bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID‐19 in lung transplant recipients: A single‐center experience
Authors: Turkkan Sinan , Beyoglu Muhammet Ali , Sahin Mehmet Furkan , Yazicioglu Alkın , Tezer Tekce Yasemin , Yekeler Erdal 
Published: July 2021

AbstractBackgroundCoronavirus disease 2019 (COVID‐19) is a global health problem. However, the course of this disease in immunosuppressed patients remains unknown. This study aimed to describe the course of COVID‐19 infection and its effects on lung transplant recipients.MethodsThis was a single‐center, retrospective, observational study. The recipients with suspicious symptoms and/or a contact history with infected individuals were diagnosed with COVID‐19 by performing a reverse transcription‐polymerase chain reaction (RT‐PCR) test using samples obtained from the nasopharynx swabs or bronchial lavage. We classified the patients into mild, moderate, and high severity groups according to their clinical conditions. In patients with positive RT‐PCR results, cell cycle inhibitor drugs were withdrawn, while steroids were maintained at the same level as in patients without clinical deterioration.ResultsOf the seven recipients diagnosed with COVID‐19 infection, one experienced a re‐infection. Each recipient had at least one comorbidity. Smell disorder (12.5%), cough/dyspnea (37%), and fever/chills/shivering (37%) were the most frequent symptoms. The mean follow‐up time after infection was 108 days. No deaths were recorded due to COVID‐19; however, the pulmonary function test values of two recipients were decreased during subsequent follow‐ups.ConclusionIn our small group of transplant recipients with COVID‐19, there were two cases of pulmonary function deterioration and a case of re‐infection, and no recipient died. It is suggested that steroid therapy should be initiated in the early period in patients with pulmonary opacities.
Effectiveness and safety of self-management interventions among adult type 2 diabetes mellitus patients in sub-Saharan Africa: a systematic review protocol
Authors: Carter Naomi , Chahal Pritpal , Chattopadhyay Kaushik 
Published: July 2021

ABSTRACT

Objective:
The objective of this review is to evaluate and synthesize evidence on the effectiveness and safety of self-management interventions among adult type 2 diabetes mellitus patients in sub-Saharan Africa.

Introduction:
Type 2 diabetes mellitus is a large and growing problem in sub-Saharan Africa. Several randomized controlled trials have been conducted assessing a range of self-management interventions among adult patients in sub-Saharan African settings. A comprehensive systematic review on the effectiveness and safety of these self-management interventions is required to inform health policy. This will allow for wide implementation of evidence-based self-management interventions in adults with type 2 diabetes mellitus in sub-Saharan Africa.

Inclusion criteria:
This systematic review will include randomized controlled trials assessing the effectiveness and safety of self-management interventions among adult type 2 diabetes mellitus patients in sub-Saharan Africa.

Methods:
The authors will undertake a systematic search for published and unpublished studies using the following sources: MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), PsycINFO (Ovid), Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Global Health (EBSCO), Directory of Open Access Journals, OpenGrey, EthOS, and ProQuest Dissertations and Theses. No language restrictions will be applied. The review will be conducted in accordance with the JBI methodology for systematic reviews of effectiveness. Narrative synthesis will be conducted, followed by meta-analysis, where feasible.

Systematic review registration number:
PROSPERO CRD42021237506
Experimental Study of Systems and Oils for Direct Cooling of Electrical Machine
Authors: Sindjui Ralph , Zito Gianluca , Zhang Shimin 
Published: July 2021

AbstractThis study presents a test campaign carried out at IFPEN aimed at understanding and characterizing the thermal behavior of electric motors incorporating direct oil cooling. Several cooling systems and oils are evaluated at different operating points, and the effect of parameter variations is investigated. Experimentations are defined and performed to understand and quantify the impact of different oils and direct cooling systems on the performances of the electrical machine. The test results make it possible to verify and quantify the gain on the thermal behavior obtained by adding an oil injection system directly to the active parts of the machine in addition to an indirect water jacket cooling. This gain is observed for a representative set of operating points and oil injection parameters. The impact of physicochemical properties of oils on direct cooling performance is assessed by a comparison of several oils. The viscous friction losses are also identified. The results presented include a repeatability and reproducibility study for speed values up to 14 krpm and continuous powers up to 60 kW.
Innovative Design, Structural Optimization, and Additive Manufacturing of New-Generation Turbine Blades
Authors: Pinelli Lorenzo , Amedei Andrea , Meli Enrico , Vanti Federico , Romani Benedetta , Benvenuti Gianluigi , Fabbrini Marco , Morganti Nicolò , Rindi Andrea , Arnone Andrea 
Published: July 2021

Abstract
The need for high performances is pushing the complexity of mechanical design at very high levels, especially for turbomachinery components. In this field, structural topology optimization methods together with additive manufacturing techniques for high-resistant alloys are considered very promising tools, but their potentialities have not been deeply investigated yet for critical rotating components like new-generation turbine blades. In this context, this research work proposes a methodology for the design, the optimization, and the additive manufacturing of extremely stressed turbomachinery components like turbine blade rows. The presented procedure pays particular attention to important aspects as fluid–structure interactions (forced response and flutter phenomena) and fatigue behavior of materials, going beyond the standard structural optimization approaches. The new design strategy enables a substantial reduction of the component mass, limiting the maximum stress and improving the vibrational behavior of the system in terms of eigenfrequencies, modal shapes, and fatigue life. Furthermore, the numerical procedure shows robustness and efficiency, making the proposed methodology an appropriate tool for rapid design and prototyping and for reducing the design costs and the typical time to market of this type of mechanical elements. The procedure has been applied to a low-pressure turbine rotor to improve the aeromechanical characteristics while keeping the aerodynamic performance. From the original geometry, mode-shapes, forcing functions (due to rotor/stator interactions), and aerodynamic damping have been numerically evaluated and used as input data for the subsequent topological optimization. Finally, the optimized geometry has been numerically and experimentally verified to confirm the improved aeromechanical design. After the structural topology optimization, the final geometries provided by the procedure have been properly rendered to make them suitable for additive manufacturing. Some prototypes of the new optimized turbine blade have been manufactured from aluminum alloy to be tested mechanically and in terms of fatigue.
State of Charge Estimation Algorithm Based on Fractional-Order Adaptive Extended Kalman Filter and Unscented Kalman Filter
Authors: Liu Weijie , Zhou Hongliang , Tang Zeqiang , Wang Tianxiang 
Published: July 2021

Abstract
Accurate estimation of state of charge (SOC) is the basis of battery management system. The fractional-order theory is introduced into the resistance-capacitance (RC)model of lithium battery, and adaptive genetic algorithm is used to identify the parameters of the RC model. Considering the changes of internal resistance and battery aging during battery discharge, the state of health (SOH) of the battery is estimated by unscented Kalman filter (UKF), and the values of internal resistance and maximum capacity of the battery are obtained. Finally, a novel estimation algorithm of lithium battery SOC based on SOH and fractional-order adaptive extended Kalman filter (FOAEKF) is proposed. An experimental system is set up to verify the effectiveness of the proposed algorithm. The experimental results show that, compared with the traditional SOC estimation algorithms, the proposed method has higher estimation accuracy, with the average error lower than 1% and the maximum error lower than 2%.
Modeling and Analysis of Sustained Annular Pressure and Gas Accumulation Caused by Tubing Integrity Failure in the Production Process of Deep Natural Gas Wells
Authors: Zhang Bo , Lu Nu , Guo Yujie , Wang Qing , Cai Mengzhe , Lou Erbiao 
Published: July 2021

Abstract
Sustained annular pressure caused by tubing leakage seriously threatens the safe production of deep gas wells. Therefore, it is necessary to fully understand the characteristics of sustained annular pressure and find potential methods to reduce risk. However, most models are about annular pressure caused by thermal expansion and cement integrity failure. Therefore, this paper establishes a model based on the energy conservation law, gas pressure–volume–temperature (PVT) properties, and volume consistency law, to study sustained annular pressure caused by tubing leakage. The results indicate that the pressure and gas volume in tubing-casing annulus increase simultaneously and gradually slow down after tubing leakage happens. The decrease of bottom-hole pressure can reduce the risk of annular pressure, which can be realized by a downhole choke. Other measures can also control the rising speed of annular pressure, including enhancement of production rate, increase of the initial length of the gas column and annular liquid with high compressibility, but the impact of formation energy and annular gas volume should be considered. Sustained annular pressure caused by shallow leaking point has a faster rising speed, longer rising period, and higher pressure value. Large leaking point leads to a remarkable increase of leaking rate and pressure rising speed. The integrity of the upper tubing string should be strengthened.
Incentivising doctor attendance in rural Bangladesh: a latent class analysis of a discrete choice experiment
Authors: Angell Blake , Khan Mushtaq , Islam Mir Raihanul , Mandeville Kate , Naher Nahitun , Hutchinson Eleanor , McKee Martin , Ahmed Syed Masud , Balabanova Dina 
Published: July 2021

ObjectiveDoctor absenteeism is widespread in Bangladesh, and the perspectives of the actors involved are insufficiently understood. This paper sought to elicit preferences of doctors over aspects of jobs in rural areas in Bangladesh that can help to inform the development of packages of policy interventions that may persuade them to stay at their posts.MethodsWe conducted a discrete choice experiment with 308 doctors across four hospitals in Dhaka, Bangladesh. Four attributes of rural postings were included based on a literature review, qualitative research and a consensus-building workshop with policymakers and key health-system stakeholders: relationship with the community, security measures, attendance-based policies and incentive payments. Respondents’ choices were analysed with mixed multinomial logistic and latent class models and were used to simulate the likely uptake of jobs under different policy packages.ResultsAll attributes significantly impacted doctor choices (p<0.01). Doctors strongly preferred jobs at rural facilities where there was a supportive relationship with the community (β=0.93), considered good attendance in education and training (0.77) or promotion decisions (0.67), with functional security (0.67) and higher incentive payments (0.5 per 10% increase of base salary). Jobs with disciplinary action for poor attendance were disliked by respondents (−0.63). Latent class analysis identified three groups of doctors who differed in their uptake of jobs. Scenario modelling identified intervention packages that differentially impacted doctor behaviour and combinations that could feasibly improve doctors’ attendance.ConclusionBangladeshi doctors have strong but varied preferences over interventions to overcome absenteeism. We generated evidence suggesting that interventions considering the perspective of the doctors themselves could result in substantial reductions in absenteeism. Designing policy packages that take account of the different situations facing doctors could begin to improve their ability and motivation to be present at their job and generate sustainable solutions to absenteeism in rural Bangladesh.
Aetiology of acute respiratory infection in preschool children requiring hospitalisation in Europe—results from the PED-MERMAIDS multicentre case–control study
Authors: Kohns Vasconcelos Malte , Loens Katherine , Sigfrid Louise , Iosifidis Elias , Epalza Cristina , Donà Daniele , Matheeussen Veerle , Papachristou Savvas , Roilides Emmanuel , Gijon Manuel , Rojo Pablo , Minotti Chiara , Da Dalt Liviana , Islam Samsul , Jarvis Jessica , Syggelou Aggeliki , Tsolia Maria , Nyirenda Nyang’wa Maggie , Keers Sophie , Renk Hanna , Gemmel Anna-Lena , D’Amore Carmen , Ciofi degli Atti Marta , Rodríguez-Tenreiro Sánchez Carmen , Martinón-Torres Federico , Burokienė Sigita , Goetghebuer Tessa , Spoulou Vana , Riordan Andrew , Calvo Cristina , Gkentzi Despoina , Hufnagel Markus , Openshaw Peter J , de Jong Menno D , Koopmans Marion , Goossens Herman , Ieven Margareta , Fraaij Pieter L A , Giaquinto Carlo , Bielicki Julia A , Horby Peter , Sharland Michael 
Published: July 2021

BackgroundBoth pathogenic bacteria and viruses are frequently detected in the nasopharynx (NP) of children in the absence of acute respiratory infection (ARI) symptoms. The aim of this study was to estimate the aetiological fractions for ARI hospitalisation in children for respiratory syncytial virus (RSV) and influenza virus and to determine whether detection of specific respiratory pathogens on NP samples was associated with ARI hospitalisation.Methods349 children up to 5 years of age hospitalised for ARI (following a symptom-based case definition) and 306 hospital controls were prospectively enrolled in 16 centres across seven European Union countries between 2016 and 2019. Admission day NP swabs were analysed by multiplex PCR for 25 targets.ResultsRSV was the leading single cause of ARI hospitalisations, with an overall population attributable fraction (PAF) of 33.4% and high seasonality as well as preponderance in younger children. Detection of RSV on NP swabs was strongly associated with ARI hospitalisation (OR adjusted for age and season: 20.6, 95% CI: 9.4 to 45.3). Detection of three other viral pathogens showed strong associations with ARI hospitalisation: influenza viruses had an adjusted OR of 6.1 (95% CI: 2.5 to 14.9), parainfluenza viruses (PIVs) an adjusted OR of 4.6 (95% CI: 1.8 to 11.3) and metapneumoviruses an adjusted OR of 4.5 (95% CI: 1.3 to 16.1). Influenza viruses had a PAF of 7.9%, PIVs of 6.5% and metapneumoviruses of 3.0%. In contrast, most other pathogens were found in similar proportions in cases and controls, includingStreptococcus pneumoniae, which was weakly associated with case status, and endemic coronaviruses.ConclusionRSV is the predominant cause of ARI hospitalisations in young children in Europe and its detection, as well as detection of influenza virus, PIV or metapneumovirus, on NP swabs can establish aetiology with high probability. PAFs for RSV and influenza virus are highly seasonal and age dependent.
Prognostic significance of serum cytokines during acute exacerbation of idiopathic interstitial pneumonias treated with thrombomodulin
Authors: Arai Toru , Matsuoka Hiroto , Hirose Masaki , Kida Hiroshi , Yamamoto Suguru , Ogata Yoshitaka , Mori Masahide , Hatsuda Kazuyoshi , Sugimoto Chikatoshi , Tachibana Kazunobu , Akira Masanori , Inoue Yoshikazu 
Published: July 2021

BackgroundAcute exacerbation (AE) has been reported to herald a poor prognosis in idiopathic pulmonary fibrosis and is now thought to do so in idiopathic interstitial pneumonias (IIPs). However, the pathophysiology of AE-IIPs is not sufficiently understood. In our previously reported SETUP trial, we found better survival in patients with AE-IIPs treated with corticosteroids and thrombomodulin than in those treated with corticosteroids alone. In that study, we collected serum samples to evaluate changes in cytokine levels and retrospectively examined the prognostic significance and pathophysiological role of serum cytokines in patients with AE-IIPs.MethodsThis study included 28 patients from the SETUP trial for whom serial serum samples had been prospectively obtained. AE-IIPs were diagnosed using the Japanese Respiratory Society criteria. All patients were treated with intravenous thrombomodulin and corticosteroids from 2014 to 2016. Serum levels of 27 cytokines were measured using Bio-Plex. The high-resolution CT pattern at the time of diagnosis of AE was classified as diffuse or non-diffuse.ResultsUnivariate analysis revealed that higher serum levels of interleukin (IL)-2, IL-7, IL-9, IL-12, IL13, basic fibroblast growth factor, granulocyte-macrophage colony-stimulating factor, interferon-γ inducible protein-10, platelet-derived growth factor and regulated on activation, normal T cell expressed and secreted (RANTES) at AE were significant predictors of 90-day survival. The HRCT pattern was also a significant clinical predictor of 90-day survival. Multivariate analysis with stepwise selection identified a higher serum RANTES level at AE to be a significant predictor of 90-day survival, including after adjustment for HRCT pattern. Multivariate analysis with stepwise selection suggested that a marked increase in the serum IL-10 level on day 8 could predict 90-day mortality.ConclusionsA higher serum RANTES level at AE the time of diagnosis predicted a good survival outcome, and an elevated serum IL-10 level on day 8 predicted a poor survival outcome.Trial registration numberUMIN000014969.
WDR5-H3K4me3 epigenetic axis regulates OPN expression to compensate PD-L1 function to promote pancreatic cancer immune escape
Authors: Lu Chunwan , Liu Zhuoqi , Klement John D , Yang Dafeng , Merting Alyssa D , Poschel Dakota , Albers Thomas , Waller Jennifer L , Shi Huidong , Liu Kebin 
Published: July 2021

BackgroundDespite PD-L1 (Programmed death receptor ligand-1) expression on tumor cells and cytotoxic T lymphocytes tumor infiltration in the tumor microenvironment, human pancreatic cancer stands out as one of the human cancers that does not respond to immune checkpoint inhibitor (ICI) immunotherapy. Epigenome dysregulation has emerged as a major mechanism in T cell exhaustion and non-response to ICI immunotherapy, we, therefore, aimed at testing the hypothesis that an epigenetic mechanism compensates PD-L1 function to render pancreatic cancer non-response to ICI immunotherapy.MethodsTwo orthotopic pancreatic tumor mouse models were used for chromatin immunoprecipitation-Seq and RNA-Seq to identify genome-wide dysregulation of H3K4me3 and gene expression. Human pancreatic tumor and serum were analyzed for osteopontin (OPN) protein level and for correlation with patient prognosis. OPN and PD-L1 cellular location were determined in the tumors using flow cytometry. The function of WDR5-H3K4me3 axis in OPN expression were determined by Western blotting. The function of H3K4me3-OPN axis in pancreatic cancer immune escape and response to ICI immunotherapy was determined in an orthotopic pancreatic tumor mouse model.ResultsMouse pancreatic tumors have a genome-wide increase in H3K4me3 deposition as compared with normal pancreas. OPN and its receptor CD44 were identified being upregulated in pancreatic tumors by their promoter H3K4me3 deposition. OPN protein is increased in both tumor cells and tumor-infiltrating immune cells in human pancreatic carcinoma and is inversely correlated with pancreatic cancer patient survival. OPN is primarily expressed in tumor cells and monocytic myeloid-derived suppressor cells (M-MDSCs), whereas PD-L1 is expressed in tumor cells, M-MDSCs, polymorphonuclear MDSCs and tumor-associated macrophages. WDR5 is essential for H3K4me3-specific histone methyltransferase activity that regulates OPN expression in tumor cells and MDSCs. Inhibition of WDR5 significantly decreased OPN protein level. Inhibition of WDR5 or knocking out of OPN suppressed orthotopic mouse pancreatic tumor growth. Inhibition of WDR5 also significantly increased efficacy of anti-PD-1 immunotherapy in suppression of mouse pancreatic tumor growth in vivo.ConclusionsOPN compensates PD-L1 function to promote pancreatic cancer immune escape. Pharmacological inhibition of the WDR5-H3K4me3 epigenetic axis is effective in suppressing pancreatic tumor immune escape and in improving efficacy of anti-PD-1 immunotherapy in pancreatic cancer.
Modified Glasgow Prognostic Score associated with survival in metastatic renal cell carcinoma treated with immune checkpoint inhibitors
Authors: Brown Jacqueline T , Liu Yuan , Shabto Julie M , Martini Dylan , Ravindranathan Deepak , Hitron Emilie Elise , Russler Greta Anne , Caulfield Sarah , Yantorni Lauren , Joshi Shreyas Subhash , Kissick Haydn , Ogan Kenneth , Nazha Bassel , Carthon Bradley C , Kucuk Omer , Harris Wayne B , Master Viraj A , Bilen Mehmet Asim 
Published: July 2021

BackgroundThe modified Glasgow Prognostic Score (mGPS) is a composite biomarker that uses albumin and C reactive protein (CRP). There are multiple immune checkpoint inhibitor (ICI)-based combinations approved for metastatic renal cell carcinoma (mRCC). We investigated the ability of mGPS to predict outcomes in patients with mRCC receiving ICI.MethodsWe retrospectively reviewed patients with mRCC treated with ICI as monotherapy or in combination at Winship Cancer Institute between 2015 and 2020. Overall survival (OS) and progression-free survival (PFS) were measured from the start date of ICI until death or clinical/radiographical progression, respectively. The baseline mGPS was defined as a summary score based on pre-ICI values with one point given for CRP>10 mg/L and/or albumin<3.5 g/dL, resulting in possible scores of 0, 1 and 2. If only albumin was low with a normal CRP, no points were awarded. Univariate analysis (UVA) and multivariate analysis (MVA) were carried out using Cox proportional hazard model. Outcomes were also assessed by Kaplan-Meier analysis.Results156 patients were included with a median follow-up 24.2 months. The median age was 64 years and 78% had clear cell histology. Baseline mGPS was 0 in 36%, 1 in 40% and 2 in 24% of patients. In UVA, a baseline mGPS of 2 was associated with shorter OS (HR 4.29, 95% CI 2.24 to 8.24, p<0.001) and PFS (HR 1.90, 95% CI 1.20 to 3.01, p=0.006) relative to a score of 0; this disparity in outcome based on baseline mGPS persisted in MVA. The respective median OS of patients with baseline mGPS of 0, 1 and 2 was 44.5 (95% CI 27.3 to not evaluable), 15.3 (95% CI 11.0 to 24.2) and 10 (95% CI 4.6 to 17.5) months (p<0.0001). The median PFS of these three cohorts was 6.7 (95% CI 3.6 to 13.1), 4.2 (95% CI 2.9 to 6.2) and 2.6 (95% CI 2.0 to 5.6), respectively (p=0.0216). The discrimination power of baseline mGPS to predict survival outcomes was comparable to the IMDC risk score based on Uno’s c-statistic (OS: 0.6312 vs 0.6102, PFS: 0.5752 vs 0.5533).ConclusionThe mGPS is prognostic in this cohort of patients with mRCC treated with ICI as monotherapy or in combination. These results warrant external and prospective validation.