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Sample records for apheresis show equivalent

  1. [Multiple apheresis].

    PubMed

    Coffe, C

    2007-05-01

    Multiple apheresis makes it possible to obtain at least two labile blood components from a single donor using a cell separator. It can be either multicomponent apheresis leading to the preparation of at least two different blood component types or red blood cell apheresis providing two identical red blood cell concentrates. These techniques available in addition to whole blood donation, are modifying collection strategies in many Etablissements Français du Sang and will contribute to improve stock logistics in the future. In areas with insufficient stock, these procedures will help achieve blood component self-sufficiency. The author first describes the principle underlying different--current or future--techniques as well as their advantages and drawbacks. He finally addresses the potential impact of these processes on the evolution of blood collection and the advantages to be gained.

  2. World apheresis registry report.

    PubMed

    Stegmayr, Bernd; Ptak, Jan; Wikström, Björn

    2007-02-01

    AEs due to lower calcium were removed from analyses, 6.4% had AEs. Significantly more AEs were found when plasma was used as a replacement fluid (p=0.017, RR 2.05, CI 1.17-3.60). There were no differences in the incidence of AEs between genders. The number of procedures was too small to allow sub analyses of AEs in relation to the diagnoses. Adverse events were not related to the procedure used (p=0.095). Those who received additional Ca infusion during the procedure had no AEs (40 sessions) while the others who received no prophylactic Ca had an AE on 45 occasions (p=0.0141, RR 1.116, CI 1.08-1.15). Data from the registry shows that centers have various approaches to apheresis. One can learn from each other's experience to reduce side effects and improve efficacy. From these data we noted that prophylactic Ca infusion reduced side effects.

  3. Volunteer donor apheresis.

    PubMed

    Waxman, Dan A

    2002-02-01

    Volunteer donor apheresis has evolved from early plasmapheresis procedures that collected single components into technically advanced multicomponent procedures that can produce combinations of red blood cells, platelets, and plasma units. Blood collection and utilization is increasing annually in the United States. The number of apheresis procedures is also increasing such that single donor platelet transfusions now exceed platelet concentrates from random donors. Donor qualifications for apheresis vary from those of whole blood. Depending on the procedure, the donor weight, donation interval, and platelet count must be taken into consideration. Adverse effects of apheresis are well known and fortunately occur in only a very small percentage of donors. The recruitment of volunteer donors is one of the most challenging aspects of a successful apheresis program. As multicomponent apheresis becomes more commonplace, it is important for collection centers to analyze the best methods to recruit and collect donors.

  4. Complications of donor apheresis.

    PubMed

    Winters, Jeffrey L

    2006-07-01

    A decreasing blood donor pool in the presence of increasing blood transfusion demands has resulted in the need to maximally utilize each blood donor. This has led to a trend in the increasing use of automated blood collections. While apheresis donation shares many reactions and injuries with whole blood donation, because of the differences, unique complications also exist. Overall, evidence in the literature suggests that the frequency of reactions to apheresis donation is less than that seen in whole blood donation, though the risk of reactions requiring hospitalization is substantially greater. The most common apheresis-specific reaction is hypocalcemia due to citrate anticoagulation, which, while usually mild, has the potential for severely injuring the donor. Other reactions to apheresis donation are uncommon (e.g., hypotension) or rare (e.g., air embolism). More worrisome, and in need of additional study, are the long-term effects of apheresis donation. Recent evidence suggests that repeated apheresis platelet donations may adversely effect thrombopoiesis as well as bone mineralization. Granulocyte donation has also been implicated in unexpected long-term consequences.

  5. Apheresis activity in Venezuela.

    PubMed

    Saltiel, Christiane

    2005-07-01

    Interest for apheresis activity has been growing in Venezuela. In 1976 there were only a few devices; in 2003, 80 apheresis machines performed 27,675 donor apheresis procedures and 547 therapeutic procedures countrywide. We report the activity at the Metropolitan Blood Bank (the largest one of the country) in the period 1999-2003: 597 therapeutic procedures were performed in 171 patients, during 212 crisis episodes. The average age was 38 +/- 16 years, 65% male and 35% female. Most of the therapeutic procedures were therapeutic plasma exchange for hematology diseases (mainly thrombotic thrombocitopenic purpura and hemophilia inhibitors), including 184 therapeutic procedures with the Autopheresis-C (Baxter Healthcare Corp., Deerfield, IL). Most common adverse effects (3.9%) were hypotension and allergic reactions to the plasma. (c) 2005 Wiley-Liss, Inc.

  6. Distribution of indications and procedures within the framework of centers participating in the WAA apheresis registry.

    PubMed

    Stegmayr, B; Mörtzell Henriksson, M; Newman, E; Witt, V; Derfler, K; Leitner, G; Eloot, S; Dhondt, A; Deeren, D; Rock, G; Ptak, J; Blaha, M; Lanska, M; Gasova, Z; Bhuiyan-Ludvikova, Z; Hrdlickova, R; Ramlow, W; Prophet, H; Liumbruno, G; Mori, E; Griskevicius, A; Audzijoniene, J; Vrielink, H; Rombout-Sestrienkova, E; Aandahl, A; Sikole, A; Tomaz, J; Lalic, K; Bojanic, I; Strineholm, V; Brink, B; Berlin, G; Dykes, J; Toss, F; Nilsson, T; Knutson, F; Ramsauer, B; Wahlstrom, A

    2017-01-04

    The WAA apheresis registry was established in 2003 and an increasing number of centers have since then included their experience and data of their procedures. The registry now contains data of more than 74,000 apheresis procedures in more than 10,000 patients. This report shows that the indications for apheresis procedures are changing towards more oncological diagnoses and stem cell collections from patients and donors and less therapeutic apheresis procedures. In centers that continue to register, the total extent of apheresis procedures and patients treated have expanded during the latest years.

  7. [LDL-apheresis: current status].

    PubMed

    Stefanutti, C; Vivenzio, A; Lucani, G; Di Giacomo, S

    2001-01-01

    State of the art of LDL-apheresis and treatment of severe familiar hypercholesterolemia. Clinical experience of treatment with LDL-apheresis of pediatric and adult patients with familial hypercholesterolemia using the following techniques: D.A.L.I., H.E.L.P., D.S.C. The outcome of treatment with LDL-apheresis in young patients, using the most recently introduced techniques, is reported. We have submitted to LDL-apheresis 11 pediatric patients. The youngest is aged 3.5. LDL-apheresis is able at improving the metabolic impairment and halting the natural evolution of atherosclerotic disease and atherosclerotic complications. At present, LDL-apheresis is the most effective and safe therapeutic approach to the treatment of homozygous, heterozygous and double heterozygous familial hypercholesterolemia.

  8. Lipoprotein-apheresis reduces circulating microparticles in individuals with familial hypercholesterolemia.

    PubMed

    Connolly, Katherine D; Willis, Gareth R; Datta, Dev B N; Ellins, Elizabeth A; Ladell, Kristin; Price, David A; Guschina, Irina A; Rees, D Aled; James, Philip E

    2014-10-01

    Lipoprotein-apheresis (apheresis) removes LDL-cholesterol in patients with severe dyslipidemia. However, reduction is transient, indicating that the long-term cardiovascular benefits of apheresis may not solely be due to LDL removal. Microparticles (MPs) are submicron vesicles released from the plasma membrane of cells. MPs, particularly platelet-derived MPs, are increasingly being linked to the pathogenesis of many diseases. We aimed to characterize the effect of apheresis on MP size, concentration, cellular origin, and fatty acid concentration in individuals with familial hypercholesterolemia (FH). Plasma and MP samples were collected from 12 individuals with FH undergoing routine apheresis. Tunable resistive pulse sensing (np200) and nanoparticle tracking analysis measured a fall in MP concentration (33 and 15%, respectively; P < 0.05) pre- to post-apheresis. Flow cytometry showed MPs were predominantly annexin V positive and of platelet (CD41) origin both pre- (88.9%) and post-apheresis (88.4%). Fatty acid composition of MPs differed from that of plasma, though apheresis affected a similar profile of fatty acids in both compartments, as measured by GC-flame ionization detection. MP concentration was also shown to positively correlate with thrombin generation potential. In conclusion, we show apheresis nonselectively removes annexin V-positive platelet-derived MPs in individuals with FH. These MPs are potent inducers of coagulation and are elevated in CVD; this reduction in pathological MPs could relate to the long-term benefits of apheresis.

  9. Low-Density Lipoprotein Apheresis

    PubMed Central

    2007-01-01

    to 62%, Lp(a) 55 to 68% and fibrinogen 56 to 65%. The mean chronic2 relative decreases in LDL-C and TC with HELP LDL apheresis ranged from 9 to 46% and 5 to 34%, respectively. Familial hypercholesterolemia patients treated with HELP did not achieve the target LDL-C value set by international guidelines (LDL-C < 2.5mmol/L, 100mg/dL). The chronic mean relative increase in HDL-C ranged from 12 to 27%. The ratio of LDL:HDL and the ratio of TC:HDL are 2 measures that have been shown to be important risk factors for cardiac events. In high-risk patients, the recommended target LDL:HDL ratio is less than or equal to 2, and the target TC:HDL ratio is less than 4. In the studies that reported chronic lipid changes, the LDL:HDL and TC:HDL ratios exceeded targeted values. Three studies investigated the effects of HELP on coronary outcomes and atherosclerotic changes. One noted that twice as many lesions displayed regression in comparison to those displaying progression. The second study found that there was a decrease in Agatston scores3 and in the volume of coronary calcium. The last study noted that 2 of 5 patients showed regression of coronary atherosclerosis, and 3 of the 5 patients showed no change as assessed by a global change score. Adverse effects were typically mild and transient, and the majority of events were related to problems with vascular access. Of the 3 studies that provided quantitative information, the proportion of adverse events ranged from 2.9 to 5.1%. GRADE Quality of Evidence In general, studies were of low quality, i.e., case series studies (Tables 1-3). No controlled studies were identified and no studies directly compared the effectiveness of the HELP system with PE or with diet and drug therapy. Conducting trials with a sufficiently large control group would not have been feasible or acceptable given that HELP represents a last alternative in these patients who are resistant to conventional therapeutic strategies. A major limitation is that there

  10. The use of a medico economic database as a part of French apheresis registry.

    PubMed

    Kanouni, T; Aubas, P; Heshmati, F

    2017-02-01

    An apheresis registry is a part of each learned apheresis society. The interest in this is obvious, in terms of knowledge of the practice of apheresis, adverse events, and technical issues. However, because of the weight of data entry it could never be exhaustive and some data will be missing. While continuing our registry efforts and our efforts to match with other existing registries, we decided to extend the data collection to a medico-economic database that is available in France, the Programme de Médicalisation du Système d'Information (PMSI) that has covered reimbursement information for each public or private hospital since 2007. It contains almost all apheresis procedures in all apheresis fields, demographic patient data, and primary and related diagnoses, among other data. Although this data does not include technical apheresis issues or other complications of the procedures, its interest is great and it is complementary to the registry. From 2003-2014, we have recorded 250,585 apheresis procedures, for 48,428 patients. We showed that the data are reliable and exhaustive. The information shows a perfect real life practice in apheresis, regarding indications, the rhythm and the duration of apheresis treatment. This prospective data collection is sustainable and allows us to assess the impact of healthcare guidelines. Our objective is to extend the data collection and match it to other existing databases; this will allow us to conduct, for example, a cohort study specifically for ECP.

  11. The new WAA apheresis registry.

    PubMed

    Stegmayr, Bernd; Klingstedt, Jonas; Grahn, Bengt Erik; Vinnervik, Peter

    2006-06-01

    The WAA (World Apheresis Association) registry for apheresis has been developed to enable registration through internet by centers all around the world. It is of no charge for the registering centers. The new version is available at the site www.iml.umu.se/medicin. Until now more than 5700 treatments have been registered from centers in 6 countries. It allows registration of acute or chronic therapeutic apheresis and also collection of stem cells, cellapheresis, photopheresis and various adsorption technologies. Registration includes diagnoses, access, anticoagulation, replacement fluids, mode of treatment, volumes processed, techniques used and adverse events that develop. Analyses of data enables improvement of quality of apheresis. The new registry enables you to change data that were wrongly entered as well as add data that was missed when you firstly entered the file. We cordially invite all of you to join the registration procedure.

  12. Unusual hand postures but not familiar tools show motor equivalence with precision grasping.

    PubMed

    Tang, Rixin; Whitwell, Robert L; Goodale, Melvyn A

    2016-06-01

    A central question in sensorimotor control is whether or not actions performed with the hands and corresponding actions performed with tools share a common underlying motor plan, even though different muscles and effectors are engaged. There is certainly evidence that tools used to extend the reach of the limb can be incorporated into the body schema after training. But even so, it is not clear whether or not actions such as grasping with tools and grasping with the fingers share the same programming network, i.e. show 'motor equivalence'. Here we first show that feedback-appropriate motor programming for grasps with atypical hand postures readily transfers to stereotypical precision grasps. In stark contrast, however, we find no evidence for an analogous transfer of the programming for grasps using tools to the same stereotypical precision grasps. These findings have important implications for our understanding of body schema. Although the extension of the limb that is afforded by tool use may be incorporated into the body schema, the programming of a grasping movement made with tools appears to resist such incorporation. It could be the case that the proprioceptive signals from the limb can be easily updated to reflect the end of a tool held in the hand, but the motor programs and sensory signals associated with grasping with the thumb and finger cannot be easily adapted to control the opening and closing of a tool. Instead, new but well-practiced motor programs are put in place for tool use that do not exhibit motor equivalence with manual grasping. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Current evidence shows that survival outcomes are equivalent for dialysis techniques.

    PubMed

    Remón Rodríguez, C; Quirós Ganga, P L

    2011-01-01

    Studies that have analyzed survival between hemodialysis and peritoneal dialysis have showed heterogeneous outcomes for both techniques, and often confusing, also dependent on many factors. For this reason, it is necessary to know if there are real differences between the two treatments, to put the scientific evidence as a fundamental pillar in the choice of treatment, along with the clinical circumstances of individual patients, preferences and lifestyle of these. A comparative review of survival among dialysis techniques cannot avoid a basic methodological characteristics or attributes, such as appropriate designs such as observational studies with large cohorts, with incidents and no prevalent populations, with "intent to treat analysis "survival analysis and multivariate analysis with adjustments to the main comorbidity. We studied the nine classical main studies (incidents before 2002), presenting similar conclusions: there are no major differences between the techniques outcomes. When performing a stratification and adjustment for comorbidities, peritoneal dialysis has a equivalent or better prognosis in the nondiabetic group, less comorbidity and younger, almost all the publications, and hemodialysis in diabetics, older and more comorbid groups. The recent studies (including incidents after 2002), concluding a similar behavior for the survival HD: DP. Similarly, age and comorbidity influence the patient's outcomes almost identical to previous studies. In the last decade has seen an improvement in the prognosis of patients on dialysis, more pronounced in PD patients, both in the U.S., and Europe, Australia and in Spain (Andalusia analysis also). Finally, by multivariate analysis, we can show that patient survival on dialysis is much more influenced by conditions at the beginning of the treatment, as age, presence of diabetes or cardiovascular disease, rather than the type of technique of dialysis.  

  14. Long-term therapeutic efficacy of lipoprotein apheresis on circulating oxidative stress parameters--A comparison of two different apheresis techniques.

    PubMed

    Kopprasch, Steffi; Bornstein, Stefan R; Bergmann, Sybille; Graessler, Juergen; Julius, Ulrich

    2015-05-01

    A chronic lipoprotein apheresis therapy leads to an expressed reduction in the incidence of cardiovascular events in high-risk patients. In addition to the elimination of atherogenic lipoproteins such as LDL and lipoprotein(a), an antioxidative effect of lipoprotein apheresis has been suspected. We investigated long-term biochemical effects in sixteen patients undergoing lipoprotein apheresis - lipid filtration (LF, n = 7) or dextran sulfate adsorption (DSA, n = 9). Systemic oxidative stress markers (blood phagocyte chemiluminescence, levels of oxidized LDL and antioxLDL antibodies) were examined at the 1st, 40th and 80th apheresis sessions. In DSA patients, the 80th apheresis session was associated with significantly higher LDL cholesterol removal and lower HDL cholesterol deprivation as compared to LF patients. In contrast to LF patients, DSA patients showed a long-term progressive decrease in circulating oxidant generating activity as evaluated by whole blood chemiluminescence (p < 0.05). Moreover, a single LF apheresis session was associated with higher systemic generation of reactive oxygen species over time. Compared to LF, long-term DSA apheresis is associated with a gradual reduction of circulating oxidative burden and may be considered a beneficial molecular mechanism of this technique. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. How we developed and use the American Society for Apheresis guidelines for therapeutic apheresis procedures.

    PubMed

    Shaz, Beth H; Schwartz, Joseph; Winters, Jeffrey L

    2014-01-01

    The decision to treat a patient with therapeutic apheresis depends on multiple factors, such as what does the patient most likely have, is the diagnosis amenable to apheresis treatment, what is the harm-versus-benefit ratio of apheresis treatment in this patient, and what are the internal and external issues associated with receiving apheresis treatment? The "Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-based Approach from the Writing Committee of the American Society for Apheresis" addresses these issues and helps aid in clinical decision making. The development and application of these Guidelines as well as potential new applications will be discussed in this article. © 2013 AABB.

  16. Indian Society for Apheresis and apheresis tourism in India--is there a future?

    PubMed

    Srivastava, R

    2006-04-01

    Apheresis has now become an internationally popular mode of treatment for multiple immune complex disorders. However, the treatment remains quite expensive in Western Europe and the US. Apheresis tourism is a part of medical tourism or medical tourism specially related to therapeutic apheresis (TA) treatment in a foreign country on a cost effective basis. In the last couple of years, 'Medical Tourism' has become an upcoming and growing enterprise in India. The Indian Society for Apheresis (ISA) has taken a plunge at the opportune time and is trying to promote apheresis tourism in India. ISA is a member of various international apheresis organizations globally including the World Apheresis Association (WAA), the International Society for Apheresis (ISFA), the International Society for Artificial Organs (ISAO) and an associate of other national apheresis societies. The Indian Society for Apheresis (ISA) and the Ludhiana MediCiti (LMC) at Ludhiana Punjab are taking a big step in this direction. The therapeutic apheresis (TA) center at LMC is being set up as a Therapeutic Apheresis Institute and Research Center of excellence. The potential future impacts on the apheresis scenario are summarized.

  17. Apheresis in developing countries around the World.

    PubMed

    Eichbaum, Quentin; Smid, W Martin; Crookes, Robert; Naim, Norris; Mendrone, Alfredo; Marques, José Francisco Comenalli; Marques, Marisa B

    2015-08-01

    At the combined American Society for Apheresis (ASFA) Annual Meeting/World Apheresis Association (WAA) Congress in San Francisco, California, in April of 2014, the opening session highlighted the status of apheresis outside of the United States. The organizers invited physicians active in apheresis in countries not usually represented at such international gatherings to give them a forum to share their experiences, challenges, and expectations in their respective countries with regard to both donor and therapeutic apheresis. Apheresis technology is expensive as well as technically and medically demanding, and low and median income countries have different experiences to share with the rest of the world. Apheresis procedures also require resources taken for granted in the developed world, such as reliable electrical power, that can be unpredictable in parts of the developing world. On the other hand, it was obvious that there are significant disparities in access to apheresis within the same country (such as in Brazil), as well as between neighboring nations in Africa and South America. A common trend in the presentations from Brazil, Indonesia, Malaysia, Nigeria, and South Africa, was the need for more and better physicians and practitioners' training in the indications of the various apheresis modalities and patient oversight during the procedures. As ASFA and WAA continue to work together, and globalization allows for increased knowledge-sharing, improved access to apheresis procedures performed by qualified personnel with safety and high-quality standards will be increasingly available. © 2014 Wiley Periodicals, Inc.

  18. Use of random versus apheresis platelet concentrates.

    PubMed

    Andreu, G; Vasse, J; Sandid, I; Tardivel, R; Semana, G

    2007-12-01

    The respective use of random (RPC) and apheresis (APC) platelet concentrates is highly heterogeneous among countries, ranging from 10 to 98% RPC in countries supposed to provide a similar transfusion service to patients. Moreover, when considering each country in the past 10 years, one can observe that some have changed their policy, switching from a majority of APC to RPC or vice versa. This presentation intends to analyse which factors may impact such decisions. For many years, the only available platelet component was a RPC obtained from whole blood donation by a two centrifugation steps process, the "platelet rich plasma" or PRP method. Since the beginning of the 1970s, APCs became available, with in fact many different techniques leading to many APCs that may not be equivalent. Since the end of the 1980s, a new method of RPC preparation was developed, using the buffy-coat (BC-PC), providing a blood component with highly preserved platelet functions as compared to RPCs prepared by the PRP technique. Finally, the use of each of these components either native, or leuco-reduced, or suspended in a storage solution, or processed with a pathogen inactivation technique adds new layers of complexity to compare them. Innumerable references can be found in the literature describing in vitro functional parameters of platelet concentrates. Although it is clear that BC-RPC retain much more their in vitro functions than PRP-RPC, indicating that no one should use the latter any more, it is much more difficult to distinguish differences between other PCs. Conversely, only a very few studies have been published related to a comparison of clinical efficacy of RPC versus APC, the endpoints being mainly CCI. Similarly to the in vitro studies, although RPC prepared with the PRP method show the lowest CCIs, no clear difference exists between "modern" RPC and APC. Another factor that may impact policy decision is the occurrence of adverse reactions in recipients. When considering

  19. Apheresis education: One center curriculum design experience.

    PubMed

    Nemec, Rosaleen

    2017-04-01

    There is little published in regards to apheresis education and curriculum for nursing. As more importance is placed on education, competency and skills for apheresis through accreditation processes, institutions are left to determine the educational requirements needed for nursing. Working with limited resources, one center has designed a comprehensive apheresis curriculum program that encompasses skills and theory for the novice to experienced learner. Utilizing existing hospital education and incorporating it into the apheresis curriculum was designed to meet the needs of the patient population, nurses and hospital. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Lipoprotein apheresis: present and future uses.

    PubMed

    Moriarty, Patrick M

    2015-12-01

    For the past 40 years, apheresis, in particular, lipoprotein apheresis, has been the therapy of choice to lower LDL-C for familial hypercholesterolemia patients with uncontrolled dyslipidemia and cardiovascular disease. With the advent of recent and future lipid-modifying agents and their ability to lower LDL-C, the question arises on what will be the future of lipoprotein apheresis. Lipoprotein apheresis lowers not only plasma levels of apolipoprotein B lipoproteins but also markers of vascular inflammation and blood rheology. Other vascular diseases, not necessarily associated with familial hypercholesterolemia, such as nephrotic syndrome and peripheral arterial disease have profited from lipoprotein apheresis therapy. In 2013, the Food and Drug Administration approved lipoprotein apheresis therapy for patients with focal segmental glomerulosclerosis. Since 2010, the German healthcare ministry has approved lipoprotein apheresis therapy for patients with an elevated lipoprotein(a) and ongoing cardiovascular disease irrespective of LDL-C levels. Recent and future lipid-modifying therapies will most likely reduce the practice of lipoprotein apheresis therapy for familial hypercholesterolemia patients. Future implications for lipoprotein apheresis will involve vascular diseases that are at present lacking clinically effective therapy, whereas acute and chronic reductions of lipids, vascular inflammation, and/or rheology may improve the clinical outcome.

  1. Platelet function, activation and apoptosis during and after apheresis.

    PubMed

    Bakry, Rania; Sayed, Douaa; Galal, Hanan; Shaker, Sanaa

    2010-10-01

    Platelets are known to undergo shape change, activation, release reaction and apoptosis/necrosis during processing and storage. Apheresis may have a deleterious impact on platelet achievability and functional integrity. Platelet concentrates from 50 male volunteers obtained by COBE spectra were screened for platelet activation (CD62 and CD154) and apoptosis (phosphatidylserine detected by Annexin V). Donor samples before separation, during apheresis and at the third day of storage were used as baseline donor samples. Platelet aggregation to adenosine diphosphate (ADP) and collagen was performed. There was a statistically significant increase in the expression of activation markers in two different samples (during separation samples and third day samples). Although the increase in Annexin V expression was not so observable, it showed a significant increase also. There was marked decline in the platelet aggregation. The correlations between the values of CD62, CD154 and Annexin V were detected in baseline samples and increased during separation and at the third day of platelets storage. Correlation between values of platelet aggregation to collagen and Annexin V was relevant only in the baseline samples. No other correlations were encountered between platelet aggregation and markers of activation and apoptosis during apheresis and storage. Initial platelet activation induced by apheresis may have an impact on phosphatidylserine expression with no impact on aggregation function of platelets during storage.

  2. Alirocumab in patients with heterozygous familial hypercholesterolaemia undergoing lipoprotein apheresis: the ODYSSEY ESCAPE trial

    PubMed Central

    Moriarty, Patrick M.; Parhofer, Klaus G.; Babirak, Stephan P.; Cornier, Marc-Andre; Duell, P. Barton; Hohenstein, Bernd; Leebmann, Josef; Ramlow, Wolfgang; Schettler, Volker; Simha, Vinaya; Steinhagen-Thiessen, Elisabeth; Thompson, Paul D.; Vogt, Anja; von Stritzky, Berndt; Du, Yunling; Manvelian, Garen

    2016-01-01

    Aim To evaluate the effect of alirocumab on frequency of standard apheresis treatments [weekly or every 2 weeks (Q2W)] in heterozygous familial hypercholesterolaemia (HeFH). Methods and results ODYSSEY ESCAPE (NCT02326220) was a double-blind study in 62 HeFH patients undergoing regular weekly or Q2W lipoprotein apheresis. Patients were randomly assigned (2:1, respectively) to receive alirocumab 150 mg (n = 41) or placebo (n = 21) Q2W subcutaneously for 18 weeks. From day 1 to week 6, apheresis rate was fixed according to the patient’s established schedule; from weeks 7 to 18, apheresis rate was adjusted based on the patient’s low-density lipoprotein cholesterol (LDL-C) response in a blinded fashion. Apheresis was not performed when the LDL-C value was ≥30% lower than the baseline (pre-apheresis) value. The primary efficacy endpoint was the rate of apheresis treatments over 12 weeks (weeks 7–18), standardized to number of planned treatments. In the alirocumab group the least square (LS) mean ± SE (95% confidence interval [CI]) per cent change in pre-apheresis LDL-C from baseline at week 6 was −53.7 ± 2.3 (−58.2 to − 49.2) compared with 1.6 ± 3.1 (–4.7 to 7.9) in the placebo group. The primary efficacy endpoint showed statistically significant benefit in favour of alirocumab (Hodges–Lehmann median estimate of treatment difference: 0.75; 95% CI 0.67–0.83; P < 0.0001). Therefore, alirocumab-treated patients had a 0.75 (75%) additional reduction in the standardized rate of apheresis treatments vs. placebo-treated patients. During this period, 63.4% of patients on alirocumab avoided all and 92.7% avoided at least half of the apheresis treatments. Adverse event rates were similar (75.6% of patients on alirocumab vs. 76.2% on placebo). Conclusions Lipoprotein apheresis was discontinued in 63.4% of patients on alirocumab who were previously undergoing regular apheresis, and the rate was at least halved in 92.7% of

  3. Successful Direct Adsorption of Lipoproteins (DALI) Apheresis During Pregnancy in an Omani Woman with Homozygous Familial Hypercholesterolemia.

    PubMed

    Al-Dughaishi, Tamima; Al-Waili, Khalid; Banerjee, Yajnavalka; Sheik, Shahila; Al-Sabti, Hilal; Al-Zakwani, Ibrahim; Al-Mukhaini, Suad; Al Wahaibi, Khalifa; Al-Hinai, Ali T; Al-Rasadi, Khalid

    2015-01-01

    We report our experience with Direct Adsorption of Lipoproteins (DALI) apheresis in an Omani pregnant woman affected by homozygous familial hypercholesterolemia. To the best of our knowledge this is the first successful pregnancy treated with DALI apheresis. The patient had a history of coronary artery disease, supra-aortic valvular stenosis and severe carotid artery disease with right carotid artery stenting. She was on a regular biweekly DALI apheresis since 2008. In May 2013, she became pregnant and rosuvastatin and ezetimibe were stopped while she continued on DALI apheresis biweekly. This treatment during pregnancy was successful with no major complications. The average low-density lipoprotein cholesterol reduction during therapy was 50%. She spontaneously delivered a healthy male infant (2,400 g) at 37 weeks. We showed that DALI apheresis therapy was safe during pregnancy with a good outcome for both mother and neonate.

  4. Blood component collection by apheresis.

    PubMed

    Burgstaler, Edwin A

    2006-07-01

    Apheresis component collection is a rapidly growing area in the blood collection field. Several instruments with varying capabilities are available. This is a brief review of the equipment available for granulocyte and apheresis component collection and indications for their use. In the United States, granulocytes are collected with the Fenwal CS3000, Fenwal CS3000 Plus, COBE (Gambro) Spectra, Haemonetics LN9000, and Fresenius AS 104. The use of hetastarch for sedimenting agent and stimulation with G-CSF and G-CSF plus dexamethasone have substantially increased granulocyte yields. Plateletapheresis is performed in the United States on the Fenwal CS3000, Fenwal CS3000 Plus, Fenwal Amicus, COBE (Gambro) Spectra, Gambro Trima Version 4, Gambro Trima Accel (Version 5), and Haemonetics LN9000. Automated red blood cell (RBC) collections are performed with the Haemonetics MCS+LN8150, Gambro Trima Version 4, Gambro Trima Accel (Version 5), Amicus, and Baxter Alyx. The RBC can be collected concurrently (with other components) in some instruments or separately in others. Plasma is collected concurrently on several instruments. Plasmapheresis for plasma only is performed on the Fenwal Autopheresis C and Haemonetics PCS2. Granulocyte yields range from 0.46 x 10(10) to 1.0 x 10(10) for unstimulated donors and 2.1 x 10(10) to 2.6 x 10(10) for donors stimulated with dexamethasone or prednisone. The use of G-CSF and G-CSF with dexamethasone has substantially increased granulocyte yields with yields of 4.1 x 10(10) to 10.8 x 10(10) reported. Platelet collection rates of 0.045-0.115 x 10(11) plt/min have been reported. Collection efficiencies of 46-85.7% have been reported. Automated (apheresis) component collection has the advantages of controlled volumes or doses of component, efficient use of the donor, multiple components from the same donor, better inventory control, and better quality control due to less manipulation of the individual components. Disadvantages of automated

  5. [Apheresis in antiphospholipid syndrome (APS)].

    PubMed

    De Silvestro, Giustina; Tison, Tiziana; Marson, Piero

    2012-01-01

    Antiphospholipid syndrome (APS) is a rare clinical disorder characterized by thromboembolic manifestations and/or obstetric complications. Along with the clinical symptoms and signs, serum antiphospholipid antibodies have to be detected. APS can be primary, i.e., without any concomitant disorders, or secondary to other autoimmune diseases, particularly systemic lupus erythematosus. Criteria for the diagnosis of APS have been clearly established. Hyperacute APS (or catastrophic antiphospholipid syndrome), often with a poor prognosis, must meet four criteria: involvement of three or more organs, rapid evolution of clinical manifestations, microangiopathic occlusion of small blood vessels at biopsy, and presence of antiphospholipid antibodies. The rationale for apheresis treatment is the removal of pathogenetic antibodies involved in the development of tissue damage. Our experience includes 23 patients, in particular 15 women treated for 19 pregnancies. According to the National Guidelines Program, the effectiveness of apheresis in catastrophic syndrome has a level of evidence of V/VI, with a strength of recommendation A; in highrisk pregnancy it has a level of evidence of V with a strength of recommendation B. It will be necessary to better define the prognosis of various categories of pregnant patients with APS, as well as useful laboratory parameters to monitor its clinical course and anticipate any complications of pregnancy.

  6. Therapeutic apheresis in critically ill patients.

    PubMed

    Sanford, Kimberly W; Balogun, Rasheed A

    2011-01-01

    Therapeutic apheresis procedures in critically ill patients comprises of therapeutic plasma exchange in most cases but also less commonly, erythrocytapheresis (red cell exchange), thrombocytapheresis, or leukocytapheresis. These procedures present a number of challenges to the apheresis healthcare team, and there are myriad beneficial and adverse effects for patients. In this patient population, one has to weigh the risks against the benefits and especially in those situations where apheresis is requested as a treatment when other alternative therapies have failed. Therapeutic plasma exchange is capable of removing toxins, pathologic auto- and allo-antibodies but will also remove beneficial medications, clotting factors and cations which are chelated by citrate anticoagulant. Herein, we review clinically significant issues that are commonly encountered in patients that are in the intensive care unit and have conditions that require therapeutic apheresis. Copyright © 2011 Wiley-Liss, Inc.

  7. Activation of complement during apheresis.

    PubMed Central

    Hetland, G; Mollnes, T E; Garred, P

    1991-01-01

    C3 activation products and the terminal complement complex (TCC) were examined in plasma during plasmapheresis of patients with Guillain-Barré Syndrome (GBS) (n = 4), Waldenström's syndrome (n = 4), and hypercholesterolaemia (n = 1), or during cytapheresis of platelet (n = 10) and granulocyte (n = 2) donors. Blood specimens were taken before, during and after the procedures. There was a significant activation of complement after apheresis in the GBS patients and one of the patients with Waldenström's syndrome, but not in the other patients. There were no significant differences in complement activation products before compared with after cytapheresis in the healthy donors. This demonstrates the biocompatibility with respect to complement activation of the materials used. The observed complement activation in some of the patients during plasma exchange is probably caused by activation products in the replacement plasma. PMID:1904328

  8. Apheresis training for nurses and physicians around the World.

    PubMed

    Neyrinck, Marleen; Vrielink, Hans

    2015-02-01

    A training program for apheresis nurses in leukocyte collection and therapeutic apheresis was developed by the Joint Task Force for Apheresis Education and Certification. This is a modular program with theoretical and practical information and knowledge. On request of the Indonesian authorities, in the capital of Indonesia Jakarta, a certification course for apheresis nurses/operators based on the training program described above was organized in December 2013. The course existed of themes related to apheresis, such as hematology, anatomy, physiology, calculations, adverse events, basics of apheresis, nursing aspects, quality, collection of cells for cellular therapies, pediatrics, and therapeutic collections (cell reductions and exchange procedures). A pretest and post-test regarding the knowledge and judgment in the themes described was taken in Bahasa Indonesia or in English. In total, 38 apheresis nurses and 32 physicians participated in the course. In the post-test, the nurses scored in a mean 72/100 and the physicians 77/100 (nurses vs. physicians: P = 0.005), which was significantly better than the results of the pretest (54/100 and 53/100, respectively (P < 0.0001 for both). In conclusion, with this course, 38 apheresis nurses/operators proved a significant increase of knowledge in the theory behind apheresis. This educational program provides an approach to educate and certificate apheresis nurses. It is also shown that also for physicians working in the field of apheresis, this course is of use increasing their knowledge regarding apheresis.

  9. LDL-Apheresis: Technical and Clinical Aspects

    PubMed Central

    Bambauer, Rolf; Bambauer, Carolin; Lehmann, Boris; Latza, Reinhard; Schiel, Ralf

    2012-01-01

    The prognosis of patients suffering from severe hyperlipidemia, sometimes combined with elevated lipoprotein (a) levels, and coronary heart disease refractory to diet and lipid-lowering drugs is poor. For such patients, regular treatment with low-density lipoprotein (LDL) apheresis is the therapeutic option. Today, there are five different LDL-apheresis systems available: cascade filtration or lipid filtration, immunoadsorption, heparin-induced LDL precipitation, dextran sulfate LDL adsorption, and the LDL hemoperfusion. There is a strong correlation between hyperlipidemia and atherosclerosis. Besides the elimination of other risk factors, in severe hyperlipidemia therapeutic strategies should focus on a drastic reduction of serum lipoproteins. Despite maximum conventional therapy with a combination of different kinds of lipid-lowering drugs, sometimes the goal of therapy cannot be reached. Hence, in such patients, treatment with LDL-apheresis is indicated. Technical and clinical aspects of these five different LDL-apheresis methods are shown here. There were no significant differences with respect to or concerning all cholesterols, or triglycerides observed. With respect to elevated lipoprotein (a) levels, however, the immunoadsorption method seems to be most effective. The different published data clearly demonstrate that treatment with LDL-apheresis in patients suffering from severe hyperlipidemia refractory to maximum conservative therapy is effective and safe in long-term application. PMID:22654591

  10. Therapeutic apheresis--state of the art in the year 2005.

    PubMed

    Bosch, Thomas

    2005-12-01

    Therapeutic apheresis is an extracorporeal blood purification method for the treatment of diseases in which pathological proteins or cells have to be eliminated. Selective plasma processing is more efficient in pathogen removal than unselective plasma exchange and does not require a substitution fluid like albumin. This overview presents the various selective devices for the treatment of plasma (plasmapheresis) and blood cells (leukocyte apheresis). Prospective randomized trials were performed for the treatment of age-related macular degeneration (Rheopheresis), sudden hearing loss (heparin-induced lipoprotein precipitation [HELP]), rheumatoid arthritis (Prosorba), dilative cardiomyopathy (Ig-Therasorb, Immunosorba), acute-on-chronic liver failure (molecular adsorbent recirculating system [MARS]), and ulcerative colitis (Cellsorba). Prospective non-randomized controlled trials were carried out treating hypercholesterolemia (Liposorber) and crossmatch-positive recipients before kidney transplantation (Immunosorba). Uncontrolled studies were done for ABO-incompatibility in living donor kidney transplantation (KT) (Glycosorb), acute humoral rejection after KT (Immunosorba) and acute liver failure (Prometheus). According to the 2002 International Apheresis Registry covering 11428 sessions in 811 patients, 79% of the patients showed an improvement of their condition by apheresis and only a few sessions were fraught with adverse effects (AE). The major AE were blood access difficulties (3.1%) and hypotension (1.6%). In summary, therapeutic apheresis is a safe and effective procedure for the treatment of diseases refractory to drug therapy.

  11. Pediatric therapeutic apheresis: rationale and indications for plasmapheresis, cytapheresis, extracorporeal photopheresis, and LDL apheresis.

    PubMed

    Kim, Yeowon A; Sloan, Steven R

    2013-12-01

    Apheresis refers to the removal of a component of the blood and is performed using a group of medical technologies in which peripheral blood is processed by an instrument that separates the various components. The selected component is isolated while the remainder is returned to the patient. The rationale behind therapeutic apheresis is to remove the pathogenic components from the circulation. Apheresis is also used for peripheral hematopoietic progenitor cell collection. The procedure can be safely performed in most children with modifications to account for smaller pediatric blood volumes.

  12. Therapeutic apheresis in Asia: An Indonesia single center experience.

    PubMed

    Triyono, Teguh; Vrielink, Hans

    2015-06-01

    In developing countries, like Indonesia, apheresis is still a relative new procedure. Nowadays, therapeutic apheresis procedures are performed in the field of hematology and neurology, especially in the teaching hospitals in Indonesia. Therapeutic apheresis procedure, that is, leukocytapheresis, therapeutic plasma exchange (TPE), and thrombocytapheresis are already performed. In the period 2009-2013, 204 apheresis procedures in 137 patients to reduce the leukocytes, 72 TPE procedures in 17 patients, and 14 thrombocyte reductions were performed in the Sardjito hospital, Yogyakarta, Indonesia. In the future, to improve the therapeutic apheresis implementation, it is important to increase the insurance coverage and also should be considered to introduce the apheresis medicine into the curriculum of appropriate physician programs in Indonesia. Especially in Indonesia, a lot of efforts are still being needed to improve implementation of therapeutic apheresis. © 2014 Wiley Periodicals, Inc.

  13. Guidelines for apheresis personnel--an overview.

    PubMed

    Cole, B

    1985-01-01

    The Guidelines for Apheresis Specialists were prepared by the Standards Committee of the Society of Hemopheresis Specialists (SHS) in response to a need to safeguard donors and patients undergoing apheresis from the viewpoint of the technical staff performing the procedures. The Guidelines address technical and administrative topics not covered by instrument manufacturer's training sessions and manuals. The Guidelines contain the following objectives: To assure that apheresis procedures are performed and supervised by qualified personnel, thereby safeguarding the donors, patients and recipients of the components harvested. To assure that apheresis procedures are carried out in a safe, efficient and appropriate manner with minimum risk and maximum benefit. To assure donor/patient safety and high quality component preparation through an effective quality control program. The Guidelines are flexible, adaptable to various physical settings, applicable to different types of instruments, and useful for both therapeutic and donor hemopheresis procedures. They avoid references to issues that may be considered to interfere with internal or external policymaking bodies. In addition, they provide a base from which policies and procedures can be formulated and amended to account for advances in technology and expertise.

  14. MUTZ-3 derived Langerhans cells in human skin equivalents show differential migration and phenotypic plasticity after allergen or irritant exposure.

    PubMed

    Kosten, Ilona J; Spiekstra, Sander W; de Gruijl, Tanja D; Gibbs, Susan

    2015-08-15

    After allergen or irritant exposure, Langerhans cells (LC) undergo phenotypic changes and exit the epidermis. In this study we describe the unique ability of MUTZ-3 derived Langerhans cells (MUTZ-LC) to display similar phenotypic plasticity as their primary counterparts when incorporated into a physiologically relevant full-thickness skin equivalent model (SE-LC). We describe differences and similarities in the mechanisms regulating LC migration and plasticity upon allergen or irritant exposure. The skin equivalent consisted of a reconstructed epidermis containing primary differentiated keratinocytes and CD1a(+) MUTZ-LC on a primary fibroblast-populated dermis. Skin equivalents were exposed to a panel of allergens and irritants. Topical exposure to sub-toxic concentrations of allergens (nickel sulfate, resorcinol, cinnamaldehyde) and irritants (Triton X-100, SDS, Tween 80) resulted in LC migration out of the epidermis and into the dermis. Neutralizing antibody to CXCL12 blocked allergen-induced migration, whereas anti-CCL5 blocked irritant-induced migration. In contrast to allergen exposure, irritant exposure resulted in cells within the dermis becoming CD1a(-)/CD14(+)/CD68(+) which is characteristic of a phenotypic switch of MUTZ-LC to a macrophage-like cell in the dermis. This phenotypic switch was blocked with anti-IL-10. Mechanisms previously identified as being involved in LC activation and migration in native human skin could thus be reproduced in the in vitro constructed skin equivalent model containing functional LC. This model therefore provides a unique and relevant research tool to study human LC biology in situ under controlled in vitro conditions, and will provide a powerful tool for hazard identification, testing novel therapeutics and identifying new drug targets.

  15. MUTZ-3 derived Langerhans cells in human skin equivalents show differential migration and phenotypic plasticity after allergen or irritant exposure

    SciTech Connect

    Kosten, Ilona J.; Spiekstra, Sander W.; Gruijl, Tanja D. de; Gibbs, Susan

    2015-08-15

    After allergen or irritant exposure, Langerhans cells (LC) undergo phenotypic changes and exit the epidermis. In this study we describe the unique ability of MUTZ-3 derived Langerhans cells (MUTZ-LC) to display similar phenotypic plasticity as their primary counterparts when incorporated into a physiologically relevant full-thickness skin equivalent model (SE-LC). We describe differences and similarities in the mechanisms regulating LC migration and plasticity upon allergen or irritant exposure. The skin equivalent consisted of a reconstructed epidermis containing primary differentiated keratinocytes and CD1a{sup +} MUTZ-LC on a primary fibroblast-populated dermis. Skin equivalents were exposed to a panel of allergens and irritants. Topical exposure to sub-toxic concentrations of allergens (nickel sulfate, resorcinol, cinnamaldehyde) and irritants (Triton X-100, SDS, Tween 80) resulted in LC migration out of the epidermis and into the dermis. Neutralizing antibody to CXCL12 blocked allergen-induced migration, whereas anti-CCL5 blocked irritant-induced migration. In contrast to allergen exposure, irritant exposure resulted in cells within the dermis becoming CD1a{sup −}/CD14{sup +}/CD68{sup +} which is characteristic of a phenotypic switch of MUTZ-LC to a macrophage-like cell in the dermis. This phenotypic switch was blocked with anti-IL-10. Mechanisms previously identified as being involved in LC activation and migration in native human skin could thus be reproduced in the in vitro constructed skin equivalent model containing functional LC. This model therefore provides a unique and relevant research tool to study human LC biology in situ under controlled in vitro conditions, and will provide a powerful tool for hazard identification, testing novel therapeutics and identifying new drug targets. - Highlights: • MUTZ-3 derived Langerhans cells integrated into skin equivalents are fully functional. • Anti-CXCL12 blocks allergen-induced MUTZ-LC migration.

  16. The effect of low-density lipoprotein apheresis on ocular microcirculation in patients with hypercholesterolaemia: a pilot study.

    PubMed

    Terai, Naim; Julius, Ulrich; Haustein, Michael; Spoerl, Eberhard; Pillunat, Lutz E

    2011-03-01

    To investigate the effect of low-density lipoprotein (LDL) apheresis on ocular microcirculation in patients with hypercholesterolaemia. Six patients with hypercholesterolaemia were included in this study. The diameter of retinal vessels was measured continuously with the retinal vessel analyser before and after LDL apheresis. After baseline assessment a monochromatic luminance flicker was applied to evoke retinal vasodilation. Flicker response was then analysed 50, 70 and 120 s after baseline measurement. In addition, cholesterol, high-density lipoprotein, LDL and triglyceride levels were obtained to find a possible correlation between changes in retinal vessel diameter and lipid metabolism before and after apheresis. The mean diameter of the arterioles at baseline was 107.6±2.1 μm and the mean diameter of the venules at baseline was 132.8±3.2 μm. The diameter of the arterioles after apheresis increased to 111.2±2.3 μm after 50 s, 113.2±2.6 μm after 70 s and 113.7±2.6 μm after 120 s, showing a trend to statistical significance at all time points (p=0.046, p=0.028 and p=0.028, respectively). The mean diameter of the venules after apheresis increased to 138.8±5.9 μm after 50 s, 139.8±6.3 μm after 70 s and 141.2±6.0 μm after 120 s, showing a trend to statistical significance at all time points (all p=0.028). Changes in retinal vascular diameter seem to be associated with the systemic effect of a single LDL apheresis. Vasodilatation of the arterioles and the venules improved after LDL apheresis, indicating an improvement of ocular perfusion in patients with hypercholesterolaemia.

  17. Establishing an institutional therapeutic apheresis registry.

    PubMed

    Mann, Steven A; McCleskey, Brandi; Marques, Marisa B; Adamski, Jill

    2016-12-01

    Apheresis was first performed as a therapeutic procedure in the 1950s. The first national therapeutic apheresis (TA) registry was established in Canada in 1981 and other national registries followed, including two attempts at establishing an international TA registry. There is no national registry in the United States. Our large, academic, tertiary hospital has a very active TA service. We created a TA database to track all procedures performed by the apheresis service by transferring data from paper appointment logs and the electronic medical records into a Microsoft Access database. Retrospective data from each TA procedure performed at UAB from January 1, 2003 through December 31, 2012 were entered, including the type of procedure, indication, date, and patient demographics. Microsoft Excel was used for data analysis. During the 10-year period, our TA service treated 1,060 patients and performed 11,718 procedures. Of these patients, 70% received therapeutic plasma exchange (TPE), 21% received extracorporeal photopheresis (ECP), 4.5% received red cell exchange (RCE), 4.2% received leukocytapheresis, and 0.6% underwent platelet depletion. Among the procedures, 54% were TPEs, 44% were ECPs, 1.3% were RCEs, 0.5% were leukocytaphereses, and 0.1% were platelet depletions. According to the current literature, national and international TA use is underreported. We believe that the UAB TA registry provides useful information about TA practices in our region and can serve as a model for other institutions. Furthermore, data from multiple institutional registries can be used for clinical research to increase the available evidence for the role of TA in various conditions. J. Clin. Apheresis 31:516-522, 2016. © 2015 Wiley Periodicals, Inc.

  18. Low-density lipoprotein apheresis: an overview.

    PubMed

    Bambauer, Rolf; Schiel, Ralf; Latza, Reinhard

    2003-08-01

    Atherosclerosis with myocardial infarction, stroke, and peripheral cellular disease still maintains its position at the top of morbidity and mortality statistics in industrialized nations. Established risk factors widely accepted are smoking, arterial hypertension, diabetes mellitus, and central obesity. Furthermore, there is a strong correlation between hyperlipidemia and atherosclerosis. The prognosis of patients suffering from severe hyperlipidemia, sometimes combined with elevated lipoprotein (a) (Lpa) levels, and coronary heart disease (CHD) refractory to diet and lipid-lowering drugs is poor. For such patients, regular treatment with low-density lipoprotein (LDL) apheresis is the therapeutic option. Today, there are four different LDL apheresis systems available: immunoadsorption, heparin-induced extracorporeal LDL/fibrinogen precipitation, dextran sulfate LDL adsorption and LDL hemoperfusion. Regarding the different LDL apheresis systems used, there is no significant difference with respect to the clinical outcome or concerning total cholesterol, LDL, high-density lipoprotein (HDL), or triglyceride concentrations. With respect to elevated Lpa levels, however, the immunoadsorption method seems to be the most effective. In 45 patients (25 women, 20 men) suffering from familial hypercholesterolemia resistant to diet and lipid lowering drugs, low-density lipoprotein (LDL) apheresis was performed over 95.6 +/- 44.7 months. Four different systems (Liposorber, 32 of 45, Kaneka, Osaka, Japan; Therasorb, 6 of 45, Baxter, Munich, Germany; Lipopak, 2 of 45, Pocard, Moscow, Russia; and Dali, 5 of 45, Fresenius, St. Wendel, Germany) were used. With all methods, average reductions of 57% for total cholesterol, 55.9% for LDL, 75.8% for lipoprotein a (Lpa), and 45.9% for triglycerides, and an average increase of 14.3% for HDL were reached. Severe side-effects such as shock or allergic reactions were very rare (0.3%) in all methods. In the course of treatment, an improvement

  19. The relationship of platelet yield, donor's characteristic and apheresis instruments in China.

    PubMed

    Yin, Guomei; Xu, Jian; Shen, Zhuolan; Wang, Yongjun; Zhu, Faming; Lv, Hangjun

    2013-12-01

    Platelet yield was associated with donor's characteristic and property of apheresis instruments. Here, we have analyzed the relationship of platelet yield, physiologic parameters of donors for different apheresis instruments in China. Data were consecutively retrieved from plateletapheresis donors during March 1, 2007 and March 1, 2012. Three different apheresis instruments MCS+, Amicus, Trima system were used for plateletapheresis and defined as group 1, 2 and 3 respectively. Totally 77,091 Plateletapheresis donations were performed in this study. 17 donations were finally aborted because of vasovagal reaction with syncope. 5861, 37,036, 34,177 donations were performed in group 1, 2 and 3 respectively. Hct and platelet values before donations were similar, but platelet yield and collection rate were showed significantly difference (p<0.05) among the three groups. The values of platelet and Hct in the males before donations were higher than those in the females, and the platelet yield and collection rate were showed significantly difference between the male group and female group (p<0.05). The overall reaction rate was 1.56%. Most donors were chosen the group 2 (51.6%) for next donation, followed by group 3 (33%) and group 1 (15.4%). We concluded that the platelet yield and collection rate in the male group were higher than those in the female group and the efficiency of plateletapheresis was associated with the kind of apheresis instruments and donor's characteristic. These data will help to work out suitable apheresis protocol based on the Chinese donor's characteristic.

  20. Healthy older observers show equivalent perceptual-cognitive training benefits to young adults for multiple object tracking.

    PubMed

    Legault, Isabelle; Allard, Rémy; Faubert, Jocelyn

    2013-01-01

    The capacity to process complex dynamic scenes is of critical importance in real life. For instance, traveling through a crowd while avoiding collisions and maintaining orientation and good motor control requires fluent and continuous perceptual-cognitive processing. It is well documented that effects of healthy aging can influence perceptual-cognitive processes (Faubert, 2002) and that the efficiency of such processes can improve with training even for older adults (Richards et al., 2006). Here we assess the capacity of older participants to improve their tracking speed thresholds in a dynamic, virtual reality environment. Results show that this capacity is significantly affected by healthy aging but that perceptual-cognitive training can significantly reduce age-related effects in older individuals, who show an identical learning function to younger healthy adults. Data support the notion that learning in healthy older persons is maintained for processing complex dynamic scenes.

  1. Healthy Older Observers Show Equivalent Perceptual-Cognitive Training Benefits to Young Adults for Multiple Object Tracking

    PubMed Central

    Legault, Isabelle; Allard, Rémy; Faubert, Jocelyn

    2013-01-01

    The capacity to process complex dynamic scenes is of critical importance in real life. For instance, traveling through a crowd while avoiding collisions and maintaining orientation and good motor control requires fluent and continuous perceptual-cognitive processing. It is well documented that effects of healthy aging can influence perceptual-cognitive processes (Faubert, 2002) and that the efficiency of such processes can improve with training even for older adults (Richards et al., 2006). Here we assess the capacity of older participants to improve their tracking speed thresholds in a dynamic, virtual reality environment. Results show that this capacity is significantly affected by healthy aging but that perceptual-cognitive training can significantly reduce age-related effects in older individuals, who show an identical learning function to younger healthy adults. Data support the notion that learning in healthy older persons is maintained for processing complex dynamic scenes. PMID:23761025

  2. Lymphocyte Changes in Normal Apheresis Donors

    DTIC Science & Technology

    1983-01-01

    SE -1 R I TY* -tL 1’Ct 4, T- T -J𔃾, A -ý r - H I- A IN 1* P 1, -c A REPORT DOCUMENTATION PAGE RA) INkr ,, fi;N ;5 E~R UdR2 GOVT ACCESO NO~ 3 ;PE,’>o...donors’ immune status. Furthermore, it is not known if there are cumulative effects resulting from multiple apheresis procedures. Of further concern is... multiple sclerosis, severe atopic eczema, infiammatory bowel disease and juvenile rheumatoid arthritis. In contrast, excessive numbers of T8+ suppressor

  3. Persistent aggregates in apheresis platelet concentrates are commonly collected from donors with a history of aggregate donation.

    PubMed

    Feys, H B; Pottel, H; Coene, J; Vandewalle, G; Vandekerckhove, P; Compernolle, V

    2016-11-01

    Platelet apheresis sometimes causes persistent aggregates (PA). This study (n = 211) shows that changing the apheresis settings to reach fixed product volumes instead of yields does not influence PA incidence, even though PA products on average contain more platelets than controls. Furthermore, logistic regression was used to model if PA can be predicted on the basis of certain predonation parameters. PA donation history was the only parameter retained, proving a strong determinant of predictability [AUC = 0.735 (SE = 0.022)]. Consequently, donations from a donor with previous PA history are 7.8 times more likely to contain PA than from a donor without preceding history.

  4. Namibia’s transition from whole blood–derived pooled platelets to single-donor apheresis platelet collections

    PubMed Central

    Pitman, John P.; Basavaraju, Sridhar V.; Shiraishi, Ray W.; Wilkinson, Robert; von Finckenstein, Bjorn; Lowrance, David W.; Marfin, Anthony A.; Postma, Maarten; Mataranyika, Mary; Sibinga, Cees Th. Smit

    2015-01-01

    BACKGROUND Few African countries separate blood donations into components; however, demand for platelets (PLTs) is increasing as regional capacity to treat causes of thrombocytopenia, including chemotherapy, increases. Namibia introduced single-donor apheresis PLT collections in 2007 to increase PLT availability while reducing exposure to multiple donors via pooling. This study describes the impact this transition had on PLT availability and safety in Namibia. STUDY DESIGN AND METHODS Annual national blood collections and PLT units issued data were extracted from a database maintained by the Blood Transfusion Service of Namibia (NAMBTS). Production costs and unit prices were analyzed. RESULTS In 2006, NAMBTS issued 771 single and pooled PLT doses from 3054 whole blood (WB) donations (drawn from 18,422 WB donations). In 2007, NAMBTS issued 486 single and pooled PLT doses from 1477 WB donations (drawn from 18,309 WB donations) and 131 single-donor PLT doses. By 2011, NAMBTS issued 837 single-donor PLT doses per year, 99.1% of all PLT units. Of 5761 WB donations from which PLTs were made in 2006 to 2011, a total of 20 (0.35%) were from donors with confirmed test results for human immunodeficiency virus or other transfusion-transmissible infections (TTIs). Of 2315 single-donor apheresis donations between 2007 and 2011, none of the 663 donors had a confirmed positive result for any pathogen. As apheresis replaced WB-derived PLTs, apheresis production costs dropped by a mean of 8.2% per year, while pooled PLT costs increased by an annual mean of 21.5%. Unit prices paid for apheresis- and WB-derived PLTs increased by 9 and 7.4% per year on average, respectively. CONCLUSION Namibia’s PLT transition shows that collections from repeat apheresis donors can reduce TTI risk and production costs. PMID:25727921

  5. Training courses for pediatric apheresis on site; how apheresis technology transfer can be performed.

    PubMed

    Witt, Volker

    2010-10-01

    Apheresis technology for pediatric patients and donors is still cumbersome, it is rare, mostly done in departments specialized for apheresis in adult patients, and therefore the staff is more or less anxious about dealing with especially little pediatric patients or donors. Our center is specialized in pediatrics and has a department for apheresis. We offered training courses for interested centers, which want to use the AMICUS™ system for leukapheresis in small children. In a 1-2 ay course the principles of leukapheresis in very small children were trained. To investigate the reproducibility of this training courses we invited the centers to share their data with us. As a standard we used a formula (C=[(AD):B×0.5]:1000) for predicting the CD34+ cell yield (C) by calculating the yield from total blood volume (D) processed, bodyweight (B), CD34+ cell count in peripheral blood (A) and an assumption of the collection efficiency of 50% (0.5). We hypostasized that the deviation of different centers should be in comparable limits of agreement as our own data. Thirteen centers from Germany, Poland, Ukraine, Romania, Italy, Hungary, and Slovakia asked from 1999 until today for support for pediatric leukapheresis. 6 centers sent 20 case report forms back (9 blood priming, 6 saline priming), from which 15 were completely filled in and available for the evaluation. The data were compared to 129 leukapheresis (41 blood priming, 88 saline priming) performed in our institution. The limit of agreement to the formula was -17.6% (±43) compared to -10.5% (±36). There was no statistically differences by the Mann-Whitney-U-test (p=0.5607). We conclude that training course held on site in different centers in different country could led to reproducible performance of standardized leukapheresis procedures in small children. In the future this could be a way for quality control in pediatric apheresis. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. [Reducing low density lipoprotein-cholesterol levels by apheresis].

    PubMed

    Reiber, I; Gógl, A

    1994-03-13

    The predominate number of homozygote familial hypercholesterolemic and approximately 20% of heterozygotes are resistant to low cholesterol diet and lipid lowering pharmacological treatment even in combination of 2 or more drugs. In such cases, the selective lipoprotein apheresis has become a promising alternative and indicated absolute (homozygotes) or relative (heterozygotes). The combination of low density lipoprotein apheresis, together with diet and drugs, should allow a maximal lowering of low density lipoprotein-cholesterol (-60-70%). Besides low density lipoprotein, various apheresis procedures may also eliminate other potentially atherogenic factors, such as lipoprotein(a) and fibrinogen and acutely improve the haemo-rheological status of the patient. The authors review several lipoprotein apheresis procedures with varying degrees of selectivity, those have and furthermore analysis the advantages and disadvantages and cost of each procedure.

  7. Thrombocyte adhesion and release of extracellular microvesicles correlate with surface morphology of adsorbent polymers for lipid apheresis.

    PubMed

    Weiss, René; Spittler, Andreas; Schmitz, Gerd; Fischer, Michael B; Weber, Viktoria

    2014-07-14

    Whole blood lipid apheresis is clinically applied to reduce low density lipoprotein cholesterol in patients with homozygous familial hypercholesterolemia. Here, we studied the correlation between physicochemical parameters, in particular, surface roughness and blood compatibility, of two polyacrylate-based and a dextran sulfate-based polymer for lipid apheresis. The adsorbent surface roughness was assessed by atomic force microscopy. Freshly isolated human thrombocytes were circulated over adsorbent columns downscaled equivalent to clinical use to study thrombocyte adhesion and microvesicle generation. Quantification of thrombocytes and microvesicles in the flow-through of the columns revealed that both thrombocyte adhesion and microvesicle generation increased with increasing adsorbent surface roughness. Activation of thrombocytes with thrombin receptor-activating peptide-6 favored their adhesion to the adsorbents, as demonstrated by preferential depletion of CD62(+) and PAC-1(+) thrombocytes. Taken together, enhanced polymer surface roughness fostered cell adhesion and microvesicle release, underscoring the role of extracellular microvesicles as markers of cellular activation and of blood compatibility.

  8. [The effect of leukocyte depletion by filtration on the quality of apheresis platelets].

    PubMed

    Yu, Yang; Feng, Qian; Zhang, Ting; Ma, Chun-Ya; Zhang, Xiao-Juan; Ge, Guo-Feng; Lin, Zi-Lin; Pan, Ji-Chun; Wang, De-Qing; Luo, Qun; Tian, Ya-Ping

    2009-08-01

    This study was aimed to investigate the effect of leukocyte depletion by filtration on the quality of apheresis platelets. 20 units of donor apheresis platelets were randomly selected and were preserved with agitation at 20 - 24 degrees C for 24 - 96 hours, then were filtered on polyester flatbed filters. The platelet concentration, mean platelet volume (MPV), volume of apheresis platelets, leukocyte count, pH value, lactate dehydrogenase (LDH) concentration, K(+) concentration and CD62p expression level on surface of platelet membrane, were detected before and after filtration, as well as the rate of leukocyte depletion and platelet loss were calculated. The results showed that the leukocyte count after filtration was remarkably lower than that before filtration (p < 0.001), and the rate of leukocyte depletion was 99.97%. Platelet loss was approximately 8%, and obviously lower than that of the national standard (p < 0.001). MPV, pH value, K(+) and LDH concentration were not significantly different before and after filtration. Compared with platelets before filtration, CD62p expression level after filtration slightly decreased (p > 0.05). CD62p expression on surface of platelet membrane in perfusion fluid obtained from filter plate was obviously higher than that before filtration (p < 0.05). MA of platelet after filtration slightly decreased (p > 0.05). It is concluded that leukocyte and partial activated platelets can be removed efficiently by using polyester flatbed filters, and platelet loss is very low. Filtration does not adversely affect coagulation activity of the platelets in vitro. Apheresis platelets after filtration can fulfil quality requirements to prevent infection of cytomegalovirus and HLA alloimmunization.

  9. Collection, storage, inspection and quality control of platelet concentrates obtained by apheresis: The situation in Spain.

    PubMed

    Castrillo, Azucena; Jimenez-Marco, Teresa; Arroyo, José L; Jurado, María L; Larrea, Luis; Maymo, Rosa M; Monge, Jorge; Muñoz, Carmen; Pajares, Ángel; Yáñez, Marta

    2017-06-01

    Diverse variables are involved in apheresis platelet collection, processing and storage. This survey shows how these are realized in Spain. An analysis of collected data was performed in a questionnaire completed by ten Transfusion Centers (TC) which perform between 50 and 520 apheresis procedures per month. This information comprises the procedures used to collect, inspect and store apheresis platelet concentrates (PC), and quality control data. Macroscopic inspection of PC is performed in all TC, especially during the first few hours post-collection and before distribution. The type of processor, duration of post-collection resting periods and temperature from the time of collection until distribution are similar in all TC. In 80% of TC, PC with small and scarce aggregates are distributed to transfusion services. The presence of clumps is influenced by type of processor, female donor, cold ambient temperature and collection of hyperconcentrated platelets, and is often recurrent in the same donor, although some TC have not found any influential variables. Overall, no objective inspection methods are followed, although there are exceptions. The degree of compliance with quality control parameters, such as the number of units studied, mean platelet yield, residual leukocyte counts and pH at expiry date, is acceptable in all TC. Compliance in terms of number of microbiological culture samples is variable. The usual practice in Spanish TC with respect to the collection, post-collection handling and storage of apheresis PC can be considered uniform, although some specific aspects of analyses should follow more objective methods. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. [Changes of platelet aggregation function of apheresis collected platelets and soluble P-selectin during storage].

    PubMed

    Xie, Zuo-Ting; Yang, Li-Hong; Tao, Zhi-Hua; Wang, Ming-Shan; Hong, Jun-Ying; Zhou, Wu; Chen, Zeng-Qiang; Dai, Mei-Jie

    2008-10-01

    The objective of this study was to explore the changes of aggregation function of apheresis platelets and soluble P-selectin (sP-selectin) during storage. 20 samples of apheresis platelets were collected, and the aggregation function were examined by function test and the level of sP-selectin every day in storage of 5 days. The results showed that the aggregation function of platelets declined obviously during storage, there were significant differences between the first-day group and any of the other groups (p < 0.01). The max platelet aggregation rate was < or = 3% in the fourth-day group; sP-selectin level in plasma increased with prolong of storage time; there were significant differences between the first-day group and any of the other groups (p < 0.05). In conclusion, platelets were activated continuously during storage, while its aggregation function declines significantly. The ability of platelet aggregation to response to ADP loses almost completely since the fourth day during platelet storage. It should be paid more attention to the damage of apheresis collected platelets during storage.

  11. Granulocyte and Monocyte Adsorption Apheresis for Generalized Pustular Psoriasis: Therapeutic Outcomes in Three Refractory Patients.

    PubMed

    Fujisawa, Tomomi; Suzuki, Satoko; Mizutani, Yoko; Doi, Tomoaki; Yoshida, Shozo; Ogura, Shinji; Seishima, Mariko

    2015-08-01

    Generalized pustular psoriasis (GPP) is a type of neutrophilic dermatosis that is sometimes resistant to medications. In patients with neutrophilic skin diseases, granulocyte and monocyte adsorption apheresis (GMA) has been demonstrated to selectively and efficiently eliminate myeloid-lineage leukocytes from the peripheral blood. We evaluated the efficacy and safety of repeated GMA therapy in three refractory GPP patients. Three GPP patients refractory to previous therapies received weekly GMA with five sessions per course, which was repeated when the symptoms reappeared. The efficacy was assessed by the disease severity scores 2 weeks after each course of GMA. The GPP severity scores of all three patients were reduced in all courses (N = 9); they were reduced by more than 3 points in six courses and by 2 points in three courses. After the first GMA course, the GPP severity scores were reduced by more than 3 points in all three patients. On average, the GPP severity scores were reduced by 4.67 and 3.67 points after the first course and repeated courses, respectively. The severity of edema and pustules were particularly improved in all patients and no adverse effects were observed. GMA showed efficacy for the treatment of refractory GPP patients as a non-pharmacologic intervention without any associated adverse effects, and was particularly effective in the first course, but also effective in the subsequent courses. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  12. Characterization and application of a miniature 10 mL stirred-tank bioreactor, showing scale-down equivalence with a conventional 7 L reactor.

    PubMed

    Betts, Jonathan I; Doig, Steven D; Baganz, Frank

    2006-01-01

    The aim of this study was to characterize the engineering environment of an instrumented 10 mL miniature stirred-tank bioreactor and evaluate its potential as a scale-down device for microbial fermentation processes. Miniature bioreactors such as the one detailed in this work have been developed by several research groups and companies and seek to address the current bottleneck at the screening stage of bioprocess development. The miniature bioreactor was characterized in terms of overall volumetric oxygen transfer coefficient and mixing time over a wide range of impeller speeds. Power input to the miniature bioreactor was directly measured, and from this the power number of each impeller was calculated and specific power input estimated, allowing the performance of the miniature bioreactor to be directly compared with that of a conventional 7 L bioreactor. The capability of the miniature bioreactor to carry out microbial fermentations was also investigated. Replicate batch fermentations of Escherichia coli DH5alpha producing plasmid DNA were performed at equal specific power input, under fully aerobic and oxygen-limiting conditions. The results showed a high degree of equivalence between the two scales with regard to growth and product kinetics. This was underlined by the equal maximum specific growth rate and equal specific DNA product yield on biomass obtained at the two scales of operation, demonstrating the feasibility of scaling down to 10 mL on the basis of equivalent specific power input.

  13. Map showing contours on the top of the Pennsylvanian and Permian Minnelusa Formation and equivalents, Powder River basin, Wyoming and Montana

    USGS Publications Warehouse

    Crysdale, B.L.

    1990-01-01

    This map is one in a series of U.S. Geological Survey Miscellaneous Field Studies (MF) maps showing computer-generated structure contours, isopachs, and cross sections of selected formations in the Powder River basin, Wyoming and Montana. The map and cross sections were constructed from information stored in a U.S. Geological Survey Evolution of Sedimentary Basins data base. This data base contains picks of geologic formation and (or) unit tops and bases determined from electric resistivity and gamma-ray logs of 8,592 wells penetrating Tertiary and older rocks in the Powder River basin. Well completion cards (scout tickets) were reviewed and compared with copies of all logs, and formation or unit contacts determined by N. M. Denson, D.L. Macke, R. R. Schumann and others. This isopach map is based on information from 1,480 of these wells that penetrate the Minnelusa Formation and equivalents.

  14. Therapeutic Apheresis in Immunologic Renal and Neurological Diseases.

    PubMed

    Bambauer, Rolf; Latza, Reinhard; Burgard, Daniel; Schiel, Ralf

    2017-02-01

    Since the mid 1970s, when membrane modules became available, plasma separation techniques have gained in importance especially in the past few years. The advantages of this method are a complete separation of the corpuscular components from the plasma and due to increased blood flow rate and higher efficacy. Systemic autoimmune diseases based on an immune pathogenesis produce autoantibodies and circulating immune complexes, which cause inflammation in the tissues of various organs. In most cases, these diseases have a poor prognosis without treatment. Therapeutic apheresis (TA) in combination with immunosuppressive therapies has led to a steady increase in survival rates over the last 40 years. The updated information on immunology and molecular biology of different immunologic diseases are discussed in relation to the rationale for apheresis therapy and its place in combination with other modern treatments. The different diseases can be treated by various apheresis methods such as therapeutic plasma exchange (TPE) with substitution solution, or with online plasma or blood purification using adsorption columns, which contain biological or non-biological agents. Here, the authors provide an overview of the most important pathogenic aspects indicating that TA can be a supportive therapy in systemic autoimmune diseases such as renal and neurological disorders. For the immunological diseases that can be treated with TA, the guidelines of the German Working Group of Clinical Nephrology and of the Apheresis Committee of the American Society for Apheresis are cited.

  15. Vascular access considerations for therapeutic apheresis procedures.

    PubMed

    Okafor, Chidi; Kalantarinia, Kambiz

    2012-01-01

    The success of therapeutic apheresis (TA), similar to hemodialysis, depends on the integrity of the extracorporeal circuit as well as a reliable vascular access. However, unlike hemodialysis, which requires high flow of blood around 400 mL/minute through the extracorporeal circuit for effective clearance, TA is usually carried out with much lower blood flow rates (<100 ml/minute). Therefore, even peripheral venous access can be considered for TA. The main determinants of the choice of vascular access for TA is the duration of the planned treatment and, to a certain degree, the indication for its use. While peripheral venous access and temporary central venous catheters are sufficient for short-term TA, tunnelled catheters and arteriovenous fistulae (AVF) are usually used for long-term treatments. Because of the large body of evidence in the hemodialysis literature on the advantages of AVF over tunnelled catheters and AV grafts, they should be considered as the preferred access for chronic TA as well. However, advance planning for the care of AVF after creation is of critical importance especially since many of the healthcare providers dealing with TA are less familiar with caring for AVF than nephrologists and dialysis nurses. In this article we first review the similarities and differences between HD and TA procedures. The pros and cons of different vascular access options are discussed next. Finally, we have included a list of recommendations on maintenance of AVF created for TA based on our own experience.

  16. Platelet concentrates, from whole blood or collected by apheresis?

    PubMed

    van der Meer, Pieter F

    2013-04-01

    Platelet concentrates can be isolated from donated whole blood with the platelet-rich plasma-method or the buffy coat-method. Alternatively, platelets can be obtained by apheresis, harvesting the platelets but returning all other cells to the donor. The quality and characteristics of platelets during storage are affected by a number of factors, such as anticoagulant, centrifugation and processing after collection, and pre- or post storage pooling, but when comparing literature on the various methods, most differences balance out. To have sufficient platelets to treat an adult patient, whole-blood-derived platelet concentrates need pooling of multiple donations, thereby increasing the risk of infectious agent transmission at least two-fold as compared with apheresis units. Allo immunization rates, acute reaction rates, and transfusion related acute lung injury rates are not different. Apheresis donation procedures have fewer adverse events. All these factors need to be considered and weighed when selecting a method of platelet collection for a blood center.

  17. Loss of Plasma Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) After Lipoprotein Apheresis

    PubMed Central

    Tavori, Hagai; Giunzioni, Ilaria; Linton, MacRae F.; Fazio, Sergio

    2014-01-01

    Rationale Lipoprotein apheresis (LA) reduces low-density lipoprotein (LDL) levels in patients with severe familial hypercholesterolemia (FH). We have recently reported that >30% of plasma proprotein convertase subtilisin/kexin 9 (PCSK9) is bound to LDL, thus we predicted that LA would also reduce plasma PCSK9 levels by removing LDL. Objective Pre- and post-apheresis plasma from 6 patients with familial hypercholesterolemia on 3 consecutive treatment cycles was used to determine changes in PCSK9 levels. Methods and Results LA drastically reduced plasma LDL (by 77±4%). Concomitantly, PCSK9 levels fell by 52±5%, strongly correlating with the LDL drop (P=0.0322; r2=0.26), but not with decreases in triglyceride (49±13%) or high-density lipoprotein levels (18±2%). Levels of albumin, creatinine, and CK-MB did not show significant changes after LA. Similar to LDL, PCSK9 levels returned to pretreatment values between cycles (2-week intervals). Fractionation of pre- and post-apheresis plasma showed that 81±11% of LDL-bound PCSK9 and 48±14% of apolipoprotein B–free PCSK9 were removed. Separation of whole plasma, purified LDL, or the apolipoprotein B–free fraction through a scaled-down, experimental dextran sulfate cellulose beads column produced similar results. Conclusions Our results show, for the first time, that modulation of LDL levels by LA directly affects plasma PCSK9 levels, and suggest that PCSK9 reduction is an additional benefit of LA. Because the loss of PCSK9 could contribute to the LDL-lowering effect of LA, then (1) anti-PCSK9 therapies may reduce frequency of LA in patients currently approved for therapy, and (2) LA and anti-PCSK9 therapies may be used synergistically to reduce treatment burden. PMID:24122718

  18. A Comparative Assessment of Quality of Platelet Concentrates Prepared by Buffy Coat Poor Platelet Concentrate Method and Apheresis Derived Platelet Concentrate Method.

    PubMed

    Mallhi, R S; Kumar, Sudeep; Philip, Joseph

    2015-12-01

    Many blood centres in country don't have costly apheresis technology and rely heavily on the platelet production from whole blood donation. We conducted this study with the aim to compare the quality of platelet concentrates (PC) prepared by Buffy Coat derived (BC-PC) and apheresis derived platelet concentrate (Apheresis-PC). Our objective was to collect data by analysis of platelet concentrates prepared by BC-PC methods and Apheresis-PC methods in respect of swirling, volume, platelet count, WBC count and pH of the PC units and elaborate on the quality parameters. Tertiary Care Hospital and Medical College. We assessed a total of 200 BC-PC and 200 Apheresis-PC for their in vitro quality by observing swirling, volume of PC, platelet count/unit, WBC count/unit and pH, to see if they satisfy the recommended quality criteria. Data was analyzed using appropriate statistical technique under the guidance of biostatistician. Apheresis-PC units showed better swirling than BC-PC units (Chi square test; P < 0.05). There was a significant difference in proportion of units satisfying the required volume QC between the two methods (Chi-square test; P < 0.05). Apheresis-PC showed better adherence to the physiological pH values (Student's unpaired t test; P < 0.05). The units of BC-PC and Apheresis-PC did not show significant difference in proportion of units satisfying the Platelet count per unit and residual WBC count per count (Chi square; P 0.203 and 0.617 respectively). There was comparable adherence to QC requirement for platelet count and WBC contamination in two methods. BC-PC were found to be adhering lesser to QC parameters for swirling, volume and pH, but found to be in required QC limits. BCPC can be used effectively in the majority of thrombocytopenic patients in resource poor setting.

  19. Whole blood and apheresis donors in Quebec, Canada: Demographic differences and motivations to donate.

    PubMed

    Charbonneau, Johanne; Cloutier, Marie-Soleil; Carrier, Élianne

    2015-12-01

    This study sought to compare demographics and donation motivations among plasma/platelet donors (PPDs) and whole blood donors (WBDs), in a voluntary and non-remunerated context. Motives to donate blood and demographic characteristics were collected through questionnaires completed by 795 WBDs and 473 PPDs. Comparison of WBDs and PPDs under chi-square tests showed that 17 out of 23 motivators were statistically different according to various demographic variables. These results demonstrate the existence of specific donor profiles both for WBDs and PPDs. Agencies should develop new recruitment strategies tailored to these donors, especially if they wish to convince WBDs to convert to apheresis donation.

  20. Pooled platelet concentrates: an alternative to single donor apheresis platelets?

    PubMed

    Pietersz, R N I

    2009-10-01

    Three types of platelet concentrates (PC) are compared: PC either processed with the platelet-rich plasma (PRP) or the Buffy coat (BC) method from whole blood units and PC obtained by apheresis. Leuko-reduction (LR) pre-storage is advocated to improve quality of the PC during storage and reduce adverse reactions in recipients. Standardization of methods allow preparation of PC with comparable yields of approximately 400 x 10(9) platelets in pooled non-LR-PRP, approximately 370 x 10(9) in pooled LR-BC-PC and in LR apheresis PC the number of platelets can be targeted on 350 x 10(9) or more with devices of various manufacturers. While viral transmission can be prevented by outstanding laboratory tests, the risk of bacterial contamination should be reduced by improved arm disinfection, deviation of the first 20-30 ml of blood and culture or rapid detection assays of the PC pre-issue. In a large prospective multicenter trial no significant difference was observed between cultures of apheresis PC (n = 15,198): 0.09% confirmed positive units versus 0.06% in pooled BC-PC (n = 37,045), respectively. Though platelet activation as measured by CD62 expression may differ in vitro in PC obtained with various apheresis equipment, and also between PC processed with the two whole blood methods there is scarce literature about the clinical impact of these findings. In conclusion the final products of LR-PC derived from whole blood or obtained by apheresis can be comparable, provided the critical steps of the processing method are identified and covered and the process is in control.

  1. Medications and therapeutic apheresis procedures: are we doing our best?

    PubMed

    Ibrahim, Rami B; Balogun, Rasheed Abiodun

    2013-02-01

    Therapeutic apheresis refers to a group of extracorporeal therapies commonly used in the treatment of a variety of neurological, renal, hematological, and other systemic diseases caused by circulating "toxic agents" that cannot be cleared by other means. This article presents an overview of the concepts underlying the effect of therapeutic apheresis procedures on prescription drugs taken by patients and describes key drug-related and procedure-related factors that may impact drug disposition during therapeutic apheresis. Therapeutic apheresis, and specifically therapeutic plasma exchange (TPE), is the process involving the extracorporeal separation of plasma from the cellular components of blood, discarding the plasma and exchanging it with replacement physiologic fluids such as albumin or fresh frozen plasma to maintain oncotic pressure and blood volume, and then returning this and the original cellular components of blood back to the patient's circulatory system (Ibrahim and Balogun, Semin Dial 2012;25:176-189). Over the last 4 decades, modern therapeutic apheresis has been used clinically for the treatment of a host of renal, hematological, and neurological diseases such as Goodpasture's syndrome, thrombotic thrombocytopenic purpura, and myasthenia gravis to name a few (Ibrahim et al., Pharmacotherapy 2007;27:1529-1549). Because of its ability to remove plasma, TPE can extract circulating drugs residing in this compartment, thereby affecting their disposition and potentially their therapeutic action (Ibrahim and Balogun, Semin Dial 2012;25:176-189; Ibrahim et al., Pharmacotherapy 2007;27:1529-1549; Kale-Pradhan and Woo, Pharmacotherapy 1997;17:684-695; Kintzel et al., J Clin Apher 2003;18:194-205). The aim of this article is to shed light on drug-related and TPE-related factors that may influence drug removal by TPE. Emphasis is put on areas needing improvement in the way of assessing drug removal by TPE. In addition, a call for an expanded investigation of TPEs

  2. Comparison of microsphere-equivalent blood flow (15O-water PET) and relative perfusion (99mTc-tetrofosmin SPECT) in myocardium showing metabolism-perfusion mismatch.

    PubMed

    Schaefer, Wolfgang M; Nowak, Bernd; Kaiser, Hans-Juergen; Koch, Karl-Christian; Block, Stephan; vom Dahl, Juergen; Buell, Udalrich

    2003-01-01

    Myocardial perfusion imaging with (99m)Tc-tetrofosmin is based on the assumption of a linear correlation between myocardial blood flow (MBF) and tracer uptake. However, it is known that (99m)Tc-tetrofosmin uptake is directly related to energy-dependent transport processes, such as Na(+)/H(+) ion channel activity, as well as cellular and mitochondrial membrane potentials. Therefore, cellular alterations that affect these energy-dependent transport processes ought to influence (99m)Tc-tetrofosmin uptake independently of blood flow. Because metabolism ((18)F-FDG)-perfusion ((99m)Tc-tetrofosmin) mismatch myocardium (MPMM) reflects impaired but viable myocardium showing cellular alterations, MPMM was chosen to quantify the blood flow-independent effect of cellular alterations on (99m)Tc-tetrofosmin uptake. Therefore, we compared microsphere-equivalent MBF (MBF_micr; (15)O-water PET) and (99m)Tc-tetrofosmin uptake in MPMM and in "normal" myocardium. Forty-two patients with severe coronary artery disease, referred for myocardial viability diagnostics, were examined using (18)F-FDG PET and (99m)Tc-tetrofosmin perfusion SPECT. Relative (18)F-FDG and (99m)Tc-tetrofosmin uptake values were calculated using 18 segments per patient. Normal myocardium and MPMM myocardium were classified using a previously validated (99m)Tc-tetrofosmin SPECT/(18)F-FDG PET score. In addition, (15)O-water PET was performed to assess kinetic-modeled MBF (MBF_kin), the water-perfusable tissue fraction (PTF), and the resulting MBF_micr (MBF_kin x PTF), which is comparable to tracer uptake values. (99m)Tc-tetrofosmin uptake and MBF_micr values were calculated for all normal and MPMM segments and averaged within their respective classifications. Mean relative (99m)Tc-tetrofosmin uptake was 86% +/- 1% in normal myocardium and 56% +/- 1% in MPMM, showing a significant difference (P < 0.001), as was expected from the classification. Contrary to these findings, mean MBF_micr in MPMM myocardium was 0

  3. Apheresis Medicine education in the United States of America: State of the discipline.

    PubMed

    Pagano, Monica B; Wehrli, Gay; Cloutier, Darlene; Galvin Karr, Eileen; Lopez-Plaza, Ileana; Schwartz, Joseph; Andrzejewski, Chester; Winters, Jeffrey L; Wong, Edward C C; Wu, Yanyun; Zantek, Nicole D

    2017-02-01

    Apheresis Medicine is a medical discipline that involves a variety of procedures (based on the targeted component to be removed or collected), indications (therapeutic vs. donation), and personnel (operators, management, and medical oversight). Apheresis services are accredited and/or regulated by a number of agencies and organizations. Given the complexity and the heterogeneity of apheresis services, it has been particularly challenging to formulate educational goals and define curriculums that easily cover all aspects of Apheresis Medicine. This review summarizes the current state of the discipline in the United States of America, and some of the challenges, strategies, and resources that Apheresis Medicine educators have used to ensure that Apheresis Medicine educational programs meet the health care needs of the relevant population within regulatory and accrediting entity frameworks.

  4. Cellular cholesterol efflux and cholesterol loading capacity of serum: effects of LDL-apheresis[S

    PubMed Central

    Adorni, M. P.; Zimetti, F.; Puntoni, M.; Bigazzi, F.; Sbrana, F.; Minichilli, F.; Bernini, F.; Ronda, N.; Favari, E.; Sampietro, T.

    2012-01-01

    High LDL-cholesterol (LDL-C) characterizes familial hypercholesterolemia (FH) and familial combined hyperlipidemia (FCH). LDL-apheresis, used in these patients to reduce LDL-C levels, has been shown to also affect HDL levels and composition. We studied LDL-apheresis effects on six FH and nine FCH subjects’ serum capacity to modulate cellular cholesterol efflux, an index of HDL functionality, and to load macrophages with cholesterol. Serum cholesterol efflux capacity (CEC) and macrophage cholesterol loading capacity (CLC) were measured before, immediately after, and two days after LDL-apheresis. The procedure reduced total cholesterol (TC), LDL-C, and apoB plasma levels (−69%, −80% and −74%, respectively), parameters only partially restored two days later. HDL-C and apoA-I plasma levels, reduced after LDL-apheresis (−27% and −16%, respectively), were restored to almost normal levels two days later. LDL-apheresis reduced serum aqueous diffusion (AD) CEC, SR-BI-CEC, and ABCA1-CEC. AD and SR-BI were fully restored whereas ABCA1-CEC remained low two days later. Sera immediately and two days after LDL-apheresis had a lower CLC than pre-LDL-apheresis sera. In conclusion, LDL-apheresis transiently reduces HDL-C levels and serum CEC, but it also reduces also serum capacity to deliver cholesterol to macrophages. Despite a potentially negative effect on HDL levels and composition, LDL-apheresis may counteract foam cells formation. PMID:22414482

  5. Effect of Mirasol pathogen reduction technology system on in vitro quality of MCS+ apheresis platelets.

    PubMed

    Mastroianni, Maria Adele; Llohn, Abid Hussain; Akkök, Çiğdem Akalın; Skogheim, Ruby; Ødegaard, Elna Rathe; Nybruket, Monica Jenssen; Flesland, Annika; Mousavi, Seyed Ali

    2013-10-01

    Reducing the risk of pathogen transmission to transfusion recipients is one of the great concerns in transfusion medicine. Important among the measures suggested to minimise pathogen transmission is pathogen reduction technology (PRT) systems. The present study examined the effects of Mirasol PRT system on MCS+ apheresis platelets in vitro quality measures during a seven-day storage period at 22°C. Statistical analysis indicated no significant difference in platelet concentrations between the control and treated platelet concentrates (PCs) during the storage period. Glucose and lactate levels were measured to determine metabolic activities of control and treated platelets. In both control and treated platelets, the amount of glucose consumed and lactate produced increased significantly with storage time, but glucose consumption and lactate production rates were significantly higher in treated platelets compared with control platelets. The mean pH of treated PCs was decreased at all time points relative to control PCs but remained within acceptable limits. The expression of P-selectin was also higher in Mirasol PRT treated platelets throughout the storage period, but differences were not statistically significant on Days 1 and 4. Finally, visual inspection of swirling indicated that Mirasol PRT treatment of platelets is associated with platelet shape change. Overall, our results show that MCS+ apheresis platelets treated with Mirasol PRT can preserve adequate in vitro properties for at least 5 days of storage.

  6. Teaching and learning apheresis medicine: The Bermuda Triangle in Education.

    PubMed

    Crookston, Kendall P; Richter, Deana M

    2010-01-01

    Apheresis Medicine has evolved markedly due to an explosion of knowledge and technology, whereas the time available for training has shrunk as curricula have become increasingly overloaded. Apheresis teaching has inherited a strong clinical context where real patient problems are used in a hands-on environment. To optimize instruction, those involved in the education of apheresis professionals need to have (1) knowledge of how clinical laboratory medicine education has developed as a field, (2) an understanding of what is known from theory and research about how people learn, and (3) the skills to design teaching/learning activities in ways consistent with literature-based principles of adult education. These developments in education provide a context for curriculum projects currently underway by the American Society for Apheresis. Teachers must determine which competencies are central to the essence of a trained professional. Specific, robust, learning objectives targeted toward the development of higher levels of thinking, professional attitudes, and requisite skills are formulated to guide the learner toward mastering those competencies. Curriculum is developed for each objective, consisting of content and the best teaching/learning methods to help learners attain the objective. Appropriate assessment strategies are identified to determine whether the objective is being achieved. The integration of objectives, curriculum, and assessment creates The Bermuda Triangle of Education (Richter, The Circle of Learning and Bermuda Triangle in Education, University of New Mexico School of Medicine, 2004). When educators do not effectively navigate The Bermuda Triangle of Education, learning may disappear into the murky depths of confusion and apathy. When successfully navigated, the result will be a significant learning experience that leads to transformation through education. 2010 Wiley-Liss, Inc.

  7. Apheresis for Collection of Ebola Convalescent Plasma in Liberia

    PubMed Central

    Brown, Jerry F.; Rowe, Kathleen; Zacharias, Peter; van Hasselt, James; Dye, John M.; Wohl, David A.; Fischer, William A.; Cunningham, Coleen K.; Thielman, Nathan M.; Hoover, David L.

    2017-01-01

    Purpose This report describes initiation of apheresis capability in Liberia, Africa to support a clinical trial of convalescent plasma therapy for Ebola Virus Disease. Methods A bloodmobile was outfitted in the United States as a four-bed apheresis unit with capabilities including pathogen reduction, electronic blood establishment computer system, designated areas for donor counseling and laboratory testing, and onboard electrical power generation. After air transport to Liberia, the bloodmobile was positioned at ELWA Hospital, Monrovia, and connected to the hospital’s power grid. Liberian staff were trained to conduct donor screening, which included questionnaire and onsite blood typing and transfusion transmitted infection (TTI) testing, and plasma collection and processing. Results The bloodmobile was operational within three weeks after arrival of the advance team. Of 101 donors who passed the pre-screening questionnaire, 32 were deferred. Twenty-eight of 99 tested survivors were deferred for positive transfusion transmitted infection (TTI) tests; 21 were positive for hepatitis B, hepatitis C, or human immunodeficiency virus. The majority of donors had type O blood; all but one were Rh positive. Forty-three survivors donated at least once; 89 apheresis attempts resulted in 81 successful collections. Conclusions Apheresis capability was emergently established in Liberia to support an efficacy trial of Ebola Convalescent Plasma. Extensive cooperation among multinational team members, engineers, logisticians and blood safety technical personnel at the operational site was required to surmount challenges to execution posed by logistical factors. The high proportion of positive TTI tests supported the use of a pathogen reduction system to enhance product safety. PMID:27393614

  8. Severe citrate toxicity complicating volunteer apheresis platelet donation.

    PubMed

    Bell, A M; Nolen, J D L; Knudson, C M; Raife, T J

    2007-02-01

    We report a case of severe citrate toxicity during volunteer donor apheresis platelet collection. The donor was a 40-year-old female, first-time apheresis platelet donor. Past medical history was remarkable for hypertension, hyperlipidemia, and depression. Reported medications included bumetanide, pravastatin, and paroxetine. Thirty minutes from the start of the procedure, the donor noted tingling around the mouth, hands, and feet. She then very rapidly developed acute onset of severe facial and extremity tetany. Empirical treatment with intravenous calcium gluconate was initiated, and muscle contractions slowly subsided over approximately 10 to 15 minutes. The events are consistent with a severe reaction to calcium chelation by sodium citrate anticoagulant resulting in symptomatic systemic hypocalcemia. Upon additional retrospective analysis, it was noted that bumetanide is a loop diuretic that may cause significant hypocalcemia. We conclude that careful screening for medications and underlying conditions predisposing to hypocalcemia is recommended to help prevent severe reactions due to citrate toxicity. Laboratory measurement of pre-procedure serum calcium levels in selected donors may identify cases requiring heightened vigilance. The case also illustrates the importance of maintaining preparedness for managing rare but serious reactions in volunteer apheresis blood donors.

  9. Apheresis techniques for collection of peripheral blood progenitor cells.

    PubMed

    Moog, Rainer

    2004-12-01

    The combination of effective mobilisation protocols and efficient use of apheresis machines has caused peripheral blood progenitor cells (PBPC) transplantation to grow rapidly. The development of apheresis technology has improved over the years. Today PBSC procedures have changed towards systems to minimise operator interaction and to reduce the collection of undesired cells such as polymorphonuclear cells and platelets using functionally closed, sterile environments for PBSC collection in keeping with Good Manufacturing Practice guidelines. Blood cell separators with continuous flow technique allow the processing of more blood than intermittent flow devices resulting in higher PBSC yields. Large volume leukapheresis with the processing of 3-4-fold donor's/patient's blood volume can increase the number of collected progenitor cells. Therefore, intermittent flow cell separators are indicated if only single vein access is available. Anticoagulant induced hypocalcaemia is an often observed side effect in long lasting PBPC harvesting and monitoring of electrolytes should be performed especially at the end of the apheresis procedure to supplement low levels of potassium, calcium or magnesium. Refinement and improvement of collection techniques continue to add to the armamentarium of current approaches for cancer and non-malignant conditions and will enable future strategies.

  10. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Seventh Special Issue.

    PubMed

    Schwartz, Joseph; Padmanabhan, Anand; Aqui, Nicole; Balogun, Rasheed A; Connelly-Smith, Laura; Delaney, Meghan; Dunbar, Nancy M; Witt, Volker; Wu, Yanyun; Shaz, Beth H

    2016-06-01

    The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating, and categorizing indications for the evidence-based use of therapeutic apheresis in human disease. Since the 2007 JCA Special Issue (Fourth Edition), the Committee has incorporated systematic review and evidence-based approaches in the grading and categorization of apheresis indications. This Seventh Edition of the JCA Special Issue continues to maintain this methodology and rigor to make recommendations on the use of apheresis in a wide variety of diseases/conditions. The JCA Seventh Edition, like its predecessor, has consistently applied the category and grading system definitions in the fact sheets. The general layout and concept of a fact sheet that was used since the fourth edition has largely been maintained in this edition. Each fact sheet succinctly summarizes the evidence for the use of therapeutic apheresis in a specific disease entity. The Seventh Edition discusses 87 fact sheets (14 new fact sheets since the Sixth Edition) for therapeutic apheresis diseases and medical conditions, with 179 indications, which are separately graded and categorized within the listed fact sheets. Several diseases that are Category IV which have been described in detail in previous editions and do not have significant new evidence since the last publication are summarized in a separate table. The Seventh Edition of the JCA Special Issue serves as a key resource that guides the utilization of therapeutic apheresis in the treatment of human disease. J. Clin. Apheresis 31:149-162, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Comparison of plasma exchange performances between Spectra Optia and COBE Spectra apheresis systems in repeated procedures considering variability and using specific statistical models.

    PubMed

    Hequet, O; Stocco, V; Assari, S; Drillat, P; Le, Q H; Kassir, A; Rigal, D; Bouzgarrou, R

    2014-08-01

    Repeated therapeutic plasma exchange (TPE) procedures using centrifugation techniques became a standard therapy in some diseases. As the new device Spectra Optia (SPO; Terumo BCT) was available, we studied its performances in repeated procedures in 20 patients in three apheresis units. First we analysed the performance results obtained by SPO. Second we compared the performances of the SPO device to a standard device, COBE Spectra (CSP; Terumo BCT) in the same patients using statistical method of mixed effects linear regression that considers variability between patients, centres and apheresis procedures. The performances analysed were classified according to plasma removal performances and their consequences on patients whose blood disturbances were assessed. Primary outcome was plasma removal efficiency (PRE) and PRE-anticoagulant corrected which was a more accurate parameter. Secondary outcomes corresponded to the volume of ACD-A consumed, platelets content in waste bag, procedure duration and status of coagulation system observed after TPE sessions. Before comparing the performances of both devices we compared the plasma volumes (PVs) processed in both techniques which showed that the PVs processed in SPO procedures were lower than in CSP procedures. In these conditions the statistical analysis revealed similar performances in both apheresis devices in PRE (p = ns) but better performances with SPO when considering higher PRE corrected by anticoagulant volume used (p < 0.05). Comparison of secondary outcomes showed no difference after SPO and CSP. After verifying that pre-apheresis patients' coagulation blood levels were identical before SPO and CSP, we showed identical haemostasis disturbances after SPO and CSP but lower platelet losses and higher fibrinogen post-apheresis blood levels after SPO (p < 0.05). No side effects or technical complications occurred during and after SPO and CSP. This study demonstrated that the Spectra Optia device is an

  12. Assessing risks of invasion through gamete performance: farm Atlantic salmon sperm and eggs show equivalence in function, fertility, compatibility and competitiveness to wild Atlantic salmon

    PubMed Central

    Yeates, Sarah E; Einum, Sigurd; Fleming, Ian A; Holt, William V; Gage, Matthew JG

    2014-01-01

    Adaptations at the gamete level (a) evolve quickly, (b) appear sensitive to inbreeding and outbreeding and (c) have important influences on potential to reproduce. We apply this understanding to problems posed by escaped farm salmon and measure their potential to reproduce in the wild. Farm Atlantic salmon (Salmo salar) are a threat to biodiversity, because they escape in large numbers and can introgress, dilute or disrupt locally adapted wild gene pools. Experiments at the whole fish level have found farm reproductive potential to be significant, but inferior compared to wild adults, especially for males. Here, we assess reproductive performance at the gamete level through detailed in vitro comparisons of the form, function, fertility, compatibility and competitiveness of farm versus wild Atlantic salmon sperm and eggs, in conditions mimicking the natural gametic microenvironment, using fish raised under similar environmental conditions. Despite selective domestication and reduced genetic diversity, we find functional equivalence in all farm fish gamete traits compared with their wild ancestral strain. Our results identify a clear threat of farm salmon reproduction with wild fish and therefore encourage further consideration of using triploid farm strains with optimized traits for aquaculture and fish welfare, as triploid fish remain reproductively sterile following escape. PMID:24822083

  13. Assessing risks of invasion through gamete performance: farm Atlantic salmon sperm and eggs show equivalence in function, fertility, compatibility and competitiveness to wild Atlantic salmon.

    PubMed

    Yeates, Sarah E; Einum, Sigurd; Fleming, Ian A; Holt, William V; Gage, Matthew Jg

    2014-04-01

    Adaptations at the gamete level (a) evolve quickly, (b) appear sensitive to inbreeding and outbreeding and (c) have important influences on potential to reproduce. We apply this understanding to problems posed by escaped farm salmon and measure their potential to reproduce in the wild. Farm Atlantic salmon (Salmo salar) are a threat to biodiversity, because they escape in large numbers and can introgress, dilute or disrupt locally adapted wild gene pools. Experiments at the whole fish level have found farm reproductive potential to be significant, but inferior compared to wild adults, especially for males. Here, we assess reproductive performance at the gamete level through detailed in vitro comparisons of the form, function, fertility, compatibility and competitiveness of farm versus wild Atlantic salmon sperm and eggs, in conditions mimicking the natural gametic microenvironment, using fish raised under similar environmental conditions. Despite selective domestication and reduced genetic diversity, we find functional equivalence in all farm fish gamete traits compared with their wild ancestral strain. Our results identify a clear threat of farm salmon reproduction with wild fish and therefore encourage further consideration of using triploid farm strains with optimized traits for aquaculture and fish welfare, as triploid fish remain reproductively sterile following escape.

  14. [Indications for apheresis in kidney transplant recipients: apheresis in the hyperimmune patient].

    PubMed

    Busnach, Ghil; Di Leo, Laura

    2012-01-01

    Patients who are sensitized through pregnancy, previous blood transfusions, or organ transplantation produce donor-specific anti-HLA antibodies (DSA) that can result in an important obstacle in kidney transplantation. Sensitized patients wait longer on the cadaver donor transplant list, may not receive a transplant, and may have greater morbidity and mortality. Sensitized patients may have living donor candidates but transplantation cannot be performed because of cross-match positivity. Kidney transplant recipients with DSA are at higher risk of developing early acute antibody-mediated rejection (AMR) despite negative complement-dependent cytotoxicity (CDC) T-cell cross-match, and thus require desensitization. Desensitization protocols using the combination of apheresis (PE) or immunoadsorption to remove DSA and/or intravenous Ig (Iv-Ig) and rituximab to downregulate antibody-mediated immune responses have made kidney transplantation feasible by abrogating CDC T-cell cross-match positivity. All sensitized patients should be studied for DSA by sensitive methods and followed over time. The presence of DSA should be documented, and also the strength or titers of the alloantibodies should be determined to decide on the type of desensitization protocol. High-dosage Iv-Ig alone does not prevent AMR in patients with strong DSA, and the addition of peritransplantation PE as unselective plasma exchange, semiselective double filtration, or selective immunoadsorption significantly decreases the incidence of AMR. The effect of addition of monoclonal antibodies such as rituximab to desensitization protocols or of PE to patients with strong anti-HLA-II DSA on allograft outcomes requires further prospective studies.

  15. Effect of leukocyte filtration on the P-selectin expression of apheresis platelets.

    PubMed

    Xie, Z T; Chen, C; Zhang, S H; Yang, H M; Tao, Z H

    2015-06-01

    The aim of this study was to investigate the effect of leukocyte filtration on the P-selectin (CD62P) surface expression of apheresis platelets during the retention period. Ten bags of apheresis platelets stored for 1 day (0-24 h) and 10 bags of apheresis platelets stored for 2 days (24-48 h) were used for leukocyte filtration (experimental group). Ten bags of apheresis platelets with the corresponding retention periods but without filtration were used as a negative control (control group). Thereafter, 100 μL of platelet suspensions from apheresis platelets with or without leukocyte filtration were sampled before and after leukocyte filtration for the detection of CD62P surface expression by flow cytometry. No statistical difference in the CD62P surface expression of apheresis platelets was observed before and after leukocyte filtration (P > 0.05), neither did the CD62P surface expression exhibit any change among the different retention periods. Leukocyte filtration does not affect the CD62P surface expression of apheresis platelets stored for up to 2 days, which indicates that leukocyte filtration does not damage the activation of apheresis platelets within the retention period.

  16. Establishment of a national on-line registry for apheresis in Korea.

    PubMed

    Song, Eun Young; Yoon, Jong Hyun; Lee, Jong Wook; Park, Chong Won; Kwon, Seog Woon; Kim, Dae Won; Lim, Young Ae; Kim, Hyun Ok; Han, Kyou Sup

    2008-04-01

    National apheresis registries can be used to evaluate changes in technology, clinical indications, and applications over the years. Since the establishment of the Korean Society of Apheresis (KSFA) in 1999, basic data on the status of apheresis have been collected using letters and e-mails on a biennial basis. In February 2006, a KSFA homepage and an on-line apheresis registry were constructed (http://www.apheresis.or.kr/). The registry consists of two sub-registries, one addressing overall aspects, e.g., the numbers and types of apheresis machines, total numbers of apheresis procedures, and the other addressing therapeutic plasmapheresis, e.g., diagnoses, modes of treatment, instrument used, replacement fluids, volumes processed, vascular access, anticoagulants, complications, and clinical responses. Data registered on-line is presumed to represent about 95% of total apheresis procedures performed in Korea. In this report, we introduce our on-line registry system and compared the data obtained by on-line registry with the previous ones.

  17. Role of therapeutic apheresis and phlebotomy techniques in anaesthesia and critical care

    PubMed Central

    Bose, Neeta; Kanzariya, Hitendra

    2014-01-01

    Therapeutic transfusion techniques such as apheresis and phlebotomy are frequently used in intensive care units. Use of the apheresis technique for the treatment of various diseases in critically ill patients is growing day by day. There are increasing evidences for using apheresis as a primary therapy or as an adjunct to other therapies for various diseases such as thrombotic thrombocytopenic purpura, haemolytic uremic syndrome, drug toxicities, autoimmune disease, sepsis and fulminant hepatic failure. Apheresis is an invasive procedure. It has significant physiologic consequences, so the care of these patients requires continuous supervision. Phlebotomy is performed as an intervention for some disease management. Its use is nowadays restricted to conditions such as polycythaemia, haemochromatosis and porphyria cutanea tarda. In this review, we have looked at various indications, procedure and complications of apheresis and phlebotomy in critical care unit. PMID:25535434

  18. Role of apheresis and dialysis in pediatric living donor liver transplantation: a single center retrospective study.

    PubMed

    Sanada, Yukihiro; Mizuta, Koichi; Urahashi, Taizen; Ihara, Yoshiyuki; Wakiya, Taiichi; Okada, Noriki; Yamada, Naoya; Koinuma, Toshitaka; Koyama, Kansuke; Tanaka, Shinichiro; Misawa, Kazuhide; Wada, Masahiko; Nunomiya, Shin; Yasuda, Yoshikazu; Kawarasaki, Hideo

    2012-08-01

    In the field of pediatric living donor liver transplantation, the indications for apheresis and dialysis, and its efficacy and safety are still a matter of debate. In this study, we performed a retrospective investigation of these aspects, and considered its roles. Between January 2008 and December 2010, 73 living donor liver transplantations were performed in our department. Twenty seven courses of apheresis and dialysis were performed for 19 of those patients (19/73; 26.0%). The indications were ABO incompatible-liver transplantation in 11 courses, fluid management in seven, acute liver failure in three, renal replacement therapy in two, endotoxin removal in two, cytokine removal in one, and liver allograft dysfunction in one. Sixteen courses of apheresis and dialysis were performed prior to liver transplantation for 14 patients. The median IgM antibody titers before and after apheresis for ABO blood type-incompatible liver transplantation was 128 and eight, respectively (P < 0.05). Eleven courses of apheresis and dialysis were performed post liver transplantation for 10 patients. The median PaO2/FiO2 ratio before and after dialysis for fluid overload was 159 and 339, respectively (P < 0.05). No bleeding or technical complications attributable to apheresis and dialysis occurred. The 1-year survival rate of the patients was 100%. Apheresis and dialysis in pediatric living donor liver transplantation are effective for antibody removal in ABO-incompatible liver transplantation, and fluid management for acute respiratory failure. © 2012 The Authors. Therapeutic Apheresis and Dialysis © 2012 International Society for Apheresis.

  19. Changing perspectives of apheresis in India in the twentieth century.

    PubMed

    Srivastava, R

    2002-04-01

    Globally, the last century (20th) has seen many changes in terms of amazing advancements and applications of modern science, medicine, biotechnology and computers. One of the dramatic outcomes of such great inventions and discoveries was that the medical profession got the wonderful tool of immunomodulation and haemapheresis which has changed the outlook of the entire spectrum of immune complex disorders both in terms of the great success in treatment and the rehabilitation from so-called incurable diseases. Additionally this has resulted in a better quality of life and lower morbidity and mortality. Organ transplants have become a reality and immunomodulation plays a pivotal role in their success. India also has tasted this sweet recipe of modern medicine and has imbibed it in its medical culture. India is not only famous for the Taj Mahal and Hawa Mahal (Agra and Jaipur) but also for its brain (of brain drain/otherwise) and betz cells which have brought glories and laurels in the field of medicine, mathematics, engineering, literature, physics and computers, etc. to the native countries and India equally. Apheresis has now invaded the Indian scenario also and there is a growing interest, demand and application for it in the clinical field. But, being a unique country, the problems encountered are also unique. This paper deals with an overview of the changing perspectives of apheresis in India in the 20th century.

  20. The Barcelona Hospital Clínic therapeutic apheresis database.

    PubMed

    Cid, Joan; Carbassé, Gloria; Cid-Caballero, Marc; López-Púa, Yolanda; Alba, Cristina; Perea, Dolores; Lozano, Miguel

    2017-09-22

    A therapeutic apheresis (TA) database helps to increase knowledge about indications and type of apheresis procedures that are performed in clinical practice. The objective of the present report was to describe the type and number of TA procedures that were performed at our institution in a 10-year period, from 2007 to 2016. The TA electronic database was created by transferring patient data from electronic medical records and consultation forms into a Microsoft Access database developed exclusively for this purpose. Since 2007, prospective data from every TA procedure were entered in the database. A total of 5940 TA procedures were performed: 3762 (63.3%) plasma exchange (PE) procedures, 1096 (18.5%) hematopoietic progenitor cell (HPC) collections, and 1082 (18.2%) TA procedures other than PEs and HPC collections. The overall trend for the time-period was progressive increase in total number of TA procedures performed each year (from 483 TA procedures in 2007 to 822 in 2016). The tracking trend of each procedure during the 10-year period was different: the number of PE and other type of TA procedures increased 22% and 2818%, respectively, and the number of HPC collections decreased 28%. The TA database helped us to increase our knowledge about various indications and type of TA procedures that were performed in our current practice. We also believe that this database could serve as a model that other institutions can use to track service metrics. © 2017 Wiley Periodicals, Inc.

  1. Long-term safety and efficacy of low-density lipoprotein apheresis in childhood for homozygous familial hypercholesterolemia.

    PubMed

    Hudgins, Lisa C; Kleinman, Bryan; Scheuer, Abby; White, Sharon; Gordon, Bruce R

    2008-11-01

    Untreated pediatric patients with homozygous familial hypercholesterolemia usually have myocardial infarctions, heart failure, or death by the teenage years. Low-density lipoprotein (LDL) apheresis effectively lowers LDL cholesterol in the short term, but there is little published information on the long-term safety and efficacy of this treatment in children. An analysis was performed of a registry of all 29 patients who began LDL apheresis before 18 years of age at 15 sites during the 11 years since approval by the United States Food and Drug Administration. A chart review of 9 patients treated at The Rogosin Institute was also performed to obtain additional details about lipid lowering, adverse events, and cardiovascular status. Of the 29 patients, 20 are currently treated, with a mean age at the start of treatment of 9 +/- 4 years (range 3 to 15) and a mean treatment duration of 6 +/- 4 years (range 2 to 21). The baseline LDL cholesterol (521 +/- 126 mg/dl) is acutely lowered by 75% and chronically lowered by 48% with biweekly sessions. Systemic adverse events have been uncommon. Atherosclerotic disease of the coronary arteries and/or aorta or aortic valve was evident by angiography and/or echocardiography in 12 patients (60%) at baseline and progressed to more severe, symptomatic disease in 6 (30%). In conclusion, LDL apheresis is well tolerated for decades by even very young pediatric patients with homozygous familial hypercholesterolemia. It effectively lowers LDL cholesterol, but target LDL levels are not achieved, and some patients will show progression of cardiovascular disease.

  2. The art of separation and adsorption: Historical review of apheresis in Japan.

    PubMed

    Matsuo, Hidenori

    2017-09-05

    Apheresis therapy was first introduced into Japan from the United State as plasmapheresis by a centrifuge method. However, the invention of hollow fiber has subsequently lead to a membrane plasma separation. Selective removal of the plasma or cell component has been improved and matured in clinical application. Therapeutic apheresis has progressed and diversified with the development of technology for membrane separation by hollow fiber and adsorption with a physicochemical adsorbent in Japan. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Granulocyte and monocyte adsorption apheresis for generalized pustular psoriasis.

    PubMed

    Shukuya, Ryoko; Hasegawa, Toshio; Niwa, Yusuke; Okuma, Keiko; Ikeda, Shigaku

    2011-12-01

    Granulocyte and monocyte adsorption apheresis (GCAP) is an extracorporeal circulation therapy that removes activated granulocytes and monocytes. GCAP was initially approved for the treatment of ulcerative colitis, which is attributed to activated granulocytes and macrophages that infiltrate the target tissues. Generalized pustular psoriasis (GPP) is also supposed to be caused by activated neutrophils. In this study, we treated two patients with refractory GPP by using GCAP. Patient 1, a 68-year-old woman who had liver cirrhosis, underwent seven GCAP sessions. Patient 2, a 26-year-old woman who had systemic lupus erythematosus and had been treated with systemic corticosteroids, underwent eight GCAP sessions. In both patients, GCAP resulted in an immediate improvement in skin lesions and fever reduction, without any adverse effects. We suggest that GCAP is an effective therapy for refractory GPP. © 2011 Japanese Dermatological Association.

  4. Severe hypercholesterolaemia: therapeutic goals and eligibility criteria for LDL apheresis in Europe.

    PubMed

    Thompson, Gilbert R; Catapano, Alberico; Saheb, Samir; Atassi-Dumont, Marielle; Barbir, Mahmoud; Eriksson, Mats; Paulweber, Bernhard; Sijbrands, Eric; Stalenhoef, Anton F; Parhofer, Klaus G

    2010-12-01

    Despite the use of currently available lipid-lowering therapies, a significant proportion of patients with severe hypercholesterolaemia do not reach treatment goals and consequently remain at increased risk for cardiovascular disease (CVD). On the basis of clinical experience, these patients tend to have the most severe forms of familial hypercholesterolaemia or markedly elevated LDL cholesterol (LDL-C) levels but are unable to tolerate statin therapy. LDL apheresis is currently the best treatment option (or treatment rescue) to bring these patients closer to therapeutic LDL objectives, and has been shown to reduce the risk of CVD along with LDL-C levels. However, criteria for LDL apheresis eligibility and the percentage of patients receiving treatment vary widely from country to country across Europe. Despite the proven benefits of LDL apheresis, access to this procedure remains limited because of its high cost and low availability, reflecting inherent limitations of this treatment modality. There is a need to both better define the patient population eligible for LDL apheresis and to create unified European guidelines governing the use of apheresis. In addition to improving access to apheresis where appropriate, new therapies are needed to further decrease LDL-C and reduce the ongoing CVD risk in patients with severe hypercholesterolaemia.

  5. Recovery of Platelet Count among Apheresis Platelet Donors

    PubMed Central

    Radhakrishnan, Krishnamoorthy; Anandan, Ashwin; Panicker, Vinod Kumar

    2016-01-01

    Introduction Increase in awareness regarding use of single donor platelets and the availability of technology has resulted in increased platelet pheresis procedures. The interval between two succesive plateletpheresis donations is much less compared to whole blood donations. Plateletpheresis procedures are associated with short term and long term adverse events. The effect of plateletpheresis on haematopoietic system remains significant. Aim To study the recovery of platelet count to baseline in plateletpheresis donors. Materials and Methods Fifty, first time apheresis donors were followed for platelet count recovery. Platelet count was measured before donation and at 30 minutes, 48 hours, 7th day and 14th day post-donation. Donor platelet count recovery to baseline was observed during the two week period. Results were analysed statistically, p<0.05 was considered statistically significant. Results Platelet count recovered to baseline by 7th day post-donation in 50% of donors in groups I (Pre-donation platelet count 1.5 lacs/μl to 2.2 lacs/μl) and II (Donors with platelet count >2.2 lacs/μl to 2.75 lacs/μl), 30% of donors in group III (Donors with platelet count >2.75 lacs/μl to 3.5 lacs/μl) of the donors. Donor’s platelet count recovered to baseline in 85% of donors by day 14 in across the three groups. Recruitment of platelets from spleen was observed in donors with pre-donation platelet count on the lower limit of normal. Conclusion By day 7, donor’s platelet count recovered to baseline in majority of the donors. Allowing enough recovery periods for donor platelet count, the minimum interval between two apheresis donations can be 7 days till more prospective studies conclude on the frequency and minimum interval between plateletpheresis donations. PMID:28208861

  6. QTc prolongation during peripheral stem cell apheresis in healthy volunteers.

    PubMed

    Korur, Aslı; Kozanoglu, Ilknur; Buyukkurt, Nurhilal; Yeral, Mahmut; Kandemir, Fatih; Gereklioglu, Cigdem; Sariturk, Cagla; Asma, Suheyl; Solmaz, Soner; Boga, Can; Ozdogu, Hakan

    2017-08-01

    Today, voluntary donation of peripheral blood stem cells by healthy donors for allogeneic hemopoietic cell transplantation is common worldwide. Such donations are associated with small but measurable risks of morbidity and mortality. Most complications are associated with citrate infusion during cell collection. We studied the effects of citrate infusion on the QTc and other vital parameters during and after peripheral stem cell apheresis in volunteers. To ensure that donors were healthy, screening included taking a detailed medical history, physical examination, and laboratory measurements of plasma calcium and magnesium. Corrected QT (QTc) values were assessed using a 12-lead electrocardiographic platform that derived QTc values automatically. In all, 141 apheresis procedures were performed. The mean QTc values at baseline, at 2 and 4 h during the procedure, and at 30 min after the procedure, were 347.6 ± 59.5, 349.9 ± 52.8, 391.8 ± 54.0, and 404.8 ± 59.2 ms, respectively. The baseline and 2 h QTcs did not differ significantly, but the baseline QTc did differ significantly from the 4 h and 30 min after the procedure values. The plasma levels of calcium and magnesium did not significantly differ before and after the procedure. QTc prolongation may develop during leukopheresis, particularly if the procedure takes more than 2 h. Thus, to enhance donor safety, QTc measurement should be standard for all donors. In addition, any family history of sudden death should be noted, to prevent the development of possible fatal arrhythmia in susceptible donors. © 2016 Wiley Periodicals, Inc.

  7. The Effect on Apheresis Platelet Quality During Shipment with Continued Interruption of Agitation for 24 and 48 Hours

    DTIC Science & Technology

    2006-01-26

    The Effect on Apheresis Platelet Quality During Shipment With Continued Interruption of Agitation for 24 and 48 Hours R.R. Leslie-Holt and V. W...EFFECT ON APHERESIS PLATELET QUALITY DURING SHIPMENT WITH CONTINUED INTERRUPTION OF AGITATION FOR 24 AND 48 HOURS. 6. AUTHOR(S) CAPT LESLIEHOLT RONNI...maintaining an oxidative metabolism. Key Words: Agitation, apheresis , lactate, pH, platelet , quality 4 INTRODUCTION The Armed Services Blood Program

  8. [Risk Assessment of Single-Donor (Apheresis) Platelet Concentrates and Pooled Whole-Blood-Derived Platelet Concentrates].

    PubMed

    Hitzler, Walter; Hutschenreuter, Gabriele; Wartensleben, Herbert

    2015-01-01

    According to the risk estimates of the Robert-Koch-Institute (RKI) and the Paul Ehrlich-Institute (PEI) an equivalence cannot be assumed to exist between the two different platelet preparations. Differences between single-donor (apheresis) platelet concentrates (ATK) and pooled whole-blood-derived platelet concentrates (PTK) result from donor populations, donation intervals, and preparation techniques. There are no prospective randomized studies with regard to the clinical efficacy, which would unambiguously demonstrate equivalence of the therapeutic efficacy of PTK (buffy coat method) in comparison to ATK. The German Association of Blood Transfusion Services (StKB) points out that, due to the non-equivalence of PTK and ATK, it is incumbent on the transfusion physician to select the platelet concentrate, make the appropriate disclosures, and assume treatment responsibility. Proper compensation for ATK and PTK must be ensured by the health insurance companies, whereby a special indication for the selection of either PTK or ATK is not given. Exceptions are patients with known HLA antibodies in which only selected platelet concentrates may be administered. Otherwise, no indication exists in the selection of the different platelet concentrates (Article is in German).

  9. The Italian Registry of Therapeutic Apheresis: granulocyte-monocyte apheresis in the treatment of inflammatory bowel disease. A multicentric study.

    PubMed

    Passalacqua, Stefano; Ferraro, Pietro Manuel; Bresci, Giampaolo; D'Ovidio, Valeria; Astegiano, Marco; Principi, Mariabeatrice; Testa, Roberto; D'Incà, Renata; Valpiani, Daniela; Armuzzi, Alessandro; Sablich, Renato; Cavallaro, Flaminia; Costa, Francesco; Di Leo, Vincenza; Colombo, Elisabetta; Santini, Alessia; Aratari, Annalisa; Lecis, Pierenrico; Saladino, Valeria; Riegler, Gabriele; Marco, Marino; Calella, Francesca; Ricci, Chiara; Guidi, Maria Luisa; Repaci, Giuseppe; Silla, Michele

    2011-12-01

    Leukocytes are thought to play an important role in the pathogenesis of inflammatory bowel diseases; granulocyte-monocyte adsorptive (GMA) apheresis, an extracorporeal technique aimed at removing activated circulating leukocytes from the blood, may represent a safe and effective therapeutic tool in these patients. The Italian Registry of Therapeutic Apheresis performed an observational, multicentric study involving 24 Gastroenterology Units. In this study, laboratory data and clinical outcomes of 230 patients (148 males, mean age 43.5 years) affected with ulcerative colitis (UC, n = 194) or Crohn's disease (CD, n = 36) who underwent one or more cycles of GMA were analyzed. Each cycle consisted of five GMA treatments. The patients were followed up for a mean of 8.7 (min. 3 to max. 12) months. At 3 months, positive outcome was achieved in 77.7% of UC patients (72.0% remission, 5.7% clinical response) and 61.3% of CD patients (54.8% remission, 6.5% clinical response). The cumulative proportion of positive outcome at 12 months was 87.1% for UC patients (83.7% remission, 3.4% clinical response) and 77.4% for CD patients (74.2% remission, 3.2% clinical response). No single clinical or laboratory parameter among those analyzed (age, sex, disease characteristics, history of smoking, medication history, baseline values of clinical activity index (CAI)/Crohn's disease activity index (CDAI), hemoglobin, white blood cells count, and erythrocyte sedimentation rate) was independently associated with clinical outcome. The procedure was well tolerated with no significant adverse effects registered. Copyright © 2011 Wiley Periodicals, Inc.

  10. Granulocyte-Monocyte Apheresis as an Adjuvant Therapy to Anti-Tumor Necrosis Factor Drugs for Ulcerative Colitis.

    PubMed

    Rodríguez-Lago, Iago; Gómez-Irwin, Laura; Fernández, Encarnación; Higuera, Rebeca; Cabriada, José Luis

    2017-02-01

    Biologic anti-tumor necrosis factor (TNF) drugs have demonstrated their efficacy for the treatment of ulcerative colitis. Nevertheless, some patients will not respond to this therapy or will develop loss of response. Leukapheresis is the main non-pharmacological therapy for some immune-mediated diseases. The aim of our study was to describe our experience with this therapy in ulcerative colitis patients after loss of response to anti-TNF treatment. Leukapheresis was indicated in four patients with left-sided or extensive colitis because of partial response to biological therapy or secondary loss of response to it. All patients received 8 to 10 sessions in an intensive regimen. Globally, a decrease in the Mayo score was observed. The overall response rate was 50% with one patient who displayed sustained response. No patients have required colectomy during follow-up. Adjuvant treatment with leukapheresis in patients with inadequate response to anti-TNF treatment showed some beneficial effect, although of limited duration, in patients with ulcerative colitis. © 2017 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  11. Which is safer source plasma for manufacturing in China: apheresis plasma or recovered plasma?

    PubMed

    Liu, Yu; Li, Changqing; Wang, Ya; Zhang, Yan; Wu, Binting; Ke, Ling; Xu, Min; Liu, Gui; Liu, Zhong

    2016-05-01

    In most countries, the plasma for derivative production includes two types of plasma, apheresis plasma (AP) and recovered plasma (RP). However, the plasma recovered from whole blood is not permitted for manufacture in China. Because of the lack of source plasma and the surplus of RP, the Chinese government is considering allowing RP as an equivalent source for the production of plasma derivatives. It is known that human blood can be contaminated by various infectious agents. The objective of the study was to evaluate if infectious risk would increase by enacting this policy. The samples from the two types of blood donors from January 1 to December 31, 2013, were collected. Supplementary testing was conducted and the residual risk (RR) of human immunodeficiency virus (HIV), hepatitis B virus, and hepatitis C virus (HCV) in the two types of blood donors and donations were calculated through the incidence-window period model. Prevalence of the markers of hepatitis E virus, hepatitis A virus, severe fever with thrombocytopenia syndrome bunyavirus, cytomegalovirus, B19, and West Nile virus was calculated. No significant difference was found in the RR of the three pathogens in the two types of blood donors. However, after the quarantine period, the RR of HCV and HIV in AP was significantly lower than that in RP. A quarantine period of 2 years will make the infectious risk of RP not significantly different than that of AP. Our data demonstrate that allowing RP to be used for the manufacture of plasma derivatives will not increase its infectious disease risk if coupled with a 2-year inventory hold. © 2016 AABB.

  12. Hemosoft: a new software for blood bank and apheresis management.

    PubMed

    Arslan, Onder

    2004-06-01

    Blood banks (BB) generate large volumes of information relating to patients and blood products sometimes stored indefinitely. Today computers are the main keys used to manage this task. BB information systems are developed mainly to assist BB specialists. We developed a new software, Hemosoft, in our blood bank. We have carried out a great deal of research into BB programs around the world in terms of program features. Using the latest technology, Hemosoft has been designed to run on a multi-user platform on the basis of a modular structure, and high security levels. Hemosoft's structural advantages are: (1) its modular structure and client/server architecture reduce initial hardware costs. (2) Relational database structure provides consistent and secure data access, (3) user-friendly graphical interface, (4) according to operational needs, Hemosoft can be expanded and transferred on to different platforms. As a MS Windows based program with graphical user interfacing, Hemosoft has all the functions and advantages of windows based applications. Barcode printing is available to ISBT 128 standard. Hemosoft's integrated modules are: blood donation, transfusion, product management, administrative follow-up, apheresis, stock management, staff-management, inter-center communication, statistics, archive, internet and video-conferencing systems, accounts, integration and security. It fulfills international transfusion medicine requirements, legislative measures and guidelines. We believe that Hemosoft is a high quality, competitive program developed to meet international standards. It is our hope that it will enforce transfusion medicine and blood banking nationwide.

  13. Gyrokinetic equivalence

    NASA Astrophysics Data System (ADS)

    Parra, Felix I.; Catto, Peter J.

    2009-06-01

    We compare two different derivations of the gyrokinetic equation: the Hamiltonian approach in Dubin D H E et al (1983 Phys. Fluids 26 3524) and the recursive methodology in Parra F I and Catto P J (2008 Plasma Phys. Control. Fusion 50 065014). We prove that both approaches yield the same result at least to second order in a Larmor radius over macroscopic length expansion. There are subtle differences in the definitions of some of the functions that need to be taken into account to prove the equivalence.

  14. The impact of discontinuation of 7-day storage of apheresis platelets (PASSPORT) on recipient safety: an illustration of the need for proper risk assessments.

    PubMed

    Kleinman, Steven; Dumont, Larry J; Tomasulo, Peter; Bianco, Celso; Katz, Louis; Benjamin, Richard J; Gajic, Ognjen; Brecher, Mark E

    2009-05-01

    Seven-day stored apheresis platelets (APs) were withdrawn from the US market after detection of two culture-positive units from 2571 tested at outdate in the PASSPORT surveillance study. The impact of this discontinuation on recipient safety was explored using mathematical modeling. Risk models for septic transfusion reactions (STRs) and transfusion-related acute lung injury (TRALI) were developed. Key assumptions were 400,000 annual APs transfused, equivalent STR risk for platelets (PLTs) stored for 5 days or more and zero for PLTs stored for less than 5 days, whole blood-derived PLTs (WBplts) administered in 5-unit pools, a 4.6-fold higher risk of false-negatives with surrogate versus culture-based bacterial testing, an AP TRALI risk between 1 per 1000 and 1 per 10,000, and a delay in TRALI risk reduction implementation in some centers by 6 to 12 months due to limited PLT availability. STR risk could increase, decrease, or remain the same depending on the percentage of inventory replaced by surrogate-tested WBplts versus culture-tested apheresis or whole blood PLTs. A delay in TRALI risk reduction implementation is likely to result in a comparable or greater risk during the delayed implementation period than the safety achieved with regard to STRs, even in the most favorable case scenario. A comprehensive risk assessment should have been conducted before the decision to discontinue PASSPORT. Risk assessments using accepted methods (and actual data when available) should precede any major blood safety decisions.

  15. LDL apheresis in the treatment of familial hypercholesterolemia: experience of Hospital Santo António, Porto.

    PubMed

    Palma, Isabel; Caldas, Ana Rita; Palma, Isabel Mangas; Queirós, José Alexandre; Madureira, Anselmo; Oliveira, José Carlos; Palma, Paulo; Correia, Carlos; Ramos, Maria Helena

    2015-03-01

    High plasma levels of low-density lipoprotein (LDL) cholesterol are a risk factor for the development of premature atherosclerosis. Direct adsorption of lipoproteins (DALI) is an apheresis technique by which LDL cholesterol is selectively removed from whole blood. The present study describes our experience with DALI LDL apheresis in severely hypercholesterolemic patients. Three hypercholesterolemic patients suffering from atherosclerotic complications were treated fortnightly by DALI apheresis, in a total of 308 sessions between December 2008 and January 2013. All patients were on the highest tolerated dose of statins and other lipid-lowering drugs. The sessions were essentially uneventful, adverse events being recorded in only 3.6% of them. A mean 63.3% acute reduction in LDL cholesterol was obtained. DALI apheresis proved to be a simple, safe and efficient method of lipid apheresis in hypercholesterolemic patients refractory to conservative lipid-lowering therapy. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  16. Formatting an experiential learning education module to encourage dysphagia assessment in apheresis patients.

    PubMed

    West, James; Stutzman, Sonja E; Atem, Folefac; Olson, DaiWai M

    2017-08-02

    Dysphagia screening is oftentimes a focus of hospitalized patients, but dysphagia can also occur in outpatient settings. Dysphagia can be overlooked by nurses and clinicians, and it is therefore important to educate nurses on the importance of dysphagia screenings. This was a randomized prospective pilot study to compare the effect of experiential learning versus traditional PowerPoint learning regarding nurses' attitudes towards performing dysphagia screening in an outpatient setting. Twelve pre and post-test surveys were collected from nurses working in outpatient apheresis about their attitudes towards dysphagia screening. Additionally, 128 electronic medical records (EMR) were reviewed to determine if education increased the occurrence of dysphagia screening. There was a statistically significant difference in the pre vs. post-test group scores (P < .001), but due to small sample size, there was insufficient evidence to reject the null hypothesis that nurses had changed their attitudes towards dysphagia screening. Comparing documentation of dysphagia assessment in the EMR, there was not a significant difference in practice before or after the educational intervention (P = 0.18). The study results showed that the both types of teaching strategies are possible with nurses and they were receptive to both. Although the results of this study did not show a significant difference in practice, more research is needed to determine how to raise awareness and put this into practice. © 2017 Wiley Periodicals, Inc.

  17. In vivo traffic of indium-111-oxine labeled human lymphocytes collected by automated apheresis

    SciTech Connect

    Read, E.J.; Keenan, A.M.; Carter, C.S.; Yolles, P.S.; Davey, R.J. )

    1990-06-01

    The in vivo traffic patterns of autologous lymphocytes were studied in five normal human volunteers using lymphocytes obtained by automated apheresis, separated on Ficoll-Hypaque gradients, and labeled ex vivo with {sup 111}In-oxine. Final lymphocyte infusions contained 1.8-3.1 X 10(9) cells and 270-390 microCi (9.99-14.43 MBq) {sup 111}In, or 11-17 microCi (0.41-0.63 MBq) per 10(8) lymphocytes. Gamma imaging showed transient lung uptake and significant retention of radioactivity in the liver and spleen. Progressive uptake of activity in normal, nonpalpable axillary and inguinal lymph nodes was seen from 24 to 96 hr. Accumulation of radioactivity also was demonstrated at the forearm skin test site, as well as in its associated epitrochlear and axillary lymph nodes, in a subject who had been tested for delayed hypersensitivity with tetanus toxoid. Indium-111-oxine labeled human lymphocytes may provide a useful tool for future studies of normal and abnormal lymphocyte traffic.

  18. Use of laboratory tests to guide initiation of autologous hematopoietic progenitor cell collection by apheresis: results from the multicenter hematopoietic progenitor cell collection by Apheresis Laboratory Trigger Survey.

    PubMed

    Makar, Robert S; Padmanabhan, Anand; Kim, Haewon C; Anderson, Christina; Sugrue, Michele W; Linenberger, Michael

    2014-10-01

    Limited literature describes the value of laboratory "triggers" to guide collection of peripheral blood (PB) hematopoietic progenitor cells (HPCs) by apheresis [HPC(A)]. We used a web-based survey to determine which parameters are used to initiate autologous HPC(A) collection in adult and pediatric patients and to identify common practice patterns. Members of the AABB Cellular Therapy Product Collection and Clinical Practices Subsection and the American Society for Apheresis HPC Donor Subcommittee drafted and developed relevant survey questions. A web link to the survey was distributed by electronic newsletter or email. Responses from 67 programs that perform autologous HPC(A) collections, including academic medical centers (n = 46), blood centers (n = 10), community hospitals (n = 5), and a variety of other medical institutions (n = 6), were analyzed. Ninety-three percent (62/67) of programs used a laboratory parameter to initiate HPC(A) collection. In both adult (40/54, 74%) and pediatric (29/38, 76%) patients, the PB CD34+ cell count was the most common parameter used to initiate HPC(A) collection. The median PB CD34+ trigger value was 10/μL for both patient populations. Among centers routinely using the PB CD34+ cell count to initiate apheresis, 51% (22/43) first sent the test before the patient presented for collection. Although more than 90% of centers used a laboratory test to trigger apheresis in cytokine-mobilized (44/48) or chemomobilized patients (50/53), only 57% (30/53) used a laboratory trigger if the patient was mobilized with granulocyte colony-stimulating factor plus plerixafor. Forty-two percent (21/50) of programs that routinely measured the PB CD34+ count before collection and discontinued further HPC(A) collection based on product CD34+ cell yield also stopped if the PB CD34+ value before apheresis was considered too low to proceed. Most programs use the PB CD34+ cell count to trigger autologous HPC(A) collection. Some centers also use this

  19. Umbilical Cord Blood Transplantation-associated Nephrotic Syndrome Successfully Treated by Low-density Lipoprotein Apheresis

    PubMed Central

    Sugawara, Yuka; Honda, Kenjiro; Katagiri, Daisuke; Nakamura, Motonobu; Kawakami, Takahisa; Nasu, Ryo; Hayashi, Akimasa; Shintani, Yukako; Tojo, Akihiro; Noiri, Eisei; Kurokawa, Mineo; Fukayama, Masashi; Nangaku, Masaomi

    2016-01-01

    The development of nephrotic syndrome (NS) after umbilical cord transplantation (UBT) has been reported in only four cases to date. We herein report the case of a 50-year-old woman who developed NS 94 days after UBT. She fell into oliguria and required dialysis. A kidney biopsy revealed focal and segmental glomerulosclerosis. Although glucocorticoid monotherapy did not improve her condition, the addition of low-density lipoprotein (LDL) apheresis resulted in remission of NS, a drastic improvement in her renal function, and withdrawal from dialysis. To the best of our knowledge, this is the first report of UBT-associated NS treated with LDL apheresis. PMID:27725544

  20. The Impact of Apheresis Platelet Manipulation on Corrected Count Increment

    PubMed Central

    Karafin, Matthew; Fuller, Alice K.; Savage, William J.; King, Karen E.; Ness, Paul M; Tobian, Aaron A. R.

    2012-01-01

    Background Concentrating and washing apheresis platelets (APs) substantially reduce the number of allergic transfusion reactions likely due to removal of plasma. However, these processes may damage platelets. This study evaluated whether concentrating or washing APs decrease the Corrected Count Increment (CCI). Study Design and Methods This retrospective study evaluated individuals who initially received unmanipulated APs and subsequently received concentrated and/or washed APs at a large university hospital between 1998 and 2009. Concentrated units were prepared by reducing the plasma volume of APs by a goal of >67%. Washed units were prepared by washing the APs with 1L normal saline. The CCI (plt × m2/uL) for all transfusions was calculated. Hypothesis testing was performed with Student’s t-tests for continuous variables and chi-square tests for dichotomous variables. Results We evaluated 121 individuals; 46 patients who received unmanipulated, concentrated and then washed APs, 59 patients who received unmanipulated and then concentrated APs; and 16 patients who received unmanipulated and then washed APs. Patient demographics were similar among the three groups. The mean CCI for unmanipulated AP transfusions at 0–2 hours post transfusion were significantly higher than concentrated and washed platelet transfusions (p<0.001). However, when accounting for platelet loss due to manipulation, concentrating APs did not impact the CCI, but the CCI remained significantly lower for washed products at all time points post transfusion (40.7% mean reduction at 20–24 hours, p<0.001). Conclusions Washing APs significantly reduces platelet count recovery and survival, as demonstrated by a significantly reduced CCI. PMID:22233358

  1. Red Cell Apheresis with Automated In-Line Filtration

    PubMed Central

    Matthes, Gert; Ingilizov, Marin; Dobao, Maria Luz; Marques, Susana; Callaert, Martine

    2014-01-01

    Summary Background The aim of this study was to provide data on concurrent red blood cell (RBC) and platelet (PLT) apheresis with RBC in-line leukoreduction and automated addition of saline-adenine-glucose-mannitol (SAGM) using the new version (V6.0) of Trima Accel®. Methods In this two-center paired study, each subject completed a test and a control procedure with an interval of 9 weeks between procedures. In the test arm, single RBC and PLT units were collected on the Trima Accel V6.0 (in-line leukofiltration and automated addition of SAGM). In the control arm, they were collected on Trima Accel V5.1/V5.2 (post-collection leukoreduction, manual SAGM addition). RBC percent hemolysis, potassium concentration and adenosine triphosphate over storage, hemoglobin (Hb) yield, and residual white blood cells (WBC) were determined. Results 34 subjects successfully completed both test and control procedures. Post-storage hemolysis was similar in both groups, and all values were less than 0.8% for both arms. Residual WBC counts in all RBC units were less than 1 × 106/unit. In-line processed RBC units (V6.0) have a significantly higher volume and more Hb/unit due to filtration recovery improvements. All procedures were well tolerated by the subjects. Conclusion In-line filtration and automated addition of storage solution on Trima Accel V6.0 allows collection of ready-to-use RBC units that meet EU requirements. PMID:24847185

  2. A Prospective Observational Survey on the Long-Term Effect of LDL Apheresis on Drug-Resistant Nephrotic Syndrome

    PubMed Central

    Muso, Eri; Mune, Masatoshi; Hirano, Tsutomu; Hattori, Motoshi; Kimura, Kenjiro; Watanabe, Tsuyoshi; Yokoyama, Hitoshi; Sato, Hiroshi; Uchida, Shunya; Wada, Takashi; Shoji, Tetsuo; Takemura, Tsukasa; Yuzawa, Yukio; Ogahara, Satoru; Sugiyama, Satoshi; Iino, Yasuhiko; Sakai, Soichi; Ogura, Yousuke; Yukawa, Susumu; Nishizawa, Yoshiki; Yorioka, Noriaki; Imai, Enyu; Matsuo, Seiichi; Saito, Takao

    2015-01-01

    Background/Aims LDL apheresis (LDL-A) is used for drug-resistant nephrotic syndrome (NS) as an alternative therapy to induce remission by improvement of hyperlipidemia. Several clinical studies have suggested the efficacy of LDL-A for refractory NS, but the level of evidence remains insufficient. A multicenter prospective study, POLARIS (Prospective Observational Survey on the Long-Term Effects of LDL Apheresis on Drug-Resistant Nephrotic Syndrome), was conducted to evaluate its clinical efficacy with high-level evidence. Methods Patients with NS who showed resistance to primary medication for at least 4 weeks were prospectively recruited to the study and treated with LDL-A. The long-term outcome was evaluated based on the rate of remission of NS 2 years after treatment. Factors affecting the outcome were also examined. Results A total of 58 refractory NS patients from 40 facilities were recruited and enrolled as subjects of the POLARIS study. Of the 44 subjects followed for 2 years, 21 (47.7%) showed remission of NS based on a urinary protein (UP) level <1.0 g/day. The UP level immediately after LDL-A and the rates of improvement of UP, serum albumin, serum creatinine, eGFR, and total and LDL cholesterol after the treatment session significantly affected the outcome. Conclusions Almost half of the cases of drug-resistant NS showed remission 2 years after LDL-A. Improvement of nephrotic parameters at termination of the LDL-A treatment was a predictor of a favorable outcome. PMID:26557843

  3. LDL-apheresis depletes apoE-HDL and pre-β1-HDL in familial hypercholesterolemia: relevance to atheroprotection

    PubMed Central

    Orsoni, Alexina; Saheb, Samir; Levels, Johannes H. M.; Dallinga-Thie, Geesje; Atassi, Marielle; Bittar, Randa; Robillard, Paul; Bruckert, Eric; Kontush, Anatol; Carrié, Alain; Chapman, M. John

    2011-01-01

    Subnormal HDL-cholesterol (HDL-C) and apolipoprotein (apo)AI levels are characteristic of familial hypercholesterolemia (FH), reflecting perturbed intravascular metabolism with compositional anomalies in HDL particles, including apoE enrichment. Does LDL-apheresis, which reduces HDL-cholesterol, apoAI, and apoE by adsorption, induce selective changes in HDL subpopulations, with relevance to atheroprotection? Five HDL subpopulations were fractionated from pre- and post-LDL-apheresis plasmas of normotriglyceridemic FH subjects (n = 11) on regular LDL-apheresis (>2 years). Apheresis lowered both plasma apoE (−62%) and apoAI (−16%) levels, with preferential, genotype-independent reduction in apoE. The mass ratio of HDL2:HDL3 was lowered from ∼1:1 to 0.72:1 by apheresis, reflecting selective removal of HDL2 mass (80% of total HDL adsorbed). Pre-LDL-apheresis, HDL2 subpopulations were markedly enriched in apoE, consistent with ∼1 copy of apoE per 4 HDL particles. Large amounts (50-66%) of apoE-HDL were removed by apheresis, preferentially in the HDL2b subfraction (−50%); minor absolute amounts of apoE-HDL were removed from HDL3 subfractions. Furthermore, pre-β1-HDL particle levels were subnormal following removal (−53%) upon apheresis, suggesting that cellular cholesterol efflux may be defective in the immediate postapheresis period. In LDL-receptor (LDL-R) deficiency, LDL-apheresis may enhance flux through the reverse cholesterol transport pathway and equally attenuate potential biglycan-mediated deposition of apoE-HDL in the arterial matrix. PMID:21957200

  4. [Platelet concentrates from whole-blood donations (buffy-coat) or apheresis: which one to use?].

    PubMed

    Lozano, María Luisa; Rivera, José; Vicente, Vicente

    2012-05-05

    Platelet concentrates (PCs) prepared either from whole-blood donations by the buffy-coat method (BC), or by plateletpheresis are indicated to prevent or treat acute hemorrhage secondary to thrombocytopenia, and there is an ongoing debate about which platelet product should be used. Usage of each of these two products is highly heterogeneous among countries and individual institutions, ranging from 10 to 90%, with a 50:50 ratio in Europe. In comparison of pooled platelets prepared by the BC method and apheresis PCs, data suggest similar efficacy of the products. Regarding recipients' adverse reactions, there is no advantage for apheresis concentrates. From the donor's point of view, evidence favours using the abundance of platelets available from whole-blood donation. As residual viral transmission risk continues to fall, the advantage of apheresis products related to the decrease to donor exposure lessens. While the cost-effectiveness of apheresis products is comparable to that of other accepted blood safety interventions, in case of emerging pathogens, probably pathogen inactivation of pooled BC PCs would be a more desirable strategy.

  5. Is there a need for a national or a global apheresis registry?

    PubMed

    Stegmayr, Bernd; Korach, Jean-Michel; Norda, Rut; Rock, Gail; Fadel, Fouad

    2003-10-01

    Indications for apheresis may vary and more than 45 different diagnoses have been reported from various countries. New devices are being developed and, in the beginning their clinical implications and use are limited to detect rare but important side effects. However, to achieve more reliable information on the effects and side effects we need more extensive sampling of data. Collection of such data is considered a safety and quality issue in several countries. However, data is still limited and little is known about therapeutic apheresis practised around the world including the incidence and pattern of adverse events. The establishment of national registries and analyses of data on a global level therefore seems important. Thus the World Apheresis Association (WAA) has initiated a global apheresis registry for therapeutic procedures and collection of e.g., stem cells. The WAA registry is Internet based and the site is at www.iml.umu.se/medicin. A login code to test the registry is needed (AL61TMS). This report deals with the aim of a global registry as well as some comparative data regarding findings of the Canadian, French and Swedish registries.

  6. Significant changes in the 6th edition of FACT-JACIE standards affecting apheresis facilities.

    PubMed

    Schwartz, Joseph

    2017-02-01

    FACT-JACIE cellular therapy standards are being revised every 3years and currently in their 6th edition. Significant changes in the 6th edition of the standards that affect apheresis facilities participating in cellular therapy product collections are presented.

  7. Apheresis and transplant of hematopoietic progenitor cells (HPC) from allogeneic donors of age above 60 years.

    PubMed

    Janssen, W E; Rahn, D; Hackett, M; Coyle, D; Tomblyn, M; Smilee, R C; Anasetti, C; Fernandez, H F

    2012-12-01

    Over the immediate past 4 years, our program has collected hematopoietic progenitor cells by apheresis from 48 individuals aged 61 and over (range 61-71 years of age). We have retrospectively analyzed the collection and transplant results associated with employing these donors, and have compared them with 175 donors aged 60 or less who were collected during the same time period. We have found no significant difference in venous access (P = 0.208), rate of post-transplant engraftment of neutrophils (P = 0.117) and platelets (P = 0.692), or in rate and grade of acute GVHD (P = 0.806). However, we have found that these older donors have a significantly lower mobilization of CD34 + cells as reflected in lower absolute counts of circulating CD34 + cells pre-apheresis (P = 0.016). This, in turn, results in lower CD34 + cell yields in apheresis products (P < 0.001), trending towards requiring more apheresis procedures (22.9 vs 13.7%, P = 0.095) to collect sufficient CD34 + cells for transplantation. We conclude that it is practical when necessary to employ donors aged 60 and above, as well as safe for both donor and intended recipient. However, concern over reduced CD34 + cell mobilization may be sufficient grounds to seek younger donors when possible.

  8. Ultrasound-guided peripheral venous access for therapeutic apheresis procedures reduces need for central venous catheters.

    PubMed

    Salazar, Eric; Garcia, Salvador; Miguel, Robin; Segura, Francisco J; Ipe, Tina S; Leveque, Christopher

    2017-08-01

    Therapeutic and donor apheresis requires adequate vascular access to achieve inlet flow rates of ∼50-100 mL/min. While central dialysis-type venous catheters can usually provide such access, their use includes several associated risks. Some of these risks can be avoided or diminished if adequate peripheral venous access can be established. Some patients have adequate peripheral veins for apheresis that cannot be readily identified visually or by palpation. We hypothesized that ultrasound-guided peripheral venous access would benefit such patients and would lead to placement of fewer central venous catheters. The technique of ultrasound-guided peripheral access for apheresis has been in use at Houston Methodist Hospital since 2012. We performed a prospective review of patients undergoing inpatient and outpatient apheresis at Houston Methodist Hospital from July 1, 2015 to September 30, 2015, to assess its benefit. During this time, we performed 831 procedures on 186 patients, including 787 therapeutic plasma exchanges, three red blood cell exchanges, 41 peripheral stem cell collections. Ultrasound-guided vascular access was used for 68 procedures (8% of all procedures), including 62 therapeutic plasma exchanges, 4 peripheral stem cell collections, and 2 red blood cell changes. Use of ultrasound-guided peripheral access prevented the placement of central venous catheters in 37 (20%) patients, demonstrating its utility in a busy transfusion service. © 2016 Wiley Periodicals, Inc.

  9. "Black cloud" vs. "white cloud" physicians - Myth or reality in apheresis medicine?

    PubMed

    Pham, Huy P; Raju, Dheeraj; Jiang, Ning; Williams, Lance A

    2017-08-01

    Many practitioners believe in the phenomenon of either being labeled a "black cloud" or "white cloud" while on-call. A "white-cloud" physician is one who usually gets fewer cases. A "black-cloud" is one who often has more cases. It is unclear if the designation is only superstitious or if there is some merit. Our aim is to objectively assess this phenomenon in apheresis medicine at our center. A one-year prospective study from 12/2014 to 11/2015 was designed to evaluate the number of times apheresis physicians and nurses were involved with emergent apheresis procedures between the hours from 10 PM and 7 AM. Other parameters collected include the names of the physician, apheresis nurse, type of emergent apheresis procedure, day of the week, and season of the year. During the study period, 32 emergent procedures (or "black-cloud" events) occurred. The median time between two consecutive events was 8 days (range: 1-34 days). We found no statistically significant association between the "black-cloud" events and attending physicians, nurses, day of the week, or season of the year by Chi-square and Fisher's analyses. However, exploratory analysis using association rule demonstrated that "black-cloud" events were more likely to happen on Thursday (2.19 times), with attending physician 2 (1.18 times), and during winter (1.15 times). The results of this pilot study may support the common perception that some physicians or nurses are either "black cloud" or "white cloud". A larger, multi-center study population is needed to validate the results of this pilot study. © 2016 Wiley Periodicals, Inc.

  10. [Single-donor (apheresis) platelets and pooled whole-blood-derived platelets--significance and assessment of both blood products].

    PubMed

    Hitzler, Walter E

    2014-01-01

    The transfusion efficacy of ATK, which contain fully functional platelets, is beyond all doubt. The equivalence of ATK and PTK has been subject of many studies. Some of those studies show the superiority of ATK's, while others do not, but there have been no studies that demonstrated a superiority of PTK's. The superiority of platelets stored in plasma and in third generation additive solution was demonstrated in clinical studies; therefore, it cannot be said that all the platelet concentrates on the German market are equivalent in efficacy. Of decisive importance, above all, is the risk of transfusion-transmitted infections with known pathogens, or those not yet discovered. This risk is different for ATK compared to PTK. Taking this difference in risk and the difference in donor exposure of transfused patients into account, it can definitely be said that ATK and PTK are not equivalent. In 2012, the Robert-Koch-Institute (RKI) published a mathematical risk model for different platelet concentrates and assessed the risk of transmitting known pathogens such as HIV, HCV, and HBV. The risk was higher for PTK compared to ATK. The relative risks for PTK derived from 4BCs were 2.2 (95%--CI: 2.1-2.4) for HIV, 2.7 (95%--CI: 2.5-3.0) for HCV, and 2.2 (95%--CI: 2.8-3.7) for HBV. At the present time, these are the relative risks of transfusion-transmitted infections with the traditional pathogens for PTK compared to ATK. In addition to the RKI assessed risks, there is the theoretical risk of a new, unknown agent, transmitted through blood exposure. The magnitude of this risk is hardly predictable for PTK. The experience gathered so far, especially in the last three decades, with the emergence of HIV, prions, and West Nil virus, shows that the biological nature of a next transfusion-transmissible infectious agent cannot be predictable. This agent, if we think at a conventional sexually transmissible agent with nucleic acid and long latent period, would spread first in areas with

  11. Fibrinogen is not a prognostic factor for response to HELP-apheresis in sudden sensorineural hearing loss (SSHL).

    PubMed

    Berger, T; Kaiser, T; Scholz, M; Bachmann, A; Ceglarek, U; Hesse, G; Hagemeyer, B; Stumvoll, M; Thiery, J; Dietz, A

    2015-12-01

    Higher levels of fibrinogen or cholesterol were associated with improved hearing recovery in SSHL patients after treatment with HELP-apheresis (Heparin-induced extracorporeal LDL precipitation apheresis). The present trial was performed to demonstrate HELP-related effects on relevant metabolic and inflammatory parameters in the context of SSHL treatment. In the framework of a single arm non-controlled trial, we investigated the variation of metabolic and inflammatory parameters using HELP-apheresis for a defined group of 100 patients with SSHL. Based on cut off inclusion criteria (Serum LDL-cholesterol >1.6 g/l and/or fibrinogen >2.0 g/l, SSHL in minimum three frequencies more than 30 dB, time after event not longer than 6 days), the protocol followed a strict time line with one single shot HELP-apheresis and follow-up monitoring including laboratory parameters at six defined time points. If HELP-apheresis could not effect improvement of hearing on day 5, additional corticosteroid treatment was applied. Concentration of anti-inflammatory IL-10 increased while other proinflammatory parameters declined. Serum levels of all measured sterols and apolipoproteins decreased significantly. None of the investigated parameters were suitable to predict hearing improvement of the patients. Levels of fibrinogen and LDL-cholesterol were not prognostic for outcome after HELP-apheresis. A significant (p < 0.001) increase of anti-inflammatory IL-10 after apheresis was notable, while most of the proinflammatory parameters declined. Despite the limited validity of a single arm non-controlled trial, these alterations on immune modulating factors indicate possible secondary pleiotropic effects caused by HELP-apheresis.

  12. Transfusion and component characteristics are not associated with allergic transfusion reactions to apheresis platelets

    PubMed Central

    Savage, William J.; Tobian, Aaron A.R.; Savage, Jessica H.; Hamilton, Robert G.; Borge, P. Dayand; Kaufman, Richard M.; Ness, Paul M.

    2014-01-01

    Background Transfusion-related characteristics have been hypothesized to cause allergic transfusion reactions (ATRs) but they have not been thoroughly studied. The primary objective of this study is to evaluate the associations of infusion rate, infusion volume, ABO mismatching, component age, and premedication with the incidence and severity of ATRs. A secondary objective is to compare the risk of these attributes relative to the previously reported risk factor for aeroallergen sensitization in transfusion recipients, as measured by an aeroallergen-specific IgE antibody screen. Study Design and Methods Clinical and transfusion-related data were collected on subjects with reported ATRs and uneventful (control) apheresis platelet transfusions over a combined 21 month period at two academic medical centers. Control transfusions were selected as the next uneventful transfusion after an ATR was reported. Logistic regression, Mann-Whitney and t tests were used to assess associations with ATRs. Previously reported aeroallergen-specific IgE screening data was incorporated into a multivariable logistic regression. Results 143 ATRs and 61 control transfusions were evaluated among 168 subjects, ages 2-86 years. Infusion rate, infusion volume, ABO mismatching, component age, and premedication showed no statistically significant association with ATRs (P>0.05). Neither infusion rate nor infusion volume increased the risk of anaphylaxis vs. mucocutaneous only ATRs. Aeroallergen sensitization has previously been associated with ATRs. After controlling for transfusion-related covariates, aeroallergen sensitization remained statistically significantly associated with ATRs (OR 2.68, 95%CI: 1.26-5.69). Conclusions Transfusion and component-specific attributes are not associated with ATRs. An allergic predisposition in transfusion recipients is associated most strongly with ATR risk. PMID:25209730

  13. Establishing Substantial Equivalence: Transcriptomics

    NASA Astrophysics Data System (ADS)

    Baudo, María Marcela; Powers, Stephen J.; Mitchell, Rowan A. C.; Shewry, Peter R.

    Regulatory authorities in Western Europe require transgenic crops to be substantially equivalent to conventionally bred forms if they are to be approved for commercial production. One way to establish substantial equivalence is to compare the transcript profiles of developing grain and other tissues of transgenic and conventionally bred lines, in order to identify any unintended effects of the transformation process. We present detailed protocols for transcriptomic comparisons of developing wheat grain and leaf material, and illustrate their use by reference to our own studies of lines transformed to express additional gluten protein genes controlled by their own endosperm-specific promoters. The results show that the transgenes present in these lines (which included those encoding marker genes) did not have any significant unpredicted effects on the expression of endogenous genes and that the transgenic plants were therefore substantially equivalent to the corresponding parental lines.

  14. Low-density lipoprotein apheresis by membrane differential filtration (cascade filtration) via arteriovenous fistula performed in children with familial hypercholesterolemia.

    PubMed

    Gülle, Saniye; Bak, Mustafa; Serdaroglu, Erkin; Can, Demet; Karabay, Ozalp

    2010-02-01

    Membrane differential filtration (cascade filtration) is an apheresis technique by which atherogenic lipoproteins can be eliminated from plasma on the basis of particle size. In this study, we aim to discuss the efficacy of low-density lipoprotein (LDL) apheresis performed by providing alternative vascular routes in two siblings with familial hypercholesterolemia who did not respond to medical treatment and diet. Of the two siblings, one was nine years old and the other one was three-and-a-half years old. Of the total of 78 apheresis processes performed, 24 were done via a permanent subclavian catheter, 36 were done via a subsequently provided arteriovenous fistula, and 18 were done via an arteriovenous graft. We observed a mean reduction in the plasma levels of total cholesterol (61.6%), LDL cholesterol (65.5%), and high-density lipoprotein cholesterol (38.6%). We noted that cascade filtration apheresis was effective in decreasing the LDL cholesterol in plasma, and no serious complications were noted. The success of the apheresis program depends on well-functioning blood access. An arteriovenous fistula may be the best route for the long-term treatment of familial hypercholesterolemia, which requires complication-free apheresis treatments.

  15. Evaluation of platelets prepared by apheresis and stored for 5 days. In vitro and in vivo studies

    SciTech Connect

    Shanwell, A.; Gulliksson, H.; Berg, B.K.; Jansson, B.A.; Svensson, L.A.

    1989-11-01

    To evaluate the effect of storage on apheresis platelets collected with a closed-system blood cell separator, an in vitro investigation was performed, with measurements of pH, lactate, ATP, the ratio of ATP to the total adenine nucleotide content, and adenylate kinase. Unmodified apheresis platelets and apheresis platelets with plasma added were compared with conventional platelets stored in PL-1240 or PL-732 plastic containers. During 6 days of storage, there were similar changes in all variables with one exception: the extracellular activity of adenylate kinase was lower in apheresis platelets with plasma than in the other three groups (p less than 0.01). In vivo studies were carried out with 111Indium-labeled autologous platelets in eight volunteers. Apheresis platelets with 100 mL of plasma added were stored in two 1000-mL containers (PL-732) at 22 degrees C during agitation. Platelets from one of the containers were labeled with 111Indium and transfused into the volunteer within 24 hours. Platelets from the other container were labeled after 5 days of storage and transfused into the same donor. There were no significant differences between apheresis platelets stored for 1 day and those stored for 5 days: the mean percentage of recovery was 58.4 and 57.6 percent, t1/2 was 69 and 67 hours, and the survival time was 5.5 and 5.6 days, respectively.

  16. The lipid- and lipoprotein- [LDL-Lp(a)] apheresis techniques. Updating.

    PubMed

    Stefanutti, C; Morozzi, C; Perrone, G; Di Giacomo, S; Vivenzio, A; D'Alessandri, G

    2012-01-01

    Therapeutic plasmapheresis allows the extracorporeal removal of plasmatic lipoproteins (Lipid-apheresis) (LA). It can be non selective (non specific), semi - selective or selective low density lipoprotein-lipoprotein(a) (specific [LDL- Lp(a)] apheresis) (Lipoprotein apheresis, LDLa). The LDL removal rate is a perfect parameter to assess the system efficiency. Plasma-Exchange (PEX) cannot be considered either specific nor, selective. In PEX the whole blood is separated into plasma and its corpuscular components usually through centrifugation or rather filtration. The corpuscular components mixed with albumin solution plus saline (NaCl 0.9%) solution at 20%-25%, are then reinfused to the patient, to substitute the plasma formerly removed. PEX eliminates atherogenic lipoproteins, but also other essential plasma proteins, such as albumin, immunoglobulins, and hemocoagulatory mediators. Cascade filtration (CF) is a method based on plasma separation and removal of plasma proteins through double filtration. During the CF two hollow-fiber filters with pores of different diameter are used to eliminate the plasma components of different weight and molecular diameter. A CF system uses a first polypropylene filter with 0.55 µm diameter pores and a second one of diacetate of cellulose with 0.02 µm pores. The first filter separates the whole blood, and the plasma is then perfused through a second filter which allows the recovery of molecules with a diameter lower than 0.02 µm, and the removal of molecules larger in diameter as apoB100-containing lipoproteins. Since both albumin and immunoglobulins are not removed, or to a negligible extent, plasma-expanders, substitution fluids, and in particular albumin, as occurs in PEX are not needed. CF however, is characterized by lower selectivity since removes also high density lipoprotein (HDL) particles which have an antiatherogenic activity. In the 80's, a variation of Lipid-apheresis has been developed which allows the LDL

  17. Evaluation of concurrent collection of in-line filtered platelets and packed red blood cells by multicomponent apheresis with three last-generation apparatuses.

    PubMed

    Picker, S M; Radojska, S M; Gathof, B S

    2006-07-01

    Multicomponent apheresis enables the collection and procession of different blood products in a single donation. Different apparatuses vary in terms of principle and efficiency. Knowledge of them is essential to analyse cost effectiveness. A total of 30 donors, well matched for baseline parameters, were randomly assigned to the concurrent collection of red blood cells (RBCs) and platelets (PLTs) with the Baxter Amicus (AM), the Haemonetics MCS plus (MCS+), and the Gambro Trima Accel (TA). The procedures were prospectively evaluated, focusing on yield, time, efficiency, citrate donor load and in vitro quality. PLT yield (x 10(11)/unit; mean +/- standard deviation) was 3.09 +/- 0.34 (AM), 2.53 +/- 0.35 (MCS+), 2.51 +/- 0.32 (TA). Absolute RBC mass (ml/unit; mean +/- standard deviation) was 177.4 +/- 2.7 (AM), 161.5 +/- 0.7 (MCS+), and 163.7 +/- 5.4 (TA). The programmed RBC collection target of 160-180 ml was reached by all instruments, whereas the programmed PLT yield of 3.0 x 10(11) was met satisfactorily by AM only. All units contained < 1 x 10(6) WBCs. In vitro RBC quality was equivalent among the systems. No significant differences were noted with collection efficiency, processed whole blood or citrate donor load. Owing to high collection and draw rates, the TA was the fastest of all the systems. The MCS+ had the longest donation/needle time and the highest PLT activation, but compensated with significantly lower draw and citrate infusion rates. The overall processing time was longest with the AM, as a result of manual procedures from donor disconnection to the final products. Multicomponent apheresis was performed safely and efficiently with all three instruments. There was no 'magic apparatus' as each system combined advantages and pitfalls for the diverse parameters evaluated.

  18. Case of generalized pustular psoriasis with end-stage renal disease successfully treated with granulocyte monocyte apheresis in combination with hemodialysis.

    PubMed

    Mabuchi, Tomotaka; Manabe, Yasuaki; Yamaoka, Hanako; Ota, Tami; Kato, Masayuki; Ikoma, Norihiro; Kusakabe, Yoshiyuki; Komaba, Hirotaka; Ozawa, Akira

    2014-06-01

    Granulocyte monocyte apheresis (GMA) is an extracorporeal apheresis instrument that removes activated neutrophils and monocytes. Generalized pustular psoriasis (GPP) is characterized by neutrophil infiltration into the epidermis that causes Kogoj's spongiotic pustule. Thus, GMA is one of the useful therapies for GPP, and it was approved for the treatment in 2012 in Japan. Herein, we report a case of GPP with end-stage renal disease (ESRD) successfully treated with GMA in combination with hemodialysis (HD). A 54-year-old Japanese female visited our outpatient clinic because of erythema with pustules on her trunk and extremities over the past 4 months. Histopathological examination showed an intraepidermal pustule filled with numerous neutrophils and spongiosis. These findings led to the diagnosis of GPP. She had ESRD and had been treated with HD twice a week for approximately 4 years. During maintenance HD twice a week, weekly GMA was started at Tokai University Hospital. The skin symptoms disappeared after five administrations of GMA. We suggest that GMA is an effective therapy for GPP patients with ESRD who are treated with HD. © 2014 Japanese Dermatological Association.

  19. Two-year experience with aerobic culturing of apheresis and whole blood-derived platelets.

    PubMed

    Kleinman, Steven H; Kamel, Hany T; Harpool, Dennis R; Vanderpool, Sandra K; Custer, Brian; Wiltbank, Thomas B; Nguyen, Kim-Anh; Tomasulo, Peter A

    2006-10-01

    Throughout its system of regional centers, Blood Systems implemented culture based bacterial testing with a standardized protocol for both apheresis and whole blood-derived platelets (PLTs). After a 24-hour hold, 4 mL of PLT product was inoculated into an aerobic bottle (BacT/ALERT, bioMérieux). Cultures were incubated for 24 hours before routine product release to prevent distribution of infected products while minimizing consignee notification, product retrievals, and hospital PLT inventory problems. Initial-positives were further tested (and bacteria identified) by performing cultures from the original component and subcultures from the BacT/ALERT bottle. Results were categorized according to AABB recommended definitions with minor modifications. The rate of true-positive detections from culturing 122,971 apheresis PLTs was 0.017 percent (95% confidence interval [CI], 0.011%-0.026%). All true-positive microorganisms were Gram-positive with a predominance of coagulase-negative Staphylococcus and Bacillus species. Twenty of the 21 true-positive samples (95%) were detected by 24 hours but only 14 (68%) were detected by 18 hours. The false-positive rate due to contamination was 0.1 percent with the majority of isolates being skin or environmental organisms. Results did not differ significantly for whole blood-derived versus apheresis PLTs. These data corroborate the fact that the rate of detection of truly contaminated PLT apheresis products in the United States is approximately 1 in 5000 (0.02%); this is lower than the 0.03 to 0.05 percent rates that were generally quoted in the literature before the implementation of prospective bacterial culturing programs.

  20. Platelet activation of platelet concentrates derived from buffy coat and apheresis methods.

    PubMed

    Ali, Soleimany Ferizhandy

    2011-02-01

    Preparation for storage may cause platelet activation. The quality of platelet concentrates plays an important role in transfusion therapy. Platelet concentrates are produced by different centrifugation methods; buffy coat (buffy coat-derived platelet concentrates-BC) and plateletpheresis (apheresis-derived platelet concentrates-APC). Their quality was assessed using the following parameters: platelet, WBC and RBC counts pH, volume, platelet factor 4 (PF4) and Annexin V. The present paper compares the quality of both platelet preparations in vitro. In this experimental study, 30 platelet concentrates were harvested with the Haemonetics MCS plus and 30 units via the buffy coat (BC) method. The percentages of Annexin V expression, PF4 levels, platelet, WBC and RBC counts, pH and volume were measure immediately after collection and after 3 days of storage. During storage for up to 3 days, BC units displayed, no significant pH or RBC, difference in comparison with apheresis preparations (p>0.05). During storage for up to 3 days, BC units displayed a significant increase in the PF4 and Annexin V expression, compared to the apheresis preparations on day three (p<0.05). The kinetics of PF4 and Annexin V levels are influenced by the method used to prepare platelets for storage. The different levels of PF4 and Annexin V in BCs and APCs clearly demonstrates a progressive activation of BC platelets exceeding that of APC. However, in vivo studies should be performed to confirm these findings.

  1. Successful treatment of three cases of generalized pustular psoriasis with granulocyte and monocyte adsorption apheresis.

    PubMed

    Suzuki, Akiko; Haruna, Kunitaka; Mizuno, Yuki; Kuwae, Yoshiyuki; Ono, Yuka; Okumura, Kazuko; Negi, Osamu; Kon, Yasuko; Takeuchi, Kaori; Takamori, Kenji; Ikeda, Shigaku; Suga, Yasushi

    2012-10-01

    Generalized pustular psoriasis (GPP) is a rare form of psoriasis characterized by the presence of variable numbers of sterile pustules appearing in erythematous and scaly lesions, which are associated with moderate to severe constitutional symptoms. It can be life-threatening especially in the elderly; therefore, medical care must be performed in rapid succession of treatment especially in refractory cases. We have performed granulocyte and monocyte adsorption apheresis (GCAP) on three GPP cases associated with several systemic and laboratory findings. As a result, the edema, erythema and numbers of sterile pustules on the skin lesions were reduced dramatically in all three patients after the first sessions of GCAP therapy. The sizes of the psoriatic lesions were reduced in all three patients following a weekly GCAP treatment for 5 consecutive weeks. Psoriasis area and severity index on discharge had improved in all three patients. No serious adverse effects were observed for up to at least 8 months after treatment. We therefore considered GCAP as one effective alternative to currently existing therapies, especially for recalcitrant cases of GPP. © 2012 The Authors. Therapeutic Apheresis and Dialysis © 2012 International Society for Apheresis.

  2. Low Density Lipoprotein Apheresis Reduces PF4 on the Surface of Platelets: a Possible Protective Mechanism Against HITT

    PubMed Central

    Tanhehco, Yvette C.; Rux, Ann H.; Sachais, Bruce S.

    2010-01-01

    Background Heparin-induced thrombocytopenia and thrombosis (HITT) is characterized by thrombocytopenia due to the formation of antibodies against heparin:platelet factor 4 (PF4) complexes. Despite the exposure to heparin during treatment and predisposition of patients with atherosclerosis to HITT, HITT in patients undergoing LDL apheresis is rare. We investigated the possibility that LDL apheresis decreases PF4 on platelet surfaces and/or plasma HITT antibody levels, either of which would disfavor HITT. Study Design and Methods We enrolled 25 patients undergoing LDL apheresis at the Hospital of the University of Pennsylvania. Blood samples were drawn before and after treatment. Plasma samples were drawn proximal and distal to the LA-15 treatment column. PF4, HITT antibodies, heparin levels and P-selectin were measured. Results No patient had clinical symptoms of HITT. The LA-15 column was found to efficiently remove PF4. PF4 levels in peripheral blood plasma did not change significantly after LDL apheresis. However, platelet surface PF4 significantly decreased after treatment. HITT antibodies were found in only 2 patients and were nonfunctional. Platelet surface P-selectin did not change during treatment. Conclusion We have demonstrated that LDL apheresis via dextran sulfate absorption removes plasma PF4 and reduces the amount of PF4 on the surface of circulating platelets. Reduced surface PF4 may decrease antibody formation and/or recognition by HITT antibodies. These data provide a potential explanation for the near lack of HITT in hypercholesterolemic patients undergoing LDL apheresis. They also suggest the possibility that LDL-apheresis using dextran sulfate adsorption may have therapeutic value in the treatment of HITT. PMID:20977482

  3. Emerging low-density lipoprotein (LDL) therapies: Management of severely elevated LDL cholesterol--the role of LDL-apheresis.

    PubMed

    McGowan, Mary P

    2013-01-01

    Low-density lipoprotein (LDL)-apheresis is a Food and Drug Administration-approved treatment for patients with homozygous familial hypercholesterolemia (FH) or severe heterozygous FH. Based on electrochemical principles, it selectively removes apolipoprotein B-containing lipoproteins through extracorporeal precipitation with either heparin (Heparin-induced Extracorporeal LDL Precipitation, ie, HELP) or dextran sulfate (Liposorber). LDL-apheresis can lead to an acute decrease in LDL cholesterol (LDL-C) of 70%-80%, but there is a rapid rebound to baseline levels within approximately 2 weeks. LDL-apheresis is typically performed once-a-week in patients with homozygous FH and every other week in those with heterozygous FH to produce time-average LDL-C reductions of ≈ 40%. Side effects associated with LDL-apheresis include hypotension (later found to be due to concomitant use of angiotensin-converting enzyme inhibitors), nausea/vomiting, flushing, angina, and fainting. Posttreatment bleeding can occur secondary to heparin used during the procedure. Challenges associated with LDL-apheresis include vascular access often requiring an arteriovenous fistula (fistulas may clot and require revision over time), the time associated with each treatment session (2-4 hours), the frequency of treatment, and the scarcity of medical centers which perform LDL-apheresis. Given the nature of LDL-apheresis, randomized placebo controlled trials are nearly impossible, and virtually all studies of clinical benefit have been non-randomized investigations of small numbers of subjects. Nonetheless, results from those studies support the benefits of LDL-C reduction for reducing coronary atherosclerosis and cardiovascular events.

  4. Apheresis product identification in the transplant center: development of point-of-care protocols for extended blood typing of stem cell apheresis products.

    PubMed

    Cummerow, C; Schwind, P; Spicher, M; Spohn, G; Geisen, C; Seifried, E; Bönig, H

    2012-06-01

    Transfusion of the 'wrong' stem cell product would almost inevitably be lethal, yet assays to confirm the contents of the product bag, except by checking labels and paperwork, are lacking. To increase the likelihood that a product mix-up would be detected in the transplant center, we developed a simple protocol for extended blood typing and hence, for confirmation of donor/product identity, on a tube segment. Apheresis samples were applied, directly or after erythrocyte enrichment, to commercially available blood typing assays, including lateral flow cards and gel agglutination cards. Without sample modification, low hematocrit and high leukocyte count obviated definitive blood typing. Using the most simple erythrocyte enrichment protocol, that is, centrifugation, reliable blood group analysis became possible with either assay. Other, more cumbersome pre-analytical protocols were also successful but provided no advantage. The preferred method was validated on 100 samples; ABD was correctly identified in 100% of cases. Of the other Rh Ags, all except two 'small e', in both cases in heterozygous individuals, were detected; there were no false positives. A simple, inexpensive point-of-care assay for extended blood typing of apheresis products is available, which can reduce the fatal risk of administering the wrong stem cell product.

  5. The 1(st) and the 2(nd) Italian Consensus Conferences on low-density lipoprotein-apheresis. A practical synopsis and update.

    PubMed

    Stefanutti, Claudia

    2016-07-07

    The clinical indications and guidelines for low-density lipoprotein (LDL)-apheresis set by the 1(st) Italian Consensus Conference held in Ostuni in 1990 and completed in 1992, but never published, are reported schematically. In 1994, within the Project "Prevention and control of the factors of the disease (FATMA)" by the Italian National Research Council, subproject 8 "Control of cardiovascular disease", a "Hearing on therapeutic apheresis: need for a target-oriented project" was organised. The meeting was the last scientific initiative on LDL-apheresis supported by public funds in Italy. After roughly two decades of use of LDL-apheresis, new guidelines were required based on the latest scientific evidence. In 2006, the Italian multicentre study on LDL-apheresis Working Group (IMSLDLa-WP), a scientific initiative at national level, was developed. It initially gathered together 19 Italian centres qualified for the application of lipid apheresis and LDL-apheresis (2007-2008), then 23 in 2010, located in the north, south, centre of Italy and in Sicily and Sardinia. The multicentre study aimed to validate the protocol for selecting patients and to create a network between the Italian centres. A secondary objective was the creation of a database of patients with familial hypercholesterolaemia and other severe forms of dyslipidaemia undergoing treatment with LDL-apheresis using the available techniques. Since LDL-apheresis has multidisciplinary treatment indications, the agreement on the new guidelines was reached through a panel of experts, of different medical and surgical specialties, with scientific and medical interest in the treatment indications, application and development of LDL-apheresis. The initiatives of the IMSLDLa-WP led to the 2(nd) Italian Consensus Conference on LDL-apheresis held in Rome in 2009. The previous and most recent guidelines are reported here synoptically.

  6. A single apheresis procedure in the donor may be enough to complete an allograft using the "Mexican method" of non-ablative allografting.

    PubMed

    Ruiz-Delgado, Guillermo J; Gutiérrez-Riveroll, Karla I; Gutiérrez-Aguirre, César H; Gómez-Almaguer, David; Eyzaguirre-Zapata, Renee; Priesca-Marin, Manuel; González-Carrillo, Martha L; Ruiz-Argüelles, Guillermo J

    2009-04-01

    Since 1999, in Mexico we have been using a regimen to conduct allografts that involves non-myeloablative conditioning and peripheral blood stem cells (PBSC) and have introduced some changes with the main goal of decreasing the cost of the procedure. We analysed the salient apheresis features of a group of 175 allogeneic peripheral blood stem cell transplants conducted in two institutions in a 7-year period. The grafts were conducted using the "Mexican" non-myelo ablative conditioning regimen employing oral busulphan, i.v. cyclophosphamide and i.v. fludarabine. In all instances, the apheresis machine employed was the Baxter CS3000 Plus and donors were mobilised with filgrastim. The apheresis procedures were performed on days 0, +1 and +2, the end-point of collection being 5,000 mL of blood/m2 in each procedure. Three apheresis sessions were planned but the number was adjusted according to the cell yield. The final number of allografted CD34 cells ranged between 0.5 and 25.4 x 10(6)/Kg of the recipient's body weight (median, 5.2 x 10(6)/Kg). One to three apheresis procedures were needed to obtain a product containing more than 0.5 x 10(6) CD34 cells/Kg of the recipient, the median being two procedures; in 72 cases (41%) a single apheresis procedure was sufficient to obtain the target number of CD34 cells. The volumes of apheresis ranged between 50 and 600 mL (median, 400 mL). Since the median cost of each apheresis procedure is 900 USD, the fact that two apheresis procedures was spared in 72 cases and one apheresis was spared in another 65 cases, led to a total saving of approximately 188,100 USD. It can be concluded that, in many cases, allogeneic transplants can be completed with a single apheresis session and that there are considerable financial benefits from this practice.

  7. The 1st and the 2nd Italian Consensus Conferences on low-density lipoprotein-apheresis. A practical synopsis and update

    PubMed Central

    Stefanutti, Claudia

    2017-01-01

    The clinical indications and guidelines for low-density lipoprotein (LDL)-apheresis set by the 1st Italian Consensus Conference held in Ostuni in 1990 and completed in 1992, but never published, are reported schematically. In 1994, within the Project “Prevention and control of the factors of the disease (FATMA)” by the Italian National Research Council, subproject 8 “Control of cardiovascular disease”, a “Hearing on therapeutic apheresis: need for a target-oriented project” was organised. The meeting was the last scientific initiative on LDL-apheresis supported by public funds in Italy. After roughly two decades of use of LDL-apheresis, new guidelines were required based on the latest scientific evidence. In 2006, the Italian multicentre study on LDL-apheresis Working Group (IMSLDLa-WP), a scientific initiative at national level, was developed. It initially gathered together 19 Italian centres qualified for the application of lipid apheresis and LDL-apheresis (2007–2008), then 23 in 2010, located in the north, south, centre of Italy and in Sicily and Sardinia. The multicentre study aimed to validate the protocol for selecting patients and to create a network between the Italian centres. A secondary objective was the creation of a database of patients with familial hypercholesterolaemia and other severe forms of dyslipidaemia undergoing treatment with LDL-apheresis using the available techniques. Since LDL-apheresis has multidisciplinary treatment indications, the agreement on the new guidelines was reached through a panel of experts, of different medical and surgical specialties, with scientific and medical interest in the treatment indications, application and development of LDL-apheresis. The initiatives of the IMSLDLa-WP led to the 2nd Italian Consensus Conference on LDL-apheresis held in Rome in 2009. The previous and most recent guidelines are reported here synoptically. PMID:27416576

  8. Clinical trial and local process evaluation of an apheresis system for preparation of white cell-reduced platelet components.

    PubMed

    Adams, M R; Dumont, L J; McCall, M; Heaton, W A

    1998-10-01

    A new method for the consistent preparation of white cell (WBC)-reduced plateletpheresis components, the Spectra Leukoreduction System (LRS), was evaluated by clinical trial and local process validation. The centrifuge-based system was projected to decrease the WBC content of plateletpheresis components to a level below 1 x 10(6) per unit. Phase I and II clinical trials were performed. The manufacturer's claims were then tested at the local level with an ongoing quality assurance program. In Phase I, a cross-over analysis of five subjects compared LRS to standard plateletpheresis procedures in collection efficiency and component quality: a panel of in vitro measures was taken on Day 0 and Day 5. In Phase II, the LRS process was tested on a larger scale (n = 57; control = 58) with component transfusion. Finally, validation, determination of degree of conformance with standards, and ongoing quality control were performed locally on a newly installed instrument. Phase I and II trials revealed no significant differences between LRS and control units in donor or recipient safety and comfort, platelet function and yield, or component volume. WBC per-unit values were significantly different: the LRS median per unit was 3.2 x 10(4) WBCs, versus 81.4 x 10(4) for control units. Assessment of process capability gave an estimate of 99-percent confidence that 99.5 percent of LRS units would be WBC reduced to < 1 x 10(6) WBCs. Local process validation and quality control revealed 90-percent confidence that 99 percent of the units would be WBC reduced and 99.9-percent confidence that 75 percent would exceed platelet yield standards; the process was stable over time. The LRS is safe for apheresis and the component produced is safe for transfusion with platelet function and yield equivalent to controls and WBC reduction superior to controls. Local process evaluation confirmed that component quality meets the goals of the institution.

  9. NHLBI state of the science symposium in therapeutic apheresis: Knowledge gaps and research opportunities in the area of hematology-oncology.

    PubMed

    Karafin, Matthew S; Sachais, Bruce S; Connelly-Smith, Laura; Field, Joshua J; Linenberger, Michael L; Padmanabhan, Anand

    2016-02-01

    The National Heart Lung and Blood Institute (NHLBI) hosted a two-day state of the science symposium on therapeutic apheresis in Bethesda, MD on November 28th-29th, 2012. The purpose of the symposium was multifaceted, and included the following aims: (a) To discuss this state of research and key scientific questions in apheresis medicine; (b) To identify gaps in knowledge for relevant cardiovascular diseases, hematological and oncological diseases, infectious diseases and sepsis, renal diseases, and neurological diseases where there may be strong therapeutic rationale for the application of apheresis treatments; (c) To explore ways of coordinating therapeutic apheresis with other medical disciplines and treatment modalities; (d) To identify and prioritize the most important research questions to be answered in apheresis medicine; and (e) To offer NHLBI suggestions on how a structured research approach can be applied to the therapeutic apheresis research agenda in future years. The following document summarizes three such key proposals presented at the meeting for evaluating apheresis therapy for the treatment of pain in sickle cell disease, heparin induced thrombocytopenia, and leukostasis from acute myeloid leukemia. The challenges and limitations regarding apheresis therapy for each disease are discussed, and avenues for future investigation for each disease are outlined.

  10. Generation of Platelet Microparticles after Cryopreservation of Apheresis Platelet Concentrates Contributes to Hemostatic Activity.

    PubMed

    Eker, İbrahim; Yılmaz, Soner; Çetinkaya, Rıza Aytaç; Pekel, Aysel; Ünlü, Aytekin; Gürsel, Orhan; Yılmaz, Sebahattin; Avcu, Ferit; Muşabak, Uğur; Pekoğlu, Ahmet; Ertaş, Zerrin; Açıkel, Cengizhan; Zeybek, Nazif; Kürekçi, Ahmet Emin; Avcı, İsmail Yaşar

    2017-03-01

    In the last decade, substantial evidence has accumulated about the use of cryopreserved platelet concentrates, especially in trauma. However, little reference has been made in these studies to the morphological and functional changes of platelets. Recently platelets have been shown to be activated by cryopreservation processes and to undergo procoagulant membrane changes resulting in the generation of platelet-derived microparticles (PMPs), platelet degranulation, and release of platelet-derived growth factors (PDGFs). We assessed the viabilities and the PMP and PDGF levels of cryopreserved platelets, and their relation with thrombin generation. Apheresis platelet concentrates (APCs) from 20 donors were stored for 1 day and cryopreserved with 6% dimethyl sulfoxide. Cryopreserved APCs were kept at -80 °C for 1 day. Thawed APCs (100 mL) were diluted with 20 mL of autologous plasma and specimens were analyzed for viabilities and PMPs by flow cytometry, for thrombin generation by calibrated automated thrombogram, and for PDGFs by enzyme-linked immunosorbent assay testing. The mean PMP and PDGF levels in freeze-thawed APCs were significantly higher (2763±399.4/µL vs. 319.9±80.5/µL, p<0.001 and 550.9±73.6 pg/mL vs. 96.5±49 pg/mL, p<0.001, respectively), but the viability rates were significantly lower (68.2±13.7% vs. 94±7.5%, p<.001) than those of fresh APCs. The mean endogenous thrombin potential (ETP) of freeze-thawed APCs was significantly higher than that of the fresh APCs (3406.1±430.4 nM.min vs. 2757.6±485.7 nM.min, p<0.001). Moreover, there was a significant positive poor correlation between ETP levels and PMP levels (r=0.192, p=0.014). Our results showed that, after cryopreservation, while levels of PMPs were increasing, significantly higher and earlier thrombin formation was occurring in the samples analyzed despite the significant decrease in viability. Considering the damage caused by the freezing process and the scarcity of evidence for their in

  11. Plasma dependent reduction in red blood cell aggregation after dextran sulfate low-density lipoprotein apheresis--implications for rheological studies.

    PubMed

    Schechner, Vered; Ben-Ami, Ronen; Hershcovici, Tiberiu; Yedgar, Shaul; Beigel, Ytzhak; Shapira, Itzhak; Berliner, Shlomo; Barsthein, Gershon

    2005-10-01

    Red blood cell (RBC) aggregation is increased in familial hypercholesterolemia, and is reduced significantly after low density lipoprotein (LDL) apheresis. The purpose of the present study was to clarify whether this reduction depends on changes in plasma composition, RBC membrane properties, or both. RBC aggregation was determined in a computerized cell flow-properties analyzer, before and after LDL apheresis. We compared RBC aggregation in autologous plasma with aggregation in a plasma-free standard solution (0.5% of dextran 500 kDa) to define the separate contributions of plasma and cellular properties to the observed RBC aggregation. RBC aggregation in autologous plasma was reduced by 35.5% after LDL apheresis (P=0.01) but was not significantly affected when measured in dextran 500. This suggests that LDL apheresis attenuated RBC aggregation by altering plasma composition rather than RBC membrane properties. These results are relevant to the understanding of hemorheological changes which follow therapeutic apheresis in hypercholesterolemic patients.

  12. Obtaining an equivalent beam

    NASA Technical Reports Server (NTRS)

    Butler, Thomas G.

    1990-01-01

    In modeling a complex structure the researcher was faced with a component that would have logical appeal if it were modeled as a beam. The structure was a mast of a robot controlled gantry crane. The structure up to this point already had a large number of degrees of freedom, so the idea of conserving grid points by modeling the mast as a beam was attractive. The researcher decided to make a separate problem of of the mast and model it in three dimensions with plates, then extract the equivalent beam properties by setting up the loading to simulate beam-like deformation and constraints. The results could then be used to represent the mast as a beam in the full model. A comparison was made of properties derived from models of different constraints versus manual calculations. The researcher shows that the three-dimensional model is ineffective in trying to conform to the requirements of an equivalent beam representation. If a full 3-D plate model were used in the complete representation of the crane structure, good results would be obtained. Since the attempt is to economize on the size of the model, a better way to achieve the same results is to use substructuring and condense the mast to equivalent end boundary and intermediate mass points.

  13. Increasing susceptibility of nitric oxide-mediated inhibitory platelet signaling during storage of apheresis-derived platelet concentrates.

    PubMed

    Kobsar, Anna; Klinker, Erdwine; Kuhn, Sabine; Koessler, Angela; Yilmaz, Pinar; Boeck, Markus; Koessler, Juergen

    2014-07-01

    Storage of platelets (PLTs) affects PLT integrity and functionality, a process named the PLT storage lesion. Normal PLT function essentially depends on the balanced interaction of activating and inhibitory signaling pathways. As there are poor data on the alterations of inhibitory signaling during storage of PLT concentrates, this study investigates the modulation capability of the cyclic nucleotide-mediated inhibitory pathways by use of the nitric oxide donor diethylamine diazenium diolate (DEA/NO). PLTs were obtained from whole blood (WB) and from apheresis-derived PLT concentrates (APCs) stored for 0, 2, and 5 days. Vasodilator-stimulated phosphoprotein (VASP) phosphorylation, cyclic nucleotide concentrations, fibrinogen binding, and agonist-induced aggregation were measured without or after stimulation with DEA/NO. DEA/NO-induced VASP phosphorylation was significantly higher in PLTs from APCs on Days 2 and 5 compared to WB, conditioned by a stronger increase of cyclic guanosine monophosphate (cGMP), but not cyclic adenosine monophosphate (cAMP), in stored PLTs. A quantity of 5 nmol/L DEA/NO neither influenced thrombin receptor activator peptide 6 and collagen-induced aggregation nor fibrinogen binding in freshly collected PLTs, whereas it significantly inhibited both in stored PLTs. Stored PLTs showed an impairment of intracellular cGMP regulation, resulting in exceeding inhibition of agonist-induced aggregation and fibrinogen binding in the course of storage. The observed effects could be an important mechanism contributing to the storage lesion with reduced activating potential of PLTs. © 2014 AABB.

  14. Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China

    PubMed Central

    Lai, Ya-Min; Yao, Wei-Yan; He, Yao; Jiang, Xuan; Gu, Yu-Bei; Chen, Min-Hu; Liu, Yu-Lan; Yuan, Yao-Zong; Qian, Jia-Ming

    2017-01-01

    Background/Aims Patients with active ulcerative colitis (UC) have elevated levels of activated myeloid-derived leukocytes as a source of inflammatory cytokines. The selective depletion of these leukocytes by adsorptive granulocyte/monocyte apheresis (GMA) with an Adacolumn should alleviate inflammation, promote remission and enhance drug efficacy. However, studies have reported contrasting efficacy outcomes based on patients’ baseline demographic variables. This study was undertaken to understand the demographic features of GMA responders and nonresponders. Methods This was a multicenter study in China involving four institutions and 34 patients with active UC. Baseline conventional medications were continued without changing the dosage. The treatment efficacy was evaluated based on the endoscopic activity index and the Mayo score. Results Thirty of the 34 patients completed all 10 GMA treatment sessions. The overall efficacy rate was 70.59%. The receiver operating characteristic analysis showed that the area under the curve was approximately 0.766 for a Mayo score of ≤5.5 with 0.273 specificity and 0.857 sensitivity (Youden index, 0.584) for GMA responders. No GMA-related serious adverse events were observed. Conclusions The overall efficacy of GMA in patients with active UC who were taking first-line medications or were corticosteroid refractory was encouraging. Additionally, GMA was well tolerated and had a good safety profile. PMID:27843131

  15. Effects of plasma nitric oxide levels on platelet activation in single donor apheresis and random donor concentrates.

    PubMed

    Büyükkağnici, Demet Iren; Ilhan, Osman; Kavas, Güzin Ozelçi; Arslan, Onder; Arat, Mutlu; Dalva, Klara; Ayyildiz, Erol

    2007-02-01

    P-selectin is an useful marker to determine platelet activation and nitric oxide inhibits platelet activation, secretion, adhesion and aggregation. The aim of this study was to investigate the relationship between nitric oxide and P-selectin values in both single donor apheresis and random donor platelet concentrates. According to the results of this study, we found that the best platelet concentrate is freshly prepared single donor apheresis concentrate and it is important to prevent activation at the beginning of the donation. Nitric oxide, which is synthesized from platelets during the storage period, is not sufficient to prevent platelet activation.

  16. Lipoprotein apheresis for the treatment of elevated circulating levels of lipoprotein(a): a critical literature review

    PubMed Central

    Franchini, Massimo; Capuzzo, Enrico; Liumbruno, Giancarlo M.

    2016-01-01

    Lipoprotein(a), which consists of a low-density lipoprotein (LDL) particle linked to an apolipoprotein(a) moiety, is currently considered an independent risk factor for cardiovascular disease due to its atherogenic (LDL-like) and prothrombotic (plasminogen-like) properties. The aim of this review is to provide an overview of the current and newer therapies for lowering increased lipoprotein(a) levels, focusing on lipoprotein apheresis. After a systematic literature search, we identified ten studies which, overall, documented that lipoprotein apheresis is effective in reducing increased lipoprotein(a) levels and cardiovascular events. PMID:26710351

  17. Low density lipoprotein apheresis in pediatric patients with homozygous familial hypercholesterolemia.

    PubMed

    Coker, Mahmut; Ucar, Sema Kalkan; Simsek, Damla Goksen; Darcan, Sukran; Bak, Mustafa; Can, Sule

    2009-04-01

    The aim of the present study is to clarify the low density lipoprotein apheresis procedure for pediatric patients with homozygous familial hypercholesterolemia (FH) in terms of efficacy, adverse effects and difficulties. The follow-up was carried out using an open, prospective uncontrolled clinical design. Data were collected from 10 patients (with an average age of 8.4 +/- 4.7 years) with FH treated with double filtration plasmapheresis. The total time span of follow-up covered five years (30.2 +/- 17.8 months [range 9-60 months]) and more than 600 sessions (62.1 +/- 35.5 sessions per patient [range 18-120 sessions]) were evaluated. The mean low density lipoprotein cholesterol (LDL-C) pre-treatment value was 375.5 +/- 127.5 mg/dL, and the post-treatment value was 147.5 +/- 73.9 mg/dL. This corresponded to a 62.8 +/- 10.3% (43-73%) acute reduction of LDL-C, while the mean high density lipoprotein cholesterol losses amounted to 41%. The chronic reduction in LDL-C ranged from 18 to 52%, with a mean level of 36.4 +/- 11.7%. The most frequently occurring technical problems were related to blood lines: puncture difficulties (4.5%), insufficient blood flow (3.5%), and obturation of the blood lines (2.4%). The main clinical adverse effects were hypotension (0.2%), chills/feeling cold (0.1%), and nausea and vomiting (0.2%). We observed that the low pediatric patient tolerance is the main problem in compliance with treatment. In conclusion, LDL apheresis, started under the age of eight years, combined with lipid-lowering drugs, provides a safe and effective lowering of the mean LDL-C levels in pediatric homozygous FH; and there are more problems with compliance for pediatric LDL apheresis than in the adult population.

  18. Expression and function of purinergic receptors in platelets from apheresis-derived platelet concentrates

    PubMed Central

    Koessler, Juergen; Weber, Katja; Koessler, Angela; Yilmaz, Pinar; Boeck, Markus; Kobsar, Anna

    2016-01-01

    Background The storage of platelets affects platelet integrity and functionality, a process named platelet storage lesion (PSL). Reduced adenosine diphosphate (ADP)-induced platelet aggregation is a typical manifestation of PSL. However, the role of ADP receptors in this context has not been evaluated yet. The aim of this study was, therefore, to investigate surface expression and function of the purinergic receptors P2Y1, P2Y12 and P2X1 in stored platelet concentrates. Material and methods Platelets were obtained from venous whole blood and from apheresis-derived platelet concentrates stored for 0, 2 and 5 days. Purinergic receptor expression was measured by flow cytometry and western blot analysis. Receptor function was determined by calcium-induced fluorescence (P2Y1 and P2X1) or by flow cytometric measurement of the platelet reactivity index (P2Y12). Results The basal surface expression and total content of purinergic receptors remained unchanged throughout storage. After an initial reduction during apheresis, P2X1-mediated calcium flux was maintained, whereas the P2Y1-mediated increase of calcium flux gradually decreased during the course of storage. In contrast, the platelet reactivity index was comparable in freshly obtained and stored platelets. Discussion The function of the P2Y12 receptor is maintained during storage of apheresis-derived platelet concentrates. However, the impairment of P2X1 and especially of P2Y1 receptor function indicated by decreased receptor-mediated calcium flux is an important mechanism contributing to reduced ADP responsiveness of stored platelets. PMID:26674810

  19. Platelet Recruitment during Multiple Donor Platelet Apheresis Differs between Cell Separators.

    PubMed

    Fontana, Stefano; Keller, Peter; Taleghani, Behrouz Mansouri

    2011-01-01

    SUMMARY: BACKGROUND: Recruitment of platelets (PLT) during donor PLT apheresis may facilitate the harvest of multiple units within a single donation. METHODS: We compared two PLT apheresis procedures (Amicus and Trima Accel) in a prospective, randomized, paired cross-over study in 60 donors. The 120 donations were compared for depletion of circulating PLT in the donors, PLT yields and PLT recruitment. A recruitment was defined as ratio of total PLT yield and donor PLT depletion > 1. RESULTS: Despite comparable differences of pre- and post-apheresis PLT counts (87 × 10(9)/l in Trima Accel vs. 92 × 10(9)/l in Amicus, p = 0.383), PLT yields were higher with Trima Accel (7.48 × 10(11) vs. 6.06 × 10(11), p < 0.001), corresponding to a higher PLT recruitment (1.90 vs. 1.42, p < 0.001). We observed a different increase of WBC counts after aphereses, which was more pronounced with Trima Accel than with Amicus (1.30 × 10(9)/l vs. 0.46 × 10(9)/l, p < 0.001). CONCLUSION: Both procedures induced PLT recruitment. This was higher in Trima Accel, contributing to a higher yield in spite of a comparable depletion of circulating PLT in the donors. This recruitment facilitates the harvest of multiple units within a single donation and seems to be influenced by the procedure utilized. The different increases of circulating donor white blood cells after donation need further investigation.

  20. Practical aspects of direct adsorption of lipoproteins from whole blood by DALI LDL-apheresis.

    PubMed

    Bosch, Thomas

    2004-10-01

    Direct adsorption of lipoproteins (DALI) from whole blood is the first LDL-hemoperfusion procedure. The present paper addresses practical questions of DALI apheresis in order to optimise DALI therapy in sometimes critically ill coronary patients. The reduction of LDL and Lp(a) by DALI can be optimised by increasing the treated blood volume and the DALI adsorber volume. Hypotension (1.2% of sessions) may be minimised by fluid intake before the session, isovolemic connection of the patient to the ECC, reduced blood flow and low ACD-A ratio. Hypocalcemia may be avoided by low citrate anticoagulation (1:40) and reduced blood flow. Bradykinin release peaks at ca. 1000 ml of treated blood volume and may cause Quincke edema (tight throat), hypotension and flush. Reduction of the blood flow rate and decrease of citrate admixture as well as administration of iv. calcium may be helpful. While ACE inhibitors are contraindicated in DALI patients, sartans may be used without problems. Some "intrinsic" PTT increase is caused by adsorption of coagulation factors; undue PTT prolongations after DALI may be avoided by reduction of the heparin dosage during priming and treatment. In patients prone to alkalosis and hypokalemia, a reduction of the ACD-A ratio is recommended. Rises of adsorber inlet pressure may be due to insufficient anticoagulation and adsorber clotting or malfunctioning of the venous access. Rinsing of the adsorber with saline, administration of a heparin bolus and increase of the citrate admixture as well as a rinse and/or repositioning of the venous access are helpful measures. If these basic rules are followed, DALI LDL-apheresis is a safe, efficient, rapid and user-friendly LDL-apheresis procedure as evidenced by more than 80,000 DALI sessions successfully performed to date.

  1. Adverse events and retention of donors of double red cell units by apheresis

    PubMed Central

    Keshelashvili, Ketevan; O’Meara, Alix; Stern, Martin; Jirout, Zuzana; Pehlic, Vildana; Holbro, Andreas; Buser, Andreas; Sigle, Jörg; Infanti, Laura

    2016-01-01

    Background Safety of double-erythrocyte (2RBC) collection and reasons for ceasing 2RBC donation were retrospectively analysed in the blood donor population of Basel, Switzerland. Methods Donors with at least 1 2RBC apheresis were included in the study. Minimal requirements were Hb ≥140 g/L and body weight ≥70 kg; serum ferritin (SF) values were measured routinely, but were not part of the selection criteria. 2RBC collections were performed with ALYX devices at 6-month intervals. Adverse events (AEs) were systematically recorded and classified according to the ISBT EHN 2008 criteria. Data of procedures were retrieved from the ALYX software. Demographics, apheresis data and AEs were analysed with descriptive statistics. Results Data of 4,377 2RBC aphereses performed in 793 donors (779 males) between 1st January 2003 and 31st May 2015 were evaluated. Mean donor age at first 2RBC donation was 44 years (standard deviation [SD] 21), median number of donations was 4 (interquartile range [IQR] 8); 32% of the donors underwent a single procedure. There were 161 AEs, mostly local haematomas (55%) and vasovagal reactions (20%); fatigue was reported in 6% of the cases and was more frequent than citrate toxicity. Two severe AEs were observed. The most frequent reasons for abandoning 2RBC donation were low SF levels and donor choice (both 11%), but most donors simply did not reply to invitations (16%). Overall, procedure-related causes (AEs, low SF levels, no time for apheresis, inadequate venous access) were observed in 14% of the cases. At the end of the observation period, 40% of the donors were still active blood donors, but only 20% were donating 2RBC. Discussion 2RBC donation is overall safe. Donor retention was low over a period of 11 years. An important reason for abandoning 2RBC was the detection of low SF levels. The impact of fatigue on donor retention and the course of iron stores after repeated 6-monthly 2RBC apheresis require further investigation. PMID:27136442

  2. Equivalence principles and electromagnetism

    NASA Technical Reports Server (NTRS)

    Ni, W.-T.

    1977-01-01

    The implications of the weak equivalence principles are investigated in detail for electromagnetic systems in a general framework. In particular, it is shown that the universality of free-fall trajectories (Galileo weak equivalence principle) does not imply the validity of the Einstein equivalence principle. However, the Galileo principle plus the universality of free-fall rotation states does imply the Einstein principle.

  3. Time-based analysis of the apheresis platelet supply chain in England.

    PubMed

    Wilding, R; Cotton, S; Dobbin, J; Chapman, J; Yates, N

    2011-10-01

    During 2009/2010 loss of platelets within NHS Blood and Transplant (NHSBT) due to time expiry was 9.3%. Hospitals remain reluctant to hold stocks of platelets due to the poor shelf life at issue. The purpose of this study was to identify areas for time compression in the apheresis platelet supply chain to extend the shelf life available for hospitals and reduce wastage in NHSBT. This was done within the context of NHSBT reconfiguring their supply chain and moving towards a consolidated and centralised approach. Time based process mapping was applied to identify value and non-value adding time in two manufacturing models. A large amount of the non-value adding time in the apheresis platelet supply chain is due to transportation and waiting for the next process in the manufacturing process to take place. Time based process mapping provides an effective 'lens' for supply chain professionals to identify opportunities for improvement in the platelet supply chain. © 2011 The Author(s). Vox Sanguinis © 2011 International Society of Blood Transfusion.

  4. [The use of therapeutic apheresis in neurological diseases and comparison between plasma exchange and immunoadsorption].

    PubMed

    Loschiavo, C; Grecò, M; Polo, A; Del Colle, R

    2015-01-01

    The use of plasmapheresis in neurological diseases with immune-mediated pathogenesis is widely certified. In recent years, the technological evolution of the dialysis membranes allowed to accompany the classical plasma exchange (PEX) treatment of apheresis by means of selective adsorption (IA). It has proved to be of equal therapeutic efficacy and, at the same time, devoid of most of the PEX side effects. The recent guidelines of the American Society for Apheresis (ASFA) and, later, the American Academy of Neurology, outlined directions and diagrams for the application of the method that has found wide use in many neurological diseases on the basis of auto-antibodies; in particular in Myasthenia Gravis, Guillain-Barre Syndrome, Multiple Sclerosis and Chronic Demyelinating Polyradiculoneuropathy. We add our experience in the treatment of 13 patients suffering from Myasthenia Gravis, treated over a four years period with filters containing tryptophan immunoadsorption in polyvinyl alcohol gel. The results confirm the achievement of a rapid regression of clinical symptoms, together with the rapid fall in the levels of antibody against acetylcholine-receptor. Therefore, the method of AI is to be considered of equal therapeutic efficacy of PEX, providing greater security in its use.

  5. Comparative study of automated plateletpheresis using five different apheresis systems in a tertiary care hospital.

    PubMed

    Chaudhary, Rajendra; Das, Sudipta Sekhar; Khetan, Dheeraj; Ojha, Shashank; Verma, Sunil

    2009-04-01

    Different types of cell separators are available nowadays based on either continuous or intermittent flow technology to meet the growing demands for single donor apheresis platelets. This prospective study compares the five machines used in our center with regard to procedure parameters, product quality and adverse effects on the donor. A total of 477 plateletpheresis on various machines were performed on eligible donors over a period of 28 months after taking informed consent. All procedures were performed following the departmental standard operating procedure (SOP) and manufacturer's instructions. All donor and procedure related details were obtained from the procedure register. Statistical analysis was done using the SPSS statistical package (version 12, USA). The median age, BSA and BMI of our plateletpheresis donors were calculated to be 29 years, 1.69 m(2) and 23.1 kg/m(2), respectively. Analyzing the parameters related to donor comfort such as donation time (DT), needle time (NT) and processing time (PT), the MCS machines were not "donor friendly" compared to Amicus and Fresenius. Platelet yield by Amicus was significantly higher as compared to other cell separators (p < 0.05). Plateletpheresis associated citrate toxicity was higher with the Amicus and MCS 3p and vasovagal side-effects was observed least with the CS 3000 machine. Though, quality of apheresis product in terms of yield is comparable with all the machines, there are differences in the systems with regard to donor safety, procedure time and donor retention.

  6. Effectiveness of the haemonetics MCS cell separator in the collection of apheresis platelets.

    PubMed

    Keklik, Muzaffer; Keklik, Ertugrul; Korkmaz, Serdal; Aygun, Bilal; Arik, Ferhat; Kilic, Ozcan; Sarikoc, Murat

    2015-12-01

    Platelet (PLT) transfusions play an important role in patients with thrombocytopenia or severely impaired platelet function. Platelet concentrates are prepared from whole-blood donations or by plateletpheresis. In recent years, different instruments have been developed to perform plateletpheresis. We evaluated an apheresis instrument, the Haemonetics MCS(®) + with regard to PLT yield, collection efficiency (CE), and collection rate (CR) in a retrospective, randomized study in 526 donors. In this system, we used leukoreduction filters post collection to obtain leukoreduced products. The Haemonetics MCS(®) + cell separator efficiently collected apheresis platelets with median PLT yields of 3.7 × 10(11), mean CE of 66.69 ± 13.73% and mean CR of 0.063 ± 0.013 × 10(11)/min. The median blood volume processed was 3290 (2420-4370) ml, and the median volume of acid citrate dextrose-A (ACD-A) used in collections on the device was 385 (196-517) ml. Also, this device allowed the collection of white blood cell (WBC) reduced plateletpheresis with mean 0.07 ± 0.15 × 10(6) WBC content. No serious donor or recipient reactions occurred.

  7. Combination of therapeutic apheresis and therapeutic ventricular assistance for end-stage heart failure patients.

    PubMed

    Schulte-Eistrup, Sebastian; Ashizawa, Satoshi; Nonaka, Kenji; Ichikawa, Seiji; Motomura, Tadashi; Murai, Noriyuki; Nosé, Yukihiko

    2002-08-01

    Dilated cardiomyopathy is a cardiac disease of unknown origin which is characterized by the gradual development of cardiac failure associated with four-chamber dilatation of the heart. Heart transplantation has been considered as the last resort for this disease. However, some patients who received support with a ventricular assist device (VAD) as a bridge-to-transplantation and then recovered without transplantation have been reported. This new concept of treating heart failure is termed bridge-to-recovery. A VAD can inhibit the heart failure compensatory mechanisms by extreme ventricular unloading. Also, heart failure is a complex neurohormonal/autocrine-paracrine syndrome, and these mechanisms consecutively lead to inflammatory response by proinflammatory cytokines; interleukin-1 alpha (IL-1 alpha), interleukin-1 beta (IL-1 beta), interleukin-2 (IL-2), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha). Furthermore, the existence of anti-beta1-adrenoceptor autoantibodies (A-beta1-AABs) in a patient with dilated cardiomyopathy has been reported. These proinflammatory cytokines and this antibody accelerate a ventricular remodeling and a contractile dysfunction over the long term. Apheresis can also inhibit the vicious cycle in heart failure by removing the factors that are produced by activated neurohormonal/autocrine-paracrine compensatory mechanisms. Therefore, we propose that the combined therapies, therapeutic VAD and therapeutic apheresis, will provide a prominent outcome for a patient who is suffering from end-stage heart failure.

  8. Single Low-Density Lipoprotein Apheresis Does Not Improve Vascular Endothelial Function in Chronically Treated Hypercholesterolemic Patients

    PubMed Central

    Ballard, Kevin D.; Mah, Eunice; Guo, Yi; Bruno, Richard S.; Taylor, Beth A.; Beam, Jo Ellen; Polk, Donna M.; Thompson, Paul D.

    2016-01-01

    Objective. To investigate vascular endothelial function (VEF) responses to a single low-density lipoprotein (LDL) apheresis session in hypercholesterolemic patients undergoing chronic treatment. Methods. We measured brachial artery flow-mediated dilation (FMD), plasma lipids, vitamin E (α- and γ-tocopherol), markers of oxidative/nitrative stress (malondialdehyde (MDA) and nitro-γ-tocopherol (NGT)), and regulators of NO metabolism (arginine (ARG) and asymmetric dimethylarginine (ADMA)) prior to (Pre) and immediately following (Post) LDL apheresis and at 1, 3, 7, and 14 d Post in 5 hypercholesterolemic patients (52 ± 11 y). Results. Relative to Pre, total cholesterol (7.8 ± 1.5 mmol/L) and LDL-cholesterol (6.2 ± 1.2 mmol/L) were 61% and 70% lower (P < 0.01), respectively, at Post and returned to Pre levels at 14 d. Brachial FMD responses (6.9 ± 3.6%) and plasma MDA, ARG, and ADMA concentrations were unaffected by LDL apheresis. Plasma α-tocopherol, γ-tocopherol, and NGT concentrations were 52–69% lower at Post (P < 0.01), and α-tocopherol remained 36% lower at 1 d whereas NGT remained 41% lower at d 3. Conclusions. Acute cholesterol reduction by LDL apheresis does not alter VEF, oxidative stress, or NO homeostasis in patients treated chronically for hypercholesterolemia. PMID:26998360

  9. Granulocyte and monocyte adsorption apheresis for refractory skin diseases due to activated neutrophils, psoriasis, and associated arthropathy.

    PubMed

    Sakanoue, Masanao; Takeda, Koichiro; Kawai, Kazuhiro; Kanekura, Takuro

    2013-10-01

    Granulocyte and monocyte adsorption apheresis (GMA), an extracorporeal apheresis instrument whose column contains cellulose acetate (CA) beads, is designed to remove activated granulocytes and monocytes. We previously demonstrated that GMA was useful for treating neutrophilic dermatoses and associated arthropathy as it adsorbs Mac-1 (CD11b/CD18)-expressing neutrophils to the CA beads by the binding of complement component (iC3b) and CD11b expressed on activated neutrophils. The objective of this study is to further assess the clinical effectiveness of GMA in the treatment of neutrophilic dermatoses and associated arthropathy. The effect of GMA for skin lesions and joint lesions was assessed in 44 and 23 patients, respectively. Mac-1 expression on peripheral neutrophils was measured by flow cytometry. Skin lesions and arthropathy improved in 39 of 44 patients (88.6%) and 22 of 23 (95.6%), respectively. Mac-1 (CD11b/CD18) expression on the peripheral neutrophils, 27.1 ± 6.66 MFI (mean fluorescence intensity) before treatment, was reduced to 17.9 ± 3.02 MFI by GMA (P < 0.05). Clinical effectiveness of GMA for the treatment of intractable neutrophilic dermatoses and associated arthropathy was further confirmed. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

  10. Generic equivalence of dermatologic products. How equivalent is equivalent?

    PubMed

    Doering, P L; Araujo, O E; Flowers, F P

    1987-05-01

    More and more pharmaceutical products are becoming available under the generic designation as patents for their brand-name counterparts expire. Although some generic products are exact duplicates of the brand-name drug, others may vary with regard to their inactive ingredients or in other ways. Sometimes these allowable variations in product formulation are clinically significant for certain individuals. Therefore it is important for both the prescriber and the dispenser of medication to recognize potential differences in marketed products so that a truly equivalent preparation can be provided when a generic substitution is made. This article chronicles a case in which miscommunication and noncommunication led to the suboptimal treatment of a skin disease with a generic "equivalent." Suggestions are made for improving interprofessional communication so that the patient's needs are served to the maximum degree.

  11. Influence of apheresis container size on the maintenance of platelet in vitro storage properties after a 30-h interruption of agitation.

    PubMed

    Wagner, Stephen J; Skripchenko, Andrey; Seetharaman, Shalini; Myrup, Andrew; Kurtz, James; Thomas-Montgomery, Dedeene; Awatefe, Helen; Moroff, Gary

    2010-08-01

    We have previously conducted studies investigating maintenance of apheresis platelet in vitro quality measures during storage under simulated shipping conditions in which agitation was interrupted. This study examines the effect of increasing bag surface area on the preservation of in vitro platelet properties during storage with continuous agitation and with a 30 h interruption of agitation. Apheresis platelets were collected in 100% plasma with the Amicus separator to provide two identical platelet products, each with approximately 4-5 x 10(11) platelets. After collection, the volume was divided equally between 1.0 and 1.3 L PL2410 containers. In an initial study, both products were continuously agitated. In a second study, both products were subjected to a single 30-h period of interrupted agitation between Days 2 and 3 of storage by placement in a standard shipping box at room temperature. In each study, units were assayed during storage for standard in vitro platelet quality measures. Platelets stored in the 1.3 L container maintained slightly greater mean pH during 7 day storage with either continuous agitation (n=6) or with a 30-h interruption of agitation (n=12) than those of similarly treated identical platelets stored in the 1.0 L container. Most noteworthy, in experiments with products stored in the 1.0 L container in which there was a large decrease in pH to levels <6.7 or <6.3 on days 5 or 7, respectively, the pH in the matched product stored in the 1.3 L container was substantially greater (0.17+/-06 and 0.37+/-0.09 pH units greater, n=4, respectively). Other measures showed either small differences or comparability of platelet in vitro parameters with storage in the two containers after an interruption of agitation.

  12. PATHOGEN EQUIVALENCY COMMITTEE UPDATE: PFRP EQUIVALENCY DETERMINATIONS

    EPA Science Inventory

    This presentation will:

    Review the mandate of the Pathogen Equivalency Committee
    Review the PEC's current membership of 10
    Discuss how a typical application is evaluated
    Note where information can be found
    List present deliberations/applications and describe t...

  13. PATHOGEN EQUIVALENCY COMMITTEE UPDATE: PFRP EQUIVALENCY DETERMINATIONS

    EPA Science Inventory

    This presentation will:

    Review the mandate of the Pathogen Equivalency Committee
    Review the PEC's current membership of 10
    Discuss how a typical application is evaluated
    Note where information can be found
    List present deliberations/applications and describe t...

  14. A longitudinal study of FDG-PET in Crohn disease patients receiving granulocyte/monocyte apheresis therapy.

    PubMed

    Kuwaki, Kotaro; Mitsuyama, Keiichi; Kaida, Hayato; Takedatsu, Hidetoshi; Yoshioka, Shinichiro; Yamasaki, Hiroshi; Yamauchi, Ryosuke; Fukunaga, Shuhei; Abe, Toshi; Tsuruta, Osamu; Torimura, Takuji

    2016-02-01

    Endoscopy is the gold standard for the diagnosis and follow-up of patients with Crohn disease (CD). However, a less invasive approach is now being sought for the management of these patients. The objective of this study was to examine whether (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) might be relevant for monitoring the disease activity in CD patients undergoing granulocyte/monocyte apheresis (GMA). This study was conducted in 12 patients with CD who were receiving treatment with 10 once-a-week GMA sessions with the Adacolumn. The response to treatment was monitored by measuring standard laboratory variables, Crohn's Disease Activity Index (CDAI) score, International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) score, and regional and global bowel uptakes on FDG-PET. In 6 of the 12 patients, significant improvement of the CDAI was observed after the final session of GMA. The patients who showed clinical response to GMA had a decrease in the regional and global bowel uptakes on FDG-PET, whereas those who did not respond showed no change. In the patients who responded to the GMA, the decrease in regional bowel uptake on FDG-PET in each disease area of the same patient varied in parallel. There was a significant correlation between decrease in the global bowel uptake on FDG-PET and improvement of the CDAI and IOIBD scores. The longitudinal changes in FDG-PET uptakes are of potential clinical interest for assessing the regional and global bowel disease activity in CD patients undergoing GMA therapy. Copyright © 2015 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  15. Granulo-monocyto apheresis is more effective in mild ulcerative colitis than in moderate to severe disease.

    PubMed

    De Cassan, Chiara; Savarino, Edoardo; Marson, Piero; Tison, Tiziana; Hatem, Giorgia; Sturniolo, Giacomo Carlo; D'Incà, Renata

    2014-12-07

    To evaluate whether the effectiveness of Granulo-monocyto apheresis (GMA), a technique that consists of the extracorporeal removal of granulocytes and monocytes from the peripheral blood, might vary according to the severity of ulcerative colitis (UC) in patients with mild to moderate-severe disease UC activity. We retrospectively reviewed prospectively collected data of patients undergoing GMA at our inflammatory bowel disease centre who had at least a 6 mo of follow-up. The demographics, clinical and laboratory data were extracted from the patients' charts and electronic records. The severity of UC was scored according to the Modified Truelove Witts Severity Index (MTWSI). A clinical response was defined as a decrease from baseline of ≥ 2 points or a value of MTWSI ≤ 2 points. A total of 41 (24 males/17 females; mean age 47 years) patients were included in the study. After GMA cycle completion, 21/28 (75%) of mild UC patients showed a clinical response compared with 7/13 (54%) of patients with moderate to severe disease (P = 0.27). At 6-mo, 14/28 (50%) of the mild UC patients maintained a clinical response compared with 2/13 (15%) of the patients with moderate to severe disease (P = 0.04). After the GMA cycle completion and during the 6-mo follow up period, 13/16 (81%) and 9/16 (56%) of mild UC patients with intolerance, resistance and contraindications to immunosuppressants and/or biologics showed a clinical response compared with 2/6 (33%) and 0/6 (0%) of patients with moderate to severe disease activity with these characteristics (P = 0.05 and P = 0.04, respectively). Patients with mild UC benefit from GMA more than patients with moderate to severe disease in the short-term period. GMA should be considered a valid therapeutic option in cases of contraindications to immunosuppressants, corticosteroids and/or biologics.

  16. Determination of thromboxane formation, soluble CD40L release and thrombopoietin clearance in apheresis platelet concentrates.

    PubMed

    Wenzel, Folker; Baertl, Anja; Hohlfeld, Thomas; Zimmermann, Norbert; Weber, Artur Aron; Lorenz, Horst; Giers, Günther

    2012-01-01

    All deleterious changes in platelet morphology, structure and function that occur in platelet concentrates (PC) during storage are titled as the 'platelet storage lesion'. No single in vitro test currently available is sufficient in assessing these changes of platelet quality. The release of soluble CD40 Ligand (sCD40L), the formation of thromboxane (TXB2) and the thrombopoietin (TPO) clearance reflect different aspects of platelet metabolism and activitiy, and were used to examine platelet quality in apheresis platelet products. At days 1, 3 and 5, in single-donor apheresis platelet products (n = 10) under routine storage conditions, sCD40L (measured by ELISA) and TXB2 (measured by RIA) were determined after platelet stimulation (recalcification and clot formation). TPO (measured by ELISA) was determined after an incubation time of 5 h at 37°C with platelet-rich plasma (adjusted initial TPO concentration of about 500 pg/mL). Results were related to a therapeutic unit (TU = 2 × 10(11) platelets). Immediately after platelet preparation, sCD40L release was 41 ± 7.6 ng/TU, TXB2 formation 1688 ± 374 ng/TU and TPO clearance 1.22 ± 0.32 ng/h/TU. At days 1, 3 and 5, sCD40L was reduced to 89 ± 7%, 71 ± 12% and 57 ± 9%, TXB2 release to 91 ± 6%, 74 ± 12% and 58 ± 9% and TPO clearance to 90 ± 15%, 84 ± 5% and 79 ± 10% of the respective control values. In conclusion, in single-donor apheresis PC, sCD40L release and TXB2 formation as well as TPO clearance by the platelets were dependent on storage duration and reduced to about 60% to 80% of the respective control values after a storage period for 5 days. These findings are in line with literature data, indicating that a loss of platelet functionality of about 30% will occur after 5 days of storage.

  17. A single apheresis procedure in the donor may be enough to complete an allograft using the “Mexican Method” of non-ablative allografting

    PubMed Central

    Ruiz-Delgado, Guillermo J.; Gutiérrez-Riveroll, Karla I.; Gutiérrez-Aguirre, César H.; Gómez-Almaguer, David; Eyzaguirre-Zapata, Renee; Priesca-Marin, Manuel; González-Carrillo, Martha L.; Ruiz-Argüelles, Guillermo J.

    2009-01-01

    Background Since 1999, in Mexico we have been using a regimen to conduct allografts that involves non-myeloablative conditioning and peripheral blood stem cells (PBSC) and have introduced some changes with the main goal of decreasing the cost of the procedure. Materials and methods We analysed the salient apheresis features of a group of 175 allogeneic peripheral blood stem cell transplants conducted in two institutions in a 7-year period. The grafts were conducted using the “Mexican” non-myelo ablative conditioning regimen employing oral busulphan, i.v. cyclophosphamide and i.v. fludarabine. In all instances, the apheresis machine employed was the Baxter CS3000 Plus and donors were mobilised with filgrastim. The apheresis procedures were performed on days 0, +1 and +2, the end-point of collection being 5,000 mL of blood/m2 in each procedure. Three apheresis sessions were planned but the number was adjusted according to the cell yield. Results The final number of allografted CD34 cells ranged between 0.5 and 25.4 × 106/Kg of the recipient’s body weight (median, 5.2 × 106/Kg). One to three apheresis procedures were needed to obtain a product containing more than 0.5 × 106 CD34 cells/Kg of the recipient, the median being two procedures; in 72 cases (41%) a single apheresis procedure was sufficient to obtain the target number of CD34 cells. The volumes of apheresis ranged between 50 and 600 mL (median, 400 mL). Conclusions Since the median cost of each apheresis procedure is 900 USD, the fact that two apheresis procedures was spared in 72 cases and one apheresis was spared in another 65 cases, led to a total saving of approximately 188,100 USD. It can be concluded that, in many cases, allogeneic transplants can be completed with a single apheresis session and that there are considerable financial benefits from this practice. PMID:19503634

  18. LDL hemoperfusion--a new procedure for LDL apheresis: biocompatibility results from a first pilot study in hypercholesterolemic atherosclerosis patients.

    PubMed

    Bosch, T; Schmidt, B; Kleophas, W; Otto, V; Samtleben, W

    1997-10-01

    Current lipid apheresis techniques can remove atherogenic lipoproteins only from plasma. The initial mandatory separation of plasma and blood cells renders the extracorporeal circuit complex. We recently described the first clinical application of a new lipid adsorber that adsorbs low-density lipoprotein (LDL) and lipoprotein (a) (Lp[a]) directly from whole blood. In continuation of our work, this paper describes the clinical biocompatibility of this new LDL hemoperfusion system. In a 2 center phase II clinical trial, 12 hypercholesterolemic patients suffering from overt coronary or peripheral artery disease were treated once with LDL hemoperfusion. The new LDL adsorber (DALI, Fresenius, St. Wendel, Germany) contained 480 ml of polyacrylate coated polyacrylamide gel. The anticoagulation protocol consisted of an initial heparin bolus followed by an acid citrate dextrose-A (ACD-A) infusion during the treatment. One patient blood volume was treated per session. All sessions were clinically uneventful. No signs of hemolysis or extracorporeal clot formation could be detected, and cell counts remained virtually constant. In a subgroup of patients (n = 4-6), further biocompatibility parameters were studied. Activation of leukocytes (elastase release), thrombocytes (beta-thromboglobulin [beta-TG] extrusion), and monocytes (interleukin (IL)-1beta and IL-6) were minimal. Complement activation (C3a and C5a generation) was negligible. The chosen anticoagulation protocol was both safe (constant ionized calcium levels) and effective (low thrombin-antithrombin formation). In summary, within the scope of a first pilot study, this new LDL hemoperfusion procedure combined the features of excellent clinical tolerance, good biocompatibility, and ease of handling. Phase III clinical trials will have to show whether these encouraging preliminary results can be corroborated in a larger patient population.

  19. Active microwave water equivalence

    NASA Technical Reports Server (NTRS)

    Boyne, H. S.; Ellerbruch, D. A.

    1980-01-01

    Measurements of water equivalence using an active FM-CW microwave system were conducted over the past three years at various sites in Colorado, Wyoming, and California. The measurement method is described. Measurements of water equivalence and stratigraphy are compared with ground truth. A comparison of microwave, federal sampler, and snow pillow measurements at three sites in Colorado is described.

  20. Acute hemolytic transfusion reaction in a pediatric patient following transfusion of apheresis platelets.

    PubMed

    Sapatnekar, Suneeti; Sharma, Girish; Downes, Katharine A; Wiersma, Susan; McGrath, Claire; Yomtovían, Roslyn

    2005-12-01

    The practice of transfusing ABO-incompatible platelets, driven primarily by concerns about inventory management, has been considered generally safe because the accompanying plasma is usually diluted in the recipient's total blood volume. However, if the platelet product contains a large volume of plasma or a high concentration of incompatible isoagglutinin, there may be hemolysis of the recipient's red cells. Patients with a small blood volume, such as babies and children, are considered to be at particular risk for such a complication. We describe the case of a baby who suffered massive hemolysis of her group A red cells after transfusion of group O Apheresis Platelets containing a high-titered anti-A isoagglutinin. We also offer a review of the literature on this subject and recommendations to avoid acute hemolytic reactions as a result of platelet transfusion.

  1. Apheresis in the treatment of recalcitrant atopic dermatitis: case series and review of the literature.

    PubMed

    Chiricozzi, Andrea; Faleri, Sara; Lanti, Alessandro; Adorno, Gaspare; Lorè, Bruno; Chimenti, Sergio; Saraceno, Rosita

    2014-01-01

    Atopic dermatitis is a chronic disabling inflammatory skin disorder, typically characterized by intensely itching, oozing, crusted, eroded vesicles or papules developing on erythematous plaques. Conventional treatments, both topical and systemic, may produce unsuccessful and unsatisfactory results. we aimed to assess the efficacy of apheretic treatments in patients with severe, recalcitrant AD, in particular, the pruritic component. four patients affected by recalcitrant and debilitating atopic dermatitis, who had previously received conventional topical and systemic therapies with poor clinical improvement, were treated with extracorporeal photopheresis or therapeutic plasma exchange. a satisfactory response to apheresis was observed with a reduction of pruritus and skin lesions. In our experience, apheretic therapies might be used as monotherapy but, more effectively, in combination with topical and/or systemic treatments. Indeed, they proved to be a safe "enhancer" for increasing the efficacy of conventional therapeutics.

  2. Proteomics of apheresis platelet supernatants during routine storage: Gender-related differences

    PubMed Central

    Dzieciatkowska, Monika; D‘Alessandroa, Angelo; Burke, Timothy A.; Kelher, Marguerite R.; Moore, Ernest E.; Banerjee, Anirban; Silliman, Christopher C.; West, Bernadette F.; Hansen, Kirk C.

    2015-01-01

    Proteomics has identified potential pathways involved in platelet storage lesions, which correlate with untoward effects in the recipient, including febrile non-haemolytic reactions. We hypothesize that an additional pathway involves protein mediators that accumulate in the platelet supernatants during routine storage in a donor gender-specific fashion. Apheresis platelet concentrates were collected from 5 healthy males and 5 females and routinely stored. The 14 most abundant plasma proteins were removed and the supernatant proteins from days 1 and 5 were analyzed via 1D-SDS-PAGE/nanoLC-MS/MS, before label-free quantitative proteomics analyses. Findings from a subset of 18 proteins were validated via LC-SRM analyses against stable isotope labeled standards. A total of 503 distinct proteins were detected in the platelet supernatants from the 4 sample groups: female or male donor platelets, either at storage day 1 or 5. Proteomics suggested a storage and gender-dependent impairment of blood coagulation mediators, pro-inflammatory complement components and cytokines, energy and redox metabolic enzymes. The supernatants from female donors demonstrated increased deregulation of structural proteins, extracellular matrix proteins and focal adhesion proteins, possibly indicating storage-dependent platelet activation. Routine storage of platelet concentrates induces changes in the supernatant proteome, which may have effects on the transfused patient, some of which are related to donor gender. Biological significance The rationale behind this study is that protein components in platelet releasates have been increasingly observed to play a key role in adverse events and impaired homeostasis in transfused recipients. In this view, proteomics has recently emerged as a functional tool to address the issue of protein composition of platelet releasates from buffy coat-derived platelet concentrates in the blood bank. Despite early encouraging studies on buffy coat-derived platelet

  3. Lipoprotein particles in homozygous familial hypercholesterolemic patients treated with portacaval shunt and LDL apheresis.

    PubMed

    Gairin, D; Monard, F; Cachera, C; Bard, J M; Amouyel, P; Duriez, P; Tacquet, A; Fruchart, J C

    1990-12-14

    Lipoprotein particles containing apolipoproteins (Apo) were studied by enzyme-linked-immunosorbent assay in two homozygous familial hypercholesterolemic patients (1 male and 1 female) with portacaval shunts, and in controls. Total Apo B, total cholesterol and LDL cholesterol were increased in both patients while complex Apo B containing particles, Lp CIII: B, were not increased in these FH patients. The dextran-sulfate cellulose columns (Liposorber LA-40) had an excellent adsorption selectivity and adsorption capacity for lipoprotein particles containing Apo B and a minimum adsorption capacity in Apo AI and Apo AII-containing particles. This apheresis technique selectively depleted plasma of atherogenic Apo B-containing particles with a minimal loss of antiatherogenic Apo AI-containing particles.

  4. Ulcerative colitis and granulocyte-monocyte-apheresis: safety and efficacy of maintenance therapy during pregnancy.

    PubMed

    D'Ovidio, Valeria; Meo, Donatella; Gozer, Maria; Bazuro, Marco E; Vernia, Piero

    2015-02-01

    Inflammatory bowel disease characteristically affects young adults in their reproductive ages. Thus the medication used for the treatment of active disease should not compromise fertility and, also, should not have teratogenic effect on baby. A lot of data are available about effects of steroids, antibiotics, and mesalazine but no data are available about safety and efficacy of granulocyte-monocyte-apheresis (GMA) during pregnancy. In this case report, the 37 year-old pregnant woman with chronically active and steroid dependent ulcerative colitis (UC), at risk of abortion, refused more aggressive pharmacological therapeutic options and gave the informed consent to GMA. To minimize symptoms and the risk of severe clinical relapse, a maintenance GMA treatment was performed throughout pregnancy. The course of pregnancy was uneventful with no side effects; the mother and the baby were all healthy and well at the delivery. © 2014 Wiley Periodicals, Inc.

  5. Granulocyte and monocyte adsorption apheresis as an effective treatment for Reiter disease.

    PubMed

    Yoshifuku, A; Oyama, K; Ibusuki, A; Kawasaki, M; Sakanoue, M; Matsushita, S; Kawai, K; Kawahara, K; Maruyama, I; Kanekura, T

    2012-04-01

    Reiter disease (RD) is characterized by a triad of sterile arthritis, urethritis and conjunctivitis. The conditions occur concomitantly or sequentially, and are associated with mucocutaneous features such as circinate balanitis and stomatitis. Arthritis usually occurs in attacks followed by recovery, but it sometimes progresses to permanent damage of the affected joints. Because the symptoms of this disorder are attributable to activated neutrophils, we assessed the efficacy of granulocyte and monocyte adsorption apheresis (GCAP) in a 73-year-old man with RD who had skin rashes on his penis, scrotum and right hand, with severe arthralgia. The patient's skin rash and joint pain responded dramatically to five sessions of GCAP delivered at intervals of 5 days. We present a detailed description of the patient and discuss the mechanisms of GCAP, and suggest that GCAP may be useful for treating RD.

  6. Short-term central venous catheter complications in patients with sickle cell disease who undergo apheresis.

    PubMed

    Yeral, Mahmut; Boga, Can; Oguzkurt, Levent; Asma, Suheyl; Kasar, Mutlu; Kozanoglu, Ilknur

    2014-01-01

    Patients with sickle cell disease (SCD) are prone to develop thrombosis and infection due to their inflammatory and immune deficiency state. These patients require red cell exchange therapy for treatment or prevention of hemoglobin S associated complications. Owing to vascular access problems, adult patients need central venous catheterization (CVC) for exchange procedures. Procedure related complications have been reported for long-term CVCs in pediatric patients. However, short-term CVC complications in adult patients are not clear. This report represents the results of documented complications of short-term CVCs in patients with SCD who undergo apheresis. A total of 142 non-tunneled catheters with average median diameter of 9 F (range 8-16 F) were implanted for apheresis. The catheters were mainly inserted through the right internal jugular vein (66.2 %). Total days of catheter were 412. Results were reported as a complication rate and event according to 1,000 catheter days and compared to a control group including 37 healthy stem cell donors. In the patient group, 1 (1 %) hematoma and 1 (1 %) infection were observed for internal jugular vein catheterization (3.7 hemorrhages and 3.7 infections according to 1,000 catheter days), whereas four (8.9 %) cases of thrombosis and 1 (2.2 %) infection (27 and 6.9 according to 1,000 catheter days) developed in femoral vein. There was a significant difference in terms of thrombosis (P = 0.009). In the control group, only individual developed thrombosis in internal jugular vein. Short-term CVC inserted through to the internal jugular vein seems to be safer than femoral vein in patients with SCD.

  7. Influence of multicomponent apheresis on donors' haematological and coagulation parameters, iron storage and platelet function.

    PubMed

    Macher, S; Sipurzynski-Budraβ, S; Rosskopf, K; Semmelrock, M; Prüller, F; Griesbacher, A; Lanzer, G; Schallmoser, K

    2012-10-01

    Multicomponent collection (MCC) enables production and processing of various blood components during one apheresis session. In this prospective crossover study, the effects of donating platelets (PLTs) and packed red blood cells (PRBCs) on donor's blood cell count, coagulation, PLT function and iron state were analysed. Forty-eight MCCs were performed using two different cell separators (Fenwal Amicus(®), CaridianBCT Trima Accel(®)). Two units of platelet concentrates and one unit of PRBCs were collected during each session. Full blood cell count and iron status were obtained on day 0 before and after apheresis, day 2, day 14 and day 42. PLT function was analysed by aggregometry and rotation thromboelastometry in parallel with coagulation tests before and after MCC and at day 2. Multicomponent collection was well tolerated without adverse side effects. Blood cell count and iron parameters declined and most of them (haemoglobin, haematocrit, transferrin, transferrin saturation and ferritin) were significantly below baseline values until at least day 42 after donation. Absent iron stores were seen in 31·3% of the donors. In contrast, PLTs significantly exceeded pre-donation values after 14 days and remained significantly increased for 42 days. After 2 days, coagulation parameters were only slightly (P > 0·05) altered, whereas PLT function was significantly reduced. Multicomponent collection is an obviously safe procedure; however, the significant long-term impact on the donor's blood count and iron store, as well as impaired PLT function, has to be considered in regard to donor safety. © 2012 The Author(s). Vox Sanguinis © 2012 International Society of Blood Transfusion.

  8. Changes in Lipids and Lipoproteins after Selective LDL Apheresis (7-Year Experience)

    PubMed Central

    Kolovou, Genovefa; Hatzigeorgiou, Georgios; Mihas, Constantinos; Gontoras, Nikos; Litras, Panagiotis; Devekousos, Dimitris; Kontodima, Panagiota; Sorontila, Constantina; Bilianou, Helen; Mavrogeni, Sophie

    2012-01-01

    Background. The aim of the study was to investigate the changes in plasma lipids and lipoproteins and the cardiovascular events after selective LDL apheresis. Methods and Results. Two pediatric patients with familial hypercholesterolemia aged 11 and 13 years and 19 dyslipidemic adults aged 41 ± 14 years underwent direct adsorption of lipoproteins (DALI) sessions. The mean follow-up period was 47 ± 23 months. The total cholesterol (TC) values before and after treatment were 8.2 ± 2.2 and 3.1 ± 1.6 mmol/l (318 ± 86 and 122 ± 62 mg/dL), respectively. The interval mean of TC was 6.9 ± 1.9 mmol/l (268 ± 75 mg/dL). The LDL cholesterol concentrations before and after treatment were 6.6 ± 2.1 and 1.7 ± 1.1 mmol/l, (256 ± 82 mg/dL and 65 ± 41 mg/dL), respectively. The percentage of acute LDL cholesterol reduction was 75 ± 11%. Cardiovascular events were observed in seven patients. The average annual event rate was 5.51%. Conclusion. LDL apheresis is a very important therapeutic tool in managing patients at high risk for premature CAD or with aggressive CAD, despite adequate medical treatment. PMID:22315677

  9. Equivalent Neutral Wind

    NASA Technical Reports Server (NTRS)

    Liu, W. Timothy; Tang, Wenqing

    1996-01-01

    The definition of equivalent neutral wind and the rationale for using it as the geophysical product of a spaceborne scatterometer are reviewed. The differences between equivalent neutral wind and actual wind, which are caused by atmospheric density stratification, are demonstrated with measurements at selected locations. A method of computing this parameter from ship and buoy measurements is described and some common fallacies in accounting for the effects of atmospheric stratification on wind shear are discussed. The computer code for the model to derive equivalent neutral wind is provided.

  10. Neutron dose equivalent meter

    DOEpatents

    Olsher, Richard H.; Hsu, Hsiao-Hua; Casson, William H.; Vasilik, Dennis G.; Kleck, Jeffrey H.; Beverding, Anthony

    1996-01-01

    A neutron dose equivalent detector for measuring neutron dose capable of accurately responding to neutron energies according to published fluence to dose curves. The neutron dose equivalent meter has an inner sphere of polyethylene, with a middle shell overlying the inner sphere, the middle shell comprising RTV.RTM. silicone (organosiloxane) loaded with boron. An outer shell overlies the middle shell and comprises polyethylene loaded with tungsten. The neutron dose equivalent meter defines a channel through the outer shell, the middle shell, and the inner sphere for accepting a neutron counter tube. The outer shell is loaded with tungsten to provide neutron generation, increasing the neutron dose equivalent meter's response sensitivity above 8 MeV.

  11. Equivalent Dynamic Models.

    PubMed

    Molenaar, Peter C M

    2017-02-16

    Equivalences of two classes of dynamic models for weakly stationary multivariate time series are discussed: dynamic factor models and autoregressive models. It is shown that exploratory dynamic factor models can be rotated, yielding an infinite set of equivalent solutions for any observed series. It also is shown that dynamic factor models with lagged factor loadings are not equivalent to the currently popular state-space models, and that restriction of attention to the latter type of models may yield invalid results. The known equivalent vector autoregressive model types, standard and structural, are given a new interpretation in which they are conceived of as the extremes of an innovating type of hybrid vector autoregressive models. It is shown that consideration of hybrid models solves many problems, in particular with Granger causality testing.

  12. [Effects of riboflavin combined with photosensitization on reduction of Gram-positive and Gram-negative indicating germs in plasma and P-selectin expression of apheresis platelet concentrates].

    PubMed

    Zhou, Xue-Yin; Xiong, Wen; Kong, Ling-Kui

    2010-08-01

    This study was purposed to confirm the practical efficacy of reducing indicating germs suspended in plasma by riboflavin and photosensitized inactivation and to evaluate its influence on activation of apheresis platelet concentrates. The synergistic effects of riboflavin combined with ultraviolet irradiation on inactivation of germs were investigated by using Escherichia Coli (E. coli) and Staphylococcus Aureus (S. aureus) as Gram⁻ and Gram(+) indicating germs, respectively. The activation status of apheresis-platelet concentrates treated with riboflavin combined with ultraviolet irradiation was detected by flow cytometry. The results showed that when 50 μmol/L of riboflavin was combined with 6.2 J/ml of ultraviolet irradiation, the T/E ratios reached 1.42 for E. coli and 1.68 for S. Aureus, and reduction of E. Coli and S. Aureus were 3.87 Logs and 3.82 Logs respectively; the CD62p expression level on germ-inactivated platelets stored at 22 degrees C for 0 and 5 days were 4.92% and 36.18% respectively, which slightly increased as compared with controls (3.94% and 32.03)% (p < 0.05). It is concluded that combination of riboflavin with ultraviolet irradiation displays well synergistic effects which can reduce E. Coli and S. Aureus counts, but no significantly influence on platelets. The partial activation of liquid platelets mainly presents metabolism damage during storage, which is found at an acceptable level.

  13. Meaning of low-density lipoprotein-apheresis for hypercholesterolemic patients at high risk for recurrence of coronary heart disease.

    PubMed

    Koga, Nobuhiko

    2002-10-01

    The goal of cholesterol-lowering therapy in hypercholesterolemic patients at high risk for recurrence of coronary heart disease (CHD) is the prevention of acute coronary syndrome by stabilization of coronary atheromatous plaque. We often encounter patients in whom it is difficult to maintain the serum cholesterol level at a desirable level with dietary therapy and drug treatment, despite the development and use of statins. For secondary prevention in patients who are at high risk for the recurrence of CHD and whose cholesterol level cannot be controlled by drugs alone, low-density lipoprotein (LDL)-apheresis therapy, which involves removal of LDL through extracorporeal circulation, is now available. Many reports concerning improvement of vascular endothelial function, improvement of myocardial ischemia, regression of coronary atherosclerotic lesions, stabilization of coronary plaque, and reduction in the incidence of cardiac events as a result of LDL-apheresis treatment have been published in various countries. We believe that LDL-apheresis should be performed on hypercholesterolemic patients with existing CHD for whom diet and maximum cholesterol-lowering drug therapies have been ineffective or not tolerated and whose LDL cholesterol level is 160 mg/dL or higher.

  14. Improvement of hemorheology by DALI apheresis: acute effects on plasma viscosity and erythrocyte aggregation in hypercholesterolemic patients.

    PubMed

    Bosch, T; Wendler, T; Jaeger, B R; Samtleben, W

    2001-10-01

    Plasma viscosity (PV) and erythrocyte aggregation (EA) are determinants of microcirculation, especially under the compromised hemodynamic conditions resulting from atherosclerosis. Direct adsorption of lipoproteins (DALI) apheresis is the first method for direct adsorption of lipoproteins; it drastically reduces low-density lipoprotein (LDL)-cholesterol and lipoprotein (a) (Lp[a]), and may therefore improve PV and EA. The current study was performed to test the effect of DALI on hemorheology. Six hypercholesterolemic patients who had been on regular LDL apheresis for at least several months were treated on a weekly or biweekly basis, on average 5 times each by DALI. Before and after each session, PV was measured by a capillary tube plasma viscosimeter and EA by rotational aggregometry. Single DALI sessions (n = 31) acutely decreased PV from 1.18 +/- 0.04 to 1.06 +/- 0.3 mPa (-10%) while EA improved from 22.8 +/- 4.4 to 13.3 +/- 4.5 (arbitrary units) (-42%). LDL-cholesterol, Lp(a), and very-low-density lipoprotein (VLDL)-cholesterol were effectively reduced while the decrease of triglycerides and fibrinogen was only moderate. DALI apheresis exerted an acute positive effect on blood hemorheology which may have beneficial effects on microcirculation. This hypothesis is in accordance with the clinical observation that in some patients, improvement of angina and/or exercise tolerance can be observed after only a few DALI sessions where changes of coronary stenoses cannot be expected yet.

  15. Low-density lipoprotein apheresis reduces platelet factor 4 on the surface of platelets: a possible protective mechanism against heparin-induced thrombocytopenia and thrombosis.

    PubMed

    Tanhehco, Yvette C; Rux, Ann H; Sachais, Bruce S

    2011-05-01

    Heparin-induced thrombocytopenia and thrombosis (HITT) is characterized by thrombocytopenia due to the formation of antibodies against heparin : platelet factor 4 (PF4) complexes. Despite the exposure to heparin during treatment and predisposition of patients with atherosclerosis to HITT, HITT in patients undergoing low-density lipoprotein (LDL) apheresis is rare. We investigated the possibility that LDL apheresis decreases PF4 on platelet (PLT) surfaces and/or plasma HITT antibody levels, either of which would disfavor HITT. We enrolled 25 patients undergoing LDL apheresis at the Hospital of the University of Pennsylvania. Blood samples were drawn before and after treatment. Plasma samples were drawn proximal and distal to the LA-15 treatment column. PF4, HITT antibodies, heparin levels, and P-selectin were measured. No patient had clinical symptoms of HITT. The LA-15 column was found to efficiently remove PF4. PF4 levels in peripheral blood plasma did not change significantly after LDL apheresis. However, PLT surface PF4 significantly decreased after treatment. HITT antibodies were found in only two patients and were nonfunctional. PLT surface P-selectin did not change during treatment. We have demonstrated that LDL apheresis via dextran sulfate absorption removes plasma PF4 and reduces the amount of PF4 on the surface of circulating PLTs. Reduced surface PF4 may decrease antibody formation and/or recognition by HITT antibodies. These data provide a potential explanation for the near lack of HITT in hypercholesterolemic patients undergoing LDL apheresis. They also suggest the possibility that LDL apheresis using dextran sulfate adsorption may have therapeutic value in the treatment of HITT. © 2010 American Association of Blood Banks.

  16. Effects of two whole blood systems (DALI and Liposorber D) for LDL apheresis on lipids and cardiovascular risk markers in severe hypercholesterolemia.

    PubMed

    Otto, Carsten; Berster, Jutta; Otto, Bärbel; Parhofer, Klaus G

    2007-01-01

    LDL apheresis is an extracorporal modality to lower the concentration of atherogenic lipoproteins, e.g., LDL cholesterol. We compared two recently introduced whole-blood LDL apheresis systems inpatients with hypercholesterolemia in a randomized cross-over trial with respect to their effects on lipoproteins as well as on other cardiovascular risk markers. Six patients (4 women, 2 men, median age 62.5 years, median BMI 25.9 kg/m(2)) on regular LDL apheresis were randomly assigned to receive six weekly treatments with either DALI (Fresenius) or Liposorber D (Kaneka). After 6 weeks, the patients were switched to the other device (again six weekly treatments). Blood was drawn before and immediately after LDL apheresis at three time points (last regular apheresis before the study; after six treatments with DALI and after six treatments with Liposorber D). LDL cholesterol concentration before the sixth apheresis (DALI 129 mg/dL, Liposorber D 132 mg/dL) as well as LDL cholesterol reduction during the sixth apheresis (DALI 68.3% and Liposorber D 68.4%) were similar with the two systems. CRP and fibrinogen concentrations were lower but interleukin-6, myeloperoxidase, and resistin concentrations were higher after the last Liposorber treatment compared with DALI (P < 0.05, respectively). No differences were observed concerning adiponectin, ghrelin, and PYY levels. In conclusion, both devices were highly effective in eliminating atherogenic lipoproteins. CRP and fibrinogen were better eliminated with Liposorber D. However, following Liposorber D, interleukin-6 levels were higher than after DALI possibly indicating an increased inflammatory activation.

  17. "The Show"

    ERIC Educational Resources Information Center

    Gehring, John

    2004-01-01

    For the past 16 years, the blue-collar city of Huntington, West Virginia, has rolled out the red carpet to welcome young wrestlers and their families as old friends. They have come to town chasing the same dream for a spot in what many of them call "The Show". For three days, under the lights of an arena packed with 5,000 fans, the…

  18. "The Show"

    ERIC Educational Resources Information Center

    Gehring, John

    2004-01-01

    For the past 16 years, the blue-collar city of Huntington, West Virginia, has rolled out the red carpet to welcome young wrestlers and their families as old friends. They have come to town chasing the same dream for a spot in what many of them call "The Show". For three days, under the lights of an arena packed with 5,000 fans, the…

  19. Freezing of Apheresis Platelet Concentrates in 6% Dimethyl Sulfoxide: The First Preliminary Study in Turkey

    PubMed Central

    Yılmaz, Soner; Çetinkaya, Rıza Aytaç; Eker, İbrahim; Ünlü, Aytekin; Uyanık, Metin; Tapan, Serkan; Pekoğlu, Ahmet; Pekel, Aysel; Erkmen, Birgül; Muşabak, Uğur; Yılmaz, Sebahattin; Avcı, İsmail Yaşar; Avcu, Ferit; Kürekçi, Emin; Eyigün, Can Polat

    2016-01-01

    Objective: Transfusion of platelet suspensions is an essential part of patient care for certain clinical indications. In this pioneering study in Turkey, we aimed to assess the in vitro hemostatic functions of platelets after cryopreservation. Materials and Methods: Seven units of platelet concentrates were obtained by apheresis. Each apheresis platelet concentrate (APC) was divided into 2 equal volumes and frozen with 6% dimethyl sulfoxide (DMSO). The 14 frozen units of APCs were kept at -80 °C for 1 day. APCs were thawed at 37 °C and diluted either with autologous plasma or 0.9% NaCl. The volume and residual numbers of leukocytes and platelets were tested in both before-freezing and post-thawing periods. Aggregation and thrombin generation tests were used to analyze the in vitro hemostatic functions of platelets. Flow-cytometric analysis was used to assess the presence of frozen treated platelets and their viability. Results: The residual number of leukocytes in both dilution groups was <1x106. The mean platelet recovery rate in the plasma-diluted group (88.1±9.5%) was higher than that in the 0.9% NaCl-diluted group (63±10%). These results were compatible with the European Directorate for the Quality of Medicines quality criteria. Expectedly, there was no aggregation response to platelet aggregation test. The mean thrombin generation potential of post-thaw APCs was higher in the plasma-diluted group (2411 nmol/L per minute) when compared to both the 0.9% NaCl-diluted group (1913 nmol/L per minute) and the before-freezing period (1681 nmol/L per minute). The flow-cytometric analysis results for the viability of APCs after cryopreservation were 94.9% and 96.6% in the plasma and 0.9% NaCl groups, respectively. Conclusion: Cryopreservation of platelets with 6% DMSO and storage at -80 °C increases their shelf life from 7 days to 2 years. Besides the increase in hemostatic functions of platelets, the cryopreservation process also does not affect their viability

  20. The GRADE approach for assessing new technologies as applied to apheresis devices in ulcerative colitis

    PubMed Central

    2010-01-01

    Background In the last few years, a new non-pharmacological treatment, termed apheresis, has been developed to lessen the burden of ulcerative colitis (UC). Several methods can be used to establish treatment recommendations, but over the last decade an informal collaboration group of guideline developers, methodologists, and clinicians has developed a more sensible and transparent approach known as the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). GRADE has mainly been used in clinical practice guidelines and systematic reviews. The aim of the present study is to describe the use of this approach in the development of recommendations for a new health technology, and to analyse the strengths, weaknesses, opportunities, and threats found when doing so. Methods A systematic review of the use of apheresis for UC treatment was performed in June 2004 and updated in May 2008. Two related clinical questions were selected, the outcomes of interest defined, and the quality of the evidence assessed. Finally, the overall quality of each question was taken into account to formulate recommendations following the GRADE approach. To evaluate this experience, a SWOT (strengths, weaknesses, opportunities and threats) analysis was performed to enable a comparison with our previous experience with the SIGN (Scottish Intercollegiate Guidelines Network) method. Results Application of the GRADE approach allowed recommendations to be formulated and the method to be clarified and made more explicit and transparent. Two weak recommendations were proposed to answer to the formulated questions. Some challenges, such as the limited number of studies found for the new technology and the difficulties encountered when searching for the results for the selected outcomes, none of which are specific to GRADE, were identified. GRADE was considered to be a more time-consuming method, although it has the advantage of taking into account patient values when defining and

  1. Automated CD34+ cell isolation of peripheral blood stem cell apheresis product.

    PubMed

    Spohn, Gabriele; Wiercinska, Eliza; Karpova, Darja; Bunos, Milica; Hümmer, Christiane; Wingenfeld, Eva; Sorg, Nadine; Poppe, Carolin; Huppert, Volker; Stuth, Juliane; Reck, Kristina; Essl, Mike; Seifried, Erhard; Bönig, Halvard

    2015-10-01

    Immunomagnetic enrichment of CD34+ hematopoietic "stem" cells (HSCs) using paramagnetic nanobead coupled CD34 antibody and immunomagnetic extraction with the CliniMACS plus system is the standard approach to generating T-cell-depleted stem cell grafts. Their clinical beneficence in selected indications is established. Even though CD34+ selected grafts are typically given in the context of a severely immunosuppressive conditioning with anti-thymocyte globulin or similar, the degree of T-cell depletion appears to affect clinical outcomes and thus in addition to CD34 cell recovery, the degree of T-cell depletion critically describes process quality. An automatic immunomagnetic cell processing system, CliniMACS Prodigy, including a protocol for fully automatic CD34+ cell selection from apheresis products, was recently developed. We performed a formal process validation to support submission of the protocol for CE release, a prerequisite for clinical use of Prodigy CD34+ products. Granulocyte-colony stimulating factor-mobilized healthy-donor apheresis products were subjected to CD34+ cell selection using Prodigy with clinical reagents and consumables and advanced beta versions of the CD34 selection software. Target and non-target cells were enumerated using sensitive flow cytometry platforms. Nine successful clinical-scale CD34+ cell selections were performed. Beyond setup, no operator intervention was required. Prodigy recovered 74 ± 13% of target cells with a viability of 99.9 ± 0.05%. Per 5 × 10E6 CD34+ cells, which we consider a per-kilogram dose of HSCs, products contained 17 ± 3 × 10E3 T cells and 78 ± 22 × 10E3 B cells. The process for CD34 selection with Prodigy is robust and labor-saving but not time-saving. Compared with clinical CD34+ selected products concurrently generated with the predecessor technology, product properties, importantly including CD34+ cell recovery and T-cell contents, were not significantly different. The automatic system is

  2. Freezing of Apheresis Platelet Concentrates in 6% Dimethyl Sulfoxide: The First Preliminary Study in Turkey.

    PubMed

    Yılmaz, Soner; Çetinkaya, Rıza Aytaç; Eker, İbrahim; Ünlü, Aytekin; Uyanık, Metin; Tapan, Serkan; Pekoğlu, Ahmet; Pekel, Aysel; Erkmen, Birgül; Muşabak, Uğur; Yılmaz, Sebahattin; Avcı, İsmail Yaşar; Avcu, Ferit; Kürekçi, Emin; Eyigün, Can Polat

    2016-03-05

    Transfusion of platelet suspensions is an essential part of patient care for certain clinical indications. In this pioneering study in Turkey, we aimed to assess the in vitro hemostatic functions of platelets after cryopreservation. Seven units of platelet concentrates were obtained by apheresis. Each apheresis platelet concentrate (APC) was divided into 2 equal volumes and frozen with 6% dimethyl sulfoxide (DMSO). The 14 frozen units of APCs were kept at -80 °C for 1 day. APCs were thawed at 37 °C and diluted either with autologous plasma or 0.9% NaCl. The volume and residual numbers of leukocytes and platelets were tested in both before-freezing and post-thawing periods. Aggregation and thrombin generation tests were used to analyze the in vitro hemostatic functions of platelets. Flow-cytometric analysis was used to assess the presence of frozen treated platelets and their viability. The residual number of leukocytes in both dilution groups was <1x106. The mean platelet recovery rate in the plasma-diluted group (88.1±9.5%) was higher than that in the 0.9% NaCl-diluted group (63±10%). These results were compatible with the European Directorate for the Quality of Medicines quality criteria. Expectedly, there was no aggregation response to platelet aggregation test. The mean thrombin generation potential of post-thaw APCs was higher in the plasma-diluted group (2411 nmol/L per minute) when compared to both the 0.9% NaCl-diluted group (1913 nmol/L per minute) and the before-freezing period (1681 nmol/L per minute). The flow-cytometric analysis results for the viability of APCs after cryopreservation were 94.9% and 96.6% in the plasma and 0.9% NaCl groups, respectively. Cryopreservation of platelets with 6% DMSO and storage at -80 °C increases their shelf life from 7 days to 2 years. Besides the increase in hemostatic functions of platelets, the cryopreservation process also does not affect their viability rates.

  3. Show Code.

    PubMed

    Shalev, Daniel

    2017-01-01

    "Let's get one thing straight: there is no such thing as a show code," my attending asserted, pausing for effect. "You either try to resuscitate, or you don't. None of this halfway junk." He spoke so loudly that the two off-service consultants huddled at computers at the end of the unit looked up… We did four rounds of compressions and pushed epinephrine twice. It was not a long code. We did good, strong compressions and coded this man in earnest until the end. Toward the final round, though, as I stepped up to do compressions, my attending looked at me in a deep way. It was a look in between willing me as some object under his command and revealing to me everything that lay within his brash, confident surface but could not be spoken. © 2017 The Hastings Center.

  4. Five Equivalent d Orbitals

    ERIC Educational Resources Information Center

    Pauling, Linus; McClure, Vance

    1970-01-01

    Amplifies and clarifies a previous paper on pyramidal d orbitals. Discusses two sets of pyramid d orbitals with respect to their maximum bond strength and their symmetry. Authors described the oblate and prolate pentagonal antiprisms arising from the two sets of five equivalent d orbitals. (RR)

  5. Equivalent Colorings with "Maple"

    ERIC Educational Resources Information Center

    Cecil, David R.; Wang, Rongdong

    2005-01-01

    Many counting problems can be modeled as "colorings" and solved by considering symmetries and Polya's cycle index polynomial. This paper presents a "Maple 7" program link http://users.tamuk.edu/kfdrc00/ that, given Polya's cycle index polynomial, determines all possible associated colorings and their partitioning into equivalence classes. These…

  6. Equivalent Colorings with "Maple"

    ERIC Educational Resources Information Center

    Cecil, David R.; Wang, Rongdong

    2005-01-01

    Many counting problems can be modeled as "colorings" and solved by considering symmetries and Polya's cycle index polynomial. This paper presents a "Maple 7" program link http://users.tamuk.edu/kfdrc00/ that, given Polya's cycle index polynomial, determines all possible associated colorings and their partitioning into equivalence classes. These…

  7. PATHOGEN EQUIVALENCY COMMITTEE (PEC)

    EPA Science Inventory

    The U.S. Environmental Protection Agency created the PEC in 1985 to make recommendations to EPA and State managers on the equivalency of unproven sewage sludge disinfection technologies/processes to either a Process to Significantly Reduce Pathogens (PSRP) or a Process to Further...

  8. PATHOGEN EQUIVALENCY COMMITTEE (PEC)

    EPA Science Inventory

    The U.S. Environmental Protection Agency created the PEC in 1985 to make recommendations to EPA and State managers on the equivalency of unproven sewage sludge disinfection technologies/processes to either a Process to Significantly Reduce Pathogens (PSRP) or a Process to Further...

  9. Characteristics of carotid atherosclerotic plaques of chronic lipid apheresis patients as assessed by In Vivo High-Resolution CMR - a comparative analysis

    PubMed Central

    2012-01-01

    Background Components of carotid atherosclerotic plaques can reliably be identified and quantified using high resolution in vivo 3-Tesla CMR. It is suspected that lipid apheresis therapy in addition to lowering serum lipid levels also has an influence on development and progression of atherosclerotic plaques. The purpose of this study was to evaluate the influence of chronic lipid apheresis (LA) on the composition of atherosclerotic carotid plaques. Methods 32 arteries of 16 patients during chronic LA-therapy with carotid plaques and stenosis of 1–80% were matched according to degree of stenosis with 32 patients, who had recently suffered an ischemic stroke. Of these patients only the asymptomatic carotid artery was analyzed. All patients underwent black-blood 3 T CMR of the carotids using parallel imaging and dedicated surface coils. Cardiovascular risk factors were recorded. Morphology and composition of carotid plaques were evaluated. For statistical evaluation Fisher’s Exact and unpaired t-test were used. A p-value <0.05 was considered statistically significant. Results Patients in the LA-group were younger (63.5 vs. 73.9. years, p<0.05), had a higher prevalence of hypercholesterolemia and of established coronary heart disease in patients and in first-degree relatives (p<0.05, respectively). LA-patients had smaller maximum wall areas (49.7 vs. 59.6mm2, p<0.05), showed lower prevalence of lipid cores (28.1% vs. 56.3%, p<0.05) and the lipid content was smaller than in the control group (5.0 vs. 11.6%, p<0.05). Minimum lumen areas and maximum total vessel areas did not differ significantly between both groups. Conclusion Results of this study suggest that, despite a severer risk profile for cardiovascular complications in LA-patients, chronic LA is associated with significantly lower lipid content in carotid plaques compared to plaques of patients without LA with similar degrees of stenosis, which is characteristic of clinically stable plaques. PMID:23194143

  10. Development of model for analysing respective collections of intended hematopoietic stem cells and harvests of unintended mature cells in apheresis for autologous hematopoietic stem cell collection.

    PubMed

    Hequet, O; Le, Q H; Rodriguez, J; Dubost, P; Revesz, D; Clerc, A; Rigal, D; Salles, G; Coiffier, B

    2014-04-01

    Hematopoietic stem cells (HSCs) required to perform peripheral hematopoietic autologous stem cell transplantation (APBSCT) can be collected by processing several blood volumes (BVs) in leukapheresis sessions. However, this may cause granulocyte harvest in graft and decrease in patient's platelet blood level. Both consequences may induce disturbances in patient. One apheresis team's current purpose is to improve HSC collection by increasing HSC collection and prevent increase in granulocyte and platelet harvests. Before improving HSC collection it seemed important to know more about the way to harvest these types of cells. The purpose of our study was to develop a simple model for analysing respective collections of intended CD34+ cells among HSC (designated here as HSC) and harvests of unintended platelets or granulocytes among mature cells (designated here as mature cells) considering the number of BVs processed and factors likely to influence cell collection or harvest. For this, we processed 1, 2 and 3 BVs in 59 leukapheresis sessions and analysed corresponding collections and harvests with a referent device (COBE Spectra). First we analysed the amounts of HSC collected and mature cells harvested and second the evolution of the respective shares of HSC and mature cells collected or harvested throughout the BV processes. HSC collections and mature cell harvests increased globally (p<0.0001) and their respective shares remained stable throughout the BV processes (p non-significant). We analysed the role of intrinsic (patient's features) and extrinsic (features before starting leukapheresis sessions) factors in collections and harvests, which showed that only pre-leukapheresis blood levels (CD34+cells and platelets) influenced both cell collections and harvests (CD34+cells and platelets) (p<0.001) and shares of HSC collections and mature unintended cells harvests (p<0.001) throughout the BV processes. Altogether, our results suggested that the main factors likely

  11. Exploratory studies of extended storage of apheresis platelets in a platelet additive solution (PAS).

    PubMed

    Slichter, Sherrill J; Corson, Jill; Jones, Mary Kay; Christoffel, Todd; Pellham, Esther; Bailey, S Lawrence; Bolgiano, Doug

    2014-01-09

    To evaluate the poststorage viability of apheresis platelets stored for up to 18 days in 80% platelet additive solution (PAS)/20% plasma, 117 healthy subjects donated platelets using the Haemonetics MCS+, COBE Spectra (Spectra), or Trima Accel (Trima) systems. Control platelets from the same subjects were compared with their stored test PAS platelets by radiolabeling their stored and control platelets with either (51)chromium or (111)indium. Trima platelets met Food and Drug Administration poststorage platelet viability criteria for only 7 days vs almost 13 days for Haemonetics platelets; ie, platelet recoveries after these storage times averaged 44 ± 3% vs 49 ± 3% and survivals were 5.4 ± 0.3 vs 4.6 ± 0.3 days, respectively. The differences in storage duration are likely related to both the collection system and the storage bag. The Spectra and Trima platelets were hyperconcentrated during collection, and PAS was added, whereas the Haemonetics platelets were elutriated with PAS, which may have resulted in less collection injury. When Spectra and Trima platelets were stored in Haemonetics' bags, poststorage viability was significantly improved. Platelet viability is better maintained in vitro than in vivo, allowing substantial increases in platelet storage times. However, implementation will require resolution of potential bacterial overgrowth during storage.

  12. Immediate adverse reactions to platelet transfusions: whole blood derived versus apheresis platelets.

    PubMed

    Salam, A; Hosain, G M; Hosain, M M; Narvios, A; Sazama, K; Lichtiger, B

    2013-01-01

    The transfusion of whole blood derived platelets (WBDPs) or apheresis platelets (APs) is standard support for cancer patients. However, disputes remain about which type of platelets are ideal in terms of efficacy, cost, and the risk of adverse reactions. This cross sectional study included 141 cancer patients who underwent chemotherapy or hematopoietic progenitor cell transplantation and received platelet transfusions at The University of Texas M.D. Anderson Cancer Center between 2002 and 2003 were retrospectively evaluated. A total of 141 patients who did not differ significantly in terms of age or sex had a reaction to transfusions (WBDPs, n=123; APs, n=18), for a frequency of 0.66% in patients who received WBDPs and 0.45% in patients who received APs, but this difference was not statistically significant (p=0.13). More WBDP-related reactions occurred in patients transfused with older platelets (>2 days old) than in patients transfused with fresh platelets, but the difference compared with AP-associated reactions was not statistically significant. However, the rate of reactions to WBDP may increase if WBDPs are stored for a prolonged time (>2 days). Until evidence becomes available that clearly refutes this; the more fresh platelets as possible may be used.

  13. Exploratory studies of extended storage of apheresis platelets in a platelet additive solution (PAS)

    PubMed Central

    Corson, Jill; Jones, Mary Kay; Christoffel, Todd; Pellham, Esther; Bailey, S. Lawrence; Bolgiano, Doug

    2014-01-01

    To evaluate the poststorage viability of apheresis platelets stored for up to 18 days in 80% platelet additive solution (PAS)/20% plasma, 117 healthy subjects donated platelets using the Haemonetics MCS+, COBE Spectra (Spectra), or Trima Accel (Trima) systems. Control platelets from the same subjects were compared with their stored test PAS platelets by radiolabeling their stored and control platelets with either 51chromium or 111indium. Trima platelets met Food and Drug Administration poststorage platelet viability criteria for only 7 days vs almost 13 days for Haemonetics platelets; ie, platelet recoveries after these storage times averaged 44 ± 3% vs 49 ± 3% and survivals were 5.4 ± 0.3 vs 4.6 ± 0.3 days, respectively. The differences in storage duration are likely related to both the collection system and the storage bag. The Spectra and Trima platelets were hyperconcentrated during collection, and PAS was added, whereas the Haemonetics platelets were elutriated with PAS, which may have resulted in less collection injury. When Spectra and Trima platelets were stored in Haemonetics’ bags, poststorage viability was significantly improved. Platelet viability is better maintained in vitro than in vivo, allowing substantial increases in platelet storage times. However, implementation will require resolution of potential bacterial overgrowth during storage. PMID:24258816

  14. Maintenance of storage properties of pediatric aliquots of apheresis platelets in fluoroethylene propylene containers.

    PubMed

    Skripchenko, Andrey; Myrup, Andrew; Thompson-Montgomery, Dedeene; Awatefe, Helen; Wagner, Stephen J

    2013-04-01

    Platelet (PLT) aliquots for pediatric use have been shown to retain in vitro properties when stored in gas-impermeable syringes for up to 6 hours. As an alternative, PLT aliquots can be stored for longer periods in containers used for storage of whole blood-derived PLTs. These containers are not available separate from whole blood collection sets and PLT volumes less than 35 mL either have not been evaluated or may be unsuitable for PLT storage. Gas-permeable fluoroethylene propylene (FEP) containers have been used in the storage of cell therapy preparations and are available in multiple sizes as single containers but have not been evaluated for PLT storage. A single apheresis unit was divided on Day 3 into small aliquots with volume ranging from 20 to 60 mL, transferred using a sterile connection device, and stored for an additional 2 days either in CLX (control) or in FEP containers. PLT storage properties of PLTs stored in FEP containers were compared to those stored in CLX containers. Standard PLT in vitro assays were performed (n =6). PLT storage properties were either similar to those of CLX containers or differed by less than 20% excepting carbon dioxide levels, which varied less than 60%. Pediatric PLT aliquots of 20, 30, and 60mL transferred on Day 3 into FEP cell culture containers adequately maintain PLT properties for an additional 2days of storage. © 2012 American Association of Blood Banks.

  15. Apheresis for babesiosis: Therapeutic parasite reduction or removal of harmful toxins or both?

    PubMed

    Saifee, Nabiha Huq; Krause, Peter J; Wu, Yanyun

    2016-10-01

    Babesiosis is a potentially life-threatening illness caused by intraerythrocytic protozoan parasites of the genus Babesia that are transmitted most commonly by Ixodes ticks, and rarely from blood transfusion or congenitally. Clinical presentations of babesiosis include asymptomatic infection, mild to moderate disease, or severe disease. Antibiotics such as atovaquone plus azithromycin or clindamycin and quinine can be used effectively to treat this disease in most cases, however in high risk populations, the mortality rate can be as high as 20% despite therapy. Therapeutic exchange transfusion has been used in severe babesiosis and is of apparent therapeutic benefit. It is not entirely clear through what mechanism therapeutic exchange transfusion may help patients. Data suggests that in addition to parasite load reduction, it is possible that therapeutic exchange transfusion removes toxins generated by babesia infection. There are many remaining questions that need to be addressed regarding exchange transfusion for babesiosis. J. Clin. Apheresis 31:454-458, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  16. Ronchi test with equivalent wavelength.

    PubMed

    García-Arellano, Anmi; Granados-Agustín, Fermín; Campos-García, Manuel; Cornejo-Rodríguez, Alejandro

    2012-05-20

    In this work we present an experimental proposal to evaluate optical surfaces with high slopes or with infrared wavelengths based on the Ronchi test as well as on the concept of equivalent wavelength. A spatial modulator is used in the implementation of the Ronchi test, and a white LED with different color filters is employed in order to generate different wavelengths. Two Ronchigrams with incoherent light, each one for a different color, are registered and computationally processed, thus generating a third one with an equivalent wavelength. The results obtained show that it is possible to generate patterns with traditional rulings and substructured sequences of Katyl. Additionally, we discuss some of the limitations of employing different rulings. Finally, we found that appropriate image enhancing algorithms allow us to improve the visibility of the resulting fringes and thus obtain a better analysis.

  17. Equivalence theorem of uncertainty relations

    NASA Astrophysics Data System (ADS)

    Li, Jun-Li; Qiao, Cong-Feng

    2017-01-01

    We present an equivalence theorem to unify the two classes of uncertainty relations, i.e. the variance-based ones and the entropic forms, showing that the entropy of an operator in a quantum system can be built from the variances of a set of commutative operators. This means that an uncertainty relation in the language of entropy may be mapped onto a variance-based one, and vice versa. Employing the equivalence theorem, alternative formulations of entropic uncertainty relations are obtained for the qubit system that are stronger than the existing ones in the literature, and variance-based uncertainty relations for spin systems are reached from the corresponding entropic uncertainty relations.

  18. Evaluation of store lesion in platelet obtained by apheresis compared to platelet derived from whole blood and its impact on the in vitro functionality.

    PubMed

    Quintero, M; Núñez, M; Mellado, S; Maldonado, M; Wehinger, S

    2015-12-01

    Platelet units for transfusion purposes are obtained manually from whole blood or by apheresis, in an automated process. In both methods, platelets during storage present a characteristics grouped under the name "storage lesion" that are associated with adverse effects on platelet units. Oxidative stress has been claimed to be one of major causes, leading to activation and apoptosis processes affecting their post transfusion functionality. In this work, we observed an association between apheresis and a reduced presence of oxidative stress and better results in functional markers in stored platelets, compared to manually obtained platelets. Then, apheresis which would ensure a greater number of functional platelets during the 5 days of storage, compared to concentrates obtained from whole blood.

  19. Pancytopenia with severe thrombocytopenia in a patient treated with twice-weekly LDL-apheresis by polyacrylate adsorption from whole blood.

    PubMed

    Nowack, Rainer; Wiedemann, Günther

    2010-01-01

    Pancytopenia with severe thrombocytopenia occurred in a patient treated with low-density lipoprotein (LDL)-apheresis by polyacrylate adsorption from whole blood, after treatment frequency had been increased from once to twice a week. Cell counts recovered with discontinuation of LDL-apheresis, but thrombocytopenia recurred after resumption of twice-weekly treatments. Thrombocyte counts remained stable following the replacement of polyacrylate adsorption from whole blood by double-filtration plasmapheresis. The complications' close coincidence with twice-weekly polyacrylate adsorption from whole blood suggests a causal relationship, although by a still unknown mechanism. Monitoring of thrombocytes should be advised in patients treated with LDL-apheresis by polyacrylate adsorption from whole blood.

  20. Establishing Substantial Equivalence: Metabolomics

    NASA Astrophysics Data System (ADS)

    Beale, Michael H.; Ward, Jane L.; Baker, John M.

    Modern ‘metabolomic’ methods allow us to compare levels of many structurally diverse compounds in an automated fashion across a large number of samples. This technology is ideally suited to screening of populations of plants, including trials where the aim is the determination of unintended effects introduced by GM. A number of metabolomic methods have been devised for the determination of substantial equivalence. We have developed a methodology, using [1H]-NMR fingerprinting, for metabolomic screening of plants and have applied it to the study of substantial equivalence of field-grown GM wheat. We describe here the principles and detail of that protocol as applied to the analysis of flour generated from field plots of wheat. Particular emphasis is given to the downstream data processing and comparison of spectra by multivariate analysis, from which conclusions regarding metabolome changes due to the GM can be assessed against the background of natural variation due to environment.

  1. Plutonium 239 Equivalency Calculations

    SciTech Connect

    Wen, J

    2011-05-31

    This document provides the basis for converting actual weapons grade plutonium mass to a plutonium equivalency (PuE) mass of Plutonium 239. The conversion can be accomplished by performing calculations utilizing either: (1) Isotopic conversions factors (CF{sub isotope}), or (2) 30-year-old weapons grade conversion factor (CF{sub 30 yr}) Both of these methods are provided in this document. Material mass and isotopic data are needed to calculate PuE using the isotopic conversion factors, which will provide the actual PuE value at the time of calculation. PuE is the summation of the isotopic masses times their associated isotopic conversion factors for plutonium 239. Isotopic conversion factors are calculated by a normalized equation, relative to Plutonium 239, of specific activity (SA) and cumulated dose inhalation affects based on 50-yr committed effective dose equivalent (CEDE). The isotopic conversion factors for converting weapons grade plutonium to PuE are provided in Table-1. The unit for specific activity (SA) is curies per gram (Ci/g) and the isotopic SA values come from reference [1]. The cumulated dose inhalation effect values in units of rem/Ci are based on 50-yr committed effective dose equivalent (CEDE). A person irradiated by gamma radiation outside the body will receive a dose only during the period of irradiation. However, following an intake by inhalation, some radionuclides persist in the body and irradiate the various tissues for many years. There are three groups CEDE data representing lengths of time of 0.5 (D), 50 (W) and 500 (Y) days, which are in reference [2]. The CEDE values in the (W) group demonstrates the highest dose equivalent value; therefore they are used for the calculation.

  2. Predicted effect of selectively testing female donors for HLA antibodies to mitigate transfusion-related acute lung injury risk from apheresis platelets.

    PubMed

    Eder, Anne F; Dy, Beth A; O'Neill, E Mary

    2016-06-01

    The use of male-donor-predominant plasma has reduced the risk of transfusion-related acute lung injury (TRALI), but the possible benefit of different mitigation strategies for other components is unknown. We evaluated the risk of TRALI from apheresis platelets (PLTs) to predict the effect of selectively testing female plateletpheresis donors who have been pregnant for HLA antibodies. The American Red Cross hemovigilance program classified TRALI cases from apheresis PLTs or red blood cells (RBCs) in 2006 to 2013 or from predominantly male-donor (>95%) plasma in 2008 to 2013 and compared the component-specific TRALI rates. The overall rate of TRALI was significantly higher for apheresis PLTs (6.2 cases per 10(6) units; OR [95% CI], 3.3 [2.3-4.8]) or plasma (3.8 cases per 10(6) units; OR [95% CI], 2.0 [1.4-2.9]) compared to RBCs (1.9 per 10(6) units). Twenty-nine of the 41 apheresis PLT cases involved female donors; 28 had been pregnant, and one had not been pregnant and was not tested. Twenty-five (61%) of the apheresis PLT TRALI cases had female donors with HLA Class I or Class II antibodies. In five of six cases that implicated specific HNA antibodies, the female parous donors also had multiple HLA antibodies. TRALI was more likely after transfusion of apheresis PLTs than male-donor-predominant plasma or RBCs. A selective strategy to test all female plateletpheresis donors who have been pregnant for HLA antibodies might reduce the risk of TRALI by approximately 60% and prevent some cases from coexisting HNA antibodies. © 2016 AABB.

  3. The transfer of contextual control over equivalence classes through equivalence classes: a possible model of social stereotyping.

    PubMed Central

    Kohlenberg, B S; Hayes, S C; Hayes, L J

    1991-01-01

    In Experiment 1, subjects acquired conditional equivalence classes controlled by three male and three female names as contextual stimuli. When equivalence relations were tested using new names not used in training (three male and three female), contextual control remained intact. Thus, generalized control of the composition of conditional equivalence classes by characteristically gender-identified names was shown. A basic analysis of this finding was tested in Experiment 2. Contextual equivalence classes were established using as contextual stimuli nonrepresentational visual figures that were members of additional pretrained three-member equivalence classes. When other stimuli in the pretrained equivalence classes were used as contextual stimuli, the conditional equivalence classes remained intact. Control subjects showed that this effect depended on the equivalence relations established in pretraining. The results show that contextual control over equivalence classes can transfer through equivalence classes. The implications of this phenomenon for social stereotyping are discussed. PMID:1774542

  4. Motivational Differences between Whole Blood and Apheresis Donors in Quebec, Canada: A Questionnaire-Based Survey in a Voluntary Nonremunerated Context.

    PubMed

    Charbonneau, Johanne; Cloutier, Marie-Soleil; Carrier, Élianne

    2015-01-01

    Background. Finding ways to recruit apheresis donors is crucial. The aim of this study was to provide a quantitative analysis of the motivations of regular plasma/platelets donors (PPDs) in comparison with those of regular whole blood donors (WBDs), in a voluntary and nonremunerated context. Study Design and Methods. Motives to donate blood and demographic characteristics were collected through questionnaires completed by 795 WBDs and 473 PPDs. Chi-square tests were completed to determine which motivations stand out across the two blood donor groups. Results. The motivator selected by the highest percentage was "my blood can save lives." Comparison of WBDs and PPDs showed that 12 out of 23 items were statistically significantly different from one group to another. Conclusion. The belief that helping others is in their nature is more prevalent among PPDs. In this sense, their profile is unique. Four other motivators distinguish this group from the WBDs: "I think there is a strong need for blood products," "it gives me a sense of pride," "I like to have goals," and "I receive telephone reminders." These motivators point to the role the ongoing support provided by blood collection agencies (BCAs) plays with PPDs.

  5. Motivational Differences between Whole Blood and Apheresis Donors in Quebec, Canada: A Questionnaire-Based Survey in a Voluntary Nonremunerated Context

    PubMed Central

    Charbonneau, Johanne; Cloutier, Marie-Soleil; Carrier, Élianne

    2015-01-01

    Background. Finding ways to recruit apheresis donors is crucial. The aim of this study was to provide a quantitative analysis of the motivations of regular plasma/platelets donors (PPDs) in comparison with those of regular whole blood donors (WBDs), in a voluntary and nonremunerated context. Study Design and Methods. Motives to donate blood and demographic characteristics were collected through questionnaires completed by 795 WBDs and 473 PPDs. Chi-square tests were completed to determine which motivations stand out across the two blood donor groups. Results. The motivator selected by the highest percentage was “my blood can save lives.” Comparison of WBDs and PPDs showed that 12 out of 23 items were statistically significantly different from one group to another. Conclusion. The belief that helping others is in their nature is more prevalent among PPDs. In this sense, their profile is unique. Four other motivators distinguish this group from the WBDs: “I think there is a strong need for blood products,” “it gives me a sense of pride,” “I like to have goals,” and “I receive telephone reminders.” These motivators point to the role the ongoing support provided by blood collection agencies (BCAs) plays with PPDs. PMID:26295006

  6. Impact of increasing sample volume from 4 ml to 8 ml on bacterial detection rates in apheresis platelets: a meta-analysis.

    PubMed

    Bruhn, R; Custer, B; Vanderpool, S; Townsend, M; Kamel, H; Tomasulo, P

    2015-04-01

    Some blood centres have increased sample volume of in-process cultures to improve detection of bacterial contamination when screening apheresis platelet units. We performed a meta-analysis to evaluate extant published North American data comparing apheresis platelet bacterial contamination rates from 4 ml and 8 ml sample volume. Pooled results indicate an 8 ml sample volume yields higher true-positive rates than 4 ml resulting in a significant increase in the detection rate and interdiction of contaminated units, which should contribute to reduced risk of adverse transfusion outcomes.

  7. Equivalent statistics and data interpretation.

    PubMed

    Francis, Gregory

    2017-08-01

    Recent reform efforts in psychological science have led to a plethora of choices for scientists to analyze their data. A scientist making an inference about their data must now decide whether to report a p value, summarize the data with a standardized effect size and its confidence interval, report a Bayes Factor, or use other model comparison methods. To make good choices among these options, it is necessary for researchers to understand the characteristics of the various statistics used by the different analysis frameworks. Toward that end, this paper makes two contributions. First, it shows that for the case of a two-sample t test with known sample sizes, many different summary statistics are mathematically equivalent in the sense that they are based on the very same information in the data set. When the sample sizes are known, the p value provides as much information about a data set as the confidence interval of Cohen's d or a JZS Bayes factor. Second, this equivalence means that different analysis methods differ only in their interpretation of the empirical data. At first glance, it might seem that mathematical equivalence of the statistics suggests that it does not matter much which statistic is reported, but the opposite is true because the appropriateness of a reported statistic is relative to the inference it promotes. Accordingly, scientists should choose an analysis method appropriate for their scientific investigation. A direct comparison of the different inferential frameworks provides some guidance for scientists to make good choices and improve scientific practice.

  8. A Retrospective Analysis of Apheresis Donor Deferral and Adverse Reactions at a Tertiary Care Centre in India

    PubMed Central

    Garg, Ketan; Kaushik, Ankit; Sharma, Richa; Rawat, DS; Mandal, AK

    2016-01-01

    Introduction With increasing demand of platelet component each day, blood bank plays a pivotal role in ensuring supply of safe blood as and when required. Plateletpheresis procedure is a relatively simple, safe and important adjunct to blood bank inventory. However, recruitment of healthy blood donors is a challenge that the health industry is facing today. Aim To determine the reasons and rates of apheresis donor deferral along with investigation of adverse reactions encountered during the procedure. Materials and Methods Records of single donor apheresis were retrospectively analysed from 1st January 2010 to 31st December 2014. The study was carried out at Blood Bank, Safdarjung Hospital, New Delhi, India. The donor details that were studied included – age, sex, type of donation (voluntary/replacement/ repeat), reason for donor deferral and type of adverse reaction, if encountered during the procedure. Results Among the 478 donors screened for plateletpheresis procedure during a study period of 5 years, 134 (28.03%) were deferred. Temporary deferrals accounted for majority (93.28%) of the deferrals. Low platelet count (50.75%) was the main reason of donor deferral followed by low haemoglobin (20.89%). Amongst the 344 selected donors, 15 (4.36%) had some type of adverse reaction associated with the procedure. Conclusion We suggest that the selection criteria for plateletpheresis donors should be revised to deal with shortage of apheresis donors. The criteria regarding minimum pre-procedure platelet count (above1.5 lac/μl) and haemoglobin (above 12.5 g/dl) need to be lowered so as to suit the Indian scenario. The lower adverse reaction rates, 14/344 (4.06%) associated with this procedure encourages safety of donors and is important in recruitment of new donors. PMID:28050376

  9. Efficacy and safety of DALI LDL-apheresis at high blood flow rates: a prospective multicenter study.

    PubMed

    Wendler, T; Schilling, R; Lennertz, A; Sodemann, K; Kleophas, W; Messner, H; Riechers, G; Wagner, J; Keller, C; Bosch, T

    2003-01-01

    Direct adsorption of lipids (DALI) is the first LDL-apheresis method compatible with whole blood. Usually, the blood flow rate is adjusted at 60-80 ml/min, which results in session times of about 2 hr. The present study was performed to test the safety and efficacy of low-density lipoprotein cholesterol (LDL-C) and lipoprotein (a) [Lp(a)] removal by DALI at high blood flow rates in order to reduce treatment time. Thirteen chronic DALI patients in seven centers suffering from hypercholesterolemia (LDL-C 162 +/- 42 mg/dl at baseline) and coronary artery disease were treated on a weekly or biweekly basis by DALI apheresis. The blood flow rate QB was held constant for at least two sessions, respectively, and was increased from 60 to 80, 120, 160, 200, and 240 ml/min. All patients had pre-existing av-fistulas. The anticoagulation was performed by a heparin bolus plus ACD-A at a ratio of citrate:blood ranging from 1:20 to 1:90. Clinically, the sessions were well tolerated and only 26/201 sessions (12%) of the treatments were fraught with minor adverse events. Acute LDL-C reductions (derived from LDL-C levels determined by lipoprotein electrophoresis) averaged 72/66/60/53/50/48% for QB=60/80/120/160/200/240 ml/min. Lp(a) reductions were 68/67/62/60/58/56%, whereas HDL-C losses were < or =10%. Routine blood chemistries and blood cell counts remained in the normal range. Treatment times averaged 142/83/45 min at Qb=60/120/240 ml/min. On average, DALI LDL-apheresis could be performed safely and effectively at high blood flow rates up to at least 120 ml/min in patients with good blood access, which significantly reduced treatment time from 142 to 83 min (-42%).

  10. Equivalence in Ventilation and Indoor Air Quality

    SciTech Connect

    Sherman, Max; Walker, Iain; Logue, Jennifer

    2011-08-01

    We ventilate buildings to provide acceptable indoor air quality (IAQ). Ventilation standards (such as American Society of Heating, Refrigerating, and Air-Conditioning Enginners [ASHRAE] Standard 62) specify minimum ventilation rates without taking into account the impact of those rates on IAQ. Innovative ventilation management is often a desirable element of reducing energy consumption or improving IAQ or comfort. Variable ventilation is one innovative strategy. To use variable ventilation in a way that meets standards, it is necessary to have a method for determining equivalence in terms of either ventilation or indoor air quality. This study develops methods to calculate either equivalent ventilation or equivalent IAQ. We demonstrate that equivalent ventilation can be used as the basis for dynamic ventilation control, reducing peak load and infiltration of outdoor contaminants. We also show that equivalent IAQ could allow some contaminants to exceed current standards if other contaminants are more stringently controlled.

  11. Comments on TNT Equivalence

    SciTech Connect

    Cooper, P.W.

    1994-07-01

    The term ``TNT Equivalence`` is used throughout the explosives and related industries to compare the effects of the output of a given explosive to that of TNT. This is done for technical design reasons in scaling calculation such as for the prediction of blast waves, craters, and structural response, and is also used as a basis for government regulations controlling the shipping, handling and storage of explosive materials, as well as for the siting and design of explosive facilities. TNT equivalence is determined experimentally by several different types of tests, the most common of which include: plate dent, ballistic mortar, trauzl, sand crush, and air blast. All of these tests do not necessarily measure the same output property of the sample explosive. As examples of this, some tests depend simply upon the CJ pressure, some depend upon the PV work in the CJ zone and in the Taylor wave behind the CJ plane, some are functions of the total work which includes that from secondary combustion in the air mixing region of the fireball and are acutely effected by the shape of the pressure-time profile of the wave. Some of the tests incorporate systematic errors which are not readily apparent, and which have a profound effect upon skewing the resultant data. Further, some of the tests produce different TNT Equivalents for the same explosive which are a function of the conditions at which the test is run. This paper describes the various tests used, discusses the results of each test and makes detailed commentary on what the test is actually measuring, how the results may be interpreted, and if and how these results can be predicted by first principals based calculations. Extensive data bases are referred to throughout the paper and used in examples for each point in the commentaries.

  12. Parallel comparison of apheresis-collected platelet concentrates stored in four different additive solutions.

    PubMed

    Nogawa, M; Naito, Y; Chatani, M; Onodera, H; Shiba, M; Okazaki, H; Matsuzaki, K; Satake, M; Nakajima, K; Tadokoro, K

    2013-11-01

    Partially replacing plasma with additive solutions in platelet (PLT) concentrates (PCs) may help to reduce transfusion reactions. Constituents of PLT additive solutions (PASs) have been revealed to affect the quality of PCs. Previous studies involved pairwise comparison of identical PLTs with two different PASs or multicomparison using random PLTs with three or more PASs. In this study, we performed parallel comparison using PCs from identical donors with four PASs. In addition to traditional parameters, the release of bioactive substances and plasma proteins was assessed. Platelets collected four times by apheresis from three donors were suspended in Intersol, SSP+, Composol or M-sol with 35% autologous plasma. The PC parameters, including PLT activation markers, glucose consumption, chemokines and plasma proteins, were assessed during 5-day storage. Mean PLT volumes were decreased in SSP+, Composol and M-sol after 5-day storage, with significant differences, whereas the hypertonic shock response (HSR) was decreased only in Intersol. Glucose consumption was faster in Intersol and M-sol than in SSP+ or Composol. PLT activation, determined as CD62P, sCD62P, sCD40L and RANTES, was significantly higher in Intersol than the other three PASs. No marked change was observed in fibrinopeptide A and C3a in any PASs. M-sol, SSP+ and Composol effectively preserved the quality of PCs. PLT activation was significantly enhanced in Intersol compared with the other three PASs. These effects seem to depend on magnesium and potassium as a constituent. Parallel comparison further verified that the PC quality largely depended on PASs but not donors. © 2013 International Society of Blood Transfusion.

  13. Benefits and challenges of starting a new therapeutic apheresis service in a resource-constrained setting.

    PubMed

    Arogundade, Fatiu A; Sanusi, Abubakr A; Oguntola, Stephen O; Omotoso, Bolanle A; Abdel-Rahman, Emaad M; Akinsola, Adewale; Balogun, Rasheed A

    2014-08-01

    Therapeutic apheresis (TA) refers to a group of extracorporeal blood treatment modalities with clinical indications for which the clinicians' knowledge, availability and applicability vary widely worldwide. Therapeutic plasma exchange (TPE), the most common TA technique, is neither readily available nor affordable in many parts of Africa. This article focuses on the challenges of starting a TPE program in a resource-constrained economy and the result of a survey of Nigerian nephrology professionals on TPE. A critical appraisal of published manuscripts from Nigeria on TA was undertaken to assess uses, methods, and challenges encountered followed by a survey of the perceptions of Nigerian nephrology professionals on TPE. Survey results: 56.7% of respondents had very little or no knowledge of TPE; 40.5% moderate and only 2.7% admitting to having a good knowledge. Only 18.9% of respondents have ever participated or observed a TPE procedure with the remaining 81.1% not having any exposure to the procedure. A vast majority of the respondents 97.3% felt they needed better exposure and training in TPE and its applications. Among consultants, 56% had little knowledge, 88% had never participated or observed the TPE procedure, and 94% felt they needed better exposure and training. There is significant limitation in accessibility, availability, and use of TPE in Nigeria; knowledge of TPE and its applications is minimal among nephrology professionals. Efforts should be concentrated on improving the knowledge and availability of TPE in resource-constrained economy like Nigeria. Centers that would be able to manage cases requiring TA should be developed. © 2014 Wiley Periodicals, Inc.

  14. Hemostatic function of apheresis platelets stored at 4 °C and 22 °C

    PubMed Central

    Reddoch, Kristin M.; Pidcoke, Heather F.; Montgomery, Robbie K.; Fedyk, Criselda G.; Aden, James K.; Ramasubramanian, Anand K.; Cap, Andrew P.

    2014-01-01

    Introduction Platelet refrigeration decreases the risk of bacterial contamination and may preserve function better than standard-of-care room temperature storage. Benefits could include lower transfusion-related complications, decreased costs, improved hemostasis in acutely bleeding patients, and extended shelf-life. In this study, we compared the effects of 22°C and 4°C storage on the functional and activation status of apheresis platelets (APs). Methods APs (n = 5 per group) were stored for 5 days at 22°C with agitation (RT) versus at 4°C with agitation (4C+AG) and without (4C). Measurements included platelet counts, mean platelet volume, blood gas analytes, aggregation response, thromboelastography, TxB2 and sCD40L release, activation markers and microparticle formation. Results Sample pH levels were within acceptable limits for storage products (pH 6.2-7.4). Platelet glucose metabolism (P < 0.05), aggregation response (ADP: RT 0; 4C+AG 5.0 ± 0.8; 4C 5.6 ± 0.9; P < 0.05), and clot strength (MA: RT 58 ± 2; 4C+AG 63 ± 2; 4C 67 ± 2; P < 0.05) were better preserved at 4°C compared to RT storage. Refrigerated samples were more activated compared to RT (P < 0.05), although TxB2 (P < 0.05) and sCD40L release (P < 0.05) were higher at RT. Agitation did not improve the quality of 4°C-stored samples. Conclusion AP stored at 4°C maintain more viable metabolic characteristics, are hemostatically more effective, and release fewer pro-inflammatory mediators than AP stored at RT over 5 days. Given the superior bacteriologic safety of refrigerated products, these data suggest that cold-stored platelets may improve outcomes for acutely bleeding patients. PMID:24169210

  15. Blood Product Supply in Germany: The Impact of Apheresis and Pooled Platelet Concentrates

    PubMed Central

    Berger, Karin; Schopohl, Dorothee; Wittmann, Georg; Schramm, Wolfgang; Ostermann, Helmut; Rieger, Christina

    2016-01-01

    Background In Germany, about 60% of all produced platelet concentrates (PCs) are apheresis PCs (APCs). Ongoing discussions on APC reimbursement and costs might lead to a potential shift in pooled PC (PPC)/APC production. Objective of this analysis was to build a comprehensive model from the societal perspective to evaluate consequences associated with shifts in platelet supply and demand. Methods Literature search, desktop researches on platelet supply and demand. Model calculations, time horizon one year: model input from the Paul-Ehrlich-Institute, data 2013. Base case: 19.2% of annual whole blood donations (WBDs) were used for production of 38.5% PPCs, decay of 46,218 PCs (8.0%). Scenarios calculated: variation in PPC proportion of 10-100%. Results Base case: during PPC production 41,957-83,913 red blood cell concentrates (RBCCs) are estimated to be lost, which corresponds to 1-2% of annual RBCCs in Germany. Scenarios were calculated for a production of 60-100% PPCs: loss is estimated to be 1.5-5.0% of annual RBCCs (65,430-218,099), decay 54,189-69,022 PCs (9.4-12.0%). Conclusion Production of different blood components is interlinked and sensitive to unidimensional decisions. Increasing PPC proportion has negative impact on the RBCC production and on the antigen-matched APC donor pool. Completion of the model calculations to predict the optimal PPC/APC proportion would require evidence on the number of refractory patients, donor pool sizes, and incidences of diseases requiring platelet transfusions. PMID:27994524

  16. Comparison of Manual Hematocrit Determinations vs Automated Methods for Hematopoietic Progenitor Cell Apheresis Products

    PubMed Central

    Avecilla, Scott T.; Marionneaux, Steven M.; Leiva, Tyler D.; Tonon, Jo-ann; Chan, Virgil T.; Moung, Christine; Meagher, Richard C.; Maslak, Peter

    2016-01-01

    BACKGROUND Allogeneic hematopoietic stem cell donor selection is based primarily on human leukocyte antigen degree of match and it often occurs without regard to the red blood cell (RBC) compatibility between donor and recipient. When major ABO-mismatched grafts are infused, it is imperative that an accurate determination of the incompatible RBC content is made to ensure that the product is safe for infusion. RBC content determination requires the hematocrit (HCT) parameter which can be obtained via manual (directly measured) or automated (calculated) methods. STUDY DESIGN AND METHODS Ninety-seven (97) apheresis hematopoietic progenitor grafts were assessed for HCT by manual testing and by 4 commercially available automated hematology analyzer instruments. A clinical model was developed to assess the frequency of unnecessary RBC reductions or alteration in standard infusion practice. RESULTS Statistically significant (p<0.001) differences were observed where the manual HCT value was markedly lower than automated HCT values. At stringent incompatible RBC threshold of 10 mL, the number of preventable RBC reduction procedures ranged from 18–69%. CONCLUSION Accurate determination of RBC content of hematopoietic progenitor grafts is essential for patient safety. Despite the rapidity and convenience offered by automated HCT methods, they significantly overestimate the incompatible RBC content of grafts which may trigger unnecessary RBC reduction procedures or split infusions. In products where automated HCT methods indicate excessive amounts of incompatible RBCs are present, we advise the performance of confirmatory testing with a manual HCT method to ensure that the automated HCT value is not a false positive. PMID:26395285

  17. Local unitary equivalence of quantum states and simultaneous orthogonal equivalence

    NASA Astrophysics Data System (ADS)

    Jing, Naihuan; Yang, Min; Zhao, Hui

    2016-06-01

    The correspondence between local unitary equivalence of bipartite quantum states and simultaneous orthogonal equivalence is thoroughly investigated and strengthened. It is proved that local unitary equivalence can be studied through simultaneous similarity under projective orthogonal transformations, and four parametrization independent algorithms are proposed to judge when two density matrices on ℂd1 ⊗ ℂd2 are locally unitary equivalent in connection with trace identities, Kronecker pencils, Albert determinants and Smith normal forms.

  18. Buffy-coat-derived pooled platelet concentrates and apheresis platelet concentrates: which product type should be preferred?

    PubMed

    Schrezenmeier, H; Seifried, E

    2010-07-01

    There is an ongoing debate whether platelet concentrates (PCs) prepared from either whole-blood donations or by plateletpheresis are superior. Usage of these two product types varies greatly between countries and individual institutions. Some use mainly apheresis PCs; others prefer pooled PCs which are produced from whole-blood donations. This review summarizes the existing information on these product types. In the first part data on quality, efficacy and safety are reviewed. It is important to note that the issue cannot be answered just by comparing 'the' apheresis platelet concentrate versus 'the' pooled platelet concentrate. Other factors which determine the quality of a product, e.g. residual leukocyte count, plasma content, additive solution or storage period may be even more important. The focus of the debate should be shifted. It is much more needed to further improve the overall quality of PCs and to optimize treatment of thrombocytopenic patients than to concentrate on a single-edged view on just the preparation method. In the second part of this review we compare the product types from the donor's point of view. If PCs which are equally safe and effective can be obtained by various methods, ethics and the safety of the healthy volunteer donor tips the scales. The decision on the use of a particular product type should take into account all aspects of efficacy, side effects and availability of the product as well as the donor's perspective and the commitment to maximize the use of the valuable whole-blood donation.

  19. Establishing Substantial Equivalence: Proteomics

    NASA Astrophysics Data System (ADS)

    Lovegrove, Alison; Salt, Louise; Shewry, Peter R.

    Wheat is a major crop in world agriculture and is consumed after processing into a range of food products. It is therefore of great importance to determine the consequences (intended and unintended) of transgenesis in wheat and whether genetically modified lines are substantially equivalent to those produced by conventional plant breeding. Proteomic analysis is one of several approaches which can be used to address these questions. Two-dimensional PAGE (2D PAGE) remains the most widely available method for proteomic analysis, but is notoriously difficult to reproduce between laboratories. We therefore describe methods which have been developed as standard operating procedures in our laboratory to ensure the reproducibility of proteomic analyses of wheat using 2D PAGE analysis of grain proteins.

  20. The expanding role of lipoprotein apheresis in the treatment of raised lipoprotein(a) in ischaemic heart disease and refractory angina

    PubMed Central

    Khan, Tina Z; Pottle, Alison; Pennell, Dudley J; Barbir, Mahmoud S

    2014-01-01

    It is increasingly recognised that lipoprotein(a) [Lp(a)], an inherited, genetically-determined form of LDL-cholesterol, is an independent cardiovascular risk factor and predictor of adverse cardiovascular outcomes. Lp(a) is felt to increase cardiovascular risk via its pro-thrombotic effect and by enhancing intimal lipoprotein deposition. Lipoprotein apheresis is currently the most effective treatment for raised Lp(a). There is a growing body of evidence suggesting that aggressively lowering raised Lp(a) may improve cardiovascular and clinical outcomes, although much more research is required in this field. Angina which is refractory to conventional medical therapy and revascularisation, is extremely challenging to manage. Treatment options for such patients remain very limited. We describe the case of a patient with refractory angina and raised lipoprotein(a) in whom aggressive reduction of Lp(a) with lipoprotein apheresis successfully ameliorated the progression of coronary stenosis and provided effective and durable relief of angina symptoms. In our centre, we are currently conducting a prospective, randomised controlled cross-over study of patients with refractory angina and raised Lp(a), randomised to undergoing lipoprotein apheresis or ‘sham’ apheresis with assessment of myocardial perfusion, carotid atherosclerosis, endothelial vascular function, thrombogenesis, oxidised phospholipids and their antibodies, exercise capacity, angina symptoms and quality of life at the beginning and end of treatment. PMID:25054114

  1. Consistency and proportionality in policy decision-making in blood safety: the case for an all-apheresis platelet supply in Germany.

    PubMed

    Vamvakas, E C; Hitzler, W E

    2013-01-01

    Recently, German investigators presented the first mathematical model finding a significant increase in the risk of HIV, HCV, and HBV transmission when pools of 4 whole-blood-derived buffy-coat platelets, rather than 1 single-donor (apheresis) component, are used to provide one platelet dose. Based, in both cases, on mathematical models employing the incidence/window-period method, the relative risk of transmission from pooled versus apheresis platelets (2.2 or 2.75 for HIV, 2.7 or 3.375 for HCV, and 3.2 or 4.0 for HBV, with pools of 4 or 5 concentrates, respectively) is similar to the difference in risk before (versus after) introduction of HIV-1 and HCV RNA screening. The absolute increase in the risk from pools (1 to 2 HIV-, HCV-, or HBV-infectious platelet doses annually) is much smaller than the yield from HIV-1 and HCV RNA screening projected in the 1990s, but it becomes similar to that yield (with up to 88 infectious platelet doses intercepted) when we consider the next transfusion-transmitted pathogen to emerge in the future. Although pathogen reduction (PR) of platelets would eliminate the difference in risk between pooled and apheresis platelets vis-a-vis viral transmission, PR is not ready for implementation because the safety of PR needs to be investigated further. German transfusion guidelines should be revised to indicate the difference in risk associated with pooled versus apheresis platelets, and transition toward an all-apheresis platelet supply should commence. These actions are consistent with and proportionate to the action taken in the 1990s when screening for HIV-1 and HCV RNA was implemented.

  2. Effective collection of peripheral blood stem cells in children weighing 20 kilogram or less in a single large-volume apheresis procedure.

    PubMed

    Salazar-Riojas, Rosario; García-Lozano, José Alberto; Valdés-Galván, Mayra; Martínez-González, Odra; Cantú-Rodríguez, Olga Graciela; González-Llano, Oscar; Gómez-De León, Andrés; Jaime-Pérez, José Carlos; Gómez-Almaguer, David; Gutiérrez-Aguirre, César Homero

    2015-10-01

    Peripheral blood stem cell (PBSC) transplantation has become a routine procedure in pediatric oncology. A special group of PBSC donors are children weighing 20 kg or less. Limited vascular access and low blood volume puts them at a higher risk. Central line placement and a priming apheresis machine are recommended to avoid these complications. PBSC collections performed from July 2006 to May 2013 in children weighing less than 20 kg were included. All donors had a central venous catheter (CVC). An apheresis machine was primed with packet red blood cells. Twenty-seven PBSC collections were performed in 22 children weighing 20 kg or less, 14 for allogeneic and 8 for autologous transplantation, in order to collect at least 2 × 10(6) CD34+ cells/kg. In the allogeneic group, median age and weight were 3 years (0.8-7) and 15.5 kg (8-20). In the autologous group, median age and weight were 3 years (2-7) and 15.35 kg (12.5-19.5). A single large-volume apheresis was sufficient to obtain the CD34+ cells needed in 78.5% and 75% of the allogeneic and autologous groups, respectively, with a median 11.84 × 10(6) and 5.79 × 10(6) CD34+ cells collected per kilogram of weight of the recipient. No serious complications related to the apheresis procedure or CVC placement occurred. PBSC collection in a single large-volume apheresis for allogeneic and autologous transplants in children weighing 20 kg or less is a safe and effective procedure when based on standardized protocols. © 2014 Wiley Periodicals, Inc.

  3. Efficacy and safety of DALI-LDL-apheresis in two patients treated with the angiotensin II-receptor 1 antagonist losartan.

    PubMed

    Bosch, Thomas; Wendler, Thorsten

    2004-08-01

    Direct adsorption of lipids (DALI) is the first low-density lipoprotein (LDL)-apheresis technique capable of adsorbing LDL and lipoprotein (a) directly from whole blood. The adsorber consists of negatively charged polyacrylate ligands linked to a Eupergit matrix. Negatively charged ligands give rise to activation of bradykinin, which is rapidly degraded by the angiotensin converting enzyme (ACE). Thus, angiotensin converting enzyme inhibitors are contraindicated in DALI-LDL-apheresis. This is the first paper to describe the efficacy and safety of DALI-LDL-apheresis in patients treated with 50 mg of the angiotensin II-receptor 1 antagonist (ARA) losartan. Two hypercholesterolemic patients were treated for 79 patient months with weekly or biweekly DALI sessions (N = 221 sessions). Approximately 1.4 patient blood volumes were treated per session. Acute reductions of LDL-cholesterol (63%) and lipoprotein (a) (62%) exceeded 60% and laboratory safety parameters remained in the apheresis typical range. Mean bradykinin plasma levels peaked in the efferent line post-adsorber at 1000 mL of treated blood volume; 467 fmol/mL (N = 6 sessions) in the ARA-treated patients and 671 fmol/mL (N = 9 sessions) in a control group of three DALI patients without ARA medication (P = 0.69, n.s.). Clinically, the DALI sessions for the ARA-treated patients were completely uneventful and blood pressure was not significantly different in the two groups. In summary, according to this retrospective pilot study, DALI-LDL-apheresis was shown for the first time to be safe and effective in patients on ARA medication.

  4. Low-density lipoprotein apheresis in a pediatric patient of familial hypercholesterolemia: Primi experientia from a tertiary care center in North India

    PubMed Central

    Dogra, Kanchan; Goyal, Alpesh; Khadgawat, Rajesh; Gupta, Yashdeep; Rout, Diptiranjan; Fulzele, Parag Prabhakar; Chaurasia, Rahul; Coshic, Poonam; Chatterjee, Kabita

    2017-01-01

    Familial hypercholesterolemia (FH) is an autosomal dominant disorder due to mutation of apolipoprotein-B receptor gene causing severe dyslipidemia. Lifestyle modification and medical treatment attenuate the disease progression, but as these fail to control the blood cholesterol levels, low-density lipoprotein (LDL) apheresis comes forth as a treatment option. To the best of our knowledge, the following is the very first case of pediatric FH being treated by LDL-apheresis to be reported from India. A severely malnourished female child presented with yellowish skin lesions over different parts of the body, viz., bilateral Achilles tendon, both knees, elbows, both pinnae, and outer canthus of both eyes. She had a strong family history of borderline hypercholesterolemia and was diagnosed as a case of FH. She was maintained on diet modification. LDL-apheresis was planned as the cholesterol levels were not controlled with the diet modificationt. However, unavailability of an appropriate kit in India for LDL-apheresis led to the use of the modified PL1 kit meant for therapeutic plasma exchange procedures. We conducted two sessions of LDL-apheresis. After the first session, the LDL-cholesterol (LDL-C) level fell by 75.9% and the total cholesterol fell by 73.5%. A second procedure led to a decline in total cholesterol level by 18.6% and LDL-C by 19.46%. Subsequently, she was advised diet modification and statin therapy with regular follow-up after every 6 months. Thus, the cascade filtration technique is a safe and effective treatment option for removing the undesired lipoproteins. PMID:28316443

  5. Equivalent intrinsic blur in amblyopia.

    PubMed

    Levi, D M; Klein, S A

    1990-01-01

    We used Gaussian blurred stimuli to explore the effect of blur on three tasks: (i) 2-line resolution; (ii) line detection; and (iii) spatial interval discrimination, in observers with amblyopia due to anisometropia, strabismus, or both. The results of our experiments can be summarized as follows. (i) 2-Line resolution: in normal foveal vision, thresholds for unblurred stimuli are approx. 0.5 min arc in the fovea. When the standard deviation (sigma) of the stimulus blur is less than 0.5 min, it has little effect upon 2-line resolution; however, thresholds are degraded when the stimulus blur, sigma, exceeds 0.5 min. We operationally define this transition point, as the equivalent intrinsic blur, or Bi. When the stimulus blur, sigma, is greater than Bi, then the resolution threshold is approximately equal to sigma. In all of the amblyopic eyes, 2-line resolution thresholds for unblurred stimuli were elevated, and the equivalent intrinsic blur was much larger. When the stimulus blur exceeds the equivalent intrinsic blur, resolution thresholds were similar in amblyopic and nonamblyopic eyes. (ii) Line detection: in both normal and amblyopic eyes, when the stimulus blur, sigma, is less than Bi, then the line detection threshold is approximately inversely proportional to sigma; i.e. (it obeys Ricco's law). When sigma is greater than Bi, the equivalent intrinsic blur, then the detection threshold is approximately a fixed contrast. All of the amblyopic eyes showed markedly elevated thresholds for detecting thin lines, but normal or near normal thresholds for detecting very blurred lines. Consequently, Ricco's diameter is larger in amblyopic than in normal eyes. (iii) Spatial interval discrimination: thresholds are proportional to the separation of the lines (i.e. Weber's law). At the optimal separation, spatial interval discrimination thresholds represent a "hyperacuity" (i.e. they are smaller than the resolution threshold). For unblurred lines, the optimal separation is

  6. Equivalence of superspace groups

    PubMed Central

    van Smaalen, Sander; Campbell, Branton J.; Stokes, Harold T.

    2013-01-01

    An algorithm is presented which determines the equivalence of two settings of a (3 + d)-dimensional superspace group (d = 1, 2, 3). The algorithm has been implemented as a web tool on , providing the transformation of any user-given superspace group to the standard setting of this superspace group in . It is shown how the standard setting of a superspace group can be directly obtained by an appropriate transformation of the external-space lattice vectors (the basic structure unit cell) and a transformation of the internal-space lattice vectors (new modulation wavevectors are linear combinations of old modulation wavevectors plus a three-dimensional reciprocal-lattice vector). The need for non-standard settings in some cases and the desirability of employing standard settings of superspace groups in other cases are illustrated by an analysis of the symmetries of a series of compounds, comparing published and standard settings and the transformations between them. A compilation is provided of standard settings of compounds with two- and three-dimensional modulations. The problem of settings of superspace groups is discussed for incommensurate composite crystals and for chiral superspace groups. PMID:23250064

  7. Equivalence of superspace groups.

    PubMed

    van Smaalen, Sander; Campbell, Branton J; Stokes, Harold T

    2013-01-01

    An algorithm is presented which determines the equivalence of two settings of a (3 + d)-dimensional superspace group (d = 1, 2, 3). The algorithm has been implemented as a web tool findssg on SSG(3+d)D, providing the transformation of any user-given superspace group to the standard setting of this superspace group in SSG(3+d)D. It is shown how the standard setting of a superspace group can be directly obtained by an appropriate transformation of the external-space lattice vectors (the basic structure unit cell) and a transformation of the internal-space lattice vectors (new modulation wavevectors are linear combinations of old modulation wavevectors plus a three-dimensional reciprocal-lattice vector). The need for non-standard settings in some cases and the desirability of employing standard settings of superspace groups in other cases are illustrated by an analysis of the symmetries of a series of compounds, comparing published and standard settings and the transformations between them. A compilation is provided of standard settings of compounds with two- and three-dimensional modulations. The problem of settings of superspace groups is discussed for incommensurate composite crystals and for chiral superspace groups.

  8. Physeal bar equivalent.

    PubMed

    Peterson, Hamlet A; Shaughnessy, William J; Stans, Anthony A

    2016-09-29

    Premature partial physeal arrest without the formation of an osseous bar - physeal bar equivalent (PBE) - is uncommon. Four children with a PBE had an infection near the distal femoral physis before the age of 11 months. Some growth was achieved after resection of the PBE in each case. Of two cases diagnosed and treated early, one required only contralateral physeal arrests to achieve limb-length equality at maturity. The other, currently 8 years and 4 months old, has a 1.1-cm limb-length discrepancy 6 years after PBE resection and will require observation until maturity. Of two cases diagnosed and treated late, one required ipsilateral femoral lengthening and contralateral femoral shortening and physeal arrests to treat the limb-length discrepancy and angular deformity. The other, currently 7 years and 1 month old, has a 4.8-cm discrepancy and will need future surgical limb-length equalization. Early recognition and treatment of PBE is required to avoid severe limb-length inequality and angular deformity.

  9. Biomonitoring Equivalents for molybdenum.

    PubMed

    Hays, Sean M; Macey, Kristin; Poddalgoda, Devika; Lu, Ming; Nong, Andy; Aylward, Lesa L

    2016-06-01

    Molybdenum is an essential trace element for mammalian, plant, and other animal systems. The Institute of Medicine (IOM) has established an Estimated Average Requirement (EAR) to assure sufficient molybdenum intakes for human populations; however excessive exposures can cause toxicity. As a result, several agencies have established exposure guidance values to protect against molybdenum toxicity, including a Reference Dose (RfD), Tolerable Daily Intake (TDI) and a Tolerable Upper Intake Level (UL). Biomonitoring for molybdenum in blood or urine in the general population is being conducted by the Canadian Health Measures Survey (CHMS) and the U.S. National Health and Nutrition Examination Survey (NHANES). Using pharmacokinetic data from controlled human dosing studies, Biomonitoring Equivalents (BEs) were calculated for molybdenum in plasma, whole blood, and urine associated with exposure guidance values set to protect against both nutritional deficits and toxicity. The BEEAR values in plasma, whole blood and urine are 0.5, 0.45 and 22 μg/L, respectively. The BEs associated with toxicity range from 0.9 to 31 μg/L in plasma, 0.8-28 μg/L in whole blood and 200-7500 μg/L in urine. These values can be used to interpret molybdenum biomonitoring data from a nutritional and toxicity perspective. Copyright © 2016. Published by Elsevier Inc.

  10. The influence of conditions utilized to hold apheresis and whole blood-derived platelet samples before platelet enumeration with three hematology analyzers.

    PubMed

    Seetharaman, Shalini; Kline, Linda; Dabay, Michelle; Kurtz, James; Moroff, Gary

    2010-08-01

    The Advia 120 (Siemens Diagnostics) hematology analyzer is different from other hematology analyzers in that it requires platelets (PLTs) to be "effectively spherical" to be counted. Our study evaluated how PLT counts with this hematology analyzer and two other models were influenced by the holding of PLT product samples. Samples were prepared from apheresis PLT products (APs) collected in ACD-A and from whole blood-derived PLT concentrates (PCs) in CP2D or ACD-A. Samples were stored in K(2) and K(3) ethylenediaminetetraacetate (EDTA) tubes at room temperature (RT) and in the cold. PLT counts were determined immediately, after 1 and 4 hours, and after an overnight hold, using Advia 120, XE-2100D, and Cell-Dyn 3700 hematology analyzers. A time-dependent increase in PLT counts was observed with AP samples held at RT using the Advia 120, but not with the other two hematology analyzers. AP samples held in the cold did not show a substantial time-dependent increase with any of the hematology analyzers. With the Advia 120, the PLT counts in the immediate samples were approximately 14% lower compared to those in cold or overnight-held RT samples. PC samples with all holding conditions and hematology analyzers did not show any substantial time-dependent increase in counts. With the Advia 120 hematology analyzer, the time-dependent increase in PLT counts with RT-held samples may be related to the need to have effectively sphered PLTs unlike that with the other two hematology analyzers. The absence of a holding effect with PC samples may indicate that only AP samples have population(s) that are slow to convert to spherical PLTs. © 2010 American Association of Blood Banks.

  11. Biomonitoring equivalents for deltamethrin.

    PubMed

    Aylward, Lesa L; Krishnan, Kannan; Kirman, Christopher R; Nong, Andy; Hays, Sean M

    2011-07-01

    Measured concentrations of chemicals in blood or urine in biomonitoring studies provide an integrated reflection of exposures to chemicals via multiple routes and pathways. The potential significance of the measured concentrations of chemicals in the context of existing toxicology data and risk assessments can be assessed if chemical-specific quantitative screening criteria are available. This work presents the derivation of Biomonitoring Equivalents (BEs) for deltamethrin, a synthetic Type II pyrethroid. BEs are estimates of biomarker concentrations that are consistent with risk assessment-based exposure guidance values such as reference doses or acceptable daily intakes. BE values were derived for deltamethrin based on two biomarkers: deltamethrin in plasma and 3-(2,2-dibromovinyl)-2,2-dimethylcyclopropane carboxylic acid (DBCA), a specific metabolite, in urine. BE values for deltamethrin in plasma were based on extrapolation from measured deltamethrin concentrations in plasma in rats under conditions consistent with the Point of Departure in the critical study underlying the USEPA RfD. BE values for DBCA in urine were derived based on pharmacokinetic data from a study in human volunteers on the urinary excretion of deltamethrin and metabolites. BE values for deltamethrin in plasma corresponding to the USEPA RfD for adults and children are 20 and 2μg/L, respectively. BE values for DBCA in urine corresponding to the adult and child-specific RfDs are 50 and 7μg/L, respectively. The urinary BE value corresponding to the ADI established by the European Commission and the Joint Meeting on Pesticide Residues is 60μg/L (as DBCA in urine). These values can be used to screen biomonitoring data in the context of current risk assessments for detlamethrin. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Biomonitoring Equivalents for selenium.

    PubMed

    Hays, Sean M; Macey, Kristin; Nong, Andy; Aylward, Lesa L

    2014-10-01

    Selenium is an essential nutrient for human health with a narrow range between essentiality and toxicity. Selenium is incorporated into several proteins that perform important functions in the body. With insufficient selenium intake, the most notable effect is Keshan disease, an endemic cardiomyopathy in children. Conversely, excessive selenium intake can result in selenosis, manifested as brittle nails and hair and gastro-intestinal disorders. As such, guidance values have been established to protect against both insufficient and excessive selenium exposures. Dietary Reference Intakes (DRIs) have been established as standard reference values for nutritional adequacy in North America. To protect against selenosis resulting from exposure to excessive amounts of selenium, several government and non-governmental agencies have established a range of guidance values. Exposure to selenium is primarily through the diet, but monitoring selenium intake is difficult. Biomonitoring is a useful means of assessing and monitoring selenium status for both insufficient and excessive exposures. However, to be able to interpret selenium biomonitoring data, levels associated with both DRIs and toxicity guidance values are required. Biomonitoring Equivalents (BEs) were developed for selenium in whole blood, plasma and urine. The BEs associated with assuring adequate selenium intake (Estimated Average Requirements - EAR) are 100, 80 and 10μg/L in whole blood, plasma and urine, respectively. The BEs associated with protection against selenosis range from 400 to 480μg/L in whole blood, 180-230μg/L in plasma, and 90-110μg/L in urine. These BE values can be used by both regulatory agencies and public health officials to interpret selenium biomonitoring data in a health risk context.

  13. Accumulation of CD62P during storage of apheresis platelet concentrates and the role of CD62P in transfusion-related acute lung injury.

    PubMed

    Tong, Shan; Wang, Haibao; Zhang, Ting; Chen, Linfeng; Liu, Bowei

    2015-11-01

    Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-associated morbidity and mortality. Activated platelets have important roles in TRALI and CD62P was identified to be an important indicator of platelet activation. However, the precise roles of CD62P in TRALI have remained elusive. The present study assessed CD62P accumulation during storage of apheresis platelet concentrates (A‑Plts) and established a mouse model of TRALI to further investigate the roles of CD62P in TRALI. The results showed that the CD62P concentration in A‑Plts was increased with the storage time. Mice were treated with monoclonal major histocompatibility complex (MHC)‑1 antibody to induce TRALI. The murine model of TRALI was successfully established as evidenced by pulmonary oedema, accompanied by decreased clearance of bronchoalveolar lavage fluid (BALF), increased pulmonary and systemic inflammation, elevated lung myeloperoxidase (MPO) activity as well as increased pulmonary and systemic coagulation in the TRALI group compared with those in the control group. To further determine the role of CD62P in TRALI, mice were treated with anti‑CD62P antibody to knockdown CD62P in vivo. It was found that pulmonary oedema, BALF clearance, pulmonary and systemic inflammation, MPO activity as well as pulmonary and systemic coagulation were decreased in the TRALI + anti‑CD62P antibody group compared with those in the TRALI + isotype antibody group. The present study supported the notion that CD62P is involved in mediating TRALI and may provide an important molecular basis for enhancing the clinical safety and effectiveness of platelet transfusion.

  14. Living donor kidney transplantation in patients with donor-specific HLA antibodies enabled by anti-CD20 therapy and peritransplant apheresis.

    PubMed

    Klein, Katrin; Süsal, Caner; Schäfer, Sebastian M; Becker, Luis Eduardo; Beimler, Jörg; Schwenger, Vedat; Zeier, Martin; Schemmer, Peter; Macher-Goeppinger, Stephan; Scherer, Sabine; Opelz, Gerhard; Morath, Christian

    2013-01-01

    Due to increasing waiting times for deceased donor kidneys, living donor kidney transplantation is increasingly performed in the presence of donor-specific antibodies (DSA). Twenty-three patients with Luminex-detected DSA were successfully desensitized by anti-CD20 therapy and immunoadsorption (N = 19) or plasmapheresis (N = 4) and received a kidney transplant from a living donor. Twelve of the 23 patients (52%) had a positive CDC and/or ELISA crossmatch result before desensitization. Six patients were negative in CDC as well as ELISA screening but positive in Luminex for DSA. The 23 patients received a median of 8 apheresis treatments before and 5 treatments after transplantation. Induction therapy was performed with either thymoglobulin (N = 11) or basiliximab (N = 12). The 2-year graft survival rate was 100%. At last follow up, a median of 12 months after transplantation, median serum creatinine was 1.42 mg/dL, median MDRD-GFR 59.5 mL/min/1.73 m(2), and median urinary protein-to-creatinine ratio 0.12. Ten out of fourteen patients (71%) who had completed the first year after transplantation by the time of analysis had no DSA by day 360. Acute T-cell mediated rejection was diagnosed in one patient (4%), and antibody-mediated changes were found in 5 patients (22%). Four out of these 5 patients showed evidence of persistent (N = 2) or reemerging plus/minus de novo DSA (N = 2) on day 360, and the 2 patients with persistent DSA lost their allograft subsequently on days 750 and 810, respectively. Infectious complications were infrequent. Our previously described treatment algorithm for desensitization of living donor kidney transplant recipients with DSA results in good graft outcomes with a low rate of side effects. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. String dualities and empirical equivalence

    NASA Astrophysics Data System (ADS)

    Dawid, Richard

    2017-08-01

    String dualities establish empirical equivalence between theories that often look entirely different with respect to their basic ontology and physical structure. Therefore, they represent a particularly interesting example of empirical equivalence in physics. However, the status of duality relations in string physics differs substantially from the traditional understanding of the role played by empirical equivalence. The paper specifies three important differences and argues that they are related to a substantially altered view on the underdetermination of theory building.

  16. Estimating equivalence with quantile regression

    USGS Publications Warehouse

    Cade, B.S.

    2011-01-01

    Equivalence testing and corresponding confidence interval estimates are used to provide more enlightened statistical statements about parameter estimates by relating them to intervals of effect sizes deemed to be of scientific or practical importance rather than just to an effect size of zero. Equivalence tests and confidence interval estimates are based on a null hypothesis that a parameter estimate is either outside (inequivalence hypothesis) or inside (equivalence hypothesis) an equivalence region, depending on the question of interest and assignment of risk. The former approach, often referred to as bioequivalence testing, is often used in regulatory settings because it reverses the burden of proof compared to a standard test of significance, following a precautionary principle for environmental protection. Unfortunately, many applications of equivalence testing focus on establishing average equivalence by estimating differences in means of distributions that do not have homogeneous variances. I discuss how to compare equivalence across quantiles of distributions using confidence intervals on quantile regression estimates that detect differences in heterogeneous distributions missed by focusing on means. I used one-tailed confidence intervals based on inequivalence hypotheses in a two-group treatment-control design for estimating bioequivalence of arsenic concentrations in soils at an old ammunition testing site and bioequivalence of vegetation biomass at a reclaimed mining site. Two-tailed confidence intervals based both on inequivalence and equivalence hypotheses were used to examine quantile equivalence for negligible trends over time for a continuous exponential model of amphibian abundance. ?? 2011 by the Ecological Society of America.

  17. In vitro platelet function of platelet concentrates prepared using three different apheresis devices determined by impedance and optical aggregometry.

    PubMed

    Jilma-Stohlawetz, Petra; Eichelberger, Beate; Horvath, Michaela; Jilma, Bernd; Panzer, Simon

    2009-08-01

    Septic transfusion reactions to apheresis platelets (PLTs) continue to occur despite preventive measures. This study evaluated the effect of two operational changes designed to reduce bacterial risk: 1) introducing inlet-line sample diversion on two-arm procedures and 2) increasing the sample volume cultured from 4 to 8 mL from all donations. Aerobic culture results and septic transfusion reactions reported between December 1, 2006, and July 31, 2008 (Period 2), were compared to March 1, 2004, to May 31, 2006 (Period 1). During Period 2, a total of 781,936 apheresis PLT collections were cultured, of which 130 donations (1:6015) were confirmed positive and 9 (1:86,882) had negative culture results but were associated with 11 septic reactions. Confirmed-positive cultures from two-arm procedures decreased (27.2 to 14.7 per 10⁵ collections; odds ratio [OR], 0.54; 95% confidence interval [CI], 0.41-0.70) in Period 2, owing to a lower rate of skin flora contamination. Detection of contamination of one-arm collections significantly increased by 54% in Period 2 (13.7 vs. 21.1 per 10⁵ collections; OR, 1.54; 95% CI, 1.05-2.27). Fewer septic transfusion reactions occurred in Period 2, but the difference did not reach significance (1.7 vs. 1.2 per 10⁵ donations; OR, 0.68; 95% CI, 0.30-1.53). Inlet-line diversion decreased bacterial contamination during two-arm collections by more than 46%. Concurrently, doubling the sample volume was associated with a 54% relative increase in culture sensitivity. These interventions act cooperatively to decrease bacterial risk.

  18. Ten years of lipoprotein apheresis for familial hypercholesterolemia in Malaysia: A creative approach by a cardiologist in a developing country.

    PubMed

    Khoo, Kah Lin; Page, Michael M; Liew, Yin Mei; Defesche, Joep C; Watts, Gerald F

    2016-01-01

    Familial hypercholesterolemia (FH) leads to premature coronary artery disease and aortic stenosis, with undertreated severe forms causing death at a young age. Lipoprotein apheresis (LA) is often required for lowering low-density lipoprotein cholesterol levels in severe FH. The objective of this study was to present the first experiences with LA in Malaysia, between 2004 and 2014. We retrospectively collected data from patient records to assess the effectiveness, adverse effects, patient quality of life, and costs associated with an LA service for genetically confirmed homozygous and heterozygous FH. We treated 13 women and 2 men aged 6 to 59 years, 10 with homozygous and 5 with heterozygous FH, all on maximally tolerated cholesterol-lowering drug therapy, for a total of 65 patient-years. Acute lowering of low-density lipoprotein cholesterol post apheresis was 56.3 ± 7.2%, with time-averaged mean lowering of 34.9 ± 13.9%. No patients experienced any cardiovascular events during the period of receiving LA. Patients receiving LA experienced few side effects and enjoyed reasonable quality of life, but inability to continue treatment was frequent because of cost. LA for severe FH can be delivered effectively in the short term in developing nations, but costs are a major barrier to sustaining this mode of treatment for this high-risk group of patients. New drug therapies for FH, such as the proprotein convertase subtilisin/kexin type 9 inhibitors, microsomal triglyceride transfer protein inhibitors, and apolipoprotein-B100 antisense oligonucleotides may allow improved care for these patients, but costs and long-term safety remain as issues to be addressed. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  19. High-efficiency DALI apheresis using 1,250 ml adsorbers in a hypercholesterolemic obese patient: a case report.

    PubMed

    Bosch, T; Lennertz, A; Samtleben, W

    2001-10-01

    Direct adsorption of lipoproteins (DALI) apheresis is the first method for direct adsorption of lipoproteins from whole blood and is therefore an easy and rapid procedure. The majority of patients reaches >60% acute low-density lipoprotein cholesterol (LDL-C) reduction using either the DALI 750 or 1000 configuration. However, in patients with extremely high LDL-C levels or very large blood volumes, these configurations may lead to suboptimal results. The current study was performed to test the safety and efficacy of DALI 1250. In a severely obese patient (185 cm, 133 kg, blood volume 7.2 L, LDL-C 239 mg/dl), 11 L of blood (1.53-fold patient blood volume) was processed at a flow rate of 80 ml/min in 2.5 h; a combined heparin-plus-citrate anticoagulation regimen was used. Commercially available DALI 1250 and DALI hardware and disposables were manufactured by Fresenius HemoCare Adsorber Technology, St. Wendel, Germany. Twenty weekly sessions were performed. Clinically and technically, the apheresis sessions were completely uneventful. As compared to DALI 1000 (n = 4 sessions), the reduction rates by DALI 1250 (n = 20) improved for LDL-C (from 52% to 66%), lipoprotein (a) (Lp[a]) (53% vs. 66%), and fibrinogen (11% vs. 16%). There was a slight increase in high-density lipoprotein cholesterol (HDL-C) loss (20% vs. 24%). Moreover, the absolute amount of LDL-C removed per session increased from 5.06 g to 5.94 g. Laboratory safety parameters remained within the normal range, the anticoagulation was well controlled, and the pressure gradients over the adsorber remained constant. In this case report, DALI 1250 was perfectly safe and significantly increased the efficacy of LDL-C and Lp(a) elimination compared to standard DALI. Thus, this high-efficiency version of DALI may be used in patients with extremely high LDL-C levels and/or large blood volumes.

  20. The role of bicarbonate in platelet additive solution for apheresis platelet concentrates stored with low residual plasma.

    PubMed

    Radwanski, Katherine; Min, Kyungyoon

    2013-03-01

    Complex platelet additive solutions (PASs) are required to store platelet (PLT) concentrates with plasma levels below 30%. Previously, apheresis PLTs stored with 5% plasma in acetate- and bicarbonate-containing PAS maintained stable pH and bicarbonate levels during 7-day storage. Due to this observation, the necessity of added bicarbonate in PAS was investigated and whether the concurrent increase in PAS pH after bicarbonate addition had any effect on PLT storage. Apheresis PLTs were stored in 5% plasma-95% high- or low-pH PAS, with or without bicarbonate (n=10 per arm). Bicarbonate PAS PLTs were paired and nonbicarbonate PAS PLTs were paired (split from same double-dose collection). PLTs were evaluated for in vitro variables on Days 1 and 7 and up to Day 14 if the Day 7 pH was higher than 6.2. PLT pH was maintained above 7.3 to Day 14 in bicarbonate PAS PLTs while pH failures below 6.2 were observed in 4 of 10 and 2 of 10 units on Day 7 in low- and high-pH nonbicarbonate PAS arms, respectively. Day 7 in vitro variables in nonbicarbonate PAS PLTs with pH values of higher than 6.2 were comparable to Day 7 variables in bicarbonate PAS PLTs. The pH of bicarbonate PAS did have a small effect on pH and bicarbonate levels in PLT units, but did not have an effect on functional variables and metabolism. Bicarbonate was not required to maintain in vitro PLT function in 5% plasma-95% PAS, but was required as a pH buffer and increased PAS pH did not significantly contribute to this effect. © 2012 American Association of Blood Banks.

  1. Monitoring and isolation of blood dendritic cells from apheresis products in healthy individuals: a platform for cancer immunotherapy.

    PubMed

    Alejandro López, J; Crosbie, Georgina; Kelly, Cathryn; McGee, Ann Marie; Williams, Katrina; Vuckovic, Slavica; Schuyler, Robert; Rodwell, Robyn; Wright, Sue J; Taylor, Kerry; Hart, Derek N J

    2002-09-15

    The fundamental role of dendritic cells (DC) in initiating and directing the primary immune response is well established. Furthermore, it is now accepted that DC may be useful in new vaccination strategies for preventing certain malignant and infectious diseases. As blood DC (BDC) physiology differs from that of the DC homologues generated in vitro from monocyte precursors, it is becoming more relevant to consider BDC for therapeutic interventions. Until recently, protocols for the isolation of BDC were laborious and inefficient; therefore, their use for investigative cancer immunotherapy is not widespread. In this study, we carefully documented BDC counts, yields and subsets during apheresis (Cobe Spectra), the initial and essential procedure in creating a BDC isolation platform for cancer immunotherapy. We established that an automated software package (Version 6.0 AutoPBPC) provides an operator-independent reliable source of mononuclear cells (MNC) for BDC preparation. Further, we observed that BDC might be recovered in high yields, often greater than 100% relative to the number of circulating BDC predicted by blood volume. An average of 66 million (range, 17-179) BDC per 10-l procedure were obtained, largely satisfying the needs for immunization. Higher yields were possible on total processed blood volumes of 15 l. BDC were not activated by the isolation procedure and, more importantly, both BDC subsets (CD11c(+)CD123(low) and CD11c(-)CD123(high)) were equally represented. Finally, we established that the apheresis product could be used for antibody-based BDC immunoselection and demonstrated that fully functional BDC can be obtained by this procedure.

  2. Spectra Optia granulocyte apheresis collections result in higher collection efficiency of viable, functional neutrophils in a randomized, crossover, multicenter trial.

    PubMed

    Cancelas, Jose A; Padmanabhan, Anand; Le, Tuan; Ambruso, Daniel R; Rugg, Neeta; Worsham, D Nicole; Pinkard, Susan L; Graminske, Sharon; Buck, Jennifer; Goldberg, Julie; Bill, Jerry

    2015-04-01

    Granulocyte transfusion from healthy donors is used in the treatment of patients with granulocyte function defects, or transient neutropenia and severe bacterial or fungal infections resistant to maximal antimicrobial treatment. This study evaluated the performance and safety of the newly developed granulocyte collection protocol of the Spectra Optia in a prospective, multicenter, open-label, randomized, paired crossover trial compared with the COBE Spectra apheresis system in a population of 32 evaluable healthy subjects. All subjects received granulocyte-colony-stimulating factor and dexamethasone before collection. Granulocyte procedures from Spectra Optia apheresis procedures had an approximately 23% higher polymorphonuclear (PMN) collection efficiency (CE) than the COBE Spectra collections (mean, 53.7% vs. 43.2%; p < 0.01), while the platelet CE (10.9% vs. 10.8%, respectively) and hematocrit (7.4% vs. 7.4%) were comparable between collections on both devices. Spectra Optia collections generated a higher total PMN yield per liter of blood processed than those produced by the COBE Spectra (with means of 8.6 × 10(10) vs. 6.8 × 10(10) , respectively). Granulocyte viability was more than 99% with both devices, and chemotaxic and bacterial killing activities of circulating versus collected granulocytes were similarly preserved. Fewer operator adjustments were required with Spectra Optia and there was no significant difference in the number or intensity of adverse events between instruments. CE of the granulocyte collection procedure with the Spectra Optia was approximately 10 percentage points higher than with the COBE Spectra, required less operator involvement, and is safe for clinical implementation. © 2014 AABB.

  3. Saponification equivalent of dasamula taila.

    PubMed

    Saxena, R B

    1994-07-01

    Saponification equivalent values of Dasamula taila are very useful for the technical and analytical work. It gives the mean molecular weight of the glycerides and acids present in Dasamula Taila. Saponification equivalent values of Dasamula taila are reported in different packings.

  4. Early-onset plasmapheresis and LDL-apheresis provide better disease control for pediatric homozygous familial hypercholesterolemia than HMG-CoA reductase inhibitors and ameliorate atherosclerosis.

    PubMed

    Dann, Eldad J; Shamir, Raanan; Mashiach, Tatiana; Shaoul, Ron; Badian, Alla; Stravets, Tselestina; Kerzman, Yelena; Finkelbaum, Svetlana; Gaitini, Diana; Lorber, Avraham; Bonstein, Lilach

    2013-10-01

    Plasmapheresis (PA) and low-density lipoprotein apheresis (LDL-A) were assessed in five children with homozygous familial hypercholesterolemia (HFH) previously receiving statins. LDL-A required smaller extracorporeal blood volumes. Mean HDL-cholesterol reduction post-procedure was 32% and 60% with LDL-A and PA, respectively. Non-HDL-C reduction was 64% and 69%, respectively. Pre-procedural LDL-C decreased significantly with weekly versus biweekly LDL-A. Carotid intimal media thickness (IMT) studies demonstrated disappearance of atheromatous lesions and normal ITM in 4/5 patients. Echocardiography revealed normal aortic valves, coronary orifices and supra-valvular area in all patients. Apheresis is effective in pediatric HFH. It may be started in patients weighing 14 kg.

  5. Psychotropic dose equivalence in Japan.

    PubMed

    Inada, Toshiya; Inagaki, Ataru

    2015-08-01

    Psychotropic dose equivalence is an important concept when estimating the approximate psychotropic doses patients receive, and deciding on the approximate titration dose when switching from one psychotropic agent to another. It is also useful from a research viewpoint when defining and extracting specific subgroups of subjects. Unification of various agents into a single standard agent facilitates easier analytical comparisons. On the basis of differences in psychopharmacological prescription features, those of available psychotropic agents and their approved doses, and racial differences between Japan and other countries, psychotropic dose equivalency tables designed specifically for Japanese patients have been widely used in Japan since 1998. Here we introduce dose equivalency tables for: (i) antipsychotics; (ii) antiparkinsonian agents; (iii) antidepressants; and (iv) anxiolytics, sedatives and hypnotics available in Japan. Equivalent doses for the therapeutic effects of individual psychotropic compounds were determined principally on the basis of randomized controlled trials conducted in Japan and consensus among dose equivalency tables reported previously by psychopharmacological experts. As these tables are intended to merely suggest approximate standard values, physicians should use them with discretion. Updated information of psychotropic dose equivalence in Japan is available at http://www.jsprs.org/en/equivalence.tables/. [Correction added on 8 July 2015, after first online publication: A link to the updated information has been added.].

  6. Equivalence between XY and dimerized models

    SciTech Connect

    Campos Venuti, Lorenzo; Roncaglia, Marco

    2010-06-15

    The spin-1/2 chain with XY anisotropic coupling in the plane and the XX isotropic dimerized chain are shown to be equivalent in the bulk. For finite systems, we prove that the equivalence is exact in given parity sectors, after taking care of the precise boundary conditions. The proof is given constructively by finding unitary transformations that map the models onto each other. Moreover, we considerably generalized our mapping and showed that even in the case of fully site-dependent couplings the XY chain can be mapped onto an XX model. This result has potential application in the study of disordered systems.

  7. Equivalent weight of humic acid from peat

    USGS Publications Warehouse

    Pommer, A.M.; Breger, I.A.

    1960-01-01

    By means of discontinuous titration, the equivalent weight of humic acid isolated from a peat was found to increase from 144 to 183 between the third and fifty-second day after the humic acid was dissolved. Infra-red studies showed that the material had probably condensed with loss of carbonyl groups. ?? 1960.

  8. Equivalence-Equivalence: Matching Stimuli with Same Discriminative Functions

    ERIC Educational Resources Information Center

    Carpentier, Franck; Smeets, Paul M.; Barnes-Holmes, Dermot

    2004-01-01

    Previous studies have shown that after being trained on A-B and A-C match-to-sample tasks, adults match not only same-class B and C stimuli (equivalence) but also BC compounds with same-class elements and with different-class elements (BC-BC). The assumption was that the BC-BC performances are based on matching equivalence and nonequivalence…

  9. Equivalence-Equivalence: Matching Stimuli with Same Discriminative Functions

    ERIC Educational Resources Information Center

    Carpentier, Franck; Smeets, Paul M.; Barnes-Holmes, Dermot

    2004-01-01

    Previous studies have shown that after being trained on A-B and A-C match-to-sample tasks, adults match not only same-class B and C stimuli (equivalence) but also BC compounds with same-class elements and with different-class elements (BC-BC). The assumption was that the BC-BC performances are based on matching equivalence and nonequivalence…

  10. Equivalence of Szegedy's and coined quantum walks

    NASA Astrophysics Data System (ADS)

    Wong, Thomas G.

    2017-09-01

    Szegedy's quantum walk is a quantization of a classical random walk or Markov chain, where the walk occurs on the edges of the bipartite double cover of the original graph. To search, one can simply quantize a Markov chain with absorbing vertices. Recently, Santos proposed two alternative search algorithms that instead utilize the sign-flip oracle in Grover's algorithm rather than absorbing vertices. In this paper, we show that these two algorithms are exactly equivalent to two algorithms involving coined quantum walks, which are walks on the vertices of the original graph with an internal degree of freedom. The first scheme is equivalent to a coined quantum walk with one walk step per query of Grover's oracle, and the second is equivalent to a coined quantum walk with two walk steps per query of Grover's oracle. These equivalences lie outside the previously known equivalence of Szegedy's quantum walk with absorbing vertices and the coined quantum walk with the negative identity operator as the coin for marked vertices, whose precise relationships we also investigate.

  11. System Equivalent for Real Time Digital Simulator

    NASA Astrophysics Data System (ADS)

    Lin, Xi

    2011-07-01

    The purpose of this research is to develop a method of making system equivalents for the Real Time Digital Simulator (RTDS), which should enhance its capability of simulating large power systems. The proposed equivalent combines a Frequency Dependent Network Equivalent (FDNE) for the high frequency electromagnetic transients and a Transient Stability Analysis (TSA) type simulation block for the electromechanical transients. The frequency dependent characteristic for FDNE is obtained by curve-fitting frequency domain admittance characteristics using the Vector Fitting method. An approach for approximating the frequency dependent characteristic of large power networks from readily available typical power-flow data is also introduced. A new scheme of incorporating TSA solution in RTDS is proposed. This report shows how the TSA algorithm can be adapted to a real time platform. The validity of this method is confirmed with examples, including the study of a multi in-feed HVDC system based network.

  12. Morita equivalence of noncommutative supertori

    NASA Astrophysics Data System (ADS)

    Chang-Young, Ee; Kim, Hoil; Nakajima, Hiroaki

    2010-06-01

    In this paper we study the extension of Morita equivalence of noncommutative tori to the supersymmetric case. The structure of the symmetry group yielding Morita equivalence appears to be intact but its parameter field becomes supersymmetrized having both body and soul parts. Our result is mainly in the two dimensional case in which noncommutative supertori have been constructed recently: The group SO(2,2,VZ0), where VZ0 denotes Grassmann even number whose body part belongs to Z, yields Morita equivalent noncommutative supertori in two dimensions.

  13. Morita equivalence of noncommutative supertori

    SciTech Connect

    Chang-Young, Ee; Kim, Hoil; Nakajima, Hiroaki

    2010-06-15

    In this paper we study the extension of Morita equivalence of noncommutative tori to the supersymmetric case. The structure of the symmetry group yielding Morita equivalence appears to be intact but its parameter field becomes supersymmetrized having both body and soul parts. Our result is mainly in the two dimensional case in which noncommutative supertori have been constructed recently: The group SO(2,2,V{sub Z}{sup 0}), where V{sub Z}{sup 0} denotes Grassmann even number whose body part belongs to Z, yields Morita equivalent noncommutative supertori in two dimensions.

  14. Tissue Engineered Human Skin Equivalents

    PubMed Central

    Zhang, Zheng; Michniak-Kohn, Bozena B.

    2012-01-01

    Human skin not only serves as an important barrier against the penetration of exogenous substances into the body, but also provides a potential avenue for the transport of functional active drugs/reagents/ingredients into the skin (topical delivery) and/or the body (transdermal delivery). In the past three decades, research and development in human skin equivalents have advanced in parallel with those in tissue engineering and regenerative medicine. The human skin equivalents are used commercially as clinical skin substitutes and as models for permeation and toxicity screening. Several academic laboratories have developed their own human skin equivalent models and applied these models for studying skin permeation, corrosivity and irritation, compound toxicity, biochemistry, metabolism and cellular pharmacology. Various aspects of the state of the art of human skin equivalents are reviewed and discussed. PMID:24300178

  15. Optical metrics and projective equivalence

    SciTech Connect

    Casey, Stephen; Dunajski, Maciej; Gibbons, Gary; Warnick, Claude

    2011-04-15

    Trajectories of light rays in a static spacetime are described by unparametrized geodesics of the Riemannian optical metric associated with the Lorentzian spacetime metric. We investigate the uniqueness of this structure and demonstrate that two different observers, moving relative to one another, who both see the Universe as static may determine the geometry of the light rays differently. More specifically, we classify Lorentzian metrics admitting more than one hyper-surface orthogonal timelike Killing vector and analyze the projective equivalence of the resulting optical metrics. These metrics are shown to be projectively equivalent up to diffeomorphism if the static Killing vectors generate a group SL(2,R), but not projectively equivalent in general. We also consider the cosmological C metrics in Einstein-Maxwell theory and demonstrate that optical metrics corresponding to different values of the cosmological constant are projectively equivalent.

  16. Equivalent magnetization over the World Ocean

    NASA Astrophysics Data System (ADS)

    Dyment, J.; Hamoudi, M.; Choi, Y.; Thebault, E.; Quesnel, Y.; Roest, W. R.; Lesur, V.

    2012-12-01

    , the Mid-Atlantic Ridge displays a more uniform signature, although off-axis variations seem associated to the Tristan and St Helena hotspots. In the Indian Ocean, a strong equivalent magnetization characterizes areas of hotspot-ridge interaction such as the Gulf of Aden, the Central Indian Ridge near Rodrigues Island, the Southwest Indian Ridge near Marion Island, and the Southeast Indian Ridge near St Paul and Amsterdam Islands. A weaker one is observed in colder area, at the Australian-Antarctic Discordance and around the Rodrigues Triple Junction. The Pacific Ocean is characterized by a generally stronger equivalent magnetization, both near ridges and in abyssal plains. Time variations, i.e. along seafloor spreading flowlines, are apparent across the Mid-Atlantic and Pacific-Antarctic ridges, with highs near the ridge axis (younger than 10 Ma) and between ~83 and 60 Ma, just after the Cretaceous Normal Superchron and lows between ~60 and 10 Ma. The Mesozoic basins of the Pacific and Atlantic oceans show a weaker equivalent magnetization before ~155 Ma and a stronger one after. Basins covered by thick sediments such as the Bengal Bay, Great Australian Bight, Nova Scotia Basin, and Western Somali Basin show a very weak equivalent magnetization, reflecting both a deeper basement and a possible thermal demagnetization. Some of these variations coincide with satellite magnetic anomalies.

  17. Quantum mechanics from an equivalence principle

    SciTech Connect

    Faraggi, A.E.; Matone, M.

    1997-05-15

    The authors show that requiring diffeomorphic equivalence for one-dimensional stationary states implies that the reduced action S{sub 0} satisfies the quantum Hamilton-Jacobi equation with the Planck constant playing the role of a covariantizing parameter. The construction shows the existence of a fundamental initial condition which is strictly related to the Moebius symmetry of the Legendre transform and to its involutive character. The universal nature of the initial condition implies the Schroedinger equation in any dimension.

  18. Equivalent damage: A critical assessment

    NASA Technical Reports Server (NTRS)

    Laflen, J. R.; Cook, T. S.

    1982-01-01

    Concepts in equivalent damage were evaluated to determine their applicability to the life prediction of hot path components of aircraft gas turbine engines. Equivalent damage was defined as being those effects which influence the crack initiation life-time beyond the damage that is measured in uniaxial, fully-reversed sinusoidal and isothermal experiments at low homologous temperatures. Three areas of equivalent damage were examined: mean stress, cumulative damage, and multiaxiality. For each area, a literature survey was conducted to aid in selecting the most appropriate theories. Where possible, data correlations were also used in the evaluation process. A set of criteria was developed for ranking the theories in each equivalent damage regime. These criteria considered aspects of engine utilization as well as the theoretical basis and correlative ability of each theory. In addition, consideration was given to the complex nature of the loading cycle at fatigue critical locations of hot path components; this loading includes non-proportional multiaxial stressing, combined temperature and strain fluctuations, and general creep-fatigue interactions. Through applications of selected equivalent damage theories to some suitable data sets it was found that there is insufficient data to allow specific recommendations of preferred theories for general applications. A series of experiments and areas of further investigations were identified.

  19. Visual Equivalence and Amodal Completion in Cuttlefish.

    PubMed

    Lin, I-Rong; Chiao, Chuan-Chin

    2017-01-01

    Modern cephalopods are notably the most intelligent invertebrates and this is accompanied by keen vision. Despite extensive studies investigating the visual systems of cephalopods, little is known about their visual perception and object recognition. In the present study, we investigated the visual processing of the cuttlefish Sepia pharaonis, including visual equivalence and amodal completion. Cuttlefish were trained to discriminate images of shrimp and fish using the operant conditioning paradigm. After cuttlefish reached the learning criteria, a series of discrimination tasks were conducted. In the visual equivalence experiment, several transformed versions of the training images, such as images reduced in size, images reduced in contrast, sketches of the images, the contours of the images, and silhouettes of the images, were used. In the amodal completion experiment, partially occluded views of the original images were used. The results showed that cuttlefish were able to treat the training images of reduced size and sketches as the visual equivalence. Cuttlefish were also capable of recognizing partially occluded versions of the training image. Furthermore, individual differences in performance suggest that some cuttlefish may be able to recognize objects when visual information was partly removed. These findings support the hypothesis that the visual perception of cuttlefish involves both visual equivalence and amodal completion. The results from this research also provide insights into the visual processing mechanisms used by cephalopods.

  20. Visual Equivalence and Amodal Completion in Cuttlefish

    PubMed Central

    Lin, I-Rong; Chiao, Chuan-Chin

    2017-01-01

    Modern cephalopods are notably the most intelligent invertebrates and this is accompanied by keen vision. Despite extensive studies investigating the visual systems of cephalopods, little is known about their visual perception and object recognition. In the present study, we investigated the visual processing of the cuttlefish Sepia pharaonis, including visual equivalence and amodal completion. Cuttlefish were trained to discriminate images of shrimp and fish using the operant conditioning paradigm. After cuttlefish reached the learning criteria, a series of discrimination tasks were conducted. In the visual equivalence experiment, several transformed versions of the training images, such as images reduced in size, images reduced in contrast, sketches of the images, the contours of the images, and silhouettes of the images, were used. In the amodal completion experiment, partially occluded views of the original images were used. The results showed that cuttlefish were able to treat the training images of reduced size and sketches as the visual equivalence. Cuttlefish were also capable of recognizing partially occluded versions of the training image. Furthermore, individual differences in performance suggest that some cuttlefish may be able to recognize objects when visual information was partly removed. These findings support the hypothesis that the visual perception of cuttlefish involves both visual equivalence and amodal completion. The results from this research also provide insights into the visual processing mechanisms used by cephalopods. PMID:28220075

  1. Equivalent probability density moments determine equivalent epidemics in an SIRS model with temporary immunity.

    PubMed

    Carr, Thomas W

    2017-02-01

    In an SIRS compartment model for a disease we consider the effect of different probability distributions for remaining immune. We show that to first approximation the first three moments of the corresponding probability densities are sufficient to well describe oscillatory solutions corresponding to recurrent epidemics. Specifically, increasing the fraction who lose immunity, increasing the mean immunity time, and decreasing the heterogeneity of the population all favor the onset of epidemics and increase their severity. We consider six different distributions, some symmetric about their mean and some asymmetric, and show that by tuning their parameters such that they have equivalent moments that they all exhibit equivalent dynamical behavior.

  2. National Institutes of Health State of the Science Symposium in Therapeutic Apheresis: scientific opportunities in extracorporeal photopheresis.

    PubMed

    Ratcliffe, Nora; Dunbar, Nancy M; Adamski, Jill; Couriel, Daniel; Edelson, Richard; Kitko, Carrie L; Levine, John E; Morgan, Shanna; Schneiderman, Jennifer; Sloan, Steve; Wu, Yanyun; Szczepiorkowski, Zbigniew M; Cooling, Laura

    2015-01-01

    The clinical use of extracorporeal photopheresis (ECP) for accepted indications such as graft-versus-host disease, transplant rejection, and cutaneous T-cell lymphoma continues to increase. Expanded applications for ECP, such as the treatment of select autoimmune diseases, are being explored. Extracorporeal photopheresis's capacity to both immunotolerize in the autoreactive setting, while immunizing against a lymphoma is unusual and suggestive of a unique mechanism. It is likely that ECP's induction of dendritic cells is key to its efficacy in both of these settings, but exactly how ECP impacts other immune components and their interactions is not fully understood. Further basic science research is necessary to elucidate how these dissimilar cellular activities are functionally integrated. On the clinical side, collaborative multicenter trials designed to recognize the principal variables controlling therapeutic responses and improve prognostic indicators may enable tailoring devices, treatment schedules, and doses to the needs of the individual patients or diseases. This review describes our current understanding of how ECP influences the immune system, reviews the existing clinical applications of ECP, and explores areas for future basic science and clinical research as presented at the National Institutes of Health State of the Science Symposium in Therapeutic Apheresis in November 2012. Published by Elsevier Inc.

  3. Comparison between the clinical efficacy of platelet concentrates, derived from buffy coat and apheresis in tumor patients.

    PubMed

    Hao, Baolan; Wang, Yan; Zhou, Jian; Shao, Shujun; Dong, Xiaofeng

    2017-08-01

    The aim of the present study was to evaluate the clinical efficacy between manual buffy coat-derived platelet concentrates (PCs) and automated apheresis platelet concentrates (APCs) in terms of their therapeutic effects. The corrected count increment (CCI) was calculated according to detected differences in platelet concentration in patients who underwent transfusion of APCs, prepared by an automated system (group I, 72 cases) or PCs derived from buffy coat by manual method (group II, 83 cases). The clinical efficacy was assessed in terms of the CCI and clinical symptoms. The platelet contents of all the PCs were detected before transfusion. The mean 1 h CCI was 13.56±4.45 and 24 h CCI was 8.67±4.21 in group I, while the mean 1 h CCI was 15.83±4.65 and 24 h CCI was 9.57±3.36 in group II. The effective rates judged by CCI for groups I and II were 53 and 64%, respectively, and those judged by clinical symptoms were 67 and 60%, respectively. In conclusion, the clinical effectiveness of manual PCs was similar to that for APCs; thus, it could be utilized for clinical use.

  4. Red blood cell exchange: 2015 American Society for Apheresis consensus conference on the management of patients with sickle cell disease.

    PubMed

    Sarode, Ravi; Ballas, Samir K; Garcia, Alicia; Kim, Haewon C; King, Karen; Sachais, Bruce; Williams, Lance A

    2016-10-09

    The American Society for Apheresis (ASFA) conducted a one-day consensus conference on red blood cell exchange (RBCx) in sickle cell disease (SCD) during its annual meeting in San Antonio, TX, on May 5, 2015. The authors of this article, a subcommittee of ASFA's Clinical Applications Committee, developed several questions with regard to pathophysiology of SCD and use of RBCx in the management of various complications. These questions were provided to the seven invited speakers who are the experts in the field of SCD. Two experts in the field moderated the proceedings of the conference, which was attended by more than 150 participants. After each presentation, there was a summary of the main points by the moderators and an open discussion with questions from the audience. A video recording of the proceedings, as well as each presentation, was made available to the authors. Each author's summary was reviewed and approved by the respective speaker before submission of this manuscript. The subcommittee also developed several key questions to generate a consensus amongst the speakers on key issues for using RBCx for patients with SCD.

  5. Efficacy of a Novel Granulocyte Monocyte Apheresis Adsorber Device in the Treatment of Inflammatory Bowel Diseases: A Pilot Study.

    PubMed

    Di Girolamo, Maria; Sartini, Alessandro; Critelli, Rosina; Bertani, Angela; Merighi, Alberto; Villa, Erica

    2016-12-01

    Granulocyte monocyte apheresis (GMA) is a non-pharmacological treatment for inflammatory bowel disease. In our study, we tested a novel GMA adsorber device in terms of clinical efficacy and safety in patients' non-response to pharmacological therapy. Secondary outcomes were the evaluation of adsorber's technical performance, the reduction of inflammatory markers and the improvement of patients' life quality. The prospective study included 18 patients enrolled from 2011 to 2012 with a monitoring of 48 weeks. All patients with Crohn's disease achieved a clinical remission after GMA treatments, sustained until the end of follow up, while 80% of ulcerative colitis patients obtained a clinical benefit, maintained after 48 weeks of monitoring. Leukocytes, neutrophils, monocytes and platelets, compared to erythrocytes and lymphocytes, were effectively removed from peripheral blood. There was no statistically significant result about serological markers of inflammation. A consistent improvement of the patients' quality of life was observed up to the end of follow up. No significant side-effects were recorded. Our study underlines the efficacy and the safety of this novel GMA adsorber device; a prospective randomized clinical trial with adequate sample size should be performed.

  6. Response of a tissue equivalent proportional counter to neutrons

    NASA Technical Reports Server (NTRS)

    Badhwar, G. D.; Robbins, D. E.; Gibbons, F.; Braby, L. A.

    2002-01-01

    The absorbed dose as a function of lineal energy was measured at the CERN-EC Reference-field Facility (CERF) using a 512-channel tissue equivalent proportional counter (TEPC), and neutron dose equivalent response evaluated. Although there are some differences, the measured dose equivalent is in agreement with that measured by the 16-channel HANDI tissue equivalent counter. Comparison of TEPC measurements with those made by a silicon solid-state detector for low linear energy transfer particles produced by the same beam, is presented. The measurements show that about 4% of dose equivalent is delivered by particles heavier than protons generated in the conducting tissue equivalent plastic. c2002 Elsevier Science Ltd. All rights reserved.

  7. Response of a tissue equivalent proportional counter to neutrons

    NASA Technical Reports Server (NTRS)

    Badhwar, G. D.; Robbins, D. E.; Gibbons, F.; Braby, L. A.

    2002-01-01

    The absorbed dose as a function of lineal energy was measured at the CERN-EC Reference-field Facility (CERF) using a 512-channel tissue equivalent proportional counter (TEPC), and neutron dose equivalent response evaluated. Although there are some differences, the measured dose equivalent is in agreement with that measured by the 16-channel HANDI tissue equivalent counter. Comparison of TEPC measurements with those made by a silicon solid-state detector for low linear energy transfer particles produced by the same beam, is presented. The measurements show that about 4% of dose equivalent is delivered by particles heavier than protons generated in the conducting tissue equivalent plastic. c2002 Elsevier Science Ltd. All rights reserved.

  8. Estimating Equivalency of Explosives Through A Thermochemical Approach

    SciTech Connect

    Maienschein, J L

    2002-07-08

    The Cheetah thermochemical computer code provides an accurate method for estimating the TNT equivalency of any explosive, evaluated either with respect to peak pressure or the quasi-static pressure at long time in a confined volume. Cheetah calculates the detonation energy and heat of combustion for virtually any explosive (pure or formulation). Comparing the detonation energy for an explosive with that of TNT allows estimation of the TNT equivalency with respect to peak pressure, while comparison of the heat of combustion allows estimation of TNT equivalency with respect to quasi-static pressure. We discuss the methodology, present results for many explosives, and show comparisons with equivalency data from other sources.

  9. Multiple Functions in Equivalence Classes

    ERIC Educational Resources Information Center

    McVeigh, Brian; Keenan, Mickey

    2009-01-01

    Four experiments examined the effects of training a "drawing" response to each of three stimuli in a 5-member equivalence class. In Experiment 1 the stimuli were an arbitrary word, a shape, or a mathematical symbol. Subjects then were trained to draw a separate component of a stickman at each of the 3 stimuli. Subsequent tests for function…

  10. The structure of equivalence classes

    PubMed Central

    Fields, Lanny; Verhave, Thom

    1987-01-01

    The structure of equivalence classes can be completely described by four parameters: class size, number of nodes, the distribution of “singles” among nodes, and directionality of training. Class size refers to the number of stimuli in a class. Nodes are stimuli linked by training to at least two other stimuli. Singles are stimuli linked by training to only one other stimulus. The distribution of singles refers to the number of singles linked by training to each node. Directionality of training refers to the use of stimuli as samples and as comparison stimuli in training. These four parameters define the different ways in which the stimuli in a class can be organized, and thus provide a basis for systematically characterizing the properties of stimuli in a given equivalence class. The four parameters can also be used to account for the development of individual differences that are commonly characterized in terms of “understanding” and connotative meaning. Methods are described for generating all possible combinations of parameter values, and a formula is introduced which specifies all of the parameter values for an equivalence class. Its utility for interrelating experimental procedures is demonstrated by analyzing a number of representative experiments that have addressed equivalence-class formation. PMID:16812494

  11. Adult Nonconservation of Numerical Equivalence.

    ERIC Educational Resources Information Center

    Murray, Frank B.; Armstrong, Sharon L.

    A conservation problem of numerical equivalence which 80% of adults reliably fail and 40% of third graders pass was developed, and responses of 188 subjects (Grades 2, 3, 5, 7, 9, 11 and college) to it and related number conservation and probability problems indicated that the differences in nonconservation were rooted in subjects' different…

  12. USEPA PATHOGEN EQUIVALENCY COMMITTEE RETREAT

    EPA Science Inventory

    The Pathogen Equivalency Committee held its retreat from September 20-21, 2005 at Hueston Woods State Park in College Corner, Ohio. This presentation will update the PEC’s membership on emerging pathogens, analytical methods, disinfection techniques, risk analysis, preparat...

  13. Expanding the Interaction Equivalency Theorem

    ERIC Educational Resources Information Center

    Rodriguez, Brenda Cecilia Padilla; Armellini, Alejandro

    2015-01-01

    Although interaction is recognised as a key element for learning, its incorporation in online courses can be challenging. The interaction equivalency theorem provides guidelines: Meaningful learning can be supported as long as one of three types of interactions (learner-content, learner-teacher and learner-learner) is present at a high level. This…

  14. Children's Equivalence Judgments: Crossmapping Effects

    ERIC Educational Resources Information Center

    Mix, Kelly S.

    2008-01-01

    Preschoolers made numerical comparisons between sets with varying degrees of shared surface similarity. When surface similarity was pitted against numerical equivalence (i.e., crossmapping), children made fewer number matches than when surface similarity was neutral (i.e, all sets contained the same objects). Only children who understood the…

  15. Equivalent Linear Logistic Test Models.

    ERIC Educational Resources Information Center

    Bechger, Timo M.; Verstralen, Huub H. F. M.; Verhelst, Norma D.

    2002-01-01

    Discusses the Linear Logistic Test Model (LLTM) and demonstrates that there are many equivalent ways to specify a model. Analyzed a real data set (300 responses to 5 analogies) using a Lagrange multiplier test for the specification of the model, and demonstrated that there may be many ways to change the specification of an LLTM and achieve the…

  16. USEPA PATHOGEN EQUIVALENCY COMMITTEE RETREAT

    EPA Science Inventory

    The Pathogen Equivalency Committee held its retreat from September 20-21, 2005 at Hueston Woods State Park in College Corner, Ohio. This presentation will update the PEC’s membership on emerging pathogens, analytical methods, disinfection techniques, risk analysis, preparat...

  17. Acquired Equivalence Changes Stimulus Representations

    ERIC Educational Resources Information Center

    Meeter, M.; Shohamy, D.; Myers, C. E.

    2009-01-01

    Acquired equivalence is a paradigm in which generalization is increased between two superficially dissimilar stimuli (or antecedents) that have previously been associated with similar outcomes (or consequents). Several possible mechanisms have been proposed, including changes in stimulus representations, either in the form of added associations or…

  18. Representational Implications for Understanding Equivalence

    ERIC Educational Resources Information Center

    Capraro, Mary Margaret; Ding, Meixia; Matteson, Shirley; Capraro, Robert M.; Li, Xiaobao

    2007-01-01

    Teachers and researchers have long recognized that students tend to misunderstand the equal sign as an operator; that is, a signal for "doing something" rather than a relational symbol of equivalence or quantity sameness. Students' equal sign misconception has been researched for more than thirty years (Weaver, 1971, 1973) with little…

  19. Equivalence theorem in effective theories

    NASA Astrophysics Data System (ADS)

    Chicherin, D.; Gorbenko, V.; Vereshagin, V.

    2011-11-01

    The famous equivalence theorem is reexamined in order to make it applicable to the case of effective theories. We slightly modify the formulation of this theorem and prove it based on the notion of the generating functional for Green functions. This allows one to trace (directly in terms of graphs) the mutual cancellation of different groups of contributions.

  20. Theoretical equivalence in classical mechanics and its relationship to duality

    NASA Astrophysics Data System (ADS)

    Teh, Nicholas J.; Tsementzis, Dimitris

    2017-08-01

    As a prolegomenon to understanding the sense in which dualities are theoretical equivalences, we investigate the intuitive 'equivalence' of hyper-regular Lagrangian and Hamiltonian classical mechanics. We show that the symplectification of these theories (via Tulczyjew's Triple) provides a sense in which they are (1) isomorphic, and (2) mutually and canonically definable through an analog of 'common definitional extension'.

  1. Equivalence Class Formation: A Method for Teaching Statistical Interactions

    ERIC Educational Resources Information Center

    Fields, Lanny; Travis, Robert; Roy, Deborah; Yadlovker, Eytan; de Aguiar-Rocha, Liliane; Sturmey, Peter

    2009-01-01

    Many students struggle with statistical concepts such as interaction. In an experimental group, participants took a paper-and-pencil test and then were given training to establish equivalent classes containing four different statistical interactions. All participants formed the equivalence classes and showed maintenance when probes contained novel…

  2. Underlining some aspects of the equivalence principle

    NASA Astrophysics Data System (ADS)

    Benedetto, E.; Feoli, A.

    2017-09-01

    We want to shed light on some discussed aspects of the principle of equivalence. We consider two different phases in the evolution of the principle. We pay attention to the fact that some textbooks do not dwell on the mathematical meaning of ‘locally flat spacetime’, which can confuse students and, occasionally, can also lead to misinterpretations. For example, the non-eliminability of tidal forces, not even locally, may suggest that the equivalence principle is wrong. By contrast, we want to show that this is in perfect agreement with the Einstein geometrical interpretation of spacetime. Finally, in order to check the approximations used in the Gedankenexperiment of an elevator, we estimate explicitly the magnitude of the deflection of light and the effects of tidal forces in a ‘real lift’.

  3. Explosive materials equivalency, test methods and evaluation

    NASA Technical Reports Server (NTRS)

    Koger, D. M.; Mcintyre, F. L.

    1980-01-01

    Attention is given to concepts of explosive equivalency of energetic materials based on specific airblast parameters. A description is provided of a wide bandwidth high accuracy instrumentation system which has been used extensively in obtaining pressure time profiles of energetic materials. The object of the considered test method is to determine the maximum output from the detonation of explosive materials in terms of airblast overpressure and positive impulse. The measured pressure and impulse values are compared with known characteristics of hemispherical TNT data to determine the equivalency of the test material in relation to TNT. An investigation shows that meaningful comparisons between various explosives and a standard reference material such as TNT should be based upon the same parameters. The tests should be conducted under the same conditions.

  4. Symmetry and equivalence in Szekeres models

    NASA Astrophysics Data System (ADS)

    Georg, Ira; Hellaby, Charles

    2017-06-01

    We solve for all Szekeres metrics that have a single Killing vector. For quasihyperboloidal (ɛ =-1 ) metrics, we find that translational symmetries are possible, but only in metrics that have shell crossings somewhere, while metrics that can be made free of shell crossings only permit rotations. The quasiplanar metrics (ɛ =0 ) either have no Killing vectors, or they admit full planar symmetry. Single symmetries in quasispherical metrics (ɛ =+1 ) are all rotations. The rotations correspond to a known family of axially symmetric metrics, which for each ɛ value, are equivalent to each other. We consider Szekeres metrics in which the line of dipole extrema is required to be geodesic in the 3-space and show the same set of families emerges. We investigate when two Szekeres metrics are physically equivalent and complete a previous list of transformations of the arbitrary functions.

  5. Early storage lesions in apheresis platelets are induced by the activation of the integrin αIIbβ₃ and focal adhesion signaling pathways.

    PubMed

    Thiele, Thomas; Iuga, Cristina; Janetzky, Susann; Schwertz, Hansjorg; Gesell Salazar, Manuela; Fürll, Birgit; Völker, Uwe; Greinacher, Andreas; Steil, Leif

    2012-12-05

    Production and storage of platelet concentrates (PC) induce protein changes in platelets leading to impaired platelet function. This study aimed to identify signaling pathways involved in the development of early platelet storage lesions in apheresis-PCs stored in plasma or additive solution (PAS). Apheresis-PCs from four donors were stored in plasma or in PAS at 22°C (n=4 each). Platelets were analyzed at day 0 (production day) and after 1, 6 and 9 days of storage. Platelet response to agonists (TRAP, collagen, ADP) and to hypotonic shock decreased, CD62P expression increased in both storage media over time. Using DIGE 1550 protein spots were monitored and compared to baseline values at day 0. Platelets in plasma displayed changes in 352 spots (166/day 1, 263/day 6 and 201/day 9); in PAS 325 spots changed (202/day 1, 221/day 6, 200/day 9). LC-ESI-MS/MS analysis of 405 platelet proteins revealed 32 proteins changed during storage in plasma (9/day 1, 15/day 6 and 26/day 9) and 28 in PAS (5/day 1, 20/day 6, 26/day 9). Ingenuity pathway analysis found integrin-αII(b)β(3) and focal adhesion signaling pathways involved in early alterations, being confirmed by Western blotting. Corresponding mRNAs in platelets were identified by next generation sequencing for 84 changed proteins. Integrin-αII(b)β(3) and focal adhesion signaling cause irreversible early storage lesions in apheresis platelets. This article is part of a Special Issue entitled: Integrated omics.

  6. Dextran-sulfate-adsorption of atherosclerotic lipoproteins from whole blood or separated plasma for lipid-apheresis--comparison of performance characteristics with DALI and Lipidfiltration.

    PubMed

    Julius, Ulrich; Parhofer, Klaus G; Heibges, Andreas; Kurz, Stefan; Klingel, Reinhard; Geiss, Hans-Christian

    2007-01-01

    For many years dextran sulfate adsorption (DSA) treatment of separated plasma has been an established technology for low-density lipoprotein (LDL)-elimination. Recently a system for the treatment of whole blood based on DSA was introduced into clinical practice. To further characterize DSA treatment of whole blood, the performance characteristics of both DSA modalities were compared at two investigational sites with two alternative LDL apheresis systems being already in routine clinical use. In prospective cross-over design, DSA whole blood treatment was compared with a whole blood polyacrylate LDL adsorption system (DALI) in one study group. DSA for plasma treatment was compared with Lipidfiltration in cross-over design in a second study group. In total, 12 patients on chronic LDL apheresis received 169 treatments. Six patients were treated twice with whole blood polyacrylate adsorption and twice with whole blood DSA. LDL-cholesterol (74.9-78.0%) and lipoprotein (a) (72.1-73.3%) were reduced by both with equal efficacy. DSA achieved a significantly higher reduction rate of fibrinogen. Another six patients were treated eight times with DSA plasma adsorption followed by 16 Lipidfiltration treatments. LDL-cholesterol (67.0-70.2%) and lipoprotein (a) (69.2-73.7%) were reduced by both with equal efficacy. Fibrinogen was eliminated more efficiently by Lipidfiltration (50.2 vs. 38.5%). DSA proved to be a safe and effective in both treatment modes, for plasma as well as for whole blood. At the discretion of the apheresis specialist, depending upon the status of national approval, DSA of whole blood complements the armamentarium of powerful modalities for extracorporeal elimination of atherosclerotic lipoproteins to meet specific individual, medical, or logistic needs.

  7. Direct adsorption of low-density lipoprotein and lipoprotein(a) from whole blood: results of the first clinical long-term multicenter study using DALI apheresis.

    PubMed

    Bosch, T; Lennertz, A; Schenzle, D; Dräger, J

    2002-01-01

    Direct adsorption of lipoproteins (DALI) is the first low-density lipoprotein (LDL)-apheresis technique by which atherogenic LDL and lipoprotein(a) (Lp(a)) can be selectively removed from whole blood without plasma separation. The present study was performed to evaluate the efficacy, selectivity and safety of long-term DALI apheresis. Sixty-three hypercholesterolemic coronary patients were treated by weekly DALI sessions. Initial LDL-cholesterol (C) plasma levels averaged 238 +/- 87 mg/dl (range 130-681 mg/dl). On average, 34 sessions (1-45) were performed processing 1.5 patient blood volumes. The primary aim was to acutely reduce LDL-C by >or=60% per session. To this end, three different adsorber sizes could be employed, i.e., DALI 500, 750, and 1000, which were used in 4, 73, and 23% of the 2156 sessions, respectively. On average, 7387 ml of blood were processed in 116 min per session. This resulted in the following mean acute changes: LDL-C 198 --> 63 mg/dl (-69%), Lp(a) 86 --> 32 mg/dl (-64%), triglycerides 185 --> 136 mg/dl (-27%). HDL-C (-11%) and fibrinogen (-15%) were not significantly influenced. The mean long-term reduction of LDL-C was 42% compared to baseline while HDL-C slightly increased in the long run (+4%). The selectivity of LDL removal was good as recoveries of albumin, immunoglobulins, and other proteins exceeded 85%. Ninety-five percent of 2156 sessions were completely uneventful. The most frequent adverse effects were hypotension (1.2% of sessions) and paresthesia (1.1%), which were probably due to citrate anticoagulation. Access problems had to be overcome in 1.5%, adsorber and hardware problems in 0.5% of the sessions. In this multicenter long-term study, DALI apheresis proved to be an efficient, safe, and easy procedure for extracorporeal LDL and Lp(a) elimination.

  8. Direct adsorption of low-density lipoprotein by DALI-LDL-apheresis: results of a prospective long-term multicenter follow-up covering 12,291 sessions.

    PubMed

    Bosch, Thomas; Gahr, Simon; Belschner, Ulrike; Schaefer, Claudia; Lennertz, Andrea; Rammo, Jörg

    2006-06-01

    Direct adsorption of lipoproteins (DALI) is the first low density lipoprotein (LDL)-apheresis technology by which atherogenic LDL and lipoprotein(a) (Lp(a)) can be selectively removed from whole blood without plasma separation. The present follow-up was carried out to evaluate the clinical efficacy, selectivity and safety of long-term DALI apheresis. The follow-up was carried out in an open, prospective uncontrolled multicenter clinical design. Included were 158 drug-resistant hypercholesterolemic patients from 28 apheresis centers. These patients underwent 12 291 DALI sessions between January 1997 and March 2002. The patients suffered from severe atherosclerosis and their mean LDL-C was 188 mg/dL before the sessions. Mean follow-up was 25 +/- 16 (range 1-56) months during which 78 +/- 53 sessions were carried out. In most treatments, DALI 750 (63%) or DALI 1000 (30%) adsorbers were used. On average, 7423 +/- 1495 mL blood was processed at a flow rate of 84 +/- 16 mL/min in 102 +/- 25 min. Acute reductions by the single DALI sessions averaged 69 +/- 12% for LDL-C, 41 +/- 18% for TG, 15 +/- 10% for HDL-C, 19 +/- 11% for fibrinogen and 62 +/- 24% for Lp(a) (in patients with Lp(a) > 30 mg/dL). Adverse events were recorded in only 3.9% of the sessions. In this 5-year follow-up, long-term therapy with DALI was safe, effective and selective as LDL-C and Lp(a) could be reduced by >60% per session in approximately 100 min treatment time while HDL-C decrease and the incidence of AE were low.

  9. Incidence and clinical significance of cardiac biomarker elevation during stem cell mobilization, apheresis, and intramyocardial delivery: an analysis from ACT34-CMI.

    PubMed

    Povsic, Thomas J; Losordo, Douglas W; Story, Kenneth; Junge, Candice E; Schatz, Richard A; Harrington, Robert A; Henry, Timothy D

    2012-11-01

    Cell therapy is a promising therapeutic for a variety of cardiovascular conditions including refractory angina. Elevation of cardiac biomarkers during cell delivery has been frequently described, but the clinical implications have never been studied. ACT34-CMI was a randomized double-blind study assessing the use of intramyocardial delivery of autologous CD34(+) cells for the treatment of refractory angina. Patients (n = 167) underwent G-CSF-mediated (5 μg/[kg day] × 5 days) stem cell mobilization, apheresis, and intramyocardial injection of 1 × 10(5)/kg or 5 × 10(5)/kg CD34(+) cells or placebo. Troponin and creatinine kinase MB were assessed at baseline (n = 161), after cell mobilization and apheresis (n = 153 and 143, respectively), and post-intramyocardial injection (n = 155 and 141, respectively). Major adverse cardiac events (MACE) included death, myocardial infarction, acute congestive heart failure, urgent revascularization, or sustained ventricular arrhythmia. Seven (4.3%) subjects had troponin above the upper limits of normal (ULN) at baseline. Thirty-four (22.2%) and 11 (7.2%) subjects had troponin levels > ULN or >3× ULN after cell mobilization and apheresis, whereas 72 (46.1%) and 39 (25.2%) subjects had troponin elevations > ULN or >3× ULN, respectively, after intramyocardial injections. Age, but no other preprocedural factors, was predictive of troponin elevation. Periprocedural troponin elevation was not associated with an increased risk of MACE during 1 year, especially in cell therapy-treated patients. Troponin elevation is common during stem cell harvesting and intramyocardial administration, is usually asymptomatic, and does not appear to be associated with long-term MACE in subjects undergoing stem cell mobilization and intramyocardial injection. Copyright © 2012 Mosby, Inc. All rights reserved.

  10. Familial hypercholesterolemia and estimation of US patients eligible for low-density lipoprotein apheresis after maximally tolerated lipid-lowering therapy.

    PubMed

    Vishwanath, Raghu; Hemphill, Linda C

    2014-01-01

    Familial hypercholesterolemia (FH), an autosomal-dominant inherited disorder, can occur in either the heterozygous (HeFH) or homozygous (HoFH) state, and is characterized by high levels of serum low-density lipoprotein cholesterol (LDL-C). Although potent statins and maximally tolerated lipid-lowering therapy (LLT) have greatly reduced the risk of premature coronary heart disease (CHD) and death, all patients with HoFH and many with severe HeFH remain far from treatment goals and are thus at risk of cardiovascular disease. LDL apheresis is the treatment of choice for these patients but remains underutilized. No formal studies or epidemiologic data have estimated the prevalence of HoFH. An HeFH prevalence of 1:500 and a simplified Hardy-Weinberg equilibrium model was used to determine the probability of finding HoFH as 1:1 million in the general population. A US population of approximately 314.8 million was used to determine the number of cases of HoFH and HeFH. The following key parameters were used to estimate the prevalence of severe HeFH: baseline pretreatment LDL-C level and distribution of patients with FH, posttreatment LDL-C level and distribution after maximally tolerated LLT, and baseline percentage of patients with HeFH who have CHD. We assumed an HeFH prevalence of 1:500 and used statistics for a Gaussian distribution after the posttreatment means and standard deviations of LDL-C levels in patients with HeFH receiving maximally tolerated LLT, as has been documented by data from clinical trials and cross-sectional studies. These estimates do not include the statin-intolerant population. The objective of this analysis was to determine the prevalence of the US population with severe HeFH with or without CHD who still will be eligible for LDL apheresis despite maximally tolerated LLT. We estimated that there are 315 US patients with HoFH and 650,000 with HeFH. The estimated prevalence of the severe HeFH population eligible for apheresis is approximately 1

  11. Equivalent circuit for birdcage resonators.

    PubMed

    Harpen, M D

    1993-02-01

    We present an equivalent circuit analysis for both low pass and high pass birdcage resonators loaded with lossy samples. In a generalization of the method of Hoult and Lauterbur (J. Magn. Reson. 34, 425 (1979)), we also derive circuit component values by application of the laws of electrodynamics. Measured resonance spectra, quality factors, and feed point impedances in a test resonator are shown to be in agreement with those predicted by the proposed model.

  12. Equivalence of quadratic performance criteria.

    NASA Technical Reports Server (NTRS)

    Martin, C.

    1973-01-01

    Necessary and sufficient conditions are derived in terms of system parameters and quadratic weighting matrices for two quadratic cost functionals that are defined to be equivalent if they generate the same optimal control law. The derived conditions lie between the conditions of Tanaka and Asai (1971) and those of Kreindler and Hedrick (1970). Sufficient conditions for a vector valued function to attain an infimum are stated.

  13. TNT Equivalency of Bulk Nitrocellulose

    DTIC Science & Technology

    1981-03-01

    9TIN ’IN AD-E400 576 CONTRACTOR REPORT ARLCD-CR-81007 TNT EQUIVALENCY OF BULK NITROCELLULOSE F. L. MCINTYRE COMPUTER SCIENCES CORPORATION NSTL...September 1978 6. PERFORMING ORG. REPORT NUMBER 7. AUTHOR(S) 8. CONTRACT OR GRANT NUMBER(e) F. L. Mc~ntyre, Computer Sciences Corporation P. Price...PROJECT. TASK Computer Sciences Corporation AREA & WORK UNIT NUMBERS NSTL Station, MS 39529 MMT-5784285 II. CONTROLLING OFFICE NAME AND ADDRESS 12

  14. The Stanford equivalence principle program

    NASA Technical Reports Server (NTRS)

    Worden, Paul W., Jr.; Everitt, C. W. Francis; Bye, M.

    1989-01-01

    The Stanford Equivalence Principle Program (Worden, Jr. 1983) is intended to test the uniqueness of free fall to the ultimate possible accuracy. The program is being conducted in two phases: first, a ground-based version of the experiment, which should have a sensitivity to differences in rate of fall of one part in 10(exp 12); followed by an orbital experiment with a sensitivity of one part in 10(exp 17) or better. The ground-based experiment, although a sensitive equivalence principle test in its own right, is being used for technology development for the orbital experiment. A secondary goal of the experiment is a search for exotic forces. The instrument is very well suited for this search, which would be conducted mostly with the ground-based apparatus. The short range predicted for these forces means that forces originating in the Earth would not be detectable in orbit. But detection of Yukawa-type exotic forces from a nearby large satellite (such as Space Station) is feasible, and gives a very sensitive and controllable test for little more effort than the orbiting equivalence principle test itself.

  15. Representing Identity and Equivalence for Scientific Data

    NASA Astrophysics Data System (ADS)

    Wickett, K. M.; Sacchi, S.; Dubin, D.; Renear, A. H.

    2012-12-01

    Matters of equivalence and identity are central to the stewardship of scientific data. In order to properly prepare for and manage the curation, preservation and sharing of digitally-encoded data, data stewards must be able to characterize and assess the relationships holding between data-carrying digital resources. However, identity-related questions about resources and their information content may not be straightforward to answer: for example, what exactly does it mean to say that two files contain the same data, but in different formats? Information content is frequently distinguished from particular representations, but there is no adequately developed shared understanding of what this really means and how the relationship between content and its representations hold. The Data Concepts group at the Center for Informatics Research in Science and Scholarship (CIRSS), University of Illinois at Urbana Champaign, is developing a logic-based framework of fundamental concepts related to scientific data to support curation and integration. One project goal is to develop precise accounts of information resources carrying the same data. We present two complementary conceptual models for information representation: the Basic Representation Model (BRM) and the Systematic Assertion Model (SAM). We show how these models provide an analytical account of digitally-encoded scientific data and a precise understanding of identity and equivalence. The Basic Representation Model identifies the core entities and relationships involved in representing information carried by digital objects. In BRM, digital objects are symbol structures that express propositional content, and stand in layered encoding relationships. For example, an RDF description may be serialized as either XML or N3, and those expressions in turn may be encoded as either UTF-8 or UTF-16 sequences. Defining this encoding stack reveals distinctions necessary for a precise account of identity and equivalence

  16. Information Leakage from Logically Equivalent Frames

    ERIC Educational Resources Information Center

    Sher, Shlomi; McKenzie, Craig R. M.

    2006-01-01

    Framing effects are said to occur when equivalent frames lead to different choices. However, the equivalence in question has been incompletely conceptualized. In a new normative analysis of framing effects, we complete the conceptualization by introducing the notion of information equivalence. Information equivalence obtains when no…

  17. Lipoprotein apheresis in the management of severe hypercholesterolemia and of elevation of lipoprotein(a): current perspectives and patient selection

    PubMed Central

    Julius, Ulrich

    2016-01-01

    This review reports the current situation with respect to therapeutic options (lifestyle and drugs) reducing the concentrations of atherogenic low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp[a]). Three lipoprotein apheresis (LA) principles have been realized: precipitation, filtration, and adsorption. Available LA methods are herein described in detail – major components, pumps, extracorporeal volume, treated volume, and anticoagulation. General features of all LA methods as well as pleotropic effects are elaborated. Indications for LA therapy are quoted: homozygous familial hypercholesterolemia (HCH), severe HCH, and isolated elevation of Lp(a) and progress of atherosclerotic disease. A major focus is on the evidence of the effect of LA on cardiovascular outcome data, and the most important publications are cited in this context. The best studies have been performed in patients with elevated Lp(a) in whom cardiovascular events were reduced by more than 80%. Major adverse effects and contraindications are listed. The impact of an LA therapy on patient quality of life and the requirements they have to fulfill are also highlighted. Finally, the future role of LA in treating high-risk patients with high LDL-C and/or high Lp(a) is discussed. It is probable that the significance of LA for treating patients with elevated LDL-C will decrease (with the exception of homozygous familial HCH) due to the application of PCSK9 inhibitors. The antisense oligonucleotide against apolipoprotein(a) could replace LA in patients with high Lp(a), provided positive outcome data are generated. PMID:27785114

  18. Comparison of platelet transfusion as fresh whole blood versus apheresis platelets for massively transfused combat trauma patients (CME).

    PubMed

    Perkins, Jeremy G; Cap, Andrew P; Spinella, Philip C; Shorr, Andrew F; Beekley, Alec C; Grathwohl, Kurt W; Rentas, Francisco J; Wade, Charles E; Holcomb, John B

    2011-02-01

    At major combat hospitals, the military is able to provide blood products to include apheresis platelets (aPLT), but also has extensive experience using fresh whole blood (FWB). In massively transfused trauma patients, we compared outcomes of patients receiving FWB to those receiving aPLT. This study was a retrospective review of casualties at the military hospital in Baghdad, Iraq, between January 2004 and December 2006. Patients requiring massive transfusion (≥10 units in 24 hr) were divided into two groups: those receiving FWB (n = 85) or aPLT (n = 284) during their resuscitation. Admission characteristics, resuscitation, and survival were compared between groups. Multivariate regression analyses were performed comparing survival of patients at 24 hours and at 30 days. Secondary outcomes including adverse events and causes of death were analyzed. Unadjusted survival between groups receiving aPLT and FWB was similar at 24 hours (84% vs. 81%, respectively; p = 0.52) and at 30 days (60% versus 57%, respectively; p = 0.72). Multivariate regression failed to identify differences in survival between patients receiving PLT transfusions either as FWB or as aPLT at 24 hours or at 30 days. Survival for massively transfused trauma patients receiving FWB appears to be similar to patients resuscitated with aPLT. Prospective trials will be necessary before consideration of FWB in the routine management of civilian trauma. However, in austere environments where standard blood products are unavailable, FWB is a feasible alternative. © 2010 American Association of Blood Banks.

  19. Hemostatic properties and protein expression profile of therapeutic apheresis plasma treated with amotosalen and ultraviolet A for pathogen inactivation.

    PubMed

    Ohlmann, Philippe; Hechler, Béatrice; Chafey, Philippe; Ravanat, Catherine; Isola, Hervé; Wiesel, Marie-Louise; Cazenave, Jean-Pierre; Gachet, Christian

    2016-09-01

    The INTERCEPT Blood System (IBS) using amotosalen-HCl and ultraviolet (UV)A inactivates a large spectrum of microbial pathogens and white blood cells in therapeutic plasma. Our aim was to evaluate to what extent IBS modifies the capacity of plasma to generate thrombin and induces qualitative or quantitative modifications of plasma proteins. Plasma units from four donors were collected by apheresis. Samples were taken before (control [CTRL]) and after IBS treatment and stored at -80°C until use. The activities of plasma coagulation factors and inhibitors and the thrombin generation potential were determined using assays measuring clotting times and the calibrated automated thrombogram (CAT), respectively. The proteomic profile of plasma proteins was examined using a two-dimensional differential in-gel electrophoresis (2D-DIGE) method. Nearly all of the procoagulant and antithrombotic factors tested retained at least 78% of their initial pre-IBS activity. Only FVII and FVIII displayed a lower level of conservation (67%), which nevertheless remained within the reference range for conventional plasma coagulation factors. The thrombin generation profile of plasma was conserved after IBS treatment. Among the 1331 protein spots revealed by 2D-DIGE analysis, only four were differentially expressed in IBS plasma compared to CTRL plasma and two were identified by mass spectrometric analysis as transthyretin and apolipoprotein A1. The IBS technique for plasma moderately decreases the activities of plasma coagulation factors and antithrombotic proteins, with no impact on the thrombin generation potential of plasma and very limited modifications of the proteomic profile. © 2016 AABB.

  20. Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

    PubMed Central

    Levy, Rebecca; Pantanowitz, Liron; Cloutier, Darlene; Provencher, Jean; McGirr, Joan; Stebbins, Jennifer; Cronin, Suzanne; Wherry, Josh; Fenton, Joseph; Donelan, Eileen; Johari, Vandita; Andrzejewski, Chester

    2010-01-01

    Background: Electronic medical records (EMRs) provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS) involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution's initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting) strategy within the EMR. Methods: A focus group of our hospital's transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium) for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater realered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encount by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also enhance data mining

  1. Lipoprotein(a)-hyperlipoproteinemia as cause of chronic spinal cord ischemia resulting in progressive myelopathy - successful treatment with lipoprotein apheresis.

    PubMed

    Heigl, Franz; Hettich, Reinhard; Mauch, Erich; Klingel, Reinhard; Fassbender, Cordula

    2017-03-01

    High concentrations of lipoprotein(a) (Lp(a)) represent an important independent and causal risk factor associated with adverse outcome in atherosclerotic cardiovascular disease (CVD). Effective Lp(a) lowering drug treatment is not available. Lipoprotein apheresis (LA) has been proven to prevent cardiovascular events in patients with Lp(a)-hyperlipoproteinemia (Lp(a)-HLP) and progressive CVD. Here we present the course of a male patient with established peripheral arterial occlusive disease (PAOD) at the early age of 41 and coronary artery disease (CAD), who during follow-up developed over 2 years a progressive syndrome of cerebellar and spinal cord deficits against the background of multifactorial cardiovascular risk including positive family history of CVD. Spastic tetraplegia and dependency on wheel chair and nursing care represented the nadir of neurological deficits. All conventional risk factors including LDL-cholesterol had already been treated and after exclusion of other causes, genetically determined Lp(a)-HLP was considered as the major underlying etiologic factor of ischemic vascular disease in this patient including spinal cord ischemia with vascular myelopathy. Treatment with an intensive regimen of chronic LA over 4.5 years now was successful to stabilize PAOD and CAD and led to very impressive neurologic and overall physical rehabilitation and improvement of quality of life.Measurement of Lp(a) concentration must be recommended to assess individual cardiovascular risk. Extracorporeal clearance of Lp(a) by LA should be considered as treatment option for select patients with progressive Lp(a)-associated ischemic syndromes.

  2. Semantic relatedness for evaluation of course equivalencies

    NASA Astrophysics Data System (ADS)

    Yang, Beibei

    Semantic relatedness, or its inverse, semantic distance, measures the degree of closeness between two pieces of text determined by their meaning. Related work typically measures semantics based on a sparse knowledge base such as WordNet or Cyc that requires intensive manual efforts to build and maintain. Other work is based on a corpus such as the Brown corpus, or more recently, Wikipedia. This dissertation proposes two approaches to applying semantic relatedness to the problem of suggesting transfer course equivalencies. Two course descriptions are given as input to feed the proposed algorithms, which output a value that can be used to help determine if the courses are equivalent. The first proposed approach uses traditional knowledge sources such as WordNet and corpora for courses from multiple fields of study. The second approach uses Wikipedia, the openly-editable encyclopedia, and it focuses on courses from a technical field such as Computer Science. This work shows that it is promising to adapt semantic relatedness to the education field for matching equivalencies between transfer courses. A semantic relatedness measure using traditional knowledge sources such as WordNet performs relatively well on non-technical courses. However, due to the "knowledge acquisition bottleneck," such a resource is not ideal for technical courses, which use an extensive and growing set of technical terms. To address the problem, this work proposes a Wikipedia-based approach which is later shown to be more correlated to human judgment compared to previous work.

  3. Dioxin equivalency: Challenge to dose extrapolation

    SciTech Connect

    Brown, J.F. Jr.; Silkworth, J.B.

    1995-12-31

    Extensive research has shown that all biological effects of dioxin-like agents are mediated via a single biochemical target, the Ah receptor (AhR), and that the relative biologic potencies of such agents in any given system, coupled with their exposure levels, may be described in terms of toxic equivalents (TEQ). It has also shown that the TEQ sources include not only chlorinated species such as the dioxins (PCDDs), PCDFs, and coplanar PCBs, but also non-chlorinated substances such as the PAHs of wood smoke, the AhR agonists of cooked meat, and the indolocarbazol (ICZ) derived from cruciferous vegetables. Humans have probably had elevated exposures to these non-chlorinated TEQ sources ever since the discoveries of fire, cooking, and the culinary use of Brassica spp. Recent assays of CYP1A2 induction show that these ``natural`` or ``traditional`` AhR agonists are contributing 50--100 times as much to average human TEQ exposures as do the chlorinated xenobiotics. Currently, the safe doses of the xenobiotic TEQ sources are estimated from their NOAELs and large extrapolation factors, derived from arbitrary mathematical models, whereas the NOAELs themselves are regarded as the safe doses for the TEQs of traditional dietary components. Available scientific data can neither support nor refute either approach to assessing the health risk of an individual chemical substance. However, if two substances be toxicologically equivalent, then their TEQ-adjusted health risks must also be equivalent, and the same dose extrapolation procedure should be used for both.

  4. Measurement equivalence in mixed mode surveys.

    PubMed

    Hox, Joop J; De Leeuw, Edith D; Zijlmans, Eva A O

    2015-01-01

    Surveys increasingly use mixed mode data collection (e.g., combining face-to-face and web) because this controls costs and helps to maintain good response rates. However, a combination of different survey modes in one study, be it cross-sectional or longitudinal, can lead to different kinds of measurement errors. For example, respondents in a face-to-face survey or a web survey may interpret the same question differently, and might give a different answer, just because of the way the question is presented. This effect of survey mode on the question-answer process is called measurement mode effect. This study develops methodological and statistical tools to identify the existence and size of mode effects in a mixed mode survey. In addition, it assesses the size and importance of mode effects in measurement instruments using a specific mixed mode panel survey (Netherlands Kinship Panel Study). Most measurement instruments in the NKPS are multi-item scales, therefore confirmatory factor analysis (CFA) will be used as the main analysis tool, using propensity score methods to correct for selection effects. The results show that the NKPS scales by and large have measurement equivalence, but in most cases only partial measurement equivalence. Controlling for respondent differences on demographic variables, and on scale scores from the previous uni-mode measurement occasion, tends to improve measurement equivalence, but not for all scales. The discussion ends with a review of the implications of our results for analyses employing these scales.

  5. Thévenin equivalence in disorderless quantum networks

    SciTech Connect

    Cain, C. A.; Wu, C. H.

    2015-01-14

    We outline the procedure of extending the Thévenin equivalence principle for classical electric circuits to reducing Aharonov-Bohm-based quantum networks into equivalent models. With examples, we show from first principles how the requirements are related to the electron band structure's Fermi level and the lattice spacing of the network. Quantum networks of varying degrees of coupling strength from four basic classifications of single and double entangled loops sharing symmetry and highly correlated band structures are used to demonstrate the concept. We show the limitations of how the principle may be applied. Several classes of examples are given and their equivalent forms are shown.

  6. Conformal dynamical equivalence and applications

    NASA Astrophysics Data System (ADS)

    Spyrou, N. K.

    2011-02-01

    The "Conformal Dynamical Equivalence" (CDE) approach is briefly reviewed, and some of its applications, at various astrophysical levels (Sun, Solar System, Stars, Galaxies, Clusters of Galaxies, Universe as a whole), are presented. According to the CDE approach, in both the Newtonian and general-relativistic theories of gravity, the isentropic hydrodynamic flows in the interior of a bounded gravitating perfect-fluid source are dynamically equivalent to geodesic motions in a virtual, fully defined fluid source. Equivalently, the equations of hydrodynamic motion in the former source are functionally similar to those of the geodesic motions in the latter, physically, fully defined source. The CDE approach is followed for the dynamical description of the motions in the fluid source. After an observational introduction, taking into account all the internal physical characteristics of the corresponding perfect-fluid source, and based on the property of the isentropic hydrodynamic flows (quite reasonable for an isolated physical system), we examine a number of issues, namely, (i) the classical Newtonian explanation of the celebrated Pioneer-Anomaly effect in the Solar System, (ii) the possibility of both the attractive gravity and the repulsive gravity in a non-quantum Newtonian framework, (iii) the evaluation of the masses - theoretical, dynamical, and missing - and of the linear dimensions of non-magnetized and magnetized large-scale cosmological structures, (iv) the explanation of the flat-rotation curves of disc galaxies, (v) possible formation mechanisms of winds and jets, and (vi) a brief presentation of a conventional approach - toy model to the dynamics of the Universe, characterized by the dominant collisional dark matter (with its subdominant luminous baryonic "contamination"), correctly interpreting the cosmological observational data without the need of the notions dark energy, cosmological constant, and universal accelerating expansion.

  7. On Vasyliunas's equivalent conductivity formalism

    NASA Technical Reports Server (NTRS)

    Pontius, D. H., Jr.

    1992-01-01

    The Vasyliunas's (1972) equivalent conductivity formalism (ECF) for representing the coupling of the ionosphere and the magnetosphere is discussed, and a new, simpler, derivation is presented of the ECF, in which certain of the underlying assumptions and their implications are made transparent. The derivation presented indicates that the only role of the ions in the ECF is to insure quasi-neutrality. It is shown that the ECF is not as robust as usually assumed and that caution must be used to insure that reasonable results are obtained.

  8. The Great Cometary Show

    NASA Astrophysics Data System (ADS)

    2007-01-01

    The ESO Very Large Telescope Interferometer, which allows astronomers to scrutinise objects with a precision equivalent to that of a 130-m telescope, is proving itself an unequalled success every day. One of the latest instruments installed, AMBER, has led to a flurry of scientific results, an anthology of which is being published this week as special features in the research journal Astronomy & Astrophysics. ESO PR Photo 06a/07 ESO PR Photo 06a/07 The AMBER Instrument "With its unique capabilities, the VLT Interferometer (VLTI) has created itself a niche in which it provide answers to many astronomical questions, from the shape of stars, to discs around stars, to the surroundings of the supermassive black holes in active galaxies," says Jorge Melnick (ESO), the VLT Project Scientist. The VLTI has led to 55 scientific papers already and is in fact producing more than half of the interferometric results worldwide. "With the capability of AMBER to combine up to three of the 8.2-m VLT Unit Telescopes, we can really achieve what nobody else can do," added Fabien Malbet, from the LAOG (France) and the AMBER Project Scientist. Eleven articles will appear this week in Astronomy & Astrophysics' special AMBER section. Three of them describe the unique instrument, while the other eight reveal completely new results about the early and late stages in the life of stars. ESO PR Photo 06b/07 ESO PR Photo 06b/07 The Inner Winds of Eta Carinae The first results presented in this issue cover various fields of stellar and circumstellar physics. Two papers deal with very young solar-like stars, offering new information about the geometry of the surrounding discs and associated outflowing winds. Other articles are devoted to the study of hot active stars of particular interest: Alpha Arae, Kappa Canis Majoris, and CPD -57o2874. They provide new, precise information about their rotating gas envelopes. An important new result concerns the enigmatic object Eta Carinae. Using AMBER with

  9. Therapeutic equivalents in clinical practice.

    PubMed

    Benson, M D

    2001-01-01

    With increasing debate over the rising expenses of health care, a variety of cost-saving measures has been attempted over the years. Use of primary care physicians as "gate keepers," reduction in the length of hospital stays, and pushing women toward vaginal birth after Cesarean section have all been utilized despite on going issues with patient satisfaction and even safety. One remarkable success in stretching health-care dollars that has often been overlooked is the prescription of therapeutic equivalents, or generic drugs. Although available on a limited basis for decades, off-brand manufacture of pharmaceuticals with identical active ingredients as those of the branded drug received a large boost through Congressional legislation in 1984 with the Hatch-Waxman Act. "Fast-track" FDA approval was initiated by Congress to introduce competition into the marketplace for drugs whose patients had expired. While giving close scrutiny to the manufacturing process and requiring the same level of regulatory supervision for factors such as bioavailability and shelf life, the Hatch-Waxman Act removed the burden and expense from generic manufacturers of proving the safety and efficacy all over again of a previously FDA-approved drug. With less than a 20% market share of all prescribed drugs in 1984, the generic drug industry has captured roughly 44% of the market in recent years while accounting for only 8% of expenditures on prescription medication. The prescription of therapeutic equivalents is one method of keeping health care costs down without compromising patient satisfaction or safety.

  10. Mechanical equivalent of quantum heat engines.

    PubMed

    Arnaud, Jacques; Chusseau, Laurent; Philippe, Fabrice

    2008-06-01

    Quantum heat engines employ as working agents multilevel systems instead of classical gases. We show that under some conditions quantum heat engines are equivalent to a series of reservoirs at different altitudes containing balls of various weights. A cycle consists of picking up at random a ball from one reservoir and carrying it to the next, thereby performing or absorbing some work. In particular, quantum heat engines, employing two-level atoms as working agents, are modeled by reservoirs containing balls of weight 0 or 1. The mechanical model helps us prove that the maximum efficiency of quantum heat engines is the Carnot efficiency. Heat pumps and negative temperatures are considered.

  11. Hysteretic damping in rotordynamics: An equivalent formulation

    NASA Astrophysics Data System (ADS)

    Genta, Giancarlo; Amati, Nicola

    2010-10-01

    The hysteretic damping model cannot be applied to time domain dynamic simulations: this is a well-known feature that has been discussed in the literature since the time when analog computers were widespread. The constant equivalent damping often introduced to overcome this problem is also discussed, and its limitations are stated, in particular those linked with its application in rotordynamics to simulate rotating damping. An alternative model based on the nonviscous damping (NVD) model, but with a limited number of additional degrees of freedom, is proposed, and the relevant equations are derived. Some examples show applications to the rotordynamics field.

  12. Evaluation of platelet function using the in vitro bleeding time and corrected count increment of transfused platelets. Comparison between platelet concentrates derived from pooled buffy coates and apheresis.

    PubMed

    Eriksson, L; Kristensen, J; Olsson, K; Bring, J; Högman, C F

    1996-01-01

    The functional capacity of transfused platelets was evaluated with in vitro bleeding time (IVBT) and corrected count increment (CCI) in order to compare platelet concentrates (PCs) derived from pooled buffy coats (BC-PCs) with PCs collected by apheresis (A-PCs). The suspension medium in the BC-PCs was 30% CPD plasma and 70% of an additive solution (containing sodium and potassium chloride, sodium citrate and phosphate, mannitol), and in the A-PCs the medium was 100% CPD plasma. IVBT was evaluated using a Thrombostat 4000/2. BC-PC and A-PC were transfused 57 and 41 times, respectively to 36 patients with chemotherapy-induced thrombocytopenia. PCs transfused within 2 days of donation were considered fresh, and those transfused within 3-5 days were considered stored. IVBT was determined before, as well as 10-30 min and 24 h after transfusion; CCI was determined 10-30 min and 24 h after transfusion. The median pretransfusion IVBT value was 486 s. It was measurable in 21 of 98 (21%) of the transfusions, i.e. below the cutoff limit of 486 s. Ten to 30 min after transfusion, the IVBT showed a measurable reduction in 90% of the transfusions with fresh BC-PCs, 92% of those with fresh a-PCs, 63% of those with stored BC-PCs and 79% of those with stored A-PCs. After 24 h, the corresponding values were 63% for fresh BC-PCs, 50% for fresh A-PCs, 26% for stored BC-PCs and 38% for stored A-PCs. The median value of CCI 10-30 min after transfusion was 20 for fresh BC-PCs, 17 for fresh A-PCs, 16 for stored BC-PCs and 14 for stored A-PCs. The difference in IVBT between fresh and stored BC-PCs was significant (p = 0.032), unlike that between fresh and stored A-PC. After 24 h the corresponding values were 7 for fresh BC-PCs, 4 for fresh A-PCs, 4 for stored BC-PCs and 3 for stored A-PCs. When all transfusions with fresh PCs (BC-PCs + A-PCs) were compared with all transfusions with stored PCs, a statistical difference was demonstrated in both CCI (p = 0.027) and IVBT (p = 0.043). Spearman

  13. Structural analysis of artificial skin equivalents

    NASA Astrophysics Data System (ADS)

    Schmitt, Robert; Marx, Ulrich; Walles, Heike; Schober, Lena

    2011-06-01

    Artificial skin equivalents ASEs based on primary fibroblasts and keratinocytes show a high batch variance in their structural and morphological characteristics. Due to biological fluctuations and variable donor age, the growth processes of 3D tissue structure show a non constant quality. Since theses ASEs are used as testing system for chemicals, pharmaceuticals or cosmetics it is of major interest to know detailed and significant characteristics about each individual ASE. Until now, the microscopic analysis process is based on the destructive preparation of histologies allowing only the characterization on a random basis. In this study we present analytical methods to characterise each individual ASE by Optical Coherence Tomography OCT in combination with image processing tools. Therefore, we developed a fully automated OCT device, that performs automatic measurements of microtiter plates MTPs holing the ASEs in a sterile environment. We developed image processing algorithms to characterize the surface structure which may function as an indicator for defects in the epidermal stratum corneum. Further, we analysed the tomographic morphological structure of the ASEs. The results show, that variances in the growth state as well different collagen formation is detectable. In combination with dynamic threshold levels, we found, that OCT is a well suited technology for automatically characterizing artificial skin equivalents and may partly substitute the preparation of histologies.

  14. An improved equivalent circuit model of radial mode piezoelectric transformer.

    PubMed

    Huang, Yihua; Huang, Wei

    2011-05-01

    In this paper, both the equivalent circuit models of the radial mode and the coupled thickness vibration mode of the radial mode piezoelectric transformer are deduced, and then with the Y-parameter matrix method and the dual-port network theory, an improved equivalent circuit model for the multilayer radial mode piezoelectric transformer is established. A radial mode transformer sample is tested to verify the equivalent circuit model. The experimental results show that the model proposed in this paper is more precise than the typical model.

  15. Foreword: Biomonitoring Equivalents special issue.

    PubMed

    Meek, M E; Sonawane, B; Becker, R A

    2008-08-01

    The challenge of interpreting results of biomonitoring for environmental chemicals in humans is highlighted in this Foreword to the Biomonitoring Equivalents (BEs) special issue of Regulatory Toxicology and Pharmacology. There is a pressing need to develop risk-based tools in order to empower scientists and health professionals to interpret and communicate the significance of human biomonitoring data. The BE approach, which integrates dosimetry and risk assessment methods, represents an important advancement on the path toward achieving this objective. The articles in this issue, developed as a result of an expert panel meeting, present guidelines for derivation of BEs, guidelines for communication using BEs and several case studies illustrating application of the BE approach for specific substances.

  16. Equivalent damage: A critical assessment

    NASA Technical Reports Server (NTRS)

    Laflen, J. H.; Cook, T. S.

    1982-01-01

    The overall goal of achieving improved life cycle management of aircraft engine, gas turbine components is a major industry thrust. Low cycle fatigue (LCF) crack initiation prediction, an important element of life cycle management as traditionally applied, may be overly conservative in estimating total cyclic life capability. Consequently, there is increasing pressure to improve predictive methods both for crack initiation and for subsequent crack propagation. The utility of equivalent damage concepts for application to hot section components of aircraft engines was studied. Specifically, the topics examined were mean stress, cumulative damage, and multiaxiality. Other factors inherently linked to this study were the basic formulation of damage parameters at elevated temperatures and the fact that hot section components experience severe temperature fluctuations throughout their service lifetime.

  17. Equivalent crystal theory of alloys

    NASA Technical Reports Server (NTRS)

    Bozzolo, Guillermo; Ferrante, John

    1991-01-01

    Equivalent Crystal Theory (ECT) is a new, semi-empirical approach to calculating the energetics of a solid with defects. The theory has successfully reproduced surface energies in metals and semiconductors. The theory of binary alloys to date, both with first-principles and semi-empirical models, has not been very successful in predicting the energetics of alloys. This procedure is used to predict the heats of formation, cohesive energy, and lattice parameter of binary alloys of Cu, Ni, Al, Ag, Au, Pd, and Pt as functions of composition. The procedure accurately reproduces the heats of formation versus composition curves for a variety of binary alloys. The results are then compared with other approaches such as the embedded atom and lattice parameters of alloys from pure metal properties more accurately than Vegard's law is presented.

  18. Breaking of Ensemble Equivalence in Networks

    NASA Astrophysics Data System (ADS)

    Squartini, Tiziano; de Mol, Joey; den Hollander, Frank; Garlaschelli, Diego

    2015-12-01

    It is generally believed that, in the thermodynamic limit, the microcanonical description as a function of energy coincides with the canonical description as a function of temperature. However, various examples of systems for which the microcanonical and canonical ensembles are not equivalent have been identified. A complete theory of this intriguing phenomenon is still missing. Here we show that ensemble nonequivalence can manifest itself also in random graphs with topological constraints. We find that, while graphs with a given number of links are ensemble equivalent, graphs with a given degree sequence are not. This result holds irrespective of whether the energy is nonadditive (as in unipartite graphs) or additive (as in bipartite graphs). In contrast with previous expectations, our results show that (1) physically, nonequivalence can be induced by an extensive number of local constraints, and not necessarily by long-range interactions or nonadditivity, (2) mathematically, nonequivalence is determined by a different large-deviation behavior of microcanonical and canonical probabilities for a single microstate, and not necessarily for almost all microstates. The latter criterion, which is entirely local, is not restricted to networks and holds in general.

  19. Equivalent equations of motion for gravity and entropy

    NASA Astrophysics Data System (ADS)

    Czech, Bartlomiej; Lamprou, Lampros; McCandlish, Samuel; Mosk, Benjamin; Sully, James

    2017-02-01

    We demonstrate an equivalence between the wave equation obeyed by the entanglement entropy of CFT subregions and the linearized bulk Einstein equation in Anti-de Sitter space. In doing so, we make use of the formalism of kinematic space [1] and fields on this space, introduced in [2]. We show that the gravitational dynamics are equivalent to a gauge invariant wave-equation on kinematic space and that this equation arises in natural correspondence to the conformal Casimir equation in the CFT.

  20. Equivalent equations of motion for gravity and entropy

    DOE PAGES

    Czech, Bartlomiej; Lamprou, Lampros; McCandlish, Samuel; ...

    2017-02-01

    We demonstrate an equivalence between the wave equation obeyed by the entanglement entropy of CFT subregions and the linearized bulk Einstein equation in Anti-de Sitter space. In doing so, we make use of the formalism of kinematic space and fields on this space. We show that the gravitational dynamics are equivalent to a gauge invariant wave-equation on kinematic space and that this equation arises in natural correspondence to the conformal Casimir equation in the CFT.

  1. 46 CFR 110.20-1 - Equivalents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Equivalents. 110.20-1 Section 110.20-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING GENERAL PROVISIONS Equivalents... engineering evaluations and tests to demonstrate the equivalence of the substitute. ...

  2. Stimulus Equivalence: Testing Sidman's (2000) Theory

    ERIC Educational Resources Information Center

    Minster, Sara Tepaeru; Jones, Max; Elliffe, Douglas; Muthukumaraswamy, Suresh D.

    2006-01-01

    Sidman's (2000) theory regarding the origin of equivalence relations predicts that a reinforcing stimulus common to distinct equivalence classes must drop out of the equivalence relations. This prediction was tested in the present study by arranging class-specific reinforcers, R1 and R2, following correct responding on the prerequisite conditional…

  3. 46 CFR 110.20-1 - Equivalents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Equivalents. 110.20-1 Section 110.20-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING GENERAL PROVISIONS Equivalents... engineering evaluations and tests to demonstrate the equivalence of the substitute. ...

  4. 46 CFR 110.20-1 - Equivalents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Equivalents. 110.20-1 Section 110.20-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING GENERAL PROVISIONS Equivalents... engineering evaluations and tests to demonstrate the equivalence of the substitute. ...

  5. 46 CFR 110.20-1 - Equivalents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Equivalents. 110.20-1 Section 110.20-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING GENERAL PROVISIONS Equivalents... engineering evaluations and tests to demonstrate the equivalence of the substitute. ...

  6. 46 CFR 110.20-1 - Equivalents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Equivalents. 110.20-1 Section 110.20-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING GENERAL PROVISIONS Equivalents... engineering evaluations and tests to demonstrate the equivalence of the substitute. ...

  7. 21 CFR 26.6 - Equivalence assessment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Equivalence assessment. 26.6 Section 26.6 Food and... Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.6 Equivalence assessment... or processes. (c) The equivalence assessment shall include information exchanges (including...

  8. 21 CFR 26.39 - Equivalence assessment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Equivalence assessment. 26.39 Section 26.39 Food... Specific Sector Provisions for Medical Devices § 26.39 Equivalence assessment. (a) In the final 6 months of the transition period, the parties shall proceed to a joint assessment of the equivalence of the...

  9. Granulocyte colony-stimulating factor increases the platelet volume in peripheral stem cell apheresis donors.

    PubMed

    Ihara, Akihiro; Matsui, Keiko; Minami, Ryouta; Uchida, Shuzou; Ueda, Shuji; Nishiura, Tetsuo

    2008-01-01

    We investigated the short-term influence of granulocyte colony-stimulating factor (G-CSF) administration on platelet counts and platelet indices in 12 donors (8 males and 4 females; median age 34 years, range 16-49) for peripheral stem cell transplantation using an automated blood cell analyzer. On day 3 (D3) compared with D0, 11 donors with normal laboratory and physical findings showed increases in platelet indices (chi(2) = 12.0, p = 0.0025). Furthermore, mean platelet volume (MPV) was significantly increased (p = 0.04). Also, platelet count decreased, and platelet distribution width and platelet-large cell ratio were increased, but these were not significant. On the contrary, 1 donor with abnormal laboratory findings who had large platelets (MPV 11.4 fl) before G-CSF administration showed decreases in platelet indices (MPV 10.3 fl) on D3, although platelet count (18.2 x 10(4)/microl) decreased after G-CSF administration. G-CSF administration induces an inflammatory process with endothelial cell activation. This is probably the reason why platelet volume increases after G-CSF use. This is the first report showing that G-CSF administration immediately induces increases in large platelets in peripheral stem cell transplant donors before harvest.

  10. [Generalization of money-handling though training in equivalence relationships].

    PubMed

    Vives-Montero, Carmen; Valero-Aguayo, Luis; Ascanio, Lourdes

    2011-02-01

    This research used a matching-to-sample procedure and equivalence learning process with language and verbal tasks. In the study, an application of the equivalence relationship of money was used with several kinds of euro coins presented. The sample consisted of 16 children (8 in the experimental group and 8 in the control group) aged 5 years. The prerequisite behaviors, the identification of coins and the practical use of different euro coins, were assessed in the pre and post phases for both groups. The children in the experimental group performed an equivalence task using the matching-to-sample procedure. This consisted of a stimulus sample and four matching stimuli, using a series of euro coins with equivalent value in each set. The children in the control group did not undergo this training process. The results showed a large variability in the children's data of the equivalence tests. The experimental group showed the greatest pre and post changes in the statistically significant data. They also showed a greater generalization in the identification of money and in the use of euro coins than the control group. The implications for educational training and the characteristics of the procedure used here for coin equivalence are discussed.

  11. Equivalence between spin Hamiltonians and boson sampling

    NASA Astrophysics Data System (ADS)

    Peropadre, Borja; Aspuru-Guzik, Alán; García-Ripoll, Juan José

    2017-03-01

    Aaronson and Arkhipov showed that predicting or reproducing the measurement statistics of a general linear optics circuit with a single Fock-state input is a classically hard problem. Here we show that this problem, known as boson sampling, is as hard as simulating the short time evolution of a large but simple spin model with long-range X Y interactions. The conditions for this equivalence are the same for efficient boson sampling, namely, having a small number of photons (excitations) as compared to the number of modes (spins). This mapping allows efficient implementations of boson sampling in small quantum computers and simulators and sheds light on the complexity of time evolution with critical spin models.

  12. A restricted proof that the weak equivalence principle implies the Einstein equivalence principle

    NASA Technical Reports Server (NTRS)

    Lightman, A. P.; Lee, D. L.

    1973-01-01

    Schiff has conjectured that the weak equivalence principle (WEP) implies the Einstein equivalence principle (EEP). A proof is presented of Schiff's conjecture, restricted to: (1) test bodies made of electromagnetically interacting point particles, that fall from rest in a static, spherically symmetric gravitational field; (2) theories of gravity within a certain broad class - a class that includes almost all complete relativistic theories that have been found in the literature, but with each theory truncated to contain only point particles plus electromagnetic and gravitational fields. The proof shows that every nonmentric theory in the class (every theory that violates EEP) must violate WEP. A formula is derived for the magnitude of the violation. It is shown that WEP is a powerful theoretical and experimental tool for constraining the manner in which gravity couples to electromagnetism in gravitation theories.

  13. Testing the weak equivalence principle

    NASA Astrophysics Data System (ADS)

    Nobili, Anna M.; Comandi, Gian Luca; Pegna, Raffaello; Bramanti, Donato; Doravari, Suresh; Maccarone, Francesco; Lucchesi, David M.

    2010-01-01

    The discovery of Dark Energy and the fact that only about 5% of the mass of the universe can be explained on the basis of the current laws of physics have led to a serious impasse. Based on past history, physics might indeed be on the verge of major discoveries; but the challenge is enormous. The way to tackle it is twofold. On one side, scientists try to perform large scale direct observations and measurements - mostly from space. On the other, they multiply their efforts to put to the most stringent tests ever the physical theories underlying the current view of the physical world, from the very small to the very large. On the extremely small scale very exciting results are expected from one of the most impressive experiments in the history of mankind: the Large Hadron Collider. On the very large scale, the universe is dominated by gravity and the present impasse undoubtedly calls for more powerful tests of General Relativity - the best theory of gravity to date. Experiments testing the Weak Equivalence Principle, on which General Relativity ultimately lies, have the strongest probing power of them all; a breakthrough in sensitivity is possible with the “Galileo Galilei” (GG) satellite experiment to fly in low Earth orbit.

  14. Establishment of an equivalence acceptance criterion for accelerated stability studies.

    PubMed

    Burdick, Richard K; Sidor, Leslie

    2013-01-01

    In this article, the use of statistical equivalence testing for providing evidence of process comparability in an accelerated stability study is advocated over the use of a test of differences. The objective of such a study is to demonstrate comparability by showing that the stability profiles under nonrecommended storage conditions of two processes are equivalent. Because it is difficult at accelerated conditions to find a direct link to product specifications, and hence product safety and efficacy, an equivalence acceptance criterion is proposed that is based on the statistical concept of effect size. As with all statistical tests of equivalence, it is important to collect input from appropriate subject-matter experts when defining the acceptance criterion.

  15. Aldehydes as alkyl carbanion equivalents for additions to carbonyl compounds

    NASA Astrophysics Data System (ADS)

    Wang, Haining; Dai, Xi-Jie; Li, Chao-Jun

    2016-12-01

    Nucleophilic addition reactions of organometallic reagents to carbonyl compounds for carbon-carbon bond construction have played a pivotal role in modern chemistry. However, this reaction's reliance on petroleum-derived chemical feedstocks and a stoichiometric quantity of metal have prompted the development of many carbanion equivalents and catalytic metal alternatives. Here, we show that naturally occurring carbonyls can be used as latent alkyl carbanion equivalents for additions to carbonyl compounds, via reductive polarity reversal. Such 'umpolung' reactivity is facilitated by a ruthenium catalyst and diphosphine ligand under mild conditions, delivering synthetically valuable secondary and tertiary alcohols in up to 98% yield. The unique chemoselectivity exhibited by carbonyl-derived carbanion equivalents is demonstrated by their tolerance to protic reaction media and good functional group compatibility. Enantioenriched tertiary alcohols can also be accessed with the aid of chiral ligands, albeit with moderate stereocontrol. Such carbonyl-derived carbanion equivalents are anticipated to find broad utility in chemical bond formation.

  16. Aldehydes as alkyl carbanion equivalents for additions to carbonyl compounds

    NASA Astrophysics Data System (ADS)

    Wang, Haining; Dai, Xi-Jie; Li, Chao-Jun

    2017-04-01

    Nucleophilic addition reactions of organometallic reagents to carbonyl compounds for carbon-carbon bond construction have played a pivotal role in modern chemistry. However, this reaction's reliance on petroleum-derived chemical feedstocks and a stoichiometric quantity of metal have prompted the development of many carbanion equivalents and catalytic metal alternatives. Here, we show that naturally occurring carbonyls can be used as latent alkyl carbanion equivalents for additions to carbonyl compounds, via reductive polarity reversal. Such 'umpolung' reactivity is facilitated by a ruthenium catalyst and diphosphine ligand under mild conditions, delivering synthetically valuable secondary and tertiary alcohols in up to 98% yield. The unique chemoselectivity exhibited by carbonyl-derived carbanion equivalents is demonstrated by their tolerance to protic reaction media and good functional group compatibility. Enantioenriched tertiary alcohols can also be accessed with the aid of chiral ligands, albeit with moderate stereocontrol. Such carbonyl-derived carbanion equivalents are anticipated to find broad utility in chemical bond formation.

  17. The transfer of avoidance evoking functions through stimulus equivalence classes.

    PubMed

    Augustson, E M; Dougher, M J

    1997-09-01

    Recent research in the area of stimulus equivalence suggests that transfer of function via members of stimulus equivalence classes may have relevance to human emotional responding and the development and generalization of certain psychological disorders. This study investigated the transfer of avoidance evoking functions through equivalence classes. Eight subjects were trained in the necessary relations for two-four member stimulus equivalence classes to emerge. Next, using an on-baseline classical conditioning procedure, one member of one class was paired with shock while one member of the other class was presented without shock. Then, while subjects engaged a key-press task, a differential, signalled avoidance task was introduced wherein shock was avoided if a response occurred to the stimulus previously associated with shock. The remaining stimuli from both classes were then presented. The behavior of all eight subjects showed the differential transfer of the avoidance evoking function. The clinical and theoretical implications of the results are discussed.

  18. Apheresis in high risk antiphospholipid syndrome pregnancy and autoimmune congenital heart block.

    PubMed

    Ruffatti, Amelia; Favaro, Maria; Brucato, Antonio; Ramoni, Veronique; Facchinetti, Myriam; Tonello, Marta; Del Ross, Teresa; Calligaro, Antonia; Hoxha, Ariela; Grava, Chiara; De Silvestro, Giustina

    2015-12-01

    In the first part a prospective cohort study was reported to evaluate the efficacy and safety of a treatment protocol including plasma exchange (PE) or PE plus intravenous immunoglobulins (IVIG) or immunoadsorption (IA) plus IVIG administered in addition to conventional therapy to 22 pregnant women with high-risk APS. The results indicate that PE or IA treatments administered along with IVIG and conventional antithrombotic therapy could be a valuable and safe therapeutic option in pregnant APS women with triple antiphospholipid antibody positivity along with a history of thrombosis and/or one or more severe pregnancy complications. In the second part the efficacy and safety of PE combined with IVIG and steroids were evaluated for the treatment of 10 patients with autoimmune congenital heart block (CHB) by comparing maternal features, pregnancy outcome and side effects with those of 24 CHB patients treated with steroids only. The patients treated with the combined therapy showed a statistically significant regression of 2nd degree blocks, an increase in heart rate at birth and a significantly lower prevalence of pacing in the first year of life. Moreover, no side effects were observed except for a few steroid-related events. If these results are confirmed by large-scale studies, the apheretic procedures could lead to improved outcomes in the treatment of these devastating diseases.

  19. Solving complex-valued linear systems via equivalent real formulations

    SciTech Connect

    DAY,DAVID M.; HEROUX,MICHAEL A.

    2000-05-22

    Most algorithms used in preconditioned iterative methods are generally applicable to complex valued linear systems, with real valued linear systems simply being a special case. However, most iterative solver packages available today focus exclusively on real valued systems, or deal with complex valued systems as an afterthought. One obvious approach to addressing this problem is to recast the complex problem into one of a several equivalent real forms and then use a real valued solver to solve the related system. However, well-known theoretical results showing unfavorable spectral properties for the equivalent real forms have diminished enthusiasm for this approach. At the same time, experience has shown that there are situations where using an equivalent real form can be very effective. In this paper, the authors explore this approach, giving both theoretical and experimental evidence that an equivalent real form can be useful for a number of practical situations. Furthermore, they show that by making good use of some of the advance features of modem solver packages, they can easily generate equivalent real form preconditioners that are computationally efficient and mathematically identical to their complex counterparts. Using their techniques, they are able to solve very ill-conditioned complex valued linear systems for a variety of large scale applications. However, more importantly, they shed more light on the effectiveness of equivalent real forms and more clearly delineate how and when they should be used.

  20. Inductive Reasoning in Zambia, Turkey, and the Netherlands Establishing Cross-Cultural Equivalence.

    ERIC Educational Resources Information Center

    van de Vijver, Fons J. R.

    2002-01-01

    Administered tasks of inductive reasoning to 704 Zambian, 877 Turkish, and 632 Dutch students from the highest 2 grades of primary and the lowest 2 grades of secondary school. Results show strong evidence for structural equivalence and partial evidence for measurement unit equivalence, but did not support full score equivalence. (SLD)

  1. Control and optimization of apheresis procedures in a COBE 2997 cell separator.

    PubMed

    Wooten, S L; Petersen, J N; Van Wie, B J

    1991-02-01

    To obtain more efficient operation of a COBE Model 2997 clinical cell separator using either a Single Stage II (SS II) or a Dual Stage separation chamber, modifications were made to allow complete computer control. Product cell density was detected using an optical sensor and controlled by automatic feedback through a microcomputer interface. Control was accomplished by automatically adjusting the red blood cell (RBC) and plasma product flow rates using a proportional-integral (PI) algorithm. Results show that, using either chamber, the product cell density can be maintained at a preselected value for extended periods of time without operator intervention. This system allowed investigation of optimal operating regions for plateletpheresis and leukapheresis procedures. The effects of centrifuge rpm and controller set point on centrifuge operation were investigated using a second order factorial experimental design. Theoretical significance of model parameters was assessed with the aid of a hindered settling model and simple reasoning about the interface position relative to the collection port. The results suggest that, in either chamber, the optimum operating region for plateletpheresis procedures occurs at moderate controller set points and high centrifuge rpm. The resultant operating efficiency and product purity values are approximately 63 percent and 0.65 respectively in the SS II chamber and approximately 70 percent and 0.70 respectively in the Dual Chamber. In the SS II, the optimum operating region for leukapheresis procedures occurred at high controller set point values for any centrifuge rpm above 1200 with an operating efficiency near 100 percent. However, in the Dual Chamber, the optimum operating region for leukapheresis procedures occurred at high controller set points and high centrifuge rpm's, again providing an operating efficiency near 100 percent.

  2. It Pays to Be Organized: Organizing Arithmetic Practice around Equivalent Values Facilitates Understanding of Math Equivalence

    ERIC Educational Resources Information Center

    McNeil, Nicole M.; Chesney, Dana L.; Matthews, Percival G.; Fyfe, Emily R.; Petersen, Lori A.; Dunwiddie, April E.; Wheeler, Mary C.

    2012-01-01

    This experiment tested the hypothesis that organizing arithmetic fact practice by equivalent values facilitates children's understanding of math equivalence. Children (M age = 8 years 6 months, N = 104) were randomly assigned to 1 of 3 practice conditions: (a) equivalent values, in which problems were grouped by equivalent sums (e.g., 3 + 4 = 7, 2…

  3. Television Quiz Show Simulation

    ERIC Educational Resources Information Center

    Hill, Jonnie Lynn

    2007-01-01

    This article explores the simulation of four television quiz shows for students in China studying English as a foreign language (EFL). It discusses the adaptation and implementation of television quiz shows and how the students reacted to them.

  4. Television Quiz Show Simulation

    ERIC Educational Resources Information Center

    Hill, Jonnie Lynn

    2007-01-01

    This article explores the simulation of four television quiz shows for students in China studying English as a foreign language (EFL). It discusses the adaptation and implementation of television quiz shows and how the students reacted to them.

  5. In vitro evaluation of COM.TEC apheresis platelet concentrates using a preparation set and pathogen inactivation over a storage period of five days.

    PubMed

    Moog, R; Fröhlich, A; Mayaudon, V; Lin, L

    2004-01-01

    The aim of the present study was to evaluate in vitro data on platelets collected by apheresis, processed on a preparation set followed by photochemical treatment (PCT). Fifteen single-donor platelet concentrates (PCs) were collected by apheresis (COM.TEC blood cell separator, Fresenius, Bad Homburg, Germany). The platelets were transferred to the preparation set and plasma was removed after centrifugation to resuspend the platelets in approximately 37% plasma and 63% platelet additive solution InterSol. PCT was done by exposing the platelets to amotosalen HCl followed by illumination with ultraviolet light. Blood cell counts and in vitro PLT function were measured up to 5 days. An average of 3.44 +/- 0.28 x 10(11) platelets were collected in a product volume of 351 +/- 21 mL. Plasma removal resulted in a mean platelet loss of 7.8%. After PCT, a progressive decrease in platelet function was observed. LDH level rose through storage (171 +/- 81 U/L) to levels approximating LDH levels observed post-collection (180 +/- 103 U/L). There was a gradual decrease of the platelets to respond to hypotonic shock response from 90 +/- 9 % post-plasma reduction to 48 +/- 16% at day 5. All PLT units met the European requirements for leukoreduction and the pH limit of 6.8 up to day 5 post-collection. The new preparation set was capable of producing platelet units meeting the requirements for PCT. Despite differences observed in in vitro platelet function parameters, PLTs at storage day 5 fit the German and European guidelines.

  6. Effect of low-dose citrate anticoagulation on the clinical safety and efficacy of direct adsorption of lipoproteins (DALI apheresis) in hypercholesterolemic patients: a prospective controlled clinical trial.

    PubMed

    Bosch, T; Heinemann, O; Duhr, C; Wendler, T; Keller, C; Fink, E; Kirschner, T; Klebert, S; Samtleben, W

    2000-10-01

    Direct adsorption of lipoproteins (DALI) is the first lipid apheresis system compatible with whole blood with the advantage of a very simple procedure. A mixture of heparin plus citrate (ACD-A) is used for the anticoagulation regimen (AR). A clinical, prospective, controlled crossover study was performed to test the safety and efficacy of low-dose citrate (LDC) anticoagulation in DALI. Five chronic DALI patients suffering from coronary heart disease and hypercholesterolemia underwent 3 DALI sessions each using the LDC anticoagulation regimen (60 IU heparin/kg body weight as initial bolus; 1:40 ACD-A: blood as perfusion). This was compared to 3 sessions per patient with the standard AR (bolus of 20 IU heparin/kg, 1:20 ACD-A as perfusion). Patient blood volumes (1.6; average of 7,040 ml) were treated with 750 ml adsorber gel per session at a blood flow rate of 60 ml/min. Mean LDL and Lp(a) reductions exceeded 60% with both AR. No clinical side effects were observed. Both AR controlled the coagulation well as evidenced by a sufficient prolongation of the partial prothrombin time (PTT) and activated clotting time as well as low thrombin-antithrombin (TAT) formation. Biocompatibility parameters exhibited favorable results (low activation of complement and cells, and only slight formation of C3a, C5a, beta-thromboglobulin, elastase, and TNF-alpha). The asymptomatic bradykinin generation was comparable in both study arms. LDC optimized the ionized calcium levels and pH in the efferent blood postadsorber. LDC anticoagulation was safe and effective, and may further improve the tolerance of DALI apheresis in hypercholesterolemic patients.

  7. Expressivism, Relativism, and the Analytic Equivalence Test

    PubMed Central

    Frápolli, Maria J.; Villanueva, Neftalí

    2015-01-01

    The purpose of this paper is to show that, pace (Field, 2009), MacFarlane’s assessment relativism and expressivism should be sharply distinguished. We do so by arguing that relativism and expressivism exemplify two very different approaches to context-dependence. Relativism, on the one hand, shares with other contemporary approaches a bottom–up, building block, model, while expressivism is part of a different tradition, one that might include Lewis’ epistemic contextualism and Frege’s content individuation, with which it shares an organic model to deal with context-dependence. The building-block model and the organic model, and thus relativism and expressivism, are set apart with the aid of a particular test: only the building-block model is compatible with the idea that there might be analytically equivalent, and yet different, propositions. PMID:26635690

  8. Expressivism, Relativism, and the Analytic Equivalence Test.

    PubMed

    Frápolli, Maria J; Villanueva, Neftalí

    2015-01-01

    The purpose of this paper is to show that, pace (Field, 2009), MacFarlane's assessment relativism and expressivism should be sharply distinguished. We do so by arguing that relativism and expressivism exemplify two very different approaches to context-dependence. Relativism, on the one hand, shares with other contemporary approaches a bottom-up, building block, model, while expressivism is part of a different tradition, one that might include Lewis' epistemic contextualism and Frege's content individuation, with which it shares an organic model to deal with context-dependence. The building-block model and the organic model, and thus relativism and expressivism, are set apart with the aid of a particular test: only the building-block model is compatible with the idea that there might be analytically equivalent, and yet different, propositions.

  9. Snow water equivalent mapping in Norway

    NASA Astrophysics Data System (ADS)

    Tveito, O. E.; Udnæs, H.-C.; Engeset, R.; Førland, E. J.; Isaksen, K.; Mengistu, Z.

    2003-04-01

    In high latitude area snow covers the ground large parts of the year. Information about the water volume as snow is of major importance in many respects. Flood forecasters at NVE need it in order to assess possible flood risks. Hydropower producers need it to plan the most efficient production of the water in their reservoirs, traders to estimate the potential energy available for the market. Meteorologists on their side use the information as boundary conditions in weather forecasting models. The Norwegian meteorological institute has provided snow accumulation maps for Norway for more than 50 years. These maps are now produced twice a month in the winter season. They show the accumulated precipitation in the winter season from the day the permanent snow cover is established. They do however not take melting into account, and do therefore not give a good description of the actual snow amounts during and after periods with snowmelt. Due to an increased need for a direct measure of water volumes as snow cover, met.no and NVE initialized a joint project in order to establish maps of the actual snow cover expressed in water equivalents. The project utilizes recent developments in the use of GIS in spatial modeling. Daily precipitation and temperature are distributed in space by using objective spatial interpolation methods. The interpolation considers topographical and other geographical parameters as well as weather type information. A degree-day model is used at each modeling point to calculate snow-accumulation and snowmelt. The maps represent a spatial scale of 1x1 km2. The modeled snow reservoir is validated by snow pillow values as well traditional snow depth observations. Preliminary results show that the new snow modeling approach reproduces the snow water equivalent well. The spatial approach also opens for a wide use in the terms of areal analysis.

  10. Variability in Opioid Equivalence Calculations.

    PubMed

    Rennick, Amanda; Atkinson, Timothy; Cimino, Nina M; Strassels, Scott A; McPherson, Mary Lynn; Fudin, Jeffrey

    2015-09-09

    Equianalgesic conversion methods are commonly used to switch patients from one opioid to another due to suboptimal pain relief or adverse events. There is no universally accepted opioid conversion method, however, and there is often significant variability between conversion resources. As a result, patients are at risk for undertreated pain and serious adverse events. The purpose of this survey was to compare the equianalgesic conversion estimates between nurse practitioners, pharmacists, and physicians for commonly prescribed opioids. A survey form was developed using Survey Monkey. Participation was solicited by providing a link to the survey via social media (e.g., Facebook, Twitter, LinkedIn, etc.) and emailing professional organizations for sharing with their members and followers. Data collected included demographics and estimated morphine equivalents (MEQs) of hydrocodone 80 mg, fentanyl transdermal patches 1,800 mcg (as 75 mcg/hour), methadone 40 mg, oxycodone 120 mg, and hydromorphone 48 mg. Participants were also asked to provide their choice of reference utilized to complete the conversions, including personal knowledge. Descriptive analyses were performed using measures of central tendency. Hypothesis testing was performed using Pearson's chi-squared and Fisher's Exact Test for categorical data and the Kruskal-Wallis equality of populations rank test for continuous data to assess differences between median opioid doses by professional groups. The total number of respondents included in the analysis was 319. Physicians, pharmacists, and nurse practitioners/physician assistants comprised 25.4%, 56.7%, and 16.3%, respectively, of respondents. The overall mean (± standard deviation) MEQ doses for fentanyl, hydrocodone, hydromorphone, methadone, and oxycodone were: 176 (±117) mg, 88 (±42) mg, 192 (±55) mg, 193 (±201) mg, and 173 (±39) mg, respectively. For fentanyl, the mean (±standard deviation) MEQ doses were 180 (±122) mg, 178 (±128) mg, and 157

  11. 21 CFR 26.9 - Equivalence determination.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS.... (a) Equivalence is established by having in place regulatory systems covering the criteria referred...

  12. 21 CFR 26.6 - Equivalence assessment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS... Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.6 Equivalence assessment...

  13. 21 CFR 26.9 - Equivalence determination.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS... Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.9 Equivalence determination...

  14. 21 CFR 26.6 - Equivalence assessment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS... Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.6 Equivalence assessment...

  15. 21 CFR 26.9 - Equivalence determination.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS... Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.9 Equivalence determination...

  16. 21 CFR 26.9 - Equivalence determination.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS... Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.9 Equivalence determination...

  17. 21 CFR 26.9 - Equivalence determination.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS... Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.9 Equivalence determination...

  18. 21 CFR 26.6 - Equivalence assessment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS... Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.6 Equivalence assessment...

  19. A Holographic Road Show.

    ERIC Educational Resources Information Center

    Kirkpatrick, Larry D.; Rugheimer, Mac

    1979-01-01

    Describes the viewing sessions and the holograms of a holographic road show. The traveling exhibits, believed to stimulate interest in physics, include a wide variety of holograms and demonstrate several physical principles. (GA)

  20. A Holographic Road Show.

    ERIC Educational Resources Information Center

    Kirkpatrick, Larry D.; Rugheimer, Mac

    1979-01-01

    Describes the viewing sessions and the holograms of a holographic road show. The traveling exhibits, believed to stimulate interest in physics, include a wide variety of holograms and demonstrate several physical principles. (GA)

  1. The impact of sunlight on high-latitude equivalent currents

    NASA Astrophysics Data System (ADS)

    Laundal, K. M.; Gjerloev, J. W.; Østgaard, N.; Reistad, J. P.; Haaland, S.; Snekvik, K.; Tenfjord, P.; Ohtani, S.; Milan, S. E.

    2016-03-01

    Ground magnetic field measurements can be mathematically related to an overhead ionospheric equivalent current. In this study we look in detail at how the global equivalent current, calculated using more than 30 years of SuperMAG magnetometer data, changes with sunlight conditions. The calculations are done using spherical harmonic analysis in quasi-dipole coordinates, a technique which leads to improved accuracy compared to previous studies. Sorting the data according to the location of the sunlight terminator and orientation of the interplanetary magnetic field (IMF), we find that the equivalent current resembles ionospheric convection patterns on the sunlit side of the terminator but not on the dark side. On the dark side, with southward IMF, the current is strongly dominated by a dawn cell and the current across the polar cap has a strong dawnward component. The contrast between the sunlit and dark side increases with increasing values of the F10.7 index, showing that increasing solar EUV flux changes not only the magnitude but also the morphology of the equivalent current system. The results are consistent with a recent study showing that Birkeland currents indirectly determine the equivalent current in darkness and that Hall currents dominate in sunlight. This has implication for the interpretation of ground magnetic field measurements and suggests that the magnetic disturbances at conjugate points will be asymmetrical when the solar illumination is different.

  2. Mapping Children's Understanding of Mathematical Equivalence

    ERIC Educational Resources Information Center

    Taylor, Roger S.; Rittle-Johnson, Bethany; Matthews, Percival G.; McEldoon, Katherine L.

    2009-01-01

    The focus of this research is to develop an initial framework for assessing and interpreting students' level of understanding of mathematical equivalence. Although this topic has been studied for many years, there has been no systematic development or evaluation of a valid measure of equivalence knowledge. A powerful method for accomplishing this…

  3. 7 CFR 1001.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1001.54 Section 1001.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1001.54 Equivalent price. See § 1000.54. Producer Price Differential ...

  4. 7 CFR 1131.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1131.54 Section 1131.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1131.54 Equivalent price. See § 1000.54. Uniform Prices ...

  5. 7 CFR 1033.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1033.54 Section 1033.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1033.54 Equivalent price. See § 1000.54. Producer Price Differential ...

  6. 7 CFR 1005.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1005.54 Section 1005.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1005.54 Equivalent price. See § 1000.54. Uniform Prices ...

  7. 7 CFR 1007.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1007.54 Section 1007.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1007.54 Equivalent price. See § 1000.54. Uniform Prices ...

  8. 7 CFR 1030.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1030.54 Section 1030.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1030.54 Equivalent price. See § 1000.54. ...

  9. 7 CFR 1032.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1032.54 Section 1032.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1032.54 Equivalent price. See § 1000.54. Producer Price Differential ...

  10. 7 CFR 1000.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1000.54 Section 1000.54 Agriculture... Prices § 1000.54 Equivalent price. If for any reason a price or pricing constituent required for computing the prices described in § 1000.50 is not available, the market administrator shall use a price or...

  11. 7 CFR 1126.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1126.54 Section 1126.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1126.54 Equivalent price. See § 1000.54. Producer Price Differential ...

  12. 7 CFR 1006.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1006.54 Section 1006.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1006.54 Equivalent price. See § 1000.54. Uniform Prices ...

  13. 7 CFR 1124.54 - Equivalent price.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1124.54 Section 1124.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Class Prices § 1124.54 Equivalent price. See § 1000.54. Producer Price Differential ...

  14. 33 CFR 155.120 - Equivalents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Equivalents. 155.120 Section 155.120 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION OIL OR HAZARDOUS MATERIAL POLLUTION PREVENTION REGULATIONS FOR VESSELS General § 155.120 Equivalents...

  15. 46 CFR 169.109 - Equivalents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Equivalents. 169.109 Section 169.109 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS General Provisions § 169.109 Equivalents. Substitutes for a fitting, appliance, apparatus, or equipment, may...

  16. 46 CFR 133.09 - Equivalents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Equivalents. When this part requires a particular fitting, material, or lifesaving appliance or arrangement, the Commandant (CG-521) may accept any other fitting, material, or lifesaving appliance or arrangement... evaluations and tests to determine the equivalent effectiveness of the substitute fitting, material,...

  17. Mania and Behavioral Equivalents: A Preliminary Study

    ERIC Educational Resources Information Center

    Sturmey, Peter; Laud, Rinita B.; Cooper, Christopher L.; Matson, Johnny L.; Fodstad, Jill C.

    2010-01-01

    Previous research has failed to address the possibility of behavioral equivalents in people with ID and mania. The relationship between a measure of mania and possible behavioral equivalents was assessed in 693 adults, most with severe or profound ID, living in a large residential setting. The mania subscale of the DASH-II proved to be a…

  18. Equivalence relations and behavior: an introductory tutorial.

    PubMed

    Sidman, Murray

    2009-01-01

    With an emphasis on procedural fundamentals, the original behavior-analytic equivalence experiments and the equivalence paradigm are described briefly. A few of the subsequent developments and implications are noted, with special reference to the possible significance of the findings with respect to language and cognition.

  19. Equivalence Relations and Behavior: An Introductory Tutorial

    ERIC Educational Resources Information Center

    Sidman, Murray

    2009-01-01

    With an emphasis on procedural fundamentals, the original behavior-analytic equivalence experiments and the equivalence paradigm are described briefly. A few of the subsequent developments and implications are noted, with special reference to the possible significance of the findings with respect to language and cognition. (Contains 9 figures.)

  20. 49 CFR 38.2 - Equivalent facilitation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Equivalent facilitation. 38.2 Section 38.2 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES General § 38.2 Equivalent facilitation. Departures from...

  1. 46 CFR 175.540 - Equivalents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... require engineering evaluations and tests to demonstrate the equivalence of the substitute. (b) The... Safety Management (ISM) Code (IMO Resolution A.741(18)) for the purpose of determining that an equivalent safety management system is in place on board a vessel. The Commandant will consider the size and...

  2. 33 CFR 106.130 - Equivalents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Equivalents. 106.130 Section 106.130 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MARITIME SECURITY MARINE SECURITY: OUTER CONTINENTAL SHELF (OCS) FACILITIES General § 106.130 Equivalents. For any...

  3. 33 CFR 106.130 - Equivalents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Equivalents. 106.130 Section 106.130 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MARITIME SECURITY MARINE SECURITY: OUTER CONTINENTAL SHELF (OCS) FACILITIES General § 106.130 Equivalents. For any...

  4. 33 CFR 106.130 - Equivalents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Equivalents. 106.130 Section 106.130 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MARITIME SECURITY MARINE SECURITY: OUTER CONTINENTAL SHELF (OCS) FACILITIES General § 106.130 Equivalents. For any...

  5. 7 CFR 1032.54 - Equivalent price.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 9 2012-01-01 2012-01-01 false Equivalent price. 1032.54 Section 1032.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1032.54 Equivalent price. See § 1000.54. Producer Price Differential...

  6. 7 CFR 1032.54 - Equivalent price.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 9 2014-01-01 2013-01-01 true Equivalent price. 1032.54 Section 1032.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Handling Class Prices § 1032.54 Equivalent price. See § 1000.54. Producer Price Differential...

  7. 7 CFR 1032.54 - Equivalent price.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 9 2013-01-01 2013-01-01 false Equivalent price. 1032.54 Section 1032.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Handling Class Prices § 1032.54 Equivalent price. See § 1000.54. Producer Price Differential...

  8. 7 CFR 1032.54 - Equivalent price.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Equivalent price. 1032.54 Section 1032.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1032.54 Equivalent price. See § 1000.54. Producer Price Differential...

  9. Equivalency Programmes (EPs) for Promoting Lifelong Learning

    ERIC Educational Resources Information Center

    Haddad, Caroline, Ed.

    2006-01-01

    Equivalency programmes (EPs) refers to alternative education programmes that are equivalent to the formal education system in terms of curriculum and certification, policy support mechanisms, mode of delivery, staff training, and other support activities such as monitoring, evaluation and assessment. The development of EPs is potentially an…

  10. Criteria equivalent to the Riemann Hypothesis

    NASA Astrophysics Data System (ADS)

    Cisło, J.; Wolf, M.

    2008-11-01

    We give a brief overview of a few criteria equivalent to the Riemann Hypothesis. Next we concentrate on the Riesz and Báez-Duarte criteria. We prove that they are equivalent and we provide some computer data to support them.

  11. Mania and Behavioral Equivalents: A Preliminary Study

    ERIC Educational Resources Information Center

    Sturmey, Peter; Laud, Rinita B.; Cooper, Christopher L.; Matson, Johnny L.; Fodstad, Jill C.

    2010-01-01

    Previous research has failed to address the possibility of behavioral equivalents in people with ID and mania. The relationship between a measure of mania and possible behavioral equivalents was assessed in 693 adults, most with severe or profound ID, living in a large residential setting. The mania subscale of the DASH-II proved to be a…

  12. 49 CFR 38.2 - Equivalent facilitation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Equivalent facilitation. 38.2 Section 38.2 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES General § 38.2 Equivalent facilitation. Departures from...

  13. 49 CFR 38.2 - Equivalent facilitation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false Equivalent facilitation. 38.2 Section 38.2 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES General § 38.2 Equivalent facilitation. Departures from...

  14. 49 CFR 38.2 - Equivalent facilitation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false Equivalent facilitation. 38.2 Section 38.2 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES General § 38.2 Equivalent facilitation. Departures from...

  15. 49 CFR 38.2 - Equivalent facilitation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Equivalent facilitation. 38.2 Section 38.2 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES General § 38.2 Equivalent facilitation. Departures from...

  16. 46 CFR 161.002-17 - Equivalents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Equivalents. 161.002-17 Section 161.002-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS... require engineering evaluations and tests to demonstrate the equivalence of the substitute. ...

  17. Galeazzi-equivalent lesions in adolescence.

    PubMed

    Kamano, Masayuki; Honda, Yoshinobu

    2002-07-01

    Two cases of a Galeazzi-equivalent lesion in adolescence are described. Accurate diagnosis of the epiphyseal injury of the distal ulna, rigid fixation of the distal radius, and stabilization of the distal radioulnar joint are keys in obtaining a good result in the treatment of Galeazzi-equivalent lesion in adolescence.

  18. 33 CFR 159.19 - Testing equivalency.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Testing equivalency. 159.19 Section 159.19 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.19 Testing equivalency. (a) If a...

  19. 33 CFR 159.19 - Testing equivalency.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Testing equivalency. 159.19 Section 159.19 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.19 Testing equivalency. (a) If a...

  20. 33 CFR 159.19 - Testing equivalency.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Testing equivalency. 159.19 Section 159.19 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.19 Testing equivalency. (a) If a...

  1. 33 CFR 159.19 - Testing equivalency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Testing equivalency. 159.19 Section 159.19 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.19 Testing equivalency. (a) If a...

  2. 33 CFR 159.19 - Testing equivalency.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Testing equivalency. 159.19 Section 159.19 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.19 Testing equivalency. (a) If a...

  3. Show Me the Way

    ERIC Educational Resources Information Center

    Dicks, Matthew J.

    2005-01-01

    Because today's students have grown up steeped in video games and the Internet, most of them expect feedback, and usually gratification, very soon after they expend effort on a task. Teachers can get quick feedback to students by showing them videotapes of their learning performances. The author, a 3rd grade teacher describes how the seemingly…

  4. Stage a Water Show

    ERIC Educational Resources Information Center

    Frasier, Debra

    2008-01-01

    In the author's book titled "The Incredible Water Show," the characters from "Miss Alaineus: A Vocabulary Disaster" used an ocean of information to stage an inventive performance about the water cycle. In this article, the author relates how she turned the story into hands-on science teaching for real-life fifth-grade students. The author also…

  5. The Ozone Show.

    ERIC Educational Resources Information Center

    Mathieu, Aaron

    2000-01-01

    Uses a talk show activity for a final assessment tool for students to debate about the ozone hole. Students are assessed on five areas: (1) cooperative learning; (2) the written component; (3) content; (4) self-evaluation; and (5) peer evaluation. (SAH)

  6. Chemistry Game Shows

    NASA Astrophysics Data System (ADS)

    Campbell, Susan; Muzyka, Jennifer

    2002-04-01

    We present a technological improvement to the use of game shows to help students review for tests. Our approach uses HTML files interpreted with a browser on a computer attached to an LCD projector. The HTML files can be easily modified for use of the game in a variety of courses.

  7. Showing What They Know

    ERIC Educational Resources Information Center

    Cech, Scott J.

    2008-01-01

    Having students show their skills in three dimensions, known as performance-based assessment, dates back at least to Socrates. Individual schools such as Barrington High School--located just outside of Providence--have been requiring students to actively demonstrate their knowledge for years. The Rhode Island's high school graduating class became…

  8. Honored Teacher Shows Commitment.

    ERIC Educational Resources Information Center

    Ratte, Kathy

    1987-01-01

    Part of the acceptance speech of the 1985 National Council for the Social Studies Teacher of the Year, this article describes the censorship experience of this honored social studies teacher. The incident involved the showing of a videotape version of the feature film entitled "The Seduction of Joe Tynan." (JDH)

  9. Honored Teacher Shows Commitment.

    ERIC Educational Resources Information Center

    Ratte, Kathy

    1987-01-01

    Part of the acceptance speech of the 1985 National Council for the Social Studies Teacher of the Year, this article describes the censorship experience of this honored social studies teacher. The incident involved the showing of a videotape version of the feature film entitled "The Seduction of Joe Tynan." (JDH)

  10. Talk Show Science.

    ERIC Educational Resources Information Center

    Moore, Mitzi Ruth

    1992-01-01

    Proposes having students perform skits in which they play the roles of the science concepts they are trying to understand. Provides the dialog for a skit in which hot and cold gas molecules are interviewed on a talk show to study how these properties affect wind, rain, and other weather phenomena. (MDH)

  11. What Do Maps Show?

    ERIC Educational Resources Information Center

    Geological Survey (Dept. of Interior), Reston, VA.

    This curriculum packet, appropriate for grades 4-8, features a teaching poster which shows different types of maps (different views of Salt Lake City, Utah), as well as three reproducible maps and reproducible activity sheets which complement the maps. The poster provides teacher background, including step-by-step lesson plans for four geography…

  12. Mars Slide Show

    NASA Technical Reports Server (NTRS)

    2006-01-01

    15 September 2006 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows a landslide that occurred off of a steep slope in Tithonium Chasma, part of the vast Valles Marineris trough system.

    Location near: 4.8oS, 84.6oW Image width: 3 km (1.9 mi) Illumination from: upper left Season: Southern Autumn

  13. Matching Derived Functionally-Same Stimulus Relations: Equivalence-Equivalence and Classical Analogies

    ERIC Educational Resources Information Center

    Carpentier, Franck; Smeets, Paul M.; Barnes-Holmes, Dermot; Stewart, Ian

    2004-01-01

    Previous studies have shown that, after being trained on A-B and A-C matching tasks, subjects match not only functionally-same B and C stimuli (stimulus equivalence), but also BC compounds with same-class elements and BC compounds with different-class elements (equivalence-equivalence). Similar performances are required in classical analogies (a :…

  14. Matching Derived Functionally-Same Stimulus Relations: Equivalence-Equivalence and Classical Analogies

    ERIC Educational Resources Information Center

    Carpentier, Franck; Smeets, Paul M.; Barnes-Holmes, Dermot; Stewart, Ian

    2004-01-01

    Previous studies have shown that, after being trained on A-B and A-C matching tasks, subjects match not only functionally-same B and C stimuli (stimulus equivalence), but also BC compounds with same-class elements and BC compounds with different-class elements (equivalence-equivalence). Similar performances are required in classical analogies (a :…

  15. Equivalence-Equivalence Responding: Training Conditions Involved in Obtaining a Stable Baseline Performance

    ERIC Educational Resources Information Center

    Garcia, Andres; Bohorquez, Cristobal; Perez, Vicente; Gutierrez, Maria Teresa; Gomez, Jesus; Luciano, Carmen; Wilson, Kelly

    2008-01-01

    Recent research has focused on the variables associated with equivalence-equivalence responding, in which participants match pairs of equivalent or nonequivalent stimuli. One such variable is the presence of response competition from nonarbitrary (physical) relational response options. In the current analysis, the experimenters examined the effect…

  16. Equivalence-Equivalence Responding: Training Conditions Involved in Obtaining a Stable Baseline Performance

    ERIC Educational Resources Information Center

    Garcia, Andres; Bohorquez, Cristobal; Perez, Vicente; Gutierrez, Maria Teresa; Gomez, Jesus; Luciano, Carmen; Wilson, Kelly

    2008-01-01

    Recent research has focused on the variables associated with equivalence-equivalence responding, in which participants match pairs of equivalent or nonequivalent stimuli. One such variable is the presence of response competition from nonarbitrary (physical) relational response options. In the current analysis, the experimenters examined the effect…

  17. On asymptotically lacunary invariant statistical equivalent set sequences

    NASA Astrophysics Data System (ADS)

    Pancaroglu, Nimet; Nuray, Fatih; Savas, Ekrem

    2013-10-01

    In this paper, we define asymptotically invariant equivalence, strongly asymptotically invariant equivalence, asymptotically invariant statistical equivalence, asymptotically lacunary invariant statistical equivalence, strongly asymptotically lacunary invariant equivalence, asymptotically lacunary invariant equivalence (Wijsman sense) for sequences of sets. Also we investigate some relations between asymptotically lacunary invariant statistical equivalence and asymptotically invariant statistical equivalence for sequences of sets. We introduce some notions and theorems as follows, asymptotically lacunary invariant statistical equivalence, strongly asymptotically lacunary invariant equivalence, asymptotically lacunary invariant equivalence (Wijsman sense) for sequences of sets.

  18. Analytical and numerical construction of equivalent cables.

    PubMed

    Lindsay, K A; Rosenberg, J R; Tucker, G

    2003-08-01

    The mathematical complexity experienced when applying cable theory to arbitrarily branched dendrites has lead to the development of a simple representation of any branched dendrite called the equivalent cable. The equivalent cable is an unbranched model of a dendrite and a one-to-one mapping of potentials and currents on the branched model to those on the unbranched model, and vice versa. The piecewise uniform cable, with a symmetrised tri-diagonal system matrix, is shown to represent the canonical form for an equivalent cable. Through a novel application of the Laplace transform it is demonstrated that an arbitrary branched model of a dendrite can be transformed to the canonical form of an equivalent cable. The characteristic properties of the equivalent cable are extracted from the matrix for the transformed branched model. The one-to-one mapping follows automatically from the construction of the equivalent cable. The equivalent cable is used to provide a new procedure for characterising the location of synaptic contacts on spinal interneurons.

  19. Allowed Vales of J in jj coupling of Equivalent Electrons.

    ERIC Educational Resources Information Center

    Tuttle, E. R.

    1980-01-01

    Provides a simple method for finding the values of the total angular momentum J for configurations of equivalent electrons in jj coupling. Shows how a knowledge of both the LS and jj terms can contribute to the students' understanding of the role of different representations in quantum mechanics. (Author/GS)

  20. Allowed Vales of J in jj coupling of Equivalent Electrons.

    ERIC Educational Resources Information Center

    Tuttle, E. R.

    1980-01-01

    Provides a simple method for finding the values of the total angular momentum J for configurations of equivalent electrons in jj coupling. Shows how a knowledge of both the LS and jj terms can contribute to the students' understanding of the role of different representations in quantum mechanics. (Author/GS)

  1. The equivalent depth of burst for impact cratering

    NASA Technical Reports Server (NTRS)

    Holsapple, K. A.

    1980-01-01

    The concept of modeling an impact cratering event with an explosive event with the explosive buried at some equivalent depth of burst (d.o.b.) is discussed. Various and different ways to define this equivalent d.o.b. are identified. Recent experimental results for a dense quartz sand are used to determine the equivalent d.o.b. for various conditions of charge type, event size, and impact conditions. The results show a decrease in equivalent d.o.b. with increasing energy for fixed impact velocity and a decrease in equivalent d.o.b. with increasing velocity for fixed energy. The values for an iron projectile are on the order of 2-3 projectile radii for energy equal to one ton of TNT, decreasing to about 1.5 radii at a megaton of TNT. The dependence on projectile and target mass density matches that included in common jet-penetration formulas for projectile densities greater than target densities and for the higher energies.

  2. The equivalent depth of burst for impact cratering

    NASA Technical Reports Server (NTRS)

    Holsapple, K. A.

    1980-01-01

    The concept of modeling an impact cratering event with an explosive event with the explosive buried at some equivalent depth of burst (d.o.b.) is discussed. Various and different ways to define this equivalent d.o.b. are identified. Recent experimental results for a dense quartz sand are used to determine the equivalent d.o.b. for various conditions of charge type, event size, and impact conditions. The results show a decrease in equivalent d.o.b. with increasing energy for fixed impact velocity and a decrease in equivalent d.o.b. with increasing velocity for fixed energy. The values for an iron projectile are on the order of 2-3 projectile radii for energy equal to one ton of TNT, decreasing to about 1.5 radii at a megaton of TNT. The dependence on projectile and target mass density matches that included in common jet-penetration formulas for projectile densities greater than target densities and for the higher energies.

  3. Not a "reality" show.

    PubMed

    Wrong, Terence; Baumgart, Erica

    2013-01-01

    The authors of the preceding articles raise legitimate questions about patient and staff rights and the unintended consequences of allowing ABC News to film inside teaching hospitals. We explain why we regard their fears as baseless and not supported by what we heard from individuals portrayed in the filming, our decade-long experience making medical documentaries, and the full un-aired context of the scenes shown in the broadcast. The authors don't and can't know what conversations we had, what documents we reviewed, and what protections we put in place in each televised scene. Finally, we hope to correct several misleading examples cited by the authors as well as their offhand mischaracterization of our program as a "reality" show.

  4. XMM on show

    NASA Astrophysics Data System (ADS)

    1998-01-01

    A unique opportunity for journalists and cameramen to view Europe's next scientific satellite, XMM, will be provided at ESA/ESTEC, Noordwijk, the Netherlands on Tuesday 10 February at 10:00 a.m. On show will be the full-size development version of XMM which has completed engineering tests. Press representatives will be permitted to inspect it and take pictures at close quarters. Robert Lainé, the XMM project manager, and Fred Jansen, the XMM project scientist will present the spacecraft and mission. Roger Bonnet, Director of the ESA Science programme will present Horizons 2000, the future ESA Science programme. After the presentations they will be available to answer questions. Due for launch in 1999, XMM is an unprecedented space observatory for X-ray astronomy, with far greater sensitivity than any previous X-ray mission. It is also ESA's largest scientific spacecraft -- almost 11 metres long and with a mass of nearly 4 tonnes.

  5. Gauge equivalence of two different IAnsaaumlItze Rfor non-Abelian charged vortices

    SciTech Connect

    Paul, S.K.

    1987-05-15

    Recently the existence of non-Abelian charged vortices has been established by taking two different Ansa$uml: tze in SU(2) gauge theories. We point out that these two Ansa$uml: tze are in two topologically equivalent prescriptions. We show that they are gauge equivalent only at infinity. We also show that this gauge equivalence is not possible for Z/sub N/ vortices in SU(N) gauge theories for Ngreater than or equal to3.

  6. Dynamic equivalences in the hard-sphere dynamic universality class.

    PubMed

    López-Flores, Leticia; Ruíz-Estrada, Honorina; Chávez-Páez, Martín; Medina-Noyola, Magdaleno

    2013-10-01

    We perform systematic simulation experiments on model systems with soft-sphere repulsive interactions to test the predicted dynamic equivalence between soft-sphere liquids with similar static structure. For this we compare the simulated dynamics (mean squared displacement, intermediate scattering function, α-relaxation time, etc.) of different soft-sphere systems, between them and with the hard-sphere liquid. We then show that the referred dynamic equivalence does not depend on the (Newtonian or Brownian) nature of the microscopic laws of motion of the constituent particles, and hence, applies independently to colloidal and to atomic simple liquids. Finally, we verify another more recently proposed dynamic equivalence, this time between the long-time dynamics of an atomic liquid and its corresponding Brownian fluid (i.e., the Brownian system with the same interaction potential).

  7. Topological equivalence between the Fibonacci quasicrystal and the Harper model.

    PubMed

    Kraus, Yaacov E; Zilberberg, Oded

    2012-09-14

    One-dimensional quasiperiodic systems, such as the Harper model and the Fibonacci quasicrystal, have long been the focus of extensive theoretical and experimental research. Recently, the Harper model was found to be topologically nontrivial. Here, we derive a general model that embodies a continuous deformation between these seemingly unrelated models. We show that this deformation does not close any bulk gaps, and thus prove that these models are in fact topologically equivalent. Remarkably, they are equivalent regardless of whether the quasiperiodicity appears as an on-site or hopping modulation. This proves that these different models share the same boundary phenomena and explains past measurements. We generalize this equivalence to any Fibonacci-like quasicrystal, i.e., a cut and project in any irrational angle.

  8. Antireflection design concepts with equivalent layers.

    PubMed

    Schallenberg, Uwe B

    2006-03-01

    Some novel concepts of designing antireflection (AR) coatings with equivalent layers are presented. As an introduction, essential papers concerning thin-film optics and AR designs are cited, and the AR problem and a previously introduced AR-hard design type are discussed. Based on the known matrix formalism, a potential AR region, an equivalent stack index, and an equivalent substrate index are defined to use the theory of stop-band suppression as a starting point for the design of broadband AR coatings. The known multicycle AR design type is identified as a typical solution to the AR problem if the presented approach is used.

  9. Public medical shows.

    PubMed

    Walusinski, Olivier

    2014-01-01

    In the second half of the 19th century, Jean-Martin Charcot (1825-1893) became famous for the quality of his teaching and his innovative neurological discoveries, bringing many French and foreign students to Paris. A hunger for recognition, together with progressive and anticlerical ideals, led Charcot to invite writers, journalists, and politicians to his lessons, during which he presented the results of his work on hysteria. These events became public performances, for which physicians and patients were transformed into actors. Major newspapers ran accounts of these consultations, more like theatrical shows in some respects. The resultant enthusiasm prompted other physicians in Paris and throughout France to try and imitate them. We will compare the form and substance of Charcot's lessons with those given by Jules-Bernard Luys (1828-1897), Victor Dumontpallier (1826-1899), Ambroise-Auguste Liébault (1823-1904), Hippolyte Bernheim (1840-1919), Joseph Grasset (1849-1918), and Albert Pitres (1848-1928). We will also note their impact on contemporary cinema and theatre.

  10. Differences in levels of platelet-derived microparticles in platelet components prepared using the platelet rich plasma, buffy coat, and apheresis procedures.

    PubMed

    Noulsri, Egarit; Udomwinijsilp, Prapaporn; Lerdwana, Surada; Chongkolwatana, Viroje; Permpikul, Parichart

    2017-04-01

    There has been an increased interest in platelet-derived microparticles (PMPs) in transfusion medicine. Little is known about PMP status during the preparation of platelet concentrates for transfusion. The aim of this study is to compare the PMP levels in platelet components prepared using the buffy coat (BC), platelet-rich plasma platelet concentrate (PRP-PC), and apheresis (AP) processes. Platelet components were prepared using the PRP-PC and BC processes. Apheresis platelets were prepared using the Trima Accel and Amicus instruments. The samples were incubated with annexin A5-FITC, CD41-PE, and CD62P-APC. At day 1 after processing, the PMPs and activated platelets were determined using flow cytometry. Both the percentage and number of PMPs were higher in platelet components prepared using the Amicus instrument (2.6±1.8, 32802±19036 particles/μL) than in platelet components prepared using the Trima Accel instrument (0.5±0.4, 7568±5298 particles/μL), BC (1.2±0.6, 12,920±6426 particles/μL), and PRP-PC (0.9±0.6, 10731±5514 particles/μL). Both the percentage and number of activated platelets were higher in platelet components prepared using the Amicus instrument (33.2±13.9, 427553±196965 cells/μL) than in platelet components prepared using the Trima Accel instrument (16.2±6.1, 211209±87706 cells/μL), BC (12.9±3.2, 140624±41003 cells/μL), and PRP-PC (21.1±6.3, 265210±86257 cells/μL). The study suggests high variability of PMPs and activated platelets in platelet components prepared using different processes. This result may be important in validating the instruments involved in platelet blood collection and processing. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Equivalent Sensor Radiance Generation and Remote Sensing from Model Parameters. Part 1; Equivalent Sensor Radiance Formulation

    NASA Technical Reports Server (NTRS)

    Wind, Galina; DaSilva, Arlindo M.; Norris, Peter M.; Platnick, Steven E.

    2013-01-01

    In this paper we describe a general procedure for calculating equivalent sensor radiances from variables output from a global atmospheric forecast model. In order to take proper account of the discrepancies between model resolution and sensor footprint the algorithm takes explicit account of the model subgrid variability, in particular its description of the probably density function of total water (vapor and cloud condensate.) The equivalent sensor radiances are then substituted into an operational remote sensing algorithm processing chain to produce a variety of remote sensing products that would normally be produced from actual sensor output. This output can then be used for a wide variety of purposes such as model parameter verification, remote sensing algorithm validation, testing of new retrieval methods and future sensor studies. We show a specific implementation using the GEOS-5 model, the MODIS instrument and the MODIS Adaptive Processing System (MODAPS) Data Collection 5.1 operational remote sensing cloud algorithm processing chain (including the cloud mask, cloud top properties and cloud optical and microphysical properties products.) We focus on clouds and cloud/aerosol interactions, because they are very important to model development and improvement.

  12. Stretched View Showing 'Victoria'

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Stretched View Showing 'Victoria'

    This pair of images from the panoramic camera on NASA's Mars Exploration Rover Opportunity served as initial confirmation that the two-year-old rover is within sight of 'Victoria Crater,' which it has been approaching for more than a year. Engineers on the rover team were unsure whether Opportunity would make it as far as Victoria, but scientists hoped for the chance to study such a large crater with their roving geologist. Victoria Crater is 800 meters (nearly half a mile) in diameter, about six times wider than 'Endurance Crater,' where Opportunity spent several months in 2004 examining rock layers affected by ancient water.

    When scientists using orbital data calculated that they should be able to detect Victoria's rim in rover images, they scrutinized frames taken in the direction of the crater by the panoramic camera. To positively characterize the subtle horizon profile of the crater and some of the features leading up to it, researchers created a vertically-stretched image (top) from a mosaic of regular frames from the panoramic camera (bottom), taken on Opportunity's 804th Martian day (April 29, 2006).

    The stretched image makes mild nearby dunes look like more threatening peaks, but that is only a result of the exaggerated vertical dimension. This vertical stretch technique was first applied to Viking Lander 2 panoramas by Philip Stooke, of the University of Western Ontario, Canada, to help locate the lander with respect to orbiter images. Vertically stretching the image allows features to be more readily identified by the Mars Exploration Rover science team.

    The bright white dot near the horizon to the right of center (barely visible without labeling or zoom-in) is thought to be a light-toned outcrop on the far wall of the crater, suggesting that the rover can see over the low rim of Victoria. In figure 1, the northeast and southeast rims are labeled

  13. Stretched View Showing 'Victoria'

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Stretched View Showing 'Victoria'

    This pair of images from the panoramic camera on NASA's Mars Exploration Rover Opportunity served as initial confirmation that the two-year-old rover is within sight of 'Victoria Crater,' which it has been approaching for more than a year. Engineers on the rover team were unsure whether Opportunity would make it as far as Victoria, but scientists hoped for the chance to study such a large crater with their roving geologist. Victoria Crater is 800 meters (nearly half a mile) in diameter, about six times wider than 'Endurance Crater,' where Opportunity spent several months in 2004 examining rock layers affected by ancient water.

    When scientists using orbital data calculated that they should be able to detect Victoria's rim in rover images, they scrutinized frames taken in the direction of the crater by the panoramic camera. To positively characterize the subtle horizon profile of the crater and some of the features leading up to it, researchers created a vertically-stretched image (top) from a mosaic of regular frames from the panoramic camera (bottom), taken on Opportunity's 804th Martian day (April 29, 2006).

    The stretched image makes mild nearby dunes look like more threatening peaks, but that is only a result of the exaggerated vertical dimension. This vertical stretch technique was first applied to Viking Lander 2 panoramas by Philip Stooke, of the University of Western Ontario, Canada, to help locate the lander with respect to orbiter images. Vertically stretching the image allows features to be more readily identified by the Mars Exploration Rover science team.

    The bright white dot near the horizon to the right of center (barely visible without labeling or zoom-in) is thought to be a light-toned outcrop on the far wall of the crater, suggesting that the rover can see over the low rim of Victoria. In figure 1, the northeast and southeast rims are labeled

  14. REFractions: The Representing Equivalent Fractions Game

    ERIC Educational Resources Information Center

    Tucker, Stephen I.

    2014-01-01

    Stephen Tucker presents a fractions game that addresses a range of fraction concepts including equivalence and computation. The REFractions game also improves students' fluency with representing, comparing and adding fractions.

  15. Snow Water Equivalent for Tuolumne River Basin

    NASA Image and Video Library

    2013-05-02

    NASA Airborne Snow Observatory measurements of snow water equivalent top image and snow albedo, or reflectivity bottom image for the Tuolumne River Basin in California Sierra Nevada on April 21, 2013.

  16. Equivalence relations and the reinforcement contingency.

    PubMed

    Sidman, M

    2000-07-01

    Where do equivalence relations come from? One possible answer is that they arise directly from the reinforcement contingency. That is to say, a reinforcement contingency produces two types of outcome: (a) 2-, 3-, 4-, 5-, or n-term units of analysis that are known, respectively, as operant reinforcement, simple discrimination, conditional discrimination, second-order conditional discrimination, and so on; and (b) equivalence relations that consist of ordered pairs of all positive elements that participate in the contingency. This conception of the origin of equivalence relations leads to a number of new and verifiable ways of conceptualizing equivalence relations and, more generally, the stimulus control of operant behavior. The theory is also capable of experimental disproof.

  17. 46 CFR 125.170 - Equivalents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... required by this subchapter may be accepted by the cognizant OCMI; by the Commanding Officer, Marine Safety... GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS GENERAL § 125.170 Equivalents... of safety....

  18. 46 CFR 114.540 - Equivalents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., calculation, information, or test which provides a level of safety equivalent to that established by specific... provisions of the International Maritime Organization (IMO) “Code of Safety for High Speed Craft” as...

  19. 46 CFR 175.540 - Equivalents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., appliance, apparatus, equipment, calculation, information, or test, which provides a level of safety... Organization (IMO) “Code of Safety for High Speed Craft” as an equivalent to compliance with...

  20. Distinguishing Provenance Equivalence of Earth Science Data

    NASA Technical Reports Server (NTRS)

    Tilmes, Curt; Yesha, Ye; Halem, M.

    2010-01-01

    Reproducibility of scientific research relies on accurate and precise citation of data and the provenance of that data. Earth science data are often the result of applying complex data transformation and analysis workflows to vast quantities of data. Provenance information of data processing is used for a variety of purposes, including understanding the process and auditing as well as reproducibility. Certain provenance information is essential for producing scientifically equivalent data. Capturing and representing that provenance information and assigning identifiers suitable for precisely distinguishing data granules and datasets is needed for accurate comparisons. This paper discusses scientific equivalence and essential provenance for scientific reproducibility. We use the example of an operational earth science data processing system to illustrate the application of the technique of cascading digital signatures or hash chains to precisely identify sets of granules and as provenance equivalence identifiers to distinguish data made in an an equivalent manner.

  1. On asymptotically generalized statistical equivalent set sequences

    NASA Astrophysics Data System (ADS)

    Savas, Ekrem

    2013-10-01

    In this paper we shall study the asymptotically λ-statistical equivalent (Wijsman sense) of multiple L. In addition to these definition, natural inclusion theorems shall also be presented. This approach has not been considered in any context before.

  2. Equivalent multipole operators for degenerate Rydberg states

    SciTech Connect

    Ostrovsky, V. N.; Vrinceanu, D.; Flannery, M. R.

    2006-08-15

    As shown by Pauli, [Z. Phys. 36, 336 (1926)], the electric dipole operator r can be replaced by the Runge-Lenz vector A when operating within the n{sup 2} degenerate manifold of hydrogenic states of principal quantum number n. We seek to develop similar rules for higher multipole operators by expressing equivalent operators in terms only of the two vector constants of motion - the orbital angular momentum L and the Runge-Lenz vector A - appropriate to the degenerate hydrogenic shell. Equivalence of two operators means here that they yield identical matrix elements within a subspace of Hilbert space that corresponds to fixed n. Such equivalent-operator techniques permit direct algebraic calculation of perturbations of Rydberg atoms by external fields and often exact analytical results for transition probabilities. Explicit expressions for equivalent quadrupole and octupole operators are derived, examples are provided, and general aspects of the problem are discussed.

  3. [Therapeutic equivalence of the new oral anticoagulants].

    PubMed

    Moreno Villar, A; Nacle López, I; Barbero Hernández, M J; Lizan Tudela, L

    2015-10-01

    In an attempt to minimize the economic impact due to the incorporation of innovative drugs, health authorities have promoted and supported the evaluation and market positioning of drugs, as equivalent therapeutic alternatives. This issue has recently gained importance, possibly due to the current economic crisis. The equivalent therapeutic alternatives are justified by the need to compete on price, and by the authorities recommendation to establish therapeutic equivalence, price and financing of medicinal products at the same time. The establishment of the new oral anticoagulants and the equivalent therapeutic alternatives is a problematic issue if it is based on the absence of direct comparisons between different drugs and the questionable methodology used in the current indirect comparisons. Currently, it is difficult to determine when a new oral anticoagulant is more recommendable than others, but efforts are being made in order to propose alternatives for the decision based on patient characteristics.

  4. Dark matter and the equivalence principle

    NASA Technical Reports Server (NTRS)

    Frieman, Joshua A.; Gradwohl, Ben-Ami

    1993-01-01

    A survey is presented of the current understanding of dark matter invoked by astrophysical theory and cosmology. Einstein's equivalence principle asserts that local measurements cannot distinguish a system at rest in a gravitational field from one that is in uniform acceleration in empty space. Recent test-methods for the equivalence principle are presently discussed as bases for testing of dark matter scenarios involving the long-range forces between either baryonic or nonbaryonic dark matter and ordinary matter.

  5. Quantum equivalence of dual field theories

    NASA Astrophysics Data System (ADS)

    Fradkin, E. S.; Tseytlin, A. A.

    1985-06-01

    Motivated by the study of ultraviolet properties of different versions of supergravities duality transformations at the quantum level are discussed. Using the background field method it is proven on shell quantum equivalence for several pairs of dual field theories known to be classically equivalent. The examples considered include duality in chiral model, duality of scalars and second rank antisymmetric gauge tensors, vector duality and duality of the Einstein theory with cosmological term and the Eddington-Schrödinger theory.

  6. Dark matter and the equivalence principle

    NASA Technical Reports Server (NTRS)

    Frieman, Joshua A.; Gradwohl, Ben-Ami

    1993-01-01

    A survey is presented of the current understanding of dark matter invoked by astrophysical theory and cosmology. Einstein's equivalence principle asserts that local measurements cannot distinguish a system at rest in a gravitational field from one that is in uniform acceleration in empty space. Recent test-methods for the equivalence principle are presently discussed as bases for testing of dark matter scenarios involving the long-range forces between either baryonic or nonbaryonic dark matter and ordinary matter.

  7. Methods for Equivalence and Noninferiority Testing

    PubMed Central

    Silva, Gisela Tunes da; Logan, Brent R.; Klein, John P.

    2009-01-01

    Classical hypothesis testing focuses on testing whether treatments have differential effects on outcome. However, sometimes clinicians may be more interested in determining whether treatments are equivalent or whether one has noninferior outcomes. We review the hypotheses for these noninferiority and equivalence research questions, consider power and sample size issues, and discuss how to perform such a test for both binary and survival outcomes. The methods are illustrated on 2 recent studies in hematopoietic cell transplantation. PMID:19147090

  8. The endotopism semigroups of an equivalence relation

    SciTech Connect

    Zhuchok, Yu V; Toichkina, E A

    2014-05-31

    In this work we investigate six types of endotopism semigroups for a given equivalence relation. Necessary and sufficient conditions for the existence of all such endotopisms are presented. Conditions for the regularity and coregularity of each of the endotopism semigroups of a given type are established. The notion of the endotype of a binary relation with respect to its endotopisms is introduced and the endotype of an arbitrary equivalence relation is calculated. Bibliography: 26 titles.

  9. Multilingual energy dictionary. [Equivalents in 6 languages

    SciTech Connect

    Isaacs, A.

    1981-01-01

    This dictionary covers 1600 entries - ranging from oil well to synthetic natural gas and waste heat recovery - that cover both concepts and equipment, providing the equivalents of the most-important energy terms in six languages: English, French, German, Italian, Portuguese, and Spanish. Each term is listed six times - under each language, with all five foreign equivalents - permitting easy translation among all six languages. Separate entries are also given for British and American English where usage differs in the two countries.

  10. The nonequivalence of behavioral and mathematical equivalence.

    PubMed

    Saunders, R R; Green, G

    1992-03-01

    Sidman and his colleagues derived behavioral tests for stimulus equivalence from the axiom in logic and mathematics that defines a relation of equivalence. The analogy has generated abundant research in which match-to-sample methods have been used almost exclusively to study interesting and complex stimulus control phenomena. It has also stimulated considerable discussion regarding interpretation of the analogy and speculation as to its validity and generality. This article reexamines the Sidman stimulus equivalence analogy in the context of a broader consideration of the mathematical axiom than was included in the original presentation of the analogy and some of the data that have accumulated in the interim. We propose that (a) mathematical and behavioral examples of equivalence relations differ substantially, (b) terminology is being used in ways that can lead to erroneous conclusions about the nature of the stimulus control that develops in stimulus equivalence experiments, and (c) complete analyses of equivalence and other types of stimulus-stimulus relations require more than a simple invocation of the analogy. Implications of our analysis for resolving current issues and prompting new research are discussed.

  11. Equivalence Relations, Contextual Control, and Naming

    PubMed Central

    Randell, Tom; Remington, Bob

    2006-01-01

    This paper reports two experiments that investigated the role of verbal behavior in the emergence and generalization of contextually controlled equivalence classes. During both experiments, participants were trained with two different combinations of the same easily nameable, yet formally unrelated, pictorial stimuli. Match-to-sample baselines for eight four-member classes were established under the contextual control of two colors. In the presence of one color, conditional relations were established between stimuli whose normative names rhymed. In the presence of the other color, conditional relations were established between stimuli whose normative names did not rhyme. Although, during Experiment 1, all participants demonstrated equivalence classes involving rhyming stimuli, none demonstrated the formation of nonrhyme equivalence classes. To investigate this finding, Experiment 2 evaluated whether participants would demonstrate both rhyme and nonrhyme equivalence classes given more extensive exposure to the experimental contingencies. All participants demonstrated contextually controlled rhyme and nonrhyme equivalence classes, although rhyme classes were demonstrated with greater facility than nonrhyme classes. Results indicate that visual stimuli are named, that verbal bases for stimulus classification can affect the emergence of contextually controlled equivalence classes, and that untrained contextually controlled conditional discriminations involving novel stimuli can emerge on the basis of participants' verbal behavior. PMID:17191757

  12. Translation of questionnaires and issues of equivalence.

    PubMed

    Chang, A M; Chau, J P; Holroyd, E

    1999-02-01

    The validity of studies using translated instruments may be questioned when there is a lack of attention to and/or minimal explanation of the procedures used for determining the equivalence between the primary and secondary language tool. Ensuring equivalence of a translated Chinese version of the Menstrual Distress Questionnaire is an important prerequisite for identifying culturally specific expressions of concepts under investigation and for cross-cultural comparisons. This paper examines the principles and procedures for determining equivalence of translated tools and their application to the development of an equivalent Chinese version of the Menstrual Distress Questionnaire. Translation and back-translation were used to develop a Chinese version of the Menstrual Distress Questionnaire. Bilingual university students completed both versions of the Menstrual Distress Questionnaire. Most of the Menstrual Distress Questionnaire items had an acceptable Kappa of >0.4. Intraclass correlation coefficients indicated moderate to high levels of equivalence for total scores and all scales. Improvement in the translation of some items is needed to further enhance the equivalence of the Chinese version of the Menstrual Distress Questionnaire.

  13. Motor equivalence during multi-finger accurate force production

    PubMed Central

    Mattos, Daniela; Schöner, Gregor; Zatsiorsky, Vladimir M.; Latash, Mark L.

    2014-01-01

    We explored stability of multi-finger cyclical accurate force production action by analysis of responses to small perturbations applied to one of the fingers and inter-cycle analysis of variance. Healthy subjects performed two versions of the cyclical task, with and without an explicit target. The “inverse piano” apparatus was used to lift/lower a finger by 1 cm over 0.5 s; the subjects were always instructed to perform the task as accurate as they could at all times. Deviations in the spaces of finger forces and modes (hypothetical commands to individual fingers) were quantified in directions that did not change total force (motor equivalent) and in directions that changed the total force (non-motor equivalent). Motor equivalent deviations started immediately with the perturbation and increased progressively with time. After a sequence of lifting-lowering perturbations leading to the initial conditions, motor equivalent deviations were dominating. These phenomena were less pronounced for analysis performed with respect to the total moment of force with respect to an axis parallel to the forearm/hand. Analysis of inter-cycle variance showed consistently higher variance in a subspace that did not change the total force as compared to the variance that affected total force. We interpret the results as reflections of task-specific stability of the redundant multi-finger system. Large motor equivalent deviations suggest that reactions of the neuromotor system to a perturbation involve large changes of neural commands that do not affect salient performance variables, even during actions with the purpose to correct those salient variables. Consistency of the analyses of motor equivalence and variance analysis provides additional support for the idea of task-specific stability ensured at a neural level. PMID:25344311

  14. Technical note: Equivalent genomic models with a residual polygenic effect.

    PubMed

    Liu, Z; Goddard, M E; Hayes, B J; Reinhardt, F; Reents, R

    2016-03-01

    Routine genomic evaluations in animal breeding are usually based on either a BLUP with genomic relationship matrix (GBLUP) or single nucleotide polymorphism (SNP) BLUP model. For a multi-step genomic evaluation, these 2 alternative genomic models were proven to give equivalent predictions for genomic reference animals. The model equivalence was verified also for young genotyped animals without phenotypes. Due to incomplete linkage disequilibrium of SNP markers to genes or causal mutations responsible for genetic inheritance of quantitative traits, SNP markers cannot explain all the genetic variance. A residual polygenic effect is normally fitted in the genomic model to account for the incomplete linkage disequilibrium. In this study, we start by showing the proof that the multi-step GBLUP and SNP BLUP models are equivalent for the reference animals, when they have a residual polygenic effect included. Second, the equivalence of both multi-step genomic models with a residual polygenic effect was also verified for young genotyped animals without phenotypes. Additionally, we derived formulas to convert genomic estimated breeding values of the GBLUP model to its components, direct genomic values and residual polygenic effect. Third, we made a proof that the equivalence of these 2 genomic models with a residual polygenic effect holds also for single-step genomic evaluation. Both the single-step GBLUP and SNP BLUP models lead to equal prediction for genotyped animals with phenotypes (e.g., reference animals), as well as for (young) genotyped animals without phenotypes. Finally, these 2 single-step genomic models with a residual polygenic effect were proven to be equivalent for estimation of SNP effects, too.

  15. Frequencies and Flutter Speed Estimation for Damaged Aircraft Wing Using Scaled Equivalent Plate Analysis

    NASA Technical Reports Server (NTRS)

    Krishnamurthy, Thiagarajan

    2010-01-01

    Equivalent plate analysis is often used to replace the computationally expensive finite element analysis in initial design stages or in conceptual design of aircraft wing structures. The equivalent plate model can also be used to design a wind tunnel model to match the stiffness characteristics of the wing box of a full-scale aircraft wing model while satisfying strength-based requirements An equivalent plate analysis technique is presented to predict the static and dynamic response of an aircraft wing with or without damage. First, a geometric scale factor and a dynamic pressure scale factor are defined to relate the stiffness, load and deformation of the equivalent plate to the aircraft wing. A procedure using an optimization technique is presented to create scaled equivalent plate models from the full scale aircraft wing using geometric and dynamic pressure scale factors. The scaled models are constructed by matching the stiffness of the scaled equivalent plate with the scaled aircraft wing stiffness. It is demonstrated that the scaled equivalent plate model can be used to predict the deformation of the aircraft wing accurately. Once the full equivalent plate geometry is obtained, any other scaled equivalent plate geometry can be obtained using the geometric scale factor. Next, an average frequency scale factor is defined as the average ratio of the frequencies of the aircraft wing to the frequencies of the full-scaled equivalent plate. The average frequency scale factor combined with the geometric scale factor is used to predict the frequency response of the aircraft wing from the scaled equivalent plate analysis. A procedure is outlined to estimate the frequency response and the flutter speed of an aircraft wing from the equivalent plate analysis using the frequency scale factor and geometric scale factor. The equivalent plate analysis is demonstrated using an aircraft wing without damage and another with damage. Both of the problems show that the scaled

  16. Stability of Thawed Apheresis Fresh-Frozen Plasma Stored for up to 120 Hours at 1°C to 6°C

    PubMed Central

    Bhakta, Varsha; Yi, Qi-Long; Jenkins, Craig

    2016-01-01

    Regulations concerning the storage of transfusable plasma differ internationally. In Canada, plasma obtained from whole blood donations and frozen within 24 hours of phlebotomy (frozen plasma, FP) may be thawed and transfused within 120 hours of refrigerated storage. However, plasma frozen within 8 hours of phlebotomy following apheresis donation (FFPA) must be transfused within 24 hours of thawing and refrigeration. Our objectives were to measure coagulation factors (F) V, VII, and VIII, fibrinogen activities, and the prothrombin time (PT) in thawed refrigerated FFPA at 0, 24, and 120 hours of storage and to compare these values to those in thawed refrigerated FP. Fibrinogen activity remained unchanged over time, while mean factor levels in 28 FFPA units declined by 17% (FV), 19.7% (FVII), and 54.6% (FVIII) over 120 hours, while PT values rose to 7.6%. Factor activities were significantly higher in FFPA than FP after 120 hours of refrigerated storage. Residual FVIII activities in thawed FFPA met predefined noninferiority criteria compared to thawed FP after 120 hours. These results support a change in Canadian regulations to permit transfusion of thawed FFPA made in a closed system and refrigerated for up to 120 hours, one that could reduce wastage of transfusable plasma. PMID:28003931

  17. The relative safety of pooled whole-blood-derived platelets prepared by the buffy-coat method versus single-donor (apheresis) platelets.

    PubMed

    Vamvakas, Eleftherios C

    2010-01-01

    Conversion to a single-donor (apheresis) platelet inventory in Western Europe and other countries that provide similar health care to the US but rely on buffy-coat pooled whole-blood-derived platelets will confer the benefit of a > or = 2-fold reduction in the risk of all emerging transfusion-transmitted infections (TTIs). In Europe, this benefit will include a > or = 2-fold reduction in the risk of acquiring variant Creutzfeldt-Jakob disease (vCJD) from platelet transfusion. In countries that use buffy coats from first-time donors to produce platelet pools, there will also be a > or = 2-fold reduction in the risk of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus infections. Conversion to a single-donor inventory collected from male donors (or female donors without a history of pregnancy or shown not to have white-blood-cell antibodies) should also reduce the risk of transfusion-related acute lung injury, although this prediction is based on theory and may not materialize or prove hard to document. Because conversion to a single-donor inventory can effect a > or = 2-fold reduction in the risk of all TTIs without incurring any risk, it is a more advantageous risk-reduction strategy for emerging TTIs compared with the introduction of pathogen-reduction systems for platelets. The latter cannot protect from vCJD and potentially also from some other emerging TTIs; moreover, they have recently been associated with an increased risk of bleeding.

  18. Correction of blood coagulation dysfunction and anemia by supplementation of red blood cell suspension, fresh frozen plasma, and apheresis platelet: results of in vitro hemodilution experiments.

    PubMed

    Li, Ling; Yang, Jiangcun; Sun, Yang; Dang, Qianli; Xu, Cuixiang; Chen, Ping; Ma, Ting; Ren, Jiangkang

    2015-02-01

    This study aimed to determine the optimal composition and timing for the administration of blood supplements during in vivo blood transfusion with red blood cells suspension (pRBC), fresh frozen plasma (FFP), and apheresis platelet (PLT) administered for the correction of anemia and coagulation dysfunction caused by in vitro hemodilution. We collected blood samples from 24 healthy volunteers and prepared various dilutions of whole blood with normal saline: 9:1, 8:2, 7:3, 6:4, 5:5, 4:6, 3:7, 2:8, and 1:9. The diluted blood samples were then supplemented with blood components at various proportions and then analyzed to determine the values of the routine blood indices, coagulation indices, and thromboelastogram measures. At hemodilutions of 40%, 50%, and 60%, the hemoglobin, coagulation indices, and platelet number and function reached critical levels, necessitating supplementation with pRBC, FFP, and PLT, respectively. When hemodilution was 90%, the supplementation required was approximately 1:1.3:0.9 of pRBC/FFP/PLT. The use of pRBC, FFP, and PLT in appropriate proportions can correct the blood coagulation dysfunction and anemia caused by in vitro hemodilution, and these proportions can be used as guidelines for in vivo massive transfusion. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. A Case of Old Age-Onset Generalized Pustular Psoriasis with a Deficiency of IL-36RN (DITRA) Treated by Granulocyte and Monocyte Apheresis.

    PubMed

    Tominaga, Chiharu; Yamamoto, Masaaki; Imai, Yasutomo; Yamanishi, Kiyofumi

    2015-01-01

    A 78-year-old woman who had been suffering from psoriasis vulgaris for 31 years was admitted to hospital because of her erythroderma. A toxic eruption was suspected and she was treated with prednisolone 30 mg daily. However, it was ineffective and, suspecting psoriatic erythroderma, cyclosporine 150 mg daily was administered with tapering of the prednisolone. Two weeks after a dose reduction of cyclosporine to 100 mg/day, erythroderma with widespread generalized pustules and fever developed. Histology of a biopsy revealed inflammatory infiltrates in the skin with a spongiform pustule of Kogoj, which was consistent with generalized pustular psoriasis (GPP). Her pustules improved with additional etretinate 20 mg/day, but the erythroderma persisted and she consulted us. Three sessions of granulocyte and monocyte apheresis once weekly were effective for her condition and decreased her serum levels of IL-6 and IL-8. She had homozygous mutations of c.[28C>T] in IL36RN which cause p.[Arg10Ter]. She is the oldest reported case of GPP with a deficiency of interleukin-36 receptor antagonist (DITRA), although GPP in DITRA has been suggested to usually occur in younger cases with no pre-existing psoriasis vulgaris.

  20. Application of a portable microscopic cell counter for the counting of residual leukocytes in leukoreduced apheresis platelet concentrates in a hospital blood bank.

    PubMed

    Chun, Sejong; Kim, Eun-Young; Cha, Seung-Yeon; Seo, Ji-Young; Koo, Hong Hoe; Cho, Duck

    2017-06-01

    While a portable microscopic cell counter has been evaluated to enumerate residual white blood cells (WBCs) in red blood cells and platelet concentrates at blood centers, it has not yet been assessed in a hospital blood bank. We investigated the performance of this device and evaluated its accuracy, along with its benefits in time management. Residual WBCs from each of 100 apheresis platelet specimens were measured manually using a Nageotte chamber, along with flow cytometry methods and an ADAM-rWBC automated instrument (NanoEnTek, Seoul, South Korea). The efficiency was calculated by measuring the time required for the analysis of one specimen ten times consecutively. Flow cytometry and the ADAM-rWBC were able to detect four sporadic cases that had residual WBCs exceeding 1/μL that were not detected by the manual method. Analysis time was the shortest with the ADAM-rWBC, followed by flow cytometry and the manual method. Our data suggest that hospital blood banks require quality control of residual WBCs; among the methods evaluated in this study, the portable microscopic cell counter offers the best time efficiency. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Predicting the extension of equivalence classes from primary generalization gradients: the merger of equivalence classes and perceptual classes.

    PubMed Central

    Fields, L; Reeve, K F; Adams, B J; Brown, J L; Verhave, T

    1997-01-01

    In Experiment 1, 6 college students were given generalization tests using 25 line lengths as samples with a long line, a short line, and a "neither" option as comparisons. The neither option was to be used if a sample did not go with the other comparisons. Then, four-member equivalence classes were formed. Class 1 included three nonsense words and the short line. Class 2 included three other nonsense words and the long line. After repeating the generalization test for line length, additional tests were conducted using members of the equivalence classes (i.e., nonsense words and lines) as comparisons and intermediate-length lines as samples. All Class 2 comparisons were selected in the presence of the test lines that also evoked the selection of the long line in the generalization test that had been given before equivalence class formation. Class 1 yielded complementary findings. Thus, the preclass primary generalization gradient predicted which test lines acted as members of each equivalence class. Regardless of using comparisons that were nonsense words or lines, the post-class-formation gradients overlapped, showing the substitutability of class members. Experiment 2 assessed the discriminability of the intermediate-length test lines from the Class 1 (shortest) and Class 2 (longest) lines. The test lines that functioned as members of an equivalence class were discriminable from the line that was a member of the same class by training. Thus, these test lines also acted as members of a dimensionally defined class of "long" or "short" lines. Extension of an equivalence class, then, involved its merger with a dimensionally defined class, which converted a close-ended class to an open-ended class. These data suggest a means of predicting class membership in naturally occurring categories. PMID:9241863

  2. Acceptance criteria for method equivalency assessments.

    PubMed

    Chatfield, Marion J; Borman, Phil J

    2009-12-15

    Quality by design (ICH-Topic Q8) requires that process control strategy requirements are met and maintained. The challenging task of setting appropriate acceptance criteria for assessment of method equivalence is a critical component of satisfying these requirements. The use of these criteria will support changes made to methods across the product lifecycle. A method equivalence assessment is required when a change is made to a method which may pose a risk to its ability to monitor the quality of the process. Establishing appropriate acceptance criteria are a vital, but not clearly understood, prerequisite to deciding the appropriate design/sample size of the equivalency study. A number of approaches are proposed in the literature for setting acceptance criteria for equivalence which address different purposes. This perspective discusses those purposes and then provides more details on setting acceptance criteria based on patient and producer risk, e.g., tolerance interval approach and the consideration of method or process capability. Applying these to a drug substance assay method for batch release illustrates that, for the equivalence assessment to be meaningful, a clear understanding and appraisal of the control requirements of the method is needed. Rather than a single exact algorithm, the analyst's judgment on a number of aspects is required in deciding the appropriate acceptance criteria.

  3. Generalization of Equivalent Crystal Theory to Include Angular Dependence

    NASA Technical Reports Server (NTRS)

    Ferrante, John; Zypman, Fredy R.

    2004-01-01

    In the original Equivalent Crystal Theory, each atomic site in the real crystal is assigned an equivalent lattice constant, in general different from the ground state one. This parameter corresponds to a local compression or expansion of the lattice. The basic method considers these volumetric transformations and, in addition, introduces the possibility that the reference lattice is anisotropically distorted. These distortions however, were introduced ad-hoc. In this work, we generalize the original Equivalent Crystal Theory by systematically introducing site-dependent directional distortions of the lattice, whose corresponding distortions account for the dependence of the energy on anisotropic local density variations. This is done in the spirit of the original framework, but including a gradient term in the density. This approach is introduced to correct a deficiency in the original Equivalent Crystal Theory and other semiempirical methods in quantitatively obtaining the correct ratios of the surface energies of low index planes of cubic metals (100), (110), and (111). We develop here the basic framework, and apply it to the calculation of Fe (110) and Fe (111) surface energy formation. The results, compared with first principles calculations, show an improvement over previous semiempirical approaches.

  4. Equivalent Skin Analysis of Wing Structures Using Neural Networks

    NASA Technical Reports Server (NTRS)

    Liu, Youhua; Kapania, Rakesh K.

    2000-01-01

    An efficient method of modeling trapezoidal built-up wing structures is developed by coupling. in an indirect way, an Equivalent Plate Analysis (EPA) with Neural Networks (NN). Being assumed to behave like a Mindlin-plate, the wing is solved using the Ritz method with Legendre polynomials employed as the trial functions. This analysis method can be made more efficient by avoiding most of the computational effort spent on calculating contributions to the stiffness and mass matrices from each spar and rib. This is accomplished by replacing the wing inner-structure with an "equivalent" material that combines to the skin and whose properties are simulated by neural networks. The constitutive matrix, which relates the stress vector to the strain vector, and the density of the equivalent material are obtained by enforcing mass and stiffness matrix equities with rec,ard to the EPA in a least-square sense. Neural networks for the material properties are trained in terms of the design variables of the wing structure. Examples show that the present method, which can be called an Equivalent Skin Analysis (ESA) of the wing structure, is more efficient than the EPA and still fairly good results can be obtained. The present ESA is very promising to be used at the early stages of wing structure design.

  5. Multigroup Equivalence Analysis for High-Dimensional Expression Data

    PubMed Central

    Yang, Celeste; Bartolucci, Alfred A.; Cui, Xiangqin

    2015-01-01

    Hypothesis tests of equivalence are typically known for their application in bioequivalence studies and acceptance sampling. Their application to gene expression data, in particular high-dimensional gene expression data, has only recently been studied. In this paper, we examine how two multigroup equivalence tests, the F-test and the range test, perform when applied to microarray expression data. We adapted these tests to a well-known equivalence criterion, the difference ratio. Our simulation results showed that both tests can achieve moderate power while controlling the type I error at nominal level for typical expression microarray studies with the benefit of easy-to-interpret equivalence limits. For the range of parameters simulated in this paper, the F-test is more powerful than the range test. However, for comparing three groups, their powers are similar. Finally, the two multigroup tests were applied to a prostate cancer microarray dataset to identify genes whose expression follows a prespecified trajectory across five prostate cancer stages. PMID:26628859

  6. Multigroup Equivalence Analysis for High-Dimensional Expression Data.

    PubMed

    Yang, Celeste; Bartolucci, Alfred A; Cui, Xiangqin

    2015-01-01

    Hypothesis tests of equivalence are typically known for their application in bioequivalence studies and acceptance sampling. Their application to gene expression data, in particular high-dimensional gene expression data, has only recently been studied. In this paper, we examine how two multigroup equivalence tests, the F-test and the range test, perform when applied to microarray expression data. We adapted these tests to a well-known equivalence criterion, the difference ratio. Our simulation results showed that both tests can achieve moderate power while controlling the type I error at nominal level for typical expression microarray studies with the benefit of easy-to-interpret equivalence limits. For the range of parameters simulated in this paper, the F-test is more powerful than the range test. However, for comparing three groups, their powers are similar. Finally, the two multigroup tests were applied to a prostate cancer microarray dataset to identify genes whose expression follows a prespecified trajectory across five prostate cancer stages.

  7. The New Wind Chill Equivalent Temperature Chart.

    NASA Astrophysics Data System (ADS)

    Osczevski, Randall; Bluestein, Maurice

    2005-10-01

    The formula used in the U.S. and Canada to express the combined effect of wind and low temperature on how cold it feels was changed in November 2001. Many had felt that the old formula for equivalent temperature, derived in the 1960s from Siple and Passel's flawed but quite useful Wind Chill Index, unnecessarily exaggerated the severity of the weather. The new formula is based on a mathematical model of heat flow from the upwind side of a head-sized cylinder moving at walking speed into the wind. The paper details the assumptions that were made in generating the new wind chill charts. It also points out weaknesses in the concept of wind chill equivalent temperature, including its steady-state character and a seemingly paradoxical effect of the internal thermal resistance of the cylinder on comfort and equivalent temperature. Some improvements and alternatives are suggested.

  8. On SLλ(I)-asymptotically statistical equivalent sequences

    NASA Astrophysics Data System (ADS)

    Gumus, Hafize; Savas, Ekrem

    2012-09-01

    This paper presents the notion of SLλ(I)-asymptotically statistical equivalence which is a natural combination of asymptotic I-equivalence and λ-statistical equivalence. We find its relation to I-asymptotically statistical convergence, strong λI-asymptotically equivalence and strong Cesàro I-asymptotically equivalence.

  9. Electrophysiological Correlates of Stimulus Equivalence Processes

    PubMed Central

    Haimson, Barry; Wilkinson, Krista M; Rosenquist, Celia; Ouimet, Carolyn; McIlvane, William J

    2009-01-01

    Research reported here concerns neural processes relating to stimulus equivalence class formation. In Experiment 1, two types of word pairs were presented successively to normally capable adults. In one type, the words had related usage in English (e.g., uncle, aunt). In the other, the two words were not typically related in their usage (e.g., wrist, corn). For pairs of both types, event-related cortical potentials were recorded during and immediately after the presentation of the second word. The obtained waveforms differentiated these two types of pairs. For the unrelated pairs, the waveforms were significantly more negative about 400 ms after the second word was presented, thus replicating the “N400” phenomenon of the cognitive neuroscience literature. In addition, there was a strong positive-tending wave form difference post-stimulus presentation (peaked at about 500 ms) that also differentiated the unrelated from related stimulus pairs. In Experiment 2, the procedures were extended to study arbitrary stimulus–stimulus relations established via matching-to-sample training. Participants were experimentally naïve adults. Sample stimuli (Set A) were trigrams, and comparison stimuli (Sets B, C, D, E, and F) were nonrepresentative forms. Behavioral tests evaluated potentially emergent equivalence relations (i.e., BD, DF, CE, etc.). All participants exhibited classes consistent with the arbitrary matching training. They were also exposed also to an event-related potential procedure like that used in Experiment 1. Some received the ERP procedure before equivalence tests and some after. Only those participants who received ERP procedures after equivalence tests exhibited robust N400 differentiation initially. The positivity observed in Experiment 1 was absent for all participants. These results support speculations that equivalence tests may provide contextual support for the formation of equivalence classes including those that emerge gradually during testing

  10. Equivalent Widths in the Spectrum of Sirius

    NASA Astrophysics Data System (ADS)

    Zhao, G.; Qiu, H. M.; Chen, Y. Q.; Li, Z. W.

    2000-02-01

    The equivalent widths of total 546 lines (26 elements are included) in the spectrum of the bright Am star Sirius from 380 to 930 nm are tabulated. The high-resolution, high signal-to-noise ratio spectrum was obtained with the Coudé Echelle Spectrograph attached to the 2.16 m telescope at Beijing Astronomical Observatory (Xinglong, China). Here we also give the results of the equivalent widths comparison between our measurements and those of Strom et al. and Sadakane & Ueta.

  11. Grammatical equivalents of Palaeolithic tools: a hypothesis.

    PubMed

    Vieira, Antonio B

    2010-09-01

    In this article, language is considered as a behavioural trait evolving by means of natural selection, in co-evolution with the Palaeolithic tool industries. This perspective enables an analysis of the grammatical and syntactic equivalents of the multiple abilities and effects of lithic tools across the successive modes of their development and consider their influence in intra-group communication and the social biology of the hominine species concerned. The hypothesis is that grammatical equivalents inherent to stone tool work guide the evolution of language.

  12. Testing the equivalence principle with unstable particles

    NASA Astrophysics Data System (ADS)

    Bonder, Y.; Fischbach, E.; Hernandez-Coronado, H.; Krause, D. E.; Rohrbach, Z.; Sudarsky, D.

    2013-06-01

    We develop a framework to test the equivalence principle under conditions where the quantum aspects of nature cannot be neglected, specifically in the context of interference phenomena with unstable particles. We derive the nonrelativistic quantum equation that describes the evolution of the wave function of unstable particles under the assumption of the validity of the equivalence principle and when small deviations are assumed to occur. As an example, we study the propagation of unstable particles in a COW experiment, and we briefly discuss the experimental implications of our formalism.

  13. Benzene risk estimation using radiation equivalent coefficients.

    PubMed

    Nakayama, Aki; Isono, Tomomi; Kikuchi, Takuro; Ohnishi, Iichiro; Igarashi, Junichiro; Yoneda, Minoru; Morisawa, Shinsuke

    2009-03-01

    We estimated benzene risk using a novel framework of risk assessment that employed the measurement of radiation dose equivalents to benzene metabolites and a PBPK model. The highest risks for 1 microg/m(3) and 3.2 mg/m(3) life time exposure of benzene estimated with a linear regression were 5.4 x 10(-7) and 1.3 x 10(-3), respectively. Even though these estimates were based on in vitro chromosome aberration test data, they were about one-sixth to one-fourteenth that from other studies and represent a fairly good estimate by using radiation equivalent coefficient as an "internal standard."

  14. Local equivalence, surface-code states, and matroids

    SciTech Connect

    Sarvepalli, Pradeep; Raussendorf, Robert

    2010-08-15

    Recently, Ji et al. disproved the local-unitary-local Clifford (LU-LC) conjecture and showed that the local unitary (LU) and local Clifford (LC) equivalence classes of the stabilizer states are not always the same. Despite the fact that this settles the LU-LC conjecture, a sufficient condition for stabilizer states that violate the LU-LC conjecture is not known. In this paper, we investigate further the properties of stabilizer states with respect to local equivalence. Our first result shows that there exist infinitely many stabilizer states that violate the LU-LC conjecture. In particular, we show that for all numbers of qubits n{>=}28, there exist distance-two stabilizer states which are counterexamples to the LU-LC conjecture. We prove that, for all odd n{>=}195, there exist stabilizer states with distance greater than two that are LU equivalent but not LC equivalent. Two important classes of stabilizer states that are of great interest in quantum computation are the cluster states and stabilizer states of the surface codes. We show that, under some minimal restrictions, both these classes of states preclude any counterexamples. In this context, we also show that the associated surface codes do not have any encoded non-Clifford transversal gates. We characterize the Calderbank-Shor-Steane (CSS) surface-code states in terms of a class of minor closed binary matroids. In addition to making a connection to an important open problem in binary matroid theory, this characterization does in some cases provide an efficient test for CSS states that are not counterexamples.

  15. The equivalence principle of quantum mechanics: Uniqueness theorem

    SciTech Connect

    Faraggi, A.E.; Matone, M.

    1997-10-28

    Recently the authors showed that the postulated diffeomorphic equivalence of states implies quantum mechanics. This approach takes the canonical variables to be dependent by the relation p = {partial_derivative}{sub q}S{sub 0} and exploits a basic GL(2,C)-symmetry which underlies the canonical formalism. In particular, they looked for the special transformations leading to the free system with vanishing energy. Furthermore, they saw that while on the one hand the equivalence principle cannot be consistently implemented in classical mechanics, on the other it naturally led to the quantum analogue of the Hamilton-Jacobi equation, thus implying the Schroedinger equation. In this letter they show that actually the principle uniquely leads to this solution. The authors also express the canonical and Schroedinger equations by means of the brackets recently introduced in the framework of N = 2 SYM. These brackets are the analogue of the Poisson brackets with the canonical variables taken as dependent.

  16. 77 FR 32632 - Ambient Air Monitoring Reference and Equivalent Methods: Designation of Three New Equivalent Methods

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-01

    ... AGENCY Ambient Air Monitoring Reference and Equivalent Methods: Designation of Three New Equivalent... of lead (Pb) in the ambient air. FOR FURTHER INFORMATION CONTACT: Robert Vanderpool, Human Exposure... CFR Part 53, the EPA evaluates various methods for monitoring the concentrations of those ambient...

  17. High School Equivalency Testing in Arizona. Forum: Responding to Changes in High School Equivalency Testing

    ERIC Educational Resources Information Center

    Hart, Sheryl

    2015-01-01

    For decades, the state of Arizona has used the General Educational Development (GED) Test to award the Arizona High School Equivalency (HSE) Diploma, as the GED Test was the only test available, recognized and accepted in the United States as the measure by which adults could demonstrate the educational attainment equivalent to high school…

  18. Claims of equivalence in medical research: are they supported by the evidence?

    PubMed

    Greene, W L; Concato, J; Feinstein, A R

    2000-05-02

    Most clinical studies are done to show comparative superiority, but many reports now claim equivalence between the investigated entities. These assertions may not always be supported by the methods used and the results obtained. To assess the justification and support for claims of clinical or therapeutic equivalence in medical journals. A search of MEDLINE for articles published from 1992 through 1996. From 1209 citations that contained the word equivalence in the title or abstract or contained the Medical Subject Heading therapeutic equivalency, we excluded 1121 studies reporting nonoriginal research, purely laboratory or other nonhuman research, and studies in which equivalence was not the main claim. The remaining 88 eligible papers were evaluated for five methodologic attributes. Only 45 (51%) of the 88 reports were specifically aimed at studying equivalence; the others either tried to show superiority or did not state a research aim. The quantitative distinctions regarded as "equivalent" ranged from 0% to 21% for direct increments and from 0% to 76% for proportionate differences. An equivalence boundary was set and confirmed with an appropriate statistical test in only 23% of reports. In 67% of reports, equivalence was declared after a failed test for comparative superiority, and in 10%, the claim of equivalence was not statistically evaluated. The sample size needed to confirm results had been calculated in advance for only 33% of reports. Sample size was 20 patients per group or fewer in 25% of reports. Many studies of clinical equivalence do not set boundaries for equivalence. Claims of "difference" or "similarity" are often made not by thoughtful examination of the data but by tests of statistical significance that are often misapplied or accompanied by inadequate sample sizes. These methodologic flaws can lead to false claims, inconsistencies, and harm to patients.

  19. Equivalent Ground Conductivity Inversion in Maritime ASF Correction

    NASA Astrophysics Data System (ADS)

    Pu, Yurong; Xi, Xiaoli; Zhu, Hong

    This letter presents an efficient method for the maritime Loran-C additional secondary factor (ASF) correction based on equivalent ground conductivity inversion. Using the proposed method, the accuracy of Loran-C system on maritime positioning, navigation, and timing (PNT) can be improved significantly with a limited number of surveys. Comparison with measured ASF results shows a root-mean-square error (RMSE) of less than 100ns in most areas.

  20. Equivalent income and fair evaluation of health care.

    PubMed

    Fleurbaey, Marc; Luchini, Stéphane; Muller, Christophe; Schokkaert, Erik

    2013-06-01

    We argue that the economic evaluation of health care (cost-benefit analysis) should respect individual preferences and should incorporate distributional considerations. Relying on individual preferences does not imply subjective welfarism. We propose a particular non-welfarist approach, based on the concept of equivalent income, and show how it helps to define distributional weights. We illustrate the feasibility of our approach with empirical results from a pilot survey. Copyright © 2012 John Wiley & Sons, Ltd.

  1. Non-Machian Singularity and Inconsistent Equivalence Principle

    NASA Astrophysics Data System (ADS)

    Verma, Murli Manohar

    We show that the non-Machian feature of singularity in the General Theory of Relativity (GTR) can be avoided with scale-invariance. Further, the global non-conservation of energy in GTR results from inconsistency between scale-invariance and equivalence principle. We propose a negative energy density component with a positive equation of state that can drive the late-time acceleration in the universe, while the positive component confines to smaller scales.

  2. The Nature of High Equivalent Width Lyman-α Galaxies

    NASA Astrophysics Data System (ADS)

    Finkelstein, S. L.; Rhoads, J. E.; Malhotra, S.; Pirzkal, N.; Wang, J.

    2005-12-01

    We present new results on the nature of the high equivalent width Lyα lines seen in high-redshift galaxies. These galaxies were identified on the basis of their large equivalent width Lyα emission, beyond the maximum expected for normal stellar populations. To be produced, this strong Lyα emission requires a strong ionizing continuum. Previous X-ray images and optical spectra show that this emission is not powered by active galactic nuclei. The optical colors of these galaxies provide a diagnostic of the stellar populations. The large equivalent widths seen in the Lyα line in these galaxies could be produced via star formation if the stellar photospheres are hotter than normal, which might be expected for star formation in low metallicity galaxies. They could also result from a top-heavy initial mass function. Both of these scenarios might be expected in primitive galaxies. To investigate these galaxies, we have computed stellar population models using the stellar population synthesis code created by Bruzual and Charlot (2003). We will use these models to predict the equivalent width distribution of the Lyα line in these high-redshift galaxies. We will also be able to derive estimates of stellar masses and stellar population ages, and be able to determine if these systems are indeed young and relatively primitive. Furthermore, we are obtaining new deep broadband imaging data on high-redshift galaxies taken from the Large Area Lyman Alpha (LALA) survey. These observations will yield better equivalent width measurements and continuum colors than previous data has allowed. We will compare these colors with the expectations for hot stars. We will also be able to constrain the star-formation rate using the UV continuum light from these galaxies, which will provide a valuable comparison with star-formation rates derived from the Lyα luminosity alone.

  3. 20 CFR 404.1526 - Medical equivalence.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Medical equivalence. 404.1526 Section 404.1526 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Medical Considerations § 404.1526 Medical...

  4. 20 CFR 404.1526 - Medical equivalence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical equivalence. 404.1526 Section 404.1526 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Medical Considerations § 404.1526 Medical...

  5. 20 CFR 404.1526 - Medical equivalence.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Medical equivalence. 404.1526 Section 404.1526 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Medical Considerations § 404.1526 Medical...

  6. 20 CFR 404.1526 - Medical equivalence.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Medical equivalence. 404.1526 Section 404.1526 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Medical Considerations § 404.1526 Medical...

  7. 20 CFR 404.1526 - Medical equivalence.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Medical equivalence. 404.1526 Section 404.1526 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Medical Considerations § 404.1526 Medical...

  8. CP Violation, Neutral Currents, and Weak Equivalence

    DOE R&D Accomplishments Database

    Fitch, V. L.

    1972-03-23

    Within the past few months two excellent summaries of the state of our knowledge of the weak interactions have been presented. Correspondingly, we will not attempt a comprehensive review but instead concentrate this discussion on the status of CP violation, the question of the neutral currents, and the weak equivalence principle.

  9. 33 CFR 155.120 - Equivalents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Equivalents. 155.120 Section 155.120 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION OIL OR HAZARDOUS MATERIAL POLLUTION PREVENTION REGULATIONS FOR VESSELS General § 155.120...

  10. 33 CFR 155.120 - Equivalents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Equivalents. 155.120 Section 155.120 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION OIL OR HAZARDOUS MATERIAL POLLUTION PREVENTION REGULATIONS FOR VESSELS General § 155.120...

  11. 33 CFR 155.120 - Equivalents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Equivalents. 155.120 Section 155.120 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION OIL OR HAZARDOUS MATERIAL POLLUTION PREVENTION REGULATIONS FOR VESSELS General § 155.120...

  12. 33 CFR 155.120 - Equivalents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Equivalents. 155.120 Section 155.120 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION OIL OR HAZARDOUS MATERIAL POLLUTION PREVENTION REGULATIONS FOR VESSELS General § 155.120...

  13. 29 CFR 825.215 - Equivalent position.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... may have occurred during the FMLA leave period, such as cost of living increases. Pay increases... that does not qualify as FMLA leave. An employee is entitled to be restored to a position with the same... entitled to such a position on return from FMLA leave. (2) Equivalent pay includes any bonus or payment...

  14. 29 CFR 825.215 - Equivalent position.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... may have occurred during the FMLA leave period, such as cost of living increases. Pay increases... that does not qualify as FMLA leave. An employee is entitled to be restored to a position with the same... entitled to such a position on return from FMLA leave. (2) Equivalent pay includes any bonus or payment...

  15. 29 CFR 825.215 - Equivalent position.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... may have occurred during the FMLA leave period, such as cost of living increases. Pay increases... that does not qualify as FMLA leave. An employee is entitled to be restored to a position with the same... entitled to such a position on return from FMLA leave. (2) Equivalent pay includes any bonus or payment...

  16. 29 CFR 825.215 - Equivalent position.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... may have occurred during the FMLA leave period, such as cost of living increases. Pay increases... that does not qualify as FMLA leave. An employee is entitled to be restored to a position with the same... entitled to such a position on return from FMLA leave. (2) Equivalent pay includes any bonus or payment...

  17. AN UPDATE ON TECHNOLOGIES SEEKING PFRP EQUIVALENCY

    EPA Science Inventory

    This presentation will: 1) Review the mandate of the Pathogen Equivalency Committee (PEC), 2) Review the PEC's current membership (of 10), 3) Discuss how a typical application is evaluated, 4) Note where information can be found by those interested in applying to the PEC, 5) List...

  18. Reading adn Auditory-Visual Equivalences

    ERIC Educational Resources Information Center

    Sidman, Murray

    1971-01-01

    A retarded boy, unable to read orally or with comprehension, was taught to match spoken to printed words and was then capable of reading comprehension (matching printed words to picture) and oral reading (naming printed words aloud), demonstrating that certain learned auditory-visual equivalences are sufficient prerequisites for reading…

  19. HOW TO PASS HIGH SCHOOL EQUIVALENCY EXAMINATION.

    ERIC Educational Resources Information Center

    KLAGSBRUN, FRANCINE, ED.

    ORGANIZED INTO A FIVE-DAY STUDY PLAN, ALLOWING ONE DAY'S STUDY TO EACH PART OF THE EQUIVALENCY EXAMINATION (SPELLING AND GRAMMAR, SOCIAL STUDIES, SCIENCE, LITERATURE, AND MATHEMATICS), THIS BOOK PROVIDES SAMPLE TESTS AND ANSWER SHEETS, A TEST SCORE RECORD AND SELF EVALUATION PROFILE, AND SUPPLEMENTARY TESTS FOR EACH SUBJECT. THE EXAMINEE CAN ORDER…

  20. AN UPDATE ON TECHNOLOGIES SEEKING PFRP EQUIVALENCY

    EPA Science Inventory

    This presentation will: 1) Review the mandate of the Pathogen Equivalency Committee (PEC), 2) Review the PEC's current membership (of 10), 3) Discuss how a typical application is evaluated, 4) Note where information can be found by those interested in applying to the PEC, 5) List...