Utilization of extracorporeal membrane oxygenation during the COVID-19 pandemic.

The ongoing outbreak of severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2, or coronavirus disease 2019 (COVID-19)] was declared a pandemic by the World Health Organization on March 11, 2020. Worldwide, more than 65 million people have been infected with this SARS-CoV-2 virus, and over 1.5 million people have died due to the viral illness. Although a tremendous amount of medical progress has been made since its inception, there continues to be ongoing research regarding the pathophysiology, treatments, and vaccines. While a vast majority of those infected develop only mild to moderate symptoms, about 5% of people have severe forms of infection resulting in respiratory failure, myocarditis, septic shock, or multi-organ failure. Despite maximal cardiopulmonary support and invasive mechanical ventilation, mortality remains high. Extracorporeal membrane oxygenation (ECMO) remains a valid treatment option when maximal conventional strategies fail. Utilization of ECMO in the pandemic is challenging from both resource allocation and ethical standpoints. This article reviews the rationale behind its use, current status of utilization, and future considerations for ECMO in critically ill COVID-19 patients

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Pan-cancer analysis of whole genomes

Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale(1-3). Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter(4); identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation(5,6); analyses timings and patterns of tumour evolution(7); describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity(8,9); and evaluates a range of more-specialized features of cancer genomes(8,10-18).Peer reviewe

More than smell - COVID-19 is associated with severe impairment of smell, taste, and chemesthesis

Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments, such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, and generally lacked quantitative measurements. Here, we report the development, implementation, and initial results of a multilingual, international questionnaire to assess self-reported quantity and quality of perception in 3 distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, and 8 others, aged 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste, and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change ±100) revealed a mean reduction of smell (-79.7 ± 28.7, mean ± standard deviation), taste (-69.0 ± 32.6), and chemesthetic (-37.3 ± 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell but also affects taste and chemesthesis. The multimodal impact of COVID-19 and the lack of perceived nasal obstruction suggest that severe acute respiratory syndrome coronavirus strain 2 (SARS-CoV-2) infection may disrupt sensory-neural mechanisms. © 2020 The Author(s) 2020. Published by Oxford University Press. All rights reserved

Arsenic exposure in Indo Gangetic plains of Bihar causing increased cancer risk

Reportedly, 300 million people worldwide are affected by the consumption of arsenic contaminated groundwater. India prominently figures amongst them and the state of Bihar has shown an upsurge in cases affected by arsenic poisoning. Escalated arsenic content in blood, leaves 1 in every 100 human being highly vulnerable to being affected by the disease. Uncontrolled intake may lead to skin, kidney, liver, bladder, or lung related cancer but even indirect forms of cancer are showing up on a regular basis with abnormal arsenic levels as the probable cause. But despite the apparent relation, the etiology has not been understood clearly. Blood samples of 2000 confirmed cancer patients were collected from pathology department of our institute. For cross-sectional design, 200 blood samples of subjects free from cancer from arsenic free pockets of Patna urban agglomeration, were collected. Blood arsenic levels in carcinoma patients as compared to sarcomas, lymphomas and leukemia were found to be higher. The geospatial map correlates the blood arsenic with cancer types and the demographic area of Gangetic plains. Most of the cancer patients with high blood arsenic concentration were from the districts near the river Ganges. The raised blood arsenic concentration in the 2000 cancer patients strongly correlates the relationship of arsenic with cancer especially the carcinoma type which is more vulnerable. The average arsenic concentration in blood of the cancer patients in the Gangetic plains denotes the significant role of arsenic which is present in endemic proportions. Thus, the study significantly correlates and advocates a strong relation of the deleterious element with the disease. It also underlines the need to address the problem by deciphering the root cause of the elevated cancer incidences in the Gangetic basin of Bihar and its association with arsenic poisoning.Applied Geolog

Development and Application of PP-CNT Composite for Hummingbird Inspired MAV Flapping Wings

Micro Air Vehicles (MAVs) are small unmanned aircrafts which have a maximum size limit of 150 mm in any direction. They can be used for surveillance, reconnaissance, targeting, etc. To perform such missions, MAVs are required to hover. Hummingbirds, having excellent flight characteristics (such as hovering, ability to fly in any direction, ability to produce a reverse camber during upstroke for generating lift in both up-down strokes), have been chosen as the bio-inspiration for wing development. Wings are required to be light, strong and fatigue resistant, to be able to properly flap during flight. Therefore, wing-material becomes a crucial component. An optimization analysis, on the basis of density and fundamental frequency values obtained through Ansys, was done for selecting the wing material. Polypropylene (PP) was observed to have desired properties such as light weight, flexibility, strength, fatigue resistance, good heat and chemical resistance etc. Mixing Carbon Nano Tubes (CNTs) with PP can further increase the strength significantly, making it more suitable for large amplitude flapping. The PP-CNT composites were developed using solution casting method. The films were characterized mechanically (using UTM). The wings were characterized by their structural dynamic properties. The modal analysis of wings was done to obtain natural frequencies and mode shapes. The analysis was aimed to get the fundamental mode in the flapping range (8-15 Hz) of hummingbirds, as resonance increases efficiency. It was also done inside vacuum chamber to observe the effect of air on the natural frequency and modes. The Ansys results were compared with the experiments in vacuum for validation of experimental results. Damping coefficient of wings was also determined. In the end, bio-mimicking of hummingbird wing was also tried by doing some material and structural advancements in the wings

New design methodology for adaptive switching gain based discrete-time sliding mode control

The adaptive sliding mode control technique relaxes the assumption of known bound of the disturbance in discrete-time systems. However, the existing technique of gain adaptation in discrete-time sliding mode control has issues of gain overestimation and underestimation. Therefore, this paper proposes a technique to adapt the switching gain such that the adaptive gain can tackle the uncertainty without any knowledge of the bound of uncertainty while overcoming the over- and under-estimation problems of switching gain.Ship Design, Production and Operation

Clay-plug sediment as the locus of arsenic pollution in Holocene alluvial-plain aquifers

Shallow aquifers in many Holocene alluvial basins around the world have in the last three decades been identified as arsenic pollution hotspots, in which the spatial variation of natural (or: geogenic) arsenic concentration is conditioned by the meandering-river geomorphology and the fluvial lithofacies distribution. Despite the large amount of publications on the specifics of the pollution, still many uncertainties remain as to the provenance and processes that lead to arsenic enrichment in aquifers. In this paper, arsenic in abandoned and sediment-filled meandering-river bends (or: clay-plugs) is highlighted as a primary source of aquifer pollution. The combination of high organic-carbon deposition rates and the presence of chemically-bound natural arsenic in sediment of this specific geomorphological setting creates the potential for microbially-steered reductive dissolution of arsenic in an anoxic environment, and subsequent migration of the desorbed arsenic to, and stratigraphic entrapment in, adjacent sandy point-bar aquifers. To assess the magnitude of the arsenic source in clay-plug, bulk sediment volume calculations were made of twenty clay plugs on the Middle Ganges Plain of Bihar (India), by combining clay-plug surface area analysis of Sentinel-2 satellite data, side-scan sonar depth profiling of oxbow lakes and the Ganges River, and sedimentological data from five cored shallow wells. ICP-MS based elemental analysis of 36 core sub-samples, complemented with published concentration data in a similar geomorphological setting in West Bengal, India, yielded an average arsenic content of 28.75 mg/kg sediment in the 12-m-thick clay plugs, which amounts to a total arsenic volume of 0.07 – 3.13 . 106 kg per clay plug. A scenario is presented for the release of arsenic from the clay-plug sediment by microbial metabolism, followed by migration of the desorbed arsenic to the bordering point-bar sands.Applied Geolog

A Simple and Fast Hole Detection Algorithm for Triangulated Surfaces

We present a simple and fast algorithm for computing the exact holes in discrete two-dimensional manifolds embedded in a threedimensional Euclidean space. We deal with the intentionally created "through holes" or "tunnel holes" in the geometry as opposed to missing triangles. The algorithm detects the holes in the geometry directly without any simplified geometry approximation. Discrete Gaussian curvature is used for approximating the local curvature flow in the geometry and for removing outliers from the collection of feature edges. We present an algorithm with varying degrees of flexibility. The algorithm is demonstrated separately for sheets and solid geometries. This article demonstrates the algorithm on triangulated surfaces. However, the algorithm and the underlying data structure are also applicable for surfaces with mixed polygons.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Numerical Analysi

On the Effect of Clock Frequency on Voltage and Electromagnetic Fault Injection

We investigate the influence of clock frequency on the success rate of a fault injection attack. In particular, we examine the success rate of voltage and electromagnetic fault attacks for varying clock frequencies. Using three different tests that cover different components of a System-on-Chip, we perform fault injection while its CPU operates at different clock frequencies. Our results show that the attack’s success rate increases with an increase in clock frequency for both voltage and EM fault injection attacks. As the technology advances push the clock frequency further, these results can help assess the impact of fault injection attacks more accurately and develop appropriate countermeasures to address them.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Cyber Securit