bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thermodynamic Analysis and Optimization of Molten Salt Reactors Coupled With Desalination Solutions
Authors: Alcorn Isabella , Louis Ethan , Gonzales Robert , Aguilar Diego , Kimber Mark 
Published: November 2024

Abstract
In recent years, Molten Salt Reactor (MSR) technology has received significant attention. Its low pressure makes the MSR a low-risk option which, when coupled with its high temperature, makes it a highly beneficial choice for power generation and suggests the ease of integration with other systems such as desalination. It is worthwhile with the growing interest in MSRs, to develop a simulation tool that can predict performance in a multi-faceted MSR-based flow loop. This study focuses on MSR applications, namely clean water production utilizing a specific optimized combination of FLiNaK and supercritical carbon dioxide (SCO2) cycles. It addresses the growing worldwide need to decarbonize our energy production and simultaneously provide clean water. The results of optimized MSR-desalination configurations exhibit promising implications for the production of abundant amounts of clean water while also maintaining ample power supply to the electrical grid. They show that a design for a coupled MSR and desalination plant are not only possible but that the components and design are scalable for 50–250 MWth power input.
Effect of Porous Walls and Nanofluids on the Thermo-Hydraulic Performance of Tapered Double-Layered Microchannel Heat Sink
Authors: Kumar Avinash , Bakli Chirodeep 
Published: November 2024

Abstract
The present study investigates the effect of porous walls on the thermo-hydraulic characteristics of tapered Double Layer Microchannel Heat Sink (DL-MCHS). Three tapered DL-MCHS with different porous walls arrangements is simulated and compared for varying tapering of the channel and Reynolds number considering water and nanofluid as coolant. The fluid flow through porous media and micro-channel is modeled using the Darcy-Brinkman-Forchheimer equation and Navier-Stokes equation respectively. The above two equations coupled with continuity and energy equations are solved numerically to depict the thermo-hydraulic characteristics of DL-MCHS. It is demonstrated that the porous walls reduce the pressure losses along with a reduction in cooling performance of tapered DL-MCHS making the use of porous walls non-viable. However, incorporating porous walls in either bottom or top channel enhances the thermal performance and the overall performance making the use of porous walls viable. Also, the use of Al2O3-H2O nanofluid enhances the performance of a heat sink further by 11% as compared to water. It is found that incorporating porous walls only in the bottom channel gives the best performance among all three porous arrangements. Finally, through an optimization study, the enhancement in thermal performance by 22.7% is reported considering TF = 0.5, Re = 600, and nanofluid as coolant making it an optimum viable design.
Generalization of RELAP5-3D Molecular Diffusion Model to a Noncondensable Gas Primary Coolant
Authors: Mesina George , Martin Robert P. 
Published: November 2024

Abstract
The molecular diffusion model [1, 2] was developed within RELAP5-3D [3, 4] in 2005. Its objective was to implement the capability of calculating the ingress of air into a particular Very Hight Temperature gas-cooled Reactor (VHTR) by molecular diffusion following an accident, such as a large break in the primary coolant system, resulting in a complete loss of flow and depressurization. The existing coding was verified and validated [4]. However, the implementation was confined to only two different gases for the primary fluid, water vapor and helium. It has become of interest to implement other gases as the primary coolant, primarily for modeling designs for new Small Modular Reactors (SMR) and microreactors. This project adds the capability to specify, through use input, a variety of noncondensable (NC) gases as the primary coolant.
The approach for molecular diffusion modeling has two parts. The first part solves the diffusion equation at each time step to calculate the various components of gas added or subtracted from each RELAP5-3D control volume due to molecular diffusion during the time step. The second part modifies the RELAP5-3D field equations with the molecular diffusion calculations so that the overall fluid behavior modeling accounts for molecular diffusion. The theory, algorithm, coding implementation and verification are given, and some numerical validation and calculational results are given.
A peptide targeting outer membrane protein A of
Acinetobacter baumannii
exhibits antibacterial activity by reducing bacterial pathogenicity
Authors: Zhao Hui , Hu Yue , Nie Dan , Li Na , Chen Zhou , Zhou Shan , Li Mingkai , Xue Xiaoyan 
Published: November 2024

ABSTRACT

The World Health Organization has classified multidrug-resistant (MDR)
Acinetobacter baumannii
as a significant threat to human health, necessitating the urgent discovery of new antibacterial drugs to combat bacterial resistance. Outer membrane protein A of
A. baumannii
(AbOmpA) is an outer membrane-anchored β-barrel-shaped pore protein that plays a critical role in bacterial adhesion, invasion, and biofilm formation. Therefore, AbOmpA is considered a key virulence factor of
A. baumannii
. Herein, we screened three phage display peptide libraries targeting AbOmpA and identified several peptides. Among them, P92 (amino acid sequence: QMGFMTSPKHSV) exhibited the highest binding affinity with AbOmpA, with a KD value of 7.84 nM.
In vitro
studies demonstrated that although P92 did not directly inhibit bacterial growth, it significantly reduced the invasion and adhesion capabilities of multiple clinical isolates of MDR
A. baumannii
and concentration-dependently inhibited biofilm formation by acting on OmpA. Furthermore, the polymerase chain reaction results confirmed a significant positive correlation between the antibacterial effect of P92 and OmpA expression levels. Encouragingly, P92 also displayed remarkable therapeutic efficacy against
A. baumannii
infection in various models, including an
in vitro
cell infection model, a mouse skin infection model, and a mouse sepsis model. These results highlight P92 as a novel and highly effective antimicrobial molecule specifically targeting the virulence factor AbOmpA.
Therapeutic drug monitoring of posaconazole delayed-release tablets and injections in pediatric patients
Authors: Wu Juan , Chen Changcheng , Luo Chengjuan , Ning Botao , Liu Yue , Li Zhuo , Zhang Shunguo , Li Zhiling 
Published: November 2024

ABSTRACT

This study aimed to investigate the dose and trough concentration (
C
min
) of posaconazole delayed-release tablets and injections, and their correlation with efficacy and safety in pediatric patients. Patients younger than 18 years old received posaconazole delayed-release tablets or injections for prophylaxis or treatment of invasive fungal disease (IFD). Blood samples were collected to determine the plasma
C
min
s, and dose regimen adjustments were made if necessary. Clinical data were collected. A total of 210
C
min
s of 113 pediatric patients were detected. The median
C
min
s were 1.0 and 1.3 mg/L for tablets and injections, respectively (
P
< 0.05). The median doses required to achieve the target
C
min
were about 6.0 mg/kg of body weight/day, and no statistical difference was observed between different age groups, formulations, or indications (
P
> 0.05). Concomitant treatment of tacrolimus and diarrhea were found to affect
C
min
s of tablets, while age, gender, and BMI were found to be correlated with
C
min
s of injections. IFD breakthrough occurred in 9.2% of patients with a median
C
min
s of 0.74 mg/L for prophylaxis, and infection progression occurred in 43.2% of patients with a median
C
min
s of 0.97 mg/L for treatment, respectively. Transaminitis was the most common adverse event. Posaconazole delayed-release tablets and injections are safe for prophylaxis and treatment of IFD in pediatric patients. An empirical initial dose of 6.0 mg/kg of body weight/day is appropriate for prophylaxis, while a higher dose should be required for the treatment of IFD. It is necessary to adjust the dose regimen according to the results of therapeutic drug monitoring.

This study is registered with
chictr.gov.cn
under identifier ChiCTR2300070008.
In vivo
emergence of resistance to ceftazidime/avibactam through modification of chromosomal AmpC β-lactamase in
Klebsiella aerogenes
Authors: Rodríguez-Pallares Salud , Blanco-Martín Tania , Lence Emilio , Aja-Macaya Pablo , Sánchez-Peña Lucía , González-Pinto Lucía , Rodríguez-Mayo María , Fernández-González Ana , Galán-Sánchez Fátima , Beceiro Alejandro , González-Bello Concepción , Bou Germán , Arca-Suárez Jorge 
Published: November 2024

ABSTRACT

We describe the
in vivo
emergence of resistance to ceftazidime/avibactam via modification of AmpC in a clinical
Klebsiella aerogenes
isolate during therapy with this combination. Paired ceftazidime/avibactam-susceptible/resistant isolates were obtained before and during ceftazidime/avibactam treatment. Whole genome sequencing revealed a differential mutation in AmpC (R148W) in the ceftazidime/avibactam-resistant isolate. Molecular cloning and structural studies confirmed the impact of this substitution, which affects the architecture of the H10 helix, on the evolved resistant phenotype.
Does strain-level persistence of lactobacilli in long-term back-slopped sourdoughs inform on domestication of food-fermenting lactic acid bacteria?
Authors: Pham Vi D. , Xu Zhaohui S. , Simpson David J. , Zhang Justina S. , Gänzle Michael G. 
Published: November 2024

ABSTRACT

Sourdoughs are maintained by back-slopping over long time periods. To determine strain-level persistence of bacteria, we characterized four sourdoughs from bakeries over a period of 3.3, 11.0, 18.0, and 19.0 years. One sourdough included isolates of
Levilactobacillus
spp. and
Fructilactobacillus
spp. that differed by fewer than 10 single-nucleotide polymorphisms (SNPs) from the isolates obtained 3.3 years earlier and thus likely represent the same strain. Isolates of
Levilactobacillus parabrevis
differed by 200–300 SNPs; their genomes were under positive selection, indicating transmission from an external source. In two other sourdoughs, isolates of
Fructilactobacillus sanfranciscensis
that were obtained 11 and 18 years apart differed by 19 and 29 SNPs, respectively, again indicating repeated isolation of the same strain. The isolate of
Fl. sanfranciscensis
from the fourth sourdough differed by 45 SNPs from the isolate obtained 19 years previously. We thus identified strain-level persistence in three out of four long-term back-slopped sourdoughs, making it possible that strains persisted over periods that are long enough to allow bacterial speciation and domestication.

IMPORTANCE
The assembly of microbial communities in sourdough is shaped by dispersal and selection. Speciation and domestication of fermentation microbes in back-slopped food fermentations have been documented for food-fermenting fungi including sourdough yeasts but not for bacteria, which evolve at a slower rate. Bacterial speciation in food fermentations requires strain-level persistence of fermentation microbes over hundreds or thousands of years. By documenting strain-level persistence in three out of four sourdoughs over a period of up to 18 years, we demonstrate that persistence over hundreds or thousands of years is possible, if not likely. We thus not only open a new perspective on fermentation control in bakeries but also support the possibility that all humans, despite their cultural diversity, share the same fermentation microbes.
Prostate Cancer Knowledge and Attitude Toward Screening Practices Among Men 40 and Over in the Jazan Region, Saudi Arabia
Authors: Elyas Anas , Mahfouz Mohamed Salih , Suwaydi Abdulkarim Zain Ahmed , Alotayf Osama Ali , Tayri Abdullah Omar , Daghriri Bandar Fahad , Daghreeri Abdulrahman Abdu , Hattan Faisal Ahmed , Akkam Mohammed Maqbul 
Published: November 2024

Background: Prostate cancer (PCa) is the second most prevalent malignancy among males and ranks as the fifth primary cause of mortality worldwide, underscoring its substantial impact on public health. Notably, there is a lack of research focused on PCa within the context of Saudi Arabia. Consequently, this study endeavours to elucidate the knowledge, attitudes, and screening practices related to PCa among males in Jazan, Saudi Arabia.Methodology: A cross‐sectional survey was carried out on males over 40 years old in the Jazan region of Saudi Arabia between December 2022 and March 2023. The survey used a web‐based questionnaire containing questions about sociodemographic characteristics, PCa knowledge, and attitudes toward screening practices. Descriptive and inferential statistical analysis evaluated the participants’ knowledge and attitudes toward PCa screening.Results: Out of the 468 male participants aged over 40 years, approximately 44% demonstrated limited awareness about PCa. Intriguingly, 60.3% of participants showed a positive attitude toward PCa screening. Moreover, 35.7% reported consulting a urologist for screening purposes. Furthermore, 25.6% had undergone a prostate‐specific antigen (PSA) test, with the predominant rationale (25.8%) being medical advice. Multivariate analysis revealed that being married (adjusted odds ratio (AOR) = 4.5, p = 0.011) and having a family history of PCa (AOR = 4.6, p = 0.001) were significant predictors of heightened PCa awareness. Concurrently, a history of PCa (AOR = 6.8, p = 0.001) and holding a postgraduate qualification (AOR = 5.5, p = 0.024) emerged as significant determinants of proactive practices toward PCa.Conclusion: The results revealed a significant lack of knowledge regarding PCa and the screening practices associated with it among the study participants. These results emphasize the urgent need to provide men with comprehensive information about the benefits and limitations of PCa screening in order to enable them to make more informed decisions.
Translation and Cross‐Cultural Adaptation of the Toronto Extremity Salvage Score (TESS) for Latin American Spanish–Speaking Patients With Limb Sarcoma
Authors: Ceballos Oscar , Cabrolier Jorge , Chehade Begoña , Hardoy Francisco , Cortes Francisco , Tolosa Ricardo , Wevar Orlando 
Published: November 2024

Background and Objectives: This study aims to translate and culturally adapt the Toronto Extremity Salvage Score (TESS) for Latin American Spanish–speaking patients, enhancing the tool’s accessibility for evaluating postsurgical functional outcomes in sarcoma patients across Latin America.Methods: The TESS questionnaires for lower extremity (LE) and upper extremity (UE) were translated and adapted following international guidelines. The process included forward and backward translation, expert committee review, and pretesting with cognitive interviewing. Patients treated for bone or soft tissue tumors in LE or UE were recruited to complete the adapted questionnaires. Test–retest reliability was evaluated by having participants complete the questionnaire again 2 weeks after the initial assessment.Results: A total of 89 participants completed the questionnaires. The study found high internal consistency, with Cronbach’s alpha values reaching 0.9437 for LE and 0.9402 for UE. An agreement rate of 98.4% for the global score of TESS‐LE (95% confidence interval [CI]: 0.909–1.059) and 93.9% for TESS‐UE (95% CI: 0.882–0.995) was observed, demonstrating strong test–retest reliability.Conclusions: The Latin American Spanish version of TESS for both lower and upper extremities is a reliable and culturally appropriate tool for assessing physical function in limb sarcoma patients. Further validation across diverse Latin American populations is encouraged to strengthen its broad applicability.
Tocqueville: sobre a erosão do solo social e político democrático
Authors: Reis Helena Esser dos 
Published: November 2024

Tocqueville considera que formas autoritárias de governo podem encontrar apoio entre os cidadãos dos “tempos democráticos”. Argumenta que a erosão das condições sociais e políticas não é fruto de uma ação opressiva externa, mas algo que atravessa as relações sociais e políticas. Mantendo formalmente, ou em aparência, certas condições de igualdade e liberdade, que se coadunam aos interesses dos indivíduos, a própria democracia pode abrir espaço para o surgimento de diversas formas de desigualdade e a opressão. Com base no autor, propomos discutir esse fenômeno que tende a fazer emergir desde dentro da própria democracia formas sociais e políticas violadoras.
Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy
Authors: Otsuki Hisao , Takahashi Kuniaki , Zimmermann Frederik M. , Mavromatis Kreton , Aminian Adel , Jagic Nikola , Dambrink Jan-Henk E. , Kala Petr , MacCarthy Philip , Witt Nils , Kobayashi Yuhei , Takahashi Tatsunori , Woo Y. Joseph , Yeung Alan C. , De Bruyne Bernard , Pijls Nico H.J. , Fearon William F. ,   on behalf of the FAME 3 Trial Investigators
Published: November 2024

BACKGROUND:
The clinical impact of a chronic total occlusion (CTO) in patients with 3-vessel coronary artery disease undergoing fractional flow reserve–guided percutaneous coronary intervention (PCI) with current-generation drug-eluting stents or coronary artery bypass grafting (CABG) is unclear.

METHODS:
The FAME 3 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation 3) compared fractional flow reserve–guided PCI with CABG in patients with 3-vessel coronary artery disease. The primary end point was major adverse cardiac and cerebrovascular events, a composite of death, myocardial infarction, stroke, or repeat revascularization at 1 year. In this substudy, the 3-year outcomes were analyzed in patients with or without a CTO.

RESULTS:

Of the patients randomized to PCI or CABG in the FAME 3 trial, 305 (21%) had a CTO. In the PCI arm, revascularization of the CTO was attempted in 61% with a procedural success rate of 88%. The incidence of major adverse cardiac and cerebrovascular events at 3 years was not significantly different between those with or without a CTO in both the PCI (15.2% versus 20.1%; adjusted hazard ratio, 0.62 [95% CI, 0.38–1.03];
P
=0.07) and the CABG (13.0% versus 12.9%; adjusted hazard ratio, 0.96 [95% CI, 0.55–1.66];
P
=0.88) arms. In those without a CTO, PCI was associated with a significantly higher risk of major adverse cardiac and cerebrovascular events compared with CABG (adjusted hazard ratio, 1.61 [95% CI, 1.20–2.17];
P
<0.01) but not in those with a CTO (adjusted hazard ratio, 1.21 [95% CI, 0.64–2.28];
P
=0.56;
P
interaction
=0.31).

CONCLUSIONS:
The presence of a CTO did not significantly impact the treatment effect of PCI versus CABG at 3 years in patients with 3-vessel coronary artery disease.

CLINICAL TRIAL REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02100722.
Risk of Major Adverse Cardiovascular Outcomes in Families With MASLD: A Population-Based Multigenerational Cohort Study
Authors: Ebrahimi Fahim , Ebrahimi Ramin , Hagström Hannes , Sundström Johan , Sun Jiangwei , Bergman David , Forss Anders , Ludvigsson Jonas F. 
Published: November 2024

BACKGROUND:
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a risk factor for cardiovascular disease. However, whether family members of individuals with MASLD also share an increased cardiovascular risk is unknown.

METHODS:
We created a nationwide multigenerational cohort study identifying all family members of Swedish adults diagnosed with biopsy-proven MASLD (1969−2017) and of matched general population comparators (by age, sex, calendar year, and county of residence). We calculated incidence rates and used Cox models to calculate adjusted hazard ratios (aHRs) and 95% CIs for incident major adverse cardiovascular events (MACE), including acute myocardial infarction, stroke, hospitalization for heart failure, or cardiovascular death. Cox models were adjusted for education, country of birth, diabetes, hypertension, obesity, dyslipidemia, chronic kidney disease, chronic obstructive pulmonary disease, and the Charlson comorbidity index.

RESULTS:

We identified 22 267 MASLD first-degree relatives (FDRs; parents, siblings, and offspring) and 5687 MASLD spouses, as well as 118 056 comparator FDRs and 29 389 comparator spouses without earlier cardiovascular disease. Overall, the mean age was 41.8 years (SD, 18.0), and 51.5% were females. Over a median of 24.6 years, the incidence rate for MACE was higher in MASLD FDRs than in comparator FDRs (65.0 versus 62.5/10 000 person-years; aHR, 1.06 [95% CI, 1.01−1.11]). MASLD FDRs had higher rates of acute myocardial infarction (23.0 versus 20.9/10 000 person-years; aHR, 1.09 [95% CI, 1.01−1.18]) and cardiovascular death (aHR, 1.09 [95% CI, 1.01−1.18]). Across generations of FDRs, the risk of MACE was uniformly increased with no differences by relationship (ie, parents, siblings, and offspring;
P
interaction
>0.05). MASLD spouses were also at an increased risk of MACE (117.6 versus 103.5/10 000 person-years; aHR, 1.09 [95% CI, 1.01−1.18]).

CONCLUSIONS:
First-degree relatives of individuals with biopsy-proven MASLD are at slightly higher risk of incident MACE, but absolute risks do not support early screening for cardiovascular disease. Shared lifestyle factors may be the main contributors, as spouses of MASLD patients also had higher risks of MACE.
Stakeholder Perspectives on a Heart Failure With Reduced Ejection Fraction Polypill: A Multi-Center Mixed Methods Study
Authors: Chen Justin C. , DeJong Colette , Agarwal Mansi , Hairston Amaris M. , Durstenfeld Matthew S. , McKay Virginia , Huffman Mark D. , Hsue Priscilla Y. , Agarwal Anubha 
Published: November 2024

BACKGROUND:
A polypill containing all 4 classes of guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF) has been proposed to change the heart failure treatment paradigm. The acceptability, appropriateness, and feasibility of a HFrEF polypill-based strategy are unknown. The purpose of this study was to elicit patients’ and providers’ priorities in the design of HFrEF polypills.

METHODS:
From April 2023 to December 2023, we conducted a convergent parallel mixed-methods study at Washington University in St. Louis, the University of California, San Francisco, and the American College of Cardiology. We administered physician surveys containing adapted implementation outcome measures to elicit physicians’ perspectives on the acceptability, feasibility, and appropriateness of a HFrEF polypill (Likert scale ranging from 1 [low] to 5 [high]). We used a purposive sampling frame to select patients and physicians for in-depth interviews. Using semi-structured interview guides, we elicited participants’ perspectives on current HFrEF care, HFrEF polypill design, and supportive strategies. The Consolidated Framework for Implementation Research v2.0 guided thematic analysis.

RESULTS:
Of the 214 survey respondents across the United States, physicians agreed that HFrEF polypills are highly acceptable (mean [SD], 4.2 [0.7]), highly appropriate (4.1 [0.8]), and highly feasible (4.1 [0.7]). Key themes from 9 patient and 22 provider interviews included the following: (1) current determinants of HFrEF care, including medication adherence, variations in clinical practice, and health care access, (2) provider-level differences in preferred HFrEF polypill design, (3) cost and equity considerations in the implementation of HFrEF polypills, and (4) research priorities for evaluating polypill effectiveness and implementation.

CONCLUSIONS:
A HFrEF polypill-based strategy was viewed as highly acceptable, appropriate, and feasible by patients and physicians. Participants described key priorities in HFrEF polypill design, titratability, and potential impacts on health equity that will directly inform future randomized controlled trials.