The Proton Improvement Plan (PIP) -II is a high intensity proton facility being developed to supp... more The Proton Improvement Plan (PIP) -II is a high intensity proton facility being developed to support a neutrino program over the next two decades at Fermilab. At its core is the design and construction of a Continuous Wave compatible superconducting radio frequency linear accelerator that would accelerate an average beam current of 2 mA up to 800 MeV. This paper presents recent updates in the beam dynamics leading to a reliable and robust linac design and simplifying the cryo-module assembly.
Introduction: Diffuse alveolar hemorrhage (DAH) is an early pulmonary complication of hematopoiet... more Introduction: Diffuse alveolar hemorrhage (DAH) is an early pulmonary complication of hematopoietic cell transplantation (HCT) associated with severe hypoxemic respiratory failure and mortality. Extracorporeal membrane oxygenation (ECMO) support is often used for respiratory failure refractory to conventional interventions; however, its use has been limited in HCT patients with DAH due to potential for worsening alveolar hemorrhage and reported high mortality.Case Presentation: We report two cases of DAH following HCT who developed refractory hypoxemic respiratory failure despite cessation of bleeding and were successfully supported with ECMO.Conclusion: DAH after HCT should not automatically preclude ECMO support; rather, these patients must be evaluated individually for ECMO within the context of their overall clinical picture.
The Proton Improvement Plan-II (PIP-II) is a proposed upgrade for the accelerator complex at Ferm... more The Proton Improvement Plan-II (PIP-II) is a proposed upgrade for the accelerator complex at Fermilab. The central piece of PIP-II is a new superconducting radio frequency (SRF) 800 MeV linear accelerator (linac) capable of operating in both continuous wave (CW) and pulse regimes. The PIP-II linac comprises a warm front-end that includes a Hion source capable of delivering 15-mA, 30keV DC or pulsed beam, a Low Energy Beam Transport (LEBT), a 162.5 MHz, CW Radio-Frequency Quadrupole (RFQ) accelerating the ions to 2.1 MeV and, a 14-m Medium Energy Beam Transport (MEBT) before beam is injected into SRF part of the linac. This paper presents the PIP-II MEBT design and, discusses operational features and considerations that lead to existing optics design such as bunch by bunch chopping system, minimization of radiation coming to the warm front-end from the SRF linac using a concrete wall, a robust vacuum protection system etc.
A 2.1 MeV, 10 mA CW RFQ has been installed and commissioned at Fermilab's test accelerator kn... more A 2.1 MeV, 10 mA CW RFQ has been installed and commissioned at Fermilab's test accelerator known as PIP-II Injector Test. This report describes the measurements of the beam properties after acceleration in the RFQ, including the energy and emittance.
The International Linear collider (ILC) is a proposed accelerator facility which is primarily bas... more The International Linear collider (ILC) is a proposed accelerator facility which is primarily based on two 11-km long superconducting (SC) main linacs. In this paper we present recent updates on the main linac design and discuss changes made in order to meet specification outlined in the technical design report (TDR).
Platelet InhIbItIon Is assocIated wIth severe bleedIng and MortalIty In chIldren on ecls Arun Sai... more Platelet InhIbItIon Is assocIated wIth severe bleedIng and MortalIty In chIldren on ecls Arun Saini1, Allan Doctor2, Avihu Gazit3, Pirooz Eghtesady4, Umar Boston4, Adam Vogel5, Philip Spinella6; 1Washington University In Saint Louis School of Medicine, Saint Louis, MO, 2Washington University School of Medicine, Saint Louis, MO, 3Washington University School of Medicine, St. Louis, MO, 4Washington University, St Louis, MO, 5Saint Louis Children's Hospital, Saint Louis, MO, 6Washington University In Saint Louis, Saint Louis, MO
Dry reforming of methane is considered a potential reaction for the utilization of waste greenhou... more Dry reforming of methane is considered a potential reaction for the utilization of waste greenhouse gases to generate valuable chemicals. However, catalyst deactivation under a harsh reaction condi...
This work is strategically premeditated to study the potential of a herbal medicinal product as a... more This work is strategically premeditated to study the potential of a herbal medicinal product as a natural bioactive ingredient to generate nanocellulose-based antibacterial architectures. In situ fibrillation of purified cellulose was done in cinnamon extract (ciE) to obtain microfibrillated cellulose (MFC). To this MFC suspension, carboxylated cellulose nanocrystals (cCNCs) were homogeneously mixed and the viscous gel thus obtained was freeze-dried to obtain lightweight and flexible composite aerogel architectures impregnated with ciE, namely, ciMFC/cCNCs. At an optimal concentration of 0.3 wt % cCNCs (i.e., for ciMFC/cCNCs_0.3), an improvement of around 106% in compressive strength and 175% increment in modulus were achieved as compared to pristine MFC architecture. The efficient loading and interaction of ciE components, specifically cinnamaldehyde, with MFC and cCNCs resulted in developing competent antibacterial surfaces with dense and uniform microstructures. Excellent and long-term antimicrobial activity of the optimized architectures (ciMFC/cCNCs_0.3) was confirmed through various antibacterial assays like the zone inhibition method, bacterial growth observation at OD600, minimum inhibitory concentration (MIC, here 1 mg/mL), minimum bactericidal concentration (MBC, here 3-5 mg/mL), and Live/Dead BacLight viability tests. The changes in the bacterial morphology with a disrupted membrane were further confirmed through various imaging techniques like confocal laser scanning microscopy, FESEM, AFM, and 3D digital microscopy. The dry composite architecture showed the persuasive capability of suppressing the growth of airborne bacteria, which in combination with antibacterial efficiency in the wet state is considered as an imperative aspect for a material to act as the novel biomaterial. Furthermore, these architectures demonstrated excellent antibacterial performance under real "in use" contamination prone conditions. Hence, this work provides avenues for the application of crude natural extracts in developing novel forms of advanced functional biomaterials that can be used for assorted biological/healthcare applications such as wound care and antimicrobial filtering units.
INTRODUCTION: Coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state in a... more INTRODUCTION: Coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state in adults with significant mortality attributable to thrombotic complications We report on the coagulation profiles of children admitted to the Intensive Care Unit with coronavirus related illness METHODS: We describe a single-center retrospective cohort of 22 children admitted to the pediatric intensive care unit with SARS-CoV2 related illness All children were admitted with PCR or antibody positive SARS-CoV2 related illness, or if antibody negative met CDC criteria for MIS-C including close family contact with COVID-19 positive patient Thromboelastography was performed on all patients in addition to routine hematologic assays RESULTS: Majority of patients (55%) were female, with median age of 6 years (IQR 2 3,14), with predominantly hispanic (59%) and black (27%) race/ethnicity Three children had preexisting comorbidities The most common clinical presentation was multisystem inflammatory syndrome (77 %) Two children, both adolescent females presented with extensive thrombotic complications- one with deep venous thrombosis and gangrene of leg, one with multiple pulmonary emboli One-third (36%) of children had abnormal values on thromboelastography (TEG) Hypercoagulability on TEG was the most frequent finding, characterized by acceleration of clot formation and increase in maximal clot amplitude Most children had minimal to no fibrinolysis on TEG suggestive of impaired fibrinolysis Elevation in D-Dimer, IL-6 level, ferritin and CRP was universal, and 50% had associated hyperfibrinogenemia (>400 mg/dL) Platelet count, prothrombin time and activated thromboplastin values were normal for all children except the two who presented with thrombotic complications CONCLUSIONS: We report abnormal coagulation profiles in one-third of critically ill children with coronavirus related illness detected by thromboelastography (TEG) Routine coagulation variables were within normal range for most patients, while TEG uncovered a pattern of accelerated clot formation and increased clot strength Our findings suggest significant inflammation associated with a distinct hypercoagulable profile in a subset of children with SARSCoV2 related illness Viscoelastic tests may be useful to characterize these abnormalities
ObjectiveShunt-related adverse events are frequent in infants after modified Blalock–Taussig desp... more ObjectiveShunt-related adverse events are frequent in infants after modified Blalock–Taussig despite use of acetylsalicylic acid prophylaxis. A higher incidence of acetylsalicylic acid-resistance and sub-therapeutic acetylsalicylic acid levels has been reported in infants. We evaluated whether using high-dose acetylsalicylic acid can decrease shunt-related adverse events in infants after modified Blalock–Taussig.MethodsIn this single-centre retrospective cohort study, we included infants ⩽1-year-old who underwent modified Blalock–Taussig placement and received acetylsalicylic acid in the ICU. We defined acetylsalicylic acid treatment groups as standard dose (⩽7 mg/kg/day) and high dose (⩾8 mg/kg/day) based on the initiating dose.ResultsThere were 34 infants in each group. Both groups were similar in age, gender, cardiac defect type, ICU length of stay, and time interval to second stage or definitive repair. Shunt interventions (18 versus 32%, p=0.16), shunt thrombosis (14 versus 17%...
The journal of trauma and acute care surgery, 2018
Agitation of platelet units stored at room temperature is performed routinely to maintain platele... more Agitation of platelet units stored at room temperature is performed routinely to maintain platelet function, and leukoreduction of blood products is the standard of care in many countries to reduce immune consequences of transfusion. The effect of agitation and leukoreduction on whole blood stored at 4°C requires investigation, as reductions in hemostatic capacity of whole blood may reduce its efficacy in treating trauma-induced coagulopathy and platelet dysfunction. We hypothesize that agitation of whole blood will not affect hemostatic function and that leukoreduction will reduce hemostatic function of whole blood. In this in vitro randomized controlled study, 21 units of leukoreduced and 20 nonleukoreduced whole blood units were each randomly assigned into four agitation groups. Hemostatic parameters were measured using viscoelastic assays (rotational thromboelastometry-Extrinsic Screening Test (ROTEM-EXTEM) and thromboelastography (TEG) platelet mapping), impedance aggregometry ...
A chemi-mechanical approach was used to extract cellulose nanofibres (CNFs) from waste mango wood... more A chemi-mechanical approach was used to extract cellulose nanofibres (CNFs) from waste mango wood scraps using a mild chemical treatment ensuring no acid hydrolysis. The dimensional analysis for CNFs has been done by taking into account both the microscopic and light scattering techniques. The FESEM (field emission scanning electron microscopy) analysis revealed the diameter of obtained CNFs in the range of 5-40nm with an average diameter of approximately 12nm. The AFM (atomic force microscopy) analysis gave a more precise average diameter value of 5nm for the obtained CNFs. The aspect ratio as determined by applying mathematical calculations on the data revealed through dynamic and static light scattering techniques (DLS, SLS) was approximately 200. The characteristic shape determined by fractal dimension investigation from SLS measurement revealed the rod/thread like shape of CNFs at lower concentrations.
A pneumatically-operated thrombectomy catheter deployment system has a plurality of components th... more A pneumatically-operated thrombectomy catheter deployment system has a plurality of components that operate collectively as a drive unit, a reciprocating assembly including a double-acting air cylinder, the Pojishonaburu a four-way valve, the high pressure pump When, and includes a waste pump, and pressure tank, and other components that are closely related. Double-acting air cylinder, reciprocating operation is assisted by the components of the drive unit, giving the thrombectomy catheter high pressure saline is used to discharge the waste fluid from the system. The pre-connected multiple components, thrombectomy catheter, saline supply bag, waste collection bag, includes other components for connecting the tube and the closely related, is connected to the drive unit. .FIELD 1
The Proton Improvement Plan (PIP) -II is a high intensity proton facility being developed to supp... more The Proton Improvement Plan (PIP) -II is a high intensity proton facility being developed to support a neutrino program over the next two decades at Fermilab. At its core is the design and construction of a Continuous Wave compatible superconducting radio frequency linear accelerator that would accelerate an average beam current of 2 mA up to 800 MeV. This paper presents recent updates in the beam dynamics leading to a reliable and robust linac design and simplifying the cryo-module assembly.
Introduction: Diffuse alveolar hemorrhage (DAH) is an early pulmonary complication of hematopoiet... more Introduction: Diffuse alveolar hemorrhage (DAH) is an early pulmonary complication of hematopoietic cell transplantation (HCT) associated with severe hypoxemic respiratory failure and mortality. Extracorporeal membrane oxygenation (ECMO) support is often used for respiratory failure refractory to conventional interventions; however, its use has been limited in HCT patients with DAH due to potential for worsening alveolar hemorrhage and reported high mortality.Case Presentation: We report two cases of DAH following HCT who developed refractory hypoxemic respiratory failure despite cessation of bleeding and were successfully supported with ECMO.Conclusion: DAH after HCT should not automatically preclude ECMO support; rather, these patients must be evaluated individually for ECMO within the context of their overall clinical picture.
The Proton Improvement Plan-II (PIP-II) is a proposed upgrade for the accelerator complex at Ferm... more The Proton Improvement Plan-II (PIP-II) is a proposed upgrade for the accelerator complex at Fermilab. The central piece of PIP-II is a new superconducting radio frequency (SRF) 800 MeV linear accelerator (linac) capable of operating in both continuous wave (CW) and pulse regimes. The PIP-II linac comprises a warm front-end that includes a Hion source capable of delivering 15-mA, 30keV DC or pulsed beam, a Low Energy Beam Transport (LEBT), a 162.5 MHz, CW Radio-Frequency Quadrupole (RFQ) accelerating the ions to 2.1 MeV and, a 14-m Medium Energy Beam Transport (MEBT) before beam is injected into SRF part of the linac. This paper presents the PIP-II MEBT design and, discusses operational features and considerations that lead to existing optics design such as bunch by bunch chopping system, minimization of radiation coming to the warm front-end from the SRF linac using a concrete wall, a robust vacuum protection system etc.
A 2.1 MeV, 10 mA CW RFQ has been installed and commissioned at Fermilab's test accelerator kn... more A 2.1 MeV, 10 mA CW RFQ has been installed and commissioned at Fermilab's test accelerator known as PIP-II Injector Test. This report describes the measurements of the beam properties after acceleration in the RFQ, including the energy and emittance.
The International Linear collider (ILC) is a proposed accelerator facility which is primarily bas... more The International Linear collider (ILC) is a proposed accelerator facility which is primarily based on two 11-km long superconducting (SC) main linacs. In this paper we present recent updates on the main linac design and discuss changes made in order to meet specification outlined in the technical design report (TDR).
Platelet InhIbItIon Is assocIated wIth severe bleedIng and MortalIty In chIldren on ecls Arun Sai... more Platelet InhIbItIon Is assocIated wIth severe bleedIng and MortalIty In chIldren on ecls Arun Saini1, Allan Doctor2, Avihu Gazit3, Pirooz Eghtesady4, Umar Boston4, Adam Vogel5, Philip Spinella6; 1Washington University In Saint Louis School of Medicine, Saint Louis, MO, 2Washington University School of Medicine, Saint Louis, MO, 3Washington University School of Medicine, St. Louis, MO, 4Washington University, St Louis, MO, 5Saint Louis Children's Hospital, Saint Louis, MO, 6Washington University In Saint Louis, Saint Louis, MO
Dry reforming of methane is considered a potential reaction for the utilization of waste greenhou... more Dry reforming of methane is considered a potential reaction for the utilization of waste greenhouse gases to generate valuable chemicals. However, catalyst deactivation under a harsh reaction condi...
This work is strategically premeditated to study the potential of a herbal medicinal product as a... more This work is strategically premeditated to study the potential of a herbal medicinal product as a natural bioactive ingredient to generate nanocellulose-based antibacterial architectures. In situ fibrillation of purified cellulose was done in cinnamon extract (ciE) to obtain microfibrillated cellulose (MFC). To this MFC suspension, carboxylated cellulose nanocrystals (cCNCs) were homogeneously mixed and the viscous gel thus obtained was freeze-dried to obtain lightweight and flexible composite aerogel architectures impregnated with ciE, namely, ciMFC/cCNCs. At an optimal concentration of 0.3 wt % cCNCs (i.e., for ciMFC/cCNCs_0.3), an improvement of around 106% in compressive strength and 175% increment in modulus were achieved as compared to pristine MFC architecture. The efficient loading and interaction of ciE components, specifically cinnamaldehyde, with MFC and cCNCs resulted in developing competent antibacterial surfaces with dense and uniform microstructures. Excellent and long-term antimicrobial activity of the optimized architectures (ciMFC/cCNCs_0.3) was confirmed through various antibacterial assays like the zone inhibition method, bacterial growth observation at OD600, minimum inhibitory concentration (MIC, here 1 mg/mL), minimum bactericidal concentration (MBC, here 3-5 mg/mL), and Live/Dead BacLight viability tests. The changes in the bacterial morphology with a disrupted membrane were further confirmed through various imaging techniques like confocal laser scanning microscopy, FESEM, AFM, and 3D digital microscopy. The dry composite architecture showed the persuasive capability of suppressing the growth of airborne bacteria, which in combination with antibacterial efficiency in the wet state is considered as an imperative aspect for a material to act as the novel biomaterial. Furthermore, these architectures demonstrated excellent antibacterial performance under real "in use" contamination prone conditions. Hence, this work provides avenues for the application of crude natural extracts in developing novel forms of advanced functional biomaterials that can be used for assorted biological/healthcare applications such as wound care and antimicrobial filtering units.
INTRODUCTION: Coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state in a... more INTRODUCTION: Coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state in adults with significant mortality attributable to thrombotic complications We report on the coagulation profiles of children admitted to the Intensive Care Unit with coronavirus related illness METHODS: We describe a single-center retrospective cohort of 22 children admitted to the pediatric intensive care unit with SARS-CoV2 related illness All children were admitted with PCR or antibody positive SARS-CoV2 related illness, or if antibody negative met CDC criteria for MIS-C including close family contact with COVID-19 positive patient Thromboelastography was performed on all patients in addition to routine hematologic assays RESULTS: Majority of patients (55%) were female, with median age of 6 years (IQR 2 3,14), with predominantly hispanic (59%) and black (27%) race/ethnicity Three children had preexisting comorbidities The most common clinical presentation was multisystem inflammatory syndrome (77 %) Two children, both adolescent females presented with extensive thrombotic complications- one with deep venous thrombosis and gangrene of leg, one with multiple pulmonary emboli One-third (36%) of children had abnormal values on thromboelastography (TEG) Hypercoagulability on TEG was the most frequent finding, characterized by acceleration of clot formation and increase in maximal clot amplitude Most children had minimal to no fibrinolysis on TEG suggestive of impaired fibrinolysis Elevation in D-Dimer, IL-6 level, ferritin and CRP was universal, and 50% had associated hyperfibrinogenemia (>400 mg/dL) Platelet count, prothrombin time and activated thromboplastin values were normal for all children except the two who presented with thrombotic complications CONCLUSIONS: We report abnormal coagulation profiles in one-third of critically ill children with coronavirus related illness detected by thromboelastography (TEG) Routine coagulation variables were within normal range for most patients, while TEG uncovered a pattern of accelerated clot formation and increased clot strength Our findings suggest significant inflammation associated with a distinct hypercoagulable profile in a subset of children with SARSCoV2 related illness Viscoelastic tests may be useful to characterize these abnormalities
ObjectiveShunt-related adverse events are frequent in infants after modified Blalock–Taussig desp... more ObjectiveShunt-related adverse events are frequent in infants after modified Blalock–Taussig despite use of acetylsalicylic acid prophylaxis. A higher incidence of acetylsalicylic acid-resistance and sub-therapeutic acetylsalicylic acid levels has been reported in infants. We evaluated whether using high-dose acetylsalicylic acid can decrease shunt-related adverse events in infants after modified Blalock–Taussig.MethodsIn this single-centre retrospective cohort study, we included infants ⩽1-year-old who underwent modified Blalock–Taussig placement and received acetylsalicylic acid in the ICU. We defined acetylsalicylic acid treatment groups as standard dose (⩽7 mg/kg/day) and high dose (⩾8 mg/kg/day) based on the initiating dose.ResultsThere were 34 infants in each group. Both groups were similar in age, gender, cardiac defect type, ICU length of stay, and time interval to second stage or definitive repair. Shunt interventions (18 versus 32%, p=0.16), shunt thrombosis (14 versus 17%...
The journal of trauma and acute care surgery, 2018
Agitation of platelet units stored at room temperature is performed routinely to maintain platele... more Agitation of platelet units stored at room temperature is performed routinely to maintain platelet function, and leukoreduction of blood products is the standard of care in many countries to reduce immune consequences of transfusion. The effect of agitation and leukoreduction on whole blood stored at 4°C requires investigation, as reductions in hemostatic capacity of whole blood may reduce its efficacy in treating trauma-induced coagulopathy and platelet dysfunction. We hypothesize that agitation of whole blood will not affect hemostatic function and that leukoreduction will reduce hemostatic function of whole blood. In this in vitro randomized controlled study, 21 units of leukoreduced and 20 nonleukoreduced whole blood units were each randomly assigned into four agitation groups. Hemostatic parameters were measured using viscoelastic assays (rotational thromboelastometry-Extrinsic Screening Test (ROTEM-EXTEM) and thromboelastography (TEG) platelet mapping), impedance aggregometry ...
A chemi-mechanical approach was used to extract cellulose nanofibres (CNFs) from waste mango wood... more A chemi-mechanical approach was used to extract cellulose nanofibres (CNFs) from waste mango wood scraps using a mild chemical treatment ensuring no acid hydrolysis. The dimensional analysis for CNFs has been done by taking into account both the microscopic and light scattering techniques. The FESEM (field emission scanning electron microscopy) analysis revealed the diameter of obtained CNFs in the range of 5-40nm with an average diameter of approximately 12nm. The AFM (atomic force microscopy) analysis gave a more precise average diameter value of 5nm for the obtained CNFs. The aspect ratio as determined by applying mathematical calculations on the data revealed through dynamic and static light scattering techniques (DLS, SLS) was approximately 200. The characteristic shape determined by fractal dimension investigation from SLS measurement revealed the rod/thread like shape of CNFs at lower concentrations.
A pneumatically-operated thrombectomy catheter deployment system has a plurality of components th... more A pneumatically-operated thrombectomy catheter deployment system has a plurality of components that operate collectively as a drive unit, a reciprocating assembly including a double-acting air cylinder, the Pojishonaburu a four-way valve, the high pressure pump When, and includes a waste pump, and pressure tank, and other components that are closely related. Double-acting air cylinder, reciprocating operation is assisted by the components of the drive unit, giving the thrombectomy catheter high pressure saline is used to discharge the waste fluid from the system. The pre-connected multiple components, thrombectomy catheter, saline supply bag, waste collection bag, includes other components for connecting the tube and the closely related, is connected to the drive unit. .FIELD 1
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