Comprehensive perioperative blood management in patients undergoing elective bypass cardiac surgery: Benefit effect of health care education and systematic correction of iron deficiency and anemia on red blood cell transfusion.

Study Objective: The aim of this study was to investigate the efficacy of a two-step patient blood management (PBM) program in red blood cell (RBC) transfusion requirements among patients undergoing elective cardiopulmonary bypass (CPB) surgery.

Design: Prospective, non-randomized, two-step protocol design.

Setting: Cardiac surgery department of Clinique Pasteur, Toulouse, France.

Grazing and ecosystem service delivery in global drylands.

Grazing represents the most extensive use of land worldwide. Yet its impacts on ecosystem services remain uncertain because pervasive interactions between grazing pressure, climate, soil properties, and biodiversity may occur but have never been addressed simultaneously. Using a standardized survey at 98 sites across six continents, we show that interactions between grazing pressure, climate, soil, and biodiversity are critical to explain the delivery of fundamental ecosystem services across drylands worldwide.

Patient blood management in elective bypass cardiac surgery: A 2-step single-centre interventional trial to analyse the impact of an educational programme and erythropoiesis stimulation on red blood cell transfusion.

Unlabelled: Anaemia and iron deficiency are frequent in patients scheduled for cardiac surgery. Perioperative patient blood management (PBM) is widely recommended in current practice guidelines. The aim of this protocol is to analyse the effect of a global perioperative PBM programme on the red blood cell (RBC) transfusion ratio, morbidities and rehabilitation score in elective cardiac surgery.

Twin gestation in a uterus didelphys with only one functional cervix: A case report.

Introduction: Twin gestation in a uterus didelphys with one fetus in each uterine cavity is rare and presents unique challenges in antepartum and intrapartum care.

Case Presentation: A 35-year-old woman with a uterus didelphys became pregnant with twins, with one fetus in each uterus, after intrauterine insemination of a single visible cervix. Multiplanar ultrasonography showed the presence of one complete cervix and a second hypoplastic cervix; it was unclear whether she could deliver both twins vaginally.

Parturient With Barnes Syndrome (Thoracolaryngopelvic Dysplasia) Undergoing Cesarean Delivery of a Neonate With Barnes Syndrome: A Case Report.

This case describes a parturient with Barnes syndrome, a rare disorder characterized by subglottic stenosis, thoracic dystrophy, and small pelvic inlet, who underwent cesarean delivery of a neonate diagnosed with Barnes syndrome. Live simulation training was performed by multidisciplinary team to prepare for the spinal anesthetic, personnel flow between 2 operating rooms, and management of various airway scenarios for the newborn. After delivery, the neonate underwent laryngoscopy-bronchoscopy with successful intubation in the operating room because of labored breathing.

Nanoparticle Size Control in Microemulsion Synthesis.

Quasi-monodisperse populations of (HO)YF·xHO nanocrystals of varying size are prepared in Igepal-stabilized microemulsions. Correlations between microemulsion composition, micelle hydrodynamic radius, and final nanoparticle size are established and shed light on the mechanism of particle size control. Under the conditions considered here, size control appears to be primarily governed by the number of micelles and the quantities of precursor ions.

Spinodal instabilities and super-Planckian excursions in natural inflation.

Models such as Natural Inflation that use pseudo-Nambu-Goldstone bosons as the inflaton are attractive for many reasons. However, they typically require trans-Planckian field excursions ΔΦ>MPl, due to the need for an axion decay constant f>MPl to have both a sufficient number of e-folds and values of ns,r consistent with data. Such excursions would in general require the addition of all other higher dimension operators consistent with symmetries, thus disrupting the required flatness of the potential and rendering the theory nonpredictive.

Relationship between time in the operating room and incident pressure ulcers: a matched case-control study.

The objective was to determine the relationship between time in the operating room (OR) and hospital-acquired pressure ulcers (HAPUs), controlling for temporality. The research team identified 931 HAPUs among surgical patients and matched them to 4 controls by hospital length of stay at the time the pressure ulcer (PU) was documented. A regression model estimated the relationship between OR time and HAPU after controlling for matching, age, sex, admission and current Braden score, weight, year, and American Society of Anesthesiologists physical status score.

Twin-to-twin transfusion syndrome: prenatal diagnosis and treatment.

Clinical Problem: Twin-to-twin transfusion syndrome (TTTS) increases perinatal morbidity and mortality for 10 to 15% of monochorionic (MC) gestations.

Pathophysiology: MC gestations are at risk due to the angioarchitecture of the shared placenta, with anastomoses of varying type, size, and quantity. TTTS results from progression of a chronic perfusion imbalance across unbalanced placental anastomoses, typically arising between 15 and 26 weeks gestation.

Risk factors for pressure ulcer development in critically Ill patients: a conceptual model to guide research.

This paper presents a proposed conceptual model to guide research on pressure ulcer risk in critically ill patients, who are at high risk for pressure ulcer development. However, no conceptual model exists that guides risk assessment in this population. Results from a review of prospective studies were evaluated for design quality and level of statistical reporting.

DNA barcoding reveals cryptic diversity in Lumbricus terrestris L., 1758 (Clitellata): resurrection of L. herculeus (Savigny, 1826).

The widely studied and invasive earthworm, Lumbricus terrestris L., 1758 has been the subject of nomenclatural debate for many years. However these disputes were not based on suspicions of heterogeneity, but rather on the descriptions and nomenclatural acts associated with the species name.

The role of interventional patient hygiene in improving clinical and economic outcomes.

Objective: To successfully educate, integrate, and empower nonlicensed personnel in the surgical intensive care unit in the use of a skin care protocol to maintain and improve skin integrity.

Design: Observational intervention study.

Setting: Surgical intensive care unit.

The effect of a pressure ulcer prevention program and the bowel management system in reducing pressure ulcer prevalence in an ICU setting.

The Braden score is a reliable predictor of a patient's potential for developing pressure ulcers. Moisture is 1 of 6 indicators considered when calculating a Braden score. Efforts to reduce the effects of moisture and enzymatic activity on skin from incontinent diarrhea have employed various types of nonstandardized and nonapproved approaches.