This paper presents complex studies on establishment of derived emission limits for potential radionuclides emitted as gaseous and liquid effluents, during the decommissioning activities (2nd and 3rd ...phases) of a nuclear research reactor, cooled and moderated with distilled water, type VVR-S, owned by the IFIN-HH. In the present paper there are described: the analysis methods and equipment used, the methodologies for calculating doses and the Derived Emission Limits (DEL), the experimentally measured activities of the representative radionuclides found in gaseous and liquid effluents resulted from decommissioning activities, as well as the effective derived limits of liquid and gaseous effluents, applying the calculation methodologies, specific to critical categories of exposed subjects. A constraint effective dose limit for a person from the critical group of 50 μSv/year was considered in calculations. From the comparison of the two series of values, measured released activities and DELs, there has been concluded that for the gaseous effluents they comply with the DELs, while in the case of liquid effluents they are higher and consequently they must be treated as liquid radioactive wastes.
•The DELs for gaseous and liquid effluents in decommissioning were studied.•The impact on the environment and critical group was assessed.•Gamma-ray spectrometry was used to determine the radionuclide composition.•Based on the dosimetry models, the values of conservative DELs were calculated.•The DELs are compliant for gases, not for liquids; require the treatment as rad-waste.
Glycemic goals of inpatients should consider the prevention of hypoglycemia and hyperglycemia. To achieve glycemic control in the hospital, guidelines recommend basal-bolus insulin therapy as the ...preferred method for treatment of persistent hyperglycemia and the use of clinical decision support systems. The aim of this study was to investigate the efficacy, safety and usability of the GlucoTab® decision support system in hospital routine care of non-critically ill patients with type 2 diabetes at 3 general wards of a university medical center. In total, 150 patients with type 2 diabetes requiring insulin therapy (56 female, age 68 ± 11 years, HbA1c 77 ± 24 mmol/mol, diabetes duration 15 ± 11 years, BMI 30 ± 6 kg/m2, length of hospital stay 9 ± 7 days) were treated with basal-bolus insulin therapy guided by GlucoTab®, a mobile decision support system providing automated workflow tasks and suggestions for insulin dosing to nurses and physicians. In total 4879 capillary blood glucose values (BG) were documented. By using the GlucoTab® system in routine care, a mean daily BG of 159 ± 32 mg/dl could be achieved. 68.8% of all BG measurements were in the acceptable range (70-<180 mg/dl). The percentage of BG values <40, <70 and ≥300 mg/dl was 0.02%, 2.2% and 2.3%, respectively. Health care professional’s adherence to the suggested insulin doses (n=7407) and workflow tasks (n=9927) was high (>93% and 91%, respectively). The study confirmed that the GlucoTab® system supports a safe, efficacious and user-friendly glycemic management of basal-bolus insulin therapy in hospital routine care. Further research will include decision support for alternative therapy types for patients with less stringent goals to prevent hypoglycemia in hospital routine care.
Disclosure
K.M. Lichtenegger: None. F. Aberer: None. A.C. Tuca: None. K. Donsa: Stock/Shareholder; Self; decide Clinical Software GmbH. B. Höll: Employee; Self; decide Clinical Software GmbH. L. Schaupp: None. J. Plank: None. P. Beck: Employee; Self; decide Clinical Software GmbH. Stock/Shareholder; Self; decide Clinical Software GmbH. F. Fruhwald: None. T.R. Pieber: Advisory Panel; Self; ADOCIA, Arecor Limited, AstraZeneca, Novo Nordisk A/S, Sanofi. Speaker's Bureau; Self; Novo Nordisk A/S. J.K. Mader: Advisory Panel; Self; Boehringer Ingelheim International GmbH, Eli Lilly and Company, Prediktor Medical, Roche Diabetes Care, Sanofi. Speaker's Bureau; Self; Abbott, AstraZeneca, Dexcom, Inc., Novo Nordisk Inc. Stock/Shareholder; Self; decide Clinical Software GmbH.
Funding
Research Studio Austria "GlucoTab“ (844737)
The aim was to investigate the applicability of a clinical decision support system in a real-world inpatient setting for patients with type 2 diabetes on general hospital wards.
A total of 150 ...patients with type 2 diabetes requiring subcutaneous insulin therapy were treated with basal-bolus insulin therapy guided by a decision support system (GlucoTab) providing automated workflow tasks and suggestions for insulin dosing to health care professionals.
By using the system, a mean daily blood glucose (BG) of 159 ± 32 mg/dL was achieved. 68.8% of measurements were in the target range (70 to <180 mg/dL). The percentage of BG values <40, <70, and ≥300 mg/dL was 0.02%, 2.2%, and 2.3%, respectively. Health care professionals’ adherence to suggested insulin doses and workflow tasks was high (>93% and 91%, respectively).
The decision support system facilitates safe and efficacious inpatient diabetes care by standardizing treatment workflow and providing decision support for basal-bolus insulin dosing.
Abstract
Introduction
A balanced moist wound environment and wound surface increase the effect of various growth factors, cytokines and chemokines, and cell growth. This can stimulate cell growth and ...wound healing. Considering this fact, we tested the effects of different secondary wound dressings and their evaporation of water when used with bacterial derived cellulose dressing in vitro and in vivo in a porcine donor site model. The aim of this study was to evaluate how the different rates of evaporation affect wound healing.
Methods
Bacterial derived cellulose dressing is a hydroactive wound dressing made from pure biotechnologically derived cellulose with more than 95% sterilized water in a sodium chloride solution. To further determine evaporation behavior, bacterial derived cellulose dressing was tested in vitro, either alone or in combination with secondary wound dressings. As secondary dressings we chose materials which are used in clincal routine such as cotton gauze, Jelonet, Aqacel Extra and Opsite Flexifix. Furthermore, in a porcine donor site model, we analyzed the effect of bacterial derived cellulose dressing, with and without secondary dressings, on wound healing in vivo. For this, the dressing materials were placed on 3x3 cm sized dermotome wounds of 1.2 mm depth arranged in groups of six on the flank of a domestic pig. The healing progress was analyzed macroscopically and histologically after 5 days.
Results
The in vitro experiments showed rapid water evaporation rates from bacterial derived cellulose dressing when using cotton gauze or Aquacel Extra as a secondary dressing, an intermediate evaporation rate after coverage with Jelonet, and a much slower rate when using Opsite Flexifix as secondary dressing. The histological results from the animal study showed that bacterial derived cellulose dressing in combination with cotton gauze or Aquacel Extra had comparable high rates of re-epithelialization. Whereas these were reduced when using Jelonet as a secondary dressing. The secondary dressing with Opsite Flexifix resulted in very slow water evaporation from the wound with consecutive very bad to non-healing wounds and a high maceration rate.
Conclusions
In the present study we were able to show that the moisture of the wound environment and evaporation from the wound can be specifically influenced by using bacterial derived cellulose dressing in combination with cotton gauze, Jelonet, Aqacel Extra and Opsite Flexifix.
Applicability of Research to Practice
The results of this study make it possible, depending on the type of wound, to positively influence cell growth and thus accelerate wound healing. This can be of great benefit in clinical wound management, especially in burn injuries and chronic wounds.
Background
The use of injectable solutions for aesthetic purposes has increased tremendously, but lacks objective support. We aimed at assessing static and dynamic effects of botulinum toxin A ...(BoNTA) on glabellar lines by use of an objective three-dimensional methodology.
Methods
We prospectively collected three-dimensional stereographic photographs of two different facial expressions (pretreatment, 30 and 90 days posttreatment) in 21 patients, receiving a total of 20 units of BoNTA in both corrugator supercilii muscles. The primary endpoint was the three-dimensional static and dynamic surface irregularity, and secondary endpoints were the glabellar line scale and overall patient satisfaction. Blinded retrospective data analysis and statistical evaluation were performed with
p
< 0.05 considered statistically significant.
Results
Static glabellar lines (neutral facial expression) were significantly reduced by − 17% and − 24% on day 30 and 90 posttreatment, respectively (vs. pretreatment; both
p
< 0.0001). Dynamic glabellar frown lines (firmest possible bilateral eye closure) demonstrated a reduction of surface irregularity by − 26% and − 21% on day 30 and 90 posttreatment, respectively (vs. pretreatment; both
p
< 0.0001). The subjective dynamic glabellar line scale documented a statistically significant improvement on day 30 posttreatment (mean ± SD: 1.5 ± 0.8;
p
< 0.05) versus pretreatment (2.8 ± 1.0). Polled patients confirmed a subjective wrinkle improvement 90 days posttreatment.
Conclusion
The presented setup detected even subtle changes of BoNTA treatment for facial wrinkling and is a promising asset for scientific evaluations of clinical studies analyzing the outcome and duration of efficacy of injectable solutions on the face.
Level of Evidence IV
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.
In this work, microwave characterization of magnetic materials using the scanning microwave microscopy (SMM) technique is presented. The capabilities of the SMM are employed for analyzing and imaging ...local magnetic properties of the materials under test at the nanoscale. The analyses are performed by acquiring both amplitude and phase of the reflected microwave signal. The changes in the reflection coefficient S11 are related to the local properties of the material under investigation, and the changes in its magnetic properties have been studied as a function of an external DC magnetic bias. Yttrium iron garnet (YIG) films deposited by RF sputtering and grown by liquid phase epitaxial (LPE) on gadolinium gallium garnet (GGG) substrates and permalloy samples have been characterized. An equivalent electromagnetic transmission line model is discussed for the quantitative analysis of the local magnetic properties. We also observed the hysteretic behavior of the reflection coefficient S11 with an external bias field. The imaging and spectroscopy analysis on the experimental results are evidently indicating the possibilities of measuring local changes in the intrinsic magnetic properties on the surface of the material.
•BNC is an excellent carrier to create on-demand antiseptic wound dressings.•When loading BNC, the formulation has to be considered that might influence uptake and release of the active ...ingredient.•Tested by using FITC-dextran molecules, the uptake and release of molecules into the BNC is size dependent.•The uptake and release capacity of BNC makes it a promising carrier for larger molecules.
Bacterial nanocellulose (BNC) is considered a promising carrier for various substances and novel approaches using BNC in combination with antiseptics are well documented. However, the difference in the molecular weight of these molecules influences their uptake by and release from BNC. Analysing the diffusion of standard molecules with different weight, e.g. dextrans, offers the possibility to investigate the mobility of various molecules. We aimed to test the use of BNC regarding uptake and release of different standard molecules as well as two commercially available antiseptics for possible applications in future wound dressings.
Diffusion profiles, uptake and release of three FITC-dextran molecules differing in weight as well as octenidine (Octenisept®) and povidone-iodine (Betaisodona®)-based antiseptics were tested with BNC-based wound dressings. Furthermore, the antiseptic efficacy of BNC in combination with antiseptics against Staphylococcus aureus was tested.
Uptake and release capacity for FITC-dextran molecules showed a molecular weight-dependent mobility from BNC into an agarose gel. The loading capacity of BNC was also inversely proportional to the molecular weight of the antiseptics. The release test for octenidine showed a sustained and prolonged delivery into a solid matrix, whereas povidone-iodine was released faster. Both antiseptic solutions combined with BNC showed a good dose-dependent efficacy against S. aureus.
Results obtained from the mobility of FITC-dextran molecules in the BNC matrix could open possible applications for the combination of BNC with other molecules for medical applications. Combination of both tested antiseptics with BNC showed to be an efficient approach to control bacterial infections.
•Among burn specialists, there is a consensus that an ideal burn wound dressing should be non-adhesive, absorbent, and should have antimicrobial properties.•Bacterial nanocellulose (BNC) is fully ...biocompatible, hydrophilic and can also protect a wound from excessive fluid loss.•Within 30min, clinically relevant concentrations of antiseptics can be achieved in BNC-based wound dressing.
With the increase of antimicrobial resistance in recent decades, other methods of preventing and fighting infections must be considered. Burn patients, whose wound areas are often extensive, are especially prone to wound infections. The loading of bacterial nanocellulose (BNC) with antiseptics has already been successfully performed but unfortunately, the described procedure is time-consuming and thus not applicable in a clinical emergency setting. Therefore, a clinically feasible approach was established.
Sheets of BNC-based wound dressings were placed into antiseptic solutions containing PHMB (Prontosan® and LAVANID® 2) and were left to soak for up to two hours. At different time points, samples were analysed for their concentration of PHMB and antiseptic efficacy.
Within 30min, clinically relevant concentrations of PHMB were achieved in the BNC-based wound dressing. The 30-min PHMB uptake for Prontosan® and LAVANID® 2 resulted in concentrations of 0.05% and 0.019%, respectively. Samples from the PHMB loaded dressing showed a dose dependent antiseptic efficacy for Staphylococcus aureus.
This experiment showed that the loading of BNC-based wound dressings with PHMB-containing antiseptics was achieved by a simple and quick procedure. According to studies a PHMB concentration of 0.001% can already inhibits all bacterial growth, indicating that the concentrations of PHMB in the BNC-based wound dressings after 30min are higher than the minimal inhibitory concentration and the antiseptic efficacy after 120min loading analysed by an standardized bacterial disk diffusion assay was shown to be comparable to the clinically used Suprasorb® X+PHMB wound dressing.
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