bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-Objective Optimization of a Geothermal Steam Turbine Combined With Reverse Osmosis and Multi-Effect Desalination for Sustainable Freshwater Production
Authors: Farsi Aida , Rosen Marc A. 
Published: December 2021

Abstract
A novel geothermal desalination system is proposed and optimized in terms of maximizing the exergy efficiency and minimizing the total cost rate of the system. The system includes a geothermal steam turbine with a flash chamber, a reverse osmosis unit, and a multi-effect distillation system. First, exergy and economic analyses of the system are performed using Engineering Equation software. Then, an artificial neural network is used to develop a mathematical function linking input design variables and objective functions for this system. Finally, a multi-objective optimization is carried out using a genetic algorithm to determine the optimum solutions. The Utopian method is used to select the favorable solution from the optimal solutions in the Pareto frontier. Also, the distributions of the values of design variables within their allowable ranges are investigated. It is found that the optimum exergy efficiency and total cost rate of the geothermal desalination system are 29.6% and 3410 $/h, respectively. Increasing the seawater salinity and decreasing the intake geothermal water temperature result in an improvement in both exergy efficiency and total cost rate of the system, while variations in the flash pressure and turbine outlet pressure lead to a conflict between the exergy efficiency and the total cost rate of the geothermal desalination system over the range of their variations.
Numerical Simulation and Optimization of CO2-Enhanced Gas Recovery in Homogeneous and Vertical Heterogeneous Reservoir Models
Authors: Liu Shuyang , Agarwal Ramesh , Sun Baojiang 
Published: December 2021

Abstract
CO2-enhanced gas recovery (CO2-EGR) is a promising, environment-friendly technology to produce more natural gas from depleted reservoirs and simultaneously sequester CO2. The subsurface flow in the heterogeneous reservoir is usually different from homogenous one, and the heterogeneity significantly affects the gas recovery. The effects of heterogeneity and the optimization of CO2 injection strategy are the key factors in CO2-EGR. Thus, one of the goals of this paper is to conduct simulations of CO2-EGR in both homogeneous and heterogeneous reservoirs to evaluate the effects of reservoir heterogeneity on CO2-EGR. The second goal is to perform optimization studies to determine optimal CO2 injection time and injection rate for achieving optimal natural gas recovery. The CO2-EGR simulations were conducted in a 3D reservoir model with a 'five-spot' well pattern by using the multi-phase simulator TOUGH2. The results show that the layers with low permeability as well as gravity segregation retard upward migration of CO2 and promote horizontal displacement efficiency. The breakthrough time of CO2 and reservoir space of underexploited natural gas directly affect the gas recovery. The optimal injection time is determined as the depleted stage, and the corresponding injection rate is optimized by using a genetic algorithm (GA) integrated with TOUGH2. The optimization of CO2 injection parameters leads to recovery factors (RFs) reaching 62.83% and 64.75% in the homogeneous and heterogeneous cases while simultaneously obtaining the economic benefit of about 8.67 and 8.95 million USD. This study shows significant economic potential as well as environmental benefits of using CO2-EGR in the depleted gas reservoir by optimizing the CO2 injection parameters. The findings of this work could assist in determining the optimal injection strategy for using CO2-EGR in industrial scale gas reservoirs.
Tribological Performance of Multiscale Micro-Textured H62 Brass Surface Fabricated by Micro-Milling and Wet Micro-Blasting
Authors: Chen Luanxia , Liu Zhanqiang , Cai Yukui , Wang Bing 
Published: December 2021

Abstract
The cylinder block/valve plate interface in the axial piston pump has been proven to be easily worn out, which will increase power loss and reduce its efficiency. The valve plate surface is required to be manufactured with low viscous friction and wear. Multiscale micro-texture has been proven to improve surface tribological properties. However, there are few types of research in the effect of surface topography on the tribological performance of multiscale micro-textured surfaces. The purpose of this study is to explore how the multiscale micro-texture on H62 brass affects its sliding friction behavior on 38CrMoAl. Based on micro-milling and wet micro-blasting, the multiscale micro-textured surface was manufactured on H62 brass. The wet micro-blasting was applied in the H62 brass after the surface micro-texturing. The surface topography of multiscale micro-textured samples processed by three abrasive grit sizes accompanied by two processing times was comprehensively measured in terms of height, feature, functional, and functional volume parameters. The tribological performance of multiscale micro-textured H62 brass was characterized by disk-on-disk frictional experiments. Through analyzing the relationship between surface morphology and tribological properties, the antifriction mechanism of the multiscale micro-textured surface was analyzed from the perspective of 3D surface roughness parameters. The friction coefficient of the multiscale micro-textured surface processed by the combination of micro-milling and wet micro-blasting decreased with the increasing grit size and micro-blasting time.
Partial-Body Cryotherapy Exposure 2 Hours Prior to a Shuttle Run Does Not Enhance Running Performance
Authors: Partridge Emily M. , Cooke Julie , McKune Andrew J. , Pyne David B. 
Published: December 2021

Purpose: To determine whether a single acute preexercise bout of partial-body cryotherapy (PBC) enhanced maximal-effort shuttle run performance, salivary enzyme concentration, and self-reported performance readiness. Methods: A total of 18 male rugby league players (age = 20.1 [0.5] y; mass = 91.4 [12.4] kg) were exposed to either PBC for 3 minutes at −136°C (1°C) or a control condition prior to a continuous, high-intensity 6 × 40-m shuttle run test. Passive saliva samples were collected to determine salivary alpha amylase (sAA) concentration. Perceived performance readiness and well-being questionnaires were completed using a 1-to-7 Likert scale. Results: The PBC exposure did not elicit a greater improvement in 6 × 40-m shuttle run performance in comparison with the control condition (standardized difference; +0.4 [5.9%]; P = .881; mean ± 90% confidence limits). The increase in sAA concentration was moderately greater 15 minutes after PBC compared with the control group (+67 [32%], P = .012) and remained moderately higher up to 2 hours post-PBC exposure compared with the control condition (+41 [40%], P = .045). There were greater improvements in self-reported perceptions of muscle soreness (+0.6 [0.4%], P = .043; units ±90% confidence limits) and mood (+0.6 [0.7%], P = .038) after PBC compared with control. Conclusions: It appears that a single 3-minute bout of PBC does not augment maximal effort shuttle run performance in elite rugby league players. Beneficial increases in sAA concentration, coupled with improved perceptions of muscle soreness and mood, should be explored further for alternative training or precompetition practices.
Gravitational Lensing and Wormhole Shadows
Authors: Bugaev M. A. , Novikov I. D. , Repin S. V. , Shelkovnikova A. A. 
Published: December 2021

Abstract
The problem of bending and scattering of light rays passing outside the entrance of a wormhole with zero gravitational mass is considered. The process of ray capture by a wormhole, as well as the formation process of a shadow when illuminated by a standard screen, is investigated. These mechanisms are also compared to the case of light ray motion in the vicinity of the Schwarzschild black hole.
Five-year follow-up of new cases after a coeliac disease mass screening
Authors: Sandström Olof , Norström Fredrik , Carlsson Annelie , Högberg Lotta , van der Palz Maria , Stenhammar Lars , Webb Charlotta , Ivarsson Anneli , Myléus Anna 
Published: December 2021

ObjectiveWe previously performed a population-based mass screening of coeliac disease in children aged 12 years in two birth cohorts resulting in 296 seropositive children, of whom 242 were diagnosed with coeliac disease after duodenal biopsies. In this follow-up study, we wanted to identify new cases in the screening population that tested negative—either converting from potential coeliac disease (seropositive but normal duodenal mucosa) or converting from seronegative at screening to diagnosed coeliac disease.MethodsAll seropositive children were invited to a follow-up appointment 5 years after the screening with renewed serological testing and recommended endoscopic investigation if seropositive. Seronegative children in the screening study (n=12 353) were linked to the National Swedish Childhood Coeliac Disease Register to find cases diagnosed in healthcare during the same period.ResultsIn total, 230 (77%) came to the follow-up appointment, including 34 of 39 with potential coeliac disease. Of these, 11 (32%) had converted to coeliac disease. One new case was found in the National Swedish Childhood Coeliac Disease Register who received the diagnosis through routine screening in children with type 1 diabetes.ConclusionsThere is a high risk of conversion to coeliac disease among those with potential disease. However, a negative screening test was associated with a very low risk for a clinical diagnosis within a follow-up period of 5 years.
Dietary patterns and birth outcomes in the ELSPAC pregnancy cohort
Authors: Mikeš Ondřej , Brantsæter Anne Lise , Knutsen Helle Katrine , Torheim Liv Elin , Bienertová Vašků Julie , Pruša Tomáš , Čupr Pavel , Janák Karel , Dušek Ladislav , Klánová Jana 
Published: December 2021

ObjectivesThe aim of this study was to identify dietary patterns in a Czech pregnancy cohort established in the early postcommunist era and investigate associations between dietary patterns, maternal characteristics and birth outcomes.MethodsPregnant women were recruited for the Czech part of the European Longitudinal Study of Pregnancy and Childhood. A self-reported questionnaire answered in late pregnancy was used to assess information about the weekly intake of 43 food items. Information about birth outcomes (birth weight, height, ponderal index, head circumference, cephalisation index, gestational length and Apgar score) was obtained from the National Registry of Newborns. Complete details on diet and birth outcomes were available for 4320 mother–infant pairs.Results and conclusionThe food items were aggregated into 28 variables and used for extraction of two dietary patterns by principal component factor analysis. The patterns were denoted ‘unhealthy’ and ‘healthy/traditional’ based on the food items with the highest factor loadings on each pattern. The ‘unhealthy’ pattern had high positive loadings on meat, processed food and confectionaries. In contrast, the ‘healthy/traditional’ pattern had high positive loadings on vegetables, dairy, fruits and wholemeal bread. Following adjustment for covariates, we found that high adherence to the unhealthy pattern (expressed as beta for 1 unit increase in pattern score), that is, the higher consumption of less healthy foods, was associated with lower birth weight: −23.8 g (95% CI −44.4 to −3.2) and length: −0.10 cm (95% CI −0.19 to −0.01) and increased cephalisation index: 0.91 μm/g (95% CI 0.23 to 1.60). The ‘healthy/traditional’ pattern was not associated with any birth outcomes. This study supports the recommendation to eat a healthy and balanced diet during pregnancy.
Characterisation of TRIM46 autoantibody-associated paraneoplastic neurological syndrome
Authors: Valencia-Sanchez Cristina , Knight Andrew M , Hammami M Bakri , Guo Yong , Mills John R , Kryzer Thomas J , Piquet Amanda L , Amin Anik , Heinzelmann Morgan , Lucchinetti Claudia F , Lennon Vanda A , McKeon Andrew , Pittock Sean J , Dubey Divyanshu 
Published: December 2021

ObjectivesTo report the expanded neurological presentations and oncological associations of tripartite motif-containing protein 46 (TRIM46)-IgG seropositive patients.MethodsArchived sera/cerebrospinal fluid (CSF) were evaluated by tissue-based immunofluorescence assay to identify patients with identical axon initial segment (AIS)-specific staining pattern. Phage immunoprecipitation sequencing (PhIP-Seq) was used to identify the putative autoantigen.ResultsIgG in serum (17) and/or CSF (16) from 25 patients yielded unique AIS-specific staining on murine central nervous system (CNS) tissue. An autoantibody specific for TRIM46 was identified by PhIP-Seq, and autoantigen specificity was confirmed by transfected COS7 cell-based assay. Clinical information was available for 22 TRIM46-IgG seropositive patients. Fifteen were female (68%). Median age was 67 years (range 25–87). Fifteen (68%) patients presented with subacute cerebellar syndrome (six isolated; nine with CNS accompaniments: encephalopathy (three), brainstem signs (two), myelopathy (two), parkinsonism (one)). Other phenotypes included limbic encephalitis (three), encephalopathy with/without seizures (two), myelopathy (two). Eighteen (82%) had cancer: neuroendocrine carcinomas (9; pancreatic (3), small-cell lung (4), oesophagus (1), endometrium (1)), adenocarcinomas (6; lung (2), ovarian (2), endometrial (1), breast (1)), sarcoma (2) and gastrointestinal tumour (1). Neurological symptoms in three followed immune checkpoint inhibitor (ICI) administration.ConclusionsThis study supports TRIM46-IgG being a biomarker of paraneoplastic CNS disorders and expands the neurological phenotypes, oncological and ICI-related adverse event associations.
Composite endpoint for ALS clinical trials based on patient preference: Patient-Ranked Order of Function (PROOF)
Authors: van Eijk Ruben P A , van den Berg L H , Lu Ying 
Published: December 2021

BackgroundPatients with amyotrophic lateral sclerosis (ALS) show considerable variation in symptoms. Treatments targeting an overall improvement in symptomatology may not address what the majority of patients consider to be most important. Here, we propose a composite endpoint for ALS clinical trials that weighs the improvement in symptoms compared with what the patient population actually wants.MethodsAn online questionnaire was sent out to a population-based registry in The Netherlands. Patients with ALS were asked to score functional domains with a validated self-reported questionnaire, and rank the order of importance of each domain. This information was used to estimate variability in patient preferences and to develop the Patient-Ranked Order of Function (PROOF) endpoint.ResultsThere was extensive variability in patient preferences among the 433 responders. The majority of the patients (62.1%) preferred to prioritise certain symptoms over others when evaluating treatments. The PROOF endpoint was established by comparing each patient in the treatment arm to each patient in the placebo arm, based on their preferred order of functional domains. PROOF averages all pairwise comparisons, and reflects the probability that a patient receiving treatment has a better outcome on domains that are most important to them, compared with a patient receiving placebo. By means of simulation we illustrate how incorporating patient preference may upgrade or downgrade trial results.ConclusionsThe PROOF endpoint provides a balanced patient-focused analysis of the improvement in function and may help to refine the risk–benefit assessment of new treatments for ALS.
What matters to people with multiple long-term conditions and their carers?
Authors: Spiers Gemma , Boulton Elisabeth , Corner Lynne , Craig Dawn , Parker Stuart , Todd Chris , Hanratty Barbara 
Published: December 2021

AbstractBackgroundThe number of people living with multiple long-term conditions is increasing worldwide. This presents challenges for health and care systems, which must adapt to meet the needs of this population. This study drew on existing data to understand what matters to people living with multiple long-term conditions and identify priorities for future research.MethodsTwo studies were conducted. (1) A secondary thematic analysis of interview, survey and workshop data collected from the 2017 James Lind Alliance Priority Setting Partnership for Older People with Multiple Conditions, and patient and public involvement workshops; (2) a review of ongoing research and published research priorities, relating to older people (80+) living with multiple long-term conditions.FindingsOlder people with multiple long-term conditions identified a number of key concerns: access to care, support for both the patient and their carer, physical and mental health and well-being and identifying opportunities for early prevention. The review identified no published research priorities or ongoing research focusing specifically on populations aged over 80 years with multiple long-term conditions.ConclusionOlder people living with multiple long-term conditions experience care that is inadequate for their needs. A holistic approach to care that extends beyond treating single conditions will ensure wide-ranging needs are met. As multimorbidity rises worldwide, this is a critical message for practitioners across health and care settings. We also recommend key areas that should be given greater focus in future research and policy to inform effective and meaningful forms of support for people living with multiple long-term conditions.
Does robotic-assisted surgery improve outcomes of total hip arthroplasty compared to manual technique? A systematic review and meta-analysis
Authors: Kumar Vishal , Patel Sandeep , Baburaj Vishnu , Rajnish Rajesh Kumar , Aggarwal Sameer 
Published: December 2021

Abstract

Background
Robot-assisted total hip arthroplasty (THA) is an emerging technology that claims to position implants with very high accuracy. However, there is currently limited data in literature on whether this improved accuracy leads to better long-term clinical outcomes. This systematic review compares the outcomes of THA done with the help of robotic assistance (RA) to those done with conventional manual techniques (MTs).

Methods
Four electronic databases were searched for eligible articles that directly compared robot-assisted THA to manual THA and had data on the radiological or clinical outcomes of both. Data on various outcome parameters were collected. Meta-analysis was conducted using a random-effects model with 95% CIs.

Results
A total of 17 articles were found eligible for inclusion, and 3600 cases were analysed. Mean operating time in the RA group was significantly longer than in the MT group. RA resulted in significantly more acetabular cups being placed inside Lewinnek’s and Callanan’s safe zones (p&lt;0.001) and had significantly reduced limb length discrepancy compared with MT. There were no statistically significant differences in the two groups in terms of incidence of perioperative complications, need for revision surgery and long-term functional outcome.

Conclusion
RA leads to highly accurate implant placement and leads to significantly reduced limb length discrepancies. However, the authors do not recommend robot-assisted techniques for routine THAs due to lack of adequate long-term follow-up data, prolonged surgical times and no significant differences in the rate of complications and implant survivorship compared with conventional MTs.
Strategies for giving feedback in the operating room
Authors: Marton Akos , Ashcroft James 
Published: December 2021

Abstract
Feedback is crucial to learning and is a difficult concept to define, occurring as a consequence of learner performance with the ultimate aim of influencing change in the learner. Here, we discuss strategies for giving feedback in the operating room revolving around the following themes: encouraging a sociocultural process, forming an educational alliance, sharing training goals, finding the appropriate time, giving task-specific feedback, approaching unsatisfactory performance and providing follow-up. It is essential that surgeons understand the fundamental feedback theories at play in the operating room described in this article and how they influence surgical training at all stages.
Concurrent Inhibition of IGF1R and ERK Increases Pancreatic Cancer Sensitivity to Autophagy Inhibitors
Authors: Stalnecker Clint A. , Grover Kajal R. , Edwards A. Cole , Coleman Michael F. , Yang Runying , DeLiberty Jonathan M. , Papke Björn , Goodwin Craig M. , Pierobon Mariaelena , Petricoin Emanuel F. , Gautam Prson , Wennerberg Krister , Cox Adrienne D. , Der Channing J. , Hursting Stephen D. , Bryant Kirsten L. 
Published: December 2021

Abstract

The aggressive nature of pancreatic ductal adenocarcinoma (PDAC) mandates the development of improved therapies. As KRAS mutations are found in 95% of PDAC and are critical for tumor maintenance, one promising strategy involves exploiting KRAS-dependent metabolic perturbations. The macrometabolic process of autophagy is upregulated in KRAS-mutant PDAC, and PDAC growth is reliant on autophagy. However, inhibition of autophagy as monotherapy using the lysosomal inhibitor hydroxychloroquine (HCQ) has shown limited clinical efficacy. To identify strategies that can improve PDAC sensitivity to HCQ, we applied a CRISPR-Cas9 loss-of-function screen and found that a top sensitizer was the receptor tyrosine kinase (RTK) insulin-like growth factor 1 receptor (IGF1R). Additionally, reverse phase protein array pathway activation mapping profiled the signaling pathways altered by chloroquine (CQ) treatment. Activating phosphorylation of RTKs, including IGF1R, was a common compensatory increase in response to CQ. Inhibition of IGF1R increased autophagic flux and sensitivity to CQ-mediated growth suppression both in vitro and in vivo. Cotargeting both IGF1R and pathways that antagonize autophagy, such as ERK–MAPK axis, was strongly synergistic. IGF1R and ERK inhibition converged on suppression of glycolysis, leading to enhanced dependence on autophagy. Accordingly, concurrent inhibition of IGF1R, ERK, and autophagy induced cytotoxicity in PDAC cell lines and decreased viability in human PDAC organoids. In conclusion, targeting IGF1R together with ERK enhances the effectiveness of autophagy inhibitors in PDAC.

Significance:
Compensatory upregulation of IGF1R and ERK–MAPK signaling limits the efficacy of autophagy inhibitors chloroquine and hydroxychloroquine, and their concurrent inhibition synergistically increases autophagy dependence and chloroquine sensitivity in pancreatic ductal adenocarcinoma.