bluuebunny/crossref_metadata_2025 huggingface dataset:
The storage container for demonstrate BWR spent nuclear fuel dry storage in Taiwan
Authors: Lin Y J , Chen C H , Yang C W , Chen C H
Published: September 2021

Considering the unique operation of each nuclear power plant and lack of BWR fuel examination data after dry storage, the Taiwan Power Company and Institute of Nuclear Energy Research conduct the “The Nuclear Fuel Storage Demonstration Project in Taiwan” to collect the data of the fuel characteristics under dry storage. In this project, BWR fuel rods among different fuel designs and fuel venders will be loaded into a simulated storage cask for 10 years. Different temperatures and environments will be adopted, for simulated normal storage condition and acceleration experiments be performed. Non-destructed examinations will be executed prior to loading the fuel rods and periodically during storage. After 10 years, the fuel rods will be extracted and examined non-destructively and destructively. This paper summarized the methodology to demonstrate the adequacy of spent fuel dry storage, the design and fabrication of the simulated storage containers, the results of performance test and the project progress. Two containers will be used in the prospective experiments; one is for the normal storage condition. The other is for accelerated experiments and various storage conditions. After completion of this project, the collected data and research results will be compared with other international projects to provide the technical basis in Taiwan.
Study on the surface structure effect of anode flow channel in proton exchange membrane fuel cell
Authors: Liu C C
Published: September 2021

The paper mainly discusses the transport behavior of hydrogen gas in the anode flow channel of the Proton Exchange Membrane Fuel Cell. The flow pattern of hydrogen gas at the anode is affected by the surface structure of flow channel. In order to accurately simulate the transport characteristics of the hydrogen gas in the anode flow channel, a structured 3-D multi-block, staggered grid system is used for spatial discretization in numerical methods, and the finite volume method is used to sequentially iteratively solve the continuous and momentum conservation equations. The coupling between velocity and pressure in the flow field is calculated by the PISO algorithm. Two shapes design of three-dimensional smooth straight flow channel and three-dimensional bump straight flow channel are adopted in this paper. The hydrogen gas with Reynolds number 200 enters the smooth straight flow channel. The flow field inside the flow channel has been developed about 0.3 ms. At the same inlet Reynolds number and straight flow channels of three kind of bump height ratio (h/H=0.25, h/H=0.5, h/H=0.75), these calculation results are discovered that the height ratio of the bump increases and the backflow effect becomes more obvious. The current density of the Proton Exchange Membrane Fuel Cell is further analyzed by the flow field variation in the bump flow channel.
Face recognition unlocking uses principal component analysis to control the vehicle door system
Authors: Lin S L , Wu J Y
Published: September 2021

In daily life, there are often simple but fatal mistakes. Such as when go driving to someplace, after closing the vehicle door with a traditional vehicle key which is so easily damaged, missed, or lost, then becomes a significant issue. To overcome this problem, a modern system in opening vehicle door locks with a face recognition system using a smartphone was introduced. This face recognition software use combined with a D1 mini control system to open the control lock in the smartphone. The research method is principal component analysis (PCA), which is mainly divided into two steps, training, and recognition, respectively. In the research of face recognition, also used PCA to find important parameters, and use the eigenvalues and feature vectors of the oblique variance matrix of face features as value, and use this as a basis for recognition, then face recognition be successful. This research establishes a software and hardware vehicle door verification system. Using the phone to unlock the door, this research uses the vehicle door to display, when face recognition successful, the door lock will be unlocked then the user can open the door. Using the face recognition system to open the door has higher security, and without bringing the key to go out, it is making life more convenient.
Surface roughness analysis of high speed milling in grooving
Authors: Chen D C , Chen T W
Published: September 2021

High-speed milling is a machining method with a low cutting depth, high feed rate, high cutting speed and high spindle speed. It also has the advantages of small thermal deformation, low cutting force resistance, and low tool wear. In this experiment, the cutting of S45C medium carbon steel was tested. This study used four factors in Taguchi’s experimental design regulations, and each factor used three level configurations. An L9 (34) orthogonal table was used to configure the factors and levels. In this study, experiments were conducted on CNC machine tools to explore the difference in the surface roughness of a work piece after cutting with different cutting parameters. It was found that high-speed cutting could indeed obtain quite excellent surfaces. After the experiment, the Taguchi method was analyzed and the results were obtained under different cutting parameters. The experiment is to use milling parameters as variables to analyze the surface roughness, and then the results were analyzed to derive the relationship between the milling parameters and surface roughness. When the feed per edge of the end mill was larger and the number of spindle revolutions was slower, the surface roughness value was larger. The process parameter combination with the best surface quality was 0.1 mm/tooth per edge and a cutting speed of 550 m/min. The best surface roughness of the work piece could be obtained under the combination of a cutting depth of 0.2 mm and a spindle speed 6500 rpm.
Projective representation of the Galilei group for classical and quantum–classical systems*
Authors: Bermúdez Manjarres A D
Published: September 2021

A physically relevant unitary irreducible non-projective representation of the Galilei group is possible in the Koopman–von Neumann formulation of classical mechanics. This classical representation is characterized by the vanishing of the central charge of the Galilei algebra. This is in contrast to the quantum case where the mass plays the role of the central charge. Here we show, by direct construction, that classical mechanics also allows for a projective representation of the Galilei group where the mass is the central charge of the algebra. We extend the result to certain kind of quantum–classical hybrid systems.
Analyzing the mechanical properties of aluminium (SiC, B4C) hybrid Composite
Authors: Kannan V. Senthil , Pugalenthi P. , Lenin K. , Sandhiya D. , Hariharan A. Sam raj , Sakthipriyan S. , Ranjith Mohan R.
Published: September 2021

Aluminium MMCs is play the major role in the industrial sectors. The aluminium MMCs are providing superior properties which cannot achieved by existing monolithic material. Now a days the more research is involves to the development of aluminium MMCs. Here we are choosing Al 7475 is a base metal and reinforced with SiC, B4C by stir casting method. The different combinations of composition in volume fraction were chosen like 85%Al 7.5%SiC 7.5%B4C, 85%Al 5%SiC 10%B4C, 85%Al 10%SiC 5%B4C. The stir casted composite is machined carefully to prepare specimens of micro hardness. The mechanical properties are including the micro hardness. The stir casted composite is machined carefully to prepare specimens of micro hardness (Vickers test), tensile test, impact test (Charpy test) and micro structure as per the ASTM standards. The composition of 85%Al 7.5%SiC 7.5%B4C, was given more hardness, tensile strength and impact strength has 126.33VHN, 196.79N/mm2 and 2 Joule. As increased the percentage of SiC is increase the mechanical properties of the Al MMC.
Metal-insulator transition in Cr-doped hollandite vanadate K2V8O16
Authors: Biswas S , Raychaudhury M De
Published: September 2021

The hollandite K2V8O16 is a metal with ferromagnetic spin fluctuations in the high temperature (tetragonal I4/m) phase and encounters metal-insulator transition (MIT) at 170 K. The mechanism behind the MIT is still controversial due to inadequate information on the electronic structure. Furthermore, substitution of Rb for K or Ti for V increases the transition temperature. We have investigated whether break in the mirror symmetry is responsible for the insulating ground state of K2V8O16 and since the Cr counterpart is a robust ferromagnet, whether Cr doping which leads to break in mirror symmetry can help in driving a gap. We find that both 25% and 75% Cr doping break the mirror symmetry but only the former leads to an insulating ground state. Ferromagnetism (FM) remains intact in the insulating phase of K2V6Cr2O16. The structural, electronic and magnetic properties of pure and doped K2V8O16 were investigated within first-principles calculations using density functional theory (DFT). Electron correlation suppresses orbital fluctuations between the partially occupied Cr and V-3dt2g states. Consequently, transfer of charge (electron) from V-3d to Cr-3dt2g states is observed which facilitates Cr3+-V4+ charge ordering. Furthermore, Peierls like structural distortion is associated to the breaking of mirror symmetry in the Cr-V rectangular four chain columns within the crystal. Therefore, the simultaneous effect of Peierls instability, charge ordering and Coulomb correlation is responsible for the MIT in K2V6Cr2O16. Besides, Cr-3d O-2p hybridization and Cr-O coupling increases with Cr doping. These two effects are cooperatively responsible for the observed FM in insulating K2V6Cr2O16. More interestingly, the strength of FM is augmented with Cr concentration in K2V8O16.
An interpretable machine learning based approach for process to areal surface metrology informatics
Authors: Obajemu Olusayo , Mahfouf Mahdi , Papananias Moschos , McLeay Thomas E , Kadirkamanathan Visakan
Published: September 2021

Surface metrology parameters represent an important class of design variables, which can be controlled because they represent the DNA or fingerprint of the whole manufacturing chain as well as form important predictors of the manufactured component’s function(s). Existing approaches of analysing these parameters are applicable to only a small subset of the parameters and, as such, tend to provide a narrow characterisation of the manufacturing environment.This paper presents a new machine learning approach for modelling the surface metrology parameters of the manufactured components. Such a modelling approach can allow one to understand better and, as a result, control the manufacturing process so that the desired surface property can be achieved whilst manipulating the process conditions. The newly proposed approach utilises a fuzzy logic based-learning algorithm to map the extracted process features to the areal surface metrology parameters. It is fully transparent since it employs IF...THEN statements to describe the relationships between the input space (in-process monitoring variables) and the output space (areal surface metrology parameters). Furthermore, the algorithm includes a ridge penalty based mechanism that allows the learning to be accurate while avoiding over-fitting. This new machine-learning framework was tested on a real-life industrial case-study where it is required to predict the areal parameters of a manufacturing (machining) process from in-process data. Specifically, the case study involves a full factorial experimental design to manufacture seventeen (17) steel bearing housing parts which are fabricated from heat-treated EN24 steel bars. Validation results showed the ability of this new framework not only to predict accurately but also to generalise across different types of areal surface metrology parameters.
Introduction
Authors: Harris James A.
Published: September 2021

‘Introduction’ presents Hume by way of a summary description of his persona as a public intellectual, or man of letters, for whom philosophy was not so much a distinct subject matter as a style of thought. Hume had some very well-known contemporaries in Adam Smith, Jean-Jacques Rousseau, and Benjamin Franklin. over his lifetime, Hume developed many theories on the following: human nature, morality, politics, and religion.
7. School’s out!
Authors: Thomas Gary
Published: September 2021

‘School's out’ reviews criticism of schools. There are first of all those who say that school does not pay. There has been an accumulating body of evidence to show that there is no clear link between economic growth and spending on education. Then there are those who see school as a rights-free zone, quashing the originality and creativity of youth. A reaction to the regimentation of school has been in the home-schooling movement. Finally, there are those who condemn schools as counterproductive, arguing that people learn best outside school. What is the future of education and schooling?
1. What are stem cells?
Authors: Slack Jonathan
Published: September 2021

‘What are stem cells?’ explains that a stem cell is a cell that can both reproduce itself and generate offspring of different functional cell types and begins by considering the nature of cells in general, wherein cells are understood to be the ultimate structural unit of an animal or plant body. Stem cells in the body persist long term, usually for the lifetime of the organism. Good examples of differentiated cells arising from stem cells are those of the skin, the blood, and the lining of the intestine. Embryonic stem cells are grown in culture from early mammalian embryos. The reason that stem cell research is seen as the source for new cures is largely because this technology offers a route to cell therapy.
6. Therapy using tissue-specific stem cells
Authors: Slack Jonathan
Published: September 2021

‘Therapy using tissue-specific stem cells’ begins with haematopoietic stem cell transplantation (HSCT), which is considered the most important type of stem cell therapy. HSCT covers the transplantation of bone marrow and other types of transplant where the blood-forming stem cells of the graft come from non-marrow sources. It is used mostly for the treatment of leukaemias and lymphomas. Some genetic diseases of the blood have also been successfully treated using allogeneic HSCT. There are also other examples of cell therapy using tissue-specific stem cells, such as epidermal cells for the treatment of burns and limbal (corneal) stem cells for treatment of eye injuries.
Tandem Mass Spectrometry–Based Amyloid Typing Using Manual Microdissection and Open-Source Data Processing
Authors: Phipps William S , Smith Kelly D , Yang Han-Yin , Henderson Clark M , Pflaum Hannah , Lerch Melissa L , Fondrie William E , Emrick Michelle A , Wu Christine C , MacCoss Michael J , Noble William S , Hoofnagle Andrew N
Published: September 2021

Objectives

Standard implementations of amyloid typing by liquid chromatography–tandem mass spectrometry use capabilities unavailable to most clinical laboratories. To improve accessibility of this testing, we explored easier approaches to tissue sampling and data processing.

Methods

We validated a typing method using manual sampling in place of laser microdissection, pairing the technique with a semiquantitative measure of sampling adequacy. In addition, we created an open-source data processing workflow (Crux Pipeline) for clinical users.

Results

Cases of amyloidosis spanning the major types were distinguishable with 100% specificity using measurements of individual amyloidogenic proteins or in combination with the ratio of λ and κ constant regions. Crux Pipeline allowed for rapid, batched data processing, integrating the steps of peptide identification, statistical confidence estimation, and label-free protein quantification.

Conclusions

Accurate mass spectrometry–based amyloid typing is possible without laser microdissection. To facilitate entry into solid tissue proteomics, newcomers can leverage manual sampling approaches in combination with Crux Pipeline and related tools.
Artificial intelligence in drug discovery: applications and techniques
Authors: Deng Jianyuan , Yang Zhibo , Ojima Iwao , Samaras Dimitris , Wang Fusheng
Published: September 2021

Artificial intelligence (AI) has been transforming the practice of drug discovery in the past decade. Various AI techniques have been used in many drug discovery applications, such as virtual screening and drug design. In this survey, we first give an overview on drug discovery and discuss related applications, which can be reduced to two major tasks, i.e. molecular property prediction and molecule generation. We then present common data resources, molecule representations and benchmark platforms. As a major part of the survey, AI techniques are dissected into model architectures and learning paradigms. To reflect the technical development of AI in drug discovery over the years, the surveyed works are organized chronologically. We expect that this survey provides a comprehensive review on AI in drug discovery. We also provide a GitHub repository with a collection of papers (and codes, if applicable) as a learning resource, which is regularly updated.
Tiara: deep learning-based classification system for eukaryotic sequences
Authors: Karlicki Michał , Antonowicz Stanisław , Karnkowska Anna
Published: September 2021

Motivation

With a large number of metagenomic datasets becoming available, eukaryotic metagenomics emerged as a new challenge. The proper classification of eukaryotic nuclear and organellar genomes is an essential step toward a better understanding of eukaryotic diversity.

Results

We developed Tiara, a deep-learning-based approach for the identification of eukaryotic sequences in the metagenomic datasets. Its two-step classification process enables the classification of nuclear and organellar eukaryotic fractions and subsequently divides organellar sequences into plastidial and mitochondrial. Using the test dataset, we have shown that Tiara performed similarly to EukRep for prokaryotes classification and outperformed it for eukaryotes classification with lower calculation time. In the tests on the real data, Tiara performed better than EukRep in analyzing the small dataset representing eukaryotic cell microbiome and large dataset from the pelagic zone of oceans. Tiara is also the only available tool correctly classifying organellar sequences, which was confirmed by the recovery of nearly complete plastid and mitochondrial genomes from the test data and real metagenomic data.

Availability and implementation

Tiara is implemented in python 3.8, available at https://github.com/ibe-uw/tiara and tested on Unix-based systems. It is released under an open-source MIT license and documentation is available at https://ibe-uw.github.io/tiara. Version 1.0.1 of Tiara has been used for all benchmarks.

Supplementary information

Supplementary data are available at Bioinformatics online.
Composite Score: prognostic tool to predict survival in patients undergoing surgery for colorectal liver metastases
Authors: Frühling Petter , Urdzik Jozef , Strömberg Cecilia , Isaksson Bengt
Published: September 2021

Background

Several existing scoring systems predict survival of patients with colorectal liver metastases. Many lack validation, rely on old clinical data, and have been found to be less accurate since the introduction of chemotherapy. This study aimed to construct and validate a clinically relevant preoperative prognostic model for patients with colorectal liver metastases.

Methods

A predictive model with data available before surgery was developed. Survival was analysed by Cox regression analysis, and the quality of the model was assessed using discrimination and calibration. The model was validated using multifold cross-validation.

Results

The model included 1212 consecutive patients who underwent liver resection for colorectal liver metastases between 2005 and 2015. Prognostic factors for survival included advanced age, raised C-reactive protein level, hypoalbuminaemia, extended liver resection, larger number of metastases, and midgut origin of the primary tumour. A Composite Score was developed based on the prognostic variables. Patients were classified into those at low, medium, and high risk. Survival differences between the groups were significant; median overall survival was 87.4 months in the low-risk group, 50.1 months in the medium-risk group, and 22.6 months in the high-risk group. The discriminative performance, assessed by the concordance index, was 0.71, 0.67, and 0.67 respectively at 1, 3, and 5 years. Calibration, assessed graphically, was close to perfect. A multifold cross-validation of the model confirmed its internal validity (C-index 0.63 versus 0.62).

Conclusion

The Composite Score categorizes patients into risk strata, and may help identify patients who have a poor prognosis, for whom surgery is questionable.
Standard versus distal Roux-en-Y gastric bypass in patients with BMI 50–60 kg/m2: 5-year outcomes of a double-blind, randomized clinical trial
Authors: Salte Odd Bjørn Kjeldaas , Svanevik Marius , Risstad Hilde , Hofsø Dag , Blom-Høgestøl Ingvild Kristine , Johnson Line Kristin , Fagerland Morten Wang , Kristinsson Jon , Hjelmesæth Jøran , Mala Tom , Sandbu Rune
Published: September 2021

Background

The optimal surgical weight loss procedure for patients with a BMI of 50 kg/m2 or more is uncertain. This study compared distal Roux-en-Y gastric bypass (RYGB) with standard RYGB.

Methods

In this double-blind RCT, patients aged 18–60 years with a BMI of 50–60 kg/m2 were allocated randomly to receive standard (150 cm alimentary, 50 cm biliopancreatic limb) or distal (150 cm common channel, 50 cm biliopancreatic limb) RYGB. The primary outcome (change in BMI at 2 years) has been reported previously. Secondary outcomes 5 years after surgery, such as weight loss, health-related quality of life, and nutritional outcomes are reported.

Results

Between May 2011 and April 2013, 123 patients were randomized, 113 received an intervention, and 92 attended 5-year follow-up. Mean age was 40 (95 per cent c.i. 38 to 41) years and 73 patients (65 per cent) were women; 57 underwent standard RYGB and 56 distal RYGB. BMI was reduced by 15.1 (95 per cent c.i. 13.9 to 16.2) kg/m2 after standard and 15.7 (14.5 to 16.9) kg/m2 after distal RYGB; the between-group difference was −0.64 (−2.3 to 1.0) kg/m2 (P = 0.447). Total cholesterol, low-density lipoprotein cholesterol, and haemoglobin A1c levels declined more after distal than after standard RYGB. High-density lipoprotein cholesterol levels increased more after standard RYGB. Vitamin A and vitamin D levels were lower after distal RYGB. Changes in bone mineral density, resting metabolic rate, and total energy intake were comparable.

Conclusion

Distal RYGB did not enable greater weight loss than standard RYGB. Differences in other outcomes favouring distal RYGB may not justify routine use of this procedure in patients with a BMI of 50–60 kg/m2. Registration number: NCT00821197 (http://www.clinicaltrials.gov).

Presented in part as abstract to the IFSO (International Federation for the Surgery of Obesity and Metabolic disorders) conference, Madrid, Spain, August 2019.
The Social Services of Spain after the neoliberal period: Longitudinal analysis from the perspective of Social Work (2012–2018)
Authors: Verde-Diego Carmen , Pastor-Seller Enrique , González-Rodríguez Rubén , Peláez Quero Encarna
Published: September 2021

The article presents a longitudinal analysis of the Social Services in Spain during the period characterised by neoliberal policies (2012–2018), as well as the situation and reactions of the professional social workers. The quantitative results of three surveys promoted by the General Council of Social Work from Spain on data from 2012, 2013 and 2018 were compared. The sample allows extrapolating the results to all the social workers in Spain. There is a loss of effectiveness and a worsening of the quality of care of the social services. However, social workers do not attribute the deterioration of the system to the increased demand, but to the cuts, privatisation and outsourcing of resources. The professional discourse is critical: it departs from the narrative of punitive neoliberalism and denounces the violation of citizens’ rights. Professional practice reveals the ethical–political commitment in the system and the public militancy of social workers in Spain.
Burn injury prevention in low- and middle- income countries: scoping systematic review
Authors: Price Kate , Lee Kwang Chear , Woolley Katherine E , Falk Henry , Peck Michael , Lilford Richard , Moiemen Naiem
Published: September 2021

Background

Burn injuries are a leading cause of morbidity and disability, with the burden of disease being disproportionately higher in low- and middle-income countries (LMIC). Burn prevention programmes have led to significant reductions in the incidence of burns in high-income countries. However, a previous systematic review published in 2015 highlighted that implementation and evaluation of similar programmes has been limited in LMIC. The objective of this scoping review and narrative synthesis was to summarise and understand the initiatives that have been carried out to reduce burn injuries in LMIC and their effectiveness.

Methods

We aimed to identify publications that described studies of effectiveness of burn prevention interventions applied to any population within a LMIC and measured burn incidence or burns-related outcomes. Suitable publications were identified from three sources. Firstly, data was extracted from manuscripts identified in the systematic review published by Rybarczyk et al. We then performed a search for manuscripts on burn prevention interventions published between January 2015 and September 2020. Finally, we extracted data from two systematic reviews where burn evidence was not the primary outcome, which were identified by senior authors. A quality assessment and narrative synthesis of included manuscripts were performed.

Results

In total, 24 manuscripts were identified and categorized according to intervention type. The majority of manuscripts (n = 16) described education-based interventions. Four manuscripts focused on environmental modification interventions and four adopted a mixed-methods approach. All of the education-based initiatives demonstrated improvements in knowledge relating to burn safety or first aid, however few measured the impact of their intervention on burn incidence. Four manuscripts described population-based educational interventions and noted reductions in burn incidence. Only one of the four manuscripts describing environmental modification interventions reported burns as a primary outcome measure, noting a reduction in burn incidence. All mixed-method interventions demonstrated some positive improvements in either burn incidence or burns-related safety practices.

Conclusion

There is a lack of published literature describing large-scale burn prevention programmes in LMIC that can demonstrate sustained reductions in burn incidence. Population-level, collaborative projects are necessary to drive forward burn prevention through specific environmental or legislative changes and supplementary educational programmes.
Emotional and Behavioral Outcomes in Childhood for Survivors of Invasive Group B Streptococcus Disease in Infancy: Findings From 5 Low- and Middle-Income Countries
Authors: Chandna Jaya , Liu Wan-Hsin , Dangor Ziyaad , Leahy Shannon , Sridhar Santhanam , John Hima B , Mucasse Humberto , Bassat Quique , Bardaji Azucena , Abubakar Amina , Nasambu Carophine , Newton Charles R , Sánchez Yanotti Clara , Libster Romina , Milner Kate , Paul Proma , Lawn Joy E ,   GBS Low and Middle income Collaborative Group for Long-term Outcomes group, Madhi Shabir A , D Z , L S , Harden Lois , Ghoor Azra , Mbatha Sibongile , Lowick Sarah , Jaye Tamara , Lala Sanjay G , Sithole Pamela , Msayi Jacqueline , Kumalo Ntombifuthi , Msibi Tshepiso Nompumelelo , S S , J H B , Arumugam Asha , Murugesan Nandhini , Rajendraprasad Nandhini , Priya Mohana , A A , N C , Adan Adam Mabrouk , Katana Patrick Vidzo , Mwangome Eva , N C R , B Q , Bardají Azucena , Bramugy Justina , M H , Massora Sergio , L R , Y C S , Medina Valeria , Rojas Andrea , Amado Daniel , Llapur Conrado J , M A K
Published: September 2021

Background

Survivors of invasive group B Streptococcus (iGBS) disease, notably meningitis, are at increased risk of neurodevelopmental impairment. However, the limited studies to date have a median follow-up to 18 months and have mainly focused on moderate or severe neurodevelopmental impairment, with no previous studies on emotional-behavioral problems among iGBS survivors.

Methods

In this multicountry, matched cohort study, we included children aged 18 months to 17 years with infant iGBS sepsis and meningitis from health demographic surveillance systems, or hospital records in Argentina, India, Kenya, Mozambique, and South Africa. Children without an iGBS history were matched to iGBS survivors for sex and age. Our primary outcomes were emotional-behavioral problems and psychopathological conditions as measured with the Child Behavior Checklist (CBCL). The CBCL was completed by the child’s primary caregiver.

Results

Between October 2019 and April 2021, 573 children (mean age, 7.18 years) were assessed, including 156 iGBS survivors and 417 non-iGBS comparison children. On average, we observed more total problems and more anxiety, attention, and conduct problems for school-aged iGBS survivors compared with the non-iGBS group. No differences were found in the proportion of clinically significant psychopathological conditions defined by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition).

Conclusions

Our findings suggested that school-aged iGBS survivors experienced increased mild emotional behavioral problems that may affect children and families. At-risk neonates including iGBS survivors need long-term follow-up with integrated emotional-behavioral assessments and appropriate care. Scale-up will require simplified assessments that are free and culturally adapted.
Pooling Sputum Samples for Efficient Mass Tuberculosis Screening in Prisons
Authors: dos Santos Paulo César Pereira , da Silva Santos Andrea , de Oliveira Roberto Dias , da Silva Bruna Oliveira , Soares Thiego Ramon , Martinez Leonardo , Verma Renu , Andrews Jason R , Croda Julio
Published: September 2021

Background

Although systematic tuberculosis screening in high-risk groups is recommended by the World Health Organization (WHO), implementation in prisons has been limited due to resource constraints. Whether Xpert Ultra sputum pooling could be a sensitive and efficient approach to mass screening in prisons is unknown.

Methods

In total, 1280 sputum samples were collected from incarcerated individuals in Brazil during mass screening and tested using Xpert G4. We selected samples for mixing in pools of 4, 8, 12, and 16, which were then tested using Ultra. In each pool, a single positive sample of differing Xpert mycobacterial loads was used. Additionally, 10 pools of 16 negative samples each were analyzed as controls. We then simulated tuberculosis screening at prevalences of 0.5–5% and calculated the cost per tuberculosis case detected at different sputum pooling sizes.

Results

The sensitivity and specificity of sputum pooling were high (sensitivity: 94%; 95% confidence interval [CI]: 88–98; specificity: 100%, 95% CI: 84–100). Sensitivity was greater in pools in which the positive sample had a high mycobacterial load compared to those that were very low (100% vs 88%). In settings with a higher tuberculosis prevalence, pools of 4 and 8 were more efficient than larger pool sizes. Larger pools decreased the costs by 87% at low prevalences, whereas smaller pools led to greater cost savings at higher prevalence at higher prevalences (57%).

Conclusions

Sputum pooling using Ultra was a sensitive strategy for tuberculosis screening. This approach was more efficient than individual testing across a broad range of simulated tuberculosis prevalence settings and could enable active case finding to be scaled while containing costs.
Accuracy of a Rapid Multiplex Polymerase Chain Reaction Plus a Chromogenic Phenotypic Test Algorithm for Detection of Extended-Spectrum β-Lactamase and Carbapenemase-Producing Gram-Negative Bacilli in Positive Blood Culture Bottles
Authors: Ong Sean Wei Xiang , Hon Pei Yun , Wee Sharon Syn Hui , Chia Jonathan Wei Zhong , Mendis Shehara , Izharuddin Ezlyn , Lin Ray Junhao , Chia Po Ying , Sim Rees Chin Swee , Chen Mark I-Cheng , Chow Angela , Yoong Joanne , Lye David Chien , Teng Christine B , Tambyah Paul Anantharajah , Banerjee Ritu , Patel Robin , De Partha Pratim , Vasoo Shawn
Published: September 2021

We studied the performance of an algorithm combining multiplex polymerase chain reaction with phenotypic detection of extended-spectrum β-lactamases and carbapenemases directly from positive blood culture bottles in patients with gram-negative bacteremia and found good concordance with routine cultures. Such an algorithm may be a tool to improve time to optimal therapy in patients with gram-negative bacteremia.
Pharmacokinetics and Efficacy of Human Hyperimmune Intravenous Immunoglobulin Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Adult Syrian Hamsters
Authors: Stauft Charles B , Tegenge Million , Khurana Surender , Lee Youri , Selvaraj Prabhuanand , Golding Hana , Wang Tony , Golding Basil
Published: September 2021

Background

After the failure of antibody therapies in treating hospitalized patients with coronavirus disease 2019 (COVID-19), we investigated the impact of viral replication on the pharmacokinetics and efficacy of a hyperimmune severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (CoVIG) product in treating SARS-CoV-2 infection using an adult Syrian hamster model.

Methods

The CoVIG was manufactured from plasma donors who had recovered from COVID-19. The dose used (400 mg/kg) was based on the dose given in clinical trials to hospitalized patients with COVID-19. Hamsters were given a single dose of CoVIG 2 days after challenge with the SARS-CoV-2 virus (isolate NY/PV08410/2020), followed by sampling of blood, nasal, tracheal, and lung tissues at different time points. The blood samples were assayed for anti–SARS-CoV-2 spike binding and used to calculate pharmacokinetic (PK) parameters. Nasal wash, tracheal, and lung tissue samples were assayed for viral replication by polymerase chain reaction (subgenomic messenger RNA).

Results

CoVIG-treated hamsters showed a reduction in viral replication in the lower respiratory tract, but minimal reduction in the upper respiratory tract, after challenge with SARS-CoV-2. Challenge resulted in altered PK parameters proportionate to viral replication, resulting in decreased area under the curve, accelerated clearance, and shorter half-life of CoVIG.

Conclusions

These data indicate that in the presence of actively replicating SARS-CoV-2 virus, PK parameters are altered and should trigger an adjustment in CoVIG dosing.
Diagnostic Stewardship in Clinical Microbiology, Essential Partner to Antimicrobial Stewardship
Authors: Sullivan Kaede V
Published: September 2021

Background

Diagnostic stewardship is an important partner to antimicrobial stewardship.

Content

Diagnostic stewardship focuses on ensuring correct diagnosis of infectious diseases while antimicrobial stewardship aims to optimize antimicrobial treatment. Both aim to improve patient outcomes. Diagnostic stewardship involves interventions that reduce testing in patients with low pretest probability, optimize a test’s likelihood ratio, and seek to warn providers when suboptimal test results might have been reported.

Conclusion

Diagnostic stewardship interventions have been described primarily in the areas of urinary tract infection, Clostridioides difficile infection, and bloodstream infection diagnosis. However, emerging areas include pneumonia and wound infections in addition to optimization of multiplexed panel-based testing.
Rare Correlated Coherent Association Rule Mining With CLS-MMS
Authors: Datta Subrata , Mali Kalyani , Ghosh Udit , Bose Subrata , Das Sourav , Ghosh Sourav
Published: September 2021

The study of coherent association rules based on propositional logic is an important area of association rule mining. Users may get a large number of itemsets for low minsup and lose valuable itemsets for high minsup. Mining without minsup may cause itemset explosions that contain spurious itemsets with low correlations and take a long time to mine. For mining coherence rules, existing approaches consider only the frequent itemsets, ignoring rare itemsets. Moreover, all items in the database are regarded equally important, which is not practical in real-world applications. By using the confidence-lift specified multiple minimum supports combined with propositional logic, we propose an efficient approach called rare correlated coherent association rule mining that addresses all of the problems stated above. We define and incorporate termination bound of support (${s}_{TB}$) and termination bound of dissociation (${d}_{TB}$) for early pruning of the candidate itemsets. In the proposed approach, support thresholds are automatically applied to the itemsets and coherent association rules are derived from the frequent and rare itemsets with high correlation and confidence. Experimental results obtained from real-life datasets show the effectiveness of the proposed approach in terms of itemsets and rule generation, correlation, confidence, runtime and scalability.
The Process of Developing a Disease Activity Index in Microscopic Colitis
Authors: Lesnovska Katarina Pihl , Münch Andreas , Bonderup Ole , Magro Fernando , Kupcinskas Juozas , Zabana Yamile , Tontini Gian Eugenio , Munck Lars Kristian , Guagnozzi Danila , Latella Giovanni , Fernandez-Banares Fernando , Miehlke Stephan , Madisch Ahmed , Wildt Signe , Hjortswang Henrik
Published: September 2021

Background and Aims

Patient-reported outcome measures [PROMs] aim to measure patients’ perception of how their disorder influences everyday functioning. The objective of this study was to develop a PROM to assess disease activity in microscopic colitis [MC] fulfilling the requirements of the Food and Drug Administration [FDA].

Methods

The European Microscopic Colitis Activity Index [E-MCAI] was developed in four steps. [1] A list of symptoms associated with active MC was created by a group of experts in the field. [2] Content validity of the symptoms was performed by experts [n = 14] and patients [n = 79] using the Content Validity Index. [3] Questions and response alternatives were created for each symptom, and validity of the E-MCAI was evaluated with cognitive interviews with patients [n = 7] and by the experts. [4] A pilot postal survey was performed to ensure usability.

Results

Seven of the symptoms related to active MC fulfilled the criteria for content validity and were included in the E-MCAI: stool consistency, stool frequency, stools at night, feel a need to pass more stools shortly after a bowel movement, urgent need to empty the bowel, leakage of stool and abdominal pain. The development and validation process resulted in the current version of the E-MCAI consisting of six questions related to MC.

Conclusions

The E-MCAI was developed using the methods advocated by the FDA. The evaluation indicates good content validity. Further evaluation will be performed to achieve construct validity, reliability and responsiveness in future cross-sectional and longitudinal studies.
A scoping review of artificial intelligence applications in thoracic surgery
Authors: Seastedt Kenneth P , Moukheiber Dana , Mahindre Saurabh A , Thammineni Chaitanya , Rosen Darin T , Watkins Ammara A , Hashimoto Daniel A , Hoang Chuong D , Kpodonu Jacques , Celi Leo A
Published: September 2021

OBJECTIVES

Machine learning (ML) has great potential, but there are few examples of its implementation improving outcomes. The thoracic surgeon must be aware of pertinent ML literature and how to evaluate this field for the safe translation to patient care. This scoping review provides an introduction to ML applications specific to the thoracic surgeon. We review current applications, limitations and future directions.

METHODS

A search of the PubMed database was conducted with inclusion requirements being the use of an ML algorithm to analyse patient information relevant to a thoracic surgeon and contain sufficient details on the data used, ML methods and results. Twenty-two papers met the criteria and were reviewed using a methodological quality rubric.

RESULTS

ML demonstrated enhanced preoperative test accuracy, earlier pathological diagnosis, therapies to maximize survival and predictions of adverse events and survival after surgery. However, only 4 performed external validation. One demonstrated improved patient outcomes, nearly all failed to perform model calibration and one addressed fairness and bias with most not generalizable to different populations. There was a considerable variation to allow for reproducibility.

CONCLUSIONS

There is promise but also challenges for ML in thoracic surgery. The transparency of data and algorithm design and the systemic bias on which models are dependent remain issues to be addressed. Although there has yet to be widespread use in thoracic surgery, it is essential thoracic surgeons be at the forefront of the eventual safe introduction of ML to the clinic and operating room.
Impact of mild cognitive impairment on unplanned readmission in patients with coronary artery disease
Authors: Ishihara Kodai , Izawa Kazuhiro P , Kitamura Masahiro , Ogawa Masato , Shimogai Takayuki , Kanejima Yuji , Morisawa Tomoyuki , Shimizu Ikki
Published: September 2021

Aims

To investigate the effect of mild cognitive impairment (MCI) on unplanned readmission in patients with coronary artery disease (CAD).

Methods and results

From 2132 CAD patients, MCI was estimated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in 243 non-dementia patients who met the study criteria. The primary outcome was unplanned hospital readmission after discharge. The incidence of MCI in this cohort was 33.3%, and 51 patients (21.0%) had unplanned readmission during a mean follow-up period of 418.6 ± 203.5 days. After adjusting for the covariates, MCI (hazard ratio, 2.28; 95% confidence interval: 1.09–4.76; P = 0.03) was independently associated with unplanned readmission in the multivariable Cox proportional hazard regression analysis. In the Kaplan–Meier analysis, the cumulative incidence of unplanned readmission for the MCI group was significantly higher than that for the non-MCI group (log-rank test, P < 0.001). Even after exclusion of the patients readmitted within 30 days of discharge, the main results did not change (log-rank test, P < 0.001).

Conclusion

Mild cognitive impairment was independently associated with unplanned readmission after adjustment for many independent variables in CAD patients. In addition to its short-term effects, the adverse effects of MCI had a persistent, long-term impact on CAD patients. Assessment of cognitive function should be conducted by health professionals prior to hospital discharge and during follow-up. To prevent readmission of CAD patients, it will be necessary to support solutions to the problems that inhibit secondary prevention behaviours based on the assessment of the patients’ cognitive function.
Critical appraisal of technologies to assess electrical activity during atrial fibrillation: a position paper from the European Heart Rhythm Association and European Society of Cardiology Working Group on eCardiology in collaboration with the Heart Rhythm Society, Asia Pacific Heart Rhythm Society, Latin American Heart Rhythm Society and Computing in Cardiology
Authors: de Groot Natasja M S , Shah Dipen , Boyle Patrick M , Anter Elad , Clifford Gari D , Deisenhofer Isabel , Deneke Thomas , van Dessel Pascal , Doessel Olaf , Dilaveris Polychronis , Heinzel Frank R , Kapa Suraj , Lambiase Pier D , Lumens Joost , Platonov Pyotr G , Ngarmukos Tachapong , Martinez Juan Pablo , Sanchez Alejandro Olaya , Takahashi Yoshihide , Valdigem Bruno P , van der Veen Alle-Jan , Vernooy Kevin , Casado-Arroyo Ruben ,   ESC Scientific Document Group, De Potter Tom , Dinov Borislav , Kosiuk Jedrzej , Linz Dominik , Neubeck Lis , Svennberg Emma , Kim Young-Hoon , Wan Elaine , Lopez-Cabanillas Nestor , Locati Emanuela T , Macfarlane Peter
Published: September 2021

We aim to provide a critical appraisal of basic concepts underlying signal recording and processing technologies applied for (i) atrial fibrillation (AF) mapping to unravel AF mechanisms and/or identifying target sites for AF therapy and (ii) AF detection, to optimize usage of technologies, stimulate research aimed at closing knowledge gaps, and developing ideal AF recording and processing technologies. Recording and processing techniques for assessment of electrical activity during AF essential for diagnosis and guiding ablative therapy including body surface electrocardiograms (ECG) and endo- or epicardial electrograms (EGM) are evaluated. Discussion of (i) differences in uni-, bi-, and multi-polar (omnipolar/Laplacian) recording modes, (ii) impact of recording technologies on EGM morphology, (iii) global or local mapping using various types of EGM involving signal processing techniques including isochronal-, voltage- fractionation-, dipole density-, and rotor mapping, enabling derivation of parameters like atrial rate, entropy, conduction velocity/direction, (iv) value of epicardial and optical mapping, (v) AF detection by cardiac implantable electronic devices containing various detection algorithms applicable to stored EGMs, (vi) contribution of machine learning (ML) to further improvement of signals processing technologies. Recording and processing of EGM (or ECG) are the cornerstones of (body surface) mapping of AF. Currently available AF recording and processing technologies are mainly restricted to specific applications or have technological limitations. Improvements in AF mapping by obtaining highest fidelity source signals (e.g. catheter–electrode combinations) for signal processing (e.g. filtering, digitization, and noise elimination) is of utmost importance. Novel acquisition instruments (multi-polar catheters combined with improved physical modelling and ML techniques) will enable enhanced and automated interpretation of EGM recordings in the near future.
A novel hypermucoviscous Klebsiella pneumoniae ST3994-K2 clone belonging to Clonal Group 86
Authors: Cerdeira Louise , Nakamura-Silva Rafael , Oliveira-Silva Mariana , Sano Elder , Esposito Fernanda , Fuga Bruna , Moura Quézia , Miranda Carlos Eduardo Saraiva , Wyres Kelly , Lincopan Nilton , Pitondo-Silva André
Published: September 2021

Emergent hypervirulent Klebsiella pneumoniae has been responsible for severe diseases, representing a serious threat to public health. We report the whole-genome sequencing of a novel ST3994-K2 clone, a single locus variant of ST86 K2, which is considered a worrying hypervirulent clone that emerged in several parts of the world. The strain K. pneumonia Kpi144 was isolated in 2013 from a blood culture of a 69-year-old male patient admitted to a tertiary hospital in Teresina, state of Piauí, northeastern Brazil. The strain was susceptible to 41 antibiotics tested, presented hypermucoviscous phenotype and a virulent behavior was observed in the Galleria mellonella infection model. Moreover, the virulome showed several virulence genes. To the best of our knowledge, this is the first worldwide report of a novel ST3994-K2 K. pneumoniae clone, an SLV of ST86 K2, which is considered a worrying virulent clone that has emerged in several parts of the world, including South America and Brazil.