Blood Utilization and Transfusion Reactions in Pediatric Patients Transfused with Conventional or Pathogen Reduced Platelets.

OBJECTIVES: To assess the safety and efficacy of a Food and Drug Administration-approved pathogen-reduced platelet (PLT) product in children, as ongoing questions regarding their use in this population remain. STUDY DESIGN: We report findings from a quality assurance review of PLT utilization, associated red blood cell transfusion trends, and short-term safety of conventional vs pathogen-reduced PLTs over a 21-month period while transitioning from conventional to pathogen-reduced PLTs at a large, tertiary care hospital. We assessed utilization in neonatal intensive care unit (NICU) patients, infants 0-1 year not in the NICU, and children age 1-18 years (PED). RESULTS: In the 48 hours after an index conventional or pathogen-reduced platelet transfusion, respectively, NICU patients received 1.0 ± 1.4 (n = 91 transfusions) compared with 1.2 ± 1.3 (n = 145) additional platelet doses (P = .29); infants 0-1 year not in the NICU received 2.8 ± 3.0 (n = 125) vs 2.6 ± 2.6 (n = 254) additional platelet doses (P = .57); and PEDs received 0.9 ± 1.6 (n = 644) vs 1.4 ± 2.2 (n = 673) additional doses (P < .001). Time to subsequent transfusion and red cell utilization were similar in every group (P > .05). The number and type of transfusion reactions did not significantly vary based on PLT type and no rashes were reported in NICU patients receiving phototherapy and pathogen-reduced PLTs. CONCLUSIONS: Conventional and pathogen-reduced PLTs had similar utilization patterns in our pediatric populations. A small, but statistically significant, increase in transfusions was noted following pathogen-reduced PLT transfusion in PED patients, but not in other groups. Red cell utilization and transfusion reactions were similar for both products in all age groups.

Health Care and Precision Medicine Research: Analysis of a Scalable Data Science Platform.

BACKGROUND: Health care data are increasing in volume and complexity. Storing and analyzing these data to implement precision medicine initiatives and data-driven research has exceeded the capabilities of traditional computer systems. Modern big data platforms must be adapted to the specific demands of health care and designed for scalability and growth. OBJECTIVE: The objectives of our study were to (1) demonstrate the implementation of a data science platform built on open source technology within a large, academic health care system and (2) describe 2 computational health care applications built on such a platform. METHODS: We deployed a data science platform based on several open source technologies to support real-time, big data workloads. We developed data-acquisition workflows for Apache Storm and NiFi in Java and Python to capture patient monitoring and laboratory data for downstream analytics. RESULTS: Emerging data management approaches, along with open source technologies such as Hadoop, can be used to create integrated data lakes to store large, real-time datasets. This infrastructure also provides a robust analytics platform where health care and biomedical research data can be analyzed in near real time for precision medicine and computational health care use cases. CONCLUSIONS: The implementation and use of integrated data science platforms offer organizations the opportunity to combine traditional datasets, including data from the electronic health record, with emerging big data sources, such as continuous patient monitoring and real-time laboratory results. These platforms can enable cost-effective and scalable analytics for the information that will be key to the delivery of precision medicine initiatives. Organizations that can take advantage of the technical advances found in data science platforms will have the opportunity to provide comprehensive access to health care data for computational health care and precision medicine research.

Proteomic analysis of fibroblastema formation in regenerating hind limbs of Xenopus laevis froglets and comparison to axolotl.

BACKGROUND: To gain insight into what differences might restrict the capacity for limb regeneration in Xenopus froglets, we used High Performance Liquid Chromatography (HPLC)/double mass spectrometry to characterize protein expression during fibroblastema formation in the amputated froglet hindlimb, and compared the results to those obtained previously for blastema formation in the axolotl limb. RESULTS: Comparison of the Xenopus fibroblastema and axolotl blastema revealed several similarities and significant differences in proteomic profiles. The most significant similarity was the strong parallel down regulation of muscle proteins and enzymes involved in carbohydrate metabolism. Regenerating Xenopus limbs differed significantly from axolotl regenerating limbs in several ways: deficiency in the inositol phosphate/diacylglycerol signaling pathway, down regulation of Wnt signaling, up regulation of extracellular matrix (ECM) proteins and proteins involved in chondrocyte differentiation, lack of expression of a key cell cycle protein, ecotropic viral integration site 5 (EVI5), that blocks mitosis in the axolotl, and the expression of several patterning proteins not seen in the axolotl that may dorsalize the fibroblastema. CONCLUSIONS: We have characterized global protein expression during fibroblastema formation after amputation of the Xenopus froglet hindlimb and identified several differences that lead to signaling deficiency, failure to retard mitosis, premature chondrocyte differentiation, and failure of dorsoventral axial asymmetry. These differences point to possible interventions to improve blastema formation and pattern formation in the froglet limb.

An open-sourced, web-based application to improve our ability to understand hunter and angler purchasing behavior from license data.

State fish and wildlife agencies rely on hunters and anglers (i.e., sportspersons) to fund management actions through revenue generated from license sales and excise taxes on hunting and fishing equipment. There is a need to develop new techniques that bridge the information gap on participation and provide agencies with an understanding of sportspersons at a resolution that can more directly inform efforts to engage sportspersons. Monitoring sportsperson participation using information about their license-purchasing behavior has the potential to reveal important patterns in recruitment (first-time purchase of a hunting or fishing license), retention (continued purchase of licenses across multiple years), and reactivation (purchase a license after several years with no purchases). Providing up-to-date information on what licenses are purchased, when and by whom may prove invaluable to managers and policy makers. We present a customizable, open-source, web-based application-huntfishapp-that allows the user to query and interact with a structured query language (SQL) hunting and fishing license database. The huntfishapp serves as an informational resource and tool that provides a framework to share information on license sales across an agency, with intent of increasing understanding of (a) sportspersons and (b) how management decisions affect sportspersons. Data dashboards, like the huntfishapp, allow agencies and non-governmental organizations to become more knowledgeable of their customer base and provide a greater understanding of management-decision effects on hunting and fishing participation.

Effective removal of phosphate from aqueous solution using humic acid coated magnetite nanoparticles.

Effective removal of excess phosphate from water is critical to counteract eutrophication and restore water quality. In this study, low cost, environmentally friendly humic acid coated magnetite nanoparticles (HA-MNP) were synthesized and applied for the remediation of phosphate from aqueous media. The HA-MNPs, characterized by FTIR, TEM and HAADF-STEM showed the extensive coating of humic acid on the magnetite surface. The magnetic nanoparticles with diameters of 7-12 nm could be easily separated from the reaction mixture by using a simple hand held magnet. Adsorption studies demonstrate the fast and effective separation of phosphate with maximum adsorption capacity of 28.9 mg/g at pH 6.6. The adsorption behavior follows the Freundlich isotherm suggesting the formation of non-uniform multilayers of phosphate on the heterogeneous surface of HA-MNP. The adsorption kinetic fits the pseudo-second order model well with rate constants of 0.206 ± 0.003, 0.073 ± 0.002 and 0.061 ± 0.003 g mg-1min-1 for phosphate (P) concentrations of 2, 5 and 10 mg/L respectively. The removal of phosphate was found higher at acidic and neutral pH compared to basic conditions. The nanoparticles exhibit good selectivity and adsorption efficiency for phosphate in presence of co-existing ions such as Cl-, SO42-and NO3- with some inhibition effect by CO32-. The effect of temperature on the adsorption reveals that the process is endothermic and spontaneous. HA-MNPs are promising, simple, environmentally friendly materials for the removal of phosphate from aqueous media.

Patient experiences of burn scars in adults and children and development of a health-related quality of life conceptual model: A qualitative study.

PURPOSE: The aim of this study was to understand the impact of burn scars on health-related quality of life (HRQOL) from the perspective of adults and children with burn scars, and caregivers to inform the development of a conceptual model of burn scar HRQOL. METHOD: Twenty-one participants (adults and children) with burn scars and nine caregivers participated in semi-structured, face-to-face interviews between 2012 and 2013. During the interviews, participants were asked to describe features about their (or their child's) burn scars and its impact on everyday life. Two coders conducted thematic analysis, with consensus achieved through discussion and review with a third coder. The literature on HRQOL models was then reviewed to further inform the development of a conceptual model of burn scar HRQOL. RESULTS: Five themes emerged from the qualitative data: 'physical and sensory symptoms', 'impact of burn scar interventions', 'impact of burn scar symptoms', 'personal factors' and 'change over time'. Caregivers offered further insights into family functioning after burn, and the impacts of burn scars and burn scar interventions on family life. In the conceptual model, symptoms (sensory and physical) of burn scars are considered proximal to HRQOL, with distal indicators including functioning (physical, emotional, social, cognitive), individual factors and the environment. Overall quality of life was affected by HRQOL. CONCLUSION: Understanding the impact of burn scars on HRQOL and the development of a conceptual model will inform future burn scar research and clinical practice.