Development of a portable blood salvage and autotransfusion technology to enhance survivability of personnel requiring major medical interventions in austere or military environments

Introduction - Uncontrolled haemorrhage is the leading cause of death on the battlefield, and two-thirds of these deaths result from non-compressible haemorrhage. Blood salvage and autotransfusion represent an alternative to conventional blood transfusion techniques for austere environments, potentially providing blood to the casualty at point of injury. The aim of this paper is to describe the design, development and initial proof-of-concept testing of a portable blood salvage and autotransfusion technology to enhance survivability of personnel requiring major medical interventions in austere or military environments. Method - A manually operable, dual-headed pump was developed that removes blood from site of injury to a collection reservoir (upper pump) and back to casualty (lower pump). Theoretical flow rate calculations determined pump configuration and a three-dimensionally printed peristaltic pump was manufactured. Flow rates were tested with fresh bovine blood under laboratory conditions representative of the predicted clinical environment. Results - Mathematical modelling suggested flow rates of 3.6 L/min and 0.57 L/min for upper and lower pumps. Using fresh bovine blood, flow rates produced were 2.67 L/min and 0.43 L/min. To mimic expected battlefield conditions, upper suction pump flow rate was calculated using a blood/air mixture. Conclusion - The authors believe that this technology can potentially enhance survivability for casualties in austere and deployed military settings through autotransfusion and cell concentration. It reduces negative effects of blood donation on the conventional donor pool, and potentially negates the logistical constraints associated with allogenic transfusions

Lessons from a large scale deployment of DGT in the Seine basin

Diffusive Gradient in Thin film (DGT) is a speciation technique now commonly used in the scientific literature to assess metallic contamination in water. However applications usually take place in a same watercourse or in neighbouring sites. We propose here to present the first results of a large scale deployment of DGTs. The main objective of the project, which is supported by the French water agency of the Seine-Normandie basin, is to evaluate the potential of passive samplers as monitoring tools. DGT devices were deployed in 45 sites, on 30 locations in the entire Seine river basin. The sampling area was 500 km long and 200 km wide around Paris. The total sampling period lasted over the whole 2009 year. Restricted gels of 0.78 were used to measure labile Cd, Cr, Co, Cu, Mn, Ni, Pb and Zn. In parallel, raw and filtered water samples were collected to measure total and dissolved metals. General physico-chemical parameters were also measured. The whole set of measurements constitute a rich dataset including large and small rivers, and reference as well as impacted sites. The results first allow us to draw a map of total, dissolved and labile metal concentrations, representing the spatial variability of metal contamination in the Seine basin. Moreover, considering the temporal variability, different behaviours, depending on the metal, can be identified. The large scale deployment of DGT in the Seine river basin was successful: all the samples have been interpreted and are exploitable, whereas the dissolved metal samples are sometimes under the detection limit. We have then built a representative data set on the water contamination in labile metal of an urban impacted basin. The results are also interpreted as labile percentage, showing the operationally possible values of lability in contrasted environmental conditions. A first approach of the factors influencing the lability highlights the significance of the nature of the organic matter to interpret the lability of the metals

Reaction-induced surface reconstruction of silver in contact with zirconium

When two solid metals are in contact at high temperature, interdi usion occurs leading in some cases to the growth of intermetallic compounds. The study of nucleation, growth and properties of these intermetallic compounds are of interest since it can be critical for many applications in industries. Yet, the e ect of these reactions on the initial surfaces of both metals is not well understood and particularly when surfaces are not perfectly flat and for short contact time. The purpose of the present study is to demonstrate that the growth of an intermetallic compound layer between to solid metals can lead to the surface reconstruction of one of them. The silver–zirconium system will be presented in order to illustrate this new phenomenon. The e ect of contact point on the di usion- reaction process has been modelled by patterning the Zr surface. The nucleation and growth of the intermetallic compounds occur along the contact points which leads to silver surface reconstruction with the growth of the preferential crystal planes f 111 g ad f 100 g . A model explaining this new phenomenon is developed based on the minimisation of Gibbs energy and the di usion rates af both Ag & Zr atoms in the binary system Ag / Zr

The influence of primary Cu6Sn5 size on the shear impact properties of Sn-Cu/Cu BGA Joints

A method is presented to control the size of primary Cu6Sn5 in ball grid array (BGA) joints while keeping all other microstructural features near-constant, enabling a direct study of the size of primary Cu6Sn5 on impact properties. For Sn-2Cu/Cu BGA joints, it is shown that larger primary Cu6Sn5 particles have a clear negative effect on the shear impact properties. Macroscopic fracture occurred by a combination of the brittle fracture of embedded primary Cu6Sn5 rods and ductile fracture of the matrix βSn. Cleavage of the Cu6Sn5 rods occurred mostly along (0001) or perpendicular to (0001) with some crack deflection between the two. The deterioration of shear impact properties with increasing Cu6Sn5 size is attributed to (1) the larger microcracks introduced by the brittle fracture of larger embedded Cu6Sn5 crystals, and (2) the less numerous and more widely spaced rods when the Cu6Sn5 crystals are larger, which makes them poor strengtheners

Structure and Computation in Immunoreagent Design : From Diagnostics to Vaccines

Novel immunological tools for efficient diagnosis and treatment of emerging infections are urgently required. Advances in the diagnostic and vaccine development fields are continuously progressing, with reverse vaccinology and structural vaccinology (SV) methods for antigen identification and structure-based antigen (re)design playing increasingly relevant roles. SV, in particular, is predicted to be the front-runner in the future development of diagnostics and vaccines targeting challenging diseases such as AIDS and cancer. We review state-of-the-art methodologies for structure-based epitope identification and antigen design, with specific applicative examples. We highlight the implications of such methods for the engineering of biomolecules with improved immunological properties, potential diagnostic and/or therapeutic uses, and discuss the perspectives of structure-based rational design for the production of advanced immunoreagents. Immunodiagnostic-based serological tests offer rapid and high-throughput diagnosis of multiple pathogens and can ascertain disease progression.3D structures of protein antigens can be used to predict epitope location using computational biology methods.Computationally designed synthetic epitopes can provide new chemical tools with distinct applications, from diagnosis and patient profiling to therapeutic approaches based on new vaccines.Structure-based antigen design is predicted to deliver future vaccines targeting challenging diseases such as HIV and cancer.As an alternative to nanoparticle epitope presentation systems, structure-based in silico epitope grafting and design methods may be adopted to transplant epitopes onto protein scaffolds to generate antigens that stimulate more potent immune responses

Protein associated with SMAD1 (PAWS1/FAM83G) is a substrate for type I bone morphogenetic protein receptors and modulates bone morphogenetic protein signalling

Bone morphogenetic proteins (BMPs) control multiple cellular processes in embryos and adult tissues. BMPs signal through the activation of type I BMP receptor kinases, which then phosphorylate SMADs 1/5/8. In the canonical pathway, this triggers the association of these SMADs with SMAD4 and their translocation to the nucleus, where they regulate gene expression. BMPs can also signal independently of SMAD4, but this pathway is poorly understood. Here, we report the discovery and characterization of PAWS1/FAM83G as a novel SMAD1 interactor. PAWS1 forms a complex with SMAD1 in a SMAD4-independent manner, and BMP signalling induces the phosphorylation of PAWS1 through BMPR1A. The phosphorylation of PAWS1 in response to BMP is essential for activation of the SMAD4-independent BMP target genes NEDD9 and ASNS. Our findings identify PAWS1 as the first non-SMAD substrate for type I BMP receptor kinases and as a novel player in the BMP pathway. We also demonstrate that PAWS1 regulates the expression of several non-BMP target genes, suggesting roles for PAWS1 beyond the BMP pathway

Nucleation and twinning in tin droplet solidification on single crystal intermetallic compounds

βSn nucleation is a key step in the formation of microstructure in electronic solder joints. Here, the heterogeneous nucleation of βSn is studied in undercooled tin droplets spread on the facets of various intermetallic compounds (IMCs). Nucleation undercoolings are measured in solidifying droplets and are linked to orientation relationships (ORs) measured by electron backscatter diffraction (EBSD). Preferred ORs developed on all IMCs studied. For the more potent nucleants (αCoSn3, IrSn4, PtSn4, PdSn4) the ORs represent relatively simple atomic matches. ORs with lower potency nucleants (Cu6Sn5, Ag3Sn, Ni3Sn4) had more complex atomic matches that are explored based on matching of the closest packed atomic rows. βSn solidification twinning is shown to be more complex than has been reported previously: both nucleation on an IMC facet and cyclic twinning of that grain occurred in many droplets on Cu6Sn5, Ag3Sn, Ni3Sn4; in all twinned droplets the Sn twinning axis occurred along a direction on the IMC with the lowest linear atomic disregistry; and interrelated cyclic twins formed consisting of up to five rings of cyclic twins all related by shared Sn axes

Patient-specific blood flow simulations in the pulmonary bifurcation of patients with tetralogy of fallot

Dysfunction of the pulmonary valve and narrowing of the branch pulmonary arteries are common chronic complications in adult patients with tetralogy of Fallot; the most common cyanotic congenital heart disease with an estimate prevalence 1 in 3000 live births. Clinical consequences include, but are not limited to, abnormal lung development and elevated pulmonary vascular resistance. It is, therefore, crucial to better understand and characterise the haemodynamic environment in the pulmonary bifurcation to better diagnose and treat these patients. In this study, we have focused on investigating the blood flow dynamics in patient-specific geometries of the pulmonary bifurcation by means of computational models

Harnessing heterogeneous nucleation to control tin orientations in electronic interconnections

While many aspects of electronics manufacturing are controlled with great precision, the nucleation of tin in solder joints is currently left to chance. This leads to a widely varying melt undercooling and different crystal orientations in each joint which results in a different resistance to electromigration, thermomechanical fatigue and other failure modes in each joint. Here we identify a family of nucleants for tin, prove their effectiveness using a novel droplet solidification technique, and demonstrate an approach to incorporate the nucleants into solder joints to control the orientation of the tin nucleation event. With this approach, it is possible to change tin nucleation from a stochastic to a deterministic process, and to generate single crystal joints with their c-axis orientation tailored to best combat a selected failure mode

Passive UHF RFID Voice Prosthesis Mounted Sensor for Microbial Growth Detection

Capacitive loading due to human tissue can lead to low efficiency for implantable Passive Radio Frequency Identification (RFID) antennas. The presented passive UHF antenna sensor provides read distances above 0.5 meters (within a body phantom) by utilizing a convoluted half-wave dipole design. It is able to detect simulated early to mature Candida albicans biofilm growth when mounted upon a voice prosthesis (up to a 30 μm biofilm thickness). Depending on the propagation frequency of interest, as early 4-hour growth (5 to 10 μm biofilm thickness) equivalent could be detected and before any device failure could occur due to the colonization. This was accomplished by utilising thin layers of polyurethane to decouple the saliva from the presented UHF sensor (biofilm growth is known to increase layer hydrophobicity). This presented sensor has better functionality within the US UHF frequency band as it detects changes above 5 μm. If there is a need for implantation within additional tissues with variable dielectric properties, a shunt capacitance of 2.6 pF could allow the system functionality within the permittivity range of 21 to 58. Allowing for immediate medical intervention before medical prosthesis failur