bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanical and Impact Properties of Composite Laminates Reinforced with Kevlar Multiaxial Warp Knit Fabrics
Authors: Kang Tae Jin , Kim Cheol 
Published: April 2023

The mechanical and impact properties of multiaxial warp knit fabric reinforced composite laminates have been studied. Kevlar® fibre was used to fabricate the multiaxial warp knit structure for unidirectional reinforcing as well as stitching yarns. Tensile, flexural, short beam shear, and impact properties have been compared with those of woven laminated composites. The results showed that increased interlaminar shear strength is the main characteristic feature of the multiaxial warp knit composite compared with plain woven laminates. The interlaminar shear strength of multiaxial warp knit composites showed up to 52% increase compared with that of woven laminates composites. Also the delamination was retarded due to the increase in interlaminar shear strength of the multiaxial warp knit composites. It is shown that the through-the-thickness reinforcing loops resist any delamination. The tensile strength of the multiaxial warp knit composites increased by about 5–12% compared with the theoretical values computed from classical lamination theory. It is generally accepted that impact induced delamination area increases with the increase in the total absorbed impact energy in collisions with foreign objects. But the multiaxial warp knit composites showed that the total absorbed impact energy decreased with the increase in through-the-thickness reinforcement fibres. The multiaxial warp knit composites showed reduced vertical deformations compared with woven laminates, as the reinforcing loop density increased.
Impact of initiating oral anticancer agents for leukemia on adherence to medications for multiple chronic conditions
Authors: Gatwood Justin , Dashputre Ankur , Rajpurohit Abhijeet , Gatwood Katie , Mackler Emily , Wallace Leah , Farris Karen , Rizvi-Toner Amna , Farley Joel 
Published: April 2023

Introduction Increased use of oral anticancer agents (OAAs) has empowered adults with chronic lymphocytic leukemia (CLL) and chronic myelogenous leukemia (CML) to manage their therapy, but this shift may complicate medication use, particularly among adults with multiple chronic conditions (MCC). Methods This retrospective cohort study used 2013–2018 commercial and Medicare claims data to assess medication use in adults with CML or CLL. To be included, patients must have been at least 18 years old, diagnosed with and had 2+ claims for an OAA indicated for either CML or CLL, continuously enrolled 12 months before and after OAA initiation, and treated for (2+ fills) at least two select chronic conditions. Proportion of days covered (PDC) determined medication adherence and was compared for 12 months before and after OAA initiation by Wilcoxon signed-rank tests, McNemar's tests, and difference-in-differences models. Results Among CLL patients, mean OAA adherence in the first year of therapy was 79.8% (SD: 21.1) and 74.7% (SD: 24.9) for commercial and Medicare patients, respectively; mean adherence for CML patients was 84.5% (SD: 15.8) and 80.1% (SD: 20.1) for commercial and Medicare patients, respectively. Adherence and the proportion adherent (PDC ≥ 80%) to comorbid therapies was generally unchanged following OAA initiation. Consistently unremarkable changes in MCC adherence were observed in 12-month difference-in-differences models, but significant decline was observed in MCC adherence after 6 months of OAA use. Conclusions OAA initiation among adults with CML or CLL was not associated with significant, initial changes to adherence to medications for chronic diseases.
Lipid and glucose abnormalities and associated factors among children living with HIV in Asia
Authors: Suwanlerk Tulathip , Rupasinghe Dhanushi , Jantarabenjakul Watsamon , An Vu T , Ross Jeremy L , Kariminia Azar , Van Lam Nguyen , Kinikar Aarti , Ounchanum Pradthana , Puthanakit Thanyawee , Nik Yusoff Nik K , Lumbiganon Pagakrong , Chokephaibulkit Kulkanya , Viet Do C , Sudjaritruk Tavitiya , Moy Fong S , Wati Dewi K , Mohamed Thahira J , Nallusamy Revathy , Kumarasamy Nagalingeswaran , Khol Vohith , Khanh Truong H , Kurniati Nia ,   on behalf of the TREAT Asia pediatric HIV Observational Database (TApHOD)
Published: April 2023

Background Children living with HIV (CLHIV) on prolonged antiretroviral therapy (ART) are at risk for lipid and glucose abnormalities. Prevalence and associated factors were assessed in a multicentre, Asian longitudinal paediatric cohort. Methods CLHIV were considered to have lipid or glucose abnormalities if they had total cholesterol ≥200 mg/dL, high-density lipoprotein (HDL) ≤35 mg/dL, low-density lipoprotein (LDL) ≥100 mg/dL, triglycerides (TG) ≥110 mg/dL, or fasting glucose >110 mg/dL. Factors associated with lipid and glucose abnormalities were assessed by logistic regression. Results Of 951 CLHIV, 52% were male with a median age of 8.0 (interquartile range [IQR] 5.0–12.0) years at ART start and 15.0 (IQR 12.0–18.0) years at their last clinic visit. 89% acquired HIV perinatally, and 30% had ever used protease inhibitors (PIs). Overall, 225 (24%) had hypercholesterolemia, 105 (27%) low HDL, 213 (58%) high LDL, 369 (54%) hypertriglyceridemia, and 130 (17%) hyperglycemia. Hypercholesterolemia was more likely among females (versus males, aOR 1.93, 95% CI 1.40–2.67). Current PIs use was associated with hypercholesterolemia (current use: aOR 1.54, 95% CI 1.09–2.20); low HDL (current use: aOR 3.16, 95% CI 1.94–5.15; prior use: aOR 10.55, 95% CI 2.53–43.95); hypertriglyceridemia (current use: aOR 3.90, 95% CI 2.65–5.74; prior use: aOR 2.89, 95% CI 1.31–6.39); high LDL (current use: aOR 1.74, 95% CI 1.09–2.76); and hyperglycemia (prior use: aOR 2.43, 95% CI 1.42–4.18). Conclusion More than half and one-fifth of CLHIV have dyslipidemia and hyperglycemia, respectively. Routine paediatric HIV care should include metabolic monitoring. The association between PIs use and dyslipidemia emphasizes the importance of rapidly transitioning to integrase inhibitor-containing regimens.
Two Thumbs Down: A 10-Year Analysis of Crossbow-Related Hand and Digit Injuries in the United States
Authors: Oleck Nicholas C. , Pyfer Bryan J. , Morris Miranda X. , Mithani Suhail K. 
Published: April 2023

Background: Modern crossbow is a popular weapon used throughout the United States for outdoor recreation. Crossbow mechanics place the hand and digits at significant risk of injury while shooting or handling these weapons; however, injury patterns have been poorly documented. In this study, the authors use a national database to assess patterns of crossbow-related injuries of the hand and digits. Methods: A retrospective review of the National Electronic Injury Surveillance System database was conducted to identify crossbow-related hand and digit injuries over the past 10 years. Demographic data, injury timing, anatomical injury location, specific injury diagnosis, and disposition data were collected. Results: A total of 15 460 crossbow-related hand injuries were identified between 2011 and 2021. A strong temporal relationship was identified, with 89% of injuries occurring between the months of August and December. Male patients sustained most injuries (>85%). Body areas injured were the digits (93.2%) and the hand (5.7%). The most common injuries were laceration (n = 7520, 48.6%), fracture (n = 4442, 28.7%), amputation (n = 1341, 8.7%), and contusion/abrasion (n = 957, 6.2%). More than 50% of cases involved injury to the thumb, with approximately 750 thumb amputations recorded during the time period examined. Conclusions: This study is the first to document the patterns of hand and digit injuries associated with crossbow use on a national scale. These findings have important implications for public health awareness campaigns targeting hunters and support the designation of crossbow “safety wings” as a mandatory feature of crossbow design.
Transradial access with Simmons guiding catheter for carotid artery stenting: Feasibility and procedural complications in a single-center experience
Authors: Muszynski P , Richard S , Finitsis S , Humbertjean L , Audibert G , Mione G , Harsan O , Derelle AL , Liao L , Zhu F , Olivot JM , Anxionnat R , Calvet D , Gory Benjamin 
Published: April 2023

Background There is an increasing number of transradial approach (TRA) for carotid artery stenting (CAS), however, similar techniques and materials as for femoral access are used. We report the results of TRA lower profile technique for CAS using a 7 F Simmons guiding catheter, especially in terms of feasibility and procedural safety in a single center. Materials and Methods We retrospectively analyzed 68 consecutive patients with symptomatic extracranial carotid stenoses who underwent 75 CAS between January 2018 and December 2021. The success and crossover rate, procedural time, fluoroscopy, clinical outcomes, technical considerations, and procedural complications were analyzed. Results TRA CAS with Simmons guiding catheter was successful in 67/75 (89.3%) cases, with a 7 (9.3%) crossover rate. Fluoroscopy mean time was 15.8 minutes. Two forearm hematomas were described. No ischemic or surgical site complications were reported. Conclusions In our experience frontline TRA with a 7 F Simmons guiding catheter is feasible with high procedural success and a low rate of access site complications.
Characteristics, clinical practice patterns, and outcomes of strokes in India: INSPIRE—A multicentre prospective study
Authors: Xavier Denis , Murphy Robert , Pais Prem , Pandian Jeyaraj , Gosala Sarma , Mathur Nandini , Khurana Dheeraj , Sundararajan R , Gupta Rajeev , Joshi Rajnish , Vanchilingam Somesh , Venkatarathanamma PN , Desai Soaham , Reddin Catriona , O’Donnell Martin , Yusuf Salim 
Published: April 2023

Background: India has a high burden of stroke, but there are limited data available on the characteristics of patients presenting with stroke in India. Aims: We aimed to document the clinical characteristics, practice patterns, and outcomes of patients presenting with acute stroke to Indian hospitals. Methods: A prospective registry study of patients admitted with acute clinical stroke was conducted in 62 centers across different regions in India between 2009 and 2013. Results: Of the 10,329 patients included in the prescribed registry, 71.4% had ischemic stroke, 25.2% had intracerebral hemorrhage (ICH), and 3.4% had an undetermined stroke subtype. Mean age was 60 years (SD = 14) with 19.9% younger than 50 years; 65% were male. A severe stroke at admission (modified-Rankin score 4–5) was seen in 62%, with 38.4% of patients having severe disability at discharge or dying during hospitalization. Cumulative mortality was 25% at 6 months. Neuroimaging was completed in 98%, 76% received physiotherapy, 17% speech and language therapy (SLT), 7.6% occupational therapy (OT), with variability among sites; 3.7% of ischemic stroke patients received thrombolysis. Receipt of physiotherapy (odds ratio (OR) = 0.41, 95% confidence interval (CI): 0.33–0.52) and SLT (OR = 0.45, 95% CI: 0.32–0.65) was associated with lower mortality, while a history of atrial fibrillation (OR = 2.22, 95% CI: 1.37–3.58) and ICH (OR = 2.00, 95% CI: 1.66–2.40) were associated with higher mortality. Conclusion: In the INSPIRE (In Hospital Prospective Stroke Registry) study, one-in-five patients with acute stroke was under 50 years of age, and one-quarter of stroke was ICH. There was a low provision of thrombolysis and poor access to multidisciplinary rehabilitation highlighting how improvements are needed to reduce morbidity and mortality from stroke in India.
Cinematic Virtual Reality for Educating Health Care Providers About Type 2 Diabetes, Disability, and Elder Abuse and Neglect: A Pilot Study
Authors: Beverly Elizabeth A. , Love Carrie , Love Matthew , Lammert Lori , Bowditch John 
Published: April 2023

Background: Diabetes care for older adults is complex and must consider geriatric syndromes, disability, and elder abuse and neglect. Health care providers would benefit from professional training programs that emphasize these risks. One new educational approach is cinematic virtual reality (cine-VR). We conducted a pilot study to evaluate a cine-VR training program based on an older patient with type 2 diabetes and multiple geriatric syndromes who is at risk for elder abuse and neglect. Methods: We employed a single-arm, pre-post-test study to assess changes in attitudes to disability and self-efficacy in identifying and managing elder abuse and neglect. Results: Thirty health care providers completed the pilot study (83.3% women, 86.7% white, 56.7% physicians, 43.4% practiced in outpatient clinics). We observed change in attitudes toward discrimination ( Z = −2.628, P = .009, Cohen’s d = .62). In addition, we observed changes in six of the eight self-efficacy items, including how participants would ask questions about abuse ( Z = −3.221, P = .001, Cohen’s d = .59) and helping an older patient make a report to the police or social services ( Z = −2.087, P = .037, Cohen’s d = .52). In addition, we observed positive changes in understanding the documentation needed to complete whether a patient reports abuse ( Z = −3.598, P < .001) as well as the legal knowledge for how to report elder abuse and neglect ( Z = −2.556, P = .011). Conclusion: Findings from this pilot study suggest that cine-VR training may increase health care providers’ awareness of discrimination and improve self-efficacy toward identifying and managing elder abuse and neglect. Research with a proper control condition is needed to confirm its effectiveness.
The Birth Companions’ Experience of the Birthing Room and How It Influences the Supportive Role: A Qualitative Study
Authors: Nilvér Helena , Berg Marie 
Published: April 2023

Aim: To explore birth companions’ experience of the birthing room and how it influences their role supporting the woman during labor and birth. Background: Although support from a birth companion positively affects the outcome of labor and birth, limited research explores how the birthing room influences the companion. This study identifies elements of the birthing room essential for the birth companion to offer optimal support to the woman during labor and birth. Methods: Fifteen birth companions were individually interviewed 2 weeks to 6 months after birth using a semi-structured interview guide. Transcribed interviews were analyzed based on reflexive thematic analysis. Results: The findings are captured by one overall theme: creating a supportive birth space in an unfamiliar environment. This creation process is further described by three subthemes: not being in the way, finding one's role, and being close to the birthing woman. Conclusions: The findings illustrate how the birthing room was an unfamiliar environment for the birth companions, but one that they needed in order to give the required support. With slight changes in physical design, the birthing room can become calmer and more private and better help the birth companion fulfill the supportive role.
Association of Symptomatic Venous Thromboembolism and BMI in Patients Undergoing Sports Medicine Knee Procedures: A Retrospective Case-Control Study
Authors: Looney Austin M. , Chopra Aman , Elkadi Seleem H. , Chau Justin , Childers Daniel F. , Chung Joon , Postma William F. 
Published: April 2023

Background: The purpose of this study was to characterize the prevalence of venous thromboembolism (VTE; including deep vein thrombosis [DVT] and pulmonary embolism [PE]) after sports medicine knee procedures by a single surgeon at an academic institution, identify factors associated with increased risk of VTE, and determine risk factor thresholds for beyond which VTE risk is elevated. Hypothesis: We hypothesized that the prevalence of VTE after sports medicine knee procedures is low, but that increasing weight and body mass index (BMI) would be associated with elevated risk. Study Design: Retrospective case-control study. Level of Evidence: Level 3. Methods: A retrospective case-control study analyzing sports medicine knee surgeries from 2017 to 2020 was conducted using current procedural terminology codes to identify cases. Optimal cutoff points for specific continuous patient characteristics were calculated to determine elevated risk of postoperative VTE. Overall VTE-free survival was assessed using Kaplan-Meier analysis and Cox proportional hazard regression models. Results: Among the 724 eligible patients, there were 13 postoperative VTE events (1.79% prevalence; 12 DVTs, 1 DVT/PE). Increasing weight and BMI were significant risk factors for postoperative VTE ( P = 0.03 and P = 0.04, respectively), with weight >94.7 kg and BMI >27.9 kg/m2 associated with elevated risk in male patients and weight >79.1 kg and BMI >28.1 kg/m2 associated with elevated risk for female patients. Cox regression demonstrated a significantly increased risk of postoperative VTE for male patients with BMI ≥27.9 kg/m2. Conclusion: Patients who undergo sports medicine knee surgery with increased weight and BMI are at an elevated risk of postoperative VTE. An individualized approach should be considered for chemoprophylaxis in patients with these risk factors. Clinical Relevance: Consider chemoprophylaxis in patients with increased weight and BMI who undergo sports medicine knee surgery since they are at an elevated risk of postoperative VTE.
Rationale and design of the SenseWhy project: A passive sensing and ecological momentary assessment study on characteristics of overeating episodes
Authors: Alshurafa Nabil I. , Stump Tammy K. , Romano Christopher S. , F. Pfammatter Angela , Lin Annie W. , Hester Josiah , Hedeker Donald , Forman Evan , Spring Bonnie 
Published: April 2023

Objectives Overeating interventions and research often focus on single determinants and use subjective or nonpersonalized measures. We aim to (1) identify automatically detectable features that predict overeating and (2) build clusters of eating episodes that identify theoretically meaningful and clinically known problematic overeating behaviors (e.g., stress eating), as well as new phenotypes based on social and psychological features. Method Up to 60 adults with obesity in the Chicagoland area will be recruited for a 14-day free-living observational study. Participants will complete ecological momentary assessments and wear 3 sensors designed to capture features of overeating episodes (e.g., chews) that can be visually confirmed. Participants will also complete daily dietitian-administered 24-hour recalls of all food and beverages consumed. Analysis Overeating is defined as caloric consumption exceeding 1 standard deviation of an individual's mean consumption per eating episode. To identify features that predict overeating, we will apply 2 complementary machine learning methods: correlation-based feature selection and wrapper-based feature selection. We will then generate clusters of overeating types and assess how they align with clinically meaningful overeating phenotypes. Conclusions This study will be the first to assess characteristics of eating episodes in situ over a multiweek period with visual confirmation of eating behaviors. An additional strength of this study is the assessment of predictors of problematic eating during periods when individuals are not on a structured diet and/or engaged in a weight loss intervention. Our assessment of overeating episodes in real-world settings is likely to yield new insights regarding determinants of overeating that may translate into novel interventions.
Venous Thromboembolism Rates Have Not Decreased in Elective Lumbar Fusion Surgery from 2011 to 2020
Authors: Ngan Alex , Song Junho , Katz Austen D. , Jung Bongseok , Zappia Luke , Trent Sarah , Silber Jeff , Virk Sohrab , Essig David 
Published: April 2023

Study Design Retrospective cohort study. Objectives This study aimed to (1) evaluate for any temporal trends in the rates of VTE, deep venous thrombosis (DVT), pulmonary embolism (PE), and mortality from 2011 to 2020 and (2) identify the predictors of VTE following lumbar fusion surgery. Methods Annual incidences of 30-day VTE, DVT, PE, and mortality were calculated for each of the operation year groups from 2011 to 2020. Multivariable Poisson regression was utilized to test the association between operation year and primary outcomes, as well as to identify significant predictors of VTE. Results A total of 121,205 patients were included. There were no statistically significant differences in VTE, DVT, PE, or mortality rates among the operation year groups. Multivariable regression analysis revealed that compared to 2011, operation year 2019 was associated with significantly lower rates of DVT. Age, BMI, prolonged operation time, prolonged length of stay, non-home discharge, anterior fusion, smoking status, functional dependence, and chronic steroid use were identified as independent predictors of VTE following lumbar fusion. Female sex, Hispanic ethnicity, and outpatient surgery setting were identified as protective factors from VTE in this cohort. Conclusions Rates of VTE after lumbar fusion have remained mostly unchanged between 2011 and 2020. Older age, higher BMI, longer operation time, prolonged length of stay, non-home discharge, anterior fusion, smoking, functional dependence, and steroid use were independent predictors of VTE after lumbar fusion, while female sex, Hispanic ethnicity, and outpatient surgery were the protective factors.
Effect of Quadriceps and Hamstring Strength Relative to Body Weight on Risk of a Second ACL Injury: A Cohort Study of 835 Patients Who Returned to Sport After ACL Reconstruction
Authors: Simonson Rebecca , Piussi Ramana , Högberg Johan , Senorski Carl , Thomeé Roland , Samuelsson Kristian , Senorski Eric Hamrin 
Published: April 2023

Background: Anterior cruciate ligament (ACL) injuries are common sports-related injuries with a high risk of reinjury after return to sport (RTS). Rehabilitation aims to regain symmetrical knee strength and function to minimize the risk of a second ACL injury after RTS. Purpose: To determine the effect of absolute quadriceps and hamstring strength, normalized by body weight, on the risk of a second ACL injury during the first 2 years after RTS in patients who have undergone ACL reconstruction (ACLR). Study Design: Cohort study; Level of evidence, 3. Methods: Data from patients after index ACLR at the time of RTS were extracted from a rehabilitation registry—Project ACL. Patients who had performed isokinetic tests for quadriceps and hamstring strength and hop tests before RTS were included. The endpoint was a second ACL injury or a follow-up of 2 years after RTS after ACLR. Results: A total of 835 patients (46% women), with a mean age of 23.9 ± 7.7 years, were included. During the study period, 69 (8.3%) second ACL injuries (ipsilateral and contralateral) occurred. Greater relative quadriceps strength in the injured leg increased the risk of a second ACL injury (relative risk [RR], 1.69 [95% CI, 1.05-2.74]; P = .032). In patients who had recovered symmetrical quadriceps strength (limb symmetry index ≥90%), there was no effect of quadriceps strength on the risk of second ACL injury (RR, 1.33 [95% CI, 0.69-2.56]; P = .39). Quadriceps strength on the healthy side or hamstring strength, regardless of side, had no effect on the risk of a second ACL injury. Conclusion: Greater relative quadriceps strength in the injured leg at the time of RTS after ACLR was associated with an increased risk of a second ACL injury. There was no effect of relative quadriceps strength on the risk of a second ACL injury in patients who had recovered symmetrical quadriceps strength.