bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous Breathing Trial Techniques for Extubating Adults and Children Who Are Critically Ill
Authors: Burns Karen E. A. , Khan Jeena , Phoophiboon Vorakamol , Trivedi Vatsal , Gomez-Builes J. Carolina , Giammarioli Benedetta , Lewis Kimberley , Chaudhuri Dipayan , Desai Kairavi , Friedrich Jan O. 
Published: February 2024

ImportanceConsiderable controversy exists regarding the best spontaneous breathing trial (SBT) technique to use.ObjectiveTo summarize trials comparing alternative SBTs.Data SourcesSeveral databases (MEDLINE [from inception to February 2023], the Cochrane Central Register of Controlled Trials [in February 2023], and Embase [from inception to February 2023] and 5 conference proceedings (from January 1990 to April 2023) were searched in this systematic review and meta-analysis.Study SelectionRandomized trials directly comparing SBT techniques in critically ill adults or children and reporting at least 1 clinical outcome were selected.Data Extraction and SynthesisPaired reviewers independently screened citations, abstracted data, and assessed quality for the systematic review and meta-analysis using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA guidelines). Data were pooled using random-effects models.Main Outcomes and MeasuresPrimary outcomes included SBT success, extubation success, and reintubation.ResultsThe systematic review and meta-analysis identified 40 trials that included 6716 patients. Low-quality evidence (14 trials [n = 4459]) suggested that patients were not more likely to pass a pressure support (PS) compared with a T-piece SBT (risk ratio [RR], 1.04; 95% CI, 0.97-1.11; P = .31; I2 = 73%), unless 1 outlier trial accounting for all heterogeneity was excluded (RR, 1.09; 95% CI, 1.06-1.12; P &amp;lt; .001; I2 = 0% [13 trials; n = 3939]; moderate-quality evidence), but were significantly more likely to be successfully extubated (RR, 1.07; 95% CI, 1.04-1.10; P &amp;lt; .001; I2 = 0%; 16 trials [n = 4462]; moderate-quality evidence). Limited data (5 trials [n = 502]) revealed that patients who underwent automatic tube compensation/continuous positive airway pressure compared with PS SBTs had a significantly higher successful extubation rate (RR, 1.10; 95% CI, 1.00-1.21; P = .04; I2 = 0% [low-quality evidence]). Compared with T-piece SBTs, high-flow oxygen SBTs (3 trials [n = 386]) had significantly higher successful extubation (RR, 1.06; 95% CI, 1.00-1.11; P = .04; I2 = 0%) and lower reintubation (RR, 0.37; 95% CI, 0.21-0.65; P = &amp;lt;.001; I2 = 0% [both low-quality evidence]) rates. Credible subgroup effects were not found.Conclusions and RelevanceIn this systematic review and meta-analysis, the findings suggest that patients undergoing PS compared with T-piece SBTs were more likely to be extubated successfully and more likely to pass an SBT, after exclusion of an outlier trial. Pressure support SBTs were not associated with increased risk of reintubation. Future trials should compare SBT techniques that maximize differences in inspiratory support.
Optimistic vs Pessimistic Message Framing in Communicating Prognosis to Parents of Very Preterm Infants
Authors: Forth Fiona A. , Hammerle Florian , König Jochem , Urschitz Michael S. , Neuweiler Philipp , Mildenberger Eva , Kidszun André 
Published: February 2024

ImportanceIn the neonatal intensive care unit, there is a lack of understanding about how best to communicate the prognosis of a serious complication to parents.ObjectiveTo examine parental preferences and the effects of optimistic vs pessimistic message framing when providing prognostic information about a serious complication.Design, Setting, and ParticipantsThis crossover randomized clinical trial was conducted at a single German university medical center between June and October 2021. Eligible participants were parents of surviving preterm infants with a birth weight under 1500 g. Data were analyzed between October 2021 and August 2022.InterventionsAlternating exposure to 2 scripted video vignettes showing a standardized conversation between a neonatologist and parents, portrayed by professional actors, about the prognosis of a hypothetical very preterm infant with severe intraventricular hemorrhage. The video vignettes differed in the framing of identical numerical outcome estimates as either probability of survival and probability of nonimpairment (optimistic framing) or a risk of death and impaired survival (pessimistic framing).Main Outcomes and MeasuresThe primary outcome was preference odds (ratio of preference for optimistic vs pessimistic framing). Secondary outcomes included state anxiety, perceptions of communication, and recall of numerical estimates.ResultsOf 220 enrolled parents (142 [64.5%] mothers; mean [SD] age: mothers, 39.1 [5.6] years; fathers, 42.7 [6.9] years), 196 (89.1%) preferred optimistic and 24 (10.1%) preferred pessimistic framing (preference odds, 11.0; 95% CI, 6.28-19.10; P &amp;lt; .001). Preference for optimistic framing was more pronounced when presented second than when presented first (preference odds, 5.41; 95% CI, 1.77-16.48; P = .003). State anxiety scores were similar in both groups at baseline (mean difference, −0.34; −1.18 to 0.49; P = .42) and increased equally after the first video (mean difference, −0.55; 95% CI, −1.79 to 0.69; P = .39). After the second video, state anxiety scores decreased when optimistic framing followed pessimistic framing but remained unchanged when pessimistic framing followed optimistic framing (mean difference, 2.15; 95% CI, 0.91 to 3.39; P &amp;lt; .001). With optimistic framing, participants recalled numerical estimates more accurately for survival (odds ratio, 4.00; 95% CI, 1.64-9.79; P = .002) but not for impairment (odds ratio, 1.50; 95% CI, 0.85-2.63; P = .16).Conclusions and RelevanceWhen given prognostic information about a serious complication, parents of very preterm infants may prefer optimistic framing. Optimistic framing may lead to more realistic expectations for survival, but not for impairment.Trial RegistrationGerman Clinical Trials Register (DRKS): DRKS00024466
International collaboration between low‐middle‐income and high‐income institutions to improve radiation therapy care delivery
Authors: Ng Diana , De Martin Tatiana , Wu Po Ting , Huang Peter , Davis Jennifer , Serdiña Jamil , Nash Jamie , Knighton Sarah , Cala Sherwin , Eduave Tisha Lee V. , Abad Anthony Albert 
Published: February 2024

AbstractIntroductionThe Philippines is a lower‐middle‐income island country with over 153 000 new cancer diagnosis each year. Despite many patients needing radiotherapy as part of disease management, there remains limitations to access. Currently, the Philippines has 50 linear accelerator facilities serving a population of 110 million. However, given the recommendation of 1 linear accelerator for every 250 thousand people, it is evident that the demand for accessible radiotherapy resources is significantly underserved in the country. This paper outlines the collaboration between GenesisCare Solutions (GCS) and Fairview Cancer Center (FCC) to address efficiency and access within the radiotherapy department at FCC.MethodsThrough international collaboration between GCS and FCC, areas for improvement were identified and categorized into four domains: Dosimetry quality, Patient workflow, Data & Reporting, and Information Technology (IT) Infrastructure. Action plans were developed then implemented. A baseline measurement was obtained for each domain, and post‐implementation evaluation undertaken at 3 months, 6 months, and 12 months. Data captured within the electronic medical record system was extrapolated, and average treatment times were established for pre‐ and post‐engagement. A paired, 2‐tailed t‐test was used for statistical analysis of outcome parameters using IBM SPSS version 23 for all statistics.ResultsTwelve months post‐initial engagement, all four domains saw positive outcomes. Improved plan quality linked to Intensity Modulated Radiotherapy (IMRT) utilization rates saw an increase from 20% to 54%. A significant reduction in patient average wait times was also observed, from 27 to 17 min (p ≤ 0.001). Prior to engagement, tracking patient demographics and diagnosis was not prioritized, post engagement an average of 92% diagnosis entry compliance was achieved.ConclusionThrough the collaboration of GCS and FCC, objectives in all action plan domains were achieved, highlighting the benefits of collaboration between low‐middle‐income and high‐income institutions.
Transition Metal‐Oxide Nanomembranes Assembly by Direct Heteroepitaxial Growth
Authors: Li Hang , Yun Shinhee , Chikina Alla , Rosendal Victor , Tran Thomas , Brand Eric , Christoffersen Christina H. , Plumb Nicholas C. , Shi Ming , Pryds Nini , Radovic Milan 
Published: February 2024

AbstractThe integration of complex oxides with a wide range of functionalities on conventional semiconductor platforms is highly demanded for functional applications. Despite continuous efforts to integrate complex oxides on Si, it is still challenging to harvest epitaxial layers using standard deposition processes. Here, a novel method is demonstrated to create high‐quality complex heterostructures on Si integrated with SrTiO3 membranes as a universal platform. The STO membrane successfully bridges a broad spectrum of complex heterostructures such as SrNbO3, SrVO3, TiO2, and dichalcogenide 2D superconducting FeSe toward semiconducting wafers (Si). Through electronic structures measured by angle‐resolved photoemission spectroscopy, the high quality and functionality of the heterostructures are verified. This study demonstrated a new pathway toward realizing electronic devices with multifunctional physical properties incorporated into Si.
Sulfur Vacancy‐Rich Bi2S3‐X@PDA Heterojunctions with Light‐Controlled Reactive Oxygen Species Generation and Elimination to Combat Biofilm Infection and Inflammation Caused by Drug‐Resistant Bacteria
Authors: Mo Dong , Pan Meng , Chen Wen , Liu Qingya , Yu Yan , Yuan Liping , Yang Yun , Deng Hanzhi , Wang Meng , Qian Zhiyong 
Published: February 2024

AbstractAntibacterial photocatalytic therapy (APCT) is one of the most promising non‐antibiotic treatment strategies for biofilm‐infected wounds and inflammation caused by drug‐resistant bacteria. However, it still faces issues such as inadequate single antibacterial capacity and lack of antioxidant capacity. In this study, a Z‐scheme heterojunction (Bi2S3‐X@PDA) is designed using a polydopamine (PDA) shell firmly anchored to the surface of sulfur vacancy‐rich bismuth sulfide nanorods (Bi2S3‐X NRs). Under near‐infrared light and hydrogen peroxide, Bi2S3‐X@PDA significantly improves the photocatalytic efficiency of reactive oxygen species generation and shows a nearly 100% broad‐spectrum antibacterial effect against multiple bacterial strains and bacterial biofilms in vitro. Interestingly, the antioxidant activity of the PDA shell in Bi2S3‐X@PDA remarkably downregulates the expression of pro‐inflammatory factors and promotes macrophage reprogramming toward the proregenerative M2 phenotype. In a mouse wound model of methicillin‐resistant Staphylococcus aureus biofilm infection, Bi2S3‐X@PDA effectively eliminates drug‐resistant bacterial biofilms through APCT/mild photothermal therapy, while reducing inflammation in normal tissues and regulating the immune microenvironment, thereby promoting rapid wound healing. Overall, this light‐controlled treatment strategy, which provides both antibacterial and anti‐inflammatory functions, is a reliable tool for combating biofilm infection and inflammation caused by drug‐resistant bacteria.
Operando Investigation of the Molecular Origins of Dipole Switching in P(VDF‐TrFE‐CFE) Terpolymer for Large Adiabatic Temperature Change
Authors: Zhu Yuan , Wu Hanxiang , Martin Andrew , Beck Paige , Allahyarov Elshad , Wongwirat Thumawadee , Rui Guanchun , Zhu Yingke , Hawthorne Daniel , Fan Jiacheng , Wu Jianghan , Zhang Siyu , Zhu Lei , Kaur Sumanjeet , Pei Qibing 
Published: February 2024

AbstractRelaxor ferroelectric polymers exhibiting a giant electrocaloric effect (ECE) can potentially be used to create next‐generation solid‐state coolers. Under an electric field, poly(vinylidene fluoride‐trifluoroethylene‐chlorofluoroethylene) terpolymer goes through a large dipolar entropy change producing a high adiabatic temperature change (ΔTECE). This work resolves the molecular origins of the large entropy change behind the electric field‐induced dipole switching. A Fourier transform infrared spectroscopy equipped with a high voltage source is used to operandoly observe the characteristic molecular vibrational modes. A short‐range trans (T) conformation of the CF2‐CH2 dyads interrupted by a gauche (G) conformation, e.g., TTTG in the terpolymer chain, undergoes a dynamic transformation that leads to a corresponding ΔTECE whenever an electric field is applied. The molecular dynamics simulation also proves that the energy barrier that the transformation from TTTGs into a long T sequence overcomes is smaller than that for all other conformations. A mixed solvent system is used to obtain T3G‐enriched terpolymer films exhibiting a 4.02 K ΔTECE at 60 MV m−1 and these films are employed to manufacture a 2‐layer‐cascaded cooling device that achieves a 6.7 K temperature lift, the highest reported value for a 2‐layer cascaded device made of fluoropolymers.
Engineering Defect‐Rich Bimetallic Telluride with Dense Heterointerfaces for High‐Performance Lithium–Sulfur Batteries
Authors: Wu Xiangpeng , Xie Rongjun , Cai Daoping , Fei Ban , Zhang Chaoqi , Chen Qidi , Sa Baisheng , Zhan Hongbing 
Published: February 2024

AbstractRechargeable lithium–sulfur (Li–S) batteries have received ever‐increasing attention owing to their ultrahigh theoretical energy density, low cost, and environmental friendliness. However, their practical application is critically plagued by the sluggish reaction kinetics, shuttling of soluble polysulfide intermediates, and uncontrollable growth of Li dendrites. Herein, a bimetallic telluride electrocatalyst with dense heterointerfaces and rich defects embedded in hollow carbon polyhedron bunches (N⊂CoTe1‐x/ZnTe1‐y@NC, abbreviated as NCZTC) is rationally designed to simultaneously address the S cathode and Li anode problems. Both experimental and computational results substitute the integration of dense heterointerfaces and rich defects can synergistically modulate the electronic structure, enhance the electrical conductivity, promote the Li+ transportation, strengthen the polysulfides adsorption and improve the catalytic activity, thereby significantly accelerating the redox conversion kinetics and prevent the dendrite growth. Consequently, Li–S batteries with NCZTC‐modified separators demonstrate excellent electrochemical performance including high specific discharge capacity, remarkable rate capability, good long‐term cycling stability, and competitive areal capacity even at high sulfur loading and lean electrolyte conditions. This study not only provides valuable guidance for designing efficient sulfur electrocatalysts with transition metal tellurides but also emphasizes the importance of heterostructure design and defect engineering for high‐performance Li–S batteries.
Macrophage Intracellular “Calcium Oscillations” Triggered Through In Situ Mineralization Regulate Bone Immunity to Facilitate Bone Repair
Authors: Zhao Jinhui , Zhang Kesheng , Wang Lingtian , Zhu Ziyang , Jiang Dajun , Zuo Yangbo , Yang Jingzhou , Jia Weitao 
Published: February 2024

AbstractBioceramics are vital for treating bone defects, and bioactive glasses (exemplified by 45S5) and calcium phosphate ceramics (CaPs, exemplified by tricalcium phosphate [β‐TCP]) are extensively explored. β‐TCP exhibits superior biocompatibility, degradability, and osteoconductive properties than 45S5; however, it lacks bioactivity, such as mineralization capability. To harness the synergies of both, four 3D printing bioceramic scaffolds: 45S5, 70% 45S5 + 30% TCP, 30% 45S5 + 70% TCP, and TCP, are manufactured. Furthermore, the investigation elucidates the correlation between their in situ mineralization capabilities and the intracellular calcium oscillations within macrophages and determines how they impact macrophage phenotypic transitions. Notably, during bioceramic degradation, there is an initial rise followed by a decline in calcium ion concentration, which results in intracellular calcium ion oscillations within macrophages. In the 70% 45S5 + 30% TCP group, early release of calcium ions promotes M1 macrophage polarization. Subsequently, rapid in situ mineralization causes a decrease in extracellular calcium ions, thus accelerating the transition of M1 to M2 macrophages and facilitating bone repair. The present study reveals a novel mechanism through which bioceramics modulate macrophage polarization, offers new insights into the initial foreign body response to bioceramics and presents a perspective on expeditious progression toward tissue repair.
Real‐Time, Non‐Invasive Monitoring of Neuronal Differentiation Using Intein‐Enabled Fluorescence Signal Translocation in Genetically Encoded Stem Cell‐Based Biosensors
Authors: Lee Euiyeon , Choi Hye Kyu , Kwon Youngeun , Lee Ki‐Bum 
Published: February 2024

AbstractReal‐time and non‐invasive monitoring of neuronal differentiation helps to increase understanding of neuronal development and develop stem cell therapies for neurodegenerative diseases. Conventional methods such as RT‐PCR, western blotting, and immunofluorescence (IF), lack single‐cell‐level resolution and require invasive procedures, fixation, and staining. These limitations hinder accurate monitoring progress of neural stem cell (NSC) differentiation and understanding its functions. Herein, a novel approach is reported to non‐invasively monitor neuronal differentiation in real‐time using cell‐based biosensors (CBBs) that detects hippocalcin, biomarker of neuronal differentiation. To construct the hippocalcin sensor proteins, two different hippocalcin bioreceptors are fused to each split‐intein, carrying split‐nuclear localization signal (NLS) peptides, respectively, and fluorescent protein is introduced as reporter. CBBs operated in the presence of hippocalcin to generate functional signal peptides, which promptly translocated the fluorescence signal to the nucleus. The NSC‐based biosensor shows fluorescence signal translocation only upon neuronal differentiation and not undifferentiated stem cells or glial cells. Furthermore, this approach allows monitoring of neural differentiation at earlier stages than detected using IF staining. It is believed that novel CBBs offer an alternative to current techniques by capturing the dynamics of differentiation progress at the single‐cell‐level and providing a tool to evaluate how NSCs efficiently differentiate into neurons.
A 3D Bioprinted Human Neurovascular Unit Model of Glioblastoma Tumor Growth
Authors: Tung Yen‐Ting , Chen Yu‐Chi , Derr Kristy , Wilson Kelli , Song Min Jae , Ferrer Marc 
Published: February 2024

AbstractA 3D bioprinted neurovascular unit (NVU) model is developed to study glioblastoma (GBM) tumor growth in a brain‐like microenvironment. The NVU model includes human primary astrocytes, pericytes and brain microvascular endothelial cells, and patient‐derived glioblastoma cells (JHH‐520) are used for this study. Fluorescence reporters are used with confocal high content imaging to quantitate real‐time microvascular network formation and tumor growth. Extensive validation of the NVU‐GBM model includes immunostaining for brain relevant cellular markers and extracellular matrix components; single cell RNA sequencing (scRNAseq) to establish physiologically relevant transcriptomics changes; and secretion of NVU and GBM‐relevant cytokines. The scRNAseq reveals changes in gene expression and cytokines secretion associated with wound healing/angiogenesis, including the appearance of an endothelial mesenchymal transition cell population. The NVU‐GBM model is used to test 18 chemotherapeutics and anti‐cancer drugs to assess the pharmacological relevance of the model and robustness for high throughput screening.
Cancer Radiosensitization Nanoagent to Activate cGAS‐STING Pathway for Molecular Imaging Guided Synergistic Radio/Chemo/Immunotherapy
Authors: Wu Zede , Li Qiuyu , Zhu Kai , Zheng Shuting , Hu Honglei , Hou Meirong , Qi Li , Chen Siwen , Xu Yikai , Zhao Bingxia , Yan Chenggong 
Published: February 2024

AbstractImmunotherapy has emerged as an innovative strategy with the potential to improve outcomes in cancer patients. Recent evidence indicates that radiation‐induced DNA damage can activate the cyclic‐GMP‐AMP synthase (cGAS)‐stimulator of interferon genes (STING) pathway to enhance the antitumor immune response. Even so, only a small fraction of patients currently benefits from radioimmunotherapy due to the radioresistance and the inadequate activation of the cGAS‐STING pathway. Herein, this work integrates hafnium oxide (HfO2) nanoparticles (radiosensitizer) and 7‐Ethyl‐10‐hydroxycamptothecin (SN38, chemotherapy drug, STING agonist) into a polydopamine (PDA)‐coated core‐shell nanoplatform (HfO2@PDA/Fe/SN38) to achieve synergistic chemoradiotherapy and immunotherapy. The co‐delivery of HfO2/SN38 greatly enhances radiotherapy efficacy by effectively activating the cGAS‐STING pathway, which then triggers dendritic cells maturation and CD8+ T cells recruitment. Consequently, the growth of both primary and abscopal tumors in tumor‐bearing mice is efficiently inhibited. Moreover, the HfO2@PDA/Fe/SN38 complexes exhibit favorable magnetic resonance imaging (MRI)/photoacoustic (PA) bimodal molecular imaging properties. In summary, these developed multifunctional complexes have the potential to intensify immune activation to realize simultaneous cancer Radio/Chemo/Immunotherapy for clinical translation.
Structuring and Shaping of Mechanically Robust and Functional Hydrogels toward Wearable and Implantable Applications
Authors: Wang Xiao‐Qiao , Xie An‐Quan , Cao Pengle , Yang Jian , Ong Wei Li , Zhang Ke‐Qin , Ho Ghim Wei 
Published: February 2024

AbstractHydrogels possess unique features such as softness, wetness, responsiveness, and biocompatibility, making them highly suitable for biointegrated applications that have close interactions with living organisms. However, conventional man‐made hydrogels are usually soft and brittle, making them inferior to the mechanically robust biological hydrogels. To ensure reliable and durable operation of biointegrated wearable and implantable devices, mechanical matching and shape adaptivity of hydrogels to tissues and organs are essential. Recent advances in polymer science and processing technologies have enabled mechanical engineering and shaping of hydrogels for various biointegrated applications. In this review, polymer network structuring strategies at micro/nanoscales for toughening hydrogels are summarized, and representative mechanical functionalities that exist in biological materials but are not easily achieved in synthetic hydrogels are further discussed. Three categories of processing technologies, namely, 3D printing, spinning, and coating for fabrication of tough hydrogel constructs with complex shapes are reviewed, and the corresponding hydrogel toughening strategies are also highlighted. These developments enable adaptive fabrication of mechanically robust and functional hydrogel devices, and promote application of hydrogels in the fields of biomedical engineering, bioelectronics, and soft robotics.