bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paediatric kidney transplantation: Towards a framework for pretransplant urological evaluation
Authors: Evans‐Barns Hannah , Mushtaq Imran , Michell Ian , Kausman Joshua , Webb Nathalie , Taghavi Kiarash 
Published: May 2022

AbstractThe role of the urologist in paediatric kidney transplantation has evolved alongside advances in management for the various causes of end‐stage kidney disease. Improvements in antenatal intervention and postnatal care have seen children with increasingly complex urological anomalies survive until transplant. Once solely responsible for the oversight of a child's surgical care, the paediatric urologist now works within a multidisciplinary transplant team, alongside transplant surgeons, paediatric nephrologists, transplant coordinators, psychologists, social workers, and transitional care specialists. We sought to identify available pretransplant evaluation frameworks to guide urological preparation and decision‐making. Drawing from available evidence and reflecting on multi‐institutional experience, we propose a streamlined approach to urologic assessment, which recognises that optimal transplant outcomes in this heterogenous cohort require lower urinary tract dysfunction to be carefully defined preoperatively.
Waitlist and posttransplant outcomes of critically ill infants awaiting heart transplantation managed without ventricular assist device support
Authors: Frandsen Erik L. , Banker Katherine A. , Mazor Robert L. , McMullan D. Michael , Law Yuk M. , Kemna Mariska S. , Albers Erin L. , Hong Borah J. , Friedland‐Little Joshua M. 
Published: May 2022

AbstractBackgroundInfants listed for heart transplant are at high risk for waitlist mortality. While waitlist mortality for children has decreased in the current era of increased ventricular assist device use, outcomes for small infants supported by ventricular assist device remain suboptimal. We evaluated morbidity and survival in critically ill infants listed for heart transplant and managed without ventricular assist device support.MethodsCritically ill infants (requiring ≥1 inotrope and mechanical ventilation or ≥2 inotropes without mechanical ventilation) listed between 2008 and 2019 were included. During the study period, infants were managed primarily medically. Mechanical circulatory support, specifically extracorporeal membrane oxygenation, was utilized as “rescue therapy” for decompensating patients.ResultsThirty‐two infants were listed 1A, 66% with congenital heart disease. Median age and weight at listing were 2.2 months and 4.4 kg, with 69% weighing <5 kg. At listing, 97% were mechanically ventilated, 41% on ≥2 inotropes, and 25% under neuromuscular blockade. Five patients were supported by ECMO after listing. A favorable outcome (transplant or recovery) was observed in 84%. One‐year posttransplant survival was 92%. Infection was the most common waitlist complication occurring in 75%. Stroke was rare, occurring in one patient who was supported on ECMO. Renal function improved from listing to transplant, death, or recovery (eGFR 70 vs 87 ml/min/1.73m2, p = .001).ConclusionA strategy incorporating a high threshold for mechanical circulatory support and acceptance of prolonged mechanical ventilation and neuromuscular blockade can achieve good survival and morbidity outcomes for critically ill infants listed for heart transplant.
Fertile ground, complex matter: Plurality of farmers’ attitudes towards green waste application as sustainable soil management
Authors: Happel Maaike , Orsi Francesco , Hartmann Thomas , Bakker Martha 
Published: May 2022

AbstractThe adoption of sustainable soil management practices such as the use of green waste from road‐side management and nature reserves is thwarted in practice by hesitance on the side of farmers. To foster the use of these practices, it is crucial to understand farmers’ decision perspectives and attitudes towards them. Using Q‐methodology, the perspectives of 12 dairy and arable farmers in The Netherlands were analysed. It was studied which barriers farmers perceive for green waste application (GWA), and whether perceptions of barriers are related to particular rationalities on the position of farmers within society. In Q‐sorts and semistructured interviews, farmers ranked their degree of agreement on 41 statements about GWA, nutrient policy information, general beliefs on soil and farm management and circular agriculture, inspired by a cultural theory framework. Six decision perspectives were identified, globally agreeing on the benefits of GWA but challenged by rapidly changing regulations regarding nutrient management. Plurality in decision perspectives captured the need for trusted information, alongside differing views on responsibility and views on sustainable agriculture. Combining Q‐methodology with cultural theory confirmed the need to include various notions of trust, power and responsibility in understanding complex decision‐making perspectives within more sustainable soil management practices.
Meta‐synthesis of family communication patterns during post‐stroke vascular aphasia: Evidence to guide practice
Authors: Ramazanu Sheena , Chisale Master R. O. , Baby Priya , Wu Vivien Xi , Mbakaya Balwani C. 
Published: May 2022

AbstractBackgroundPrevious studies have predominantly focused on the needs of persons with aphasia (PWA), after a stroke diagnosis. However, aphasia is found to cause communication challenges in persons with stroke and their family caregivers as a unit. Evidence is inconclusive about the communication patterns of both persons with aphasia and their family caregivers after a stroke. Studies have not been synthesized on facilitators and barriers of communication patterns between PWA and family caregivers after a stroke.AimsA meta‐synthesis of qualitative evidence was conducted to explore family communication patterns after post‐stroke vascular aphasia.MethodsAn electronic literature search of PubMed, CINAHL, Cochrane Library, PsyINFO, and Scopus was performed from January to March 2021. The methods of qualitative meta‐synthesis were underpinned by Sandelowski and Barosso's guidelines. Data analysis was facilitated by Braun and Clarke thematic analysis, using NVivo 11 software.ResultsA total of twenty studies were included for meta‐synthesis. Three themes with corresponding subthemes were identified: (1) changes in family communication patterns (subthemes: adapting to the changes in PWA after a stroke, striving toward communication recovery); (2) facilitators of family communication patterns (subthemes: supportive communication techniques, hope of recovery, time to re‐adjust, and community engagement [recreational activities]); and (3) barriers of communication (subthemes: emotional turmoil and daunting tasks of rehabilitation).Linking Evidence to ActionAlthough persons with aphasia and family caregivers are striving to achieve normalcy in communication, they are often challenged by communication deficits and protective family behaviors. Therefore, to establish effective communication, it is of paramount importance for nursing professionals to educate PWAs and their caregivers on facilitators and barriers of family communication patterns. Technology‐based family communication facilitation and support groups for PWA and their family caregivers are recommended to promote family communication. The review was registered with PROSPERO (CRD42021235519).
Fin de vida en pacientes con cáncer no curable. Percepciones de los pacientes sobre el sistema de salud
Authors: De Vries Esther , Medina-Rico Mauricio , Osorio Clavijo Katalina , Rodríguez Nicole Alejandra , Vicuña Jiménez Víctor Manuel , Leal Fabián , Calvache José Andrés , Moreno Socorro 
Published: May 2022

Objetivo: Identificar y analizar experiencias y opiniones que pacientes oncológicos sin opción curativa tienen respecto al sistema de salud en torno a sus cuidados paliativos y deseos de final de vida. Métodos: Estudio cualitativo con perspectiva crítico-constructivista. Se realizaron 22 entrevistas en profundidad a pacientes entre 28 y 78 años con algunos de los cánceres más frecuentes (mama, cuello uterino, colon, estómago, entre otros, con una expectativa de vida entre seis y doce meses) atendidos en el Hospital Universitario San José de Popayán, el Hospital Universitario San Ignacio y el Instituto Nacional de Cancerología en Bogotá. Resultados: Se identificaron dos categorías de experiencias y deseos de los pacientes: una acerca de la atención e información que desean recibir por parte del personal de salud y otra relacionada con el sistema de salud, que incluye problemas administrativos con las EPS, la importancia de brindar continuidad en la atención médica, la oportunidad en la entrega de medicamentos y la asignación de citas, y la infraestructura hospitalaria direccionada hacia la Institución donde desean ser atendidos. Conclusiones: Los resultados de este estudio contribuyen al entendimiento de las experiencias que los pacientes con cáncer no curable han tenido con el sistema de salud. Es necesario educar al personal de salud sobre la necesidad de indagar y discutir los deseos de sus pacientes para ofrecer ayuda pertinente que optimice su calidad de vida. Se debe mejorar la infraestructura de los centros de cuidados paliativos y urgencias, el agendamiento de citas y la entrega oportuna de medicamentos.
Rotor Stability Effects of Tilting Pad Journal Bearings With Assembled Clearance Asymmetry
Authors: Urbiola-Soto Leonardo , Pennacchi Paolo 
Published: May 2022

Abstract
This paper presents component and system-level analyses to understand the stiffness, damping, and rotor stability effects of tilting pad journal bearings (TPJB) with assembled clearance variation across pads. This variation results from a normal manufacturing process of the bearing components, i.e., shaft, bearing shell, pad radius, and pad thickness, whose machining tolerances add in a closed-loop producing a different assembled clearance per pad. The results are compared to the standard analysis practice of uniformly setting all pads assembled clearance to its maximum and minimum stack-up values to find the worst case for stability. The component-level analysis follows a rigid rotor approach. While in the system-level analysis, a full rotor-bearings-seals model of a lightweight, high-speed centrifugal compressor is employed. A four-pad TPJB with a load between pads (LBP) configuration is considered. Large differences in stiffness and log dec are encountered, while almost negligible differences are found in damping. Also, some interesting observations related to rotor-bearing planar mode shapes are reported when the bearing pads have dissimilar assembled clearances. These modes disappear once the labyrinth seal force coefficients are incorporated into the full model.
Stability of Allowable Flaw Angles for High Toughness Ductile Pipes Subjected to Bending Stress in the ASME Code Section XI
Authors: Hasegawa Kunio , Strnadel Bohumír , Li Yinsheng , Lacroix Valéry 
Published: May 2022

Abstract
Allowable stresses for pipes with circumferential flaws are provided by the ASME Code Section XI. The stresses for the high toughness pipes are determined by fully plastic collapse stresses and safety factors. The plastic collapse stresses are estimated by limit load criteria, which are also provided by the ASME Code Section XI. When applied stresses of the pipes at the flaw locations are less than the allowable stresses, the flaws are acceptable for the end-of-evaluation period. The allowable stresses are categorized for various service-level conditions of the plant operation. When pipe walls are thin, part-through flaws can easily develop into through-wall flaws, and the likelihood of coolant leakage is high. The ASME Code Section XI provides final allowable flaw angles of through-wall flaws that are a limit on the length of part-through wall flaws for thin-walled pipes. The final allowable angles are currently applied to pipes in order to maintain structural tolerance if the part-through flaws become through-wall flaws. To ensure that this stability is not compromised, plastic collapse stresses for through-wall flaws are combined with the allowable stresses. However, the final allowable angles of through-wall flaws are not identified for thin-walled pipes. This paper compares plastic collapse stresses of through-wall flaws and allowable stresses of part-through flaws for pipes. The comparison of these stresses is used to derive the final allowable angles of through-wall flaws. The angles can be expressed either in the form of exact solutions or as conventional options that are appropriate for various service-level conditions.
Non-Conservatism of ASME BPVC Section III Division 5 Isochronous Stress–Strain Curves for 316H Stainless Steel at Low Stresses
Authors: Petkov Markian , Young George A. , Juan Pierre-Alexandre 
Published: May 2022

Abstract
Future Gen IV high-temperature reactors are expected to operate above 450 °C where creep effects are significant in safety-related structures, e.g., reactor vessels. The ASME Boiler and Pressure Vessel Code (BPVC) Section III Division 5 provides the rules and methodologies for design of such high-temperature components. Of high relevance to the designer are the isochronous stress–strain curves (ISSCs) part of the rules for deformation limits in the code. The ISSCs are an important method to estimate accumulated inelastic strains at a given stress and duration at elevated temperatures. In this study, the ISSCs for 316H stainless steel in the current edition of the ASME BPVC Section III Division 5 have been reevaluated between 593 °C and 750 °C by adopting a physics-informed minimum creep rate model to reconstruct them. It is demonstrated that the current ASME Section III Division 5 minimum creep rate model underpredicts creep rates compared to experimental data at low stresses (e.g., 650 °C, &lt;40 MPa). By employing a physics-informed minimum creep rate model which captures both diffusive- and dislocation glide/climb-controlled creep regimes, this deficiency is addressed. The ASME ISSCs for 316H stainless steel are then reconstructed by adopting this modified minimum creep rate model. It was found that the ASME ISSCs could underestimate total accumulated strains at ∼σ/σy &lt;0.65 for durations t &gt;1000 h by &gt;10 times which could give rise to non-conservatism in inelastic strain. Experimental data at various temperatures confirm the findings. Potential approaches to address this non-conservatism in inelastic strain and the implications to design are discussed.
Runoff of Russian Rivers under Current and Projected Climate Change: a Review 2. Climate Change Impact on the Water Regime of Russian Rivers in the XXI Century
Authors: Gelfan A. N. , Gusev E. M. , Kalugin A. S. , Krylenko I. N. , Motovilov Yu. G. , Nasonova O. N. , Millionshchikova T. D. , Frolova N. L. 
Published: May 2022

Abstract
The present overview is the second part of the article “Runoff of Russian Rivers Under Current and Projected Climate Change: A Review,” which focuses on modern assessment of possible changes in the runoff characteristics of Russian rivers in the XXI century under projected global climate change. The article considers two assessment groups: based on (1) climate models and (2) hydrological models, using data of climate model simulations. The review mainly presents works that have been published over the last 7−8 years, since the release of the previous IPCC Assessment Report and the National Assessment Report of Roshydromet. It is noted that, in recent years, there has been a shift regarding the methodology of assessment of hydrological consequences of projected climate change—from simulations based on climate models to simulations based on regional hydrological models that allow one to simulate characteristics of the water regime of rivers over a historical period more accurately and to assess their possible changes in the future with lower uncertainty than climate models.
Visualising harms in publications of randomised controlled trials: consensus and recommendations
Authors: Phillips Rachel , Cro Suzie , Wheeler Graham , Bond Simon , Morris Tim P , Creanor Siobhan , Hewitt Catherine , Love Sharon , Lopes Andre , Schlackow Iryna , Gamble Carrol , MacLennan Graeme , Habron Chris , Gordon Anthony C , Vergis Nikhil , Li Tianjing , Qureshi Riaz , Everett Colin C , Holmes Jane , Kirkham Amanda , Peckitt Clare , Pirrie Sarah , Ahmed Norin , Collett Laura , Cornelius Victoria 
Published: May 2022

AbstractObjectiveTo improve communication of harm in publications of randomised controlled trials via the development of recommendations for visually presenting harm outcomes.DesignConsensus study.Setting15 clinical trials units registered with the UK Clinical Research Collaboration, an academic population health department, Roche Products, andTheBMJ.ParticipantsExperts in clinical trials: 20 academic statisticians, one industry statistician, one academic health economist, one data graphics designer, and two clinicians.Main outcomemeasuresA methodological review of statistical methods identified visualisations along with those recommended by consensus group members. Consensus on visual recommendations was achieved (at least 60% of the available votes) over a series of three meetings with participants. The participants reviewed and critically appraised candidate visualisations against an agreed framework and voted on whether to endorse each visualisation. Scores marginally below this threshold (50-60%) were revisited for further discussions and votes retaken until consensus was reached.Results28 visualisations were considered, of which 10 are recommended for researchers to consider in publications of main research findings. The choice of visualisations to present will depend on outcome type (eg, binary, count, time-to-event, or continuous), and the scenario (eg, summarising multiple emerging events or one event of interest). A decision tree is presented to assist trialists in deciding which visualisations to use. Examples are provided of each endorsed visualisation, along with an example interpretation, potential limitations, and signposting to code for implementation across a range of standard statistical software. Clinician feedback was incorporated into the explanatory information provided in the recommendations to aid understanding and interpretation.ConclusionsVisualisations provide a powerful tool to communicate harms in clinical trials, offering an alternative perspective to the traditional frequency tables. Increasing the use of visualisations for harm outcomes in clinical trial manuscripts and reports will provide clearer presentation of information and enable more informative interpretations. The limitations of each visualisation are discussed and examples of where their use would be inappropriate are given. Although the decision tree aids the choice of visualisation, the statistician and clinical trial team must ultimately decide the most appropriate visualisations for their data and objectives. Trialists should continue to examine crude numbers alongside visualisations to fully understand harm profiles.
One in two people admitted to hospital with covid-19 develop complications and may need support
Authors: Saul Helen , Gursul Deniz , Cassidy Samantha , Harrison Ewen 
Published: May 2022

The studyDrake TM, Riad AM, Fairfield CJ, et al. Characterisation of in-hospital complications associated with covid-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study. Lancet 2021;398:10296.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/one-in-two-people-hospitalised-with-covid-19-develop-complications-may-need-support/
Estimating the threshold of health workforce densities towards universal health coverage in Africa
Authors: Ahmat Adam , Asamani James Avoka , Abdou Illou Mourtala Mahaman , Millogo Jean Jacques Salvador , Okoroafor Sunny C , Nabyonga-Orem Juliet , Karamagi Humphrey Cyprian , Nyoni Jennifer 
Published: May 2022

BackgroundThere have been past efforts to develop benchmarks for health workforce (HWF) needs across countries which have been helpful for advocacy and planning. Still, they have neither been country-specific nor disaggregated by cadre—primarily due to data inadequacies. This paper presents an analysis to estimate a threshold of 13 cadres of HWF density to support the progressive realisation of universal health coverage (UHC).MethodUsing UHC service coverage as the outcome measure, a two-level structural equation model was specified and analysed in STATA V.16. In the first level of structural equations, health expenditure per capita—one of the cross-cutting inputs for UHC, was used to explain the critical inputs for service delivery/coverage. In the second level of the model, the critical inputs for service delivery were used to explain the UHC Service Coverage Index (UHC SCI), in which the contribution of the HWF was ‘partial out’.ResultsThe analysis found that a unit increase in the HWF density per 10 000 population is positively associated with statistically significant improvements in the UHC SCI of countries (β=0.127, p<0.001). Similarly, a positive and statistically significant association was established between diagnostic readiness and the UHC SCI (β=0.243, p=0.015). Essential medicines readiness was positively correlated but not statistically significant (β=0.053, p=0.658). Controlling for other variables, a density of 134.23 per 10 000 population across 13 HWF categories is necessary to attain at least 70% UHC SCI.ConclusionConsistent with current knowledge, the HWF is a significant predictor of the UHC SCI. Attaining at least 70% of the UHC SCI requires about 134.23 health workers (a mix of 13 cadres) per 10 000 population.
Skill decay in surgeons deployed on military operations: a systematic review
Authors: Stansfield Tim , Tai N 
Published: May 2022

IntroductionDecay of surgical skills due to paucity of opportunity to operate is a potential threat to patients being cared for by the Defence Medical Services while on operational deployment. Our aim was to review the literature regarding skill decay in the trained surgeon in order to understand how it may affect clinical performance and patient outcomes. We also wished to survey the likely causes of such decay and possible means of mitigation.MethodsA systematic review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Study bias assessment was also undertaken. Content summaries for the papers included study design and methodology, participant level of experience, measures and magnitude of effect, duration of no practice, and study limitations.ResultsFive papers met the selection criteria. There were insufficient quantitative data on the impact of surgical skill decay on patient outcome, surgeon performance or mitigation strategies, and a meaningful quantitative synthesis could not be undertaken.ConclusionsThis systematic review of the literature found very little specific evidence confirming or refuting surgical skill decay in trained surgeons, with measurement of decay hampered by the lack of an accepted methodology. Studying this in the deployed setting may offer a firmer evidence base from which to generate policy. Potential mitigation strategies are discussed.PROSPERO registration numberID260846.