to describe asthma control and healthcare consumption of severe asthma patients treated with biologics. Design: The Second Souffle study is a real-life prospective observational study endorsed by the Clinical Research Initiative in Severe Asthma: a Lever for Innovation & Science Network. Methods: Adults with a confirmed diagnosis of severe asthma for at least 12 months’ duration were enrolled in the study. A self-administered questionnaire including the Asthma Control Questionnaire (ACQ), Asthma Quality of Life Questionnaire (AQLQ) and a compliance evaluation test was given to the patients. Healthcare consumption within 12 months prior to enrolment was documented. In patients receiving biologics, doctors indicated whether the patients were biologic responders or non-responders. Results: The characteristics of 431 patients with severe asthma were analysed. Among them, 409 patients (94.9%) presented asthma with type 2 inflammation (T2 high) profile, and 297 (72.6%) patients with a T2 high phenotype were treated with a biologic. Physicians estimated that 88.2% of patients receiving biologics were responders. However, asthma control was only achieved in 25.3% of those patients (ACQ > 0.75). A high proportion of patients (77.8%) identified as responders to biologics were not controlled according to the ACQ score. About 50% of patients continue to use oral corticosteroids either daily (25.2%) or more than three times a year for at least three consecutive days (25.6%). Gastro-oesophageal Reflux Disease (GERD) and Obstructive Sleep Apnoea syndrome (OSA) were identified as independent factors associated with uncontrolled asthma. Conclusion: Although a high proportion of severe asthma patients respond to biologics, only 25.3% have controlled asthma. GERD and OSA are independent factors of uncontrolled asthma.
Predictive factors of response to infliximab therapy in Brazilian inflammatory bowel disease patients
Authors: Martins Camilla de Almeida , Azevedo Matheus Freitas Cardoso de , Carlos Alexandre Sousa , Damião Aderson Omar Mourão Cintra , Sobrado Junior Carlos Walter , Nahas Sergio Carlos , Queiroz Natália Sousa Freitas 
Published: November 2023

Background: Biological therapies have revolutionized the treatment of patients with inflammatory bowel disease (IBD). Infliximab (IFX) has been shown to be effective in inducing and maintaining remission in patients with Crohn’s disease and ulcerative colitis. However, about one-third of the patients are primary non-responders, and up to half can lose response over time. Hence, it is important to assess which factors are related to treatment failure. Objectives: We aimed to identify factors predicting clinical and endoscopic remission with IFX treatment during maintenance therapy in a Brazilian IBD referral center. Design: We conducted a cross-sectional study to describe demographic, clinical, and IBD therapy-related characteristics of IBD patients treated with IFX for at least 6 months in a Brazilian referral center. Subsequently, we evaluated factors associated with clinical and endoscopic remission (primary and secondary outcomes, respectively). Methods: We used descriptive statistics to summarize the essential demographic and clinical characteristics of the population. The association of sociodemographic and clinical variables with outcomes was analyzed using multivariable logistic regression. Results: A total of 131 IBD patients (the mean age 41.7 years) were enrolled in this study. Clinical and endoscopic remission were observed in 79.4% and 58.2% of the patients, respectively. In the multivariable analysis, IFX therapy duration and higher albumin levels increased the likelihood of clinical remission, while previous surgery decreased its chance. Prior use of adalimumab and higher C-reactive protein levels reduced the likelihood of endoscopic remission. Conclusion: In summary, this study has enhanced our understanding of the predictive factors of treatment response to IFX in a well-characterized Brazilian IBD population. Trial registration: 4.254.501 and 2.903.748.