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01), factor X (p less then 0.01), and fibrinogen levels (p less then 0.01). Thrombin generation was well preserved. Fibrinolytic biomarkers were raised correlating with the degree of shock (p less then 0.01), and 8% of casualties had hyperfibrinolysis on ROTEM analysis. Plasmin-antiplasmin complexes (p less then 0.01) and d-dimer levels (p = 0.01) were higher and clot firmness lower (p = 0.02) in those injured by explosion compared to GSW's. Conclusions ATC was present and correlated with shock, similar to civilian trauma. Thrombin generation remained adequate. Fibrinogen and factor V levels were disproportionately low but still sufficient to allow clot formation. Fibrinolysis is a key feature, probably due to a tissue plasminogen activator surge at the time of injury. Blast injuries are associated with a greater activation of fibrinolysis than GSWs.Background Visible light, in particular blue light, has been identified as an additional contributor to cutaneous photo-aging. However, clinical studies demonstrating the clear effect of blue light on photo-aging are still scarce and so far, most studies have focused on broad spectrum visible light. While there is evidence for increased skin pigmentation, the underlying mechanisms of photo-aging in vivo are still unclear. Furthermore, there is still a need for active ingredients to significantly protect against blue light induced hyperpigmentation in vivo. Our study had two aims to detect visible changes in skin pigmentation following repeated irradiation of the skin with LED-based blue light; and to reduce pigmentation using suitable active ingredients. Method We conducted a randomized, double-blind and placebo controlled clinical study on 33 female volunteers with skin phototypes III and IV. We used a repetitive blue light (4x 60 J cm-2 , 450 nm) irradiation protocol on the volunteers' inner forearms. Using Moreover, we have shown evidence that both an extract of the microalga Scenedesmus rubescens and niacinamide (Vitamin B3) have the potential to protect against blue light induced hyperpigmentation.Rationale Fentanyl and its analogues play an important role in hospital and clinic as anesthetic. However, illicitly manufactured fentanyl as well as the new psychoactive substances (NPS) account for 30% of all deaths in the United States. Since fentanyl derivatives and NPS are designed to produce similar effects, their related substances are similar or even have same active groups. A comprehensive analysis of the related substances of alfentanil hydrochloride can provide a basis for the identification and supervision of fentanyl derivatives and NPS. Methods A liquid chromatography quadrupole time-of-flight tandem mass spectrometry (LC/QTOF-MS/MS) method was developed for the separation and characterization of related substances in alfentanil hydrochloride. Degradation studies were conducted according to the ICH-prescribed stress conditions. The compounds were identified mainly through positive electrospray ionization QTOF high-resolution mass spectrometric measurement of the accurate masses of the precursor enforcement of fentanyl and its analogues.The importance of the targeted treatment of acquired hypofibrinogenemia during hemorrhage with a concentrated fibrinogen product (either cryoprecipitate or fibrinogen concentrate) cannot be underestimated. Fibrinogen concentrate is a pathogen inactivated, pooled product that offers a highly purified single factor concentrate. Cryoprecipitate is a pooled product that comes with a spectrum of other coagulation factors which may further enhance (additional procoagulant effect) or even disturb (prothrombotic risk) hemostasis. The pros and cons of each product are discussed.The Texas Ranger Special Operations Group (SOG) performs high-risk warrant service and responds to callouts for evolving kinetic situations and special missions as required. These operations may occur many hours from a trauma center. Fresh whole blood (FWB) transfusions may offer a stopgap for those who are critically injured. To make FWB transfusions a viable option, several steps must be implemented. The following lays out how the Texas Ranger SOG will implement and conduct FWB transfusions using low titer group O whole blood. The techniques outlined may be useful for communities that may face critical blood shortage in disasters.The primary aim of the study was to investigate whether iodixanol and trehalose would have a synergic effect on the cryosurvival of electroejaculated ram semen. Tris-based diluter was used to prepare 9 different extenders by the addition of iodixanol or trehalose alone or varying combinations of these substances. Diluters were prepared as follows Tris (control), Io5 (5% iodixanol), Tr25 (25 mmol/L trehalose), Tr50 (50 mmol/L trehalose), Tr50 + Io1.25 (50 mmol/L trehalose and 1.25% iodixanol), Tr50 + Io2.5 (50 mmol/L trehalose and 2.5% iodixanol), Tr50 + Io5 (50 mmol/L trehalose and 5% iodixanol), Tr25 + Io5 (25 mmol/L trehalose and 5% iodixanol) and Tr12.5 + Io5 (12.5 mmol/L trehalose and 5% iodixanol). Supplementation of the freezing extender with trehalose or iodixanol alone supported the protection of both morphological and functional integrity of ram spermatozoa and total motility at 1 and 4 hr post-thawing respectively. However, beyond these positive effects, the combination of trehalose (25 mmol/L) and iodixanol (5%) significantly increased post-thaw sperm longevity and motion properties at the end of 4-hr incubation. The results of the study clearly showed that there was positive synergic effect of iodixanol and trehalose on cryosurvival of ram semen.Current knowledge gaps on tendon tissue healing can partly be ascribed to the limited availability of physiologically relevant culture models. An unnatural extracellular matrix, high serum levels and random cell morphology in vitro mimic strong vascularization and lost cell elongation in pathology, and discord with a healthy, in vivo cell microenvironment. The thereby induced phenotypic drift in tendon-derived cells (TDCs) compromises the validity of the research model. Therefore, this research quantified the extracellular matrix (ECM)-, serum-, and cell morphology-guided phenotypic changes in tendon cells of whole tendon fascicle explants with intact ECM and TDCs cultured in a controlled microenvironmental niche. Explanted murine tail tendon fascicles were cultured in serum-rich or serum-free medium and phenotype was assessed using transcriptome analysis. Next, phenotypic marker gene expression was measured in in vitro expanded murine tail TDCs upon culture in serum-rich or serum-free medium on aligned or random collagen I patterns. Freshly isolated fascicles or TDCs served as native controls. In both systems, the majority of tendon-specific genes were similarly attenuated in serum-rich culture. Strikingly, 1-week serum-deprived culture-independent of cell morphology-converged TDC gene expression toward native levels. This study reveals a dynamic serum-responsive tendon cell phenotype. HSP targets Extracting fascicles or TDCs from their native environment causes large changes in cellular phenotype, which can be limited and even reversed by serum deprivation. We conclude that serum-derived factors override matrix-integrity and cell morphology cues and that serum-deprivation stimulates a more physiological microenvironment for in vitro studies.Emotions play a key role in our daily life through their control over our thoughts and behaviors. While it is commonly accepted that depressive patients have emotional perception disorders, it is important to know how these disorders affect patients' sensory perception to develop products to provide them with better support. In this study, we first examined the existence of modifications in the emotional perception of subjects with minor depressive symptoms (MDS, n=80) compared with healthy controls (HC, n=80) using a nonverbal method based on pictures to measure projected emotions and personality traits the Sense'n Feel™ method. link2 The investigated stimuli were two unpleasant and two pleasant odors and one pleasant food product a madeleine. Second, we investigated the hedonic, familiarity and intensity olfactory perceptions of the subjects using the same stimuli. No significant difference was found in any olfactory qualities between the two groups. Concerning the pleasant olfactory stimuli, however, we did note that the MDS subjects had a significantly lower score for the positive emotion of joy/happiness than the controls. Additionally, the MDS group's attribution of some positive personality traits for the three pleasant stimuli was significantly weaker than that in the HC group. These results could be explained by the affective state of the MDS subjects; they were more anxious and more alexithymic compared with the controls. Further research is needed to validate our study in clinically depressed individuals and to determine whether the modifications of the emotional olfactory perception are due to the disease and/or to neuropsychological alterations.Examination of the female external genitalia to assess for sexual abuse is performed in living individuals, and the interpretation of the findings is based on evidence-based studies. However, in the deceased, no such studies are available, and postmortem changes could present as suspicious findings that can be mistaken for trauma. Patches of discoloration in the hymen were reported previously in one case as hypostasis (i.e., livor and lividity), and based on this finding, it was listed as a finding that is not associated with trauma. This was a retrospective study that was conducted in the Center of Forensic and Legal Medicine in Dammam, Saudi Arabia over a 4-year period. The study included 30 deceased women in whom photographic documentation of their external genitalia was assessed for postmortem changes. The postmortem interval ranged from less than 24 h to more than 100 days, and the ages of these deceased women were in the 20-40 year-old age group. In cases where the hymen, vagina, and/or fossa navicularis were clearly visible, none of these areas showed any hypostatic discoloration. A comparison between antemortem and postmortem appearance of the hymen in one case clearly showed the absence of hypostatic changes in the hymen. In conclusion, any discoloration of the external genitalia that is detected in a female decedent requires serious consideration.Therapeutic innovation for human papilloma virus-related (HPV+) head and neck squamous cell carcinomas (HNSCCs) is impaired by inadequate preclinical models and absence of accurate biomarkers. This study establishes the first well-characterized panel of patient-derived xenografts (PDXs) and organoids from HPV+ HNSCCs while determining fidelity of the models to the distinguishing genetic features of this cancer type. Despite low engraftment rates, whole exome sequencing showed that PDXs retain multiple distinguishing features of HPV+ HNSCC lost in existing cell lines, including PIK3CA mutations, TRAF3 deletion, and absence of EGFR amplifications. Engrafted HPV+ tumors frequently contained NOTCH1 mutations, thus providing new models for a negatively prognostic alteration in this disease. Genotype-phenotype associations in the models were then tested for prediction of tumor progression and survival in published clinical cohorts. link3 Observation of high tumor mutational burdens (TMBs) in the faster-growing models facilitated identification of a novel association between TMB and local progression in both HPV+ and HPV- patients that was prognostic in HPV- cases.