41 research outputs found
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Abstract: Esophageal Reconstruction with Supercharged Jejunal Interposition: A Reliable Intervention for Establishing Esophageal Continuity in a Pediatric Population
A Thermophilic Ionic Liquid-Tolerant Cellulase Cocktail for the Production of Cellulosic Biofuels
Generation of biofuels from sugars in lignocellulosic biomass is a promising alternative to liquid fossil fuels, but efficient and inexpensive bioprocessing configurations must be developed to make this technology commercially viable. One of the major barriers to commercialization is the recalcitrance of plant cell wall polysaccharides to enzymatic hydrolysis. Biomass pretreatment with ionic liquids (ILs) enables efficient saccharification of biomass, but residual ILs inhibit both saccharification and microbial fuel production, requiring extensive washing after IL pretreatment. Pretreatment itself can also produce biomass-derived inhibitory compounds that reduce microbial fuel production. Therefore, there are multiple points in the process from biomass to biofuel production that must be interrogated and optimized to maximize fuel production. Here, we report the development of an IL-tolerant cellulase cocktail by combining thermophilic bacterial glycoside hydrolases produced by a mixed consortia with recombinant glycoside hydrolases. This enzymatic cocktail saccharifies IL-pretreated biomass at higher temperatures and in the presence of much higher IL concentrations than commercial fungal cocktails. Sugars obtained from saccharification of IL-pretreated switchgrass using this cocktail can be converted into biodiesel (fatty acid ethyl-esters or FAEEs) by a metabolically engineered strain of E. coli. During these studies, we found that this biodiesel-producing E. coli strain was sensitive to ILs and inhibitors released by saccharification. This cocktail will enable the development of novel biomass to biofuel bioprocessing configurations that may overcome some of the barriers to production of inexpensive cellulosic biofuels
Remote ischemic conditioning: from experimental observation to clinical application: report from the 8th Biennial Hatter Cardiovascular Institute Workshop
In 1993, Przyklenk and colleagues made the intriguing experimental observation that 'brief ischemia in one vascular bed also protects remote, virgin myocardium from subsequent sustained coronary artery occlusion' and that this effect '.... may be mediated by factor(s) activated, produced, or transported throughout the heart during brief ischemia/reperfusion'. This seminal study laid the foundation for the discovery of 'remote ischemic conditioning' (RIC), a phenomenon in which the heart is protected from the detrimental effects of acute ischemia/reperfusion injury (IRI), by applying cycles of brief ischemia and reperfusion to an organ or tissue remote from the heart. The concept of RIC quickly evolved to extend beyond the heart, encompassing inter-organ protection against acute IRI. The crucial discovery that the protective RIC stimulus could be applied non-invasively, by simply inflating and deflating a blood pressure cuff placed on the upper arm to induce cycles of brief ischemia and reperfusion, has facilitated the translation of RIC into the clinical setting. Despite intensive investigation over the last 20 years, the underlying mechanisms continue to elude researchers. In the 8th Biennial Hatter Cardiovascular Institute Workshop, recent developments in the field of RIC were discussed with a focus on new insights into the underlying mechanisms, the diversity of non-cardiac protection, new clinical applications, and large outcome studies. The scientific advances made in this field of research highlight the journey that RIC has made from being an intriguing experimental observation to a clinical application with patient benefit
Single-stage Total Cranial Vault Remodeling for Correction of Turricephaly: Description of a New Technique.
Background: Turricephaly is considered one of the most difficult cranial deformities to correct as addressing cranial height can result in increased intracranial pressure. We describe a new technique of total calvarial remodeling with bony transposition to simultaneously correct turricephaly and brachycephaly while preserving intracranial volume. Methods: A retrospective review of patients undergoing single-stage cranial vault remodeling by a single surgeon (J.G.M.) at a single center between 2007 and 2015 was performed. The procedure consists of a frontal bandeau followed by a 1 cm 360o axial strip craniectomy. The strip is then rotated 90 degrees into a coronal orientation and interposed between fronto-parietal and parito-occipital segments. Modification for occipital widening can also be performed. Results: Six patients with turribrachycephaly underwent the procedure over the 8-year period. Four patients were operated at less than 1 year of age, one patient underwent surgery at 2 years, and one at 9 years. Mean operative time was 4 hours, and mean transfusion was 300cc. There were no major complications. Mean cranial height reduction achieved was 1.6 cm (range, 1.0-2.0 cm), and mean anterior-posterior expansion was 3.4 cm (range, 2.3-4.5 cm). Patients also showed improvement in supraorbital retrusion. Conclusion: Single-stage cranial vault remodeling with axial strip craniectomy and coronal interposition is safe and allows for simultaneous correction of turricephaly and brachycephaly while preserving intracranial volume
Modification of the Melbourne Method for Total Calvarial Vault Remodeling.
Background: Sagittal synostosis is the most common form of single suture synostosis. It often results in characteristic calvarial deformities, including a long, narrow head, frontal bossing, a bullet-shaped occiput, and an anteriorly placed vertex. Several methods for correcting the phenotypic deformities have been described, each with their own advantages and challenges. In this study, we describe a modification of the Melbourne method of total calvarial remodeling for correcting scaphocephaly. Methods: We conducted a retrospective review of all consecutive patients who underwent total calvarial remodeling using a modified version of the Melbourne technique from 2011 to 2015. We evaluated clinical photographs, computed tomographic imaging, and cephalic indices both pre- and postoperatively to determine morphologic changes after operation. Results: A total of 9 patients underwent the modified Melbourne technique for calvarial vault remodeling during the study period. Intraoperative blood loss was 260 mL (range, 80-400 mL), and mean intraoperative transfusion was 232 mL (range, 0-360 mL). The average length of stay in the hospital was 3.9 days. The mean cephalic indices increased from 0.66 to 0.74 postoperatively (P < 0.01). Conclusions: A modified Melbourne method for calvarial vault reconstruction addresses the phenotypic aspects of severe scaphocephaly associated with isolated sagittal synostosis and maintains a homeotopic relationship across the calvaria. It is associated with shorter operative times, lower blood loss, and lower transfusion requirements
Collection of Bilateral Cleft Lip and Palate Standard Set Variables: Establishing a Baseline
Background: The International Consortium for Healthcare Outcomes Measurement recently published a consensus Standard Set of clinical and patient-centered metrics to measure outcomes for patients with cleft lip and/or palate (CLP). This study aims to evaluate how the Standard Set compares to existing data collected to anticipate the impact that the Standard Set may have on quality and quantity of outcome data. Methods: Extraction of the Standard Set data points was attempted retrospectively for all nonsyndromic patients with bilateral cleft lip and/or palate who underwent primary lip and/or palate repair by a single surgeon (JGM) between June 2007 and June 2014. Results: Bilateral cleft lip repair was performed on 32 patients of which 29 also underwent palate repair. All but one of the baseline demographic and phenotypic variables were available. All perioperative variables were collected, but data quality was heterogeneous. There were no early complications. At 5 years, 29.6% of patients were lost to follow-up; however, a degree of data was available on 11 of the 12 clinical metrics for those remaining. Of patients with Veau IV cleft palate and follow-up at age 5, 1 patient (6.7%) had an oronasal fistula and 1 had velopharyngeal incompetence requiring Furlow palatoplasty (6.7%). No patient-reported data were collected for any time point. Conclusion: Prospective collection of the International Consortium for Healthcare Outcomes Measurement Standard Set will improve consistency of clinical data and add the patient perspective currently lacking in outcome measures collected for patients with bilateral cleft
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Abstract: Long-Term Outcomes Following Flap Reconstruction in Pediatric Pressure Ulcers
The Baltic and North Seas Climatology (BNSC) - A comprehensive, observation-based data product of atmospheric and hydrographic parameters
The Baltic and North Seas Climatology (BNSC) presented here is a new climatology calculated solely from marine in situ observations. Created in cooperation between University of Hamburg (UHH), Federal Maritime and Hydrographic Agency [Bundesamt fur Seeschifffahrt und Hydrographie (BSH)] and German Meteorological Service [Deutscher Wetterdienst (DWD)], the BNSC is an update of the KLIWAS ("Klimawandel und WasserstraBen") climatology for the North Sea and is extended to the Baltic Sea. A thorough quality control, the reduction of the temporal sampling error and spatial and temporal averaging were applied to the observations, yielding time series of gridded fields of atmospheric and hydrographic parameters in the region of the Baltic, the North Sea and adjacent regions of the North Atlantic. The atmospheric subset of the BNSC consists of time series of monthly mean gridded fields of 2 m air and dew point temperature and air pressure at sea level for the period 1950-2015 on a horizontal 1 degrees x 1 degrees grid. Climatological fields are provided as well. The hydrographic part of the BNSC comprises the variables water temperature and salinity on 105 depth levels for the time interval 1873-2015. The grid boxes' edge length is 0.25 degrees in both zonal and meridional direction. Monthly and annual mean fields are provided as well as decadal monthly mean fields. To create homogenous fields, the method of objective analysis was applied to the fields of decadal means. Furthermore, an extensive sensitivity study was carried out to assess the sensitivity of the data product to the amount of observational data. The BNSC introduced here is compared to several different data products: three reanalyses (ERA-Interim, ERA40 and COSMO-REA6), the corresponding KUWAS product and meteorological station data for the atmospheric part. The hydrographic subset is compared to the KLIWAS climatology, the BALTIC ATLAS and the Baltic Sea Physical Reanalysis Product. The BNSC data product allows studying of climate variability but also holds the chance to validate regional numerical climate simulations, which makes it a valuable reference data set. The BSNC is freely available via the website of University of Hamburg's Integrated Climate Data Center