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.

Graphene Quantum Dots-Based Electrochemical Biosensing Platform for Early Detection of Acute Myocardial Infarction.

Heart failure resulting from acute myocardial infarction (AMI) is an important global health problem. Treatments of heart failure and AMI have improved significantly over the past two decades; however, the available diagnostic tests only give limited insights into these heterogeneous conditions at a reversible stage and are not precise enough to evaluate the status of the tissue at high risk. Innovative diagnostic tools for more accurate, more reliable, and early diagnosis of AMI are urgently needed. A promising solution is the timely identification of prognostic biomarkers, which is crucial for patients with AMI, as myocardial dysfunction and infarction lead to more severe and irreversible changes in the cardiovascular system over time. The currently available biomarkers for AMI detection include cardiac troponin I (cTnI), cardiac troponin T (cTnT), myoglobin, lactate dehydrogenase, C-reactive protein, and creatine kinase and myoglobin. Most recently, electrochemical biosensing technologies coupled with graphene quantum dots (GQDs) have emerged as a promising platform for the identification of troponin and myoglobin. The results suggest that GQDs-integrated electrochemical biosensors can provide useful prognostic information about AMI at an early, reversible, and potentially curable stage. GQDs offer several advantages over other nanomaterials that are used for the electrochemical detection of AMI such as strong interactions between cTnI and GQDs, low biomarker consumption, and reusability of the electrode; graphene-modified electrodes demonstrate excellent electrochemical responses due to the conductive nature of graphene and other features of GQDs (e.g., high specific surface area, π-π interactions with the analyte, facile electron-transfer mechanisms, size-dependent optical features, interplay between bandgap and photoluminescence, electrochemical luminescence emission capability, biocompatibility, and ease of functionalization). Other advantages include the presence of functional groups such as hydroxyl, carboxyl, carbonyl, and epoxide groups, which enhance the solubility and dispersibility of GQDs in a wide variety of solvents and biological media. In this perspective article, we consider the emerging knowledge regarding the early detection of AMI using GQDs-based electrochemical sensors and address the potential role of this sensing technology which might lead to more efficient care of patients with AMI.

Plasmonically-enhanced all-optical integrated phase-change memory.

Integrated phase-change photonic memory devices offer a novel route to non-volatile storage and computing that can be carried out entirely in the optical domain, obviating the necessity for time and energy consuming opto-electrical conversions. Such memory devices generally consist of integrated waveguide structures onto which are fabricated small phase-change memory cells. Switching these cells between their amorphous and crystalline states modifies significantly the optical transmission through the waveguide, so providing memory, and computing, functionality. To carry out such switching, optical pulses are sent down the waveguide, coupling to the phase-change cell, heating it up, and so switching it between states. While great strides have been made in the development of integrated phase-change photonic devices in recent years, there is always a pressing need for faster switching times, lower energy consumption and a smaller device footprint. In this work, therefore, we propose the use of plasmonic enhancement of the light-matter interaction between the propagating waveguide mode and the phase-change cell as a means to faster, smaller and more energy-efficient devices. In particular, we propose a form of plasmonic dimer nanoantenna of significantly sub-micron size that, in simulations, offers significant improvements in switching speeds and energies. Write/erase speeds in the range 2 to 20 ns and write/erase energies in the range 2 to 15 pJ were predicted, representing improvements of one to two orders of magnitude when compared to conventional device architectures.

The State-of-the-Art of Sensors and Environmental Monitoring Technologies in Buildings.

Building energy consumption accounts for 30%-45% of the global energy demand. With an ever-increasing world population, it has now become essential to minimize the energy consumption for the future of the environment. One of the most crucial aspects in this regard is the utilization of sensing and environmental monitoring technologies in buildings as these technologies provide stakeholders, such as owners, designers, managers, and occupants, with important information regarding the energy performance, safety and cost-effectiveness of the building. With the global sensors market value predicted to exceed $190 billion by 2021 and the number of sensors deployed worldwide forecasted to reach the '1 Trillion' mark by 2025, a state-of-the-art review of various commercially-viable sensor devices and the wide range of communication technologies that complement them is highly desirable. This paper provides an insight into various sensing and environmental monitoring technologies commonly deployed in buildings by surveying different sensor technologies, wired and wireless communication technologies, and the key selection parameters and strategies for optimal sensor placement. In addition, we review the key characteristics and limitations of the most prominent battery technologies in use today, different energy harvesting sources and commercial off-the-shelf solutions, and various challenges and future perspectives associated with the application of sensing and environmental monitoring technologies within buildings.

Frequency of G6PD Mediterranean in individuals with and without malaria in Southern Pakistan.

BACKGROUND: Pakistan has an estimated annual burden of 1.5 million malaria cases. The current situation calls for an effective malaria control and eradication programme in this country. Currently, primaquine is an attractive option for eliminating reservoirs of Plasmodium vivax hypnozoites and killing gametocytes of Plasmodium falciparum. However, this drug causes haemolysis in individuals who are glucose-6-phosphate (G6PD) deficient. It is important to map G6PD deficiency and malaria distribution in Pakistan to design an effective malaria eradication regimen. Frequency of G6PD deficiency (G6PDd) in malaria patients has not been reported from Pakistan in any meaningful way. The purpose of this study was to evaluate the frequency of G6PD c.563C>T (G6PD Mediterranean) in male individuals with and without falciparum malaria. METHODS: Two hundred and ten archived DNA samples from males (110 from falciparum malaria patients and 100 from healthy individuals) were utilized in this study. Healthy blood donors were selected based on stringent pre-defined criteria. Patients were confirmed for malaria parasites on microscopy and or immune chromatographic assay detecting P. falciparum histidine-rich protein 2. Parasitaemia was also computed. DNA samples were tested for G6PD c.563C>T mutation through PCR-RFLP according to the previously defined protocol and its allelic frequency was computed. RESULTS: G6PD c.563C>T was observed in four of 110 patients with falciparum malaria and in two of 100 healthy donors. Mean (± SD) haemoglobin, median (IQR) platelet and median (IQR) parasite count in G6PD-deficient malaria-patients were 8.9 ± 0.9 g/dL, 124 × 109/L (IQR 32, 171) and 57,920/µL of blood (IQR 12,920, 540,000) respectively. CONCLUSIONS: Cumulative allelic frequency for G6PD 563c.C>T was 0.0285 detected in 6 of 210 X-chromosomes in Southern Pakistan. Frequency for this G6PD allele was 0.0364 in malaria-patients and 0.0200 in healthy individuals. Large studies including females are needed to elucidate the true burden of G6PDd in malaria-endemic areas. The information will enable local health policy makers to design effective strategies for eliminating malaria form this region.

In vitro toxic effects of reduced graphene oxide nanosheets on lung cancer cells.

The intriguing properties of reduced graphene oxide (rGO) have paved the way for a number of potential biomedical applications such as drug delivery, tissue engineering, gene delivery and bio-sensing. Over the last decade, there have been escalating concerns regarding the possible toxic effects, behaviour and fate of rGO in living systems and environments. This paper reports on integrative chemical-biological interactions of rGO with lung cancer cells, i.e. A549 and SKMES-1, to determine its potential toxicological impacts on them, as a function of its concentration. Cell viability, early and late apoptosis and necrosis were measured to determine oxidative stress potential, and induction of apoptosis for the first time by comparing two lung cancer cells. We also showed the general trend between cell death rates and concentrations for different cell types using a Gaussian process regression model. At low concentrations, rGO was shown to significantly produce late apoptosis and necrosis rather than early apoptotic events, suggesting that it was able to disintegrate the cellular membranes in a dose dependent manner. For the toxicity exposures undertaken, late apoptosis and necrosis occurred, which was most likely resultant from limited bioavailability of unmodified rGO in lung cancer cells.

Can conventional phase-change memory devices be scaled down to single-nanometre dimensions?

The scaling potential of 'mushroom-type' phase-change memory devices is evaluated, down to single-nanometre dimensions, using physically realistic simulations that combine electro-thermal modelling with a Gillespie Cellular Automata phase-transformation approach. We found that cells with heater contact sizes as small as 6 nm could be successfully amorphized and re-crystallized (RESET and SET) using moderate excitation voltages. However, to enable the efficient formation of amorphous domes during RESET in small cells (heater contact diameters of 10 nm or less), it was necessary to improve the thermal confinement of the cell to reduce heat loss via the electrodes. The resistance window between the SET and RESET states decreased as the cell size reduced, but it was still more than an order of magnitude even for the smallest cells. As expected, the RESET current reduced as the cells got smaller; indeed, RESET current scaled with the inverse of the heater contact diameter and ultra-small RESET currents of only 19 µA were achieved for the smallest cells. Our results show that the conventional mushroom-type phase-change cell architecture is scalable and operable in the sub-10nm region.

Design of practicable phase-change metadevices for near-infrared absorber and modulator applications.

Phase-change chalcogenide alloys, such as Ge2Sb2Te5 (GST), have very different optical properties in their amorphous and crystalline phases. The fact that such alloys can be switched, optically or electrically, between such phases rapidly and repeatedly means that they have much potential for applications as tunable photonic devices. Here we incorporate chalcogenide phase-change films into a metal-dielectric-metal metamaterial electromagnetic absorber structure and design absorbers and modulators for operation at technologically important near-infrared wavelengths, specifically 1550 nm. Our design not only exhibits excellent performance (e.g. a modulation depth of ~77% and an extinction ratio of ~20 dB) but also includes a suitable means for protecting the GST layer from environmental oxidation and is well-suited, as confirmed by electro-thermal and phase-transformation simulations, to in situ electrical switching. We also present a systematic study of design optimization, including the effects of expected manufacturing tolerances on device performance and, by means of a sensitivity analysis, identify the most critical design parameters.