bluuebunny/crossref_metadata_2025_split huggingface dataset:
The staging and grading system in defining periodontitis cases: consistency and accuracy amongst periodontal experts, general dentists and undergraduate students
Authors: Marini Lorenzo , Tonetti Maurizio S. , Nibali Luigi , Rojas Mariana A. , Aimetti Mario , Cairo Francesco , Cavalcanti Raffaele , Crea Alessandro , Ferrarotti Francesco , Graziani Filippo , Landi Luca , Sforza Nicola M. , Tomasi Cristiano , Pilloni Andrea 
Published: December 2020

AbstractAimThe objective of this study was to evaluate consistency and accuracy of the periodontitis staging and grading classification system.MethodsThirty participants (10 periodontal experts, 10 general dentists and 10 undergraduate students) and a gold‐standard examiner were asked to classify 25 fully documented periodontitis cases twice. Fleiss kappa was used to estimate consistency across examiners. Intraclass correlation coefficient (ICC) was used to calculate consistency across time. Quadratic weighted kappa and percentage of complete agreement versus gold standard were computed to assess accuracy.ResultsFleiss kappa for stage, extent and grade were 0.48, 0.37 and 0.45 respectively. The highest ICC was provided by students for stage (0.91), whereas the lowest ICC by general dentists for extent (0.79). Pairwise comparisons against gold standard showed mean value of kappa >0.81 for stage and >0.41 for grade and extent. Agreement with the gold standard for all three components of the case definition was achieved in 47.2% of cases. The study identified specific factors associated with lower consistency and accuracy.ConclusionsDiagnosis was highly consistent across time and moderately between examiners. Accuracy was almost perfect for stage and moderate for grade and extent. Additional efforts are required to improve training of general dentists.
Innovation in flood risk management: An ‘Avenues of Innovation’ analysis
Authors: Guerriero Rebecca , Penning‐Rowsell Edmund C. 
Published: December 2020

AbstractInnovation in flood risk management (FRM) is a driver for change. Research, however, is sparse in this area, and innovation itself appears to be left largely to chance. This paper uses a ’systems of innovation’ approach, defining ’avenues’ of innovation, to explore factors that promote or inhibit innovation. The research is based on in‐depth interviews with 10 leading figures in FRM in the United Kingdom, and describes the interactions and iterations involved. We conclude that in terms of practice the encouragement of champions should be enhanced, risk cultures require concerted attention to minimise risk aversion, learning should be facilitated, and innovation scaled up to maximise its effectiveness. We aim also to add to the literature on innovation systems, providing a case study of a complex field previously unexplored in this regard. Detailed innovation‐encouraging processes here need to be better understood and FRM policies and practices adjusted accordingly.
Effect of lactic acid stress on biofilm formation of Escherichia coli O26 at different temperatures
Authors: Mi Xiaoyu , Hu Jie , Zhang Su , Wang Siqi , Zhao Wangchen , Wang Longfeng , Jiang Yun 
Published: December 2020

AbstractSimilar to Escherichia coli O157, non‐O157 also inherits certain acid resistance, and its stress response can be induced under acidic conditions, which may be affected by temperature. In this study, O26, the main serotype of non‐O157 E. coli, was investigated in order to evaluate the effect of lactic acid stress on its biofilm formation (BF) at different temperatures. Firstly, the BF ability of 22 isolates of E. coli O26 were compared by means of crystal violet staining and the result showed that all strains had certain BF ability with variation among strains. Then, the strain 126Z with strong capacity and strain G13Z2 with medium capacity were selected for BF experiment in acidic TSB (pH 4.0 and 5.0, adjusted with lactic acid) at 15°C and 25°C, respectively. The results showed that the BF of O26 was decreased with increasing concentration of lactic acid, and the higher the concentration of lactic acid was, the less the amount of biofilm formed. Moreover, the effect of temperature on BF of different capacity strains was related to the pH value, that is, with a lower concentration of lactic acid, the higher the temperature was, the faster the biofilm amount increased. Under a higher acid concentration, the BF of two strains showed different dynamic changes and were inhibited in the later stage, in which the biofilm amount of 126Z decreased significantly at 15°C, while that of G13Z2 decreased more significant at 25°C. This observation was further confirmed by scanning electron microscope (SEM) and confocal laser scanning microscopy (CLSM). This finding suggests that combined temperature and lactic acid intervention may be an effective method to prevent BF, and the results of present work would provide scientific basis for the risk assessment of E. coli O26 in food processing.
Applying free word association to understand the perception of fish as a meal by Brazilians with different consumption frequencies
Authors: Viana Fernanda M. , Deliza Rosires , Monteiro Maria Lúcia G. , Martins Inayara B. A. , de Oliveira Denize C. R. , Conte‐Junior Carlos A. 
Published: December 2020

AbstractThe aim of the present study was to investigate through free word association the Brazilian consumers' perception of fish as a meal and to explore whether different fish consumption frequencies play a role. The participants were split into high, occasional, and low consumption groups according to their self‐reported fish consumption frequency. Brazilian consumers' general associations with fish were strongly related to health benefits, which was considered a motivating factor for the high consumption group. However, for the low consumption group, the unfamiliarity, the low convenience and the high price represent barriers to fish consumption. Although they did not present negative feelings regarding fish, it was not possible to determine the factors that influence fish consumption for the group of occasional consumers. The elaboration of semi ready‐to‐eat products from fish residues and further studies focusing on occasional consumers can be strategies to increase the Brazilian per capita consumption of fish.Practical ApplicationsFish is an important source of high quality nutrients and its intake contributes to maintaining a healthy diet. However, the per capita consumption of this matrix is still low in Brazil. The present study observed that the perception of Brazilian consumers regarding fish as a meal was significantly affected by their fish consumption frequency. Therefore, the different consumer profiles must be taken into account for the development of more appropriate marketing and communication strategies aimed at increasing the consumption of this important product in the country.
Exploration of the Effects of Rural Obstetric Unit Closures on Birth Outcomes in North Carolina
Authors: Sullivan Margaret H. , Denslow Sheri , Lorenz Kathleen , Dixon Suzanne , Kelly Emma , Foley Kathleen A. 
Published: December 2020

AbstractPurposeClosures of rural labor and delivery (L/D) units have prompted national and state‐based efforts to assess the impact on birth outcomes. This study explores local effects of L/D closures in rural areas of North Carolina (NC).MethodsThis is a retrospective cohort study of birth outcomes of 4,065 women in 5 rural areas of NC with L/D unit closures between 2013 and 2017. Outcomes were abstracted from birth certificate data from the NC Vital Statistics Reporting System. Localized outcomes 1 year prior to L/D unit closure were compared with outcomes 1 and 2 years post closure, including: (1) birth location and demographics, (2) change in travel patterns for birth, and (3) birth outcomes, including rates of labor induction, cesarean deliveries, maternal morbidity, and neonatal outcomes.FindingsBefore closures, 25%‐56% of deliveries occurred outside county of residence. Commercially insured and college‐educated women were more likely to deliver out‐of‐area. Closures increased travel distance to delivery hospital an average of 7‐27 miles. In 2 areas, cesarean delivery rates decreased despite an increase in labor inductions. There was also variability between areas in prenatal care adequacy and breastfeeding.ConclusionsWe found that L/D unit closures in rural NC disproportionately affected women on Medicaid. The impact showed area‐specific variability, highlighting effects potentially masked by statewide or national analyses. Implications for future L/D closures would be eased by regional coordination and planning to mitigate negative effects, and state and national policies should address the excess burden placed on vulnerable populations.
Sleep−wake cycle dysregulation in idiopathic REM sleep behaviour disorder
Authors: Liguori Claudio , Zuccarelli Vittorio , Spanetta Matteo , Izzi Francesca , Biagio Mercuri Nicola , Placidi Fabio 
Published: December 2020

SummaryAlteration of the circadian sleep−wake rhythm has been suggested in patients affected by idiopathic rapid eye movement sleep behaviour disorder. Because actigraphy is the validated instrument to monitor the sleep−wake cycle, the aim of the present study was to investigate the circadian sleep−wake rhythm in patients with idiopathic rapid eye movement sleep behaviour disorder compared with healthy aged controls. Fourteen‐day actigraphic recording, a comprehensive sleep interview, and cognitive and behavioural domains were investigated in patients affected by idiopathic rapid eye movement sleep behaviour disorder, and compared with controls similar for age, sex and cognitive performances. Patients with idiopathic rapid eye movement sleep behaviour disorder showed reduced relative amplitude and alteration of both sleep and wake compared with controls. Patients with idiopathic rapid eye movement sleep behaviour disorder also showed subjective sleep and wake complaints, and higher scores at the Beck Depression Inventory, compared with controls. Beck Depression Inventory scores correlated with sleep actigraphic parameters, such as sleep latency, sleep efficiency, time in bed, and relative amplitude. Therefore, the present study showed the dysregulation of the sleep−wake cycle in patients with idiopathic rapid eye movement behaviour disorder. Moreover, depressive symptoms documented in patients with idiopathic rapid eye movement sleep behaviour disorder correlated with the sleep−wake rhythm dysregulation.
“I got tested at home, the help came to me”: acceptability and feasibility of home‐based TB testing of household contacts using portable molecular diagnostics in South Africa
Authors: Medina‐Marino Andrew , de Vos Lindsey , Bezuidenhout Dana , Denkinger Claudia M. , Schumacher Samuel G. , Shin Sanghyuk S. , Stevens Wendy , Theron Grant , van der Walt Martie , Daniels Joseph 
Published: December 2020

AbstractObjectiveThe effectiveness of household contact investigations is limited by low referral uptake for clinic‐based TB testing by symptomatic household contacts. We qualitatively investigated the acceptability and perceived benefits of home‐based TB testing using a portable GeneXpert‐I instrument (GX‐I) in an urban South African township.MethodsIn‐depth interviews were conducted with household contacts tested and those that observed testing. Semi‐structured interviews explored household contact’s understanding of TB, perceptions of the GX‐I device and testing procedures, confidentiality, willingness to refer others, and views on home‐ vs. clinic‐based testing. Focus group discussions with home‐based TB testing implementing staff assessed operational considerations for scale‐up. Data were analysed using a constant comparison approach to qualitatively evaluate the acceptability and feasibility of home‐based TB testing.ResultsThirty in‐depth interviews and two focus group discussions were conducted. Observing one’s own sputum being tested resulted in an emergent trust in home‐based TB testing, the GX‐I device and one’s test results. Home‐based TB testing was considered convenient, helped to overcome apathy towards testing and mitigated barriers to clinic‐based testing. Perceptions that home‐based TB testing contributes to improved household and community health resulted in an emergent theme of alleviation of health insecurities. Operational concerns regarding inadvertent disclosure of one’s diagnosis to household members and time spent in people’s homes were identified.ConclusionsHome‐based TB testing was acceptable and feasible. Individuals expressed belief in the machine by being able to witness the testing process. Though most themes mirrored qualitative studies of home‐based HIV testing, the alleviation of health insecurities theme is unique to home‐based TB testing. Future research must evaluate the impact of home‐based TB testing on case finding yield, time‐to‐treatment initiation and household outcomes.
Numerical Investigation of a Partially Loaded Supersonic Organic Rankine Cycle Turbine Stage
Authors: Ziaja Karl , Post Pascal , Sembritzky Marwick , Schramm Andreas , Willers Ole , Kunte Harald , Seume Joerg R. , di Mare Francesca 
Published: December 2020

Abstract
The organic Rankine cycle (ORC) represents an emerging technology aimed at exploiting lower temperature heat sources, such as waste heat in industrial processes or exhaust heat in combustion engines. One key aspect of this technology is the efficient and economical operation at part load, typically realized by a partial admission control, which is challenging to predict numerically. Full-annulus computation can only be avoided applying empirical partial admission loss models to conventional full-admission computations. This article aims at assessing the reliability of such a loss model under real-gas and supersonic conditions as a first step toward knowledge-based improved loss models. Three different operating points of an 18.3 kW ORC turbine working with an ethanol–water mixture with two open stator passages (2 × 36 deg) are considered. Full-annulus computational fluid dynamics (CFD) computations are compared to experimental data and results of simulations in a conventional, full-admission, periodic 72 deg-sector model with application of a one-dimensional partial admission loss model. The experimentally obtained mass flow rate and efficiency are matched overall within their measurements accuracy. By highest inlet total pressure, the computed efficiency deviates about 4% from the experiments. Predictions of efficiency based on the full-admission and loss model correction deviate from full-annulus computations less than 1%. These findings suggest that the used empirical correlations for partial admission losses can provide acceptable results in the configuration under investigation.
Grade and Temperature Dependent Reference Curves for Realistic Fen Quantification of Austenitic Stainless Steels
Authors: Seppänen Tommi , Alhainen Jouni , Arilahti Esko , Solin Jussi 
Published: December 2020

Abstract
Environmental effects of LWR coolant need to be factored in when defining cumulative fatigue usage of primary circuit components. The basis is a set of codified design rules and fatigue design curves, based on experimental data.
To accurately quantify environmental effects, the reference curve in air to which fatigue life in water is compared shall be as reliable as possible. Literature studies and accumulated data at VTT reveal that the use of common reference curves for a wide range of austenitic stainless steel alloys and temperatures is unreliable. Some design codes already include measures to consider this but ASME III is not yet among them. The ASME III design curve is adopted from NUREG/CR-6909 and contains no consideration for dependence of temperature or stainless steel grade.
Two different stainless steel grades, AISI 304L and 347, have previously been used in environmentally-assisted fatigue experiments at VTT. In this paper, reference curves for the AISI 304L heat are presented at room temperature and 325 °C to complement the curves already available for AISI 347. Demonstration of realistic environmental effect quantification is done using these reference curves as an alternative to the NUREG methodology.
Analysis of the Flange Seal Groove Cracking in a Hydrocracking Reactor
Authors: Zhuang Fakun , Liu Wen , Xie Guoshan , Shao Shanshan , Han Zhiyuan 
Published: December 2020

Abstract
The hydrocracking reactor, serving at the high temperature and pressure and containing S and N elements in medium, are the key equipment in the hydrocracking plant. Due to the severe operational conditions, flange and nozzle cracking commonly occurs, especially for the seal groove between the flange and gasket. A cracked stainless flange is found in a hydrocracking reactor during parking and maintenance. Through a series of experiments including chemical composition, metallographic analysis, SEM and fracture analysis, the flange seal groove is analyzed. Under the long term operation at high temperature and high pressure, the σ phase is found in the flange material which will increase the cracking tendency. The hydrogen content measurement also proves that the material has the hydrogen embrittlement tendency. Hence, the combination of σ brittle phase and high stress causes the flange seal groove cracking. After cracking, hydrogen element enters the fracture, thus accelerating the crack growth. Therefore, in order to prevent the flange cracking, the assembly stress should be controlled in an appropriate range. If necessary, periodical inspection must be performed.
Development of the Buckling Evaluation Method for Large Scale Vessel by the Testing of Gr. 91 Vessel Subjected to Vertical and Horizontal Loading
Authors: Okafuji Takashi , Miura Kazuhiro , Sago Hiromi , Murakami Hisatomo , Ando Masanori , Miyazaki Masashi 
Published: December 2020

Abstract
Larger-diameter cylindrical vessels for commercial fast breeder reactors (FBRs) are planned to increase the electric generation capacity with thinner vessels compared to the existing ones. The modified 9Cr-1Mo steel (ASME Grade 91 steel) has high yield stress and low tangent modulus after yielding, and plans to be applied as well as austenitic stainless steel for vessels in existing FBR power plants. Although elasto-plastic axial compression, bending and shear buckling are expected to occur in vessels, the current buckling strength evaluation from the Japan Society of Mechanical Engineers (JSME) standard “Design and Construction for Nuclear Power Plants, Division 2 Fast Reactors” mainly focuses on plastic buckling of thick cylindrical vessels.
Seismic base isolation is being devised for next-generation FBR power plants by the increasing seismic design load in Japan. When a horizontal seismic base isolation design is adopted, cylindrical vessels are subject to cyclic vertical seismic load with long-period horizontal seismic wave. The deformation by cyclic vertical load reduces the buckling strength.
In this paper, we modified the existing buckling strength equations focusing on elasto-plastic axial compression, bending and shear buckling under cyclic axial load (hereinafter called “modified equations”), and confirmed their applicability through a series of elasto-plastic buckling analyses. We also conducted a series of buckling tests on Grade 91 steel vessels in the load regions where axial compression, bending and shear buckling interact, and where axial compression and bending buckling are dominant due to large vertical load. The buckling behavior and the buckling load estimated by the elasto-plastic buckling analysis considering the actual material stress–strain relationship and imperfections in the test vessel suitably agreed with corresponding test results in the load regions.
Results From Environmentally-Assisted Short Crack Fatigue Testing on Austenitic Stainless Steels
Authors: Coult Ben , Griffiths Adam , Beswick Jack , Gill Peter , Platts Norman , Smith Jean , Stevens Gary 
Published: December 2020

Abstract
The effect of environment on fatigue life is currently assessed using methods (such as NUREG/CR-6909) that may be excessively conservative when applied to plant components and loading transients. To reduce this conservatism, the ASME WG-EFEM has proposed the development of an improved assessment methodology for environmental fatigue based on a Total Life Prediction approach that would be adequately, but not excessively, conservative. Such an approach necessitates the development of analytical methods for the various stages of crack nucleation, short crack growth and long crack growth. Hence, there is a requirement to undertake testing within the short crack growth regime that would bridge the gap between fatigue nucleation and long crack growth (Paris Law) enabling better prediction of total life measured by fatigue endurance.
A test methodology has been developed by Wood to enable short crack growth testing with in-situ monitoring using DCPD. Testing has been undertaken in both high temperature air (300°C) and simulated end-of-cycle primary water chemistry at 300°C on cold-worked stainless steel specimens, which were subject to a range of load ratios and rise times. FEA modelling has been undertaken to determine the effective stress intensity factors applied under the loading conditions based on the specific material properties.
This paper presents the results from a testing program conducted with EPRI, to measure fatigue crack growth data for short cracks from 0.15 mm to 1.0 mm. Crack growth rates have been compared to those predicted in ASME, Code Case N-809 and results from material specific in-house testing to assist the understanding of the behaviour of mechanically short cracks.