bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Reactor Safety Measures for the European Sodium Fast Reactor—Part I: Conceptual Design
Authors: Guidez Joel , Bodi Janos , Mikityuk Konstantin , Girardi Enrico , Carluec Bernard 
Published: June 2021

Abstract
Following up the previous collaborative project on European sodium fast reactor (CP-ESFR project), the European sodium fast reactor—safety measures assessment and research tools (ESFR-SMART project) considers the safety objectives envisaged for generation-IV reactors, taking into account the lessons learned from the Fukushima accident, in order to increase the ESFR safety level. In accordance with these objectives, guidelines have been defined to drive the ESFR-SMART developments, mainly simplifying the design and using all the positive features of sodium fast reactors (SFR), such as low coolant pressure, efficiency of natural convection, possibility of decay heat removal (DHR) by atmospheric air, high thermal inertia, and long grace period before a human intervention is needed. In this paper, a set of new ambitious safety measures is introduced for further evaluation within the project. The proposed set aims at consistency with the main lines of safety evolutions since the Fukushima accident. The paper gives a first review of the new propositions to enhance the ESFR safety, leading to a simplified reactor, forgiving and including a lot of passivity. This first version is supported by the various project tasks in order to assess the relevance of the whole design in comparison to the final safety objectives.
Research on Effect Factors of Mechanical Response of Cross-Fault Buried Gas Pipeline Based on Fluid–Structure Interaction
Authors: Li Qiaochu , He Sha 
Published: June 2021

Abstract
Long-distance buried pipelines inescapably go through seismic fracture zones which makes the buried pipelines be easily influenced by the diastrophism. A strong and resilient pipe can withstand a certain degree of seismic oscillation. However, it is really difficult for buried pipelines to resist the permanent ground displacement caused by faulting and surface damage. Most of the existing studies only focus on the two-phase contact between pipeline and soil, and the mechanical behavior of the cross-fault pipeline under transportation condition has not been studied. In this article, ADINA finite element software is used to establish a pipe-soil-fluid three-phase coupling model based on fluid–structure interaction (FSI), and the influence of the parameters of pipe, fluid and fault on the mechanical properties of cross-fault buried gas pipeline is studied. The model considering the effect of fluid–structure interaction can effectively simulate the mechanical response of pipelines in the actual working condition. The work presented in this article can provide a reference for the design and safety of cross-fault buried pipeline conveying fluid.
Erosion of the Himalaya-Karakoram recorded by Indus Fan deposits since the Oligocene
Authors: Feng Han , Lu Huayu , Carrapa Barbara , Zhang Hanzhi , Chen Jun , Wang Ying , Clift Peter D. 
Published: June 2021

Abstract
The Cenozoic erosion history of the Himalaya-Karakoram, which is a function of tectonically driven uplift and monsoon climatic evolution in South Asia, remains elusive, especially prior to the Miocene. Here, we present a multiproxy geochemical and thermochronological analysis of the oldest samples available from the Arabian Sea, which we used to investigate the erosion history of the Himalayan and Karakoram orogenic system. The Indus Fan records rapid and sustained erosion of the Himalayan-Karakoram mountains from before 24 Ma (ca. 30) to ca. 16 Ma concurrent with changing provenance from the Indian (Himalayan) and Eurasian plates. Our data, combined with previous studies of younger Indus Fan deposits, indicate that the mid-to-late Cenozoic erosion history of the Himalayan-Karakoram mountains is overall consistent with a vigorous monsoonal climate from the late Oligocene to middle Miocene and with changes in global climate in the late Miocene, whereas erosion and deposition are relatively insensitive to changes in sources and rock erodibility. Although tectonic processes were active throughout, we suggest that the erosional signatures of the Himalayan-Karakoram mountains from the Indus Fan largely preserve a record of climate changes since the Oligocene.
The Influence of a Magnetic Storm on Tectonic Deformations and the Coast Effect
Authors: Sobolev G. A. 
Published: June 2021

Abstract
Records of 58 identical broadband seismograph stations were studied made during strong geomagnetic storms. Oscillations of periods of a few hours were studied. These were compared with synchronous variations of earth tides. Anomalous changes in deformation rate were observed after storms at stations installed near continent–ocean boundaries. They lasted a few days and had amplitudes of a few millimeters per minute.
Risk factors for adverse outcomes among 35 879 veterans with and without diabetes after diagnosis with COVID-19
Authors: Wander Pandora L , Lowy Elliott , Beste Lauren A , Tulloch-Palomino Luis , Korpak Anna , Peterson Alexander C , Young Bessie A , Boyko Edward J 
Published: June 2021

IntroductionRisk factors and mediators of associations of diabetes with COVID-19 outcomes are unclear.Research design and methodsWe identified all veterans receiving Department of Veterans Affairs healthcare with ≥1 positive nasal swab for SARS-CoV-2 (28 February–31 July 2020; n=35 879). We assessed associations of diabetes (with and without insulin use) with hospitalization, intensive care unit (ICU) admission, or death at 30 days, and with hazard of death until the censoring date. Among participants with diabetes (n=13 863), we examined associations of hemoglobin A1c and antihyperglycemic medication use with COVID-19 outcomes. We estimated mediation between diabetes and outcomes by comorbidities (cardiovascular disease, heart failure, and chronic kidney disease), statin or ACE inhibitor/angiotensin receptor blocker (ARB) use, and cardiac biomarkers (brain natriuretic peptide and troponin).ResultsDiabetes with and without insulin use was associated with greater odds of hospitalization, ICU admission, and death at 30 days, and with greater hazard of death compared with no diabetes (OR 1.73, 1.76 and 1.63, and HR 1.61; and OR 1.39, 1.49 and 1.33, and HR 1.37, respectively, all p<0.0001). Prior sulfonylurea use was associated with greater odds of hospitalization and prior insulin use with hospitalization and death among patients with diabetes; among all participants, statin use was associated with lower mortality and ARB use with lower odds of hospitalization. Cardiovascular disease-related factors mediated <20% of associations between diabetes and outcomes.ConclusionsDiabetes is independently associated with adverse outcomes from COVID-19. Associations are only partially mediated by common comorbidities.
Antibiotic use and colorectal neoplasia: a systematic review and meta-analysis
Authors: Aneke-Nash Chino , Yoon Garrett , Du Mengmeng , Liang Peter 
Published: June 2021

Background and aimsColorectal cancer (CRC) is the third most common cancer for women and men and the second leading cause of cancer death in the USA. There is emerging evidence that the gut microbiome plays a role in CRC development, and antibiotics are one of the most common exposures that can alter the gut microbiome. We performed a systematic review and meta-analysis to characterise the association between antibiotic use and colorectal neoplasia.MethodsWe searched PubMed, EMBASE, and Web of Science for articles that examined the association between antibiotic exposure and colorectal neoplasia (cancer or adenoma) through 15 December 2019. A total of 6031 citations were identified and 6 papers were included in the final analysis. We assessed the association between the level of antibiotic use (defined as number of courses or duration of therapy) and colorectal neoplasia using a random effects model.ResultsSix studies provided 16 estimates of the association between level of antibiotic use and colorectal neoplasia. Individuals with the highest levels of antibiotic exposure had a 10% higher risk of colorectal neoplasia than those with the lowest exposure (effect size: 1.10, 95% CI 1.01 to 1.18). We found evidence of high heterogeneity (I2=79%, p=0.0001) but not of publication bias.ConclusionsHigher levels of antibiotic exposure is associated with an increased risk of colorectal neoplasia. Given the widespread use of antibiotics in childhood and early adulthood, additional research to further characterise this relationship is needed.
Low yield of head CT in cirrhotic patients presenting with hepatic encephalopathy
Authors: Hanna Angy , Gill Inayat , Imam Zaid , Halalau Alexandra , Jamil Laith H 
Published: June 2021

Goals and backgroundThe utility of routine head CT (HCT) in hepatic encephalopathy (HE) evaluation is unclear. We investigated HCT yield in detecting acute intracranial abnormalities in cirrhotic patients presenting with HE.StudyRetrospective review of cirrhotic patient encounters with HE between 2016 and 2018 at Beaumont Health, in Michigan was performed. A low-risk (LR) indication for HCT was defined as altered mental status (AMS), which included dizziness and generalised weakness. A high-risk (HR) indication was defined as trauma/fall, syncope, focal neurological deficits (FNDs) or headache. Descriptive statistics and univariate/multivariate analyses by logistic regression were performed using SPSS to identify HCT abnormality correlates.ResultsFive hundred twenty unique encounters were reviewed. Mean age was 63.4 (12.1) years, 162 (37.5%) had alcoholic cirrhosis and median Model for End-Stage Liver Disease (MELD)-score was 17 (13–23). LR indication was reported in 408 (78.5%) patients and FNDs reported in 24 (4.6%) patients. Only 13 (2.5%) patients were found to have an acute intracranial pathology (seven haemorrhagic stroke, two ischaemic stroke, four subdural haematoma). Aspirin use prior to presentation (aOR 4.6, 95% CI 1.1 to 19.2), and HR indication (aOR 7.3, 95% CI 2.3 to 23.8) were independent correlates of acute intracranial pathology on HCT. Age, sex, MELD-score, haemoglobin, platelet count, race and cirrhosis aetiology did not correlate with HCT abnormalities. Number needed to screen to identify one acute pathology was 14 in HR indications versus 82 for LR indications.ConclusionRoutine HCTs in cirrhotic patients presenting with HE with AMS in the absence of history of trauma, headache, syncope, FNDs or aspirin use is of low diagnostic yield.
Variation in waiting times by diagnostic category: an observational study of 1,951 referrals to a neurology outpatient clinic
Authors: Biggin Fran , Howcroft Timothy , Davies Quinta , Knight Jo , Emsley Hedley C A 
Published: June 2021

ObjectiveTo investigate the frequency of diagnoses seen among new referrals to neurology outpatient services; to understand how these services are used through exploratory analysis of diagnostic tests and follow-up appointments; and to examine the waiting times between referral and appointment.MethodsRoutine data from new National Health Service appointments at a single consultant-delivered clinic between September 2016 and January 2019 were collected. These clinical data were then linked to hospital administrative data. The combined data were assigned diagnostic categories based on working diagnoses to allow further analysis using descriptive statistics.ResultsFive diagnostic categories accounted for 62% of all patients seen within the study period, the most common of which was headache disorders. Following a first appointment, 50% of all patients were offered at least one diagnostic test, and 35% were offered a follow-up appointment, with variation in both measures by diagnostic category. Waiting times from referral to appointment also varied by diagnostic category. 65% of patients with a seizure/epilepsy disorder were seen within the 18-week referral to treatment target, compared with 38% of patients with a movement disorder.ConclusionsA small number of diagnostic categories account for a large proportion of new patients. This information could be used in policy decision-making to describe a minimum subset of categories for diagnostic coding. We found significant differences in waiting times by diagnostic category, as well as tests ordered, and follow-up offered; further investigation could address causes of variation.
Cognitive development of children with Kawasaki disease and the parenting stress of their caregivers in Taiwan: a case–control study
Authors: Wang Liang-Jen , Tsai Zi-Yu , Chang Ling-Sai , Kuo Ho-Chang 
Published: June 2021

ObjectiveKawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multisystemic vasculitis common in patients with KD may influence blood perfusion in the brain, and thus caregivers of children with KD may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (coronary artery lesion (CAL)). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress.DesignA case–control study with consecutive sampling.SettingA medical centre (Kaohsiung Chang Gung Memorial Hospital, Taiwan).ParticipantsThis study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% boys) and 85 healthy children (mean age: 6.4 years, 54.1% boys).Primary and secondary outcome measuresBased on the children’s age, each patient with KD and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index (PSI)-Short Form.ResultsWe observed no significant differences in any developmental index, cognitive function or parenting stress between patients with KD and controls. Among the children with KD, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL. Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college or lower.ConclusionCaregivers’ education is associated to parenting stress, and caregivers of patients with KD who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfil their parenting roles.
Do women’s empowerment and socioeconomic status predict the adequacy of antenatal care? A cross-sectional study in five South Asian countries
Authors: Anik Asibul Islam , Islam Md Rashedul , Rahman Md Shafiur 
Published: June 2021

ObjectivesRelative to the attention given to improving the measurement of adequacy of antenatal care (ANC) in South Asian (SA) region, the influence of women’s empowerment and socioeconomic status (WESES) on adequate ANC services has hardly received any attention. This study aimed to investigate the present scenario of adequacy of ANC in SA and how its adequacy was associated with WESES.Setting and participantsUsing the Demographic and Health Survey data set of five SA countries, that is, Afghanistan, Bangladesh, India, Nepal and Pakistan, 48 107 women were selected in this study who received at least one ANC component and had at least one live birth in the 3 or 5 years preceding the survey.AnalysisMultilevel logistic regression models were used to investigate the relationship between adequacy of ANC and WESES.ResultsOnly 30% women received adequate ANC in SA, ranging from 8.4% (95% CI 7.1% to 9.9%) in Afghanistan to 39.8% (95% CI 37.4% to 42.2%) in Nepal. The poor utilisation of adequate ANC services was most prevalent among the women residing in rural areas and that of poor families as well as low empowerment status in SA countries. Different levels of WESES, that is, highly empowered but poor (adjusted OR (AOR): 1.33; 95% CI 1.18 to 1.49), lowly empowered but rich (AOR: 2.07; 95% CI 1.84 to 2.32) and highly empowered and rich women (AOR: 3.07; 95% CI 2.75 to 3.43), showed significant positive association with adequate ANC services than the poor and low empowered women, after adjusting the potential covariates.ConclusionAs unsatisfactory level of adequate ANC services has been observed in SA region, this study suggests a nationwide comprehensive improvement of women’s empowerment status as well as establishment of necessary healthcare centres in remote areas is essential to ensure long-term and sustainable adequacy of ANC services.
Use of health-related quality-of-life measures for Indigenous child and youth populations: a scoping review protocol
Authors: McCarty Georgia , Derrett Sarah , Sullivan Trudy , Crengle Sue , Wyeth Emma 
Published: June 2021

IntroductionMeasures of health-related quality-of-life (HRQoL) are increasingly important for evaluating healthcare interventions and treatments, understanding the burden of disease, identifying health inequities, allocating health resources and for use in epidemiological studies. Although many HRQoL measures developed for use in adult populations are robust, they are not necessarily designed, or appropriate, to measure HRQoL for children/youth. Furthermore, the appropriateness of HRQoL measures for use with Indigenous child/youth populations has not been closely examined. The aims of this scoping review are to (1) identify and describe empirical studies using HRQoL measures among children/youth (aged 8–17 years) from Indigenous populations within the Pacific Rim, (2) summarise the study designs and modes of HRQoL measure administration, (3) describe the key dimensions of the identified HRQoL measures used among Indigenous populations, including specifically among Māori and (4) map the HRQoL measure dimensions to commonly used Māori models of health.Methods and analysisThe scoping review framework developed by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines will be followed for best practice and reporting. An iterative search of peer-reviewed published empirical research reporting the use of child/youth HRQoL measures among Indigenous populations will be conducted. This literature will be identified across the following five databases: Ovid (Medline), PubMed, Scopus, Web of Science and CINHAL. The search will be restricted to papers published in English between January 1990 and June 2020. Two reviewers will independently review the papers in two stages. A third reviewer will resolve any discrepancies that arise. A data charting form will be completed using data extracted from each paper.Ethics and disseminationEthical approval was not required for this scoping review. Dissemination will include publication of the scoping review in a peer-reviewed journal. This scoping review will inform a larger research project (HRC 20/166).
Exploring high mortality rates among people with multiple and complex needs: a qualitative study using peer research methods
Authors: Perry Rachel , Adams Emma A. , Harland Jill , Broadbridge Angela , Giles Emma L. , McGeechan Grant J. , O'Donnell Amy , Ramsay Sheena E. 
Published: June 2021

ObjectiveTo explore the perceived reasons underlying high mortality rates among people with multiple and complex needs.DesignQualitative study using peer research.SettingNorth East of England.ParticipantsThree focus group discussions were held involving (1) people with lived experience of multiple and complex needs (n=5); (2) front-line staff from health, social care and voluntary organisations that support multiple and complex needs groups (n=7); and (3) managers and commissioners of these organisations (n=9).ResultsFindings from this study provide valuable perspectives of people with multiple complex needs and those that provide them with support on what may be perceived factors underlying premature mortality. Mental ill health and substance misuse (often co-occurring dual diagnosis) were perceived as influencing premature mortality among multiple and complex needs groups. Perceptions of opportunities to identify people at risk included critical life events (eg, bereavement, relationship breakdown) and transitions (eg, release from prison, completion of drug treatment). Early prevention, particularly supporting young people experiencing adverse childhood experiences, was also highlighted as a priority.ConclusionHigh mortality in multiple and complex needs groups may be reduced by addressing dual diagnosis, providing more support at critical life events and investing in early prevention efforts. Future interventions could take into consideration the intricate nature of multiple and complex needs and improve service access and navigation.
Exploring human factors in the operating room: a protocol for a scoping review of training offerings for healthcare professionals
Authors: Lee Alex , Tipney Ben , Finstad Alexandra , Rahman Alvi , Devenny Kirsten , Abou Khalil Jad , Kuziemsky Craig , Balaa Fady 
Published: June 2021

IntroductionApplying human factors principles in surgical care has potential benefits for patient safety and care delivery. Although different theoretical frameworks of human factors exist, how providers are being trained in human factors and how human factors are being understood in vivo in the operating room (OR) remain unknown. The aim of this scoping review is to evaluate the application of human factors for the OR environment as described by education and training offerings for healthcare professionals.Methods and analysisThis scoping review will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. MEDLINE, Embase, PsycINFO, CINAHL, Health and Psychosocial Instruments and ERIC databases were searched on August 2020 from inception to identify relevant studies that describe the content, application and impact of human factors training for healthcare professionals or trainees who work in or interface with the OR environment. Titles, abstracts and full texts will be independently screened by two authors for eligible studies. Any disagreements will be resolved by discussion or by a third author when disagreement persists. Study information and training characteristics, such as the training tool used and type of learners and teachers, will be charted and summarised, and key themes in human factors training will be identified. Each training offering will be classified under the appropriate knowledge area(s) of human factors described by the Chartered Institute of Ergonomics & Human Factors (CIEHF). Themes that are not captured by the CIEHF framework will be independently recorded by two authors and included based on group discussion and consensus.Ethics and disseminationResearch ethics board approval is not required for this scoping review. The findings of this study will be disseminated at local and national conferences and will be published in a peer-reviewed journal.