Microcirculatory assessment of red blood cell transfusion in children with severe anemia

Background: Pediatric hematology patients frequently receive red blood all transfusions for severe anemia. Our goal was to assess the effect of blood transfusion on the microcirculation and thus provide information on the quality of tissue perfusion. Methods and patients: The sublingual microcirculation was visualized with Sidestream-Darkfield Imaging in 20 anemic (Hb: 7.2 g/dL, 95% CI 6.6-7.9) children receiving red blood cell transfusions and in age matched healthy non-anemic controls. Functional vessel density (FVD) was determined with a semiautomatic program. Results: Immediately after transfusion FVD increased (13.4 versus 15 mm/mm2) and RBC velocity (696 (598-792) versus 628 (549-707) μm/s) decreased but FVD was always significantly lower and RBC velocity was always higher than in the age matched control group (FVD 17 mm/mm2; RBC velocity: 486 (441-530) μm/s). FVD at baseline was lower in patients with infections but with a larger increase after transfusion compared to anemic children without infections (∆FVD 3.4 versus ∆FVD 1.3 mm/mm2). Hemoglobin levels and capillary density correlated well. We did see a larger rise in FVD with transfusion of RBCs aged < 12 days. Conclusion: Whereas conventional monitoring methods may not be able to assess the effect of therapies aimed to improve tissue perfusion, SDF imaging can demonstrate improvements after transfusion but also continuous differences to non-anemic controls. In particular, the microcirculation of anemic oncology patients with infection improves after transfusion. Transfusion thresholds might need to be set higher in in such patients and fresh RBCs < 12 day of storage should be used

Return On Marketing Investment Driven Sponsorship: Optimizing This Marketing Investment In Latin America

Marketing campaigns and strategies: We are all constantly exposed to their bombardment in our every day life, but few understand the undergoing revolution this field is experiencing to finally measure, in financial terms, its impact. Gone are the days of the creative marketing and to stay is the era of quantifiable marketing, a new stage in the field that simply wants to measure if the marketing effort has yielded an impact on what really counts: selling more, to more people, more often and at a higher margin. The following paper targets the sponsorship side of the marketing field, whether expos and trade shows, sponsorships of musical events, recreational gatherings, or company driven shows. Its objective is clear, in as to show a methodology that achieves a strategy to optimize this investment for consumer companies in Latin America. After a comprehensive market study, that analyzed the current measuring marketing methods in Mexico of over 70 marketing executives that manage over $ 282 million dollars in yearly marketing budgets, the proposed methodology was successfully implemented during 2006 for Tequila Casa Cuervo in Mexico by the author. A case study will be presented at the end of this paper to provide a real life example

Strategic Sales Planning Of The Complex Sale In Latin America

Due to the broad offering and the tendency of customers to view IT and Telecom solutions as a commodity, the complex sales environment in Latin America is facing an increasing degree of uncertainty, reflected in a poor sales planning and forecasting effort that is having a significant impact in the profitability of most companies in these verticals.The presentation of this ongoing case is the attempt to empower the sales managers and executives, the largest profession in the world, with a solid and practical strategic sales methodology to allow them to better plan their sales effort in their assigned territories, customer listing or specific vertical. The obvious result expected from this methodology and research is to provide a sales planning model that ensures a higher certainty of the sales forecast, as well as have impact on such sales success metrics as average close rate, average closing cycle and the overall ROMI (return on marketing investment)  of the company’s sales effort. The case can be viewed in three parts or components: and initial extensive exploratory research to determine the exact current nature and situation of the complex sales in Latin America, second, the development of the appropriate sales methodology, and the implementation and evaluation of the sales planning model in the field

Algorithmic analysis and hardware implementation of a two-wire-interface communication analyser

This paper discusses the development of an algorithm for the data analysis to monitor Two-Wire-Interface operation in order to improve the reliability of communication. This algorithm is designed to improve code-efficiency with regards to hardware modelling. An algorithm for the protocol used in the Standard-Mode, Fast-Mode, Fast-Mode Plus and High-Speed-Mode was developed. The proposed algorithm has been derived using the bus protocol specification and implemented in hardware via a hardware description language. The correct operation of the algorithm was proofed by applying the hardware system on a sample communication. The paper also describes the development process of embedded systems and provides information on aspects regarding hardware modelling including a mathematical description of the TWI protocol is provided

ROMI-Driven Sales Promotions: How The Biggest Coca-Cola Bottler Outside Of The U.S. Learned How To Measure The Impact Of Their Sales Promotions

As part of the arsenal of marketing, sales promotions are strategies wherein an incentive is offered to the final consumer or customer to impact sales in the short term (not to exceed three months). Also part of the family are trade promotions that have the same objective, but whose incentives are targeted to the channel of distribution or the POP owners instead of the final consumer. &nbsp;By this definition, one would suppose it is one of the tools of marketing that is the easiest to measure in financial terms because of its short-term nature and specific aim to impact hard metrics, such as sales vs. other campaigns, that try to impact soft metrics, such as brand consideration of purchase intent.&nbsp;Sadly, as the market study presented indicates, few marketing executives, well knowing the exact costs related in each promotion, bother to estimate the required resulting sales to obtain an attractive return on investment and few and far between do a post-mortem examination to quantify the real returns. &nbsp;As such, the objective of this paper is to present an easy methodology to evaluate, before and after, in financial terms, sales promotions of all different types and of all verticals, whether they are B2C or B2B. &nbsp;Also, an in-the-field assessment of the methodology will be presented inside the promotional division of FEMSA, the biggest Coca-Cola Bottler in the world (outside of the US) which performs over 300 promotions per year. The example will serve to illustrate how to implement and replicate this methodology inside of other companies, as well as give evidence of its impact

Communication Barriers in the Decision-making Process: System Language and System Thinking

A major problem in the decision-making process is poor communication regarding threats and risks between information security experts and decision makers. By their nature, experts have a strong interest in operational details and limited insight into the purpose of the organization as they may not fully understand the mission and business. They are overusing System Language and System Thinking. This means they will fail making themselves fully understood by the decision makers, who are therefore not able to make carefully considered risk-based decisions. \ \ This paper describes the theory behind the underlying communication problem between information security experts and decision makers and the use of System Language and System Thinking. We questioned 63 participants, observed and analyzed their opinions, and discussed the results. This has led to Lessons Learned for developing a curriculum on Information Security and Privacy Protection (IS&PP) and defining areas for further research.

Microcirculatory assessment of red blood cell transfusion in children with severe anemia

Background: Pediatric hematology patients frequently receive red blood all transfusions for severe anemia. Our goal was to assess the effect of blood transfusion on the microcirculation and thus provide information on the quality of tissue perfusion. Methods and patients: The sublingual microcirculation was visualized with Sidestream-Darkfield Imaging in 20 anemic (Hb: 7.2 g/dL, 95% CI 6.6-7.9) children receiving red blood cell transfusions and in age matched healthy non-anemic controls. Functional vessel density (FVD) was determined with a semiautomatic program. Results: Immediately after transfusion FVD increased (13.4 versus 15 mm/mm2) and RBC velocity (696 (598-792) versus 628 (549-707) μm/s) decreased but FVD was always significantly lower and RBC velocity was always higher than in the age matched control group (FVD 17 mm/mm2; RBC velocity: 486 (441-530) μm/s). FVD at baseline was lower in patients with infections but with a larger increase after transfusion compared to anemic children without infections (∆FVD 3.4 versus ∆FVD 1.3 mm/mm2). Hemoglobin levels and capillary density correlated well. We did see a larger rise in FVD with transfusion of RBCs aged < 12 days. Conclusion: Whereas conventional monitoring methods may not be able to assess the effect of therapies aimed to improve tissue perfusion, SDF imaging can demonstrate improvements after transfusion but also continuous differences to non-anemic controls. In particular, the microcirculation of anemic oncology patients with infection improves after transfusion. Transfusion thresholds might need to be set higher in in such patients and fresh RBCs < 12 day of storage should be used