Non-severe allergic transfusion reaction: A hidden cause of wastage of blood product and laboratory resources.

BACKGROUND AND OBJECTIVES: Blood transfusions are often needlessly aborted following a non-severe allergic reaction despite responding well to medication resulting into partial transfusion of the implicated blood product. This results in the wastage of untransfused blood component and resources spent on unnecessary laboratory work-up of these reactions. MATERIALS AND METHODS: We aimed to review the amount of blood product and laboratory resource wastage associated with non-severe allergic transfusion reaction (ATR) in a tertiary care hospital. RESULTS: A total of 174,632 blood products were released and transfused during the study period (2019-2021). There were 336 adverse transfusion reactions with an estimated rate of 1.9 per 1000 blood products administered. Of 336, 145 (43%) were ATR, of which 141 (97%) were non-severe and 4 (3%) were severe. The most commonly associated symptom was found to be urticaria in 31 (22%). All non-severe ATR completely resolved with medication. Seventy-nine percent of the transfusions associated with non-severe ATRs were aborted, of which 37% were followed by additional transfusions. The estimated loss of blood product volume and the cost of non-severe ATR (including transfusion reaction work-up, discarded blood product and additional transfusion) was 11,185 ml (11 L) and Pakistani rupees 1,831,546 ($11,592.06 or €8598.78), respectively. CONCLUSION: Non-severe ATR was found to be associated with a significant proportion of laboratory resource wastage and that of blood product in our institution. Revision of institutional guidelines for management and lab work-up of transfusion reactions would be helpful in alleviating this unnecessary loss in a resource-constraint transfusion-setting.

Model-Based Fault Diagnosis of an Anti-Lock Braking System via Structural Analysis.

The anti-lock braking system (ABS) is an essential part in ensuring safe driving in vehicles. The Security of onboard safety systems is very important. In order to monitor the functions of ABS and avoid any malfunction, a model-based methodology with respect to structural analysis is employed in this paper to achieve an efficient fault detection and identification (FDI) system design. The analysis involves five essential steps of SA applied to ABS, which includes critical faults analysis, fault modelling, fault detectability analysis and fault isolability analysis, Minimal Structural Over-determined (MSO) sets selection, and MSO-based residual design. In terms of the four faults in the ABS, they are evaluated to be detectable through performing a structural representation and making the Dulmage-Mendelsohn decomposition with respect to the fault modelling, and then they are proved to be isolable based on the fault isolability matrix via SA. After that, four corresponding residuals are generated directly by a series of suggested equation combinations resulting from four MSO sets. The results generated by numerical simulations show that the proposed FDI system can detect and isolate all the injected faults, which is consistent with the theoretical analysis by SA, and also eventually validated by experimental testing on the vehicle (EcoCAR2) ABS.

Design and Evaluation of a Structural Analysis-Based Fault Detection and Identification Scheme for a Hydraulic Torque Converter.

A hydraulic torque converter (HTC) is a key component in an automatic transmission. To monitor its operating status and to detect and locate faults, and considering the high-efficiency fault detection and identification (FDI) scheme design by the methodology of structural analysis (SA), this paper presents an SA-based FDI system design and validation for the HTC. By the technique of fault mode and effect analysis (FMEA), eight critical faults are obtained, and then two fault variables are chosen to delegate them. Fault detectability and isolability, coupled with different sensor placements, are analyzed, and as a result, two speed sensors and two torque sensors of pump and turbine are selected to realize the maximal fault detectability and fault isolability: all six faults are detectable, four faults are uniquely isolable, and two faults are isolated from the other faults, but not from each other. Then five minimal structurally overdetermined (MSO) sets are easily acquired by SA to generate five corresponding residuals. The proposed FDI scheme of the HTC by SA is first validated by a theoretical model, then by an offline experiment in a commercial SUV, and the testing results indicate a consistent conclusion with the simulations and theory analysis.

Inflammatory mediators in the immunobiology of bronchopulmonary dysplasia.

Inflammation is important in the development of bronchopulmonary dysplasia (BPD). Polymorphonuclear cells and macrophages and proinflammatory cytokines/chemokines denote early inflammation in clinical scenarios such as in utero inflammation with chorioamnionitis or initial lung injury associated with respiratory distress syndrome or ventilator-induced lung injury. The persistence and non-resolution of lung inflammation contributes greatly to BPD, including altering the lung's ability to repair, contributing to fibrosis, and inhibiting secondary septation, alveolarization, and normal vascular development. Further understanding of the role of inflammation in the pathogenesis of BPD, in particular, during the chronic inflammatory period, offers us the opportunity to develop inflammation-related prevention and treatment strategies of this disease that has long-standing consequences for very premature infants.