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Background: The use of veno-venous extracorporeal membrane oxygenation (VV ECMO) remains controversial in trauma patients with acute respiratory distress syndrome (ARDS). Here, we aimed to investigate the therapeutic benefits of VV ECMO and the factors affecting patient outcomes. Methods: From 2017 to 2019, 21/1938 trauma patients (median age: 47 years; 18 men) at a level I trauma center received VV ECMO for post-traumatic ARDS. Demographic, injury-specific, ECMO, and outcome data were prospectively collected and retrospectively reviewed to analyze the factors affecting hospital mortality and ECMO results. Results: 19 patients (90.5%) were successfully weaned off ECMO; 16 patients (76.2%) survived to discharge. In univariate analysis, there was a significant difference in survival between the groups with a Trauma and Injury Severity Score (TRISS) ⩾0.5 and TRISS <0.5 (p = 0.05). The area under the receiver operating characteristic curve (AUC) for both TRISS and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) scores for death was 0.78. In those who failed ECMO weaning, the AUCs of the TRISS and RESP scores were 0.90 and 0.80, respectively. Conclusions: In patients with ARDS caused by severe trauma and supported by VV ECMO, survival is associated with TRISS; TRISS and RESP scores may be predictive of mortality and failure in ECMO weaning. [ABSTRACT FROM AUTHOR]

Patients with two congenital heart diseases (CHDs), Ebstein’s anomaly (EA) and left ventricular noncompaction (LVNC), suffer higher morbidity than either CHD alone. The genetic etiology and pathogenesis of combined EA/LVNC remain largely unknown. We investigated a familial EA/LVNC case associated with a variant (p.R237C) in the gene encoding Kelch-like protein 26 (KLHL26) by differentiating induced pluripotent stem cells (iPSCs) generated from affected and unaffected family members into cardiomyocytes (iPSC-CMs) and assessing iPSC-CM morphology, function, gene expression, and protein abundance. Compared with unaffected iPSC-CMs, CMs containing the KLHL26 (p.R237C) variant exhibited aberrant morphology including distended endo(sarco)plasmic reticulum (ER/SR) and dysmorphic mitochondria and aberrant function that included decreased contractions per minute, altered calcium transients, and increased proliferation. Pathway enrichment analyses based on RNASeq data indicated that the “structural constituent of muscle” pathway was suppressed, whereas the “ER lumen” pathway was activated. Taken together, these findings suggest that iPSC-CMs containing this KLHL26 (p.R237C) variant develop dysregulated ER/SR, calcium signaling, contractility, and proliferation. NEW & NOTEWORTHY We demonstrate here that iPSCs derived from patients with Ebstein’s anomaly and left ventricular noncompaction, when differentiated into cardiomyocytes, display significant structural and functional changes that offer insight into disease pathogenesis, including altered ER/SR and mitochondrial morphology, contractility, and calcium signaling. [ABSTRACT FROM AUTHOR]

Vitiation air heater (VAH) combustion characteristics for a direct-connect scramjet combustor (DCSC) were experimentally studied. The VAH consists of a head, modular chamber, and circular-to-rectangular shape transition (CRST) nozzle. The CRST nozzle transforms the circular cross-sectioned rocket-type VAH into a rectangular cross-sectioned scramjet combustor. The CRST nozzle exit Mach numbers at the top, middle, and bottom were measured using a tungsten wedge. The oblique shock formed by the wedge was captured using Schlieren visualization and recorded with a high-speed camera. The θ-β-M relation showed that the exit Mach number was 2.04 ± 0.04 with a chamber pressure of 1.685 ± 0.07 MPa. With the VAH design point verified, preliminary scramjet combustor ignition tests were conducted. As the fuel was not auto-ignited by the vitiated air, the forced ignition method, in which VAH ignition flame ignites the scramjet fuel, was used. The Schlieren images showed that a cavity shear layer combustion mode was formed and also showed that the forced ignition method could be used as a reference model for the ignitor-ignition method. [ABSTRACT FROM AUTHOR]

Aim: The incidence of fungal sinusitis is increasing; however, its pathophysiology has not been investigated previously. We investigate the effect of periodontitis on the incidence of fungal sinusitis over a 12‐year follow‐up period using nationwide population‐based data. Materials and Methods: The periodontitis group was randomly selected from the National Health Insurance Service database. The non‐periodontitis group was obtained by propensity score matching considering several variables. The primary end point was the diagnosis of sinonasal fungal balls (SFBs) and invasive fungal sinusitis (IFS). Results: The periodontitis and non‐periodontitis groups included 12,442 and 12,442 individuals, respectively. The overall adjusted hazard ratio (aHR) for SFBs in the periodontitis group was 1.46 (p =.002). In subgroup analysis, the aHR for SFBs was 1.59 (p = 0.008) for those with underlying chronic kidney disease (CKD), 1.58 (p =.022) for those with underlying atopic dermatitis, 1.48 (p =.019) for those with chronic obstructive pulmonary disease (COPD), and 1.36 (p =.030) for those with diabetes mellitus (DM), but these values are applicable only when considering the relationship between periodontitis and SFB. The aHR for IFS in the periodontitis group was higher than in the non‐periodontitis group (2.80; p =.004). Conclusions: The risk of SFBs and IFS increased after diagnosis of periodontitis. This trend is often more severe in patients with DM, COPD, or CKD, but this association with underlying diseases is applicable only when considering the association between periodontitis and fungal sinusitis. [ABSTRACT FROM AUTHOR]

Electrochemical metallization threshold switch (ECM TS) has received significant attention for various applications owing to its high ON/OFF ratio, fast switching characteristics, and simple active electrode/dielectric layer/inert electrode structures. However, the excess diffusion of active metal ions causes severe variation in threshold voltage and poor endurance. Furthermore, the small room for inert electrode metal is a problem to be solved for various applications of ECM TS. Here, a novel structure is proposed in which a two‐dimensional platinum diselenide (PtSe2) is inserted between the dielectric layer and inert electrode to engineer the conductive filament by controlling the active metal ion concentration. The low work function, superior inertness, layered structure, and smooth surface of PtSe2 insertion layer lead to thin and weak conductive filament with few active metal atoms and allow the use of various metals as inert electrode. Consequently, PtSe2‐inserted ECM TS shows high reliability in both threshold voltage distribution (σ/µ = ≈6.58%) and endurance (>106 cycles). Furthermore, PtSe2‐inserted ECM TS‐based 2 × 2 cross‐bar array is proposed as AND and OR logic circuits. This study is expected to pave the way for the development of ECM TS for next‐generation electronic applications. [ABSTRACT FROM AUTHOR]