Donor Groups Research Articles

Diversity and Antibiotic Susceptibility of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae from the Urine of Human Population Using Bacteria-Contaminated Water in Butembo Urban Area (DR Congo, Central Africa)

Aims: This study aims to investigate the extended-spectrum beta-lactamases (ESBLs)-producing Enterobacteriaceae in the human urine samples and to understand the potential influence of the contaminated water the urine donors use. Study Design and Methodology: One hundred urine samples from females and the same number from males were collected from donors of different age groups and analysed. One hundred urine samples from females and the same number from males were collected from donors of different age groups. The enterobacterial isolation was done on CLED agar medium. Their identification was carried out first by the enzymatic technic, then using MALDI–TOF MS method. ESBLs-producing enterobacteria were identified by searching the synergy between Clavulanic acid and 3rd generation Cephalosporins. The antimicrobial susceptibility tests were carried out using the disk diffusion method. Results: In male urine samples, the identified ESBLs-producing strains belong to E. coli, E. agglomerans and K. pneumoniae. They were in 11 samples: 3 from donors aged 20 years or less, 3 also from those aged 21 to 40 years as well as in those aged 41 to 60 years, and 2 in samples from donors aged over than 60 years. In female urine samples, the identified ESBLs-producing strains belong to Escherichia coli, Enterobacter agglomerans, Yersinia frederiksenii, Salmonella typhi and Klebsiella pneumoniae. They were in 27 samples: 3 from donors aged 20 years or less, 9 from those aged 21 to 40 years, 12 from those aged 41 to 60 years, and 3 from donors aged over than 60 years. All the strains were sensitive to Imipenem and resistant to Cefotaxim, Ceftazidin, Amoxicillin+Clavulanic acid and Nitrofurantoin. The Multi-Antibiotic Resistance (MAR) index varied from 0.416 (E. coli strains, youngest male donors) to 0.916 (E. coli strains, old female donors). Most of strains react differently from one antibiotic to another (P<0.05), with the exception of E. coli strains from most samples. Most of the identified ESBLs-producing species have been reported in surface and groundwater the population use. These water resources could play a role in the human urinary tract infections. Conclusion: There is a serious health problem with great MAR indices for all bacterial species identified. Treating water before use could reduce the viability and spreading of ESBLs-producing bacteria and genes into the population.

Boosted electro-optic performance in second-order nonlinear optical chromophores featuring thiophen-2-amine-derived donor groups

Two innovative second-order nonlinear optical chromophores, designated as B–C, have been synthesized, featuring thiophene-derived donors and a tricyanovinyldihydrofuran bridge as acceptors. These chromophores have undergone comprehensive characterization. Notably, the donor components of chromophores B–C were (methyl(phenyl)amino)thiophene and (4-methoxyphenylamino)thiophene, respectively, in contrast to the diethylamino phenyl unit present in chromophore A. Density functional theory calculations suggested that the first hyperpolarizability of chromophore C, with a (methoxyphenyl amino) thiophene donor, was approximately 60 % higher than that of chromophores A and B. This indicates that merely substituting the benzene ring with thiophene does not significantly enhance the electron-donating ability of the donor. Polymeric thin films doped with 25 wt% of chromophores A-C exhibited r33 values of 39 p.m./V, 46 p.m./V, and 76 p.m./V, respectively. The electro-optic coefficients of chromophores B and C were 18 % and 95 % higher than that of chromophore A, respectively. These findings confirm that thiophene-derived donors, particularly those with multiple heteroatoms, can effectively enhance the electro-optical coefficient of chromophores.

Colonization of microbiota derived from Macaca fascicularis, Bama miniature pigs, beagle dogs, and C57BL/6J mice alleviates DSS-induced colitis in germ-free mice.

Fecal microbiota transplantation (FMT) is an innovative and promising treatment for inflammatory bowel disease (IBD), which is related to the capability of FMT to supply functional microorganisms to improve recipient gut health. Numerous studies have highlighted considerable variability in the efficacy of FMT interventions for IBD. Several factors, including the composition of the donor microorganisms, significantly affect the efficacy of FMT in the treatment of IBD. Consequently, identifying the functional microorganisms in the donor is crucial for enhancing the efficacy of FMT. To explore potential common anti-inflammatory bacteria with therapeutic implications for IBD, germ-free (GF) BALB/c mice were pre-colonized with fecal microbiota obtained from diverse donors, including Macaca fascicularis (MCC_FMT), Bama miniature pigs (BP_FMT), beagle dogs (BD_FMT), and C57BL/6 J mice (Mice_FMT). Subsequently, mice were treated with dextran sodium sulfate (DSS). As expected, the symptoms of colitis were alleviated by MCC_FMT, BP_FMT, BD_FMT, and Mice_FMT, as demonstrated by the prevention of an elevated disease activity index in mice. Additionally, the utilization of distinct donors protected the intestinal barrier and contributed to the regulation of cytokine homeostasis. Metagenomic sequencing data showed that the microbial community structure and dominant species were significantly different among the four groups, which may be linked to variations in the anti-inflammatory efficacy observed in the respective groups. Notably, Lactobacillus reuteri and Flavonifractor plautii were consistently present in all four groups. L. reuteri exhibited a significant negative correlation with IL-1β, and animal studies further confirmed its efficacy in alleviating IBD, suggesting the presence of common functional bacteria across different donors that exert anti-inflammatory effects. This study provides essential foundational data for the potential clinical applications of FMT.IMPORTANCEDespite variations in efficacy observed among donors, numerous studies have underscored the potential of fecal microbiota transplantation (FMT) for managing inflammatory bowel disease (IBD), indicating the presence of shared anti-IBD bacterial species. In the present study, the collective anti-inflammatory efficacy observed across all four donor groups prompted the identification of two common bacterial species using metagenomics. A significant negative correlation between Lactobacillus reuteri and IL-1β was revealed. Furthermore, mice gavaged with L. reuteri successfully managed the colitis challenge induced by dextran sodium sulfate (DSS), suggesting that L. reuteri may act as an efficacious bacterium mediating shared anti-inflammatory effects among variable donors. This finding highlights the utilization of variable donors to screen FMT core bacteria, which may be a novel strategy for developing FMT applications.

Multivariable linear model for predicting graft weight based on 3-dimensional volumetry in regards to body weight change of living liver donor: an observational cohort study.

The purpose of this study is to build a prediction model for estimating graft weight about different graft volumetry methods combined with other variables. Donors who underwent living-donor right hepatectomy from March 2021 to March 2023 were included. Estimated graft volume measured by conventional method and 3-dimensional (3D) software were collected as well as the actual graft weight. Linear regression was used to build a prediction model. Donor groups were divided according to the 3D volumetry of <700 cm3, 700-899 cm3, and ≥900 cm3 to compare the performance of different models. A total of 119 donors were included. Conventional volumetry showed R2 of 0.656 (P < 0.001) while 3D software showed R2 of 0.776 (P < 0.001). The R2 of the multivariable model was 0.842 (P < 0.001) including for 3D volume (β = 0.623, P < 0.001), body mass index (β = 7.648, P < 0.001), and amount of weight loss (β = -7.252, P < 0.001). The median errors between different models and actual graft weight did not differ in donor groups (<700 and 700-899 cm3), while the median error of univariable linear model using 3D software (122.5; interquartile range [IQR], 61.5-179.8) was significantly higher than multivariable-adjusted linear model (41.5; IQR, 24.8-69.8; P = 0.003) in donors with estimated graft weight ≥900 cm3. The univariable 3D volumetry model showed an acceptable outcome for donors with an estimated graft volume <900 cm3. For donors with an estimated graft volume ≥900 cm3, the multivariable-adjusted linear model showed higher accuracy.

The Causes of Platelet Aggregation in Version 6.4 Trima Accel Automated Blood Collection System and the Comparison of Two Intervention Measures

To explore the causes of platelet aggregation in version 6.4 Trima Accel automated blood collection system and the effect of 2 intervention measures. The data on platelet aggregation (n=61) and non-aggregation (n=323) of 61 donors in 2020 were collected and the causes of aggregation were analyzed. Then the 72 donors with platelet aggregation in 2021 were randomized into intervention group A (increasing the anticoagulant-to-blood ratio) and intervention group B (wrapping the donor's arm with an electric blanket to keep warm and improve the blood flow speed). The collection time, average blood flow speed, number of machine alarms, anticoagulant usage, deaggregation and citrate reaction of the two groups were compared. Platelet aggregation was negatively correlated with the average blood flow speed (r =-0.394) and positively correlated with the collection time (r =0.458). The equations for predicting aggregation and non-aggregation were constructed based on Bayesian and Fisher discriminant analysis, and the predicted accuracy was 77.1%. The comparison of the effects of two intervention measures showed that the average blood flow speed in group B was higher than that in group A; the collection time, number of machine alarms, anticoagulant usage and proportion of citrate reaction in blood donors in group B were all lower than those in Group A, all these differences were significant (P < 0.05). In the entire cohort in 2021, 90.28% of the products were immediately deaggregated after collection, and 9.72% of the products were deaggregated within 4 hours. There was no statistically significant difference in deaggregation between the two intervention groups (P >0.05). During apheresis platelet collection, the predictive equations for aggregation and non-aggregation can be used to predict the occurrence probability of aggregation, and the intervention can be made in advance. Both intervention measures are effective in reducing platelet aggregation, however, measure B has the advantages of improving the speed of blood collection, shortening the collection time, reducing the alarm frequency and the anticoagulant usage, and reducing the incidence of citrate reaction in blood donors.

The application of real-time indocyanine green fluorescence cholangiography in laparoscopic living donor left lateral sectionectomy.

The judgment of the division point of the bile duct has always been one of the difficulties of laparoscopic left lateral sectionectomy (LLLS). The purpose of this study was to assess the effects of indocyanine green (ICG) fluorescence cholangiography during LLLS on the occurrence of biliary complications in both donors and recipients. The optimal dose and injection time of ICG were also investigated. This is a retrospective cohort study. From October 2016 to December 2022, the clinical data of 103 donors who underwent LLLS and relevant recipients were retrospectively analyzed. According to whether ICG fluorescence cholangiography was used, they were divided into a non-ICG group (n=46) and an ICG group (n=57). Biliary complications were observed and the optimal dose and injection time of ICG were explored. Three donors in the non-ICG group suffered from bile leakage. Four grafts had multiple bile duct openings and biliary complications were observed in the relevant recipients who received these grafts in the non-ICG group. Two recipients had bile leakage, and the other two had biliary stenosis. There was no biliary complications both in donors and recipients in the ICG group. The fluorescence intensity of the liver was 108.1±17.6 at a dose of 0.004 mg/kg 90 minutes after injection, significantly weaker than that at 0.05 mg/kg 30 minutes (200.3±17.6, P=0.001) and 90 minutes after injection (140.2±15.4, P=0.001). The fluorescence intensity contrast value at a dose of 0.004 mg/kg was stronger than that at 0.05 mg/kg, both measured 90 minutes after injection (0.098±0.032 vs. 0.078±0.022, P=0.021). ICG fluorescence cholangiography is safe and feasible in LLLS. It reduces biliary complications in both donors and recipients. The optimal ICG dose was 0.004 mg/kg, and 90 minutes after injection was the best observation time. ICG fluorescence cholangiography is recommended for routine use in LLLS.

Extended Criteria Donor Use in Lung Transplants From Donation After Controlled Circulatory Death

BackgroundMost institutions apply the criteria for controlled donation after cardiac death (cDCD) lung retrieval identical to the criteria for donation after brain death (DBD). The availability of extended criteria donor (ECD) in lung transplants from cDCD remains unclear. MethodsThe United Network for Organ Sharing (UNOS) database was queried for adult lung transplants from cDCD, from May 03, 2005, to March 15, 2022. ECDs were defined by one or more items at variance from standard criteria: age 55 years or more, PaO2:FiO2 300 or less, smoking 20 pack-years or more, diabetes, or purulent secretions upon bronchoscopy. Recipients were divided into the standard criteria donor (SCD) group and the ECD group, and assessed for short- and long-term survival and postoperative events. ResultsAmong 827 records, the SCD and ECD group showed no differences in 5-year (P = .56) survival. No significant differences were found in 30-day, 90-day, 1-year mortality and postoperative outcomes before discharge, whether in length of hospital stay, rate of ventilator support for >48 hours or reintubation, incidence of grade 3 PGD 72 hours posttransplant, acute rejection, or dialysis. None of the 5 donor factors used as criteria for lung retrieval was independently associated with cDCD recipient survival. ConclusionsUsing donor lungs that extend the DBD criteria may be a safe strategy in cDCD lung transplantation. However, the current criteria may not be a perfect fit for cDCD lung retrieval. The specific DCD criteria for standard lung retrieval need to be determined.

Differing Effects of Nonlinearity around the Proton Acceptor on CH··O and NH··O H-Bond Strength within Proteins.

The effects of deviations from nonlinearity around the carbonyl proton acceptor of an amide group are assessed by DFT quantum chemical calculations for both CH··O and NH··O H-bonds. The proton donors are the imidazole functional group of His and the indole of Trp, which are paired respectively with N-methylacetamide and acetamide. The displacement of either CH or NH group toward the carbonyl O sp2 lone pairs stabilizes the system and strengthens the H-bond. But the two donor groups differ in their response to a shift out of the amide plane. While the NH··O H-bond is weakened by this displacement, a substantial strengthening is observed when the CH donor is moved out of this plane, in one direction versus the other. This pattern is explained on the basis of simple Coulombic considerations.

Functionalization of a [2]Catenane with Donor-Acceptor Chromophores Using a Metal Template and Click Reactions.

Synthesizing molecules with significant topological features, such as catenanes, tailored with specific groups to confer desired functionality, is essential for investigating various properties arising from the entanglement due to mechanical bonds. This investigation can pave the way for uncovering novel functional materials employing mechanically interlocked molecules (MIMs). In this direction, we have synthesized a π-donor (D) and π-acceptor (A) functionalized [2]catenane using a non-labile Co(III) metal ion as a template with pyridine-diamide templating center and utilizing click reaction for ring-closing. The donor group is a fluorene derivative, and the acceptor is a benzophenazine derivative, commonly employed in synthesizing conjugated polymers for various optoelectronic devices. Synthetically, the acceptor group was introduced into a macrocycle with a pyridine diamide unit. It was then threaded with a ligand having alkyne terminals to obtain the desired [2]pseudorotaxane utilizing cobalt ion as a template. Ring-closing was then performed with a di-azide functionalized molecule with the donor chromophore. The desired D-A functionalized [2]catenane was obtained after demetalation. All the starting materials, macrocycle, and entangled structures have been characterized by 1H-NMR, 13C-NMR, and mass spectroscopy. Some of these materials were also characterized by single-crystal X-ray analysis. The photophysical properties are studied by UV-visible and fluorescence spectroscopy.

Assessing the Impact of Amide Donor Groups on Stability and NMR Relaxation Efficiency of Monohydrated Fe(III) Complexes

Assessing the Impact of Amide Donor Groups on Stability and NMR Relaxation Efficiency of Monohydrated Fe(III) Complexes

Subcellular one carbon metabolism in cancer, aging and epigenetics.

The crosstalk between metabolism and epigenetics is an emerging field that is gaining importance in different areas such as cancer and aging, where changes in metabolism significantly impacts the cellular epigenome, in turn dictating changes in chromatin as an adaptive mechanism to bring back metabolic homeostasis. A key metabolic pathway influencing an organism's epigenetic state is one-carbon metabolism (OCM), which includes the folate and methionine cycles. Together, these cycles generate S-adenosylmethionine (SAM), the universal methyl donor essential for DNA and histone methylation. SAM serves as the sole methyl group donor for DNA and histone methyltransferases, making it a crucial metabolite for chromatin modifications. In this review, we will discuss how SAM and its byproduct, S-adenosylhomocysteine (SAH), along with the enzymes and cofactors involved in OCM, may function in the different cellular compartments, particularly in the nucleus, to directly regulate the epigenome in aging and cancer.

The avidity of virus-specific antibodies obtained from &lt;i&gt;in vitro&lt;/i&gt; stimulated memory b cells does not change one month after booster with Sputnik V or Comirnaty

The protective properties of long-term immunological memory after vaccination against COVID-19 are characterized by the neutralizing activity of serum antibodies and antibodies secreted by memory B cells upon repeated encounter with the antigen. Somatic hypermutations occurring in the immunoglobulin genes of memory B cells are one of the mechanisms for increasing the affinity of antibodies. At the moment, the effect of booster vaccination against COVID-19 with vector vaccines, on the maturation of memory B cells remains poorly understood. The purpose of this work was to determine how COVID-19 booster affects the affinity of RBD-specific IgG antibodies secreted by memory B cells. B lymphocytes were isolated from peripheral mononuclear blood cells of volunteers who had been revaccinated against COVID-19 with Sputnik V or Comirnaty. B cells were stimulated in vitro with CD40L expressed on the surface of A549 feeder cells and IL-21. Supernatants were concentrated 8-fold using centrifugal concentrators. In the obtained supernatants from stimulated memory B cells, the level of IgG antibodies specific to wild-type RBD was determined by enzyme-linked immunosorbent assay (ELISA). To determine the avidity index, ELISA with 7M urea was provided. It was shown that despite a general increase in the amount of antigen-specific IgG antibodies obtained from stimulated memory B cells, there was no change in the avidity of these antibodies one month after booster in both groups of donors. The obtained results contribute to the understanding of the mechanisms of memory B cell maturation after booster vaccinations against COVID-19 and may be useful for deciding on the strategy of booster vaccination.

ACKR1 gene polymorphisms in Bombay blood group (Oh) individuals of Indian origin

BackgroundACKR1 blood group genes exhibit a high degree of polymorphisms with varying allele distribution seen among different populations and ethnic groups. The study aimed to genotype ACKR1 antigens and to establish FY allele frequency among the individuals with the Bombay (Oh) blood group phenotype. Materials and methodsACKR1 phenotype and genotype frequencies were estimated on 160 individuals typed as Oh and were compared with 100 non-oh blood donors from Mumbai, India by molecularly genotyping via PCR-RFLP. ResultsThe allelic and genotypic frequency of T(−67)C polymorphism showed the dominance of T allele and TT genotype [OR= 3.26 (0.59–17.99)] in both the study groups. The ACKR1 null (Fya-b-) phenotype was not found in the tested group. While the genotypic combination among the Oh group individuals was FYA/FYB (45.3 %), FYA/FYA (42.7 %), and FYB/FYB (12 %), in the non-Oh group donors, it was observed as FYA/FYB (53.3 %), FYA/FYA (39.1 %), and FYB/FYB (7.6 %).The haplotype TGGGC occurred in 38.4 % of the Oh group, but in non-Oh donors, it was found to be 50.9 % [OR = 1.820 (1.196–2.771)], and the difference was statistically significant (p = 0.005). Similarly, the TGGGT haplotype was found at a frequency of 12.7 % in non-Oh donors and 27.1 % in Oh group [OR= 0.411 (0.234–0.722)] (p = 0.001). ConclusionsThis study shows the prevalence of ACKR1 gene polymorphisms, including weak ACKR1 antigens in Oh individuals with a high frequency of haplotype TGGGC. The present study demonstrated for the first time the genotypes FyBweak, FyAweak and Fy Aweak/FyBESon RBC membranes in Indian subjects with Oh phenotype.

Effects of structural subtleties on the electrochemical potentials of fluorescent amino-terephthalonitriles

The present work focuses on investigation of the electrochemical properties of amino terephthalonitrile based single benzene fluorophores (Am-TN-SBFs) and correlating them with their highly emissive characteristics. We already know that the emissive properties of the Am-TN-SBFs could be modulated by altering the position and geometries of the donor and acceptor groups. In order to understand whether the electrochemical properties of these Am-TN-SBFs could also be tuned in the similar manner, redox properties were studied which remained largely unexplored till date. We were able to successfully identify the key structural characteristics responsible for inducing fluorescence in these molecules, while also facilitating the generation of appealingly low electrochemical potentials. We synthesized few benzomorpholino-based SBFs, which proved to be highly emissive and demonstrated remarkably low quasi-reversible oxidation potential. These molecules hold potential for constructing devices tailored for future electroluminescence-based applications.

A Type of Stable Amides Behaves as Acyl Transfer Reagents upon Visible-Light Irradiation through Self-Aromatization.

Organic molecules with light-modifiable reactivity are important in many fields because they can serve as the "switch" for light to trigger chemical processes. Herein, we disclose a new type of stable non-twisted amides, the reactivity of which can be turned on by light as acyl transfer reagents. Upon photo-activation, these amides react with various nucleophiles including amines, phenols, hydroxide, thiols, boronic acids, and alkynes either under metal-free or metal-catalysis conditions. This reactivity hinges on the design and synthesis of a photo-activatable reagent (7-nitro-5,6-dihydrophenanthridine), which undergoes self-aromatization enabled by an internal oxidant under light. This masked acyl donor group is anticipated to be useful in scenarios where light is preferred to trigger a chemical process.

Smart design of highly luminescent octupolar mesogenic tetra styryl-alkynyl bipyrimidine-based chromophores presenting non-linear optical properties

The research investigations reported in this paper focuses on the influence of rational design on the photophysical properties of new all-organic multifunctional chromophores. Nonlinear optical (NLO) behavior, optical properties and mesogenicity of several new π-conjugated octupolar chromophores, presenting alkoxy styryl-alkynyl donor groups carrying aliphatic achiral and chiral chains in the 3,4/3,5/2,4 position, connected to electron-accepting 2,2-bipyrimidine cores are investigated by various techniques (light-transmission measurements, polarized-light optical microscopy, differential scanning calorimetry measurements, two-photon excited fluorescence and Hyper Rayleigh Scattering). The mesogenic properties were investigated depending on the position of the alkoxy chain and the 3,4 derivatives were found to exhibit liquid-crystal properties with the formation columnar phases over large temperature ranges which were confirmed by small-angle X-ray scattering analysis. All the molecules exhibit exceptional high fluorescence quantum yields values around 80 % and excellent nonlinear optical properties.

Introduction of Electron Donor Groups into the Azulene Structure: The Appearance of Intense Absorption and Emission in the Visible Region.

In this work, through the Suzuki-Miyaura cross-coupling reaction with high yields, new π-conjugated azulene compounds containing diphenylaniline groups at positions 2 and 6 of azulene were synthesized. The obtained diphenylaniline-azulenes have intensely visible-light absorbing and emitting (in the wavelength range from 400 to 600 nm) properties. It has been shown that such unique optical properties, in particular fluorescent emission in the region of blue and green photoluminescence (λem at 495 and 525 nm), which were absent in the original azulene, are the result of the electron donor effect of diphenylaniline groups, which significantly changes the electronic structure of azulene and leads to the allowed HOMO → LUMO electron transition.

Impact of the chemical insertion of the dimethylamino group on the electronic and optical properties of the 4-(methoxyphenyl acetonitrile) monomer (MPA): a DFT theoretical investigation.

Density functional theory (DFT) calculations on the ground and the first excited state are performed on the modified and unmodified 4-(methoxyphenyl acetonitrile) monomer (referred to as MPA). The modified monomer named MFA is obtained by Knoevenagel condensation of MPA with dimethylformamide dimethyl acetal (DMF-DMA). DFT computations show that the chemical grafting of the dimethylamino group onto the MPA unit induces a great change in the geometric, electronic, and optical properties. Going from MPA to MFA monomer, a great change in the frontier orbitals of the highest occupied molecular orbital (HOMO) and the lowest unoccupied molecular orbital (LUMO) in the ground and the first excited state is observed. Consequently, a reduction in the energy gap HOMO-LUMO and an enhancement in the absorption and emission properties are observed under the chemical modification. The observed modifications in the electronics and optical properties are the result of the charge transfer appearing between the cyano (C≡N) acceptor group and the dimethylamino (DMF-DMA)-grafted group donor ring. Quantum chemical calculations were performed in the ground and the first excited state using the density functional theory (DFT), and it extends the time-dependent density functional theory (TD-DFT), implemented in the Gaussian 09 software package. The ground state is obtained by optimization of the studied molecular geometries by employing the DFT/M062X/6-31G(d,p) level of theory. The first excited state is obtained by re-optimization of the ground state geometries using the TD-DFT/M062X/6-31G(d,p) level of theory. The contour plots of the frontier orbitals and the molecular electrostatic potential (MEP) maps are obtained from the ground and the first excited state, optimized geometries, and drawn using Gaussview software.

Effectiveness and satisfaction with virtual and donor dissections: A randomized controlled trial

In recent years, human anatomy education has faced challenges with traditional donor dissection, leading to the emergence of virtual dissection as an alternative. This study aims to investigate the academic performance and satisfaction of medical students by comparing the virtual and donor dissections. An open-labeled crossover randomized controlled trial was conducted with 154 first-year medical students in Human Anatomy and Neuroanatomy laboratories, which were divided into three classes. Students were randomly assigned to either the virtual (virtual dissection followed by donor dissection) or donor (donor dissection followed by virtual dissection) groups in each class. A curriculum, incorporating head-mounted displays (HMDs), a life-sized touchscreen, and tablets, was developed. Data was evaluated through quizzes and surveys. In the Human Anatomy laboratory, each class of the donor group conducted heart extraction, dissection and observation. In observation class, the virtual group had a significantly higher mean quiz score than the donor group (p < 0.05). Compared to the donor, satisfaction was significantly higher for the HMD (understanding of concept and immersion), life-size touchscreen (esthetics, understanding of the concept, and spatial ability), and tablet (esthetics, understanding of the concept, spatial ability, and continuous use intention). In the Neuroanatomy laboratory, the virtual group showed significantly higher mean quiz scores than the donor group (p < 0.05), and tablet showed a significantly higher satisfaction than donor in terms of esthetics, understanding of the concept, and spatial ability. These results suggest that virtual dissection has the potential to supplement or replace donor dissection in anatomy education. This study is innovative in that it successfully delivered scenario-based virtual content and validated the efficacy in academic performance and satisfaction when using virtual devices compared to donor.Trial registration: This research has been registered in the Clinical Research Information Service (CRIS, https://cris.nih.go.kr/cris/search/detailSearch.do?search_lang=E&focus=reset_12&search_page=L&pageSize=10&page=undefined&seq=26002&status=5&seq_group=26002) with registration number "KCT0009075" and registration date "27/12/2023".

A two‐stage adaptive robust model for designing a reliable blood supply chain network with disruption considerations in disaster situations

AbstractWe consider multi‐period blood supply chain network design in disaster situations that involve blood donor groups, permanent and temporary blood collection facilities, blood banks, and hospitals. We use a discrete scenario set to model the uncertain blood supply and demand, and the unforeseeable disruptions in permanent blood collection facilities, blood banks, and road links arising from a disaster, where instead of complete failure, disrupted permanent blood collection facilities and blood blanks may only lose part of their capacities. To design a reliable blood supply network to mitigate the possible disruptions, we present a two‐stage adaptive robust model that integrates the location, inventory, and allocation decisions incorporating a blood sharing strategy, where blood can be delivered from a disrupted/non‐disrupted blood bank to disrupted blood banks to enhance the flexibility of the relief network. For this novel problem, we devise an exact algorithm that integrates column‐and‐constraint generation and Benders decomposition and introduce several non‐trivial acceleration techniques to speed up the solution generation process. We conduct extensive numerical studies on random data sets to evaluate the algorithmic performance. We also conduct a case study in Tehran to demonstrate its real‐life applicability and examine the impacts of key model parameters on the solutions. The numerical results verify the benefits of our model over typical benchmarks, that is, deterministic and stochastic models, and the superiority of our solution algorithm over the CPLEX solver and two well‐known solution approaches, that is, column‐and‐constraint generation and Benders decomposition. Finally, based on the numerical results, we derive managerial insights from the analytical findings.