bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive evaluation of multi-energy complementary ecosystem based on improved multicriteria decision-making method
Authors: Shuyi Huang , Xuetong Zou , Huaguang Liang , Jie Chen 
Published: January 2024

Abstract
The multi-energy complementary ecosystem is an important form of the modern energy system. However, standardized evaluation criteria and the corresponding method framework have not yet been formed, resulting in unclear standards and irregular processes of its construction. To cope with this issue, a novel comprehensive evaluation framework for multi-energy complementary ecosystems is proposed in this study. First, a 5D comprehensive evaluation criteria system, including environment, economy, technology, safety and systematicness, is constructed. Then, a novel multicriteria decision-making model integrating an analytic network process, entropy and preference-ranking organization method for enrichment evaluation under an intuitional fuzzy environment is proposed. Finally, four practical cases are used for model testing and empirical analysis. The results of the research show that the unit cost of the energy supply and the internal rate of return indexes have the highest weights of 0.142 and 0.010, respectively. It means that they are the focus in the construction of a multi-energy complementary ecosystem. The net flows of four cases are 0.015, 0.123, –0.132 and –0.005, indicating that cases with a variety of energy supply forms and using intelligent management and control platforms to achieve cold, heat and electrical coupling have more advantages.
Numerical modelling and simulation analysis of wind blades: a critical review
Authors: Alrowwad Ibrahim , Wang Xiaojia , Zhou Ningling 
Published: January 2024

AbstractWind energy has emerged as a promising renewable energy source and wind turbine technology has developed rapidly in recent years. Improved wind turbine performance depends heavily on the design and optimization of wind blades. This work offers a critical evaluation of the state of the art in the field of numerical modelling and simulation analysis, which have become crucial for the design and optimization of wind blades. The evaluation of the literature includes considerable research on the application of numerical methods for the structural and aerodynamic performance of wind blades under various operating situations, as well as for analysis and optimization of wind blades. The article illustrates how numerical techniques can be used to analyse wind blade performance and maximize design efficiency. The study of blade performance under various wind conditions has also been made possible through the use of simulation analysis, thus enhancing the efficiency and dependability of wind turbines. Improvements in wind turbine efficiency and dependability, and ultimately the move towards a more sustainable energy future, will be greatly helpful for the development of numerical modelling and simulation techniques.
Energy potential assessment and techno–economic analysis of micro hydro–photovoltaic hybrid system in Goda Warke village, Ethiopia
Authors: Feyissa Ephrem Assefa , Tibba Getachew Shunki , Binchebo Tarekegn Limore , Bekele Endeshaw Alemu , Kole Adem Tibesso 
Published: January 2024

Abstract
Rural Ethiopia has significant untapped potential for hydro and solar energy generation systems. However, challenges arise from seasonal variations and unfavourable topographic positions of flowing rivers, hindering the efficient exploitation of these resources. Despite the country’s abundance in hydro and solar energy resources, &gt;75% of the population still lack access to electricity from the national grid. This work deals with energy resource potential assessment and techno–economic analysis of micro hydro–photovoltaic (PV) hybrid systems, considered in the case study of Goda Warke village, located in the Yaya Gulele district. A novel framework is proposed that utilizes the Natural Resource Soil Conservation Service curve number method to assess the energy potential of micro-hydro energy in ungauged basins, specifically at the exit point of the Girar River basin catchment. The average monthly flow rate in the basin is 0.975 m3/s, while the area exhibits a solar radiation potential of 5.39 kWh/m2/day. Energy policy promotes expanding access to modern energy sources and utilization of indigenous energy resources. Simulation results indicate that the hydro/PV/diesel generator (DG)/battery and hydro/PV/battery systems are the most optimal choices based on net present cost, with the inclusion of a DG for economic comparison. Micro-hydro energy covers most of the electric load in the area, achieving a capacity factor of 47.5%. The cost of energy and net present cost were found to be sensitive to variables such as the price of diesel fuel, pipe head loss, and the growth of the village load. The optimized system demonstrated a hydro energy potential of 1405.37 MWh/year and a PV energy output of 274.04 MWh/year, resulting in a levelized cost of energy of 0.0057 and 0.049 $/kWh for the hydro and PV components, respectively.
Explainable machine learning using echocardiography to improve risk prediction in patients with chronic coronary syndrome
Authors: Molenaar Mitchel A , Bouma Berto J , Asselbergs Folkert W , Verouden Niels J , Selder Jasper L , Chamuleau Steven A J , Schuuring Mark J 
Published: January 2024

AbstractAimsThe European Society of Cardiology guidelines recommend risk stratification with limited clinical parameters such as left ventricular (LV) function in patients with chronic coronary syndrome (CCS). Machine learning (ML) methods enable an analysis of complex datasets including transthoracic echocardiography (TTE) studies. We aimed to evaluate the accuracy of ML using clinical and TTE data to predict all-cause 5-year mortality in patients with CCS and to compare its performance with traditional risk stratification scores.Methods and resultsData of consecutive patients with CCS were retrospectively collected if they attended the outpatient clinic of Amsterdam UMC location AMC between 2015 and 2017 and had a TTE assessment of the LV function. An eXtreme Gradient Boosting (XGBoost) model was trained to predict all-cause 5-year mortality. The performance of this ML model was evaluated using data from the Amsterdam UMC location VUmc and compared with the reference standard of traditional risk scores. A total of 1253 patients (775 training set and 478 testing set) were included, of which 176 patients (105 training set and 71 testing set) died during the 5-year follow-up period. The ML model demonstrated a superior performance [area under the receiver operating characteristic curve (AUC) 0.79] compared with traditional risk stratification tools (AUC 0.62–0.76) and showed good external performance. The most important TTE risk predictors included in the ML model were LV dysfunction and significant tricuspid regurgitation.ConclusionThis study demonstrates that an explainable ML model using TTE and clinical data can accurately identify high-risk CCS patients, with a prognostic value superior to traditional risk scores.
Immunoinformatics assisted design of a multi-epitope kit for detecting Cronobacter sakazakii in powdered infant formula
Authors: Oladipo Elijah K , Obisanya Olukayode I , Owoeye Victoria O , Shittu Oyinlola G , Adamitonde Mautin G , Ikwuka Emmanuel C , Ojewale Solomon O , Tijani Adewale J , Adedokun Feranmi A , Adedokun Amudatu A , Oyedepo Temitope A , Onyeaka Helen 
Published: January 2024

Abstract

Objectives
Cronobacter sakazakii, formerly Enterobacter sakazakii, is an emerging ubiquitous and opportunistic foodborne pathogen with a high mortality rate. It has been implicated in cases of meningitis, septicaemia, and necrotizing enterocolitis among infants worldwide in association with powdered infant formula (PIF). This study was an insilico designed peptide base kit framework, using immunoinformatic techniques for quick detection of C. sakazakii in PIF.

Materials and Methods
In the present study, a peptide-based kit was designed with a bioinformatic technique to rapidly identify C. sakazakii in PIF using flhE, secY, and bcsC, which are genes responsible for its biofilm formation, as target genes. The antigenicity, membrane topology, and the presence of signal peptides of the target genes were analysed using VaxiJen, DeepTMHMM, and SignalP servers. To provide stability and flexibility to the multiple-epitope construct, the linear B cells and helper T cells (IL-4 (interleukin 4) and IL-10 (interleukin 10) inducing epitopes) were linked with a GSGSG linker followed by the addition of protein disulphide bonds. To ascertain specificity, the multi-epitope construct was molecularly docked against genes from sources other than PIF, like alfalfa, and the environment, with PIF being the highest: –328.48. Finally, the codons were modified using the pET28a(+) vector, and the resultant multi-epitope construct was successfully cloned in silico.

Results
The final construct had a length of 486 bp, an instability index of 23.26, a theoretical pI of 9.34, a molecular weight of 16.5 kDa, and a Z-score of –3.41.

Conclusions
The multi-epitope peptide construct could be a conceptual framework for creating a C. sakazakii peptide-based detection kit, which has the potential to provide fast and efficient detection. However, there is a need for additional validation through the in vitro and in vivo techniques.
Association between piperacillin/tazobactam use and acute kidney injury in critically ill patients: a retrospective multicentre cohort study
Authors: Tomazini Bruno Martins , Besen Bruno Adler Maccagnan Pinheiro , Taniguchi Leandro Utino , Zampieri Fernando Godinho , Cavalcanti Alexandre Biasi 
Published: January 2024

Abstract

Background
Piperacillin/tazobactam is one of the most common antibiotics prescribed in the ICU and the combination of piperacillin/tazobactam with vancomycin has been associated with acute kidney injury (AKI) in critically ill patients. However, data on the risk of AKI with piperacillin/tazobactam, despite vancomycin co-exposure, are lacking.

Objectives
To investigate the association of piperacillin/tazobactam with AKI and renal replacement therapy (RRT) among adult ICU patients.

Methods
We analysed data from patients included in two open access databases (MIMIC-IV and eICU). Critically ill patients who received piperacillin/tazobactam or cefepime (a cephalosporin with similar broad-spectrum activity to piperacillin/tazobactam) during their first ICU stay were eligible for the study. Marginal structural Cox models, accounting for time-fixed covariates and time-dependent covariates were performed. The primary outcomes were AKI and need of RRT.

Results
A total of 20 107 patients were included, with 11 213 in the piperacillin/tazobactam group and 8894 in the cefepime group. Exposure to piperacillin/tazobactam was associated with AKI (HR 1.77; 95% CI 1.51–2.07; P &lt; 0.001) and with need of RRT (HR 1.31; 95% CI 1.08–1.57; P = 0.005). Tests for interaction were not statistically significant for occurrence of AKI and RRT in the subgroup of patients exposed to vancomycin or not (P = 0.26 and P = 0.6, respectively).

Conclusions
In critically ill patients, exposure to piperacillin/tazobactam was associated with increased risk of AKI and with increased risk of RRT, regardless of combination therapy with vancomycin.
Association of piperacillin and vancomycin exposure on acute kidney injury during combination therapy
Authors: Venugopalan Veena , Maranchick Nicole , Hanai Devorah , Hernandez Yaima Jimenez , Joseph Yuliya , Gore Amanda , Desear Kathryn , Peloquin Charles , Neely Michael , Felton Timothy , Shoulders Bethany , Alshaer Mohammad 
Published: January 2024

Abstract

Objectives
Acute kidney injury (AKI) is a well-documented adverse effect observed with piperacillin/tazobactam in combination with vancomycin. The pharmacokinetics of these antibiotics when given in combination have not been previously evaluated. The purpose of this study was to compare the exposure of vancomycin + piperacillin/tazobactam in patients with and without AKI.

Methods
Ninety adult patients, who received at least 72 h of vancomycin + piperacillin/tazobactam combination therapy and had available serum concentrations of vancomycin and piperacillin were included in the study. Nephrotoxicity was defined as a 1.5-fold increase in serum creatinine within 7 days from baseline. Median daily AUCs were calculated in those with nephrotoxicity (vancomycin + piperacillin/tazobactam ‘N’) versus those without nephrotoxicity (vancomycin + piperacillin/tazobactam ‘WN’) during the first 7 days of combination therapy.

Results
The overall incidence of AKI in those receiving vancomycin + piperacillin/tazobactam was 20% (18/90). The median daily vancomycin AUCs did not differ between the vancomycin + piperacillin/tazobactam ‘WN’ and vancomycin + piperacillin/tazobactam ‘N’ groups. Although not statistically significant, the median daily vancomycin AUCs in the vancomycin + piperacillin/tazobactam ‘N’ group were numerically greater on Day 5 and trended downwards thereafter. For the piperacillin group, the median daily AUCs did not vary between groups, except on Day 7 where the vancomycin + piperacillin/tazobactam ‘WN’ group had statistically greater median piperacillin AUC than the vancomycin + piperacillin/tazobactam ‘N’ group (P = 0.046).

Conclusions
Utilizing serum creatinine-defined AKI, our study did not find any significant differences in vancomycin and piperacillin/tazobactam exposure between the groups with and without nephrotoxicity. These data indicate that vancomycin + piperacillin/tazobactam should not be avoided due to the risk of overexposure; instead, clinicians should continue to use these therapies cautiously.
Implementing the WHO AWaRe antibiotic book guidance in lower-resource settings: the case of the Lao PDR
Authors: Chansamouth Vilada , Inlorkham Phouthavanh , Keohavong Bounxou , Bellingham Khonsavath , van Doorn H Rogier , Mayxay Mayfong , Newton Paul N , Turner Paul , Day Nicholas P J , Ashley Elizabeth A 
Published: January 2024

Abstract
In 2022, WHO released the WHO AWaRe (Access, Watch, Reserve) antibiotic book to promote the rational use of antibiotics. Here, we review the AWaRe antibiotic book from the perspective of implementation in low-resource settings, using the Lao PDR (Laos) as a case study. Not all recommendations in the AWaRe antibiotic book match the epidemiology of infectious diseases and antimicrobial susceptibility patterns in Laos and other low- and middle-income countries (LMICs), e.g. melioidosis, rickettsial disease and leptospirosis are common causes of sepsis and febrile illness in Laos but do not feature in the AWaRe book. Conversely, some infectious diseases like Clostridioides difficile-associated diarrhoea are in the AWaRe antibiotic book but rarely considered in Laos with no diagnostic tests available. Only 29/39 antibiotics in the AWaRe book are available in Laos, with no Reserve group antimicrobials available. The AWaRe book stimulates countries such as Laos to consider alternative diagnoses and include additional antimicrobials in the national essential medicines list (NEML). However, it should be updated to include regional important pathogens that are not included. Comprehensive antibiotic use guidelines alone might not assure appropriate use or control overuse of antibiotics. Access to antibiotics is challenging in low-resource settings in terms of unavailability in the country (low demand or small market size), patchy access, especially for those living in remote areas, and unaffordability. All these systemic factors can contribute to inappropriate use of antibiotics. Improved access to antibiotics, strengthening diagnostic capacity and promoting antibiotic stewardship should be combined.
A single-institution retrospective exploratory analysis on the effectiveness and safety of lenvatinib plus pembrolizumab for advanced endometrial cancer: insights from ProMisE molecular classification system
Authors: Chiba Yohei , Kagabu Masahiro , Osakabe Mitsumasa , Ito Rikako , Sato Sho , Takatori Eriko , Kaido Yoshitaka , Nagasawa Takayuki , Shoji Tadahiro , Yanagawa Naoki , Baba Tsukasa 
Published: January 2024

Abstract

Background
The Proactive Molecular Risk Classifier for Endometrial Cancer has identified four risk groups for the prognosis of endometrial cancer. Lenvatinib plus pembrolizumab was recently approved as a second-line treatment for unresectable endometrial cancer, but reports in clinical practice are lacking. The relationship between the efficacy of lenvatinib/pembrolizumab and Proactive Molecular Risk Classifier for Endometrial Cancer classification is unclear.

Methods
This single-centre retrospective study included patients who underwent lenvatinib/pembrolizumab therapy at Iwate Medical University Hospital between January 2022 and March 2023. Formalin-fixed paraffin-embedded specimens obtained from patients before treatment were collected and classified into the mismatch repair-deficient, p53 abnormal and no specific molecular profile subtypes using immunohistochemistry. The response rate, progression-free survival and adverse events were evaluated using electronic medical records. The study was approved by the hospital’s ethics committee (approval number: MH2022-093).

Results
This study enrolled 20 patients, who underwent a median follow-up of 17.8 months (95% confidence interval: 16.6–18.9). The best overall response rate was 60.0% (36.1–80.9), and the median progression-free survival was 11.6 months (2.9–20.3). The median progression-free survival in the p53 abnormal group (n = 9) was 3.4 months (3.0–3.8); however, progression-free survival did not reach the median (P &lt; 0.001) in the mismatch repair-deficient/no specific molecular profile group (n = 11). Symptomatic immune-related adverse events (except hypothyroidism) occurred in 4/20 (25.0%) patients, and partial responses were observed in all cases. No treatment-related deaths occurred.

Conclusion
The p53abn group in the Proactive Molecular Risk Classifier for Endometrial Cancer classification has a poor prognosis even after treatment with lenvatinib/pembrolizumab.
Real-world outcomes of nivolumab plus ipilimumab combination therapy for advanced renal cell carcinoma in Japanese patients: data with a minimum of 3 years of follow-up
Authors: Ishihara Hiroki , Yuki Nemoto , Ishiyama Ryo , Ikeda Takashi , Kobari Yuki , Fukuda Hironori , Yoshida Kazuhiko , Shimmura Hiroaki , Hashimoto Yasunobu , Iizuka Junpei , Kondo Tsunenori , Takagi Toshio 
Published: January 2024

Abstract

Background
Long-term follow-up data regarding treatment outcomes of nivolumab plus ipilimumab combination therapy for advanced renal cell carcinoma as a first-line therapy are limited in real-world Japanese populations.

Methods
We retrospectively evaluated data of 56 advanced renal cell carcinoma patients treated with nivolumab plus ipilimumab, with a follow-up of at least 3 years. Survival, tumour response and adverse event profiles were assessed.

Results
A total of 41 patients (73%) were histopathologically diagnosed with clear-cell renal cell carcinoma, and 34 (61%) were categorized into the International Metastatic renal cell carcinoma Database Consortium intermediate-risk group. The median follow-up period was 34.4 months. Regarding an effectiveness profile, median progression-free survival, time to treatment failure and overall survival were 9.01, 12.5 and 49.0 months, respectively. Objective response was observed in 27 patients (48%), including eight patients with complete response (14%), and the median duration of response was 30.8 months. Multivariate analyses showed that clear-cell histology was an independent factor of longer overall survival (hazard ratio: 0.23, P = 0.0013). Regarding safety profiles, adverse events of any grade and those with grade ≥3 developed in 40 (71%) and 25 patients (45%), respectively. Median time to adverse event development was 1.68 months. Treatment was interrupted in 28 patients (50%), and corticosteroid administration was needed in 25 (45%).

Conclusion
The 3-year follow-up data showed that nivolumab plus ipilimumab combination therapy exhibited a feasible effectiveness in real-world Japanese patients with advanced renal cell carcinoma. Accordingly, the high risk of adverse event development, which often requires treatment withdrawal and corticosteroid administration, should be considered.
Invasive cervical cancer incidence following bivalent human papillomavirus vaccination: a population-based observational study of age at immunization, dose, and deprivation
Authors: Palmer Tim J , Kavanagh Kimberley , Cuschieri Kate , Cameron Ross , Graham Catriona , Wilson Allan , Roy Kirsty 
Published: January 2024

Abstract

Background
High-risk human papillomavirus causes cervical cancer. Vaccines have been developed that significantly reduce the incidence of preinvasive and invasive disease. This population-based observational study used linked screening, immunization, and cancer registry data from Scotland to assess the influence of age, number of doses, and deprivation on the incidence of invasive disease following administration of the bivalent vaccine.

Methods
Data for women born between January 1, 1988, and June 5, 1996, were extracted from the Scottish cervical cancer screening system in July 2020 and linked to cancer registry, immunization, and deprivation data. Incidence of invasive cervical cancer per 100 000 person-years and vaccine effectiveness were correlated with vaccination status, age at vaccination, and deprivation; Kaplan Meier curves were calculated.

Results
No cases of invasive cancer were recorded in women immunized at 12 or 13 years of age irrespective of the number of doses. Women vaccinated at 14 to 22 years of age and given 3 doses of the bivalent vaccine showed a significant reduction in incidence compared with all unvaccinated women (3.2/100 000 [95% confidence interval (CI) = 2.1 to 4.6] vs 8.4 [95% CI = 7.2 to 9.6]). Unadjusted incidence was significantly higher in women from most deprived (Scottish Index of Multiple Deprivation 1) than least deprived (Scottish Index of Multiple Deprivation 5) areas (10.1/100 000 [95% CI = 7.8 to 12.8] vs 3.9 [95% CI = 2.6 to 5.7]). Women from the most deprived areas showed a significant reduction in incidence following 3 doses of vaccine (13.1/100 000 [95% CI = 9.95 to 16.9] vs 2.29 [95% CI = 0.62 to 5.86]).

Conclusion
Our findings confirm that the bivalent vaccine prevents the development of invasive cervical cancer and that even 1 or 2 doses 1 month apart confer benefit if given at 12-13 years of age. At older ages, 3 doses are required for statistically significant vaccine effectiveness. Women from more deprived areas benefit more from vaccination than those from less deprived areas.