Study protocol for DICE trial: Video-assisted thoracoscopic surgery decortication versus interventional radiology guided chest tube insertion for the management of empyema
Background: Empyema is a common thoracic surgery presentation, defined as pus in the pleural space. Despite the commonality of empyema, consensus on initial management remains ambiguous. Two standard of care treatment options include inserting a chest tube (thoracostomy) and the administration of intrapleural fibrinolytics, or an initial surgical approach, surgical decortication. Due to the complexity of this pleural space infection, often repeat interventions are required after initial management in order to achieve source control and resolution of clinical symptoms. This study aims to identify the most effective initial management option for empyema.
Study design: We present a study protocol for a randomized control trial (RCT) comparing adult individuals with empyema to one of two standard of care initial management options. Participants will be randomized into either interventional radiology guided chest tube insertion with intrapleural fibrinolytics (Dornase 5 mg and Alteplase 10 mg intrapleural twice daily for three days) or video-assisted thoracoscopic surgery (VATS) decortication.
Methods: All adults with empyema meeting inclusion criteria will be invited to participate. They will be randomized into one of two intervention groups; interventional radiology guided chest tube insertion with fibrinolytics or initial VATS decortication. Each intervention will take place within 48 hours of randomization. The primary outcome will be the rate of re-intervention within 30 days. Re-intervention is defined as repeat chest tube insertion, VATS decortication, or decortication via thoracotomy. Secondary outcomes include a change in the size of empyema, length of stay, morbidity, as well as 30-day and 90-day mortality, as well as quality of life measurements.
Anticipated impact: This study is aimed at identifying the most effective initial management option for individuals with empyema
Villin Controls the Formation and Enlargement of Punctate Actin Foci in Pollen Tubes
Self-incompatibility (SI) in Papaver rhoeas triggers dramatic actin alterations in pollen. However, how actin alterations in SI pollen tubes are mechanistically achieved remains largely unexplored. Here we have used treatment with the calcium ionophore A23187 to mimic the SI-induced elevation in cytosolic Ca2+ and trigger the formation of the distinctive F-actin foci. Live-cell imaging reveals that this remodeling involves F-actin fragmentation and depolymerization, accompanied by the rapid formation of punctate actin foci and subsequent increase in their size.
We establish that actin foci are generated and enlarged from crosslinking of fragmented actin filament structures. Moreover, we show that villins associate with actin structures and are involved in this actin reorganization process. Notably, we demonstrate that Arabidopsis villin5 promotes actin depolymerization and formation of actin foci by fragmenting actin filaments, and controlling the enlargement of actin foci via bundling actin filaments. Our study thus uncovers important, novel insights about the molecular players and mechanisms involved in forming the distinctive actin foci in pollen tubes.
Rack for 3 x TubeSpin® Bioreactor 600 (6) |
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TP99013 | Westburg | each | Ask for price |
Solid screw cap for TubeSpin Bioreactor 450/600 (36) |
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TP87355 | Westburg | each | Ask for price |
TubeSpin Bioreactor 50 with septum (for robotic loading) (180) |
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TP86050 | Westburg | each | Ask for price |
MAGic Clamp™ Tube Rack, 4x500ml or 600ml conical bottles (max. 1) |
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H1000-MR-T600 | Benchmark Scientific | 1 PC | EUR 210.02 |
MAGic Clamp Tube Rack 4x500mL or 600mL conical bottles (max. 1) - EACH |
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MIX7170 | Scientific Laboratory Supplies | EACH | EUR 305.1 |
Beaker Simax 600ml - PK10 |
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152/600 | Scientific Laboratory Supplies | PK10 | EUR 156.6 |
Suspension Flasks, 600ml, Vent |
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25-215 | Genesee Scientific | 5 per Sleeve, 40 Flasks/Unit | EUR 109.97 |
Description: Surface Area: 182.0cm2 |
Bottle 600ml HDPE WM + Cap |
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BOT3312 | Scientific Laboratory Supplies | EACH | EUR 2.05 |
TC Treated Flasks, 600ml, Plug |
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25-210 | Genesee Scientific | 5 per Sleeve, 40 Flasks/Unit | EUR 106.68 |
Description: Growth Area: 182.0cm2 |
TC Treated Flasks, 600ml, Vent |
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25-211 | Genesee Scientific | 5 per Sleeve, 40 Flasks/Unit | EUR 110.38 |
Description: Growth Area: 182.0cm2 |
Piggy? Tube Rotator, including rotisserie for 42 x 0.5mL~0.8mL tubes, 2/pk, 50 x 1.5mL~2.0mL tubes, 2/pk, rotisserie for 14 x 5mL~7mL tubes, 2/pk, rotisserie for 14 x 10mL~15mL tubes, 2/pk, rotisserie for 6 x 50mL tubs, 1/pk |
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ACT-1040 | ACTGene | each | EUR 848.4 |
Beaker PMP Low Form 600mL - PK12 |
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BEA33720 | Scientific Laboratory Supplies | PK12 | EUR 270 |
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VIS2264 | Scientific Laboratory Supplies | EACH | EUR 179.55 |
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Duran Beaker 600ml Low Form - PK10 |
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Pyrex Beaker 600ml Low Form - PK10 |
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BEA12160 | Scientific Laboratory Supplies | PK10 | EUR 126.9 |
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BEA10400 | Scientific Laboratory Supplies | PK10 | EUR 60.75 |
Duran Beaker 600ml Tall Form - PK10 |
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Pyrex Beaker 600ml Tall Form - PK10 |
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Pyrex Beaker 600ml Heavy Duty - PK6 |
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BEA12840 | Scientific Laboratory Supplies | PK6 | EUR 118.8 |
Academy Low Form Beaker 600ml - PK6 |
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BEA34100 | Scientific Laboratory Supplies | PK6 | EUR 16.2 |
Azlon Beaker PP 600ml Stacking - PK5 |
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BEA5132 | Scientific Laboratory Supplies | PK5 | EUR 32.4 |
Academy Heavy Duty Beaker 600ml - PK6 |
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BEA0126 | Scientific Laboratory Supplies | PK6 | EUR 55.49 |
Solid liq Extrac Assembly 600ml - EACH |
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Q600RDSX | Scientific Laboratory Supplies | EACH | EUR 1031.4 |
Basin Evaporating FB Spout 600ml - PK10 |
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BAS2026 | Scientific Laboratory Supplies | PK10 | EUR 294.3 |
IKA Double-Walled Beaker 600mL - EACH |
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VIS2262 | Scientific Laboratory Supplies | EACH | EUR 936.9 |
Centrifuge Tubes S 2420 30ml Qfit - PK10 |
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QBC24C24R0 | Scientific Laboratory Supplies | PK10 | EUR 270 |
FA-6x250 rotor for 6 x 250mL tubes 5910 R/5920 R - EACH |
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E5895175007 | Scientific Laboratory Supplies | EACH | EUR 4862.7 |
Insert For 10 Beakers 250-600ml - EACH |
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WAS6076 | Scientific Laboratory Supplies | EACH | EUR 348.11 |
Azlon Beaker 600ml PP Low Form - PK5 |
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BEA5034 | Scientific Laboratory Supplies | PK5 | EUR 37.8 |
Nalgene Beaker 600ml PP Low Form - PK4 |
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BEA3352 | Scientific Laboratory Supplies | PK4 | EUR 51.3 |
Beaker tall form heavy duty 600mL - PK10 |
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BEA3024 | Scientific Laboratory Supplies | PK10 | EUR 139.05 |
SLS Select Trigger Spray Bottle 600ml - EACH |
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CLE9010 | Scientific Laboratory Supplies | EACH | EUR 9.17 |
Optional generator 14mm x 130mm saw tooth, for 50ml tubes up to 250ml vessels |
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BCM1236 | Bio Basic | 1 pcs, 1 UNIT | EUR 1407.54 |
Optional generator 14mm x 130mm saw tooth, for 50ml tubes up to 250ml vessels |
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D1000-M14 | GenDepot | ea | EUR 1290 |
15PL 15mL Rack for 15mL Tubes - EACH |
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HS23215 | Scientific Laboratory Supplies | EACH | EUR 49.55 |
Adapter pack, for 5ml and 7ml (12-13mm) tubes in 15ml rotors, 8/pk. |
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C3100-ADP | Benchmark Scientific | 1 PC | EUR 121.95 |
ABgene 0.65mL Blank Tubes, 10 racks of 96 tubes/case |
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MAAB-1256 | Westburg | each | EUR 455.08 |
Falcon Cushion For 175ml And 225ml Tubes - PK8 |
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352090 | Scientific Laboratory Supplies | PK8 | EUR 97.2 |
ADAPTERS FOR 10/15ML TUBES IN 50ML ROTOR,6/CS |
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480140 | CORNING | 6/pk | EUR 144 |
Description: Lab Equipment; General Purpose Centrifuges (affliated brand) |
ADAPTERS FOR 5/7/10ML TUBES IN 15ML ROTOR,6/CS |
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480142 | CORNING | 6/pk | EUR 136.8 |
Description: Lab Equipment; General Purpose Centrifuges (affliated brand) |
Magnetic Stand for 4 Tubes (15mL, 50mL) |
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MB-01 | ACROBIOSYSTEMS | 1EA | EUR 267.5 |
Description: The Magnetic Stand is the indispensable tool for customers to use magnetic bead products.The Magnetic Stand contains magnets with strong magnetic attraction, which can be separated in a centrifuge tube to achieve rapid separation and purification of substances such as cells, proteins, or nucleic acids, and has a wide range of applications. |
0.1ML PCR STRIP TUBES AND CAPS (0.07ML WORKING VOLUME)4 TUBES/4 CAPS PER STRIP, 250 STRIP TUBES AND STRIP CAPS PER UNIT |
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PCR-0104-C | CORNING | 250/pk | EUR 1244.4 |
Description: PCR Plates & Tubes; PCR Tubes - Axygen |
BEAKER,600ML,PLASTIC,LOW FORM,PP,6/6 |
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1000P-600 | CORNING | 6/pk | EUR 67.2 |
Description: Reusable Plastics; Resuable Beakers |
Nunc Rack for 6 x 200ml Tubes - EACH |
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374179 | Scientific Laboratory Supplies | EACH | EUR 129.6 |
StrepMan Magnet for 15ml and 50ml tubes |
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IB6-5650-065 | Westburg | each | EUR 420.74 |
12 Well Tube Rack 5/15mL Tubes - PK2 |
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E0030119827 | Scientific Laboratory Supplies | PK2 | EUR 59.4 |
Adapter for 4-15ml Tubes - EACH |
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GBA1763 | Scientific Laboratory Supplies | EACH | EUR 202.5 |
Adapter for 85ml round bucket for use with standard Vacu- tainer and Falcon tubes 9-15ml 2 pcs. - PK2 |
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E5702724009 | Scientific Laboratory Supplies | PK2 | EUR 217.35 |
Adapter for 85ml round bucket for use with standard Vacu- tainer and Falcon tubes 4-10ml 2 pcs. - PK2 |
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E5702735000 | Scientific Laboratory Supplies | PK2 | EUR 217.35 |
Basin Pyrex 600ml Flat Form Curved Sides - PK10 |
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BAS15100 | Scientific Laboratory Supplies | PK10 | EUR 375.3 |
Kimble Tall Form Beaker With Spout 600ml - PK10 |
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BEA3456 | Scientific Laboratory Supplies | PK10 | EUR 83.72 |
Adapter 50mL tubes Centriprep 30mL - PK2 |
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E5910764006 | Scientific Laboratory Supplies | PK2 | EUR 359.1 |
Aluminum housed mantle for griffin beaker 600ml, 325W, 115V |
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100BTM610 | Glascol | each | EUR 363 |
Aluminum housed mantle for griffin beaker 600ml, 325W, 230V |
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100BTM611 | Glascol | each | EUR 379 |
Fabric mantle for 600ml griffin beaker, 325W, 115V |
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100AO610 | Glascol | each | EUR 394 |
Fabric mantle for 600ml griffin beaker, 325W, 230V |
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100AO611 | Glascol | each | EUR 412 |
Test Tube rack for 41 x 15mL tubes - EACH |
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BAT3070 | Scientific Laboratory Supplies | EACH | EUR 163.35 |
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Test Tube rack for 76 x 15mL tubes - EACH |
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BAT3074 | Scientific Laboratory Supplies | EACH | EUR 325.35 |
Test Tube rack for 30 x 50mL tubes - EACH |
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BAT3076 | Scientific Laboratory Supplies | EACH | EUR 325.35 |
DURAN Beaker High Form Without Spout 600mL - PK10 |
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BOT0550 | Scientific Laboratory Supplies | PK10 | EUR 126.9 |
Block For 24 X 5-7mL Tubes (12mm) - EACH |
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SHA2104 | Scientific Laboratory Supplies | EACH | EUR 780.3 |
ADAPTERS FOR 5/7ML TUBES IN 50ML ROTOR,6/CS |
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480141 | CORNING | 6/pk | EUR 144 |
Description: Lab Equipment; General Purpose Centrifuges (affliated brand) |
50ml Plug-Seal Centrifuge Tubes with Rack, 25 tubes/rack |
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10-0501 | IHC World | - | EUR 12.5 |
Adaptor For 7 X 15ml Tubes |
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CEN0634 | Scientific Laboratory Supplies | EACH | EUR 140.22 |
Mini Cooler 0c 12 x 0.5-2ml Tubes |
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FRE0003 | Scientific Laboratory Supplies | EACH | EUR 380.16 |
Universal Rack For 12 x 15-50mL Tubes - EACH |
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RAC2214 | Scientific Laboratory Supplies | EACH | EUR 113.4 |
250mL centrifuge tube PP (59.8 X 160mm), with screw-cap, 14 bags of 5 tubes |
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C1250 | MTC Bio | 70 | EUR 234 |
Adapter pack for C5000-6H and C5000-8, for 5ml and 7ml (12-13mm) tubes, 8/pk. |
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C5000-ADP | Benchmark Scientific | 1 each | EUR 118.24 |
Reducing Adapter for 15mL/5mL tubes, 25/pk |
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C4015 | MTC Bio | 25/pack | EUR 47.88 |
Description: Adapter for SureStrain Premium Cell Strainers |
Conical Tubes 50mL - PK48 |
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E0030122267 | Scientific Laboratory Supplies | PK48 | EUR 58.05 |
Adaptor For 50ml Tubes - PK8 |
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E5804737008 | Scientific Laboratory Supplies | PK8 | EUR 124.2 |
Adapter for 5/15mL tubes - PK2 |
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E5910702000 | Scientific Laboratory Supplies | PK2 | EUR 301.05 |
Adapter for 15 x 4-8mL tubes - PK2 |
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E5910703007 | Scientific Laboratory Supplies | PK2 | EUR 301.05 |
Adapter for 50mL tubes - PK2 |
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E5910712006 | Scientific Laboratory Supplies | PK2 | EUR 279.45 |
Insert for 2 x 10ml Tubes - EACH |
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CEN0524 | Scientific Laboratory Supplies | EACH | EUR 153.9 |
Insert for 15ml Tubes - EACH |
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CEN0642 | Scientific Laboratory Supplies | EACH | EUR 153.9 |
Tubes 50ml Conical HD - PK12 |
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X13758 | Scientific Laboratory Supplies | PK12 | EUR 233.55 |
Mini Cooler -20c 32 x 0.5-2ml Tubes |
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FRE0006 | Scientific Laboratory Supplies | EACH | EUR 380.16 |
CryoBox 81 Places for 3-4-5mL Tubes - Red - PK4 |
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CRY1132 | Scientific Laboratory Supplies | PK4 | EUR 44.55 |
Optional generator, 10mm x 115mm saw tooth, for 15ml & 50ml tubes |
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D1000-M10 | GenDepot | ea | EUR 390 |
Culture Tube, 14mL, 17 x 100mm, PP, w/ attached 2-position screw-cap, printed graduations, sterile, 20 bags of 25 tubes, 500/case |
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T8830 | MTC Bio | 500/pack | EUR 207.58 |
Description: Culture Tube 14mL |
Culture Tube, 14mL, 17 x 100mm, PP, w/ attached 2-position screw-cap, printed graduations, sterile, 10 foam racks of 50 tubes, 500/case |
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T8832 | MTC Bio | 500/pack | EUR 255.73 |
Description: Culture Tube 14mL |
Culture Tube, 14mL, 17 x 100mm, PS, w/ attached 2-position screw-cap, printed graduations, sterile, 20 bags of 25 tubes, 500/case |
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T8840 | MTC Bio | 500 | EUR 225 |
Culture Tube, 14mL, 17 x 100mm, PS, w/ attached 2-position screw-cap, printed graduations, sterile, 10 foam racks of 50 tubes, 500/case |
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T8842 | MTC Bio | 500 | EUR 259 |
Adapter Pack for 5mL Tubes in 15mL Cavity - PK4 |
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CEN2063 | Scientific Laboratory Supplies | PK4 | EUR 76.95 |
25ml PP (27x77mm), with screw cap, sterile, 8 bags of 25 tubes, 200/pack |
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C2625-B | MTC Bio | 200/pack | EUR 101.2 |
CoolRack 50 ml 4 x 50ml tubes - EACH |
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432062 | Scientific Laboratory Supplies | EACH | EUR 432 |
Conical Tubes 15mL - PK200 |
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E0030122208 | Scientific Laboratory Supplies | PK200 | EUR 89.1 |
Conical Tubes 50mL - PK200 |
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E0030122232 | Scientific Laboratory Supplies | PK200 | EUR 106.65 |
Conical Tubes 15mL - PK100 |
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E0030122259 | Scientific Laboratory Supplies | PK100 | EUR 102.6 |
Rotor Angle 6 x 85ml Tubes - EACH |
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CEN0641 | Scientific Laboratory Supplies | EACH | EUR 2204.55 |
Mini Cooler 0c 12 x 0.5-2ml Tubes - EACH |
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FRE0001 | Scientific Laboratory Supplies | EACH | EUR 305.1 |
Mini Cooler 0c 32 x 0.5-2ml Tubes - EACH |
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FRE0002 | Scientific Laboratory Supplies | EACH | EUR 488.7 |
Adapter for 4 x 15/50ml tubes, pack of 2 |
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IPD9600-50T | Benchmark Scientific | each | EUR 1946.7 |
Rack For 50ml Tubes 12 Place - EACH |
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SHA4452 | Scientific Laboratory Supplies | EACH | EUR 461.7 |
Disk modul for RS-RD 20, 8 x 50ml tubes |
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RSE-RD15 | PHOENIX PEPTIDE | 8 x 50ml tubes | EUR 99 |
Optional generator, 10mm x 115mm saw tooth, for 15ml and 50ml tubes |
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BCM1235 | Bio Basic | 1 pcs, 1 UNIT | EUR 517.18 |
Adapter for 100ml rectangular bucket for use with 50-75ml tubes 2 pcs. - PK2 |
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E5804760000 | Scientific Laboratory Supplies | PK2 | EUR 172.8 |
Adapter for 250ml rectangular bucket for use with 180-250ml tubes 2 pcs. - PK2 |
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E5810770009 | Scientific Laboratory Supplies | PK2 | EUR 228.15 |
CryoBox 81 Places for 3-4-5mL Tubes - Green - PK4 |
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CRY1134 | Scientific Laboratory Supplies | PK4 | EUR 47.25 |
50ml TC Tubes, Conical, 440 units/box |
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04-5540150 | Gentaur Genprice | 440 units/box | EUR 85.2 |
Rotor Angle + lid 6 x 50ml Tubes - EACH |
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CEN0060 | Scientific Laboratory Supplies | EACH | EUR 1039.5 |
Adapter D26mm 30ml Tubes - PK2 |
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CEN2640 | Scientific Laboratory Supplies | PK2 | EUR 140.4 |
Adapter D18mm 16ml Tubes - PK2 |
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CEN2642 | Scientific Laboratory Supplies | PK2 | EUR 140.4 |
Adapter D17mm 15ml Tubes - PK2 |
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CEN2644 | Scientific Laboratory Supplies | PK2 | EUR 140.4 |
Palintest 10ml Tubes Pk5 - PK5 |
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WAT8034 | Scientific Laboratory Supplies | PK5 | EUR 52.65 |
Mini Cooler -20c 12 x 0.5-2ml Tubes - EACH |
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FRE0004 | Scientific Laboratory Supplies | EACH | EUR 252.45 |
Mini Cooler -20c 32 x 0.5-2ml Tubes - EACH |
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FRE0005 | Scientific Laboratory Supplies | EACH | EUR 403.65 |
A method for percutaneous radiologic gastrostomy tube placement without sedation as a bridge to lung transplantation
Gastrostomy tube placement is an appropriate option for long-term nutritional support for patients who cannot tolerate oral intake. Common indications for a gastrostomy tube include head and neck tumors and neurological disorders. Several methods for gastrostomy tube insertion exist (eg, surgical, endoscopic, and radiologic) that require sedation or general anesthesia, which can pose risks of cardiopulmonary compromise and postsurgical pulmonary complications. Unlike other methods, our practice uses a percutaneous balloon-assisted gastrostomy tube insertion method for which we can perform without sedation.
We report a case of a percutaneous radiologic gastrostomy procedure for a patient with end stage lung disease as a bridge to lung transplantation, who is not a candidate for sedation and is high-risk for general anesthesia. Through enteral feeds administered through the successfully placed gastrostomy tube, the patient showed steady improvement in weight gain over the course of several months before approval for listing by the lung transplant selection committee. Our case highlights how gastrostomy tube placement can be safely performed in patients who are not sedation candidates using the minimally invasive balloon-assisted gastrostomy tube insertion method and local anesthetic.
Passive Release Technique Produces the Most Accurate Endotracheal Tube Cuff Pressure Than Manual Palpation and Minimum Occlusive Volume Technique in the Absence of Manometer
Objective: This study aimed to compare the accuracy of the endotracheal tube (ETT) cuff pressure of the manual palpation (MP), passive release (PR), and minimum occlusive volume (MOV) techniques.
Methods: This study is a true experiment with simple randomisation. The subjects of this study were 105 patients divided into 3 groups: MP group (n=35), PR group (n=35), and MOV group (n=35). After intubation, ETT cuff inflation was performed using 3 different techniques. The ETT cuff pressure was recorded using a manometer. The data were analysed using the chi-square test, Kruskal-Wallis test, and Mann-Whitney test in the SPSS 20 software.
Results: The mean ETT cuff pressure was 60.2±28.8 cmH2O in the MP group, 30.4±5.5 cmH2O in the PR group, and 25.8±9.6 cmH2O in the MOV group (p=0.000). The PR group had the highest pressure accuracy (77%) (p=0.000).
Conclusion: The PR technique had the highest accuracy and can be used as an alternative ETT cuff inflation technique in the absence of a manometer.
Non-contact detection of thiodiglycol vapors and associated degradation products using atmospheric flow tube mass spectrometry
Thiodiglycol (TDG) is a synthetic precursor and an environmental degradation product of sulfur mustard (HD). Consequently, its presence can be indicative of illicit preparation or historical presence of chemical weapons, but its lower toxicity lends itself to use as an HD simulant for testing and method development. Detection of TDG vapor often proves elusive with existing techniques exhibiting undesirably high detection limits in the gas phase (>ppm). Moreover, traditional approaches to detecting TDG vapor rely upon non-specific approaches that do not provide the certainty afforded by mass spectrometry.
Using atmospheric flow tube mass spectrometry (AFT-MS), which has previously demonstrated the capacity to detect parts-per-quadrillion levels of vapor, we evaluate the capacity of this approach for non-contact residue analysis based upon TDG vapor sampling and nitrate clustering chemistry. Furthermore, we discuss challenges with ambient vapor detection using the AFT-MS system and associated observations related to TDG degradation into 2,2′-sulfonyldiglycol from exposure to ambient conditions with vapor detection being possible even after 7-weeks of sample aging.