Prediction of Chameleonic Efficiency

<p>Prediction of chameleonic properties from environment-dependent conformational ensembles generated by molecular dynamics in explicit solvent is presented. This methodology yields predictive models of overall polarity (experimentally determined EPSA) and hydrogen bond donor exposure (experimentally measured <i>delta</i> log <i>P</i>_oct-tol) for 24 FDA-approved drug molecules. Two quantitative indices of chameleonic efficiency are introduced to aid drug designers striving to combine sufficient permeability and solubility.</p>

Prediction of Chameleonic Efficiency

<p>Prediction of chameleonic properties from environment-dependent conformational ensembles generated by molecular dynamics in explicit solvent is presented. This methodology yields predictive models of overall polarity (experimentally determined EPSA) and hydrogen bond donor exposure (experimentally measured <i>delta</i> log <i>P</i>_oct-tol) for 24 FDA-approved drug molecules. Two quantitative indices of chameleonic efficiency are introduced to aid drug designers striving to combine sufficient permeability and solubility.</p>

A cost-analysis study of using adult red cell packs and Pedi-Packs in newborn intensive care units in Southern Iran

Background and objective Saving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors. Methods In this cross-sectional study, all transfused neonates (n = 70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates’ transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared. Results Considering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate. Conclusions The assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.

A cost-analysis study of using adult red cell packs and Pedi-Packs in Newborn Intensive Care Units in Southern Iran

Background and objective: Saving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors. Methods: In this cross-sectional study, all transfused neonates (n=70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates’ transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared. Results: Considering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate.Conclusions: The assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.

Comparative Cost Analysis of Using Pedi-packs and Adult Red Cell Packs in Newborn Intensive Care Units in Southern Iran

Background and objective:In most developing countries, blood transfusions are routinely administered by adult red blood cells (RBCs) packs in infants leading to wastage of a large amount of blood supplies as well as having high donor exposure risk. We aimed to compare the cost-effectiveness of hypothetical pediatric pack compared to adult RBCs pack in neonates.Methods: In this cross-sectional study, all transfused neonates (n = 70) who were admitted to the newborn intensive care unit (NICU) of Nemazee Hospital, a tertiary referral hospital in Shiraz, Southern Iran, were evaluated between March and June, 2019. Based on the blood bank information during the study period and transfusion indices, a specific pediatric pack was suggested and cost-effectiveness of new and traditional transfusion methods was compared.Results: Considering the mean number of transfusions per neonate: 3.57 and mean volume of transfused packed red cells: 20 ml per transfusion during the study period; a quadruple pediatric pack (240 ml divided in 4 sub-packs) was purposed and cost-analysis of pediatric and adult pack was performed. Mathematically, we proved higher cost-effectiveness in using pediatric versus adult pack. Additionally, using pediatric packs leads to 13.74% reduction in RBCs wastage per transfusion and 68.13% reduction in donor exposure rate.Conclusions: Assignment of dedicated pediatric pack for infants will be able to substantially reduce donor exposure risk as well as wasted resources leading to higher cost effectiveness. This finding should be taken into consideration especially in developing countries in order to promote both economic situation and child health status.

The lasting smell of emotions: The effects of reutilizing fear sweat samples

A growing body of research has shown that human apocrine sweat carries information about the emotional state of its donor. Exposure to sweat produced in a fear-inducing context triggers in its receivers a simulacrum of this emotional state, as evidenced by increased medial frontalis and corrugator supercilii (facial electromyography; fEMG) activity – two facial muscles involved in the display of fear facial expressions. However, despite the increased interest in the effects of emotional sweat, little is known about the properties of these chemical sweat samples. The goal of this study was to examine whether a second application of the same sweat sample would yield reliable results. Specifically, we assessed whether sweat samples collected from Portuguese males (N = 8) in fear (vs. neutral)-inducing contexts would produce similar fEMG activations (i.e., in the medial frontalis and corrugator supercilii) in female receivers (N = 60) across two independent applications (the first with Dutch and the second with Portuguese receivers). Our findings showed that exposure to fear (vs. neutral) sweat resulted in higher activation of both muscles compared with neutral odors, revealing a similar data pattern across the two applications and underlining the feasibility of reusing emotional sweat samples. The implications of these findings for properties of these sweat volatiles are discussed.

Audit of Red Cell Transfusions in the Neonatal Intensive Care Unit, Rotunda Hospital 2011-2015

Introduction/Background Neonates are an intensively transfused group of vulnerable patients. Neonatal transfusion practice and general care has evolved over recent years, including the introduction of pedi-packs to limit donor exposure, and it remains important to audit practice. Inappropriate transfusions expose babies to potential adverse effects of transfusion. A national audit performed in the UK in 2010 concluded that there is a lack of evidence to back many of the existing recommendations for neonatal transfusion. We undertook a prospective audit in order to review 5 years of transfusion practice in a tertiary NICU. Our current neonatal transfusion guidelines are based upon internationally published guidelines. Aims & Objectives: To determine the number of babies transfused, whether transfusions were adherent to local guidelines, to identify areas requiring improvement and to determine whether continuous auditing and feedback to clinicians improves practice Methodology/Interventions This was a prospective audit conducted over a 5 year period. Data were prospectively and retrospectively retrieved from patient charts and electronic databases. Data were stored in a password-protected excel spreadsheet created on a secure hospital network. Results and Discussion A total of 557 babies were transfused with red cells during the period 2011 -2015, representing 7-12% of babies admitted to NICU. The median number of transfusions decreased in babies of all birth weight categories between 2011-2015. The biggest change was in babies <750g, where median donor exposure was reduced from 2 to 1 during this time. The overall percentage of babies admitted to NICU requiring a blood transfusion reduced from 12% to 7%. The most significant reduction was seen in babies ≥1500g with a reduction from 4% in 2011 to 2% in 2015. Conclusions Auditing of neonatal transfusion especially in the area of pedi-pack top up transfusions highlighted specific areas where improvements could be made. This includes adherence to guidelines, consultant-led decision to transfuse (when time permits), and on-going audit and feedback to clinicians. These measures along with a multi-disciplinary approach to blood management have seen an overall reduction in percentage of babies being transfused without compromising the well-being of the baby. This has led to a reduction of donor exposure to the baby and a reduction in the cost and workload across all disciplines of staff associated with blood transfusion leading to an overall improvement to patient safety and quality of care. Despite this, the transfusion rate in babies of < 1000g remains the highest however this would be expected given the overall clinical needs of babies in this birth weight category. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures Ní Áinle: Actelion UK: Research Funding.