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Sample records for high relapse rates

  1. High rates of relapse in adolescents crack users after inpatient clinic discharge

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    Rosemeri Siqueira Pedroso

    Full Text Available ABSTRACT Objective The objective of the present study was to evaluate 88 adolescent crack users referred to hospitalization and to follow them up after discharge to investigate relapse and factors associated with treatment. Methods Cohort (30 and 90 days after discharge from a psychiatric hospital and a rehab clinic for treatment for chemical dependency in Porto Alegre between 2011 and 2012. Instruments: Semi-structured interview, conducted to evaluate the sociodemographic profile of the sample and describe the pattern of psychoactive substance use; Crack Use Relapse Scale/CURS; Questionnaire Tracking Users to Crack/QTUC; K-SADS-PL. Results In the first follow-up period (30 days after discharge, 65.9% of participants had relapsed. In the second follow-up period (90 days after discharge, 86.4% of participants had relapsed. Conclusion This is one of the first studies that show the extremely high prevalence of early relapse in adolescent crack users after discharge, questioning the cost/benefit of inpatient treatment for this population. Moreover, these results corroborate studies which suggested, young psychostimulants users might need tailored intensive outpatient treatment with contingency management and other behavioral strategies, in order to increase compliance and reduce drug or crime relapse, but this specific therapeutic modality is still scarce and must be developed in Brazil.

  2. ANALYSIS OF RELAPSE RATE AND METASTASES OF HIGH DIFFERENTIATED THYROID CANCER

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    E. V. Savenok

    2015-01-01

    Full Text Available  Analysis of rate of relapses and metastases with well-differentiated thyroid cancer was performed for patients in 2009 to 2013. The study involved 189 patients with thyroid cancer including 98 (51.9 % patients suffering from papillary thyroid cancer, 77 (40.7 % patients suffering from follicular thyroid cancer, and 14 (7.4 % patients suffering from medullary thyroid cancer. 2.04 % of the 98 patients suffering from papillary thyroid cancer manifested a relapse, and lymphogenic metastases of cancer were revealed with 1.0 % of patients. With follicular thyroid cancer (n = 77, lymphogenic metastases were registered in 7.8 % of cases, relapses were revealed in 1.3 % of cases. This analysis demonstrated that observation of patients for 5 years revealed a higher percentage of metastases with patients that suffered from follicular thyroid cancer.

  3. IIVP salvage regimen induces high response rates in patients with relapsed lymphoma before autologous stem cell transplantation.

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    Abali, Huseyin; Oyan, Basak; Koc, Yener; Kars, Ayse; Barista, Ibrahim; Uner, Aysegul; Turker, Alev; Demirkazik, Figen; Tekin, Fatma; Tekuzman, Gulten; Kansu, Emin

    2005-06-01

    Patients with relapsed lymphoma can be cured with high-dose chemotherapy and autologous hematopoietic stem cell transplantation (HSCT). New therapeutic approaches with better cytoreductive capacity are needed for relapsed patients to keep their chance for cure with transplantation. We report 30 patients with relapsed lymphoma, median age 43 years, treated with IIVP salvage regimen consisting of ifosfamide, mesna, idarubicin, and etoposide for 2 or 3 cycles. Seventeen patients had non-Hodgkin lymphoma (NHL) and 13 patients had Hodgkin disease (HD). Fourteen (47%) patients were at their first relapse. Overall response rate was 86.6% (n = 26) with 19 patients (63.3%) achieving complete response. Overall response rate was 92% in patients with HD and 82% in NHL. The most frequent side effects observed were grade III-IV neutropenia (87%) and thrombocytopenia (73%). IIVP regimen is a highly effective salvage therapy for patients with relapsed HD or NHL who are candidates for autologous HSCT. Close follow up is necessary because of the high incidence of grade III-IV hematologic toxicity.

  4. Low-dose-rate brachytherapy for the treatment of localised prostate cancer in men with a high risk of disease relapse.

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    Laing, Robert; Uribe, Jennifer; Uribe-Lewis, Santiago; Money-Kyrle, Julian; Perna, Carla; Chintzoglou, Stylianos; Khaksar, Sara; Langley, Stephen E M

    2018-04-01

    To report clinical outcomes of 125 I low-dose-rate prostate brachytherapy (LDR-PB) as monotherapy or combined with androgen-deprivation therapy (ADT) and/or external beam radiotherapy (EBRT) in high-risk localised prostate cancer. Analysis of clinical outcomes from a prospective cohort of patients treated with LDR-PB alone or combined treatment in a single institution. Men with a high risk of disease relapse were identified by the National Institute for Health and Care Excellence (NICE) criteria or by the National Comprehensive Cancer Network (NCCN) criteria. Relapse-free survival (RFS), overall survival (OS), prostate cancer-specific survival (PCSS), and metastases-free survival (MFS), were analysed together with patient-reported symptom scores and physician-reported adverse events. The NICE and NCCN criteria identified 267 and 202 high-risk patients, respectively. NICE-defined patients had significantly lower pre-treatment PSA levels, Gleason scores LDR-PB monotherapy. At 9 years after implantation RFS was 89% and 87% in the NICE and NCCN groups, respectively (log-rank P = 0.637), and OS 93% and 94%, respectively (log-rank P = 0.481). All of the survival estimates were similar between LDR-PB monotherapy and combined therapies. Cox proportional hazards regression confirmed RFS was similar between the treatment types. Treatment-related toxicity was also similar between the treatment methods. LDR-PB is effective at controlling localised prostate cancer in patients with a high risk of disease relapse. As the present study was not randomised, it is not possible to define those patients who need the addition of ADT and/or EBRT. However, the NICE criteria appear suitable to define treatment options where patients could benefit from LDR-PB as monotherapy or combined treatment. This choice should be discussed with the patient taking into account comorbidities and presence of multiple high-risk factors. © 2018 The Authors BJU International © 2018 BJU International

  5. High rate of complete responses to immune checkpoint inhibitors in patients with relapsed or refractory Hodgkin lymphoma previously exposed to epigenetic therapy

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    Lorenzo Falchi

    2016-11-01

    Full Text Available Abstract Options for patients with relapsed or refractory (R/R classical Hodgkin lymphoma (cHL after brentuximab vedotin (Bv and autologous stem cell transplantation (ASCT are limited. Immune checkpoint inhibitors (ICI are active in this population but rarely induce complete response (CR. Ten patients with R/R cHL after ASCT and Bv received pembrolizumab (n = 8 or nivolumab (n = 2. Five had been previously exposed to 5-azacitidine on a phase 1 study. Among nine evaluable patients, seven (78% achieved CR, one partial response, and one reduction of tumor burden. All five patients who had received 5-azacitidine prior to ICI achieved CR, while only two of four who did not receive prior 5-azacitidine achieved CR. At a median follow-up of 9.9 months [0.5–14.3], eight patients are alive and five are still receiving treatment. We documented an unprecedented CR rate after ICI in patients with R/R cHL. We hypothesize that hypomethylating agents might have an immune priming effect and enhance the efficacy of ICI.

  6. High risk of postpartum relapses in neuromyelitis optica spectrum disorder.

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    Klawiter, Eric C; Bove, Riley; Elsone, Liene; Alvarez, Enrique; Borisow, Nadja; Cortez, Melissa; Mateen, Farrah; Mealy, Maureen A; Sorum, Jaime; Mutch, Kerry; Tobyne, Sean M; Ruprecht, Klemens; Buckle, Guy; Levy, Michael; Wingerchuk, Dean; Paul, Friedemann; Cross, Anne H; Jacobs, Anu; Chitnis, Tanuja; Weinshenker, Brian

    2017-11-28

    To study the effect of pregnancy on the frequency of neuromyelitis optica spectrum disorder (NMOSD) relapse and evaluate rates of pregnancy-related complications in an international multicenter setting. We administered a standardized survey to 217 women with NMOSD from 7 medical centers and reviewed their medical records. We compared the annualized relapse rate (ARR) during a baseline period 2 years prior to a participant's first pregnancy to that during pregnancy and to the 9 months postpartum. We also assessed pregnancy-related complications. There were 46 informative pregnancies following symptom onset in 31 women with NMOSD. Compared to baseline (0.17), ARR was increased both during pregnancy (0.44; p = 0.035) and during the postpartum period (0.69; p = 0.009). The highest ARR occurred during the first 3 months postpartum (ARR 1.33). A total of 8 of 76 (10.5%) with onset of NMOSD prior to age 40 experienced their initial symptom during the 3 months postpartum, 2.9 times higher than expected. The postpartum period is a particularly high-risk time for initial presentation of NMOSD. In contrast to published observations in multiple sclerosis, in neuromyelitis optica, relapse rate during pregnancy was also increased, although to a lesser extent than after delivery. © 2017 American Academy of Neurology.

  7. Bortezomib or high-dose dexamethasone for relapsed multiple myeloma

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    P.G. Richardson (Paul Gerard); P. Sonneveld (Pieter); M.W. Schuster (Michael); D. Irwin (David); E.A. Stadtmauer (Edward); T. Facon (Thierry); J-L. Harousseau (Jean-Luc); D. Ben-Yehuda (Dina); S. Lonial (Sagar); H. Goldschmidt (Hartmut); D. Reece (Donna); J.F. San Miguel (Jesús Fernando); J. Bladé (Joan); M. Boccadoro (Mario); J. Cavenagh (Jamie); W. Dalton (William); A.L. Boral (Anthony); D.-L. Esseltine (Dixie-Lee); J.B. Porter (Jane); D. Schenkein (David); K.C. Anderson (Kenneth)

    2005-01-01

    textabstractBACKGROUND: This study compared bortezomib with high-dose dexamethasone in patients with relapsed multiple myeloma who had received one to three previous therapies. METHODS: We randomly assigned 669 patients with relapsed myeloma to receive either an intravenous bolus of bortezomib (1.3

  8. Relapse rate of uveitis post-methotrexate treatment in juvenile idiopathic arthritis.

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    Kalinina Ayuso, Viera; van de Winkel, Evelyne Leonce; Rothova, Aniki; de Boer, Joke Helena

    2011-02-01

    To evaluate the efficacy of methotrexate (MTX) and the effect of its withdrawal on relapse rate of uveitis associated with juvenile idiopathic arthritis (JIA). Retrospective case series. Data of 22 pediatric JIA patients who were being treated with MTX for active uveitis were studied retrospectively. Relapse rate after the withdrawal of MTX was established. Anterior chamber (AC) inflammation, topical steroid use during the first year of MTX treatment, and associations of relapses after the withdrawal were evaluated statistically. Duration of MTX treatment and its withdrawal was determined individually in collaboration with a rheumatologist with an intention to continue the treatment for at least 1 year and to withdraw in case of inactivity of uveitis and arthritis. Inactivity of uveitis was defined as the presence of ≤0.5+ cells in the AC. Eighteen patients (18/22; 82%) showed improvement of their uveitis with a significant decrease in activity of AC inflammation after a minimal period of 3 months of MTX treatment. A topical steroid-sparing effect was observed when MTX was administered for a period of 3 to 9 months. MTX was discontinued because of inactive uveitis in 13 patients. In 9 patients (8/13; 69%) a relapse of uveitis was observed after a mean time of 7.5 months (± SD 7.3). Six patients (6/13; 46%) had a relapse within the first year after the withdrawal. Relapse-free survival after withdrawal of MTX was significantly longer in patients who had been treated with MTX for more than 3 years (P = .009), children who were older than 8 years at the moment of withdrawal (P = .003), and patients who had an inactivity of uveitis of longer than 2 years before withdrawal of MTX (P = .033). Longer inactivity under MTX therapy was independently protective for relapses after the withdrawal (hazard ratio = 0.07; 95% confidence interval 0.01-0.86; P = .038), which means that 1-year increase of duration of inactive uveitis before the withdrawal of MTX results in a

  9. Relapse rates after psychotherapy for depression - stable long-term effects? A meta-analysis.

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    Steinert, Christiane; Hofmann, Mareike; Kruse, Johannes; Leichsenring, Falk

    2014-10-01

    Depression is the most common mental disorder. Effective psychotherapeutic treatments for depression exist; however, data on their long-term effectiveness beyond a time span of two years is still scarce. Our aim was to perform a meta-analysis, investigating (a) overall rates of relapse more than two years after psychotherapy (meta-analysis 1), and (b) if psychotherapy has more enduring effects than non-psychotherapeutic comparison conditions (e.g. pharmacotherapy, treatment as usual), again beyond a time span of two years post-therapy (meta-analysis 2). We searched electronic databases Medline, PsycINFO and the COCHRANE Library. Main selection criteria were (i) RCT of psychotherapy with follow-up interval of more than 2 years, (ii) primary diagnosis of depression, assessed by observer ratings, (iii) report of relapse at follow-up. We identified 11 studies, 6 of which included a non-psychotherapeutic comparison condition. Together they comprised long-term data of 966 patients. Mean follow-up duration was 4.4 years. The overall relapse rate at long-term follow-up was 0.39 (95% CI 0.29, 0.50). Psychotherapy resulted in significantly less relapses (53.1% vs. 71.1%, OR 0.51; 95% CI 0.32, 0.82, p=0.005) than comparison treatments. This finding corresponded to a number needed to treat (NNT) of 5.55. Results can only be preliminary as data was sparse and studies differed methodologically. Heterogeneity in the first meta-analysis was high (I(2)=82%). Results indicated publication bias. The relapse rate more than two years after psychotherapy is relatively high, but significantly lower compared to non-psychotherapeutic treatments. Multiannual follow-ups should routinely be included in future psychotherapy RCTs. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Sarcocystis nesbitti causes acute, relapsing febrile myositis with a high attack rate: description of a large outbreak of muscular sarcocystosis in Pangkor Island, Malaysia, 2012.

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    Claire M Italiano

    2014-05-01

    Full Text Available BACKGROUND: From the 17th to 19th January 2012, a group of 92 college students and teachers attended a retreat in a hotel located on Pangkor Island, off the west coast of Peninsular Malaysia. Following the onset of symptoms in many participants who presented to our institute, an investigation was undertaken which ultimately identified Sarcocystis nesbitti as the cause of this outbreak. METHODOLOGY/PRINCIPAL FINDINGS: All retreat participants were identified, and clinical and epidemiological information was obtained via clinical review and self-reported answers to a structured questionnaire. Laboratory, imaging and muscle biopsy results were evaluated and possible sources of exposure, in particular water supply, were investigated. At an average of 9-11 days upon return from the retreat, 89 (97% of the participants became ill. A vast majority of 94% had fever with 57% of these persons experiencing relapsing fever. Myalgia was present in 91% of patients. Facial swelling from myositis of jaw muscles occurred in 9 (10% patients. The median duration of symptoms was 17 days (IQR 7 to 30 days; range 3 to 112. Out of 4 muscle biopsies, sarcocysts were identified in 3. S. nesbitti was identified by PCR in 3 of the 4 biopsies including one biopsy without observed sarcocyst. Non-Malaysians had a median duration of symptoms longer than that of Malaysians (27.5 days vs. 14 days, p = 0.001 and were more likely to experience moderate or severe myalgia compared to mild myalgia (83.3% vs. 40.0%, p = 0.002. CONCLUSIONS/SIGNIFICANCE: The similarity of the symptoms and clustered time of onset suggests that all affected persons had muscular sarcocystosis. This is the largest human outbreak of sarcocystosis ever reported, with the specific Sarcocystis species identified. The largely non-specific clinical features of this illness suggest that S. nesbitti may be an under diagnosed infection in the tropics.

  11. Sarcocystis nesbitti causes acute, relapsing febrile myositis with a high attack rate: description of a large outbreak of muscular sarcocystosis in Pangkor Island, Malaysia, 2012.

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    Italiano, Claire M; Wong, Kum Thong; AbuBakar, Sazaly; Lau, Yee Ling; Ramli, Norlisah; Syed Omar, Sharifah Faridah; Kahar Bador, Maria; Tan, Chong Tin

    2014-05-01

    From the 17th to 19th January 2012, a group of 92 college students and teachers attended a retreat in a hotel located on Pangkor Island, off the west coast of Peninsular Malaysia. Following the onset of symptoms in many participants who presented to our institute, an investigation was undertaken which ultimately identified Sarcocystis nesbitti as the cause of this outbreak. All retreat participants were identified, and clinical and epidemiological information was obtained via clinical review and self-reported answers to a structured questionnaire. Laboratory, imaging and muscle biopsy results were evaluated and possible sources of exposure, in particular water supply, were investigated. At an average of 9-11 days upon return from the retreat, 89 (97%) of the participants became ill. A vast majority of 94% had fever with 57% of these persons experiencing relapsing fever. Myalgia was present in 91% of patients. Facial swelling from myositis of jaw muscles occurred in 9 (10%) patients. The median duration of symptoms was 17 days (IQR 7 to 30 days; range 3 to 112). Out of 4 muscle biopsies, sarcocysts were identified in 3. S. nesbitti was identified by PCR in 3 of the 4 biopsies including one biopsy without observed sarcocyst. Non-Malaysians had a median duration of symptoms longer than that of Malaysians (27.5 days vs. 14 days, p = 0.001) and were more likely to experience moderate or severe myalgia compared to mild myalgia (83.3% vs. 40.0%, p = 0.002). The similarity of the symptoms and clustered time of onset suggests that all affected persons had muscular sarcocystosis. This is the largest human outbreak of sarcocystosis ever reported, with the specific Sarcocystis species identified. The largely non-specific clinical features of this illness suggest that S. nesbitti may be an under diagnosed infection in the tropics.

  12. Increasing Incidence in Relapsing-Remitting MS and High Rates among Young Women in Finland: A Thirty-Year Follow-Up

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    Marja-Liisa Sumelahti

    2014-01-01

    Full Text Available Object. Gender and disease course specific incidences were studied in high- and medium-risk regions of MS in Finland. Methods. Age- and gender-specific incidences with 95% CIs were calculated in 10-year periods from 1981 to 2010. Poser diagnostic criteria were used and compared with the McDonald criteria from 2001 to 2010. Association between age and diagnostic delay over time was assessed by using the Kruskal-Wallis test. Results. 1419 (89% RRMS and 198 (11% PPMS cases were included. RRMS incidence increased with the female to male ratio (F/M from 4,2/105 (F/M 1.9 to 9,7 (2.3, while that of PPMS decreased from 1,2 (1.6 to 0,7 (1.2. The use of McDonald criteria did not change the conclusion. The decreasing diagnostic delay and age at diagnosis in RRMS were associated within the 10-year periods and contrasted those in PPMS. Increasing female risk in RRMS was observed in the high-risk region. Conclusion. Increasing RRMS incidence and high female ratios shown in each age group indicate gender-specific influences acting already from childhood. A more precise definition of the risk factors and their action in MS is needed to provide a better understanding of underlying pathological processes and a rationale for the development of new preventive and treatment strategies.

  13. Relapse rate following antithyroid drug therapy of immunogenic and non-immunogenic hyperthyroidism

    International Nuclear Information System (INIS)

    Voth, E.; Dickmann, N.; Schicha, H.; Emrich, D.

    1990-01-01

    Data of 196 patients treated for hyperthyroidism exclusively with anthyroid drugs were analyzed retrospectively concerning the relapse rate within a follow-up period of four years. Patients were subdivided for primary or recurrent disease, and for immunogenic or non-immunogenic hyperthyroidism, respectively. In immunogenic as well as in non-immunogenic hyperthyroidism, the relapse rate was significantly lower for patients with primary disease (35% and 52%, respectively) compared to those with recurrent hyperthyroidism (82%, p [de

  14. Extending supplementary feeding for children younger than 5 years with moderate acute malnutrition leads to lower relapse rates

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    Children with moderate acute malnutrition (MAM) have a high rate of relapse and death in the year following recovery. In this pilot study, we evaluate the long-term benefits of an extended course of nutritional therapy for children with MAM. Rural Malawian children 6 to 59 months old with MAM, defin...

  15. The mortality and response rate after FLANG regimen in patients with refractory/relapsed acute leukemia

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    Vali A Mehrzad

    2012-01-01

    Full Text Available Background: Oncologists today are greatly concerned about the treatment of relapsed/refractory acute leukemia. FLANG regimen, combination of novantron, cytarabine, fludarabine, and granulocyte-colony stimulating factor, has been used in treatment of refractory/relapsed acute leukemia since 1990s. The present study has evaluated mortality and response rate of this regimen. Materials and Methods: In this study, 25 patients with refractory/relapsed acute leukemia aged 15-55 years underwent FLANG regimen at Seyed-Al-Shohada Hospital, Isfahan, Iran during 2008-2009. One month later, bone marrow samples were taken to evaluate the responsiveness to treatment. Participants were followed for a year. The data was analyzed by student-t and chi-square tests, logistic, and Cox regression analysis, and Kaplan-Meier curves in SPSS 19. Results: Out of the 25 patients, 8 patients (32% had acute lymphoblastic leukemia (5 refractory and 3 relapsed cases and 17 subjects had acute myeloid leukemia (7 refractory and 10 relapsed cases. According to the bone marrow biopsies taken one month after FLANG regimen, 10 patients (40% had responded to treatment. Five patients of the 10 responders underwent successful bone marrow transplantation (BMT. On the other hand, 13 patients (52%, who had not entered the CR period, died during the follow-up. Logistic regression analysis did not reveal any significant associations between disease type and responsiveness to treatment. Conclusion: This study indicated higher rates of unresponsiveness to treatment while its mortality rate was comparable with other studies. Overall, according to limitations for BMT (as the only chance for cure in Iran, it seems that FLANG therapy is an acceptable choice for these patients.

  16. Treatment strategies in patients with AML or high-risk myelodysplastic syndrome relapsed after Allo-SCT.

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    Sauer, T; Silling, G; Groth, C; Rosenow, F; Krug, U; Görlich, D; Evers, G; Albring, J; Besoke, R; Mesters, R M; Müller-Tidow, C; Kessler, T; Büchner, T; Berdel, W E; Stelljes, M

    2015-04-01

    Non-relapse mortality after Allo-SCT has significantly decreased over the last years. Nevertheless, relapse remains a major cause for post SCT mortality in patients with AML and high-risk myelodysplastic syndrome (MDS). In this retrospective single-center analysis, we have analyzed the treatment outcomes of 108 patients with AML or MDS, who relapsed after Allo-SCT. Seventy of these patients (65%) were treated with salvage therapies containing chemotherapy alone, allogeneic cell-based treatment or the combination of both. Thirty-eight patients (35%) received palliative treatment. Median OS after diagnosis of relapse was 130 days. Compared with patients who received chemotherapy alone, response to salvage therapy was significantly improved in patients treated with a combination of chemo- and allogeneic cell-based therapy (CR rate 57% vs 13%, P=0.002). Among risk factors concerning pretreatment characteristics, disease status before first Allo-SCT, and details of transplantation, only the time interval from Allo-SCT to relapse was an independent predictor of response to salvage therapy and OS. These data confirmed that time to relapse after transplantation is an important prognostic factor. Up to now, only patients eligible for treatment regimens containing allogeneic cell-based interventions achieved relevant response rates.

  17. Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation

    International Nuclear Information System (INIS)

    Li, Richard; Polishchuk, Alexei; DuBois, Steven; Hawkins, Randall; Lee, Stephanie W.; Bagatell, Rochelle; Shusterman, Suzanne; Hill-Kayser, Christine; Al-Sayegh, Hasan; Diller, Lisa; Haas-Kogan, Daphne A.; Matthay, Katherine K.; London, Wendy B.

    2017-01-01

    Purpose: External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials: We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results: Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease (P=.03). Conclusions: Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy.

  18. Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation

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    Li, Richard [Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Polishchuk, Alexei [School of Medicine, University of California San Francisco, San Francisco, California (United States); DuBois, Steven [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Hawkins, Randall [School of Medicine, University of California San Francisco, San Francisco, California (United States); Lee, Stephanie W. [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Bagatell, Rochelle [Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania (United States); Shusterman, Suzanne [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Hill-Kayser, Christine [Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Al-Sayegh, Hasan [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Diller, Lisa [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Haas-Kogan, Daphne A. [Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Matthay, Katherine K. [School of Medicine, University of California San Francisco, San Francisco, California (United States); London, Wendy B. [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); and others

    2017-02-01

    Purpose: External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials: We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results: Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease (P=.03). Conclusions: Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy.

  19. Reirradiation and lomustine in patients with relapsed high-grade gliomas

    International Nuclear Information System (INIS)

    Arcicasa, Mauro; Roncadin, Mario; Bidoli, Ettore; Dedkov, Anatolyi; Gigante, Marco; Trovo, Mauro G.

    1999-01-01

    Purpose: The aim of this study was to evaluate the toxicity, response, and survival of patients with relapsed high-grade gliomas after radiation therapy (RT) combined with lomustine (CCNU). Methods and Materials: Thirty-one patients with relapsed gliomas at least 6 months after completion of RT were reirradiated. Twenty-four patients had a pathological diagnosis of high-grade gliomas, whereas 7 had a radiological diagnosis of relapsed malignant gliomas. The study focused on patients with high-grade relapsed gliomas. A total dose of 34.5 Gy was delivered in 23 fractions over 4.5 weeks. Oral administration of CCNU (130 mg/m 2 ) was begun at the same time as RT, and was repeated every 6 weeks until disease progression, or up to 12 courses. Results: Twelve of 24 patients had surgery before RT plus CCNU treatment. Median interval between RT courses was 14 months (range 6-73). All patients received a complete course of RT, and 22 of 24 patients received at least one course of CCNU. Objective responses were seen in 14 evaluable patients: 3 with partial response, 5 with stable disease, and 6 with progressive disease. Duration of partial response was 20, 9, and 8 months. Median time to progression and overall survival from the onset of retreatment were 8.4 months (range 1-22) and 13.7 months (range 1-63+), respectively. One case of G4 thrombocytopenia was observed. Five patients had G1 or G2 leucopenia and 3 patients had G3 leucopenia. Moderate nausea and vomiting were reported in 4 patients. One patient, after one course of CCNU, refused further chemotherapy. No significant difference in survival from relapse was found between patients who underwent surgery before RT plus CCNU and those who received only RT plus CCNU (p = 0.74). Conclusion: Overall, the acute toxicity was moderate, and patient compliance was good. Reirradiation of high-grade glioma was associated with modest subjective and objective response rates. It is remarkable that median overall survival from relapse

  20. Gemcitabine and docetaxel in relapsed and unresectable high-grade osteosarcoma and spindle cell sarcoma of bone

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    Palmerini, E.; Jones, R. L.; Marchesi, E.; Paioli, A.; Cesari, M.; Longhi, A.; Meazza, C.; Coccoli, L.; Fagioli, F.; Asaftei, S.; Grignani, G.; Tamburini, A.; Pollack, S. M.; Picci, P.; Ferrari, S.

    2016-01-01

    Background Few new compounds are available for relapsed osteosarcoma. We retrospectively evaluated the activity of gemcitabine (G) plus docetaxel (D) in patients with relapsed high-grade osteosarcoma and high-grade spindle cell sarcoma of bone (HGS). Methods Patients receiving G 900?mg/m2 d 1, 8; D 75?mg/m2 d 8, every 21?days were eligible. Primary end-point: progression-free survival (PFS) at 4?months; secondary end-point: overall survival (OS) and response rate. Results Fifty-one patients w...

  1. Treatment of relapsed or refractory acute leukemia in childhood with bisantrene combined with high dose aracytine.

    Science.gov (United States)

    Leblanc, T; Deméocq, F; Leverger, G; Baruchel, A; Lemerle, S; Vannier, J P; Nelken, B; Guillot, T; Schaison, G

    1994-01-01

    Bisantrene is an anthracene derivative which has demonstrated activity in acute myeloblastic leukemia (AML) and in lymphoma. The present study was designed to assess the reinduction rate and toxicity of bisantrene (250 mg/m2/d x 5) associated with aracytine (100 mg/m2 twice a day x 5) in refractory and relapsed acute childhood leukemia. Patients who relapsed after bone marrow transplantation were eligible. Twenty-six children were included. Diagnoses were as follows: 13 AML, 9 acute lymphoblastic leukemia (ALL), and 4 undifferentiated leukemia (AUL). All patients had been very highly pretreated, especially with anthracyclines, and most of them were of poor prognosis. The overall response rate was 46% with a 95% confidence interval ranging from 27-65%. According to diagnosis, complete remission (CR) rates are: AML: 5/13, ALL: 5/9, and AUL: 2/4. Four children died, three from infection and one from acute lysis syndrome. The major toxicity was infection with grade 3 and 4 episodes occurring in 42% of patients. No significant cardiac toxicity was noted. Hepatic and renal toxicity was noted. Hepatic and renal toxicity were limited and transient. Bisantrene in association with aracytine is effective in both AML and ALL of childhood. Bisantrene should be evaluated with a five-day schedule in other pediatric malignancies. In children with acute leukemia previously treated with high dose aracytine, new combination regimen is warranted.

  2. Reduction in relapse rate of radioiodine therapy in patients of toxic multinodular goiter: a quality improvement project

    International Nuclear Information System (INIS)

    Mitra, Sujata; Muthu, Sonai G.

    2012-01-01

    Radioiodine ( 131 I) therapy is the definitive treatment of toxic multinodular goiter (TMNG). Treatment failure may result in relapse after 131 I therapy. The present study was undertaken to reduce treatment failure rate of 131 I therapy in TMNG patients. Multiple causes may have lead to treatment failure of 131 I in TMNG patients making it difficult to establish a direct cause-effect relationship and take corrective action. Therefore, the JURAN methodology of quality improvement was applied. The treatment failure rate in 80 TMNG patients treated with 131 I in the period 2003-06 was 29%. The root cause analysis identified delay in decision to radioablate and concomitant antithyroid drugs (ATD) with 131 I therapy as factors leading to relapse. In 2007, a change in management was introduced with decision to radioablate all TMNG patients not remitting at 1 year of ATD and to withdraw ATD for 2 weeks prior to 131 I therapy. A total of 63 patients of TMNG followed the changed protocol between 2007 and 2009. Further analysis showed that one of the factors identified in the initial brainstorming (high iodide pool in the patient) had not been addressed in the protocol currently followed. The protocol was modified to include patient preparation and implemented after standardization. The post- 131 I relapse rate in patients treated after implementation of the new protocol from 2007 to 2009 was 18% which further reduced to 16% in 2011 after modification of the protocol. The failure rate of 131 I therapy in TMNG reduced from 29% to 16% through standardization of the treatment procedure achieved by the use of Juran Methodology that helped to identify process-related defects. (author)

  3. Reduction in relapse rate of radioiodine therapy in patients of toxic multinodular goiter: a quality improvement project

    Energy Technology Data Exchange (ETDEWEB)

    Mitra, Sujata; Muthu, Sonai G., E-mail: sujatamitra@tatasteel.com [Department of Nuclear Medicine, Tata Main Hospital, Jamshedpur (India)

    2012-01-15

    Radioiodine ({sup 131}I) therapy is the definitive treatment of toxic multinodular goiter (TMNG). Treatment failure may result in relapse after {sup 131}I therapy. The present study was undertaken to reduce treatment failure rate of {sup 131}I therapy in TMNG patients. Multiple causes may have lead to treatment failure of {sup 131}I in TMNG patients making it difficult to establish a direct cause-effect relationship and take corrective action. Therefore, the JURAN methodology of quality improvement was applied. The treatment failure rate in 80 TMNG patients treated with {sup 131}I in the period 2003-06 was 29%. The root cause analysis identified delay in decision to radioablate and concomitant antithyroid drugs (ATD) with {sup 131}I therapy as factors leading to relapse. In 2007, a change in management was introduced with decision to radioablate all TMNG patients not remitting at 1 year of ATD and to withdraw ATD for 2 weeks prior to {sup 131}I therapy. A total of 63 patients of TMNG followed the changed protocol between 2007 and 2009. Further analysis showed that one of the factors identified in the initial brainstorming (high iodide pool in the patient) had not been addressed in the protocol currently followed. The protocol was modified to include patient preparation and implemented after standardization. The post-{sup 131}I relapse rate in patients treated after implementation of the new protocol from 2007 to 2009 was 18% which further reduced to 16% in 2011 after modification of the protocol. The failure rate of {sup 131}I therapy in TMNG reduced from 29% to 16% through standardization of the treatment procedure achieved by the use of Juran Methodology that helped to identify process-related defects. (author)

  4. Enhancing Brain Lesions during Acute Optic Neuritis and/or Longitudinally Extensive Transverse Myelitis May Portend a Higher Relapse Rate in Neuromyelitis Optica Spectrum Disorders.

    Science.gov (United States)

    Orman, G; Wang, K Y; Pekcevik, Y; Thompson, C B; Mealy, M; Levy, M; Izbudak, I

    2017-05-01

    Neuromyelitis optica spectrum disorders are inflammatory demyelinating disorders with optic neuritis and/or longitudinally extensive transverse myelitis episodes. We now know that neuromyelitis optica spectrum disorders are associated with antibodies to aquaporin-4, which are highly concentrated on astrocytic end-feet at the blood-brain barrier. Immune-mediated disruption of the blood-brain barrier may manifest as contrast enhancement on brain MR imaging. We aimed to delineate the extent and frequency of contrast enhancement on brain MR imaging within 1 month of optic neuritis and/or longitudinally extensive transverse myelitis attacks and to correlate contrast enhancement with outcome measures. Brain MRIs of patients with neuromyelitis optica spectrum disorders were evaluated for patterns of contrast enhancement (periependymal, cloudlike, leptomeningeal, and so forth). The Fisher exact test was used to evaluate differences between the proportion of contrast enhancement in patients who were seropositive and seronegative for aquaporin-4 antibodies. The Mann-Whitney test was used to compare the annualized relapse rate and disease duration between patients with and without contrast enhancement and with and without seropositivity. Brain MRIs of 77 patients were evaluated; 59 patients (10 males, 49 females) were scanned within 1 month of optic neuritis and/or longitudinally extensive transverse myelitis attacks and were included in the analysis. Forty-eight patients were seropositive, 9 were seronegative, and 2 were not tested for aquaporin-4 antibodies. Having brain contrast enhancement of any type during an acute attack was significantly associated with higher annualized relapse rates ( P = .03) and marginally associated with shorter disease duration ( P = .05). Having periependymal contrast enhancement was significantly associated with higher annualized relapse rates ( P = .03). Brain MRIs of patients with neuromyelitis optica spectrum disorders with contrast

  5. Multimodal Hazard Rate for Relapse in Breast Cancer: Quality of Data and Calibration of Computer Simulation

    Directory of Open Access Journals (Sweden)

    Michael Retsky

    2014-11-01

    Full Text Available Much has occurred since our 2010 report in Cancers. In the past few years we published several extensive reviews of our research so a brief review is all that will be provided here. We proposed in the earlier reports that most relapses in breast cancer occur within 5 years of surgery and seem to be associated with some unspecified manner of surgery-induced metastatic initiation. These events can be identified in relapse data and are correlated with clinical data. In the last few years an unexpected mechanism has become apparent. Retrospective analysis of relapse events by a Brussels anesthesiology group reported that a perioperative NSAID analgesic seems to reduce early relapses five-fold. We then proposed that primary surgery produces a transient period of systemic inflammation. This has now been identified by inflammatory markers in serum post mastectomy. That could explain the early relapses. It is possible that an inexpensive and non-toxic NSAID can reduce breast cancer relapses significantly. We want to take this opportunity to discuss database quality issues and our relapse hazard data in some detail. We also present a demonstration that the computer simulation can be calibrated with Adjuvant-on-line, an often used clinical tool for prognosis in breast cancer.

  6. High interleukin-6 mRNA expression is a predictor of relapse in colon cancer

    DEFF Research Database (Denmark)

    Olsen, Jesper; Kirkeby, Lene T; Olsen, Jørgen

    2015-01-01

    AIM: To investigate the expression of interleukin-6 (IL6) in colon cancer tissue, and to examine if the risk of relapse is influenced by IL6 expression. MATERIALS AND METHODS: Fresh-frozen biopsies from tumor and normal adjacent tissues were taken from patients with colon cancer during surgery...... for clinicopathological characteristics (Hazard Ratio=2.16, 95% CI=1.07-4.40; pcolon cancer tissue at the transcriptional level and is significantly associated with increased risk of relapse....... to normal adjacent tissue (pcancer stage. We found a significant association between high IL6 expression and risk of relapse (Hazard Ratio=2.23, 95% CI=1.10-4.53; p

  7. ADAR2 editing activity in newly diagnosed versus relapsed pediatric high-grade astrocytomas

    International Nuclear Information System (INIS)

    Tomaselli, Sara; Galeano, Federica; Massimi, Luca; Di Rocco, Concezio; Lauriola, Libero; Mastronuzzi, Angela; Locatelli, Franco; Gallo, Angela

    2013-01-01

    High-grade (WHO grade III and IV) astrocytomas are aggressive malignant brain tumors affecting humans with a high risk of recurrence in both children and adults. To date, limited information is available on the genetic and molecular alterations important in the onset and progression of pediatric high-grade astrocytomas and, even less, on the prognostic factors that influence long-term outcome in children with recurrence. A-to-I RNA editing is an essential post-transcriptional mechanism that can alter the nucleotide sequence of several RNAs and is mediated by the ADAR enzymes. ADAR2 editing activity is particularly important in mammalian brain and is impaired in both adult and pediatric high-grade astrocytomas. Moreover, we have recently shown that the recovered ADAR2 activity in high-grade astrocytomas inhibits in vivo tumor growth. The aim of the present study is to investigate whether changes may occur in ADAR2-mediated RNA editing profiles of relapsed high-grade astrocytomas compared to their respective specimens collected at diagnosis, in four pediatric patients. Total RNAs extracted from all tumor samples and controls were tested for RNA editing levels (by direct sequencing on cDNA pools) and for ADAR2 mRNA expression (by qRT-PCR). A significant loss of ADAR2-editing activity was observed in the newly diagnosed and recurrent astrocytomas in comparison to normal brain. Surprisingly, we found a substantial rescue of ADAR2 editing activity in the relapsed tumor of the only patient showing prolonged survival. High-grade astrocytomas display a generalized loss of ADAR2-mediated RNA editing at both diagnosis and relapse. However, a peculiar Case, in complete remission of disease, displayed a total rescue of RNA editing at relapse, intriguingly suggesting ADAR2 activity/expression as a possible marker for long-term survival of patients with high-grade astrocytomas

  8. Reduction in relapse rate of radioiodine therapy in patients of toxic multinodular goiter: A quality improvement project

    OpenAIRE

    Mitra, Sujata; Muthu, Sonai G

    2012-01-01

    Introduction: Radioiodine (I-131) therapy is the definitive treatment of toxic multinodular goiter (TMNG). Treatment failure may result in relapse after I-131 therapy. The present study was undertaken to reduce treatment failure rate of I-131 therapy in TMNG patients. Materials and Methods: Multiple causes may have lead to treatment failure of I-131 in TMNG patients making it difficult to establish a direct cause?effect relationship and take corrective action. Therefore, the JURAN methodology...

  9. Gemcitabine and docetaxel in relapsed and unresectable high-grade osteosarcoma and spindle cell sarcoma of bone.

    Science.gov (United States)

    Palmerini, E; Jones, R L; Marchesi, E; Paioli, A; Cesari, M; Longhi, A; Meazza, C; Coccoli, L; Fagioli, F; Asaftei, S; Grignani, G; Tamburini, A; Pollack, S M; Picci, P; Ferrari, S

    2016-04-20

    Few new compounds are available for relapsed osteosarcoma. We retrospectively evaluated the activity of gemcitabine (G) plus docetaxel (D) in patients with relapsed high-grade osteosarcoma and high-grade spindle cell sarcoma of bone (HGS). Patients receiving G 900 mg/m(2) d 1, 8; D 75 mg/m(2) d 8, every 21 days were eligible. Primary end-point: progression-free survival (PFS) at 4 months; secondary end-point: overall survival (OS) and response rate. Fifty-one patients were included, with a median age of 17 years (8-71), 26 (51%) were pediatric patients. GD line of treatment: 2nd in 14 patients, ≥3rd in 37. 25 (49%) patients had metastases limited to lungs, 26 (51%) multiple sites. 40 (78%) osteosarcoma, 11 (22%) HGS. Eight (16%) patients achieved surgical complete response (sCR2) after GD. Four-month PFS rate was 46%, and significantly better for patients with ECOG 0 (ECOG 0: 54% vs ECOG 1: 43% vs ECOG 2: 0%; p = 0.003), for patients undergoing metastasectomy after GD (sCR2 75% vs no-sCR2 40 %, p = 0.02) and for osteosarcoma (osteosarcoma 56% vs HGS 18%; p = 0.05), with no differences according to age, line of treatment, and pattern of metastases. Forty-six cases had RECIST measurable disease: 6 (13%) patients had a partial response (PR), 20 (43%) had stable disease (SD) and 20 (43%) had progressive disease (PD). The 1-year OS was 30%: 67% for PR, 54% for SD and 20% for PD (p = 0.005). GD is an active treatment for relapsed high-grade osteosarcoma, especially for ECOG 0 patients, and should be included in the therapeutic armamentarium of metastatic osteosarcoma.

  10. Gemcitabine and docetaxel in relapsed and unresectable high-grade osteosarcoma and spindle cell sarcoma of bone

    International Nuclear Information System (INIS)

    Palmerini, E.; Jones, R. L.; Marchesi, E.; Paioli, A.; Cesari, M.; Longhi, A.; Meazza, C.; Coccoli, L.; Fagioli, F.; Asaftei, S.; Grignani, G.; Tamburini, A.; Pollack, S. M.; Picci, P.; Ferrari, S.

    2016-01-01

    Few new compounds are available for relapsed osteosarcoma. We retrospectively evaluated the activity of gemcitabine (G) plus docetaxel (D) in patients with relapsed high-grade osteosarcoma and high-grade spindle cell sarcoma of bone (HGS). Patients receiving G 900 mg/m 2 d 1, 8; D 75 mg/m 2 d 8, every 21 days were eligible. Primary end-point: progression-free survival (PFS) at 4 months; secondary end-point: overall survival (OS) and response rate. Fifty-one patients were included, with a median age of 17 years (8–71), 26 (51 %) were pediatric patients. GD line of treatment: 2nd in 14 patients, ≥3rd in 37. 25 (49 %) patients had metastases limited to lungs, 26 (51 %) multiple sites. Histology: 40 (78 %) osteosarcoma, 11 (22 %) HGS. Eight (16 %) patients achieved surgical complete response (sCR2) after GD. Four-month PFS rate was 46 %, and significantly better for patients with ECOG 0 (ECOG 0: 54 % vs ECOG 1: 43 % vs ECOG 2: 0 %; p = 0.003), for patients undergoing metastasectomy after GD (sCR2 75 % vs no-sCR2 40 %, p = 0.02) and for osteosarcoma (osteosarcoma 56 % vs HGS 18 %; p = 0.05), with no differences according to age, line of treatment, and pattern of metastases. Forty-six cases had RECIST measurable disease: 6 (13 %) patients had a partial response (PR), 20 (43 %) had stable disease (SD) and 20 (43 %) had progressive disease (PD). The 1-year OS was 30 %: 67 % for PR, 54 % for SD and 20 % for PD (p = 0.005). GD is an active treatment for relapsed high-grade osteosarcoma, especially for ECOG 0 patients, and should be included in the therapeutic armamentarium of metastatic osteosarcoma

  11. High population increase rates.

    Science.gov (United States)

    1991-09-01

    In addition to its economic and ethnic difficulties, the USSR faces several pressing demographic problems, including high population increase rates in several of its constituent republics. It has now become clear that although the country's rigid centralized planning succeeded in covering the basic needs of people, it did not lead to welfare growth. Since the 1970s, the Soviet economy has remained sluggish, which as led to increase in the death and birth rates. Furthermore, the ideology that held that demography could be entirely controlled by the country's political and economic system is contradicted by current Soviet reality, which shows that religion and ethnicity also play a significant role in demographic dynamics. Currently, Soviet republics fall under 2 categories--areas with high or low natural population increase rates. Republics with low rates consist of Christian populations (Armenia, Moldavia, Georgia, Byelorussia, Russia, Lithuania, Estonia, Latvia, Ukraine), while republics with high rates are Muslim (Tadzhikistan, Uzbekistan, Turkmenistan, Kirgizia, Azerbaijan Kazakhstan). The later group has natural increase rates as high as 3.3%. Although the USSR as a whole is not considered a developing country, the later group of republics fit the description of the UNFPA's priority list. Another serious demographic issue facing the USSR is its extremely high rate of abortion. This is especially true in the republics of low birth rates, where up to 60% of all pregnancies are terminated by induced abortions. Up to 1/5 of the USSR's annual health care budget is spent on clinical abortions -- money which could be better spent on the production of contraceptives. Along with the recent political and economic changes, the USSR is now eager to deal with its demographic problems.

  12. Rates and Durability of Response to Salvage Radiation Therapy Among Patients With Refractory or Relapsed Aggressive Non-Hodgkin Lymphoma

    International Nuclear Information System (INIS)

    Tseng, Yolanda D.; Chen, Yu-Hui; Catalano, Paul J.; Ng, Andrea

    2015-01-01

    Purpose: To evaluate the response rate (RR) and time to local recurrence (TTLR) among patients who received salvage radiation therapy for relapsed or refractory aggressive non-Hodgkin lymphoma (NHL) and investigate whether RR and TTLR differed according to disease characteristics. Methods and Materials: A retrospective review was performed for all patients who completed a course of salvage radiation therapy between January 2001 and May 2011 at Brigham and Women's Hospital/Dana-Farber Cancer Institute. Separate analyses were conducted for patients treated with palliative and curative intent. Predictors of RR for each subgroup were assessed using a generalized estimating equation model. For patients treated with curative intent, local control (LC) and progression-free survival were estimated with the Kaplan-Meier method; predictors for TTLR were evaluated using a Cox proportional hazards regression model. Results: Salvage radiation therapy was used to treat 110 patients to 121 sites (76 curative, 45 palliative). Salvage radiation therapy was given as part of consolidation in 18% of patients treated with curative intent. Median dose was 37.8 Gy, with 58% and 36% of curative and palliative patients, respectively, receiving 39.6 Gy or higher. The RR was high (86% curative, 84% palliative). With a median follow-up of 4.8 years among living patients, 5-year LC and progression-free survival for curative patients were 66% and 34%, respectively. Refractory disease (hazard ratio 3.3; P=.024) and lack of response to initial chemotherapy (hazard ratio 4.3; P=.007) but not dose (P=.93) were associated with shorter TTLR. Despite doses of 39.6 Gy or higher, 2-year LC was only 61% for definitive patients with refractory disease or disease that did not respond to initial chemotherapy. Conclusions: Relapsed or refractory aggressive NHL is responsive to salvage radiation therapy, and durable LC can be achieved in some cases. However, refractory disease is associated with a

  13. Radioiodine therapy in toxic multinodular goiter- the influence of carbimazole therapy and dietary iodine on relapse rates

    International Nuclear Information System (INIS)

    Mitra, S.; Muthu, G.S.

    2007-01-01

    Full text: The relapse rate of radioiodine therapy in toxic multinodular goiter (TMNG) is reported to be around 34% at one year. The effect of antithyroid drugs on the response rate is controversial with studies reporting a higher relapse rate in patients pretreated with antithyroid drugs. Other studies report no influence of pretreatment with antithyroid drugs. The thyroid clinic at Tata Main Hospital is a referral center for thyroid disorders in Jamshedpur. 63 patients of TMNG (Group A) were treated with Radioiodine between 1995-2003. The demographic profile of these patients was as follows: M/F- 38%: 62%, 76% of patients were above 40 years, 85% had been on anti-thyroid drugs for more than 18 months. Fixed dose radioiodine in an oral dose varying from 5-10 mCi was given in all patients of Group A. 32.4 % of patients continued to be toxic or relapsed after a period of euthyroid status within 1 year of Radioiodine therapy. A change in protocol for radioiodine therapy was introduced in 2003. This included withdrawal of antithyroid drugs for one month before radioiodine therapy and the use of noniodized salt and abstinence from seafood in diet during this period. 33 TMN Goiter patients (Group B) followed this protocol before receiving Radioiodine. The dose of Radioiodine remained 5-10 mCi. The age and sex profile of Group A and B were comparable. However, Group B patients had been on antithyroid drugs for a shorter period (p< 0.001). The dose of Radioiodine in 94% of Group B patients was between 7-10mCi, whereas this was 63.4% in Group A. The rest of the patients had received a dose between 5-7 mCi. The relapse rate in Group B was 9.1% compared to 32.4% in Group A. Improvement in response rates with increase in Radioiodine dose remains controversial.P PThe better response rate in Group B patients may be attributed to the withdrawal of antithyroid drugs for one month before therapy and the reduction in dietary intake of Iodine for a month before therapy. However, a

  14. Therapeutic Community Effectiveness on Self-Esteem and Relapse Rate among Drug Users

    Directory of Open Access Journals (Sweden)

    Mosayyeb Yarmohammadi-Vasel

    2012-04-01

    Full Text Available Objective: In recent years, the Therapeutic Community(TC has become a widespread treatment alternative for drug addicts. TC have been widely studied with emphasis on thair effectiveness. The aims of the present study was to examined effectiveness of TC on self esteem and decrease of relapse. Materials & Methods: Research Statistics universe constitutes of all the substance abusers who have come to the TC centers of Tehran and Mashad. samples is chosen as stratified sampling of the cities of Tehran & Mashad. This study conducted among 165 substance abuser, examined their drug use 2 years. The study utilized a quasi-experimental design with one group, clients were tested at 3 points in time pretest (at admission time, posttest (3-6 months after treatment and 1-year Follo-up (1-year after treatment using the self esteem questionnaire. Results: The findings show that (a about half (50% the clients were clean at follow-up (b significant linear increases on self esteem After 3 to 6 months of treatment(P<0.05. Conclusion: This study provides evidence that TC could effective approach to increases on self esteem and decrease of relapse.

  15. Vaginal HDR-afterloading in the treatment of endometrial carcinoma - analysis of side effects and relapse rates

    International Nuclear Information System (INIS)

    Weiss, E.; Arnold-Bofinger, H.; Weidner, N.; Hirnle, P.; Bamberg, M.

    1996-01-01

    Introduction: In a retrospective analysis side effects, relapse rates and the value of in vivo dosimetry for vaginal HDR-brachytherapy (BT) in women with endometrial carcinoma are evaluated. Material and Methods: From 1987 to 1993 124 women received vaginal HDR-BT (Ir-192) only for adjuvant treatment of early endometrial carcinoma. The usual fractionation was 1x7 Gy per week applied to the surface of the vaginal cylinder to a total dose of 21 Gy. During BT we performed in vivo dosimetry using bladder and rectal probes. The measured doses per patient in the bladder ranged from 1.5 to 9.8 Gy, 6.7 Gy in the mean. In the rectum the mean dose was 8.2 Gy (1.7 to 13.8 Gy). Results: The analysis of side effects shows that only 23 of 124 women (18 %) reported any problems at all. 13 women (10 %) noticed dysuria or pollakisuria for a maximum of 6 weeks. The average measured bladder dose in those patients was 5.3 Gy, (below the average bladder dose of 6.7 Gy). Diarrhea was reported in 3 patients (2 %), in those the average measured rectal dose was 6.8 Gy (lower than the average rectal dose of 8.2 Gy). 6 women (5 %) received antibiotic treatment because of bacteriuria. Of all patients 10 (8%) had a pelvic relapse, 3 in the vagina only. 5 women showed distant metastases during follow-up (3 of those having also a local relapse). Discussion and Conclusion: With only 2 % vaginal relapses HDR-BT is a save method to reduce the probability of vaginal metastases of endometrial carcinoma in an adjuvant setting. Moreover the incidence of acute side effects is low, no lasting complications were seen in our patients. There existed no correlation between the incidence of side effects and the measured in vivo doses in bladder and rectum, questioning the future usage in the era of well advanced BT-planning systems

  16. Conventional-Dose versus High-Dose Chemotherapy for Relapsed Germ Cell Tumors

    Directory of Open Access Journals (Sweden)

    Deaglan J. McHugh

    2018-01-01

    Full Text Available The majority of metastatic germ cell tumors (GCTs are cured with cisplatin-based chemotherapy, but 20–30% of patients will relapse after first-line chemotherapy and require additional salvage strategies. The two major salvage approaches in this scenario are high-dose chemotherapy (HDCT with autologous stem cell transplant (ASCT or conventional-dose chemotherapy (CDCT. Both CDCT and HDCT have curative potential in the management of relapsed/refractory GCT. However, due to a lack of conclusive randomized trials, it remains unknown whether sequential HDCT or CDCT represents the optimal initial salvage approach, with practice varying between tertiary institutions. This represents the most pressing question remaining for defining GCT treatment standards and optimizing outcomes. The authors review prognostic factors in the initial salvage setting as well as the major studies assessing the efficacy of CDCT, HDCT, or both, describing the strengths and weaknesses that formed the rationale behind the ongoing international phase III “TIGER” trial.

  17. A randomized controlled trial to compare cure and relapse rate of paucibacillary multidrug therapy with monthly rifampicin, ofloxacin, and minocycline among paucibacillary leprosy patients in Agra District, India

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2015-01-01

    Full Text Available Objectives: To study cure rate and relapse rate of standard World Health Organization paucibacillary multidrug therapy (PB-MDT with monthly rifampicin, ofloxacin, and minocycline for six months (ROM-6 among paucibacillary leprosy patients. Methods: A total of 268 patients, detected during active search in Agra district during 2001-2004, who had paucibacillary (PB leprosy having 1-5 skin lesions and/or one nerve thickening/tenderness, were allocated, using random number tables, to two treatment groups; PB-MDT and ROM-6. On the first day of the month, dose of PB-MDT and of the ROM were given under supervision for 6 months. After completion of drug therapy, patients were followed every 6 months for first 5 years and later annually for next 3 years for monitoring disease status, cure rates, reactions and relapses. Cηi σθuαρε test was used to compare relapse rates. Results: The cure rate at 2 years was 99% in ROM-6 and 97.0% in PB-MDT group, of those who completed treatment and the difference was statistically not significant. At 5 years, only 88 patients in PB-MDT group and 90 patients in ROM-6 group could be followed; all were observed to be cured. However, during the period of 5-8 years, 3 of 67 patients in PB-MDT group and 1 of 73 in ROM-6 group were observed to have relapsed. In all, 10 relapses were noted (3 in ROM-6 and 7 in PB-MDT group giving a relapse rate of 1.10/100 person years in PB-MDT and 0.435/100 person years in ROM groups (P = 0.053 ; statistically not significant. Of the 10 relapses, 5 occurred within 5 years (3 in PB-MDT group and 2 in ROM-6, 4 during 5-8 years (3 in PB-MDT and 1 in ROM-6, and 1 occurred in MDT group after 8 years. Limitation: A number of patients were lost to follow up after release from treatment and thus actual number of relapses in the study could not be assessed. Additionally, diagnosis was purely clinical and histology could not be done for reasons related to functional difficulties in the field

  18. Cytomegalovirus reactivation is associated with a lower rate of early relapse in myeloid malignancies independent of in-vivo T cell depletion strategy.

    Science.gov (United States)

    Hilal, Talal; Slone, Stacey; Peterson, Shawn; Bodine, Charles; Gul, Zartash

    2017-06-01

    The association between cytomegalovirus (CMV) reactivation and relapse risk has not been evaluated in relation to T cell depletion strategies. We evaluated 93 patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) and analyzed the association between T cell depletion strategies with the cumulative incidence of relapse and CMV reactivation. A total of 33% of patients who received ATG vs. 34% who received alemtuzumab developed CMV reactivation. The cumulative incidence of relapse was 3% at 1year and 20% at 3 years in patients with CMV reactivation vs. 30% at 1year and 38% at 3 years in patients without CMV reactivation (p=0.02). When analyzed separately, this effect persisted in the myeloid, but not the lymphoid group. There was a numerical trend towards increased non-relapse mortality (NRM) in patients with CMV reactivation, especially in the myeloid group. The choice of T cell depleting agent and the rate of CMV reactivation were not associated with different overall survival (OS) rates. These results suggest that the choice of T cell depletion strategy may have similar effects on rates of CMV reactivation, disease relapse, and survival. Further studies examining these variables in patients not exposed to in-vivo T cell depleting agents may be of interest. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Pharmacometric Analysis of the Relationship Between Absolute Lymphocyte Count and Expanded Disability Status Scale and Relapse Rate, Efficacy End Points, in Multiple Sclerosis Trials.

    Science.gov (United States)

    Novakovic, A M; Thorsted, A; Schindler, E; Jönsson, S; Munafo, A; Karlsson, M O

    2018-05-10

    The aim of this work was to assess the relationship between the absolute lymphocyte count (ALC), and disability (as measured by the Expanded Disability Status Scale [EDSS]) and occurrence of relapses, 2 efficacy endpoints, respectively, in patients with remitting-relasping multiple sclerosis. Data for ALC, EDSS, and relapse rate were available from 1319 patients receiving placebo and/or cladribine tablets. Pharmacodynamic models were developed to characterize the time course of the endpoints. ALC-related measures were then evaluated as predictors of the efficacy endpoints. EDSS data were best fitted by a model where the logit-linear disease progression is affected by the dynamics of ALC change from baseline. Relapse rate data were best described by the Weibull hazard function, and the ALC change from baseline was also found to be a significant predictor of time to relapse. Presented models have shown that once cladribine exposure driven ALC-derived measures are included in the model, the need for drug effect components is of less importance (EDSS) or disappears (relapse rate). This simplifies the models and theoretically makes them mechanism specific rather than drug specific. Having a reliable mechanism-specific model would allow leveraging historical data across compounds, to support decision making in drug development and possibly shorten the time to market. © 2018, The American College of Clinical Pharmacology.

  20. Change in Pattern of Relapse After Antiangiogenic Therapy in High-Grade Glioma

    International Nuclear Information System (INIS)

    Narayana, Ashwatha; Kunnakkat, Saroj D.; Medabalmi, Praveen; Golfinos, John; Parker, Erik; Knopp, Edmond; Zagzag, David; Eagan, Patricia; Gruber, Deborah; Gruber, Michael L.

    2012-01-01

    Purpose: Local recurrence is the dominant pattern of relapse in high-grade glioma (HGG) after conventional therapy. The recent use of antiangiogenic therapy has shown impressive radiologic and clinical responses in adult HGG. The preclinical data suggesting increased invasiveness after angiogenic blockade have necessitated a detailed analysis of the pattern of recurrence after therapy. Methods and Materials: A total of 162 consecutive patients with HGG, either newly diagnosed (n = 58) or with recurrent disease (n = 104) underwent therapy with bevacizumab at 10 mg/kg every 2 weeks and conventional chemotherapy with or without involved field radiotherapy until disease progression. The pattern of recurrence and interval to progression were the primary aims of the present study. Diffuse invasive recurrence (DIR) was defined as the involvement of multiple lobes with or without crossing the midline. Results: At a median follow-up of 7 months (range, 1–37), 105 patients had recurrence, and 79 patients ultimately developed DIR. The interval to progression was similar in the DIR and local recurrence groups (6.5 and 6.3 months, p = .296). The hazard risk of DIR increased exponentially with time and was similar in those with newly diagnosed and recurrent HGG (R 2 = 0.957). The duration of bevacizumab therapy increased the interval to recurrence (p < .0001) and improved overall survival (p < .0001). However, the pattern of relapse did not affect overall survival (p = .253). Conclusion: Along with an increase in median progression-free survival, bevacizumab therapy increased the risk of DIR in HGG patients. The risk of increased invasion with prolonged angiogenic blockade should be addressed in future clinical trials.

  1. Change in Pattern of Relapse After Antiangiogenic Therapy in High-Grade Glioma

    Energy Technology Data Exchange (ETDEWEB)

    Narayana, Ashwatha, E-mail: ashwatha.narayana@nyumc.org [Department of Radiation Oncology, New York University Langone Medical Center, New York, NY (United States); Department of Neurosurgery, New York University Langone Medical Center, New York, NY (United States); Kunnakkat, Saroj D. [Department of Radiation Oncology, New York University Langone Medical Center, New York, NY (United States); Medabalmi, Praveen [Department of Biostatistics, New York University Langone Medical Center, New York, NY (United States); Golfinos, John; Parker, Erik [Department of Neurosurgery, New York University Langone Medical Center, New York, NY (United States); Knopp, Edmond [Department of Radiology, New York University Langone Medical Center, New York, NY (United States); Zagzag, David [Department of Pathology, New York University Langone Medical Center, New York, NY (United States); Eagan, Patricia [Department of Neuro-Oncology, New York University Langone Medical Center, New York, NY (United States); Atlantic Health System, Overlook Hospital, Summit, NJ (United States); Gruber, Deborah [Department of Neuro-Oncology, New York University Langone Medical Center, New York, NY (United States); Gruber, Michael L. [Department of Neurosurgery, New York University Langone Medical Center, New York, NY (United States); Department of Neuro-Oncology, New York University Langone Medical Center, New York, NY (United States); Atlantic Health System, Overlook Hospital, Summit, NJ (United States)

    2012-01-01

    Purpose: Local recurrence is the dominant pattern of relapse in high-grade glioma (HGG) after conventional therapy. The recent use of antiangiogenic therapy has shown impressive radiologic and clinical responses in adult HGG. The preclinical data suggesting increased invasiveness after angiogenic blockade have necessitated a detailed analysis of the pattern of recurrence after therapy. Methods and Materials: A total of 162 consecutive patients with HGG, either newly diagnosed (n = 58) or with recurrent disease (n = 104) underwent therapy with bevacizumab at 10 mg/kg every 2 weeks and conventional chemotherapy with or without involved field radiotherapy until disease progression. The pattern of recurrence and interval to progression were the primary aims of the present study. Diffuse invasive recurrence (DIR) was defined as the involvement of multiple lobes with or without crossing the midline. Results: At a median follow-up of 7 months (range, 1-37), 105 patients had recurrence, and 79 patients ultimately developed DIR. The interval to progression was similar in the DIR and local recurrence groups (6.5 and 6.3 months, p = .296). The hazard risk of DIR increased exponentially with time and was similar in those with newly diagnosed and recurrent HGG (R{sup 2} = 0.957). The duration of bevacizumab therapy increased the interval to recurrence (p < .0001) and improved overall survival (p < .0001). However, the pattern of relapse did not affect overall survival (p = .253). Conclusion: Along with an increase in median progression-free survival, bevacizumab therapy increased the risk of DIR in HGG patients. The risk of increased invasion with prolonged angiogenic blockade should be addressed in future clinical trials.

  2. [Research and control of relapse tuberculosis cases].

    Science.gov (United States)

    Yamagishi, Fumio; Toyota, Makoto

    2009-12-01

    With this symposium, we focused on the relapse of tuberculosis in Japan. Out of 19,893 tuberculosis patients registered in 2007 in Japan, 7.48% were classified as relapse cases. Relapse cases have the risk of acquired drug resistance. But we have few analyses of the proportion of relapse tuberculosis cases with standard short course regimens for six months, factors contributing to tuberculosis relapse and the proportion of drug resistance among relapse TB cases in Japan. Therefore we analyzed the relapse tuberculosis cases in two rural areas and three urban areas. We also analyzed the proportion of drug resistance among relapse cases with the data of drug susceptibility survey of Ryoken. 1. Research of relapse tuberculosis cases: Makoto TOYOTA (Kochi City Public Health Center). To clarify the relapse rate and factors contributing to tuberculosis relapse, we investigated the relapse tuberculosis cases in the municipality where the proportion of elderly tuberculosis patients was high. Out of 902 tuberculosis patients registered in Kochi City Public Health Center during 10 years, 20 pulmonary tuberculosis patients were confirmed relapse cases with initial registered records. Pretreatment cavitations, sputum culture positivity at 2 months, medical miss-management (e.g. number of doses, duration of therapy) and poor adherence were considered to be factors contributing to tuberculosis relapse. Out of 20 relapse cases, 12 cases were detected with symptoms, while only 3 cases were detected by examination in law. 2. A clinical study on relapse cases of pulmonary tuberculosis: Shuichi TAKIKAWA (National Hospital Organization Nishibeppu National Hospital). The relapse of pulmonary tuberculosis was investigated. In the cases with a treatment history before short course chemotherapy, drug resistance rate was high, and thus it needs to be cautious of drug resistance at the time of the retreatment. In the cases with a treatment history of short course chemotherapy, relapse cases

  3. Clinical factors related to schizophrenia relapse.

    Science.gov (United States)

    Porcelli, Stefano; Bianchini, Oriana; De Girolamo, Giovanni; Aguglia, Eugenio; Crea, Luciana; Serretti, Alessandro

    2016-01-01

    Relapses represent one of the main problems of schizophrenia management. This article reviews the clinical factors associated with schizophrenia relapse. A research of the last 22 years of literature data was performed. Two-hundred nineteen studies have been included. Three main groups of factors are related to relapse: factors associated with pharmacological treatment, add-on psychotherapeutic treatments and general risk factors. Overall, the absence of a maintenance therapy and treatment with first generation antipsychotics has been associated with higher risk of relapse. Further, psychotherapy add-on, particularly with cognitive behaviour therapy and psycho-education for both patients and relatives, has shown a good efficacy for reducing the relapse rate. Among general risk factors, some could be modified, such as the duration of untreated psychosis or the substance misuse, while others could not be modified as male gender or low pre-morbid level of functioning. Several classes of risk factors have been proved to be relevant in the risk of relapse. Thus, a careful assessment of the risk factors here identified should be performed in daily clinical practice in order to individualise the relapse risk for each patient and to provide a targeted treatment in high-risk subjects.

  4. Relapsed childhood high hyperdiploid acute lymphoblastic leukemia: presence of preleukemic ancestral clones and the secondary nature of microdeletions and RTK-RAS mutations

    DEFF Research Database (Denmark)

    Davidsson, J; Paulsson, K; Lindgren, D

    2010-01-01

    Although childhood high hyperdiploid acute lymphoblastic leukemia is associated with a favorable outcome, 20% of patients still relapse. It is important to identify these patients already at diagnosis to ensure proper risk stratification. We have investigated 11 paired diagnostic and relapse samp...

  5. Relapsed childhood high hyperdiploid acute lymphoblastic leukemia: presence of preleukemic ancestral clones and the secondary nature of microdeletions and RTK-RAS mutations

    DEFF Research Database (Denmark)

    Davidsson, J; Paulsson, K; Lindgren, D

    2010-01-01

    Although childhood high hyperdiploid acute lymphoblastic leukemia is associated with a favorable outcome, 20% of patients still relapse. It is important to identify these patients already at diagnosis to ensure proper risk stratification. We have investigated 11 paired diagnostic and relapse...

  6. Tick-Borne Relapsing Fever Outbreak Among a High School Football Team at an Outdoor Education Camping Trip, Arizona, 2014.

    Science.gov (United States)

    Jones, Jefferson M; Hranac, Carter R; Schumacher, Mare; Horn, Kim; Lee, Darlene M; Terriquez, Joel; Engelthaler, David M; Peoples, Marie; Corrigan, Jennifer; Replogle, Adam; Souders, Nina; Komatsu, Kenneth K; Nieto, Nathan C

    2016-09-07

    During August 2014, five high school students who had attended an outdoor education camp were hospitalized with a febrile illness, prompting further investigation. Ten total cases of tick-borne relapsing fever (TBRF) were identified-six cases confirmed by culture or visualization of spirochetes on blood smear and four probable cases with compatible symptoms (attack rate: 23%). All patients had slept in the campsite's only cabin. Before the camp, a professional pest control company had rodent proofed the cabin, but no acaricides had been applied. Cabin inspection after the camp found rodents and Ornithodoros ticks, the vector of TBRF. Blood samples from a chipmunk trapped near the cabin and from patients contained Borrelia hermsii with identical gene sequences (100% over 630 base pairs). Health departments in TBRF endemic areas should consider educating cabin owners and pest control companies to apply acaricides during or following rodent proofing, because ticks that lack rodents for a blood meal might feed on humans. © The American Society of Tropical Medicine and Hygiene.

  7. Early detection of tumor relapse/regrowth by consecutive minimal residual disease monitoring in high-risk neuroblastoma patients

    Science.gov (United States)

    Hirase, Satoshi; Saitoh, Atsuro; Hartomo, Tri Budi; Kozaki, Aiko; Yanai, Tomoko; Hasegawa, Daiichiro; Kawasaki, Keiichiro; Kosaka, Yoshiyuki; Matsuo, Masafumi; Yamamoto, Nobuyuki; Mori, Takeshi; Hayakawa, Akira; Iijima, Kazumoto; Nishio, Hisahide; Nishimura, Noriyuki

    2016-01-01

    Neuroblastoma is an aggressive pediatric tumor accounting for ~15% of cancer-associated mortalities in children. Despite the current intensive therapy, >50% of high-risk patients experience tumor relapse or regrowth caused by the activation of minimal residual disease (MRD). Although several MRD detection protocols using various reverse transcription-quantitative polymerase chain reaction (RT-qPCR) markers have been reported to evaluate the therapeutic response and disease status of neuroblastoma patients, their clinical significance remains elusive. The present study reports two high-risk neuroblastoma patients, whose MRD was consecutively monitored using 11 RT-qPCR markers (CHRNA3, CRMP1, DBH, DCX, DDC, GABRB3, GAP43, ISL1, KIF1A, PHOX2B and TH) during their course of treatment. The two patients initially responded to the induction therapy and reached MRD-negative status. The patients' MRD subsequently became positive with no elevation of their urinary homovanillic acid, urinary vanillylmandelic acid and serum neuron-specific enolase levels at 13 or 19 weeks prior to the clinical diagnosis of tumor relapse or regrowth. The present cases highlight the possibility of consecutive MRD monitoring using 11 markers to enable an early detection of tumor relapse or regrowth in high-risk neuroblastoma patients. PMID:27446404

  8. High Rate Digital Demodulator ASIC

    Science.gov (United States)

    Ghuman, Parminder; Sheikh, Salman; Koubek, Steve; Hoy, Scott; Gray, Andrew

    1998-01-01

    The architecture of High Rate (600 Mega-bits per second) Digital Demodulator (HRDD) ASIC capable of demodulating BPSK and QPSK modulated data is presented in this paper. The advantages of all-digital processing include increased flexibility and reliability with reduced reproduction costs. Conventional serial digital processing would require high processing rates necessitating a hardware implementation in other than CMOS technology such as Gallium Arsenide (GaAs) which has high cost and power requirements. It is more desirable to use CMOS technology with its lower power requirements and higher gate density. However, digital demodulation of high data rates in CMOS requires parallel algorithms to process the sampled data at a rate lower than the data rate. The parallel processing algorithms described here were developed jointly by NASA's Goddard Space Flight Center (GSFC) and the Jet Propulsion Laboratory (JPL). The resulting all-digital receiver has the capability to demodulate BPSK, QPSK, OQPSK, and DQPSK at data rates in excess of 300 Mega-bits per second (Mbps) per channel. This paper will provide an overview of the parallel architecture and features of the HRDR ASIC. In addition, this paper will provide an over-view of the implementation of the hardware architectures used to create flexibility over conventional high rate analog or hybrid receivers. This flexibility includes a wide range of data rates, modulation schemes, and operating environments. In conclusion it will be shown how this high rate digital demodulator can be used with an off-the-shelf A/D and a flexible analog front end, both of which are numerically computer controlled, to produce a very flexible, low cost high rate digital receiver.

  9. Five-year follow-up of survival and relapse in patients who received cryotherapy during high-dose chemotherapy for stem cell transplantation shows no safety concerns.

    Science.gov (United States)

    Svanberg, A; Ohrn, K; Birgegård, G

    2012-11-01

    We have previously published a randomised controlled study of the efficacy of cryotherapy in preventing acute oral mucositis after high-dose chemotherapy for stem cell transplantation. The present study is a 5-year follow-up safety study of survival in these patients. In the previously published study oral cryotherapy (cooling of the oral cavity) during high-dose chemotherapy significantly reduced mucositis grade and opiate use in the treated group. All patients were followed up for at least 5 years with regard to relapse and death rates. Baseline data, transplant complications and mucositis data were compared. Significantly more patients (25/39) who received oral cryotherapy were alive after 5 years compared to 15/39 in the control group (P= 0.025). Relapse rates were similar. The only baseline difference was a lower proportion of patients in complete remission at transplantation in the control group (6 vs. 13, P= 0.047). This 5-year follow-up study gave no support for safety concerns with cryotherapy. © 2012 Blackwell Publishing Ltd.

  10. The Effectiveness of Marlaat’s Cognitive Behavior Intervention and Group Treatment Based on Change Stages for Recovery and Relapse Prevention Rates in Male Heroin Crack Addicts

    Directory of Open Access Journals (Sweden)

    S Khodadust

    2014-11-01

    Full Text Available Objective: The aim of this study was the Study of effectiveness of Marlaat’s cognitive behavior intervention and group treatment based on change stages for recovery and relapse rates in male heroin crack addictions. Method: In a experimental research design, 45 men addictions, who were diagnosed as the dependence of the heroin crack on the basis of DSM-IV-TR criteria, were chosen after successfully detoxified. They were divided two experimental groups (30 participants and a control group (15 participants that have been selected by random sampling. The first experimental group was undergone group treatment based on change stages underwent 16 sessions of 1.5 hours, totally 24 hours and the second experimental groups who were undergone Marlaat’s cognitive behavior intervention has been held 15 sessions of 2 hours, totally 24 hours. The control group were just received MMT without any psychotherapy. All participants were assessed by structured interview, urine test, before treatment, after treatment and after 3 months follow up. Results: Results showed that both psychotherapy treatments were affected on recovery and relapse rates. Conclusion: It seems that psychological problems and conflicts before addiction and after addiction could be caused for individuals’ tendency to narcotics consumption. Therefore, applying of psychotherapy could be useful in relapse prevention.

  11. Effects of needs-assessment-based psycho-education of schizophrenic patients' families on the severity of symptoms and relapse rate of patients.

    Science.gov (United States)

    Kheirabadi, Gholam Reza; Rafizadeh, Mahnaz; Omranifard, Victoria; Yari, Azam; Maracy, Mohammad Reza; Mehrabi, Tayebe; Sadri, Sima

    2014-11-01

    Family psycho-education is one of the most effective interventions for preventing relapse in patients with schizophrenia. We evaluated the efficacy of a needs-assessment-based educational program in comparison with a current program (textbook based) in the treatment of schizophrenia. Patients with schizophrenia and their families (N = 60) were allocated to needs-assessment-based education (treatment) and textbook-based (control) programs; both included 10 sessions of education within about 6 months. Symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS) prior to intervention and every 3 months for a total of 18 months. A 25% decrease or increase in total PANSS score was considered as response or relapse, respectively. Forty-two cases completed the study. The total PANSS score was significantly decreased in both groups with more reduction in the treatment group. Positive and negative scale scores were reduced in the treatment group, but not significantly in the control group. Response rate was higher in the treatment group and relapse rate was lower (15% vs. 27.2%, P = 0.279). In logistic regression analysis, needs-assessment-based psycho-education was associated with more treatment response. Needs-assessment-based psycho-education is more effective than textbook-based education for treating schizophrenia. We recommend psychiatric care centers to conduct needs-assessment and develop their own program for family psycho-education.

  12. Effect of Preserving the Pituitary Stalk During Resection of Craniopharyngioma in Children on the Diabetes Insipidus and Relapse Rates and Long-Term Outcomes.

    Science.gov (United States)

    Cheng, Jing; Fan, Yanqin; Cen, Bo

    2017-09-01

    The objective of this study was to investigate the effect of preserving an infiltrated pituitary stalk during the resection of craniopharyngioma of pituitary stalk origin on postoperative outcomes and thus provide a theoretical basis for microsurgical treatment and prognosis. We screened the clinical data of all 103 pediatric patients with craniopharyngioma undergoing surgical treatment at our department between January 2006 and January 2013 and conducted a retrospective analysis of 82 patients with craniopharyngioma originating in the pituitary stalk. The patients were followed up from 12 months to 8 years. We analyzed the effect of preserving the pituitary stalk on the early and persistent diabetes insipidus rates, postoperative relapse rate, and mortality. In the total resection group (n = 67), the early and persistent diabetes insipidus rates were significantly lower in the 46 patients (68.7%) with a pituitary stalk than in those whose pituitary stalk was removed (P  0.05). In the subtotal resection group (n = 15), a significant difference was observed in the early and persistent diabetes insipidus rates (P  0.05). For children with craniopharyngioma of pituitary stalk origin, preserving the pituitary stalk has a significant effect on the early and persistent diabetes insipidus rates. When intraoperative exploration showed excessive adhesion between the tumor and pituitary stalk, we opted to preserve the pituitary stalk, which significantly reduced the early and persistent postoperative diabetes insipidus rates, without significantly increasing the relapse or mortality rate.

  13. The Effects of Family-Centered Problem-Solving Education on Relapse Rate, Self Efficacy and Self Esteem Among Substance Abusers.

    Science.gov (United States)

    Habibi, Rahim; Nikbakht Nasrabadi, Alireza; Shabany Hamedan, Maryam; Saleh Moqadam, Amirreza

    2016-03-01

    The success of drug abuse treatment and relapse prevention methods depends widely on not only pharmaceutical and non-pharmaceutical therapies but also self efficacy and self esteem promotion. The current study attempted to clarify the effects of Problem Solving Education (PSE) on relapse rate, self efficacy and self esteem among drug abusers. This non-controlled clinical trial (quasi-experimental) assessed 60 opium and heroin abusers who were willing to quit and were referred to the Mehr Center of Addiction Treatment and Rehabilitation Facility. The patients were allocated to two groups of 30 (intervention and control groups). While both groups received the routine care of the clinic, the intervention group also attended eight 45-minute family-centered PSE sessions. The Coopersmith Self esteem Inventory and Quit Addiction Self efficacy Questionnaire were filled out for all subjects before and after the intervention. Drug relapse was investigated four times with two-week intervals. The two groups were compared using chi-square and Student's-t tests. Logistic regression analysis was applied to determine factors affecting drug relapse. A total of 45 individuals (21 and 24 in the intervention and control groups, respectively) completed the study. At baseline, the two groups had no significant difference regarding their mean scores of self esteem and self efficacy (P = 0.692 and 0.329, respectively). After the intervention, however, the mean changes of self esteem scores were 20.10 ± 3.75 for the intervention group and 4.50 for the control group (P self efficacy scores in the mentioned groups were 34 34.17 ± 5.19 and 9.03± 2.04, respectively (P self efficacy and self esteem among patients.

  14. Tandem autologous-allo-SCT is feasible in patients with high-risk relapsed non-Hodgkin's lymphoma.

    Science.gov (United States)

    Crocchiolo, R; Castagna, L; Fürst, S; El-Cheikh, J; Faucher, C; Oudin, C; Granata, A; Bouabdallah, R; Coso, D; Chabannon, C; Balzarotti, M; Santoro, A; Blaise, D

    2013-02-01

    Allo-SCT is used to exploit GVL effect in high-risk relapsed non-Hodgkin's lymphoma (NHL). Here, we retrospectively analyzed 34 high-risk NHL patients who underwent auto-SCT followed closely by reduced-intensity allo-SCT ('tandem auto-allo') from January 2002 to November 2010. The search for an allogeneic donor was started at the beginning of salvage regimen. Median patients' age was 47 (27-68) years; histotypes were: diffuse large B-cell n=5, follicular n=14, transformed follicular n=4, mantle-cell n=5, plasmocytoid lymphoma n=1, anaplastic large T-cell n=2, peripheral T-cell n=3. Donors were HLA-identical siblings (n=29) or 10/10-matched unrelated individuals (n=5). Median interval between auto-SCT and allo-SCT was 77 days (36-197). At a median follow-up of 46 (8-108) months since allo-SCT, 5-year OS is 77% (61-93) and PFS is 68% (51-85). Disease relapse or progression occurred in six patients, 100-day TRM was 0%, 2-year TRM incidence was 6%. In conclusion, tandem transplantation is feasible in high-risk NHL patients having a HLA-identical donor. This approach could represent a suitable therapeutic option for those patients with high-risk NHL potentially benefitting from further therapy after auto-SCT. Donor searches should be started promptly whenever such an approach is chosen.

  15. Temporal changes in incidence and pattern of central nervous system relapses in children with acute lymphoblastic leukaemia treated on four consecutive Medical Research Council Trials, 1985–2001

    Science.gov (United States)

    Krishnan, Shekhar; Wade, Rachel; Moorman, Anthony V; Mitchell, Chris; Kinsey, Sally E; Eden, TOB; Parker, Catriona; Vora, Ajay; Richards, Sue; Saha, Vaskar

    2009-01-01

    Despite the success of contemporary treatment protocols in childhood acute lymphoblastic leukaemia (ALL), relapse within the central nervous system (CNS) remains a challenge. To better understand this phenomenon, we have analysed the changes in incidence and pattern of CNS relapses in 5564 children enrolled on four successive MRC-ALL trials between 1985 and 2001. Changes in the incidence and pattern of CNS relapses were examined and the relationship with patient characteristics assessed. Factors affecting post-relapse outcome were determined. Overall, relapses declined by 49%. Decreases occurred primarily in non-CNS and combined relapses with a progressive shift towards later (≥30 months from diagnosis) relapses (p<0·0001). Although isolated CNS relapses declined, the proportional incidence and timing of relapse remained unchanged. Age and presenting white cell count were risk factors for CNS relapse. On multivariate analysis, the time to relapse and the trial period influenced post-relapse outcomes. Relapse trends differed within biological subtypes. In ETV6-RUNX1 ALL, relapse patterns mirrored overall trends while in High Hyperdiploidy ALL, these appear to have plateaued over the latter two trial periods. Intensive systemic and intrathecal chemotherapy have decreased the overall CNS relapse rates and changed the patterns of recurrence. The heterogeneity of therapeutic response in the biological subtypes suggests room for further optimisation using currently available chemotherapy. PMID:20016529

  16. JUVENILE MYOCLONIC EPILEPSY: A FOCUS ON THE EFFICACY OF THERAPY AND THE RATE OF RELAPSES ACCORDING TO LONG-TERM FOLLOW-UP DATA

    Directory of Open Access Journals (Sweden)

    K. Yu. Mukhin

    2015-01-01

    Full Text Available Juvenile myoclonic epilepsy (JME is a type of adolescent-onset idiopathic generalized epilepsy with the appearance of massive myoclonic seizures and, in most cases, generalized convulsions occurring chiefly in the period after awakening. It is assumed that there is a two-locus (dominant and recessive model of inheritance of JME; moreover, the dominant gene is located on the short arm of chromosome 6. JME is one of the most common types of epilepsy and most frequent among idiopathic generalized epilepsies. Its rate is 5 to 11 % of all types of epilepsy with some female predominance. The diagnosis of JME creates no problems in typical cases. The disease is generally manifested by a concurrence of myoclonic (usually in the hands and generalized clonic-tonic-clonic seizures occurring during waking. Typical absences and epileptic myoclonus of the eyelid are rarer. Seizures are clearly provoked by sleep deprivation. As in other types of idiopathic epilepsy, the patients’ neurological status is normal; no intellectual disabilities are observed. This type of epilepsy is well treatable and, when initial monotherapy is correctly used, sustainable remission occurs immediately in the vast majority (75–85 % of the patients with JME. However, the problem of these patients, unlike that of patients with many forms of idiopathic epilepsy, is that sleep pattern disturbance, missing a dose of antiepileptic drugs (AED, or therapy refusal give rise to relapse of seizures in the vast majority of patients even in long-term remission.Due to the fact that the data available in the literature on the efficacy of therapy in patients with JME and particularly on the results of its discontinuation are contradictory, the authors of the paper conducted an investigation to determine therapeutic effectiveness and the frequency of relapse of seizures in patients with JME during a long-term follow-up.The study enrolled 106 JME patients who had been regularly followed up at

  17. Effects of repeated withdrawal from alcohol on recovery of cognitive impairment under abstinence and rate of relapse.

    Science.gov (United States)

    Loeber, Sabine; Duka, Theodora; Welzel Márquez, Helga; Nakovics, Helmut; Heinz, Andreas; Mann, Karl; Flor, Herta

    2010-01-01

    Several authors suggest that withdrawal from alcohol could cause neurotoxic lesions in the frontal lobe and thereby affect cognitive function. In line with this, previous studies have demonstrated greater cognitive impairment of alcohol-dependent patients with two or more previous detoxifications (Hi-detox) compared with patients with less than two detoxifications (Lo-detox). The aim of the present study was to investigate whether repeated withdrawal from alcohol affects recovery of cognitive function and is related to relapse. Forty-eight alcohol-dependent patients (Hi-detox: n = 31, Lo-detox: n = 17) and 36 healthy controls underwent a comprehensive neuropsychological test-battery. Patients were tested after completion of detoxification (T1) and 3 (T2, n = 35) and 6 (T3, n = 28) months after discharge. Healthy controls were tested at T1 (n = 36) and T2 (n = 16). Drinking behaviour was assessed at all times. Patients performed significantly worse than controls at T1 as well as T2 with regard to attention/executive function. Recovery of attention/executive function was observed within the second 3 months after discharge, but the Hi-detox group performed worse than the Lo-detox group. No association with relapse was observed. This study provides first evidence, that repeated withdrawal from alcohol might be associated with reduced brain plasticity as indicated by a delay of recovery from impairment of attention/executive function. However, little evidence was found for a direct influence of cognitive impairment on treatment success.

  18. A Phase I Study of CPI-613 in Combination with High-Dose Cytarabine and Mitoxantrone for Relapsed or Refractory Acute Myeloid Leukemia.

    Science.gov (United States)

    Pardee, Timothy S; Anderson, Rebecca G; Pladna, Kristin M; Isom, Scott; Ghiraldeli, Lais P; Miller, Lance D; Chou, Jeff W; Jin, Guangxu; Zhang, Wei; Ellis, Leslie R; Berenzon, Dmitriy; Howard, Dianna S; Hurd, David D; Manuel, Megan; Dralle, Sarah; Lyerly, Susan; Powell, Bayard L

    2018-05-01

    Purpose: CPI-613, a lipoate analogue that inhibits pyruvate dehydrogenase (PDH) and α-ketogluterate dehydrogenase (KGDH), has activity in patients with myeloid malignancies. This study explored the role of mitochondrial metabolism in chemotherapy response and determined the MTD, efficacy, and safety of CPI-613 combined with high-dose cytarabine and mitoxantrone in patients with relapsed or refractory acute myeloid leukemia. Experimental Design: The role of mitochondrial response to chemotherapy was assessed in cell lines and animal models. A phase I study of CPI-613 plus cytarabine and mitoxantrone was conducted in patients with relapsed or refractory AML. Results: Exposure to chemotherapy induced mitochondrial oxygen consumption that depended on PDH. CPI-613 sensitized AML cells to chemotherapy indicating that mitochondrial metabolism is a source of resistance. Loss of p53 did not alter response to CPI-613. The phase I study enrolled 67 patients and 62 were evaluable for response. The overall response rate was 50% (26CR+5CRi/62). Median survival was 6.7 months. In patients over 60 years old, the CR/CRi rate was 47% (15/32) with a median survival of 6.9 months. The response rate for patients with poor-risk cytogenetics also was encouraging with 46% (11/24 patients) achieving a CR or CRi. RNA sequencing analysis of a subset of baseline bone marrow samples revealed a gene expression signature consistent with the presence of B cells in the pretreatment marrow of responders. Conclusions: The addition of CPI-613 to chemotherapy is a promising approach in older patients and those with poor-risk cytogenetics. Clin Cancer Res; 24(9); 2060-73. ©2018 AACR . ©2018 American Association for Cancer Research.

  19. High-dose therapy and autologous bone marrow transplantation for Hodgkin's disease patients with relapses potentially treatable by radical radiation therapy

    International Nuclear Information System (INIS)

    Pezner, Richard D.; Nademanee, Auayporn; Forman, Stephen J.

    1995-01-01

    Purpose: A retrospective review evaluated the results of autologous bone marrow transplantation (A-BMT) for patients with relapsed Hodgkin's disease (HD) who were potentially treatable by radical radiation therapy (RRT). Methods and Materials: Evaluated patient cases met the following criteria: initial treatment with chemotherapy (with or without involved field radiation therapy 20 Gy to spinal cord); HD at time of salvage therapy limited to lymph nodes, Waldeyer's ring, liver, spleen, direct extension sites, and/or one lung. Results: There were 23 A-BMT patients treated between 1986 and 1991 who fulfilled the criteria. Three (13%) patients died from treatment-related complications and eight (35%) developed nonfatal Grade 3-4 complications. The 3-year actuarial disease-free survival rate was 61%. The 3-year disease-free survival rate was 55% for the nine patients with at least one prior disease-free interval (DFI) > 12 months, 67% for nine patients with DFI 0.10). These results are comparable to retrospective studies of RRT results in selected relapsed HD patients. Conclusions: Long-term disease-free survival is frequently possible with either A-BMT or RRT appropriately selected relapsed HD patients. In considering treatment options, important prognostic factors include initial stage of disease, number of prior relapses, DFI, and extent of relapsed disease

  20. CAR-T cells and allogeneic hematopoietic stem cell transplantation for relapsed/refractory B-cell acute lymphoblastic leukemia.

    Science.gov (United States)

    Liu, Jun; Zhang, Xi; Zhong, Jiang F; Zhang, Cheng

    2017-10-01

    Relapsed/refractory acute lymphoblastic leukemia (ALL) has a low remission rate after chemotherapy, a high relapse rate and poor long-term survival even when allogeneic hematopoietic stem cell transplantation (allo-HSCT) is performed. Chimeric antigen receptors redirected T cells (CAR-T cells) can enhance disease remission with a favorable outcome for relapsed/refractory ALL, though some cases quickly relapsed after CAR-T cell treatment. Thus, treatment with CAR-T cells followed by allo-HSCT may be the best way to treat relapsed/refractory ALL. In this review, we first discuss the different types of CAR-T cells. We then discuss the treatment of relapsed/refractory ALL using only CAR-T cells. Finally, we discuss the use of CAR-T cells, followed by allo-HSCT, for the treatment of relapsed/refractory ALL.

  1. Regional homogeneity changes between heroin relapse and non-relapse patients under methadone maintenance treatment: a resting-state fMRI study.

    Science.gov (United States)

    Chang, Haifeng; Li, Wei; Li, Qiang; Chen, Jiajie; Zhu, Jia; Ye, Jianjun; Liu, Jierong; Li, Zhe; Li, Yongbin; Shi, Ming; Wang, Yarong; Wang, Wei

    2016-08-18

    Methadone maintenance treatment (MMT) is recognized as one of the most effective treatments for heroin addiction but its effect is dimmed by the high incidence of heroin relapse. However, underlying neurobiology mechanism of heroin relapse under MMT is still largely unknown. Here, we took advantage of a resting-state fMRI technique by analysis of regional homogeneity (ReHo), and tried to explore the difference of brain function between heroin relapsers and non-relapsers in MMT. Forty MMT patients were included and received a 12-month follow-up. All patients were given baseline resting-state fMRI scans by using a 3.0 T GE Signa Excite HD whole-body MRI system. Monthly self-report and urine test were used to assess heroin relapse or non-relapse. Subjective craving was measured with visual analog scale. The correlation between ReHo and the degree of heroin relapse was analyzed. Compared with the non-relapsers, ReHo values were increased in the bilateral medial orbitofrontal cortex, right caudate, and right cerebellum of the heroin relapsers while those in the left parahippocampal gyrus, left middle temporal gyrus, right lingual gyrus, and precuneus were decreased in heroin relapsers. Importantly, altered ReHo in the right caudate were positively correlated with heroin relapse rates or subjective craving response. Using the resting-state fMRI technique by analysis of ReHo, we provided the first resting-state fMRI evidence that right caudate may serve as a potential biomarker for heroin relapse prediction and also as a promising target for reducing relapse risk.

  2. Ipsilateral Breast Tumor Relapse: Local Recurrence Versus New Primary Tumor and the Effect of Whole-Breast Radiotherapy on the Rate of New Primaries

    International Nuclear Information System (INIS)

    Gujral, Dorothy M.; Sumo, Georges; Owen, John R.; Ashton, Anita; Bliss, Judith M.; Haviland, Joanne; Yarnold, John R.

    2011-01-01

    Purpose: The justification for partial breast radiotherapy after breast conservation surgery assumes that ipsilateral breast tumor relapses (IBTR) outside the index quadrant are mostly new primary (NP) tumors that develop despite radiotherapy. We tested the hypothesis that whole-breast radiotherapy (WBRT) is ineffective in preventing NP by comparing development rates in irradiated and contralateral breasts after tumor excision and WBRT. Methods and Materials: We retrospectively reviewed 1,410 women with breast cancer who were entered into a prospective randomized trial of radiotherapy fractionation and monitored annually for ipsilateral breast tumor relapses (IBTR) and contralateral breast cancer (CLBC). Cases of IBTR were classified into local recurrence (LR) or NP tumors based on location and histology and were subdivided as definite or likely depending on clinical data. Rates of ipsilateral NP and CLBC were compared over a 15-year period of follow-up. Results: At a median follow-up of 10.1 years, there were 150 documented cases of IBTR: 118 (79%) cases were definite or likely LR; 27 (18%) cases were definite or likely NP; and 5 (3%) cases could not be classified. There were 71 cases of CLBC. The crude proportion of definite-plus-likely NP was 1.9% (27/1,410) patients compared with 5% (71/1,410) CLBC patients. Cumulative incidence rates at 5, 10, and 15 years were 0.8%, 2.0%, and 3.5%, respectively, for definite-plus-likely NP and 2.4%, 5.8%, and 7.9%, respectively for CLBC, suggesting a difference in the rates of NP and CLBC. Conclusions: This analysis suggests that WBRT reduces the rate of ipsilateral NP tumors. The late presentation of NP has implications for the reporting of trials that are testing partial breast radiotherapy.

  3. High efficacy and safety of low-dose CD19-directed CAR-T cell therapy in 51 refractory or relapsed B acute lymphoblastic leukemia patients.

    Science.gov (United States)

    Pan, J; Yang, J F; Deng, B P; Zhao, X J; Zhang, X; Lin, Y H; Wu, Y N; Deng, Z L; Zhang, Y L; Liu, S H; Wu, T; Lu, P H; Lu, D P; Chang, A H; Tong, C R

    2017-12-01

    Refractory or relapsed B lymphoblastic leukemia (B-ALL) patients have a dismal outcome with current therapy. We treated 42 primary refractory/hematological relapsed (R/R) and 9 refractory minimal residual disease by flow cytometry (FCM-MRD + ) B-ALL patients with optimized second generation CD19-directed CAR-T cells. The CAR-T-cell infusion dosages were initially ranged from 0.05 to 14 × 10 5 /kg and were eventually settled at 1 × 10 5 /kg for the most recent 20 cases. 36/40 (90%) evaluated R/R patients achieved complete remission (CR) or CR with incomplete count recovery (CRi), and 9/9 (100%) FCM-MRD + patients achieved MRD - . All of the most recent 20 patients achieved CR/CRi. Most cases only experienced mild to moderate CRS. 8/51 cases had seizures that were relieved by early intervention. Twenty three of twenty seven CR/CRi patients bridged to allogeneic hematopoietic stem cell transplantation (allo-HCT) remained in MRD - with a median follow-up time of 206 (45-427) days, whereas 9 of 18 CR/CRi patients without allo-HCT relapsed. Our results indicate that a low CAR-T-cell dosage of 1 × 10 5 /kg, is effective and safe for treating refractory or relapsed B-ALL, and subsequent allo-HCT could further reduce the relapse rate.

  4. HOW DOES FINGOLIMOD (GILENYA® FIT IN THE TREATMENT ALGORITHM FOR HIGHLY ACTIVE RELAPSING-REMITTING MULTIPLE SCLEROSIS?

    Directory of Open Access Journals (Sweden)

    Franz eFazekas

    2013-05-01

    Full Text Available Multiple sclerosis (MS is a neurological disorder characterised by inflammatory demyelination and neurodegeneration in the central nervous system (CNS. Until recently, disease modifying treatment was based on agents requiring parenteral delivery, thus limiting long-term compliance. Basic treatments such as beta-interferon provide only moderate efficacy, and although therapies for second-line treatment and highly active MS are more effective, they are associated with potentially severe side effects. Fingolimod (Gilenya® is the first oral treatment of MS and has recently been approved as single disease-modifying therapy in highly active relapsing-remitting multiple sclerosis (RRMS for adult patients with high disease activity despite basic treatment (beta-interferon and for treatment-naïve patients with rapidly evolving severe RRMS. At a scientific meeting that took place in Vienna on November 18th, 2011, experts from 10 Central and Eastern European countries discussed the clinical benefits and potential risks of fingolimod for MS, suggested how the new therapy fits within the current treatment algorithm and provided expert opinion for the selection and management of patients.

  5. Monitoring minimal residual disease in children with high-risk relapses of acute lymphoblastic leukemia: prognostic relevance of early and late assessment.

    Science.gov (United States)

    Eckert, C; Hagedorn, N; Sramkova, L; Mann, G; Panzer-Grümayer, R; Peters, C; Bourquin, J-P; Klingebiel, T; Borkhardt, A; Cario, G; Alten, J; Escherich, G; Astrahantseff, K; Seeger, K; Henze, G; von Stackelberg, A

    2015-08-01

    The prognosis for children with high-risk relapsed acute lymphoblastic leukemia (ALL) is poor. Here, we assessed the prognostic importance of response during induction and consolidation treatment prior to hematopoietic stem cell transplantation (HSCT) aiming to evaluate the best time to assess minimal residual disease (MRD) for intervention strategies and in future trials in high-risk ALL relapse patients. Included patients (n=125) were treated uniformly according to the ALL-REZ BFM (Berlin-Frankfurt-Münster) 2002 relapse trial (median follow-up time=4.8 years). Patients with MRD ⩾10(-3) after induction treatment (76/119, 64%) or immediately preceding HSCT (19/71, 27%) had a significantly worse probability of disease-free survival 10 years after relapse treatment begin, with 26% (±6%) or 23% (±7%), respectively, compared with 58% (±8%) or 48% (±7%) for patients with MRD treatment reduced MRD to treatment can be used to quantify the activity of different induction treatment strategies in phase II trials. MRD persistence at ⩾10(-3) before HSCT reflects a disease highly resistant to conventional intensive chemotherapy and requiring prospective controlled investigation of new treatment strategies and drugs.

  6. Improved survival of multiple myeloma patients with late relapse after high-dose treatment and stem cell support, a population-based study of 348 patients in Denmark in 1994-2004

    DEFF Research Database (Denmark)

    Vangsted, Annette Juul; Klausen, Tobias W; Andersen, Niels F

    2010-01-01

    To analyse if patients with early relapse after high-dose chemotherapy with stem cell support (HDT) benefit from new treatment strategies in a population-based setting.......To analyse if patients with early relapse after high-dose chemotherapy with stem cell support (HDT) benefit from new treatment strategies in a population-based setting....

  7. High-dose therapy followed by bone marrow transplantation for relapsed follicular non-Hodgkin's lymphoma

    NARCIS (Netherlands)

    Schouten, IC; Raemaekers, JJM; Kluin-Nelemans, HC; vanKamp, H; Mellink, WAM; vantVeer, MB

    1996-01-01

    Purpose: To analyze whether, in addition to survival, and disease-free survival progression-free interval after transplantation would be longer than the last progression-free interval before transplantation, supporting the argument that high-dose therapy may change the biologic behavior of the

  8. High FDG uptake areas on pre-radiotherapy PET/CT identify preferential sites of local relapse after chemoradiotherapy for locally advanced oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Calais, Jeremie; Lemarignier, Charles; Vera, Pierre [Henri Becquerel Cancer Center and Rouen University Hospital, Nuclear Medicine Department, Rouen (France); University of Rouen, QuantIF-LITIS (Equipe d' Accueil 4108-FR CNRS 3638), Faculty of Medicine, Rouen (France); Dubray, Bernard [University of Rouen, QuantIF-LITIS (Equipe d' Accueil 4108-FR CNRS 3638), Faculty of Medicine, Rouen (France); Centre Henri Becquerel and Rouen University Hospital, Department of Radiotherapy and Medical Physics, Rouen (France); Nkhali, Lamyaa; Thureau, Sebastien; Modzelewski, Romain; Gardin, Isabelle [Henri Becquerel Cancer Center and Rouen University Hospital, Nuclear Medicine Department, Rouen (France); University of Rouen, QuantIF-LITIS (Equipe d' Accueil 4108-FR CNRS 3638), Faculty of Medicine, Rouen (France); Centre Henri Becquerel and Rouen University Hospital, Department of Radiotherapy and Medical Physics, Rouen (France); Di Fiore, Frederic [Rouen University Hospital, Department of Gastroenterology, Rouen (France); Rouen University Hospital, Department of Oncology, Henri Becquerel Cancer Center, IRON, Rouen (France); Michel, Pierre [Rouen University Hospital, Department of Gastroenterology, Rouen (France)

    2015-05-01

    The high failure rates in the radiotherapy (RT) target volume suggest that patients with locally advanced oesophageal cancer (LAOC) would benefit from increased total RT doses. High 2-deoxy-2-[{sup 18}F]fluoro-D-glucose (FDG) uptake (hotspot) on pre-RT FDG positron emission tomography (PET)/CT has been reported to identify intra-tumour sites at increased risk of relapse after RT in non-small cell lung cancer and in rectal cancer. Our aim was to confirm these observations in patients with LAOC and to determine the optimal maximum standardized uptake value (SUV{sub max}) threshold to delineate smaller RT target volumes that would facilitate RT dose escalation without impaired tolerance. The study included 98 consecutive patients with LAOC treated by chemoradiotherapy (CRT). All patients underwent FDG PET/CT at initial staging and during systematic follow-up in a single institution. FDG PET/CT acquisitions were coregistered on the initial CT scan. Various subvolumes within the initial tumour (30, 40, 50, 60, 70, 80 and 90 % SUV{sub max} thresholds) and in the subsequent local recurrence (LR, 40 and 90 % SUV{sub max} thresholds) were pasted on the initial CT scan and compared[Dice, Jaccard, overlap fraction (OF), common volume/baseline volume, common volume/recurrent volume]. Thirty-five patients had LR. The initial metabolic tumour volume was significantly higher in LR tumours than in the locally controlled tumours (mean 25.4 vs 14.2 cc; p = 0.002). The subvolumes delineated on initial PET/CT with a 30-60 % SUV{sub max} threshold were in good agreement with the recurrent volume at 40 % SUV{sub max} (OF = 0.60-0.80). The subvolumes delineated on initial PET/CT with a 30-60 % SUV{sub max} threshold were in good to excellent agreement with the core volume (90 % SUV{sub max}) of the relapse (common volume/recurrent volume and OF indices 0.61-0.89). High FDG uptake on pretreatment PET/CT identifies tumour subvolumes that are at greater risk of recurrence after CRT in

  9. Detection rate of PET/CT in patients with biochemical relapse of prostate cancer using [{sup 68}Ga]PSMA I and T and comparison with published data of [{sup 68}Ga]PSMA HBED-CC

    Energy Technology Data Exchange (ETDEWEB)

    Berliner, Christoph; Tienken, Milena; Kobayashi, Yuske; Helberg, Annabelle; Kirchner, Uve; Klutmann, Susanne; Mester, Janos; Bannas, Peter [University Medical Center Hamburg-Eppendorf, Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg (Germany); Frenzel, Thorsten [University Medical Center Hamburg-Eppendorf, Ambulatory Center, Department for Radiation Oncology, Hamburg (Germany); Beyersdorff, Dirk [University Medical Center Hamburg-Eppendorf, Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg (Germany); University Medical Center Hamburg-Eppendorf, Martini-Klinik, Hamburg (Germany); Budaeus, Lars [University Medical Center Hamburg-Eppendorf, Martini-Klinik, Hamburg (Germany); Wester, Hans-Juergen [Technical University Munich, Pharmaceutical Radiochemistry, Garching (Germany)

    2017-04-15

    To determine the detection rate of PET/CT in biochemical relapse of prostate cancer using [{sup 68}Ga]PSMA I and T and to compare it with published detection rates of [{sup 68}Ga]PSMA HBED-CC. We performed a retrospective analysis in 83 consecutive patients with documented biochemical relapse after prostatectomy. All patients underwent whole body [{sup 68}Ga]PSMA I and T PET/CT. PET/CT images were evaluated for presence of local recurrence, lymph node metastases, and distant metastases. Proportions of positive PET/CT results were calculated for six subgroups with increasing prostate specific antigen (PSA) levels (<0.5 ng/mL, 0.5 to <1.0 ng/mL, 1.0 to <2.0 ng/mL, 2.0 to <5.0 ng/mL, 5.0 to <10.0, ≥10.0 ng/mL). Detection rates of [{sup 68}Ga]PSMA I and T were statistically compared with published detection rates of [{sup 68}Ga]PSMA HBED-CC using exact Fisher's test. Median PSA was 0.81 (range: 0.01 - 128) ng/mL. In 58/83 patients (70 %) at least one [{sup 68}Ga]PSMA I and T positive lesion was detected. Local recurrent cancer was present in 18 patients (22 %), lymph node metastases in 29 patients (35 %), and distant metastases in 15 patients (18 %). The tumor detection rate was positively correlated with PSA levels, resulting in detection rates of 52 % (<0.5 ng/mL), 55 % (0.5 to <1.0 ng/mL), 70 % (1.0 to <2.0 ng/mL), 93 % (2.0 to <5.0 ng/mL), 100 % (5.0 to <10.0 ng/mL), and 100 % (≥10.0 ng/mL). There was no significant difference between the detection rate of [{sup 68}Ga]PSMA I and T and published detection rates of [{sup 68}Ga]PSMA HBED-CC (all p>0.05). [{sup 68}Ga]PSMA I and T PET/CT has high detection rates of recurrent prostate cancer that are comparable to [{sup 68}Ga]PSMA HBED-CC. (orig.)

  10. Is High Dose Therapy Superior to Conventional Dose Therapy as Initial Treatment for Relapsed Germ Cell Tumors? The TIGER Trial

    Directory of Open Access Journals (Sweden)

    Darren R. Feldman, Robert Huddart, Emma Hall, Jörg Beyer, Thomas Powles

    2011-01-01

    Full Text Available Metastatic germ cell tumours (GCTs are usually cured with cisplatin based chemotherapy and standard treatment algorithms are established. However when this treatment fails and the disease relapses, standard treatment is much more uncertain. Both conventional dose therapy (CDT and high dose therapy (HDT are widely used, due to the lack of conclusive data supporting one specific approach. A recent retrospective analysis focusing on this population suggested a significant benefit for HDT. Retrospective analyses are prone to bias, and therefore while this data is provocative it is by no mean conclusive. For this reason the international community is supporting a prospective randomised trial in this area comparing CDT(TIP with sequential HDT (TICE. The planned open labelled randomised phase III study (TIGER is due to open in 2011 and will recruit 390 patients to detect a 13% difference in 2 year progression free survival (primary endpoint. It is hoped that this large study will conclusively resolve the uncertainty which currently exists.

  11. Efficacy of Cladribine Tablets in high disease activity subgroups of patients with relapsing multiple sclerosis: A post hoc analysis of the CLARITY study.

    Science.gov (United States)

    Giovannoni, Gavin; Soelberg Sorensen, Per; Cook, Stuart; Rammohan, Kottil W; Rieckmann, Peter; Comi, Giancarlo; Dangond, Fernando; Hicking, Christine; Vermersch, Patrick

    2018-04-01

    In the CLARITY (CLAdRIbine Tablets treating multiple sclerosis orallY) study, Cladribine Tablets significantly improved clinical and magnetic resonance imaging (MRI) outcomes (vs placebo) in patients with relapsing-remitting multiple sclerosis. Describe two clinically relevant definitions for patients with high disease activity (HDA) at baseline of the CLARITY study (utility verified in patients receiving placebo) and assess the treatment effects of Cladribine Tablets 3.5 mg/kg compared with the overall study population. Outcomes of patients randomised to Cladribine Tablets 3.5 mg/kg or placebo were analysed for subgroups using HDA definitions based on high relapse activity (HRA; patients with ⩾2 relapses during the year prior to study entry, whether on DMD treatment or not) or HRA plus disease activity on treatment (HRA + DAT; patients with ⩾2 relapses during the year prior to study entry, whether on DMD treatment or not, PLUS patients with ⩾1 relapse during the year prior to study entry while on therapy with other DMDs and ⩾1 T1 Gd+ or ⩾9 T2 lesions). In the overall population, Cladribine Tablets 3.5 mg/kg reduced the risk of 6-month-confirmed Expanded Disability Status Scale (EDSS) worsening by 47% vs placebo. A risk reduction of 82% vs placebo was seen in both the HRA and HRA + DAT subgroups (vs 19% for non-HRA and 18% for non-HRA + DAT), indicating greater responsiveness to Cladribine Tablets 3.5 mg/kg in patients with HDA. There were consistent results for other efficacy endpoints. The safety profile in HDA patients was consistent with the overall CLARITY population. Patients with HDA showed clinical and MRI responses to Cladribine Tablets 3.5 mg/kg that were generally better than, or at least comparable with, the outcomes seen in the overall CLARITY population.

  12. Predictors of marijuana relapse in the human laboratory: robust impact of tobacco cigarette smoking status.

    Science.gov (United States)

    Haney, Margaret; Bedi, Gillinder; Cooper, Ziva D; Glass, Andrew; Vosburg, Suzanne K; Comer, Sandra D; Foltin, Richard W

    2013-02-01

    Few marijuana smokers in treatment achieve sustained abstinence, yet factors contributing to high relapse rates are unknown. Study 1: data from five inpatient laboratory studies assessing marijuana intoxication, withdrawal, and relapse were combined to assess factors predicting the likelihood and severity of relapse. Daily, nontreatment-seeking marijuana smokers (n = 51; 10 ± 5 marijuana cigarettes/day) were enrolled. Study 2: to isolate the effects of cigarette smoking, marijuana intoxication, withdrawal, and relapse were assessed in daily marijuana and cigarette smokers (n = 15) under two within-subject, counter-balanced conditions: while smoking tobacco cigarettes as usual (SAU), and after at least 5 days without cigarettes (Quit). Study 1: 49% of participants relapsed the first day active marijuana became available. Tobacco cigarette smokers (75%), who were not abstaining from cigarettes, were far more likely to relapse than non-cigarette smokers (odds ratio: 19, p marijuana administration and those with more negative affect and sleep disruption during marijuana withdrawal were more likely to have severe relapse episodes (p 87%) relapsed to marijuana whether in the SAU or Quit phase. Tobacco cigarette smoking did not significantly influence relapse, nor did it affect marijuana intoxication or most symptoms of withdrawal relative to tobacco cessation. Daily marijuana smokers who also smoke cigarettes have high rates of marijuana relapse, and cigarette smoking versus recent abstinence does not directly influence this association. These data indicate that current cigarette smoking is a clinically important marker for increased risk of marijuana relapse. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  13. The effects of duration of glucocorticoid therapy on relapse rate in anti-neutrophil cytoplasm antibody associated vasculitis: A meta-analysis

    Science.gov (United States)

    Walsh, Michael; Merkel, Peter A.; Mahr, Alfred; Jayne, David

    2010-01-01

    Objective Disease relapses are common for patients with anti-neutrophil cytoplasm antibody associated vasculitis (AAV). The role of low-dose glucocorticoids (GC) in relapse prevention is controversial. We undertook a systematic review and meta-analysis to determine if GC target doses influence relapses of AAV. Methods Medline, EMBASE and Cochrane databases were searched for observational studies and randomized controlled trials of treatment of AAV that included a predefined GC treatment plan. The association of GC target dose with the proportion of relapses in studies was assessed using meta-regression and multi-level generalized linear modeling. Results Thirteen studies (983 patients) were identified for inclusion. There were no studies directly comparing GC regimens. We classified 288 patients as having a non-zero GC target dose by study end and 695 patients as having a zero GC target dose by study end. The pooled proportion of patients with a relapse was 36% (95% confidence interval [CI] 25 to 47%). GC regimen was the most significant variable explaining the variability between the proportions of patients with relapses. The proportion of patients with a relapse was 14% (95% CI 10 to 19%) in non-zero GC target dose and 43% (95% CI 33 to 52%) in zero GC target dose studies. Differences other than GC regimens exist between studies that complicate the comparability of trials and isolation of the variability in relapses due to GC target alone. Conclusions Studies with longer courses of GC in AAV are associated with fewer relapses. These results have implications for study design and outcome assessment in clinical trials of AAV. PMID:20235186

  14. Relapse of imported Plasmodium vivax malaria is related to primaquine dose: a retrospective study

    Directory of Open Access Journals (Sweden)

    Townell Nicola

    2012-06-01

    Full Text Available Abstract Background Relapsing Plasmodium vivax infection results in significant morbidity for the individual and is a key factor in transmission. Primaquine remains the only licensed drug for prevention of relapse. To minimize relapse rates, treatment guidelines have recently been revised to recommend an increased primaquine dose, aiming to achieve a cumulative dose of ≥6 mg/kg, i.e. ≥420 mg in a 70 kg patient. The aims of this study were to characterize the epidemiology of P. vivax infection imported into Queensland Australia, to determine the rates of relapse, to investigate the use of primaquine therapy, and its efficacy in the prevention of relapse. Methods A retrospective study was undertaken of laboratory confirmed P. vivax infection presenting to the two major tertiary hospitals in Queensland, Australia between January 1999 and January 2011. Primaquine dosing was classified as no dose, low dose ( Results Twenty relapses occurred following 151 primary episodes of P. vivax infection (13.2%. Relapses were confirmed among 3/21 (14.2%, 9/50 (18.0%, 1/54 (1.9% and 7/18 (38.9% of patients administered no dose, low dose, high dose and unknown primaquine dose respectively. High dose primaquine therapy was associated with a significantly lower rate of relapse compared to patients who were prescribed low dose therapy (OR 11.6, 95% CI 1.5-519, p = 0.005. Conclusions Relapse of P. vivax infection is more likely in patients who received low dose primaquine therapy. This study supports the recommendations that high dose primaquine therapy is necessary to minimize relapse of P. vivax malaria.

  15. Understanding High Rate Behavior Through Low Rate Analog

    Science.gov (United States)

    2014-04-28

    challenges in high rate character- isation of polymers. The most important is that, owing to their low stress wavespeed, the structural response of...box’ tool, to provide supporting date for the rate dependent mechanical character- isation . Experiments were performed on a TA instruments Q800

  16. Mitoxantrone, etoposide and cytarabine following epigenetic priming with decitabine in adults with relapsed/refractory acute myeloid leukemia or other high-grade myeloid neoplasms: a phase 1/2 study.

    Science.gov (United States)

    Halpern, A B; Othus, M; Huebner, E M; Buckley, S A; Pogosova-Agadjanyan, E L; Orlowski, K F; Scott, B L; Becker, P S; Hendrie, P C; Chen, T L; Percival, M-E M; Estey, E H; Stirewalt, D L; Walter, R B

    2017-12-01

    DNA methyltransferase inhibitors sensitize leukemia cells to chemotherapeutics. We therefore conducted a phase 1/2 study of mitoxantrone, etoposide and cytarabine following 'priming' with 5-10 days of decitabine (dec/MEC) in 52 adults (median age 55 (range: 19-72) years) with relapsed/refractory acute myeloid leukemia (AML) or other high-grade myeloid neoplasms. During dose escalation in cohorts of 6-12 patients, all dose levels were well tolerated. As response rates appeared similar with 7 and 10 days of decitabine, a 7-day course was defined as the recommended phase 2 dose (RP2D). Among 46 patients treated at/above the RP2D, 10 (22%) achieved a complete remission (CR), 8 without measurable residual disease; five additional patients achieved CR with incomplete platelet recovery, for an overall response rate of 33%. Seven patients (15%) died within 28 days of treatment initiation. Infection/neutropenic fever, nausea and mucositis were the most common adverse events. While the CR rate compared favorably to a matched historic control population (observed/expected CR ratio=1.77), CR rate and survival were similar to two contemporary salvage regimens used at our institution (G-CLAC (granulocyte colony-stimulating factor (G-CSF); clofarabine; cytarabine) and G-CLAM (G-CSF; cladribine; cytarabine; mitoxantrone)). Thus, while meeting the prespecified efficacy goal, we found no evidence that dec/MEC is substantially better than other cytarabine-based regimens currently used for relapsed/refractory AML.

  17. Orexin Receptor Targets for Anti-Relapse Medication Development in Drug Addiction

    Directory of Open Access Journals (Sweden)

    Ronald E. See

    2011-06-01

    Full Text Available Drug addiction is a chronic illness characterized by high rates of relapse. Relapse to drug use can be triggered by re-exposure to drug-associated cues, stressful events, or the drug itself after a period of abstinence. Pharmacological intervention to reduce the impact of relapse-instigating factors offers a promising target for addiction treatment. Growing evidence has implicated an important role of the orexin/hypocretin system in drug reward and drug-seeking, including animal models of relapse. Here, we review the evidence for the role of orexins in modulating reward and drug-seeking in animal models of addiction and the potential for orexin receptors as specific targets for anti-relapse medication approaches.

  18. Costs and effectiveness of fingolimod versus alemtuzumab in the treatment of highly active relapsing-remitting multiple sclerosis in the UK: re-treatment, discount, and disutility.

    Science.gov (United States)

    Montgomery, Stephen M; Kusel, Jeanette; Nicholas, Richard; Adlard, Nicholas

    2017-09-01

    Patients with relapsing-remitting multiple sclerosis (RRMS) treated with disease modifying therapies (DMTs) who continue to experience disease activity may be considered for escalation therapies such as fingolimod, or may be considered for alemtuzumab. Previous economic modeling used Markov models; applying one alternative technique, discrete event simulation (DES) modeling, allows re-treatment and long-term adverse events (AEs) to be included in the analysis. A DES was adapted to model relapse-triggered re-treatment with alemtuzumab and the effect of including ongoing quality-adjusted life year (QALY) decrements for AEs that extend beyond previous 1-year Markov cycles. As the price to the NHS of fingolimod in the UK is unknown, due to a confidential patient access scheme (PAS), a variety of possible discounts were tested. The interaction of re-treatment assumptions for alemtuzumab with the possible discounts for fingolimod was tested to determine which DMT resulted in lower lifetime costs. The lifetime QALY results were derived from modeled treatment effect and short- and long-term AEs. Most permutations of fingolimod PAS discount and alemtuzumab re-treatment rate resulted in fingolimod being less costly than alemtuzumab. As the percentage of patients who are re-treated with alemtuzumab due to experiencing a relapse approaches 100% of those who relapse whilst on treatment, the discount required for fingolimod to be less costly drops below 5%. Consideration of treatment effect alone found alemtuzumab generated 0.2 more QALYs/patient; the inclusion of AEs up to a duration of 1 year reduced this advantage to only 0.14 QALYs/patient. Modeling AEs with a lifetime QALY decrement found that both DMTs generated very similar QALYs with the difference only 0.04 QALYs/patient. When the model captured alemtuzumab re-treatment and long-term AE decrements, it was found that fingolimod is cost-effective compared to alemtuzumab, assuming application of only a modest level of

  19. Report of a Phase II Study of Clofarabine and Cytarabine in De Novo and Relapsed and Refractory AML Patients and in Selected Elderly Patients at High Risk for Anthracycline Toxicity

    Science.gov (United States)

    Cooper, Barry; Holmes, Houston; Vance, Estil; Berryman, Robert Brian; Maisel, Christopher; Li, Sandy; Saracino, Giovanna; Tadic-Ovcina, Mirjana; Fay, Joseph

    2011-01-01

    Purpose. To determine the efficacy and safety of clofarabine and cytarabine (Ara-C) in adult patients with relapsed or refractory acute myeloid leukemia (AML) and in elderly patients with untreated AML and heart disease. Patients and Methods. Patients with relapsed/refractory AML and older patients for whom there was a concern over toxicity from additional anthracyclines received 5 days of clofarabine, 40 mg/m2 per day i.v. over 1 hour, followed 4 hours later by Ara-C, 1,000 mg/m2 per day i.v. over 2 hours. Results. Thirty patients were enrolled. The median age was 67 years (range, 38–82 years) and 18 (60%) had received at least one prior therapy. Eleven (37%) patients had a history of cardiovascular disease and were considered to be at high risk for anthracycline toxicity. High-risk cytogenetic abnormalities were present in 14 (47%) patients. The overall response rate (complete remission [CR] plus partial remission) was 53%, including a CR in 14 patients (47%). Responses were observed in all cytogenetic risk groups and in patients who had received up to five prior therapies. The median disease-free survival interval was 9.5 months. The 30-day mortality rate was 20% (de novo AML, 8%; relapsed/refractory AML, 28%). Of the 14 patients achieving a CR, half were able to proceed to curative hematopoietic stem cell transplantation. Conclusions. Clofarabine in combination with Ara-C is effective in both untreated and previously treated patients with AML. In addition, it represents a useful remission induction strategy to serve as a bridge to transplantation in older patients with AML. PMID:21273514

  20. Gender differences in alcohol and substance use relapse.

    Science.gov (United States)

    Walitzer, Kimberly S; Dearing, Ronda L

    2006-03-01

    This review explores gender differences in relapse and characteristics of relapse events in alcohol and substance use. For alcohol, relapse rates were similar across gender. Although negative mood, childhood sexual abuse, alcohol-related self-efficacy, and poorer coping strategies predicted alcohol relapse, gender did not moderate these effects. Gender did moderate the association between marriage and alcohol relapse. For women, marriage and marital stress were risk factors for alcohol relapse; among men, marriage lowered relapse risk. This gender difference in the role of marriage in relapse may be a result of partner differences in problem drinking. Alcoholic women are more likely to be married to heavy drinking partners than are alcoholic men; thus, alcoholic women may be put at risk of relapse by marriage and alcoholic men may be protected by marriage. There are fewer studies documenting gender differences in substance abuse relapse so conclusions are limited and tentative. In contrast to the lack of gender differences in alcohol relapse rates, women appear less likely to experience relapse to substance use, relative to men. Women relapsing to substance use appear to be more sensitive to negative affect and interpersonal problems. Men, in contrast, may be more likely to have positive experiences prior to relapse.

  1. The Alcohol Relapse Risk Assessment: a scoring system to predict the risk of relapse to any alcohol use after liver transplant.

    Science.gov (United States)

    Rodrigue, James R; Hanto, Douglas W; Curry, Michael P

    2013-12-01

    Alcohol relapse after liver transplant heightens concern about recurrent disease, nonadherence to the immunosuppression regimen, and death. To develop a scoring system to stratify risk of alcohol relapse after liver transplant. Retrospective medical record review. All adult liver transplants performed from May 2002 to February 2011 at a single center in the United States. The incidence of return to any alcohol consumption after liver transplant. Thirty-four percent (40/118) of patients with a history of alcohol abuse/dependency relapsed to use of any alcohol after liver transplant. Nine of 25 hypothesized risk factors were predictive of alcohol relapse after liver transplant: absence of hepatocellular carcinoma, tobacco dependence, continued alcohol use after liver disease diagnosis, low motivation for alcohol treatment, poor stress management skills, no rehabilitation relationship, limited social support, lack of nonmedical behavioral consequences, and continued engagement in social activities with alcohol present. Each independent predictor was assigned an Alcohol Relapse Risk Assessment (ARRA) risk value of 1 point, and patients were classified into 1 of 4 groups by ARRA score: ARRA I = 0, ARRA II = 1 to 3, ARRA III = 4 to 6, and ARRA IV = 7 to 9. Patients in the 2 higher ARRA classifications had significantly higher rates of alcohol relapse and were more likely to return to pretransplant levels of drinking. Alcohol relapse rates are moderately high after liver transplant. The ARRA is a valid and practical tool for identifying pretransplant patients with alcohol abuse or dependency at elevated risk of any alcohol use after liver transplant.

  2. Cortico-amygdala coupling as a marker of early relapse risk in cocaine-addicted individuals

    Directory of Open Access Journals (Sweden)

    Meredith J Mchugh

    2014-02-01

    Full Text Available Addiction to cocaine is a chronic condition characterized by high rates of early relapse. This study builds on efforts to identify neural markers of relapse risk by studying resting state functional connectivity (rsFC in neural circuits arising from the amygdala; a brain region implicated in relapse-related processes including craving and reactivity to stress following acute and protracted withdrawal from cocaine. Whole-brain resting-state fMRI connectivity (6 min was assessed in 45 cocaine-addicted individuals and 22 healthy controls. Cocaine-addicted individuals completed scans in the final week of a residential treatment episode. To approximate preclinical models of relapse-related circuitry separate seeds were derived for the left and right basolateral (BLA and corticomedial (CMA amygdala. Participants also completed the Iowa Gambling Task, Wisconsin Card Sorting Test, Cocaine Craving Questionnaire, Obsessive Compulsive Cocaine Use scale, Temperament and Character Inventory and the NEO-PI-R. Relapse within the first 30 days post-treatment (n = 24 was associated with reduced rsFC between the left CMA and ventromedial prefrontal cortex/rostral anterior cingulate cortex (vmPFC/rACC relative to cocaine-addicted individuals who remained abstinent (non-relapse, n = 21. Non-relapse participants evidenced reduced rsFC between the bilateral BLA and visual processing regions (lingual gyrus/cuneus compared to controls and relapsed participants. Early relapse was associated with fewer years of education but unrelated to trait reactivity to stress, neurocognitive and clinical characteristics or cocaine use history. Findings suggest that rsFC within neural circuits implicated in preclinical models of relapse may provide a promising marker of relapse risk in cocaine-addicted individuals. Future efforts to replicate the current findings and alter connectivity within these circuits may yield novel interventions and improve treatment outcomes.

  3. Relapse prevention and smoking cessation.

    Science.gov (United States)

    Davis, J R; Glaros, A G

    1986-01-01

    A multicomponent smoking relapse prevention treatment based on Marlatt and Gordon's (1980) model of the relapse process was developed and evaluated. Behavior-analytic methods were used to develop assessment instruments, training situations, and coping responses. The prevention components were presented in the context of a basic broad-spectrum stop-smoking program, and were compared with the basic program plus discussion control, and the basic program alone. Smoking-related dependent variables generally did not differ between groups at any time from pre-treatment to 12 month follow-up. Only the subjects in the relapse prevention condition improved problem-solving and social skills needed to cope with high-risk situations. These subjects also tended to take longer to relapse and smoke fewer cigarettes at the time of relapse. Subjects above the median level of competence on measures of social skill at post-treatment remained abstinent significantly longer. Maintenance of non-smoking was found to be related to the degree of competence with which individuals deal with high-risk situations. Results are discussed in relation to models of compliance with therapeutic regimens.

  4. Elevated Serum IL-17 Expression at Cessation Associated with Graves’ Disease Relapse

    Directory of Open Access Journals (Sweden)

    Jianhui Li

    2018-01-01

    Full Text Available Background. Antithyroid drug (ATD treatment occupies the cornerstone therapeutic modality of Graves’ disease (GD with a high relapse rate after discontinuation. This study aimed to assess potential risk factors for GD relapse especially serum interleukin-17 (IL-17 expression. Methods. Consecutive newly diagnosed GD patients who were scheduled to undergo ATD therapy from May 2011 to May 2014 were prospectively enrolled. Risk factors for GD relapse were analyzed by univariate and multivariate Cox proportional hazard analyses. The association between serum IL-17 expression at cessation and GD relapse was analyzed with relapse-free survival (RFS by the Kaplan–Meier survival analysis and log-rank test. Results. Of the 117 patients, 72 (61.5% maintained a remission for 12 months after ATD withdrawal and 45 (38.5% demonstrated GD relapse. The final multivariate Cox analysis indicated elevated IL-17 expression at cessation to be an independent risk factor for GD relapse within 12 months after ATD withdrawal (HR: 3.04, 95% CI: 1.14–7.67, p=0.021. Patients with higher expressions of IL-17 (≥median value at cessation demonstrated a significantly higher RFS than those with lower levels by the Kaplan–Meier analysis and log-rank test (p=0.028. Conclusions. This present study indicated elevated serum IL-17 expression at cessation to be a predictor for GD relapse within 12 months.

  5. An Ultra-High Field Study of Cerebellar Pathology in Early Relapsing-Remitting Multiple Sclerosis Using MP2RAGE.

    Science.gov (United States)

    Fartaria, Mário João; OʼBrien, Kieran; Şorega, Alexandra; Bonnier, Guillaume; Roche, Alexis; Falkovskiy, Pavel; Krueger, Gunnar; Kober, Tobias; Bach Cuadra, Meritxell; Granziera, Cristina

    2017-05-01

    The aim of this study was to study focal cerebellar pathology in early stages of multiple sclerosis (MS) using ultra-high-field magnetization-prepared 2 inversion-contrast rapid gradient-echo (7T MP2RAGE). Twenty early-stage relapsing-remitting MS patients underwent an MP2RAGE acquisition at 7 T magnetic resonance imaging (MRI) (images acquired at 2 different resolutions: 0.58 × 0.58 × 0.58 mm, 7T_0.58, and 0.75 × 0.75 × 0.90 mm, 7T_0.75) and 3 T MRI (1.0 × 1.0 × 1.2 mm, 3T_1.0). Total cerebellar lesion load and volume and mean cerebellar lesion volume were compared across images using a Wilcoxon signed-rank test. Mean T1 relaxation times in lesions and normal-appearing tissue as well as contrast-to-noise ratio (CNR) measurements were also compared using a Wilcoxon signed-rank test. A multivariate analysis was applied to assess the contribution of MRI metrics to clinical performance in MS patients. Both 7T_0.58 and 7T_0.75 MP2RAGE showed significantly higher lesion load compared with 3T_1.0 MP2RAGE (P < 0.001). Plaques that were judged as leukocortical in 7T_0.75 and 3T_1.0 MP2RAGEs were instead identified as WM lesions in 7T_0.58 MP2RAGE. Cortical lesion CNR was significantly higher in MP2RAGEs at 7 T than at 3 T. Total lesion load as well as total and mean lesion volume obtained at both 7 T and 3 T MP2RAGE significantly predicted attention (P < 0.05, adjusted R = 0.5), verbal fluency (P < 0.01, adjusted R = 0.6), and motor performance (P = 0.01, adjusted R = 0.7). This study demonstrates the value of 7 T MP2RAGE to study the cerebellum in early MS patients. 7T_0.58 MP2RAGE provides a more accurate anatomical description of white and gray matter pathology compared with 7T_0.75 and 3T_1.0 MP2RAGE, likely due to the improved spatial resolution, lower partial volume effects, and higher CNR.

  6. Alcohol consumption and symptoms as predictors for relapse of DSM-5 alcohol use disorder.

    Science.gov (United States)

    Tuithof, Marlous; ten Have, Margreet; van den Brink, Wim; Vollebergh, Wilma; de Graaf, Ron

    2014-07-01

    Alcohol consumption levels and alcohol use disorder (AUD) symptoms may serve as easily quantifiable markers for AUD relapse after remission and might help prevention workers identify at-risk individuals. We investigated the predictive value of alcohol consumption and AUD symptoms on relapse. Data are from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). We selected 506 people in ≥12-month DSM-5 AUD remission at baseline and assessed their status at 3-year follow-up. AUD symptoms and drinking patterns were assessed using the Composite International Diagnostic Interview 3.0. Time since remission was assessed retrospectively at baseline and ranged from 1 to 48 years. Predictors for relapse were examined using Cox regression analysis. Cumulative AUD relapse rate was 5.6% at 5 years, 9.1% at 10 years and 12.0% at 20 years. Relapse was predicted by both medium (15-28/22-42 drinks weekly for women/men) and high (≥29/43) past alcohol intake, 6+ lifetime AUD symptoms, 'impaired control over use', and at-risk (≥8/15) current intake. The risk of relapse was especially high when medium or high past intake or 6+ lifetime symptoms coincided with current at-risk drinking. Only a minority of people in DSM-5 AUD remission relapsed, but the risk of relapse increased substantially with the presence of at least one of the risk factors. Moreover, at-risk current drinking coupled with other risk factors substantially increased the likelihood of relapse. Therefore, current drinking may provide an adequate reference point for relapse prevention. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. High burn rate solid composite propellants

    Science.gov (United States)

    Manship, Timothy D.

    High burn rate propellants help maintain high levels of thrust without requiring complex, high surface area grain geometries. Utilizing high burn rate propellants allows for simplified grain geometries that not only make production of the grains easier, but the simplified grains tend to have better mechanical strength, which is important in missiles undergoing high-g accelerations. Additionally, high burn rate propellants allow for a higher volumetric loading which reduces the overall missile's size and weight. The purpose of this study is to present methods of achieving a high burn rate propellant and to develop a composite propellant formulation that burns at 1.5 inches per second at 1000 psia. In this study, several means of achieving a high burn rate propellant were presented. In addition, several candidate approaches were evaluated using the Kepner-Tregoe method with hydroxyl terminated polybutadiene (HTPB)-based propellants using burn rate modifiers and dicyclopentadiene (DCPD)-based propellants being selected for further evaluation. Propellants with varying levels of nano-aluminum, nano-iron oxide, FeBTA, and overall solids loading were produced using the HTPB binder and evaluated in order to determine the effect the various ingredients have on the burn rate and to find a formulation that provides the burn rate desired. Experiments were conducted to compare the burn rates of propellants using the binders HTPB and DCPD. The DCPD formulation matched that of the baseline HTPB mix. Finally, GAP-plasticized DCPD gumstock dogbones were attempted to be made for mechanical evaluation. Results from the study show that nano-additives have a substantial effect on propellant burn rate with nano-iron oxide having the largest influence. Of the formulations tested, the highest burn rate was a 84% solids loading mix using nano-aluminum nano-iron oxide, and ammonium perchlorate in a 3:1(20 micron: 200 micron) ratio which achieved a burn rate of 1.2 inches per second at 1000

  8. High-rate lithium thionyl chloride cells

    Science.gov (United States)

    Goebel, F.

    1982-03-01

    A high-rate C cell with disc electrodes was developed to demonstrate current rates which are comparable to other primary systems. The tests performed established the limits of abuse beyond which the cell becomes hazardous. Tests include: impact, shock, and vibration tests; temperature cycling; and salt water immersion of fresh cells.

  9. Lithium thionyl chloride high rate discharge

    Science.gov (United States)

    Klinedinst, K. A.

    1980-04-01

    Improvements in high rate lithium thionyl chloride power technology achieved by varying the electrolyte composition, operating temperature, cathode design, and cathode composition are discussed. Discharge capacities are plotted as a function of current density, cell voltage, and temperature.

  10. Concomitant chemoradiotherapy with high dose rate brachytherapy ...

    African Journals Online (AJOL)

    Concomitant chemoradiotherapy with high dose rate brachytherapy as a definitive treatment modality for locally advanced cervical cancer. T Refaat, A Elsaid, N Lotfy, K Kiel, W Small Jr, P Nickers, E Lartigau ...

  11. Second hematopoietic SCT for leukemia relapsing after myeloablative T cell-depleted transplants does not prolong survival.

    Science.gov (United States)

    McIver, Z A; Yin, F; Hughes, T; Battiwalla, M; Ito, S; Koklanaris, E; Haggerty, J; Hensel, N F; Barrett, A John

    2013-09-01

    Patients with leukemia relapsing after allogeneic hematopoietic SCT have a dismal prognosis. A second SCT offers a further opportunity for cure, but has a high rate of treatment failure. To determine the utility of this option, we analyzed 59 consecutive patients relapsing after a myeloablative HLA-matched sibling T cell-depleted (TCD) SCT. Twenty-five patients (13 relapsing within 6 months and 12 relapsing between 6 and 170 months after the first SCT) received a T-replete second SCT. Thirty-eight patients relapsing early had a shorter survival than the 21 patients relapsing later (median 96 vs 298 days, P=0.0002). In patients relapsing early, the second SCT did not improve OS compared with patients receiving non-SCT treatments (median survival 109 vs 80 days, P=0.41). In patients relapsing late, despite an early trend in favor of second SCT, survival was comparable for patients receiving a second SCT compared with non retransplanted patients (median survival 363.5 vs 162 days, P=0.49). Disappointingly, our results do not demonstrate an important survival benefit for a second T-replete allogeneic SCT to treat relapse following a TCD SCT.

  12. Factors associated with relapse in schizophrenia

    African Journals Online (AJOL)

    increases the economic burden on health care systems because of its associated morbidity .... Depression in schizophrenia has been associated with higher rates of relapse ... The researchers approached the psychiatric nursing staff of mental.

  13. Relapses in Multiple Sclerosis: Definition, Pathophysiology, Features, Imitators, and Treatment

    Directory of Open Access Journals (Sweden)

    Serhan Sevim

    2016-09-01

    Full Text Available Relapse in multiple sclerosis (MS is defined as a neurologic deficit associated with an acute inflammatory demyelinating event that lasts at least 24 hours in the absence of fever and infection. Myelinoclasis and axonal transection occur in relapses. Diagnosis, prognosis, treatment, and many other features of the disease are directly related to the relapses. MS starts as the relapsing-remitting (RRMS form in 85% of patients. A large number of relapses in the first years, polysymptomatic relapses, and pyramidal system, brain stem, and spinal cord involvement are signs of a poor outcome. The average frequency of relapses is approximately one per year during the first years of RRMS. The frequency of relapses increases during systemic infections, psychological stress, and in the postpartum first 3 months. Seventy-five percent of relapses are monosymptomatic. Pseudo-relapses and paroxysmal symptoms are distinguished from relapses by their sudden onset, sudden termination, and shorter duration. Contrast enhancement is valuable in imaging, but undetectable in most relapses. The regression in the first few weeks of relapses is explained by reduction of the edema, and by remyelination in the following months. Relapses and their features are also among the main determinants of treatment. High-dose methylprednisolone and early treatment with adrenocorticotropic hormone reduce post-relapse disability and shorten the duration of relapses. Plasmapheresis is a good option for patients who do not respond to steroid treatment. Identification of relapses by patients and physicians, distinguishing them from imitators, proper evaluation, treatment when necessary, and monitoring the results are of great importance for patients with MS. The educational levels of patients and physicians regarding these parameters should be increased. Well-designed studies that evaluate the long-term effect of relapse treatment on disability are needed.

  14. Multiple-clone activation of hypnozoites is the leading cause of relapse in Plasmodium vivax infection.

    Directory of Open Access Journals (Sweden)

    Flávia Carolina F de Araujo

    Full Text Available BACKGROUND: Plasmodium vivax infection is characterized by a dormant hepatic stage, the hypnozoite that is activated at varying periods of time after clearance of the primary acute blood-stage, resulting in relapse. Differentiation between treatment failure and new infections requires characterization of initial infections, relapses, and clone multiplicity in vivax malaria infections. METHODOLOGY/PRINCIPAL FINDINGS: Parasite DNA obtained from primary/relapse paired blood samples of 30 patients with P. vivax infection in Brazil was analyzed using 10 molecular markers (8 microsatellites and MSP-1 blocks 2 and 10. Cloning of PCR products and genotyping was used to identify low-frequency clones of parasites. We demonstrated a high frequency of multiple-clone infections in both primary and relapse infections. Few alleles were identified per locus, but the combination of these alleles produced many haplotypes. Consequently, the majority of parasites involved in relapse showed haplotypes that were distinct from those of primary infections. Plasmodium vivax relapse was characterized by temporal variations in the predominant parasite clones. CONCLUSIONS/SIGNIFICANCE: The high rate of low frequency alleles observed in both primary and relapse infections, along with temporal variation in the predominant alleles, might be the source of reported heterologous hypnozoite activation. Our findings complicate the concept of heterologous activation, suggesting the involvement of undetermined mechanisms based on host or environmental factors in the simultaneous activation of multiple clones of hypnozoites.

  15. High Strain Rate Characterisation of Composite Materials

    DEFF Research Database (Denmark)

    Eriksen, Rasmus Normann Wilken

    -reinforced polymers, were considered, and it was first shown that the loading history controls equilibrium process. Then the High-speed servo-hydraulic test machine was analysed in terms its ability to create a state of constant strain rate in the specimen. The invertible inertial forces in the load train prevented...... from designing and constructing a high-speed servo-hydraulic test machine and by performing a comprehensive test series. The difficulties encountered in the test work could be addressed with the developed analysis. The conclusion was that the High-speed servo-hydraulic test machine is less suited...... for testing fibre-reinforced polymers due to their elastic behaviour and low strain to failure. This is problematic as the High-speed servo-hydraulic test machine closes the gap between quasi-static tests rates and lower strain rates, which are achievable with the Split Hopkinson Pressure Bar. The Split...

  16. High-Dose-Rate Brachytherapy Alone for Localized Prostate Cancer in Patients at Moderate or High Risk of Biochemical Recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Hoskin, Peter [Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex (United Kingdom); Rojas, Ana, E-mail: arc03@btconnect.com [Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex (United Kingdom); Lowe, Gerry; Bryant, Linda; Ostler, Peter; Hughes, Rob; Milner, Jessica; Cladd, Helen [Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex (United Kingdom)

    2012-03-15

    Purpose: To evaluate genitourinary (GU) and gastrointestinal (GI) morbidity and biochemical control of disease in patients with localized prostate adenocarcinoma treated with escalating doses per fraction of high-dose rate brachytherapy alone. Methods and Materials: A total of 197 patients were treated with 34 Gy in four fractions, 36 Gy in four fractions, 31.5 Gy in three fractions, or 26 Gy in two fractions. Median follow-up times were 60, 54, 36, and 6 months, respectively. Results: Incidence of early Grade {>=} 3 GU morbidity was 3% to 7%, and Grade 4 was 0% to 4%. During the first 12 weeks, the highest mean International Prostate Symptom Score (IPSS) value was 14, and between 6 months and 5 years it was 8. Grade 3 or 4 early GI morbidity was not observed. The 3-year actuarial rate of Grade 3 GU was 3% to 16%, and was 3% to 7% for strictures requiring surgery (4-year rate). An incidence of 1% Grade 3 GI events was seen at 3 years. Late Grade 4 GU or GI events were not observed. At 3 years, 99% of patients with intermediate-risk and 91% with high-risk disease were free of biochemical relapse (log-rank p = 0.02). Conclusions: There was no significant difference in urinary and rectal morbidity between schedules. Biochemical control of disease in patients with intermediate and high risk of relapse was good.

  17. Topotecan in the treatment of relapsed small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Elisabeth Quoix

    2008-12-01

    Full Text Available Elisabeth QuoixService de Pneumologie, Hôpitaux Universitaires, Strasbourg, FranceAbstract: Small cell lung cancer (SCLC represents about 15% to 20% of all lung cancers. Chemotherapy is the cornerstone of the treatment, cisplatin–etoposide combination being the most used combination as first-line therapy. Despite high initial chemosensitivity, most SCLC patients will experience relapse sooner or later. Unfortunately, second-line chemotherapy does not result in a high response rate like first-line therapy, most patients having developed wide chemoresistance. This chemoresistance is far more important in refractory patients, ie, those who never responded to first-line therapy or who relapsed within 3 months after the end of chemotherapy, than in sensitive patients, ie, those who relapse more than 3 months after the end of chemotherapy. Topotecan, a topoisomerase I inhibitor, is the most studied drug in this second-line setting and has proved its efficacy as a single agent and in combination. A phase III trial comparing oral topotecan to best supportive care (BSC in relapsed SCLC demonstrated a significant survival benefit as well as a better quality of life. Although the usual schedule is 1.5 mg/m2, days 1–5 intravenously, it is not convenient for patients with relapsed SCLC, especially those who are refractory because of their short survival expectation. Oral topotecan is of similar efficacy and much more convenient with limited stay in a treatment unit and has a comparable toxicity profile for these patients with short expected survival. Combination of topotecan with platinum salts or taxanes does not seem to improve further the outcome of the patients and thus single-agent therapy with topotecan is the standard treatment for relapsed SCLC.Keywords: topotecan, small cell lung cancer, chemoresistance

  18. Daily corticosteroids reduce infection-associated relapses in frequently relapsing nephrotic syndrome: a randomized controlled trial.

    Science.gov (United States)

    Gulati, Ashima; Sinha, Aditi; Sreenivas, Vishnubhatla; Math, Aparna; Hari, Pankaj; Bagga, Arvind

    2011-01-01

    Relapses of nephrotic syndrome often follow minor infections, commonly of the upper respiratory tract. Daily administration of maintenance prednisolone during intercurrent infections was examined to determine whether the treatment reduces relapse rates in children with frequently relapsing nephrotic syndrome. In a randomized controlled trial (nonblind, parallel group, tertiary-care hospital), 100 patients with idiopathic, frequently relapsing nephrotic syndrome eligible for therapy with prolonged low-dose, alternate-day prednisolone with or without levamisole were randomized to either receive their usual dose of alternate-day prednisolone daily for 7 days during intercurrent infections (intervention group) or continue alternate-day prednisolone (controls). Primary outcome was assessed by comparing the rates of infection-associated relapses at 12-month follow-up. Secondary outcomes were the frequency of infections and the cumulative amount of prednisolone received in both groups. Patients in the intervention group showed significantly lower infection-associated (rate difference, 0.7 episodes/patient per year; 95% confidence intervals [CI] 0.3, 1.1) and lower total relapse rates (0.9 episodes/patient per year, 95% CI 0.4, 1.4) without increase in steroid toxicity. Poisson regression, adjusted for occurrence of infections, showed that daily administration of prednisolone during infections independently resulted in 59% reduction in frequency of relapses (rate ratio, 0.41; 95% CI 0.3, 0.6). For every six patients receiving this intervention, one showed a reduction of relapse frequency to less than three per year. Daily administration of maintenance doses of prednisolone, during intercurrent infections, significantly reduces relapse rates and the proportion of children with frequently relapsing nephrotic syndrome.

  19. Thrombus Formation at High Shear Rates.

    Science.gov (United States)

    Casa, Lauren D C; Ku, David N

    2017-06-21

    The final common pathway in myocardial infarction and ischemic stroke is occlusion of blood flow from a thrombus forming under high shear rates in arteries. A high-shear thrombus forms rapidly and is distinct from the slow formation of coagulation that occurs in stagnant blood. Thrombosis at high shear rates depends primarily on the long protein von Willebrand factor (vWF) and platelets, with hemodynamics playing an important role in each stage of thrombus formation, including vWF binding, platelet adhesion, platelet activation, and rapid thrombus growth. The prediction of high-shear thrombosis is a major area of biofluid mechanics in which point-of-care testing and computational modeling are promising future directions for clinically relevant research. Further research in this area will enable identification of patients at high risk for arterial thrombosis, improve prevention and treatment based on shear-dependent biological mechanisms, and improve blood-contacting device design to reduce thrombosis risk.

  20. Comparison of enrofloxacin and ceftiofur sodium for the treatment of relapse of undifferentiated fever/bovine respiratory disease in feedlot cattle

    Science.gov (United States)

    Abutarbush, Sameeh M.; Schunicht, Oliver C.; Wildman, Brian K.; Hannon, Sherry J.; Jim, G. Kee; Ward, Tracy I.; Booker, Calvin W.

    2012-01-01

    This commercial field trial compared the efficacy of enrofloxacin and ceftiofur sodium in beef cattle at high risk of developing undifferentiated fever (UF), also known as bovine respiratory disease (BRD) that received tilmicosin at feedlot arrival, were diagnosed and initially treated for UF with tilmicosin, and subsequently required a second UF treatment (first relapse). Feedlot cattle (n = 463) were randomly assigned to 2 experimental groups: ENRO or CEF. Second UF relapse, 3rd UF relapse, overall case fatality and BRD case fatality rates were lower in the ENRO group than in the CEF group (P enrofloxacin than ceftiofur sodium for treatment of UF relapse. PMID:22753964

  1. High frame rate synthetic aperture duplex imaging

    DEFF Research Database (Denmark)

    Stuart, Matthias Bo; Tomov, Borislav Gueorguiev; Pihl, Michael Johannes

    2013-01-01

    aperture flow imaging as demonstrated in this paper. Synthetic aperture, directional beamforming, and cross-correlation are used to produce B-mode and vector velocity images at high frame rates. The frame rate equals the effective pulse repetition frequency of each imaging mode. Emissions for making the B...... estimation is −1.8% and the relative standard deviation 5.4%. The approach can thus estimate both high and low velocities with equal accuracy and thereby makes it possible to present vector flow images with a high dynamic range. Measurements are made using the SARUS research scanner, a linear array......Conventional color flow images are limited in velocity range and can either show the high velocities in systole or be optimized for the lower diastolic velocities. The full dynamics of the flow is, thus, hard to visualize. The dynamic range can be significantly increased by employing synthetic...

  2. [Relapse: causes and consequences].

    Science.gov (United States)

    Thomas, P

    2013-09-01

    Relapse after a first episode of schizophrenia is the recurrence of acute symptoms after a period of partial or complete remission. Due to its variable aspects, there is no operational definition of relapse able to modelise the outcome of schizophrenia and measure how the treatment modifies the disease. Follow-up studies based on proxys such as hospital admission revealed that 7 of 10 patients relapsed after a first episode of schizophrenia. The effectiveness of antipsychotic medications on relapse prevention has been widely demonstrated. Recent studies claim for the advantages of atypical over first generation antipsychotic medication. Non-adherence to antipsychotic represents with addictions the main causes of relapse long before some non-consensual factors such as premorbid functioning, duration of untreated psychosis and associated personality disorders. The consequences of relapse are multiple, psychological, biological and social. Pharmaco-clinical studies have demonstrated that the treatment response decreases with each relapse. Relapse, even the first one, will contribute to worsen the outcome of the disease and reduce the capacity in general functionning. Accepting the idea of continuing treatment is a complex decision in which the psychiatrist plays a central role besides patients and their families. The development of integrated actions on modifiable risk factors such as psychosocial support, addictive comorbidities, access to care and the therapeutic alliance should be promoted. Relapse prevention is a major goal of the treatment of first-episode schizophrenia. It is based on adherence to the maintenance treatment, identification of prodromes, family active information and patient therapeutical education. Copyright © 2013 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

  3. Baltimore District Tackles High Suspension Rates

    Science.gov (United States)

    Maxwell, Lesli A.

    2007-01-01

    This article reports on how the Baltimore District tackles its high suspension rates. Driven by an increasing belief that zero-tolerance disciplinary policies are ineffective, more educators are embracing strategies that do not exclude misbehaving students from school for offenses such as insubordination, disrespect, cutting class, tardiness, and…

  4. Endorectal high dose rate brachytherapy quality assurance

    International Nuclear Information System (INIS)

    Devic, S.; Vuong, T.; Evans, M.; Podgorsak, E.

    2008-01-01

    We describe our quality assurance method for preoperative high dose rate (HDR) brachytherapy of endorectal tumours. Reproduction of the treatment planning dose distribution on a daily basis is crucial for treatment success. Due to the cylindrical symmetry, two types of adjustments are necessary: applicator rotation and dose distribution shift along the applicator axis. (author)

  5. Patients with primary diffuse large B-cell lymphoma of female genital tract have high risk of central nervous system relapse.

    Science.gov (United States)

    Cao, Xin-xin; Li, Jian; Zhang, Wei; Duan, Ming-hui; Shen, Ti; Zhou, Dao-bin

    2014-06-01

    The objective of this study was to evaluate retrospectively the clinical characteristics, treatments, and outcomes of patients with primary diffuse large B-cell lymphoma (DLBCL) of the female genital tract. The basic characteristics, treatments, and outcomes of six patients diagnosed with primary DLBCL of the female genital tract, including the ovary, uterine cervix, and vagina, treated in our hospital between 2000 and 2012, were analyzed retrospectively. Seven of 323 (2.2 %) newly diagnosed DLBCLs were diagnosed as primary female genital tract DLBCL. Six patients with complete medical data were included in the analysis. The median age at diagnosis was 52.5 years (range 20-65). The presenting symptoms included abnormal vaginal bleeding, increased vaginal discharge, abdominal fullness, and abdominal pain. Two patients had stage IE disease and four patients had stage IIE disease. Treatment included chemotherapy only in five patients, and combined chemotherapy and localized radiation in one patient. After a median follow-up of 58 months, four patients showed relapse in the central nervous system and two had died from progressive disease. The median progression-free survival was 27 months and the median overall survival for this group has not been reached. Patients with primary female genital tract DLBCL may have poor outcomes and a high risk of central nervous system relapse. Central nervous system prophylaxis might be considered in addition to systemic chemotherapy for DLBCL of the female genital tract.

  6. Clinical features and relapse rates after surgery in type 1 autoimmune pancreatitis differ from type 2: a study of 114 surgically treated European patients.

    Science.gov (United States)

    Detlefsen, Sönke; Zamboni, Giuseppe; Frulloni, Luca; Feyerabend, Bernd; Braun, Felix; Gerke, Oke; Schlitter, Anna Melissa; Esposito, Irene; Klöppel, Günter

    2012-01-01

    At the recent consensus conference on autoimmune pancreatitis (AIP) in Honolulu, we presented preliminary data from our study of surgically treated AIP patients. Our data strongly supported the separation of AIP into type 1 and type 2. Our study is based on a total of 114 surgically treated European AIP patients. Our aims were to elucidate serum IgG4 elevation, other organ involvement, relapse of disease, steroid treatment and diabetes after surgery in 114 surgically treated European AIP patients. 88 pancreaticoduodenectomies, 22 left-sided resections and 4 total pancreatectomies were examined. All cases were graded for granulocytic epithelial lesions, IgG4-positive cells, storiform fibrosis, phlebitis and eosinophilic granulocytes. Follow-up data were obtained from 102/114 patients, mean follow-up was 5.3 years. Histologically, 63 (55.3%) of the 114 patients fulfilled the criteria of type 1 AIP, while 51 (44.7%) patients fulfilled the criteria of type 2 AIP. Type 1 AIP patients were older and more often males than type 2 AIP patients. Elevation of serum IgG4, involvement of extrapancreatic organs, disease relapse, systemic steroid treatment and diabetes after surgery were noted more often in type 1 AIP, while inflammatory bowel disease (IBD) was observed mainly in type 2 AIP. Histological typing of AIP is clinically important because type 1 AIP is part of the IgG4-related disease and type 2 AIP is associated with IBD. Our data also show that relapse of disease and steroid treatment after surgery occur more frequently in type 1 than in type 2 AIP. Copyright © 2012 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  7. [Central nervous system relapse in diffuse large B cell lymphoma: Risk factors].

    Science.gov (United States)

    Sancho, Juan-Manuel; Ribera, Josep-Maria

    2016-01-15

    Central nervous system (CNS) involvement by lymphoma is a complication associated, almost invariably, with a poor prognosis. The knowledge of the risk factors for CNS relapse is important to determine which patients could benefit from prophylaxis. Thus, patients with very aggressive lymphomas (such as lymphoblastic lymphoma or Burkitt's lymphoma) must systematically receive CNS prophylaxis due to a high CNS relapse rate (25-30%), while in patients with indolent lymphoma (such as follicular lymphoma or marginal lymphoma) prophylaxis is unnecessary. However, the question about CNS prophylaxis in patients with diffuse large B-cell lymphoma (DLBCL), the most common type of lymphoma, remains controversial. The information available is extensive, mainly based on retrospective and heterogeneous studies. There seems that immunochemotherapy based on rituximab reduces the CNS relapse rate. On the other hand, patients with increased serum lactate dehydrogenase plus more than one extranodal involvement seem to have a higher risk of CNS relapse, but a prophylaxis strategy based only on the presence of these 2 factors does not prevent all CNS relapses. Patients with involvement of testes or breast have high risk of CNS relapse and prophylaxis is mandatory. Finally, CNS prophylaxis could be considered in patients with DLBCL and renal or epidural space involvement, as well as in those cases with MYC rearrangements, although additional studies are necessary. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  8. High-dose-rate brachytherapy alone post-hysterectomy for endometrial cancer

    International Nuclear Information System (INIS)

    MacLeod, Craig; Fowler, Allan; Duval, Peter; D'Costa, Ieta; Dalrymple, Chris; Firth, Ian; Elliott, Peter; Atkinson, Ken; Carter, Jonathan

    1998-01-01

    Purpose: To evaluate the outcome of post-hysterectomy adjuvant vaginal high-dose-rate (HDR) brachytherapy. Methods and Materials: A retrospective analysis was performed on a series of 143 patients with endometrial cancer treated with HDR brachytherapy alone post-hysterectomy from 1985 to June 1993. Of these patients, 141 received 34 Gy in four fractions prescribed to the vaginal mucosa in a 2-week period. The median follow-up was 6.9 years. Patients were analyzed for treatment parameters, survival, local recurrence, distant relapse, and toxicity. Results: Five-year relapse free survival and overall survival was 100% and 88% for Stage 1A, 98% and 94% for Stage IB, 100% and 86% for Stage IC, and 92% and 92% for Stage IIA. The overall vaginal recurrence rate was 1.4%. The overall late-toxicity rate was low, and no RTOG grade 3, 4, or 5 complications were recorded. Conclusion: These results are similar to reported international series that have used either low-dose-rate or HDR brachytherapy. The biological effective dose was low for both acute and late responding tissues compared with some of the HDR brachytherapy series, and supports using this lower dose and possibly decreasing late side-effects with no apparent increased risk of vaginal recurrence

  9. High strain rate behaviour of polypropylene microfoams

    Directory of Open Access Journals (Sweden)

    Martínez A.B.

    2012-08-01

    Full Text Available Microcellular materials such as polypropylene foams are often used in protective applications and passive safety for packaging (electronic components, aeronautical structures, food, etc. or personal safety (helmets, knee-pads, etc.. In such applications the foams which are used are often designed to absorb the maximum energy and are generally subjected to severe loadings involving high strain rates. The manufacture process to obtain polymeric microcellular foams is based on the polymer saturation with a supercritical gas, at high temperature and pressure. This method presents several advantages over the conventional injection moulding techniques which make it industrially feasible. However, the effect of processing conditions such as blowing agent, concentration and microfoaming time and/or temperature on the microstructure of the resulting microcellular polymer (density, cell size and geometry is not yet set up. The compressive mechanical behaviour of several microcellular polypropylene foams has been investigated over a wide range of strain rates (0.001 to 3000 s−1 in order to show the effects of the processing parameters and strain rate on the mechanical properties. High strain rate tests were performed using a Split Hopkinson Pressure Bar apparatus (SHPB. Polypropylene and polyethylene-ethylene block copolymer foams of various densities were considered.

  10. High strain rate behaviour of polypropylene microfoams

    Science.gov (United States)

    Gómez-del Río, T.; Garrido, M. A.; Rodríguez, J.; Arencón, D.; Martínez, A. B.

    2012-08-01

    Microcellular materials such as polypropylene foams are often used in protective applications and passive safety for packaging (electronic components, aeronautical structures, food, etc.) or personal safety (helmets, knee-pads, etc.). In such applications the foams which are used are often designed to absorb the maximum energy and are generally subjected to severe loadings involving high strain rates. The manufacture process to obtain polymeric microcellular foams is based on the polymer saturation with a supercritical gas, at high temperature and pressure. This method presents several advantages over the conventional injection moulding techniques which make it industrially feasible. However, the effect of processing conditions such as blowing agent, concentration and microfoaming time and/or temperature on the microstructure of the resulting microcellular polymer (density, cell size and geometry) is not yet set up. The compressive mechanical behaviour of several microcellular polypropylene foams has been investigated over a wide range of strain rates (0.001 to 3000 s-1) in order to show the effects of the processing parameters and strain rate on the mechanical properties. High strain rate tests were performed using a Split Hopkinson Pressure Bar apparatus (SHPB). Polypropylene and polyethylene-ethylene block copolymer foams of various densities were considered.

  11. Relapse Prevention: An Introduction to Marlatt’s Cognitive – Behavior Model

    Directory of Open Access Journals (Sweden)

    Farshad Nemati

    2002-10-01

    Full Text Available High rate of relapse after apparently successful treatment is a common problem facing with most approaches to treatment of drug dependency. This has led to the development of a variety of strategies for relapse prevention. Among these, Marlatt’s cognitive – behavioural model has received a good deal of attention. It is based on two major axes: Identification of warning sings and development of necessary skills for coping with risk situations. In fact, client’s perception relating to their abilities to cope with high - risk situations can lead to lapse. Relapes is a function of client’s reaction to this initial lapes.Since formal training for addiction counsellors typically includes instruction on Marlatt’s relapes taxonomy and intervention strategies have been designed based on his classification systems of high – risk stimuli, it is nececsary for addiction counsellors to become familiar with this system. This paper presents an overview of Marlatts taxonomy of high – risk situations for relapse and his approach to relapse prevention. Special attention is given to definition of relapse, stages of relaps and relapse prevention strategies.

  12. High dose rate endobronchial brachytherapy - treatment technique

    International Nuclear Information System (INIS)

    Carvalho, Heloisa de Andrade; Aisen, Salim; Haddad, Cecilia Maria Kalil; Nadalin, Wladimir; Pedreira Junior, Wilson Leite; Chavantes, Maria Cristina

    1998-01-01

    High dose rate endobronchial brachytherapy is efficient in symptom relief due to obstructive endobronchial malignancies. However, it's role in survival improvement for patients with lung cancer is not yet established. The use of this treatment in increasing, specially in the developing countries. The purpose of this paper is to present the treatment technique used in the Radiotherapy Department of the Hospital da Clinicas, University of Sao Paulo, based on an experience of 60 cases treated with 180 procedures. Some practical suggestions and rules adopted in the Department are described. The severe complications rate is 6.7%, demonstrating an adequate patient selection associated with the technique utilized. (author)

  13. Electronics for very high rate tracking detectors

    International Nuclear Information System (INIS)

    Williams, H.H.; Dressnandt, N.; Ekenberg, T.; Gerds, E.J.; Newcomer, F.M.; Tedja, S.; Van Berg, R.; Van der Speigel, J.

    1995-01-01

    Results are presented on a system of electronics designed for very high rate tracking detectors at the SSC and LHC. The primary goal was a system for signal detection, time measurement, and readout for the straw tracker for SDC. An integrated circuit incorporating eight channels of amplifier-shaper-discriminator (including detector tail cancellation), and two different integrated circuits for time measurement are described. The performance of tracking measurements up to counting rates of 8 MHz per wire is reported, as well as preliminary results from a baseline restoration circuit. (orig.)

  14. Prognostic value of comorbidity for auto-SCT eligibility and outcome in relapsed or refractory aggressive non-Hodgkin's lymphoma.

    Science.gov (United States)

    Plattel, W J; Kluin-Nelemans, H C; de Bock, G H; van Imhoff, G W

    2011-06-01

    Salvage reinduction therapy followed by high-dose chemotherapy (HDCT) and auto-SCT is the treatment of choice for fit patients with refractory or relapsed aggressive non-Hodgkin's lymphoma (NHL). We assessed the prognostic value of comorbidity at the time of relapse to predict receipt of auto-SCT and outcome. We analyzed 156 consecutive NHL patients, referred to our center between 1999 and 2007 for salvage reinduction therapy, followed by HDCT and auto-SCT. Comorbidity according to the hematopoietic SCT comorbidity index was scored at relapse and directly before HDCT and auto-SCT. Primary end points were actual receipt of auto-SCT and survival. At relapse, comorbidity scores of 0, 1-2 and ≥3 were found among 64 (41%), 62 (40%) and 30 (19%) patients, respectively. Ultimately, 95 patients received auto-SCT. Higher comorbidity scores at relapse were associated with significantly less chance of receiving auto-SCT and with inferior OS, independently from secondary age-adjusted International Prognostic Index (sAAIPI) scores. For transplanted patients, OS rates at 5 years were 62, 30 and 17% for relapse comorbidity scores of 0, 1-2 and ≥3, respectively. In patients with relapsed NHL, comorbidity at relapse is associated with receipt of auto-SCT and subsequent survival independently from the sAAIPI.

  15. High strain rate studies in rock

    International Nuclear Information System (INIS)

    Grady, D.

    1977-01-01

    Dynamic compression studies using high velocity impact are usually considered to involve a catastrophic process of indeterminate loading rate by which a material is brough to a shock compressed state. Although this is frequently the case, methods are also available to control the rate of strain during the shock compression process. One of the most accurate of these methods makes use of the anomalous nonlinear elastic property of glass to transform an initial shock or step wave input into a ramp wave of known amplitude and duration. Fused silica is the most carefully calibrated material for this purpose and, when placed between the test specimen and the impact projectile, can provide loading strain rates in the range of 10 4 /s to 10 6 /s for final stress states of approximately 3.9 GPa or less.Ramp wave compression experiments have been conducted on dolomite at strain rates of 3 x 10 4 /s. Both initial yielding and subsequent deformation at this strain rate agrees well with previous shock wave studies (epsilon-dotapprox.10 6 /s) and differs substantially from quasi-static measurements (epsilon-dotapprox.10 -4 /s). The ramp wave studies have also uncovered a pressure-induced phase transition in dolomite initiating at 4.0 GPa

  16. Proton Therapy as Salvage Treatment for Local Relapse of Prostate Cancer Following Cryosurgery or High-Intensity Focused Ultrasound

    International Nuclear Information System (INIS)

    Holtzman, Adam L.; Hoppe, Bradford S.; Letter, Haley P.; Bryant, Curtis; Nichols, Romaine C.; Henderson, Randal H.; Mendenhall, William M.; Morris, Christopher G.; Williams, Christopher R.; Li, Zuofeng; Mendenhall, Nancy P.

    2016-01-01

    Purpose: Local recurrence of prostate cancer after cryosurgery (CS) and high-intensity focused ultrasound (HIFU) is an emerging problem for which optimal management is unknown. Proton therapy (PT) may offer advantages over other local therapeutic options. This article reviews a single institution's experience using PT for salvage of local recurrent disease after HIFU or CS. Methods and Materials: We reviewed the medical records of 21 consecutive patients treated with salvage PT following a local recurrence of prostate cancer after CS (n=12) or HIFU (n=9) between January 2007 and July 2014. Patients were treated to a median dose of 74 Gy(relative biological effectiveness [RBE]; range: 74-82 Gy[RBE]) and 8 patients received androgen deprivation therapy with radiation therapy. Patients were evaluated for quality of life (QOL) by using the Expanded Prostate Index Composite questionnaire and toxicity by using Common Terminology Criteria for Adverse Events, version 3.0, weekly during treatment, every 6 months for 2 years after treatment, and then annually. Results: Median follow-up was 37 months (range: 6-95 months). The 3-year biochemical progression-free survival (bPFS) rate was 77%. The 3-year grade 3 toxicity rate was 17%; however, 2 of these patients had pre-existing grade 3 GU toxicities from their HIFU/CRYO prior to PT. At 1 year, bowel summary, urinary incontinence, and urinary obstructive QOL scores declined, but only the bowel QOL score at 12 months met the minimally important difference threshold. Conclusions: PT achieved a high rate of bPFS with acceptable toxicity and minimal changes in QOL scores compared with baseline pre-PT functions. Although most patients have done fairly well, the study size is small, follow-up is short, and early results suggest that outcomes with PT for salvage after HIFU or CS failure are inferior to outcomes with PT given in the de novo setting with respect to disease control, toxicity, and QOL.

  17. Proton Therapy as Salvage Treatment for Local Relapse of Prostate Cancer Following Cryosurgery or High-Intensity Focused Ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Holtzman, Adam L. [University of Florida Health Proton Therapy Institute, University of Florida College of Medicine, Jacksonville, Florida (United States); Hoppe, Bradford S., E-mail: bhoppe@floridaproton.org [University of Florida Health Proton Therapy Institute, University of Florida College of Medicine, Jacksonville, Florida (United States); Letter, Haley P.; Bryant, Curtis; Nichols, Romaine C.; Henderson, Randal H.; Mendenhall, William M.; Morris, Christopher G. [University of Florida Health Proton Therapy Institute, University of Florida College of Medicine, Jacksonville, Florida (United States); Williams, Christopher R. [Department of Surgery, University of Florida College of Medicine, Jacksonville, Florida (United States); Li, Zuofeng; Mendenhall, Nancy P. [University of Florida Health Proton Therapy Institute, University of Florida College of Medicine, Jacksonville, Florida (United States)

    2016-05-01

    Purpose: Local recurrence of prostate cancer after cryosurgery (CS) and high-intensity focused ultrasound (HIFU) is an emerging problem for which optimal management is unknown. Proton therapy (PT) may offer advantages over other local therapeutic options. This article reviews a single institution's experience using PT for salvage of local recurrent disease after HIFU or CS. Methods and Materials: We reviewed the medical records of 21 consecutive patients treated with salvage PT following a local recurrence of prostate cancer after CS (n=12) or HIFU (n=9) between January 2007 and July 2014. Patients were treated to a median dose of 74 Gy(relative biological effectiveness [RBE]; range: 74-82 Gy[RBE]) and 8 patients received androgen deprivation therapy with radiation therapy. Patients were evaluated for quality of life (QOL) by using the Expanded Prostate Index Composite questionnaire and toxicity by using Common Terminology Criteria for Adverse Events, version 3.0, weekly during treatment, every 6 months for 2 years after treatment, and then annually. Results: Median follow-up was 37 months (range: 6-95 months). The 3-year biochemical progression-free survival (bPFS) rate was 77%. The 3-year grade 3 toxicity rate was 17%; however, 2 of these patients had pre-existing grade 3 GU toxicities from their HIFU/CRYO prior to PT. At 1 year, bowel summary, urinary incontinence, and urinary obstructive QOL scores declined, but only the bowel QOL score at 12 months met the minimally important difference threshold. Conclusions: PT achieved a high rate of bPFS with acceptable toxicity and minimal changes in QOL scores compared with baseline pre-PT functions. Although most patients have done fairly well, the study size is small, follow-up is short, and early results suggest that outcomes with PT for salvage after HIFU or CS failure are inferior to outcomes with PT given in the de novo setting with respect to disease control, toxicity, and QOL.

  18. Relapsed childhood acute lymphoblastic leukemia in the Nordic countries

    DEFF Research Database (Denmark)

    Oskarsson, Trausti; Söderhäll, Stefan; Arvidson, Johan

    2016-01-01

    Relapse is the main reason for treatment failure in childhood acute lymphoblastic leukemia. Despite improvements in the up-front therapy, survival after relapse is still relatively poor, especially for high-risk relapses. The aims of this study were to assess outcomes following acute lymphoblastic...... leukemia relapse after common initial Nordic Society of Paediatric Haematology and Oncology protocol treatment; to validate currently used risk stratifications, and identify additional prognostic factors for overall survival. Altogether, 516 of 2735 patients (18.9%) relapsed between 1992 and 2011 and were...

  19. High repetition rate intense ion beam source

    International Nuclear Information System (INIS)

    Hammer, D.A.; Glidden, S.C.; Noonan, B.

    1992-01-01

    This final report describes a ≤ 150kV, 40kA, 100ns high repetition rate pulsed power system and intense ion beam source which is now in operation at Cornell University. Operation of the Magnetically-controlled Anode Plasma (MAP) ion diode at > 100Hz (burst mode for up to 10 pulse bursts) provides an initial look at repetition rate limitations of both the ion diode and beam diagnostics. The pulsed power systems are capable of ≥ 1kHz operation (up to 10 pulse bursts), but ion diode operation was limited to ∼100Hz because of diagnostic limitations. By varying MAP diode operating parameters, ion beams can be extracted at a few 10s of keV or at up to 150keV, the corresponding accelerating gap impedance ranging from about 1Ω to about 10Ω. The ability to make hundreds of test pulses per day at an average repetition rate of about 2 pulses per minute permits statistical analysis of diode operation as a function of various parameters. Most diode components have now survived more than 10 4 pulses, and the design and construction of the various pulsed power components of the MAP diode which have enabled us to reach this point are discussed. A high speed data acquisition system and companion analysis software capable of acquiring pulse data at 1ms intervals (in bursts of up to 10 pulses) and processing it in ≤ min is described

  20. High strain rate deformation of layered nanocomposites.

    Science.gov (United States)

    Lee, Jae-Hwang; Veysset, David; Singer, Jonathan P; Retsch, Markus; Saini, Gagan; Pezeril, Thomas; Nelson, Keith A; Thomas, Edwin L

    2012-01-01

    Insight into the mechanical behaviour of nanomaterials under the extreme condition of very high deformation rates and to very large strains is needed to provide improved understanding for the development of new protective materials. Applications include protection against bullets for body armour, micrometeorites for satellites, and high-speed particle impact for jet engine turbine blades. Here we use a microscopic ballistic test to report the responses of periodic glassy-rubbery layered block-copolymer nanostructures to impact from hypervelocity micron-sized silica spheres. Entire deformation fields are experimentally visualized at an exceptionally high resolution (below 10 nm) and we discover how the microstructure dissipates the impact energy via layer kinking, layer compression, extreme chain conformational flattening, domain fragmentation and segmental mixing to form a liquid phase. Orientation-dependent experiments show that the dissipation can be enhanced by 30% by proper orientation of the layers.

  1. High strain rate deformation of layered nanocomposites

    Science.gov (United States)

    Lee, Jae-Hwang; Veysset, David; Singer, Jonathan P.; Retsch, Markus; Saini, Gagan; Pezeril, Thomas; Nelson, Keith A.; Thomas, Edwin L.

    2012-11-01

    Insight into the mechanical behaviour of nanomaterials under the extreme condition of very high deformation rates and to very large strains is needed to provide improved understanding for the development of new protective materials. Applications include protection against bullets for body armour, micrometeorites for satellites, and high-speed particle impact for jet engine turbine blades. Here we use a microscopic ballistic test to report the responses of periodic glassy-rubbery layered block-copolymer nanostructures to impact from hypervelocity micron-sized silica spheres. Entire deformation fields are experimentally visualized at an exceptionally high resolution (below 10 nm) and we discover how the microstructure dissipates the impact energy via layer kinking, layer compression, extreme chain conformational flattening, domain fragmentation and segmental mixing to form a liquid phase. Orientation-dependent experiments show that the dissipation can be enhanced by 30% by proper orientation of the layers.

  2. High-frame-rate digital radiographic videography

    Science.gov (United States)

    King, Nicholas S. P.; Cverna, Frank H.; Albright, Kevin L.; Jaramillo, Steven A.; Yates, George J.; McDonald, Thomas E.; Flynn, Michael J.; Tashman, Scott

    1994-10-01

    High speed x-ray imaging can be an important tool for observing internal processes in a wide range of applications. In this paper we describe preliminary implementation of a system having the eventual goal of observing the internal dynamics of bone and joint reactions during loading. Two Los Alamos National Laboratory (LANL) gated and image intensified camera systems were used to record images from an x-ray image convertor tube to demonstrate the potential of high frame-rate digital radiographic videography in the analysis of bone and joint dynamics of the human body. Preliminary experiments were done at LANL to test the systems. Initial high frame-rate imaging (from 500 to 1000 frames/s) of a swinging pendulum mounted to the face of an X-ray image convertor tube demonstrated high contrast response and baseline sensitivity. The systems were then evaluated at the Motion Analysis Laboratory of Henry Ford Health Systems Bone and Joint Center. Imaging of a 9 inch acrylic disk with embedded lead markers rotating at approximately 1000 RPM, demonstrated the system response to a high velocity/high contrast target. By gating the P-20 phosphor image from the X-ray image convertor with a second image intensifier (II) and using a 100 microsecond wide optical gate through the second II, enough prompt light decay from the x-ray image convertor phosphor had taken place to achieve reduction of most of the motion blurring. Measurement of the marker velocity was made by using video frames acquired at 500 frames/s. The data obtained from both experiments successfully demonstrated the feasibility of the technique. Several key areas for improvement are discussed along with salient test results and experiment details.

  3. High counting rate resistive-plate chamber

    International Nuclear Information System (INIS)

    Peskov, V.; Anderson, D.F.; Kwan, S.

    1993-05-01

    Parallel-plate avalanche chambers (PPAC) are widely used in physics experiments because they are fast ( 5 counts/mm 2 . A resistive-plate chamber (RPC) is similar to the PPAC in construction except that one or both of the electrodes are made from high resistivity (≥10 10 Ω·cm) materials. In practice RPCs are usually used in the spark mode. Resistive electrodes are charged by sparks, locally reducing the actual electric field in the gap. The size of the charged surface is about 10 mm 2 , leaving the rest of the detector unaffected. Therefore, the rate capability of such detectors in the spark mode is considerably higher than conventional spark counters. Among the different glasses tested the best results were obtained with electron type conductive glasses, which obey Ohm's law. Most of the work with such glasses was done with high pressure parallel-plate chambers (10 atm) for time-of-flight measurements. Resistive glasses have been expensive and produced only in small quantities. Now resistive glasses are commercially available, although they are still expensive in small scale production. From the positive experience of different groups working with the resistive glasses, it was decided to review the old idea to use this glass for the RPC. This work has investigated the possibility of using the RPC at 1 atm and in the avalanche mode. This has several advantages: simplicity of construction, high rate capability, low voltage operation, and the ability to work with non-flammable gases

  4. ERCC2 2251A>C genetic polymorphism was highly correlated with early relapse in high-risk stage II and stage III colorectal cancer patients: A preliminary study

    Directory of Open Access Journals (Sweden)

    Lee Su-Chen

    2008-02-01

    Full Text Available Abstract Background Early relapse in colorectal cancer (CRC patients is attributed mainly to the higher malignant entity (such as an unfavorable genotype, deeper tumor invasion, lymph node metastasis and advance cancer stage and poor response to chemotherapy. Several investigations have demonstrated that genetic polymorphisms in drug-targeted genes, metabolizing enzymes, and DNA-repairing enzymes are all strongly correlated with inter-individual differences in the efficacy and toxicity of many treatment regimens. This preliminary study attempts to identify the correlation between genetic polymorphisms and clinicopathological features of CRC, and evaluates the relationship between genetic polymorphisms and chemotherapeutic susceptibility of Taiwanese CRC patients. To our knowledge, this study discusses, for the first time, early cancer relapse and its indication by multiple genes. Methods Six gene polymorphisms functional in drug-metabolism – GSTP1 Ile105Val, ABCB1 Ile1145Ile, MTHFR Ala222Val, TYMS double (2R or triple (3R tandem repeat – and DNA-repair genes – ERCC2 Lys751Gln and XRCC1 Arg399Gln – were assessed in 201 CRC patients using a polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP technique and DNA sequencing. Patients were diagnosed as either high-risk stage II (T2 and 3 N0 M0 or III (any T N1 and 2 M0 and were administered adjuvant chemotherapy regimens that included 5-fluorouracil (5FU and leucovorin (LV. The correlations between genetic polymorphisms and patient clinicopathological features and relapses were investigated. Results In this study, the distributions of GSTP1 (P = 0.003, ABCB1 (P = 0.001, TYMS (P ERCC2 (P XRCC1 (P = 0.006 genotypes in the Asian population, with the exception of MTHFR (P = 0.081, differed significantly from their distributions in a Caucasian population. However, the unfavorable genotype ERCC2 2251A>C (P = 0.006, tumor invasion depth (P = 0.025, lymph node metastasis (P = 0

  5. On high interest rates in Brazil

    Directory of Open Access Journals (Sweden)

    Francisco Lafaiete Lopes

    2014-03-01

    Full Text Available This article examines the question of why interest rates are so high in Brazil as compared to the international average. It looks at theoretical arguments based on excessive government deficits, structural lack of private savings, inflation bias, excessive investment demand and fear of floating. An informal look at the evidence does not strongly corroborate any of these arguments. Hence a wise central bank should consider "testing" the market to make sure it is not dealing with an extreme equilibrium configuration or a long standing disequilibrium.

  6. Flashing motor at high transition rate

    International Nuclear Information System (INIS)

    Ai Baoquan; Wang Liqiu; Liu Lianggang

    2007-01-01

    The movement of a Brownian particle in a fluctuating two-state periodic potential is investigated. At high transition rate, we use a perturbation method to obtain the analytical solution of the model. It is found that the net current is a peaked function of thermal noise, barrier height and the fluctuation ratio between the two states. The thermal noise may facilitate the directed motion at a finite intensity. The asymmetry parameter of the potential is sensitive to the direction of the net current

  7. The efficacy of natalizumab in patients with relapsing multiple sclerosis: subgroup analyses of AFFIRM and SENTINEL.

    LENUS (Irish Health Repository)

    Hutchinson, Michael

    2012-02-01

    The AFFIRM and SENTINEL studies showed that natalizumab was effective both as monotherapy and in combination with interferon beta (IFNbeta)-1a in patients with relapsing multiple sclerosis (MS). Further analyses of AFFIRM and SENTINEL data were conducted to determine the efficacy of natalizumab in prespecified patient subgroups according to baseline characteristics: relapse history 1 year before randomization (1, 2, > or = 3), Expanded Disability Status Scale score (< or = 3.5, > 3.5), number of T2 lesions (< 9, > or = 9), presence of gadolinium-enhancing (Gd+) lesions (0, > or = 1), age (< 40, > or = 40) and gender (male, female). A post hoc analysis was conducted to determine the efficacy of natalizumab in patients with highly active disease (i. e., > or = 2 relapses in the year before study entry and > or = 1 Gd+ lesion at study entry). In both AFFIRM and SENTINEL studies natalizumab reduced the annualized relapse rates across all subgroups (except the small subgroups with < 9 baseline T2 lesions) over 2 years. In AFFIRM, natalizumab significantly reduced the risk of sustained disability progression in most subgroups. In SENTINEL, natalizumab significantly reduced the risk of sustained disability progression in the following subgroups: > or = 9 T2 lesions at baseline, > or = 1 Gd+ lesions at baseline, female patients and patients < 40 years of age. Natalizumab reduced the risk of disability progression by 64 % and relapse rate by 81 % in treatment- naive patients with highly active disease and by 58 % and 76 %, respectively, in patients with highly active disease despite IFNbeta-1a treatment. These results indicate that natalizumab is effective in reducing disability progression and relapses in patients with relapsing MS, particularly in patients with highly active disease.

  8. Potential risk factors associated with risk for drop-out and relapse during and following withdrawal of opioid prescription medication.

    Science.gov (United States)

    Heiwe, Susanne; Lönnquist, Ingeborg; Källmén, Håkan

    2011-10-01

    Withdrawal of opioid medication in patients with chronic pain has a drop-out and relapse problem. To evaluate if depressive symptoms, anxiety and pain intensity are potential risk factors for drop-out or relapse during the withdrawal process. Further, to assess internal consistency of scales for assessment of these potential risk factors. Twenty-nine patients were included. After 2 years 28 of these were followed-up. Those with depressive symptoms at baseline had a significant risk for drop-out from the withdrawal program (odds ratio 1.37) and relapse into use of opioids at follow-up (odds ratio 1.44). Drop-outs rated depressive symptoms significantly higher before detoxification. Those who relapsed rated significantly higher for pain intensity, depressive symptoms and abstinence prior to withdrawal. All scales had high reliability. To avoid drop-out and relapse clinical practice need to screen for depressive symptoms, pain intensity, and abstinence. This article presents significant reliability of scales useful within dependency centers. They can be used to identify these risk factors for drop-out and relapse, respectively, when initiating the withdrawal process. Taking these risk factors into consideration could improve the outcome of the withdrawal process by preventing drop-out and relapse. Copyright © 2011 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

  9. High dose rate brachytherapy for oral cancer

    International Nuclear Information System (INIS)

    Yamazaki, Hideya; Yoshida, Ken; Yoshioka, Yasuo; Shimizutani, Kimishige; Koizumi, Masahiko; Ogawa, Kazuhiko; Furukawa, Souhei

    2013-01-01

    Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer. (author)

  10. High dose rate brachytherapy for oral cancer.

    Science.gov (United States)

    Yamazaki, Hideya; Yoshida, Ken; Yoshioka, Yasuo; Shimizutani, Kimishige; Furukawa, Souhei; Koizumi, Masahiko; Ogawa, Kazuhiko

    2013-01-01

    Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer.

  11. Ultra Fast, High Rep Rate, High Voltage Spark Gap Pulser

    Science.gov (United States)

    1995-07-01

    current rise time. The spark gap was designed to have a coaxial geometry reducing its inductance. Provisions were made to pass flowing gas between the...ULTRA FAST, HIGH REP RATE, HIGH VOLTAGE SPARK GAP PULSER Robert A. Pastore Jr., Lawrence E. Kingsley, Kevin Fonda, Erik Lenzing Electrophysics and...Modeling Branch AMSRL-PS-EA Tel.: (908)-532-0271 FAX: (908)-542-3348 U.S. Army Research Laboratory Physical Sciences Directorate Ft. Monmouth

  12. Analysis of renal impairment in MM-003, a phase III study of pomalidomide + low - dose dexamethasone versus high - dose dexamethasone in refractory or relapsed and refractory multiple myeloma

    Science.gov (United States)

    Weisel, Katja C.; Dimopoulos, Meletios A.; Moreau, Philippe; Lacy, Martha Q.; Song, Kevin W.; Delforge, Michel; Karlin, Lionel; Goldschmidt, Hartmut; Banos, Anne; Oriol, Albert; Alegre, Adrian; Chen, Christine; Cavo, Michele; Garderet, Laurent; Ivanova, Valentina; Martinez-Lopez, Joaquin; Knop, Stefan; Yu, Xin; Hong, Kevin; Sternas, Lars; Jacques, Christian; Zaki, Mohamed H.; Miguel, Jesus San

    2016-01-01

    Pomalidomide + low-dose dexamethasone is effective and well tolerated for refractory or relapsed and refractory multiple myeloma after bortezomib and lenalidomide failure. The phase III trial MM-003 compared pomalidomide + low-dose dexamethasone with high-dose dexamethasone. This subanalysis grouped patients by baseline creatinine clearance ≥ 30 − < 60 mL/min (n=93, pomalidomide + low-dose dexamethasone; n=56, high-dose dexamethasone) or ≥ 60 mL/min (n=205, pomalidomide + low-dose dexamethasone; n=93, high-dose dexamethasone). Median progression-free survival was similar for both subgroups and favored pomalidomide + low-dose dexamethasone versus high-dose dexamethasone: 4.0 versus 1.9 months in the group with baseline creatinine clearance ≥ 30 − < 60 mL/min (P<0.001) and 4.0 versus 2.0 months in the group with baseline creatinine clearance ≥ 60 mL/min (P<0.001). Median overall survival for pomalidomide + low-dose dexamethasone versus high-dose dexamethasone was 10.4 versus 4.9 months (P=0.030) and 15.5 versus 9.2 months (P=0.133), respectively. Improved renal function, defined as an increase in creatinine clearance from < 60 to ≥ 60 mL/min, was similar in pomalidomide + low-dose dexamethasone and high-dose dexamethasone patients (42% and 47%, respectively). Improvement in progression-free and overall survival in these patients was comparable with that in patients without renal impairment. There was no increase in discontinuations of therapy, dose modifications, and adverse events in patients with moderate renal impairment. Pomalidomide at a starting dose of 4 mg + low-dose dexamethasone is well tolerated in patients with refractory or relapsed and refractory multiple myeloma, and of comparable efficacy if moderate renal impairment is present. This trial was registered with clinicaltrials.gov identifier 01311687 and EudraCT identifier 2010-019820-30. PMID:27081177

  13. Relapsing polychondritis: commentary

    Directory of Open Access Journals (Sweden)

    R.D. Altman

    2011-09-01

    Full Text Available Relapsing Polychondritis (RP is a multisystem disease of unknown etiology characterized by episodic inflammation of cartilage and potentially progressive degeneration of cartilaginous tissue, such as auricular, nasal and laryngotracheobronchial cartilage. However, many other proteoglycan- rich structures may be involved, such as inner ear, eyes, blood vessels, heart and kidneys (1- 4. RP was first described by Jacksh-Wartenhorst in 1923, who named it “polychondropathia” (5. Pearson et al. (6 introduced the term “relapsing polychondritis” in 1960...

  14. Operation of high rate microstrip gas chambers

    CERN Document Server

    Barr, A J; Bouclier, Roger; Capéans-Garrido, M; Dominik, Wojciech; Manzin, G; Million, Gilbert; Hoch, M; Ropelewski, Leszek; Sauli, Fabio; Sharma, A

    1996-01-01

    We describe recent measurements carried out in well controlled and reproducible conditions to help understanding the factors affecting the short and long term behaviour of Microstrip Gas Chambers. Special care has been taken concerning the gas purity and choice of materials used in the system and for the detectors construction. Detectors built on glasses with surface resistivity in the range $10^{13}-10^{15} \\Omega/\\Box$ have shown satisfactory performance as they do not show charging-up process at high rate and stand the large doses required for the future high luminosity experiments (~10 mC·cm-1·yr-1). Concerning the lifetime measurements, it has been observed that chambers manufactured on high-resistivity glass are far more susceptible of suffering ageing than detectors made on low resistivity, electron-conducting supports, independently of the metal used for the artwork (chromium or gold) at least in clean gas conditions. The successfully operation in the laboratory of detectors manufactured on diamond-...

  15. Consideration of wear rates at high velocity

    Science.gov (United States)

    Hale, Chad S.

    The development of the research presented here is one in which high velocity relative sliding motion between two bodies in contact has been considered. Overall, the wear environment is truly three-dimensional. The attempt to characterize three-dimensional wear was not economically feasible because it must be analyzed at the micro-mechanical level to get results. Thus, an engineering approximation was carried out. This approximation was based on a metallographic study identifying the need to include viscoplasticity constitutive material models, coefficient of friction, relationships between the normal load and velocity, and the need to understand wave propagation. A sled test run at the Holloman High Speed Test Track (HHSTT) was considered for the determination of high velocity wear rates. In order to adequately characterize high velocity wear, it was necessary to formulate a numerical model that contained all of the physical events present. The experimental results of a VascoMax 300 maraging steel slipper sliding on an AISI 1080 steel rail during a January 2008 sled test mission were analyzed. During this rocket sled test, the slipper traveled 5,816 meters in 8.14 seconds and reached a maximum velocity of 1,530 m/s. This type of environment was never considered previously in terms of wear evaluation. Each of the features of the metallography were obtained through micro-mechanical experimental techniques. The byproduct of this analysis is that it is now possible to formulate a model that contains viscoplasticity, asperity collisions, temperature and frictional features. Based on the observations of the metallographic analysis, these necessary features have been included in the numerical model, which makes use of a time-dynamic program which follows the movement of a slipper during its experimental test run. The resulting velocity and pressure functions of time have been implemented in the explicit finite element code, ABAQUS. Two-dimensional, plane strain models

  16. High Data Rate Architecture (HiDRA)

    Science.gov (United States)

    Hylton, Alan; Raible, Daniel

    2016-01-01

    high-rate laser terminals. These must interface with the existing, aging data infrastructure. The High Data Rate Architecture (HiDRA) project is designed to provide networked store, carry, and forward capability to optimize data flow through both the existing radio frequency (RF) and new laser communications terminal. The networking capability is realized through the Delay Tolerant Networking (DTN) protocol, and is used for scheduling data movement as well as optimizing the performance of existing RF channels. HiDRA is realized as a distributed FPGA memory and interface controller that is itself controlled by a local computer running DTN software. Thus HiDRA is applicable to other arenas seeking to employ next-generation communications technologies, e.g. deep space. In this paper, we describe HiDRA and its far-reaching research implications.

  17. An open trial of mindfulness-based cognitive therapy for the prevention of perinatal depressive relapse/recurrence.

    Science.gov (United States)

    Dimidjian, Sona; Goodman, Sherryl H; Felder, Jennifer N; Gallop, Robert; Brown, Amanda P; Beck, Arne

    2015-02-01

    Pregnant women with histories of depression are at high risk of depressive relapse/recurrence during the perinatal period, and options for relapse/recurrence prevention are limited. Mindfulness-based cognitive therapy (MBCT) has strong evidence among general populations but has not been studied among at-risk pregnant women to prevent depression. We examined the feasibility, acceptability, and clinical outcomes of depression symptom severity and relapse/recurrence associated with MBCT adapted for perinatal women (MBCT-PD). Pregnant women with depression histories were recruited from obstetrics clinics in a large health maintenance organization at two sites and enrolled in MBCT-PD (N = 49). Self-reported depressive symptoms and interview-based assessments of depression relapse/recurrence status were measured at baseline, during MBCT-PD, and through 6-months postpartum. Pregnant women reported interest, engagement, and satisfaction with the program. Retention rates were high, as were rates of completion of daily homework practices. Intent to treat analyses indicated a significant improvement in depression symptom levels and an 18 % rate of relapse/recurrence through 6 months postpartum. MBCT-PD shows promise as an acceptable, feasible, and clinically beneficial brief psychosocial prevention option for pregnant women with histories of depression. Randomized controlled trials are needed to examine the efficacy of MBCT-PD for the prevention of depressive relapse/recurrence during pregnancy and postpartum.

  18. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Clinicians Publications for Your Patients MS Navigator Program Programs and Services for Your Patients Contact Us Clinical Fellows ... Relapsing-remitting MS (RRMS) Relapsing-remitting ...

  19. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... for You and Your Practice Publications for Clinicians Publications for Your Patients MS Navigator Program Programs and Services for Your Patients ... Relapsing-remitting MS (RRMS) Relapsing-remitting MS ( ...

  20. Photocathodes for High Repetition Rate Light Sources

    Energy Technology Data Exchange (ETDEWEB)

    Ben-Zvi, Ilan [Stony Brook Univ., NY (United States). Dept. of Physics and Astronomy. Center for Accelerator Science and Education

    2014-04-20

    This proposal brought together teams at Brookhaven National Laboratory (BNL), Lawrence Berkeley National Laboratory (LBNL) and Stony Brook University (SBU) to study photocathodes for high repetition rate light sources such as Free Electron Lasers (FEL) and Energy Recovery Linacs (ERL). Below details the Principal Investigators and contact information. Each PI submits separately for a budget through his corresponding institute. The work done under this grant comprises a comprehensive program on critical aspects of the production of the electron beams needed for future user facilities. Our program pioneered in situ and in operando diagnostics for alkali antimonide growth. The focus is on development of photocathodes for high repetition rate Free Electron Lasers (FELs) and Energy Recovery Linacs (ERLs), including testing SRF photoguns, both normal-­conducting and superconducting. Teams from BNL, LBNL and Stony Brook University (SBU) led this research, and coordinated their work over a range of topics. The work leveraged a robust infrastructure of existing facilities and the support was used for carrying out the research at these facilities. The program concentrated in three areas: a) Physics and chemistry of alkali-­antimonide cathodes (BNL – LBNL) b) Development and testing of a diamond amplifier for photocathodes (SBU -­ BNL) c) Tests of both cathodes in superconducting RF photoguns (SBU) and copper RF photoguns (LBNL) Our work made extensive use of synchrotron radiation materials science techniques, such as powder-­ and single-­crystal diffraction, x-­ray fluorescence, EXAFS and variable energy XPS. BNL and LBNL have many complementary facilities at the two light sources associated with these laboratories (NSLS and ALS, respectively); use of these will be a major thrust of our program and bring our understanding of these complex materials to a new level. In addition, CHESS at Cornell will be used to continue seamlessly throughout the NSLS dark period and

  1. Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Fikreyesus, Mahlet; Soboka, Matiwos; Feyissa, Garumma Tolu

    2016-10-20

    Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH). Data were collected using interviewer administered questionnaire. We used medication adherence rating scale (MARS) to assess compliance to medication and abnormal involuntary movement scale (AIMS) to detect medication side effects. Logistic regression analysis was used to identify independent predictors of psychotic relapse. All variables with P-value value higher when compared to those who have never experienced medication side effects (aOR = 1.83, 95 % CI = 1.01, 3.31). The high prevalence of relapse among patients with psychotic disorder needs special attention. Clinicians need to pay attention to medication side effects the patient faces. Intervening noncompliance to medication and appropriately managing medication side effects may help in preventing psychotic relapse that may result because of non-compliance. The provision of counseling, psycho education, psycho social support may help patients in improving compliance to medication and reducing psychotic relapse. Developing and strengthening community based rehabilitation services should be emphasized as part of mental healthcare services.

  2. Daclizumab high-yield process reduced the evolution of new gadolinium-enhancing lesions to T1 black holes in patients with relapsing-remitting multiple sclerosis.

    Science.gov (United States)

    Radue, E-W; Sprenger, T; Vollmer, T; Giovannoni, G; Gold, R; Havrdova, E; Selmaj, K; Stefoski, D; You, X; Elkins, J

    2016-02-01

    In the SELECT study, treatment with daclizumab high-yield process (DAC HYP) versus placebo reduced the frequency of gadolinium-enhancing (Gd(+) ) lesions in patients with relapsing-remitting multiple sclerosis (RRMS). The objective of this post hoc analysis of SELECT was to evaluate the effect of DAC HYP on the evolution of new Gd(+) lesions to T1 hypointense lesions (T1 black holes). SELECT was a randomized double-blind study of subcutaneous DAC HYP 150 or 300 mg or placebo every 4 weeks. Magnetic resonance imaging (MRI) scans were performed at baseline and weeks 24, 36 and 52 in all patients and monthly between weeks 4 and 20 in a subset of patients. MRI scans were evaluated for new Gd(+) lesions that evolved to T1 black holes at week 52. Data for the DAC HYP groups were pooled for analysis. Daclizumab high-yield process reduced the number of new Gd(+) lesions present at week 24 (P = 0.005) or between weeks 4 and 20 (P = 0.014) that evolved into T1 black holes at week 52 versus placebo. DAC HYP treatment also reduced the percentage of patients with Gd(+) lesions evolving to T1 black holes versus placebo. Treatment with DAC HYP reduced the evolution of Gd(+) lesions to T1 black holes versus placebo, suggesting that inflammatory lesions that evolved during DAC HYP treatment are less destructive than those evolving during placebo treatment. © 2016 EAN.

  3. A Phase I Study of Pulse High-Dose Vorinostat (V) plus Rituximab (R), Ifosphamide, Carboplatin, and Etoposide (ICE) in Patients with Relapsed Lymphoma

    Science.gov (United States)

    Budde, Lihua E.; Zhang, Michelle M.; Shustov, Andrei R.; Pagel, John M.; Gooley, Ted A.; Oliveira, George R.; Chen, Tara L.; Knudsen, Nancy L.; Roden, Jennifer E.; Kammerer, Britt E.; Frayo, Shani L.; Warr, Thomas A.; Boyd, Thomas E.; Press, Oliver W.; Gopal, Ajay K.

    2013-01-01

    SUMMARY Given the poor outcomes of relapsed aggressive lymphomas and preclinical data suggesting that ≥2.5 μM concentrations of vorinostat synergize with both etoposide and platinums, we hypothesized that pulse high-dose vorinostat could safely augment the anti-tumour activity of (R)ICE [(rituximab), ifosphamide, carboplatin, etoposide] chemotherapy. We conducted a phase I dose escalation study using a schedule with oral vorinostat ranging from 400 mg/d to 700 mg bid for 5 days in combination with the standard (R)ICE regimen (days 3, 4 and 5). Twenty-nine patients (median age 56 years, median 2 prior therapies, 14 chemoresistant [of 27 evaluable], 2 prior transplants) were enrolled and treated. The maximally tolerated vorinostat dose was defined as 500 mg twice daily × 5 days. Common dose limiting toxicities included infection (n=2), hypokalaemia (n=2), and transaminitis (n=2). Grade 3 related gastrointestinal toxicity was seen in 9 patients. The median vorinostat concentration on day 3 was 4.5 μM (range 4.2–6.0 μM) and in vitro data confirmed the augmented antitumour and histone acetylation activity at these levels. Responses were observed in 19 of 27 evaluable patients (70%) including 8 complete response/unconfirmed complete response. High-dose vorinostat can be delivered safely with (R)ICE, achieves potentially synergistic drug levels, and warrants further study, although adequate gastrointestinal prophylaxis is warranted. PMID:23356514

  4. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... MS Relapsing-remitting MS (RRMS) Share this page Facebook Twitter Email Relapsing-remitting MS (RRMS) Relapsing-remitting ... Here Start Here Colophon Stay Informed Join Us Facebook Twitter LinkedIn YouTube Pinterest MS Connection About the ...

  5. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Relapsing-remitting MS (RRMS) Share this page Facebook Twitter Email Relapsing-remitting MS (RRMS) Relapsing-remitting MS ( ... Start Here Colophon Stay Informed Join Us Facebook Twitter LinkedIn YouTube Pinterest MS Connection About the Society ...

  6. Brachytherapy treatment with high dose rate

    International Nuclear Information System (INIS)

    Santana Rodriguez, Sergio Marcelino; Rodriguez Rodriguez, Lissi Lisbet; Ciscal Chiclana, Onelio Alberto

    2009-01-01

    Retrospectively analyze results and prognostic factors of cervical cancer patients treated with radio concomitant cisplatin-based chemotherapy, radiation therapy combined modality. Methods: From January 2003 to December 2007, 198 patients with invasive cervical cancer were treated at the Oncology Department of Hospital Robau Celestino Hernandez (brachytherapy performed at INOR). The most common age group was 31 to 40 years. The histology in squamous cell carcinoma accounted for 84.3% of cases. The treatment consisted of external pelvic irradiation and vaginal brachytherapy, high dose rate. Concomitant chemotherapy consisted of cisplatin 40 mg/m2 weekly with a maximum of 70 mg for 5 weeks. Results: 66.2% of patients completed 5 cycles of chemotherapy. The median overall survival was 39 months, overall survival, disease-free survival and survival free of locoregional recurrence at 5 years of 78%, 76% and 78.6% respectively .. We found that clinical stage, histological type (adenocarcinoma worst outcome) were statistically related to level of response. Conclusions: Treatment with external pelvic radiation, brachytherapy and concurrent weekly cisplatin in patients with stage IIIB cervical cancer is feasible in the Chilean public health system, well tolerated and results comparable to international literature. (Author)

  7. Multiple Sclerosis Relapses: Epidemiology, Outcomes and Management. A Systematic Review.

    Science.gov (United States)

    Kalincik, Tomas

    2015-01-01

    Relapses (episodic exacerbations of neurological signs or symptoms) are a defining feature of relapsing-remitting multiple sclerosis (MS), the most prevalent MS phenotype. While their diagnostic value relates predominantly to the definition of clinically definite MS, their prognostic value is determined by their relatively high associated risk of incomplete remission resulting in residual disability. The mechanisms governing a relapse incidence are unknown, but numerous modifiers of relapse risk have been described, including demographic and clinical characteristics, many of which represent opportunities for improved disease management. Also relapse phenotypes have been associated with patient and disease characteristics and an individual predisposition to certain phenotypic presentations may imply individual neuroanatomical disease patterns. While immunomodulatory therapies and corticosteroids represent the mainstay of relapse prevention and acute management, respectively, their effect has only been partial and further search for more efficient relapse therapies is warranted. Other areas of research include pathophysiology and determinants of relapse incidence, recurrence and phenotypes, including the characteristics of the relapsing and non-relapsing multiple sclerosis variants and their responsiveness to therapies. © 2015 S. Karger AG, Basel.

  8. Recurrence and Relapse in Bipolar Mood Disorder

    Directory of Open Access Journals (Sweden)

    S Gh Mousavi

    2004-06-01

    Full Text Available Background: Despite the effectiveness of pharmacotherapy in acute phase of bipolar mood disorder, patients often experience relapses or recurrent episodes. Hospitalization of patients need a great deal of financial and humanistic resources which can be saved through understanding more about the rate of relapse and factors affecting this rate. Methods: In a descriptive analytical study, 380 patients with bipolar disorder who were hospitalized in psychiatric emergency ward of Noor hospital, Isfahan, Iran, were followed. Each patient was considered for; the frequency of relapse and recurrence, kind of pharmachotherapy, presence of psychotherapeutic treatments, frequency of visits by psychiatrist and the rank of present episode. Results: The overall prevalence of recurrence was 42.2%. Recurrence was lower in patients using lithium carbonate or sodium valproate or combined therapy (about 40%, compared to those using carbamazepine (80%. Recurrence was higher in patients treated with only pharmacotherapy (44.5% compared to those treated with both pharmacotherapy and psychotherapy (22.2%. Patients who were visited monthy by psychiatrist had lower rate of recurrence compared to those who had irregular visits. Conclusion: The higher rate of recurrence observed in carbamazepine therapy may be due to its adverse reactions and consequently poor compliance to this drug. Lower rates of recurrence with psychotherapy and regular visits may be related to the preventive effects of these procedures and especially to the effective management of stress. Keywords: Bipolar Mood Disorder, Recurrence, Relapse.

  9. Prefrontal cortex plasticity mechanisms in drug seeking and relapse

    NARCIS (Netherlands)

    van den Oever, M.C.; Spijker, S.; Smit, A.B.; de Vries, T.J.

    2010-01-01

    Development of pharmacotherapy to reduce relapse rates is one of the biggest challenges in drug addiction research. The enduring nature of relapse suggests that it is maintained by long-lasting molecular and cellular adaptations in the neuronal circuitry that mediates learning and processing of

  10. An intervention study to prevent relapse in patients with schizophrenia

    NARCIS (Netherlands)

    van Meijel, B.; Kruitwagen, C.; van der Gaag, M.; Kahn, R.S.; Grypdonck, M.H.E.

    2006-01-01

    Purpose: To determine whether the use of relapse prevention plans (RPPs) in nursing practice is an effective intervention in reducing relapse rates among patients with schizophrenia. Design and Methods: Experimental design. Patients with schizophrenia (or a related psychotic disorder) and nurses

  11. High mitogenomic evolutionary rates and time dependency.

    NARCIS (Netherlands)

    Subramanian, S.; Denver, D.R.; Millar, C.D.; Heupink, T.; Aschrafi, A.; Emslie, S.D.; Baroni, C.; Lambert, D.M.

    2009-01-01

    Using entire modern and ancient mitochondrial genomes of Adelie penguins (Pygoscelis adeliae) that are up to 44000 years old, we show that the rates of evolution of the mitochondrial genome are two to six times greater than those estimated from phylogenetic comparisons. Although the rate of

  12. Irinotecan in patients with relapsed or cisplatin-refractory germ cell cancer: a phase II study of the German Testicular Cancer Study Group

    OpenAIRE

    Kollmannsberger, C; Rick, O; Klaproth, H; Kubin, T; Sayer, H G; Hentrich, M; Welslau, M; Mayer, F; Kuczyk, M; Spott, C; Kanz, L; Bokemeyer, C

    2002-01-01

    Despite generally high cure rates in patients with metastatic germ cell cancer, patients with progressive disease on first-line cisplatin-based chemotherapy or with relapsed disease following high-dose salvage therapy exhibit a very poor prognosis. Irinotecan has shown antitumour activity in human testicular tumour xenografts in nude mice. We have performed a phase II study examining the single agent activity of irinotecan in patients with metastatic relapsed or cisplatin-refractory germ cell...

  13. Development of Ethanol Withdrawal-Related Sensitization and Relapse Drinking in Mice Selected for High or Low Ethanol Preference

    Science.gov (United States)

    Lopez, Marcelo F.; Grahame, Nicholas J.; Becker, Howard C.

    2010-01-01

    Background Previous studies have shown that high alcohol consumption is associated with low withdrawal susceptiblility, while at the same time, other studies have shown that exposure to ethanol vapor increases alcohol drinking in rats and mice. In the present studies, we sought to shed light on this seeming contradiction by using mice selectively bred for High- (HAP) and Low- (LAP) Alcohol Preference, first, assessing these lines for differences in signs of ethanol withdrawal and second, for differences in the efficacy of intermittent alcohol vapor exposure on elevating subsequent ethanol intake. Methods Experiment 1 examined whether these lines of mice differed in ethanol withdrawal-induced CNS hyperexcitability and the development of sensitization to this effect following intermittent ethanol vapor exposure. Adult HAP and LAP lines (replicates 1 and 2), and the C3H/HeNcr inbred strain (included as a control genotype for comparison purposes) received intermittent exposure to ethanol vapor and were evaluated for ethanol withdrawal-induced seizures assessed by scoring handling-induced convulsions (HIC). Experiment 2 examined the influence of chronic intermittent ethanol exposure on voluntary ethanol drinking. Adult male and female HAP-2 and LAP-2 mice, along with male C57BL/6J (included as comparative controls) were trained to drink 10% ethanol using a limited access (2 hr/day) 2-bottle choice paradigm. After stable baseline daily intake was established, mice received chronic intermittent ethanol vapor exposure in inhalation chambers. Ethanol intake sessions resumed 72 hr after final ethanol (or air) exposure for 5 consecutive days. Results Following chronic ethanol treatment, LAP mice exhibited overall greater withdrawal seizure activity compared to HAP mice. In Experiment 2, chronic ethanol exposure/withdrawal resulted in a significant increase in ethanol intake in male C57BL/6J, and modestly elevated intake in HAP-2 male mice. Ethanol intake for male control mice

  14. Cheetah: A high frame rate, high resolution SWIR image camera

    Science.gov (United States)

    Neys, Joel; Bentell, Jonas; O'Grady, Matt; Vermeiren, Jan; Colin, Thierry; Hooylaerts, Peter; Grietens, Bob

    2008-10-01

    A high resolution, high frame rate InGaAs based image sensor and associated camera has been developed. The sensor and the camera are capable of recording and delivering more than 1700 full 640x512pixel frames per second. The FPA utilizes a low lag CTIA current integrator in each pixel, enabling integration times shorter than one microsecond. On-chip logics allows for four different sub windows to be read out simultaneously at even higher rates. The spectral sensitivity of the FPA is situated in the SWIR range [0.9-1.7 μm] and can be further extended into the Visible and NIR range. The Cheetah camera has max 16 GB of on-board memory to store the acquired images and transfer the data over a Gigabit Ethernet connection to the PC. The camera is also equipped with a full CameralinkTM interface to directly stream the data to a frame grabber or dedicated image processing unit. The Cheetah camera is completely under software control.

  15. A Phase I Trial of High-Dose Lenalidomide and Melphalan as Conditioning for Autologous Stem Cell Transplantation in Relapsed or Refractory Multiple Myeloma.

    Science.gov (United States)

    Mark, Tomer M; Guarneri, Danielle; Forsberg, Peter; Rossi, Adriana; Pearse, Roger; Perry, Arthur; Pekle, Karen; Tegnestam, Linda; Greenberg, June; Shore, Tsiporah; Gergis, Usama; Mayer, Sebastian; Van Besien, Koen; Ely, Scott; Jayabalan, David; Sherbenou, Daniel; Coleman, Morton; Niesvizky, Ruben

    2017-06-01

    Autologous stem cell transplantation (ASCT) conditioned with high-dose chemotherapy has long been established as the standard of care for eligible patients with newly diagnosed multiple myeloma. Despite recent therapeutic advances, high-dose melphalan (HDM) remains the chemotherapy regimen of choice in this setting. Lenalidomide (LEN) in combination with low-dose dexamethasone is recognized as a standard of care for patients with relapsed or refractory multiple myeloma (RRMM), and there is growing support for the administration of LEN as maintenance therapy post-ASCT. In view of the above, the present phase I clinical trial was designed to evaluate the safety and tolerability of high-dose LEN (HDLEN) in patients with RRMM, and to determine the maximum tolerated dose of HDLEN when added to HDM before ASCT. Despite administering HDLEN at doses of up to 350 mg/day, the maximum tolerated dose could not be determined, owing to an insufficient number of dose-limiting toxicities in the 21 patients enrolled in the trial. Conditioning with HDLEN plus HDM was associated with a favorable tolerability profile. Adverse events following ASCT were as expected with HDM. Median progression-free and overall survival were 10 months and 22 months, respectively, in this population of heavily pretreated patients. Our findings suggest that HDLEN in combination with HDM may offer significant potential as a conditioning regimen before ASCT in patients with RRMM. These preliminary findings are now being evaluated further in an ongoing phase II clinical trial. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  16. Hematologic Response to Vorinostat Treatment in Relapsed Myeloid Leukemia of Down Syndrome.

    Science.gov (United States)

    Scheer, Carina; Kratz, Christian; Witt, Olaf; Creutzig, Ursula; Reinhardt, Dirk; Klusmann, Jan-Henning

    2016-09-01

    Children with Down syndrome are at high risk to develop myeloid leukemia (ML-DS). Despite their excellent prognosis, children with ML-DS particularly suffer from severe therapy-related toxicities and for relapsed ML-DS the cure rates are very poor. Here we report the clinical course of one child with ML-DS treated with the histone deacetylase (HDAC) inhibitor vorinostat (suberoylanilide hydroxamic acid) after second relapse. The child had previously received conventional chemotherapy and stem cell transplantation, yet showed a remarkable clinical and hematologic response. Thus, HDAC inhibitor may represent an effective class of drugs for the treatment of ML-DS. © 2016 Wiley Periodicals, Inc.

  17. Ceramic high-rate timing RPCs

    International Nuclear Information System (INIS)

    Lopes, L.; Ferreira Marques, R.; Fonte, P.; Hennetier, L.; Pereira, A.; Sousa Correia, A.M.

    2006-01-01

    Following some previous work, we report here considerable improvements on the counting rate capability of timing RPCs by the use of ceramic electrodes with a resistivity of 10 9 Ω.cm. The X-ray sensitivity of the detector depends linearly on the counting rate with a slope of 9% per 100 kHz/cm 2 , free from charge depletion effects, while keeping a timing accuracy, measured with 511 keV synchronous photon pairs, around 90 ps σ up to 75 kHz/cm 2

  18. A multicentre phase-II feasibility study evaluating gemcitabine /vinorelbine / prednisolone combination chemotherapy in relapsed / refractory hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Naqi, N.; Ahmad, S.; Shah, I.; Khattak, J.

    2013-01-01

    Objective: To determine the efficacy and toxicity of Gemcitabine, Vinorelbine and Prednisolone (GVP) salvage chemotherapy in relapsed / refractory Hodgkin's Lymphoma (HL). Study Design: A phase-II non-randomized single arm study. Place and Duration of Study: This study was conducted at Combined Military Hospital and Medical College Lahore, Mayo Hospital, King Edward Medical University, Lahore, Allied Hospital, Punjab Medical College, Faisalabad and Combined Military Hospital, Rawalpindi, from January 2007 to December 2007. Methodology: Fifty adult patients with relapsed/refractory HL, adequate marrow reserve, hepatorenal and pulmonary functions, with radiological measurable disease and Karnofsky performance status of 0 - 2 non-candidates for stem cell transplantation, were enrolled. Four 28 days cycles of GVP (Gemcitabine 1000 mg/m2, Vinorelbine 30 mg/m2 on day 1 and 8 intravenously with oral Prednisolone 100 mg/day on day 1 - 5) were given. Response evaluation done according to Cotswolds meeting recommendations and toxicity was evaluated with NCI-CTC (National Cancer Institute - Common Terminology Criteria for adverse events v 3.0). Results: Forty patients completing 4 cycles of GVP, 14 refractory/early relapse and 26 late relapsed (one year postprimary treatment with ABVD) were available for evaluation. The overall response (CRu+PR) rate was 77.5% with better response 85% in late relapsed patients. Haematological toxicity was most common and seen in 70% of cases. Conclusion: GVP is well-tolerated regimen with high response rate and needs to be tested in late relapsed HL. (author)

  19. Socio-economic correlates of relapsed patients admitted in a Nigerian mental health institution.

    Science.gov (United States)

    Gbiri, Caleb A; Badru, Fatai A; Ladapo, Harry T O; Gbiri, Adefolakemi A

    2011-03-01

    Relapse in psychiatric disorders is highly distressing, costly and engenders burn-out syndrome among mental-health workers. To study the socio-economic factors associated with relapse in individual admitted with psychiatric disorders and the pattern of socio-economic impact of relapse in those groups. A cross-sectional survey of all relapsed patients without cognitive deficit admitted into the federal Neuro-Psychiatric Hospital, Lagos, Nigeria between June and October 2007 was conducted using a self-validated Structured Interview Schedule (Relapse Socio-economic Impact Interview Schedule) and Key Informant Interview Guide. Secondary data were elicited from the patient folders, case notes, ward admission registers and nominal rolls. Data were summarised using mean, standard deviation, frequency and percentiles. Pearson's moment correlation coefficient was used to test the association among variables. The Mann-Whitney U-test was used to compare the pre-morbid and the post-morbid states. This study involved 102 respondents. Their mean age was 36.5 ± 9.8 years, mainly of male gender (72.5%) suffering from schizophrenic disorder (37.8%). Relapse and re-admission ranged between 2 and 12. Unemployment rate, marital separation and divorce increased more than 5-fold from pre-morbid to morbid states. Few (4.9%) could still settle their hospital/drug bills on their own, while most (95.1%) depended on family, philanthropist and government/waivers to pay for their bills. Their social relationships were negatively influenced with most of them expressing social isolation and low quality of life. There were significant relationships (Peconomic status, employment status and marital status of the respondents between the pre-morbid and post-morbid periods. The illness significantly affected the emotional status of the participants. Relapse and readmission in psychiatric patients have a negative impact on socio-economic well-being of patients, family and the society. Efforts should

  20. Transition to high rate aerospace NDI processes

    Science.gov (United States)

    Vanderheiden, Bert; Thomson, Clint; Ivakhnenko, Igor; Garner, Chuck

    2018-04-01

    With the rapidly expanding use of carbon fiber composite materials in military and commercial aircraft, processes to manufacture and inspect the structural components must evolve to ensure economic viability. Inspection techniques which were developed to inspect products produced at a rate of one or two structures a month are not fast or flexible enough to inspect more than 8500 parts per month. This presentation describes the evolution of phased array ultrasonic inspection systems to provide the increased rate capacity, the flexibility to accommodate multiple unique designs, and the ability to rapidly adjust to product design changes. The paper will describe how system developments were made in response to new programs resulting in a much less expensive, higher degree of accuracy, increased flexibility, and lower cycle time inspections.

  1. Regional homogeneity changes between heroin relapse and non-relapse patients under methadone maintenance treatment: a resting-state fMRI study

    OpenAIRE

    Chang, Haifeng; Li, Wei; Li, Qiang; Chen, Jiajie; Zhu, Jia; Ye, Jianjun; Liu, Jierong; Li, Zhe; Li, Yongbin; Shi, Ming; Wang, Yarong; Wang, Wei

    2016-01-01

    Background Methadone maintenance treatment (MMT) is recognized as one of the most effective treatments for heroin addiction but its effect is dimmed by the high incidence of heroin relapse. However, underlying neurobiology mechanism of heroin relapse under MMT is still largely unknown. Here, we took advantage of a resting-state fMRI technique by analysis of regional homogeneity (ReHo), and tried to explore the difference of brain function between heroin relapsers and non-relapsers in MMT. Met...

  2. High exposure rate hardware ALARA plan

    International Nuclear Information System (INIS)

    Nellesen, A.L.

    1996-10-01

    This as low as reasonably achievable review provides a description of the engineering and administrative controls used to manage personnel exposure and to control contamination levels and airborne radioactivity concentrations. HERH waste is hardware found in the N-Fuel Storage Basin, which has a contact dose rate greater than 1 R/hr and used filters. This waste will be collected in the fuel baskets at various locations in the basins

  3. Why Are Real Interest Rates So High?

    OpenAIRE

    Zvi Bodie; Alex Kane; Robert L. McDonald

    1983-01-01

    This paper applies the Capital Asset Pricing Model to help explain the anomalous behavior of real interest rates during the last several years. Specifically,we are able to show that the increased volatility of bond prices since the change in Federal Reserve operating procedure in October 1979 has substantially increased the required real risk premium on long term bonds. We also consider and reject the possibility that increased risk alone accounts for the recent increase in the short-term rea...

  4. Prolonged Survival of Acute Lymphoblastic Leukemia with Intrathecal Treatments for Isolated Central Nervous System Relapse

    Directory of Open Access Journals (Sweden)

    Elan Gorshein

    2018-01-01

    Full Text Available Acute lymphoblastic leukemia is commonly cured when diagnosed in the pediatric population. It portends a poorer prognosis if present in adult patients. Although adults frequently achieve complete remission, relapse rates are substantial, particularly among the elderly and high-risk populations. In the absence of prophylactic intrathecal chemotherapy, more than half of patients may develop CNS involvement or relapse, which is associated with significant risk for systemic illness. This report describes a patient with acute lymphoblastic leukemia with repeated isolated CNS relapses. This case should remind clinicians that isolated CNS disease in the absence of systemic recurrence could successfully respond to intrathecal therapy and offer patients a favorable quality of life.

  5. Isolation of Trypanosoma brucei gambiense from cured and relapsed sleeping sickness patients and adaptation to laboratory mice.

    Directory of Open Access Journals (Sweden)

    Patient Pati Pyana

    Full Text Available BACKGROUND: Sleeping sickness due to Trypanosoma brucei (T.b. gambiense is still a major public health problem in some central African countries. Historically, relapse rates around 5% have been observed for treatment with melarsoprol, widely used to treat second stage patients. Later, relapse rates of up to 50% have been recorded in some isolated foci in Angola, Sudan, Uganda and Democratic Republic of the Congo (DRC. Previous investigations are not conclusive on whether decreased sensitivity to melarsoprol is responsible for these high relapse rates. Therefore we aimed to establish a parasite collection isolated from cured as well as from relapsed patients for downstream comparative drug sensitivity profiling. A major constraint for this type of investigation is that T.b. gambiense is particularly difficult to isolate and adapt to classical laboratory rodents. METHODOLOGY/PRINCIPAL FINDINGS: From 360 patients treated in Dipumba hospital, Mbuji-Mayi, D.R. Congo, blood and cerebrospinal fluid (CSF was collected before treatment. From patients relapsing during the 24 months follow-up, the same specimens were collected. Specimens with confirmed parasite presence were frozen in liquid nitrogen in a mixture of Triladyl, egg yolk and phosphate buffered glucose solution. Isolation was achieved by inoculation of the cryopreserved specimens in Grammomys surdaster, Mastomys natalensis and SCID mice. Thus, 85 strains were isolated from blood and CSF of 55 patients. Isolation success was highest in Grammomys surdaster. Forty strains were adapted to mice. From 12 patients, matched strains were isolated before treatment and after relapse. All strains belong to T.b. gambiense type I. CONCLUSIONS AND SIGNIFICANCE: We established a unique collection of T.b. gambiense from cured and relapsed patients, isolated in the same disease focus and within a limited period. This collection is available for genotypic and phenotypic characterisation to investigate the

  6. Social settings and addiction relapse.

    Science.gov (United States)

    Walton, M A; Reischl, T M; Ramanthan, C S

    1995-01-01

    Despite addiction theorists' acknowledgment of the impact of environmental factors on relapse, researchers have not adequately investigated these influences. Ninety-six substance users provided data regarding their perceived risk for relapse, exposure to substances, and involvement in reinforcing activities. These three setting attributes were assessed in their home, work, and community settings. Reuse was assessed 3 months later. When controlling for confounding variables, aspects of the home settings significantly distinguished abstainers from reusers; perceived risk for relapse was the strongest predictor of reuse. Exposure to substances and involvement in reinforcing activities were not robust reuse indicators. The work and community settings were not significant determinants of reuse. These findings offer some initial support for the utility of examining social settings to better understand addiction relapse and recovery. Identification of setting-based relapse determinants provides concrete targets for relapse prevention interventions.

  7. Targeting BTK with ibrutinib in relapsed chronic lymphocytic leukemia.

    Science.gov (United States)

    Byrd, John C; Furman, Richard R; Coutre, Steven E; Flinn, Ian W; Burger, Jan A; Blum, Kristie A; Grant, Barbara; Sharman, Jeff P; Coleman, Morton; Wierda, William G; Jones, Jeffrey A; Zhao, Weiqiang; Heerema, Nyla A; Johnson, Amy J; Sukbuntherng, Juthamas; Chang, Betty Y; Clow, Fong; Hedrick, Eric; Buggy, Joseph J; James, Danelle F; O'Brien, Susan

    2013-07-04

    The treatment of relapsed chronic lymphocytic leukemia (CLL) has resulted in few durable remissions. Bruton's tyrosine kinase (BTK), an essential component of B-cell-receptor signaling, mediates interactions with the tumor microenvironment and promotes the survival and proliferation of CLL cells. We conducted a phase 1b-2 multicenter study to assess the safety, efficacy, pharmacokinetics, and pharmacodynamics of ibrutinib (PCI-32765), a first-in-class, oral covalent inhibitor of BTK designed for treatment of B-cell cancers, in patients with relapsed or refractory CLL or small lymphocytic lymphoma. A total of 85 patients, the majority of whom were considered to have high-risk disease, received ibrutinib orally once daily; 51 received 420 mg, and 34 received 840 mg. Toxic effects were predominantly grade 1 or 2 and included transient diarrhea, fatigue, and upper respiratory tract infection; thus, patients could receive extended treatment with minimal hematologic toxic effects. The overall response rate was the same in the group that received 420 mg and the group that received 840 mg (71%), and an additional 20% and 15% of patients in the respective groups had a partial response with lymphocytosis. The response was independent of clinical and genomic risk factors present before treatment, including advanced-stage disease, the number of previous therapies, and the 17p13.1 deletion. At 26 months, the estimated progression-free survival rate was 75% and the rate of overall survival was 83%. Ibrutinib was associated with a high frequency of durable remissions in patients with relapsed or refractory CLL and small lymphocytic lymphoma, including patients with high-risk genetic lesions. (Funded by Pharmacyclics and others; ClinicalTrials.gov number, NCT01105247.).

  8. Patterns of failure following high-dose chemotherapy and stem cell rescue for relapsed/refractory non-Hodgkin's lymphoma: implications for the use of adjuvant involved field radiotherapy

    International Nuclear Information System (INIS)

    Mundt, Arno J.; Williams, Stephanie F.; Hallahan, Dennis; Weichselbaum, Ralph R.

    1996-01-01

    Purpose: Recent data have suggested a benefit to involved-field radiotherapy (IFRT) in conjunction with high-dose chemotherapy (HDCT) and autologous stem cell rescue (SCR) in patients with metastatic breast cancer, advanced neuroblastoma and relapsed/refractory Hodgkin's disease. The purpose of this study is to determine whether a similar role exists for IFRT in patients with relapsed/refractory Non-Hodgkin's Lymphoma (NHL) undergoing HDCT. Methods/Materials: Forty-nine adult patients with refractory (17) or relapsed (32) NHL underwent HDCT with SCR between 9/90 and 9/95. The most common histology was diffuse large cell (42.8%). Initial stages were I (3), II (23), III (5) and IV (18). All patients had a history of conventional chemotherapy (median regimens 2, range 1-3), 17 (34.7%) had previous RT. Treatment consisted of conventional dose induction chemotherapy followed by high-dose intensification with cytoxan, busulfan and either ara-C or VP-16. Seven patients (14.3%) received IFRT (median dose 34.5 Gy, range 20-45 Gy) to eleven sites of persistent disease following HDCT (HDCT+IFRT). Patients treated with RT to sites of progressive disease following HDCT (salvage RT) were not included in the HDCT+IFRT group. No patient received total body irradiation (TBI). One hundred sixty four sites were identified. Sites were designated as amenable or not to IFRT and divided into those achieving a complete response to induction (IndCR) and those which did not (non-IndCR). An amenable site is defined as disease localized to either an organ or nodal chain and encompassable within a standard RT portal. Relapse sites were designated as in previous (involved) sites (present prior to HDCT) or in new (uninvolved) sites. Median followup was 19.7 months (range, 1-57.3 months). Results: The 4-year actuarial progression-free (PFS), cause-specific (CSS) and overall (OS) survivals of the entire group were 36.4%, 45.9% and 34.9%, respectively. Excluding toxic deaths, 20 (47.6%) patients

  9. Implementation of High-Dose-Rate Brachytherapy and Androgen Deprivation in Patients With Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lilleby, Wolfgang, E-mail: wolfgang.lilleby@ous-hf.no [Cancer Clinic, Oslo University Hospital, Norwegian Radiumhospital, Department of Radiotherapy and Oncology, Oslo (Norway); Tafjord, Gunnar; Raabe, Nils K. [Cancer Clinic, Oslo University Hospital, Norwegian Radiumhospital, Department of Radiotherapy and Oncology, Oslo (Norway)

    2012-07-01

    Purpose: To evaluate outcome (overall survival [OS], the actuarial 5-year cancer-specific survival [CSS], disease-free survival [DFS], biochemical failure-free survival [BFS]), complications and morbidity in patients treated with high-dose-rate brachytherapy (HDR-BT) boost and hormonal treatment with curative aims. Methods: Between 2004 and 2009, 275 prospectively followed pN0/N0M0 patients were included: 19 patients (7%) with T2, Gleason score 7 and prostate-specific antigen (PSA) <10 and 256 patients (93%) with T3 or Gleason score 8-10 or PSA >20 received multimodal treatment with conformal four-field radiotherapy (prostate/vesiculae 2 Gy Multiplication-Sign 25) combined with HDR-BT (iridium 192; prostate 10 Gy Multiplication-Sign 2) with long-term androgen deprivation therapy (ADT). Results: After a median observation time of 44.2 months (range, 10.4-90.5 months) 12 patients had relapsed clinically and/or biochemically and 10 patients were dead, of which 2 patients died from prostate cancer. Five-year estimates of BFS, CSS, DFS, and OS rates were 98.5%, 99.3%, 95.6%, and 96.3%, respectively. None of the patients with either Gleason score <8 or with intermediate risk profile had relapsed. The number of HDR-BT treatments was not related to outcome. Despite of age (median, 65.7 years; range, 45.7-77 years) and considerable pretreatment comorbidity in 39 of 275 patients, Genitourinary treatment-related morbidity was moderate with long-lasting Radiation Therapy Oncology Group Grade 2 voiding problems in 26 patients (9.5%) and occasionally mucous discharge in 20 patients (7%), none with Grade >2 for gastrointestinal at follow-up. Complications during implantations were related to pubic arch interference (4 patients) and lithotomy time, causing 2 patients to develop compartment syndrome. Conclusion: Despite still preliminary observations, our 5-year outcome estimates favor the implementation of high-dose-rate brachytherapy in high-risk patients combined with conformal

  10. Impact of side-effects of atypical antipsychotics on non-compliance, relapse and cost.

    Science.gov (United States)

    Mortimer, A; Williams, P; Meddis, D

    2003-01-01

    Atypical antipsychotics generally have milder side-effects than conventional antipsychotics, but also differ among themselves in this respect. This study aimed to compare the impact of different side-effect profiles of individual atypical antipsychotics on non-compliance, relapse and cost in schizophrenia. A state-transition model was built using literature data supplemented by expert opinion. The model found that quetiapine and ziprasidone were similar in estimated non-compliance and relapse rates. Olanzapine and risperidone had higher estimated non-compliance and relapse rates, and incremental, 1-year, per-patient direct costs, using US-based cost data, of approximately $530 (95% confidence interval [CI] approximately $275, $800), and approximately $485 (95% CI approximately $235, $800), respectively, compared with quetiapine. Incremental costs attributable to different side-effect profiles were highly significant. This study shows that differing side-effect profiles of the newer antipsychotic agents are likely to lead to different compliance rates, and consequent variation in relapse rates. The cost implications of these heterogenous clinical outcomes are substantial.

  11. High readmission rate after heart valve surgery

    DEFF Research Database (Denmark)

    Sibilitz, K L; Berg, S K; Thygesen, L C

    2015-01-01

    investigated. RESULTS: After valve surgery, the self-reported health was lower (Short Form-36 (SF-36) Physical Component Scale (PCS): 44.5 vs. 50.6 and Mental Component Scale (MCS): 51.9 vs. 55.0, pClinical signs......BACKGROUND: After heart valve surgery, knowledge on long-term self-reported health status and readmission is lacking. Thus, the optimal strategy for out-patient management after surgery remains unclear. METHODS: Using a nationwide survey with linkage to Danish registers with one year follow-up, we...... included all adults 6-12months after heart valve surgery irrespective of valve procedure, during Jan-June 2011 (n=867). Participants completed a questionnaire regarding health-status (n=742), and answers were compared with age- and sex-matched healthy controls. Readmission rates and mortality were...

  12. Improved outcome after relapse in children with acute myeloid leukaemia

    DEFF Research Database (Denmark)

    Abrahamsson, Jonas; Clausen, Niels; Gustafsson, Göran

    2007-01-01

    investigated. The study included all 146 children in the Nordic countries diagnosed with AML between 1988 and 2003, who relapsed. Data on disease characteristics and relapse treatment were related to outcome. Sixty-six percentage achieved remission with survival after relapse (5 years) 34 +/- 4%. Of 122......In the Nordic Society for Paediatric Haematology and Oncology paediatric study acute myeloid leukaemia (AML) 93, event-free survival was 50% and overall survival was 66%, indicating that many patients were cured following relapse. Factors influencing outcome in children with relapsed AML were...... patients who received re-induction therapy, 77% entered remission with 40 +/- 5% survival. Remission rates were similar for different re-induction regimens but fludarabine, cytarabine, granulocyte colony-stimulating factor-based therapy had low treatment-related mortality. Prognostic factors for survival...

  13. In search of the optimal platform for Post-Allogeneic SCT immunotherapy in relapsed multiple myeloma: a systematic review.

    Science.gov (United States)

    Oostvogels, R; Uniken Venema, S M; de Witte, M; Raymakers, R; Kuball, J; Kröger, N; Minnema, M C

    2017-09-01

    Allogeneic stem cell transplantation (allo-SCT) has the potential to induce sustained remissions in patients with multiple myeloma (MM). Currently, allo-SCT is primarily performed in high-risk MM patients, most often in the setting of early relapse after first-line therapy with autologous SCT. However, the implementation of allo-SCT for MM is jeopardized by high treatment-related mortality (TRM) rates as well as high relapse rates. In this systematic review, we aimed to identify a safe allo-SCT strategy that has optimal 1-year results regarding mortality, relapse and severe GvHD, creating opportunities for post-transplantation strategies to maintain remissions in the high-risk group of relapsed MM patients. Eleven studies were included. Median PFS ranged from 5.2 to 36.8 months and OS was 13.0 to 63.0 months. The relapse related mortality at 1 year varied between 0 and 50% and TRM between 8 and 40%. Lowest GvHD incidences were reported for conditioning regimens with T-cell depletion using ATG or graft CD34+ selection. Similar strategies could lay the foundation for a post-transplant immune platform, this should be further evaluated in prospective clinical trials.

  14. High dose rate brachytherapy source measurement intercomparison.

    Science.gov (United States)

    Poder, Joel; Smith, Ryan L; Shelton, Nikki; Whitaker, May; Butler, Duncan; Haworth, Annette

    2017-06-01

    This work presents a comparison of air kerma rate (AKR) measurements performed by multiple radiotherapy centres for a single HDR 192 Ir source. Two separate groups (consisting of 15 centres) performed AKR measurements at one of two host centres in Australia. Each group travelled to one of the host centres and measured the AKR of a single 192 Ir source using their own equipment and local protocols. Results were compared to the 192 Ir source calibration certificate provided by the manufacturer by means of a ratio of measured to certified AKR. The comparisons showed remarkably consistent results with the maximum deviation in measurement from the decay-corrected source certificate value being 1.1%. The maximum percentage difference between any two measurements was less than 2%. The comparisons demonstrated the consistency of well-chambers used for 192 Ir AKR measurements in Australia, despite the lack of a local calibration service, and served as a valuable focal point for the exchange of ideas and dosimetry methods.

  15. Lapse and relapse following inpatient treatment of opiate dependence.

    LENUS (Irish Health Repository)

    Smyth, B P

    2010-06-01

    We conducted a prospective follow-up study of consecutive opiate dependent patients admitted to a residential addiction treatment service for detoxification. We measured the rate of relapse following discharge, and sought to identify factors that were associated with early relapse (i.e., a return to daily opiate use). Follow-up interviews were conducted with 109 patients, of whom, 99 (91%) reported a relapse. The initial relapse occurred within one week in 64 (59%) cases. Multivariate survival analysis revealed that earlier relapse was significantly predicted by younger age, greater heroin use prior to treatment, history of injecting, and a failure to enter aftercare. Unexpectedly, those who were in a relationship with an opiate user had significantly delayed relapse. Those who completed the entire six-week inpatient treatment programme also had a significantly delayed relapse. In order to reduce relapse and the associated increased risk of fatal overdose, services providing residential opiate detoxification should prepare people for admission, strive to retain them in treatment for the full admission period and actively support their entry into planned aftercare in order to improve outcome.

  16. High-deposition-rate ceramics synthesis

    Energy Technology Data Exchange (ETDEWEB)

    Allendorf, M.D.; Osterheld, T.H.; Outka, D.A. [Sandia National Laboratories, Livermore, CA (United States)] [and others

    1995-05-01

    Parallel experimental and computational investigations are conducted in this project to develop validated numerical models of ceramic synthesis processes. Experiments are conducted in the High-Temperature Materials Synthesis Laboratory in Sandia`s Combustion Research Facility. A high-temperature flow reactor that can accommodate small preforms (1-3 cm diameter) generates conditions under which deposition can be observed, with flexibility to vary both deposition temperature (up to 1500 K) and pressure (as low as 10 torr). Both mass spectrometric and laser diagnostic probes are available to provide measurements of gas-phase compositions. Experiments using surface analytical techniques are also applied to characterize important processes occuring on the deposit surface. Computational tools developed through extensive research in the combustion field are employed to simulate the chemically reacting flows present in typical industrial reactors. These include the CHEMKIN and Surface-CHEMKIN suites of codes, which permit facile development of complex reaction mechanisms and vastly simplify the implementation of multi-component transport and thermodynamics. Quantum chemistry codes are also used to estimate thermodynamic and kinetic data for species and reactions for which this information is unavailable.

  17. Liquid Argon Calorimeter performance at High Rates

    CERN Document Server

    Seifert, F; The ATLAS collaboration

    2013-01-01

    The expected increase of luminosity at HL-LHC by a factor of ten with respect to LHC luminosities has serious consequences for the signal reconstruction, radiation hardness requirements and operations of the ATLAS liquid argon calorimeters in the endcap, respectively forward region. Small modules of each type of calorimeter have been built and exposed to a high intensity proton beam of 50 GeV at IHEP/Protvino. The beam is extracted via the bent crystal technique, offering the unique opportunity to cover intensities ranging from $10^6$ p/s up to $3\\cdot10^{11}$ p/s. This exceeds the deposited energy per time expected at HL-LHC by more than a factor of 100. The correlation between beam intensity and the read-out signal has been studied. The data show clear indications of pulse shape distortion due to the high ionization build-up, in agreement with MC expectations. This is also confirmed from the dependence of the HV currents on beam intensity.

  18. Impact of a second FDG PET scan before adjuvant therapy for the early detection of residual/relapsing tumours in high-risk patients with oral cavity cancer and pathological extracapsular spread

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Chun-Ta; Huang, Shiang-Fu; Chen, I-How; Kang, Chung-Jan [Chang Gung Memorial Hospital and Chang Gung University, Department of Otorhinolaryngology, Head and Neck Surgery, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Fan, Kang-Hsing; Lin, Chien-Yu [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Radiation Oncology, Taoyuan (China); Wang, Hung-Ming [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Medical Oncology, Taoyuan (China); Ng, Shu-Hang [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Diagnostic Radiology, Taoyuan (China); Hsueh, Chuen; Lee, Li-Yu [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Pathology, Taoyuan (China); Lin, Chih-Hung [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Plastic and Reconstructive Surgery, Taoyuan (China); Yen, Tzu-Chen [Chang Gung Memorial Hospital and Chang Gung University, Head and Neck Oncology Group, Taoyuan (China); Chang Gung Memorial Hospital and Chang Gung University, Department of Nuclear Medicine and Molecular Imaging Center, Taoyuan (China)

    2012-06-15

    Extracapsular spread (ECS) to the cervical lymph nodes is a major adverse prognostic factor in oral cavity squamous cell carcinoma (OSCC). We prospectively examined the value of FDG PET immediately before postoperative radiotherapy/concurrent chemoradiotherapy (pre-RT/CCRT PET) to detect residual/relapsing disease in the early postsurgical follow-up period in high-risk OSCC patients with ECS. We examined 183 high-risk OSCC patients with ECS who underwent preoperative FDG PET/CT for staging purposes. Of these patients, 29 underwent a second pre-RT/CCRT FDG PET/CT scan. The clinical utility of the second FDG PET/CT was examined using Kaplan-Meier curve analysis. Patients who underwent the second FDG PET/CT scan had baseline clinicopathological characteristics similar to those who did not undergo a second scan. Of the patients who underwent the second scan, seven (24 %) had unexpected, newly discovered lesions. Five eventually died of the disease, and two had no evidence of recurrence after a change in RT field and dose. In an event-based analysis at 2 months, rates of neck control (6/29 vs. 6/154, p = 0.001), distant metastases (3/29 vs. 4/154, p = 0.046), and disease-free survival (7/29 vs. 10/154, p = 0.003) were significantly higher in patients who received a second PET scan than in those who did not. The second pre-RT/CCRT PET scan was of particular benefit for detecting new lesions in OSCC patients with both ECS and lymph node standardized uptake value (SUV) of {>=}5.2 in the first PET scan. The present findings support the clinical value of pre-RT/CCRT FDG PET for defining treatment strategy in OSCC patients with both ECS and high nodal SUV, even when FDG PET had already been performed during the initial staging work-up. (orig.)

  19. High-dose chemotherapy and auto-SCT for relapsed and refractory Hodgkin's lymphoma patients refractory to first-line salvage chemotherapy but responsive to second-line salvage chemotherapy.

    Science.gov (United States)

    Rauf, Muhammad Shahzad; Maghfoor, Irfan; Elhassan, Tusneem Ahmed M; Akhtar, Saad

    2015-01-01

    Relapsed or primary refractory Hodgkin's lymphoma (HL) patients refractory to first-line salvage chemotherapy (first salvage) and unable to undergo high-dose chemotherapy (HDC) and autologous stem cell transplant (auto-SCT) have very poor outcome. Some patients are offered second-line salvage chemotherapy (second salvage), if they are responsive and may receive HDC auto-SCT. We identified 31 patients (18 males, 13 females) from 1996-2012 who received second salvage prior to auto-SCT. Median age at auto-SCT is 22 years. Patients were grouped as (1) relapsed-refractory (Rel:Ref): patients with prior complete response (CR) and on relapse found refractory to first salvage and received second salvage and (2) refractory-refractory (Ref:Ref): patients refractory to both primary treatment and first salvage and received second salvage. Median follow-up is 63 months (18-170). Disease status after second salvage prior to HDC was CR 16 %, partial response (PR) 71 % and stable disease 13 %. After HDC auto-SCT, CR:PR: progressive disease was observed in 18 (58 %): four (12 %): nine (29 %) patients, respectively. Five-year overall survival (OS) for whole group is 57 % (Rel:Ref vs. Ref:Ref, 73 % vs. 48 %, p = 0.48). Progression-free survival (PFS) for whole group is 52 % (Rel:Ref vs. Ref:Ref, 73 % vs. 40 % respectively, p = 0.11). Second-line salvage is a valid approach with no long-term side effects for those HL patients who do not respond to first-line salvage chemotherapy and they can be candidate of HDC and stem cell transplant with a high ORR, the PFS and OS in relapse-refractory and refractory-refractory group of patients.

  20. Medical chart validation of an algorithm for identifying multiple sclerosis relapse in healthcare claims.

    Science.gov (United States)

    Chastek, Benjamin J; Oleen-Burkey, Merrikay; Lopez-Bresnahan, Maria V

    2010-01-01

    Relapse is a common measure of disease activity in relapsing-remitting multiple sclerosis (MS). The objective of this study was to test the content validity of an operational algorithm for detecting relapse in claims data. A claims-based relapse detection algorithm was tested by comparing its detection rate over a 1-year period with relapses identified based on medical chart review. According to the algorithm, MS patients in a US healthcare claims database who had either (1) a primary claim for MS during hospitalization or (2) a corticosteroid claim following a MS-related outpatient visit were designated as having a relapse. Patient charts were examined for explicit indication of relapse or care suggestive of relapse. Positive and negative predictive values were calculated. Medical charts were reviewed for 300 MS patients, half of whom had a relapse according to the algorithm. The claims-based criteria correctly classified 67.3% of patients with relapses (positive predictive value) and 70.0% of patients without relapses (negative predictive value; kappa 0.373: p value of the operational algorithm. Limitations of the algorithm include lack of differentiation between relapsing-remitting MS and other types, and that it does not incorporate measures of function and disability. The claims-based algorithm appeared to successfully detect moderate-to-severe MS relapse. This validated definition can be applied to future claims-based MS studies.

  1. High School Graduation Rates:Alternative Methods and Implications

    OpenAIRE

    Jing Miao; Walt Haney

    2004-01-01

    The No Child Left Behind Act has brought great attention to the high school graduation rate as one of the mandatory accountability measures for public school systems. However, there is no consensus on how to calculate the high school graduation rate given the lack of longitudinal databases that track individual students. This study reviews literature on and practices in reporting high school graduation rates, compares graduation rate estimates yielded from alternative methods, and estimates d...

  2. Relapsing Polychondritis Following Alopecia Areata

    Directory of Open Access Journals (Sweden)

    John C. Starr

    2010-01-01

    Full Text Available A case of alopecia areata followed by relapsing polychondritis is presented. Similar cases from the literature are reviewed and speculation about the relationship of these diseases is offered. Although the occurrence of these diseases together could be coincidental, an association seems immunologically plausible. Thus, relapsing polychondritis might be an unusual systemic manifestation of alopecia areata.

  3. Prefrontal gamma-aminobutyric acid type A receptor insertion controls cue-induced relapse to nicotine seeking.

    Science.gov (United States)

    Lubbers, Bart R; van Mourik, Yvar; Schetters, Dustin; Smit, August B; De Vries, Taco J; Spijker, Sabine

    2014-11-01

    Current smoking cessation therapies offer limited success, as relapse rates remain high. Nicotine, which is the major component of tobacco smoke, is thought to be primarily responsible for the addictive properties of tobacco. However, little is known about the molecular mechanisms underlying nicotine relapse, hampering development of more effective therapies. The objective of this study was to elucidate the role of medial prefrontal cortex (mPFC) glutamatergic and gamma-aminobutyric acid (GABA)ergic receptors in controlling relapse to nicotine seeking. Using an intravenous self-administration model, we studied glutamate and gamma-aminobutyric acid receptor regulation in the synaptic membrane fraction of the rat mPFC following extinction and cue-induced relapse to nicotine seeking. Subsequently, we locally intervened at the level of GABAergic signaling by using a mimetic peptide of the GABA receptor associated protein-interacting domain of GABA type A (GABAA) receptor subunit γ2 (TAT-GABAγ2) and muscimol, a GABAA receptor agonist. Alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid and N-methyl-D-aspartate receptors were not regulated after the 30-min relapse test. However, GABAA receptor subunits α1 and γ2 were upregulated, and interference with GABAA receptor insertion in the cell membrane using the TAT-GABAγ2 peptide in the dorsal mPFC, but not the ventral mPFC, significantly increased responding during relapse. Increasing GABAA transmission with muscimol in the dorsal and ventral mPFC attenuated relapse. These data indicate that cue-induced relapse entails a GABAergic plasticity mechanism that limits nicotine seeking by restoring inhibitory control in the dorsal mPFC. GABAA receptor-mediated neurotransmission in the dorsal mPFC constitutes a possible future therapeutic target for maintaining smoking abstinence. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  4. High School Graduation Rates:Alternative Methods and Implications

    Directory of Open Access Journals (Sweden)

    Jing Miao

    2004-10-01

    Full Text Available The No Child Left Behind Act has brought great attention to the high school graduation rate as one of the mandatory accountability measures for public school systems. However, there is no consensus on how to calculate the high school graduation rate given the lack of longitudinal databases that track individual students. This study reviews literature on and practices in reporting high school graduation rates, compares graduation rate estimates yielded from alternative methods, and estimates discrepancies between alternative results at national, state, and state ethnic group levels. Despite the graduation rate method used, results indicate that high school graduation rates in the U.S. have been declining in recent years and that graduation rates for black and Hispanic students lag substantially behind those of white students. As to graduation rate method preferred, this study found no evidence that the conceptually more complex methods yield more accurate or valid graduation rate estimates than the simpler methods.

  5. Relapse to cocaine seeking in an invertebrate.

    Science.gov (United States)

    Amaning-Kwarteng, Akua O; Asif-Malik, Aman; Pei, Yue; Canales, Juan J

    2017-06-01

    Addiction is characterised by cycles of compulsive drug taking, periods of abstinence and episodes of relapse. The extinction/reinstatement paradigm has been extensively used in rodents to model human relapse and explore underlying mechanisms and therapeutics. However, relapse to drug seeking behaviour has not been previously demonstrated in invertebrates. Here, we used a cocaine conditioned place preference (CPP) paradigm in the flatworm, planarian, followed by extinction and reinstatement of drug seeking. Once baseline preference was established for one of two distinctly textured environments (i.e. compartments with a coarse or smooth surface), planarian received pairings of cocaine (5μM) in the non-preferred, and vehicle in the most preferred, environment, and were tested for conditioning thereafter. Cocaine produced robust CPP, measured as a significant increase in the time spent in the cocaine-paired compartment. Subsequently, planarian underwent extinction training, reverting back to their original preference within three sessions. Brief exposure to cocaine (5μM) or methamphetamine (5μM) reinstated cocaine-seeking behaviour. By contrast, the high affinity dopamine transporter inhibitor, (N-(n-butyl)-3α-[bis (4-fluorophenyl) methoxy]-tropane) (JHW007), which in rodents exhibits a neurochemical and behavioural profile distinct from cocaine, was ineffective. The present findings demonstrate for the first time reinstatement of extinguished cocaine seeking in an invertebrate model and suggest that the long-term adaptations underlying drug conditioning and relapse are highly conserved through evolution. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Activated mesenchymal stem cell administration inhibits chronic alcohol drinking and suppresses relapse-like drinking in high-alcohol drinker rats.

    Science.gov (United States)

    Ezquer, Fernando; Quintanilla, María Elena; Morales, Paola; Ezquer, Marcelo; Lespay-Rebolledo, Carolyne; Herrera-Marschitz, Mario; Israel, Yedy

    2017-10-18

    Neuroinflammation has been reported to follow chronic ethanol intake and may perpetuate alcohol consumption. Present studies determined the effect of human mesenchymal stem cells (hMSCs), known for their anti-inflammatory action, on chronic ethanol intake and relapse-like ethanol intake in a post-deprivation condition. Rats were allowed 12-17 weeks of chronic voluntary ethanol (10% and 20% v/v) intake, after which a single dose of activated hMSCs (5 × 10 5 ) was injected into a brain lateral ventricle. Control animals were administered vehicle. After assessing the effect of hMSCs on chronic ethanol intake for 1 week, animals were deprived of ethanol for 2 weeks and thereafter an ethanol re-access of 60 min was allowed to determine relapse-like intake. A single administration of activated hMSCs inhibited chronic alcohol consumption by 70% (P 80 mg/dl. The single hMSC administration reduced relapse-like blood ethanol levels to 20 mg/dl. Chronic ethanol intake increased by 250% (P chronic ethanol intake, an effect that was fully abolished by the administration of hMSCs. This study supports the neuroinflammation-chronic ethanol intake hypothesis and suggest that mesenchymal stem cell administration may be considered in the treatment of alcohol use disorders. © 2017 Society for the Study of Addiction.

  7. Prevention of relapse of Graves' disease by treatment with an intrathyroid injection of dexamethasone.

    Science.gov (United States)

    Mao, Xiao-Ming; Li, Hui-Qin; Li, Qian; Li, Dong-Mei; Xie, Xiao-Jing; Yin, Guo-Ping; Zhang, Peng; Xu, Xiang-Hong; Wu, Jin-Dan; Chen, Song-Wang; Wang, Shu-Kui

    2009-12-01

    Antithyroid drugs are widely used in the treatment of Graves' disease (GD), but the relapse rate is very high after therapy withdrawal. We evaluated the reduction effects of intrathyroid injection of dexamethasone (IID) on the relapse rate of hyperthyroidism in patients with newly diagnosed GD. A total of 191 patients with GD completed the study. After 6 months of treatment with methimazole (MMI), the patients were randomly assigned to receive either MMI (96 patients) alone or MMI combined with IID (MMI+IID; 95 patients) treatment for 3 months, followed by continuing a dose of MMI that would maintain euthyroidism for the next 9 months in all of the patients. After withdrawal of the medical therapy, patients were followed for 24 months, and the relapse rate of hyperthyroidism was evaluated. No statistical difference was observed in the levels of serum FT(4), TSH, or TSH receptor antibodies (TR-Ab), the thyroid volume, or the TR-Ab positive rate between the two groups at month 6. After the next 3 months of treatment with MMI+IID or MMI alone, the levels of TSH increased significantly, and the levels of serum TR-Ab, the TR-Ab positive rate, and thyroid volume decreased significantly in the MMI+IID group compared with the MMI group. Seven patients (7.4%) experienced a relapse of overt hyperthyroidism in the MMI+IID group and 49 patients (51%) in MMI group during the 2-yr follow-up period (P prevent relapse of hyperthyroidism in GD after medical therapy withdrawal.

  8. The Effect of Minimum Wage Rates on High School Completion

    Science.gov (United States)

    Warren, John Robert; Hamrock, Caitlin

    2010-01-01

    Does increasing the minimum wage reduce the high school completion rate? Previous research has suffered from (1. narrow time horizons, (2. potentially inadequate measures of states' high school completion rates, and (3. potentially inadequate measures of minimum wage rates. Overcoming each of these limitations, we analyze the impact of changes in…

  9. High regression rate, high density hybrid fuels, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — This SBIR program will investigate high energy density novel nanofuels combined with high density binders for use with an N2O oxidizer. Terves has developed...

  10. The american high school graduation rate : trends and levels

    OpenAIRE

    Heckman, James J.; LaFontaine, Paul A.

    2008-01-01

    This paper uses multiple data sources and a unified methodology to estimate the trends and levels of the U.S. high school graduation rate. Correcting for important biases that plague previous calculations, we establish that (a) the true high school graduation rate is substantially lower than the official rate issued by the National Center for Educational Statistics; (b) it has been declining over the past 40 years; (c) majority/minority graduation rate differentials are substantial and have n...

  11. Temporal dynamics of high repetition rate pulsed single longitudinal ...

    Indian Academy of Sciences (India)

    ing (GIG) cavity, single-mode dye laser pumped by high repetition rate ... in a high loss cavity, a detailed theoretical study and optimization of cavity ..... rate for high conversion efficiency and longer pulse width of the single-mode dye laser.

  12. Quantum data locking for high-rate private communication

    OpenAIRE

    Lupo, Cosmo; Lloyd, Seth

    2015-01-01

    We show that, if the accessible information is used as a security quantifier, quantum channels with a certain symmetry can convey private messages at a tremendously high rate, as high as less than one bit below the rate of non-private classical communication. This result is obtained by exploiting the quantum data locking effect. The price to pay to achieve such a high private communication rate is that accessible information security is in general not composable. However, composable security ...

  13. High-Rate Strong-Signal Quantum Cryptography

    Science.gov (United States)

    Yuen, Horace P.

    1996-01-01

    Several quantum cryptosystems utilizing different kinds of nonclassical lights, which can accommodate high intensity fields and high data rate, are described. However, they are all sensitive to loss and both the high rate and the strong-signal character rapidly disappear. A squeezed light homodyne detection scheme is proposed which, with present-day technology, leads to more than two orders of magnitude data rate improvement over other current experimental systems for moderate loss.

  14. Long-term results of exclusive low-dose rate curie-therapy for a high-grade vaginal intraepithelial neoplasia

    International Nuclear Information System (INIS)

    Blanchard, P.; Monnier, L.; Dumas, I.; Azoury, F.; Mazeron, R.; Haie-Meder, C.

    2010-01-01

    The authors report the results of an exclusive low dose rate curie therapy for female patients treated for a grade 3 vaginal intraepithelial neoplasia. They reviewed the medical files of patients treated since 1983, i.e. 28 women. They analysed demographic characteristics, the clinic description of lesions, possible treatments which occurred before this high-grade vaginal intraepithelial neoplasia, possible previous history of cervical or endometrial cancer, curie therapy detailed data, presence of tumorous relapse. According to that, they conclude that a 60 Gy exclusive low- vaginal dose-rate curie-therapy is an efficient and well tolerated treatment for high-grade vaginal intraepithelial neoplasia. Short communication

  15. Second and third responses to the same induction regimen in relapsing patients with multiple myeloma.

    Science.gov (United States)

    Paccagnella, A; Chiarion-Sileni, V; Soesan, M; Baggio, G; Bolzonella, S; De Besi, P; Casara, D; Frizzarin, M; Salvagno, L; Favaretto, A

    1991-09-01

    From September 1975 to December 1986, 115 consecutive previously untreated patients with multiple myeloma (MM) were treated with combination chemotherapy consisting of BCNU, cyclophosphamide, melphalan, vincristine, and prednisone (M-2). No patients were excluded or lost during follow-up. Forty-three percent of the patients were Stage I plus II, and 57% were Stage III. Thirty-eight patients (33%) had blood urea nitrogen greater than or equal to 40 mg/dl (substage B). Reaching an objective response treatment was stopped, generally after 1 year, and restarted at relapse. After induction therapy, 94 patients (82%) responded and had a median duration of response (MDR) of 22 months. After first relapse, 26 of 38 patients (69%) responded again to the same regimen and had an MDR of 11 months. This response rate and MDR are significantly lower than the ones achieved in induction chemotherapy. After second relapse, 7 of 16 patients (44%) again responded with an MDR of 3.5 months. The median survival time (MST) was 50.5 months for all patients. The most relevant side effect was leukopenia. No case of secondary leukemia was noticed. The authors conclude that patients with MM can be treated safely without maintenance therapy after reaching remission because a high response rate can be obtained in first and even second relapse. The planned treatment pause at remission does not adversely affect the survival time. Secondary leukemia is infrequent after this policy. Quality of life improves during the treatment pause.

  16. Treatment of multiple sclerosis relapses with high-dose methylprednisolone reduces the evolution of contrast-enhancing lesions into persistent black holes.

    Science.gov (United States)

    Di Gregorio, Maria; Gaetani, Lorenzo; Eusebi, Paolo; Floridi, Piero; Picchioni, Antonella; Rosi, Giovanni; Mancini, Andrea; Floridi, Chiara; Baschieri, Francesca; Gentili, Lucia; Sarchielli, Paola; Calabresi, Paolo; Di Filippo, Massimiliano

    2018-03-01

    The MRI evidence of persistent black holes (pBHs) on T1-weighted images reflects brain tissue loss in multiple sclerosis (MS). The evolution of contrast-enhancing lesions (CELs) into pBHs probably depends on the degree and persistence of focal brain inflammation. The aim of our retrospective study was to evaluate the effect of a single cycle of intravenous methylprednisolone (IVMP), as for MS relapse treatment, on the risk of CELs' evolution into pBHs. We selected 57 patients with CELs on the baseline MRI scan. We evaluated the evolution of CELs into pBHs on a follow-up MRI scan performed after ≥ 6 months in patients exposed and not exposed to IVMP for the treatment of relapse after the baseline MRI. In our cohort, 182 CELs were identified in the baseline MRI and 57 of them (31.3%) evolved into pBHs. In the multivariate analysis, the exposure of CELs to IVMP resulted to be a significant independent protective factor against pBHs' formation (OR 0.28, 95% CI 0.11-0.766, p = 0.005), while ring enhancement pattern and the fact of being symptomatic were significant risk factors for CELs' conversion into pBHs (OR 6.42, 95% CI 2.55-17.27, p < 0.001 and OR 13.19, 95% CI 1.56-288.87, p = 0.037). The exposure of CELs to a cycle of IVMP as for relapse treatment is associated with a lower risk of CELs' evolution into pBHs. Future studies are required to confirm the potential independent protective effect of IVMP on CELs' evolution into pBHs.

  17. High rate flame synthesis of highly crystalline iron oxide nanorods

    International Nuclear Information System (INIS)

    Merchan-Merchan, W; Taylor, A M; Saveliev, A V

    2008-01-01

    Single-step flame synthesis of iron oxide nanorods is performed using iron probes inserted into an opposed-flow methane oxy-flame. The high temperature reacting environment of the flame tends to convert elemental iron into a high density layer of iron oxide nanorods. The diameters of the iron oxide nanorods vary from 10 to 100 nm with a typical length of a few microns. The structural characterization performed shows that nanorods possess a highly ordered crystalline structure with parameters corresponding to cubic magnetite (Fe 3 O 4 ) with the [100] direction oriented along the nanorod axis. Structural variations of straight nanorods such as bends, and T-branched and Y-branched shapes are frequently observed within the nanomaterials formed, opening pathways for synthesis of multidimensional, interconnected networks

  18. TBI parameters and relapse of acute leukemia

    International Nuclear Information System (INIS)

    Sugawara, Tadashi; Inoue, Toshihiko; Mori, Tomoyuki.

    1994-01-01

    The purpose of this study, which involved 240 acute leukemia patients (ALL: 115, ANL: 125) who received an allogeneic bone marrow transplantation (BMT) with preconditioning by total body irradiation (TBI) and chemotherapy, was to examine retrospectively the TBI factors that may have influenced a leukemic relapse. The patients were divided into two groups: 124 patients who had received their BMT within a diagnosis-transplantation period of 9 months or less (DTP9 group), and 116 patients who had received their BMT within a diagnosis-transplantation period of 10 months or more (DTP10 group). It was concluded that: (1) the higher the TBI dose, the fewer the relapse rates in DTP9 group; (2) the longer the TBI period, the greater the increase in the relapse rate in DTP10 group. It was thus speculated that an effective TBI regimen for acute leukemia patients may vary depending on the length of time that has elapsed from the diagnosis of leukemia to the BMT. (author)

  19. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... in RRMS; however, each person's experience with RRMS will be unique. Following a relapse, the new symptoms ... and worsening, you and your MS care provider will likely want to consider a more aggressive treatment ...

  20. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... course – is characterized by clearly defined attacks of new or increasing neurologic symptoms. These attacks – also called ... either active (with relapses and/or evidence of new MRI activity) or not active , as well as ...

  1. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... defined attacks of new or increasing neurologic symptoms. These attacks – also called relapses or exacerbations – are followed ... as well as the nerve fibers themselves. During these inflammatory attacks, activated immune cells cause small, localized ...

  2. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Treating MS Comprehensive Care Find an MS Care Provider Medications Managing Relapses Rehabilitation Complementary & Alternative Medicines For Clinicians Resources & Support Library & Education Programs Find Support Advanced Care ...

  3. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... without symptoms of which the person is aware. What happens in RRMS? Relapsing-remitting MS is defined ... a different mechanism of action in order to control the disease activity more effectively and help prevent ...

  4. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Rule Out For Clinicians Treating MS Comprehensive Care Find an MS Care Provider Medications Managing Relapses Rehabilitation ... Medicines For Clinicians Resources & Support Library & Education Programs Find Support Advanced Care Needs Resources for Specific Populations ...

  5. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... the periods of remission. At different points in time, RRMS can be further characterized as either active ( ... increase in disability over a specified period of time following a relapse) or not worsening . An increase ...

  6. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... attacks of inflammation (relapses) in the CNS, progressive forms of MS involve much less of this type ... and memory or information processing). People with progressive forms of MS are more likely to experience gradually ...

  7. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Team Make the Most of Your Doctor Visits Advance Medical Directives d Find an MS Care Provider ... in RRMS; however, each person's experience with RRMS will be unique. Following a relapse, the new symptoms ...

  8. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... as shown by the arrows, often occur as part of a relapse. However, new MRI lesions indicating ... course of your disease at different points in time helps you and your MS care provider discuss ...

  9. HIGH-RATE DISINFECTION TECHNIQUES FOR COMBIND SEWER OVERFLOW

    Science.gov (United States)

    This paper presents high-rate disinfection technologies for combined sewer overflow (CSO). The high-rate disinfection technologies of interest are: chlorination/dechlorination, ultraviolet light irradiation (UV), chlorine dioxide (ClO2 ), ozone (O3), peracetic acid (CH3COOOH )...

  10. High Graduate Unemployment Rate and Taiwanese Undergraduate Education

    Science.gov (United States)

    Wu, Chih-Chun

    2011-01-01

    An expansion in higher education in combination with the recent global economic recession has resulted in a high college graduate unemployment rate in Taiwan. This study investigates how the high unemployment rate and financial constraints caused by economic cutbacks have shaped undergraduates' class choices, job needs, and future income…

  11. Circuit and interconnect design for high bit-rate applications

    NARCIS (Netherlands)

    Veenstra, H.

    2006-01-01

    This thesis presents circuit and interconnect design techniques and design flows that address the most difficult and ill-defined aspects of the design of ICs for high bit-rate applications. Bottlenecks in interconnect design, circuit design and on-chip signal distribution for high bit-rate

  12. High-dose-rate brachytherapy with two or three fractions as monotherapy in the treatment of locally advanced prostate cancer

    International Nuclear Information System (INIS)

    Hoskin, Peter; Rojas, Ana; Ostler, Peter; Hughes, Robert; Alonzi, Roberto; Lowe, Gerry; Bryant, Linda

    2014-01-01

    Background: To evaluate late urinary (GU) and gastrointestinal (GI) adverse events (AEs) and biochemical control of disease after high-dose rate brachytherapy (HDR-BT) in locally advanced prostate cancer. Patients and methods: 227 consecutive patients were treated with 3 × 10.5 Gy (n = 109) or 2 × 13 Gy (n = 118) HDR-BT alone. Biochemical failure was assessed using the Phoenix definition of PSA nadir + 2 μg/l and late AEs using the RTOG scoring system and the International Prostate Symptom Score (IPSS). Results: Kaplan–Meier estimates and prevalence of late events indicate that urinary, bowel and IPSS symptoms are higher after 31.5 Gy than after 26 Gy, however differences are significant only for Grade 1 and 2 urinary toxicity. Kaplan–Meier estimates of morbidity are consistently and considerably higher than time-point estimates of prevalence; which reflects the transient nature of most symptoms. At 3 years 93% and 97% of patients treated with 26 and 31.5 Gy, respectively, were free from biochemical relapse (p = 0.5) and 91% for the latter regimen at 5 years. In univariate and multivariate analysis risk-category was the only significant predictor of relapse (p < 0.03). Conclusion: These HDR-BT schedules achieved high levels of biochemical control of disease in patients with advanced prostate cancer with few severe complications seen throughout the first 3 years

  13. Introduction to State Estimation of High-Rate System Dynamics.

    Science.gov (United States)

    Hong, Jonathan; Laflamme, Simon; Dodson, Jacob; Joyce, Bryan

    2018-01-13

    Engineering systems experiencing high-rate dynamic events, including airbags, debris detection, and active blast protection systems, could benefit from real-time observability for enhanced performance. However, the task of high-rate state estimation is challenging, in particular for real-time applications where the rate of the observer's convergence needs to be in the microsecond range. This paper identifies the challenges of state estimation of high-rate systems and discusses the fundamental characteristics of high-rate systems. A survey of applications and methods for estimators that have the potential to produce accurate estimations for a complex system experiencing highly dynamic events is presented. It is argued that adaptive observers are important to this research. In particular, adaptive data-driven observers are advantageous due to their adaptability and lack of dependence on the system model.

  14. Processing of high-temperature superconductors at high strain rates

    International Nuclear Information System (INIS)

    Mamalis, A.G.; Pantazsopoulos, G.; Manolakos, D.E.; Szalay, A.

    2000-01-01

    This new book provides, for the first time, a systematic, unified presentation of all steps in the processing of high-temperature superconductor materials, ranging from synthesis of various systems to fabrication and industrial applications. Also covered are characterization techniques and current directions in research and development. The authors are leading specialists who bring to this new book their many years of experience in research, education and industrial engineering work in superconductor materials. This book is primarily focused on the bulk-fabrication techniques of high-temperature ceramic superconducting components, especially on the combination of dynamic powder-consolidation and subsequent deformation processing. The properties of these ceramics, which are difficult-to-form materials by applying conventional techniques, are combined for the net-shape manufacturing of such components for the construction of HTS deviceshor e llipsis. However, very important topics such as superconducting structures, chemical synthesis, film fabrication and characterization techniques are also reviewedhor e llipsis to provide a complete, comprehensive view of superconductors engineering

  15. High dose rate brachytherapy in treatment of high grade astrocytomas

    International Nuclear Information System (INIS)

    Garcia-Alejo, R.; Delgado, J.M.; Cerro, E. del; Torres, J.J.; Martinez, R.

    1996-01-01

    From May 1994 to June 1995, 18 patients with high grade astrocytomas were entered prospectively on a selective protocol combining surgery, external beam radiotherapy, stereotactic interstitial implantation with HDR Iridium 192 and chemotherapy. Only those patients with tumor size 100cc or less average dimension, high grade astrocytoma, Karnofsky 70 or greater, unilateral, circumscribed, unifocal, tumor stable or responding to external radiation and supratentorial were included in the study. Ages ranged from 16 to 69 years. There were 13 males and 5 females. Surgery consisted of biopsy only in 3 patients, subtotal resection in 11, and gross total resection in 4 patients. Focal external beam radiation portals included the contrast enhancing mass on CT scan plus a 3 cm margin. The protocol called for minimum tumor dose of 60 Gy to be given in 2 Gy daily fractions. An interstitial brachytherapy boost was to be performed two weeks after the conclusion of external beam radiation. The dose was 30 Gy in 4 fractions. The authors analyze on basis on their personal experience, the possibilities and the limits offered by this therapeutic procedure in neuro-oncology. Using stereotactic techniques, interstitial brachytherapy of brain tumors was technically possible with negligible acute morbidity and mortality, and appeared to be effective and may provide for an increase in tumor control in selected cases

  16. High-Dose-Rate Brachytherapy Boost Effect on Local Tumor Control in Young Women With Breast Cancer

    International Nuclear Information System (INIS)

    Guinot, Jose-Luis; Baixauli-Perez, Cristobal; Soler, Pablo; Tortajada, Maria Isabel; Moreno, Araceli; Santos, Miguel Angel; Mut, Alejandro; Gozalbo, Francisco; Arribas, Leoncio

    2015-01-01

    Purpose: To evaluate the local control rate and complications of a single fraction of high-dose-rate brachytherapy (HDR BT) boost in women aged 45 yeas and younger after breast-conserving therapy. Methods and Materials: Between 1999 and 2007, 167 patients between the ages of 26 and 45 years old (72 were 40 years old or younger), with stages T1 to T2 invasive breast cancer with disease-free margin status of at least 5 mm after breast-conserving surgery received 46 to 50 Gy whole-breast irradiation plus a 7-Gy HDR-BT boost (“fast boost”). An axillary dissection was performed in 72.5% of the patients and sentinel lymph node biopsy in 27.5%. A supraclavicular area was irradiated in 19% of the patients. Chemotherapy was used in 86% of the patients and hormone treatment in 77%. Clinical nodes were present in 18% and pathological nodes in 29%. The pathological stage was pT0: 5%, pTis: 3%, pT1: 69% and pT2: 23%. Intraductal component was present in 40% and 28% were G3. Results: At a median follow-up of 92 months, 9 patients relapsed on the margin of the implant, and 1 patient in another quadrant, resulting in a 10-year local relapse rate of 4.3% and a breast relapse rate of 4.9%, with breast preservation in 93.4%; no case of mastectomy due to poor cosmesis arose. Actuarial 5- and 10-year disease-free, cause-specific, and overall survival rates were 87.9% and 85.8%, and 92.1% and 88.4%, and 92.1% and 87.3%, respectively. In a univariate analysis, triple-negative cases and negative hormone receptors did worse, but in a multivariate analysis, only the last factor was significant for local and breast control. Asymptomatic fibrosis G2 was recorded in 3 cases, and there were no other late complications. Cosmetic results were good to excellent in 97% of cases. Conclusions: A single dose of 7 Gy using the fast-boost technique is well tolerated, with a low rate of late complications and improved local tumor control in women aged 45 and younger, compared to published data

  17. High-Dose-Rate Brachytherapy Boost Effect on Local Tumor Control in Young Women With Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Guinot, Jose-Luis, E-mail: jguinot@fivo.org [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Baixauli-Perez, Cristobal [Health Services Research Unit, Center for Public Health Research, Valencia (Spain); Soler, Pablo; Tortajada, Maria Isabel; Moreno, Araceli; Santos, Miguel Angel; Mut, Alejandro [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Gozalbo, Francisco [Department of Pathology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Arribas, Leoncio [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain)

    2015-01-01

    Purpose: To evaluate the local control rate and complications of a single fraction of high-dose-rate brachytherapy (HDR BT) boost in women aged 45 yeas and younger after breast-conserving therapy. Methods and Materials: Between 1999 and 2007, 167 patients between the ages of 26 and 45 years old (72 were 40 years old or younger), with stages T1 to T2 invasive breast cancer with disease-free margin status of at least 5 mm after breast-conserving surgery received 46 to 50 Gy whole-breast irradiation plus a 7-Gy HDR-BT boost (“fast boost”). An axillary dissection was performed in 72.5% of the patients and sentinel lymph node biopsy in 27.5%. A supraclavicular area was irradiated in 19% of the patients. Chemotherapy was used in 86% of the patients and hormone treatment in 77%. Clinical nodes were present in 18% and pathological nodes in 29%. The pathological stage was pT0: 5%, pTis: 3%, pT1: 69% and pT2: 23%. Intraductal component was present in 40% and 28% were G3. Results: At a median follow-up of 92 months, 9 patients relapsed on the margin of the implant, and 1 patient in another quadrant, resulting in a 10-year local relapse rate of 4.3% and a breast relapse rate of 4.9%, with breast preservation in 93.4%; no case of mastectomy due to poor cosmesis arose. Actuarial 5- and 10-year disease-free, cause-specific, and overall survival rates were 87.9% and 85.8%, and 92.1% and 88.4%, and 92.1% and 87.3%, respectively. In a univariate analysis, triple-negative cases and negative hormone receptors did worse, but in a multivariate analysis, only the last factor was significant for local and breast control. Asymptomatic fibrosis G2 was recorded in 3 cases, and there were no other late complications. Cosmetic results were good to excellent in 97% of cases. Conclusions: A single dose of 7 Gy using the fast-boost technique is well tolerated, with a low rate of late complications and improved local tumor control in women aged 45 and younger, compared to published data

  18. Economic costs associated with an MS relapse

    LENUS (Irish Health Repository)

    O'Connell, K.

    2014-09-01

    This was an prospective audit composed of medical chart review and patient questionnaire. Relapses were stratified into 3 groups: low, moderate and high intensity. Age, gender, MS subtype, disease duration, expanded disability status scale (EDSS) score, disease modifying therapy (DMT) use and employment status were recorded. Direct costs included GP visits, investigations, clinic visit, consultations with medical staff, medication and admission costs. Indirect costs assessed loss of earnings, partner\\'s loss of earnings, childcare, meals and travel costs.

  19. Outcome following late marrow relapse in childhood acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Chessells, J.; Leiper, A.; Rogers, D.

    1984-01-01

    Thirty-four children with acute lymphoblastic leukemia, who developed bone marrow relapse after treatment was electively stopped, received reinduction, consolidation, continuing therapy, and intrathecal (IT) methotrexate (MTX). Sixteen children who relapsed within six months of stopping treatment had a median second-remission duration of 26 weeks; all next relapses occurred in the bone marrow. In 18 children who relapsed later, the median duration of second remission was in excess of two years, but after a minimum of four years follow-up, 16 patients have so far relapsed again (six in the CNS). CNS relapse occurred as a next event in four of 17 children who received five IT MTX injections only and in two of 14 children who received additional regular IT MTX. Although children with late marrow relapses may achieve long second remissions, their long-term out-look is poor, and regular IT MTX does not afford adequate CNS prophylaxis. It remains to be seen whether more intensive chemotherapy, including high-dose chemoradiotherapy and bone marrow transplantation, will improve the prognosis in this group of patients

  20. Treatment effectiveness of alemtuzumab compared with natalizumab, fingolimod, and interferon beta in relapsing-remitting multiple sclerosis: a cohort study.

    Science.gov (United States)

    Kalincik, Tomas; Brown, J William L; Robertson, Neil; Willis, Mark; Scolding, Neil; Rice, Claire M; Wilkins, Alastair; Pearson, Owen; Ziemssen, Tjalf; Hutchinson, Michael; McGuigan, Christopher; Jokubaitis, Vilija; Spelman, Tim; Horakova, Dana; Havrdova, Eva; Trojano, Maria; Izquierdo, Guillermo; Lugaresi, Alessandra; Prat, Alexandre; Girard, Marc; Duquette, Pierre; Grammond, Pierre; Alroughani, Raed; Pucci, Eugenio; Sola, Patrizia; Hupperts, Raymond; Lechner-Scott, Jeannette; Terzi, Murat; Van Pesch, Vincent; Rozsa, Csilla; Grand'Maison, François; Boz, Cavit; Granella, Franco; Slee, Mark; Spitaleri, Daniele; Olascoaga, Javier; Bergamaschi, Roberto; Verheul, Freek; Vucic, Steve; McCombe, Pamela; Hodgkinson, Suzanne; Sanchez-Menoyo, Jose Luis; Ampapa, Radek; Simo, Magdolna; Csepany, Tunde; Ramo, Cristina; Cristiano, Edgardo; Barnett, Michael; Butzkueven, Helmut; Coles, Alasdair

    2017-04-01

    Alemtuzumab, an anti-CD52 antibody, is proven to be more efficacious than interferon beta-1a in the treatment of relapsing-remitting multiple sclerosis, but its efficacy relative to more potent immunotherapies is unknown. We compared the effectiveness of alemtuzumab with natalizumab, fingolimod, and interferon beta in patients with relapsing-remitting multiple sclerosis treated for up to 5 years. In this international cohort study, we used data from propensity-matched patients with relapsing-remitting multiple sclerosis from the MSBase and six other cohorts. Longitudinal clinical data were obtained from 71 MSBase centres in 21 countries and from six non-MSBase centres in the UK and Germany between Nov 1, 2015, and June 30, 2016. Key inclusion criteria were a diagnosis of definite relapsing-remitting multiple sclerosis, exposure to one of the study therapies (alemtuzumab, interferon beta, fingolimod, or natalizumab), age 65 years or younger, Expanded Disability Status Scale (EDSS) score 6·5 or lower, and no more than 10 years since the first multiple sclerosis symptom. The primary endpoint was annualised relapse rate. The secondary endpoints were cumulative hazards of relapses, disability accumulation, and disability improvement events. We compared relapse rates with negative binomial models, and estimated cumulative hazards with conditional proportional hazards models. Patients were treated between Aug 1, 1994, and June 30, 2016. The cohorts consisted of 189 patients given alemtuzumab, 2155 patients given interferon beta, 828 patients given fingolimod, and 1160 patients given natalizumab. Alemtuzumab was associated with a lower annualised relapse rate than interferon beta (0·19 [95% CI 0·14-0·23] vs 0·53 [0·46-0·61], pmultiple sclerosis. Alemtuzumab seems superior to fingolimod and interferon beta in mitigating relapse activity. Natalizumab seems superior to alemtuzumab in enabling recovery from disability. Both natalizumab and alemtuzumab seem highly

  1. Daclizumab for the treatment of relapsing-remitting multiple sclerosis.

    Science.gov (United States)

    Herwerth, Marina; Hemmer, Bernhard

    2017-06-01

    Multiple sclerosis (MS) is a common inflammatory disease of the central nervous system. Over the last two decades, the number of therapeutic options for the treatment of relapsing remitting MS (RRMS) has been constantly growing, providing new treatment options to patients. Areas covered: Herein, the authors review the recently approved monoclonal antibody daclizumab for the treatment of RRMS. Based on original articles, they discuss its mode of action and evaluate its efficacy and safety profile compared to other available agents. Expert opinion: The IL-2 receptor modulator daclizumab is a new highly effective agent for the treatment of RRMS with novel immunomodulatory properties. Compared to interferon-beta i.m., daclizumab is more effective in reducing relapse rates and MRI activity. However, its use is limited by the risk of autoimmune disorders and hepatotoxicity. Similar to other monoclonal antibodies for RRMS, therapy with daclizumab needs a strict preselection and monitoring of patients based on individual risk benefit assessment. Given its substantial effectiveness, daclizumab can be an attractive option for patients with highly active MS.

  2. Quantum data locking for high-rate private communication

    International Nuclear Information System (INIS)

    Lupo, Cosmo; Lloyd, Seth

    2015-01-01

    We show that, if the accessible information is used as a security quantifier, quantum channels with a certain symmetry can convey private messages at a tremendously high rate, as high as less than one bit below the rate of non-private classical communication. This result is obtained by exploiting the quantum data locking effect. The price to pay to achieve such a high private communication rate is that accessible information security is in general not composable. However, composable security holds against an eavesdropper who is forced to measure her share of the quantum system within a finite time after she gets it. (paper)

  3. High incidence of chronic graft-versus-host disease after myeloablative allogeneic stem cell transplantation for chronic lymphocytic leukemia in Sweden: graft-versus-leukemia effect protects against relapse.

    Science.gov (United States)

    Machaczka, Maciej; Johansson, Jan-Erik; Remberger, Mats; Hallböök, Helene; Lazarevic, Vladimir Lj; Wahlin, Björn Engelbrekt; Omar, Hamdy; Wahlin, Anders; Juliusson, Gunnar; Kimby, Eva; Hägglund, Hans

    2013-12-01

    Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a potentially curative treatment option for eligible patients with chronic lymphocytic leukemia (CLL). However, it is known that cure of CLL is only possible if a graft-versus-leukemia effect is present. Between 1994 and 2007, 48 adults underwent allo-SCT for poor-risk CLL in Sweden. Of these, ten (21%) patients aged 24-53 years (median: 46 years) received myeloablative conditioning (MAC), based on TBI and cyclophosphamide. All MAC patients had refractory, poorly controlled CLL before allo-SCT (partial remission in 9/10 patients and progressive disease in one). The cumulative incidence of acute graft-versus-host disease (GVHD) grades II-IV was 30%. Nine patients developed chronic GVHD; extensive in four. Rates of nonrelapse mortality at 1, 3 and 10 years were 0, 10 and 20%, respectively. Two patients relapsed 36 and 53 months after transplantation. Six patients were still alive after a median follow-up time of 11.5 years (range 5.9-13.7). The probabilities of relapse-free and overall survival from 1, 3 and 5 years after transplantation were 100, 90 and 70%, and 100, 90 and 80%, respectively. Nevertheless, our analysis of long-term outcome after MAC allo-SCT for CLL suggests that younger patients with poorly controlled CLL may benefit from MAC allo-SCT.

  4. Effectiveness of high interest rate policy on exchange rates: A reexamination of the Asian financial crisis

    Directory of Open Access Journals (Sweden)

    Chin Diew Lai

    2006-09-01

    Full Text Available One of the most controversial issues in the aftermath of the Asian financial crisis has been the appropriate response of monetary policy to a sharp decline in the value of some currencies. In this paper, we empirically examine the effects on Asian exchange rates of sharply higher interest rates during the Asian financial crisis. Taking account of the currency contagion effect, our results indicate that sharply higher interest rates helped to support the exchange rates of South Korea, the Philippines, and Thailand. For Malaysia, no significant causal relation is found from the rate of interest to exchange rates, as the authorities in Malaysia did not actively adopt a high interest rate policy to defend the currency.

  5. Interstitial high-dose rate brachytherapy as boost for anal canal cancer

    International Nuclear Information System (INIS)

    Falk, Alexander Tuan; Claren, Audrey; Benezery, Karen; François, Eric; Gautier, Mathieu; Gerard, Jean-Pierre; Hannoun-Levi, Jean-Michel

    2014-01-01

    To assess clinical outcomes of patients treated with a high-dose rate brachytherapy boost for anal canal cancer (ACC). From August 2005 to February 2013, 28 patients presenting an ACC treated by split-course external beam radiotherapy (EBRT) and HDR brachytherapy with or without chemotherapy in a French regional cancer center in Nice were retrospectively analyzed. Median age was 60.6 years [34 – 83], 25 patients presented a squamous cell carcinoma and 3 an adenocarcinoma; 21 received chemotherapy. Median dose of EBRT was 45 Gy [43.2 – 52]. Median dose of HDR brachytherapy was 12 Gy [10 - 15] with a median duration of 2 days. Median overall treatment time was 63 days and median delay between EBRT and brachytherapy was 20 days. Two-year local relapse free, metastatic free, disease free and overall survivals were 83%, 81.9%, 71.8% and 87.7% respectively. Acute toxicities were frequent but not severe with mostly grade 1 toxicities: 37% of genito-urinary, 40.7% of gastro-intestinal and 3.7% of cutaneous toxicities. Late toxicities were mainly G1 (43.1%) and G2 (22%). Two-year colostomy-free survival was 75.1%, one patient had a definitive sphincter amputation. High-dose rate brachytherapy for anal canal carcinoma as boost represents a feasible technique compared to low or pulsed-dose rate brachytherapy. This technique remains an excellent approach to precisely boost the tumor in reducing the overall treatment time

  6. A Unique Case of Relapsing Polychondritis Presenting with Acute Pericarditis

    Directory of Open Access Journals (Sweden)

    John V. Higgins

    2013-01-01

    Full Text Available Relapsing polychondritis (RP is an inflammatory disease of the cartilaginous tissue primarily affecting the cartilaginous structures of the ear, nose, joints, and the respiratory system. Cardiovascular complications of RP are associated with high morbidity and mortality and occur most commonly as valvular disease. Pericarditis is a less common complication, occurring in 4% of patients with RP and has not previously been described at presentation. We describe a case of relapsing polychondritis with acute pericarditis at presentation.

  7. How Did Successful High Schools Improve Their Graduation Rates?

    Science.gov (United States)

    Robertson, Janna Siegel; Smith, Robert W.; Rinka, Jason

    2016-01-01

    The researchers surveyed 23 North Carolina high schools that had markedly improved their graduation rates over the past five years. The administrators reported on the dropout prevention practices and programs to which they attributed their improved graduation rates. The majority of schools reported policy changes, especially with suspension. The…

  8. Effect of high heating rate on thermal decomposition behaviour of ...

    Indian Academy of Sciences (India)

    the thermal decomposition behaviour of the aforementioned powder at high heating rates was taken into considera- ... does not change the process of releasing hydrogen from titanium hydride ... from titanium hydride in a sequence of steps.

  9. Treatment of the prostate cancer with high dose rate brachytherapy

    International Nuclear Information System (INIS)

    Martinez, Alvaro; Torres Silva, Felipe

    2002-01-01

    The prostate cancer treatment in early stages is controversial. The high dose rate brachytherapy has been used like monotherapy or boost with external beam radiotherapy in advanced disease. This paper describes the technique and the advantages over other modalities

  10. Effect of high heating rate on thermal decomposition behaviour of ...

    Indian Academy of Sciences (India)

    Effect of high heating rate on thermal decomposition behaviour of titanium hydride ... hydride powder, while switching it from internal diffusion to chemical reaction. ... TiH phase and oxides form on the powder surface, controlling the process.

  11. Increased strength of concrete subject to high loading rates

    International Nuclear Information System (INIS)

    Curbach, M.

    1987-01-01

    Within the scope of this work various problems are discussed which occur in connection with concrete under high tensile loading rates (e.g. when a plane crashes on a nuclear power plant very high loads occur which act only for a very short time). Particularly the causes for the already frequently noticed increases in strength with increasing loading rates are investigated and also the question whether this increased strength can be taken into account when dimensioning a construction. (MM) [de

  12. Quantum Communication with a High-Rate Entangled Photon Source

    Science.gov (United States)

    Wilson, Nathaniel C.; Chaffee, Dalton W.; Lekki, John D.; Wilson, Jeffrey D.

    2016-01-01

    A high generation rate photon-pair source using a dual element periodically-poled potassium titanyl phosphate (PP KTP) waveguide is described. The photon-pair source features a high pair generation rate, a compact power-efficient package, and continuous wave (CW) or pulsed operation. Characterization and test results are presented. Details and preliminary results of a laboratory free-space QKD experiment with the B92 protocol are also presented.

  13. Interferon alpha 2 maintenance therapy may enable high rates of treatment discontinuation in chronic myeloid leukemia.

    Science.gov (United States)

    Burchert, A; Saussele, S; Eigendorff, E; Müller, M C; Sohlbach, K; Inselmann, S; Schütz, C; Metzelder, S K; Ziermann, J; Kostrewa, P; Hoffmann, J; Hehlmann, R; Neubauer, A; Hochhaus, A

    2015-06-01

    A minority of chronic myeloid leukemia (CML) patients is capable of successfully discontinuing imatinib. Treatment modalities to increase this proportion are currently unknown. Here, we assessed the role of interferon alpha 2a (IFN) on therapy discontinuation in a previously reported cohort of 20 chronic phase CML patients who were treated upfront with IFN alpha plus imatinib followed by IFN monotherapy to maintain cytogenetic or molecular remission (MR) after imatinib discontinuation. After a median follow-up of 7.9 years (range, 5.2-12.2), relapse-free survival was 73% (8/11 patients) and 84% (5/6 patients) for patients who discontinued imatinib in major MR (MMR) and MR4/MR4.5, respectively. Ten patients discontinued IFN after a median of 4.5 years (range, 0.24-9.3). After a median of 2.8 years (range, 0.7-5.1), nine of them remain in ongoing treatment-free remission with MR5 (n=6) and MR4.5 (n=3). The four patients who still administer IFN are in stable MR5, MR4.5, MR4, and MMR, respectively. In conclusion, an IFN/imatinib induction treatment followed by a temporary IFN maintenance therapy may enable a high rate of treatment discontinuation in CML patients in at least MMR when stopping imatinib.

  14. High Heating Rates Affect Greatly the Inactivation Rate of Escherichia coli

    Science.gov (United States)

    Huertas, Juan-Pablo; Aznar, Arantxa; Esnoz, Arturo; Fernández, Pablo S.; Iguaz, Asunción; Periago, Paula M.; Palop, Alfredo

    2016-01-01

    Heat resistance of microorganisms can be affected by different influencing factors. Although, the effect of heating rates has been scarcely explored by the scientific community, recent researches have unraveled its important effect on the thermal resistance of different species of vegetative bacteria. Typically heating rates described in the literature ranged from 1 to 20°C/min but the impact of much higher heating rates is unclear. The aim of this research was to explore the effect of different heating rates, such as those currently achieved in the heat exchangers used in the food industry, on the heat resistance of Escherichia coli. A pilot plant tubular heat exchanger and a thermoresistometer Mastia were used for this purpose. Results showed that fast heating rates had a deep impact on the thermal resistance of E. coli. Heating rates between 20 and 50°C/min were achieved in the heat exchanger, which were much slower than those around 20°C/s achieved in the thermoresistometer. In all cases, these high heating rates led to higher inactivation than expected: in the heat exchanger, for all the experiments performed, when the observed inactivation had reached about seven log cycles, the predictions estimated about 1 log cycle of inactivation; in the thermoresistometer these differences between observed and predicted values were even more than 10 times higher, from 4.07 log cycles observed to 0.34 predicted at a flow rate of 70 mL/min and a maximum heating rate of 14.7°C/s. A quantification of the impact of the heating rates on the level of inactivation achieved was established. These results point out the important effect that the heating rate has on the thermal resistance of E. coli, with high heating rates resulting in an additional sensitization to heat and therefore an effective food safety strategy in terms of food processing. PMID:27563300

  15. Seeing the signs: Using the course of residual depressive symptomatology to predict patterns of relapse and recurrence of major depressive disorder.

    Science.gov (United States)

    Verhoeven, Floor E A; Wardenaar, Klaas J; Ruhé, Henricus G Eric; Conradi, Henk Jan; de Jonge, Peter

    2018-02-01

    Major depressive disorder (MDD) is characterized by high relapse/recurrence rates. Predicting individual patients' relapse/recurrence risk has proven hard, possibly due to course heterogeneity among patients. This study aimed to (1) identify homogeneous data-driven subgroups with different patterns of relapse/recurrence and (2) identify associated predictors. For a year, we collected weekly depressive symptom ratings in 213 primary care MDD patients. Latent class growth analyses (LCGA), based on symptom-severity during the 24 weeks after no longer fulfilling criteria for the initial major depressive episode (MDE), were used to identify groups with different patterns of relapse/recurrence. Associations of baseline predictors with these groups were investigated, as were the groups' associations with 3- and 11-year follow-up depression outcomes. LCGA showed that heterogeneity in relapse/recurrence after no longer fulfilling criteria for the initial MDE was best described by four classes: "quick symptom decline" (14.0%), "slow symptom decline" (23.3%), "steady residual symptoms" (38.7%), and "high residual symptoms" (24.1%). The latter two classes showed lower self-esteem at baseline, and more recurrences and higher severity at 3-year follow-up than the first two classes. Moreover, the high residual symptom class scored higher on neuroticism and lower on extraversion and self-esteem at baseline. Interestingly, the steady residual symptoms and high residual symptoms classes still showed higher severity of depressive symptoms after 11 years. Some measures were associated with specific patterns of relapse/recurrence. Moreover, the data-driven relapse/recurrence groups were predictive of long-term outcomes, suggesting that patterns of residual symptoms could be of prognostic value in clinical practice. © 2017 Wiley Periodicals, Inc.

  16. Extramedullary Relapse Following Total Marrow and Lymphoid Irradiation in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hyun [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Stein, Anthony [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Tsai, Nicole [Department of Biostatistics, City of Hope National Medical Center, Duarte, California (United States); Schultheiss, Timothy E. [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Palmer, Joycelynne [Department of Biostatistics, City of Hope National Medical Center, Duarte, California (United States); Liu, An [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Rosenthal, Joseph [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Department of Pediatrics, City of Hope National Medical Center, Duarte, California (United States); Forman, Stephen J. [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Wong, Jeffrey Y.C., E-mail: jwong@coh.org [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States)

    2014-05-01

    Purpose: Approximately 5% to 20% of patients who undergo total body irradiation (TBI) in preparation for hematopoietic cell transplantation (HCT) can develop extramedullary (EM) relapse. Whereas total marrow and lymphoid irradiation (TMLI) provides a more conformally targeted radiation therapy for patients, organ sparing has the potential to place the patient at a higher risk for EM relapse than TBI. This study evaluated EM relapse in patients treated with TMLI at our institution. Methods and Materials: Patients eligible for analysis had been enrolled in 1 of 3 prospective TMLI trials between 2006 and 2012. The TMLI targeted bones, major lymph node chains, liver, spleen, testes, and brain, using image-guided tomotherapy with total dose ranging from 12 to 15 Gy. Results: A total of 101 patients with a median age of 47 years were studied. The median follow-up was 12.8 months. Incidence of EM relapse and bone marrow (BM) relapse were 12.9% and 25.7%, respectively. Of the 13 patients who had EM relapse, 4 also had BM relapse, and 7 had EM disease prior to HCT. There were a total of 19 EM relapse sites as the site of initial recurrence: 11 soft tissue, 6 lymph node, 2 skin. Nine of these sites were within the target region and received ≥12 Gy. Ten initial EM relapse sites were outside of the target region: 5 sites received 10.1 to 11.4 Gy while 5 sites received <10 Gy. Pretransplantation EM was the only significant predictor of subsequent EM relapse. The cumulative incidence of EM relapse was 4% at 1 year and 11.4% at 2 years. Conclusions: EM relapse incidence was as frequent in regions receiving ≥10 Gy as those receiving <10 Gy. EM relapse rates following TMLI that included HCT regimens were comparable to published results with regimens including TBI and suggest that TMLI is not associated with an increased EM relapse risk.

  17. Extramedullary Relapse Following Total Marrow and Lymphoid Irradiation in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation

    International Nuclear Information System (INIS)

    Kim, Ji Hyun; Stein, Anthony; Tsai, Nicole; Schultheiss, Timothy E.; Palmer, Joycelynne; Liu, An; Rosenthal, Joseph; Forman, Stephen J.; Wong, Jeffrey Y.C.

    2014-01-01

    Purpose: Approximately 5% to 20% of patients who undergo total body irradiation (TBI) in preparation for hematopoietic cell transplantation (HCT) can develop extramedullary (EM) relapse. Whereas total marrow and lymphoid irradiation (TMLI) provides a more conformally targeted radiation therapy for patients, organ sparing has the potential to place the patient at a higher risk for EM relapse than TBI. This study evaluated EM relapse in patients treated with TMLI at our institution. Methods and Materials: Patients eligible for analysis had been enrolled in 1 of 3 prospective TMLI trials between 2006 and 2012. The TMLI targeted bones, major lymph node chains, liver, spleen, testes, and brain, using image-guided tomotherapy with total dose ranging from 12 to 15 Gy. Results: A total of 101 patients with a median age of 47 years were studied. The median follow-up was 12.8 months. Incidence of EM relapse and bone marrow (BM) relapse were 12.9% and 25.7%, respectively. Of the 13 patients who had EM relapse, 4 also had BM relapse, and 7 had EM disease prior to HCT. There were a total of 19 EM relapse sites as the site of initial recurrence: 11 soft tissue, 6 lymph node, 2 skin. Nine of these sites were within the target region and received ≥12 Gy. Ten initial EM relapse sites were outside of the target region: 5 sites received 10.1 to 11.4 Gy while 5 sites received <10 Gy. Pretransplantation EM was the only significant predictor of subsequent EM relapse. The cumulative incidence of EM relapse was 4% at 1 year and 11.4% at 2 years. Conclusions: EM relapse incidence was as frequent in regions receiving ≥10 Gy as those receiving <10 Gy. EM relapse rates following TMLI that included HCT regimens were comparable to published results with regimens including TBI and suggest that TMLI is not associated with an increased EM relapse risk

  18. Stretching of red blood cells at high strain rates

    Science.gov (United States)

    Mancuso, J. E.; Ristenpart, W. D.

    2017-10-01

    Most work on the mechanical behavior of red blood cells (RBCs) in flow has focused on simple shear flows. Relatively little work has examined RBC deformations in the physiologically important extensional flow that occurs at the entrance to a constriction. In particular, previous work suggests that RBCs rapidly stretch out and then retract upon entering the constriction, but to date no model predicts this behavior for the extremely high strain rates typically experienced there. In this Rapid Communication, we use high speed video to perform systematic measurements of the dynamic stretching behavior of RBCs as they enter a microfluidic constriction. We demonstrate that both the Kelvin-Voigt and Skalak viscoelastic models capture the observed stretching dynamics, up to strain rates as high as 2000 s-1. The results indicate that the effective elastic modulus of the RBC membrane at these strain rates is an order of magnitude larger than moduli measured by micropipette aspiration or other low strain rate techniques.

  19. Solidification at the High and Low Rate Extreme

    Energy Technology Data Exchange (ETDEWEB)

    Meco, Halim [Iowa State Univ., Ames, IA (United States)

    2004-12-19

    The microstructures formed upon solidification are strongly influenced by the imposed growth rates on an alloy system. Depending on the characteristics of the solidification process, a wide range of growth rates is accessible. The prevailing solidification mechanisms, and thus the final microstructure of the alloy, are governed by these imposed growth rates. At the high rate extreme, for instance, one can have access to novel microstructures that are unattainable at low growth rates. While the low growth rates can be utilized for the study of the intrinsic growth behavior of a certain phase growing from the melt. Although the length scales associated with certain processes, such as capillarity, and the diffusion of heat and solute, are different at low and high rate extremes, the phenomena that govern the selection of a certain microstructural length scale or a growth mode are the same. Consequently, one can analyze the solidification phenomena at both high and low rates by using the same governing principles. In this study, we examined the microstructural control at both low and high extremes. For the high rate extreme, the formation of crystalline products and factors that control the microstructure during rapid solidification by free-jet melt spinning are examined in Fe-Si-B system. Particular attention was given to the behavior of the melt pool at different quench-wheel speeds. Since the solidification process takes place within the melt-pool that forms on the rotating quench-wheel, we examined the influence of melt-pool dynamics on nucleation and growth of crystalline solidification products and glass formation. High-speed imaging of the melt-pool, analysis of ribbon microstructure, and measurement of ribbon geometry and surface character all indicate upper and lower limits for melt-spinning rates for which nucleation can be avoided, and fully amorphous ribbons can be achieved. Comparison of the relevant time scales reveals that surface-controlled melt

  20. Pedalling rate affects endurance performance during high-intensity cycling

    DEFF Research Database (Denmark)

    Nielsen, Jens Steen; Hansen, Ernst Albin; Sjøgaard, Gisela

    2004-01-01

    The purpose of this study into high-intensity cycling was to: (1) test the hypothesis that endurance time is longest at a freely chosen pedalling rate (FCPR), compared to pedalling rates 25% lower (FCPR-25) and higher (FCPR+25) than FCPR, and (2) investigate how physiological variables......, and endurance time at W90 with FCPR-25, FCPR, and FCPR+25. Power reserve was calculated as the difference between applied power output at a given pedalling rate and peak crank power at this same pedalling rate. W90 was 325 (47) W. FCPR at W90 was 78 (11) rpm, resulting in FCPR-25 being 59 (8) rpm and FCPR+25...... time was negatively related to VO(2max), W90 and % MHC I, while positively related to power reserve. In conclusion, at group level, endurance time was longer at FCPR and at a pedalling rate 25% lower compared to a pedalling rate 25% higher than FCPR. Further, inter-individual physiological variables...

  1. Risk factors associated with gastroesophageal reflux disease relapse in primary care patients successfully treated with a proton pump inhibitor.

    Science.gov (United States)

    López-Colombo, A; Pacio-Quiterio, M S; Jesús-Mejenes, L Y; Rodríguez-Aguilar, J E G; López-Guevara, M; Montiel-Jarquín, A J; López-Alvarenga, J C; Morales-Hernández, E R; Ortiz-Juárez, V R; Ávila-Jiménez, L

    There are no studies on the factors associated with gastroesophageal reflux disease (GERD) relapse in primary care patients. To identify the risk factors associated with GERD relapse in primary care patients that responded adequately to short-term treatment with a proton pump inhibitor. A cohort study was conducted that included GERD incident cases. The patients received treatment with omeprazole for 4 weeks. The ReQuest questionnaire and a risk factor questionnaire were applied. The therapeutic success rate and relapse rate were determined at 4 and 12 weeks after treatment suspension. A logistic regression analysis of the possible risk factors for GERD relapse was carried out. Of the 83 patient total, 74 (89.16%) responded to treatment. Symptoms recurred in 36 patients (48.64%) at 4 weeks and in 13 patients (17.57%) at 12 weeks, with an overall relapse rate of 66.21%. The OR multivariate analysis (95% CI) showed the increases in the possibility of GERD relapse for the following factors at 12 weeks after treatment suspension: basic educational level or lower, 24.95 (1.92-323.79); overweight, 1.76 (0.22-13.64); obesity, 0.25 (0.01-3.46); smoking, 0.51 (0.06-3.88); and the consumption of 4-12 cups of coffee per month, 1.00 (0.12-7.84); citrus fruits, 14.76 (1.90-114.57); NSAIDs, 27.77 (1.12-686.11); chocolate, 0.86 (0.18-4.06); ASA 1.63 (0.12-21.63); carbonated beverages, 4.24 (0.32-55.05); spicy food 7-16 times/month, 1.39 (0.17-11.17); and spicy food ≥ 20 times/month, 4.06 (0.47-34.59). The relapse rate after short-term treatment with omeprazole was high. The consumption of citrus fruits and NSAIDs increased the possibility of GERD relapse. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  2. Decay rate of the false vacuum at high temperatures

    International Nuclear Information System (INIS)

    Eboli, O.J.P.; Marques, G.C.

    1986-01-01

    We investigate, within the semiclassical approach, the high temperature behaviour of the decay rate (Γ) of the metastable vacuum in Field Theory. We exhibit some exactly soluble (1+1) and (3+1) dimensional examples and develop a formal expression for γ in the high temperature limit. (Author) [pt

  3. Authoritative School Climate and High School Dropout Rates

    Science.gov (United States)

    Jia, Yuane; Konold, Timothy R.; Cornell, Dewey

    2016-01-01

    This study tested the association between school-wide measures of an authoritative school climate and high school dropout rates in a statewide sample of 315 high schools. Regression models at the school level of analysis used teacher and student measures of disciplinary structure, student support, and academic expectations to predict overall high…

  4. High-repetition-rate short-pulse gas discharge.

    Science.gov (United States)

    Tulip, J; Seguin, H; Mace, P N

    1979-09-01

    A high-average-power short-pulse gas discharge is described. This consists of a volume-preionized transverse discharge of the type used in gas lasers driven by a Blumlein energy storage circuit. The Blumlein circuit is fabricated from coaxial cable, is pulse-charged from a high-repetition-rate Marx-bank generator, and is switched by a high-repetition-rate segmented rail gap. The operation of this discharge under conditions typical of rare-gas halide lasers is described. A maximum of 900 pps was obtained, giving a power flow into the discharge of 30 kW.

  5. Authoritative school climate and high school dropout rates.

    Science.gov (United States)

    Jia, Yuane; Konold, Timothy R; Cornell, Dewey

    2016-06-01

    This study tested the association between school-wide measures of an authoritative school climate and high school dropout rates in a statewide sample of 315 high schools. Regression models at the school level of analysis used teacher and student measures of disciplinary structure, student support, and academic expectations to predict overall high school dropout rates. Analyses controlled for school demographics of school enrollment size, percentage of low-income students, percentage of minority students, and urbanicity. Consistent with authoritative school climate theory, moderation analyses found that when students perceive their teachers as supportive, high academic expectations are associated with lower dropout rates. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  6. Rates of fetal polydrug exposures in methadone-maintained pregnancies from a high-risk population.

    Directory of Open Access Journals (Sweden)

    Kaitlyn Delano

    Full Text Available Methadone maintenance treatment (MMT is the standard of care during pregnancy for opioid-dependency, showing efficacy in improving prenatal care and reducing risk of relapse. By design, however, MMT is only intended to prevent withdrawal thus facilitating cognitive behavioural interventions. In order to maximize the benefits of MMT, it is essential that methadone is both properly prescribed and that additional addiction treatment is concurrently administered. This study aims to determine the effectiveness of MMT engagement in high-risk pregnant women in reducing polydrug use by objective laboratory examination of neonatal meconium.Over a 29-month period, the Motherisk Laboratory at the Hospital for Sick Children in Toronto analyzed meconium samples as per request by social services and hospitals for drugs of abuse.Of the 904 meconium samples received, 273 were tested for methadone with 164 positive and 109 negative for methadone. Almost half of the methadone positive samples (46.34% were also positive for at least one other opioid compound, which did not differ statistically from the methadone-negative control samples (46.79%; Chi square test, p=0.94. No differences were found between the methadone positive and negative groups in rates of concurrent amphetamines, cocaine, cannabis, and alcohol use indicating a similar risk of polydrug use between pregnant women taking or not taking methadone in this population.The high rates of additional opioid and other drug use in the MMT group, suggest that MMT is failing this population of patients. It is possible that methadone doses during pregnancy are not appropriately adjusted for changes in pharmacokinetic parameters (e.g. blood volume, renal function during the second and third trimesters. This may result in sub-therapeutic dosing creating withdrawal symptoms leading to additional substance use. Alternatively, these results may be demonstrating a substantial lack in delivery of addiction support

  7. An exploratory study on association between family relationship and relapse among methamphetamine users in Compulsory Treatment System of Khon Kaen and Yasothon Provinces.

    Science.gov (United States)

    Rodseeda, Pritsana; Ratanasiri, Amornrat; Kanato, Manop; Pinitsoontorn, Somdej; Chiawiriyabunya, Isara

    2010-03-01

    It was estimated that 3.5 million Thais have ever used "Yaba (methamphetamine)" at least once in their entire life. The Northeastern region had the highest number of Yaba users with a high relapse rate after treatment. The authors aimed to explore the association between relapse, among methamphetamine users in the Compulsory Treatment System of Khon Kaen and Yasothon Provinces, and family relationship as well as other contextual factors. An exploratory study was conducted from all cases of post-treatment methamphetamine users in the databases of Khon Kaen Drug Dependence Treatment Center and Yasothorn Provincial Probation Office during October 2007 and February 2008. Interviews and observations were done for data collection. Double data entry was applied. Pearson Chi-square, Fisher's exact test and odds ratio were used to assess the associations. Sixty-five users were found (13 relapses and 52 abstainers). Family relationship revealed no significant association with relapse of the methamphetamine users. Other contextual factors, however, did. They were social acceptance [acceptance by community leader (p = 0.006), acceptance for working or studying (p = 0.049)], risky community situations [using Yaba of close friend, existence of Yaba users and Yaba trading in community (p = 0.014, p agent and drinking of alcohol to reduce Yaba desire (p = 0.012 and p = 0.013)]. Effect of family relationship on relapse among post-treatment methamphetamine users could not be demonstrated in the present study. But several contextual factors had significant relationship with the relapse.

  8. Evolution of high tooth replacement rates in sauropod dinosaurs.

    Science.gov (United States)

    D'Emic, Michael D; Whitlock, John A; Smith, Kathlyn M; Fisher, Daniel C; Wilson, Jeffrey A

    2013-01-01

    Tooth replacement rate can be calculated in extinct animals by counting incremental lines of deposition in tooth dentin. Calculating this rate in several taxa allows for the study of the evolution of tooth replacement rate. Sauropod dinosaurs, the largest terrestrial animals that ever evolved, exhibited a diversity of tooth sizes and shapes, but little is known about their tooth replacement rates. We present tooth replacement rate, formation time, crown volume, total dentition volume, and enamel thickness for two coexisting but distantly related and morphologically disparate sauropod dinosaurs Camarasaurus and Diplodocus. Individual tooth formation time was determined by counting daily incremental lines in dentin. Tooth replacement rate is calculated as the difference between the number of days recorded in successive replacement teeth. Each tooth family in Camarasaurus has a maximum of three replacement teeth, whereas each Diplodocus tooth family has up to five. Tooth formation times are about 1.7 times longer in Camarasaurus than in Diplodocus (315 vs. 185 days). Average tooth replacement rate in Camarasaurus is about one tooth every 62 days versus about one tooth every 35 days in Diplodocus. Despite slower tooth replacement rates in Camarasaurus, the volumetric rate of Camarasaurus tooth replacement is 10 times faster than in Diplodocus because of its substantially greater tooth volumes. A novel method to estimate replacement rate was developed and applied to several other sauropodomorphs that we were not able to thin section. Differences in tooth replacement rate among sauropodomorphs likely reflect disparate feeding strategies and/or food choices, which would have facilitated the coexistence of these gigantic herbivores in one ecosystem. Early neosauropods are characterized by high tooth replacement rates (despite their large tooth size), and derived titanosaurs and diplodocoids independently evolved the highest known tooth replacement rates among archosaurs.

  9. Evolution of high tooth replacement rates in sauropod dinosaurs.

    Directory of Open Access Journals (Sweden)

    Michael D D'Emic

    Full Text Available BACKGROUND: Tooth replacement rate can be calculated in extinct animals by counting incremental lines of deposition in tooth dentin. Calculating this rate in several taxa allows for the study of the evolution of tooth replacement rate. Sauropod dinosaurs, the largest terrestrial animals that ever evolved, exhibited a diversity of tooth sizes and shapes, but little is known about their tooth replacement rates. METHODOLOGY/PRINCIPAL FINDINGS: We present tooth replacement rate, formation time, crown volume, total dentition volume, and enamel thickness for two coexisting but distantly related and morphologically disparate sauropod dinosaurs Camarasaurus and Diplodocus. Individual tooth formation time was determined by counting daily incremental lines in dentin. Tooth replacement rate is calculated as the difference between the number of days recorded in successive replacement teeth. Each tooth family in Camarasaurus has a maximum of three replacement teeth, whereas each Diplodocus tooth family has up to five. Tooth formation times are about 1.7 times longer in Camarasaurus than in Diplodocus (315 vs. 185 days. Average tooth replacement rate in Camarasaurus is about one tooth every 62 days versus about one tooth every 35 days in Diplodocus. Despite slower tooth replacement rates in Camarasaurus, the volumetric rate of Camarasaurus tooth replacement is 10 times faster than in Diplodocus because of its substantially greater tooth volumes. A novel method to estimate replacement rate was developed and applied to several other sauropodomorphs that we were not able to thin section. CONCLUSIONS/SIGNIFICANCE: Differences in tooth replacement rate among sauropodomorphs likely reflect disparate feeding strategies and/or food choices, which would have facilitated the coexistence of these gigantic herbivores in one ecosystem. Early neosauropods are characterized by high tooth replacement rates (despite their large tooth size, and derived titanosaurs and

  10. Salvage radiotherapy for prostate-specific antigen relapse after radical prostatectomy for prostate cancer. A single-center experience

    International Nuclear Information System (INIS)

    Yoshida, Takahiro; Nakayama, Masashi; Suzuki, Osamu

    2011-01-01

    The aim of this study was to investigate the efficacy and prognostic factors of salvage radiotherapy for prostate-specific antigen relapse after radical prostatectomy for prostate cancer at a single center in Japan. A retrospective review of the medical records of 51 patients who underwent salvage radiotherapy for prostate-specific antigen relapse after radical prostatectomy was carried out. Salvage radiotherapy was undergone for the single indication of at least two consecutive prostate-specific antigen elevations >0.1 ng/ml. Salvage radiotherapy was delivered to the prostatic bed at a total dose of 60 or 64 Gy. Late toxicity was scored according to the Common Terminology Criteria for Adverse Events 3.0. A total dose of 60 and 64 Gy were administered to 26 and 25 patients, respectively. The median prostate-specific antigen level at the initiation of radiotherapy was 0.29 ng/ml (range, 0.11-1.10 ng/ml). With a median follow-up of 57.3 months (range, 9.9-134.0 months), the prostate-specific antigen relapse-free rate at 5 years was 50.7%. Multivariate analysis using Cox's proportional hazards regression model revealed that the Gleason score at radical prostatectomy ≥8 significantly predicted prostate-specific antigen relapse after salvage radiotherapy (hazard ratio 4.531; 95% confidence interval 1.413-14.535; P=0.011). The prostate-specific antigen relapse-free rate at 5 years in the Gleason score at radical prostatectomy ≤7 and at radical prostatectomy ≥8 was 62.7 and 15.4%, respectively. Salvage radiotherapy was effective for prostate-specific antigen relapse after radical prostatectomy with tolerable toxicities in Japanese patients. A high Gleason score seemed to be a poor prognostic factor. (author)

  11. Low dose rate and high dose rate intracavitary treatment for cervical cancer

    International Nuclear Information System (INIS)

    Hareyama, Masato; Oouchi, Atsushi; Shidou, Mitsuo

    1997-01-01

    From 1984 through 1993, 144 previous untreated patients with carcinoma of uterine cervix were treated with either low dose rate 137 Cs therapy (LDR) or high dose rate 60 Co therapy (HDR). The local failure rates for more than 2-years for the primary lesions were 11.8% (8 of 63 patients) for LDR and 18.0% (11 of 61 patients). Rectal complication rates were significantly lower for HDR versus LDR (14.3% VS. 32.8%. p<0.01). Also, bladder complication rates were significantly lower for HDR versus LDR (0% VS. 10.4%, p<0.005). Treatment results in term of local control were equivalent for HDR and LDR treatment. However, the incidence of complications was higher for the LDR group than for the HDR group. (author)

  12. Measurement of viscosity of slush at high shear rates

    OpenAIRE

    小林, 俊一; 川村, 公之; 津川, 圭一; 和泉, 薫; Kobayashi, Shun'ichi; Kawamura, Kimiyuki; Tugawa, Keiichi; Izumi, Kaoru

    1988-01-01

    Measurements of viscosity of slush were carried out using a method of flow along an inclined smooth surface in a 0℃cold room. The method was used to get the values of viscosity under high shear rates (25 and 75s^). From our experiments two important results were obtained: 1) the viscosity of slush decreases with increasing shear rates; 2) The fluid behavior is pseudoplastic that the values of non-Newtonian index of viscosity were less than unity.

  13. Radiobiological aspects of continuous low dose-rate irradiation and fractionated high dose-rate irradiation

    International Nuclear Information System (INIS)

    Turesson, I.

    1990-01-01

    The biological effects of continuous low dose-rate irradiation and fractionated high dose-rate irradiation in interstitial and intracavitary radiotherapy and total body irradiation are discussed in terms of dose-rate fractionation sensitivity for various tissues. A scaling between dose-rate and fraction size was established for acute and late normal-tissue effects which can serve as a guideline for local treatment in the range of dose rates between 0.02 and 0.005 Gy/min and fraction sizes between 8.5 and 2.5 Gy. This is valid provided cell-cycle progression and proliferation can be ignored. Assuming that the acute and late tissue responses are characterized by α/β values of about 10 and 3 Gy and a mono-exponential repair half-time of about 3 h, the same total doses given with either of the two methods are approximately equivalent. The equivalence for acute and late non-hemopoietic normal tissue damage is 0.02 Gy/min and 8.5 Gy per fraction; 0.01 Gy/min and 5.5 Gy per fraction; and 0.005 Gy/min and 2.5Gy per fraction. A very low dose rate, below 0.005 Gy/min, is thus necessary to simulate high dose-rate radiotherapy with fraction sizes of about 2Gy. The scaling factor is, however, dependent on the repair half-time of the tissue. A review of published data on dose-rate effects for normal tissue response showed a significantly stronger dose-rate dependence for late than for acute effects below 0.02 Gy/min. There was no significant difference in dose-rate dependence between various acute non-hemopoietic effects or between various late effects. The consistent dose-rate dependence, which justifies the use of a general scaling factor between fraction size and dose rate, contrasts with the wide range of values for repair half-time calculated for various normal-tissue effects. This indicates that the model currently used for repair kinetics is not satisfactory. There are also few experimental data in the clinical dose-rate range, below 0.02 Gy/min. It is therefore

  14. U.S. High School Graduation Rates: Patterns and Explanations

    OpenAIRE

    Richard J. Murnane

    2013-01-01

    I survey the evidence on patterns in U.S. high school graduation rates over the period 1970–2010 and report the results of new research conducted to fill in holes in the evidence. I begin by pointing out the strengths and limitations of existing data sources. I then describe six striking patterns in graduation rates. They include stagnation over the last three decades of the twentieth century, significant race-, income-, and gender-based gaps, and significant increases in graduation rates o...

  15. THE AMERICAN HIGH SCHOOL GRADUATION RATE: TRENDS AND LEVELS*

    Science.gov (United States)

    Heckman, James J.; LaFontaine, Paul A.

    2009-01-01

    This paper applies a unified methodology to multiple data sets to estimate both the levels and trends in U.S. high school graduation rates. We establish that (a) the true rate is substantially lower than widely used measures; (b) it peaked in the early 1970s; (c) majority/minority differentials are substantial and have not converged for 35 years; (d) lower post-1970 rates are not solely due to increasing immigrant and minority populations; (e) our findings explain part of the slowdown in college attendance and rising college wage premiums; and (f) widening graduation differentials by gender help explain increasing male-female college attendance gaps. PMID:20625528

  16. THE AMERICAN HIGH SCHOOL GRADUATION RATE: TRENDS AND LEVELS.

    Science.gov (United States)

    Heckman, James J; Lafontaine, Paul A

    2010-05-01

    This paper applies a unified methodology to multiple data sets to estimate both the levels and trends in U.S. high school graduation rates. We establish that (a) the true rate is substantially lower than widely used measures; (b) it peaked in the early 1970s; (c) majority/minority differentials are substantial and have not converged for 35 years; (d) lower post-1970 rates are not solely due to increasing immigrant and minority populations; (e) our findings explain part of the slowdown in college attendance and rising college wage premiums; and (f) widening graduation differentials by gender help explain increasing male-female college attendance gaps.

  17. A review of reaction rates in high temperature air

    Science.gov (United States)

    Park, Chul

    1989-01-01

    The existing experimental data on the rate coefficients for the chemical reactions in nonequilibrium high temperature air are reviewed and collated, and a selected set of such values is recommended for use in hypersonic flow calculations. For the reactions of neutral species, the recommended values are chosen from the experimental data that existed mostly prior to 1970, and are slightly different from those used previously. For the reactions involving ions, the recommended rate coefficients are newly chosen from the experimental data obtained more recently. The reacting environment is assumed to lack thermal equilibrium, and the rate coefficients are expressed as a function of the controlling temperature, incorporating the recent multitemperature reaction concept.

  18. High rate tests of the LHCb RICH Upgrade system

    CERN Multimedia

    Blago, Michele Piero

    2016-01-01

    One of the biggest challenges for the upgrade of the LHCb RICH detectors from 2020 is to readout the photon detectors at the full 40 MHz rate of the LHC proton-proton collisions. A test facility has been setup at CERN with the purpose to investigate the behaviour of the Multi Anode PMTs, which have been proposed for the upgrade, and their readout electronics at high trigger rates. The MaPMTs are illuminated with a monochromatic laser that can be triggered independently of the readout electronics. A first series of tests, including threshold scans, is performed at low trigger rates (20 kHz) for both the readout and the laser with the purpose to characterise the behaviour of the system under test. Then the trigger rate is increased in two separate steps. First the MaPMTs are exposed to high illumination by triggering the pulsed laser at a high (20 MHz) repetition rate while the DAQ is readout at the same low rate as before. In this way the performance of the MaPMTs and the attached electronics can be evaluated ...

  19. Semi-solid electrodes having high rate capability

    Energy Technology Data Exchange (ETDEWEB)

    Chiang, Yet-Ming; Duduta, Mihai; Holman, Richard; Limthongkul, Pimpa; Tan, Taison

    2017-11-28

    Embodiments described herein relate generally to electrochemical cells having high rate capability, and more particularly to devices, systems and methods of producing high capacity and high rate capability batteries having relatively thick semi-solid electrodes. In some embodiments, an electrochemical cell includes an anode, a semi-solid cathode that includes a suspension of an active material and a conductive material in a liquid electrolyte, and an ion permeable membrane disposed between the anode and the cathode. The semi-solid cathode has a thickness in the range of about 250 .mu.m-2,500 .mu.m, and the electrochemical cell has an area specific capacity of at least 5 mAh/cm.sup.2 at a C-rate of C/2.

  20. [Clinical and biological prognostic factors in relapsed acute myeloid leukemia patients].

    Science.gov (United States)

    Yébenes-Ramírez, Manuel; Serrano, Josefina; Martínez-Losada, Carmen; Sánchez-García, Joaquín

    2016-09-02

    Acute myeloid leukemia (AML) is the most frequent type of acute leukemia in adults. Despite recent advances in the characterization of pathogenesis of AML, the cure rates are under 40%, being leukemia relapse the most common cause of treatment failure. Leukaemia relapse occurs due to clonal evolution or clonal escape. In this study, we aimed to analyze the clinical and biological factors influencing outcomes in patients with AML relapse. We included a total of 75 AML patients who experienced leukaemia relapse after achieving complete remission. We performed complete immunophenotyping and conventional karyotyping in bone marrow aspirates obtained at diagnosis and at leukemia relapse. Overall survival (OS) of the series was 3.7%±2.3, leukaemia progression being the most common cause of death. Patients relapsing before 12 months and those with adverse cytogenetic-molecular risk had statistically significant worse outcomes. A percentage of 52.5 of patients showed phenotypic changes and 50% cytogenetic changes at relapse. We did not find significant clinical factors predicting clonal evolution. The presence of clonal evolution at relapse did not have a significant impact on outcome. Patients with relapsed AML have a dismal prognosis, especially those with early relapse and adverse cytogenetic-molecular risk. Clonal evolution with phenotypic and cytogenetic changes occurred in half of the patients without predictive clinical factors or impact on outcome. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  1. The Effect of a Condylar Repositioning Plate on Condylar Position and Relapse in Two-Jaw Surgery

    Directory of Open Access Journals (Sweden)

    Gyu Sik Jung

    2017-01-01

    Full Text Available BackgroundNumerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship.MethodsWe evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate.ResultsA 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits.ConclusionsOur condylar repositioning method using a centric relation splint and mini-plate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.

  2. Depression relapse and ethological measures

    NARCIS (Netherlands)

    Hale, WWH; Jansen, JHC; Bouhuys, AL; vandenHoofdakker, RH

    1997-01-01

    Within the framework of interactional theories on depression, the question is raised whether depression relapse can be predicted by observable behavior of remitted patients and their interviewer during an interaction (i.e. discharge interview). Thirty-four patients were interviewed at hospital

  3. Neurocognitive Predictors of Drug Relapse

    NARCIS (Netherlands)

    R. Marhe (Reshmi)

    2013-01-01

    textabstractWorldwide, about 35 million people, that is 0.8% of the world’s adult population, use heroin and/or cocaine and more than 10-13% of these drug users are or will become drug dependent (UNODC, World Drug Report, 2012). Drug dependency is characterized as a chronic relapsing disorder

  4. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Treating MS d Comprehensive Care Developing a Healthcare Team Make the Most of Your Doctor Visits Advance Medical Directives d Find an MS Care Provider Partners in MS Care d Managing Relapses Plasmapheresis d Rehabilitation Functional Electrical Stimulation (FES) ...

  5. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Become an MS Activist Take Action Current Advocacy Issues Advocacy Results Advocacy News d Raise Awareness d ... MS are more likely to experience gradually worsening problems with walking and mobility, along with whatever other symptoms they may have. Diagnosing relapsing-remitting MS (RRMS) Learn More Learn More ... Room MS Prevalence ...

  6. Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Mahlet Fikreyesus

    2016-10-01

    Full Text Available Abstract Background Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH. Methods Data were collected using interviewer administered questionnaire. We used medication adherence rating scale (MARS to assess compliance to medication and abnormal involuntary movement scale (AIMS to detect medication side effects. Logistic regression analysis was used to identify independent predictors of psychotic relapse. All variables with P-value <0.25 in the bivariate analyses were entered into multivariate logistic regression and variables with P-value < 0.05 in the final model were declared to be significantly associated with the outcome variable. Results The prevalence of relapse among patients with psychotic disorder was 24.6 % (n = 95. Of this, 25.4 and 22.4 % were males and females respectively. The odds of developing psychotic relapse among patients living with family was 72 % lower than that of patients living alone (aOR = 0.28, 95 % CI = 0.08, 0.93. The odds of developing psychotic relapse among patients compliant to medication was 69 % lower than that of patients who were not compliant to medications (aOR = 0.31, 95 % CI = 0.12, 0.80. The odds of developing psychotic relapse among patients having high score on social support score was 48 % lower than that of patients who were compliant to medications (aOR = 0.52, 95 % CI = 0.28, 0.95. The odds of developing psychotic relapse among patients reporting to have sought religious support was 45 % lower than that of patients who have not sought religious support (aOR = 0.55, 95 % CI = 0.31, 0.96. On the other hand, the odds of developing

  7. Efficacy of argon plasma coagulation for locoregional relapse after chemoradiotherapy for esophageal cancer

    International Nuclear Information System (INIS)

    Kikuchi, Yoshinori; Domon, Kaoru; Otsuka, Takafumi

    2011-01-01

    Salvage therapy for residual or relapsed esophageal cancer after chemoradiotherapy (CRT) has not yet been established. We retrospectively evaluated relapse-free survival (RFS) after local recurrence following CRT and local control rate in patients who underwent argon plasma coagulation (APC). We reviewed the records of 14 patients who underwent APC after CRT for esophageal cancer at our department between 2001 and 2010 and analyzed overall survival (OS), 5-year survival rate, local control rate after APC and RFS-defined as the period between the end of CRT and the time when an iodine-negative area was found. Median OS and median RFS (mRFS) were 33 months and 6 months, respectively. The 5-year survival rate was 16.2%, and the local control rate after APC was 71.4% (10/14). RFS was significantly longer in the T1 group than in the T2/T3 group (p=0.03); the local control rate after APC did not significantly differ between groups. The high-dose (HD) radiation group had a significantly longer RFS and a tendency toward a higher local control rate after APC than did the standard-dose (SD) radiation group. APC was safe and resulted in a high rate of local control, regardless of T factor. HD radiation was associated with longer RFS and greater efficacy of APC treatment for local recurrence. (author)

  8. Impact of prior treatment and depth of response on survival in MM-003, a randomized phase 3 study comparing pomalidomide plus low-dose dexamethasone versus high-dose dexamethasone in relapsed/refractory multiple myeloma

    Science.gov (United States)

    San Miguel, Jesus F.; Weisel, Katja C.; Song, Kevin W.; Delforge, Michel; Karlin, Lionel; Goldschmidt, Hartmut; Moreau, Philippe; Banos, Anne; Oriol, Albert; Garderet, Laurent; Cavo, Michele; Ivanova, Valentina; Alegre, Adrian; Martinez-Lopez, Joaquin; Chen, Christine; Renner, Christoph; Bahlis, Nizar Jacques; Yu, Xin; Teasdale, Terri; Sternas, Lars; Jacques, Christian; Zaki, Mohamed H.; Dimopoulos, Meletios A.

    2015-01-01

    Pomalidomide is a distinct oral IMiD® immunomodulatory agent with direct antimyeloma, stromal-support inhibitory, and immunomodulatory effects. The pivotal, multicenter, open-label, randomized phase 3 trial MM-003 compared pomalidomide + low-dose dexamethasone vs high-dose dexamethasone in 455 patients with refractory or relapsed and refractory multiple myeloma after failure of bortezomib and lenalidomide treatment. Initial results demonstrated significantly longer progression-free survival and overall survival with an acceptable tolerability profile for pomalidomide + low-dose dexamethasone vs high-dose dexamethasone. This secondary analysis describes patient outcomes by treatment history and depth of response. Pomalidomide + low-dose dexamethasone significantly prolonged progression-free survival and favored overall survival vs high-dose dexamethasone for all subgroups analyzed, regardless of prior treatments or refractory status. Both univariate and multivariate analyses showed that no variable relating to either the number (≤ or > 3) or type of prior treatment was a significant predictor of progression-free survival or overall survival. No cross-resistance with prior lenalidomide or thalidomide treatment was observed. Patients achieving a minimal response or better to pomalidomide + low-dose dexamethasone treatment experienced a survival benefit, which was even higher in those achieving at least a partial response (17.2 and 19.9 months, respectively, as compared with 7.5 months for patients with less than minimal response). These data suggest that pomalidomide + low-dose dexamethasone should be considered a standard of care in patients with refractory or relapsed and refractory multiple myeloma regardless of prior treatment. ClinicalTrials.gov: NCT01311687; EudraCT: 2010-019820-30. PMID:26160879

  9. Cladribine tablets for relapsing-remitting multiple sclerosis

    DEFF Research Database (Denmark)

    Rammohan, Kottil; Giovannoni, Gavin; Comi, Giancarlo

    2012-01-01

    BACKGROUND: In the phase III CLARITY study, treatment with cladribine tablets at cumulative doses of 3.5 or 5.25mg/kg over 96 weeks led to significant reductions in annualized relapse rates (ARR) versus placebo in patients with relapsing-remitting multiple sclerosis. Further post hoc analyses...... of CLARITY study data were conducted to determine the efficacy of cladribine tablets across patient subgroups stratified by baseline characteristics. METHODS: Relapse rates over the 96-week CLARITY study were analyzed in cohorts stratified by demographics; disease duration; treatment history and disease...... activity at baseline. RESULTS: In the intent-to-treat population (n=437, 433 and 456 in the placebo, cladribine 3.5 and 5.25mg/kg groups, respectively), treatment with cladribine tablets 3.5 and 5.25mg/kg led to consistent improvements in ARR versus placebo in patients stratified by gender; age (≤40...

  10. High-rate performance of muon drift tube detectors

    International Nuclear Information System (INIS)

    Schwegler, Philipp

    2014-01-01

    The Large Hadron Collider (LHC) at the European Centre for Particle Physics, CERN, collides protons with an unprecedentedly high centre-of-mass energy and luminosity. The collision products are recorded and analysed by four big experiments, one of which is the ATLAS detector. In parallel with the first LHC run from 2009 to 2012, which culminated in the discovery of the last missing particle of the Standard Model of particle physics, the Higgs boson, planning of upgrades of the LHC for higher instantaneous luminosities (HL-LHC) is already progressing. The high instantaneous luminosity of the LHC puts high demands on the detectors with respect to radiation hardness and rate capability which are further increased with the luminosity upgrade. In this thesis, the limitations of the Muon Drift Tube (MDT) chambers of the ATLAS Muon Spectrometer at the high background counting rates at the LHC and performance of new small diameter muon drift tube (sMDT) detectors at the even higher background rates at HL-LHC are studied. The resolution and efficiency of sMDT chambers at high γ-ray and proton irradiation rates well beyond the ones expected at HL-LHC have been measured and the irradiation effects understood using detailed simulations. The sMDT chambers offer an about an order of magnitude better rate capability and are an ideal replacement for the MDT chambers because of compatibility of services and read-out. The limitations of the sMDT chambers are now in the read-out electronics, taken from the MDT chambers, to which improvements for even higher rate capability are proposed.

  11. High Strain Rate Tensile Testing of Silver Nanowires: Rate-Dependent Brittle-to-Ductile Transition.

    Science.gov (United States)

    Ramachandramoorthy, Rajaprakash; Gao, Wei; Bernal, Rodrigo; Espinosa, Horacio

    2016-01-13

    The characterization of nanomaterials under high strain rates is critical to understand their suitability for dynamic applications such as nanoresonators and nanoswitches. It is also of great theoretical importance to explore nanomechanics with dynamic and rate effects. Here, we report in situ scanning electron microscope (SEM) tensile testing of bicrystalline silver nanowires at strain rates up to 2/s, which is 2 orders of magnitude higher than previously reported in the literature. The experiments are enabled by a microelectromechanical system (MEMS) with fast response time. It was identified that the nanowire plastic deformation has a small activation volume (ductile failure mode transition was observed at a threshold strain rate of 0.2/s. Transmission electron microscopy (TEM) revealed that along the nanowire, dislocation density and spatial distribution of plastic regions increase with increasing strain rate. Furthermore, molecular dynamic (MD) simulations show that deformation mechanisms such as grain boundary migration and dislocation interactions are responsible for such ductility. Finally, the MD and experimental results were interpreted using dislocation nucleation theory. The predicted yield stress values are in agreement with the experimental results for strain rates above 0.2/s when ductility is pronounced. At low strain rates, random imperfections on the nanowire surface trigger localized plasticity, leading to a brittle-like failure.

  12. Allogeneic stem cell transplantation in children with acute lymphoblastic leukemia after isolated central nervous system relapse: our experiences and review of the literature.

    Science.gov (United States)

    Yoshihara, T; Morimoto, A; Kuroda, H; Imamura, T; Ishida, H; Tsunamoto, K; Naya, M; Hibi, S; Todo, S; Imashuku, S

    2006-01-01

    The prognosis of patients with acute lymphoblastic leukemia (ALL) and central nervous system (CNS) relapse has historically been very poor. Although chemo-radiotherapy has improved outcomes, some patients still have a poor prognosis after CNS relapse. Therefore, allogeneic hematopoietic stem cell transplantation (allo-SCT) has recently become an option for treatment of CNS leukemia; however, information, particularly on the long-term outcome of transplant recipients, is limited. We performed allo-SCT in eight pediatric patients with ALL (n=7) or T-cell type non-Hodgkin's lymphoma (n=1), who had isolated CNS relapse. All patients survived for a median of 70.5 (range, 13-153) months after SCT. Sequelae developed late in some patients: mental retardation (IQ=47) in one patient, severe alopecia in two patients, limited chronic graft-versus-host-disease in three patients, and amenorrhea and/or hypothyroidism in three patients. Except for a pre-school child with post transplant CNS relapse, six out of seven patients show normal school/social performance. Our results clearly indicate a high cure rate of isolated CNS relapse by allo-SCT in pediatric lymphoid malignancies; however, there needs to be further studies to determine which are the appropriate candidates for transplantation and what is the best transplant regimen to achieve high cure rate and maintain good quality of life.

  13. High data rate coding for the space station telemetry links.

    Science.gov (United States)

    Lumb, D. R.; Viterbi, A. J.

    1971-01-01

    Coding systems for high data rates were examined from the standpoint of potential application in space-station telemetry links. Approaches considered included convolutional codes with sequential, Viterbi, and cascaded-Viterbi decoding. It was concluded that a high-speed (40 Mbps) sequential decoding system best satisfies the requirements for the assumed growth potential and specified constraints. Trade-off studies leading to this conclusion are viewed, and some sequential (Fano) algorithm improvements are discussed, together with real-time simulation results.

  14. Predicting High Frequency Exchange Rates using Machine Learning

    OpenAIRE

    Palikuca, Aleksandar; Seidl,, Timo

    2016-01-01

    This thesis applies a committee of Artificial Neural Networks and Support Vector Machines on high-dimensional, high-frequency EUR/USD exchange rate data in an effort to predict directional market movements on up to a 60 second prediction horizon. The study shows that combining multiple classifiers into a committee produces improved precision relative to the best individual committee members and outperforms previously reported results. A trading simulation implementing the committee classifier...

  15. Decay rate of the false vacuum at high tempratures

    International Nuclear Information System (INIS)

    Eboli, O.J.P.; Marques, G.C.

    1984-01-01

    Within the semiclassical approach, the high temperaure behaviour of the decay rate of the metastable vacuum in Field Theory is investigated. It is shown that, contrarily to what has been proposed in the literature, the pre-exponential factor exhibits a nontrivial dependence on the temperature. Furthermore, this dependence is such that at very high temperatures it is as important as the exponential factor and consequently it spoils many conclusions drawn up to now on Cosmological Phase Transitions. (Author) [pt

  16. Electrophoretic Deposition of Gallium with High Deposition Rate

    Directory of Open Access Journals (Sweden)

    Hanfei Zhang

    2014-12-01

    Full Text Available In this work, electrophoretic deposition (EPD is reported to form gallium thin film with high deposition rate and low cost while avoiding the highly toxic chemicals typically used in electroplating. A maximum deposition rate of ~0.6 μm/min, almost one order of magnitude higher than the typical value reported for electroplating, is obtained when employing a set of proper deposition parameters. The thickness of the film is shown to increase with deposition time when sequential deposition is employed. The concentration of Mg(NO32, the charging salt, is also found to be a critical factor to control the deposition rate. Various gallium micropatterns are obtained by masking the substrate during the process, demonstrating process compatibility with microfabrication. The reported novel approach can potentially be employed in a broad range of applications with Ga as a raw material, including microelectronics, photovoltaic cells, and flexible liquid metal microelectrodes.

  17. READOUT ELECTRONICS FOR A HIGH-RATE CSC DETECTOR

    International Nuclear Information System (INIS)

    OCONNOR, P.; GRATCHEV, V.; KANDASAMY, A.; POLYCHRONAKOS, V.; TCHERNIATINE, V.; PARSONS, J.; SIPPACH, W.

    1999-01-01

    A readout system for a high-rate muon Cathode Strip Chamber (CSC) is described. The system, planned for use in the forward region of the ATLAS muon spectrometer, uses two custom CMOS integrated circuits to achieve good position resolution at a flux of up to 2,500 tracks/cm 2 /s

  18. Digital approach to high rate gamma-ray spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Korolczuk, Stefan; Mianowski, Slawomir; Rzadkiewicz, Jacek; Sibczynski, Pawel; Swiderski, Lukasz; Szewinski, Jaroslaw; Zychor, Izabella [Narodowe Centrum Badan Jadrowych (NCBJ), 05-400 Otwock, (Poland)

    2015-07-01

    Basic concepts and preliminary results of creating high rate digital spectrometry system using efficient ADCs and latest FPGA are presented as well as a comparison with commercially available devices. The possibility to use such systems, coupled to scintillators, in plasma experiments is discussed. (authors)

  19. High rate of teenage pregnancy and sexually transmitted infections ...

    African Journals Online (AJOL)

    There is increased in teenage pregnancy despite the presence of dual protection practice and health care awareness programmes related to health and sexuality education in South Africa. The present study explores the underlying causes of high teenage pregnancy and sexually transmitted diseases rates, including HIV ...

  20. Twinning in copper deformed at high strain rates

    Indian Academy of Sciences (India)

    Abstract. Copper samples having varying microstructures were deformed at high strain rates using a split-. Hopkinson pressure bar. Transmission electron microscopy results show deformation twins present in samples that were both annealed and strained, whereas samples that were annealed and left unstrained, as well ...

  1. High Frame Rate Synthetic Aperture 3D Vector Flow Imaging

    DEFF Research Database (Denmark)

    Villagómez Hoyos, Carlos Armando; Holbek, Simon; Stuart, Matthias Bo

    2016-01-01

    , current volumetric ultrasonic flow methods are limited to one velocity component or restricted to a reduced field of view (FOV), e.g. fixed imaging planes, in exchange for higher temporal resolutions. To solve these problems, a previously proposed accurate 2-D high frame rate vector flow imaging (VFI...

  2. Sphaleron rate at high temperature in 1+1 dimensions

    International Nuclear Information System (INIS)

    Smit, Jan; Tang, W.H.

    1999-01-01

    We resolve the controversy in the high temperature behavior of the sphaleron rate in the abelian Higgs model in 1+1 dimensions. The T 2 behavior at intermediate lattice spacings is found to change into T ((2)/(3)) behavior in the continuum limit. The results are supported by analytic arguments that the classical approximation is good for this model

  3. NIDA-Drug Addiction Treatment Outcome Study (DATOS) Relapse as a Function of Spirituality/Religiosity.

    Science.gov (United States)

    Schoenthaler, Stephen J; Blum, Kenneth; Braverman, Eric R; Giordano, John; Thompson, Ben; Oscar-Berman, Marlene; Badgaiyan, Rajendra D; Madigan, Margaret A; Dushaj, Kristina; Li, Mona; Demotrovics, Zsolt; Waite, Roger L; Gold, Mark S

    The connection between religion/spirituality and deviance, like substance abuse, was first made by Durkheim who defined socially expected behaviors as norms. He explained that deviance is due in large part to their absence (called anomie), and concluded that spirituality lowers deviance by preserving norms and social bonds. Impairments in brain reward circuitry, as observed in Reward Deficiency Syndrome (RDS), may also result in deviance and as such we wondered if stronger belief in spirituality practice and religious belief could lower relapse from drugs of abuse. The NIDA Drug Addiction Treatment Outcome Study data set was used to examine post hoc relapse rates among 2,947 clients who were interviewed at 12 months after intake broken down by five spirituality measures. Our main findings strongly indicate, that those with low spirituality have higher relapse rates and those with high spirituality have higher remission rates with crack use being the sole exception. We found significant differences in terms of cocaine, heroin, alcohol, and marijuana relapse as a function of strength of religious beliefs (x 2 = 15.18, p = 0.028; logistic regression = 10.65, p = 0.006); frequency of attending religious services (x 2 = 40.78, p Durkheim's social bond theory. Stronger spiritual/religious beliefs and practices are directly associated with remission from abused drugs except crack. Much like the value of having a sponsor, for clients who abuse drugs, regular spiritual practice, particularly weekly attendance at the religious services of their choice is associated with significantly higher remission. These results demonstrate the clinically significant role of spirituality and the social bonds it creates in drug treatment programs.

  4. Recurrence due to Relapse or Reinfection With Mycobacterium tuberculosis: A Whole-Genome Sequencing Approach in a Large, Population-Based Cohort With a High HIV Infection Prevalence and Active Follow-up

    Science.gov (United States)

    Guerra-Assunção, José Afonso; Houben, Rein M. G. J.; Crampin, Amelia C.; Mzembe, Themba; Mallard, Kim; Coll, Francesc; Khan, Palwasha; Banda, Louis; Chiwaya, Arthur; Pereira, Rui P. A.; McNerney, Ruth; Harris, David; Parkhill, Julian; Clark, Taane G.; Glynn, Judith R.

    2015-01-01

    Background. Recurrent tuberculosis is a major health burden and may be due to relapse with the original strain or reinfection with a new strain. Methods. In a population-based study in northern Malawi, patients with tuberculosis diagnosed from 1996 to 2010 were actively followed after the end of treatment. Whole-genome sequencing with approximately 100-fold coverage was performed on all available cultures. Results of IS6110 restriction fragment-length polymorphism analyses were available for cultures performed up to 2008. Results. Based on our data, a difference of ≤10 single-nucleotide polymorphisms (SNPs) was used to define relapse, and a difference of >100 SNPs was used to define reinfection. There was no evidence of mixed infections among those classified as reinfections. Of 1471 patients, 139 had laboratory-confirmed recurrences: 55 had relapse, and 20 had reinfection; for 64 type of recurrence was unclassified. Almost all relapses occurred in the first 2 years. Human immunodeficiency virus infection was associated with reinfection but not relapse. Relapses were associated with isoniazid resistance, treatment before 2007, and lineage-3 strains. We identified several gene variants associated with relapse. Lineage-2 (Beijing) was overrepresented and lineage-1 underrepresented among the reinfecting strains (P = .004). Conclusions. While some of the factors determining recurrence depend on the patient and their treatment, differences in the Mycobacterium tuberculosis genome appear to have a role in both relapse and reinfection. PMID:25336729

  5. High production rate of IBAD-MgO buffered substrate

    Energy Technology Data Exchange (ETDEWEB)

    Yoshizumi, M., E-mail: myoshizumi@istec.or.j [Superconductivity Research Laboratory, ISTEC, Shinonome 1-10-13, Koto-ku, Tokyo 135-0062 (Japan); Miyata, S.; Ibi, A.; Fukushima, H.; Yamada, Y.; Izumi, T.; Shiohara, Y. [Superconductivity Research Laboratory, ISTEC, Shinonome 1-10-13, Koto-ku, Tokyo 135-0062 (Japan)

    2009-10-15

    The conventional IBAD (Ion Beam Assisted Deposition) process using fluorite materials yields low production rates, resulting in high production cost, which reduces the motivation for practical application in spite of its high quality. The IBAD process using rock salt materials, e.g. MgO, is well known as a strong candidate of practical application due to its potential of high production rate and high in-plane grain alignment. In this work, the IBAD-MgO process was investigated for a newly developed architecture of PLD (Pulsed Laser Deposition)-CeO{sub 2}/sputter-LMO (LaMnO{sub 3})/IBAD-MgO/sputter-GZO (Gd{sub 2}Zr{sub 2}O{sub 7})/Hastelloy{sup TM} to make long buffered metal tapes with high properties and a high production rate. The 50 m-long IBAD-MgO substrates with about 4 deg. of DELTAphiCeO{sub 2} in an XRD phi scan could be fabricated repeatedly. A GdBCO (GdBa{sub 2}Cu{sub 3}O{sub x}) layer deposited on the buffered substrate showed the minimum I{sub c} value of 325 A/cm-w in a 41 m-long tape. Almost of the tape showed 500-600 A/cm-w of I{sub c} value. The deposition time for the IBAD-MgO layer was 60 s which was about 2 orders of magnitude shorter than the conventional IBAD process. The production rate of 24 m/h was realized at the IBAD-MgO process to fabricate the GdBCO coated conductor with high J{sub c} and I{sub c} properties.

  6. Physical nature of strain rate sensitivity of metals and alloys at high strain rates

    Science.gov (United States)

    Borodin, E. N.; Gruzdkov, A. A.; Mayer, A. E.; Selyutina, N. S.

    2018-04-01

    The role of instabilities of plastic flow at plastic deformation of various materials is one of the important cross-disciplinary problems which is equally important in physics, mechanics and material science. The strain rate sensitivities under slow and high strain rate conditions of loading have different physical nature. In the case of low strain rate, the sensitivity arising from the inertness of the defect structures evolution can be expressed by a single parameter characterizing the plasticity mechanism. In our approach, this is the value of the characteristic relaxation time. In the dynamic case, there are additional effects of “high-speed sensitivity” associated with the micro-localization of the plastic flow near the stress concentrators. In the frames of mechanical description, this requires to introduce additional strain rate sensitivity parameters, which is realized in numerous modifications of Johnson–Cook and Zerilli–Armstrong models. The consideration of both these factors is fundamental for an adequate description of the problems of dynamic deformation of highly inhomogeneous metallic materials such as steels and alloys. The measurement of the dispersion of particle velocities on the free surface of a shock-loaded material can be regarded as an experimental expression of the effect of micro-localization. This is also confirmed by our results of numerical simulation of the propagation of shock waves in a two-dimensional formulation and analytical estimations.

  7. Cases of typhoid fever in Copenhagen region: a retrospective study of presentation and relapse.

    Science.gov (United States)

    Barrett, Freja Cecille; Knudsen, Jenny Dahl; Johansen, Isik Somuncu

    2013-08-11

    Typhoid fever is a systemic illness which in high-income countries mainly affects travellers. The incidence is particularly high on the Indian subcontinent. Travellers who visit friends and relatives (VFR) have been shown to have a different risk profile than others. We wished to identify main characteristics for travellers infected with S. Typhi considering both clinical and laboratory findings in order to provide for faster and better diagnostics in the future. The outcome of treatment, especially concerning relapse, was evaluated as well. Retrospectively collected data from 19 adult cases of typhoid fever over a 5-year period at the Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre Denmark. The patients were young adults, presenting with symptoms within a month after travelling. 84% were returned from travelling in the Indian subcontinent. 17 out of 19 patients were VFR-travellers. The main symptoms were fever (100%), gastrointestinal symptoms (84%), headache (58%) and dry cough (26%). Laboratory findings showed elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH) in all cases and elevated alanine transaminase (ALAT) in 47% of cases. In primary cases 4 isolates were fully susceptible to ciprofloxacin, the remaining were intermediate susceptible. Relapse occurred in 37% of the cases and only in cases where the patient was infected by a strain with intermediate susceptibility. Better pre-travel counselling should be given to VFR-travellers. The main symptoms and laboratory findings confirm previous findings. The relapse rate was unexpected high and could be correlated to ciprofloxacin-resistance.

  8. Radiation shielding and dose rate distribution for the building of the high dose rate accelerator

    International Nuclear Information System (INIS)

    Matsuda, Koji; Takagaki, Torao; Nakase, Yoshiaki; Nakai, Yohta.

    1984-03-01

    A high dose rate electron accelerator was established at Osaka Laboratory for Radiation Chemistry, Takasaki Establishment, JAERI in the fiscal year of 1975. This report shows the fundamental concept for the radiation shielding of the accelerator building and the results of their calculations which were evaluated through the model experiments. After the construction of the building, the leak radiation was measured in order to evaluate the calculating method of radiation shielding. Dose rate distribution of X-rays was also measured in the whole area of the irradiation room as a data base. (author)

  9. Relapse and Craving in Alcohol-Dependent Individuals: A Comparison of Self-Reported Determinants.

    Science.gov (United States)

    Snelleman, Michelle; Schoenmakers, Tim M; van de Mheen, Dike

    2018-06-07

    Negative affective states and alcohol-related stimuli increase risk of relapse in alcohol dependence. In research and in clinical practice, craving is often used as another important indicator of relapse, but this lacks a firm empirical foundation. The goal of the present study is to explore and compare determinants for relapse and craving, using Marlatt's (1996) taxonomy of high risk situations as a template. We conducted semi-structured interviews with 20 alcohol-dependent patients about their most recent relapse and craving episodes. Interview transcripts were carefully reviewed for their thematic content, and codes capturing the thematic content were formulated. In total, we formulated 42 relapse-related codes and 33 craving-related codes. Descriptions of craving episodes revealed that these episodes vary in frequency and intensity. The presence of alcohol-related stimuli (n = 11) and experiencing a negative emotional state (n = 11) were often occurring determinants of craving episodes. Both negative emotional states (n = 17) and testing personal control (n = 11) were viewed as important determinants of relapses. Craving was seldom mentioned as a determinant for relapse. Additionally, participants reported multiple determinants preceding a relapse, whereas craving episodes were preceded by only one determinant. Patient reports do not support the claim that craving by itself is an important proximal determinant for relapse. In addition, multiple determinants were present before a relapse. Therefore, future research should focus on a complexity of different determinants.

  10. Virtual reality cue exposure for the relapse prevention of tobacco consumption: a study protocol for a randomized controlled trial.

    Science.gov (United States)

    Giovancarli, Camille; Malbos, Eric; Baumstarck, Karine; Parola, Nathalie; Pélissier, Marie-Florence; Lançon, Christophe; Auquier, Pascal; Boyer, Laurent

    2016-02-19

    Successful interventions have been developed for smoking cessation, but the success of smoking relapse prevention interventions has been limited. In particular, cognitive behavioural therapy (CBT) has been hampered by a high relapse rate. Because relapses can be due to the presence of conditions associated with tobacco consumption (such as drinking in bars with friends), virtual reality exposure therapy (VRET) can generate synthetic environments that represent risk situations for the patient in the context of relapse prevention. The primary objective of this study is to evaluate the effectiveness of CBT coupled with VRET, in comparison to CBT alone, in the prevention of smoking relapse. The secondary objectives are to assess the impact of CBT coupled with VRET on anxiety, depression, quality of life, self-esteem and addictive comorbidities (such as alcohol, cannabis, and gambling). A third objective examines the feasibility and acceptability of VR use considering elements such as presence, cybersickness and number of patients who complete the VRET program. The present study is a 14-month (2 months of therapy followed by 12 months of follow-up), prospective, comparative, randomized and open clinical trial, involving two parallel groups (CBT coupled with VRET versus CBT alone). The primary outcome is the proportion of individuals with tobacco abstinence at 6 months after the end of the therapy. Abstinence is defined by the total absence of tobacco consumption assessed during a post-test interview and with an apparatus that measures the carbon monoxide levels expired. A total of 60 individuals per group will be included. This study is the first to examine the efficacy of CBT coupled with VRET in the prevention of smoking relapse. Because VRET is simple to use and has a low cost, this interactive therapeutic method might be easily implemented in clinical practice if the study confirms its efficacy. ClinicalTrials.gov Identifier: NCT02205060 (registered 25 July 2014).

  11. High strain-rate soft material characterization via inertial cavitation

    Science.gov (United States)

    Estrada, Jonathan B.; Barajas, Carlos; Henann, David L.; Johnsen, Eric; Franck, Christian

    2018-03-01

    Mechanical characterization of soft materials at high strain-rates is challenging due to their high compliance, slow wave speeds, and non-linear viscoelasticity. Yet, knowledge of their material behavior is paramount across a spectrum of biological and engineering applications from minimizing tissue damage in ultrasound and laser surgeries to diagnosing and mitigating impact injuries. To address this significant experimental hurdle and the need to accurately measure the viscoelastic properties of soft materials at high strain-rates (103-108 s-1), we present a minimally invasive, local 3D microrheology technique based on inertial microcavitation. By combining high-speed time-lapse imaging with an appropriate theoretical cavitation framework, we demonstrate that this technique has the capability to accurately determine the general viscoelastic material properties of soft matter as compliant as a few kilopascals. Similar to commercial characterization algorithms, we provide the user with significant flexibility in evaluating several constitutive laws to determine the most appropriate physical model for the material under investigation. Given its straightforward implementation into most current microscopy setups, we anticipate that this technique can be easily adopted by anyone interested in characterizing soft material properties at high loading rates including hydrogels, tissues and various polymeric specimens.

  12. Miniaturized Stretchable and High-Rate Linear Supercapacitors

    Science.gov (United States)

    Zhu, Wenjun; Zhang, Yang; Zhou, Xiaoshuang; Xu, Jiang; Liu, Zunfeng; Yuan, Ningyi; Ding, Jianning

    2017-07-01

    Linear stretchable supercapacitors have attracted much attention because they are well suited to applications in the rapidly expanding field of wearable electronics. However, poor conductivity of the electrode material, which limits the transfer of electrons in the axial direction of the linear supercapacitors, leads to a serious loss of capacity at high rates. To solve this problem, we use gold nanoparticles to decorate aligned multiwall carbon nanotube to fabricate stretchable linear electrodes. Furthermore, we have developed fine stretchable linear supercapacitors, which exhibited an extremely high elasticity up to 400% strain with a high capacitance of about 8.7 F g-1 at the discharge current of 1 A g-1.

  13. HIGH-RATE ANAEROBIC TREATMENT OF ALCOHOLIC WASTEWATERS

    Directory of Open Access Journals (Sweden)

    Florencio L.

    1997-01-01

    Full Text Available Modern high-rate anaerobic wastewater treatment processes are rapidly becoming popular for industrial wastewater treatment. However, until recently stable process conditions could not be guaranteed for alcoholic wastewaters containing higher concentrations of methanol. Although methanol can be directly converted into methane by methanogens, under specific conditions it can also be converted into acetate and butyrate by acetogens. The accumulation of volatile fatty acids can lead to reactor instability in a weakly buffered reactor. Since this process was insufficiently understood, the application of high-rate anaerobic reactors was highly questionable. This research investigated the environmental factors that are of importance in the predominance of methylotrophic methanogens over acetogens in a natural mixed culture during anaerobic wastewater treatment in upflow anaerobic sludge bed reactors. Technological and microbiological aspects were investigated. Additionally, the route by which methanol is converted into methane is also presented

  14. Translational Phase I Trial of Vorinostat (Suberoylanilide Hydroxamic Acid) Combined with Cytarabine and Etoposide in Patients with Relapsed, Refractory, or High-Risk Acute Myeloid Leukemia

    Science.gov (United States)

    Gojo, Ivana; Tan, Ming; Fang, Hong-Bin; Sadowska, Mariola; Lapidus, Rena; Baer, Maria R.; Carrier, France; Beumer, Jan H.; Anyang, Bean N.; Srivastava, Rakesh K.; Espinoza-Delgado, Igor; Ross, Douglas D.

    2015-01-01

    Purpose To determine the maximum-tolerated dose (MTD) of the histone deacetylase inhibitor vorinostat combined with fixed doses of cytarabine (ara-C or cytosine arabinoside) and etoposide in patients with poor-risk or advanced acute leukemia, to obtain preliminary efficacy data, describe pharmacokinetics, and in vivo pharmacodynamic effects of vorinostat in leukemia blasts. Experimental Design In this open-label phase I study, vorinostat was given orally on days one to seven at three escalating dose levels: 200 mg twice a day, 200 mg three times a day, and 300 mg twice a day. On days 11 to 14, etoposide (100 mg/m2) and cytarabine (1 or 2 g/m2 twice a day if ≥65 or vorinostat 200 mg twice a day. Of 21 patients enrolled, seven attained a complete remission (CR) or CR with incomplete platelet recovery, including six of 13 patients treated at the MTD. The median remission duration was seven months. No differences in percentage S-phase cells or multidrug resistance transporter (MDR1 or BCRP) expression or function were observed in vivo in leukemia blasts upon vorinostat treatment. Conclusions Vorinostat 200 mg twice a day can be given safely for seven days before treatment with cytarabine and etoposide. The relatively high CR rate seen at the MTD in this poor-risk group of patients with AML warrants further studies to confirm these findings. PMID:23403629

  15. Spallation model for the high strain rates range

    Science.gov (United States)

    Dekel, E.; Eliezer, S.; Henis, Z.; Moshe, E.; Ludmirsky, A.; Goldberg, I. B.

    1998-11-01

    Measurements of the dynamic spall strength in aluminum and copper shocked by a high power laser to pressures of hundreds of kbars show a rapid increase in the spall strength with the strain rate at values of about 107 s-1. We suggest that this behavior is a result of a change in the spall mechanism. At low strain rates the spall is caused by the motion and coalescence of material's initial flaws. At high strain rates there is not enough time for the flaws to move and the spall is produced by the formation and coalescence of additional cavities where the interatomic forces become dominant. Material under tensile stress is in a metastable condition and cavities of a critical radius are formed in it due to thermal fluctuations. These cavities grow due to the tension. The total volume of the voids grow until the material disintegrates at the spall plane. Simplified calculations based on this model, describing the metal as a viscous liquid, give results in fairly good agreement with the experimental data and predict the increase in spall strength at high strain rates.

  16. Highly variable rates of genome rearrangements between hemiascomycetous yeast lineages.

    Directory of Open Access Journals (Sweden)

    2006-03-01

    Full Text Available Hemiascomycete yeasts cover an evolutionary span comparable to that of the entire phylum of chordates. Since this group currently contains the largest number of complete genome sequences it presents unique opportunities to understand the evolution of genome organization in eukaryotes. We inferred rates of genome instability on all branches of a phylogenetic tree for 11 species and calculated species-specific rates of genome rearrangements. We characterized all inversion events that occurred within synteny blocks between six representatives of the different lineages. We show that the rates of macro- and microrearrangements of gene order are correlated within individual lineages but are highly variable across different lineages. The most unstable genomes correspond to the pathogenic yeasts Candida albicans and Candida glabrata. Chromosomal maps have been intensively shuffled by numerous interchromosomal rearrangements, even between species that have retained a very high physical fraction of their genomes within small synteny blocks. Despite this intensive reshuffling of gene positions, essential genes, which cluster in low recombination regions in the genome of Saccharomyces cerevisiae, tend to remain syntenic during evolution. This work reveals that the high plasticity of eukaryotic genomes results from rearrangement rates that vary between lineages but also at different evolutionary times of a given lineage.

  17. Precise muon drift tube detectors for high background rate conditions

    Energy Technology Data Exchange (ETDEWEB)

    Engl, Albert

    2011-08-04

    The muon spectrometer of the ATLAS-experiment at the Large Hadron Collider consists of drift tube chambers, which provide the precise measurement of trajectories of traversing muons. In order to determine the momentum of the muons with high precision, the measurement of the position of the muon in a single tube has to be more accurate than {sigma}{<=}100 {mu}m. The large cross section of proton-proton-collisions and the high luminosity of the accelerator cause relevant background of neutrons and {gamma}s in the muon spectrometer. During the next decade a luminosity upgrade to 5.10{sup 34} cm{sup -2}s{sup -1} is planned, which will increase the background counting rates considerably. In this context this work deals with the further development of the existing drift chamber technology to provide the required accuracy of the position measurement under high background conditions. Two approaches of improving the drift tube chambers are described: - In regions of moderate background rates a faster and more linear drift gas can provide precise position measurement without changing the existing hardware. - At very high background rates drift tube chambers consisting of tubes with a diameter of 15 mm are a valuable candidate to substitute the CSC muon chambers. The single tube resolution of the gas mixture Ar:CO{sub 2}:N{sub 2} in the ratio of 96:3:1 Vol %, which is more linear and faster as the currently used drift gas Ar:CO{sub 2} in the ratio of 97:3 Vol %, was determined at the Cosmic Ray Measurement Facility at Garching and at high {gamma}-background counting rates at the Gamma Irradiation Facility at CERN. The alternative gas mixture shows similar resolution without background. At high background counting rates it shows better resolution as the standard gas. To analyse the data the various parts of the setup have to be aligned precisely to each other. The change to an alternative gas mixture allows the use of the existing hardware. The second approach are drift tubes

  18. Iodine laser of high efficiency and fast repetition rate

    Energy Technology Data Exchange (ETDEWEB)

    Hohla, K; Witte, K J

    1976-07-01

    The scaling laws of an iodine laser of high efficiency and fast repetition rate are reported. The laser is pumped with a new kind of low pressure Hg-UV-lamps which convert 32% of the electrical input in UV-light in the absorption band of the iodine laser and which can be fired up to 100 Hz. Details of a 10 kJ/1 nsec system as dimensions, energy density, repetition rate, flow velocity, gas composition and gas pressure and the overall efficiency are given which is expected to be about 2%.

  19. Study of magnetorheological fluids at high shear rates

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xiaojie; Gordaninejad, Faramarz [University of Nevada, Department of Mechanical Engineering, Reno, NV (United States)

    2006-08-15

    The tunable rheological properties of magnetorheological (MR) materials at high shear rates are studied using a piston-driven flow-mode-type rheometer. The proposed method provides measurement of the apparent viscosity and yield stress of MR fluids for a shear rate range of 50 to 40,000 s{sup -1}. The rheological properties of a commercial MR fluid, as well as a newly developed MR polymeric gel, and a ferrofluid-based MR fluid are investigated. The results for apparent viscosity and dynamic and static shear stresses under different applied magnetic fields are reported. (orig.)

  20. Successful radiotherapy at the rare extramedullary localization of a chemotherapy refractory relapse Burkitt-All

    International Nuclear Information System (INIS)

    Menschel, E.; Koller, E.; Bernhart, M.; Noesslinger, T.; Pfeilstoecker, M.

    2003-01-01

    The intensive therapy of the Burkitt-All achieved higher remission rates in the last years. Relapses and therapy refractory are a big medial problem. Radiotherapy in contribution with radiosensitizer used by an extramedullary large relapse of Burkitt-All is documented in this article as a successful therapy method. (boteke)

  1. Smoking Cessation and Relapse Prevention among Undergraduate Students: A Pilot Demonstration Project.

    Science.gov (United States)

    Ramsay, Jim; Hoffmann, Anne

    2004-01-01

    The prevalence of college students' tobacco use is widely recognized, but successful cessation and relapse-prevention programs for these smokers have drawn little attention. The authors, who explored the feasibility of training peers to lead cessation and relapse-prevention programs for undergraduates, found a quit rate of 88.2%, suggesting that…

  2. Palaeohistological Evidence for Ancestral High Metabolic Rate in Archosaurs.

    Science.gov (United States)

    Legendre, Lucas J; Guénard, Guillaume; Botha-Brink, Jennifer; Cubo, Jorge

    2016-11-01

    Metabolic heat production in archosaurs has played an important role in their evolutionary radiation during the Mesozoic, and their ancestral metabolic condition has long been a matter of debate in systematics and palaeontology. The study of fossil bone histology provides crucial information on bone growth rate, which has been used to indirectly investigate the evolution of thermometabolism in archosaurs. However, no quantitative estimation of metabolic rate has ever been performed on fossils using bone histological features. Moreover, to date, no inference model has included phylogenetic information in the form of predictive variables. Here we performed statistical predictive modeling using the new method of phylogenetic eigenvector maps on a set of bone histological features for a sample of extant and extinct vertebrates, to estimate metabolic rates of fossil archosauromorphs. This modeling procedure serves as a case study for eigenvector-based predictive modeling in a phylogenetic context, as well as an investigation of the poorly known evolutionary patterns of metabolic rate in archosaurs. Our results show that Mesozoic theropod dinosaurs exhibit metabolic rates very close to those found in modern birds, that archosaurs share a higher ancestral metabolic rate than that of extant ectotherms, and that this derived high metabolic rate was acquired at a much more inclusive level of the phylogenetic tree, among non-archosaurian archosauromorphs. These results also highlight the difficulties of assigning a given heat production strategy (i.e., endothermy, ectothermy) to an estimated metabolic rate value, and confirm findings of previous studies that the definition of the endotherm/ectotherm dichotomy may be ambiguous. © The Author(s) 2016. Published by Oxford University Press, on behalf of the Society of Systematic Biologists. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. High Data Rate Optical Wireless Communications Based on Ultraviolet Band

    KAUST Repository

    Sun, Xiaobin

    2017-10-01

    Optical wireless communication systems based on ultraviolet (UV)-band has a lot inherent advantages, such as low background solar radiation, low device dark noise. Besides, it also has small restrictive requirements for PAT (pointing, acquisition, and tracking) because of its high atmospheric scattering with molecules and aerosols. And these advantages are driving people to explore and utilize UV band for constructing and implementing a high-data-rate, less PAT communication links, such as diffuse-line-of-sight links (diffuse-LOS) and non-line-of-sight (NLOS). The responsivity of the photodetector at UV range is far lower than that of visible range, high power UV transmitters which can be easily modulated are under investigation. These factors make it is hard to realize a high-data-rate diffuse-LOS or NLOS UV communication links. To achieve a UV link mentioned above with current devices and modulation schemes, this thesis presents some efficient modulation schemes and available devices for the time being. Besides, a demonstration of ultraviolet-B (UVB) communication link is implemented utilizing quadrature amplitude modulation (QAM) orthogonal frequency-division multiplexing (OFDM). The demonstration is based on a 294-nm UVB-light-emitting-diode (UVB-LED) with a full-width at half-maximum (FWHM) of 9 nm, and according to the measured L-I-V curve, we set the bias voltage as 7V for maximum the ac amplitude and thus get a high signal-noise-ratio (SNR) channel, and the light output power is 190 μW with such bias voltage. Besides, there is a unique silica gel lens on top of the LED to concentrate the beam. A -3-dB bandwidth of 29 MHz was measured and a high-speed near-solar-blind communication link with a data rate of 71 Mbit/s was achieved using 8-QAM-OFDM at perfect alignment, and 23.6 Mbit/s using 2-QAM-OFDM when the angle subtended by the pointing direction of the UVB-LED and photodetector (PD) is 12 degrees, thus establishing a diffuse-line-of-sight (LOS) link

  4. Prevention of relapsing backache

    Directory of Open Access Journals (Sweden)

    Raspe, Heiner

    2006-05-01

    Full Text Available Background: The condition of non-specific back pain is characterized by high prevalence, non satisfactory therapeutic options and severe socioeconomic consequences. Therefore prevention seems an attractive option to downsize the problem. However, the construction of effective preventive measures is complicated by the obscure aetiology of the condition, the multidimensionality of risk and prognostic factors (bio psychosocial model! and the variability of its natural as well as clinical course. This led to the development of a wide variety of preventive measures: e. g. exercise programs, educational measures (including back school, ergonomic modification of the work environment, mechanical supports (e. g. back belts as well as multidisciplinary interventions. For two reasons the workplace seems to be a suitable setting for prevention. First, because a number of strong risk factors are associated with working conditions and second, because it allows addressing a large proportion of the adult population. Against this background the assessment at hand sets out to answer the following questions: What is the amount and methodological quality of the available scientific literature on the effectiveness of back pain prevention in the workplace environment? What are effective measures for the prevention of back pain and its consequences in the workplace environment and how effective are they? Is back pain prevention in the workplace environment cost-effective? Is there a need for more research? As primary outcomes for effectiveness the assessment will focus on time lost from work and the frequency and duration of episodes with back pain. The preventive measures assessed belong to the following categories: exercise programs, educational and information measures, multidimensional interventions, back belts, lifting teams and ergonomic interventions. Methods: The assessment is based on a systematic review of the published literature according to the

  5. High-Rate Performance of Muon Drift Tube Detectors

    CERN Document Server

    Schwegler, Philipp

    The Large Hadron Collider (LHC) at the European Centre for Particle Physics, CERN, collides protons with an unprecedentedly high centre-of-mass energy and luminosity. The collision products are recorded and analysed by four big experiments, one of which is the ATLAS detector. In parallel with the first LHC run from 2009 to 2012, which culminated in the discovery of the last missing particle of the Standard Model of particle physics, the Higgs boson, planning of upgrades of the LHC for higher instantaneous luminosities (HL-LHC) is already progressing. The high instantaneous luminosity of the LHC puts high demands on the detectors with respect to radiation hardness and rate capability which are further increased with the luminosity upgrade. In this thesis, the limitations of the Muon Drift Tube (MDT) chambers of the ATLAS Muon Spectrometer at the high background counting rates at the LHC and performance of new small diameter muon drift tube (sMDT) detectors at the even higher background rates at HL-LHC are stud...

  6. Dynamic High-Temperature Characterization of an Iridium Alloy in Compression at High Strain Rates

    Energy Technology Data Exchange (ETDEWEB)

    Song, Bo [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Experimental Environment Simulation Dept.; Nelson, Kevin [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Mechanics of Materials Dept.; Lipinski, Ronald J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Advanced Nuclear Fuel Cycle Technology Dept.; Bignell, John L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Structural and Thermal Analysis Dept.; Ulrich, G. B. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Radioisotope Power Systems Program; George, E. P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Radioisotope Power Systems Program

    2014-06-01

    Iridium alloys have superior strength and ductility at elevated temperatures, making them useful as structural materials for certain high-temperature applications. However, experimental data on their high-temperature high-strain-rate performance are needed for understanding high-speed impacts in severe elevated-temperature environments. Kolsky bars (also called split Hopkinson bars) have been extensively employed for high-strain-rate characterization of materials at room temperature, but it has been challenging to adapt them for the measurement of dynamic properties at high temperatures. Current high-temperature Kolsky compression bar techniques are not capable of obtaining satisfactory high-temperature high-strain-rate stress-strain response of thin iridium specimens investigated in this study. We analyzed the difficulties encountered in high-temperature Kolsky compression bar testing of thin iridium alloy specimens. Appropriate modifications were made to the current high-temperature Kolsky compression bar technique to obtain reliable compressive stress-strain response of an iridium alloy at high strain rates (300 – 10000 s-1) and temperatures (750°C and 1030°C). Uncertainties in such high-temperature high-strain-rate experiments on thin iridium specimens were also analyzed. The compressive stress-strain response of the iridium alloy showed significant sensitivity to strain rate and temperature.

  7. High-dose-rate versus low-dose-rate brachytherapy in the treatment of cervical cancer: analysis of tumor recurrence - the University of Wisconsin experience

    International Nuclear Information System (INIS)

    Petereit, Daniel G.; Sarkaria, Jann N.; Potter, David M.; Schink, Julian C.

    1999-01-01

    Purpose: To retrospectively compare the clinical outcome for cervical cancer patients treated with high-dose-rate (HDR) vs. low-dose-rate (LDR) brachytherapy. Methods and Materials: One hundred ninety-one LDR patients were treated from 1977 to 1988 and compared to 173 HDR patients treated from 1989 to 1996. Patients of similar stage and tumor volumes were treated with identical external beam fractionation schedules. Brachytherapy was given in either 1 or 2 LDR implants for the earlier patient cohort, and 5 HDR implants for the latter cohort. For both patient groups, Point A received a minimum total dose of 80 Gy. The linear-quadratic formula was used to calculate the LDR dose-equivalent contribution to Point A for the HDR treatments. The primary endpoints assessed were survival, pelvic control, relapse-free survival, and distant metastases. Endpoints were estimated using the Kaplan-Meier method. Comparisons between treatment groups were performed using the log-rank test and Cox proportional hazards models. Results: The median follow-up was 65 months (2 to 208 months) in the LDR group and 22 months (1 to 85 months) in the HDR group. For all stages combined there was no difference in survival, pelvic control, relapse-free survival, or distant metastases between LDR and HDR patients. For Stage IB and II HDR patients, the pelvic control rates were 85% and 80% with survival rates of 86% and 65% at 3 years, respectively. In the LDR group, Stage IB and II patients had 91% and 78% pelvic control rates, with 82% and 58% survival rates at 3 years, respectively. No difference was seen in survival or pelvic control for bulky Stage I and II patients combined (> 5 cm). Pelvic control at 3 years was 44% (HDR) versus 75% (LDR) for Stage IIIB patients (p = 0.002). This difference in pelvic control was associated with a lower survival rate in the Stage IIIB HDR versus LDR population (33% versus 58%, p = 0.004). The only major difference, with regard to patient characteristics

  8. Mechanical characterization of rocks at high strain rate

    Directory of Open Access Journals (Sweden)

    Konstantinov A.

    2012-08-01

    Full Text Available The paper presents the dynamic characterization in tension and compression of three rocks, Carrara marble, Onsernone gneiss and Peccia Marble, at high strain-rates. Two versions of a Split Hopkinson Bar have been used. The version for direct tension tests is installed at the DynaMat Laboratory of the University of Applied Sciences of Southern Switzerland, while the traditional version in compression is installed at the Laboratory of Dynamic Investigation of Materials of Lobachevsky State University. Results of the tests show a significantly strain-rate sensitive behaviour, exhibiting dynamic strength increasing with strain-rate. The experimental research has been developed in the frame of the Swiss-Russian Joint Research Program.

  9. The Cost of Relapse in Schizophrenia.

    Science.gov (United States)

    Pennington, Mark; McCrone, Paul

    2017-09-01

    Schizophrenia is a chronic and debilitating mental illness characterised by periods of relapse that require resource intensive management. Quantifying the cost of relapse is central to the evaluation of the cost effectiveness of treating schizophrenia. We aimed to undertake a comprehensive search of the available literature on the cost of relapse. We performed a search on multiple databases (MEDLINE, Embase, PsycINFO and Health Management Information Consortium) for any study reporting a cost of relapse or data from which such a cost could be calculated. Costs are reported in 2015 international dollars. We found 16 studies reporting costs associated with relapse over a defined period of time and identified a cost associated with hospitalisation for relapse in 43 studies. Eight clinical decision analyses also provided cost estimates. Studies from the US report excess costs of relapse of $6033-$32,753 (2015 Purchasing Power Parity dollars [PPP$]) over periods of 12-15 months. European studies report excess costs of $8665-$18,676 (2015 PPP$) over periods of 6-12 months. Estimates of the cost of hospitalisation for relapse are more diverse, and associated with marked differences in typical length of stay across jurisdictions. Wide ranges in the estimated cost of relapse may reflect differences in sample section and relapse definition as well as practice styles and differences in resource costs. Selection of the most appropriate cost estimate should be guided by the definition of relapse and the analysis setting.

  10. High freight rates hinder oil markets' return to equilibrium

    International Nuclear Information System (INIS)

    Anon

    2005-01-01

    Hurricane damage to refineries in the US has created shortages of refined products there, boosting imports and sending freight rates across the Atlantic to record levels. The situation was made worse for a time by a strike at France's main oil terminals in the Mediterranean, which prevented some oil tankers from being rapidly redeployed to routes across the Atlantic. Worldscale (WS) rates for routes from the UK and Europe to the US Atlantic and Gulf Coasts rose well above WS500 for clean tonnage during October. High rates were nevertheless not simply confined to product tankers crossing the Atlantic. Rates for crude tankers to the US have also risen, and tightness has begun to appear in some other markets as well. The net result has been to slow down the movement of oil from regions of surplus to those of scarcity, depressing prices in the former and keeping them at high levels in the latter. Atlantic tanker markets look like remaining tight for the rest of the year and perhaps beyond. (author)

  11. Investigation of high-rate lithium-thionyl chloride cells

    Science.gov (United States)

    Hayes, Catherine A.; Gust, Steven; Farrington, Michael D.; Lockwood, Judith A.; Donaldson, George J.

    Chemical analysis of a commercially produced high-rate D-size lithium-thionyl cell was carried out, as a function of rate of discharge (1 ohm and 5 ohms), depth of discharge, and temperature (25 C and -40 C), using specially developed methods for identifying suspected minor cell products or impurities which may effect cell performance. These methods include a product-retrieval system which involves solvent extraction to enhance the recovery of suspected semivolatile minor chemicals, and methods of quantitative GC analysis of volatile and semivolatile products. The nonvolatile products were analyzed by wet chemical methods. The results of the analyses indicate that the predominant discharge reaction in this cell is 4Li + 2SOCl2 going to 4LiCl + S + SO2, with SO2 formation decreasing towards the end of cell life (7 to 12 Ah). The rate of discharge had no effect on the product distribution. Upon discharge of the high-rate cell at -40 C, one cell exploded, and all others exhibited overheating and rapid internal pressure rise when allowed to warm up to room temperature.

  12. Development of amplifier and shaper for high-rate MWPC

    International Nuclear Information System (INIS)

    Kamiji, Ichinori; Nanjo, Hajime; Kawasaki, Naoki; Maeda, Yosuke; Naito, Daichi; Seki, Shigeto; Nakagiri, Kota; Sasao, Noboru; Nomura, Tadashi

    2015-01-01

    A multi-wire proportional chamber (MWPC) will be used as an in-beam charged particle detector for the J-PARC E14 (KOTO) experiment. The maximum counting rate of the MWPC is expected to be up to 1 MHz per channel due to the high neutron and photon flux, expected to be 1 GHz for the 30 x 30 cm"2 area. An amplifier to cope with such high counting-rate is required. We developed a prototype of such amplifier, which has a charge preamplifier with the integration time of 3 ns and a pulse shaping part with three pole-zero cancellation networks. The shaper reduced the characteristic long tail lasting tens of microseconds in the signal of MWPC to 150 ns. Its performance has been tested by using a single-channel MWPC which has almost the same geometrical parameters as the MWPC to be installed in the KOTO experiment. (author)

  13. Characteristics of Multiplexed Grooved Nozzles for High Flow Rate Electrospray

    International Nuclear Information System (INIS)

    Kim, Kyoung Tae; Kim, Woo Jin; Kim, Sang Soo

    2007-01-01

    The electrospray operated in the cone-jet mode can generate highly charged micro droplets in an almost uniform size at flow rates. Therefore, the multiplexing system which can retain the characteristics of the cone-jet mode is inevitable for the electrospray application. This experiment reports the multiplexed grooved nozzle system with the extractor. The effects of the grooves and the extractor on the performance of the electrospray were evaluated through experiments. Using the grooved nozzle, the stable cone-jet mode can be achieved at the each groove in the grooved mode. Furthermore, the number of nozzles per unit area is increased by the extractor. The multiplexing density is 12 jets per cm 2 at 30 mm distance from the nozzle tip to the ground plate. The multiplexing system for the high flow rate electrospray is realized with the extractor which can diminish the space charge effect without sacrificing characteristics of the cone-jet mode

  14. A simple risk scoring system for prediction of relapse after inpatient alcohol treatment.

    Science.gov (United States)

    Pedersen, Mads Uffe; Hesse, Morten

    2009-01-01

    Predicting relapse after alcoholism treatment can be useful in targeting patients for aftercare services. However, a valid and practical instrument for predicting relapse risk does not exist. Based on a prospective study of alcoholism treatment, we developed the Risk of Alcoholic Relapse Scale (RARS) using items taken from the Addiction Severity Index and some basic demographic information. The RARS was cross-validated using two non-overlapping samples, and tested for its ability to predict relapse across different models of treatment. The RARS predicted relapse to drinking within 6 months after alcoholism treatment in both the original and the validation sample, and in a second validation sample it predicted admission to new treatment 3 years after treatment. The RARS can identify patients at high risk of relapse who need extra aftercare and support after treatment.

  15. Immunotoxin – a new treatment option in patients with relapsed and refractory Hodgkin lymphoma

    Science.gov (United States)

    Novakovic, Barbara Jezersek

    2015-01-01

    Background Even though Hodgkin lymphoma is a highly curable disease, some of the patients have either a refractory disease or experience a relapse following a successful primary therapy. Durable responses and remissions in patients with relapsed or refractory disease may be achieved in approximately one-half with salvage chemotherapy followed by high dose chemotherapy (HDT) and autologous hematopoietic cell rescue (SCT). On the other hand, patients who relapse after HDT and autologous SCT or those who have failed at least two prior multi-agent chemotherapy regimens and are not candidates for HDT have limited treatment options. Conclusions A new treatment option in this population is an immunotoxin Brentuximab vedotin composed of a CD30 directed antibody linked to the antitubulin agent monomethyl auristatin E. It has demonstrated a substantial effectiveness and an acceptable toxicity. In the pivotal study, the overall response rate was 75% with 34% of complete remissions. The median durations of response were 20.5 and 6.7 months for those with complete remission and all responding patients, respectively. The median overall survival was 40.5 months (3-years overall survival 54%) and the median progression-free survival 9.3 months. The most common non-hematologic toxicities were peripheral sensory neuropathy, nausea, and fatigue while the most common severe side effects were neutropenia, thrombocytopenia, anemia, and peripheral sensory neuropathy. PMID:26834516

  16. Detection of relapse in early stage Hodgkin's disease: role of routine follow up studies

    International Nuclear Information System (INIS)

    Torrey, Margaret J.; Poen, Joseph C.; Hoppe, Richard T.

    1995-01-01

    Purpose: To examine the costs and benefits of an established practice of routine follow-up in a cohort of patients treated with radiation therapy for early stage Hodgkin's disease. Materials and Methods: We retrospectively examined patterns of follow-up and methods of relapse detection among 709 patients with Ann Arbor Stage I-II Hodgkin's disease treated with sub-total lymphoid irradiation (STLI) or total lymphoid irradiation (TLI) between 1969-1994. We determined the probability of relapse detection for each of 7 routine follow up procedures, compared their relative costs, and determined the impact of each procedure on the likelihood of overall survival following salvage therapy. Results: Relapse has occurred in 157 patients (22%) at a median 1.9 years (range 0-13 years) following treatment. 133 relapses (85%) occurred during the first 5 years of follow. Detailed information concerning the method of relapse detection was available on 107 patients. These 107 patients form the basis of this analysis. Relapse was identified by history (Hx) alone in 55% of patients, physical exam (PE) in 14%, chest x-ray (CXR) in 23% and abdominal x-ray (KUB) in 7%. Only one relapse (1%) was identified by a routine laboratory study - erythrocyte sedimentation rate (ESR). The rate of relapse detection was highest for a combination of history and physical exam (78/10,000 exams) followed by CXR (26/10,000 exams), KUB (10/10,000 exams) and ESR (1/10,000 tests). Complete blood count (CBC) and serum chemistries were never the primary factor in detecting HD relapse. Radiographs accounted for greater than 60% of charges while laboratory studies and physician charges accounted for approximately 20% each. The projected charges (1994 dollars) of relapse detection by routine follow up Hx and PE was [dollar]10,600 compared with [dollar]68,200 for CXR, [dollar]141,800 for KUB and [dollar]156,400 for ESR. 10 year actuarial survival following salvage therapy was 65% overall, 65% for patients in whom

  17. Detection of relapse in early stage Hodgkin's disease: role of routine follow up studies

    Energy Technology Data Exchange (ETDEWEB)

    Torrey, Margaret J; Poen, Joseph C; Hoppe, Richard T

    1995-07-01

    Purpose: To examine the costs and benefits of an established practice of routine follow-up in a cohort of patients treated with radiation therapy for early stage Hodgkin's disease. Materials and Methods: We retrospectively examined patterns of follow-up and methods of relapse detection among 709 patients with Ann Arbor Stage I-II Hodgkin's disease treated with sub-total lymphoid irradiation (STLI) or total lymphoid irradiation (TLI) between 1969-1994. We determined the probability of relapse detection for each of 7 routine follow up procedures, compared their relative costs, and determined the impact of each procedure on the likelihood of overall survival following salvage therapy. Results: Relapse has occurred in 157 patients (22%) at a median 1.9 years (range 0-13 years) following treatment. 133 relapses (85%) occurred during the first 5 years of follow. Detailed information concerning the method of relapse detection was available on 107 patients. These 107 patients form the basis of this analysis. Relapse was identified by history (Hx) alone in 55% of patients, physical exam (PE) in 14%, chest x-ray (CXR) in 23% and abdominal x-ray (KUB) in 7%. Only one relapse (1%) was identified by a routine laboratory study - erythrocyte sedimentation rate (ESR). The rate of relapse detection was highest for a combination of history and physical exam (78/10,000 exams) followed by CXR (26/10,000 exams), KUB (10/10,000 exams) and ESR (1/10,000 tests). Complete blood count (CBC) and serum chemistries were never the primary factor in detecting HD relapse. Radiographs accounted for greater than 60% of charges while laboratory studies and physician charges accounted for approximately 20% each. The projected charges (1994 dollars) of relapse detection by routine follow up Hx and PE was [dollar]10,600 compared with [dollar]68,200 for CXR, [dollar]141,800 for KUB and [dollar]156,400 for ESR. 10 year actuarial survival following salvage therapy was 65% overall, 65% for patients in whom

  18. Miniaturized Stretchable and High-Rate Linear Supercapacitors

    OpenAIRE

    Zhu, Wenjun; Zhang, Yang; Zhou, Xiaoshuang; Xu, Jiang; Liu, Zunfeng; Yuan, Ningyi; Ding, Jianning

    2017-01-01

    Linear stretchable supercapacitors have attracted much attention because they are well suited to applications in the rapidly expanding field of wearable electronics. However, poor conductivity of the electrode material, which limits the transfer of electrons in the axial direction of the linear supercapacitors, leads to a serious loss of capacity at high rates. To solve this problem, we use gold nanoparticles to decorate aligned multiwall carbon nanotube to fabricate stretchable linear electr...

  19. High repetition rate burst-mode spark gap

    International Nuclear Information System (INIS)

    Faltens, A.; Reginato, L.; Hester, R.; Chesterman, A.; Cook, E.; Yokota, T.; Dexter, W.

    1978-01-01

    Results are presented on the design and testing of a pressurized gas blown spark gap switch capable of high repetition rates in a burst mode of operation. The switch parameters which have been achieved are as follows: 220-kV, 42-kA, a five pulse burst at 1-kHz, 12-ns risetime, 2-ns jitter at a pulse width of 50-ns

  20. High rate multiplicity detector for relativistic heavy-ion collisions

    International Nuclear Information System (INIS)

    Beavis, D.; Bennett, M.J.; Carroll, J.B.; Chiba, J.; Chikanian, A.; Crawford, H.J.; Cronqvist, M.; Dardenne, Y.; Debbe, R.; Doke, T.; Engelage, J.; Flores, I.; Greiner, L.; Hayano, R.S.; Hallman, T.J.; Heckman, H.H.; Kashiwagi, T.; Kikuchi, J.; Kumar, B.S.; Kuo, C.; Lindstrom, P.J.; Mitchell, J.W.; Nagamiya, S.; Nagle, J.L.; Pope, J.K.; Stankus, P.; Tanaka, K.H.; Welsh, R.C.; Zhan, W.

    1995-01-01

    We have constructed and operated a detector to measure the multiplicity of secondary particles produced in nucleus-nucleus collisions in the E878 experiment at the Brookhaven National Laboratory AGS facility. We describe the operation and performance of the detector in a high rate Au beam environment, and interpret the multiplicity data in terms of the impact parameters of the nucleus-nucleus collisions. ((orig.))

  1. High rate multiplicity detector for relativistic heavy-ion collisions

    Energy Technology Data Exchange (ETDEWEB)

    Beavis, D [Brookhaven National Lab., Upton, NY (United States); Bennett, M J [Yale University, A.W. Wright Nuclear Structure Laboratory, New Haven, CT 06511 (United States); Carroll, J B [University of California at Los Angeles, Los Angeles, CA (United States); Chiba, J [KEK National High Energy Physics, Tsukuba (Japan); Chikanian, A [Yale University, A.W. Wright Nuclear Structure Laboratory, New Haven, CT 06511 (United States); Crawford, H J [University of California Space Sciences Laboratory, Berkeley, CA (United States); Cronqvist, M [University of California Space Sciences Laboratory, Berkeley, CA (United States); Dardenne, Y [University of California Space Sciences Laboratory, Berkeley, CA (United States); Debbe, R [Brookhaven National Lab., Upton, NY (United States); Doke, T [Waseda University, Science and Engineering Research Institute, Waseda (Japan); Engelage, J [University of California Space Sciences Laboratory, Berkeley, CA (United States); Flores, I [University of California Space Sciences Laboratory, Berkeley, CA (United States); Greiner, L [University of California Space Sciences Laboratory, Berkeley, CA (United States); Hayano, R S [University of Tokyo, Tokyo (Japan); Hallman, T J [University of California at Los Angeles, Los Angeles, CA (United States); Heckman, H H [Lawrence Berkeley Lab., CA (United States); Kashiwagi, T [Waseda University, Science and Engineering Research Institute, Waseda (Japan); Kikuchi, J [Waseda University, Science and Engineering Research Institute, Waseda (Japan); Kumar, B S [Yale University, A.W. Wright Nuclear Structure Laboratory, New Haven, CT 06511 (United States); Kuo, C [University of California Space Sciences Laboratory, Berkeley, CA (United States); Lindstrom, P J [Lawrence Berkeley Lab., CA (United States); Mitchell, J W [Universities Space Research Association/Goddard Space Flight Center, Greenbelt, MD (United States); Nagamiya, S; E878 Collaboration

    1995-04-21

    We have constructed and operated a detector to measure the multiplicity of secondary particles produced in nucleus-nucleus collisions in the E878 experiment at the Brookhaven National Laboratory AGS facility. We describe the operation and performance of the detector in a high rate Au beam environment, and interpret the multiplicity data in terms of the impact parameters of the nucleus-nucleus collisions. ((orig.)).

  2. MDT Performance in a High Rate Background Environment

    CERN Document Server

    Aleksa, Martin; Hessey, N P; Riegler, W

    1998-01-01

    A Cs137 gamma source with different lead filters in the SPS beam-line X5 has been used to simulate the ATLAS background radiation. This note shows the impact of high background rates on the MDT efficiency and resolution for three kinds of pulse shaping and compares the results with GARFIELD simulations. Furthermore it explains how the performance can be improved by time slewing corrections and double track separation.

  3. Relapse Prevention: An Overview of Marlatts Cognitive- Behavioral Model

    Directory of Open Access Journals (Sweden)

    2008-11-01

    Full Text Available Relapse prevention(RPis an important component of alcoholism treatment. The RP model proposed by Marlatt and Gordon suggests that both immediate determinants (e.g.,high- risk situations, coping skills, outcome expectancies, and the abstinence violation effect and covert antecedents (e.g., lifestyle factor and urges and cravings can contribute to relapse.The RP model also incorporates numerous specific and global intervention strategies that allow therapist and client to address each step of the relapse process. Specific interventions include identifying specific high-risk situations for each client and enhancing the client's skills for coping with those situations, increasing the client's self- efficacy, eliminating myths regarding alcohol's effects, managing lapses, and restructuring the client's perceptions of the relapse process. Global strategies comprise balancing the client's lifestyle and helping him or her develop positive addictions, employing stimulus control techniques and urgemanagement techniques, and developing relapse road maps. Several studies have provided theoretical and practical support for the RP model.

  4. High rate amplifier-digitizer system for liquid argon calorimeters

    International Nuclear Information System (INIS)

    Droege, T.F.; Lobkowicz, F.; Fukushima, Y.

    1978-01-01

    A low-cost charge amplifier for a liquid argon photon detector and a new method for pulse height analysis are described. This scheme is suitable for high-energy photon detection with high counting rate. Samples of preamplifer output are taken just before and just after the arrival of the charge from the detector. The difference of these samples provides a stable pedestal and rejects low frequency noise. Short two-pulse resolving time (approximately equal to 200ns) is achieved. 6 refs

  5. Abuse resistant high rate lithium/thionyl chloride cells

    Energy Technology Data Exchange (ETDEWEB)

    Surprenant, J.; Snuggerud, D.

    1982-08-01

    A compact, disc shaped lithium/thionyl chloride cell has been developed by Altus Corporation. The cell has a 6 Amphr capacity and is capable of high rate discharge at high voltage. Discharge data is presented over the range of 0.07 to 1.1 Amperes. The cell is operable over the temperature range of -40/sup 0/C to +70/sup 0/C, and has a 10 year shelf life at 20/sup 0/C. Safety features allow the cells to withstand fire, puncture, shock, spin, forced discharge or forced charge without dangerous reactions.

  6. Abuse resistant high rate lithium/thionyl chloride cells

    Science.gov (United States)

    Surprenant, J.; Snuggerud, D.

    A compact, disk shaped lithium/thionyl chloride cell has been developed. The cell has a 6 Amphr capacity and is capable of high rate discharge at high voltage. Discharge data are presented over the range of 0.07 to 1.1 amperes. The cell is operable over the temperature range of -40 C to +70 C, and has a 10 year shelf life at 20 C. Safety features allow the cells to withstand fire, puncture, shock, spin, forced discharge or forced charge without dangerous reactions.

  7. Semi-solid electrodes having high rate capability

    Energy Technology Data Exchange (ETDEWEB)

    Chiang, Yet-Ming; Duduta, Mihai; Holman, Richard; Limthongkul, Pimpa; Tan, Taison

    2017-11-28

    Embodiments described herein relate generally to electrochemical cells having high rate capability, and more particularly to devices, systems and methods of producing high capacity and high rate capability batteries having relatively thick semi-solid electrodes. In some embodiments, an electrochemical cell includes an anode and a semi-solid cathode. The semi-solid cathode includes a suspension of an active material of about 35% to about 75% by volume of an active material and about 0.5% to about 8% by volume of a conductive material in a non-aqueous liquid electrolyte. An ion-permeable membrane is disposed between the anode and the semi-solid cathode. The semi-solid cathode has a thickness of about 250 .mu.m to about 2,000 .mu.m, and the electrochemical cell has an area specific capacity of at least about 7 mAh/cm.sup.2 at a C-rate of C/4. In some embodiments, the semi-solid cathode slurry has a mixing index of at least about 0.9.

  8. Allogeneic transplantation for multiple myeloma: late relapse may occur as localised lytic lesion/plasmacytoma despite ongoing molecular remission.

    Science.gov (United States)

    Byrne, J L; Fairbairn, J; Davy, B; Carter, I G; Bessell, E M; Russell, N H

    2003-02-01

    Allogeneic SCT for myeloma may be curative for young patients, but its role remains controversial because of a reported high TRM in some series. Since 1991, we have performed 25 allografts for myeloma using fully matched sibling donors. Of the 18 evaluable patients, 13 achieved CR at a median time of 2.5 months post-transplant. The five patients who were not in CR when assessed at 3 months received a short course of alpha-interferon and four subsequently achieved CR with this approach at a median of 82 days. One patient who failed to respond to IFN went on to achieve CR after four doses of DLI therapy, thus giving an overall CR rate of 72%. Seven patients have relapsed at a median of 4.7 years post-transplant (range 1.38-7.7 years) including two patients who had received IFN therapy. In five of these cases, relapse has been as a localised area of bone disease or isolated plasmacytoma with no evidence of marrow involvement by trephine biopsy or molecular analysis. All patients with localised relapse were treated with local radiotherapy +/-DLI and four are currently disease free despite two patients having had further treatment for a second localised lesion. Six patients died of TRM (24%) and the OS at 8 years is currently 69% with an EFS of 26%. These results suggest that allogeneic SCT for myeloma can be carried out with an acceptable TRM and a high CR rate. However, late relapses as localised disease may be a frequent finding and may represent foci of myeloma not eradicated by the conditioning. The use of pretransplant MRI scanning and top-up radiotherapy to involved areas may be useful in preventing this type of relapse.

  9. High Strain Rate and Shock-Induced Deformation in Metals

    Science.gov (United States)

    Ravelo, Ramon

    2012-02-01

    Large-scale non-equilibrium molecular Dynamics (MD) simulations are now commonly used to study material deformation at high strain rates (10^9-10^12 s-1). They can provide detailed information-- such as defect morphology, dislocation densities, and temperature and stress profiles, unavailable or hard to measure experimentally. Computational studies of shock-induced plasticity and melting in fcc and bcc single, mono-crystal metals, exhibit generic characteristics: high elastic limits, large directional anisotropies in the yield stress and pre-melting much below the equilibrium melt temperature for shock wave propagation along specific crystallographic directions. These generic features in the response of single crystals subjected to high strain rates of deformation can be explained from the changes in the energy landscape of the uniaxially compressed crystal lattice. For time scales relevant to dynamic shock loading, the directional-dependence of the yield strength in single crystals is shown to be due to the onset of instabilities in elastic-wave propagation velocities. The elastic-plastic transition threshold can accurately be predicted by a wave-propagation stability analysis. These strain-induced instabilities create incipient defect structures, which can be quite different from the ones, which characterize the long-time, asymptotic state of the compressed solid. With increase compression and strain rate, plastic deformation via extended defects gives way to amorphization associated with the loss in shear rigidity along specific deformation paths. The hot amorphous or (super-cooled liquid) metal re-crystallizes at rates, which depend on the temperature difference between the amorphous solid and the equilibrium melt line. This plastic-amorphous transition threshold can be computed from shear-waves stability analyses. Examples from selected fcc and bcc metals will be presented employing semi-empirical potentials of the embedded atom method (EAM) type as well as

  10. Scale dependence of rock friction at high work rate.

    Science.gov (United States)

    Yamashita, Futoshi; Fukuyama, Eiichi; Mizoguchi, Kazuo; Takizawa, Shigeru; Xu, Shiqing; Kawakata, Hironori

    2015-12-10

    Determination of the frictional properties of rocks is crucial for an understanding of earthquake mechanics, because most earthquakes are caused by frictional sliding along faults. Prior studies using rotary shear apparatus revealed a marked decrease in frictional strength, which can cause a large stress drop and strong shaking, with increasing slip rate and increasing work rate. (The mechanical work rate per unit area equals the product of the shear stress and the slip rate.) However, those important findings were obtained in experiments using rock specimens with dimensions of only several centimetres, which are much smaller than the dimensions of a natural fault (of the order of 1,000 metres). Here we use a large-scale biaxial friction apparatus with metre-sized rock specimens to investigate scale-dependent rock friction. The experiments show that rock friction in metre-sized rock specimens starts to decrease at a work rate that is one order of magnitude smaller than that in centimetre-sized rock specimens. Mechanical, visual and material observations suggest that slip-evolved stress heterogeneity on the fault accounts for the difference. On the basis of these observations, we propose that stress-concentrated areas exist in which frictional slip produces more wear materials (gouge) than in areas outside, resulting in further stress concentrations at these areas. Shear stress on the fault is primarily sustained by stress-concentrated areas that undergo a high work rate, so those areas should weaken rapidly and cause the macroscopic frictional strength to decrease abruptly. To verify this idea, we conducted numerical simulations assuming that local friction follows the frictional properties observed on centimetre-sized rock specimens. The simulations reproduced the macroscopic frictional properties observed on the metre-sized rock specimens. Given that localized stress concentrations commonly occur naturally, our results suggest that a natural fault may lose its

  11. A new high rate positron lifetime measurement system

    International Nuclear Information System (INIS)

    Bedwell, M.O.; Paulus, T.J.

    1979-01-01

    Positron lifetime measuring system, a technique to perform non-destructive studies on the internal structure of materials, has many components common to those used for nuclear time spectroscopy systems. In each case, a timing coincidence curve is measured for the energy range of interest, and this is accomplished in a typical timing coincidence system. The paper first describes the conventional timing coincidence system, then a new fast timing system is introduced. Comparing to the conventional fast/slow timing system, the fast timing technique offers reduced complexity, lower system cost, and improved high data rate capability. Experimental results show that the FWHM timing resolution ranges from 190 ps for a 1.1 : 1 dynamic range to 337 ps for a 100 : 1 dynamic range of signals with 60 Co. As for the timing resolution as a function of energy, the FWHM resolution for each channel ranges from 124 ps at 1 MeV to 400 ps at 100 keV. Since the excellent timing performance is maintained even at very high input rate, the experimenters can use much more active sources to increase the true coincidence rate and reduce data accumulation time. This method has the added advantage of minimizing long term drift effects since the experiments can be conducted in less time. (Wakatsuki, Y.)

  12. Miniaturized Stretchable and High-Rate Linear Supercapacitors.

    Science.gov (United States)

    Zhu, Wenjun; Zhang, Yang; Zhou, Xiaoshuang; Xu, Jiang; Liu, Zunfeng; Yuan, Ningyi; Ding, Jianning

    2017-12-01

    Linear stretchable supercapacitors have attracted much attention because they are well suited to applications in the rapidly expanding field of wearable electronics. However, poor conductivity of the electrode material, which limits the transfer of electrons in the axial direction of the linear supercapacitors, leads to a serious loss of capacity at high rates. To solve this problem, we use gold nanoparticles to decorate aligned multiwall carbon nanotube to fabricate stretchable linear electrodes. Furthermore, we have developed fine stretchable linear supercapacitors, which exhibited an extremely high elasticity up to 400% strain with a high capacitance of about 8.7 F g -1 at the discharge current of 1 A g -1 .

  13. High Dose-Rate Versus Low Dose-Rate Brachytherapy for Lip Cancer

    International Nuclear Information System (INIS)

    Ghadjar, Pirus; Bojaxhiu, Beat; Simcock, Mathew; Terribilini, Dario; Isaak, Bernhard; Gut, Philipp; Wolfensberger, Patrick; Brömme, Jens O.; Geretschläger, Andreas; Behrensmeier, Frank; Pica, Alessia; Aebersold, Daniel M.

    2012-01-01

    Purpose: To analyze the outcome after low-dose-rate (LDR) or high-dose-rate (HDR) brachytherapy for lip cancer. Methods and Materials: One hundred and three patients with newly diagnosed squamous cell carcinoma of the lip were treated between March 1985 and June 2009 either by HDR (n = 33) or LDR brachytherapy (n = 70). Sixty-eight patients received brachytherapy alone, and 35 received tumor excision followed by brachytherapy because of positive resection margins. Acute and late toxicity was assessed according to the Common Terminology Criteria for Adverse Events 3.0. Results: Median follow-up was 3.1 years (range, 0.3–23 years). Clinical and pathological variables did not differ significantly between groups. At 5 years, local recurrence-free survival, regional recurrence-free survival, and overall survival rates were 93%, 90%, and 77%. There was no significant difference for these endpoints when HDR was compared with LDR brachytherapy. Forty-two of 103 patients (41%) experienced acute Grade 2 and 57 of 103 patients (55%) experienced acute Grade 3 toxicity. Late Grade 1 toxicity was experienced by 34 of 103 patients (33%), and 5 of 103 patients (5%) experienced late Grade 2 toxicity; no Grade 3 late toxicity was observed. Acute and late toxicity rates were not significantly different between HDR and LDR brachytherapy. Conclusions: As treatment for lip cancer, HDR and LDR brachytherapy have comparable locoregional control and acute and late toxicity rates. HDR brachytherapy for lip cancer seems to be an effective treatment with acceptable toxicity.

  14. Brachytherapy for early oral tongue cancer. Low dose rate to high dose rate

    International Nuclear Information System (INIS)

    Yamazaki, Hideya; Inoue, Takehiro; Yoshida, Ken; Yoshioka, Yasuo; Shimizutani, Kimishige; Inoue, Toshihiko; Furukawa, Souhei; Kakimoto, Naoya

    2003-01-01

    To examine the compatibility of low dose rate (LDR) with high dose rate (HDR) brachytherapy, we reviewed 399 patients with early oral tongue cancer (T1-2N0M0) treated solely by brachytherapy at Osaka University Hospital between 1967 and 1999. For patients in the LDR group (n=341), the treatment sources consisted of Ir-192 pin for 227 patients (1973-1996; irradiated dose, 61-85 Gy; median, 70 Gy), Ra-226 needle for 113 patients (1967-1986; 55-93 Gy; median, 70 Gy). Ra-226 and Ir-192 were combined for one patient. Ir-192 HDR (microSelectron-HDR) was used for 58 patients in the HDR group (1991-present; 48-60 Gy; median, 60 Gy). LDR implantations were performed via oral and HDR via a submental/submandibular approach. The dose rates at the reference point for the LDR group were 0.30 to 0.8 Gy/h, and for the HDR group 1.0 to 3.4 Gy/min. The patients in the HDR group received a total dose of 48-60 Gy (8-10 fractions) during one week. Two fractions were administered per day (at least a 6-h interval). The 3- and 5-year local control rates for patients in the LDR group were 85% and 80%, respectively, and those in the HDR group were both 84%. HDR brachytherapy showed the same lymph-node control rate as did LDR brachytherapy (67% at 5 years). HDR brachytherapy achieved the same locoregional result as did LDR brachytherapy. A converting factor of 0.86 is applicable for HDR in the treatment of early oral tongue cancer. (author)

  15. High Dose-Rate Versus Low Dose-Rate Brachytherapy for Lip Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ghadjar, Pirus, E-mail: pirus.ghadjar@insel.ch [Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern (Switzerland); Bojaxhiu, Beat [Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern (Switzerland); Simcock, Mathew [Swiss Group for Clinical Cancer Research Coordinating Center, Bern (Switzerland); Terribilini, Dario; Isaak, Bernhard [Division of Medical Radiation Physics, Inselspital, Bern University Hospital, and University of Bern, Bern (Switzerland); Gut, Philipp; Wolfensberger, Patrick; Broemme, Jens O.; Geretschlaeger, Andreas; Behrensmeier, Frank; Pica, Alessia; Aebersold, Daniel M. [Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern (Switzerland)

    2012-07-15

    Purpose: To analyze the outcome after low-dose-rate (LDR) or high-dose-rate (HDR) brachytherapy for lip cancer. Methods and Materials: One hundred and three patients with newly diagnosed squamous cell carcinoma of the lip were treated between March 1985 and June 2009 either by HDR (n = 33) or LDR brachytherapy (n = 70). Sixty-eight patients received brachytherapy alone, and 35 received tumor excision followed by brachytherapy because of positive resection margins. Acute and late toxicity was assessed according to the Common Terminology Criteria for Adverse Events 3.0. Results: Median follow-up was 3.1 years (range, 0.3-23 years). Clinical and pathological variables did not differ significantly between groups. At 5 years, local recurrence-free survival, regional recurrence-free survival, and overall survival rates were 93%, 90%, and 77%. There was no significant difference for these endpoints when HDR was compared with LDR brachytherapy. Forty-two of 103 patients (41%) experienced acute Grade 2 and 57 of 103 patients (55%) experienced acute Grade 3 toxicity. Late Grade 1 toxicity was experienced by 34 of 103 patients (33%), and 5 of 103 patients (5%) experienced late Grade 2 toxicity; no Grade 3 late toxicity was observed. Acute and late toxicity rates were not significantly different between HDR and LDR brachytherapy. Conclusions: As treatment for lip cancer, HDR and LDR brachytherapy have comparable locoregional control and acute and late toxicity rates. HDR brachytherapy for lip cancer seems to be an effective treatment with acceptable toxicity.

  16. High rate 4π β-γ coincidence counting system

    International Nuclear Information System (INIS)

    Johnson, L.O.; Gehrke, R.J.

    1978-01-01

    A high count rate 4π β-γ coincidence counting system for the determination of absolute disintegration rates of short half-life radionuclides is described. With this system the dead time per pulse is minimized by not stretching any pulses beyond the width necessary to satisfy overlap coincidence requirements. The equations used to correct for the β, γ, and coincidence channel dead times and for accidental coincidences are presented but not rigorously developed. Experimental results are presented for a decaying source of 56 Mn initially at 2 x 10 6 d/s and a set of 60 Co sources of accurately known source strengths varying from 10 3 to 2 x 10 6 d/s. A check of the accidental coincidence equation for the case of two independent sources with varying source strengths is presented

  17. Miniaturized star tracker for micro spacecraft with high angular rate

    Science.gov (United States)

    Li, Jianhua; Li, Zhifeng; Niu, Zhenhong; Liu, Jiaqi

    2017-10-01

    There is a clear need for miniaturized, lightweight, accurate and inexpensive star tracker for spacecraft with large anglar rate. To face these new constraints, the Beijing Institute of Space Long March Vehicle has designed, built and flown a low cost miniaturized star tracker that provides autonomous ("Lost in Space") inertial attitude determination, 2 Hz 3-axis star tracking, and digital imaging with embedded compression. Detector with high sensitivity is adopted to meet the dynamic and miniature requirement. A Sun and Moon avoiding method based on the calculation of Sun and Moon's vector by astronomical theory is proposed. The produced prototype weight 0.84kg, and can be used for a spacecraft with 6°/s anglar rate. The average angle measure error is less than 43 arc second. The ground verification and application of the star tracker during the pick-up flight test showed that the capability of the product meet the requirement.

  18. Development of miniature γ dose rate monitor with high sensitivity

    International Nuclear Information System (INIS)

    Shi Huilu; Tuo Xianguo; Xi Dashun; Tang Rong; Mu Keliang; Yang Jianbo

    2009-01-01

    This paper introduces a miniature γ dose rate monitor with high sensitivity which design based on single chip microcomputer, it can continue monitoring γ dose rate and then choose wire or wireless communications to sent the monitoring data to host according to the actual conditions. It has two kinds of power supply system, AC power supply system and battery which can be chose by concrete circumstances. The design idea and implementation technology of hardware and software and the system structure of the monitor are detailed illustrated in this paper. The experimental results show that measurable range is 0.1 mR/h-200 mR/h, the sensitivity of γ is 90 cps/mR/h, dead time below 200 us, error of stability below ±10%. (authors)

  19. Low resistance bakelite RPC study for high rate working capability

    International Nuclear Information System (INIS)

    Dai, T.; Han, L.; Hou, S.; Liu, M.; Li, Q.; Song, H.; Xia, L.; Zhang, Z.

    2014-01-01

    This paper presents series efforts to lower resistance of bakelite electrode plate to improve the RPC capability under high rate working condition. New bakelite material with alkali metallic ion doping has been manufactured and tested. This bakelite is found unstable under large charge flux and need further investigation. A new structure of carbon-embedded bakelite RPC has been developed, which can reduce the effective resistance of electrode by a factor of 10. The prototype of the carbon-embedded chamber could function well under gamma radiation source at event rate higher than 10 kHz/cm 2 . The preliminary tests show that this kind of new structure performs as efficiently as traditional RPCs

  20. High and low dose-rate brachytherapy for cervical carcinoma

    International Nuclear Information System (INIS)

    Orton, C.G.

    1998-01-01

    For the brachytherapy component of the r[iation treatment of cervical carcinoma, high dose rate (HDR) is slowly replacing conventional low dose rate (LDR) due primarily to r[iation safety and other physical benefits attributed to the HDR modality. Many r[iation oncologists are reluctant to make this change because of perceived r[iobiological dis[vantages of HDR. However, in clinical practice HDR appears to be as effective as LDR but with a lower risk of late complications, as demonstrated by one randomized clinical trial and two comprehensive literature and practice surveys. The reason for this appears to be that the r[iobiological dis[vantages of HDR are outweighed by the physical [vantages. (orig.)

  1. High-rate, High Temperature Acetotrophic Methanogenesis Governed by a Three Population Consortium in Anaerobic Bioreactors

    OpenAIRE

    Ho, Dang; Jensen, Paul; Gutierrez-Zamora, Maria-Luisa; Beckmann, Sabrina; Manefield, Mike; Batstone, Damien

    2016-01-01

    A combination of acetate oxidation and acetoclastic methanogenesis has been previously identified to enable high-rate methanogenesis at high temperatures (55 to 65°C), but this capability had not been linked to any key organisms. This study combined RNA-stable isotope probing on 13C-labelled acetate and 16S amplicon sequencing to identify the active micro-organisms involved in high-rate methanogenesis. Active biomass was harvested from three bench-scale thermophilic bioreactors treating waste...

  2. Effectiveness of Relapse Prevention Cognitive-Behavioral Model in Opioid-Dependent Patients Participating in the Methadone Maintenance Treatment in Iran.

    Science.gov (United States)

    Pashaei, Tahereh; Shojaeizadeh, Davoud; Rahimi Foroushani, Abbas; Ghazitabatabae, Mahmoud; Moeeni, Maryam; Rajati, Fatemeh; M Razzaghi, Emran

    2013-08-01

    To evaluate the effectiveness of a relapse prevention cognitive-behavioral model, based on Marlatt treatment approach, in Opioid-dependent patients participating in the Methadone Maintenance Treatment (MMT) in Iran. The study consisted of 92 individuals treated with methadone in Iranian National Center of Addiction Studies (INCAS). Participants were randomized into two groups: educational intervention group (N=46) and control group (N=46). The intervention was comprised of 10 weekly 90 minute sessions, done during a period of 2.5 months based on the most high risk situations determined using Inventory Drug Taking Situation instrument. Relapse was defined as not showing up for MMT, drug use for at least 5 continuous days, and a positive urinary morphine test. While, only 36.4% of the intervention group relapsed into drug use, 63.6% of the control group relapsed. The result of the logistic regressions showed that the odd ratio of the variable of intervention program for the entire follow up period was 0.43 (P<0.01). Further, the odd ratio of this variable in one month, three months, and 195 days after the therapy were 0.48 (P<.03), 0.31 (P<.02), and 0.13 (P<.02) respectively that revealed that on average, the probability of relapse among individuals in the intervention group was lower than patients in control group. Relapse prevention model based on Marlatt treatment approach has an effective role in decreasing relapse rate. This model can be introduced as a complementary therapy in patients treated with methadone maintenance.

  3. Handling high data rate detectors at Diamond Light Source

    Science.gov (United States)

    Pedersen, U. K.; Rees, N.; Basham, M.; Ferner, F. J. K.

    2013-03-01

    An increasing number of area detectors, in use at Diamond Light Source, produce high rates of data. In order to capture, store and process this data High Performance Computing (HPC) systems have been implemented. This paper will present the architecture and usage for handling high rate data: detector data capture, large volume storage and parallel processing. The EPICS area Detector frame work has been adopted to abstract the detectors for common tasks including live processing, file format and storage. The chosen data format is HDF5 which provides multidimensional data storage and NeXuS compatibility. The storage system and related computing infrastructure include: a centralised Lustre based parallel file system, a dedicated network and a HPC cluster. A well defined roadmap is in place for the evolution of this to meet demand as the requirements and technology advances. For processing the science data the HPC cluster allow efficient parallel computing, on a mixture of ×86 and GPU processing units. The nature of the Lustre storage system in combination with the parallel HDF5 library allow efficient disk I/O during computation jobs. Software developments, which include utilising optimised parallel file reading for a variety of post processing techniques, are being developed in collaboration as part of the Pan-Data EU Project (www.pan-data.eu). These are particularly applicable to tomographic reconstruction and processing of non crystalline diffraction data.

  4. Precise muon drift tube detectors for high background rate conditions

    CERN Document Server

    Engl, Albert; Dünnweber, Wolfgang

    The muon spectrometer of the ATLAS-experiment at the Large H adron Collider consists of drift tube chambers, which provide the precise m easurement of trajec- tories of traversing muons. In order to determine the moment um of the muons with high precision, the measurement of the position of the m uon in a single tube has to be more accurate than σ ≤ 100 m. The large cross section of proton-proton-collisions and th e high luminosity of the accelerator cause relevant background of neutrons and γ s in the muon spectrome- ter. During the next decade a luminosity upgrade [1] to 5 10 34 cm − 2 s − 1 is planned, which will increase the background counting rates consider ably. In this context this work deals with the further development of the existing drift chamber tech- nology to provide the required accuracy of the position meas urement under high background conditions. Two approaches of improving the dri ft tube chambers are described: • In regions of moderate background rates a faster and more lin ear ...

  5. Proportional chambers and multiwire drift chambers at high rates

    International Nuclear Information System (INIS)

    Walenta, A.H.

    1977-01-01

    The high event and particle rates expected for ISABELLE intersecting storage rings raise the question whether PWC's and drift chambers, now widely in use in experiments, still can operate under such conditions. Various effects depend on the number of avalanches produced per length of wire N and the size of the avalanche Q, i.e., on the number of positive ions created in an avalanche. Therefore the important parameter for the following discussion is the product QN. The minimum Q is determined by the type and noise level of preamplifiers used. Examples are given for a typical low noise amplifier as well as for a typical integrated ''cheap'' amplifier. The rate/wire length N depends on the chamber arrangement, wire spacing, etc. In multiwire drift chambers, a single wire shows space-charge effects reducing the pulse height by 1% at a rate of N = 7 x 10 3 mm -1 sec -1 . At a rate of N approximately equal to 10 5 mm -1 sec -1 an efficiency loss of the order of 1% was noticed. The aging effect due to deposits on the anode wire can be reduced using low noise amplifiers and low gas gain to such an extent that a lifetime of about half a year at ISABELLE can be expected. The use of conventional cheap preamplifiers will result in a typical lifetime of about 30 days. Improvements are probable. The time resolution of Δt/sub r/ = 4 nsec fwhm seems adequate for event rates of 10 7 sec -1 . The memory time Δt/sub m/ greater than or equal to 100 nsec may cause serious problems for pattern recognition depending on layout and readout. The use of induced signals on cathode pads, thus reading out shorter parts of the wire, can solve the problem

  6. Experimental investigation of bond strength under high loading rates

    Directory of Open Access Journals (Sweden)

    Michal Mathias

    2015-01-01

    Full Text Available The structural behaviour of reinforced concrete is governed significantly by the transmission of forces between steel and concrete. The bond is of special importance for the overlapping joint and anchoring of the reinforcement, where rigid bond is required. It also plays an important role in the rotational capacity of plastic hinges, where a ductile bond behaviour is preferable. Similar to the mechanical properties of concrete and steel also the characteristics of their interaction changes with the velocity of the applied loading. For smooth steel bars with its main bond mechanisms of adhesion and friction, nearly no influence of loading rate is reported in literature. In contrast, a high rate dependence can be found for the nowadays mainly used deformed bars. For mechanical interlock, where ribs of the reinforcing steel are bracing concrete material surrounding the bar, one reason can be assumed to be in direct connection with the increase of concrete compressive strength. For splitting failure of bond, characterized by the concrete tensile strength, an even higher dynamic increase is observed. For the design of Structures exposed to blast or impact loading the knowledge of a rate dependent bond stress-slip relationship is required to consider safety and economical aspects at the same time. The bond behaviour of reinforced concrete has been investigated with different experimental methods at the University of the Bundeswehr Munich (UniBw and the Joint Research Centre (JRC in Ispra. Both static and dynamic tests have been carried out, where innovative experimental apparatuses have been used. The bond stress-slip relationship and maximum pull-out-forces for varying diameter of the bar, concrete compressive strength and loading rates have been obtained. It is expected that these experimental results will contribute to a better understanding of the rate dependent bond behaviour and will serve for calibration of numerical models.

  7. The second therapeutic trial for children with hematological malignancies who relapsed after their first allogeneic SCT: long-term outcomes.

    Science.gov (United States)

    Nishikawa, Takuro; Inagaki, Jiro; Nagatoshi, Yoshihisa; Fukano, Reiji; Nakashima, Kentaro; Ito, Nobuhiro; Sawa, Daisuke; Kawano, Yoshifumi; Okamura, Jun

    2012-11-01

    The impact of a second all-SCT on the long-term outcomes of children who relapse after allo-SCT has been unclear. We retrospectively analyzed the long-term outcomes of different salvage treatments for such children. Sixty-six children with hematological malignancies (40 ALL, 22 AML, three MDS, and one CML) who relapsed after a first allo-SCT received either a second allo-SCT (n = 16) or CTx and/or DLI (n = 50). The median follow-up for all children was 9.1 yr. The five-yr OS after relapse was significantly better in patients who underwent a second allo-SCT (42.9%) than in patients treated with CTx and/or DLI (11.8%) (p SCT, two died more than five yr after the second allo-SCT. A second allo-SCT can therefore lead to a prolonged OS in patients who relapse after allo-SCT. However, a second allo-SCT should be selected carefully. This is because the mortality rate is still high, even when there is an extensive duration of time following the second allo-SCT. © 2012 John Wiley & Sons A/S.

  8. Association of peripheral inflammation with body mass index and depressive relapse in bipolar disorder.

    Science.gov (United States)

    Bond, David J; Andreazza, Ana C; Hughes, John; Dhanoa, Taj; Torres, Ivan J; Kozicky, Jan-Marie; Young, L Trevor; Lam, Raymond W; Yatham, Lakshmi N

    2016-03-01

    Bipolar I disorder (BD) is associated with increased inflammation, which is believed to be central to disease etiology and progression. However, BD patients also have high rates of obesity, itself an inflammatory condition, and the relative contributions of mood illness and obesity to inflammation are unknown. Moreover, the impact of inflammation on clinical illness course has not been well studied. The objectives of this analysis were therefore: (1) to determine if inflammation in BD is mood illness-related or secondary to elevated body mass index (BMI), and (2) to investigate the impact of inflammation on prospectively-ascertained relapse into depression and mania. We measured the serum levels of 7 inflammatory cytokines (TNF-α, γ-interferon, monocyte chemoattractant protein-1 [MCP-1], IL-1α, IL-2, IL-6, and IL-8) and 2 anti-inflammatory cytokines (IL-4 and IL-10) in 52 early-stage BD patients and 22 healthy subjects. In patients, a multivariate multiple regression model that controlled for psychotropic medications found that higher BMI, but not recent (past-6-month) mood episodes, predicted greater inflammatory cytokines (p=.05). Healthy subjects also had a BMI-related increase in inflammatory cytokines (pdepressive relapse in the 12 months after cytokine measurement: IL-1α (pdepressive relapse. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Accuracy assessment of high-rate GPS measurements for seismology

    Science.gov (United States)

    Elosegui, P.; Davis, J. L.; Ekström, G.

    2007-12-01

    Analysis of GPS measurements with a controlled laboratory system, built to simulate the ground motions caused by tectonic earthquakes and other transient geophysical signals such as glacial earthquakes, enables us to assess the technique of high-rate GPS. The root-mean-square (rms) position error of this system when undergoing realistic simulated seismic motions is 0.05~mm, with maximum position errors of 0.1~mm, thus providing "ground truth" GPS displacements. We have acquired an extensive set of high-rate GPS measurements while inducing seismic motions on a GPS antenna mounted on this system with a temporal spectrum similar to real seismic events. We found that, for a particular 15-min-long test event, the rms error of the 1-Hz GPS position estimates was 2.5~mm, with maximum position errors of 10~mm, and the error spectrum of the GPS estimates was approximately flicker noise. These results may however represent a best-case scenario since they were obtained over a short (~10~m) baseline, thereby greatly mitigating baseline-dependent errors, and when the number and distribution of satellites on the sky was good. For example, we have determined that the rms error can increase by a factor of 2--3 as the GPS constellation changes throughout the day, with an average value of 3.5~mm for eight identical, hourly-spaced, consecutive test events. The rms error also increases with increasing baseline, as one would expect, with an average rms error for a ~1400~km baseline of 9~mm. We will present an assessment of the accuracy of high-rate GPS based on these measurements, discuss the implications of this study for seismology, and describe new applications in glaciology.

  10. Australian high-dose-rate brachytherapy protocols for gynaecological malignancy

    International Nuclear Information System (INIS)

    MacLeod, C.; Dally, M.; Stevens, M.; Thornton, D.; Carruthers, S.; Jeal, P.

    2001-01-01

    There is no consensus over the optimal dose fractionation schedules for high-dose-rate (HDR) brachytherapy used for gynaecological malignancy. In Australian public hospital departments of radiation oncology, HDR brachytherapy for gynaecological cancer is being more commonly used. A survey of public departments that are using this technology, or that plan to introduce this technology, was performed. Their current protocols are presented. In general, protocols are similar biologically; however, the practical aspects such as the number of fractions given do vary and may reflect resource restrictions or, alternatively, differences in interpretations of the literature and of the best protocols by clinicians. Copyright (2001) Blackwell Science Pty Ltd

  11. Development of ultra high speed photographic system using high repetition rate visible laser

    International Nuclear Information System (INIS)

    Lee, Jong Min; Cha, Byung Hun; Kim, Sung Ho; Kim, Jung Bog; Lim, Chang Hwan; Cha, Hyung Ki; Song, Kyu Seok; Lee, Byung Deok; Rhi, Jong Hoon; Baik, Dae Hyun; Han, Jae Min; Rho, Si Pyo; Lee, Byung Cheol; Jeong, Do Yung; Choi, An Seong; Jeong, Chan Ik; Park, Dae Ung; Jeong, Sung Min; Lee, Sang Kil; Kim, Heon Jun; Jang, Rae gak; Jo, Do Hun; Park, Min Young

    1992-12-01

    The goal of this project is to develop and commercialize a high speed photographic system equipped with a high repetition rate visible laser. The developed system provides the characteristics of high time resolution and large number of frames. The system consists of 10 W air cooled CVL or a 30 W water cooled CVL, a rotating drum-type high speed camera with the framing rate of 35,000 fps, and a automatic control device. The system has the performance of 10 nsec time resolution, 35,000 fps framing rate, and 250 picture frames. The high speed photographic systems are widely applied to the fields such as high-efficient engine development, high-speed vibration analysis, shock wave propagation study, flow visualization analysis, weapon development, etc. (Author)

  12. High dose rate versus low dose rate interstitial radiotherapy for carcinoma of the floor of mouth

    International Nuclear Information System (INIS)

    Inoue, Takehiro; Inoue, Toshihiko; Yamazaki, Hideya; Koizumi, Masahiko; Kagawa, Kazufumi; Yoshida, Ken; Shiomi, Hiroya; Imai, Atsushi; Shimizutani, Kimishige; Tanaka, Eichii; Nose, Takayuki; Teshima, Teruki; Furukawa, Souhei; Fuchihata, Hajime

    1998-01-01

    Purpose: Patients with cancer of the floor of mouth are treated with radiation because of functional and cosmetic reasons. We evaluate the treatment results of high dose rate (HDR) and low dose rate (LDR) interstitial radiation for cancer of the floor of mouth. Methods and Materials: From January 1980 through March 1996, 41 patients with cancer of the floor of mouth were treated with LDR interstitial radiation using 198 Au grains, and from April 1992 through March 1996 16 patients with HDR interstitial radiation. There were 26 T1 tumors, 30 T2 tumors, and 1 T3 tumor. For 21 patients treated with interstitial radiation alone, a total radiation dose of interstitial therapy was 60 Gy/10 fractions/6-7 days in HDR and 85 Gy within 1 week in LDR. For 36 patients treated with a combination therapy, a total dose of 30 to 40 Gy of external radiation and a total dose of 48 Gy/8 fractions/5-6 days in HDR or 65 Gy within 1 week in LDR were delivered. Results: Two- and 5-year local control rates of patients treated with HDR interstitial radiation were 94% and 94%, and those with LDR were 75% and 69%, respectively. Local control rate of patients treated with HDR brachytherapy was slightly higher than that with 198 Au grains (p = 0.113). For late complication, bone exposure or ulcer occurred in 6 of 16 (38%) patients treated with HDR and 13 of 41 (32%) patients treated with LDR. Conclusion: HDR fractionated interstitial brachytherapy can be an alternative to LDR brachytherapy for cancer of the floor of mouth and eliminate radiation exposure for the medical staff

  13. Melarsoprol sensitivity profile of Trypanosoma brucei gambiense isolates from cured and relapsed sleeping sickness patients from the Democratic Republic of the Congo.

    Directory of Open Access Journals (Sweden)

    Patient Pyana Pati

    2014-10-01

    Full Text Available Sleeping sickness caused by Trypanosoma brucei (T.b. gambiense constitutes a serious health problem in sub-Sahara Africa. In some foci, alarmingly high relapse rates were observed in patients treated with melarsoprol, which used to be the first line treatment for patients in the neurological disease stage. Particularly problematic was the situation in Mbuji-Mayi, East Kasai Province in the Democratic Republic of the Congo with a 57% relapse rate compared to a 5% relapse rate in Masi-Manimba, Bandundu Province. The present study aimed at investigating the mechanisms underlying the high relapse rate in Mbuji-Mayi using an extended collection of recently isolated T.b. gambiense strains from Mbuji-Mayi and from Masi-Manimba.Forty five T.b. gambiense strains were used. Forty one were isolated from patients that were cured or relapsed after melarsoprol treatment in Mbuji-Mayi. In vivo drug sensitivity tests provide evidence of reduced melarsoprol sensitivity in these strains. This reduced melarsoprol sensitivity was not attributable to mutations in TbAT1. However, in all these strains, irrespective of the patient treatment outcome, the two aquaglyceroporin (AQP 2 and 3 genes are replaced by chimeric AQP2/3 genes that may be associated with resistance to pentamidine and melarsoprol. The 4 T.b. gambiense strains isolated in Masi-Manimba contain both wild-type AQP2 and a different chimeric AQP2/3. These findings suggest that the reduced in vivo melarsoprol sensitivity of the Mbuji-Mayi strains and the high relapse rates in that sleeping sickness focus are caused by mutations in the AQP2/AQP3 locus and not by mutations in TbAT1.We conclude that mutations in the TbAQP2/3 locus of the local T.b. gambiense strains may explain the high melarsoprol relapse rates in the Mbuji-Mayi focus but other factors must also be involved in the treatment outcome of individual patients.

  14. Automated Production of High Rep Rate Foam Targets

    Science.gov (United States)

    Hall, F.; Spindloe, C.; Haddock, D.; Tolley, M.; Nazarov, W.

    2016-04-01

    Manufacturing low density targets in the numbers needed for high rep rate experiments is highly challenging. This report summarises advances from manual production to semiautomated and the improvements that follow both in terms of production time and target uniformity. The production process is described and shown to be improved by the integration of an xyz robot with dispensing capabilities. Results are obtained from manual and semiautomated production runs and compared. The variance in the foam thickness is reduced significantly which should decrease experimental variation due to target parameters and could allow for whole batches to be characterised by the measurement of a few samples. The work applies to both foil backed and free standing foam targets.

  15. New Approach to reduce High School Dropout Rates

    Directory of Open Access Journals (Sweden)

    Mauricio Cristhian Portillo-Torres

    2015-05-01

    Full Text Available From 2006 to 2014, the Ministry of Public Education of Costa Rica implemented four strategic actions to reduce high school dropout rates. The main purpose of these actions was to promote student participation and student identification with their school. Studies prepared by the Ministry of Education and the Comptroller of the Republic were revised to assess the impact of these actions. The result of these actions does not show an actual decrease in the number of students who leave high school. Therefore, a more holistic view is necessary to ensure the students’ stay. This review suggests using use the concept of student engagement and applying a three tier system-wide dropout preventive actions: universal, targeted and intensive.

  16. High repetition rate driver circuit for modulation of injection lasers

    International Nuclear Information System (INIS)

    Dornan, B.R.; Goel, J.; Wolkstein, H.J.

    1981-01-01

    An injection laser modulator comprises a self-biased field effect transistor (FET) and an injection laser to provide a quiescent state during which lasing of the injection laser occurs in response to a high repetition rate signal of pulse coded modulation (pcm). The modulator is d.c. coupled to an input pulse source of pcm rendering it compatible with an input pulse referenced to ground and not being subject to voltage level shifting of the input pulse. The modulator circuit in its preferred and alternate embodiments provides various arrangements for high impedance input and low impedance output matching. In addition, means are provided for adjusting the bias of the FET as well as the bias of the injection laser

  17. High-rate lithium thionyl-chloride battery development

    Energy Technology Data Exchange (ETDEWEB)

    Cieslak, W.R.; Weigand, D.E.

    1993-12-31

    We have developed a lithium thionyl-chloride cell for use in a high rate battery application to provide power for a missile computer and stage separation detonators. The battery pack contains 20 high surface area ``DD`` cells wired in a series-parallel configuration to supply a nominal 28 volts with a continuous draw of 20 amperes. The load profile also requires six squib firing pulses of one second duration at a 20 ampere peak. Performance and safety of the cells were optimized in a ``D`` cell configuration before progressing to the longer ``DD` cell. Active surface area in the ``D`` cell is 735 cm{sup 2}, and 1650 cm{sup 2} in the ``DD`` cell. The design includes 1.5M LiAlCl{sub 4}/SOCl{sub 2} electrolyte, a cathode blend of Shawinigan Acetylene Black and Cabot Black Pearls 2000 carbons, Scimat ETFE separator, and photoetched current collectors.

  18. On the response of rubbers at high strain rates.

    Energy Technology Data Exchange (ETDEWEB)

    Niemczura, Johnathan Greenberg (University of Texas-Austin)

    2010-02-01

    In this report, we examine the propagation of tensile waves of finite deformation in rubbers through experiments and analysis. Attention is focused on the propagation of one-dimensional dispersive and shock waves in strips of latex and nitrile rubber. Tensile wave propagation experiments were conducted at high strain-rates by holding one end fixed and displacing the other end at a constant velocity. A high-speed video camera was used to monitor the motion and to determine the evolution of strain and particle velocity in the rubber strips. Analysis of the response through the theory of finite waves and quantitative matching between the experimental observations and analytical predictions was used to determine an appropriate instantaneous elastic response for the rubbers. This analysis also yields the tensile shock adiabat for rubber. Dispersive waves as well as shock waves are also observed in free-retraction experiments; these are used to quantify hysteretic effects in rubber.

  19. High rate capability of lithium/silver vanadium oxide cells

    International Nuclear Information System (INIS)

    Takeuchi, E.S.; Zelinsky, M.A.; Keister, P.

    1986-01-01

    High rate characteristics of the lithium/silver vanadium oxide system were investigated in test cells providing four different limiting surface areas. The cells were tested by constant current and constant resistance discharge with current densities ranging from 0.04 to 6.4 mA/cm/sup 2/. The maximum current density under constant resistance and constant current discharges which would deliver 50% of theoretical capacity was determined. The ability of the cells to deliver high current pulses was evaluated by application of 10 second pulses with current densities ranging from 3 to 30 mA/cm/sup 2/. The voltage delay characteristics of the cells were determined after 1 to 3 months of storage at open circuit voltage or under low level background currents. The volumetric and gravimetric energy density of the SVO system is compared to other cathode materials

  20. Low power ion spectrometer for high counting rates

    International Nuclear Information System (INIS)

    Klein, J.W.; Dullenkopf, P.; Glasmachers, A.; Melbert, J.; Winkelnkemper, W.

    1980-01-01

    This report describes in detail the electronic concept for a time-of-flight (TOF) ion spectrometer for high counting rates and high dynamic range which can be used as a satellite instrument. The detection principle of the spectrometer is based on a time-of-flight and energy measurement for each incident ion. The ionmass is related to these two quantities by a simple equation. The described approach for the mass identification systems is using an analog fast-slow concept: The fast TOF-signal preselects the gainstep in the much slower energy channel. The conversion time of the mass identifier is approximately 10 -6 s and the dynamic range of the energy channel is better than 10 3 (20 keV to 25 MeV). The purpose of this study was to demonstrate the feasibility of a TOF-spectrometer capable to measure the ion composition in planetary magnetospheres. (orig.) [de

  1. Radiation Parameters of High Dose Rate Iridium -192 Sources

    Science.gov (United States)

    Podgorsak, Matthew B.

    A lack of physical data for high dose rate (HDR) Ir-192 sources has necessitated the use of basic radiation parameters measured with low dose rate (LDR) Ir-192 seeds and ribbons in HDR dosimetry calculations. A rigorous examination of the radiation parameters of several HDR Ir-192 sources has shown that this extension of physical data from LDR to HDR Ir-192 may be inaccurate. Uncertainty in any of the basic radiation parameters used in dosimetry calculations compromises the accuracy of the calculated dose distribution and the subsequent dose delivery. Dose errors of up to 0.3%, 6%, and 2% can result from the use of currently accepted values for the half-life, exposure rate constant, and dose buildup effect, respectively. Since an accuracy of 5% in the delivered dose is essential to prevent severe complications or tumor regrowth, the use of basic physical constants with uncertainties approaching 6% is unacceptable. A systematic evaluation of the pertinent radiation parameters contributes to a reduction in the overall uncertainty in HDR Ir-192 dose delivery. Moreover, the results of the studies described in this thesis contribute significantly to the establishment of standardized numerical values to be used in HDR Ir-192 dosimetry calculations.

  2. High-rep-rate Thomson scattering for LHD

    Science.gov (United States)

    den Hartog, D. J.; Borchardt, M. T.; Holly, D. J.; Schmitz, O.; Yasuhara, R.; Yamada, I.; Funaba, H.; Osakabe, M.; Morisaki, T.

    2017-10-01

    A high-rep-rate pulse-burst laser system is being built for the LHD Thomson scattering (TS) diagnostic. This laser will have two operating scenarios, a fast-burst sequence of 15 kHz rep rate for at least 15 ms, and a slow-burst sequence of 1 kHz for at least 50 ms. There will be substantial flexibility in burst sequences for tailoring to experimental requirements. This new laser system will operate alongside the existing lasers in the LHD TS diagnostic, and will use the same beamline. This increase in temporal resolution capability complements the high spatial resolution (144 points) of the LHD TS diagnostic, providing unique measurement capability unmatched on any other fusion experiment. The new pulse-burst laser is a straightforward application of technology developed at UW-Madison, consisting of a Nd:YAG laser head with modular flashlamp drive units and a customized control system. Variable pulse-width drive of the flashlamps is accomplished by IGBT (insulated gate bipolar transistor) switching of electrolytic capacitor banks. Direct control of the laser Pockels cell drive enables optimal pulse energy extraction, producing >1.5 J q-switched pulses with 20 ns FWHM. Burst operation of this laser system will be used to capture fast time evolution of the electron temperature and density profiles during events such as ELMs, RMP perturbations, and various MHD modes. This work is supported by the U. S. Department of Energy and the National Institute for Fusion Science (Japan).

  3. Radiation safety program in a high dose rate brachytherapy facility

    International Nuclear Information System (INIS)

    Rodriguez, L.V.; Hermoso, T.M.; Solis, R.C.

    2001-01-01

    The use of remote afterloading equipment has been developed to improve radiation safety in the delivery of treatment in brachytherapy. Several accidents, however, have been reported involving high dose-rate brachytherapy system. These events, together with the desire to address the concerns of radiation workers, and the anticipated adoption of the International Basic Safety Standards for Protection Against Ionizing Radiation (IAEA, 1996), led to the development of the radiation safety program at the Department of Radiotherapy, Jose R. Reyes Memorial Medical Center and at the Division of Radiation Oncology, St. Luke's Medical Center. The radiation safety program covers five major aspects: quality control/quality assurance, radiation monitoring, preventive maintenance, administrative measures and quality audit. Measures for evaluation of effectiveness of the program include decreased unnecessary exposures of patients and staff, improved accuracy in treatment delivery and increased department efficiency due to the development of staff vigilance and decreased anxiety. The success in the implementation required the participation and cooperation of all the personnel involved in the procedures and strong management support. This paper will discuss the radiation safety program for a high dose rate brachytherapy facility developed at these two institutes which may serve as a guideline for other hospitals intending to install a similar facility. (author)

  4. Portable radiation meters evaluation in high rates of air kerma

    International Nuclear Information System (INIS)

    Damatto, Willian B.; Potiens, Maria da Penha A.; Vivolo, Vitor

    2015-01-01

    A set of portable meters of ionizing radiation high rates of air kerma (teletectors) commonly used in emergencies in Brazil and sent to the Calibration Laboratory of IPEN were under several tests and analyst is parameters for the detectors behavior were established, specifying their sensitivities and operating characteristics. Applied tests were: reading equipment variation with battery voltage, geotropism effect, energy dependence, the angular dependence and overload. Thus it was possible to determine the most common characteristic found in these equipment (quality control programs). The behavior of 17 portable meters was analyzed and in this study, 10 of them have been tested. It was performed to characterize the gamma irradiating system (radiation dosimetry field) that possesses higher activity in teletectors for testing of larger measuring range. New calibration criteria were established following international recommendations. Therefore, it was made the improvement of the quality control programme of portable meters of ionizing radiation high rates of air kerma calibration laboratory, benefiting the users of such equipment with better consistent calibration measurements. (author)

  5. Audits in high dose rate brachytherapy in Brazil

    International Nuclear Information System (INIS)

    Marechal, M.H.; Rosa, L.A.; Velasco, A.; Paiva, E. de; Goncalves, M.; Castelo, L.C.

    2002-01-01

    The lack of well established dosimetry protocols for HDR sources is a point of great concern regarding the uniformity of procedures within a particular country. The main objective of this paper is to report the results of an implementation of the audit program in dosimetry of high dose rate brachytherapy sources used by the radiation therapy centers in Brazil. In Brazil, among 169 radiotherapy centers, 35 have HDR brachytherapy systems. This program started in August 2001 and until now eight radiotherapy services were audited. The audit program consists of the visit in loco to each center and the evaluation of the intensity of the source with a well type chamber specially design for HDR 192 Ir sources. The measurements was carried out with a HDR1000PLUS Brachytherapy Well Type Chamber and a MAX 4000 Electrometer, both manufactured by Standard Imaging Inc. The chamber was calibrated in air kerma strength by the Accredited Dosimetry Calibration Laboratory, Department of Medical Physics, University of Wisconsin in the USA. The same chamber was calibrated in Brazil using a 192 lr high dose rate source whose intensity was determined by 60 Co gamma rays and 250 kV x rays interpolation methodology. The Nk of 60 Co and 250 kV x rays were provided by the Brazilian National Standard Laboratory for Ionizing Radiation (LMNRI)

  6. High-temperature rate constant measurements for OH+xylenes

    KAUST Repository

    Elwardani, Ahmed Elsaid

    2015-06-01

    The overall rate constants for the reactions of hydroxyl (OH) radicals with o-xylene (k 1), m-xylene (k 2), and p-xylene (k 3) were measured behind reflected shock waves over 890-1406K at pressures of 1.3-1.8atm using OH laser absorption near 306.7nm. Measurements were performed under pseudo-first-order conditions. The measured rate constants, inferred using a mechanism-fitting approach, can be expressed in Arrhenius form as:k1=2.93×1013exp(-1350.3/T)cm3mol-1s-1(890-1406K)k2=3.49×1013exp(-1449.3/T)cm3mol-1s-1(906-1391K)k3=3.5×1013exp(-1407.5/T)cm3mol-1s-1(908-1383K)This paper presents, to our knowledge, first high-temperature measurements of the rate constants of the reactions of xylene isomers with OH radicals. Low-temperature rate-constant measurements by Nicovich et al. (1981) were combined with the measurements in this study to obtain the following Arrhenius expressions, which are applicable over a wider temperature range:k1=2.64×1013exp(-1181.5/T)cm3mol-1s-1(508-1406K)k2=3.05×109exp(-400/T)cm3mol-1s-1(508-1391K)k3=3.0×109exp(-440/T)cm3mol-1s-1(526-1383K) © 2015 The Combustion Institute.

  7. Jab1/Csn5-Thioredoxin Signaling in Relapsed Acute Monocytic Leukemia under Oxidative Stress.

    Science.gov (United States)

    Zhou, Fuling; Pan, Yunbao; Wei, Yongchang; Zhang, Ronghua; Bai, Gaigai; Shen, Qiuju; Meng, Shan; Le, Xiao-Feng; Andreeff, Michael; Claret, Francois X

    2017-08-01

    Purpose: High levels of ROS and ineffective antioxidant systems contribute to oxidative stress, which affects the function of hematopoietic cells in acute myeloid leukemia (AML); however, the mechanisms by which ROS lead to malignant transformation in relapsed AML-M5 are not completely understood. We hypothesized that alterations in intracellular ROS would trigger AML-M5 relapse by activating the intrinsic pathway. Experimental Design: We studied ROS levels and conducted c-Jun activation domain-binding protein-1 ( JAB1/COPS5 ) and thioredoxin ( TRX ) gene expression analyses with blood samples obtained from 60 matched AML-M5 patients at diagnosis and relapse and conducted mechanism studies of Jab1's regulation of Trx in leukemia cell lines. Results: Our data showed that increased production of ROS and a low capacity of antioxidant enzymes were characteristics of AML-M5, both at diagnosis and at relapse. Consistently, increased gene expression levels of TRX and JAB1/COPS5 were associated with low overall survival rates in patients with AML-M5. In addition, stimulating AML-M5 cells with low concentrations of hydrogen peroxide led to increased Jab1 and Trx expression. Consistently, transfection of ectopic Jab1 into leukemia cells increased Trx expression, whereas silencing of Jab1 in leukemia cells reduced Trx expression. Mechanistically, Jab1 interacted with Trx and stabilized Trx protein. Moreover, Jab1 transcriptionally regulated Trx. Furthermore, depletion of Jab1 inhibited leukemia cell growth both in vitro and in vivo Conclusions: We identified a novel Jab1-Trx axis that is a key cellular process in the pathobiologic characteristics of AML-M5. Targeting the ROS/Jab1/Trx pathway could be beneficial in the treatment of AML-M5. Clin Cancer Res; 23(15); 4450-61. ©2017 AACR . ©2017 American Association for Cancer Research.

  8. Prescription procedures in medication for relapse prevention after inpatient treatment for alcohol use disorders in Switzerland.

    Science.gov (United States)

    Buri, Caroline; Moggi, Franz; Giovanoli, Anna; Strik, Werner

    2007-01-01

    In randomized controlled trials with high internal validity, pharmacotherapy using acamprosate, naltrexone, and, to a somewhat lesser extent, disulfiram has proved effective in preventing relapse in patients with alcohol use disorders (AUD). There remains, however, a paucity of studies with sufficient external validity in which the effectiveness of pharmacotherapy in clinical practice is investigated. This study aimed to make a contribution to close this gap in research. In this naturalistic, prospective study, a comparison on indices of substance use, psychiatric symptoms, and treatment service utilization was carried out using samples of 92 patients who received pharmacotherapy and 323 patients who did not receive pharmacotherapy following discharge from 12 residential AUD programmes (index stay). Patients that received pharmacotherapy were more likely to use alcohol during the index stay and at the 1-year follow-up. Moreover, this patient group more readily utilized treatment services during a 2-year period prior to and a 1-year period following index stay than patients who were not given pharmacotherapy. Nevertheless, when pharmacotherapy was prescribed before first post-treatment alcohol use, it was associated with delay of alcohol use, fewer relapses, and a reduced need for inpatient treatment. In many cases, however, medication was not prescribed until alcohol use and relapse had occurred. The length of time to first alcohol use was longer, and the cumulative abstinence rate higher, for disulfiram than for acamprosate, the latter being generally prescribed for more severely alcohol-dependent patients. There is a need for further studies to probe the reasons why medication for relapse prevention is not prescribed upon discharge from residential treatment and for less severely alcohol-dependent patients.

  9. A high repetition rate XUV seeding source for FLASH2

    International Nuclear Information System (INIS)

    Willner, Arik

    2012-05-01

    Improved performance of free-electron laser (FEL) light sources in terms of timing stability, pulse shape and spectral properties of the amplified FEL pulses is of interest in material science, the fields of ultrafast dynamics, biology, chemistry and even special branches in industry. A promising scheme for such an improvement is direct seeding with high harmonic generation (HHG) in a noble gas target. A free-electron laser seeded by an external extreme ultraviolet (XUV) source is planned for FLASH2 at DESY in Hamburg. The requirements for the XUV/soft X-ray source can be summarized as follows: A repetition rate of at least 100 kHz in a 10 Hz burst is needed at variable wavelengths from 10 to 40 nm and pulse energies of several nJ within a single laser harmonic. This application requires a laser amplifier system with exceptional parameters, mJ-level pulse energy, 10-15 fs pulse duration at 100 kHz (1 MHz) burst repetition rate. A new optical parametric chirped-pulse amplification (OPCPA) system is under development in order to meet these requirements, and very promising results have been achieved in the last three years. In parallel to this development, a new HHG concept is necessary to sustain high average power of the driving laser system and to generate harmonics with high conversion efficiencies. Currently, the highest conversion efficiency with HHG has been demonstrated using gas-filled capillary targets. For our application, only a free-jet target can be used for HHG, in order to overcome damage threshold limitations of HHG target optics at a high repetition rate. A novel dual-gas multijet gas target has been developed and first experiments show remarkable control of the degree of phase matching forming the basis for improved control of the harmonic photon flux and the XUV pulse characteristics. The basic idea behind the dual-gas concept is the insertion of matching zones in between multiple HHG sources. These matching sections are filled with hydrogen which

  10. A high repetition rate XUV seeding source for FLASH2

    Energy Technology Data Exchange (ETDEWEB)

    Willner, Arik

    2012-05-15

    Improved performance of free-electron laser (FEL) light sources in terms of timing stability, pulse shape and spectral properties of the amplified FEL pulses is of interest in material science, the fields of ultrafast dynamics, biology, chemistry and even special branches in industry. A promising scheme for such an improvement is direct seeding with high harmonic generation (HHG) in a noble gas target. A free-electron laser seeded by an external extreme ultraviolet (XUV) source is planned for FLASH2 at DESY in Hamburg. The requirements for the XUV/soft X-ray source can be summarized as follows: A repetition rate of at least 100 kHz in a 10 Hz burst is needed at variable wavelengths from 10 to 40 nm and pulse energies of several nJ within a single laser harmonic. This application requires a laser amplifier system with exceptional parameters, mJ-level pulse energy, 10-15 fs pulse duration at 100 kHz (1 MHz) burst repetition rate. A new optical parametric chirped-pulse amplification (OPCPA) system is under development in order to meet these requirements, and very promising results have been achieved in the last three years. In parallel to this development, a new HHG concept is necessary to sustain high average power of the driving laser system and to generate harmonics with high conversion efficiencies. Currently, the highest conversion efficiency with HHG has been demonstrated using gas-filled capillary targets. For our application, only a free-jet target can be used for HHG, in order to overcome damage threshold limitations of HHG target optics at a high repetition rate. A novel dual-gas multijet gas target has been developed and first experiments show remarkable control of the degree of phase matching forming the basis for improved control of the harmonic photon flux and the XUV pulse characteristics. The basic idea behind the dual-gas concept is the insertion of matching zones in between multiple HHG sources. These matching sections are filled with hydrogen which

  11. High rate response of ultra-high-performance fiber-reinforced concretes under direct tension

    Energy Technology Data Exchange (ETDEWEB)

    Tran, Ngoc Thanh [Department of Civil and Environmental Engineering, Sejong University, 98 Gunja-Dong, Gwangjin-Gu, Seoul 143-747 (Korea, Republic of); Tran, Tuan Kiet [Department of Civil and Environmental Engineering, Sejong University, 98 Gunja-Dong, Gwangjin-Gu, Seoul 143-747 (Korea, Republic of); Department of Civil Engineering and Applied Mechanics, Ho Chi Minh City University of Technology and Education, 01 Vo Van Ngan, Thu Duc District, Ho Chi Minh City (Viet Nam); Kim, Dong Joo, E-mail: djkim75@sejong.ac.kr [Department of Civil and Environmental Engineering, Sejong University, 98 Gunja-Dong, Gwangjin-Gu, Seoul 143-747 (Korea, Republic of)

    2015-03-15

    The tensile response of ultra-high-performance fiber-reinforced concretes (UHPFRCs) at high strain rates (5–24 s{sup −} {sup 1}) was investigated. Three types of steel fibers, including twisted, long and short smooth steel fibers, were added by 1.5% volume content in an ultra high performance concrete (UHPC) with a compressive strength of 180 MPa. Two different cross sections, 25 × 25 and 25 × 50 mm{sup 2}, of tensile specimens were used to investigate the effect of the cross section area on the measured tensile response of UHPFRCs. Although all the three fibers generated strain hardening behavior even at high strain rates, long smooth fibers produced the highest tensile resistance at high rates whereas twisted fiber did at static rate. The breakages of twisted fibers were observed from the specimens tested at high strain rates unlike smooth steel fibers. The tensile behavior of UHPFRCs at high strain rates was clearly influenced by the specimen size, especially in post-cracking strength.

  12. High Data Rate Satellite Communications for Environmental Remote Sensing

    Science.gov (United States)

    Jackson, J. M.; Munger, J.; Emch, P. G.; Sen, B.; Gu, D.

    2014-12-01

    Satellite to ground communication bandwidth limitations place constraints on current earth remote sensing instruments which limit the spatial and spectral resolution of data transmitted to the ground for processing. Instruments such as VIIRS, CrIS and OMPS on the Soumi-NPP spacecraft must aggregate data both spatially and spectrally in order to fit inside current data rate constraints limiting the optimal use of the as-built sensors. Future planned missions such as HyspIRI, SLI, PACE, and NISAR will have to trade spatial and spectral resolution if increased communication band width is not made available. A number of high-impact, environmental remote sensing disciplines such as hurricane observation, mega-city air quality, wild fire detection and monitoring, and monitoring of coastal oceans would benefit dramatically from enabling the downlinking of sensor data at higher spatial and spectral resolutions. The enabling technologies of multi-Gbps Ka-Band communication, flexible high speed on-board processing, and multi-Terabit SSRs are currently available with high technological maturity enabling high data volume mission requirements to be met with minimal mission constraints while utilizing a limited set of ground sites from NASA's Near Earth Network (NEN) or TDRSS. These enabling technologies will be described in detail with emphasis on benefits to future remote sensing missions currently under consideration by government agencies.

  13. High fall incidence and fracture rate in elderly dialysis patients.

    Science.gov (United States)

    Polinder-Bos, H A; Emmelot-Vonk, M H; Gansevoort, R T; Diepenbroek, A; Gaillard, C A J M

    2014-12-01

    Although it is recognised that the dialysis population is ageing rapidly, geriatric complications such as falls are poorly appreciated, despite the many risk factors for falls in this population. The objective of this study was to determine the incidence, complications and risk factors for falls in an elderly dialysis population. A one-year observational study of chronic dialysis patients aged ≥ 70 years. At baseline, patient characteristics were noted and during follow-up the vital parameters and laboratory values were recorded. Patients were questioned weekly about falls, fall circumstances and consequences by trained nurses. 49 patients were included with a median age of 79.3 years (70-89 years). During follow-up 40 fall accidents occurred in 27 (55%) patients. Falls resulted in fractures in 15% of cases and in hospital admissions in 15%. In haemodialysis (HD) patients, the mean systolic blood pressure (SBP) before HD was lower in fallers compared with non-fallers (130 vs. 143 mmHg). Several patients in the lower blood pressure category received antihypertensive medication. For every 5 mmHg lower SBP (before HD) the fall risk increased by 30% (hazard ratio (HR) 1.30, 95% CI 1.03-1.65, p = 0.03). Furthermore, fall risk increased by 22% for every 10 pmol/l rise of parathyroid hormone (HR 1.22, 95% CI 1.06-1.39, p = 0.004). Elderly dialysis patients have a high incidence of falls accompanied by a high fracture rate. Given the high complication rate, elderly patients at risk of falling should be identified and managed. Reduction of blood pressure-lowering medication might be a treatment strategy to reduce falls.

  14. Treatment-related mortality in relapsed childhood acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Oskarsson, Trausti; Söderhäll, Stefan; Arvidson, Johan

    2018-01-01

    BACKGROUND: Treatment of relapsed childhood acute lymphoblastic leukemia (ALL) is particularly challenging due to the high treatment intensity needed to induce and sustain a second remission. To improve results, it is important to understand how treatment-related toxicity impacts survival...

  15. Cosmological Evolution of the Central Engine in High-Luminosity, High-Accretion Rate AGN

    Directory of Open Access Journals (Sweden)

    Matteo Guainazzi

    2014-12-01

    Full Text Available In this paper I discuss the status of observational studies aiming at probing the cosmological evolution of the central engine in high-luminosity, high-accretion rate Active Galactic Nuclei (AGN. X-ray spectroscopic surveys, supported by extensive multi-wavelength coverage, indicate a remarkable invariance of the accretion disk plus corona system, and of their coupling up to redshifts z≈6. Furthermore, hard X-ray (E >10 keV surveys show that nearby Seyfert Galaxies share the same central engine notwithstanding their optical classication. These results suggest that the high-luminosity, high accretion rate quasar phase of AGN evolution is homogeneous over cosmological times.

  16. Recurrent tuberculosis in an urban area in China: relapse or exogenous reinfection?

    Science.gov (United States)

    Shen, Xin; Yang, Chongguang; Wu, Jie; Lin, Senlin; Gao, Xu; Wu, Zheyuan; Tian, Jiyun; Gan, Mingyu; Luo, Tao; Wang, Lili; Yu, Chenlei; Mei, Jian; Pan, Qichao; DeRiemer, Kathryn; Yuan, ZhengAn; Gao, Qian

    2017-01-01

    Recurrent tuberculosis is an important indicator of the effectiveness of tuberculosis control and can occur by relapse or exogenous reinfection. We conducted a retrospective cohort study on all bacteriologically confirmed tuberculosis cases that were successfully treated between 2000 and 2012 in Shanghai, an urban area with a high number but a low prevalence rate of tuberculosis cases and a low prevalence of HIV infection. Genotyping the Mycobacterium tuberculosis from clinical isolates was used to distinguish between relapse and reinfection. In total, 5.3% (710/13,417) of successfully treated cases had a recurrence, a rate of 7.55 (95% CI 7.01–8.13) episodes per 1000 person-years, more than 18 times the rate of tuberculosis in the general population. Patients who were male, age 30–59, retreatment cases, had cavitation, diabetes, drug-resistant or multidrug-resistant tuberculosis in their initial episode of tuberculosis, were at high risk for a recurrence. Among 141 recurrent cases that had paired isolates, 59 (41.8%) had different genotypes, indicating reinfection with a different strain. Patients who completed treatment were still at high risk of another episode of tuberculosis and exogenous reinfection contributed a significant proportion of the recurrent tuberculosis cases. Targeted control strategies are needed to prevent new tuberculosis infections in this setting. PMID:28237039

  17. Does improvement in maternal attachment representations predict greater maternal sensitivity, child attachment security and lower rates of relapse to substance use? A second test of Mothering from the Inside Out treatment mechanisms.

    Science.gov (United States)

    Suchman, Nancy E; DeCoste, Cindy; Borelli, Jessica L; McMahon, Thomas J

    2018-02-01

    In this study, we replicated a rigorous test of the proposed mechanisms of change associated with Mothering from the Inside out (MIO), an evidence-based parenting therapy that aims to enhance maternal reflective functioning and mental representations of caregiving in mothers enrolled in addiction treatment and caring for young children. First, using data from 84 mothers who enrolled in our second randomized controlled trial, we examined whether therapist fidelity to core MIO treatment components predicted improvement in maternal reflective functioning and mental representations of caregiving, even after taking fidelity to non-MIO components into account. Next, we examined whether improvement in directly targeted outcomes (e.g., maternal mentalizing and mental representations of caregiving) led to improvements in the indirectly targeted outcome of maternal caregiving sensitivity, even after controlling for other plausible competing mechanisms (e.g., improvement in maternal psychiatric distress and substance use). Third, we examined whether improvement in targeted parenting outcomes (e.g., maternal mentalizing, mental representations of caregiving and caregiving sensitivity) was associated in improvement in child attachment status, even after controlling for competing mechanisms (e.g., improvement in maternal psychiatric distress and substance use). Finally, we examined whether improvement in maternal mentalizing and caregiving representations was associated with a reduction in relapse to substance use. Support was found for the first three tests of mechanisms but not the fourth. Implications for future research and intervention development are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. High bit rate germanium single photon detectors for 1310nm

    Science.gov (United States)

    Seamons, J. A.; Carroll, M. S.

    2008-04-01

    There is increasing interest in development of high speed, low noise and readily fieldable near infrared (NIR) single photon detectors. InGaAs/InP Avalanche photodiodes (APD) operated in Geiger mode (GM) are a leading choice for NIR due to their preeminence in optical networking. After-pulsing is, however, a primary challenge to operating InGaAs/InP single photon detectors at high frequencies1. After-pulsing is the effect of charge being released from traps that trigger false ("dark") counts. To overcome this problem, hold-off times between detection windows are used to allow the traps to discharge to suppress after-pulsing. The hold-off time represents, however, an upper limit on detection frequency that shows degradation beginning at frequencies of ~100 kHz in InGaAs/InP. Alternatively, germanium (Ge) single photon avalanche photodiodes (SPAD) have been reported to have more than an order of magnitude smaller charge trap densities than InGaAs/InP SPADs2, which allowed them to be successfully operated with passive quenching2 (i.e., no gated hold off times necessary), which is not possible with InGaAs/InP SPADs, indicating a much weaker dark count dependence on hold-off time consistent with fewer charge traps. Despite these encouraging results suggesting a possible higher operating frequency limit for Ge SPADs, little has been reported on Ge SPAD performance at high frequencies presumably because previous work with Ge SPADs has been discouraged by a strong demand to work at 1550 nm. NIR SPADs require cooling, which in the case of Ge SPADs dramatically reduces the quantum efficiency of the Ge at 1550 nm. Recently, however, advantages to working at 1310 nm have been suggested which combined with a need to increase quantum bit rates for quantum key distribution (QKD) motivates examination of Ge detectors performance at very high detection rates where InGaAs/InP does not perform as well. Presented in this paper are measurements of a commercially available Ge APD

  19. A digital approach for real time high-rate high-resolution radiation measurements

    International Nuclear Information System (INIS)

    Gerardi, G.; Abbene, L.

    2014-01-01

    Modern spectrometers are currently developed by using digital pulse processing (DPP) systems, showing several advantages over traditional analog electronics. The aim of this work is to present digital strategies, in a time domain, for the development of real time high-rate high-resolution spectrometers. We propose a digital method, based on the single delay line (SDL) shaping technique, able to perform multi-parameter analysis with high performance even at high photon counting rates. A robust pulse shape and height analysis (PSHA), applied on single isolated time windows of the detector output waveforms, is presented. The potentialities of the proposed strategy are highlighted through both theoretical and experimental approaches. To strengthen our approach, the implementation of the method on a real-time system together with some experimental results are presented. X-ray spectra measurements with a semiconductor detector are performed both at low and high photon counting rates (up to 1.1 Mcps)

  20. A digital approach for real time high-rate high-resolution radiation measurements

    Energy Technology Data Exchange (ETDEWEB)

    Gerardi, G.; Abbene, L., E-mail: leonardo.abbene@unipa.it

    2014-12-21

    Modern spectrometers are currently developed by using digital pulse processing (DPP) systems, showing several advantages over traditional analog electronics. The aim of this work is to present digital strategies, in a time domain, for the development of real time high-rate high-resolution spectrometers. We propose a digital method, based on the single delay line (SDL) shaping technique, able to perform multi-parameter analysis with high performance even at high photon counting rates. A robust pulse shape and height analysis (PSHA), applied on single isolated time windows of the detector output waveforms, is presented. The potentialities of the proposed strategy are highlighted through both theoretical and experimental approaches. To strengthen our approach, the implementation of the method on a real-time system together with some experimental results are presented. X-ray spectra measurements with a semiconductor detector are performed both at low and high photon counting rates (up to 1.1 Mcps)

  1. High dose rate versus medium dose rate intraluminal brachytherapy in inoperable esophageal carcinoma

    International Nuclear Information System (INIS)

    Langendijk, J.; Jager, J.; Jong, J. de; Rijken, J.; Pannebakker, M.

    1996-01-01

    Introduction: The purpose of this study was to compare the results of medium dose rate (MDR) intraluminal brachytherapy (ILBT) and high dose rate (HDR) ILBT in patients with inoperable esophageal carcinoma, with regard to dysphagia, complication rate and survival. Material and methods: Included were 114 patients with inoperable esophageal cancer who were treated with a single session of ILBT. In all cases a single dose of 15 Gy was administered, calculated at a 1 cm radius. Forty-eight patients were treated with MDR ( 137 Cs)ILBT. In June 1990 MDR was replaced by HDR and from then 66 patients were treated with HDR ( 192 Ir). Dysphagia was prospectively scored using a 5-point scale at 6 weeks, 3, 6, 9 and 12 months. Results: No significant differences were noted between the two groups with regard to pretreatment variables. In patients treated with MDR-ILBT improvement of swallowing ability was noted in 30 out of 42 evaluable patients (71%), no change in 9 (21%) and progression of dysphagia in 3 patients (8%), as compared to 34 out of 59 evaluable patients (58%), 16 (27%) and 6 (15%) resp. in de HDR-ILBT group. In the latter category, progression of dysphagia was caused by fistulae in 2 patients. The differences were not significant (ns). Additional treatment in case of recurrent or persistent dysphagia was needed in 50% of the cases in the MDR-ILBT group as compared to 41% in the HDR-ILBT group (ns). The median survival of the MDR-ILBT group was 3.9 months as compared to 4.3 months in the HDR-ILBT group (ns). In 2 patients (4%) treated with MDR-ILBT bronchio-oesphageal fistulae developed at 6 weeks and 2 months. In the HDR-ILBT group fistulae were noted in 7 cases (11%) at 2 weeks, 4 weeks, 2, 3, 3, 4 and 9 months (ns). In all of these cases persistent of recurrent tumour was present. Conclusions: No significant differences were noted with regard to palliation of dysphagia, survival and complication rate between MDR-ILBT and HDR-ILBT in the management of esophageal

  2. High-rate fermentative hydrogen production from beverage wastewater

    International Nuclear Information System (INIS)

    Sivagurunathan, Periyasamy; Sen, Biswarup; Lin, Chiu-Yue

    2015-01-01

    Highlights: • Hybrid immobilized-bacterial cells show stable operation over 175 days. • Low HRT of 1.5 h shows peak hydrogen production rate of 55 L/L-d. • Electricity generation is 9024 kW-d from 55 L/L-d hydrogen using beverage wastewater. • Granular sludge formed only at 2–3 h HRT with presence of Selenomonas sp. - Abstract: Hydrogen production from beverage industry wastewater (20 g/L hexose equivalent ) using an immobilized cell reactor with a continuous mode of operation was studied at various hydraulic retention times (HRT, 8–1.5 h). Maximum hydrogen production rate (HPR) of 55 L/L-d was obtained at HRT 1.5 h (an organic loading of 320 g/L-d hexose equivalent ). This HPR value is much higher than those of other industrial wastewaters employed in fermentative hydrogen production. The cell biomass concentration peaked at 3 h HRT with a volatile suspended solids (VSS) concentration of 6.31 g/L (with presence of self-flocculating Selenomonas sp.), but it dropped to 3.54 gVSS/L at 1.5 h HRT. With the shortening of HRT, lactate concentration increased but the concentration of the dominant metabolite butyrate did not vary significantly. The Clostridium species dynamics was not significantly affected, but total microbial community structure changed with respect to HRT variation as evident from PCR–DGGE analyses. Analysis of energy production rate suggests that beverage wastewater is a high energy yielding feedstock, and can replace 24% of electricity consumption in a model beverage industry

  3. Efficacy of Group Cognitive–behavioral Therapy in Maintenance Treatment and Relapse Prevention for Bipolar Adolescents

    Directory of Open Access Journals (Sweden)

    Soroor Arman

    2018-01-01

    Full Text Available Background: Despite conducting wide-ranging of pharmacotherapy for bipolar adolescents, many of them are showing a deficit in functioning with high relapse rate. The aim of the current study was to develop a manual and investigate the efficacy of group cognitive–behavioral therapy (G-CBT for female bipolar adolescents. Materials and Methods: During the first qualitative phase of a mixed-methods study, a manual of G-CBT was developed. Then, 32 female bipolar adolescents aged 12–19 years old, receiving usual maintenance medications (UMM, were selected. Participants were randomized to the control (UMM and intervention group (5, 2 h weekly sessions based on G-CBT manual with UMM. The parents in intervention group participated in three parallel sessions. All participants filled the following questionnaires before 1, 3, and 6 months after the initiation of the study: Young Mania Rating Scale, Children Depression Inventory and Global Assessment of Functioning. The results were analyzed using SPSS 21 software. The concurrent qualitative phase was analyzed through thematic analysis. Results: The results showed no significant differences in all questionnaires' scores through intervention and follow-up sessions (P > 0.05. However, using cutoff point of CDI, G-CBT was effective for intervention group (relapse rate: 25% vs. 44.4%. Two themes were extracted from the second qualitative phase: emotion recognition and emotion regulation, especially in anger control. Conclusions: The results showed that the addition of G-CBT to UMM leads to decrease in the depressive scores but has no effect on manic symptoms and relapse rate.

  4. Efficacy of Group Cognitive-behavioral Therapy in Maintenance Treatment and Relapse Prevention for Bipolar Adolescents.

    Science.gov (United States)

    Arman, Soroor; Golmohammadi, Farnaz; Maracy, Mohammadreza; Molaeinezhad, Mitra

    2018-01-01

    Despite conducting wide-ranging of pharmacotherapy for bipolar adolescents, many of them are showing a deficit in functioning with high relapse rate. The aim of the current study was to develop a manual and investigate the efficacy of group cognitive-behavioral therapy (G-CBT) for female bipolar adolescents. During the first qualitative phase of a mixed-methods study, a manual of G-CBT was developed. Then, 32 female bipolar adolescents aged 12-19 years old, receiving usual maintenance medications (UMM), were selected. Participants were randomized to the control (UMM) and intervention group (5, 2 h weekly sessions based on G-CBT manual with UMM). The parents in intervention group participated in three parallel sessions. All participants filled the following questionnaires before 1, 3, and 6 months after the initiation of the study: Young Mania Rating Scale, Children Depression Inventory and Global Assessment of Functioning. The results were analyzed using SPSS 21 software. The concurrent qualitative phase was analyzed through thematic analysis. The results showed no significant differences in all questionnaires' scores through intervention and follow-up sessions ( P > 0.05). However, using cutoff point of CDI, G-CBT was effective for intervention group (relapse rate: 25% vs. 44.4%). Two themes were extracted from the second qualitative phase: emotion recognition and emotion regulation, especially in anger control. The results showed that the addition of G-CBT to UMM leads to decrease in the depressive scores but has no effect on manic symptoms and relapse rate.

  5. Treatment and outcome of patients with relapsed clear cell sarcoma of the kidney: a combined SIOP and AIEOP study.

    Science.gov (United States)

    Gooskens, S L; Furtwängler, R; Spreafico, F; van Tinteren, H; de Kraker, J; Vujanic, G M; Leuschner, I; Coulomb-L'Herminé, A; Godzinski, J; Schleiermacher, G; Stoneham, S; Bergeron, C; Pritchard-Jones, K; Graf, N; van den Heuvel-Eibrink, M M

    2014-07-15

    Clear cell sarcoma of the kidney (CCSK) is an uncommon paediatric renal tumour. Relapses occur in about 15% of the patients. Since detailed clinical information on relapsed CCSK is scarce, the current study aims to describe outcome of patients with relapsed CCSK treated according to recent European protocols. We analysed prospectively collected data of all CCSK patients who developed a relapse after complete remission at the end of primary treatment, entered onto SIOP and AIEOP trials between 1992 and 2012. Thirty-seven of 237 CCSK patients (16%) treated according to SIOP and AIEOP protocols developed a relapse. Median time from initial diagnosis to relapse was 17 months (range, 5.5 months - 6.6 years). Thirt-five out of thirty-seven relapses (95%) were metastatic; the most common sites of relapse were the brain (n=13), lungs (n=7) and bone (n=5). Relapse treatment consisted of chemotherapy (n=30), surgery (n=19) and/or radiotherapy (n=18), followed by high-dose chemotherapy and autologous bone marrow transplantation (ABMT) in 14 patients. Twenty-two out of thirty-seven patients (59%) achieved a second complete remission (CR); 15 of whom (68%) developed a second relapse. Five-year event-free survival (EFS) after relapse was 18% (95% CI: 4%-32%), and 5-year overall survival (OS) was 26% (95% CI: 10%-42%). In this largest series of relapsed CCSK patients ever described, overall outcome is poor. Most relapses are metastatic and brain relapses are more common than previously recognised. Intensive treatment aiming for local control, followed by high dose chemotherapy and ABMT, seems to be of benefit to enhance survival. Novel development of targeted therapy is urgently required.

  6. RCS Leak Rate Calculation with High Order Least Squares Method

    International Nuclear Information System (INIS)

    Lee, Jeong Hun; Kang, Young Kyu; Kim, Yang Ki

    2010-01-01

    As a part of action items for Application of Leak before Break(LBB), RCS Leak Rate Calculation Program is upgraded in Kori unit 3 and 4. For real time monitoring of operators, periodic calculation is needed and corresponding noise reduction scheme is used. This kind of study was issued in Korea, so there have upgraded and used real time RCS Leak Rate Calculation Program in UCN unit 3 and 4 and YGN unit 1 and 2. For reduction of the noise in signals, Linear Regression Method was used in those programs. Linear Regression Method is powerful method for noise reduction. But the system is not static with some alternative flow paths and this makes mixed trend patterns of input signal values. In this condition, the trend of signal and average of Linear Regression are not entirely same pattern. In this study, high order Least squares Method is used to follow the trend of signal and the order of calculation is rearranged. The result of calculation makes reasonable trend and the procedure is physically consistence

  7. High dose rate brachytherapy for the palliation of malignant dysphagia

    International Nuclear Information System (INIS)

    Homs, Marjolein Y.V.; Eijkenboom, Wilhelmina M.H.; Coen, Veronique L.M.A.; Haringsma, Jelle; Blankenstein, Mark van; Kuipers, Ernst J.; Siersema, Peter D.

    2003-01-01

    Background and purpose: High dose rate (HDR) brachytherapy is a commonly used palliative treatment for esophageal carcinoma. We evaluated the outcome of HDR brachytherapy in patients with malignant dysphagia. Material and methods: A retrospective analysis over a 10-year period was performed of 149 patients treated with HDR brachytherapy, administered in one or two sessions, at a median dose of 15 Gy. Patients were evaluated for functional outcome, complications, recurrent dysphagia, and survival. Results: At 6 weeks after HDR brachytherapy, dysphagia scores had improved from a median of 3 to 2 (n=104; P<0.001), however, dysphagia had not improved in 51 (49%) patients. Procedure-related complications occurred in seven (5%) patients. Late complications, including fistula formation or bleeding, occurred in 11 (7%) patients. Twelve (8%) patients experienced minor retrosternal pain. Median survival of the patients was 160 days with a 1-year survival rate of 15%. Procedure-related mortality was 2%. At follow-up, 55 (37%) patients experienced recurrent dysphagia. In 34 (23%) patients a metal stent was placed to relieve persistent or recurrent dysphagia. Conclusion: HDR brachytherapy is a moderately effective treatment for the palliation of malignant dysphagia. The incidence of early major complications is low, however, persistent and recurrent dysphagia occur frequently, and require often additional treatment

  8. Decay rates of resonance states at high level density

    International Nuclear Information System (INIS)

    Persson, E.; Technische Univ. Dresden; Gorin, T.; Technische Univ. Dresden; Rotter, I.; Technische Univ. Dresden

    1996-05-01

    The time dependent Schroedinger equation of an open quantum mechanical system is solved by using the stationary bi-orthogonal eigenfunctions of the non-Hermitean time independent Hamilton operator. We calculate the decay rates at low and high level density in two different formalism. The rates are, generally, time dependent and oscillate around an average value due to the non-orthogonality of the wavefunctions. The decay law is studied disregarding the oscillations. In the one-channel case, it is proportional to t -b with b∼3/2 in all cases considered, including the critical region of overlapping where the non-orthogonality of the wavefunctions is large. Starting from the shell model, we get b∼2 for 2 and 4 open decay channels and all coupling strengths to the continuum. When the closed system is described by a random matrix, b∼1+K/2 for K=2 and 4 channels. This law holds in a limited time interval. The distribution of the widths is different in the two models when more than one channel are open. This leads to the different exponents b in the power law. Our calculations are performed with 190 and 130 states, respectively, most of them in the critical region. The theoretical results should be proven experimentally by measuring the time behaviour of de-excitation of a realistic quantum system. (orig.)

  9. Routine quality control of high dose rate brachytherapy equipment

    International Nuclear Information System (INIS)

    Guzman Calcina, Carmen S.; Almeida, Adelaide de; Rocha, Jose R. Oliveira

    2001-01-01

    A Quality Assurance program should be installed also for High Dose Rate brachytherapy, in the order to achieve a correct dose administration to the patient and for the safety to those involved directly with the treatment. The work presented here has the following purposes: Analyze the types of equipment tests presented by the official protocols (TG40, TG56 e ARCAL XXX), evaluate the brachytherapy routine tests of protocols from various national and international radiotherapy services and compare the latter with those presented in the official protocols. As a result, we conclude the following: TG56 presents a higher number of tests when compared to the other official protocols and most of the tests presented by the analyzed services are present in TG56. A suggestion for a basic protocol is presented, emphasizing the periodicity and tolerance level of each of the tests. (author)

  10. Behavior of fiber reinforced metal laminates at high strain rate

    Science.gov (United States)

    Newaz, Golam; Sasso, Marco; Amodio, Dario; Mancini, Edoardo

    2018-05-01

    Carbon Fiber Reinforced Aluminum Laminate (CARALL) is a good system for energy absorption through plastic deformation in aluminum and micro-cracking in the composite layers. Moreover, CARALL FMLs also provide excellent impact resistance due to the presence of aluminum layer. The focus of this research is to characterize the CARALL behavior under dynamic conditions. High strain rate tests on sheet laminate samples have been carried out by means of direct Split Hopkinson Tension Bar. The sample geometry and the clamping system were optimized by FEM simulations. The clamping system has been designed and optimized in order reduce impedance disturbance due to the fasteners and to avoid the excessive plastic strain outside the gauge region of the samples.

  11. Safety handling manual for high dose rate remote afterloading system

    International Nuclear Information System (INIS)

    1999-01-01

    This manual is mainly for safety handling of 192 Ir-RALS (remote afterloading system) of high dose rate and followings were presented: Procedure and document format for the RALS therapy and for handling of its radiation source with the purpose of prevention of human errors and unexpected accidents, Procedure for preventing errors occurring in the treatment schedule and operation, and Procedure and format necessary for newly introducing the system into a facility. Consistency was intended in the description with the quality assurance guideline for therapy with small sealed radiation sources made by JASTRO (Japan Society for Therapeutic Radiology and Oncology). Use of the old type 60 Co-RALS was pointed out to be a serious problem remained and its safety handling procedure was also presented. (K.H.)

  12. Calibration of {sup 192}Ir high dose rate brachytherapy sources

    Energy Technology Data Exchange (ETDEWEB)

    Marechal, M H [Instituto de Radioprotecao e Dozimetria, Rio de Jainero (Brazil); Almeida, C.E. de [Laboratorio de Ciencias Radiologicas, UERL, Rio de Janeiro (Brazil); Sibata, C H [Roswell Park Cancer Inst., Buffalo, NY (United States)

    1996-08-01

    A method for calibration of high dose rate sources used in afterloading brachytherapy systems is described. The calibration for {sup 192}Ir is determined by interpolating {sup 60}Co gamma-rays and 250 kV x-rays calibration factors. All measurements were done using the same build up caps as described by Goetsch et al and recommended by AAPM. The attenuation correction factors were determined to be 0.9903, 0.9928 and 0.9993 for {sup 192}Ir, {sup 60}Co and 250 kV x-ray, respectively. A wall + cap thickness of 0.421 g.cm{sup -2} is recommended for all measurements to ensure electronic equilibrium for {sup 60}Co and {sup 192}Ir gamma-ray beams. A mathematical formalism is described for determination of (N{sub x}){sub Ir}. (author). 5 refs, 1 fig.

  13. Closed cycle high-repetition-rate pulsed HF laser

    Science.gov (United States)

    Harris, Michael R.; Morris, A. V.; Gorton, Eric K.

    1997-04-01

    The design and performance of a closed cycle high repetition rate HF laser is described. A short pulse, glow discharge is formed in a 10 SF6:1 H2 gas mixture at a total pressure of approximately 110 torr within a 15 by 0.5 by 0.5 cm3 volume. Transverse, recirculated gas flow adequate to enable repetitive operation up to 3 kHz is imposed by a centrifugal fan. The fan also forces the gas through a scrubber cell to eliminate ground state HF from the gas stream. An automated gas make-up system replenishes spent gas removed by the scrubber. Typical mean laser output powers up to 3 W can be maintained for extended periods of operation.

  14. Pulsed dose rate and fractionated high dose rate brachytherapy: choice of brachytherapy schedules to replace low dose rate treatments

    International Nuclear Information System (INIS)

    Visser, Andries G.; Aardweg, Gerard J.M.J. van den; Levendag, Peter C.

    1996-01-01

    Purpose: Pulsed dose rate (PDR) brachytherapy is a new type of afterloading brachytherapy (BT) in which a continuous low dose rate (LDR) treatment is simulated by a series of 'pulses,' i.e., fractions of short duration (less than 0.5 h) with intervals between fractions of 1 to a few hours. At the Dr. Daniel den Hoed Cancer Center, the term 'PDR brachytherapy' is used for treatment schedules with a large number of fractions (at least four per day), while the term 'fractionated high dose rate (HDR) brachytherapy' is used for treatment schedules with just one or two brachytherapy fractions per day. Both treatments can be applied as alternatives for LDR BT. This article deals with the choice between PDR and fractionated HDR schedules and proposes possible fractionation schedules. Methods and Materials: To calculate HDR and PDR fractionation schedules with the intention of being equivalent to LDR BT, the linear-quadratic (LQ) model has been used in an incomplete repair formulation as given by Brenner and Hall, and by Thames. In contrast to earlier applications of this model, both the total physical dose and the overall time were not kept identical for LDR and HDR/PDR schedules. A range of possible PDR treatment schedules is presented, both for booster applications (in combination with external radiotherapy (ERT) and for BT applications as a single treatment. Because the knowledge of both α/β values and the half time for repair of sublethal damage (T (1(2)) ), which are required for these calculations, is quite limited, calculations regarding the equivalence of LDR and PDR treatments have been performed for a wide range of values of α/β and T (1(2)) . The results are presented graphically as PDR/LDR dose ratios and as ratios of the PDR/LDR tumor control probabilities. Results: If the condition that total physical dose and overall time of a PDR treatment must be exactly identical to the values for the corresponding LDR treatment regimen is not applied, there appears

  15. Performance of high-rate gravel-packed oil wells

    Energy Technology Data Exchange (ETDEWEB)

    Unneland, Trond

    2001-05-01

    Improved methods for the prediction, evaluation, and monitoring of performance in high-rate cased-hole gravel-packed oil wells are presented in this thesis. The ability to predict well performance prior to the gravel-pack operations, evaluate the results after the operation, and monitor well performance over time has been improved. This lifetime approach to performance analysis of gravel-packed oil wells contributes to increase oil production and field profitability. First, analytical models available for prediction of performance in gravel-packed oil wells are reviewed, with particular emphasis on high-velocity flow effects. From the analysis of field data from three North Sea oil fields, improved and calibrated cased-hole gravel-pack performance prediction models are presented. The recommended model is based on serial flow through formation sand and gravel in the perforation tunnels. In addition, new correlations for high-velocity flow in high-rate gravel-packed oil wells are introduced. Combined, this improves the performance prediction for gravel-packed oil wells, and specific areas can be targeted for optimized well design. Next, limitations in the current methods and alternative methods for evaluation and comparison of well performance are presented. The most widely used parameter, the skin factor, remains a convenient and important parameter. However, using the skin concept in direct comparisons between wells with different reservoir properties may result in misleading or even invalid conclusions. A discussion of the parameters affecting the skin value, with a clarification of limitations, is included. A methodology for evaluation and comparison of gravel-packed well performance is presented, and this includes the use of results from production logs and the use of effective perforation tunnel permeability as a parameter. This contributes to optimized operational procedures from well to well and from field to field. Finally, the data sources available for

  16. HIGH-DOSE RATE BRACHYTHERAPY IN CARCINOMA CERVIX STAGE IIIB

    Directory of Open Access Journals (Sweden)

    Sathya Maruthavanan

    2016-07-01

    Full Text Available INTRODUCTION Radiotherapy is the standard treatment in locally advanced (IIB-IVA and early inoperable cases. The current standard of practice with curable intent is concurrent chemoradiation in which intracavitary brachytherapy is an integral component of radiotherapy. This study aims at assessing the efficacy of HDR ICBT (High-dose rate intracavitary brachytherapy in terms local response, normal tissue reactions, and feasibility. METHODS AND MATERIALS A total of 20 patients of stage IIIB cancer of the uterine cervix were enrolled in the study and were planned to receive concurrent chemotherapy weekly along with EBRT (external beam radiotherapy to a dose of 50 Gy/25 Fr. Suitability for ICBT was assessed at 40 Gy/20 Fr. 6/20 patients were suitable at 40 Gy and received HDR ICBT with a dose of 5.5 Gy to point A in 4 sessions (5.5 Gy/4 Fr. The remaining 14/20 patients completed 50 Gy and received HDR ICBT with a dose of 6 Gy to point A in 3 sessions (6 Gy/3 Fr. RESULTS A total of 66 intracavitary applications were done and only one application required dose modification due to high bladder dose, the pelvic control rate was 85% (17/20. 10% (2/20 had stable disease and 5% (1/20 had progressive disease at one year of follow up. When toxicity was considered only 15% developed grade I and grade II rectal complications. Patient compliance and acceptability was 100%. Patients were very comfortable with the short treatment time as compared with patients on LDR ICBT (low-dose rate intracavitary brachytherapy treatment interviewed during the same period. CONCLUSION This study proves that HDR brachytherapy is efficacious and feasible in carcinoma of cervix stage IIIB. It also proves that good dose distribution can be achieved with HDR intracavitary facility by the use of dose optimization. The short treatment time in HDR ICBT makes it possible to maintain this optimised dose distribution throughout the treatment providing a gain in the therapeutic ratio and

  17. Rocket propellants with reduced smoke and high burning rates

    Energy Technology Data Exchange (ETDEWEB)

    Menke, K.; Eisele, S. [Fraunhofer-Institut fuer Chemische Technologie (ICT), Pfinztal-Berghausen (Germany)

    1997-07-01

    Rocket propellants with reduced smoke and high burning rates recommend themselves for use in a rocket motor for high accelerating tactical missiles. They serve for an improved camouflage on the battle field and may enable guidance control due to the higher transmission of their rocket plume compared to traditional aluminized composite propellants. In this contribution the material based ranges of performance and properties of three non aluminized rocket propellants will be introduced and compared to each other. The selected formulations based on AP/HTPB; AP/PU/TMETN and AP/HMX/GAP/TMETN have roughly the same specific impulse of I{sub SP}=2430 Ns/kg at 70:1 expansion ratio. The burning rates in the pressure range from 10-18 MPa vary from to 26-33 mm/s for the AP/HTPB propellant, 52-68 mm/s for the formulation based on AP/PU/TMETN and 28-39 mm/s for the propellant based on AP/HMX/GAP. With 58% and 20% AP-contents the propellants with nitrate ester plasticizers create a much smaller secondary signature than the AP/HTPB representative containing 85% AP. Their disadvantage, however, is the connection of high performance to a high level of energetic plasticizer. For this reason, the very fast burning propellant based on AP/PU/TMETN is endowed with a low elastic modulus and is limited to a grain configuration which isn`t exposed too much to the fast and turbulent airstream. The mechanical properties of the AP/HMX/GAP-propellant are as good or better as those of the AP/HTPB propellant. The first one exhibits the same performance and burn rates as the composite representative but produces only one fifth of HCl exhaust. For this reason it is recommended for missile applications, which must have high accelerating power together with a significantly reduced plume signature and smoke production. (orig.) [Deutsch] Rauchreduzierte Festtreibstoffe mit hohen Abbrandgeschwindigkeiten bieten sich fuer den Antrieb hochbeschleunigender taktischer Flugkoerper an, da sie gegenueber

  18. High repetition rate, high energy, actively Q-switched all-in-fiber laser

    Science.gov (United States)

    Lecourt, J. B.; Bertrand, A.; Guillemet, S.; Hernandez, Y.; Giannone, D.

    2010-05-01

    We report an actively Q-switched Ytterbium-doped all-in-fibre laser delivering 10ns pulses with high repetition rate (from 100kHz to 1MHz). The laser operation has been validated at three different wavelengths (1040, 1050 and 1064nm). The laser can deliver up to 20Watts average power with an high beam quality (M2 = 1).

  19. High-power pre-chirp managed amplification of femtosecond pulses at high repetition rates

    International Nuclear Information System (INIS)

    Liu, Yang; Li, Wenxue; Zhao, Jian; Bai, Dongbi; Luo, Daping; Zeng, Heping

    2015-01-01

    Femtosecond pulses at 250 MHz repetition rate from a mode-locked fiber laser are amplified to high power in a pre-chirp managed amplifier. The experimental strategy offers a potential towards high-power ultrashort laser pulses at high repetition rates. By investigating the laser pulse evolution in the amplification processes, we show that self-similar evolution, finite gain bandwidth and mode instabilities determine pulse characteristics in different regimes. Further average power scaling is limited by the mode instabilities. Nevertheless, this laser system enables us to achieve sub-50 fs pulses with an average power of 93 W. (letter)

  20. Mathematical Models of Tuberculosis Reactivation and Relapse

    Directory of Open Access Journals (Sweden)

    Robert Steven Wallis

    2016-05-01

    Full Text Available The natural history of human infection with Mycobacterium tuberculosis (Mtb is highly variable, as is the response to treatment of active tuberculosis. There is presently no direct means to identify individuals in whom Mtb infection has been eradicated, whether by a bactericidal immune response or sterilizing antimicrobial chemotherapy. Mathematical models can assist in such circumstances by measuring or predicting events that cannot be directly observed. The 3 models discussed in this review illustrate instances in which mathematical models were used to identify individuals with innate resistance to Mtb infection, determine the etiology of tuberculosis in patients treated with tumor necrosis factor antagonists, and predict the risk of relapse in persons undergoing tuberculosis treatment. These examples illustrate the power of various types of mathematic models to increase knowledge and thereby inform interventions in the present global tuberculosis epidemic.

  1. Preventing Postpartum Smoking Relapse: A Randomized Clinical Trial.

    Science.gov (United States)

    Levine, Michele D; Cheng, Yu; Marcus, Marsha D; Kalarchian, Melissa A; Emery, Rebecca L

    2016-04-01

    Most women who quit smoking during pregnancy will relapse postpartum. Previous efforts to prevent postpartum relapse have been unsuccessful at increasing rates of sustained abstinence. To evaluate the relative efficacy of 2 different approaches to prevent postpartum smoking relapse. Pregnant women who recently had quit smoking were recruited before the end of pregnancy. Intervention sessions were conducted through a combination of telephone calls and in-person visits beginning at delivery and continuing through 24 weeks postpartum. Participants completed assessments at the prenatal baseline and at 12, 24, and 52 weeks postpartum. Participants were recruited between March 2008 and December 2012. The dates of the analysis were April 2014 to February 2015. Women received postpartum-adapted, behavioral smoking relapse prevention intervention and were randomly assigned to an enhanced cognitive behavioral intervention that included additional specialized strategies and content focused on women's postpartum concerns about mood, stress, and weight (Strategies to Avoid Returning to Smoking [STARTS]) or a supportive, time and attention-controlled comparison (SUPPORT). Intervention began before delivery and continued through 24 weeks postpartum. The primary outcome was biochemically confirmed sustained tobacco abstinence at 52 weeks postpartum. Secondary outcomes were self-reported mood, levels of perceived stress, and degree of concern about smoking-related weight gain. The study cohort comprised 300 participants (150 randomly assigned to each group). Their mean (SD) age was 24.99 (5.65) years. Overall, 38.0% (114 of 300), 33.7% (101 of 300), and 24.0% (72 of 300) of the sample maintained abstinence at 12, 24, and 52 weeks' postpartum, respectively. There were no differences between the intervention groups in abstinence or time to relapse. Self-reported depressive symptoms and perceived stress significantly improved over time, and improvements were similar for both

  2. Sexting Rates and Predictors From an Urban Midwest High School.

    Science.gov (United States)

    Gregg, David; Somers, Cheryl L; Pernice, Francesca Maria; Hillman, Stephen B; Kernsmith, Poco

    2018-06-01

    Risks associated with teen sexting draw increasing concern from teachers and communities as developments in communication software and devices make sharing private content faster and simpler each year. We examined rates, recipients, and predictors of teen sexting to better plan education and preventative policies and strategies. A comprehensive literature review was conducted to determine the most likely predictors of teen sexting using prior survey studies and theoretical conceptions. We surveyed 314 high school students in an urban area of a large Midwestern city. Males were found to more frequently report sexting. Impulsivity, frequency of electronic communication, peer pressure, peer sexting, and social learning significantly predicted sexting beyond age, race, and sex. Self-esteem did not moderate the effect of peer pressure to sext. Structural predictive models attained good fit to the data, and neither were moderated by sex. Sexting was highly associated with reported peer pressure, perceived norms, and impulsive decision making. Adolescents in relationships may be at particular risk of sexting. These findings will help parents, teens, and educators take appropriate measures to inform about and encourage the safe use of technology. © 2018, American School Health Association.

  3. Optimized dose distribution of a high dose rate vaginal cylinder

    International Nuclear Information System (INIS)

    Li Zuofeng; Liu, Chihray; Palta, Jatinder R.

    1998-01-01

    Purpose: To present a comparison of optimized dose distributions for a set of high-dose-rate (HDR) vaginal cylinders calculated by a commercial treatment-planning system with benchmark calculations using Monte-Carlo-calculated dosimetry data. Methods and Materials: Optimized dose distributions using both an isotropic and an anisotropic dose calculation model were obtained for a set of HDR vaginal cylinders. Mathematical optimization techniques available in the computer treatment-planning system were used to calculate dwell times and positions. These dose distributions were compared with benchmark calculations with TG43 formalism and using Monte-Carlo-calculated data. The same dwell times and positions were used for a quantitative comparison of dose calculated with three dose models. Results: The isotropic dose calculation model can result in discrepancies as high as 50%. The anisotropic dose calculation model compared better with benchmark calculations. The differences were more significant at the apex of the vaginal cylinder, which is typically used as the prescription point. Conclusion: Dose calculation models available in a computer treatment-planning system must be evaluated carefully to ensure their correct application. It should also be noted that when optimized dose distribution at a distance from the cylinder surface is calculated using an accurate dose calculation model, the vaginal mucosa dose becomes significantly higher, and therefore should be carefully monitored

  4. High detection rate of dog circovirus in diarrheal dogs.

    Science.gov (United States)

    Hsu, Han-Siang; Lin, Ting-Han; Wu, Hung-Yi; Lin, Lee-Shuan; Chung, Cheng-Shu; Chiou, Ming-Tang; Lin, Chao-Nan

    2016-06-17

    Diarrhea is one of the most common clinical symptoms reported in companion animal clinics. Dog circovirus (DogCV) is a new mammalian circovirus that is considered to be a cause of alimentary syndromes such as diarrhea, vomiting and hemorrhagic enteritis. DogCV has previously only been identified in the United States, Italy, Germany (GeneBank accession number: KF887949) and China (GeneBank accession number: KT946839). Therefore, the aims of this study were to determine the prevalence of DogCV in Taiwan and to explore the correlation between diarrhea and DogCV infection. Clinical specimens were collected between 2012 and 2014 from 207 dogs suffering from diarrhea and 160 healthy dogs. In this study, we developed a sensitive and specific SYBR Green-based real-time PCR assays to detected DogCV in naturally infected animals. Of the analyzed fecal samples from diarrheal dogs and health dogs, 58 (28.0 %) and 19 (11.9 %), respectively, were DogCV positive. The difference in DogCV prevalence was highly significant (P = 0.0002755) in diarrheal dogs. This is the first study to reveal that DogCV is currently circulating in domestic dogs in Taiwan and to demonstrate its high detection rate in dogs with diarrhea.

  5. An integrated CMOS high data rate transceiver for video applications

    International Nuclear Information System (INIS)

    Liang Yaping; Sun Lingling; Che Dazhi; Liang Cheng

    2012-01-01

    This paper presents a 5 GHz CMOS radio frequency (RF) transceiver built with 0.18 μm RF-CMOS technology by using a proprietary protocol, which combines the new IEEE 802.11n features such as multiple-in multiple-out (MIMO) technology with other wireless technologies to provide high data rate robust real-time high definition television (HDTV) distribution within a home environment. The RF frequencies cover from 4.9 to 5.9 GHz: the industrial, scientific and medical (ISM) band. Each RF channel bandwidth is 20 MHz. The transceiver utilizes a direct up transmitter and low-IF receiver architecture. A dual-quadrature direct up conversion mixer is used that achieves better than 35 dB image rejection without any on chip calibration. The measurement shows a 6 dB typical receiver noise figure and a better than 33 dB transmitter error vector magnitude (EVM) at −3 dBm output power. (semiconductor integrated circuits)

  6. Metrology challenges for high-rate nanomanufacturing of polymer structures

    Science.gov (United States)

    Mead, Joey; Barry, Carol; Busnaina, Ahmed; Isaacs, Jacqueline

    2012-10-01

    The transfer of nanoscience accomplishments into commercial products is hindered by the lack of understanding of barriers to nanoscale manufacturing. We have developed a number of nanomanufacturing processes that leverage available high-rate plastics fabrication technologies. These processes include directed assembly of a variety of nanoelements, such as nanoparticles and nanotubes, which are then transferred onto a polymer substrate for the fabrication of conformal/flexible electronic materials, among other applications. These assembly processes utilize both electric fields and/or chemical functionalization. Conducting polymers and carbon nanotubes have been successfully transferred to a polymer substrate in times less than 5 minutes, which is commercially relevant and can be utilized in a continuous (reel to reel/roll to roll) process. Other processes include continuous high volume mixing of nanoelements (CNTs, etc) into polymers, multi-layer extrusion and 3D injection molding of polymer structures. These nanomanufacturing processes can be used for wide range of applications, including EMI shielding, flexible electronics, structural materials, and novel sensors (specifically for chem/bio detection). Current techniques to characterize the quality and efficacy of the processes are quite slow. Moreover, the instrumentation and metrology needs for these manufacturing processes are varied and challenging. Novel, rapid, in-line metrology to enable the commercialization of these processes is critically needed. This talk will explore the necessary measurement needs for polymer based nanomanufacturing processes for both step and continuous (reel to reel/roll to roll) processes.

  7. High Rate Micromechanical Behavior of Grafted Polymer Nanoparticle Films

    Science.gov (United States)

    Thomas, Edwin

    We report the ultra high strain rate behavior of films comprised of polymer grafted nanoparticles (NPs) and compare the results to homopolymer films. The films are formed by flow coating a suspension of polystyrene (PS) chains of 230 kg/mol grafted to 16nm diameter SiO2\\ at a graft density of 0.6 chains/nm2 resulting a film with 1 vol % SiO2. Films of 267 kg/mol PS were also flow coated and both films were impacted at velocities 350-700 ms-1 using 3.7 micron SiO2\\ projectiles to achieve increments in kinetic energy (KE) of 1:2:4. The KE of the projectiles before and after penetration was measured to determine the penetration energy. TEM and SEM suggest the projectile initially induces plastic flow due to the adiabatic temperature rise from impact. As the projectile deforms the film, the lower magnitude, biaxial stress state in the peripherial regions causes material microvoid formation and initiation of craze growth in the radial and tangential directions. The anchoring of the grafted polymer chains to the NPs increases the penetration energy relative to the pure homopolymer by 50% and the films capacity to delocalize the impact by 200%. These results suggest that highly grafted NP films may be useful in lightweight protection systems. In collaboration with Omri Fried, Olawale Lawal, Yang Jiao, Victor Hsaio, Thevamaran Ramathasan, Mujin Zhou, Richard Vaia.

  8. The status of low dose rate and future of high dose rate Cf-252 brachytherapy

    International Nuclear Information System (INIS)

    Rivard, M.J.; Wierzbicki, J.G.; Van den Heuvel, F.; Chuba, P.J.; Fontanesi, J.

    1997-12-01

    This work describes the current status of the US low dose rate (LDR) Cf-252 brachytherapy program. The efforts undertaken towards development of a high dose rate (HDR) remotely after loaded Cf-252 source, which can accommodate 1 mg or greater Cf-252, are also described. This HDR effort is a collaboration between Oak Ridge National Laboratory (ORNL), commercial remote after loader manufactures, the Gershenson Radiation Oncology Center (ROC), and Wayne State University. To achieve this goal, several advances in isotope chemistry and source preparation at ORNL must be achieved to yield a specific material source loading of greater than or equal 1 mg Cf-252 per mm3. Development work with both radioactive and non-radioactive stand-ins for Cf-252 have indicated the feasibility of fabricating such sources. As a result, the decreased catheter diameter and computer controlled source placement will permit additional sites (e.g. brain, breast, prostate, lung, parotid, etc.) to be treated effectively with Cf-252 sources. Additional work at the Radiochemical Engineering and Development Center (REDC) remains in source fabrication, after loader modification, and safe design. The current LDR Cf-252 Treatment Suite at the ROC is shielded and licensed to hold up to 1 mg of Cf-252. This was designed to maintain cumulative personnel exposure, both external to the room and in direct isotope handling, at less than 20 microSv/hr. However, cumulative exposure may be greatly decreased if a Cf-252 HDR unit is employed which would eliminate direct isotope handling and decrease treatment times from tilde 3 hours to an expected range of 3 to 15 minutes. Such a Cf-252 HDR source will also demonstrate improved dose distributions over current LDR treatments due to the ability to step the point-like source throughout the target volume and weight the dwell time accordingly

  9. Tumor relapse present in oncologic nasal repair

    International Nuclear Information System (INIS)

    Galvez Chavez, Julio Cesar; Sanchez Wals, Lenia; Monzon Fernandez, Abel Nicolas; Morales Tirado, Roxana

    2009-01-01

    Tumor relapse is one of the more fearsome complications of the oncologic course and also to obscure the life prognosis, causing the loss of many reconstructions and of exhausting the repairing surgical possibilities. The aim of this study was to determine the relapse frequency, the repercussion on the repair and the subsequent medical course of patients operated on malign nasal tumors

  10. Yield strength of molybdenum, tantalum and tungsten at high strain rates and very high temperatures

    International Nuclear Information System (INIS)

    Škoro, G.P.; Bennett, J.R.J.; Edgecock, T.R.; Booth, C.N.

    2012-01-01

    Highlights: ► New experimental data on the yield strength of molybdenum, tantalum and tungsten. ► High strain rate effects at record high temperatures (up to 2700 K). ► Test of the consistency of the Zerilli–Armstrong model at very high temperatures. - Abstract: Recently reported results of the high strain rate, high temperature measurements of the yield strength of tantalum and tungsten have been analyzed along with new experimental results on the yield strength of molybdenum. Thin wires are subjected to high stress by passing a short, fast, high current pulse through a thin wire; the amplitude of the current governs the stress and the repetition rate of the pulses determines the temperature of the wire. The highest temperatures reached in the experiments were 2100 °C (for molybdenum), 2250 °C (for tantalum) and 2450 °C (for tungsten). The strain-rates in the tests were in the range from 500 to 1500 s −1 . The parameters for the constitutive equation developed by Zerilli and Armstrong have been determined from the experimental data and the results have been compared with the data obtained at lower temperatures. An exceptionally good fit is obtained for the deformation of tungsten.

  11. Growth rate of sheep fed high fat ration

    Directory of Open Access Journals (Sweden)

    Darwinsyah Lubis

    1998-10-01

    Full Text Available Incorporating high amount of fats into the ration for ruminants will affect the rumen microbes adversely and will reducefiber digestion potential. To correct such negative effects, the free fatty acids used for feed should be bond with Ca++, so it canpassing through the rumen savely (rumen by-pass fat. To test the Ca-fat utilization biologically, 20 growing male Garut shee pwere used and fed with 4 type of isocaloric-isoprotein concentrate feed which were allotted based on a randomized block desig nwith 5 replications. The concentrate (C-A was a positive control diet, while C-B was substituted with 10% free fatty acids (negative control, C-C was substituted with 10% Ca-fat, and C-D with 15% Ca-fat. The concentrate feed was fed at 500 g/d, while forage (King grass was 4 kg/d. Results of the experiment showed that the negative effect of free fatty acids can be corrected if it was given in the form of Ca-fat. Growth rate curve indicating a good growing pattern, with average daily gain was 100.18, 87.68, 112.86, and 115.00 g/d (P0.05. Carcass production was relatively good, where for C-A, C-B, C-C, and C-D were 14.84, 14.68, 16.34, and 15.72 kg (P<0.05 respectively, with final live weights of 34.00, 31.74, 34.58, and 34.30 kg (P<0.05. It can be concluded that Ca-fat (rumen by-pass fat can be used as an energy source component for growing sheep diet, and give the best result at 10% substitution rate in concentrate feed.

  12. Urethral stricture following high dose rate brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Sullivan, Lisa; Williams, Scott G.; Tai, Keen Hun; Foroudi, Farshad; Cleeve, L.; Duchesne, Gillian M.

    2009-01-01

    Purpose: To evaluate the incidence, timing, nature and outcome of urethral strictures following high dose rate brachytherapy (HDRB) for prostate carcinoma. Methods and materials: Data from 474 patients with clinically localised prostate cancer treated with HDRB were analysed. Ninety percent received HDRB as a boost to external beam radiotherapy (HDRBB) and the remainder as monotherapy (HDRBM). Urethral strictures were graded according to the Common Terminology Criteria for Adverse Events v3.0. Results: At a median follow-up of 41 months, 38 patients (8%) were diagnosed with a urethral stricture (6-year actuarial risk 12%). Stricture location was bulbo-membranous (BM) urethra in 92.1%. The overall actuarial rate of grade 2 or more BM urethral stricture was estimated at 10.8% (95% CI 7.0-14.9%), with a median time to diagnosis of 22 months (range 10-68 months). All strictures were initially managed with either dilatation (n = 15) or optical urethrotomy (n = 20). Second line therapy was required in 17 cases (49%), third line in three cases (9%) and 1 patient open urethroplasty (grade 3 toxicity). Predictive factors on multivariate analysis were prior trans-urethral resection of prostate (hazard ratio (HR) 2.81, 95% CI 1.15-6.85, p = 0.023); hypertension (HR 2.83, 95% CI 1.37-5.85, p = 0.005); and dose per fraction used in HDR (HR for 1 Gy increase per fraction 1.33, 95% CI 1.08-1.64, p = 0.008). Conclusions: BM urethral strictures are the most common late grade 2 or more urinary toxicity following HDR brachytherapy for prostate cancer. Most are manageable with minimally invasive procedures. Both clinical and dosimetric factors appear to influence the risk of stricture formation.

  13. Sarcocystis nesbitti causes acute, relapsing febrile myositis with a high attack rate: description of a large outbreak of muscular sarcocystosis in Pangkor Island, Malaysia, 2012.

    OpenAIRE

    Claire M Italiano; Kum Thong Wong; Sazaly AbuBakar; Yee Ling Lau; Norlisah Ramli; Sharifah Faridah Syed Omar; Maria Kahar Bador; Chong Tin Tan

    2014-01-01

    BACKGROUND: From the 17th to 19th January 2012, a group of 92 college students and teachers attended a retreat in a hotel located on Pangkor Island, off the west coast of Peninsular Malaysia. Following the onset of symptoms in many participants who presented to our institute, an investigation was undertaken which ultimately identified Sarcocystis nesbitti as the cause of this outbreak. METHODOLOGY/PRINCIPAL FINDINGS: All retreat participants were identified, and clinical and epidemiological i...

  14. High rate of non-response and relapse associated with peginterferon-alfa monotherapy for the treatment of acute hepatitis C in HIV-infected patients

    NARCIS (Netherlands)

    Arends, J.E.; Van Assen, S.; Wensing, A.J.; Stek, C.; Mudrikova, T.; Van Baarle, D.; Sprenger, H.G.; Hoepelman, A.

    2010-01-01

    Background: The incidence of acute hepatitis C virus infection (HCV) in patients infected with human immunodeficiency virus (HIV) is rising. Because of low patient numbers and a wide variety of inclusion criteria between studies, the optimal treatment regimen is under debate. We advocated

  15. High dose rate brachytherapy for superficial cancer of the esophagus

    International Nuclear Information System (INIS)

    Maingon, Philippe; D'Hombres, Anne; Truc, Gilles; Barillot, Isabelle; Michiels, Christophe; Bedenne, Laurent; Horiot, Jean Claude

    2000-01-01

    Purpose: We analyzed our experience with external radiotherapy, combined modality treatment, or HDR brachytherapy alone to limited esophageal cancers. Methods and Materials: From 1991 to 1996, 25 patients with limited superficial esophagus carcinomas were treated by high dose rate brachytherapy. The mean age was 63 years (43-86 years). Five patients showed superficial local recurrence after external radiotherapy. Eleven patients without invasion of the basal membrane were staged as Tis. Fourteen patients with tumors involving the submucosa without spreading to the muscle were staged as T1. Treatment consisted of HDR brachytherapy alone in 13 patients, external radiotherapy and brachytherapy in 8 cases, and concomitant chemo- and radiotherapy in 4 cases. External beam radiation was administered to a total dose of 50 Gy using 2 Gy daily fractions in 5 weeks. In cases of HDR brachytherapy alone (13 patients), 6 applications were performed once a week. Results: The mean follow-up is 31 months (range 24-96 months). Twelve patients received 2 applications and 13 patients received 6 applications. Twelve patients experienced a failure (48%), 11/12 located in the esophagus, all of them in the treated volume. One patient presented an isolated distant metastasis. In the patients treated for superficial recurrence, 4/5 were locally controlled (80%) by brachytherapy alone. After brachytherapy alone, 8/13 patients were controlled (61%). The mean disease-free survival is 14 months (1-36 months). Overall survival is 76% at 1 year, 37% at 2 years, and 14% at 3 years. Overall survival for Tis patients is 24% vs. 20% for T1 (p 0.83). Overall survival for patients treated by HDR brachytherapy alone is 43%. One patient presented with a fistula with local failure after external radiotherapy and brachytherapy. Four stenosis were registered, two were diagnosed on barium swallowing without symptoms, and two required dilatations. Conclusion: High dose rate brachytherapy permits the treating

  16. Predicting Relapse among Young Adults: Psychometric Validation of the Advanced Warning of Relapse (AWARE) Scale

    Science.gov (United States)

    Kelly, John F.; Hoeppner, Bettina B.; Urbanoski, Karen A.; Slaymaker, Valerie

    2011-01-01

    Objective Failure to maintain abstinence despite incurring severe harm is perhaps the key defining feature of addiction. Relapse prevention strategies have been developed to attenuate this propensity to relapse, but predicting who will, and who will not, relapse has stymied attempts to more efficiently tailor treatments according to relapse risk profile. Here we examine the psychometric properties of a promising relapse risk measure - the Advance WArning of RElapse scale (AWARE) scale (Miller and Harris, 2000) in an understudied but clinically important sample of young adults. Method Inpatient youth (N=303; Age 18-24; 26% female) completed the AWARE scale and the Brief Symptom Inventory-18 (BSI) at the end of residential treatment, and at 1-, 3-, and 6-months following discharge. Internal and convergent validity was tested for each of these four timepoints using confirmatory factor analysis and correlations (with BSI scores). Predictive validity was tested for relapse 1, 3, and 6 months following discharge, as was incremental utility, where AWARE scores were used as predictors of any substance use while controlling for treatment entry substance use severity and having spent time in a controlled environment following treatment. Results Confirmatory factor analysis revealed a single, internally consistent, 25-item factor that demonstrated convergent validity and predicted subsequent relapse alone and when controlling for other important relapse risk predictors. Conclusions The AWARE scale may be a useful and efficient clinical tool for assessing short-term relapse risk among young people and, thus, could serve to enhance the effectiveness of relapse prevention efforts. PMID:21700396

  17. Predicting relapse among young adults: psychometric validation of the Advanced WArning of RElapse (AWARE) scale.

    Science.gov (United States)

    Kelly, John F; Hoeppner, Bettina B; Urbanoski, Karen A; Slaymaker, Valerie

    2011-10-01

    Failure to maintain abstinence despite incurring severe harm is perhaps the key defining feature of addiction. Relapse prevention strategies have been developed to attenuate this propensity to relapse, but predicting who will, and who will not, relapse has stymied attempts to more efficiently tailor treatments according to relapse risk profile. Here we examine the psychometric properties of a promising relapse risk measure-the Advance WArning of RElapse (AWARE) scale (Miller & Harris, 2000) in an understudied but clinically important sample of young adults. Inpatient youth (N=303; Ages 18-24; 26% female) completed the AWARE scale and the Brief Symptom Inventory-18 (BSI) at the end of residential treatment, and at 1-, 3-, and 6-months following discharge. Internal and convergent validity was tested for each of these four timepoints using confirmatory factor analysis and correlations (with BSI scores). Predictive validity was tested for relapse 1, 3, and 6 months following discharge, as was incremental utility, where AWARE scores were used as predictors of any substance use while controlling for treatment entry substance use severity and having spent time in a controlled environment following treatment. Confirmatory factor analysis revealed a single, internally consistent, 25-item factor that demonstrated convergent validity and predicted subsequent relapse alone and when controlling for other important relapse risk predictors. The AWARE scale may be a useful and efficient clinical tool for assessing short-term relapse risk among young people and, thus, could serve to enhance the effectiveness of relapse prevention efforts. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. High-dose-rate brachytherapy in uterine cervical carcinoma

    International Nuclear Information System (INIS)

    Patel, Firuza D.; Rai, Bhavana; Mallick, Indranil; Sharma, Suresh C.

    2005-01-01

    Purpose: High-dose-rate (HDR) brachytherapy is in wide use for curative treatment of cervical cancer. The American Brachytherapy Society has recommended that the individual fraction size be <7.5 Gy and the range of fractions should be four to eight; however, many fractionation schedules, varying from institution to institution, are in use. We use 9 Gy/fraction of HDR in two to five fractions in patients with carcinoma of the uterine cervix. We found that our results and toxicity were comparable to those reported in the literature and hereby present our experience with this fractionation schedule. Methods and Materials: A total of 121 patients with Stage I-III carcinoma of the uterine cervix were treated with HDR brachytherapy between 1996 and 2000. The total number of patients analyzed was 113. The median patient age was 53 years, and the histopathologic type was squamous cell carcinoma in 93% of patients. The patients were subdivided into Groups 1 and 2. In Group 1, 18 patients with Stage Ib-IIb disease, tumor size <4 cm, and preserved cervical anatomy underwent simultaneous external beam radiotherapy to the pelvis to a dose of 40 Gy in 20 fractions within 4 weeks with central shielding and HDR brachytherapy of 9 Gy/fraction, given weekly, and interdigitated with external beam radiotherapy. The 95 patients in Group 2, who had Stage IIb-IIIb disease underwent external beam radiotherapy to the pelvis to a dose of 46 Gy in 23 fractions within 4.5 weeks followed by two sessions of HDR intracavitary brachytherapy of 9 Gy each given 1 week apart. The follow-up range was 3-7 years (median, 36.4 months). Late toxicity was graded according to the Radiation Therapy Oncology Group criteria. Results: The 5-year actuarial local control and disease-free survival rate was 74.5% and 62.0%, respectively. The actuarial local control rate at 5 years was 100% for Stage I, 80% for Stage II, and 67.2% for Stage III patients. The 5-year actuarial disease-free survival rate was 88.8% for

  19. Managing Clutter in a High Pulse Rate Echolocation System

    Directory of Open Access Journals (Sweden)

    Jacob Isbell

    2018-03-01

    Full Text Available The use of echolocation for navigating in dense, cluttered environments is a challenge due to the need for rapid sampling of nearby objects in the face of delayed echoes from distant objects. In the wild, echolocating bats frequently encounter this situation when leaving the roost or while hunting. If long-delay echoes from a distant object are received after the next pulse is sent out, these “aliased” echoes appear as close-range phantom objects. Little is known about how bats cope with these situations. In this work, we demonstrate a novel strategy to manage aliasing in cases where a single target is actively being tracked at close range. This paper presents three reactive strategies for a high pulse-rate sonar system to combat aliased echoes: (1 changing the interpulse interval to move the aliased echoes away in time from the tracked target, (2 changing positions to create a geometry without aliasing, and (3 a phase-based, transmission beam-shaping strategy to illuminate the target and not the aliasing object.

  20. Pregnancy after kidney transplantation: high rates of maternal complications

    Directory of Open Access Journals (Sweden)

    Cristina Candido

    Full Text Available Abstract Introduction: Women regain fertility a few time after renal transplantation. However, viability of pregnancy and maternal complications are still unclear. Objective: To describe the outcomes of pregnancies in kidney transplanted patients, focusing on maternal complications. Methods: Retrospective study of pregnancies in kidney transplanted patients between 2004 and 2014, followed up 12 months after delivery. Each pregnancy was considered an event. Results: There were 53 pregnancies in 36 patients. Mean age was 28 ± 5years. Pregnancy occurred 4.4 ± 3.0 years post-transplant. Immunosuppression before conception was tacrolimus, azathioprine, and prednisone in 74% of the cases. There were 15% miscarriages in the 1st trimester and 8% in 2nd trimester. In 41% of the cases, it was necessary to induce labor. From all births, 22% were premature and 17% very premature. There were 5% stillbirths and 5% of neonatal deaths. De novo proteinuria occurred in 60%, urinary tract infection in 23%, preeclampsia in 11%, acute rejection in 6%, and graft loss in 2% of the cases. It was observed a significant increase in creatinine at preconception comparing to 3rd trimester and follow-up (1.17 vs. 1.46 vs. 1.59 mg/dL, p < 0.001. Conclusion: Although the sample is limited, the number of miscarriages was higher than in the general population, with high rates of maternal complications. Sustained increase of creatinine suggests increased risk of graft loss in long-term.

  1. MATHEMATICAL MODELING OF HEATING RATE PRODUCT AT HIGH HEAT TREATMENT

    Directory of Open Access Journals (Sweden)

    M. M. Akhmedova

    2014-01-01

    Full Text Available Methods of computing and mathematical modeling are all widely used in the study of various heat exchange processes that provide the ability to study the dynamics of the processes, as well as to conduct a reasonable search for the optimal technological parameters of heat treatment.This work is devoted to the identification of correlations among the factors that have the greatest effect on the rate of heating of the product at hightemperature heat sterilization in a stream of hot air, which are chosen as the temperature difference (between the most and least warming up points and speed cans during heat sterilization.As a result of the experimental data warming of the central and peripheral layers compote of apples in a 3 liter pot at high-temperature heat treatment in a stream of hot air obtained by the regression equation in the form of a seconddegree polynomial, taking into account the effects of pair interaction of these parameters. 

  2. A high rate clarifier for load levelling in sewerage systems.

    Science.gov (United States)

    Jago, R A; Davey, A; Li, H

    2003-01-01

    The combining of chemically assisted clarification with a proprietary physical separation technology has led to a high rate process for clarifying flocculated sewage and other waste streams. This hybrid physico-chemical system, known as the CDS Fine Solids Separation (FSS) System, was developed over a two year period within a sewage treatment plant environment. This paper summarises the results of a recent field trial of the system with a Victorian water authority which experiences heavy loading of sewers in a coastal town during holiday periods. The trial sought to evaluate the FSS as a tool for smoothing the load on the 11 km long sewer to the sewage treatment plant (STP). The FSS system could possibly enable the costly augmentation of the sewer to be deferred, particularly as the capacity of the existing sewer pipe is satisfactory for most of the year. Water quality parameters were determined for a range of flowrates and operational conditions over a two month period. Large reductions were achieved in TSS, TP, FC, turbidity and BOD5, with only minimal reductions in NH3 and TON. These results showed that the FSS could meet the authority's objectives for load levelling and would provide a 20-25% increase in effective sewer capacity. The data are also discussed in terms of possible use of the effluent from the FSS for water reuse applications.

  3. High rate composting of herbal pharmaceutical industry solid waste.

    Science.gov (United States)

    Ali, M; Duba, K S; Kalamdhad, A S; Bhatia, A; Khursheed, A; Kazmi, A A; Ahmed, N

    2012-01-01

    High rate composting studies of hard to degrade herbal wastes were conducted in a 3.5 m(3) capacity rotary drum composter. Studies were spread out in four trials: In trial 1 and 2, one and two turns per day rotation was observed, respectively, by mixing of herbal industry waste with cattle (buffalo) manure at a ratio of 3:1 on wet weight basis. In trial 3 inocula was added in raw waste to enhance the degradation and in trial 4 composting of a mixture of vegetable market waste and herbal waste was conducted at one turn per day. Results demonstrated that the operation of the rotary drum at one turn a day (trial 1) could provide the most conducive composting conditions and co-composting (trial 4) gave better quality compost in terms of temperature, moisture, nitrogen, and Solvita maturity index. In addition a FT-IR study also revealed that trial 1 and trial 4 gave quality compost in terms of stability and maturity due to the presence of more intense peaks in the aromatic region and less intense peaks were found in the aliphatic region compared with trial 2 and trial 3.

  4. High rate of destruction of molecular clouds by hot stars

    International Nuclear Information System (INIS)

    Heydari-Malayeri, M.; Lortet, M.C.; Deharveng, L.

    1980-01-01

    Tenorio-Tagle (1979) first proposed the idea of a third dynamical phase, the champagne phase, following the formation and expansion phases of an HII region. The champagne phase begins when the high pressure gas of an HII region formed inside a molecular cloud reaches the edge of the cloud and bursts into the lower pressure, low density, intercloud medium. One important implication of the model is the prediction of an enormous enhancement of the rate of erosion of the molecular cloud by the ionising radiation of hot stars, which begins as soon as the process of the decrease of the gas density between the star and the cloud is started. The proportion of hydrogen molecules eroded by ionising photons may reach about 10 -2 . The mass eroded may exceed the mass of the ionised gas in the case where the ionisation front reaching the edge of the cloud is of D-type. Additional mechanisms (for instance stellar winds), if at work, may even increase the efficiency of the mechanism. (Auth.)

  5. CMOS pixel sensors on high resistive substrate for high-rate, high-radiation environments

    Energy Technology Data Exchange (ETDEWEB)

    Hirono, Toko, E-mail: thirono@uni-bonn.de [Physikalisches Institute der Universität Bonn, Bonn (Germany); Barbero, Marlon; Breugnon, Patrick; Godiot, Stephanie [CPPM, Aix-Marseille Universite, CNRS/IN2P3, Marseille (France); Gonella, Laura; Hemperek, Tomasz; Hügging, Fabian; Krüger, Hans [Physikalisches Institute der Universität Bonn, Bonn (Germany); Liu, Jian; Pangaud, Patrick [CPPM, Aix-Marseille Universite, CNRS/IN2P3, Marseille (France); Peric, Ivan [IPE, Karlsruher Institut für Technologie, Karlsruhe (Germany); Pohl, David-Leon [Physikalisches Institute der Universität Bonn, Bonn (Germany); Rozanov, Alexandre [CPPM, Aix-Marseille Universite, CNRS/IN2P3, Marseille (France); Rymaszewski, Piotr [Physikalisches Institute der Universität Bonn, Bonn (Germany); Wang, Anqing [CPPM, Aix-Marseille Universite, CNRS/IN2P3, Marseille (France); Wermes, Norbert [Physikalisches Institute der Universität Bonn, Bonn (Germany)

    2016-09-21

    A depleted CMOS active pixel sensor (DMAPS) has been developed on a substrate with high resistivity in a high voltage process. High radiation tolerance and high time resolution can be expected because of the charge collection by drift. A prototype of DMAPS was fabricated in a 150 nm process by LFoundry. Two variants of the pixel layout were tested, and the measured depletion depths of the variants are 166 μm and 80 μm. We report the results obtained with the prototype fabricated in this technology.

  6. Solid State Track Recorder fission rate measurements at high neutron fluence and high temperature

    International Nuclear Information System (INIS)

    Ruddy, F.H.; Roberts, J.H.; Gold, R.

    1985-01-01

    Solid State Track Recorder (SSTR) techniques have been used to measure 239-Pu, 235-U, and 237-Np fission rates for total neutron fluences approaching 5 x 10 17 n/cm 2 at temperatures in the range 680 to 830 0 F. Natural quartz crystal SSTRs were used to withstand the high temperature environment and ultra low-mass fissionable deposits of the three isotopes were required to yield scannable track densities at the high neutron fluences. The results of these high temperature, high neutron fluence measurements are reported

  7. High mutation rates limit evolutionary adaptation in Escherichia coli.

    Directory of Open Access Journals (Sweden)

    Kathleen Sprouffske

    2018-04-01

    Full Text Available Mutation is fundamental to evolution, because it generates the genetic variation on which selection can act. In nature, genetic changes often increase the mutation rate in systems that range from viruses and bacteria to human tumors. Such an increase promotes the accumulation of frequent deleterious or neutral alleles, but it can also increase the chances that a population acquires rare beneficial alleles. Here, we study how up to 100-fold increases in Escherichia coli's genomic mutation rate affect adaptive evolution. To do so, we evolved multiple replicate populations of asexual E. coli strains engineered to have four different mutation rates for 3000 generations in the laboratory. We measured the ability of evolved populations to grow in their original environment and in more than 90 novel chemical environments. In addition, we subjected the populations to whole genome population sequencing. Although populations with higher mutation rates accumulated greater genetic diversity, this diversity conveyed benefits only for modestly increased mutation rates, where populations adapted faster and also thrived better than their ancestors in some novel environments. In contrast, some populations at the highest mutation rates showed reduced adaptation during evolution, and failed to thrive in all of the 90 alternative environments. In addition, they experienced a dramatic decrease in mutation rate. Our work demonstrates that the mutation rate changes the global balance between deleterious and beneficial mutational effects on fitness. In contrast to most theoretical models, our experiments suggest that this tipping point already occurs at the modest mutation rates that are found in the wild.

  8. States with low non-fatal injury rates have high fatality rates and vice-versa.

    Science.gov (United States)

    Mendeloff, John; Burns, Rachel

    2013-05-01

    State-level injury rates or fatality rates are sometimes used in studies of the impact of various safety programs or other state policies. How much does the metric used affect the view of relative occupational risks among U.S. states? This paper uses a measure of severe injuries (fatalities) and of less severe injuries (non-fatal injuries with days away from work, restricted work, or job transfer-DART) to examine that issue. We looked at the correlation between the average DART injury rate (from the BLS Survey of Occupational Injuries and Illnesses) and an adjusted average fatality rate (from the BLS Census of Fatal Occupational Injuries) in the construction sector for states for 2003-2005 and for 2006-2008. The RAND Human Subjects Protection Committee determined that this study was exempt from review. The correlations between the fatal and non-fatal injury rates were between -0.30 and -0.70 for all construction and for the subsector of special trade contractors. The negative correlation was much smaller between the rate of fatal falls from heights and the rate of non-fatal falls from heights. Adjusting for differences in the industry composition of the construction sector across states had minor effects on these results. Although some have suggested that fatal and non-fatal injury rates should not necessarily be positively correlated, no one has suggested that the correlation is negative, which is what we find. We know that reported non-fatal rates are influenced by workers' compensation benefits and other factors. Fatality rates appear to be a more valid measure of risk. Efforts to explain the variations that we find should be undertaken. Copyright © 2012 Wiley Periodicals, Inc.

  9. Performance of Drift-Tube Detectors at High Counting Rates for High-Luminosity LHC Upgrades

    CERN Document Server

    Bittner, Bernhard; Kortner, Oliver; Kroha, Hubert; Manfredini, Alessandro; Nowak, Sebastian; Ott, Sebastian; Richter, Robert; Schwegler, Philipp; Zanzi, Daniele; Biebel, Otmar; Hertenberger, Ralf; Ruschke, Alexander; Zibell, Andre

    2016-01-01

    The performance of pressurized drift-tube detectors at very high background rates has been studied at the Gamma Irradiation Facility (GIF) at CERN and in an intense 20 MeV proton beam at the Munich Van-der-Graaf tandem accelerator for applications in large-area precision muon tracking at high-luminosity upgrades of the Large Hadron Collider (LHC). The ATLAS muon drifttube (MDT) chambers with 30 mm tube diameter have been designed to cope with and neutron background hit rates of up to 500 Hz/square cm. Background rates of up to 14 kHz/square cm are expected at LHC upgrades. The test results with standard MDT readout electronics show that the reduction of the drift-tube diameter to 15 mm, while leaving the operating parameters unchanged, vastly increases the rate capability well beyond the requirements. The development of new small-diameter muon drift-tube (sMDT) chambers for LHC upgrades is completed. Further improvements of tracking e?ciency and spatial resolution at high counting rates will be achieved with ...

  10. Solid state pump lasers with high power and high repetition rate

    International Nuclear Information System (INIS)

    Oba, Masaki; Kato, Masaaki; Arisawa, Takashi

    1995-01-01

    We built a laser diode pumped solid state green laser (LDPSSGL) rated at high repetition rate. Two laser heads are placed in one cavity with a rotator in between to design to avoid thermal lensing and thermal birefringence effect. Although average green laser power higher than 10 W was obtained at 1 kHz repetition rate with pulse width of 20-30 nsec, the beam quality was so much deteriorated that energy efficiency was as low as 2 %. Learning from this experience that high power oscillator causes a lot of thermal distortion not only in the laser rod but also in the Q-switch device, we proceeded to built a oscillator/amplifier system. A low power oscillator has a slab type crystal in the cavity. As a result spatial distribution of laser power was extremely improved. As we expect that the high repetition rate solid state laser should be CW operated Q-switch type laser from the view point of lifetime of diode lasers, a conventional arc lamp pumped CW Q-switch green YAG laser of which the repetition rate is changeable from 1 kHz to 5 kHz and the pulse width is 250-570 nsec was also tested to obtain pumping characteristics of a dye laser as a function of power, pulse width etc., and dye laser pulse width of 100-130 nsec were obtained. (author)

  11. High resolution gamma-ray spectroscopy at high count rates with a prototype High Purity Germanium detector

    Science.gov (United States)

    Cooper, R. J.; Amman, M.; Vetter, K.

    2018-04-01

    High-resolution gamma-ray spectrometers are required for applications in nuclear safeguards, emergency response, and fundamental nuclear physics. To overcome one of the shortcomings of conventional High Purity Germanium (HPGe) detectors, we have developed a prototype device capable of achieving high event throughput and high energy resolution at very high count rates. This device, the design of which we have previously reported on, features a planar HPGe crystal with a reduced-capacitance strip electrode geometry. This design is intended to provide good energy resolution at the short shaping or digital filter times that are required for high rate operation and which are enabled by the fast charge collection afforded by the planar geometry crystal. In this work, we report on the initial performance of the system at count rates up to and including two million counts per second.

  12. Transistor reset preamplifier for high-rate high-resolution spectroscopy

    International Nuclear Information System (INIS)

    Landis, D.A.; Cork, C.P.; Madden, N.W.; Goulding, F.S.

    1981-10-01

    Pulsed transistor reset of high resolution charge sensitive preamplifiers used in cooled semiconductor spectrometers can sometimes have an advantage over pulsed light reset systems. Several versions of transistor reset spectrometers using both silicon and germanium detectors have been built. This paper discusses the advantages of the transistor reset system and illustrates several configurations of the packages used for the FET and reset transistor. It also describes the preamplifer circuit and shows the performance of the spectrometer at high rates

  13. Physics and quality assurance for high dose rate brachytherapy

    International Nuclear Information System (INIS)

    Anderson, Lowell L.

    1995-01-01

    Purpose: To review the physical aspects of high dose rate (HDR) brachytherapy, including commissioning and quality assurance, source calibration and dose distribution measurements, and treatment planning methods. Following the introduction of afterloading in brachytherapy, development efforts to make it 'remote' culminated in 1964 with the near-simultaneous appearance of remote afterloaders in five major medical centers. Four of these machines were 'high dose rate', three employing 60Co and one (the GammaMed) using a single, cable-mounted 192Ir source. Stepping-motor source control was added to the GammaMed in 1974, making it the precursor of modern remote afterloaders, which are now suitable for interstitial as well as intracavitary brachytherapy by virtue of small source-diameter and indexer-accessed multiple channels. Because the 192Ir sources currently used in HDR remote afterloaders are supplied at a nominal air-kerma strength of 11.4 cGy cm2 s-1 (10 Ci), are not collimated in clinical use, and emit a significant fraction (15%) of photons at energies greater than 600 keV, shielding and facility design must be undertaken as carefully and thoroughly as for external beam installations. Licensing requirements of regulatory agencies must be met with respect both to maximum permissible dose limits and to the existence and functionality of safety devices (door interlocks, radiation monitors, etc.). Commissioning and quality assurance procedures that must be documented for HDR remote afterloading relate to (1) machine, applicator, guide-tube, and facility functionality checks, (2) source calibration, (3) emergency response readiness, (4) planning software evaluation, and (5) independent checks of clinical dose calculations. Source calibration checks must be performed locally, either by in-air measurement of air kerma strength or with a well ionization chamber calibrated (by an accredited standards laboratory) against an in-air measurement of air kerma strength for the

  14. Eye on the B-ALL: B-cell receptor repertoires reveal persistence of numerous B-lymphoblastic leukemia subclones from diagnosis to relapse

    Science.gov (United States)

    Bashford-Rogers, R J M; Nicolaou, K A; Bartram, J; Goulden, N J; Loizou, L; Koumas, L; Chi, J; Hubank, M; Kellam, P; Costeas, P A; Vassiliou, G S

    2016-01-01

    The strongest predictor of relapse in B-cell acute lymphoblastic leukemia (B-ALL) is the level of persistence of tumor cells after initial therapy. The high mutation rate of the B-cell receptor (BCR) locus allows high-resolution tracking of the architecture, evolution and clonal dynamics of B-ALL. Using longitudinal BCR repertoire sequencing, we find that the BCR undergoes an unexpectedly high level of clonal diversification in B-ALL cells through both somatic hypermutation and secondary rearrangements, which can be used for tracking the subclonal composition of the disease and detect minimal residual disease with unprecedented sensitivity. We go on to investigate clonal dynamics of B-ALL using BCR phylogenetic analyses of paired diagnosis-relapse samples and find that large numbers of small leukemic subclones present at diagnosis re-emerge at relapse alongside a dominant clone. Our findings suggest that in all informative relapsed patients, the survival of large numbers of clonogenic cells beyond initial chemotherapy is a surrogate for inherent partial chemoresistance or inadequate therapy, providing an increased opportunity for subsequent emergence of fully resistant clones. These results frame early cytoreduction as an important determinant of long-term outcome. PMID:27211266

  15. Is risk of central nervous system (CNS) relapse related to adjuvant taxane treatment in node-positive breast cancer? Results of the CNS substudy in the intergroup Phase III BIG 02-98 Trial

    DEFF Research Database (Denmark)

    Pestalozzi, B.C.; Francis, P.; Quinaux, E.

    2008-01-01

    BACKGROUND: Breast cancer central nervous system (CNS) metastases are an increasingly important problem because of high CNS relapse rates in patients treated with trastuzumab and/or taxanes. PATIENTS AND METHODS: We evaluated data from 2887 node-positive breast cancer patients randomised in the BIG...

  16. High versus low-dose rate brachytherapy for cervical cancer.

    Science.gov (United States)

    Patankar, Sonali S; Tergas, Ana I; Deutsch, Israel; Burke, William M; Hou, June Y; Ananth, Cande V; Huang, Yongmei; Neugut, Alfred I; Hershman, Dawn L; Wright, Jason D

    2015-03-01

    Brachytherapy plays an important role in the treatment of cervical cancer. While small trials have shown comparable survival outcomes between high (HDR) and low-dose rate (LDR) brachytherapy, little data is available in the US. We examined the utilization of HDR brachytherapy and analyzed the impact of type of brachytherapy on survival for cervical cancer. Women with stages IB2-IVA cervical cancer treated with primary (external beam and brachytherapy) radiotherapy between 2003-2011 and recorded in the National Cancer Database (NCDB) were analyzed. Generalized linear mixed models and Cox proportional hazards regression were used to examine predictors of HDR brachytherapy use and the association between HDR use and survival. A total of 10,564 women including 2681 (25.4%) who received LDR and 7883 (74.6%) that received HDR were identified. Use of HDR increased from 50.2% in 2003 to 83.9% in 2011 (Puse of HDR. While patients in the Northeast were more likely to receive HDR therapy, there were no other clinical or socioeconomic characteristics associated with receipt of HDR. In a multivariable Cox model, survival was similar between the HDR and LDR groups (HR=0.93; 95% CI 0.83-1.03). Similar findings were noted in analyses stratified by stage and histology. Kaplan-Meier analyses demonstrated no difference in survival based on type of brachytherapy for stage IIB (P=0.68), IIIB (P=0.17), or IVA (P=0.16) tumors. The use of HDR therapy has increased rapidly. Overall survival is similar for LDR and HDR brachytherapy. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Analysis of audiometric relapse-free survival in patients with immune-mediated hearing loss exclusively treated with corticosteroids.

    Science.gov (United States)

    Mata-Castro, Nieves; García-Chilleron, Raimon; Gavilanes-Plasencia, Javier; Ramírez-Camacho, Rafael; García-Fernández, Alfredo; García-Berrocal, José Ramón

    2017-10-12

    To describe the results in terms of audiometric relapse-free survival and relapse rate in immunomediated hearing loss patients treated exclusively with corticosteroids. Retrospective study of patients with audiometric relapses, monitored from 1995 to 2014, in two centres of the Community of Madrid. We evaluated 31 patients with a mean age of 48.52 years (14.67 SD), of which 61.3% were women. Most hearing loss was fluctuating (48.4%). Only 16.1% of patients had systemic autoimmune disease. There is a moderate positive correlation between the sex variable and the systemic involvement variable (Spearman's correlation coefficient=0.356): specifically, between being female and systemic disease. The relative incidence rate of relapse in the first year was 2.01 relapses/year with a 95% CI (1.32 to 2.92). The mean survival time of the event (audiometric relapse) was 5.25 months (SD 0.756). With multivariate analysis, the only variable that achieved statistical significance was age, with a hazard ratio of 1.032 (95% CI; 1.001-1.063, P=.043). Immune-mediated disease of the inner ear is a chronic disease with relapses. Half of the patients with immunomediated hearing loss treated exclusively with corticosteroids relapse before 6 months of follow-up. In addition, if a patient has not relapsed, they are more likely to relapse as each year passes. Analysis of the of audiometric relapse- free survival will enable the effect of future treatments to be compared and their capacity to reduce the rhythm of relapses. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  18. Do high fetal catecholamine levels affect heart rate variability and ...

    African Journals Online (AJOL)

    Objectives. To deternrine the relationship between Umbilical arterial catecholamine levels and fetal heart rate variability and meconium passage. Study design. A prospective descriptive study was perfonned. Umbilical artery catecholamine levels were measured in 55 newborns and correlated with fetal heart rate before ...

  19. TRP 9904 - Constitutive Behavior of High Strength Multiphase Sheel Steel Under High Strain Rate Deformation

    Energy Technology Data Exchange (ETDEWEB)

    David Matlock; John Speer

    2005-03-31

    The focus of the research project was to systematically assess the strain rate dependence of strengthening mechanisms in new advanced high strength sheet steels. Data were obtained on specially designed and produced Duel Phase and TRIP steels and compared to the properties of automotive steels currently in use.

  20. Long-Term Outcomes and Patterns of Relapse of Early-Stage Extranodal Marginal Zone Lymphoma Treated With Radiation Therapy With Curative Intent

    International Nuclear Information System (INIS)

    Teckie, Sewit; Qi, Shunan; Lovie, Shona; Navarrett, Scott; Hsu, Meier; Noy, Ariela; Portlock, Carol; Yahalom, Joachim

    2015-01-01

    Purpose: To report the long-term outcome and patterns of relapse of a large cohort of marginal zone lymphoma (MZL) patients treated with curative-intent radiation therapy (RT) alone. Patients and Methods: We reviewed the charts of 490 consecutive patients with stage IE or IIE MZL referred between 1992 and 2012 to our institution. Of those, 244 patients (50%) were treated with RT alone. Pathology was confirmed by hematopathologists at our institution. Patient and disease factors were analyzed for association with relapse-free survival (RFS) and overall survival (OS). Results: Median age of the cohort was 59 years, and median follow-up was 5.2 years. Ann Arbor stage was IE in 92%. Most common disease sites were stomach (50%), orbit (18%), non-thyroid head-and-neck (8%), skin (8%), and breast (5%). Median RT dose was 30 Gy. Five-year OS and RFS were 92% and 74%, respectively. Cumulative incidence of disease-specific death was just 1.1% by 5 years. Sixty patients (24%) developed relapse of disease; 10 were in the RT field. Crude rate of transformation to pathologically confirmed large-cell lymphoma was 1.6%. On multivariable analysis, primary disease site (P=.007) was independently associated with RFS, along with age (P=.04), presence of B-symptoms (P=.02), and International Prognostic Index risk group (P=.03). All disease sites except for head-and-neck had worse RFS relative to stomach. Conclusion: Overall and cause-specific survival are high in early-stage extra-nodal MZL treated with curative RT alone. In this large cohort of 244 patients, most patients did not experience relapse of MZL after curative RT; when relapses did occur, the majority were in distant sites. Stomach cases were less likely to relapse than other anatomic sites. Transformation to large-cell lymphoma was rare

  1. Immunotoxin – a new treatment option in patients with relapsed and refractory Hodgkin lymphoma

    Directory of Open Access Journals (Sweden)

    Novakovic Barbara Jezersek

    2015-12-01

    Full Text Available Background. Even though Hodgkin lymphoma is a highly curable disease, some of the patients have either a refractory disease or experience a relapse following a successful primary therapy. Durable responses and remissions in patients with relapsed or refractory disease may be achieved in approximately one-half with salvage chemotherapy followed by high dose chemotherapy (HDT and autologous hematopoietic cell rescue (SCT. On the other hand, patients who relapse after HDT and autologous SCT or those who have failed at least two prior multi-agent chemotherapy regimens and are not candidates for HDT have limited treatment options.

  2. Italian real life experience with ibrutinib: results of a large observational study on 77 relapsed/refractory mantle cell lymphoma.

    Science.gov (United States)

    Broccoli, Alessandro; Casadei, Beatrice; Morigi, Alice; Sottotetti, Federico; Gotti, Manuel; Spina, Michele; Volpetti, Stefano; Ferrero, Simone; Spina, Francesco; Pisani, Francesco; Merli, Michele; Visco, Carlo; Paolini, Rossella; Zilioli, Vittorio Ruggero; Baldini, Luca; Di Renzo, Nicola; Tosi, Patrizia; Cascavilla, Nicola; Molica, Stefano; Ilariucci, Fiorella; Rigolin, Gian Matteo; D'Alò, Francesco; Vanazzi, Anna; Santambrogio, Elisa; Marasca, Roberto; Mastrullo, Lucia; Castellino, Claudia; Desabbata, Giovanni; Scortechini, Ilaria; Trentin, Livio; Morello, Lucia; Argnani, Lisa; Zinzani, Pier Luigi

    2018-05-04

    Although sometimes presenting as an indolent lymphoma, mantle cell lymphoma (MCL) is an aggressive disease, hardly curable with standard chemo-immunotherapy. Current approaches have greatly improved patients' outcomes, nevertheless the disease is still characterized by high relapse rates. Before approval by EMA, Italian patients with relapsed/refractory MCL were granted ibrutinib early access through a Named Patient Program (NPP). An observational, retrospective, multicenter study was conducted. Seventy-seven heavily pretreated patients were enrolled. At the end of therapy there were 14 complete responses and 14 partial responses, leading to an overall response rate of 36.4%. At 40 months overall survival was 37.8% and progression free survival was 30%; disease free survival was 78.6% at 4 years: 11/14 patients are in continuous complete response with a median of 36 months of follow up. Hematological toxicities were manageable, and main extra-hematological toxicities were diarrhea (9.4%) and lung infections (9.0%). Overall, 4 (5.2%) atrial fibrillations and 3 (3.9%) hemorrhagic syndromes occurred. In conclusions, thrombocytopenia, diarrhea and lung infections are the relevant adverse events to be clinically focused on; regarding effectiveness, ibrutinib is confirmed to be a valid option for refractory/relapsed MCL also in a clinical setting mimicking the real world.

  3. Metaplastic carcinoma. Breast. Relapse. Chemotherapy and Radiotherapy

    International Nuclear Information System (INIS)

    Marquez, A.; Terrasa, J.; Garcia, J.M.; Rifa, J.

    1996-01-01

    Metaplastic carcinoma of the breast is a rare tumor. The appearance of unexpected mesenchymal elements within the epithelial tumors is the squamous metaplasia. These tumors have a different clinical behaviour that classical breast carcinoma. We present a case of metaplastic mammary carcinoma with multiple relapses treated with a combination of chemotherapy and radiotherapy. The use of chemotherapy after local treatment has enhanced the relapse-free survival. The combined treatment modality seems to produce some benefit in the management of the local relapses of this neoplasms

  4. High mutation rates limit evolutionary adaptation in Escherichia coli

    Science.gov (United States)

    Wagner, Andreas

    2018-01-01

    Mutation is fundamental to evolution, because it generates the genetic variation on which selection can act. In nature, genetic changes often increase the mutation rate in systems that range from viruses and bacteria to human tumors. Such an increase promotes the accumulation of frequent deleterious or neutral alleles, but it can also increase the chances that a population acquires rare beneficial alleles. Here, we study how up to 100-fold increases in Escherichia coli’s genomic mutation rate affect adaptive evolution. To do so, we evolved multiple replicate populations of asexual E. coli strains engineered to have four different mutation rates for 3000 generations in the laboratory. We measured the ability of evolved populations to grow in their original environment and in more than 90 novel chemical environments. In addition, we subjected the populations to whole genome population sequencing. Although populations with higher mutation rates accumulated greater genetic diversity, this diversity conveyed benefits only for modestly increased mutation rates, where populations adapted faster and also thrived better than their ancestors in some novel environments. In contrast, some populations at the highest mutation rates showed reduced adaptation during evolution, and failed to thrive in all of the 90 alternative environments. In addition, they experienced a dramatic decrease in mutation rate. Our work demonstrates that the mutation rate changes the global balance between deleterious and beneficial mutational effects on fitness. In contrast to most theoretical models, our experiments suggest that this tipping point already occurs at the modest mutation rates that are found in the wild. PMID:29702649

  5. Accelerated Total Lymphoid Irradiation-containing Salvage Regimen for Patients With Refractory and Relapsed Hodgkin Lymphoma: 20 Years of Experience

    Energy Technology Data Exchange (ETDEWEB)

    Rimner, Andreas; Lovie, Shona [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Hsu, Meier [Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Chelius, Monica [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Zhang, Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Chau, Karen [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Moskowitz, Alison J.; Matasar, Matthew; Moskowitz, Craig H. [Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Yahalom, Joachim, E-mail: yahalomj@mskcc.org [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States)

    2017-04-01

    Purpose: We report the long-term results of integrated accelerated involved field radiation therapy (IFRT) followed by total lymphoid irradiation (TLI) as part of the high-dose salvage regimen followed by autologous bone marrow transplantation or autologous stem cell transplantation in patients with relapsed or refractory Hodgkin lymphoma (HL). Methods and Materials: From November 1985 to July 2008, 186 previously unirradiated patients with relapsed or refractory HL underwent salvage therapy on 4 consecutive institutional review board–approved protocols. All patients had biopsy-proven primary refractory or relapsed HL. After standard-dose salvage chemotherapy (SC), accelerated IFRT (18-20 Gy) was given to relapsed or refractory sites, followed by TLI (15-18 Gy) and high-dose chemotherapy. Overall survival (OS) and event-free survival (EFS) were analyzed by Cox analysis and disease-specific survival (DSS) by competing-risk regression. Results: With a median follow-up period of 57 months among survivors, 5- and 10-year OS rates were 68% and 56%, respectively; 5- and 10-year EFS rates were 62% and 56%, respectively; and 5- and 10-year cumulative incidences of HL-related deaths were 21% and 29%, respectively. On multivariate analysis, complete response to SC was independently associated with improved OS and EFS. Primary refractory disease and extranodal disease were independently associated with poor DSS. Eight patients had grade 3 or higher cardiac toxicity, with 3 deaths. Second malignancies developed in 10 patients, 5 of whom died. Conclusions: Accelerated IFRT followed by TLI and high-dose chemotherapy is an effective, feasible, and safe salvage strategy for patients with relapsed or refractory HL with excellent long-term OS, EFS, and DSS. Complete response to SC is the most important prognostic factor.

  6. Accelerated Total Lymphoid Irradiation-containing Salvage Regimen for Patients With Refractory and Relapsed Hodgkin Lymphoma: 20 Years of Experience

    International Nuclear Information System (INIS)

    Rimner, Andreas; Lovie, Shona; Hsu, Meier; Chelius, Monica; Zhang, Zhigang; Chau, Karen; Moskowitz, Alison J.; Matasar, Matthew; Moskowitz, Craig H.; Yahalom, Joachim

    2017-01-01

    Purpose: We report the long-term results of integrated accelerated involved field radiation therapy (IFRT) followed by total lymphoid irradiation (TLI) as part of the high-dose salvage regimen followed by autologous bone marrow transplantation or autologous stem cell transplantation in patients with relapsed or refractory Hodgkin lymphoma (HL). Methods and Materials: From November 1985 to July 2008, 186 previously unirradiated patients with relapsed or refractory HL underwent salvage therapy on 4 consecutive institutional review board–approved protocols. All patients had biopsy-proven primary refractory or relapsed HL. After standard-dose salvage chemotherapy (SC), accelerated IFRT (18-20 Gy) was given to relapsed or refractory sites, followed by TLI (15-18 Gy) and high-dose chemotherapy. Overall survival (OS) and event-free survival (EFS) were analyzed by Cox analysis and disease-specific survival (DSS) by competing-risk regression. Results: With a median follow-up period of 57 months among survivors, 5- and 10-year OS rates were 68% and 56%, respectively; 5- and 10-year EFS rates were 62% and 56%, respectively; and 5- and 10-year cumulative incidences of HL-related deaths were 21% and 29%, respectively. On multivariate analysis, complete response to SC was independently associated with improved OS and EFS. Primary refractory disease and extranodal disease were independently associated with poor DSS. Eight patients had grade 3 or higher cardiac toxicity, with 3 deaths. Second malignancies developed in 10 patients, 5 of whom died. Conclusions: Accelerated IFRT followed by TLI and high-dose chemotherapy is an effective, feasible, and safe salvage strategy for patients with relapsed or refractory HL with excellent long-term OS, EFS, and DSS. Complete response to SC is the most important prognostic factor.

  7. High-Pressure Burning Rate Studies of Solid Rocket Propellants

    Science.gov (United States)

    2013-01-01

    monopropellant burning rate. The self-de§agration rates of neat AP are plotted in Fig. 2 for both pressed pellets and single crystals. There is agreement...rate data from various investigators: 1 ¡ [2]; pressed pellets : 2 ¡ [3], 3 ¡ [4], and 4 ¡ [2]; and single crystals: 5 ¡ [5], and 6 ¡ [6]. Line ¡ AP...7]. Strand or window burners have had more use in the solid propellant community. There are numerous types and styles of combustion vessels, but they

  8. Mechanical characterization of alloys in extreme conditions of high strain rates and high temperature

    Science.gov (United States)

    Cadoni, Ezio

    2018-03-01

    The aim of this paper is the description of the mechanical characterization of alloys under extreme conditions of temperature and loading. In fact, in the frame of the Cost Action CA15102 “Solutions for Critical Raw Materials Under Extreme Conditions (CRM-EXTREME)” this aspect is crucial and many industrial applications have to consider the dynamic response of materials. Indeed, for a reduction and substitution of CRMs in alloys is necessary to design the materials and understand if the new materials behave better or if the substitution or reduction badly affect their performance. For this reason, a deep knowledge of the mechanical behaviour at high strain-rates of considered materials is required. In general, machinery manufacturing industry or transport industry as well as energy industry have important dynamic phenomena that are simultaneously affected by extended strain, high strain-rate, damage and pressure, as well as conspicuous temperature gradients. The experimental results in extreme conditions of high strain rate and high temperature of an austenitic stainless steel as well as a high-chromium tempered martensitic reduced activation steel Eurofer97 are presented.

  9. Development of a cryogenic hydrogen microjet for high-intensity, high-repetition rate experiments

    Science.gov (United States)

    Kim, J. B.; Göde, S.; Glenzer, S. H.

    2016-11-01

    The advent of high-intensity, high-repetition-rate lasers has led to the need for replenishing targets of interest for high energy density sciences. We describe the design and characterization of a cryogenic microjet source, which can deliver a continuous stream of liquid hydrogen with a diameter of a few microns. The jet has been imaged at 1 μm resolution by shadowgraphy with a short pulse laser. The pointing stability has been measured at well below a mrad, for a stable free-standing filament of solid-density hydrogen.

  10. The High Strain Rate Deformation Behavior of High Purity Magnesium and AZ31B Magnesium Alloy

    Science.gov (United States)

    Livescu, Veronica; Cady, Carl M.; Cerreta, Ellen K.; Henrie, Benjamin L.; Gray, George T.

    The deformation in compression of pure magnesium and AZ31B magnesium alloy, both with a strong basal pole texture, has been investigated as a function of temperature, strain rate, and specimen orientation. The mechanical response of both metals is highly dependent upon the orientation of loading direction with respect to the basal pole. Specimens compressed along the basal pole direction have a high sensitivity to strain rate and temperature and display a concave down work hardening behavior. Specimens loaded perpendicularly to the basal pole have a yield stress that is relatively insensitive to strain rate and temperature and a work hardening behavior that is parabolic and then linearly upwards. Both specimen orientations display a mechanical response that is sensitive to temperature and strain rate. Post mortem characterization of the pure magnesium was conducted on a subset of specimens to determine the microstructural and textural evolution during deformation and these results are correlated with the observed work hardening behavior and strain rate sensitivities were calculated.

  11. Effect and toxicity of endoluminal high-dose-rate (HDR) brachytherapy in centrally located tumors of the upper respiratory tract

    International Nuclear Information System (INIS)

    Harms, W.; Wannenmacher, M.; Becker, H.; Herth, F.; Fritz, P.

    2000-01-01

    Aim: To assess effect an toxicity of high-dose-rate afterloading (HDR) alone or in combination with external beam radiotherapy (EBRT) in centrally located tumors of the upper respiratory tract. Patients and Methods: From 1987 to 1996, 55 patients were treated. Twenty-one patients (group A1: 17 non-small-cell lung cancer [NSCLC], A2: 4 metastases from other malignancies) were treated using HDR alone due to a relapse after external beam irradiation. In 34 previously untreated and inoperable patients (group B1: 27 NSCLC, B2: 7 metastases from other malignancies) HDR was given as a boost after EBRT (30 to 60 Gy, median 50). HDR was carried out with a 192 Ir source (370 GBq). The brachytherapy dose (group A: 5 to 27 Gy, median 20; B: 10 to 20 Gy, median 15) was prescribed to 1 cm distance from the source axis. A distanciable applicator was used in 39/55 patients. Results: In group A1, a response rate (CR, PR) of 53% (group B1: 77%) was reached. The median survival (Kaplan-Meier) was 5 months in group A1 (B1: 20 months). The 1-, 3- and 5-year local progression free survival rates (Kaplan-Meier) were 66% (15%), 52% (0%), and 37% (0%) in group B1 (group A1). Prognostic favorable factors in group B1 were a tumor diameter 70. Grade-1 or 2 toxicity (RTOG/EORTC) occurred in 0% in group A and in 6% in group B. We observed no Grad-3 or 4 toxicity. Complications caused by persistent or progressive local disease occurred in 3 patients in goup A (fatal hemorrhage, tracheomediastinal fistula, hemoptysis) and in 2 patients in group B (fatal hemorrhage, hemoptysis). Conclusions: HDR brachytherapy is an effective treatment with moderate side effects. In combination with external beam irradiation long-term remissions can be reached in one third of the patients. (orig.) [de

  12. The Rate Sensitivity of High Strength Syntactic Foam

    National Research Council Canada - National Science Library

    Doleski, Robert; Plunkett, Stephen; Tucker, Wayne

    2003-01-01

    .... Quasi-static experiments were also conducted in compression, tension, and shear. A comparison of the quasi-static and dynamic properties showed that syntactic foam is mildly dependent on rate in compression...

  13. Distinctive clinical course and pattern of relapse in adolescents with medulloblastoma

    International Nuclear Information System (INIS)

    Tabori, Uri; Sung, Lillian; Hukin, Juliette; Laperriere, Normand; Crooks, Bruce; Carret, Anne-Sophie; Silva, Mariana; Odame, Isaac; Mpofu, Chris; Strother, Douglas; Wilson, Beverly; Samson, Yvan; Bouffet, Eric

    2006-01-01

    Purpose: To report the clinical course of adolescents with medulloblastoma, with specific emphasis on prognosis and pattern of relapse. Methods and Materials: We retrospectively studied the clinical course and outcomes of children aged 10-20 years with medulloblastoma, treated at centers throughout Canada between 1986 and 2003. To better assess time to relapse, a cohort of patients aged 3-20 years at diagnosis was generated. Results: A total of 72 adolescents were analyzed. Five-year overall survival and event-free survival rates were 78.3% ± 5.4% and 68.0% ± 6.2%, respectively. Late relapses occurred at a median of 3.0 years (range, 0.3-6.8 years). In univariate analysis, conventional risk stratification and the addition of chemotherapy to craniospinal radiation did not have prognostic significance. Female patients had improved overall survival (p = 0.007). Time to relapse increased with age in a linear fashion. After relapse, patients faired poorly regardless of treatment modality. Patients who did not receive chemotherapy initially had improved progression-free survival at relapse (p 0.05). Conclusions: Our study suggests that adolescents with medulloblastoma might have a unique prognosis and pattern of relapse, dissimilar to those in younger children. They might benefit from different risk stratifications and prolonged follow-up. These issues should be addressed in future prospective trials

  14. Experimental characterization and modelling of UO2 mechanical behaviour at high temperatures and high strain rates

    International Nuclear Information System (INIS)

    Salvo, Maxime

    2014-01-01

    The aim of this work is to characterize and model the mechanical behavior of uranium dioxide (UO 2 ) during a Reactivity Initiated Accident (RIA). The fuel loading during a RIA is characterized by high strain rates (up to 1/s) and high temperatures (1000 C - 2500 C). Two types of UO 2 pellets (commercial and high density) were therefore tested in compression with prescribed displacement rates (0.1 to 100 mm/min corresponding to strain rates of 10 -4 - 10 -1 /s) and temperatures (1100 C - 1350 C - 1550 C et 1700 C). Experimental results (geometry, yield stress and microstructure) allowed us to define a hyperbolic sine creep law and a Drucker-Prager criterion with associated plasticity, in order to model grain boundaries fragmentation at the macroscopic scale. Finite Element Simulations of these tests and of more than 200 creep tests were used to assess the model response to a wide range of temperatures (1100 C - 1700 C) and strain rates (10 -9 /s - 10 -1 /s). Finally, a constitutive law called L3F was developed for UO 2 by adding to the previous model irradiation creep and tensile macroscopic cracking. The L3F law was then introduced in the 1.5D scheme of the fuel performance code ALCYONE-RIA to simulate the REP-Na tests performed in the experimental reactor CABRI. Simulation results are in good agreement with post tests examinations. (author) [fr

  15. Modelling of behaviour of metals at high strain rates

    OpenAIRE

    Panov, Vili

    2006-01-01

    The aim of the work presented in this thesis was to produce the improvement of the existing simulation tools used for the analysis of materials and structures, which are dynamically loaded and subjected to the different levels of temperatures and strain rates. The main objective of this work was development of tools for modelling of strain rate and temperature dependant behaviour of aluminium alloys, typical for aerospace structures with pronounced orthotropic properties, and their implementa...

  16. High birth rates despite easy access to contraception and abortion

    DEFF Research Database (Denmark)

    Hognert, Helena; Skjeldestad, Finn E; Gemzell-Danielsson, Kristina

    2017-01-01

    INTRODUCTION: The aim of this study was to describe and compare contraceptive use, fertility, birth, and abortion rates in the Nordic countries. MATERIAL AND METHODS: National data on births, abortions, fertility rate (1975-2013), redeemed prescriptions of hormonal contraceptives and sales figures...... contraception followed by the levonorgestrel-releasing intrauterine system were the most common methods. During 1975-2013 abortion rates decreased in Denmark (from 27/1000 women to 15/1000 women aged 15-44/1000 women) and Finland (from 20 to 10/1000 women), remained stable in Norway (≈16) and Sweden (≈20......) and increased in Iceland (from 6 to 15/1000 women). Birth rates remained stable around 60/1000 women aged 15-44 in all countries except for Iceland where the birth rate decreased from 95 to 65/1000 women. Abortion rates were highest in the age group 20-24 years. In the same age group, Sweden had a lower...

  17. High speed surface cleaning by a high repetition rated TEA-CO2 laser

    International Nuclear Information System (INIS)

    Tsunemi, Akira; Hirai, Ryo; Hagiwara, Kouji; Nagasaka, Keigo; Tashiro, Hideo

    1994-01-01

    We demonstrated the feasibility of high speed cleaning of solid surfaces by the laser ablation technique using a TEA-CO 2 laser. The laser pulses with the repetition rate of 1 kHz were applied to paint, rust, moss and dirt attached on the surfaces. The attachments were effectively removed without the damage of bulk surfaces by the irradiation of line-focused sequential pulses with an energy of 300 mJ/pulse. A cleaning rate reached to 17 m 2 /hour for the case of paint removal from iron surfaces. (author)

  18. Hazard rate for a two-channel protective system subject to a high demand rate

    International Nuclear Information System (INIS)

    Oliveira, L.F.; Youngblood, R.; Melo, P.F.F.

    1989-01-01

    A basic figure of merit associated with a protective system for an industrial plant is the number of accidents expected to occur in the plant within a given period of time, with the system installed. By definition, in a plant equipped with a protective system, an accident can only happen if an initiating event (a demand) occurs while the protective system is unavailable, that is, while it is in one of its possible failed states. This means that the hazard rate or accident frequency depends on the demand rate and on the unavailability of the protective systems. It has long been recognized that the demand rate influences the unavailability of the protective system, and practical expressions incorporating that effect have been developed for single-channel (Lees, 1982) and multi-channel (Kumamoto and Henley 1978) protective systems. The effect has also been incorporated into a Markovian treatment of a plant protection system (Papazoglou and Cho, 1985). In a previous paper (Oliveira and Netto, 1987) a Markovian approach was used to derive analytical expressions for the evaluation of the plant hazard rate for a single-channel protective system, properly accounting for the effects of the demand and the repair rates. In this paper the authors present an extension of that model to the case of a plant equipped with a two-channel protective system

  19. Significance of definitions of relapse after discontinuation of oral antivirals in HBeAg-negative chronic hepatitis B.

    Science.gov (United States)

    Papatheodoridis, George V; Manolakopoulos, Spilios; Su, Tung-Hung; Siakavellas, Spyros; Liu, Chun-Jen; Kourikou, Anastasia; Yang, Hung-Chih; Kao, Jia-Horng

    2017-08-31

    Relapses are observed in most hepatitis B e antigen (HBeAg)-negative chronic hepatitis B patients who discontinue treatment with nucleos(t)ide analogues (NAs); however, the rates of relapse vary widely among studies, and whether all patients with relapse need retreatment is unclear. The aim of this study was to assess the impact of different definitions on the rates of posttreatment relapse and therefore on the probability of retreatment in patients who have discontinued effective long-term NA therapy. In total, 130 HBeAg-negative chronic hepatitis B patients without cirrhosis and before NA treatment were included. All had on-therapy virological remission for ≥24 months and close follow-up for ≥12 months after stopping NA treatment or until retreatment, which started on stringent predefined criteria. Relapses rates based on several predetermined definitions of virological and perhaps biochemical criteria were assessed. The median duration of therapy was 60 months and the median duration of on-therapy virological remission was 43 months. During a median off-NAs follow-up of 15 months, no patient experienced liver decompensation or died. Cumulative relapse rates were 2%-49%, 4%-73%, 11%-82%, and 16%-90% at 3, 6, 12, and 24 months, respectively, whereas cumulative retreatment rates were 15%, 22%, and 40% at 6, 12, and 24 months, respectively, after discontinuation of NA therapy. No patient characteristic was independently associated with the probability of relapse based on at least two definitions or of retreatment. In HBeAg-negative chronic hepatitis B patients who discontinue NA therapy, the definition of relapse has a great impact on off-NAs relapse rates and potentially on the probability of retreatment. Regardless of definition, off-NAs relapses cannot be easily predicted by patient characteristics. A substantial proportion of such patients may not require retreatment if stringent criteria are adopted. (Hepatology 2017). © 2017 by the American Association

  20. Long term results of a prospective dose escalation phase-II trial: Interstitial pulsed-dose-rate brachytherapy as boost for intermediate- and high-risk prostate cancer

    International Nuclear Information System (INIS)

    Lettmaier, Sebastian; Lotter, Michael; Kreppner, Stephan; Strnad, Annedore; Fietkau, Rainer; Strnad, Vratislav

    2012-01-01

    Purpose: We reviewed our seven year single institution experience with pulsed dose rate brachytherapy dose escalation study in patients with intermediate and high risk prostate cancer. Materials and methods: We treated a total of 130 patients for intermediate and high risk prostate cancer at our institution between 2000 and 2007 using PDR-brachytherapy as a boost after conformal external beam radiation therapy to 50.4 Gy. The majority of patients had T2 disease (T1c 6%, T2 75%, T3 19%). Seventy three patients had intermediate-risk and 53 patients had high-risk disease according to the D’Amico classification. The dose of the brachytherapy boost was escalated from 25 to 35 Gy – 33 pts. received 25 Gy (total dose 75 Gy), 63 pts. 30 Gy (total dose 80 Gy) and 34 pts. 35 Gy, (total dose 85 Gy) given in one session (dose per pulse was 0.60 Gy or 0.70 Gy/h, 24 h per day, night and day, with a time interval of 1 h between two pulses). PSA-recurrence-free survival according to Kaplan–Meier using the Phoenix definition of biochemical failure was calculated and also late toxicities according to Common Toxicity Criteria scale were assessed. Results: At the time of analysis with a median follow-up of 60 months biochemical control was achieved by 88% of patients – only 16/130 patients (12.3%) developed a biochemical relapse. Biochemical relapse free survival calculated according to Kaplan–Meier for all patients at 5 years was 85.6% (83.9% for intermediate-risk patients and 84.2% for high-risk patients) and at 9 years’ follow up it was 79.0%. Analysing biochemical relapse free survival separately for different boost dose levels, at 5 years it was 97% for the 35 Gy boost dose and 82% for the 25 and 30 Gy dose levels. The side effects of therapy were negligible: There were 18 cases (15%) of grade 1/2 rectal proctitis, one case (0.8%) of grade 3 proctitis, 18 cases (15%) of grade 1/2 cystitis, and no cases (0%) with dysuria grade 3. No patient had a bulbourethral

  1. Potassium vapor assisted preparation of highly graphitized hierarchical porous carbon for high rate performance supercapacitors

    Science.gov (United States)

    Liu, Zheng; Zeng, Ying; Tang, Qunli; Hu, Aiping; Xiao, Kuikui; Zhang, Shiying; Deng, Weina; Fan, Binbin; Zhu, Yanfei; Chen, Xiaohua

    2017-09-01

    Ultrahigh graphitized carbon microspheres with rich hierarchical pores (AGHPCM-1) have been successfully synthesized through the one-step activation-carbonization strategy (OACS) with porous sulfonated poly-divinylbenzene as the carbon precursor, iron as the hard template and catalyst, and potassium hydroxide (KOH) as activation agent. Through the XRD, TEM, Raman and BET analysis, AGHPCM-1 shows very high graphitization degree and rich micro-, meso- and macro-pores. More importantly, the mechanism for KOH to improve the graphitization degree of carbon materials in OACS has been illustrated by the thermodynamical theory. The tremendous heat releasing from the reaction between the catalyst precursor of Fe2O3 and potassium vapor plays a key role in the formation of graphitized carbon. It may provide a general direction to prepare highly graphitized porous carbon at a moderate temperature. Integrating the advantages of high graphitization degree and rich hierarchical porous structure, the AGHPCM-1 exhibits an excellent rate performance with a response to up to the high current density of 150 A g-1 and high scan rate of 2000 mV s-1. No obvious capacitance decay can be observed after 10000 charge/discharge cycles even at the high current density of 20 A g-1.

  2. [Application of Competing Risks Model in Predicting Smoking Relapse Following Ischemic Stroke].

    Science.gov (United States)

    Hou, Li-Sha; Li, Ji-Jie; Du, Xu-Dong; Yan, Pei-Jing; Zhu, Cai-Rong

    2017-07-01

    To determine factors associated with smoking relapse in men who survived from their first stroke. Data were collected through face to face interviews with stroke patients in the hospital, and then repeated every three months via telephone over the period from 2010 to 2014. Kaplan-Meier method and competing risk model were adopted to estimate and predict smoking relapse rates. The Kaplan-Meier method estimated a higher relapse rate than the competing risk model. The four-year relapse rate was 43.1% after adjustment of competing risk. Exposure to environmental tobacco smoking outside of home and workplace (such as bars and restaurants) ( P =0.01), single ( P <0.01), and prior history of smoking at least 20 cigarettes per day ( P =0.02) were significant predictors of smoking relapse. When competing risks exist, competing risks model should be used in data analyses. Smoking interventions should give priorities to those without a spouse and those with a heavy smoking history. Smoking ban in public settings can reduce smoking relapse in stroke patients.

  3. Pharmacological interventions for alcohol relapse prevention

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    Health NHS Foundation Trust, Birmingham, UK ... ABSTRACT: Alcohol dependence is a chronic, debilitating disorder that is an important .... hours, or as long as alcohol remains in the blood. ... term and slightly improving days to relapse.

  4. A multiwire proportional counter for very high counting rates

    International Nuclear Information System (INIS)

    Barbosa, A.F.; Guedes, G.P.; Tamura, E.; Pepe, I.M.; Oliveira, N.B.

    1997-12-01

    Preliminary measurements in a proportional counter with two independently counting wires showed that counting rates up to 10 6 counts/s per wire can be reached without critical loss in the true versus measured linearity relation. Results obtained with a detector containing 30 active wires (2 mm pitch) are presented. To each wire is associated a fast pre-amplifier and a discriminator channel. Global counting rates in excess to 10 7 events/s are reported. Data acquisition systems are described for 1D (real time) and 2D (off-line) position sensitive detection systems. (author)

  5. A multiwire proportional counter for very high counting rates

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa, A F; Guedes, G P [Centro Brasileiro de Pesquisas Fisicas (CBPF), Rio de Janeiro, RJ (Brazil); Tamura, E [Laboratorio Nacional de Luz Sincrotron (LNLS), Campinas, SP (Brazil); Pepe, I M; Oliveira, N B [Bahia Univ., Salvador, BA (Brazil). Inst. de Fisica

    1997-12-01

    Preliminary measurements in a proportional counter with two independently counting wires showed that counting rates up to 10{sup 6} counts/s per wire can be reached without critical loss in the true versus measured linearity relation. Results obtained with a detector containing 30 active wires (2 mm pitch) are presented. To each wire is associated a fast pre-amplifier and a discriminator channel. Global counting rates in excess to 10{sup 7} events/s are reported. Data acquisition systems are described for 1D (real time) and 2D (off-line) position sensitive detection systems. (author) 13 refs., 6 figs.

  6. [A preliminary analysis of the high birth rate in India].

    Science.gov (United States)

    Shao, N

    1981-01-01

    The author first provides some basic demographic data for India and points out that the current annual rate of population growth of 2.45 percent is slightly higher than the annual increase in food production. Problems in the areas of employment, education, housing, and transportation, as well as the general problem of poverty, are seen as a consequence of this imbalance. The lack of success of the national family planning program is attributed primarily to the failure to achieve a satisfactory rate of economic growth. Contributory factors include early marriage, the low status of women, the desire for large families, and administrative problems associated with the family planning program.

  7. Early life adversity influences stress response association with smoking relapse.

    Science.gov (United States)

    al'Absi, Mustafa; Lemieux, Andrine; Westra, Ruth; Allen, Sharon

    2017-11-01

    We examined the hypothesis that stress-related blunting of cortisol in smokers is particularly pronounced in those with a history of severe life adversity. The two aims of this study were first to examine hormonal, craving, and withdrawal symptoms during ad libitum smoking and after the first 24 h of abstinence in smokers who experienced high or low levels of adversity. Second, we sought to examine the relationship between adversity and hypothalamic-pituitary-adrenal (HPA) hormones to predict relapse during the first month of a smoking cessation attempt. Hormonal and self-report measures were collected from 103 smokers (49 women) during ad libitum smoking and after the first 24 h of abstinence. HPA hormones were measured during baseline rest and in response to acute stress in both conditions. All smokers were interested in smoking cessation, and we prospectively used stress response measures to predict relapse during the first 4 weeks of the smoking cessation attempt. The results showed that high adversity was associated with higher distress and smoking withdrawal symptoms. High level of early life adversity was associated with elevated HPA activity, which was found in both salivary and plasma cortisol. Enhanced adrenocorticotropic hormone (ACTH) stress response was evident in high-adversity but not in low-adversity relapsers. This study demonstrated that early life adversity is associated with stress-related HPA responses. The study also demonstrated that, among smokers who experienced a high level of life adversity, heightened ACTH and cortisol responses were linked with increased risk for smoking relapse.

  8. Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma.

    Science.gov (United States)

    Stewart, A Keith; Rajkumar, S Vincent; Dimopoulos, Meletios A; Masszi, Tamás; Špička, Ivan; Oriol, Albert; Hájek, Roman; Rosiñol, Laura; Siegel, David S; Mihaylov, Georgi G; Goranova-Marinova, Vesselina; Rajnics, Péter; Suvorov, Aleksandr; Niesvizky, Ruben; Jakubowiak, Andrzej J; San-Miguel, Jesus F; Ludwig, Heinz; Wang, Michael; Maisnar, Vladimír; Minarik, Jiri; Bensinger, William I; Mateos, Maria-Victoria; Ben-Yehuda, Dina; Kukreti, Vishal; Zojwalla, Naseem; Tonda, Margaret E; Yang, Xinqun; Xing, Biao; Moreau, Philippe; Palumbo, Antonio

    2015-01-08

    Lenalidomide plus dexamethasone is a reference treatment for relapsed multiple myeloma. The combination of the proteasome inhibitor carfilzomib with lenalidomide and dexamethasone has shown efficacy in a phase 1 and 2 study in relapsed multiple myeloma. We randomly assigned 792 patients with relapsed multiple myeloma to carfilzomib with lenalidomide and dexamethasone (carfilzomib group) or lenalidomide and dexamethasone alone (control group). The primary end point was progression-free survival. Progression-free survival was significantly improved with carfilzomib (median, 26.3 months, vs. 17.6 months in the control group; hazard ratio for progression or death, 0.69; 95% confidence interval [CI], 0.57 to 0.83; P=0.0001). The median overall survival was not reached in either group at the interim analysis. The Kaplan-Meier 24-month overall survival rates were 73.3% and 65.0% in the carfilzomib and control groups, respectively (hazard ratio for death, 0.79; 95% CI, 0.63 to 0.99; P=0.04). The rates of overall response (partial response or better) were 87.1% and 66.7% in the carfilzomib and control groups, respectively (P<0.001; 31.8% and 9.3% of patients in the respective groups had a complete response or better; 14.1% and 4.3% had a stringent complete response). Adverse events of grade 3 or higher were reported in 83.7% and 80.7% of patients in the carfilzomib and control groups, respectively; 15.3% and 17.7% of patients discontinued treatment owing to adverse events. Patients in the carfilzomib group reported superior health-related quality of life. In patients with relapsed multiple myeloma, the addition of carfilzomib to lenalidomide and dexamethasone resulted in significantly improved progression-free survival at the interim analysis and had a favorable risk-benefit profile. (Funded by Onyx Pharmaceuticals; ClinicalTrials.gov number, NCT01080391.).

  9. Relapsing polychondritis and airway involvement.

    Science.gov (United States)

    Ernst, Armin; Rafeq, Samaan; Boiselle, Phillip; Sung, Arthur; Reddy, Chakravarthy; Michaud, Gaetane; Majid, Adnan; Herth, Felix J F; Trentham, David

    2009-04-01

    To assess the prevalence and characteristics of airway involvement in relapsing polychondritis (RP). Retrospective chart review and data analysis of RP patients seen in the Rheumatology Clinic and the Complex Airway Center at Beth Israel Deaconess Medical Center from January 2004 through February 2008. RP was diagnosed in 145 patients. Thirty-one patients had airway involvement, a prevalence of 21%. Twenty-two patients were women (70%), and they were between 11 and 61 years of age (median age, 42 years) at the time of first symptoms. Airway symptoms were the first manifestation of disease in 17 patients (54%). Dyspnea was the most common symptom in 20 patients (64%), followed by cough, stridor, and hoarseness. Airway problems included the following: subglottic stenosis (n = 8; 26%); focal and diffuse malacia (n = 15; 48%); and focal stenosis in different areas of the bronchial tree in the rest of the patients. Twelve patients (40%) required and underwent intervention including balloon dilatation, stent placement, tracheotomy, or a combination of the above with good success. The majority of patients experienced improvement in airway symptoms after intervention. One patient died during the follow-up period from the progression of airway disease. The rest of the patients continue to undergo periodic evaluation and intervention. In this largest cohort described in the English language literature, we found symptomatic airway involvement in RP to be common and at times severe. The nature of airway problems is diverse, with tracheomalacia being the most common. Airway intervention is frequently required and in experienced hands results in symptom improvement.

  10. High dose rate 192Ir calibration: Indonesia experiences

    International Nuclear Information System (INIS)

    Nasukha; Tjiptanto, D.; Darmasyah, R.; Kurniawan, B.

    2002-01-01

    Indonesia with a population of more than 200 Million people which spread on about 5000 islands, up to now only has 23 radiotherapy centers and some not active anymore. As mention by Parkin et al that Cervix/Utery and breast cancer are the most estimated numbers of new cases of cancers in women for developing countries, stomach and lung cancers in men. Indonesia as a developing country is likely similar to other developing countries on numbers of new cases of cancers in women. But quite different in men, in Indonesia the most common cancers are nasopharynx and thyroid cancers. The use of lr-192 sources in high dose-rate (HDR) remotely afterloaded brachytherapy treatments have greatly increased in recent years and variety of such sources are commercially available. Nine radiotherapy centers in Indonesia installed Nucletron microSelectron HDR remote afterloader. Based on the data of CiptoMangunkusurno Hospital, Jakarta that the most common cancers are the cervix, breast, nasopharynx and thyroid cancers which of percentage are about 31%, 25 %, 13%, and 6 % respectively. It means that the use of HDR 192 Ir brachytherapy has to be an effective tool in the treatments. Two methods have been studied and applied to calibrate HDR 192 Ir brachytherapy in Indonesia, especially for Nucletron microSelectron HDR 192 lr remote afterloader brachytherapy. Calibration of HDR 192 Ir brachytherapy source has been done by Cavity lonization Chamber and with Well Type lonization Chamber. First, 0.6 cc of NE Farmer type dosimeter that was calibrated to 60 Co and 250 kV of x-rays in air kerma was used in this experiment. Position of measurement (detector and source) at the center of the room and about 1 meter from the floor. Eight variation of distances from 10 cm to 40 cms have been carried out measurement as recommended by IAEA-TECDOC-1079. Correction have been given for scatters, non-uniformity, and attenuation. To solve the problem of scatter correction factor was used Matlab programming

  11. A system approach to high quality picture-rate conversion

    NARCIS (Netherlands)

    Bartels, C.L.L.; Cordes, C.N.; Riemens, B.; Haan, de G.

    2010-01-01

    Various techniques have been implemented to improve the motion portrayal of flat-panel displays, of which the widespread introduction of motion-compensated picture-rate conversion systems is an essential part. However, a careful design of such systems is critical as they have the potential to

  12. Key requirements for high quality picture-rate conversion.

    NARCIS (Netherlands)

    Cordes, C.N.; Haan, de G.

    2009-01-01

    Past LCD-TV generations suffered from a poor motion portrayal, causing the blurring of moving objects. Hence, various techniques have been implemented to improve their motion portrayal, of which the widespread introduction of motion compensated picture-rate conversion in TV systems is an essential

  13. High triacylglycerol turnover rate in human skeletal muscle

    DEFF Research Database (Denmark)

    Sacchetti, Massimo; Saltin, Bengt; Olsen, David B

    2004-01-01

    In the present study we investigated the relationship between plasma fatty acids (FA) and intramuscular triacylglycerol (IMTAG) kinetics of healthy volunteers. With this aim [U-(13)C]-palmitate was infused for 10 h and FA kinetics determined across the leg. In addition, the rate of FA incorporation...

  14. Anomalous electric field changes and high flash rate beneath a ...

    Indian Academy of Sciences (India)

    In spite of many experimental and theoretical studies the relationships between storm dynamics, severe weather,and lightning activity have been least understood.Measurements of electric field made under a severe thunderstorm at a northeastern Indian station,Guwahati,India are reported. Lightning flash rate increases ...

  15. High-temperature rate constant measurements for OH+xylenes

    KAUST Repository

    Elwardani, Ahmed Elsaid; Badra, Jihad; Farooq, Aamir

    2015-01-01

    The overall rate constants for the reactions of hydroxyl (OH) radicals with o-xylene (k 1), m-xylene (k 2), and p-xylene (k 3) were measured behind reflected shock waves over 890-1406K at pressures of 1.3-1.8atm using OH laser absorption near 306

  16. Development of bonded semiconductor device for high counting rate high efficiency photon detectors

    International Nuclear Information System (INIS)

    Kanno, Ikuo

    2008-01-01

    We are trying to decrease dose exposure in medical diagnosis by way of measuring the energy of X-rays. For this purpose, radiation detectors for X-ray energy measurement with high counting rate should be developed. Direct bonding of Si wafers was carried out to make a radiation detector, which had separated X-ray absorber and detector. The resistivity of bonding interface was estimated with the results of four-probe measurements and model calculations. Direct bonding of high resistivity p and n-Si wafers was also performed. The resistance of the pn bonded diode was 0.7 MΩ. The resistance should be increased in the future. (author)

  17. Monitoring treatment response and metastatic relapse in advanced bladder cancer by liquid biopsy analysis

    DEFF Research Database (Denmark)

    Birkenkamp-Demtröder, Karin; Christensen, Emil; Nordentoft, Iver Kristiansen

    2017-01-01

    of circulating tumour DNA (ctDNA) in plasma and urine to detect metastatic relapse after cystectomy and measure treatment efficacy. We exome sequenced tumour and germline DNA from patients with muscle-invasive bladder cancer and monitored ctDNA in 370 liquid biopsies throughout the disease courses by 84......DNA detection in plasma and diagnosis of relapse was 101 d after cystectomy (range 0-932 d). Early detection of metastatic relapse and treatment response using liquid biopsies represents a novel, highly sensitive tool for monitoring patients, supporting clinicians, and guiding treatment decisions. PATIENT...

  18. Development of a high-count-rate neutron detector with position sensitivity and high efficiency

    International Nuclear Information System (INIS)

    Nelson, R.; Sandoval, J.

    1996-01-01

    While the neutron scattering community is bombarded with hints of new technologies that may deliver detectors with high-count-rate capability, high efficiency, gamma-ray insensitivity, and high resolution across large areas, only the time-tested, gas-filled 3 He and scintillation detectors are in widespread use. Future spallation sources with higher fluxes simply must exploit some of the advanced detector schemes that are as yet unproved as production systems. Technologies indicating promise as neutron detectors include pixel arrays of amorphous silicon, silicon microstrips, microstrips with gas, and new scintillation materials. This project sought to study the competing neutron detector technologies and determine which or what combination will lead to a production detector system well suited for use at a high-intensity neutron scattering source

  19. High Strain Rate Testing of Welded DOP-26 Iridium

    Energy Technology Data Exchange (ETDEWEB)

    Schneibel, J. H. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Miller, R. G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Carmichael, C. A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Fox, E. E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Ulrich, G. B. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); George, E. P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-08-01

    The iridium alloy DOP-26 is used to produce Clad Vent Set cups that protect the radioactive fuel in radioisotope thermoelectric generators (RTGs) which provide electric power for spacecraft and rovers. In a previous study, the tensile properties of DOP-26 were measured over a wide range of strain rates and temperatures and reported in ORNL/TM-2007/81. While that study established the properties of the base material, the fabrication of the heat sources requires welding, and the mechanical properties of welded DOP-26 have not been extensively characterized in the past. Therefore, this study was undertaken to determine the mechanical properties of DOP-26 specimens containing a transverse weld in the center of their gage sections. Tensile tests were performed at room temperature, 750, 900, and 1090°C and engineering strain rates of 1×10-3 and 10 s-1. Room temperature testing was performed in air, while testing at elevated temperatures was performed in a vacuum better than 1×10-4 Torr. The welded specimens had a significantly higher yield stress, by up to a factor of ~2, than the non-welded base material. The yield stress did not depend on the strain rate except at 1090°C, where it was slightly higher for the faster strain rate. The ultimate tensile stress, on the other hand, was significantly higher for the faster strain rate at temperatures of 750°C and above. At 750°C and above, the specimens deformed at 1×10-3 s-1 showed pronounced necking resulting sometimes in perfect chisel-edge fracture. The specimens deformed at 10 s-1 exhibited this fracture behavior only at the highest test temperature, 1090°C. Fracture occurred usually in the fusion zone of the weld and was, in most cases, primarily intergranular.

  20. High estradiol levels improve false memory rates and meta-memory in highly schizotypal women.

    Science.gov (United States)

    Hodgetts, Sophie; Hausmann, Markus; Weis, Susanne

    2015-10-30

    Overconfidence in false memories is often found in patients with schizophrenia and healthy participants with high levels of schizotypy, indicating an impairment of meta-cognition within the memory domain. In general, cognitive control is suggested to be modulated by natural fluctuations in oestrogen. However, whether oestrogen exerts beneficial effects on meta-memory has not yet been investigated. The present study sought to provide evidence that high levels of schizotypy are associated with increased false memory rates and overconfidence in false memories, and that these processes may be modulated by natural differences in estradiol levels. Using the Deese-Roediger-McDermott paradigm, it was found that highly schizotypal participants with high estradiol produced significantly fewer false memories than those with low estradiol. No such difference was found within the low schizotypy participants. Highly schizotypal participants with high estradiol were also less confident in their false memories than those with low estradiol; low schizotypy participants with high estradiol were more confident. However, these differences only approached significance. These findings suggest that the beneficial effect of estradiol on memory and meta-memory observed in healthy participants is specific to highly schizotypal individuals and might be related to individual differences in baseline dopaminergic activity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.