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In recent years, the need for low-carbon power has seen hydrogen emerge as a potential fuel to replace conventional hydrocarbons in combustion to limit CO2 emissions in several sectors, including aeronautics. The challenges posed by hydrogen combustion are similar to the issues of kerosene flames but more challenging, like nitrogen oxide (NOx) emissions and flame flashback. One potential solution to address these problems is to burn a rich mixture of hydrogen and air in globally lean conditions on a coaxial injector to obtain a stable and staged combustion and attempt to reduce emissions. In this article, the evolution of NOx production as more air is mixed into the fuel is studied, as well as the changes in flame size and structure. In particular, the appearance of a secondary flame front is observed and increasing the proportion of air in the fuel mixture both shortens the flame and reduces the NOx emission index. Additionally, the effect of the global equivalence ratio and flame thermal power is studied. Finally, existing models for NOx emission of hydrogen flames on a coaxial injector based on average flame residence time and strain rate are tested and shown to have promising results. [ABSTRACT FROM AUTHOR]

Introduction: Haemolysis and inflammation contribute to cardiac surgery-associated acute kidney injury (CS-AKI). We aimed to assess the performance of plasma haemolysis index (HI) and interleukine-6 (IL-6) for the prediction of all-stage CS-AKI. We also assessed their ability to predict moderate-to-severe CS-AKI and to discriminate persistent from transient CS-AKI. Methods: Adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were prospectively included. Haemolysis index and IL-6 were measured immediately after the end of CPB and 6 hours later. Correction for haemodilution relied upon changes in albuminaemia. Persistent CS-AKI was defined as a steady/increasing CS-AKI stage between the 48th and the 60th postoperative hour as compared with the worst stage observed within the 48 first hours. Results: Among 82 patients, CS-AKI occurred in 37 (45%) patients. Postoperative HI and IL-6 were positively correlated to the duration of CPB (r ≤ 0.51, p ≤ 0.0003). Whether we considered isolated measurements of HI or IL-6, their indexation to haemodilution or not, their kinetics and/or their combination, the prediction of all stage CS-AKI was inaccurate (area under the receiver operating characteristic curve [AUCROC]≤ 0.68) whereas moderate-to-severe CS-AKI (6 patients only) was predicted with an honourable performance (AUCROC = 0.77 [95%CI 0.67;0.86] and 0.87 [95%CI 0.77;0.93] for HI and IL-6, respectively). The persistent/transient nature of CS-AKI was inaccurately predicted (AUCROC ≤ 0.68). Conclusions: In a population in which most CS-AKI cases were mild, although they frequently (41%) persisted >48 hours, CS-AKI was inaccurately predicted by HI and/or IL-6. A better performance for moderate-to-severe CS-AKI prediction is likely. These preliminary findings are yet to be validated. [ABSTRACT FROM AUTHOR]

Hydrogen-fueled carbon-free energy is a growing prospect for the future of several industries, including the aeronautical and energy generation sectors. However, the transition to hydrogen comes with several challenges: flame stabilization due to the unique combustion properties of hydrogen compared to conventional fuels and control of nitrogen oxides (NOx) production due to the higher combustion temperature. In addition, the high flammability of hydrogen poses an increased risk of flashback in premixed configurations commonly used to generate low-NOx flames. As a consequence, research into strategies for low-NOx hydrogen combustion is developing, and several technologies are being considered for industrial use. Among these technologies, we consider here a dual swirl coaxial injector operated in nonpremixed conditions. This setup enables the stabilization of multiple types of flame structures that are parametrically investigated for their NOx emissions. The flame structure is observed using OH* chemiluminescence images collected using an intensified CCD camera equipped with a bandpass filter. Exhaust gas species mole fractions of NO, NO2, and O2 are measured using NDIR gas detectors and a paramagnetic sensor. This investigation reveals that stabilization of hydrogen-air flames on the double swirl injector is possible and that varying the flow parameters induces changes in structure that affect NOx emissions, independently of swirl level, residence time, and temperature that also play a role. The study is carried out at atmospheric pressure. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of expanded criteria donors (ECD) on urinary complications in kidney transplantation. Patients and Methods: The UriNary Complications Of Renal Transplant (UNyCORT) is a cohort study based on the French prospective Données Informatisées et VAlidées en Transplantation/Computerized and VAlidated Data in Transplantation (DIVAT) cohort. Data were extracted between 1 January 2002 and 1 January 2018 with 1‐year minimum follow‐up, in relation to 44 pre‐ and postoperative variables. ECD status was included according to United Network for Organ Sharing (UNOS) definition. The primary outcome of the UNyCORT study was the association between the donor's ECD/standard criteria donors (SCD) status and urinary complications at 1 year in uni‐ and multivariate analysis. Sub‐group analysis, stratified analysis on ECD/SCD donor's status and transplant failure analysis were then conducted. Results: Between 1 January 2002 and 1 January 2018, 10 279 kidney transplants in adult recipients were recorded within the DIVAT network. A total of 8559 (83.4%) donors were deceased donors and 1699 (16.6%) were living donors (LD). Among donation after circulatory death (DCD) donors, 224 (2.85%) were uncontrolled DCD and 93 (1.09%) were controlled DCD donors. A total of 3617 (43.9%) deceased donors were ECD. The overall urological complication rate was 16.26%. The donor's ECD status was significantly associated with an increased risk of urological complications at 1 year in multivariate analysis (odds ratio: 1.50, 95% CI 1.31–1.71; P < 0.001) and especially with stenosis and ureteric fistulae at 1 year. There is no association with LD, uncontrolled and controlled DCD. The placement of an endo‐ureteric stent was beneficial in preventing urinary complications in all donors and particularly in ECD donors. Conclusion: The donor's ECD status is associated with a higher likelihood of stenosis and ureteric fistulae at 1 year. Recipients of grafts from ECD donors should probably be considered for closer urological monitoring and systematic preventive measures. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to examine the sensitivity of muscle biopsy (MB) in ANCA-associated vasculitis (AAV), identify factors predicting MB positivity and assess the prognostic value of a positive MB. Methods We conducted a single-centre retrospective study of AAV with an MB performed at diagnosis. AAV classification [granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA)] followed the European Medicines Agency algorithm. A logistic regression model was used to identify the factors associated with MB positivity. Survival curves were generated using the Kaplan–Meier method. Results Among 276 AAV patients (1995–2018), 101 had an MB. Seventy-eight patients were included: 33 with GPA, 25 with MPA and 20 with EGPA. MB samples were positive in 45 cases (58%): 17 GPA, 16 MPA and 12 EGPA. Univariate analysis focussed on GPA and MPA, revealed that the MB yield was higher in females [22/31 (71%) vs 11/27 (41%); P  = 0.02] and in anti-MPO patients [25/37 (68%) vs 6/19 (32%) for anti-PR3; P  = 0.01]. By multivariate analysis, three factors predicted MB positivity: anti-MPO ANCA [odds ratio (OR) 10.67 (CI 2.09, 81.68)], female sex [OR 5.3 (CI 1.16, 32.35)] and neutrophil count [OR 1.33 (CI 1.07, 1.8)]. MB positivity had no impact on relapse, death or end-stage renal disease–free survival. Conclusions MB is a safe and efficient diagnostic tool for AAV. Predictors of MB yield include ANCA type, sex and neutrophil count. MB cannot substitute for kidney biopsy when indicated, but should be considered in other cases. [ABSTRACT FROM AUTHOR]