Damage Control Surgery for Liver Trauma

The liver is one of the most commonly injured organs of the abdomen after major trauma and may lead to the extravasation of major amounts of blood. Damage control surgery (DCS) as a concept exists for over one hundred years but has been more widely optimized and implemented over the past few decades. Minimizing the time from the trauma scene to the hospital and recognizing the patterns of injury and the “lethal triad” (acidosis, hypothermia, coagulopathy) is vital to understand which patients will benefit the most from DCS. Immediate patient resuscitation, massive blood transfusion, and taking the patient to the operating room as soon as possible are the critical initial steps that have been associated with improved outcomes. Bleeding and contamination control should be the priority in this first exploratory laparotomy, while the patient should be transferred to the intensive care unit postoperatively with only temporary abdominal wall closure. Once the patient is stabilized, a second operation should be performed where an anatomic liver resection or other more major procedures may take place, along with permanent closure of the abdominal wall

Information-Centric Connectivity

Mobile devices are often presented with multiple connectivity options usually making a selection either randomly or based on load/wireless conditions metrics, as is the case of current offloading schemes. In this paper we claim that link-layer connectivity can be associated with information-availability and in this respect connectivity decisions should be information-aware. This constitutes a next step for the Information-Centric Networking paradigm, realizing the concept of Information-Centric Connectivity (ICCON). We elaborate on different types of information availability and connectivity decisions in the context of ICCON, present specific use cases and discuss emerging opportunities, challenges and technical approaches. We illustrate the potential benefits of ICCON through preliminary simulation and numerical results in an example use case

Identification of Theophrastus’ pigments egyptios yanos and psimythion from archaeological excavations

Following 4th c. B.C. Theophrastus treatise On Stones, regarding preparation of pigments, blue and white ones coming from fresh archaeological excavations in Attica, Greece, a blue made by Kremer factory and a white reproduced following ancient recipe were all submitted to analytical measurements. New results derived from the application of Infrared Photoacoustic Spectroscopy (IRPAS), Scanning Electron X Ray Microprobe Analyser (SEM-EDS), X-Ray Diffraction (XRD) and Raman spectroscopy identified their mineralogical content. The Theophrastus’ “psimythion” and “kyanos egyptios” are attributed to the lead white (cerussite and hydrocerussite) and the Egyptian blue (cuprorivaite) respectively.Suivant le traité « Des Pierres » de Théophraste, ive siècle BC, à propos de la préparation des pigments, un pigment blanc et un bleu provenant de fouilles archéologiques récentes en Attique, un bleu fabriqué par le laboratoire Kremer et un blanc reproduit selon une ancienne recette ont été soumis à des analyses physiques. La spectroscopie photoacoustique infrarouge (IRPAS), l’analyse par microscopie électronique à balayage et spectroscopie à dispersion d’énergie (SEM-EDS) et la spectroscopie Raman ont permis d’identifier leur composition minéralogique. Les Théophraste psimythion et kyanos egyptios sont respectivement attribués au blanc de plomb (cérusite et hydrocérusite) et au bleu égyptien (cuprorivaite)

An increase of interleukin-33 serum levels after coronary stent implantation is associated with coronary in-stent restenosis

AbstractThe study aim was to determine the predictive value of interleukin (IL)-33, a recently described member of the IL-1 family of cytokines, for the development of in-stent restenosis (ISR). IL-33 serum levels were measured in 387 consecutive patients undergoing percutaneous coronary intervention (PCI) of whom 193 had stable angina, 93 non-ST elevation myocardial infarction (NSTEMI), and 101 ST-elevation MI (STEMI), respectively. Blood was taken directly before and 24h after stent implantation. The presence of ISR was initially evaluated by clinical means after six to eight months. When presence of myocardial ischemia was suspected, coronary angiography was performed to confirm the suspected diagnosis of ISR. Clinical ISR was present in total in 34 patients (8.8%). IL-33 was detectable in 185 patients and was below detection limit in 202 patients. In patients with decreased IL-33 (n=95), unchanged or non-detectable levels (n=210) or increased levels of IL-33 after PCI (n=82), ISR-rate was 2.1%, 9.5% and 14.6%, respectively (p<0.05). Accordingly, patients with ISR showed a significant increase of IL-33 upon PCI (p<0.05). This association was independent from clinical presentation and risk factors as well as numbers and type of stents. In patients with both stable and unstable coronary artery disease, an increase of IL-33 serum levels after stent implantation is associated with a higher rate of in-stent restenosis

IP Over ICN Goes Live

Information-centric networking (ICN) has long been advocating for radical changes to the IP-based Internet. However, the upgrade challenges that this entails have hindered ICN adoption. To break this loop, the POINT project proposed a hybrid, IP-over-ICN, architecture: IP networks are preserved at the edge, connected to each other over an ICN core. This exploits the key benefits of ICN, enabling individual network operators to improve the performance of their IP-based services, without changing the rest of the Internet. We provide an overview of POINT and outline how it improves upon IP in terms of performance and resilience. Our focus is on the successful trial of the POINT prototype in a production network, where real users operated actual IP-based applications

Pediatric trauma and emergency surgery: an international cross-sectional survey among WSES members

Background: In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods: A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021-03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis. Results: A total of 133 participants from 34 countries, i.e. 5 continents responded to the survey. They were most commonly affiliated with larger hospitals (&gt; 500 beds in 72.9%) and with level I or II trauma centers (82.0%), respectively. 74.4% of hospitals offer unrestricted pediatric medical care, but only 63.2% and 42.9% of the participants had sufficient experiences with trauma care in children ≤ 10 and ≤ 5&nbsp;years of age (p = 0.0014). This situation is aggravated in participants from smaller hospitals (p &lt; 0.01). With regard to hospital size (≤ 500 versus &gt; 500 in-hospital beds), larger hospitals were more likely affiliated with advanced trauma centers, more elaborated pediatric intensive care infrastructure (p &lt; 0.0001), treated children at all ages more frequently (p = 0.0938) and have higher case-loads of severely injured children &lt; 12&nbsp;years of age (p = 0.0009). Therefore, the majority of larger hospitals reserve either pediatric surgery departments or board-certified pediatric surgeons (p &lt; 0.0001) and in-hospital trauma management is conducted more multi-disciplinarily. However, the majority of respondents does not feel prepared for treatment of severe pediatric trauma and call for special educational and practical training courses (overall: 80.2% and 64.3%, respectively). Conclusions: Multi-professional management of pediatric trauma and individual experiences with severely injured children depend on volumes, level of trauma centers and infrastructure of the hospital. However, respondents from hospitals at all levels of trauma care complain about an alarming lack of knowledge on pediatric trauma management

A pan-European epidemiological study reveals honey bee colony survival depends on beekeeper education and disease control

Reports of honey bee population decline has spurred many national efforts to understand the extent of the problem and to identify causative or associated factors. However, our collective understanding of the factors has been hampered by a lack of joined up trans-national effort. Moreover, the impacts of beekeeper knowledge and beekeeping management practices have often been overlooked, despite honey bees being a managed pollinator. Here, we established a standardised active monitoring network for 5 798 apiaries over two consecutive years to quantify honey bee colony mortality across 17 European countries. Our data demonstrate that overwinter losses ranged between 2% and 32%, and that high summer losses were likely to follow high winter losses. Multivariate Poisson regression models revealed that hobbyist beekeepers with small apiaries and little experience in beekeeping had double the winter mortality rate when compared to professional beekeepers. Furthermore, honey bees kept by professional beekeepers never showed signs of disease, unlike apiaries from hobbyist beekeepers that had symptoms of bacterial infection and heavy Varroa infestation. Our data highlight beekeeper background and apicultural practices as major drivers of honey bee colony losses. The benefits of conducting trans-national monitoring schemes and improving beekeeper training are discussed