An Analytical Evaluation of Distortion-Induced Fatigue in Steel Bridges

Multi-girder steel bridges designed prior to the mid-1980's, have developed cracks due to distortion-induced fatigue. An analytical evaluation was conducted to better understand the effects of bridge configurations and common retrofits on distortion-induced fatigue, as quantified by hot spot stress in web gap regions. Results are described herein and present relative distortion-induced fatigue susceptibility of multi-girder bridges with varied skew angle, cross frame spacing, bracing configuration, and cross frame stiffness as well as regions within each variation where cracking is most likely to occur. Performance of retrofit techniques was also compared and included positive attachment, a slotted connection stiffener, a back-up stiffener, and cross frame removal with each implemented both locally and globally. In addition, influence surfaces were generated and analyzed for three bridge configurations to better understand the relationship between load placement and distortion-induced fatigue related stresses. It is hoped that this research will benefit bridge engineers working to identify and extend the fatigue life of bridges susceptible to distortion-induced fatigue

Restoring heathlands after afforestation on two islands in western Norway

The ongoing loss of red-listed coastal heathlands is a threat to biodiversity and cultural heritage legacies throughout the Atlantic coastal regions of Europe. It is possible to restore degraded and afforested heathlands, but restoration interventions are often labour-intensive and costly, and the outcome of specific restoration actions are not well documented. We assess the efficiency of restoring coastal heathlands through natural succession (i.e. ‘passive restoration') after removal of Sitka spruce Picea sitchensis (Bong.) Carr. plantations. The study was replicated on two neighbouring islands in a nature reserve in Western Norway. Low-intensity free-range sheep grazing was implemented as part of the reserve management plan. Furthermore, we tested the effect of leaving the clear-felled woody material as chips on site, this being a cost-efficient strategy on islands. Succession was monitored 1, 2, 4/5 and 8 years after clear-felling, and revegetation of vascular plants and bryophytes was compared to target heathland vegetation. Surprisingly, we found different successional trajectories on the two islands. Species composition on one island approached target heathland vegetation during succession, but not on the other. Wood chips reduced species richness and slowed the restoration process, but these negative effects were only short-term (<8 years). Differences in seed bank composition and soil conditions due to land use may explain the deviating successional trajectories on the two islands. We also found that management actions beyond clear-felling and introducing sheep grazing are necessary due to the rapid seed regeneration of the Sitka spruce.publishedVersio

Low D-dimer levels at diagnosis of venous thromboembolism are associated with reduced risk of recurrence: data from the TROLL registry

Background: Venous thromboembolism (VTE) is a frequent disease with a high risk of recurrence. It has been suggested that the D-dimer level at the time of VTE diagnosis can be used to identify patients at a low risk of recurrence. Objectives: We aimed to investigate the impact of D-dimer levels measured at the time of VTE diagnosis on the risk of recurrence in a large cohort of patients with a first-time VTE. Methods: The study included 2585 patients with first symptomatic non-cancer–associated VTE from the Venous Thrombosis Registry in Østfold Hospital (TROLL) (2005- 2020). All recurrent events during the follow-up were recorded, and cumulative incidences of recurrence were estimated according to D-dimer levels of ≤1900 ng/mL (≤25th percentile) and >1900 ng/mL. Results: During a median follow-up of 3.3 years, 395 patients experienced a recurrent VTE. The 1- and 5-year cumulative incidences of recurrence were 2.9% (95% CI: 1.8- 4.6) and 11.4% (95% CI: 8.7-14.8), respectively, in those with a D-dimer concentration of ≤1900 ng/mL and 5.0% (95% CI, 4.0-6.1) and 18.3% (95% CI: 16.2-20.6), respectively, in those with a D-dimer concentration of >1900 ng/mL, respectively. In patients with unprovoked VTE, the 5-year cumulative incidence was 14.3% (95% CI: 10.3-19.7) in the ≤1900-ng/mL category, and 20.2% (95% CI: 17.3-23.5) in the >1900-ng/mL category. Conclusions: D-dimer levels within the lowest quartile, measured at the time of VTE diagnosis, were associated with lower recurrence risk. Our findings imply that D-dimer levels measured at the time of diagnosis may be used to identify patients with VTE at a low risk of recurrent VTE

The venous thrombosis registry in Østfold Hospital (TROLL registry) - design and cohort description

Purpose: The incidence of venous thromboembolism (VTE) is expected to increase over the next decades, further increasing its substantial impact on patients and health care resources. Registries have the benefit of reporting real-world data without excluding clinically important subgroups. Our aim was to describe a Norwegian VTE registry and to provide descriptive data on the population and management. Registry Population: The Venous Thrombosis Registry in Østfold Hospital (TROLL) is an ongoing registry of consecutive patients diagnosed with, treated, and/or followed up for VTE at Østfold Hospital, Norway, since 2005. Baseline and follow-up data, including demographics, clinical features, risk factors, diagnostic procedures, classification of VTE, and treatment were collected during hospitalization, and at scheduled outpatient visits. Findings to Date: From January 2005 to June 2021, 5037 patients were eligible for research in TROLL. Median age was 67 years (interquartile range, 55–77), and 2622 (52.1%) were male. Of these, 2736 (54.3%) had pulmonary embolism (PE), 2034 (40.4%) had deep vein thrombosis (DVT), and 265 (5.3%) had upper-extremity DVT or splanchnic or cerebral sinus vein thrombosis. In total, 2330 (46.3%) were classified as unprovoked VTE, and 1131 (22.5%) had cancer. Direct oral anticoagulants were the most frequent therapeutic agents (39.3%) followed by low-molecular-weight heparins (30.4%) and vitamin K antagonists (30.3%). Outpatient treatment for PE increased from 4% in 2005 to 23% in 2019. Future Plans: TROLL is a population-based ongoing registry that represents a valuable source of real-world data that will be used for future research on the management and outcomes of VTE

Making the Transition: An Assessment of Distressed and Non-distressed Counties in Eastern Kentucky

One hundred and twenty-one Appalachian counties are currently classified as ‘distressed’ by the Appalachian Regional Commission. Distressed counties have higher rates of poverty and unemployment, and lower per capita income, than non-distressed counties. Currently, forty-two of Kentucky’s fifty-one Appalachian counties are classified as distressed, an increase of approximately nine percent from 1990. As a step towards understanding county-level strategies that may be used to successfully transition from distressed to non-distressed status, this study investigated a number of additional social and economic variables for a group of six currently distressed and six currently nondistressed counties in eastern Kentucky. County-level population, education, and economic data were obtained from the U.S. Census Bureau for each census period between 1970 and 2000. Graphs and maps were used to identify and analyze trends in population, education, and economic variables for each group of counties. Key differences in educational attainment levels and industrial diversity were observed between the distressed and non-distressed groups. Project results were used to develop a broad set of guidelines (an ‘action plan’) intended to assist currently distressed counties in making the transition to non-distressed status. The quality of life will improve for all the people of Appalachia as more counties make this transition successfully, and the goal of building sustainable Appalachian communities will be increasingly within reach

A combined individual and group-based stabilization and skill training intervention versus treatment as usual for patients with long lasting posttraumatic reactions receiving outpatient treatment in specialized mental health care – a study protocol for a randomized controlled trial

Background Suffering linked to previous interpersonal trauma is common among patients in mental health care. Diagnostic labels may vary, but the clinical picture is often characterized by long-lasting and complex psychological and somatic symptoms, subjective distress and reduced quality of health and life. A substantial proportion of patients do not recover after individual treatment in ordinary specialized mental healthcare settings, despite the proven usefulness of individual trauma-specific treatments. The therapeutic factors that arise in group settings, such as normalization, shame reduction and corrective relational experiences, may be particularly useful for trauma survivors. However, evidence in support of group treatment for trauma survivors is scarce. This study aims to test whether combining a novel group intervention to individual treatment is superior to conventional individual out-patient treatment in an ordinary community mental health hospital. Methods: In a single-site, non-blinded, randomized controlled trial (RCT), the effect of a combined group-based stabilization and skill-training (SST) intervention added to individual treatment will be compared to conventional treatment (treatment as usual, TAU) alone. Participants (N = 160) with ongoing and long-lasting reactions related to known adverse life events from the past will be recruited among patients at general outpatient clinics in a community mental health centre at St. Olav’s University Hospital, Trondheim, Norway. Following baseline assessment and randomization, participants will complete follow-up measures at 4, 8, 13 and 19 months post-baseline. The primary outcome is personal recovery (The questionnaire about the process of recovery , QPR). Secondary outcomes include (1) self-reported symptoms of posttraumatic stress, general mental and somatic health symptoms, well-being, functional impairment and client satisfaction, (2) immunological and endocrine response measured in blood samples and (3) national registry data on occupational status, use of mental health services and pharmacological treatment. Additionally, mechanisms of change via posttraumatic cognitions will be examined. Discussion: The addition of a group-based intervention to individual treatment for trauma survivors might prove to be an efficient way to meet the need of long-lasting high-intensity treatment in a large group of patients in mental health care, thereby reducing their suffering and increasing their psychosocial functioning

Cerebrospinal fluid catecholamines in delirium and dementia

Abstract Dopamine and noradrenaline are functionally connected to delirium and have been targets for pharmacological interventions but the biochemical evidence to support this notion is limited. To study the CSF levels of dopamine, noradrenaline and the third catecholamine adrenaline in delirium and dementia, these were quantified in three patient cohorts: (i) cognitively normal elderly patients (n = 122); (ii) hip fracture patients with or without delirium and dementia (n = 118); and (iii) patients with delirium precipitated by another medical condition (medical delirium, n = 26). Delirium was assessed by the Confusion Assessment Method. The hip fracture cohort had higher CSF levels of noradrenaline and adrenaline than the two other cohorts (both P &amp;lt; 0.001). Within the hip fracture cohort those with delirium (n = 65) had lower CSF adrenaline and dopamine levels than those without delirium (n = 52, P = 0.03, P = 0.002). Similarly, the medical delirium patients had lower CSF dopamine levels than the cognitively normal elderly (P &amp;lt; 0.001). Age did not correlate with the CSF catecholamine levels. These findings with lower CSF dopamine levels in hip fracture- and medical delirium patients challenge the theory of dopamine excess in delirium and question use of antipsychotics in delirium. The use of alpha-2 agonists with the potential to reduce noradrenaline release needs further examination

Tiltak for å ta vare på truet natur. Kunnskapsgrunnlag for 90 truete arter og 33 truete naturtyper

Aalberg Haugen, I.M., Kyrkjeeide, M.O., Bjerke, J.W, Brandrud, T.E., Hegre, H., Jokerud, M., Vange, V., Westergaard, K.B., Øien, D.-I., Myklebost, H., Hanssen, O., Hassel, K., Järnegren, J., Endrestøl, A., Lyngstad, A., Nordén, J., Dervo, B.K., Evju, M., Mjelde, M., Nordén, B., Christie, H., Gjershaug, J.O., Pedersen, B., Austrheim, G., Mattison, J., Ødegaard, F., Handberg, Ø.N, Magnussen, K, Dombu, S.V., Ruano, M., Daverdin, M., Jackson, C.R., Hanssen, F., Dervo, B., & Singsaas, F.T. 2019. Tiltak for å ta vare på truet natur: Kunnskapsgrunnlag for 90 truete arter og 33 truete naturtyper. NINA Rapport 1646. Norsk institutt for naturforskning. Prosjektet «Tiltak for å ta vare på truet natur» ble gjennomført i 2018 av NINA i samarbeid med Menon Economics, NTNU Vitenskapsmuseet og Norsk institutt for vannforskning (NIVA) på oppdrag fra Miljødirektoratet. I prosjektet ble det fremstilt 90 kunnskapsgrunnlag for arter og 33 kunnskapsgrunnlag for naturtyper. For samtlige kunnskapsgrunnlag ble det laget et sammendrag, en såkalt «syntese», som inneholder bakgrunnskunnskap, rødlistestatus, påvirkningsfaktorer, mål, tiltak med kostnadsberegninger og en anbefaling av hvilke tiltak som bør igangsettes for måloppnåelse. Forfatter av det enkelte kunnskapsgrunnlag og referanser er ikke gjengitt i syntesene. Disse syntesene ble videreutviklet av oppdragsgiver til å inneholde et kapittel om virkemidler som vil gi måloppnåelse. De videreutviklede syntesene ble levert som beslutningsgrunnlag av oppdragsgiver til Klima- og miljødepartementet desember 2018. Denne rapporten inneholder samtlige synteser slik de ble levert til oppdragsgiver i oktober 2018. I tillegg inneholder rapporten en oversikt over samtlige kunnskapsgrunnlag som disse syntesene er bygget på. Kunnskapsgrunnlagene er laget i form av en Excel-bok og har ikke tidligere blitt publisert. Kunnskapsgrunnlagene er nå gjort tilgjengelige gjennom denne rapporten som vedlegg, og de kan lastes ned fra denne rapportens nettside. Hvert kunnskapsgrunnlag inneholder informasjon om forfatter og en referanseliste. I denne rapporten angis det hvordan kunnskapsgrunnlagene skal refereres til