bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence on structure and fracture mechanics evaluations of a BWR feedwater nozzle following weld overlay repair
Authors: Liu Ru-Feng , Young Ming-Chung 
Published: June 2023

Abstract
This present paper summarizes applying weld overlay repair on the feedwater nozzle in a boiling water reactor, and evaluates the influence on the structure and fracture mechanics of the component. The requirements for utilizing a full structural weld overlay, including the weld overlay design, effects of welding residual stresses (WRSs), impacts of weld shrinkage, prediction of potential flaw growth, and influence on ASME Code Section III design evaluations, are further defined in ASME Code Case N-504–2. In order to confirm the effectiveness of the weld overlay design of the nozzle, the WRSs following overlay installation were determined using engineering simulation software. The impacts of weld shrinkage from overlay welding are also addressed. The shrinkage stresses were evaluated via a numerical model of the attached piping system to ensure the design margins of the pipe structure. Since the weld overlay technique is well known to be effective in mitigating crack initiation or cracking to leakage, a fatigue crack growth prediction under ASME Code Section XI must be conducted to address the fatigue qualification of the affected component. The ASME Code Section III construction qualification of the whole nozzle region must consider the applicable thermal transient stresses, structural discontinuities, and bimetallic effects that are caused by the weld overlay. This investigation proves that the current stress analyses of the nozzle and the pipe structure are not significantly affected by the added overlay mass, so the structural integrity of the component can be ensured, meeting the requirements of ASME Code Case N-504–2.
Successful extended use of Impella 5.5 as a bridge to heart transplantation
Authors: Sharaf Omar M , Diaz-Ayllon Hannia P , Myers Elisha M , Ahmed Mustafa M , Bleiweis Mark S , Jeng Eric I 
Published: June 2023

Abstract
We present the case of a 60-year-old gentleman who was admitted with acute-on-chronic cardiogenic shock and was supported with axillary Impella 5.5® for 123 days prior to heart transplantation. Total length of temporary mechanical circulatory support (MCS) was 132 days, which included 9 days with an intra-aortic balloon pump prior to Impella. During support, the patient remained extubated, participated in regular ambulation and rehabilitation with physical therapy and had continuous monitoring of device positioning. He did not experience any vascular or septic events while on temporary MCS and had improved hemodynamics and renal function after Impella initiation. Post-transplantation course was uncomplicated, and he is doing well without evidence for allograft dysfunction over 581 days post-transplantation. To our knowledge, this is the longest Impella 5.5®-supported patient during the new United Network for Organ Sharing Heart Allocation era who was successfully bridged to heart transplantation with over 1-year follow-up.
Capacity to love and problematic sexuality: the role of defense mechanisms and psychopathological suffering
Authors: Ciocca Giacomo , Origlia Giulia , Limoncin Erika , Mollaioli Daniele , Tanzilli Annalisa , Lingiardi Vittorio , Jannini Emmanuele A 
Published: June 2023

Abstract

Background
Limitation to the capacity to love is often a feature of a suffering personality.

Aim
We aimed to investigate the role of the capacity to love in hypersexual behavior, considering both distress and defense mechanisms as possible psychological mediators.

Methods
Through an online platform, we recruited a convenience sample of 521 subjects (390 [74.9%] females and 131 [25.1%] males; mean [SD] age, 26.46 [5.89] years).

Outcomes
Recruited subjects completed a psychometric protocol that included completion of the following measurement tools: (1) the Capacity to Love Inventory (CTL-I), (2) the Hypersexual Behavior Inventory (HBI), (3) the 30-item self-report Defense Mechanisms Rating Scale, and (4) the Brief Symptom Inventory. We then performed correlation and regression analyses and used a mediation model for data analysis.

Results
A significant negative relationship between the capacity to love and hypersexual behavior was found. Furthermore, indirect effects were also statistically significant, supporting the hypothesis that limitation to the capacity to love is related to hypersexuality through the paths of psychological distress and immature defense mechanisms. Finally, compared to the other subjects, those with pathological scores for the HBI showed significantly lower scores on the CTL-I, which suggested limitations to the capacity to love.

Clinical Implications
The relationship between limitation to the capacity to love and hypersexuality is fundamental to the diagnostic process in persons with problematic sexuality and psychopathological distress.

Strengths and Limitations
This study is the first, to our knowledge, to highlight the role of the capacity to love in sexual behavior, although future studies in specific clinical sample groups would be suitable for further investigation of the relationships among the considered variables.

Conclusion
The etiology of limitation in the capacity to love is related to dysfunctional aspects of psychological functioning, such as psychological distress and immature defense mechanisms, and these factors together generate problematic sexuality such as hypersexual behavior. Our results highlight the central role in mental and sexual health of the capacity to love. Based on these findings, clinicians should take these aspects into consideration for diagnosis and treatment of patients presenting with problematic sexuality.
Do patients with Peyronie’s disease perceive penile curvature in adults and children differently than the general population?
Authors: Henry Alexander J , Holler Jordan T , Lui Jason , Breyer Benjamin N , Ziegelmann Matthew , Cohen Tal , Smith Ryan P , Yeaman Clinton , Winkelman Andrew J , Villanueva Carlos , Kern Nora G 
Published: June 2023

Abstract

Background
As perception of penile curvature varies widely, we sought to understand how adults perceive curvature and how these opinions compare with those of patients with curvature, specifically Peyronie’s disease (PD).

Aim
To investigate the perspectives of curvature correction from adults with and without PD, as well as differences within demographics.

Methods
A cross-sectional survey was administered to adult patients and nonpatient companions in general urology clinics at 3 institutions across the United States. Men, women, and nonbinary participants were recruited. Patients were grouped as having PD vs andrology conditions without PD vs general urology conditions plus companions. The survey consisted of unlabeled 2-dimensional images of penis models with varying degrees of curvature. Participants selected images that they would want surgically corrected for themselves and their children. Univariable and multivariable analyses were performed to identify demographic variables associated with willingness to correct.

Outcomes
Our main outcome was to detect differences in threshold to correct curvature between those with and without PD.

Results
Participants were grouped as follows: PD (n = 141), andrology (n = 132), and general (n = 302) . Respectively, 12.8%, 18.9%, and 19.9% chose not to surgically correct any degree of curvature (P = .17). For those who chose surgical correction, the mean threshold for correction was 49.7°, 51.0°, and 51.0° (P = .48); for their children, the decision not to correct any degree of curvature was 21.3%, 25.4%, and 29.3% (P = .34), which was significantly higher than correction for themselves (P &lt; .001). The mean threshold for their children’s correction was 47.7°, 53.3°, and 49.4° for the PD, andrology, and general groups (P = .53), with thresholds no different vs themselves (P = .93). On multivariable analysis, no differences were seen in demographics within the PD and andrology groups. In the general group, participants aged 45 to 54 years and those who identified as LGBTQ (lesbian, gay, bisexual, transgender, queer) had a higher threshold for correction as compared with their counterparts when factoring other demographic variables (63.2° vs 48.8°, P = .001; 62.1° vs 50.4°, P = .05).

Clinical Implications
With changing times and viewpoints, this study stresses the importance of shared decision making and balancing risks and benefits to correction of penile curvature.

Strengths and Limitations
Strengths include the broad population surveyed. Limitations include the use of artificial models.

Conclusion
No significant differences were seen in the decision to surgically correct curvature between participants with and without PD, with participants being less likely to choose surgical correction for their children.
Implicit commitment in a general setting
Authors: ŁeŁyk Mateusz , Nicolai Carlo 
Published: June 2023

Abstract
Gödel’s Incompleteness Theorems suggest that no single formal system can capture the entirety of one’s mathematical beliefs, while pointing at a hierarchy of systems of increasing logical strength that make progressively more explicit those implicit assumptions. This notion of implicit commitment motivates directly or indirectly several research programmes in logic and the foundations of mathematics; yet there hasn’t been a direct logical analysis of the notion of implicit commitment itself. In a recent paper, we carried out an initial assessment of this project by studying necessary conditions for implicit commitments; from seemingly weak assumptions on implicit commitments of an arithmetical system $S$, it can be derived that a uniform reflection principle for $S$—stating that all numerical instances of theorems of $S$ are true—must be contained in $S$’s implicit commitments. This study gave rise to unexplored research avenues and open questions. This paper addresses the main ones. We generalize this basic framework for implicit commitments along two dimensions: in terms of iterations of the basic implicit commitment operator, and via a study of implicit commitments of theories in arbitrary first-order languages, not only couched in an arithmetical language.
Advanced Non-compressible Torso Hemorrhage Management is Combat Casualty Care’s Moon Shot
Authors: Naveed Asad , Gomez David , Rezende-Neto Joao , Ahmed Najma , Beckett Andrew 
Published: June 2023

ABSTRACT
Non-compressible torso hemorrhage continues to cause considerable preventable mortality on the battlefield. In this editorial, we highlight the burden of deaths, the most at-risk torso structures, current interventions, and their limitations and recommendations for future research and device development.
Suicide Characteristics of Veterans Hospitalized for Suicide Ideation or Attempt
Authors: Primack Jennifer M , Thompson Matthew F , Peters Aileen , Quinn McKenzie , Kelsey Madeline , Miller Ivan W , Bozzay Melanie 
Published: June 2023

ABSTRACT

Introduction
Veteran suicide rates continue to be unacceptably high, with the most common risk factor being a past suicide attempt (SA). However, some characteristics of suicidal ideation (SI) and behavior among Veterans hospitalized for suicide risk remain under-reported.

Materials and Methods
One hundred and eighty-three Veterans hospitalized for either an SA or SI with intent were screened for enrollment in a treatment study to prevent suicide. Veterans completed a demographic form, the Columbia-Suicide Severity Rating Scale, and the McLean borderline personality disorder screening measure shortly after inpatient psychiatric admission. Chi-squared and t-tests were used to compare suicide characteristics (e.g., intensity, duration, deterrents, and controllability) between Veterans with and without a lifetime history of SA. Thematic analyses of the reported method of SI were conducted.

Results
Sixty-seven percent of participants were hospitalized for SI and 33% were hospitalized for SA. Twenty-one percent of Veterans hospitalized for SI also endorsed a recent SA in the weeks preceding hospitalization. Most participants reported at least one lifetime SA (71%). Veterans with a lifetime history of SA reported greater frequency and duration of ideation in the week before hospitalization (t[169] =  −2.56, P = .01; t[168] =  −2.04, P = .04) while also reporting that deterrents were less likely to prevent an SA (t[107.09] =  −3.58, P = .001) compared to those with no lifetime SA.

Conclusion
Overall, Veterans hospitalized for SI/SA demonstrated markers of chronic suicide risk, as most participants endorsed a past attempt in their lifetime. Some Veterans admitted for SI also reported a past month’s attempt, suggesting that in certain cases, hospitalization does not immediately follow an acute suicidal crisis. A past SA differentiated Veterans on average frequency and duration of SI as well as the perception of deterrents preventing suicidal behavior. Therefore, a thorough evaluation of suicide methods and intensity may be informative in treatment planning for Veterans at greatest risk of suicide.
Musculoskeletal Injury Concealment in the Reserve Officers’ Training Corps: A Survey of Cadets’ Reporting Behaviors
Authors: Wooldridge Joshua D , Schilling Brian K , Young Daniel L , Radzak Kara N 
Published: June 2023

ABSTRACT

Background
Among service members, musculoskeletal injuries threaten military readiness and place a substantial burden on medical and financial resources. Emerging research suggests that service members regularly conceal injuries, especially in training environments. The Reserve Officers’ Training Corps (ROTC) is a critical training environment for future U.S. military commissioned officers. Training activities expose cadets to a high risk of injury while in the ROTC. The purpose of this study was to explore injury-reporting behaviors in cadets and factors associated with injury concealment.

Materials and Methods
We invited Army, Air Force, and Naval cadets from six host universities participating in officer training to complete an online, self-reported survey regarding injury reporting and concealment. Cadets answered questions about pain or injuries experienced during officer training. Survey questions pertained to an injury’s anatomic location, onset, severity, functional limitations, and whether or not the injury had been reported. Cadets also selected factors that influenced the decision to report or conceal injuries from predetermined lists in a “choose any” fashion. A series of χ2 tests of independence compared the relationship between injury reporting and other injury characteristics for each individual injury.

Results
One hundred fifty-nine cadets (121 Army, 26 Air Force, and 12 Naval) completed the survey. Eighty-five cadets disclosed a total of 219 injuries. Two-thirds of injuries (144/219) were concealed. Twenty-six percent of participants (22/85) reported all injuries, whereas the remainder (63/85, 74%) had at least one concealed injury. In relation to injury reporting/concealment, there was a weak association with injury onset (χ21 = 4.24, P = .04, V = 0.14), a moderate association with anatomic location (χ212 = 22.64, P = .03, V = 0.32), and relatively strong associations with injury severity (χ23 = 37.79, P &lt; .001, V = 0.42) and functional limitations (χ23 = 42.91, P &lt; .001, V = 0.44).

Conclusions
Two-thirds of injuries went unreported in this sample of ROTC cadets. Functional limitations, symptom severity, and injury onset may be the largest factors that influence the decision to report or conceal musculoskeletal injuries. This study establishes the foundation for researching injury reporting in cadets and adds to the existing military evidence on the topic.
Low-Cost Ear Procedure Simulator With Syringe and Tuning Fork: Training Course and Results
Authors: Avillion Michael P , Jones Nolan N , Ghias Adeeba F , Kram Yoseph A , Liming Bryan J , Chen Brian S 
Published: June 2023

ABSTRACT

Introduction
Medical simulation is a continuously expanding field. In surgical specialties, in particular, simulation can provide an alternative avenue for learning. The objective of this process improvement project was to evaluate the effectiveness and practicality of adding simulation-based training to our educational curriculum regarding common otologic procedures.

Materials and Methods
A low-cost, novel ear procedure simulator was designed and constructed from readily available clinic supplies. Participants were asked to fill out a pre-simulator survey to assess their own comfort and skill level before undergoing the simulation course. A pre-simulation PowerPoint training course was then administered to participants. The participants then underwent the simulation training course and were again asked to fill out a post-simulator training exercise survey to reassess their own comfort and skill level. Institutional review board approval was not required by Tripler Army Medical Center.

Results
A total of 15 participants consisting of junior residents in otolaryngology, third- and fourth-year medical students rotating on an otolaryngology clinical clerkship, and one physician assistant in otolaryngology were included in the study. There was a significant improvement in both provider comfort with the procedure and clinical performance of the procedure among participants after training on the simulation-based model.

Conclusions
Simulation-based training provides a safe, effective, and cost-friendly alternative to clinical medical education. Future studies are needed to address the wide-scale applicability of these results to other forms of surgical training.
A search for the missing baryons with X-ray absorption lines towards the blazar 1ES 1553+113
Authors: Spence David , Bonamente Massimiliano , Nevalainen Jukka , Tuominen Toni , Ahoranta Jussi , de Plaa Jelle , Liu Wenhao , Wijers Nastasha 
Published: June 2023

ABSTRACT
This paper presents an analysis of XMM–Newton and Chandra X-ray spectra of the quasar 1ES 1553+113, in search for absorption lines from the intervening warm–hot intergalactic medium (WHIM). A search for O vii, O viii, and Ne ix resonance absorption lines was performed at eight fixed redshifts that feature O vi or H i broad Lyman α absorption lines that were previously detected from Hubble Space Telescope (HST) data. The search yielded one possible detection of O vii at a redshift z ≃ 0.1877 with an O vi prior, with a statistical significance that is equivalent to a 2.6σ confidence level. The spectra were also stacked at the wavelengths of the expected redshifted O vii and O viii lines, but the analysis did not reveal evidence for the presence of additional X-ray absorbing WHIM. Moreover, the spectra were used to investigate two putative O vii absorption lines that were detected serendipitously in an earlier analysis of the same data by F. Nicastro and collaborators. The paper also presents a comprehensive statistical framework for cosmological inferences from the analysis of absorption lines, which makes use of cosmological simulations for the joint probability distributions of far-ultraviolet (FUV) and X-ray ions. Accordingly, we conclude that the new possible O vii absorption at z ≃ 0.1877 is consistent with a contribution from the hot WHIM to the baryon density in an amount of ΩWHIM, X/Ωb = 44 ± 22 per cent. However, there are large systematic uncertainties associated with the temperature and abundances of the absorbers, and only a larger sample of X-ray sources can provide an accurate determination of the cosmological density of the WHIM.
Timing the X-ray pulsating companion of the hot subdwarf HD 49798 with NICER
Authors: Rigoselli Michela , De Grandis Davide , Mereghetti Sandro , Malacaria Christian 
Published: June 2023

ABSTRACT
HD 49798 is a hot subdwarf of O spectral type in a 1.55 d orbit with the X-ray source RX J0648.0−4418, a compact object with a spin period of $13.2\,$s. We use recent data from the Neutron Star Interior Composition Explorer instrument, joined with archival data from XMM–Newton and ROSAT, to obtain a phase-connected timing solution spanning ∼30 yr. Contrary to previous works, which relied on parameters determined through optical observations, the new timing solution could be derived using only X-ray data. We confirm that the compact object is steadily spinning up with $\dot{P} = -2.28(2) \times 10^{-15}\,$s s−1 and obtain a refined measure of the projected semimajor axis of the compact object aXsin i = 9.60(5) light-second. This allows us to determine the inclination and masses of the system as $i=84.5(7)\,$deg, MX = 1.220(8) $\rm {M}_\odot$, and $M_{\rm opt}=1.41(2)\,$$\rm {M}_\odot$. We also study possible long-term (approximately years) and orbital variations of the soft X-ray pulsed flux, without finding evidence for variability. In the light of the new findings, we discuss the nature of the compact object, concluding that the possibility of a neutron star in the subsonic propeller regime is unlikely, while accretion of the subdwarf wind on to a massive white dwarf can explain the observed luminosity and spin-up rate for a wind velocity of ∼800 km s−1.
Turbulence in compact to giant H ii regions
Authors: García-Vázquez J , Henney William J , Castañeda H O 
Published: June 2023

ABSTRACT
Radial velocity fluctuations on the plane of the sky are a powerful tool for studying the turbulent dynamics of emission line regions. We conduct a systematic statistical analysis of the H α velocity field for a diverse sample of nine ${\rm H\, \small{II}}$ regions, spanning two orders of magnitude in size and luminosity, located in the Milky Way and other Local Group galaxies. By fitting a simple model to the second-order spatial structure function of velocity fluctuations, we extract three fundamental parameters: the velocity dispersion, the correlation length, and the power-law slope. We determine credibility limits for these parameters in each region, accounting for observational limitations of noise, atmospheric seeing, and the finite map size. The plane-of-sky velocity dispersion is found to be a better diagnostic of turbulent motions than the line width, especially for lower luminosity regions where the turbulence is subsonic. The correlation length of velocity fluctuations is found to be always roughly 2 per cent of the ${\rm H\, \small{II}}$ region diameter, implying that turbulence is driven on relatively small scales. No evidence is found for any steepening of the structure function in the transition from subsonic to supersonic turbulence, possibly due to the countervailing effect of projection smoothing. Ionized density fluctuations are too large to be explained by the action of the turbulence in any but the highest luminosity sources. A variety of behaviours are seen on scales larger than the correlation length, with only a minority of sources showing evidence for homogeneity on the largest scales.