Implementation of a whole blood programme within a blood service: Practical guidance for blood providers

Abstract Background and Objectives Early balanced transfusion is recommended for resuscitation of patients with severe bleeding. Whole blood (WB) is reintroduced as a feasible alternative to blood components, as it includes red blood cells, plasma and platelets in a physiological ratio. Materials and Methods In this review, we aim to provide practical guidance and a framework for blood providers aiming to implement a WB programme. The review summarizes recommendations and practical implications identified from published literature, regulatory requirements and current programmes. Results WB donors are selected based on national donor selection criteria. When the patients' ABO‐type is unknown, low titre anti‐A and anti‐B group‐O WB (LTOWB) are recommended. ABO‐group type‐specific blood can be used in patients with known ABO type. Anticoagulants include CPD and CPDA‐1. Leukoreduction can be performed with a platelet‐sparing filter. WB is stored at +2 to –6°C for up to 35 days. Rotation of the stock and re‐manufacturing to red cell concentrates minimizes outdating. The EDQM Guide to the preparation, use and quality assurance of blood components provides the minimum requirements. Post‐implementation follow‐up includes haemovigilance and quality surveillance. End users should be involved in the development of the programme and training of personnel. Emergency collection of WB can enable transfusion to patients in remote areas, during disasters and during war. Conclusion We conclude that implementation of a WB programme for routine and emergency management of patients with severe bleeding can be performed in a structured, safe and sustainable way.

Transforming transfusion safety: Insights from implementing bedside electronic checks at a large UK National Health Service trust

Abstract Background and Objectives Bedside electronic transfusion checks (BETC) enhance transfusion safety by reducing errors associated with manual processes. Despite national recommendations, BETC adoption in the United Kingdom remains limited. This study reports on the implementation of BETC at four hospitals at Barts Health NHS Trust, aiming to share insights on the implementation process. Materials and Methods The main implementation was split into three phases: (1) pre‐pilot, (2) pilot and (3) main implementation (2022–2025). Staff surveys on training satisfaction and key performance indicators (KPIs) on transfusion activity were used to evaluate the uptake of the BETC system. Statistical process control (SPC) charts were used to identify trends, variation and patterns in the data following the implementation of BETC. Results A total of 5079 staff were trained and 404 personal digital assistant (PDA) devices deployed across four hospitals. Early implementation highlighted that training 60% of staff was insufficient for optimal system use, increasing this threshold to 80% improved adoption. BETC was initially more commonly used for blood administration than group and screen (G&S) sample labelling. Over time, increased usage of BETC for G&S labelling correlated with a marked reduction in sample rejection rates across all sites. Staff reported high satisfaction with training, with 99.5% rating it positively. Conclusion Early adopters played a pivotal role, but achieving widespread adoption required extended training and support. Addressing technical and workflow barriers, coupled with mandatory system use, could enhance the speed of impact of BETC. These insights offer guidance for future adopters aiming to improve transfusion safety and efficiency.

Catherine Kearns, The Rural Landscapes of Archaic Cyprus. An Archaeology of Environmental and Social Change. Cambridge, Cambridge University Press 2022

A newly developed selective grafted resin for radium

Radium analysis in natural waters remains a current challenge in the field of radiological monitoring, as well as for environmental concerns. A new Ra-selective grafted resin was developed in the present work; a calix[4]arene derivative functionalized with a crown-6 ether and two synergistic carboxylic groups serves as the selective chelating agent, while the support consists of SiO 2 . Its properties were investigated in the laboratory by coupling experimental data with a modelling approach. The resin was shown to be efficient for Ra within the pH range typical of natural waters (∼6–8). Its affinity for Ra was significantly higher than for other alkaline earth cations, although it remained sensitive to salt loading. This trend was confirmed by batch sorption tests conducted with both synthetic aqueous media and various natural water samples. The proposed resin appears promising for radium extraction and pre-concentration from natural waters.

Initiating transformative medical practices to address environmental challenges – proceedings of “Santé en 2050”, the French national conference on healthcare adaptation

“Santé en 2050” is the first medical conference in France dedicated to the adaptation of healthcare systems to environmental constraints. Organized in 2024 and 2025 by healthcare professionals within The Shifters, a non-profit association committed to raising public awareness of the dual carbon challenge, the conference provided both a scientific platform for research on mitigation and adaptation in health and a forum to enhance professional competencies on these cross-cutting issues. Over its two successful editions, the event mapped the emerging disease landscape driven by environmental exposures and climate change, affecting both communicable and non-communicable diseases due to shifting temperatures, precipitation patterns, mass population movements, unhealthy lifestyles, and increasing pollution. Climate change also poses indirect threats to health by straining infrastructure, disrupting supply chains, and triggering crises that practitioners must address with ever-scarcer resources. The conference underscored the urgent need for a systemic overhaul of healthcare to build resilient, sustainable care pathways. It provided attendees with practical tools to integrate ecodesigned care, integrative medical approaches, and non-pharmacological interventions into their daily practice. The conference further explored pressing ethical and philosophical dilemmas, examining how technology, research priorities, and innovation must evolve in response to environmental constraints and the broader responsibility of medicine at a population level. Here we summarize the topics discussed during the two editions of the conference. By equipping healthcare workers with skills in epidemiology, disease prevention, and continuity of care amid accelerating environmental change, “Santé en 2050” aims to prepare the medical community for the challenges of tomorrow.

Assessing the Critical Failure Factors of AI Chatbots for Research Using ISM Approach: A Case of Philippine State University Researchers

Despite the potential of artificial intelligence chatbots in overcoming the tedious tasks of research, scholars have considered critical failure factors before fully integrating such tool into the research process. While extensive works have comprehensively described these factors, none have explored their interrelationships in depth. Therefore, this paper applies interpretive structural modeling analyses to an actual case study of a university in the Philippines to understand the structural relationships among factors. It is found that the authors' lack of knowledge in the research field is the most influential factor. This implies that artificial intelligence chatbots must remain an auxiliary tool in research writing and authors must still possess the firsthand, necessary knowledge to serve as the main contributor of new knowledge in the field.

Healthy Ageing: Social, Behavioural and Design Innovations in Research

Available open access digitally under CC-BY licence. This book shares insights from the Healthy Ageing Challenge, bringing research, business, policy and practice together to create age-friendly homes, workplaces and communities. Spanning co-design with older people, business collaboration and innovations in design, work, housing, culture and health, it explores the real-world impact of ageing research and the possibilities for business in developing an ageing market. From age-friendly homes to climate-resilient communities, the book provides a rich evidence base for healthier, more connected lives.

Identification of a sub-population of synovial mesenchymal stem cells with enhanced treatment efficacy in a rat model of osteoarthritis

Osteoarthritis (OA) is a painful, debilitating disease with no cure or treatments that can predictably stop/reverse its progression. Treatment is particularly difficult since articular cartilage lacks intrinsic repair capacity, despite mesenchymal stem cells (MSCs) being present in the joint with robust chondrogenic potential. While heterogeneity exists among MSC subtypes within human synovium, it remains unclear which populations can regenerate cartilage or impact OA progression. We clonally isolated MSCs from normal and OA patient synovium using indexed flow cytometry, then characterized them through differentiation assays and quantitative proteomics. MSC clones were transplanted into a xenograft rat OA model and evaluated by histology and immunofluorescence. We identified heterogeneity in putative MSCs within and between patient groups and their repair capacity in the rat model. However, traditional cell surface markers could not distinguish these subtypes, highlighting the need for single-cell level understanding. Using unbiased proteomics, we identified CD47 as a novel MSC marker. CD47 Hi cells demonstrated robust treatment efficacy in the rat OA model and directly contributed to new articular cartilage formation. Characterizing MSC subtypes is essential for identifying candidates appropriate for clinical investigation and exploiting functional MSCs for cartilage regeneration strategies.

Doubling dolutegravir dosage reduces the viral reservoir in ART-treated people with HIV

Whether antiretroviral therapy (ART) is always completely suppressive, or HIV might continue to replicate at low levels despite ART in some people with HIV (PWH), is still debated. Here, we intensified the ART regimen by doubling dolutegravir (DTG) dosage and investigated the impact of this strategy on HIV blood and tissue reservoirs, immune activation, and inflammation. Twenty HIV-infected adults, who had received a triple ART consisting of 50 mg DTG/600 mg abacavir/300 mg lamivudine pre-intensification and had been suppressed on ART for at least 2 years, were enrolled in a phase 2 randomized clinical trial ( https://clinicaltrials.gov/ identifier: NCT05351684). Half of them received an additional 50 mg of DTG for a period of 84 days. As expected, plasma and tissue DTG concentrations significantly increased during the study period in the intensified group but not in the control group. Accordingly, significant decreases in total HIV DNA, intact HIV DNA, and cell-associated unspliced (US) HIV RNA in peripheral blood mononuclear cells, as well as in the US RNA/total DNA ratio, were observed in the intensified group but not in the control group. Intensification also modestly reduced markers of immune activation and exhaustion but had no measurable impact on systemic or tissue inflammation. Together with this, intensification resulted in a temporary decrease in the CD4/CD8 ratio that returned to baseline by day 84. Our results strongly suggest that the pre-intensification ART regimen was not completely suppressive. If confirmed in larger clinical trials, these results could have an impact on the clinical management of PWH and HIV curative strategies.

Resolving synaptic events using subsynaptically targeted GCaMP8 variants

While genetically encoded Ca 2+ indicators are valuable for visualizing neural activity, their speed and sensitivity have had limited performance when compared to chemical dyes and electrophysiology, particularly at synaptic compartments. We addressed these limitations by engineering a suite of next-generation GCaMP8-based indicators, targeted to presynaptic boutons, active zones, and postsynaptic compartments at the Drosophila neuromuscular junction. We first validated these sensors to be superior to previous versions and synthetic dyes. Next, we developed a Python-based analysis program, CaFire , which enables the automated quantification of evoked and spontaneous Ca² + signals. Using CaFire , we show a ratiometric presynaptic GCaMP8m sensor accurately captures physiologically relevant presynaptic Ca 2+ changes with superior sensitivity and similar kinetics compared to chemical dyes. Moreover, we test the ability of an active zone-targeted, ratiometric GCaMP8m sensor to report differences in Ca² + between release sites. Finally, a newly engineered postsynaptic GCaMP8m, positioned near glutamate receptors, detects quantal events with temporal and signal resolution comparable to electrophysiological recordings. These next-generation indicators and analytical methods demonstrate that GCaMP8 sensors, targeted to synaptic compartments, can now achieve the speed and sensitivity necessary to resolve Ca 2+ dynamics at levels previously only attainable with chemical dyes or electrophysiology.