Bronchopulmonary Dysplasia: Ongoing Challenges from Definitions to Clinical Care.

Bronchopulmonary dysplasia (BPD) is the most common complication of extreme prematurity. Its etiology is multifactorial and is attributed to genetic susceptibility to prenatal and postnatal factors. As advancements in neonatology have led to the increased survival of premature infants, a parallel increase in the incidence of BPD has occurred. Over time, the definition and diagnostic criteria for BPD have evolved, as have management strategies. However, challenges continue to exist in the management of these infants, which is not surprising given the complexity of the disease. We summarize the key diagnostic criteria and provide insight into the challenges related to various aspects of BPD definitions, data comparisons, and clinical care implementation.

The value of automated gel column agglutination technology in the identification of true inherited D blood types in massively transfused patients.

BACKGROUND: Massive transfusion of D- trauma patients in the combat setting involves the use of D+ red blood cells (RBCs) or whole blood along with suboptimal pretransfusion test result documentation. This presents challenges to the transfusion service of tertiary care military hospitals who ultimately receive these casualties because initial D typing results may only reflect the transfused RBCs. After patients are stabilized, mixed-field reaction results on D typing indicate the patient's true inherited D phenotype. This case series illustrates the utility of automated gel column agglutination in detecting mixed-field reactions in these patients. STUDY DESIGN AND METHODS: The transfusion service test results, including the automated gel column agglutination D typing results, of four massively transfused D- patients transfused D+ RBCs is presented. To test the sensitivity of the automated gel column agglutination method in detecting mixed-field agglutination reactions, a comparative analysis of three automated technologies using predetermined mixtures of D+ and D- RBCs is also presented. RESULTS: The automated gel column agglutination method detected mixed-field agglutination in D typing in all four patients and in the three prepared control specimens. The automated microwell tube method identified one of the three prepared control specimens as indeterminate, which was subsequently manually confirmed as a mixed-field reaction. The automated solid-phase method was unable to detect any mixed fields. CONCLUSION: The automated gel column agglutination method provides a sensitive means for detecting mixed-field agglutination reactions in the determination of the true inherited D phenotype of combat casualties transfused massive amounts of D+ RBCs.

An evaluation of a perceived overqualification scale across work settings.

The authors extended and evaluated the dimensionality of the L. J. Khan and P. C. Morrow (1991) subjective underemployment scale. They used data from 3 independent samples to assess the measurement properties of the scale. The results of confirmatory factor analyses supported 2 dimensions and indicated that the measurement model parameters partially generalized across samples. Correlational and additional confirmatory factor analytic results rendered empirical support for most of the postulated relationships of the 2 overqualification dimensions with the somatization, job satisfaction, and organizational commitment variables. The findings indicate that the scale of perceived overqualification needs to be further developed and validated in different samples. The implications of the findings for person-job fit are discussed.