Schistocytes were observed above 1% in many diseases other than TTP /HUS. Therefore, it is important to understand that schistocytes could be seen in various diseases, and in these cases, schistocytes were usually detected together with other red blood cell morphologic changes. These data support ICSH recommendation that a schistocyte count should be considered clinically meaningful if schistocytes represent the main morphological abnormality in the PB smear.

Pulsed corona induced plasma chemical process (PPCP) has been investigated for the simultaneous removal of NO(x) (nitrogen oxides) and SO2 (sulfur dioxide) from the flue gas emission. It is one of the world's largest scales of PPCP for treating NO(x) and SO2 simultaneously. A PPCP unit equipped with an average 120 kW modulator has been installed and tested at an industrial incinerator with the gas flow rate of 42 000 m3/h. To improve the removal efficiency of SO2 and NO(x), ammonia (NH3) and propylene (C3H6) were used as chemical additives. It was observed that the pulsed corona induced plasma chemical process made significant NO(x) and SO2 conversion with reasonable electric power consumption. The ammonia injection was very effective in the enhancement of SO2 removal. NO removal efficiency was significantly improved by injecting a C3H6 additive. In the experiments, the removal efficiencies of SO2 and NO(x) were approximately 99 and 70%, respectively. The specific energy consumption during the normal operation was approximately 1.4 Wh/m3, and the nanopulse conversion efficiency of 64.3% was achieved with the pulsed corona induced plasma chemical process.

We propose a framework for design roadmapping that parallels existing product roadmapping and technology roadmapping processes. It leverages three needs we have observed in organizations as they use existing roadmapping processes: (1) to focus on development of customer and user experiences (UX), not just on features; (2) to increase engagement of designers early in the planning process; and (3) to provide a means for rapidly responding to changes in the environment. Design roadmapping is an attempt to reconcile differences that arise when customer/user needs are not considered simultaneously with technology choices. The proposed design roadmapping process assists project prioritization and selection. The process aggregates design experience elements along a timeline that associates key user needs with the products, services, and/or systems the organization wishes to deliver. To illustrate the design roadmapping process, we conducted a case study in which we applied the design roadmapping process to projects undertaken by a large corporation's innovation lab located in research centers in San Francisco and Mountain View, CA, in partnership with corporate stakeholders located in Asia. The five-step design roadmapping procedure is provided along with detailed information. The decisions from the design roadmapping process have been incorporated into the company's commercial plans. Key findings in this corporate case study bolster the positive impact of design roadmapping in moving strategic thinking from a technology/ feature-driven process to one that is design/experience-driven. It shows how firms might weigh choices between user needs, design principles, and technological innovation.

It is uncertain whether an initial inappropriate empirical antibiotic treatment of coagulase-negative staphylococci (CoNS) bacteremia adversely affects the outcome. A retrospective cohort study of CoNS bacteremia was performed at the Dongguk University Ilsan Hospital during a 3-year period. During the study period, 109 patients with CoNS bacteremia were enrolled. The median age of the patients was 72 years and most (96%, 105/109) had one or more comorbid diseases. Among the participants, 29% (32/109) received an appropriate empirical antimicrobial therapy. The 30-day mortality was 24% (26/109) and CoNS bacteremia-related mortality was 14% (15/109). There was no difference in the CoNS bacteremia-related mortality between the group with an inappropriate empirical treatment (13%, 10/77) and that with an appropriate treatment (16%, 5/32) (p = 0.46). In the multivariate analysis using the Cox regression analysis method, Pitt bacteremia scores [hazard ratio (HR) 1.48; 95% confidence interval (CI) 1.09-2.01; p = 0.01] and retention of eradicable focus (HR 5.0; 95% CI 1.39-17.9; p = 0.01) were found to be associated with CoNS bacteremia-related mortality. The results suggest that inappropriate empirical therapy might not necessarily be associated with the 30-day mortality or CoNS bacteremia-related mortality. Conversely, Pitt bacteremia scores and retention of eradicable focus were associated with poor outcomes.

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Background/AimsProcalcitonin (PCT) may prove to be a useful marker to exclude or predict bloodstream infection (BSI). However, the ability of PCT levels to differentiate BSI from non-BSI episodes has not been evaluated in nosocomial BSI.MethodsWe retrospectively reviewed the medical records of patients ≥ 18 years of age with suspected BSI that developed more than 48 hours after admission.ResultsOf the 785 included patients, 105 (13.4%) had BSI episodes and 680 (86.6%) had non-BSI episodes. The median serum PCT level was elevated in patients with BSI as compared with those without BSI (0.65 ng/mL vs. 0.22 ng/mL, p = 0.001). The optimal PCT cut-off value of BSI was 0.27 ng/mL, with a corresponding sensitivity of 74.6% (95% confidence interval [CI], 66.4% to 81.7%) and a specificity of 56.5% (95% CI, 52.7% to 60.2%). The area under curve of PCT (0.692) was significantly larger than that of C-reactive protein (CRP; 0.526) or white blood cell (WBC) count (0.518). However, at the optimal cut-off value, PCT failed to predict BSI in 28 of 105 cases (26.7%). The PCT level was significantly higher in patients with an eGFR < 60 mL/min/1.73 m2 than in those with an eGFR ≥ 60 mL/min/1.73 m2 (0.68 vs. 0.17, p = 0.01).ConclusionsPCT was more useful for predicting nosocomial BSI than CRP or WBC count. However, the diagnostic accuracy of predicting BSI remains inadequate. Thus, PCT is not recommended as a single diagnostic tool to avoid taking blood cultures in the nosocomial setting.

Background: Although plasma free hemoglobin (fHb) test is important for assessing intravascular hemolysis, it is still dependent on the gold standard Harboe method using manual and labor-intensive spectrometric measurements at the wavelength of 380-415-450 nm. We established an automated fHb assay using a routine chemistry autoanalyzer that can be tuned to a wavelength of 380-416-450 nm. Methods:The linearity, precision, accuracy, correlation, and sample carryover of fHb measurement using TBA200FRneo method and manual Harboe method were evaluated, respectively. fHb values measured by manual Harboe method were compared with those measured by our new automated TBA200FRneo method.Results: fHb measurements were linear in the range of 0.05~38.75 µmol/L by TBA200FRneo and 0.05~9.69 µmol/L by manual Harboe method. Imprecision analysis (%CV) revealed 0.9~2.8% for TBA200FRneo method and 5.3~13.6% for the manual Harboe method. Comparison analysis showed 0.9986 of correlation coefficient (T BA200FRneo = 0.970 × Harboe + 0.12). In analytical accuracy analysis, the manual Harboe method revealed about 4 times higher average total error % (12.2%) than the TBA200FRneo automated method (2.8%). The sample carryover was −0.0016% in TBA200FRneo method and 0.0038% in Harboe method. Conclusions:In the measurement of fHb, the automated TBA200FRneo method showed better performance than the conventional Harboe method. It is expected that the automated fHb assay using the routine chemistry analyzer can replace the gold standard Harboe method which is labor-intensive and need an independent spectrophotometry equipment.

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