Secondary Acute Myeloid Leukemia in a One-Year-Old Girl Diagnosed with JAK2-V617F Mutation Positive Myeloproliferative Neoplasm

Myeloproliferative neoplasms (MPNs) are a group of clonal disorders characterized by hyperproliferation of hematologic cell lines and have been associated with tyrosine kinase JAK2-V617F mutations. Secondary acute myeloid leukemia (sAML) is a known complication of JAK2-V617F+ MPNs and bears a poor prognosis. Although the evolution of a JAK2-V617F+ MPN to a mixed-lineage leukemia has been reported in the pediatric population, no evolutions into sAML have been described. We present a case of a one-year-old girl diagnosed with JAK2-V617F+ MPN with evolution into sAML. Despite initial morphologic remission, she eventually relapsed and succumbed to her disease

Agriculture Irrigation and Water Use

The 17 Western States, plus Arkansas, Florida, and Louisiana, account for 91 percent of all U.S. irrigated acreage, with the Western States alone contributing over 85 percent. This report integrates data on the distribution, characteristics, uses, and management of water resources from a wide variety of data sources. The report includes charts and tables on water use in irrigation; farm data comparing selected characteristics of irrigated and nonirrigated farms; and data on water application systems, sources of water, pump energy expenses by energy type, values of irrigated and nonirrigated land, and cash rents

Risk Factors for Noninvasive Ventilation Failure in Children Post-Hematopoietic Cell Transplant

Rationale: Little is known on the use of noninvasive ventilation (NIPPV) in pediatric hematopoietic cell transplant (HCT) patients. Objective: We sought to describe the landscape of NIPPV use and to identify risk factors for failure to inform future investigation or quality improvement. Methods: This is a multicenter, retrospective observational cohort of 153 consecutive children post-HCT requiring NIPPV from 2010-2016. Results: 97 (63%) failed NIPPV. Factors associated with failure on univariate analysis included: longer oxygen use prior to NIPPV (p=0.04), vasoactive agent use (p40 at 4 hours [aOR=6.3 9(95% CI: 2.4, 16.4), p<0.001] and vasoactive use [aOR=4.9 (95% CI: 1.9, 13.1), p=0.001]. Of note, 11 patients had a cardiac arrest during intubation (11%) and 3 others arrested prior to intubation. These 14 patients were closer to HCT [14 days (IQR:4, 73) vs 54 (IQR:21,117), p<0.01] and there was a trend toward beginning NIPPV outside of the PICU and arrest during/prior to intubation (p=0.056). Conclusions: In this cohort respiratory rate at 4 hours and vasoactive use are independent risk factors of NIPPV failure. An objective model to predict which children may benefit from a trial of NIPPV, may also inform the timing of both NIPPV initiation and uncomplicated intubation

The Discount Rate: A Review of Opposing Viewpoint

The discount rate as an imposed or calculated rate of future returns to capital investment is a critical factor in the economic evaluation of proposed as well as private investment projects. For example, a government project that promises substantial net benefits when evaluated at a rate of 5 percent may well appear wasteful if the rate is even marginally greater, say 5 1/8 percent. At stake in determining the appropriate discount rate is the efficient allocation of resources between private and public sectors of the economy. The discount rate suggests which projects should be undertaken, and thus the proportion of the economy's activity that should be undertaken, by public agencies as opposed to the proportion that should remain in the private sector. So it is vital to understand what determines an 'appropriate' discount rate

ANALYSIS OF IRRIGATION POTENTIAL IN THE SOUTHEAST: FLORIDA, A SPECIAL REPORT

The doubling of population in Florida between 1960-80 brought about increasing demands for water by agricultural and urban-industrial activities. Irrigated acreage remained highly concentrated in the central counties around Lake Okeechobee, where climatic factors are especially conducive to the production of specialty crops such as citrus, vegetables, tropical fruits, and sugarcane. Prolonged drought during the early 1960's stimulated significant growth in the region's irrigated acreage. In recent years, other U.S. regions and Mexico have provided Florida with intense competition in the market for specialty crops. Florida has 1.2 million acres of unirrigated cropland and another 1.5 million acres of pastureland in soil classes I, II, and III, which represent potential area for irrigation development

Irrigation Potentials in Humid Regions of Eastern United States Based on Drought and Market Conditions.

Ph.D.Physical geographyUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/158051/1/8106093.pd

IRRIGATION IN HUMID REGIONS AN ANNOTATED INTERDISCIPLINARY BIBLIOGRAPHY

This bibliography identifies some of the important literature on the economic and related aspects of irrigation, with special but not exclusive reference to the humid regions of the Eastern United States. The bibliography is categorized under three main headings: on-farm irrigation planning; state, regional, geographic, and economic assessments; and national irrigation and selected policy assessments. To account for distinctive climatic variations reflected in irrigated cropland patterns in the Eastern States, four specific agricultural areas are given intensive treatment, including Florida, the Delmarva Peninsula, southern New Jersey, and Minnesota