Every minute counts: A comparison of thawing times and haemostatic quality of plasma thawed at 37°C and 45°C using four different methods.

BACKGROUND: Having faster plasma thawing devices could be beneficial for transfusion services, as it may improve the rapid availability of thawed plasma for bleeding patients, and it might remove the need to have extended pre-thawed plasma: thus, reducing unnecessary plasma wastage. STUDY DESIGN AND METHODS: The aims of this study were to assess (a) the thawing times and (b) in vitro haemostatic quality of thawed plasma using Barkey Plasmatherm V (PTV) at 37 and 45°C versus Barkey Plasmatherm Classic (PTC) at 37 and 45°C, Sarstedt Sahara-III Maxitherm (SS-III) at 37°C and Helmer Scientific Thermogenesis Thermoline (TT) at 37°C. Haemostatic quality was assessed using LG-Octaplas at three different time points: baseline (5 min), 24 and 120 h after thawing. RESULTS: The thawing time (SD) of 2 and 4 units was significantly different between different thawers. PTV at 45°C was the fastest method for both 2 and 4 units (7.06 min [0.68], 9.6 min [0.87], respectively). SS-III at 37°C being the slowest method (24.69 min [2.09] and 27.18 min [4.4], respectively) (p = < 0.05). Baseline measurements for all assays showed no significant difference in the prothrombin time, fibrinogen, FII, FV, protein C activity or free protein S antigen between all methods tested. However, at baseline PTV (both 37°C and 45°C) had significantly higher levels of FVII, FVIII and FXI and shortened activated partial thromboplastin time. DISCUSSION: PTV was the quickest method at thawing plasma at both 37 and at 45°C. The haemostatic quality of plasma thawed at 45 versus 37°C was not impaired. Thawing frozen plasma at 45°C should be considered.

A systematic review of whether Health Impact Assessment frameworks support best practice principles.

OBJECTIVES: Health Impact Assessment (HIA) is an evidence-based approach to assess the likely public health impacts of a policy or plan in any sector. Several HIA frameworks are available to guide practitioners doing a HIA. This systematic review sought to determine whether these support practitioners to meet best practice principles defined by the International Association for Impact Assessment. STUDY DESIGN: This was a systematic review. METHODS: Three complementary search strategies were used to identify frameworks in June 2022. We used three databases to find completed HIAs published in the last five years and hand-searched their reference lists for frameworks. We also searched 23 HIA repositories using Google's Advanced function and contacted HIA practitioners via two international mailing lists. We used a bespoke quality appraisal tool to assess frameworks against the principles. RESULTS: The search identified 24 HIA frameworks. None of the frameworks achieved a 'good' rating for all best practice principles. Many identified the principles but did not provide guidance on how to meet them at all HIA steps. The highest number of frameworks were rated 'good' for ethical use of evidence and comprehensive approach to health (n = 15). Eight frameworks were rated as 'good' for participation, and two for equity. The highest number of frameworks rated 'poor' for sustainability (n = 11). CONCLUSIONS: There is marked variation in the degree to which HIA frameworks support the best practice principles. HIA practitioners could select elements from different frameworks for practical guidance to meet all the best practice principles.

Impact of mid-Z gas fill on dynamics and performance of shock-driven implosions at the OMEGA laser.

Shock-driven implosions with 100% deuterium (D_{2}) gas fill compared to implosions with 50:50 nitrogen-deuterium (N_{2}D_{2}) gas fill have been performed at the OMEGA laser facility to test the impact of the added mid-Z fill gas on implosion performance. Ion temperature (T_{ion}) as inferred from the width of measured DD-neutron spectra is seen to be 34%±6% higher for the N_{2}D_{2} implosions than for the D_{2}-only case, while the DD-neutron yield from the D_{2}-only implosion is 7.2±0.5 times higher than from the N_{2}D_{2} gas fill. The T_{ion} enhancement for N_{2}D_{2} is observed in spite of the higher Z, which might be expected to lead to higher radiative loss, and higher shock strength for the D_{2}-only versus N_{2}D_{2} implosions due to lower mass, and is understood in terms of increased shock heating of N compared to D, heat transfer from N to D prior to burn, and limited amount of ion-electron-equilibration-mediated additional radiative loss due to the added higher-Z material. This picture is supported by interspecies equilibration timescales for these implosions, constrained by experimental observables. The one-dimensional (1D) kinetic Vlasov-Fokker-Planck code ifp and the radiation hydrodynamic simulation codes hyades (1D) and xrage [1D, two-dimensional (2D)] are brought to bear to understand the observed yield ratio. Comparing measurements and simulations, the yield loss in the N_{2}D_{2} implosions relative to the pure D_{2}-fill implosion is determined to result from the reduced amount of D_{2} in the fill (fourfold effect on yield) combined with a lower fraction of the D_{2} fuel being hot enough to burn in the N_{2}D_{2} case. The experimental yield and T_{ion} ratio observations are relatively well matched by the kinetic simulations, which suggest interspecies diffusion is responsible for the lower fraction of hot D_{2} in the N_{2}D_{2} relative to the D_{2}-only case. The simulated absolute yields are higher than measured; a comparison of 1D versus 2D xrage simulations suggest that this can be explained by dimensional effects. The hydrodynamic simulations suggest that radiative losses primarily impact the implosion edges, with ion-electron equilibration times being too long in the implosion cores. The observations of increased T_{ion} and limited additional yield loss (on top of the fourfold expected from the difference in D content) for the N_{2}D_{2} versus D_{2}-only fill suggest it is feasible to develop the platform for studying CNO-cycle-relevant nuclear reactions in a plasma environment.

Frecuencia y distribución de metástasis pulmonar por sarcoma óseo en el Instituto Nacional de Cancerología: periodo 1986-1996 / Frequency and distribution of pulmonary metastases induced by bone sarcoma in the Instituto Nacional de Cancerologia: period 1986-1996

Antecedentes. Los sarcomas óseos son poco frecuentes, pero inducen hasta 80 por ciento de metástasis pulmonar. En población mexicana esta información se desconoce, por lo que describimos su frecuencia en el Instituto Nacional de Cancerología. Métodos. Se revisaron los expedientes de pacientes con sarcoma, registrados entre 1986-1996. Se recabo información demográfica, la histología del tumor y el tiempo de desarrollo de la metástasis. Resultados. Se incluyeron en el estudio 173 casos. De éstos, 74 (43 por ciento) desarrollaron metástasis pulmonar; 102 (60 por ciento) fueron hombres y 71 (40 por ciento) mujeres. Se observó una mediana de edad de 21 años. Se registraron 120 (70 por ciento) casos con diagnóstico de osteosarcoma, 54 (45 por ciento) de los cuales presentaron metástasis; 35 (20 por ciento) casos de condrosarcoma, en 10 (29 por ciento) de los cuales se confirmó metástasis a pulmón y 18 (10 por ciento) casos con sarcoma de Ewing, 10 (56 por ciento) de éstos con metástasis. Considerando la fecha de ingreso, se observaron medianas de tiempo de desarrollo de metástasis pulmonar de hasta 15 meses. A 50 meses, en los pacientes con sarcoma de Ewing, se calculó una supervivencia del 60 por ciento, significativamente menor a la observada en los otros grupos (p=0.0368). Los pacientes con osteosarcoma y metástasis presentaron una supervivencia del 70 por ciento a 50 meses, significativamente menor a la registrada de los osteosarcomas sin metástasis (p=0.0319). Conclusiones. Se encontró una frecuencia del 43 por ciento de metástasis pulmonar. El osteosarcoma y el sarcoma de Ewing fueron los principales inductores de este tipo de metástasis y los grupos en los que se registraron los menores tiempos de supervivencia en presencia o no de metástasis, respectivamente

Carcinoma de células no pequeñas de pulmón etapa III-B/IV. Experiencia en el Instituto Nacional de Cancerología, 1988-1992 / Non-small cell lung carcinoma stage IIIB/IV. Experience in the Instituto Nacional de Cancerologia, 1988-1992

Análisis retrospectivo en pacientes con carcinoma de células no pequeñas de pulmón etapa III-B/IV, estudiados en la Consulta Externa del Instituto Nacional de Cancerología durante enero de 1988 a diciembre de 1992. Se atendieron 683 pacientes con diagnóstico de cáncer de pulmón; de éstos, 313 se encontraron en etapa III-B/IV (46 por ciento) en etapa IV. Doscientos diecisiete fueron hombres (69 por ciento) y 96 (31 por ciento) mujeres con predominio de pacientes mayores de 60 años. La relación hombre:mujer aumentó a partir de la cuarta década de la vida. La neoplasia más frecuente fue adenocarcinoma (60 por ciento) seguida por carcinoma epidermoide (38 por ciento) y carcinoma de células grandes (2 por ciento). Las modalidades de tratamiento empleadas fueron radioterapia (25 por ciento), sintomático (25 por ciento) y quimioterapia (21 por ciento). No fueron tratados 18 por ciento por las condiciones físicas al momento del ingreso. La supervivencia observada no mostró diferencias en relación a etapa clínica ni tipo histológico; sin embargo, por esquema terapéutico se identificaron algunas diferencias. De tal forma, la medida de supervivencia en los enfermos que recibieron quimioterapia y radioterapia combinadas fue de 243 días; en cambio, fue 210 días en los sujetos tratados con quimioterapia y de 189 días en pacientes con esquema estándar de radioterapia. En 56 de 113 pacientes que recibieron radioterapia hipofraccionada la supervivencia fue de 133 días. Finalmente, los sujetos que no fueron tratados sobrevivieron apenas 58 días