bluuebunny/crossref_metadata_2025_split huggingface dataset:
Numerical Simulation and Measurements of Reaction Load for an Impulsively Loaded Pressure Vessel
Authors: Fister Matthew , Fehlmann Kevin , Spernjak Dusan 
Published: October 2021

Abstract
Los Alamos National Laboratory (LANL) designs and utilizes impulsively loaded pressure vessels for the confinement of experimental configurations involving explosives. For physics experiments with hazardous materials, a two-barrier containment system is needed, where an impulsively (or, explosively) loaded pressure vessel is assembled as an inner confinement vessel, inside an outer containment vessel (subject to quasi-static load in the event of confinement vessel breach). Design of the inner and outer vessels and support structure must account for any directional loads imparted by the blast loading on the inner vessel. Typically there is a shock-attenuating assembly between the inner confinement and outer containment pressure barriers, which serves to mitigate any dynamic load transfer from inner to outer vessel. Depending on the shock-attenuating approach, numerical predictions of these reaction loads can come with high levels of uncertainty due to model sensitivities.
Present work here focuses on the numerical predictions and measurements of the reaction loads due to detonating 30 g of TNT equivalent in the Inner Pressure Confinement Vessel (IPCV) for proton imaging of small-scale shock physics experiments at LANL. Direct reaction load measurements from IPCV testing is presented alongside numerical predictions. Using the experimental measurements from the firing site, we refine the tools and methodology utilized for reaction load predictions and explore the primary model sensitivities which contribute to uncertainties. The numerical tools, modeling methodology, and primary drivers of model uncertainty identified here will improve the capability to model detonation experiments and enable design load calculations of other impulsively loaded pressure vessels with higher accuracy.
Design by Analysis, Codes, Standards and Rules on EAF - Applicability to Stainless Steels in PWR Primary Piping
Authors: Solin Jussi , Seppänen Tommi , Vanninen Rami , Pulkkinen Erkki , Lemettinen Petri 
Published: October 2021

Abstract
This paper discusses general principles, assumptions and challenges in management of fatigue in operating NPP’s. The roots and state-of-the-art in different design codes, design curves and rules are briefly reviewed. It is noted that the ASME Boiler and Pressure Vessel Code, Section III was originally prepared as a Design Code to ensure appropriate design and manufacture of nuclear vessels. ‘Design by Rule’ was replaced by ‘Design by Analysis’. Today, ASME III and the related international codes are also used for ‘Operation by Analysis’. Demonstration that the fatigue usage factor is less than unity is not sufficient for proactive component life management. Quantitative analyses of fatigue usage and factors affecting it are needed, including the environmental effects. Differences between the design curves and penalty factors for environmental effects are illustrated through selected examples.
Supports for Non-Metallic Large Diameter Pipes
Authors: Shitole Bhaskar , Heinrichs Cynthia 
Published: October 2021

Abstract
Large diameter non-metallic pipes, designed and engineered as conventional aboveground piping to various international standards, have extensive applications. The support points for such piping are designed with cautions such as smaller support spans and avoiding point loads as compared to metal piping. Avoiding point loads is accomplished by providing a cradle, or a fully encirclement clamp shoe support. These support designs such as one diameter length of the cradle support and encirclement clamp shoe are based on arbitrary practice rather than a quantifiable limit Non-metallic pipes are not isotropic in behavior. Non-metallic pipes have different behavior for hoop strength and longitudinal strength. Non-metal pipes have a modulus of elasticity one hundredth to one thousandth as large as steel pipes. The longitudinal strength of these non-metal pipes will be used to determine the pipe support spans, but this assumes that pipe retains its circular cross-section at the support point. Non-metallic pipes will ovalize at the support points. Ovalized pipe has a reduced section modulus compared to circular pipes and hence higher stresses. Beyond a certain increase in pipe load, either due to increased span, heavy intermediate components or high-density fluid carried, the pipe support location will ovalize or/and buckle. This ovalizing and shell buckling is prevented by providing a cradle support or holding the non-metallic pipe in a rigid/metal full encirclement saddle or clamped shoe. Such a support design reduces ovalizing of the non-metal pipe and maintains its load-carrying ability by ensuring that entire non-metallic pipe cross-section is taking up pipe load. Stresses can therefore be assessed according to the basic rules of beam design from strength of materials concepts. Induced bending stresses can then be calculated for comparison against longitudinal strength limits. But the means to determine the need for cradle or a clamped shoe is complicated. ASME design codes NM-1 for plastics and NM-2 do not provide such guidance and this is left to the designer. ASME Code case N-886 discusses PE pipe design and cautions against axial buckling from compressive stresses but does not provide guidance on the support design.
This paper is an analytical study on pipe support aspects of non-metallic pipes as compared to metal pipes. The guidance and set of formulae generated can be applied to the range of non-metallic pipes available and in industry use today. This paper provides a basis that can be adopted by engineers to decide a threshold point below which bending moments should be kept on a piping system. If the piping system at the supports is going to a see a bending stress higher than the buckling stress limit, then strengthen the support by providing a full encirclement clamp type of support.
Reliability and validity of a Spanish-language measure assessing clinical capacity to sustain Paediatric Early Warning Systems (PEWS) in resource-limited hospitals
Authors: Agulnik Asya , Malone Sara , Puerto-Torres Maria , Gonzalez-Ruiz Alejandra , Vedaraju Yuvanesh , Wang Huiqi , Graetz Dylan , Prewitt Kim , Villegas Cesar , Cardenas-Aguierre Adolfo , Acuna Carlos , Arana Ana Edith , Díaz Rosdali , Espinoza Silvana , Guerrero Karla , Martínez Angélica , Mendez Alejandra , Montalvo Erika , Soberanis Dora , Torelli Antonella , Quelal Janeth , Villanueva Erika , Devidas Meenakshi , Luke Douglas , McKay Virginia 
Published: October 2021

BackgroundPaediatric Early Warning Systems (PEWSs) improve identification of deterioration, however, their sustainability has not been studied. Sustainability is critical to maximise impact of interventions like PEWS, particularly in low-resource settings. This study establishes the reliability and validity of a Spanish-language Clinical Sustainability Assessment Tool (CSAT) to assess clinical capacity to sustain interventions in resource-limited hospitals.MethodsParticipants included PEWS implementation leadership teams of 29 paediatric cancer centres in Latin America involved in a collaborative to implement PEWS. The CSAT, a sustainability assessment tool validated in high-resource settings, was translated into Spanish and distributed to participants as an anonymous electronic survey. Psychometric, confirmatory factor analysis (CFA), and multivariate analyses were preformed to assess reliability, structure and initial validity. Focus groups were conducted after participants reviewed CSAT reports to assess their interpretation and utility.ResultsThe CSAT survey achieved an 80% response rate (n=169) with a mean score of 4.4 (of 5; 3.8–4.8 among centres). The CSAT had good reliability with an average internal consistency of 0.77 (95% CI 0.71 to 0.81); and CFAs supported the seven-domain structure. CSAT results were associated with respondents’ perceptions of the evidence for PEWS, its implementation and use in their centre, and their assessment of the hospital culture and implementation climate. The mean CSAT score was higher among respondents at centres with longer time using PEWS (p<0.001). Focus group participants noted the CSAT report helped assess their centre’s clinical capacity to sustain PEWS and provided constructive feedback for improvement.ConclusionsWe present information supporting the reliability and validity of the CSAT tool, the first Spanish-language instrument to assess clinical capacity to sustain evidence-based interventions in hospitals of variable resource levels. This assessment demonstrates a high capacity to sustain PEWS in these resource-limited centres with improvement over time from PEWS implementation.
Royal Naval Medical Staff School—An update
Authors: Bussell S. N. , Marshall G. , Schofield H. R. M. , Brockie B. 
Published: October 2021

AbstractFour significant changes in the training of RN Medical and Nursing personnel have taken place over the past four years, since training was last outlined in the article commemorating the Branch Centenary namely, the resurrection of MA training with a significantly increased throughput than previously; a relocation from Dophin II to purpose-built accommodation in the grounds of Haslar Hospital; the introduction of the QARNNS Medical Assistant, and also that of the Direct Entry QARNNS Registered General Nurse within the Rating Structure.Current training regimes and constraints are highlighted at all levels to familiarise and update the Branch with the changes and to promote a better understanding of the abilities and capabilities of the Royal Naval Medical and Nursing Services.
Fine needle aspiration cytology as part of a three stage diagnostic approach to breast lumps in a District General Hospital
Authors: Spalding T. J. W. , Dewar E. P. , Buchanan J. D. , Mugridge A. R. , Conroy B. 
Published: October 2021

SummaryRecent studies from specialist breast centres have suggested that fine needle aspiration cytology in conjunction with mammography and clinical examination can provide a prompt and accurate diagnosis of breast lumps. These three methods of diagnosis have been assessed in the context of a district general hospital by analysing 104 consecutive breast lesions with known histology, of which 75 were benign and 29 malignant. The results are presented in terms of the sensitivity and specificity for each method.Fine needle aspiration cytology had a sensitivity for malignancy of 88% (n=26) and a specificity of 97% (n=58). Similarly, sensitivity for mammography was 95% (n=20) and clinical examination 90% (n=29). Respective specificiaties were 96% (n=45) and 83% (n=75). In none of the 29 patients with breast cancer were all three modalities negative.It is concluded that without specialist breast clinicians and cytologists, a combination of fine needle aspiration cytology, clinical examination and mammography can still provide a degree of preoperative diagnostic accuracy comparable with specialist centres, allowing prompt counselling with all the subsequent benefits.
The Boat People of Vietnam. Rescue on the South China Sea
Authors: Hayes T. J. , Thomas D. , Dewar E. P. 
Published: October 2021

AbstractPoor economic conditions in Vietnam have encouraged large numbers of people seeking a better life in the West to join the flow of political refugees leaving the country as “boat people”. We report the events surrounding one such group of people who were rescued from the South China Sea by the Outback 88 Task Group.
Penetrating missile injuries in the Gulf War 1991
Authors: Spalding T. J. W. , Stewart M. P. M. , Tulloch D. N. , Stephens K. M. 
Published: October 2021

AbstractDuring the Gulf War in 1991 63 patients (including 29 Iraqi prisoners of war) with penetrating missile injuries underwent surgery in a British Army Field Hospital. Their injuries and initial operative management are reported.Fifty-one casualties (81%) suffered an average of nine wounds (range 1–45) due to fragmentation weapons, and 12 casualties sustained bullet wounds. All wounds were explored following the established principles of war surgery. The extremities were involved in 48 patients (76%). Eight compound long bone fractures were managed with external skeletal fixators applied at the time of initial surgery. Laparotomy was performed on seven patients, one of whom died. The average duration of surgery was 77 minutes for fragment wounds and 85 minutes for bullet wounds.
Distant haemorrhagic effects in intra-arterial Tissue Plasminogen Activator — The effect of a bolus dose
Authors: Cripps N. P. J. , Ward A. S. 
Published: October 2021

AbstractDetails are reported of four patients who developed serious distant haemorrhagic complications while undergoing peripheral arterial thrombolysis with intra-arterial tissue plasminogen activator (t-PA). The thrombolytic regime comprised a 20 mg bolus of t-PA followed by a continuous infusion of 1 mg/hr.Four additional cases of haemorrhage at the catheter entry site were also encountered in a group of 23 patients exposed to the bolus-infusion t-PA regimen. The high haemorrhage rate (31%) is a significant disadvantage of this thrombolytic protocol.
Personality, Individual Differences and Command in War: 1982
Authors: Jolly R. T. 
Published: October 2021

SummaryIn 1982, a small percentage of Great Britain’s armed forces was involved in a short but bitter action to recover some territory in the South Atlantic region that had been invaded by another nation. As part of a UK Ministry of Defence-sponsored study, 30 Commanding Officers of British sea, land and air units involved in Operation CORPORATE participated between seven and nine years later in a research study investigating their individual variations in personality and the perceived effects of their experience of Command in War. Ten single-seat, fast jet pilots from a slightly younger age group were also investigated.
The Post Traumatic Stress Management Course at RN Hospital, Haslar
Authors: Charlotte B Nevison , Julia J M Flower , Peter L N Naish 
Published: October 2021

AbstractA rehabilitation programme for PTSD sufferers has been in operation at the RN Hospital, Haslar, for eight years. During this time a large database has accumulated, comprising a wide range of materials, including case histories and assessments. For this initial evaluation of the course’s efficacy, the data from three standard mental health assessment instruments were examined. Scores on all measures revealed considerable reductions in symptoms over the duration of the course, with some statistically significant improvements maintained at follow-up.
The Mortality of Royal Naval Submariners 1960–1989
Authors: Inskip Hazel 
Published: October 2021

AbstractThe mortality pattern of 15,318 Royal Naval submariners has been examined to assess the long term effects on health of serving in submarines. The main outcome measures used were standardised mortality ratios (SMRs) which present the submariners’ mortality rates as a percentage of those for men in England and Wales. The SMR for all causes of death combined was low at 86, this being comparable to findings in other studies of Armed Forces personnel. Cancer mortality was particularly low with an SMR of 69 and there was no particular cancer site which showed an excess. Raised mortality from digestive diseases was seen; the excess was attributable to cirrhosis of the liver which gave rise to an SMR of 221 based on 12 deaths, alcohol being a contributory factor in eight. This excess mortality from cirrhosis was concentrated in the period 1970-79 and occurred in men who had left the Royal Navy. Deaths from accidents and violence were also higher than expected with an SMR of 115, but this was due to high levels of accidents occurring after discharge from the Navy.
Mild aortic valve disease and the diastolic pressure–volume relationship in heart failure with preserved ejection fraction
Authors: Verbrugge Frederik H , Reddy Yogesh N V , Eleid Mackram F , Lin Grace , Burkhoff Daniel , Borlaug Barry A 
Published: October 2021

ObjectiveMild aortic valve stenosis (AS) and aortic valve (AV) sclerosis are associated with diastolic dysfunction and increased mortality in the general population. This study specifically investigated the impact of mild AV disease in heart failure with preserved ejection fraction (HFpEF).MethodsConsecutive patients hospitalised with HFpEF (n=370) underwent assessment of cardiac structure and function and long-term clinical follow-up.ResultsIn the study cohort, 111 had mild AS (30%), 104 AV sclerosis (28%) and 155 a non-calcified AV (42%). Mild-to-moderate AV regurgitation (AR) was present in 64 (17%). Compared with patients with a normal AV, those with AV disease were older, with worse renal function and more atrial fibrillation. E/e′ increased from non-calcified AV to AV sclerosis to mild AS (13.8 (10.8–16.8) vs 15.0 (10.9–20.0) vs 18.0 (12.7–23.3), respectively; p<0.001)). Left ventricular diastolic pressure–volume relationships were shifted leftwards in patients with AS and AV sclerosis, but not influenced by AR. The left ventricular end-diastolic volume normalised at 20 mm Hg was 117±34 mL, 106±30 mL and 112±30 mL in non-calcified AV, AV sclerosis and mild AS, respectively (p=0.023), while 112±32 mL in mild-to-moderate AR. Over 30 months (IQR, 8–61 months), 247 patients died (67%). The presence of mild AV disease was associated with increased mortality, but this was no longer significant after adjusting for age and sex.ConclusionsLow-grade AV disease is common among patients hospitalised for HFpEF and is associated with older age, atrial arrhythmia, renal dysfunction, higher left heart filling pressures and increased left ventricular chamber stiffness.
Escalating incidence of infective endocarditis in Europe in the 21st century
Authors: Talha Khawaja M , Baddour Larry M , Thornhill Martin H , Arshad Verda , Tariq Wajeeha , Tleyjeh Imad M , Scott Christopher G , Hyun Meredith C , Bailey Kent R , Anavekar Nandan S , Palraj Raj , Sohail M Rizwan , DeSimone Daniel C , Dayer Mark J 
Published: October 2021

AimTo provide a contemporary analysis of incidence trends of infective endocarditis (IE) with its changing epidemiology over the past two decades in Europe.MethodsA systematic review was conducted at the Mayo Clinic, Rochester. Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus and Web of Science were searched for studies published between 1 January 2000 and 30 November 2020. All studies were independently reviewed by four referees and those that included a population-based incidence of IE in patients, irrespective of age, in Europe were included. Least squares regression was used to estimate pooled temporal trends in IE incidence.ResultsOf 9138 articles screened, 18 studies were included in the review. Elderly men predominated in all studies. IE incidence increased 4.1% per year (95% CI 1.8% to 6.4%) in the pooled regression analysis of eight studies that included comprehensive and consistent trends data. When trends data were weighted according to population size of individual countries, an increase in yearly incidence of 0.27 cases per 100 000 people was observed. Staphylococci and streptococci were the most common pathogens identified. The rate of surgical intervention ranged from 10.2% to 60.0%, and the rate of inpatient mortality ranged from 14.3% to 17.5%. In six studies that examined the rate of injection drug use, five of them reported a rate of less than 10%.ConclusionBased on findings from our systematic review, IE incidence in Europe has doubled over the past two decades in Europe. Multiple factors are likely responsible for this striking increase.Trial registeration numberCRD42020191196.
Gravity in $${\varvec{d=2+\epsilon }}$$ dimensions and realizations of the diffeomorphisms group
Authors: Martini Riccardo , Ugolotti Alessandro , Del Porro Francesco , Zanusso Omar 
Published: October 2021

AbstractWe discuss two separate realizations of the diffeomorphism group for metric gravity, which give rise to theories that are classically equivalent, but quantum mechanically distinct. We renormalize them in $$d=2+\epsilon $$

d
=
2
+
ϵ

dimensions, developing a new procedure for dimensional continuation of metric theories and highlighting connections with the constructions that previously appeared in the literature. Our hope is to frame candidates for ultraviolet completions of quantum gravity in $$d>2$$

d
>
2

and give some perturbative mean to assess their existence in $$d=4$$

d
=
4

, but also to speculate on some potential obstructions in the continuation of such candidates to finite values of $$\epsilon $$
ϵ
. Our results suggest the presence of a conformal window in d which seems to extend to values higher than four.
Habitat mapping for human well-being: a tool for reducing risk in disaster-prone coastal environments and human communities
Authors: Oki Yuri , Kitazato Hiroshi , Fujii Toyonobu , Yasukawa Soichiro 
Published: October 2021

Abstract
Coastal ecosystems consist of diverse habitats, such as reed beds, salt marshes, mangrove swamps, tidal flats, river deltas, seagrass fields, coral reefs, sandy/rocky-shore beaches and other habitats that harbour biodiversity. The Great East Japan Earthquake of March 2011 caused severe damage to one-third of the fishing communities along the Pacific Ocean of NE Japan. Coastal species, such as seagrasses, function as nursery areas for commercially important species. Coastal ecosystems provide natural infrastructure for the prevention and reduction of hazardous events, a process known as ecosystem-based disaster risk reduction (Eco-DRR). The preparation of topographic and thematic maps of coastal marine environments is essential to establish and visualize the concept of Eco-DRR. Experience gained following the Japanese earthquake, as well as examples from Indonesia and Thailand in the wake of 2004 Indian Ocean tsunami, showed that Eco-DRR is an affordable and sustainable approach. Dissemination of habitat maps should be further promoted as a way to ‘Build Back Better’. To scale up and promote Eco-DRR, scientists must work in a transdisciplinary manner and engage with society by understanding the roles of ecosystems by monitoring and analysing, providing solutions and raising the awareness of community and policy makers, enabling them to better implement Eco-DRR.