bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Inert Species on the Static and Dynamic Stability of a Piloted, Swirl-Stabilized Flame
Authors: Rodriguez Camacho Javier , Akiki Michel , Blust James , O'Connor Jacqueline 
Published: November 2023

Abstract
Carbon sequestration and utilization has been proposed as a method for decarbonizing high-efficiency industrial gas turbines operating on natural gas fuels for power generation and industrial markets. To increase the efficiency of the carbon removal process from the exhaust stream of the turbine, exhaust gas recirculation (EGR) can be used. EGR recycles a portion of the engine exhaust into the inlet, increasing the concentration of inert species in the exhaust stream to improve the performance and cost-effectiveness of CO2 separation systems. This strategy can, however, reduce the oxygen concentration in the air, leading to changes in flame stabilization in the combustor. In this study, we investigate the effect of air diluted with inert gases of different compositions and the impact that these mixtures have on flame static and dynamic stability. A swirl-stabilized flame in a single-nozzle, variable-length combustor is used to measure the flame behavior for oxygen concentrations of 15–21% by volume. A constant adiabatic flame temperature test matrix is conducted to mimic operation in an industrial gas turbine. High-speed chemiluminescence imaging is used to determine the change in flame shape and dynamics for each gas composition. As the oxygen concentration decreases, the flame lifts from the centerbody, resulting in an aerodynamically stabilized flame at the lowest O2 concentrations. Different compositions of gases result in different flame shapes, where higher levels of N2 in the diluents result in more flame stabilization in the outer recirculation zone as compared to those with higher levels of CO2. The flame oscillation mechanisms also change with oxygen concentration, where the lifted flames at low O2 levels exhibit an ignition/extinction oscillation mode as compared to a vortex-shedding-coupled oscillation mode at high O2 levels where the flame is stabilized on the centerbody. Companion chemical kinetics simulations are used to explain changes in the flame's shape and behavior.
Association of lineage 4.2.2 of
Mycobacterium tuberculosis
with the 63-bp deletion variant of the
mpt64
gene
Authors: Song Zexuan , He Wencong , Pei Shaojun , Zhao Bing , Cao Xiaolong , Wang Yiting , He Ping , Liu Dongxin , Ma Aijing , Ou Xichao , Xia Hui , Wang Shengfen , Liu Chunfa , Zhao Yanlin 
Published: November 2023

ABSTRACT

Tuberculosis (TB) remains the primary cause of death from an infectious disease worldwide. The MPT64 antigen assay is an expedited diagnostic method that is increasingly adopted in many TB diagnostic laboratories and clinical settings worldwide. However, the diagnostic accuracy of the MPT64 antigen assay is influenced by the presence of 63bp deletion variants within the
mpt64
gene, and the potential association of this variant with the lineage or sub-lineage of
Mycobacterium tuberculosis
complex (MTBC) remains unverified. In this study, we analyzed the MPT64 antigen assay using isolates from the major lineage and sub-lineage of MTBC combined with whole-genome sequencing. Notably, we found a significant association between the 63bp deletion variant in the
mpt64
gene and
M. tuberculosis
Lineage 4.2.2 (L4.2.2) globally. Phylogenetic analysis revealed that L4.2.2 isolates were divided into two clusters (Clades A and B). Importantly, all isolates within Clade A exhibited the 63bp deletion variant in the
mpt64
gene. Furthermore, using the Bayesian Skyline population model, we observed that the effective population size of Clade A has remained relatively constant. These findings highlight that MPT64-based testing should be cautiously used, and MPT64 negative results should be validated using an alternative assay in regions where L4.2.2 isolates are prevalent, such as China and Vietnam. These L4.2.2 isolates with the 63bp deletion variant in
mpt64
warrant greater consideration during the development of diagnostic tests and study of their immunomodulatory role. Overall, this study provides valuable insights into a better understanding of the virulence and diagnosis of MTBC isolates based on the MPT64 protein.

IMPORTANCE

To date, rapid diagnostic methods based on the MPT64 antigen assay are increasingly utilized to differentiate between non-tuberculous mycobacteria and TB disease in clinical settings. Furthermore, numerous novel techniques based on the MPT64 release assay are continuously being developed and applied for the identification of both pulmonary and extrapulmonary TB. However, the diagnostic accuracy of the MPT64 antigen assay is influenced by the presence of 63 bp deletion variants within the
mpt64
gene. To our knowledge, this is the first report on the association between the 63 bp deletion variant in
mpt64
and
Mycobacterium tuberculosis
L4.2.2 globally, which highlights the need for the cautious utilization of MPT64-based testing in regions where L4.2.2 isolates are prevalent, such as China and Vietnam, and MPT64 negative results should be confirmed with another assay. In addition, further studies on vaccine development and immunology based on MPT64 should consider these isolates with 63 bp deletion variant.
Trends in diagnostic tests ordered for children: a retrospective analysis of 1.7 million laboratory test requests in Oxfordshire, UK from 2005 to 2019
Authors: Thomas Elizabeth T , Withrow Diana R , Shine Brian , Gill Peter , Perera Rafael , Heneghan Carl 
Published: November 2023

ObjectiveTo better understand testing patterns in children, we measured temporal trends in paediatric testing from 2005 to 2019 in Oxfordshire, UK.DesignDescriptive study of population-based secondary data.SettingOxfordshire University Hospitals National Health Service Trust laboratories.ParticipantsChildren aged 0–15 years in Oxfordshire who received at least one blood test.Main outcome measuresWe estimated average annual percentage changes (AAPCs) in test use using joinpoint regression models. Temporal changes in age-adjusted rates in test use were calculated overall and stratified by healthcare setting, sex, and age.ResultsBetween 2005 and 2019, 1 749 425 tests were performed among 113 607 children. Overall test use declined until 2012, when test rates appeared to increase (AAPC 1.5%, 95% CI −0.8% to 3.9%). Most tests were performed in inpatient settings, where testing rates stayed steady (AAPC −0.6%, 95% CI −2.1% to 0.9%). Increases were highest in females, those aged 6–15 years and in the outpatient setting. The greatest increase in testing was for vitamin D (AAPC 26.5%), followed by parathyroid hormone (9.8%), iron studies (9.3%), folate (8.4%), vitamin B12(8.4%), HbA1c (8.0%), IgA (7.9%) and coeliac (7.7%).ConclusionsAfter an initial decline, laboratory test use by children in Oxfordshire demonstrated an apparent increase since 2012. Test use increased in outpatient and general practice settings, however remained steady in inpatient settings. Further research should examine the root causes and implications for test increases, and whether these increases are warranted. We encourage clinicians to consider the individual and systemic implications of performing blood tests in children.
Impact and cost-effectiveness of measles vaccination through microarray patches in 70 low-income and middle-income countries: mathematical modelling and early-stage economic evaluation
Authors: Fu Han , Abbas Kaja , Malvolti Stefano , Gregory Christopher , Ko Melissa , Amorij Jean-Pierre , Jit Mark 
Published: November 2023

BackgroundMicroarray patches (MAPs) are a promising technology being developed to reduce barriers to vaccine delivery based on needles and syringes (N&S). To address the evidence gap on the public health value of applying this potential technology to immunisation programmes, we evaluated the health impact on measles burden and cost-effectiveness of introducing measles-rubella MAPs (MR-MAPs) in 70 low-income and middle-income countries (LMICs).MethodsWe used an age-structured dynamic model of measles transmission and vaccination to project measles cases, deaths and disability-adjusted life-years during 2030–2040. Compared with the baseline scenarios with continuing current N&S-based practice, we evaluated the introduction of MR-MAPs under different measles vaccine coverage projections and MR-MAP introduction strategies. Costs were calculated based on the ingredients approach, including direct cost of measles treatment, vaccine procurement and vaccine delivery. Model-based burden and cost estimates were derived for individual countries and country income groups. We compared the incremental cost-effectiveness ratios of introducing MR-MAPs to health opportunity costs.ResultsMR-MAP introduction could prevent 27%–37% of measles burden between 2030 and 2040 in 70 LMICs, compared with the N&S-only immunisation strategy. The largest health impact could be achieved under lower coverage projection and accelerated introduction strategy, with 39 million measles cases averted. Measles treatment cost is a key driver of the net cost of introduction. In countries with a relatively higher income, introducing MR-MAPs could be a cost-saving intervention due to reduced treatment costs. Compared with country-specific health opportunity costs, introducing MR-MAPs would be cost-effective in 16%–81% of LMICs, depending on the MR-MAPs procurement prices and vaccine coverage projections.ConclusionsIntroducing MR-MAPs in LMICs can be a cost-effective strategy to revitalise measles immunisation programmes with stagnant uptake and reach undervaccinated children. Sustainable introduction and uptake of MR-MAPs has the potential to improve vaccine equity within and between countries and accelerate progress towards measles elimination.
Impact of the MEESSI-AHF tool to guide disposition decision-making in patients with acute heart failure in the emergency department: a before-and-after study
Authors: Mirò Òscar , Llorens Pere , Rosselló Xavier , Gil Víctor , Sánchez Carolina , Jacob Javier , Herrero-Puente Pablo , López-Diez María Pilar , Llauger Lluis , Romero Rodolfo , Fuentes Marta , Tost Josep , Bibiano Carlos , Alquézar-Arbé Aitor , Martín-Mojarro Enrique , Bueno Héctor , Peacock Frank , Martin-Sanchez Francisco Javier , Pocock Stuart 
Published: November 2023

ObjectivesTo determine the impact of risk stratification using the MEESSI-AHF (Multiple Estimation of risk based on the Emergency department Spanish Score In patients with acute heart failure) scale to guide disposition decision-making on the outcomes of ED patients with acute heart failure (AHF), and assess the adherence of emergency physicians to risk stratification recommendations.MethodsThis was a prospective quasi-experimental study (before/after design) conducted in eight Spanish EDs which consecutively enrolled adult patients with AHF. In the pre-implementation stage, the admit/discharge decision was performed entirely based on emergency physician judgement. During the post-implementation phase, emergency physicians were advised to ‘discharge’ patients classified by the MEESSI-AHF scale as low risk and ‘admit’ patients classified as increased risk. Nonetheless, the final decision was left to treating emergency physicians. The primary outcome was 30-day all-cause mortality. Secondary outcomes were days alive and out of hospital, in-hospital mortality and 30-day post-discharge combined adverse event (ED revisit, hospitalisation or death).ResultsThe pre-implementation and post-implementation cohorts included 1589 and 1575 patients, respectively (median age 85 years, 56% females) with similar characteristics, and 30-day all-cause mortality was 9.4% and 9.7%, respectively (post-implementation HR=1.03, 95% CI=0.82 to 1.29). There were no differences in secondary outcomes or in the percentage of patients entirely managed in the ED without hospitalisation (direct discharge from the ED, 23.5% vs 24.4%, OR=1.05, 95% CI=0.89 to 1.24). Adjusted models did not change these results. Emergency physicians followed the MEESSI-AHF-based recommendation on patient disposition in 70.9% of cases (recommendation over-ruling: 29.1%). Physicians were more likely to over-rule the recommendation when ‘discharge’ was recommended (56.4%; main reason: need for hospitalisation for a second diagnosis) than when ‘admit’ was recommended (12.8%; main reason: no appreciation of severity of AHF decompensation by emergency physician), with an OR for over-ruling the ‘discharge’ compared with the ‘admit’ recommendation of 8.78 (95% CI=6.84 to 11.3).ConclusionsImplementing the MEESSI-AHF risk stratification tool in the ED to guide disposition decision-making did not improve patient outcomes.
Gut virome in inflammatory bowel disease and beyond
Authors: Tun Hein Min , Peng Ye , Massimino Luca , Sin Zhen Ye , Parigi Tommaso Lorenzo , Facoetti Amanda , Rahman Shaila , Danese Silvio , Ungaro Federica 
Published: November 2023

ObjectiveThe gut virome is a dense community of viruses inhabiting the gastrointestinal tract and an integral part of the microbiota. The virome coexists with the other components of the microbiota and with the host in a dynamic equilibrium, serving as a key contributor to the maintenance of intestinal homeostasis and functions. However, this equilibrium can be interrupted in certain pathological states, including inflammatory bowel disease, causing dysbiosis that may participate in disease pathogenesis. Nevertheless, whether virome dysbiosis is a causal or bystander event requires further clarification.DesignThis review seeks to summarise the latest advancements in the study of the gut virome, highlighting its cross-talk with the mucosal microenvironment. It explores how cutting-edge technologies may build upon current knowledge to advance research in this field. An overview of virome transplantation in diseased gastrointestinal tracts is provided along with insights into the development of innovative virome-based therapeutics to improve clinical management.ResultsGut virome dysbiosis, primarily driven by the expansion ofCaudovirales, has been shown to impact intestinal immunity and barrier functions, influencing overall intestinal homeostasis. Although emerging innovative technologies still need further implementation, they display the unprecedented potential to better characterise virome composition and delineate its role in intestinal diseases.ConclusionsThe field of gut virome is progressively expanding, thanks to the advancements of sequencing technologies and bioinformatic pipelines. These have contributed to a better understanding of how virome dysbiosis is linked to intestinal disease pathogenesis and how the modulation of virome composition may help the clinical intervention to ameliorate gut disease management.
Hot brain: practical climate change advice for neurologists
Authors: Sisodiya Sanjay M 
Published: November 2023

‘We are called to be architects of the future, not its victims’—Buckminster FullerPeople with chronic neurological conditions may be vulnerable to change and less able to manage its demands: neurological diseases are among the most burdensome. Whether climate change has particular effects on specific neurological diseases or not, the known impaired resilience to change affecting people with neurological diseases requires neurologists to have awareness of potential climate impacts and their management. Preparedness should include understanding of general national and local alerts and action systems, and the ability to advise patients about managing extreme weather events, particularly heatwaves, but also floods and cold snaps. At the same time, we need more research into the particular consequences of climate change on specific neurological diseases. Climate change is a serious healthcare issue, requiring the neurological community to respond as it would, or did, to other serious challenges, such as COVID-19. As disease experts, we all have a role to play.
Surgical timing and long-term outcomes in patients with severe haemorrhagic spinal cord cavernous malformations
Authors: Tian An , Cui Ziwei , Ren Jian , Ren Yeqing , Ye Ming , Li Guilin , He Chuan , Li Xiaoyu , Zeng Gao , Hu Peng , Ma Yongjie , Yu Jiaxing , Li Jingwei , Bian Lisong , Yang Fan , Li Qianwen , Ling Feng , Hong Tao , Sun Liyong , Zhang Hongqi 
Published: November 2023

BackgroundSurgical resection of the lesions remains the main treatment method for most symptomatic spinal cord cavernous malformations (SCCMs) to eliminate the occupation and associated subsequent lifelong haemorrhagic risk. However, the timing of surgical intervention remains controversial, especially for patients in the acute stage after severe haemorrhage.MethodsPatients diagnosed with SCCMs who were surgically treated between January 2002 and December 2021 were selected and retrospectively reviewed. The Modified McCormick Scale (MMS) was used to evaluate neurological and disability status. All medical information was reviewed, and all patients were followed up for at least 6 months.ResultsA total of 279 patients were ultimately included. With regard to long-term outcomes, 110 (39.4%) patients improved, 159 (57.0%) remained unchanged and 10 (3.6%) worsened. For patients with an MMS score of 2–5 on admission, in univariate and multivariate analyses, a ≤6 weeks period between onset and surgery (adjusted OR 3.211, 95% CI 1.504 to 6.856, p=0.003) was a significant predictor of improved MMS. Among 69 patients who first presented with severe haemorrhage, undergoing surgery within 6 weeks of the onset of severe haemorrhage (adjusted OR 4.901, 95% CI 1.126 to 21.325, p=0.034) was significantly associated with improvement of MMS score.ConclusionSurgical timing can influence the long-term outcome of SCCMs. For patients with symptomatic SCCMs, especially those with severe haemorrhage, early surgical intervention within 6 weeks can provide more benefit.
Computing of temperature-dependent thermal conductivity and viscosity correlation for solar energy and turbulence appliances via artificial neuro network algorithm
Authors: Qureshi M. Zubair Akbar , Faisal M. , Malik Kaleem Razzaq , Shah Nehad Ali 
Published: November 2023

The growing popularity of artificial intelligence approaches has led to their application in a wide range of engineering fields. The most widely used artificial intelligence tool, artificial neural networks, can be used to predict data with high accuracy. An artificial neural network approach is being used to predict effective and accurate thermal conductivity and viscosity models for hybrid nanofluid systems. Here, new types of correlations relating to the thermophysical properties of Fly Ash–Cu nanoparticles with diameter sized 15.2[Formula: see text]nm and which are temperature-dependent are developed. The highest thermal conductivity and viscosity values were obtained for hybrid nanofluids with a mixture ratio of 20:80, with maximum amplification exceeding 83.2% and 65%, respectively, over the base fluid. The Fly Ash–Cu/water hybrid nanofluid’s viscosity and thermal conductivity are evaluated for a concentration range of 0–4%. The evaluation of the Fly Ash–Cu/water hybrid nanofluids system at concentrations ranging from 0 to 4% most likely entails a scientific or engineering study aimed at understanding the behavior and properties of this nanofluid mixture. Nanoparticles can agglomerate or settle in the base fluid over time, compromising the stability of the nanofluids. Researchers may be interested in determining how varied quantities of Fly Ash and Cu nanoparticles affect the nanofluid’s stability and sedimentation behavior. The heat transfer potential is examined within the optimistic range of temperatures of 30–80∘C. Many fruitful results for turbulence and solar energy have been drawn. The Mouromtseff number achieved an optimal value for all concentration levels. The heat transfers of turbulent flow and thermal conductivity of hybrid nanofluids increase with the augmented values of concentrations and temperature. Researchers found an increase in thermal conductivity of hybrid nanofluids at 0–4% concentrations, potentially impacting heat transfer applications. The conclusion explores the potential integration of the developed correlations and neural network model into practical engineering or industrial applications involving solar energy and turbulence appliances. In this work, we extend the work of Kanti et al. [Sol. Energy Mater. Sol. Cells 234 (2022) 111423] which is on the properties of water-based fly ash-copper hybrid nanofluid for solar energy applications.
Enhancing Asian Indigenous Language Processing through Deep Learning-based Handwriting Recognition and Optimization Techniques
Authors: Manimaran A. , Syed Mohammad Haider , Kumar M. Siva , Selvanayaki S. , Sunitha Gurram , Manna Asmita 
Published: November 2023

Asian indigenous language or autochthonous language is a language which is native to a region and spoken by indigenous people in Asia. This language is a linguistically different community created in the region. Recently, researchers in handwriting detection studies comparing with indigenous languages have attained important internet amongst the research community. A new development of artificial intelligence (AI), natural language processing (NLP), cognitive analytics, and computational linguistics (CL) find it helpful in the analysis of regional low-resource languages. It can be obvious in the obtainability of effectual machine detection methods and open access handwritten databases. Tamil is the most ancient Indian language that is mostly exploited in the Southern part of India, Sri Lanka, and Malaysia. Tamil handwritten Character Recognition (HCR) is a critical procedure in optical character detection. Therefore, this study designs a Henry Gas Solubility Optimization with Deep Learning-based Handwriting Recognition Model (HGSODL-HRM) for Asian Indigenous Language Processing. The proposed HGSODL-HRM technique relies on computer vision and DL concepts for automated handwriting recognition in the Tamil language, which is one of the popular indigenous languages in Asia. To accomplish this, the HGSODL-HRM technique employs a capsule network (CapsNet) model for feature vector generation with the HGSO algorithm as a hyperparameter optimizer. For the recognition of handwritten characters, wavelet neural network (WNN) model is exploited. Finally, the WNN parameters can be optimally chosen by sail fish optimizer (SFO) algorithm. To demonstrate the promising results of the HGSODL-HRM system, an extensive range of simulations can be implemented. The simulation outcomes stated the betterment of the HGSODL-HRM system compared to recent DL models.