Uniform Procedure Research Articles

What Happens to Unused Symptom Response Kits in the Community: A Narrative Review.

Introduction: It is a common practice in Ontario to prescribe patients with advanced life-limiting illness a Symptom Response Kit (SRK), an emergency medication and medical supply kit, to manage distressing symptoms in the community toward the end of life (EOL). These are hugely beneficial to patients; however, the medications included have high risk profiles, and there is no uniform procedure in place for the return or disposal of SRKs. This narrative review aims to identify what happens to unused SRKs when no longer needed. Methodology: The literature search was conducted on Medline Ovid, Embase, and CINAHL databases in early 2022 and re-conducted from 2022 to September 15, 2023. Ontario Health at Home (OHAH) websites were also searched in early 2022 and again in January 2024. We included conference abstracts, systematic reviews, scoping reviews, and clinical trials published in the English language that discussed the use of SRK (or equivalent) in community palliative care. Results: Twenty-six studies were included, 12 (46.2%) of which originated from the United States and 3 (11.5%) from Canada. Few studies (34.6%) discussed safety. One study provided instructions given to patients and families regarding return or disposal of unused kits. There was no consistent terminology for SRKs in studies or throughout OHAH organization websites. Three OHAH organizations' websites had instructions available on procedures for disposal or return of unused kits. Conclusions: There is a paucity of research on the use of SRK, although the practice is common. There is no consensus on SRK terminology and no studies evaluating the return or safe disposal of SRKs in the community when no longer needed. Future work should establish safety regulations, disposal monitoring, supervision of use, and terminology standardization. OHAH organizations provincially are conducting innovative work in this area.

Issues of the profession of a land classifier

From the legal point of view, the soil science classification is regulated by the Geodetic and Cartographic Law, where it is defined as the division of soils into valuation classes due to their production quality determined on the basis of the genetic characteristics of the soil. The executive act regulating the issue of soil science classification of land are the provisions included in the Regulation of the Council of Ministers of September 12, 2012 on soil science classification of land (Journal of Laws 2012, item 1246). The aim of the article was to present the problems resulting from the lack of regulation of the profession of land classifier and the lack of uniform administrative procedures regarding the selection of the classifier for the purposes of the classifications. The research method used is the case study. The method was supported by the analysis of legislation in the above-mentioned scope.

Abstract 4134594: More than One Way to Catch a Fish: Micra Extraction Case Series

Description of Cases: Case 1: A 72 year old male with atrial fibrillation (AF) and tachy-brady syndrome underwent Micra implantation. On post-procedure day 2, pacing thresholds were unacceptably elevated. A new Micra device was deployed; subsequently, a microsnare was placed through the Micra delivery catheter and the docking button of the old Micra was successfully snared (Figure A). The old Micra was then captured over the delivery catheter and removed from the body. Case 2: A 76 year old male underwent Micra implantation and AV node ablation for AF with persistent tachycardia. One month later, he presented with heart failure and interval decrease in ejection fraction from 66% to 33%. After biventricular leads were implanted, an Agilis catheter was advanced towards the Micra. The docking button was successfully snared with a gooseneck snare (Figure B), and the Micra was extracted with gentle traction. Case 3: A 76 year old male with complete heart block and longstanding persistent AF received a Micra. Nine months later, he presented with heart failure and interval decrease in ejection fraction from 55% to 25%. A defibrillator lead was implanted but no suitable CS branch was identified. The Aveir retrieval catheter was advanced and the Micra docking button was captured with the triloop snare (Figure C). The protective sleeve was advanced over the Micra and it was successfully removed. Subsequently, a left bundle area lead was placed. Discussion: Although uncommon, extraction of the tined leadless pacemaker (Micra) may be indicated at times. As rates of implantation continue to increase, establishing uniform procedures for extraction becomes increasingly important. These three cases highlight unique options for Micra extraction, and the feasibility of each approach. However, a dedicated tool and protocol would be ideal for patient safety and consistency. No complications occurred with the above cases.

Two decades of population change in Saudi Arabia: Exploring effective redistribution strategies

Census 2022 of Saudi Arabia was released recently, with 12 years of intercensal interval. Although it appeared provisional having no reports similar to the 2010 census, efforts to analyze, interpret, disseminate, and discuss were essential for building structures and systems at par with demographic trends and patterns. An analysis was carried out with this census data compared to 2004 and 2010 to track population change—demographic pace, trends, and patterns—over the two decades. Data from all three censuses were analyzed with conventional demographic techniques. A reduction in growth was observed with a declining percentage of the childhood population but with an expanding percentage of the adults (working age) indicating a demographic dividend resulted, mostly, from fertility decline. An aging trend established by the previous censuses was lost, recently: the constriction of the pyramid of 2010 was changed to a different shape. Not only the percentage distribution trends were uneven but also the age-based indices. Thus, these trends revealed a demographic difference to an extent, that demands standardized reports, uniform procedures for the data collection and compilation, and geographic distribution equations. The increasing concentration in urban centers of major administrative areas—Al-Riyadh, Makkah Al-Mokarramah, and the Eastern Region demand redistribution policies. Self-contained townships appear as a strategic option in population redistribution, guaranteeing quality standards and lifestyle.

Innovation and Construction of International Investment Dispute Settlement Mechanism Under the “Belt and Road” Initiative

The article discusses in depth the innovation and construction of international investment dispute settlement mechanism under the “Belt and Road” initiative. The article firstly outlines the background and importance of the “Belt and Road” initiative and emphasizes its role in promoting regional cooperation and economic ties, as well as the ensuing new challenges of international investment dispute settlement. The article then analyzes the basic principles and theoretical framework of international investment law from a jurisprudential perspective and points out the shortcomings of existing international investment dispute settlement mechanisms such as the ICSID and WTO dispute settlement mechanisms in terms of transparency, predictability of decisions, and litigation costs. The article suggests the establishment of diversified dispute settlement channels and specialized dispute settlement bodies to provide fair and transparent services. In addition, the article emphasizes the importance of developing uniform rules, procedures and standards for dispute settlement, and makes recommendations for strengthening international legal cooperation in order to enhance the efficiency and fairness of dispute settlement, and the enforceability and credibility of dispute settlement outcomes. The article concludes that future legal research should continue to focus on the innovativeness and flexibility of the international investment dispute settlement mechanism, in order to adapt to the new changes and challenges in the field of international investment, and to provide a solid guarantee for the smooth implementation of the “Belt and Road” initiative.

Unified Platform for Automated Tests of Inverter-Based Resources with Harware-in-the-loop

Testing of inverter-based resources (IBRs) faces challenges in establishing standardized procedures across all product development stages. Most of the testing approaches use Hardware-in-the-Loop (HIL) during the early stages independently from the final product testing, which can lead to discrepant results. To solve these issues, this paper proposes a unified platform for automatically testing IBRs. It can be used during all product development stages, from pure simulation to Controller Hardware-in-the-Loop (CHIL) and finally on the complete commercial product, ensuring uniform test procedures with different test setups. A case study describing compliance tests of grid-connection codes of photovoltaic (PV) inverters are presented to demonstrate the proposed approach. Experimental tests were performed in accordance to Brazilian grid-connection codes in an ISO/IEC 17025 accredited laboratory. The results obtained with the proposed platform in CHIL and full-hardware showed high similarity with the ones obtained with the accredited laboratory, validating the proposed approach. In addition, the platform can be used to perform tests not specified in standards and to verify the performance of IBRs in operating conditions that are often difficult to be tested in laboratory. Ensuring consistent test procedures, the platform facilitates comparable results along all the testing stages, reducing the product development cycle.

Developing a New Method to Rapidly Map Eucalyptus Distribution in Subtropical Regions Using Sentinel-2 Imagery

Eucalyptus plantations with fast growth and short rotation play an important role in improving economic conditions for local farmers and governments. It is necessary to map and update eucalyptus distribution in a timely manner, but to date, there is a lack of suitable approaches for quickly mapping its spatial distribution in a large area. This research aims to develop a uniform procedure to map eucalyptus distribution at a regional scale using the Sentinel-2 imagery on the Google Earth Engine (GEE) platform. Different seasonal Senstinel-2 images were first examined, and key vegetation indices from the selected seasonal images were identified using random forest and Pearson correlation analysis. The selected key vegetation indices were then normalized and summed to produce new indices for mapping eucalyptus distribution based on the calculated best cutoff values using the ROC (Receiver Operating Characteristic) curve. The uniform procedure was tested in both experimental and test sites and then applied to the entire Fujian Province. The results indicated that the best season to distinguish eucalyptus forests from other forest types was winter. The composite indices for eucalyptus–coniferous forest separation (CIEC) and for eucalyptus–broadleaf forest separation (CIEB), which were synthesized from the enhanced vegetation index (EVI), plant senescing reflectance index (PSRI), shortwave infrared water stress index (SIWSI), and MERIS terrestrial chlorophyll index (MTCI), can effectively differentiate eucalyptus from other forest types. The proposed procedure with the best cutoff values (0.58 for CIEC and 1.29 for CIEB) achieved accuracies of above 90% in all study sites. The eucalyptus classification accuracies in Fujian Province, with a producer’s accuracy of 91%, user’s accuracy of 97%, and overall accuracy of 94%, demonstrate the strong robustness and transferability of this proposed procedure. This research provided a new insight into quickly mapping eucalyptus distribution in subtropical regions. However, more research is still needed to explore the robustness and transferability of this proposed method in tropical regions or in other subtropical regions with different environmental conditions.

Comparison of Different Obturation Techniques in the Dentinal Tubule Penetration of EndoSequence® Bioceramic Sealer HiFlow™: An In-Vitro Study.

Background This study aimed to assess the dentinal tubule penetration of bioceramic sealer(DTPB) using EndoSequence® Bioceramic Sealer HiFlow™ (BCHF). Three obturation techniques were compared, namely, single cone (SC), cold lateral condensation (CLC), and warm vertical compaction (WVC) using scanning electron microscopy (SEM). Methodology A total of 45 intact mandibular premolars were decoronated, instrumented, and irrigated with uniform procedures. Subsequently, they were randomly assigned into the following three groups according to the gutta-percha and BCHF obturation technique: Group 1 (n = 15) with the SC technique, Group 2 (n = 15) with the CLC technique, and Group 3 (n = 15) with the WVC technique. Afterward, the roots were sectioned at three levels (coronal, middle, apical) from the apex and examined using SEM to determine the maximum distance of DTPB in µm. The collected data were analyzed using SPSS software (IBM Corp., Armonk, NY, USA) using the one-way analysis of variance test and Bonferroni tests. The level of significance was set at α of 0.05. Results Significant differences were observed in the maximum distances of DTPB values among the three levels across groups (p < 0.05). Both the WVC and CLC groups exhibited higher values compared to the SC group (p < 0.05). Specifically, the DTPB maximum distance at the apical third was significantly higher in the CLC group than in the WVC and SC groups (p < 0.05). Additionally, the coronal third in each group demonstrated significant DTPB maximum distance (p < 0.05) compared to the other groups. Conclusions BCHF with the WVC and CLC obturation technique showed the best performance in DTPB maximum distance values at the three levels.

Effect of Staff Digital Literacy on Customs Goods Clearance at Jomo Kenyatta International Airport, Kenya

Purpose: The clearance of imported goods at airports used the risk-based management customs systems of clearance to enhance faster clearance of goods from air cargo complexes, the use of Electronic Data Interchange (EDI), there was quick cargo clearance of perishable cargo, and uniform and simple procedure of cargo handling. There were e-payment systems that enhanced faster clearances with an overall aim of minimizing dwell time of cargo to be handled at the airport's storage complexes. The purpose of the study was to determine the effect of staff digital literacy on customs goods clearance at Jomo Kenyatta International Airport, Kenya. Methodology: This study employed an explanatory research design. The target population of the study was 245 KRA employees. Data was collected using questionnaires. The data were coded and entered into the Statistical Package for Social Sciences (SPSS). Collected data was analyzed using descriptive and inferential statistics. Results: The findings showed that staff digital literacy had a positive and significant effect on customs goods clearance (β=0.485, p=0.000). Conclusion: KRA needs to engage its staff in digital literacy training. Furthermore, gaining digital literacy skills helps staff to make use of all that technology has to offer in terms of learning, creativity, and teamwork, which enhances their custom goods clearances even more.

Shear Force of Interior Beam–Column Joints under Symmetrical Loading with Two Transverse Forces on the Beam †

The beam-to-column connection is a particularly vulnerable element in frame structures under seismic action and is often responsible for building damages. Experimental investigations carried out over the past six decades on shear strength in frame joints have not led to the establishment of a uniform procedure in the design codes of different countries. The reason lies probably in the varied nature of the investigated parameters and in the varied configurations of beam–column connections. A good knowledge of the forces passing through the frame joints in the beam–beam and column–column direction would allow both their adequate computation in new buildings and the verification of existing ones without requiring experimental studies. In the design codes of the leading countries in seismic engineering, the shear force is determined by the capacitive method, considering only the area of the longitudinal reinforcement of the beam passing through the column. This method shows us how much shear force the beam reinforcement can take, but not what the magnitude of the resulting forces actually is as a result of the acting loads. In addition, the method of the codes does not indicate the contribution of the concrete to the total magnitude of the shear force in the beam–column connection. In the proposed mathematical model for calculating the forces that leave the beam, the full dimensions of the cross-section of the beam were taken into account. The material properties and cross-sectional shape were also taken into account. A determining factor for the magnitude of forces entering the beam–column joint is the acting load on the beam. In this paper, the load of two transverse forces was considered. The forces are applied in different possible positions, while remaining symmetrically located on the beam. The calculations are based on Menabrea’s theorem to determine the hyperstatic unknowns. The results of the proposed method for the considered beam show that the magnitude of the shear force differs from that accepted in the literature and the norms by 2% to 27%, depending on the stage of development of the crack. In comparison, the Eurocode-recommended method shows differences in the order of 27% to 40% for the adopted beam under static loads.

Global Inference and Test for Eigensystems of Imaging Data Over Complicated Domains

A nonparametric approach for analyzing eigensystems of image data over a complex domain is novelly developed. The proposed estimators, which are based on bivariate splines, have both oracle efficiency of O p ( n − 1 / 2 ) , meaning they are asymptotically indistinguishable from estimators computed with true trajectories, and computational efficiency with more convenient spectrum decomposition forms. Under mild conditions, we derive consistency and weak convergence of our proposed estimators, which can be used to construct confidence intervals and simultaneous confidence corridors for any individual eigenvalue and eigenfunction, as well as design uniform inference procedures for eigensystems with a diverging number of components. In addition, we extend our method to two-sample test problems. Extensive simulation results provide strong support for the asymptotic theory, and the procedures are applied to two potential seawater temperature data sets to demonstrate its validity.

Comparison of Gravimetric Determination of Methane Sorption Capacities of Coals for Using Their Results in Assessing Outbursts in Mines

The gravimetric method for determining coal gas sorption has many advantages and limitations. The article presents the influence of various factors on the results of methane sorption on coal. In mining practice, in addition to sorption properties of coal, knowledge of methane sorption capacity and effective diffusion coefficient determined when assuming a unipore sorption/desorption model are crucial for predicting sudden releases of methane from coal seams to a mine ventilation environment. In Poland, determining sorption capacities of coals for methane is mandatory when starting mining operations in new parts of coal deposits threatened by outbursts. Traditionally, gravimetric microbalances, such as intelligent gravimetric analysis (IGA), are used to determine adsorption capacity and desorption rate. Recently, newer microbalances XEMIS have been introduced to the market. Two gas laboratories, AGH in Krakow and CLP-B in Jastrzebie-Zdroj, respectively, compared experimental adsorption isotherms using XEMIS microbalances with mutually exchanged coal samples. Both sorption capacity at the pressure of 1 bar (a1bar) and effective diffusion coefficient (De) were independently determined for the coal samples tested. The results obtained are comparable despite the use of different microbalance XEMIS models. The conducted studies and comparative evaluation of the results allowed for assessing procedures for determining sorption properties using XEMIS microbalances. The exchange of laboratory experiences also allowed for the identification of methodology factors crucial for the development of a uniform procedure for conducting similar studies with XEMIS microbalance. The proposed factors for testing the sorption behavior of methane in coal structures may be helpful in mining practice.

Core Decompression with Bone Marrow Aspirate Concentrate Implantation in Osteonecrosis of the Femoral Head with a Minimum of 2-year Follow-up - A Pilot Study.

Osteonecrosis of the femoral head (ONFH), resulting from impaired blood supply to the head of the femur, presents a significant challenge to clinicians due to its debilitating nature. Conservative treatment often offers insufficient pain relief and debilitating functional outcomes which necessitate alternative therapies. Bone marrow aspirate concentrate (BMAC), a potent orthobiologics and rich in mesenchymal stromal cells and growth factors, holds good promise as the minimally invasive procedure for ONFH. With the preceding research suggesting clinical and functional efficacy, we assessed the therapeutic effectiveness of BMAC in ONFH management in joint preservation. A prospective cohort study was conducted with 20 patients suffering from ONFH who failed to respond to 6 months of conservative treatment. A uniform surgical procedure was performed by a single surgeon, involving bone marrow extraction from the anterior iliac crest and subsequent processing into an 8-10 mL of BMAC concentrate. The BMAC was then injected into the implanted into the decompressed femoral head. The post-operative protocol comprised weight-bearing mobilization, physiotherapy, and a 4-week NSAID-free regimen. Outcome measures included pain scores, hip function, knee symptoms, sports activities, patient satisfaction, and recommendation of the procedure. Of the 20 patients suffering from ONFH, primarily the left side, most of whom were at stage 2b, significant pain reduction and functional improvement were observed over 24 months. The mean pain score decreased from 9.00 to 3.55, while the hip function score increased from 46.12 to 88.60. However, some patients encountered complications such as symptom recurrence (5%), disease progression (10%), and persistent pain (5%). Core decompression with BMAC implantation emerges as a promising, effective, and safe treatment for ONFH with better costeffectiveness and minimal side effects, making it a feasible treatment alternative.

О системности процессуальных гарантий на этапе окончания различных видов предварительного расследования

This article examines the stage of completing the preliminary investigation, inquiry in the general order, inquiry in an abbreviated form (before sending the criminal case to the prosecutor with an indictment, indictment, indictment resolution) as an element of a unified system for completing the preliminary investigation. Attention is drawn to the fact that currently the criminal procedural law at the final stage of the preliminary investigation does not provide for a uniform procedure for approval (coordination) and presentation of final procedural documents to participants in criminal proceedings, which affects the legality of criminal proceedings. The procedure for procedural activities at the stage of completing a preliminary investigation without sufficient grounds varies significantly. It is concluded that the rights and legitimate interests of participants in criminal proceedings at the stage of completion of the inquiry in the general order, inquiry in an abbreviated form are not properly ensured. Proposals are formulated to improve criminal procedural legislation aimed at increasing the level of guarantees of both the rights and legitimate interests of participants in the process, and the implementation of the control and security role of this stage of the preliminary investigation.

Comparative Evaluation of Fracture Resistance of Composite Core Buildup Materials: An In Vitro Study.

Aim This study aimed to compare the fracture resistance of different materials used in composite core buildups, including conventional filler composite, nanofiller composite, and short fiber-reinforced composite (SFRC). Methods This in vitro study was conducted on 30 freshly extracted premolars. The teeth were treated using a uniform endodontic procedure, and Fiber Posts (REFORPOST, Angelus) were placed. The teeth were then divided into three groups and restored using different materials. Group 1 was restored using SFRC(everX Posterior, GC, Europe), Group 2 using microfiller composite (Te-Econom Flow, Ivoclar Vivadent), and Group 3 using nanofiller composite (Tetric N-Flow, Ivoclar Vivadent). The restoration materials were then light-cured for 40 seconds. The teeth were placed in a Universal Testing Machine (Instron) and a load was applied with a stainless-steel ball (4 mm diameter) until the tooth fractured. The fracture load for each tooth was recorded, and after the mechanical test, the experimental groups were examined for failure modes. Statistical analysis was performed using SPSS version 21.0 software. A one-way ANOVA test was conducted to compare more than two groups, followed by Tukey's test for post hoc pairwise comparison. Results The mean fracture resistance of the microfiller composite (346.94±44.63) was the lowest among the three groups. When analyzed using Tukey's test at p<0.05, fracture resistance was significantly higher in the SFRC, followed by nanofillers and microfiller composites. Conclusion Due to the increasing demand for aesthetic restorations in recent years, composites have become important in modern restorative dentistry. The development and implementation of composite dental restorative materials rely on a comprehensive understanding of each composite component and consideration of methods for modifying each component. As a result, the findings of this study will be beneficial in determining which material to use based on specific cases.

The Conditions and Manner of Executing the Contract with The Substitute Goods Are in The International Sales Convention and Subject Rights

Considering the expansion of international relations and the need for uniform laws in the international arena in recent decades, many efforts have been made to create transnational laws. The Convention on the International Sale of Goods has been developed to harmonise the laws regarding the rights of contracts so that by joining this convention, the countries will end the problems caused by the multiplicity of laws and create a uniform procedure. In a domestic or international sales contract, the seller must deliver the goods to the buyer by the terms of the contract. If the seller violates the contract and provides a defective or non-conforming product, the performance guarantee is stipulated in the Convention on the International Sale of Goods. In this research, we examine the guarantee of the right to request a replacement product. In paragraph 2 of Article 46 of the Convention, the buyer has the right to request a replacement product in case of a fundamental violation. If there is no fundamental violation of the goods and the possibility of remedying the defects of the goods, the buyer can request the removal of the defects of the goods. The institution of submission of substitute goods does not exist in Iranian law in the sense that is mentioned in the convention. Considering the non-accession of Iran, it will be useful to review the submission of substitute goods in Iran's law.

The Role of Accounting and Audit in Sustainable Development

Abstract The involvement of accountants and auditors in sustainable development has become more and more present in the literature specialised forums. Sustainability accounting works in the same direction with corporate practices and the evolution of best practices for financial standards. Accountants and auditors contribute to the standardization of uniform procedures for all the nations. Our study will present the responsibilities and work area of accountants and auditors in the economic sector for sustainability. The traditional role of accountants and auditors is evolving towards a more comprehensive spectrum that also includes a sustainability role. We considered the analysis of specialized literature to identify the involvement of sustainability in different fields, sustainability being a subject of interdisciplinary interest.. The current role of accountants and auditors in promoting sustainable development by examining actions set by accounting regulatory authorities and representatives of the accounting profession through a qualitative analysis. Our research aims to enrich the specialized literature in academic financial research. The actual case study will present the involvement of accountants and auditors in the area of sustainable development that desire to achieve the standards proposed by the UN. The importance of work performed by accountants and auditors for international businesses for sustainable development will be also presented. Although it is really important to keep in mind that the actual paper has boundaries that could provide new interesting opportunities for research areas.

Use of virtual reality in children in a broad range of medical settings: a systematic narrative review of recent meta-analyses.

Virtual reality (VR) is an emerging method that can be used in many scenarios involving children. VR has been increasingly studied as it has become cheaper, more widely available, and of better quality. In this review of current meta-analyses on the use of VR in children in the medical setting, we examined its role in 5 broad settings where it is used to alleviate pain and anxiety as well as in therapeutic scenarios. The study scope was purposefully broad to highlight a wide range of cases. We searched the ScienceDirect, SpringerLink, Cochrane Library, PubMed, and PMC databases for meta-analyses using VR in pediatric populations in medical settings. The National Institutes of Health quality assessment tool and Quality of Reporting of Meta-analyses statement checklist were used to verify study quality. Six hundred fifty-three articles were retrieved; after the application of the inclusion and exclusion criteria, 11 remained. These meta-analyses included cerebral palsy (4 meta-analyses), attention deficit/hyperactivity disorder (2 meta-analyses), burn care (1 meta-analysis), preoperative anxiety (2 meta-analyses), and needle-involving procedures (2 meta-analyses). The meta-analyses showed broadly positive results, with VR being useful in the areas in which it was applied. This study had several limitations. The meta-analyses consistently highlighted a high level of heterogeneity, making it challenging to draw clear conclusions. Most meta-analyses across all fields yielded encouraging results. However, further studies are required to confirm these findings. Guidelines must be established for future experiments to provide a standard and uniform procedure for reducing the heterogeneity of experimental methods.

Spleen autotransplantation on liver versus greater omentum for simultaneous injuries of liver and spleen: an experimental study.

In a simulated situation of simultaneous spleen and liver trauma, we aimed to compare the outcomes of treating both injuries with spleen autotransplantation on the omentum (SAO) alongside hepatorrhaphy versus spleen autotransplantation as a patch on the liver parenchyma. A total of 24 rats were separated into two groups: the SAO and the spleen autotransplantation on the liver. They underwent a uniform and simultaneous procedure involving full-thickness injuries to the left lobe of the liver and grade 4 spleen injuries. We measured hemoglobin, white blood cell (WBC), complement (C3 and C4), and immunoglobulin G, M, and A (IgG, IgM, IgA) levels before and 4 weeks after the surgery. We utilized Technetium-99m scintigraphy to evaluate the posttransplant splenic graft functions 4 weeks after the surgery. The two groups had no significant difference in the hematologic and immunologic factors before surgery. However, both procedures significantly reduced hemoglobin, C3, IgG, and IgA levels (all P<0.05). WBC counts significantly increased in the SAO group, whereas the IgM level decreased after the intervention (P<0.05). WBC was increased in the SAO group, while IgM and IgA were decreased in the SAO group. The Technetium uptake was similar between the two groups (P=0.3). In simultaneous spleen and liver injuries, the autotransplantation of splenic into the liver parenchyma appears to be a promising surgical approach for preserving spleen function and hepatorrhaphy at the same time instead of doing them separately.

Donors with repeated blood product discards for filtration problems, clots or hemolysis: Causes and follow-up.

Sanquin donor medicine department is informed when donations or their components are rejected. This can occur isolated or frequently. It is undesirable because the donations cannot be used and there may be an underlying medical cause. Based on regional approaches, a uniform procedure was developed. Information about whole blood, plasma- plateletpheresis donations from which one or more components were rejected for filtration time (>2 h), hemolysis or clots were extracted from blood bank information system. After rejection of two successive components or donations or total ≥3 the donor is contacted. Depending on the medical history and investigation by the family doctor, the donor carrier is re-evaluated. We looked for the causes of the discarded products and performed a survey among blood services regarding polices with discarded products. One or more components from 1742 of about 2.2 million successful donations (0.08%) were rejected. The highest percentage of rejection was seen in plateletpheresis (1.5%), all for clots. No underlying medical causes were found. 24 whole blood donors were found to have sickle cell trait (SCT) and were permanently deferred. The policies for follow-up after discarded products or acceptance of SCT donors vary between the 16 blood banks. Six organizations do not follow-up donors and seven accept SCT for blood or plasma donation. Informing donors with repeated discarded products avoids the non-use of donations. Causes of repeated discarded products can be found by follow-up of donors. The results of the survey indicate a large discrepancy in policies applied worldwide.