Undocumented Citizens of the United States: The Repercussions of Denying Birth Certificates

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Deceased donor procurement biopsy practices, interpretation, and histology-based decision-making: A survey of US kidney transplant centers

INTRODUCTION: The utility of kidney procurement biopsies is controversial. Understanding the current landscape of how clinicians obtain and use biopsies in organ evaluation may help inform consensus-building efforts. METHODS: An electronic survey was distributed to clinicians at US kidney transplant programs (April 22, 2021-June 30, 2021) to evaluate donor biopsy indications, frequency, processing and interpretation, and impact of findings on practices. RESULTS: Responses from staff involved in organ acceptance (73% surgeons, 20% nephrologists, 6% coordinators) at 95 transplant centers were analyzed, representing 40% of US transplant centers and 50% of recent deceased donor kidney transplant volume. More than a third of centers (35%) reported obtaining procurement biopsies on most-to-all kidneys. Most clinicians decided when to biopsy jointly with the Organ Procurement Organization (OPO) (82%) based on formal criteria for the decision (72%), although 41% reported having requested a biopsy outside of the criteria. Most respondents used a semiquantitative scoring system for interpretation (57%). Many respondents reported rarely or never having access to renal specialty pathologists (37%) or to telepathology (59%). Most respondents reported that a favorable biopsy result would encourage them to accept a marginal donor kidney (72%); nearly half (46%) indicated that an unfavorable biopsy result would lead to decline of a standard criteria kidney. CONCLUSION: Procurement biopsies are commonly used in organ acceptance decisions despite inconsistent access to experienced renal pathologists and heterogeneous approaches to criteria, scoring, and interpretation. Ongoing study and consensus building are needed to direct procurement biopsy practice toward increasing organ utilization and reducing allocation inefficiency

Razvoj i fizikokemijsko vrednovanje farmakosoma diklofenaka

Pharmacosomes are amphiphilic lipid vesicular systems that have shown their potential in improving the bioavailability of poorly water soluble as well as poorly lipophilic drugs. Diclofenac is a poorly water soluble drug and also causes gastrointestinal toxicity. To improve the water solublity of diclofenac, its pharmacosomes (phospholipid complex) have been prepared and evaluated for physicochemical analysis. Diclofenac was complexed with phosphatidylcholine (80 %) in equimolar ratio, in the presence of dichloromethane, by the conventional solvent evaporation technique. Pharmacosomes thus prepared were evaluated for drug solubility, drug content, surface morphology (by scanning electron microscopy), phase transition behaviour (by differential scanning calorimetry), crystallinity (by X-ray powder diffraction) and in vitro dissolution. Pharmacosomes of diclofenac were found to be irregular or disc shaped with rough surfaces in SEM. Drug content was found to be 96.2 1.1 %. DSC thermograms and XRPD data confirmed the formation of the phospholipid complex. Water solubility of the prepared complex was found to be 22.1 µg mL1 as compared to 10.5 µg mL1 of diclofenac. This improvement in water solubility in prepared pharmacosomes may result in improved dissolution and lower gastrointestinal toxicity. Pharmacosomes showed 87.8 % while the free diclofenac acid showed a total of only 60.4 % drug release at the end of 10 h of the dissolution study.Farmakosomi su amfifilni lipidni vezikularni sustavi sa sposobnošću poboljšanja bioraspoloživosti lijekova slabo topljivih u vodi i organskim otapalima. U svrhu povećanja topljivosti diklofenaka (ljekovite tvari koja je slabo vodotopljiva, a uzrokuje i gastrointestinalnu toksičnost) pripravljeni su i evaluirani njegovi farmakosomi (fosfolipidni kompleksi). Diklofenak je kompleksiran s fosfatidilkolinom (80 %) u ekvimolarnom omjeru, u prisutnosti diklormetana, konvencionalnom metodom evaporacije. Tako pripravljenim farmakosomima ispitivana je topljivost, sadržaj ljekovite tvari, morfologija površine (pomoću pretražne elektronske mikroskopije), ponašanje pri prijelazu faza (pomoću diferencijalne pretražne kalorimetrije), kristaliničnost (rendgenskom analizom praha) i in vitro oslobađanje. Farmakosomi diklofenaka su nepravilnog oblika ili u obliku diska te imaju neravnu površinu u SEM-u. Sadržaj ljekovite tvari je 96,2 1,1 %. DSC termogrami i XRPD podaci potvrdili su nastajanje fosfolipidnog kompleksa. Topljivost u vodi dobivenih kompleksa bila je 22,1 µg mL1, a topljivost samog diklofenaka 10,5 µg mL1. Postignuto poboljšanje topljivosti može imati za posljedicu povećano oslobađanje i manju gastrointestinalnu toksičnost. Tijekom 10 h iz farmakosoma se oslobodilo 87,8 %, a iz slobodnog diklofenaka samo 60,4 % ljekovite tvari

Exploring the differences in cloud properties observed by the Terra and Aqua MODIS Sensors

The aerosol-cloud interaction in different parts of the globe is examined here using multi-year statistics of remotely sensed data from two MODIS sensors aboard NASA's <i>Terra</i> (morning) and <i>Aqua</i> (afternoon) satellites. Simultaneous retrievals of aerosol loadings and cloud properties by the MODIS sensor allowed us to explore morning-to-afternoon variation of liquid cloud fraction (CF) and optical thickness (COT) for clean, moderately polluted and heavily polluted clouds in different seasons. Data analysis for seven-years of MODIS retrievals revealed strong temporal and spatial patterns in morning-to-afternoon variation of cloud fraction and optical thickness over different parts of the global oceans and the land. For the vast areas of stratocumulus cloud regions, the data shows that the days with elevated aerosol abundance were also associated with enhanced afternoon reduction of CF and COT pointing to the possible reduction of the indirect climate forcing. A positive correlation between aerosol optical depth and morning-to-afternoon variation of trade wind cumulus cloud cover was also found over the northern Indian Ocean, though no clear relationship between the concentration of Indo-Asian haze and morning-to-afternoon variation of COT was established. Over the Amazon region during wet conditions, aerosols are associated with an enhanced convective process in which morning shallow warm clouds are organized into afternoon deep convection with greater ice cloud coverage. Analysis presented here demonstrates that the new technique for exploring morning-to-afternoon variability in cloud properties by using the differences in data products from the two daily MODIS overpasses is capable of capturing some of the major features of diurnal variations in cloud properties and can be used for better understanding of aerosol radiative effects

A new inscribed amulet from Gerasa (Jerash)

During the 2016 campaign of the Danish-German Jerash Northwest Quarter Project, a gem was discovered in a fill layer, which had been intentionally filled in in order to close a large, well-constructed Roman-period cistern. The amuletic ring-stone considered here adds to the magic material known from Jerash. Although the gem was found out of its primary context, both the iconographic scene on the obverse and the magical inscription on the reverse are unparalleled. The stone belongs to a group of magical amulets in which an image prompted by Classical mythology is combined with an inscription that transforms the image into a specifically magical object intended to act as a love spell.Pendant la campagne 2016 du projet germano-danois Jerash Northwest Quarter, une gemme a été découverte dans un niveau de remblai, qui avait été constitué volontairement afin de combler une grande citerne bien construite de la période romaine. L'amulette dont il est ici question est une addition au corpus magique de Jérash. Bien qu’on ait découvert la gemme hors de son contexte, aussi bien la scène représentée sur l’avers que l’inscription magique sur le revers sont sans parallèles. La pierre appartient à un groupe d’amulettes magiques sur lesquelles une image issue de la mythologie classique est combinée à une inscription qui transforme l’image en un objet magique, spécifiquement destiné à être un sortilège d’amour.خلال المخيم الدنماركي- الألماني سنة 2016 في الربع الشمالي الغربي في مشروع جرش تم العثور على جوهرة ثمينة في الطبقة المطمورة، والتي تم ملؤها وطمرها عمداً من أجل تغطية جزء كبير من بئر جيد المنشأ يعود للفترة الرومانية. تميمة الخاتم الحجري اعتبرت هنا على أنها أُضيفت للمادة السحرية المعروفة من جرش. على الرغم من أنه تم العثور على هذه الجوهرة الثمينة خارج سياقها الأساسي. إن كل من الرسم التصويري الموجود على الوجه الخارجي والنقش السحري الموجود على الوجه النقيض له لا نظير لهما. إن الحجر الذي ينتمي إلى مجموعة التمائم السحرية هو عبارة عن الصورة التي تروج لها الأساطير الكلاسيكية والتي هي عبارة عن دمج بين نقش يحول الصورة إلى موضوع سحري، وتحديداً إلى قطعة سحرية حجرية المقصود منها أن تكون بمثابة تعويذة حب

The unitary ability of IQ and indexes in WAIS-IV

Lichtenberger and Kaufman (2009, p. 167) defined unitary ability as ‘an ability […] that is represented by a cohesive set of scaled scores, each reflecting slightly different or unique aspects of the ability’. Flanagan and Kaufman (2009) and Lichtenberger and Kaufman (2012) used a difference of 23 IQ points between the highest score (Max) and the lowest score (Min) obtained by a subject in the four Indexes of the WAIS-IV to define unitarity of the total IQ score. A similar method has been used to assess the unitary ability of the four Indexes, with a threshold of 5 points. Such difference scores (of 23 for IQ and 5 for Indexes) are considered high and infrequent and the authors therefore conclude that the corresponding Full-Scale IQ score or Index score is uninterpretable. In this paper we argue that these thresholds are inappropriate because they are based on the wrong standard deviation. The main aim of this study was to establish variability thresholds for IQ and the WAIS-IV Indexes for the American standardization sample and to compare these thresholds with those for the Italian standardization sample. We also consider an alternative approach to determining whether an IQ score represents a unitary ability, based on the maximum difference score for the 10 core subtests that contribute to Full-Scale IQ scores

Photoelectric Emission from Interstellar Dust: Grain Charging and Gas Heating

We model the photoelectric emission from and charging of interstellar dust and obtain photoelectric gas heating efficiencies as a function of grain size and the relevant ambient conditions. Using realistic grain size distributions, we evaluate the net gas heating rate for various interstellar environments, and find less heating for dense regions characterized by R_V=5.5 than for diffuse regions with R_V=3.1. We provide fitting functions which reproduce our numerical results for photoelectric heating and recombination cooling for a wide range of interstellar conditions. In a separate paper we will examine the implications of these results for the thermal structure of the interstellar medium. Finally, we investigate the potential importance of photoelectric heating in H II regions, including the warm ionized medium. We find that photoelectric heating could be comparable to or exceed heating due to photoionization of H for high ratios of the radiation intensity to the gas density. We also find that photoelectric heating by dust can account for the observed variation of temperature with distance from the galactic midplane in the warm ionized medium.Comment: 50 pages, including 18 figures; corrected title and abstract field