bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protection of Nuclear Power Plants Against Severe Winds: Impact of the Local Building Configuration on the Wind Speed to Consider
Authors: Défossez Arièle , Dupont Eric , Grammosenis Laurence , Cordier Hervé , Le Morvan Tiphaine 
Published: October 2020

Abstract
Over the years, power plants have been hit by numerous severe weather events (storm, flood, heat wave...). EDF (Electricity of France) and ASN (Nuclear Safety Authority) want to assess the future impact of severe weather events on the power plants. Furthermore, recent research on storms estimates more accurate wind speed return values than before. For this reason, the severe wind value is an important parameter to quantify on a NPP (Nuclear Power Plant) site, in order to verify if the protection measures are sufficient or, if necessary, to design adequate protection.
To cope with those objectives, wind flow behavior around a PWR (Pressurized Water Reactor) nuclear power plant is studied. The goal of this work is to check that there is no exceeding local wind speed relative to the wind entering the site. The severe winds are characterized locally near the buildings in terms of location and amplitude. Different kind of topology for the nuclear power plant sites are studied in the project: near a cliff, in a plain or in a basin.
In our study, the CFD (Computational Fluid Dynamics) open source tool Code_Saturne developed at EDF-R&D is used to simulate the wind over a French PWR site located in nearly flat terrain in a plain. The 3D mesh includes buildings of the site. Several wind directions corresponding to the prevailing winds are studied. Two wind speeds corresponding to wind speed return values are studied (eg: the inlet wind speed is 25 m/s at 10 meter high for a return period of 50 years). Furthermore, several locations selected near buildings are studied carefully. Swirling flows have been viewed between buildings.
Analysis of the results shows that the wind speed near the buildings does not exceed the wind speed at the entrance of the domain for the three directions studied except near the cooling towers and above buildings. However, this result should not be generalized to other PWR sites due to the specificities of each site such as relief, buildings position, buildings size, roughness, wind rose... This methodology could be applied at other nuclear power plant sites.
Research on Operating Strategy of Total Loss of Essential Service Water System With RHR Not Connected in PWR Unit
Authors: Zhang Shengtao , Yi Ke 
Published: October 2020

Abstract
Essential Service Water System (WES) is part of the nuclear power plant cooling system which provides the final heat sink for nuclear power plants. Therefore, WES must operate stably, safely and reliably for a long time. The total loss of WES accident is a design extended condition and will result in the loss of the final heat sink of the unit. The consequences of the accident are severe. In order to deal with the accident quickly and effectively and ensure the safety and economics of the power plant in accident condition, it’s necessary to formulate corresponding treatment strategy to deal with the transient.
This paper developed a strategy for dealing with the total loss of WES with Residual Heat Removal System (RHR) not connected condition in Generation III nuclear power plant. The structure of the WES system and the types of failures that may occur are analyzed, and thus the symptoms of the faults are obtained and the entry conditions for the operating strategy are determined. The effect of faults on unit equipment and safety functions and the impact on nuclear steam supply system (NSSS) control are analyzed in this paper. Combined with the unit design, the system and equipment for controlling and mitigating related safety functions are analyzed, and the mitigation method and the fallback strategy of the fault are determined. Thereby a complete operating strategy of total loss of WES with RHR not connected is obtained. In addition, this paper analyzes and evaluates the operating strategy by simulating thermal hydraulic calculation for the first time. The results show that without staff intervention Component Cooling System (WCC) temperature reached 55°C limits after running a few minutes. Based on the intervention of the operating strategy proposed in this paper, WCC temperature reached the 55°C limits when the unit was operated at about 4 hours and 55 minutes. The result shows that and the strategy can effectively alleviate the failure and provide sufficient intervention time for the operator to bring the unit to a safe state.
Preliminary Investigation on Improvement of FP Management During BWR Severe Accident With MELCOR-2.2
Authors: Matsubara Kento , Yamaji Akifumi , Li Xin , Fujiwara Daisuke , Shirai Hiroshi , Noujuu Takumi 
Published: October 2020

Abstract
According to the current Boiling Water Reactor (BWR) accident management procedure, the Reactor Pressure Vessel (RPV) is not depressurized until the core water level has decreased to a predetermined threshold level (e.g., 10% of the active fuel length from the bottom of the active fuel (BAF)) when the backup low pressure water injection is unavailable. In the meantime, significant Fission Products (FPs) may be released due to core degradation. In such case, excessive FP deposition on the RPV dome may lead to heat up and failure of the top flange sealing of the Primary Containment Vessel (PCV) due to radiation heat. For BWR4/Mark-I TQUV event, the relationship between the different depressurization timings and FP release and depositions (represented by CsI and CsOH) on RPV (especially, steam dryer and RPV dome), D/W, W/W have been highlighted with MELCOR-2.2 analyses. Overall, it may be understood that the later the depressurization timing, the later the RPV failure timing, but the larger the amount of FP released to RPV. The remaining FP not trapped by water pool were mostly deposited on the RPV steam dryer. Clear correlation between the FP deposition amount on the steam dryer and its temperature could be confirmed. However, more investigations may be necessary to reveal what determines the RPV dome temperature, which seemed to have limited influence on the D/W head temperature profile.
Thermal-Hydraulic Performance Analysis of Fluid Flow in Tube With Helical Screw Inserts in Transition Flow
Authors: Chaurasia Shashank Ranjan , Sarviya R. M. 
Published: October 2020

Abstract
An experimental analysis is arranged to evaluate thermal hydraulic performance analysis on fluid flow in helical screw inserts in tube with number of strips and different twist ratios in Transition flow regime. Single strip insert is also compared with double strip inserts of helical screw inserts with three values of twist ratios. Heat transfer enhancement is achieved with fluid flow in double strip as compared to single strip helical screw insert at decreases values of twist ratios and increases values of Reynolds number (Re). Maximum enhancement in the value of Nusselt number is achieved with double strip inserts at low value of twist ratio and Reynolds number as compared to Single strip inserts. Common correlations of Nusselt number and friction factor are generated. Thermal performance factor (TPF) is achieved maximum values with double strip insert at all flow rates at 2.5 of twist ratio than single strip inserts. Double strip inserts show suitability of helical screw insert in heat exchangers to compact the size of thermal applications.
Research on Probabilistic Safety Assessment (PSA) Method of Safety Class Distributed Control System (DCS) in Nuclear Power Plant Based on Fuzzy Markov Process
Authors: Xufeng Tian , Hao Yan 
Published: October 2020

Abstract
Safety class DCS (Distributed Control System) in nuclear power plant is characterized by multi-state interaction, complex function and unknown fault mechanism, which limits the use of tradition PSA (Probabilistic Safety Assessment) method such as event tree and fault tree. An improved dynamic probabilistic security simulation method is proposed based on fuzzy Markov process to quantitative evaluation the risk of Safety class DCS in nuclear power plant, which resolved the failure uncertainty problem without in-depth understanding of failure mechanism. Firstly, the fuzzy fault tree reliability evaluation model is established based on fuzzy theory and FTA (Fault Tree Analysis), which describes the probability and degree of failure with fuzzy number. Then, the fuzzy fault tree is transformed into fuzzy Markov chain, this model is described mathematically, and the reliability indexes are simulated and analyzed with Monte Carlo simulation method, the change of system safety performance in long-term operation is obtained. Finally, the scientificity and effectiveness is verified by the example of redundant analog output module of safety class DCS in nuclear plant.
Levetiracetam for convulsive status epilepticus in childhood: systematic review and meta-analysis
Authors: Abdelgadir Ibtihal , Hamud Ali , Kadri Ayodeji , Akram Shazia , Pullattayil Abdul , Akobeng Anthony K , Powell Colin 
Published: October 2020

ImportanceProlonged seizures are life-threatening emergencies associated with significant morbidity.ObjectiveTo determine the efficacy and safety of levetiracetam in treating convulsive status epilepticus (CSE) in childhood.Data sources and study selectionsPubMed, Embase, the Cochrane Central Register of Controlled Trials and Cumulative Index to Nursing and Allied Health Literature were searched from inception up to April 2020. Only randomised controlled trials (RCTs) that included children aged 1 month–18 years were assessed. Two reviewers performed data assessment and extraction.Data extraction and synthesisTen studies out of the 20 637 citations identified were included.Main outcomesCessation of seizure activities, time to cessation of seizure activities, need for rapid sequence intubation (RSI), intensive care unit (ICU) admission, recurrence of seizures at 24 hours, adverse events and all-cause mortality.ResultsWe included 10 RCTs (n=1907). There was no significant difference in cessation of seizure activities when levetiracetam was compared with phenytoin (risk ratio (RR)=1.03, 95% CI 0.98 to 1.09), levetiracetam to fosphenytoin (RR=1.16, 95% CI 1.00 to 1.35) or levetiracetam to valproate (RR=1.10, 95% CI 0.94 to 1.27). No differences were found in relation to the timing of cessation of seizures for levetiracetam versus phenytoin (mean difference (MD)=−0.45, 95% CI −1.83 to 0.93), or levetiracetam versus fosphenytoin (MD=−0.70, 95% CI −4.26 to 2.86). There were no significant differences with regard to ICU admissions, adverse events, recurrence of seizure at 24 hours, RSI and all-cause mortality.ConclusionLevetiracetam is comparable to phenytoin, fosphenytoin and valproate as a second line treatment of paediatric CSE.
Efficacy of neoadjuvant atezolizumab treatment in patients with advanced urothelial bladder cancer according to the BASQ classification: a study protocol for an open-label, two-cohort, phase II trial
Authors: Yuk Hyeong Dong , Jeong Chang Wook , Kwak Cheol , Kim Hyeon , Moon Kyung Chul , Ku Ja Hyeon 
Published: October 2020

IntroductionAtezolizumab is a programmed death ligand-1 inhibitor for urothelial bladder cancer treatment. Atezolizumab has become the standard therapy for patients with urothelial bladder cancer who are not responding to cisplatin-based chemotherapy and is also used as a first-line treatment in cisplatin-ineligible patients. However, the efficacy of atezolizumab as a neoadjuvant chemotherapy for radical cystectomy has not yet been published and is still under study. This trial investigates the effectiveness of basal/squamous-like (BASQ) classification in the selection of an effective target group of patients with muscle-invasive bladder cancer (MIBC) for neoadjuvant atezolizumab treatment.Methods and analysisThis study is an open-label, two-cohort, phase II trial. It was designed to evaluate the efficacy of neoadjuvant atezolizumab treatment in patients with MIBC (T2–4N0M0) pathological responses after neoadjuvant chemotherapy and radical cystectomy. According to the molecular subtype characteristics of previous transurethral resection of the bladder specimens, patients are divided into two groups: luminal type (KRT5/6−KRT14−FOXA1+GATA3+) and basal type (KRT5/6+KRT14+FOXA1−GATA3−). Every 3 weeks, atezolizumab is administered at a dose of 1200 mg for three cycles prior to radical cystectomy in patients with MIBC. The primary end point is objective pathological responses in the intention-to-treat patients. The secondary end point is a 1-year progression-free survival difference according to the BASQ classification in patients who underwent neoadjuvant atezolizumab treatment.Ethics and disseminationThe study protocol was approved by the Institutional Review Board of Seoul National University Hospital, Seoul, Republic of Korea (H 1806-051-950). The trial is registered at ClinicalTrials.gov. The trial results will be published in peer-reviewed journals and at conferences.Trial registration numberNCT03577132.
Identifying factors associated with high use of acute care in Canada: protocol of a population-based retrospective cohort study
Authors: Zhang Mengmeng , Ma Jinhui , Xie Feng , Thabane Lehana 
Published: October 2020

IntroductionHigh-cost users (HCUs) account for a small proportion of the population but use a disproportionately large share of healthcare resources. Although HCUs exist in all healthcare types, acute care is the most expensive type of service and the most significant contributor to expenditures among HCUs. This study aims to determine demographic, socioeconomic and clinical factors associated with being HCUs in adult patients (≥18 years) receiving acute care in Canada.Methods and analysisThis is a population-based analysis using a national linked dataset. Adult patients who had at least one interaction with acute care facilities each year from 2011 to 2014 were captured in the dataset, and those living in institutions or other collective residences were not covered. The primary outcome is HCU of acute care (yes/no), which is defined as whether a patient is within the top 10% of the highest acute care cost users in his/her province. Multilevel logistic regression will be used to identify factors associated with HCU and to examine the provincial variations of these identified risk factors. Sensitivity analyses investigating the influences of different high user definitions and missing data on the study results will also be performed.Ethics and disseminationAll researchers will follow the codes and rules set by Statistics Canada and the Research Data Centre and give priority to the confidentiality of the data during and after this study. The study findings will be published in peer-review journals and disseminated at academic conferences.
Study protocol for the PURSUIT-HFpEF study: a Prospective, Multicenter, Observational Study of Patients with Heart Failure with Preserved Ejection Fraction
Authors: Suna Shinichiro , Hikoso Shungo , Yamada Takahisa , Uematsu Masaaki , Yasumura Yoshio , Nakagawa Akito , Takeda Toshihiro , Kojima Takayuki , Kida Hirota , Oeun Bolrathanak , Sunaga Akihiro , Kitamura Tetsuhisa , Dohi Tomoharu , Okada Katsuki , Mizuno Hiroya , Nakatani Daisaku , Iso Hiroyasu , Matsumura Yasushi , Sakata Yasushi 
Published: October 2020

IntroductionNeither the pathophysiology nor an effective treatment for heart failure with preserved ejection fraction (HFpEF) has been elucidated to date. The purpose of this ongoing study is to elucidate the pathophysiology and prognostic factors for patients with HFpEF admitted to participating institutes. We also aim to obtain insights into the development of new diagnostic and treatment methods by analysing patient background factors, clinical data and follow-up information.Methods and analysisThis study is a prospective, multicentre, observational study of patients aged ≥20 years admitted due to acute decompensated heart failure with preserved left ventricular ejection fraction (≥50%) and elevated N-terminal-pro brain natriuretic peptide (NT-proBNP) (≥400 pg/mL). The study began in June 2016, with the participation of Osaka University Hospital and 31 affiliated facilities. We will collect data on history in detail, accompanying diseases, quality of life, frailty score, medication history, and laboratory and echocardiographic data. We will follow-up each patient for 5 years, and collect outcome data on mortality, cause of death, and the number and cause of hospitalisation. The target number of registered cases is 1500 cases in 5 years.Ethics and disseminationThe protocol was approved by the Institutional Review Board (IRB) of Osaka University Hospital on 24 February 2016 (ID: 15471), and by the IRBs of the all participating facilities. The findings will be disseminated through peer-reviewed publications and conference presentations.
Experiences of breast feeding at work for physicians, residents and medical students: a scoping review
Authors: Frolkis Alexandra , Michaud Allison , Nguyen Khue-Tu , Bruton Joe Moss , Lithgow Kirstie , Ruzycki Shannon M 
Published: October 2020

ObjectiveTo review and summarise the available literature regarding breastfeeding experiences of medical students, residents and physicians.Eligibility criteriaArticles of any design, including non-peer reviewed data that examine the experiences of breast feeding of medical students, residents and staff physicians.Information sourcesOvid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid EMBASE, Scopus and Web of Science.Risk of biasAll peer-reviewed studies underwent risk-of-bias assessment using relevant tools, depending on the study design.Included studiesWe included 71 citations; 51 surveys, 3 narrative descriptions, 9 editorials or letters to the editor, and 3 reviews.Synthesis of resultsIncluded articles were heterogeneous with respect to their study design, target population and outcomes reported. Most articles had a high risk of bias. Only five articles reported the impact of an intervention.Description of effectDespite heterogeneity, the majority of articles described important barriers to breast feeding for physicians, residents and medical students. These barriers were similar across studies, and included inadequate and inaccessible space, time constraints and inflexible scheduling, and lack of colleague support. The consequences of these barriers included low milk supply and early discontinuation of breast feeding.Strengths and limitations of evidenceDue to the observed heterogeneity of articles identified in this review, we are unable to assess trends in barriers or duration of breastfeeding over time.InterpretationInterventions to overcome systemic and cultural barriers to breast feeding are needed to meet legal obligations of workplaces for physicians and trainees. These interventions should be formally evaluated using implementation science or quality improvement methods.
Outbreak of COVID-19 and SARS in mainland China: a comparative study based on national surveillance data
Authors: Zhao Lin , Feng Dan , Ye Run-Ze , Wang Hai-Tao , Zhou Yu-Hao , Wei Jia-Te , J. de Vlas Sake , Cui Xiao-Ming , Jia Na , Yin Chao-Nan , Li Shi-Xue , Wang Zhi-Qiang , Cao Wu-Chun 
Published: October 2020

ObjectiveTo compare the epidemiological characteristics and transmission dynamics in relation to interventions against the COVID-19 and severe acute respiratory syndrome (SARS) outbreak in mainland China.DesignComparative study based on a unique data set of COVID-19 and SARS.SettingOutbreak in mainland China.ParticipantsThe final database included 82 858 confirmed cases of COVID-19 and 5327 cases of SARS.MethodsWe brought together all existing data sources and integrated them into a comprehensive data set. Individual information on age, sex, occupation, residence location, date of illness onset, date of diagnosis and clinical outcome was extracted. Control measures deployed in mainland China were collected. We compared the epidemiological and spatial characteristics of COVID-19 and SARS. We estimated the effective reproduction number to explore differences in transmission dynamics and intervention effects.ResultsCompared with SARS, COVID-19 affected more extensive areas (1668 vs 230 counties) within a shorter time (101 vs 193 days) and had higher attack rate (61.8 vs 4.0 per million persons). The COVID-19 outbreak had only one epidemic peak and one epicentre (Hubei Province), while the SARS outbreak resulted in two peaks and two epicentres (Guangdong Province and Beijing). SARS-CoV-2 was more likely to infect older people (median age of 52 years), while SARS-CoV tended to infect young adults (median age of 34 years). The case fatality rate (CFR) of either disease increased with age, but the CFR of COVID-19 was significantly lower than that of SARS (5.6% vs 6.4%). The trajectory of effective reproduction number dynamically changed in relation to interventions, which fell below 1 within 2 months for COVID-19 and within 5.5 months for SARS.ConclusionsChina has taken more prompt and effective responses to combat COVID-19 by learning lessons from SARS, providing us with some epidemiological clues to control the ongoing COVID-19 pandemic worldwide.
Targeting the gut-liver-immune axis to treat cirrhosis
Authors: Tranah Thomas Henry , Edwards Lindsey A , Schnabl Bernd , Shawcross Debbie Lindsay 
Published: October 2020

Cirrhotic portal hypertension is characterised by development of the decompensating events of ascites, encephalopathy, portal hypertensive bleeding and hepatorenal syndrome, which arise in a setting of cirrhosis-associated immune dysfunction (CAID) and define morbidity and prognosis. CAID describes the dichotomous observations that systemic immune cells are primed and display an inflammatory phenotype, while failing to mount robust responses to pathogen challenge. Bacterial infections including spontaneous bacterial peritonitis are common complications of advanced chronic liver disease and can precipitate variceal haemorrhage, hepatorenal syndrome and acute-on-chronic liver failure; they frequently arise from gut-derived organisms and are closely linked with dysbiosis of the commensal intestinal microbiota in advanced chronic liver disease.Here, we review the links between cirrhotic dysbiosis, intestinal barrier dysfunction and deficits of host-microbiome compartmentalisation and mucosal immune homoeostasis that occur in settings of advanced chronic liver disease. We discuss established and emerging therapeutic strategies targeted at restoring intestinal eubiosis, augmenting gut barrier function and ameliorating the mucosal and systemic immune deficits that characterise and define the course of decompensated cirrhosis.