Formalizing and Verifying Workflows Used in Blood Banks

AbstractBlood banks use automation to decrease errors in delivering safe blood for transfusion. The Food and Drug Administration (FDA) of the United States and other organizations recommend blood banks to validate their computer system process, which is resource and labor intensive. For this reason, we have created a formal workflow model for blood bank operations and used an automated tool to verify that it satisfies safety properties. Our methodology started by understanding and gathering information about blood bank procedure. Then we mapped all procedures into processes in a workflow engine. Then we used the verification packages provided by the workflow engine to check the safety properties

The Pragmatic Nature of Manipulation

Broadly defined, manipulation is a kind of covert behavior or a means, whether linguistic or non- linguistic, used by manipulators in certain communicative encounters to achieve their goals, desires, and interests regardless of the perceptual, cognitive , and emotional feelings of their interlocutors. In this regard, they utilize myriad devices, especially those dishonest ones, like cunning, lying, making tricks, deceiving, and the like. To be successful in doing so, manipulators should have a cognition which enables them to pursue their own interests through making use of some aspects of human cognition, notably reasoning, checking for likeliness, and emotions. As such, manipulators play on their targets’ weaknesses to influence their motivation, beliefs, emotions, and reaction. For some scholars, manipulation is a psychologicalissuebecause it can be considered as a kind of human behavior or cognition. For others, it falls within the region of cognitive pragmatics since it is basically based on the use of cognition in relation to context. In this study, as far as language use is concerned, it is argued that manipulation is more pragmatic than psychological in nature. Besides, it is characterized by pragmatic features other than the cognitive ones. Hence, it is felt, here, that there is a need to reveal those pragmatic aspects to locate its treatment in its right place. This is done by means of identifying the relationship between manipulation and various pragmatic theories and issues

Understanding the role of therapeutic plasma exchange in COVID-19: preliminary guidance and practices

Background and objectives: Cytokine release syndrome in COVID-19 is due to a pathological inflammatory response of raised cytokines. Removal of these cytokines by therapeutic plasma exchange (TPE) prior to end-organ damage may improve clinical outcomes. This manuscript is intended to serve as a preliminary guidance document for application of TPE in patients with severe COVID-19. Material and methods: The available literature pertaining to the role of TPE for treatment of COVID-19 patients was reviewed to guide optimal management. It included indication, contraindication, optimal timing of initiation and termination of TPE, vascular access and anticoagulants, numbers and mode of procedures, outcome measures and adverse events. Results: Out of a total of 78 articles, only 65 were directly related to the topic. From these 65, only 32 were acceptable as primary source, while 33 were used as supporting references. TPE in critically ill COVID-19 patients may be classified under ASFA category III grade 2B. The early initiation of TPE for 1–1·5 patient’s plasma volume with fresh frozen plasma, or 4–5% albumin or COVID-19 convalescent plasma as replacement fluids before multiorgan failure, has better chances of recovery. The number of procedures can vary from three to nine depending on patient response. Conclusion: TPE in COVID-19 patients may help by removing toxic cytokines, viral particles and/or by correcting coagulopathy or restoring endothelial membrane. Severity score (SOFA & APACHE II) and cytokine levels (IL-6, C-reactive protein) can be used to execute TPE therapy and to monitor response in COVID-19 patients

Thrombin Generating Capacity and Phenotypic Association in ABO Blood Groups

<div><p>Individuals with blood group O have a higher bleeding risk than non-O blood groups. This could be explained by the lower levels of FVIII and von Willebrand Factor (VWF) levels in O individuals. We investigated the relationship between blood groups, thrombin generation (TG), prothrombin activation and thrombin inactivation. Plasma levels of VWF, FVIII, antithrombin, fibrinogen, prothrombin and α₂Macroglobulin (α₂M) levels were determined. TG was measured in platelet rich (PRP) and platelet poor plasma (PPP) of 217 healthy donors and prothrombin conversion and thrombin inactivation were calculated. VWF and FVIII levels were lower (75% and 78%) and α₂M levels were higher (125%) in the O group. TG is 10% lower in the O group in PPP and PRP. Less prothrombin was converted in the O group (86%) and the thrombin decay capacity was lower as well. In the O group, α₂M plays a significantly larger role in the inhibition of thrombin (126%). In conclusion, TG is lower in the O group due to lower prothrombin conversion, and a larger contribution of α₂M to thrombin inactivation. The former is unrelated to platelet function because it is similar in PRP and PPP, but can be explained by the lower levels of FVIII.</p></div

Lack of Antibodies to SARS-CoV-2 among Blood Donors during COVID-19 Lockdown: A Study from Saudi Arabia

In response to the coronavirus disease 2019 (COVID-19), Saudi Arabia have imposed timely restrictions to minimize the infection spread, lower the risk for vulnerable groups, and reduce the pressure on healthcare services. The effectiveness of these measures has not been assessed comprehensively and, thereby, remains uncertain. Besides monitoring the number of COVID-19 cases diagnosed by molecular assays, the seroprevalence can serve as an indicator for the incidence rate among the general population. This study aimed to evaluate seroprevalence status of all healthy blood donors who attended one of the main largest hospital located in the western region of Saudi Arabia from 1 January to 31 May 2020. The study period covered two months prior to reporting the first COVID-19 case in the country on 2 March 2020. Importantly, it covered the period when &ldquo;lock-down type&rdquo; measures have been enforced. Samples were subjected to in-house enzyme-linked immunosorbent assay (ELISA), chemiluminescence immunoassay (CLIA), and microneutralization (MN). The sero statuses of all samples were confirmed negative, demonstrating the lack of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among blood donors during COVID-19 lockdown period. This study supports the hypothesis that COVID-19 restrictions have potential for limiting the extent of the infection

Production and Quality Assurance of Human Polyclonal Hyperimmune Immunoglobulins Against SARS-CoV-2

The coronavirus disease 2019 (COVID-19) pandemic has highlighted the potential therapeutic value of early passive polyclonal immunotherapy using high-titer convalescent plasma (CCP). Human polyclonal hyperimmune immunoglobulin (HIG) has several advantages over CCP. Unlike CCP, HIG can provide standardized and controlled antibody content. It is also subjected to robust pathogen reduction rendering it virally safe and is purified by technologies demonstrated to preserve immunoglobulin neutralization capacity and Fc fragment integrity. This document provides an overview of current practices and guidance for the collection and testing of plasma rich in antibodies against Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) and its industrial fractionation for the manufacture of quality-assured and safe HIG. Considerations are also given to the production of HIG preparations in low- and middle-income countries

Effect of ABO blood type on prothrombin conversion and thrombin inactivation.

<p>The total amount of prothrombin converted was increased in the non-O blood groups (A), but the maximum rate of prothrombin conversion was statistically comparable between the groups (B). The total thrombin decay capacity was increased in the non-O blood group compared to the O group (C). Thrombin-antithrombin (T-AT) formation during TG is significantly increased in the non-O group, whereas the amount of thrombin-α₂M (T-α₂M) is comparable (D-E). However, the contribution of α₂M to the inhibition of thrombin was increased in the O blood group (F). Data represent individual measurements of donors divided into different ABO groups. * p<0.05, **p<0.01 and ***p<0.001.</p

Effect of ABO blood type on the plasma levels of VWF, FVIII, prothrombin, fibrinogen, antithrombin and α₂M in healthy subjects.

<p>VWF (A) and FVIII (B) levels were significantly higher in non O blood groups. Prothrombin (C), fibrinogen (D) and antithrombin (E) levels did not differ between the blood groups, and α₂M levels (F) were significantly lower in non O blood groups. Data represent individual measurements of donors divided into different ABO groups. * p<0.05, **p<0.01 and ***p<0.001.</p