bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel reconfiguration of the solar array to enhance peak power and efficiency under partial shading conditions: experimental validation
Authors: Mishra Vijay Laxmi , Chauhan Yogesh K , Verma K S 
Published: August 2023

Abstract
Non-homogeneous irradiation patterns and temperature levels immensely affect the performance of solar photovoltaic arrays. Partial shading conditions on solar arrays reduce the peak power and efficiency. This paper provides a new remedy called a novel Ramanujan reconfiguration (NRR) to eliminate this physical shading problem in solar photovoltaic systems. NRR is a static-based reconfigured technique that is built using a three-diode model with the help of the MATLAB®/Simulink® tool. The special feature of the proposed NRR technique is that when shade occurs on the solar modules, it gets realigned in a particular row, column, diagonal, corner, centre and middle peripheral cages. This helps over a wide range of shade dispersion on the solar array. The novel topology is tested against the conventional total cross-tied (TCT) model and recently introduced advanced reconfigured models, namely odd–even topology (OET) and Kendoku topology (KDT). The results are tested under certain shading conditions. The proposed NRR technique increases the peak power by 4.45, 2.15 and 2.17 W under the first shading condition regarding TCT, OET and KDT. Its efficiency is improved by 0.51–2.18% under the third shading condition compared with other considered models in this study. In addition, NRR leads to smooth output curves under the second, third and fourth shading conditions, effectively mitigating the local power peaks. The experimental results show the proposed enhanced performance of the novel model against the other models.
Power quality assessment in different wind power plant models considering wind turbine wake effects
Authors: Khatamiaghda Mohsen , Bahraminejad Saeed , Fadaeinedjad Roohollah 
Published: August 2023

Abstract
The intense increase in the installed capacity of wind farms has required a computationally efficient dynamic equivalent model of wind farms. Various types of wind-farm modelling aim to identify the accuracy and simulation time in the presence of the power system. In this study, dynamic simulation of equivalent models of a sample wind farm, including single-turbine representation, multiple-turbine representation, quasi-multiple-turbine representation and full-turbine representation models, are performed using a doubly-fed induction generator wind turbine model developed in DIgSILENT software. The developed doubly-fed induction generator model in DIgSILENT is intended to simulate inflow wind turbulence for more accurate performance. The wake effects between wind turbines for the full-turbine representation and multiple-turbine representation models have been considered using the Jensen method. The developed model improves the extraction power of the turbine according to the layout of the wind farm. The accuracy of the mentioned methods is evaluated by calculating the output parameters of the wind farm, including active and reactive powers, voltage and instantaneous flicker intensity. The study was carried out on a sample wind farm, which included 39 wind turbines. The simulation results confirm that the computational loads of the single-turbine representation (STR), the multiple-turbine representation and the quasi-multiple-turbine representation are 1/39, 1/8 and 1/8 times the full-turbine representation model, respectively. On the other hand, the error of active power (voltage) with respect to the full-turbine representation model is 74.59% (1.31%), 43.29% (0.31%) and 7.19% (0.11%) for the STR, the multiple-turbine representation and the quasi-multiple representation, respectively.
Safety Profile and Clinical and Virological Outcomes of Nirmatrelvir-Ritonavir Treatment in Patients With Advanced Chronic Kidney Disease and Coronavirus Disease 2019
Authors: Chan Gordon Chun Kau , Lui Grace Chung Yan , Wong Candy Ngai Sze , Yip Sindy Sin Ting , Li Timothy Chun Man , Cheung Catherine Siu King , Sze Ryan Kin Ho , Szeto Cheuk Chun , Chow Kai Ming 
Published: August 2023

Abstract

Background
Nirmatrelvir-ritonavir is currently not recommended in patients with an estimated glomerular filtration rate (eGFR) &lt;30 mL/minute/1.73 m2.

Methods
To determine the safety profile and clinical and virological outcomes of nirmatrelvir-ritonavir use at a modified dosage in adults with chronic kidney disease (CKD), a prospective, single-arm, interventional trial recruited patients with eGFR &lt;30 mL/minute/1.73 m2 and on dialysis. Primary outcomes included safety profile, adverse/serious adverse events, and events leading to drug discontinuation. Disease symptoms, virological outcomes by serial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral polymerase chain reaction (PCR) tests, rapid antigen tests, and virological and symptomatic rebound were also recorded.

Results
Fifty-nine (69.4%) of the 85 participants had stage 5 CKD and were on dialysis. Eighty (94.1%) completed the full treatment course; 9.4% and 5.9% had adverse and serious adverse events, and these were comparable between those with eGFR &lt; or &gt;30 mL/minute/1.73 m2. The viral load significantly decreased on days 5, 15, and 30 (P &lt; .001 for all), and the reduction was consistent in the subgroup with eGFR &lt;30 mL/minute/1.73 m2. Ten patients had virological rebound, which was transient and asymptomatic.

Conclusions
Among patients with CKD, a modified dose of nirmatrelvir-ritonavir is a well-tolerated therapy in mild COVID-19 as it can effectively suppress the SARS-CoV-2 viral load with a favorable safety profile. Virological and symptomatic rebound, although transient with low infectivity, may occur after treatment. Nirmatrelvir-ritonavir should be considered for use in patients with CKD, including stage 5 CKD on dialysis.
Clinical Trials Registration. Clinical Trials.gov; identifier: NCT05624840.
Risk of Misleading Conclusions in Observational Studies of Time-to-Antibiotics and Mortality in Suspected Sepsis
Authors: Pak Theodore R , Young Jessica , McKenna Caroline S , Agan Anna , DelloStritto Laura , Filbin Michael R , Dutta Sayon , Kadri Sameer S , Septimus Edward J , Rhee Chanu , Klompas Michael 
Published: August 2023

Abstract

Background
Influential studies conclude that each hour until antibiotics increases mortality in sepsis. However, these analyses often (1) adjusted for limited covariates, (2) included patients with long delays until antibiotics, (3) combined sepsis and septic shock, and (4) used linear models presuming each hour delay has equal impact. We evaluated the effect of these analytic choices on associations between time-to-antibiotics and mortality.

Methods
We retrospectively identified 104 248 adults admitted to 5 hospitals from 2015–2022 with suspected infection (blood culture collection and intravenous antibiotics ≤24 h of arrival), including 25 990 with suspected septic shock and 23 619 with sepsis without shock. We used multivariable regression to calculate associations between time-to-antibiotics and in-hospital mortality under successively broader confounding-adjustment, shorter maximum time-to-antibiotic intervals, stratification by illness severity, and removing assumptions of linear hourly associations.

Results
Changing covariates, maximum time-to-antibiotics, and severity stratification altered the magnitude, direction, and significance of observed associations between time-to-antibiotics and mortality. In a fully adjusted model of patients treated ≤6 hours, each hour was associated with higher mortality for septic shock (adjusted odds ratio [aOR]: 1.07; 95% CI: 1.04–1.11) but not sepsis without shock (aOR: 1.03; .98–1.09) or suspected infection alone (aOR: .99; .94–1.05). Modeling each hour separately confirmed that every hour of delay was associated with increased mortality for septic shock, but only delays &gt;6 hours were associated with higher mortality for sepsis without shock.

Conclusions
Associations between time-to-antibiotics and mortality in sepsis are highly sensitive to analytic choices. Failure to adequately address these issues can generate misleading conclusions.
Effect of serum creatinine difference between the Jaffe and the enzymatic method on kidney disease detection and staging
Authors: Boss Kristina , Stolpe Susanne , Müller André , Wagner Bernd , Wichert Marc , Assert Roland , Volbracht Lothar , Stang Andreas , Kowall Bernd , Kribben Andreas 
Published: August 2023

ABSTRACT

Background
Serum creatinine (SCr), mainly determined by the Jaffe or an enzymatic method, is the central marker to assess kidney function. Deviations between these two methods may affect the diagnosis and staging of acute kidney injury (AKI) and chronic kidney disease (CKD).

Methods
The results of the first parallel SCr measurement (Jaffe and enzymatic method) of adult in- and outpatients in the same serum sample at the University Hospital Essen (Essen, Germany) between 2020–2022 were retrospectively evaluated. A Bland–Altman plot with 95% limits of agreement (LoAs) was used to assess the difference between the Jaffe and the enzymatic SCr (eSCr) method. We used the 2009 Chronic Kidney Disease Epidemiology Collaboration equation for determination of estimated glomerular filtration rate (eGFR) according to the Kidney Disease: Improving Global Outcomes guidelines.

Results
A total of 41 144 parallel SCr measurements were evaluated. On average, Jaffe SCr was 0.07 mg/dl higher than eSCr (LoA −0.12; 0.25 mg/dl). In 19% of all cases there was a different CKD stage when comparing eGFR between both SCr methods, of which 98% resulted in a more severe CKD stage determined with Jaffe SCr. In 1.6% of all cases Jaffe SCr was ≥0.3 mg/dl higher than eSCr.

Conclusion
The present study showed that methods of SCr measurement may affect both the diagnosis and staging of AKI and CKD. This must be taken into account when interpreting measurements of renal function in everyday clinical practice, but also when planning and comparing studies on renal diseases. One should therefore stay with one method for SCr measurement, preferably with the enzymatic method.
Apical post-infarction ventricular septal defect blockage using the direct externalization and enmeshment to the right ventricular moderator band concept: case series
Authors: Toledano Bryan Rene F , Rivera Ramon Miguel M , Prado Jose Paolo A , Sabas Michelangelo L , Cheng Dexter Eugene D 
Published: August 2023

Abstract

Background
Transcatheter treatment in post-infarction ventricular septal defects can be unique and complex; hence, the development of a new technique is needed to improve outcomes.

Summary
We describe two cases in which large and complex apical post-infarction ventricular septal defects were treated with a novel transcatheter approach as salvage and the other due to refusal for open surgical repair. By direct externalization and enmeshment of a device to the right ventricular moderator band, the defect was blocked and immediate improvement of haemodynamics was achieved.

Conclusion
In large, complex, apical post-infarction ventricular septal defects with no apical rims, the DEXTER technique allows for exclusion of the defect and vestigialization of the right ventricular apex. An immediate and dramatic haemodynamic improvement can therefore be achieved.
How to: a practical guide to cardiac conduction devices on chest radiograph
Authors: Tun Kyaw Soe , Reidy Donnchadh , Buckley Una 
Published: August 2023

Abstract
With the increasing number of cardiac conduction devices (CCDs) insertions with various complexities in recent decades, it is crucial for clinicians (especially internal medicine residents and cardiologists) to have an up-to-date review of the current devices on chest radiograph. Chest X-ray remains the most cost-effective and accessible imaging modality to assess the device position and its associated complications, not only immediately after insertion but also during the follow-up visit as outpatient. Various types of CCDs such as permanent pacemaker, implantable cardioverter defibrillator, and cardiac resynchronization therapy (CRT, CRT with defibrillation or pacing) with their appearances on chest radiograph and possible complications with a step-by-step guide to how to assess are discussed in this article.
O01 Why is urinary tract infection so hard to diagnose and treat? Hints from a unique human microtissue model of bladder infection
Authors: Flores Carlos , Jafari Nazila , Ling Jefferson , Loh Amanda , Maset Ramón Garcia , Hoedek Marloes , Leung Richard , Aw Angeline , White Ian J , Fernando Raymond , Rohn Jennifer L 
Published: August 2023

Abstract
Although urinary tract infection (UTI) appears, on the face of it, to be a simple bacterial infection, upwards of one in four UTI cases recur despite antibiotic therapy. While antimicrobial resistance after empirical treatment undoubtedly accounts for some of these failures, recurrent UTI despite the administration of an appropriate antibiotic, or in the face of prophylactic therapy, remains poorly understood and is likely due to complex and multifactorial aspects of the interaction between the pathogen and its host. In parallel, the role of the healthy uromicrobiome in this process is also far from clear. The vast majority of what little we know about UTI host/pathogen interactions at the urothelial surface has been extrapolated from forced infection experiments in mice, a species that does not naturally experience UTI and whose bladder environment differs significantly from that of humans. For this reason, our lab has been developing alternative, human-cell-based lab models to study the behaviour of both uropathogens and healthy commensals using fully stratified and differentiated urothelial platforms, including lab-on-chip models with flow and stretch parameters. In this talk, I will present recent data putting the most common uropathogens through their paces in our most advanced static model, 3D-UHU. All uropathogens tested, including Escherichia coli, Klebsiella, Enterococcus, Pseudomonas, Group B Streptococcus and Proteus, were able to invade the urothelium to take up residence inside cells, where they would be expected to avoid detection by diagnostic urine tests as well as host neutrophils. Intracellular residence would also foil most oral antibiotics, which are poorly permeant to the urothelial barrier. Some bacteria species, especially Pseudomonas and Proteus, formed biofilms on the surface of the urothelium, a behaviour that would also help the bacteria to withstand antibiotic treatment. What's more, we observed that some bacteria susceptible to antibiotics in diagnostic media were effectively resistant in the human organoid environment, suggesting that there could be a disconnect between predicted drug and clinical outcome. This phenomenon may be partly explained by our experiments showing that, in some species of uropathogen, the urine environment encourages biofilm formation over the free planktonic state. These experiments highlight diverse infection strategies, shed light on how diagnosis and treatment can fail, and reveal strategies for improving both in the future.
P04 Urinary tract infections in HSCT: how big is the problem?
Authors: Baltas Ioannis , Kavallieros Konstantinos , Konstantinou Ioannis , Gibani Malick M , Davies Frances , Pavlu Jiri 
Published: August 2023

Abstract

Objectives
Urinary tract infections (UTIs) in HSCT recipients are understudied. We aimed to describe the incidence, clinical and laboratory findings of patients with UTIs during HSCT.

Methods
This was a retrospective analysis of all patients admitted for HSCT between 1 January 2020 and 31 December 2022 in a large London tertiary centre. Patient-level data were collected from the electronic medical record.

Results
There was a total of 400 admissions for HSCT during the study period, 56.25% (227/400) for autografts and 43.25% (173/400) for allografts. Median age was 55 years (IQR 43–62) and 59% of patients were male. A total of 588 infection episodes were recorded (mean 1.43 episodes per patient, 95% CI 1.39–1.56). Almost all patients (96.75%, 387/400) developed at least one infection episode during their inpatient stay for HSCT. The most common sources of infection were neutropenic fever (56.1%, 330/588) and non-neutropenic fever (17%, 100/588), followed by central line-associated bloodstream infections (10.2%, 60/588) and hospital- or ventilator-associated pneumonias (7%, 41/588). UTIs accounted for only 2% (12/588) of the total infection episodes. Only two UTIs (16.7%, 2/12) were associated with bacteraemia. A total of 1307 urine cultures were sent for all patients (3.23 per patient) and 93.5% of all patients had at least one urine culture. Growth of a specific pathogen was observed in 50/1307 cultures (3.8% positivity rate). The most common isolates included Escherichia coli (50%, 25/50) and Enterococcus spp. (22%, 11/50). The most common clinical syndrome for patients with positive cultures was neutropenic fever 40%, 20/50), followed by UTI (22%, 11/50) and non-neutropenic fever (6%, 3/50). 32% of positive samples (16/50) were considered to represent colonization. Pyuria was uncommon (8%, 4/50), including in patients with UTIs (18.2%, 2/11), as was haematuria (10%, 5/50 for all patients, 9.1%, 1/11 for patients with UTI).

Conclusions
UTIs account for a small proportion of infections in HSCT recipients during their inpatient stay. Urine culture results are challenging to interpret, as they are often associated with undifferentiated fever syndromes or represent colonization. Urine microscopy results are unreliable in HSCT patients and should not be used to rule in or rule out UTI.
P15 Women’s satisfaction with the management of urinary tract infections during the COVID-19 pandemic: a qualitative analysis of free-text comments from a national survey in England
Authors: Dababneh A’mar , Sanyaolu Leigh , Ahmed Haroon , Alagiyawanna Dushyanthi , Lecky Donna , Cooper Emily 
Published: August 2023

Abstract

Background
Urinary tract infections (UTIs) are one of the most common bacterial infections affecting women. The COVID-19 pandemic altered how healthcare was accessed and delivered with rapid adoption of remote technologies. This study explored women’s satisfaction with the care they received for UTI in general practice during the pandemic.

Methods
We analysed 799 responses to an open-ended question regarding women’s satisfaction with the management of their most recent UTIs. A thematic analysis was inductively conducted and supported by NVivo V.12.

Results
Most women (72.7%) were satisfied with their UTI management. Main study themes related to consultation, management, patient’s feelings, and safety during the pandemic. Themes on positive aspects of care were related to thorough assessment and treatment by a doctor and having a positive experience with the healthcare provider (HCP). Themes on the negative aspects of care were related to long waiting times, use of virtual consultations, and patients feeling uninformed and invalidated about their UTIs.

Conclusions
Patient satisfaction was closely linked to a positive face-to-face HCP interaction, prompt assessment and treatment, and discussion about prevention and self-care. To improve satisfaction, systems and consultations should account for patient choice in the HCP they consult with, allow for additional information about when and why a urine test should be provided, and ensure there is a platform for discussing patient preferences for antibiotic prescription or alternative therapy. Using resources to discuss these topics with patients may help address these issues, including risks and benefits of antibiotics, alternative treatments, prevention and self-care.
Regimes in astrophysical lensing: refractive optics, diffractive optics, and the Fresnel scale
Authors: Jow Dylan L , Pen Ue-Li , Feldbrugge Job 
Published: August 2023

ABSTRACT
Astrophysical lensing has typically been studied in two regimes: diffractive optics and refractive optics. Previously, it has been assumed that the Fresnel scale, RF, is the relevant physical scale that separates these two regimes. With the recent introduction of Picard–Lefschetz theory to the field of lensing, it has become possible to generalize the refractive description of discrete images to all wave parameters, and, in particular, exactly evaluate the diffraction integral at all frequencies. In this work, we assess the regimes of validity of refractive and diffractive approximations for a simple one-dimensional lens model through comparison with this exact evaluation. We find that, contrary to previous assumptions, the true separation scale between these regimes is given by $R_F/\sqrt{\kappa }$, where κ is the convergence of the lens. Thus, when the lens is strong, refractive optics can hold for arbitrarily small scales. We also argue that intensity variations in diffractive optics are generically small, which has implications for the study of strong diffractive interstellar scintillation.
Achromatic rapid flares in hard X-rays in the γ-ray binary LS I + 61 303
Authors: Saavedra Enzo A , Romero Gustavo E , Bosch-Ramon Valenti , Kefala Elina 
Published: August 2023

ABSTRACT
We report on the presence of very rapid hard X-ray variability in the γ-ray binary LS I + 61 303. The results were obtained by analysing Nuclear Spectroscopic Telescope Array (NuSTAR) data, which show two achromatic strong flares on ks time-scales before apastron. The Swift/Burst Alert Telescope orbital X-ray light curve is also presented, and the NuSTAR data are put in the context of the system orbit. The spectrum and estimated physical conditions of the emitting region indicate that the radiation is synchrotron emission from relativistic electrons, likely produced in a shocked pulsar wind. The achromaticity suggests that losses are dominated by escape or adiabatic cooling in a relativistic flow, and the overall behaviour in hard X-rays can be explained by abrupt changes in the size of the emitting region and/or its motion relative to the line of sight, with Doppler boosting potentially being a prominent effect. The rapid changes of the emitter could be the result of different situations such as quick changes in the intra-binary shock, variations in the re-accelerated shocked pulsar wind outside the binary, or strong fluctuations in the location and size of the Coriolis shock region. Although future multiwavelength observations are needed to further constrain the physical properties of the high-energy emitter, this work already provides important insight into the complex dynamics and radiation processes in LS I + 61 303.