Search

Efficacy of mesenchymal stem cells (MSCs) for treatment of acute respiratory distress syndrome (ARDS) suggests bioactive bone marrow MSC extracellular vesicles (BM-MSC EVs) may be effective. A patient with severe COVID-19 associated ARDS who was presumed to expire was treated with a BM-MSC EV preparation (14 doses over two months) as a rescue treatment for refractory COVID ARDS. Near complete reversal of lung inflammation and fibrosis (per computed tomography), near complete restoration of mobility, hospital discharge (3 months) with resumption of normal activities of daily living (one year) and return to work occurred. No adverse events occurred despite repeated dosing of investigational product, highlighting safety of this potential therapy for ARDS.

Abstract Background Readmission rates for heart failure remain high, and affordable technology for early detection of heart failure decompensation in the home environment is needed. Lung ultrasound has been shown to be a sensitive tool to detect pulmonary congestion due to heart failure, and monitoring patients in their home environment with lung ultrasound could help to prevent hospital admissions. The aim of this project was to investigate whether patient-performed tele-guided ultrasound in the home environment using an ultraportable device is feasible.Affiliations: Journal instruction requires a country for affiliations; however, these are missing in affiliations [1, 2]. Please verify if the provided country are correct and amend if necessary.Correct Methods Stable ambulatory patients with heart failure received a handheld ultrasound probe connected to a smart phone or tablet. Instructions for setup were given in person during a clinic visit or over the phone. During each ultrasound session, patients obtained six ultrasound clips from the anterior and lateral chest with verbal and visual tele-guidance from an ultrasound trained clinician. Patients also reported their weight and degree of dyspnea, graded on a 5-point scale. Two independent reviewers graded the ultrasound clips based on the visibility of the pleural line and A or B lines. Results Eight stable heart failure patients each performed 10–12 lung ultrasound examinations at home under remote guidance within a 1-month period. There were no major technical difficulties. A total of 89 ultrasound sessions resulted in 534 clips of which 88% (reviewer 1) and 84% (reviewer 2) were interpretable. 91% of ultrasound sessions produced interpretable clips bilaterally from the lateral chest area, which is most sensitive for the detection of pulmonary congestion. The average time to complete an ultrasound session was 5 min with even shorter recording times for the last session. All patients were clinically stable during the study period and no false positive B-lines were observed. Conclusions In this feasibility study, patients were able to produce interpretable lung ultrasound exams in more than 90% of remotely supervised sessions in their home environment. Larger studies are needed to determine whether remotely guided lung ultrasound could be useful to detect heart failure decompensation early in the home environment.

Barely visible impact damage (BVID) occurs in composite laminates subjected to low-velocity impact. They can then exhibit significant effect on mechanical performance of laminates. Previously, it is shown, analytically and experimentally, that BVID occurs at a critical energy level and below this energy level there is no induced damage. However, repeated impact may cause BVID even below the critical energy level. This paper is a novel investigation that deals with the cyclic behaviour of quasi-isotropic glass/epoxy laminated composites under indentation, which is a quasi-static version of low-velocity impact. In particular, this study aims to investigate the ply thickness effect on matrix crack-induced delamination damage in the case of laminated composites under cyclic quasi static indentation loadings. The effect of different parameters, such as load level and ply thickness, on the damage evolution were here investigated. Tests were performed according to the ASTM 7136 standard. Since the glass layer was translucent, it was also possible to visually inspect the matrix delamination during the tests. The laminates were subjected to load levels lower than the critical load level, while there was no evidence of damages when samples were indented just once. However, by increasing the number of cycles, matrix crack-induced delamination appeared in the samples. In brief, it was observed that the ply thickness and energy level have significant effects on the intensity of the induced damage.

Context: Pathogenesis of uterine synechia remains unsolved, the causal relationship between synechia and infertility is not clearly established. Aims: To evaluate the rabbit as an experimental model for Asherman′s syndrome using the endometrial curettage as trigger mechanism then to evaluate its impact on fertility. Settings and Design: Experimental study Materials and Methods: 13 female rabbits. All submitted traumatic endometrial curettage. Animals of Group 1 (n = 7) were sacrificed at various times following surgery (day 7, 15 and 30), animals of Group 2 (n = 6) were bred and sacrificed during pregnancy. Main outcome were synechia occurring, number of implanted fetus, lumen surface/ global horn perimeter ratio (LS-GHP ratio) and epithelium thickness. Statistical Analysis: Means were compared using Student ′t′ test (P < 0.05 was considered significant). Number of implantation sites of two horns were compared with the Wilcoxon test. Results: No synechia have been observed. Examinations at Day 7, 15 and 30 demonstrate a complete regeneration of endometrium. We observed a significant diminished LS-GHP ratio at day 7 (0.042 ± 0.004 vs 0.074 ± 0.002 mm; P = 0.013) with a higher simple columnar epithelium compared to control (16.6 ± 3.39 vs 10.98 ± 1.7; P = 0.001). We observed a diminished ovum implantation in traumatized horns, even if it was not statistically significant. Conclusion: Even if no intrauterine adhesion were observed, this model represents a pathogenesis condition in the rabbit similar to intrauterine adhesions observed in the human with negative impact on implantation.