6 research outputs found

    Case Report: Effective management of adalimumab-induced acquired hemophilia A with the CyDRI protocol

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    IntroductionAcquired Hemophilia A (AHA) is a rare autoimmune disorder characterized by the emergence of inhibitors that specifically target coagulation Factor VIII, frequently resulting in severe bleeding episodes.MethodsWe conducted a retrospective analysis of the medical records of a 68-year-old male patient who presented with adalimumab-induced AHA.ResultsThe patient received adalimumab, a tumor necrosis factor inhibitor antibody, as part of his treatment for rheumatoid arthritis. The patient’s clinical journey, characterized by intense bleeding and coagulopathy, was effectively managed with the application of recombinant Factor VIIa (rFVIIa) and the CyDRi protocol.DiscussionThe case emphasizes the importance of prompt coagulation assessment in patients with bleeding symptoms receiving disease-modifying therapy for rheumatoid arthritis that includes adalimumab therapy, considering the rare yet life-threatening nature of AHA. Additionally, this report provides an extensive review of the existing literature on drug-induced AHA, with a special emphasis on cases linked to immunomodulatory medications. Through this two-pronged approach, our report aims to enhance understanding and awareness of this severe complication among healthcare providers, promoting timely diagnosis and intervention

    Polarized Imaging Nephelometer Development and Applications on Aircraft

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    Satellite remote sensing is the only method that is able to measure climate forcing atmospheric constituents on a global scale. Aerosols have large impacts on climate, through influencing radiation directly and through their effects on clouds. Remote sensing algorithms that deduce aerosol properties from satellite measurements of scattered sunlight rely on information about scattering patterns of aerosols. Chapter 1 places the work in context through a literature survey, and introduces and clarifies theoretical constructs necessary for understanding the remaining chapters. In order to improve our understanding of light scattering by aerosol particles, and to enable routine in situ airborne measurements of aerosol light scattering to calibrate and validate satellite algorithms, at LACO (Laboratory for Aerosols Clouds and Optics) we have developed an instrument called the Polarized Imaging Nephelometer (PI-Neph). We designed and built the portable PI-Neph instrument at UMBC (University of Maryland, Baltimore County); it directly measures the ambient volume scattering coefficient and the phase matrix elements P11, phase function, and -P12/P11, polarized phase function. Chapter 2 introduces the PI-Neph instrument, while chapter 3 lays out the calibration and data reduction algorithm. The PI-Neph employs illuminating lasers and polarization control, sampling of ambient air through an inlet, and wide field of view detection of scattered light in a scattering angle range of 3� to 176�. The instrument does not employ any moving parts, therefore it is robust and fast enough for airborne measurements. The PI-Neph first measured at a laser wavelength of 532nm, and was first deployed successfully in 2011 aboard the B200 aircraft of NASA Langley during the DEVOTE (Development and Evaluation of satellite ValidatiOn Tools by Experiments) project. In 2013, we upgraded the PI-Neph to measure at 473nm, 532nm, and 671nm nearly simultaneously. LACO has deployed the PI-Neph on a number of airborne field campaigns aboard three different NASA aircraft. This dissertation describes the PI-Neph instrument, the measurement approach, algorithm, and calibrations. Chapter 4 is a validation and error analysis case study, which quantifies the exceptionally good agreement of artificial polystyrene sphere data with Mie theory. The PS sphere validation data was collected during the 2012 deployment for the Deep Convective Clouds and Chemistry (DC3) field campaign. Residuals between Mie fit and PS data (angular mean and population standard deviation) in case of the cross fits were the following. The differences of P11 data and P11 fit (predicted by fit to -P12/P11), relative to the P11 data, was -1.9% � 5.5%. The differences of -P12/P11 data versus -P12/P11 fit (predicted by the fit to P11) was 0.028 � 0.062. Chapter 4 also quantifies the P11 and -P12/P11 calibration errors through a Monte Carlo simulation. At an ambient aerosol scattering coefficient of 100 Mm-1, it is estimated that the PI-Neph will measure P11 (at individual scattering angles) with relative systematic error of approximately 2.3%, and -P12/P11 with absolute systematic error of approximately 0.033. Chapter 5 presents highlights from field measurements. The DEVOTE project enabled the initial PI-Neph results, such as scattering coefficient validation via comparison to other measurements, comparison of polystyrene sphere data to Mie theory, a comparison to AERONET derived phase function, and retrieval of microphysical properties of aerosols in collaboration with Dr. Oleg Dubovik. Chapter 5 also provides an overview of DC3 data, an assessment of data quality, and quantifications of PI-Neph capabilities and noise levels. This dissertation demonstrates the capability of the PI-Neph to measure ambient levels of aerosols down to 10 Mm-1, by measurement examples from the DEVOTE and DC3 aircraft deployments. As a conclusion, an itemized list of accomplishments is given in chapter 6, along with promising future research directions

    In Situ Measurements of Angular-Dependent Light Scattering by Aerosols over the Contiguous United States

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    This work provides a synopsis of aerosol phase function (F (sub 11)) and polarized phase function (F (sub 12)) measurements made by the Polarized Imaging Nephelometer (PINeph) during the Studies of Emissions, Atmospheric Composition, Clouds and Climate Coupling by Regional Surveys (SEAC4RS) and the Deep Convection Clouds and Chemistry (DC3) field campaigns. In order to more easily explore this extensive dataset, an aerosol classification scheme is developed that identifies the different aerosol types measured during the deployments. This scheme makes use of ancillary data that include trace gases, chemical composition, aerodynamic particle size and geographic location, all independent of PI-Neph measurements. The PI-Neph measurements are then grouped according to their ancillary data classifications and the resulting scattering patterns are examined in detail. These results represent the first published airborne measurements of F (sub 11) and minus F (sub 12) divided by F (sub 11) for many common aerosol types. We then explore whether PI-Neph light-scattering measurements alone are sufficient to reconstruct the results of this ancillary data classification algorithm. Principal component analysis (PCA) is used to reduce the dimensionality of the multi-angle PI-Neph scattering data and the individual measurements are examined as a function of ancillary data classification. Clear clustering is observed in the PCA score space, corresponding to the ancillary classification results, suggesting that, indeed, a strong link exists between the angular scattering measurements and the aerosol type or composition. Two techniques are used to quantify the degree of clustering and it is found that in most cases the results of the ancillary data classification can be predicted from PI-Neph measurements alone with better than 85 percent recall. This result both emphasizes the validity of the ancillary data classification as well as the PI-Neph's ability to distinguish common aerosol types without additional information

    DustCube, a nanosatellite mission to binary asteroid 65803 Didymos as part of the ESA AIM mission

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    Nanosatellites are a promising option for the exploration of the solar system and near-Earth objects, providing an agile, reduced cost and mass solution for interplanetary missions. This paper summarises the efforts done during the Phase A study aimed at assessing the feasibility of a nanosatellite-based mission concept for a 3U CubeSat to the vicinity of the binary asteroid 65803 Didymos. The nanosatellite is meant to be part of the Asteroid Impact Mission (AIM) which is the European element of the NASA-ESA jointly developed Asteroid Impact & Deflection Assessment (AIDA) mission. The inclusion of a scientific optical payload based on a Nephelometer, the selected orbital and navigation strategy, together with the differences found between the Beyond-Earth space environments (radiation, micrometeoroids, ejected material, illumination conditions, communications access) and a typical LEO polar environment, unveils new technical challenges to be faced along interplanetary missions. These challenges have been identified and analysed to be included within the DustCube concept of operations, are described in this manuscript
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