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As the body's largest organ, the skin is an integrated multisensory system with self‐healing ability and helps stabilize body temperature. It is herein, inspired by natural skin, a wearable patch made from porous polydimethylsiloxane (PDMS) skeleton, poly(vinyl alcohol) (PVA) hydrogel, and silicon oxide (SiO2) particles, offers a combination of self‐healing properties, along with hybrid radiative and evaporative cooling mechanisms, designed for electromyographic (EMG) signal detection and human‐machine interaction. The patch has both high mid‐infrared (MIR) emittance (96%) and visible to near‐infrared (visNIR) reflectance (80%), coupled with efficient water evaporation from the PVA hydrogel, resulting in a hybrid cooling power of 180 W m−2. It obtains a temperature drop of ≈7.7 °C using this patch under a solar intensity of ≈700 W m−2. Furthermore, the patch demonstrates self‐healing ability with ultrafast recovery of electrical conductivity (1 s) and a self‐healing efficiency (≈71%) of fracture strain. Thus, the wearable patch can detect high‐quality EMG signals and provide cooling effects and self‐healing capabilities that enhance comfortability and durability. These features make the patch an advanced solution for developing next‐generation wearable patches that can meet the rigorous demands of durable body temperature control in various applications. [ABSTRACT FROM AUTHOR]

Introduction: Ascending aorta or hemi‐arch replacement is a frequently used treatment for patients with acute type A thoracic aortic dissection, particularly those who are elderly or have multiple comorbidities. However, in cases where there are secondary entry tears in the aortic arch or descending aorta, this procedure may not fully resolve the issue. The true lumen may remain compressed due to perfusion of the false lumen and usually require reoperation. Methods: Between January 2019 and July 2022, 18 patients underwent endovascular total aortic arch repair and fenestration technique without requiring median re‐sternotomy. Aortic stent grafts were implanted via the femoral approach, utilizing prosthetic vessels as an appropriate proximal landing zone for aortic stent graft deployment. Based on the debranching conditions of the arch in previous surgery, single, double or triple in situ fenestrations (ISFs) were performed, respectively. Results: All 18 cases were technically successful, with a median follow‐up period of 20 months (range: 18–31 months). All patients had a favourable postoperative course, with no deaths within 30 days or during their hospital stay. There were no instances of disabling stroke, paraplegia, endo‐leak, stent graft migration or stent graft‐induced new entry. In addition, all patients exhibited complete thrombosis of the false lumen at the level of the aortic arch. Conclusion: Our preliminary experience suggests that endovascular total arch repair combined with ISF technique is a viable, effective and safe option for treatment. Our mid‐term results have been promising, but we acknowledge the need for further evaluation to assess long‐term outcomes and durability. [ABSTRACT FROM AUTHOR]

As the scientific research community along with healthcare professionals and decision makers around the world fight tirelessly against the coronavirus disease 2019 (COVID‐19) pandemic, the need for comparative effectiveness research (CER) on preventive and therapeutic interventions for COVID‐19 is immense. Randomized controlled trials markedly under‐represent the frail and complex patients seen in routine care, and they do not typically have data on long‐term treatment effects. The increasing availability of electronic health records (EHRs) for clinical research offers the opportunity to generate timely real‐world evidence reflective of routine care for optimal management of COVID‐19. However, there are many potential threats to the validity of CER based on EHR data that are not originally generated for research purposes. To ensure unbiased and robust results, we need high‐quality healthcare databases, rigorous study designs, and proper implementation of appropriate statistical methods. We aimed to describe opportunities and challenges in EHR‐based CER for COVID‐19‐related questions and to introduce best practices in pharmacoepidemiology to minimize potential biases. We structured our discussion into the following topics: (1) study population identification based on exposure status; (2) ascertainment of outcomes; (3) common biases and potential solutions; and (iv) data operational challenges specific to COVID‐19 CER using EHRs. We provide structured guidance for the proper conduct and appraisal of drug and vaccine effectiveness and safety research using EHR data for the pandemic. This paper is endorsed by the International Society for Pharmacoepidemiology (ISPE). [ABSTRACT FROM AUTHOR]

Purpose: Supplementing investigator‐specified variables with large numbers of empirically identified features that collectively serve as 'proxies' for unspecified or unmeasured factors can often improve confounding control in studies utilizing administrative healthcare databases. Consequently, there has been a recent focus on the development of data‐driven methods for high‐dimensional proxy confounder adjustment in pharmacoepidemiologic research. In this paper, we survey current approaches and recent advancements for high‐dimensional proxy confounder adjustment in healthcare database studies. Methods: We discuss considerations underpinning three areas for high‐dimensional proxy confounder adjustment: (1) feature generation—transforming raw data into covariates (or features) to be used for proxy adjustment; (2) covariate prioritization, selection, and adjustment; and (3) diagnostic assessment. We discuss challenges and avenues of future development within each area. Results: There is a large literature on methods for high‐dimensional confounder prioritization/selection, but relatively little has been written on best practices for feature generation and diagnostic assessment. Consequently, these areas have particular limitations and challenges. Conclusions: There is a growing body of evidence showing that machine‐learning algorithms for high‐dimensional proxy‐confounder adjustment can supplement investigator‐specified variables to improve confounding control compared to adjustment based on investigator‐specified variables alone. However, more research is needed on best practices for feature generation and diagnostic assessment when applying methods for high‐dimensional proxy confounder adjustment in pharmacoepidemiologic studies. [ABSTRACT FROM AUTHOR]

Mushroom bodies (MBs), one of the central brain structures in Drosophila melanogaster, are involved in several cognitive behaviors, such as olfactory learning and memory, visual context generalization, choice behavior facing conflicting cues. Attention is a cognitive behavior, and it facilitates a focus on the attended event while filtering out irrelevant events, thereby allowing more rapid and accurate reactions at a lower threshold in primates. Using the visual orientation paradigm in a flight simulator, we observed that MBs modulate salience-based selective fixation behavior, which resembles attention in primates to a certain degree. We found that the fixation ability of MB-deficient flies was significantly reduced when the contrast levels were lowered as well as when a certain amount of background noise was applied. Moreover, MB-deficient flies exhibited poor object fixation ability in the presence of an olfactory ‘distracter’. Furthermore, during visual selection among multiple objects of different contrast, flies with MBs were able to ‘pop-out’ of the most salient object in a three-object selection paradigm. Finally, we determined that flies exhibited cross-modal synergistic integration between olfactory and visual signals during object-fixation behavior, which was independent of MBs. Taken together, our findings suggest that MBs do not contribute to cross-modal synergetic integration between olfactory and visual signals; instead, they confer sensory gain control and inhibitory gating in flies, this property allows entry of the salient signal as well as filters out background noise and irrelevant signals. [ABSTRACT FROM AUTHOR]

Dopamine is a major neuromodulator in both vertebrates and invertebrates and has profound effects on many physiological processes, including the regulation of attention. Most studies of the functions of dopamine use models with long-term blockade of dopamine release and few effects of transient blockade have yet been reported. The goal of the present study was to determine the role of dopamine in attention-like behavior in Drosophila by taking advantage of the fly's orientation behavior during flight. The examination of several different transgenic flies in a single-target visual attention paradigm showed that flies lost their orientation ability if dopamine release was blocked from the beginning of the development of dopaminergic neurons. This is similar to the attention loss in mammals. However, if the blockade of dopamine release was induced during the experimental procedure, flies performed normally. Statistical analysis of the behavioral assessment showed a significant difference between long-term and transient blockade. Using the RNA interference approach, we generated flies with down-regulated J-domain protein, which is a potential cochaperone in synaptic vesicle release, to make an alternative form of long-term dopamine-blockade mutant. Behavioral assays revealed that flies with permanent J-domain protein down-regulation specifically in dopaminergic neurons have an attention defect similar to that induced by long-term blockade of dopamine release. Furthermore, dopamine depletion beginning at eclosion also caused an attention deficit. Our results indicate that prolonged but not transient blockade of dopamine release impairs visual attention-like behavior in Drosophila. [ABSTRACT FROM AUTHOR]