Objectives: In 2015, three London cardiac centres, with different transfusion infrastructure support, merged to form the Barts Heart Centre. We describe the impact on transfusion rate, blood usage and interoperator variation.
Design: Data was collected on all adult patients undergoing cardiac surgery during 2014 as well as 2016, using the National Institute Cardiovascular Outcomes Research (NICOR) data set.
Measurements And Main Results: Over the two time periods, a total of 3,647 cardiac procedures were performed (1,930 in 2014 and 1,717 in 2016). There were no significant differences in type of surgery or patient comorbidity between the two epochs of time. Overall, red blood cell transfusion at 24 hours and until hospital discharge reduced significantly in 2016 (odds ratio 0.77; 95% confidence interval 0.68-0.89; p=0.0002). Interoperator variability (adjusted for comorbidities) reduced after merger from standard deviation 0.394 (standard error (SE) 0.096) to 0.269 (SE 0.082), p=0.001.
Conclusion: Clinical and organisational factors can improve transfusion service.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7032573 | PMC |
http://dx.doi.org/10.7861/fhj.2019-0014 | DOI Listing |
Nat Commun
December 2024
Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Biological systems are complex, encompassing intertwined spatial, molecular and functional features. However, methodological constraints limit the completeness of information that can be extracted. Here, we report the development of INSIHGT, a non-destructive, accessible three-dimensional (3D) spatial biology method utilizing superchaotropes and host-guest chemistry to achieve homogeneous, deep penetration of macromolecular probes up to centimeter scales, providing reliable semi-quantitative signals throughout the tissue volume.
View Article and Find Full Text PDFNat Commun
December 2024
Department of Chemical Engineering, Electrochemical Innovation Lab, University College London, London, UK.
High-temperature proton exchange membrane fuel cells (HT-PEMFCs) offer solutions to challenges intrinsic to low-temperature PEMFCs, such as complex water management, fuel inflexibility, and thermal integration. However, they are hindered by phosphoric acid (PA) leaching and catalyst migration, which destabilize the critical three-phase interface within the membrane electrode assembly (MEA). This study presents an innovative approach to enhance HT-PEMFC performance through membrane modification using picosecond laser scribing, which optimises the three-phase interface by forming a graphene-like structure that mitigates PA leaching.
View Article and Find Full Text PDFNat Commun
December 2024
Department of Chemistry, University of Western Ontario, London, Ontario, N6A 5B7, Canada.
Metal-organic frameworks (MOFs) are a class of porous materials that are of topical interest for their utility in water-related applications. Nevertheless, molecular-level insight into water-MOF interactions and MOF hydrolytic reactivity remains understudied. Herein, we report two hydrolytic pathways leading to either structural stability or framework decomposition of a MOF (ZnMOF-1).
View Article and Find Full Text PDFAdv Healthc Mater
December 2024
Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK.
Despite the significant advantages of Shape Memory Polymers (SMPs), material processing and production challenges have limited their applications. Recent advances in fiber manufacturing offer a novel approach to processing polymers, broadening the functions of fibers beyond optical applications. In this study, a thermal drawing technique for SMPs to fabricate Shape Memory Polymer Fibers (SMPFs) tailored for medical applications, featuring programmable stiffness and shape control is developed.
View Article and Find Full Text PDFCureus
November 2024
Gastroenterology and Hepatology, Barts Health NHS Trust, London, GBR.
Inconsistent documentation of large-volume paracentesis (LVP) procedures in a tertiary hospital presents risks to patient safety and procedural quality. This study aimed to improve the completeness and accuracy of LVP documentation through the implementation of a structured checklist, developed in alignment with the British Society of Gastroenterology (BSG) Safety Toolkit. The intervention was conducted over three Plan-Do-Study-Act (PDSA) cycles and involved multidisciplinary collaboration, the integration of Local Safety Standards for Invasive Procedures (LocSSIPs) into the Clinical Record System (CRS), and targeted training for staff.
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