German Red Cross

About: German Red Cross is a healthcare organization based out in Berlin, Germany. It is known for research contribution in the topics: Transplantation & Mesenchymal stem cell. The organization has 653 authors who have published 1146 publications receiving 40111 citations. The organization is also known as: Deutsches Rotes Kreuz & DRK.

Modelling and Optimizing Mathematics Learning in Children

Abstract: This study introduces a student model and control algorithm, optimizing mathematics learning in children. The adaptive system is integrated into a computer-based training system for enhancing numerical cognition aimed at children with developmental dyscalculia or difficulties in learning mathematics. The student model consists of a dynamic Bayesian network which incorporates domain knowledge and enables the operation of an online system of automatic control. The system identifies appropriate tasks and exercise interventions on the basis of estimated levels of accumulated knowledge. Student actions are evaluated and monitored to extract statistical patterns which are useful for predictive control. The training system is adaptive and personalizes the learning experience, which improves both success and motivation. Comprehensive testing of input data validates the quality of the obtained results and confirms the advantage of the optimized training. Pilot results of training effects are included and discussed.

Safety and effectiveness of a Patient Blood Management (PBM) program in surgical patients - the study design for a multi-centre prospective epidemiologic non-inferiority trial

Abstract: Preoperative and hospital-acquired anaemia is common among surgical patients. It is associated with an increased risk of morbidity and mortality and a strong risk factor for allogeneic blood transfusions with their own inherent risks. Patient Blood Management (PBM) concepts aim to increase and preserve autologous erythrocyte volume and to optimise haemotherapy. They thus have great potential to benefit patients.

C4 allotyping distinguishes HLA-1314.1 and B14.2 subgroups

Abstract: Complement allotyping (C4, C2, and BF) was performed in 60 unrelated individuals and 15 families characterized for the subtypes (14.1 and 14.2) within HLA-B14. Eighty-seven percent of B14.2 individuals typed positive for the rare C4A2 variant. In contrast, less than 7% of B14.1 individuals were positive for this C4 allotype which is in keeping with a control background frequency. Family studies revealed that three distinct complotypes (complement haplotypes) are characteristic for the two HLA-1314 subgroups. The SC22 and FC31 complotypes characterize the B14.2 subtype, whereas SC31 appears to define B14.1.

Renewed considerations on ethical values for blood and plasma donations and donors.

Abstract: In this issue of Blood Transfusion, Carlo Petrini, Head of the Bioethics Unit of the National Institute of Health in Italy, reviews the ethical implications for blood and plasma donors involved in supplying plasma for the production of plasma-derived medicinal products1. There has been constant debate on this topic for a long time now, particularly regarding voluntary non-remunerated donations (VNRD) as opposed to paid donations. However, whereas issues regarding patients’ safety, donors’ safety and the impact on blood and plasma supply to meet patients’ needs have been extensively discussed2–4, the ethical values underpinning this debate have hardly been considered in the recent past. In this respect, the article by Carlo Petrini, much inspired by the Nuffield Council on Bioethics report on “Human bodies: donation for medicine and research”5, brings a renewed vision of these ethical values which it is important to share with the “blood community” and all other concerned stakeholders. With two other recent reviews on this topic6,7, the article by Carlo Petrini first brings insight into the ethical values involved and then provides helpful clarification of the related terminology. Finally, he offers the possibility of carrying out an ethical evaluation, using the tool described by the Nuffield Council report5. First, it is essential to develop awareness of the ethical principles concerning donors and on motivating further promotion of VNRD, as has recently been done for blood products1,5,6 and haematopoietic stem cells7. These principles are as follows: dignity, non-maleficence, beneficence, autonomy and justice. The principle of dignity is closely related to the “prohibition on making the human body and its parts as such a source of financial gain”, clearly stated in the European Convention on Human Rights and Biomedicine of 1997 (“Oviedo Convention”)8 and the Charter of Fundamental Rights of the European Union9. In this respect, remuneration for blood donation would violate the principle of human dignity. Complying with the principles of non-maleficence and beneficence means that the donor should not be subject to unnecessary or unreasonable harm. Remuneration and profit have been objectively shown to encourage high frequency donations with potentially harmful consequences for the donors10. Donor safety is all the more important as the act of donation is a medical procedure for which the donor will not derive any direct benefit. This constitutive absence of beneficence for donors is a major difference from the ethics governing patients undergoing medical procedures and who are expecting therapeutic benefit from them. Respecting donor’s autonomy involves avoiding any coercion/pressure. As it may be more attractive to those from lower socio-economic groups who have a greater need to use this option to gain income, remuneration for blood could be viewed as coercion against donors, compromising their autonomous decision-making. The principle of justice requires that the burden of donation does not fall disproportionately on a particular group or class, especially when the benefit is accrued to a different group or class. When remuneration is used as an inducement to provide blood or blood components, the “burden of donation” is being shifted to underprivileged populations. Once these ethical principles have been made clear and generally accepted, it is important to reflect on the terminology proposed by the Nuffield Council5 in respect of transactions made in connection with human bodily material, including blood and plasma. A recompense is a payment to a person in recognition of losses they have incurred, material or otherwise. This may take the form of either reimbursement of direct financial expenses incurred in donating bodily material (such as train fares), or compensation for non-financial losses (such as inconvenience, discomfort and time). A reward is a material advantage gained by a person as a result of donating bodily material, which goes beyond “recompensing” the person for the losses they incurred in donating. If reward is calculated as a wage or equivalent it becomes remuneration. A purchase is a payment in direct exchange for a “thing” (a commodity). The review of the ethical principles and the proposed terminology about transactions of human bodily materials led the Nuffield Council to envisage shifting the attention away from the paid/unpaid donation dilemma towards making a distinction between altruistic and non-altruistic interventions. With the aim of seeking areas of shared consensus on what can be done by institutions and organisations to “facilitate” donation of human bodily material (such as blood and plasma), the Nuffield Council suggested an “Intervention Ladder” as a useful tool for analysing the ethical acceptability of different forms of encouragement for donating bodily material in various circumstances5. It is of prime importance to compare each of the six “rungs” of this “Intervention Ladder” with the definition of VNRD of the Council of Europe11. Rungs 1–4 (encompassing, for example, information campaigns, letters of thanks, small tokens, refreshments and reimbursements of direct travel costs incurred in donating) have been classified as altruist-focused. They are fully compatible with the definition of VNRD of the Council of Europe. Rungs 5–6 (encompassing payment either in the form of cash or in kind which could be considered a substitute for money) have been classified as non-altruist-focused. They clearly do not comply with the Council of Europe’s definition of VNRD. Developing awareness of the ethical principles concerning blood and plasma donations and donors, as well as the related terminology and the Nuffield Council “Intervention Ladder” should help in the assessment of current practices and in the better determination of what should be ethically acceptable when encouraging donations to meet patients’ needs for blood components and plasma-derived medicinal products. As an example, these tools should help reflection on the problematic status of time off work that might be far in excess of the time reasonably needed for donation and travel, which can still be given for a donation. This could lead, far from any polemics, to consider moving to ethically more acceptable modes of recognition- encouragement-compensation, as has happened in France, Romania and French-speaking Belgium in the past few years. Similarly, monetary incentives given to students frequently donating plasma could be reviewed and considered as financial motivation12 and, as such, ethically questionable, and, it is to be hoped, lead to a move towards ethically more acceptable modes of recognition-encouragement-compensation. In any case, altruism (and VNRD), widely understood as entailing a selfless gift to others without expectation of remuneration, should continue to play a central role in ethical thinking in this field13, keeping in mind the wellbeing of the donor, and the potential for harm and exploitation that exists within donation practices. Renewed awareness of these views should also help review and improve of the tools currently used to assess and monitor implementation of VNRD14 and its consequences for patients’ and donors’ safety. In addition, renewed consideration of these views could also help better implementation of the existing legal instruments regarding ethical principles for donors and patients and, consequently, VNRD8,9,15. Further, this renewed vision of ethical values for blood and plasma donations and donors should help in supporting important communal values about the kind of society in which we wish to live: a society in which a growing proportion of the blood and plasma supply, sufficient to meet the needs of patients, comes from VNRD, as the most ethically acceptable way of obtaining blood and plasma for patients. Ultimately, in a long-term perspective, this renewed vision of ethical values for blood and plasma donations and donors should help each of the involved stakeholders -mainly donors, blood establishments, plasma collectors, manufacturers of blood components and plasma-derived medicinal products, prescribers, health care providers, health authorities, policy- and decision-makers, and of course patients-understand and accept that VNRD should be considered as the best way to ensure both a safe and sustainable blood and plasma supply for patients and a safe and sustainable donor population.