Bag Systems Research Articles

3D printing and intelligent technology increase convenience, reliability, and patient acceptance of ostomy nursing: a randomized controlled trial.

Traditional ostomy bags commonly cause skin allergy and inflammation around the stoma, as well as leakage. This study aimed to examine the effect of a 3D-printed ostomy bag with sensors and stimulators on stoma nursing. This is a randomized controlled trial. This trial involved 113 distinct individuals who undergo colorectal cancer surgery and intestinal obstruction surgery, with resulting stoma. The date of trial registration was January 17, 2019, and the date of first recruitment was May 1, 2019. Patients were randomized into two groups: intelligent 3D-printed ostomy bag (3D group, n = 57) and Coloplast one-piece pouching systems (control group, n = 56). The shape of ostomy and the surrounding skin of all the 57 patients of the 3D group was scanned by a handheld 3D scanner. Then, the ostomy bag chassis (also known as skin barrier) was 3D printed and an intelligent device adhered to the ostomy bag. The wearing time, leakage rate, the Discoloration, Erosion, and Tissue Overgrowth (DET) score, and the Acceptance of Illness Scale (AIS) were observed. In the 3D-printed bag group, the time to wear (0.7 ± 0.4m) was significantly shorter than that of the control group (9.1 ± 3.5m). The leakage rate of 3D-printed bag (1.75%) was significantly lower than that of the control group (16.1%). The DET score for the 3D-printed bag group was also lower than that of the control group, and the AIS score for the 3D-printed bag group was higher than that of the control group. The 3D-printed ostomy bags and the linked computer program can significantly reduce wearing time, leakage rate, and stoma complications. This may improve the quality of home ostomy care for patients and reduce the incidence of skin complications around the stoma.Registration number: ChiCTR1900020752.

Synthesis, Characterization, and In-Vitro Evaluation of Silibinin-loaded PEGylated Niosomal Nanoparticles: Potential Anti-Cancer Effects on SW480 Colon Cancer Cells.

Colorectal cancer is a significant global health concern with high mortality rates. Silibinin is a compound derived from milk thistle with anticancer properties and may be a potential treatment option for colorectal cancer. Its poor solubility limits its clinical application, but various strategies, such as nanoparticle encapsulation, have shown promise. In this study, a PEGylated niosomal drug delivery system was used to enhance the solubility of silibinin, and its anti-proliferative effects were evaluated against human colorectal cancer cell lines. The silibinin-loaded PEGylated niosomal nanoparticles (NIO-SIL) were fabricated using the thin-film hydration method and characterized with dialysis bag, AFM, SEM, DLS, and FTIR systems. Finally, the cancerous cells and human normal cells were treated with NIO-SIL and pure silibinin. The proliferation, apoptosis, and cell cycle of these cells were evaluated. Subsequently, the expression of Bax, Bcl-2, p53, and cyclin D1 genes was measured using real-time PCR. The drug release profile, size, morphology, and chemical interactions of the synthesized PEGylated niosomal nanoparticles were suitable for use as a drug delivery system. Both pure silibinin and NIO-SIL could reduce the proliferation of cancerous cells, induce apoptosis, and cause cell cycle arrest, with no significant negative effects reported on human normal cells. Both pure silibinin and NIO-SIL reduced the expression of the Bcl-2 and cyclin D1 genes while increasing the expression of Bax and p53. (p-value < 0.05 *). The outcomes of this study indicate the high potential of PEGylated niosomal nanoparticles for encapsulation and delivery of silibinin to cancer cells, with no negative effects on normal cells.

Turning Trash Into Treasure: A Simple Protocol for Human Mesenchymal Stromal Cell Isolation From Used Bone Marrow Collection Kits.

The therapeutic potential of mesenchymal stromal cells (MSCs) has been extensively investigated in both preclinical and clinical settings. Recent years have witnessed the emergence of numerous isolation protocols and culture techniques, ranging from the selection of subpopulations to preserve stemness to preconditioning strategies aimed at enhancing therapeutic efficacy, tailored to the specific tissue source. In this protocol, we present a straightforward and cost-effective method for isolating human MSCs (hMSCs) from discarded bone marrow collection kits (comprising bag and filter systems) originally intended for removing impurities and unwanted cellular debris from the collected bone marrow aspirate, ensuring the purity of the stem cell population during stem cell transplantation. Utilizing basic laboratory equipment, we demonstrate the isolation of hMSCs, highlighting the expression of specific surface antigens, and multilineage differentiation into adipogenic, osteogenic, and chondrogenic lineages in vitro. This sustainable and resource-efficient approach not only contributes to reducing medical waste but also holds promise for advancing regenerative medicine applications. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Isolation of human mesenchymal stromal cells from bone marrow collection kits Basic Protocol 2: Culture of human mesenchymal stromal cells Basic Protocol 3: Characterization of human mesenchymal stromal cells with flow cytometry analysis Basic Protocol 4: Characterization of human mesenchymal stromal cells with multilineage differentiation under in vitro conditions.

Pilot-scale cultivation of the red alga Porphyridium purpureum over a two-year period in a greenhouse

Microalgae can form renewable feedstock for many sectors. However, most microalgae commercially cultivated are difficult to grow in colder climates. To overcome this problem one could cultivate cold tolerant algae. One such alga is the red marine alga Porphyridium purpureum. It is currently often cultivated in bag systems in limited volumes. In this study we cultivated P. purpureum at pilot-scale in horizontal tubular reactors in a greenhouse. P. purpureum was grown in batch mode in a total volume of either 350, 500, 1000 or 1500 L. A total of 28 batches, spread over two years, were cultivated reaching a maximum dry weight of 1.94 g L−1. The growth was continuously monitored to calculate the productivities and growth rates. The P and N concentrations were measured frequently during four batches to calculate the P and N usage per gram biomass. To calculate CO2 fixation efficiencies the total CO2 consumption was monitored during 6 of the 28 batches. A maximum productivity and growth rate of respectively 0.195 g L−1 day−1 and 0.233 day−1 were achieved while the P and N usage varied from 3.2–6.19 and 14.5–36.6 mg g−1 biomass for P and N, respectively. Growth was supported between 10 °C and 30 °C, while temperatures above 34—35 °C proved to be detrimental. The CO2 efficiencies differed among the 6 tested periods with the highest utilization efficiency being 13.5% and the lowest a mere 1.5%. Further large-scale, continuous, tests would be needed to fully optimize the cultivation of P. purpureum in larger volumes.

A Modular Chain Bioreactor Design for Fungal Productions.

Plastic bag bioreactors are single-use bioreactors, frequently used in solid culture fermentation. This study developed plastic bag bioreactors with more effective aeration conditions and particular connection elements that yield sensors, environmental control, and modular connectivity. This bioreactor system integrates the bags in a chain that circulates air and moisture through filtered connections. Within the present scope, this study also aimed to reveal that cultures in different plastic bags can be produced without affecting each other. In this direction, biomass production in the modular chain bioreactor (MCB) system developed in this study was compared to traditional bag systems. In addition, contamination experiments were carried out between the bags in the system, and it was observed that the filters in the developed system did not affect the microorganisms in different bags.

Assessment of the possibility of using various fire extinguishing means in high-rise buildings

Introduction. To date, fires in high-rise buildings are one of the significant problems faced by fire protection units. Unique objects require a special approach in terms of fire safety and fire extinguishing. The most important task is to ensure the supply of extinguishing agents to the height using modern fire-fighting equipment and installations.Materials and methods.In September 2021, to conduct experimental scientific and tactical exercises on the roof of the Neva Towers tower, a program and methodology for supplying fire extinguishing agents in various ways to the height were developed. The following methods of feeding to height were considered: deployment using the equipment of a container for high-altitude firefighting, feeding from an installation with compression foam technology, feeding using a waterjet cutting unit “Cobra”.Theoretical bases. A theoretical assessment of the possibility of supplying extinguishing agents to a height with the help of new fire-rescue equipment confirmed the need for experimental scientific and tactical exercises on the roof of the Neva Towers tower.Results and discussions. As a result of the scientific and tactical exercises, the effectiveness of the use of new fire extinguishing systems with compression foam supply, as well as installations with waterjet cutting technology “Cobra” was proved. It was possible to provide a feed to a height of 350 m.Conclusions. To date, with the help of new fire extinguishing technologies, it has been experimentally proven that their use is most effective compared to “traditional” methods of supplying extinguishing agents. In the future, it is necessary to conduct more detailed studies of the hydrodynamic parameters of pumping and bag systems in order to develop recommendations for preliminary planning of the actions of forces and means of fire and rescue units.

Web-Based Bag and Luggage Sales Information System

This study aims to design and create a web-based information system that functions to help manage the sales process at CV. Purnama. This research was conducted in March 2020 at the Informatics Laboratory, University of Muhammadiyah Sidoarjo and CV. Purnama. This research was conducted using the waterfall method, data were collected through interviews, literature study, and problem analysis. The results of this study are the design and manufacture of Web-Based Bag and Suitcase Sales Information Systems at CV. Purnama which aims to increase promotion and facilitate the operational management in CV. Purnama. This information system has two actors, namely admin as manager of information systems and customers as consumers. Based on this research, the conclusion is that with the sales system (e-commerce), CV. Purnama can facilitate the conventional transaction process to become more modern with the availability of online transactions.

An insight to the internal quality control of blood components separated using the latest whole blood collection and processing systems: Experience from a tertiary care hospital blood transfusion service in Eastern India.

With blood component therapy becoming the standard of care in transfusion medicine globally, the quality control (QC) of these components has become a routine and mandatory program in all blood centers. Extensive utilization of blood components has been observed in our multidisciplinary tertiary care hospital. We use quadruple bag systems and automated component extraction facilities for collection and processing of whole blood (WB). In this study, we analyzed our data relating to QC of all blood components which we prepare and issue for transfusion. The retrospective 5-year study comprised 47,430 WB collections which were separated into blood components using quadruple bags and automated component extraction machine. A total of 90 units of WB were processed into blood components for the machine calibration and validation. Routine use of the system was started once the calibration and validation results were acceptable. At least 1% of each component prepared was subjected to QC as per departmental standard operating procedures. Statistical analysis was done using the SPSS statistical package. The mean volume, hematocrit (Hct), platelet (PLT), and white blood cell (WBC) in 350 and 450 mL WB units were 394.63 mL, 39.43%, 0.93 × 1011, and 3.12 × 109 and 507.75 mL, 40.72%, 1.13 × 1011, and 3.45 × 109, respectively, with mean recovery of PLT and WBC in buffy coat being 95.54% and 68.63% and 97.87% and 74.51%, respectively. As high as 89.91% RBC recovery was noted in the packed red blood cell units which were subjected to QC. QC of random donor platelets was performed in 979 (2.36%) units with acceptable results. The mean fibrinogen and FVIII values were estimated to be 469.17 mg and 217.34 IU (1.07 IU/mL) and 600.21 mg and 273.39 IU (1.11 IU/mL) in fresh frozen plasma units prepared from 350 and 450 mL WB, respectively. A total of 578 (1.62%) units of cryoprecipitate were investigated for QC with favorable results. We conclude that QC data generated in this study will provide invaluable information about the performance of the latest blood collection systems. QC of all blood components under study complied with both national and international standards. We opine that all blood centers should establish a complete QC program and adhere to departmental protocols and manufacturer's instructions for its execution and effective outcome.

Web-Based Bag And Luggage Sales Information System At CV. Purnama

This study aims to design and create a web-based information system that functions to help manage the sales process at CV. Purnama. This research was conducted in March 2020 at the Informatics Laboratory, University of Muhammadiyah Sidoarjo and CV. Purnama. This research was conducted using the waterfall method, data were collected through interviews, literature study, and problem analysis. The results of this study are the design and manufacture of Web-Based Bag and Suitcase Sales Information Systems at CV. Purnama which aims to increase promotion and facilitate the operational management in CV. Purnama. This information system has two actors, namely admin as manager of information systems and customers as consumers. Based on this research, the conclusion is that with the sales system (e-commerce), CV. Purnama can facilitate the conventional transaction process to become more modern with the availability of online transactions.

Newborn resuscitation devices: The known unknowns and the unknown unknowns

Infant resuscitation devices used at birth must be capable of delivering adequate and consistent ventilation in a controlled and predictable manner to a wide patient weight range, and combinations of transitional lung states. Manual inflation resuscitation devices delivering positive pressure lung inflation at birth can be classified broadly into two types: 1) flow generating, ie silicone self-inflating bags (SIB) also known as bag valve mask (BVM) and 2) flow dependent, ie anaesthetic flow inflating bag (FIB) and t-piece resuscitator (TPR) systems (eg: Neopuff, GE Panda and Draeger Resuscitaires). Globalization, lower production costs, and an expanding market need for devices, has led to a proliferation of brands (both reusable and single use) within a class type. T-piece resuscitators have become the dominant device particularly in high income countries. There remains a paucity of information on the performance characteristics of these devices and their ability to provide the required respiratory parameters for effective and safe ventilation across the full-expected weight range and lung states to which they will be applied. This review aims to inform current clinical practise on the biomechanical efficiency, reliability and efficacy of the most common devices used to apply PPV to newborns and infants ≤10 kgs.

Enriching leukapheresis improves T cell activation and transduction efficiency during CAR T processing

The majority of CD19-directed CAR T cell products are manufactured using an autologous process. Although using a patient's leukapheresis reduces the risks of rejection, it introduces variability in starting material composition and the presence of cell populations that might negatively affect production of chimeric antigen receptor (CAR) T cells, such as myeloid cells. In this work, the effect of monocytes (CD14) on the level of activation, growth, and transduction efficiency was monitored across well plate and culture bag platforms using healthy donor leukapheresis. Removal of monocytes from leukapheresis improved the level of activation 2-fold, achieving the same level of activation as when initiating the process with a purified T cell starting material. Two activation reagents were tested in well plate cultures, revealing differing sensitivities to starting material composition. Monocyte depletion in culture bag systems had a significant effect on transduction efficiency, improving consistency and increasing the level of CAR expression by up to 64% compared to unsorted leukapheresis. Cytotoxicity assays revealed that CAR T cell products produced from donor material depleted of monocytes and isolated T cells consistently outperformed those made from unsorted leukapheresis. Analysis of memory phenotypes and gene expression indicated that CAR T cells produced using depleted starting material displayed a more rested and naive state.

Establishment of a cell processing laboratory to support hematopoietic stem cell transplantation and chimeric antigen receptor (CAR)-T cell therapy

Cell processing laboratories are an important part of cancer treatment centers. Cell processing laboratories began by supporting hematopoietic stem cell (HSC) transplantation programs. These laboratories adapted closed bag systems, centrifuges, sterile connecting devices and other equipment used in transfusion services/blood banks to remove red blood cells and plasma from marrow and peripheral blood stem cells products. The success of cellular cancer immunotherapies such as Chimeric Antigen Receptor (CAR) T-cells has increased the importance of cell processing laboratories. Since many of the diseases successfully treated by CAR T-cell therapy are also treated by HSC transplantation and since HSC transplantation teams are well suited to manage patients treated with CAR T-cells, many cell processing laboratories have begun to produce CAR T-cells. The methods that have been used to process HSCs have been modified for T-cell enrichment, culture, stimulation, transduction and expansion for CAR T-cell production. While processing laboratories are well suited to manufacture CAR T-cells and other cellular therapies, producing these therapies is challenging. The manufacture of cellular therapies requires specialized facilities which are costly to build and maintain. The supplies and reagents, especially vectors, can also be expensive. Finally, highly skilled staff are required. The use of automated equipment for cell production may reduce labor requirements and the cost of facilities. The steps used to produce CAR T-cells are reviewed, as well as various strategies for establishing a laboratory to manufacture these cells.

Stem cells out of the bag: characterization of ex vivo expanded mesenchymal stromal cells for possible clinical use.

Aim:Mesenchymal stromal cells (MSC) are a promising tool for cellular therapy and regenerative medicine. One major difficulty in establishing a MSC expansion protocol is the large volume of bone marrow (BM) required. We studied whether cells trapped within a collection bag and filter system could be considered as a source of MSC.Results:From the 20 BM collection bag and filter systems, we recovered an average of 1.68 × 108 mononuclear cells, which is the equivalent to 60 ml of filtered BM. Mononuclear cells were expanded ex vivo to 17 × 106 MSC, with purity shown by a CD44+, CD105+, CD90+ and CD73+ immunophenotype, a reduction of 20% proliferating cells in a mixed lymphocyte reaction and also the ability of adipocyte differentiation.Conclusion:Long-term MSC cultures were established from the usually discarded BM collection bag and filter, maintaining an appropriate phenotype and function, being suitable for both investigation and clinical settings.

Development of a novel bioreactor platform for CAR T-Cells expansion

Background & Aim Chimeric Antigen Receptor (CAR) T-cell immunotherapies have successfully demonstrated a new therapeutic approach to combat serious life-threatening diseases, culminating with the approval of Yescarta® (Gilead) and Kymriah® (Novartis) by FDA and EMA. But while the clinical success of these products has been remarkable, the need for a consistent and cost effective manufacturing process still needs to be assessed. At present, T-cell manufacturing and production capabilities are greatly lagging and will not be able to meet the predicted surge in demand unless new technologies and processes are developed. These processes need to be highly regulated, and consistently achieve high yield and good cells quality. A number of systems have been used for CAR-T cell expansion (e.g. static and rocking bag systems). These technologies have many advantages, but they generally lack in scalability, suffer from manufacturing bottlenecks or low automation. Our group demonstrated that it is possible to grow T-cells in a stirred tank, without affecting cell growth or quality. However, the development of a novel platform, specifically designed for cell and gene therapies, enables us to address limitations of existing platforms. Methods, Results & Conclusion The focus of this work is to design and develop a novel bioreactor platform that is both closed and automated, and suitable for the production of adherent and suspension cells for cell and gene therapy applications. We have analyzed the cell growth kinetics in the platform and have compared it with existing systems. The process is tightly controlled via an online monitoring and control system which measures metabolites, dissolved oxygen and pH, with the possibility of automated culture volume expansion. T-Cells from healthy donors were expanded in different bioreactors (stirred tanks, bags, static gas permeable bags, gas permeable membrane flasks) for 7 days in batch or fed-batch conditions. To ensure the systems could be appropriately compared, the dissolved oxygen concentration, titer and spent medium was used as the basis for comparison. The results show the performance of the examined system in terms of cell growth and fold expansion is comparable with the other bioreactors. The quality of the final product (with respect to cell viability, phenotype and differentiation) was also determined by flow cytometry analysis. This work presents the initial assessment of the platform and the data will be used to optimize the design of the bioreactor system.

Obituary: Ruby Nelly Irene Pietersz (1942–2018)

Ruby Pietersz, MD, PhD, passed away on 1 March 2018 at the age of 75. Her legacy: whole-blood separation into components by the buffy coat method, applicable as a routine procedure, currently used in many blood centres around the world. Ruby was born in 1942 in Malang, Dutch East Indies (now, Indonesia). Between 1944 and 1945, she was, with her mother, interned in a camp in Malang during the Japanese occupation. Ruby and her family moved to The Netherlands in 1952. She was trained as a laboratory technician, worked in a hospital in Zwolle and subsequently moved to Amsterdam in 1966 to work at the laboratory of haematology and blood transfusion of the Free University of Amsterdam. In 1967, she started studying medicine, mainly in the evening times, and became a medical doctor in 1977. Next, she became a specialist in internal medicine in 1982 and joined the Red Cross Blood Bank in Amsterdam. In that time, Hans Loos and Peter Prins, chemical engineers of the Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, had preliminary results to separate whole blood in red cells, plasma and a buffy coat, containing 90% of the platelets and 70% of the white cells. From these buffy coats, platelet concentrates could be made. As part of her thesis, Ruby developed a validated method to produce leucocyte-poor platelet concentrates from five buffy coats, which could be stored for 7 days at room temperature. This method is now used in routine all over the world in many blood transfusion centres and blood banks and has increased the provision of platelet concentrates for patients enormously. Ruby further optimized the production of red cell and platelet concentrates by integrating leucocyte-removing filters in blood bag systems. Another very important development, initiated by Ruby, was the standardized cooling of whole blood from body temperature to room temperature, and subsequent overnight storage of whole blood at ambient temperature. This facilitated the uniform separation of whole blood that was collected in the afternoon and evening, during business hours the next morning, which was an enormous logistic improvement. Overnight hold also reduced the risk of bacterial contamination. With spiking experiments, Ruby proved that a 16- to 20-h hold of whole blood at room temperature, in combination with subsequent removal of the buffy coat and the remaining white cells by filtration, could abrogate the risk of contamination with Yersinia enterocolitica. The buffy coat method in combination with overnight room temperature storage of whole blood quickly found acceptance all over the world. Ruby was particularly proud that Canadian Blood Services in Canada moved to the buffy coat method after 2006. Her research continued after Blood Bank Amsterdam became part of the national Sanquin Blood Supply organization in 1998, when she became manager of Research, Development and Education. She found great enjoyment in sharing her knowledge. She travelled to many countries to assist blood processing facilities to implement the buffy coat method. She received numerous visitors from other blood centres all over the world to learn how the buffy coat procedure worked in routine conditions. She set up national training courses for blood bank staff which still continue to this day, and trained many physicians, including haematologists and transfusion specialists. Her work was her life fulfilment. However, Dutch laws are strict and she had to retire at the age of 65 in 2007. She found new enjoyment in having more time to care for her family and friends. After her retirement, she did continue to travel abroad to help blood banks to set up their procedures. In 2014, she had an important role in the European IPA project to strengthen the Blood Transfusion Organization in the former Republic of Macedonia. Her last publication [Pietersz et al., Int J Clin Transfus Med 2016;3:55] can be regarded as her testament; Good Manufacturing Procedures, SOPs, training, validation, and traceability all were regarded extremely important by Ruby. When she retired, she was knighted as Officer in the Order of Orange-Nassau for her many achievements for society. She was an honorary member of the Dutch Transfusion Society, and of the BEST Collaborative, of which she was a founding member. Early January 2018, we were informed that she had an incurable kidney tumour. Ruby had the following motto in her PhD thesis: ‘People without friends are poor. I did not know I was so rich’. Ruby wanted this motto to be used on her mourning card, to reflect the warmth of true friendships that she had had in her life. She will be missed by her family, friends and colleagues around the world, especially for the kind person that she was.

Media photo-degradation in pharmaceutical biotechnology - impact of ambient light on media quality, cell physiology, and IgG production in CHO cultures.

BACKGROUNDMany vital components in bioprocess media are prone to photo‐conversion or photo‐degradation upon exposure to ambient light, with severe negative consequences for biomass yield and overall productivity. However, there is only limited awareness of light irradiation as a potential risk factor when working in transparent glass bioreactors, storage vessels or disposable bag systems. The chemical complexity of most media renders a root‐cause analysis difficult. This study investigated in a novel, holistic approach how light‐induced changes in media composition relate to alterations in radical burden, cell physiology, morphology, and product formation in industrial Chinese hamster ovary (CHO) bioprocesses.RESULTSTwo media formulations from proprietary and commercial sources were tested in a pre‐hoc light exposure scenario prior to cultivation. Using fluorescence excitation/emission (EEM) matrix spectroscopy, a photo‐sensitization of riboflavin was identified as a likely cause for drastically decreased IgG titers (up to −80%) and specific growth rates (−50% to −90%). Up to three‐fold higher radical levels were observed in photo‐degraded medium. On the biological side, this resulted in significant changes in cell morphology and aberrations in the normal IgG biosynthesis/secretion pathway.CONCLUSIONThese findings clearly illustrate the underrated impact of room light after only short periods of exposure, occurring accidentally or knowingly during bioprocess development and scale‐ up. The detrimental effects, which may share a common mechanistic cause at the molecular level, correlate well with changes in spectroscopic properties. This offers new perspectives for online monitoring concepts, and improved detectability of such effects in future. © 2018 The Authors. Journal of Chemical Technology & Biotechnology published by JohnWiley & Sons Ltd on behalf of Society of Chemical Industry.

A randomized controlled trial of one bag vs. two bag system of fluid delivery in children with diabetic ketoacidosis: Experience from a developing country

PurposeTo compare one vs. two bag system with respect to blood glucose variability (BGV), time for resolution of acidosis and incidence of hypoglycemia, hypokalemia, and cerebral edema in children with diabetic ketoacidosis (DKA). Material and methodsIn an open labelled randomized controlled trial, thirty consecutive patients ≤12years with DKA were randomized to either one (n=15) or two bag (n=15) system of intravenous fluid delivery. The two bags had similar electrolyte but differing dextrose concentration (none vs. 12.5%) and changing the rate of fluid, delivered different dextrose concentrations. BGV was primary outcome while hypoglycemia (blood glucose, BG<50mg/dL), hypokalemia (serum potassium<3.5mEq/L), time to resolution of acidosis and cerebral edema were secondary outcomes. ResultsThe one and two bag systems had similar BGV parameters; median hourly absolute BG change (mg/dL) [44 (30–74.5) vs. 36 (31–49); p=0.54], mean of standard deviation of BG measurements [65.1 (25.1) vs. 65.5 (26.8); p=0.96] and median number of undesirable events (hourly blood sugar change ≥50mg/dL) [4.5 (1.75–6.0) vs. 5.0 (3.0–8.0); p=0.31]. The incidence of hypoglycemia [42.9% (n=6) vs. 26.7% (n=4); p=0.45] and hypokalemia [64% (n=9) vs. 67% (n=10); p=0.23], and mean (SD) time to resolution of acidosis [20.3 (14.8) and 20.3 (7.0); p=0.59] were similar in both the groups. None had cerebral edema. ConclusionsThe one and two bag systems were similar to each other with respect to BGV, incidence of complications and time to resolution of acidosis.

MEASURING THE EFFECT OF THE SOLID WASTE EDUCATION FOR SUSTAINABILITY AT ELEMENTARY SCHOOLS IN DA NANG CITY, VIETNAM

Environmental education provides people with knowledge about the biophysical environment and its associated problems. Environmental education of children (ages 6-12) can be used as key inputs to increase environmentally friendly activities associated with solid waste treatment in Vietnam, as it is not systematically done in the country. This study aims to measure the effects of environmental education, which consist of knowledge of environmental problems due to improper treatment of waste as well as the benefits of recycling at two elementary schools in Da Nang city, Vietnam.In March 2015 three hundred and ten 5th grade students were randomly separated into 2 treatment groups. Group 1 had an activity with a game and group 2 had an activity without. Afterwards students could participate in (1) a garbage separation game, (2) a seminar to learn about the present status of eco-bag systems and voluntary food residue recycling in Da Nang city, and (3) a questionnaire survey to assess the impacts of the environmental education. The results showed that students had limited knowledge about the characteristics of eco–bag (29%) and plastic bag (55%). After environmental education activities, students’ correct answers increased as: eco–bag (87%), plastic bag (71%), food waste (93%), and food waste recycling systems (87%). However, there was no difference in results from the questionnaire between the 2 treatment groups.Based on the results, an environmental education program should be developed in the schools to improve the future of solid waste management in Vietnam.

Potential Clinical Benefits of a Two-bag System for Fluid Management in Pediatric Intensive Care Unit Patients with Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM) that requires appropriate treatment with insulin and intravenous fluids. Both one-bag and two-bag systems of fluid management are used to treat pediatric diabetic ketoacidosis. We compare the one-bag and two-bag systems of fluid managementwith regard to incidence of hypoglycemia, serum bicarbonate correction, pH correction and discharge from the pediatric intensive care unit (PICU). This was a retrospective study of 61 patients less than 21 years old admitted to the PICU with a diagnosis of DKA. Of the 61 patients, 38 were treated with the one-bag system and 23 treated with the two-bag system. The two-bag system had significantly (p=0.03) lower incidence of hypoglycemia (n=2, 8.7%) compared to the one-bag system (n=13, 34.2%). The two-bag system had significantly (p=0.001) fewer hours of PICU stay (M=29.6, SD=15.23) than the one-bag system (M=47.9, SD=22.32). However, there were no significant differences between the bag systems for hours for pH and bicarbonate correction. The two-bag system is associated with lower incidence of hypoglycemia and faster discharge from the PICU. We recommend that clinicians consider using the two-bag system for fluid management in pediatric patients with diabetic ketoacidosis.

A study on parenteral nutrition regimens in surgical and traumatological profile patients using all-in-one 3-compartment bag systems

Total Parenteral Nutrition (TPN) can be administered using individual containers or "all in one" type, commercial bags or multi bottle solutions prepared in the hospital drug-store. The aim of this work is to study the clinical efficiency and safety of surgical and traumatologic profile patients in Intensive Care Units (ICU) using all-in-one 3 compartment bag systems (TNA-peri). Fifteen adults with hypercatabolism syndrome of various genesis taking treatment in the surgical resuscitation department were included in this study and followed for four months (Nov 2013 to Feb 2014). In the course of study, depending upon the main pathology and performed surgical procedure, all the patients were divided into 2 groups. The first group patients (T-group) were given TNA-peri, 1 vial 2 times per day and the second group patients (K-group) were given standard multi-bottle systems containing amino acids solutions, glucose solutions, fat emulsions and micronutrients: vitamins, microelements, electrolytes in the volume estimated pursuant to the physiological needs. It is observed that the T-group receiving TNA-Peri, had more efficient recovery of hemoglobin and whole protein level with less duration of respiratory support, period of stay in ICU and frequency of suppurative septic complications compared to the K-group patients. This study shows that all-in-one, 3 component bags to be the system of choice to increase the clinical efficiency in surgical and traumatologic profile patients. Keywords: Parenteral nutrition, TPN, intravenous, resuscitation and intensive care of traumatic patients, resuscitation and intensive care of surgical patients, clinical efficiency