A new model for the characterization of infection risk in gunshot injuries:Technology, principal consideration and clinical implementation

<p>Abstract</p> <p>Introduction</p> <p>The extent of wound contamination in gunshot injuries is still a topic of controversial debate. The purpose of the present study is to develop a model that illustrates the contamination of wounds with exogenous particles along the bullet path.</p> <p>Material and methods</p> <p>To simulate bacteria, radio-opaque barium titanate (3-6 μm in diameter) was atomized in a dust chamber. Full metal jacket or soft point bullets caliber .222 (n = 12, v₀= 1096 m/s) were fired through the chamber into a gelatin block directly behind it. After that, the gelatin block underwent multi-slice CT in order to analyze the permanent and temporary wound cavity.</p> <p>Results</p> <p>The permanent cavity caused by both types of projectiles showed deposits of barium titanate distributed over the entire bullet path. Full metal jacket bullets left only few traces of barium titanate in the temporary cavity. In contrast, the soft point bullets disintegrated completely, and barium titanate covered the entire wound cavity.</p> <p>Discussion</p> <p>Deep penetration of potential exogenous bacteria can be simulated easily and reproducibly with barium titanate particles shot into a gelatin block. Additionally, this procedure permits conclusions to be drawn about the distribution of possible contaminants and thus can yield essential findings in terms of necessary therapeutic procedures.</p

The ‘affect tagging and consolidation’ (ATaC) model of depression vulnerability

Since the 1960’s polysomnographic sleep research has demonstrated that depressive episodes are associated with REM sleep alterations. Some of these alterations, such as increased REM sleep density, have also been observed in first-degree relatives of patients and remitted patients, suggesting that they may be vulnerability markers of major depressive disorder (MDD), rather than mere epiphenomena of the disorder. Neuroimaging studies have revealed that depression is also associated with heightened amygdala reactivity to negative emotional stimuli, which may also be a vulnerability marker for MDD. Several models have been developed to explain the respective roles of REM sleep alterations and negatively-biased amygdala activity in the pathology of MDD, however the possible interaction between these two potential risk-factors remains uncharted. This paper reviews the roles of the amygdala and REM sleep in the encoding and consolidation of negative emotional memories, respectively. We present our ‘affect tagging and consolidation’ (ATaC) model, which argues that increased REM sleep density and negatively-biased amygdala activity are two separate, genetically influenced risk-factors for depression which interact to promote the development of negative memory bias – a well-known cognitive vulnerability marker for depression. Predictions of the ATaC model may motivate research aimed at improving our understanding of sleep dependent memory consolidation in depression aetiology

Structurally coupled inversion of ERT and refraction seismic data combined with cluster-based model integration

Electrical resistivity tomography (ERT) and refraction seismics are among the most frequently used geophysical methods for site-investigations and the combined results can be very helpful to fill in the gaps between the point measurements made by traditional geotechnical methods such as Cone Penetration Test (CPT), core-drilling and geophysical borehole logging. The interpretation of the results from a geophysical investigation constituting a single method often yields ambiguous results. Hence, an approach utilizing multiple techniques is often necessary. To facilitate interpretation of such a combined dataset, we propose a more controlled and objective approach and present a method for a structurally coupled inversion of 2D electrical resistivity and refraction seismic data using unstructured meshes. Mean shift clustering is used to combine the two images and to compare the separate and coupled inversion methodologies. Two synthetic examples are used to demonstrate the method, and a field-data example is included as a proof of concept. In all cases a significant improvement by the coupling is visible. The methodology can be used as a tool for improved data interpretation and for obtaining a more comprehensive and complete picture of the subsurface by combining geophysical methods

Lehrbuch zu spektroskopischen, chromatographischen, elektrochemischen und thermischen Analysenmethoden

Das Rückgrat der Analytik Die Bedeutung der instrumentellen Methoden in der Arzneimittelanalytik wächst, die Verfahren werden ständig weiterentwickelt und verbessert. Die Neuauflage dieses bewährten Lehrbuchs passt alle instrumentellen Analysenmethoden dem Stand der Wissenschaft und der aktuellen Ausgabe des Arzneibuchs an. Neue oder erweiterte Themen sind unter Anderem: - Emissionsspektroskopie und Massenspektrometrie mit induktiv gekoppeltem Plasma (ICP-OES und ICP-MS) - Kopplungsverfahren der IR-Spektroskopie - Raman-Spektroskopie - Massenspektrometrische Ionisationsverfahren Durch die fokussierte Behandlung von bekannten sowie neuen Anwendungen bietet dieses Lehrbuch einen aktuellen und modernen Einblick in die Möglichkeiten der pharmazeutischen Analytik. Die Verknüpfung mit der aktuellen Ausgabe des Arzneibuchs stellt den Praxisbezug her. Das Buch wendet sich gleichermaßen an Studierende und Praktiker, sei es in der Pharmazie, der Biologie oder der Chemie/Biochemie.5., überarbeitete Auflage 201

Effects of a new piezoelectric device on periosteal microcirculation after subperiosteal preparation

INTRODUCTION: Subperiosteal preparation using a periosteal elevator leads to disturbances of local periosteal microcirculation. Soft-tissue damage can usually be considerably reduced using piezoelectric technology. For this reason, we investigated the effects of a novel piezoelectric device on local periosteal microcirculation and compared this approach with the conventional preparation of the periosteum using a periosteal elevator. MATERIAL AND METHODS: A total of 20 Lewis rats were randomly assigned to one of two groups. Subperiosteal preparation was performed using either a piezoelectric device or a periosteal elevator. Intravital microscopy was performed immediately after the procedure as well as three and eight days postoperatively. Statistical analysis of microcirculatory parameters was performed offline using analysis of variance (ANOVA) on ranks (p<0.05). RESULTS: At all time points investigated, intravital microscopy demonstrated significantly higher levels of periosteal perfusion in the group of rats that underwent piezosurgery than in the group of rats that underwent treatment with a periosteal elevator. CONCLUSION: The use of a piezoelectric device for subperiosteal preparation is associated with better periosteal microcirculation than the use of a conventional periosteal elevator. As a result, piezoelectric devices can be expected to have a positive effect on bone metabolism

Accelerated vascularization of tissue engineering constructs in vivo by preincubated co-culture of aortic fragments and osteoblasts

There is an urgent critical need for the development of clinically relevant tissue-engineered large bone substitutes that can promote early vascularization after transplantation. To promote rapid blood vessel growth in the engineered tissue, we preincubated aortic fragments, as well as, co-cultures of aortic fragments and osteoblast-like cells in matrigel-filled PLGA scaffolds before implantation into the dorsal skinfold chambers of balb/c mice. Despite an acceptable and low inflammatory response, preincubated aortic fragments accelerate early angiogenesis of tissue-engineered constructs; the angiogenesis was found to occur faster than that observed in previous studies. Thus, the time-period for achieving a denser microvascular network could be reduced to half. In addition, co-culture with osteoblasts enhances this angiogenic effect significantly (against preincubated aortic fragments alone). During the preincubation period, aortic fragments begin to form a network of vessel-like structures additionally supported by osteoblast-like cells. After transplantation, further development of a dense microvasculature continues rapidly. Therefore, preincubation of aortic fragments, especially in co-culture with osteoblast-like cells, in 3D extracellular matrices supports the rapid vascularization of tissue-engineered constructs. This method is a promising approach to establish a dense microvascular network in these constructs

Mixture models for undiagnosed prevalent disease and interval-censored incident disease: applications to a cohort assembled from electronic health records

For cost-effectiveness and efficiency, many large-scale general-purpose cohort studies are being assembled within large health-care providers who use electronic health records. Two key features of such data are that incident disease is interval-censored between irregular visits and there can be pre-existing (prevalent) disease. Because prevalent disease is not always immediately diagnosed, some disease diagnosed at later visits are actually undiagnosed prevalent disease. We consider prevalent disease as a point mass at time zero for clinical applications where there is no interest in time of prevalent disease onset. We demonstrate that the naive Kaplan-Meier cumulative risk estimator underestimates risks at early time points and overestimates later risks. We propose a general family of mixture models for undiagnosed prevalent disease and interval-censored incident disease that we call prevalence-incidence models. Parameters for parametric prevalence-incidence models, such as the logistic regression and Weibull survival (logistic-Weibull) model, are estimated by direct likelihood maximization or by EM algorithm. Non-parametric methods are proposed to calculate cumulative risks for cases without covariates. We compare naive Kaplan-Meier, logistic-Weibull, and non-parametric estimates of cumulative risk in the cervical cancer screening program at Kaiser Permanente Northern California. Kaplan-Meier provided poor estimates while the logistic-Weibull model was a close fit to the non-parametric. Our findings support our use of logistic-Weibull models to develop the risk estimates that underlie current US risk-based cervical cancer screening guidelines. Published 2017. This article has been contributed to by US Government employees and their work is in the public domain in the USA

What Can We Learn From A Doubly Randomized Preference Trial?-An Instrumental Variables Perspective

The doubly randomized preference trial (DRPT) is a randomized experimental design with three arms: a treatment arm, a control arm, and a preference arm. The design has useful properties that have gone unnoticed in the applied and methodological literatures. This paper shows how to interpret the DRPT design using an instrumental variables (IV) framework. The IV framework reveals that the DRPT separately identifies three different treatment effect parameters: the Average Treatment Effect (ATE), the Average Treatment Effect on the Treated (ATT), and the Average Treatment Effect on the Untreated (ATU). The ATE, ATT, and ATU parameters are important for program evaluation research because in realistic settings many social programs are optional rather than mandatory and some people who are eligible for a program choose not to participate. Most of the paper is concerned with the interpretation of the research design. To make the ideas concrete, the final section provides an empirical example using data from an existing DRPT study