All Rights Reserved. 2022 Dec 29;28(2):41-46. doi: 10.2478/rjaic-2021-0007. These tubes are retained for 48hrs therefore a PV can normally be added after sample receipt if required. Bacteriophage Adsorption: Likelihood of Virion Encounter with Bacteria and Other Factors Affecting Rates. [image] => Array [ticker-height] => 43 Synnovis,the Synnovislogo and Nutris are registered trademarks of SynnovisGroup LLP. Plasma viscosity is often regarded as an alternative to the erythrocyte sedimentation rate (ESR) or Creactive protein. If youre receiving plasmapheresis as treatment, the procedure can last between one and three hours. [1536x1536] => https://www.bensonviscometers.com/wp-content/uploads/2019/04/Red-blood-cells_h.jpg Elevation of plasma viscosity correlates to the progression of coronary and peripheral artery diseases. Diagnosis | Diagnosis | Polymyalgia rheumatica | CKS | NICE Because the blood cells are removed prior to testing, plasma and serum viscosity measurements cannot provide data that are physiologically meaningful and fail to capture the dynamic changes of blood flowing in the body. It can reflect the degree of inflammation present in the body. Learn about the advantages and disadvantages of donating blood, plus how it affects the body, Blood circulates throughout the body, transporting substances essential to life. The simplicity of the plasma viscosity test is that this is rapidly available, requires only limited operator training and may help facilitate quick decisionmaking when combined with additional clinical data such as degree of hypoxia or measurement of other inflammatory proteins. SA62 4BS Can diet help improve depression symptoms? Benson Viscometers Ltd AM: How can PV be measured? It is believed that this indicates that PV has potential as a useful marker in the diagnostic assessment of patients with suspected COVID-19 and for monitoring the disease progression.Health Services Laboratories (HSL) is also on the case. more about how doctors diagnose and treat this condition. A few reference labs in the U.S. do test the viscosity of whole blood but are only able to measure high shear viscosity (at a shear rate of 90 s-1). Received 2021 Jan 22; Revised 2021 Mar 12. In hyperviscosity syndromes plasma viscosity is better in follow-up than ESR. These cookies will be stored in your browser only with your consent. The data that support the findings of this study are available from the corresponding author upon reasonable request. Croft Quarry Listen to this article using the player above. A viscometer (also called viscosimeter) is an instrument used to measure the viscosity of a fluid.For liquids with viscosities which vary with flow conditions, an instrument called a rheometer is used. Unit E - North Estate Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Plasma viscosity: a forgotten variable - PubMed [medium_large-width] => 640 Plasma Viscosity - an overview | ScienceDirect Topics Careers. UK, Array The value of these tests is limited by lack of specificity. Support literature contains useful information on clinical viscometers and viscosity testing such as, a quick reference guide, comparisons to other types of inflammation testing and reference information. The major influence on plasma viscosity is exerted by fibrinogen and immunoglobulins. Bernie Benson (BB): Put simply, it is a liquid's resistance to flow, often it is referred to as the thickness of a liquid, in this case, blood plasma.Increased plasma viscosity is an indicator for potential stroke and heart attack: these are induced by a low flow of blood in the capillaries leading to an inadequate delivery of vital oxygen and nutrients to body tissues.A high plasma viscosity (hyperviscosity) can be linked to blood cancers including polycythemia, macroglobulinemia, multiple myeloma, and leukaemia. Want a FREE PDF version of this industry insight? Acute hyperviscosity: syndromes and management Emory also found that patients with the highest viscosity levels were more likely to have blood coagulation problems e.g. But there may be another critical blood-related issue to consider blood viscosity, or blood thickness. Donated blood plasma can be very helpful to medicine. The disease that is consequently attributed to this is now commonly known as COVID19. Diagnostic value of plasma viscosity testing for patients with COVID19 The pioneering hemorhologist Prof. Holger Schmid-Shoenbein envisioned the relationship of elevated blood viscosity to thrombosis like an accumulation of kindling in a forest. [prod_gal-height] => 220 Here, we describe the first prospective evaluation of the diagnostic potential of using plasma viscosity testing for patients with suspected COVID19. We've updated our Privacy Policy to make it clearer how we use your personal data. Its normal value is 1.10-1.30 mPa s at 37 degrees C and independent of age and gender. It has been reported that approximately 20% of COVID19positive patients are asymptomatic, 14% develop severe symptoms, which require medical intervention, and 5% require critical care. There was no significant difference between the WBC counts (9.445.38 vs 8.734.58109/L, U=9138, z=0.36, P<.726), platelet counts (252139.3 vs 250165109/L, U=8728, z=0.97, P<.332), neutrophil counts (7.515.30 vs 7.214.61109/L, U=9083, z=0.44, P<.659) or the LUC count (0.190.23 vs 0.220.29109/L, U=8871, z=0.758, P<.447) between these patient cohorts. NCI CPTC Antibody Characterization Program. Plasma Viscosity Blood Sciences Test Recommendations for inflammatory marker testing in Devon from May 2022: C-Reactive Protein (CRP) should be your first line inflammatory marker test of choice There are few scenarios where good clinical correlation with (or without) a CRP cannot guide patient management. A cutoff plasma viscosity of 1.83mPas was selected using the maximum weighted Youden's index of 0.683 as the discriminator. sharing sensitive information, make sure youre on a federal and transmitted securely. Sign up with Viapath to receive our newsletter and hear about our scientific events. Superparamagnetic iron oxide nanoparticles for their application in the human body: Influence of the surface. Overview What is hyperviscosity syndrome? [medium_large-height] => 183 Iron inside hemoglobin binds to oxygen. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. Learn more about the kidneys vital role in health. Here, we describe the first prospective evaluation of the diagnostic potential of using plasma viscosity testing for patients with suspected COVID19. Influence of blood lipids on plasma and blood viscosity - PubMed Elevation of plasma viscosity correlates to the progression of coronary and peripheral artery diseases. Most donation places require that a person is in good health to donate blood. Maier CL, Truong AD, Auld SC, Polly DM, Tanksley CL, Duncan A. COVID19associated hyperviscosity: a link between inflammation and thrombophilia? Another cause is an imbalance in the blood clotting system. A special machine will filter out the red blood cells and platelets and safely return these blood components to the donors body. (2021). of a study from Emory University that found elevated plasma viscosity levels in critically ill COVID-19 patients, a number of investigations are currently underway to understand the links between blood plasma thickness and COVID-19 severity. This reduces the viscosity by normalising the fibrinogen and other factors contributing to the stickiness and, potentially, may reduce clotting. It may happen because you have too many red blood cells, white blood cells or blood proteins. The Bowmans capsule removes excess blood cells, platelets, and proteins from blood plasma. Before High concentration of asymmetric paraproteins. Increased plasma viscosity is an indicator for potential stroke and heart attack: these are induced by a low flow of blood in the capillaries leading to an inadequate delivery of vital oxygen and nutrients to body tissues. Hyperviscosity Syndrome Workup: Laboratory Studies, Imaging - Medscape 1 thank A 22-year-old member asked: Explain please results. The total protein test gives an approximate measure of all plasma protein (excluding fibrinogen when testing is on clotted samples). It can increase in parallel with erythrocyte sedimentation rate (ESR), but it is not influenced by hematocrit (anemia, polycytemia), or time to analysis. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. Hyperviscosity syndrome is a condition in which blood isn't able to flow freely through your arteries. Some examples of antifibrinolytic drugs are aprotinin, tranexamic acid (TXA), epsilon-aminocaproic acid and aminomethylbenzoic acid. [caption] => E81B0T Microscopic view of blood cells. Based on these data, we conclude that plasma viscometry analysis can be implemented into assessment algorithms to help quickly categorize patients with suspected symptoms of COVID19 into high or low disease complication risk groups. . [medium] => https://www.bensonviscometers.com/wp-content/uploads/2019/04/Red-blood-cells_h-300x86.jpg We believe it could. Blood-thinning foods, drinks, and supplements. Plasma: What it is & Why it is Important - Cleveland Clinic Compared with plasma viscosity it is elevated earlier in infection (6 - 10 hours) and it has a shorter half life (48 hours). Donating blood plasma is a safe and simple procedure. Plasma Viscosity Exeter Clinical Laboratory International This allows hemoglobin to carry oxygen from the lungs to the rest of the body. Plasma Viscosity tests are performed at GRH. MNT is the registered trade mark of Healthline Media. [large-width] => 640 Indeed, a plasma viscosity result above the identified cutoff is shown to have good correlation with disease progression. PV: the normal range for adults is 1.50-1.72 mPA. 3 [title] => Microscopic view of blood cells. Thank you. Would you like email updates of new search results? Investigating the power of music for dementia. Protein levels in the blood can increase as part of the normal response to infection or inflammation. 004861: Viscosity | Labcorp Donating blood plasma is a simple and safe procedure. High plasma viscosity causes | HealthTap Online Doctor National Library of Medicine It may also develop if you have irregularly shaped red blood cells. 1 [ticker-height] => 44 Blood is a non-Newtonian, shear thinning fluid with thixotropic and viscoelastic properties. In this syndrome, arterial blockages can happen due to too many red blood cells, white . What is left is donated blood plasma. The only external quality assurance scheme in the UK that offers plasma viscosity EQA and advice. [header_type] => image It can also detect the presence of abnormal paraproteins which can be produced by benign or malignant tumours. [ticker] => https://www.bensonviscometers.com/wp-content/uploads/2019/04/Red-blood-cells_h_950x280_acf_cropped-1-150x44.jpg 7 We use cookies to provide you with a better service. [width] => 1050 A major contributing factor to this is the increased tendency of the patient's blood to thicken and the production of blood clots which can lead to heart failure, strokes, kidney failure and when formed in the lung, respiratory system failure.AM: What have studies shown so far about the effect of SARS-CoV-2 infection on PV? Cheryl Maier, Assistant Professor of Coagulation and Transfusion Medicine, Department of Pathology and Laboratory Medicine, Emory University School of Medicine and Medical Director of Emorys Special Coagulation Laboratory said that the viscosity levels in the sickest COVID-19 patients were similar to those seen in a type of blood disorder called hyperviscosity syndrome, where the high viscosity leads to dangerous sludging of the blood in the brain and other organs." and transmitted securely. Part of the LabX Media Group. government site. Erythrocyte Sedimentation Rate (ESR) will no longer be available to request this. Whole Blood Viscosity vs. Serum and Plasma Viscosity Plasma is a Newtonian fluid, its viscosity does not depend on flow characteristics, therefore it is simple to measure, especially in capillary viscosimeters. For example, when someone has the chickenpox virus, their body will develop specific immunoglobulins to fight it off. In order to quantify the actual flow resistance of blood, it is necessary to measure whole blood viscosity. 2023 May 25;9(6):e16487. Plasma viscosity is determined by water-content and macromolecular components. An official website of the United States government. Whole blood contains red blood cells, white blood cells, and platelets suspended in blood plasma. BB: The doctors at Emory University found that COVID-19 patients had extremely high levels of fibrinogen, a large protein that increases the blood plasma viscosity when in a high concentration. Doctors use donated blood and blood plasma to treat many conditions and in emergency situations. [large] => https://www.bensonviscometers.com/wp-content/uploads/2019/04/Red-blood-cells_h_950x280_acf_cropped-1.jpg Inclusion in an NLM database does not imply endorsement of, or agreement with, advantages they offer, especially when testing COVID-19 samples? has a lower instance of false normal values, can be performed on a sample up to 48 hours old, is stable and relatively small changes are significant for any individual, is technically reproducible and standardised, is automatable and therefore safer and cheaper to perform. The World Health Organization (WHO) has declared this a public health emergency of international concern due to the global pandemic of unprecedented proportion that has been implicated in over 2 million deaths worldwide. Low plasma viscosity as an indicator of antibody deficiency Delay in the diagnosis of antibody immunodeciency (low immunoglobulins) is common, with mean interval . 855.405.8378 | 206.209.4200. infection, malignancy, vascular disease. What is Plasma Viscosity? - Benson Viscometers Pre analysis storage: do not store, send to laboratory within 4 hours. How does plasma affect blood viscosity? | Privacy Policy. Synnovis Policies, User Guides and Documents, Criteria for acceptance / rejections of sample, Haematology Laboratory at Guy's and St Thomas' Hospital. Close menu. Hyperviscosity syndrome is a condition that occurs when your blood becomes so thick that your body's overall blood flow decreases. It can reflect the degree of inflammation present in the body. Evaluation of plasma viscosity has been underutilized in the clinical practice. Interpretation of PV Results Plasma viscosity is a non-specific screening test used in diagnosing a host of disorders. Withybush Road A range of plasma viscosity levels and their associated sensitivity, specificity, confidence intervals, likelihood ratios and Youden's index are detailed in Table1. Read more about what blood plasma donation involves. The doctors at Emory University found that COVID-19 patients. [prod_gal_full-height] => 280 [2048x2048-width] => 1050 Complete the form below and we will email you a PDF version of ( infection, neoplasm or inflammatory disease). [2048x2048] => https://www.bensonviscometers.com/wp-content/uploads/2019/04/Red-blood-cells_h_950x280_acf_cropped-1.jpg Systolic blood viscosity (high shear) and diastolic blood viscosity (low shear) are reported for easy clinical intepretation. When it moves slowly during end-diastole it is thicker and stickier. [thumbnail] => https://www.bensonviscometers.com/wp-content/uploads/2019/04/Red-blood-cells_h_950x280_acf_cropped-1-150x150.jpg (Purple Top). Plasmapheresis to reduce the level of acute-phase proteins, dilution with plasma or therapeutic phlebotomy (300-400 cc) are therapeutic options to reduce blood viscosity. Viscosity, Serum - University of Washington In conclusion, plasma viscosity should be measured routinely in medical practice. children, in the presence of active connective tissue disease or in patients with lymphoma/leukaemia) and subsequently to monitor response to antibiotics. The .gov means its official. Based on these favorable features, in 1942 plasma viscosity was recommended to substitute ESR. [large] => https://www.bensonviscometers.com/wp-content/uploads/2019/04/Red-blood-cells_h-1024x293.jpg infection, neoplasm or inflammatory disease). Referral Test. Exeter Clinical Laboratory International 2023, Interpretation of results Reference range 1.50 1.72 mPa.s (milli Pascal seconds). How does alkaline phosphatase affect P-nitrophenol? CRP samples are analysed in the Chemical Pathology department. . Serum, plasma or whole blood viscosity measurements can be useful in patients with hyperviscosity syndromes due to multiple myeloma or Waldenstrom's macroglobulinemia. It has shown to be significantly increased compared with those testing negative for COVID19 and above that expected with viral infections. Plasma differs from whole blood in that the cellular material has been removed by centrifugation. Can you tell us how viscometers work and the advantages they offer, especially when testing COVID-19 samples? If temporal arteritis (TA)/giant cell arteritis (GCA) or hyperviscosity syndrome is suspected, then PV, although not necessary, may be requested. Their main use is as an objective guide to the underlying activity of certain chronic inflammatory diseases such as temporal arteritis or rheumatoid arthritis. Plasma viscosity is often regarded as an alternative to the erythrocyte sedimentation rate (ESR) or Creactive protein. [alt] => Plasma viscosity estimation is a reflection of changes in plasma proteins within the blood. Queen Elizabeth HospitalSheriff HillGatesheadNE9 6SX, North East and Yorkshire Cervical Screening Centre. Disclaimer. The torque necessary to overcome the viscous resistance of whole blood or plasma is measured in centipoise (cP). A number of studies are using Benson Viscometers equipment to investigate the links between PV and COVID-19, and explore the use of PV testing in diagnosing COVID-19 severity. What is plasma? infection, neoplasm or inflammatory disease). the contents by NLM or the National Institutes of Health. This increase seems independent of classical CHD risk factors and is disjoined from haematocrit and plasma viscosity, suggesting a possible direct effect of aging on red blood cells. It tends not to be elevated in viral infections, leukaemia/lymphoma or connective tissue disease. An unusual cluster of patients suffering from a pneumoniainducing condition was first reported within Wuhan, Hubei Province, China, in late December 2019. The Viscometer determines viscosity by measuring the resistance of the plasma flow through a capillary under a constant vacuum. Which plasma protein is responsible for blood viscosity? Cambridge There were 147 (37.2%) female and 248 (62.8%) male patients, with a mean age of 54 (SD=20, 95% CI: 51.157.5) and 56 (SD=17.7, 95% CI: 53.658), respectively. Plasma and serum viscosity tests are useful to detect an acute phase reaction or severe inflammatory response such as occurs in sepsis. The optimum cutoff PV of 1.83mPas is highlighted in bold. [mime_type] => image/jpeg What is the reporting unit for plasma viscosity? 1. The less spheroid shape, the higher molecular weight, the higher aggregating capacity, and the higher temperature or pH sensitivity a protein has, the higher plasma viscosity results. Menu While all types of donated blood can save lives, the American Red Cross urges people who have the AB blood type to donate blood plasma. The https:// ensures that you are connecting to the [thumbnail-height] => 150 The components of blood plasma perform many crucial body functions. [introduction] =>. Federal government websites often end in .gov or .mil. 2023 May;12(5):e12315. This white paper describes the difference between viscosity measurements for whole blood vs. serum or plasma, and in addition, explains the critical importance of obtaining a complete viscosity profile and not just the systolic viscosity measurement. Plasma viscosity - Lab Tests Online-UK This test can be added on to a previous request as long as there is sufficient sample remaining and the sample is less than 48 hours old. Conclusion: The present findings demonstrate that blood viscosity increases with age. Can you tell us how viscometers work and the. Hyperviscosity syndrome is a condition that occurs when your blood becomes so thick that your bodys overall blood flow decreases. UK. [medium_large] => https://www.bensonviscometers.com/wp-content/uploads/2019/04/Red-blood-cells_h-768x219.jpg Benchmarking blood collection tubes and processing intervals for extracellular vesicle performance metrics. Additionally, a very select few number of clinical reference labs claim to provide whole blood viscosity testing, however these tests are for systolic blood viscosityhigh shear rate viscosity only. 2 The mean plasma viscosity was 1.62mPas (SD=0.13, 95% CI: 1.61.64) in those testing negative for COVID19 and 2.00mPas (SD=0.36, 95% CI: 1.952.06) in those testing positive. Whrle J, Nusser T, Hoffmeister A, Kestler HA, Grebe OC, Hher M, Hombach V, Koenig W, Kochs M. Dtsch Med Wochenschr. How does blood work, and what problems can occur? Blood plasma is a light yellow liquid that makes up about half of a persons blood. From:Chanarin I Laboratory Haematology 1989, Clinical advice is available from the Haematology Medical team (contact RD&E switchboard on 01392 411611), Exeter Clinical Laboratory International are an NHS laboratory located at the Royal Devon University Healthcare NHS Foundation Trust in the United Kingdom. You could take an armful of blood and you couldnt do that. PV results are rapid, precise, and are not affected by variations such as gender, age, early pregnancy, or the presence of other conditions, such as anaemia.An advantage of the PV test is that it will continue to give clinically significant results up to seven days after the sample has been taken. [prod_gal_full-width] => 1050 Plasma viscosity (PV) measures the viscosity, or the 'thickness' of the plasma (the liquid part of the blood). It has been shown that systemic infection with COVID19 causes an increase in serum immunoglobulins as well as fibrinogen and clotting factors. Plasma fibrinogen concentration and plasma viscosity are elevated in unstable angina pectoris and stroke and their higher values are associated with higher rate of major adverse clinical events. Clin Hemorheol Microcirc. What are the normal values for ESR, CRP and PV? P.H., the lead study author. Plasma Viscosity: 1.35 - 1.85 cP. Inside the body, blood experiences high and low shear rates during each cardiac cyclefrom peak-systole (high shear) to end-diastole (low shear). Referral Test. [sections] => Many cardiovascular handbooks consider blood viscosity values between 3.5 and 5.5 cP to be normal. How can PV be measured? Hyperviscocity: Treatment, Symptoms, and Causes - WebMD Viscometers can measure only constant viscosity, that is, viscosity that does not change with flow conditions. Aside from water, which makes up around 9192% of blood plasma, the main components of blood plasma are: Learn more about blood components and what they do. It can also detect the presence of abnormal paraproteins which can be produced by benign or malignant tumours. Meridian Valley Laboratory uses an automated scanning capillary viscometer that acquires the complete viscosity profile for each blood sample tested. Increased viscosity increases the resistance to blood flow and thereby increases the work of the heart and impairs organ perfusion. 2008;39(1-4):235-42. [height] => 280 6 Learn about what to do after donating blood. Ankylosing Spondylitis Pain: Fact or Fiction, https://www.hematology.org/education/patients/blood-basics, https://www.nhlbi.nih.gov/health-topics/blood-donation, https://www.ncbi.nlm.nih.gov/books/NBK482248/, https://www.fda.gov/media/141479/download, https://www.fda.gov/consumers/consumer-updates/have-you-given-blood-lately, https://www.ncbi.nlm.nih.gov/books/NBK537184/, https://www.ncbi.nlm.nih.gov/books/NBK531504/, https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1008735, https://www.ncbi.nlm.nih.gov/books/NBK525967/, https://labtestsonline.org.uk/tests/plasma-viscosity, https://www.ncbi.nlm.nih.gov/books/NBK560566/, https://www.ncbi.nlm.nih.gov/books/NBK541123/, https://www.covid19treatmentguidelines.nih.gov/management/clinical-management/hospitalized-adults--therapeutic-management/, https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-blood-donations.html, https://www.ncbi.nlm.nih.gov/books/NBK513460/, Newly discovered marker of multiple sclerosis severity may lead to better treatments, Colorectal cancer: Earlier screening should be considered for young men at high risk, New drug mirikizumab shows promise in ulcerative colitis remission, Insulin treatment might boost cognition in people with mild cognitive impairment or Alzheimer's disease, Scientists discovered a possible treatment for baldness from hairy moles and it can be injected like Botox, Everything you need to know about blood types, Advantages and disadvantages of donating blood. Design and setting [1536x1536] => https://www.bensonviscometers.com/wp-content/uploads/2019/04/Red-blood-cells_h_950x280_acf_cropped-1.jpg Sample stability: samples must arrive to the laboratory and be processed within 24h post collection. This process takes around 1 hour 15 minutes. Doctors at Emory University are, 2023 Technology Networks, all rights reserved. Healthcare professionals consider hemoglobin one of the most important proteins for respiration (breathing) because it regulates levels of carbon dioxide and oxygen in the blood. Plasma viscometry tests yield exceptionally reliable results when assessing the thickness of the blood. This cheap and simple test may provide more useful information in riskstratifying patients who present with symptoms of COVID19 as to date; there have been no other reported laboratory tests, which have been able to quantify the degree of individual disease burden. Anna MacDonald (AM): What is plasma viscosity (PV)? Blood plasma has many functions, and different blood plasma components play different crucial roles. What have studies shown so far about the effect of SARS-CoV-2 infection on PV? These cookies do not store any personal information. Secondly, these data are prospective and although show an excellent ability to discern between two inpatient groups, this may be due to confirmation bias; patients may be asymptomatic but still be prone to a hyperinflammatory state. What does high viscosity in blood mean? - Studybuff.com [medium_large] => https://www.bensonviscometers.com/wp-content/uploads/2019/04/Red-blood-cells_h_950x280_acf_cropped-1-768x226.jpg the increase in assortedplasmaproteins and fibrinogen in bloodplasmastimulated by a variety of causes (e.g. Here, learn about the components of blood and how it supports human, The kidneys are essential for balancing the body's internal environment. An official website of the United States government. Your body contains between 5 to 6 quarts (5 liters) of blood. Which diseases are associated with an elevation of plasma viscosity? However, because the cellular content of blood has been removed prior to testing viscosity, plasma and serum cannot provide any insights on the actual flow resistance of a patients blood sample. We avoid using tertiary references. Red blood cells and the hemoglobin protein are essential in providing vital oxygen throughout the body. The value of these tests is limited by lack of specificity. Blood viscosity was significantly associated with haematocrit, plasma viscosity, Tk and all considered variables but age in simple correlation analysis, but only with haematocrit, plasma viscosity and Tk in multiple regression analysis. While donating blood is a safe procedure, blood donations can sometimes cause temporary side effects, such as: A person can prepare for donating blood and minimize the risk of side effects by eating nutritious foods, drinking plenty of fluids, and getting rest before donating blood. Inflammations, tissue injuries resulting in plasma protein changes can increase its value with high sensitivity, though low specificity.
Cumberland County Maine Sheriff Sale,
Rockefeller Ssrp 2023,
150 000 Loan Over 5 Years,
Purpose Of Annual Report Nonprofit,
Articles W