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Vaccine-induced immune thrombotic thrombocytopenia (VITT) is primarily a complication of adenoviral vector-based covid-19 vaccination. In VITT, thrombocytopenia and thrombosis mediated by anti-platelet factor 4 (PF4) antibodies can be severe, often characterized by thrombosis at unusual sites such as the cerebral venous sinus and splanchnic circulation. Like in heparin-induced thrombocytopenia (HIT) and spontaneous HIT, VITT antibodies recognize PF4-polyanion complexes and activate PF4-treated platelets but additionally bind to un-complexed PF4, a critical finding that could be leveraged for more specific detection of VITT. Intravenous immunoglobulin and non-heparin-based anticoagulation remain the mainstay of treatment. Second dose/boosters of mRNA covid-19 vaccines appear safe in patients with adenoviral vector-associated VITT. Emerging data is consistent with the possibility that ultra-rare cases of VITT may be seen in the setting of mRNA and virus-like particle (VLP) technology-based vaccinations and until more data is available, it is prudent to consider VITT in the differential diagnosis of all post-vaccine thrombosis and thrombocytopenia reactions. [ABSTRACT FROM AUTHOR]

Background: 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.Study Design and Methods: 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.Results: 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.Conclusion: 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. [ABSTRACT FROM AUTHOR]

This paper describes CyberGIS Gateway as an online problem-solving environment for multiple science communities to conduct data-rich geospatial research and education. CyberGIS Gateway is a key modality in the CyberGIS software environment. Scalable gateway application integration has been the focus of CyberGIS Gateway in order to efficiently develop highly interactive online geographic information systems (GIS) user interface components and couple a rich collection of heterogeneous and distributed geospatial data and analytical services for advanced cyberGIS capabilities on advanced cyberinfrastructure. An open mashup and service API approach is developed to address the integration challenges in CyberGIS Gateway application development. This approach is applied and evaluated in developing several representative cyberGIS data and analytical applications. The experience gained from the integration practice is shared. The education and outreach activities in CyberGIS Gateway are presented to illustrate the impact of CyberGIS Gateway in GIScience communities and the effective collaboration within the science gateway community. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Antibodies specific for platelet factor 4 (PF4)/ heparin complexes are the hallmark of heparin-induced thrombocytopenia/thrombosis (HIT) but many antibody-positive patients have normal platelet counts. The basis for this is not fully understood, but it is believed that antibodies testing positive in the serotonin release assay (SRA) are most likely to cause disease. We addressed this issue by characterizing PF4-dependent binding of HIT antibodies to intact platelets and found that most antibodies testing positive in the SRA, but none of those testing negative, bind to and activate platelets when PF4 is present without any requirement for heparin (p<0.0001). Binding of SRA-positive antibodies to platelets was inhibited by chondroitinase ABC digestion (p<0.05) and by addition of chondroitin-4-sulfate (CS) or heparin in excess quantities. The findings suggest that, although all HIT antibodies recognize PF4 in a complex with heparin, only a subset recognize more subtle epitopes induced in PF4 when it binds to CS, the major platelet glycosaminoglycan. Antibodies having this property could explain "delayed HIT" seen in some individuals after discontinuation of heparin and the high risk of thrombosis that persists for weeks in patients recovered from HIT. [ABSTRACT FROM AUTHOR]

Background: There are very few documented reports in literature of cerebral venous sinus thrombosis (CVST) caused by immune-mediated heparin-induced thrombocytopenia (HIT). Further, there are very few reports of false negative serotonin release assays (SRAs) when testing for immune-mediated HIT. Case presentation: We present a case of a 60- year-old male with recent unfractionated heparin administration for venous thromboembolism prophylaxis, an elevated 4T score of 5 and acute CVST in which immune-mediated HIT was suspected. The enzyme-linked immunosorbent assay (ELISA) screening assay was positive for PF4 antibodies and subsequent reflexive SRA testing was negative. However, given the clinical picture, a false-negative SRA was suspected (and eventually confirmed), prompting use of the alternative PF4-dependent p-selectin expression assay (PEA) which was confirmed to be positive. The patient was successfully managed with a bivalirudin infusion and eventually transitioned to apixaban. Conclusion: It is uncommon for immune-mediated HIT with thrombosis to manifest as CVST. Similarly, false-negative SRA is uncommon in immune-mediated HIT. Take-away lessons from our case report include considering HIT in CVST patients with an elevated 4T score and considering the entire clinical picture and degree of suspicion for HIT when interpreting negative HIT testing results. The PEA, in conjunction with the 4Ts score, may be considered as an alternate diagnostic assay for HIT. [ABSTRACT FROM AUTHOR]

Summary: The interdisciplinary field of cyberGIS (geographic information science and systems (GIS) based on advanced cyberinfrastructure) has a major focus on data‐ and computation‐intensive geospatial analytics. The rapidly growing needs across many application and science domains for such analytics based on disparate geospatial big data poses significant challenges to conventional GIS approaches. This paper describes CyberGIS‐Jupyter, an innovative cyberGIS framework for achieving data‐intensive, reproducible, and scalable geospatial analytics using Jupyter Notebook based on ROGER, the first cyberGIS supercomputer. The framework adapts the Notebook with built‐in cyberGIS capabilities to accelerate gateway application development and sharing while associated data, analytics, and workflow runtime environments are encapsulated into application packages that can be elastically reproduced through cloud‐computing approaches. As a desirable outcome, data‐intensive and scalable geospatial analytics can be efficiently developed and improved and seamlessly reproduced among multidisciplinary users in a novel cyberGIS science gateway environment. [ABSTRACT FROM AUTHOR]