bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation on the Effects of Carbon Macro-Segregation of Mechanical Properties Using a Large-Scale Forged Low Alloy Steel for a BWR Reactor Pressure Vessel
Authors: Hayashi Takahiro , Ogawa Takuya , Sumiya Rie , Yamaoka Tetsushi , Tanaka Shigeaki , Hattori Yasuhiro , Mori Atsushi 
Published: October 2020

Abstract
Control of carbon macro-segregation in the steel-making process for large steel forgings is of great importance in order to achieve the material properties and structural reliability required for the pressure vessels of nuclear power plant components. It is well known that high carbon content due to carbon macro-segregation can affect the mechanical properties of steels, leading to decreases in ductility and fracture toughness.
In this study, possible effects of carbon macro-segregation have been examined using a large-scale forged steel “bottom head dome” of a reactor pressure vessel (RPV) manufactured for a recent BWR. Material testing conducted included chemical analyses, tensile tests and Charpy impact tests. In the center part of the concave disk-shaped forged material, carbon content varied slightly in the material thickness direction within the range of carbon content requirement, as expected from the relationship between the solidification and the resultant segregation process in the cast ingot material and the forging process from the ingot to the dome material. The results of each mechanical test also showed full compliance with the properties required in the code regardless of the carbon content at each of the thickness locations examined. All the tests results demonstrated that with the steel-making technology and practice employed, carbon macro-segregation is well controlled to achieve the required material properties even in large-scale forged materials used in BWRs.
Hyponatraemia despite isotonic maintenance fluid therapy: a time series intervention study
Authors: Chromek Milan , Jungner Åsa , Rudolfson Niclas , Ley David , Bockenhauer Detlef , Hagander Lars 
Published: October 2020

ObjectiveTo examine the prevalence of dysnatraemias among children admitted for paediatric surgery before and after a change from hypotonic to isotonic intravenous maintenance fluid therapy.DesignRetrospective consecutive time series intervention study.SettingPaediatric surgery ward at the Children’s Hospital in Lund, during a 7-year period, 2010–2017.PatientsAll children with a blood sodium concentration measurement during the study period were included. Hypotonic maintenance fluid (40 mmol/L NaCl and 20 mmol/L KCl) was used during the first 3 years of the study (646 patients), and isotonic solution (140 mmol/L NaCl and 20 mmol/L KCl) was used during the following period (807 patients).Main outcome measuresPrimary outcomes were sodium concentration and occurrence of hyponatraemia (<135 mmol/L) or hypernatraemia (>145 mmol/L).ResultsOverall, the change from hypotonic to isotonic intravenous maintenance fluid therapy was associated with a decreased prevalence of hyponatraemia from 29% to 22% (adjusted OR 0.65 (0.51–0.82)) without a significantly increased odds for hypernatraemia (from 3.4% to 4.3%, adjusted OR 1.2 (0.71–2.1)). Hyponatraemia <130 mmol/L decreased from 6.2% to 2.6%, and hyponatraemia <125 mmol/L decreased from 2.0% to 0.5%.ConclusionsRoutine use of intravenous isotonic maintenance fluids was associated with lower prevalence of hyponatraemia, although hyponatraemia still occurred in over 20% of patients. We propose that the composition and the volume of administered fluid need to be addressed.
Is patellofemoral pain preventable? A systematic review and meta-analysis of randomised controlled trials
Authors: Culvenor Adam G , van Middelkoop Marienke , Macri Erin M , Crossley Kay M 
Published: October 2020

Objective
To evaluate the effectiveness of interventions to reduce the risk of incident patellofemoral pain.

Design
Systematic review and meta-analysis, with strength of evidence evaluated separately for each intervention type.

Data sources
MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus.

Eligibility criteria for selecting studies
Randomised controlled trials evaluating the effectiveness of interventions to reduce patellofemoral pain risk compared with a control/non-exposed group.

Results

Thirteen trials of mostly military recruits and young athletes analysed six different interventions. There was low certainty evidence from two trials (227 participants) that patellofemoral braces worn during physical activity (compared with no brace) effectively reduced the risk of patellofemoral pain (risk ratio (RR) 0.40, 95% CI 0.22 to 0.73; I
2
=24.0%). There was low certainty evidence from one trial (320 participants) that running technique retraining to (run softer) reduced patellofemoral pain risk (RR 0.21, 95% CI 0.07 to 0.60). There was low certainty evidence from four trials (3364 participants) that multicomponent (strengthening/neuromuscular) exercise programmes did not significantly reduce the risk of patellofemoral pain (RR 0.49, 95% CI 0.18 to 1.36; I
2
=64.9%), although broad CIs may reflect exercise dose variations among studies. There was very low certainty evidence from four trials (2314 participants) that foot orthoses (compared with flat inserts/no orthosis) did not significantly reduce the risk of patellofemoral pain (RR 0.63, 95% CI 0.35 to 1.13; I
2
=0.0%). Static stretching and a running programme that progressed intensity (compared with volume) did not significantly influence patellofemoral pain risk (single studies).

Conclusion
There is low-level evidence that patellofemoral braces and running technique retraining can reduce the risk of patellofemoral pain by 60%–79%.
Glycolytic overload-driven dysfunction of periodontal ligament fibroblasts in high glucose concentration, corrected by glyoxalase 1 inducer
Authors: Ashour Amal , Xue Mingzhan , Al-Motawa Maryam , Thornalley Paul J , Rabbani Naila 
Published: October 2020

IntroductionPatients with diabetes have increased risk of periodontal disease, with increased risk of weakening of periodontal ligament and tooth loss. Periodontal ligament is produced and maintained by periodontal ligament fibroblasts (PDLFs). We hypothesized that metabolic dysfunction of PDLFs in hyperglycemia produces an accumulation of the reactive glycating agent, methylglyoxal (MG), leading to increased formation of the major advanced glycation endproduct, MG-H1 and PDLF dysfunction. The aim of this study was to assess if there is dicarbonyl stress and functional impairment of human PDLFs in primary culture in high glucose concentration—a model of hyperglycemia, to characterize the metabolic drivers of it and explore remedial intervention by the glyoxalase 1 inducer dietary supplement,trans-resveratrol and hesperetin combination (tRES-HESP).Research design and methodsHuman PDLFs were incubated in low and high glucose concentration in vitro. Metabolic and enzymatic markers of MG and glucose control were quantified and related changes in the cytoplasmic proteome and cell function—binding to collagen-I, assessed. Reversal of PDLF dysfunction by tRES-HESP was explored.ResultsIn high glucose concentration cultures, there was a ca. twofold increase in cellular MG, cellular protein MG-H1 content and decreased attachment of PDLFs to collagen-I. This was driven by increased hexokinase-2 linked glucose metabolism and related increased MG formation. Proteomics analysis revealed increased abundance of chaperonins, heat shock proteins (HSPs), Golgi-to-endoplasmic reticulum transport and ubiquitin E3 ligases involved in misfolded protein degradation in high glucose concentration, consistent with activation of the unfolded protein response by increased misfolded MG-modified proteins. PDLF dysfunction was corrected by tRES-HESP.ConclusionsIncreased hexokinase-2 linked glucose metabolism produces dicarbonyl stress, increased MG-modified protein, activation of the unfolded protein response and functional impairment of PDLFs in high glucose concentration. tRES-HESP resolves this at source by correcting increased glucose metabolism and may be of benefit in prevention of diabetic periodontal disease.
Bridging research integrity and global health epidemiology (BRIDGE) statement: guidelines for good epidemiological practice
Authors: Alba Sandra , Verdonck Kristien , Lenglet Annick , Rumisha Susan F , Wienia Martijn , Teunissen Imre , Straetemans Masja , Mendoza Walter , Jeannetot Daniel , Weibel Daniel , Mayanja-Kizza Harriet , Juvekar Sanjay 
Published: October 2020

BackgroundResearch integrity and research fairness have gained considerable momentum in the past decade and have direct implications for global health epidemiology. Research integrity and research fairness principles should be equally nurtured to produce high-quality impactful research—but bridging the two can lead to practical and ethical dilemmas. In order to provide practical guidance to researchers and epidemiologist, we set out to develop good epidemiological practice guidelines specifically for global health epidemiology, targeted at stakeholders involved in the commissioning, conduct, appraisal and publication of global health research.MethodsWe developed preliminary guidelines based on targeted online searches on existing best practices for epidemiological studies and sought to align these with key elements of global health research and research fairness. We validated these guidelines through a Delphi consultation study, to reach a consensus among a wide representation of stakeholders.ResultsA total of 45 experts provided input on the first round of e-Delphi consultation and 40 in the second. Respondents covered a range of organisations (including for example academia, ministries, NGOs, research funders, technical agencies) involved in epidemiological studies from countries around the world (Europe: 19; Africa: 10; North America: 7; Asia: 5; South-America: 3 Australia: 1). A selection of eight experts were invited for a face-to-face meeting. The final guidelines consist of a set of 6 standards and 42 accompanying criteria including study preparation, protocol development, data collection, data management, data analysis, dissemination and communication.ConclusionWhile guidelines will not by themselves guard global health from questionable and unfair research practices, they are certainly part of a concerted effort to ensure not only mutual accountability between individual researchers, their institutions and their funders but most importantly their joint accountability towards the communities they study and society at large.
Factors associated with head circumference and indices of cognitive development in early childhood
Authors: Nicolaou Laura , Ahmed Tahmeed , Bhutta Zulfiqar Ahmed , Bessong Pascal , Kosek Margaret , Lima Aldo A M , Shrestha Sanjaya , Chandyo Ram , Mduma Estomih R , Murray-Kolb Laura , Morgan Brooks , Grigsby Matthew R , Checkley William 
Published: October 2020

BackgroundWhile head circumference (HC) has been related to intracranial volume and brain size, its association with cognitive function remains unclear. We sought to understand the relationship among various biological and socioeconomic risk factors, HC and cognitive development.MethodsWe analysed data across resource-poor settings in Bangladesh, India, Nepal, Peru, South Africa and Tanzania from the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development longitudinal birth cohort study. Participating children were enrolled and followed up between 2009 and 2014. A final sample of 1210 children aged 0–24 months were included in the analyses. The main outcomes were HC for age Z-score and cognitive, gross motor and language scores from Bayley Scales of Infant Development-III tests. Length, weight and HC were measured monthly, and cognitive tests were administered at 6, 15 and 24 months of age. To disentangle the associations between risk factors and HC from linear growth and to distinguish the direct and indirect effects of these risk factors on cognitive function, we conducted mediation analysis using longitudinal models to account for all data measured during follow-up.ResultsAverage HC-for-age Z-score (HCAZ) was −0.54 (95% CI −0.47 to −0.62) near birth and −1.01 (95% CI −0.94 to −1.08) at 24 months. Children with higher enrolment weight (p<0.0001), higher socioeconomic score (p=0.00037) and taller mothers (p=0.00084) had higher HCAZ at all ages, while enteropathogen infection (p=0.013) and more febrile episodes (p=0.013) were associated with lower HCAZ. The associations between HCAZ and enrolment weight-for-age, maternal height, socioeconomic status or pathogen burden were partly mediated through their associations with length-for-age. HCAZ showed no association with cognitive, gross motor or language skills at 6, 15 and 24 months of age.ConclusionsThe main risk factors associated with HC are similar to those associated with body length, and HC is not related to cognitive function.
Patient-reported feasibility of chest and thumb ECG after cryptogenic stroke in Sweden: an observational study
Authors: Magnusson Peter , Lyren Adam , Mattsson Gustav 
Published: October 2020

ObjectivesThe aim of this study was to assess the feasibility, based on a questionnaire, of the chest and thumb ECG system Coala Heart Monitor in patients who recently had a stroke.DesignObservational study.SettingTwo stroke units, Region Gävleborg, Sweden.Participants and interventionsThis study, Transient ECG Assessment in Stroke Evaluation (TEASE), included patients who had a stroke between 2017 and 2019. Patients eligible for anticoagulation in the presence of atrial fibrillation were scheduled for 28 days monitoring.Primary and secondary outcome measuresThe questionnaire regarding feasibility of monitoring included seven questions, using a 100 mm Visual Analogue Scale which covered overall satisfaction, technical feasibility, remember to monitor, physical application, feeling of security, help from others and recommendation to others. A lower score indicated better outcome.ResultsThe prespecified number of 100 patients underwent the monitoring and 83 out of the 97 alive patients returned the questionnaire (response rate 85.6%). The median age was 69.5 years, mean CHA2DS2-VASc score was 4.4±1.3 points and 59.0% were men (n=49). The median time from index stroke to start of monitoring was 7.0 days. Patients performed on average 90.1%±15.0% of scheduled ECG-transmissions. In all seven questions, the median score ranged from 4 to 8. The vast majority reported acceptable outcomes, that is, the 95th percentile ranged from 30 to 54. There was no significant difference between men and women with regard to any of the seven questions (p values ranging from 0.117 to 0.849). Two of the seven outcome scores correlated significantly to patient age (Spearman’s r=−0.238 and r=−0.308, and p values 0.031 and 0.005 for ‘overall satisfaction’ and ‘remember to monitor’, respectively).ConclusionIn stroke survivors, chest and thumb ECG two times per day over a period of 4 weeks is feasible from a patient’s perspective. The Coala Heart Monitor provides a valuable and convenient tool for monitoring after stroke.Trial registration numberNCT03301662.
Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people’s perspectives
Authors: Bellairs-Walsh India , Perry Yael , Krysinska Karolina , Byrne Sadhbh J. , Boland Alexandra , Michail Maria , Lamblin Michelle , Gibson Kerry L. , Lin Ashleigh , Li Tina Yutong , Hetrick Sarah , Robinson Jo 
Published: October 2020

ObjectivesGeneral practitioners (GPs) have a key role in supporting young people who present with suicidal behaviour/self-harm. However, little is known about young people’s opinions and experiences related to GPs’ practices for such presentations, and their decisions to disclose suicidal behaviour/self-harm to GPs. Additionally, existing guidelines for the management of suicide risk and/or self-harm have not incorporated young people’s perspectives. This study aimed to explore young people’s views and experiences related to the identification, assessment and care of suicidal behaviour and self-harm in primary care settings with GPs.Design, setting and participantsTwo qualitative focus groups were conducted in Perth, Western Australia, with 10 young people in total (Mage = 20.67 years; range: 16–24). Data were collected using a semistructured, open-ended interview schedule and analysed using thematic analysis.ResultsFive major themes were identified from the focus groups. (1) Young people wanted a collaborative dialogue with GPs, which included being asked about suicidal behaviour/self-harm, informed of treatment processes and having autonomy in decision making; (2) young people were concerned with a loss of privacy when disclosing suicidal behaviour/self-harm; (3) young people viewed labels and assessments as problematic and reductionist—disliking the terms ‘risk’ and ‘risk assessment’, and assessment approaches that are binary and non-holistic; (4) young people highlighted the importance of GPs’ attitudes, with a genuine connection, attentiveness and a non-judgemental demeanour seen as paramount; and (5) young people wanted to be provided with practical support and resources, followed-up, and for GPs to be competent when working with suicidal behaviour/self-harm presentations.ConclusionsOur study identified several concerns and recommendations young people have regarding the identification, assessment and care of suicidal behaviour/self-harm in primary care settings. Taken together, these findings may inform the development of resources for GPs, and support progress in youth-oriented best practice.
Tailored smartphone intervention to promote healthy eating among Brazilian adolescents: a randomised controlled trial protocol
Authors: Melo Giselle Rhaisa , Correa Lima Stefany , M dos Santos Chagas Carolina , Nakano Eduardo Y , Toral Natacha 
Published: October 2020

IntroductionAdolescent eating patterns are characterised by high consumption of unhealthy foods, which has resulted in an increasing prevalence of overweight and chronic diseases. It is crucial to promote healthy eating habits, and nutritional interventions based on the transtheoretical model have been found to be especially effective. Mobile health strategies also seem promising for adolescents. This study aims to outline a smartphone intervention via WhatsApp for adolescents to promote healthy eating consumption, better nutritional knowledge, self-efficacy in the adoption of healthy practices and progress through the stages of change.Methods and analysisThere will be three distinct groups in this randomised study: a general intervention group (GG), in which the participants will receive the same healthy eating messages, based on the Brazilian food guide; a tailored intervention group (TG), in which the participants will receive healthy eating messages based on their stage of change; and a control group (CG), in which participants will receive messages on a different theme. Possession of a smartphone, use of WhatsApp and being a senior student (16–19 years) from a public school of the Federal District of Brazil will be the study’s inclusion criteria. Rural schools will be excluded. The sample size estimated is 390 individuals: 38 in the GG, 314 in the TG and 38 in the CG. The intervention will last 6 weeks, with a daily message sent to the students. We will investigate nutritional knowledge, self-efficacy in the adoption of healthy eating practices, food consumption and stages of change using preintervention and postintervention questionnaires. Memorisation of the messages will be also assessed.Ethics and disseminationThe study was approved by the University of Brasília, School of Health Sciences and Research Ethics Committee. At the end of the study, the participating schools will receive a printed report with the main results of the intervention.Trial registration numberRBR-5b9jk7.
Lower limb MSK injuries among school-aged rugby and football players: a systematic review
Authors: Anderson David Stewart , Cathcart John , Wilson Iseult , Hides Julie , Leung Felix , Kerr Daniel 
Published: October 2020

ObjectiveThe objective of this systematic review was to explore the incidence of lower limb musculoskeletal (MSK) injuries sustained by rugby union, rugby league, soccer, Australian Rules and Gaelic football players under 18 years. The review sought to identify the mechanisms and types of injury sustained and to compare between sports.DesignThis systematic review focused on the incidence of lower limb injury in adolescent team sports that involved running and kicking a ball. A literature search of studies published prior to January 2020 was conducted using SportDiscus, Medline and PubMed databases. The Standard Quality Assessment Criteria appraisal tool was used to assess the quality of each article included in the review. Two or more authors independently reviewed all papers.ResultsSixteen papers met the inclusion criteria; prospective cohort (N=14), retrospective (n=1) and longitudinal (n=1). These studies investigated injuries in rugby union and rugby league (n=10), football (soccer) (n=3), Australian Rules (n=2) and Gaelic football (n=1). There were a total of 55 882 participants, aged 7–19 years old, who reported 6525 injuries. The type, site and mechanisms of injury differed across sports.SummaryLower limb injuries were common in adolescent rugby, soccer, Gaelic football and Australian Rules football players, however these studies may not fully reflect the true injury burden where recurrent and overuse injuries have not been considered. There were differences between sports in the mechanisms, types and severity of injury.
Initial impact of COVID-19’s stay-at-home order on motor vehicle traffic and crash patterns in Connecticut: an interrupted time series analysis
Authors: Doucette Mitchell L , Tucker Andrew , Auguste Marisa E , Watkins Amy , Green Christa , Pereira Flavia E , Borrup Kevin T , Shapiro David , Lapidus Garry 
Published: October 2020

IntroductionUnderstanding how the COVID-19 pandemic has impacted our health and safety is imperative. This study sought to examine the impact of COVID-19’s stay-at-home order on daily vehicle miles travelled (VMT) and MVCs in Connecticut.MethodsUsing an interrupted time series design, we analysed daily VMT and MVCs stratified by crash severity and number of vehicles involved from 1 January to 30 April 2017, 2018, 2019 and 2020. MVC data were collected from the Connecticut Crash Data Repository; daily VMT estimates were obtained from StreetLight Insight’s database. We used segmented Poisson regression models, controlling for daily temperature and daily precipitation.ResultsThe mean daily VMT significantly decreased 43% in the post stay-at-home period in 2020. While the mean daily counts of crashes decreased in 2020 after the stay-at-home order was enacted, several types of crash rates increased after accounting for the VMT reductions. Single vehicle crash rates significantly increased 2.29 times, and specifically single vehicle fatal crash rates significantly increased 4.10 times when comparing the pre-stay-at-home and post-stay-at-home periods.DiscussionDespite a decrease in the number of MVCs and VMT, the crash rate of single vehicles increased post stay-at-home order enactment in Connecticut after accounting for reductions in VMT.