Search

The main structures of the engine room of the CHP are among the most responsible reinforced concrete structures, since during operation they are subjected to significant technological loads, including those not provided for by the project. One of the most significant impacts is seismic. During the long-term operation of the CHP, the building structures have experienced significant alternating loads. As a result, the thermal power plants built 45-60 years ago and currently in operation have a reduced level of seismic resistance. As recent events in Turkey have shown, ensuring the safe operation of power plants is a key task. However, new construction is expensive and not always justified, in this regard, the task is to ensure the seismic resistance of existing power plants in seismically hazardous areas.

The article provides the results of computational studies of the stress-strain state of reinforced concrete structures chambers of locks No. 15 and No. 16 of the Gorodetsky complex of hydraulic structures, performed on the basis of a finite element model taking into account the data of long-term monitoring and field surveys. Combinations of loads that are pleasant in computational studies correspond to the most unfavorable operating conditions. The applied finite element models take into account the structural features of the structure, including interlocking construction joints and the actual location of the reinforcement. In the computational studies, the load-bearing capacity of the actual anchoring of the new repair concrete and the concrete of the main array was checked; the distribution of vertical stresses in the chamber walls, in the reinforcement of the chamber wall, the values of the main stresses in the concrete block under the construction joint was obtained. Conclusions are drawn about the values of horizontal displacements of the upper parts of the chamber walls, cracking in the walls, and the need for reliable anchoring of new repair concrete to the concrete of the main array.

Este trabajo comprende el estudio del efecto del sodio proveniente del NaCl (halita), sobre la morfología del Si eutéctico en una aleación Al-Si hipoeutéctica vaciada. La fusión se llevó acabo en dos hornos, el primero a combustión de gas LP con crisol de grafito para incrementar el contenido de Si en la aleación, de 0.13 a 5 % en peso utilizando silicio metálico con una pureza de 99.35%, y el segundo de resistencias eléctricas con el mismo tipo de crisol, para controlar la temperatura a 750º C. El material fundido fue vaciado en moldes de arena shell, diseñados para evitar impurezas e interacciones en las zonas de estudio. Para añadir la sal al baño metálico, se usaron dos técnicas: una con insuflación mediante gas argón y la otra por gravedad, en ambos casos se manejaron tres cantidades de sal, 0.5, 1.5 y 2.5% en peso respectivamente, pulverizada y precalentada a 150º C durante 60 min. Mediante análisis químico se determinó el contenido de NaCl en la sal siendo de 99.5% en peso, con este dato se calculó la cantidad teórica de sal necesaria. Las muestras obtenidas fueron analizadas metalográficamente, evidenciando la modificación morfológica del Si eutéctico en la escala #2 a #4 de acuerdo a la literatura, presentando los mejores resultados las muestras con 1.5 y 2.5% de sal agregada por gravedad. Finalmente, mediante microscopia electrónica de barrido se caracterizaron los precipitados presentes en las muestras.This work, comprehends a study about the effect of sodium obtained from NaCl (halita) upon the morphology of eutectic silicon in a cast hypoeutectic Al-Si alloy. The melting was carried out in two furnaces, the first was done using LP gas combustion with a graphite crucible for increasing the content of Si in the alloy from 0.13 to 5% wt, using metallic silicon with a purity of 99.35% wt. The second melting was done using electric resistances with the same kind of crucible to control the temperature at 750º C. The melting material was cast into molds of shell sand, to avoid sludge and interaction in the study areas. To add the salt to the metallic bath, two techniques were used; one with injection by means of argon gas and the other one by gravity. In both cases three quantities of salt were used, 0.5, 1.5 and 2.5% in weight respectively, powdered and preheated at 150º C during 60 min. The content of NaCl in the salt, 95% wt was determined by chemical analysis. The theoretical quantity of necessary salt was calculated with this data. The obtained samples were analyzed metallographically, evidencing the modification of the eutectic Si in the scale #2 at #4, in agreement with the literature, presenting the best results the samples with 1.5 & 2.5% wt of salt added by gravity. Finally, by means of scanning electron microscopy, the precipitate present was characterized in the samples.

Over two decades, most cancer vaccines failed clinical development. Key factors may be the lack of efficient priming with tumor-specific antigens and strong immunostimulatory signals. MVX-ONCO-1, a personalized cell-based cancer immunotherapy, addresses these critical steps utilizing clinical-grade material to replicate a successful combination seen in experimental models: inactivated patient's own tumor cells, providing the widest cancer-specific antigen repertoire and a standardized, sustained, local delivery over days of a potent adjuvant achieved by encapsulated cell technology. We conducted an open-label, single-arm, first-in-human phase I study with MVX-ONCO-1 in patients with advanced refractory solid cancer. MVX-ONCO-1 comprises irradiated autologous tumor cells coimplanted with two macrocapsules containing genetically engineered cells producing granulocyte-macrophage colony-stimulating factor. Patients received six immunizations over 9 weeks without maintenance therapy. Primary objectives were safety, tolerability, and feasibility, whereas secondary objectives focused on efficacy and immune monitoring. Data from 34 patients demonstrated safety and feasibility with minor issues. Adverse events included one serious adverse event possibly related to investigational medicinal product and two moderate-related adverse events. More than 50% of the patients with advanced and mainly nonimmunogenic tumors showed clinical benefits, including partial responses, stable diseases, and prolonged survival. In recurrent/metastatic head and neck squamous cell carcinoma, one patient achieved a partial response, whereas another survived for more than 7 years without anticancer therapy for over 5 years. MVX-ONCO-1 is safe, well tolerated, and beneficial across several tumor types. Ongoing phase IIa trials target patients with advanced recurrent/metastatic head and neck squamous cell carcinoma after initial systemic therapy., Significance: This first-in-human phase I study introduces a groundbreaking approach to personalized cancer immunotherapy, addressing limitations of traditional strategies. By combining autologous irradiated tumor cells as a source of patient-specific antigens and utilizing encapsulated cell technology for localized, sustained delivery of granulocyte-macrophage colony-stimulating factor as an adjuvant, the study shows a very good safety and feasibility profile. This innovative approach holds the promise of addressing tumor heterogeneity by taking advantage of each patient's antigenic repertoire., (©2024 The Authors; Published by the American Association for Cancer Research.)

Background: The terms syndemic and infodemic have both been applied to the COVID-19 pandemic, and emphasize concurrent socio-cultural dynamics that are distinct from the epidemiological outbreak itself. We argue that the COVID-19 pandemic has exposed yet another important socio-political dynamic that can best be captured by the concept of a quandemic - a portmanteau of "quantification" and "pandemic"., Main Text: The use of quantifiable metrics in policymaking and evaluation has increased throughout the last decades, and is driven by a synergetic relationship between increases in supply and advances in demand for data. In most regards this is a welcome development. However, a quandemic, refers to a situation where a small subset of quantifiable metrics dominate policymaking and the public debate, at the expense of more nuanced and multi-disciplinary discourse. We therefore pose that a quandemic reduces a complex pandemic to a few metrics that present an overly simplified picture. During COVID-19, these metrics were different iterations of case numbers, deaths, hospitalizations, diagnostic tests, bed occupancy rates, the R-number and vaccination coverage. These limited metrics came to constitute the internationally recognized benchmarks for effective pandemic management. Based on experience from the Nordic region, we propose four distinct dynamics that characterize a quandemic: 1) A limited number of metrics tend to dominate both political, expert, and public spheres and exhibit a great deal of rigidity over time. 2) These few metrics crowd-out other forms of evidence relevant to pandemic response. 3) The metrics tend to favour certain outcomes of pandemic management, such as reducing hospitalization rates, while not capturing potential adverse effects such as social isolation and loneliness. 4) Finally, the metrics are easily standardized across countries, and give rise to competitive dynamics based on international comparisons and benchmarking., Conclusion: A quandemic is not inevitable. While metrics are an indispensable part of evidence-informed policymaking, being attentive to quandemic dynamics also means identifying relevant evidence that might not be captured by these few but dominant metrics. Pandemic responses need to account for and consider multilayered vulnerabilities and risks, including socioeconomic inequities and comorbidities., (© 2024. The Author(s).)

This article examines collaborative environmental governance under authoritarian political structures. Building on the theoretical frame of authoritarian environmentalism, it peruses fieldwork material collected during 2009-2019 to determine the most prominent features of recent collaborative governance efforts in the field of water management in Vietnam, a historically seasonal flooding-dependent country. A key feature is technocratisation, where top-down management structures and practices prioritise technocratic solutions to environmental challenges over deliberation, awareness raising, and integration of local knowledge. Another equally important feature is authoritarian intensification, by which increasingly complex environmental management functions, coupled with the state's determination to retain political control, reinforce authoritarian governance. We jointly refer to these features as captured collaboration, signifying a strong authoritarian regime dominance in both vertical and horizontal relations of environmental governance. However, while captured collaboration still appears to be a defining collaborative characteristic, the article acknowledges rising calls for deliberative government in Vietnamese society. This is particularly outspoken in relation to the highly contested issues of hydropower construction and enhanced floods, debates that simultaneously have paved the way for a burgeoning, though much delayed, paradigm shift., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: The exceptional production of research evidence during the COVID-19 pandemic required deployment of scientists to act in advisory roles to aid policy-makers in making evidence-informed decisions. The unprecedented breadth, scale and duration of the pandemic provides an opportunity to understand how science advisors experience and mitigate challenges associated with insufficient, evolving and/or conflicting evidence to inform public health decision-making., Objectives: To explore critically the challenges for advising evidence-informed decision-making (EIDM) in pandemic contexts, particularly around non-pharmaceutical control measures, from the perspective of experts advising policy-makers during COVID-19 globally., Methods: We conducted in-depth qualitative interviews with 27 scientific experts and advisors who are/were engaged in COVID-19 EIDM representing four WHO regions and 11 countries (Australia, Canada, Colombia, Denmark, Ghana, Hong Kong, Nigeria, Sweden, Uganda, UK, USA) from December 2020 to May 2021. Participants informed decision-making at various and multiple levels of governance, including local/city (n=3), state/provincial (n=8), federal or national (n=20), regional or international (n=3) and university-level advising (n=3). Following each interview, we conducted member checks with participants and thematically analysed interview data using NVivo for Mac software., Results: Findings from this study indicate multiple overarching challenges to pandemic EIDM specific to interpretation and translation of evidence, including the speed and influx of new, evolving, and conflicting evidence; concerns about scientific integrity and misinterpretation of evidence; the limited capacity to assess and produce evidence, and adapting evidence from other contexts; multiple forms of evidence and perspectives needed for EIDM; the need to make decisions quickly and under conditions of uncertainty; and a lack of transparency in how decisions are made and applied., Conclusions: Findings suggest the urgent need for global EIDM guidance that countries can adapt for in-country decisions as well as coordinated global response to future pandemics., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This paper contributes to the debate on race- and gender-based discrimination in grading. We apply a quasi-experimental research design exploiting a shift from open grading in 2018 (examinee's name clearly visible on written assignments), to blind grading in 2019 (only student ID number visible). The analysis thus informs name-based stereotyping and discrimination, where student ethnicity and gender are derived from their names on written assignments. The case is a quantitative methods exam at Roskilde University (Denmark). We rely on OLS regression models with interaction terms to analyze whether blind grading has any impact on the relative grading differences between the sexes (female vs. male examinees) and/or between the two core ethnic groups (ethnic minorities vs. ethnic majority examinees). The results show no evidence of gender or ethnic bias based on names in the grading process. The results were validated by several checks for robustness. We argue that the weaker evidence of ethnic discrimination in grading vis-à-vis discrimination in employment and housing suggests the relevance of gauging the stakes involved in potentially discriminatory activities., Competing Interests: No authors have competing interests.

There is a growing interest in One Health, reflected by the rising number of publications relating to One Health literature, but also through zoonotic disease outbreaks becoming more frequent, such as Ebola, Zika virus and COVID-19. This paper uses bibliometric analysis to explore the state of One Health in academic literature, to visualise the characteristics and trends within the field through a network analysis of citation patterns and bibliographic links. The analysis focuses on publication trends, co-citation network of scientific journals, co-citation network of authors, and co-occurrence of keywords. The bibliometric analysis showed an increasing interest for One Health in academic research. However, it revealed some thematic and disciplinary shortcomings, in particular with respect to the inclusion of environmental themes and social science insights pertaining to the implementation of One Health policies. The analysis indicated that there is a need for more applicable approaches to strengthen intersectoral collaboration and knowledge sharing. Silos between the disciplines of human medicine, veterinary medicine and environment still persist. Engaging researchers with different expertise and disciplinary backgrounds will facilitate a more comprehensive perspective where the human-animal-environment interface is not researched as separate entities but as a coherent whole. Further, journals dedicated to One Health or interdisciplinary research provide scholars the possibility to publish multifaceted research. These journals are uniquely positioned to bridge between fields, strengthen interdisciplinary research and create room for social science approaches alongside of medical and natural sciences., Competing Interests: The authors report no conflicts of interest., (© 2020 The Authors.)

Background Aims: Several studies report on Good Manufacturing Process (GMP)-compliant manufacturing protocols for the ex vivo expansion of tumor-infiltrating lymphocytes (TILs) for the treatment of patients with refractory melanoma and other solid malignancies. Further opportunities for improvements in terms of ergonomy and operating time have been identified., Methods: To enable GMP-compliant TILs production for adoptive cell therapy needs, a simple automated and reproducible protocol for TILs manufacturing with the use of a closed system was developed and implemented at the authors' institution., Results: This protocol enabled significant operating time reduction during TILs expansion while allowing the generation of high-quality TILs products., Conclusions: A simplified and efficient method of TILs expansion will enable the broadening of individualized tumor therapy and will increase patients' access to state-of-the-art TILs adoptive cell therapy treatment., (Copyright © 2020. Published by Elsevier Inc.)

Background: Antimicrobial resistance (AMR) is a growing problem worldwide in need of global coordinated action. With the endorsement of the Global Action Plan (GAP) on AMR in 2015, the 194 member states of the World Health Organization committed to integrating the five objectives and corresponding actions of the GAP into national action plans (NAPs) on AMR. The article analyzes patterns of alignment between existing NAPs and the GAP, bringing to the fore new methodologies for exploring the relationship between globally driven health policies and activities at the national level, taking income, geography and governance factors into account., Methods: The article investigates the global governance of AMR. Concretely, two proxies are devised to measure vertical and horizontal alignment between the GAP and existing NAPs: (i) a syntactic indicator measuring the degree of verbatim overlap between the GAP and the NAPs; and (ii) a content indicator measuring the extent to which the objectives and corresponding actions outlined in the GAP are addressed in the NAPs. Vertical alignment is measured by the extent to which each NAP overlaps with the GAP. Horizontal alignment is explored by measuring the degree to which NAPs overlap with other NAPs across regions and income groups. In addition, NAP implementation is explored using the Global Database for Antimicrobial Resistance Country Self-Assessment., Findings: We find strong evidence of vertical alignment, particularly among low-income countries and lower-middle-income countries but weaker evidence of horizontal alignment within regions. In general, we find the NAPs in our sample to be mostly aligned with the GAP's five overarching objectives while only moderately aligned with the recommended corresponding actions. Furthermore, we see several cases of what can be termed 'isomorphic mimicry', characterized by strong alignment in the policies outlined but much lower levels of alignment in terms of actual implemented policies., Conclusion: To strengthen the alignment of national AMR policies, we recommend global governance initiatives based on individualized responsibilities some of which should be legally binding. Our study provides limited evidence of horizontal alignment within regions, which implies that regional governance institutions (e.g., WHO regional offices) should primarily act as mediators between global and local demands to strengthen a global governance regime that minimizes policy fragmentation and mimicry behavior across member states.

This brief commentary argues that glocal governance introduces a fruitful new perspective to the global governance debate of AMR, and cautions against too strict a focus on establishing globally binding governance regimes for curbing AMR.

- The aim was to examine whether the postprocedural change in C-reactive protein (CRP) and fibrinogen levels was associated with the extent of periprocedural arterial injury caused by endovascular treatment (EVT). The study recruited 71 patients undergoing EVT. Eighty-four patients that underwent angiography served as a control group. CRP and fibrinogen were measured at baseline, and at 8, 24 and 48 hours following the procedure. In all experimental group patients, lesion complexity, percutaneous transluminal angioplasty (PTA) treated segment length, balloon inflation time and stented segment length were recorded. There was significant increase in plasma CRP and fibrinogen levels 48 hours following EVT (p<0.001). There was no significant difference in CRP and fibrinogen levels among different TASC groups. CRP levels were significantly higher in stent subgroup compared to PTA subgroup. Significant positive correlation was found between PTA treated segment length and CRP increase between 8 and 24 hours following EVT (r=0.313, p=0.02), balloon inflation time and CRP increase in the aforementioned time frame (r=0.270, p=0.03), as well as between CRP increase at 8 hours and stented segment length (r=0.535, p=0.01). This study showed that the arterial injury caused by EVT reflected on the level of inflammatory biomarkers.

Understanding the relationship between people and their soundscapes in an urban context of innumerable and diverse sensory stimulations is a difficult endeavor. What public space users hear and how they evaluate it in relation to their performed or intended activities can influence users' engagement with their spaces as well as their assessment of suitability of public space for their needs or expectations. While the interaction between the auditory experience and activity is a topic gaining momentum in soundscape research, capturing the complexity of this relationship in context remains a multifaceted challenge. In this paper, we address this challenge by researching the user-soundscape relationships in relation to users' activities. Building on previous soundscape studies, we explore the role and interaction of three potentially influencing factors in users' soundscape evaluations: level of social interaction of users' activities, familiarity and expectations, and we employ affordance theory to research the ways in which users bring their soundscapes into use. To this end, we employ a mixed methods design, combining quantitative, qualitative and spatial analyses to analyze how users of three public spaces in Amsterdam evaluate their soundscapes in relation to their activities. We documented the use of an urban park in Amsterdam through non-intrusive behavioral mapping to collect spatial data on observable categories of activities, and integrated our observations with on site questionnaires on ranked soundscape evaluations and free responses detailing users' evaluations, collected at the same time from park users. One of our key findings is that solitary and socially interactive respondents evaluate their soundscapes differently in relation to their activities, with the latter offering higher suitability and lower disruption ratings than the former; this points to qualitatively different auditory experiences, analyzed further based on users' open-ended justifications for their evaluations. We provide a methodological contribution (adding to existing soundscape evaluation methodologies), an empirical contribution (providing insight on how users explain their soundscape evaluations in relation to their activities) and a policy and design-related contribution, offering additional insight on a transferable methodology and process that practitioners can employ in their work on the built environment to address the multisensory experience of public spaces.

Objective: This study presents national surveys of patient exposure from nuclear medicine (NM) diagnostic procedures in 2010 and 2015 in the Republic of Croatia., Methods: The survey was performed according to the European Commission Dose DataMed (DDM) project methodology. 28 most frequent NM diagnostic procedures were identified. Data about frequencies of procedures and average administered activities of radioisotopes used in those procedures were collected. Average administered activities were converted to effective doses according to the dose conversion coefficients. Then the collective effective dose to the population and an effective dose per capita were calculated based on the number of the most frequent NM diagnostic procedures and the average effective dose per procedure., Results: In 2010, 41200 NM diagnostic procedures led to 146.7 manSv collective effective dose to the population and in 2015, 42000 NM diagnostic procedures led to 146.8 manSv collective effective dose to the population. The frequencies of NM diagnostic procedures were 9.7 and 9.8 annually per 1000 population with 34.1 μSv and 34.2 μSv effective dose per capita for 2010 and 2015, respectively. The main contributors to the annual collective dose from NM in Croatia are examinations of the bone, heart, thyroid and PET/CT tumour diagnostic. Average administered activities have not changed considerably from 2010 to 2015. Nevertheless, within the frequency of some of the procedures, significant changes were found in five-year period., Conclusions: Frequencies, average administered activities and collective effective dose to the population from NM diagnostic procedures in Croatia are comparable to the values reported by other European surveys. Changes were found between 2010 and 2015 and we intend to perform this study periodically to identify possible trends, but also to raise awareness about the potential dose optimization.

Background: Cardiac arrest in the parturient is often fatal, but appropriate resuscitation in this special situation may save the lives of the mother and/or unborn baby. Concern has arisen as to application of recommended techniques for resuscitation in the obstetric patient. The Israel Board of Anesthesiology has incorporated simulation assessment into accreditation examinations. The candidates represent a unique national cohort in which we were able to assess competence in the simulated scenario of cardiorespiratory arrest in the parturient. METHODS A simulated scenario of preeclampsia with magnesium toxicity leading to cardiac arrest in a pregnant patient was performed by 25 senior anesthesiology residents. A unique two-stage simulation examination consisting of high fidelity simulation followed immediately by oral debriefing was conducted. The assessment was scored using a predetermined checklist of key actions and answers to clarifying questions. Simulation performance was compared to debriefing performance. RESULTS During the board examination, resuscitation not specific to the pregnant patient was performed well (commencing chest compressions, bag-mask ventilation, cardiac defibrillation); however actions specific to the parturient were performed poorly. Left uterine displacement, cricoid pressure during bag-mask ventilation, and instructing preparations to be made for perimortem cesarean delivery within 5 minutes were performed by 68%, 48%, and 40% of candidates respectively (lower 99% confidence limit 42%, 25%, and 19%, respectively). Cricoid pressure during bag-mask ventilation was performed by 48% (25%) but described in debriefing by 80% of candidates (53%) (P = 0.08), and time setting for perimortem cesarean delivery was performed by 40% (29%) but described by 80% (53%) (P = 0.05) of examinees. CONCLUSIONS Senior anesthesiology residents have poor knowledge of resuscitation of the pregnant patient. The results suggest 2-stage simulation including an oral component may reveal disparities in knowledge not assessed by simulation alone, but definitive conclusions require further study.

Summary: Microparticles are small phospholipid vesicles of less than 1 µm released into the blood flow by various types of cells such as endothelial, platelet, white or red blood cells. They are involved in many biological and physiological processes including hemostasis. In addition, an elevated number of microparticles in the blood is observed in various pathological situations. In the context of transfusion, erythrocyte-derived microparticles are found in red blood cell concentrates. Their role is not elucidated, and they are considered as a type of storage lesion. The purpose of this review is to present recent data showing that erythrocyte-derived microparticles most likely play a role in transfusion medicine and could cause transfusion complications.

Congenital hyperinsulinism (CHI) is a major cause of persistent hypoglycemia in the neonatal and early infancy periods. Althought the disease is relatively rare with incidence of about 1:25 000-50 000 live births, the importance of the disease should not be underestimated. Namely, prompt recognition and management of patients with CHI is essential, if permanent neurological impairment is to be avoided. CHI is caused by mutations in one of the 7 genes involved in the regulation of insulin secretion in pancreatic beta-cells. It is important to introduce specific medical therapy as soon as diagnosis is established. Severe, neonatal forms of CHI are often resistant to medications, thus they require surgical procedure. The preoperative genetic testing and scintigraphy are indicated to distinguish histological subtypes of the disease (focal vs. diffuse CHI). Patients with focal disease are usually cured after pancreatic resection, while diffuse disease has much worse prognosis. This manuscript offers novel insights into CHI and emphasizes the role of early diagnosis as crucial for succesful treatment that was recently enriched with novel options.

Background: The storage of blood induces the formation of erythrocytes-derived microparticles. Their pathogenic role in blood transfusion is not known so far, especially the risk to trigger alloantibody production in the recipient. This work aims to study the expression of clinically significant blood group antigens on the surface of red blood cells microparticles., Material and Methods: Red blood cells contained in erythrocyte concentrates were stained with specific antibodies directed against blood group antigens and routinely used in immunohematology practice. After inducing erythrocytes vesiculation with calcium ionophore, the presence of blood group antigens was analysed by flow cytometry., Results: The expression of several blood group antigens from the RH, KEL, JK, FY, MNS, LE and LU systems was detected on erythrocyte microparticles. The presence of M (MNS1), N (MNS2) and s (MNS4) antigens could not be demonstrated by flow cytometry, despite that glycophorin A and B were identified on microparticles using anti-CD235a and anti-MNS3., Discussion: We conclude that blood group antigens are localized on erythrocytes-derived microparticles and probably keep their immunogenicity because of their capacity to bind specific antibody. Selective segregation process during vesiculation or their ability to elicit an immune response in vivo has to be tested by further studies.

Millions of blood products are transfused every year; many lives are thus directly concerned by transfusion. The three main labile blood products used in transfusion are erythrocyte concentrates, platelet concentrates and fresh frozen plasma. Each of these products has to be stored according to its particular components. However, during storage, modifications or degradation of those components may occur, and are known as storage lesions. Thus, biomarker discovery of in vivo blood aging as well as in vitro labile blood products storage lesions is of high interest for the transfusion medicine community. Pre-analytical issues are of major importance in analyzing the various blood products during storage conditions as well as according to various protocols that are currently used in blood banks for their preparations. This paper will review key elements that have to be taken into account in the context of proteomic-based biomarker discovery applied to blood banking.

In this prospective study, we used two full-scale prehospital trauma scenarios (severe chest injury and severe head injury) and checklists of specific actions, reflecting essential actions for a safe treatment and successful outcome, were used to assess performance of postinternship physician graduates of the Advanced Trauma Life Support (ATLS) course. In the first 36 participants, simulated training followed basic training in airway and breathing management, whereas in the next 36 participants, 45 min of simulative training in airway management using the Air-Man simulator (Laerdal, Norway) were added before performing the study scenarios. The content of training was based on common mistakes performed by participants of the first group. After the change in training, the number of participants not performing cricoid pressure or not using medication during intubation decreased from 55% (20 of 36) to 8% (3 of 36) and from 42% (15 of 36) to 11% (4 of 36), respectively (P < 0.05). The number of participants not holding the tube properly before fixation decreased from 28% (10 of 36) to 0% (0 of 36) (P < 0.05). In the severe head trauma scenario, performed by 15 of 36 participants in each group, the incidence of mistakes in the management of secondary airway or breathing problems after initial intubation decreased from 60% (9 of 15) to 0% (0 of 15) (P < 0.05). The present study highlights problems in prehospital trauma management, as provided by the ATLS course. It seems that graduates may benefit from simulation-based airway and breathing training. However, clinical benefits from simulation-based training need to be evaluated.

Low-energy laser irradiation (LELI) has been found to modulate biological processes. The present study investigated the effect of LELI on infarct size after chronic myocardial infarction (MI) and ischemia-reperfusion injury in rats. The left anterior descending (LAD) coronary artery was ligated in 83 rats to create MI or ischemia-reperfusion injury. The hearts of the laser-irradiated (LI) rats received irradiation after LAD coronary artery occlusion and 3 days post-MI. At 14, 21, and 45 days post-LAD coronary artery permanent occlusion, infarct sizes (percentage of left ventricular volume) in the non-laser-irradiated (NLI) rats were 52 +/- 12 (SD), 47 +/- 11, and 34 +/- 7%, respectively, whereas in the LI rats they were significantly lower, being 20 +/- 8, 15 +/- 6, and 10 +/- 4%, respectively. Left ventricular dilatation (LVD) in the chronic infarcted rats was significantly reduced (50-60%) in LI compared with NLI rats. LVD in the ischemia-reperfusion-injured LI rats was significantly reduced to a value that did not differ from intact normal noninfarcted rats. Laser irradiation caused a significant 2.2-fold elevation in the content of inducible heat shock proteins (specifically HSP70i) and 3.1-fold elevation in newly formed blood vessels in the heart compared with NLI rats. It is concluded that LELI caused a profound reduction in infarct size and LVD in the rat heart after chronic MI and caused complete reduction of LVD in ischemic-reperfused heart. This phenomenon may be partially explained by the cardioprotective effect of the HSP70i and enhanced angiogenesis in the myocardium after laser irradiation.