bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of heart failure patients with COVID‐19: a joint position paper of the Chinese Heart Failure Association & National Heart Failure Committee and the Heart Failure Association of the European Society of Cardiology
Authors: Zhang Yuhui , Coats Andrew J.S. , Zheng Zhe , Adamo Marianna , Ambrosio Giuseppe , Anker Stefan D. , Butler Javed , Xu Dingli , Mao Jingyuan , Khan Muhammad Shahzeb , Bai Ling , Mebazaa Alexandre , Ponikowski Piotr , Tang Qizhu , Ruschitzka Frank , Seferovic Petar , Tschöpe Carsten , Zhang Shuyang , Gao Chuanyu , Zhou Shenghua , Senni Michele , Zhang Jian , Metra Marco 
Published: May 2020

AbstractThe coronavirus disease 2019 (COVID‐19) pandemic of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection is causing considerable morbidity and mortality worldwide. Multiple reports have suggested that patients with heart failure (HF) are at a higher risk of severe disease and mortality with COVID‐19. Moreover, evaluating and treating HF patients with comorbid COVID‐19 represents aformidable clinical challenge as symptoms of both conditions may overlap and they may potentiate each other. Limited data exist regarding comprehensive management of HF patients with concomitant COVID‐19. Since these issues pose serious new challenges for clinicians worldwide, HF specialists must develop a structured approach to the care of patients with COVID‐19 and be included early in the care of these patients. Therefore, the Heart Failure Association of the European Society of Cardiology and the Chinese Heart Failure Association & National Heart Failure Committee conducted web‐based meetings to discuss these unique clinical challenges and reach a consensus opinion to help providers worldwide deliver better patient care. The main objective of this position paper is to outline the management of HF patients with concomitant COVID‐19 based on the available data and personal experiences of physicians from Asia, Europe and the United States.
Development, characterization, and application of a 2‐Compartment system to investigate the impact of pH inhomogeneities in large‐scale CHO‐based processes
Authors: Paul Katrin , Böttinger Katharina , Mitic Bernd M. , Scherfler Georg , Posch Christoph , Behrens Dirk , Huber Christian G. , Herwig Christoph 
Published: May 2020

AbstractLarge‐scale bioreactors for the production of monoclonal antibodies reach volumes of up to 25 000 L. With increasing bioreactor size, mixing is however affected negatively, resulting in the formation of gradients throughout the reactor. These gradients can adversely affect process performance at large scale. Since mammalian cells are sensitive to changes in pH, this study investigated the effects of pH gradients on process performance. A 2‐Compartment System was established for this purpose to expose only a fraction of the cell population to pH excursions and thereby mimicking a large‐scale bioreactor. Cells were exposed to repeated pH amplitudes of 0.4 units (pH 7.3), which resulted in decreased viable cell counts, as well as the inhibition of the lactate metabolic shift. These effects were furthermore accompanied by increased absolute lactate levels. Continuous assessment of molecular attributes of the expressed target protein revealed that subunit assembly or N‐glycosylation patterns were only slightly influenced by the pH excursions. The exposure of more cells to the same pH amplitudes further impaired process performance, indicating this is an important factor, which influences the impact of pH inhomogeneity. This knowledge can aid in the design of pH control strategies to minimize the effects of pH inhomogeneity in large‐scale bioreactors.
Temperature‐dependent analysis of crosstalk and delay uncertainty in multilayer graphene nanoribbon interconnects
Authors: Mona Chanu Waikhom , Das Debaprasad 
Published: May 2020

SummaryIn this article, we have analyzed delay uncertainty due to crosstalk in multilayer graphene nanoribbon (MLGNR) interconnects. Crosstalk is a challenging problem in deep‐sub‐micron and nanometer designs. In this work, we have analyzed the crosstalk delay with a wide variation in chip operating temperature. The mean free path is modeled as a function of temperature. Furthermore, the resistance of MLGNR interconnect system is modeled. Crosstalk delay analysis is performed for both top‐contact MLGNR and side‐contact MLGNR (SC‐MLGNR) interconnects and compared the results with that of the traditional Cu interconnects. The analysis has been carried out for different interconnect widths 11, 16, and 22 nm and lengths 10, 50, and 100 μm for three different chip operating temperatures 233, 300, and 398K. The decrease in rise/fall delay (speed up) and increase in rise/fall time delay (slow down) are modeled. Finally, the delay uncertainty is modeled for different interconnect systems. The percentage change in delay values for speed up and slow down cases are −23.4%, −29.8% and 114.4%, 161.9%, respectively, for 10μm SC‐MLGNR interconnect. It is shown that the delay uncertainty is significantly less in SC‐MLGNR interconnects and with the advancement of technology the performance is improved as compared with copper interconnects.
Optimization of secondary user capacity in a centralized cooperative cognitive radio network with primary user under priority
Authors: Debnath Sanjoy , Rai Chandrashekhar , Sen Debarati , Baishya Srimanta , Arif Wasim 
Published: May 2020

AbstractThe primary objective of cognitive radio is to maximize the spectrum utilization and the capacity of secondary users under standard parametric constraints. The radiometer, or energy detection, is one of the convenient methods of spectrum sensing under a cooperative communication framework. However, the selection of a suitable threshold is a major issue in order to optimize the secondary user capacity considering primary user on priority. In this article, we investigate a double threshold energy detection scheme and obtain an analytical model for optimum thresholding in diverse fading conditions under the constraint of the probability of detection. We use a meta‐heuristic optimization algorithm, namely, the particle swarm optimization with an aging leader and challengers, to observe the effect of varying threshold levels in fusion region, signal to noise ratio (SNR) levels of primary user, and calculate the normalized achievable capacity of secondary user for various fading channels. The results show that, with increasing value of threshold within the decision region, the probability of detection decreases while the normalized secondary user capacity is enhanced. Conversely, the probability of detection increases and the normalized secondary user capacity decreases with increasing values of the SNR level. We also observe the effect of receiver diversity with maximal ratio combining for Nakagami‐m fading channel coefficients. The result shows that the probability of detection and normalized capacity decrease with an increase of the number of receiver branches.
COX‐2/PGE2 axis regulates hippocampal BDNF/TrkB signaling via EP2 receptor after prolonged seizures
Authors: Yu Ying , Jiang Jianxiong 
Published: May 2020

AbstractObjectiveThe objective of this study was to identify the signaling pathway that is immediately triggered by status epilepticus (SE) and in turn contributes to the excessive brain‐derived neurotrophic factor (BDNF)/tropomyosin‐related kinase receptor B (TrkB) signaling within the hippocampus.MethodsWe used quantitative PCR, enzyme‐linked immunosorbent assay, and Western blot analysis to examine gene expression at both mRNA and protein levels in the hippocampus following prolonged SE in mice and rats. Three classical animal models of SE were utilized in the present study to avoid any model‐ or species‐specific findings.ResultsWe showed that both cyclooxygenase‐2 (COX‐2) and BDNF in the hippocampus were rapidly upregulated after SE onset; however, the induction of COX‐2 temporally preceded that of BDNF. Blocking COX‐2 activity by selective inhibitor SC‐58125 prevented BDNF elevation in the hippocampus following SE; prostaglandin E2 (PGE2), a major product of COX‐2 in the brain, was sufficient to stimulate hippocampal cells to secrete BDNF, suggesting that a PGE2 signaling pathway might be directly involved in hippocampal BDNF production. Inhibiting the Gαs‐coupled PGE2 receptor EP2 by our recently developed selective antagonist TG6‐10‐1 decreased the SE‐triggered phosphorylation of the cAMP response element‐binding protein (CREB) and activation of the BDNF/TrkB signaling in the hippocampus.SignificanceThe molecular mechanisms whereby BDNF/TrkB signaling is upregulated in the hippocampus by SE largely remain unknown. Our findings suggest that COX‐2 via the PGE2/EP2 pathway regulates hippocampal BDNF/TrkB activity following prolonged seizures. EP2 inhibition by our bioavailable and brain‐permeable antagonists such as TG6‐10‐1 might therefore provide a novel strategy to suppress the abnormal TrkB activity, an event that can sufficiently trigger pathogenic processes within the brain including acquired epileptogenesis.
Risk factors for cholecystitis after stent placement in patients with distal malignant biliary obstruction
Authors: Takinami Masaki , Murohisa Gou , Yoshizawa Yashiro , Shimizu Erina , Nagasawa Masamichi 
Published: May 2020

AbstractBackground /PurposeLimited data are available for acute cholecystitis after Self‐Expandable Metallic Stent (SEMS) placement in patients with malignant distal biliary obstruction. We aimed to identify risk factors for cholecystitis.MethodsThis was a retrospective, single‐center study of 280 patients (336 stents) who received endoscopic SEMS placement between May 2005 and April 2016. Clinical records were used to perform risk factor analyses.ResultsOf 336 SEMS placement procedures, 25 (7.4%) led to development of cholecystitis. Logistic regression analysis revealed three independent risk factors: covered SEMS (P = .014), tumor involvement to the cystic duct (P = .017), and presence of gallstones (P = .022). Median time to cholecystitis onset was shorter with covered SEMS than with uncovered SEMS (P = .034), and in patients with pancreatic cancer compared to those with other cancers (P = .001). Severe cholecystitis developed within 30 days after covered SEMS placement in three patients with pancreatic cancer without tumor involvement to the cystic duct.ConclusionsUse of covered SEMS might be a risk factor for cholecystitis onset within 30 days after placement. Clinicians should be aware of the risk for severe cholecystitis after covered SEMS placement, even if the tumor does not invade the cystic duct.
Multiparametric MRI Radiomic Model for Preoperative Predicting WHO/ISUP Nuclear Grade of Clear Cell Renal Cell Carcinoma
Authors: Li Qiong , Liu Yu‐jia , Dong Di , Bai Xu , Huang Qing‐bo , Guo Ai‐tao , Ye Hui‐yi , Tian Jie , Wang Hai‐yi 
Published: May 2020

BackgroundNuclear grade is of importance for treatment selection and prognosis in patients with clear cell renal cell carcinoma (ccRCC).PurposeTo develop and validate an MRI‐based radiomic model for preoperative predicting WHO/ISUP nuclear grade in ccRCC.Study TypeRetrospective.PopulationIn all, 379 patients with histologically confirmed ccRCC. Training cohort (n = 252) and validation cohort (n = 127) were randomly assigned.Field Strength/SequencePretreatment 3.0T renal MRI. Imaging sequences were fat‐suppressed T2WI, contrast‐enhanced T1WI, and diffusion weighted imaging.AssessmentThree prediction models were developed using selected radiomic features, radiomic and clinicoradiologic characteristics, and a model containing only clinicoradiologic characteristics. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to assess the predictive performance of these models in predicting high‐grade ccRCC.Statistical TestsThe least absolute shrinkage and selection operator (LASSO) and minimum redundancy maximum relevance (mRMR) method were used for the selection of radiomic features and clinicoradiologic characteristics, respectively. Multivariable logistic regression analysis was used to develop the radiomic signature of radiomic features and clinicoradiologic model of clinicoradiologic characteristics.ResultsThe radiomic signature showed good performance in discriminating high‐grade (grades 3 and 4) from low‐grade (grades 1 and 2) ccRCC, with sensitivity, specificity, and AUC of 77.3%, 80.0%, and 0.842, respectively, in the validation cohort. The radiomic model, combining radiomic signature and clinicoradiologic characteristics, displayed good predictive ability for high‐grade with sensitivity, specificity, and accuracy of 63.6%, 93.3%, and 88.2%, respectively, in the validation cohort. The radiomic model showed a significantly better performance than the clinicoradiologic model (P < 0.05).Data ConclusionMultiparametric MRI‐based radiomic model can predict WHO/ISUP grade in patients with ccRCC with satisfying performance, and thus could help the physician to improve treatment decisions.Level of Evidence3Technical Efficacy Stage2
Nutrition Therapy in Critically Ill Patients With Coronavirus Disease 2019
Authors: Martindale Robert , Patel Jayshil J. , Taylor Beth , Arabi Yaseen M. , Warren Malissa , McClave Stephen A. 
Published: May 2020

AbstractIn the midst of a coronavirus disease 2019 (COVID‐19) pandemic, a paucity of data precludes derivation of COVID‐19–specific recommendations for nutrition therapy. Until more data are available, focus must be centered on principles of critical care nutrition modified for the constraints of this disease process, ie, COVID‐19–relevant recommendations. Delivery of nutrition therapy must include strategies to reduce exposure and spread of disease by providing clustered care, adequate protection of healthcare providers, and preservation of personal protective equipment. Enteral nutrition (EN) should be initiated early after admission to the intensive care unit (ICU) using a standard isosmolar polymeric formula, starting at trophic doses and advancing as tolerated, while monitoring for gastrointestinal intolerance, hemodynamic instability, and metabolic derangements. Intragastric EN may be provided safely, even with use of prone‐positioning and extracorporeal membrane oxygenation. Clinicians should have a lower threshold for switching to parenteral nutrition in cases of intolerance, high risk of aspiration, or escalating vasopressor support. Although data extrapolated from experience in acute respiratory distress syndrome warrants use of fiber additives
and probiotic organisms, the lack of benefit precludes a recommendation for micronutrient supplementation. Practices that increase exposure or contamination of equipment, such as monitoring gastric residual volumes, indirect calorimetry to calculate requirements, endoscopy or fluoroscopy to achieve enteral access, or transport out of the ICU for additional imaging, should be avoided. At all times, strategies for nutrition therapy need to be assessed on a risk/benefit basis, paying attention to risk for both the patient and the healthcare provider.
Engineered biomaterials for cancer immunotherapy
Authors: Cai Lulu , Xu Jialu , Yang Zhenglin , Tong Rongsheng , Dong Ziliang , Wang Chao , Leong Kam W. 
Published: May 2020

AbstractAlthough cancer immunotherapy is showing tremendous promise and has progressed to the clinic, it has only achieved sporadic efficacy, with only a fraction of patients benefitting from the therapy and with undesirable side effects due to poor selectivity and high doses. Localized delivery of immunomodulators to activate anticancer immunity in situ avoids overactivation of the systemic immune system and reduces side effects. Engineered biomaterials—implantable, injectable, or transdermal—fabricated into drug delivery devices are critical components for the development of localized cancer immunotherapies. In this review, we briefly summarize progress in the application of engineered biomaterials to the localized delivery of cancer immunotherapy.
A rare case of NIPT discrepancy caused by the placental mosaicism of three different karyotypes, 47,XXX, 47,XX,+21, and 48,XXX,+21
Authors: Li Jin , Xie Mingshui , Wang Fang , Ma Jianhong , Li Jiafu , Chen Chen , Li Zhimin , Wang Juan , Zhang Yuanzhen , Li Yirong 
Published: May 2020

AbstractBackgroundPlacental mosaicism is one of the major reasons for noninvasive prenatal testing (NIPT) discrepancy. Herein, we discovered a rare case of placenta with complex karyotypes that caused false‐positive and false‐negative results in noninvasive prenatal testing.MethodsNext‐generation sequencing (NGS) and Quantitative fluorescent polymerase chain reaction (QF‐PCR) were performed on the cord blood sample, fetal tissues, and eight placental biopsies. Fluorescent In Situ Hybridization (FISH) and karyotyping were also carried to confirm the fetal genome status.ResultsThe results suggested that the fetal chromosome was 47,XXX and the placenta had three karyotypes of 48,XXX,+21, 47,XX,+21, and 47,XXX. QF‐PCR indicated that the extra chromosome 21 and chromosome X were all from the father. It is speculated that the zygote may have 48,XXX,+21 karyotype and trisomy rescue could be the main mechanism for the development of the homogeneous fetus and complex mosaic placenta.ConclusionOverall, the complicated nature of our case underlines the importance of discussing with parents the possibility of both atypical and discordant results during preconfirmatory amniocentesis counseling and consent.
An irregular metal trace inpainting network for x‐ray CT metal artifact reduction
Authors: Peng Chengtao , Li Bin , Li Ming , Wang Hongxiao , Zhao Zhuo , Qiu Bensheng , Chen Danny Z. 
Published: May 2020

PurposeMetal implants in the patient's body can generate severe metal artifacts in x‐ray computed tomography (CT) images. These artifacts may cover the tissues around the metal implants in CT images and even corrupt the tissue regions, thus affecting disease diagnosis using these images. Previous deep learning metal trace inpainting methods used both valid pixels of uncorrupted areas and invalid pixels of corrupted areas to patch metal trace (i.e., the holes of removed metal‐corrupted regions). Such methods cannot recover fine details well and often suffer information mismatch due to interference of invalid pixels, thus incurring considerable secondary artifacts. In this paper, we develop a new irregular metal trace inpainting network for reducing metal artifacts.MethodsWe develop a new deep learning network to patch irregular metal trace in metal‐corrupted sinograms to reduce metal artifacts for isometric fan‐beam CT. Our new method patches irregular metal trace in CT sinograms using only valid pixels, avoiding interference from invalid pixels. Furthermore, to enable the inpainting network to recover as many details as possible, we design an auxiliary inpainting network to suppress the probable secondary artifacts in CT images to assist fine detail restoration. The image produced by the auxiliary network is then projected onto a sinogram via a forward projection (FP) algorithm and is fused with the sinogram predicted by the inpainting network in order to predict the final recovered sinogram. Our entire network is trained end‐to‐end to extract cross‐domain information between the sinogram domain and CT image domain.ResultsWe compare our proposed method with two traditional and four deep learning‐based metal trace inpainting methods, and with an iterative reconstruction method on four datasets: dental fillings (panoramic and local perspectives), hip prostheses, and spine fixations. We use both quantitative and qualitative indices to evaluate our method, and the analyses suggest that our method reduces the most metal artifacts and produces the best quality CT images. Additionally, our proposed method takes 0.1512 s on average to process a CT slice, which meets the clinical requirement.ConclusionsThis paper proposes a new deep learning network to patch irregular metal trace in corrupted sinograms to reduce metal artifacts. Our method restores more fine details in irregular metal trace and has a superior capability on metal artifact reduction compared with state‐of‐the‐art methods.
Preliminary clinical experience with Calypso anchored beacons for tumor tracking in lung SBRT
Authors: Sarkar Vikren , Szegedi Martin , Paxton Adam , Nelson Geoff , Rassiah‐Szegedi Prema , Reddy Chakravarthy B. , Tao Randa , Hitchcock Ying J. , Kokeny Kristine E. , Salter Bill J. 
Published: May 2020

PurposeTo present our preliminary experience with the recently released Calypso lung beacons to track lung tumor location during stereotactic body radiation therapy (SBRT).Materials/MethodsFive recent lung SBRT patients had Calypso lung beacons implanted for tumor tracking during treatment. Beacons were placed by a pulmonologist using fluoroscopic navigation within 1 week prior to planning four‐dimensional computed tomography (4DCT) acquisition. Patients were immobilized in a full‐body double‐vacuum bag. For the first three patients, a verification 4DCT was obtained prior to the first fraction with the patient in the treatment position to assess both beacon migration and motion of tumor and beacons relative to planning day. For each treatment fraction, Calypso was used to position the patient. A verification cone‐beam CT (CBCT) confirmed the Calypso‐defined target position was appropriate. Real‐time Calypso tracking information was also acquired and compared to an action level that was used to determine if the tumor migrated outside of the planning target volume.ResultsFor four patients, the implant procedure was well tolerated, with average CBCT‐based shifts being within 0.2 mm of the shifts reported by Calypso at the time of imaging. The other patient had a small pneumothorax due to very peripheral tumor location and experienced beacon migration. However, the patient quickly recovered from the pneumothorax, and after deactivating that beacon, motion tracking was possible throughout his treatment.ConclusionsAll patients were successfully treated with SBRT using the newly released Calypso lung beacons, with initial positioning confirmed by this clinic's current clinical standard of CBCT. The system allowed us to validate, with real‐time confirmation, that the planned internal target volumes were appropriate to each day's extent of actual tumor motion. An efficient and effective workflow for utilizing the new lung beacons for SBRT treatments was developed.
Circadian Rhythm of Substrate Oxidation and Hormonal Regulators of Energy Balance
Authors: Rynders Corey A. , Morton Sarah J. , Bessesen Daniel H. , Wright Kenneth P. , Broussard Josiane L. 
Published: May 2020

ObjectiveThe circadian system provides an organism with the ability to anticipate daily food availability and appropriately coordinate metabolic responses. Few studies have simultaneously assessed factors involved in both the anticipation of energy availability (i.e., hormones involved in appetite regulation) and subsequent metabolic responses (such as energy expenditure and substrate oxidation) under conditions designed to reveal circadian rhythmicity.MethodsEight healthy adults (four females; age: 28.0 ± 2.3 years; BMI: 24.3 ± 2.9 kg/m2) participated in a 26‐hour constant routine protocol involving continuous wakefulness with constant posture, temperature, dim light, and hourly isocaloric snacks. Indirect calorimetry was performed every 3 hours for measurement of energy expenditure and substrate oxidation. Subjective hunger was obtained hourly using questionnaires. Saliva and plasma were obtained hourly to assess melatonin (circadian phase marker) and hormones (leptin, ghrelin, and peptide YY).ResultsFat and carbohydrate oxidation was highest in the biological evening and morning, respectively. Subjective hunger ratings peaked during the middle of the biological day. Significant circadian rhythms were identified for ghrelin and peptide YY with peaks in the biological evening and morning, respectively.ConclusionsThese findings support a role for the circadian system in the modulation of nutrient oxidation, subjective measures of appetite, and appetitive hormones.