Verbesserung der Wundheilung durch wassergefiltertes Infrarot A (wIRA) bei Patienten mit chronischen venösen Unterschenkel-Ulzera einschließlich infrarot-thermographischer Beurteilung

Background: Water-filtered infrared-A (wIRA) is a special form of heat radiation with a high tissue-penetration and with a low thermal burden to the surface of the skin. wIRA is able to improve essential and energetically meaningful factors of wound healing by thermal and non-thermal effects. Aim of the study: prospective study (primarily planned randomised, controlled, blinded, de facto with one exception only one cohort possible) using wIRA in the treatment of patients with recalcitrant chronic venous stasis ulcers of the lower legs with thermographic follow-up. Methods: 10 patients (5 males, 5 females, median age 62 years) with 11 recalcitrant chronic venous stasis ulcers of the lower legs were treated with water-filtered infrared-A and visible light irradiation (wIRA(+VIS), Hydrosun® radiator type 501, 10 mm water cuvette, water-filtered spectrum 550–1400 nm) or visible light irradiation (VIS; only possible in one patient). The uncovered wounds of the patients were irradiated two to five times per week for 30 minutes at a standard distance of 25 cm (approximately 140 mW/cm2 wIRA and approximately 45 mW/cm2 VIS). Treatment continued for a period of up to 2 months (typically until closure or nearly closure of the ulcer). The main variable of interest was “percent change of ulcer size over time” including complete wound closure. Additional variables of interest were thermographic image analysis, patient’s feeling of pain in the wound, amount of pain medication, assessment of the effect of the irradiation (by patient and by clinical investigator), assessment of feeling of the wound area (by patient), assessment of wound healing (by clinical investigator) and assessment of the cosmetic state (by patient and by clinical investigator). For these assessments visual analogue scales (VAS) were used. Results: The study showed a complete or nearly complete healing of lower leg ulcers in 7 patients and a clear reduction of ulcer size in another 2 of 10 patients, a clear reduction of pain and pain medication consumption (e.g. from 15 to 0 pain tablets per day), and a normalization of the thermographic image (before the beginning of the therapy typically hyperthermic rim of the ulcer with relative hypothermic ulcer base, up to 4.5°C temperature difference). In one patient the therapy of an ulcer of one leg was performed with the fully active radiator (wIRA(+VIS)), while the therapy of an ulcer of the other leg was made with a control group radiator (only VIS without wIRA), showing a clear difference in favour of the wIRA treatment. All mentioned VAS ratings improved remarkably during the period of irradiation treatment, representing an increased quality of life. Failures of complete or nearly complete wound healing were seen only in patients with arterial insufficiency, in smokers or in patients who did not have venous compression garment therapy. Discussion and conclusions: wIRA can alleviate pain considerably (with an impressive decrease of the consumption of analgesics) and accelerate wound healing or improve a stagnating wound healing process and diminish an elevated wound exudation and inflammation both in acute and in chronic wounds (in this study shown in chronic venous stasis ulcers of the lower legs) and in problem wounds including infected wounds. In chronic recalcitrant wounds complete healing is achieved, which was not reached before. Other studies have shown that even without a disturbance of wound healing an acute wound healing process can be improved (e.g. reduced pain) by wIRA. wIRA is a contact-free, easily used and pleasantly felt procedure without consumption of material with a good penetration effect, which is similar to solar heat radiation on the surface of the earth in moderate climatic zones. Wound healing and infection defence (e.g. granulocyte function including antibacterial oxygen radical formation of the granulocytes) are critically dependent on a sufficient energy supply (and on sufficient oxygen). The good clinical effect of wIRA on wounds and also on problem wounds and wound infections can be explained by the improvement of both the energy supply and the oxygen supply (e.g. for the granulocyte function). wIRA causes as a thermal effect in the tissue an improvement in three decisive factors: tissue oxygen partial pressure, tissue temperature and tissue blood flow. Besides this non-thermal effects of infrared-A by direct stimulation of cells and cellular structures with reactions of the cells have also been described. It is concluded that wIRA can be used to improve wound healing, to reduce pain, exudation, and inflammation and to increase quality of life.Hintergrund: Wassergefiltertes Infrarot A (wIRA) ist eine spezielle Form der Wärmestrahlung mit hoher Gewebepenetration bei geringer thermischer Oberflächenbelastung. wIRA vermag über thermische und nicht-thermische Effekte wesentliche und energetisch bedeutsame Faktoren der Wundheilung zu verbessern. Ziel der Studie: prospektive Studie (primär randomisiert, kontrolliert, verblindet geplant, de facto mit einer Ausnahme nur eine Kohorte möglich) mit wassergefiltertem Infrarot A (wIRA) in der Therapie von Patienten mit therapierefraktären chronischen venösen Unterschenkel-Ulzera mit thermographischer Verlaufskontrolle. Methoden: 10 Patienten (5 Männer, 5 Frauen, Median des Alters 62 Jahre) mit 11 therapierefraktären chronischen venösen Unterschenkel-Ulzera wurden mit wassergefiltertem Infrarot A und sichtbarem Licht (wIRA(+VIS), Hydrosun®-Strahler Typ 501, 10 mm Wasserküvette, wassergefiltertes Spektrum 550–1400 nm) oder mit sichtbarem Licht (VIS; nur bei einem Patienten möglich) bestrahlt. Die unbedeckten Wunden der Patienten wurden zwei- bis fünfmal pro Woche über bis zu 2 Monate (typischerweise bis zum Wundschluss oder Fast-Wundschluss des Ulkus) für jeweils 30 Minuten mit einem Standardabstand von 25 cm bestrahlt (ungefähr 140 mW/cm2 wIRA und ungefähr 45 mW/cm2 VIS). Hauptzielvariable war die „prozentuale Änderung der Ulkusgröße über die Zeit“ einschließlich des kompletten Wundschlusses. Zusätzliche Zielvariablen waren thermographische Bildanalyse, Schmerzempfinden des Patienten in der Wunde, Schmerzmittelverbrauch, Einschätzung des Effekts der Bestrahlung (durch Patient und durch klinischen Untersucher), Einschätzung des Patienten des Gefühls im Wundbereich, Einschätzung der Wundheilung durch den klinischen Untersucher sowie Einschätzung des kosmetischen Zustandes (durch Patienten und durch klinischen Untersucher). Für diese Erhebungen wurden visuelle Analogskalen (VAS) verwendet. Ergebnisse: Die Studie ergab eine vollständige oder fast vollständige Abheilung der Unterschenkel-Ulzera bei 7 Patienten sowie eine deutliche Ulkusverkleinerung bei 2 weiteren der 10 Patienten, eine bemerkenswerte Minderung der Schmerzen und des Schmerzmittelverbrauchs (von z.B. 15 auf 0 Schmerztabletten täglich) und eine Normalisierung des thermographischen Bildes (vor Therapiebeginn typischerweise hyperthermer Ulkusrandwall mit relativ hypothermem Ulkusgrund, bis zu 4,5°C Temperaturdifferenz). Bei einem Patienten wurde ein Ulkus an einem Bein mit dem Vollwirkstrahler (wIRA(+VIS)) therapiert, während ein Ulkus am anderen Bein mit einem Kontrollgruppenstrahler (nur VIS, ohne wIRA) behandelt wurde, was einen deutlichen Unterschied zugunsten der wIRA-Therapie zeigte. Alle aufgeführten VAS-Einschätzungen verbesserten sich während der Bestrahlungstherapie-Periode sehr stark, was einer verbesserten Lebensqualität entsprach. Ein kompletter oder fast kompletter Wundschluss wurde nur bei Patienten mit peripherer arterieller Verschlusskrankheit, Rauchern oder Patienten mit fehlender venöser Kompressionstherapie nicht erreicht. Diskussion und Schlussfolgerungen: wIRA kann sowohl bei akuten Wunden als auch bei chronischen Wunden (in dieser Studie für chronische venöse Unterschenkelulzera gezeigt) und Problemwunden einschließlich infizierter Wunden Schmerzen deutlich mindern (mit eindrucksvoller Abnahme des Schmerzmittelverbrauchs) und die Wundheilung beschleunigen oder einen stagnierenden Wundheilungsprozess verbessern sowie eine erhöhte Wundsekretion und Entzündung mindern. Bei chronischen therapierefraktären Wunden werden vollständige Abheilungen erreicht, die zuvor nicht erreicht wurden. Andere Studien haben sogar ohne Wundheilungsstörung eine Verbesserung (z.B. Schmerzreduktion) der akuten Wundheilung durch wIRA gezeigt. wIRA ist ein kontaktfreies, verbrauchsmaterialfreies, leicht anzuwendendes, als angenehm empfundenes Verfahren mit guter Tiefenwirkung, das der Sonnenwärmestrahlung auf der Erdoberfläche in gemäßigten Klimazonen nachempfunden ist. Wundheilung und Infektionsabwehr (z.B. Granulozytenfunktion einschließlich antibakterieller Sauerstoffradikalbildung der Granulozyten) hängen ganz entscheidend von einer ausreichenden Energieversorgung (und von ausreichend Sauerstoff) ab. Die gute klinische Wirkung von wIRA auf Wunden und auch auf Problemwunden und Wundinfektionen lässt sich über die Verbesserung sowohl der Energiebereitstellung als auch der Sauerstoffversorgung (z.B. für die Granulozytenfunktion) erklären. wIRA bewirkt als thermischen Effekt im Gewebe eine Verbesserung von drei entscheidenden Faktoren: Sauerstoffpartialdruck im Gewebe, Gewebetemperatur und Gewebedurchblutung. Daneben wurden auch nicht-thermische Effekte von Infrarot A durch direkte Reizsetzung auf Zellen und zelluläre Strukturen mit Reaktionen der Zellen beschrieben. Es wird geschlossen, dass wIRA verwendet werden kann, um Wundheilung zu verbessern, Schmerzen, Sekretion und Entzündung zu reduzieren und die Lebensqualität zu steigern

An investigation of the mechanism controlling the co-deposition of aluminas with copper during electrodeposition of copper

Experimental work was undertaken to determine the mechanism controlling the co-deposition of aluminas with copper during electrode-position of copper. The aluminas were present in the copper plating electrolytes as an insoluble disperse phase. Three possible mechanisms for co-deposition of aluminas were studied, They were mechanical inclusion, electrophoretic deposition, and adsorption. The results of experimental studies established that mechanical inclusion was not a significant factor in the mechanism controlling co-deposition of aluminas with copper. Theoretical considerations of the compositions of the copper plating electrolytes indicated that co-deposition of aluminas by an electrophoretic mechanism was highly unlikely. The conclusions arrived at by theoretical considerations were substantiated by experimental measurements of the zeta potential of the aluminas. The alumina content of the copper electra deposits was also studied as a function of the pH of the plating bath. The results of these tests in conjunction with sedimentation studies demonstrated the absence of an isoelectric point for the aluminas over the pH range studied. The presence of thiourea in the electrolytic plating baths (a sub stance known to be adsorbed on a copper cathode during electrodeposition), profoundly affected the amount of alumina in the electrodepasit, however, no adsorption of thiourea on aluminas in aqueous dispersions was detected

An Investigation of the Sled Push Exercise: Quantification of Work, Kinematics, and Related Physical Characteristics

The purpose of this dissertation was to describe the basic characteristics of performing resisted sprint training using a push sled for the enhancement of sport performance. Specifically, this dissertation served to: 1.) quantify the frictional forces involved between a push sled and an AstroTurf® surface at 6 loads, 2.) derive an estimation of mechanical work performed during sled push training, 3.) outline the velocity characteristics of 3 sled pushing loads scaled to the athletes body mass for comparison against their sprinting ability and 4.) determine the interrelations of fitness characteristics to the ability to sprint under heavy resistance. The following are major findings of this dissertation. 1.) Coefficients of static friction (0.53 – 0.37) and dynamic friction (0.35 – 0.28) were calculated at multiple loads for the AstroTurf® surface. 2.) A direct near perfect relationship exists between total system load of the sled and the forces required to initiate and maintain movement of the sled. Although a direct measurement of force would be more precise and account for changes in velocity, the total system load may be a more practical alternative for daily use. 3.) Statistically significant changes in velocity characteristics were observed within each sled pushing load as well as when comparing each load to sprinting. Decrements in peak velocity ranged from about 40%-51% when comparing resisted to unresisted sprinting. Load increments of 25% body mass were heavy enough to cause statistically significant differences in velocity characteristics. 4.) Statistically significant correlations were observed in anthropometry, sprinting ability, jumping ability, and strength to sled pushing. The results indicate that larger athletes, who can not only produce greater force but produce those forces rapidly, in addition to excelling at jumping and sprinting compared to their peers demonstrate the ability to move faster against heavy loads and slow down less from unresisted conditions. The strongest athletes demonstrated statistically nonsignificant differences in peak velocity drop off when compared to their weaker counterparts; however, small to moderate effect sizes (d = 0.27 – 1.02) were observed indicating a practical difference between strength levels in peak velocity and peak velocity drop off

Catholicism and Evolution: Polygenism and Original Sin (Part II)

As documented in the first installment of this essay (Hofmann 2020b), through-out the first half of the twentieth century, theological conformity to monogenism, the alleged descent of all human beings from Adam and Eve, was closely linked to Catholic doctrines of original sin. Receptivity to polygenism, the more scientifically supported account of human origins through a transitional population, was further discouraged by Pius XII’s 1950 encyclical Humani generis. Nevertheless, de facto acceptance of polygen-ism became commonplace following Vatican II. A significant turning point was reached when an effort to have polygenism designated “contrary to Catholic faith” failed to persuade the Council Fathers and the topic was not included in Dei Verbum, the 1965 Dogmatic Constitution on Divine Revelation. In 1968, the presentation of polygenism as a viable theological option in TheSupplement to A New Catechism was clear evidence that opposition to polygenism within the Roman Curia had abated. Furthermore, a pre-ponderance of post-Vatican II theological discourse on original sin either marginalized monogenism or retained it in a spiritual rather than a biological sense. The historical record shows that theological commitment to monogenism has been more deeply rooted in doctrines of Catholic tradition than was the case for geostasis. Secondly, again in contrast to geostasis, monogenism has been amenable to nuanced conceptual development, including purely spiritual characterizations. These two historical factors provide some explanation for the longstanding Catholic commitment to monogenism. To the extent that dogmatic convictions premised upon traditional doctrines of original sin continue to be perceived as both compelling and authoritative, it can be expected that some form of theological monogenism will also persist

Therapie chronischer Wunden mit wassergefiltertem Infrarot A (wIRA)

The central portion of chronic wounds is often hypoxic and relatively hypothermic, representing a deficient energy supply of the tissue, which impedes wound healing or even makes it impossible. Water-filtered infrared-A (wIRA) is a special form of heat radiation with a high tissue penetration and a low thermal load to the skin surface. wIRA produces a therapeutically usable field of heat and increases temperature, oxygen partial pressure and perfusion of the tissue. These three factors are decisive for a sufficient tissue supply with energy and oxygen and consequently as well for wound healing, especially in chronic wounds, and infection defense. wIRA acts both by thermal and thermic as well as by non-thermal and non-thermic effects. wIRA can advance wound healing or improve an impaired wound healing process and can especially enable wound healing in non-healing chronic wounds. wIRA can considerably alleviate the pain and diminish wound exudation and inflammation and can show positive immunomodulatory effects. In a prospective, randomized, controlled study of 40 patients with chronic venous stasis ulcers of the lower legs irradiation with wIRA and visible light (VIS) accelerated the wound healing process (on average 18 vs. 42 days until complete wound closure, residual ulcer area after 42 days 0.4 cm² vs. 2.8 cm²) and led to a reduction of the required dose of pain medication in comparison to the control group of patients treated with the same standard care (wound cleansing, wound dressing with antibacterial gauze, and compression garment therapy) without the concomitant irradiation. Another prospective study of 10 patients with non-healing chronic venous stasis ulcers of the lower legs included extensive thermographic investigation. Therapy with wIRA(+VIS) resulted in a complete or almost complete wound healing in 7 patients and a marked reduction of the ulcer size in another 2 of the 10 patients, a clear reduction of pain and required dose of pain medication, and a normalization of the thermographic image. In a current prospective, randomized, controlled, blinded study patients with non-healing chronic venous stasis ulcers of the lower legs are treated with compression garment therapy, wound cleansing, wound dressings and 30 minutes irradiation five times per week over 9 weeks. A preliminary analysis of the first 23 patients of this study has shown in the group with wIRA(+VIS) compared to a control group with VIS an advanced wound healing, an improved granulation and in the later phase of treatment a decrease of the bacterial burden. Some case reports have demonstrated that wIRA can also be used for mixed arterial-venous ulcers or arterial ulcers, if irradiation intensity is chosen appropriately low and if irradiation is monitored carefully. wIRA can be used concerning decubital ulcers both in a preventive and in a therapeutic indication. wIRA can improve the resorption of topically applied substances also on wounds. An irradiation with VIS and wIRA presumably acts with endogenous protoporphyrin IX (or protoporphyrin IX of bacteria) virtually similar as a mild photodynamic therapy (endogenous PDT-like effect). This could lead to improved cell regeneration and wound healing and to antibacterial effects. In conclusion, these results indicate that wIRA generally should be considered for the treatment of chronic wounds.Das Zentrum von chronischen Wunden ist oft hypoxisch und relativ hypotherm. Dies entspricht einer defizitären Energiebereitstellung im Gewebe, die die Wundheilung behindert oder unmöglich macht. Wassergefiltertes Infrarot A (wIRA) ist eine spezielle Form der Wärmestrahlung mit hohem Eindringvermögen in das Gewebe bei geringer thermischer Oberflächenbelastung. wIRA erzeugt ein therapeutisch nutzbares Wärmefeld und steigert Temperatur, Sauerstoffpartialdruck sowie die Durchblutung im Gewebe. Diese drei Faktoren sind entscheidend für eine ausreichende Versorgung des Gewebes mit Energie und Sauerstoff und deshalb auch für die Wundheilung, speziell bei chronischen Wunden, und die Infektionsabwehr. wIRA wirkt sowohl über thermische und temperaturabhängige als auch über nicht-thermische und temperaturunabhängige Effekte. wIRA kann die Wundheilung beschleunigen oder einen stagnierenden Wundheilungsprozess verbessern und insbesondere bei nicht-heilenden chronischen Wunden eine Wundheilung ermöglichen. wIRA vermag Schmerzen deutlich zu mindern und die Wundsekretion sowie Entzündung zu reduzieren sowie positive immunmodulierende Effekte zu zeigen. In einer prospektiven, randomisierten, kontrollierten Studie mit 40 Patienten mit chronischen venösen Unterschenkelulzera führte eine Bestrahlung mit wIRA und sichtbarem Licht (VIS) zu einer schnelleren Wundheilung (im Durchschnitt 18 vs. 42 Tage bis zum kompletten Wundschluss, Restulkusfläche nach 42 Tagen 0,4 cm² vs. 2,8 cm²) und einem geringeren Schmerzmittelverbrauch gegenüber einer in gleicher Form (Wundsäuberung, antibakterielle Wundauflagen und Kompressionstherapie) therapierten, aber nicht bestrahlten Kontrollgruppe. Eine weitere prospektive Studie mit 10 Patienten mit aufwändiger thermographischer Verlaufskontrolle ergab unter Therapie mit wIRA(+VIS) eine vollständige oder fast vollständige Abheilung therapierefraktärer chronischer Unterschenkelulzera bei 7 sowie eine deutliche Ulkusverkleinerung bei 2 weiteren der 10 Patienten, eine ausgeprägte Minderung der Schmerzen und des Schmerzmittelverbrauchs und eine Normalisierung des thermographischen Bildes. In einer laufenden prospektiven, randomisierten, kontrollierten, verblindeten Studie werden Patienten mit nicht-heilenden chronischen venösen Unterschenkelulzera mit Kompressionstherapie, Wundsäuberung und nicht-adhäsiven Wundauflagen sowie 30 Minuten Bestrahlung fünfmal pro Woche über 9 Wochen behandelt. Eine vorläufige Auswertung der ersten 23 Patienten zeigte, dass die Gruppe mit wIRA(+VIS) verglichen mit einer Kontrollgruppe mit VIS eine schnellere Wundheilung, eine bessere Granulation und in der späteren Phase der Behandlung eine Abnahme der bakteriellen Last der Wunden aufwies. Einige Fallberichte haben gezeigt, dass wIRA selbst bei gemischt arteriell-venösen Ulzera oder arteriellen Ulzera eingesetzt werden kann, wenn die Bestrahlungsstärke angemessen niedrig gewählt und die Bestrahlung sorgfältig überwacht wird. wIRA kann bei Dekubitalulzera sowohl präventiv als auch therapeutisch eingesetzt werden. wIRA kann die Resorption topisch applizierter Substanzen auch auf Wunden verbessern. Eine Bestrahlung mit VIS und wIRA wirkt vermutlich in Verbindung mit endogenem Protoporphyrin IX (oder Protoporphyrin IX von Bakterien) quasi ähnlich wie eine milde photodynamische Therapie (endogener PDT-ähnlicher Effekt). Dies kann die Zellregeneration und Wundheilung fördern und antibakteriell wirken. Zusammengefasst zeigen die Ergebnisse, dass wIRA generell für die Behandlung chronischer Wunden erwogen werden sollte

Compensation effects in GaN:Mg probed by Raman spectroscopy and photoluminescence measurements

This article may be downloaded for personal use only. Any other use requires prior permission of the author and AIP Publishing. This article appeared in J. Appl. Phys. 113, 103504 (2013) and may be found at https://doi.org/10.1063/1.4794094.Compensation effects in metal organic chemical vapour deposition grown GaN doped with magnesium are investigated with Raman spectroscopy and photoluminescence measurements. Examining the strain sensitive E2(high) mode, an increasing compressive strain is revealed for samples with Mg-concentrations lower than 7 × 1018 cm−3. For higher Mg-concentrations, this strain is monotonically reduced. This relaxation is accompanied by a sudden decrease in crystal quality. Luminescence measurements reveal a well defined near band edge luminescence with free, donor bound, and acceptor bound excitons as well as a characteristic donor acceptor pair (DAP) luminescence. Following recent results, three acceptor bound excitons and donor acceptor pairs are identified. Along with the change of the strain, a strong modification in the luminescence of the dominating acceptor bound exciton and DAP luminescence is observed. The results from Raman spectroscopy and luminescence measurements are interpreted as fingerprints of compensation effects in GaN:Mg leading to the conclusion that compensation due to defect incorporation triggered by Mg-doping already affects the crystal properties at doping levels of around 7 × 1018 cm−3. Thereby, the generation of nitrogen vacancies is introduced as the driving force for the change of the strain state and the near band edge luminescence.DFG, 43659573, SFB 787: Halbleiter - Nanophotonik: Materialien, Modelle, Bauelement

Saying Goodbye to an Old Friend

https://openriver.winona.edu/wsuarboretumstories/1024/thumbnail.jp

Tube shape selection for heat recovery from particle-laden exhaust gas streams

Heat recovery from exhaust gas streams is applicable to a wide variety of industries. Two problems encountered in exhaust gas heat recovery are: the high heat transfer resistance of gases and the presence of entrained particulate matter, which can limit the use of extended surface area. Standard heat exchangers use round tube. This study uses Computational Fluid Dynamics (CFD) to investigate whether round or another shape is the best tube selection for exhaust heat recovery. Tube shape rankings are based on taking into account heat transfer, gas flow resistance and foulability. Foulability is inferred from the average wall shear stress around the front or back of each shape. An estimated asymptotic fouling resistance is used to calculate an equivalent fouled j factor, jf. CFD results suggest the best tube for exhaust heat recovery is an elliptical tube. The ellipse shape produced j/f and jf/f ratios (where f is the tube bank friction factor) over 1.5 times larger than that of standard round tube. A flattened round tube is also promising and may be the practical and economic optimum