Analysis of platelet-rich plasma extraction variations in platelet and blood components between 4 common commercial kits

Background: Platelet-rich plasma (PRP) has been extensively used as a treatment in tissue healing in tendinopathy, muscle injury, and osteoarthritis. However, there is variation in methods of extraction, and this produces different types of PRP. Purpose: To determine the composition of PRP obtained from 4 commercial separation kits, which would allow assessment of current classification systems used in cross-study comparisons. Study Design: Controlled laboratory study. Methods: Three normal adults each donated 181 mL of whole blood, some of which served as a control and the remainder of which was processed through 4 PRP separation kits: GPS III (Biomet Biologics), Smart-Prep2 (Harvest Terumo), Magellan (Arteriocyte Medical Systems), and ACP (Device Technologies). The resultant PRP was tested for platelet count, red blood cell count, and white blood cell count, including differential in a commercial pathology laboratory. Glucose and pH measurements were obtained from a blood gas autoanalyzer machine. Results: Three kits taking samples from the “buffy coat layer” were found to have greater concentrations of platelets (3-6 times baseline), while 1 kit taking samples from plasma was found to have platelet concentrations of only 1.5 times baseline. The same 3 kits produced an increased concentration of white blood cells (3-6 times baseline); these consisted of neutrophils, leukocytes, and monocytes. This represents high concentrations of platelets and white blood cells. A small drop in pH was thought to relate to the citrate used in the sample preparation. Interestingly, an unexpected increase in glucose concentrations, with 3 to 6 times greater than baseline levels, was found in all samples. Conclusion:This study reveals the variation of blood components, including platelets, red blood cells, leukocytes, pH, and glucose in PRP extractions. The high concentrations of cells are important, as the white blood cell count in PRP samples has frequently been ignored, being considered insignificant. The lack of standardization of PRP preparation for clinical use has contributed at least in part to the varying clinical efficacy in PRP use. Clinical Relevance: The variation of platelet and other blood component concentrations between commercial PRP kits may affect clinical treatment outcomes. There is a need for standardization of PRP for clinical use

A Case Report of Multiple Aseptic Facial and Spinal Abscesses in a 45-Year-Old with Inflammatory Bowel Disease

INTRODUCTION Sterile abscess syndrome is a rarely described entity that is often associated with auto-inflammatory disorders. Although clinically similar to septic abscesses, sterile abscesses are known to be unaffected by antibiotic regimens and instead highly sensitive to steroids. The association of sterile abscesses with inflammatory bowel disease has been well-described. The majority of sterile abscess syndromes described in the literature are intraabdominal abscesses related to a primary gastrointestinal inflammatory disease. We describe a unique case of extra-abdominal sterile abscess syndrome associated with inflammatory bowel disease presenting as facial and paraspinal lesions

Tools and Algorithms for SoC Communication Traces

In this paper, we study seven well-known trace analysis techniques both from the hardware and software domain and discuss their performance on communication-centric system-on-chip (SoC) traces. SoC traces are usually huge in size and concurrent in nature, therefore mining SoC traces poses additional challenges. We provide a hands-on discussion of the selected tools/algorithms in terms of the input, output, and analysis methods they employ. Hardware traces also varies in nature when observed in different level, this work can help developers/academicians to pick up the right techniques for their work. We take advantage of a synthetic trace generator to find the interestingness of the mined outcomes for each tool as well as we work with a realistic GEM5 set up to find the performance of these tools on more realistic SoC traces. Comprehensive analysis of the tool's performance and a benchmark trace dataset are also presented

Mining SoC Message Flows with Attention Model

High-quality system-level message flow specifications are necessary for comprehensive validation of system-on-chip (SoC) designs. However, manual development and maintenance of such specifications are daunting tasks. We propose a disruptive method that utilizes deep sequence modeling with the attention mechanism to infer accurate flow specifications from SoC communication traces. The proposed method can overcome the inherent complexity of SoC traces induced by the concurrent executions of SoC designs that existing mining tools often find extremely challenging. We conduct experiments on five highly concurrent traces and find that the proposed approach outperforms several existing state-of-the-art trace mining tools.Comment: 7 page

Using a Resident-Led Process Improvement Committee to Change Pain Medication Prescribing Habits: Early Results

The aims of this project were to: Streamline the ordering of IV and PO pain meds Encourage the appropriate ordering of Ofirmev

Assessing mental health for China's police: psychometric features of the Self-Rating Depression Scale and Symptom Checklist 90-Revised

Police mental health is important because police officers usually encounter stressors that cause high levels of stress. In order to better understand mental health for Chinese police, the Zung Self-Rating Depression Scale (SDS) and Symptom Checklist 90-Revised (SCL-90-R) are commonly used in mainland China. Unfortunately, both the SDS and SCL-90-R lack detailed information on their psychometric properties. More specifically, factor structures of the SDS and SCL-90-R have yet to be confirmed among the police population in mainland China. Therefore, the present study compared several factor structures of the SDS and SCL-90-R proposed by prior research and to determine an appropriate structure for the police population. Utilizing cluster sampling, 1151 traffic police officers (1047 males; mean age = 36.6 years [SD = 6.10]) from 49 traffic police units in Jiangxi Province (China) participated in this study. Confirmatory factor analysis (CFA) with Akaike information criterion (AIC) was used to decide the best fit structure. In the SDS, the three-factor model (first posited by Kitamura et al.) had the smallest AIC and outperformed other models. In the SCL-90-R, the eight-factor model had the smallest AIC and outperformed the one-factor and nine-factor models. CFA fit indices also showed that both the three-factor model in the SDS and the eight-factor model in the SCL-90-R had satisfactory fit. The present study's results support the use of both SDS and SCL-90-R for police officers in mainland China

The Role of the Uncinate Margin in Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma: A Survival Analysis

Introduction: Positive margins during pancreaticoduodenectomy for pancreatic cancer portend worse survival, but additional resection of the uncinate margin is typically unfeasible without major vascular reconstruction. The survival benefit of resecting additional neck or bile duct margins in the face of a positive uncinate is also unknown. We examined the impact of re-resection of these margins on survival. Methods: Patients with pancreatic adenocarcinoma who underwent pancreaticoduodenectomy from 2006-2015. Pancreatic neck, bile duct, uncinate, and duodenal frozen section margins were assessed before and after resection of positive margins. Kaplan-Meier survival curves were compared with log-rank tests. Multivariable Cox regression was used to assess the effect of margin status on overall survival. Results: Among 508 patients identified, 388 (76.4%) underwent a pylorus-preserving procedure, 435 (85.6%) had T3 tumors, and 379 (74.6%) had nodal involvement. There were 21 instances where an uncinate margin was concurrently positive with a neck or bile duct margin; this additional neck or bile duct margin was resected in 13 cases (61.9%). Resection of additional margins when the uncinate was concurrently positive was not associated with improved survival (p=0.36). Median survival with and without positive uncinate margins was 13.8 vs. 19.7 months (p=0.04). A positive uncinate margin was associated with decreased survival independent of other margins and cancer stage (HR 1.28 [95% CI 1.00-1.65]). Conclusion: In patients with pancreatic adenocarcinoma, positive uncinate margins are associated with decreased overall survival; resection of additional margins at the neck and bile duct in those with a positive uncinate margin is not warranted