Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Genome-wide identification and phenotypic characterization of seizure-associated copy number variations in 741,075 individuals

Copy number variants (CNV) are established risk factors for neurodevelopmental disorders with seizures or epilepsy. With the hypothesis that seizure disorders share genetic risk factors, we pooled CNV data from 10,590 individuals with seizure disorders, 16,109 individuals with clinically validated epilepsy, and 492,324 population controls and identified 25 genome-wide significant loci, 22 of which are novel for seizure disorders, such as deletions at 1p36.33, 1q44, 2p21-p16.3, 3q29, 8p23.3-p23.2, 9p24.3, 10q26.3, 15q11.2, 15q12-q13.1, 16p12.2, 17q21.31, duplications at 2q13, 9q34.3, 16p13.3, 17q12, 19p13.3, 20q13.33, and reciprocal CNVs at 16p11.2, and 22q11.21. Using genetic data from additional 248,751 individuals with 23 neuropsychiatric phenotypes, we explored the pleiotropy of these 25 loci. Finally, in a subset of individuals with epilepsy and detailed clinical data available, we performed phenome-wide association analyses between individual CNVs and clinical annotations categorized through the Human Phenotype Ontology (HPO). For six CNVs, we identified 19 significant associations with specific HPO terms and generated, for all CNVs, phenotype signatures across 17 clinical categories relevant for epileptologists. This is the most comprehensive investigation of CNVs in epilepsy and related seizure disorders, with potential implications for clinical practice

ESDA2010-25375 INFLUENCE OF HYDROGEN ADDITION ON LEAN PREMIXED METHANE-AIR FLAME STATISTICS

ABSTRAC

AMINO ACID AND VITAMIN CONTENT OF PROPOLIS COLLECTED BY NATIVE CAUCASICAN HONEYBEES

The polyphenol content of propolis has received a lot of attention due to the benign biological properties noted in the chemical composition studies. However, there are very limited studies about other chemical components found in trace amounts in nature which contribute to the therapeutic properties of propolis. The present study, therefore, investigated the amino acid and vitamin composition of propolis. Propolis harvested by 60 colonies of Apis mellifera caucasica belonged to local non-migratory beekeepers. The A. m. caucasica is known for its distinctive propolis collecting capability which native to the secluded Ardahan Province of Turkey. Vitamin (Thiamine, Riboflavin) combinations of propolis were determined using the HPLC (High-Performance Liquid Chromatography) fluorescent detector. An amino acid analysis was also performed with the UFLC (Ultra-Fast Liquid Chromatography) system consisting of binary pump and UV/VIS. Our findings record that the vitamin and amino acid content of propolis samples collected from three areas of different altitudes in the same region differed from each other. Vitamin 61 content and Vitamin B2 content ranged between 0.025-0.16 mg/100g, and 0.304-0.777mg/100g, respectively. A maximum amount of amino acid was reported as leucine, while a minimum amount of amino acid was seen as tryptophan in Ardahan propolis. Consequently, the vitamin and amino acid content of propolis, which derived from secondary plant metabolites of resin, varied depending on their geographical altitudes. Those vitamin and amino acids found in the propolis composition are believed to have beneficial therapeutic properties

Amino Acid and Vitamin Content of Propolis Collected by Native Caucasican Honeybees

The polyphenol content of propolis has received a lot of attention due to the benign biological properties noted in the chemical composition studies. However, there are very limited studies about other chemical components found in trace amounts in nature which contribute to the therapeutic properties of propolis. The present study, therefore, investigated the amino acid and vitamin composition of propolis. Propolis harvested by 60 colonies of Apis mellifera caucasica belonged to local non-migratory beekeepers. The A. m. caucasica is known for its distinctive propolis collecting capability which native to the secluded Ardahan Province of Turkey. Vitamin (Thiamine, Riboflavin) combinations of propolis were determined using the HPLC (High-Performance Liquid Chromatography) fluorescent detector. An amino acid analysis was also performed with the UFLC (Ultra-Fast Liquid Chromatography) system consisting of binary pump and UV/VIS. Our findings record that the vitamin and amino acid content of propolis samples collected from three areas of different altitudes in the same region differed from each other. Vitamin B1 content and Vitamin B2 content ranged between 0.025-0.16 mg/100g, and 0.304-0.777mg/100g, respectively. A maximum amount of amino acid was reported as leucine, while a minimum amount of amino acid was seen as tryptophan in Ardahan propolis. Consequently, the vitamin and amino acid content of propolis, which derived from secondary plant metabolites of resin, varied depending on their geographical altitudes. Those vitamin and amino acids found in the propolis composition are believed to have beneficial therapeutic properties