Identification of chemically sulfated/desulfated glycosaminoglycans in contaminated heparins and development of a simple assay for the detection of most contaminants in heparin

Contaminated heparin was linked to at least 149 deaths and hundreds of adverse reactions. Published report indicates that heparin contaminants were a natural impurity, dermatan sulfate, and a contaminant, oversulfated chondroitin sulfate (OSCS). OSCS was assumed to derive from animal cartilage. By analyzing 26 contaminated heparin lots from different sources, our data indicate that the heparin contaminants were chemically sulfated or chemically sulfated/desulfated glycosaminoglycans (GAGs) consisting of heparan sulfate, chondroitin sulfate, and dermatan sulfate based on monosaccharide quantification, CE, heparin lyase digestion, and liquid chromatography/mass spectrometry analysis. Since currently recommended heparin quality control assays had failed to detect certain heparin contaminants, a simple method that detects most contaminants in heparin was developed. This assay detects specific heparin structures that most contaminants cannot mimic and can be performed in any laboratory equipped with an UV spectrometer

Protocol for the Promoting Resilience in Stress Management (PRISM) Intervention: A Multi-Site Randomized Controlled Trial for Adolescents and Young Adults with Advanced Cancer

Background Adolescents and young adults (AYAs) with cancer are at high risk of poor psychosocial outcomes, and evidence-based interventions designed to meet their psychosocial and communication needs are lacking. The main objective of this project is to test the efficacy of a new adaptation of the Promoting Resilience in Stress Management intervention for AYAs with Advanced Cancer (PRISM-AC). Methods/design The PRISM-AC trial is a 2-arm, parallel, non-blinded, multisite, randomized controlled trial. 144 participants with advanced cancer will be enrolled and randomized to either usual, non-directive, supportive care without PRISM-AC (“control” arm) or with PRISM-AC (“experimental” arm). PRISM is a manualized, skills-based training program comprised of four 30–60 min, one-on-one sessions targeting AYA-endorsed resilience resources (stress-management, goal-setting, cognitive-reframing, and meaning-making). It also includes a facilitated family meeting and a fully equipped smartphone app. The current adaptation includes an embedded advance care planning module. English- or Spanish-speaking individuals 12–24 years old with advanced cancer (defined as progressive, recurrent, or refractory disease, or any diagnosis associated with \u3c 50% survival) receiving care at 4 academic medical centers are eligible. Patients’ caregivers are also eligible to participate in this study if they are able to speak and read English or Spanish, and are cognitively and physically able to participate. Participants in all groups complete surveys querying patient-reported outcomes at the time of enrollment and 3-, 6-, 9-, and 12-months post-enrollment. The primary outcome of interest is patient-reported health-related quality of life (HRQOL) and secondary outcomes of interest include patient anxiety, depression, resilience, hope and symptom burden, parent/caregiver anxiety, depression and health-related quality of life, and family palliative care activation. We will conduct intention-to-treat analysis to compare the group means of primary and secondary outcomes between PRISM-AC arm and control arm with regression models. Discussion This study will provide methodologically rigorous data and evidence regarding a novel intervention to promote resilience and reduce distress among AYAs with advanced cancer. This research has the potential to offer a practical, skills-based curriculum designed to improve outcomes for this high-risk group. Trial registration ClinicalTrials.gov Identifier NCT03668223, September 12, 2018

A Century of Drought in Hawaiʻi: Geospatial Analysis and Synthesis across Hydrological, Ecological, and Socioeconomic Scales

Drought is a prominent feature of Hawaiʻi’s climate. However, it has been over 30 years since the last comprehensive meteorological drought analysis, and recent drying trends have emphasized the need to better understand drought dynamics and multi-sector effects in Hawaiʻi. Here, we provide a comprehensive synthesis of past drought effects in Hawaiʻi that we integrate with geospatial analysis of drought characteristics using a newly developed 100-year (1920–2019) gridded Standardized Precipitation Index (SPI) dataset. The synthesis examines past droughts classified into five categories: Meteorological, agricultural, hydrological, ecological, and socioeconomic drought. Results show that drought duration and magnitude have increased significantly, consistent with trends found in other Pacific Islands. We found that most droughts were associated with El Niño events, and the two worst droughts of the past century were multi-year events occurring in 1998–2002 and 2007–2014. The former event was most severe on the islands of O’ahu and Kaua’i while the latter event was most severe on Hawaiʻi Island. Within islands, we found different spatial patterns depending on leeward versus windward contrasts. Droughts have resulted in over $80 million in agricultural relief since 1996 and have increased wildfire risk, especially during El Niño years. In addition to providing the historical context needed to better understand future drought projections and to develop effective policies and management strategies to protect natural, cultural, hydrological, and agricultural resources, this work provides a framework for conducting drought analyses in other tropical island systems, especially those with a complex topography and strong climatic gradients

Pediatric medical traumatic stress in individuals with craniofacial conditions

Purpose: This article reviews the literature focused on the psychological effects of craniofacial care for patients and their families. It provides an overview of pediatric medical traumatic stress associated with craniofacial conditions and related care along with a review of its risk and protective factors. Findings from studies of pediatric medical traumatic stress in craniofacial populations are also reviewed. Conclusion: The article concludes with strategies for identifying, addressing, and preventing medical traumatic stress in the context of craniofacial care. Specific implications for speech language pathologists are also shared with respect to ways of minimizing risks for medical traumatic stress in craniofacial care. Future directions are also delineated and include strategies to improve screening and support for patients with craniofacial conditions and their families, along with the development of interventions aimed at increasing resilience

Influence of deposition strategies on tensile and fatigue properties in a wire + arc additive manufactured Ti-6Al-4V

This paper investigates the influence of two different deposition strategies, oscillation and parallel pass, on the tensile and high cycle fatigue properties of a wire + arc additive manufactured Ti-6Al-4V alloy in the as-built condition. In the oscillation build, the plasma torch and the wire feeder continuously oscillated across the wall thickness direction. In contrast, four single layers were deposited consecutively in the same direction along the wall length in the parallel pass build. Test specimens were manufactured in horizontal and vertical orientation with respect to the deposited layers. Compared with the parallel pass build, the oscillation build had lower static strength due to its coarser transformation microstructure. However, the elongation values were similar. The presence of columnar primary β grains has resulted in anisotropic elongation values. The vertical samples with loading axis parallel to the primary β grains showed 40% higher elongation than the horizontal samples. The fatigue strength was comparable with its wrought counterpart and greater than typical material by casting. At 107 cycles, fatigue strength of 600 MPa was achieved for the oscillation build vertical samples and the parallel pass build in both orientations. Only the oscillation build horizontal samples had lower fatigue strength of 500 MPa. Fractography analysis showed that most of the samples (about 70%) had crack initiation from pores, about 20% samples had crack initiated from microstructural features and the rest did not failed (runouts at 107 cycles)

Demographic and Clinical Correlates of Diabetes-Related Quality of Life among Youth with Type 1 Diabetes

To evaluate the reliability and cluster structure of the Pediatric Quality of Life Inventory Type 1 Diabetes Module 3.0 (PedsQL-T1DM) and associated subscales and to explore the associations between PedsQL-T1DM total score and demographic and clinical characteristics and clinical indicators among a large racially/ethnically diverse cohort of youth with type 1 diabetes

Silverstein and WFB Prevalence of and Disparities in Barriers to Care Experienced by Youth with Type 1 Diabetes

To describe the prevalence of access and process barriers to health care and to examine their relationship to sociodemographic and disease factors in a large and diverse cohort of US youth with type 1 diabetes

Clinical Xenotransplantation of Organs: Why Aren't We There Yet?

Mohiuddin discusses the lessons learned from large animal xenograft models and why the immunological barrier is still the most important hurdle preventing clinical xenotransplantation of organs

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO