Characterising the challenges of managing difficult red blood cell alloantibodies in liver transplant recipients.

Aims: Formation of red blood cell alloantibodies (RBCAs) complicates transfusion support in liver transplantation (LT). Difficult RBCAs (DAs, >3 antibodies or antibodies for which <25% donors are antigen negative) further challenge care. This study characterises DA outcomes relative to non-difficult RBCAs (NDAs).

Estimating the serological underrecognition of patients with weak or partial RHD variants.

Background: For patients with weak or discrepant RhD RBC phenotypes, RHD genotyping is employed to determine need for RhD-negative management. However, many RHD variants are type D-negative or D-positive. Serological recognition rates (RRs) of weak and partial RHD variants are poorly characterized.

What is a trait? Lessons from the human chin.

The chin, a distinguishing feature of Homo sapiens, has sparked ongoing debates regarding its evolutionary origins and adaptive significance. We contend that these controversies stem from a fundamental disagreement about what constitutes a well-defined biological trait, a problem that has received insufficient attention despite its recognized importance in biology. In this paper, we leverage paleoanthropological research on the human chin to investigate the general issue of character or trait identification.

Cell Fate: What's Evolution Got to Do With It?

Theoretical frameworks concerning cell fate typically center on proximate causes to explain how cells know what type they are meant to become. While major advances in cell fate theory have been achieved by these mechanism-focused frameworks, there are some aspects of cell decision-making that require an evolutionary interpretation. While mechanistic biologists sometimes turn to evolutionary theory to gain insights about cell fate (cancer is a good example), it is not entirely clear in cell fate theory what insights evolutionary theory can add, and why in some cases it is required for understanding cell fate.

The concepts and origins of cell mortality.

Organismal death is foundational to the evolution of life, and many biological concepts such as natural selection and life history strategy are so fashioned only because individuals are mortal. Organisms, irrespective of their organization, are composed of basic functional units-cells-and it is our understanding of cell death that lies at the heart of most general explanatory frameworks for organismal mortality. Cell death can be exogenous, arising from transmissible diseases, predation, or other misfortunes, but there are also endogenous forms of death that are sometimes the result of adaptive evolution.

Antibody Titers in Transfusion Medicine: A Critical Reevaluation of Testing Accuracy, Reliability, and Clinical Use.

Context.—: Substantial variability between different antibody titration methods has been identified since the development and introduction of the uniform procedure in 2008.

Objective.

Alloimmunization Against RBC Antigens Is Not Associated With Decreased Survival in Liver Transplant Recipients.

Background: Improvement of liver transplantation (LT) outcomes requires better understanding of factors affecting survival. The presence of RBC alloantibodies (RBCAs) on survival in LT recipients was evaluated.

Methods: This study was a single-center, retrospective cohort study reviewing transfusion records and all-cause mortality between 2002 and 2021.

RHD genotyping to resolve weak and discrepant RhD patient phenotypes.

Background: We instituted RHD genotyping in our transfusion service for obstetrical patients and transfusion candidates. We sought to examine how RHD genotyping resolved weak or discrepant automated microplate direct agglutination (MDA) RhD phenotypings and impacted needs for Rh Immune Globulin (RhIG) and D-negative RBCs.

Study Design And Methods: We investigated RhD phenotypes with equivocal or reagent-discrepant automated MDA (Immucor, Norcross, GA), weak-2+ immediate-spin tube typings, historically discrepant RhD typings, or D+ typings with anti-D.

Impact of Child Passenger Safety Education for Pediatric Nurses.

Background: Hospital-based child passenger safety education is effective in decreasing car seat misuse. Although child passenger safety training has been studied with pediatricians, emergency physicians, and emergency nurses, there is a lack of literature regarding child passenger safety training performed by pediatric nurses.

Objective: The purpose of this study was to determine the effect of a 30-min child passenger safety education session on pediatric nurses' child passenger safety knowledge and confidence.

Integrating science, technology, engineering, and math (STEM) and music: Putting the arts in science, technology, engineering, arts, and math (STEAM) through acoustics.

Music is an important part of education and most students are ardent fans. However, the students are not necessarily aware of the artistic and technical details it takes to create what they hear. These details are what necessitate music and technology coming together.

Transfusion-Transmitted Cache Valley Virus Infection in a Kidney Transplant Recipient With Meningoencephalitis.

Background: Cache Valley virus (CVV) is a mosquito-borne virus that is a rare cause of disease in humans. In the fall of 2020, a patient developed encephalitis 6 weeks following kidney transplantation and receipt of multiple blood transfusions.

Methods: After ruling out more common etiologies, metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) was performed.

Obstetric and Newborn Weak D-Phenotype RBC Testing and Rh Immune Globulin Management Recommendations: Lessons From a Blinded Specimen-Testing Survey of 81 Transfusion Services.

Context.—: Modern RHD genotyping can be used to determine when patients with serologic weak D phenotypes have RHD gene variants at risk for anti-D alloimmunization. However, serologic testing, RhD interpretations, and laboratory management of these patients are quite variable.

International guidelines regarding the role of IVIG in the management of Rh- and ABO-mediated haemolytic disease of the newborn.

Haemolytic disease of the newborn (HDN) can be associated with significant morbidity. Prompt treatment with intensive phototherapy (PT) and exchange transfusions (ETs) can dramatically improve outcomes. ET is invasive and associated with risks.

Educating and Empowering Inner-City High School Students in Bleeding Control.

Introduction: Unintentional bleeding is the leading cause of death in people 1-44 years of age in the United States. The Stop the Bleed (STB) campaign is a nationwide course that teaches the public to ensure their own safety, call 911, find the bleeding injury, and achieve temporary hemorrhage control by several techniques. Although the national campaign for the training course was inspired by active shooter events, the training can be applied to motor vehicle accidents and small-scale penetrating and gunshot wounds.

Compelling Voices of Diversity, Equity, and Inclusion in Prelicensure Nursing Students: Application of the Cultural Humility Framework.

Background: Diversity, equity, and inclusion are increasingly recognized as core values for guiding nursing education, practice, and research. The conceptual framework of cultural humility has been adapted in a variety of health care settings, fostering a culture of diversity, equity, and inclusion through openness, supportive interaction, self-awareness, self-reflection, and critique.

Problem: Nurse educators have the opportunity, but may find it challenging, to teach students about the changing landscape of health care and the populations we serve.

Heterogeneity in Approaches for Switching From Universal to Patient ABO Type-Specific Blood Components During Massive Hemorrhage.

Context.—: ABO mistransfusions are rare and potentially fatal events. Protocols are required by regulatory agencies to minimize this risk to patients, but how these are applied in the context of massive transfusion protocols (MTPs) is not specifically defined.

Institution of prothrombin complex concentrate protocols is associated with a reduction in plasma administration at a Tertiary Care Hospital.

Study Objective: Explore how the introduction of 4-factor prothrombin complex concentrates (4F-PCC) protocols for reversing anticoagulation and the treatment of critical bleeding influenced blood product utilization.

Design: A retrospective analysis of the utilization rate of plasma and 4F-PCC from September 2012 through December 2018.

Setting: Blood bank and pharmacy records of a single large tertiary care medical center.

Programmed cell death as a black queen in microbial communities.

Programmed cell death (PCD) in unicellular organisms is in some instances an altruistic trait. When the beneficiaries are clones or close kin, kin selection theory may be used to explain the evolution of the trait, and when the trait evolves in groups of distantly related individuals, group or multilevel selection theory is invoked. In mixed microbial communities, the benefits are also available to unrelated taxa.

Blood transfusion utilization in hospitalized COVID-19 patients.

Background: The acute respiratory illness designated coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China, in December 2019 and caused a worldwide pandemic. Concerns arose about the impact of the COVID-19 pandemic on blood donations and potential significant blood transfusion needs in severely ill COVID-19 patients. Data on blood usage in hospitalized COVID-19 patients are scarce.

A dynastic elite in monumental Neolithic society.

The nature and distribution of political power in Europe during the Neolithic era remains poorly understood. During this period, many societies began to invest heavily in building monuments, which suggests an increase in social organization. The scale and sophistication of megalithic architecture along the Atlantic seaboard, culminating in the great passage tomb complexes, is particularly impressive.

Passive Immunity for Coronavirus Disease 2019: A Commentary on Therapeutic Aspects Including Convalescent Plasma.

In the ongoing pandemic of coronavirus disease 2019 (COVID-19), the novel virus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is infecting a naïve population. The innate immunity of the infected patient is unable to mount an effective defense, resulting in a severe illness with substantial morbidity and mortality. As most treatment modalities including antivirals and anti-inflammatory agents are mostly ineffective, an immunological approach is needed.