bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prothrombin Complex Concentrate vs Conservative Management in ICH Associated With Direct Oral Anticoagulants
Authors: Ip Bonaventure , Pan Sangqi , Yuan Zhong , Hung Trista , Ko Ho , Leng Xinyi , Liu Yuying , Li Shuang , Lee Sing Yau , Cheng Cyrus , Chan Howard , Mok Vincent , Soo Yannie , Wu Xiaoli , Lui Leong Ting , Chan Rosa , Abrigo Jill , Dou Qi , Seiffge David , Leung Thomas 
Published: February 2024

ImportanceIntracerebral hemorrhage (ICH) associated with direct oral anticoagulant (DOAC) use carries extremely high morbidity and mortality. The clinical effectiveness of hemostatic therapy is unclear.ObjectiveTo compare the clinical and radiological outcomes of DOAC-associated ICH treated with prothrombin complex concentrate (PCC) vs conservative management.Design, Setting, and ParticipantsIn this population-based, propensity score–weighted retrospective cohort study, patients who developed DOAC-associated ICH from January 1, 2016, to December 31, 2021, in Hong Kong were identified. The outcomes of patients who received 25 to 50 IU/kg PCC with those who received no hemostatic agents were compared. Data were analyzed from May 1, 2022, to June 30, 2023.Main Outcomes and MeasuresThe primary outcome was modified Rankin scale of 0 to 3 or returning to baseline functional status at 3 months. Secondary outcomes were mortality at 90 days, in-hospital mortality, and hematoma expansion. Weighted logistic regression was performed to evaluate the association of PCC with study outcomes. In unweighted logistic regression models, factors associated with good neurological outcome and hematoma expansion in DOAC-associated ICH were identified.ResultsA total of 232 patients with DOAC-associated ICH, with a mean (SD) age of 77.2 (9.3) years and 101 (44%) female patients, were included. Among these, 116 (50%) received conservative treatment and 102 (44%) received PCC. Overall, 74 patients (31%) patients had good neurological recovery and 92 (39%) died within 90 days. Median (IQR) baseline hematoma volume was 21.7 mL (3.6-66.1 mL). Compared with conservative management, PCC was not associated with improved neurological recovery (adjusted odds ratio [aOR], 0.62; 95% CI, 0.33-1.16; P = .14), mortality at 90 days (aOR, 1.03; 95% CI, 0.70-1.53; P = .88), in-hospital mortality (aOR, 1.11; 95% CI, 0.69-1.79; P = .66), or reduced hematoma expansion (aOR, 0.94; 95% CI, 0.38-2.31; P = .90). Higher baseline hematoma volume, lower Glasgow coma scale, and intraventricular hemorrhage were associated with lower odds of good neurological outcome but not hematoma expansion.Conclusions and RelevanceIn this cohort study, Chinese patients with DOAC-associated ICH had large baseline hematoma volumes and high rates of mortality and functional disability. PCC treatment was not associated with improved functional outcome, hematoma expansion, or mortality. Further studies on novel hemostatic agents as well as neurosurgical and adjunctive medical therapies are needed to identify the best management algorithm for DOAC-associated ICH.
Automatic end‐to‐end VMAT treatment planning for rectal cancers
Authors: Huang Kai , Chung Christine , Ludmir Ethan B. , Zhang Lifei , Owens Constance A. , Vega Jean Gumma‐De La , Duryea Jack , Zhao Yao , Chen Xinru , Fuentes David , Cardenas Carlos E. , Briere Tina Marie , Beddar Sam , Court Laurence E. , Das Prajnan 
Published: February 2024

AbstractBackgroundThe treatment planning process from segmentation to producing a deliverable plan is time‐consuming and labor‐intensive. Existing solutions automate the segmentation and planning processes individually. The feasibility of combining auto‐segmentation and auto‐planning for volumetric modulated arc therapy (VMAT) for rectal cancers in an end‐to‐end process is not clear.PurposeTo create and clinically evaluate a complete end‐to‐end process for auto‐segmentation and auto‐planning of VMAT for rectal cancer requiring only the gross tumor volume contour and a CT scan as inputs.MethodsPatient scans and data were retrospectively selected from our institutional records for patients treated for malignant neoplasm of the rectum. We trained, validated, and tested deep learning auto‐segmentation models using nnU‐Net architecture for clinical target volume (CTV), bowel bag, large bowel, small bowel, total bowel, femurs, bladder, bone marrow, and female and male genitalia. For the CTV, we identified 174 patients with clinically drawn CTVs. We used data for 18 patients for all structures other than the CTV. The structures were contoured under the guidance of and reviewed by a gastrointestinal (GI) radiation oncologist. The predicted results for CTV in 35 patients and organs at risk (OAR) in six patients were scored by the GI radiation oncologist using a five‐point Likert scale. For auto‐planning, a RapidPlan knowledge‐based planning solution was modeled for VMAT delivery with a prescription of 25 Gy in five fractions. The model was trained and tested on 20 and 34 patients, respectively. The resulting plans were scored by two GI radiation oncologists using a five‐point Likert scale. Finally, the end‐to‐end pipeline was evaluated on 16 patients, and the resulting plans were scored by two GI radiation oncologists.ResultsIn 31 of 35 patients, CTV contours were clinically acceptable without necessary modifications. The CTV achieved a Dice similarity coefficient of 0.85 (±0.05) and 95% Hausdorff distance of 15.25 (±5.59) mm. All OAR contours were clinically acceptable without edits, except for large and small bowel which were challenging to differentiate. However, contours for total, large, and small bowel were clinically acceptable. The two physicians accepted 100% and 91% of the auto‐plans. For the end‐to‐end pipeline, the two physicians accepted 88% and 62% of the auto‐plans.ConclusionsThis study demonstrated that the VMAT treatment planning technique for rectal cancer can be automated to generate clinically acceptable and safe plans with minimal human interventions.
Automatic image quality evaluation in digital radiography using for‐processing and for‐presentation images
Authors: Tsalafoutas Ioannis A. , AlKhazzam Shady , Tsapaki Virginia , Kharita Mohammed Hassan 
Published: February 2024

AbstractPurposeTo investigate the impact of digital image post‐processing algorithms on various image quality (IQ) metrics of radiographic images under different exposure conditions.MethodsA custom‐made phantom constructed according to the instructions given in the IAEA Human Health Series No.39 publication was used, along with the respective software that automatically calculates various IQ metrics. Images with various exposure parameters were acquired with a digital radiography unit, which for each acquisition produces two images: one for‐processing (raw) and one for‐presentation (clinical). Various examination protocols were used, which incorporate diverse post‐processing algorithms. The IQ metrics’ values (IQ‐scores) obtained were analyzed to investigate the effects of increasing incident air kerma (IAK) on the image receptor, tube potential (kVp), additional filtration, and examination protocol on image quality, and the differences between image type (raw or clinical).ResultsThe IQ‐scores were consistent for repeated identical exposures for both raw and clinical images. The effect that changes in exposure parameters and examination protocol had on IQ‐scores were different depending on the IQ metric and image type. The expected positive effect that increasing IAK and decreasing tube potential should have on IQ was clearly exhibited in two IQ metrics only, the signal difference‐to‐noise‐ratio (SDNR) and the detectability index (d’), for both image types. No effect of additional filtration on any of the IQ metrics was detected on images of either type. An interesting finding of the study was that for all different image acquisition selections the d’ scores were larger in raw images, whereas the other IQ metrics were larger in clinical images for most of the cases.ConclusionsSince IQ‐scores of raw and their respective clinical images may be largely different, the same type of image should be consistently used for monitoring IQ constancy and when results from different X‐ray systems are compared.
SPTLC2 variants are associated with early‐onset ALS and FTD due to aberrant sphingolipid synthesis
Authors: Naruse Hiroya , Ishiura Hiroyuki , Esaki Kayoko , Mitsui Jun , Satake Wataru , Greimel Peter , Shingai Nanoka , Machino Yuka , Kokubo Yasumasa , Hamaguchi Hirotoshi , Oda Tetsuya , Ikkaku Tomoko , Yokota Ichiro , Takahashi Yuji , Suzuki Yuta , Matsukawa Takashi , Goto Jun , Koh Kishin , Takiyama Yoshihisa , Morishita Shinichi , Yoshikawa Takeo , Tsuji Shoji , Toda Tatsushi 
Published: February 2024

AbstractObjectiveAmyotrophic lateral sclerosis (ALS) is a devastating, incurable neurodegenerative disease. A subset of ALS patients manifests with early‐onset and complex clinical phenotypes. We aimed to elucidate the genetic basis of these cases to enhance our understanding of disease etiology and facilitate the development of targeted therapies.MethodsOur research commenced with an in‐depth genetic and biochemical investigation of two specific families, each with a member diagnosed with early‐onset ALS (onset age of <40 years). This involved whole‐exome sequencing, trio analysis, protein structure analysis, and sphingolipid measurements. Subsequently, we expanded our analysis to 62 probands with early‐onset ALS and further included 440 patients with adult‐onset ALS and 1163 healthy controls to assess the prevalence of identified genetic variants.ResultsWe identified heterozygous variants in the serine palmitoyltransferase long chain base subunit 2 (SPTLC2) gene in patients with early‐onset ALS. These variants, located in a region closely adjacent to ORMDL3, bear similarities to SPTLC1 variants previously implicated in early‐onset ALS. Patients with ALS carrying these SPTLC2 variants displayed elevated plasma ceramide levels, indicative of increased serine palmitoyltransferase (SPT) activity leading to sphingolipid overproduction.InterpretationOur study revealed novel SPTLC2 variants in patients with early‐onset ALS exhibiting frontotemporal dementia. The combination of genetic evidence and the observed elevation in plasma ceramide levels establishes a crucial link between dysregulated sphingolipid metabolism and ALS pathogenesis. These findings expand our understanding of ALS's genetic diversity and highlight the distinct roles of gene defects within SPT subunits in its development.
Finite‐dimensional, output‐predictor‐based, adaptive observer for heat PDEs with sensor delay
Authors: Rafia H. , Benabdelhadi A. , Giri F. , Ouadi H. , Chaoui F. Z. 
Published: February 2024

SummaryWe are considering the problem of designing observers for heat partial differential equations (PDEs) that are subject to sensor delay and parameter uncertainty. In order to get finite‐dimensional observers, described by ordinary differential equations (ODE), we develop a design method based on the modal decomposition approach. The approach is extended so that both parameter uncertainty and sensor delay effects are compensated for. To cope more effectively with sensor delay, an output predictor is designed and the online provided output predictions are substituted to the future output values in the observer. To compensate for parameter uncertainty, we design a parameter estimator providing online parameter estimates, which are substituted to the unknown parameters in the observer. The parameter estimator design is made decoupled from the observer gain design by using an appropriate decoupling transformation. Using an analysis of the small‐gain‐theorem type, the whole (state and parameter) estimation error system is shown to be exponentially stable, under well‐defined conditions on the observer dimension, the sensor delay, and signal persistent excitation (PE).
Multifunctional Dual Network Hydrogel Loaded with Novel Tea Polyphenol Magnesium Nanoparticles Accelerates Wound Repair of MRSA Infected Diabetes
Authors: Hu Xulin , He Jian , Qiao Liang , Wang Chun , Wang Yao , Yu Rongxin , Xu Wei , Wang Fan , Yang Shuhao , Zhang Xiangchun , Qian Zhiyong 
Published: February 2024

AbstractMethicillin‐resistant Staphylococcus aureus (MRSA) biofilm infection, caused by impaired glucose metabolism in diabetic foot patients, poses a significant obstacle to the healing process and carries a high risk of being life‐threatening. Due to microvascular occlusion and the entrenchment of MRSA biofilms in diabetic foot, controlling and effectively treating MRSA infection remains challenging. Traditional hydrogels suffer from swelling‐related mechanical issues and inadequate drug release control, limiting their applications as biomimetic extracellular matrices for wound healing. Herein, a double‐network hydrogel composed of polyvinyl alcohol, sodium alginate, and gelatin (PSG) loaded with tea polyphenol self‐assembled magnesium nanoparticles (TP‐Mg NPs) with antibacterial and angiogenic properties for treating MRSA‐infected diabetic foot wounds under hyperglycemic conditions is constructed. TP‐Mg@PSG exhibits enhanced mechanical strength and toughness for wound attachment and recovery movement torsion. In the acidic infection microenvironment representative of MRSA‐infected wounds, the TP‐Mg@PSG hydrogel degrades to release TP‐Mg NPs, showing excellent anti‐MRSA biofilm effect and high biocompatibility. Such localized controlled release enhances the inhibition of MRSA infection and reduces the inflammatory response in rats, promoting cell proliferation and rapid wound repair. Therefore, this study presents a multifunctional biomaterial system for managing diabetic foot conditions, highlighting its potential for clinical applications.
Manipulation of Surface Electrical Charge on Nanocomposite Membranes Confers Wide Spectrum Bactericidal Effects and Promotes Tissue Regeneration
Authors: Song Jia , Lu Yanhui , Pan Ting , Wang Jianfeng , Liu Ziqi , Xu Lei , Zhang Siqi , Li Yiping , Bai Yunyang , Heng Boon Chin , Zheng Xiaona , Wu Haoyan , Han Xiaoyu , Guo Yusi , Cui Qun , Deng Xuliang , Zhang Xuehui 
Published: February 2024

AbstractUtilization of electro‐responsive biomaterials with antibacterial properties is advantageous for facilitating septic wound healing and tissue regeneration. However, the dose‐response effects of electrical stimuli from these materials against bacteria are not rigorously characterized, and achieving synergy of bactericidal and pro‐regenerative effects of biomaterials remains a major challenge. Here, a graded series of flexible BaTiO3/P(VDF‐TrFE) electroactive nanocomposite membranes (EMs) are developed with varying surface charge intensities, to serve as antibacterial dressing for septic wound healing. EMs display broad‐spectrum antibacterial effects against both Gram‐positive and Gram‐negative bacteria in a dose‐dependent manner, depending on the magnitude of their surface electrical potential. Mechanistically, the surface charge of EMs increase intracellular levels of reactive oxygen species within bacteria cells, which in turn caused oxidative damage to the bacterial membrane, thereby suppressing bacterial activity and biofilm formation. Moreover, in vivo studies demonstrated that EMs effectively inhibited S. aureus infection and accelerated wound healing in a mouse skin defect model, as well as ameliorated P. gingivalis‐mediated periodontal inflammation in a mouse periodontitis model. Hence, this study optimizes the antibacterial properties of electroactive materials and characterizes the dose‐response effects of surface electrical charge against bacteria, thus validating the therapeutic applications of electroactive biomaterials in combating bacterial infection.
Mechanically Programmable Composite Metamaterials with Switchable Positive/Negative Poisson's Ratio
Authors: Du Lamei , Shi Wei , Gao Han , Jia Hongxing , Zhang Qiuting , Liu Mingjie , Xu Ye 
Published: February 2024

AbstractDesign of mechanical metamaterials with a negative Poisson's ratio (NPR), known as auxetics, is of great importance in the development of flexible electronics and tissue engineering. However, the mechanical performance of conventional auxetic metamaterials is largely hindered by the high porosity and lack of tunability, which restricts their practical engineering applications. Here, this study presents a programmable approach for designing integrated two‐phase auxetic composite metamaterials with pore‐free structure, robust interfaces, and customized mechanical properties by substituting the vacancy of the auxetic lattices (frame phase) with hydrogel‐based soft fillers (matrix phase). Manipulated by two‐phase stiffness contrast, integrated composite metamaterials exhibit a functional transition between auxetic and non‐auxetic behaviors. Rationally designing Young's modulus ratios in spatial domains endows the programming of composite metamaterials with the desired spatial heterogeneity. Furthermore, the incorporation of temperature‐responsive hydrogels to auxetic frames also enbles the development of dynamic programmable composites with the thermo‐driven adaptability. As a practical application demonstration, designed programmable composites are used to dynamically tune the phononic bandgaps. The design strategy of integrated two‐phase composite metamaterials paves the way for the development of advanced auxetic engineering materials with programmable mechanical properties, providing opportunity for conformal electronic patches, bio‐scaffolds, and smart functionality applications.
Light‐Responsive Nanoassemblies: Advancing Biomedical Innovation
Authors: Sia Chin Siew , Tey Beng Ti , Low Liang Ee 
Published: February 2024

AbstractThe integrative use of light and nanoassemblies has made a profound impact in the biomedical field for diagnosis, drug delivery, and phototherapy. Recent advances in the development of light‐responsive nanoassemblies showcase their capabilities in facilitating targeted diagnosis and therapy with minimal invasiveness, shaping the future of personalized medicine. In this work, the fundamental differences between types of light in biomedical applications, and the application of light‐responsive nanoassemblies in diagnosis and therapy are described, their biosafety profile is overviewed and discussed, and the translational challenges and potential clinical outlook of this emerging field are outlined.
Insights into Civilian Electromagnetic Absorption Materials: Challenges and Innovative Solutions
Authors: Lv Hualiang , Cui Jiacheng , Li Bangxin , Yuan Mingyue , Liu Jiajun , Che Renchao 
Published: February 2024

AbstractThe emergence and widespread adoption of fifth‐generation wireless technology in civilian sectors have advanced the information revolution, while simultaneously leading to a variety of negative impacts. Foremost issues in the civilian domain include electromagnetic (EM) pollution, interference, and the inefficient use of EM energy. Despite growing global awareness, progress in devising effective solutions is sluggish, underlining the complexity of these issues. The delay in addressing EM concerns arises from several factors, including a considerable gap in comprehensive understanding and the absence of a unified stance on these critical issues. Moreover, the emergence of new challenges like EM interference and energy inefficiency indicates a clear need for innovative ideas and approaches. Addressing these civilian issues extends beyond the inherent properties of EM absorbers, requiring combination of tailored macro‐structural designs and external energy field management for a comprehensive solution. This situation emphasizes the urgent need for diverse strategies and creative thinking to navigate the challenges posed by the civilian EM issues. This perspective underscores these identified challenges and systematically proposes practical approaches to each, aiming to foster both conversation and action in this crucial area. The insights provided are expected to substantially aid in confronting and alleviating these pressing EM concerns.
Bio‐Inspired Porous Microneedles Dwelled Stem Cells for Diabetic Wound Treatment
Authors: Fan Lu , Zhang Xiaoxuan , Wang Li , Song Yizuo , Yi Kexin , Wang Xiaoju , Zhang Hongbo , Li Ling , Zhao Yuanjin 
Published: February 2024

AbstractDiabetic wound healing is a serious, complex, and chronic process; one current promising and focusing technology in this area is stem cell treatment. Here, novel porous microneedle (MN) arrays is fabricated, which can highly mimetic stem cell niches, through template filling, and particle etching method. The human adipose‐derived stem cells (ADSCs) are encapsulated in Matrigel then loaded into the porous MN arrays by post‐perfusion. Because of the extracellular matrix‐mimicking, the biocompatible Matrigel offers a bionic microenvironment of stem cell nest suitable for growth. Benefiting from the numerous pore structures of MNs, the loaded ADSCs have enough space to fully absorb nutrients, proliferate greatly and exhibit prompted function. In addition, the cell‐loaded MN arrays have enough mechanical strength to penetrate the skin, allowing the ADSCs to get into the deep wound areas. Based on these features, the performance of the resultant MN arrays in promoting tissue regeneration is demonstrated, collagen deposition and angiogenesis in diabetes wounds of rat models. Thus, it is believe that the bioinspired porous MNs can act as excellent stem cell scaffolds and will find many practical values in clinic wound healing.
Integrated Bilayer Microneedle Dressing and Triboelectric Nanogenerator for Intelligent Management of Infected Wounds
Authors: Wang Kun , Ding Qihang , Qi Manlin , Zhang Wei , Hou Yuxiao , Cao Ruida , Li Chunyan , Xu Lin , Wang Lin , Kim Jong Seung 
Published: February 2024

AbstractThe integration of real‐time monitoring and on‐demand treatment has substantial potential to accelerate wound healing processes. In this context, versatile bilayer microneedles (MNs) and a triboelectric nanogenerator (TENG) are developed as a theranostic platform for efficient wound management. This platform provides benefits including controlling infection, promoting cell migration and proliferation, and the capability for biochemical sensing. The bilayer MNs comprise a solvable polyvinylpyrrolidone MN (pMN) affixed atop a conductive stainless‐steel MN (sMN). The robust sMN penetrates the requisite skin depth, while the pMN, infused with antibiotics, ensures sustained drug release upon dissolution in the interstitial fluids. Concurrently, the TENG generates electrical stimulation transmitted to the wound site through the conductive sMN, contributing to accelerated wound closure. Furthermore, the sMN, coated with silver and carbon nanotubes (CNT/Ag/sMN), functions as a transdermal electrochemical sensor to assess the wound state by detecting hydrogen peroxide and uric acid. Notably, in vivo animal studies have demonstrated that the MN‐TENG device not only effectively inhibits bacterial growth and expedites wound healing but also monitors wound biomarkers, thereby validating its utility in improving infected wound recovery. Consequently, this MN‐TENG based transdermal strategy fosters advancements in diagnostic and therapeutic technologies within wound management and related biomedical domains.