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BACKGROUND: Standardized treatment of split-thickness skin graft (STSG) donor sites is not established. Bleeding can necessitate premature dressing changes, interrupting the healing process and increasing pain. PURPOSE: A collagen/oxidized regenerated cellulose (C/ORC) dressing was used on the donor site. The authors hypothesized that the collagen matrix could decrease bleeding-related complications, reduce pain, and foster epithelialization. METHODS: The C/ORC matrix was applied to the donor site after hemostasis was achieved. Dressings were removed between postoperative days 4 and 7, and the patients’ pain levels, bleeding complications, and percentage healed were recorded. RESULTS: Thirty-nine patients were treated with the C/ORC donor site dressing. Of these, 35 patients (89.7%) were receiving at least prophylactic anticoagulation, and no bleeding complications were recorded. The average area of donor sites was 123.8 cm2 (range, 20-528 cm2). Utilizing the Numerical Rating Scale, 25 patients (64.1%) reported no pain with dressing removal while 5 (12.8%) reported a decrease in pain. The percentage of epithelialization as assessed by treating clinician was at least equivalent to other modalities. CONCLUSIONS: The application of a C/ORC matrix to STSG donor wound sites resulted in no bleeding complications and excellent pain control while promoting epithelialization in the patients studied. Following this study, the C/ORC dressing has been incorporated into the authors’ standard protocol.

BACKGROUND: Necrotizing soft tissue infection (NSTI) is rare and characterized by rapid onset and spread of inflammation and necrosis. The infection starts within the fascia but can rapidly progress to include musculature, subcutaneous fat, and overlying skin. Its presentation is considered a surgical emergency. Persons who use intravenous or subcutaneous opioids are at higher risk of NSTIs. PURPOSE: The purpose of this case report is to describe the positive clinical outcome after consulting with wound specialists and using a dressing regimen to expedite more rapid wound healing, shortened time to skin graft, and improved pain tolerance in a patient with a history of intravenous and subcutaneous heroin use. CASE REPORT: The patient presented with an NSTI that required extensive debridement of the bilateral upper extremities. The acute surgical wound service was consulted. A dressing regimen consisting of hypochlorous acid–preserved wound cleansing, followed by carboxymethylcellulose fiber with 1.2% ionic silver covered by hydrocellular foam to promote a moist healing environment, was used to facilitate granulation. RESULTS: Healthy granulation tissue was noted 6 days after debridement. The improved rate of granulation and the patient’s tolerance to dressing changes secondary to decreased pain from these dressings significantly expedited the time to graft and wound healing. The patient underwent split-thickness skin grafting 10 days after debridement. There was 100% uptake of the grafts on postgraft day 8. CONCLUSION: The favorable clinical outcome suggests that early consultation with wound specialists and implementation of the dressing regimen were effective in this patient regarding improved pain control and healing. However, because the patient left against medical advice on hospital day 20, the clinical course could not be followed beyond the first few postoperative weeks.

A novel and controlled methodology combining UPS/XPS spectroscopies intended to determine the electronic state at the surface of ceria nanopowders.

Background Respiratory virus infections (RVI) are an important cause of pneumonia with increased risk of morbidity and mortality in patients with hematologic malignancies (HM) especially after stem cell transplantation. However, data on RVI in this population without stem cell transplant is still lacking. Here we aim to look at trends of RVI in HM population. Methods We conducted a retrospective cohort study of adult patients with HM diagnosed with RVI at our institution. We analyzed data from multiplex qualitative PCR-based respiratory viral panel (RVP) samples taken from January 2016 to June 2020. Lower respiratory tract infection (LRTI) was defined as abnormal chest radiography with positive RVP. Results Fifty-seven unique episodes were analyzed out of 54 patients. Thirty (52.6%) were females and the most common underlying malignancy was Non-Hodgkin’s Lymphoma (21, 36.8%). Median age was 61 (range 23-92) years old and 44/57 (77.1%) patients received chemotherapy within 30 days prior to RVI. Patient characteristics are summarized in Table 1. Most common viruses included Rhinovirus/Enterovirus (25, 43.8%), Influenza A/B (14, 24.5%) and RSV A/B (7,12.2%), respectively. Out of 39 patients who underwent chest imaging, 13/39 (33.3%) had evidence of LRTI. Out of 45 cases diagnosed as outpatients, 11/45 (24.4%) required hospital admission. ICU admission and mechanical ventilation were required in 5/57 (8.7%) and 2/57 (3.5%), respectively. Bacterial and fungal co-infection were seen in 1 (Pseudomonas spp) and 3 (Aspergillus spp.), respectively. Of note, only 1/57(1.8%) died at 30 days after RVI diagnosis. Conclusion Only one third developed LRTI after RVI in HM patients with very low 30-day mortality. However, we still found several bacterial and fungal co-infections. Thus, adequate diagnosis for RVI and co-infections with proper treatment should be required. Further studies with larger sample size are still needed. Disclosures All Authors: No reported disclosures.

Acute Myeloid Leukemia (AML) is an aggressive blood cancer in adults. Intensive induction therapy successfully induces a complete response in up to 80% of the adult patients but a fraction of them is refractory or relapses. The fraction of non-responsive or relapsing patients is especially high amongst medically unfit and older patients, who cannot undergo aggressive chemotherapy treatment. Therefore, offering patients failing on first line intensive chemotherapy and medically unfit and older patients an effective treatment option for long-term control or even cure of disease represents a significant yet unmet clinical need.As a component of the innate immunity, NK cells have recently shown great promise for the treatment of patients with different malignancies. Here, we show that injection of human interleukin-2 (IL-2) complexes (IL-2cx) induce the de novo generation and massive expansion of NK cell precursorsin vivo. Furthermore, IL-2cx-expanded NK cells exert effector functions with the capacity to control the growth of non-self MHC class I-deficient RMA-S lymphoma cellsin vivo, while remaining tolerant towards MHC class-expressing self RMA cells.In an experimental setup mimicking the clinical case of refractory patients after intensive AML induction therapy, IL-2cx treatment mediated strong anti-AML responses following haploidentical bone marrow transplantation without the need for adoptive transfer of donor-derived orin vitroautologous expanded NK cells. Thus, this study demonstrates that IL-2cx immunotherapy allows thein vivogeneration and expansion of functionally mature NK cells to achieve long-term response in AML paving the way to an effective treatment option.

A sequential analysis using Ultra-violet Photoelectron Spectroscopy (UPS) and X-ray Photoelectron Spectroscopy (XPS) on ceria nanopowders has been implemented to identify the influence of the X-ray beam on the surface of this oxide. For the first time, UPS analysis evidenced the photoreductive effect of XPS analysis on ceria after an oxidative

Tracheobronchomalacia (TBM) and excessive dynamic airway collapse (EDAC) are airway abnormalities that share a common feature of expiratory narrowing but are distinct pathophysiologic entities. Both entities are collectively referred to as expiratory central airway collapse (ECAC). The

Introduction Negative-pressure wound therapy (NPWT) with instillation and dwell time is an accepted adjunct therapy for infected wounds. A study was conducted to assess whether the use of hypochlorous acid preserved wound cleanser (HAPWOC) (Vashe, Urgo Medical North America, Fort Worth, TX, USA) as the irrigant would reduce the cost of care in comparison to 0.9% saline (NaCl). Method A comparative, observational, retrospective analysis assessed 27 serious and infected wounds in 24 patients. The lesions were of different and complex etiologies, including necrotizing fasciitis and stage IV diabetic foot ulcers. NPWT was used as part of the overall multimodal treatment regimen. The only variance in the treatment protocol was the use of saline (N=8) or HAPWOC (N=19) as the irrigant. Results When compared to NaCl, wounds treated with HAPWOC trended toward fewer operating room (OR) visits versus NaCl (3.3 versus 4.1) and a shorter length of hospital stay (LOS) (24.3 days versus 37.9 days). The Orlando Health Transparency guide shows the cost of OR debridement as $2,525. Thus, debridement for HAPWOC-treated wounds ($8,332) costs $2,020 (24%) less than for NaCl-treated wounds ($10,352). Using the 2016 Kaiser Health data (average daily hospital cost, excludingall interventions: $2,052), the cost of HAPWOC and NaCl instill translates to $49,864 and $77,771, respectively, a difference of $27,906 (56%) more for NaCl treatment. The Agency for Healthcare Research and Quality (AHRQ) 2012 data indicate an average daily cost of hospital stay, including all interventions, of $10,400. Thus, HAPWOC treatment cost translates to $252,720 versus NaCl-related costs of $394,160; in these calculations, using NaCl costs $141.440 (+56%) more per patient than HAPWOC. Conclusion The use of NPWT with HAPWOC versus NaCl as instillation in NPWT reduces the number of visits to the operating room and LOS. This has a significant impact on lowering the cost of care when HAPWOC is used.

Rational design and precise engineering are needed to optimize the structural and chemical parameters of functional materials. In this work, we demonstrate how pre-formed binary metal selenides can be an excellent synthetic choice for the synthesis of ternary coinage metal selenide nanoparticles (NPs) with controlled composition. The mild conditions required to obtain these ternary coinage metal selenide NPs offered an easy synthesis of n% CuAgSe–TiO2 (n = 0.01, 0.1, 0.3 and 1.0 mol%) nanocomposites for photocatalytic applications without compromising the structural and morphological characteristics of TiO2 and without having any organic ligands around the NPs. The use of ternary metal selenide nanocomposites CuAgSe–TiO2 results in a clear improvement in their photocatalytic activity for the photodegradation of formic acid as compared to the well-known benchmark for photocatalysis, TiO2 (P25), and its binary metal selenide nanocomposites Cu2−xSe–TiO2. DFT calculations establish semi-metallic behavior of CuAgSe NPs and show that CuAgSe–TiO2 forms a semimetallic-semiconductor heterojunction allowing a better charge separation to enhance its photocatalytic activity.

An accurate experimental determination of electronic structures in semi-conductor nanopowders is a challenging task. We propose here to combine UPS and UV-Vis spectroscopies in order to get the full description of the electronic band alignment of powder samples, TiO2 rutile and anatase. For UPS measurements, two preparation methods, namely the dropping method and electrophoretic deposition, were used to prepare layers of titania powders on a conducting substrate, ITO or Ag. Both methods lead to comparable results, with a quantitative description of the energy levels from the valence band. Combining these results with the UV-Vis spectra of the same powders enables the determination of the absolute position of the valence band maximum and the conduction band minimum. Combined UPS-UV-Vis spectroscopy provides a better insight into the properties of a powdered material which can differ from single crystal model systems. It can also be used to predict the electronic transfer in mixed phase systems during photocatalytic processes.

fff; International audience; Mo/TiO2 catalysts with atomic dispersion of molybdenum appear active and stable in the gas-phase hydrogenation of CO2. The comparison between various titania materials shows a crucial effect of the support surface structure on the methanol yield. Molybdenum supported at low coverage on rutile titania nanorods is the most active and methanol-selective system. From catalyst characterization by aberration-corrected scanning transmission electron microscopy, near-ambient pressure X-ray photoelectron spectroscopy, diffuse reflectance UV-vis spectroscopy, and temperature-programmed techniques, we suggest that the most active catalysts for methanol production involve atomically-dispersed oxomolybdate species with high reducibility and strong interaction with the rutile support.

The demand of the baking industry has increased steadily in recent years due to which the sector must also face new challenges involving cost, time, and quality of products; it must also achieve optimal profitability rates and contribution margin. According to the aforementioned, it is essential to plan each stage of the processes, the forecast of demand, supply of materials and consumables, production capacity, and distribution and transportation of products. An essential part of these considerations is inventory and warehouse management. Here, we propose a method that makes use of tools such as material requirement planning, economic order quantity, supplier approval, and standardization, which aims to improve the current defective product indicator of 11.43% generated by poor inventory management. After the implementation of the pilot plans, a reduction of 60% was achieved to sustain the effectiveness of the integrating model, the improvement was corroborated with a simulation, obtaining the same results.

International audience; Pt-based materials are widely used as heterogeneous catalysts, in particular for pollutant removal applications. The nature of the active Pt phase responsible for CO oxidation has long been investigated with a view at designing more efficient formulations. The state of Pt has often been proposed to differ depending on experimental conditions, e.g. metallic Pt poisoned with CO being present at lower temperature before light-off, while an oxidized Pt surface prevails above light-off temperature. In stark contrast with all previous reports, we show here that both metallic and oxidized Pt are present in similar proportions under reaction conditions at the surface of ca. 1 nm nanoparticles showing high activity at 30 °C. The simultaneous presence of metallic and oxidized Pt enables a synergy between these phases. The main role of metallic Pt phase is to provide strong adsorption sites for CO, while that of oxidized Pt supposedly supplies reactive oxygen. Our results emphasize the complex dual oxidic-metallic nature of supported Pt catalysts and its evolving nature under reaction conditions, warranting a whole rethink of the mechanism of other reaction and metals, particularly redox and electrochemical reactions.

In Peru, architecture SMEs have a very large gap between technology and information, it is because many times companies only sought to meet the objectives of each project without thinking about the automation of processes, reduction of delivery times or costs of personal. Generating in many situations, delays in deliveries or requests for time extensions (a traditional practice in the country) that directly affects personnel costs and company profits, therefore the proposal seeks to design a monitoring model that allows reducing the times between activities and rework, optimizing deliveries to the client and ensuring the quality of the projects delivered.

This research focuses on the application of the primary tools in industrial engineering with regards to companies and sectors within a country. This analysis focuses on small and medium enterprises in the footwear sector. Small companies currently form a nucleus in the world economy, and thus, research sources include companies in the footwear sector in Lima, Peru. With the aim of continuous improvement, the objective of this research is to implement and control the processes used by the sector through Lean methodology with the following indicators: optimization of the effective time of operators by 13%, production increment by 20%, and finally reduction in reprocessing by 63%. The impact on work is based on changes in machines, stations, functions, tools, and workshop designs to increase productivity in the footwear industry by 23.62%. Therefore, applying operations as tools is essential to effectively analyze and control production.

The beverage manufacturing industry is an extremely competitive sector. Small- and medium-sized businesses usually encounter order fulfillment issues and have high operating costs, negatively affecting their profitability. In this study, we consider a small soft drink production company to design an improvement model. The proposed design is based on the combination of lean manufacturing tools and other tools that may be required depending on the situation. In this sense, the proposed model is based on the 5S methodology, workstation redesigning, process standardization, and reliability-based maintenance. The implementation of the proposed design will increase the efficiency of the production process by 8.8%.

Small and medium toilet manufacturing businesses in Peru face significant problems such as low productivity because of a high rate of production losses. To address this issue, the present study proposes the application of a lean manufacturing technique, such as the Poka-Yoke model, which improves the production flow within the company by implementing a transportation cart with a safety system to help reduce material falls during the manufacturing process. The results showed a 24% increase in productivity and reduction in problems of damaged products that did not meet quality standards, thus preventing their subsequent reprocessing.

The Peruvian export supply is primarily based on the segment of dressings and condiments. This paper seeks to adapt lean manufacturing tools using Poka-Yoke techniques and process standardization, which may align with existing processes to prevent production errors. This combination of tools is expected to reduce the percentage of waste generated throughout the condiment production process. Subsequent to an initial evaluation of the current method combined with the application of both the tools, 11.4% waste reduction was ultimately reported.