Summary
Introduction
Cord blood (CB) is being increasingly used as a source of hematopoietic stem cells for transplantation to treat diseases of the blood and immune systems, and there is an urgent ...need to expand CB banking worldwide. CB processing requires costly machinery or a clean room that hampers wider application of CBT particularly in the developing countries.
Methods
We developed a novel filtration system using a nonchemical‐coated and nonwoven polyester fabric filter, which traps cells through affinity and does not require centrifugation or potentially toxic chemicals.
Results
Cell processing with the device resulted in minimum cell loss of total cells and CD34+ cells, without impairing the ability of CD34+ cells to engraft and differentiate both in vivo and in vitro.
Conclusion
CB processing with this device is simple, cost‐effective, and nontoxic without requiring costly equipment will thus facilitate international CB banking, which helps in meeting the increasing worldwide demand for CB for allogeneic hematopoietic stem cell transplantation.
Postoperative delirium (POD) following surgery is a prevalent and distressing condition associated with adverse patient outcomes and an increased healthcare burden.
To assess the effectiveness of the ...Safe Brain Initiative care bundle (SBI-CB) in reducing POD in the postanesthesia care unit (PACU).
A multicenter, quality-improvement initiative with retrospective analysis of collected data.
The study was conducted in the operating rooms and postanesthesia care units (PACUs) of four hospitals across Denmark and Turkey.
The convenience sample of patients were aged ≥18 years, scheduled for surgery, and could communicate verbally. Age, sex, preoperative delirium, and the American Society for Anesthesiology physical status classification were used in statistical methods to control for potential confounding influences.
The SBI-CB, 18 delirium-reducing recommendations aligned with international guidelines. The intervention included patient education, staff training, coordination meetings across centers, and a dashboard for the monitoring of outcomes in the PACU.
The primary outcome was the POD trend in the PACU during implementation months, assessed through Nu-DESC screening at up to three time points in the PACU. We also examined the length of hospital stay.
Data were collected from 18,697 adult patients across four hospitals. Initial POD incidence in the PACU after the first three months was 16.36% across all sites (n = 1021). POD in the PACU was observed across all age groups, with peak incidence in younger (18–35 years) and older (>75 years) patients. General anesthesia and longer surgical duration (>1 h) were identified as significant risk factors for POD in the PACU. Matched patients who experienced POD in the PACU had longer stays in hospital, with a mean increase from 35 to 69 h (p < 0.001). Implementation of the SBI-CB was associated with a decreased risk of POD in the PACU for each month of SBI-CB implementation (adjusted odds ratio 0.96, 95% confidence interval: 0.94, 0.97, p < 0.001).
The presented pragmatic implementation of a multidisciplinary care bundle, encompassing pre-, intra-, and postoperative measures alongside outcome monitoring, has the potential to significantly reduce the incidence of POD in the PACU. Improved patient outcomes may be achieved for general surgical departments with patient cohorts not typically considered at risk for developing POD.
Trial Registration: Clinicaltrials.gov, identifier NCT05765162.
•Data was collected for 18,697 adult patients for a quality-improvement initiative, implementing a care bundle of 18 recommendations for improving patients' wellbeing and neurocognitive function in the perioperative phase, at four hospitals and data was analyzed retrospectively.•A significant reduction in the risk of postoperative delirium in the postanesthesia care unit was observed for at least 19 months after the care bundle was initiated.•Patients with postoperative delirium in the postanesthesia care unit stayed nearly twice as long in hospital on average.•Use of general anesthesia and surgical duration longer than one hour were identified as significant risk factors for postoperative delirium in the postanesthesia care unit.•Postoperative delirium in the postanesthesia care unit was observed in all adult age groups and peak incidence occurred in both younger and older adults.
Japan, Russia, and Turkey are major examples of countries with different ethnic, religious, and cultural background that embarked on the path of modernization without having been colonized by a ...Western country. In all three cases, national consciousness has played a significant role in this context. The project of Modernity is obviously of European origin, but is it essentially European? Does modernization imply loss of a country's cultural or national identity? If so, what is the "fate" of the modernization process in these cases? The presence of the idea and reality of civil society can be considered a real marker of Modernity in this respect, because it presupposes the development of liberalism, individualism and human rights. But are these compatible with nationalism and with the idea of a national religion? These questions are the more pressing, as Japan is considered part of the Western world in many respects, and Russia and Turkey are defining their relation to the European Union in different ways. An investigation of these three countries, set off against more general reflections, sheds light on the possibilities or limitations of modernization n a non-European context.
The Industry Tour at the 1999 AACE International Annual Meeting in Denver will feature a day-long tour of the Colorado-Big Thompson Project (CB-T). The CB-T was constructed by the US Bureau of ...Reclamation from 1938 to 1957 and is operated by the Northern Colorado Water Conservancy District. Born of the drought of Dust Bowl days and one of the projects authorized by the US National Industrial Recovery Act of 1933, the CB-T project was envisioned to provide supplemental water to the northern Front Range and to put people to work in the wake of the Depression. For in excess of 40 years, the C-BT has done both.
