Establishment of prophylactic enoxaparin dosing recommendations to achieve targeted anti-factor Xa concentrations in children with CHD

Background Enoxaparin may be used to prevent central venous catheter-related thrombosis in patients with CHD. We aimed to determine whether current enoxaparin dosing regimens effectively achieve anti-factor Xa concentrations within prophylactic goal ranges in this patient population. Methods We implemented a formal protocol aimed at reducing central venous catheter-related thrombosis in children with CHD in January, 2016. Standard empiric prophylactic enoxaparin dosing regimens were used – for example, 0.75 mg/kg/dose every 12 hours for patients <2 months of age and 0.5 mg/kg/dose every 12 hours for patients ⩾2 months of age – with anti-factor Xa goal range of 0.25–0.49 IU/ml. Patients <2 years of age who received enoxaparin and had at least one valid steady-state anti-factor Xa measurement between 25 January, 2016 and 31 August, 2016 were retrospectively reviewed. Results During the study period, 47 patients had 186 anti-factor Xa concentrations measured, of which 20 (11%) were above and 112 (60%) were below the prophylactic goal range. Anti-factor Xa concentrations within the goal range were ultimately achieved in 31 patients. Median dose required to achieve anti-factor Xa concentrations within the prophylactic range was 0.89 mg/kg/dose (25, 75%: 0.75, 1.11) for patients <2 months (n=23 patients) and 0.79 mg/kg/dose (25, 75%: 0.62, 1.11) for patients ⩾2 months (n=8 patients). Conclusions Enoxaparin doses required to achieve prophylactic anti-factor Xa concentrations in young children with CHD were consistently higher than the currently recommended prophylactic dosing regimens. Further study is needed to determine whether dose titration to achieve prophylactic anti-factor Xa concentrations is effective in preventing central venous catheter-related thrombosis

Separation of Blood Mixtures Using Fluorescently Labeled Antibodies

Identifying and analyzing biological mixture samples at a crime scene are of paramount concern for forensic scientists, especially if that type of evidence contains only one cell type. The presence of multiple contributors in a biological evidence sample reduces the probative value of DNA evidence and can sometimes lead to its eventual loss of value. As such, this study was performed in an attempt to examine and evaluate flow cytometry analysis as a means to separate blood mixture samples labeled with fluorescent antibodies. Fluorescein Isothiocyanate (FITC) antibodies were specifically targeted and bound to HLA (Human Leukocyte Antigens) markers present on nucleated cells in the blood, after which they were isolated from the blood mixture utilizing Fluorescent Activated Cell Sorting (FACS) - A high throughput technique that separates cell populations based on their optical activity, followed by STR analysis. This approach was tested on fresh blood mixtures containing two contributors, where one contributor possessed an HLA A*02 allele that was not shared with the other contributor. We hypothesize that HLA A*02 positive samples would exhibit fluorescence when bound with the fluorescently labeled antibodies while the HLA A*02 samples would not. As such, we would be able to separate both cell populations using FACS followed by STR analysis. Such a work flow is believed to yield discriminant STR profiles unique to each contributor thus increasing the probative value of the evidence at hand. Results supported our hypothesis and yielded discriminant STR profiles for both contributors, with minor peaks from the A*02 negative contributor being observed in A*02 positive contributor sample. We can then conclude that HLA-A*02 antibodies coupled to FACS is a suitable method that can be utilized to evaluate and separate blood mixture samples in an attempt to yield discriminant STR profiles.https://scholarscompass.vcu.edu/uresposters/1264/thumbnail.jp

\Gamma-extensions of the spectrum of an orbifold

We introduce the \Gamma-extension of the spectrum of the Laplacian of a Riemannian orbifold, where \Gamma is a finitely generated discrete group. This extension, called the \Gamma-spectrum, is the union of the Laplace spectra of the \Gamma-sectors of the orbifold, and hence constitutes a Riemannian invariant that is directly related to the singular set of the orbifold. We compare the \Gamma-spectra of known examples of isospectral pairs and families of orbifolds and demonstrate that it many cases, isospectral orbifolds need not be \Gamma-isospectral. We additionally prove a version of Sunada's theorem that allows us to construct pairs of orbifolds that are \Gamma-isospectral for any choice of \Gamma.Comment: To appear in the Transactions of the AM

Capturing Conflicting Accounts of Domestic Labour:The Household Portrait as a Methodology

Drawing on data from a UK study conducted in 2014/2015, based on qualitative interviews with 25 working parent, heterosexual couples on their domestic division of labour, I argue that the interactive methodology of the ‘Household Portrait’ not only provides data on the distribution of household labour but also reveals gender differences in how domestic labour is conceptualised and measured. Disagreements and inconsistencies between couples over who ‘mostly’ does various tasks embody gendered perceptions of the meaning of doing domestic tasks and the appropriate temporal frame for evaluating individual contributions. Partners’ joking competition over their respective contributions highlight not just the normative expectations guiding what women and men feel they should do but also the criteria that they think should be used to measure their contributions