Stored blood transfusion induces transient pulmonary arterial hypertension without impairing coagulation in an ovine model of nontraumatic haemorrhage.

BACKGROUND AND OBJECTIVES: Transfusion of blood products in particular older products is associated with patient morbidity. Previously, we demonstrated a higher incidence of acute lung injury in lipopolysaccharide-treated sheep transfused with stored blood products. As transfusion following haemorrhage is more common, we aimed to determine whether a 'first hit' of isolated haemorrhage would precipitate similar detrimental effects following transfusion and also disrupt haemostasis. MATERIALS AND METHODS: Anaesthetized sheep had 33% of their total blood volume collected into Leukotrap bags (Pall Medical), which were processed into packed red blood cells and cross-matched for transfusion into other sheep. After 30 mins, the sheep were resuscitated with either: fresh (<5 days old) or stored (35-42 days old) ovine blood followed by 4% albumin to replacement volume, albumin alone or normal saline alone and monitored for 4 h. RESULTS: The first hit of haemorrhage precipitated substantial decreases in mean arterial pressure however haemostasis was preserved. Transfusion of stored ovine blood induced (1) transient pulmonary arterial hypertension but no oedema and (2) reduced fibrinogen levels more than fresh blood, but neither induced coagulopathy. Thus, transfusion of stored blood affected pulmonary function even in the absence of overt organ injury. CONCLUSION: The fact that stored blood transfusions: (1) did not induce acute lung injury in contrast to previous lipopolysaccharide-primed animal models identifies the 'first hit' as an important determinant of the severity of transfusion-mediated injury; (2) impaired pulmonary dynamics verifies the sensitivity and vulnerability of the pulmonary system to injury.

Analysis of last statements prior to execution: methods, themes and future directions.

Worldwide, over 1000 people were executed in 2016 and over 3000 sentenced to death. Death row prisoners have high rates of mental illness, often combined with neurological impairment. Prolonged confinement has further negative effects on psychological function. There is a growing literature examining key themes and psychological constructs in death row prisoners immediately prior to execution. To date, this literature centres largely but not exclusively on last statements from death row in Texas, owing to ease of availability. The most common themes in last statements are love, spirituality and apology or regret. The most common psychological constructs are 'identification-egression' (e.g. attachment to a lost person or ideal, such as freedom), unbearable psychological pain and rejection-aggression. This is still a relatively new area of research and new techniques, such as computerised quantitative text analysis, are likely to complement rather than replace more traditional forms of thematic and textual analysis. For the future, it is essential that studies in this field continue to specify precisely, which last statements they use, so that overlap can be identified, and that more countries are studied (if possible). It would also be useful to expand the research frame to relate the content of last statements to additional variables relating to prisoners' offences, physical health, mental health, family structure and broader circumstances. Finally, ethical issues require continued consideration in this complex, fascinating, growing field.

Forgiveness, spirituality and love: thematic analysis of last statements from Death Row, Texas (2002-17).

BACKGROUND: Psychological features associated with execution are not fully understood. AIMS: To analyse demographics of individuals executed in Texas and investigate whether there has been any change in common themes and psychological factors evident in last statements before execution between 2002 and 2017. DESIGN: Analysis of last statements from Death Row, Texas. METHODS: We (a) studied themes and psychological factors in last statements in Texas between August 2011 and May 2017; and (b) combined our 2011-17 data with our previous data (2002-06 and 2006-11) to present an overall analysis of last statements from 2002 to 2017. RESULTS: Between April 2002 and May 2017 (279 executions; 240 last statements), the execution rate in Texas fell from 25 per year to 12; median time on death row increased from 108.5 months to 149.5; median age at execution increased from 38 years to 40.5; and the proportion of offences involving multiple victims rose from 28.4% to 47.1%. The most common themes in last statements were love (78%), spirituality (58%), regret (35%) and apology (35%). The most common psychological factors were identification-egression (51%), unbearable psychological pain (47%) and rejection-aggression (40%). Two themes (forgiveness, use of poetry/literature) and three psychological factors (inability to adjust, interpersonal relations, identification-egression) became less common. CONCLUSIONS: Between 2002 and 2017, executed prisoners in Texas became fewer and older, spent longer on death row and had committed more serious offences. Themes of love and spirituality were constants, but requests for forgiveness declined.

Synthesis of MII[N(SiMe3)2][Me3SiNC(tBu)NSiMe3] (M = Sn, Ge) from amidinate precursors: active catalysts for phenyl isocyanate cyclization.

Mixed amidinato amido complexes [Me3SiNC(tBu)NSiMe3]M[N(SiMe3)2] (M = Sn 2, Ge 3) were prepared by the reaction of [Me3SiNC(tBu)NSiMe3]Li (1a) with SnCl2 and GeCl2(dioxane) in ether. The N(SiMe3)2 ligand in these compounds is derived from the rearrangement of the [Me3SiNC(tBu)NSiMe3]- anion with extrusion of tBuCN. The susceptibility of [Me3SiNC(tBu)NSiMe3]- to rearrangement appears to be dependent on reaction solvent and on the coordinated metal center. Single-crystal X-ray diffraction studies of 2 and 3 are presented. Replacement of Me for tBu in the ligand allowed [Me3SiNC(Me)NSiMe3]2SnII (4) to be isolated, and an X-ray structure of this compound is reported. The isolation of 4 indicates that steric factors also play a role in the stability of [Me3SiNC(tBu)NSiMe3]-. Compounds 2 and 3 are outstanding catalysts for the cyclotrimerization of phenyl isocyanates to perhydro-1,3,5-triazine-2,4,6-triones (isocyanurates) at room temperature. In contrast, complex 4 catalytically reacts with phenyl isocyanate to produce isocyanate dimer and trimer in a 52:35 ratio.

Characterization of chemokine receptors expressed in primitive blood cells during human hematopoietic ontogeny.

Chemokines are capable of regulating a variety of fundamental processes of hematopoietic cells that include proliferation, differentiation, and migration. To evaluate potential chemokine signaling pathways important to the regulation of primitive human hematopoietic cells, we examined chemokine receptor expression of highly purified subpopulations of uncommitted human blood cells. CXCR1-, CXCR2-, CXCR4-, and CCR5-expressing cells were detected by flow cytometry among human blood subsets depleted of lineage-restricted cells (Lin(-)) derived from adult bone marrow, mobilized peripheral blood, cord blood (CB), and circulating fetal blood. Although these chemokine receptors could be detected on Lin(-) cells throughout human development, only CXCR4 could be detected in CD34(-)CD38(-)Lin(-) and CD34(+)CD38(-)Lin(-) subfractions enriched for stem cell function, suggesting that independent of ontogeny, CXCR4-mediated signals are critical to primitive hematopoiesis. Distinct to other stages of human hematopoietic development, primitive CB cells expressed higher levels of CXCR1, CXCR2, CCR5, and CXCR4 on both CD34(-)CD38(-)Lin(-) and CD34(+)CD38(-)Lin(-) subsets. Isolation of these fractions revealed expression of additional chemokine receptors CCR7, CCR8, and Bonzo (STRL133), whereas BOB (GPR15) could not be detected. Our study illustrates that rare uncommitted hematopoietic cells express chemokine receptors not previously associated with primitive human blood cells. Based on these results, we suggest that signaling pathways mediated by chemokine receptors identified here may play a fundamental role in hematopoietic stem cell regulation and provide alternative receptor targets for retroviral pseudotyping for genetic modification of repopulating cells.