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Sample records for hypervelocity impact survivability

  1. Survival of fossils under extreme shocks induced by hypervelocity impacts.

    Science.gov (United States)

    Burchell, M J; McDermott, K H; Price, M C; Yolland, L J

    2014-08-28

    Experimental data are shown for survival of fossilized diatoms undergoing shocks in the GPa range. The results were obtained from hypervelocity impact experiments which fired fossilized diatoms frozen in ice into water targets. After the shots, the material recovered from the target water was inspected for diatom fossils. Nine shots were carried out, at speeds from 0.388 to 5.34 km s(-1), corresponding to mean peak pressures of 0.2-19 GPa. In all cases, fragmented fossilized diatoms were recovered, but both the mean and the maximum fragment size decreased with increasing impact speed and hence peak pressure. Examples of intact diatoms were found after the impacts, even in some of the higher speed shots, but their frequency and size decreased significantly at the higher speeds. This is the first demonstration that fossils can survive and be transferred from projectile to target in hypervelocity impacts, implying that it is possible that, as suggested by other authors, terrestrial rocks ejected from the Earth by giant impacts from space, and which then strike the Moon, may successfully transfer terrestrial fossils to the Moon.

  2. Panspermia Survival Scenarios for Organisms that Survive Typical Hypervelocity Solar System Impact Events.

    Science.gov (United States)

    Pasini, D.

    2014-04-01

    Previous experimental studies have demonstrated the survivability of living cells during hypervelocity impact events, testing the panspermia and litho-panspermia hypotheses [1]. It has been demonstrated by the authors that Nannochloropsis Oculata Phytoplankton, a eukaryotic photosynthesizing autotroph found in the 'euphotic zone' (sunlit surface layers of oceans [2]), survive impacts up to 6.93 km s-1 (approx. shock pressure 40 GPa) [3, 4]. Also shown to survive impacts up to 5.49 km s-1 is the tardigrade species Hypsibius dujardini (a complex micro-animal consisting of 40,000 cells) [5, 6]. It has also been shown that they can survive sustained pressures up to 600 MPa using a water filled pressure capsule [7]. Additionally bacteria can survive impacts up to 5.4 km s-1 (~30 GPa) - albeit with a low probability of survival [1], and the survivability of yeast spores in impacts up to 7.4 km s-1 (~30 GPa) has also recently been demonstrated [8]. Other groups have also reported that the lichen Xanthoria elegans is able to survive shocks in similar pressure ranges (~40 GPa) [9]. Here we present various simulated impact regimes to show which scenarios are condusive to the panspermia hypothesis of the natural transfer of life (via an icy body) through space to an extraterrestrial environment.

  3. Hypervelocity impacts into graphite

    Science.gov (United States)

    Latunde-Dada, S.; Cheesman, C.; Day, D.; Harrison, W.; Price, S.

    2011-03-01

    Studies have been conducted into the characterisation of the behaviour of commercial graphite (brittle) when subjected to hypervelocity impacts by a range of projectiles. The experiments were conducted with a two-stage gas gun capable of launching projectiles of differing density and strength to speeds of about 6kms-1 at right angles into target plates. The damage caused is quantified by measurements of the crater depth and diameters. From the experimental data collected, scaling laws were derived which correlate the crater dimensions to the velocity and the density of the projectile. It was found that for moderate projectile densities the crater dimensions obey the '2/3 power law' which applies to ductile materials.

  4. Survival of the Tardigrade Hypsibius Dujardini during Hypervelocity Impact Events up to 5.49 km s-1

    Science.gov (United States)

    Pasini, D.

    2014-04-01

    Studies have previously been conducted to verify the survivability of living cells during hypervelocity impact events to test the panspermia and lithopanspermia hypotheses [1, 2]. It has been demonstrated that bacteria survive impacts up to 5.4 km s-1 (approx. shock pressure 30 GPa) - albeit with a low probability of survival [1], whilst larger, more complex, objects (such as seeds) break up at ~1 km s-1 [2]. The survivability of yeast spores in impacts up to 7.4 km s-1 has also recently been shown [3]. Previous work by the authors demonstrated the survivability of Nannochloropsis Oculata Phytoplankton, a eukaryotic photosynthesizing autotroph found in the 'euphotic zone' (sunlit surface layers of oceans [4]), at impact velocities up to 6.07 km s-1 [5]. Other groups have also reported that lichens are able to survive shocks in similar pressure ranges [6]. However, whilst many simple single celled organisms have now been shown to survive such impacts (and the associated pressures) as those encountered during the migration of material from one planet to another [1, 3, 5], complex multicellular organisms have either largely not been tested or, those that have been, have not survived the process [2]. Hypsibius dujardini, like most species of tardigrade, are complex organisms composed of approximately 40,000 cells [7]. When humidity decreases they enter a highly dehydrated state known as a 'tun' and can survive extreme temperatures (as low as - 253°C or as high as 151°C), as well as exposure to Xrays and the vacuum of space [7]. Here we test the shock survivability of Hypsibius dujardini by firing a nylon projectile onto a frozen sample of water containing frozen tardigrades using a light gas gun (LGG) [8]. The recovered ice and water were then analysed under an optical microscope to check the viability of any remnant organisms that may have survived impact, and the pressures generated.

  5. Hypervelocity impact shield

    Science.gov (United States)

    Cour-Palais, Burton G. (Inventor); Crews, Jeanne Lee (Inventor)

    1991-01-01

    A hypervelocity impact shield and method for protecting a wall structure, such as a spacecraft wall, from impact with particles of debris having densities of about 2.7 g/cu cm and impact velocities up to 16 km/s are disclosed. The shield comprises a stack of ultra thin sheets of impactor disrupting material supported and arranged by support means in spaced relationship to one another and mounted to cover the wall in a position for intercepting the particles. The sheets are of a number and spacing such that the impacting particle and the resulting particulates of the impacting particle and sheet material are successively impact-shocked to a thermal state of total melt and/or vaporization to a degree as precludes perforation of the wall. The ratio of individual sheet thickness to the theoretical diameter of particles of debris which may be of spherical form is in the range of 0.03 to 0.05. The spacing between adjacent sheets is such that the debris cloud plume of liquid and vapor resulting from an impacting particle penetrating a sheet does not puncture the next adjacent sheet prior to the arrival thereat of fragment particulates of sheet material and the debris particle produced by a previous impact.

  6. Survival of Nannochloropsis Phytoplankton in Hypervelocity Impact Events up to Velocities of 6.07 km/s

    Science.gov (United States)

    Pasini, D. L. S.; Price, M. C.; Burchell, M. J.; Cole, M. J.

    2013-09-01

    Studies have previously been conducted to verify the survivability of living cells during hypervelocity impact events to test the panspermia and lithopanspermia hypothesis [1], [2]. It has been demonstrated that bacteria survive impacts up to 5.4 km s-1 (approx. shock pressure 30 GPa) - albeit with a low probability of survival [1] whilst larger more complex objects (such as seeds) break up at ~1 km s-1 [2]. The survivability of yeast spores in impacts up to 7.4 km s-1 has also recently been shown [3]. We demonstrate here the survivability of Nannochloropsis Phytoplankton, a eukaryotic photosynthesizing autotroph found in the 'euphotic zone'(sunlit surface layers of oceans) [4] at impact velocities up to 6.07 km s-1. Phytoplankton from a culture sample was frozen and then fired into water (to simulate oceanic impacts, as described in [5]) using a light gas gun (LGG) [6]. The water was then retrieved and placed into a sealed culture vessel and left under a constant light source to check the viability of any remnant organisms.

  7. Hypervelocity impact technology and applications: 2007.

    Energy Technology Data Exchange (ETDEWEB)

    Reinhart, William Dodd; Chhabildas, Lalit C. (Air Force Research Laboratory, AFRL/RWMW, Eglin AFB, FL)

    2008-07-01

    The Hypervelocity Impact Society is devoted to the advancement of the science and technology of hypervelocity impact and related technical areas required to facilitate and understand hypervelocity impact phenomena. Topics of interest include experimental methods, theoretical techniques, analytical studies, phenomenological studies, dynamic material response as related to material properties (e.g., equation of state), penetration mechanics, and dynamic failure of materials, planetary physics and other related phenomena. The objectives of the Society are to foster the development and exchange of technical information in the discipline of hypervelocity impact phenomena, promote technical excellence, encourage peer review publications, and hold technical symposia on a regular basis. It was sometime in 1985, partly in response to the Strategic Defense Initiative (SDI), that a small group of visionaries decided that a conference or symposium on hypervelocity science would be useful and began the necessary planning. A major objective of the first Symposium was to bring the scientists and researchers up to date by reviewing the essential developments of hypervelocity science and technology between 1955 and 1985. This Symposia--HVIS 2007 is the tenth Symposium since that beginning. The papers presented at all the HVIS are peer reviewed and published as a special volume of the archival journal International Journal of Impact Engineering. HVIS 2007 followed the same high standards and its proceedings will add to this body of work.

  8. Microbial rock inhabitants survive hypervelocity impacts on Mars-like host planets: first phase of lithopanspermia experimentally tested.

    Science.gov (United States)

    Horneck, Gerda; Stöffler, Dieter; Ott, Sieglinde; Hornemann, Ulrich; Cockell, Charles S; Moeller, Ralf; Meyer, Cornelia; de Vera, Jean-Pierre; Fritz, Jörg; Schade, Sara; Artemieva, Natalia A

    2008-02-01

    The scenario of lithopanspermia describes the viable transport of microorganisms via meteorites. To test the first step of lithopanspermia, i.e., the impact ejection from a planet, systematic shock recovery experiments within a pressure range observed in martian meteorites (5-50 GPa) were performed with dry layers of microorganisms (spores of Bacillus subtilis, cells of the endolithic cyanobacterium Chroococcidiopsis, and thalli and ascocarps of the lichen Xanthoria elegans) sandwiched between gabbro discs (martian analogue rock). Actual shock pressures were determined by refractive index measurements and Raman spectroscopy, and shock temperature profiles were calculated. Pressure-effect curves were constructed for survival of B. subtilis spores and Chroococcidiopsis cells from the number of colony-forming units, and for vitality of the photobiont and mycobiont of Xanthoria elegans from confocal laser scanning microscopy after live/dead staining (FUN-I). A vital launch window for the transport of rock-colonizing microorganisms from a Mars-like planet was inferred, which encompasses shock pressures in the range of 5 to about 40 GPa for the bacterial endospores and the lichens, and a more limited shock pressure range for the cyanobacterium (from 5-10 GPa). The results support concepts of viable impact ejections from Mars-like planets and the possibility of reseeding early Earth after asteroid cataclysms.

  9. Microbial Rock Inhabitants Survive Hypervelocity Impacts on Mars-Like Host Planets: First Phase of Lithopanspermia Experimentally Tested

    Science.gov (United States)

    Horneck, Gerda; Stöffler, Dieter; Ott, Sieglinde; Hornemann, Ulrich; Cockell, Charles S.; Moeller, Ralf; Meyer, Cornelia; de Vera, Jean-Pierre; Fritz, Jörg; Schade, Sara; Artemieva, Natalia A.

    2008-02-01

    The scenario of lithopanspermia describes the viable transport of microorganisms via meteorites. To test the first step of lithopanspermia, i.e., the impact ejection from a planet, systematic shock recovery experiments within a pressure range observed in martian meteorites (550 GPa) were performed with dry layers of microorganisms (spores of Bacillus subtilis, cells of the endolithic cyanobacterium Chroococcidiopsis, and thalli and ascocarps of the lichen Xanthoria elegans) sandwiched between gabbro discs (martian analogue rock). Actual shock pressures were determined by refractive index measurements and Raman spectroscopy, and shock temperature profiles were calculated. Pressure-effect curves were constructed for survival of B. subtilis spores and Chroococcidiopsis cells from the number of colony-forming units, and for vitality of the photobiont and mycobiont of Xanthoria elegans from confocal laser scanning microscopy after live/dead staining (FUN-I). A vital launch window for the transport of rock-colonizing microorganisms from a Mars-like planet was inferred, which encompasses shock pressures in the range of 5 to about 40 GPa for the bacterial endospores and the lichens, and a more limited shock pressure range for the cyanobacterium (from 510 GPa). The results support concepts of viable impact ejections from Mars-like planets and the possibility of reseeding early Earth after asteroid cataclysms.

  10. Hypervelocity impact experiments on tether materials

    Science.gov (United States)

    Sabath, D.; Paul, K. G.

    Tethered systems are new and exciting means for various applications, such as the re-entry of small payloads from the space station. Due to payload mass constraints of the launch vehicle, the mass of the tethered system should be minimised. Therefore, fibres are the choice for tether materials. The probability of a severe impact into the tether is very high due its large surface area despite its small diameter. Hence, the risk of an impact of a micrometeoroid or a space debris particle cutting the tether should be investigated prior to flight. This work reports first observations of hypervelocity impact experiments on three different braided materials used for tether applications. The tether samples -- Dyneema, Kevlar and Spectra -- were tested using the plasma drag accelerator (PDA) facility of the Fachgebiet Raumfahrttechnik (LRT), Technische Universität München (TUM). An overview of the morphology of such impacts is presented. The extent of damage is compared to other materials commonly found on spacecraft. A risk assessment of an impact cutting the tether with current meteoroid and debris models and data from LDEF, Eureca and HST solar arrays, is also given.

  11. Characterizing Hypervelocity Impact Plasma Through Experiments and Simulations

    Science.gov (United States)

    Close, Sigrid; Lee, Nicolas; Fletcher, Alex; Nuttall, Andrew; Hew, Monica; Tarantino, Paul

    2017-10-01

    Hypervelocity micro particles, including meteoroids and space debris with masses computational fluid dynamics (CFD) simulations that allow us to extend to regimes not currently possible with ground-based technology. We show that significant impact-produced radio frequency (RF) emissions occurred in frequencies ranging from VHF through L-band and that these emissions were highly correlated with fast (>20 km/s) impacts that produced a fully ionized plasma.

  12. Experimental hypervelocity impact effects on simulated planetesimal materials

    Energy Technology Data Exchange (ETDEWEB)

    Tedeschi, W.J.; Schulze, J.F. [Sandia National Labs., Albuquerque, NM (United States); Remo, J.L. [Quantametrics, Inc., St. James, NY (United States); Young, R.P. Jr [Calspan Field Services, Inc., Arnold AFS, TN (United States). AEDC Div.

    1994-08-01

    Experimental results are presented from a series of hypervelocity impact tests on simulated comet and asteroid materials for the purpose of characterizing their response to hypervelocity kinetic energy impacts. Nine tests were conducted at the Air Force Arnold Engineering Development Center (AEDC) S1 Range Facility on ice, rock, and iron target samples using a spherical 2.39 mm diameter aluminum impactor (0.0192 gm) at impact velocities of from 7.6 to 8.4 km/sec. The test objectives were to collect target response phenomenology data on cratering, momentum deposition and enhancement, target fragmentation, and material response under hypervelocity impact loading conditions. A carefully designed ballistic pendulum was used to measure momentum deposition into the targets. Observations and measurements of the impacted samples provide important insights into the response of these materials to kinetic energy impacts, especially in regards to unexpectedly large measured values of momentum enhancement to some of the targets. Such information is required to allow us to successfully deflect or fragment comets or asteroids which might someday be detected on collision trajectories with Earth.

  13. An Imaging System for Satellite Hypervelocity Impact Debris Characterization

    Science.gov (United States)

    2015-10-18

    Debris Program Office and the Air Force Space and Missile Systems Center. 8. REFERENCES 1. Osiander, R., and Ostdiek, P., “Introduction to Space ... Debris ,” Handbook of Space Engineering, Archaeology, and Heritage, CRC Press, Boca Raton, FL, 2009, pp. 363-379. 2. Englert, C., et al., “Optical...An Imaging System for Satellite Hypervelocity Impact Debris Characterization Matthew Moraguez, Dr. Kunal Patankar University of Florida Dr

  14. Survey of the hypervelocity impact technology and applications.

    Energy Technology Data Exchange (ETDEWEB)

    Chhabildas, Lalit Chandra; Orphal, Dennis L.

    2006-05-01

    HVIS 2005 was a clear success. The Symposium brought together nearly two hundred active researchers and students from thirteen countries around the world. The 84 papers presented at HVIS 2005 constitute an ''update'' on current research and the state-of-the-art of hypervelocity science. Combined with the over 7000 pages of technical papers from the eight previous Symposia, beginning in 1986, all published in the International Journal of Impact Engineering, the papers from HVIS 2005 add to the growing body of knowledge and the progressing state-of-the-art of hypervelocity science. It is encouraging to report that even with the limited funding resources compared to two decades ago, creativity and ingenuity in hypervelocity science are alive and well. There is considerable overlap in different disciplines that allows researchers to leverage. Experimentally, higher velocities are now available in the laboratory and are ideally suited for space applications that can be tied to both civilian (NASA) and DoD military applications. Computationally, there is considerable advancement both in computer and modeling technologies. Higher computing speeds and techniques such as parallel processing allow system level type applications to be addressed directly today, much in contrast to the situation only a few years ago. Needless to say, both experimentally and computationally, the ultimate utility will depend on the curiosity and the probing questions that will be incumbent upon the individual researcher. It is quite satisfying that over two dozen students attended the symposium. Hopefully this is indicative of a good pool of future researchers that will be needed both in the government and civilian industries. It is also gratifying to note that novel thrust areas exploring different and new material phenomenology relevant to hypervelocity impact, but a number of other applications as well, are being pursued. In conclusion, considerable progress is still being

  15. Axial focusing of energy from a hypervelocity impact on earth

    Energy Technology Data Exchange (ETDEWEB)

    Boslough, M.B.; Chael, E.P.; Trucano, T.G.; Crawford, D.A.

    1994-12-01

    We have performed computational simulations to determine how energy from a large hypervelocity impact on the Earth`s surface would couple to its interior. Because of the first-order axial symmetry of both the impact energy source and the stress-wave velocity structure of the Earth, a disproportionate amount of energy is dissipated along the axis defined by the impact point and its antipode (point opposite the impact). For a symmetric and homogeneous Earth model, all the impact energy that is radiated as seismic waves into the Earth at a given takeoff angle (ray parameter), independent of azimuthal direction, is refocused (minus attenuation) on the axis of symmetry, regardless of the number of reflections and refractions it has experienced. Material on or near the axis of symmetry experiences more strain cycles with much greater amplitude than elsewhere, and therefore experiences more irreversible heating. The focusing is most intense in the upper mantle, within the asthenosphere, where seismic energy is most effectively converted to heat. For a sufficiently energetic impact, this mechanism might generate enough local heating to create an isostatic instability leading to uplift, possibly resulting in rifting, volcanism, or other rearrangement of the interior dynamics of the planet. These simulations demonstrate how hypervelocity impact energy can be transported to the Earth`s interior, supporting the possibility of a causal link between large impacts on Earth and major internally-driven geophysical processes.

  16. Discrete Particle Method for Simulating Hypervelocity Impact Phenomena

    Directory of Open Access Journals (Sweden)

    Erkai Watson

    2017-04-01

    Full Text Available In this paper, we introduce a computational model for the simulation of hypervelocity impact (HVI phenomena which is based on the Discrete Element Method (DEM. Our paper constitutes the first application of DEM to the modeling and simulating of impact events for velocities beyond 5 kms-1. We present here the results of a systematic numerical study on HVI of solids. For modeling the solids, we use discrete spherical particles that interact with each other via potentials. In our numerical investigations we are particularly interested in the dynamics of material fragmentation upon impact. We model a typical HVI experiment configuration where a sphere strikes a thin plate and investigate the properties of the resulting debris cloud. We provide a quantitative computational analysis of the resulting debris cloud caused by impact and a comprehensive parameter study by varying key parameters of our model. We compare our findings from the simulations with recent HVI experiments performed at our institute. Our findings are that the DEM method leads to very stable, energy–conserving simulations of HVI scenarios that map the experimental setup where a sphere strikes a thin plate at hypervelocity speed. Our chosen interaction model works particularly well in the velocity range where the local stresses caused by impact shock waves markedly exceed the ultimate material strength.

  17. Discrete Particle Method for Simulating Hypervelocity Impact Phenomena.

    Science.gov (United States)

    Watson, Erkai; Steinhauser, Martin O

    2017-04-02

    In this paper, we introduce a computational model for the simulation of hypervelocity impact (HVI) phenomena which is based on the Discrete Element Method (DEM). Our paper constitutes the first application of DEM to the modeling and simulating of impact events for velocities beyond 5 kms-1. We present here the results of a systematic numerical study on HVI of solids. For modeling the solids, we use discrete spherical particles that interact with each other via potentials. In our numerical investigations we are particularly interested in the dynamics of material fragmentation upon impact. We model a typical HVI experiment configuration where a sphere strikes a thin plate and investigate the properties of the resulting debris cloud. We provide a quantitative computational analysis of the resulting debris cloud caused by impact and a comprehensive parameter study by varying key parameters of our model. We compare our findings from the simulations with recent HVI experiments performed at our institute. Our findings are that the DEM method leads to very stable, energy-conserving simulations of HVI scenarios that map the experimental setup where a sphere strikes a thin plate at hypervelocity speed. Our chosen interaction model works particularly well in the velocity range where the local stresses caused by impact shock waves markedly exceed the ultimate material strength.

  18. Design of orbital debris shields for oblique hypervelocity impact

    Science.gov (United States)

    Fahrenthold, Eric P.

    1994-01-01

    A new impact debris propagation code was written to link CTH simulations of space debris shield perforation to the Lagrangian finite element code DYNA3D, for space structure wall impact simulations. This software (DC3D) simulates debris cloud evolution using a nonlinear elastic-plastic deformable particle dynamics model, and renders computationally tractable the supercomputer simulation of oblique impacts on Whipple shield protected structures. Comparison of three dimensional, oblique impact simulations with experimental data shows good agreement over a range of velocities of interest in the design of orbital debris shielding. Source code developed during this research is provided on the enclosed floppy disk. An abstract based on the work described was submitted to the 1994 Hypervelocity Impact Symposium.

  19. Investigation on plasma generated during hypervelocity impact at different impact velocities and angles

    Energy Technology Data Exchange (ETDEWEB)

    Song, Weidong, E-mail: swdgh@bit.edu.cn; Lv, Yangtao; Wang, Cheng; Li, Jianqiao [State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing 100081 (China)

    2015-12-15

    A 3D Smoothed Particle Hydrodynamics code was developed to investigate plasma generation by considering a chemical reaction process in hypervelocity impacts of an aluminum projectile on an aluminum target. The chemical reaction process was described by the reaction rate based on the Arrhenius equation and used to calculate the plasma generation during the impact simulation. The predicted result was verified by empirical formulas and a new empirical formula was proposed based on the comparisons and analyses. The influence of the impact angle was discussed for different impact velocities. Then, the application of both the new and original empirical formulas for protection design from plasma generated by hypervelocity impact was discussed, which demonstrated that the code and model were useful in the prediction of hypervelocity impacts on spacecraft.

  20. Theoretical Research Progress in High-Velocity/Hypervelocity Impact on Semi-Infinite Targets

    Directory of Open Access Journals (Sweden)

    Yunhou Sun

    2015-01-01

    Full Text Available With the hypervelocity kinetic weapon and hypersonic cruise missiles research projects being carried out, the damage mechanism for high-velocity/hypervelocity projectile impact on semi-infinite targets has become the research keystone in impact dynamics. Theoretical research progress in high-velocity/hypervelocity impact on semi-infinite targets was reviewed in this paper. The evaluation methods for critical velocity of high-velocity and hypervelocity impact were summarized. The crater shape, crater scaling laws and empirical formulae, and simplified analysis models of crater parameters for spherical projectiles impact on semi-infinite targets were reviewed, so were the long rod penetration state differentiation, penetration depth calculation models for the semifluid, and deformed long rod projectiles. Finally, some research proposals were given for further study.

  1. Hypervelocity impact properties of graphene armor via molecular dynamics simulations

    Directory of Open Access Journals (Sweden)

    Wang W.

    2012-08-01

    Full Text Available Hypervelocity impact properties of two different graphene armor systems are investigated using molecular dynamics simulations. One system is the so-called spaced armor which consists of a number of graphene plates spaced certain distance apart. Its response under normal impact of a spherical projectile is studied, focusing on the effect of the number of graphene monolayers per plate (denoted by n on the penetration resistance of the armor. We find that under normal impact by a spherical projectile the penetration resistance increases with decreasing number of monolayers per plate (n, and the best penetration resistance is achieved in the system with one graphene layer for each plate. Note that the monolayers in all the simulated multilayer graphene plates were AB-stacked. The second system being studied is the laminated copper/graphene composites with the graphene layers inside copper, on impact or back surface, or on both the impact and back surfaces. The simulation results show that under normal impact by a spherical projectile the laminated copper/graphene composite has much higher penetration resistance than the monolithic copper plate. The best efficiency is achieved when the graphene layers are on both the impact and back surfaces.

  2. Hypervelocity Impact Test Facility: A gun for hire

    Science.gov (United States)

    Johnson, Calvin R.; Rose, M. F.; Hill, D. C.; Best, S.; Chaloupka, T.; Crawford, G.; Crumpler, M.; Stephens, B.

    1994-01-01

    An affordable technique has been developed to duplicate the types of impacts observed on spacecraft, including the Shuttle, by use of a certified Hypervelocity Impact Facility (HIF) which propels particulates using capacitor driven electric gun techniques. The fully operational facility provides a flux of particles in the 10-100 micron diameter range with a velocity distribution covering the space debris and interplanetary dust particle environment. HIF measurements of particle size, composition, impact angle and velocity distribution indicate that such parameters can be controlled in a specified, tailored test designed for or by the user. Unique diagnostics enable researchers to fully describe the impact for evaluating the 'targets' under full power or load. Users regularly evaluate space hardware, including solar cells, coatings, and materials, exposing selected portions of space-qualified items to a wide range of impact events and environmental conditions. Benefits include corroboration of data obtained from impact events, flight simulation of designs, accelerated aging of systems, and development of manufacturing techniques.

  3. The electromagnetic properties of plasma produced by hypervelocity impact

    Science.gov (United States)

    Zhang, Qingming; Gong, Liangfei; Ma, Yuefen; Long, Renrong; Gong, Zizheng

    2018-02-01

    The change of electron density in moving plasma in this paper is empirically determined according to multiple ground-based experimental results and the assumption of the Maxwell distribution. Moreover, the equation of the magnetic field intensity, dominated by the current due to the collective electron movement during the expansion, is presented on the basis of the Biot-Savart law, and its relationship with time and space is subsequently depicted. In addition, hypervelocity impact experiments on a 2AL12 target have been carried out using a two-stage light gas gun to accelerate a 2AL12 projectile of 6.4 mm to 6.2 km/s. Spiral coils are designed to measure the intensity of the electromagnetic field induced by this impact. The experimental results show that the magnetic field strength is an alternate pulse maintaining nearly 1 ms and its maximum is close to 15 μT, which is strong enough to interfere with the communication circuit and chip in spacecrafts. Lastly, numerical simulation of the magnetic field intensity using this experimental parameter reveals that the intensity in our estimation from our theory tends to be well consistent with the experimental data in the first peak of the pulse signal.

  4. Hypervelocity impacts into porous graphite: experiments and simulations.

    Science.gov (United States)

    Hébert, D; Seisson, G; Rullier, J-L; Bertron, I; Hallo, L; Chevalier, J-M; Thessieux, C; Guillet, F; Boustie, M; Berthe, L

    2017-01-28

    We present experiments and numerical simulations of hypervelocity impacts of 0.5 mm steel spheres into graphite, for velocities ranging between 1100 and 4500 m s(-1) Experiments have evidenced that, after a particular striking velocity, depth of penetration no longer increases but decreases. Moreover, the projectile is observed to be trapped below the crater surface. Using numerical simulations, we show how this experimental result can be related to both materials, yield strength. A Johnson-Cook model is developed for the steel projectile, based on the literature data. A simple model is proposed for the graphite yield strength, including a piecewise pressure dependence of the Drucker-Prager form, which coefficients have been chosen to reproduce the projectile penetration depth. Comparisons between experiments and simulations are presented and discussed. The damage properties of both materials are also considered, by using a threshold on the first principal stress as a tensile failure criterion. An additional compressive failure model is also used for graphite when the equivalent strain reaches a maximum value. We show that the experimental crater diameter is directly related to the graphite spall strength. Uncertainties on the target yield stress and failure strength are estimated.This article is part of the themed issue 'Experimental testing and modelling of brittle materials at high strain rates'. © 2016 The Author(s).

  5. Induction Heating of Hypervelocity Impact Samples to 2500 Degrees Centigrade

    Science.gov (United States)

    Simmons, Joshua; Pardo, Art; Henderson, Don; Rodriguez, Karen

    2014-01-01

    The Remote Hypervelocity Test Laboratory (RHTL) at White Sands Test Facility (WSTF) was asked to heat samples up to 2500 degrees Centigrade (4532 degrees Fahrenheit) to simulate reentry scenarios of crafts where heated shields are impacted with single small particles ranging from 0.2 to 1.0 millimeters (.008 to.039 inches) of various materials. The team decided an electromagnetic induction (induction heater) was the best method to achieve and control the temperatures in a rapid manner. The samples consisted of three-dimensional carbon-carbon and two-dimensional carbon-phenolic, which are both electrically conductive. After several attempts the team was able to achieve over 2500 degrees Centigrade (4532 degrees Fahrenheit) in ambient atmosphere. When the system was moved to the target chamber and the vacuum system evacuated down to 250 millitorr, arcing occurred between the bus bars and tank, the feedthrough fittings that carried the coolant and current, and between the target sample and coil. To overcome this arcing, conformal coatings, room temperature vulcanization (RTV) silicone, and other non-conductive materials were used to isolate the electromagnetic fields.

  6. Improving Metallic Thermal Protection System Hypervelocity Impact Resistance Through Design of Experiments Approach

    Science.gov (United States)

    Poteet, Carl C.; Blosser, Max L.

    2001-01-01

    A design of experiments approach has been implemented using computational hypervelocity impact simulations to determine the most effective place to add mass to an existing metallic Thermal Protection System (TPS) to improve hypervelocity impact protection. Simulations were performed using axisymmetric models in CTH, a shock-physics code developed by Sandia National Laboratories, and validated by comparison with existing test data. The axisymmetric models were then used in a statistical sensitivity analysis to determine the influence of five design parameters on degree of hypervelocity particle dispersion. Several damage metrics were identified and evaluated. Damage metrics related to the extent of substructure damage were seen to produce misleading results, however damage metrics related to the degree of dispersion of the hypervelocity particle produced results that corresponded to physical intuition. Based on analysis of variance results it was concluded that the most effective way to increase hypervelocity impact resistance is to increase the thickness of the outer foil layer. Increasing the spacing between the outer surface and the substructure is also very effective at increasing dispersion.

  7. Plasma and collision processes of hypervelocity meteorite impact in the prehistory of life

    Science.gov (United States)

    Managadze, G.

    2010-07-01

    A new concept is proposed, according to which the plasma and collision processes accompanying hypervelocity impacts of meteorites can contribute to the arising of the conditions on early Earth, which are necessary for the appearance of primary forms of living matter. It was shown that the processes necessary for the emergence of living matter could have started in a plasma torch of meteorite impact and have continued in an impact crater in the case of the arising of the simplest life form. It is generally accepted that planets are the optimal place for the origin and evolution of life. In the process of forming the planetary systems the meteorites, space bodies feeding planet growth, appear around stars. In the process of Earth's formation, meteorite sizes ranged from hundreds and thousands of kilometres. These space bodies consisted mostly of the planetesimals and comet nucleus. During acceleration in Earth's gravitational field they reached hypervelocity and, hitting the surface of planet, generated powerful blowouts of hot plasma in the form of a torch. They also created giant-size craters and dense dust clouds. These bodies were composed of all elements needed for the synthesis of organic compounds, with the content of carbon being up to 5%-15%. A new idea of possible synthesis of the complex organic compounds in the hypervelocity impact-generated plasma torch was proposed and experimentally confirmed. A previously unknown and experimentally corroborated feature of the impact-generated plasma torch allowed a new concept of the prehistory of life to be developed. According to this concept the intensive synthesis of complex organic compounds arose during meteoritic bombardment in the first 0.5 billion years at the stage of the planet's formation. This most powerful and destructive action in Earth's history could have played a key role and prepared conditions for the origin of life. In the interstellar gas-dust clouds, the synthesis of simple organic matter could

  8. Influence of impact conditions on plasma generation during hypervelocity impact by aluminum projectile

    Science.gov (United States)

    Song, Weidong; Lv, Yangtao; Li, Jianqiao; Wang, Cheng; Ning, Jianguo

    2016-07-01

    For describing hypervelocity impact (relative low-speed as related to space debris and much lower than travelling speed of meteoroids) phenomenon associated with plasma generation, a self-developed 3D code was advanced to numerically simulate projectiles impacting on a rigid wall. The numerical results were combined with a new ionization model which was developed in an early study to calculate the ionized materials during the impact. The calculated results of ionization were compared with the empirical formulas concluded by experiments in references and a good agreement was obtained. Then based on the reliable 3D numerical code, a series of impacts with different projectile configurations were simulated to investigate the influence of impact conditions on hypervelocity impact generated plasma. It was found that the form of empirical formula needed to be modified. A new empirical formula with a critical impact velocity was advanced to describe the velocity dependence of plasma generation and the parameters of the modified formula were ensured by the comparison between the numerical predictions and the empirical formulas. For different projectile configurations, the changes of plasma charges with time are different but the integrals of charges on time almost stayed in the same level.

  9. Stochastic modeling of hypervelocity impacts in attitude propagation of space debris

    Science.gov (United States)

    Sagnières, Luc B. M.; Sharf, Inna

    2017-02-01

    Bombardment of orbital debris and micrometeoroids on active and inoperative satellites is becoming an increasing threat to space operations and has significant consequences on space missions. Concerns with orbital debris have led agencies to start developing debris removal missions and knowing a target's rotational parameters ahead of time is crucial to the eventual success of such a mission. A new method is proposed, enabling the inclusion of hypervelocity impacts into spacecraft attitude propagation models by considering the transfer of angular momentum from collisions as a stochastic jump process. Furthermore, the additional momentum transfer due to ejecta created during these hypervelocity impacts, an effect known as momentum enhancement, is considered. In order to assess the importance of collisions on attitude propagation, the developed model is applied to two pieces of space debris by using impact fluxes from ESA's Meteoroid and Space Debris Terrestrial Environment Reference (MASTER) model.

  10. Burst Pressure Failure of Titanium Tanks Damaged by Secondary Plumes from Hypervelocity Impacts on Aluminum Shields

    Science.gov (United States)

    Nahra, Henry; Ghosn, Louis; Christiansen, Eric; Davis, B. Alan; Keddy, Chris; Rodriquez, Karen; Miller, Joshua; Bohl, William

    2011-01-01

    Metallic pressure tanks used in space missions are inherently vulnerable to hypervelocity impacts from micrometeoroids and orbital debris; thereby knowledge of impact damage and its effect on the tank integrity is crucial to a spacecraft risk assessment. This paper describes tests that have been performed to assess the effects of hypervelocity impact (HVI) damage on Titanium alloy (Ti-6Al-4V) pressure vessels burst pressure and characteristics. The tests consisted of a pair of HVI impact tests on water-filled Ti-6Al-4V tanks (water being used as a surrogate to the actual propellant) and subsequent burst tests as well as a burst test on an undamaged control tank. The tanks were placed behind Aluminum (Al) shields and then each was impacted with a 7 km/s projectile. The resulting impact debris plumes partially penetrated the Ti-6Al-4V tank surfaces resulting in a distribution of craters. During the burst tests, the tank that failed at a lower burst pressure did appear to have the failure initiating at a crater site with observed spall cracks. A fracture mechanics analysis showed that the tanks failure at the impact location may have been due to a spall crack that formed upon impact of a fragmentation on the Titanium surface. This result was corroborated with a finite element analysis from calculated Von-Mises and hoop stresses.

  11. Determine ISS Soyuz Orbital Module Ballistic Limits for Steel Projectiles Hypervelocity Impact Testing

    Science.gov (United States)

    Lyons, Frankel

    2013-01-01

    A new orbital debris environment model (ORDEM 3.0) defines the density distribution of the debris environment in terms of the fraction of debris that are low-density (plastic), medium-density (aluminum) or high-density (steel) particles. This hypervelocity impact (HVI) program focused on assessing ballistic limits (BLs) for steel projectiles impacting the enhanced Soyuz Orbital Module (OM) micrometeoroid and orbital debris (MMOD) shield configuration. The ballistic limit was defined as the projectile size on the threshold of failure of the OM pressure shell as a function of impact speeds and angle. The enhanced OM shield configuration was first introduced with Soyuz 30S (launched in May 2012) to improve the MMOD protection of Soyuz vehicles docked to the International Space Station (ISS). This test program provides HVI data on U.S. materials similar in composition and density to the Russian materials for the enhanced Soyuz OM shield configuration of the vehicle. Data from this test program was used to update ballistic limit equations used in Soyuz OM penetration risk assessments. The objective of this hypervelocity impact test program was to determine the ballistic limit particle size for 440C stainless steel spherical projectiles on the Soyuz OM shielding at several impact conditions (velocity and angle combinations). This test report was prepared by NASA-JSC/ HVIT, upon completion of tests.

  12. An Ellipsoidal Particle-Finite Element Method for Hypervelocity Impact Simulation. Chapter 1

    Science.gov (United States)

    Shivarama, Ravishankar; Fahrenthold, Eric P.

    2004-01-01

    A number of coupled particle-element and hybrid particle-element methods have been developed for the simulation of hypervelocity impact problems, to avoid certain disadvantages associated with the use of pure continuum based or pure particle based methods. To date these methods have employed spherical particles. In recent work a hybrid formulation has been extended to the ellipsoidal particle case. A model formulation approach based on Lagrange's equations, with particles entropies serving as generalized coordinates, avoids the angular momentum conservation problems which have been reported with ellipsoidal smooth particle hydrodynamics models.

  13. A Kernel-Free Particle-Finite Element Method for Hypervelocity Impact Simulation. Chapter 4

    Science.gov (United States)

    Park, Young-Keun; Fahrenthold, Eric P.

    2004-01-01

    An improved hybrid particle-finite element method has been developed for the simulation of hypervelocity impact problems. Unlike alternative methods, the revised formulation computes the density without reference to any kernel or interpolation functions, for either the density or the rate of dilatation. This simplifies the state space model and leads to a significant reduction in computational cost. The improved method introduces internal energy variables as generalized coordinates in a new formulation of the thermomechanical Lagrange equations. Example problems show good agreement with exact solutions in one dimension and good agreement with experimental data in a three dimensional simulation.

  14. Elastic-plastic effect study in hypervelocity impact by SPH method

    Directory of Open Access Journals (Sweden)

    Gong Xiangfei

    2015-01-01

    Full Text Available A new distributed parallel SPH programming scheme using AMR (adaptive mesh refinement background grid is proposed, in which the size of a grid is decided based on maximal smoothed length of local particles. In detonation simulation, computational complexity of the new scheme is better than O(NlgN which is the best order of magnitude in the previous methods. Several hypervelocity impact problems are simulated using the new SPH scheme with state equations or strength model. The simulation results are discussed comparison to experimental and computed results in other literature.

  15. Design and testing of miniaturized plasma sensor for measuring hypervelocity impact plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Goel, A., E-mail: ashish09@stanford.edu; Tarantino, P. M.; Lauben, D. S.; Close, S. [Department of Aeronautics and Astronautics, Stanford University, Stanford, California 94305 (United States)

    2015-04-15

    An increasingly notable component of the space environment pertains to the impact of meteoroids and orbital debris on spacecraft and the resulting mechanical and electrical damages. Traveling at speeds of tens of km/s, when these particles, collectively referred to as hypervelocity particles, impact a satellite, they vaporize, ionize, and produce a radially expanding plasma that can generate electrically harmful radio frequency emission or serve as a trigger for electrostatic discharge. In order to measure the flux, composition, energy distribution, and temperature of ions and electrons in this plasma, a miniaturized plasma sensor has been developed for carrying out in-situ measurements in space. The sensor comprises an array of electrostatic analyzer wells split into 16 different channels, catering to different species and energy ranges in the plasma. We present results from numerical simulation based optimization of sensor geometry. A novel approach of fabricating the sensor using printed circuit boards is implemented. We also describe the test setup used for calibrating the sensor and show results demonstrating the energy band pass characteristics of the sensor. In addition to the hypervelocity impact plasmas, the plasma sensor developed can also be used to carry out measurements of ionospheric plasma, diagnostics of plasma propulsion systems, and in other space physics experiments.

  16. Hypervelocity impact resistance of reinforced carbon carbon/carbon foam thermal protection systems

    Science.gov (United States)

    Grujicic, M.; Pandurangan, B.; Zhao, C. L.; Biggers, S. B.; Morgan, D. R.

    2006-05-01

    Common aero vehicles (CAVs) are aerodynamically designed, (from orbit) re-entry, un-powered military vehicles planned to be used for deployment of the desired munitions with increased accuracy and range. In one of the currently considered designs of the CAVs, their outer skin is planned to be constructed from two-ply panels. The outer play is made of a carbon-carbon composite while the inner ply is constructed from a carbon-based foam. In the present work a transient non-linear-dynamics-based analysis is carried out in order to predict the extent of damage and the probability for failure of the carbon-carbon/carbon-foam CAV panels during potential hypervelocity impact of space debris with the outer surface of the CAVs. The results obtained show that the extent of damage scales with the normal component of the momentum associated with the debris particles just before the impact. In addition, it is found that despite its relatively low strength, the carbon-foam can provide a major increase in the resistance of the CAV panels towards penetration of the hypervelocity debris particles. This finding has been linked with an attendant consolidation of the foam, the process that is capable of absorbing a substantial amount of kinetic energy carried by the debris particles.

  17. Novel deformation processes and microstructures involving ballistic penetrator formation and hypervelocity impact and penetration phenomena

    Energy Technology Data Exchange (ETDEWEB)

    Murr, L.E.; Pappu, S.; Garcia, E.P. [Univ. of Texas, El Paso, TX (United States)] [and others

    1996-11-01

    Light metallography and transmission electron microscopy techniques affording unique observations of microstructural issues in connection with a related set of novel, high-strain-rate deformation processes provide some fundamental insight into the following areas: shock-wave induced twinning, explosive welding, shaped charge development, explosively-formed penetrator phenomena, hypervelocity impact cratering in metal targets, and long, dense rod penetration/perforation of thick metal targets. Although shock wave phenomena are precursors in all these processes, deformation twins are rarely observed in the residual, process microstructures. In the case of hypervelocity impact craters, no deformation twins are observed in the crater-related target microstructures. Microbands that appear to be related to twins are observed. Melt-related phenomena are observed only in the explosive weld-wave interfaces. Jetting phenomena related to shaped charges and crater rim formation are dominated by dynamic recrystallization, which provides a mechanism for extreme plastic flow in the solid state. Differences observed between rod penetration of rolled homogeneous armor and Ti-alloy thick targets manifest themselves in distinct microstructural differences that also do not include melt phenomena.

  18. Multichannel fiber laser Doppler vibrometer studies of low momentum and hypervelocity impacts

    Science.gov (United States)

    Posada-Roman, Julio E.; Jackson, David A.; Cole, Mike J.; Garcia-Souto, Jose A.

    2017-12-01

    A multichannel optical fiber laser Doppler vibrometer was demonstrated with the capability of making simultaneous non-contact measurements of impacts at 3 different locations. Two sets of measurements were performed, firstly using small ball bearings (1 mm-5.5 mm) falling under gravity and secondly using small projectiles (1 mm) fired from an extremely high velocity light gas gun (LGG) with speeds in the range 1 km/s-8 km/s. Determination of impact damage is important for industries such as aerospace, military and rail, where the effect of an impact on the structure can result in a major structural damage. To our knowledge the research reported here demonstrates the first trials of a multichannel fiber laser Doppler vibrometer being used to detect hypervelocity impacts.

  19. Hypervelocity impacts and the evolution of planetary surfaces and interiors

    Science.gov (United States)

    Watters, Wesley Andres

    2009-06-01

    The thesis consists of five studies relating impact processes to the evolution of planetary interiors as well as impact structures on planetary surfaces. Chapter 2 is concerned with developing methods for estimating the amount of heat deposited deep in terrestrial mantles by large impacts. Chapter 3 makes use of these results to compute the consequences of impact-related thermal buoyancy perturbations in numerical models of subsolidus convection. Among the important results of this work is a relation for the time-scale on which a buoyancy anomaly flattens and spreads before it is halted by convective downflows, as well as a condition that indicates for what perturbation magnitudes and Rayleigh numbers the flow is significantly slowed at a global scale. Chapter 4 describes a structural model of Endurance Crater in Meridiani Planum on Mars, which is constrained by observations gathered by the MER- B Opportunity rover. These results reveal new insights about the planform shape of the crater excavation flow, as well as the connection between crater shape and pre-existing structures in target materials. The study presented in chapter 5 relates the planimetric shape of simple impact craters on Mars ( D Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.)

  20. Impact features tracing hypervelocity airbursts on earth from the atmosphere to the ground

    Science.gov (United States)

    Courty, M. M.

    2012-12-01

    In the absence of deep craters, impact features have been debated to possibly tracing proximal ejecta from yet undetected structure or airburst debris from a meteorite collision with the terrestrial atmosphere or lithosphere. We examine the possibility for impact features to have originated from the shock layer formed ahead of a hypervelocity collider in the earth atmosphere. This hypothesis is approached by comparing impact features from controlled materials to puzzling geological ones: (1) debris collected at the ground from a high altitude meteor airburst recorded on 2011 August 2nd in Southern France; (2) laboratory experiments performed for defense purposes at the CEA Gramat Center (France) with the Persephone hypervelocity light gas gun; (3) the Zhamanshin impact breccia, the Lybian glass, the Egyptian Dakhleh glass, the Tasmanian Darwin glass, the Australasian tektite strewnfield and the Australian Henbury crater field. The Persephone experiments include collisions from 4.1 to 7.9 km/s by a steel projectile embedded into a polycarbonate holder with a polystyrene separator on to a 40 mm thick aluminum target. The impact features been characterized by coupling Environmental SEM with EDS, Raman micro-spectrometry, XRD, TEM, Tof-SIMS, ICP-MS and isotope analyses. Similar carbonaceous polymorphs that are closely imbricated at meso to nano-scales to the crystallized components (including the metal blebs) and to the glass phases (spherules or matrix) are present in all the impact features studied. They dominantly consist of aliphatic polymers, rare aromatic compounds, with graphite-lonsdaleite inclusions. The Persephone experiments help relating the graphite-lonsdaleite couple to transformed organic residues by the transient high pressure shock (a few tens MPa) and the transient heating (ca 100°C) and the aliphatic polymers to new hydrocarbons that formed from the pulverized polycarbonate and polystyrene. The Persephone experiments provide the controlled situation

  1. Vulnerability analysis of a pressurized aluminum composite vessel against hypervelocity impacts

    Directory of Open Access Journals (Sweden)

    Hereil Pierre-Louis

    2015-01-01

    Full Text Available Vulnerability of high pressure vessels subjected to high velocity impact of space debris is analyzed with the response of pressurized vessels to hypervelocity impact of aluminum sphere. Investigated tanks are CFRP (carbon fiber reinforced plastics overwrapped Al vessels. Explored internal pressure of nitrogen ranges from 1 bar to 300 bar and impact velocity are around 4400 m/s. Data obtained from Xrays radiographies and particle velocity measurements show the evolution of debris cloud and shock wave propagation in pressurized nitrogen. Observation of recovered vessels leads to the damage pattern and to its evolution as a function of the internal pressure. It is shown that the rupture mode is not a bursting mode but rather a catastrophic damage of the external carbon composite part of the vessel.

  2. Interpolation/extrapolation technique with application to hypervelocity impact of space debris

    Science.gov (United States)

    Rule, William K.

    1992-01-01

    A new technique for the interpolation/extrapolation of engineering data is described. The technique easily allows for the incorporation of additional independent variables, and the most suitable data in the data base is automatically used for each prediction. The technique provides diagnostics for assessing the reliability of the prediction. Two sets of predictions made for known 5-degree-of-freedom, 15-parameter functions using the new technique produced an average coefficient of determination of 0.949. Here, the technique is applied to the prediction of damage to the Space Station from hypervelocity impact of space debris. A new set of impact data is presented for this purpose. Reasonable predictions for bumper damage were obtained, but predictions of pressure wall and multilayer insulation damage were poor.

  3. Finite element analysis of hypervelocity impact behaviour of CFRP-Al/HC sandwich panel

    Directory of Open Access Journals (Sweden)

    Phadnis Vaibhav A.

    2015-01-01

    Full Text Available The mechanical response of CFRP-Al/HC (carbon fibre-reinforced/epoxy composite face sheets with Al honeycomb core sandwich panels to hyper-velocity impact (up to 1 km/s is studied using a finite-element model developed in ABAQUS/Explicit. The intraply damage of CFRP face sheets is analysed by mean of a user-defined material model (VUMAT employing a combination of Hashin and Puck criteria, delamination modelled using cohesive-zone elements. The damaged Al/HC core is assessed on the basis of a Johnson Cook dynamic failure model while its hydrodynamic response is captured using the Mie-Gruneisen equation of state. The results obtained with the developed finite-element model showed a reasonable correlation to experimental damage patterns. The surface peeling of both face sheets was evident, with a significant delamination around the impact location accompanied by crushing HC core.

  4. Hypervelocity Impact Experiments on Epoxy/Ultra-High Molecular Weight Polyethylene Composite Panels Reinforced with Nanotubes

    Science.gov (United States)

    Khatiwada, Suman; Laughman, Jay W.; Armada, Carlos A.; Christiansen, Eric L.; Barrera, Enrique V.

    2012-01-01

    Advanced composites with multi-functional capabilities are of great interest to the designers of aerospace structures. Polymer matrix composites (PMCs) reinforced with high strength fibers provide a lightweight and high strength alternative to metals and metal alloys conventionally used in aerospace architectures. Novel reinforcements such as nanofillers offer potential to improve the mechanical properties and add multi-functionality such as radiation resistance and sensing capabilities to the PMCs. This paper reports the hypervelocity impact (HVI) test results on ultra-high molecular weight polyethylene (UHMWPE) fiber composites reinforced with single-walled carbon nanotubes (SWCNT) and boron nitride nanotubes (BNNT). Woven UHMWPE fabrics, in addition to providing excellent impact properties and high strength, also offer radiation resistance due to inherent high hydrogen content. SWCNT have exceptional mechanical and electrical properties. BNNT (figure 1) have high neutron cross section and good mechanical properties that add multi-functionality to this system. In this project, epoxy based UHMWPE composites containing SWCNT and BNNT are assessed for their use as bumper shields and as intermediate plates in a Whipple Shield for HVI resistance. Three composite systems are prepared to compare against one another: (I) Epoxy/UHMWPE, (II) Epoxy/UHMWPE/SWCNT and (III) Epoxy/UHMWPE/SWCNT/BNNT. Each composite is a 10.0 by 10.0 by 0.11 cm3 panel, consisting of 4 layers of fabrics arranged in cross-ply orientation. Both SWCNT and BNNT are 0.5 weight % of the fabric preform. Hypervelocity impact tests are performed using a two-stage light gas gun at Rice University

  5. Numerical Simulation for Predicting Hypervelocity Impact Damage in Laminated Composite Plate

    Science.gov (United States)

    Ito, Ryo; Nagao, Yosuke; Fukunaga, Hisao

    In this study, we conduct the numerical simulations of hypervelocity impacts (HVIs) of a projectile on CFRP laminated plate targets by means of two-dimensional axisymmetric SPH method. To simulate the delamination of the laminated composite plate due to the HVIs, an interface modelling technique for mixed-mode delamination is adopted. Additionally, a treatment method for the anisotropy of CFRP composites in the axisymmetric coordinate system is described. Numerical simulation results show good agreement with experimental results in respect of the ballistic limits and the damaged area. Consequently, it is shown that the interface particle technique for modelling the delamination of a laminated composite plate is effective, and we can predict the ballistic limits and the damaged area of laminated composite plate with this technique.

  6. Hypervelocity nanoparticle impacts on free-standing graphene: A sui generis mode of sputtering

    Energy Technology Data Exchange (ETDEWEB)

    Eller, Michael J.; Della-Negra, Serge [Institut de Physique Nucléaire d’Orsay, UMR8608, CNRS/IN2P3, Université Paris-Sud 11, Orsay F-91406 (France); Liang, Chao-Kai; Clubb, Aaron B.; Schweikert, Emile A., E-mail: schweikert@chem.tamu.edu [Department of Chemistry, Texas A and M University, College Station, Texas 77843-3144 (United States); Kim, Hansoo [Microscopy and Imaging Center, Texas A and M University, College Station, Texas 77843-2257 (United States); Young, Amanda E. [Materials Characterization Facility, Texas A and M University, College Station, Texas 77843-3122 (United States)

    2015-01-28

    The study of the interaction of hypervelocity nano-particles with a 2D material and ultra-thin targets (single layer graphene, multi-layer graphene, and amorphous carbon foils) has been performed using mass selected gold nano-particles produced from a liquid metal ion source. During these impacts, a large number of atoms are ejected from the graphene, corresponding to a hole of ∼60 nm{sup 2}. Additionally, for the first time, secondary ions have been observed simultaneously in both the transmission and reflection direction (with respect to the path of the projectile) from a 2D target. The ejected area is much larger than that predicted by molecular dynamic simulations and a large ionization rate is observed. The mass distribution and characteristics of the emitted secondary ions are presented and offer an insight into the process to produce the large hole observed in the graphene.

  7. Orthotropic node-separation finite element method for composite laminate in hypervelocity impact simulation

    Science.gov (United States)

    Zhang, Xiaotian; Liu, Tao; Qiu, Xinming

    2017-11-01

    This paper reports a finite element modeling approach to simulate the hypervelocity impact (HVI) response of composite laminate. Node-separation finite element (NSFE) method based on scalar-element-fracture technique for isotropic material in HVI simulation has been presented in the previous study. To extend NSFE to composite materials, an orthotropic node-separation finite element (ONSFE) method is developed. This approach employs an orthotropic continuum material model and a corresponding orthotropic-element-fracture technique to represent the HVI behavior/damage of composite laminate. A series of HVI simulations are conducted and the developed ONSFE method is validated by comparing with the experimental data. The simulation results show that ONSFE can successfully capture the HVI phenomena of composite laminate, such as the orthotropic property, nonlinear shock response, perforation, fiber breakage and delamination. Finally, a HVI event of Whipple shield is simulated and the computational capability of ONSFE for predicting the damage state of the composite bumper is further evaluated.

  8. Ejection and Lofting of Dust from Hypervelocity Impacts on the Moon

    Science.gov (United States)

    Hermalyn, B.; Schultz, P. H.

    2011-12-01

    Hypervelocity impact events mobilize and redistribute fine-grained regolith dust across the surfaces of planetary bodies. The ejecta mass-velocity distribution controls the location and emplacement of these materials. The current flux of material falling on the moon is dominated by small bolides and should cause frequent impacts that eject dust at high speeds. For example, approximately 25 LCROSS-sized (~20-30m diameter) craters are statistically expected to be formed naturally on the moon during any given earth year. When scaled to lunar conditions, the high-speed component of ejecta from hypervelocity impacts can be lofted for significant periods of time (as evidenced by the LCROSS mission results, c.f., Schultz, et al., 2010, Colaprete, et al., 2010). Even at laboratory scales, ejecta can approach orbital velocities; the higher impact speeds and larger projectiles bombarding the lunar surface may permit a significant portion of material to be launched closer to escape velocity. When these ejecta return to the surface (or encounter local topography), they impact at hundreds of meters per second or faster, thereby "scouring" the surface with low mass oblique impacts. While these high-speed ejecta represent only a small fraction of the total ejected mass, the lofting and subsequent ballistic return of this dust has the highest mobilization potential and will be directly applicable to the upcoming LADEE mission. A suite of hypervelocity impact experiments into granular materials was performed at the NASA Ames Vertical Gun Range (AVGR). This study incorporates both canonical sand targets and air-fall pumice dust to simulate the mechanical properties of lunar regolith. The implementation of a Particle Tracking Velocimetry (PTV) technique permits non-intrusive measurement of the ejecta velocity distribution within the ejecta curtain by following the path of individual ejecta particles. The PTV system developed at the AVGR uses a series of high-speed cameras (ranging

  9. Extension and Validation of a Hybrid Particle-Finite Element Method for Hypervelocity Impact Simulation. Chapter 2

    Science.gov (United States)

    Fahrenthold, Eric P.; Shivarama, Ravishankar

    2004-01-01

    The hybrid particle-finite element method of Fahrenthold and Horban, developed for the simulation of hypervelocity impact problems, has been extended to include new formulations of the particle-element kinematics, additional constitutive models, and an improved numerical implementation. The extended formulation has been validated in three dimensional simulations of published impact experiments. The test cases demonstrate good agreement with experiment, good parallel speedup, and numerical convergence of the simulation results.

  10. Momentum Enhancement due to Crater Ejecta during Hypervelocity Impact of Highly Porous and Consolidated Rock

    Science.gov (United States)

    Walker, James; Chocron, Sidney; Grosch, Donald; Durda, Daniel; Housen, Kevin

    2017-06-01

    Experiments were performed with impacts of 2.54- to 4.45-cm-diameter aluminum spheres at 2.1 km/s into both consolidated rock (granite) and highly porous rock (pumice). Measured in these experiments was the momentum enhancement -- that is, how much momentum is transferred to the rock by the impactor. The transferred momentum is greater than the impactor due to the crater ejecta. The momentum enhancement is characterized by β , which is the ratio of the momentum transferred to the target and the momentum of the impactor. High speed video recorded the impact event, the ejecta from the target, and the motion of the target (hung in a ballistic pendulum arrangement). Constitutive models of rock that include porosity and crush-up behavior when incorporated into impact physics codes (specifically CTH and EPIC) show good agreement with crater depth, but they do not show good agreement with momentum enhancement. This paper will review the data and place it in the context of other momentum enhancement data, including the nonlinear effect of scale size. It will also explore the difficulties in large-scale numerical modeling of the momentum enhancement. An application of this data is determining the effectiveness of deflecting asteroids and comet nuclei by hypervelocity impacts.

  11. Hypervelocity Impact Performance of Open Cell Foam Core Sandwich Panel Structures

    Science.gov (United States)

    Ryan, Shannon; Christiansen, Eric; Lear, Dana

    2009-01-01

    Metallic foams are a relatively new class of materials with low density and novel physical, mechanical, thermal, electrical and acoustic properties. Although incompletely characterized, they offer comparable mechanical performance to traditional spacecraft structural materials (i.e. honeycomb sandwich panels) without detrimental through-thickness channeling cells. There are two competing types of metallic foams: open cell and closed cell. Open cell foams are considered the more promising technology due to their lower weight and higher degree of homogeneity. Leading micrometeoroid and orbital debris shields (MMOD) incorporate thin plates separated by a void space (i.e. Whipple shield). Inclusion of intermediate fabric layers, or multiple bumper plates have led to significant performance enhancements, yet these shields require additional non-ballistic mass for installation (fasteners, supports, etc.) that can consume up to 35% of the total shield weight [1]. Structural panels, such as open cell foam core sandwich panels, that are also capable of providing sufficient MMOD protection, represent a significant potential for increased efficiency in hypervelocity impact shielding from a systems perspective through a reduction in required non-ballistic mass. In this paper, the results of an extensive impact test program on aluminum foam core sandwich panels are reported. The effect of pore density, and core thickness on shielding performance have been evaluated over impact velocities ranging from 2.2 - 9.3 km/s at various angles. A number of additional tests on alternate sandwich panel configurations of comparable-weight have also been performed, including aluminum honeycomb sandwich panels (see Figure 1), Nomex honeycomb core sandwich panels, and 3D aluminum honeycomb sandwich panels. A total of 70 hypervelocity impact tests are reported, from which an empirical ballistic limit equation (BLE) has been derived. The BLE is in the standard form suitable for implementation in

  12. Hypervelocity Impact Performance of Open Cell Foam Core Sandwich Panel Structures

    Science.gov (United States)

    Ryan, S.; Ordonez, E.; Christiansen, E. L.; Lear, D. M.

    2010-01-01

    Open cell metallic foam core sandwich panel structures are of interest for application in spacecraft micrometeoroid and orbital debris shields due to their novel form and advantageous structural and thermal performance. Repeated shocking as a result of secondary impacts upon individual foam ligaments during the penetration process acts to raise the thermal state of impacting projectiles ; resulting in fragmentation, melting, and vaporization at lower velocities than with traditional shielding configurations (e.g. Whipple shield). In order to characterize the protective capability of these structures, an extensive experimental campaign was performed by the Johnson Space Center Hypervelocity Impact Technology Facility, the results of which are reported in this paper. Although not capable of competing against the protection levels achievable with leading heavy shields in use on modern high-risk vehicles (i.e. International Space Station modules), metallic foam core sandwich panels are shown to provide a substantial improvement over comparable structural panels and traditional low weight shielding alternatives such as honeycomb sandwich panels and metallic Whipple shields. A ballistic limit equation, generalized in terms of panel geometry, is derived and presented in a form suitable for application in risk assessment codes.

  13. Hypervelocity impact testing of advanced materials and structures for micrometeoroid and orbital debris shielding

    Science.gov (United States)

    Ryan, Shannon; Christiansen, Eric L.

    2013-02-01

    A series of 66 hypervelocity impact experiments have been performed to assess the potential of various materials (aluminium, titanium, copper, stainless steel, nickel, nickel/chromium, reticulated vitreous carbon, silver, ceramic, aramid, ceramic glass, and carbon fibre) and structures (monolithic plates, open-cell foam, flexible fabrics, rigid meshes) for micrometeoroid and orbital debris (MMOD) shielding. Arranged in various single-, double-, and triple-bumper configurations, screening tests were performed with 0.3175 cm diameter Al2017-T4 spherical projectiles at nominally 6.8 km/s and normal incidence. The top performing shields were identified through target damage assessments and their respective weight. The top performing candidate shield at the screening test condition was found to be a double-bumper configuration with a 0.25 mm thick Al3003 outer bumper, 6.35 mm thick 40 PPI aluminium foam inner bumper, and 1.016 mm thick Al2024-T3 rear wall (equal spacing between bumpers and rear wall). In general, double-bumper candidates with aluminium plate outer bumpers and foam inner bumpers were consistently found to be amongst the top performers. For this impact condition, potential weight savings of at least 47% over conventional all-aluminium Whipple shields are possible by utilizing the investigated materials and structures. The results of this study identify materials and structures of interest for further, more in-depth, impact investigations.

  14. Development of a Numerical Model of Hypervelocity Impact into a Pressurized Composite Overwrapped Pressure Vessel

    Science.gov (United States)

    Garcia, M. A.; Davis, B. A.; Miller, J. E.

    2017-01-01

    As the outlook for space exploration becomes more ambitious and spacecraft travel deeper into space than ever before, it is increasingly important that propulsion systems perform reliably within the space environment. The increased reliability compels designers to increase design margin at the expense of system mass, which contrasts with the need to limit vehicle mass to maximize payload. Such are the factors that motivate the integration of high specific strength composite materials in the construction of pressure vessels commonly referred to as composite overwrapped pressure vessels (COPV). The COPV consists of a metallic liner for the inner shell of the COPV that is stiff, negates fluid permeation and serves as the anchor for composite laminates or filaments, but the liner itself cannot contain the stresses from the pressurant it contains. The compo-site-fiber reinforced polymer (CFRP) is wound around the liner using a combination of hoop (circumferential) and helical orientations. Careful consideration of wrap orientation allows the composite to evenly bear structural loading and creates the COPV's characteristic high strength to weight ratio. As the CFRP overwrap carries most of the stresses induced by pressurization, damage to the overwrap can affect mission duration, mission success and potentially cause loss-of-vehicle/loss-of-crew. For this reason, it is critical to establish a fundamental understanding of the mechanisms involved in the failure of a stressed composite such as that of the COPV. One of the greatest external threats to the integrity of a spacecraft's COPV is an impact from the meteoroid and orbital debris environments (MMOD). These impacts, even from submillimeter particles, generate extremely high stress states in the CFRP that can damage numerous fibers. As a result of this possibility, initial assumptions in survivability analysis for some human-rated NASA space-craft have assumed that any alteration of the vessel due to impact is

  15. Cassini Ring Plane Crossings: Hypervelocity Impact Risks to Sun Sensor Assemblies

    Science.gov (United States)

    Lee, Allan Y.

    2016-01-01

    For both F/G and D-ring crossings: Probability of a penetration damage of the SSH (Sun Sensor Head) window glass is very low; Optical attenuation due to craters on the surface of the window glass caused by direct HVI (Hyper-Velocity Impact) by dust particle is estimated to be less than 1 percent; Optical attenuation due to secondary debris cloud generated by the disintegrated ring dust particles is estimated to be less than 1 percent. To better manage the Sun sensor damage risk during selected proximal orbit crossings, it is highly desirable to follow the contingency procedures mentioned in Section VII of the paper: Details of this contingency procedure are given in the paper entitled "Cassini Operational Sun Sensor Risk Management During Proximal Orbit Saturn Ring Plane Crossings" authored by David M. Bates. Based on results of risk analyses documented in this work and contingency planning work described in the paper mentioned above, we judge that the proximal orbit campaign will be safe from the viewpoint of dust HVI hazard.

  16. Detection of hypervelocity dust impacts on the Earth orbiting Cluster and MMS spacecraft and problems with signal interpretation

    Science.gov (United States)

    Vaverka, Jakub; Pellinen-Wannberg, Asta; Kero, Johan; Mann, Ingrid; De Spiegeleer, Alexandre; Hamrin, Maria; Norberg, Carol; Pitkänen, Timo

    2017-04-01

    Detection of hypervelocity dust impacts on a spacecraft body by electric field instruments have been reported by several missions such as Voyager, WIND, Cassini, STEREO. The mechanism of this detection is still not completely understood and is under intensive laboratory investigation. A commonly accepted theory is based on re-collection of plasma cloud particles generated by a hypervelocity dust impact by a spacecraft surface and an electric field antenna resulting in a fast change in the potential of the spacecraft body and antenna. These changes can be detected as a short pulse measured by the electric field instrument. We present the first detection of dust impacts on the Earth-orbiting MMS and Cluster satellites. Each of the four MMS spacecraft provide probe-to-spacecraft potential measurements for their respective the six electric field antennas. This gives a unique view on signals generated by dust impacts and allow their reliable identification which is not possible for example on the Cluster spacecraft. We discuss various instrumental effects and solitary waves, commonly present in the Earth's magnetosphere, which can be easily misinterpreted as dust impacts. We show the influence of local plasma environment on dust impact detection for satellites crossing various regions of the Earth's magnetosphere where the concentration and the temperature of plasma particles change significantly.

  17. Effects of Hypervelocity Impacts on Silicone Elastomer Seals and Mating Aluminum Surfaces

    Science.gov (United States)

    deGroh, Henry C., III; Steinetz, Bruce M.

    2009-01-01

    While in space silicone based elastomer seals planned for use on NASA's Crew Exploration Vehicle (CEV) are exposed to threats from micrometeoroids and orbital debris (MMOD). An understanding of these threats is required to assess risks to the crew, the CEV orbiter, and missions. An Earth based campaign of hypervelocity impacts on small scale seal rings has been done to help estimate MMOD threats to the primary docking seal being developed for the Low Impact Docking System (LIDS). LIDS is being developed to enable the CEV to dock to the ISS (International Space Station) or to Altair (NASA's next lunar lander). The silicone seal on LIDS seals against aluminum alloy flanges on ISS or Altair. Since the integrity of a seal depends on both sealing surfaces, aluminum targets were also impacted. The variables considered in this study included projectile mass, density, speed, incidence angle, seal materials, and target surface treatments and coatings. Most of the impacts used a velocity near 8 km/s and spherical aluminum projectiles (density = 2.7 g/cubic cm), however, a few tests were done near 5.6 km/s. Tests were also performed using projectile densities of 7.7, 2.79, 2.5 or 1.14 g/cubic cm. Projectile incidence angles examined included 0 deg, 45 deg, and 60 deg from normal to the plane of the target. Elastomer compounds impacted include Parker's S0383-70 and Esterline's ELA-SA-401 in the as received condition, or after an atomic oxygen treatment. Bare, anodized and nickel coated aluminum targets were tested simulating the candidate mating seal surface materials. After impact, seals and aluminum plates were leak tested: damaged seals were tested against an undamaged aluminum plate; and undamaged seals were placed at various locations over craters in aluminum plates. It has been shown that silicone elastomer seals can withstand an impressive level of damage before leaking beyond allowable limits. In general on the tests performed to date, the diameter of the crater in

  18. Hypervelocity impact effect of molecules from Enceladus' plume and Titan's upper atmosphere on NASA's Cassini spectrometer from reactive dynamics simulation.

    Science.gov (United States)

    Jaramillo-Botero, Andres; An, Qi; Cheng, Mu-Jeng; Goddard, William A; Beegle, Luther W; Hodyss, Robert

    2012-11-21

    The NASA/ESA Cassini probe of Saturn analyzed the molecular composition of plumes emanating from one of its moons, Enceladus, and the upper atmosphere of another, Titan. However, interpretation of this data is complicated by the hypervelocity (HV) flybys of up to ~18 km/sec that cause substantial molecular fragmentation. To interpret this data we use quantum mechanical based reactive force fields to simulate the HV impact of various molecular species and ice clathrates on oxidized titanium surfaces mimicking those in Cassini's neutral and ion mass spectrometer (INMS). The predicted velocity dependent fragmentation patterns and composition mixing ratios agree with INMS data providing the means for identifying the molecules in the plume. We used our simulations to predict the surface damage from the HV impacts on the INMS interior walls, which we suggest acts as a titanium sublimation pump that could alter the instrument's readings. These results show how the theory can identify chemical events from hypervelocity impacts in space plumes and atmospheres, providing in turn clues to the internal structure of the corresponding sources (e.g., Enceladus). This may be valuable in steering modifications in future missions.

  19. Hypervelocity microparticle characterization

    Energy Technology Data Exchange (ETDEWEB)

    Idzorek, G.C.

    1996-11-01

    To protect spacecraft from orbital debris requires a basic understanding of the processes involved in hypervelocity impacts and characterization of detectors to measure the space environment. Both require a source of well characterized hypervelocity particles. Electrostatic acceleration of charged microspheres provides such a source. Techniques refined at the Los Alamos National Laboratory provided information on hypervelocity impacts of particles of known mass and velocity ranging from 20-1000 nm diameter and 1-100 km/s. A Van De Graaff generator operating at 6 million volts was used to accelerate individual carbonyl iron microspheres produced by a specially designed particle source. Standard electrostatic lenses and steering were used to control the particles flight path. Charge sensitive pickoff tubes measured the particle charge and velocity in- flight without disturbing the particle. This information coupled with the measured Van De Graaff terminal voltage allowed calculation of the particle energy, mass, momenta and (using an assumed density) the size. Particles with the desired parameters were then electrostatically directed to a target chamber. Targets used in our experiments included cratering and foil puncture targets, microphone momentum enhancement detectors, triboluminescent detectors, and ``splash`` charge detectors. In addition the system has been used to rapidly characterize size distributions of conductive plastic particles and potentially provide a method of easily sorting microscopic particles by size.

  20. Surviving Impact in Experiments and on Planets

    Science.gov (United States)

    Schultz, P. H.

    2012-12-01

    speed objects hitting the Moon. As a result, some processes observed in laboratory experiments can guide further computer simulations and benchmarking. For example, vapor expansion scours away downrange surface materials while low-angle, hypervelocity projectile fragments melt and mix with the target downrange, thereby creating distinct compositions. At large scales on the Moon, the reduction in cratering efficiency exposes early-time processes and becomes even more obvious for oblique impacts where the these processes are mapped across the surface. Impacts on the edge of an adjacent basin or crater (e.g., King Crater on the Moon) expose the surviving impactor component in the downrange melt, rather than proposing a near-surface mafic intrusion. At basin scales, the disrupted inner ring and downrange extension create the appearance of a double impact (e.g., Orientale, Crisium and Moscoviense basins). Large basins formed also may preserve signatures of melt-mixed impactor components within the basin along the inner ring uprange, e.g., Mg-rich spinels within the inner ring of Moscoviense.

  1. Hypervelocity impact facility for simulating materials exposure to impact by space debris

    Science.gov (United States)

    Rose, M. F.; Best, S.; Chaloupka, T.; Stephens, B.; Crawford, G.

    1993-01-01

    As a result of man's venturing into space, the local debris contributed by his presence exceeds, at some orbital altitudes, that of the natural component. Man's contribution ranges from fuel residue to large derelect satellites that weigh many kilograms. Current debris models are able to predict the growth of the problem and suggest that spacecraft must employ armor or bumper shields for some orbital altitudes now, and that, the problem will become worse as a function of time. The practical upper limit to the velocity distribution is on the order of 40 km/s and is associated with the natural environment. The maximum velocity of the man-made component is in the 14-16 km/s range. The Long Duration Exposure Facility (LDEF) has verified that the 'high probability of impact' particles are in the microgram to milligram range. These particles can have significant effects on coatings, insulators, and thin metallic layers. The surface of thick materials becomes pitted and the local debris component is enhanced by ejecta from the debris spectrum in a controlled environment. The facility capability is discussed in terms of drive geometry, energetics, velocity distribution, diagnostics, and projectile/debris loading. The facility is currently being used to study impact phenomena on Space Station Freedom's solar array structure, other solar array materials, potential structural materials for use in the station, electrical breakdown in the space environment, and as a means of clarifying or duplicating the impact phenomena on the LDEF surfaces. The results of these experiments are described in terms of the mass/velocity distribution incident on selected samples, crater dynamics, and sample geometry.

  2. Experimental Hypervelocity Dust Impact in Olivine: FIB/TEM Characterization of Micron-Scale Craters with Comparison to Natural and Laser-Simulated Small-Scale Impact Effects

    Science.gov (United States)

    Christoffersen, R.; Loeffler, M. J.; Rahman, Z.; Dukes, C.; IMPACT Team

    2017-01-01

    The space weathering of regoliths on airless bodies and the formation of their exospheres is driven to a large extent by hypervelocity impacts from the high relative flux of micron to sub-micron meteoroids that comprise approximately 90 percent of the solar system meteoroid population. Laboratory hypervelocity impact experiments are crucial for quantifying how these small impact events drive space weathering through target shock, melting and vaporization. Simulating these small scale impacts experimentally is challenging because the natural impactors are both very small and many have velocities above the approximately 8 kilometers-per-second limit attainable by conventional chemical/light gas accelerator technology. Electrostatic "dust" accelerators, such as the one recently developed at the Colorado Center for Lunar Dust and Atmospheric Studies (CCLDAS), allow the experimental velocity regime to be extended up to tens of kilometers-per-second. Even at these velocities the region of latent target damage created by each impact, in the form of microcraters or pits, is still only about 0.1 to 10 micrometers in size. Both field-emission analytical scanning electron microscopy (FE-SEM) and advanced field-emission scanning transmission electron microscopy (FE-STEM) are uniquely suited for characterizing the individual dust impact sites in these experiments. In this study, we have used both techniques, along with focused ion beam (FIB) sample preparation, to characterize the micrometer to nanometer scale effects created by accelerated dust impacts into olivine single crystals. To our knowledge this work presents the first TEM-scale characterization of dust impacts into a key solar system silicate mineral using the CCLDAS facility. Our overarching goal for this work is to establish a basis to compare with our previous results on natural dust-impacted lunar olivine and laser-irradiated olivine.

  3. First Principles Based Reactive Atomistic Simulations to Understand the Effects of Molecular Hypervelocity Impact on Cassini's Ion and Neutral Mass Spectrometer

    Science.gov (United States)

    Jaramillo-Botero, A.; Cheng, M-J; Cvicek, V.; Beegle, Luther W.; Hodyss, R.; Goddard, W. A., III

    2011-01-01

    We report here on the predicted impact of species such as ice-water, CO2, CH4, and NH3, on oxidized titanium, as well as HC species on diamond surfaces. These simulations provide the dynamics of product distributions during and after a hypervelocity impact event, ionization fractions, and dissociation probabilities for the various species of interest as a function of impact velocity (energy). We are using these results to determine the relevance of the fragmentation process to Cassini INMS results, and to quantify its effects on the observed spectra.

  4. Hypervelocity Impact Testing of International Space Station Meteoroid/Orbital Debris Shielding Using an Inhibited Shaped Charge Launcher

    Science.gov (United States)

    Kerr, Justin H.; Grosch, Donald

    2001-01-01

    Engineers at the NASA Johnson Space Center have conducted hypervelocity impact (HVI) performance evaluations of spacecraft meteoroid and orbital debris (M/OD) shields at velocities in excess of 7 km/s. The inhibited shaped charge launcher (ISCL), developed by the Southwest Research Institute, launches hollow, circular, cylindrical jet tips to approximately 11 km/s. Since traditional M/OD shield ballistic limit performance is defined as the diameter of sphere required to just perforate or spall a spacecraft pressure wall, engineers must decide how to compare ISCL derived data with those of the spherical impactor data set. Knowing the mass of the ISCL impactor, an equivalent sphere diameter may be calculated. This approach is conservative since ISCL jet tips are more damaging than equal mass spheres. A total of 12 tests were recently conducted at the Southwest Research Institute (SWRI) on International Space Station M/OD shields. Results of these tests are presented and compared to existing ballistic limit equations. Modification of these equations is suggested based on the results.

  5. Identification of minerals and meteoritic materials via Raman techniques after capture in hypervelocity impacts on aerogel

    Energy Technology Data Exchange (ETDEWEB)

    Burchell, M J; Mann, J; Creighton, J A; Kearsley, A; Graham, G A; Esposito, A P; Franchi, I A; Westphal, A J; Snead, C

    2004-10-04

    For this study, an extensive suite of mineral particles analogous to components of cosmic dust were tested to determine if their Raman signatures can be recognized after hypervelocity capture in aerogel. The mineral particles were mainly of greater than 20 micrometers in size and were accelerated onto the silica aerogel by light gas gun shots. It was found that all the individual minerals captured in aerogel could be subsequently identified using Raman (or fluorescent) spectra. The beam spot size used for the laser illumination was of the order of 5 micrometers, and in some cases the captured particles were of a similar small size. In some samples fired into aerogel there was observed a shift in the wavenumbers of some of the Raman bands, a result of the trapped particles being at quite high temperatures due to heating by the laser. Temperatures of samples under laser illumination were estimated from the relative intensities of Stokes and anti-Stokes Raman bands, or, in the case of ruby particles, from the wavenumber of fluorescence bands excited by the laser. It was found that the temperature of particles in aerogel varied greatly, dependent upon laser power and the nature of the particle. In the worst case, some particles were shown to have temperatures in the 500-700 C range at a laser power of about 3 mW at the sample. However most of the mineral particles examined at this laser power had temperatures below 200 C. This is sufficiently low a temperature not to damage most materials expected to be found captured in aerogel in space. In addition, selected meteorite samples were examined to obtain Raman signatures of their constituent minerals and were then shot into aerogel. It was possible to find several Raman signatures after capture in aerogel and obtain a Raman map of a whole grain in situ in the aerogel. Finally, a Raman analysis was carried out of a particle captured in aerogel in space and carbonaceous material identified. In general therefore it is

  6. Characterizing Hypervelocity Impact (HVI-Induced Pitting Damage Using Active Guided Ultrasonic Waves: From Linear to Nonlinear

    Directory of Open Access Journals (Sweden)

    Menglong Liu

    2017-05-01

    Full Text Available Hypervelocity impact (HVI, ubiquitous in low Earth orbit with an impacting velocity in excess of 1 km/s, poses an immense threat to the safety of orbiting spacecraft. Upon penetration of the outer shielding layer of a typical two-layer shielding system, the shattered projectile, together with the jetted materials of the outer shielding material, subsequently impinge the inner shielding layer, to which pitting damage is introduced. The pitting damage includes numerous craters and cracks disorderedly scattered over a wide region. Targeting the quantitative evaluation of this sort of damage (multitudinous damage within a singular inspection region, a characterization strategy, associating linear with nonlinear features of guided ultrasonic waves, is developed. Linear-wise, changes in the signal features in the time domain (e.g., time-of-flight and energy dissipation are extracted, for detecting gross damage whose characteristic dimensions are comparable to the wavelength of the probing wave; nonlinear-wise, changes in the signal features in the frequency domain (e.g., second harmonic generation, which are proven to be more sensitive than their linear counterparts to small-scale damage, are explored to characterize HVI-induced pitting damage scattered in the inner layer. A numerical simulation, supplemented with experimental validation, quantitatively reveals the accumulation of nonlinearity of the guided waves when the waves traverse the pitting damage, based on which linear and nonlinear damage indices are proposed. A path-based rapid imaging algorithm, in conjunction with the use of the developed linear and nonlinear indices, is developed, whereby the HVI-induced pitting damage is characterized in images in terms of the probability of occurrence.

  7. A SELF-CONSISTENT MODEL OF THE CIRCUMSTELLAR DEBRIS CREATED BY A GIANT HYPERVELOCITY IMPACT IN THE HD 172555 SYSTEM

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, B. C.; Melosh, H. J. [Department of Physics, Purdue University, 525 Northwestern Avenue, West Lafayette, IN 47907 (United States); Lisse, C. M. [JHU-APL, 11100 Johns Hopkins Road, Laurel, MD 20723 (United States); Chen, C. H. [STScI, 3700 San Martin Drive, Baltimore, MD 21218 (United States); Wyatt, M. C. [Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA (United Kingdom); Thebault, P. [LESIA, Observatoire de Paris, F-92195 Meudon Principal Cedex (France); Henning, W. G. [NASA Goddard Space Flight Center, 8800 Greenbelt Road, Greenbelt, MD 20771 (United States); Gaidos, E. [Department of Geology and Geophysics, University of Hawaii at Manoa, Honolulu, HI 96822 (United States); Elkins-Tanton, L. T. [Department of Terrestrial Magnetism, Carnegie Institution for Science, Washington, DC 20015 (United States); Bridges, J. C. [Department of Physics and Astronomy, University of Leicester, Leicester LE1 7RH (United Kingdom); Morlok, A., E-mail: johns477@purdue.edu [Department of Physical Sciences, Open University, Walton Hall, Milton Keynes MK7 6AA (United Kingdom)

    2012-12-10

    Spectral modeling of the large infrared excess in the Spitzer IRS spectra of HD 172555 suggests that there is more than 10{sup 19} kg of submicron dust in the system. Using physical arguments and constraints from observations, we rule out the possibility of the infrared excess being created by a magma ocean planet or a circumplanetary disk or torus. We show that the infrared excess is consistent with a circumstellar debris disk or torus, located at {approx}6 AU, that was created by a planetary scale hypervelocity impact. We find that radiation pressure should remove submicron dust from the debris disk in less than one year. However, the system's mid-infrared photometric flux, dominated by submicron grains, has been stable within 4% over the last 27 years, from the Infrared Astronomical Satellite (1983) to WISE (2010). Our new spectral modeling work and calculations of the radiation pressure on fine dust in HD 172555 provide a self-consistent explanation for this apparent contradiction. We also explore the unconfirmed claim that {approx}10{sup 47} molecules of SiO vapor are needed to explain an emission feature at {approx}8 {mu}m in the Spitzer IRS spectrum of HD 172555. We find that unless there are {approx}10{sup 48} atoms or 0.05 M{sub Circled-Plus} of atomic Si and O vapor in the system, SiO vapor should be destroyed by photo-dissociation in less than 0.2 years. We argue that a second plausible explanation for the {approx}8 {mu}m feature can be emission from solid SiO, which naturally occurs in submicron silicate ''smokes'' created by quickly condensing vaporized silicate.

  8. Excess of L-alanine in amino acids synthesized in a plasma torch generated by a hypervelocity meteorite impact reproduced in the laboratory

    Science.gov (United States)

    Managadze, George G.; Engel, Michael H.; Getty, Stephanie; Wurz, Peter; Brinckerhoff, William B.; Shokolov, Anatoly G.; Sholin, Gennady V.; Terent'ev, Sergey A.; Chumikov, Alexander E.; Skalkin, Alexander S.; Blank, Vladimir D.; Prokhorov, Vyacheslav M.; Managadze, Nina G.; Luchnikov, Konstantin A.

    2016-10-01

    We present a laboratory reproduction of hypervelocity impacts of a carbon containing meteorite on a mineral substance representative of planetary surfaces. The physical conditions of the resulting impact plasma torch provide favorable conditions for abiogenic synthesis of protein amino acids: We identified glycine and alanine, and in smaller quantities serine, in the produced material. Moreover, we observe breaking of alanine mirror symmetry with L excess, which coincides with the bioorganic world. Therefore the selection of L-amino acids for the formation of proteins for living matter could have been the result from plasma processes occurring during the impact meteorites on the surface. This indicates that the plasma torch from meteorite impacts could play an important role in the formation of biomolecular homochirality. Thus, meteorite impacts possibly were the initial stage of this process and promoted conditions for the emergence of a living matter.

  9. Excess of L-Alanine in Amino Acids Synthesized in a Plasma Torch Generated by a Hypervelocity Meteorite Impact Reproduced in the Laboratory

    Science.gov (United States)

    Managadze, George G.; Engle, Michael H.; Getty, Stephanie A.; Wurz, Peter; Brinckerhoff, William B.; Shokolov, Anatoly; Sholin, Gennady; Terent'ev, Sergey A.; Chumikov, Alexander E.; Skalkin, Alexander S

    2016-01-01

    We present a laboratory reproduction of hypervelocity impacts of a carbon containing meteorite on a mineral substance representative of planetary surfaces. The physical conditions of the resulting impact plasma torch provide favorable conditions for abiogenic synthesis of protein amino acids: We identified glycine and alanine, and in smaller quantities serine, in the produced material. Moreover, we observe breaking of alanine mirror symmetry with L excess, which coincides with the bioorganic world. Therefore the selection of L-amino acids for the formation of proteins for living matter could have been the result from plasma processes occurring during the impact meteorites on the surface. This indicates that the plasma torch from meteorite impacts could play an important role in the formation of biomolecular homochirality. Thus, meteorite impacts possibly were the initial stage of this process and promoted conditions for the emergence of a living matter.

  10. Luminous Efficiency of Hypervelocity Meteoroid Impacts on the Moon Derived from the 2015 Geminid Meteor Shower

    Science.gov (United States)

    Moser, D. E.; Suggs, R. M.; Ehlert, S. R.

    2017-01-01

    Meteoroids cannot be observed directly because of their small size. In-situ measurements of the meteoroid environment are rare and have very small collecting areas. The Moon, in contrast, has a large collecting area and therefore can be used as a large meteoroid detector for gram-kilogram sized particles. Meteoroids striking the Moon create an impact flash observable by Earth-based telescopes. Their kinetic energy is converted to luminous energy with some unknown luminous efficiency ?(v), which is likely a function of meteoroid velocity (among other factors). This luminous efficiency is imperative to calculating the kinetic energy and mass of the meteoroid, as well as meteoroid fluxes, and it cannot be determined in the laboratory at meteoroid speeds and sizes due to mechanical constraints. Since laboratory simulations fail to resolve the luminous efficiency problem, observations of the impact flash itself must be utilized. Meteoroids associated with specific meteor showers have known speed and direction, which simplifies the determination of the luminous efficiency. NASA has routinely monitored the Moon for impact flashes since early 2006 [1]. During this time, several meteor showers have produced multiple impact flashes on the Moon, yielding a sufficient sample of impact flashes with which to perform a luminous efficiency analysis similar to that outlined in Bellot Rubio et al. [2, 3] and further described by Moser et al. [4], utilizing Earth-based measurements of the shower flux and mass index. The Geminid meteor shower has produced the most impact flashes in the NASA dataset to date with over 80 detections. More than half of these Geminids were recorded in 2015 (locations pictured in Fig. 1), and may represent the largest single-shower impact flash sample known. This work analyzes the 2015 Geminid lunar impacts and calculates their luminous efficiency. The luminous efficiency is then applied to calculate the kinetic energies and mass-es of these shower

  11. First-Order Simulation of Strewn Debris Fields Accompanying Exoatmospheric Re-entry Vehicle Fragmentation by Hypervelocity Impact

    Science.gov (United States)

    1994-09-01

    available information from satellite on- orbit and laboratory collisions. Atmospheric fragment re-entry is modelled using an exponentially dense...interceptions se caracterisent par des etendues de debris mesurant des centaines de kilometres. Si I’ on suppose une distribution uniforme des fragments, on...tests and on- orbit collisions. Much of this work is necessarily speculative: the dynamics of hypervelocity collisions and material behaviour under

  12. Experimental hypervelocity impact into quartz sand. II - Effects of gravitational acceleration

    Science.gov (United States)

    Gault, D. E.; Wedekind, J. A.

    1977-01-01

    Experimental results for craters formed by aluminum spheres impacting at normal incidence against quartz sand targets in gravitational acceleration environments ranging from 0.073 to 1.0 g (g = 980 cm/sq sec) are reported. Impact velocities varied from 0.4 to 8.0 km/sec. Crater dimensions and formation times are compared with results from a simplified dimensional analysis of the cratering processes. Although the comparison indicates a dominant role of gravity relative to the target strength for craters formed in sand, the results serve primarily to emphasize that both gravity and strength are variables of fundamental significance to cratering processes.

  13. Impact of Flight Enthalpy, Fuel Simulant, and Chemical Reactions on the Mixing Characteristics of Several Injectors at Hypervelocity Flow Conditions

    Science.gov (United States)

    Drozda, Tomasz G.; Baurle, Robert A.; Drummond, J. Philip

    2016-01-01

    conditions. The mixing parameters of interest, such as mixing efficiency and total pressure recovery, are then computed and compared to the values obtained from RAS under the true enthalpy conditions and using helium and hydrogen. Finally, the impact of combustion on mixing, often deemed small enough to neglect at hypervelocity conditions, is assessed by comparing the results obtained from the hydrogen-fueled reacting and non-reacting RAS. For reacting flows, in addition to mixing efficiency and total pressure recovery, the combustion efficiency and thrust potential are also considered. In all of the simulations, the incoming air Mach number and the fuel-to-air ratio are the same, while the total pressure, total enthalpy, and the fuel simulant vary depending on the case considered. It is found that under some conditions the "cold" flow experiments are a good approximation of the flight.

  14. Luminous Efficiency of Hypervelocity Meteoroid Impacts on the Moon Derived from the 2015 Geminid Meteor Shower

    Science.gov (United States)

    Moser, D. E.; Suggs, R. M.; Ehlert, S. R.

    2017-01-01

    Since early 2006 the Meteoroid Environment Office (MEO) at NASA's Marshall Space Flight Center has routinely monitored the Moon for impact flashes produced by meteoroids striking the lunar surface. Activity from the Geminid meteor shower (EM) was observed in 2015, resulting in the detection of 45 lunar impact flashes (roughly 10% of the NASA dataset), in about 10 hours of observation with peak R magnitudes ranging from 6.5 to 11. A subset of 30 of these flashes, observed 14-15 December, was analyzed in order to determine the luminous efficiency, the ratio of emitted luminous energy to the meteoroid's kinetic energy. The resulting luminous efficiency, found to range between n = 1.8 x 10(exp -4) and 3.3 x 10(exp -3), depending on the assumed mass index and flux, was than applied to calculate the masses of Geminid meteoroids striking the Moon in 2015.

  15. Experimental hypervelocity impact into quartz sand - Distribution and shock metamorphism of ejecta

    Science.gov (United States)

    Stoeffler, D.; Gault, D. E.; Wedekind, J.; Polkowski, G.

    1975-01-01

    Results are presented for vertical impacts of 0.3-g cylindrical plastic projectiles into noncohesive quartz sand in which vertical and horizontal reference strate were employed by using layers of colored sand. The impacts were performed at velocities of 5.9-6.9 km/sec with a vertical gun ballistic range. The craters, 30-33 cm in diameter, reveal a radial decay of the ejecta mass per unit area with a power of -2.8 to -3.5. Material displaced from the upper 15% of the crater depth d is represented within the whole ejecta blanked, material from deeper than 28% of d is deposited inside 2 crater radii, and no material from deeper than 33% of d was ejected beyond the crater rim. Shock-metamorphosed particles (glassy agglutinates, cataclastic breccias, and comminuted quartz) amount to some 4% of the total displaced mass and indicate progressive zones of decay of shock intensity from a peak pressure of 300 kbar. The shock-metamorphosed particles and the shock-induced change in the grain size distribution of ejected samples have close analogies to the basic characteristics of the lunar regolith. Possible applications to regolith formation and to ejecta formations of large-scale impact craters are discussed.

  16. Particle Size Distrbution in an Experimental Hypervelocity Impact on Dry Sandstone.

    Science.gov (United States)

    Buhl, Elmar; Poelchau, Michael H.; Deutsch, Alex; Kenkmann, Thomas; Dresen, Georg

    2013-04-01

    The particle size distribution (PSD) is a frequently used parameter to describe the deformation-induced fragmentation of fault rocks. It has been shown that resulting particle sizes may be described by a power law (fractal) size distribution: N(d) ~ dD where N(d) is the number of particles larger than diameter d, and D is the D-value. PSDs reported for impact deformation are still very few. D-values for natural and experimental impacts have been reported to range between 1.2-1.8 and 1.4-1.7, respectively. Here we show the systematic distribution of the PSD in the subsurface of an experimental impact crater. The investigated experiment was performed in the framework of the MEMIN project [1]. A 20 cm cube of quartz-rich sandstone (Seeberger Sandstein) was impacted by a 2.5 mm steel sphere at 4.8 km/s, producing a crater of 5.76 cm diameter and 11.0 mm depth [2]. For sample preparation the crater was impregnated with epoxy and the block was bisected. Thin sections were prepared from the crater sub-surface. Backscattered electron (BSE) micro-analysis was conducted by means of a Zeiss Leo 1525 Scanning Electron Microscope. A succession of 20 images (400x magnification) with increasing distance from the crater floor was analyzed. The image analysis software JMicrovision was used for automated object extraction. Area and perimeter of all detected particles were exported and used for PSD analysis. The obtained PSD were fit with a linear function in a log-log plot over at least one order of magnitude in diameter indicating that the PSD follows a power law relationship N(d) ~ dD. The distinct modes of deformation in the crater sub-surface [3] are closely linked to the fracture pattern and thus with the D-value. As expected, comminution was most effective closest to the crater floor. The highest D-value of 1.74 was found at a depth of 0.26-1.07 mm beneath the crater floor. Thus the largest fraction of fine material is situated in there. With growing distance the D-values drop

  17. Risk Assessment of Cassini Sun Sensor Integrity Due to Hypervelocity Impact of Saturn Dust Particles

    Science.gov (United States)

    Lee, Allan Y.

    2016-01-01

    A sophisticated interplanetary spacecraft, Cassini is one of the heaviest and most sophisticated interplanetary spacecraft humans have ever built and launched. Since achieving orbit at Saturn in 2004, Cassini has collected science data throughout its four-year prime mission (2004-08), and has since been approved for first and second extended missions through September 2017. In late 2016, the Cassini spacecraft will begin a daring set of ballistic orbits that will hop the rings and dive between the upper atmosphere of Saturn and its innermost D-ring twenty-two times. The "dusty" environment of the inner D-ring region the spacecraft must fly through is hazardous because of the possible damage that dust particles, travelling at speeds as high as 31.4 km/s, can do to spacecraft hardware. During hazardous proximal ring-plane crossings, the Cassini mission operation team plans to point the high-gain antenna to the RAM vector in order to protect most of spacecraft instruments from the incoming energetic ring dust particles. However, this particular spacecraft attitude will expose two Sun sensors (that are mounted on the antenna dish) to the incoming dust particles. High-velocity impacts on the Sun sensor cover glass might penetrate the 2.54-mm glass cover of the Sun sensor. Even without penetration damage, craters created by these impacts on the surface of the cover glass will degrade the transmissibility of light through it. Apart from being directly impacted by the dust particles, the Sun sensors are also threatened by some fraction of ricochet ejecta that are produced by dust particle impacts on the large antenna dish (made of graphite fiber epoxy composite material). Finally, the spacecraft attitude control system must cope with disturbances due to both the translational and angular impulses imparted on the large antenna dish and the long magnetometer boom by the incoming high-velocity projectiles. Analyses performed to quantify the risks the Sun sensors must contend

  18. Hypervelocity Impact Testing of Materials for Additive Construction: Applications on Earth, the Moon, and Mars

    Science.gov (United States)

    Ordonez, Erick; Edmunson, Jennifer; Fiske, Michael; Christiansen, Eric; Miller, Josh; Davis, Bruce Alan; Read, Jon; Johnston, Mallory; Fikes, John

    2017-01-01

    Additive Construction is the process of building infrastructure such as habitats, garages, roads, berms, etcetera layer by layer (3D printing). The National Aeronautics and Space Administration (NASA) and the United States Army Corps of Engineers (USACE) are pursuing additive construction to build structures using resources available in-situ. Using materials available in-situ reduces the cost of planetary missions and operations in theater. The NASA team is investigating multiple binders that can be produced on planetary surfaces, including the magnesium oxide-based Sorel cement; the components required to make Ordinary Portland Cement (OPC), the common cement used on Earth, have been found on Mars. The availability of OPC-based concrete on Earth drove the USACE to pursue additive construction for base housing and barriers for military operations. Planetary and military base structures must be capable of resisting micrometeoroid impacts with velocities ranging from 11 to 72km/s for particle sizes 200 micrometers or more (depending on protection requirements) as well as bullets and shrapnel with a velocity of 1.036km/s with projectiles 5.66mm diameter and 57.40mm in length, respectively.

  19. Aerogel Keystones: Extraction Of Complete Hypervelocity Impact Events From Aerogel Collectors

    Energy Technology Data Exchange (ETDEWEB)

    Westphal, A J; Snead, C; Butterworth, A; Graham, G A; Bradley, J; Bajt, S; Grant, P G; Bench, G; Brennan, S; Piannetta, P

    2003-11-07

    In January 2006, the Stardust mission will return the first samples from a solid solar-system body since Apollo, and the first samples of contemporary interstellar dust ever collected. Although sophisticated laboratory instruments exist for the analysis of Stardust samples, techniques for the recovery of particles and particle residues from aerogel collectors remain primitive. Here we describe our recent progress in developing techniques for extracting small volumes of aerogel, which we have called ''keystones,'' which completely contain particle impacts but minimize the damage to the surrounding aerogel collector. These keystones can be fixed to custom-designed micromachined silicon fixtures (so-called ''microforklifts''). In this configuration the samples are self-supporting, which can be advantageous in situations in which interference from a supporting substrate is undesirable. The keystones may also be extracted and placed onto a substrate without a fixture. We have also demonstrated the capability of homologously crushing these unmounted keystones for analysis techniques which demand flat samples.

  20. A ballistic limit equation for hypervelocity impacts on composite honeycomb sandwich panel satellite structures

    Science.gov (United States)

    Ryan, S.; Schaefer, F.; Destefanis, R.; Lambert, M.

    During a recent experimental test campaign performed in the framework of ESA Contract 16721, the ballistic performance of multiple satellite-representative Carbon Fibre Reinforced Plastic (CFRP)/Aluminium honeycomb sandwich panel structural configurations (GOCE, Radarsat-2, Herschel/Planck, BeppoSax) was investigated using the two-stage light-gas guns at EMI. The experimental results were used to develop and validate a new empirical Ballistic Limit Equation (BLE), which was derived from an existing Whipple-shield BLE. This new BLE provided a good level of accuracy in predicting the ballistic performance of stand-alone sandwich panel structures. Additionally, the equation is capable of predicting the ballistic limit of a thin Al plate located at a standoff behind the sandwich panel structure. This thin plate is the representative of internal satellite systems, e.g. an Al electronic box cover, a wall of a metallic vessel, etc. Good agreement was achieved with both the experimental test campaign results and additional test data from the literature for the vast majority of set-ups investigated. For some experiments, the ballistic limit was conservatively predicted, a result attributed to shortcomings in correctly accounting for the presence of high surface density multi-layer insulation on the outer facesheet. Four existing BLEs commonly applied for application with stand-alone sandwich panels were reviewed using the new impact test data. It was found that a number of these common approaches provided non-conservative predictions for sandwich panels with CFRP facesheets.

  1. Single microparticle launching method using two-stage light-gas gun for simulating hypervelocity impacts of micrometeoroids and space debris.

    Science.gov (United States)

    Kawai, Nobuaki; Tsurui, Kenji; Hasegawa, Sunao; Sato, Eiichi

    2010-11-01

    A single microparticle launching method is described to simulate the hypervelocity impacts of micrometeoroids and microdebris on space structures at the Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency. A microparticle placed in a sabot with slits is accelerated using a rifled two-stage light-gas gun. The centrifugal force provided by the rifling in the launch tube separates the sabot. The sabot-separation distance and the impact-point deviation are strongly affected by the combination of the sabot diameter and the bore diameter, and by the projectile diameter. Using this method, spherical projectiles of 1.0-0.1 mm diameter were launched at up to 7 km/s.

  2. High-pressure mineral phases of olivine (Mg2SiO4) formed by pre-compression followed by laser-driven hypervelocity shock impact

    Science.gov (United States)

    Turner, A. A.; Tschauner, O. D.; Zaug, J. M.; Stavrou, E.; Armstrong, M.

    2016-12-01

    Understanding high-pressure phase transitions of olivine is a growing sphere of interest for Geoscientists, as olivine is an abundant mineral in the upper mantle of the Earth as well as pre-shocked meteorites. Knowledge of extreme condition olivine chemistry will provide insight into the process of shock metamorphism, which alters the composition and texture of materials during bolide impact and under extreme terrestrial conditions. The intention of investigating olivine under high pressures is to determine under what conditions the silicate spinel Ringwoodite (γ-Mg2SiO4), a high-pressure phase of olivine, is synthesized in shock-metamorphosed meteorites and to explore the nature of olivine beyond the phase boundary of Ringwoodite. Queries posed for these experiments focus primarily on what possible phases form as the result of compressing olivine to pressures above the 40 GPa, the likelihood of those phases to be conserved upon shock release, and what retrograde transformation products could possibly be generated from olivine under such pressures. Two independent endmember specimens (forsterite) of single crystal olivine (Mg2SiO4) were coated with 2.5 µm of aluminum and pre-compressed to 25 and 35 GPa, respectively in a diamond anvil cell. Lithium fluoride served as the pressure-transmitting medium. The specimens were then exposed to a laser-driven hypervelocity shock impact (400 picosecond duration) in order to investigate what phases if any form under more extreme pressures and dynamic stress states. The addition of laser-driven hypervelocity shock added 18 GPa of pressure to the pre-compressed samples, for a total of 43 and 53 GPa, respectively. From the analysis of the x-ray diffraction (XRD) measurements, it was determined that the olivine underwent a reduction of silicon and oxidation of the aluminum coating. These are fascinating observations revealed from a combined static and shock compression experiment. This work was performed under the auspices of

  3. Survivability of systems under multiple factor impact

    Energy Technology Data Exchange (ETDEWEB)

    Korczak, Edward [Telecommunications Research Institute, Warsaw (Poland); Levitin, Gregory [Israel Electric Corporation Ltd., Haifa (Israel)]. E-mail: levitin@iec.co.il

    2007-02-15

    The paper considers vulnerable multi-state series-parallel systems operating under influence of external impacts. Both the external impacts and internal failures affect system survivability, which is determined as the probability of meeting a given demand. The external impacts are characterized by several destructive factors affecting the system or its parts simultaneously. In order to increase the system's survivability a multilevel protection against the destructive factors can be applied to its subsystems. In such systems, the protected subsystems can be destroyed only if all of the levels of their protection are destroyed. The paper presents an algorithm for evaluating the survivability of series-parallel systems with arbitrary configuration of multilevel protection against multiple destructive factor impacts. The algorithm is based on a composition of Boolean and the Universal Generating Function techniques. Illustrative examples are presented.

  4. Sensitivity of dual-wall structures under hypervelocity impact to multi-layer thermal insulation thickness and placement

    Science.gov (United States)

    Schonberg, William P.

    1993-01-01

    Results are presented from an experimental study in which Al dual-wall structures were tested, under various high-speed impact conditions, with a view to the effect of multilayer insulation thickness and location on perforation resistance. Attention is given to comparisons of the damage sustained by dual-wall systems with multilayer insulation blankets of various thicknesses and at various locations within the dual-wall system, under comparable impact loading conditions. The placement of the insulation has a significant effect on the ballistic limit of the dual-wall structures considered, while reducing insulation thickness by as much as a third did not.

  5. Electrocardiographic abnormalities in centenarians: impact on survival

    Directory of Open Access Journals (Sweden)

    Rabuñal-Rey Ramón

    2012-04-01

    Full Text Available Abstract Background The centenarian population is gradually increasing, so it is becoming more common to see centenarians in clinical practice. Electrocardiogram abnormalities in the elderly have been reported, but several methodological biases have been detected that limit the validity of their results. The aim of this study is to analyse the ECG abnormalities in a prospective study of the centenarian population and to assess their impact on survival. Method We performed a domiciliary visit, where a medical history, an ECG and blood analysis were obtained. Barthel index (BI, cognitive mini-exam (CME and Charlson index (ChI were all determined. Patients were followed up by telephone up until their death. Results A total of 80 centenarians were studied, 26 men and 64 women, mean age 100.8 (SD 1.3. Of these, 81% had been admitted to the hospital at least once in the past, 81.3% were taking drugs (mean 3.3, rank 0–11. ChI was 1.21 (SD 1.19. Men had higher scores both for BI (70 -SD 34.4- vs. 50.4 -SD 36.6-, P = .005 and CME (16.5 -SD 9.1- vs. 9.1 –SD 11.6-, P = .008; 40.3% of the centenarians had anaemia, 67.5% renal failure, 13% hyperglycaemia, 22.1% hypoalbuminaemia and 10.7% dyslipidaemia, without statistically significant differences regarding sex. Only 7% had a normal ECG; 21 (26.3% had atrial fibrillation (AF, 30 (37.5% conduction defects and 31 (38.8% abnormalities suggestive of ischemia, without sex-related differences. A history of heart disease was significantly associated with the presence of AF (P = .002, OR 5.2, CI 95% 1.8 to 15.2 and changes suggestive of ischemia (P = .019, OR 3.2, CI 95% 1.2-8.7. Mean survival was 628 days (SD 578.5, median 481 days. Mortality risk was independently associated with the presence of AF (RR 2.0, P = .011, hyperglycaemia (RR 2.2, P = .032, hypoalbuminaemia (RR 3.5, P P = .024. Conclusion Although ECG abnormalities are common in centenarians, they are not related to

  6. Momentum Enhancement from Hypervelocity Crater Ejecta: Implications for the AIDA Target

    Science.gov (United States)

    Flynn, G. J.; Durda, D. D.; Patmore, E. B.; Jack, S. J.; Molesky, M. J.; Strait, M. M.; Macke, R. M.

    2017-09-01

    We performed hypervelocity impact cratering of porous meteorites and terrestrial pumice and found higher values of the momentum enhancement factor due to ejecta than found in hydrocode modeling. This has important implications for kinetic impact deflection of small, hazardous asteroids and on the Asteroid Impact and Deflection Assessment mossion.

  7. The NASA Ames Hypervelocity Free Flight Aerodynamic Facility: Experimental Simulation of the Atmospheric Break-Up of Meteors

    Science.gov (United States)

    Wilder, M. C.; Bogdanoff, D. W.

    2015-01-01

    The Hypervelocity Free Flight Aerodynamic Facility at NASA Ames Research Center provides a potential platform for the experimental simulation of meteor breakup at conditions that closely match full-scale entry condition for select parameters. The poster describes the entry environment simulation capabilities of the Hypervelocity Free Flight Aerodynamic Facility (HFFAF) at NASA Ames Research Center and provides example images of the fragmentation of a hypersonic projectile for which break-up was initiated by mechanical forces (impact with a thin polymer diaphragm).

  8. Hypervelocity orbital intercept guidance using certainty control

    Science.gov (United States)

    Alfano, Salvatore; Fosha, Charles E., Jr.

    1991-06-01

    Terminal guidance of a hypervelocity exoatmospheric orbital interceptor with free end time is examined. A new approach called certainty control is developed where control energy expenditure is reduced by constraining the expected final state to a function of projected estimate error. Conceptually, the constraint produces a shrinking sphere about the predicted impact point with the radius being a function of estimated error. If the predicted miss is inside or touching the sphere, thrusting is not necessary. The interceptor is modeled as a satellite with lateral thrusting capability using two-body orbital dynamics. The target is modeled as an intercontinental ballistic missile (IBM) in its final boost phase prior to burnout. Filtering is accomplished using an eight-state extended Kalman filter with line-of-sight and range updates. The estimated relative trajectory and variances are propagated numerically to predicted impact time and then approximated by splines, eliminating the need to propagate new data repeatedly when present conditions are varied. A search is then made for a new impact time and point that will minimize present interceptor velocity changes and final mass distance. This control strategy, which is applied to two intercept problems, substantially reduces fuel consumption.

  9. Ultrahigh-speed X-ray imaging of hypervelocity projectiles

    Science.gov (United States)

    Miller, Stuart; Singh, Bipin; Cool, Steven; Entine, Gerald; Campbell, Larry; Bishel, Ron; Rushing, Rick; Nagarkar, Vivek V.

    2011-08-01

    High-speed X-ray imaging is an extremely important modality for healthcare, industrial, military and research applications such as medical computed tomography, non-destructive testing, imaging in-flight projectiles, characterizing exploding ordnance, and analyzing ballistic impacts. We report on the development of a modular, ultrahigh-speed, high-resolution digital X-ray imaging system with large active imaging area and microsecond time resolution, capable of acquiring at a rate of up to 150,000 frames per second. The system is based on a high-resolution, high-efficiency, and fast-decay scintillator screen optically coupled to an ultra-fast image-intensified CCD camera designed for ballistic impact studies and hypervelocity projectile imaging. A specially designed multi-anode, high-fluence X-ray source with 50 ns pulse duration provides a sequence of blur-free images of hypervelocity projectiles traveling at speeds exceeding 8 km/s (18,000 miles/h). This paper will discuss the design, performance, and high frame rate imaging capability of the system.

  10. The Physical Understanding of the Use of Coatings to Mitigate Hypervelocity Gouging Considering Real Test Sled Dimensions

    Science.gov (United States)

    2004-09-01

    F08635-97-C-0041, Albuquerque, NM: Applied Research Associates, Inc., February 1998. 109. Schoenfeld , William P. “Requirements for Upgrading the Holloman...Mullin. “Scale Modeling of Hypervelocity Impact,” International Journal of Impact Engineering , 5 :693–701 (1987). 136. Holian, Kathleen S. and Brad Lee

  11. Impact of marital status on renal cancer patient survival.

    Science.gov (United States)

    Wang, Hongzhi; Wang, Lu; Kabirov, Ildar; Peng, Li; Chen, Guang; Yang, Yinhui; A, Zamyatnin Andrey; Xu, Wanhai

    2017-09-19

    Marital status is an independent prognostic factor for various cancer types. The present study used the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute (NCI) to analyze the impact of marital status on renal cancer patient survival outcomes. We identified a total of 62,405 eligible patients (23,800 women and 38,605 men). Overall 5-year renal cancer cause-specific survival (CSS) was 80.3% in the married group, 69.2% in the widowed group, 78.9% in the single group, and 76.5% in the divorced/separated group. The widowed patient group had the highest female/male ratio, more distant metastases, and fewer high-grade (III/IV) tumors. Most widowed patients (90.4%) were elderly (>60 years old). In our study, male renal cancer patients benefited more from marriage than females. We also found that white married patients had better survival outcomes than other white patient groups, but black unmarried and married patients exhibited similar survival outcomes. Our results show that, in general, unmarried patients have higher rates of cancer-specific mortality and highlight the importance of psychological intervention for cancer patients during treatment.

  12. Cometary impact and amino acid survival - Chemical kinetics and thermochemistry

    Science.gov (United States)

    Ross, D.S.

    2006-01-01

    The Arrhenius parameters for the initiating reactions in butane thermolysis and the formation of soot, reliable to at least 3000 K, have been applied to the question of the survival of amino acids in cometary impacts on early Earth. The pressure/temperature/time course employed here was that developed in hydrocode simulations for kilometer-sized comets (Pierazzo and Chyba, 1999), with attention to the track below 3000 K where it is shown that potential stabilizing effects of high pressure become unimportant kinetically. The question of survival can then be considered without the need for assignment of activation volumes and the related uncertainties in their application to extreme conditions. The exercise shows that the characteristic times for soot formation in the interval fall well below the cooling periods for impacts ranging from fully vertical down to about 9?? above horizontal. Decarboxylation, which emerges as more rapid than soot formation below 2000-3000 K, continues further down to extremely narrow impact angles, and accordingly cometa??ry delivery of amino acids to early Earth is highly unlikely. ?? 2006 American Chemical Society.

  13. Study of the Transformation of Meteoritic Organics during Hypervelocity Impacts in Support of Characterisation of Exogenous Organic Matter on the Surface of Icy Satellites

    Science.gov (United States)

    Zaitsev, Maxim; Gerasimov, Mikhail; Ivanova, Marina; Lorenz, Cyril; Aseev, Sergey; Korochantsev, Alexander

    The main goal of the planned missions to Jupiter's Galilean satellites Ganymede or Europa is the search for extraterrestrial life which can be reviled by characterization of surface organics at the landing site. Planets and satellites are exposed for steady meteoritic and cometary bombardment which delivers exogenous organic species. The exogenous organic matter on the satellites surfaces can be represented by both unaltered organic matter of meteorites and comets, and by organic matter which is synthesized from organic and/or mineral components of falling bodies during the impacts. Adequate interpretation of volatile organic compounds (VOCs) on the surface of Ganymede or Europa must take into account the presence of exogenous organic matter described above. The quantitative composition of exogenous organics is difficult to predict because it depends on the frequency of meteoritic/cometary bombardment, conditions and efficiency of organic synthesis in water mantle below the ice crust, speed of the ice crust renovation, and other factors. However, the qualitative composition of exogenous organics can be described through the study of organic matter in different classes of meteorites and products of their shock-evaporative transformation. We have carried out comparative studies of VOCs - products of pyrolysis of carbonaceous chondrites and condensed products of their high-temperature transformation in simulated shock-induced evaporation by pulse laser. We have investigated VOCs in samples of carbonaceous CM2 and CO3 chondrites (Murchison and Kainsaz respectively) and in condensed products of their high-temperature evaporation in neutral (helium) atmosphere using pyrolytic gas chromatography coupled with mass spectrometry (Pyr-GC/MS) [1, 2]. Condensates contained the same hydrocarbons that we extracted at 460(°) C from the bulk samples of meteorites (aliphatic, alicyclic and aromatic hydrocarbons) but sufficiently larger amount of nitrogen-containing compounds

  14. Examination of Steel Specimens Impacted at Hypervelocity

    Science.gov (United States)

    1975-06-01

    However, the shock velocity in lead is lower, thus requiring smaller lead projectiles to give the same shock reverberation time as for an iron...X10xl0I xl0I xl010 p is in gm/cm3 C/Po, 2D/Po, and 3S/P are in ergs/gm and where o andthe remaining quantities are in mm/psec. The reverberation time is

  15. DebriSat Hypervelocity Impact Test

    Science.gov (United States)

    2015-08-01

    data would include fragment size, area-to-mass ratio, density, shape, material composition, optical properties, and radar cross-section...of a multi-shock shield (Fig. 2) which consisted of five separate bumpers. Four bumpers were fiberglass construction and one was steel mesh. Two...only the four fiberglass bumpers for an inflatable module project several years prior to the Debrisat Program. The previous test used a 1.4-cm-diam

  16. Selecting habitat to survive: the impact of road density on survival in a large carnivore.

    Directory of Open Access Journals (Sweden)

    Mathieu Basille

    Full Text Available Habitat selection studies generally assume that animals select habitat and food resources at multiple scales to maximise their fitness. However, animals sometimes prefer habitats of apparently low quality, especially when considering the costs associated with spatially heterogeneous human disturbance. We used spatial variation in human disturbance, and its consequences on lynx survival, a direct fitness component, to test the Hierarchical Habitat Selection hypothesis from a population of Eurasian lynx Lynx lynx in southern Norway. Data from 46 lynx monitored with telemetry indicated that a high proportion of forest strongly reduced the risk of mortality from legal hunting at the home range scale, while increasing road density strongly increased such risk at the finer scale within the home range. We found hierarchical effects of the impact of human disturbance, with a higher road density at a large scale reinforcing its negative impact at a fine scale. Conversely, we demonstrated that lynx shifted their habitat selection to avoid areas with the highest road densities within their home ranges, thus supporting a compensatory mechanism at fine scale enabling lynx to mitigate the impact of large-scale disturbance. Human impact, positively associated with high road accessibility, was thus a stronger driver of lynx space use at a finer scale, with home range characteristics nevertheless constraining habitat selection. Our study demonstrates the truly hierarchical nature of habitat selection, which aims at maximising fitness by selecting against limiting factors at multiple spatial scales, and indicates that scale-specific heterogeneity of the environment is driving individual spatial behaviour, by means of trade-offs across spatial scales.

  17. Selecting habitat to survive: the impact of road density on survival in a large carnivore.

    Science.gov (United States)

    Basille, Mathieu; Van Moorter, Bram; Herfindal, Ivar; Martin, Jodie; Linnell, John D C; Odden, John; Andersen, Reidar; Gaillard, Jean-Michel

    2013-01-01

    Habitat selection studies generally assume that animals select habitat and food resources at multiple scales to maximise their fitness. However, animals sometimes prefer habitats of apparently low quality, especially when considering the costs associated with spatially heterogeneous human disturbance. We used spatial variation in human disturbance, and its consequences on lynx survival, a direct fitness component, to test the Hierarchical Habitat Selection hypothesis from a population of Eurasian lynx Lynx lynx in southern Norway. Data from 46 lynx monitored with telemetry indicated that a high proportion of forest strongly reduced the risk of mortality from legal hunting at the home range scale, while increasing road density strongly increased such risk at the finer scale within the home range. We found hierarchical effects of the impact of human disturbance, with a higher road density at a large scale reinforcing its negative impact at a fine scale. Conversely, we demonstrated that lynx shifted their habitat selection to avoid areas with the highest road densities within their home ranges, thus supporting a compensatory mechanism at fine scale enabling lynx to mitigate the impact of large-scale disturbance. Human impact, positively associated with high road accessibility, was thus a stronger driver of lynx space use at a finer scale, with home range characteristics nevertheless constraining habitat selection. Our study demonstrates the truly hierarchical nature of habitat selection, which aims at maximising fitness by selecting against limiting factors at multiple spatial scales, and indicates that scale-specific heterogeneity of the environment is driving individual spatial behaviour, by means of trade-offs across spatial scales.

  18. The impact of comorbidity on cancer survival: a review

    Directory of Open Access Journals (Sweden)

    Søgaard M

    2013-11-01

    Full Text Available Mette Søgaard,1 Reimar Wernich Thomsen,1 Kristine Skovgaard Bossen,2 Henrik Toft Sørensen,1 Mette Nørgaard1 1Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; 2Danish Cancer Society, Copenhagen, Denmark Background: A number of studies have shown poorer survival among cancer patients with comorbidity. Several mechanisms may underlie this finding. In this review we summarize the current literature on the association between patient comorbidity and cancer prognosis. Prognostic factors examined include tumor biology, diagnosis, treatment, clinical quality, and adherence. Methods: All English-language articles published during 2002–2012 on the association between comorbidity and survival among patients with colon cancer, breast cancer, and lung cancer were identified from PubMed, MEDLINE and Embase. Titles and abstracts were reviewed to identify eligible studies and their main results were then extracted. Results: Our search yielded more than 2,500 articles related to comorbidity and cancer, but few investigated the prognostic impact of comorbidity as a primary aim. Most studies found that cancer patients with comorbidity had poorer survival than those without comorbidity, with 5-year mortality hazard ratios ranging from 1.1 to 5.8. Few studies examined the influence of specific chronic conditions. In general, comorbidity does not appear to be associated with more aggressive types of cancer or other differences in tumor biology. Presence of specific severe comorbidities or psychiatric disorders were found to be associated with delayed cancer diagnosis in some studies, while chronic diseases requiring regular medical visits were associated with earlier cancer detection in others. Another finding was that patients with comorbidity do not receive standard cancer treatments such as surgery, chemotherapy, and radiation therapy as often as patients without comorbidity, and their chance of

  19. Survival

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — These data provide information on the survival of California red-legged frogs in a unique ecosystem to better conserve this threatened species while restoring...

  20. Impact of planting date on annual clover survival in oat

    Science.gov (United States)

    Interseeding annual clovers in cereal grains may help organic producers reduce the need for tillage in their cropping systems. In this study in eastern South Dakota, we evaluated seedling emergence and survival of two annual clovers in oat as affected by planting date. Berseem clover (Trifolium al...

  1. The impact of household wealth on child survival in Ghana.

    Science.gov (United States)

    Lartey, Stella T; Khanam, Rasheda; Takahashi, Shingo

    2016-11-22

    Improving child health is one of the major policy agendas for most of the governments, especially in the developing countries. These governments have been implementing various strategies such as improving healthcare financing, improving access to health, increasing educational level, and income level of the household to improve child health. Despite all these efforts, under-five and infant mortality rates remain high in many developing nations. Some previous studies examined how economic development or household's economic condition contributes to child survival in developing countries. In Ghana, the question as to what extent does economic circumstances of households reduces infant and child mortality still remain largely unanswered. Thus, the purpose of this study is to investigate the extent to which wealth affects the survival of under-five children, using data from the Demographic and Health Survey (DHS) of Ghana. In this study, we use four waves of data from Demographic and Health Surveys (DHS) of Ghana from 1993 to 2008. The DHS is a detailed data set that provides comprehensive information on households and their demographic characteristics in Ghana. Data was obtained by distributing questionnaires to women (from 6000 households) of reproductive age between 15 and 49 years, which asked, among other things, their birth history information. The Weibull hazard model with gamma frailty was used to estimate wealth effect, as well as the trend of wealth effect on child's survival probability. We find that household wealth status has a significant effect on the child survival in Ghana. A child is more likely to survive when he/she is from a household with high wealth status. Among other factors, birth spacing and parental education were found to be highly significant to increase a child's survival probability. Our findings offer plausible mechanisms for the association of household wealth and child survival. We therefore suggest that the Government of Ghana

  2. Impact of beta blockers on epithelial ovarian cancer survival.

    Science.gov (United States)

    Diaz, Elena S; Karlan, Beth Y; Li, Andrew J

    2012-11-01

    Stress may promote ovarian cancer progression through mechanisms including autonomic nervous system mediators such as norepinephrine and epinephrine. Beta blockers, used to treat hypertension, block production of these adrenergic hormones, and have been associated with prolonged survival in several malignancies. We sought to determine the association between beta blocker use and epithelial ovarian cancer (EOC) disease progression and survival. We performed an institutional retrospective review of patients with EOC treated between 1996 and 2006. Patients underwent cytoreductive surgery followed by platinum-based chemotherapy. Women were considered beta blocker users if these medications were documented on at least two records more than 6 months apart. Statistical tests included Fisher's exact, Kaplan-Meier, and Cox regression analyses. 248 met inclusion criteria. 68 patients used antihypertensives, and 23 used beta blockers. Median progression-free survival for beta blocker users was 27 months, compared with 17 months for non-users (p=0.05). Similarly, overall disease-specific survival was longer for beta blocker users (56 months) compared with non-users (48 months, p=0.02, hazard ratio=0.56). Multivariate analysis identified beta blocker use as an independent positive prognostic factor, after controlling for age, stage, grade, and cytoreduction status (p=0.03). Overall survival remained longer for beta blocker users (56 months) when compared with hypertensive patients on other medications (34 months) and patients without hypertension (51 months) (p=0.007). In this cohort of patients with EOC, beta blocker use was associated with a 54% reduced chance of death compared with that of non-users. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. The True Origin of Hypervelocity Stars

    Science.gov (United States)

    Gnedin, Oleg

    2011-10-01

    We propose to obtain WFC3 images of 4 hypervelocity stars in the Galactic halo, in order to conclusively establish their origin. This will be a final epoch of a long-term program to measure precise proper motions in an absolute inertial frame. The origin of these unique stars with extremely large positive radial velocities, in excess of the escape speed from the Galaxy, is consistent only with being ejected by the massive black hole at the Galactic center. Reconstructing the full three-dimensional space motion of these stars, through astrometric proper motions, provides a unique opportunity to measure the shape of the triaxial dark matter halo, at larger distances than is afforded by tidal streams. In Cycles 15 and 17 our team obtained two epochs of observations for these stars with ACS. The accuracy of the proper motion measurement was affected by the CTE degradation in ACS and the unexpected change in the PSF after SM4. The CTE error of HVS3 was unfortunately amplified by the need to use different guide stars and take the second-epoch observations at a 180 degree different orientation. We request third-epoch observations for 4 targets with WFC3 to double the proper motion baseline to 5-6 years and to reduce the systematic error using our newly-developed CTE correction. The new measurement will conclusively confirm or reject the Galactocentric origin of HVSs.

  4. Impact of age, gender and race on patient and graft survival ...

    African Journals Online (AJOL)

    identified as being predictors of reduced graft survival in the elderly patient, including increasing patient age, a pre- transplant history of non-skin cancer, time on the waiting list of less than 1 year, and tobacco use.' Much more controversial is the impact of gender on patient and graft survival following renal transplantation.

  5. Radio-transmitters have no impact on survival of pre-fledged American Woodcocks

    Science.gov (United States)

    Daly, Kyle O.; Andersen, David E.; Brininger, Wayne L.; Cooper, Thomas R.

    2015-01-01

    American Woodcocks (Scolopax minor) are a high priority species of conservation need across most of their breeding range due to long-term population declines. Survival of juveniles may be key to understanding these population declines, but there have been few direct estimates of juvenile woodcock survival rates, and no recent assessment of the possible effect of radio-tagging on juvenile survival. In 2011 and 2012, we radio-tagged 73 juvenile American Woodcocks in west-central Minnesota and compared survival rates of radio-tagged (N = 58) and non-radio-tagged (N = 82) juveniles during the period from hatching to fledging. We compared survival rates of juveniles with known fates and used logistic-exposure models to assess the potential impact of radio-transmitters on survival. We evaluated variables related to juvenile survival including age, hatch date, maximum and minimum temperature, precipitation, and year to assess the possible effects of radio-transmitters. The best-supported model of survival rate of juvenile American Woodcocks included the interaction of age and year and a negative effect of precipitation (β = −0.76, 85% CI: −1.08 to −0.43), but did not include a negative effect of transmitters. Our results suggest that radio-transmitters did not impact survival of juvenile American Woodcocks and that transmitters are a reliable tool for studying survival of juvenile American Woodcocks, and perhaps other precocial shorebirds.

  6. Heart failure etiology impacts survival of patients with heart failure

    DEFF Research Database (Denmark)

    Pecini, Redi; Møller, Daniel Vega; Torp-Pedersen, Christian

    2010-01-01

    BACKGROUND: The impact of heart failure (HF) etiology on prognosis of HF is not well known. METHODS: 3078 patients (median age 75years, 61% male) hospitalized with HF were studied. Patients were classified into six etiology groups: hypertension (HTN, 13.9%), ischemic heart disease (IHD, 42...

  7. Impact of comorbidity on survival after palliative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nieder, Carsten [Nordland Hospital, Department of Oncology and Palliative Medicine, Bodoe (Norway); University of Tromsoe, Institute of Clinical Medicine, Faculty of Health Sciences, Tromsoe (Norway); Engljaehringer, Kirsten [Nordland Hospital, Department of Oncology and Palliative Medicine, Bodoe (Norway); Angelo, Kent [University of Tromsoe, Institute of Clinical Medicine, Faculty of Health Sciences, Tromsoe (Norway)

    2014-12-15

    To evaluate prognostic factors for survival after palliative radiotherapy (PRT) with consideration of different comorbidities and the Charlson comorbidity index (CCI). Between 2007 and 2012, 525 consecutive patients were treated with PRT and included in this retrospective study. Most patients received PRT for bone metastases, for brain metastases, or in order to improve thoracic symptoms from lung cancer. Median age was 69 years. Uni- and multivariate analyses were performed. We recommend assessment of comorbidity when prescribing PRT and selecting the optimal fractionation regimen, because most patients with severe comorbidities had limited survival. One of the possible explanations could be that only a minority of these patients are fit for systemic therapy, which plays an important role in the overall treatment concept. (orig.) [German] Auswertung der prognostischen Faktoren nach palliativer Strahlentherapie (PST) unter besonderer Beruecksichtigung von Begleiterkrankungen und des Charlson Komorbiditaetsindex (CCI). Zwischen 2007 und 2012 wurden 525 konsekutive Patienten mit PST behandelt und in diese retrospektive Studie eingeschlossen. Die haeufigsten PST Indikationen waren Skelett- und Hirnmetastasen bzw. symptomatische Lungentumoren. Das mediane Alter betrug 69 Jahre. Die Ueberlebensdaten wurden in uni- und multivariaten Modellen analysiert. Nur 7 % der Patienten hatten keinerlei Begleiterkrankungen. Bei 49 % lag ein CCI von 1-2 vor, bei 36 % von 3-4 und bei 9 % von mehr als 4. Juengere Patienten, Frauen und Nichtraucher hatten signifikant weniger Begleiterkrankungen. Patienten ohne Begleiterkrankungen waren in signifikant besserem Allgemeinzustand (AZ) und erhielten oefter eine zusaetzliche palliative systemische Therapie. Sowohl Patienten mit niedrigem CCI als auch solche mit nur einer Krebserkrankung in der Anamnese ueberlebten signifikant laenger. In der multivariaten Analyse waren auch noch der AZ und die Anzahl der mit Metastasen befallenen Organe mit

  8. Heart failure etiology impacts survival of patients with heart failure

    DEFF Research Database (Denmark)

    Pecini, Redi; Møller, Daniel Vega; Torp-Pedersen, Christian

    2010-01-01

    BACKGROUND: The impact of heart failure (HF) etiology on prognosis of HF is not well known. METHODS: 3078 patients (median age 75years, 61% male) hospitalized with HF were studied. Patients were classified into six etiology groups: hypertension (HTN, 13.9%), ischemic heart disease (IHD, 42...... risk, HR 1.71 (CI: 1.3-2.2, p/=30% (HR 1.3, CI: 1.0-1.5, p=0.03), compared to the reference (p-value for interaction...

  9. The techniques of metallic foil electrically exploding driving hypervelocity flyer to more than 10 km/s for shock wave physics experiments.

    Science.gov (United States)

    Wang, Guiji; He, Jia; Zhao, Jianheng; Tan, Fuli; Sun, Chengwei; Mo, Jianjun; Xong, Xin; Wu, Gang

    2011-09-01

    Electrical explosion of metallic foil or wire is widely used to the fields of material science (preparation of nao-meter materials), dynamics of materials, and high energy density physics. In this paper, the techniques of gaining hypervelocity flyer driven by electrical explosion of metallic foil were researched, which are used to study dynamics of materials and hypervelocity impact modeling of space debris. Based on low inductance technologies of pulsed storage energy capacitor, detonator switch and parallel plate transmission lines with solid films insulation, two sets of experimental apparatuses with storage energy of 14.4 kJ and 40 kJ were developed for launching hypervelocity flyer. By means of the diagnostic technologies of velocity interferometer system for any reflectors and fibre-optic pins, the hypervelocity polyester (Mylar) flyers were gained. For the apparatus of 14.4 kJ, flyer of diameter φ6 ~ φ10 mm and thickness of 0.1 ~ 0.2 mm was accelerated to the hypervelocity of 10 ~ 14 km/s. And for the apparatus of 40 kJ, flyer of diameter φ20 ~ 30 mm and thickness of 0.2 mm was launched to the velocity of 5 ~ 8 km/s. The flatness of the flyer is not more than 34 ns for the flyer with diameter of 20 mm, and less than 22 ns for the flyer with diameter of 10 mm. Based on the Lagrange hydrodynamic code, one dimensional simulation was done by introducing database of equation of states, discharging circuit equation and Joule heat equation, and modifying energy equation. The simulation results are well agreed with the experimental results in accelerating processing. The simulation results can provide good advices in designing new experiments and developing new experimental devices. Finally, some experiments of materials dynamics and hypervelocity impact of space debris were done by using the apparatus above. The results show that the apparatus of metallic foil electrically exploding driving hypervelocity flyer is a good and versatile tool for shock dynamics.

  10. An analysis of the survivability of sensor darts in impacts with trees.

    Energy Technology Data Exchange (ETDEWEB)

    Prentice, John K. (Sci-Tac, Inc., Boulder, CO.); Gardner, David Randall

    2005-07-01

    A methodology was developed for computing the probability that the sensor dart for the 'Near Real-Time Site Characterization for Assured HDBT Defeat' Grand-Challenge LDRD project will survive deployment over a forested region. The probability can be decomposed into three approximately independent probabilities that account for forest coverage, branch density and the physics of an impact between the dart and a tree branch. The probability that a dart survives an impact with a tree branch was determined from the deflection induced by the impact. If a dart that was deflected so that it impacted the ground at an angle of attack exceeding a user-specified, threshold value, the dart was assumed to not survive the impact with the branch; otherwise it was assumed to have survived. A computer code was developed for calculating dart angle of attack at impact with the ground and a Monte Carlo scheme was used to calculate the probability distribution of a sensor dart surviving an impact with a branch as a function of branch radius, length, and height from the ground. Both an early prototype design and the current dart design were used in these studies. As a general rule of thumb, it we observed that for reasonably generic trees and for a threshold angle of attack of 5{sup o} (which is conservative for dart survival), the probability of reaching the ground with an angle of attack less than the threshold is on the order of 30% for the prototype dart design and 60% for the current dart design, though these numbers should be treated with some caution.

  11. Impact of nutritional stress on early embryonic survival

    Directory of Open Access Journals (Sweden)

    Sukanta Mondal

    2015-09-01

    Full Text Available Background: Low reproductive efficiency is the most critical problem faced by the livestock industry across the globe. Early embryonic loss is one the major cause of poor reproductive efficiency resulting in delayed pregnancy, fewer calves born, reduced milk production, slower genetic progress and substantial financial loss to the beef or dairy industry. The establishment of pregnancy results from the interaction between the embryo and the dam and is the culmination of a series of events initiated with development of the follicle and gametes. Among numerous internal and external factors nutrition has the potency to alter the micro-environment of the oocyte and the embryo, making it more hostile to optimal fertilization and pre-implantation embryonic growth. Understanding the impact of nutritional stress on oocyte function, embryo development and reciprocal signaling networks between the embryo and uterus will lead to alleviation of the problems of early embryonic mortality.

  12. Impact microcraters on an Australasian microtektite

    Digital Repository Service at National Institute of Oceanography (India)

    ShyamPrasad, M.; Sudhakar, M.

    has a welded promontory, is unique. The projectiles that produced the impacts defined varying trajectories and velocities, ranging from hypervelocity to low velocity (a few 10 m/s). The impacts took place while the microtektite was in flight...

  13. Integrated population modeling reveals the impact of climate on the survival of juvenile emperor penguins.

    Science.gov (United States)

    Abadi, Fitsum; Barbraud, Christophe; Gimenez, Olivier

    2017-03-01

    Early-life demographic traits are poorly known, impeding our understanding of population processes and sensitivity to climate change. Survival of immature individuals is a critical component of population dynamics and recruitment in particular. However, obtaining reliable estimates of juvenile survival (i.e., from independence to first year) remains challenging, as immatures are often difficult to observe and to monitor individually in the field. This is particularly acute for seabirds, in which juveniles stay at sea and remain undetectable for several years. In this work, we developed a Bayesian integrated population model to estimate the juvenile survival of emperor penguins (Aptenodytes forsteri), and other demographic parameters including adult survival and fecundity of the species. Using this statistical method, we simultaneously analyzed capture-recapture data of adults, the annual number of breeding females, and the number of fledglings of emperor penguins collected at Dumont d'Urville, Antarctica, for the period 1971-1998. We also assessed how climate covariates known to affect the species foraging habitats and prey [southern annular mode (SAM), sea ice concentration (SIC)] affect juvenile survival. Our analyses revealed that there was a strong evidence for the positive effect of SAM during the rearing period (SAMR) on juvenile survival. Our findings suggest that this large-scale climate index affects juvenile emperor penguins body condition and survival through its influence on wind patterns, fast ice extent, and distance to open water. Estimating the influence of environmental covariates on juvenile survival is of major importance to understand the impacts of climate variability and change on the population dynamics of emperor penguins and seabirds in general and to make robust predictions on the impact of climate change on marine predators. © 2016 John Wiley & Sons Ltd.

  14. The Impact of IT Outsourcing on Surviving Employees: Managing Survivor Syndrome Symptoms

    Science.gov (United States)

    Lyons, Tony R.

    2010-01-01

    Global outsourcing of information technology functions has become a major tool used by organizations to increase or maintain competitive market positioning. One often overlooked in determining an organization's level of success from outsourcing is the negative impact on the behavioral and emotional well-being of surviving employees, often referred…

  15. Oak mast production and animal impacts on acorn survival in the central hardwoods

    Science.gov (United States)

    Kenneth F. Kellner; Jeffery K. Riegel; Nathanael I. Lichti; Robert K. Swihart

    2013-01-01

    As part of the Hardwood Ecosystem Experiment we measured mast production in white (Quercus alba) and black (Q. velutina) oak, and quantified the impacts of seed predators on acorn survival over a 3-year period. Specifically, we measured the proportion of acorns of each species infested with weevils (Curculio spp...

  16. Hypervelocity Technology Escape System Concepts. Volume 1. Development and Evaluation

    Science.gov (United States)

    1988-07-01

    vigilance 0 Prophylactic ,ledici nes/therapeutic drugs* Stomach awareness Key: HVT = Hypervelocity vehicle DCS = Decompression sickness CNS = Central ...Extrapolated A-V pressure ANpessure presur diffe ~ nce difen .. ~~,~of 80 mm Hg’ -W mmHO .. ,....s........ 40 80 80 100 120 140 180 180 200 RPM Human...thermal control. When the environmental tempe .ature is increased, arterial/ venous shunts are opened In the skin increasing blood flow in these areas

  17. The probability of forming hypervelocity stars in the Galaxy

    Science.gov (United States)

    Dremova, G. N.; Dremov, V. V.; Orlov, V. V.; Tutukov, A. V.; Shirokova, K. S.

    2015-11-01

    The probability of forming a Galactic hypervelocity star is estimated for the scenario of Hills, which describes the dynamical capture of one component of a binary star by the gravitational field of the supermassive black hole in the Galactic center, leading to the ejection of the other component. Ten thousand initial orientations of the binary orbits were considered, and the semi-major axes of the binary orbits were varied in a wide range from 11.3 R ⊙ to 425 R ⊙. Two series of computations were carried out, in which the mass of the supermassive black hole was taken to be 106 M ⊙ and 3.4 × 106 M ⊙. Numerical simulations of encounters of the binary and black hole in the framework of the three-body and N-body problems are used to localize regions favorable for the formation of hypervelocity stars. The motion of the ejected star in the regular field of the Galaxy is calculated, and the conditions under which the star escapes the Galaxy defined. The probability of escaping the Galaxy is caluclated as a function of various parameters the initial separation of the binary components and the distance of the binary from the black hole. On average, the probability of forming a hypervelocity star is higher for closer encounters and more tightly bound binary pairs.

  18. Impact of body mass index on ovarian cancer survival varies by stage.

    Science.gov (United States)

    Bandera, Elisa V; Lee, Valerie S; Qin, Bo; Rodriguez-Rodriguez, Lorna; Powell, C Bethan; Kushi, Lawrence H

    2017-07-11

    Research on the effect of body mass index (BMI) on ovarian cancer survival is inconsistent, but previous studies did not consider the possible impact of ascites, bowel obstruction, or cachexia, which commonly occur in late-stage disease. We evaluated the association of BMI, before and around the time of diagnosis, with overall and disease-specific survival in a cohort study of primary invasive epithelial ovarian cancers diagnosed from 2000 to 2013 in Kaiser Permanente Northern California (KPNC) (n=1184). Deaths were identified through December 2014, with a median follow-up of 37 months. Proportional hazards regression was used to estimate overall and ovarian cancer-specific mortality, accounting for prognostic variables including age at diagnosis, race, stage, grade, histology, comorbidities, treatment, post-treatment CA125 levels, ascites, and bowel obstruction. There was no evidence of an association between BMI and overall or ovarian cancer-specific survival. However, we found strong effect modification by stage (P interaction <0.01). Compared with normal prediagnosis BMI (18.5-24.9 kg m -2 ), for women who were obese before diagnosis (BMI⩾35 kg m -2 ) ovarian cancer-specific survival was lower among those diagnosed at stages I/II (hazard ratio (HR): 3.40; 95% confidence interval (CI): 1.16-9.99), but increased among those diagnosed with stage IV disease (HR: 0.58; 95% CI: 0.35-0.96). Associations were attenuated after excluding those diagnosed with cachexia (n=82) and further adjustment for ascites and bowel obstruction, with no evidence of effect modification by these factors. Associations of obesity with ovarian cancer survival may differ by stage, with decreased survival among those with localised disease and increased survival among those with late-stage disease. Stage-specific effects of obesity on survival suggest a tailored approach to improve prognosis may be appropriate.

  19. Prognostic factors for locoregional recurrence and survival in stage IIIC breast carcinoma: impact of adjuvant radiotherapy.

    Science.gov (United States)

    Kuru, B

    2011-04-01

    The aims of the present study were to define the prognostic factors for locoregional recurrence (LRR) and survival in stage IIIC breast carcinoma as well as to examine the impact of adjuvant radiotherapy on the outcome of the disease. The records of 586 consecutive patients with stage IIIC breast carcinoma who underwent modified radical mastectomy were evaluated, and the prognostic factors for LRR and survival were analysed. Survival curves were generated using the Kaplan-Meier method, and multivariate analysis was performed using the Cox proportional hazard model. Five-year LRR and survival of stage IIIC breast carcinoma were 15 percent and 41.3 percent, respectively. Five-year LRR was significantly lower and five-year survival was significantly higher for all patients as well as for T1-2 patients with one to three apical node involvements who were treated with adjuvant radiotherapy. In multivariate analysis, apical node involvement, age below 35 years, T4 tumour, grade 3, extracapsular extension and lymphovascular invasion decreased survival, whereas adjuvant tamoxifen and adjuvant radiotherapy (risk ratio [RR] 0.51, 95 percent confidence interval [CI] 0.39-0.67) increased survival. Adjuvant radiotherapy was the sole independent factor that was found to be significantly associated with decreased LRR (RR 0.25, 95 percent CI 0.16-0.38). Radiotherapy decreased LRR and increased survival significantly in all stage IIIC patients and in the subgroup of T1-2 patients with one to three apical node involvements. Thus, it should be considered in the treatment of stage IIIC breast carcinoma.

  20. The impact of psychosocial intervention on survival in cancer: a meta-analysis.

    Science.gov (United States)

    Fu, Wayne W; Popovic, Marko; Agarwal, Arnav; Milakovic, Milica; Fu, Terence S; McDonald, Rachel; Fu, Gordon; Lam, Michael; Chow, Ronald; Cheon, Stephanie; Pulenzas, Natalie; Lam, Henry; DeAngelis, Carlo; Chow, Edward

    2016-04-01

    The impact of psychosocial interventions on survival remains controversial in patients with cancer. A meta-analysis of the recent literature was conducted to evaluate the potential survival benefit associated with psychosocial interventions for cancer patients. MEDLINE, EMBASE, and Cochrane Central were searched from January 2004 to May 2015 for all randomized controlled trials (RCTs) that compared survival outcomes between cancer patients receiving a psychosocial intervention and those receiving other, or no interventions. Endpoints included one-, two-, and four-year overall survival. Subgroup analyses were performed to compare group-versus individually-delivered interventions, and to assess breast cancer-only trials. Of 5,080 identified articles, thirteen trials were included for analysis. There was a significant survival benefit for the intervention group at one year [risk ratio (RR) =0.82; 95% confidence interval (CI), 0.67-1.00; P=0.04] and two years (RR =0.86; 95% CI, 0.78-0.95; P=0.003). However, no significant difference was detected at four years (RR =0.94; 95% CI, 0.85-1.04; P=0.24). Among patients with breast cancer, there was a significant survival benefit of psychosocial interventions at one year (RR =0.59; 95% CI, 0.42-0.82; P=0.002), but no difference at two years (RR =0.82; 95% CI, 0.67-1.02; P=0.07) or four years (RR =0.95; 95% CI, 0.73-1.23; P=0.68). Group-delivered interventions had a significant survival benefit favouring the intervention group at one year (RR =0.57; 95% CI, 0.41-0.79; P=0.0008), but no difference at two years (RR =0.84; 95% CI, 0.68-1.02; P=0.08) or four years (RR =0.94; 95% CI, 0.75-1.20; P=0.64). Individually-delivered interventions had no significant survival benefit at one year (RR =0.92; 95% CI, 0.79-1.08; P=0.32), two years (RR =0.87; 95% CI, 0.75-1.00; P=0.05), or four years (RR =0.93; 95% CI, 0.84-1.04; P=0.21). For the main analysis and group-delivered treatments, psychosocial interventions demonstrated only short

  1. Multiple HPV genotype infection impact on invasive cervical cancer presentation and survival.

    Science.gov (United States)

    Nogueira Dias Genta, Maria Luiza; Martins, Toni Ricardo; Mendoza Lopez, Rossana V; Sadalla, José Carlos; de Carvalho, João Paulo Mancusi; Baracat, Edmund Chada; Levi, José Eduardo; Carvalho, Jesus Paula

    2017-01-01

    Invasive cervical cancer (ICC) is the third most common malignant neoplasm affecting Brazilian women. Little is known about the impact of specific HPV genotypes in the prognosis of ICC. We hypothesized that HPV genotype would impact ICC clinical presentation and survival. Women diagnosed with ICC at the Instituto do Câncer do Estado de São Paulo (ICESP) between May 2008 and June 2012 were included in the study and were followed until December 2015. HPV genotype was detected from formalin-fixed paraffin-embedded (FFPE) tumor tissue samples using Onclarity™ system (BD Viper™ LT automated system). 292 patients aged 50±14 years were analyzed. HPVDNA was detected in 84% of patients. The HPV genotypes studied were: HPV16 (64%), HPV18 (10%), HPV33-58 (7%), HPV45 (5%), HPV31 (4%) and other high-risk HPV genotypes (11%). HPV genotypes showed different distributions regarding histological type and clinical stage. Patients were followed for 35±21 months. The overall survival at 5 years after diagnosis of cervical cancer was 54%. Age, clinical staging, histological type and multiple HPV genotypes infection detected in the same tumor specimen were associated with poorer overall survival on multivariate Cox proportional hazard analysis (pgenotype affected survival. Multiple HPV genotype infection was associated with poorer ICC survival in our study, compared with single genotype infection. HPV genotyping from FFPE tumor tissue using an automated assay such as the Onclarity BD™ assay provides a simpler alternative for routine clinical use. This is the largest study employing an automated HPV genotyping assay using FFPE of ICC. Multiple HPV genotype infection adversely influenced survival.

  2. The pivotal impact of center characteristics on survival of candidates listed for deceased donor kidney transplantation.

    Science.gov (United States)

    Schold, Jesse D; Harman, Jeffrey S; Chumbler, Neale R; Duncan, R Paul; Meier-Kriesche, Herwig-Ulf

    2009-02-01

    There are currently over half a million end-stage renal disease patients and >70,000 patients listed to receive a deceased donor kidney transplant in the United States. To receive a deceased donor transplant, patients are placed on a waiting list at one of approximately 240 centers. Although candidate decisions to list at a particular center may often be made passively (based on proximity or physician referral), the important question remains as to whether the center of listing has a significant impact on patient outcomes. The study evaluated adult kidney transplant candidates in the United States listed from 1995 to 2000 (n = 108,928) with follow-up through 2006. The primary outcome of patient survival was investigated with survival models evaluated with respect to 4 center characteristics (volume, donor quality, waiting time, past performance). Center characteristics derived from years preceding listing, simulating information that could be attainable for prospective candidates. Center waiting time had a marked association with survival (Adjusted hazard ratio = 1.32, 95% confidence interval: 1.27-1.38 for the longest waiting times). Past performance and donor quality also had significant association with survival; center volume was not a significant factor. The cumulative impact of center factors resulted in an average 4-year difference in life expectancy. Center characteristics at listing were strongly correlated with levels at the time of transplantation and centers with the "best" characteristics were located in every region of the country. Center characteristics have significant impact on kidney transplant candidate survival. Information regarding the variability and importance of center factors should be clearly disseminated to transplant candidates.

  3. Use and duration of chemotherapy and its impact on survival in early-stage ovarian cancer.

    Science.gov (United States)

    Dinkelspiel, Helen E; Tergas, Ana I; Zimmerman, Lilli A; Burke, William M; Hou, June Y; Chen, Ling; Hillyer, Grace; Neugut, Alfred I; Hershman, Dawn L; Wright, Jason D

    2015-05-01

    Although 5-year survival for early-stage ovarian cancer is favorable, prognosis at recurrence is poor, necessitating appropriate initial management. We examined the patterns of care and the impact of the duration of chemotherapy on survival for women with early-stage ovarian cancer. We used the SEER-Medicare database to identify women ≥ 65 years of age with stage I ovarian cancer diagnosed from 1992 to 2009. Patients were categorized as low-risk (non-clear cell histology, stage IA or IB, grade 1 or 2) or high-risk (clear cell histology, grade 3, or stage IC). We used multivariable logistic regression models to determine predictors of chemotherapy use and duration and Cox proportional hazards models to evaluate the effect of chemotherapy use and duration on survival. We identified 1394 patients. Among low-risk patients, 32.9% received adjuvant chemotherapy and the use of chemotherapy increased with time. Among high-risk patients, 71.9% received adjuvant chemotherapy; 44.2% had ≤ 3 months of treatment, and 55.8% had > 3 months of treatment. Older patients were less likely to receive chemotherapy, while those with higher stage and grade were more likely to receive chemotherapy (Pearly-stage ovarian cancer patients, practice patterns are widely divergent. Extended duration chemotherapy does not appear to impact survival for women with high-risk disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Impact of periodontal maintenance on tooth survival in patients with removable partial dentures.

    Science.gov (United States)

    Tada, Sayaka; Allen, Patrick Finbarr; Ikebe, Kazunori; Matsuda, Ken-ichi; Maeda, Yoshinobu

    2015-01-01

    Removable partial dentures (RPDs) may have a negative impact on oral health and have the potential to cause further tooth loss, especially of abutment teeth. However, no evidence indicates the effective interval of regular periodontal maintenance after RPD provision. This practice-based cohort study aimed to examine the impact of regular periodontal maintenance visits on survival of RPD abutment teeth. One hundred and ninety-two patients had been previously provided with 304 new clasp-retained RPDs at Osaka University Dental Hospital, Japan. Using the Kaplan-Meier method and log-rank test, 1094 abutments were analysed to illustrate survival curves and to compare each curve. According to the frequency of periodontal maintenance, study samples were divided into three groups; every 3-6 months (3-6M) group, 1-year (1Y) group and no-maintenance (NM) group. Seven-year cumulative survival rates were 83.7% (3-6M), 75.5% (1Y) and 71.9% (NM) respectively. Survival of abutment teeth in the 3-6M group was significantly better than both 1Y (p = 0.005) and NM (p periodontal maintenance at least once in 6 months had the most favourable outcome. Frequent periodontal maintenance after RPD provision could be effective in preventing further tooth loss. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Graft pathology at the time of harvest: impact on long-term survival

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2014-12-01

    Full Text Available Objective: This study aims to present the graft pathology at the time of harvest and its impact on long-term survival. Methods: The remnants of the bypass grafts from 66 consecutive patients with coronary artery disease receiving a coronary artery bypass grafting were investigated pathologically, and pertinent predictive risk factors and survival were analyzed. Results: Medial degenerative changes with or without intimal proliferation were present in 36.8%, 37.8% and 35.6% of left internal mammary artery (IMA, radial artery and saphenous vein grafts. There were 2 (3.0% hospital deaths and 9 (14.1% late deaths. Multinomial logistic regression revealed left IMA pathological changes, dyslipidemia, history of percutaneous transluminal coronary angioplasty/stent deployment and Y-graft were significant predictive risk factors negatively influencing the patients’ long-term survival. Kaplan-Meier survival analysis revealed that the long-term survival of patients with left IMA pathological changes were significantly reduced compared with those without (74.1% vs. 91.4%, P=0.002; whereas no differences were noted in long-term survivals between patients with and without pathological changes of the radial arterial or saphenous vein grafts. Conclusion: Pathological changes may be seen in the bypass graft at the time of harvest. The subtle ultrastructural modifications and the expressions of vascular tone regulators might be responsible for late graft patency. The pathological changes of the left IMA at the time of harvest rather than those of the radial artery or saphenous vein graft affect significantly longterm survival. Non-traumatic maneuver of left IMA harvest, well-controlled dyslipidemia and avoidance of using composite grafts can be helpful in maintaining the architecture of the grafts.

  6. Impact of scalp location on survival in head and neck melanoma: A retrospective cohort study.

    Science.gov (United States)

    Xie, Charles; Pan, Yan; McLean, Catriona; Mar, Victoria; Wolfe, Rory; Kelly, John

    2017-03-01

    Scalp melanomas have more aggressive clinicopathological features than other melanomas and mortality rates more than twice that of melanoma located elsewhere. We sought to describe the survival of patients with scalp melanoma versus other cutaneous head and neck melanoma (CHNM), and explore a possible independent negative impact of scalp location on CHNM survival. A retrospective cohort study was performed of all invasive primary CHNM cases seen at a tertiary referral center over a 20-year period. Melanoma-specific survival (MSS) was compared between scalp melanoma and other invasive CHNM. Multivariable Cox proportional hazards regression was performed to determine associations with survival. On univariate analysis, patients with scalp melanoma had worse MSS than other CHNM (hazard ratio 2.22, 95% confidence interval 1.59-3.11). Scalp location was not associated with MSS in CHNM on multivariable analysis (hazard ratio 1.11, 95% confidence interval 0.77-1.61) for all tumors together, but remained independently associated with MSS for the 0.76- to 1.50-mm thickness stratum (hazard ratio 5.51, 95% confidence interval 1.55-19.59). Disease recurrence was not assessed because of unavailable data. The poorer survival of scalp melanoma is largely explained by greater Breslow thickness and a higher proportion of male patients. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  7. Impact of Interstitial Pneumonia on the Survival and Risk Factors Analysis of Patients with Hematological Malignancy

    Directory of Open Access Journals (Sweden)

    Wei-Liang Chen

    2013-01-01

    Full Text Available Background. The emergence of interstitial pneumonia (IP in patients with hematological malignancy (HM is becoming a challenging scenario in current practice. However, detailed characterization and investigation of outcomes and risk factors on survival have not been addressed. Methods. We conducted a retrospective study of 42,584 cancer patients covering the period between 1996 and 2008 using the institutional cancer registry system. Among 816 HM patients, 61 patients with IP were recognized. The clinical features, laboratory results, and histological types were studied to determine the impact of IP on survival and identify the profile of prognostic factors. Results. HM patients with IP showed a significant worse survival than those without IP in the 5-year overall survival (P=0.027. The overall survival showed no significant difference between infectious pneumonia and noninfectious interstitial pneumonia (IIP versus nIIP (P=0.323. In a multivariate Cox regression model, leukocyte and platelet count were associated with increased risk of death. Conclusions. The occurrence of IP in HM patients is associated with increased mortality. Of interest, nIIP is a prognostic indicator in patients with lymphoma but not in patients with leukemia. However, aggressive management of IP in patients with HM is strongly advised, and further prospective survey is warranted.

  8. Impact of Pancreatic Rat Islet Density on Cell Survival during Hypoxia

    Directory of Open Access Journals (Sweden)

    A. Rodriguez-Brotons

    2016-01-01

    Full Text Available In bioartificial pancreases (BP, the number of islets needed to restore normoglycaemia in the diabetic patient is critical. However, the confinement of a high quantity of islets in a limited space may impact islet survival, particularly in regard to the low oxygen partial pressure (PO2 in such environments. The aim of the present study was to evaluate the impact of islet number in a confined space under hypoxia on cell survival. Rat islets were seeded at three different concentrations (150, 300, and 600 Islet Equivalents (IEQ/cm2 and cultured in normal atmospheric pressure (160 mmHg as well as hypoxic conditions (15 mmHg for 24 hours. Cell viability, function, hypoxia-induced changes in gene expression, and cytokine secretion were then assessed. Notably, hypoxia appeared to induce a decrease in viability and increasing islet density exacerbated the observed increase in cellular apoptosis as well as the loss of function. These changes were also associated with an increase in inflammatory gene transcription. Taken together, these data indicate that when a high number of islets are confined to a small space under hypoxia, cell viability and function are significantly impacted. Thus, in order to improve islet survival in this environment during transplantation, oxygenation is of critical importance.

  9. Skp2 expression unfavorably impacts survival in resectable esophageal squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Liang Yi

    2012-05-01

    Full Text Available Abstract Background The correlation of S-phase kinase–associated protein 2 (Skp2 with metastasis and prognosis in esophageal squamous cell carcinoma (ESCC is controversial. The purpose of this study was to explore whether there was a correlation between the expression of Skp2 evaluated by immunohistochemistry and the clinical outcome of patients with operable ESCC, and to further determine the possible mechanism of the impact of Skp2 on survival. Methods Tissue microarrays that included 157 surgically resected ESCC specimens was successfully generated for immunohistochemical evaluation. The clinical/prognostic significance of Skp2 expression was analyzed. Kaplan-Meier analysis was used to compare the postoperative survival between groups. The prognostic impact of clinicopathologic variables and Skp2 expression was evaluated using a Cox proportional hazards model. A cell proliferation assay and a colony formation assay were performed in ESCC cell lines to determine the function of Skp2 on the progression of ESCC in vitro. Results Skp2 expression correlated closely with the T category (p = 0.035 and the pathological tumor-node-metastasis (TNM stage (p = 0.027. High expression of Skp2 was associated with poor overall survival in resectable ESCC (p = 0.01. The multivariate Cox regression analysis demonstrated that pathological T category, pathological N category, cell differentiation, and negative Skp2 expression were independent factors for better overall survival. In vitro assays of ESCC cell lines demonstrated that Skp2 promoted the proliferative and colony-forming capacity of ESCCs. Conclusions Negative Skp2 expression in primary resected ESCC is an independent factor for better survival. Skp2 may play a pro-proliferative role in ESCC cells.

  10. Looking inward: The impact of operative time on graft survival after liver transplantation.

    Science.gov (United States)

    Lee, David D; Li, Jun; Wang, Guihua; Croome, Kristopher P; Burns, Justin M; Perry, Dana K; Nguyen, Justin H; Hopp, Wallace J; Taner, C Burcin

    2017-10-01

    Operative time often has been cited as an important factor for postoperative outcomes. Despite this belief, most efforts to improve liver transplant outcomes have largely focused on only patient and donor factors, and little attention has been paid on operative time. The primary objective of this project was to determine the impact of operative time on graft survival after liver transplant. A retrospective review of 2,877 consecutive liver transplants performed at a single institution was studied. Data regarding recipient, donor, and operative characteristics, including detailed granular operative times were collected prospectively and retrospectively reviewed. Using an instrument variable approach, Cox multivariate modeling was performed to assess the impact of operative time without the confounding of known and unknown variables. Of the 2,396 patients who met the criteria for review, the most important factors determining liver transplant graft survival included recipient history of Hepatitis C (hazard ratio 1.45, P = .02), donor age (hazard ratio 1.23, P = .03), use of liver graft from donation after cardiac death donor (hazard ratio 1.50, P operative time (hazard ratio 1.26, P = .01). In detailed analysis of stages of the liver transplant operation, the time interval from incision to anhepatic phase was associated with graft survival (hazard ratio 1.33; P = .02). Using a novel instrument variable approach, we demonstrate that operative time (in particular, the time interval from incision to anhepatic time) has a significant impact on graft survival. It also seems that some of this efficiency is under the influence of the transplant surgeon. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Can hedgerow management mitigate the impacts of predation on songbird nest survival?

    Science.gov (United States)

    Dunn, Jenny C; Gruar, Derek; Stoate, Chris; Szczur, John; Peach, Will J

    2016-12-15

    Nest predators can have significant impacts on songbird reproductive success. These impacts may be amplified by habitat simplification and here we test whether sympathetic management of farmland hedgerows can reduce nest depredation, especially by corvids. We test whether songbirds select nest sites according to structural features of hedgerows (including nest visibility and accessibility), and whether these features influence nest predation risk. Songbirds selected nesting sites affording higher vegetation cover above the nest, increased visibility on the nest-side of the hedgerow and reduced visibility on the far side of the hedge. Nest survival was unrelated to corvid abundance and only weakly related (at the egg stage) to corvid nest proximity. Nest survival at the chick stage was higher where vegetation structure restricted access to corvid-sized predators (averaging 0.78 vs. 0.53), and at nests close to potential vantage points. Overall nest survival was sensitive to hedgerow structure (accessibility) particularly at low exposure to corvid predation, while the overall impact of corvid exposure was dependent on the relationship involving proximity to vantage points. Nest survival over the chick stage was much higher (0.67) in stock-proof, trimmed and mechanically cut hedgerows, (which tended to provide lower side visibility and accessibility) than in recently laid, remnant or leggy hedgerows (0.18). Long-term reductions in the management of British hedgerows may therefore be exposing nesting songbirds to increased predation risk. We recommend regular rotational cutting of hedgerows to maintain a dense woody structure and thereby reduce songbird nest predation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. The impact of environmental conditions on Campylobacter jejuni survival in broiler faeces and litter

    Directory of Open Access Journals (Sweden)

    Shaun Smith

    2016-06-01

    Full Text Available Introduction: Campylobacter jejuni is the leading bacterial food-borne pathogen within the European Union, and poultry meat is an important vehicle for its transmission to humans. However, there is limited knowledge about how this organism persists in broiler litter and faeces. The aim of this study was to assess the impact of a number of environmental parameters, such as temperature, humidity, and oxygen, on Campylobacter survival in both broiler litter and faeces. Materials and methods: Used litter was collected from a Campylobacter-negative broiler house after final depopulation and fresh faeces were collected from transport crates. Samples were confirmed as Campylobacter negative according to modified ISO methods for veterinary samples. Both sample matrices were inoculated with 9 log10 CFU/ml C. jejuni and incubated under high (≥85% and low (≤70% relative humidity conditions at three different temperatures (20°C, 25°C, and 30°C under both aerobic and microaerophilic atmospheres. Inoculated litter samples were then tested for Campylobacter concentrations at time zero and every 2 hours for 12 hours, while faecal samples were examined at time zero and every 24 hours for 120 hours. A two-tailed t-test assuming unequal variance was used to compare mean Campylobacter concentrations in samples under the various temperature, humidity, and atmospheric conditions. Results and discussion: C. jejuni survived significantly longer (P≤0.01 in faeces, with a minimum survival time of 48 hours, compared with 4 hours in used broiler litter. C. jejuni survival was significantly enhanced at 20°C in all environmental conditions in both sample matrices tested compared with survival at 25°C and 30°C. In general, survival was greater in microaerophilic compared with aerobic conditions in both sample matrices. Humidity, at the levels examined, did not appear to significantly impact C. jejuni survival in any sample matrix. The persistence of Campylobacter

  13. Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival Outcomes

    Directory of Open Access Journals (Sweden)

    Pornswan Ngamprasertwong

    2013-01-01

    Full Text Available In this retrospective cohort study, we aimed to determine the incidence of intraoperative maternal hypotension during fetoscopic surgery for twin-twin transfusion syndrome (TTTS and to evaluate the impact of intraoperative hypotension on fetal survival. A total of 328 TTTS patients with recipient twin cardiomyopathy who underwent fetoscopic surgery under epidural anesthesia were included. The exposure of interest was maternal medical therapy with nifedipine for the treatment of fetal cardiomyopathy. We found that intraoperative hypotension occurred in 53.4% (175/328 patients. There was no statistically significant difference in incidence of hypotension between nifedipine exposure and nonexposure groups (54.8% versus 50.8%, P=0.479. However, the nifedipine exposure group received a statistically significant higher dose of phenylephrine (7.04 ± 6.38 mcg/kg versus 4.70 ± 4.14 mcg/kg, P=0.018 and higher doses of other vasopressor, as counted by number of treatments (6.06 ± 4.58 versus 4.96 ± 3.42, P=0.022. There were no statistically significant differences in acute fetal survival rate (within 5 days and fetal survival rate at birth between hypotensive and nonhypotensive patients. We concluded that preoperative exposure to nifedipine resulted in increased intraoperative maternal vasopressor requirement during fetoscopic surgery under epidural anesthesia. In patients who had intraoperative maternal hypotension, there was no correlation between the presence of maternal hypotension and postoperative fetal survival.

  14. Severe Obesity Impacts Recurrence-Free Survival of Women with High-Risk Endometrial Cancer: Results of a French Multicenter Study

    National Research Council Canada - National Science Library

    Canlorbe, Geoffroy; Bendifallah, Sofiane; Raimond, Emilie; Graesslin, Olivier; Hudry, Delphine; Coutant, Charles; Touboul, Cyril; Bleu, Géraldine; Collinet, Pierre; Darai, Emile; Ballester, Marcos

    2015-01-01

    Studies focusing on the impact of obesity on survival in endometrial cancer (EC) have reported controversial results and few data exist on the impact of obesity on recurrence rate and recurrence-free survival (RFS...

  15. Adjuvant Radiation Therapy Treatment Time Impacts Overall Survival in Gastric Cancer

    Energy Technology Data Exchange (ETDEWEB)

    McMillan, Matthew T. [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Ojerholm, Eric [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Roses, Robert E., E-mail: Robert.Roses@uphs.upenn.edu [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Plastaras, John P.; Metz, James M. [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Mamtani, Ronac [Department of Hematology/Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Karakousis, Giorgos C.; Fraker, Douglas L.; Drebin, Jeffrey A. [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Stripp, Diana; Ben-Josef, Edgar [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Datta, Jashodeep [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States)

    2015-10-01

    Purpose: Prolonged radiation therapy treatment time (RTT) is associated with worse survival in several tumor types. This study investigated whether delays during adjuvant radiation therapy impact overall survival (OS) in gastric cancer. Methods and Materials: The National Cancer Data Base was queried for patients with resected gastric cancer who received adjuvant radiation therapy with National Comprehensive Cancer Network–recommended doses (45 or 50.4 Gy) between 1998 and 2006. RTT was classified as standard (45 Gy: 33-36 days, 50.4 Gy: 38-41 days) or prolonged (45 Gy: >36 days, 50.4 Gy: >41 days). Cox proportional hazards models evaluated the association between the following factors and OS: RTT, interval from surgery to radiation therapy initiation, interval from surgery to radiation therapy completion, radiation therapy dose, demographic/pathologic and operative factors, and other elements of adjuvant multimodality therapy. Results: Of 1591 patients, RTT was delayed in 732 (46%). Factors associated with prolonged RTT were non-private health insurance (OR 1.3, P=.005) and treatment at non-academic facilities (OR 1.2, P=.045). Median OS and 5-year actuarial survival were significantly worse in patients with prolonged RTT compared with standard RTT (36 vs 51 months, P=.001; 39 vs 47%, P=.005); OS worsened with each cumulative week of delay (P<.0004). On multivariable analysis, prolonged RTT was associated with inferior OS (hazard ratio 1.2, P=.002); the intervals from surgery to radiation therapy initiation or completion were not. Prolonged RTT was particularly detrimental in patients with node positivity, inadequate nodal staging (<15 nodes examined), and those undergoing a cycle of chemotherapy before chemoradiation therapy. Conclusions: Delays during adjuvant radiation therapy appear to negatively impact survival in gastric cancer. Efforts to minimize cumulative interruptions to <7 days should be considered.

  16. Impact of Prehospital Transportation on Survival in Skiers and Snowboarders with Traumatic Brain Injury.

    Science.gov (United States)

    Sun, Hai; Samra, Navdeep S; Kalakoti, Piyush; Sharma, Kanika; Patra, Devi Prasad; Dossani, Rimal H; Thakur, Jai Deep; Disbrow, Elizabeth A; Phan, Kevin; Veeranki, Sreenivas P; Pabaney, Aqueel; Notarianni, Christina; Owings, John T; Nanda, Anil

    2017-08-01

    Prehospital helicopter use and its impact on outcomes in snowboarders and skiers incurring traumatic brain injury (TBI) is unknown. The present study investigates the association of helicopter transport with survival of snowboarders and skiers with TBI, in comparison with ground emergency medical services (EMS), by using data derived from the National Trauma Data Bank (2007-2014). Primary and secondary endpoints were defined as in-hospital survival and absolute risk reduction based upon number needed to transport (treat) respectively. Multivariable regression models including traditional logit model, model fitted with generalized estimating equations, and those incorporating results from propensity score matching methods were used to investigate the association of helicopter transport with survival compared with ground EMS. Of the 1018 snowboarders and skiers who met the criteria, 360 (35.4%) were transported via helicopters whereas 658 (64.6%) via ground EMS with a mortality rate of 1.7% and 1.5%, respectively. Multivariable log-binomial models demonstrated association of prehospital helicopter transport with increased survival (odds ratio 8.58; 95% confidence interval 1.09-67.64; P = 0.041; absolute risk reduction: 10.06%). This finding persisted after propensity score matching (odds ratio 24.73; 95% confidence interval 5.74-152.55; P < 0.001). The corresponding absolute risk reduction implies that approximately 10 patients need to be transported via helicopter to save 1 life. Based on our robust statistical analysis of retrospective data, our findings suggest prehospital helicopter transport improved survival in patients incurring TBI after snowboard- or ski-related falls compared with those transported via ground EMS. Policies directed at using helicopter services at remote winter resorts or ski or snowboarding locations should be implemented. Copyright © 2017. Published by Elsevier Inc.

  17. Impact of Marital Status on Tumor Stage at Diagnosis and on Survival in Male Breast Cancer.

    Science.gov (United States)

    Adekolujo, Orimisan Samuel; Tadisina, Shourya; Koduru, Ujwala; Gernand, Jill; Smith, Susan Jane; Kakarala, Radhika Ramani

    2017-07-01

    The effect of marital status (MS) on survival varies according to cancer type and gender. There has been no report on the impact of MS on survival in male breast cancer (MBC). This study aims to determine the influence of MS on tumor stage at diagnosis and survival in MBC. Men with MBC ≥18 years of age in the SEER database from 1990 to 2011 were included in the study. MS was classified as married and unmarried (including single, divorced, separated, widowed). Kaplan-Meier method was used to estimate the 5-year cancer-specific survival. Multivariate regression analyses were done to determine the effect of MS on presence of Stage IV disease at diagnosis and on cancer-specific mortality. The study included 3,761 men; 2,647 (70.4%) were married. Unmarried men were more often diagnosed with Stage IV MBC compared with married (10.7% vs. 5.5%, p < .001). Unmarried men (compared with married) were significantly less likely to undergo surgery (92.4% vs. 96.7%, p < .001). Overall unmarried males with Stages II, III, and IV MBC have significantly worse 5-year cancer-specific survival compared with married. On multivariate analysis, being unmarried was associated with increased hazard of death (HR = 1.43, p < .001) and increased likelihood of Stage IV disease at diagnosis ( OR = 1.96, p < .001). Unmarried males with breast cancer are at greater risk for Stage IV disease at diagnosis and poorer outcomes compared with married males.

  18. Racemization of Valine by Impact-Induced Heating

    Science.gov (United States)

    Furukawa, Yoshihiro; Takase, Atsushi; Sekine, Toshimori; Kakegawa, Takeshi; Kobayashi, Takamichi

    2017-05-01

    Homochirality plays an important role in all living organisms but its origin remains unclear. It also remains unclear whether such chiral molecules survived terrestrial heavy impact events. Impacts of extraterrestrial objects on early oceans were frequent and could have affected the chirality of oceanic amino acids when such amino acids accumulated during impacts. This study investigated the effects of shock-induced heating on enantiomeric change of valine with minerals such as olivine ([Mg0.9, Fe0.1]2SiO4), hematite (Fe2O3), and calcite (CaCO3). With a shock wave generated by an impact at 0.8 km/s, both uc(d)- and uc(l)-enriched valine were significantly decomposed and partially racemized under all experimental conditions. Different minerals had different shock impedances; therefore, they provided different P-T conditions for identical impacts. Furthermore, the high pH of calcite promoted the racemization of valine. The results indicate that in natural hypervelocity impacts, amino acids in shocked oceanic water would have decomposed completely, since impact velocity and the duration of shock compression and heating are typically greater in hypervelocity impact events than those in experiments. Even with the shock wave by the impact of small and decelerated projectiles in which amino acids survive, the shock heating may generate sufficient heat for significant racemization in shocked oceanic water. However, the duration of shock induced heating by small projectiles is limited and the population of such decelerated projectiles would be limited. Therefore, even though impacts of asteroids and meteorites were frequent on the prebiotic Earth, impact events would not have significantly changed the ee of proteinogenic amino acids accumulated in the entire ocean.

  19. Hybrid Guidance Control for a Hypervelocity Small Size Asteroid Interceptor Vehicle

    Science.gov (United States)

    Zebenay, Melak M.; Lyzhoft, Joshua R.; Barbee, Brent W.

    2017-01-01

    Near-Earth Objects (NEOs) are comets and/or asteroids that have orbits in proximity with Earth's own orbit. NEOs have collided with the Earth in the past, which can be seen at such places as Chicxulub crater, Barringer crater, and Manson crater, and will continue in the future with potentially significant and devastating results. Fortunately such NEO collisions with Earth are infrequent, but can happen at any time. Therefore it is necessary to develop and validate techniques as well as technologies necessary to prevent them. One approach to mitigate future NEO impacts is the concept of high-speed interceptor. This concept is to alter the NEO's trajectory via momentum exchange by using kinetic impactors as well as nuclear penetration devices. The interceptor has to hit a target NEO at relative velocity which imparts a sufficient change in NEO velocity. NASA's Deep Impact mission has demonstrated this scenario by intercepting Comet Temple 1, 5 km in diameter, with an impact relative speed of approximately 10 km/s. This paper focuses on the development of hybrid guidance navigation and control (GNC) algorithms for precision hypervelocity intercept of small sized NEOs. The spacecraft's hypervelocity and the NEO's small size are critical challenges for a successful mission as the NEO will not fill the field of view until a few seconds before intercept. The investigation needs to consider the error sources modeled in the navigation simulation such as spacecraft initial state uncertainties in position and velocity. Furthermore, the paper presents three selected spacecraft guidance algorithms for asteroid intercept and rendezvous missions. The selected algorithms are classical Proportional Navigation (PN) based guidance that use a first order difference to compute the derivatives, Three Plane Proportional Navigation (TPPN), and the Kinematic Impulse (KI). A manipulated Bennu orbit that has been changed to impact Earth will be used as a demonstrative example to compare the

  20. The impact of repeated surgery and adjuvant therapy on survival for patients with recurrent glioblastoma.

    Science.gov (United States)

    De Bonis, Pasquale; Fiorentino, Alba; Anile, Carmelo; Balducci, Mario; Pompucci, Angelo; Chiesa, Silvia; Sica, Gigliola; Lama, Gina; Maira, Giulio; Mangiola, Annunziato

    2013-07-01

    Treatment of glioblastoma recurrence can have a palliative aim, after considering risks and potential benefits. The aim of this study is to verify the impact of surgery and of palliative adjuvant treatments on survival after recurrence. From January 2002 to June 2008, we treated 76 consecutive patients with recurrent glioblastoma. Treatment was: 1-surgery alone--17 patients; 2-adjuvant-therapy alone--24 patients; 3-surgery and adjuvant therapy--16 patients; no treatment--19 patients. The impact on median overall-survival (OS-time between recurrence and death/last follow-up) of age, Karnofsky performance scale (KPS), resection extent and adjuvant treatment scheme (Temozolomide alone vs low-dose fractionated radiotherapy vs others) was determined. Survival curves were obtained through the Kaplan-Meier method. Cox proportional-hazards was used for multivariate analyses. Significance was set at p<0.05. Median OS was 7 months. At univariate analysis, patients with a KPS≥70 had a longer OS (9 months vs 5 months--p<0.0001). OS was 6 months for patients treated with surgery alone, 5 months for patients that received no treatment, 8 months for patients treated with chemotherapy alone, 14 months for patients treated with surgery and adjuvant therapy--p=0.01. Patients with a KPS<70 were significantly at risk for death - HR 2.8 - p=0.001. Subgroup analysis showed no significant differences between patients receiving gross total or partial tumor resection and among patients receiving different adjuvant therapy schemes. Major surgical morbidity at tumor recurrence occurred in 16 out of 33 patients (48%). It is fundamental, before deciding to operate patients for recurrence, to carefully consider the impact of surgical morbidity on outcome. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. Assessing the impact of early detection biases on breast cancer survival of Catalan women

    OpenAIRE

    Roso-Llorach, Albert; Forné, Carles; Macià, Francesc; Galcerán, Jaume; Marcos-Gragera, Rafael; Rué i Monné, Montserrat

    2014-01-01

    Survival estimates for women with screen-detected breast cancer are affected by biases specific to early detection. Lead-time bias occurs due to the advance of diagnosis, and length-sampling bias because tumors detected on screening exams are more likely to have slower growth than tumors symptomatically detected. Methods proposed in the literature and simulation were used to assess the impact of these biases. If lead-time and length-sampling biases were not taken into account, the median surv...

  2. Reaction of Projectiles with Targets during Hypervelocity Impact

    Science.gov (United States)

    Russell, Rod; Bless, Stephan; Persad, Chadee; Manthiram, Karthish

    2009-06-01

    Hollow tungsten projectiles were filled with bismuth oxide or copper and shot into aluminum blocks at 2200 m/s. The blocks were cut open, and the contents and morphology of the penetration channels were examined. In the case of copper fill, the channel was found to be filled with a black foam containing closed-cell bubbles. X-ray diffraction revealed the presence of CuAl2, indicating reaction with the aluminum target. In the case of bismuth oxide, there was little foam, but the penetration channel walls had many craters, which contained nodules of bismuth metal, again indicating reaction with the target. There were variations in crater diameter apparently corresponding to the onset and termination of the reactions. The exothermic nature of the reactions produced cracks in the target blocks.

  3. FTIR Analyses of Hypervelocity Impact Deposits: DebriSat Tests

    Science.gov (United States)

    2015-03-27

    reststrahlen bands). • Diffuse reflectance ( biconical , hemispherical) spectra are also particle size dependent. • There is not a unique spectral signature...Qualitative Biconical Reflectance Unexposed stainless steel and uncoated underside of Whipple plate are featureless. Post test coating has two absorption...solar cell, Z-93 thermal control paint, aluminum. – Laboratory biconical and hemispherical reflectance: pre and post test. • SEM stub witness

  4. Simulation of melting and vaporization of metals at hypervelocity impact

    Energy Technology Data Exchange (ETDEWEB)

    Povarnitsyn, M E; Khishchenko, K V; Levashov, P R [Joint Institute for High Temperature, Russian Academy of Sciences, 13/19 Izhorskaya, Moscow 125412 (Russian Federation)], E-mail: povar@ihed.ras.ru

    2008-02-15

    Simulations of experiments on shock-induced melting, fragmentation and vaporization in aluminum and zinc targets are presented. A titanium impactor moves at a velocity of 10.4 km/s and causes melting of these materials in a shock wave. Under rarefaction thermodynamic path crosses the liquid-vapor coexistence boundary and enters into metastable liquid region. Liquid in a metastable state may undergo either liquid-vapor phase separation or mechanical fragmentation. Homogeneous nucleation theory and mechanical fragmentation criterion of Grady are taken into account to control the kinetics of these processes in our model. The first effect dominates in the vicinity of the critical point, the second one - at lower temperatures. Analysis of phase transitions and kinetics of phase separation is performed using thermodynamically complete equation of state with allowance for stable and metastable regions for all materials under consideration.

  5. In-Flight Imaging Systems for Hypervelocity and Re-Entry Vehicles Project

    Data.gov (United States)

    National Aeronautics and Space Administration — It is proposed to create a rugged, reliable, compact, standardized imaging system for hypervelocity and re-entry vehicles using sapphire windows, small imagers, and...

  6. Impact of body mass index on perioperative outcomes and survival after resection for gastric cancer.

    Science.gov (United States)

    Ejaz, Aslam; Spolverato, Gaya; Kim, Yuhree; Poultsides, George A; Fields, Ryan C; Bloomston, Mark; Cho, Clifford S; Votanopoulos, Konstantinos; Maithel, Shishir K; Pawlik, Timothy M

    2015-05-01

    Among patients undergoing resection for gastric cancer, the impact of body mass index (BMI) on outcomes is not well understood. We sought to define the impact of non-normal BMI on short- and long-term outcomes after gastric cancer resection. We identified 775 patients who underwent gastrectomy for adenocarcinoma between 2000 and 2012 from the multi-institutional US Gastric Cancer Collaborative. Clinicopathologic characteristics, operative details, and oncologic outcomes were collected, and patients were stratified according to BMI. Most patients in the cohort were classified as having normal BMI (n = 338, 43.6%), followed by overweight (n = 229, 29.6%), obese (n = 153, 19.7%), and underweight (n = 55, 7.1%). After stratifying by BMI, there were no significant differences in the incidence of postoperative blood transfusions, perioperative morbidity, postoperative infectious complications, length of stay, perioperative 30-d in-hospital death, or readmission across groups (all P > 0.05). BMI did not impact overall or recurrence-free survival after stratifying by stage (all P > 0.05). However, underweight patients with low preoperative albumin levels had worse overall survival (OS) compared with that of patients of normal BMI. BMI did not impact perioperative morbidity, recurrence-free, or OS in patients undergoing gastric resection for adenocarcinoma. Underweight patients with BMI cancer. These high-risk patients should have their nutritional status optimized both before and after gastrectomy in an attempt to modify this risk factor and, in turn, achieve better outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Pinyon and juniper encroachment into sagebrush ecosystems impacts distribution and survival of greater sage-grouse

    Science.gov (United States)

    Coates, Peter S.; Prochazka, Brian; Ricca, Mark; Gustafson, K. Ben; Ziegler, Pilar T.; Casazza, Michael L.

    2017-01-01

    In sagebrush (Artemisia spp.) ecosystems, encroachment of pinyon (Pinus spp.) and juniper (Juniperus spp.; hereafter, “pinyon-juniper”) trees has increased dramatically since European settlement. Understanding the impacts of this encroachment on behavioral decisions, distributions, and population dynamics of greater sage-grouse (Centrocercus urophasianus) and other sagebrush obligate species could help benefit sagebrush ecosystem management actions. We employed a novel two-stage Bayesian model that linked avoidance across different levels of pinyon-juniper cover to sage-grouse survival. Our analysis relied on extensive telemetry data collected across 6 yr and seven subpopulations within the Bi-State Distinct Population Segment (DPS), on the border of Nevada and California. The first model stage indicated avoidance behavior for all canopy cover classes on average, but individual grouse exhibited a high degree of heterogeneity in avoidance behavior of the lowest cover class (e.g., scattered isolated trees). The second stage modeled survival as a function of estimated avoidance parameters and indicated increased survival rates for individuals that exhibited avoidance of the lowest cover class. A post hoc frailty analysis revealed the greatest increase in hazard (i.e., mortality risk) occurred in areas with scattered isolated trees consisting of relatively high primary plant productivity. Collectively, these results provide clear evidence that local sage-grouse distributions and demographic rates are influenced by pinyon-juniper, especially in habitats with higher primary productivity but relatively low and seemingly benign tree cover. Such areas may function as ecological traps that convey attractive resources but adversely affect population vital rates. To increase sage-grouse survival, our model predictions support reducing actual pinyon-juniper cover as low as 1.5%, which is lower than the published target of 4.0%. These results may represent effects of pinyon

  8. Determination of the impact of melanoma surgical timing on survival using the National Cancer Database.

    Science.gov (United States)

    Conic, Ruzica Z; Cabrera, Claudia I; Khorana, Alok A; Gastman, Brian R

    2018-01-01

    The ideal timing for melanoma treatment, predominantly surgery, remains undetermined. Patient concern for receiving immediate treatment often exceeds surgeon or hospital availability, requiring establishment of a safe window for melanoma surgery. To assess the impact of time to definitive melanoma surgery on overall survival. Patients with stage I to III cutaneous melanoma and with available time to definitive surgery and overall survival were identified by using the National Cancer Database (N = 153,218). The t test and chi-square test were used to compare variables. Cox regression was used for multivariate analysis. In a multivariate analysis of patients in all stages who were treated between 90 and 119 days after biopsy (hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.01-1.18) and more than 119 days (HR, 1.12; 95% CI, 1.02-1.22) had a higher risk for mortality compared with those treated within 30 days of biopsy. In a subgroup analysis of stage I, higher mortality risk was found in patients treated within 30 to 59 days (HR, 1.05; 95% CI, 1.01-1.1), 60 to 89 days (HR, 1.16; 95% CI, 1.07-1.25), 90 to 119 days (HR, 1.29; 95% CI, 1.12-1.48), and more than 119 days after biopsy (HR, 1.41; 95% CI, 1.21-1.65). Surgical timing did not affect survival in stages II and III. Melanoma-specific survival was not available. Expeditious treatment of stage I melanoma is associated with improved outcomes. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  9. The impact of histology on survival for patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy

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    Alonso Carrasco

    2014-01-01

    Full Text Available Objective: To evaluate the impact of histology on cancer-specific and overall survival for patients with metastatic renal cell carcinoma (mRCC undergoing cytoreductive nephrectomy (CN. Materials and Methods: We retrospectively reviewed the data of 505 patients with mRCC who underwent CN at Mayo Clinic, Rochester, MN, USA, between 1970 and 2008. All specimen were re-reviewed by a single genitourinary pathologist. Survival was estimated using the Kaplan-Meier method and compared according to histology with the log-rank test. Cox proportional hazard regression models were used to evaluate the association of histology with outcome. Results: Forty (8% patients with non-clear cell histology and 465 (92% patients with clear cell histology were identified. The median follow-up was 7.8 years. Metastatic non-clear cell histology was associated with a significantly older median age at nephrectomy (66 vs. 60 years; P = 0.002, larger median tumor size (11.5 vs. 9.2 cm; P = 0.02, and higher rate of lymph node involvement (50% vs. 16%; P < 0.001. No significant difference in 3-year cancer-specific survival (25% vs. 22%; P = 0.50 was noted between patients with clear cell and non-clear cell histology. On multivariate analysis, non-clear cell histology was not significantly associated with patients′ risk of death from cancer (HR 0.96; 95% CI 0.61, 1.51; P = 0.85. Conclusions: Non-clear cell histology was not independently associated with adverse survival for patients with mRCC undergoing CN. As such, we advocate that surgical resection should continue to be considered in the multimodal treatment approach to these patients, while additional efforts to risk stratify and optimize management in this setting remain necessary.

  10. Impact of mulches and growing season on indicator bacteria survival during lettuce cultivation.

    Science.gov (United States)

    Xu, Aixia; Buchanan, Robert L; Micallef, Shirley A

    2016-05-02

    In fresh produce production, the use of mulches as ground cover to retain moisture and control weeds is a common agricultural practice, but the influence that various mulches have on enteric pathogen survival and dispersal is unknown. The goal of this study was to assess the impact of different mulching methods on the survival of soil and epiphytic fecal indicator bacteria on organically grown lettuce during different growing seasons. Organically managed lettuce, cultivated with various ground covers--polyethylene plastic, corn-based biodegradable plastic, paper and straw mulch--and bare ground as a no-mulch control, was overhead inoculated with manure-contaminated water containing known levels of generic Escherichia coli and Enterococcus spp. Leaves and soil samples were collected at intervals over a two week period on days 0, 1, 3, 5, 7, 10 and 14, and quantitatively assessed for E. coli, fecal coliforms and Enterococcus spp. Data were analyzed using mixed models with repeated measures and an exponential decline with asymptote survival model. Indicator bacterial concentrations in the lettuce phyllosphere decreased over time under all treatments, with more rapid E. coli declines in the fall than in the spring (pplastic mulches in all trials, and higher enterococci levels under straw in fall 2014 (p<0.05). This study demonstrates that mulches used in lettuce production may impact the fate of enteric bacteria in soil or on lettuce, most likely in relation to soil moisture retention, and other weather-related factors, such as temperature and rainfall. The data suggest that the time between exposure to a source of enteric bacteria and harvesting of the crop is season dependent, which has implications for determining best harvest times. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Impact of Focused Ultrasound-enhanced Drug Delivery on Survival in Rats with Glioma

    Science.gov (United States)

    Treat, Lisa Hsu; Zhang, Yongzhi; McDannold, Nathan; Hynynen, Kullervo

    2009-04-01

    Malignancies of the brain remain difficult to treat with chemotherapy because the selective permeability of the blood-brain barrier (BBB) blocks many potent agents from reaching their target. Previous studies have illustrated the feasibility of drug and antibody delivery across the BBB using MRI-guided focused ultrasound. In this study, we investigated the impact of focused ultrasound-enhanced delivery of doxorubicin on survival in rats with aggressive glioma. Sprague-Dawley rats were implanted with 9 L gliosarcoma cells in the brain. Eight days after implantation, each rat received one of the following: (1) no treatment (control), (2) a single treatment with microbubble-enhanced MRI-guided focused ultrasound (FUS only), (3) a single treatment with i.v. liposomal doxorubicin (DOX only), or (4) a single treatment with microbubble-enhanced MRI-guided focused ultrasound and concurrent i.v. injections of liposomal doxorubicin (FUS+DOX). The survival time from implantation to death or euthanasia was recorded. We observed a modest but significant increase in median survival time in rats treated with combined MRI-guided focused ultrasound chemotherapy, compared to chemotherapy alone (p0.10). Our study demonstrates for the first time a therapeutic benefit achieved with ultrasound-enhanced drug delivery across the blood-brain barrier. This confirmation of efficacy in an in vivo tumor model indicates that targeted drug delivery using MRI-guided focused ultrasound has the potential to have a major impact on the treatment of patients with brain tumors and other neurological disorders.

  12. Subsurface deformation in hypervelocity cratering experiments into high-porosity tuffs

    Science.gov (United States)

    Winkler, Rebecca; Poelchau, Michael H.; Moser, Stefan; Kenkmann, Thomas

    2016-10-01

    Hypervelocity impact experiments on porous tuff targets were carried out to determine the effect of porosity on deformation mechanisms in the crater's subsurface. Blocks of Weibern Tuff with about 43% porosity were impacted by 2.5 mm and 12.0 mm diameter steel spheres with velocities between 4.8 km s-1 and 5.6 km s-1. The postimpact subsurface damage was quantified with computer tomography as well as with meso- and microscale analyses of the bisected crater subsurface. The intensity and style of deformation in mineral clasts and the tuff matrix were mapped and their decay with subsurface depth was determined. Subsurface deformation styles include pore space compaction, clast rotation, as well as microfracture formation. Evaluation of the deformation indicates near-surface energy coupling at a calculated depth of burial of 2 projectile diameters (dp), which is in conflict with the crater shape, which displays a deep, central penetration tube. Subsurface damage extends to 2 dp beneath the crater floor in the experiments with 2.5 mm projectiles and increases to 3 dp for 12 mm projectiles. Based on overprinting relationships and the geometrical orientation of deformation features, a sequence of subsurface deformation events was derived (1) matrix compaction, (2) intragranular crack formation in clasts, (3) deformation band formation in the compacted matrix, (4) tensile fracturing.

  13. Numerical Simulation of Interaction of Hypervelocity Particle Stream with a Target

    Energy Technology Data Exchange (ETDEWEB)

    Lomov, I; Liu, B; Georgevich, V; Antoun, T

    2007-07-31

    We present results of direct numerical simulations of impact of hypervelocity particle stream with a target. The stream of interest consists of submillimeter (30-300 micron) brittle ceramic particles. Current supercomputer capabilities make it possible to simulate a realistic size of streams (up to 20 mm in diameter and 500 mm in length) while resolving each particle individually. Such simulations make possible to study the damage of the target from synergistic effects of individual impacts. In our research we fixed the velocity distribution along the axis of the stream (1-4 km/s) and volume fraction of the solid material (1-10%) and study effects of particle size variation, particle and target material properties and surrounding air properties. We ran 3D calibration simulations with up to 10 million individual particles and conducted sensitivity studies with 2D cylindrically symmetric simulations. We used an Eulerian Godunov hydrocode with adaptive mesh refinement. The particles, target material and air are represented with volume-of-fluid approach. Brittle particle and target material has been simulated with pressure-dependent yield strength and Steinberg model has been used for metal targets. Simulations demonstrated penetration depth and a hole diameter similar to experimental observations and can explain the influence of parameters of the stream on the character of the penetration.

  14. Impact of reconstruction methods and pathological factors on survival after pancreaticoduodenectomy

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    Salah Binziad

    2013-01-01

    Full Text Available Background: Surgery remains the mainstay of therapy for pancreatic head (PH and periampullary carcinoma (PC and provides the only chance of cure. Improvements of surgical technique, increased surgical experience and advances in anesthesia, intensive care and parenteral nutrition have substantially decreased surgical complications and increased survival. We evaluate the effects of reconstruction type, complications and pathological factors on survival and quality of life. Materials and Methods: This is a prospective study to evaluate the impact of various reconstruction methods of the pancreatic remnant after pancreaticoduodenectomy and the pathological characteristics of PC patients over 3.5 years. Patient characteristics and descriptive analysis in the three variable methods either with or without stent were compared with Chi-square test. Multivariate analysis was performed with the logistic regression analysis test and multinomial logistic regression analysis test. Survival rate was analyzed by use Kaplan-Meier test. Results: Forty-one consecutive patients with PC were enrolled. There were 23 men (56.1% and 18 women (43.9%, with a median age of 56 years (16 to 70 years. There were 24 cases of PH cancer, eight cases of PC, four cases of distal CBD cancer and five cases of duodenal carcinoma. Nine patients underwent duct-to-mucosa pancreatico jejunostomy (PJ, 17 patients underwent telescoping pancreatico jejunostomy (PJ and 15 patients pancreaticogastrostomy (PG. The pancreatic duct was stented in 30 patients while in 11 patients, the duct was not stented. The PJ duct-to-mucosa caused significantly less leakage, but longer operative and reconstructive times. Telescoping PJ was associated with the shortest hospital stay. There were 5 postoperative mortalities, while postoperative morbidities included pancreatic fistula-6 patients, delayed gastric emptying in-11, GI fistula-3, wound infection-12, burst abdomen-6 and pulmonary infection-2. Factors

  15. Splenectomy in patients with myeloproliferative neoplasms: efficacy, complications and impact on survival and transformation.

    Science.gov (United States)

    Santos, Fabio P S; Tam, Constantine S; Kantarjian, Hagop; Cortes, Jorge; Thomas, Deborah; Pollock, Raphael; Verstovsek, Srdan

    2014-01-01

    Splenectomy may be an effective therapeutic option for treating massive splenomegaly in patients with myeloproliferative neoplasms (MPNs). There are still limited data on its short- and long-term benefits and risks. Efficacy and short-term complications were analyzed in 94 patients with different MPNs who underwent splenectomy at M. D. Anderson Cancer Center. The long-term impact of splenectomy on overall survival (OS) and transformation free survival (TFS) was evaluated in 461 patients with myelofibrosis (MF) seen at M. D. Anderson, including 50 who underwent splenectomy during disease evolution. Splenectomy improved anemia and thrombocytopenia in 47% and 66% of patients, respectively. The most common complications were leukocytosis (76%), thrombocytosis (43%) and venous thromboembolism (16%). Post-operative mortality was 5%. Among patients with MF, splenectomy during disease evolution was associated with decreased OS (hazard ratio [HR] = 2.17, p HR = 2.17, p < 0.0001). This effect was independent of the Dynamic International Prognostic Scoring System. Splenectomy is a possible therapeutic option for patients with MF and other MPNs, and its greatest benefits are related to improvement in spleen pain and discomfort, anemia and thrombocytopenia. However, in patients with MF it appears to be associated with increased mortality.

  16. Impact of Diabetes and Hyperglycemia on Survival in Advanced Breast Cancer Patients

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    Cynthia Villarreal-Garza

    2012-01-01

    Full Text Available Purpose. We examined the impact of diabetes and hyperglycemia on cancer-specific survival of patients with metastatic or recurrent breast cancer (BC. Methods. We performed a retrospective analysis of 265 patients with advanced BC receiving palliative chemotherapy. BC-specific mortality was compared for diabetic and nondiabetic patients as well as for patients that presented hyperglycemia during treatment. Results. No difference was observed between the diabetic and nondiabetic patients in terms of overall survival (OS. A difference in OS was observed between nondiabetic patients and diabetic patients who had hyperglycemia. The OS was greater in diabetic patients with proper metabolic control than diabetic patients with hyperglycemia. The risk of death was higher in patients with mean glucose levels >130 mg/dL during treatment. Several factors were associated with poor OS: tumor stage, hormone-receptor-negative tumors, HER2 negative disease, multiple metastatic sites, presence of visceral metastases, and mean glucose >130 mg/dL. Conclusion. Elevated glucose levels are associated with a poor outcome in diabetic and nondiabetic patients in contrast to patients with normoglycemic levels, conferring an elevated risk of death. According to these results, clinicians should monitor glucose levels during treatment for advanced breast cancer disease and take action to maintain normal glucose levels.

  17. Treatment of the axila in breast cancer surgery: Systematic review of its impact on survival.

    Science.gov (United States)

    García Novoa, Alejandra; Acea Nebril, Benigno

    2017-11-01

    Sentinel lymph node biopsy and ACOSOG-Z0011 criteria have modified axillary treatment in breast cancer surgery. We performed a systematic review of studies assessing the impact of axillary treatment on survival. The search showed 6891 potentially eligible items. Of them, 23 clinical trials and 12 meta-analyses published between 1980 and 2017 met the study criteria. The review revealed that axillary lymph node dissection (ALND) can be omitted in patients pN0 and pN1mic, without compromising survival. In patients pN1 it is proposed not to treat the axilla or replace ALND for axillary radiotherapy. The main limitations of this study are the inclusion of old tests that do not use therapeutic targets and lack of risk categorization of relapse. In conclusion, axillary treatment can be avoided in patients without metastatic involvement or micrometastases in the sentinel lymph node. However, there is no evidence to make a recommendation of axillary treatment in N1 patients, so individualized analysis of patient risk factors is needed. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Splenectomy in patients with Myeloproliferative Neoplasms: efficacy, complications and impact on survival and transformation

    Science.gov (United States)

    Santos, Fabio P S; Tam, Constantine S; Kantarjian, Hagop; Cortes, Jorge; Thomas, Deborah; Pollock, Raphael; Verstovsek, Srdan

    2013-01-01

    Background Splenectomy may be an effective therapeutic option for treating massive splenomegaly in patients with myeloproliferative neoplasms (MPNs). There is still limited data on its short- and long-term benefits and risks. Methods Efficacy and short-term complications were analyzed in 94 patients with different MPNs who underwent splenectomy at MD Anderson. The long-term impact of splenectomy on overall survival (OS) and transformation free survival (TFS) was evaluated in 461 patients with myelofibrosis (MF) seen at MD Anderson including 50 who underwent splenectomy during disease evolution. Results Splenectomy improved anemia and thrombocytopenia in 47% and 66% of patients, respectively. Most common complications were leukocytosis (76%), thrombocytosis (43%), and venous thromboembolism (16%). Post-operative mortality was 5%. Among patients with MF, splenectomy during disease evolution was associated with decreased OS (Hazard Ratio [HR] =2.17, pSplenectomy is a possible therapeutic option for patients with MF and other MPNs, and its greatest benefits are related to improvement in spleen pain and discomfort, anemia and thrombocytopenia. However, in patients with MF it appears to be associated with increased mortality. PMID:23573823

  19. Impact of Treatment Time on the Survival of Patients Suffering from Invasive Fungal Rhinosinusitis

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    Patorn Piromchai

    2014-01-01

    Full Text Available Background Invasive fungal rhinosinusitis is an uncommon disease with high mortality rates. There is currently no consensus on the best treatment timing. We studied the impact of the treatment timing on the survival of patients experiencing invasive fungal rhinosinusitis. Methods We conducted a retrospective study of patients suffering from invasive fungal rhinosinusitis. The duration of symptoms, clinical presentations, clinical signs, diagnoses, treatments, and outcomes were collected. Results It was observed that more than 70% of the mortalities occurred within the subgroup of patients who exhibited symptoms of the disease within 14 days before admission. After adjusting for the confounders, the time taken to treat the patients was the most statistically significant predictor for mortality ( P = 0.045. We found no significant relationships between mortality and its significant covariates, which included the underlying diseases ( P = 0.91 or complications ( P = 0.55. Conclusions Our study demonstrates that the time taken to treat the patients is an important determinant for the survival of patients who are afflicted with invasive fungal rhinosinusitis. The appropriate treatments should be administered within 14 days from the time the symptoms begin to manifest.

  20. Impact of treatment time on the survival of patients suffering from invasive fungal rhinosinusitis.

    Science.gov (United States)

    Piromchai, Patorn; Thanaviratananich, Sanguansak

    2014-01-01

    Invasive fungal rhinosinusitis is an uncommon disease with high mortality rates. There is currently no consensus on the best treatment timing. We studied the impact of the treatment timing on the survival of patients experiencing invasive fungal rhinosinusitis. We conducted a retrospective study of patients suffering from invasive fungal rhinosinusitis. The duration of symptoms, clinical presentations, clinical signs, diagnoses, treatments, and outcomes were collected. It was observed that more than 70% of the mortalities occurred within the subgroup of patients who exhibited symptoms of the disease within 14 days before admission. After adjusting for the confounders, the time taken to treat the patients was the most statistically significant predictor for mortality (P = 0.045). We found no significant relationships between mortality and its significant covariates, which included the underlying diseases (P = 0.91) or complications (P = 0.55). Our study demonstrates that the time taken to treat the patients is an important determinant for the survival of patients who are afflicted with invasive fungal rhinosinusitis. The appropriate treatments should be administered within 14 days from the time the symptoms begin to manifest.

  1. Nutritional status of allogeneic hematopoietic stem cell transplantation recipients: influencing risk factors and impact on survival.

    Science.gov (United States)

    El-Ghammaz, Amro Mohamed Sedky; Ben Matoug, Rima; Elzimaity, Maha; Mostafa, Nevine

    2017-04-24

    Patients subjected to allogeneic hematopoietic stem cell transplantation (HSCT) are at increased nutritional risk which in turn may alter their outcome. For providing good nutritional care for patients, it is important to analyze risk factors influencing nutritional status during and after HSCT. Fifty patients undergoing allogeneic HSCT were subjected to nutritional status assessment by using the patient-generated subjective global assessment (PG-SGA) at initial admission, day 30 and day 180. Two patients (4%) had malnutrition at admission, 36 (72%) at day 30, and 24 (48%) at day 180. At day 30, comorbidity index higher than 0 and fever lasting for more than 1 week had a significant impact on nutritional status (P = .004 and P = .006, respectively). Regarding day 180, comorbidity index higher than 0 and presence of ≥grade II acute gastrointestinal graft versus host disease (GI GVHD) significantly influenced nutritional status (P = .017 and P = .026, respectively). Well-nourished patients at admission and day 180 had a significantly higher overall survival (OS) in comparison to malnourished patients (P Nutritional status at admission and day 180 had a significant influence on OS in multivariate analysis (P = .039 and P = .032, respectively). Allogeneic HSCT patients having high comorbidity index, developing prolonged fever, and experiencing ≥grade II acute GI GVHD suffer from worsening in their nutritional status during hospitalization and after discharge. Also, nutritional status at admission and day 180 significantly influences their survival.

  2. Impact of Acetic Acid on the Survival of L. plantarum upon Microencapsulation by Coaxial Electrospraying

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    Laura G. Gómez-Mascaraque

    2017-01-01

    Full Text Available In this work, coaxial electrospraying was used for the first time to microencapsulate probiotic bacteria, specifically Lactobacillus plantarum, within edible protein particles with the aim of improving their resistance to in vitro digestion. The developed structures, based on an inner core of whey protein concentrate and an outer layer of gelatin, were obtained in the presence of acetic acid in the outer solution as a requirement for the electrospraying of gelatin. Despite the limited contact of the inner suspension and outer solution during electrospraying, the combination of the high voltage used during electrospraying with the presence of acetic acid was found to have a severe impact on the lactobacilli, not only decreasing initial viability but also negatively affecting the survival of the bacteria during storage and their resistance to different stress conditions, including simulated in vitro digestion.

  3. Conceptual Design of a Flight Validation Mission for a Hypervelocity Asteroid Intercept Vehicle

    Science.gov (United States)

    Barbee, Brent W.; Wie, Bong; Steiner, Mark; Getzandanner, Kenneth

    2013-01-01

    Near-Earth Objects (NEOs) are asteroids and comets whose orbits approach or cross Earth s orbit. NEOs have collided with our planet in the past, sometimes to devastating effect, and continue to do so today. Collisions with NEOs large enough to do significant damage to the ground are fortunately infrequent, but such events can occur at any time and we therefore need to develop and validate the techniques and technologies necessary to prevent the Earth impact of an incoming NEO. In this paper we provide background on the hazard posed to Earth by NEOs and present the results of a recent study performed by the NASA/Goddard Space Flight Center s Mission Design Lab (MDL) in collaboration with Iowa State University s Asteroid Deflection Research Center (ADRC) to design a flight validation mission for a Hypervelocity Asteroid Intercept Vehicle (HAIV) as part of a Phase 2 NASA Innovative Advanced Concepts (NIAC) research project. The HAIV is a two-body vehicle consisting of a leading kinetic impactor and trailing follower carrying a Nuclear Explosive Device (NED) payload. The HAIV detonates the NED inside the crater in the NEO s surface created by the lead kinetic impactor portion of the vehicle, effecting a powerful subsurface detonation to disrupt the NEO. For the flight validation mission, only a simple mass proxy for the NED is carried in the HAIV. Ongoing and future research topics are discussed following the presentation of the detailed flight validation mission design results produced in the MDL.

  4. Fragmentation of Millimeter-Size Hypervelocity Projectiles on Combined Mesh-Plate Bumpers

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    Aleksandr Cherniaev

    2017-01-01

    Full Text Available This numerical study evaluates the concept of a combined mesh-plate bumper as a shielding system protecting unmanned spacecraft from small (1 mm orbital debris impacts. Two-component bumpers consisting of an external layer of woven mesh (aluminum or steel directly applied to a surface of the aluminum plate are considered. Results of numerical modeling with a projectile velocity of 7 km/s indicate that, in comparison to the steel mesh-combined bumper, the combination of aluminum mesh and aluminum plate provides better fragmentation of small hypervelocity projectiles. At the same time, none of the combined mesh/plate bumpers provide a significant increase of ballistic properties as compared to an aluminum plate bumper. This indicates that the positive results reported in the literature for bumpers with metallic meshes and large projectiles are not scalable down to millimeter-sized particles. Based on this investigation’s results, a possible modification of the combined mesh/plate bumper is proposed for the future study.

  5. Exobiology: Laboratory tests of the impact related aspects of Panspermia

    Science.gov (United States)

    Burchell, M. J.; Shrine, N. R. G.; Bunch, A.; Zarnecki, J. C.

    The idea that life began elsewhere and then naturally migrated to the Earth is known as Panspermia. One such possibility is that life is carried on objects (meteorites, comets and dust) that arrive at the Earth. The life (bacteria) is then presumed to survive the sudden deceleration and impact, and then subsequently develop here on Earth. This step, the survivability of bacteria during the deceleration typical of an object arriving at Earth from space, is studied in this paper. To this end a two-stage light gas gun was used to fire projectiles coated with bacteria into a variety of targets at impact speeds of 3.8 to 4.9 km s-1. Targets used were rock, glass, metal and aerogel (density 100 kg m-3). Various techniques were used to search for bacteria that had transferred to the target material during the impact. These included taking cultures from the target crater and ejecta, and use of fluorescent dyes to mark sites of live bacteria. So far only one sample has shown a signal for bacteria surviving an impact. This was for bacteria cultured from the ejecta spalled from a rock surface during an impact. However, this result needs to be repeated before any firm claims can be made for bacteria surviving a hypervelocity impact event.

  6. Impact of MELD allocation policy on survival outcomes after liver transplantation: a single-center study in northeast Brazil

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    Thales Paulo Batista

    2011-01-01

    Full Text Available OBJECTIVE: To analyze the impact of model for end-stage liver disease (MELD allocation policy on survival outcomes after liver transplantation (LT. INTRODUCTION: Considering that an ideal system of grafts allocation should also ensure improved survival after transplantation, changes in allocation policies need to be evaluated in different contexts as an evolutionary process. METHODS: A retrospective cohort study was carried out among patients who underwent LT at the University of Pernambuco. Two groups of patients transplanted before and after the MELD allocation policy implementation were identified and compared using early postoperative mortality and post-LT survival as end-points. RESULTS: Overall, early postoperative mortality did not significantly differ between cohorts (16.43% vs. 8.14%; p = 0.112. Although at 6 and 36-months the difference between pre-vs. post-MELD survival was only marginally significant (p = 0.066 and p = 0.063; respectively, better short, medium and long-term post-LT survival were observed in the post-MELD period. Subgroups analysis showed special benefits to patients categorized as nonhepatocellular carcinoma (non-HCC and moderate risk, as determined by MELD score (15-20. DISCUSSION: This study ensured a more robust estimate of how the MELD policy affected post-LT survival outcomes in Brazil and was the first to show significantly better survival after this new policy was implemented. Additionally, we explored some potential reasons for our divergent survival outcomes. CONCLUSION: Better survival outcomes were observed in this study after implementation of the MELD criterion, particularly amongst patients categorized as non-HCC and moderate risk by MELD scoring. Governmental involvement in organ transplantation was possibly the main reason for improved survival.

  7. The impact of positive circumferential margin on survival following oesophagectomy using the new 7th TNM classification.

    Science.gov (United States)

    Theologou, Thomas; Diab, Mohammad; Kyaw, Phyo A; Gosney, John R; McShane, James; Howes, Nathan; Page, Richard D; Shackcloth, Michael

    2013-11-01

    Previous studies looking at the influence of positive circumferential margin (CRM) on survival after oesophagectomy are conflicting. This may be due to the fact that older versions of the TNM classification were used, which do not predict survival as accurately as the new 7th edition. We examine whether CRM involvement has an impact on survival when the 7th TNM classification is used. Over a 10-year period, 199 patients who had undergone potentially curative resection for oesophageal cancer with postoperative histopathological T3 were identified. A total of 151 (75.9%) were found to have CRM involvement (CRM was free of tumour. Cancers were staged according to the International Union against Cancer TNM 7th edition. First, univariate and then multivariate Cox regression analysis were performed to assess the factors influencing survival. Potentially significant predictors (P CRM involvement was found to have no effect on survival following oesophagectomy [hazard ratio 1.28 (95% CI: 0.82-2.01) (P = 0.28)]. This was seen for all N-stages. Stage of disease, age at operation, % predicted forced expiratory volume in 1 second and shortness of breath [(according to New York Heart Association classification)] were all significant predictors of survival. With this study, it became clear that CRM involvement does not affect long-term survival of patients after oesophagectomy. Patients with CRM involvement should not necessarily be considered to have had an incomplete resection.

  8. Assessment of the impact of comorbidity on the survival of cancer patients treated by palliative care teams.

    Science.gov (United States)

    Calvo-Espinos, Claudio; De Gaona-Lana, Estefania Ruiz; Gonzalez-Anguren, Cristina; Lama-Gay, Marcos

    2015-08-01

    The usefulness of the age-adjusted Charlson Comorbidity Index (ACCI) as a gauge of the impact of comorbidity on survival is known in the geriatric population. In palliative care, there is little research studying the correlation between comorbidity and survival in the advanced stages of oncological disease. The aim of our study was to explore the impact of comorbidity, measured with the ACCI, on survival in our patients. Our hypothesis was that higher ACCI scores would be associated with lower survival rates after the first visit. We conducted a prospective observational study over one year. Patients were attended by palliative home care teams. The main variables were: survival from metastatic disease after the first visit and ACCI score on the first visit. We also employed a descriptive analysis and a Kaplan-Meier survival analysis, including different ranges of ACCI scores. The final sample included 66 subjects. The standard patient was a 76-year-old man with lung cancer who had received chemotherapy. The overall average ACCI score was 10.45. Significant differences were found between the different locations of metastatic disease (greater survivals in breast, ovary, and prostate; p = 0.005) and some treatments (hormone and radiotherapy; p = 0.001 for each), but not from the first visit. We found lower survival rates among lung cancer patients with higher comorbidity (ACCI ≥ 11, p = 0.047), with no differences on other primary locations or overall values. The data show that comorbidity measured by the ACCI may be an interesting prognostic factor during the late stages of disease, as we have found in lung cancer. More research is certainly needed.

  9. Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy.

    Science.gov (United States)

    Tilki, Derya; Hu, Brian; Nguyen, Hao G; Dall'Era, Marc A; Bertini, Roberto; Carballido, Joaquín A; Chandrasekar, Thenappan; Chromecki, Thomas; Ciancio, Gaetano; Daneshmand, Siamak; Gontero, Paolo; Gonzalez, Javier; Haferkamp, Axel; Hohenfellner, Markus; Huang, William C; Koppie, Theresa M; Linares, Estefania; Lorentz, C Adam; Mandel, Philipp; Martinez-Salamanca, Juan I; Master, Viraj A; Matloob, Rayan; McKiernan, James M; Mlynarczyk, Carrie M; Montorsi, Francesco; Novara, Giacomo; Pahernik, Sascha; Palou, Juan; Pruthi, Raj S; Ramaswamy, Krishna; Rodriguez Faba, Oscar; Russo, Paul; Shariat, Shahrokh F; Spahn, Martin; Terrone, Carlo; Thieu, William; Vergho, Daniel; Wallen, Eric M; Xylinas, Evanguelos; Zigeuner, Richard; Libertino, John A; Evans, Christopher P

    2015-02-01

    Metastatic renal cell carcinoma can be clinically diverse in terms of the pattern of metastatic disease and response to treatment. We studied the impact of metastasis and location on cancer specific survival. The records of 2,017 patients with renal cell cancer and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 centers in the United States and Europe were analyzed. Number and location of synchronous metastases were compared with respect to patient cancer specific survival. Multivariable Cox regression models were used to quantify the impact of covariates. Lymph node metastasis (155) or distant metastasis (725) was present in 880 (44%) patients. Of the patients with distant disease 385 (53%) had an isolated metastasis. The 5-year cancer specific survival was 51.3% (95% CI 48.6-53.9) for the entire group. On univariable analysis patients with isolated lymph node metastasis had a significantly worse cancer specific survival than those with a solitary distant metastasis. The location of distant metastasis did not have any significant effect on cancer specific survival. On multivariable analysis the presence of lymph node metastasis, isolated distant metastasis and multiple distant metastases were independently associated with cancer specific survival. Moreover higher tumor thrombus level, papillary histology and the use of postoperative systemic therapy were independently associated with worse cancer specific survival. In our multi-institutional series of patients with renal cell cancer who underwent radical nephrectomy and tumor thrombectomy, almost half of the patients had synchronous lymph node or distant organ metastasis. Survival was superior in patients with solitary distant metastasis compared to isolated lymph node disease. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  10. Amyotrophic lateral sclerosis: impact of pulmonary follow-up and mechanical ventilation on survival. A study of 114 cases.

    Science.gov (United States)

    Sanjuán-López, Pilar; Valiño-López, Paz; Ricoy-Gabaldón, Jorge; Verea-Hernando, Héctor

    2014-12-01

    To study the impact of ventilatory management and treatment on the survival of patients with amyotrophic lateral sclerosis (ALS). Retrospective analysis of 114 consecutive patients admitted to a general hospital, evaluating demographic data, type of presentation, clinical management, treatment with mechanical ventilation and survival. descriptive and Kaplan-Meier estimator. Sixty four patients presented initial bulbar involvement. Overall mean survival after diagnosis was 28.0 months (95%CI, 21.1-34.8). Seventy patients were referred to the pulmonary specialist (61.4%) and 43 received non-invasive ventilation (NIV) at 12.7 months (median) after diagnosis. Thirty seven patients continued to receive NIV with no subsequent invasive ventilation. The mean survival of these patients was 23.3 months (95%CI, 16.7-28.8), higher in those without bulbar involvement, although below the range of significance. Survival in the 26 patients receiving programmed NIV was higher than in the 11 patients in whom this was indicated without prior pulmonary assessment (considered following diagnosis, P<.012, and in accordance with the start of ventilation, P<.004). A total of 7 patients were treated invasively; mean survival in this group was 72 months (95%CI, 14.36-129.6), median 49.6±17.5 (95%CI, 15.3-83.8), and despite the difficulties involved in home care, acceptance and tolerance was acceptable. Long-term mechanical ventilation prolongs survival in ALS. Programmed pulmonary assessment has a positive impact on survival of ALS patients and is key to the multidisciplinary management of this disease. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  11. The Impact of Sarcopenia on Survival and Complications in Surgical Oncology: A Review of the Current Literature

    Science.gov (United States)

    JOGLEKAR, SAVITA; NAU, PETER N.; MEZHIR, JAMES J.

    2016-01-01

    Sarcopenia is the subclinical loss of skeletal muscle and strength and has been extensively studied in both the cancer and surgical literature. Specifically, sarcopenia has gained significant recognition as an important prognostic factor for both complications and survival in cancer patients. Herein, we review the current literature to date highlighting the specific impact of sarcopenia in patients undergoing oncologic procedures. PMID:26310812

  12. Theory of an Electromagnetic Mass Accelerator for Achieving Hypervelocities

    Science.gov (United States)

    Thom, Karlheinz; Norwood, Joseph., Jr.

    1961-01-01

    It is shown that for any electromagnetic accelerator which employs an electromagnetic force for driving the projectile and uses the projectile as the heat sink for the energy dissipated in it by ohmic heating, the maximum velocity attainable without melting is a function of the mass of the projectile. Therefore, for hypervelocities a large projectile mass is required and thus a power supply of very large capacity is necessary. It is shown that the only means for reducing the power requirement is maximizing the gradient of the mutual inductance. In the scheme of the sliding-coil accelerator investigated herein, the gradient of the mutual inductance is continuously maintained at a high value. It is also shown that for minimum length of the accelerator, the current must be kept constant despite the rise in induced voltage during acceleration. The use of a capacitor bank as an energy source with the condition that the current be kept constant is investigated. Experiments at low velocities are described.

  13. MMT hypervelocity star survey. III. The complete survey

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Warren R.; Geller, Margaret J.; Kenyon, Scott J., E-mail: wbrown@cfa.harvard.edu, E-mail: mgeller@cfa.harvard.edu, E-mail: skenyon@cfa.harvard.edu [Smithsonian Astrophysical Observatory, 60 Garden Street, Cambridge, MA 02138 (United States)

    2014-05-20

    We describe our completed spectroscopic survey for unbound hypervelocity stars (HVSs) ejected from the Milky Way. Three new discoveries bring the total number of unbound late B-type stars to 21. We place new constraints on the nature of the stars and on their distances using moderate resolution MMT spectroscopy. Half of the stars are fast rotators; they are certain 2.5-4 M {sub ☉} main sequence stars at 50-120 kpc distances. Correcting for stellar lifetime, our survey implies that unbound 2.5-4 M {sub ☉} stars are ejected from the Milky Way at a rate of 1.5 × 10{sup –6} yr{sup –1}. These unbound HVSs are likely ejected continuously over the past 200 Myr and do not share a common flight time. The anisotropic spatial distribution of HVSs on the sky remains puzzling. Southern hemisphere surveys like SkyMapper will soon allow us to map the all-sky distribution of HVSs. Future proper motion measurements with Hubble Space Telescope and Gaia will provide strong constraints on origin. Existing observations are all consistent with HVS ejections from encounters with the massive black hole in the Galactic center.

  14. Hypervelocity Stars: From the Galactic Center to the Halo

    Science.gov (United States)

    Kenyon, Scott J.; Bromley, Benjamin C.; Geller, Margaret J.; Brown, Warren R.

    2008-06-01

    Hypervelocity stars (HVSs) traverse the Galaxy from the central black hole to the outer halo. We show that the Galactic potential within 200 pc acts as a high-pass filter preventing low-velocity HVSs from reaching the halo. To trace the orbits of HVSs throughout the Galaxy, we construct two forms of the potential which reasonably represent the observations in the range 5-105 pc: a simple spherically symmetric model and a bulge-disk-halo model. We use the Hills mechanism (disruption of binaries by the tidal field of the central black hole) to inject HVSs into the Galaxy and to compute the observable spatial and velocity distributions of HVSs with masses in the range 0.6-4 M⊙. These distributions reflect the mass function in the Galactic center, properties of binaries in the Galactic center, and aspects of stellar evolution and the injection mechanism. For 0.6-4 M⊙ main-sequence stars, the fraction of unbound HVSs and the asymmetry of the velocity distribution for their bound counterparts increase with stellar mass. The density profiles for unbound HVSs decline with distance from the Galactic center approximately as r-2 (but are steeper for the most massive stars, which evolve off the main sequence during their travel time from the Galactic center); the density profiles for the bound ejecta decline with distance approximately as r-3. In a survey with a limiting magnitude of Vlesssim 23, the detectability of HVSs (unbound or bound) increases with stellar mass.

  15. Environmental conditions and prey-switching by a seabird predator impact juvenile salmon survival

    Science.gov (United States)

    Wells, Brian K.; Santora, Jarrod A.; Henderson, Mark J.; Warzybok, Pete; Jahncke, Jaime; Bradley, Russell W.; Huff, David D.; Schroeder, Isaac D.; Nelson, Peter; Field, John C.; Ainley, David G.

    2017-01-01

    Due to spatio-temporal variability of lower trophic-level productivity along the California Current Ecosystem (CCE), predators must be capable of switching prey or foraging areas in response to changes in environmental conditions and available forage. The Gulf of the Farallones in central California represents a biodiversity hotspot and contains the largest common murre (Uria aalge) colonies along the CCE. During spring, one of the West Coast's most important Chinook salmon (Oncorhynchus tshawytscha) populations out-migrates into the Gulf of the Farallones. We quantify the effect of predation on juvenile Chinook salmon associated with ecosystem-level variability by integrating long-term time series of environmental conditions (upwelling, river discharge), forage species abundance within central CCE, and population size, at-sea distribution, and diet of the common murre. Our results demonstrate common murres typically forage in the vicinity of their offshore breeding sites, but in years in which their primary prey, pelagic young-of-year rockfish (Sebastesspp.), are less available they forage for adult northern anchovies (Engraulis mordax) nearshore. Incidentally, while foraging inshore, common murre consumption of out-migrating juvenile Chinook salmon, which are collocated with northern anchovy, increases and population survival of the salmon is significantly reduced. Results support earlier findings that show timing and strength of upwelling, and the resultant forage fish assemblage, is related to Chinook salmon recruitment variability in the CCE, but we extend those results by demonstrating the significance of top-down impacts associated with these bottom-up dynamics. Our results demonstrate the complexity of ecosystem interactions and impacts between higher trophic-level predators and their prey, complexities necessary to quantify in order to parameterize ecosystem models and evaluate likely outcomes of ecosystem management options.

  16. Modeling longitudinal data and its impact on survival in observational nephrology studies: tools and considerations.

    Science.gov (United States)

    Streja, Elani; Goldstein, Leanne; Soohoo, Melissa; Obi, Yoshitsugu; Kalantar-Zadeh, Kamyar; Rhee, Connie M

    2017-04-01

    Nephrologists and kidney disease researchers are often interested in monitoring how patients' clinical and laboratory measures change over time, what factors may impact these changes, and how these changes may lead to differences in morbidity, mortality, and other outcomes. When longitudinal data with repeated measures over time in the same patients are available, there are a number of analytical approaches that could be employed to describe the trends and changes in these measures, and to explore the associations of these changes with outcomes. Researchers may choose a streamlined and simplified analytic approach to examine trajectories with subsequent outcomes such as estimating deltas (subtraction of the last observation from the first observation) or estimating per patient slopes with linear regression. Conversely, they could more fully address the data complexity by using a longitudinal mixed model to estimate change as a predictor or employ a joint model, which can simultaneously model the longitudinal effect and its impact on an outcome such as survival. In this review, we aim to assist nephrologists and clinical researchers by reviewing these approaches in modeling the association of longitudinal change in a marker with outcomes, while appropriately considering the data complexity. Namely, we will discuss the use of simplified approaches for creating predictor variables representing change in measurements including deltas and patient slopes, as well more sophisticated longitudinal models including joint models, which can be used in addition to simplified models based on the indications and objectives of the study as warranted. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  17. Environmental conditions and prey-switching by a seabird predator impact juvenile salmon survival

    Science.gov (United States)

    Wells, Brian K.; Santora, Jarrod A.; Henderson, Mark J.; Warzybok, Pete; Jahncke, Jaime; Bradley, Russell W.; Huff, David D.; Schroeder, Isaac D.; Nelson, Peter; Field, John C.; Ainley, David G.

    2017-10-01

    Due to spatio-temporal variability of lower trophic-level productivity along the California Current Ecosystem (CCE), predators must be capable of switching prey or foraging areas in response to changes in environmental conditions and available forage. The Gulf of the Farallones in central California represents a biodiversity hotspot and contains the largest common murre (Uria aalge) colonies along the CCE. During spring, one of the West Coast's most important Chinook salmon (Oncorhynchus tshawytscha) populations out-migrates into the Gulf of the Farallones. We quantify the effect of predation on juvenile Chinook salmon associated with ecosystem-level variability by integrating long-term time series of environmental conditions (upwelling, river discharge), forage species abundance within central CCE, and population size, at-sea distribution, and diet of the common murre. Our results demonstrate common murres typically forage in the vicinity of their offshore breeding sites, but in years in which their primary prey, pelagic young-of-year rockfish (Sebastes spp.), are less available they forage for adult northern anchovies (Engraulis mordax) nearshore. Incidentally, while foraging inshore, common murre consumption of out-migrating juvenile Chinook salmon, which are collocated with northern anchovy, increases and population survival of the salmon is significantly reduced. Results support earlier findings that show timing and strength of upwelling, and the resultant forage fish assemblage, is related to Chinook salmon recruitment variability in the CCE, but we extend those results by demonstrating the significance of top-down impacts associated with these bottom-up dynamics. Our results demonstrate the complexity of ecosystem interactions and impacts between higher trophic-level predators and their prey, complexities necessary to quantify in order to parameterize ecosystem models and evaluate likely outcomes of ecosystem management options.

  18. Acute Childhood Cardiorenal Syndrome and Impact of Cardiovascular Morbidity on Survival

    Directory of Open Access Journals (Sweden)

    Wasiu A. Olowu

    2011-01-01

    Full Text Available Cardiorenal syndrome (CRS clinical types, prevalence, aetiology, and acute cardiovascular morbidity impact on the outcome of acute kidney function perturbation were determined. Forty-seven of 101 (46.53% patients with perturbed kidney function had CRS. Types 3 and 5 CRS were found in 10 and 37 patients, respectively. Type 3 CRS was due to acute glomerulonephritis (AGN; =7, captopril (=1, frusemide (=1, and hypovolaemia (=1. Malaria-associated haemoglobinuria (=20, septicaemia (=11, lupus nephritis (=3, tumour lysis syndrome (=2, and acute lymphoblastic leukaemia (=1 caused Type 5 CRS. The cumulative mortality in hypertensive CRS was similar to nonhypertensive CRS (51.4% versus 40.9%; =.119. Mortality in CRS and non-CRS was similar (45.7% versus 24.5%; =.053. Type 5 survived better than type 3 CRS (66.7% versus 12.5%; =.001. Risk factors for mortality were Type 3 CRS (=.001, AGN-associated CRS (=.023, dialysis requiring CRS (=.008, and heart failure due to causes other than anaemia (=.003. All-cause-mortality was 34.2%. Preventive measures aimed at the preventable CRS aetiologies might be critical to reducing its prevalence.

  19. Usefulness and prognostic impact on survival of WHO reclassification in FAB low risk myelodyplastic syndromes.

    Science.gov (United States)

    Breccia, Massimo; Carmosino, Ida; Biondo, Francesca; Mancini, Marco; Russo, Eleonora; Latagliata, Roberto; Alimena, Giuliana

    2006-02-01

    In 1999, WHO proposed a revised classification for myelodysplastic syndromes (MDS). According to this system, FAB low risk MDS (RA and RARS) were defined as such when the presence of dysplastic features was only restricted to the erythroid lineage, and new categories, refractory cytopenia with multilineage dysplasia (RCMD) and refractory cytopenia with multilineage dysplasia and ringed sideroblasts (RCMD-RS), were added. In a retrospective analysis of 240 consecutive patients diagnosed at our institution as having FAB RA and RARS, we reclassified the disease following the WHO criteria and we found that 179/214 patients (84%) still remained in the RA category, while 35/214 (16%) moved to RCMD. Moreover, 17/26 patients (65%) maintained the RARS diagnosis, whereas 9/26 (35%) were re-classified as RCMD-RS. We detected differences among the WHO subgroups as to age and sex distribution as well as to median survival observed by stratifying patients according to different prognostic scoring systems. Furthermore we confirmed the usefulness of WHO segregation with regard to its predictive value for evolution into acute leukaemia. Our study provides evidence that WHO classification may have prognostic impact on MDS subgroups which are usually categorized by FAB as having a favourable outcome.

  20. Clinical Impact of Selective and Non-selective Beta Blockers on Survival in Ovarian Cancer Patients

    Science.gov (United States)

    Watkins, Jack L.; Thaker, Premal H.; Nick, Alpa M.; Ramondetta, Lois M.; Kumar, Sanjeev; Urbauer, Diana L.; Matsuo, Koji; Squires, Kathryn; Lutgendorf, Susan K.; Ramirez, Pedro T.; Sood, Anil K.

    2015-01-01

    BACKGROUND Preclinical evidence suggests that sustained adrenergic activation can promote ovarian cancer growth and metastasis. We examined the impact of beta-adrenergic blockade on clinical outcome of women with epithelial ovarian, primary peritoneal or fallopian tube cancers (collectively, EOC). METHODS A multicenter review of 1,425 women with histopathologically confirmed EOC was performed. Comparisons were made between patients with documented beta blocker use during chemotherapy and those without beta blocker use. RESULTS The median age of patients in this study was 63 years (range, 21–93 years). The sample included 269 patients who received beta blockers. Of those, 193 (71.7%) were receiving beta-1 adrenergic receptor (ADRB1) selective agents, and the remaining patients were receiving non-selective beta antagonists. The primary indication for beta blocker use was hypertension but also included arrhythmia and post-myocardial infarction management. For patients receiving any beta blocker, the median overall survival (OS) was 47.8 months versus42 months (P = 0.04) for non-users. The median OS based on beta blocker receptor selectivity was 94.9 months for those receiving non-selective beta blockers versus 38 months for those receiving ADRB1 selective agents (P beta blocker had a longer median OS than non-users observed (38.2 vs 90 months, P beta blockers in epithelial ovarian cancer patients was associated with longer OS. These findings may have implications for new therapeutic approaches. PMID:26301456

  1. Clinical impact of selective and nonselective beta-blockers on survival in patients with ovarian cancer.

    Science.gov (United States)

    Watkins, Jack L; Thaker, Premal H; Nick, Alpa M; Ramondetta, Lois M; Kumar, Sanjeev; Urbauer, Diana L; Matsuo, Koji; Squires, Kathryn C; Coleman, Robert L; Lutgendorf, Susan K; Ramirez, Pedro T; Sood, Anil K

    2015-10-01

    Preclinical evidence has suggested that sustained adrenergic activation can promote ovarian cancer growth and metastasis. The authors examined the impact of beta-adrenergic blockade on the clinical outcome of women with epithelial ovarian, primary peritoneal, or fallopian tube cancers (collectively, epithelial ovarian cancer [EOC]). A multicenter review of 1425 women with histopathologically confirmed EOC was performed. Comparisons were made between patients with documented beta-blocker use during chemotherapy and those without beta-blocker use. The median age of patients in the current study was 63 years (range, 21-93 years). The sample included 269 patients who received beta-blockers. Of those, 193 (71.7%) were receiving beta-1-adrenergic receptor selective agents, and the remaining patients were receiving nonselective beta antagonists. The primary indication for beta-blocker use was hypertension but also included arrhythmia and postmyocardial infarction management. For patients receiving any beta-blocker, the median overall survival (OS) was 47.8 months versus 42 months for nonusers (P =.04). The median OS based on beta-blocker receptor selectivity was 94.9 months for those receiving nonselective beta-blockers versus 38 months for those receiving beta-1-adrenergic receptor selective agents (Pbeta-blocker compared with nonusers (38.2 months vs 90 months; Pbeta-blockers in patients with EOC was associated with longer OS. These findings may have implications for new therapeutic approaches. Cancer 2015;121:3435-43. © 2015 American Cancer Society. © 2015 American Cancer Society.

  2. 3 MV hypervelocity dust accelerator at the Colorado Center for Lunar Dust and Atmospheric Studies

    Science.gov (United States)

    Shu, Anthony; Collette, Andrew; Drake, Keith; Grün, Eberhard; Horányi, Mihály; Kempf, Sascha; Mocker, Anna; Munsat, Tobin; Northway, Paige; Srama, Ralf; Sternovsky, Zoltán; Thomas, Evan

    2012-07-01

    A hypervelocity dust accelerator for studying micrometeorite impacts has been constructed at the Colorado Center for Lunar Dust and Atmospheric Studies (CCLDAS) at the University of Colorado. Based on the Max-Planck-Institüt für Kernphysik (MPI-K) accelerator, this accelerator is capable of emitting single particles of a specific mass and velocity selected by the user. The accelerator consists of a 3 MV Pelletron generator with a dust source, four image charge pickup detectors, and two interchangeable target chambers: a large high-vacuum test bed and an ultra-high vacuum impact study chamber. The large test bed is a 1.2 m diameter, 1.5 m long cylindrical vacuum chamber capable of pressures as low as 10-7 torr while the ultra-high vacuum chamber is a 0.75 m diameter, 1.1 m long chamber capable of pressures as low as 10-10 torr. Using iron dust of up to 2 microns in diameter, final velocities have been measured up to 52 km/s. The spread of the dust particles and the effect of electrostatic focusing have been measured using a long exposure CCD and a quartz target. Furthermore, a new technique of particle selection is being developed using real time digital filtering techniques. Signals are digitized and then cross-correlated with a shaped filter, resulting in a suppressed noise floor. Improvements over the MPI-K design, which include a higher operating voltage and digital filtering for detection, increase the available parameter space of dust emitted by the accelerator. The CCLDAS dust facility is a user facility open to the scientific community to assist with instrument calibrations and experiments.

  3. 3 MV hypervelocity dust accelerator at the Colorado Center for Lunar Dust and Atmospheric Studies

    Energy Technology Data Exchange (ETDEWEB)

    Shu, Anthony; Horanyi, Mihaly; Kempf, Sascha; Thomas, Evan [Colorado Center for Lunar Dust and Atmospheric Studies, Boulder, Colorado 80303 (United States); Department of Physics, University of Colorado, Boulder, Colorado 80309 (United States); Laboratory for Atmospheric and Space Physics, 1234 Innovation Drive, Boulder, Colorado 80303 (United States); Collette, Andrew; Drake, Keith; Northway, Paige [Colorado Center for Lunar Dust and Atmospheric Studies, Boulder, Colorado 80303 (United States); Laboratory for Atmospheric and Space Physics, 1234 Innovation Drive, Boulder, Colorado 80303 (United States); Gruen, Eberhard [Colorado Center for Lunar Dust and Atmospheric Studies, Boulder, Colorado 80303 (United States); MPI fuer Kernphysik, Saupfercheckweg 1, D-69117 Heidelberg (Germany); Mocker, Anna [Colorado Center for Lunar Dust and Atmospheric Studies, Boulder, Colorado 80303 (United States); MPI fuer Kernphysik, Saupfercheckweg 1, D-69117 Heidelberg (Germany); IRS, Universitaet Stuttgart, Pfaffenwaldring 31, D-70569 Stuttgart (Germany); Munsat, Tobin [Colorado Center for Lunar Dust and Atmospheric Studies, Boulder, Colorado 80303 (United States); Department of Physics, University of Colorado, Boulder, Colorado 80309 (United States); Srama, Ralf [MPI fuer Kernphysik, Saupfercheckweg 1, D-69117 Heidelberg (Germany); IRS, Universitaet Stuttgart, Pfaffenwaldring 31, D-70569 Stuttgart (Germany); and others

    2012-07-15

    A hypervelocity dust accelerator for studying micrometeorite impacts has been constructed at the Colorado Center for Lunar Dust and Atmospheric Studies (CCLDAS) at the University of Colorado. Based on the Max-Planck-Instituet fuer Kernphysik (MPI-K) accelerator, this accelerator is capable of emitting single particles of a specific mass and velocity selected by the user. The accelerator consists of a 3 MV Pelletron generator with a dust source, four image charge pickup detectors, and two interchangeable target chambers: a large high-vacuum test bed and an ultra-high vacuum impact study chamber. The large test bed is a 1.2 m diameter, 1.5 m long cylindrical vacuum chamber capable of pressures as low as 10{sup -7} torr while the ultra-high vacuum chamber is a 0.75 m diameter, 1.1 m long chamber capable of pressures as low as 10{sup -10} torr. Using iron dust of up to 2 microns in diameter, final velocities have been measured up to 52 km/s. The spread of the dust particles and the effect of electrostatic focusing have been measured using a long exposure CCD and a quartz target. Furthermore, a new technique of particle selection is being developed using real time digital filtering techniques. Signals are digitized and then cross-correlated with a shaped filter, resulting in a suppressed noise floor. Improvements over the MPI-K design, which include a higher operating voltage and digital filtering for detection, increase the available parameter space of dust emitted by the accelerator. The CCLDAS dust facility is a user facility open to the scientific community to assist with instrument calibrations and experiments.

  4. Advanced Unilateral Retinoblastoma: The Impact of Ophthalmic Artery Chemosurgery on Enucleation Rate and Patient Survival at MSKCC.

    Directory of Open Access Journals (Sweden)

    David H Abramson

    Full Text Available To report on the influence of ophthalmic artery chemosurgery (OAC on enucleation rates, ocular and patient survival from metastasis and impact on practice patterns at Memorial Sloan Kettering for children with advanced intraocular unilateral retinoblastoma.Single-center retrospective review of all unilateral retinoblastoma patients with advanced intraocular retinoblastoma treated at MSKCC between our introduction of OAC (May 2006 and December 2014. End points were ocular survival, patient survival from metastases and enucleation rates.156 eyes of 156 retinoblastoma patients were included. Primary enucleation rates have progressively decreased from a rate of >95% before OAC to 66.7% in the first year of OAC use to the present rate of 7.4%. The percent of patients receiving OAC has progressively increased from 33.3% in 2006 to 92.6% in 2014. Overall, ocular survival was significantly better in eyes treated with OAC in the years 2010-2014 compared to 2006-2009 (p = 0.023, 92.7% vs 68.0% ocular survival at 48 months. There have been no metastatic deaths in the OAC group but two patients treated with primary enucleation have died of metastatic disease.OAC was introduced in 2006 and its impact on patient management is profound. Enucleation rates have decreased from over 95% to less than 10%. Our ocular survival rate has also significantly and progressively improved since May 2006. Despite treating more advanced eyes rather then enucleating them patient survival has not been compromised (there have been no metastatic deaths in the OAC group. In our institution, enucleation is no longer the most common treatment for advanced unilateral retinoblastoma.

  5. Investigation of Orbital Debris Impacts on Shuttle Radiator Panels

    Science.gov (United States)

    Hyde, James L.; Christiansen, Eric L.; Lear, Dana M.; Kerr, Justin H.; Lyons, Frankel; Herrin, Jason H.; Ryan, Shannon J.

    2009-01-01

    This paper documents the data collected from two hypervelocity micro-meteoroid orbital debris (MMOD) impact events where the shuttle payload bay door radiator sandwich panel was completely perforated. Scanning Electron Microscope/Energy-Dispersive x-ray Spectroscopy (SEM/EDS) analysis of impact residue provided evidence to identify the source of each impact. Impact site features that indicate projectile directionality are discussed, along with hypervelocity impact testing on representative samples conducted to simulate the impact event. The paper provides results of a study of impact risks for the size of particles that caused the MMOD damage and the regions of the orbiter vehicle that would be vulnerable to an equivalent projectile

  6. Insights from past millennia into climatic impacts on human health and survival

    Science.gov (United States)

    McMichael, Anthony J.

    2012-01-01

    Climate change poses threats to human health, safety, and survival via weather extremes and climatic impacts on food yields, fresh water, infectious diseases, conflict, and displacement. Paradoxically, these risks to health are neither widely nor fully recognized. Historical experiences of diverse societies experiencing climatic changes, spanning multicentury to single-year duration, provide insights into population health vulnerability—even though most climatic changes were considerably less than those anticipated this century and beyond. Historical experience indicates the following. (i) Long-term climate changes have often destabilized civilizations, typically via food shortages, consequent hunger, disease, and unrest. (ii) Medium-term climatic adversity has frequently caused similar health, social, and sometimes political consequences. (iii) Infectious disease epidemics have often occurred in association with briefer episodes of temperature shifts, food shortages, impoverishment, and social disruption. (iv) Societies have often learnt to cope (despite hardship for some groups) with recurring shorter-term (decadal to multiyear) regional climatic cycles (e.g., El Niño Southern Oscillation)—except when extreme phases occur. (v) The drought–famine–starvation nexus has been the main, recurring, serious threat to health. Warming this century is not only likely to greatly exceed the Holocene's natural multidecadal temperature fluctuations but to occur faster. Along with greater climatic variability, models project an increased geographic range and severity of droughts. Modern societies, although larger, better resourced, and more interconnected than past societies, are less flexible, more infrastructure-dependent, densely populated, and hence are vulnerable. Adverse historical climate-related health experiences underscore the case for abating human-induced climate change. PMID:22315419

  7. Impact of donor-to-recipient weight ratio on survival after bilateral lung transplantation.

    Science.gov (United States)

    Delom, F; Danner-Boucher, I; Dromer, C; Thumerel, M; Marthan, R; Nourry-Lecaplain, L; Magnan, A; Jougon, J; Fessart, D

    2014-06-01

    The aim of this study was to investigate the relationship between donor-to-recipient weight ratio and post-transplantation survival. From February 1988 to November 2006, 255 adult bilateral lung transplantation patients from 2 different centers were retrospectively analyzed. The cohort was divided into 4 groups depending on the quartile ranges of the donor-to-recipient weight ratio. A time-to-event analysis was performed for risk of death after transplantation conditional on 5-year survival using Kaplan-Meier and Cox proportional hazards models. The mean weight ratio for the study cohort was 1.23 ± 0.39. For all lung transplant recipients during the study period, survival rate at 5 years was 58%. Median survival was 6.3 years in the cohort subgroup with weight ratio ratio >1.23. Weight ratio >1.23 recipients had a significant survival advantage out to 5 years compared with weight ratio ratio. Weight ratio strata affected overall survival, with quartile 1 (lower weight ratio recipients) experiencing the lowest 5-year survival (39.1%), followed by quartile 2 (57.8%), quartile 4 (68.2%), and quartile 3 (70.3%) recipients. The effect of weight ratio strata on survival was statistically significant for the quartile 1 recipients (lower quartile) as compared with the 3 other quartiles. Our findings show a statistically significant effect of donor-to-recipient weight ratios on bilateral lung transplantation survival. A higher donor-to-recipient weight ratio was associated with improved survival after bilateral lung transplantation and likely reflects a mismatch between a relatively overweight donor vs recipient. In contrast, a lower donor-to-recipient ratio was associated with increased mortality after bilateral lung transplantation. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Prenatal Stress Exposure Generates Higher Early Survival and Smaller Size without Impacting Developmental Rate in a Pacific Salmon.

    Science.gov (United States)

    Capelle, Pauline M; Semeniuk, Christina A D; Sopinka, Natalie M; Heath, John W; Love, Oliver P

    2016-12-01

    Prenatal exposure to elevated glucocorticoids can act as a signal of environmental stress, resulting in modifications to offspring phenotype. While "negative" phenotypic effects (i.e., smaller size, slower growth) are often reported, recent research coupling phenotype with other fitness-related traits has suggested positive impacts of prenatal stress. Using captive Chinook salmon (Oncorhynchus tshawytscha), we treated eggs with biologically relevant cortisol levels-low (300 ng mL(-1) ), high (1,000 ng mL(-1) ), or control (0 ng mL(-1) )-to examine the early-life impacts of maternally transferred stress hormones on offspring. Specifically, we measured early survival, rate of development, and multiple measures of morphology. Low and high cortisol dosing of eggs resulted in significantly higher survival compared to controls (37% and 24% higher, respectively). Fish reared from high dose eggs were structurally smaller compared to control fish, but despite this variation in structural size, exposure to elevated cortisol did not impact developmental rate. These results demonstrate that elevations in egg cortisol can positively influence offspring fitness through an increase in early survival while also altering phenotype at a critical life-history stage. Overall, these results suggest that exposure to prenatal stress may not always produce apparently negative impacts on offspring fitness and further proposes that complex phenotypic responses should be examined in relevant environmental conditions. © 2017 Wiley Periodicals, Inc.

  9. Adverse foraging conditions may impact body mass and survival of a high Arctic seabird

    Science.gov (United States)

    Harding, A.M.A.; Welcker, J.; Steen, H.; Hamer, K.C.; Kitaysky, A.S.; Fort, J.; Talbot, S.L.; Cornick, L.A.; Karnovsky, N.J.; Gabrielsen, G.W.; Gremillet, D.

    2011-01-01

    Tradeoffs between current reproduction and future survival are widely recognized, but may only occur when food is limited: when foraging conditions are favorable, parents may be able to reproduce without compromising their own survival. We investigated these tradeoffs in the little auk (Alle alle), a small seabird with a single-egg clutch. During 2005-2007, we examined the relationship between body mass and survival of birds breeding under contrasting foraging conditions at two Arctic colonies. We used corticosterone levels of breeding adults as a physiological indicator of the foraging conditions they encountered during each reproductive season. We found that when foraging conditions were relatively poor (as reflected in elevated levels of corticosterone), parents ended the reproductive season with low body mass and suffered increased post-breeding mortality. A positive relationship between body mass and post-breeding survival was found in one study year; light birds incurred higher survival costs than heavy birds. The results of this study suggest that reproducing under poor foraging conditions may affect the post-breeding survival of long-lived little auks. They also have important demographic implications because even a small change in adult survival may have a large effect on populations of long-lived species. ?? 2011 Springer-Verlag.

  10. Modeling the airborne survival of influenza virus in a residential setting: the impacts of home humidification

    Directory of Open Access Journals (Sweden)

    Myatt Theodore A

    2010-09-01

    Full Text Available Abstract Background Laboratory research studies indicate that aerosolized influenza viruses survive for longer periods at low relative humidity (RH conditions. Further analysis has shown that absolute humidity (AH may be an improved predictor of virus survival in the environment. Maintaining airborne moisture levels that reduce survival of the virus in the air and on surfaces could be another tool for managing public health risks of influenza. Methods A multi-zone indoor air quality model was used to evaluate the ability of portable humidifiers to control moisture content of the air and the potential related benefit of decreasing survival of influenza viruses in single-family residences. We modeled indoor AH and influenza virus concentrations during winter months (Northeast US using the CONTAM multi-zone indoor air quality model. A two-story residential template was used under two different ventilation conditions - forced hot air and radiant heating. Humidity was evaluated on a room-specific and whole house basis. Estimates of emission rates for influenza virus were particle-size specific and derived from published studies and included emissions during both tidal breathing and coughing events. The survival of the influenza virus was determined based on the established relationship between AH and virus survival. Results The presence of a portable humidifier with an output of 0.16 kg water per hour in the bedroom resulted in an increase in median sleeping hours AH/RH levels of 11 to 19% compared to periods without a humidifier present. The associated percent decrease in influenza virus survival was 17.5 - 31.6%. Distribution of water vapor through a residence was estimated to yield 3 to 12% increases in AH/RH and 7.8-13.9% reductions in influenza virus survival. Conclusion This modeling analysis demonstrates the potential benefit of portable residential humidifiers in reducing the survival of aerosolized influenza virus by controlling humidity

  11. High-resolution imaging of hypervelocity metal jets using advanced high-speed photographic techniques

    Energy Technology Data Exchange (ETDEWEB)

    Shaw, L.L.; Muelder, S.A.

    1995-08-29

    It is now possible to obtain high resolution sequential photographs of the initial formation and evolution of hypervelocity metal jets formed by shaped charge devices fired in air. Researchers have been frustrated by the high velocity of the jet material and the luminous sheath of hot gases cloaking the jet that made detailed observation of the jet body extremely difficult. The camera system that provides the photographs is a large format multi-frame electro-optic camera, referred to as an IC camera (IC stands for image converter), that utilizes electro-optic shuttering, monochromatic pulsed laser illumination and bandpass filtering to provide sequential pictures (in 3D if desired) with minimal degradation due to luminous air shocks or motion blur. The large format (75mm image plane), short exposure (15 ns minimum), ruby laser illumination and bandpass filtering (monochromatic illumination while excluding extraneous light) produces clear, sharp, images of the detailed surface structure of a metal shaped charge jet during early jet formation, elongation of the jet body, jet tip evolution and subsequent particulation (breakup) of the jet body. By utilizing the new camera system in conjunction with the more traditional rotating mirror high speed cameras, pulsed radiography, and electrical sensors, a maximum amount of, often unique, data can be extracted from a single experiment. This paper was intended primarily as an oral presentation. For purposes of continuity and simplicity in these proceedings, the authors have chosen to concentrate on the development of the IC camera system and its impact on the photography of high speed shaped chargejets.

  12. Impact of chronic obstructive pulmonary disease on survival and symptoms of severe aortic valve stenosis

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Dahl, Jordi S; Kjeldsen, Bo J

    2015-01-01

    severe comorbidities, including chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: Since the beginning of our TAVI program in March 2008, data on all 131 TAVI patients were prospectively and consecutively collected in this registry with complete follow-up. COPD was present in 37...... patients. By January 2012 survival data were collected from the Danish Civil Registration System. Median follow-up duration was 559 days. RESULTS: Overall survival and survival from cardiac death was equivalent in both patients with and without COPD (p = 0.98 and p = 0.26) in the follow-up period. Further...

  13. The impact of pregnancy on breast cancer survival in women who carry a BRCA1 or BRCA2 mutation.

    Science.gov (United States)

    Valentini, Adriana; Lubinski, Jan; Byrski, Tomasz; Ghadirian, Parviz; Moller, Pal; Lynch, Henry T; Ainsworth, Peter; Neuhausen, Susan L; Weitzel, Jeffrey; Singer, Christian F; Olopade, Olufunmilayo I; Saal, Howard; Lyonnet, Dominique Stoppa; Foulkes, William D; Kim-Sing, Charmaine; Manoukian, Siranoush; Zakalik, Dana; Armel, Susan; Senter, Leigha; Eng, Charis; Grunfeld, Eva; Chiarelli, Anna M; Poll, Aletta; Sun, Ping; Narod, Steven A

    2013-11-01

    Physicians are often approached by young women with a BRCA mutation and a recent history of breast cancer who wish to have a baby. They wish to know if pregnancy impacts upon their future risks of cancer recurrence and survival. To date, there is little information on the survival experience of women who carry a mutation in one of the BRCA genes and who become pregnant. From an international multi-center cohort study of 12,084 women with a BRCA1 or BRCA2 mutation, we identified 128 case subjects who were diagnosed with breast cancer while pregnant or who became pregnant after a diagnosis of breast cancer. These women were age-matched to 269 mutation carriers with breast cancer who did not become pregnant (controls). Subjects were followed from the date of breast cancer diagnosis until the date of last follow-up or death from breast cancer. The Kaplan-Meier method was used to estimate 15-year survival rates. The hazard ratio for survival associated with pregnancy was calculated using a left-truncated Cox proportional hazard model, adjusting for other prognostic factors. Among women who were diagnosed with breast cancer when pregnant or who became pregnant thereafter, the 15-year survival rate was 91.5 %, compared to a survival of 88.6 % for women who did not become pregnant (adjusted hazard ratio = 0.76; 95 % CI 0.31-1.91; p = 0.56). Pregnancy concurrent with or after a diagnosis of breast cancer does not appear to adversely affect survival among BRCA1/2 mutation carriers.

  14. The impact of body mass index dynamics on survival of patients with advanced pancreatic cancer receiving chemotherapy.

    Science.gov (United States)

    Choi, Younak; Kim, Tae-Yong; Lee, Kyung-hun; Han, Sae-Won; Oh, Do-Youn; Im, Seock-Ah; Kim, Tae-You; Bang, Yung-Jue

    2014-07-01

    High body mass index (BMI) is linked to an increased risk of developing pancreatic cancer (PC). However, in patients with advanced PC (APC), especially those receiving palliative chemotherapy, the impact of BMI on survival has not been investigated fully. To assess changes in BMI during the course of APC and their impact on patient survival, specifically for those receiving palliative chemotherapy. Consecutive patients with APC, all of whom were treated with palliative chemotherapy, were enrolled during 2003-2010. Clinical characteristics and prognoses were analyzed. A total of 425 patients participated (median age, 60.1 years). At diagnosis of APC, patients' BMI distribution of patients was as follow: Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  15. The impact of bevacizumab treatment on survival and quality of life in newly diagnosed glioblastoma patients

    DEFF Research Database (Denmark)

    Poulsen, Hans Skovgaard; Urup, Thomas; Michaelsen, Signe Regner

    2014-01-01

    Glioblastoma multiforme (GBM) remains one of the most devastating tumors, and patients have a median survival of 15 months despite aggressive local and systemic therapy, including maximal surgical resection, radiation therapy, and concomitant and adjuvant temozolomide. The purpose of antineoplastic...

  16. Combined spatio-temporal impacts of climate and longline fisheries on the survival of a trans-equatorial marine migrant.

    Directory of Open Access Journals (Sweden)

    Raül Ramos

    Full Text Available Predicting the impact of human activities and their derivable consequences, such as global warming or direct wildlife mortality, is increasingly relevant in our changing world. Due to their particular life history traits, long-lived migrants are amongst the most endangered and sensitive group of animals to these harming effects. Our ability to identify and quantify such anthropogenic threats in both breeding and wintering grounds is, therefore, of key importance in the field of conservation biology. Using long-term capture-recapture data (34 years, 4557 individuals and year-round tracking data (4 years, 100 individuals of a trans-equatorial migrant, the Cory's shearwater (Calonectris diomedea, we investigated the impact of longline fisheries and climatic variables in both breeding and wintering areas on the most important demographic trait of this seabird, i.e. adult survival. Annual adult survival probability was estimated at 0.914±0.022 on average, declining throughout 1978-1999 but recovering during the last decade (2005-2011. Our results suggest that both the incidental bycatch associated with longline fisheries and high sea surface temperatures (indirectly linked to food availability; SST increased mortality rates during the long breeding season (March-October. Shearwater survival was also negatively affected during the short non-breeding season (December-February by positive episodes of the Southern Oscillation Index (SOI. Indirect negative effects of climate at both breeding (SST and wintering grounds (SOI had a greater impact on survival than longliner activity, and indeed these climatic factors are those which are expected to present more unfavourable trends in the future. Our work underlines the importance of considering both breeding and wintering habitats as well as precise schedules/phenology when assessing the global role of the local impacts on the dynamics of migratory species.

  17. Impact of modern chemotherapy on the survival of women presenting with de novo metastatic breast cancer

    OpenAIRE

    Pal Sumanta K; Dehaven Mary; Nelson Rebecca A; Onami Susan; Hsu JoAnn; Waliany Sarah; Kruper Laura; Mortimer Joanne

    2012-01-01

    Abstract Background Data that directly associate utilization of novel systemic therapies with survival trends in metastatic breast cancer (MBC) are limited. In the setting of de novo MBC, large registry analyses cite positive temporal trends in survival, but the extent to which advances in systemic therapy have contributed to these gains is not clear. Methods The City of Hope Cancer Registry was used to identify a consecutive series of patients with de novo MBC who received their first line o...

  18. Impact of modern chemotherapy on the survival of women presenting with de novo metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    Pal Sumanta K

    2012-09-01

    Full Text Available Abstract Background Data that directly associate utilization of novel systemic therapies with survival trends in metastatic breast cancer (MBC are limited. In the setting of de novo MBC, large registry analyses cite positive temporal trends in survival, but the extent to which advances in systemic therapy have contributed to these gains is not clear. Methods The City of Hope Cancer Registry was used to identify a consecutive series of patients with de novo MBC who received their first line of therapy between 1985 and 2004. Comprehensive clinicopathologic and treatment-related data were collected for each patient. Univariate analyses were conducted via Cox regression to identify factors associated with improved survival. Multivariate analysis was also conducted via Cox regression and the stepwise procedure was used to identify independent predictors of survival. Results A total of 324 patients with de novo MBC were identified. After application of exclusion criteria, including the sole presence of supraclavicular node metastasis, 274 patients were retained in the analysis. The treatment-related characteristics associated with improved survival included: use of endocrine therapy (hazard ratio [HR] 0.60, 95%CI 0.47-0.77; P Conclusions The overall survival of women with de novo metastatic breast cancer has improved over the past 20 years. However, the contribution of conventional cytotoxic agents to this improvement is minimal.

  19. Predictors of Locoregional Failure and Impact on Overall Survival in Patients With Resected Exocrine Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Merrell, Kenneth W.; Haddock, Michael G. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Quevedo, J. Fernando [Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota (United States); Harmsen, William S. [Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota (United States); Kendrick, Michael L. [Department of General Surgery, Mayo Clinic, Rochester, Minnesota (United States); Miller, Robert C. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Hallemeier, Christopher L., E-mail: hallemeier.christopher@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

    2016-03-01

    Purpose: Resection of exocrine pancreatic cancer is necessary for cure, but locoregional and distant relapse is common. We evaluated our institutional experience to better understand risk factors for locoregional failure (LRF) and its impact on overall survival (OS). Methods and Materials: We reviewed 1051 consecutive patients with nonmetastatic exocrine pancreatic cancer who underwent resection at our institution between March 1987 and January 2011. Among them, 458 had adequate follow-up and evaluation for study inclusion. All patients received adjuvant chemotherapy (n=80 [17.5%]) or chemoradiation therapy (n=378 [82.5%]). Chemotherapy and chemoradiation therapy most frequently consisted of 6 cycles of gemcitabine and 50.4 Gy in 28 fractions with concurrent 5-fluorouracil, respectively. Locoregional control (LRC) and OS were estimated with the Kaplan-Meier method. Univariate and multivariate analyses were performed with Cox proportional hazards regression models incorporating propensity score. Results: Median patient age was 64.5 years (range: 29-88 years). Median follow-up for living patients was 84 months (range: 6-300 months). Extent of resection was R0 (83.8%) or R1 (16.2%). Overall crude incidence of LRF was 17% (n=79). The 5-year LRC for patients with and without radiation therapy was 80% and 68%, respectively (P=.003; hazard ratio [HR]: 0.45; 95% confidence interval [CI]: 0.28-0.76). Multivariate analysis, incorporating propensity score, indicated radiation therapy (P<.0001; HR: 0.23; 95% CI: 0.12-0.42) and positive lymph node ratio of ≥0.2 (P=.02; HR: 1.78; 95% CI: 1.10-2.9) were associated with LRC. In addition, LRF was associated with worse OS (P<.0001; HR: 5.0; 95% CI: 3.9-6.3). Conclusions: In our analysis of 458 patients with resected pancreatic cancer, positive lymph node ratio of ≥0.2 and no adjuvant chemoradiation therapy were associated with increased LRF risk. LRF was associated with poor OS. Radiation therapy should be considered as

  20. The Impact of Radiation Treatment Time on Survival in Patients With Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shaikh, Talha [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Handorf, Elizabeth A. [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Murphy, Colin T. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Mehra, Ranee [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Ridge, John A. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Galloway, Thomas J., E-mail: Thomas.Galloway@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)

    2016-12-01

    Purpose: To assess the impact of radiation treatment time (RTT) in head and neck cancers on overall survival (OS) in the era of chemoradiation. Methods and Materials: Patients with diagnoses of tongue, hypopharynx, larynx, oropharynx, or tonsil cancer were identified by use of the National Cancer Database. RTT was defined as date of first radiation treatment to date of last radiation treatment. In the definitive setting, prolonged RTT was defined as >56 days, accelerated RTT was defined as <47 days, and standard RTT was defined as 47 to 56 days. In the postoperative setting, prolonged RTT was defined as >49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ{sup 2} tests to identify predictors of RTT. The Kaplan-Meier method was used to compare OS among groups. Cox proportional hazards model was used for OS analysis in patients with known comorbidity status. Results: 19,531 patients were included; 12,987 (67%) had a standard RTT, 4,369 (34%) had an accelerated RTT, and 2,165 (11%) had a prolonged RTT. On multivariable analysis, accelerated RTT (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.73-0.97) was associated with an improved OS, and prolonged RTT (HR 1.25; 95% CI 1.14-1.37) was associated with a worse OS relative to standard RTT. When the 9,200 (47%) patients receiving definitive concurrent chemoradiation were examined, prolonged RTT (HR 1.29; 95% CI 1.11-1.50) was associated with a worse OS relative to standard RTT, whereas there was no significant association between accelerated RTT and OS (HR 0.76; 95% CI 0.57-1.01). Conclusion: Prolonged RTT is associated with worse OS in patients receiving radiation therapy for head and neck cancer, even in the setting of chemoradiation. Expeditious completion of radiation should continue to be a quality metric for the management of head and neck malignancies.

  1. The Impact of Chemoembolization Endpoints on Survival in Hepatocellular Carcinoma Patients

    Science.gov (United States)

    Jin, Brian; Wang, Dingxin; Lewandowski, Robert J.; Riaz, Ahsun; Ryu, Robert K.; Sato, Kent T.; Larson, Andrew C.; Salem, Riad; Omary, Reed A.

    2010-01-01

    OBJECTIVE To investigate the relationship between angiographic embolic endpoints of transarterial chemoembolization (TACE) and survival in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS This study retrospectively assessed 105 patients with surgically unresectable HCC who underwent TACE. Patients were classified according to a previously established subjective angiographic chemoembolization endpoint (SACE) scale. Only one patient was classified as SACE level 1 and thus excluded from all subsequent analysis. Survival was evaluated with Kaplan-Meier analysis. Multivariate analysis with Cox’s proportional hazard regression model was used to determine independent prognostic risk factors of survival. RESULTS Overall median survival was 21.1 months (95% confidence interval [CI], 15.9–26.4). Patients embolized to SACE levels 2 and 3 were aggregated and had a significantly higher median survival (25.6 months; 95% CI, 16.2–35.0) than patients embolized to SACE level 4 (17.1 months; 95% CI, 13.3–20.9) (p = 0.035). Multivariate analysis indicated that SACE level 4 (Hazard ratio [HR], 2.49; 95% CI, 1.41–4.42; p = 0.002), European Cooperative Oncology Group performance status > 0 (HR, 1.97; 95% CI, 1.15–3.37; p = 0.013), American Joint Committee on Cancer stage 3 or 4 (HR, 2.42; 95% CI, 1.27–4.60; p = 0.007), and Child-Pugh class B (HR, 1.94; 95% CI, 1.09–3.46; p = 0.025) were all independent negative prognostic indicators of survival. CONCLUSION Embolization to an intermediate, sub-stasis endpoint (SACE levels 2 and 3) during TACE improves survival compared to embolization to a higher, stasis endpoint (SACE level 4). Interventional oncologists should consider targeting these intermediate, sub-stasis angiographic endpoints during TACE. PMID:21427346

  2. Impact of local treatment on overall survival of patients with metastatic prostate cancer: systematic review and meta-analysis

    Science.gov (United States)

    Carneiro, Arie; Baccaglini, Willy; Glina, Felipe P.A.; Kayano, Paulo P.; Nunes, Victor M.; Smaletz, Oren; Bernardo, Wanderley Marques; de Carvalho, Icaro Thiago; Lemos, Gustavo Caserta

    2017-01-01

    ABSTRACT Context Currently, standard treatment of metastatic prostatic cancer (MPCa) is androgen-deprivation therapy (ADT). Recent studies suggested that local treatment of MPCa is related to increase of survival of those patients, as observed in other tumors. Objective To evaluate the impact of local treatment on overall survival and cancer specific survival in 3 and 5 years in patients with MPCa. Materials and Methods Systematic review and meta-analysis of population studies published at PubMed, Scielo, Lilacs, Cochrane and EMBASE databases until June 2016. Several large cohorts and Post-Roc studies were included, that evaluated patients with MPCa submitted to local treatment (LT) using radiotherapy (RDT), surgery (RP) or brachytherapy (BCT) or not submitted to local treatment (NLT). Results 34.338 patients were analyzed in six included papers, 31.653 submitted to NLT and 2.685 to LT. Overall survival in three years was significantly higher in patients submitted to LT versus NLT (64.2% vs. 44.5%; RD 0.19, 95% CI, 0.17-0.21; p<0.00001; I2=0%), as well as in five years (51.9% vs. 23.6%; RD 0.30, 95% CI, 0.11-0.49; p<0.00001; I2=97%). Sensitive analysis according to type of local treatment showed that surgery (78.2% and 45.0%; RD 0.31, 95% CI, 0.26-0.35; p<0.00001; I2=50%) and radiotherapy (60.4% and 44.5%; RD 0.17, 95% CI, 0.12-0.22; p<0.00001; I2=67%) presented better outcomes. Conclusion LT using RDT, RP or BCT seems to significantly improve overall survival and cancer-specific survival of patients with metastatic prostatic cancer. Prospective and randomized studies must be performed in order to confirm our results. PMID:27802009

  3. Impact of Heart Transplantation on Survival in Patients on Venoarterial Extracorporeal Membrane Oxygenation at Listing in France.

    Science.gov (United States)

    Jasseron, Carine; Lebreton, Guillaume; Cantrelle, Christelle; Legeai, Camille; Leprince, Pascal; Flecher, Erwan; Sirinelli, Agnes; Bastien, Olivier; Dorent, Richard

    2016-09-01

    Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used as a short-term circulatory support in patients with refractory cardiogenic shock providing a bridge to long-term mechanical circulatory support or transplantation. In France, a higher priority status is granted to transplant candidates on VA-ECMO than to those on long-term mechanical circulatory support. This study aimed to evaluate the impact of transplantation as primary therapy on survival in patients on VA-ECMO at listing. This was a retrospective analysis of data from the French national registry CRISTAL including all patients (n = 866) newly registered on the waiting list for heart transplantation between January 2010 and December 2011. We compared outcomes of 80 patients on VA-ECMO at listing to outcomes of the comparison group. In the VA-ECMO group, a Cox proportional hazard model with transplantation as a time dependent variable was used to evaluate the effect of transplantation on survival. Patients on VA-ECMO were more often on ventilator and dialysis and had a higher bilirubin level than other candidates. One-year overall survival rate was lower in candidates from the study group (52.2%) compared with comparison group (75.5%), (P < 0.01). One-year posttransplant survival was 70% in the VA-ECMO group and 81% in comparison group (P = 0.06). In the VA-ECMO group, transplantation was associated with a lower risk of mortality (hazard ratio, 0.44; 95% confidence interval, 0.2-0.9). Transplantation provides a survival benefit in listed patients on VA-ECMO even if posttransplant survival remains inferior than for patients without VA-ECMO. Transplantation may be considered to be an acceptable primary therapy in selected patients on VA-ECMO.

  4. Does Lung Donation by Heart Donors Have an Impact on Survival in Heart Transplant Recipients?

    Science.gov (United States)

    Xia, Y; Friedmann, P; Bello, R; Goldstein, D; D'Alessandro, D

    2017-02-01

    Lung procurement is increasing during multiorgan recovery and substantially alters the explant process. This study evaluated whether lung donation by a heart donor affects survival in heart transplant recipients. Retrospective analysis of United Network for Organ Sharing (UNOS) adult heart transplantation data from 1998 to 2012 was performed. Lung donors (LDs) were defined as those having at least one lung procured and transplanted. Non-LDs had neither lung transplanted. Heart transplant recipients who had previous transplants, who had heterotopic transplants, who were waitlisted for other organs or who were temporarily delisted were excluded from the analysis. Kaplan-Meier survival analysis and Cox proportional hazards regression were performed. Of 23 590 heart transplant recipients meeting criteria during the study period, 8638 (36.6%) transplants were from LDs. Donors in the LD group had less history of cigarette use (15.5% vs. 29.5%, p < 0.001). On univariate analysis, LDs were associated with improved patient survival (p < 0.001). On multivariate analysis, LDs were not significantly associated with patient survival (adjusted hazard ratio 0.98, 95% confidence interval 0.94-1.03). Analysis of the UNOS registry suggested that donor pulmonary status and lung procurement had no detrimental effect on survival in heart transplant recipients, supporting the present practice of using donor lungs whenever possible. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  5. Survival impact of centralization and clinical guidelines for soft tissue sarcoma (A prospective and exhaustive population-based cohort.

    Directory of Open Access Journals (Sweden)

    Olfa Derbel

    Full Text Available The outcome of sarcoma has been suggested in retrospective and non-exhaustive studies to be better through management by a multidisciplinary team of experts and adherence to clinical practice guidelines (CPGs. The aim of this prospective and exhaustive population based study was to confirm the impact of adherence to CPGs on survival in patients with localized sarcoma.Between 2005 and 2007, all evaluable adult patients with a newly diagnosis of localized sarcoma located in Rhone Alpes region (n = 634, including 472 cases of soft-tissue sarcoma (STS, were enrolled. The prognostic impact of adherence to CPGs on progression-free survival (PFS and overall survival (OS was assessed by multivariate Cox model in this cohort.The median age was 61 years (range 16-92. The most common subtypes were liposarcoma (n = 133, 28%, unclassified sarcoma (n = 98, 20.7% and leiomyosarcoma (n = 69, 14.6%. In the initial management phase, from diagnosis to adjuvant treatment, the adherence to CPGs for patients with localized STS was 36% overall, corresponding to 56%, 85%, 96% and 84% for initial surgery, radiation therapy, chemotherapy and follow-up, respectively. Adherence to CPGs for surgery was the strongest independent prognostic factor of PFS, along with age, gender, grade, and tumor size. For OS, multivariate analysis adherence to CPGs for surgery was a strong independent prognostic factor, with an important interaction with a management in the regional expert centers.This study demonstrates impact of CPGs and treatment within an expert center on survival for STS patients in a whole population-based cohort.

  6. Negative impact of rurality on lung cancer survival in a population-based study.

    Science.gov (United States)

    Westeel, Virginie; Pitard, Alexandre; Martin, Mael; Thaon, Isabelle; Depierre, Alain; Dalphin, Jean-Charles; Arveux, Patrick

    2007-07-01

    Several studies have suggested that rurality is a risk factor for worse prognosis in cancer. The study population included the 2268 lung cancer cases collected between 1981 and 1996 in the Doubs Cancer Registry (France). The numbers of patients were 849 (31.8%) in rural areas and 89 (3.3%) in very rural areas. The relative 5-year survival was 15.2% in rural areas and 13.4% in urban areas (p = 0.5), and 2.7% in very rural areas and 14.4% in extended urban areas (p = 0.02). Multivariate analyses of observed and relative survival showed that patients living in very rural areas (p < 0.0001), 65 years of age and older and having small cell carcinoma had a significantly shorter survival. This study showed that the multidimensional definition of rurality identified a population with unfavorable prognoses.

  7. The demographic impact of extreme events: stochastic weather drives survival and population dynamics in a long-lived seabird.

    Science.gov (United States)

    Frederiksen, M; Daunt, F; Harris, M P; Wanless, S

    2008-09-01

    1. Most scenarios for future climate change predict increased variability and thus increased frequency of extreme weather events. To predict impacts of climate change on wild populations, we need to understand whether this translates into increased variability in demographic parameters, which would lead to reduced population growth rates even without a change in mean parameter values. This requires robust estimates of temporal process variance, for example in survival, and identification of weather covariates linked to interannual variability. 2. The European shag Phalacrocorax aristotelis (L.) shows unusually large variability in population size, and large-scale mortality events have been linked to winter gales. We estimated first-year, second-year and adult survival based on 43 years of ringing and dead recovery data from the Isle of May, Scotland, using recent methods to quantify temporal process variance and identify aspects of winter weather linked to survival. 3. Survival was highly variable for all age groups, and for second-year and adult birds process variance declined strongly when the most extreme year was excluded. Survival in these age groups was low in winters with strong onshore winds and high rainfall. Variation in first-year survival was not related to winter weather, and process variance, although high, was less affected by extreme years. A stochastic population model showed that increasing process variance in survival would lead to reduced population growth rate and increasing probability of extinction. 4. As in other cormorants, shag plumage is only partially waterproof, presumably an adaptation to highly efficient underwater foraging. We speculate that this adaptation may make individuals vulnerable to rough winter weather, leading to boom-and-bust dynamics, where rapid population growth under favourable conditions allows recovery from periodic large-scale weather-related mortality. 5. Given that extreme weather events are predicted to become

  8. Impact of individual and neighborhood factors on disparities in prostate cancer survival.

    Science.gov (United States)

    DeRouen, Mindy C; Schupp, Clayton W; Koo, Jocelyn; Yang, Juan; Hertz, Andrew; Shariff-Marco, Salma; Cockburn, Myles; Nelson, David O; Ingles, Sue A; John, Esther M; Gomez, Scarlett L

    2018-01-09

    We addressed the hypothesis that individual-level factors act jointly with social and built environment factors to influence overall survival for men with prostate cancer and contribute to racial/ethnic and socioeconomic (SES) survival disparities. We analyzed multi-level data, combining (1) individual-level data from the California Collaborative Prostate Cancer Study, a population-based study of non-Hispanic White (NHW), Hispanic, and African American prostate cancer cases (N = 1800) diagnosed from 1997 to 2003, with (2) data on neighborhood SES (nSES) and social and built environment factors from the California Neighborhoods Data System, and (3) data on tumor characteristics, treatment and follow-up through 2009 from the California Cancer Registry. Multivariable, stage-stratified Cox proportional hazards regression models with cluster adjustments were used to assess education and nSES main and joint effects on overall survival, before and after adjustment for social and built environment factors. African American men had worse survival than NHW men, which was attenuated by nSES. Increased risk of death was associated with residence in lower SES neighborhoods (quintile 1 (lowest nSES) vs. 5: HR = 1.56, 95% CI: 1.11-2.19) and lower education (survival. Both individual- and contextual-level SES influence overall survival of men with prostate cancer. Additional research is needed to identify the mechanisms underlying these robust associations. Copyright © 2018. Published by Elsevier Ltd.

  9. Impact of dialysis modality on technique survival in end-stage renal disease patients.

    Science.gov (United States)

    Lee, Jong-Hak; Park, Sun-Hee; Lim, Jeong-Hoon; Park, Young-Jae; Kim, Sang Un; Lee, Kyung-Hee; Kim, Kyung-Hoon; Park, Seung Chan; Jung, Hee-Yeon; Kwon, Owen; Choi, Ji-Young; Cho, Jang-Hee; Kim, Chan-Duck; Kim, Yong-Lim

    2016-01-01

    This study analyzed the risk factors for technique survival in dialysis patients and compared technique survival rates between hemodialysis (HD) and peritoneal dialysis (PD) in a prospective cohort of Korean patients. A total of 1,042 patients undergoing dialysis from September 2008 to June 2011 were analyzed. The dialysis modality was defined as that used 90 days after commencing dialysis. Technique survival was compared between the two dialysis modalities, and the predictive risk factors were evaluated. The dialysis modality was an independent risk factor predictive of technique survival. PD had a higher risk for technique failure than HD (hazard ratio [HR], 10.8; 95% confidence interval [CI], 1.9 to 62.0; p = 0.008) during a median follow-up of 11.0 months. In the PD group, a high body mass index (BMI) was an independent risk factor for technique failure (HR, 1.3; 95% CI, 1.0 to 1.8; p = 0.036). Peritonitis was the most common cause of PD technique failure. The difference in technique survival between PD and HD was more prominent in diabetic patients with a good nutritional status and in non-diabetic patients with a poor nutritional status. In a prospective cohort of Korean patients with end-stage renal disease, PD was associated with a higher risk of technique failure than HD. Diabetic patients with a good nutritional status and non-diabetic patients with a poor nutritional status, as well as patients with a higher BMI, had an inferior technique survival rate with PD compared to HD.

  10. Long-term Deleterious Impact of Surgeon Care Fragmentation After Colorectal Surgery on Survival: Continuity of Care Continues to Count.

    Science.gov (United States)

    Justiniano, Carla F; Xu, Zhaomin; Becerra, Adan Z; Aquina, Christopher T; Boodry, Courtney I; Swanger, Alex; Temple, Larissa K; Fleming, Fergal J

    2017-11-01

    Surgical care fragmentation at readmission impacts short-term outcomes. However, the long-term impact of surgical care fragmentation is unknown. The purpose was to evaluate the impact of surgical care fragmentation, encompassing both surgeon and hospital care, at readmission after colorectal surgery on 1-year survival. This was a retrospective cohort study. The study included patients undergoing colorectal resection in New York State from 2004 to 2014. Included were 20,016 patients undergoing colorectal resection who were readmitted within 30 days of discharge and categorized by source-of-care fragmentation. Each readmission was classified by the source of fragmentation: readmission to the index hospital and managed by another provider, readmission to another hospital by the index surgeon, and readmission to another hospital by another provider. Patients readmitted to the index hospital and managed by the index surgeon served as controls. One-year overall survival and 1-year colorectal cancer-specific survival were the outcomes measured. After propensity adjustment, surgeon care fragmentation was independently associated with decreased survival. In comparison with patients without surgical care fragmentation (patients readmitted to the index hospital and managed by the index surgeon), patients readmitted to the index hospital and managed by another provider had over a 2-fold risk (HR, 2.33; 95% CI, 2.10-2.60) and patients readmitted to another hospital by another provider had almost a 2-fold risk (HR, 1.91; 95% CI, 1.63-2.25) of 1-year mortality. Among 9545 patients with a colorectal cancer diagnosis, surgical care fragmentation was once again associated with decreased survival with patients readmitted to the index hospital and managed by another provider having a HR of 2.12 (95% CI, 1.76-2.56) and patients readmitted to another hospital by another provider having a HR of 1.57 (95% CI, 1.17-2.11) compared with patients readmitted to the index hospital and managed

  11. Immunocompetence index selection of broiler chicken lines for disease resistance and their impact on survival rate

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar

    2013-06-01

    Full Text Available Aim: This study was aimed to develop the disease resistance broiler chicken lines over two generations (G0 , G1 and G2 of selection for immunocompetence (IC index by targeting all the facets of immune response traits viz., humoral response (HR to Sheep red blood cells (SRBC, cell mediated immune response (CMI to phytohaeagglutination- Pmitogen (PHA-P, levels of serum serum immunoglobin- G (IgG and serum lysozyme (LZM level.Materials and Methods: The SDLSynthetic Dam Line (SDL broiler line consisting of 303, 204 and 300 birds in G0 , G1 and G2 generations, respectively were screened for immunocompetence traits such as humoral response to SRBCs, cell mediated immune response to PHA-Pand levels of serum lysozyme by Lysoplate assay and IgG by SRID method, and ranked based on their IC index values. Results: The percent survival rate up to 6 weeks of age in SDL broiler chicken lines were selected for high immunocompetence index (HIC and low immunocompetence index values (LIC over two generations (G1 , G1 and G2 of selection and observed that significant differences (P< 0.05 in percent survival pattern in the base population (n= 303 with the highest survivability of 100.00% was observed in 5-6 weeks of age followed by 99.37% and 97.23% in 4-5 and 0-4 weeks of age respectively. In the G1 generation, significant differences ( P<0.01 was noticed in the selected high and low index lines up to 6 weeks of age with the overall survival rate lower in high index lines (93.10% as compared to the low index lines (97.62%. Whereas the reverse trend was observed in the G2 generation that the high index line had significantly (P<0.05 higher survival percent (98.62% as compared to the low index lines (97.93%. Moreover, the overall survival rate was better substantially over the two generations of divergent immunocompetent index selection of SDL broiler chicken lines. The present investigation revealed that breeding for better immunocompetence status by selection index

  12. The NPM1 mutation type has no impact on survival in cytogenetically normal AML.

    Directory of Open Access Journals (Sweden)

    Friederike Pastore

    Full Text Available NPM1 mutations represent frequent genetic alterations in patients with acute myeloid leukemia (AML associated with a favorable prognosis. Different types of NPM1 mutations have been described. The purpose of our study was to evaluate the relevance of different NPM1 mutation types with regard to clinical outcome. Our analyses were based on 349 NPM1-mutated AML patients treated in the AMLCG99 trial. Complete remission rates, overall survival and relapse-free survival were not significantly different between patients with NPM1 type A or rare type mutations. The NPM1 mutation type does not seem to play a role in risk stratification of cytogenetically normal AML.

  13. Impact of Resection on Survival of Isocitrate Dehydrogenase 1-Mutated World Health Organization Grade II Astrocytoma After Malignant Progression.

    Science.gov (United States)

    Grau, Stefan J; Hampl, Juergen A; Kohl, Ann-Cathrin; Timmer, Marco; Duval, Inga V; Blau, Tobias; Ruge, Maximilian I; Goldbrunner, Roland H

    2017-07-01

    To evaluate the impact of surgical resection and adjuvant treatment on the course of patients after malignant progression of previously treated isocitrate dehydrogenase 1 (IDH1)-mutated World Health Organization (WHO) grade II astrocytoma. This retrospective study explored 56 patients undergoing tumor resection for malignant progression after previously treated IDH1-mutated WHO grade II astrocytoma. We analyzed survival after malignant progression, analyzed overall survival (OS), and identified prognostic factors using Kaplan-Meier estimates and log-rank test. By the time of malignant transformation, median age was 44 years, and median Karnofsky Performance Status (KPS) score was 90. Complete resection of contrast-enhancing tissue was achieved in 18 (32.1%) patients. Median survival after re-resection was 33 months (95% confidence interval [CI], 20-46); median OS was 123 months (95% CI, 77-170). Gross total tumor resection, postoperative KPS score ≥80, adjuvant radiochemotherapy, and prior radiotherapy significantly correlated with post-malignant progression survival. Patients in good clinical condition with malignant progression of previously treated low-grade gliomas should receive aggressive treatment, including re-resection. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Impacts of sporulation temperature, exposure to compost matrix and temperature on survival of Bacillus cereus spores during livestock mortality composting.

    Science.gov (United States)

    Stanford, K; Reuter, T; Gilroyed, B H; McAllister, T A

    2015-04-01

    To investigate impact of sporulation and compost temperatures on feasibility of composting for disposal of carcasses contaminated with Bacillus anthracis. Two strains of B. cereus, 805 and 1391, were sporulated at either 20 or 37°C (Sporulation temperature, ST) and 7 Log10 CFU g(-1) spores added to autoclaved manure in nylon bags (pore size 50 μm) or in sealed vials. Vials and nylon bags were embedded into compost in either a sawdust or manure matrix each containing 16 bovine mortalities (average weight 617 ± 33 kg), retrieved from compost at intervals over 217 days and survival of B. cereus spores assessed. A ST of 20°C decreased spore survival by 1·4 log10 CFU g(-1) (P Compost temperatures >55°C reduced spore survival (P compost temperatures were key factors influencing survival of B. cereus spores in mortality compost. Composting may be most appropriate for the disposal of carcasses infected with B. anthracis at ambient temperatures ≤20°C under thermophillic composting conditions (>55°C). © 2015 The Society for Applied Microbiology.

  15. Diabetes, hypertension and hyperlipidemia: prevalence over time and impact on long-term survival after liver transplantation.

    Science.gov (United States)

    Parekh, J; Corley, D A; Feng, S

    2012-08-01

    With increasing short-term survival, the transplant community has turned its focus to delineating the impact of medical comorbidities on long-term outcomes. Unfortunately, conditions such as diabetes, hypertension and hyperlipidemia are difficult to track and often managed outside of the transplant center by primary care providers. We collaborated with Kaiser Permanente Northern California to create a database of 598 liver transplant recipients, which incorporates diagnostic codes along with laboratory and pharmacy data. Specifically, we determined the prevalence of diabetes, hypertension and hyperlipidemia both before and after transplant and evaluated the influence of disease duration as a time-dependent covariate on posttransplant survival. The prevalence of these comorbidities increased steadily from the time of transplant to 7 years after transplant. The estimated risk for all-cause mortality (hazard ratio = 1.07 per year increment, 95% CI 1.01-1.13, p hyperlipidemia. Greater attention to management of diabetes may mitigate its negative impact on long-term survival in liver transplant recipients. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

  16. Does Off-Pump Coronary Artery Bypass Grafting Negatively Impact Long-Term Survival and Freedom from Reintervention?

    Directory of Open Access Journals (Sweden)

    Shahzad G. Raja

    2013-01-01

    Full Text Available Recently published evidence has raised concerns about worse late mortality and increasing need for reintervention after off-pump coronary artery bypass grafting. We undertook this study to assess the impact of off-pump coronary artery bypass grafting on survival and freedom from reintervention at 10 years. From January 2002 to December 2002, 307 consecutive patients who had isolated multivessel off-pump coronary artery bypass grafting at our institution were compared to a control group of 397 patients that underwent multivessel on-pump coronary artery bypass grafting during the same period. In addition, univariate and risk-adjusted comparisons between the two groups were performed at 10 years. Kaplan-Meier survival was similar for the two cohorts. After adjusting for clinical covariates, off-pump coronary artery bypass grafting did not emerge as a significant independent predictor of long-term mortality (Hazard Ratio 0.91; 95% Confidence Interval 0.70–1.12, readmission to hospital for cardiac cause (Hazard Ratio 0.96; 95% Confidence Interval 0.78–1.10, or the need for reintervention (Hazard Ratio 0.93; 95% Confidence Interval 0.87–1.05. Off-pump coronary artery bypass grafting compared with on-pump coronary artery bypass grafting does not adversely impact survival or freedom from reintervention at a 10-year follow-up.

  17. Distribution and Impact of Comorbidities on Survival and Leukemic Transformation in Myeloproliferative Neoplasm-Associated Myelofibrosis: A Retrospective Cohort Study.

    Science.gov (United States)

    Bartoszko, Justyna; Panzarella, Tony; McNamara, Caroline Jane; Lau, Anthea; Schimmer, Aaron D; Schuh, Andre C; Sibai, Hassan; Maze, Dawn; Yee, Karen W L; Devlin, Rebecca; Gupta, Vikas

    2017-11-01

    We sought to describe the distribution and impact of comorbidities on outcomes in patients with myelofibrosis, a disease characterized by aberrant bone marrow function with eventual fibrosis. Comorbidities were scored using the Adult Comorbidity Evaluation-27 (ACE-27) and the Hematopoietic Cell Transplant Comorbidity Index (HCT-CI), in which a score ≥ 3 indicates severe comorbidities. We conducted a retrospective study of 306 patients with a confirmed diagnosis of myelofibrosis. Patients were seen from 1999 to 2014 with a median follow-up of 2 years. Multivariable Cox proportional hazards models were constructed to assess the impact of comorbidities on overall survival and leukemic transformation from the date of presentation to our center. A series of descriptive analyses were performed examining the distribution of comorbidities captured by the scales. On multivariable survival analysis, an ACE-27 score of 3 was associated with an almost twofold increase in the risk of all-cause death (hazard ratio [HR] 1.95; 95% confidence interval [CI], 1.06-3.58; P = .03) compared with a lower score of 0 to 1. An HCT-CI score ≥ 3 was marginally significantly associated with an increased risk of all-cause death (HR 1.60; 95% CI 0.96-2.68; P = .07). ACE-27 captured a greater spectrum of cardiovascular and venous thrombotic disease. No impact of comorbidities on leukemic transformation was observed. Although the presence of severe comorbidities was lower when assessed by ACE-27 (13%) compared with HCT-CI (23%), and the spectrums of comorbidities captured were different, the overall impact of severe comorbidities as assessed by both scales appears to be similar and associated with a survival disadvantage. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Impact of age, gender and race on patient and graft survival ...

    African Journals Online (AJOL)

    Background. Optimising renal allograft survival is crucially important in developing countries because of limited resources to treat irreversible renal failure. However, although many factors can be manipulated to improve outcome, certain demographic factors are immutable in individual patients. The present study evaluated ...

  19. EARLY-STAGE YOUNG BREAST CANCER PATIENTS : IMPACT OF LOCAL TREATMENT ON SURVIVAL

    NARCIS (Netherlands)

    Bantema-Joppe, Enja J.; de Munck, Linda; Visser, Otto; Willemse, Pax H. B.; Langendijk, Johannes A.; Siesling, Sabine; Maduro, John H.

    2011-01-01

    Purpose: In young women, breast-conserving therapy (BCT), i.e., lumpectomy followed by radiotherapy, has been associated with an increased risk of local recurrence. Still, there is insufficient evidence that BCT impairs survival. The aim of our study was to compare the effect of BCT with mastectomy

  20. Modeling the Impact of Breast-Feeding by HIV-Infected Women on Child Survival.

    Science.gov (United States)

    Heymann, Sally Jody

    1990-01-01

    Models the survival outcomes of children in developing countries born to women infected with human immunodeficiency virus (HIV) who are breast-fed, bottle-fed, and wet-nursed. Uses decision analysis to assess the relative risk of child mortality from HIV transmission and non-HIV causes associated with different methods of feeding. (FMW)

  1. Venous thromboembolism in ovarian cancer: incidence, risk factors and impact on survival.

    LENUS (Irish Health Repository)

    Abu Saadeh, Feras

    2013-09-01

    Ovarian cancer has a higher incidence of venous thromboembolism (VTE) than other cancers. Clear cell cancers carry the highest risk at 11-27%. The aim of this study was to identify the predisposing factors for VTE in a population of ovarian cancer patients and to determine the influence of VTE on overall survival.

  2. Impact of diet, body mass index and physical activity on cancer survival

    NARCIS (Netherlands)

    Kampman, E.; Vrieling, A.; Duijnhoven, van F.J.B.; Winkels, R.M.

    2012-01-01

    With the increase in the number of cancer patients worldwide in the coming years, the need for knowledge on the influence of lifestyle factors on cancer survival is increasing. In this paper, the current knowledge on diet, body mass index, and physical activity in relation to cancer outcome is

  3. Ureteric complications in live related donor renal transplantation - impact on graft and patient survival

    Directory of Open Access Journals (Sweden)

    A Srivastava

    2004-01-01

    Full Text Available Objective : The study was performed with an aim to determine the incidence of ureteric complications in live related donor renal transplantation, and to study the effect of ureteric complications on long term graft and patient survival. Patients And Methods: Records of 1200 consecutive live related renal transplants done from 1989-2002 were reviewed. Twenty-six ureteric complications were noted to occur and treatment modalities employed were documented. In the non complication group sufficient data for evaluation was available in 867 patients. Survival analysis were performed using Kaplan-Meier techniques. Results: The overall incidence of urological complications is 2.9%. Complications occurred at a mean interval of 31.9 days after renal transplantation. Ureteric complications occurred in 2% patients with stented and 7.7% patients with non stented anastomosis (p=0.001. Mean follow up following renal transplantation was 37.4 months. Survival analysis showed that ureteric complications did not increase the risk of graft fai lu re or patient death. Conclusions: Ureteric complications in live related donor renal transplantation occurred in 2.9 % patients and did not impair graft and patient survival.

  4. The impact of hemoglobin levels on patient and graft survival in renal transplant recipients.

    LENUS (Irish Health Repository)

    Moore, Jason

    2008-08-27

    It remains unclear whether low hemoglobin levels are associated with increased mortality or graft loss after renal transplantation. This study assessed the relationship of hemoglobin levels with patient and graft survival in 3859 patients with functioning renal transplants more than 6-months posttransplantation.

  5. The impact of oxygen availability on stress survival and radical formation of Bacillus cereus

    NARCIS (Netherlands)

    Mols, J.M.; Pier, I.; Zwietering, M.H.; Abee, T.

    2009-01-01

    Both the growth and stress survival of two model Bacillus cereus strains, ATCC 14579 and ATCC 10987, were tested in three different conditions varying in oxygen availability, i.e., aerobic, microaerobic and anaerobic conditions. Both B. cereus strains displayed highest growth rates and yields under

  6. Impacts of Bokashi on survival and growth rates of Pinus pseudostrobus in community reforestation projects.

    Science.gov (United States)

    Jaramillo-López, P F; Ramírez, M I; Pérez-Salicrup, D R

    2015-03-01

    Community-based small-scale reforestation practices have been proposed as an alternative to low-efficiency massive reforestations conducted by external agents. These latter conventional reforestations are often carried out in soils that have been seriously degraded and this has indirectly contributed to the introduction of non-native species and/or acceptance of very low seedling survival rates. Bokashi is a fermented soil organic amendment that can be made from almost any available agricultural byproduct, and its beneficial effects in agriculture have been reported in various contexts. Here, we report the results of a community-based small-scale experimental reforestation where the provenance of pine seedlings (local and commercial) and the use of Bokashi as a soil amendment were evaluated. Bokashi was prepared locally by members of a small rural community in central Mexico. Almost two years after the establishment of the trial, survival rates for the unamended and amended local trees were 97-100% while survival of the commercial trees from unamended and amended treatments were 87-93%. Consistently through time, local and commercial seedlings planted in Bokashi-amended soils were significantly taller (x̅ = 152 cm) than those planted in unamended soils (̅x = 86 cm). An unplanned infection by Cronartium quercuum in the first year of the experiment was considered as a covariable. Infected seedlings showed malformations but this did not affect survival and growth rates. Bokashi amendment seems as an inexpensive, locally viable technology to increase seedling survival and growth and to help recover deforested areas where soils have been degraded. This allows local stakeholders to see more rapid results while helping them to maintain their interest in conservation activities. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Electromagnetic diagnostic techniques for hypervelocity projectile detection, velocity measurement, and size characterization: Theoretical concept and first experimental test

    Energy Technology Data Exchange (ETDEWEB)

    Uhlig, W. Casey; Heine, Andreas, E-mail: andreas.heine@emi.fraunhofer.de [Fraunhofer EMI, Eckerstr. 4, 79104 Freiburg (Germany)

    2015-11-14

    A new measurement technique is suggested to augment the characterization and understanding of hypervelocity projectiles before impact. The electromagnetic technique utilizes magnetic diffusion principles to detect particles, measure velocity, and indicate relative particle dimensions. It is particularly suited for detection of small particles that may be difficult to track utilizing current characterization methods, such as high-speed video or flash radiography but can be readily used for large particle detection, where particle spacing or location is not practical for other measurement systems. In this work, particles down to 2 mm in diameter have been characterized while focusing on confining the detection signal to enable multi-particle characterization with limited particle-to-particle spacing. The focus of the paper is on the theoretical concept and the analysis of its applicability based on analytical and numerical calculation. First proof-of-principle experimental tests serve to further validate the method. Some potential applications are the characterization of particles from a shaped-charge jet after its break-up and investigating debris in impact experiments to test theoretical models for the distribution of particles size, number, and velocity.

  8. Impact of Sodium Chloride and Heat on Survival Time of Linguatula Serrata Nymphs in vitro: An Experimental Study

    Directory of Open Access Journals (Sweden)

    B. Hajimohammadi

    2012-07-01

    Full Text Available Introduction: Linguatula serrata is a zoonotic parasite, belonging to the class Pentastomida. The major aim of this study was to evaluate the impact of sodium chloride (NaCl and heat on survival time of Linguatula serrata nymphs. Materials & Methods: Thirty nymphs (10 in triplicate were separately transferred to plastic tubes, containing different concentrations of NaCl solution (2%, 5% and 10%. Meanwhile, 30 nymphs in tubes containing Phosphate Buffer Saline (PBS were separately treated by +50°C, +60°C and +72°C. As control group, thirty nymphs were stored in PBS at +4°C. The effects of different conditions on survival time of the nymphs were evaluated by observing their motility in different periods of time. Results: The survival time of the nymphs stored in 10% NaCl solution was too short and all of them were dead after 3 hours. But the other ones maintained in 2% NaCl solution were significantly more resistant (p<0.05 and were survived for 2 days. All the nymphs pertaining to each +60°C and +72°C treatments were found dead after first 5-minute storage interval; the nymphs stored at +50°C died totally after 20 minutes. The nymphs maintained in PBS at +4°C (control group showed the longest survival time (p<0.05; all of them were alive until day 4 and the last ones died on day 34. Conclusion: It is concluded that salting and heating have significant parasiticidal effects on L. serrata nymphs and could be used as disinfecting methods in processing of meat products especially liver. However, refrigeration at +4°C increases the resistance of the nymphs in meat products and therefore might endanger the food safety.

  9. Impact of Resection Margin Distance on Survival of Pancreatic Cancer: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Kim, Kyung Su; Kwon, Jeanny; Kim, Kyubo; Chie, Eui Kyu

    2017-07-01

    While curative resection is the only chance of cure in pancreatic cancer, controversies exist about the impact of surgical margin status on survival. Non-standardized pathologic report and different criteria on the R1 status made it difficult to implicate adjuvant therapy after resection based on the margin status. We evaluated the influence of resection margins on survival by meta-analysis. We thoroughly searched electronic databases of PubMed, EMBASE, and Cochrane Library. We included studies reporting survival outcomes with different margin status: involved margin (R0 mm), margin clearance with ≤ 1 mm (R0-1 mm), and margin with > 1 mm (R>1 mm). Hazard ratio (HR) for overall survival was extracted, and a random-effects model was used for pooled analysis. A total of eight retrospective studies involving 1,932 patients were included. Pooled HR for overall survival showed that patients with R>1 mm had reduced risk of death than those with R0-1 mm (HR, 0.74; 95% confidence interval [CI], 0.61 to 0.88; p=0.001). In addition, patients with R0-1 mm had reduced risk of death than those with R0 mm (HR, 0.81; 95% CI, 0.72 to 0.91; p < 0.001). There was no heterogeneity between the included studies (I(2) index, 42% and 0%; p=0.10 and p=0.82, respectively). Our results suggest that stratification of the patients based on margin status is warranted in the clinical trials assessing the role of adjuvant treatment for pancreatic cancer.

  10. The impact of frailty on functional survival in patients 1 year after cardiac surgery.

    Science.gov (United States)

    Lytwyn, James; Stammers, Andrew N; Kehler, D Scott; Jung, Patrick; Alexander, Bryce; Hiebert, Brett M; Dubiel, Chris; Kimber, Dustin; Hamm, Naomi; Clarke, Mekayla; Fraser, Carly; Pedreira, Brittany; Duhamel, Todd A; Tangri, Navdeep; Arora, Rakesh C

    2017-12-01

    This study determined whether frailty provides incremental value to the European System for Cardiac Operative Risk Evaluation II in identifying patients at risk of poor 1-year functional survival. This prospective study in patients undergoing cardiac surgery defined frailty using 3 common definitions: (1) the Modified Fried Criteria; (2) the Short Physical Performance Battery; and (3) the Clinical Frailty Scale. The primary outcome was functional survival, defined as being alive at 1 year postsurgery with a health-related quality of life score greater than 60 on the EuroQol-Visual Analogue Scale. Of the 188 participants, 49.5%, 52.6%, and 31.9% were deemed frail according to the Modified Fried Criteria, Short Physical Performance Battery, and Clinical Frailty Scale, respectively. The median age of our cohort was 71.0 years (29.3% female). The probability of functional survival at 1 year for the entire cohort was 73.9%. After adjusting for the European System for Cardiac Operative Risk Evaluation II, patients deemed frail under the Modified Fried Criteria, Short Physical Performance Battery, and Clinical Frailty Scale had an increased odds ratio for poor functional survival of 3.44, 3.47, and 2.08, respectively. When compared with the European System for Cardiac Operative Risk Evaluation II alone, the Modified Fried Criteria, Short Physical Performance Battery, and Clinical Frailty Scale showed an absolute improvement in the discrimination slope of 6.7%, 6.5%, and 2.4% with a category-free classification improvement of 59.6%, 59.2%, and 35.1%, respectively. Preoperative frailty was associated with a 2- to 3.5-fold higher risk of poor functional survival 1 year after cardiac surgery. The addition of frailty to the European System for Cardiac Operative Risk Evaluation II provides incremental value in identifying patients at risk of poor functional survival 1 year postsurgery, regardless of frailty definition. Copyright © 2017 The American Association for

  11. Impact of elevated temperature on the growth, survival and trophic dynamics of winter flounder larvae: a mesocosm study

    Energy Technology Data Exchange (ETDEWEB)

    Keller, A. A.; Klein-MacPhee, G. [Rhode Island Univ., Narragansett, RI (United States)

    2000-12-01

    The impact of increased temperature on the growth, survival and trophic dynamics of winter flounder larvae was studied in a land-based mesocosm, in order to gain a better understanding of the factors controlling the recruitment of winter flounder, the dominant commercial fish in Narragansett Bay, Rhode Island. The investigation was prompted by a number of recent studies suggesting that the declining flounder population observed over the past 14 years was in some manner related to warmer winter temperatures which cause to increase the mortality of flounder larvae as well as predator activity. The paper describes the impact of increasing water temperature by three degrees relative to control systems in six enclosed mesocosms over a diatom post-winter-spring bloom period. The study focused on the effects of the altered temperature on food availability, abundance of active predators and the growth and survival of winter flounder larvae. It was observed that cooler temperature tended to prolong the incubation period of the larvae, resulting in hatching at a larger size in the cool mesocosm relative to the warm. Daily instantaneous growth and mortality rates showed a significant inverse relationship. The cumulative impact of warmer temperatures resulted in a 10 to 16 per cent decline of larvae surviving to metamorphosis (about six weeks). Increased temperature-mediated egg predation effects were also observed. It was concluded that chronic over-exploitation is associated with a long-term decline in winter flounder stock abundance despite production of good year-classes. Incorporation of the effect of warmer temperatures into fishing management plans, e. g. reducing fishing pressure following periods of successive warm winters, might be the most likely way to arrest declining stocks of winter flounder in the affected area. 34 refs., 4 tabs., 10 figs.

  12. Enteric Virus Survival during Household Laundering and Impact of Disinfection with Sodium Hypochlorite▿

    OpenAIRE

    Gerba, Charles P.; Kennedy, Denise

    2007-01-01

    This study was conducted to determine whether enteric viruses (adenovirus, rotavirus, and hepatitis A virus) added to cotton cloth swatches survive the wash cycle, the rinse cycle, and a 28-min permanent press drying cycle as commonly practiced in households in the United States. Detergent with and without bleach (sodium hypochlorite) was added to washing machines containing sterile and virus-inoculated 58-cm2 swatches, 3.2 kg of cotton T-shirts and underwear, and a soiled pillowcase designed...

  13. Impact of Renal Failure on Survival of African Patients with Cirrhosis

    Directory of Open Access Journals (Sweden)

    Attia K

    2008-01-01

    Full Text Available To assess the effect of renal failure on the survival of black African patients with cirrhosis, we studied 132 (82 males, 50 females cirrhotic black African patients with mean age of 47.5 ±14.4 years and mean follow-up period of 373 ± 194 days. The edema and ascitis were the main reasons for admission to hospital. Renal failure was present in 30 (22.7% patients, and it was positively correlated to the severity of the stage of the liver disease, and associated with severe hyponatremia. Survival at 1 year was 60.1% and 37.6% in the absence or presence of renal failure, respectively (p< 0.001. The stage of the liver disease was significantly inversely corre-lated with survival, which was further diminished in the presence of renal failure:23.7% versus 12.5% for Child-Pugh-Turcote (CPT A-B in the absence or presence of renal failure, respectively (p= 0.67, 30.2% versus 81.8% for CPT C in the absence or the presence of renal failure respectively (p< 0.001. Hyponatremia has also appeared detrimental to survival, since mortality was 38.4% versus 81.8% in the absence or the presence of hyponatremia respectively (p< 0.001. By multivariate analysis, renal failure, CPT stage C, and hyponatremia independently significantly correlated to mortality in patients with cirrhosis. We conclude that renal failure is frequently associated with decompensated cirrhosis. The presence of renal failure in this setting often results in high mortality. Renal failure that occurs in the setting of a severe liver disease and hyponatremia may be part of hepatorenal syndrome.

  14. Impact of obesity and body fat distribution on survival after pancreaticoduodenectomy for pancreatic adenocarcinoma.

    Science.gov (United States)

    Gaujoux, Sébastien; Torres, Javiera; Olson, Sara; Winston, Corrine; Gonen, Mithat; Brennan, Murray F; Klimstra, David S; D'Angelica, Michael; DeMatteo, Ronald; Fong, Yuman; House, Michael; Jarnagin, William; Kurtz, Robert C; Allen, Peter J

    2012-09-01

    Epidemiologic studies have reported a positive correlation between body mass index (BMI) and pancreatic cancer risk, but clinical relevance of obesity and/or body fat distribution on tumor characteristics and cancer-related outcome remain controversial. We sought to assess the influence of obesity and body fat distribution on pathologic characteristics and survival after pancreaticoduodenectomy for pancreatic adenocarcinoma. Demographic and biometric data were collected on 328 patients undergoing pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. In a subset of patients, pancreatic fatty infiltration and fibrosis were assessed pathologically, and visceral fat area (VFA) was evaluated. Influence of BMI and body fat distribution on tumor characteristics and survival were evaluated. A significant positive correlation between BMI and VFA was observed, with a wide range of VFA value within each BMI class. According to BMI or VFA distribution, there were no significant differences in patient characteristics, intraoperative or perioperative outcome, or pathologic characteristics, with the exception of significantly higher blood loss in patients with an increased body weight or VFA. Unadjusted overall and disease-free survival between BMI class and VFA quartile were not significantly different. In this study, obesity and body fat distribution were not correlated with specific tumor characteristics or cancer-related outcome.

  15. Impact of Chronic Kidney Disease on Survival After Amputation in Individuals With Diabetes

    Science.gov (United States)

    Lavery, Lawrence A.; Hunt, Nathan A.; Ndip, Agbor; Lavery, David C.; Van Houtum, William; Boulton, Andrew J.M.

    2010-01-01

    OBJECTIVE To identify factors that influence survival after diabetes-related amputations. RESEARCH DESIGN AND METHODS We abstracted medical records of 1,043 hospitalized subjects with diabetes and a lower-extremity amputation from 1 January to 31 December 1993 in six metropolitan statistical areas in south Texas. We identified mortality in the 10-year period after amputation from death certificate data. Diabetes was verified using World Health Organization criteria. Amputations were identified by ICD-9-CM codes 84.11–84.18 and categorized as foot, below-knee amputation, and above-knee amputation and verified by reviewing medical records. We evaluated three levels of renal function: chronic kidney disease (CKD), hemodialysis, and no renal disease. We defined CKD based on a glomerular filtration rate Procedural Terminology (CPT) codes (90921, 90925, 90935, and 90937). We used χ2 for trend and Cox regression analysis to evaluate risk factors for survival after amputation. RESULTS Patients with CKD and dialysis had more below-knee amputations and above-knee amputations than patients with no renal disease (P amputation had a 167% increase in hazard (HR 2.67, 95% CI 2.14–3.34), and below-knee amputation patients had a 67% increase in hazard for death. CONCLUSIONS Survival after amputation is lower in diabetic patients with CKD, dialysis, and high-level amputations. PMID:20739688

  16. Impact of preoperative levels of hemoglobin and albumin on the survival of pancreatic carcinoma.

    Science.gov (United States)

    Ruiz-Tovar, J; Martín-Pérez, E; Fernández-Contreras, M E; Reguero-Callejas, M E; Gamallo-Amat, C

    2010-11-01

    Pancreatic cancer presents the worst survival rates of all neoplasms. Surgical resection is the only potentially curative treatment, but is associated with high complication rates and outcome is bad even in those resected cases. Therefore, candidates amenable for resection must be carefully selected. Identification of prognostic factors preoperatively may help to improve the treatment of these patients, focusing on individually management based on the expected response. We perform a retrospective study of 59 patients with histological diagnosis of pancreatic carcinoma between 1999 and 2003, looking for possible prognostic factors. We analyze 59 patients, 32 males and 27 females with a mean age of 63.8 years. All the patients were operated, performing palliative surgery in 32% and tumoral resection in 68%, including pancreaticoduodenectomies in 51% and distal pancreatectomy in 17%. Median global survival was 14 months (Range 1-110).We observed that preoperative levels of hemoglobin under 12 g/dl (p = 0.0006) and serum albumina under 2.8 g/dl (p = 0.021) are associated with worse survival. Preoperative levels of hemoglobin and serum albumina may be prognostic indicators in pancreatic cancer.

  17. Effectiveness of glues used for harmonic radar tag attachment and impact on survival and behavior of three insect pests.

    Science.gov (United States)

    Boiteau, G; Meloche, F; Vincent, C; Leskey, T C

    2009-02-01

    The ability of three cyanoacrylate glues to ensure a durable bond between the Colorado potato beetle, Leptinotarsa decemlineata (Say), the plum curculio, Conotrachelus nenuphar (Herbst), or the corn rootworms (Western Corn Rootworm, Diabrotica virgifera virgifera LeConte and Northern Corn Rootworm, Diabrotica longicornis Smith and Lawrence) and the harmonic radar tag without impact on behavior and survival was assessed as part of a study on the use of harmonic radar technology to track these insect pests. Droplets of 0.1 mg of Krazy Glue, Loctite, and Bowman FSA applied to the pronotum had no effect on the survival of the Colorado potato beetle or plum curculio after 5 and 7 d, but caused > 40% mortality after only 4 h with both the western and northern corn rootworms. The three glues created an effective bond lasting 4-5 d between the harmonic radar tag and the Colorado potato beetle in > 85% of cases and the plum curculio in almost 50% of cases. There was no detectable impact of the glue treatment on feeding or walking behavior of the Colorado potato beetle. Analysis of the same behaviors with the plum curculio showed no impact on the ability to walk on a vertical surface, the speed of travel, or the duration of travel. There was no significant impact on feeding by female plum curculio but indication that males treated with Krazy Glue fed less. Overall, results quantified the effectiveness of the cyanoacrylate glues at providing a durable bond with no significant impact on mobility or behavior of the Colorado potato beetle or plum curculios. However, the toxicity of the glues against the corn rootworms suggests that similar toxicity or sublethal effects may exist with other insects.

  18. Hypervelocity Capability of the HYPULSE Shock-Expansion Tunnel for Scramjet Testing

    Science.gov (United States)

    Foelsche, Robert O.; Rogers, R. Clayton; Tsai, Ching-Yi; Bakos, Robert J.; Shih, Ann T.

    2001-01-01

    New hypervelocity capabilities for scramjet testing have recently been demonstrated in the HYPULSE Shock-Expansion Tunnel (SET). With NASA's continuing interests in scramjet testing at hypervelocity conditions (Mach 12 and above), a SET nozzle was designed and added to the HYPULSE facility. Results of tests conducted to establish SET operational conditions and facility nozzle calibration are presented and discussed for a Mach 15 (M15) flight enthalpy. The measurements and detailed computational fluid dynamics calculations (CFD) show the nozzle delivers a test gas with sufficiently wide core size to be suitable for free-jet testing of scramjet engine models of similar scale as, those tested in conventional low Mach number blow-down test facilities.

  19. Experimental demonstration of plasma-drag acceleration of a dust cloud to hypervelocities.

    Science.gov (United States)

    Ticoş, C M; Wang, Zhehui; Wurden, G A; Kline, J L; Montgomery, D S; Dorf, L A; Shukla, P K

    2008-04-18

    Simultaneous acceleration of hundreds of dust particles to hypervelocities by collimated plasma flows ejected from a coaxial gun is demonstrated. Graphite and diamond grains with radii between 5 and 30 microm, and flying at speeds up to 3.7 km/s, have been recorded with a high-speed camera. The observations agree well with a model for plasma-drag acceleration of microparticles much larger than the plasma screening length.

  20. [Impact of Gleason score on biochemical recurrence free survival after radical prostatectomy with positive surgical margins].

    Science.gov (United States)

    Roux, V; Eyraud, R; Brureau, L; Gourtaud, G; Senechal, C; Fofana, M; Blanchet, P

    Research of predictive factors of biochemical recurrence to guide the establishment of an adjuvant treatment after radical prostatectomy for cancer with positive surgical margins. A retrospective cohort of 1577 afro-caribbean patients undergoing radical prostatectomy operated between 1st January 2000 and 1st July 2013 was analyzed. In this cohort, 406 patients had positive surgical margin, we excluded 11 patients who received adjuvant therapy (radiotherapy, hormonotherapy, radio-hormonotherapy) and 2 patients for whom histological analysis of the surgical specimen was for a pT4 pathological stage. After a descriptive analysis, we used a Cox model to look for predictors of survival without biochemical recurrence then, depending on the significant variables, we separated our population into six groups: stage pT2 with Gleason score≤3+4 (group 1), stage pT2 with a score of Gleason≥4+3 (group 2), stage pT3a with a Gleason core≤3+4 (group 3), pT3a stage with a score of Gleason≥4+3 (group 4), stage pT3b with a Gleason score≤3+4 (group 5) and stage pT3b Gleason≥with a score of 4+3 (group 6) and compared survival without biochemical recurrence using a log rank test. After radical prostatectomy with surgical margins with an anatomopathological stage≤pT3b, a Gleason score≥4+3 had a pejorative survival without biochemical recurrence than pathological stage (Pbiochemical recurrence after radical prostatectomy with positive surgical margins were the majority Gleason postoperative (Pbiochemical recurrence than pathological stage pT2 or pT3 at the patients having been treated for prostate cancer by radical prostatectomy with positive surgical margins. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Parasite co-infections and their impact on survival of indigenous cattle.

    Directory of Open Access Journals (Sweden)

    Samuel M Thumbi

    Full Text Available In natural populations, individuals may be infected with multiple distinct pathogens at a time. These pathogens may act independently or interact with each other and the host through various mechanisms, with resultant varying outcomes on host health and survival. To study effects of pathogens and their interactions on host survival, we followed 548 zebu cattle during their first year of life, determining their infection and clinical status every 5 weeks. Using a combination of clinical signs observed before death, laboratory diagnostic test results, gross-lesions on post-mortem examination, histo-pathology results and survival analysis statistical techniques, cause-specific aetiology for each death case were determined, and effect of co-infections in observed mortality patterns. East Coast fever (ECF caused by protozoan parasite Theileria parva and haemonchosis were the most important diseases associated with calf mortality, together accounting for over half (52% of all deaths due to infectious diseases. Co-infection with Trypanosoma species increased the hazard for ECF death by 6 times (1.4-25; 95% CI. In addition, the hazard for ECF death was increased in the presence of Strongyle eggs, and this was burden dependent. An increase by 1000 Strongyle eggs per gram of faeces count was associated with a 1.5 times (1.4-1.6; 95% CI increase in the hazard for ECF mortality. Deaths due to haemonchosis were burden dependent, with a 70% increase in hazard for death for every increase in strongyle eggs per gram count of 1000. These findings have important implications for disease control strategies, suggesting a need to consider co-infections in epidemiological studies as opposed to single-pathogen focus, and benefits of an integrated approach to helminths and East Coast fever disease control.

  2. Intratumoral delivery of bortezomib: impact on survival in an intracranial glioma tumor model.

    Science.gov (United States)

    Wang, Weijun; Cho, Hee-Yeon; Rosenstein-Sisson, Rachel; Marín Ramos, Nagore I; Price, Ryan; Hurth, Kyle; Schönthal, Axel H; Hofman, Florence M; Chen, Thomas C

    2017-04-14

    OBJECTIVE Glioblastoma (GBM) is the most prevalent and the most aggressive of primary brain tumors. There is currently no effective treatment for this tumor. The proteasome inhibitor bortezomib is effective for a variety of tumors, but not for GBM. The authors' goal was to demonstrate that bortezomib can be effective in the orthotopic GBM murine model if the appropriate method of drug delivery is used. In this study the Alzet mini-osmotic pump was used to bring the drug directly to the tumor in the brain, circumventing the blood-brain barrier; thus making bortezomib an effective treatment for GBM. METHODS The 2 human glioma cell lines, U87 and U251, were labeled with luciferase and used in the subcutaneous and intracranial in vivo tumor models. Glioma cells were implanted subcutaneously into the right flank, or intracranially into the frontal cortex of athymic nude mice. Mice bearing intracranial glioma tumors were implanted with an Alzet mini-osmotic pump containing different doses of bortezomib. The Alzet pumps were introduced directly into the tumor bed in the brain. Survival was documented for mice with intracranial tumors. RESULTS Glioma cells were sensitive to bortezomib at nanomolar quantities in vitro. In the subcutaneous in vivo xenograft tumor model, bortezomib given intravenously was effective in reducing tumor progression. However, in the intracranial glioma model, bortezomib given systemically did not affect survival. By sharp contrast, animals treated with bortezomib intracranially at the tumor site exhibited significantly increased survival. CONCLUSIONS Bypassing the blood-brain barrier by using the osmotic pump resulted in an increase in the efficacy of bortezomib for the treatment of intracranial tumors. Thus, the intratumoral administration of bortezomib into the cranial cavity is an effective approach for glioma therapy.

  3. Cardiac Sarcoidosis: The Impact of Age and Implanted Devices on Survival.

    Science.gov (United States)

    Zhou, Ying; Lower, Elyse E; Li, Hui-Ping; Costea, Alexandru; Attari, Mehran; Baughman, Robert P

    2017-01-01

    To assess the clinical characteristics, diagnosis, and outcome of cardiac sarcoidosis in a single institution sarcoidosis clinic. Patients with cardiac sarcoidosis were identified using refined World Association of Sarcoidosis and Other Granulomatous Diseases (WASOG) criteria of highly probable and probable. Patient demographics, local and systemic treatments, and clinical outcome were collected. Of the 1,815 patients evaluated over a 6-year period, 73 patients met the WASOG criteria for cardiac sarcoidosis. The median age at diagnosis was 46 years, with a median follow-up of 8.8 years. Reduced left ventricular ejection fraction (LVEF) was the most common manifestation (54.8%). Patients with arrhythmias experienced ventricular tachycardia or severe heart block, (35.6% and 19.2%, respectively) with or without reduced LVEF. A total of 45 (61.6%) patients underwent cardiac PET scan and/or MRI, with 41 (91.1%) having a positive study. During follow-up, 10 patients (13.7%) either underwent transplant (n = 3) or died (n = 7) from sarcoidosis. Kaplan-Meier survival curves revealed 5- and 10-year survival rates of 95.5% and 93.4%, respectively. Univariate factors of age at diagnosis  40% were associated with improved survival. Cox regression analysis demonstrated that age ≥ 46 years and lack of an implanted pacemaker or defibrillator were the only independent predictors of mortality. The new WASOG criteria were able to characterize cardiac involvement in our sarcoidosis clinic. Age and lack of pacemaker or defibrillator were the significant predictors of mortality for cardiac sarcoidosis, and reduced LVEF < 40% was associated with worse prognosis. ClinicalTrials.gov; No.: NCT02356445; URL: www.clinicaltrials.gov. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  4. [Impact of ishemia-reperfusion injury on long survival rate in intestinal transplantation in rats].

    Science.gov (United States)

    Lausada, Natalia; Stringa, Pablo; Cabanne, Ana; Ramisch, Diego; Machuca, Mariana; Galvao, Flavio; Coronato, Silvia; Raimondi, Jorge Clemente; Gondolesi, Gabriel

    2011-06-01

    The intestine is a highly sensitive tissue to ischemia-reperfusion (IR) injury that will early respond increasing its permeability. Later this response is translated in morphologic and histological changes that reveal the degree of damage. The heterotopic intestinal transplantation model in rats allows to evaluate the evolution of intestinal tissue injury after ischemia-reperfusion without affecting the long survival rate. The aim of this paper is to establish a relationship between the ischemic reperfusion injury with the long-term survival Ten intestinal transplants were analyzed in adult, Wistar, inbred, male rats. Light microscopical examination was performed on intestine graft: 1) immediately post-dissection, 2) at the end of cold isquemia, 3) 30 min, 4) 48hs and 5) 5 days post-transplant procedure, respectively. Biopsies were reported according to Park's classification and extension of staining using immunohistochemestry to malondialdehyde (MDA) products. The Park's classification indexes reported in samples were 1) 0,57 +/- 1,13 (N=10); 2) 2,71 +/- 1,25 (N=10); 3) 4,14 +/- 0,89 (N=10); 4) 1,0 +/- 0,81 (N=7); 5) 0 (N=7). The highest levels of immunohistochemical detection of MDA were observed thirty minutes post-reperfusion (extension of staining between 51% to 75%). Three animals died when they were sampled at 48 hours, and the biopsies had Park's classification > or = 4 at 30 minutes post-reperfusion and endotoxemic signology. The highest degree of mucosal damage was observed immediately post-reperfusion. At 48hs the graft tended to be normalized Failure to repair the immediately I-R injury signficantly affects the long term survival.

  5. The impact of organisational external peer review on colorectal cancer treatment and survival in the Netherlands

    NARCIS (Netherlands)

    Kilsdonk, M. J.; van Dijk, B. A. C.; Otter, R.; Siesling, S.; van Harten, W. H.

    2014-01-01

    Background: Organisational external peer review was introduced in 1994 in the Netherlands to improve multidisciplinary cancer care. We examined the clinical impact of this programme on colorectal cancer care. Methods: Patients with primary colorectal cancer were included from 23 participating

  6. The impact of prostate edema on cell survival and tumor control after permanent interstitial brachytherapy for early stage prostate cancers

    Science.gov (United States)

    (Jay Chen, Zhe; Roberts, Kenneth; Decker, Roy; Pathare, Pradip; Rockwell, Sara; Nath, Ravinder

    2011-08-01

    Previous studies have shown that procedure-induced prostate edema during permanent interstitial brachytherapy (PIB) can cause significant variations in the dose delivered to the prostate gland. Because the clinical impact of edema-induced dose variations strongly depends on the magnitude of the edema, the temporal pattern of its resolution and its interplay with the decay of radioactivity and the underlying biological processes of tumor cells (such as tumor potential doubling time), we investigated the impact of edema-induced dose variations on the tumor cell survival and tumor control probability after PIB with the 131Cs, 125I and 103Pd sources used in current clinical practice. The exponential edema resolution model reported by Waterman et al (1998 Int. J. Radiat. Oncol. Biol. Phys. 41 1069-77) was used to characterize the edema evolutions previously observed during clinical PIB for prostate cancer. The concept of biologically effective dose, taking into account tumor cell proliferation and sublethal damage repair during dose delivery, was used to characterize the effects of prostate edema on cell survival and tumor control probability. Our calculation indicated that prostate edema, if not appropriately taken into account, can increase the cell survival and decrease the probability of local control of PIB. The magnitude of an edema-induced increase in cell survival increased with increasing edema severity, decreasing half-life of radioactive decay and decreasing photon energy emitted by the source. At the doses currently prescribed for PIB and for prostate cancer cells characterized by nominal radiobiology parameters recommended by AAPM TG-137, PIB using 125I sources was less affected by edema than PIB using 131Cs or 103Pd sources due to the long radioactive decay half-life of 125I. The effect of edema on PIB using 131Cs or 103Pd was similar. The effect of edema on 103Pd PIB was slightly greater, even though the decay half-life of 103Pd (17 days) is longer than

  7. Survival Impact of Adjuvant Radiation Therapy in Masaoka Stage II to IV Thymomas: A Systematic Review and Meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Yu Jin; Kim, Eunji [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Hak Jae, E-mail: khjae@snu.ac.kr [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Wu, Hong-Gyun [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Cancer Research Institute, Seoul National University College of Medicine, Seoul (Korea, Republic of); Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul (Korea, Republic of); Yan, Jinchun [Department of Radiation Oncology, Dalian Medical University, Liaoning (China); Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Liu, Qin [The Wistar Institute, Philadelphia, Pennsylvania (United States); Patel, Shilpen [Department of Radiation Oncology, University of Washington Medical Center, Seattle, Washington (United States)

    2016-04-01

    Purpose: To evaluate the survival impact of postoperative radiation therapy (PORT) in stage II to IV thymomas, using systematic review and meta-analysis. Methods and Materials: A database search was conducted with EMBASE, PubMed, Web of Science, Cochrane Library, and Ovid from inception to August 2015. Thymic carcinomas were excluded, and studies comparing overall survival (OS) with and without PORT in thymomas were included. The hazard ratios (HRs) of OS were extracted, and a random-effects model was used in the pooled analysis. Results: Seven retrospective series with a total of 1724 patients were included and analyzed. Almost all of the patients underwent macroscopically complete resection, and thymoma histology was confirmed by the World Health Organization criteria. In the overall analysis of stage II to IV thymomas, OS was not altered with the receipt of PORT (HR 0.79, 95% confidence interval [CI] 0.58-1.08). Although PORT was not associated with survival difference in Masaoka stage II disease (HR 1.45, 95% CI 0.83-2.55), improved OS was observed with the addition of PORT in the discrete pooled analysis of stage III to IV (HR 0.63, 95% CI 0.40-0.99). Significant heterogeneity and publication bias were not found in the analyses. Conclusions: From the present meta-analysis of sole primary thymomas, we suggest the potential OS benefit of PORT in locally advanced tumors with macroscopically complete resection, but not in stage II disease. Further investigations with sufficient survival data are needed to establish detailed treatment indications.

  8. The impact of combined pulmonary fibrosis and chronic obstructive pulmonary disease on long-term survival after lung cancer surgery.

    Science.gov (United States)

    Sekine, Yasuo; Sakairi, Yuichi; Yoshino, Mitsuru; Koh, Eitetsu; Hata, Atsushi; Suzuki, Hidemi; Yoshino, Ichiro

    2014-06-01

    The purpose of this study was to determine the impact of pulmonary fibrosis (PF) on postoperative complications and on long-term survival after surgical resection in lung cancer patients with chronic obstructive pulmonary disease (COPD). A retrospective chart review was conducted of 380 patients with COPD who had undergone pulmonary resection for lung cancer at the University Hospital between 1990 and 2005. The definition of COPD was a preoperative forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio of less than 70%; PF was defined as obvious bilateral fibrous change in the lower lung fields, confirmed by computed tomography. PF was present in 41 patients (10.8%) with COPD; the remaining 339 patients (89.2%) did not have PF. The preoperative FVC/FEV1 was significantly lower in the group of patients with PF than in the group without (p < 0.05). Acute lung injury and home oxygen therapy were significantly more common in the PF group; however, the 30-day mortality was similar between the groups. The cumulative survival at 3 and 5 years was 53.6 and 36.9%, respectively, in the PF group and 71.4 and 66.1%, respectively, in the non-PF group (p = 0.0009). Increased age, decreased body mass index, advanced pathologic stage, and the existence of PF were identified as independent risk factors for decreased survival. PF is a risk factor for decreased survival after surgical treatment in lung cancer patients with COPD. Georg Thieme Verlag KG Stuttgart · New York.

  9. Impacts of low dose rate irradiation on the fertility, fecundity and hatchling survival of Japanese rice fish (medaka, Oryzias latipes)

    Energy Technology Data Exchange (ETDEWEB)

    Hinton, T.G.; Coughlin, D.P.; Marsh, L.C.; Yi, Yi; Winn, R. [Georgia Univ., Savannah River Ecology Laboratory, Drawer E, Aiken, SC (United States)

    2004-07-01

    A renewed international interest in the effects on biota from low dose rate irradiation has recently occurred. Much of that interest is centered on the relevance of previously accepted dose rate guidelines (e.g. 10 mGy d{sup -1} for aquatic biota) suggested by the ICRP and IAEA. All parties concerned seem to agree that additional data are needed on population level impacts from chronic low-level exposures to radionuclides. Using a Low Dose Rate Irradiation Facility (LoDIF), we conducted an experiment on the fecundity, fertility and hatchling survival of Japanese Rice Fish (medaka, Oryzias latipes). Fish were exposed externally to {sup 137}Cs from juvenile through adulthood at mean dose rates of 3.5, 35 and 350 mGy d{sup -1}. Fish were bred at maturity and the following endpoints were examined: 1) the number of eggs produced; 2) the percent of eggs that hatched; and 3) the survival of hatchlings 20-days post hatch. The influence of gender was examined by breeding irradiated males with control females; control males with irradiated females; irradiated males with irradiated females; and control males with control females. The data contribute to our understanding the impacts of low dose rate irradiation. (author)

  10. Impact of Body Mass Index on Complications and Survival after Surgery for Esophageal and Gastro-Esophageal-Junction Cancer

    DEFF Research Database (Denmark)

    Kruhlikava, Iryna; Kirkegård, Jakob; Mortensen, Frank Viborg

    2017-01-01

    Background and Aims: The impact of body mass index on complications and survival in patients undergoing esophagectomy has been extensively studied with conflicting results. In this study, we assess the impact of body mass index on complications and survival following surgery for esophageal...... patients included in the study. Body mass index was calculated as weight in kilograms divided by height in meters squared. We grouped patients according to their body mass index, using the World Health Organization definition, as underweight (body mass index body mass index......: 18.5–24.9 kg/m2), overweight (body mass index: 25–29.9 kg/m2), and obese (body mass index ⩽ 30 kg/m2). Results: Median age at surgery was 65 years (range: 27–84 years), of which 207 (72.6%) were males. Patients with the lowest body mass index and the obese patients seemed to have a higher frequency...

  11. Central Versus Peripheral Pulmonary Embolism: Analysis of the Impact on the Physiological Parameters and Long-term Survival

    Science.gov (United States)

    Alonso Martinez, José Luis; Anniccherico Sánchez, Francisco Javier; Urbieta Echezarreta, Miren Aranzazu; García, Ione Villar; Álvaro, Jorge Rojo

    2016-01-01

    Background: Studies aimed at assessing whether the emboli lodged in the central pulmonary arteries carry a worse prognosis than more peripheral emboli have yielded controversial results. Aims: To explore the impact on survival and long-term prognosis of central pulmonary embolism. Patients and Methods: Consecutive patients diagnosed with acute symptomatic pulmonary embolism by means of computed tomography (CT) angiography were evaluated at episode index and traced through the computed system of clinical recording and following-up. Central pulmonary embolism was diagnosed when thrombi were seen in the trunk or in the main pulmonary arteries and peripheral pulmonary embolism when segmental or subsegmental arteries were affected. Results: A total of 530 consecutive patients diagnosed with pulmonary embolism were evaluated; 255 patients had central pulmonary embolism and 275 patients had segmental or subsegmental pulmonary embolism. Patients with central pulmonary embolism were older, had higher plasma levels of N-terminal of the prohormone brain natriuretic peptide (NT-ProBNP), troponin I, D-dimer, alveolar-arterial gradient, and shock index (P pulmonary embolism had an all-cause mortality of 40% while patients with segmental or subsegmental pulmonary embolism (PE) had an overall mortality of 27% and odds ratio of 1.81 [confidence interval (CI) 95% 1.16-1.9]. Survival was lower in patients with central PE than in patients with segmental or subsegmental pulmonary embolism, even after avoiding confounders (P = .018). Conclusions: Apart from a greater impact on hemodynamics, gas exchange, and right ventricular dysfunction, central pulmonary embolism associates a shorter survival and an increased long-term mortality. PMID:27114970

  12. Remaining missed opportunities of child survival in Peru: modelling mortality impact of universal and equitable coverage of proven interventions.

    Science.gov (United States)

    Tam, Yvonne; Huicho, Luis; Huayanay-Espinoza, Carlos A; Restrepo-Méndez, María Clara

    2016-10-04

    Peru has made great improvements in reducing stunting and child mortality in the past decade, and has reached the Millennium Development Goals 1 and 4. The remaining challenges or missed opportunities for child survival needs to be identified and quantified, in order to guide the next steps to further improve child survival in Peru. We used the Lives Saved Tool (LiST) to project the mortality impact of proven interventions reaching every women and child in need, and the mortality impact of eliminating inequalities in coverage distribution between wealth quintiles and urban-rural residence. Our analyses quantified the remaining missed opportunities in Peru, where prioritizing scale-up of facility-based case management for all small and sick babies will be most effective in mortality reduction, compared to other evidenced-based interventions that prevent maternal and child deaths. Eliminating coverage disparities between the poorest quintiles and the richest will reduce under-five and neonatal mortality by 22.0 and 40.6 %, while eliminating coverage disparities between those living in rural and urban areas will reduce under-five and neonatal mortality by 29.3 and 45.2 %. This projected neonatal mortality reduction achieved by eliminating coverage disparities is almost comparable to that already achieved by Peru over the past decade. Although Peru has made great strides in improving child survival, further improvement in child health, especially in newborn health can be achieved if there is universal and equitable coverage of proven, quality health facility-based interventions. The magnitude of reduction in mortality will be similar to what has been achieved in the past decade. Strengthening health system to identify, understand, and direct resources to the poor and rural areas will ensure that Peru achieve the Sustainable Development Goals by 2030.

  13. Thrombotic Thrombocytopenic Purpura in Black People: Impact of Ethnicity on Survival and Genetic Risk Factors.

    Science.gov (United States)

    Martino, Suella; Jamme, Mathieu; Deligny, Christophe; Busson, Marc; Loiseau, Pascale; Azoulay, Elie; Galicier, Lionel; Pène, Frédéric; Provôt, François; Dossier, Antoine; Saheb, Samir; Veyradier, Agnès; Coppo, Paul

    2016-01-01

    Black people are at increased risk of thrombotic thrombocytopenic purpura (TTP). Whether clinical presentation of TTP in Black patients has specific features is unknown. We assessed here differences in TTP presentation and outcome between Black and White patients. Clinical presentation was comparable between both ethnic groups. However, prognosis differed with a lower death rate in Black patients than in White patients (2.7% versus 11.6%, respectively, P = .04). Ethnicity, increasing age and neurologic involvement were retained as risk factors for death in a multivariable model (P Black patients had a better survival than White patients (P = .03). Salvage therapies were similarly performed between both groups, suggesting that disease severity was comparable. The comparison of HLA-DRB1*11, -DRB1*04 and -DQB1*03 allele frequencies between Black patients and healthy Black individuals revealed no significant difference. However, the protective allele against TTP, HLA-DRB1*04, was dramatically decreased in Black individuals in comparison with White individuals. Black people with TTP may have a better survival than White patients despite a comparable disease severity. A low natural frequency of HLA-DRB1*04 in Black ethnicity may account for the greater risk of TTP in this population.

  14. Wolbachia infections that reduce immature insect survival: predicted impacts on population replacement.

    Science.gov (United States)

    Crain, Philip R; Mains, James W; Suh, Eunho; Huang, Yunxin; Crowley, Philip H; Dobson, Stephen L

    2011-10-05

    The evolutionary success of Wolbachia bacteria, infections of which are widespread in invertebrates, is largely attributed to an ability to manipulate host reproduction without imposing substantial fitness costs. Here, we describe a stage-structured model with deterministic immature lifestages and a stochastic adult female lifestage. Simulations were conducted to better understand Wolbachia invasions into uninfected host populations. The model includes conventional Wolbachia parameters (the level of cytoplasmic incompatibility, maternal inheritance, the relative fecundity of infected females, and the initial Wolbachia infection frequency) and a new parameter termed relative larval viability (RLV), which is the survival of infected larvae relative to uninfected larvae. The results predict the RLV parameter to be the most important determinant for Wolbachia invasion and establishment. Specifically, the fitness of infected immature hosts must be close to equal to that of uninfected hosts before population replacement can occur. Furthermore, minute decreases in RLV inhibit the invasion of Wolbachia despite high levels of cytoplasmic incompatibility, maternal inheritance, and low adult fitness costs. The model described here takes a novel approach to understanding the spread of Wolbachia through a population with explicit dynamics. By combining a stochastic female adult lifestage and deterministic immature/adult male lifestages, the model predicts that even those Wolbachia infections that cause minor decreases in immature survival are unlikely to invade and spread within the host population. The results are discussed in relation to recent theoretical and empirical studies of natural population replacement events and proposed applied research, which would use Wolbachia as a tool to manipulate insect populations.

  15. Impact of ureteral length on urological complications and patient survival after kidney transplantation.

    Science.gov (United States)

    Ali-Asgari, Majid; Dadkhah, Farid; Ghadian, Alireza; Nourbala, Mohammad Hossein

    2013-09-01

    Urologic complications are of the most important complications after kidney transplantation which increases mortality and morbidity significantly. We designed this study to evaluate the association between ureteral length and postoperative complications. We recorded the length of the transplanted ureter during the operation. Ureter-to-bladder anastomosis was performed using modified Lich-Gregoir method on the ureteral stent. Complications like urine leakage and increased creatinine were evaluated. We used both univariate and multivariate analyses and survival analysis according lengths of ureter. It means that the main variable is ureteral length and other variables are studied based on it. A total of 395 patients with the mean age of 37 years (range, 18 to 68 years) were enrolled in the study, twenty six graft lost during the follow-up period. The Mean age of recipients was 37 ± 13 years. Urinary stenosis was seen in 6 patients (1.5%) and urinary leakage in 4 (1%) patients. The complication rate was not significantly different between these groups (P = 0.67). We found that there were no significant difference among complication (P = 0.25), hospitalization (P = 0.31) and survival (P = 0.84) at 5.5 cm length cut off. The length of transplanted ureter does not affect the postoperative urologic complications (including urinary fistula and ureter-to-bladder anastomosis stricture), and it seems that decreased rate of complication frequency during the recent years is due to technical improvement, surgeon's skillfulness and development in use of immunosuppressant's postoperatively.

  16. Pregnancy-associated breast cancer in Taiwanese women: potential treatment delay and impact on survival.

    Science.gov (United States)

    Yang, Ya-Ling; Chan, K Arnold; Hsieh, Fon-Jou; Chang, Li-Yun; Wang, Ming-Yang

    2014-01-01

    This study investigated the clinicopathologic characteristics and survival of women diagnosed with pregnancy-associated breast cancer (PABC) in Taiwan. PABC is defined as breast cancer diagnosed during pregnancy or within 1 year after obstetric delivery. Our sample of PABC patients (N = 26) included all patients diagnosed at a major medical center in northern Taiwan from 1984 through 2009. Among these patients, 15 were diagnosed during pregnancy and 11 were diagnosed within 1 year after delivery. The comparison group included 104 patients within the same age range as the PABC patients and diagnosed with breast cancer not associated with pregnancy from 2004 through 2009 at the same hospital. Patients' initiating treatment delayed, 5-year and 10-year overall survival were delineated by stratified Kaplan-Meier estimates. Patients' characteristics were associated with initiating treatment delayed was evaluated with multivariate proportional hazards modeling. Antepartum PABC patients were younger and had longer time between diagnosis and treatment initiation than postpartum PABC patients. The predictor of treatment delayed was including birth parity, cancer stage, and pregnancy. The PABC group had larger tumors, more advanced cancer stage, and tumors with less progesterone receptor than the comparison group. The antepartum PABC patients had higher mortality than postpartum PABC and comparison groups within 5 years after diagnosis. Based on these results, we confirmed that pregnant women with breast cancer were more likely to delay treatment. Therefore, we recommend that breast cancer screening should be integrated into the prenatal and postnatal routine visits for early detection of the women's breast problems.

  17. Concurrent Radiotherapy and Gemcitabine for Unresectable Pancreatic Adenocarcinoma: Impact of Adjuvant Chemotherapy on Survival

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Kazuhiko, E-mail: kogawa@med.u-ryukyu.ac.jp [Department of Radiology, University of the Ryukyus, Okinawa (Japan); Ito, Yoshinori [Department of Radiation Oncology, National Cancer Center, Tokyo (Japan); Hirokawa, Naoki [Department of Radiology, Sapporo Medical University, Sapporo (Japan); Shibuya, Keiko [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University, Kyoto (Japan); Kokubo, Masaki [Department of Radiation Oncology, Institute of Biomedical Research and Innovation Hospital, Kobe (Japan); Ogo, Etsuyo [Department of Radiation Oncology, Kurume University, Kurume (Japan); Shibuya, Hitoshi [Department of Radiology, Tokyo Medical and Dental University, Tokyo (Japan); Saito, Tsutomu [Department of Radiation Oncology, Nihon University Itabashi Hospital, Tokyo (Japan); Onishi, Hiroshi [Department of Radiology, Yamanashi University, Yamanashi (Japan); Karasawa, Katsuyuki [Department of Radiation Oncology, Tokyo Metropolitan Komagome Hospital, Tokyo (Japan); Nemoto, Kenji [Department of Radiation Oncology, Yamagata University, Yamagata (Japan); Nishimura, Yasumasa [Department of Radiation Oncology, Kinki University School of Medicine, Osaka (Japan)

    2012-06-01

    Purpose: To retrospectively analyze results of concurrent chemoradiotherapy (CCRT) using gemcitabine (GEM) for unresectable pancreatic adenocarcinoma. Methods and Materials: Records of 108 patients treated with concurrent external beam radiotherapy (EBRT) and GEM were reviewed. The median dose of EBRT in all 108 patients was 50.4 Gy (range, 3.6-60.8 Gy), usually administered in conventional fractionations (1.8-2 Gy/day). During radiotherapy, most patients received GEM at a dosage of 250 to 350 mg/m{sup 2} intravenously weekly for approximately 6 weeks. After CCRT, 59 patients (54.6%) were treated with adjuvant chemotherapy (AC), mainly with GEM. The median follow-up for all 108 patients was 11.0 months (range, 0.4-37.9 months). Results: Initial responses after CCRT for 85 patients were partial response: 26 patients, no change: 51 patients and progressive disease: 8 patients. Local progression was observed in 35 patients (32.4%), and the 2-year local control (LC) rate in all patients was 41.9%. Patients treated with total doses of 50 Gy or more had significantly more favorable LC rates (2-year LC rate, 42.9%) than patients treated with total doses of less than 50 Gy (2-year LC rate, 29.6%). Regional lymph node recurrence was found in only 1 patient, and none of the 57 patients with clinical N0 disease had regional lymph node recurrence. The 2-year overall survival (OS) rate and the median survival time in all patients were 23.5% and 11.6 months, respectively. Patients treated with AC had significantly more favorable OS rates (2-year OS, 31.8%) than those treated without AC (2-year OS, 12.4%; p < 0.0001). On multivariate analysis, AC use and clinical T stage were significant prognostic factors for OS. Conclusions: CCRT using GEM yields a relatively favorable LC rate for unresectable pancreatic adenocarcinoma, and CCRT with AC conferred a survival benefit compared to CCRT without AC.

  18. Impacts of episodic acidification on in-stream survival and physiological impairment of Atlantic salmon (Salmo salar) smolts

    Energy Technology Data Exchange (ETDEWEB)

    McCormick, S.D.; Monette, M.Y. [United States Geological Survey, Turners Falls, MA (United States). Conte Anadromous Fish Research Center; Massachusetts Univ., Amherst, MA (United States). Organismic and Evolutionary Biology Program; Keyes, A. [United States Geological Survey, Turners Falls, MA (United States). Conte Anadromous Fish Research Center; Nislow, K.H. [Massachusetts Univ., Amherst, MA (United States). Organismic and Evolutionary Biology Program; United States Dept. of Agriculture, Amherst, MA (United States). Northern Research Station

    2009-02-20

    Episodic acidification is negatively impacting the conservation and recovery of Atlantic salmon in the northeastern United States. This article described a set of field studies conducted to determine the impacts of acid and aluminium (Al) levels on the survival, smolt development, ion homeostasis, and stress in Atlantic salmon smolts located in Connecticut River restoration streams in Vermont. The fish were observed in cages in 5 separate streams that encompassed a range of different acid and Al levels for two 6-day intervals at the peak of smolt development. The study showed that physiological parameters remained unchanged for smolts located in the high water quality reference site. However, mortality, loss of plasma chloride, and gill Na{sup +}/K{sup +}-ATPase activity, and elevated gill Al occurred at the sites with the highest levels of inorganic Al and the lowest pH levels. Losses of plasma chloride, moderately elevated gill Al, and increased plasma cortisol and glucose levels occurred at less severely impacted sites. The study also demonstrated that gill Al was a more accurate predictor of integrated physiological impacts than water chemistry. It was concluded that Al and low pH can cause mortality and impair smolt development in juvenile Atlantic salmon. 36 refs., 2 tabs., 4 figs.

  19. Impact of CRAB symptoms in survival of patients with symptomatic myeloma in novel agent era

    Directory of Open Access Journals (Sweden)

    Aya Nakaya

    2017-02-01

    Full Text Available The acronym CRAB summarizes the most typical clinical manifestations of multiple myeloma, these being hypercalcemia, renal failure, anemia, and bone disease. CRAB can be used to distinguish between active, symptomatic multiple myeloma and monoclonal gammopathy of undermined significance or smoldering myeloma. The distinction is relevant not only for classification and diagnosis but also for therapy. CRAB factors influence the prognosis of multiple myeloma. However, it is unclear whether the presence of CRAB factors has an influence on the prognosis of myeloma treated with novel agents. In the current study, patients with hypercalcemia and bone disease showed a significantly worse prognosis, whereas anemia and renal failure showed no difference in survival. Novel agents used for treatment of patients with renal failure suggested a favorable outcome compared with conventional therapy. Bone disease was the most common factor and may have the strongest prognostic value in symptomatic myeloma patients using novel agents.

  20. Wolbachia infections that reduce immature insect survival: Predicted impacts on population replacement

    Directory of Open Access Journals (Sweden)

    Crowley Philip H

    2011-10-01

    Full Text Available Abstract Background The evolutionary success of Wolbachia bacteria, infections of which are widespread in invertebrates, is largely attributed to an ability to manipulate host reproduction without imposing substantial fitness costs. Here, we describe a stage-structured model with deterministic immature lifestages and a stochastic adult female lifestage. Simulations were conducted to better understand Wolbachia invasions into uninfected host populations. The model includes conventional Wolbachia parameters (the level of cytoplasmic incompatibility, maternal inheritance, the relative fecundity of infected females, and the initial Wolbachia infection frequency and a new parameter termed relative larval viability (RLV, which is the survival of infected larvae relative to uninfected larvae. Results The results predict the RLV parameter to be the most important determinant for Wolbachia invasion and establishment. Specifically, the fitness of infected immature hosts must be close to equal to that of uninfected hosts before population replacement can occur. Furthermore, minute decreases in RLV inhibit the invasion of Wolbachia despite high levels of cytoplasmic incompatibility, maternal inheritance, and low adult fitness costs. Conclusions The model described here takes a novel approach to understanding the spread of Wolbachia through a population with explicit dynamics. By combining a stochastic female adult lifestage and deterministic immature/adult male lifestages, the model predicts that even those Wolbachia infections that cause minor decreases in immature survival are unlikely to invade and spread within the host population. The results are discussed in relation to recent theoretical and empirical studies of natural population replacement events and proposed applied research, which would use Wolbachia as a tool to manipulate insect populations.

  1. Caries risk and number of restored surfaces have impact on the survival of posterior composite restorations.

    Science.gov (United States)

    Balevi, Ben

    2014-12-01

    Cochrane Library, PubMed, the Web of Science (ISI) and Scopus. Longitudinal studies of direct class II or classes I and II restorations in permanent dentition of at least five years duration, a minimum of 20 restorations at final recall and the original datasets available were considered. Only English language studies were included. Two reviewers screened titles independently. Multivariate Cox regression method to analyse the variables of interest and hazard ratios with respective 95% confidence intervals were determined. The annual failure rate (AFR) of the investigated restorations and subgroups was calculated. Twelve studies, nine prospective and three retrospective were included. A total of 2,816 restorations (2,585 Class II and 231 Class I restorations) were included in the analysis. Five hundred and sixty-nine restorations failed during the observation period, and the main reasons for failure were caries and fracture. Regression analyses showed a significantly higher risk of failure for restorations in high-caries-risk individuals and those with a higher number of restored surfaces. The overall annual failure rate at five years and ten years was 1.8% and 2.4% respectively. The rates were higher in high-caries-rate individuals at 3.2% and 4.6% respectively. The conclusion of the present meta-analysis of 12 clinical studies based on raw data is that caries risk and number of restored surfaces play a significant role in restoration survival, and that, on average, posterior resin composite restorations show a good survival, with annual failure rates of 1.8% at five years and 2.4% after ten years of service.

  2. Impact of Physical Activity on Cancer-Specific and Overall Survival of Patients with Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Gaetan Des Guetz

    2013-01-01

    Full Text Available Background. Physical activity (PA reduces incidence of colorectal cancer (CRC. Its influence on cancer-specific (CSS and overall survival (OS is controversial. Methods. We performed a literature-based meta-analysis (MA of observational studies, using keywords “colorectal cancer, physical activity, and survival” in PubMed and EMBASE. No dedicated MA was found in the Cochrane Library. References were cross-checked. Pre- and postdiagnosis PA levels were assessed by MET. Usually, “high” PA was higher than 17 MET hour/week. Hazard ratios (HRs for OS and CSS were calculated, with their 95% confidence interval. We used more conservative adjusted HRs, since variables of adjustment were similar between studies. When higher PA was associated with improved survival, HRs for detrimental events were set to <1. We used EasyMA software and fixed effect model whenever possible. Results. Seven studies (8056 participants were included, representing 3762 men and 4256 women, 5210 colon and 1745 rectum cancers. Mean age was 67 years. HR CSS for postdiagnosis PA (higher PA versus lower was 0.61 (0.44–0.86. The corresponding HR OS was 0.62 (0.54–0.71. HR CSS for prediagnosis PA was 0.75 (0.62–0.91. The corresponding HR OS was 0.74 (0.62–0.89. Conclusion. Higher PA predicted a better CSS. Sustained PA should be advised for CRC. OS also improved (reduced cardiovascular risk.

  3. Impact of Physical Activity on Cancer-Specific and Overall Survival of Patients with Colorectal Cancer

    Science.gov (United States)

    Des Guetz, Gaetan; Uzzan, Bernard; Bouillet, Thierry; Nicolas, Patrick; Chouahnia, Kader; Zelek, Laurent; Morere, Jean-François

    2013-01-01

    Background. Physical activity (PA) reduces incidence of colorectal cancer (CRC). Its influence on cancer-specific (CSS) and overall survival (OS) is controversial. Methods. We performed a literature-based meta-analysis (MA) of observational studies, using keywords “colorectal cancer, physical activity, and survival” in PubMed and EMBASE. No dedicated MA was found in the Cochrane Library. References were cross-checked. Pre- and postdiagnosis PA levels were assessed by MET. Usually, “high” PA was higher than 17 MET hour/week. Hazard ratios (HRs) for OS and CSS were calculated, with their 95% confidence interval. We used more conservative adjusted HRs, since variables of adjustment were similar between studies. When higher PA was associated with improved survival, HRs for detrimental events were set to <1. We used EasyMA software and fixed effect model whenever possible. Results. Seven studies (8056 participants) were included, representing 3762 men and 4256 women, 5210 colon and 1745 rectum cancers. Mean age was 67 years. HR CSS for postdiagnosis PA (higher PA versus lower) was 0.61 (0.44–0.86). The corresponding HR OS was 0.62 (0.54–0.71). HR CSS for prediagnosis PA was 0.75 (0.62–0.91). The corresponding HR OS was 0.74 (0.62–0.89). Conclusion. Higher PA predicted a better CSS. Sustained PA should be advised for CRC. OS also improved (reduced cardiovascular risk). PMID:24222762

  4. Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study.

    Science.gov (United States)

    Mattison, Julie A; Roth, George S; Beasley, T Mark; Tilmont, Edward M; Handy, April M; Herbert, Richard L; Longo, Dan L; Allison, David B; Young, Jennifer E; Bryant, Mark; Barnard, Dennis; Ward, Walter F; Qi, Wenbo; Ingram, Donald K; de Cabo, Rafael

    2012-09-13

    Calorie restriction (CR), a reduction of 10–40% in intake of a nutritious diet, is often reported as the most robust non-genetic mechanism to extend lifespan and healthspan. CR is frequently used as a tool to understand mechanisms behind ageing and age-associated diseases. In addition to and independently of increasing lifespan, CR has been reported to delay or prevent the occurrence of many chronic diseases in a variety of animals. Beneficial effects of CR on outcomes such as immune function, motor coordination and resistance to sarcopenia in rhesus monkeys have recently been reported. We report here that a CR regimen implemented in young and older age rhesus monkeys at the National Institute on Aging (NIA) has not improved survival outcomes. Our findings contrast with an ongoing study at the Wisconsin National Primate Research Center (WNPRC), which reported improved survival associated with 30% CR initiated in adult rhesus monkeys (7–14 years) and a preliminary report with a small number of CR monkeys. Over the years, both NIA and WNPRC have extensively documented beneficial health effects of CR in these two apparently parallel studies. The implications of the WNPRC findings were important as they extended CR findings beyond the laboratory rodent and to a long-lived primate. Our study suggests a separation between health effects, morbidity and mortality, and similar to what has been shown in rodents, study design, husbandry and diet composition may strongly affect the life-prolonging effect of CR in a long-lived nonhuman primate.

  5. Pregnancy-associated breast cancer in Taiwanese women: potential treatment delay and impact on survival.

    Directory of Open Access Journals (Sweden)

    Ya-Ling Yang

    Full Text Available This study investigated the clinicopathologic characteristics and survival of women diagnosed with pregnancy-associated breast cancer (PABC in Taiwan. PABC is defined as breast cancer diagnosed during pregnancy or within 1 year after obstetric delivery. Our sample of PABC patients (N = 26 included all patients diagnosed at a major medical center in northern Taiwan from 1984 through 2009. Among these patients, 15 were diagnosed during pregnancy and 11 were diagnosed within 1 year after delivery. The comparison group included 104 patients within the same age range as the PABC patients and diagnosed with breast cancer not associated with pregnancy from 2004 through 2009 at the same hospital. Patients' initiating treatment delayed, 5-year and 10-year overall survival were delineated by stratified Kaplan-Meier estimates. Patients' characteristics were associated with initiating treatment delayed was evaluated with multivariate proportional hazards modeling. Antepartum PABC patients were younger and had longer time between diagnosis and treatment initiation than postpartum PABC patients. The predictor of treatment delayed was including birth parity, cancer stage, and pregnancy. The PABC group had larger tumors, more advanced cancer stage, and tumors with less progesterone receptor than the comparison group. The antepartum PABC patients had higher mortality than postpartum PABC and comparison groups within 5 years after diagnosis. Based on these results, we confirmed that pregnant women with breast cancer were more likely to delay treatment. Therefore, we recommend that breast cancer screening should be integrated into the prenatal and postnatal routine visits for early detection of the women's breast problems.

  6. Racial and Ethnic Disparities in the Impact of Obesity on Breast Cancer Risk and Survival: A Global Perspective123

    Science.gov (United States)

    Bandera, Elisa V; Maskarinec, Gertraud; Romieu, Isabelle; John, Esther M

    2015-01-01

    Obesity is a global concern, affecting both developed and developing countries. Although there are large variations in obesity and breast cancer rates worldwide and across racial/ethnic groups, most studies evaluating the impact of obesity on breast cancer risk and survival have been conducted in non-Hispanic white women in the United States or Europe. Given the known racial/ethnic differences in tumor hormone receptor subtype distribution, obesity prevalence, and risk factor profiles, we reviewed published data for women of African, Hispanic, and Asian ancestry in the United States and their countries of origin. Although the data are limited, current evidence suggests a stronger adverse effect of obesity on breast cancer risk and survival in women of Asian ancestry. For African Americans and Hispanics, the strength of the associations appears to be more comparable to that of non-Hispanic whites, particularly when accounting for subtype and menopausal status. Central obesity seems to have a stronger impact in African-American women than general adiposity as measured by body mass index. International data from countries undergoing economic transition offer a unique opportunity to evaluate the impact of rapid weight gain on breast cancer. Such studies should take into account genetic ancestry, which may help elucidate differences in associations between ethnically admixed populations. Overall, additional large studies that use a variety of adiposity measures are needed, because the current evidence is based on few studies, most with limited statistical power. Future investigations of obesity biomarkers will be useful to understand possible racial/ethnic biological differences underlying the complex association between obesity and breast cancer development and progression. PMID:26567202

  7. Racial and ethnic disparities in the impact of obesity on breast cancer risk and survival: a global perspective.

    Science.gov (United States)

    Bandera, Elisa V; Maskarinec, Gertraud; Romieu, Isabelle; John, Esther M

    2015-11-01

    Obesity is a global concern, affecting both developed and developing countries. Although there are large variations in obesity and breast cancer rates worldwide and across racial/ethnic groups, most studies evaluating the impact of obesity on breast cancer risk and survival have been conducted in non-Hispanic white women in the United States or Europe. Given the known racial/ethnic differences in tumor hormone receptor subtype distribution, obesity prevalence, and risk factor profiles, we reviewed published data for women of African, Hispanic, and Asian ancestry in the United States and their countries of origin. Although the data are limited, current evidence suggests a stronger adverse effect of obesity on breast cancer risk and survival in women of Asian ancestry. For African Americans and Hispanics, the strength of the associations appears to be more comparable to that of non-Hispanic whites, particularly when accounting for subtype and menopausal status. Central obesity seems to have a stronger impact in African-American women than general adiposity as measured by body mass index. International data from countries undergoing economic transition offer a unique opportunity to evaluate the impact of rapid weight gain on breast cancer. Such studies should take into account genetic ancestry, which may help elucidate differences in associations between ethnically admixed populations. Overall, additional large studies that use a variety of adiposity measures are needed, because the current evidence is based on few studies, most with limited statistical power. Future investigations of obesity biomarkers will be useful to understand possible racial/ethnic biological differences underlying the complex association between obesity and breast cancer development and progression. © 2015 American Society for Nutrition.

  8. Favorable survival of acetabular reconstruction with bone impaction grafting in dysplastic hips.

    NARCIS (Netherlands)

    Somford, M.P.; Bolder, S.B.T.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Schreurs, B.W.

    2008-01-01

    Acetabular bone loss hampers implantation of a total hip arthroplasty in patients with developmental dysplasia of the hip. The bone impaction grafting technique in combination with a cemented total hip can restore the bone stock in these patients, but do these reconstructions yield satisfying

  9. The Ghana essential health interventions program: a plausibility trial of the impact of health systems strengthening on maternal & child survival.

    Science.gov (United States)

    Awoonor-Williams, John Koku; Bawah, Ayaga A; Nyonator, Frank K; Asuru, Rofina; Oduro, Abraham; Ofosu, Anthony; Phillips, James F

    2013-01-01

    comparison districts for core indicators of health status and survival rates. To elucidate results, hierarchical child survival hazard models will be estimated that incorporate measures of health system strength as survival determinants, adjusting for the potentially confounding effects of parental and household characteristics. Qualitative systems appraisal procedures will be used to monitor and explain GEHIP implementation innovations, constraints, and progress. By demonstrating practical means of strengthening a real-world health system while monitoring costs and assessing maternal and child survival impact, GEHIP is expected to contribute to national health policy, planning, and resource allocation that will be needed to accelerate progress with the Millennium Development Goals.

  10. High-volume ovarian cancer care: survival impact and disparities in access for advanced-stage disease.

    Science.gov (United States)

    Bristow, Robert E; Chang, Jenny; Ziogas, Argyrios; Randall, Leslie M; Anton-Culver, Hoda

    2014-02-01

    To characterize the impact of hospital and physician ovarian cancer case volume on survival for advanced-stage disease and investigate socio-demographic variables associated with access to high-volume providers. Consecutive patients with stage IIIC/IV epithelial ovarian cancer (1/1/96-12/31/06) were identified from the California Cancer Registry. Disease-specific survival analysis was performed using Cox-proportional hazards model. Multivariate logistic regression analyses were used to evaluate for differences in access to high-volume hospitals (HVH) (≥20 cases/year), high-volume physicians (HVP) (≥10 cases/year), and cross-tabulations of high- or low-volume hospital (LVH) and physician (LVP) according to socio-demographic variables. A total of 11,865 patients were identified. The median ovarian cancer-specific survival for all patients was 28.2 months, and on multivariate analysis the HVH/HVP provider combination (HR = 1.00) was associated with superior ovarian cancer-specific survival compared to LVH/LVP (HR = 1.31, 95%CI = 1.16-1.49). Overall, 2119 patients (17.9%) were cared for at HVHs, and 1791 patients (15.1%) were treated by HVPs. Only 4.3% of patients received care from HVH/HVP, while 53.1% of patients were treated by LVH/LVP. Both race and socio-demographic characteristics were independently associated with an increased likelihood of being cared for by the LVH/LVP combination and included: Hispanic race (OR = 1.72, 95%CI = 1.22-2.42), Asian/Pacific Islander race (OR = 1.57, 95%CI = 1.07-2.32), Medicaid insurance (OR = 2.51, 95%CI = 1.46-4.30), and low socioeconomic status (OR = 2.84, 95%CI = 1.90-4.23). Among patients with advanced-stage ovarian cancer, the provider combination of HVH/HVP is an independent predictor of improved disease-specific survival. Access to high-volume ovarian cancer providers is limited, and barriers are more pronounced for patients with low socioeconomic status, Medicaid insurance, and racial minorities. Copyright © 2013

  11. Survival After Chemoradiation in Resected Pancreatic Cancer: The Impact of Adjuvant Gemcitabine

    Energy Technology Data Exchange (ETDEWEB)

    Baschnagel, Andrew; Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Margolis, Jeffrey; Nadeau, Laura [Department of Medical Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Stein, Julie; Jury, Robert [Department of Surgery, William Beaumont Hospital, Royal Oak, Michigan (United States); Robertson, John M., E-mail: jrobertson@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States)

    2012-07-01

    Purpose: To evaluate survival in patients with resected pancreatic cancer treated with concurrent chemoradiation with or without adjuvant gemcitabine (Gem). Methods and Materials: From 1998 to 2010, 86 patients with pancreatic adenocarcinoma who underwent resection were treated with adjuvant concurrent chemoradiation. Thirty-four patients received concurrent 5-fluorouracil-based chemoradiation (5-FU/RT) with traditional field radiation (range, 45-61.2 Gy; median, 50.4 Gy) without further adjuvant therapy. Thirty patients received traditional field 5-FU/RT (range, 45-60.4 Gy; median, 50.4 Gy) with Gem (1,000 mg/m{sup 2} weekly) either before and after radiotherapy or only after radiotherapy. Twenty-two patients received concurrent full-dose Gem (1,000 mg/m{sup 2} weekly)-based chemoradiation (Gem/RT), consisting of involved-field radiation (range, 27-38 Gy; median, 36 Gy) followed by further adjuvant Gem. Results: The median age of the cohort was 65 years (range, 40-80 years). Of the patients, 58 had T3 tumors (67%), 22 had T2 tumors (26%), and 6 had T1 tumors (7%). N1 disease was present in 61 patients (71%), whereas 18 patients (21%) had R1 resections. Performance status, lymph node status, and margin status were all similar among the treatment groups. Median follow-up was 19.0 months. Median overall survival (OS) (19.2 months, 19.0 months, and 21.0 months) and 3-year OS rates (26.5%, 27.2%, and 32.1%) were similar among patients with 5-FU/RT with no adjuvant Gem, those with 5-FU/RT with adjuvant Gem, and those with Gem/RT with adjuvant Gem, respectively (p = 0.88). Patients who received adjuvant Gem had a similar median OS (22.1 months) and 3-year OS rate (29%) compared to patients who did not (19.2 months and 26.5%, respectively) (p = 0.62). There was a trend for improved 3-year OS rates in patients with R0 vs. R1 resections (28.1% vs. 14.2%, p = 0.06) and in patients with T1 and T2 vs. T3 tumors (38% vs. 20%, p = 0.09). Node-negative patients had an improved 3

  12. Surviving the Genocide: The Impact of the Rwandan Genocide on Child Mortality

    OpenAIRE

    Ciani, Federico; Giannelli, Gianna Claudia

    2013-01-01

    Between April and July 1994 Rwanda experienced a tremendous wave of inter-ethnic violence that caused at least 500,000 deaths. Combining birth history data drawn from the 2000 Rwanda Demographic and Health Survey with prefecture-level information on the intensity of the conflict, we examine the impact of the civil war on infant and child mortality. War exposure is measured exploiting the differential effects of timing of birth and genocide intensity at the household and geographic level. Cons...

  13. Adult Hippocampal Neurogenesis in Parkinson’s Disease: Impact on Neuronal Survival and Plasticity

    Directory of Open Access Journals (Sweden)

    Martin Regensburger

    2014-01-01

    Full Text Available In Parkinson’s disease (PD and other synucleinopathies, chronic neurodegeneration occurs within different areas of the central nervous system leading to progressive motor and nonmotor symptoms. The symptomatic treatment options that are currently available do not slow or halt disease progression. This highlights the need of a better understanding of disease mechanisms and disease models. The generation of newborn neurons in the adult hippocampus and in the subventricular zone/olfactory bulb system is affected by many different regulators and possibly involved in memory processing, depression, and olfaction, symptoms which commonly occur in PD. The pathology of the adult neurogenic niches in human PD patients is still mostly elusive, but different preclinical models have shown profound alterations of adult neurogenesis. Alterations in stem cell proliferation, differentiation, and survival as well as neurite outgrowth and spine formation have been related to different aspects in PD pathogenesis. Therefore, neurogenesis in the adult brain provides an ideal model to study disease mechanisms and compounds. In addition, adult newborn neurons have been proposed as a source of endogenous repair. Herein, we review current knowledge about the adult neurogenic niches in PD and highlight areas of future research.

  14. Functional Gain After Inpatient Stroke Rehabilitation: Correlates and Impact on Long-Term Survival.

    Science.gov (United States)

    Scrutinio, Domenico; Monitillo, Vincenzo; Guida, Pietro; Nardulli, Roberto; Multari, Vincenzo; Monitillo, Francesco; Calabrese, Gianluigi; Fiore, Pietro

    2015-10-01

    Prediction of functional outcome after stroke rehabilitation (SR) is a growing field of interest. The association between SR and survival still remains elusive. We sought to investigate the factors associated with functional outcome after SR and whether the magnitude of functional improvement achieved with rehabilitation is associated with long-term mortality risk. The study population consisted of 722 patients admitted for SR within 90 days of stroke onset, with an admission functional independence measure (FIM) score of stroke onset to rehabilitation admission (PStroke Scale score at rehabilitation admission (P<0.001), and aphasia (P=0.021) were independently associated with FIM gain. The R2 of the model was 0.275. During a median follow-up of 6.17 years, 36.9% of the patients died. At multivariable Cox analysis, age (P<0.0001), coronary heart disease (P=0.018), atrial fibrillation (P=0.042), total cholesterol (P=0.015), and total FIM gain (P<0.0001) were independently associated with mortality. The adjusted hazard ratio for death significantly decreased across tertiles of increasing FIM gain. Several factors are independently associated with functional gain after SR. Our findings strongly suggest that the magnitude of functional improvement is a powerful predictor of long-term mortality in patients admitted for SR. © 2015 American Heart Association, Inc.

  15. Enteric Virus Survival during Household Laundering and Impact of Disinfection with Sodium Hypochlorite▿

    Science.gov (United States)

    Gerba, Charles P.; Kennedy, Denise

    2007-01-01

    This study was conducted to determine whether enteric viruses (adenovirus, rotavirus, and hepatitis A virus) added to cotton cloth swatches survive the wash cycle, the rinse cycle, and a 28-min permanent press drying cycle as commonly practiced in households in the United States. Detergent with and without bleach (sodium hypochlorite) was added to washing machines containing sterile and virus-inoculated 58-cm2 swatches, 3.2 kg of cotton T-shirts and underwear, and a soiled pillowcase designed to simulate the conditions (pH, organic load, etc.) encountered in soiled laundry. The most important factors for the reduction of virus in laundry were passage through the drying cycle and the addition of sodium hypochlorite. Washing with detergent alone was not found to be effective for the removal or inactivation of enteric viruses, as significant concentrations of virus were found on the swatches (reductions of 92 to 99%). It was also demonstrated that viruses are readily transferred from contaminated cloths to uncontaminated clothes. The use of sodium hypochlorite reduced the number of infectious viruses on the swatches after washing and drying by at least 99.99%. Laundering practices in common use in the United States do not eliminate enteric and respiratory viruses from clothes. The use of bleach can further reduce the numbers of enteric viruses in laundry. PMID:17526793

  16. Enteric virus survival during household laundering and impact of disinfection with sodium hypochlorite.

    Science.gov (United States)

    Gerba, Charles P; Kennedy, Denise

    2007-07-01

    This study was conducted to determine whether enteric viruses (adenovirus, rotavirus, and hepatitis A virus) added to cotton cloth swatches survive the wash cycle, the rinse cycle, and a 28-min permanent press drying cycle as commonly practiced in households in the United States. Detergent with and without bleach (sodium hypochlorite) was added to washing machines containing sterile and virus-inoculated 58-cm2 swatches, 3.2 kg of cotton T-shirts and underwear, and a soiled pillowcase designed to simulate the conditions (pH, organic load, etc.) encountered in soiled laundry. The most important factors for the reduction of virus in laundry were passage through the drying cycle and the addition of sodium hypochlorite. Washing with detergent alone was not found to be effective for the removal or inactivation of enteric viruses, as significant concentrations of virus were found on the swatches (reductions of 92 to 99%). It was also demonstrated that viruses are readily transferred from contaminated cloths to uncontaminated clothes. The use of sodium hypochlorite reduced the number of infectious viruses on the swatches after washing and drying by at least 99.99%. Laundering practices in common use in the United States do not eliminate enteric and respiratory viruses from clothes. The use of bleach can further reduce the numbers of enteric viruses in laundry.

  17. IMPACTS OF TISSUE-TYPE PLASMINOGEN ACTIVATOR (TPA ON NEURONAL SURVIVAL

    Directory of Open Access Journals (Sweden)

    Arnaud eChevilley

    2015-10-01

    Full Text Available Tissue-type plasminogen activator (tPA a serine protease is constituted of five functional domains through which it interacts with different substrates, binding proteins and receptors. In the last years, great interest has been given to the clinical relevance of targeting tPA in different diseases of the central nervous system, in particular stroke. Among its reported functions in the central nervous system, tPA displays both neurotrophic and neurotoxic effects. How can the protease mediate such opposite functions remain unclear but several hypotheses have been proposed. These include an influence of the degree of maturity and/or the type of neurons, of the level of tPA, of its origin (endogenous or exogenous or of its form (single chain tPA versus two chain tPA. In this review, we will provide a synthetic snapshot of our current knowledge regarding the natural history of tPA and discuss how it sustains its pleiotropic functions with focus on excitotoxic/ischemic neuronal death and neuronal survival.

  18. Impact of human immunodeficiency virus on survival after liver transplantation: analysis of United Network for Organ Sharing database.

    Science.gov (United States)

    Mindikoglu, Ayse L; Regev, Arie; Magder, Laurence S

    2008-02-15

    The outcome of liver transplantation (LT) in patients infected with human immunodeficiency virus (HIV) has been a matter of controversy. A retrospective cohort study was performed to assess the impact of HIV on LT survival by using United Network for Organ Sharing registry Standard Transplant Analysis and Research files. A total of 138 HIV(+) and 30,520 HIV(-) patients who were > or =18 years old and underwent LT during the highly active antiretroviral therapy era (starting January 1, 1997) in the United States were included. Among all HIV(+) patients, the estimated 2-year survival probability was lower (70%) than among non-HIV patients (81%). This excess risk appeared entirely among those with coinfections, that is, HIV with hepatitis B virus or hepatitis C virus (HCV), as none of the 24 HIV-infected patients who did not have hepatitis B virus or HCV died during an average of 1.2 years of follow-up per person. Among HCV(+) patients, those with HIV coinfection had significantly lower survival rates than patients without HIV (P=0.006). Controlling for age, coinfection, Model for End-Stage Liver Disease scores, and other potential confounders in a proportional hazards regression analysis, HIV(+) patients had a hazard ratio of 1.41 (P=0.14, 95% confidence interval: 0.90-2.22) for mortality after LT. HIV(+) patients without HCV coinfection seemed to have good prognosis, whereas patients who had HIV/HCV coinfection had poor outcomes, which were significantly worse than that seen in those with HCV alone.

  19. Fullerenes in an impact crater on the LDEF spacecraft

    Science.gov (United States)

    Radicati di Brozolo, F.; Bunch, T. E.; Fleming, R. H.; Macklin, J.

    1994-01-01

    The fullerenes C60 and C70 have been found to occur naturally on Earth and have also been invoked to explain features in the absorption spectra of interstellar clouds. But no definitive spectroscopic evidence exists for fullerenes in space and attempts to find fullerenes in carbonaceous chondrites have been unsuccessful. Here we report the observation of fullerenes associated with carbonaceous impact residue in a crater on the Long Duration Exposure Facility (LDEF) spacecraft. Laser ionization mass spectrometry and Raman spectroscopy indicate the presence of fullerenes in the crater and in adjacent ejecta. Man-made fullerenes survive experimental hypervelocity (approximately 6.1 km s-1) impacts into aluminium targets, suggesting that space fullerenes contained in a carbonaceous micrometeorite could have survived the LDEF impact at velocities towards the lower end of the natural particle encounter range (fullerenes were unlikely to have formed as instrumental artefacts, nor are they present as contaminants. Although we cannot specify the origin of the fullerenes with certainty, the most plausible source is the chondritic impactor. If, alternatively, the impact produced the fullerenes in situ on LDEF, then this suggests a viable mechanism for fullerene production in space.

  20. Impact of intra-abdominal fat on surgical outcome and overall survival of patients with gastric cancer.

    Science.gov (United States)

    Kim, J H; Chin, H M; Hwang, S S; Jun, K H

    2014-01-01

    The aim of this study was to evaluate the impact of obesity on surgical outcome and prognosis in patients with gastric cancer. A total of 304 patients who underwent curative gastrectomy for gastric adenocarcinoma between January 2005 and March 2008were enrolled. Body mass index (BMI) was calculated before the operation and visceral fat area (VFA) was measured by abdominal computed tomography (CT). The patients were divided according to BMI class and VFA quartile. The influence of BMI and VFA on surgical outcome and survival was evaluated. The median BMI was 23.3 kg/m(2) and the median VFA was 103 cm(2). There was a significant positive correlation between BMI and VFA. According to BMI class and VFA quartile, there were no significant differences in patients' characteristics or surgical outcome, with the exception of a significantly longer operation time and fewer retrieved lymph nodes in patients with a high BMI and VFA. The unadjusted overall and disease free survival were not significantly different between BMI classes or VFA quartiles. Obesity, as represented by BMI and VFA, may not be a poor prognostic factor in patients with gastric cancer. Copyright © 2014 Surgical Associates Ltd. All rights reserved.

  1. Impact of Changes in Perinatal Care on Neonatal Respiratory Outcome and Survival of Preterm Newborns: An Overview of 15 Years

    Directory of Open Access Journals (Sweden)

    Filipa Flor-de-Lima

    2012-01-01

    Full Text Available Survival and outcomes for preterm infants with respiratory distress syndrome (RDS have improved over the past 30 years. We conducted a study to assess the changes in perinatal care and delivery room management and their impact on respiratory outcome of very low birth weight newborns, over the last 15 years. A comparison between two epochs was performed, the periods before and after 2005, when early nasal continuous positive airway pressure (NCPAP and Intubation-SURfactant-Extubation (INSURE were introduced in our center. Three hundred ninety-five clinical records were assessed, 198 (50.1% females, gestational age 29.1 weeks (22–36, and birth weight 1130 g (360–1498. RDS was diagnosed in 247 (62.5% newborns and exogenous surfactant was administered to 217 (54.9%. Thirty-three (8.4% developed bronchopulmonary dysplasia (BPD, and 92 (23% were deceased. With the introduction of early NCPAP and INSURE, there was a decrease on the endotracheal intubation need and invasive ventilation (P<0.0001, oxygen therapy (P=0.002, and mortality (P<0.0001. The multivariate model revealed a nonsignificant reduction in BPD between the two epochs (OR=0.86; 95% CI 0.074–9.95; P=0.9. The changes in perinatal care over the last 15 years were associated to an improvement of respiratory outcome and survival, despite a nonsignificant decrease in BPD rate.

  2. Impacts of episodic acidification on in-stream survival and physiological impairment of Atlantic salmon (Salmo salar) smolts

    Science.gov (United States)

    McCormick, S.D.; Keyes, A.; Nislow, K.H.; Monette, M.Y.

    2009-01-01

    We conducted field studies to determine the levels of acid and aluminum (Al) that affect survival, smolt development, ion homeostasis, and stress in Atlantic salmon (Salmo salar) smolts in restoration streams of the Connecticut River in southern Vermont, USA. Fish were held in cages in five streams encompassing a wide range of acid and Al levels for two 6-day intervals during the peak of smolt development in late April and early May. Physiological parameters were unchanged from initial sampling at the hatchery and the high water quality reference site (pH > 7.0, inorganic Al water chemistry alone. The results indicate that Al and low pH under field conditions in some New England streams can cause mortality and impair smolt development in juvenile Atlantic salmon and provide direct evidence that episodic acidification is impacting conservation and recovery of Atlantic salmon in the northeastern USA.

  3. Impact of Bacillus thuringiensis strains on survival, reproduction and foraging behaviour in bumblebees (Bombus terrestris).

    Science.gov (United States)

    Mommaerts, Veerle; Jans, Kris; Smagghe, Guy

    2010-05-01

    Bacillus thuringiensis (Bt) and its protein crystals are used worldwide, either as a spray or when expressed in transgenic crops, for the control of pest insects. However, owing to their intensive use, there exists a debate regarding the involvement of this microbial insecticide in bee colony losses. In this study, in a tiered approach using laboratory microcolonies, an evaluation was made of the potential lethal and sublethal hazards on colony reproduction and foraging behaviour of workers of the bumblebee Bombus terrestris (L.) of two commercial Bt strains: kurstaki (Dipel) and aizawai (Xentari). Bumblebees, like honey bees, are intensively used in modern agriculture for pollination and fulfil a crucial role in the natural ecosystem. Exposure of bumblebees dermally or via treated pollen to either of the two Bt formulations at their field recommended rates (0.1%) caused no reduction in survival. However, when applied in the feeding sugar water, aizawai killed all workers at a concentration of 0.1%, but this lethal effect was lost at 0.01%. With respect to reproductive effects, kurstaki was harmless, while aizawai at 0.1% delivered in the feeding sugar water and pollen reduced reproduction by 100 and 31% respectively. Lower doses of 0.01% aizawai in the sugar water showed no more effect. In addition, kurstaki at 0.1% and aizawai at 0.01% in the feeding sugar water did not impair the foraging behaviour, resulting in normal nest colony performance. The results with kurstaki and aizawai demonstrated that, in general, the Bt strains are safe to B. terrestris bumblebees, although in some cases there were detrimental effects that depended on strain and route of exposure. In addition, the authors believe that to draw firm conclusions regarding the hazards of Bt to bumblebees would require more information on relevant concentrations of Bt products in the environment. Hence, routine testing for lethal and sublethal effects is recommended to ascertain combined use of Bt

  4. Impact of Coexisting Pulmonary Diseases on Survival of Patients With Lung Adenocarcinoma

    Science.gov (United States)

    Jian, Zhi-Hong; Huang, Jing-Yang; Ko, Pei-Chieh; Jan, Shiou-Rung; Nfor, Oswald Ndi; Lung, Chia-Chi; Ku, Wen-Yuan; Ho, Chien-Chang; Pan, Hui-Hsien; Liaw, Yung-Po

    2015-01-01

    Abstract Asthma, chronic obstructive pulmonary disease (COPD), and pulmonary tuberculosis (TB) are common pulmonary diseases associated with lung cancer. Besides, smoking is more prevalent in Taiwanese men. This study evaluated gender disparities in coexisting pulmonary diseases on survival of patients with lung adenocarcinoma. Patients newly diagnosed with lung cancer between 2003 and 2008 were identified from Taiwan National Health Insurance Research Database. Cases with lung adenocarcinoma were further confirmed using the Cancer Registry Database and followed up until the end of 2010. Cox proportional hazard regression was used to calculate the hazard ratio (HR) of coexisting asthma, COPD, and/or TB to estimate all-cause mortality risk. During the study period, 13,399 cases of lung adenocarcinoma were identified. The HRs of adenocarcinoma in men and women were 1.20 (95% confidence interval [CI], 1.10–1.30) and 1.05 (95% CI, 0.95–1.16), respectively, for individuals with asthma, 1.32 (95% CI, 1.16–1.51) and 0.97 (95% CI, 0.89–1.05), respectively, for COPD, and 0.99 (95% CI, 0.93–1.06) and 1.06 (95% CI, 0.86–1.32), respectively, for individuals with TB. Specifically, among men with coexisting pulmonary diseases, the HRs were 1.63 (95% CI, 1.25–2.13), 1.31 (95% CI, 1.08–1.59), and 1.23 (95% CI, 1.11–1.36) for individuals with asthma + COPD + TB, asthma + COPD, and COPD + TB, respectively. However, there was no increase risk of mortality among women with coexisting pulmonary diseases. Coexisting pulmonary diseases are at an elevated risk of mortality among male patients with lung adenocarcinoma. Such patients deserve greater attention while undergoing cancer treatment. PMID:25634179

  5. Real-world impact of non-breast cancer-specific death on overall survival in resectable breast cancer.

    Science.gov (United States)

    Fu, Jianfei; Wu, Lunpo; Jiang, Mengjie; Li, Dan; Jiang, Ting; Fu, Wei; Wang, Liangjing; Du, Jinlin

    2017-07-01

    The real-world occurrence rate of non-breast cancer-specific death (non-BCSD) and its impact on patients with breast cancer are poorly recognized. Women with resectable breast cancer from 1990 to 2007 in the Surveillance, Epidemiology, and End Results database (n = 199,963) were analyzed. The outcome events of breast cancer were classified as breast cancer-specific death (BCSD), non-BCSD, or survival. Binary logistics was used to estimate the occurrence rates of non-BCSD and BCSD with different clinicopathological factors. The Gray method was used to measure the cumulative incidence of non-BCSD and BCSD. The ratio of non-BCSDs to all causes of death and stacked cumulative incidence function plots were used to present the impact of non-BCSD on overall survival (OS). Models of Cox proportional hazards regression and competing risk regression were compared to highlight the suitable model. There were 12,879 non-BCSDs (6.44%) and 28,784 BCSDs (14.39%). The oldest age group (>62 years), black race, and a single or divorced marital status were associated with more non-BCSDs. With adjustments for age, a hormone receptor-positive (HoR+) status was no longer related to increased non-BCSDs. In patients with grade 1, stage I disease and an HoR+ status as well as the oldest subgroup, a great dilution of non-BCSD on all causes of death could be observed, and this led to incorrect interpretations. The inaccuracy, caused by the commonly used Cox proportional hazards model, could be corrected by a competing risk model. OS was largely impaired by non-BCSD during early breast cancer. For some future clinical trial planning, especially for the oldest patients and those with HoR+ breast cancer, non-BCSD should be considered a competing risk event. Cancer 2017;123:2432-43. © 2017 American Cancer Society. © 2017 American Cancer Society.

  6. Impact of flattening-filter-free radiation on the clonogenic survival of astrocytic cell lines

    Energy Technology Data Exchange (ETDEWEB)

    Steenken, Caroline; Fleckenstein, Jens; Kegel, Stefan; Jahnke, Lennart; Simeonova, Anna; Hartmann, Linda; Kuebler, Jens; Veldwijk, Marlon R.; Wenz, Frederik; Herskind, Carsten; Giordano, Frank Anton [Universitaetsmedizin Mannheim (UMM), Medical Faculty Mannheim, Heidelberg University, Department of Radiation Oncology, Mannheim (Germany)

    2015-07-15

    Flattening-filter-free (FFF) beams are increasingly used in radiotherapy as delivery times can be substantially reduced. However, the relative biologic effectiveness (RBE) of FFF may be increased relative to conventional flattened (FLAT) beams due to differences in energy spectra. Therefore, we investigated the effects of FFF and FLAT beams on the clonogenic survival of astrocytoma cells. Three cell lines (U251, U251-MGMT, and U87) were irradiated with 6-MV and 10-MV X-rays from a linear accelerator in FFF- or FLAT-beam modes at dose rates in the range of 0.5-24 Gy/min. The surviving fraction (SF) as function of dose (2-12 Gy) was determined by the colony formation assay and fitted by the linear-quadratic model. For both beams (FFF or FLAT), the cells were pelleted in conical 15-ml centrifuge tubes and irradiated at 2-cm depth in a 1 x 1-cm{sup 2} area on the central axis of a 30 x 30-cm{sup 2} field. Dosimetry was performed with a 0.3-cm{sup 3} rigid ionization chamber. RBE was determined for FFF versus FLAT irradiation. The RBE of FFF at 7.3-11.3 Gy was 1.027 ± 0.013 and 1.063 ± 0.018 relative to FLAT beams for 6- and 10-MV beams, respectively, and was only significantly higher than 1 for 10 MV. Significantly increased survival rates were seen for lower dose rates (0.5 Gy/min FLAT vs. 5 Gy/min FLAT) at higher doses (11.9 Gy), while no differences were seen at dose rates ≥ 1.4 Gy/min (1.4 Gy/min FFF vs. 14 Gy/min FFF and 2.4 Gy/min FFF vs. 24 Gy/min FFF). FFF beams showed only a slightly increased RBE relative to FLAT beams in this experimental set-up, which is unlikely to result in clinically relevant differences in outcome. (orig.) [German] Die Flattening-Filter-freie (FFF) Bestrahlungstechnik findet zunehmend Verwendung, da sich die Applikationsdauer der einzelnen Fraktionen deutlich verkuerzen laesst. Aufgrund der Unterschiede im Spektrum koennte die relative biologische Wirksamkeit (RBW) von FFF jedoch hoeher sein als bei konventioneller Technik (d.h. bei

  7. Accuracy of cause of death data routinely recorded in a population-based cancer registry: impact on cause-specific survival and validation using the Geneva cancer registry

    Science.gov (United States)

    2013-01-01

    Background Information on the underlying cause of death of cancer patients is of interest because it can be used to estimate net survival. The population-based Geneva Cancer Registry is unique because registrars are able to review the official cause of death. This study aims to describe the difference between the official and revised cause-of-death variables and the impact on cancer survival estimates. Methods The recording process for each cause of death variable is summarised. We describe the differences between the two cause-of-death variables for the 5,065 deceased patients out of the 10,534 women diagnosed with breast cancer between 1970 and 2009. The Kappa statistic and logistic regression are applied to evaluate the degree of concordance. The impact of discordance on cause-specific survival is examined using the Kaplan Meier method. Results The overall agreement between the two variables was high. However, several subgroups presented a lower concordance, suggesting differences in calendar time and less attention given to older patients and more advanced diseases. Similarly, the impact of discordance on cause-specific survival was small on overall survival but larger for several subgroups. Conclusion Estimation of cancer-specific survival could therefore be prone to bias when using the official cause of death. Breast cancer is not the more lethal cancer and our results can certainly not be generalised to more lethal tumours. PMID:24373194

  8. Impact of Molecular Subtypes in Muscle-invasive Bladder Cancer on Predicting Response and Survival after Neoadjuvant Chemotherapy.

    Science.gov (United States)

    Seiler, Roland; Ashab, Hussam Al Deen; Erho, Nicholas; van Rhijn, Bas W G; Winters, Brian; Douglas, James; Van Kessel, Kim E; Fransen van de Putte, Elisabeth E; Sommerlad, Matthew; Wang, Natalie Q; Choeurng, Voleak; Gibb, Ewan A; Palmer-Aronsten, Beatrix; Lam, Lucia L; Buerki, Christine; Davicioni, Elai; Sjödahl, Gottfrid; Kardos, Jordan; Hoadley, Katherine A; Lerner, Seth P; McConkey, David J; Choi, Woonyoung; Kim, William Y; Kiss, Bernhard; Thalmann, George N; Todenhöfer, Tilman; Crabb, Simon J; North, Scott; Zwarthoff, Ellen C; Boormans, Joost L; Wright, Jonathan; Dall'Era, Marc; van der Heijden, Michiel S; Black, Peter C

    2017-10-01

    An early report on the molecular subtyping of muscle-invasive bladder cancer (MIBC) by gene expression suggested that response to neoadjuvant chemotherapy (NAC) varies by subtype. To investigate the ability of molecular subtypes to predict pathological downstaging and survival after NAC. Whole transcriptome profiling was performed on pre-NAC transurethral resection specimens from 343 patients with MIBC. Samples were classified according to four published molecular subtyping methods. We developed a single-sample genomic subtyping classifier (GSC) to predict consensus subtypes (claudin-low, basal, luminal-infiltrated and luminal) with highest clinical impact in the context of NAC. Overall survival (OS) according to subtype was analyzed and compared with OS in 476 non-NAC cases (published datasets). Gene expression analysis was used to assign subtypes. Receiver-operating characteristics were used to determine the accuracy of GSC. The effect of GSC on survival was estimated by Cox proportional hazard regression models. The models generated subtype calls in expected ratios with high concordance across subtyping methods. GSC was able to predict four consensus molecular subtypes with high accuracy (73%), and clinical significance of the predicted consensus subtypes could be validated in independent NAC and non-NAC datasets. Luminal tumors had the best OS with and without NAC. Claudin-low tumors were associated with poor OS irrespective of treatment regimen. Basal tumors showed the most improvement in OS with NAC compared with surgery alone. The main limitations of our study are its retrospective design and comparison across datasets. Molecular subtyping may have an impact on patient benefit to NAC. If validated in additional studies, our results suggest that patients with basal tumors should be prioritized for NAC. We discovered the first single-sample classifier to subtype MIBC, which may be suitable for integration into routine clinical practice. Different molecular

  9. The Impact and Oxidation Survival of Selected Meteoritic Compounds: Signatures of Asteroid Organic Material on Planetary Surfaces

    Science.gov (United States)

    Cooper, George; Horz, Fred; Oleary, Alanna; Chang, Sherwood

    2013-01-01

    Polar, non-volatile organic compounds may be present on the surfaces (or near surfaces) of multiple Solar System bodies. If found, by current or future missions, it would be desirable to determine the origin(s) of such compounds, e.g., asteroidal or in situ. To test the possible survival of meteoritic compounds both during impacts with planetary surfaces and under subsequent (possibly) harsh ambient conditions, we subjected known meteoritic compounds to relatively high impact-shock pressures and/or to varying oxidizing/corrosive conditions. Tested compounds include sulfonic and phosphonic acids (S&P), polyaromatic hydrocarbons (PAHs) amino acids, keto acids, dicarboxylic acids, deoxy sugar acids, and hydroxy tricarboxylic acids (Table 1). Meteoritic sulfonic acids were found to be relatively abundant in the Murchison meteorite and to possess unusual S-33 isotope anomalies (non mass-dependent isotope fractionations). Combined with distinctive C-S and C-P bonds, the S&P are potential signatures of asteroidal organic material.

  10. Cardiopulmonary Bypass has No Significant Impact on Survival in Patients Undergoing Nephrectomy and Level III-IV Inferior Vena Cava Thrombectomy: Multi-Institutional Analysis.

    Science.gov (United States)

    Nguyen, Hao G; Tilki, Derya; Dall'Era, Marc A; Durbin-Johnson, Blythe; Carballido, Joaquín A; Chandrasekar, Thenappan; Chromecki, Thomas; Ciancio, Gaetano; Daneshmand, Siamak; Gontero, Paolo; Gonzalez, Javier; Haferkamp, Axel; Hohenfellner, Markus; Huang, William C; Espinós, Estefania Linares; Mandel, Philipp; Martinez-Salamanca, Juan I; Master, Viraj A; McKiernan, James M; Montorsi, Francesco; Novara, Giacomo; Pahernik, Sascha; Palou, Juan; Pruthi, Raj S; Rodriguez-Faba, Oscar; Russo, Paul; Scherr, Douglas S; Shariat, Shahrokh F; Spahn, Martin; Terrone, Carlo; Vergho, Daniel; Wallen, Eric M; Xylinas, Evanguelos; Zigeuner, Richard; Libertino, John A; Evans, Christopher P

    2015-08-01

    The impact of cardiopulmonary bypass in level III-IV tumor thrombectomy on surgical and oncologic outcomes is unknown. We determine the impact of cardiopulmonary bypass on overall and cancer specific survival, as well as surgical complication rates and immediate outcomes in patients undergoing nephrectomy and level III-IV tumor thrombectomy with or without cardiopulmonary bypass. We retrospectively analyzed 362 patients with renal cell cancer and with level III or IV tumor thrombus from 1992 to 2012 at 22 U.S. and European centers. Cox proportional hazards models were used to compare overall and cancer specific survival between patients with and without cardiopulmonary bypass. Perioperative mortality and complication rates were assessed using logistic regression analyses. Median overall survival was 24.6 months in noncardiopulmonary bypass cases and 26.6 months in cardiopulmonary bypass cases. Overall survival and cancer specific survival did not differ significantly in both groups on univariate analysis or when adjusting for known risk factors. On multivariate analysis no significant differences were seen in hospital length of stay, Clavien 1-4 complication rate, intraoperative or 30-day mortality and cancer specific survival. Limitations include the retrospective nature of the study. In our multi-institutional analysis the use of cardiopulmonary bypass did not significantly impact cancer specific survival or overall survival in patients undergoing nephrectomy and level III or IV tumor thrombectomy. Neither approach was independently associated with increased mortality on multivariate analysis. Greater surgical complications were not independently associated with the use of cardiopulmonary bypass. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. Impact of obesity on perioperative complications and long-term survival of patients with gastric cancer.

    Science.gov (United States)

    Bickenbach, Kai A; Denton, Brian; Gonen, Mithat; Brennan, Murray F; Coit, Daniel G; Strong, Vivian E

    2013-03-01

    The prevalence of obesity is increasing in the United States. Obesity has been associated with worse surgical outcomes, but its impact on long-term outcomes in gastric cancer is unclear. The aim of this study was to evaluate the effects of being overweight on surgical and long-term outcomes for patients with gastric cancer. Patients who underwent curative intent resection for gastric carcinoma from 1985 to 2007 were identified from a prospectively collected gastric cancer database. Overweight was defined as a body mass index (BMI) of 25 kg/m(2) or higher. Clinical outcomes of overweight and nonoverweight patients were compared. From the total population of 1,853 patients, 1,125 (60.7%) were overweight. Overweight patients tended to have more proximal tumors and a lower T stage. Accurate complication data were available on a subset of patients from 2000 to 2007. A BMI of ≥25 was associated with increased postoperative complications (47.9 vs. 35.8%, p gastric cancer.

  12. Lymph node metastases do not impact survival in follicular variant papillary thyroid cancer.

    Science.gov (United States)

    Schneider, David F; Elfenbein, Dawn; Lloyd, Ricardo V; Chen, Herbert; Sippel, Rebecca S

    2015-01-01

    Follicular variant of papillary thyroid cancer (FVPTC) is the most common and fastest growing subtype of papillary thyroid cancer (PTC) with features of both PTC and follicular thyroid cancer (FTC). The purpose of this study was to determine the patient and tumor features associated with lymph node metastases (LNM) in FVPTC. This was a retrospective review of adult (≥18) patients with histologically confirmed diagnoses of FVPTC within the SEER database between 1988 and 2009. LNM were defined by at least two lymph nodes with metastatic disease. To determine factors associated with LNM, we constructed a multivariate logistic regression model from significant variables (p Cox proportional hazards model to understand the relative importance of LNM in determining disease-specific mortality (DSM). Of the 20,357 cases of FVPTC with lymph node data available, 1,761 (8.7%) had LNM; 61.1% of these LNM were located in the central neck and 38.9% were in the lateral neck. Extrathyroidal extension (odds ratio [OR] 2.6, 95% confidence interval [CI] 2.2-3.0, p 4 cm (hazards ratio [HR] 5.3, 95% CI 2.2-12.8, p extension (HR 8.2, 95% CI 3.0-22.0, p < 0.01) were the strongest predictors of DSM. LNM occur in less than 10% of patients with FVPTC but do not impact DSM. Instead, DSM in FVPTC is related to size and local invasion.

  13. Impact of XIAP protein levels on the survival of myeloma cells

    Science.gov (United States)

    Desplanques, Grégoire; Giuliani, Nicola; Delsignore, Roberto; Rizzoli, Vittorio; Bataille, Régis; Barillé-Nion, Sophie

    2009-01-01

    Background XIAP is the best characterized and the most potent direct endogenous caspase inhibitor and is considered a key actor in the control of apoptotic threshold in cancer cells. In this report, we specifically addressed XIAP regulation and function in myeloma cells. Design and Methods XIAP and its endogenous inhibitor XAF-1 protein levels and their regulation were assessed by immunoblot analysis in myeloma cell lines or primary myeloma cells. XIAP knockdown by RNA interference was used to evaluate XIAP impact on in vitro drug sensitivity and in vivo tumor growth. Results Our results indicate that myeloma cells expressed high levels of XIAP protein that were tightly regulated during growth factor stimulation or stress condition. Of note, an increased XIAPlevel was evidenced during the blockade of the canonical cap-dependent translation by the mTOR inhibitor rapamycin, supporting the hypothesis of a functional IRES sequence in XIAP mRNA. In addition, caspase-mediated XIAP cleavage correlated to an apoptotic process occurring upon cell treatment with the proteasome inhibitor bortezomib. Importantly, XIAP knockdown using RNA interference enhanced drug sensitivity and decreased tumor formation in NOD/SCID mice. Finally, myeloma cells also expressed the XIAP inhibitor XAF-1 that interacted with XIAP in viable myeloma cells. Conclusions Altogether, our data argue for a delicate control of XIAP function in myeloma cells and stimulate interest in targeting XIAP in myeloma treatment. PMID:19001278

  14. Thermal protection for hypervelocity flight in earth's atmosphere by use of radiation backscattering ablating materials

    Science.gov (United States)

    Howe, John T.; Yang, Lily

    1991-01-01

    A heat-shield-material response code predicting the transient performance of a material subject to the combined convective and radiative heating associated with the hypervelocity flight is developed. The code is dynamically interactive to the heating from a transient flow field, including the effects of material ablation on flow field behavior. It accomodates finite time variable material thickness, internal material phase change, wavelength-dependent radiative properties, and temperature-dependent thermal, physical, and radiative properties. The equations of radiative transfer are solved with the material and are coupled to the transfer energy equation containing the radiative flux divergence in addition to the usual energy terms.

  15. The Urban Heat Island and its spatial scale dependent impact on survival and development in butterflies of different thermal sensitivity.

    Science.gov (United States)

    Kaiser, Aurélien; Merckx, Thomas; Van Dyck, Hans

    2016-06-01

    Climate alteration is one of the most cited ecological consequences of urbanization. However, the magnitude of this impact is likely to vary with spatial scale. We investigated how this alteration affects the biological fitness of insects, which are especially sensitive to ambient conditions and well-suited organisms to study urbanization-related changes in phenotypic traits. We monitored temperature and relative air humidity in wooded sites characterized by different levels of urbanization in the surroundings. Using a split-brood design experiment, we investigated the effect of urbanization at the local (i.e., 200 × 200 m) and landscape (i.e., 3 × 3 km) scale on two key traits of biological fitness in two closely related butterfly species that differ in thermal sensitivity. In line with the Urban Heat Island concept, urbanization led to a 1°C increase in daytime temperature and an 8% decrease in daytime relative humidity at the local scale. The thermophilous species Lasiommata megera responded at the local scale: larval survival increased twofold in urban compared to rural sites. Urbanized sites tended to produce bigger adults, although this was the case for males only. In the woodland species Pararge aegeria, which has recently expanded its ecological niche, we did not observe such a response, neither at the local, nor at the landscape scale. These results demonstrate interspecific differences in urbanization-related phenotypic plasticity and larval survival. We discuss larval pre-adaptations in species of different ecological profiles to urban conditions. Our results also highlight the significance of considering fine-grained spatial scales in urban ecology.

  16. Therapeutic impact of dietary vitamin D supplementation for preventing right ventricular remodeling and improving survival in pulmonary hypertension.

    Directory of Open Access Journals (Sweden)

    Hiroaki Tanaka

    Full Text Available Pulmonary hypertension (PH, caused by elevated pulmonary vascular resistance, leads to right heart failure and ultimately death. Vitamin D deficiency can predispose individuals to hypertension and left ventricular dysfunction; however, it remains unknown how serum vitamin D level is related to PH and right ventricular (RV dysfunction.Serum 25-hydroxyvitamin D [25(OHD] levels were assessed in PH patients for an association with disease severity. To examine whether vitamin D supplementation could prevent the development of pulmonary vascular remodeling and RV dysfunction in PH, a rat model of PH was fed either normal chow or a high vitamin D diet.The majority (95.1% of PH patients had 25(OHD levels in the insufficiency range, which is associated with increased mean pulmonary artery pressure, increased pulmonary vascular resistance, and decreased cardiac output in PH patients. Vitamin D supplementation significantly increased serum 25(OHD levels and improved survival in PH rats. Interestingly, while the supplemented rats retained the typical increases in medial thickness of the muscular pulmonary arteries and RV systolic pressure, RV cardiomyocyte hypertrophy and B-type natriuretic peptide expression was significantly attenuated.Vitamin D deficiency is frequently seen in patients diagnosed with PH and low serum levels of 25(OHD are associated with severity of PH and RV dysfunction. Vitamin D supplementation in PH rats improved survival via ameliorating pathological RV hypertrophy. These findings suggest an insufficient intake of vitamin D might potentially accelerate RV dysfunction, leading to a crucial clinical impact of vitamin D supplementation in PH.

  17. Cardiopulmonary bypass (CPB) has no significant impact on survival in patients undergoing nephrectomy and level III-IV inferior vena cava thrombectomy; a multi-institutional analysis

    Science.gov (United States)

    Dall'Era, Marc A.; Durbin-Johnson, Blythe; Carballido, Joaquín A.; Chandrasekar, Thenappan; Chromecki, Thomas; Ciancio, Gaetano; Daneshmand, Siamak; Gontero, Paolo; Gonzalez, Javier; Haferkamp, Axel; Hohenfellner, Markus; Huang, William C.; Espinós, Estefania Linares; Mandel, Philipp; Martinez-Salamanca, Juan I.; Master, Viraj A.; McKiernan, James M.; Montorsi, Francesco; Novara, Giacomo; Pahernik, Sascha; Palou, Juan; Pruthi, Raj S.; Rodriguez-Faba, Oscar; Russo, Paul; Scherr, Douglas S.; Shariat, Shahrokh F.; Spahn, Martin; Terrone, Carlo; Vergho, Daniel; Wallen, Eric M.; Xylinas, Evanguelos; Zigeuner, Richard; Libertino, John A.; Evans, Christopher P.

    2016-01-01

    Purpose The impact of cardiopulmonary bypass (CPB) usage in level III-IV tumor thrombectomy on surgical and oncologic outcomes is unknown. We sought to determine the impact of cardiopulmonary bypass (CPB) on overall and cancer specific survival, as well as surgical complication rates, and immediate outcomes in patients undergoing nephrectomy and level III-IV tumor thrombectomy with or without CPB. Patients and Methods We retrospectively analyzed 362 patients with RCC and with level III or IV tumor thrombus from 1992 to 2012 in 22 US and European centers. Cox proportional hazards models were used to compare overall and cancer-specific survival between patients with and without CPB. Perioperative mortality and complications rates were assessed using logistic regression analyses. Results The median overall survival was 24.6 months in non-CPB patients and 26.6 months in CPB patients. Overall survival and cancer-specific survival (CSS) did not differ significantly in both groups, neither in univariate analysis nor when adjusting for known risk factors. In multivariate analysis, no significant differences were seen in hospital LOS, Clavien 1-4 complication rate, intraoperative or 30 day mortality, and CSS between both groups. Limitations include the retrospective nature of the study. Conclusions In our multi-institutional analysis, the use of cardiopulmonary bypass did not significantly impact cancer specific survival or overall survival in patients undergoing nephrectomy and level III or IV tumor thrombectomy. Neither approach was independently associated with increased mortality in the multivariate analysis. Higher surgical complications were not independently associated with the use of CPB. PMID:25797392

  18. Clinical impact of postprogression survival for overall survival in elderly patients (aged 75 years or older with advanced nonsmall cell lung cancer

    Directory of Open Access Journals (Sweden)

    Reiko Yoshino

    2015-01-01

    Full Text Available Introduction: The effects of first-line single-agent chemotherapy on overall survival (OS might be confounded by subsequent treatments in elderly patients with nonsmall cell lung cancer (NSCLC. We, therefore, aimed to evaluate whether progression-free survival (PFS, postprogression survival (PPS, or tumor response might be a valid surrogate endpoint for OS in this patient population. Patients and Methods: We retrospectively reviewed the clinical data of 58 elderly patients with advanced NSCLC, who received first-line single-agent cytotoxic chemotherapy at our institution between October 2003 and November 2013. The relationships of PFS, PPS, and tumor response with OS were individually analyzed. Results: The study cohort included 46 men and 12 women with a median age of 79 years (range: 75-87 years. There were 30 adenocarcinomas, 22 squamous cell carcinomas, and 6 other histologic types with 1 stage IIIA, 9 IIIB, and 48 IV cases. The performance status (PS scores were 0, 1, and 2 in 18, 35, and 5 patients, respectively. The median PFS and OS were 2.8 and 5.4 months, respectively. Our analyses revealed a strong correlation of PPS and PFS with OS, whereas that between tumor shrinkage and OS was weak. Tumor stage and PS after initial treatment were significantly associated with PPS. Individual analysis indicated that PPS might serve as a surrogate for OS in elderly patients with advanced NSCLC receiving first-line single-agent chemotherapy. Conclusion: Our findings suggested that the disease course after progression following first-line single-agent chemotherapy might influence the OS of elderly patients with advanced NSCLC.

  19. A bridging stent to surgery in patients with esophageal and gastroesophageal junction cancer has a dramatic negative impact on patient survival

    DEFF Research Database (Denmark)

    Nassar, M; Kjaer, D W; Jensen, Lone Susanne

    2017-01-01

    This study aimed to assess the impact of esophageal stenting on postoperative complications and survival in patients with obstructing esophageal and gastroesophageal junction (GEJ) cancer. All patients treated without neoadjuvant therapy that had an R0-resection performed for esophageal and GEJ c...

  20. Identification of sigma factor SigmaB-controlled genes and their impact on acid stress, high hydrostatic pressure, and freeze survival in Listeria monocytogenes EGD-e

    NARCIS (Netherlands)

    Wemekamp-Kamphuis, H.H.; Wouters, J.A.; Leeuw, de P.P.L.A.; Hain, T.; Chakraborty, T.; Abee, T.

    2004-01-01

    The gene encoding the alternative sigma factor sigma(B) in Listeria monocytogenes is induced upon exposure of cells to several stresses. In this study, we investigated the impact of a sigB null mutation on the survival of L. monocytogenes EGD-e at low pH, during high-hydrostatic-pressure treatment,

  1. Impact on survival of early detection of isolated breast recurrences after the primary treatment for breast cancer : a meta-analysis

    NARCIS (Netherlands)

    Lu, W.L.; Jansen, L.; Post, W.J.; Bonnema, J.; van de Velde, J.C.; de Bock, G.H.

    Purpose The purpose was to establish the impact on survival of early detection of a local recurrence of breast cancer as compared to late detection. Design A meta-analysis was carried out using Cochrane review manager software (RevMan version 4.2). Studies were included if women were treated for

  2. Markers of fibroblast-rich tumor stroma and perivascular cells in serous ovarian cancer : Inter- and intra-patient heterogeneity and impact on survival

    NARCIS (Netherlands)

    Corvigno, Sara; Wisman, G. Bea A.; Mezheyeuski, Artur; van der Zee, Ate G. J.; Nijman, Hans W.; Avall-Lundqvist, Elisabeth; Ostman, Arne; Dahlstrand, Hanna

    2016-01-01

    Inter- and intra-patient variations in tumor microenvironment of serous ovarian cancer are largely unexplored. We aimed to explore potential co-regulation of tumor stroma characteristics, analyze their concordance in primary and metastatic lesions, and study their impact on survival. A tissue

  3. Three-body encounters in the Galactic Centre: the origin of the hypervelocity star SDSS J090745.0+024507

    NARCIS (Netherlands)

    Gualandris, A.; Portegies Zwart, S.F.; Sipior, M.S.

    2005-01-01

    In the late 1980s Hills predicted that runaway stars could be accelerated to velocities greater than 1000kms-1 by dynamical encounters with the supermassive black hole (SMBH) in the Galactic Centre. The recently discovered hypervelocity star SDSS J090745.0+024507 (hereafter the HVS) is escaping the

  4. The hypervelocity hot subdwarf US 708 - remnant of a double-detonation SN Ia?

    Science.gov (United States)

    Geier, Stephan

    2013-10-01

    Type Ia supernovae {SN Ia} are the most important standard candles for measuring the expansion history of the universe. The thermonuclear explosion of a white dwarf can explain their observed properties, but neither the progenitor systems nor any stellar remnants have been conclusively identified. Underluminous SN Ia have been proposed to originate from a so-called double-detonation of a white dwarf. After a critical amount of helium is deposited on the surface through accretion from a close companion, the helium is ignited causing a detonation wave that triggers the explosion of the white dwarf itself. The helium star will then be ejected at so large a velocity that it will escape the Galaxy. The predicted properties of this remnant are an excellent match to the so-called hypervelocity star US 708, a hot, helium-rich star moving at more than 750 km/s, sufficient to leave the Galaxy.Here we propose medium-resolution COS spectroscopy to measure the vsini of the hypervelocity He-sdO US 708 for the first time and to search for abundance anomalies caused by pollution through an SN Ia event. This will allow us to test the double-detonation scenario with sdB donor empirically.

  5. The Anatomy of a Shock-Boundary Layer Interaction in Hypervelocity Flow

    Science.gov (United States)

    Knisely, Andrew; Swantek, Andrew; Austin, Joanna

    2013-11-01

    We examine laminar shock-boundary layer interaction over a double wedge geometry in hypervelocity flow. The macroscopic features of this configuration have been shown to be sensitive to the thermochemical energy exchange occurring on a molecular scale. In the current work, an expansion tube is used to accelerate air and nitrogen gas to hypervelocity flow conditions (3.8 km/s, 8.0 MJ/kg) over a 30-55 degree double wedge model. To examine the response of the gas dynamic flow features to real gas effects, we ``tune'' the chemical composition (O2 content) of the freestream by varying the relative ratio of nitrogen gas and air in the initial test gas. High speed schlieren and chemiluminescence (100k fps) are used to produce overlaid images that visualize the flow structures and identify regions of increased thermochemical activity. These qualitative data are combined with quantitative, pointwise NO vibrational temperature measurements made in the A-X transition band (220-255 nm) to investigate regions of interest such as behind the bow shock and in the shear layer. A transition in bow shock standoff distance and post-shock temperature profiles is identified at 50% O2 content. The authors would like to acknowledge funding from the U.S. Air Force Office of Scientific Research, grant number FA 9550-11-1-0129, with Dr John Schmisseur as program manager.

  6. The Impact of Egg Ozonation on Hatching Success, Larval Growth, and Survival of Atlantic Cod, Atlantic Salmon, and Rainbow Trout.

    Science.gov (United States)

    Fry, Jessica; Casanova, Pérez Juan; Hamoutene, Dounia; Lush, Lynn; Walsh, Andy; Couturier, Cyr

    2015-03-01

    The direct exposure of fish eggs to ozonated water has generated interest as a means of ensuring pathogen-free eggs without the use of harsh chemicals. However, there are numerous knowledge gaps, including safe contact times, exposure levels, and potential long-term effects on aquaculture species in both freshwater and seawater. The effect of different ozone (O3) doses (0.5-1.0, 1.5-2.0, and 2.5-3.0 mg of O3/L for 90 s) on recently fertilized eggs of Atlantic Cod Gadus morhua and eyed eggs of Atlantic Salmon Salmo salar and Rainbow Trout Oncorhynchus mykiss was evaluated in comparison with the effects of two commercial disinfectants: Perosan (0.004 mg/L) and Ovadine (100 mg/L). The impact of ozone application was evaluated based on hatching success, larval nucleic acid concentration, larval growth, and survival. Overall, results indicated that ozonation of Atlantic Cod eggs at a dose less than 3.0 mg/L for 90 s produced no negative effect on the larvae up to 30 d posthatch. Furthermore, ozonation of Atlantic Salmon and Rainbow Trout eggs generated no negative effect on the larvae, based on monitoring until 85% yolk sac re-absorption (16 d posthatch).

  7. Characterization of hypervelocity metal fragments for explosive initiation

    Science.gov (United States)

    Yeager, John D.; Bowden, Patrick R.; Guildenbecher, Daniel R.; Olles, Joseph D.

    2017-07-01

    The fragment impact response of two plastic-bonded explosive (PBX) formulations was studied using explosively driven aluminum fragments. A generic aluminum-capped detonator generated sub-mm aluminum particles moving at hypersonic velocities. The ability of these fragments to initiate reaction or otherwise damage two PBX materials was assessed using go/no-go experiments at standoff distances of up to 160 mm. Lower density PBX 9407 (RDX-based) was initiable at up to 115 mm, while higher density PBX 9501 (HMX-based) was only initiable at up to 6 mm. Several techniques were used to characterize the size, distribution, and velocity of the particles. Witness plate materials, including copper and polycarbonate, and backlit high speed video were used to characterize the distribution of particles, finding that the aluminum cap did not fragment homogeneously but rather with larger particles in a ring surrounding finer particles. Finally, precise digital holography experiments were conducted to measure the three-dimensional shape and size of the fastest-moving fragments, which ranged between 100 and 700 μm and traveled between 2.2 and 3.2 km/s. Crucially, these experiments showed variability in the fragmentation in terms of the number of fragments at the leading edge of the fragment field, indicating that both single and multiple shock impacts could be imparted to the target material. These types of data are critical for safety experiments and hydrocode simulations to quantify shock-to-detonation transition mechanisms and the associated risk-margins for these materials.

  8. Environmentally relevant concentrations of polyethylene microplastics negatively impact the survival, growth and emergence of sediment-dwelling invertebrates.

    Science.gov (United States)

    Ziajahromi, Shima; Kumar, Anupama; Neale, Peta A; Leusch, Frederic D L

    2018-02-05

    Microplastics are a widespread environmental pollutant in aquatic ecosystems and have the potential to eventually sink to the sediment, where they may pose a risk to sediment-dwelling organisms. While the impacts of exposure to microplastics have been widely reported for marine biota, the effects of microplastics on freshwater organisms at environmentally realistic concentrations are largely unknown, especially for benthic organisms. Here we examined the effects of a realistic concentration of polyethylene microplastics in sediment on the growth and emergence of a freshwater organism Chironomus tepperi. We also assessed the influence of microplastic size by exposing C. tepperi larvae to four different size ranges of polyethylene microplastics (1-4, 10-27, 43-54 and 100-126 μm). Exposure to an environmentally relevant concentration of microplastics, 500 particles/kg sediment , negatively affected the survival, growth (i.e. body length and head capsule) and emergence of C. tepperi. The observed effects were strongly dependent on microplastic size with exposure to particles in the size range of 10-27 μm inducing more pronounced effects. While growth and survival of C. tepperi were not affected by the larger microplastics (100-126 μm), a significant reduction in the number of emerged adults was observed after exposure to the largest microplastics, with the delayed emergence attributed to exposure to a stressor. While scanning electron microscopy showed a significant reduction in the size of the head capsule and antenna of C. tepperi exposed to microplastics in the 10-27 μm size range, no deformities to the external structure of the antenna and mouth parts in organisms exposed to the same size range of microplastics were observed. These results indicate that environmentally relevant concentrations of microplastics in sediment induce harmful effects on the development and emergence of C. tepperi, with effects greatly dependent on particle size. Copyright

  9. Multiple Gene-Environment Interactions on the Angiogenesis Gene-Pathway Impact Rectal Cancer Risk and Survival.

    Science.gov (United States)

    Sharafeldin, Noha; Slattery, Martha L; Liu, Qi; Franco-Villalobos, Conrado; Caan, Bette J; Potter, John D; Yasui, Yutaka

    2017-09-28

    Characterization of gene-environment interactions (GEIs) in cancer is limited. We aimed at identifying GEIs in rectal cancer focusing on a relevant biologic process involving the angiogenesis pathway and relevant environmental exposures: cigarette smoking, alcohol consumption, and animal protein intake. We analyzed data from 747 rectal cancer cases and 956 controls from the Diet, Activity and Lifestyle as a Risk Factor for Rectal Cancer study. We applied a 3-step analysis approach: first, we searched for interactions among single nucleotide polymorphisms on the pathway genes; second, we searched for interactions among the genes, both steps using Logic regression; third, we examined the GEIs significant at the 5% level using logistic regression for cancer risk and Cox proportional hazards models for survival. Permutation-based test was used for multiple testing adjustment. We identified 8 significant GEIs associated with risk among 6 genes adjusting for multiple testing: TNF (OR = 1.85, 95% CI: 1.10, 3.11), TLR4 (OR = 2.34, 95% CI: 1.38, 3.98), and EGR2 (OR = 2.23, 95% CI: 1.04, 4.78) with smoking; IGF1R (OR = 1.69, 95% CI: 1.04, 2.72), TLR4 (OR = 2.10, 95% CI: 1.22, 3.60) and EGR2 (OR = 2.12, 95% CI: 1.01, 4.46) with alcohol; and PDGFB (OR = 1.75, 95% CI: 1.04, 2.92) and MMP1 (OR = 2.44, 95% CI: 1.24, 4.81) with protein. Five GEIs were associated with survival at the 5% significance level but not after multiple testing adjustment: CXCR1 (HR = 2.06, 95% CI: 1.13, 3.75) with smoking; and KDR (HR = 4.36, 95% CI: 1.62, 11.73), TLR2 (HR = 9.06, 95% CI: 1.14, 72.11), EGR2 (HR = 2.45, 95% CI: 1.42, 4.22), and EGFR (HR = 6.33, 95% CI: 1.95, 20.54) with protein. GEIs between angiogenesis genes and smoking, alcohol, and animal protein impact rectal cancer risk. Our results support the importance of considering the biologic hypothesis to characterize GEIs associated with cancer outcomes.

  10. Multiple Gene-Environment Interactions on the Angiogenesis Gene-Pathway Impact Rectal Cancer Risk and Survival

    Directory of Open Access Journals (Sweden)

    Noha Sharafeldin

    2017-09-01

    Full Text Available Characterization of gene-environment interactions (GEIs in cancer is limited. We aimed at identifying GEIs in rectal cancer focusing on a relevant biologic process involving the angiogenesis pathway and relevant environmental exposures: cigarette smoking, alcohol consumption, and animal protein intake. We analyzed data from 747 rectal cancer cases and 956 controls from the Diet, Activity and Lifestyle as a Risk Factor for Rectal Cancer study. We applied a 3-step analysis approach: first, we searched for interactions among single nucleotide polymorphisms on the pathway genes; second, we searched for interactions among the genes, both steps using Logic regression; third, we examined the GEIs significant at the 5% level using logistic regression for cancer risk and Cox proportional hazards models for survival. Permutation-based test was used for multiple testing adjustment. We identified 8 significant GEIs associated with risk among 6 genes adjusting for multiple testing: TNF (OR = 1.85, 95% CI: 1.10, 3.11, TLR4 (OR = 2.34, 95% CI: 1.38, 3.98, and EGR2 (OR = 2.23, 95% CI: 1.04, 4.78 with smoking; IGF1R (OR = 1.69, 95% CI: 1.04, 2.72, TLR4 (OR = 2.10, 95% CI: 1.22, 3.60 and EGR2 (OR = 2.12, 95% CI: 1.01, 4.46 with alcohol; and PDGFB (OR = 1.75, 95% CI: 1.04, 2.92 and MMP1 (OR = 2.44, 95% CI: 1.24, 4.81 with protein. Five GEIs were associated with survival at the 5% significance level but not after multiple testing adjustment: CXCR1 (HR = 2.06, 95% CI: 1.13, 3.75 with smoking; and KDR (HR = 4.36, 95% CI: 1.62, 11.73, TLR2 (HR = 9.06, 95% CI: 1.14, 72.11, EGR2 (HR = 2.45, 95% CI: 1.42, 4.22, and EGFR (HR = 6.33, 95% CI: 1.95, 20.54 with protein. GEIs between angiogenesis genes and smoking, alcohol, and animal protein impact rectal cancer risk. Our results support the importance of considering the biologic hypothesis to characterize GEIs associated with cancer outcomes.

  11. Impact of relative humidity, inoculum carrier and size, and native microbiota on Salmonella ser. Typhimurium survival in baby lettuce.

    Science.gov (United States)

    López-Gálvez, Francisco; Gil, Maria Isabel; Allende, Ana

    2018-04-01

    The effects of relative humidity (RH), fluctuating climate conditions, inoculum size and carrier on the survival of Salmonella enterica serovar Typhimurium on baby lettuce in environmental test chambers were studied. Buffered peptone water (BPW), distilled water (DW), and irrigation water (IW) were compared as inoculum carriers. Additionally, survival of Salmonella in suspensions prepared using filtered and unfiltered IW was assessed. Salmonella Typhimurium survived better on baby lettuce plants at high RH independently of the inoculum size. When lettuce plants were grown under fluctuating environmental conditions, Salmonella survival was similar under both RH conditions. Regarding the inoculum carrier, the inoculated microorganism survived better on lettuce plants when BPW was used as carrier both at high and low RH. Survival rate of Salmonella in IW was affected by the presence of native microbiota. Native microbiota present in IW did not affect survival of Salmonella or the levels of mesophilic bacteria on the baby lettuce leaves. The information obtained in the present study contributes to the knowledge on the effect of environmental conditions on pathogenic bacteria survival on growing edible plants. These results are useful when selecting the methodology to carry out experimental studies on the survival of microbial pathogens under different pre-harvest conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Smoking has no impact on survival and it is not associated with ACE gene I/D polymorphism in hemodialysis patients.

    Science.gov (United States)

    Kiss, István; Kiss, Zoltán; Kerkovits, Lóránt; Paksy, András; Ambrus, Csaba

    2017-01-01

    The relationship between smoking and mortality in patients on hemodialysis is controversial. Earlier studies showed that the insertion/deletion (I/D) polymorphism of the ACE gene might have an effect on mortality. The aim of this study was to test the impact of smoking on survival and whether this association was influenced by ACE gene I/D polymorphism in patients on maintenance hemodialysis. In this prospective, multicenter cohort study we analyzed 709 prevalent patients on maintenance hemodialysis. Patients were allocated into groups based on their smoking habit. Outcome data were collected during the 144-month follow-up period. Outcomes of current smokers and lifelong non-smokers were compared. In order to control for interactions between predictor variables, we also identified 160 matched pairs for further sub-analysis. The vast majority of patients (67%) were non-smokers, followed by current smokers (22.2%) and ex-smokers (9.8%). Smoking had no impact on survival in the matched pair analysis ( p = 0.99). After adjustment for ACE I/D polymorphism and other co-variates, smoking had no effect on survival. Our data suggest that smoking has no impact on survival; neither is it associated with ACE gene I/D polymorphism in hemodialysis patients.

  13. Methylenetetrahydrofolate reductase 677C>T and methionine synthase 2756A>G mutations: no impact on survival, cognitive functioning, or cognitive decline in nonagenarians

    DEFF Research Database (Denmark)

    Bathum, Lise; von Bornemann Hjelmborg, Jacob; Christiansen, Lene

    2007-01-01

    BACKGROUND: Several reports have shown an association between homocysteine, cognitive functioning, and survival among the oldest-old. Two common polymorphisms in the genes coding for methylenetetrahydrofolate reductase (MTHFR 677C>T) and methionine synthase (MTR 2756A>G) have an impact on plasma...... homocysteine level. METHODS: We examined the effect of the MTHFR 677C>T and MTR 2756A>G genotypes on baseline cognitive functioning, cognitive decline over 5 years measured in three assessments, and survival in a population-based cohort of 1581 nonagenarians. Cognitive functioning was assessed by using...

  14. The Risk of Growing Fast: Does fast growth have a negative impact on the survival rates of firms?

    NARCIS (Netherlands)

    Zhou, Haibo; van der Zwan, Peter; de Kok, Jan; Hartog, Chantal

    2012-01-01

    Fast-growing firms are considered as the central drivers of job creation in the economy. There is an abundance of literature on the separate subjects of firm growth and firm survival. However, the relationship between survival and growth is neglected. Using the Dutch Longitudinal Enterprise Database

  15. The impact of bone marrow micrometastases on metastatic disease-free survival in patients with colorectal carcinoma.

    LENUS (Irish Health Repository)

    O'Connor, O J

    2012-02-03

    AIMS: The biological relevance of bone marrow micrometastases (BMM) in colorectal cancer remains unknown. Here, we investigate their nature by examining the impact of the presence of BMM on metastatic disease-free survival in a cohort of patients with this disease. METHODS: Sixty-three consecutive patients undergoing surgery for colorectal cancer of any stage were studied after approval of the study protocol by the local ethics committee and with full individual informed consent. All had bilateral iliac crest bone marrow aspirates prior to operation. Aspirates were then examined for the presence of aberrant cytokeratin-18-positive cells by a blinded observer using both flow cytometric and APAAP immunohistochemical techniques. RESULTS: Mean follow-up after surgery was 4.6 years (range 1.9-6.9) for those without hepatic metastases at diagnosis. Seven of 34 patients with Dukes\\' stage A or B developed metastatic disease after a mean interval of 4.7 years (range 3.8-6.8). However, only 2 of these patients demonstrated BMM at the time of surgery. Nine of 15 patients with Dukes\\' C carcinoma at the time of surgery subsequently developed metastases after a mean interval of 4.4 years (range 1.9-6.9). Again, only two of these patients had BMM detectable initially. In only three of the 14 patients known to have metastases at the time of operation (i.e. Dukes\\'\\'D\\' disease) were BMM found. CONCLUSION: The presence of BMM as detected by this methodology was not predictive of tumour recurrence or metastasis. This study does not support the consideration of adjuvant therapy based on the presence of BMM at a single pre-operative time point in patients with colorectal cancer.

  16. What is the impact of bisphosphonate therapy upon dental implant survival? A systematic review and meta-analysis.

    Science.gov (United States)

    Ata-Ali, Javier; Ata-Ali, Fadi; Peñarrocha-Oltra, David; Galindo-Moreno, Pablo

    2016-02-01

    A systematic review and meta-analysis are carried out to assess the scientific evidence that bisphosphonate therapy can decrease the success rate of dental implants. The PubMed (Medline) database was used to search for articles published up until February 22, 2014. The meta-analysis was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The Newcastle-Ottawa scale (NOS) was used to assess study quality. The combinations of search terms resulted in a list of 256 titles. Fourteen finally met the inclusion criteria and were thus selected for inclusion in the systematic review. Eight studies (six retrospective and two prospective) were included in the meta-analysis, with a total of 1288 patients (386 cases and 902 controls) and 4562 dental implants (1090 dental implants in cases and 3472 in controls). The summary odds ratio (OR = 1.43, P = 0.156) indicates that there is not enough evidence that bisphosphonates have a negative impact upon implant survival. According to the number need to harm (NNH), over 500 dental implants are required in patients receiving bisphosphonate treatment to produce a single implant failure. Our results show that dental implant placement in patients receiving bisphosphonates does not reduce the dental implant success rate. On the other hand, such patients are not without complications, and risk evaluation therefore must be established on an individualized basis, as one of the most serious though infrequent complications of bisphosphonate therapy is bisphosphonate-related osteonecrosis of the jaws. Given the few studies included in our meta-analysis, further prospective studies involving larger sample sizes and longer durations of follow-up are required to confirm the results obtained. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Severe Obesity Impacts Recurrence-Free Survival of Women with High-Risk Endometrial Cancer: Results of a French Multicenter Study.

    Science.gov (United States)

    Canlorbe, Geoffroy; Bendifallah, Sofiane; Raimond, Emilie; Graesslin, Olivier; Hudry, Delphine; Coutant, Charles; Touboul, Cyril; Bleu, Géraldine; Collinet, Pierre; Darai, Emile; Ballester, Marcos

    2015-08-01

    Studies focusing on the impact of obesity on survival in endometrial cancer (EC) have reported controversial results and few data exist on the impact of obesity on recurrence rate and recurrence-free survival (RFS). The aim of this study was to assess the impact of obesity on surgical staging and RFS in EC according to the European Society of Medical Oncology (ESMO) risk groups. Data of 729 women with EC who received primary surgical treatment between January 2000 and December 2012 were abstracted from a multicenter database. RFS distributions according to body mass index (BMI) in each ESMO risk group were estimated using the Kaplan-Meier method. Survival was evaluated using the log-rank test, and the Cox proportional hazards model was used to determine influence of multiple variables. Distribution of the 729 women with EC according to BMI was BMI obese women in the low-/intermediate-risk groups, but a BMI ≥ 35 was independently correlated to a poorer RFS (hazard ratio 12.5; 95 % confidence interval 3.1-51.3) for women in the high-risk group. Severe obesity negatively impacts RFS in women with high-risk EC, underlining the importance of complete surgical staging and adapted adjuvant therapies in this subgroup of women.

  18. The impact of television fiction on public expectations of survival following inhospital cardiopulmonary resuscitation by medical professionals.

    Science.gov (United States)

    Van den Bulck, Jan J M

    2002-12-01

    Research has shown that the public overestimates the survival chances of patients after cardiopulmonary resuscitation. Other studies have suggested that demonstrably exaggerated survival rates in medical television fiction might affect these estimates. Such studies were mostly conducted in the United States, dealt with cardiopulmonary resuscitation in general, and asked respondents to indicate their source of medical information, an unreliable survey technique. To examine whether public perceptions of survival after inhospital cardiopulmonary resuscitation by physicians and nurses is related to the consumption of medical drama, without relying on respondents' self-reports of what influences them. To examine whether training in basic cardiopulmonary resuscitation techniques mediates this relationship. A random sample of 820 third and fifth year secondary school students completed a questionnaire in which they indicated their consumption of medical television fiction, their practical knowledge of cardiopulmonary resuscitation techniques, and their estimates of the survival rate after inhospital cardiopulmonary resuscitation. A relationship was found between the consumption of medical television drama and higher estimates of cardiopulmonary resuscitation survival. Practical knowledge of cardiopulmonary resuscitation also resulted in increased estimated survival rates. An interaction effect of drama and practical knowledge was found. Respondents with practical knowledge were less affected by television. The consumption of medical television drama is related to overestimating survival chances after inhospital resuscitation by physicians and nurses following cardiopulmonary arrest. A practical knowledge of basic cardiopulmonary resuscitation techniques moderates but does not eliminate the television effect.

  19. Discovery of Two New Hypervelocity Stars from the LAMOST Spectroscopic Surveys

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Y.; Liu, X.-W.; Chen, B.-Q. [South-Western Institute for Astronomy Research, Yunnan University, Kunming 650500 (China); Zhang, H.-W.; Wang, C.; Tian, Z.-J. [Department of Astronomy, Peking University, Beijing 100871 (China); Xiang, M.-S.; Li, Y.-B. [Key Laboratory of Optical Astronomy, National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012 (China); Yuan, H.-B. [Department of Astronomy, Beijing Normal University, Beijing 100875 (China); Wang, B., E-mail: yanghuang@pku.edu.cn, E-mail: x.liu@pku.edu.cn, E-mail: zhanghw@pku.edu.cn [Key Laboratory for the Structure and Evolution of Celestial Objects, Yunnan Observatories, CAS, Kunming 650216 (China)

    2017-09-20

    We report the discovery of two new unbound hypervelocity stars (HVSs) from the LAMOST spectroscopic surveys. They are, respectively, a B2V-type star of ∼7 M {sub ⊙} with a Galactic rest-frame radial velocity of 502 km s{sup −1} at a Galactocentric radius of ∼21 kpc and a B7V-type star of ∼4 M {sub ⊙} with a Galactic rest-frame radial velocity of 408 km s{sup −1} at a Galactocentric radius of ∼30 kpc. The origins of the two HVSs are not clear given their currently poorly measured proper motions. However, the future data releases of Gaia should provide proper motion measurements accurate enough to solve this problem. The ongoing LAMOST spectroscopic surveys are expected to yield more HVSs to form a statistical sample, providing vital constraints on understanding the nature of HVSs and their ejection mechanisms.

  20. The impact of the Catechol-O-methyltransferase Val158Met polymorphism on survival in the general population – the HUNT study

    Directory of Open Access Journals (Sweden)

    Skorpen Frank

    2007-06-01

    Full Text Available Abstract Background The catechol-O-methyltransferase (COMT gene contains a functional polymorphism, Val158Met which has been related to common diseases like cancer, psychiatric illness and myocardial infarction. Whether the Val158Met polymorphism is associated with survival has not been evaluated in the general population. The aim of this prospective study was to evaluate the impact of codon 158 COMT gene polymorphism on survival in a population-based cohort. Methods The sample comprised 2979 non-diabetic individuals who participated in the Nord-Trøndelag Health Study (HUNT in the period 1995–97. The subjects were followed up with respect to mortality throughout year 2004. Results 212 men and 183 women died during the follow up. No association between codon 158 COMT gene polymorphism and survival was found. The unadjusted relative risk of death by non-ischemic heart diseases with Met/Met or Met/Val genotypes was 3.27 (95% confidence interval, 1.19–9.00 compared to Val/Val genotype. When we adjusted for age, gender, smoking, coffee intake and body mass index the relative risk decreased to 2.89 (95% confidence interval, 1.04–8.00. Conclusion During 10 year of follow-up, the Val158Met polymorphism had no impact on survival in a general population. Difference in mortality rates from non-ischemic heart diseases may be incidental and should be evaluated in other studies.

  1. Does Type of Tumor Histology Impact Survival among Patients with Stage IIIB/IV Non-Small Cell Lung Cancer Treated with First-Line Doublet Chemotherapy?

    Science.gov (United States)

    Clements, Karen M.; Peltz, Gerson; Faries, Douglas E.; Lang, Kathleen; Nyambose, Joshua; Earle, Craig C.; Sugarman, Katherine P.; Taylor, Douglas C. A.; Thompson, David; Marciniak, Martin D.

    2010-01-01

    Chemotherapy regimens may have differential efficacy by histology in nonsmall cell lung cancer (NSCLC). We examined the impact of histology on survival of patients (N = 2,644) with stage IIIB/IV NSCLC who received first-line cisplatin/carboplatin plus gemcitabine (C/C+G) and cisplatin/carboplatin plus a taxane (C/C+T) identified retrospectively in the SEER cancer registry (1997–2002). Patients with squamous and nonsquamous cell carcinoma survived 8.5 months and 8.1 months, respectively (P = .018). No statistically significant difference was observed in survival between C/C+G and C/C+T in both histologies. Adjusting for clinical and demographic characteristics, the effect of treatment regimen on survival did not differ by histology (P for interaction = .257). There was no statistically significant difference in hazard of death by histology in both groups. These results contrast the predictive role of histology and improved survival outcomes observed for cisplatin-pemetrexed regimens in advanced nonsquamous NSCLC. PMID:22482053

  2. Does Type of Tumor Histology Impact Survival among Patients with Stage IIIB/IV Non-Small Cell Lung Cancer Treated with First-Line Doublet Chemotherapy?

    Directory of Open Access Journals (Sweden)

    Karen M. Clements

    2010-01-01

    Full Text Available Chemotherapy regimens may have differential efficacy by histology in nonsmall cell lung cancer (NSCLC. We examined the impact of histology on survival of patients (N=2,644 with stage IIIB/IV NSCLC who received first-line cisplatin/carboplatin plus gemcitabine (C/C+G and cisplatin/carboplatin plus a taxane (C/C+T identified retrospectively in the SEER cancer registry (1997–2002. Patients with squamous and nonsquamous cell carcinoma survived 8.5 months and 8.1 months, respectively (P=.018. No statistically significant difference was observed in survival between C/C+G and C/C+T in both histologies. Adjusting for clinical and demographic characteristics, the effect of treatment regimen on survival did not differ by histology (P for interaction =.257. There was no statistically significant difference in hazard of death by histology in both groups. These results contrast the predictive role of histology and improved survival outcomes observed for cisplatin-pemetrexed regimens in advanced nonsquamous NSCLC.

  3. Markers of fibroblast-rich tumor stroma and perivascular cells in serous ovarian cancer: Inter- and intra-patient heterogeneity and impact on survival

    OpenAIRE

    Corvigno, Sara; Wisman, G Bea A; Mezheyeuski, Artur; van der Zee, Ate G.J.; Nijman, Hans W; Avall-Lundqvist, Elisabeth; Ostman, Arne; Dahlstrand, Hanna

    2016-01-01

    Inter- and intra-patient variations in tumor microenvironment of serous ovarian cancer are largely unexplored. We aimed to explore potential co-regulation of tumor stroma characteristics, analyze their concordance in primary and metastatic lesions, and study their impact on survival. A tissue microarray (TMA) with 186 tumors and 91 matched metastases was subjected to immunohistochemistry double staining with endothelial cell marker CD34 and fibroblast and pericyte markers alpha-SMA, PDGF beta...

  4. Impact of hypotension after return of spontaneous circulation on survival in patients of out-of-hospital cardiac arrest.

    Science.gov (United States)

    Chiu, Yu Koon; Lui, Chun Tat; Tsui, Kwok Leung

    2018-01-01

    To investigate the relationship between hypotension in the first 3h after return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest. This retrospective cohort study occurred at two regional hospitals and included adult OHCA patients who experienced ROSC from July 1, 2014 to December 31, 2015. Hemodynamic and inotrope administration data were retrieved for 3h after ROSC. We calculated the hypotensive exposure index (HEI) as the surrogate marker of the exposure of hypotension. The area under the ROC curve and multivariate logistic regression models were performed to analyze the effect of HEI on survival. Mean arterial pressure (MAP) was explored in the surviving and non-surviving patient groups using repeated measures MANCOVA, adjusted for the use of inotropes and down time. A total of 289 patients were included in the study, and 29 survived. The median 1-hour HEI and 3-hour HEI were significantly lower in the survival group (pMANCOVA indicated that an interaction existed between post-ROSC time and downtime [F(5,197)=2.31, p=0.046]. No significant change in the MAP was observed in the 3h after ROSC, except in the group with a prolonged down time. According to the tests examining the effects of the use of inotropes on the survival outcomes of the different subjects, the MAP was significantly higher in the surviving group [F(1,201)=4.11; p=0.044; ηp2=0.020]. Among the patients who experienced ROSC after OHCA, post-ROSC hypotension was an independent predictor of survival. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Impact of collaborative care on survival time for dogs with congestive heart failure and revenue for attending primary care veterinarians.

    Science.gov (United States)

    Lefbom, Bonnie K; Peckens, Neal K

    2016-07-01

    OBJECTIVE To assess the effects of in-person collaborative care by primary care veterinarians (pcDVMs) and board-certified veterinary cardiologists (BCVCs) on survival time of dogs after onset of congestive heart failure (CHF) and on associated revenue for the attending pcDVMs. DESIGN Retrospective cohort study. ANIMALS 26 small-breed dogs treated for naturally occurring CHF secondary to myxomatous mitral valve disease at a multilocation primary care veterinary hospital between 2008 and 2013. PROCEDURES Electronic medical records were reviewed to identify dogs with confirmed CHF secondary to myxomatous mitral valve disease and collect information on patient care, survival time, and pcDVM revenue. Data were compared between dogs that received collaborative care from the pcDVM and a BCVC and dogs that received care from the pcDVM alone. RESULTS Dogs that received collaborative care had a longer median survival time (254 days) than did dogs that received care from the pcDVM alone (146 days). A significant positive correlation was identified between pcDVM revenue and survival time for dogs that received collaborative care (ie, the longer the dog survived, the greater the pcDVM revenue generated from caring for that patient). CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that collaborative care provided to small-breed dogs with CHF by a BCVC and pcDVM could result in survival benefits for affected dogs and increased revenue for pcDVMs, compared with care provided by a pcDVM alone.

  6. Impact on survival of the number of lymph nodes resected in patients with lymph node-negative gastric cancer.

    Science.gov (United States)

    Chu, Xiaoyuan; Yang, Zhong-Fa

    2015-06-01

    Patients with lymph node-negative gastric cancer show a better overall survival rate than those who have a pathological lymph node-positive gastric cancer. But a large number of patients still develop recurrence. We aimed to explore the significant prognostic factors of lymph node-negative gastric cancer and determine how many lymph nodes should be removed. A total of 3103 patients who underwent radical operation are identified from the Surveillance, Epidemiology, and End Results database. Standard survival methods and restricted multivariable Cox regression models were applied. The overall survival rate was significantly higher with an increasing number of negative lymph node resected. Among the 843 patients who had the exact T stage, the overall survival rate was significantly better in T3-4 group with more than 15 lymph nodes resected (P patients (P = 0.44). A further 25 more lymph nodes resection did not show additional survival benefits. Multivariate analysis of patients demonstrated that age, depth of tumor invasion, and the number of lymph nodes resected were the significant and independent prognostic factors. A lymphadenectomy with more than 15 lymph nodes removal should be performed for T3-4 lymph node-negative gastric cancer. But the survival benefit of a lymphadenectomy with more than 25 lymph nodes removal is disputed. And the further treatment should refer to the prognostic indicators.

  7. Anaplastic astrocytoma: prognostic factors and survival in 4807 patients with emphasis on receipt and impact of adjuvant therapy.

    Science.gov (United States)

    Shin, Jacob Y; Diaz, Aidnag Z

    2016-09-01

    To determine the receipt and impact of adjuvant therapy on overall survival (OS) for anaplastic astrocytoma (AA). Data were extracted from the National Cancer Data Base (NCDB). Chi square test, Kaplan-Meier method, and Cox regression models were employed in SPSS 22.0 (Armonk, NY: IBM Corp.) for data analyses. 4807 patients with AA diagnosed from 2004 to 2013 who underwent surgery were identified. 3243 (67.5 %) received adjuvant chemoRT, 525 (10.9 %) adjuvant radiotherapy (RT) alone, 176 (3.7 %) adjuvant chemotherapy alone and 863 (18.0 %) received no adjuvant therapy. Patients were more likely to receive adjuvant chemoRT if they were diagnosed in 2009-2013 (p = 0.022), were ≤ 50 years (p < 0.001), were male (p = 0.043), were Asian or White race (p < 0.001), had private insurance (p < 0.001), had income ≥$38,000 (p < 0.001), or underwent total resection (p < 0.003). Those who received adjuvant chemoRT had significantly better 5-year OS than the other adjuvant treatment types (41.8 % vs. 31.2 % vs. 29.8 % vs. 27.4 %, p < 0.001). This significant 5-year OS benefit was also observed regardless of age at diagnosis. Of those undergoing adjuvant chemoRT, those receiving ≥59.4 Gy had significantly better 5-year OS than those receiving <59.4 Gy (44.4 % vs. 25.9 %, p < 0.001). There was no significant difference in OS when comparing 59.4 Gy to higher RT doses. On multivariate analysis, receipt of adjuvant chemoRT, age at diagnosis, extent of disease, and insurance status were independent prognostic factors for OS. Adjuvant chemoRT is an independent prognostic factor for improved OS in AA and concomitant chemoRT should be considered for all clinically suitable patients who have undergone surgery for the disease.

  8. Risk of pneumonia and urinary tract infection within the first week after total hip arthroplasty and the impact on survival

    Directory of Open Access Journals (Sweden)

    Glassou EN

    2017-01-01

    Full Text Available Eva N Glassou,1,2 Torben B Hansen,1,3 Alma B Pedersen2 1University Clinic of Hand, Hip and Knee Surgery, Department of Orthopedic Surgery, Regional Hospital West Jutland, Aarhus University, 2Department of Clinical Epidemiology, Aarhus University Hospital, 3The Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement, Aarhus University, Aarhus, Denmark Background: Pneumonia and urinary tract infections (UTIs increase morbidity and mortality. There is little epidemiological evidence from large population-based studies on risk factors for these infections and subsequent mortality in total hip arthroplasty (THA patients.Aim: To examine the risk factors of postoperative pneumonia and UTI after THA and their impact on survival.Patients and methods: We used the Danish Hip Arthroplasty Register to identify THAs due to osteoarthritis registered from 2000 to 2013. We collected data about comorbidities, mortality and infections in relation to primary hospitalization and potential predictive variables from administrative databases. Regression models were used to estimate associations between potential risk factors and infection, and subsequently, between infection and mortality.Results: In total 84,812 THAs were included. The cumulative incidence of pneumonia and UTI within 7 days of the primary procedure were 0.21 (95% confidence interval [CI]: 0.18–0.25 and 0.29 (95% CI: 0.26–0.33, respectively. Patient-related risk factors for infection were being 80 years or older, gender and a comorbidity burden at time of surgery. The hazard ratio (HR of dying within 90 days of the primary THA was 10.67 (95% CI: 5.79–19.57 compared to patients without pneumonia. For patients with UTIs, the HR was 1.64 (95% CI: 0.41–6.59 compared to those without a UTI.Conclusion: Pneumonia was associated with an increased short-term risk of dying, despite adjustment for coexisting comorbidity and other potential confounders. Age, gender and comorbidity were the most

  9. Impact of Celiac Plexus Neurolysis on Survival in Patients with Unresectable Pancreatic Cancer: A Retrospective, Propensity Score Matching Analysis.

    Science.gov (United States)

    Oh, Tak Kyu; Lee, Woo Jin; Woo, Sang Myung; Kim, Nam Woo; Yim, Jiyeon; Kim, Dae Hyun

    2017-03-01

    Pain caused by pancreatic cancer (PC) is difficult to control. Celiac plexus neurolysis (CPN) can effectively control the pain and reduce the use of opioids. However, the effect of CPN on survival for patients with unresectable PC remains controversial. To determine if CPN is associated with survival benefits for these patients. Retrospective, observational cohort study. National Cancer Center in Korea. The CPN group included patients who were diagnosed with unresectable PC and underwent fluoroscopically guided bilateral CPN (10 mL dehydrated alcohol each side) once between January 1, 2006, and December 31, 2013. Patients with PC who did not undergo CPN were in the control group; for the final control group, 1:1 propensity score (PS) matching was conducted with the CPN group. The main outcome was median survival (PC diagnosis to death) after PS matching, assessed using Kaplan-Meier curves. For the primary overall survival analysis, the CPN and control groups included 110 and 258 patients, respectively. The median survival period was not significantly different between the CPN and control groups (278 vs. 203 days, P = 0.246), even after PS matching (278 vs. 180 days, P = 0.127), or based on time to CPN from diagnosis (≤ 6 vs. > 6 months; 255 vs. 310 days, P = 0.147). Retrospective design, small sample size, and inconsistent timing of CPN after the diagnosis date. CPN did not affect survival for patients with unresectable PC. Considering the limitations of the retrospective design, a well-designed prospective design study should be conducted.Key words: Celiac plexus, pancreatic neoplasms, survival, neurolysis, pain, propensity score matching, opioids, cancer.

  10. REVEAL risk scores applied to riociguat-treated patients in PATENT-2: Impact of changes in risk score on survival.

    Science.gov (United States)

    Benza, Raymond L; Farber, Harrison W; Frost, Adaani; Ghofrani, Hossein-Ardeschir; Gómez-Sánchez, Miguel A; Langleben, David; Rosenkranz, Stephan; Busse, Dennis; Meier, Christian; Nikkho, Sylvia; Hoeper, Marius M

    2017-11-11

    The Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL) risk score (RRS) calculator was developed using data derived from the REVEAL registry, and predicts survival in patients with pulmonary arterial hypertension (PAH) based on multiple patient characteristics. Herein we applied the RRS to a pivotal PAH trial database, the 12-week PATENT-1 and open-label PATENT-2 extension studies of riociguat. We examined the effect of riociguat vs placebo on RRS in PATENT-1, and investigated the prognostic implications of change in RRS during PATENT-1 on long-term outcomes in PATENT-2. RRS was calculated post hoc for baseline and Week 12 of PATENT-1, and Week 12 of PATENT-2. Patients were grouped into risk strata by RRS. Kaplan-Meier estimates were made for survival and clinical worsening-free survival in PATENT-2 to evaluate the relationship between RRS in PATENT-1 and long-term outcomes in PATENT-2. A total of 396 patients completed PATENT-1 and participated in PATENT-2. In PATENT-1, riociguat significantly improved RRS (p = 0.031) and risk stratum (p = 0.018) between baseline and Week 12 compared with placebo. RRS at baseline, and at PATENT-1 Week 12, and change in RRS during PATENT-1 were significantly associated with survival (hazard ratios for a 1-point reduction in RRS: 0.675, 0.705 and 0.804, respectively) and clinical worsening-free survival (hazard ratios of 0.736, 0.716 and 0.753, respectively) over 2 years in PATENT-2. RRS at baseline and Week 12, and change in RRS, were significant predictors of both survival and clinical worsening-free survival. These data support the long-term predictive value of the RRS in a controlled study population. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. The impact of vacuum-assisted closure on long-term survival after post-sternotomy mediastinitis.

    Science.gov (United States)

    Sjögren, Johan; Nilsson, Johan; Gustafsson, Ronny; Malmsjö, Malin; Ingemansson, Richard

    2005-10-01

    Post-sternotomy mediastinitis after coronary artery bypass grafting is reported to be a strong predictor for poor late survival when using conventional wound-healing therapies. The aim of this study was to compare the long-term survival after vacuum-assisted closure treated mediastinitis following coronary artery bypass grafting with that of patients without mediastinitis. Another objective was to identify risk factors for developing mediastinitis. Forty-six patients were treated for mediastinitis, with vacuum-assisted closure but without additional tissue flaps, after isolated coronary bypass grafting between January 1999 and September 2004. During this period, 4,781 patients underwent isolated coronary bypass grafting without mediastinitis. Actuarial survival was compared with the log-rank test. Univariate and multivariate analysis were used to identify risk factors for mediastinitis. There was no difference in early or late survival between the mediastinitis group treated with vacuum-assisted closure and the control group (p = not significant). The survival at 1, 3, and 5 years was 92.9% +/- 4.0%, 89.2% +/- 5.2%, and 89.2% +/- 5.2%, respectively, in the vacuum-assisted closure group; and 96.5% +/- 0.3%, 92.1% +/- 0.5%, and 86.9% +/- 0.8%, respectively, in the control group. Diabetes mellitus, low left ventricular ejection fraction, obesity, renal failure, and three-vessel disease were identified as risk factors for developing mediastinitis. This study suggests that patients with vacuum-assisted closure treated mediastinitis may have similar long-term survival as patients without mediastinitis after coronary artery bypass grafting. The independent risk factors identified were similar to those found in previous studies. Our data support that vacuum-assisted closure therapy minimizes the negative effects of mediastinitis on late survival after coronary artery bypass grafting.

  12. Cluster-randomized study of intermittent preventive treatment for malaria in infants (IPTi in southern Tanzania: evaluation of impact on survival

    Directory of Open Access Journals (Sweden)

    Schellenberg Joanna

    2011-12-01

    Full Text Available Abstract Background Intermittent Preventive Treatment for malaria control in infants (IPTi consists of the administration of a treatment dose of an anti-malarial drug, usually sulphadoxine-pyrimethamine, at scheduled intervals, regardless of the presence of Plasmodium falciparum infection. A pooled analysis of individually randomized trials reported that IPTi reduced clinical episodes by 30%. This study evaluated the effect of IPTi on child survival in the context of a five-district implementation project in southern Tanzania. [Trial registration: clinical trials.gov NCT00152204]. Methods After baseline household and health facility surveys in 2004, five districts comprising 24 divisions were randomly assigned either to receive IPTi (n = 12 or not (n = 12. Implementation started in March 2005, led by routine health services with support from the research team. In 2007, a large household survey was undertaken to assess the impact of IPTi on survival in infants aged two-11 months through birth history interviews with all women aged 13-49 years. The analysis is based on an "intention-to-treat" ecological design, with survival outcomes analysed according to the cluster in which the mothers lived. Results Survival in infants aged two-11 months was comparable in IPTi and comparison areas at baseline. In intervention areas in 2007, 48% of children aged 12-23 months had documented evidence of receiving three doses of IPTi, compared to 2% in comparison areas (P P = 0.31. Conclusion The lack of evidence of an effect of IPTi on survival could be a false negative result due to a lack of power or imbalance of unmeasured confounders. Alternatively, there could be no mortality impact of IPTi due to low coverage, late administration, drug resistance, decreased malaria transmission or improvements in vector control and case management. This study raises important questions for programme evaluation design.

  13. Hypervelocity launchers

    CERN Document Server

    Igra, Ozer

    2016-01-01

    In the present volume numerous descriptions of Ram accelerators are presented. These descriptions provide good overview on the progress made and the present state of the Ram accelerator technology worldwide.  In addition, articles describing light gas gun, ballistic range including a chapter dealing with shock waves in solids are given. Along with the technical description of considered facilities, samples of obtained results are also included. Each chapter is written by an expert in the described topic providing a comprehensive description of the discussed phenomena.  .

  14. [Survival and impact of bronchiolitis obliterans syndrome after lung transplantation at the Academic Hospital Groningen, 1990/'98].

    Science.gov (United States)

    van den Berg, J W; van der Bij, W; de Boer, W J; Postma, D S; Timens, W; Koëter, G H

    1999-10-30

    To describe the results of the lung transplantation programme in Groningen in relation to the bronchiolitis obliterans syndrome (BOS), in the first 118 consecutive patients. Retrospective. Data were collected on the 118 patients subjected to lung transplantation in November 1990 to June 1998 in the University Hospital Groningen, the Netherlands, regarding the prevalence of chronic transplant dysfunction (BOS) and survival. 117 lung transplantations (95 bilateral lung transplantations including 2 retransplants, and 22 single lung transplantations) and 1 heart-lung transplantation had been performed. The patients were 70 males and 48 females with a mean age of 42 years (range: 9-64). The mean (SD) survival at 1, 2, 3 and 5 years post transplantation was 83% (3), 70% (4), 66% (5) and 61% (5) respectively. The median survival amounted to 2447 days. The mean (SD) prevalence of BOS at respectively 1, 2, 3 and 5 years post transplantation was 32% (5), 36% (5), 44% (5) en 54% (6). After a diagnosis of BOS stage I the median survival was 649 days. The survival of the lung transplant programme of the University Hospital Groningen is considered to compare favourably with other centres. The prevalence of BOS is considerable, and comparable with the prevalence of BOS reported by other programmes. BOS is associated with a decreased life expectancy.

  15. Impact of Intraluminal Brachytherapy on Survival Outcome for Radiation Therapy for Unresectable Biliary Tract Cancer: A Propensity-Score Matched-Pair Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Yoshioka, Yasuo [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Ogawa, Kazuhiko, E-mail: kogawa@radonc.med.osaka-u.ac.jp [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Oikawa, Hirobumi [Department of Radiology, Iwate Medical University, Iwate (Japan); Onishi, Hiroshi [Department of Radiology, University of Yamanashi, Yamanashi (Japan); Kanesaka, Naoto [Department of Radiology, Tokyo Medical University, Tokyo (Japan); Tamamoto, Tetsuro [Department of Radiation Oncology, Nara Medical University of Medicine, Nara (Japan); Kosugi, Takashi [Department of Radiology, Hamamatsu University School of Medicine, Shizuoka (Japan); Hatano, Kazuo [Department of Radiation Oncology, Chiba Cancer Center, Chiba (Japan); Kobayashi, Masao [Department of Radiology, Jikei University School of Medicine, Tokyo (Japan); Ito, Yoshinori [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Takayama, Makoto [Department of Radiology, Kyorin University School of Medicine, Tokyo (Japan); Takemoto, Mitsuhiro [Department of Radiology, Okayama University, Okayama (Japan); Karasawa, Katsuyuki [Department of Radiation Oncology, Tokyo Metropolitan Komagome Hospital, Tokyo (Japan); Nagakura, Hisayasu [Department of Radiology, KKR Sapporo Medical Center, Hokkaido (Japan); Imai, Michiko [Department of Radiation Oncology, Iwata City Hospital, Shizuoka (Japan); Kosaka, Yasuhiro [Department of Radiation Oncology, Kobe City Medical Center General Hospital, Hyogo (Japan); Yamazaki, Hideya [Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto (Japan); Isohashi, Fumiaki [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Nemoto, Kenji [Department of Radiation Oncology, Yamagata University, Yamagata (Japan); Nishimura, Yasumasa [Department of Radiation Oncology, Kinki University Faculty of Medicine, Osaka (Japan)

    2014-07-15

    Purpose: To determine whether adding intraluminal brachytherapy (ILBT) to definitive radiation therapy (RT) for unresectable biliary tract cancer has a positive impact on survival outcome. Methods and Materials: The original cohort comprised 209 patients, including 153 who underwent external beam RT (EBRT) alone and 56 who received both ILBT and EBRT. By matching propensity scores, 56 pairs (112 patients) consisting of 1 patient with and 1 patient without ILBT were selected. They were well balanced in terms of sex, age, performance status, clinical stage, jaundice, and addition of chemotherapy. The impact of ILBT on overall survival (OS), disease-specific survival (DSS), and local control (LC) was investigated. Results: The 2-year OS rates were 31% for the ILBT+ group and 40% for theILBT– group (P=.862). The 2-year DSS rates were 42% for the ILBT+ group and 41% for the ILBT– group (P=.288). The 2-year LC rates were 65% for the ILBT+ group and 35% for the ILBT– group (P=.094). Three of the 4 sensitivity analyses showed a significantly better LC for the ILBT+ group (P=.010, .025, .049), and another showed a marginally better LC (P=.068), and none of the sensitivity analyses showed any statistically significant differences in OS or DSS. Conclusions: In the treatment for unresectable biliary tract cancer, the addition of ILBT to RT has no impact on OS or DSS but is associated with better LC. Therefore, the role of ILBT should be addressed by other measures than survival benefit, for example, by less toxicity, prolonged biliary tract patency decreasing the need for further palliative interventions, or patient quality of life.

  16. G80A Single Nucleotide Polymorphism in Reduced Folate Carrier-1 Gene in a Mexican Population and its Impact on Survival in Patients with Acute Lymphoblastic Leukemia.

    Science.gov (United States)

    Candelaria, Myrna; Ojeda, Juan; Gutiérrez-Hernández, Olga; Taja-Chayeb, Lucia; Vidal-Millán, Silvia; Dueñas-González, Alfonso

    2016-01-01

    Hyper-CVAD is the treatment for patients with acute lymphoblastic leukemia in our institution. To evaluate the impact of single nucleotide polymorphisms at genes associated with methotrexate metabolism on survival. The presence of the single nucleotide polymorphisms G80A at reduced folate carrier-1 gene and C677T in the methylenetetrahydrofolate reductase gene was determined by denaturing high performance liquid chromatography and validated by sequencing. Both single nucleotide polymorphisms were evaluated in 71 healthy donors and in an exploratory pilot trial with acute lymphoblastic leukemia patients to determine the influence of these single nucleotide polymorphisms on clinical outcome. Clinical characteristics, response, and outcome were registered. A Cox regression analysis was done to evaluate factors influencing response and overall survival. There were no differences in the frequency of single nucleotide polymorphisms between volunteers and acute lymphoblastic leukemia patients according to the Hardy-Weinberg test. Sensitivity and specificity were 72 and 91% for the G80A, and 64 and 75% for the C677T, respectively. The multivariate analysis showed that the T-immunophenotype and the presence of single nucleotide polymorphism G80A reduced folate carrier-1 were associated with a shorter relapse-free survival and overall survival. The presence of G80A single nucleotide polymorphism at reduced folate carrier-1 gene in acute lymphoblastic leukemia patients was associated with a poorer prognosis.

  17. The impact of glucocorticosteroids administered for systemic diseases on the osseointegration and survival of dental implants placed without bone grafting-A retrospective study in 31 patients.

    Science.gov (United States)

    Petsinis, Vassilis; Kamperos, Georgios; Alexandridi, Foteini; Alexandridis, Konstantinos

    2017-08-01

    To evaluate the impact of glucocorticosteroids, administered for the treatment of systemic diseases, on the osseointegration and survival of dental implants placed without bone grafting. A retrospective study was conducted in search of patients treated with dental implants while receiving glucocorticosteroid therapy for various systemic diseases. In these cases, a conventional two-stage surgical protocol was used, without bone regeneration procedures. The osseointegration was clinically and radiographically tested at the uncovering of the implants. The follow-up after loading was set at a minimum of 3 years. A total of 31 patients were included in the study. Of the 105 dental implants placed, 104 were osseointegrated (99%). No bone absorption was radiographically noted at the uncovering of the osseointegrated implants. All of the osseointegrated implants were successfully loaded for the prosthetic restoration. The mean follow-up period after loading was 71 months, with an implant survival rate of 99%. Glucocorticosteroid intake for systemic diseases does not have a significant impact on the osseointegration and the 3-year survival of dental implants placed with a conventional two-stage surgical protocol and without bone grafting. Therefore, it should not be considered a contraindication for dental implant placement. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Impact of marital status at diagnosis on survival and its change over time between 1973 and 2012 in patients with nasopharyngeal carcinoma: a propensity score-matched analysis.

    Science.gov (United States)

    Xu, Cheng; Liu, Xu; Chen, Yu-Pei; Mao, Yan-Ping; Guo, Rui; Zhou, Guan-Qun; Tang, Ling-Long; Lin, Ai-Hua; Sun, Ying; Ma, Jun

    2017-12-01

    The impact of marital status at diagnosis on survival outcomes and its change over time in patients with nasopharyngeal carcinoma (NPC) are unclear. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients diagnosed with NPC in the United States from 1973 to 2012. A primary comparison (married vs. unmarried) was implemented with 1:1 propensity score matching. Secondary comparisons were performed individually between three unmarried subgroups (single, separated/divorced, widowed) and married group. The effect of marital status on cause-specific survival (CSS) and overall survival (OS) were evaluated using univariate/multivariate analysis. Moreover, we investigated the change over time (1973-2012) in the effect of marital status on NPC survival. Married patients had better 5-year CSS/OS than unmarried patients (61.1% vs. 52.6%, P < 0.001; 55.6% vs. 45.3%, P < 0.001, respectively). In multivariate analysis, unmarried patients had significantly poorer CSS/OS than married patients (adjusted hazard ratio [aHR] = 1.35, P < 0.001; aHR = 1.40, P < 0.001, respectively). The survival benefit of being married was only detected in non-Hispanic white and Chinese American patients. Single, separated/divorced, and widowed patients had significantly poorer CSS/OS than married patients (aHR = 1.37 and 1.37; 1.46 and 1.42; 1.43 and 1.48, respectively; all P < 0.001). The change over time in the effect of marital status on survival was more stable in male than female. The strength of the negative effect of separated/divorced and widowed status showed a downward and upward trend, respectively. Gender difference in the adverse effect of single status on NPC survival became smaller over time. Only non-Hispanic white and Chinese American patients with NPC obtain survival benefits from married status. Single and widowed patients are regarded as high-risk population. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  19. Proof-Carrying Survivability

    Science.gov (United States)

    2013-01-15

    pp.289-302 ( Impact factor : 2.09). 2. Julic, J. and Zuo, Y. (2012). “An RFID Survivability Impact Model in the Military Domain”, Proc. of 18 th...Availability, Reliability and Security, 40(4), pp. 406-418 ( Impact factor : 2.016). 10. Zuo, Y. (2010). “A Holistic Approach for Specification of Security... Impact factor : 1.596). 20. Zuo, Y., Pimple, M. and Lande, S. (2009). “A Framework for RFID Survivability Requirement Analysis and Specification”, Proc

  20. Sex-specific early survival drives adult sex ratio bias in snowy plovers and impacts mating system and population growth.

    Science.gov (United States)

    Eberhart-Phillips, Luke J; Küpper, Clemens; Miller, Tom E X; Cruz-López, Medardo; Maher, Kathryn H; Dos Remedios, Natalie; Stoffel, Martin A; Hoffman, Joseph I; Krüger, Oliver; Székely, Tamás

    2017-07-03

    Adult sex ratio (ASR) is a central concept in population biology and a key factor in sexual selection, but why do most demographic models ignore sex biases? Vital rates often vary between the sexes and across life history, but their relative contributions to ASR variation remain poorly understood-an essential step to evaluate sex ratio theories in the wild and inform conservation. Here, we combine structured two-sex population models with individual-based mark-recapture data from an intensively monitored polygamous population of snowy plovers. We show that a strongly male-biased ASR (0.63) is primarily driven by sex-specific survival of juveniles rather than adults or dependent offspring. This finding provides empirical support for theories of unbiased sex allocation when sex differences in survival arise after the period of parental investment. Importantly, a conventional model ignoring sex biases significantly overestimated population viability. We suggest that sex-specific population models are essential to understand the population dynamics of sexual organisms: reproduction and population growth are most sensitive to perturbations in survival of the limiting sex. Overall, our study suggests that sex-biased early survival may contribute toward mating system evolution and population persistence, with implications for both sexual selection theory and biodiversity conservation.

  1. Sex-specific early survival drives adult sex ratio bias in snowy plovers and impacts mating system and population growth

    Science.gov (United States)

    Küpper, Clemens; Miller, Tom E. X.; Cruz-López, Medardo; Maher, Kathryn H.; dos Remedios, Natalie; Stoffel, Martin A.; Hoffman, Joseph I.; Krüger, Oliver; Székely, Tamás

    2017-01-01

    Adult sex ratio (ASR) is a central concept in population biology and a key factor in sexual selection, but why do most demographic models ignore sex biases? Vital rates often vary between the sexes and across life history, but their relative contributions to ASR variation remain poorly understood—an essential step to evaluate sex ratio theories in the wild and inform conservation. Here, we combine structured two-sex population models with individual-based mark–recapture data from an intensively monitored polygamous population of snowy plovers. We show that a strongly male-biased ASR (0.63) is primarily driven by sex-specific survival of juveniles rather than adults or dependent offspring. This finding provides empirical support for theories of unbiased sex allocation when sex differences in survival arise after the period of parental investment. Importantly, a conventional model ignoring sex biases significantly overestimated population viability. We suggest that sex-specific population models are essential to understand the population dynamics of sexual organisms: reproduction and population growth are most sensitive to perturbations in survival of the limiting sex. Overall, our study suggests that sex-biased early survival may contribute toward mating system evolution and population persistence, with implications for both sexual selection theory and biodiversity conservation. PMID:28634289

  2. Impact of renal allograft nephrectomy on graft and patient survival following retransplantation: a systematic review and meta-analysis.

    Science.gov (United States)

    Lin, Jinwen; Wang, Rending; Xu, Ying; Chen, Jianghua

    2018-02-12

    It is not clear whether renal allograft removal affects the outcome of renal retransplantation. This study aimed to determine the effect of allograft nephrectomy (AN) and no-AN (No AN) on renal retransplantation. A systematic review and meta-analysis were conducted using MEDLINE, Embase and the Cochrane Library. Observational studies or randomized controlled trials including renal retransplantation recipients with AN or No-AN were included. The primary outcomes were graft survival, patient survival, acute rejection (AR) and delayed graft dysfunction; the secondary outcomes were positive panel reactive antibody rate and serum creatinine level at 1 year after retransplantation, cold ischemia time and time of hemodialysis before recent transplantation. Pooled estimates of odds ratios (ORs) and the weighted mean difference for outcomes were calculated. A total of 13 studies divided into 20 trials including 1923 patients were analyzed. The No-AN group had a significantly higher 3-year graft survival rate {OR 0.48 [95% confidence interval (CI) 0.34-0.69], 10 studies, n = 1030} and 5-year graft survival rate [OR 0.65 (95% CI 0.44-0.97), 16 studies, n = 1878] than the AN group. The rates of 5-year patient survival [OR 1.82 (95% CI 1.14-2.90), 5 studies, n = 749], positive panel reactive antibody [OR 3.08 (95% CI 2.08-4.56), 12 studies, n = 1225], AR [OR 1.59 (95% CI 1.21-2.09), 15 studies, n = 1388] and delayed graft dysfunction [OR 1.66 (95% CI 1.20-2.03), 8 studies, n = 879] were all significantly higher in the AN group. Compared with the No-AN group, cold ischemia time was longer in the AN group [weighted mean difference 1.84 (95% CI 0.90-2.79), 7 studies, n = 919]. The rate of 1-year graft survival and 10-year graft survival, serum creatinine levels at 1 year after retransplantation and the time of hemodialysis before recent transplantation were similar between the AN and No-AN groups. We recommend allowing the failed graft to remain unless

  3. Impact of immunohistochemistry-based molecular subtype on chemosensitivity and survival in Hispanic breast cancer patients following neoadjuvant chemotherapy

    Science.gov (United States)

    Gómez, Rodolfo; Ossa, Carlos Andrés; Montoya, María Elvira; Echeverri, Carolina; Ángel, Gonzalo; Ascuntar, Johana; Borrero, Mauricio; Gil, Mónica; Herrera, Sabrina; Gutiérrez, Eduardo; Herazo, Fernando; Jiménez, Alejo; Madrid, Jorge; Reyes, Pedro Alejandro; Zuluaga, Lina; García, Héctor

    2015-01-01

    Background Neoadjuvant chemotherapy (NAC) is the standard treatment for patients with locally advanced breast cancer, showing improvement in disease-free survival (DFS) and overall survival (OS) rates in patients achieving pathological complete response (pCR). The relationship between immunohistochemistry-based molecular subtyping (IMS), chemo sensitivity and survival is currently a matter of interest. We explore this relationship in a Hispanic cohort of breast cancer patients treated with NAC. Methods A retrospective survival analysis was performed on Colombian females with breast cancer treated at Instituto de Cancerología-Clinica Las Américas between January 2009 and December 2011. Patients were classified according to immunohistochemistry-based subtyping into the following five groups: Luminal A, Luminal B, Luminal B/HER 2+, HER2-enriched, and triple-negative breast cancer. Demographic characteristics, recurrence pattern, and survival rate were reviewed by bivariate and multivariate analysis. Results A total of 328 patients fulfilled the study’s inclusion parameters and the distribution of subtypes were as follows: Luminal A: 73 (22.3%), Luminal B/HER2−: 110 (33.5%), Luminal B/HER2+: 75 (22.9%), HER2-enriched: 30 (9.1%), and triple-negative: 40 (12.2%). The median follow-up was 41 months (interquartile range: 31–52). Pathological response to NAC was as follows: complete pathological response (pCR) in 28 (8.5%) patients, partial 247 (75.3%); stable disease 47 (14.3%), and progression 6 (1.8%) patients. The presence of pCR had a significant DFS and OS in the entire group (p = 0.01) but subtypes had different DFS in Luminal B (p = 0.01) and triple negative (p = 0.02) and also OS in Luminal B (p = 0.01) and triple negative (p = 0.01). Conclusions pCR is associated with an improved overall survival and disease-free survival rates in this group of Hispanics patients. Advanced stages, Luminal B subtypes, triple-negative tumours and non-pCR showed lower DFS

  4. Impact of different temperatures on survival and energy metabolism in the Asian citrus psyllid, Diaphorina citri Kuwayama.

    Science.gov (United States)

    El-Shesheny, Ibrahim; Hijaz, Faraj; El-Hawary, Ibrahim; Mesbah, Ibrahim; Killiny, Nabil

    2016-02-01

    Temperature influences the life history and metabolic parameters of insects. Asian citrus psyllid (ACP), Diaphorina citri is a tropical and subtropical pest. ACP invaded new regions around the world and threatened the citrus industry as a vector for Huanglongbing (HLB) disease. ACP is widely distributed and can survive high (up to 45 °C) and low temperatures (as low as -6 °C). The precise mechanism of temperature tolerance in ACP is poorly understood. We investigated adult survival, cellular energy balance, gene expression, and nucleotide and sugar-nucleotide changes under the effect of different temperature regimes (0 °C to 45 °C with 5 °C intervals). The optimum temperatures for survival were 20 and 25 °C. Low temperatures of 0 °C and 5 °C caused 50% mortality after 2 and 4 days respectively, while one day at high temperature (40 °C and 45 °C) caused more than 95% mortality. The lowest quantity of ATP (3.69 ± 1.6 ng/insect) and the maximum ATPase enzyme activities (57.43 ± 7.6 μU/insect) were observed at 25 °C. Correlation between ATP quantities and ATPase activity was negative. Gene expression of hsp 70, V-type proton ATPase catalytic subunit A and ATP synthase α subunit matched these results. Twenty-four nucleotides and sugar-nucleotides were quantified using HPLC in ACP adults maintained at low, high, and optimum temperatures. The nucleotide profiles were different among treatments. The ratios between AMP:ATP and ADP:ATP were significantly decreased and positively correlated to adults survival, whereas the adenylate energy charge was increased in response to low and high temperatures. Exploring energy metabolic regulation in relation with adult survival might help in understanding the physiological basis of how ACP tolerates newly invaded regions. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. The impact of autonomic dysfunction on survival in patients with dementia with Lewy bodies and Parkinson's disease with dementia.

    Directory of Open Access Journals (Sweden)

    Kajsa Stubendorff

    Full Text Available INTRODUCTION: Autonomic dysfunction is a well-known feature in neurodegenerative dementias, especially common in α-synucleinopathies like dementia with Lewy bodies and Parkinson's disease with dementia. The most common symptoms are orthostatic hypotension, incontinence and constipation, but its relevance in clinical practice is poorly understood. There are no earlier studies addressing the influence of autonomic dysfunction on clinical course and survival. The aim of this study was to investigate the frequency of the three most common features of autonomic dysfunction and analyze how it affects survival. METHODS: Thirty patients with dementia with Lewy bodies and Parkinson's disease with dementia were included in this prospective, longitudinal follow-up study. Presence of incontinence and constipation was recorded at baseline. Blood pressure was measured at baseline, after 3 months and after 6 months according to standardized procedures, with 5 measurements during 10 minutes after rising. Orthostatic hypotension was defined using consensus definitions and persistent orthostatic hypotension was defined as 5 or more measurements with orthostatic hypotension. Difference in survival was analyzed 36 months after baseline. RESULTS: There was a high frequency of persistent orthostatic blood pressure (50%, constipation (30% and incontinence (30%. Patients with persistent orthostatic hypotension had a significantly shorter survival compared to those with no or non-persistent orthostatic hypotension (Log rank x(2 = 4.47, p = 0.034. Patients with constipation and/or urinary incontinence, in addition to persistent orthostatic hypotension, had a poorer prognosis compared to those with isolated persistent orthostatic hypotension or no orthostatic hypotension (Log rank x(2 = 6.370, p = 0.041. DISCUSSION: According to our findings, the identification of autonomic dysfunction seems to be of great importance in clinical practice, not only to

  6. Defining the coupled effects of cryogenic, space-radiation, and hypervelocity impact damamge on COPV's Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of the research proposed herein is to define the coupled (combined) effect of critical environments on the structural performance of composite overwrap...

  7. Failure Mechanisms of Ni-H2 and Li-Ion Batteries Under Hypervelocity Impacts

    Science.gov (United States)

    Miller, J. E.; Lyons, F.; Christiansen, E. L.; Lear, D. M.

    2017-01-01

    Lithium-Ion (Li-Ion) batteries have yielded significant performance advantages for many industries, including the aerospace industry, and have been selected to replace nickel hydrogen (Ni-H2) batteries for the International Space Station (ISS) program to meet the energy storage demands. As the ISS uses its vast solar arrays to generate its power, the solar ar-rays meet their sunlit power demands and supply excess power to battery packs for power de-livery on the sun obscured phase of the approximate 90 minute low Earth orbit. These large battery packs are located on the exterior of the ISS, and as such, the battery packs are ex-posed to external environment threats like naturally occurring meteoroids and artificial orbital debris (MMOD). While the risks from these solid particle environments has been known and addressed to an acceptable risk of failure through shield design, it is not possible to completely eliminate the risk of loss of these assets on orbit due to MMOD, and as such, failure consequences to the ISS have been considered.

  8. Defining the coupled effects of cryogenic, space-radiation, and hypervelocity impact damamge on COPV's Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The intent of the proposed effort is to investigate the detailed composite overwrapped pressure vessel (COPV) performance characteristics after being subject to...

  9. Hypervelocity Impact Analysis of International Space Station Whipple and Enhanced Stuffed Whipple Shields

    Science.gov (United States)

    2004-12-01

    4.826 mm) Al2219-T87 Rear Wall 0.04” (1.016 mm) Al2024 -T3 Witness Plate 4.5” Front to Back 3” Gap from Back of Rear Wall to Front of...Witness Plate 0.08” (2.032 mm) Al6061-T6 Bumper 0.19” (4.826 mm) RW Al2219-T87 Rear Wall 0.04” Al2024 -T3 Witness Plate 6 Layers of Nextel AF62, 6

  10. Toward a Characterization of the Debris Cloud Created in a Hypervelocity Impact on a Thin Plate

    Science.gov (United States)

    1993-08-01

    I.0) CALL DHOLE (TS,DP,RP,RT,LP,V,BHN,DH) MTARG-PI*(DH/2.0)*(DH/2.0)*TS*RT R-L22/TS IF (R.GE.1.0) FSR-I.0 IF (R.LT.1.0) ISR=R MSR-FSR*MTARG MUSM-MTARG... DHOLE (TS,DP,RP,RT,LP,V,BHN,DH) 4 IMPLICIT DOUBLE PRECISION (A-H,O-Z) 89 DOUBLE PRECISION K,LP C ....... THIS SUBROUTINE CALCULATES THE HOLE IN A THIN

  11. A ballistic limit equation for hypervelocity impacts on CFRP Al H/C satellite structures

    Science.gov (United States)

    Ryan, S.; Schäfer, F.; Destefanis, R.; Lambert, M.

    Composite sandwich panels consisting of Carbon Fiber Reinforced Plastic facesheets bonded to Aluminum honeycomb cores CFRP Al H C SP are amongst the most commonly used structures for satellites due to their relative low mass and high thermal and mechanical stability To assess the threat of micrometeoroid orbital debris M OD on a satellite mission equations which define the limits of structural perforation in terms of impactor mass velocity and angle are required This type of equation is referred to as a Ballistic Limit Equation BLE There is presently no validated BLE existing for application in the risk assessment of CFRP Al H C SP structures During a recent experimental test campaign performed in the framework of ESA Contract 16721 e g 1 using EMI s two-stage light-gas guns the ballistic performance of multiple representative CFRP Al HC SP structural configurations GOCE Radarsat-2 Herschel Planck BeppoSax was investigated The experimental results have been used to adjust and validate a new empirical BLE derived from an existing Whipple Shield BLE which provides a significant improvement in the accuracy of ballistic performance prediction over existing techniques Additionally the equation is capable of predicting the ballistic limit of an Electronic-box representative structure located behind the structural wall Good agreement with the experimental results is achieved for the vast majority of test set-ups For some set-ups the ballistic limit was conservatively predicted however this is attributed to the additional

  12. Hypervelocity impact microfoil perforations in the LEO space environment (LDEF, MAP AO-023 experiment)

    Science.gov (United States)

    Mcdonnell, J. A. M.; Stevenson, T. J.

    1992-01-01

    The Microabrasion Foil Experiment comprises arrays of frames, each supporting two layers of closely spaced metallic foils and a back-stop plate. The arrays, deploying aluminum and brass foil ranging from 1.5 to some 30 microns were exposed for 5.78 years on NASA's LDEF at a mean altitude of 458 km. They were deployed on the North, South, East, West, and Space pointing faces; results presented comprise the perforation rates for each location as a function of foil thickness. Initial results refer primarily to aluminum of 5 microns thickness or greater. This penetration distribution, comprising 2,342 perforations in total, shows significantly differing characteristics for each detector face. The anisotropy confirms, incorporating the dynamics of particulate orbital mechanics, the dominance of incorporating extraterrestrial particulates penetrating thicknesses greater than 20 microns in Al foil, yielding fluxes compatible with hyperbolic geocentric velocities. For thinner foils, a disproportionate increase in flux of particles on the East, North, and South faces shows the presence of orbital particulates which exceed the extraterrestrial component perforation rate at 5 micron foil thickness by a factor of approx. 4.

  13. Impact of aspirin and statins on long-term survival in patients hospitalized with acute myocardial infarction complicated by heart failure

    DEFF Research Database (Denmark)

    Lewinter, Christian; Bland, John M; Crouch, Simon

    2014-01-01

    AIMS: Aspirin and statins are established therapies for acute myocardial infarction (MI), but their benefits in patients with chronic heart failure (HF) remain elusive. We investigated the impact of aspirin and statins on long-term survival in patients hospitalized with acute MI complicated by HF....... METHODS AND RESULTS: Of 4251 patients in the Evaluation of Methods and Management of Acute Coronary Events (EMMACE)-1 and -2 observational studies, 1706 patients had HF. A propensity score-matching method estimated the average treatment effects (ATEs) of aspirin and statins on survival over 90 months....... ATEs were calculated as relative risk differences in all-cause mortality comparing patients receiving aspirin and statins with controls, respectively. Moreover, combined aspirin and statins vs. none (ATE I), aspirin or statins vs. none (ATE II), and aspirin and statins vs. aspirin or statins (ATE III...

  14. The impact of coronary artery disease severity on late survival after combined aortic valve replacement and coronary artery bypass grafting - experience of a single cardiac surgery center.

    Science.gov (United States)

    Perek, Bartłomiej; Misterski, Marcin; Stachowiak, Wojciech; Buczkowski, Piotr; Stefaniak, Sebastian; Puślecki, Mateusz; Urbanowicz, Tomasz; Budniak, Wiktor; Jemielity, Marek

    2014-12-01

    The severity of coronary artery disease (CAD) may have an impact on the outcomes of patients (pts) after aortic valve replacement (AVR) and coronary artery bypass grafting (CABG). The aim of the study was to analyze survival after simultaneous AVR and CABG with respect to CAD severity. The study involved 143 consecutive pts (40 women and 103 men) with a mean age of 65.1 ± 7.7 years treated between 2006 and 2009. The indication for surgery was aortic stenosis accompanied by left main or three-vessel disease (group A; n = 43) and by single- or two-vessel disease (group B; n = 100). In-hospital and late mortality were analyzed. Post-discharge survival was estimated using the Kaplan-Meier method. Moreover, selected preoperative clinical and echocardiographic data as well as intraoperative variables were compared between the groups. In-hospital mortality was 4.7% in group A and 3.0% in group B (NS). The 12-month and 48-month survival probability rates were 0.88 ± 0.05 and 0.83 ± 0.06 in group A, and 0.97 ± 0.01 and 0.92 ± 0.03 in group B, respectively (p < 0.05). Patients in group A and B differed (p < 0.05) with respect to the preoperative prevalence of arterial hypertension (65.1% vs. 42.0%) and atrial fibrillation (18.6% vs. 6.0%) as well as with regard to the rate of complete revascularization (20.9% vs. 85.0%, group A and B, respectively). Coronary artery disease severity impacts long-term survival after combined AVR and CABG. Patients with left main or three-vessel disease more often undergo incomplete surgical revascularization, and this fact may be one of the predictors of an unfavorable outcome.

  15. The impact of coronary artery disease severity on late survival after combined aortic valve replacement and coronary artery bypass grafting – experience of a single cardiac surgery center

    Science.gov (United States)

    Misterski, Marcin; Stachowiak, Wojciech; Buczkowski, Piotr; Stefaniak, Sebastian; Puślecki, Mateusz; Urbanowicz, Tomasz; Budniak, Wiktor; Jemielity, Marek

    2014-01-01

    Introduction The severity of coronary artery disease (CAD) may have an impact on the outcomes of patients (pts) after aortic valve replacement (AVR) and coronary artery bypass grafting (CABG). Aim The aim of the study was to analyze survival after simultaneous AVR and CABG with respect to CAD severity. Material and methods The study involved 143 consecutive pts (40 women and 103 men) with a mean age of 65.1 ± 7.7 years treated between 2006 and 2009. The indication for surgery was aortic stenosis accompanied by left main or three-vessel disease (group A; n = 43) and by single- or two-vessel disease (group B; n = 100). In-hospital and late mortality were analyzed. Post-discharge survival was estimated using the Kaplan-Meier method. Moreover, selected preoperative clinical and echocardiographic data as well as intraoperative variables were compared between the groups. Results In-hospital mortality was 4.7% in group A and 3.0% in group B (NS). The 12-month and 48-month survival probability rates were 0.88 ± 0.05 and 0.83 ± 0.06 in group A, and 0.97 ± 0.01 and 0.92 ± 0.03 in group B, respectively (p < 0.05). Patients in group A and B differed (p < 0.05) with respect to the preoperative prevalence of arterial hypertension (65.1% vs. 42.0%) and atrial fibrillation (18.6% vs. 6.0%) as well as with regard to the rate of complete revascularization (20.9% vs. 85.0%, group A and B, respectively). Conclusions Coronary artery disease severity impacts long-term survival after combined AVR and CABG. Patients with left main or three-vessel disease more often undergo incomplete surgical revascularization, and this fact may be one of the predictors of an unfavorable outcome. PMID:26336450

  16. Impact of aspirin and statins on long-term survival in patients hospitalized with acute myocardial infarction complicated by heart failure: an analysis of 1706 patients.

    Science.gov (United States)

    Lewinter, Christian; Bland, John M; Crouch, Simon; Cleland, John G F; Doherty, Patrick; LeWinter, Martin M; Køber, Lars; Hall, Alistair S; Gale, Christopher P

    2014-01-01

    Aspirin and statins are established therapies for acute myocardial infarction (MI), but their benefits in patients with chronic heart failure (HF) remain elusive. We investigated the impact of aspirin and statins on long-term survival in patients hospitalized with acute MI complicated by HF. Of 4251 patients in the Evaluation of Methods and Management of Acute Coronary Events (EMMACE)-1 and -2 observational studies, 1706 patients had HF. A propensity score-matching method estimated the average treatment effects (ATEs) of aspirin and statins on survival over 90 months. ATEs were calculated as relative risk differences in all-cause mortality comparing patients receiving aspirin and statins with controls, respectively. Moreover, combined aspirin and statins vs. none (ATE I), aspirin or statins vs. none (ATE II), and aspirin and statins vs. aspirin or statins (ATE III) were assessed. The median survival times of the ATE I, ATE II and ATE III were 25, 50, and 85 months, respectively. Regarding aspirin, the ATE was significantly improved at 6, 12, and 90 months [ATE 6 months: 10%, 95% confidence interval (CI) 3-18%], where the ATE of statins favoured survival at 1-24 months (ATE 1 month: 5%, 95% CI 0.3-10%). Mortality was lower at 1, 6, and 24 months in those who received aspirin and statins (ATE I). When the combination was compared with either treatment alone, an effect persisted between 6 and 90 months (ATE III). In patients with acute MI complicated by HF, prescription of aspirin and statins either alone or together was associated with better long-term survival. © 2013 The Authors. European Journal of Heart Failure © 2013 European Society of Cardiology.

  17. HR+/Her2- breast cancer in pre-menopausal women: The impact of younger age on clinical characteristics at diagnosis, disease management and survival.

    Science.gov (United States)

    De Camargo Cancela, Marianna; Comber, Harry; Sharp, Linda

    2016-12-01

    Young women (20-39 years-old) with breast cancer are diagnosed with more aggressive tumours and consequently have poorer survival. However, there is an evidence gap as to whether age has an independent effect on survival of pre-menopausal women diagnosed with HR+/Her2- tumours. The aim of this population-based study was to compare characteristics at diagnosis, determinants of treatment and survival in women aged 20-39 and 40-49 years diagnosed with HR+/Her2- tumours. From the National Cancer Registry Ireland, we identified women aged 20-49 diagnosed with a first invasive HR+/Her2- breast cancer during 2002-2008. Women aged 20-39 were compared to those aged 40-49 years. Poisson regression with robust error variance was used to explore the impact of age on treatment receipt. Associations between age and survival from all causes was investigated using Cox models. In multivariate models, women aged 20-39 significantly more often having no cancer-directed surgery (IRR=1.49, 95%CI 1.07, 2.08). In those having surgery, younger age was associated with significantly higher likelihood of receiving chemotherapy; age was not associated with receipt of adjuvant radiotherapy or endocrine therapy. Women aged 20-39 undergoing surgery were significantly more likely to die than women aged 40-49 (HR=1.84, 95%CI: 1.31, 2.59). Age is an independent prognostic factor in younger women diagnosed with HR+/Her2- breast cancer, supporting the hypothesis that breast cancer in women under 40 has more aggressive behaviour, even within HR+/Her2- tumours. Future research should explore the reasons for poorer survival in order to inform strategies to improve outcomes in this age group. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Retroperitoneal lymph node dissection (RPLD) in conjunction with nephroureterectomy in the treatment of infiltrative transitional cell carcinoma (TCC) of the upper urinary tract: impact on survival.

    Science.gov (United States)

    Brausi, Maurizio A; Gavioli, Mirko; De Luca, Giuseppe; Verrini, Giorgio; Peracchia, Giancarlo; Simonini, Gianluca; Viola, Massimo

    2007-11-01

    To evaluate the prognostic impact of retroperitoneal lymph node dissection (RPLD) performed during nephroureterectomy on time to recurrence and survival in patients with infiltrative transitional cell carcinoma (TCC) of the upper urinary tract. The charts of 82 patients with T2-T4 TCC of the upper tract were retrospectively reviewed. The median patient age was 67.7 yr. Seventy-nine patients underwent nephroureterectomy and three had partial nephrectomy. Forty patients (48.8%) had RPLD with removal of more than five nodes after nephroureterectomy (group 1), whereas 42 (51.2%) had nephroureterectomy only (group 2). Median follow-up was 64.7 mo. The prognostic role of RPLD, T (2 vs. 3-4), G (2 vs. 3), N (0 vs. 1-2 vs. x), age (65 yr) and sex on time to recurrence and survival were evaluated. Median time to recurrence and overall survival were 51.2 and 52.5 mo, respectively, in group 1 and 18.5 and 21.2 mo in group 2. Univariate analysis demonstrated that RPLD and T and N status were significantly related both to time to recurrence (p=0.009, 0.008, and 0.009, respectively) and survival (p=0.000006, 0.003, and 0.003). When analyzed using the Cox proportional hazard model, RPLD and T category were the only two factors demonstrating independent significance on overall survival (p=0.004 and 0.008). The results indicate a possible curative role of RPLD in the treatment of patients with infiltrative TCC of the upper urinary tract. Further randomized trials are needed to confirm these results.

  19. The dark side of the moon: impact of moon phases on long-term survival, mortality and morbidity of surgery for lung cancer.

    Science.gov (United States)

    Kuehnl, A; Herzog, M; Schmidt, M; Hornung, H-M; Jauch, K-W; Hatz, R A; Graeb, C

    2009-04-16

    Superstition is common and causes discomfiture or fear, especially in patients who have to undergo surgery for cancer. One superstition is, that moon phases influence surgical outcome. This study was performed to analyse lunar impact on the outcome following lung cancer surgery. 2411 patients underwent pulmonary resection for lung cancer in the past 30 years at our institution. Intra- and postoperative complications as well as long-term follow-up data were entered in our lung-cancer database. Factors influencing mortality, morbidity and survival were analyzed. Rate of intra-operative complications as well as rate of post-operative morbidity and mortality was not significantly affected by moon phases. Furthermore, there was no significant impact of the lunar cycle on long-term survival. In this study there was no evidence that outcome of surgery for lung cancer is affected by the moon. These results may help the physician to quiet the mind of patients who are somewhat afraid of wrong timing of surgery with respect to the moon phases. However, patients who strongly believe in the impact of moon phase should be taken seriously and correct timing of operations should be conceded to them as long as key-date scheduling doesn't constrict evidence based treatment regimens.

  20. Research Status and Action of Sub-millimeter Debris Impact Damage on Spacecraft Structure

    OpenAIRE

    Higashide, Masumi; Kurosaki, Hirohisa; Hasegawa, Sunao; 東出, 真澄; 黒崎, 裕久; 長谷川, 直

    2015-01-01

    To assess debris impact risk for the satellite, submillimeter debris impact damage has not been investigated enough to conduct satellite protective designing. JAXA is researching vulnerability of satellite structure materials against submillimeter debris impact, and proposing shielding methods. This report shows summary of submillimeter impact damages of honeycomb sandwich panels. The damage of the panel was investigated by hypervelocity impact experiments with the two-stage light gas gun in ...

  1. Impact of mammographic screening on ethnic and socioeconomic inequities in breast cancer stage at diagnosis and survival in New Zealand: a cohort study.

    Science.gov (United States)

    Seneviratne, Sanjeewa; Campbell, Ian; Scott, Nina; Shirley, Rachel; Lawrenson, Ross

    2015-01-31

    Indigenous Māori women experience a 60% higher breast cancer mortality rate compared with European women in New Zealand. We explored the impact of differences in rates of screen detected breast cancer on inequities in cancer stage at diagnosis and survival between Māori and NZ European women. All primary breast cancers diagnosed in screening age women (as defined by the New Zealand National Breast Cancer Screening Programme) during 1999-2012 in the Waikato area (n = 1846) were identified from the Waikato Breast Cancer Register and the National Screening Database. Stage at diagnosis and survival were compared for screen detected (n = 1106) and non-screen detected (n = 740) breast cancer by ethnicity and socioeconomic status. Indigenous Māori women were significantly more likely to be diagnosed with more advanced cancer compared with NZ European women (OR = 1.51), and approximately a half of this difference was explained by lower rate of screen detected cancer for Māori women. For non-screen detected cancer, Māori had significantly lower 10-year breast cancer survival compared with NZ European (46.5% vs. 73.2%) as did most deprived compared with most affluent socioeconomic quintiles (64.8% vs. 81.1%). No significant survival differences were observed for screen detected cancer by ethnicity or socioeconomic deprivation. The lower rate of screen detected breast cancer appears to be a key contributor towards the higher rate of advanced cancer at diagnosis and lower breast cancer survival for Māori compared with NZ European women. Among women with screen-detected breast cancer, Māori women do just as well as NZ European women, demonstrating the success of breast screening for Māori women who are able to access screening. Increasing breast cancer screening rates has the potential to improve survival for Māori women and reduce breast cancer survival inequity between Māori and NZ European women.

  2. In Vitro Evaluation of the Impact of the Probiotic E. coli Nissle 1917 on Campylobacter jejuni’s Invasion and Intracellular Survival in Human Colonic Cells

    Directory of Open Access Journals (Sweden)

    Yosra A. Helmy

    2017-08-01

    Full Text Available Campylobacter jejuni is a leading cause of bacterial food poisoning in humans. Due to the rise in antibiotic-resistant Campylobacter, there exists a need to develop antibiotic-independent interventions to control infections in humans. Here, we evaluated the impact of Escherichia coli Nissle 1917 (EcN, a probiotic strain, on C. jejuni’s invasion and intracellular survival in polarized human colonic cells (HT-29. To further understand how EcN mediates its impact, the expression of 84 genes associated with tight junctions and cell adhesion was profiled in HT-29 cells after treatment with EcN and challenge with C. jejuni. The pre-treatment of polarized HT-29 cells with EcN for 4 h showed a significant effect on C. jejuni’s invasion (∼2 log reduction of the colonic cells. Furthermore, no intracellular C. jejuni were recovered from EcN pre-treated HT-29 cells at 24 h post-infection. Other probiotic strains tested had no significant impact on C. jejuni invasion and intracellular survival. C. jejuni decreased the expression of genes associated with epithelial cells permeability and barrier function in untreated HT-29 cells. However, EcN positively affected the expression of genes that are involved in enhanced intestinal barrier function, decreased cell permeability, and increased tight junction integrity. The results suggest that EcN impedes C. jejuni invasion and subsequent intracellular survival by affecting HT-29 cells barrier function and tight junction integrity. We conclude that EcN might be a viable alternative for controlling C. jejuni infections.

  3. Impact of dialysis modality on the survival of patients with end-stage renal disease and prior stroke.

    Science.gov (United States)

    Wang, I-Kuan; Liang, Wen-Miin; Lin, Cheng-Li; Liu, Yao-Lung; Chang, Chiz-Tzung; Yen, Tzung-Hai; Huang, Chiu-Ching; Sung, Fung-Chang

    2016-01-01

    Of patients with end-stage renal disease (ESRD), 8-16 % had a history of stroke at dialysis initiation. We used the National Health Insurance Research Database of Taiwan to evaluate whether peritoneal dialysis (PD) or hemodialysis (HD) confers a survival advantage for patients with incident ESRD and prior stroke. We identified 975 patients undergoing PD and 975 propensity score-matched patients with newly diagnosed ESRD and prior stroke undergoing HD between 2000 and 2010. Both cohorts were followed up until the end of 2011. Comparisons of the risks of mortality between PD and HD were analyzed using the Cox proportional hazards regression model. In the propensity score-matched cohorts, there was a 2.4 per 100 person-years greater mortality in patients with PD (20.4 vs. 18.0 per 100 person-years) with an adjusted hazard ratio (HR) of 1.20 (95 % CI 1.06-1.36). For patients with diabetes, ESRD and prior stroke, patients undergoing PD had inferior survival compared with those undergoing HD (adjusted HR 1.22, 95 % CI 1.05-1.43), particularly among female patients (adjusted HR 1.55, 95 % CI 1.25-1.91). For patients with ESRD and prior stroke but without diabetes, there was no significant difference in mortality between PD and HD (adjusted HR 1.20, 95 % CI 0.96-1.50). PD was associated with overall poorer survival among patients with diabetes, ESRD and prior stroke and with similar overall survival among patients with ESRD and prior stroke, but without diabetes, compared with HD.

  4. Impact on regional recurrence and survival of axillary surgery in women with node-negative primary breast cancer

    DEFF Research Database (Denmark)

    Axelsson, C K; Düring, M; Christiansen, P M

    2009-01-01

    BACKGROUND: This study examined whether axillary lymph node dissection (ALND) with removal of many normal lymph nodes resulted in a reduced rate of axillary recurrence and better survival, as reported in recent studies. METHODS: The follow-up analyses were based on 8657 patients with node-negativ...... leave the concept of the sentinel node biopsy intact, as a highly specific procedure compared to ALND....

  5. Survival outcomes of obese patients in type II endometrial cancer: Defining the prognostic impact of increasing BMI.

    Science.gov (United States)

    Billingsley, Caroline C; Cansino, Catherine; O'Malley, David M; Cohn, David E; Fowler, Jeffrey M; Copeland, Larry J; Backes, Floor J; Salani, Ritu

    2016-03-01

    To investigate the role of obesity as a risk factor for type II endometrial cancer (EC), as well as the prognostic significance of increasing body mass index (BMI) on survival. A single institution retrospective analysis of 154 type II EC cases from 1987 to 2010 was conducted. Patients were categorized into cohorts by BMI (normal (obese class I (30-34.9), and obese class II-III (≥35)). Descriptive, regression and ANOVA analyses were performed. Kaplan-Meier curves were compared with log rank tests. The BMI distribution was 22.8% normal BMI; 24% overweight; 17.5% class I; and 35.7% class II-III. The median follow up was 41 months. The median progression-free survival (PFS) was 45.4, 36.0, 35.3 and 42.0 months and overall survival (OS) was 54.7, 44.7, 44.8 and 49.7 months, among the respective groups. There was no association between BMI and PFS (p=0.71), OS (p=0.72), or time to recurrence (p=0.71). There were no differences among the increasing BMI groups compared to normal weight women for the risk of death. Our analysis did not reveal any differences in outcomes by BMI group. Our data reveals that obesity is highly prevalent in type II ECs, though obesity has not historically been described as a risk factor. While BMI as a single variable may not be prognostic for survival outcomes, the role of obesity as a risk factor for type II EC should be further investigated, given the increasing prevalence of obesity in type II ECs. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Survival Analysis of Advanced HCC Treated with Radioembolization: Comparing Impact of Clinical Performance Status Versus Vascular Invasion/Metastases.

    Science.gov (United States)

    Ali, Rehan; Gabr, Ahmed; Abouchaleh, Nadine; Al Asadi, Ali; Mora, Ronald A; Kulik, Laura; Abecassis, Michael; Riaz, Ahsun; Salem, Riad; Lewandowski, Robert J

    2017-09-06

    In this study, we aim to compare the effects of prognostic indicators on survival analysis for Barcelona Clinic Liver Cancer (BCLC) C patients undergoing yttrium-90 radioembolization (Y-90). A prospectively acquired database (2003-2017) for BCLC C hepatocellular carcinoma (HCC) patients that underwent radioembolization with Y-90 was searched. The criteria for BCLC C status (Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 1 or 2, metastases, and/or portal vein thrombosis (PVT)) were recorded. Kaplan-Meier survival analyses were performed from the date of the first radioembolization with Y-90, censored to curative treatment, to determine median overall survival (OS). Cox regression hazards model was used for multivariate analyses. Significance was set at P < 0.05. 547 BCLC C patients treated with radioembolization with Y-90 had a median OS of 10.7 months (range: 9.5-12.9). 43% (233 of 547) patients classified as BCLC C solely by their ECOG PS had a median OS of 19.4 months (14.7-23.7); 57% (314 of 547) patients with PVT/metastases had a median OS of 7.7 months (6.7-8.7). On multivariate analysis, ECOG PS was not found to be a statistically significant prognostic indicator of OS in BCLC C whereas metastases and PVT exhibited hazards ratios (95%CI) of 0.51 (0.38-0.69) and 0.49 (0.38-0.63), respectively (P < 0.0001). Patients classified as BCLC C due to ECOG PS 1 demonstrated longer survival when compared to those presenting with PVT, metastases and/or ECOG PS 2. Hence, ECOG PS 1, as an isolated variable, may not be a true indicator of advanced disease.

  7. Impact of immune parameters on long-term survival in metastatic renal cell      carcinoma

    DEFF Research Database (Denmark)

    Donskov, Frede; Maase, Hans von der

    2006-01-01

    with estimated       5-year survival rates of 60%, 25%, and 0%, respectively. These findings       were apparent in both our own prognostic model and in an extended Memorial       Sloan-Kettering Cancer Center (New York, NY) prognostic model. CONCLUSION:       This study points on five clinical and three...

  8. Prognostic Impact of Diabetes and Prediabetes on Survival Outcomes in Patients With Chronic Heart Failure: A Post?Hoc Analysis of the GISSI?HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca?Heart Failure) Trial

    OpenAIRE

    Dauriz, Marco; Targher, Giovanni; Temporelli, Pier Luigi; Lucci, Donata; Gonzini, Lucio; Nicolosi, Gian Luigi; Marchioli, Roberto; Tognoni, Gianni; Latini, Roberto; Cosmi, Franco; Tavazzi, Luigi; Maggioni, Aldo Pietro; Maggioni, Aldo P; Porcu, Maurizio; Yusuf, Salim

    2017-01-01

    Background The independent prognostic impact of diabetes mellitus (DM) and prediabetes mellitus (pre?DM) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of DM and pre?DM on survival outcomes in the GISSI?HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca?Heart Fa...

  9. Impact of treatment in long-term survival patients with follicular lymphoma: A Spanish Lymphoma Oncology Group registry.

    Directory of Open Access Journals (Sweden)

    Mariano Provencio

    Full Text Available Follicular lymphoma is the second most common non-Hodgkin lymphoma in the United States and Europe. However, most of the prospective randomized studies have very little follow-up compared to the long natural history of the disease. The primary aim of this study was to investigate the long-term survival of our series of patients with follicular lymphoma.A total of 1074 patients with newly diagnosed FL were enrolled. Patients diagnosed were prospectively enrolled from 1980 to 2013.Median follow-up was 54.9 months and median overall survival is over 20 years in our series. We analyzed the patients who are still alive beyond 10 years from diagnosis in order to fully assess the prognostic factors that condition this group. Out of 166 patients who are still alive after more than 10 years of follow-up, 118 of them (73% are free of evident clinical disease. Variables significantly associated with survival at 10 years were stage < II (p <0.03, age < 60 years (p <0.0001, low FLIPI (p <0.002, normal β2 microglobulin (p <0.005, no B symptoms upon diagnosis (p <0.02, Performance Status 0-1 (p <0.03 and treatment with anthracyclines and rituximab (p <0.001, or rituximab (p <0.0001.A longer follow-up and a large series demonstrated a substantial population of patients with follicular lymphoma free of disease for more than 10 years.

  10. Does postoperative radiation therapy impact survival in non-metastatic sarcomatoid renal cell carcinoma? A SEER-based study.

    Science.gov (United States)

    Eminaga, Okyaz; Akbarov, Ilgar; Wille, Sebastian; Engelmann, Udo

    2015-10-01

    The effect of adjuvant radiation therapy on survival in sarcomatoid renal cell carcinoma (sRCC) with no evidence of distant metastasis remains unclear. Subjects diagnosed with non-metastatic sRCC were identified using the Surveillance Epidemiology and End Results (SEER) (2004-2012) database and divided into groups based on their surgical treatment (ST): no surgery or radiation therapy (NSR); partial nephrectomy (PNE); radical nephrectomy with ureterectomy and bladder cuff resection (RNE + UE + BLAD); and radical nephrectomy (RNE). Certain radical nephrectomy cases also received adjuvant external-beam radiation therapy (RNE + RAD). The Kaplan-Meier method was used to estimate overall survival (OS). A multivariable competing risks regression analysis was used to calculate disease-specific survival (DSS) probability and to determine factors associated with cause-specific mortality (CSM). A total of 408 patients were included in this study. The 5-year OS and predicted DSS were significantly higher in the patients who underwent STs (i.e., PNE, RNE + UE + BLAD, RNE, and RNE + RAD) (20.1-54.0 and 20.1-59.9 %, respectively) than in the NSR group (9.0 and 11.6 %, respectively) (P therapy did not increase OS in non-metastatic sRCC patients.

  11. Uptake and Tolerance of Chemotherapy in Elderly Patients with Small Cell Lung Cancer and Impact on Survival

    Directory of Open Access Journals (Sweden)

    Stacey Fisher

    2012-01-01

    Full Text Available The treatment of elderly cancer patients is complicated by many factors. We sought to assess the uptake and tolerance of chemotherapy among patients 75 years and older diagnosed with small cell lung cancer (SCLC in years 2004–2008 in Alberta, Canada, and assess their survival. All patients who met the above criteria and had an oncologist-consult were included. Data were obtained from the Alberta Cancer Registry and chart review. A total of 171 patients were included in the study, 117 (68% of whom began chemotherapy. Of those, 52% completed all cycles, 66% did not have any dose reductions, and 31% completed all cycles at the recommended dose. The risk of death for patients who did not complete all cycles of chemotherapy was 2.72 (95% CI: 1.52–4.87 and for those who completed all cycles but with a reduced dose was 1.02 (95% CI: 0.57–1.82 relative to those who completed chemotherapy at full dose after adjusting for several demographic/clinical factors. Our results suggest that a significant proportion of elderly patients are able to tolerate chemotherapy and receive a survival benefit from it while those who experience toxicity may receive a survival benefit from a reduction in chemotherapy dose as opposed to stopping treatment.

  12. Impact of Nodal Level Distribution on Survival in Oral Cavity Squamous Cell Carcinoma: A Population-Based Study.

    Science.gov (United States)

    Marchiano, Emily; Patel, Tapan D; Eloy, Jean Anderson; Baredes, Soly; Park, Richard Chan Woo

    2016-07-01

    Regional lymph node metastasis is an important prognostic factor in squamous cell carcinoma of the head and neck, decreasing survival by up to 50%. Oral cavity squamous cell carcinoma (OC-SCCa) most commonly spreads to levels I, II, and III. Retrospective analysis of a population-based tumor registry. Academic medical center. The Surveillance, Epidemiology, and End Results (SEER) database was queried for cases of OC-SCCa from 2004 to 2011 (22,973 cases). Resulting data including patient demographics, clinicopathological features, topographical distribution of nodal metastasis, and survival based on lymph node level involvement were analyzed. In total, 8281 patients were identified with OC-SCCa who underwent neck dissection. Level I, closely followed by levels II and III, represented the most commonly involved nodal basins. The 5-year disease-specific survival (DSS) for patients with only level I, II, or III was 42.0% compared with 30.6% for the level IV group (P Oral cavity squamous cell carcinoma most commonly involves nodal levels I, II, and III. Involvement of nodal level IV or V portends a worse prognosis than patients with only level I to III disease, and multimodality therapy should be considered for these patients. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  13. Impact of nonoperative treatment, vertebroplasty, and kyphoplasty on survival and morbidity after vertebral compression fracture in the medicare population.

    Science.gov (United States)

    Chen, Andrew T; Cohen, David B; Skolasky, Richard L

    2013-10-02

    The treatment of vertebral compression fractures with vertebral augmentation procedures is associated with acute pain relief and improved mobility, but direct comparisons of treatments are limited. Our goal was to compare the survival rates, complications, lengths of hospital stay, hospital charges, discharge locations, readmissions, and repeat procedures for Medicare patients with new vertebral compression fractures that had been acutely treated with vertebroplasty, kyphoplasty, or nonoperative modalities. The 2006 Medicare Provider Analysis and Review File database was used to identify 72,693 patients with a vertebral compression fracture. Patients with a previous vertebral compression fracture, those who had had a vertebral augmentation procedure in the previous year, those with a diagnosis of malignant neoplasm, and those who had died were excluded, leaving 68,752 patients. The patients were stratified into nonoperative treatment (55.6%), vertebroplasty (11.2%), and kyphoplasty (33.2%) cohorts. Survival rates were compared with use of Kaplan-Meier analysis and Cox regression. Results were adjusted for potential confounding variables. Secondary parameters of interest were analyzed with the chi-square test (categorical variables) and one-way analysis of variance (continuous variables), with the level of significance set at p < 0.05. The estimated three-year survival rates were 42.3%, 49.7%, and 59.9% for the nonoperative treatment, vertebroplasty, and kyphoplasty groups, respectively. The adjusted risk of death was 20.0% lower for the kyphoplasty group than for the vertebroplasty group (hazard ratio = 0.80, 95% confidence interval, 0.77 to 0.84). Patients in the kyphoplasty group had the shortest hospital stay and the highest hospital charges and were the least likely to have had pneumonia and decubitus ulcers during the index hospitalization and at six months postoperatively. However, kyphoplasty was more likely to result in a subsequent augmentation procedure

  14. Ejection of Hyper-Velocity Stars by Intermediate-Mass Black Holes

    Energy Technology Data Exchange (ETDEWEB)

    Baumgardt, Holger [Argelander Institute for Astronomy, University of Bonn, Auf dem Huegel 71, 53121 Bonn (Germany); Gualandris, Alessia [Astronomical Institute ' Anton Pannekoek' , University of Amsterdam, Kruislaan 403 (Netherlands); Zwart, Simon Portegies [Astronomical Institute ' Anton Pannekoek' , University of Amsterdam, Kruislaan 403 (Netherlands)

    2006-12-15

    We have performed N-body simulations of the formation of hyper-velocity stars (HVS) in the centre of the Milky Way due to inspiralling intermediate-mass black holes (IMBHs). We find that due to dynamical friction, IMBHs sink into the centre of the Galaxy where they deplete the central cusp of stars. Some of these stars become HVS and are ejected with velocities sufficiently high to escape the Galaxy. Our simulations show that HVS are generated in short bursts which last only a few Myrs until the IMBH is swallowed by the supermassive black hole (SMBH). After the HVS have reached the galactic halo, their escape velocities correlate with the distance from the Galactic centre in the sense that the fastest HVS can be found furthest away from the centre. Finally, our simulations show that the presence of an IMBH in the Galactic centre changes the stellar density distribution inside r < 0.02 pc into a core profile, which takes at least 100 Myrs to replenish.

  15. THE NATURE OF HYPERVELOCITY STARS AND THE TIME BETWEEN THEIR FORMATION AND EJECTION

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Warren R.; Geller, Margaret J.; Kenyon, Scott J. [Smithsonian Astrophysical Observatory, 60 Garden Street, Cambridge, MA 02138 (United States); Cohen, Judith G., E-mail: wbrown@cfa.harvard.edu, E-mail: mgeller@cfa.harvard.edu, E-mail: skenyon@cfa.harvard.edu, E-mail: jlc@astro.caltech.edu [Palomar Observatory, Mail Stop 249-17, California Institute of Technology, Pasadena, CA 91125 (United States)

    2012-07-20

    We obtain Keck HIRES spectroscopy of HVS5, one of the fastest unbound stars in the Milky Way halo. We show that HVS5 is a 3.62 {+-} 0.11 M{sub Sun} main-sequence B star at a distance of 50 {+-} 5 kpc. The difference between its age and its flight time from the Galactic center is 105 {+-} 18 (stat) {+-}30 (sys) Myr; flight times from locations elsewhere in the Galactic disk are similar. This 10{sup 8} yr 'arrival time' between formation and ejection is difficult to reconcile with any ejection scenario involving massive stars that live for only 10{sup 7} yr. For comparison, we derive arrival times of 10{sup 7} yr for two unbound runaway B stars, consistent with their disk origin where ejection results from a supernova in a binary system or dynamical interactions between massive stars in a dense star cluster. For HVS5, ejection during the first 10{sup 7} yr of its lifetime is ruled out at the 3{sigma} level. Together with the 10{sup 8} yr arrival times inferred for three other well-studied hypervelocity stars (HVSs), these results are consistent with a Galactic center origin for the HVSs. If the HVSs were indeed ejected by the central black hole, then the Galactic center was forming stars {approx_equal}200 Myr ago, and the progenitors of the HVSs took {approx_equal}100 Myr to enter the black hole's loss cone.

  16. Experimental Investigation of Mars Science Laboratory Entry Vehicle Aeroheating in AEDC Hypervelocity Tunnel 9

    Science.gov (United States)

    Hollis, Brian R.; Collier, Arnold S.

    2017-01-01

    An experimental investigation of the aeroheating environment of the Mars Science Laboratory entry vehicle was conducted in the Arnold Engineering Development Complex Hypervelocity Wind Tunnel 9. Testing was performed on a 6-in. (0.1524 m) diameter model in the tunnel's Mach 8 and Mach 10 nozzles at free stream Reynolds numbers from 4.1×10*exp 6)/ft to 49×10(exp 6)/ft and from 1.2×10(exp 6)/ft to 19×10(exp 6)/ft, respectively, using pure nitrogen test gas. These conditions spanned the boundary layer flow regimes from completely laminar to fully turbulent flow over the entire forebody. A computational fluid dynamics study was conducted in support of the wind tunnel testing. Laminar and turbulent solutions were generated for all wind tunnel test conditions and comparisons of predicted heating distributions were performed with the data. These comparisons showed agreement for most cases to within the estimated +/-12% experimental uncertainty margin for fully-laminar or fully-turbulent conditions, while transitional heating data were bounded by laminar and turbulent predictions. These results helped to define uncertainty margins on the use of computational tools for vehicle design.

  17. Artists’ Survival Rate

    DEFF Research Database (Denmark)

    Bille, Trine; Jensen, Søren

    2017-01-01

    The literature of cultural economics generally finds that an artistic education has no significant impact on artists’ income and careers in the arts. In our research, we have readdressed this question by looking at the artists’ survival in the arts occupations. The results show that an artistic...... education has a significant impact on artists’ careers in the arts and we find important industry differences....

  18. Risk stratification to determine the impact of induction therapy on survival, rejection and adverse events after pediatric heart transplant: A multi-institutional study.

    Science.gov (United States)

    Castleberry, Chesney; Pruitt, Elizabeth; Ameduri, Rebecca; Schowengerdt, Kenneth; Edens, Erik; Hagin, Nancy; Kirklin, James K; Naftel, David; Urschel, Simon

    2017-05-11

    Induction therapy is increasingly being used in pediatric heart transplantation. General versus risk-adapted use remains controversial. We aimed to determine the impact of induction therapy on outcomes after stratifying patients by diagnosis and risk. The Pediatric Heart Transplant Study (PHTS) database was used to identify patients (age ≤18 years) who underwent transplantation between January 1, 2001 and December 31, 2014. Patients were excluded if they survived induction agents. Patients were stratified using a multivariable model to predict 1-year mortality. Patients within the top 25% risk of predicted mortality were defined as high risk (HR) and the bottom 75% as low risk (LR). Of the 2,860 patients studied, 1,370 received anti-lymphocyte antibody (ALA), 707 received an interleukin-2 receptor antagonist (IL-2RA) and 783 received no induction (NI) therapy. Overall, patients with NI had lower survival (p induction therapy (p induction therapy. Although induction therapy is associated with decreased rejection, it was not found to directly influence survival on multivariable analysis. Lower risk patients may benefit the most from induction therapy, particularly IL-2RA, which may be correlated with decreased infection and rejection in this cohort. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  19. High tumour cannabinoid CB1 receptor immunoreactivity negatively impacts disease-specific survival in stage II microsatellite stable colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Sofia B Gustafsson

    Full Text Available BACKGROUND: There is good evidence in the literature that the cannabinoid system is disturbed in colorectal cancer. In the present study, we have investigated whether CB(1 receptor immunoreactive intensity (CB(1IR intensity is associated with disease severity and outcome. METHODOLOGY/PRINCIPAL FINDINGS: CB(1IR was assessed in formalin-fixed, paraffin-embedded specimens collected with a consecutive intent during primary tumour surgical resection from a series of cases diagnosed with colorectal cancer. Tumour centre (n = 483 and invasive front (n = 486 CB(1IR was scored from 0 (absent to 3 (intense staining and the data was analysed as a median split i.e. CB(1IR <2 and ≥2. In microsatellite stable, but not microsatellite instable tumours (as adjudged on the basis of immunohistochemical determination of four mismatch repair proteins, there was a significant positive association of the tumour grade with the CB(1IR intensity. The difference between the microsatellite stable and instable tumours for this association of CB(1IR was related to the CpG island methylation status of the cases. Cox proportional hazards regression analyses indicated a significant contribution of CB(1IR to disease-specific survival in the microsatellite stable tumours when adjusting for tumour stage. For the cases with stage II microsatellite stable tumours, there was a significant effect of both tumour centre and front CB(1IR upon disease specific survival. The 5 year probabilities of event-free survival were: 85±5 and 66±8%; tumour interior, 86±4% and 63±8% for the CB(1IR<2 and CB(1IR≥2 groups, respectively. CONCLUSIONS/SIGNIFICANCE: The level of CB(1 receptor expression in colorectal cancer is associated with the tumour grade in a manner dependent upon the degree of CpG hypermethylation. A high CB(1IR is indicative of a poorer prognosis in stage II microsatellite stable tumour patients.

  20. Prostaglandin receptor EP3 regulates cell proliferation and migration with impact on survival of endometrial cancer patients.

    Science.gov (United States)

    Zhu, Junyan; Trillsch, Fabian; Mayr, Doris; Kuhn, Christina; Rahmeh, Martina; Hofmann, Simone; Vogel, Marianne; Mahner, Sven; Jeschke, Udo; von Schönfeldt, Viktoria

    2018-01-02

    Prostaglandin E2 (PGE2) receptor 3 (EP3) regulates tumor cell proliferation, migration, and invasion in numerous cancers. The role of EP3 as a prognostic biomarker in endometrial cancer remains unclear. The primary aim of this study was to analyze the prognostic significance of EP3 expression in endometrial cancer. We analyzed the EP3 expression of 140 endometrial carcinoma patients by immunohistochemistry. RL95-2 endometrial cancer cell line was chosen from four endometrial cancer cell lines (RL95-2, Ishikawa, HEC-1-A, and HEC-1-B) according to EP3 expression level. Treated with PGE2 and EP3 antagonist, RL95-2 cells were investigated by MTT, BrdU, and wound healing assay for functional assessment of EP3. EP3 staining differed significantly according to WHO tumor grading in both whole cohort (p = 0.01) and the subgroup of endometrioid carcinoma (p = 0.01). Patients with high EP3 expression in their respective tumors had impaired progression-free survival as well as overall survival in both cohorts above. EP3 expression in the overall cohort was identified as an independent prognostic marker for progression-free survival (HR 1.014, 95%CI 1.003-1.024, p = 0.01) when adjusted for age, stage, grading, and recurrence. Treatment with EP3 antagonists induced upregulation of estrogen receptor β and decreased activity of Ras and led to attenuated proliferation and migration of RL95-2 cells. EP3 seems to play a crucial role in endometrial cancer progression. In the context of limited systemic treatment options for endometrial cancer, this explorative analysis identifies EP3 as a potential target for diagnostic workup and therapy.

  1. Impact of nutritional factors on survival in patients with inoperable oesophageal cancer undergoing self-expanding metal stent insertion.

    Science.gov (United States)

    Gray, Ronan T; O'donnell, Mark E; Scott, Ryan D; McGuigan, James A; Mainie, Inder

    2011-06-01

    Undernutrition has been shown to be predictive of 30-day mortality in patients undergoing self-expanding metal stent (SEMS) insertion for inoperable oesophageal cancer. The aim of this study was to assess the relationship between nutritional factors and 30-day mortality in patients undergoing SEMS insertion for palliation of oesophageal cancer. A retrospective cohort study was conducted from April 2007 to June 2009. BMI, swallowing ability, calorific intake and nature of nutritional support were recorded. ICD-10 causes of death were obtained from the Department of Health and Social Services. Fifty-six stents were inserted into 53 patients (mean age 70 years, male n=35). Median (interquartile range) BMI was 21.0 kg/m (18.7-24.0). Median pre-SEMS swallowing grade was 3. Median calorific intake as a percentage of estimated daily requirements was 94.0% (75.6-100.0%). Thirty (56.6%) patients tolerated an oral diet enhanced with supplement drinks whereas 23 (43.4%) patients required more invasive forms of enteral and parenteral support. The 30-day mortality rate was 11.3% (n=6) and cumulative median survival was 84 (interquartile range 38-156) days. BMI, calorific intake and swallowing capacity were not predictors of survival. Although there was a nonsignificant trend for reduced survival in those patients who did (n=23) receive invasive nutritional support compared with those who did not (n=30) (83.9 vs. 151.3 days, P=0.053), invasive nutritional support itself was not predictive of 30-day mortality (P=0.74). The requirement for invasive nutritional support before SEMS insertion is associated with a poor prognosis and possibly represents more aggressive tumour pathology. Further prospective assessment of prognostic factors, including nutritional parameters, to facilitate reliable selection of appropriate palliative modalities in oesophageal cancer is required.

  2. Early-Stage Classic Hodgkin Lymphoma: The Utilization of Radiation Therapy and Its Impact on Overall Survival

    Energy Technology Data Exchange (ETDEWEB)

    Parikh, Rahul R., E-mail: rparikh@chpnet.org [Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center and Mount Sinai St. Luke' s-Roosevelt Hospitals, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, New York (United States); Grossbard, Michael L. [Division of Hematology-Oncology, Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, New York, New York (United States); Harrison, Louis B. [Department of Radiation Oncology, Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Yahalom, Joachim [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2015-11-01

    Purpose: To examine the association between radiation therapy (RT) utilization and overall survival (OS) for patients with early-stage Hodgkin lymphoma (HL). Methods and Materials: Using the National Cancer Database, we evaluated clinical features and survival outcomes among patients diagnosed with stage I/II HL from 1998 to 2011. The association between RT use, covariables, and outcome was assessed in a Cox proportional hazards regression model. Propensity score matching was performed to balance observed confounding factors. Survival was estimated using the Kaplan-Meier method. Results: Among the 41,943 patients in the National Cancer Database with stage I/II HL, 29,752 patients were analyzed for this study. Radiation therapy use was associated with younger age (≤40 years), favorable insured status, higher socioeconomic status (income, education), and treatment at comprehensive community cancer centers (all P<.05). Five-year OS for patients receiving RT was 94.5%, versus 88.9% for those not receiving RT (P<.01). Radiation therapy use was a significant predictor of OS in the “As-Treated” cohort (hazard ratio 0.53, 95% confidence interval 0.49-0.58, P<.01) and intention-to-treat analysis (P<.01). After propensity score matching based on clinicopathologic characteristics, RT use remained associated with improved OS (hazard ratio 0.46, 95% confidence interval 0.38-0.56, P<.01). Over the study period, RT utilization for this cohort decreased from 55% to 44%, most commonly because it was not part of the planned initial treatment strategy. Conclusions: Consolidation RT was associated with improved OS for patients with early-stage classic HL. We also have identified patient-specific variations in the use of RT that may be targeted to improve patient access to care.

  3. Effect of low concentrations of benzalkonium chloride on acanthamoebal survival and its potential impact on empirical therapy of infectious keratitis.

    Science.gov (United States)

    Tu, Elmer Y; Shoff, Megan E; Gao, Weihua; Joslin, Charlotte E

    2013-05-01

    The significant antiacanthamoebal effect of benzalkonium chloride, at or below concentrations used for preservation of common ophthalmic preparations, should be understood both when choosing empiric antibiotic therapy for infectious keratitis and when assessing the persistent rise in Acanthamoeba cases in the United States since 2003. To characterize the antiacanthamoebal efficacy of low concentrations of benzalkonium chloride (BAK) for drug preservation and therapeutic effect against Acanthamoeba. Experimental study with a review of the literature. Laboratory. A concentration of 10(4) trophozoites of 3 well-characterized clinical strains of Acanthamoeba were exposed at 0.5, 2.0, 3.5, 5.0, and 6.5 hours to BAK (0.001%, 0.002%, and 0.003%), moxifloxacin hydrochloride (0.5%), and moxifloxacin (0.5%) + BAK (0.001% and 0.003%) with hydrogen peroxide (3%) and amoeba saline controls. Amoeba survival was calculated using the most probable number method recorded as log kill values. The relationship of BAK concentration and exposure time as well as the relative effect of BAK and moxifloxacin on acanthamoebal survival were analyzed. Amoebicidal activity of BAK is both time dependent and concentration dependent in pooled and strain-stratified analyses (P independent inhibitory effect or additive effect to BAK efficacy on acanthamoebal survival. The profound antiacanthamoebal effect of BAK, 0.003%, was similar to that of hydrogen peroxide for certain strains. Low concentrations of BAK, previously demonstrated to concentrate and persist in ocular surface epithelium, exhibit significant antiacanthamoebal activity in vitro at or below concentrations found in commercially available ophthalmic anti-infectives. The unexplained persistence of the Acanthamoeba keratitis outbreak in the United States, clusters abroad, and clinical studies reporting resolution or modification of Acanthamoeba keratitis without specific antiacanthamoebal therapy suggests that other contributing factors

  4. Impact of treatment in long-term survival patients with follicular lymphoma: A Spanish Lymphoma Oncology Group registry

    Science.gov (United States)

    Provencio, Mariano; Sabín, Pilar; Gomez-Codina, Jose; Calvo, Virginia; Llanos, Marta; Gumá, Josep; Quero, Cristina; Blasco, Ana; Cruz, Miguel Angel; Aguiar, David; García-Arroyo, Francisco; Lavernia, Javier; Martinez, Natividad; Morales, Manuel; Saez-Cusi, Alvaro; Rodriguez, Delvys; de la Cruz, Luis; Sanchez, Jose Javier; Rueda, Antonio

    2017-01-01

    Background Follicular lymphoma is the second most common non-Hodgkin lymphoma in the United States and Europe. However, most of the prospective randomized studies have very little follow-up compared to the long natural history of the disease. The primary aim of this study was to investigate the long-term survival of our series of patients with follicular lymphoma. Patients and methods A total of 1074 patients with newly diagnosed FL were enrolled. Patients diagnosed were prospectively enrolled from 1980 to 2013. Results Median follow-up was 54.9 months and median overall survival is over 20 years in our series. We analyzed the patients who are still alive beyond 10 years from diagnosis in order to fully assess the prognostic factors that condition this group. Out of 166 patients who are still alive after more than 10 years of follow-up, 118 of them (73%) are free of evident clinical disease. Variables significantly associated with survival at 10 years were stage < II (p <0.03), age < 60 years (p <0.0001), low FLIPI (p <0.002), normal β2 microglobulin (p <0.005), no B symptoms upon diagnosis (p <0.02), Performance Status 0–1 (p <0.03) and treatment with anthracyclines and rituximab (p <0.001), or rituximab (p <0.0001). Conclusions A longer follow-up and a large series demonstrated a substantial population of patients with follicular lymphoma free of disease for more than 10 years. PMID:28493986

  5. The impact of Bevacizumab (Avastin on survival in metastatic solid tumors--a meta-analysis and systematic review.

    Directory of Open Access Journals (Sweden)

    Limor Amit

    Full Text Available PURPOSE: To evaluate the effect of Bevacizumab in combination with chemotherapy on overall survival of patients with metastatic solid tumors. DESIGN: A systematic literature search to identify randomized trials comparing chemotherapy with and without Bevacizumab in metastatic cancer. The primary end point was overall survival (OS and the secondary end points were progression free survival (PFS and toxicity. A meta-analysis was performed for each tumor type and for the combination of all tumors. RESULTS: 24 randomized trials with 8 different types of malignancies were included in this meta-analysis. Patients treated with Bevacizumab had an OS benefit, hazard ratio (HR 0.89 (95% CI 0.84-0.93, P<0.00001 I(2-4%. The combined analysis showed a PFS benefit with a HR 0.71 (95% CI 0.68-0.74, P<0.00001, I(2-54%. The toxicity analysis showed a statistically significant increase in fatal adverse events (FAEs in the Bevacizumab treatment arm, risk ratio (RR 1.47 (95% CI 1.1-1.98. A separate analysis of the lung cancer trials showed an increased risk of fatal pulmonary hemorrhage with a RR of 5.65 (95% CI 1.26-25.26. The risk of G3-4 adverse events was increased: RR 1.2 (95% CI 1.15-1.24. CONCLUSION: in this combined analysis Bevacizumab improved OS (with little heterogeneity and PFS. These results should be considered in the light of lack of markers predictive of response and the increased severe and fatal toxicity seen with Bevacizumab treatment.

  6. High tumour cannabinoid CB1 receptor immunoreactivity negatively impacts disease-specific survival in stage II microsatellite stable colorectal cancer.

    Science.gov (United States)

    Gustafsson, Sofia B; Palmqvist, Richard; Henriksson, Maria L; Dahlin, Anna M; Edin, Sofia; Jacobsson, Stig O P; Öberg, Åke; Fowler, Christopher J

    2011-01-01

    There is good evidence in the literature that the cannabinoid system is disturbed in colorectal cancer. In the present study, we have investigated whether CB(1) receptor immunoreactive intensity (CB(1)IR intensity) is associated with disease severity and outcome. CB(1)IR was assessed in formalin-fixed, paraffin-embedded specimens collected with a consecutive intent during primary tumour surgical resection from a series of cases diagnosed with colorectal cancer. Tumour centre (n = 483) and invasive front (n = 486) CB(1)IR was scored from 0 (absent) to 3 (intense staining) and the data was analysed as a median split i.e. CB(1)IR microsatellite stable, but not microsatellite instable tumours (as adjudged on the basis of immunohistochemical determination of four mismatch repair proteins), there was a significant positive association of the tumour grade with the CB(1)IR intensity. The difference between the microsatellite stable and instable tumours for this association of CB(1)IR was related to the CpG island methylation status of the cases. Cox proportional hazards regression analyses indicated a significant contribution of CB(1)IR to disease-specific survival in the microsatellite stable tumours when adjusting for tumour stage. For the cases with stage II microsatellite stable tumours, there was a significant effect of both tumour centre and front CB(1)IR upon disease specific survival. The 5 year probabilities of event-free survival were: 85±5 and 66±8%; tumour interior, 86±4% and 63±8% for the CB(1)IRcolorectal cancer is associated with the tumour grade in a manner dependent upon the degree of CpG hypermethylation. A high CB(1)IR is indicative of a poorer prognosis in stage II microsatellite stable tumour patients.

  7. Alternative lengthening of telomeres is enriched in, and impacts survival of TP53 mutant pediatric malignant brain tumors.

    Science.gov (United States)

    Mangerel, Joshua; Price, Aryeh; Castelo-Branco, Pedro; Brzezinski, Jack; Buczkowicz, Pawel; Rakopoulos, Patricia; Merino, Diana; Baskin, Berivan; Wasserman, Jonathan; Mistry, Matthew; Barszczyk, Mark; Picard, Daniel; Mack, Stephen; Remke, Marc; Starkman, Hava; Elizabeth, Cynthia; Zhang, Cindy; Alon, Noa; Lees, Jodi; Andrulis, Irene L; Wunder, Jay S; Jabado, Nada; Johnston, Donna L; Rutka, James T; Dirks, Peter B; Bouffet, Eric; Taylor, Michael D; Huang, Annie; Malkin, David; Hawkins, Cynthia; Tabori, Uri

    2014-12-01

    Although telomeres are maintained in most cancers by telomerase activation, a subset of tumors utilize alternative lengthening of telomeres (ALT) to sustain self-renewal capacity. In order to study the prevalence and significance of ALT in childhood brain tumors we screened 517 pediatric brain tumors using the novel C-circle assay. We examined the association of ALT with alterations in genes found to segregate with specific histological phenotypes and with clinical outcome. ALT was detected almost exclusively in malignant tumors (p = 0.001). ALT was highly enriched in primitive neuroectodermal tumors (12 %), choroid plexus carcinomas (23 %) and high-grade gliomas (22 %). Furthermore, in contrast to adult gliomas, pediatric low grade gliomas which progressed to high-grade tumors did not exhibit the ALT phenotype. Somatic but not germline TP53 mutations were highly associated with ALT (p = 1.01 × 10(-8)). Of the other alterations examined, only ATRX point mutations and reduced expression were associated with the ALT phenotype (p = 0.0005). Interestingly, ALT attenuated the poor outcome conferred by TP53 mutations in specific pediatric brain tumors. Due to very poor prognosis, one year overall survival was quantified in malignant gliomas, while in children with choroid plexus carcinoma, five year overall survival was investigated. For children with TP53 mutant malignant gliomas, one year overall survival was 63 ± 12 and 23 ± 10 % for ALT positive and negative tumors, respectively (p = 0.03), while for children with TP53 mutant choroid plexus carcinomas, 5 years overall survival was 67 ± 19 and 27 ± 13 % for ALT positive and negative tumors, respectively (p = 0.07). These observations suggest that the presence of ALT is limited to a specific group of childhood brain cancers which harbor somatic TP53 mutations and may influence the outcome of these patients. Analysis of ALT may contribute to risk stratification and targeted therapies to

  8. Impact of moisture on survival of Aedes aegypti eggs and ovicidal activity of Metarhizium anisopliae under laboratory conditions

    Directory of Open Access Journals (Sweden)

    C Luz

    2008-03-01

    Full Text Available The effect of relative humidity (43%, 75%, 86% and > 98% on Aedes aegypti eggs treated with Metarhizium anisopliae or water only was tested for up to a six months exposure at 25ºC. Survival of larvae inside eggs was clearly affected by the lowest humidity (43% tested, and eclosion diminished at all humidities after increasing periods of exposure. M. anisopliae showed to have a strong ovicidal activity only at humidity close to saturation. No difference of activity was found between conidia and hyphal bodies tested. This fungus affected larvae inside eggs and has potential as a control agent of this important vector in breeding sites with high moisture.

  9. Optimization of heart failure medication after cardiac resynchronization therapy and the impact on long-term survival

    DEFF Research Database (Denmark)

    Witt, Christoffer Tobias; Kronborg, Mads Brix; Nohr, Ellen Aagaard

    2015-01-01

    AIMS: Treatment with evidence-based heart failure (HF) medication reduces morbidity and mortality, yet they remain underused and underdosed. Cardiac resynchronization therapy (CRT) improves haemodynamics, and might allow for optimization of HF medication. We analysed treatment with HF medication......HR 0.55 (0.38-0.80); P = 0.002). CONCLUSION: After CRT implantation, optimization of HF treatment is possible, and long-term adherence to HF medication remains high. Higher doses of BB and ACEi/ARB were associated with prolonged survival....

  10. Impact of Lifestyle Diseases on Postoperative Complications and Survival in Elderly Patients with Stage I Non-Small Cell Lung Cancer

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    Sang Seok Jeong

    2017-04-01

    Full Text Available Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years. Forty-six patients (41.8% had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%. The in-hospital mortality rate was 0.9% (n=1. The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%, including 7 (6.4% with prolonged air leakage, 6 (5.5% with atrial fibrillation, 5 (4.5% with delirium and atelectasis, and 3 (2.7% with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030 and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043 had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant

  11. Impacts of Carpobrotus edulis (L. N.E.Br. on the germination, establishment and survival of native plants: a clue for assessing its competitive strength.

    Directory of Open Access Journals (Sweden)

    Ana Novoa

    Full Text Available Does Carpobrotus edulis have an impact on native plants? How do C. edulis' soil residual effects affect the maintenance of native populations? What is the extent of interspecific competition in its invasion process? In order to answer those questions, we established pure and mixed cultures of native species and C. edulis on soil collected from invaded and native areas of Mediterranean coastal dunes in the Iberian Peninsula. We examined the impact of the invader on the germination, growth and survival of seeds and adult plants of two native plant species (Malcolmia littorea (L. R.Br, and Scabiosa atropurpurea L. growing with ramets or seeds of C. edulis. Residual effects of C. edulis on soils affected the germination process and early growth of native plants in different ways, depending on plant species and density. Interspecific competition significantly reduced the germination and early growth of native plants but this result was soil, density, timing and plant species dependent. Also, at any density of adult individuals of C. edulis, established native adult plants were not competitive. Moreover, ramets of C. edulis had a lethal effect on native plants, which died in a short period of time. Even the presence of C. edulis seedlings prevents the recruitment of native species. In conclusion, C. edulis have strong negative impacts on the germination, growth and survival of the native species M. littorea and S. atropurpurea. These impacts were highly depended on the development stages of native and invasive plants. Our findings are crucial for new strategies of biodiversity conservation in coastal habitats.

  12. Anal Carcinoma: Impact of TN Category of Disease on Survival, Disease Relapse, and Colostomy Failure in US Gastrointestinal Intergroup RTOG 98-11 Phase 3 Trial

    Science.gov (United States)

    Gunderson, Leonard L.; Moughan, Jennifer; Ajani, Jaffer A.; Pedersen, John E.; Winter, Kathryn A.; Benson, Al B.; Thomas, Charles R.; Mayer, Robert J.; Haddock, Michael G.; Rich, Tyvin A.; Willett, Christopher G.

    2013-01-01

    Purpose The long-term update of US GI Intergroup RTOG 98-11 anal cancer trial found that concurrent chemoradiation (CCRT) with fluorouracil (5-FU) plus mitomycin had a significant impact on disease-free survival (DFS) and overall survival (OS) compared with induction plus concurrent 5-FU plus cisplatin. The intent of the current analysis was to determine the impact of tumor node (TN) category of disease on survival (DFS and OS), colostomy failure (CF), and relapse (local-regional failure [LRF] and distant metastases [DM]) in this patient group. Methods and Materials DFS and OS were estimated univariately by using the Kaplan-Meier method, and 6 TN categories were compared by the log–rank test (T2N0, T3N0, T4N0, T2N1-3, T3N1-3, and T4N1-3). Time to relapse and colostomy were estimated by the cumulative incidence method, and TN categories were compared using Gray’s test. Results Of 682 patients, 620 were analyzable for outcomes by TN category. All endpoints showed statistically significant differences among the TN categories of disease (OS, P<.0001; DFS, P<.0001; LRF, P<.0001; DM, P=.0011; CF, P=.01). Patients with the poorest OS, DFS, and LRF outcomes were those with T3-4N-positive (+) disease. CF was lowest for T2N0 and T2N+ (11%, 11%, respectively) and worst for the T4N0, T3N+, and T4N+ categories (26%, 27%, 24%, respectively). Conclusions TN category of disease has a statistically significant impact on OS, DFS, LRF, DM, and CF in patients treated with CCRT and provides excellent prognostic information for outcomes in patients with anal carcinoma. Significant challenges remain for patients with T4N0 and T3-4N+ categories of disease with regard to survival, relapse, and CF and lesser challenges for T2-3N0/T2N+ categories. PMID:24035327

  13. Impact of institutional accreditation by the Japan Society of Gynecologic Oncology on the treatment and survival of women with cervical cancer.

    Science.gov (United States)

    Mikami, Mikio; Shida, Masako; Shibata, Takeo; Katabuchi, Hidetaka; Kigawa, Junzo; Aoki, Daisuke; Yaegashi, Nobuo

    2018-03-01

    The Japan Society of Gynecologic Oncology (JSGO) initiated a nation-wide training system for the education and certification for gynecologic oncologists in 2005. To assess the impact of the quality of the JSGO-accredited institutions, JSGO undertook an analysis of the Uterine Cervical Cancer Registry of the Japan Society of Obstetrics and Gynecology (JSOG) to determine the effectiveness of the JSGO-accredited institutions on the treatment and survival of women with cervical cancer. The effectiveness of 119 JSGO-accredited institutions and 125 non-JSGO-accredited institutions on the treatment and survival of women with cervical cancer were compared by analyzing the tumor characteristics, treatment patterns, and survival outcomes of women with stage T1B-T4 cervical cancer utilizing the data in the JSOG nation-wide registry for cervical cancer (2006-2009). A total of 14,185 eligible women were identified: 10,920 (77.0%) cases for 119 JSGO-accredited institutions and 3,265 (23.0%) cases for 125 non-accredited institutions. A multivariate analysis showed that age, stage, histology type, and treatment pattern were independently associated with mortality. Moreover, women who received treatment at the JSGO-accredited institutions had a significantly decreased mortality risk compared to non-accredited institutions (adjusted hazard ratio [aHR]=0.843; 95% confidence interval [CI]=0.784-0.905). Similar findings on multivariate analysis were seen among subset of women who received surgery alone (aHR=0.552; 95% CI=0.393-0.775) and among women who received radiotherapy (aHR=0.845; 95% CI=0.766-0.931). Successful implementation of gynecologic oncology accrediting institution was associated with improved survival outcome of women with cervical cancer in Japan.

  14. Measuring the impact of emergency medical services (EMS) on out-of-hospital cardiac arrest survival in a developing country: A key metric for EMS systems' performance.

    Science.gov (United States)

    El Sayed, Mazen; Al Assad, Reem; Abi Aad, Yasmin; Gharios, Nour; Refaat, Marwan M; Tamim, Hani

    2017-07-01

    Out-of-hospital cardiac arrest (OHCA) can be used to evaluate the overall performance of the emergency medical services' (EMS) system. This study assessed the impact of EMS on OHCA survival rates in a setting where the prehospital system is underdeveloped.A retrospective chart review was carried out over a 5-year period of all adult OHCA patients admitted to the emergency department (ED) of a tertiary care center in Lebanon.A total of 271 patients with OHCA (179 [66.1%] men, mean age of 69.9 [standard deviation = 15.0 years] were enrolled. The most common OHCA location was residence/home (58.7%). The majority of arrests were witnessed (51.7%) with 6.1% witnessed by EMS; 211 patients (75.6%) were transported to the ED by EMS. Prehospital cardiopulmonary resuscitation (CPR) was done by EMS for 43.2% of the patients, whereas only 4.4% received CPR from a family member/bystander. Prehospital automated external defibrillator use was documented in 1.5% of cases in the prehospital setting. Only 2 patients had return of spontaneous circulation prior to ED arrival. Most patients (96.7%) were resuscitated in the ED. Patients presented to the ED mostly in asystole (79.3%). Forty-three patients (15.9%) survived to hospital admission and 13 (4.8%) were discharged alive with over half of them (53.8%) had a good neurological outcome upon discharge (cerebral performance category 1 or 2).Survival of EMS-treated OHCA victims in Lebanon is not as expected. Medical oversight of EMS activities is needed to link EMS activities to clinical outcomes and improve survival from cardiac arrest in Lebanon.

  15. More than Just the Number of Brain Metastases: Evaluating the Impact of Brain Metastasis Location and Relative Volume on Overall Survival After Stereotactic Radiosurgery.

    Science.gov (United States)

    Emery, Ashley; Trifiletti, Daniel M; Romano, Kara D; Patel, Nirav; Smolkin, Mark E; Sheehan, Jason P

    2017-03-01

    Most evidence describing outcomes of patients with brain metastases is based on number of brain metastases, rather than location or volume. We evaluated the impact of tumor location and relative volume on overall survival (OS) among a large cohort of patients treated with stereotactic radiosurgery. Clinical, radiographic, and dosimetric data were collected on patients treated with first (if multiple) stereotactic radiosurgery for brain metastases. Multivariate analyses were performed to investigate the impact of brain metastasis relative location and volume on OS after stereotactic radiosurgery. Analysis included 300 patients with 817 tumors (116 patients with single brain metastasis). The most common tumor locations were supratentorial (75% of tumors), cerebellar (19%), and brainstem (5%). Median tumor volume was 0.4 mL (range, 0.003-65.0 mL). Tumor-specific factors associated with inferior OS included brainstem location versus both supratentorial and cerebellum locations for particular assumed values of cube root tumor volume (P < 0.001 for each) and increasing total supratentorial tumor volume (P = 0.004). Patients with supratentorial tumors and cerebellar tumors demonstrated similar OS, and cube root total tumor volume within the cerebellum and brainstem did not predict for OS. The presence of brainstem metastases and cumulative supratentorial tumor volume are adverse features that result in inferior survival. These results can be used to inform patient prognosis and future clinical trial design. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Impact of Trough Levels of Tacrolimus on Kidney Function and Graft Survival in Short and Longer Periods After Renal Transplantation.

    Science.gov (United States)

    Žilinská, Z; Dedinská, I; Breza, J; Laca, L

    2016-10-01

    Optimizing immunosuppressive treatment in the early posttransplant period is important for achieving long-term graft function and survival. There were 205 renal transplant recipients involved in this study. Patients were divided into groups according to the induction therapy (no induction vs basiliximab/daclizumab vs rabbit antithymocyte globulin), maintenance therapy at the time of transplantation (tacrolimus [TAC] vs cyclosporine), the average trough TAC levels in months 4 to 6 after TO and serum creatinine 5 years after renal transplantation. The incidence of acute rejection was significantly higher in cyclosporine than in TAC group of patients (P = .0364). The average TAC levels on elapsed time after transplantation significantly decreased (P < .0001). Five years after renal transplantation, there were higher TAC levels (5.6 ± 0.7 ng/mL) in the group with "zero" low levels than in the group with "zero" high levels (4.6 ± 1.1 ng/mL), which was statistically significant (P < .0001). We did not find any difference in graft and patient survival in posttransplant years 2 to 5 according to TAC levels or the induction treatment. In our study, we have confirmed that better graft function 5 years after transplantation was connected with higher trough tacrolimus levels on elapsed time after renal transplantation. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Impact of Microplastic Beads and Fibers on Waterflea (Ceriodaphnia dubia) Survival, Growth, and Reproduction: Implications of Single and Mixture Exposures.

    Science.gov (United States)

    Ziajahromi, Shima; Kumar, Anupama; Neale, Peta A; Leusch, Frederic D L

    2017-11-03

    There is limited knowledge regarding the adverse effects of wastewater-derived microplastics, particularly fibers, on aquatic biota. In this study, we examined the acute (48 h) and chronic (8 d) effects of microplastic polyester fibers and polyethylene (PE) beads on freshwater zooplankton Ceriodaphnia dubia. We also assessed the acute response of C. dubia to a binary mixture of microplastic beads and fibers for the first time. Acute exposure to fibers and PE beads both showed a dose-dependent effect on survival. An equitoxic binary mixture of beads and fibers resulted in a toxic unit of 1.85 indicating less than additive effects. Chronic exposure to lower concentrations did not significantly affect survival of C. dubia, but a dose-dependent effect on growth and reproduction was observed. Fibers showed greater adverse effects than PE beads. While ingestion of fibers was not observed, scanning electron microscopy showed carapace and antenna deformities after exposure to fibers, with no deformities observed after exposure to PE beads. While much of the current research has focused on microplastic beads, our study shows that microplastic fibers pose a greater risk to C. dubia, with reduced reproductive output observed at concentrations within an order of magnitude of reported environmental levels.

  18. Impact of Early Low-Grade Proteinuria and Allograft Dysfunction on Survival in Expanded Criteria Donor Kidney Transplant Recipients.

    Science.gov (United States)

    López, V; Cabello, M; Ruíz-Esteban, P; Sola, E; Gutiérrez, C; Jironda, C; Burgos, D; González-Molina, M; Hernández, D

    2015-11-01

    Recent studies have demonstrated a relationship between low-grade proteinuria and worse graft survival, but this has not been fully studied in expanded criteria donor (ECD) kidney transplant recipients. The aim of this study was to assess whether the combination of early low-grade proteinuria (proteinuria (300 mg/d) and median creatinine (Cr; 1.7 mg/dL; interquartile range, 1.4-2.1 mg/dL) at the third month post-transplantation: Group A (Cr proteinuria proteinuria ≥300 mg/24 h; n = 38), Group C (Cr ≥1.7 mg/dL and proteinuria proteinuria ≥300 mg/24 h; n = 55). Death-censored graft survival was significantly lower in Group D compared with the rest (P proteinuria and a lower estimated glomerular filtration rate (eGFR) as associated with graft failure (hazard rate [HR] 2.5, 95% confidence interval [CI], 1.09-5.97; P = .03). The early association of low-grade proteinuria and allograft dysfunction represents an important risk factor for graft loss in ECD kidney transplant recipients. Strategies to optimize renal function could improve the outcome in this specific population. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Metabolic and protein interaction sub-networks controlling the proliferation rate of cancer cells and their impact on patient survival.

    Science.gov (United States)

    Feizi, Amir; Bordel, Sergio

    2013-10-24

    Cancer cells can have a broad scope of proliferation rates. Here we aim to identify the molecular mechanisms that allow some cancer cell lines to grow up to 4 times faster than other cell lines. The correlation of gene expression profiles with the growth rate in 60 different cell lines has been analyzed using several genome-scale biological networks and new algorithms. New possible regulatory feedback loops have been suggested and the known roles of several cell cycle related transcription factors have been confirmed. Over 100 growth-correlated metabolic sub-networks have been identified, suggesting a key role of simultaneous lipid synthesis and degradation in the energy supply of the cancer cells growth. Many metabolic sub-networks involved in cell line proliferation appeared also to correlate negatively with the survival expectancy of colon cancer patients.

  20. BCR-ABL mutations in chronic myeloid leukemia treated with tyrosine kinase inhibitors and impact on survival.

    Science.gov (United States)

    Pagnano, Katia Borgia Barbosa; Bendit, Israel; Boquimpani, Carla; De Souza, Carmino Antonio; Miranda, Eliana C M; Zalcberg, Ilana; Larripa, Irene; Nardinelli, Luciana; Silveira, Rosana Antunes; Fogliatto, Laura; Spector, Nelson; Funke, Vaneuza; Pasquini, Ricardo; Hungria, Vania; Chiattone, Carlos Sérgio; Clementino, Nelma; Conchon, Monika; Moiraghi, Elena Beatriz; Lopez, Jose Luis; Pavlovsky, Carolina; Pavlovsky, Miguel A; Cervera, Eduardo E; Meillon, Luis Antonio; Simões, Belinda; Hamerschlak, Nelson; Bozzano, Alicia Helena Magarinos; Mayta, Ernesto; Cortes, Jorge; Bengió, Raquel M

    2015-01-01

    This is the largest Latin American study of BCR-ABL mutations in chronic myeloid leukemia (CML) patients, resistant to imatinib (IM). In 195/467 (41%) patients, mutations were detected. The most frequent mutation was T315I (n = 31, 16%). Progression-free (PFS) and overall survival (OS) at 5 years were lower in patients with BCR-ABL mutations (43% vs. 65%, p = 0.07 and 47% vs. 72%, p = 0.03, respectively) and in those with the T315I mutation (p = 0.003 and p = 0.03). OS and PFS were superior in subgroup who switched to second generation inhibitors (SGIs) after IM failure (OS: 50% vs. 39% p = 0.01; PFS: 48% vs. 30% p = 0.02). BCR-ABL mutations conferred a significant poor prognosis in CML patients.

  1. Impact of morcellation on survival outcomes of patients with unexpected uterine leiomyosarcoma: a systematic review and meta-analysis.

    Science.gov (United States)

    Bogani, Giorgio; Cliby, William A; Aletti, Giovanni D

    2015-04-01

    To review the current evidence on the effects of intra-abdominal morcellation on survival outcomes of patients affected by unexpected uterine leiomyosarcoma (ULMS) and to estimate the risk of recurrence in those patients. PubMed (MEDLINE), Scopus, Embase, Web of Science databases as well as ClinicalTrials.gov, were searched for data evaluating the effects of intra-abdominal morcellation on survival outcomes of patients with undiagnosed ULMS. Studies were evaluated per the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) and the American College of Obstetricians and Gynecologists (ACOG) guidelines. Sixty manuscripts were screened, 11 (18%) were selected and four (7%) were included. Overall, 202 patients were included: 75 (37%) patients had morcellation of ULMS, while 127 (63%) patients had not. A meta-analysis of these studies showed that morcellation increased the overall (62% vs. 39%; OR: 3.16 (95% CI: 1.38, 7.26)) and intra-abdominal (39% vs. 9%; OR: 4.11 (95% CI: 1.92, 8.81)) recurrence rates as well as death rate (48% vs. 29%; OR: 2.42 (95% CI: 1.19, 4.92)). No between-group difference in cumulative extra-abdominal recurrence (OR: 0.34 (95% CI: 0.07, 1.59)) rate was observed. Our data support a significant correlation between uterine morcellation and an increased risk of intra-abdominal recurrence in patients affected by unexpected ULMS. However, the limited data on this issue and the absence of high level of evidence suggest the need of further studies designed to estimate the risk to benefit ratio of morcellation in patients with uterine fibroids and undiagnosed ULMS. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Impact of fluid status and inflammation and their interaction on survival: a study in an international hemodialysis patient cohort.

    Science.gov (United States)

    Dekker, Marijke J E; Marcelli, Daniele; Canaud, Bernard J; Carioni, Paola; Wang, Yuedong; Grassmann, Aileen; Konings, Constantijn J A M; Kotanko, Peter; Leunissen, Karel M; Levin, Nathan W; van der Sande, Frank M; Ye, Xiaoling; Maheshwari, Vaibhav; Usvyat, Len A; Kooman, Jeroen P

    2017-05-01

    In hemodialysis patients extracellular fluid overload is a predictor of all-cause and cardiovascular mortality, and a relation with inflammation has been reported in previous studies. The magnitude and nature of this interaction and the effects of moderate fluid overload and extracellular fluid depletion on survival are still unclear. We present the results of an international cohort study in 8883 hemodialysis patients from the European MONDO initiative database where, during a three-month baseline period, fluid status was assessed using bioimpedance and inflammation by C-reactive protein. All-cause mortality was recorded during 12 months of follow up. In a second analysis a three-month baseline period was added to the first baseline period, and changes in fluid and inflammation status were related to all-cause mortality during six-month follow up. Both pre-dialysis estimated fluid overload and fluid depletion were associated with an increased mortality, already apparent at moderate levels of estimated pre-dialysis fluid overload (1.1-2.5L); hazard ratio 1.64 (95% confidence interval 1.35-1.98). In contrast, post-dialysis estimated fluid depletion was associated with a survival benefit (0.74 [0.62-0.90]). The concurrent presence of fluid overload and inflammation was associated with the highest risk of death. Thus, while pre-dialysis fluid overload was associated with inflammation, even in the absence of inflammation, fluid overload remained a significant risk factor for short-term mortality, even following improvement of fluid status. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  3. The regulatory interaction of EVI1 with the TCL1A oncogene impacts cell survival and clinical outcome in CLL.

    Science.gov (United States)

    Vasyutina, E; Boucas, J M; Bloehdorn, J; Aszyk, C; Crispatzu, G; Stiefelhagen, M; Breuer, A; Mayer, P; Lengerke, C; Döhner, H; Beutner, D; Rosenwald, A; Stilgenbauer, S; Hallek, M; Benner, A; Herling, M

    2015-10-01

    Dysregulated T-cell leukemia/lymphoma-1A (TCL1A), a modulator in B-cell receptor (BCR) signaling, is causally implicated in chronic lymphocytic leukemia (CLL). However, the mechanisms of the perturbed TCL1A regulation are largely unknown. To characterize TCL1A-upstream networks, we functionally screened for TCL1A-repressive micro-RNAs (miRs) and their transcriptional regulators. We identified the novel miR-484 to target TCL1A's 3'-UTR and to be downregulated in CLL. In chromatin immunoprecipitations and reporter assays, the oncogenic transcription factor of myeloid cells, EVI1, bound and activated the miR-484 promoter. Most common in CLL was a pan-EVI1 transcript variant. EVI1 protein expression revealed distinct normal-tissue and leukemia-associated patterns of EVI1/TCL1A co-regulation. EVI1 levels were particularly low in TCL1A-high CLL or such cellular subsets. Global gene expression profiles from a 337-patient set linked EVI1 networks to BCR signaling and cell survival via TCL1A, BTK and other molecules of relevance in CLL. Enforced EVI1, as did miR-484, repressed TCL1A. Furthermore, it reduced phospho-kinase levels, impaired cell survival, mitigated BCR-induced Ca-flux and diminished the in vitro ibrutinib response. Moreover, TCL1A and EVI1 showed a strongly interactive hazard prediction in prospectively treated patients. Overall, we present regressive EVI1 as a novel regulatory signature in CLL. Through enhanced TCL1A and other EVI1-targeted hallmarks of CLL, this contributes to an aggressive cellular and clinical phenotype.

  4. The Impact of Space Flight on Survival and Interaction of Cupriavidus metallidurans CH34 with Basalt, a Volcanic Moon Analog Rock

    Directory of Open Access Journals (Sweden)

    Natalie Leys

    2017-04-01

    Full Text Available Microbe-mineral interactions have become of interest for space exploration as microorganisms could be used to biomine from extra-terrestrial material and extract elements useful as micronutrients in life support systems. This research aimed to identify the impact of space flight on the long-term survival of Cupriavidus metallidurans CH34 in mineral water and the interaction with basalt, a lunar-type rock in preparation for the ESA spaceflight experiment, BIOROCK. Therefore, C. metallidurans CH34 cells were suspended in mineral water supplemented with or without crushed basalt and send for 3 months on board the Russian FOTON-M4 capsule. Long-term storage had a significant impact on cell physiology and energy status (by flow cytometry analysis, plate count and intracellular ATP measurements as 60% of cells stored on ground lost their cell membrane potential, only 17% were still active, average ATP levels per cell were significantly lower and cultivability dropped to 1%. The cells stored in the presence of basalt and exposed to space flight conditions during storage however showed less dramatic changes in physiology, with only 16% of the cells lost their cell membrane potential and 24% were still active, leading to a higher cultivability (50% and indicating a general positive effect of basalt and space flight on survival. Microbe-mineral interactions and biofilm formation was altered by spaceflight as less biofilm was formed on the basalt during flight conditions. Leaching from basalt also changed (measured with ICP-OES, showing that cells release more copper from basalt and the presence of cells also impacted iron and magnesium concentration irrespective of the presence of basalt. The flight conditions thus could counteract some of the detrimental effects observed after the 3 month storage conditions.

  5. Revascularization and cardioprotective drug treatment in myocardial infarction patients: how do they impact on patients' survival when delivered as usual care

    Directory of Open Access Journals (Sweden)

    Courteau Josiane

    2006-05-01

    Full Text Available Abstract Background Randomized clinical trials showed the benefit of pharmacological and revascularization treatments in secondary prevention of myocardial infarction (MI, in selected population with highly controlled interventions. The objective of this study is to measure these treatments' impact on the cardiovascular (CV mortality rate among patients receiving usual care in the province of Quebec. Methods The study population consisted of a "naturalistic" cohort of all patients ≥ 65 years old living in the Quebec province, who survived a MI (ICD-9: 410 in 1998. The studied dependant variable was time to death from a CV disease. Independent variables were revascularization procedure and cardioprotective drugs. Death from a non CV disease was also studied for comparison. Revascularization procedure was defined as percutaneous transluminal coronary angioplasty (PTCA or coronary artery bypass graft (CABG. The exposure to cardioprotective drugs was defined as the number of cardioprotective drug classes (Acetylsalicylic Acid (ASA, Beta-Blockers, Angiotensin-Converting Enzyme (ACE Inhibitors, Statins claimed within the index period (first 30 days after the index hospitalization. Age, gender and a comorbidity index were used as covariates. Kaplan-Meier survival curves, Cox proportional hazard models, logistic regressions and regression trees were used. Results The study population totaled 5596 patients (3206 men; 2390 women. We observed 1128 deaths (20% within two years following index hospitalization, of them 603 from CV disease. The CV survival rate at two years is much greater for patients with revascularization, regardless of pharmacological treatments. For patients without revascularization, the CV survival rate increases with the number of cardioprotective drug classes claimed. Finally, Cox proportional hazard models, regression tree and logistic regression analyses all revealed that the absence of revascularization and, to a lower extent

  6. Robust location, extraction, handling and storage of small hypervelocity particles c aptured in aerogel collectors

    Science.gov (United States)

    Westphal, A.; Snead, C.; Borg, J.; Quirico, E.; Raynal, P.; Zolensky, M.; Ferrini, G.; Colangeli, L.; Palumbo, P.

    It has been about a decade since the first demonstrations that hypervelocity particles could be captured, partially intact, in aerogel collectors. But the initial promise of a bonanza of partially-intact extraterrestrial particles, collected in space, has yet to materialize. One of the difficulties that investigators have encountered is that the location, extraction, handling and analysis of very small (10 microns and smaller) grains, which constitute the vast majority of the captured particles, is challenging and burdensome. Furthermore, current extraction techniques tend to be destructive over large areas of the collectors. We have developed techniques which may alleviate some of these difficulties. We have learned how to rapidly and efficiently locate captured particles in aerogel collectors, using an automated microscopic scanning system originally developed for experimental nuclear astrophysics. We have learned how to precisely excavate small access tunnels and trenches using an automated micromanipulator and glass microneedles as tools. These excavations are only destructive to the collector in a very small area --- this feature may be particularly important for excavations in the precious Stardust collectors. Using actuatable silicon microtweezers, we have learned how to extract and store ``naked'' particles --- essentially free of aerogel --- as small as 3 microns in size. We have also developed a technique for extracting particles, along with their terminal tracks, still embedded in small cubical aerogel blocks. We have developed a novel method for storing very small particles in etched nuclear tracks. We have applied these techniques to the extraction and storage of grains captured in aerogel collectors (PIE, OCDE, Comet- 99) in low earth orbit.

  7. An artificial neural network to discover hypervelocity stars: candidates in Gaia DR1/TGAS

    Science.gov (United States)

    Marchetti, T.; Rossi, E. M.; Kordopatis, G.; Brown, A. G. A.; Rimoldi, A.; Starkenburg, E.; Youakim, K.; Ashley, R.

    2017-09-01

    The paucity of hypervelocity stars (HVSs) known to date has severely hampered their potential to investigate the stellar population of the Galactic Centre and the Galactic potential. The first Gaia data release (DR1, 2016 September 14) gives an opportunity to increase the current sample. The challenge is the disparity between the expected number of HVSs and that of bound background stars. We have applied a novel data mining algorithm based on machine learning techniques, an artificial neural network, to the Tycho-Gaia astrometric solution catalogue. With no pre-selection of data, we could exclude immediately ˜99 per cent of the stars in the catalogue and find 80 candidates with more than 90 per cent predicted probability to be HVSs, based only on their position, proper motions and parallax. We have cross-checked our findings with other spectroscopic surveys, determining radial velocities for 30 and spectroscopic distances for five candidates. In addition, follow-up observations have been carried out at the Isaac Newton Telescope for 22 stars, for which we obtained radial velocities and distance estimates. We discover 14 stars with a total velocity in the Galactic rest frame >400 km s-1, and five of these have a probability of >50 per cent of being unbound from the Milky Way. Tracing back their orbits in different Galactic potential models, we find one possible unbound HVS with v ˜ 520 km s-1, five bound HVSs and, notably, five runaway stars with median velocity between 400 and 780 km s-1. At the moment, uncertainties in the distance estimates and ages are too large to confirm the nature of our candidates by narrowing down their ejection location, and we wait for future Gaia releases to validate the quality of our sample. This test successfully demonstrates the feasibility of our new data-mining routine.

  8. The Urban Heat Island and its spatial scale dependent impact on survival and development in butterflies of different thermal sensitivity

    OpenAIRE

    Kaiser, Aur?lien; Merckx, Thomas; Van Dyck, Hans

    2016-01-01

    Abstract Climate alteration is one of the most cited ecological consequences of urbanization. However, the magnitude of this impact is likely to vary with spatial scale. We investigated how this alteration affects the biological fitness of insects, which are especially sensitive to ambient conditions and well?suited organisms to study urbanization?related changes in phenotypic traits. We monitored temperature and relative air humidity in wooded sites characterized by different levels of urban...

  9. Impact of Gender in Renal Cell Carcinoma: The Relationship of FABP7 and BRN2 Expression with Overall Survival.

    Science.gov (United States)

    Tan, Cheng; Takayama, Tatsuya; Takaoka, Naohisa; Fujita, Hiromi; Miyazaki, Miki; Sugiyama, Takayuki; Ozono, Seiichiro

    2014-01-01

    To investigate the relationship between gender differences in fatty acid-binding protein7 (FABP7) and BRN2 (POU class 3 homeobox 2) expression in renal cell carcinoma (RCC) and the prognosis of patients with RCC. immunohistochemical (IHC) staining as well as reverse transcription-polymerase chain reaction (RT-PCR) was performed in renal tissues from 103 patients (83 men, mean age = 63.6 years old; 20 women, mean age = 63.1 years old) underwent radical nephrectomy from January 1, 2001 through December 31, 2010. The probability of overall patient survival was estimated using the Kaplan-Meier method. FABP7 mRNA expression was more frequent in men (P = 0.07) while BRN2 protein expression was significantly more frequent in women (P = 0.029). In particular, FABP7 was expressed in 100% of G1 renal cell carcinoma both in mRNA and protein levels. In women, FABP7 (-) and BRN2 (+) groups had a worse prognosis both in mRNA level (P = 0.038) and protein level (P = 0.058). BRN2 was expressed 100% of papillary RCC both in mRNA and protein levels. Our results demonstrated that gender was a key factor in FABP7 and BRN2 expression in RCC, and the combination with FABP7 and BRN2 stratified by gender could be a new potential prognostic factor in patients with RCC.

  10. Atg7 deficiency impairs host defense against Klebsiella pneumoniae by impacting bacterial clearance, survival and inflammatory responses in mice.

    Science.gov (United States)

    Ye, Yan; Li, Xuefeng; Wang, Wenxue; Ouedraogo, Kiswendsida Claude; Li, Yi; Gan, Changpei; Tan, Shirui; Zhou, Xikun; Wu, Min

    2014-09-01

    Klebsiella pneumoniae (Kp) is a Gram-negative bacterium that can cause serious infections in humans. Autophagy-related gene 7 (Atg7) has been implicated in certain bacterial infections; however, the role of Atg7 in macrophage-mediated immunity against Kp infection has not been elucidated. Here we showed that Atg7 expression was significantly increased in murine alveolar macrophages (MH-S) upon Kp infection, indicating that Atg7 participated in host defense. Knocking down Atg7 with small-interfering RNA increased bacterial burdens in MH-S cells. Using cell biology assays and whole animal imaging analysis, we found that compared with wild-type mice atg7 knockout (KO) mice exhibited increased susceptibility to Kp infection, with decreased survival rates, decreased bacterial clearance, and intensified lung injury. Moreover, Kp infection induced excessive proinflammatory cytokines and superoxide in the lung of atg7 KO mice. Similarly, silencing Atg7 in MH-S cells markedly increased expression levels of proinflammatory cytokines. Collectively, these findings reveal that Atg7 offers critical resistance to Kp infection by modulating both systemic and local production of proinflammatory cytokines. Copyright © 2014 the American Physiological Society.

  11. Impact of secondary cytoreductive surgery on survival in patients with platinum sensitive recurrent ovarian cancer: analysis of the CALYPSO trial.

    Science.gov (United States)

    Lee, Chee Khoon; Lord, Sarah; Grunewald, Tami; Gebski, Val; Hardy-Bessard, Anne-Claire; Sehouli, Jalid; Woie, Kathrine; Heywood, Mark; Schauer, Christian; Vergote, Ignace; Scambia, Giovanni; Ferrero, Annamaria; Harter, Philipp; Pujade-Lauraine, Eric; Friedlander, Michael

    2015-01-01

    The role of secondary cytoreductive surgery (SCR) in platinum-sensitive recurrent ovarian cancer (ROC) remains controversial. The overall survival (OS) benefits for surgery reported in observational studies may be due to the selection of patients with better prognosis. Using data from the CALYPSO trial, OS of patients who had SCR was compared to those treated with chemotherapy alone. Multivariate analyses were performed to adjust for prognostic factors. We also tested for an interaction between baseline prognostic groupings and the benefit of surgery. Of the 975 patients randomised in CALYPSO, 19% had SCR and 80% had chemotherapy alone. OS was longer for the SCR group than for chemotherapy alone (median, 49.9 vs. 29.7 months; adjusted hazard ratio (HR), 0.68; P = 0.004). For patients with SCR, the 3-year OS was 72% for those with no measurable disease, and 28% if residual tumour was larger than 5 cm. Patients with good prognostic features benefited the most from SCR (HR 0.43; P < 0.001). The benefit of SCR was less in patients with poorer prognostic features (test of trend P < 0.001). SCR was associated with improved OS in platinum-sensitive ROC, particularly in patients with favourable prognostic characteristics. However, these findings may be due to selection bias, and hence randomised trials are still essential. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Vascular endothelial growth factor A (VEGFA gene polymorphisms have an impact on survival in a subgroup of indolent patients with chronic lymphocytic leukemia.

    Directory of Open Access Journals (Sweden)

    Carol Lozano-Santos

    Full Text Available Vascular endothelial growth factor (VEGF-mediated angiogenesis contributes to the pathogenesis of B-cell chronic lymphocytic leukaemia (CLL. We investigated the impact of VEGFA gene diversity on the clinical outcome of patients with this disease. A VEGFA haplotype conformed by positions rs699947 (-1540C>A, rs833061 (-460T>C and rs2010963 (405C>G and two additional single-nucleotide polymorphisms (SNPs, rs3025039 (936C>T and rs25648 (1032C>T, were analysed in 239 patients at the time of their CLL diagnosis. Here, we showed that homozygosity for rs699947/rs833061/rs2010963 ACG haplotype (ACG+/+ genotype correlated with a reduced survival in CLL patients (ACG+/+ vs other genotypes: HR = 2.3, p = 0.002; recessive model. In multivariate analysis, the ACG+/+ genotype was identified as a novel independent prognostic factor (HR = 2.1, p = 0.005. Moreover, ACG homozygosity subdivided patients with CLL with otherwise indolent parameters into prognostic subgroups with different outcomes. Specifically, patients carrying the ACG+/+ genotype with mutated IgVH, very low and low-risk cytogenetics, initial clinical stage, CD38 negative status or early age at diagnosis showed a shorter survival (ACG+/+ vs other genotypes: HR = 3.5, p = 0.035; HR = 3.4, p = 0.001; HR = 2.2, p = 0.035; HR = 3.4, p = 0.0001 and HR = 3.1, p = 0.009, respectively. In conclusion, VEGFA ACG+/+ genotype confers an adverse effect in overall survival in CLL patients with an indolent course of the disease. These observations support the biological and prognostic implications of VEGFA genetics in CLL.

  13. Association with pregnancy increases the risk of local recurrence but does not impact overall survival in breast cancer: A case-control study of 87 cases.

    Science.gov (United States)

    Genin, A S; De Rycke, Y; Stevens, D; Donnadieu, A; Langer, A; Rouzier, R; Lerebours, F

    2016-12-01

    Pregnancy-associated breast cancer (PABC) constitutes 7% of all BCs in young women. The prognosis of PABC remains controversial. In this study, we evaluated the impact of the association of pregnancy with BC on the rates of overall survival (OS), disease free survival (DFS), and distant and local recurrence-free survival. We conducted a retrospective unicenter case-control study. We enrolled PABC patients treated at our institution between 1992 and 2009. For each case, 2 BC controls were matched for age and year of diagnosis. Univariate and multivariate analyses were performed to assess the parameters associated with prognosis. Eighty-seven PABC patients were enrolled and matched with 174 controls. The univariate analysis did not reveal any significant differences in OS, DFS or distant recurrence rates between the 2 groups. Pregnancy associated status, a tumor larger than T2 and neoadjuvant chemotherapy as the primary treatment were significantly associated with an increased risk of local relapse. The multivariate analysis showed that the pregnancy associated status and the tumor size were strong prognostic factors of local recurrence. Pregnancy associated status negates the prognostic value of tumor size, as both T0-T2 and T3-T4 PABC patients have the same poor prognosis as control BC patients with T3-T4 tumors. Interestingly, although PABC patients have more locally advanced tumors, they did not have a higher rate of radical surgery than the control BC patients. Pregnancy associated status is a strong prognostic factor of local relapse in BC. In PABC patients, when possible, radical surgery should be the preferred first treatment step. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. The dark side of the moon: Impact of moon phases on long-term survival, mortality and morbidity of surgery for lung cancer

    Directory of Open Access Journals (Sweden)

    Kuehnl A

    2009-04-01

    Full Text Available Abstract Objective Superstition is common and causes discomfiture or fear, especially in patients who have to undergo surgery for cancer. One superstition is, that moon phases influence surgical outcome. This study was performed to analyse lunar impact on the outcome following lung cancer surgery. Methods 2411 patients underwent pulmonary resection for lung cancer in the past 30 years at our institution. Intra-and postoperative complications as well as long-term follow-up data were entered in our lung-cancer database. Factors influencing mortality, morbidity and survival were analyzed. Results Rate of intra-operative complications as well as rate of post-operative morbidity and mortality was not significantly affected by moon phases. Furthermore, there was no significant impact of the lunar cycle on long-term survial. Conclusion In this study there was no evidence that outcome of surgery for lung cancer is affected by the moon. These results may help the physician to quite the mind of patients who are somewhat afraid of wrong timing of surgery with respect to the moon phases. However, patients who strongly believe in the impact of moon phase should be taken seriously and correct timing of operations should be conceded to them as long as key-date scheduling doesn't constrict evidence based treatment regimens.

  15. Impact of brine acidification on hatchability, survival and reproduction of Artemia parthenogenetica and Artemia franciscana in salt ponds, Bohai Bay, China

    Science.gov (United States)

    Sui, Liying; Deng, Yuangao; Wang, Jing; Sorgeloos, Patrick; Van Stappen, Gilbert

    2014-01-01

    We studied the effect of pH (pH 5, 6, 7 and 8) on the hatching percentage, survival and reproduction of Artemia strains in Bohai Bay salt ponds. Strains included parthenogenetic Artemia from Bohai Bay (BHB), Artemia franciscana from San Francisco Bay, and A. franciscana artificially produced in salt ponds in Vietnam. The latter was included as a potential inoculum for biological management of salt ponds. The hatching percentage of cysts after 24 h and the survival rate of the tested Artemia strains were significantly reduced when exposed to a culture medium at pH 5 for 18 d ( PArtemia to 48 h acid exposure varied with developmental stage, increasing in the following order: juvenile, nauplii, pre-adult, with maximum tolerance in adults. All strains of Artemia tested could not reproduce at pH 5. At pH levels from pH 6-8, a higher pH generally resulted in a shorter brood interval and enhanced ovoviviparity. Hence, we suggest that brine acidification has a negative impact on Artemia populations in the Bohai Bay saltworks. Inoculation of Artemia with either local parthenogenetic Artemia or exotic A. franciscana should be feasible at pH 7-8.

  16. Markers of fibroblast-rich tumor stroma and perivascular cells in serous ovarian cancer: Inter- and intra-patient heterogeneity and impact on survival.

    Science.gov (United States)

    Corvigno, Sara; Wisman, G Bea A; Mezheyeuski, Artur; van der Zee, Ate G J; Nijman, Hans W; Åvall-Lundqvist, Elisabeth; Östman, Arne; Dahlstrand, Hanna

    2016-04-05

    Inter- and intra-patient variations in tumor microenvironment of serous ovarian cancer are largely unexplored. We aimed to explore potential co-regulation of tumor stroma characteristics, analyze their concordance in primary and metastatic lesions, and study their impact on survival. A tissue microarray (TMA) with 186 tumors and 91 matched metastases was subjected to immunohistochemistry double staining with endothelial cell marker CD34 and fibroblast and pericyte markers α-SMA, PDGFβR and desmin. Images were digitally analyzed to yield "metrics" related to vasculature and stroma features. Intra-case analyses showed that PDGFβR in perivascular cells and fibroblasts were strongly correlated. Similar findings were observed concerning α-SMA. Most stroma characteristics showed large variations in intra-case comparisons of primary tumors and metastasis. Large PDGFβR-positive stroma fraction and high PDGFβFR positive perivascular intensity were both significantly associated with shorter survival in uni- and multi-variate analyses (HR 1.7, 95% CI 1.1-2.5; HR 1.7, 95% CI 1.1-2.8). In conclusion, we found PDGFβR- and α-SMA-expression to be largely independent of each other but concordantly activated in perivascular cells and in fibroblasts within the primary tumor. Stromal characteristics differed between primary tumors and metastases. PDGFβR in perivascular cells and in fibroblasts may be novel prognostic markers in serous ovarian cancer.

  17. Impact of Tumor Factors on Survival in Patients with Hepatocellular Carcinoma Classified Based on Kinki Criteria Stage B2.

    Science.gov (United States)

    Arizumi, Tadaaki; Minami, Tomohiro; Chishina, Hirokazu; Kono, Masashi; Takita, Masahiro; Yada, Norihisa; Hagiwara, Satoru; Minami, Yasunori; Ida, Hiroshi; Ueshima, Kazuomi; Kamata, Ken; Minaga, Kosuke; Komeda, Yoriaki; Takenaka, Mamoru; Sakurai, Toshiharu; Watanabe, Tomohiro; Nishida, Naoshi; Kudo, Masatoshi

    2017-01-01

    Tumors classified based on the Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) are heterogeneous in nature. Previously, the Kinki criterion was proposed for a more precise subclassification of tumors in BCLC-stage B. However, tumors in sub-stage B2 include various size and number of HCCs even with the Kinki criteria, which could lead to heterogeneity for overall survival (OS). In this study, we assessed how the size and number of tumors affect the OS and time to progression (TTP) in patients with Kinki criteria stage B2 tumors and treated with transarterial chemoembolization (TACE). Of 906 HCC patients treated with TACE at Kindai University Hospital, 236 patients with HCC considered as Kinki criteria stage B2 were examined. They were classified into the following 4 groups according to the maximum tumor diameter and number of tumors: B2a group, tumor size ≤6 cm and total number of tumors ≤6; B2b group, size ≤6 cm and number >6; B2c group, size >6 cm and number ≤6; and B2d group, size >6 cm and number >6. The OS and TTP of patients in each group were compared. There were 131 patients (55.5%) in the B2a group, 58 (24.6%) in the B2b group, 41 (17.4%) in the B2c group, and 6 (0.03%) in the B2d group. Comparison of the survivals revealed that the median OS was 2.8 years (95% CI 2.0-3.5) in the B2a group, 2.8 years (95% CI 2.0-3.3) in the B2b group, 1.9 years (95% CI 0.8-4.0) in the B2c group, and 2.3 years (95% CI 1.2-ND [no data]) in the B2d group, respectively (p = 0.896). The median TTP in B2a, B2b, B2c, and B2d sub-substage HCC were13.2, 12.1, 13.8, and 11.5 months, respectively (p = 0.047). The median TTP in B2a + B2c sub-substage patients was longer than that in B2b + B2d sub-substage HCC patients (14.0 months and 10.4 months; p = 0.002). No significant differences were observed in the OS among HCC patients subclassified based on the maximum tumor diameter and tumor number in Kinki criteria stage B2. Consequently, Kinki criteria

  18. Impact of High Risk for Obstructive Sleep Apnea on Survival after Acute Coronary Syndrome: Insights from the ERICO Registry.

    Science.gov (United States)

    Maia, Flavia C; Goulart, Alessandra C; Drager, Luciano F; Staniak, Henrique L; Santos, Itamar de Souza; Lotufo, Paulo Andrade; Bensenor, Isabela M

    2017-01-01

    Obstructive sleep apnea (OSA) is a very often clinical condition that can be associated with high mortality risk, particularly in coronary heart disease (CHD). The diagnosis of OSA is not always accessible via the gold-standard method polysomnography. To evaluate long-term influence of the high risk for OSA on fatal and non-fatal outcomes after acute coronary syndrome (ACS) in the Acute Coronary Syndrome Registry Strategy (ERICO) Study using the Berlin questionnaire as a surrogate. Berlin questionnaire, a screening questionnaire for OSA, was applied in 639 cases of ACS 30 days after the index event. Cox regression proportional-hazards model was used to calculate the hazard ratio (HR) of all-cause, cardiovascular and CHD (myocardial infarction) mortality, as well as, the combined endpoint of fatal or recurrent non-fatal CHD. The high-risk group for OSA had higher frequencies of previous personal/family history of CHD and diabetes, in addition to a poorer event-free survival, as compared to the low-risk group (p-log-rank=0.03). The HR for fatal or recurrent non-fatal CHD was 4.26 (95% confidence interval, 1.18 - 15.36) in patients at high risk for OSA compared to those at low risk for OSA after a 2.6-year mean follow-up. Using Berlin questionnaire, we were able to identify high risk for OSA as an independent predictor of non-fatal reinfarction or CHD mortality in post-ACS individuals in a long-term follow-up.

  19. Impact of the botanical insecticide Neem Azal on survival and reproduction of the biting louse Damalinia limbata on angora goats.

    Science.gov (United States)

    Habluetzel, Annette; Carnevali, Fiorella; Lucantoni, Leonardo; Grana, Lucia; Attili, Anna Rita; Archilei, Francesca; Antonini, Marco; Valbonesi, Alessandro; Abbadessa, Valerio; Esposito, Fulvio; van der Esch, Stephen Andrew

    2007-03-31

    Secondary metabolites present in the neem tree (Azadirachta indica A. Juss, Meliaceae), exhibit a wide range of biological activities in insects. However, few studies have been undertaken to assess the potential of neem products as insecticides for the control of ectoparasites of domestic animals. This study was undertaken to estimate the efficacy of Neem Azal, an azadirachtin-rich extract of neem seeds, in controlling Damalinia limbata (Phthiraptera) louse infestation of angora goats. The study was conducted on a fibre animal farm situated in Central Italy. Groups of 11-12 goats were treated with Neem Azal at an azadirachtin concentration of 650ppm or 125ppm, with Neguvon or were left untreated. Their louse burden was assessed fortnightly to monthly for 22 weeks. A reduction in louse densities of 76-96% was observed from week 2 to week 18 after treatment with the neem solution containing azadirachtin at a concentration of 650ppm. At the lower test concentration (125ppm) a reduction of 60-92% could be recorded from week 2 to week 14. Neem Azal was found to reduce the survival of both adult and nymph stages of D. limbata and to interfere with oviposition and oogenesis of female lice. A decrease in oviposition was observed in neem exposed female lice and the examination of their ovaries revealed morphological alterations in both vitellogenic and previtellogenic ovarioles at the follicular and germinal level. Since neem compounds target different life stages and physiological processes of D. limbata, the development of insecticide resistance by biting lice exposed to neem-based insecticides appears unlikely. For this reason and for its prolonged activity, which in principle allows angora goats to be protected for a large part of the mohair production cycle, neem-based insecticides may have a potential interest for mohair producing breeders.

  20. Location of cardiac arrest and impact of pre-arrest chronic disease and medication use on survival.

    Science.gov (United States)

    Granfeldt, Asger; Wissenberg, Mads; Hansen, Steen Møller; Lippert, Freddy K; Torp-Pedersen, Christian; Christensen, Erika Frischknecht; Christiansen, Christian Fynbo

    2017-05-01

    Cardiac arrest in a private location is associated with a higher mortality when compared to public location. Past studies have not accounted for pre-arrest factors such as chronic disease and medication. To investigate whether the association between cardiac arrest in a private location and a higher mortality can be explained by differences in chronic diseases and medication. We identified 27,771 out-of-hospital cardiac arrest patients ≥18 years old from the Danish Cardiac Arrest Registry (2001-2012). Using National Registries, we identified pre-arrest chronic disease and medication. To investigate the importance of cardiac arrest related factors and chronic disease and medication use we performed adjusted Cox regression analyses during day 0-7 and day 8-365 following cardiac arrest to calculate hazard ratios (HR) for death. Day 0-7: Un-adjusted HR for death day 0-7 was 1.21 (95%CI:1.18-1.25) in private compared to public location. When including cardiac arrest related factors HR for death was 1.09 (95%CI:1.06-1.12). Adding chronic disease and medication to the analysis changed HR for death to 1.08 (95%CI:1.05-1.12). 8-365 day: The un-adjusted HR for death day 8-365 was 1.70 (95% CI: 1.43-2.02) in private compared to public location. When including cardiac arrest related factors the HR decreased to 1.39 (95% CI: 1.14-1.68). Adding chronic disease and medication to the analysis changed HR for death to 1.27 (95% CI:1.04-1.54). The higher mortality following cardiac arrest in a private location is partly explained by a higher prevalence of chronic disease and medication use in patients surviving until day 8. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Impact of coexisting pulmonary diseases on survival of patients with lung adenocarcinoma: a STROBE-compliant article.

    Science.gov (United States)

    Jian, Zhi-Hong; Huang, Jing-Yang; Ko, Pei-Chieh; Jan, Shiou-Rung; Nfor, Oswald Ndi; Lung, Chia-Chi; Ku, Wen-Yuan; Ho, Chien-Chang; Pan, Hui-Hsien; Liaw, Yung-Po

    2015-01-01

    Asthma, chronic obstructive pulmonary disease (COPD), and pulmonary tuberculosis (TB) are common pulmonary diseases associated with lung cancer. Besides, smoking is more prevalent in Taiwanese men. This study evaluated gender disparities in coexisting pulmonary diseases on survival of patients with lung adenocarcinoma. Patients newly diagnosed with lung cancer between 2003 and 2008 were identified from Taiwan National Health Insurance Research Database. Cases with lung adenocarcinoma were further confirmed using the Cancer Registry Database and followed up until the end of 2010. Cox proportional hazard regression was used to calculate the hazard ratio (HR) of coexisting asthma, COPD, and/or TB to estimate all-cause mortality risk. During the study period, 13,399 cases of lung adenocarcinoma were identified. The HRs of adenocarcinoma in men and women were 1.20 (95% confidence interval [CI], 1.10-1.30) and 1.05 (95% CI, 0.95-1.16), respectively, for individuals with asthma, 1.32 (95% CI, 1.16-1.51) and 0.97 (95% CI, 0.89-1.05), respectively, for COPD, and 0.99 (95% CI, 0.93-1.06) and 1.06 (95% CI, 0.86-1.32), respectively, for individuals with TB. Specifically, among men with coexisting pulmonary diseases, the HRs were 1.63 (95% CI, 1.25-2.13), 1.31 (95% CI, 1.08-1.59), and 1.23 (95% CI, 1.11-1.36) for individuals with asthma + COPD + TB, asthma + COPD, and COPD + TB, respectively. However, there was no increase risk of mortality among women with coexisting pulmonary diseases. Coexisting pulmonary diseases are at an elevated risk of mortality among male patients with lung adenocarcinoma. Such patients deserve greater attention while undergoing cancer treatment.

  2. Impact of Vibrio parahaemolyticus and white spot syndrome virus (WSSV) co-infection on survival of penaeid shrimp Litopenaeus vannamei

    Science.gov (United States)

    Zhang, Xiaojing; Song, Xiaoling; Huang, Jie

    2016-11-01

    White spot syndrome virus (WSSV) is an important viral pathogen that infects farmed penaeid shrimp, and the threat of Vibrio parahaemolyticus infection to shrimp farming has become increasingly severe. Viral and bacterial cross or superimposed infections may induce higher shrimp mortality. We used a feeding method to infect Litopenaeus vannamei with WSSV and then injected a low dose of V. parahaemolyticus (WSSV+Vp), or we first infected L. vannamei with a low-dose injection of V. parahaemolyticus and then fed the shrimp WSSV to achieve viral infection (Vp+WSSV). The eff ect of V. parahaemolyticus and WSSV co-infection on survival of L. vannamei was evaluated by comparing cumulative mortality rates between experimental and control groups. We also spread L. vannamei hemolymph on thiosulfate citrate bile salt sucrose agar plates to determine the number of Vibrio, and the WSSV copy number in L. vannamei gills was determined using an absolute quantitative polymerase chain reaction (PCR) method. LvMyD88 and Lvakt gene expression levels were detected in gills of L. vannamei by real-time PCR to determine the cause of the diff erent mortality rates. Our results show that (1) the cumulative mortality rate of L. vannamei in the WSSV+Vp group reached 100% on day 10 after WSSV infection, whereas the cumulative mortality rate of L. vannamei in the Vp+WSSV group and the WSSV-alone control group approached 100% on days 11 and 13 of infection; (2) the number of Vibrio in the L. vannamei group infected with V. parahaemolyticus alone declined gradually, whereas the other groups showed significant increases in the numbers of Vibrio ( Pvannamei and vice versa. The combined accelerated proliferation of both V. parahaemolyticus and WSSV led to massive death of L. vannamei.

  3. Impact of ICD lead on the system durability, predictors of long-term survival following ICD system extraction.

    Science.gov (United States)

    Jacheć, Wojciech; Tomasik, Andrzej; Polewczyk, Anna; Kutarski, Andrzej

    2017-10-01

    Implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) systems are considered as having higher risk of complication and shorter durability but reasons of this multifactorial phenomenon remain unclear. We aimed to analyze this problem in population of patients with ICD leads referred for lead extraction (TLE). We have compared TLE indications, procedural results, and defined the long-term outcomes of TLE in patients with ICD/CRT-D devices (n  =  482, ICD (+)) with lead extractions in patients with standard pacemakers (n  =  1,402, ICD (-)). Demographic, clinical characteristics, and procedural outcomes were ascertained from single, primary operator registry. Long-term survival data were provided by the National Health Fund. The ICD (+) subgroup had a significantly higher incidence rate of either infective or noninfective indications for TLE. The clinical success rate of extraction was 99.2% in ICD (+) versus 97.4% in ICD (-) (P  =  0.05) at a complication rate of 1.04% versus 2.14% (NS), respectively. In the median follow-up of 3.39 years, 142 patients from the ICD (+) subgroup and 303 from the ICD (-) subgroup died. The highest mortality rate of 41.1% was observed in the ICD (+) subgroup with infective indications. Infection, renal failure, diabetes, and age were the multivariate factors associated with increased mortality in the ICD (+) subgroup. ICD leads remain more vulnerable, with respect to mechanical failure and their propensity to infection, in comparison to pacing leads. Their TLE is very effective at least complication rate, when performed by a highly skilled and experienced operator. However, long-term mortality after their TLE is high and is affected mostly by infections or patient-related factors. © 2017 Wiley Periodicals, Inc.

  4. Dramatic impact of blood transfusion on cancer-specific survival after radical cystectomy irrespective of tumor stage.

    Science.gov (United States)

    Buchner, Alexander; Grimm, Tobias; Schneevoigt, Birte-Swantje; Wittmann, Georg; Kretschmer, Alexander; Jokisch, Friedrich; Grabbert, Markus; Apfelbeck, Maria; Schulz, Gerald; Gratzke, Christian; Stief, Christian G; Karl, Alexander

    2017-04-01

    The aim of the present study was to determine the influence of intraoperative and postoperative blood transfusion on cancer-specific outcome. Follow-up data were collected from 722 patients undergoing radical cystectomy for urothelial carcinoma of the bladder (UCB) between 2004 and 2014. Median follow-up was 26 months (interquartile range 12-61 months). Outcome was analyzed in relation to the amount of intraoperative and postoperative blood transfusion and different tumor stages. The primary endpoint was cancer-specific survival (CSS) after cystectomy. Kaplan-Meier analysis with log-rank test and Cox regression models were used. Intraoperative blood transfusion was given in 36% (263/722) and postoperative blood transfusion in 18% (132/722). In patients with and without intraoperative blood transfusion, 5 year CSS was 48% and 67%, respectively (p blood transfusion, 5 year CSS was 48% and 63%, respectively (p transfused red blood cell (RBC) units [intraoperatively: hazard ratio (HR) = 1.08, 95% confidence interval (CI) 1.01-1.15, p = .023; postoperatively: HR = 1.14, 95% CI 1.07-1.21, p transfusions was also found in favorable subgroups (pT1 tumor, hemoglobin ≥13 mg/dl, p = .004) and in a high-volume surgeon subgroup (n = 244, p Blood transfusions during and after radical cystectomy were independent prognostic factors for CSS in this retrospective study. Therefore, efforts should be made to reduce the necessity of intraoperative and postoperative blood transfusion in cystectomy patients.

  5. The Impact of Gender, Partner Status, and Race on Locoregional Failure and Overall Survival in Head and Neck Cancer Patients in Three Radiation Therapy Oncology Group (RTOG) Trials

    Science.gov (United States)

    Dilling, Thomas J.; Bae, Kyounghwa; Paulus, Rebecca; Watkins-Bruner, Deborah; Garden, Adam S.; Forastiere, Arlene; Ang, K. Kian; Movsas, Benjamin

    2011-01-01

    PURPOSE We investigated the impact of race, in conjunction with gender and partner status, on both locoregional control (LRC) and overall survival (OS) in three head and neck trials conducted by the Radiation Therapy Oncology Group (RTOG). METHODS AND MATERIALS Patients from RTOG 9003, 9111, and 9703 were included. Patients were stratified by treatment arms. Covariates of interest were partner status (partnered/non-partnered), race (white/non-white), and sex (female/male). Chi-square testing demonstrated homogeneity across treatment arms. Hazards ratio (HR) was used to estimate time to event outcome. Unadjusted and adjusted HRs were calculated for all covariates with associated 95% confidence intervals (CIs) and p-values. RESULTS 1736 patients were analyzed. Unpartnered males had inferior OS to partnered females (adjusted HR=1.22, 95% CI=(1.09, 1.36)), partnered males (adjusted HR=1.20, 95% CI=(1.09, 1.28)), and unpartnered females (adjusted HR=1.20, 95% CI=(1.09, 1.32)). White females had superior OS compared with white males, non-white females, and non-white males. Non-white males had inferior OS compared to white males. Partnered whites had improved OS relative to partnered non-white, unpartnered white, and unpartnered non-white patients. Unpartnered males had inferior LRC than partnered males (adjusted HR=1.26, 95% CI=(1.09, 1.46)) and unpartnered females (adjusted HR=1.30, 95% CI=(1.05, 1.62)). White females had superior LRC to non-white males and females. White males had improved LRC than non-white males. Partnered whites had improved LRC than partnered and unpartnered non-white patients. Unpartnered whites had improved LRC than unpartnered non-whites. CONCLUSIONS Race, gender, and partner status impacted on both overall survival and locoregional failure, both singly and in combination. PMID:21549515

  6. Family history of colorectal cancer and its impact on survival in patients with resected stage III colon cancer: results from NCCTG Trial N0147 (Alliance).

    Science.gov (United States)

    Jansson-Knodell, Claire L; Foster, Nathan R; Sargent, Daniel J; Limburg, Paul J; Thibodeau, Stephen N; Smyrk, Thomas C; Sinicrope, Frank A; Jahagirdar, Balkrishna; Goldberg, Richard M; Alberts, Steven R

    2017-02-01

    Family history of colon cancer often portends increased risk of disease development; however, the prognostic significance of family history related to disease and survival outcomes is unclear. To investigate the relationship between family history of colorectal cancer and survival outcomes in stage III colon cancer patients, a prospective cohort of 1,935 patients with resected stage III colon cancer enrolled in a randomized controlled trial (N0147), comparing the standard of care FOLFOX to FOLFOX with cetuximab, was studied. Patients completed a baseline questionnaire on family history and were followed every 6 months until death or 5 years after randomization. We examined the endpoints of disease-free survival (DFS), time to recurrence (TTR) and overall survival (OS), comparing patients with a positive versus negative family history of colorectal cancer. The adjusted hazard ratios (HRs) for patients with a positive family history were 0.95 [95% confidence interval (CI), 0.78-1.16] for DFS, 0.94 (95% CI, 0.76-1.16) for TTR, and 0.92 (95% CI, 0.74-1.15) for OS (all adjusted P>0.47). A non-significant trend toward improved DFS (P=0.17; adjusted P=0.34) was observed when 2 or more relatives were affected as compared to 0 relatives (multivariate HR: 0.72; 95% CI, 0.45-1.15), whereas subjects with histories of 0 or 1 affected relatives had similar DFS (multivariate HR for 1 vs. 0: 1.00; 95% CI, 0.81-1.24). Interactions of the molecular factors KRAS, BRAF, and MMR with family history were also explored. The only significant interaction was for deficient MMR (dMMR) and first-degree relatives with a family history of colorectal cancer (0 vs. 1 vs. 2+ relatives) for a benefit on OS (univariate P=0.001), which remained significant after adjusting for other factors (P=0.029). Among patients with stage III resected colon cancer treated with adjuvant FOLFOX, a family history of colorectal cancer did not significantly impact DFS, TTR, or OS outcomes, with the exception of

  7. Impact of non-HIV and HIV risk factors on survival in HIV-infected patients on HAART: a population-based nationwide cohort study.

    Science.gov (United States)

    Obel, Niels; Omland, Lars Haukali; Kronborg, Gitte; Larsen, Carsten S; Pedersen, Court; Pedersen, Gitte; Sørensen, Henrik Toft; Gerstoft, Jan

    2011-01-01

    We determined the impact of three factors on mortality in HIV-infected patients who had been on highly active antiretroviral therapy (HAART) for at least one year: (1) insufficient response to (HAART) and presence of AIDS-defining diseases, (2) comorbidity, and (3) drug and alcohol abuse and compared the mortality to that of the general population. In a Danish nationwide, population-based cohort study, we used population based registries to identify (1) all Danish HIV-infected patients who started HAART in the period 1 January 1998-1 July 2009, and (2) a comparison cohort of individuals matched on date of birth and gender (N = 2,267 and 9,068, respectively). Study inclusion began 1 year after start of HAART. Patients were categorised hierarchically in four groups according to the three risk factors, which were identified before study inclusion. The main outcome measure was probability of survival from age 25 to 65 years. The probability of survival from age 25 to age 65 was substantially lower in HIV patients [0.48 (95% confidence interval (CI) 0.42-0.55)] compared to the comparison cohort [0.88 (0.86 to 0.90)]. However, in HIV patients with no risk factors (N = 871) the probability of survival was equivalent to that of the general population [0.86 (95% CI 0.77-0.92)]. In contrast, the probability of survival was 0.58 in patients with HIV risk factors (N = 704), 0.30 in patients with comorbidities (N = 479), and 0.03 in patients with drug or alcohol abuse (N = 313). The increased risk of death in HIV-infected individuals is mainly attributable to risk factors that can be identified prior to or in the initial period of antiretroviral treatment. Mortality in patients without risk factors on a successful HAART is almost identical to that of the non-HIV-infected population.

  8. Family history of colorectal cancer and its impact on survival in patients with resected stage III colon cancer: results from NCCTG Trial N0147 (Alliance)

    Science.gov (United States)

    Jansson-Knodell, Claire L.; Foster, Nathan R.; Sargent, Daniel J.; Limburg, Paul J.; Thibodeau, Stephen N.; Smyrk, Thomas C.; Sinicrope, Frank A.; Jahagirdar, Balkrishna; Goldberg, Richard M.

    2017-01-01

    Background Family history of colon cancer often portends increased risk of disease development; however, the prognostic significance of family history related to disease and survival outcomes is unclear. Methods To investigate the relationship between family history of colorectal cancer and survival outcomes in stage III colon cancer patients, a prospective cohort of 1,935 patients with resected stage III colon cancer enrolled in a randomized controlled trial (N0147), comparing the standard of care FOLFOX to FOLFOX with cetuximab, was studied. Patients completed a baseline questionnaire on family history and were followed every 6 months until death or 5 years after randomization. Results We examined the endpoints of disease-free survival (DFS), time to recurrence (TTR) and overall survival (OS), comparing patients with a positive versus negative family history of colorectal cancer. The adjusted hazard ratios (HRs) for patients with a positive family history were 0.95 [95% confidence interval (CI), 0.78–1.16] for DFS, 0.94 (95% CI, 0.76–1.16) for TTR, and 0.92 (95% CI, 0.74–1.15) for OS (all adjusted P>0.47). A non-significant trend toward improved DFS (P=0.17; adjusted P=0.34) was observed when 2 or more relatives were affected as compared to 0 relatives (multivariate HR: 0.72; 95% CI, 0.45–1.15), whereas subjects with histories of 0 or 1 affected relatives had similar DFS (multivariate HR for 1 vs. 0: 1.00; 95% CI, 0.81–1.24). Interactions of the molecular factors KRAS, BRAF, and MMR with family history were also explored. The only significant interaction was for deficient MMR (dMMR) and first-degree relatives with a family history of colorectal cancer (0 vs. 1 vs. 2+ relatives) for a benefit on OS (univariate P=0.001), which remained significant after adjusting for other factors (P=0.029). Conclusions Among patients with stage III resected colon cancer treated with adjuvant FOLFOX, a family history of colorectal cancer did not significantly impact DFS

  9. Evaluating the Impact of Zimbabwe's Prevention of Mother-to-Child HIV Transmission Program: Population-Level Estimates of HIV-Free Infant Survival Pre-Option A.

    Directory of Open Access Journals (Sweden)

    Raluca Buzdugan

    Full Text Available We estimated HIV-free infant survival and mother-to-child HIV transmission (MTCT rates in Zimbabwe, some of the first community-based estimates from a UNAIDS priority country.In 2012 we surveyed mother-infant pairs residing in the catchment areas of 157 health facilities randomly selected from 5 of 10 provinces in Zimbabwe. Enrolled infants were born 9-18 months before the survey. We collected questionnaires, blood samples for HIV testing, and verbal autopsies for deceased mothers/infants. Estimates were assessed among i all HIV-exposed infants, as part of an impact evaluation of Option A of the 2010 WHO guidelines (rolled out in Zimbabwe in 2011, and ii the subgroup of infants unexposed to Option A. We compared province-level MTCT rates measured among women in the community with MTCT rates measured using program monitoring data from facilities serving those communities.Among 8568 women with known HIV serostatus, 1107 (12.9% were HIV-infected. Among all HIV-exposed infants, HIV-free infant survival was 90.9% (95% confidence interval (CI: 88.7-92.7 and MTCT was 8.8% (95% CI: 6.9-11.1. Sixty-six percent of HIV-exposed infants were still breastfeeding. Among the 762 infants born before Option A was implemented, 90.5% (95% CI: 88.1-92.5 were alive and HIV-uninfected at 9-18 months of age, and 9.1% (95%CI: 7.1-11.7 were HIV-infected. In four provinces, the community-based MTCT rate was higher than the facility-based MTCT rate. In Harare, the community and facility-based rates were 6.0% and 9.1%, respectively.By 2012 Zimbabwe had made substantial progress towards the elimination of MTCT. Our HIV-free infant survival and MTCT estimates capture HIV transmissions during pregnancy, delivery and breastfeeding regardless of whether or not mothers accessed health services. These estimates also provide a baseline against which to measure the impact of Option A guidelines (and subsequently Option B+.

  10. The Impact of Coexisting Asthma, Chronic Obstructive Pulmonary Disease and Tuberculosis on Survival in Patients with Lung Squamous Cell Carcinoma.

    Science.gov (United States)

    Huang, Jing-Yang; Jian, Zhi-Hong; Ndi Nfor, Oswald; Jhang, Kai-Ming; Ku, Wen-Yuan; Ko, Pei-Chieh; Jan, Shiou-Rung; Ho, Chien-Chang; Lung, Chia-Chi; Pan, Hui-Hsien; Liang, Yu-Chiu; Liaw, Yung-Po

    2015-01-01

    Pulmonary diseases [asthma, chronic obstructive pulmonary disease (COPD), and tuberculosis (TB)] are associated with lung cancer mortality. However, the relationship between coexisting pulmonary diseases and survival in patients with lung squamous cell carcinoma (SqCC) has not been well defined. Patients newly diagnosed with SqCC between 2003 and 2008 were identified by linking the National Health Insurance Research Database and Taiwan Cancer Registry Database. Cases with SqCC were followed up until death, loss to follow-up, or study end in 2010. Information on health status, date of death and the main causes of death was ascertained from the National Death Registry Database. Cox proportional hazard regression was used to calculate the hazard ratio (HR) of coexisting asthma, COPD and/or TB. During the study period, a total of 5406 cases with SqCC were enrolled. For all cause-mortality, HRs were 1.08 [95% confidence interval (CI), 0.99-1.18], 1.04 (95% CI, 0.97-1.12), and 1.14 (95% CI, 1.00-1.31) for individuals with asthma, COPD, and TB, respectively. Specifically, among men with coexisting pulmonary diseases, the HRs were 1.56 (95% CI, 1.23-1.97) and 1.11 (95% CI, 1.00-1.24) for individuals with asthma+COPD+TB and asthma+COPD, respectively. Among male patients with stage III SqCC, HRs were 3.41 (95%CI, 1.27-9.17) and 1.65 (95%CI, 1.10-2.47) for individuals with asthma+TB and asthma+COPD+TB, respectively. Among male patients with stage IV SqCC, HRs were 1.40 (95%CI, 1.00-1.97) and 1.25 (95%CI, 1.03-1.52) for individuals with asthma+ COPD+TB and asthma. Among female patients with stage I and II, HR was 0.19 (95%CI, 005-0.77) for individuals with asthma. Coexisting pulmonary diseases increased the risk of mortality from SqCC in male patients. For female patients with early stage SqCC, pre-existing asthma decreased mortality. These patients deserve greater attention while undergoing cancer treatment.

  11. The Impact of Coexisting Asthma, Chronic Obstructive Pulmonary Disease and Tuberculosis on Survival in Patients with Lung Squamous Cell Carcinoma.

    Directory of Open Access Journals (Sweden)

    Jing-Yang Huang

    Full Text Available Pulmonary diseases [asthma, chronic obstructive pulmonary disease (COPD, and tuberculosis (TB] are associated with lung cancer mortality. However, the relationship between coexisting pulmonary diseases and survival in patients with lung squamous cell carcinoma (SqCC has not been well defined.Patients newly diagnosed with SqCC between 2003 and 2008 were identified by linking the National Health Insurance Research Database and Taiwan Cancer Registry Database. Cases with SqCC were followed up until death, loss to follow-up, or study end in 2010. Information on health status, date of death and the main causes of death was ascertained from the National Death Registry Database. Cox proportional hazard regression was used to calculate the hazard ratio (HR of coexisting asthma, COPD and/or TB.During the study period, a total of 5406 cases with SqCC were enrolled. For all cause-mortality, HRs were 1.08 [95% confidence interval (CI, 0.99-1.18], 1.04 (95% CI, 0.97-1.12, and 1.14 (95% CI, 1.00-1.31 for individuals with asthma, COPD, and TB, respectively. Specifically, among men with coexisting pulmonary diseases, the HRs were 1.56 (95% CI, 1.23-1.97 and 1.11 (95% CI, 1.00-1.24 for individuals with asthma+COPD+TB and asthma+COPD, respectively. Among male patients with stage III SqCC, HRs were 3.41 (95%CI, 1.27-9.17 and 1.65 (95%CI, 1.10-2.47 for individuals with asthma+TB and asthma+COPD+TB, respectively. Among male patients with stage IV SqCC, HRs were 1.40 (95%CI, 1.00-1.97 and 1.25 (95%CI, 1.03-1.52 for individuals with asthma+ COPD+TB and asthma. Among female patients with stage I and II, HR was 0.19 (95%CI, 005-0.77 for individuals with asthma.Coexisting pulmonary diseases increased the risk of mortality from SqCC in male patients. For female patients with early stage SqCC, pre-existing asthma decreased mortality. These patients deserve greater attention while undergoing cancer treatment.

  12. Electrical failure on satellite's power harnesses due to small debris impacts

    OpenAIRE

    Hirai, Takayuki; Higashide, Masumi; Kurosaki, Hirohisa; Kawakita, Shirou; Mando, Yuki; Yamaguchi, Shota; Tanaka, Koji; 平井, 隆之; 東出, 真澄; 黒崎, 裕久; 川北, 史朗; 万戸, 雄輝; 山口, 翔太; 田中, 孝治

    2017-01-01

    Loss of satellite functions due to space debris collisions includes not only mechanical failures like breakup of satellite main bodies but also electric failures such as decrease in power supply from solar arrays and power harnesses. In particular, the past hypervelocity impact experiments suggest that sustained arcs and resulting ground faults on the power harnesses could be triggered by impacts of tiny space debris particles smaller than 1 mm which constantly impact on satellite surfaces. T...

  13. The metastatic infiltration at the metastasis/brain parenchyma-interface is very heterogeneous and has a significant impact on survival in a prospective study

    Science.gov (United States)

    Siam, Laila; Bleckmann, Annalen; Chaung, Han-Ning; Mohr, Alexander; Klemm, Florian; Barrantes-Freer, Alonso; Blazquez, Raquel; Wolff, Hendrik A.; Lüke, Florian; Rohde, Veit; Stadelmann, Christine; Pukrop, Tobias

    2015-01-01

    The current approach to brain metastases resection is macroscopic removal of metastasis until reaching the glial pseudo-capsule (gross total resection (GTR)). However, autopsy studies demonstrated infiltrating metastatic cells into the parenchyma at the metastasis/brain parenchyma (M/BP)-interface. Aims/Methods: To analyze the astrocyte reaction and metastatic infiltration pattern at the M/BP-interface with an organotypic brain slice coculture system. Secondly, to evaluate the significance of infiltrating metastatic tumor cells in a prospective biopsy study. Therefore, after GTR, biopsies were obtained from the brain parenchyma beyond the glial pseudo-capsule and analyzed histomorphologically. Results: The coculture revealed three types of cancer cell infiltration. Interestingly, the astrocyte reaction was significantly different in the coculture with a benign, neuroectodermal-derived cell line. In the prospective biopsy study 58/167 (34.7%) samples revealed infiltrating metastatic cells. Altogether, 25/39 patients (64.1%) had proven to exhibit infiltration in at least one biopsy specimen with significant impact on survival (OS) (3.4 HR; p = 0.009; 2-year OS was 6.6% versus 43.5%). Exceptionally, in the non-infiltrating cohort three patients were long-term survivors. Conclusions: Metastatic infiltration has a significant impact on prognosis. Secondly, the astrocyte reaction at the M/BP-interface is heterogeneous and supports our previous concept of the organ-specific defense against metastatic (organ-foreign) cells. PMID:26299612

  14. The impact of FLT3 mutations on treatment response and survival in Chinese de novo AML patients.

    Science.gov (United States)

    Qiu, Qiao-Cheng; Wang, Chao; Bao, Xie-Bing; Yang, Jing; Shen, Hong-Jie; Ding, Zi-Xuan; Liu, Hong; He, Jun; Yao, Hong; Chen, Su-Ning; Li, Zheng; Xue, Sheng-Li; Liu, Song-Bai

    2017-09-06

    Two distinct forms of FMS-like tyrosine kinase 3 (FLT3) mutations, internal tandem duplication (ITD) in the juxtamembrane domain and point mutation within the activation loop of the tyrosine kinase domain (TKD), have been identified in considerable number of patients with AML. This study was aimed to analyze the impacts of these mutations on clinical outcomes, and assess the efficacy of different therapeutic regimens (allo-HSCT, sorafenib, or conventional chemotherapy) for AML patients with FLT3 mutations after the standard induction therapy. We analyzed DNA samples from 158 consecutive de novo AML patients (18-60 years, excluding APL) with FLT3 mutations between July 2010 and October 2015. We found that AML patients with FLT3-TKD mutations have more favorable clinical outcomes than those with FLT3-ITD mutations. We also found that allo-HSCT therapy subgroup achieved longer OS and RFS than non-allo-HSCT therapy subgroup for FLT3-ITD positive patients (p AML patients have more favorable clinical outcomes than those with FLT3-ITD mutations. Allo-HSCT therapy subgroup achieved longer OS and RFS than non-allo-HSCT therapy subgroup for FLT3-ITD positive patients. Compared with the clinical outcomes in non-primary refractory patients, sorafenib did not show an obvious beneficial effect for the primary refractory patients.

  15. Impact of an osteoporosis specialized unit on bone health in breast cancer survivals treated with aromatase inhibitors.

    Science.gov (United States)

    Martínez, Purificación; Galve, Elena; Arrazubi, Virginia; Sala, M Ángeles; Fernández, Seila; Pérez, Clara E; Arango, Juan F; Torre, Iñaki

    2017-10-11

    Considering the increased fracture risk in early breast cancer patients treated with aromatase inhibitors (AI), we assessed the impact of a preventive intervention conducted by a specialized osteoporosis unit on bone health at AI treatment start. Retrospective cohort of postmenopausal women who started treatment with AI after breast cancer surgical/chemotherapy treatment and were referred to the osteoporosis unit for a comprehensive assessment of bone health. Bone densitometry and fracture screening by plain X-ray were performed at the baseline visit and once a year for 5 years. The final record included 130 patients. At AI treatment start, 49% had at least one high-risk factor for fractures, 55% had osteopenia, and 39% osteoporosis. Based on the baseline assessment, 79% of patients initiated treatment with bisphosphonates, 88% with calcium, and 79% with vitamin D. After a median of 65 (50-77) months, 4% developed osteopenia or osteoporosis, and 14% improved their densitometric diagnosis. Fifteen fractures were recorded in 11 (8.5%) patients, all of them receiving preventive treatment (10 with bisphosphonates). During the follow-up period, patients with one or more high-risk factors for fracture showed a greater frequency of fractures (15% vs. 3%) and experienced the first fracture earlier than those without high-risk factors (mean of 99 and 102 months, respectively; P=0.023). The preventive intervention of a specialized unit at the start of AI treatment in breast cancer survivors allows the identification of patients with high fracture risk and may contribute to preventing bone events in these patients. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  16. Optimized O'Neill/Glaser Model for Human Population of Space and its Impact on Survival Probabilities

    Science.gov (United States)

    Curreri, Peter A.

    2010-01-01

    Two contemporary issues foretell a shift from our historical Earth based industrial economy and habitation to a solar system based society. The first is the limits to Earth s carrying capacity, that is the maximum number of people that the Earth can support before a catastrophic impact to the health of the planet and human species occurs. The simple example of carrying capacity is that of a bacterial colony in a Petri dish with a limited amount of nutrient. The colony experiences exponential population growth until the carrying capacity is reached after which catastrophic depopulation often results. Estimates of the Earth s carrying capacity vary between 14 and 40 billion people. Although at current population growth rates we may have over a century before we reach Earth s carrying limit our influence on climate and resources on the planetary scale is becoming scientifically established. The second issue is the exponential growth of knowledge and technological power. The exponential growth of technology interacts with the exponential growth of population in a manner that is unique to a highly intelligent species. Thus, the predicted consequences (world famines etc.) of the limits to growth have been largely avoided due to technological advances. However, at the mid twentieth century a critical coincidence occurred in these two trends humanity obtained the technological ability to extinguish life on the planetary scale (by nuclear, chemical, biological means) and attained the ability to expand human life beyond Earth. This paper examines an optimized O'Neill/Glaser model (O Neill 1975; Curreri 2007; Detweiler and Curreri 2008) for the economic human population of space. Critical to this model is the utilization of extraterrestrial resources, solar power and spaced based labor. A simple statistical analysis is then performed which predicts the robustness of a single planet based technological society versus that of multiple world (independent habitats) society.

  17. Numerical Simulation of Projectile Oblique Impact on Microspacecraft Structure

    Directory of Open Access Journals (Sweden)

    Zhiyuan Zhang

    2017-01-01

    Full Text Available In the present study, the microspacecraft bulkhead was reduced to the double honeycomb panel, and the projectile oblique hypervelocity impact on the double honeycomb panel was simulated. The distribution of the debris cloud and the damage of a honeycomb sandwich panel were investigated when the incident angles were set to be 60°, 45°, and 30°. The results showed that as incident angle decreased, the distribution of debris cloud was increased gradually, while the maximum perforation size of the rear face sheet was firstly increased with the decrease of the incident angle and then decreased. On the other hand, the damage area and the damage degree of the front face sheet of the second honeycomb panel layer were increased with the decrease of the incident angle. Finally, the critical angle of front and rear face sheets of the honeycomb sandwich panel was obtained under oblique hypervelocity impact.

  18. Salinity Tolerance of H. stipulacea - Will H. stipulacea Survive the Impacts of Desalination Plants in the Ocean?

    Science.gov (United States)

    Oscar, M. A.

    2016-02-01

    One of the many potential effects of desalination plants on the nearby marine environments is the increase in salinity in the area of discharge. With almost half of the world's desalinated water being produced in the countries of the Middle East, there is a rising concern of the effects of the these plants on marine ecosystems. Seagrasses form some of the most valuable ecosystems on earth, with an estimated value of $2.8 106 sq km-1 yr-1. Salinity changes is one of the main factors impacting the distribution of seagrasses making it an important factor when studying effects of desalination in the marine environment. Halophila stipulacea, a native seagrass to the Red sea is often termed as a euryhaline (able to grow in wide ranges of salinity) species. One of the aims of this study was to find how tolerant H. stipulacea is to changes in salinities. Halophila stipulacea plants were collected from the northern Gulf of Aqaba, Red Sea (Eilat, Israel) and acclimated in mesocosms at similar conditions to the site of collection (40 PSU). Following acclimation, they were exposed to control (40], hypo (15, 20, 25) and hyper 55, 60 and 65 PSU) salinities for 3 weeks, followed by a 3-week recovery phase. Plants were followed over time for changes in growth parameters and photophysiology in parallel to changes in gene expression. Hyper and hypo-salinities caused a steady decrease in the growth of the plants, leaf area, photosynthetic ability (quantum efficiency of photosystem II- Fv/Fm) and in chlorophyll content. The plants seemed to recover from stress after returning to control salinity as indicated by the recovery in Fv/Fm, leaf count and chlorophyll content. Overall, plants coped less at 15 and 65 PSU. At 25, 55 and 60 PSU, plants could acclimate to the salinity with indications of stress. The results suggest that salinities as high as 60 PSU would not be a concern for the growth of H. stipulacea if that is the only effect of desalinitaiton plants.

  19. The Impact of Comorbid Depression on Educational Inequality in Survival after Acute Coronary Syndrome in a Cohort of 83 062 Patients and a Matched Reference Population

    Science.gov (United States)

    Osler, Merete; Prescott, Eva; Wium-Andersen, Ida Kim; Ibfelt, Else Helene; Jørgensen, Martin Balslev; Andersen, Per Kragh; Jørgensen, Terese Sara Høj; Wium-Andersen, Marie Kim; Mårtensson, Solvej

    2015-01-01

    Background Patients with low socioeconomic position have higher rates of mortality after diagnosis of acute coronary syndrome (ACS), but little is known about the mechanisms behind this social inequality. The aim of the present study was to examine whether any educational inequality in survival after ACS was influenced by comorbid conditions including depression. Methods From 2001 to 2009 all first-time ACS patients were identified in the Danish National Patient Registry. This cohort of 83 062 ACS patients and a matched reference population were followed for incident depression and mortality until December 2012 by linkage to person, patients and prescription registries. Educational status was defined at study entry and the impact of potential confounders and mediators (age, gender, cohabitation status, somatic comorbidity and depression) on the relation between education and mortality were identified by drawing a directed acyclic graph and analysed using multiple Cox regression analyses. Findings During follow-up, 29 583(35.6%) of ACS patients and 19 105(22.9%) of the reference population died. Cox regression analyses showed an increased mortality in the lowest educated compared to those with high education in both ACS patients and the reference population. Adjustment for previous and incident depression or other covariables only attenuated the relations slightly. This pattern of associations was seen for mortality after 30 days, 1 year and during total follow-up. Conclusion In this study the relative excess mortality rate in lower educated ACS patients was comparable with the excess risk associated with low education in the background population. This educational inequality in survival remained after adjustment for somatic comorbidity and depression. PMID:26513652

  20. Body composition and survival in stable coronary heart disease: impact of lean mass index and body fat in the "obesity paradox".

    Science.gov (United States)

    Lavie, Carl J; De Schutter, Alban; Patel, Dharmendrakumar A; Romero-Corral, Abel; Artham, Surya M; Milani, Richard V

    2012-10-09

    Our goal was to determine the impact of lean mass index (LMI) and body fat (BF) on survival in patients with coronary heart disease (CHD). An inverse relationship between obesity and prognosis has been demonstrated (the "obesity paradox") in CHD, which has been explained by limitations in the use of body mass index in defining body composition. We studied 570 consecutive patients with CHD who were referred to cardiac rehabilitation, stratified as Low (≤25% in men and ≤35% in women) and High (>25% in men and >35% in women) BF and as Low (≤18.9 kg/m2 in men and ≤15.4 kg/m2 in women) and High LMI, and followed for 3 years for survival. Mortality is inversely related to LMI (p<0.0001). Mortality was highest in the Low BF/Low LMI group (15%), which was significantly higher than in the other 3 groups, and lowest in the High BF/High LMI group (2.2%), which was significantly lower than in the other 3 groups. In Cox regression analysis as categoric variables, low LMI (hazard ratio [HR]: 3.1; 95% confidence interval [CI]: 1.3 to 7.1) and low BF (HR: 2.6; 95% CI: 1.1 to 6.4) predicted higher mortality, and as continuous variables, high BF (HR: 0.91; 95% CI: 0.85 to 0.97) and high LMI (HR: 0.81; 95% CI: 0.65 to 1.00) predicted lower mortality. In patients with stable CHD, both LMI and BF predict mortality, with mortality particularly high in those with Low LMI/Low BF and lowest in those with High LMI/High BF. Determination of optimal body composition in primary and secondary CHD prevention is needed. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. The Impact of Comorbid Depression on Educational Inequality in Survival after Acute Coronary Syndrome in a Cohort of 83 062 Patients and a Matched Reference Population.

    Science.gov (United States)

    Osler, Merete; Prescott, Eva; Wium-Andersen, Ida Kim; Ibfelt, Else Helene; Jørgensen, Martin Balslev; Andersen, Per Kragh; Jørgensen, Terese Sara Høj; Wium-Andersen, Marie Kim; Mårtensson, Solvej

    2015-01-01

    Patients with low socioeconomic position have higher rates of mortality after diagnosis of acute coronary syndrome (ACS), but little is known about the mechanisms behind this social inequality. The aim of the present study was to examine whether any educational inequality in survival after ACS was influenced by comorbid conditions including depression. From 2001 to 2009 all first-time ACS patients were identified in the Danish National Patient Registry. This cohort of 83 062 ACS patients and a matched reference population were followed for incident depression and mortality until December 2012 by linkage to person, patients and prescription registries. Educational status was defined at study entry and the impact of potential confounders and mediators (age, gender, cohabitation status, somatic comorbidity and depression) on the relation between education and mortality were identified by drawing a directed acyclic graph and analysed using multiple Cox regression analyses. During follow-up, 29 583(35.6%) of ACS patients and 19 105(22.9%) of the reference population died. Cox regression analyses showed an increased mortality in the lowest educated compared to those with high education in both ACS patients and the reference population. Adjustment for previous and incident depression or other covariables only attenuated the relations slightly. This pattern of associations was seen for mortality after 30 days, 1 year and during total follow-up. In this study the relative excess mortality rate in lower educated ACS patients was comparable with the excess risk associated with low education in the background population. This educational inequality in survival remained after adjustment for somatic comorbidity and depression.

  2. The Impact of Comorbid Depression on Educational Inequality in Survival after Acute Coronary Syndrome in a Cohort of 83 062 Patients and a Matched Reference Population.

    Directory of Open Access Journals (Sweden)

    Merete Osler

    Full Text Available Patients with low socioeconomic position have higher rates of mortality after diagnosis of acute coronary syndrome (ACS, but little is known about the mechanisms behind this social inequality. The aim of the present study was to examine whether any educational inequality in survival after ACS was influenced by comorbid conditions including depression.From 2001 to 2009 all first-time ACS patients were identified in the Danish National Patient Registry. This cohort of 83 062 ACS patients and a matched reference population were followed for incident depression and mortality until December 2012 by linkage to person, patients and prescription registries. Educational status was defined at study entry and the impact of potential confounders and mediators (age, gender, cohabitation status, somatic comorbidity and depression on the relation between education and mortality were identified by drawing a directed acyclic graph and analysed using multiple Cox regression analyses.During follow-up, 29 583(35.6% of ACS patients and 19 105(22.9% of the reference population died. Cox regression analyses showed an increased mortality in the lowest educated compared to those with high education in both ACS patients and the reference population. Adjustment for previous and incident depression or other covariables only attenuated the relations slightly. This pattern of associations was seen for mortality after 30 days, 1 year and during total follow-up.In this study the relative excess mortality rate in lower educated ACS patients was comparable with the excess risk associated with low education in the background population. This educational inequality in survival remained after adjustment for somatic comorbidity and depression.

  3. Impact of cabazitaxel on 2-year survival and palliation of tumour-related pain in men with metastatic castration-resistant prostate cancer treated in the TROPIC trial

    DEFF Research Database (Denmark)

    Bahl, A; Oudard, S; Tombal, B

    2013-01-01

    Cabazitaxel significantly improves overall survival (OS) versus mitoxantrone in patients with metastatic castration-resistant prostate cancer after docetaxel failure. We examined patient survival at 2 years and tumour-related pain with cabazitaxel versus mitoxantrone.......Cabazitaxel significantly improves overall survival (OS) versus mitoxantrone in patients with metastatic castration-resistant prostate cancer after docetaxel failure. We examined patient survival at 2 years and tumour-related pain with cabazitaxel versus mitoxantrone....

  4. A spatial individual-based model predicting a great impact of copious sugar sources and resting sites on survival of Anopheles gambiae and malaria parasite transmission.

    Science.gov (United States)

    Zhu, Lin; Qualls, Whitney A; Marshall, John M; Arheart, Kris L; DeAngelis, Donald L; McManus, John W; Traore, Sekou F; Doumbia, Seydou; Schlein, Yosef; Müller, Günter C; Beier, John C

    2015-02-05

    Agent-based modelling (ABM) has been used to simulate mosquito life cycles and to evaluate vector control applications. However, most models lack sugar-feeding and resting behaviours or are based on mathematical equations lacking individual level randomness and spatial components of mosquito life. Here, a spatial individual-based model (IBM) incorporating sugar-feeding and resting behaviours of the malaria vector Anopheles gambiae was developed to estimate the impact of environmental sugar sources and resting sites on survival and biting behaviour. A spatial IBM containing An. gambiae mosquitoes and humans, as well as the village environment of houses, sugar sources, resting sites and larval habitat sites was developed. Anopheles gambiae behaviour rules were attributed at each step of the IBM: resting, host seeking, sugar feeding and breeding. Each step represented one second of time, and each simulation was set to run for 60 days and repeated 50 times. Scenarios of different densities and spatial distributions of sugar sources and outdoor resting sites were simulated and compared. When the number of natural sugar sources was increased from 0 to 100 while the number of resting sites was held constant, mean daily survival rate increased from 2.5% to 85.1% for males and from 2.5% to 94.5% for females, mean human biting rate increased from 0 to 0.94 bites per human per day, and mean daily abundance increased from 1 to 477 for males and from 1 to 1,428 for females. When the number of outdoor resting sites was increased from 0 to 50 while the number of sugar sources was held constant, mean daily survival rate increased from 77.3% to 84.3% for males and from 86.7% to 93.9% for females, mean human biting rate increased from 0 to 0.52 bites per human per day, and mean daily abundance increased from 62 to 349 for males and from 257 to 1120 for females. All increases were significant (P malaria parasite transmission.

  5. Predicted space motions for hypervelocity and runaway stars: proper motions and radial velocities for the Gaia Era

    Energy Technology Data Exchange (ETDEWEB)

    Kenyon, Scott J.; Brown, Warren R.; Geller, Margaret J. [Smithsonian Astrophysical Observatory, 60 Garden Street, Cambridge, MA 02138 (United States); Bromley, Benjamin C., E-mail: skenyon@cfa.harvard.edu, E-mail: wbrown@cfa.harvard.edu, E-mail: mgeller@cfa.harvard.edu, E-mail: bromley@physics.utah.edu [Department of Physics, University of Utah, 115 S 1400 E, Rm 201, Salt Lake City, UT 84112 (United States)

    2014-10-01

    We predict the distinctive three-dimensional space motions of hypervelocity stars (HVSs) and runaway stars moving in a realistic Galactic potential. For nearby stars with distances less than 10 kpc, unbound stars are rare; proper motions alone rarely isolate bound HVSs and runaways from indigenous halo stars. At large distances of 20-100 kpc, unbound HVSs are much more common than runaways; radial velocities easily distinguish both from indigenous halo stars. Comparisons of the predictions with existing observations are encouraging. Although the models fail to match observations of solar-type HVS candidates from SEGUE, they agree well with data for B-type HVS and runaways from other surveys. Complete samples of g ≲ 20 stars with Gaia should provide clear tests of formation models for HVSs and runaways and will enable accurate probes of the shape of the Galactic potential.

  6. Survival Analysis

    CERN Document Server

    Miller, Rupert G

    2011-01-01

    A concise summary of the statistical methods used in the analysis of survival data with censoring. Emphasizes recently developed nonparametric techniques. Outlines methods in detail and illustrates them with actual data. Discusses the theory behind each method. Includes numerous worked problems and numerical exercises.

  7. Modelling survival

    DEFF Research Database (Denmark)

    Ashauer, Roman; Albert, Carlo; Augustine, Starrlight

    2016-01-01

    well GUTS, calibrated with short-term survival data of Gammarus pulex exposed to four pesticides, can forecast effects of longer-term pulsed exposures. Thirdly, we tested the ability of GUTS to estimate 14-day median effect concentrations of malathion for a range of species and use these estimates...

  8. Impact of a critical health workforce shortage on child health in Zimbabwe: a country case study on progress in child survival, 2000–2013

    Science.gov (United States)

    Haley, Connie A; Vermund, Sten H; Moyo, Precious; Madzima, Bernard; Kanyowa, Trevor; Desta, Teshome; Mwinga, Kasonde; Brault, Marie A

    2017-01-01

    Abstract Despite notable progress reducing global under-five mortality rates, insufficient progress in most sub-Saharan African nations has prevented the achievement of Millennium Development Goal four (MDG#4) to reduce under-five mortality by two-thirds between 1990 and 2015. Country-level assessments of factors underlying why some African countries have not been able to achieve MDG#4 have not been published. Zimbabwe was included in a four-country study examining barriers and facilitators of under-five survival between 2000 and 2013 due to its comparatively slow progress towards MDG#4. A review of national health policy and strategy documents and analysis of qualitative data identified Zimbabwe’s critical shortage of health workers and diminished opportunities for professional training and education as an overarching challenge. Moreover, this insufficient health workforce severely limited the availability, quality, and utilization of life-saving health services for pregnant women and children during the study period. The impact of these challenges was most evident in Zimbabwe’s persistently high neonatal mortality rate, and was likely compounded by policy gaps failing to authorize midwives to deliver life-saving interventions and to ensure health staff make home post-natal care visits soon after birth. Similarly, the lack of a national policy authorizing lower-level cadres of health workers to provide community-based treatment of pneumonia contributed to low coverage of this effective intervention and high child mortality. Zimbabwe has recently begun to address these challenges through comprehensive policies and strategies targeting improved recruitment and retention of experienced senior providers and by shifting responsibility of basic maternal, neonatal and child health services to lower-level cadres and community health workers that require less training, are geographically broadly distributed, and are more cost-effective, however the impact of these

  9. Prognostic impact of the lymph node metastatic ratio on 5-year survival of patients with rectal cancer not submitted to preoperative chemoradiation

    Directory of Open Access Journals (Sweden)

    Alfredo Luiz Jacomo

    2011-12-01

    Full Text Available Lymph node metastases are a major prognostic factor in colorectal cancer. Inadequate lymph node resection is related to shorter survival. The lymph nodes ratio (LNR has