Anemia is a risk factor for adverse outcomes, which can be aggravated by unnecessary phlebotomies. In blood culture testing, up to 30 ml of blood can be withdrawn per sample, even though most ...manufacturers recommend blood volumes of 10 ml or less. After assessing the filling volume of blood culture bottles at our institution, we investigated whether an educational intervention could optimize filling volume of blood culture bottles without negatively affecting microbiology testing.
We weighed 10,147 blood cultures before and 11,806 blood cultures after a six-month educational intervention, during which employees were trained regarding correct filling volume via lectures, handouts, emails, and posters placed at strategic places.
Before the educational intervention, only 31% of aerobic and 34% of anaerobic blood cultures were filled correctly with 5-10 ml of blood. The educational intervention increased the percentage of correctly filled bottles to 43% (P < 0.001) for both aerobic and anaerobic samples without negatively affecting results of microbiologic testing. In addition, sample volume was reduced from 11.0 ± 6.5 to 9.4 ± 5.1 ml (P < 0.001) in aerobic bottles and from 10.1 ± 5.6 to 8.8 ± 4.8 ml (P < 0.001) in anaerobic bottles.
Education of medical personnel is a simple and effective way to reduce iatrogenic blood loss and possibly moderate the extent of phlebotomy-induced anemia.
While many efforts have been made to pave the way toward human space colonization, little consideration has been given to the methods of protecting spacefarers against harsh cosmic and local ...radioactive environments and the high costs associated with protection from the deleterious physiological effects of exposure to high-Linear energy transfer (high-LET) radiation. Herein, we lay the foundations of a roadmap toward enhancing human radioresistance for the purposes of deep space colonization and exploration. We outline future research directions toward the goal of enhancing human radioresistance, including upregulation of endogenous repair and radioprotective mechanisms, possible leeways into gene therapy in order to enhance radioresistance via the translation of exogenous and engineered DNA repair and radioprotective mechanisms, the substitution of organic molecules with fortified isoforms, and methods of slowing metabolic activity while preserving cognitive function. We conclude by presenting the known associations between radioresistance and longevity, and articulating the position that enhancing human radioresistance is likely to extend the healthspan of human spacefarers as well.
Background
Rotational thromboelastometry (ROTEM) has been studied in patients with advanced chronic liver disease (ACLD) without considering the impact of portal hypertension. We evaluated the ...influence of the hepatic venous pressure gradient (HVPG) on ROTEM results in patients with ACLD.
Methods
Cross-sectional study; ACLD patients undergoing HVPG measurement within the prospective Vienna Cirrhosis Study (NCT03267615) underwent concomitant ROTEM testing.
Results
Among 159 patients (68% male; Child–Pugh-A: 53%, Child–Pugh-B: 34%, Child–Pugh-C: 13%), 21 patients (13%) had a HVPG between 6 and 10 mmHg, 84 patients (53%) between 10 and 19 mmHg, and 54 patients (34%) ≥ 20 mmHg. Child–Pugh-C patients (vs. Child–Pugh-A and vs. Child–Pugh-B patients, respectively) showed longer clot formation time (CFT: median 187 s vs. 122 s vs. 122 s,
p
= 0.007) and lower maximum clot firmness (MCF: median: 45 mm vs. 56 mm vs. 56 mm,
p
= 0.002) in extrinsic thromboelastometry (EXTEM), while platelet counts were similar across Child–Pugh stages. In the overall cohort, ROTEM parameters did not differ by severity of portal hypertension. However, among compensated Child–Pugh-A patients, MCF decreased with increasing portal pressure, i.e. in higher HVPG strata (HVPG 9–10 mmHg: median MCF: 59 mm vs. HVPG 10–19 mmHg: 56 mm vs HVPG ≥ 20 mmHg: 54 mm,
p
= 0.023). Furthermore, patients with short CFT and high MCF in EXTEM had higher levels of lipopolysaccharide-binding protein, C-reactive protein, and procalcitonin, as well as higher leukocyte counts (all
p
< 0.05).
Conclusions
Portal hypertension seems to impact ROTEM results only in compensated Child–Pugh-A patients. Bacterial translocation and systemic inflammation may trigger a procoagulant state in patients with ACLD.
Abstract
Treatment of the tetraalkyldigallium compound R
2
Ga–GaR
2
(
1
) R = CH(SiMe
3
)
2
with functionalized dicarboxylic acids (2,2′‐bipyridyl‐3,3′‐dicarboxylic acid, 2,2′‐iminodibenzoic acid, ...2,2′‐dithiodibenzoic acid) resulted in the formation of large heterocycles in which two Ga–Ga bonds were bridged by two dicarboxylato spacer ligands. Each Ga–Ga bond was bridged by two carboxylate groups in an almost ideal perpendicular arrangement that favors the formation of macrocyclic structures. The N–H groups of the imino‐bridged compound pointed towards the center of the molecule and formed a network of hydrogen bonds through interactions with carboxylate oxygen atoms. Both disulfur groups of the dithio derivative adopted an ideal coplanar arrangement and came into relatively close contact, which might indicate a weak closed‐shell bonding interaction between the sulfur atoms.
Treatment of the tetraalkyldigallium compound R2Ga–GaR2 (1) R = CH(SiMe3)2 with functionalized dicarboxylic acids (2,2′‐bipyridyl‐3,3′‐dicarboxylic acid, 2,2′‐iminodibenzoic acid, ...2,2′‐dithiodibenzoic acid) resulted in the formation of large heterocycles in which two Ga–Ga bonds were bridged by two dicarboxylato spacer ligands. Each Ga–Ga bond was bridged by two carboxylate groups in an almost ideal perpendicular arrangement that favors the formation of macrocyclic structures. The N–H groups of the imino‐bridged compound pointed towards the center of the molecule and formed a network of hydrogen bonds through interactions with carboxylate oxygen atoms. Both disulfur groups of the dithio derivative adopted an ideal coplanar arrangement and came into relatively close contact, which might indicate a weak closed‐shell bonding interaction between the sulfur atoms.
Ga–Ga bonds act as effective templates for the generation of macrocyclic compounds with dicarboxylato spacer ligands in the bridging positions. Hydrogen bonds or sulfur–sulfur closed‐shell interactions were observed with functionalized amino or dithio spacer ligands.
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