4,563 research outputs found

    Case Report: The management of hemorrhagic shock of different origins by target-controlled coagulation and extracorporeal organ support (continuous renal replacement therapy)

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    IntroductionTrauma-related severe bleeding and peripartum hemorrhage complicated by shock state is challenging for acute care physicians. Management steps relating to each other include damage control surgery, maintenance of optimal clotting preconditions, point-of-care and targeted supplementation of coagulation factors, control of hyperfibrinolysis, and supplementation of thrombocytes. Extensive tissue damage and surgical management of bleeding activate the proinflammatory process, leading to a dysregulated immune response. The originating systemic inflammation produces further damage, harmfully altering clot formation through the activation of immunothrombosis.Clinical findingsThe case report presents one obstetric, massive bleeding patient and one politraumatized patient with severe hemorrhage. Both underwent extended surgery regarding bleeding control intervention.Interventions and outcomeElimination of coagulation disorder was driven by point-of-care viscoelastometry and targeted clotting factor supplementation. Continuous renal replacement therapy and the hemadsorption technique augmented the well-established, up-to-date recommendations-guided care throughout the treatment line. The patients could leave the intensive care unit 4 and 8 days following the initial injury.ConclusionPrompt administration of extracorporeal organ support enhanced the recovery from hemorrhagic shock

    Clinical, immunological and genetic features of histiocytic disorders

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    UMSL Bulletin 2023-2024

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    The 2023-2024 Bulletin and Course Catalog for the University of Missouri St. Louis.https://irl.umsl.edu/bulletin/1088/thumbnail.jp

    Functional Nanomaterials and Polymer Nanocomposites: Current Uses and Potential Applications

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    This book covers a broad range of subjects, from smart nanoparticles and polymer nanocomposite synthesis and the study of their fundamental properties to the fabrication and characterization of devices and emerging technologies with smart nanoparticles and polymer integration

    LIPIcs, Volume 251, ITCS 2023, Complete Volume

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    LIPIcs, Volume 251, ITCS 2023, Complete Volum

    UMSL Bulletin 2022-2023

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    The 2022-2023 Bulletin and Course Catalog for the University of Missouri St. Louis.https://irl.umsl.edu/bulletin/1087/thumbnail.jp

    Data-assisted modeling of complex chemical and biological systems

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    Complex systems are abundant in chemistry and biology; they can be multiscale, possibly high-dimensional or stochastic, with nonlinear dynamics and interacting components. It is often nontrivial (and sometimes impossible), to determine and study the macroscopic quantities of interest and the equations they obey. One can only (judiciously or randomly) probe the system, gather observations and study trends. In this thesis, Machine Learning is used as a complement to traditional modeling and numerical methods to enable data-assisted (or data-driven) dynamical systems. As case studies, three complex systems are sourced from diverse fields: The first one is a high-dimensional computational neuroscience model of the Suprachiasmatic Nucleus of the human brain, where bifurcation analysis is performed by simply probing the system. Then, manifold learning is employed to discover a latent space of neuronal heterogeneity. Second, Machine Learning surrogate models are used to optimize dynamically operated catalytic reactors. An algorithmic pipeline is presented through which it is possible to program catalysts with active learning. Third, Machine Learning is employed to extract laws of Partial Differential Equations describing bacterial Chemotaxis. It is demonstrated how Machine Learning manages to capture the rules of bacterial motility in the macroscopic level, starting from diverse data sources (including real-world experimental data). More importantly, a framework is constructed though which already existing, partial knowledge of the system can be exploited. These applications showcase how Machine Learning can be used synergistically with traditional simulations in different scenarios: (i) Equations are available but the overall system is so high-dimensional that efficiency and explainability suffer, (ii) Equations are available but lead to highly nonlinear black-box responses, (iii) Only data are available (of varying source and quality) and equations need to be discovered. For such data-assisted dynamical systems, we can perform fundamental tasks, such as integration, steady-state location, continuation and optimization. This work aims to unify traditional scientific computing and Machine Learning, in an efficient, data-economical, generalizable way, where both the physical system and the algorithm matter

    Evaluating the sustainability and resiliency of local food systems

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    With an ever-rising global population and looming environmental challenges such as climate change and soil degradation, it is imperative to increase the sustainability of food production. The drastic rise in food insecurity during the COVID-19 pandemic has further shown a pressing need to increase the resiliency of food systems. One strategy to reduce the dependence on complex, vulnerable global supply chains is to strengthen local food systems, such as by producing more food in cities. This thesis uses an interdisciplinary, food systems approach to explore aspects of sustainability and resiliency within local food systems. Lifecycle assessment (LCA) was used to evaluate how farm scale, distance to consumer, and management practices influence environmental impacts for different local agriculture models in two case study locations: Georgia, USA and England, UK. Farms were grouped based on urbanisation level and management practices, including: urban organic, peri-urban organic, rural organic, and rural conventional. A total of 25 farms and 40 crop lifecycles were evaluated, focusing on two crops (kale and tomatoes) and including impacts from seedling production through final distribution to the point of sale. Results were extremely sensitive to the allocation of composting burdens (decomposition emissions), with impact variation between organic farms driven mainly by levels of compost use. When composting burdens were attributed to compost inputs, the rural conventional category in the U.S. and the rural organic category in the UK had the lowest average impacts per kg sellable crop produced, including the lowest global warming potential (GWP). However, when subtracting avoided burdens from the municipal waste stream from compost inputs, trends reversed entirely, with urban or peri-urban farm categories having the lowest impacts (often negative) for GWP and marine eutrophication. Overall, farm management practices were the most important factor driving environmental impacts from local food supply chains. A soil health assessment was then performed on a subset of the UK farms to provide insight to ecosystem services that are not captured within LCA frameworks. Better soil health was observed in organically-farmed and uncultivated soils compared to conventionally farmed soils, suggesting higher ecosystem service provisioning as related to improved soil structure, flood mitigation, erosion control, and carbon storage. However, relatively high heavy metal concentrations were seen on urban and peri-urban farms, as well as those located in areas with previous mining activity. This implies that there are important services and disservices on farms that are not captured by LCAs. Zooming out from a focus on food production, a qualitative methodology was used to explore experiences of food insecurity and related health and social challenges during the COVID-19 pandemic. Fourteen individuals receiving emergency food parcels from a community food project in Sheffield, UK were interviewed. Results showed that maintaining food security in times of crisis requires a diverse set of individual, household, social, and place-based resources, which were largely diminished or strained during the pandemic. Drawing upon social capital and community support was essential to cope with a multiplicity of hardship, highlighting a need to develop community food infrastructure that supports ideals of mutual aid and builds connections throughout the food supply chain. Overall, this thesis shows that a range of context-specific solutions are required to build sustainable and resilient food systems. This can be supported by increasing local control of food systems and designing strategies to meet specific community needs, whilst still acknowledging a shared global responsibility to protect ecosystem, human, and planetary health
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