The use of chitosan as a skin-regeneration agent in burns injuries: A review

Chitosan is an amino-polysaccharide, traditionally obtained by the partial deacetylation of chitin from exoskeletons of crustaceans. Properties such as biocompatibility, hemostasis, and the ability to absorb physiological fluids are attributed to this biopolymer. Chitosan’s biological properties are regulated by its origin, polymerization degree, and molecular weight. In addition, it possesses antibacterial and antifungal activities. It also has been used to prepare films, hydrogels, coatings, nanofibers, and absorbent sponges, all utilized for the healing of skin wounds. In in vivo studies with second-degree burns, healing has been achieved in at least 80% of the cases between the ninth and twelfth day of treatment with chitosan coatings. The crucial steps in the treatment of severe burns are the early excision of damaged tissue and adequate coverage to minimize the risk of infection. So far, partial-thickness autografting is considered the gold standard for the treatment of full-thickness burns. However, the limitations of donor sites have led to the development of skin substitutes. Therefore, the need for an appropriate dermal equivalent that functions as a regeneration template for the growth and deposition of new skin tissue has been recognized. This review describes the properties of chitosan that validate its potential in the treatment of skin burns.

A SIMPLE NONPARAMETRIC APPROACH FOR ESTIMATION AND INFERENCE OF CONDITIONAL QUANTILE FUNCTIONS

In this paper, we present a new nonparametric method for estimating a conditional quantile function and develop its weak convergence theory. The proposed estimator is computationally easy to implement and automatically ensures quantile monotonicity by construction. For inference, we propose to use a residual bootstrap method. Our Monte Carlo simulations show that this new estimator compares well with the check-function-based estimator in terms of estimation mean squared error. The bootstrap confidence bands yield adequate coverage probabilities. An empirical example uses a dataset of Canadian high school graduate earnings, illustrating the usefulness of the proposed method in applications.

Double Barreled Graft (Chimney) as a Strategy to Preserve Supraortic Branches in Contained Ruptured Thoracic Aneurysm Thoraco Endovascular Aortic Aneurysmal Repair- A Case Report

Out of many strategies that are used to treat aortic arch disease, including open surgery, branched techniques, and hybrid repair with Thoracic Endovascular Aortic Aneurysmal Repair (TEVAR) and supra-aortic branch reconstruction and fenestration, Thoracic Endovascular Aortic Aneurysmal Repair (TEVAR) incorporating chimney is frequently used in unstable and morbid patients not suitable for other procedures. We describe here a case of contained rupture of a thoracic aortic aneurysm, which was treated with TEVAR incorporating a double chimney to the left common carotid and left subclavian arteries. There was an uncomplicated course of the procedure with complete coverage of aneurysm with stent-graft and open aortic arch vessels when followed up to 6 months. There were no complications noted as well. In this case we took the precaution to upsize the stent-graft by 20% to 30% also for adequate coverage of aneurysm we had to adopt to the chimney technique. To prevent complications like gutter and endoleaks, the kissing technique was used during deployment. In addition, there was adequate coverage of chimney-grafts with adequate proximal projection.

A Systematic Mapping of Accessibility Problems Encountered on Websites and Mobile Apps: A Comparison Between Automated Tests, Manual Inspections and User Evaluations

The use of websites and mobile applications has become essential for numerous daily activities. However, not everyone can have full access to such services and content due to many websites and applications being inaccessible to people with disabilities, such as people with vision impairments. In this context, even though developers may demonstrate an effort to create more accessible content, there is limited information about the characteristics of different accessibility assessment methods applied to websites and mobile applications. Thus, the present study aimed to perform a meta-analysis of 38 types of accessibility problems on websites and mobile applications extracted from 38 studies in the literature from an initial search of 304 articles. Studies carried out automated assessments using tools, expert-based inspections and user testing involving disabled people. The results confirm other considerations made in the literature, showing that automated evaluation methods have significant limitations on an adequate coverage of accessibility problems, covering less than 40% of the types of problems found on websites and less than 20% on mobile apps. A significant percentage of problems both on mobile and web platforms were only encountered by studies involving users. Expert inspection showed a higher coverage of problems encountered by users, both on mobile apps and on websites, despite not covering all of them. Thus, the article concludes by showing a consolidation of literature data to reinforce that effective accessibility evaluations of web and mobile applications should count in expert-based inspections and user tests involving people with disabilities.

A SARS-CoV-2 spike ferritin nanoparticle vaccine protects hamsters against Alpha and Beta virus variant challenge

The emergence of SARS-CoV-2 variants of concern (VOC) requires adequate coverage of vaccine protection. We evaluated whether a SARS-CoV-2 spike ferritin nanoparticle vaccine (SpFN), adjuvanted with the Army Liposomal Formulation QS21 (ALFQ), conferred protection against the Alpha (B.1.1.7), and Beta (B.1.351) VOCs in Syrian golden hamsters. SpFN-ALFQ was administered as either single or double-vaccination (0 and 4 week) regimens, using a high (10 μg) or low (0.2 μg) dose. Animals were intranasally challenged at week 11. Binding antibody responses were comparable between high- and low-dose groups. Neutralizing antibody titers were equivalent against WA1, B.1.1.7, and B.1.351 variants following two high dose vaccinations. Dose-dependent SpFN-ALFQ vaccination protected against SARS-CoV-2-induced disease and viral replication following intranasal B.1.1.7 or B.1.351 challenge, as evidenced by reduced weight loss, lung pathology, and lung and nasal turbinate viral burden. These data support the development of SpFN-ALFQ as a broadly protective, next-generation SARS-CoV-2 vaccine.

Electrodeposition of Pb and PbO2 on Graphite Felt in Membraneless Flow-Through Reactor: A Method to Prepare Lightweight Electrode Grids for Lead-Acid Batteries

One of the possible ways of mitigating the primary lead-acid battery downside—mass— is to replace the heavy lead grids that can add up to half of the total electrode’s mass. The grids can be exchanged for a lightweight, chemically inert, and conductive material such as graphite felt. To reduce carbon surface area, Pb/PbO2 can be electrochemically deposited on graphite felt. A flow-through reactor was applied to enhance penetration of adequate coverage of graphite felt fibers. Three types of electrolytes (acetate, nitrate, and methanesulfonate) and two additives (ligninsulfonate and Triton X-100) were tested. The prepared composite electrodes showed greater mechanical strength, up to 5 times lower electrical resistivity, and acted as Pb and PbO2 electrodes in sulfuric acid electrolytes.

Predictors of Health Insurance Literacy Among University Employees

Background: Health insurance literacy (HIL) is “the degree to which individuals have the knowledge, ability, and confidence to find and evaluate information about plans, select the best plan for their own or their families’ financial and health circumstances and use the plan once enrolled”. Many Americans have low health insurance literacy, but this concept has not been studied to the same extent as general health literacy. Objective: The purpose of this study was to explore predictors of health insurance literacy among employees of a large public institution of higher education in the South-Atlantic. Design: This single-setting cross-sectional study employed an online, anonymous survey administered to approximately 3,000 employees at a large university in the USA after open enrollment in state health insurance. The survey measured demographics and included a validated measure of health insurance literacy. Results: Using several multivariate regression models, results (N=480) indicated high overall HIL. Subscale means were highest for likelihood of using insurance plans proactively and confidence comparing insurance plans but were lower for confidence choosing and using insurance plans, indicating lack of understanding that may lead to poor insurance coverage choice and use. Employment category, income, race, and age also predicted HIL. Discussion: Based on the results, there is an opportunity for employers to provide information about health insurance policies. Health promotion programs should also seek to increase HIL through educational programs and policies to ensure both adequate coverage and ability to use health insurance in such a way that it promotes and protects one’s health.

El Estado de Derecho frente al COVID: Reserva de ley y derechos fundamentales

LABURPENA: Azterketa honen xedea hau da: kritikoki aztertzea ea COVID-19aren kontrako borrokaren testuinguruan askatasuna (zirkulazio askerako eta biltzeko eskubidea, funtsean) murrizteko onetsitako neurri ugariak konstituzioan sartzen diren. Ez dago eztabaidagai neurri horiek, kasu gehienetan, beharrezkoak direla, baina bai neurriak nola hartu dituzten. Pandemiaren aurkako borroka egiteko moduari jarritako eragozpen juridiko nagusia da lege-erreserba urratu duela, eta, horrekin batera, segurtasun juridikoaren printzipioari ere kalte egin zaiola. Azterlanak eskema honi jarraitzen dio: lehenik eta behin, lege-erreserbaren konstituzio-esanahia eta -irismena azaltzen dira, gure Konstituzio Auzitegiaren doktrina eta jurisprudentzia finkatuaren arabera; bigarrenik, aztertzen da ea normaltasunaren zuzenbideak (Osasun Publikoaren Arloko Neurri Bereziei buruzko 3/1986 Lege Organikoa, zehazki), oinarrizko eskubideak orokorrean mugatzeko, erreserba horren eskakizunak asetzen dituen edo ez; hirugarrenik, aztertzen da ea, krisi- edo salbuespen-zuzenbidearen barruan, hartutako neurriek alarma-egoeran estaldura egokia duten edo haietakoren batek salbuespen-egoera aktibatzea behar izango zuen; azkenik, kritikoki azaltzen da eskubideak murrizteko neurriak hartzeko eskumena Gobernuko kideei edo autonomia-erkidegoen presidenteei eskuordetzeak eragin duen lege-erreserbaren urraketa. ABSTRACT: The scope of this study is to critically analyze the constitutional fit of the numerous measures restricting freedom - the right to free movement and assembly, fundamentally - that have been approved in the context of the fight against COVID 19. It is not discussed that, in most cases, they are necessary measures, but the way and the form in which they have been adopted are. The main legal objection to the way in which the fight against the pandemic has been carried out is that the reservation of law has been violated and with this the principle of legal certainty has also been damaged. The study follows the following scheme: in the first place, the constitutional meaning and scope of the reservation of law according to the doctrine and consolidated jurisprudence of our Constitutional Court are exposed; secondly, it examines whether the law of normality (specifically LO 3/1986 on Special Measures in Public Health Matters) satisfies or not the requirements of this reservation in order to establish limitations of fundamental rights in a general way; thirdly, it examines whether within the crisis or emergency law, the different measures adopted have adequate coverage in the state of alarm or some of them would have required to activate the state of exception; finally, it critically exposes the violation of the reserve of law that has meant the delegation of the competence to adopt restrictive measures of rights in members of the Government or in presidents of Autonomous Communities. RESUMEN: El objeto de este estudio es analizar críticamente el encaje constitucional de las numerosas medidas restrictivas de la libertad -el derecho a la libre circulación y de reunión, fundamentalmente- que se han aprobado en el contexto de la lucha contra el COVID 19. No se discute que, en la mayor parte de los casos, son medidas necesarias, pero sí el modo y la forma en que se han adoptado. La principal objeción jurídica al modo en que se ha llevado a cabo la lucha contra la pandemia es que se ha vulnerado la reserva de ley y con ello se ha lesionado también el principio de seguridad jurídica. El estudio sigue el siguiente esquema: en primer lugar se exponen el significado y alcance constitucionales de la reserva de ley según la doctrina y la jurisprudencia consolidada de nuestro Tribunal Constitucional; en segundo lugar, se examina si el Derecho de la normalidad (concretamente la LO 3/1986 de Medidas Especiales en Materia de Salud Pública) satisface o no las exigencias de esa reserva a los efectos de establecer limitaciones de derechos fundamentales con carácter general; en tercer lugar se examina si dentro del Derecho de crisis o de excepción, las diferentes medidas adoptadas tienen cobertura adecuada en el estado de alarma o algunas de ellas hubieran requerido activar el estado de excepción; finalmente, se expone críticamente la vulneración de la reserva de ley que ha supuesto la delegación de la competencia para adoptar medidas restrictivas de derechos en miembros del Gobierno o en presidentes de Comunidades Autónomas.

The SIC protocol: A seven-step strategy to minimize complications potentially related to the insertion of centrally inserted central catheters

Insertion of central venous catheters in the cervico-thoracic area is potentially associated with the risk of immediate/early untoward events, some of them negligible (repeated punctures), some relevant (accidental arterial puncture), and some severe (pneumothorax). Furthermore, different strategies adopted during insertion may reduce or increase the incidence of late catheter-related complications (infection, venous thrombosis, dislodgment). This paper describes a standardized protocol (S.I.C.: Safe Insertion of Centrally Inserted Central Catheters) for the systematic application of seven basic beneficial strategies to be adopted during insertion of central venous catheters in the cervico-thoracic region, aiming to minimize immediate, early, or late insertion-related complications. These strategies include: preprocedural evaluation, appropriate aseptic technique, ultrasound guided insertion, intra-procedural assessment of the tip position, adequate protection of the exit site, proper securement of the catheter, and adequate coverage of the exit site.