Plasma utilization has increased over the past two decades, and there is a growing concern that many plasma transfusions are inappropriate. Plasma transfusion is not without risk, and certain ...complications are more likely with plasma than other blood components. Clinical and laboratory investigations of the patients suffering reactions after infusion of fresh‐frozen plasma (FFP) define the etiology and pathogenesis of the panoply of adverse effects. We review here the pathogenesis, diagnosis, and management of the risks associated with plasma transfusion. Risks commonly associated with FFP include: 1) transfusion‐related acute lung injury, 2) transfusion‐associated circulatory overload, and 3) allergic and/or anaphylactic reactions. Other less common risks include 1) transmission of infections, 2) febrile nonhemolytic transfusion reactions, 3) red blood cell alloimmunization, and 4) hemolytic transfusion reactions. The effects of pathogen inactivation or reduction methods on these risks are also discussed. Fortunately, a majority of the adverse effects are not lethal and are adequately treated in clinical practice.
Climate change and increasing anthropogenic activities, such as over-exploitation of groundwater, are exerting unavoidable stress on groundwater resources. This study investigated the spatio-temporal ...variation of depth to groundwater level (DGWL) and the impacts of climatic (precipitation, maximum temperature, and minimum temperature) and anthropogenic (gross district product (GDP), population, and net irrigated area (NIA)) variables on DGWL during 1994–2020. The study considered DGWL in 113 observation wells and piezometers located in arid western plains (Barmer and Jodhpur districts) and semi-arid eastern plains (Jaipur, Ajmer, Dausa, and Tonk districts) of Rajasthan State, India. Statistical methods were employed to examine the annual and seasonal patterns of DGWL, and the generalized additive model (GAM) was used to determine the impacts of climatic and anthropogenic variables on DGWL. During 1994–2020, except for Barmer District, where the mean annual DGWL was almost constant (around 26.50 m), all other districts exhibited increase in DGWL, with Ajmer District experiencing the most increase. The results also revealed that 36 observation wells and piezometers showed a statistically significant annual increasing trend in DGWL and 34 observation wells and piezometers exhibited a statistically significant decreasing trend in DGWL. Similarly, 32 observation wells and piezometers showed an statistically significant increasing trend and 37 observation wells and piezometers showed a statistically significant decreasing trend in winter; 33 observation wells and piezometers indicated a statistically significant increasing trend and 34 had a statistically significant decreasing trend in post-monsoon; 35 observation wells and piezometers exhibited a statistically significant increasing trend and 32 observation wells and piezometers showed a statistically significant decreasing trend in pre-monsoon; and 36 observation wells and piezometers reflected a statistically significant increasing trend and 30 observation wells and piezometers reflected a statistically significant decreasing trend in monsoon. Interestingly, most of the observation wells and piezometers with increasing trends of DGWL were located in Dausa and Jaipur districts. Furthermore, the GAM analysis revealed that climatic variables, such as precipitation, significantly affected DGWL in Barmer District, and DGWL in all other districts was influenced by anthropogenic variables, including GDP, NIA, and population. As a result, stringent regulations should be implemented to curb excessive groundwater extraction, manage agricultural water demand, initiate proactive aquifer recharge programs, and strengthen sustainable management in these water-scarce regions.
A variety of economically relevant processes are better modeled by using two-dimensional (2-D) models, which is the case, for instance, in metal rolling and the pharmaceutical industries. Typically ...Roesser and Fornasini Marchesini Local State Space (FMSLSS) models incorporate delayed states leading to a challenging stability analysis task. The main contribution of this work is to provide new convex stability analysis criteria for discrete-time FMSLSS models under both saturating function and time-varying delays. In particular, the saturating function tailors the digital control behavior, capturing the effect of finite wordlength. With Wirtinger and reciprocally convex sum lemmas, these new conditions can achieve less conservative results than other recent literature methods. Consequently, as illustrated by examples, this proposal enlarges the class of systems that can be stable-certified, still keep reasonable the associated computational effort.
Transfusion of COVID-19 convalescent plasma (CCP) containing high titers of anti-SARS-CoV-2 antibodies serves as therapy for COVID-19 patients. Transfusions early during disease course was found to ...be beneficial. Lessons from the SARS-CoV-2 pandemic could inform early responses to future pandemics and may continue to be relevant in lower resource settings. We sought to identify factors correlating to high antibody titers in convalescent plasma donors and understand the magnitude and pharmacokinetic time course of both transfused antibody titers and the endogenous antibody titers in transfused recipients.
Plasma samples were collected up to 174 days after convalescence from 93 CCP donors with mild disease, and from 16 COVID-19 patients before and after transfusion. Using ELISA, anti-SARS-CoV-2 Spike RBD, S1, and N-protein antibodies, as well as capacity of antibodies to block ACE2 from binding to RBD was measured in an
assay. As an estimate for viral load, viral RNA and N-protein plasma levels were assessed in COVID-19 patients.
Anti-SARS-CoV-2 antibody levels and RBD-ACE2 blocking capacity were highest within the first 60 days after symptom resolution and markedly decreased after 120 days. Highest antibody titers were found in CCP donors that experienced fever. Effect of transfused CCP was detectable in COVID-19 patients who received high-titer CCP and had not seroconverted at the time of transfusion. Decrease in viral RNA was seen in two of these patients.
Our results suggest that high titer CCP should be collected within 60 days after recovery from donors with past fever. The much lower titers conferred by transfused antibodies compared to endogenous production in the patient underscore the importance of providing CCP prior to endogenous seroconversion.
Evaluating status, variability and identifying the factors influencing groundwater quality is essential to manage and conserve groundwater resources. The present study aims to examine groundwater ...quality for 15 water quality parameters from 84 stations in arid and semi-arid districts of Rajasthan, India, using annual data from 2000 to 2018. Statistical methods such as descriptive test statistics, Mann-Kendall (MK) test, Sen’s slope estimation, and Principal component analysis (PCA) were used to analyze the hydrochemical parameters. While World Health Organisation (WHO) and Bureau of Indian Standards (BIS) guidelines were used to assess the suitability of groundwater for domestic purposes, sodium adsorption ratio (SAR), electrical conductivity (EC), and United States Salinity (USSL) diagrams were used for irrigation suitability. Further Generalized Additive Model (GAM) was used to explore the effect of climatic (precipitation, temperature) and anthropogenic (net irrigated area (NIA), fertilizer usage, industrialization, and population) variables on groundwater quality. The empirical results reveal that in groundwater of the study area sodium (Na+) and potassium (K+) were the dominating cations, while chloride (Cl−) and bicarbonate (HCO3−) were the dominating anions. The groundwater was predominantly Na–Cl type. Further, most stations witnessed an increasing trend in calcium, magnesium, sodium, chloride, bicarbonate and sulphate and a decreasing trend in potassium, fluoride and nitrate. The SAR, EC, and USSL indicate that the groundwater in the region is suitable for irrigation if salinity control measures are implemented. Chloride, fluoride and sodium concentrations exceeded the prescribed guideline limits in most stations, jeopardizing the suitability of water for drinking and posing significant health hazards. The GAM analysis revealed that anthropogenic variables significantly impact the groundwater quality parameters compared to the climatic variables. Accordingly, it is suggested that anthropogenic parameters must be addressed while formulating groundwater resource management policies. Thus, policies should focus on the stringent enactment of regulations and guidelines controlling the excessive use of fertilizers, implementing proper disposal of municipal solid and liquid waste, and managing industrial pollutants.
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•The results reveal that groundwater in the examined districts is generally neutral to slightly alkaline.•On average, Na+ + K+ were the dominating cations, while Cl− and HCO3− were the dominating anions.•Majority of observation stations witnessed an increasing trend in Ca2+, Mg2+, Na+, Cl−, HCO3−, and SO42−.•The SAR, EC, and USSL indicate that the groundwater in the region is suitable for irrigation purposes.•GAM analysis revealed a significant anthropogenic influence on groundwater quality.
BACKGROUND: Transfusion‐related acute lung injury (TRALI) is the leading cause of transfusion‐related deaths. Donor HLA antibodies have been implicated in TRALI cases. Blood centers are implementing ...TRALI risk reduction strategies based on HLA antibody screening of some subpopulations of ever‐pregnant apheresis platelet (PLT) donors. However, if screening assay cutoffs are too sensitive, donation loss may adversely impact blood availability.
STUDY DESIGN AND METHODS: Pregnancy history and HLA antibody screening and single‐antigen bead data from blood donors in the Retrovirus Epidemiology Donor Study‐II Leukocyte Antibody Prevalence Study were evaluated for correlations between assay screening values, HLA antibody titer, and number of HLA antigen specificities. The probabilities of matching a cognate antigen in a recipient were calculated and examined in association with total number of specificities observed and screening values. The relative impact of imposing various screening assay cutoffs or pregnancy stratification was examined in relation to detection of HLA antibody–reactive donations and loss of donors and donations.
RESULTS: We provide evidence that higher HLA antibody screening assay values are associated with maintaining higher screening signals upon dilution and an increased breadth of specificities compared with lower screening values; the latter correlated with an increased risk of a cognate antigen match in potential recipients. Depending on the TRALI risk reduction strategy used, the potential loss of donations ranged between 0.9 and 6.0%.
CONCLUSION: This analysis should enable blood centers to decide upon a TRALI risk reduction strategy for apheresis PLTs that is consistent with how much donation loss the blood center can tolerate.
Abstract This paper examines the evolution of Rajasthan's water poverty status and identifies key areas where intervention is needed to address the state's water woes. For this, a modified water ...poverty index (MWPI) has been constructed using data from the National Sample Survey (NSS). To understand the spatial and temporal change, MWPI has been computed for all 33 districts for 2012 and 2018. Although the state's overall water poverty status has improved over the given period, descriptive data analysis reveals a decline in the resource component of the index. A deterioration in the index value of some of the districts' access, capacity, and secondary sources is also a concern. Given the dwindling access to safe, sufficient, and reliable water sources and an increase in the burden of water‐related disease, the study recommends policy initiatives that urgently and explicitly address these issues.
PurposeThe purpose of the present study is to examine the inter-relationship between the multi-dimensional poverty and water poverty using household level data for Indian ...states.Design/methodology/approachA modified water poverty index (MWPI) for both rural and urban households was created using the five components approach and various quantifiable proxies. Principal component analysis (PCA) has been used for the construction of MWPI. Multidimensionality of poverty (MPI) is measured using the Alkire and Foster methodology. Further, the study has utilized correlation and Tobit regression analysis to show the relationship between MWPI and MPI.FindingsThe empirical findings suggest that there is a positive and significant relationship between multidimensional poverty and water poverty, with the extent of relationship being greater in rural areas. The results show that in rural areas all the components of water poverty has significant impact on multidimensional poverty, whereas in urban areas except use component all others have significant impact on multidimensional poverty. Further, components of multidimensional poverty were also found to be significantly impacting water poverty.Practical implicationsThe study suggests that policymakers cannot treat both forms of poverty in isolation. If India aims to reduce poverty, then it needs to pay significant attention to improving water conditions.Originality/valueThis is a pioneering attempt to construct water poverty index at the household level while accounting for micro-level differences for Indian economy. It highlights that water poverty leads to multi-dimensional poverty and vice-versa.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-12-2021-0731.
The study examines the effect of corporate social responsibility (CSR) culture on the relationship between CSR strategy–sustainability linkages, ethics and the CSR outcomes in public sector ...organizations in India. Using a sample of 200 lower-, middle- and upper-level CSR managers, a mediation model by Baron and Kenny was outlined and tested. Results demonstrate that CSR strategy–sustainability linkages and ethics have a positive relationship with CSR culture and CSR outcomes. Further, CSR culture has a positive relationship with the CSR outcomes of employees’ CSR perceptions and competence. While CSR culture fitfully mediated the relationship between ethics and competence, partial mediation was found in all other cases. Thus, the adoption of strategic and sustainable CSR not only leads to desirable CSR outcomes but is also associated with a better fit between CSR and culture. Hence, strategic and sustainable CSR and organizational ethics must facilitate greater congruence between CSR and organizational culture.
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