bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progress and Experience From the Decommissioning of the Eurochemic Reprocessing Plant
Authors: Lewandowski Patrick , Teunckens Lucien , Walthéry Robert , Millen Danny , Baumann Sven 
Published: April 2020

Abstract
Belgoprocess started the industrial decommissioning of the main process building of the former Eurochemic reprocessing plant in 1990, after completion of a pilot project. Two small storage buildings for end products from reprocessing were dismantled to verify the assumptions made in a previous paper study on decommissioning, to demonstrate and develop dismantling techniques and to train personnel. Both buildings were emptied and decontaminated to background levels. They were demolished and the remaining concrete debris was disposed of as industrial waste, and green field conditions restored.
The main process building is a large rectangular construction of about 80 m long, 27 m wide and 30 m high. About 106 individual cell structures have to be dismantled, involving the removal and decontamination of equipment from each cell, the decontamination of the cell walls, ceilings and floors, the dismantling of the ventilation system. These activities are followed by a complete monitoring of all surfaces in view of the unconditional release of the remaining structures. About 1,500 Mg of metal structures, and 12,500 m3 of concrete with 55,000 m2 of concrete surfaces have to be removed and/or to be decontaminated.
The paper presents a status overview of the decommissioning and decontamination activities at the former Eurochemic reprocessing plant on the nuclear site of Dessel in Belgium. The specific Belgoprocess approach will be highlighted, in which the decommissioning activities are carried out on an industrial scale with special emphasis on cost minimisation, the use of technology on an industrial representative scale. The specific alpha contamination of equipment and building surfaces require that the decommissioning work is done with adequate protective clothing. Adapted breathing and cooling air systems have been provided to enable the operators to carry out the decommissioning tasks in acceptable working conditions.
Impact Assessment Analysis for Surface Storage of Radioactive Waste Addressing Radiotoxicity and Chemotoxicity: Application to an Existing Radium-Waste Surface Storage Facility
Authors: Mallants Dirk , Dierckx Ann , Wang Lian , Volckaert Geert 
Published: April 2020

Abstract
Radioactive wastes often contain considerable amounts of non-radiological and potentially toxic components such as heavy metals, organics, etc. The present study discusses an impact assessment methodology applied to the surface repository located at Olen (Belgium) containing various wastes from radium and uranium production. The impact assessment considered leaching to groundwater and use of groundwater for production of drinking water and irrigation. Leaching of radionuclides and non-radiological components from the storage facility was calculated using numerical models of water flow and contaminant transport. Results showed that leaching from the waste forms containing the highest concentration in radium, uranium, lead, and arsenic (i.e., various uranium mill tailings and radium sources and needles) did not lead to unacceptable concentrations in the groundwater when a reasonable leaching period was considered.
Hybrid Probabilistic and Possibilistic Safety Assessment: Methodology and Application
Authors: Kato Kazuyuki , Amano Osamu , Ikeda Takao , Yoshida Hideji , Takase Hiroyasu 
Published: April 2020

Abstract
This paper presents a unified methodology to handle variability and ignorance by using probabilistic and possibilistic techniques respectively. The methodology has been applied to the safety assessment of geological disposal of high level radioactive waste. Ignorances associated with scenarios, models and parameters were defined in terms of fuzzy membership functions derived through a series of interviews to the experts, while variability was formulated by means of probability density functions (pdfs) based on available data sets. The exercise demonstrated the applicability of the new methodology and, in particular, its advantage in quantifying ignorances based on expert opinion and in providing information on the dependence of assessment results on the level of conservatism. In addition, it was shown that sensitivity analysis can identify key parameters contributing to uncertainties associated with results of the overall assessment. The information mentioned above can be utilized to support decision making and to guide the process of disposal system development and optimization of protection against potential exposure.
Principles and Limitations for Natural Attenuation of Radionuclides in Former Uranium Mining and Milling Sites
Authors: Dudel Ernst Gert , Brackhage Carsten , Clemens Claudia , Dienemann Holger , Mkandawire Martin , Rotsche Joachim , Weiske Arndt 
Published: April 2020

Abstract
Development of a self-sustainable remediation process seems to require an approach that uses the entire ecosystem functions. Selected effects have been documented in four case studies both in forests and wetlands: I) In the course of vegetation and soil development on experimental plots forested since 1963, concentration of RNs was reduced from &gt;1000 Bq/kg to &lt;200 Bq/kg in the top soil due to dilution by accumulation of organic carbon; II) in the stem wood of spruce and alder as few as 13–54 mg U/ha had been fixed; III) wetland compartments acted as strong sinks (&gt; 1000 Bq/kg in organic matter); IV) water quality below a natural wetland — working as a filter within an uranium mineralisation hot spot in Malawi (SE-Africa) (&gt; 2000 Bq/kg soil) — demonstrated no difference to a reference brook within the catchment.
The Development and Implementation of Successful Waste Characterization and Management Programs
Authors: Moody David W. , Peters Kevin J. 
Published: April 2020

Abstract
Consideration of established waste management programs is beneficial to organizations and agencies in the developmental stages of such programs. The intent of this paper is to facilitate the development of comprehensive, efficient and integrated waste characterization programs to ensure regulatory, technical and quality compliance. In the developmental phase, the components needed for each characterization activity, such as characterization technique, qualification of instrumentation and personnel, and input and output documentation, are designed for the program. Indoctrination, training and application of designed characterization processes implement the components. Internal assessments and audits are performed to verify successful implementation and ensure ongoing program improvement.
Detection of a novel haemoplasma species in fattening pigs with skin alterations, fever and anaemia
Authors: Stadler Julia , Ade Julia , Ritzmann Mathias , Hoelzle Katharina , Hoelzle Ludwig E 
Published: April 2020

BackgroundIn a fattening farm in Southern Germany, skin alterations (urticaria, haemorrhagic diathesis) and high fever were observed in 30% of the pigs 2 weeks after arrival. Feed intake was severely compromised in affected pigs.MethodsAfter detailed clinical observation, blood samples from affected pigs were collected for haematological, PCR and serological investigations. In addition, pathological investigations were performed on one pig.Results and conclusionAnalysis of blood parameters revealed a normocytic, normochromic anaemia. A novel porcine haemoplasma species was detected in blood samples of affected pigs and spleen sample of the necropsied pig by PCR. Phylogenetic analyses based on the 16S rDNA showed 99% identity to a novel porcine haemoplasma (‘Candidatus (Ca.) M. haemosuis’) species which has recently been described in China. Interestingly, this is the first report of ‘Ca. M. haemosuis’ in pigs with clinical signs resembling those of Mycoplasma (M) suis and the first description of this novel haemoplasma species outside Asia. On‐farm affected pigs were treated with oxytetracycline and non‐steroidal anti‐inflammatory drugs. Clinical signs improved after implementation of treatment and optimisation of management procedures. This case might indicate that other porcine haemoplasma species than M suis can induce fever and skin alterations and may have an economic impact on affected farms.
Use of Low‐Density Lipoprotein–Lowering Therapies Before and After PCSK9 Inhibitor Initiation
Authors: Rymer Jennifer A. , Mues Katherine E. , Monda Keri L. , Bratton Emily W. , Wirtz Heidi S. , Okerson Ted , Overman Robert A. , Brookhart M. Alan , Muntner Paul , Wang Tracy Y. 
Published: April 2020

Background

Proprotein convertase subtilisin/kexin type 9 inhibitors (
PCSK
9i) are used to reduce low‐density lipoprotein (
LDL
) cholesterol.
PCSK
9i use after initiation, as well as persistence with or alterations to other
LDL
‐lowering therapy after
PCSK
9i initiation, is not well understood.

Methods and Results

We conducted a retrospective study of alirocumab or evolocumab (
PCSK
9i) new users from July 2015 to December 2017 in the MarketScan Early View database of US commercial insurance beneficiaries. We determined the prevalence of
PCSK
9i interruption (≥30‐day gap in supply) and
LDL
‐lowering therapy use in the year after
PCSK
9i initiation. The average age of 6151 patients initiating
PCSK
9i therapy was 63 years, 44.4% were women, and 76.8% had atherosclerotic cardiovascular disease. Overall, 52.2% (95%
CI
, 50.8%–53.7%) of patients had an interruption in
PCSK
9i therapy in the first year after treatment initiation and 62.5% remained on
PCSK
9i therapy at 1‐year postinitiation. Also, 27.7% of patients were taking a statin at the time of
PCSK
9i initiation, with only 22.4% on statin therapy at 1 year after
PCSK
9i initiation. Ezetimibe use decreased from 20.9% at the time of
PCSK
9i initiation to 12.0% a year later. By 1 year after
PCSK
9i initiation, 44.0% of patients had experienced an interruption in all
LDL
‐lowering therapies, and 26.6% were no longer on any
LDL
‐lowering therapies.

Conclusions

After
PCSK
9i initiation, statins were often discontinued, whereas more than half of patients experienced an interruption in
PCSK
9i therapy. These results suggest that many new
PCSK
9i users may remain at high risk for cardiovascular events because of interruptions in
LDL
‐lowering therapy.
Inhibition of protein kinase C beta phosphorylation activates nuclear factor-kappa B and improves postischemic recovery in type 1 diabetes
Authors: Alleboina Satyanarayana , Wong Thomas , Singh Madhu V , Dokun Ayotunde O 
Published: April 2020

Peripheral artery disease (PAD) is a major health problem and is caused by atherosclerosis in arteries outside the heart leading to impaired blood flow. The presence of diabetes significantly increases the likelihood of having worse outcomes in PAD, and the molecular mechanisms involved are poorly understood. Hyperglycemia in diabetes activates the nuclear factor-kappa B (NF-κB) pathway, and chronic inflammation in diabetes is associated with vascular complications. Ischemia also activates NF-κB signaling that is important for perfusion recovery in experimental PAD. We hypothesized that prolonged exposure of endothelial cells to high glucose in diabetes impairs ischemic activation of the NF-κB pathway and contributes to poor perfusion recovery in experimental PAD. We assessed the effect of high glucose and ischemia on canonical and non-canonical NF-κB activation in endothelial cells and found both conditions activate both pathways. However, exposure of endothelial cells to high glucose impairs ischemia-induced activation of the canonical NF-κB pathway but not the non-canonical pathway. We probed an array of antibodies against signaling proteins in the NF-κB pathway to identify proteins whose phosphorylation status are altered in endothelial cells exposed to high glucose. Protein kinase C beta (PKCβ) was among the proteins identified, and its role in impaired ischemia-induced activation of NF-κB during hyperglycemia has not been previously described. Inhibition of PKCβ improves ischemia-induced NF-κB activation in vitroand in vivo. It also improves perfusion recovery in diabetic mice following experimental PAD. Thus, in diabetes, PKCβ phosphorylation contributes to impaired ischemic activation of NF-κB and likely a mechanism contributing to poor PAD outcomes. Impact statement Diabetes worsens the outcomes of peripheral arterial disease (PAD) likely in part through inducing chronic inflammation. However, in PAD, recovery requires the nuclear factor-kappa B (NF-κB) activation, a known contributor to inflammation. Our study shows that individually, both ischemia and high glucose activate the canonical and non-canonical arms of the NF-κB pathways. We show for the first time that prolonged high glucose specifically impairs ischemia-induced activation of the canonical NF-κB pathway through activation of protein kinase C beta (PKCβ). Accordingly, inhibition of PKCβ restores the ischemia-induced NF-κB activity both in vitroin endothelial cells and in vivoin hind limbs of type 1 diabetic mice and improves perfusion recovery after experimental PAD. Thus, this study provides a mechanistic insight into how diabetes contributes to poor outcomes in PAD and a potential translational approach to improve PAD outcomes.
Medical Liability in Sinus Surgery: A Westlaw Database Analysis From 2000 to 2017
Authors: Shah Suparna N. , Ramirez Arianna V. , Haroun Kareem B. , Chaaban Mohamad R. 
Published: April 2020

Background Medical malpractice occurs when a hospital or health-care provider through negligent act or omission results in an injury to a patient. More than 50% of otolaryngologists have faced at least 1 claim, with rhinology being the most litigated subspecialty. This study aims to analyze medical litigation trends in Rhinology from 2000 to 2017 in the United States. Methods The Westlaw database was reviewed from 2000 to 2017. Data were compiled on the demographics of the plaintiffs, procedures, nature of damages, legal allegations, and the use of expert witnesses, physician demographics/practice characteristics, verdicts, indemnities, and county/state of case. Results There were 75 cases that met inclusion criteria after review of 125 cases. Majority of cases went to trial over settlement (80%) and were found in the Northeast region of the United States (36%). Most common cited legal allegations were improper performance and failure to follow standard of care. The most common nature of injuries were eye injury (29%) and intracranial complications (27%). The highest payouts were for progression of disease followed by intracranial injury. Of the 75 total cases analyzed, 37 (49.3%) used expert witnesses. When an expert witness was used at trial, the verdict statistically favored the defendant (62.5%). Conclusions Our analysis reveals the importance of meticulous surgical techniques and thorough preoperative evaluations.
Clinical value of event-free survival in acute myeloid leukemia
Authors: Maiti Abhishek , Kantarjian Hagop M. , Popat Vinita , Borthakur Gautam , Garcia-Manero Guillermo , Konopleva Marina Y. , DiNardo Courtney D. , Verstovsek Srdan , Andreeff Michael , Kadia Tapan M. , Ajufo Helen O. , Goswamy Rohit V. , Blanco Carlos , Velasquez Miguel , Daver Naval G. , Pemmaraju Naveen , Pierce Sherry R. , Wierda William G. , Kornblau Steven M. , Ravandi Farhad , Cortes Jorge E. 
Published: April 2020

Abstract
The value of event-free survival (EFS) as an end point in acute myeloid leukemia (AML) trials has been questioned. We hypothesized that rather than a surrogate for overall survival (OS), improvement in EFS may decrease the use of health care. In this retrospective study, we identified 400 patients with AML who were treated on first-line therapy trials and had OS between 2 and 36 months. We captured health care use from diagnosis until death or until the patient was censored at stem cell transplantation (SCT). We used correlation and regression analysis to determine the relation between health care use and EFS. Among patients with newly diagnosed AML, 35% had adverse-risk AML, 48% received intensive chemotherapy, and 28% received hypomethylating agents. The median EFS censored at SCT was 9.7 months. Longer EFS led to a significant decline in health care use regardless of OS. This held true for all observations, including overall health care use (r = −0.45), sum of clinic visits, emergency room visits, hospitalizations, consultations (r = −0.44), sum of invasive procedures, laboratory and imaging studies (r = −0.51), and blood product transfusions (r = −0.19). These correlations were stronger for patients who achieved a complete remission and held true across age, treatment, and disease risk subgroups. In patients with newly diagnosed AML, improvement in EFS correlates with a decrease in all health care use irrespective of OS duration.
Correlation between benign joint hypermobility syndrome and primary focal hyperhidrosis in children: a novel concept
Authors: Parvaneh Vadood Javadi , Shahvaladi Hoda , Rahmani Khosro , Yekta Sara Javdani , Gorji Fatemeh Abdollah , Shiari Reza , Abdollahimajd Fahimeh 
Published: April 2020

Abstract
Background
Benign joint hypermobility syndrome (BJHS) is one of the most common hereditary connective tissue disorders in children in which autonomic nervous system involvement has been reported. This study aimed to evaluate the frequency of primary focal hyperhidrosis in children with BJHS.

Methods
This observational-analytical study was conducted in a case-control setting on children aged 3 to 15 years in 2018 at Mofid Children’s Hospital, Tehran, Iran. Benign joint hypermobility syndrome was diagnosed according to the Brighton criteria; then, the patients referred to a dermatologist for evaluation of hyperhidrosis.

Results
In total, 130 eligible patients with confirmed BJHS and 160 age- and sex-matched healthy subjects were enrolled in this study. Primary focal hyperhidrosis (PFH) was seen in 56.2 and 16.3% of the cases and controls, respectively, indicating a significant difference (P < 0.05). The severity of hyperhidrosis did not differ between the two groups.

Conclusion
Although the results of the study showed a significant correlation between BJHS and PFH, more comprehensive studies are needed to confirm these findings.
Differences in well-being and fear of death among female hospice employees and volunteers in Hungary
Authors: Zana Ágnes , Kegye Adrienne , Czeglédi Edit , Hegedűs Katalin 
Published: April 2020

Abstract
Background
Voluntary work plays a significant role in hospice care, but international research has mainly been conducted on the mental health and fear of death of paid hospice staff. The aim of the present study was to compare the Hungarian hospice volunteers with paid employees with regard to attitudes and fear of death, as well as mental health in order to see their role in hospice work and their psychological well-being more clearly.

Methods
The target population of the cross-sectional questionnaire study was hospice care providers in Hungary (N = 1255). The response rate was 15.5% (N = 195); 91.8% (N = 179) of them were women. The mean age of female hospice workers was 45.8 years (SD = 10.46 years, range: 23–73 years). One-quarter (27.9%, N = 50) of the female respondents were volunteers. The instruments were: the Multidimensional Fear of Death Scale, the Perceived Stress Scale, the WHO-5 Well-Being Index, and a shortened versions of the Beck Depression Inventory and the Maastricht Vital Exhaustion Questionnaire.

Results
Volunteers scored significantly lower on 5 dimensions of fear of death than paid employees, and showed significantly lower levels of vital exhaustion and significantly higher levels of psychological well-being than paid employees. Fear of the dying process was associated with an increased perceived stress, depressive symptoms, and vital exhaustion in both groups. Psychological well-being showed a significant negative, moderate correlation with four aspects of fear of death among paid staff; this pattern did not appear in the volunteer group. In addition, the association between fear of premature death and perceived stress, vital exhaustion, and depressive symptoms was more pronounced is case of paid workers.

Conclusion
Higher levels of psychological well-being and lower levels of fear of death among hospice volunteers suggest that they are less exhausted than paid employees. Increasing the recruitment of volunteers in hospices may help reduce the overload and exhaustion of paid employees.
Successful recovery of COVID-19 pneumonia in a patient from Colombia after receiving chloroquine and clarithromycin
Authors: Millán-Oñate José , Millan William , Mendoza Luis Alfonso , Sánchez Carlos Guillermo , Fernandez-Suarez Hugo , Bonilla-Aldana D. Katterine , Rodríguez-Morales Alfonso J. 
Published: April 2020

Abstract
Background
COVID-19 pandemics is a challenge for public health and infectious diseases clinicians, especially for the therapeutical approach that is not yet adequately defined. Amid this situation, investigational agents are being used, including chloroquine. We report here the clinical features and therapeutic course of the first reported patient with confirmed COVID-19 pneumonia that recovered in Colombia, after the use of chloroquine and clarithromycin.

Case presentation
A 34-year-old male, returning from Spain, presented with complaints of fever, and cough, and class-II obesity, being hospitalized. The respiratory viruses and bacteria tested by FilmArray® PCR were negative. Two days later, clarithromycin was started because the patient was suspected as community-acquired pneumonia. At the third day, the rRT-PCR confirmed the SARS-CoV-2 infection. A day later, chloroquine was started because of that. His chest computed tomography was performed and showed bilateral multifocal ground-glass opacities with consolidation, which suggested viral pneumonia as a differential diagnosis. Progressively his clinical condition improved and at day 9, patient rRT-PCR for SARS-CoV-2 became negative. The patient was discharged and isolated at home per 14 days.

Conclusions
Our patient improved significantly. This and other COVID-19 cases are urgently demanding results from clinical trials that support evidence-based therapeutical approaches to this pandemic and the clinical management of patients, especially those at critical care.
Clinical impact of splicing in neurodevelopmental disorders
Authors: Sanders Stephan J. , Schwartz Grace B. , Farh Kyle Kai-How 
Published: April 2020

AbstractClinical exome sequencing is frequently used to identify gene-disrupting variants in individuals with neurodevelopmental disorders. While splice-disrupting variants are known to contribute to these disorders, clinical interpretation of cryptic splice variants outside of the canonical splice site has been challenging. Here, we discuss papers that improve such detection.