scholarly journals An Audit of Perioperative Blood Transfusions in a Regional Hospital to Rationalise a Maximum Surgical Blood Ordering Schedule

2018 ◽  
Vol 46 (5) ◽  
pp. 498-503
Author(s):  
R. M. Blank ◽  
S. P. Blank ◽  
H. E. Roberts
Keyword(s):  
Large Scale ◽  
Major Amputation ◽  
Joint Arthroplasty ◽  
Blood Transfusions ◽  
Local Data ◽  
Preoperative Testing ◽  
Site Specific ◽  
Retrospective Audit ◽  
A Site ◽  
Cross Matching

Appropriate preoperative blood typing and cross-matching is an important quality improvement target to minimise costs and rationalise the use of blood bank resources. This can be facilitated using a maximum surgical blood ordering schedule (MSBOS) for specific operations. It is recommended that individual hospitals develop a site-specific MSBOS based on institutional data, but this is challenging in non-tertiary centres without electronic databases. Our aim was to audit our perioperative blood transfusions to develop a site-specific MSBOS. A retrospective audit of blood transfusions in surgical patients in our regional referral hospital was conducted using five years’ coded administrative data. Procedures with higher transfusion rates warranting preoperative testing (type and screen with or without subsequent cross-matching) were identified. There were about 15,000 eligible surgical procedures performed in our institution over the audit period. The need for preoperative testing was identified for only a few procedures, namely laparotomy, bowel resection, major amputation, joint arthroplasty, hip/femur fracture and humerus surgery, and procedures for obstetric complications. We observed a reduction in transfusion rates over time for total joint arthroplasty. The use of coding data represents an efficient method by which centres without electronic anaesthesia information management systems can conduct large-scale audits to develop a site-specific MSBOS. This would represent a significant improvement for hospitals that currently base preoperative testing recommendations on expert opinion alone. As many procedures in regional centres have very low transfusion rates, hospitals with a similar case mix to ours could consider selectively auditing higher-risk operations where local data is most likely to alter testing recommendations.

scholarly journals Precision Tillage: Online variation of tillage depth

1970 ◽  
Vol 63 ◽  
Author(s):  
S. Walther ◽  
T. Schüle ◽  
K. Köller
Keyword(s):  
Soil Conservation ◽  
Large Scale ◽  
Unit Area ◽  
Control Unit ◽  
Important Condition ◽  
Site Specific ◽  
Hydraulic Cylinders ◽  
Displacement Transducers ◽  
A Site ◽  
Basic Equipment

Precision Farming equipment is more and more common on modern, large scale farm enterprises. With basic equipment being available, an important condition for the use of site-specific approaches is given. Site-specific approaches may help to increase the efficiency of a farm enterprise, as well as may help to achieve certain, predefined goals. A site-specific tillage strategy focusing on soil conservation was developed and evaluated. Online inclination data and local available biomass, calculated from yield maps, was used to compute necessary working depth for each unit area of a site. A control-unit controlling an electronic valve for two hydraulic cylinders fitted with displacement transducers and an on-board computer system implemented the calculated working depth online. While working precision was excellent, the time span require to switch between two working depths can be optimized.

scholarly journals Functional expression of a yeast mitochondrial intron-encoded protein requires RNA processing at a conserved dodecamer sequence at the 3' end of the gene.

1989 ◽  
Vol 9 (4) ◽  
pp. 1507-1512 ◽  
Author(s):  
H Zhu ◽  
H Conrad-Webb ◽  
X S Liao ◽  
P S Perlman ◽  
R A Butow
Keyword(s):  
Genetic Analysis ◽  
Rna Processing ◽  
Fold Increase ◽  
Functional Expression ◽  
Rrna Gene ◽  
Yeast Mitochondria ◽  
Wild Type ◽  
Site Specific ◽  
Var1 Gene ◽  
A Site

All mRNAs of yeast mitochondria are processed at their 3' ends within a conserved dodecamer sequence, 5'-AAUAAUAUUCUU-3'. A dominant nuclear suppressor, SUV3-I, was previously isolated because it suppresses a dodecamer deletion at the 3' end of the var1 gene. We have tested the effects of SUV3-1 on a mutant containing two adjacent transversions within a dodecamer at the 3' end of fit1, a gene located within the 1,143-base-pair intron of the 21S rRNA gene, whose product is a site-specific endonuclease required in crosses for the quantitative transmission of that intron to 21S alleles that lack it. The fit1 dodecamer mutations blocked both intron transmission and dodecamer cleavage, neither of which was suppressed by SUV3-1 when present in heterozygous or homozygous configurations. Unexpectedly, we found that SUV3-1 completely blocked cleavage of the wild-type fit1 dodecamer and, in SUV3-1 homozygous crosses, intron conversion. In addition, SUV3-1 resulted in at least a 40-fold increase in the amount of excised intron accumulated. Genetic analysis showed that these phenotypes resulted from the same mutation. We conclude that cleavage of a wild-type dodecamer sequence at the 3' end of the fit1 gene is essential for fit1 expression.

scholarly journals Long-term effectiveness of faecal immunochemical test screening for proximal and distal colorectal cancers

Gut ◽  
2021 ◽  
pp. gutjnl-2020-322545
Author(s):  
Han-Mo Chiu ◽  
Grace Hsiao-Hsuan Jen ◽  
Ying-Wei Wang ◽  
Jean Ching-Yuan Fann ◽  
Chen-Yang Hsu ◽  
...  
Keyword(s):  
Large Scale ◽  
Distal Colon ◽  
Population Based ◽  
Proximal Colon ◽  
Advanced Stage ◽  
Site Specific ◽  
Faecal Immunochemical Test ◽  
Immunochemical Test ◽  
Selection Factors

ObjectiveTo measure the effects of faecal immunochemical test (FIT) for colorectal cancer (CRC) screening on overall and site-specific long-term effectiveness of population-based organised service screening.DesignA prospective cohort study of Taiwanese nationwide biennial FIT screening was performed. A total of 5 417 699 eligible subjects were invited to attend screening from 2004 through 2009 and were followed up until 2014. We estimated the adjusted relative rates (aRRs) on the effectiveness of reducing advanced-stage CRC (stage II+) and CRC death by Bayesian Poisson regression models with the full adjustment for a cascade of self-selection factors (including the screening rate and the colonoscopy rate) and the completeness of colonoscopy together with demographic features.ResultsFIT screening (exposed vs unexposed) reduced the incidence of advanced-stage CRC (48.4 vs 75.7 per 100 000) and mortality (20.3 vs 41.3 per 100 000). Statistically significant reductions of both incidence of advanced-stage CRCs (aRR=0.66, 95% CI 0.63 to 0.70) and deaths from CRC (aRR=0.60, 95% CI 0.57 to 0.64) were noted. FIT screening was more effective in reducing distal advanced-stage CRCs (aRR=0.61, 95% CI 0.58 to 0.64) and CRC mortality (aRR=0.56, 95% CI 0.53 to 0.69) than proximal advanced CRCs (aRR=0.84, 95% CI 0.77 to 0.92) and CRC mortality (aRR=0.72, 95% CI 0.66 to 0.80).ConclusionA large-scale population-based biennial FIT screening demonstrates 34% significant reduction of advanced-stage CRCs and 40% reduction of death from CRC with larger long-term effectiveness in the distal colon than the proximal colon. Our findings provide a strong and consistent evidence-based policy for supporting a sustainable population-based FIT organised service screening worldwide. The disparity of site-specific long-term effectiveness also provides an insight into the remedy for lower effectiveness of FIT screening in the proximal colon.

scholarly journals Consecutive sexual maturation observed in a rock shell population in the vicinity of the Fukushima Daiichi Nuclear Power Plant, Japan

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toshihiro Horiguchi ◽  
Kayoko Kawamura ◽  
Yasuhiko Ohta
Keyword(s):  
Power Plant ◽  
Nuclear Power Plant ◽  
Sexual Maturation ◽  
Nuclear Power ◽  
Tohoku Earthquake ◽  
Site Specific ◽  
Thais Clavigera ◽  
Rock Shell ◽  
Fukushima Daiichi ◽  
A Site

AbstractIn 2012, after the accident at the Fukushima Daiichi Nuclear Power Plant (FDNPP) that followed the Tohoku earthquake and tsunami in March 2011, no rock shell (Thais clavigera; currently recognized as Reishia clavigera; Gastropoda, Neogastropoda, Muricidae) specimens were found near the plant from Hirono to Futaba Beach (a distance of approximately 30 km). In July 2016, however, rock shells were again found to inhabit the area. From April 2017 to May 2019, we collected rock shell specimens monthly at two sites near the FDNPP (Okuma and Tomioka) and at a reference site ~ 120 km south of the FDNPP (Hiraiso). We examined the gonads of the specimens histologically to evaluate their reproductive cycle and sexual maturation. The gonads of the rock shells collected at Okuma, ~ 1 km south of the FDNPP, exhibited consecutive sexual maturation during the 2 years from April 2017 to May 2019, whereas sexual maturation of the gonads of specimens collected at Hiraiso was observed only in summer. The consecutive sexual maturation of the gonads of the specimens collected at Okuma might not represent a temporary phenomenon but rather a site-specific phenotype, possibly caused by specific environmental factors near the FDNPP.

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