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ObjectivesOur understanding of blunt cerebrovascular injury (BCVI) has changed significantly in recent decades, resulting in a heterogeneous description of diagnosis, treatment, and outcomes in the literature which is not suitable for data pooling. Therefore, we endeavored to develop a core outcome set (COS) to help guide future BCVI research and overcome the challenge of heterogeneous outcomes reporting.MethodsAfter a review of landmark BCVI publications, content experts were invited to participate in a modified Delphi study. For round 1, participants submitted a list of proposed core outcomes. In subsequent rounds, panelists used a 9-point Likert scale to score the proposed outcomes for importance. Core outcomes consensus was defined as >70% of scores receiving 7 to 9 and

Background: Severely injured patients may suffer from acute disease-related or injury-related malnutrition involving a marked inflammatory response. This study investigated the prevalence and incidence of malnutrition and its relation with complications in severely injured patients admitted to the intensive care unit (ICU). Methods: This observational prospective cohort study included severely injured patients (Injury Severity Score ≥ 16), admitted to the ICU of five level-1 trauma centers in the Netherlands and United States. Malnutrition was defined as a Subjective Global Assessment score ≤ 5. Complications included systemic-, surgery-, and fracture-related complications, pneumonia, urinary tract infection, deep venous thrombosis, and pulmonary embolism. In-ICU and in-hospital mortality were recorded separately. The complication rate was compared between patients who had or developed malnutrition and patients who remained well-nourished, using multivariable logistic regression analysis. Results: Of 100 included patients, twelve (12%) were malnourished at admission. Of the 88 well-nourished patients, 44 developed malnutrition during ICU admission, (ICU incidence 50%, 95% confidence interval [CI] 40–60%). Another 18 patients developed malnutrition at the ward (overall in-hospital incidence 70%, 95% CI 61–80%). The 62 patients who developed malnutrition and 12 patients who were malnourished upon admission had more complications than the 26 patients who remained well-nourished (58% vs. 50% vs. 27% respectively; p = 0.03; Odds Ratio 3.4, 95% CI 1.2–9.6). Conclusions: 50% of severely injured patients developed malnutrition during ICU admission, increasing to 70% during hospital admission. Malnutrition was related to an increased risk of complications. Recognition of sub-optimally nourished severely injured patients and assessment of nutritional needs could be valuable in optimizing their clinical outcomes. Level of evidence: Level III, Prognostic/Epidemiological.Key points: This observational prospective cohort study investigated the prevalence and incidence of malnutrition and its relation with complications and in-hospital outcomes in severely injured patients admitted to the ICU. The majority of severely injured patients developed malnutrition during ICU and hospital admission. Malnutrition is found to be correlated to an increased risk of complications, especially pneumonia, and a longer hospital stay. [ABSTRACT FROM AUTHOR]

In-space biomanufacturing provides a sustainable solution to facilitate long-term, self-sufficient human habitation in extraterrestrial environments. However, its dependence on Earth-supplied feedstocks renders in-space biomanufacturing economically nonviable. Here, we develop a process termed alternative feedstock-driven in-situ biomanufacturing (AF-ISM) to alleviate dependence on Earth-based resupply of feedstocks. Specifically, we investigate three alternative feedstocks (AF)—Martian and Lunar regolith, post-consumer polyethylene terephthalate, and fecal waste—to develop an alternative medium for lycopene production using Rhodococcus jostii PET strain S6 (RPET S6). Our results show that RPET S6 could directly utilize regolith simulant particles as mineral replacements, while the addition of anaerobically pretreated fecal waste synergistically supported its cell growth. Additionally, lycopene production using AF under microgravity conditions achieved levels comparable to those on Earth. Furthermore, an economic analysis shows significant lycopene production cost reductions using AF-ISM versus conventional methods. Overall, this work highlights the viability of AF-ISM for in-space biomanufacturing. Reducing reliance on Earth-supplied feedstocks is crucial for advancing in-space biomanufacturing. Here, the authors explored three alternative feedstocks – Martian and Lunar regolith, post-consumer polyethylene terephthalate, and fecal waste – to develop an alternative medium for cost-effective in-space lycopene biomanufacturing. [ABSTRACT FROM AUTHOR]

UnlabelledFully automated radiosynthesizers are continuing to be developed to meet the growing need for the reliable production of PET tracers made under current good manufacturing practice guidelines. There is a current trend toward supporting kitlike disposable cassettes that come preconfigured for particular tracers, thus eliminating the need for cleaning protocols between syntheses and enabling quick transitions to synthesizing other tracers. Though ideal for production, these systems are often limited for the development of novel tracers because of pressure, temperature, and chemical compatibility considerations. This study demonstrated the versatile use of the ELIXYS fully automated radiosynthesizer to adapt and produce 8 different (18)F-labeled PET tracers of varying complexity.MethodsThree-reactor syntheses of 2-deoxy-2-(18)F-fluoro-β-d-arabinofuranosylcytosine (d-(18)F-FAC), 2-deoxy-2-(18)F-fluoro-5-methyl-β-l-arabinofuranosyluracil (l-(18)F-FMAU), and 2-deoxy-2-(18)F-fluoro-5-ethyl-β-d-arabinofuranosyluracil (d-(18)F-FEAU) along with the 1-reactor syntheses of d-(18)F-FEAU, (18)F-FDG, 3-deoxy-3-(18)F-fluoro-l-thymidine ((18)F-FLT), (18)F-fallypride, 9-(4-(18)F-fluoro-3-hydroxymethylbutyl)-guanine ((18)F-FHBG), and N-succinimidyl-4-(18)F-fluorobenzoate ((18)F-SFB), were all produced using ELIXYS without the need for any hardware modifications or reconfiguration. Synthesis protocols were adapted and slightly modified from those in the literature but were not fully optimized. Furthermore, (18)F-FLT, (18)F-FDG, and (18)F-fallypride were produced sequentially on the same day and used for preclinical imaging of A431 tumor-bearing severe combined immunodeficient mice and wild-type BALB/c mice. To assess future translation to the clinical setting, several batches of tracers were subjected to a full set of quality control tests.ResultsAll tracers were produced with radiochemical yields comparable to those in the literature. (18)F-FLT, (18)F-FDG, and (18)F-fallypride were successfully used to image the mice, with results consistent with those reported in the literature. All tracers that were subjected to clinical quality control tests passed.ConclusionThe ELIXYS radiosynthesizer facilitates rapid tracer development and is capable of producing multiple (18)F-labeled PET tracers suitable for clinical applications using the same hardware setup.

In this study, a lab scale direct membrane filtration (DMF) system using ultrafiltration membranes was operated to compare synthetic and real wastewater to evaluate their membrane fouling propensity and the partitioning of organics and nutrients during concentration. For fouling prevention, cyclic operation was used which consisted of 90 s of filtration followed by 15 s of relaxation and backwashing conducted every 15 min. The system was tested at a high initial flux of 80 LMH (L/m2·h), and the trials were run until a 90% volume reduction was achieved for each batch. Both the synthetic and real wastewater showed similar fouling propensities and organic and nutrient partitioning. The synthetic and real wastewater had an average flux of 46.3 LMH and 28.5 LMH and an average total chemical oxygen demand rejection of 90.3% and 83.1% after 30 h of operation, respectively. The recovery of organics was similar in both influents, resulting in 65.5% and 64.0% of the total chemical oxygen demand concentrations in the concentrate stream for synthetic and real wastewaters, respectively. The total phosphorous and nitrogen concentrations were also similar in terms of rejection rates resulting in 85% and 78% for the synthetic and 89% and 65% for the fresh WWs, respectively. The comparison revealed that synthetic wastewater, though not identical to real wastewater, can serve as a surrogate in DMF studies. This will help to remove one of the key sources of variability in current DMF studies and will allow for more rapid development of DMF technology. [ABSTRACT FROM AUTHOR]