bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Upstream Unsteadiness on the Unstarting of a Supersonic Inlet Turbine
Authors: Mushtaq Noraiz , Gaetani Paolo 
Published: November 2023

Abstract
A 15% increase in thermal efficiency at medium pressure ratios is promised by rotating detonation engine technology over conventional Joule–Bryton cycles. A supersonic inlet turbine is a viable option to extract substantial work from the highly fluctuating and supersonic flow delivered by the detonating combustor. However, an additional unstarting mechanism based on the generation of a collective shock from the coalescence of leading-edge bow-shock waves further restricts the available design space. First, the effect of unsteady inlet conditions with variable frequency, amplitude, and mean value on collective shock generation is investigated. Then, a fast and cost-effective tool was developed and verified to predict bow-shock wave motion from a prescribed inlet Mach trend; the parameters of the transfer function were estimated with a classical identification method based on a step-response computational fluid dynamics (CFD) simulation. The model was employed to rapidly calculate the maximum amplitude of fluctuations accepted by the supersonic blade row for each frequency and average inlet Mach number. Finally, the influence of the inlet geometric angle, pitch to leading-edge thickness ratio, and static temperature on the model parameters is studied. The preliminary observations of the parametric analysis were confirmed by the rigorous quantitative approach of a global sensitivity analysis based on Sobol sensitivity indices.
Fulminant amoebic colitis co-infection in a patient with COVID-19
Authors: Gandhi Jignesh , Awasthi Alpana Arunkumar , Banker Amay 
Published: November 2023

A woman in her 80s who presented with sudden abdominal pain and bloody stool associated with fever, dry cough and malaise, was found to be COVID-19 RT-PCR positive with fulminating necrotising amoebic colitis. She underwent right extended hemicolectomy with ileostomy and survived despite an unpredictable post-operative course, the need for aggressive intensive care and other major risk factors, and was discharged home after the twentieth day of her presentation.This case summarises the survival of a geriatric patient diagnosed with two lethal complications - amoebic colitis and COVID-19 respiratory infection with the aid of prompt surgical intervention and appropriate critical care.
Practical multidisciplinary framework for the assessment and management of patients with unexplained chronic aerodigestive symptoms
Authors: Quigley Nathan , Mistry Sandeep G , Vasant Dipesh H , Vasani Sarju 
Published: November 2023

ObjectivePatients experiencing unexplained chronic throat symptoms (UCTS) are frequently referred to gastroenterology and otolaryngology outpatient departments for investigation. Often despite extensive investigations, an identifiable structural abnormality to account for the symptoms is not found. The objective of this article is to provide a concise appraisal of the evidence-base for current approaches to the assessment and management of UCTS, their clinical outcomes, and related healthcare utilisation.DesignThis multidisciplinary review critically examines the current understanding of aetiological theories and pathophysiological drivers in UCTS and summarises the evidence base underpinning various diagnostic and management approaches.ResultsThe evidence gathered from the review suggests that single-specialty approaches to UCTS inadequately capture the substantial heterogeneity and pervasive overlaps among clinical features and biopsychosocial factors and suggests a more unified approach is needed.ConclusionDrawing on contemporary insights from the gastrointestinal literature for disorders of gut–brain interaction, this article proposes a refreshed interdisciplinary approach characterised by a positive diagnosis framework and patient-centred therapeutic model. The overarching aim of this approach is to improve patient outcomes and foster collaborative research efforts.
Genetically predicted causal associations between periodontitis and psychiatric disorders
Authors: Tong Shuangshuang , Lyu Yanlin , Huang Wentao , Zeng Ruijie , Jiang Rui , Lian Qizhou , Leung Felix W , Sha Weihong , Chen Hao 
Published: November 2023

BackgroundPsychiatric disorders have serious harm to individuals’ lives with high disease burden. Observational studies reported inconsistent associations between periodontitis and some psychiatric disorders, and the causal correlations between them remain unknown.ObjectiveThis study aims to explore the causal associations between periodontitis and psychiatric disorders.MethodsA series of two-sample Mendelian randomisation (MR) analyses were employed using genome-wide association study summary statistics for periodontitis in adults from Gene-Lifestyle Interactions in Dental Endpoints Consortium and 10 psychiatric disorders from Psychiatric Genomics Consortium. Causal effects were primarily estimated using the inverse-variance weighted (IVW) method. Various sensitivity analyses were also conducted to assess the robustness of our results.FindingsThe MR analysis suggested that genetically determined periodontitis was not causally associated with 10 psychiatric disorders (IVW, all p>0.089). Furthermore, the reverse MR analysis revealed that 10 psychiatric disorders had no causal effect on periodontitis (IVW, all p>0.068). We discovered that all the results were consistent in the four MR analytical methods, including the IVW, MR-Egger, weighted median and weighted mode. Besides, we did not identify any heterogeneity or horizontal pleiotropy in the sensitivity analysis.ConclusionsThese results do not support bidirectional causal associations between genetically predicted periodontitis and 10 common psychiatric disorders. Potential confounders might contribute to the previously observed associations.Clinical implicationsOur findings might alleviate the concerns of patients with periodontitis or psychiatric disorders. However, further research was warranted to delve into the intricate relationship between dental health and mental illnesses.
Heart rate: an accessible risk indicator in adult congenital heart disease
Authors: Hendriks Paul M , van den Bosch Annemien E , Kors Jan A , Geenen Laurie W , Baggen Vivan J M , Eindhoven Jannet A , Kauling Robert M , Cuypers Judith A A E , Boersma Eric , Roos-Hesselink Jolien W 
Published: November 2023

BackgroundHigher resting heart rate has been described as a risk factor for adverse outcome in healthy individuals and cardiovascular patients. The aim of this study was to evaluate resting heart rate as risk factor in adult congenital heart disease (ACHD).MethodsIn this prospective observational cohort study, patients with moderate or complex ACHD were included at routine outpatient visit. Standard 12-lead ECGs were obtained in rest. Heart rate was obtained from the ECG automatically by the Modular ECG Analysis System (MEANS). The primary endpoint was all-cause mortality and the secondary endpoint was a composite of all-cause mortality and heart failure. Survival was derived using the Kaplan-Meier estimator. Subgroups based on heart rate tertiles were compared by the log-rank test. Cox proportional hazards models were adjusted for clinical factors including age, sex and diagnosis (moderate vs complex ACHD).ResultsA total of 556 patients were included (median age 32 years (IQR 24–41), 57.6% male). Mean heart rate was 69±13 bpm. Negative chronotropic medication was used by 74 (13.3%) patients. During a median follow-up of 10.1 (IQR 9.6–10.5) years, 36 patients (6.5%) died and 83 (14.9%) reached the secondary endpoint. Patients with higher heart rates had significantly lower survival and heart failure-free survival. After adjusting for clinical factors, heart rate remained associated with mortality (HR 1.57 per 10 bpm, 95% CI 1.26 to 1.96) and mortality or heart failure (HR 1.33 per 10 bpm, 95% CI 1.13 to 1.57).ConclusionHigher heart rate is associated with lower survival and heart failure-free survival in ACHD.
Genotype-guided new approach for dose optimisation of hydroxychloroquine administration in Chinese patients with SLE
Authors: Xie Han , Wen Xin , Wang Yuchun , Huang Xuan , Shu Qing , Wang Dandan , Geng Linyu , Jin Ziyi , Shen Wei , Ge Weihong , Zhu Yizhun , Sun Lingyun 
Published: November 2023

ObjectivesThe study aims to investigate the impact of gene polymorphisms on blood hydroxychloroquine (HCQ) concentrations in patients with SLE and provide guidelines for individualised care.Methods489 Chinese patients with SLE taking HCQ for more than 3 months were collected in this study. The blood HCQ, desethylhydroxychloroquine (DHCQ) and desethylchloroquine concentrations were measured. The optimal blood concentration of HCQ was determined by receiver operating characteristic curve analysis. Single nucleotide polymorphisms of metabolic enzymes involved in HCQ metabolism were genotyped and the associations with treatment effects were investigated.ResultsThe cut-off value of HCQ was 559.67 ng/mL, with sensitivity and specificity values of 0.51 and 0.89, respectively. The TC and CC genotypes of CYP2C8 (rs7910936) were significantly related to the increase in blood HCQ concentrations, and the CYP2C8 (rs10882521) TT genotype was associated with lower blood HCQ concentrations. The DHCQ:HCQ ratio was highest in patients with the GG genotype of the CYP2D6*10 (rs1065852) polymorphism and lowest in those with the AA genotype. Patients with the CYP2C8 (rs7910936) CC genotype were more likely to achieve the optimal blood concentration (p=0.030) in HCQ 200 mg/day group and patients with the CYP2D6*10 (rs1065852) GG genotype were more likely to reach the optimal blood concentration (p=0.049) in 400 mg/day group.ConclusionsOur results suggest that the optimal blood concentration of HCQ measured approximately 12–18 hours after the last dosage may be between 500 and 600 ng/mL in Chinese patients with SLE. The observed variations in HCQ concentrations between individuals can potentially be attributed to genetic polymorphisms in CYP2D6*10 (rs1065852) and CYP2C8 (rs7910936 and rs10882521). Genotypical testing of patients and regular monitoring of blood levels are recommended for optimising HCQ dosage management in Chinese patients with SLE.Trial registration numberChiCTR2300070628.
Involving patients as research partners in research in rheumatology: a literature review in 2023
Authors: Elhai Muriel , Benavent Diego , Aouad Krystel , Studenic Paul , Bertheussen Heidi , Primdahl Jette , Zabalan Codruta , de Wit Maarten , Gossec Laure 
Published: November 2023

ObjectiveThe inclusion of patient research partners (PRPs) in research projects is increasingly recognised and recommended in rheumatology. The level of involvement of PRPs in translational research in rheumatology remains unknown, while in randomised clinical trials (RCTs), it has been reported to be 2% in 2020. Therefore, we aimed to assess the involvement of PRPs in recent translational studies and RCTs in rheumatology.MethodsWe conducted a scoping literature review of the 80 most recent articles (40 translational studies and 40 RCTs) from four target diseases: rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus and lower extremity osteoarthritis. We selected 20 papers from each disease, published up until 1 March 2023, in rheumatology and general scientific journals. In each paper, the extent of PRP involvement was assessed. Analyses were descriptive.ResultsOf 40 translational studies, none reported PRP involvement. Of 40 RCTs, eight studies (20%) reported PRP involvement. These trials were mainly from Europe (75%) and North America (25%). Most of them (75%) were non-industry funded. The type of PRP involvement was reported in six of eight studies: six studies reported PRP participation in the study design or design of the intervention and two of them in the interpretation of the results. All the trials reporting the number of PRPs (75%), involved at least two PRPs.ConclusionDespite a worldwide movement advocating for increased patient involvement in research, PRPs in translational research and RCTs in rheumatology are significantly under-represented. This limited involvement of PRPs in research highlights a persistent gap between the existing recommendations and actual practice.
Development and external validation of a prediction model for venous thromboembolism in systemic lupus erythematosus
Authors: You Hanxiao , Zhao Jiuliang , Zhang Miaojia , Jin Ziyi , Feng Xuebing , Tan Wenfeng , Wu Lijun , Duan Xinwang , Luo Hui , Zhao Cheng , Zhan Feng , Wu Zhenbiao , Li Hongbin , Yang Min , Xu Jian , Wei Wei , Wang Yanhong , Shi Juhong , Qu Jingge , Wang Qian , Leng Xiaomei , Tian Xinping , Zhao Yan , Li Mengtao , Zeng Xiaofeng 
Published: November 2023

ObjectivePatients with systemic lupus erythematosus (SLE) have an increased risk of venous thromboembolism (VTE). We conducted this study to develop a risk score algorithm for VTE in patients with SLE that provides individualised risk estimates.MethodsWe developed a clinical prediction model of VTE in 4502 patients with SLE based on the Chinese SLE Treatment and Research group cohort (CSTAR) from January 2009 to January 2020 and externally validated in 3780 patients with SLE in CSTAR from January 2020 to January 2022. Baseline data were obtained and VTE events were recorded during the follow-up. The prediction model was developed to predict VTE risk within 6 months in patients with SLE, using multivariate logistic regression and least absolute shrinkage and selection operator. SLE-VTE score and nomogram were established according to the model.ResultsA total of 4502 patients included in the development cohort, 135 had VTE events. The final prediction model (SLE-VTE score) included 11 variables: gender, age, body mass index, hyperlipidaemia, hypoalbuminaemia, C reactive protein, anti-β2GPI antibodies, lupus anticoagulant, renal involvement, nervous system involvement and hydroxychloroquine, with area under the curve of 0.947 and 0.808 in the development (n=4502) and external validation cohort (n=3780), respectively. According to the net benefit and predicted probability thresholds, we recommend annual screening of VTE in high risk (≥1.03%) patients with SLE.ConclusionVarious factors are related to the occurrence of VTE in patients with SLE. The proposed SLE-VTE risk score can accurately predict the risk of VTE and help identify patients with SLE with a high risk of VTE who may benefit from thromboprophylaxis.
The Zhenbao Incident of 1969: Mao’s Version of “Manufacturing Consent”
Authors: Lee Joseph 
Published: November 2023

Abstract
In March 1969, the Sino-Soviet military clash on Zhenbao Island marked a critical juncture in the development of the US-China rapprochement. Despite Mao’s solid grip on power and the opportune momentum for policy change after the Soviet invasion of Czechoslovakia, a formidable anti-US sentiment had taken shape since the founding of the People’s Republic of China, especially during the Cultural Revolution, which provided insufficient opportunities to change the diplomatic course. Eventually, Mao directly ordered an ambush on Zhenbao to persuade the public by heightening tensions with Moscow. When the Soviet threat had surpassed that of the United States and the justification for a conciliatory approach toward Washington was prepared, Mao resumed a restrained strategic move toward Sino-American rapprochement. The Zhenbao incident was Mao’s version of “manufacturing consent”, as he laid the foundation for the trilateral relationship’s transformation.
The Date of the Stein Manuscript of the Platform Sūtra
Authors: Galambos Imre 
Published: November 2023

Abstract
As some of the earliest extant examples of Chan writings survived in the Dunhuang library cave, they have been studied extensively in modern scholarship as witnesses of texts that were to leave a lasting impact throughout East Asia. This paper uses a codicological perspective to re-examine the so-called Stein manuscript of the Platform Sūtra kept at the British Library. This is one of the key sources for the study of early Chan, primarily because it contains what is often claimed to the be the earliest copy of the Platform Sūtra. The paper’s aim is to demonstrate that the manuscript, in its physical reality, can tell us additional information beyond what has already been learned from the text in it. This entails a shift from a focus on the transmission of the text to its use in a concrete setting. On the one hand, the ‘material’ approach can offer insights into the identity and background of the persons and communities involved in copying and using such texts, and on the other, it can help to reassess the accepted dating of the manuscript. Among the key pieces of information not considered before is an ownership note written on the spine of the manuscript, pointing to a connection with educational setting.
Spatiotemporal Variability of Extreme Rainfall Indices over Nicaragua between 2001 and 2016 and Their Relationship with Teleconnection Patterns
Authors: Mendez-Rivas Ruth , Palacios Maycol Mena , Lemus Reiner Palomino 
Published: November 2023

Abstract
We investigated nine indices of spatiotemporal extreme precipitation events over Nicaragua during 2001–16, from GPCC, Climate Hazards Group Infrared Precipitation with Station data (CHIRPS), and IMERG, and their correlation with teleconnection patterns. The main objectives were to evaluate the variability of extreme precipitation events, to know the performance of IMERG and CHIRPS in the characterization of these extreme events, using GPCC and four rain gauges as references, and finally to determine the teleconnection patterns that have the highest correlation with these indices. The spatial coverage of the area with the highest number of consecutive days with daily precipitation less than 1 mm corresponds to the Pacific region, with annual mean values of up to 120 continuous days. Some extreme precipitation event indices (RR, RX1day, and RX5day) show a decreasing trend, suggesting that the study area has been experiencing a reduction of extreme precipitation indices in terms of intensities and duration throughout the study period. In addition, it was observed that CHIRPS shows a better fit when dealing with precipitation events that do not exceed certain thresholds and IMERG improves when describing intense precipitation event patterns. We found that the tropical Pacific SST EOF (EOFPAC), Niño-3.4, Pacific warm pool region (PACWARM), and SOI have a greater influence on extreme precipitation events, these results suggest that they are being controlled by ENSO episodes, providing a better understanding of the climate configuration, as a prediction and forecasting potential, useful for agriculture, land use, and risk management.
Asian Anthropogenic Aerosol Forcing Played a Key Role in the Multidecadal Increase in Australian Summer Monsoon Rainfall
Authors: Fahrenbach Nora L. S. , Bollasina Massimo A. , Samset BjØrn H. , Cowan Tim , Ekman Annica M. L. 
Published: November 2023

Abstract
Observations show a significant increase in Australian summer monsoon (AUSM) rainfall since the mid-twentieth century. Yet the drivers of this trend, including the role of anthropogenic aerosols, remain uncertain. We addressed this knowledge gap using historical simulations from a suite of Coupled Model Intercomparison Project phase 6 (CMIP6) models, the CESM2 Large Ensemble, and idealized single-forcing simulations from the Precipitation Driver Response Model Intercomparison Project (PDRMIP). Our results suggest that Asian anthropogenic aerosol emissions played a key role in the observed increase in AUSM rainfall from 1930 to 2014, alongside the influence of internal variability. Sulfate aerosol emissions over Asia led to regional surface cooling and strengthening of the climatological Siberian high over eastern China, which altered the meridional temperature and sea level pressure gradients across the Indian Ocean. This caused an intensification and southward shift of the Australian monsoonal westerlies (and the local Hadley cell) and resulted in a precipitation increase over northern Australia. Conversely, the influence of increased greenhouse gas concentrations on AUSM rainfall was minimal due to the compensation between thermodynamically induced wettening and transient eddy-induced drying trends. At a larger scale, aerosol and greenhouse gas forcing played a key role in the climate response over the Indo-Pacific sector and eastern equatorial Pacific, respectively (coined the “tropical Pacific east–west divide”). These findings contribute to an improved understanding of the drivers of the multidecadal trend in AUSM rainfall and highlight the need to reduce uncertainties in future projections under different aerosol emission trajectories, which is particularly important for northern Australia’s agriculture.

Significance Statement
Australian summer monsoon (AUSM) rainfall plays a vital role in sustaining northern Australia’s unique biodiversity and extensive agricultural industry. While observations show a significant increase in AUSM rainfall since the mid-twentieth century, the causes remain uncertain. We find that anthropogenic aerosol emissions from Asia played a key role in driving this multidecadal AUSM rainfall trend by inducing dynamic adjustments over the Indo-Pacific sector. These findings highlight the need to consider different aerosol emission trajectories when assessing future projections of AUSM rainfall.
Impact of facility type and volume in locally advanced esophageal cancer
Authors: Muslim Zaid , Stroever Stephanie , Poulikidis Kostantinos , Connery Cliff P , Nitzkorski James R , Bhora Faiz Y 
Published: November 2023

Background We hypothesized that academic facilities and high-volume facilities would be independently associated with improved survival and a greater propensity for performing surgery in locally advanced esophageal cancer. Methods We identified patients diagnosed with stage IB–III esophageal cancer during 2004–2016 from the National Cancer Database. Facility type was categorized as academic or community, and facility volume was based on the number of times a facility's unique identification code appeared in the dataset. Each facility type was dichotomized into high- and low-volume subgroups using the cutoff of 20 esophageal cancers treated/year. We fitted multivariable regression models in order to assess differences in surgery selection and survival between facilities according to type and volume. Results Compared to patients treated at high-volume community hospitals, those at high-volume academic facilities were more likely to undergo surgery (odds ratio: 1.865, p < 0.001) and were associated with lower odds of death (odds ratio: 0.784, p = 0.004). For both academic and community hospitals, patients at high-volume facilities were more likely to undergo surgery compared to those at low-volume facilities, p < 0.05. For patients treated at academic facilities, high-volume facilities were associated with lower odds of death (odds ratio: 0.858, p = 0.02) compared to low-volume facilities, while there was no significant difference in the odds of death between high- and low-volume community hospitals (odds ratio: 1.018, p = 0.87). Conclusions Both facility type and case volume impact surgery selection and survival in locally advanced esophageal cancer. Compared to community hospitals, academic facilities were more likely to perform surgery and were associated with improved survival.