Immune-complex deposits in “pauci-immune” glomerulonephritis: a case report and brief review of recent literature

Anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis is considered a “pauci-immune” disease, characterized by absent or mild glomerular tuft staining for immunoglobulin and/or complement. We describe a 72-year-old man with progressive renal failure over five months who was found to have P-ANCA associated crescentic glomerulonephritis. Renal biopsy also revealed immunofluorescence staining for Immunoglobulin G and C3. Treatment comprised corticosteroids, cyclophosphamide, and plasmapheresis but unfortunately kidney function did not recover, likely due to substantial interstitial fibrosis at diagnosis. This case illustrates that serologic evaluation for ANCAs should not be discounted when immune deposits are present. Prompt diagnosis is warranted

Accuracy and Reliability of Examiners’ Observations of Pre-Practice Warm-Up and FIFA 11+ Injury Prevention Program Exercises

Background: The Fédération Internationale de Football Association (FIFA) 11+ is an injury prevention program that decreases the incidence of lower extremity injuries. The purpose of the current study was to understand what specific exercises prevented injury from occurring. We thus developed and tested a form to identify these exercises. We hypothesize that trained examiners could accurately and reliably use this form to identify and record individual exercises performed during preparticipation warm-up. Methods: A repeated-measures study design was used in this investigation. After observing five prepractice warm-up videos obtained from multiple high schools, 11 examiners observed and recorded performed exercises at two different times. The videos included four soccer teams and one American football team. Accuracy, interexaminer reliability, and intraexaminer reliability were assessed. Sensitivity, specificity, accuracy, and percent agreement with a FIFA 11+ expert were measured for each exercise component. Results: The intraclass correlation coefficients between examiners and individually ranged from 0.22 to 1.00 and 0.58 to 1.00, respectively. Reliability was lowest for exercises with similar movements. The percent agreement across all examiners for individual exercises ranged from 20% to 100%. Additionally, the percent agreement between each examiner and the “gold standard” examiner was high (range, 69.6% to 90.4%). For exercises with similar movements, accuracy and reliability were considerably improved (97%) when combined into one category. Conclusion: We determined that trained examiners with different backgrounds and experience can make accurate and reliable observations of most exercises observed in warm-up programs. Using the proposed form, researchers can accurately record exercises and perform quality and fidelity assessments of warm-up exercise routines

The Changing Financial Landscape of Renal Transplant Practice: A National Cohort Analysis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/136048/1/ajt14018_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/136048/2/ajt14018.pd

National Variation in Use of Immunosuppression for Kidney Transplantation: A Call for Evidence‐Based Regimen Selection

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/133631/1/ajt13758_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/133631/2/ajt13758.pd

High-Performance Silicon Photonic Single-Sideband Modulators for Cold Atom Interferometry

The most complicated and challenging system within a light-pulse atom interferometer (LPAI) is the laser system, which controls the frequencies and intensities of multiple laser beams over time to configure quantum gravity and inertial sensors. The main function of an LPAI laser system is to perform cold-atom generation and state-selective detection and to generate coherent two-photon process for the light-pulse sequence. Substantial miniaturization and ruggedization of the laser system can be achieved by bringing together most key functions of the laser and optical system onto a photonic integrated circuit (PIC). Here we demonstrate a high-performance silicon photonic carrier-suppressed single-sideband (CS-SSB) modulator PIC with dual-parallel Mach-Zehnder modulators (DP-MZMs) operating near 1560 nm, which can dynamically shift the frequency of the light for the desired function within the LPAI. Independent RF control of channels in SSB modulator enables the extensive study of imbalances in both the optical and RF phases and amplitudes to simultaneously reach 30 dB carrier suppression and unprecedented 47.8 dB sideband suppression with peak conversion efficiency of -6.846 dB (20.7 %). Using a silicon photonic SSB modulator with time-multiplexed frequency shifting in an LPAI laser system, we demonstrate cold-atom generation, state-selective detection, and the realization of atom interferometer fringes to estimate gravitational acceleration, $g \approx 9.77 \pm 0.01 \,\rm{m/s^2}$, in a Rubidium ($^{87}$Rb) atom system.Comment: 18 pages, 9 figure

The impact of direct‐acting antiviral agents on liver and kidney transplant costs and outcomes

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146297/1/ajt14895_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146297/2/ajt14895.pd

Prescription opioid use before and after kidney transplant: Implications for posttransplant outcomes

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/1/AJT14714-sup-0001-AppendixS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/2/ajt14714_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/3/ajt14714.pd

A Compact Cold-Atom Interferometer with a High Data-Rate Grating Magneto-Optical Trap and a Photonic-Integrated-Circuit-Compatible Laser System

The extreme miniaturization of a cold-atom interferometer accelerometer requires the development of novel technologies and architectures for the interferometer subsystems. Here we describe several component technologies and a laser system architecture to enable a path to such miniaturization. We developed a custom, compact titanium vacuum package containing a microfabricated grating chip for a tetrahedral grating magneto-optical trap (GMOT) using a single cooling beam. In addition, we designed a multi-channel photonic-integrated-circuit-compatible laser system implemented with a single seed laser and single sideband modulators in a time-multiplexed manner, reducing the number of optical channels connected to the sensor head. In a compact sensor head containing the vacuum package, sub-Doppler cooling in the GMOT produces 15 uK temperatures, and the GMOT can operate at a 20 Hz data rate. We validated the atomic coherence with Ramsey interferometry using microwave spectroscopy, then demonstrated a light-pulse atom interferometer in a gravimeter configuration for a 10 Hz measurement data rate and T = 0 - 4.5 ms interrogation time, resulting in $\Delta$ g / g = 2.0e-6. This work represents a significant step towards deployable cold-atom inertial sensors under large amplitude motional dynamics.Comment: 21 pages, 10 figure

Outcome implications of benzodiazepine and opioid co- prescription in kidney transplant recipients

The outcomes of benzodiazepine and opioid co- prescription are not well- defined in transplant populations. We examined linked national transplant registry and pharmaceutical records to characterize benzodiazepine and opioid use in the years before and after transplant in large US cohort of kidney transplant recipients (2007- 2016; N = 98 620), and associations (adjusted hazard ratio, LCLaHRUCL) with death and graft failure. Among the cohort, 15.6% filled benzodiazepine prescriptions in the year before transplant, and 14.0% filled benzodiazepine prescriptions in the year after transplant (short- acting, 9.5%; long- acting, 3.3%; both 1.1%). Use of short- acting benzodiazepines in the year before transplant was associated with a 22% increased risk of death in the year after transplant (aHR, 1.081.221.38), while use of all classes in the year after transplant was associated with increased risk of death from >1 to 5 years (aHR: short- acting 1.291.391.48; long- acting 1.121.251.40; both 1.461.742.07). Recipients who used benzodiazepines were also more likely to fill opioid prescriptions. Recipients who filled both classes of benzodiazepine and the highest level of opioids had a 2.9- fold increased risk of death compared to recipients who did not use either. Co- prescription of benzodiazepines and opioids in kidney transplant recipients is associated with increased mortality. Ongoing research is needed to understand mechanisms of risk relationships.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162821/2/ctr14005.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162821/1/ctr14005_am.pd