Web-based Dashboard on ECMO Utilization in Germany: An Interactive Visualization, Analyses, and Prediction Based on Real-life Data.

In Germany, a comprehensive reimbursement policy for extracorporeal membrane oxygenation (ECMO) results in the highest per capita use worldwide, although benefits remain controversial. Public ECMO data is unstructured and poorly accessible to healthcare professionals, researchers, and policymakers. In addition, there are no uniform policies for ECMO allocation which confronts medical personnel with ethical considerations during health crises such as respiratory virus outbreaks.Retrospective information on adult and pediatric ECMO support performed in German hospitals was extracted from publicly available reimbursement data and hospital quality reports and processed to create the web-based ECMO Dashboard built on Open-Source software. Patient-level and hospital-level data were merged resulting in a solid base for ECMO use analysis and ECMO demand forecasting with high spatial granularity at the level of 413 county and city districts in Germany.The ECMO Dashboard ( https://www.ecmo-dash.de/ ), an innovative visual platform, presents the retrospective utilization patterns of ECMO support in Germany. It features interactive maps, comprehensive charts, and tables, providing insights at the hospital, district, and national levels. This tool also highlights the high prevalence of ECMO support in Germany and emphasizes districts with ECMO surplus - where patients from other regions are treated, or deficit - origins from which ECMO patients are transferred to other regions. The dashboard will evolve iteratively to provide stakeholders with vital information for informed and transparent resource allocation and decision-making.Accessible public routine data could support evidence-informed, forward-looking resource management policies, which are urgently needed to increase the quality and prepare the critical care infrastructure for future pandemics.

Complex coacervation of food grade antimicrobial lauric arginate with lambda carrageenan.

In this study, the complex coacervation mechanism of Lauric arginate ester (LAE) with λ-carrageenan was studied using turbidimetry, light scattering and electrophoresis. The complexes formed were found to have a bilayer-like structure using small angle X-ray scattering (SAXS) and cryo-TEM (transmission electron microscopy). It was observed that mixing LAE with Sodium dodecyl sulfate (SDS) could significantly reduce the interactions between mixed micelles and λ-carrageenan. The interactions between LAE/SDS and λ-carrageenan were found to be predominantly entropy driven. Mixed micelles of LAE/Tween 20 and LAE/SDS showed significantly less interactions with carrageenan compared to pure LAE micelles. Interfacial properties of complexes were measured using surface tension measurements. It was observed that pure LAE showed good foaming behavior and when mixed with increasing amounts of carrageenan the foaming capacity decreased. Reduction in foam volume was due to reduced availability of free LAE molecules for foam stabilization and due to hydrophilic nature of complexes.