Retrospective Study to Reduce Blood Transfusion Waste in Remote Island Healthcare Settings

Background. Tokunoshima is a remote island in the Amami Islands, 470 km southwest of the Kagoshima mainland. It has a population of 23,000 and consists of three towns: Tokunoshima, Isen, and Amagi. Three medical institutions on the island are responsible for blood transfusion medicine, but there is no blood stockpiling station on the island, and blood is stockpiled in each of the hospitals. Although Tokunoshima Tokushukai Hospital is responsible for 70% of transfusion medicine on Tokunoshima, it is difficult to maintain a sufficient amount of blood in stock considering disposal. Aim. To determine whether changing the distribution of blood types in a hospital’s stockpile would reduce the transfusion disposal rate. Methods. This was a retrospective survey. By changing the in-house stock of blood products for transfusions delivered to our hospital over 10 years from January 2013 to December 2017 (preintervention) and from January 2018 to December 2022 (postintervention), we compared the cost-saving effects of these two intervention strategies on disposal rates and blood inventories, as well as the survival rates of case profiles requiring transfusion interventions in hospital-donated transfusion and ABO-incompatible transfusion between two periods. The hospital's stock of RBC had changes that storage of type (A, B, O, AB) RBC from (4, 4, 4, 2) units in the pre-interventon to (2, 2, 6, 0) units in the postintervention. Results. The annual blood product waste rate decreased from 23.4% in the preintervention period to 17.9% in the post-intervention period. Conclusion. By changing the blood products stockpiled for transfusion medicine in Tokunoshima, the transfusion disposal rate can be reduced

Decomposition of powerful axisymmetrically polarized laser pulses in underdense plasma

Interaction of relativistically intense axisymmetrically polarized (radially or azimuthally polarized) laser pulses (RIAPLP) with underdense plasma is shown experimentally and theoretically to be essentially different from the interaction of conventional Gaussian pulses. The difference is clearly observed in distinct spectra of the side-scattered laser light for the RIAPLP and Gaussian pulses, as well as in the appearance of a spatially localized strong side emission of second harmonic of the laser pulse in the case of RIAPLP. According to our analysis based on three-dimensional particle-in-cell simulations, this is a result of instability in the propagation of RIAPLP in uniform underdense plasma