Vivostat Platelet-Rich Fibrin® for Complicated or Chronic Wounds-A Pilot Study

Vivostat Platelet-Rich Fibrin® (PRF) is an autologous platelet concentrate used for the local treatment of chronic or complicated wounds. Still, its application for this indication is not evidence-based. Therefore, we performed this monocentric retrospective pilot study investigating the clinical outcome of a local treatment of chronic or complicated wounds in 35 patients (23 male, 12 female, mean age 68.7 years) treated with Vivostat PRF®. This study population is the largest among published studies analyzing the clinical efficacy of Vivostat PRF® on chronic wounds so far. Using the perpendicular method we divided the wounds into three sizes (30 cm2). The clinical efficacy of the Vivostat PRF treatment was the primary endpoint and was divided into three groups of increasing degrees of wound improvement: (1) no improvement of the wound (wound area was not reduced > 10% under Vivostat PRF® treatment), (2) improvement of the wound (reduced area > 10% under Vivostat PRF® treatment) and (3) complete epithelialization (wounds that were completely re-epithelialized after Vivostat PRF® treatment). We included patients' diagnosis and concomitant diseases (peripheral arterial occlusive disease (PAOD)), chronic venous insufficiency (CVI)), diabetic foot syndrome (DFS)) in our data analysis in order to investigate their potential impact on the wound healing capacity of Vivostat PRF®. Our results show that in the entire study population, 13 out of 35 (37.1%) patients experienced wound improvement and 14 out of 35 (40%) patients showed complete epithelialization of their wound under Vivostat PRF® treatment. In summary, 77.1% of the treated patients benefited from the Vivostat PRF® therapy

Is total arch replacement associated with an increased risk after acute type A dissection?

Background The surgical strategy for acute type A aortic dissection (AADA) usually consists of reconstruction of the tear-lesion in the affected part of the ascending aorta. The optimal strategy either to replace the ascending aorta (AAR) or to replace the ascending aorta and the total aortic arch (TAAR) is still under debate. Our study compares the 30-day mortality between AAR and TAAR in AADA surgery. Results In 292 (86.1%) patients AAR and in 47 (13.9%) patients TAAR was performed for emergent AADA. Patients were older (P=0.049) in the AAR group. The median log Euro-SCORE was 25.5% (12.7; 41.7) for AAR and 19.7% (11.7; 32.2) for the TAAR patient cohort (P=0.12). Operative time, cardiopulmonary bypass- (CPB), cross-clamp- and ischemic time were significantly longer in the TAAR group (P<0.001). The overall 30-day mortality-rate was 17.7% (n=60) but was not significantly different between the two groups (P=0.27). Forty-nine (16.8%) patients died in the AAR and 11 patients (23.4%) in the TAAR group. After propensity-score matching, no difference in mortality was seen between the subgroups as well (P=0.44). Multivariable analysis identified the Euro-SCORE, long operation-time, postoperative dialysis and arrhythmia and administration of red blood cell concentrates as risk factors for 30-day mortality, but not for TAAR versus AAR. Conclusions The therapeutic goal in AADA surgery should be the complete restoration of the aorta to avoid further long-term complications and re-operations. Though 30-day mortality and postoperative co-morbidity for AAR are comparable to those in TAAR after treatment of AADA in our analysis, decision-making for the surgical strategy should weigh the operative risk of TAAR against the long-term outcome

Effects of different ischemic preconditioning strategies on physiological and cellular mechanisms of intestinal ischemia/reperfusion injury: Implication from an isolated perfused rat small intestine model

Background Intestinal ischemia/reperfusion (I/R)-injury often results in sepsis and organ failure and is of major importance in the clinic. A potential strategy to reduce I/R-injury is the application of ischemic preconditioning (IPC) during which repeated, brief episodes of I/R are applied. The aim of this study was to evaluate physiological and cellular effects of intestinal I/R-injury and to compare the influence of in-vivo IPC (iIPC) with ex-vivo IPC (eIPC), in which blood derived factors and nerval regulations are excluded. Results I/R-injury decreased intestinal galactose uptake (iIPC group: p<0.001), increased vascular perfusion pressure (iIPC group: p<0.001; eIPC group: p<0.01) and attenuated venous flow (iIPC group: p<0.05) while lactate-to-pyruvate ratio (iIPC group, eIPC group: p<0.001), luminal flow (iIPC group: p<0.001; eIPC group: p<0.05), goblet cell ratio (iIPC group, eIPC group: p<0.001) and apoptosis (iIPC group, eIPC group: p<0.05) were all increased. Application of iIPC prior to I/R increased vascular galactose uptake (P<0.05) while eIPC had no significant impact on parameters of I/R-injury. On cellular level, I/R-injury resulted in a reduction of the phosphorylation of several MAPK signaling molecules. Application of iIPC prior to I/R increased phosphorylation of JNK2 and p38δ while eIPC enhanced CREB and GSK-3α/β phosphorylation. Conclusion Intestinal I/R-injury is associated with major physiological and cellular changes. However, the overall influence of the two different IPC strategies on the acute phase of intestinal I/R-injury is rather limited

Thoughts on opportunities from high-energy nuclear collisions

This document summarizes thoughts on opportunities from high-energy nuclear collisions.Comment: 10 pages, pd

Physiological-based cord clamping versus immediate cord clamping for infants born with a congenital diaphragmatic hernia (PinC):study protocol for a multicentre, randomised controlled trial

Introduction Pulmonary hypertension is a majordeterminant of postnatal survival in infants with acongenital diaphragmatic hernia (CDH). The current careduring the perinatal stabilisation period in these infantsmight contribute to the development of pulmonaryhypertension after birth—in particular umbilical cordclamping before lung aeration. An ovine model ofdiaphragmatic hernia demonstrated that cord clampingafter lung aeration, called physiological-based cordclamping (PBCC), avoided the initial high pressures in thelung vasculature while maintaining adequate blood flow,thereby avoiding vascular remodelling and aggravationof pulmonary hypertension. We aim to investigate if theimplementation of PBCC in the perinatal stabilisation periodof infants born with a CDH could reduce the incidence ofpulmonary hypertension in the first 24 hours after birth.Methods and analysis We will perform a multicentre,randomised controlled trial in infants with an isolatedleft-sided CDH, born at ≥35.0 weeks. Before birth, infantswill be randomised to either PBCC or immediate cordclamping, stratified by treatment centre and severity ofpulmonary hypoplasia on antenatal ultrasound. PBCCwill be performed using a purpose- built resuscitationtrolley. Cord clamping will be performed when the infantis considered respiratory stable, defined as a heartrate &gt;100 bpm, preductal oxygen saturation &gt;85%,while using a fraction of inspired oxygen of &lt;0.5. Theprimary outcome is pulmonary hypertension diagnosedin the first 24 hours after birth, based on clinical andechocardiographic parameters. Secondary outcomesinclude neonatal as well as maternal outcomes.Ethics and dissemination Central ethical approvalwas obtained from the Medical Ethical Committee ofthe Erasmus MC, Rotterdam, The Netherlands (METC2019-0414). Local ethical approval will be obtained bysubmitting the protocol to the regulatory bodies and localinstitutional review boards

CONTENT 2016, The Eighth International Conference on Creative Content Technologies: March 20-24, 2016, Rome, Italy

The Eighth International Conference on Creative Content Technologies (CONTENT 2016), held between March 20-24, 2016 in Rome, Italy, continued a series of events targeting advanced concepts, solutions and applications in producing, transmitting and managing various forms of content and their combination. Multi-cast and uni-cast content distribution, content localization, on-demand or following customer profiles are common challenges for content producers and distributors. Special processing challenges occur when dealing with social, graphic content, animation, speech, voice, image, audio, data, or image contents. Advanced producing and managing mechanisms and methodologies are now embedded in current and soon-to-be solutions

A Key to More Information within Less Bandwidth at Higher Quality

This paper proposes a novel, yet extremely compact model representation method. Its main feature is that 3D shapes are represented in terms of functions instead of geometric primitives. Given a set of – typically only a few – specific parameters, the evaluation of such a function results in a model that is one instance of a general shape. Particularly important for the web context with client systems of widely varying rendering performance is the support of a semantic level-of-detail superior to any low-level polygon reduction scheme. The shape description language has the power of a full programming language, but it has an extremely simple syntax. It can be regarded as some form of a ’mesh creation/manipulation language’. It is designed to facilitate the composition of more complex modeling operations out of simpler ones. Thus, it allows to create highlevel operators which evaluate to arbitrarily complex, parameterized shapes. The underlying shape representation is a boundary representation mesh in combination with Catmull/Clark subdivision surfaces

A scalable rendering framework for generative 3D content

Delivering high quality 3D content through a web browser is still a challenge especially when intellectual property (IP) protection is necessary. Thus, the transfer of 3D modeling information to a client should be avoided. In our work we present a solution to this problem by introducing a server-side rendering framework. Only images are transferred to the client, the actual 3D content is not delivered. By providing simple proxy geometry it is still possible to provide direct interaction on the client. Our framework incorporates the Generative Modeling Language (GML) for the description and rendering of generative content. It is then possible to not only interact with the 3D content, but to modify the actual shape within the possibilities of the generative content. By introducing a control layer and encapsulating processing and rendering of the generative content in a so called GML Rendering Unit (GRU) it is possible to provide a scalable rendering framework

Automatic fly-through camera animations for 3D architectural repositories

Virtual fly-through animations through computer generated models are a strong tool to convey properties and the appearance of these models. In, e.g., architectural models the big advantage of such a fly-through animation is that it is possible to convey the structure of the model easily. However, the path generation is not always trivial, to get a good looking animation. The proposed approach in this paper can handle arbitrary 3D models and then extract a meaningful and good looking camera path. To visualize the path HTML/X3DOM is used and therefore it is possible to view the final result in a browser with X3DOM support

Sustainable Markup and Annotation of 3D Geometry

We propose a novel general method to enrich ordinary 3D models with semantic information. Based on the Collada format this approach fits perfectly into the XML world: It allows bi-directional linking, from a web resource to a (part of) a 3D model, and the reverse direction as well. We also describe our software framework prototype for 3D-annotation by non-3D-specialists, in our case cultural heritage professionals