Notes

Well-designed hypogonadism within middle-aged and elderly males: testo-sterone treatment or otherwise not?
The present Perspective examined the latest evidence on the association between the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and the incidence/mortality of coronavirus disease 2019 (COVID-19). Our critical appraisal from existing literature does not support discontinuation of ACEIs/ARBs in clinical practice as there is absence of solid evidence. However, we do recommend future research perspective in formulation and implementation of practice-changing guidelines.
Impaired autonomic nervous system regulation is frequently observed in patients with stroke. The aim of this prospective study was to evaluate the impact of cardiac autonomic tone on functional outcome after the early post-stroke rehabilitation.

One hundred and three consecutive patients (67 ± 11 years, body mass index (BMI) 27.1 ± 5.4 kg/m
, 64% men) with ischaemic (84% of patients) and haemorrhagic stroke were studied. Depressed heart rate variability (HRV), as a surrogate marker of increased sympathetic tone, was defined by the standard deviation of NN intervals < 100 ms and HRV triangular index ≤ 20 assessed from a 24 h Holter electrocardiogram at admission to rehabilitation (23 ± 16 days after stroke). Twenty-two per cent of patients had depressed HRV at baseline and were comparable with patients with normal HRV with regard to their functional [Barthel Index (BI), modified Rankin Scale (mRS), and Rivermead Motor Assessment (RMA)] and biochemical status. After a 4-week follow-up, 70% of patients with depressed HRV showed a cumulative functional disability, defined by mRS ≥ 4, BI ≤ 70, and RMA ≤ 5, in contrast to patients with normal HRV (35%, P = 0.003). Patients with depressed HRV showed a worse functional status by BI (-16%, P < 0.001), RMA (-12%, P < 0.05), and mRS (+16%, P < 0.01), compared with patients with normal HRV. Cumulative functional disability was associated with depressed HRV (odds ratio 4.25, 95% confidence interval 1.56-11.54, P < 0.005) after adjustment for age, sex, and body mass index (odds ratio 4.6, 95% confidence interval 1.42-14.97, P < 0.05).

The presence of autonomic cardiovascular dysregulation in patients with subacute stroke was associated with adverse functional outcome after the early post-stroke rehabilitation.
The presence of autonomic cardiovascular dysregulation in patients with subacute stroke was associated with adverse functional outcome after the early post-stroke rehabilitation.
Acute right heart failure (RHF) is a severe complication of right ventricular infarction. The management of acute RHF poses a number of challenges, such as providing haemodynamic support. Temporary circulatory support (TCS) may be required upon failing medical therapy. The ProtekDuo® dual lumen cannula provides a minimally invasive option for (TCS) through a groin-free internal jugular vein approach. We present the largest patient series to date using the ProtekDuo® cannula as temporary right ventricular assist device (t-RVAD) in RHF after acute myocardial infarction (MI).

From July 2016 to November 2019, 10 patients underwent t-RVAD implantation for RHF following acute MI. Transthoracic and transoesophageal echocardiography were performed in all patients to assess cardiac function, with a particular focus on RV function. Cumulative 30-day survival was 60%. Mean TAPSE was 6.4 ± 3.1 mm, mean fractional area change was 12.1 ± 4.2%, and mean right ventricular end diastolic area was 19.8 ± 2.7 cm
. Mean impxplantation, as well as the option for adding an oxygenator to the t-RVAD circuit.
We show that groin-free, percutaneous implantation of the ProtekDuo® cannula is a feasible and safe tool for TCS in acute RHF post-MI. This approach provides the advantages of percutaneous implantation including complete mobilization and non-surgical bedside explantation, as well as the option for adding an oxygenator to the t-RVAD circuit.
The aim of this paper was to analyse heart failure (HF) signs and symptoms, hospital referrals, and prescription patterns in patients receiving sacubitril/valsartan (sac/val) in primary care and cardiology settings in Germany.

A retrospective cohort study of electronic medical records identified 1263 adults (aged ≥18 years) in the German IMS® Disease Analyzer database who were prescribed sac/val during 2016 and had at least 6 months of data following sac/val initiation. Clinical characteristics were collected during the 12 months before the first recorded sac/val prescription (index date) and 6 months post-index. Details of sac/val dose and prescription patterns were also recorded in the 6 months post-index. HF signs, symptoms, and all-cause hospital referrals were evaluated for 90 days pre-index and 30-120 days post-index. Most patients (62%) were prescribed the lowest sac/val dose of 24/26 mg twice daily (b.i.d.) at index; only 14% of patients initiated on 24/26 mg or 49/51 mg b.i.d. were up-titrated tonician inertia.
A high prevalence of muscle wasting, that is, reduction in muscle mass, in patients with peripheral artery disease (PAD) and heart failure (HF) has been reported. However, whether the association between PAD and muscle wasting is independent of shared risk factors such as diabetes mellitus has not been examined.

We retrospectively enrolled 440 HF patients (mean age, 74 years; inter-quartile range, 64-82 years; 52% male). Muscle wasting was defined as an appendicular skeletal muscle mass index (ASMI) of <7.0 kg/m
in men and <5.4 kg/m
in women. PAD was defined as an ankle brachial index (ABI) of <0.9 in either leg. The prevalence of PAD in HF patients was 21%. ASMI was positively correlated with ABI in HF patients. In multivariate logistic regression analysis, ASMI and muscle wasting were selected as independent explanatory factors of the presence of PAD after adjustment for age, sex, diabetes mellitus, hypertension, dyslipidaemia, estimated glomerular filtration rate, and smoking status, established risk factors of atherosclerosis. In propensity score-matched analysis, frequency of muscle wasting was higher in patients with PAD than in patients with an ABI of ≧1.1 (72.1% vs. 52.5%, P = 0.04).

The results suggest that there is an independent link between PAD and muscle wasting in HF patients.
The results suggest that there is an independent link between PAD and muscle wasting in HF patients.The authors wish to make the following corrections to this paper [...].This paper presents the development process of a robust and ROS-based Drive-By-Wire system designed for an autonomous electric vehicle from scratch over an open source chassis. A revision of the vehicle characteristics and the different modules of our navigation architecture is carried out to put in context our Drive-by-Wire system. The system is composed of a Steer-By-Wire module and a Throttle-By-Wire module that allow driving the vehicle by using some commands of lineal speed and curvature, which are sent through a local network from the control unit of the vehicle. Additionally, a Manual/Automatic switching system has been implemented, which allows the driver to activate the autonomous driving and safely taking control of the vehicle at any time. Finally, some validation tests were performed for our Drive-By-Wire system, as a part of our whole autonomous navigation architecture, showing the good working of our proposal. The results prove that the Drive-By-Wire system has the behaviour and necessary requirements to automate an electric vehicle. In addition, after 812 h of testing, it was proven that it is a robust Drive-By-Wire system, with high reliability. The developed system is the basis for the validation and implementation of new autonomous navigation techniques developed within the group in a real vehicle.Construction activities often generate intensive ground-borne vibrations that may adversely affect structure safety, human comfort, and equipment functionality. Vibration monitoring systems are commonly deployed to assess the vibration impact on the surrounding environment during the construction period. However, traditional vibration monitoring systems are associated with limitations such as expensive devices, difficult installation, complex operation, etc. Few of these monitoring systems have integrated functions such as in situ data processing and remote data transmission and access. By leveraging the recent advances in information technology, an Internet of Things (IoT) sensing system has been developed to provide a promising alternative to the traditional vibration monitoring system. A microcomputer (Raspberry Pi) and a microelectromechanical systems (MEMS) accelerometer are adopted to minimize the system cost and size. A USB internet dongle is used to provide 4G communication with cloud. CCT241533 Chk inhibitor Time synchronization and different operation modes have been designed to achieve energy efficiency. The whole system is powered by a rechargeable solar battery, which completely avoids cabling work on construction sites. Various alarm functions, MySQL database for measurement data storage, and webpage-based user interface are built on a public cloud platform. The architecture of the IoT vibration sensing system and its working mechanism are introduced in detail. The performance of the developed IoT vibration sensing system has been successfully validated by a series of tests in the laboratory and on a selected construction site.Patients with gliomas, isocitrate dehydrogenase 1 (IDH1) mutation status have been studied as a prognostic indicator. Recent advances in machine learning (ML) have demonstrated promise in utilizing radiomic features to study disease processes in the brain. We investigate whether ML analysis of multiparametric radiomic features from preoperative Magnetic Resonance Imaging (MRI) can predict IDH1 mutation status in patients with glioma. This retrospective study included patients with glioma with known IDH1 status and preoperative MRI. Radiomic features were extracted from Fluid-Attenuated Inversion Recovery (FLAIR) and Diffused Weighted Imaging (DWI). The dataset was split into training, validation, and testing sets by stratified sampling. Synthetic Minority Oversampling Technique (SMOTE) was applied to the training sets. eXtreme Gradient Boosting (XGBoost) classifiers were trained, and the hyperparameters were tuned. Receiver operating characteristic curve (ROC), accuracy, and f1-scores were collected. A total of 100 patients (age 55 ± 15, M/F 60/40); with IDH1 mutant (n = 22) and IDH1 wildtype (n = 78) were included. The best performance was seen with a DWI-trained XGBoost model, which achieved ROC with Area Under the Curve (AUC) of 0.97, accuracy of 0.90, and f1-score of 0.75 on the test set. The FLAIR-trained XGBoost model achieved ROC with AUC of 0.95, accuracy of 0.90, f1-score of 0.75 on the test set. A model that was trained on combined FLAIR-DWI radiomic features did not provide incremental accuracy. The results show that a XGBoost classifier using multiparametric radiomic features derived from preoperative MRI can predict IDH1 mutation status with > 90% accuracy.Over the last 15 years, the ability to harness a patient's own immune system has led to significant progress in cancer therapy. For instance, immunotherapeutic strategies, including checkpoint inhibitors or adoptive cell therapy using chimeric antigen receptor T-cell (CAR-T), are specifically aimed at enhancing adaptive anti-tumour immunity. Several research groups demonstrated that adaptive anti-tumour immunity is highly sustained by innate immune responses. Host innate immunity provides the first line of defence and mediates recognition of danger signals through pattern recognition receptors (PRRs), such as cytosolic sensors of pathogen-associated molecular patterns (PAMPs) and damage-associated molecular pattern (DAMP) signals. The retinoic acid-inducible gene I (RIG-I) is a cytosolic RNA helicase, which detects viral double-strand RNA and, once activated, triggers signalling pathways, converging on the production of type I interferons, proinflammatory cytokines, and programmed cell death. Approaches aimed at activating RIG-I within cancers are being explored as novel therapeutic treatments to generate an inflammatory tumour microenvironment and to facilitate cytotoxic T-cell cross-priming and infiltration.
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