Comparison of outcomes in hematological malignancies treated with haploidentical or HLA-identical sibling hematopoietic stem cell transplantation following myeloablative conditioning: A meta-analysis

Science.gov (United States)

Guo, Dan; Xu, Peipei; Chen, Bing

2018-01-01

Purpose Haploidentical and human leukocyte antigen (HLA)-identical sibling hematopoietic stem transplantation are two main ways used in allogeneic hematopoietic stem cell transplantation (allo-HSCT). In recent years, remarkable progress has been made in haploidentical allo-HSCT (HID-SCT), and some institutions found HID-SCT had similar outcomes as HLA-identical sibling allo-HSCT (ISD-SCT). To clarify if HID-SCT has equal effects to ISD-SCT in hematologic malignancies, we performed this meta-analysis. Methods Relevant articles published prior to February 2017 were searched on PubMed. Two reviewers assessed the quality of the included studies and extracted data independently. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated for statistical analysis. Results Seven studies including 1919 patients were included. The rate of platelet engraftment is significantly lower after HID-SCT versus ISD-SCT while there is no difference in neutrophil engraftment (OR = 2.58, 95% CI = 1.70–3.93, P SCT versus ISD-SCT (OR = 1.88, 95% CI = 1.42–2.49, P SCT group (OR = 0.70, 95% CI = 0.55–0.90, P = 0.005). The incidence rates of overall survival (OS) and disease-free-survival/leukemia-free survival/relapse-free survival (DFS/LFS/RFS) after ISD-SCT are all significantly superior to HID-SCT (OR = 1.32, 95% CI = 1.08–1.62, P = 0.006; OR = 1.25, 95% CI = 1.03–1.52, P = 0.02). There is no significant difference in transplantation related mortality (TRM) rate after HID-SCT and ISD-SCT. Conclusion After myeloablative conditioning, patients receiving ISD-SCT have a faster engraftment, lower acute GVHD and longer life expectancy compared to HID-SCT with GVHD prophylaxis (cyclosporine A, methotrexate, mycophenolate mofetil and antithymoglobulin; CsA + MTX + MMF + ATG). Currently, HID-SCT with GVHD prophylaxis (CsA + MTX + MMF + ATG) may not replace ISD-SCT when HLA-identical sibling donor available. PMID:29381772

Evidence for a GVL effect following reduced-intensity allo-SCT in ALL: a British Society of Blood and Marrow Transplantation study.

Science.gov (United States)

Medd, P G; Peniket, A J; Littlewood, T J; Pearce, R; Perry, J; Kirkland, K E; Shaw, B E; Potter, M N; Craddock, C F; Milligan, D W; Fielding, A K; Marks, D I; Cook, G

2013-07-01

Myeloablative allo-SCT decreases relapse incidence (RI) in ALL. Reduced intensity conditioning (RIC) may extend allo-SCT to older and less fit patients. Sixty-nine ALL patients reported to the BSBMT underwent fludarabine-based RIC allo-SCT, 38 from unrelated donors (UD). Forty-four patients received alemtuzumab. ALL was in CR in 64 patients (93%). This was a second or third SCT in 23 patients. Two-year OS and PFS were 36% and 32%, respectively. In multivariate analysis male recipients demonstrated better OS and PFS (hazard ratio (HR) = 0.42, P = 0.008 and HR = 0.45, P = 0.012, respectively). Two-year TRM was 29%: higher with younger age (HR = 0.97/year, P = 0.041), female recipient (HR = 2.55, P = 0.049) and increasing grade of acute GVHD (HR = 1.87, P = 0.001). Two-year RI was 38% and was lower in patients with acute and chronic GVHD (HR = 0.62 per increasing grade, P = 0.035 and HR = 0.52, P = 0.025, respectively). Long-term ALL-free survival is achievable following fludarabine-based RIC allo-SCT. The association between GVHD and decreased RI suggests the presence of a GVL effect.

Targeting myeloid cells to the brain using non-myeloablative conditioning.

Directory of Open Access Journals (Sweden)

Chotima Böttcher

Full Text Available Bone marrow-derived cells (BMDCs are able to colonize the central nervous system (CNS at sites of damage. This ability makes BMDCs an ideal cellular vehicle for transferring therapeutic genes/molecules to the CNS. However, conditioning is required for bone marrow-derived myeloid cells to engraft in the brain, which so far has been achieved by total body irradiation (TBI and by chemotherapy (e.g. busulfan treatment. Unfortunately, both regimens massively disturb the host's hematopoietic compartment. Here, we established a conditioning protocol to target myeloid cells to sites of brain damage in mice using non-myeloablative focal head irradiation (HI. This treatment was associated with comparatively low inflammatory responses in the CNS despite cranial radiation doses which are identical to TBI, as revealed by gene expression analysis of cytokines/chemokines such as CCL2, CXCL10, TNF-α and CCL5. HI prior to bone marrow transplantation resulted in much lower levels of blood chimerism defined as the percentage of donor-derived cells in peripheral blood ( 95% or busulfan treatment (> 50%. Nevertheless, HI effectively recruited myeloid cells to the area of motoneuron degeneration in the brainstem within 7 days after facial nerve axotomy. In contrast, no donor-derived cells were detected in the lesioned facial nucleus of busulfan-treated animals up to 2 weeks after transplantation. Our findings suggest that myeloid cells can be targeted to sites of brain damage even in the presence of very low levels of peripheral blood chimerism. We established a novel non-myeloablative conditioning protocol with minimal disturbance of the host's hematopoietic system for targeting BMDCs specifically to areas of pathology in the brain.

Gonadal function and fertility after stem cell transplantation in childhood: comparison of a reduced intensity conditioning regimen containing melphalan with a myeloablative regimen containing busulfan.

Science.gov (United States)

Panasiuk, Anna; Nussey, Stephen; Veys, Paul; Amrolia, Persis; Rao, Kanchan; Krawczuk-Rybak, Maryna; Leiper, Alison

2015-09-01

The occurrence of late sequelae after myeloablative conditioning regimens for stem-cell transplantation (SCT) has prompted the introduction of reduced-intensity chemotherapy (RIC) regimens in an attempt to reduce toxicity and spare fertility. We retrospectively evaluated gonadal function in survivors of SCT in childhood by comparing patients conditioned with a myeloablative regimen containing busulfan and cyclophosphamide (BuCy, N = 51, 28 boys) and a RIC regimen containing fludarabine and melphalan (FluMel, N = 40, 19 boys). Spontaneous puberty occurred in 56% of girls and 89% of boys after BuCy, whereas 90% of females and all males in the FluMel group entered puberty spontaneously (P = 0·012). Significantly more females (61%) conditioned with BuCy required hormone replacement compared with the FluMel group (10·5%, P = 0·012). Females in the FluMel group took significantly longer to develop elevation of serum follicle-stimulating hormone (FSH) concentrations (>10 iu/l) from the onset of puberty than females in the BuCy group (median 5·2 years vs. 2·7 years respectively, P = 0·0135). In males no difference was noted between the two conditioning groups in time to FSH elevation (median 4 years in FluMel versus 6 years in BuCy). Whilst the two regimens have similar effects on the testis, ovarian function seems to be better preserved in females undergoing SCT with RIC. © 2015 John Wiley & Sons Ltd.

Chest health surveillance utility in the early detection of bronchiolitis obliterans syndrome in children after allo-SCT.

Science.gov (United States)

Gassas, A; Craig-Barnes, H; Dell, S; Doyle, J; Schechter, T; Sung, L; Egeler, M; Palaniyar, N

2013-06-01

To prospectively assess whether periodic chest health surveillance is beneficial for the early detection of bronchiolitis obliterans syndrome (BOS) in children after allo-SCT. Children up to 18 years of age receiving allo-SCT from September 2009 to September 2011 were included. Surveillance consisted of the following: a 7-item respiratory system questionnaire of cough, wheeze and shortness of breath; focused physical examination; and pulmonary function test (PFT) conducted before SCT and at 1, 3, 6, 9, 12, 18 and 24 months after SCT. Thirty-nine patients were enrolled. Five children developed BOS at a median time of 192 days (range 94-282). Positive response comparisons between the BOS group vs the non-BOS group were NS for history questionnaire (P=0.2), heart rate (P=0.3), respiratory rate (P=0.3) and oxygen saturation monitoring (P=0.8). Differences between the two groups for chest auscultation and PFT were statistically significant (P=0.03 and P=0.01, respectively). However, chest auscultation in the BOS group was only positive after BOS diagnosis. PFT reduction was evident in the asymptomatic phase (BOS group 33%; non-BOS group 4.5%, P=0.01). Changes in PFT, but not history/physical examination, allow the early detection of BOS in children after SCT. Our study is limited by the small sample size.

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

Science.gov (United States)

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

2013-02-01

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

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

Science.gov (United States)

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

2011-06-01

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

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

NARCIS (Netherlands)

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

Salvage reinduction therapy followed by high-dose chemotherapy (HDCT) and auto-SCT is the treatment of choice for fit patients with refractory or relapsed aggressive non-Hodgkin's lymphoma (NHL). We assessed the prognostic value of comorbidity at the time of relapse to predict receipt of auto-SCT

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

Science.gov (United States)

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

2013-12-01

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

Different impact of intermediate and unfavourable cytogenetics at the time of diagnosis on outcome of de novo AML after allo-SCT: a long-term retrospective analysis from a single institution.

Science.gov (United States)

Nahi, H; Remberger, M; Machaczka, M; Ungerstedt, J; Mattson, J; Ringden, O; Le-Blanc, Katarina; Ljungman, P; Hägglund, H

2012-12-01

Karyotype of myeloblasts at the time of AML diagnosis has been shown to be prognostic significant for pre-remission outcome and outcome after allo-SCT, but the latter requires further studies. We conducted a retrospective analysis of the impact of intermediate and unfavourable cytogenetics at the time of primary diagnosis on outcome after allo-SCT in de novo AML. The study included 169 patients who underwent allo-SCT at Karolinska University Hospital between 1980 and 2010. Intermediate and unfavourable cytogenetics were found in 129 (76%) and 40 patients (24%), respectively. Myeloablative and reduced-intensity conditioning were given to 120 (71%) and 49 (29%) patients, respectively. Allo-SCT was performed in CR1 in 122 patients (72%). TRM was 16% in both cytogenetics groups. Relapse occurred in 29% patients with intermediate and in 45% patients with unfavourable cytogenetics (P=0.01). The probabilities of 5-year OS for patients with intermediate and unfavourable cytogenetics were 60 and 43%, respectively (P=0.02). Multivariate analysis revealed intermediate cytogenetics, chronic GVHD, and recipient CMV-negative serostatus as variables associated with favourable OS. Our study showed that outcome after allo-SCT in de novo AML differs depending on cytogenetic risk-group; however its position in post-remission therapy of eligible AML patients is not threatened.

Clinical factors affecting engraftment and transfusion needs in SCT: a single-center retrospective analysis.

Science.gov (United States)

Liesveld, J; Pawlowski, J; Chen, R; Hyrien, O; Debolt, J; Becker, M; Phillips, G; Chen, Y

2013-05-01

Successful utilization of SCT modalities often requires utilization of both red cell and platelet transfusions. In this retrospective evaluation of clinical factors affecting transplant engraftment and transfusion utilization at a single transplant center in 505 patients from 2005 through 2009, we found that graft type, donor type and the conditioning regimen intensity significantly affected both the neutrophil engraftment time (PSCT patients required an average of 6.2 red cell units, and 7.9 platelet transfusions in the first 100 days with a wide s.d. Among auto-SCT patients, 5% required neither RBC nor platelet transfusions. Some reduced-intensity transplants were also associated with no transfusion need, and in allogeneic transplants, conditioning regimen intensity was positively correlated with platelet transfusion events as assessed by multivariate analysis. Other patient characteristics such as gender, graft type, donor type, underlying disease and use of TBI were all independently associated with transfusion needs in SCT patients. Further studies are required to understand the means to minimize transfusions and potential related complications in SCT patients.

The hatfield SCT lunar atlas photographic atlas for Meade, Celestron and other SCT telescopes

CERN Document Server

Cook, Jeremy

2005-01-01

Schmitt-Cassegrain Telescopes (SCT) and Schmitt-Maksutov telescopes - which include the best-selling models from Meade, Celestron, and other important manufacturers - reverse the visual image left for right, giving a "mirror image". This makes it extremely difficult for observers to identify lunar features at the eyepiece of one of these instruments, using conventional atlases which show the Moon "upside-down" with south at the top. The human brain just doesn't cope well with trying to compare the real thing with a map that is a mirror-image of it!The Hatfield SCT Lunar Atlas solves the problem. Photographs and the detailed key maps are exactly as the Moon appears through the eyepiece of an SCT or Maksutov telescope. Smaller IAU-standard reference photographs are included on each page, to make it simple to compare the mirrored SCT photographs and maps with those that appear in other conventional atlases.Every owner of an SCT - and that's most amateur astronomers - will want this!.

Pilot experience with opebacan/rBPI21 in myeloablative hematopoietic cell transplantation [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

Eva Guinan

2015-12-01

Full Text Available Bacterial infection and inflammation contribute significantly to the morbidity and mortality of myeloablative allogeneic hematopoietic cell transplantation (HCT. Endotoxin, a component of the outer membrane of Gram-negative bacteria, is a potent inflammatory stimulus in humans. Bactericidal/permeability increasing protein (BPI, a constituent of human neutrophil granules, binds endotoxin thereby precluding endotoxin-induced inflammation and also has direct anti-infective properties against bacteria. As a consequence of myeloablative therapy used in preparation for hematopoietic cell infusion, patients experience gastrointestinal leak of bacteria and bacterial toxins into the systemic circulation and a period of inflammatory cytokine elevation associated with subsequent regimen-related toxicities.  Patients frequently become endotoxemic and febrile as well as BPI-deficient due to sustained neutropenia. To examine whether enhancing endotoxin-neutralizing and anti-infective activity by exogenous administration of a recombinant N-terminal fragment of BPI (rBPI21, generic name opebacan might ameliorate regimen-related toxicities including infection, we recruited patients scheduled to undergo myeloablative HCT to participate in a proof-of-concept prospective phase I/II trial. After the HCT preparative regimen was completed, opebacan was initiated 18-36 hours prior to administration of allogeneic hematopoietic stem cells (defined as Day 0 and continued for 72 hours. The trial was to have included escalation of rBPI21 dose and duration but was stopped prematurely due to lack of further drug availability.  Therefore, to better understand the clinical course of opebacan-treated patients (n=6, we compared their outcomes with a comparable cohort meeting the same eligibility criteria and enrolled in a non-interventional myeloablative HCT observational study (n = 35.  Opebacan-treated participants had earlier platelet engraftment (p=0.005, mirroring

Validations of SCT Methylation as a Hallmark Biomarker for Lung Cancers

Science.gov (United States)

Fujimoto, Junya; Wistuba, Ignacio; Lam, Stephen; Yatabe, Yasushi; Wang, Yi-Wei; Stastny, Victor; Gao, Boning; Larsen, Jill E; Girard, Luc; Liu, Xiaoyun; Song, Kai; Behrens, Carmen; Kalhor, Neda; Xie, Yang; Zhang, Michael Q; Minna, John D; Gazdar, Adi F

2016-01-01

Background The human secretin (SCT) gene encodes secretin, a hormone with limited tissue distribution. Analysis of The Cancer Genome Atlas (TCGA) 450K methylation array data indicated that the SCT promoter region is differentially hypermethylated in lung cancer. Our purpose was to validate SCT methylation as a potential cancer biomarker for lung cancer. Methods We analyzed TCGA data, and developed and applied SCT-specific bisulfite DNA sequencing and quantitative methylation specific PCR (qMSP) assays. Results The analyses of TCGA 450K data of 801 samples showed that SCT hypermethylation has an area under curve (AUC) value >0.98 to distinguish lung adenocarcinomas or squamous cell carcinomas from non-malignant lung. We confirmed the highly discriminative SCT methylation by bisulfite sequencing of lung cancer cell lines and normal blood cells. By applying qMSP, we found that SCT hypermethylation was frequently detected in all major subtypes of malignant NSCLC (AUC=0.92, n=108) and SCLC cancers (AUC=0.93, n=40) but less frequently present in lung carcinoids (AUC=0.54, n=20). SCT hypermethylation appeared in lung carcinoma in situ samples during multistage pathogenesis and increased in invasive samples. Further analyses of TCGA 450K data showed that SCT hypermethylation is highly discriminative in most types of other malignant tumors but less frequently present in low-grade malignant tumors. The only normal tissue with high methylation was the placenta. Conclusions Our findings demonstrated that SCT methylation is a highly discriminative biomarker for lung and other malignant tumors, and less frequently present in low-grade malignant tumors including lung carcinoids, and appears at the carcinoma in situ stage. PMID:26725182

Commissioning of the SCT

International Nuclear Information System (INIS)

Hayward, Helen

2010-01-01

In September 2008, the large hadron collider (LHC) at CERN was switched on with successful tests of circulating beam in both directions of the ring. The ATLAS semiconductor tracker (SCT) has been installed in the ATLAS cavern since summer 2007 and then integrated with the rest of the ATLAS subdetectors, in preparation for this event. After the SCT was assembled on the surface, the process of being commissioned using cosmic ray events began, and continued after the SCT was installed in the cavern with the rest of the ATLAS detector. Performance results will be given for the recent cosmic runs.

Second auto-SCT for treatment of relapsed multiple myeloma.

Science.gov (United States)

Gonsalves, W I; Gertz, M A; Lacy, M Q; Dispenzieri, A; Hayman, S R; Buadi, F K; Dingli, D; Hogan, W J; Kumar, S K

2013-04-01

High-dose therapy and auto-SCT remain integral in the initial treatment of multiple myeloma (MM), and are increasingly being applied for management of relapsed disease. We examined the outcomes in 98 patients undergoing salvage auto-SCT (auto-SCT2) for relapsed MM after receiving an initial transplant (auto-SCT1) between 1994 and 2009. The median age at auto-SCT2 was 60 years (range: 35-74). The median time between auto-SCT1 and auto-SCT2 was 46 months (range: 10-130). Treatment-related mortality was seen in 4%. The median PFS from auto-SCT2 was 10.3 (95% confidence interval (CI): 7-14) months and the median OS from auto-SCT2 was 33 months (95% CI: 28-51). In a multivariable analysis, shorter time to progression (TTP) after auto-SCT1, not achieving a CR after auto-SCT2, higher number of treatment regimens before auto-SCT2 and a higher plasma cell labeling index at auto-SCT2 predicted for shorter PFS. However, only a shorter TTP after auto-SCT1 predicted for a shorter OS post auto-SCT2. Hence, auto-SCT2 is an effective and feasible therapeutic option for MM patients relapsing after other treatments, especially in patients who had a TTP of at least 12 months after their auto-SCT1.

ATLAS silicon microstrip Semiconductor Tracker (SCT)

International Nuclear Information System (INIS)

Unno, Y.

2000-01-01

Silicon microstrip semiconductor tracking system (SCT) will be in operation in the ATLAS detector in the Large Hadron Collider (LHC) at CERN. Challenging issues in the SCT are the radiation tolerance to the fluence of 2x10 14 1-MeV-neutron-equivalent particles/cm 2 at the designed luminosity of 1x10 34 cm -2 /s of the proton-proton collisions and the speed of the electronics to identify the crossing bunches at 25 ns. The developments and the status of the SCT are presented from the point of view of these issues. Series production of the SCT will start in the year 2001 and the SCT will be installed into the ATLAS detector during 2003-2004

TRT and SCT barrels merge

CERN Multimedia

Wells, P S

2006-01-01

The SCT barrel was inserted in the TRT on 17 February, just missing Valentine's day. This was a change of emphasis for the two detectors. In the preceeding months there had been a lot of focus on testing their performance. The TRT had been observing cosmic rays through several sectors of the barrel, and all the modules on each of the four layers of the SCT had been characterised prior to integration. In parallel, the engineering teams, lead by Marco Olcese, Andrea Catinaccio, Eric Perrin, Neil Dixon, Iourii Gusakov, Gerard Barbier and Takashi Kohriki, had been preparing for this critical operation. Figure 1: Neil Dixon and Marco Olcese verifying the final alignment The two detectors had to be painstakingly aligned to be concentric to within a millimetre. The SCT was held on a temporary cantilever stand, and the TRT in the ID trolley had to inch over it. Finally the weight of the SCT was transferred to the rails on the inside of the TRT itself. The SCT services actually protruded a little outside the oute...

Validation of SCT Methylation as a Hallmark Biomarker for Lung Cancers.

Science.gov (United States)

Zhang, Yu-An; Ma, Xiaotu; Sathe, Adwait; Fujimoto, Junya; Wistuba, Ignacio; Lam, Stephen; Yatabe, Yasushi; Wang, Yi-Wei; Stastny, Victor; Gao, Boning; Larsen, Jill E; Girard, Luc; Liu, Xiaoyun; Song, Kai; Behrens, Carmen; Kalhor, Neda; Xie, Yang; Zhang, Michael Q; Minna, John D; Gazdar, Adi F

2016-03-01

The human secretin gene (SCT) encodes secretin, a hormone with limited tissue distribution. Analysis of the 450k methylation array data in The Cancer Genome Atlas (TCGA) indicated that the SCT promoter region is differentially hypermethylated in lung cancer. Our purpose was to validate SCT methylation as a potential biomarker for lung cancer. We analyzed data from TCGA and developed and applied SCT-specific bisulfite DNA sequencing and quantitative methylation-specific polymerase chain reaction assays. The analyses of TCGA 450K data for 801 samples showed that SCT hypermethylation has an area under the curve (AUC) value greater than 0.98 that can be used to distinguish lung adenocarcinomas or squamous cell carcinomas from nonmalignant lung tissue. Bisulfite sequencing of lung cancer cell lines and normal blood cells allowed us to confirm that SCT methylation is highly discriminative. By applying a quantitative methylation-specific polymerase chain reaction assay, we found that SCT hypermethylation is frequently detected in all major subtypes of malignant non-small cell lung cancer (AUC = 0.92, n = 108) and small cell lung cancer (AUC = 0.93, n = 40) but is less frequent in lung carcinoids (AUC = 0.54, n = 20). SCT hypermethylation appeared in samples of lung carcinoma in situ during multistage pathogenesis and increased in invasive samples. Further analyses of TCGA 450k data showed that SCT hypermethylation is highly discriminative in most other types of malignant tumors but less frequent in low-grade malignant tumors. The only normal tissue with a high level of methylation was the placenta. Our findings demonstrated that SCT methylation is a highly discriminative biomarker for lung and other malignant tumors, is less frequent in low-grade malignant tumors (including lung carcinoids), and appears at the carcinoma in situ stage. Copyright © 2015 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Prevalence of menstrual cycles and outcome of 50 pregnancies after high-dose chemotherapy and auto-SCT in non-Hodgkin and Hodgkin lymphoma patients younger than 40 years.

Science.gov (United States)

Akhtar, S; Youssef, I; Soudy, H; Elhassan, T A M; Rauf, S M; Maghfoor, I

2015-12-01

Data are limited regarding the prevalence of menstrual cycles and pregnancies after high-dose chemotherapy (HDC) and auto-stem cell transplantation (SCT). Female patients who underwent HDC auto-SCT for non-Hodgkin and Hodgkin lymphoma (1997-2012) were reviewed. The selection criteria were as follows: (1) alive without disease 12 and 24 months after auto-SCT for menstrual cycles and pregnancy, respectively, (2) age SCT, and (3) no primary infertility. One-hundred and seventy-six females underwent single auto-SCT. Eighty-nine were eligible for menstrual cycles and pregnancy analysis. Median age at auto-SCT was 25 years (14-40 years), at pregnancy 27 years (20-37 years), median follow-up 65 months (range 24-190). Regular menstrual-cycles resumed in 56/89 patients (63%). Increasing age (P=0.02) and number of prior chemotherapy cycles (P=0.02) are associated with higher risk of amenorrhea. Forty patients tried to get pregnant, 26 (65%) became pregnant 50 times: 43 (86%) live birth, 7 (14%) miscarriage and 2/50 had birth defects. Twenty-four patients practiced breastfeeding (median duration 4 months (1-24 months)). Enough breast milk production was reported 62.5% vs 100% in those patients who did or did not receive above the diaphragm radiation therapy, respectively, (P=0.066). Our data highlights significantly higher than perceived incidence of menstrual cycle resumption, successful pregnancies and breastfeeding after HDC auto-SCT.

The Hatfield SCT lunar atlas photographic atlas for Meade, Celestron, and other SCT telescopes

CERN Document Server

2014-01-01

In a major publishing event for lunar observers, the justly famous Hatfield atlas is updated in even more usable form. This version of Hatfield’s classic atlas solves the problem of mirror images, making identification of left-right reversed imaged lunar features both quick and easy. SCT and Maksutov telescopes – which of course include the best-selling models from Meade and Celestron – reverse the visual image left to right. Thus it is extremely difficult to identify lunar features at the eyepiece of one of the instruments using a conventional Moon atlas, as the human brain does not cope well when trying to compare the real thing with a map that is a mirror image of it. Now this issue has at last been solved.   In this atlas the Moon’s surface is shown at various sun angles, and inset keys show the effects of optical librations. Smaller non-mirrored reference images are also included to make it simple to compare the mirrored SCT plates and maps with those that appear in other atlases. This edition s...

The neurocognitive nature of children with ADHD comorbid sluggish cognitive tempo: Might SCT be a disorder of vigilance?

Science.gov (United States)

Baytunca, Muharrem Burak; Inci, Sevim Berrin; Ipci, Melis; Kardas, Burcu; Bolat, Gul Unsel; Ercan, Eyup Sabri

2018-03-21

Sluggish Cognitive Tempo (SCT) refers to a clinical construct including several symptoms such as sluggishness, absentmindedness, low energy. In the present study, we compared neurocognitive laboratory outcomes of ADHD children with or without SCT. The CNS Vital Signs Battery was utilized to measure neurocognitive measure of the participants. The SCT+ADHD group comprised of 42 subjects, ADHD group was 41 subjects and control group was 24 subjects. The cognitive flexibility score was found to be more severely impaired in ADHD children with SCT in comparison to the ADHD-only. Additionally, greater deficits in the Shifting Attention Test (p = 0.014) and the Continuous Performance Test (reaction time score, p SCT+ADHD group relative to ADHD group. Processing speed, visual/auditory memory, psychomotor speed and reaction time were not found to more impaired in those comorbid with SCT. Impairments in the cognitive flexibility and more specifically shifting attention and continuous performance may be indicative of vigilance and orientation problems rather than executive functions for the SCT construct. Copyright © 2018 Elsevier B.V. All rights reserved.

Modelling of performance of the ATLAS SCT detector

International Nuclear Information System (INIS)

Kazi, S.

2000-01-01

Full text: The ATLAS detector being built at LHC will use the SCT (semiconductor tracking) module for particle tracking in the inner core of the detector. An analytical/numerical model of the discriminator threshold dependence and the temperature dependence of the SCT module was derived. Measurements were conducted on the performance of the SCT module versus temperature and these results were compared with the predictions made by the model. The affect of radiation damage of the SCT detector was also investigated. The detector will operate for approximately 10 years so a study was carried out on the effects of the 10 years of radiation exposure to the SCT

The ATLAS semiconductor tracker (SCT)

International Nuclear Information System (INIS)

Jackson, J.N.

2005-01-01

The ATLAS detector (CERN,LHCC,94-43 (1994)) is designed to study a wide range of physics at the CERN Large Hadron Collider (LHC) at luminosities up to 10 34 cm -2 s -1 with a bunch-crossing rate of 40 MHz. The Semiconductor Tracker (SCT) forms a key component of the Inner Detector (vol. 1, ATLAS TDR 4, CERN,LHCC 97-16 (1997); vol. 2, ATLAS TDR 5, CERN,LHCC 97-17 (1997)) which is situated inside a 2 T solenoid field. The ATLAS Semiconductor Tracker (SCT) utilises 4088 silicon modules with binary readout mounted on carbon fibre composite structures arranged in the forms of barrels in the central region and discs in the forward region. The construction of the SCT is now well advanced. The design of the SCT modules, services and support structures will be briefly outlined. A description of the various stages in the construction process will be presented with examples of the performance achieved and the main difficulties encountered. Finally, the current status of the construction is reviewed

Prevalence of chimerism after non-myeloablative hematopoietic stem cell transplantation

Directory of Open Access Journals (Sweden)

Azulamara da Silva Ruiz

Full Text Available CONTEXT AND OBJECTIVE: Non-myeloablative hematopoietic stem cell transplantation (NMA-HSCT is performed in onco-hematological patients who cannot tolerate ablative conditioning because of older age or comorbidities. This approach does not completely eliminate host cells and initially results in mixed chimerism. Long-term persistence of mixed chimerism results in graft rejection and relapse. Involvement of graft-versus-host disease is concomitant with complete chimerism and graft-versus-tumor effect. The aim of this study was to evaluate the prevalence of chimerism in onco-hematological patients who underwent NMA-HSCT. DESIGN AND SETTING: Observational clinical study on chimerism status after human leukocyte antigen-identical NMA-HSCT at the Discipline of Hematology and Hemotherapy of Universidade Federal de São Paulo. METHODS: We sequentially analyzed the amplification of APO-B, D1S80, DxS52, FVW, 33.6, YNZ-2 and H-ras primers using variable number of tandem repeats (VNTR on 17 pairs and fluorescent in situ hybridization (FISH with the XY probe and SRY primer on 13 sex-unmatched pairs. RESULTS: The informativeness of the primers using VNTR was 60% for APO-B, 75% D1S80, 36% DxS52, 14% FVW, 40% YNZ-22 and 16% H-ras. The SRY primer was informative in female receptors with male donors. The XY-FISH method was informative in 100% of the sex-unmatched pairs. CONCLUSION: These methods were sensitive and informative. In VNTR, the association of APO-B with D1S80 showed 88% informativeness. The quantitative FISH method was more sensitive, but had the disadvantage of only being used for sex-unmatched pairs.

ICD-11 (JLMMS) and SCT Inter-Operation.

Science.gov (United States)

Mamou, Marzouk; Rector, Alan; Schulz, Stefan; Campbell, James; Solbrig, Harold; Rodrigues, Jean-Marie

2016-01-01

The goal of this work is to contribute to a smooth and semantically sound inter-operability between the ICD-11 (International Classification of Diseases-11th revision Joint Linearization for Mortality, Morbidity and Statistics) and SNOMED CT (SCT). To guarantee such inter-operation between a classification, characterized by a single hierarchy of mutually exclusive and exhaustive classes, as is the JLMMS successor of ICD-10 on the one hand, and the multi-hierarchical, ontology-based clinical terminology SCT on the other hand, we use ontology axioms that logically express generalizable truths. This is expressed by the compositional grammar of SCT, together with queries on axiomsof SCT. We test the feasibility of the method on the circulatory chapter of ICD-11 JLMMS and present limitations and results.

Auto-SCT improves survival in systemic light chain amyloidosis: a retrospective analysis with 14-year follow-up.

Science.gov (United States)

Parmar, S; Kongtim, P; Champlin, R; Dinh, Y; Elgharably, Y; Wang, M; Bashir, Q; Shah, J J; Shah, N; Popat, U; Giralt, S A; Orlowski, R Z; Qazilbash, M H

2014-08-01

Optimal treatment approach continues to remain a challenge for systemic light chain amyloidosis (AL). So far, Auto-SCT is the only modality associated with long-term survival. However, failure to show survival benefit in randomized study raises questions regarding its efficacy. We present a comparative outcome analysis of Auto-SCT to conventional therapies (CTR) in AL patients treated over a 14-year period at our institution. Out of the 145 AL amyloidosis patients, Auto-SCT was performed in 80 patients with 1-year non-relapse mortality rate of 12.5%. Novel agents were used as part of induction therapy in 56% of transplant recipients vs 46% of CTR patients. Hematological and organ responses were seen in 74.6% and 39% in the Auto-SCT arm vs 53% and 12% in the CTR arm, respectively. The projected 5-year survival for Auto-SCT vs CTR was 63% vs 38%, respectively. Landmark analysis of patients alive at 1-year after diagnosis showed improved 5-year OS of 72% with Auto-SCT vs 65% in the CTR arm. In the multivariate analysis, age SCT were associated with improved survival. In conclusion, Auto-SCT is associated with long-term survival for patients with AL amyloidosis.

The results of the irradiations of microstrip detectors for the ATLAS tracker (SCT)

International Nuclear Information System (INIS)

Dervan, P.J.

2003-01-01

The SemiConductor Tracker (SCT) of ATLAS will operate in the Large Hadron Collider (LHC) at CERN, which will reach luminosities of 10 34 cm 2 s -1 . Silicon single-sided microstrip detectors will be used for particle tracking. Due to the proximity to the beam, the silicon detectors need to withstand damage from ionising radiation (10 Mrad total dose) and from non-ionising radiation such as neutrons (2x10 14 1 MeV equivalent neutrons/cm 2 total fluence). The final characteristics of the silicon SCT detectors which are needed to operate under LHC conditions and the conclusions reached after various years of test irradiation studies will be reported. The integration and performance of these detectors in complete SCT modules is also discussed

Advancing the Multi-Informant Assessment of Sluggish Cognitive Tempo: Child Self-Report in Relation to Parent and Teacher Ratings of SCT and Impairment.

Science.gov (United States)

Sáez, Belén; Servera, Mateu; Burns, G Leonard; Becker, Stephen P

2018-04-27

Despite increasing interest in sluggish cognitive tempo (SCT) in children and advancements in its measurement, little research has examined child self-reported SCT. Child self-report of SCT is important for the multi-informant assessment of SCT. The current study used a large, school-based sample of children and a multi-informant design to examine child self-reported SCT using the Child Concentration Inventory - Version 2 (CCI-2) which was recently revised based on meta-analytic findings and parallels the item content of validated parent and teacher rating scales. The study involved 2142 unique children (ages 8-13 years, 50.51% males). Children (n = 1980) completed measures of SCT, loneliness, and preference for solitude. Mothers (n = 1648), fathers (n = 1358), and teachers (n = 1773) completed measures of SCT, attention-deficit/hyperactivity disorder-IN (ADHD-IN), academic impairment, social impairment, and conflicted shyness. Children's self-reported SCT demonstrated good reliability with the 15 SCT symptoms showing moderate to strong loadings on the SCT factor. The child self-report SCT factor also showed moderate convergent validity with mother, father, and teacher ratings of children's SCT. In addition, higher child-reported SCT predicted greater mother, father, and teacher ratings of children's academic impairment even after controlling for mother, father, and teacher ratings of children's SCT and ADHD-IN. Higher child-rated SCT also predicted greater mother ratings of children's social impairment after controlling for mother ratings of children's SCT and ADHD-IN. The present study provides initial empirical support for the reliability and validity of child-reported SCT as part of the multi-informant assessment of SCT. A key direction for future research includes evaluating the unique contributions of different informants and their utility within specific contexts to guide evidence-based recommendations for assessing SCT.

Incidence of extramedullary relapse after haploidentical SCT for advanced AML/myelodysplastic syndrome.

Science.gov (United States)

Yoshihara, S; Ikegame, K; Kaida, K; Taniguchi, K; Kato, R; Inoue, T; Fujioka, T; Tamaki, H; Okada, M; Soma, T; Ogawa, H

2012-05-01

Extramedullary (EM) relapse of leukemia after allo-SCT in patients with AML/myelodysplastic syndrome has been increasingly reported. The reduced effectiveness of the GVL effect in EM sites, as compared with BM, has been suggested to underlie this problem. We retrospectively analyzed the pattern of relapse after haploidentical SCT (haplo-SCT), performed as the first or second SCT. Among 38 patients who received haplo-SCT as their first SCT, the cumulative incidences of BM and EM relapse at 3 years were 40.5 and 10.9%, respectively. Among 19 patients who received haplo-SCT as their second SCT, the cumulative incidences of BM and EM relapse were 30.9 and 31.9%, respectively. Moreover, most of the patients who underwent repeat haplo-SCT for the treatment of EM relapse had further EM relapse at other sites. Post-relapse survival did not differ significantly with different patterns of relapse. The frequent occurrence of EM relapse after haplo-SCT, particularly when performed as a second SCT, suggests that the potent GVL effect elicited by an HLA disparity also occurs preferentially in BM. Our findings emphasize the need for a treatment strategy for EM relapse that recognizes the reduced susceptibility of EM relapse to the GVL effect.

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

Science.gov (United States)

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

2015-04-01

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

Amplitude modulation in δ Sct stars: statistics from an ensemble of Kepler targets

Science.gov (United States)

Bowman, Dominic M.; Kurtz, Donald W.; Breger, Michel; Murphy, Simon J.; Holdsworth, Daniel L.

2017-10-01

The results of a search for amplitude modulation of pulsation modes in 983 δ Sct stars, which have effective temperatures between 6400 ⩽ Teff ⩽ 10 000 K in the Kepler Input Catalogue and were continuously observed by the Kepler Space Telescope for 4 yr, are presented. A total of 603 δ Sct stars (61.3 per cent) are found to exhibit at least one pulsation mode that varies significantly in amplitude over 4 yr. Furthermore, it is found that amplitude modulation is not restricted to a specific region within the classical instability strip in the HR diagram, therefore its cause is not necessarily dependent on stellar parameters such as Teff or log g. On the other hand, many δ Sct stars show constant pulsation amplitudes demonstrating that the cause of pulsational non-linearity in these stars is not well understood.

The role of hematopoietic SCT in adult Burkitt lymphoma.

Science.gov (United States)

Ahmed, S O; Sureda, A; Aljurf, M

2013-05-01

Adult Burkitt lymphoma (BL) is an aggressive disease characterized by frequent extranodal presentation, bulky disease and a rapid clinical course. Although intensive chemotherapeutic regimes result in long-term disease-free survival in most patients, a significant proportion of patients will have high-risk disease that may be refractory or that will relapse. In these patients, the role of hematopoietic SCT is not well defined, especially in the era of modern chemoimmunotherapy. Upfront auto-SCT has been reported to be feasible in patients who have high-risk features at presentation, and in whom it is a clinical option. In patients with relapsed disease, auto-SCT can result in a PFS of 30-40%. Allo-SCT is an option in relapsing patients with a sibling or matched related donor who may not be eligible for, or may have previously received, an auto-SCT; the role of RIC and T-cell depletion is not well defined. Disease status at transplant is the most significant predictor of outcome in patients undergoing SCT. Here we review the available evidence pertaining to SCT in patients with BL, including in those who are HIV positive (HIV+) and those with B-cell lymphoma unclassified (BCLU). Prospective studies in the era of modern intensive chemoimmunotherapeutic regimes are required to delineate the precise role of transplantation for BL. Developments in molecular diagnostics, incorporation of FDG-PET and minimal residual disease monitoring along with new therapies may further assist in refining treatment algorithms.

Matched-pair analysis to compare the outcomes of a second salvage auto-SCT to systemic chemotherapy alone in patients with multiple myeloma who relapsed after front-line auto-SCT.

Science.gov (United States)

Yhim, H-Y; Kim, K; Kim, J S; Kang, H J; Kim, J-A; Min, C-K; Bae, S H; Park, E; Yang, D-H; Suh, C; Kim, M K; Mun, Y-C; Eom, H S; Shin, H J; Yoon, H-J; Kwon, J H; Lee, J H; Kim, Y S; Yoon, S-S; Kwak, J-Y

2013-03-01

The aims of this study were to investigate the outcomes of second salvage auto-SCT and to identify the impacts of a second auto-SCT compared with systemic chemotherapy alone on disease outcome. Data from 48 patients who underwent second auto-SCT were matched to 144 patients (1:3) who received systemic chemotherapy alone from the Korean Myeloma Registry. Groups were matched for nine potential prognostic factors and compared for treatment outcomes. The median age of matching-pairs at relapse was 55.5 years. A total of 156 patients (81%) received vincristine, doxorubicin and dexamethasone induction therapy before the first auto-SCT. Thirty-five patients (73%) in the second auto-SCT group received novel agent-based therapies before the second auto-SCT, and similar proportion in both groups received novel therapies after relapse of front-line auto-SCT. With a median follow-up of 55.3 months, patients who underwent a second auto-SCT had significantly better median OS (55.5 vs 25.4 months, P=0.035). In multivariate analysis for OS, SCT, International Staging System III and salvage chemotherapy alone were independent predictors for worse OS. The outcomes of second auto-SCT appear to be superior to those of systemic chemotherapy alone. A randomized trial comparing both treatment strategies is required.

Lung transplantation for bronchiolitis obliterans syndrome after allo-SCT.

Science.gov (United States)

Holm, A M; Riise, G C; Hansson, L; Brinch, L; Bjørtuft, O; Iversen, M; Simonsen, S; Fløisand, Y

2013-05-01

Chronic GVHD (cGVHD) associated bronchiolitis obliterans syndrome (BOS) is a serious complication after allo-SCT, and lung transplantation (LTx) may be the ultimate treatment option. To evaluate this treatment, data on all patients with LTx after allo-SCT ever performed in Sweden, Norway, Denmark and Finland were recorded and compared with survival data from the Scandiatransplant registry. In total, LTx after allo-SCT had been performed in 13 patients. Allo-SCT was done because of AML (n=6), CML (n=3), ALL (n=2), immunodeficiency (n=1) and aplastic anemia (n=1). All developed clinical cGVHD, with median interval from allo-SCT to LTx of 8.2 (0.7-16) years. Median age at LTx was 34 (16-55) years, and the median postoperative observation time was 4.2 (0.1-15) years. Two patients died, one due to septicemia, the other of relapsing leukemia, after 2 and 14 months, respectively. Four developed BOS, one of these was retransplanted. The survival did not significantly differ from the survival in matched LTx controls, being 90% 1 year and 75% 5 years after LTx compared with 85% and 68% in the controls. We therefore suggest that LTx may be considered in carefully selected patients with BOS due to cGVHD after allo-SCT.

SCT: a suite of programs for comparing atomistic models with small-angle scattering data.

Science.gov (United States)

Wright, David W; Perkins, Stephen J

2015-06-01

Small-angle X-ray and neutron scattering techniques characterize proteins in solution and complement high-resolution structural studies. They are of particular utility when large proteins cannot be crystallized or when the structure is altered by solution conditions. Atomistic models of the averaged structure can be generated through constrained modelling, a technique in which known domain or subunit structures are combined with linker models to produce candidate global conformations. By randomizing the configuration adopted by the different elements of the model, thousands of candidate structures are produced. Next, theoretical scattering curves are generated for each model for trial-and-error fits to the experimental data. From these, a small family of best-fit models is identified. In order to facilitate both the computation of theoretical scattering curves from atomistic models and their comparison with experiment, the SCT suite of tools was developed. SCT also includes programs that provide sequence-based estimates of protein volume (either incorporating hydration or not) and add a hydration layer to models for X-ray scattering modelling. The original SCT software, written in Fortran, resulted in the first atomistic scattering structures to be deposited in the Protein Data Bank, and 77 structures for antibodies, complement proteins and anionic oligosaccharides were determined between 1998 and 2014. For the first time, this software is publicly available, alongside an easier-to-use reimplementation of the same algorithms in Python. Both versions of SCT have been released as open-source software under the Apache 2 license and are available for download from https://github.com/dww100/sct.

Longitudinal health-related quality of life outcomes and related factors after pediatric SCT.

Science.gov (United States)

Barrera, M; Atenafu, E; Hancock, K

2009-08-01

Our purpose was to investigate longitudinally health-related quality of life (HRQOL) outcomes and related factors up to 2 years post-pediatric SCT. A total of 99 mothers of patients, aged 1.5-17 years, completed two standardized HRQOL questionnaires, generic and disease specific (DS), about the child, and reported on their own symptoms of depression and family function pre-SCT, 12 and 24 months post-SCT. Clinical (diagnosis, radiation), child (age) and family (maternal depression) information was also obtained. Significant improvement in physical and psychosocial HRQOL from pre-SCT to 1 or 2 years post-SCT was reported. Survivors of ALL were reported to have poorer physical and psychosocial HRQOL than survivors of solid tumors on the DS measure. Maternal depression was negatively associated with physical and psychosocial HRQOL. Maternal education (higher) at pre-SCT predicted improvements in physical domains 2 years post-SCT; mother's age (older) and child's age (younger) also predicted improvements of physical and emotional HRQOL. We conclude that survivors of pediatric SCT improved physical and psychosocial HRQOL by 1 and 2 years post-SCT. Older survivors whose mothers are younger and distressed, with lower education at SCT have compromised HRQOL compared to other survivors. This study has important implications for the care of SCT survivors and their families.

Recent test results on the ATLAS SCT detector

International Nuclear Information System (INIS)

Pernegger, H.

2003-01-01

The ATLAS Semiconductor Tracker (SCT) will be a central part of the tracking system of the ATLAS experiment. The SCT, which is currently under construction, will consist of four concentric barrels of silicon detectors as well as two silicon endcap detectors formed by nine disks each. After an overview of the SCT and the detector module layout, the paper will summarize recent test results obtained from silicon detector modules, which have been extensively tested before starting their large series production. The tests presented here cover electrical performance of individual modules, their performance after irradiation, as well as system tests in a multi-module setup

ATLAS silicon microstrip detector system (SCT)

International Nuclear Information System (INIS)

Unno, Y.

2003-01-01

The S CT together with the pixel and the transition radiation tracker systems and with a central solenoid forms the central tracking system of the ATLAS detector at LHC. Series production of SCT Silicon microstrip sensors is near completion. The sensors have been shown to be robust against high voltage operation to the 500 V required after fluences of 3x10 14 protons/cm 2 . SCT barrel modules are in series production. A low-noise CCD camera has been used to debug the onset of leakage currents

Enhanced transbuccal salmon calcitonin (sCT) delivery: effect of chemical enhancers and electrical assistance on in vitro sCT buccal permeation.

Science.gov (United States)

Oh, Dong-Ho; Chun, Kyeung-Hwa; Jeon, Sang-Ok; Kang, Jeong-Won; Lee, Sangkil

2011-10-01

This study investigates the combined effect of absorption enhancers and electrical assistance on transbuccal salmon calcitonin (sCT) delivery, using fresh swine buccal tissue. We placed 200 IU (40 μg/mL) of each sCT formulation--containing various concentrations of ethanol, N-acetyl-L-cysteine (NAC), and sodium deoxyglycocholate (SDGC)--onto the donor part of a Franz diffusion cell. Then, 0.5 mA/cm(2) of fixed anodal current was applied alone or combined with chemical enhancers. The amount of permeated sCT was analyzed using an ELISA kit, and biophysical changes of the buccal mucosa were investigated using FT-IR spectroscopy, and hematoxylin-eosin staining methods were used to evaluate histological alteration of the buccal tissues. The flux (J(s)) of sCT increased with the addition of absorption enhancer groups, but it was significantly enhanced by the application of anodal iontophoresis (ITP). FT-IR study revealed that all groups caused an increase in lipid fluidity but only the groups containing SDGC showed statistically significant difference. Although the histological data of SDGC groups showed a possibility for tissue damage, the present enhancing methods appear to be safe. In conclusion, the combination of absorption enhancers and electrical assistance is a potential strategy for the enhancement of transbuccal sCT delivery. Copyright © 2011 Elsevier B.V. All rights reserved.

Outcome of poor response Paediatric AML using early SCT

DEFF Research Database (Denmark)

Wareham, Neval E; Heilmann, Carsten; Abrahamsson, Jonas

2013-01-01

) or > 5% blasts after AM (n = 14, refractory disease). Poor response patients received intensively timed induction and proceeded to SCT when a donor was available. RESULTS: Thirty-one of 267 evaluable patients (12%) had a poor response. SCT was performed in 25; using matched unrelated donors in 13......BACKGROUND: Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients...... treated with SCT. MATERIAL AND METHODS: Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n = 17...

Oral cryotherapy reduces mucositis and opioid use after myeloablative therapy--a randomized controlled trial.

Science.gov (United States)

Svanberg, Anncarin; Birgegård, Gunnar; Ohrn, Kerstin

2007-10-01

Mucositis is a major complication in myeloablative therapy, which often necessitates advanced pharmacological pain treatment, including i.v. opioids. Attempts to prevent oral mucositis have included oral cryotherapy, which has been shown to reduce mucositis, but there is a lack of knowledge concerning the effect of oral cryotherapy on opioid use by reducing the mucositis for patients treated with myeloablative therapy before bone marrow transplantation (BMT). The aim of the present study was to evaluate if oral cryotherapy could delay or alleviate the development of mucositis and thereby reduce the number of days with i.v. opioids among patients who receive myeloablative therapy before BMT. Eighty patients 18 years and older, scheduled for BMT, were included consecutively and randomised to oral cryotherapy or standard oral care. A stratified randomisation was used with regard to type of transplantation. Intensity of pain, severity of mucositis and use of opioids were recorded using pain visual analogue scale (VAS) scores, mucositis index scores and medical and nursing charts. This study showed that patients receiving oral cryotherapy had less pronounced mucositis and significantly fewer days with i.v. opioids than the control group. In the autologous setting, cryotherapy patients also needed significantly lower total dose of opioids. Oral cryotherapy is an effective and well-tolerated therapy to alleviate mucositis and consequently reduce the number of days with i.v. opioids among patients treated with myeloablative therapy before BMT.

Performance and operation of the semiconductor tracker (SCT)

CERN Document Server

Dervan, P; The ATLAS collaboration

2013-01-01

After more than 3 years of successful operation at the LHC, we report on the operation and performance of the ATLAS Semi-Conductor Tracker (SCT) functioning in a high luminosity, high radiation environment. The SCT is constructed of 4088 silicon detector modules, for a total of 6.3 million strips. Each module is designed, constructed and tested to operate as a stand-alone unit, mechanically, electrically, optically and thermally. The modules are mounted into two types of structures: one barrel (4 cylinders) and two end-cap systems (9 disks on each end of the barrel). The SCT silicon micro-strip sensors are processed in the planar p-in-n technology. The signals are processed in the front-end ABCD3TA ASICs, which use a binary readout architecture. Data is transferred to the off-detector readout electronics via optical fibres. We find 99.3% of the SCT modules are operational and the hit efficiency exceeds the design specifications. We will report on the operation and performance of the detector, including an ove...

Differences in mothers' and fathers' psychological distress after pediatric SCT: a longitudinal study.

Science.gov (United States)

Barrera, M; Atenafu, E; Doyle, J; Berlin-Romalis, D; Hancock, K

2012-07-01

The purpose of this study was to examine longitudinally psychological distress and its correlates in mothers and fathers of children who undergo SCT, up to 2 years post SCT. A total of 111 parents of patients diagnosed mainly with leukemia completed standardized measures of depression and anxiety symptoms as indicators of psychological distress, 85 at 1 year pre-SCT and 81 at 2 years post SCT. Parents' age and gender, child's age, diagnosis, radiation history, behavior and physical health were examined as potential related factors. Linear mixed models for repeated measures with appropriate covariance structure were used in the analysis. Depression and anxiety scores significantly decreased by 2 years for mothers and fathers. Mothers reported significantly more depression symptoms than did fathers, but reported comparable symptoms of anxiety. Pre-SCT depression and anxiety scores, mother's age (younger), child's behavior problems, radiation history and diagnosis of neuroblastoma predicted maternal distress 2 years post SCT; pre-SCT depression and anxiety scores, father's age (older) and child's diagnosis predicted father's distress. This study highlights differences and similarities in mothers' and fathers' psychological distress and identifies related risk factors. The results can guide interventions for mothers and fathers whose children undergo SCT based on their pre-SCT psychosocial risk.

Outcome of poor response paediatric AML using early SCT.

Science.gov (United States)

Wareham, Neval E; Heilmann, Carsten; Abrahamsson, Jonas; Forestier, Erik; Gustafsson, Britt; Ha, Shau-Yin; Heldrup, Jesper; Jahnukainen, Kirsi; Jónsson, Ólafur G; Lausen, Birgitte; Palle, Josefine; Zeller, Bernward; Hasle, Henrik

2013-03-01

Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients treated with SCT. Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n = 17) or > 5% blasts after AM (n = 14, refractory disease). Poor response patients received intensively timed induction and proceeded to SCT when a donor was available. Thirty-one of 267 evaluable patients (12%) had a poor response. SCT was performed in 25; using matched unrelated donors in 13, matched sibling donors in 6, cord blood donor in 4, and haploidentical donor in two. The median follow-up for the 31 poor responding patients was 2.6 years (range 0.4 - 8.1 years) and 3-year probability of survival 70% (95% CI 59-77%). The poor responders in the NOPHO-AML 2004 protocol had a favourable prognosis treated with time-intensive induction followed by SCT. © 2012 John Wiley & Sons A/S.

Indications for allo- and auto-SCT for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2015.

Science.gov (United States)

Sureda, A; Bader, P; Cesaro, S; Dreger, P; Duarte, R F; Dufour, C; Falkenburg, J H F; Farge-Bancel, D; Gennery, A; Kröger, N; Lanza, F; Marsh, J C; Nagler, A; Peters, C; Velardi, A; Mohty, M; Madrigal, A

2015-08-01

This is the sixth special report that the European Society for Blood and Marrow Transplantation regularly publishes on the current practice and indications for haematopoietic SCT for haematological diseases, solid tumours and immune disorders in Europe. Major changes have occurred in the field of haematopoietic SCT over the last years. Cord blood units as well as haploidentical donors have been increasingly used as stem cell sources for allo-SCT, thus, augmenting the possibility of finding a suitable donor for a patient. Continuous refinement of conditioning strategies has also expanded not only the number of potential indications but also has permitted consideration of older patients or those with co-morbidity for a transplant. There is accumulating evidence of the role of haematopoietic SCT in non-haematological disorders such as autoimmune diseases. On the other hand, the advent of new drugs and very effective targeted therapy has challenged the role of SCT in some instances or at least, modified its position in the treatment armamentarium of a given patient. An updated report with revised tables and operating definitions is presented.

Construction of the ATLAS SCT Endcap modules

International Nuclear Information System (INIS)

Snow, Stephen W.

2007-01-01

The ATLAS Semi-Conductor Tracker (SCT) uses silicon strip detectors to measure trajectories of charged particles coming from 14 TeV proton-proton collisions at the Large Hadron Collider at CERN. The SCT provides at least four space points, in the radial range of 27-50 cm from the beam, for tracks within the angular acceptance vertical bar η vertical bar <2.5. The SCT is built up of 4088 modules, each consisting of two or four silicon detectors, a hybrid carrying several readout ASICS, and other components to support, cool and align the detectors. We report on construction of over 2000 end-cap modules of the SCT by a group of 14 institutes from seven countries. A key aspect of the project was to fully standardise the final module tests and to insist that test data from all institutes was stored in a single central database, while leaving institutes flexibility to vary their module assembly methods to suit local circumstances. First the module specifications and tests used for quality control are summarised, then we describe the main test results. Finally, we report our experience in terms of component quality, assembly and testing rates, yield of good modules and causes of lost modules. At the outset we assumed losses during assembly of 15% and procured components accordingly; in fact, losses were around 7%

Distress, problems and supportive care needs of patients treated with auto- or allo-SCT.

Science.gov (United States)

Braamse, A M J; van Meijel, B; Visser, O; Huijgens, P C; Beekman, A T F; Dekker, J

2014-02-01

Hematological malignancies and treatment with hematopoietic SCT are known to affect patients' quality of life. The problem profile and care needs of this patient group need clarification, however. This study aimed to assess distress, problems and care needs after allo- or auto-SCT, and to identify risk factors for distress, problems or care needs. In this cross-sectional study, patients treated with allo-SCT or auto-SCT for hematological malignancies completed the Distress Thermometer and Problem List. Three patient groups were created: 0-1, 1-2.5 and 2.5-5.5 years after transplantation. After allo-SCT, distress and the number of problems tended to be lower with longer follow-up. After auto-SCT, distress was highest at 1-2.5 year(s). Patients mainly reported physical problems, followed by cognitive-emotional and practical problems. A minority reported care needs. Risk factors for distress as well as problems after allo-SCT included younger age, shorter time after transplantation and GVHD. A risk factor for distress as well as problems after auto-SCT was the presence of comorbid diseases. Up to 5 years after auto-SCT or allo-SCT, patients continue to experience distress and problems. Judged by prevalence, physical problems are first priority in supportive care, followed by cognitive-emotional and practical problems.

The ATLAS SCT: Commissioning experience and SLHC upgrade

Energy Technology Data Exchange (ETDEWEB)

Mitrevski, J. [Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064 (United States)], E-mail: Jovan.Mitrevski@cern.ch

2009-06-01

The ATLAS Semiconductor Tracker (SCT) has been installed, and fully connected to electrical, optical and cooling services. Commissioning has been performed both with calibration data and cosmic ray events. The cosmics were used to align the detector, measure the hit efficiency and set the timing. The SCT is now ready to take data when the LHC turns on this autumn. At the same time, it is clear that the present ATLAS tracker will need to be renewed for projected luminosity upgrade of the LHC, the SLHC. This is mainly driven by occupancy and radiation hardness issues. The new tracker will likely be entirely made of silicon, with the space of the present SCT largely taken up by detectors with much shorter strips. Several large-scale R and D projects on the sensors and module concepts for this upgrade are running, including sensor and module prototyping. We will report upon the commissioning experience from the SCT, use it to extract valuable lessons for future silicon tracker projects, and give an up-to-date overview of the status and results of the R and D efforts for the ATLAS tracker upgrade.

The ATLAS SCT: Commissioning experience and SLHC upgrade

International Nuclear Information System (INIS)

Mitrevski, J.

2009-01-01

The ATLAS Semiconductor Tracker (SCT) has been installed, and fully connected to electrical, optical and cooling services. Commissioning has been performed both with calibration data and cosmic ray events. The cosmics were used to align the detector, measure the hit efficiency and set the timing. The SCT is now ready to take data when the LHC turns on this autumn. At the same time, it is clear that the present ATLAS tracker will need to be renewed for projected luminosity upgrade of the LHC, the SLHC. This is mainly driven by occupancy and radiation hardness issues. The new tracker will likely be entirely made of silicon, with the space of the present SCT largely taken up by detectors with much shorter strips. Several large-scale R and D projects on the sensors and module concepts for this upgrade are running, including sensor and module prototyping. We will report upon the commissioning experience from the SCT, use it to extract valuable lessons for future silicon tracker projects, and give an up-to-date overview of the status and results of the R and D efforts for the ATLAS tracker upgrade.

Spray cryotherapy (SCT): institutional evolution of techniques and clinical practice from early experience in the treatment of malignant airway disease.

Science.gov (United States)

Browning, Robert; Turner, J Francis; Parrish, Scott

2015-12-01

Spray cryotherapy (SCT) was initially developed for gastroenterology (GI) endoscopic use in the esophagus. In some institutions where a device has been utilized by GI, transition to use in the airways by pulmonologists and thoracic surgeons occurred. Significant differences exist, however, in the techniques for safely using SCT in the airways. We describe the early experience at Walter Reed National Military Medical Center from 2011 to 2013 using SCT in patients with malignant airway disease and the evolution of our current techniques and clinical practice patterns for SCT use in patients. In November 2013 enrollment began in a multi-institutional prospective SCT registry in which we are still enrolling and will be reported on separately. Twenty-seven patients that underwent 80 procedures (2.96 procedures/patient). The average age was 63 years with a range of 20 to 87 years old. The average Eastern Cooperative Oncology Group (ECOG) status was 1.26. All malignancies were advanced stage disease. All procedures were performed in the central airways. Other modalities were used in combination with SCT in 31 (39%) of procedures. Additionally 45 of the 80 (56%) procedures were performed in proximity to a silicone, hybrid, or metal stent. Three complications occurred out of the 80 procedures. All three were transient hypoxia that limited continued SCT treatments. These patients were all discharged from the bronchoscopy recovery room to their pre-surgical state. SCT can be safely used for treatment of malignant airway tumor (MAT) in the airways. Understanding passive venting of the nitrogen gas produced as the liquid nitrogen changes to gas is important for safe use of the device. Complications can be minimized by adopting strict protocols to maximize passive venting and to allow for adequate oxygenation in between sprays.

Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT.

Science.gov (United States)

Vrijmoet-Wiersma, C M J; Egeler, R M; Koopman, H M; Bresters, D; Norberg, A L; Grootenhuis, M A

2010-06-01

With the aim of assessing parental stress after SCT, 73 parents of children and adolescents who underwent SCT 5 or 10 years ago responded to questionnaires on general distress (General Health Questionnaire (GHQ)), disease-related stress (Pediatric Inventory for Parents-short form (PIP-SF)) and perceptions of child vulnerability (Child Vulnerability Scale (CVS)). General distress scores were comparable with the reference groups, but 40% of the mothers at 5 years after SCT reported increased stress levels as compared with 26% in the community-based reference group. Disease-related stress was comparable with the reference group of parents of children who were just off cancer treatment, 5 years after SCT. At 10 years after SCT, scores were lower than the reference group. Perceived child vulnerability did diminish over time, but remained high in parents of SCT survivors, compared with parents of healthy children: 96% of the parents at 5 years after SCT and 76% of the parents at 10 years after SCT scored above the cutoff point. Perceived vulnerability was found to be a predictor for parental disease-related stress. To conclude, although most parents of SCT survivors are resilient, the majority of parents perceive their child to be much more vulnerable as compared with parents of healthy children. This perception is associated with disease-related stress and may induce overprotective parenting.

Lung transplantation for bronchiolitis obliterans syndrome after allo-SCT

DEFF Research Database (Denmark)

Holm, A M; Riise, Gerdt; Hansson, Leif Helmuth

2013-01-01

and Finland were recorded and compared with survival data from the Scandiatransplant registry. In total, LTx after allo-SCT had been performed in 13 patients. Allo-SCT was done because of AML (n=6), CML (n=3), ALL (n=2), immunodeficiency (n=1) and aplastic anemia (n=1). All developed clinical c...

First Combined SCT/TRT Cosmics Seen in SR1

CERN Multimedia

M. Jose Costa; H. Pernegger

A major milestone for the Inner Detector project has been accomplished in early May as cosmic rays going through both the barrel Semiconductor Tracker (SCT) and Transition Radiation Tracker (TRT) have been successfully recorded in the SR1 building on the ATLAS experimental site at CERN. A cosmic-ray track in the combined SCT-TRT barrel As reported also in this issue of the eNews, in February of this year the SCT barrel was inserted into the TRT in the SR1 building. One eighth of the TRT barrel and a quarter of the SCT barrel were then cabled to power supplies and to the data acquisition system in order to verify the good operation of the detector before installation in the ATLAS cavern. After first checks of noise levels in the final detectors, a critical goal was to study its response to cosmic rays using a set of scintillators to give the external trigger, thus undertaking the enormous challenge of integrating the full chain of the detectors, the DAQ, and the reconstruction and monitoring software. A ...

Early-onset acute kidney injury is a poor prognostic sign for allogeneic SCT recipients.

Science.gov (United States)

Shingai, N; Morito, T; Najima, Y; Kobayashi, T; Doki, N; Kakihana, K; Ohashi, K; Ando, M

2015-12-01

Acute kidney injury (AKI) following stem-cell transplantation (SCT) contributes to a poor prognosis, yet its impact may vary depending on the timing of AKI onset. A prospective cohort study was performed to understand the significance of the onset timing in 103 allogeneic SCT (allo-SCT) recipients. AKI prior to stem-cell engraftment was defined as early AKI and subsequently occurring AKI as late AKI. Propensity score (PS) for early AKI was calculated using a logistic regression model to reduce confounding effects related to differences in clinical background between the early and late AKI groups. The cumulative incidences of early and late AKI were 22.3% and 54.9%, respectively. Non-relapse mortality (NRM) was 39.1% and 7.0%, and overall survival (OS) was 56.5% and 90.9% in early and late AKI at 100 days after AKI, respectively (PSCT was 41.5% and 19.1% in early and late AKI, respectively (P=0.048). Logistic regression analysis adjusted for the PS showed that early AKI was significantly associated with OS (odds ratio (95% confidence interval); 4.63 (1.15-21.4), P=0.031) but with neither NRM (1.25 (0.28-5.33), P=0.766) nor CKD (1.85 (0.41-8.60), P=0.422). In conclusion, early AKI may portend a poor survival for allo-SCT recipients.

Comparison of the effects of salmon calcitonin (sCT) and calcitonin gene-related peptide (CGRP) in a number of in vivo and in vitro tests

International Nuclear Information System (INIS)

Welch, S.P.; Brase, D.; Cooper, C.; Dewey, W.L.

1986-01-01

sCT and CGRP have been shown previously to have multiple activities in the central nervous system (CNS). Recent work has shown that CGRP (15 μg) intraventricularly (IVT) produces a naloxone reversible 37% inhibition in the p-phenylquinone test (PPQ) accompanied by severe diarrhea. The ED50 of sCT in the PPQ test is 362 ng and this effect is not reversed totally by naloxone. The onset of CGRP is more rapid than that of sCT. sCT and CGRP (10 -6 M) both produce naloxone reversible inhibition of the electrically stimulated guinea pig ileum (GPI) (25% and 50% respectively). Both sCT and CGRP (10 -6 M) produce contracture (15% and 40% respectively) of the non-stimulated GPI that is not blocked by atropine. Both sCT and CGRP block the naloxone-induced contracture of the morphine (MS04) dependent ilea (29% and 68% respectively). Both sCT and CGRP produce biphasic shifts in the MS04 acetylcholine dose-effect curves in the stimulated and nonstimulated GPI, respectively. Neither sCT nor CGRP (10 -9 to 10 -4 M) displaces 3 H-naloxone binding to mouse brain membranes. Both sCT and CGRP may produce their effects by modulation of CA +2 fluxes in the CNS and GPI

Allogeneic hematopoietic stem-cell transplantation for acute myeloid leukemia in remission

DEFF Research Database (Denmark)

Nagler, Arnon; Rocha, Vanderson; Labopin, Myriam

2013-01-01

Cyclophosphamide (Cy) combined with total-body irradiation (TBI) or with busulfan (Bu) are currently the most common myeloablative regimens used in allogeneic stem-cell transplantation (alloSCT) in adults with acute myelogenous leukemia (AML). Intravenous (IV) Bu has more predictable...

Construction and Performance of the ATLAS SCT Barrels and Cosmic Tests

CERN Document Server

Demirkoz, Bilge Melahat

2007-01-01

ATLAS is a multi-purpose detector for the LHC and will detect proton-proton collisions with center of mass energy of $14$TeV. Part of the central inner detector, the Semi-Conductor Tracker (SCT) barrels, were assembled and tested at Oxford University and later integrated at CERN with the TRT (Transition Radiation Tracker) barrel. The barrel SCT is composed of 4 layers of silicon strip modules with two sensor layers with $80 \\mu$m channel width. The design of the modules and the barrels has been optimized for low radiation length while maintaining mechanical stability, bringing services to the detector, and ensuring a cold and dry environment. The high granularity, high detector efficiency and low noise occupancy ($ < 5 \\times 10^{-4}$) of the SCT will enable ATLAS to have an efficient pattern recognition capability. Due to the binary nature of the SCT read-out, a stable read-out system and the calibration system is of critical importance. SctRodDaq is the online software framework for the calibration and a...

Pharmacokinetics and pharmacodynamics of SCT800, a new recombinant FVIII, in hemophilia A mice

Science.gov (United States)

Gu, Ruo-lan; Liu, Liang; Xie, Liang-zhi; Gai, Wen-lin; Cao, Si-shuo; Meng, Zhi-yun; Gan, Hui; Wu, Zhuo-na; Li, Jian; Zheng, Ying; Zhu, Xiao-xia; Dou, Gui-fang

2016-01-01

Aim: SCT800 is a new third-generation recombinant FVIII agent that is undergoing promising preclinical study. This study aimed to investigate the pharmacokinetic and pharmacodynamic profiles of SCT800 in hemophilia A mice. Methods: After hemophilia A mice were intravenously injected with single dose of SCT800 (80, 180, and 280 IU/kg) or the commercially available product Xyntha (280 IU/kg), pharmacokinetics profiles were evaluated based on measuring plasma FVIII: C. For pharmacodynamics study, dose-response curves of SCT800 and Xyntha (1–200 IU/kg) were constructed using a tail bleeding model monitoring both bleeding time and blood loss. Results: Pharmacokinetics profile analysis showed a dose independency of SCT800 ranging from 80 to 280 IU/kg and comparable pharmacokinetic profiles between SCT800 and Xyntha at the doses tested. Pharmacodynamics study revealed comparable ED50 values of SCT800 and Xyntha in the tail bleeding model: 14.78 and 15.81 IU/kg for bleeding time, respectively; 13.50 and 13.58 IU/kg for blood loss, respectively. Moreover, at the doses tested, the accompanying dose-related safety evaluation in the tail bleeding model showed lower hypercoagulable tendency and wider dosage range potential for SCT800 than Xyntha. Conclusion: In hemophilia A mice, SCT800 shows comparable pharmacokinetics and pharmacodynamics to Xyntha at the doses tested, and possibly with better safety properties. PMID:26806305

Etoposide-containing conditioning regimen reduces the occurrence of hemophagocytic lymphohistiocytosis after SCT.

Science.gov (United States)

Kobayashi, R; Tanaka, J; Hashino, S; Ota, S; Torimoto, Y; Kakinoki, Y; Yamamoto, S; Kurosawa, M; Hatakeyama, N; Haseyama, Y; Sakai, H; Sato, K; Fukuhara, T

2014-02-01

Hemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening disease of severe hyperinflammation caused by uncontrolled proliferation of activated lymphocytes and macrophages that secrete high amounts of inflammatory cytokines. HLH occurring after SCT is difficult to diagnose. It is characterized by severe clinical manifestations and high mortality. Despite current therapeutic approaches, outcomes remain poor. We analyzed the incidence and risk factors of HLH after SCT and the response to treatment and prognosis of 554 patients with HLH after SCT. The cumulative incidence of HLH after SCT was 4.3% (24/554). Use of etoposide in the conditioning regimen was only factor that reduced HLH after SCT (P=0.027). All patients who received autologous transplantation were successfully treated. Patients with liver dysfunction (for example, high total bilirubin level, prolonged prothrombin time and high level of fibrinogen degradation products) had a poor response to treatment for HLH. Physicians should be cautious of HLH, while not using etoposide for conditioning regimen.

Haploidentical hematopoietic SCT increases graft-versus-tumor effect against renal cell carcinoma.

Science.gov (United States)

Budak-Alpdogan, T; Sauter, C T; Bailey, C P; Biswas, C S; Panis, M M; Civriz, S; Flomenberg, N; Alpdogan, O

2013-08-01

Allogeneic hematopoietic SCT (HSCT) has been shown to be an effective treatment option for advanced renal cell cancer (RCC). However, tumor resistance/relapse remains as the main post transplant issue. Therefore, enhancing graft-versus-tumor (GVT) activity without increasing GVHD is critical for improving the outcome of HSCT. We explored the GVT effect of haploidentical-SCT (haplo-SCT) against RCC in murine models. Lethally irradiated CB6F1 (H2K(b/d)) recipients were transplanted with T-cell-depleted BM cells from B6CBAF1 (H2K(b/k)) mice. Haplo-SCT combined with a low-dose haploidentical (HI) T-cell infusion (1 × 10(5)) successfully provided GVT activity without incurring GVHD. This effect elicited murine RCC growth control and consequently displayed a comparative survival advantage of haplo-SCT recipients when compared with MHC-matched (B6D2F1CB6F1) and parent-F1 (B6CB6F1) transplant recipients. Recipients of haplo-SCT had an increase in donor-derived splenic T-cell numbers, T-cell proliferation and IFN-γ-secreting donor-derived T-cells, a critical aspect for anti-tumor activity. The splenocytes from B6CBAF1 mice had a higher cytotoxicity against RENCA cells than the splenocytes from B6 and B6D2F1 donors after tumor challenge. These findings suggest that haplo-SCT might be an innovative immunotherapeutic platform for solid tumors, particularly for renal cell carcinoma.

The ATLAS SCT: Commissioning Experience and SLHC Upgrade

OpenAIRE

Mitrevski, J

2008-01-01

The ATLAS Semiconductor Tracker (SCT) has been installed, and fully connected to electrical, optical and cooling services. Commissioning has been performed both with calibration data and cosmic ray events. The cosmics were used to align the detector, measure the hit efficiency and set the timing. The SCT is now ready to take data when the LHC turns on this autumn. At the same time, it is clear that the present ATLAS tracker will need to be renewed for projected luminosity upgrade of the LHC, ...

Early relapse after single auto-SCT for multiple myeloma is a major predictor of survival in the era of novel agents.

Science.gov (United States)

Jimenez-Zepeda, V H; Reece, D E; Trudel, S; Chen, C; Tiedemann, R; Kukreti, V

2015-02-01

The role of auto-SCT in the treatment of multiple myeloma (MM) in the era of novel agents continues to evolve. It is now clear that the depth of response and clinical outcomes have significantly improved as a result of the combination of these strategies. However, not all patients with MM who undergo auto-SCT are able to sustain a meaningful response and 20% of patients relapse shortly after auto-SCT. In this study, we aimed to assess the impact of early relapse (ER) after auto-SCT on OS for MM patients undergoing single auto-SCT who had received novel agent-based induction regimens. All consecutive patients with MM undergoing single auto-SCT from January 2002 to September 2012 who had novel induction therapy were evaluated. A total of 184 patients were identified. The median OS and PFS for the group of transplanted patients were 93 and 25.4 months, respectively. Median time to relapse was 17.2 months with 40% having relapsed at the time of analysis. ER (SCT) was seen in 27 (36%) out of 75 patients who had relapsed, and median OS was significantly shorter than in those with non-ER. Multivariate analysis showed ER as the major independent prognostic factor for OS. On the basis of these findings, we conclude that not only attainment of a good response, but sustainability of it, appears to be a major prognostic variable in MM in the era of novel therapy. Patients with ER post auto-SCT should biologically be characterized in prospective studies to better understand the mechanisms of resistance associated with this particular entity.

Single Event Upset Studies Using the ATLAS SCT

CERN Document Server

Dafinca, A; The ATLAS collaboration; Weidberg, A R

2014-01-01

Single Event Upsets (SEU) are expected to occur during high luminosity running of the ATLAS SemiConductor Tracker (SCT). The SEU cross sections were measured in pion beams with momenta in the range 200 to 465 MeV/c and proton test beams at 24 GeV/c but the extrapolation to LHC conditions is non-trivial because of the range of particle types and momenta. The SEUs studied occur in the p-i-n photodiode and the registers in the ABCD chip. Comparisons between predicted SEU rates and those measured from ATLAS data are presented. The implications for ATLAS operation are discussed

Reduced-intensity conditioning allogeneic SCT as salvage treatment for relapsed multiple myeloma.

Science.gov (United States)

de Lavallade, H; El-Cheikh, J; Faucher, C; Fürst, S; Stoppa, A-M; Coso, D; Bouabdallah, R; Chabannon, C; Gastaut, J-A; Blaise, D; Mohty, M

2008-06-01

The aim of this retrospective analysis was to assess the benefit of reduced-intensity conditioning allo SCT (RIC allo-SCT) in a cohort of 32 relapsed multiple myeloma (MM) patients. A total of 19 patients had an HLA-identical sibling donor ('donor' group), while 13 patients had no donor ('no-donor' group). There were no significant differences between these two groups as for prognosis risk factors. Eighteen patients from the 'donor' group could actually proceed to RIC allo-SCT. With a median follow-up of 36 (range, 21-60) months, six patients died from transplant-related toxicity (cumulative incidence, 33% (95% CI, 11-55%)). Only 4 patients from the 18 transplanted patients (22%; 95% CI, 7-48%) progressed after RIC allo-SCT, as compared to 12 (86%; 95% CI, 56-98%; P=0.0003) among the nontransplanted patients. In an 'intention-to-treat' analysis, the Kaplan-Meier estimate of PFS was significantly higher in the 'donor' group as compared to the 'no-donor' group (P=0.01; 46 versus 8% at 3 years). There was no difference in terms of overall survival. However, in multivariate analysis, actual performance of RIC allo-SCT was associated with better PFS (relative risk, 0.35; 95% CI, 0.15-0.82; P=0.01). These data suggest a potential benefit for RIC allo-SCT in the management of relapsed MM warranting further prospective investigations.

Characterizing the observational properties of δ Sct stars in the era of space photometry from the Kepler mission

Science.gov (United States)

Bowman, Dominic M.; Kurtz, Donald W.

2018-05-01

The δ Sct stars are a diverse group of intermediate-mass pulsating stars located on and near the main sequence within the classical instability strip in the Hertzsprung-Russell diagram. Many of these stars are hybrid stars pulsating simultaneously with pressure and gravity modes that probe the physics at different depths within a star's interior. Using two large ensembles of δ Sct stars observed by the Kepler Space Telescope, the instrumental biases inherent to Kepler mission data and the statistical properties of these stars are investigated. An important focus of this work is an analysis of the relationships between the pulsational and stellar parameters, and their distribution within the classical instability strip. It is found that a non-negligible fraction of main-sequence δ Sct stars exist outside theoretical predictions of the classical instability boundaries, which indicates the necessity of a mass-dependent mixing length parameter to simultaneously explain low and high radial order pressure modes in δ Sct stars within the Hertzsprung-Russell diagram. Furthermore, a search for regularities in the amplitude spectra of these stars is also presented, specifically the frequency difference between pressure modes of consecutive radial order. In this work, it is demonstrated that an ensemble-based approach using space photometry from the Kepler mission is not only plausible for δ Sct stars, but that it is a valuable method for identifying the most promising stars for mode identification and asteroseismic modelling. The full scientific potential of studying δ Sct stars is as yet unrealized. The ensembles discussed in this paper represent a high-quality data set for future studies of rotation and angular momentum transport inside A and F stars using asteroseismology.

Udgravningerne i Sct. Nicolaj Gade

DEFF Research Database (Denmark)

Alrø Jensen, Michael

2013-01-01

Ved renoveringen af Sct. Nicolaj Gade i 2010 og 2011 blev et af de hidtil største sammenhængende arealer (190m²) af Ribes markedsplads afdækket umiddelbart under eksisterende gadeniveau. Ved den efterfølgende undersøgelse kunne den allerede kendte parcelstruktur iagttages, og der blev udtaget...

Engineering for the ATLAS SemiConductor Tracker (SCT) End-cap

Energy Technology Data Exchange (ETDEWEB)

Abdesselam, A; Barr, A [Department of Physics, Oxford University, Oxford (United Kingdom); Allport, P P [Department of Physics, Oliver Lodge Laboratory, University of Liverpool, Liverpool (United Kingdom); Anderson, B [Department of Physics, University College, University of London, London (United Kingdom); Andricek, L; Becker, H [Max-Planck-Institut fuer Physik, Muenchen (Germany); Anghinolfi, F [European Laboratory for Particle Physics (CERN), Geneva (Switzerland); Apsimon, R J; Austin, A; Barclay, P; Batchelor, L E; Benes, J [Centro Nacional de Microelectronica de Barcelona, CNM-IMB, CSIC, Barcelona (Spain); Atkinson, T [University of Melbourne, Parkville, Victoria 3052 (Australia); Band, H [NIKHEF, Amsterdam (Netherlands); Bates, R L; Bell, W H [Department of Physics and Astronomy, University of Glasgow, Glasgow (United Kingdom); Batley, J R [Cavendish Laboratory, Cambridge University, Cambridge (United Kingdom); Beck, G; Belymam, A [Department of Physics, Queen Mary and Westfield College, University of London, London (United Kingdom); Bell, P [School of Physics and Astronomy, University of Manchester, Manchester (United Kingdom)], E-mail: S.J.Haywood@rl.ac.uk (and others)

2008-05-15

The ATLAS SemiConductor Tracker (SCT) is a silicon-strip tracking detector which forms part of the ATLAS inner detector. The SCT is designed to track charged particles produced in proton-proton collisions at the Large Hadron Collider (LHC) at CERN at an energy of 14 TeV. The tracker is made up of a central barrel and two identical end-caps. The barrel contains 2112 silicon modules, while each end-cap contains 988 modules. The overall tracking performance depends not only on the intrinsic measurement precision of the modules but also on the characteristics of the whole assembly, in particular, the stability and the total material budget. This paper describes the engineering design and construction of the SCT end-caps, which are required to support mechanically the silicon modules, supply services to them and provide a suitable environment within the inner detector. Critical engineering choices are highlighted and innovative solutions are presented - these will be of interest to other builders of large-scale tracking detectors. The SCT end-caps will be fully connected at the start of 2008. Further commissioning will continue, to be ready for proton-proton collision data in 2008.

Single Event Upset Studies Using the ATLAS SCT

CERN Document Server

Weidberg, A R; The ATLAS collaboration

2013-01-01

Single Event Upsets (SEU) are expected to occur during high luminosity running of the ATLAS SemiConductor Tracker (SCT). The SEU cross sections were measured in pion beams with momenta in the range 200 to 465 MeV/c and proton test beams at 24 GeV/c but the extrapolation to LHC conditions is non-trivial because of the range of particle types and momenta. The SEUs studied occur in the \\emph{p-i-n} photodiode and the registers in the ABCD chip. Comparisons between predicted SEU rates and those measured from ATLAS data are presented. The implications for ATLAS operation are discussed.

Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy.

Science.gov (United States)

Girmenia, C; Rossolini, G M; Piciocchi, A; Bertaina, A; Pisapia, G; Pastore, D; Sica, S; Severino, A; Cudillo, L; Ciceri, F; Scimè, R; Lombardini, L; Viscoli, C; Rambaldi, A

2015-02-01

Infections by carbapenem-resistant Klebsiella pneumoniae (CRKp) represent a challenging problem after SCT. A retrospective survey (January 2010 to July 2013) involving 52 Italian centers was performed to assess the epidemiology and the prognostic factors of CRKp infections in auto- and allo-SCT. Cases of CRKp infection were reported in 53.4% of centers. CRKp infections were documented in 25 auto-SCTs and 87 allo-SCTs, with an incidence of 0.4% (from 0.1% in 2010 to 0.7% in 2013) and 2% (from 0.4% in 2010 to 2.9% in 2013), respectively. A CRKp colonization documented before or after transplant was followed by an infection in 25.8% of auto-SCT and 39.2% of allo-SCT patients. The infection-related mortality rates were 16% and 64.4%, respectively. A pre-transplant CRKp infection (hazard ratio (HR) 0.33, 95% confidence intervals (CIs) 0.15-0.74; P=0.007) and a not CRKp-targeted first-line treatment (HR 2.67, 95% CI 1.43-4.99; P=0.002) were independent factors associated with an increased mortality in allo-SCT patients who developed a CRKp infection. Our study shows challenging findings of CRKp infections in SCT patients in Italy particularly after allo-SCT. The detection of carriers and the definition of early therapeutic strategies represent critical aspects of the management of CRKp infections after SCT.

Prognostic factors and outcome in relapsed multiple myeloma after nonmyeloablative allo-SCT: a single center experience.

Science.gov (United States)

Minnema, M C; van Dorp, S; van de Donk, N W C J; Schouten, F; Kersten, M J; Coenen, J L L M; Schouten, H; Zweegman, S; Schaafsma, R; Lokhorst, H M

2011-02-01

For relapsed multiple myeloma (MM) patients, allo-SCT is a possible treatment option, but recent data obtained using a nonmyeloablative (NMA) conditioning regimen are scarce. We retrospectively collected data from 38 relapsed MM patients who received a NMA allo-SCT from October 2001 to January 2008. In total, 18 patients (48%) were transplanted using a matched unrelated donor. The median follow-up is 2.3 years. In 16 patients (42%) the response improved and eight patients (21%) were rapidly progressive within 6 months after allo-SCT. In total, 15 patients (39%) were in CR after allo-SCT. The median PFS was 1.4 years (range, 0.1-4.9), and having a CR after allo-SCT or having chronic GVHD resulted in longer PFS. Median OS was 3.1 years (range, 0.2-7.2) and again having a CR after allo-SCT or chronic GVHD was associated with a better OS. Six patients (16%) have died from treatment-related diseases. These results indicate that NMA allo-SCT is a treatment option in relapsed MM patients and that results may be improved by strategies that enhance the CR rate after allo-SCT.

Electrical performance of ATLAS-SCT KB end-cap modules

CERN Document Server

D'Onofrio, M; Donegà, M; Ferrère, D; Mangin-Brinet, M; Mikulec, B; Weber, M; Ikegami, Y; Kohriki, T; Kondo, T; Terada, S; Unno, Y; Pernegger, H; Roe, S; Wallny, R; Moorhead, G F; Taylor, G; García, J E; Gonzáles, S; Vos, M A; Toczek, B

2003-01-01

The Semiconductor Tracker (SCT) is one of the ATLAS Inner Detector elements which aims to track charged particles in the ATLAS experiment. It consists of four cylindrical layers (barrels) of silicon strip detectors, with nine disks in each of the forward and backward directions. Carbon fibre structures will support a total of 4088 modules, which are the basic functional sub-unit of the SCT. Each module consists of single sided silicon micro-strip detectors glued back to back with a 40 mrad stereo-angle, and attached to a hybrid. The scope of this document is to present the electrical performances of prototype end-cap modules proposed for the ATLAS-SCT, as an alternative to the baseline. The layout of these modules is based on the implementation of the barrel module hybrid in the end-cap geometry. A complete set of electrical measurements is summarized in this paper, including irradiated module tests and beam tests.

Myeloablation-associated deletion of ORF4 in a human coronavirus 229E infection.

Science.gov (United States)

Greninger, Alexander L; Pepper, Gregory; Shean, Ryan C; Cent, Anne; Palileo, Isabel; Kuypers, Jane M; Schiffer, Joshua T; Jerome, Keith R

2017-01-01

We describe metagenomic next-generation sequencing (mNGS) of a human coronavirus 229E from a patient with AML and persistent upper respiratory symptoms, who underwent hematopoietic cell transplantation (HCT). mNGS revealed a 548-nucleotide deletion, which comprised the near entirety of the ORF4 gene, and no minor allele variants were detected to suggest a mixed infection. As part of her pre-HCT conditioning regimen, the patient received myeloablative treatment with cyclophosphamide and 12 Gy total body irradiation. Iterative sequencing and RT-PCR confirmation of four respiratory samples over the 4-week peritransplant period revealed that the pre-conditioning strain contained an intact ORF4 gene, while the deletion strain appeared just after conditioning and persisted over a 2.5-week period. This sequence represents one of the largest genomic deletions detected in a human RNA virus and describes large-scale viral mutation associated with myeloablation for HCT.

Hot off the press - First Combined SCT/TRT Endcap Cosmics Seen in SR1

CERN Multimedia

Christian Schmitt

Following the successful combined SCT/TRT barrel test in the Spring 2006 (see ATLAS eNews from May 2006), a similar combined SCT/TRT endcap test is currently being performed in the SR1 building on the ATLAS experimental site at CERN. One quadrant of the SCT and two sectors of the TRT have been cabled up and are used in this test. The picture shows one of the first combined tracks seen in the cosmics runs. The data taking and combined testing is expected to last until December 11th. The event display below shows one of the first combined tracks seen in the cosmics run. There are three different views of the same event: the top left part shows a x-y view of the event where the track can be seen in red, the SCT spacepoints in green, and the SCT strips in grey. On the right is the z-phi view, where also the TRT DriftCircles can be seen as white dots. In the bottom window, the TRT wheels are on top and the SCT disks are shown below with the hits corresponding to those shown in the top window. The TRT DriftCircl...

Outcome of relapse after allogeneic HSCT in children with ALL enrolled in the ALL-SCT 2003/2007 trial.

Science.gov (United States)

Kuhlen, Michaela; Willasch, Andre M; Dalle, Jean-Hugues; Wachowiak, Jacek; Yaniv, Isaac; Ifversen, Marianne; Sedlacek, Petr; Guengoer, Tayfun; Lang, Peter; Bader, Peter; Sufliarska, Sabina; Balduzzi, Adriana; Strahm, Brigitte; von Luettichau, Irene; Hoell, Jessica I; Borkhardt, Arndt; Klingebiel, Thomas; Schrappe, Martin; von Stackelberg, Arend; Glogova, Evgenia; Poetschger, Ulrike; Meisel, Roland; Peters, Christina

2018-01-01

Relapse remains the major cause of treatment failure in children with high-risk acute lymphoblastic leukaemia (ALL) undergoing allogeneic haematopoietic stem-cell transplantation (allo-SCT). Prognosis is considered dismal but data on risk factors and outcome are lacking from prospective studies. We analysed 242 children with recurrence of ALL after first allo-SCT enrolled in the Berlin-Frankfurt-Munster (BFM) ALL-SCT-BFM 2003 and ALL-SCT-BFM international 2007 studies. Median time from allo-SCT to relapse was 7·7 months; median follow-up from relapse after allo-SCT until last follow-up was 3·4 years. The 3-year event-free survival (EFS) was 15% and overall survival (OS) was 20%. The main cause of death was disease progression or relapse (86·5%). The majority of children (48%) received salvage therapy without second allo-SCT, 26% of the children underwent a second allo-SCT and 25% received palliative treatment only. In multivariate analyses, age, site of relapse, time to relapse and type of salvage therapy were identified as significant prognostic factors for OS and EFS, whereas factors associated with first SCT were not statistically significant. Combined approaches incorporating novel immunotherapeutic treatment options and second allo-SCT hold promise to improve outcome in children with post allo-SCT relapse. © 2017 John Wiley & Sons Ltd.

Long-term outcome of patients with multiple [corrected] myeloma-related advanced renal failure following auto-SCT.

Science.gov (United States)

Glavey, S V; Gertz, M A; Dispenzieri, A; Kumar, S; Buadi, F; Lacy, M; Hayman, S R; Kapoor, P; Dingli, D; McCurdy, A; Hogan, W J; Gastineau, D A; Leung, N

2013-11-01

Renal failure commonly complicates multiple myeloma (MM) and is associated with reduced survival. It is not clear whether auto-SCT results in improved renal function or attainment of independence from dialysis in patients with advanced renal impairment due to MM. We conducted a retrospective cohort study of all patients who underwent auto-SCT for MM complicated by advanced renal failure at our institution over a 10-year period (2000-2010). We aimed to assess the association between auto-SCT and renal outcome in patients with serum creatinine (SCr) over 3 mg/dL, attributable to MM, including those who were dialysis dependent. Thirty patients (2.8% of all auto-SCT patients) met inclusion criteria. Fourteen of 15 patients who were dialysis dependent before auto-SCT remained dialysis dependent in the long term despite hematological response (HR). Of the remaining 15 patients with SCr >3 mg/dL, an improvement in glomerular filtration rate (GFR) from 15 to 19.4 mL/min/1.73 m(2) was noted post auto-SCT (P=0.035); however, neither HR post auto-SCT or pre-existing renal function were independently associated with renal outcome. Auto-SCT was not associated with independence from dialysis in patients with renal failure due to MM at our institution. Although auto-SCT was associated with an improvement in GFR in patients with SCr >3 mg/dL, this improvement was not related to HR.

Modified high-dose melphalan and autologous SCT for AL amyloidosis or high-risk myeloma: analysis of SWOG trial S0115.

Science.gov (United States)

Sanchorawala, V; Hoering, A; Seldin, D C; Finn, K T; Fennessey, S A; Sexton, R; Mattar, B; Safah, H F; Holmberg, L A; Dean, R M; Orlowski, R Z; Barlogie, B

2013-11-01

We designed a trial using two sequential cycles of modified high-dose melphalan at 100 mg/m(2) and autologous SCT (mHDM/SCT) in AL amyloidosis (light-chain amyloidosis, AL), AL with myeloma (ALM) and host-based high-risk myeloma (hM) patients through SWOG-0115. The primary objective was to evaluate OS. From 2004 to 2010, 93 eligible patients were enrolled at 17 centers in the United States (59 with AL, 9 with ALM and 25 with hM). The median OS for patients with AL and ALM was 68 months and 47 months, respectively, and has not been reached for patients with hM. The median PFS for patients with AL and ALM was 38 months and 16 months, respectively, and has not been reached for patients with hM. The treatment-related mortality (TRM) was 12% (11/93) and was observed only in patients with AL after SCT. Grade 3 and higher non-hematologic adverse events were experienced by 81%, 67% and 57% of patients with AL, ALM and hM, respectively, during the first and second HDM/SCT. This experience demonstrates that with careful selection of patients and use of mHDM for SCT in patients with AL, ALM and hM, even in the setting of a multicenter study, OS can be improved with acceptable TRM and morbidity.

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

Science.gov (United States)

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

2012-11-01

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

Myeloablative radioimmunotherapies in the conditioning of patients with AML, MDS and multiple myeloma prior to stem cell transplantation; Myeloablative Radioimmuntherapien zur Konditionierung bei Patienten mit AML, MDS und multiplem Myelom vor Stammzelltransplantation

Energy Technology Data Exchange (ETDEWEB)

Buchmann, I. [Abt. fuer Nuklearmedizin, Universitaetsklinik Heidelberg (Germany)

2008-06-15

Aggressive consolidation chemotherapy and hematopoietic stem cell transplantation have improved the prognosis of patients with acute myeloid leukemia (AML), myelodyplastic syndrome (MDS) and multiple myeloma. Nevertheless, only a minor fraction of patients achieve long-term disease-free survival after stem cell transplantation with disease recurrence being the most common cause of treatment failure. In addition, therapy-related effects such as toxicity of chemotherapy and complications of stem cell transplantation increase mortality rates significantly. Myeloablative radioimmunotherapy uses radiolabeled monoclonal antibodies (mAb) with affinity for the hematopoietic marrow. It applies high radiation doses in the bone marrow but spares normal organs. Adding myeloablative radioimmunotherapy to the conditioning schemes of AML, MDS and multiple myeloma before stem cell transplantation allows for the achievement of a pronounced antileukemic/antimyeloma effect for the reduction of relapse rates without significant increase of acute organ toxicity and therapy-related mortality. In order to optimise therapy, a rational design of the nuclide-antibody combination is necessary. {sup 90}Y, {sup 188}Re and {sup 131}I are the most frequently used {beta}{sup -}-particles. Of these, {sup 90}Y is the most qualified nuclide for myeloablation. Backbone stabilised DTPA are ideal chelators to stably conjugate {sup 90}Y to antibodies so far. For myeloablative conditioning, anti-CD66-, -45- and -33-mAb are used. The anti-CD66-antibody BW250/183 binds to normal hematopoietic cells but not to leukemic blasts and myeloma cells. The {sup 90}Y-2B3M-DTPA-BW250/183 is the most suited radioimmunoconjugate for patients with an infiltration grade of leukemic blasts in the bone marrow < 25%. The specific doses (Gy/GBq) are 10.2 {+-} 1.8 (bone marrow), 2.7 {+-} 2 (liver) and < 1 (kidneys). In contrast, radiolabeled anti-CD33- and anti-CD45-antibodies bind to both, most of white blood cells and

Outcome of relapse after allogeneic HSCT in children with ALL enrolled in the ALL-SCT 2003/2007 trial

DEFF Research Database (Denmark)

Kuhlen, Michaela; Willasch, Andre M; Dalle, Jean-Hugues

2018-01-01

Relapse remains the major cause of treatment failure in children with high-risk acute lymphoblastic leukaemia (ALL) undergoing allogeneic haematopoietic stem-cell transplantation (allo-SCT). Prognosis is considered dismal but data on risk factors and outcome are lacking from prospective studies. We...... analysed 242 children with recurrence of ALL after first allo-SCT enrolled in the Berlin-Frankfurt-Munster (BFM) ALL-SCT-BFM 2003 and ALL-SCT-BFM international 2007 studies. Median time from allo-SCT to relapse was 7·7 months; median follow-up from relapse after allo-SCT until last follow-up was 3·4 years....... The 3-year event-free survival (EFS) was 15% and overall survival (OS) was 20%. The main cause of death was disease progression or relapse (86·5%). The majority of children (48%) received salvage therapy without second allo-SCT, 26% of the children underwent a second allo-SCT and 25% received palliative...

Severe Pulmonary Toxicity After Myeloablative Conditioning Using Total Body Irradiation: An Assessment of Risk Factors

International Nuclear Information System (INIS)

Kelsey, Chris R.; Horwitz, Mitchell E.; Chino, Junzo P.; Craciunescu, Oana; Steffey, Beverly; Folz, Rodney J.; Chao, Nelson J.; Rizzieri, David A.; Marks, Lawrence B.

2011-01-01

Purpose: To assess factors associated with severe pulmonary toxicity after myeloablative conditioning using total body irradiation (TBI) followed by allogeneic stem cell transplantation. Methods and Materials: A total of 101 adult patients who underwent TBI-based myeloablative conditioning for hematologic malignancies at Duke University between 1998 and 2008 were reviewed. TBI was combined with high-dose cyclophosphamide, melphalan, fludarabine, or etoposide, depending on the underlying disease. Acute pulmonary toxicity, occurring within 90 days of transplantation, was scored using Common Terminology Criteria for Adverse Events version 3.0. Actuarial overall survival and the cumulative incidence of acute pulmonary toxicity were calculated via the Kaplan-Meier method and compared using a log-rank test. A binary logistic regression analysis was performed to assess factors independently associated with acute severe pulmonary toxicity. Results: The 90-day actuarial risk of developing severe (Grade 3-5) pulmonary toxicity was 33%. Actuarial survival at 90 days was 49% in patients with severe pulmonary toxicity vs. 94% in patients without (p < 0.001). On multivariate analysis, the number of prior chemotherapy regimens was the only factor independently associated with development of severe pulmonary toxicity (odds ratio, 2.7 per regimen). Conclusions: Severe acute pulmonary toxicity is prevalent after TBI-based myeloablative conditioning regimens, occurring in approximately 33% of patients. The number of prior chemotherapy regimens appears to be an important risk factor.

Functional testing of the ATLAS SCT barrels

International Nuclear Information System (INIS)

Phillips, Peter W.

2007-01-01

The ATLAS SCT (semiconductor tracker) comprises 2112 barrel modules mounted on four concentric barrels of length 1.6m and up to 1m diameter, and 1976 endcap modules supported by a series of nine wheels at each end of the barrel region, giving a total silicon area of 60m 2 . The assembly of modules onto each of the four barrel structures has recently been completed. In addition to functional tests made during the assembly process, each completed barrel was operated in its entirety. In the case of the largest barrel, with an active silicon area of approximately 10m 2 , this corresponds to more than one million instrumented channels. This paper documents the electrical performance of the four individual SCT barrels. An overview of the readout chain is also given

Poor concordance of spiral CT (SCT) and high probability ventilation-perfusion (V/Q) studies in the diagnosis of pulmonary embolism (PE)

International Nuclear Information System (INIS)

Roman, M.R.; Angelides, S.; Chen, N.

2000-01-01

Full text: Despite its limitations, V/Q scintigraphy remains the favoured non-invasive technique for the diagnosis of pulmonary embolism (PE). PE is present in 85-90% and 30-40% of high and intermediate probability V/Q studies respectively. The value of spiral CT (SCT), a newer imaging modality, has yet to be determined. The aims of this study were to determine the frequency of positive SCT for PE in high and intermediate probability V/Q studies performed within 24hr apart. 15 patients (6M, 9F, mean age - 70.2) with a high probability study were included. Six (40%) SCT were reported as positive (four with emboli present in the main pulmonary arteries), seven as negative, one equivocal and one was technically sub-optimal. Pulmonary angiography was not performed in any patient. In all seven negative studies, the SCT was performed before the V/Q study. Of these, two studies were revised to positive once the result of the V/Q study was known, while, three others had resolving mismatch V/Q defects on follow-up studies (performed 5-14 days later); two of these three also had a positive duplex scan of the lower limbs. One other was most likely due to chronic thromboembolic disease. Only three patients had a V/Q scan prior to the SCT; all were positive for PE on both imaging modalities. Of 26 patients (11M, 15F, mean age - 68.5) with an intermediate probability V/Q study, SCT was positive in only two (8%). Thus the low detection rate of PE by SCT in this albeit small series, raises doubts as to its role in the diagnosis of PE. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

Management of CML in the Pediatric Age Group: Imatinib Mesylate or SCT.

Science.gov (United States)

El-Alfy, Mohsen S; Al-Haddad, Alaa M; Hamed, Ahmed A

2010-12-01

Management of CML has changed markedly since the introduction of tyrosine kinase inhibitors (TKIs). However stem cell transplantation (SCT) remains a valid therapeutic modality especially in developing countries due to its relatively lower cost. We aim to compare between imatinib mesylate and SCT as regard outcome in CML in the pediatric age group. Forty-eight patients with newly diagnosed CML in the chronic phase, aged 3 to 18 years were enrolled in this prospective study. Patients without a matched donor (Group I; N=30) were assigned to receive imatinib mesylate at a dose of 340mg÷m2÷day, while patients with a fully matched related donor (Group II; N=18), were offered SCT. Response (hematologic, cytogenetic and molecular), side effects and survival were analyzed. Complete hematologic response was obtained in 97% of the patients in group I and 94% in group II. Major cytogenetic response (CyR) was obtained in 80% of patients in group I and 100% in group II. Complete CyR was 57% in group I and 64% in group II. Major molecular response (MMR) was 36% in group I and 50% in group II with no significant difference between both groups. Six years overall survival (OS) was 87% in the 1st group and 61% in the 2nd group (pSCT group (55% had GVHD and 78% had infection). Imatinib mesylate has a superior OS and EFS than SCT in children. It is generally safe and well tolerated. Imatinib mesylate should be the 1st line treatment of pediatric patients with CML in the chronic phase. CML- Imatinib- SCT- Pediatrics.

Whole body X-ray CT scanner SCT-3000T series

International Nuclear Information System (INIS)

Saida, Teruhiko; Takemura, Kunihiko; Suzuki, Satoru; Sato, Yukio; Kawamoto, Yasushi; Goto, Mitsuhiro; Mishina, Yukio

1989-01-01

The whole body CT scanner, SCT-3000T series which improve the patient through-put and the diagnostic capability, has been developed. In the SCT-3000T series CT scanners, the great reduction of the reconstruction time and the scan cycle time has been achieved by developing the special purpose hardwares for image reconstruction such as the fast front end processor, the intelligent buffer memory. In case of the SCT-3000TX routine conditions of operation, including 3.0 sec scan, table increment, image reconstruction and image filing, the scan cycle time is about 9 seconds which is the shortest value among the competitive models. Furthermore, the higher diagnostic capability has been provided with the system, by adopting the 1024 x 1024 display matrices, and by developing the diagnostic softwares such as 3-D display program, arbitrary curved plane MPR program, r-CBF measurement program and etc. (author)

Value of liver elastography and abdominal ultrasound for detection of complications of allogeneic hemopoietic SCT.

Science.gov (United States)

Karlas, T; Weber, J; Nehring, C; Kronenberger, R; Tenckhoff, H; Mössner, J; Niederwieser, D; Tröltzsch, M; Lange, T; Keim, V

2014-06-01

Hepatic complications contribute to morbidity and mortality after allogeneic hemopoietic SCT. Liver Doppler ultrasound and elastography represent promising methods for pretransplant risk assessment and early detection of complications. Ultrasound (liver and spleen size, liver perfusion) and elastography (transient elastography (TE); right liver lobe acoustic radiation force impulse imaging (r-ARFI); left liver lobe ARFI (l-ARFI)) were prospectively evaluated in patients with indications for allo-SCT. Measurements were performed before and repeatedly after SCT. Results were compared with the incidence of life-threatening complications and death during the first 150 days after SCT. Of 59 included patients, 16 suffered from major complications and 9 of them died within the follow-up period. At baseline, liver and spleen size, liver perfusion, TE and r-ARFI did not differ significantly between patients with and without severe complications. In contrast, l-ARFI was significantly elevated in patients who later developed severe complications (1.58±0.30 m/s vs 1.37±0.27 m/s, P=0.030). After SCT, l-ARFI values remained elevated and TE showed increasing liver stiffness in patients with complications. The value of conventional liver ultrasound for prediction of severe SCT complications is limited. Increased values for TE and l-ARFI are associated with severe SCT complications and demand further evaluation.

Charge deposition in the SCT due to beamloss

CERN Document Server

The ATLAS collaboration

2013-01-01

The purpose of this study was to estimate the distribution of charge collected by the strips 6 of ATLAS SCT modules in a 25ns window under two LHC proton beam scrape scenarios. 7 This was done in order to see whether this charge would be greater than the nominal amount 8 above which damage to the modules is expected to occur, which is 5nC/strip over 25ns. 9 Specifically, the damage is expected to occur to the channels of the front-end ABCD3T 10 binary readout chips of the SCT modules. Due to limited numbers of fully simulated single 11 proton collisions with the beam pipe (at 450 GeV) and the TAS collimator (at 7 TeV) a 12 method of sampling SCT hits-with-replacement is developed to obtain an upper limit on the 13 charge per strip for a 108 proton scrape over 25ns. Under this assumption the maximum 14 charge collected per strip is determined to be less than 0.4nC for the 450 GeV beam pipe 15 scrape scenario and less than 1.9nC for the 7 TeV TAS collimator scrape scenario, within 16 the damage threshold in bot...

SCT-4800T whole body X-ray CT scanner

International Nuclear Information System (INIS)

Okumura, Yoshitaka; Sato, Yukio; Kuwahara, Hiroshi

1994-01-01

A whole body X-ray CT scanner, the SCT-4800T (trade name: INTELLECT series), has been developed. This system is the first CT scanner that is combined with general radiographic functions. The general radiographic functions include a patient couch with film casette and several tube support systems along with the CT scanner. This newly designed CT scanner also features a compact and light-weight gantry with a 700 mm diameter apperture and user-friendly operater's console. The SCT-4800T brings a new level of patient and operator comfort to the emergency radiology examination site. (author)

Impact of sickle cell trait on the thrombotic risk associated with non-O blood groups in northern Nigeria.

Science.gov (United States)

Ahmed, Sagir G; Kagu, Modu B; Ibrahim, Umma A; Bukar, Audu A

2015-10-01

The non-O blood group is an established risk factor for deep vein thrombosis (DVT), while controversy surrounds the role of sickle cell trait (SCT) as a risk factor for DVT. We hypothesised that if SCT is a risk factor for DVT, individuals with non-O blood groups and SCT (Hb AS) would have a higher risk of DVT than their counterparts with non-O blood groups and normal haemoglobin phenotype (Hb AA). We retrospectively analysed the prevalence of SCT and non-O blood groups among 148 DVT patients with control subjects in order to determine the role of SCT as a risk factor for DVT and its impact on the risk of DVT among patients with non-O blood groups. In comparison with control subjects, DVT patients had significantly higher prevalences of SCT (35.1% vs 27.7%, p=0.04) and non-O blood groups (68.9% vs 45.9%, p=0.02). The odds ratios for DVT due to SCT, non-O blood groups with normal Hb phenotype (Hb AA) and non-O blood groups with SCT (Hb AS) were 1.3, 2.4 and 3.5, respectively. These results suggest that SCT by itself is a weak risk factor for DVT but it has the potential of escalating the DVT risk among patients with non-O blood groups. The combined effects of elevated clotting factors (non-O group effect) and increased clotting factor activation (SCT effect) were responsible for the escalated DVT risk among patients with co-inheritance of non-O blood groups and SCT. Co-inheritance of SCT and non-O blood group is, therefore, an important mixed risk factor for DVT. This should be taken into account when assessing DVT risk profiles of patients in Africa and other parts of the world where the SCT is prevalent.

Differences in mothers' and fathers' health-related quality of life after pediatric SCT: a longitudinal study.

Science.gov (United States)

Barrera, M; Atenafu, E; Doyle, J; Berlin-Romalis, D; Hancock, K

2012-06-01

The purpose of this study was to examine longitudinally health-related quality of life (HRQOL) and related factors in mothers and fathers of children who undergo SCT, before, and 1 and 2 years after SCT. A total of 84 parents (49 mothers/35 fathers) of patients diagnosed mainly with leukemia completed a HRQOL measure before SCT, 46 at 1 year (26 mothers/20 fathers) and 50 parents (31 mothers/19 fathers) at 2 years post SCT. Physical and psychosocial HRQOL summary scores are reported. Parents' age and gender, child's diagnosis, radiation history, age, behavior and physical health were examined. Linear mixed models for repeated measures with a covariate structure were used for analysis. Physical HRQOL did not differ between mothers and fathers or over time. Maternal and paternal psychosocial HRQOL scores improved by 2 years post SCT. Child's behavior problems and poor health, and maternal age (younger) predicted poor maternal psychosocial HRQOL 2 years post SCT. Child's behavior problems, diagnosis and treatment severity predicted poor paternal psychosocial HRQOL. These findings identify similar (child's poor behavior) and differential risk factors (parental young age, disease and treatment severity, and child's poor health status) for poor HRQOL for mothers and fathers. These findings can guide comprehensive family-care interventions before, during and after pediatric SCT.

Patient socioeconomic status as a prognostic factor for allo-SCT.

Science.gov (United States)

Silla, L; Fischer, G B; Paz, A; Daudt, L E; Mitto, I; Katz, B; da Graça Grossini, M; Bittencourt, H N; Jochims, A; Fogliatto, L; Bittar, C M; Friedrisch, J R; Bittencourt, R I

2009-04-01

The aim of the present study was to assess the influence of socioeconomic status (SeS) on the outcome of allo-SCT at a Brazilian SCT center. In total, 201 patients receiving HLA-identical related allo-SCTs were studied. The median age was 30 years. Overall, 163 patients had malignancies (CML 68, ALL/AML 63, myelodysplastic syndrome 12 and others 20). SeS was defined according to the Brazilian Association of Market Research Agencies classification, where people are clustered in groups A-E (richest to poorest). In total, 146 patients (72%) were classified as richest (A+B+C) and 55 (28%) as poorest (D+E). The D+E SeS group was associated with a higher incidence of chronic GVHD and acute GVHD (hazard ratio (HR)=2.61; P=0.001 and HR=2.62; P=0.001, respectively), better platelet and neutrophil engraftment (HR=1.94; P=factor in patients undergoing allo-SCT in Brazil, influencing engraftment, TRM and overall survival.

Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT

NARCIS (Netherlands)

Vrijmoet-Wiersma, C. M. J.; Egeler, R. M.; Koopman, H. M.; Bresters, D.; Norberg, A. L.; Grootenhuis, M. A.

2010-01-01

With the aim of assessing parental stress after SCT, 73 parents of children and adolescents who underwent SCT 5 or 10 years ago responded to questionnaires on general distress (General Health Questionnaire (GHQ)), disease-related stress (Pediatric Inventory for Parents-short form (PIP-SF)) and

BDNF Overexpression Exhibited Bilateral Effect on Neural Behavior in SCT Mice Associated with AKT Signal Pathway.

Science.gov (United States)

Chen, Mei-Rong; Dai, Ping; Wang, Shu-Fen; Song, Shu-Hua; Wang, Hang-Ping; Zhao, Ya; Wang, Ting-Hua; Liu, Jia

2016-10-01

Spinal cord injury (SCI), a severe health problem in worldwide, was commonly associated with functional disability and reduced quality of life. As the expression of brain-derived neurotrophic factor (BDNF) was substantial event in injured spinal cord, we hypothesized whether BDNF-overexpression could be in favor of the recovery of both sensory function and hindlimb function after SCI. By using BDNF-overexpression transgene mice [CMV-BDNF 26 (CB26) mice] we assessed the role of BDNF on the recovery of neurological behavior in spinal cord transection (SCT) model. BMS score and tail-flick test was performed to evaluate locomotor function and sensory function, respectively. Immunohistochemistry was employed to detect the location and the expression of BDNF, NeuN, 5-HT, GAP-43, GFAP as well as CGRP, and the level of p-AKT and AKT were examined through western blot analysis. BDNF overexpressing resulted in significant locomotor functional recovery from 21 to 28 days after SCT, compared with wild type (WT)+SCT group. Meanwhile, the NeuN, 5-HT and GAP-43 positive cells were markedly increased in ventral horn in BDNF overexpression animals, compared with WT mice with SCT. Moreover, the crucial molecular signal, p-AKT/AKT has been largely up-regulated, which is consistent with the improvement of locomotor function. However, in this study, thermal hyperpathia encountered in sham (CB26) group and WT+SCT mice and further aggravated in CB26 mice after SCT. Also, following SCT, the significant augment of positive-GFAP astrocytes and CGRP fibers were found in WT+SCT mice, and further increase was seen in BDNF over-expression transgene mice. BDNF-overexpression may not only facilitate the recovery of locomotor function via AKT pathway, but also contributed simultaneously to thermal hyperalgesia after SCT.

The area postrema (AP) and the parabrachial nucleus (PBN) are important sites for salmon calcitonin (sCT) to decrease evoked phasic dopamine release in the nucleus accumbens (NAc).

Science.gov (United States)

Whiting, Lynda; McCutcheon, James E; Boyle, Christina N; Roitman, Mitchell F; Lutz, Thomas A

2017-07-01

The pancreatic hormone amylin and its agonist salmon calcitonin (sCT) act via the area postrema (AP) and the lateral parabrachial nucleus (PBN) to reduce food intake. Investigations of amylin and sCT signaling in the ventral tegmental area (VTA) and nucleus accumbens (NAc) suggest that the eating inhibitory effect of amylin is, in part, mediated through the mesolimbic 'reward' pathway. Indeed, administration of the sCT directly to the VTA decreased phasic dopamine release (DA) in the NAc. However, it is not known if peripheral amylin modulates the mesolimbic system directly or whether this occurs via the AP and PBN. To determine whether and how peripheral amylin or sCT affect mesolimbic reward circuitry we utilized fast scan cyclic voltammetry under anesthesia to measure phasic DA release in the NAc evoked by electrical stimulation of the VTA in intact, AP lesioned and bilaterally PBN lesioned rats. Amylin (50μg/kg i.p.) did not change phasic DA responses compared to saline control rats. However, sCT (50μg/kg i.p.) decreased evoked DA release to VTA-stimulation over 1h compared to saline treated control rats. Further investigations determined that AP and bilateral PBN lesions abolished the ability of sCT to suppress evoked phasic DA responses to VTA-stimulation. These findings implicate the AP and the PBN as important sites for peripheral sCT to decrease evoked DA release in the NAc and suggest that these nuclei may influence hedonic and motivational processes to modulate food intake. Copyright © 2017 Elsevier Inc. All rights reserved.

Long-term event-free and overall survival after risk-adapted melphalan and SCT for systemic light chain amyloidosis.

Science.gov (United States)

Landau, H; Smith, M; Landry, C; Chou, J F; Devlin, S M; Hassoun, H; Bello, C; Giralt, S; Comenzo, R L

2017-01-01

Stem cell transplantation (SCT), an effective therapy for amyloid light chain (AL) amyloidosis patients, is associated with low treatment-related mortality (TRM) with appropriate patient selection and risk-adapted dosing of melphalan (RA-SCT). Consolidation after SCT increases hematologic complete response (CR) rates and may improve overall survival (OS) for patients with SCT with or without consolidation. Melphalan was administered at 100 (14%), 140 (52%) and 200 (34%) mg/m 2 . The TRM rate at 100 days was 5%. RA-SCT resulted in CR in 24% (3 months) and 48% (12 months) of patients. The CR rate was particularly high (62%) in patients offered bortezomib consolidation. With a median follow-up among survivors of 7.7 years, median event-free survival (EFS) with RA-SCT was 4.04 years (95% confidence interval (CI): 3.41-5.01 years); median OS was 10.4 years (95% CI: 7.3-not achieved). Patients with CR at 12 months after SCT had significantly longer EFS (P=0.01) and OS (P=0.04). In a multivariate analysis, melphalan dose had no impact on EFS (P=0.26) or OS (P=0.11). For selected patients, RA-SCT was safe and was associated with extended long-term survival. With the availability of novel agents for consolidation, RA-SCT remains a very effective and important backbone treatment for AL amyloidosis.

Beamtest results of ATLAS SCT Modules in 2002

CERN Document Server

Barr, A J; Dolezal, Z; Donega, M; D'Onofrio, M; García, J E; González, S; Horazdovsky, T; Kazi, S; Kodys, P; Moorhead, G F; Reznicek, P; Solar, M; Vos, M; Wallny, R

2004-01-01

Beamtests of ATLAS Semiconductor Tracker (SCT) modules carried out at the ATLAS testbeam facility at the CERN SPS H8. During 2002, three beam runs were carried out in May/June, July and August. In the August 2002 beam test period four irradiated modules, two ``K5'' end-cap and two barrel, with the final design were tested. Module propierties (efficiency, charge collection, signal/noise, pulse shape) and the dependence of them for a particle high incidence angle was studied. A comparison with previous testbeam results was also performed. Time-stamping performance of SCT modules and specially, the effect of irradiation on the time characteristics of the Front End was investigated more closely. On this note we show a summary of these studies.

Evaluation of salmon calcitonin (sCT) enteric-coated capsule for enhanced absorption and GI tolerability in rats.

Science.gov (United States)

Wu, Lei; Zhang, Ge; Lu, Qin; Sun, Qian; Wang, Mulan; Li, Na; Gao, Zidong; Sun, Ya; Li, Tingting; Han, Deen; Yu, Xue; Wang, Lei; Sun, Wei; Zhao, Di; Wu, Yaning; Lu, Yang; Chen, Xijing

2010-03-01

Considering the chronic and repeated nature of salmon calcitonin (sCT) therapy, the oral route is a preferred route of administration. But, the oral bioavailability of sCT is very low due to enzymatic degradation and poor permeation across intestinal epithelial cells. It was the aim of this study to investigate the pharmacodynamic (PD), pharmacokinetic (PK), and mucosal injury characteristic of sCT oral delivery system. In this study, PD experiments were performed to find a suitable releasing region of sCT, an effect absorption enhancer, and an optimal mass ratio of sCT/enhancer. In addition, the PK experiments were designed to validate the absorption enhancement of this oral delivery system. Histopathological evaluations on the intestinal mucosa were carried out to assess any potential toxicity of the absorption enhancer. Through the PD research, we determined that oral sCT enteric-coated capsules containing sCT and citric acid (CA) with a ratio of 1:20 may be an adaptable delivery. PK study further proved that the oral absorption of sCT was enhanced from this delivery system. Finally, no damage on intestinal mucosa was observed when rats received the delivery system containing CA for up to 7 days. These results suggested that enteric-coated capsules with a certain amount of CA might give enhanced oral delivery of peptide drugs like sCT.

A phase II study of V-BEAM as conditioning regimen before second auto-SCT for multiple myeloma.

Science.gov (United States)

Wang, T-F; Fiala, M A; Cashen, A F; Uy, G L; Abboud, C N; Fletcher, T; Wu, N; Westervelt, P; DiPersio, J F; Stockerl-Goldstein, K E; Vij, R

2014-11-01

High-dose melphalan has been the standard conditioning regimen for auto-SCT in multiple myeloma (MM) for decades. A more effective conditioning regimen may induce deeper responses and longer remission duration. It is especially needed in the setting of second auto-SCT, which rarely achieves comparable results with the first auto-SCT using the same conditioning regimen. Here we conducted a phase II study to investigate the efficacy and safety of a conditioning regimen V-BEAM (bortezomib-BEAM) before second auto-SCT for multiple myeloma. Ten patients were enrolled from September 2012 to May 2013. The CR rate at day +100 after auto-SCT was 75%; all except for one patient remained in remission after a median follow-up of 6 months. Three patients developed Clostridium difficile infection. Two patients died within the first 30 days of auto-SCT from neutropenic colitis and overwhelming sepsis, respectively. Due to the high rate of morbidity and mortality, the study was terminated after 10 patients. In summary, although the conditioning regimen V-BEAM before second auto-SCT for MM provided promising responses, it was associated with unexpected treatment-related toxicity and should not be investigated further without modifications.

EVAPORATIVE COOLING - CONCEPTUAL DESIGN FOR ATLAS SCT

CERN Document Server

Niinikoski, T O

1998-01-01

The conceptual design of an evaporative two-phase flow cooling system for the ATLAS SCT detector is described, using perfluorinated propane (C3F8) as a coolant. Comparison with perfluorinated butane (C4F10) is made, although the detailed design is presented only for C3F8. The two-phase pressure drop and heat transfer coefficient are calculated in order to determine the dimensions of the cooling pipes and module contacts for the Barrel SCT. The region in which the flow is homogeneous is determined. The cooling cycle, pipework, compressor, heat exchangers and other main elements of the system are calculated in order to be able to discuss the system control, safety and reliability. Evaporative cooling appears to be substantially better than the binary ice system from the point of view of safety, reliability, detector thickness, heat transfer coefficient, cost and simplicity.

Circulating Candida-specific anti-mannan antibodies precede invasive candidiasis in patients undergoing myelo-ablative chemotherapy.

NARCIS (Netherlands)

Verduyn Lunel, F.M.; Donnelly, J.P.; Lee, H.A.L. van der; Blijlevens, N.M.A.; Verweij, P.E.

2009-01-01

The kinetics of circulating Candida mannan and anti-mannan antibodies were studied in consecutive plasma samples, obtained upon hospital admission, of 21 patients with microbiologically proven invasive candidiasis and 30 control patients who underwent myelo-ablative chemotherapy. The detection of

Results of a search for γ Dor and δ SCT stars with the Kepler spacecraft

Energy Technology Data Exchange (ETDEWEB)

Bradley, P. A.; Miles, L. F. [XCP-6, MS F-699 Los Alamos National Laboratory, Los Alamos, NM 87545 (United States); Guzik, J. A. [XTD-NTA, MS T-086 Los Alamos National Laboratory, Los Alamos, NM 87545 (United States); Uytterhoeven, K. [Instituto de Astrofisica de Canarias, 38200 La Laguna, Tenerife, Spain and Departamento de Astrofisica, Universidad de La Laguna, E-38200 La Laguna, Tenerife (Spain); Jackiewicz, J. [New Mexico State University, Las Cruces, NM 88003 (United States); Kinemuchi, K., E-mail: pbradley@lanl.gov [Apache Point Observatory, Sunspot, NM 88349 (United States)

2015-02-01

The light curves of 2768 stars with effective temperatures and surface gravities placing them near the gamma Doradus (γ Dor)/delta Scuti (δ Sct) instability region were observed as part of the Kepler Guest Observer program from Cycles 1 through 5. The light curves were analyzed in a uniform manner to search for γ Dor, δ Sct, and hybrid star pulsations. The γ Dor, δ Sct, and hybrid star pulsations extend asteroseismology to stars slightly more massive (1.4–2.5 M{sub ⊙}) than our Sun. We find 207 γ Dor, 84 δ Sct, and 32 hybrid candidate stars. Many of these stars are cooler than the red edge of the γ Dor instability strip as determined from ground-based observations made before Kepler. A few of our γ Dor candidate stars lie on the hot side of the ground-based γ Dor instability strip. The hybrid candidate stars cover the entire region between 6200 K and the blue edge of the ground-based δ Sct instability strip. None of our candidate stars are hotter than the hot edge of the ground-based δ Sct instability strip. Our discoveries, coupled with the work of others, show that Kepler has discovered over 2000 γ Dor, δ Sct, and hybrid star candidates in the 116 square degree Kepler field of view. We found relatively few variable stars fainter than magnitude 15, which may be because they are far enough away to lie between spiral arms in our Galaxy, where there would be fewer stars.

Results of a search for γ Dor and δ SCT stars with the Kepler spacecraft

International Nuclear Information System (INIS)

Bradley, P. A.; Miles, L. F.; Guzik, J. A.; Uytterhoeven, K.; Jackiewicz, J.; Kinemuchi, K.

2015-01-01

The light curves of 2768 stars with effective temperatures and surface gravities placing them near the gamma Doradus (γ Dor)/delta Scuti (δ Sct) instability region were observed as part of the Kepler Guest Observer program from Cycles 1 through 5. The light curves were analyzed in a uniform manner to search for γ Dor, δ Sct, and hybrid star pulsations. The γ Dor, δ Sct, and hybrid star pulsations extend asteroseismology to stars slightly more massive (1.4–2.5 M ⊙ ) than our Sun. We find 207 γ Dor, 84 δ Sct, and 32 hybrid candidate stars. Many of these stars are cooler than the red edge of the γ Dor instability strip as determined from ground-based observations made before Kepler. A few of our γ Dor candidate stars lie on the hot side of the ground-based γ Dor instability strip. The hybrid candidate stars cover the entire region between 6200 K and the blue edge of the ground-based δ Sct instability strip. None of our candidate stars are hotter than the hot edge of the ground-based δ Sct instability strip. Our discoveries, coupled with the work of others, show that Kepler has discovered over 2000 γ Dor, δ Sct, and hybrid star candidates in the 116 square degree Kepler field of view. We found relatively few variable stars fainter than magnitude 15, which may be because they are far enough away to lie between spiral arms in our Galaxy, where there would be fewer stars.

Intestinal response to myeloablative chemotherapy in piglets

DEFF Research Database (Denmark)

Pontoppidan, Peter Erik Lotko; Shen, René Liang; Petersen, Bodil L

2014-01-01

Chemotherapy-induced myeloablation prior to allogeneic hematopoietic stem cell transplantation (HSCT) may be associated with severe toxicity. The current understanding of the pathophysiology of oral and gastrointestinal (GI) toxicity is largely derived from studies in rodents and very little...... is known from humans, especially children. We hypothesized that milk-fed piglets can be used as a clinically relevant model of GI-toxicity related to a standard conditioning chemotherapy (intravenous busulfan, Bu plus cyclophosphamide, Cy) used prior to HSCT. In study 1, dose-response relationships were....../kg) and bone marrow was collected on day 11. Histology of bone marrow samples showed total aplasia after treatment A. Using this treatment in study 2, Bu-Cy pigs showed lowered spleen and intestinal weights and variable clinical signs of dehydration, sepsis, and pneumonia at tissue collection. Oral mucositis...

Stable long-term pulmonary function after fludarabine, antithymocyte globulin and i.v. BU for reduced-intensity conditioning allogeneic SCT.

Science.gov (United States)

Dirou, S; Malard, F; Chambellan, A; Chevallier, P; Germaud, P; Guillaume, T; Delaunay, J; Moreau, P; Delasalle, B; Lemarchand, P; Mohty, M

2014-05-01

Lung function decline is a well-recognized complication following allogeneic SCT (allo-SCT). Reduced-intensity conditioning (RIC) and in vivo T-cell depletion by administration of antithymocyte globulin (ATG) may have a protective role in the occurrence of late pulmonary complications. This retrospective study reported the evolution of lung function parameters within the first 2 years after allo-SCT in a population receiving the same RIC regimen that included fludarabine and i.v. BU in combination with low-dose ATG. The median follow-up was 35.2 months. With a median age of 59 years at the time of transplant, at 2 years, the cumulative incidences of non-relapse mortality was as low as 9.7%. The cumulative incidence of relapse was 33%. At 2 years, the cumulative incidences of extensive chronic GVHD (cGVHD) and of pulmonary cGVHD were 23.1% and 1.9%, respectively. The cumulative incidences of airflow obstruction and restrictive pattern were 3.8% and 9.6%, respectively. Moreover, forced expiratory volume (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio remained stable from baseline up to 2 years post transplantation (P=0.26, P=0.27 and P=0.07, respectively). These results correspond favorably with the results obtained with other RIC regimens not incorporating ATG, and suggest that ATG may have a protective pulmonary role after allo-SCT.

Donor-derived HLA antibody production in patients undergoing SCT from HLA antibody-positive donors.

Science.gov (United States)

Taniguchi, K; Yoshihara, S; Maruya, E; Ikegame, K; Kaida, K; Hayashi, K; Kato, R; Inoue, T; Fujioka, T; Tamaki, H; Okada, M; Onuma, T; Fujii, N; Kusunoki, Y; Soma, T; Saji, H; Ogawa, H

2012-10-01

Pre-existing donor-specific HLA antibodies in patients undergoing HLA-mismatched SCT have increasingly been recognized as a risk factor for primary graft failure. However, the clinical implications of the presence of HLA antibodies in donors remain unknown. We prospectively examined 123 related donors for the presence of HLA antibodies by using a Luminex-based single antigen assay. Of these, 1/57 (1.8%) male, 6/27 (22%) parous female and 0/39 (0%) nonparous female donors were HLA antibody-positive. Then, we determined the presence of HLA antibodies in seven patients who received SCT from antibody-positive donors. Of these, four became HLA antibody-positive after SCT. The specificities of the antibodies that emerged in the patients closely resembled those of the antibodies found in the donors, indicating their production by donor-derived plasma cells. Moreover, the kinetics of the HLA antibody levels were similar in all four patients: levels started increasing within 1 week after SCT and peaked at days 10-21, followed by a gradual decrease. These results suggest that donor-derived HLA antibody production frequently occurs in patients undergoing SCT from antibody-positive donors. Further studies are warranted for clarifying the clinical significance of donor-derived HLA antibodies, including the role of these antibodies in post transplant platelet transfusion refractoriness.

Development of the Shimadzu computed tomographic scanner SCT-200N

International Nuclear Information System (INIS)

Ishihara, Hiroshi; Yamaoka, Nobuyuki; Saito, Masahiro

1982-01-01

The Shimadzu Computed Tomographic Scanner SCT-200N has been developed as an ideal CT scanner for diagnosing the head and spine. Due to the large aperture, moderate scan time and the Zoom Scan Mode, any part of the body can be scanned. High quality image can be obtained by adopting the precisely stabilized X-ray unit and densely packed array of 64-detectors. As for its operation, capability of computed radiography (CR) prior to patient positioning and real time reconstruction ensure efficient patient through-put. Details of the SCT-200N are described in this paper. (author)

Distress, problems and supportive care needs of patients treated with auto- or allo-SCT

NARCIS (Netherlands)

Annemarie Braamse; prof Berno van Meijel; O. Visser; P.C. Huijgens; A.T.F. Beekman; J. Dekker

2013-01-01

Hematological malignancies and treatment with hematopoietic SCT are known to affect patients’ quality of life. The problem profile and care needs of this patient group need clarification, however. This study aimed to assess distress, problems and care needs after allo- or auto-SCT, and to identify

Distress, problems and supportive care needs of patients treated with auto- or allo-SCT

NARCIS (Netherlands)

Braamse, A.M.J.; van Meijel, B.; Visser, O.; Huijgens, P.C.; Beekman, A.T.F.; Dekker, J.

2014-01-01

Hematological malignancies and treatment with hematopoietic SCT are known to affect patients' quality of life. The problem profile and care needs of this patient group need clarification, however. This study aimed to assess distress, problems and care needs after allo-or auto-SCT, and to identify

Myeloablative radioimmunotherapies in the conditioning of patients with AML, MDS and multiple myeloma prior to stem cell transplantation

International Nuclear Information System (INIS)

Buchmann, I.

2008-01-01

Aggressive consolidation chemotherapy and hematopoietic stem cell transplantation have improved the prognosis of patients with acute myeloid leukemia (AML), myelodyplastic syndrome (MDS) and multiple myeloma. Nevertheless, only a minor fraction of patients achieve long-term disease-free survival after stem cell transplantation with disease recurrence being the most common cause of treatment failure. In addition, therapy-related effects such as toxicity of chemotherapy and complications of stem cell transplantation increase mortality rates significantly. Myeloablative radioimmunotherapy uses radiolabeled monoclonal antibodies (mAb) with affinity for the hematopoietic marrow. It applies high radiation doses in the bone marrow but spares normal organs. Adding myeloablative radioimmunotherapy to the conditioning schemes of AML, MDS and multiple myeloma before stem cell transplantation allows for the achievement of a pronounced antileukemic/antimyeloma effect for the reduction of relapse rates without significant increase of acute organ toxicity and therapy-related mortality. In order to optimise therapy, a rational design of the nuclide-antibody combination is necessary. 90 Y, 188 Re and 131 I are the most frequently used β - -particles. Of these, 90 Y is the most qualified nuclide for myeloablation. Backbone stabilised DTPA are ideal chelators to stably conjugate 90 Y to antibodies so far. For myeloablative conditioning, anti-CD66-, -45- and -33-mAb are used. The anti-CD66-antibody BW250/183 binds to normal hematopoietic cells but not to leukemic blasts and myeloma cells. The 90 Y-2B3M-DTPA-BW250/183 is the most suited radioimmunoconjugate for patients with an infiltration grade of leukemic blasts in the bone marrow 90 Y-anti-CD45-mAb YAML568 are 6.4 ± 1.2 (bone marrow), 3.9 ± 1.4 (liver) and 1.1 ± 0.4 (kidneys). CD45 is expressed also on the extramedullar clonogenic myeloma progenitor cell that circulates in the peripheral blood. Thus, the conditioning of

Sporadic late-onset nemaline myopathy with MGUS: long-term follow-up after melphalan and SCT.

Science.gov (United States)

Voermans, Nicol C; Benveniste, Olivier; Minnema, Monique C; Lokhorst, Henk; Lammens, Martin; Meersseman, Wouter; Delforge, Michel; Kuntzer, Thierry; Novy, Jan; Pabst, Thomas; Bouhour, Françoise; Romero, Norma; Leblond, Veronique; Bergh, Peter van den; Vekemans, Marie-Christiane; van Engelen, Baziel G; Eymard, Bruno

2014-12-02

Sporadic late-onset nemaline myopathy (SLONM) is a rare, late-onset myopathy that progresses subacutely. If associated with a monoclonal gammopathy of unknown significance (MGUS), the outcome is unfavorable: the majority of these patients die within 1 to 5 years of respiratory failure. This study aims to qualitatively assess the long-term treatment effect of high-dose melphalan (HDM) followed by autologous stem cell transplantation (SCT) in a series of 8 patients with SLONM-MGUS. We performed a retrospective case series study (n = 8) on the long-term (1-8 years) treatment effect of HDM followed by autologous SCT (HDM-SCT) on survival, muscle strength, and functional capacities. Seven patients showed a lasting moderate-good clinical response, 2 of them after the second HDM-SCT. All of them had a complete, a very good partial, or a partial hematologic response. One patient showed no clinical or hematologic response and died. This case series shows the positive effect of HDM-SCT in this rare disorder. Factors that may portend an unfavorable outcome are a long disease course before the hematologic treatment and a poor hematologic response. Age at onset, level and type of M protein (κ vs λ), and severity of muscle weakness were not associated with a specific outcome. This study provides Class IV evidence that for patients with SLONM-MGUS, HDM-SCT increases the probability of survival and functional improvement. © 2014 American Academy of Neurology.

Fluoropyrimidine-HAI (hepatic arterial infusion) versus systemic chemotherapy (SCT) for unresectable liver metastases from colorectal cancer.

Science.gov (United States)

Mocellin, Simone; Pasquali, Sandro; Nitti, Donato

2009-07-08

Although locoregional treatments such as hepatic arterial infusion (HAI) claim the advantage of delivering higher doses of anticancer agents directly into the metastatic organ as compared to systemic chemotherapy (SCT), the benefit in terms of overall survival (OS) is unclear. We quantitatively summarized the results of randomised controlled trials (RCT) comparing HAI to SCT for the treatment of unresectable liver metastatic disease from colorectal cancer (CRC). The aim of this work is to quantitatively summarize the results of RCT comparing HAI to SCT for the treatment of unresectable hepatic metastases from CRC. A systematic review of reports published until September 2008 on the findings of RCT that compared HAI to SCT for the treatment of unresectable CRC liver metastases was performed by searching the MEDLINE, Embase, Cancerlit, Cochrane and GoogleScholar electronic databases as well as other databanks collecting information on clinical trials. Inclusion criteria were patients with unresectable CRC liver metastases enrolled in RCT comparing HAI to SCT. The outcome measures were tumor response rate and overall survival. Two authors independently carried out study selection and assessment of methodological quality. A third author performed a concordance analysis in order to unravel potential systematic biases. Ten RCT were identified that met the eligibility criteria. HAI regimens were based on floxuridine (FUDR), 5-fluorouracil or either one of these two fluoropyrimidines in eight and one RCT, respectively. SCT consisted of FUDR or 5-fluorouracil in three and seven RCT, respectively. By pooling the summary data, tumor response rate resulted 42.9% and 18.4% for HAI and SCT, respectively (RR = 2.26; 95% CI, 1.80 to 2.84; P < 0.0001). Mean weighted median OS times were 15.9 and 12.4 months for HAI and SCT, respectively: the meta-risk of death was not statistically different between the two treatment groups (HR = 0.90; 95% CI, 0.76 to 1.07; P = 0.24). Currently

BREATHER (PENTA 16) short-cycle therapy (SCT) (5 days on/2 days off) in young people with chronic human immunodeficiency virus infection: an open, randomised, parallel-group Phase II/III trial.

Science.gov (United States)

Butler, Karina; Inshaw, Jamie; Ford, Deborah; Bernays, Sarah; Scott, Karen; Kenny, Julia; Klein, Nigel; Turkova, Anna; Harper, Lynda; Nastouli, Eleni; Paparini, Sara; Choudhury, Rahela; Rhodes, Tim; Babiker, Abdel; Gibb, Diana

2016-06-01

For human immunodeficiency virus (HIV)-infected adolescents facing lifelong antiretroviral therapy (ART), short-cycle therapy (SCT) with long-acting agents offers the potential for drug-free weekends, less toxicity, better adherence and cost savings. To determine whether or not efavirenz (EFV)-based ART in short cycles of 5 days on and 2 days off is as efficacious (in maintaining virological suppression) as continuous EFV-based ART (continuous therapy; CT). Secondary objectives included the occurrence of new clinical HIV events or death, changes in immunological status, emergence of HIV drug resistance, drug toxicity and changes in therapy. Open, randomised, non-inferiority trial. Europe, Thailand, Uganda, Argentina and the USA. Young people (aged 8-24 years) on EFV plus two nucleoside reverse transcriptase inhibitors and with a HIV-1 ribonucleic acid level [viral load (VL)] of  12 months. Young people were randomised to continue daily ART (CT) or change to SCT (5 days on, 2 days off ART). Follow-up was for a minimum of 48 weeks (0, 4 and 12 weeks and then 12-weekly visits). The primary outcome was the difference between arms in the proportion with VL > 50 copies/ml (confirmed) by 48 weeks, estimated using the Kaplan-Meier method (12% non-inferiority margin) adjusted for region and age. In total, 199 young people (11 countries) were randomised (n = 99 SCT group, n = 100 CT group) and followed for a median of 86 weeks. Overall, 53% were male; the median age was 14 years (21% ≥ 18 years); 13% were from the UK, 56% were black, 19% were Asian and 21% were Caucasian; and the median CD4% and CD4 count were 34% and 735 cells/mm(3), respectively. By week 48, only one participant (CT) was lost to follow-up. The SCT arm had a 27% decreased drug exposure as measured by the adherence questionnaire and a MEMSCap(™) Medication Event Monitoring System (MEMSCap Inc., Durham, NC, USA) substudy (median cap openings per week: SCT group, n = 5; CT group, n�

Silicon microstrip detectors for the ATLAS SCT

Czech Academy of Sciences Publication Activity Database

Robinson, D.; Allport, P.; Andricek, L.; Böhm, Jan; Buttar, C.; Carter, J. R.; Chilingarov, A.; Clark, A. G.; Feriere, D.; Fuster, J.

2002-01-01

Roč. 485, 1-2 (2002), s. 84-88 ISSN 0168-9002 R&D Projects: GA MPO RP-4210/69 Institutional research plan: CEZ:AV0Z1010920 Keywords : ATLAS SCT * silicon microstrip detectors * irradiation * quality control Subject RIV: BF - Elementary Particles and High Energy Physics Impact factor: 1.167, year: 2002

Differentiating SCT and inattentive symptoms in ADHD using fMRI measures of cognitive control.

Science.gov (United States)

Fassbender, Catherine; Krafft, Cynthia E; Schweitzer, Julie B

2015-01-01

Attention Deficit/Hyperactivity Disorder (ADHD) is associated with different impairment profiles in the symptom domains of hyperactivity/impulsivity and/or inattention. An additional symptom domain of sluggish cognitive tempo (SCT) has also been proposed. Although there is a degree of correlation between the SCT symptom domain and inattention, it has been proposed as a distinct disorder independent of ADHD. The objective of this study was to examine the neural substrates of cue-related preparatory processes associated with SCT symptoms versus inattentive symptoms in a group of adolescents with ADHD. We also compared cue-related effects in the entire ADHD group compared with a group of typically developing (TD) peers. A modified cued flanker paradigm and fMRI examined brain activity associated with attention preparation and motor response preparation. Between group contrasts between the ADHD and TD group revealed significant hypoactivity in the ADHD group during general attention preparation in the supplementary motor area (SMA) and in the right superior parietal lobe (SPL) during response preparation. In the ADHD group, greater numbers of SCT symptoms were associated with hypoactivity in the left SPL to cues in general whereas greater numbers of inattentive symptoms were associated with greater activity in the SMA to cues that provided no information and less activity in the thalamus during response preparation. Hypoactivity in the SPL with increasing SCT symptoms may be associated with impaired reorienting or shifting of attention. Altered activity in the SMA and thalamus with increasing inattention may be associated with a general problem with response preparation, which may also reflect inefficient processing of the response preparation cue. Our results support a degree of differentiation between SCT and inattentive symptom profiles within adolescents with ADHD.

Expansion of donor-reactive host T cells in primary graft failure after allogeneic hematopoietic SCT following reduced-intensity conditioning.

Science.gov (United States)

Koyama, M; Hashimoto, D; Nagafuji, K; Eto, T; Ohno, Y; Aoyama, K; Iwasaki, H; Miyamoto, T; Hill, G R; Akashi, K; Teshima, T

2014-01-01

Graft rejection remains a major obstacle in allogeneic hematopoietic SCT following reduced-intensity conditioning (RIC-SCT), particularly after cord blood transplantation (CBT). In a murine MHC-mismatched model of RIC-SCT, primary graft rejection was associated with activation and expansion of donor-reactive host T cells in peripheral blood and BM early after SCT. Donor-derived dendritic cells are at least partly involved in host T-cell activation. We then evaluated if such an expansion of host T cells could be associated with graft rejection after RIC-CBT. Expansion of residual host lymphocytes was observed in 4/7 patients with graft rejection at 3 weeks after CBT, but in none of the 17 patients who achieved engraftment. These results suggest the crucial role of residual host T cells after RIC-SCT in graft rejection and expansion of host T cells could be a marker of graft rejection. Development of more efficient T cell-suppressive conditioning regimens may be necessary in the context of RIC-SCT.

ADHD and SCT Symptomatology in Relation to College Students' Use of Self-Regulated Learning Strategies.

Science.gov (United States)

Shelton, Christopher R; Addison, William E; Hartung, Cynthia M

2017-02-01

The present study examined the relation between self-regulated learning (SRL) strategies and ADHD and sluggish cognitive tempo (SCT) symptomatology. Participants were 303 college students, aged 18 to 25 ( M = 20.04, SD = 1.45), from a Midwestern university who completed the Barkley Adult ADHD Rating Scale-IV (BAARS-IV), and a shortened, generalized version of the Motivated Strategies for Learning Questionnaire (MSLQ). Among college students, inattention symptomatology was consistently predictive of deficits in use of value, expectancy, and self-regulation strategies, while SCT symptomatology was only predictive of deficits in the use of self-regulation strategies. This study is the first to examine the relation between SCT symptomatology and SRL strategy use in college students. The findings revealed that SRL strategy use differs between college students exhibiting ADHD or SCT symptomatology. Remediation focusing on these deficits would likely increase academic achievement. Clinical implications, limitations, and suggestions for future research are discussed.

Long-term follow-up of patients undergoing auto-SCT for advanced germ cell tumour: a multicentre cohort study.

Science.gov (United States)

Seftel, M D; Paulson, K; Doocey, R; Song, K; Czaykowski, P; Coppin, C; Forrest, D; Hogge, D; Kollmansberger, C; Smith, C A; Shepherd, J D; Toze, C L; Murray, N; Sutherland, H; Nantel, S; Nevill, T J; Barnett, M J

2011-06-01

Failure of cisplatin-based chemotherapy in advanced germ cell tumour (GCT) is associated with a poor outcome. High-dose chemotherapy and auto-SCT is one therapeutic option, although the long-term outcome after this procedure is unclear. We conducted a multicentre cohort study of consecutive patients undergoing a single auto-SCT for GCT between January 1986 and December 2004. Of 71 subjects, median follow-up is 10.1 years. OS at 5 years is 44.7% (95% confidence interval (CI) 32.9-56.5%) and EFS is 43.5% (95% CI 31.4-55.1%). There were seven (10%) treatment-related deaths within 100 days of auto-SCT. Three (4.2%) patients developed secondary malignancies. Of 33 relapses, 31 occurred within 2 years of auto-SCT. Two very late relapses were noted 13 and 11 years after auto-SCT. In multivariate analysis, favourable outcome was associated with IGCCC (International Germ Cell Consensus Classification) good prognosis disease at diagnosis, primary gonadal disease and response to salvage chemotherapy. We conclude that auto-SCT results in successful outcome for a relatively large subgroup of patients with high-risk GCT. Late relapses may occur, a finding not previously reported.

ON THE PULSATIONAL-ORBITAL-PERIOD RELATION OF ECLIPSING BINARIES WITH δ-SCT COMPONENTS

Energy Technology Data Exchange (ETDEWEB)

Zhang, X. B.; Luo, C. Q. [Key Laboratory of Optical Astronomy, National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012 (China); Fu, J. N. [Department of Astronomy, Beijing Normal University, Beijing 100875 (China)

2013-11-01

We have deduced a theoretical relation between the pulsation and orbital-periods of pulsating stars in close binaries based on their Roche lobe filling. It appears to be of a simple linear form, with the slope as a function of the pulsation constant, the mass ratio, and the filling factor for an individual system. Testing the data of 69 known eclipsing binaries containing δ-Sct-type components yields an empirical slope of 0.020 ± 0.006 for the P{sub pul}-P{sub orb} relation. We have further derived the upper limit of the P{sub pul}/P{sub orb} ratio for the δ-Sct stars in eclipsing binaries with a value of 0.09 ± 0.02. This value could serve as a criterion to distinguish whether or not a pulsator in an eclipsing binary pulsates in the p-mode. Applying the deduced P{sub pul}-P{sub orb} relation, we have computed the dominant pulsation constants for 37 δ-Sct stars in eclipsing systems with definite photometric solutions. These ranged between 0.008 and 0.033 days with a mean value of about 0.014 days, indicating that δ-Sct stars in eclipsing binaries mostly pulsate in the fourth or fifth overtones.

Plerixafor (a CXCR4 antagonist following myeloablative allogeneic hematopoietic stem cell transplantation enhances hematopoietic recovery

Directory of Open Access Journals (Sweden)

Michael M. B. Green

2016-08-01

Full Text Available Abstract Background The binding of CXCR4 with its ligand (stromal-derived factor-1 maintains hematopoietic stem/progenitor cells (HSPCs in a quiescent state. We hypothesized that blocking CXCR4/SDF-1 interaction after hematopoietic stem cell transplantation (HSCT promotes hematopoiesis by inducing HSC proliferation. Methods We conducted a phase I/II trial of plerixafor on hematopoietic cell recovery following myeloablative allogeneic HSCT. Patients with hematologic malignancies receiving myeloablative conditioning were enrolled. Plerixafor 240 μg/kg was administered subcutaneously every other day beginning day +2 until day +21 or until neutrophil recovery. The primary efficacy endpoints of the study were time to absolute neutrophil count >500/μl and platelet count >20,000/μl. The cumulative incidence of neutrophil and platelet engraftment of the study cohort was compared to that of a cohort of 95 allogeneic peripheral blood stem cell transplant recipients treated during the same period of time and who received similar conditioning and graft-versus-host disease prophylaxis. Results Thirty patients received plerixafor following peripheral blood stem cell (n = 28 (PBSC or bone marrow (n = 2 transplantation. Adverse events attributable to plerixafor were mild and indistinguishable from effects of conditioning. The kinetics of neutrophil and platelet engraftment, as demonstrated by cumulative incidence, from the 28 study subjects receiving PBSC showed faster neutrophil (p = 0.04 and platelet recovery >20 K (p = 0.04 compared to the controls. Conclusions Our study demonstrated that plerixafor can be given safely following myeloablative HSCT. It provides proof of principle that blocking CXCR4 after HSCT enhances hematopoietic recovery. Larger, confirmatory studies in other settings are warranted. Trial registration ClinicalTrials.gov NCT01280955

Physical and emotional well-being of survivors of childhood and young adult allo-SCT - A Danish national cohort study.

Science.gov (United States)

Jensen, Josef Nathan; Gøtzsche, Frederik; Heilmann, Carsten; Sengeløv, Henrik; Adamsen, Lis; Christensen, Karl Bang; Larsen, Hanne Baekgaard

2016-08-01

The aim of this investigation was to examine, within a population-based study of a national cohort comprising Danish survivors of allo-SCT (n = 148), the long-term effects of allo-SCT in children and young adults. Physical and emotional well-being was assessed using the Short Form 36 (SF-36) and the HADS. Allo-SCT-related data were obtained from the participants' medical records. The study includes 148 patients, with an 89% response rate (n = 132). For comparison purposes, norm data from Danish (1994, n = 6000), Swedish (2006, n = 285), and British (2001, n = 1792) population samples were used. Factors negatively influencing the SF-36 subscales included female gender; TBI; stem cells derived from PB; older age at time of questioning; and living alone. Factors significantly (p SCT patients were similar to norm data. In conclusion, this national cohort study shows that patients treated with SCT in early life (SCT, showed similar levels of anxiety, depression, and physical and emotional well-being to those of the normal population. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Use of G-CSF to hasten neutrophil recovery after auto-SCT for AML is not associated with increased relapse incidence: a report from the Acute Leukemia Working Party of the EBMT.

Science.gov (United States)

Czerw, T; Labopin, M; Gorin, N-C; Giebel, S; Blaise, D; Dumas, P-Y; Foa, R; Attal, M; Schaap, N; Michallet, M; Bonmati, C; Veelken, H; Mohty, M

2014-07-01

Application of G-CSF in AML is controversial as leukemic blasts may express receptors interacting with the cytokine, which may stimulate leukemia growth. We retrospectively analyzed the impact of G-CSF use to accelerate neutrophil recovery after auto-SCT on outcome. Adults with AML in first CR autografted between 1994 and 2010 were included. Nine hundred and seventy two patients were treated with G-CSF after auto-SCT whereas 1121 were not. BM and PB were used as a source of stem cells in 454 (22%) and 1639 (78%) cases, respectively. The incidence of relapse at 5 years in the BM-auto-SCT group was 38% for patients receiving post-transplant G-CSF and 43% for those not treated with G-CSF, P=0.46. In the PB-auto-SCT cohort, respective probabilities were 48% and 49%, P=0.49. No impact of the use of G-CSF could be demonstrated with respect to the probability of leukemia-free survival: in the BM-auto-SCT group, 51% for G-CSF(+) and 48% for G-CSF(-), P=0.73; in PB-auto-SCT group, 42% for G-CSF(+) and 43% for G-CSF(-), P=0.83. Although G-CSF administration significantly shortened the neutropenic phase, no beneficial effect was observed with regard to non-relapse mortality. In patients with AML, the use of G-CSF after auto-SCT is not associated with increased risk of relapse irrespective of the source of stem cells used.

ALLOGENEIC TRANSPLANTATION FOR CHRONIC LYMPHOCYTIC LEUKEMIA

Directory of Open Access Journals (Sweden)

Luca Laurenti

2010-08-01

Full Text Available Even if Chronic lymphocytic leukemia (CLL often has an indolent behavior with good responsiveness to cytoreductive treatment, about 20% of the patients, so called "poor-risk" patients, show an aggressive course and die within a few years despite early intensive therapies. Criteria for poor-risk disease according to the European Bone Marrow Transplantation (EBMT CLL Transplant Consensus are: purine analogue refractoriness, early relapse after purine analogue combination therapy, CLL with p53 lesion requiring treatment. Allogeneic transplant has potential curative role in CLL, however burden with very  high transplant related mortality (TRM rates of 38-50%: A major advance in reducing the short-term morbidity and mortality of allogeneic stem cell transplantation (SCT has been the introduction of non-myeloablative or reduced intensity conditioning (RIC regimens to allow engraftment of allogeneic stem cells. There is no doubt that the crucial therapeutic principle of allo-SCT in CLL is graft versus leukemia (GVL activity. The major complications of allogeneic SCT in CLL are: chronic graft-versus-host-disease (GVHD affecting quality of life, high graft rejection and infection rates rates correlated with preexisting immunosuppression. Disease relapse remains the major cause of failure after RIC allo-HCT in CLL patients. Sensitive minimal residual disease (MRD quantification has strong prognostic impact after transplant.

Physical and emotional well-being of survivors of childhood and young adult allo-SCT

DEFF Research Database (Denmark)

Jensen, Josef Nathan; Gøtzsche, Frederik; Heilmann, Carsten

2016-01-01

The aim of this investigation was to examine, within a population-based study of a national cohort comprising Danish survivors of allo-SCT (n = 148), the long-term effects of allo-SCT in children and young adults. Physical and emotional well-being was assessed using the Short Form 36 (SF-36) and ...... of anxiety, depression, and physical and emotional well-being to those of the normal population....

Multimodal treatment with ALL-like chemotherapy, Auto-SCT and radiotherapy for lymphoblastic lymphoma.

Science.gov (United States)

Bersvendsen, Hanne; Kolstad, Arne; Blystad, Anne Kirsti; Aurlien, Ellen; Fosså, Alexander; Kvaløy, Stein O; Holte, Harald; Lauritzsen, Grete F

2014-05-01

Recommended treatment for lymphoblastic lymphomas, a highly aggressive, relatively rare lymphoma entity predominantly seen in teenagers and young adults, includes acute lymphoblastic leukemia (ALL)-like induction chemotherapy. Whether these patients should be consolidated with maintenance chemotherapy or autologous stem cell transplantation (Auto-SCT) and the use of radiotherapy are matters of debate. We reviewed treatment and outcome for 25 consecutive patients above the age of 15 years with lymphoblastic lymphoma (T-lineage; T-LBL, n = 19; B-lineage; B-LBL, n = 6) seen at a single center during a 12-year period (1999-2011). Patients were given an ALL-like chemotherapy induction regimen, and responding patients were consolidated with Auto-SCT and local radiotherapy when applicable. Median age at diagnosis was 33 years (range 15-65). Seventeen of the T-LBL patients had a mediastinal mass, three patients had central nervous system (CNS) involvement. Chemotherapy with intensified CNS prophylaxis induced an overall response rate of 92% (CR 84%, PR 8%). In total 23/25 (92%) patients underwent Auto-SCT in first remission while 13 of 14 eligible patients with mediastinal involvement received local radiotherapy. Twenty percent of the patients had hepatotoxicity grade 3-4 and 32% thromboembolic events (TE). Two patients (8%) died of treatment-related toxicity. One patient had progressive disease and died of lymphoma. Three patients have relapsed, but two of these (both B-LBL) are currently alive in second CR after Allo-SCT. With a median follow-up of 98 months (range 1-163) the 5- and 8-year PFS and OS are 76% and 84%, respectively. Combined intensive ALL-like induction and early consolidation chemotherapy followed by Auto-SCT and local radiation therapy resulted in high sustained cure rates.

Design and development of a work robot to place ATLAS SCT modules onto barrel cylinders

International Nuclear Information System (INIS)

Terada, S.; Kobayashi, H.; Sengoku, H.; Kato, Y.; Hara, K.; Honma, F.; Ikegami, Y.; Iwata, Y.; Kohriki, T.; Kondo, T.; Nakano, I.; Takashima, R.; Tanaka, R.; Ujiie, N.; Unno, Y.; Yasuda, S.

2005-01-01

More than 2000 silicon modules need to be placed and fastened on the ATLAS SCT barrel tracker. A semi-automatic pick-and-place work robot was designed and developed to cope with the module placement for the SCT barrel assembly. We found that this robot could place modules to a mechanical precision of better than 25 μm

Design and development of a work robot to place ATLAS SCT modules onto barrel cylinders

CERN Document Server

Terada, S; Honma, F; Ikegami, Y; Iwata, Y; Kato, Y; Kobayashi, H; Kohriki, T; Kondo, T; Nakano, I; Sengoku, H; Takashima, R; Tanaka, R; Ujiie, N; Unno, Y; Yasuda, S

2005-01-01

More than 2000 silicon modules need to be placed and fastened on the ATLAS SCT barrel tracker. A semi-automatic pick-and-place work robot was designed and developed to cope with the module placement for the SCT barrel assembly. We found that this robot could place modules to a mechanical precision of better than 25 mum.

Study on the correlation between SCT features and pathology, MVD, expressions of VEGF in renal cell carcinoma

International Nuclear Information System (INIS)

Chen Xuejun; Gao Jianbo; Yang Xuehua; Zhou Zhigang; Guo Hua; Yue Songwei

2005-01-01

Objective: To evaluate the correlation between spiral CT (SCT) features and pathology, MVD, and expressions of VEGF in renal cell carcinoma (RCC). Methods: Thirty-four patients with RCC diagnosed by pathology underwent SCT examinations. MVD and expressions of VEGF were examined immunohistochemically using SABC techniques. Results: (1) The detection and characterization as well as accuracy of staging in 34 RCC on two-phase enhanced SCT scans were 100%, 100%, and 94%, respectively. (2) Tumors with low density ring on SCT scans mostly had pseudocapsules at pathological examination. The nuclear grade was higher in groups of tumor without low density ring, with central necrosis, and the diameter larger than 3.0 cm than in those of tumor with low density ring, without central necrosis, and the diameter less than 3.0 cm (P<0.01, P<0.01, P<0.01, respectively). (3) In 34 cases of RCC, the mean MVD was 89.5 ± 56.0. The positive expression of VEGF was 70.6% (24/34). (4) The MVD and positive expressions of VEGF in groups of tumor without a low density ring, with central necrosis on SCT scans were higher than in those tumor with a low density ring, without central necrosis (P<0.05 respectively in each of the groups). On early enhanced scans, MVD was closely correlated with tumor enhancement (P<0.05). MVD was higher in tumors with intravenous tumor emboli than in tumors without emboli (P<0.01). Conclusion: (1) Two-phase enhanced SCT scan was a reliable technique in the detection, characterization and staging of RCC. (2) Some SCT features were closely correlated with MVD and expressions of VEGF in RCC, which could be a noninvasive method in predicting aggressiveness and metastasis. (authors)

Allogeneic Stem Cell Transplant for Acute Myeloid Leukemia: Evolution of an Effective Strategy in India

Directory of Open Access Journals (Sweden)

Abhijeet Ganapule

2017-12-01

Full Text Available Purpose: There are limited data from developing countries on the role and cost-effectiveness of allogeneic stem cell transplantation (allo-SCT for patients with acute myeloid leukemia (AML. Patients and Methods: We undertook a retrospective descriptive study of all patients with AML who underwent allo-SCT from 1994 to 2013 at our center to evaluate the clinical outcomes and cost-effectiveness of this therapeutic modality. Results: Two hundred fifty-four consecutive patients, median age 34 years, who underwent allo-SCT at our center were included in this study. There were 161 males (63.4%. The 5-year overall survival (OS and event-free survival for the entire cohort was 40.1 ± 3.5% and 38.7 ± 3.4%, respectively. The 5-year OS for patients in first (CR1, second, and third complete remission and with disease/refractory AML was 53.1 ± 5.2%, 48.2 ± 8.3%, 31.2 ± 17.8%, and 16.0 ± 4.4%, respectively (P < .001. From 2007, reduced intensity conditioning (RIC with fludarabine and melphalan (Flu/Mel was used in a majority of patients in CR1 (n = 67. Clinical outcomes were compared with historical conventional myeloablative conditioning regimens (n = 38. Use of Flu/Mel was associated with lower treatment-related mortality at 1 year, higher incidence of chronic graft-versus-host-disease, and comparable relapse rates. The 5-year OS and event-free survival for Flu/Mel and myeloablative conditioning group was 67.2 ± 6.6% versus 38.1 ± 8.1% (P = .003 and 63.8 ± 6.4% versus 32.3 ± 7.9% (P = .002, respectively. Preliminary cost analysis suggests that in our medical cost payment system, RIC allo-SCT in CR1 was likely the most cost-effective strategy in the management of AML. Conclusion: In a resource-constrained environment, Flu/Mel RIC allo-SCT for AML CR1 is likely the most efficacious and cost-effective approach in a subset of newly diagnosed young adult patients.

Study of a twisted ATLAS SCT Barrel deformation as revealed by a photogrammetric survey

CERN Document Server

Dobson, E; Heinemann, F; Karagoz-Unel, M

2007-01-01

A photogrammetry survey on the SCT barrels was performed as an engineering check on the structure of the ATLAS Semiconductor Tracker (SCT) shortly after construction. Analysis of the data obtained revealed small scale elliptical deformation as well as a twist of the structure. The results of the survey are presented as well as interpolation of the measured targets to the module positions and a comparison with track based alignment measurements.

The ATLAS SCT grounding and shielding concept and implementation

CERN Document Server

Bates, RL; Bernabeu, J; Bizzell, J; Bohm, J; Brenner, R; Bruckman de Renstrom, P A; Catinaccio, A; Cindro, V; Ciocio, A; Civera, J V; Chouridou, S; Dervan, P; Dick, B; Dolezal, Z; Eklund, L; Feld, L; Ferrere, D; Gadomski, S; Gonzalez, F; Gornicki, E; Greenhall, A; Grillo, A A; Grosse-Knetter, J; Gruwe, M; Haywood, S; Hessey, N P; Ikegami, Y; Jones, T J; Kaplon, J; Kodys, P; Kohriki, T; Kondo, T; Koperny, S; Lacasta, C; Lozano Bahilo, J; Malecki, P; Martinez-McKinney, F; McMahon, S J; McPherson, A; Mikulec, B; Mikus, M; Moorhead, G F; Morrissey, M C; Nagai, K; Nichols, A; O'Shea, V; Pater, J R; Peeters, S J M; Pernegger, H; Perrin, E; Phillips, P W; Pieron, J P; Roe, S; Sanchez, J; Spencer, E; Stastny, J; Tarrant, J; Terada, S; Tyndel, M; Unno, Y; Wallny, R; Weber, M; Weidberg, A R; Wells, P S; Werneke, P; Wilmut, I

2012-01-01

This paper describes the design and implementation of the grounding and shielding system for the ATLAS SemiConductor Tracker (SCT). The mitigation of electromagnetic interference and noise pickup through power lines is the critical design goal as they have the potential to jeopardize the electrical performance. We accomplish this by adhering to the ATLAS grounding rules, by avoiding ground loops and isolating the different subdetectors. Noise sources are identified and design rules to protect the SCT against them are described. A rigorous implementation of the design was crucial to achieve the required performance. This paper highlights the location, connection and assembly of the different components that affect the grounding and shielding system: cables, filters, cooling pipes, shielding enclosure, power supplies and others. Special care is taken with the electrical properties of materials and joints. The monitoring of the grounding system during the installation period is also discussed. Finally, after con...

SCT: Spinal Cord Toolbox, an open-source software for processing spinal cord MRI data.

Science.gov (United States)

De Leener, Benjamin; Lévy, Simon; Dupont, Sara M; Fonov, Vladimir S; Stikov, Nikola; Louis Collins, D; Callot, Virginie; Cohen-Adad, Julien

2017-01-15

For the past 25 years, the field of neuroimaging has witnessed the development of several software packages for processing multi-parametric magnetic resonance imaging (mpMRI) to study the brain. These software packages are now routinely used by researchers and clinicians, and have contributed to important breakthroughs for the understanding of brain anatomy and function. However, no software package exists to process mpMRI data of the spinal cord. Despite the numerous clinical needs for such advanced mpMRI protocols (multiple sclerosis, spinal cord injury, cervical spondylotic myelopathy, etc.), researchers have been developing specific tools that, while necessary, do not provide an integrative framework that is compatible with most usages and that is capable of reaching the community at large. This hinders cross-validation and the possibility to perform multi-center studies. In this study we introduce the Spinal Cord Toolbox (SCT), a comprehensive software dedicated to the processing of spinal cord MRI data. SCT builds on previously-validated methods and includes state-of-the-art MRI templates and atlases of the spinal cord, algorithms to segment and register new data to the templates, and motion correction methods for diffusion and functional time series. SCT is tailored towards standardization and automation of the processing pipeline, versatility, modularity, and it follows guidelines of software development and distribution. Preliminary applications of SCT cover a variety of studies, from cross-sectional area measures in large databases of patients, to the precise quantification of mpMRI metrics in specific spinal pathways. We anticipate that SCT will bring together the spinal cord neuroimaging community by establishing standard templates and analysis procedures. Copyright © 2016 Elsevier Inc. All rights reserved.

The role of HLA antibodies in allogeneic SCT: is the 'type-and-screen' strategy necessary not only for blood type but also for HLA?

Science.gov (United States)

Yoshihara, S; Taniguchi, K; Ogawa, H; Saji, H

2012-12-01

The role of HLA antibodies in SCT has drawn increasing attention because of the significantly increased number of patients who receive HLA-mismatched SCT, including cord blood transplantation, haploidentical SCT and unrelated SCT. Technical advancements in the methods of HLA Ab testing have realized rapid, accurate and objective identification, as well as quantification of specific HLA antibodies. Recent clinical studies have suggested that the presence of donor-specific HLA antibodies (DSA) in patients is associated with graft failure in HLA-mismatched SCT when the above-listed stem cell sources are used and results in different impacts. Of note, most of the 'HLA-matched' unrelated SCT actually involve HLA mismatches in HLA-DP and the presence of antibodies against this locus has been reported to be associated with graft failure. Thus, HLA Ab should be examined as a work-up for all patients who undergo SCT from 'alternative donors.' The simplest route for preventing HLA Ab-mediated graft failure in Ab-positive patients is to avoid donors who possess the target Ag of HLA antibodies. If SCT from such donors must be performed, treatment for DSA before SCT may improve the chances of successful donor engraftment.

An auto-SCT-based total therapy resulted in encouraging outcomes in adolescents and young adults with acute lymphoblastic leukemia: report from a single center of China.

Science.gov (United States)

Huang, J; Zou, D-H; Li, Z-J; Fu, M-W; Xu, Y; Zhao, Y-Z; Qi, J-Y; Feng, S-Z; Liu, B-C; Lin, D; Mi, Y-C; Han, M-Z; Wang, J-X; Qiu, L-G

2012-08-01

Application of auto-SCT in the post-remission therapy for adolescents and young adults (AYAs) with ALL is controversial. We analyzed the outcomes of 79 AYAs (15-24 years) with ALL who received our designed total therapy protocol with auto-SCT in first CR from 1990 to 2009. The estimated OS and EFS at 5 years for the cohort were 62.8±5.9 and 61.5±5.7%. The cumulative non-relapse mortality and relapse rate at 5 years for the cohort were 7.2±3.1 and 33.6±5.8%. Time to CR >4 weeks was the only independent unfavorable factor associated with OS, EFS and relapse in multivariate analysis. Patients in standard risk (SR) group and high risk (HR) group had better OS (78.3±7.4, 63.8±10.2 vs 38.1±11.6%) and EFS (78.0±7.4, 63.4±9.4 vs 32.4±11.3%), and lower relapse rate (15.9±6.5, 31.5±9.5 vs 65.7±11.8%) compared with patients in very high risk (VHR) group. Our data confirmed that auto-SCT-based total therapy might be an optional treatment strategy for AYAs with ALL in SR. Patients in HR also could get benefit from such schedule. But for those in VHR, allogenetic SCT is still the prior recommendation for the frequent recurrence after auto-SCT.

Peculiarities and Variations in the Optical Spectrum of the RV Tauri-type Star R Sct

Directory of Open Access Journals (Sweden)

Kipper Tõnu

2013-06-01

Full Text Available We analyzed some new high resolution optical spectra of the semiregular RV Tauri-type star R Sct. Fundamental parameters were found to be Teff = 4500 K, log g = 0.0 and ξt = 4.0 km s−1. The results of chemical analysis show that R Sct is a metal-poor star with [Fe/H]≈ −0.5. The carbon content with respect to iron is significantly larger than in the Sun, [C/Fe]=0.84, but there is an evident deficiency of heavy elements. We found no tight correlation of the chemical abundances on the condensation temperatures of elements. This means that in R Sct the depletion by condensation into dust does not work, with possible exception of Ca and Sc. The luminosity derived from the Hipparcos parallax corresponds to a tip of the red-giant branch or slightly above it. Thus it is possible that R Sct evolved off the early-AGB when it has not yet experienced the third dredge-up in thermal pulses, or it is still located on AGB. The peculiarities of spectral features (emissions, line-splitting and the complicated time-variable radial velocities were also studied.

Distress, problems, and supportive care needs of patients treated with auto- or allo-SCT. Bone Marrow Transplant.

NARCIS (Netherlands)

Annemarie Braamse; prof Berno van Meijel; A.T. Beekman; O. Visser; J. Dekker

2014-01-01

Abstract Hematological malignancies and treatment with hematopoietic SCT are known to affect patients' quality of life. The problem profile and care needs of this patient group need clarification, however. This study aimed to assess distress, problems and care needs after allo- or auto-SCT, and to

Long-term renal toxicity in children following fractionated total-body irradiation (TBI) before allogeneic stem cell transplantation (SCT)

International Nuclear Information System (INIS)

Gerstein, Johanna; Meyer, Andreas; Fruehauf, Joerg; Karstens, Johann H.; Bremer, Michael; Sykora, Karl-Walter

2009-01-01

Purpose: to retrospectively assess the incidence and time course of renal dysfunction in children (≤ 16 years) following total-body irradiation (TBI) before allogeneic stem cell transplantation (SCT). Patients and methods: between 1986 and 2003, 92 children (median age, 11 years; range, 3-16 years) underwent TBI before allogeneic SCT. 43 of them had a minimum follow-up of 12 months (median, 51 months; range, 12-186 months) and were included into this analysis. Conditioning regimen included chemotherapy and fractionated TBI with 12 Gy (n = 26) or 11.1 Gy (n = 17). In one patient, renal dose was limited to 10 Gy by customized renal shielding due to known nephropathy prior to SCt. Renal dysfunction was defined as an increase of serum creatinine > 1.25 times the upper limit of age-dependent normal. Results: twelve children (28%) experienced an episode of renal dysfunction after a median of 2 months (range, 1-10 months) following SCT. In all but one patient renal dysfunction was transient and resolved after a median of 8 months (range, 3-16 months). One single patient developed persistent renal dysfunction with onset at 10 months after SCT. None of these patients required dialysis. The actuarial 3-year freedom from persistent renal toxicity for children surviving > 12 months after SCt was 97.3%. Conclusion: the incidence of persistent renal dysfunction after fractionated TBI with total doses ≤ 12 Gy was very low in this analysis. (orig.)

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

Science.gov (United States)

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

2017-09-01

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

Tandem high-dose chemotherapy and auto-SCT for malignant brain tumors in children under 3 years of age.

Science.gov (United States)

Sung, K W; Lim, D H; Lee, S H; Yoo, K H; Koo, H H; Kim, J H; Suh, Y-L; Joung, Y S; Shin, H J

2013-07-01

In an effort to improve survival and reduce late adverse effects of radiation therapy (RT), 25 children SCT following six cycles of induction chemotherapy. RT was either not given or deferred until 3 years of age if the patient was in CR after tandem HDCT/auto-SCT. Tumors relapsed or progressed in nine patients (five during induction treatment), and two of these patients survived after receiving salvage treatment, including RT. Two patients died due to toxicities during tandem HDCT/auto-SCT. A total of 16 patients survived to a median follow-up period of 52 months (range 18-96) from the time of diagnosis. Four of these patients did not receive RT, two received local RT (L-RT), three received craniospinal RT (CSRT), and seven received both L-RT and CSRT. The 5-year OS and EFS rates were 67.8±9.4% and 55.5±10.0%, respectively. Neuroendocrine and neurocognitive functions evaluated 3 years after tandem HDCT/auto-SCT were acceptable. Our results indicate that tandem HDCT/auto-SCT may improve survival in young children with malignant brain tumors with an acceptable level of risk of long-term toxicity.

Particle Physics and Astronomy Research Council (PPARC) members, United Kingdom, visiting the ATLAS semiconductor tracker (SCT) module tests.

CERN Multimedia

Patrice Loïez

2002-01-01

Photo 01: Mr Peter Warry, PPARC Chairman, Victrex Plc, United Kingdom visiting the ATLAS SCT module tests with Dr Joleen Pater, SCT (Manchester). Photo 02: PPARC Council Members, United Kingdom, visiting the ATLAS SCT module tests. L.t to r.: Mrs Judith Scott, Chief Executive, British Computer Society, Prof. George Efstathiou, Institute of Astronomy, University of Cambridge, Mr Peter Warry, PPARC Chairman, Victrex Plc, Prof. Martin Ward, Director X-Ray Astronomy, of Leicester, Prof. James Stirling, Director, Institute for Particle Physics Phenomenology, University of Durham and Prof. Brian Foster, University of Bristol.

Report on the SCT Forward Electrical Module Program

CERN Document Server

Benes, J; Feld, L; Hornung, M; Joos, D; Ketterer, C; Kodys, P; Kubik, P; Ludwig, J; Modesto, P; Rieth, G; Runge, K; Smith, T; Snow, S W; Taylor, G; Webel, M

1999-01-01

IN THE CONTEXT OF THE ATLAS SCT FORWARD HYBRID PROGRAM, THREEELECTRICAL DETECTOR MODULES HAVE BEEN BUILT. THIS NOTE DESCRIBES THEASSEMBLY AND SUMMARISES THE MECHANICAL AND ELECTRICAL PROPERTIES OFTHESE MODULES. SOME COMMENTS ON THE SPECIAL REQUIREMENTS OF THEPRODUCTION OF A REAL MODULE AS COMPARED TO DUMMY MODULES ARE GIVEN.A LIST OF OPEN QUESTIONS ARISING FROM THIS ASSEMBLY RUN IS APPENDED.

Estimating induced-activation of SCT barrel-modules in the ATLAS radiation environment.

CERN Document Server

Buttar, C M; Dawson, I; Mandic, I; Moraes, A

2002-01-01

One of the consequences of operating detector systems in the harsh radiation environments of the ATLAS inner-detector will be radioactivation of the components. If the levels of radioactivity and corresponding dose rates are significant, then there will be implications for any access or maintenance operations. Given in this note are predictions for the radioactivation of SCT barrel-modules in the expected radiation environment of the inner-detector, based on both calculations and measurements. It is shown that both neutron-capture and high-energy hadron reactions must be taken into account. The predictions show that, from a radiological point of view, the SCT barrel-modules should not pose any serious problems.

Application of advanced thermal management technologies to the ATLAS SCT barrel module baseboards

Energy Technology Data Exchange (ETDEWEB)

Apsimon, R.J. [Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 OQX (United Kingdom); Batchelor, L.E. [Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 OQX (United Kingdom); Beck, G.A. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom); Canard, P. [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Carter, A.A. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom)]. E-mail: a.a.carter@qmul.ac.uk; Carter, J.R. [Cavendish Laboratory, University of Cambridge, J.J. Thomson Avenue, Cambridge CB3 0HE (United Kingdom); Davis, V.R. [Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 OQX (United Kingdom); Oliveira, R. de [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Gibson, M.D. [Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 OQX (United Kingdom); Hominal, L. [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Ilie, D.M. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom); Ilie, S.D. [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Leboube, C.G. [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Mistry, J. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom); Morin, J. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom); Morris, J.; Nagai, K. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom); Sexton, I.; Thery, X. [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Tyndel, M. [Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 OQX (United Kingdom)

2006-09-15

The paper describes the application of advanced thermal management technologies to the design and production of the barrel module baseboard of the SemiConductor Tracker (SCT) of the ATLAS experiment at the Large Hadron Collider (LHC). The barrel modules contain silicon microstrip sensors and readout ASICs for tracking charged particles, and the baseboard forms the central element of the module, providing both its necessary thermal management and its mechanical structure. The baseboard requirements and specifications are given, and design and fabrication details are described. The properties of the 3000 baseboards successfully produced for the SCT are summarised.

Solid and Cystic Tumor (SCT of the Pancreas in an Adult Man

Directory of Open Access Journals (Sweden)

K. Ohiwa

1997-01-01

Full Text Available Solid and cystic tumor (SCT of the pancreas predominantly Occurs in women, and the occurrence in men is extremely rare. We experienced a male case of SCT. A 38-year-old man was admitted with the complaint of upper abdominal pain. CT scan showed the presence of a mass in the head of the pancreas. The mass was composed of high density areas and low density areas. Ultrasonograms revealed the mass being composed of high echoic areas and low echoic areas. The mass .was hypovascular on angiography. SCT was suspected and pancreaticoduodenectomy was performed. The cut surface of the tumor showed mainly cystic degenerative areas containing dark red hemorrhagic materials. Microscopically, there were solid areas in the periphery and pseudopapillary areas in the center. No metastasis was found in the removed lymph nodes. The tumor cells were not stained by Grimelius' silver stain. The tumor cells were positive for alpha-l-antitrypsin (AAT and neuron-specific enolase (NSE. Pancreatic hormones such as insulin, glucagon, and somatostatin were all negative. Electron micrograph showed that tumor cells were rich in mitochondria. Zymogen granules and neurosecretory granules were not detected. Estrogen receptor (ER and progesterone receptor (PR were both negative.

A multigene array for measurable residual disease detection in AML patients undergoing SCT

Science.gov (United States)

Goswami, M; McGowan, K S; Lu, K; Jain, N; Candia, J; Hensel, N F; Tang, J; Calvo, K R; Battiwalla, M; Barrett, A J; Hourigan, C S

2015-01-01

AML is a diagnosis encompassing a diverse group of myeloid malignancies. Heterogeneous genetic etiology, together with the potential for oligoclonality within the individual patient, have made the identification of a single high-sensitivity marker of disease burden challenging. We developed a multiple gene measurable residual disease (MG-MRD) RQ–PCR array for the high-sensitivity detection of AML, retrospectively tested on 74 patients who underwent allo-SCT at the NHLBI in the period 1994–2012. MG-MRD testing on peripheral blood samples prior to transplantation demonstrated excellent concordance with traditional BM-based evaluation and improved risk stratification for post-transplant relapse and OS outcomes. Pre-SCT assessment by MG-MRD predicted all clinical relapses occurring in the first 100 days after allo-SCT compared with 57% sensitivity using WT1 RQ–PCR alone. Nine patients who were negative for WT1 prior to transplantation were correctly reclassified into a high-risk MG-MRD-positive group, associated with 100% post-transplant mortality. This study provides proof of principle that a multiple gene approach may be superior to the use of WT1 expression alone for AML residual disease detection. PMID:25665046

Performance And Radiation Hardness Of The Atlas/sct Detector Module

CERN Document Server

Eklund, L

2003-01-01

The ATLAS experiment is a general purpose experiment being constructed at the Large Hadron Collider (LHC) at FERN, Geneva. ATLAS is designed to exploit the full physics potential of LHC, in particular to study topics concerning the Higgs mechanism, Super-symmetry and CP violation. The cross sections for the processes under study are extremely small, requiring very high luminosity colliding beams. The Semiconductor Tracker (SCT) is an essential part of the Inner Detector tracking system of ATLAS. The active elements of the SCT is 4088 detector modules, tiled on four barrel cylinders and eighteen endcap disks. As a consequence of the high luminosity, the detector modules will operate in a harsh radiation environment. This thesis describes work concerning radiation hardness, beam test performance and methods for production testing of detector modules. The radiation hardness studies have been focused on the electrical performance of the front-end ASIC and the detector module. The results have identified features ...

A snap-shot of a cosmic ray event seen in the different layers of both the SCT and TRT detectors.

CERN Multimedia

2006-01-01

Clean tracks of cosmic rays were detected in the completed semiconductor tracker (SCT) and transition radiation tracker (TRT) barrels. These tracking tests come just months after the successful insertion of the SCT into the TRT

Risk and prevention of graft failure in patients with preexisting donor-specific HLA antibodies undergoing unmanipulated haploidentical SCT.

Science.gov (United States)

Yoshihara, S; Maruya, E; Taniguchi, K; Kaida, K; Kato, R; Inoue, T; Fujioka, T; Tamaki, H; Ikegame, K; Okada, M; Soma, T; Hayashi, K; Fujii, N; Onuma, T; Kusunoki, Y; Saji, H; Ogawa, H

2012-04-01

A role of donor-specific HLA antibodies (DSA) in graft failure after SCT has been suggested, but the relevance of DSA in unmanipulated haploidentical SCT (haplo-SCT) remains unknown. We prospectively examined HLA antibodies using the Luminex-based single Ag assay for 79 adult patients undergoing unmanipulated haplo-SCT. Among them, 16 (20.2%) were HLA Ab-positive, including five patients with antibodies not corresponding to donor HLA Ags and 11 DSA-positive patients. Of the 11 DSA-positive patients, five received treatments to decrease DSA levels, including two, who received plasma exchange and rituximab, two who received platelet transfusions from healthy-related donors having DSA-corresponding HLA Ags and one who received bortezomib. Platelet transfusion was the most simple and effective treatment option for class I DSA. The cumulative incidence of neutrophil recovery was significantly lower in pretransplant (post-treatment) DSA-positive patients than in DSA-negative patients (61.9 vs 94.4%, P=0.026). Notably, three of five patients with high levels of DSA had graft failure. Donors should be selected on the basis of an evaluation of HLA antibodies. If haplo-SCT from donors with HLA Ags that correspond to high levels of DSA must be performed, then recipients should be treated for DSA to improve the chances of successful donor engraftment.

Robotic mounting of ATLAS barrel SCT modules

International Nuclear Information System (INIS)

Nickerson, R.B.; Viehhauser, G.; Wastie, R.; Terada, S.; Unno, Y.; Kohriki, T.; Ikegami, Y.; Hara, K.; Kobayashi, H.; Barbier, G.; Clark, A.G.; Perrin, E.; Carter, A.A.; Mistry, J.; Morris, J.

2006-01-01

The 2112 silicon detector modules of the barrel part of the ATLAS SemiConductor Tracker (SCT) have been mounted on their carbon fibre support structure. Module insertion, placement and fixing were performed by robotic assembly tooling. We report on our experience with this assembly method. Part of the mounting sequence involves a partial survey of elements of the support structure which is needed to align the modules properly during insertion. An analysis of these data is used to estimate the positional accuracy of the robots

Spectral evolution of Nova V400 Per (1974) and Nova V373 Sct (1975)

International Nuclear Information System (INIS)

Rosino, L.

1978-01-01

Photographic and spectroscopic observations of the two galactic novae, V400 Per and V373 Sct, which appeared in 1974 and 1975, have been carried out at Asiago. The light curves of the two novae were characterized by the presence of brightness oscillations during the early decline. The spectral evolution was quite normal: the spectra showed at first, over a relatively strong continuum, wide emission bands of moderate excitation, accompanied by blueshifted absorptions, with radial velocities of - 1760 kms -1 (Nova Per) and - 1260 kms -1 (Nova Sct). Later, after the novae entered the nebular stage, the continuum weakened, the absorption disappeared and the novae displayed the usual emission spectrum, with permitted and forbidden lines of high excitation ([O III], N III, He I, He II). Forbidden lines of Fe VI and Fe VII - and in Nova Sct, also Fe X and A X - were present for a time, but they soon disappeared, so that at the end the spectrum was dominated by the [O III] nebular lines, even stronger than Hα. (Auth.)

The excitation of solar-like oscillations in a δ Sct star by efficient envelope convection

DEFF Research Database (Denmark)

Antoci, V.; Handler, G.; Kallinger, T.

2011-01-01

Delta Scuti (δSct) stars are opacity-driven pulsators with masses of 1.5-2.5Msolar, their pulsations resulting from the varying ionization of helium. In less massive stars such as the Sun, convection transports mass and energy through the outer 30per cent of the star and excites a rich spectrum...... of resonant acoustic modes. Based on the solar example, with no firm theoretical basis, models predict that the convective envelope in δSct stars extends only about 1per cent of the radius, but with sufficient energy to excite solar-like oscillations. This was not observed before the Kepler mission, so...... the presence of a convective envelope in the models has been questioned. Here we report the detection of solar-like oscillations in the δSct star HD187547, implying that surface convection operates efficiently in stars about twice as massive as the Sun, as the ad hoc models predicted....

A prospective registration study to determine feasibility of hematopoietic SCT in adults with acute leukemia: planning, expectations and reality.

Science.gov (United States)

Labopin, M; Gorin, N-C; Polge, E; Socié, G; Gurman, G; Gluckman, E; Jindra, P; Poiré, X; Schäfer-Eckart, K; Ruutu, T; Milone, G; Arcese, W; Mohty, M; Rocha, V

2014-03-01

For adults with acute leukemia, it is important to know whether the therapeutic schemes initially planned were actually implemented. The European Group for Blood and Marrow transplantation Acute Leukemia Working Party prospectively followed 695 consecutive patients who were registered at the time of HLA typing. Of 304 patients with an available matched sibling donor (MSD), SCT was planned in 264, chemotherapy in 33 and autografting in 7. For the rest, an unrelated donor (UD) search was initiated in 198. Among these, 117 were transplanted, 114 received chemotherapy and 77 underwent autografting. Probabilities of receiving a planned treatment were 60 and 65% at 1 and 2 years, respectively. Patients scheduled to receive MSD SCT had an 82% probability, whereas those scheduled to undergo UD SCT had a 57% probability, of receiving their transplant at 1 year. The only factor associated with a lower probability of MSD SCT in first remission was delayed HLA typing (HR=0.82; P=0.03). One year after enrollment, 40% of patients did not follow their initial treatment plan. Because OS was 50% only at 3 years and only 57% of the patients without a MSD underwent SCT, this suggests room for improvement in outcomes for adults with acute leukemia.

Next-generation sequencing indicates false-positive MRD results and better predicts prognosis after SCT in patients with childhood ALL.

Science.gov (United States)

Kotrova, M; van der Velden, V H J; van Dongen, J J M; Formankova, R; Sedlacek, P; Brüggemann, M; Zuna, J; Stary, J; Trka, J; Fronkova, E

2017-07-01

Minimal residual disease (MRD) monitoring via quantitative PCR (qPCR) detection of Ag receptor gene rearrangements has been the most sensitive method for predicting prognosis and making post-transplant treatment decisions for patients with ALL. Despite the broad clinical usefulness and standardization of this method, we and others have repeatedly reported the possibility of false-positive MRD results caused by massive B-lymphocyte regeneration after stem cell transplantation (SCT). Next-generation sequencing (NGS) enables precise and sensitive detection of multiple Ag receptor rearrangements, thus providing a more specific readout compared to qPCR. We investigated two cohorts of children with ALL who underwent SCT (30 patients and 228 samples). The first cohort consisted of 17 patients who remained in long-term CR after SCT despite having low MRD positivity (SCT monitoring using qPCR. Only one of 27 qPCR-positive samples was confirmed to be positive by NGS. Conversely, 10 of 15 samples with low qPCR-detected MRD positivity from 13 patients who subsequently relapsed were also confirmed to be positive by NGS (P=0.002). These data show that NGS has a better specificity in post-SCT ALL management and indicate that treatment interventions aimed at reverting impending relapse should not be based on qPCR only.

The ATLAS SCT grounding and shielding concept and implementation

Czech Academy of Sciences Publication Activity Database

Bates, R.L.; Bell, P.J.; Bernabeu, J.; Böhm, Jan; Šťastný, Jan

2012-01-01

Roč. 7, MAR (2012), 1-31 ISSN 1748-0221 R&D Projects: GA MŠk LA08032 Institutional research plan: CEZ:AV0Z10100502 Keywords : ATLAS * LHC * SCT * Si microstrip and pad detectors * large detector systems for particle and astroparticle physics * detector grounding Subject RIV: BF - Elementary Particles and High Energy Physics Impact factor: 1.869, year: 2011

High prevalence of Dapsone-induced oxidant hemolysis in North American SCT recipients without glucose-6-phosphate-dehydrogenase deficiency.

Science.gov (United States)

Olteanu, H; Harrington, A M; George, B; Hari, P N; Bredeson, C; Kroft, S H

2012-03-01

Dapsone (4-4'-diaminodiphenylsulfone) is commonly used for Pneumocystis jirovecii pneumonia (PCP) prophylaxis in immunocompromised patients. Oxidant hemolysis is a known complication of dapsone, but its frequency in adult patients who have undergone a SCT for hematological malignancies is not well established. We studied the presence of oxidant hemolysis, by combining examination of RBC morphology and laboratory data, in 30 patients who underwent a SCT and received dapsone for PCP prophylaxis, and compared this group with 26 patients who underwent a SCT and received trimethoprim-sulfamethoxazole (TMP-SMX) for PCP prophylaxis. All patients had normal glucose-6-phosphate dehydrogenase (G6PDH) enzymatic activity. In SCT patients, dapsone compared with TMP-SMX for PCP prophylaxis was associated with a high incidence of oxidant hemolysis (87 vs 0%, PSCT patients is 20-fold higher than the reported rate in the population of HIV-infected patients, and thus much higher than the prevalence of G6PDH variants in the general population. In our patients, it manifested clinically as a lower Hb that was not significant enough to result in increased packed RBC transfusions.

Epstein-Barr virus (EBV) reactivation is a frequent event after allogeneic stem cell transplantation (SCT) and quantitatively predicts EBV-lymphoproliferative disease following T-cell--depleted SCT

NARCIS (Netherlands)

van Esser, J W; van der Holt, B; Meijer, E; Niesters, H G; Trenschel, R; Thijsen, S F; van Loon, A M; Frassoni, F; Bacigalupo, A; Schaefer, U W; Osterhaus, A D; Gratama, J W; Löwenberg, B; Verdonck, L F; Cornelissen, J J

2001-01-01

Reactivation of the Epstein-Barr virus (EBV) after allogeneic stem cell transplantation (allo-SCT) may evoke a protective cellular immune response or may be complicated by the development of EBV-lymphoproliferative disease (EBV-LPD). So far, very little is known about the incidence, recurrence, and

The pharmacokinetics and safety of twice daily i.v. BU during conditioning in pediatric allo-SCT recipients.

Science.gov (United States)

Le Gall, J B; Milone, M C; Waxman, I M; Shaw, L M; Harrison, L; Duffy, D; van de Ven, C; Militano, O; Geyer, M B; Morris, E; Bhatia, M; Satwani, P; George, D; Garvin, J H; Bradley, M B; Schwartz, J; Baxter-Lowe, L A; Cairo, M S

2013-01-01

Intravenous BU divided four times daily (q6 h) has been shown to be safe and effective in pediatric allo-SCT recipients. Though less frequent dosing is desirable, pharmacokinetic (PK) data on twice daily (q12 h) i.v. BU administration in pediatric allo-SCT recipients is limited. We prospectively examined the PK results in a cohort of pediatric allo-SCT recipients receiving i.v. BU q12 h as part of conditioning before allo-SCT. BU levels were obtained after the first dose of conditioning. PK parameter analysis (n=49) yielded the following 95% confidence intervals (CI₉₅): weight-normalized volume of distribution: 0.65-0.73 L/kg; t(1/2): 122-147 min; weight-normalized clearance (CL(n)): 3.4-4.3 mL/min/kg; and area under the curve: 1835-2180 mmol × min/L. From these results, a steady state concentration was calculated with CI₉₅ between 628-746 ng/mL. Comparison between recipients ≤4 vs >4 years old revealed significant differences in t(1/2) (mean: 115 vs 146 min, P=0.008) and CL(n) (mean: 4.4 vs 3.5 mL/min/kg, P=0.038). Intravenous BU q12 h had a comparable PK to i.v. BU q6 h PK seen in the literature, and in pediatric allo-SCT recipients, is a feasible, attractive alternative to i.v. q6h dosing.

O transplante de células-tronco hematopoéticas no tratamento dos linfomas não Hodgkin Hematopoietic stem cell transplantation for non-Hodgkin lymphomas

Directory of Open Access Journals (Sweden)

Renata Baldissera

2010-05-01

event-free and overall survival in patients with chemosensitive relapses of aggressive non-Hodgkin's lymphoma (NHL after conventional therapy. These results encouraged many investigators to use HDT as part of first-line therapy but the results are contradictory. There is no consensus regarding management of relapsed or refractory DLBCL. In follicular lymphomas, autologous stem cell transplantation (SCT is considered the treatment of choice for young patients with relapsed disease. Autologous SCT has also been evaluated in prospective trials as first-line treatment for high risk patients at diagnosis, but the results are not yet conclusive. In mantle cell lymphoma, autologous stem cell transplantation has been employed as part of first-line therapy. Allo-SCT for patients with lymphoma was first performed in the mid-1980s. The high transplant-related mortality, seen after myeloablative conditioning, discouraged broader interest in this approach and made further research difficult. The generally lower relapse rates after allo-SCT, the association of GvHD with reduced relapse rates, the increase of relapse rates after ex vivo or in vivo T-cell depletion, and the frequent responses to DLIs all support the existence of a graft-vs.-lymphoma effect. However, further data analysis supports the view that not all lymphomas are equal. While slowly proliferating diseases such as follicular lymphoma seem particularly sensitive targets for allogeneic T-cells, results of allo-SCT with aggressive B-cell lymphomas have been less convincing. Patients with these latter diseases obviously need vigorous debulking of their tumor prior to conditioning. Reduced-intensity conditioning fueled a renaissance of allo-SCT as treatment of lymphoma because the lower expected TRM was highly attractive for a patient population where the transplant-related death rate after myeloablative conditioning had, in many instances, exceeded 50%.

Potential prolongation of PFS in mantle cell lymphoma after R-HyperCVAD: auto-SCT consolidation or rituximab maintenance.

Science.gov (United States)

Ahmadi, T; McQuade, J; Porter, D; Frey, N; Loren, A W; Goldstein, S C; Svoboda, J; Stadtmauer, E; Schuster, S J; Nasta, S D

2012-08-01

We retrospectively analyzed 44 patients undergoing first-line treatment for mantle cell lymphoma with R-HyperCVAD, with or without rituximab (R) maintenance or auto-SCT. The primary study end point was PFS; secondary end point was overall survival.Median follow up for all patients was 3.3 years. Median age was 54 years, and 95% (n=42) were stage III or IV at diagnosis. In all, 17 patients underwent consolidative auto-SCT and 12 patients received R maintenance. The overall response rate was 95%, with 91% achieving complete response (CR). Median PFS for all patients was 3.5 years. Median PFS was 2.3 years for patients treated with R-HyperCVAD alone vs 3.9 years (P=0.02) with R-HyperCVAD+ R maintenance and 4.5 years (P=0.01) with R-HyperCVAD+ auto-SCT. For patients who did not achieve CR at interim staging, PFS for R-HyperCVAD alone was 1.4 years vs not reached for R-HyperCVAD+ consolidation (either R maintenance or auto-SCT) (P=0.02). PFS for patients with CR at interim staging was 3.3 years vs not reached (P=0.04) after consolidation. Our data suggest potential improvement in PFS when R-HyperCVAD is consolidated with either R maintenance or auto-SCT. This benefit appears particularly significant in those patients who do not achieve CR at interim restaging.

Investigation of Υ Dor - δ Sct hybrid stars based on high precission space photometry and complementary ground based spectroscopy

International Nuclear Information System (INIS)

Hareter, M.

2013-01-01

Stellar pulsation carries information on the physical condition within the star. While pressure modes (p modes) probe the outer layers of a star, gravity modes (g modes) penetrate deep into the radiative zone and thus carry valuable information on the physical conditions there. gamma Dor stars are stars that pulsate in such modes, apart from white dwarfs and slowly pulsating B (SPB) stars. Therefore, these stars are important test benches for stellar evolution and pulsation theory. delta Sct - gamma Dor hybrids are stars that pulsate like gamma Dor stars with g modes but also with p modes as the delta Sct stars do. This makes them even more suited for asteroseismology. The CoRoT long runs offer a great opportunity to analyse a large sample of stars observed homogeneously, uninterrupted and long time base of about 150 days, which is practically unachievable with ground based observation. Since space missions avoid the scintillation caused by the Earth's atmosphere, they allow to detect stellar oscillations on a sub-millimagnitude level even for stars as faint as 15th magnitude. The photometric data is supplemented by AAOmega classification spectroscopy, allowing to determine effective tem- peratures and surface gravity. With these data a statistical approach was adopted to describe the pulsation behaviour gamma Dor and delta Sct - gamma Dor hybrid stars. A temperature - period relation was found for gamma Dor and delta Sct stars, but none for delta Sct - gamma Dor hybrid stars, when considering their strongest g mode or p mode, respectively. The instability domain of hybrid stars is equal to that of delta Sct stars and is not con- fined to the overlapping region of the delta Sct and gamma Dor IS in the Hertzsprung- Russell diagram. Hybrid stars behave differently in the g mode regime than gamma Dor stars, which poses a serious question on how to define properly a delta Sct - gamma Dor hybrid. The convective flux blocking mechanism is supposed to work for stars

Impact of power purchases from non-utilities on the utility cost of capital

International Nuclear Information System (INIS)

Kahn, E.; Stoft, S.; Belden, T.

1995-01-01

The bond rating agencies in the USA have asserted that long-term power purchase contracts between non-utility generators and utilities are the equivalent of debt to the utilities, and therefore raise the cost of capital to the purchaser. Non-Utility generators claim that these contracts reduce risk to the utilities. This debate is reflected in the 1992 Energy Policy Act. This paper investigates this controversy from the perspective of the equity markets. Using a CAPM framework, various specifications of the cost of equity capital are estimated, to shed light on this question. No evidence is found for the hypothesis that non-utility generation contracts raise the cost of capital. There does appear to be a slight increase in this cost for those utilities seeking to build their own generation capacity as opposed to purchasing it from non-utility suppliers. (author)

Safety and efficacy of high-dose melphalan and auto-SCT in patients with AL amyloidosis and cardiac involvement.

Science.gov (United States)

Girnius, S; Seldin, D C; Meier-Ewert, H K; Sloan, J M; Quillen, K; Ruberg, F L; Berk, J L; Doros, G; Sanchorawala, V

2014-03-01

In Ig light chain (AL) amyloidosis, cardiac involvement is associated with worse prognosis and increased treatment-related complications. In this retrospective cohort study, we assessed survival, hematologic and cardiac responses to high-dose melphalan and auto-SCT (HDM/SCT) in patients with AL amyloidosis and cardiac involvement, stratified by cardiac biomarkers brain natriuretic peptide and Troponin I, analogous to the Mayo cardiac staging. Forty-seven patients underwent HDM/SCT based upon functional measures; six patients had modified cardiac stage I disease, seventeen had modified cardiac stage II disease and twenty-four had modified cardiac stage III disease. Treatment-related mortality was 4% for all patients and 8% for patients with stage III disease. Three-year survival was 88% and EFS was 47%; these did not differ by stage. By intention-to-treat analysis, 27% of patients achieved a hematologic complete response and 32% a very good partial response, of whom 70 and 45%, respectively, have not required additional therapy at 36 months. Cardiac response was achieved in 53% of patients. We conclude that with appropriate patient selection and a risk-adapted treatment approach, HDM/SCT is safe and effective in patients with AL amyloidosis and cardiac involvement.

Thermal performance measurements on ATLAS-SCT KB forward modules

CERN Document Server

Donegà, M; D'Onofrio, M; Ferrère, D; Hirt, C; Ikegami, Y; Kohriki, T; Kondo, T; Lindsay, S; Mangin-Brinet, M; Niinikoski, T O; Pernegger, H; Perrin, E; Taylor, G; Terada, S; Unno, Y; Wallny, R; Weber, M

2003-01-01

The thermal design of the KB module is presented. A Finite Elements Analysis (FEA) has been used to finalize the module design. The thermal performance of an outer irradiated KB module has been measured at different cooling conditions. The thermal runaway of the module has been measured. The FEA model has been compared with the measurements and has been used to predict the thermal performance in a realistic SCT scenario.

Radiation damage status of the ATLAS silicon strip detectors (SCT)

CERN Document Server

Kondo, Takahiko; The ATLAS collaboration

2017-01-01

The Silicon microstrip detector system (SCT) of the ATLAS experiment at LHC has been working well for about 7 years since 2010. The innermost layer has already received a few times of 10**13 1-MeV neutron-equivalent fluences/cm2. The evolutions of the radiation damage effects on strip sensors such as leakage current and full depletion voltages will be presented.

SCT for severe autoimmune diseases: consensus guidelines of the European Society for Blood and Marrow Transplantation for immune monitoring and biobanking.

Science.gov (United States)

Alexander, T; Bondanza, A; Muraro, P A; Greco, R; Saccardi, R; Daikeler, T; Kazmi, M; Hawkey, C; Simoes, B P; Leblanc, K; Fibbe, W E; Moore, J; Snarski, E; Martin, T; Hiepe, F; Velardi, A; Toubert, A; Snowden, J A; Farge, D

2015-02-01

Over the past 15 years, SCT has emerged as a promising treatment option for patients with severe autoimmune diseases (ADs). Mechanistic studies recently provided the proof-of-concept that restoration of immunological tolerance can be achieved by haematopoietic SCT in chronic autoimmunity through eradication of the pathologic, immunologic memory and profound reconfiguration of the immune system, that is, immune 'resetting'. Nevertheless, a number of areas remain unresolved and warrant further investigation to refine our understanding of the underlying mechanisms of action and to optimize clinical SCT protocols. Due to the low number of patients transplanted in each centre, it is essential to adequately collect and analyse biological samples in a larger cohort of patients under standardized conditions. The European society for blood and marrow transplantation Autoimmune Diseases and Immunobiology Working Parties have, therefore, undertaken a joint initiative to develop and implement guidelines for 'good laboratory practice' in relation to procurement, processing, storage and analysis of biological specimens for immune reconstitution studies in AD patients before, during and after SCT. The aim of this document is to provide practical recommendations for biobanking of samples and laboratory immune monitoring in patients with ADs undergoing SCT, both for routine supportive care purposes and investigational studies.

SCT Barrel Assembly Complete

CERN Multimedia

L. Batchelor

As reported in the April 2005 issue of the ATLAS eNews, the first of the four Semiconductor Tracker (SCT) barrels, complete with modules and services, arrived safely at CERN in January of 2005. In the months since January, the other three completed barrels arrived as well, and integration of the four barrels into the entire barrel assembly commenced at CERN, in the SR1 building on the ATLAS experimental site, in July. Assembly was completed on schedule in September, with the addition of the innermost layer to the 4-barrel assembly. Work is now underway to seal the barrel thermal enclosure. This is necessary in order to enclose the silicon tracker in a nitrogen atmosphere and provide it with faraday-cage protection, and is a delicate and complicated task: 352 silicon module powertapes, 352 readout-fibre bundles, and over 400 Detector Control System sensors must be carefully sealed into the thermal enclosure bulkhead. The team is currently verifying the integrity of the low mass cooling system, which must be d...

Evaluating the construct validity of adult ADHD and SCT among college students: a multitrait-multimethod analysis of convergent and discriminant validity.

Science.gov (United States)

Leopold, Daniel R; Bryan, Angela D; Pennington, Bruce F; Willcutt, Erik G

2015-03-01

To advance our understanding of adult ADHD and sluggish cognitive tempo (SCT), the present study investigates their construct validity by exploring the nature of trait- and method-related variance in self- and parent-ratings of ADHD and SCT. Using a multitrait-multimethod (MTMM) design, response variance in college undergraduates' (n = 3,925) and a subset of their parents' (n = 2,242) ratings was decomposed into method, trait, and error-specific variance. Global evidence for convergent and discriminant validity was supported, but parameter-level comparisons suggest that method effects, situational specificity, and ADHD's core feature--inattention--are prominent. This investigation offers two important conclusions: (a) SCT appears to be a related but separate factor from ADHD; and (b) self- and parent-ratings of emerging adult ADHD exhibit low to moderate correlations and support the situational specificity hypothesis, suggesting that multiple raters should be consulted when assessing adult ADHD. Implications of these findings and recommendations for the continued study of SCT are discussed. © 2014 SAGE Publications.

Thermal performance of the Atlas SCT forward modules

CERN Document Server

Clark, A; Nasteva, I; Snow, S W; Wallny, R; Wilmut, I

2003-01-01

We describe the thermal design of the Atlas SCT forward modules and their cooling blocks. We report on the performance of the $C_3 F_8$ evaporative cooling system and the blocks alone, then on the performance of an irradiated inner module mounted on two alternative prototype cooling blocks (baseline and PEEK split). Runs are presented at different cooling conditions, representative of those expected to be used in the final experiment. We have also measured thermal runaway, with the module mounted on the PEEK split block and cooled with liquid cooling.

Vorinostat plus tacrolimus/methotrexate to prevent GVHD after myeloablative conditioning, unrelated donor HCT.

Science.gov (United States)

Choi, Sung Won; Braun, Thomas; Henig, Israel; Gatza, Erin; Magenau, John; Parkin, Brian; Pawarode, Attaphol; Riwes, Mary; Yanik, Greg; Dinarello, Charles A; Reddy, Pavan

2017-10-12

The oral histone deacetylase (HDAC) inhibitor (vorinostat) is safe and results in low incidence of acute graft-versus-host disease (GVHD) after reduced-intensity conditioning, related donor hematopoietic cell transplantation (HCT). However, its safety and efficacy in preventing acute GVHD in settings of heightened clinical risk that use myeloablative conditioning, unrelated donor (URD), and methotrexate are not known. We conducted a prospective, phase 2 study in this higher-risk setting. We enrolled 37 patients to provide 80% power to detect a significant difference in grade 2 to 4 acute GVHD of 50% compared with a reduction in target to 28%. Eligibility included adults with a hematological malignancy to receive myeloablative HCT from an available 8/8-HLA matched URD. Patients received GVHD prophylaxis with tacrolimus and methotrexate. Vorinostat (100 mg twice daily) was started on day -10 and continued through day +100 post-HCT. Median age was 56 years (range, 18-69 years), and 95% had acute myelogenous leukemia or high-risk myelodysplastic syndrome. Vorinostat was safe and tolerable. The cumulative incidence of grade 2 to 4 acute GVHD at day 100 was 22%, and for grade 3 to 4 it was 8%. The cumulative incidence of chronic GVHD was 29%; relapse, nonrelapse mortality, GVHD-free relapse-free survival, and overall survival at 1 year were 19%, 16%, 47%, and 76%, respectively. Correlative analyses showed enhanced histone (H3) acetylation in peripheral blood mononuclear cells and reduced interleukin 6 ( P = .028) and GVHD biomarkers (Reg3, P = .041; ST2, P = .002) at day 30 post-HCT in vorinostat-treated subjects compared with similarly treated patients who did not receive vorinostat. Vorinostat for GVHD prevention is an effective strategy that should be confirmed in a randomized phase 3 study. This trial was registered at www.clinicaltrials.gov as #NCT01790568. © 2017 by The American Society of Hematology.

T-cell chimerism is valuable in predicting early mortality in steroid-resistant acute graft-versus-host disease after myeloablative allogeneic cell transplantation

DEFF Research Database (Denmark)

Minculescu, Lia; Madsen, Hans O.; Sengeløv, Henrik

2014-01-01

The main aim of this study was to evaluate the impact of early T-cell chimerism status on the incidence and clinical course of acute graft-versus-host disease (aGVHD) in allogeneic transplant recipients after myeloablative conditioning. Of 62 patients, 38 (61%) had complete T-cell donor chimerism...

Screening and monitoring of MPL W515L mutation with real-time PCR in patients with myelofibrosis undergoing allogeneic-SCT.

Science.gov (United States)

Alchalby, H; Badbaran, A; Bock, O; Fehse, B; Bacher, U; Zander, A R; Kröger, N

2010-09-01

Monitoring of minimal residual disease (MRD) after allogeneic (allo)-SCT for myelofibrosis (MF) allows recognizing the depth of remission and thus guides application of appropriate therapeutic interventions. MPL W515L/K mutations, which are detected in 5-10% of JAK2V617F-negative patients, may be useful for this purpose. Using a highly sensitive quantitative PCR method, we tested 90 patients with MF who underwent allo-SCT for the presence of MPL W515L/K mutations. Two patients with primary MF were found to harbor MPLW515L while no patient was positive for MPLW515K mutation. Both patients were JAK2V617F negative and cleared the mutation rapidly after allo-SCT and remained negative for a median follow-up of 19 months. The results of molecular monitoring correlated well with other remission parameters such as normalization of peripheral blood counts and morphology and complete donor chimerism. We conclude that MPLW515L can be cleared after allo-SCT and hence may be used as an MRD marker in a proportion of JAK2V617F-negative MF patients.

SUPPORT CARD FOR THE FORWARD SCT MODULE

CERN Document Server

Greenall, A

2002-01-01

Previously in the development and testing stage of ATLAS SCT Forward modules support cards have been used which interface the module to the DAQ by using only the Redundant inputs for the module configuration and the 'spying' of the ABCD Master chip(s) data. As module development has matured there is now a necessity to be able to test modules in the laboratory using also their Primary input/output data routes i.e. using the optical chips DORIC [1] and VDC [2] but without the need of optical fibres. A Forward Kapton Support Card, FKSC, has been developed so that both Primary and Redundant data routes can be used for module testing.

Operational experience of ATLAS SCT and Pixel Detector

CERN Document Server

Kocian, Martin; The ATLAS collaboration

2017-01-01

The ATLAS Inner Detector based on silicon sensors is consisting of a strip detector (SCT) and a pixel detector. It is the crucial component for vertexing and tracking in the ATLAS experiment. With the excellent performance of the LHC well beyond the original specification the silicon tracking detectors are facing substantial challenges in terms of data acquisition, radiation damage to the sensors, and SEUs in the readout ASICs. The approaches on how the detector systems cope with the demands of high luminosity operation while maintaining excellent performance through hardware upgrades, software and firmware algorithms, and operational settings, are presented.

Immunoparesis and polyclonal immunoglobulin recovery after auto-SCT for patients with multiple myeloma treated at a single institution.

Science.gov (United States)

Jimenez-Zepeda, Victor H; Duggan, Peter; Neri, Paola; Chaudhry, Ahsan; Tay, Jason; Bahlis, Nizar

2017-11-21

Immunoparesis and polyclonal immunoglobulin recovery have been recently described as common indicators of immune dysfunction in patients with multiple myeloma. In the present study, we aimed to assess the impact of immunoparesis and polyclonal immunoglobulin recovery at day-100 post autologous stem cell transplant (auto-SCT) on clinical outcomes. A total of 302 patients were included for the analysis of immunoparesis, and 197 were evaluable for polyclonal immunoglobulin recovery evaluation. Immunoparesis was observed in 93.5% of cases, with 47% of cases having polyclonal immunoglobulin recovery at 12 months post auto-SCT. Median overall and progression-free survival were longer in the group of patients with complete or partial normalization of polyclonal immunoglobulins. Patients receiving consolidation had a lower level of polyclonal reconstitution. In conclusion, polyclonal immunoglobulin recovery by 12 months post-auto-SCT is associated with superior overall and progression free survival in patients with MM. Efforts to better enhance polyclonal recovery deserve further investigation.

Outcomes of adults with active or progressive hematological malignancies at the time of allo-SCT: a survey from the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC).

Science.gov (United States)

Chevallier, P; Labopin, M; Milpied, N; Bilger, K; Socié, G; Yakoub-Agha, I; Michallet, M; Bulabois, C-E; Maury, S; Beguin, Y; Bay, J-O; Blaise, D; Maillard, N; Guillerm, G; Daguindeau, E; Raus, N; Mohty, M

2014-03-01

Previous data suggested that allo-SCT might be an effective therapy in the setting of chemo-refractory/relapsed diseases because of the potent long-term immune-mediated tumor control. This retrospective study aimed to analyze the outcome of adult patients who received allo-SCT in a chemo-refractory/relapsed status. The series included 840 patients with active or progressive disease at the time of transplant. Median age was 50 years. With a median follow-up of 40 months, 3-year OS, disease-free survival (DFS), and non-relapse mortality rates were 29±2, 23±2, and 30±2%, respectively. At the last follow-up, 252 patients (30%) were still alive (of whom 201 were in CR (24%). In a Cox multivariate analysis, the use of a reduced-intensity conditioning (RIC) before allo-SCT and use of an HLA-identical sibling donor remained independently associated with a better OS (hazard ratio (HR)=0.82; 95% confidence interval (CI), 0.69-0.98, P=0.03; and HR=0.79; 95% CI, 0.66-0.93, P=0.006, respectively). Also, a diagnosis of myelodysplastic syndrome/myeloproliferative disorder, Hodgkin lymphoma and non-Hodgkin lymphoma compared with acute leukemia had a favorable impact on OS (HR=0.55; 95% CI, 0.45-0.68, PSCT may be of benefit in some subgroups of patients with active or progressive hematological malignancies at the time of allo-SCT.

NKp46 expression on NK cells as a prognostic and predictive biomarker for response to allo-SCT in patients with AML.

Science.gov (United States)

Chretien, Anne-Sophie; Devillier, Raynier; Fauriat, Cyril; Orlanducci, Florence; Harbi, Samia; Le Roy, Aude; Rey, Jérôme; Bouvier Borg, Gaelle; Gautherot, Emmanuel; Hamel, Jean-François; Ifrah, Norbert; Lacombe, Catherine; Cornillet-Lefebvre, Pascale; Delaunay, Jacques; Toubert, Antoine; Arnoulet, Christine; Vey, Norbert; Blaise, Didier; Olive, Daniel

2017-01-01

NKp46 is a major determinant of natural killer (NK) cell function and it is implicated in tumor immune surveillance in acute myeloid leukemia (AML). The purpose of this study was to investigate the prognostic significance of NKp46 expression in an independent cohort of patients with AML, and to investigate the impact of NKp46 on clinical outcome after allogeneic stem cell transplantation (allo-SCT). NKp46 expression was assessed at diagnosis on NK cells by flow cytometry (N = 180 patients). Clinical outcome was evaluated with regard to NKp46 expression. Patients with NKp46 high phenotype at diagnosis had better progression-free survival (PFS) and overall survival (OS) than patients with NKp46 low phenotype (74.3% vs. 46.6%, p = 0.014; 82.6% vs. 57.1%, p = 0.010, respectively). In multivariate analysis, high NKp46 was an independent factor for improved OS (HR = 0.409, p = 0.010) and PFS (HR = 0.335, p = 0.011). Subgroup analysis revealed that allo-SCT had a favorable impact on PFS in patients with NKp46 high phenotype ( p = 0.025). By contrast, allo-SCT did not impact PFS in patients with low NKp46 expression ( p = 0.303). In conclusion, we validate the prognostic value of NKp46 expression at diagnosis in AML. However, the prognostic value of NKp46 expression is limited to patients treated with allo-SCT, thus suggesting that NKp46 status may be predictive for allo-SCT responsiveness.

Early CD3+/CD15+ peripheral blood leukocyte chimerism patterns correlate with long-term engraftment in non-malignant hematopoietic SCT.

Science.gov (United States)

Ketterl, T G; Flesher, M; Shanley, R; Miller, W

2014-04-01

Following hematopoietic SCT (HSCT) for non-malignant disorders (NMDs) variable donor chimerism among lympho-hematopoietic lines may be observed. We retrospectively evaluated early post-HSCT, lineage-sorted (CD3+ and CD15+) peripheral blood leukocyte chimerism data to characterize patterns and assess for association with long-term CD15+ engraftment. 'Early' was defined as the first value obtained between days +14 and +42, 'late' as the last recorded value after day +90. 'High' donor chimerism was defined as 80% on either fraction at all time-points. Patients were classified into four subgroups with respect to early CD3+/CD15+ chimerism patterns (high/low) then analyzed for long-term CD15+ chimerism status. A total of 135 transplants were evaluable, with all three time-points available in 97. Underlying disease, graft source, patient age and conditioning intensity varied. 'Split' early chimerism (discordant high/low CD3+/CD15+ status) was common. Multivariable analysis revealed strong association between conditioning regimen and primary disease on early CD3+/CD15+ chimerism patterns and a dominant predictive effect of early CD15+ chimerism on long-term CD15+ donor engraftment (observed at median day +365). These data may guide real-time clinician decisions (restraint vs intervention, when available) when faced with unfavorable or unusual early lympho-hematopoietic chimerism patterns following HSCT for NMD.

Total dose effects on ATLAS-SCT front-end electronics

CERN Document Server

Ullán, M; Dubbs, T; Grillo, A A; Spencer, E; Seiden, A; Spieler, H; Gilchriese, M G D; Lozano, M

2002-01-01

Low dose rate effects (LDRE) in bipolar technologies complicate the hardness assurance testing for high energy physics applications. The damage produced in the ICs in the real experiment can be underestimated if fast irradiations are carried out, while experiments done at the real dose rate are usually unpractical due to the still high total doses involved. In this work the sensitivity to LDRE of two bipolar technologies proposed for the ATLAS-SCT experiment at CERN is evaluated, finding one of them free of those effects. (12 refs).

Comparative genomics and transcriptome analysis of Lactobacillus rhamnosus ATCC 11443 and the mutant strain SCT-10-10-60 with enhanced L-lactic acid production capacity.

Science.gov (United States)

Sun, Liang; Lu, Zhilong; Li, Jianxiu; Sun, Feifei; Huang, Ribo

2018-02-01

Mechanisms for high L-lactic acid production remain unclear in many bacteria. Lactobacillus rhamnosus SCT-10-10-60 was previously obtained from L. rhamnosus ATCC 11443 via mutagenesis and showed improved L-lactic acid production. In this study, the genomes of strains SCT-10-10-60 and ATCC 11443 were sequenced. Both genomes are a circular chromosome, 2.99 Mb in length with a GC content of approximately 46.8%. Eight split genes were identified in strain SCT-10-10-60, including two LytR family transcriptional regulators, two Rex redox-sensing transcriptional repressors, and four ABC transporters. In total, 60 significantly up-regulated genes (log 2 fold-change ≥ 2) and 39 significantly down-regulated genes (log 2 fold-change ≤ - 2) were identified by a transcriptome comparison between strains SCT-10-10-60 and ATCC 11443. KEGG pathway enrichment analysis revealed that "pyruvate metabolism" was significantly different (P < 0.05) between the two strains. The split genes and the differentially expressed genes involved in the "pyruvate metabolism" pathway are probably responsible for the increased L-lactic acid production by SCT-10-10-60. The genome and transcriptome sequencing information and comparison of SCT-10-10-60 with ATCC 11443 provide insights into the anabolism of L-lactic acid and a reference for improving L-lactic acid production using genetic engineering.

AUTOLOGOUS STEM CELL TRANSPLANTATION FOR CHRONIC LYMPHOCYTIC LEUKEMIA STILL A VALID TREATMENT OPTION, OR IS THE GAME OVER ?

Directory of Open Access Journals (Sweden)

Fabienne McClanahan

2012-01-01

Full Text Available

Chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab (FCR has been established as the current standard of care for young and fit patients with chronic lymphocytic leukemia (CLL. In the early nineties of the last century, long before the advent of fludarabine or antibody-based strategies, there was realistic hope that myeloablative therapy followed by autologous stem cell transplantation (autoSCT might be an effective and potentially curative front-line treatment option for suitable patients with CLL. Since then, several prospective trials have disenthralled this hope: although autoSCT can prolong event and progression-free survival if used as part of early front-line treatment, it does not improve overall survival, while it is associated with an increased risk of late adverse events such as secondary malignancies. In addition, autoSCT lacks the potential to overcome the negative impact of biomarkers that confer resistance to chemotherapy or early relapse. The role of autoSCT has also been explored in the context of FCR, and it was demonstrated that its effect is inferior to the currently established optimal treatment regimen. In view of ongoing attempts to improve on FCR, promising clinical activity of new substances even in relapsed/ refractory CLL patients, exciting novel cell therapy approaches and advantages in the understanding of the disease and detection of Minimal Residual Disease (MRD, autoSCT has lost its place as a standard treatment option for CLL.

AUTOLOGOUS STEM CELL TRANSPLANTATION FOR CHRONIC LYMPHOCYTIC LEUKEMIA STILL A VALID TREATMENT OPTION, OR IS THE GAME OVER ?

Directory of Open Access Journals (Sweden)

Fabienne McClanahan

2012-11-01

Full Text Available Chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab (FCR has been established as the current standard of care for young and fit patients with chronic lymphocytic leukemia (CLL. In the early nineties of the last century, long before the advent of fludarabine or antibody-based strategies, there was realistic hope that myeloablative therapy followed by autologous stem cell transplantation (autoSCT might be an effective and potentially curative front-line treatment option for suitable patients with CLL. Since then, several prospective trials have disenthralled this hope: although autoSCT can prolong event and progression-free survival if used as part of early front-line treatment, it does not improve overall survival, while it is associated with an increased risk of late adverse events such as secondary malignancies. In addition, autoSCT lacks the potential to overcome the negative impact of biomarkers that confer resistance to chemotherapy or early relapse. The role of autoSCT has also been explored in the context of FCR, and it was demonstrated that its effect is inferior to the currently established optimal treatment regimen. In view of ongoing attempts to improve on FCR, promising clinical activity of new substances even in relapsed/ refractory CLL patients, exciting novel cell therapy approaches and advantages in the understanding of the disease and detection of Minimal Residual Disease (MRD, autoSCT has lost its place as a standard treatment option for CLL.

Efficacy of cisplatin-based immunochemotherapy plus alloSCT in high-risk chronic lymphocytic leukemia : final results of a prospective multicenter phase 2 HOVON study

NARCIS (Netherlands)

van Gelder, M.; van Oers, M. H.; Alemayehu, W. G.; Abrahamse-Testroote, M. C. J.; Cornelissen, J. J.; Chamuleau, M. E.; Zachee, P.; Hoogendoorn, M.; Nijland, M.; Petersen, E. J.; Beeker, A.; Timmers, G-J; Verdonck, L.; Westerman, M.; de Weerdt, O.; Kater, A. P.

Allogeneic stem cell transplantation (alloSCT) remains the only curative option for CLL patients. Whereas active disease at the time of alloSCT predicts poor outcome, no standard remission-induction regimen exists. We prospectively assessed outcome after cisplatin-containing immune-chemotherapy

Myeloablative temozolomide enhances CD8⁺ T-cell responses to vaccine and is required for efficacy against brain tumors in mice.

Directory of Open Access Journals (Sweden)

Luis A Sanchez-Perez

Full Text Available Temozolomide (TMZ is an alkylating agent shown to prolong survival in patients with high grade glioma and is routinely used to treat melanoma brain metastases. A prominent side effect of TMZ is induction of profound lymphopenia, which some suggest may be incompatible with immunotherapy. Conversely, it has been proposed that recovery from chemotherapy-induced lymphopenia may actually be exploited to potentiate T-cell responses. Here, we report the first demonstration of TMZ as an immune host-conditioning regimen in an experimental model of brain tumor and examine its impact on antitumor efficacy of a well-characterized peptide vaccine. Our results show that high-dose, myeloablative (MA TMZ resulted in markedly reduced CD4(+, CD8(+ T-cell and CD4(+Foxp3(+ TReg counts. Adoptive transfer of naïve CD8(+ T cells and vaccination in this setting led to an approximately 70-fold expansion of antigen-specific CD8(+ T cells over controls. Ex vivo analysis of effector functions revealed significantly enhanced levels of pro-inflammatory cytokine secretion from mice receiving MA TMZ when compared to those treated with a lower lymphodepletive, non-myeloablative (NMA dose. Importantly, MA TMZ, but not NMA TMZ was uniquely associated with an elevation of endogenous IL-2 serum levels, which we also show was required for optimal T-cell expansion. Accordingly, in a murine model of established intracerebral tumor, vaccination-induced immunity in the setting of MA TMZ-but not lymphodepletive, NMA TMZ-led to significantly prolonged survival. Overall, these results may be used to leverage the side-effects of a clinically-approved chemotherapy and should be considered in future study design of immune-based treatments for brain tumors.

Thiotepa-based versus total body irradiation-based myeloablative conditioning prior to allogeneic stem cell transplantation for acute myeloid leukaemia in first complete remission: a retrospective analysis from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation.

Science.gov (United States)

Eder, Sandra; Labopin, Myriam; Arcese, William; Or, Reuven; Majolino, Ignazio; Bacigalupo, Andrea; de Rosa, Gennaro; Volin, Liisa; Beelen, Dietrich; Veelken, Hendrik; Schaap, Nicolaas P M; Kuball, Jurgen; Cornelissen, Jan; Nagler, Arnon; Mohty, Mohamad

2016-01-01

Thiotepa is an alkylating compound with an antineoplastic and myeloablative activity and can mimic the effect of radiation. However, it is unknown whether this new regimen could safely replace the long-established ones. This retrospective matched-pair analysis evaluated the outcome of adults with acute myeloid leukaemia in first complete remission who received myeloablative conditioning either with a thiotepa-based (n = 121) or a cyclophosphamide/total body irradiation-based (TBI; n = 358) regimen for allogeneic hematopoietic stem cell transplantation from an HLA-matched sibling or an unrelated donor. With a median follow-up of 44 months, the outcome was similar in both groups. Acute graft-versus-host disease grade II-IV was observed in 25% after thiotepa-containing regimen versus 35% after TBI (P = 0.06). The 2-yr cumulative incidence of chronic graft-versus-host disease was 40.5% for thiotepa and 41% for TBI (P = 0.98). At 2 yrs, the cumulative incidences of non-relapse mortality and relapse incidence were 23.9% (thiotepa) vs. 22.4% (TBI; P = 0.66) and 17.2% (thiotepa) vs. 23.3% (TBI; P = 0.77), respectively. The probabilities of leukaemia-free and overall survival at 2 yrs were not significantly different between the thiotepa and TBI groups, at 58.9% vs. 54.2% (P = 0.95) and 61.4% vs. 58% (P = 0.72), respectively. Myeloablative regimens using combinations including thiotepa can provide satisfactory outcomes, but the optimal conditioning remains unclear for the individual patient in this setting. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Efficacy and safety of micafungin for prophylaxis of invasive fungal infections in patients undergoing haplo-identical hematopoietic SCT.

Science.gov (United States)

El-Cheikh, J; Venton, G; Crocchiolo, R; Fürst, S; Faucher, C; Granata, A; Oudin, C; Coso, D; Bouabdallah, R; Vey, N; Duran, S; Fougereau, E; Berger, P; Chabannon, C; Blaise, D

2013-11-01

Invasive fungal infections (IFIs) such as candidiasis and mold infections have caused significant morbidity and mortality among immunocompromised patients in recent years. Micafungin, a new echinocandin, inhibits fungal cell wall β-glucan synthesis, with potent activity against most species of Candida and Aspergillus. The aim of this observational study was to investigate the efficacy and safety of micafungin in prophylaxis of IFIs in 26 high-risk adult patients with various hematological diseases receiving haplo-identical Allo-SCT. Only two patients had a history of possible aspergillosis before transplant treated by voriconazole. The patients received a median of four lines (2-7) of treatment before Allo-SCT. Thirteen patients (50%) received at least one prior Auto-SCT; and eight patients (31%) received a previous Allo-SCT. Patients received a median of 29 infusions (range, 15-85) of micafungin (50 mg/day i.v. as a 1-h infusion). The treatment was initiated at the beginning of the transplant conditioning regimen until the hospital discharge. None of our patients discontinued the treatment for drug-related adverse events. Micafungin was not associated with any hepatotoxicity. Only one patient (4%) discontinued the treatment because of early disease progression. In all patients no Candida and/or Aspergillus species was documented after 3 and 6 months from transplant. None of our patients presented a positive galactomannan antigenemia >0.5. Nine patients (35%) presented a CMV reactivation. Four patients presented an acute GVHD grade II and two patients presented a chronic GVHD. The median follow-up was 11 months (3-23). At the last follow-up, there were 20 patients (77%) who were alive; four patients (12%) died because of disease progression and two patients because of graft failure. Micafungin has a good safety and tolerability profile, with an efficacy in preventing IFI in this high-risk population. Our data provide support for an efficacy study in a

Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

DEFF Research Database (Denmark)

Uhlving, H H; Buchvald, F; Heilmann, C J

2012-01-01

Bronchiolitis obliterans (BO) following allogeneic haematopoietic SCT (HSCT) is a serious complication affecting 1.7-26% of the patients, with a reported mortality rate of 21-100%. It is considered a manifestation of chronic graft-versus-host disease, but our knowledge of aetiology and pathogenes...... treatment options for BO and presents the treatment results with HDPM in a paediatric national HSCT-cohort.Bone Marrow Transplantation advance online publication, 29 August 2011; doi:10.1038/bmt.2011.161....

ALLOGENEIC TRANSPLANTATION FOR CHRONIC LYMPHOCYTIC LEUKEMIA

Directory of Open Access Journals (Sweden)

Patrizia Chiusolo

2010-05-01

Full Text Available

Even if Chronic lymphocytic leukemia (CLL often has an indolent behavior with good responsiveness to cytoreductive treatment, about 20% of the patients, so called "poor-risk" patients, show an aggressive course and die within a few years despite early intensive therapies. Criteria for poor-risk disease according to the European Bone Marrow Transplantation (EBMT CLL Transplant Consensus are: purine analogue refractoriness, early relapse after purine analogue combination therapy, CLL with p53 lesion requiring treatment.

Allogeneic transplant has potential curative role in CLL, however burden with very  high transplant related mortality (TRM rates of 38-50%:

A major advance in reducing the short-term morbidity and mortality of allogeneic stem cell transplantation (SCT has been the introduction of non-myeloablative or reduced intensity conditioning (RIC regimens to allow engraftment of allogeneic stem cells. There is no doubt that the crucial therapeutic principle of allo-SCT in CLL is graft versus leukemia (GVL activity.

The major complications of allogeneic SCT in CLL are: chronic graft-versus-host-disease (GVHD affecting quality of life, high graft rejection and infection rates rates correlated with preexisting immunosuppression. Disease relapse remains the major cause of failure after RIC allo-HCT in CLL patients.

Sensitive minimal residual disease (MRD quantification has strong prognostic impact after transplant.

(Non-)utilization of pre-hospital emergency care by migrants and non-migrants in Germany.

Science.gov (United States)

Kietzmann, Diana; Knuth, Daniela; Schmidt, Silke

2017-01-01

This study was designed to explore the utilization and non-utilization of pre-hospital emergency care by migrants and non-migrants, and the factors that influence this behaviour. A cross-sectional representative German survey was conducted in a sample of 2.175 people, 295 of whom had a migration background. An additional sample of 50 people with Turkish migration background was conducted, partially in the Turkish language. Apart from socio-demographics, the utilization of emergency services and the reasons for non-utilization were assessed. Migrants had a higher utilization rate of pre-hospital emergency care (RR = 1.492) than non-migrants. Furthermore, migrants who were not born in Germany had a lower utilization rate (RR = 0.793) than migrants who were born in Germany. Regarding non-utilization, the most frequently stated reasons belonged to the categories initial misjudgment of the emergency situation and acting on one's own behalf, with the latter stated more frequently by migrants than by non-migrants. To prevent over-, under-, and lack of supply, it is necessary to transfer knowledge about the functioning of the medical emergency services, including first aid knowledge.

Auto-SCT induces a phenotypic shift from CMP to GMP progenitors, reduces clonogenic potential and enhances in vitro and in vivo cycling activity defined by (18)F-FLT PET scanning.

Science.gov (United States)

Woolthuis, C; Agool, A; Olthof, S; Slart, R H J A; Huls, G; Smid, W M; Schuringa, J J; Vellenga, E

2011-01-01

Autologous SCT (auto-SCT) introduces a reduced tolerance to chemotherapy even in patients with adequate engraftment, suggesting long-term effects of the transplantation procedure on the BM capacity. To study the hematopoietic cell compartment after auto-SCT, CD34(+) BM cells (n = 16) from patients at 6-9 months after auto-SCT were studied with regard to the progenitor subsets, colony frequency and cell cycle status. The BM compartments were studied in vivo using PET tracer 3-fluoro-3-deoxy-L-thymidine (¹⁸F-FLT PET). BM CD34(+) cells after auto-SCT were compared with normal CD34(+) cells and showed a phenotypic shift from common myeloid progenitor (CMP mean percentage 3.7 vs 19.4%, P=0.001) to granulocyte-macrophage progenitor (GMP mean percentage 51.8 vs 27.6%, P=0.01). In addition, a reduced clonogenic potential and higher cycling activity especially of the GMP fraction (41% ± 4 in G2/S phase vs 19% ± 2, P = 0.03) were observed in BM after auto-SCT compared with normal. The enhanced cycling activity was confirmed in vivo by showing a significantly higher uptake of the ¹⁸F-FLT PET tracer by the BM compartment. This study shows that auto-SCT results in defects of the hematopoietic compartment at least 6 months after auto-SCT, characterized by changes in the composition of progenitor subsets and enhanced in vitro and in vivo cycling activity.

High-dose myeloablative versus conventional low-dose radioimmunotherapy (RIT) of mantle cell lymphoma (MCL) with the chimeric anti-CD20 antibody C2B8

International Nuclear Information System (INIS)

Behr, T.M.; Gotthardt, M.; Schipperm, M.L.; Gratz, S.; Behe, M.P.; Brittinger, G.; Woermann, B.; Becker, W.

2002-01-01

CD20 has been used as target molecule for low-dose as well as high-dose, myeloablative RIT of B-cell NHL. MCL is an especially aggressive, prognostically unfavorable form of B-cell NHL. The aim of this study was to investigate whether high-dose, myeloablative RIT with the 131 I-labeled chimeric anti-CD20 antibody C2B8 (rituxan, Mabthera, Roche) may be therapeutically more effective than conventional low-dose therapy in MCL. A total of twelve patients with chemorefractory or relapsed mantle cell lymphoma were studied so far (all of them having relapsed after high-dose chemotherapy, seven of them combined with 12 Gy TBI). A diagnostic-dosimetric study was performed with 10 mCi of 131 I-C2B8 at a protein dose of 2.5 mg/kg. In case of splenic pooling, the protein dose was increased until a more 'favorable' biodistribution was obtained. Therapy was performed with conventional (30-75 mCi; n=4) or myeloablative activities (261-515 mCi; n=8) of 131 I-C2B8 at the previously optimized protein dose, aiming at whole-body doses of ≤ 0.8 Gy (for low-dose RIT) or lung doses of ≤ 27 Gy (for high-dose RIT). Clinical follow-up was obtained for up to 42 months. Overall, in 11 patients the 2.5 mg/kg protein dose was used, whereas in one patient with marked splenomegaly, 10 mg/kg were necessary to overcome the splenic antigenic sink. In the high-dose patients, non-hematologic toxicity was restricted to mild to moderate nausea, fever, transient bilirubin or liver enzyme elevations. Despite thyroid blocking, 6/8 high-dose (in contrast to 0/4 low-dose) patients developed hypothyroidism, requiring thyroxine substitution at 6-18 months after RIT. The response rate in the low-dose arm was only 1(PR)/4, whereas 7/8 high-dose patients experienced complete and the remainder a partial remission. 6 high-dose patients are still in CR (one of them relapsed locally at 3 months, one systemically at 26 months after RIT), and 7 are still alive for up to 42+ months. In contrast to low-dose therapy

Laser characterisation of a 3D single-type column p-type prototype module read out with ATLAS SCT electronics

International Nuclear Information System (INIS)

Ehrich, T.; Kuehn, S.; Boscardin, M.; Dalla Betta, G.-F.; Eckert, S.; Jakobs, K.; Maassen, M.; Parzefall, U.; Piemonte, C.; Pozza, A.; Ronchin, S.; Zorzi, N.

2007-01-01

In this paper measurements of a 3D single-type column (3D-stc) microstrip silicon device are shown. The 3D-stc sensor has n-type columns in p-type substrate. It has been connected to an ATLAS SCT ABCD3T chip and is readout with ATLAS SCT electronics at 40 MHz. Spatial measurements were done with a laser setup to investigate the expected low field region in 3D devices. An influence of the p-stops on the collected charge has been observed

Laser characterisation of a 3D single-type column p-type prototype module read out with ATLAS SCT electronics

Energy Technology Data Exchange (ETDEWEB)

Ehrich, T. [Physikalisches Institut, Universitaet Freiburg, Hermann-Herder Str. 3, 79104 Freiburg (Germany); Kuehn, S. [Physikalisches Institut, Universitaet Freiburg, Hermann-Herder Str. 3, 79104 Freiburg (Germany)], E-mail: susanne.kuehn@physik.uni-freiburg.de; Boscardin, M.; Dalla Betta, G.-F. [ITC-irst Trento, Microsystems Division, via Sommarive, 18 38050 Povo di Trento (Italy); Eckert, S.; Jakobs, K.; Maassen, M.; Parzefall, U. [Physikalisches Institut, Universitaet Freiburg, Hermann-Herder Str. 3, 79104 Freiburg (Germany); Piemonte, C.; Pozza, A.; Ronchin, S.; Zorzi, N. [ITC-irst Trento, Microsystems Division, via Sommarive, 18 38050 Povo di Trento (Italy)

2007-12-11

In this paper measurements of a 3D single-type column (3D-stc) microstrip silicon device are shown. The 3D-stc sensor has n-type columns in p-type substrate. It has been connected to an ATLAS SCT ABCD3T chip and is readout with ATLAS SCT electronics at 40 MHz. Spatial measurements were done with a laser setup to investigate the expected low field region in 3D devices. An influence of the p-stops on the collected charge has been observed.

BK Virus-Hemorrhagic Cystitis Following Allogeneic Stem Cell Transplantation: Clinical Characteristics and Utility of Leflunomide Treatment

Directory of Open Access Journals (Sweden)

Young Hoon Park

2016-08-01

Full Text Available Objective: BK virus-hemorrhagic cystitis (BKV-HC is a potential cause of morbidity and mortality in patients having undergone allogeneic stem cell transplantation (Allo-SCT. We analyzed the clinical features of BKV-HC following Allo-SCT and reported the utility of leflunomide therapy for BKV-HC. Materials and methods: From January 2005 to June 2014, among the 69 patients underwent Allo-SCT in our institution, the patients who experienced BKV-HC were investigated retrospectively. Results: Hemorrhagic cystitis (HC was observed in 30 patients (43.5%, and among them, 18 patients (26.1% were identified as BKV-HC. The median age of the patients (12 males and 6 females was 45 years (range, 13-63. Patients received Allo-SCT from acute myeloid leukemia (n=11, aplastic anemia (n=4, myelodysplastic syndrome (n=2, and non-Hodgkin lymphoma (n=1.The donor types were a HLA-matched sibling donor for 6 patients, HLA-matched unrelated donor for 9, and a haploidentical familial donor for 2. The median onset and duration of BKV-HC was on day 21 (range, 7-97 after transplantation and 22 days (range, 6-107. Eleven patients (62.1% had grade I-II HC and seven patients (38.9% had grade III-IV (high-grade HC. Among the seven patients who had high-grade HC, one had complete response (CR, one partial response (PR, and five no response (NR. Among the five non-responders, one died of BKV-HC associated complications. The remaining four patients were treated with leflunomide, with achieving CR (n=2 and PR (n=2. The median duration from the start of leflunomide therapy to response was 13 days (range, 8–17 days. All patients tolerated the leflunomide treatment well, with three patients having mild gastrointestinal symptoms, including anorexia and abdominal bloating. Conclusion: BKV-HC was commonly observed in patients with HC following Allo-SCT. In high-grade BKV-HC patients who fail supportive care, leflunomide may be a feasible option without significant toxicity. Materials

Optimal pricing of non-utility generated electric power

International Nuclear Information System (INIS)

Siddiqi, S.N.; Baughman, M.L.

1994-01-01

The importance of an optimal pricing policy for pricing non-utility generated power is pointed out in this paper. An optimal pricing policy leads to benefits for all concerned: the utility, industry, and the utility's other customers. In this paper, it is shown that reliability differentiated real-time pricing provides an optimal non-utility generated power pricing policy, from a societal welfare point of view. Firm capacity purchase, and hence an optimal price for purchasing firm capacity, are an integral part of this pricing policy. A case study shows that real-time pricing without firm capacity purchase results in improper investment decisions and higher costs for the system as a whole. Without explicit firm capacity purchase, the utility makes greater investment in capacity addition in order to meet its reliability criteria than is socially optimal. It is concluded that the non-utility generated power pricing policy presented in this paper and implied by reliability differentiated pricing policy results in social welfare-maximizing investment and operation decisions

Allogeneic stem cell transplantation for thalassemia major in India

Directory of Open Access Journals (Sweden)

Vikram Mathews

2017-12-01

Full Text Available Allogeneic stem cell transplantation (allo-SCT is the only currently available curative treatment for thalassemia major. Since it was first done in 1981, several thousand patients have benefited from it and it is now possible to offer this treatment in different parts of the world with good results. With better risk stratification and supportive care, the results of allo-SCT are now very good even in high risk patients who have significant iron overload related organ dysfunction. The improvements have mainly been in the conditioning strategies with less toxic myeloablation and management of the complications of SCT. However, several challenges remain. Transplant related complications still cause significant morbidity and mortality. There is data to show that the results of transplantation as best if done in well transfused and chelated patients <7 years of age. As only a third of the patients will have a matched related donor, there is need for investigating SCT with alternative donors. Experience with SCT for thalassemia major from matched unrelated donors or haplo-identical donors is still limited but needs further exploration. Adequate management needs to be provided post-SCT for all pre-existing complications particularly iron chelation to prevent further organ dysfunction. Systematic follow-up is needed to measure long term outcomes. The biggest challenges in India are the cost of this treatment and access to centres capable of providing this treatment. With greater support from the government, health insurance and philanthropic programs, there has been a rapid increase in the number of SCTs for thalassemia major in India. The number centres providing this treatment are also increasing making this curative treatment more widely available in India.

Continuing ARAS visible spectroscopic monitoring of the slow classical nova Sct 2017 = ASASSN-17hx

Science.gov (United States)

Guarro, Joan; Berardi, Paolo; Sollecchia, Umberto; Lester, Tim; Bohlsen, Terry; Luckas, Paul; Campos, Fran; Franco, Lorenzo; Garde, Olivier; Buil, Christian; Edlin, Jim; Teyssier, François

2017-09-01

We report the results of our continuing spectroscopic monitoring of the slow classical nova Sct 2017 = ASASSN-17hx (Atel# 10523, #10524, #10527, #10558, #10736) as part of the ongoing program by members of the ARAS group.

Amplitude Modulation in the δ Sct star KIC 7106205

Directory of Open Access Journals (Sweden)

Bowman Dominic. M.

2015-01-01

Full Text Available The δ Sct star KIC 7106205 showed amplitude modulation in a single p mode, whilst all other p and g modes remained stable in amplitude and phase over 1470 d of the Kepler dataset. The data were divided into 30 time bins of equal length and a series of consecutive Fourier transforms was calculated. A fixed frequency, calculated from a least-squares fit of all data, allowed amplitude and phase for every mode in each time bin to be tracked. The missing p mode energy was not transferred to any other visible modes.

Allo-SCT for  Philadelphia-negative myeloproliferative neoplasms in blast phase: a study from the Societe Française de Greffe de Moelle et de Therapie Cellulaire (SFGM-TC).

Science.gov (United States)

Cahu, X; Chevallier, P; Clavert, A; Suarez, F; Michallet, M; Vincent, L; Vigouroux, S; Blaise, D; Mariette, C; Bilger, K; Robin, M; Yakoub-Agha, I; Peffault de Latour, R; Mohty, M

2014-06-01

Progression of Philadelphia-negative myeloproliferative (MPN) or myelodysplastic/myeloproliferative neoplasms (MDS/MPN) to acute myeloid leukemia (AML) is an adverse event in the course of the disease. Although allogeneic hematopoietic SCT (allo-SCT) is considered as the only curative therapy, few data exist on the outcome of patients with Philadelphia-negative MPN or MDS/MPN in blast phase who received an allo-SCT. Sixty patients were included in this retrospective study. AML was secondary to an MPN in 43 cases, whereas AML evolved from an MDS/MPN in 17 cases. Patients received allo-SCT in CR or advanced disease in 26 cases and 34 cases, respectively. With a median follow-up of 31 months (range, 25-44), OS and leukemia-free survival (LFS) were, respectively, 18% and 9% at 3 years. CR at transplant was associated with an improved LFS in univariate and multivariate analysis. The 3-year LFS was 18% for patients undergoing allo-SCT in CR versus 3% in advanced disease (P=0.008). Absence of thrombosis and an intermediate or favorable AML karyotype were associated with an improved outcome for patients who received allo-SCT in CR. New strategies are needed to improve the outcome of patients with MPN-MDS/MPN in blast phase.

Beam tests of ATLAS SCT silicon strip detector modules

CERN Document Server

Campabadal, F; Key, M; Lozano, M; Martínez, C; Pellegrini, G; Rafí, J M; Ullán, M; Johansen, L; Pommeresche, B; Stugu, B; Ciocio, A; Fadeev, V; Gilchriese, M G D; Haber, C; Siegrist, J; Spieler, H; Vu, C; Bell, P J; Charlton, D G; Dowell, John D; Gallop, B J; Homer, R J; Jovanovic, P; Mahout, G; McMahon, T J; Wilson, J A; Barr, A J; Carter, J R; Fromant, B P; Goodrick, M J; Hill, J C; Lester, C G; Palmer, M J; Parker, M A; Robinson, D; Sabetfakhri, A; Shaw, R J; Anghinolfi, F; Chesi, Enrico Guido; Chouridou, S; Fortin, R; Grosse-Knetter, J; Gruwé, M; Ferrari, P; Jarron, P; Kaplon, J; MacPherson, A; Niinikoski, T O; Pernegger, H; Roe, S; Rudge, A; Ruggiero, G; Wallny, R; Weilhammer, P; Bialas, W; Dabrowski, W; Grybos, P; Koperny, S; Blocki, J; Brückman, P; Gadomski, S; Godlewski, J; Górnicki, E; Malecki, P; Moszczynski, A; Stanecka, E; Stodulski, M; Szczygiel, R; Turala, M; Wolter, M; Ahmad, A; Benes, J; Carpentieri, C; Feld, L; Ketterer, C; Ludwig, J; Meinhardt, J; Runge, K; Mikulec, B; Mangin-Brinet, M; D'Onofrio, M; Donega, M; Moêd, S; Sfyrla, A; Ferrère, D; Clark, A G; Perrin, E; Weber, M; Bates, R L; Cheplakov, A P; Saxon, D H; O'Shea, V; Smith, K M; Iwata, Y; Ohsugi, T; Kohriki, T; Kondo, T; Terada, S; Ujiie, N; Ikegami, Y; Unno, Y; Takashima, R; Brodbeck, T; Chilingarov, A G; Hughes, G; Ratoff, P; Sloan, T; Allport, P P; Casse, G L; Greenall, A; Jackson, J N; Jones, T J; King, B T; Maxfield, S J; Smith, N A; Sutcliffe, P; Vossebeld, Joost Herman; Beck, G A; Carter, A A; Lloyd, S L; Martin, A J; Morris, J; Morin, J; Nagai, K; Pritchard, T W; Anderson, B E; Butterworth, J M; Fraser, T J; Jones, T W; Lane, J B; Postranecky, M; Warren, M R M; Cindro, V; Kramberger, G; Mandic, I; Mikuz, M; Duerdoth, I P; Freestone, J; Foster, J M; Ibbotson, M; Loebinger, F K; Pater, J; Snow, S W; Thompson, R J; Atkinson, T M; Bright, G; Kazi, S; Lindsay, S; Moorhead, G F; Taylor, G N; Bachindgagyan, G; Baranova, N; Karmanov, D; Merkine, M; Andricek, L; Bethke, Siegfried; Kudlaty, J; Lutz, Gerhard; Moser, H G; Nisius, R; Richter, R; Schieck, J; Cornelissen, T; Gorfine, G W; Hartjes, F G; Hessey, N P; de Jong, P; Muijs, A J M; Peeters, S J M; Tomeda, Y; Tanaka, R; Nakano, I; Dorholt, O; Danielsen, K M; Huse, T; Sandaker, H; Stapnes, S; Bargassa, Pedrame; Reichold, A; Huffman, T; Nickerson, R B; Weidberg, A; Doucas, G; Hawes, B; Lau, W; Howell, D; Kundu, N; Wastie, R; Böhm, J; Mikestikova, M; Stastny, J; Broklová, Z; Broz, J; Dolezal, Z; Kodys, P; Kubík, P; Reznicek, P; Vorobel, V; Wilhelm, I; Chren, D; Horazdovsky, T; Linhart, V; Pospísil, S; Sinor, M; Solar, M; Sopko, B; Stekl, I; Ardashev, E N; Golovnya, S N; Gorokhov, S A; Kholodenko, A G; Rudenko, R E; Ryadovikov, V N; Vorobev, A P; Adkin, P J; Apsimon, R J; Batchelor, L E; Bizzell, J P; Booker, P; Davis, V R; Easton, J M; Fowler, C; Gibson, M D; Haywood, S J; MacWaters, C; Matheson, J P; Matson, R M; McMahon, S J; Morris, F S; Morrissey, M; Murray, W J; Phillips, P W; Tyndel, M; Villani, E G; Dorfan, D E; Grillo, A A; Rosenbaum, F; Sadrozinski, H F W; Seiden, A; Spencer, E; Wilder, M; Booth, P; Buttar, C M; Dawson, I; Dervan, P; Grigson, C; Harper, R; Moraes, A; Peak, L S; Varvell, K E; Chu Ming Lee; Hou Li Shing; Lee Shih Chang; Teng Ping Kun; Wan Chang Chun; Hara, K; Kato, Y; Kuwano, T; Minagawa, M; Sengoku, H; Bingefors, N; Brenner, R; Ekelöf, T J C; Eklund, L; Bernabeu, J; Civera, J V; Costa, M J; Fuster, J; García, C; García, J E; González-Sevilla, S; Lacasta, C; Llosa, G; Martí i García, S; Modesto, P; Sánchez, J; Sospedra, L; Vos, M; Fasching, D; González, S; Jared, R C; Charles, E

2005-01-01

The design and technology of the silicon strip detector modules for the Semiconductor Tracker (SCT) of the ATLAS experiment have been finalised in the last several years. Integral to this process has been the measurement and verification of the tracking performance of the different module types in test beams at the CERN SPS and the KEK PS. Tests have been performed to explore the module performance under various operating conditions including detector bias voltage, magnetic field, incidence angle, and state of irradiation up to 3 multiplied by 1014 protons per square centimetre. A particular emphasis has been the understanding of the operational consequences of the binary readout scheme.

Finite Element calculations of heat transfer for Forward SCT ModulesPart I - the Outer Module

CERN Document Server

Blocki, J; Perrin, E

2000-01-01

A status report on the thermal performance of the baseline SCT forward modules is presented. Possible design changes of the outer module which lead to significant improvements of the thermal characteristics of the module are indicated, in the context of a 2-point cooling scheme.

First SCT Barrel arrives at CERN

CERN Multimedia

Apsimon, R

Mid-January saw the arrival at CERN of Barrel #3, the first of four SCT barrels. The barrels are formed as low-mass cylinders of carbon fibre skins on a honeycomb carbon core. They are manufactured in industry and then have all the final precision supports added and the final geometric metrology carried out at Geneva University. Barrel #3, complete with its 384 silicon detector modules, arrived by road from Oxford University in England where the modules were mounted using a purpose-built robot. The modules had been selected from the output of all four barrel module building clusters (in Japan, Scandinavia, USA and the UK). Since Barrel #3 will be exposed to high radiation levels within the tracker volume, these modules, representing over half a million readout channels, have been extensively tested at their operational temperature of around -25 degrees Celcius and at voltages of up to 500V. The dangers of shipping such a fragile component of ATLAS were apparent to all and considerable attention was focused...

Evolution of non-expected utility preferences

CERN Document Server

Widekind, Sven von; Fandel, G

2008-01-01

The theory on the evolution of preferences deals with the endogenous formation of preference relations in strategic situations. It is related to the field of evolutionary game theory. In this book we analyze the role and the influence of general, possibly non-expected utility preferences in such an evolutionary setup. In particular, we demonstrate that preferences which diverge from von Neumann-Morgenstern expected utility may potentially prove to be successful under evolutionary pressures.

ATLAS SCT - Progress on the Silicon Modules

CERN Multimedia

Tyndel, M.

The ATLAS SCT consists of 4088 silicon modules. Each module is made up of 4 silicon sensors with 1536 readout strips. Individual strips are connected to FE amplifiers, discriminators and pipelines on the module, i.e. there are 12 radiation hard ASICs, each containing 128 channels on the module. The sensors and the ASICs were developed for the ATLAS experiment and production is proceeding smoothly with over half the components delivered. The components of a module - 4 silicon sensors, a Cu/polyimide hybrid and pitch adaptor, and 12 ASICs - need to be carefully and precisely assembled onto a carbon and ceramic framework, which supports the module and removes the heat. Eleven production clusters are preparing to carry this out over the next two years. An important milestone for the barrel modules has been passed with the first cluster (KEK) now in production (~40 modules produced). A second cluster UK-B has qualified by producing five modules within specification (see below) and is about to start production. T...

Th17 plasticity and transition toward a pathogenic cytokine signature are regulated by cyclosporine after allogeneic SCT.

Science.gov (United States)

Gartlan, Kate H; Varelias, Antiopi; Koyama, Motoko; Robb, Renee J; Markey, Kate A; Chang, Karshing; Wilkinson, Andrew N; Smith, David; Ullah, Md Ashik; Kuns, Rachel D; Raffelt, Neil C; Olver, Stuart D; Lineburg, Katie E; Teal, Bianca E; Cheong, Melody; Teng, Michele W L; Smyth, Mark J; Tey, Siok-Keen; MacDonald, Kelli P A; Hill, Geoffrey R

2017-02-14

T-helper 17 (Th17) cells have been widely implicated as drivers of autoimmune disease. In particular, Th17 cytokine plasticity and acquisition of an interleukin-17A + (IL-17A + )interferon γ(IFNγ) + cytokine profile is associated with increased pathogenic capacity. Donor Th17 polarization is known to exacerbate graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT); however, donor Th17 cytokine coexpression and plasticity have not been fully characterized. Using IL-17 "fate-mapping" mice, we identified IL-6-dependent Th17 cells early after allo-SCT, characterized by elevated expression of proinflammatory cytokines, IL-17A, IL-22, granulocyte-macrophage colony-stimulating factor, and tumor necrosis factor. This population did not maintain lineage fidelity, with a marked loss of IL-17A and IL-22 expression late posttransplant. Th17 cells were further segregated based on IFNγ coexpression, and IL-17A + IFNγ + Th17 displayed an enhanced proinflammatory phenotype. Th17 cytokine plasticity and IFNγ production were critically dependent upon donor-derived IL-12p40, and cyclosporine (CsA) treatment regulated this differentiation pathway. This observation was highly concordant with clinical samples from allo-SCT recipients receiving CsA-based immune suppression where although the IFNγ-negative-Th17 subset predominated, IFNγ + -Th17 cells were also present. In sum, Th17 polarization and ensuing differentiation are mediated by sequential inflammatory signals, which are modulated by immunosuppressive therapy, leading to distinct phenotypes within this lineage.

Improving the transition of highly complex patients into the community: impact of a pharmacist in an allogeneic stem cell transplant (SCT) outpatient clinic.

Science.gov (United States)

Chieng, Ruth; Coutsouvelis, John; Poole, Susan; Dooley, Michael J; Booth, Diana; Wei, Andrew

2013-12-01

Patients having undergone allogeneic stem cell transplantation (SCT) require complex medication regimens. To ensure the safe and effective management of this patient group, specialised care in a centre with a dedicated and experienced healthcare team is essential. The aim of this study was to evaluate the effectiveness of a specialty clinical pharmacist working in an ambulatory SCT clinic. A prospective cohort study was conducted on patients post SCT and discharged to the ambulatory setting. Patients were reviewed by a clinical pharmacist weekly for six visits. At these visits a medication review was undertaken. Interventions from these reviews were recorded. Interventions were then assigned a risk rating by a multidisciplinary panel. Adherence was also assessed by a Morisky questionnaire and review of dose administration aids. Comparison of data over the six-visit period was undertaken. In total 23 patients were enrolled in the study. All six visits were completed in 17 patients and 161 interventions were recorded at an average of 1.4 interventions per patient visit. The panel rated 40 % of interventions as high risk, 46 % as medium risk and 14 % as low risk. At all visit points high- and medium-risk interventions constituted >80 % of the total. Morisky scores improved by an average of 1.53 (p SCT outpatient clinic resulted in regular and effective intervention contributing to improved medication management and adherence.

Dadirri: Using a Philosophical Approach to Research to Build Trust between a Non-Indigenous Researcher and Indigenous Participants

Directory of Open Access Journals (Sweden)

Megan Marie Stronach

2014-09-01

Full Text Available Abstract: This article focuses on a philosophical approach employed in a PhD research project that set out to investigate sport career transition (SCT experiences of elite Indigenous Australian sportsmen. The research was necessary as little is known about the transition of this cohort to a life after sport, or their experiences of retirement. A key problem within the SCT paradigm is a presumption that an end to elite sport requires a process of adjustment that is common to all sportspeople—a rather narrow perspective that fails to acknowledge the situational complexity and socio-cultural diversity of elite athletes. With such a range of personal circumstances, it is reasonable to suppose that athletes from different cultural groups will have different individual SCT needs. The researcher is non-Indigenous and mature aged: she encountered a number of challenges in her efforts to understand Indigenous culture and its important sensitivities, and to build trust with the Indigenous male participants she interviewed. An Indigenous philosophy known as Dadirri, which emphasises deep and respectful listening, guided the development of the research design and methodology. Consistent with previous studies conducted by non-Indigenous researchers, an open-ended and conversational approach to interviewing Indigenous respondents was developed. The objective was for the voices of the athletes to be heard, allowing the collection of rich data based on the participants’ perspectives about SCT. An overview of the findings is presented, illustrating that Indigenous athletes experience SCT in complex and distinctive ways. The article provides a model for non-Indigenous researchers to conduct qualitative research with Indigenous people.

Accurate and log g of δ Sct stars using Asteroseismology

Science.gov (United States)

Antonio, García Hernández; Monteiro, Mário J. P. F. G.; Guo, Zhao; Reese, Daniel R.; Suárez, Juan Carlos; Martín, Susana; Pascual-Granado, Javier; Moya, Andrés; Garrido, Rafael

2017-10-01

In this work, we present a new method to determine the surface gravity of δ Sct stars. We used a refined relation and the stellar parallaxes or luminosities to determine their masses and radii. A comparison with the data obtained from the binary analysis, has shown that the values found by both methods are equivalent, within the uncertainties. Moreover, thanks to the refined relation, the uncertainties in log g are of the order of those usually estimated with high-resolution spectroscopy. Because of that, this new method to determine the surface gravity is an important step forward to break the degeneracy problem in the spectroscopic analysis.

Bronchiolitis obliterans syndrome after allogeneic hematopoietic SCT: phenotypes and prognosis.

Science.gov (United States)

Bergeron, A; Godet, C; Chevret, S; Lorillon, G; Peffault de Latour, R; de Revel, T; Robin, M; Ribaud, P; Socié, G; Tazi, A

2013-06-01

Bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic SCT (HSCT) is recognized as a new-onset obstructive lung defect (OLD) in pulmonary function testing and is related to pulmonary chronic GVHD. Little is known about the different phenotypes of patients with BOS and their outcomes. We reviewed the data of all allogeneic HSCT recipients referred to our pulmonary department for a non-infectious bronchial disease between 1999 and 2010. We identified 103 patients (BOS (n=77), asthma (n=11) and chronic bronchitis (n=15)). In patients with BOS, we identified two functional phenotypes: a typical OLD, that is, forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7 (n=53), and an atypical OLD with a concomitant decrease in the FEV1 <80% and FVC <80% predicted with a normal total lung capacity (n=24). The typical OLD was characterized by more severe FEV1 and fewer centrilobular nodules on the computed tomography scan. The FEV1 was not significantly affected during the follow-up, regardless of the phenotype. In addition to acute and extensive chronic GVHD, only the occurrence of BOS soon after transplantation and the intentional treatment of BOS with steroids were associated with a poor survival. The determination of patient subgroups should be explored to improve the management of this condition.

Pitch adaptors of the ATLAS-SCT Endcap detector modules

International Nuclear Information System (INIS)

Ullan, M; Lozano, M; Campabadal, F; Fleta, C; Pellegrini, G; Garcia, C; Gonzalez, F

2007-01-01

Interconnection between detectors and electronics in modern High Energy Physics has become an issue of difficult solution due to the need to integrate both parts in the same module and the need for a low mass, simple connection. The Endcap section of the Semiconductor Tracker (SCT) of the ATLAS experiment at CERN has adopted the solution of using interface devices called pitch adaptors or fan-ins that, mounted on the modules, and using automatic wire bonding, connect the detector's multiple channels to the front-end electronics, adapting their different designs (pad pitch, dimensions, position). This paper describes the characteristics of these devices, the qualification tests that they have been submitted to, and the final results of their fabrication including quality assurance procedures

Characteristic patterns of relapse after allogeneic hematopoietic SCT for adult T-cell leukemia-lymphoma: a comparative study of recurrent lesions after transplantation and chemotherapy by the Nagasaki Transplant Group.

Science.gov (United States)

Itonaga, H; Sawayama, Y; Taguchi, J; Honda, S; Taniguchi, H; Makiyama, J; Matsuo, E; Sato, S; Ando, K; Imanishi, D; Imaizumi, Y; Yoshida, S; Hata, T; Moriuchi, Y; Fukushima, T; Miyazaki, Y

2015-04-01

Allogeneic hematopoietic SCT (allo-SCT) is a promising therapy that may provide long-term durable remission for adult T-cell leukemia-lymphoma (ATL) patients; however, the incidence of relapse associated with ATL remains high. To determine the clinical features of these patients at relapse, we retrospectively analyzed tumor lesions in 30 or 49 patients who relapsed following allo-SCT or chemotherapy (CHT), respectively, at three institutions in Nagasaki prefecture between 1997 and 2011. A multivariate analysis revealed that the development of abnormal lymphocytes in the peripheral blood of patients at relapse was less frequent after allo-SCT than after CHT (PSCT (P=0.014). Lesions were more frequently observed in the central nervous systems of patients who relapsed with new lesions only (P=0.005). Thus, the clinical manifestation of relapsed ATL was slightly complex, especially in post-transplant patients. Our results emphasized the need to develop adoptive modalities for early and accurate diagnoses of relapsed ATL.

CD4(+)and CD8(+)T-cell reactions against leukemia-associated- or minor-histocompatibility-antigens in AML-patients after allogeneic SCT.

Science.gov (United States)

Steger, Brigitte; Milosevic, Slavoljub; Doessinger, Georg; Reuther, Susanne; Liepert, Anja; Braeu, Marion; Schick, Julia; Vogt, Valentin; Schuster, Friedhelm; Kroell, Tanja; Busch, Dirk H; Borkhardt, Arndt; Kolb, Hans-Jochem; Tischer, Johanna; Buhmann, Raymund; Schmetzer, Helga

2014-04-01

T-cells play an important role in the remission-maintenance in AML-patients (pts) after SCT, however the role of LAA- (WT1, PR1, PRAME) or minor-histocompatibility (mHag, HA1) antigen-specific CD4(+) and CD8(+)T-cells is not defined. A LAA/HA1-peptide/protein stimulation, cloning and monitoring strategy for specific CD8(+)/CD4(+)T-cells in AML-pts after SCT is given. Our results show that (1) LAA-peptide-specific CD8+T-cells are detectable in every AML-pt after SCT. CD8(+)T-cells, recognizing two different antigens detectable in 5 of 7 cases correlate with long-lasting remissions. Clonal TCR-Vβ-restriction exemplarily proven by spectratyping in PRAME-specific CD8(+)T-cells; high PRAME-peptide-reactivity was CD4(+)-associated, as shown by IFN-γ-release. (2) Two types of antigen-presenting cells (APCs) were tested for presentation of LAA/HA1-proteins to CD4(+)T-cells: miniEBV-transduced lymphoblastoid cells (B-cell-source) and CD4-depleted MNC (source for B-cell/monocyte/DC). We provide a refined cloning-system for proliferating, CD40L(+)CD4(+)T-cells after LAA/HA1-stimulation. CD4(+)T-cells produced cytokines (GM-CSF, IFN-γ) upon exposure to LAA/HA1-stimulation until after at least 7 restimulations and demonstrated cytotoxic activity against naive blasts, but not fibroblasts. Antileukemic activity of unstimulated, stimulated or cloned CD4(+)T-cells correlated with defined T-cell-subtypes and the clinical course of the disease. In conclusion we provide immunological tools to enrich and monitor LAA/HA1-CD4(+)- and CD8(+)T-cells in AML-pts after SCT and generate data with relevant prognostic value. We were able to demonstrate the presence of LAA-peptide-specific CD8(+)T-cell clones in AML-pts after SCT. In addition, we were also able to enrich specific antileukemic reactive CD4(+)T-cells without GvH-reactivity upon repeated LAA/HA1-protein stimulation and limiting dilution cloning. Copyright © 2013 Elsevier GmbH. All rights reserved.

NMR investigations of structural and dynamics features of natively unstructured drug peptide - salmon calcitonin: implication to rational design of potent sCT analogs.

Science.gov (United States)

Rawat, Atul; Kumar, Dinesh

2013-01-01

Backbone dynamics and conformational properties of drug peptide salmon calcitonin have been studied in aqueous solution using nuclear magnetic resonance (NMR). Although salmon calcitonin (sCT) is largely unfolded in solution (as has been reported in several circular dichroism studies), the secondary H(α) chemical shifts and three bond H(N) -H(α) coupling constants indicated that most of the residues of the peptide are populating the α-helical region of the Ramachandran (ϕ, ψ) map. Further, the peptide in solution has been found to exhibit multiple conformational states exchanging slowly on the NMR timescale (10(2) -10(3)  s(-1) ), inferred by the multiple chemical shift assignments in the region Leu4-Leu12 and around Pro23 (for residues Gln20-Tyr22 and Arg24). Possibly, these slowly exchanging multiple conformational states might inhibit symmetric self-association of the peptide and, in part, may account for its reduced aggregation propensity compared with human calcitonin (which lacks this property). The (15) N NMR-relaxation data revealed (i) the presence of slow (microsecond-to-millisecond) timescale dynamics in the N-terminal region (Cys1-Ser5) and core residues His17 and Asn26 and (ii) the presence of high frequency (nanosecond-to-picosecond) motions in the C-terminal arm. Put together, the various results suggested that (i) the flexible C-terminal of sCT (from Thr25-Thr31) is involved in identification of specific target receptors, (ii) whereas the N-terminal of sCT (from Cys1-Gln20) in solution - exhibiting significant amount of conformational plasticity and strong bias towards biologically active α-helical structure - facilitates favorable conformational adaptations while interacting with the intermembrane domains of these target receptors. Thus, we believe that the structural and dynamics features of sCT presented here will be useful guiding attributes for the rational design of biologically active sCT analogs. Copyright © 2012 European Peptide

Aerobic exercise capacity at long-term follow-up after paediatric allogeneic haematopoietic SCT

DEFF Research Database (Denmark)

Mathiesen, S; Uhlving, H H; Buchvald, F

2014-01-01

Peak oxygen uptake (VO2peak), a measure of aerobic exercise capacity, predicts mortality and morbidity in healthy and diseased individuals. Our aim was to determine VO2peak years after paediatric allogeneic haematopoietic SCT (HSCT) and to identify associations with baseline patient and donor...... type or GvHD were found. Although causes for reduced VO2peak may be multiple, our findings stress the need to focus on physical activity post HSCT to prevent lifestyle diseases and improve quality of life....

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

Science.gov (United States)

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

2015-01-01

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

Optical data links for the ATLAS SCT and Pixel Detector

International Nuclear Information System (INIS)

Gregor, I.M.; Weidberg, A.R.; Lee, S.C.; Chu, M.L.; Teng, P.K.

2001-01-01

ATLAS (The ATLAS Technical Proposal, CERN/LHCC 94-33) is one of the large electronic particle detectors at LHC (The LHC Conceptual Design, Report- The Yellow Book, CERN/AC/95-05(LHC)) which will become operational in 2005. It is planned to use radiation tolerant optical links for the data transfer from the SemiConductor Tracker (SCT) (ATLAS Inner Detector Technical Proposal, CERN/LHCC 97-16 and CERN/LHCC 97-17). and Pixel Detector (ATLAS Pixel Detector Technical Proposal, CERN/LHCC 98-13) systems to the acquisition electronics over a distance up to 140m. The overall architecture and the performance of these optical data links are described. One of the three candidate designs for an on-detector Opto-Package is presented

Purchasing non-utility power

International Nuclear Information System (INIS)

Brackeen, L.G.

1990-01-01

The author discusses Houston Lighting and Power Company's procedure for purchasing power from cogenerators. By way of introduction, HL and P is the eighth largest electric utility in the United States in terms of kilowatt-hour sales and the second largest purchaser of natural gas in the nation. HL and P is also the principal utility providing electric service to the massive petrochemical industry in Southeast Texas. Of the 4,800 MW of cogeneration available, HL and P buys 945 MW under firm contracts, wheel 1,600 MW to other utilities, buy 400 MW under non-firm contracts and the balance is self-generation used to displace power which would otherwise be purchased from HL and P. With all this cogeneration capacity available, the problem until recently has been managing the surplus. HL and P now is finding itself in the unaccustomed position of needing to buy additional power or build plants to meet the modest growth it forecasts for Houston. The need for additional capacity coincides with the expiration of cogeneration contracts in 1993 and 1994. To meet this capacity need, they are determined to avoid buying cogeneration at a very high price and on delivery terms which do not reflect realistic benefits to their electric customers. The paper gives information on the background on PUC regulations and legislation, then briefly reviews the procedure for purchase of cogenerated power in Texas

Radiation hardness and lifetime studies of LEDs and VCSELs for the optical readout of the ATLAS SCT

CERN Document Server

Beringer, J; Mommsen, R K; Nickerson, R B; Weidberg, A R; Monnier, E; Hou, H Q; Lear, K L

1999-01-01

We study the radiation hardness and the lifetime of Light Emitting Diodes (LEDs) and Vertical Cavity Surface Emitting Laser diodes (VCSELs) in the context of the development of the optical readout for the ATLAS SemiConductor Tracker (SCT) at LHC. About 170 LEDs from two different manufacturers and about 130 VCSELs were irradiated with neutron and proton fluences equivalent to (and in some cases more than twice as high as) the combined neutral and charged particle fluence of about 5x10 sup 1 sup 4 n (1 MeV eq. in GaAs)/cm sup 2 expected in the ATLAS inner detector. We report on the radiation damage and the conditions required for its partial annealing under forward bias, we calculate radiation damage constants, and we present post-irradiation failure rates for LEDs and VCSELs. The lifetime after irradiation was investigated by operating the diodes at an elevated temperature of 50 degree sign C for several months, resulting in operating times corresponding to up to 70 years of operation in the ATLAS SCT. From o...

Future of US utilities under non-proliferation policy

International Nuclear Information System (INIS)

Ladesich, J.N.

1978-01-01

The non-proliferation policy, a negative policy that closes the back end of the nuclear fuel cycle, is only a small part of a chaotic energy environment characterized by inaction. The impact of this environment on California utilities has resulted in a virtual moratorium on new facilities at a time when the nuclear option can be shown to be vital. Utilities are experiencing uncertainties in future power generation because alternatives to nuclear energy may not be the best choices. Utilities feel frustrated by the inaction; not by the objectives of the accountability and security proposals. The utilities will continue to support nuclear power and the completion of the fuel cycle in spite of these uncertainties

Health-related quality of life in pediatric patients after allogeneic SCT: development of the PedsQL Stem Cell Transplant module and results of a pilot study.

Science.gov (United States)

Lawitschka, A; Güclü, E D; Varni, J W; Putz, M; Wolff, D; Pavletic, S; Greinix, H; Peters, C; Felder-Puig, R

2014-08-01

With increased survival after pediatric allogeneic hematopoietic SCT health-related quality of life (HRQL) has emerged as an essential health outcome. The impact of transplant and chronic GVHD (cGVHD)-associated morbidity remains a major obstacle. In 2005, the National Institutes of Health (NIH) Consensus Conference on Criteria for Clinical Trials in cGVHD recommended HRQL tools as an independent measure of the impact of disease burden. The NIH recommendations did not provide a cGVHD-specific tool for HRQOL measures in children. This report focuses on the development of an SCT-specific instrument to assess HRQL in children and adolescents. For the assessment of generic HRQL we chose the PedsQL (Pediatric Quality of Life Inventory) Generic Cores Scales, which have been used in a large number of healthy, acutely ill and chronically ill children and adolescents. To capture SCT- and, specifically, cGVHD-related problems, we developed the PedsQL Stem Cell Transplant module by reviewing the literature, taking over some items/scales of other PedsQL modules, interviewing patients, parents and members of the health-care team, and applying the PedsQL measurement methods. The final PedsQL Stem Cell Transplant module consists of the HRQL domains: pain and hurt, fatigue/sleeping problems/weakness, nausea, worry/anxiety about disease/treatment, nutritional problems, neurocognitive problems, communication about disease/treatment, loneliness, physical functioning and additional somatic complaints (pruritus, skin inflammation, oral problems, eyes or breathing) including patients' and parents' assessment. It was tested in 35 pediatric patients, who were referred to our SCT Outpatient Clinic about 100 days post SCT. Both the generic PedsQL and the SCT-specific scales showed high internal consistency, with Cronbach alpha levels of ⩾0.70 in almost all scales. Most problems were detected within the HRQL domains of physical functioning and pain. The summary scores of the generic Peds

US versus non-US utility procurement practices

International Nuclear Information System (INIS)

Clark, H.

1991-01-01

Utilities, particularly in the USA, have often been accused by the uranium industry of behaving like a herd with respect to their activities in the nuclear fuel market. While I disagree with this characterization, I do recognize that utilities in general have certain common motivations influencing their nuclear fuel procurement activities which may make them appear to follow each other. This paper reviews these motivations, how they differ between US and non-US utilities, how such differences lead to different procurement practices in the USA and elsewhere, the resulting impacts on the nuclear fuel market, and the changes, if, any, which one may expect in the future. The discussion in this paper is geared mainly towards the uranium market, though the concepts discussed are also somewhat applicable to the other components of nuclear fuel. (author)

Non-parametric estimation of the individual's utility map

OpenAIRE

Noguchi, Takao; Sanborn, Adam N.; Stewart, Neil

2013-01-01

Models of risky choice have attracted much attention in behavioural economics. Previous research has repeatedly demonstrated that individuals' choices are not well explained by expected utility theory, and a number of alternative models have been examined using carefully selected sets of choice alternatives. The model performance however, can depend on which choice alternatives are being tested. Here we develop a non-parametric method for estimating the utility map over the wide range of choi...

Coal's sleeping market: non-utility generators

International Nuclear Information System (INIS)

McMahan, R.L.; Knutson, K.S.

1992-01-01

The article briefly profiles the coal market for non-utility generation (NUG). Coal consumption by NUGs, currently estimated at around 6.1 million tons, is projected to reach nearly 13.6 million tons by 1995 and 21.2 million tons by 2000. If the projected growth is achieved the NUG market may become one of the strongest market segments for the coal industry into the next century. 3 figs., 2 tabs

Utilization Bound of Non-preemptive Fixed Priority Schedulers

Science.gov (United States)

Park, Moonju; Chae, Jinseok

It is known that the schedulability of a non-preemptive task set with fixed priority can be determined in pseudo-polynomial time. However, since Rate Monotonic scheduling is not optimal for non-preemptive scheduling, the applicability of existing polynomial time tests that provide sufficient schedulability conditions, such as Liu and Layland's bound, is limited. This letter proposes a new sufficient condition for non-preemptive fixed priority scheduling that can be used for any fixed priority assignment scheme. It is also shown that the proposed schedulability test has a tighter utilization bound than existing test methods.

Associated petroleum gas in Russia: reasons for non-utilization

Energy Technology Data Exchange (ETDEWEB)

Roeland, Tonje Hulbak

2010-10-22

This report studies the factors hindering increased utilization of associated petroleum gas (APG) in Russia. The issue of flaring versus utilization is studied from a Technology Innovation System (TIS) perspective, seeing the non-utilization issue as a problem of technology diffusion. There are many technological options available for APG utilization, but a main blocking mechanism in the Russian case is the Gazprom monopoly on gas transportation via their pipelines. A commonly discussed solution is policy to ensure third party access, but this study finds that this solution holds little potential, as its ramifications are too extensive and unacceptable to the key actor Gazprom. More promising solutions may be found in small, emerging engineering companies. (Author)

Determinants of postnatal care non-utilization among women in Nigeria.

Science.gov (United States)

Somefun, Oluwaseyi Dolapo; Ibisomi, Latifat

2016-01-11

Although, there are several programs in place in Nigeria to ensure maternal and child health, maternal and neonatal mortality rates remain high with maternal mortality rates being 576/100,000 and neonatal mortality rates at 37/1000 live births (NDHS, 2013). While there are many studies on the utilization of maternal health services such as antenatal care and skilled delivery at birth, studies on postnatal care are limited. Therefore, the aim of this study is to examine the factors associated with the non-utilization of postnatal care among mothers in Nigeria using the Nigeria Demographic and Health Survey (NDHS) 2013. For analysis, the postnatal care uptake for 19,418 children born in the 5 years preceding the survey was considered. The dependent variable was a composite variable derived from a list of questions on postnatal care. A multinomial logistic regression model was applied to examine the adjusted and unadjusted determinants of non-utilization of postnatal care. Results from this study showed that 63% of the mothers of the 19,418 children did not utilize postnatal care services in the period examined. About 42% of the study population between 25 and 34 years did not utilize postnatal care and 61% of the women who did not utilize postnatal care had no education. Results from multinomial logistic regression show that antenatal care use, distance, education, place of delivery, region and wealth status are significantly associated with the non-utilization of postnatal care services. This study revealed the low uptake of postnatal care service in Nigeria. To increase mothers' utilization of postnatal care services and improve maternal and child health in Nigeria, interventions should be targeted at women in remote areas who don't have access to services and developing mobile clinics. In addition, it is crucial that steps should be taken on educating women. This would have a significant influence on their perceptions about the use of postnatal care services in

Utility of Social Cognitive Theory in Intervention Design for Promoting Physical Activity among African-American Women: A Qualitative Study.

Science.gov (United States)

Joseph, Rodney P; Ainsworth, Barbara E; Mathis, LaTanya; Hooker, Steven P; Keller, Colleen

2017-09-01

We examined the cultural relevance of Social Cognitive Theory (SCT) in the design of a physical activity intervention for African-American women. A qualitative study design was used. Twenty-five African-American women (Mean age = 38.5 years, Mean BMI = 39.4 kg·m2) were enrolled in a series of focus groups (N = 9) to elucidate how 5 SCT constructs (ie, Behavioral Capability, Outcome Expectations, Self-efficacy, Self-regulation, Social Support) can be culturally tailored in the design of a physical activity program for African-American women. For the construct of Behavioral Capability, participants were generally unaware of the amount, intensity, and types of physical activity needed for health benefits. Outcome Expectations associated with physical activity included increased energy, improved health, weight loss, and positive role modeling behaviors. Constructs of Self-efficacy and Self-regulation were elicited through the women perceiving themselves as a primary barrier to physical activity. Participants endorsed the need of a strong social support component and identified a variety of acceptable sources to include in a physical activity program (ie, family, friends, other program participants). Findings explicate the utility of SCT as a behavioral change theoretical basis for tailoring physical activity programs to African-American women.

Iterative local Chi2 alignment approach for the ATLAS SCT detector

CERN Document Server

Härtel, Roland

An approach for the alignment of SCT modules in the ATLAS Inner Detector with particle tracks was developed and implemented in the ATLAS software framework Athena. The approach uses distance of closest approach residuals and a linear least squares minimization to derive the most probable set of alignment parameters for each module. The procedure is iterative, i.e. with the first set of alignment constants a track refit is done and the alignment algorithm is repeated. Correlations between modules are only implicitly taken into account due to the improvement of track parameters through the iterations. A derivation of the underlying concepts is presented. The achievable accuracy and limits of the alignment approach were studied with Monte Carlo simulated tracks in the Athena framework. The results and limitations obtained with the present versions of Athena and the proposed alignment software are presented.

Factors associated with pulmonary toxicity after myeloablative conditioning using fractionated total body irradiation

Energy Technology Data Exchange (ETDEWEB)

Byun, Hwa Kyung; Yoon, Hong In; Cho, Jae Ho [Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of); and others

2017-09-15

Pulmonary toxicities, including infectious pneumonia (IP) and idiopathic pneumonia syndrome (IPS), are serious side effects of total body irradiation (TBI) used for myeloablative conditioning. This study aimed to evaluate clinical factors associated with IP and IPS following TBI. Fifty-eight patients with hematologic malignancies who underwent TBI before allogeneic hematopoietic stem cell transplantation between 2005 and 2014 were reviewed. Most patients (91%) received 12 Gy in 1.5 Gy fractions twice a day. Pulmonary toxicities were diagnosed based on either radiographic evidence or reduced pulmonary function, and were subdivided into IP and IPS based on the presence or absence of concurrent infection. Pulmonary toxicities developed in 36 patients (62%); 16 (28%) had IP and 20 (34%) had IPS. IP was significantly associated with increased treatment-related mortality (p = 0.028) and decreased survival (p = 0.039). Multivariate analysis revealed that the risk of developing IPS was significantly higher in patients who received stem cells from a matched unrelated donor than from a matched sibling donor (p = 0.021; hazard ratio [HR] = 12.67; 95% confidence interval [CI], 1.46–110.30). Combining other conditioning agents with cyclophosphamide produced a higher tendency to develop IP (p = 0.064; HR = 6.19; 95% CI, 0.90–42.56). IP and IPS involve different risk factors and distinct pathogeneses that should be considered when planning treatments before and after TBI.

Factors associated with pulmonary toxicity after myeloablative conditioning using fractionated total body irradiation

International Nuclear Information System (INIS)

Byun, Hwa Kyung; Yoon, Hong In; Cho, Jae Ho

2017-01-01

Pulmonary toxicities, including infectious pneumonia (IP) and idiopathic pneumonia syndrome (IPS), are serious side effects of total body irradiation (TBI) used for myeloablative conditioning. This study aimed to evaluate clinical factors associated with IP and IPS following TBI. Fifty-eight patients with hematologic malignancies who underwent TBI before allogeneic hematopoietic stem cell transplantation between 2005 and 2014 were reviewed. Most patients (91%) received 12 Gy in 1.5 Gy fractions twice a day. Pulmonary toxicities were diagnosed based on either radiographic evidence or reduced pulmonary function, and were subdivided into IP and IPS based on the presence or absence of concurrent infection. Pulmonary toxicities developed in 36 patients (62%); 16 (28%) had IP and 20 (34%) had IPS. IP was significantly associated with increased treatment-related mortality (p = 0.028) and decreased survival (p = 0.039). Multivariate analysis revealed that the risk of developing IPS was significantly higher in patients who received stem cells from a matched unrelated donor than from a matched sibling donor (p = 0.021; hazard ratio [HR] = 12.67; 95% confidence interval [CI], 1.46–110.30). Combining other conditioning agents with cyclophosphamide produced a higher tendency to develop IP (p = 0.064; HR = 6.19; 95% CI, 0.90–42.56). IP and IPS involve different risk factors and distinct pathogeneses that should be considered when planning treatments before and after TBI

Induction of transplantation tolerance to fully mismatched cardiac allografts by T cell mediated delivery of alloantigen

Science.gov (United States)

Tian, Chaorui; Yuan, Xueli; Jindra, Peter T.; Bagley, Jessamyn; Sayegh, Mohamed H.; Iacomini, John

2010-01-01

Induction of transplantation tolerance has the potential to allow for allograft acceptance without the need for life-long immunosuppression. Here we describe a novel approach that uses delivery of alloantigen by mature T cells to induce tolerance to fully allogeneic cardiac grafts. Adoptive transfer of mature alloantigen-expressing T cells into myeloablatively conditioned mice results in long-term acceptance of fully allogeneic heart transplants without evidence of chronic rejection. Since myeloablative conditioning is clinically undesirable we further demonstrated that adoptive transfer of mature alloantigen-expressing T cells alone into mice receiving non-myeloablative conditioning resulted in long-term acceptance of fully allogeneic heart allografts with minimal evidence of chronic rejection. Mechanistically, tolerance induction involved both deletion of donor-reactive host T cells and the development of regulatory T cells. Thus, delivery of alloantigen by mature T cells induces tolerance to fully allogeneic organ allografts in non-myeloablatively conditioned recipients, representing a novel approach for tolerance induction in transplantation. PMID:20452826

miR-434-3p and DNA hypomethylation co-regulate eIF5A1 to increase AChRs and to improve plasticity in SCT rat skeletal muscle.

Science.gov (United States)

Shang, Fei-Fei; Xia, Qing-Jie; Liu, Wei; Xia, Lei; Qian, Bao-Jiang; You, Ling; He, Mu; Yang, Jin-Liang; Wang, Ting-Hua

2016-03-11

Acetylcholine receptors (AChRs) serve as connections between motor neurons and skeletal muscle and are essential for recovery from spinal cord transection (SCT). Recently, microRNAs have emerged as important potential biotherapeutics for several diseases; however, whether miRNAs operate in the modulation of AChRs remains unknown. We found increased AChRs numbers and function scores in rats with SCT; these increases were reduced following the injection of a eukaryotic translation initiation factor 5A1 (eIF5A1) shRNA lentivirus into the hindlimb muscle. Then, high-throughput screening for microRNAs targeting eIF5A1 was performed, and miR-434-3p was found to be robustly depleted in SCT rat skeletal muscle. Furthermore, a highly conserved miR-434-3p binding site was identified within the mRNA encoding eIF5A1 through bioinformatics analysis and dual-luciferase assay. Overexpression or knockdown of miR-434-3p in vivo demonstrated it was a negative post-transcriptional regulator of eIF5A1 expression and influenced AChRs expression. The microarray-enriched Gene Ontology (GO) terms regulated by miR-434-3p were muscle development terms. Using a lentivirus, one functional gene (map2k6) was confirmed to have a similar function to that of miR-434-3p in GO terms. Finally, HRM and MeDIP-PCR analyses revealed that DNA demethylation also up-regulated eIF5A1 after SCT. Consequently, miR-434-3p/eIF5A1 in muscle is a promising potential biotherapy for SCI repair.

Project risk management for development of non-utility power generators (NUGs)

International Nuclear Information System (INIS)

Lau, T.

1990-01-01

The growing Non-Utility Generation (NUG) industry has brought new opportunities and challenges for the insurance industry. There can be unique engineering and financial risks involved in the development of Non-Utility Power Generation projects. The use of new technologies to meet stringent environmental regulations and to improve project performance and efficiency presents new challenges to the project developers and designers. The lack of funding, resources and experience of some of these projects may create unusual risks that could result in failure or deficiency in the performance of the projects

Assessment of value of spiral CT in preoperative evaluation of endovascular graft exclusion for abdominal aortic aneurysm

International Nuclear Information System (INIS)

Jing Zaiping; Zhao Jun; Zhu Wenjiang; Xiao Yi

1998-01-01

Purpose: The assess the value of spiral CT (SCT) in preoperative evaluation of endovascular graft exclusion (EVGE) for abdominal aortic aneurysm (AAA). Methods: 41 case with AAA received SCT scanning. Two and three dimensional images were reconstructed, utilizing the shaded surface display (SSD), maximum-intensity Projection (MIP) and multiplanar reformation (MPR). Information were obtained regarding the size and features of AAA, length and diameters of aneurysm's neck, status of the branches of aorta, etc. Results: Nine patients had spinal CT study prior EVGE procedure and the grafts selected according to the parameters obtained by SCT matched perfectly to the needs of deployment. Conclusion: CTA provides high quality images. It is a high-speed and non-invasive method which can provide three-dimensional images of AAA and its main branches and all the parameters needed in EVGE

LOOKING FOR A CONNECTION BETWEEN THE Am PHENOMENON AND HYBRID {delta} Sct -{gamma} Dor PULSATION: DETERMINATION OF THE FUNDAMENTAL PARAMETERS AND ABUNDANCES OF HD 114839 AND BD +18 4914

Energy Technology Data Exchange (ETDEWEB)

Hareter, M.; Weiss, W. [Department of Astronomy, University of Vienna, Tuerkenschanzstrasse 17, A-1180 Wien (Austria); Fossati, L. [Department of Physics and Astronomy, Open University, Walton Hall, Milton Keynes MK6 7AA (United Kingdom); Suarez, J. C. [Instituto de Astrofisica de Andalucia (CSIC), Glorieta de la Astronomia S/N, 18008, Granada (Spain); Uytterhoeven, K. [Kiepenheuer-Institut fuer Sonnenphysik, Schoeneckstr. 6, D-79104 Freiburg (Germany); Rainer, M.; Poretti, E., E-mail: hareter@astro.univie.ac.at [INAF-Osservatorio Astronomico di Brera, Via E. Bianchi 46, 23807, Merate (Saint Lucia) (Italy)

2011-12-20

{delta} Sct-{gamma} Dor hybrids pulsate simultaneously in p- and g-modes, which carry information on the structure of the envelope as well as to the core. Hence, they are key objects for investigating A and F type stars with asteroseismic techniques. An important requirement for seismic modeling is small errors in temperature, gravity, and chemical composition. Furthermore, we want to investigate the existence of an abundance indicator typical for hybrids, something that is well established for the roAp stars. Previous to the present investigation, the abundance pattern of only one hybrid and another hybrid candidate has been published. We obtained high-resolution spectra of HD 114839 and BD +18 4914 using the SOPHIE spectrograph of the Observatoire de Haute-Provence and the HARPS spectrograph at ESO La Silla. For each star we determined fundamental parameters and photospheric abundances of 16 chemical elements by comparing synthetic spectra with the observations. We compare our results to that of seven {delta} Sct and nine {gamma} Dor stars. For the evolved BD +18 4914 we found an abundance pattern typical for an Am star, but could not confirm this peculiarity for the less evolved star HD 114839, which is classified in the literature as uncertain Am star. Our result supports the concept of evolved Am stars being unstable. With our investigation we nearly doubled the number of spectroscopically analyzed {delta} Sct-{gamma} Dor hybrid stars, but did not yet succeed in identifying a spectroscopic signature for this group of pulsating stars. A statistically significant spectroscopic investigation of {delta} Sct- {gamma} Dor hybrid stars is still missing, but would be rewarding considering the asteroseismological potential of this group.

LOOKING FOR A CONNECTION BETWEEN THE Am PHENOMENON AND HYBRID δ Sct -γ Dor PULSATION: DETERMINATION OF THE FUNDAMENTAL PARAMETERS AND ABUNDANCES OF HD 114839 AND BD +18 4914

International Nuclear Information System (INIS)

Hareter, M.; Weiss, W.; Fossati, L.; Suárez, J. C.; Uytterhoeven, K.; Rainer, M.; Poretti, E.

2011-01-01

δ Sct-γ Dor hybrids pulsate simultaneously in p- and g-modes, which carry information on the structure of the envelope as well as to the core. Hence, they are key objects for investigating A and F type stars with asteroseismic techniques. An important requirement for seismic modeling is small errors in temperature, gravity, and chemical composition. Furthermore, we want to investigate the existence of an abundance indicator typical for hybrids, something that is well established for the roAp stars. Previous to the present investigation, the abundance pattern of only one hybrid and another hybrid candidate has been published. We obtained high-resolution spectra of HD 114839 and BD +18 4914 using the SOPHIE spectrograph of the Observatoire de Haute-Provence and the HARPS spectrograph at ESO La Silla. For each star we determined fundamental parameters and photospheric abundances of 16 chemical elements by comparing synthetic spectra with the observations. We compare our results to that of seven δ Sct and nine γ Dor stars. For the evolved BD +18 4914 we found an abundance pattern typical for an Am star, but could not confirm this peculiarity for the less evolved star HD 114839, which is classified in the literature as uncertain Am star. Our result supports the concept of evolved Am stars being unstable. With our investigation we nearly doubled the number of spectroscopically analyzed δ Sct-γ Dor hybrid stars, but did not yet succeed in identifying a spectroscopic signature for this group of pulsating stars. A statistically significant spectroscopic investigation of δ Sct- γ Dor hybrid stars is still missing, but would be rewarding considering the asteroseismological potential of this group.

Finite Element calculations of heat transfer for the Forward SCT ModulesPart II - the Inner Module ATL-COM-INDET-2000-015

CERN Document Server

Blocki, J

2000-01-01

A status report on the thermal performance of the baseline SCT inner forward modules is presented. In order to understand improvements of the thermal behaviour, design changes that have been proposed elsewhere for the outer module, and which lead to significant improvements of the thermal characteristics of the modules, have been applied to the inner module.

The polymorphism IL-1 beta T-31C is associated with a longer overall survival in patients with multiple myeloma undergoing auto-SCT

DEFF Research Database (Denmark)

Vangsted, A.J.; Klausen, T.W.; Ruminski, W.

2009-01-01

high-dose melphalan treatment followed by Auto-SCT and examined the influence of single nucleotide polymorphisms (SNPs) in genes involved in the inflammatory response. We found that the polymorphism IL-1 beta T-31C significantly influenced overall survival (OS; P = 0.02) and that carriers...

Simulation analysis of emissions trading impact on a non-utility power plant

International Nuclear Information System (INIS)

Imran, Kashif; Ahmad, Intesar; Hassan, Tehzeebul; Aslam, Muhammad Farooq; Ngan, Hon-Wing

2009-01-01

Non-utility power plants can competitively participate in open electricity market to reduce operational costs but in the absence of pollution charges or emissions trading such generators are tempted to cause greater pollution for profit maximization. This paper presents a solution that incorporates pollution charges for nitrogen oxides and sulphur dioxide emissions in line with existing national environmental quality standards and a new carbon dioxide emissions trading mechanism. A novel approach has been used for allocation of allowable emissions that favors efficiently fuelled and environmentally friendly operation for maximizing profit. Impact of proposed carbon trading on economical utilization of enormous indigenous coal reserves has been analyzed and determined to be acceptable. Software developed in this paper, harnessing Sequential Quadratic Programming capabilities of Matlab, is shown to be adequate simulation tool for various emissions trading schemes and an useful operational decision making tool for constrained non-linear optimization problem of a non-utility power plant. (author)

Simulation analysis of emissions trading impact on a non-utility power plant

Energy Technology Data Exchange (ETDEWEB)

Imran, Kashif; Ahmad, Intesar [Department of Electrical Engineering, COMSATS Institute of IT, Lahore (Pakistan); Hassan, Tehzeebul [Department of Electrical Engineering, University of Engineering and Technology (UET), Lahore (Pakistan); Aslam, Muhammad Farooq [Department of Electrical Engineering, University of Management and Technology (UMT), Lahore (Pakistan); Ngan, Hon-Wing [Department of Electrical Engineering, Hong Kong Polytechnic University (China)

2009-12-15

Non-utility power plants can competitively participate in open electricity market to reduce operational costs but in the absence of pollution charges or emissions trading such generators are tempted to cause greater pollution for profit maximization. This paper presents a solution that incorporates pollution charges for nitrogen oxides and sulphur dioxide emissions in line with existing national environmental quality standards and a new carbon dioxide emissions trading mechanism. A novel approach has been used for allocation of allowable emissions that favors efficiently fuelled and environmentally friendly operation for maximizing profit. Impact of proposed carbon trading on economical utilization of enormous indigenous coal reserves has been analyzed and determined to be acceptable. Software developed in this paper, harnessing Sequential Quadratic Programming capabilities of Matlab, is shown to be adequate simulation tool for various emissions trading schemes and an useful operational decision making tool for constrained non-linear optimization problem of a non-utility power plant. (author)

Non-hip, non-spine fractures drive healthcare utilization following a fracture: the Global Longitudinal study of Osteoporosis in Women (GLOW)

Science.gov (United States)

Ioannidis, G.; Flahive, J.; Pickard, L.; Papaioannou, A.; Chapurlat, R. D.; Saag, K. G.; Silverman, S.; Anderson, F. A.; Gehlbach, S. H.; Hooven, F. H.; Boonen, S.; Compston, J. E.; Cooper, C.; Díez-Perez, A.; Greenspan, S. L.; LaCroix, A. Z.; Lindsay, R.; Netelenbos, J. C.; Pfeilschifter, J.; Rossini, M.; Roux, C.; Sambrook, P. N.; Siris, E. S.; Watts, N. B.

2016-01-01

Summary We evaluated healthcare utilization associated with treating different fracture types in over 51,000 women aged ≥55 years. Over the course of 1 year, there were five times more non-hip, non-spine fractures than hip or spine fractures, resulting in twice as many days of hospitalization and rehabilitation/nursing home care for non-hip, non-spine fractures. Purpose To evaluate the medical healthcare utilization associated with treating several types of fractures in women aged 55 years or older from various geographic regions. Methods Information from the Global Longitudinal study of Osteoporosis in Women (GLOW) was collected via self-administered patient questionnaires at baseline and year 1 (n=51,491). Self-reported clinically recognized low-trauma fractures at year 1 were classified as incident spine, hip, wrist/hand, arm/shoulder, pelvis, rib, leg, and other fractures. Healthcare utilization data were self-reported and included whether the fracture was treated at a doctor’s office/clinic or at a hospital. Patients were also asked if they had undergone surgery or been treated at a rehabilitation center or nursing home. Results Over the 1-year study period, there were 195 spine, 134 hip, and 1,654 non-hip, non-spine fractures. In the GLOW cohort, clinical vertebral fractures resulted in 617 days of hospitalization and 512 days of rehabilitation/nursing home care, while hip fractures accounted for 1,306 days of hospitalization and 1,650 days of rehabilitation/nursing home care. Of particular interest is the result that non-hip, non-spine fractures resulted in 3,805 days in hospital and 5,186 days of rehabilitation/nursing home care. Conclusions While hip and vertebral fractures are well recognized for their associated increase in health resource utilization, non-hip, non-spine fractures, by virtue of their 5-fold greater number, require significantly more healthcare resources. PMID:22525976

Social cognitive theory and physical activity: a systematic review and meta-analysis.

Science.gov (United States)

Young, M D; Plotnikoff, R C; Collins, C E; Callister, R; Morgan, P J

2014-12-01

This review investigated three research questions (i) What is the utility of social cognitive theory (SCT) to explain physical activity (PA)?; (ii) Is the effectiveness of SCT moderated by sample or methodological characteristics? and (iii) What is the frequency of significant associations between the core SCT constructs and PA? Ten electronic databases were searched with no date or sample restrictions. Forty-four studies were retrieved containing 55 SCT models of PA. Methodological quality was assessed using a standardized tool. A random-effects meta-analysis revealed that SCT accounted for 31% of the variance in PA. However, methodological quality was mostly poor for these models. Methodological quality and sample age moderated the PA effect size, with increases in both associated with greater variance explained. Although self-efficacy and goals were consistently associated with PA, outcome expectations and socio-structural factors were not. This review determined that SCT is a useful framework to explain PA behaviour. Higher quality models explained more PA variance, but overall methodological quality was poor. As such, high-quality studies examining the utility of SCT to explain PA are warranted. © 2014 World Obesity.

Simple preparation of thiol-ene particles in glycerol and surface functionalization by thiol-ene chemistry (TEC) and surface chain transfer free radical polymerization (SCT-FRP)

DEFF Research Database (Denmark)

Hoffmann, Christian; Chiaula, Valeria; Yu, Liyun

2018-01-01

functionalization of excess thiol groups via photochemical thiol-ene chemistry (TEC) resulting in a functional monolayer. In addition, surface chain transfer free radical polymerization (SCT-FRP) was used for the first time to introduce a thicker polymer layer on the particle surface. The application potential...

Prophylaxis of mucosal toxicity by oral propantheline and cryotherapy in children with malignancies undergoing myeloablative chemo-radiotherapy

International Nuclear Information System (INIS)

Sato, Atsushi; Imaizumi, Masue; Saisho-Hattori, Takako; Koizumi, Yoshitsugu; Iinuma, Kazuie; Minegishi, Masayoshi

2006-01-01

Mucosal toxicity is an incapacitating complication of intensive chemo-radiotherapy for children with malignant disorders, and is physically and psychologically distressful. It is therefore important to minimize mucosal toxicity in those patients. In this report, the effects of the combined prophylaxis of oral cooling (cryotherapy) and administration of propantheline, an anticholinergic drug, were studied in patients (aged 2-16 year) with acute leukemias or solid tumors, who underwent myeloablative chemo-radiotherapy and autologous peripheral blood stem cell rescue from 1993 to 1997. Patients were pretreated with the combined prophylaxis (n=12) or single prophylaxis (n=5), or left untreated (n=7). The combined prophylaxis significantly reduced the severe mucositis (combined, 8.3%; single, 20.0%; and untreated, 42.9%) and severe diarrhea (combined, 16.7%; single, 60.0%; and untreated, 57.1%). Moreover, the combined prophylaxis tended to shorten the periods of febrile episodes defined as temperature >38 deg C (combined, 3.8 days; single, 4.6 days; and untreated, 5.6 days). Therefore, the combination of propantheline and oral cryotherapy may be feasible and effective for reduction of mucosal toxicity in patients with malignancy who undergo high-dose chemotherapy. (author)

Non-cirrhotic portal hypertension entity in South Africa? anew

African Journals Online (AJOL)

1991-03-02

Mar 2, 1991 ... SCT, 0. 19. Patent s = splenomegaly and/or hepatosplenomegaly; SCT = splenectomy; ova ~ oesophageal variceal bleeding;. P = pancytopaenia; 0 = other (diabetes. chronic pancreat~is). 94 - 400. GGT. 0-50. 36 - 130. 128 - 243. 47 - 218 000. 1,2 - 1,9. TABLE 11. COAGULATION AND LIVER FUNCTION ...

The impact of center experience on results of reduced intensity:allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

DEFF Research Database (Denmark)

Giebel, S; Labopin, M; Mohty, M

2013-01-01

Allogeneic hematopoietic SCT with reduced-intensity conditioning (RIC-HSCT) is increasingly adopted for the treatment of older adults with AML. Our goal was to verify for the first time, if center experience influences outcome of RIC-HSCT. Results of 1413 transplantations from HLA-matched related...

Are oral health-related self-efficacy, knowledge and fatalism indicators for non-toothbrush ownership in a homeless population?

Science.gov (United States)

Jones, K; Brennan, D; Parker, E; Steffens, M; Jamieson, L

2016-03-01

To determine if the social cognitive theory (SCT)-constructs of oral health-related efficacy, knowledge and fatalism were indicators of non-toothbrush ownership in a metropolitan-based homeless population in Australia. Self-report data were collected from a convenience sample of 248 homeless participants located in Adelaide, Australia. Log binomial regression was used to estimate the strength of the association of the SCT constructs efficacy, knowledge and fatalism with the frequency of non-ownership of a toothbrush before and after adjusting for selected characteristics and associated factors. Of the study population (aged 17-78 years, 79% male) just over one-fifth (21%) did not own a toothbrush. In an unadjusted model, low self-efficacy (PR = 1.18) and low knowledge (1.27) were indicators for non-toothbrush ownership. These relationships were attenuated by 5.2% and 3.2% respectively after adjusting for social determinants, health factors, substance use and dental service utilisation-related factors, but remained statistically significant in the final model. Poor oral health-related self-efficacy and knowledge were both indicators for non-ownership of a toothbrush among a homeless population. This relationship held even after adjustment for relevant social and behavioural factors. Fatalism was not an indicator for non-toothbrush ownership in this population.

The 52nd International Conference on Medicinal Chemistry (RICT 2016) of the French Medicinal Chemistry Society (SCT) Held in Caen (Normandy).

Science.gov (United States)

Sapi, Janos; Van Hijfte, Luc; Dallemagne, Patrick

2017-06-21

Outstanding Medchem in France: Guest editors Janos Sapi, Luc Van Hjfte, and Patrick Dallemagne look back at the 52 nd International Conference on Medicinal Chemistry (RICT 2016) held in Caen, France. They discuss the history of the French Medicinal Chemistry Society (Société de Chimie Thérapeutique, SCT) and provide highlights of last year's events, including some key presentations now collected in this Special Issue. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Estimating the treatment effect from non-randomized studies: The example of reduced intensity conditioning allogeneic stem cell transplantation in hematological diseases

Directory of Open Access Journals (Sweden)

Resche-Rigon Matthieu

2012-08-01

Full Text Available Abstract Background In some clinical situations, for which RCT are rare or impossible, the majority of the evidence comes from observational studies, but standard estimations could be biased because they ignore covariates that confound treatment decisions and outcomes. Methods Three observational studies were conducted to assess the benefit of Allo-SCT in hematological malignancies of multiple myeloma, follicular lymphoma and Hodgkin’s disease. Two statistical analyses were performed: the propensity score (PS matching approach and the inverse probability weighting (IPW approach. Results Based on PS-matched samples, a survival benefit in MM patients treated by Allo-SCT, as compared to similar non-allo treated patients, was observed with an HR of death at 0.35 (95%CI: 0.14-0.88. Similar results were observed in HD, 0.23 (0.07-0.80 but not in FL, 1.28 (0.43-3.77. Estimated benefits of Allo-SCT for the original population using IPW were erased in HR for death at 0.72 (0.37-1.39 for MM patients, 0.60 (0.19-1.89 for HD patients, and 2.02 (0.88-4.66 for FL patients. Conclusion Differences in estimated benefits rely on whether the underlying population to which they apply is an ideal randomized experimental population (PS or the original population (IPW. These useful methods should be employed when assessing the effects of innovative treatment in non-randomized experiments.

Factors Influencing Pulmonary Toxicity in Children Undergoing Allogeneic Hematopoietic Stem Cell Transplantation in the Setting of Total Body Irradiation-Based Myeloablative Conditioning

Energy Technology Data Exchange (ETDEWEB)

Abugideiri, Mustafa, E-mail: Mabugid@emory.edu [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Nanda, Ronica H. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Butker, Charlotte [Emory University, Atlanta, Georgia (United States); Zhang, Chao [Department of Biostatistics, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Kim, Sungjin [Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, California (United States); Chiang, Kuang-Yueh [Aflac Cancer Center and Blood Disorders Center, Children' s Healthcare of Atlanta, and Pediatric Hematology, Oncology, Bone Marrow Transplant, Emory University, Atlanta, Georgia (United States); Butker, Elizabeth; Khan, Mohammad K. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Haight, Ann E. [Aflac Cancer Center and Blood Disorders Center, Children' s Healthcare of Atlanta, and Pediatric Hematology, Oncology, Bone Marrow Transplant, Emory University, Atlanta, Georgia (United States); Chen, Zhengjia [Department of Biostatistics, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Esiashvili, Natia [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

2016-02-01

Purpose: This study evaluated factors associated with increased risk of pulmonary toxicity (PT) from any cause in pediatric patients after myeloablative conditioning, using total body irradiation (TBI), followed by allogeneic hematopoietic stem cell transplantation (HSCT). Methods and Materials: The records of 129 consecutive pediatric patients (range: 1-21 years of age) who underwent TBI-based myeloablative conditioning for hematologic malignancies at our institution between January 2003 and May 2014 were reviewed. Although total TBI doses ranged from 10.5 to 14 Gy, lung doses were limited to 10 Gy with partial transmission blocks. TBI dose rates ranged from 5.6 cGy/min to 20.9 cGy/min. PT was classified using clinical symptoms, radiographic evidence, and ventilatory defects on pulmonary function tests. Noninfectious (idiopathic) pneumonia syndrome (IPS) was characterized by patients exhibiting PT while demonstrating no signs of infection throughout the follow-up period. Results: PT from any cause developed in 70.5% of patients and was significantly associated with increased transplantation-related mortality (TRM) (P=.03) and decreased overall survival (OS) (P=.02). IPS developed in 23.3% of patients but was not associated with increased TRM (P=.6) or decreased OS (P=.5). Acute graft-versus-host disease (GVHD) significantly affected PT (P=.001) but did not significantly influence the development of IPS (P=.4). Infection was a leading cause of PT (75.8%). TBI dose rate significantly affected development of overall PT (P=.02) and was the sole factor to significantly influence the incidence of IPS (P=.002). TBI total dose, dose per fraction, disease type, transplantation chemotherapy, age of patient, sex, and donor type did not significantly impact overall PT or IPS. Conclusions: A high incidence of PT was noted in this large series of homogeneously treated pediatric patients undergoing TBI for allogeneic HSCT. TBI dose rates affected overall PT and strongly

Evolutions in clinical reasoning assessment: The Evolving Script Concordance Test.

Science.gov (United States)

Cooke, Suzette; Lemay, Jean-François; Beran, Tanya

2017-08-01

Script concordance testing (SCT) is a method of assessment of clinical reasoning. We developed a new type of SCT case design, the evolving SCT (E-SCT), whereby the patient's clinical story is "evolving" and with thoughtful integration of new information at each stage, decisions related to clinical decision-making become increasingly clear. We aimed to: (1) determine whether an E-SCT could differentiate clinical reasoning ability among junior residents (JR), senior residents (SR), and pediatricians, (2) evaluate the reliability of an E-SCT, and (3) obtain qualitative feedback from participants to help inform the potential acceptability of the E-SCT. A 12-case E-SCT, embedded within a 24-case pediatric SCT (PaedSCT), was administered to 91 pediatric residents (JR: n = 50; SR: n = 41). A total of 21 pediatricians served on the panel of experts (POE). A one-way analysis of variance (ANOVA) was conducted across the levels of experience. Participants' feedback on the E-SCT was obtained with a post-test survey and analyzed using two methods: percentage preference and thematic analysis. Statistical differences existed across levels of training: F = 19.31 (df = 2); p decision-making process. The E-SCT demonstrated very good reliability and was effective in distinguishing clinical reasoning ability across three levels of experience. Participants found the E-SCT engaging and representative of real-life clinical reasoning and decision-making processes. We suggest that further refinement and utilization of the evolving style case will enhance SCT as a robust, engaging, and relevant method for the assessment of clinical reasoning.

Association Between Facility-Level Utilization of Non-pharmacologic Chronic Pain Treatment and Subsequent Initiation of Long-Term Opioid Therapy.

Science.gov (United States)

Carey, Evan P; Nolan, Charlotte; Kerns, Robert D; Ho, P Michael; Frank, Joseph W

2018-05-01

Expert guidelines recommend non-pharmacologic treatments and non-opioid medications for chronic pain and recommend against initiating long-term opioid therapy (LTOT). We examined whether veterans with incident chronic pain receiving care at facilities with greater utilization of non-pharmacologic treatments and non-opioid medications are less likely to initiate LTOT. Retrospective cohort study PARTICIPANTS: Veterans receiving primary care from a Veterans Health Administration facility with incident chronic pain between 1/1/2010 and 12/31/2015 based on either of 2 criteria: (1) persistent moderate-to-severe patient-reported pain and (2) diagnoses "likely to represent" chronic pain. The independent variable was facility-level utilization of pain-related treatment modalities (non-pharmacologic, non-opioid medications, LTOT) in the prior calendar year. The dependent variable was patient-level initiation of LTOT (≥ 90 days within 365 days) in the subsequent year, adjusting for patient characteristics. Among 1,094,569 veterans with incident chronic pain from 2010 to 2015, there was wide facility-level variation in utilization of 10 pain-related treatment modalities, including initiation of LTOT (median, 16%; range, 5-32%). Veterans receiving care at facilities with greater utilization of non-pharmacologic treatments were less likely to initiate LTOT in the year following incident chronic pain. Conversely, veterans receiving care at facilities with greater non-opioid and opioid medication utilization were more likely to initiate LTOT; this association was strongest for past year facility-level LTOT initiation (adjusted rate ratio, 2.10; 95% confidence interval, 2.06-2.15, top vs. bottom quartile of facility-level LTOT initiation in prior calendar year). Facility-level utilization patterns of non-pharmacologic, non-opioid, and opioid treatments for chronic pain are associated with subsequent patient-level initiation of LTOT among veterans with incident chronic pain

Digitalization of a non-irradiated acute myeloid leukemia model.

Science.gov (United States)

Li, Rudong; Cheng, Hui; Cheng, Tao; Liu, Lei

2016-08-26

Computer-aided, interdisciplinary researches for biomedicine have valuable prospects, as digitalization of experimental subjects provide opportunities for saving the economic costs of researches, as well as promoting the acquisition of knowledge. Acute myeloid leukemia (AML) is intensively studied over long periods of time. Till nowaday, most of the studies primarily focus on the leukemic cells rather than how normal hematopoietic cells are affected by the leukemic environment. Accordingly, the conventional animal models for AML are mostly myeloablated as leukemia can be induced with short latency and complete penetrance. Meanwhile, most previous computational models focus on modeling the leukemic cells but not the multi-tissue leukemic body resided by both leukemic and normal blood cells. Recently, a non-irradiated AML mouse model has been established; therefore, normal hematopoietic cells can be investigated during leukemia development. Experiments based on the non-irradiated animal model have monitored the kinetics of leukemic and (intact) hematopoietic cells in multiple tissues simultaneously; and thus a systematic computational model for the multi-tissue hematopoiesis under leukemia has become possible. In the present work, we adopted the modeling methods in previous works, but aimed to model the tri-tissue (peripheral blood, spleen and bone marrow) dynamics of hematopoiesis under leukemia. The cell kinetics generated from the non-irradiated experimental model were used as the reference data for modeling. All mathematical formulas were systematically enumerated, and model parameters were estimated via numerical optimization. Multiple validations by additional experimental data were then conducted for the established computational model. In the results, we illustrated that the important fact of functional depression of hematopoietic stem/progenitor cells (HSC/HPC) in leukemic bone marrow (BM), which must require additional experiments to be established, could

Assessment of non-backfittable concepts to improve PWR uranium utilization

International Nuclear Information System (INIS)

LaBelle, D.W.; Sankovich, M.F.; Spetz, S.W.; Uotinen, V.O.

1980-12-01

Seven non-backfittable improvements to light water reactors were assessed for Batelle/Pacific Northwest Laboratories in support of the Department of Energy's program on Advanced Reactor Studies. The objective was to provide industrial perspective as to which concepts have the best potential for development to improve fuel utilization. The concepts were rated against the assessment criteria while considering the key questions identified for each concept, and recommendations were made for further action on unresolved key questions. The concepts were subjectively ranked against each other in terms of relative investment potential. The ranking considered all criteria but, for example, weighted fuel utilization savings more heavily than development costs. Finally, conclusions and recommendations for future action were determined. The reference design for this study was the NASAP Composite Improved PWR

Development and psychometric properties of a Calcium Intake Questionnaire based on the social cognitive theory (CIQ-SCT) for Iranian women.

Science.gov (United States)

Nematollahi, Mahin; Eslami, Ahmad Ali

2018-01-01

Background: Osteoporosis is common among women which may be mostly due to the low intake of calcium. This article reports the development, cultural adaptation and psychometric properties of a Calcium Intake Questionnaire based on the social cognitive theory (CIQ-SCT)among Iranian women. Methods: In 2016, this cross-sectional study was carried out among 400 younger than 50 years old women in Isfahan, Iran. After literature review, a preliminary 35-item questionnaire was developed. Then, forward-backward translation and cultural adaptation of the tool was conducted. Content Validity Index confirmed by an expert panel and Face Validity was evaluated in a pilot study. Exploratory and confirmatory factor analyses (EFA &CFA) were conducted on the calibration and validation sample, respectively. Reliability was also assessed using internal consistency test. Results: After determining content and face validity, 20 items with 5 factors (self-efficacy,outcome expectations, social support and self-regulation) were obtained. Cronbach alpha for the instrument was found to be 0.901. In EFA, we identified a 4-factor model with a total variance of 72.3%. The results related to CFA (CMIN/DF=1.850, CFI =0.946, TLI=0.938, RMSEA=0.069[90% CI: 0.057-0.081]) indicated that the model was fit to the social cognitive theory. Self regulation was detected as the best predictor for calcium intake. Conclusion: The CIQ-SCT showed acceptable levels of reliability and validity in explaining the calcium intake based on the constructs of social cognitive theory. Further psychometric testing is recommended in different population to approve the external validity of the instrument.

Allogeneic stem cell transplant in patients with chronic lymphocytic leukemia with 17p deletion: consult-transplant versus consult- no-transplant analysis.

Science.gov (United States)

Poon, Michelle L; Fox, Patricia S; Samuels, Barry I; O'Brien, Susan; Jabbour, Elias; Hsu, Yvonne; Gulbis, Alison; Korbling, Martin; Champlin, Richard; Abruzzo, Lynne V; Bassett, Roland L; Khouri, Issa F

2015-03-01

Allogeneic stem cell transplant (alloSCT) can overcome the adverse prognosis of chronic lymphocytic leukemia with 17p deletion (17p- CLL). However, its applicability remains unclear. Since 2007, our leukemia service has referred patients with 17p- CLL for alloSCT at presentation. In this study, the outcomes of these patients were reviewed retrospectively to determine whether they underwent alloSCT and why patients did not undergo alloSCT. Fifty-two patients with 17p- CLL who were referred to the transplant service from 2007 to 2010 were identified. Of these patients, 32 (62%) did not undergo alloSCT, mainly because of treatment- or disease-related complications (n = 15). The 2-year post-referral overall survival rates of the alloSCT and non-SCT groups were 64% and 25%, respectively (p = 0.001). These findings suggest that while alloSCT is an effective therapy in patients with 17p- CLL, pre-SCT complications may preclude a significant proportion of patients from undergoing the procedure.

Non-protein and agro-industrial by-products utilization by ruminants in Bangladesh

International Nuclear Information System (INIS)

Tareque, A.M.M.

1987-01-01

A series of experiments were designed to (1) investigate mixtures of locally available feedstuffs, particularly agro-industrial by-products with or without non-protein nitrogen supplementation as production rations for local and imported breeds of ruminants, (2) formulate rations based on locally available feedstuffs which can be compounded either on a large scale or at the village level for local animals, (3) determine the nutritive value of some non-conventional feedstuffs in terms of their digestibility and their ability to promote microbial synthesis. Rice straw, constituting about 85% of the total available feed dry matter in Bangladesh, is considered a basal, or sometimes the sole, feed for ruminant animals. The efficiency of utilization of rice straw could be improved by adding non-conventional feed resources, such as azolla, banana plant, sweet potato leaves and other legumes and grasses. Rates of growth and feed efficiency by local animals were found to be higher in those fed with urea treated rice straw or bagasse, with or without the addition of concentrates, than in animals fed untreated straw. Rations were also found to be satisfactory when rice straw was fed in combination with urea, legumes such as cowpea hay, azolla and sweet potato leaves or concentrates. It is concluded that the utilization of rice straw by ruminants can be improved by suitable supplementation with non-conventional feed resources. Research is needed to evaluate the use of molasses as a feed ingredient for ruminants in Bangladesh. (author)

On the non-proliferation framework of Japan's peaceful nuclear utilization program

International Nuclear Information System (INIS)

Kano, Takashi

1996-01-01

The Conference of the States Party to the Treaty on the Non-proliferation of Nuclear Weapons (hereinafter referred to as the NPT) convened in New York, from April 17 to May 12, 1995 and decided that the NPT shall continue in force indefinitely, after reviewing the operation and affirming some aspects of the NPT, while emphasizing the ''Decision on Strengthening the Review Process'' for the NPT and the ''Decision on Principles and Objectives for Nuclear Non-proliferation and Disarmament,'' also adopted by the Conference. In parallel, Japan made its basic non-proliferation policy clear in the ''Long-Term Program for Research, Development and Utilization of Nuclear Energy'' which was decided by the Atomic Energy Commission (chaired by Mikio Oomi, then Minister of the Science and Technology Agency of Japan) in June 1994. The Long-Term Program discusses various problems facing post-Cold-War international society and describes Japan's policy for establishing international confidence concerning non-proliferation. This paper summarizes Japan's non-proliferation policy as articulated in the Long-Term Program, and describes some results of an analysis comparing the Long-Term Program with the resolutions on the international non-proliferation frameworks adopted by the NPT conference

Characteristics and utilization of non-wood pulp and paper; Himokuzai pulp / kami no tokucho to sono riyo

Energy Technology Data Exchange (ETDEWEB)

Hara, H. [Mishima Paper Co. Ltd., Shizuoka (Japan)

1998-09-01

The reasons, difficulty in the usage, and the methods of use of non-wood papers are discussed. Non-wood papers sold in Japan are arranged basing on published data. The type of non-wood paper classified as special printing paper makes up the majority, and there are a variety of other products such as printing board, coated paper, thin paper, wrapping paper, functional paper, and watercolor paper. Kenaf and cotton are used in large quantities as non-wood plants for paper production, and use of bagasse and bamboo is increasing. Non-wood paper are used in consideration of environmental and resources problems and for utilizing the special features of non-wood fiber, and the characteristics of non-wood pulp and the effect of non-wood paper are discussed in this report. It is expected that papers utilizing the characteristics of non-wood paper will be developed. Non-wood papers are substitutions for various papers produced from wood pulp, and the fundamental point is the method of improving the original quality and paper quality by combining with non-wood pulp. 11 refs., 4 figs., 3 tabs.

NON-EXPECTED UTILITY THEORIES: WEIGHTED EXPECTED, RANK DEPENDENT, AND CUMULATIVE PROSPECT THEORY UTILITY

OpenAIRE

Tuthill, Jonathan W.; Frechette, Darren L.

2002-01-01

This paper discusses some of the failings of expected utility including the Allais paradox and expected utility's inadequate one dimensional characterization of risk. Three alternatives to expected utility are discussed at length; weighted expected utility, rank dependent utility, and cumulative prospect theory. Each alternative is capable of explaining Allais paradox type problems and permits more sophisticated multi dimensional risk preferences.

Factors associated with the non-utilization of contraceptives in adolescence

OpenAIRE

Boruchovitch, Evely

1992-01-01

Elaborou-se revisão crítica da literatura sobre os fatores associados ao não uso de anticoncepcionais, na adolescência. Procurou-se integrar resultados de pesquisa, tanto no sentido de uma maior compreensão da vulnerabilidade do adolescente para problemas como a gravidez indesejada e a AIDS, quanto para o desenvolvimento de uma educação sexual mais efetiva e realista para esta faixa etária.The literature concerning the major correlates of the non-utilization contraceptives in adolescence is c...

Reduced-intensity conditioning for the treatment of malignant and life-threatening non-malignant disorders.

Science.gov (United States)

Slavin, Shimon; Aker, Mehmet; Shapira, Michael Y; Resnick, Igor; Bitan, Menachem; Or, Reuven

2003-01-01

Allogeneic bone marrow or blood stem cell transplantation (BMT) represents an important therapeutic tool for the treatment of an otherwise incurable broad spectrum of malignant and non-malignant diseases. Until recently, BMT was used primarily to replace a malignant, genetically abnormal or deficient immunohematopoietic compartment and therefore, highly toxic myeloablative regimens were considered mandatory for more effective eradication of all undesirable host-derived hematopoietic cells, including stem cells and their progeny. Our preclinical and ongoing clinical studies indicated that much more effective eradication of host immunohematopoietic system cells can be mediated by donor lymphocytes in the process of adoptive allogeneic cell therapy following BMT. Thus, eradication of all malignant cells, especially in patients with CML and, to a lesser extent, in patients with other hematologic malignancies can be accomplished despite complete resistance of puch tumor cells to maximally tolerated doses of chemoradiotherapy. Our cumulative experience suggested that graft-versus-malignancy effects might be used as a tool for eradication of otherwise resistant tumor cells of host origin. We speculated that the therapeutic benefit of BMT may be improved by using safer conditioning for engraftment of donor stem cells induce host-versus-graft unresponsiveness to enable engraftment of donor lymphocytes for subsequent induction of graft-versus-malignancy effects, or even graft-versus-autoimmunity and graft-versus-genetically abnormal cells. In other words, focusing on more selective and smarter rather than stronger modalities. Effective BMT procedures may be accomplished without lethal conditioning of the host, using a new, well-tolerated and user-friendly non-myeloablative regimen, thus eliminating or minimizing immediate and late procedure-related toxicity and mortality. It appears that initial induction of graft tolerance, mediated by engraftment of donor stem cells, leads

Hyperbilirubinaemia: its utility in non-perforated appendicitis.

Science.gov (United States)

Sandstrom, Anna; Grieve, David A

2017-07-01

The diagnosis of acute appendicitis is made using clinical findings and investigations. Recent studies have suggested that serum bilirubin, a cheap and simple biochemical test, is a positive predictor in the diagnosis of appendiceal perforation and may be more specific than C-reactive protein (CRP) and white cell count (WCC). The aim of this study was to investigate the utility of the serum bilirubin level in patients with suspected acute but non-perforative appendicitis. A retrospective chart review of 213 patients who presented with suspected appendicitis in a 6-month period to Nambour General Hospital was performed. Serum bilirubin, WCC and CRP were recorded and analysed as to their utility in relation to the final diagnosis. A total of 196 patients underwent an appendicectomy and 41 of these were negative. The specificity of hyperbilirubinaemia for appendicitis overall was 0.83 with a positive predictive value (PPV) of 0.86, compared with CRP (specificity 0.40, PPV 0.75) and WCC (specificity 0.67, PPV 0.85). The area under the receiver operating characteristic curve for bilirubin was 0.6289 compared to 0.6171 for CRP and 0.7219 for WCC. A subgroup analysis of those with complicated appendicitis demonstrated a PPV for bilirubin of 0.66 compared to 0.58 for WCC and 0.34 for CRP in agreement with the literature. Subgroup analysis of hyperbilirubinaemia in simple appendicitis demonstrated a PPV of 0.81 compared to CRP (0.71) and WCC (0.82). Bilirubin had a higher specificity than CRP and WCC overall in patients with appendicitis. Hyperbilirubinaemia had a high PPV in patients with simple appendicitis. © 2015 Royal Australasian College of Surgeons.

The impact of a conditional cash transfer program on the utilization of non-targeted services: Evidence from Afghanistan.

Science.gov (United States)

Witvorapong, Nopphol; Foshanji, Abo Ismael

2016-03-01

While existing research suggests that health-related conditional cash transfer (CCT) programs have positive impacts on the utilization of CCT-targeted health services, little is known as to whether they also influence the utilization of non-targeted health services-defined as general health services for which program participants are not financially motivated. Based on a sample of 6649 households in a CCT program that took place in May 2009-June 2011 in Afghanistan, we evaluate the impact of the receipt of CCTs on the utilization of non-targeted health services both by women, who were direct beneficiaries of the program, and by members of their households. We estimate the outcomes of interest through four probit models, accounting for potential endogeneity of the CCT receipt and dealing with lack of credible exclusion restrictions in different ways. In comparison with the control group, the receipt of CCTs is found to be associated with an increase in the probability of utilizing non-targeted services among household members across regression models. The results are mixed, with regard to the utilization by women, suggesting that there exist non-economic barriers to health care, unique to women, that are not captured by the data. The results confirm the importance of accounting for direct as well as indirect effects in policy evaluation and suggest that future studies investigate more deeply the role of community health workers in removing non-economic barriers for Afghan women and the possibility of introducing an incentive structure to motivate them to contribute more actively to population health in Afghanistan. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reaction of intermetallic compounds of the ScT composition (T=Ag, Cu, Zn, Ni) with hydrogen

International Nuclear Information System (INIS)

Shilkin, S.P.; Volkova, L.S.; Tarasov, B.P.

1995-01-01

Reaction of intermetallic compounds of ScT composition (T=Ag, Cu, Zn, Ni), crystallized in CsCl structural type, with hydrogen at 0.2-10 MPa pressure and 293-673 K temperature is studied by chemical, x-ray phase and complex thermogravimetry analysis methods. It is shown that under such conditions hydrogen absorption by ScAg and ScCu is accompanied by the decay of their source matrices into scandium dihydride and metal silver and copper respectively. For ScZn a fine-dispersion mixture of scandium dihydride with zinc and hydride phase of a new zinc-containing intermetallic compound appears to be the finite reaction product. In case of ScNi a hydride phase of ScNiH 2.6 composition is produced, which is crystallized in a rhombic syngony with the lattice periods: a=0.5281±0.0007, b=0.7393±0.0009 and c=0.3327±0.0004 nm. 9 refs.; 2 tabs

Integrated CO{sub 2} Capture and Utilization Using Non-Thermal Plasmolysis

Energy Technology Data Exchange (ETDEWEB)

Moss, Matthew, E-mail: mmoss1@sheffield.ac.uk; Reed, Daniel G.; Allen, Ray W. K.; Styring, Peter [UK Centre for Carbon Dioxide Utilisation, Department of Chemical and Biological Engineering, University of Sheffield, Sheffield (United Kingdom)

2017-08-02

In this work, two simple processes for carbon dioxide (CO{sub 2}) such as capture and utilization have been combined to form a whole systems approach to carbon capture and utilization (CCU). The first stage utilizes a pressure swing adsorption (PSA) system, which offers many benefits over current amine technologies. It was found that high selectivity can be achieved with rapid adsorption/desorption times while employing a cheap, durable sorbent that exhibits no sorbent losses and is easily regenerated by simple pressure drops. The PSA system is capable of capturing and upgrading the CO{sub 2} concentration of a waste gas stream from 12.5% to a range of higher purities. As many CCU end processes have some tolerance toward impurities in the feed, in the form of nitrogen (N{sub 2}), for example, this is highly advantageous for this PSA system since CO{sub 2} purities in excess of 80% can be achieved with only a few steps and minimal energy input. Non-thermal plasma is one such technology that can tolerate, and even benefit from, small N{sub 2} impurities in the feed, therefore a 100% pure CO{sub 2} stream is not required. The second stage of this process deploys a nanosecond pulsed corona discharge reactor to split the captured CO{sub 2} into carbon monoxide (CO), which can then be used as a chemical feedstock for other syntheses. Corona discharge has proven industrial applications for gas cleaning and the benefit of pulsed power reduces the energy consumption of the system. The wire-in-cylinder geometry concentrates the volume of gas treated into the area of high electric field. Previous work has suggested that moderate conversions can be achieved (9%), compared to other non-thermal plasma methods, but with higher energy efficiencies (>60%).

Assessment of clinical reasoning: A Script Concordance test designed for pre-clinical medical students.

Science.gov (United States)

Humbert, Aloysius J; Johnson, Mary T; Miech, Edward; Friedberg, Fred; Grackin, Janice A; Seidman, Peggy A

2011-01-01

The Script Concordance test (SCT) measures clinical reasoning in the context of uncertainty by comparing the responses of examinees and expert clinicians. It uses the level of agreement with a panel of experts to assign credit for the examinee's answers. This study describes the development and validation of a SCT for pre-clinical medical students. Faculty from two US medical schools developed SCT items in the domains of anatomy, biochemistry, physiology, and histology. Scoring procedures utilized data from a panel of 30 expert physicians. Validation focused on internal reliability and the ability of the SCT to distinguish between different cohorts. The SCT was administered to an aggregate of 411 second-year and 70 fourth-year students from both schools. Internal consistency for the 75 test items was satisfactory (Cronbach's alpha = 0.73). The SCT successfully differentiated second- from fourth-year students and both student groups from the expert panel in a one-way analysis of variance (F(2,508) = 120.4; p students from the two schools were not significantly different (p = 0.20). This SCT successfully differentiated pre-clinical medical students from fourth-year medical students and both cohorts of medical students from expert clinicians across different institutions and geographic areas. The SCT shows promise as an easy-to-administer measure of "problem-solving" performance in competency evaluation even in the beginning years of medical education.

Beyond Sexual Orientation: Integrating Gender/Sex and Diverse Sexualities via Sexual Configurations Theory.

Science.gov (United States)

van Anders, Sari M

2015-07-01

Sexual orientation typically describes people's sexual attractions or desires based on their sex relative to that of a target. Despite its utility, it has been critiqued in part because it fails to account for non-biological gender-related factors, partnered sexualities unrelated to gender or sex, or potential divergences between love and lust. In this article, I propose Sexual Configurations Theory (SCT) as a testable, empirically grounded framework for understanding diverse partnered sexualities, separate from solitary sexualities. I focus on and provide models of two parameters of partnered sexuality--gender/sex and partner number. SCT also delineates individual gender/sex. I discuss a sexual diversity lens as a way to study the particularities and generalities of diverse sexualities without privileging either. I also discuss how sexual identities, orientations, and statuses that are typically seen as misaligned or aligned are more meaningfully conceptualized as branched or co-incident. I map out some existing identities using SCT and detail its applied implications for health and counseling work. I highlight its importance for sexuality in terms of measurement and social neuroendocrinology, and the ways it may be useful for self-knowledge and feminist and queer empowerment and alliance building. I also make a case that SCT changes existing understandings and conceptualizations of sexuality in constructive and generative ways informed by both biology and culture, and that it is a potential starting point for sexual diversity studies and research.

Improving the Prediction of Total Surgical Procedure Time Using Linear Regression Modeling

Directory of Open Access Journals (Sweden)

Eric R. Edelman

2017-06-01

Full Text Available For efficient utilization of operating rooms (ORs, accurate schedules of assigned block time and sequences of patient cases need to be made. The quality of these planning tools is dependent on the accurate prediction of total procedure time (TPT per case. In this paper, we attempt to improve the accuracy of TPT predictions by using linear regression models based on estimated surgeon-controlled time (eSCT and other variables relevant to TPT. We extracted data from a Dutch benchmarking database of all surgeries performed in six academic hospitals in The Netherlands from 2012 till 2016. The final dataset consisted of 79,983 records, describing 199,772 h of total OR time. Potential predictors of TPT that were included in the subsequent analysis were eSCT, patient age, type of operation, American Society of Anesthesiologists (ASA physical status classification, and type of anesthesia used. First, we computed the predicted TPT based on a previously described fixed ratio model for each record, multiplying eSCT by 1.33. This number is based on the research performed by van Veen-Berkx et al., which showed that 33% of SCT is generally a good approximation of anesthesia-controlled time (ACT. We then systematically tested all possible linear regression models to predict TPT using eSCT in combination with the other available independent variables. In addition, all regression models were again tested without eSCT as a predictor to predict ACT separately (which leads to TPT by adding SCT. TPT was most accurately predicted using a linear regression model based on the independent variables eSCT, type of operation, ASA classification, and type of anesthesia. This model performed significantly better than the fixed ratio model and the method of predicting ACT separately. Making use of these more accurate predictions in planning and sequencing algorithms may enable an increase in utilization of ORs, leading to significant financial and productivity related

Improving the Prediction of Total Surgical Procedure Time Using Linear Regression Modeling.

Science.gov (United States)

Edelman, Eric R; van Kuijk, Sander M J; Hamaekers, Ankie E W; de Korte, Marcel J M; van Merode, Godefridus G; Buhre, Wolfgang F F A

2017-01-01

For efficient utilization of operating rooms (ORs), accurate schedules of assigned block time and sequences of patient cases need to be made. The quality of these planning tools is dependent on the accurate prediction of total procedure time (TPT) per case. In this paper, we attempt to improve the accuracy of TPT predictions by using linear regression models based on estimated surgeon-controlled time (eSCT) and other variables relevant to TPT. We extracted data from a Dutch benchmarking database of all surgeries performed in six academic hospitals in The Netherlands from 2012 till 2016. The final dataset consisted of 79,983 records, describing 199,772 h of total OR time. Potential predictors of TPT that were included in the subsequent analysis were eSCT, patient age, type of operation, American Society of Anesthesiologists (ASA) physical status classification, and type of anesthesia used. First, we computed the predicted TPT based on a previously described fixed ratio model for each record, multiplying eSCT by 1.33. This number is based on the research performed by van Veen-Berkx et al., which showed that 33% of SCT is generally a good approximation of anesthesia-controlled time (ACT). We then systematically tested all possible linear regression models to predict TPT using eSCT in combination with the other available independent variables. In addition, all regression models were again tested without eSCT as a predictor to predict ACT separately (which leads to TPT by adding SCT). TPT was most accurately predicted using a linear regression model based on the independent variables eSCT, type of operation, ASA classification, and type of anesthesia. This model performed significantly better than the fixed ratio model and the method of predicting ACT separately. Making use of these more accurate predictions in planning and sequencing algorithms may enable an increase in utilization of ORs, leading to significant financial and productivity related benefits.

In vivo T-cell depletion using alemtuzumab in family and unrelated donor transplantation for pediatric non-malignant disease achieves engraftment with low incidence of graft vs. host disease.

Science.gov (United States)

Saif, M A; Borrill, R; Bigger, B W; Lee, H; Logan, A; Poulton, K; Hughes, S; Turner, A J; Bonney, D K; Wynn, R F

2015-03-01

In vivo T-cell depletion, using alemtuzumab therapy prior to SCT, can reduce the incidence of GVHD. This treatment has a potential to delay immune reconstitution resulting in increased morbidity due to viral illnesses. We retrospectively analyzed data on all pediatric patients with non-malignant disorders who received alemtuzumab-based conditioning regimens in our center over the last 10 yr (n = 91). Our data show an OS of 91.2%. The incidence of acute (grade 2-4) GVHD was 18.7% and that of chronic GVHD 5.5%. Viremia due to adenovirus, EBV and CMV was seen in 19.8%, 64.8% and 39.6% patients, respectively, with only two deaths attributed to viral infection (adenovirus). Chimerism level at three month was predictive of graft outcome. Nine patients, who had graft failure after first SCT, were salvaged with a second SCT using RIC and same donor (if available). Based on these results, we conclude that the use of in vivo T-cell depletion is safe, achieves good chimerism and does not lead to increased morbidity and mortality due to viral infections. It is associated with a reduced incidence of chronic GVHD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Test of Social Cognitive Theory to Explain Men's Physical Activity During a Gender-Tailored Weight Loss Program.

Science.gov (United States)

Young, Myles D; Plotnikoff, Ronald C; Collins, Clare E; Callister, Robin; Morgan, Philip J

2016-11-01

Physical inactivity is a leading contributor to the burden of disease in men. Social-cognitive theories may improve physical activity (PA) interventions by identifying which variables to target to maximize intervention impact. This study tested the utility of Bandura's social cognitive theory (SCT) to explain men's PA during a 3-month weight loss program. Participants were 204 overweight/obese men (M [SD] age = 46.6 [11.3] years; body mass index = 33.1 [3.5] kg/m 2 ). A longitudinal, latent variable structural equation model tested the associations between SCT constructs (i.e., self-efficacy, outcome expectations, intention, and social support) and self-reported moderate-to-vigorous PA (MVPA) and examined the total PA variance explained by SCT. After controlling for Time 1 cognitions and behavior, the model fit the data well (χ 2 = 73.9, degrees of freedom = 39, p social support. This study provides some evidence supporting the tenets of SCT when examining PA behavior in overweight and obese men. Future PA and weight loss interventions for men may benefit by targeting self-efficacy and intention, but the utility of targeting social support and outcome expectations requires further examination. © The Author(s) 2015.

A Guide to Community Shared Solar: Utility, Private, and Non-Profit Project Development (Book)

Energy Technology Data Exchange (ETDEWEB)

Coughlin, J.; Grove, J.; Irvine, L.; Jacobs, J. F.; Johnson Phillips, S.; Sawyer, A.; Wiedman, J.

2012-05-01

This guide is organized around three sponsorship models: utility-sponsored projects, projects sponsored by special purpose entities - businesses formed for the purpose of producing community solar power, and non-profit sponsored projects. The guide addresses issues common to all project models, as well as issues unique to each model.

3-bromopyruvate and sodium citrate target glycolysis, suppress survivin, and induce mitochondrial-mediated apoptosis in gastric cancer cells and inhibit gastric orthotopic transplantation tumor growth.

Science.gov (United States)

Wang, Ting-An; Zhang, Xiao-Dong; Guo, Xing-Yu; Xian, Shu-Lin; Lu, Yun-Fei

2016-03-01

Glycolysis is the primary method utilized by cancer cells to produce the energy (adenosine triphosphate, ATP) required for cell proliferation. Therefore, inhibition of glycolysis may inhibit tumor growth. We previously found that both 3-bromopyruvate (3-BrPA) and sodium citrate (SCT) can inhibit glycolysis in vitro; however, the underlying inhibitory mechanisms remain unclear. In the present study, we used a human gastric cancer cell line (SGC-7901) and an orthotopic transplantation tumor model in nude mice to explore the specific mechanisms of 3-BrPA and SCT. We found that both 3-BrPA and SCT effectively suppressed cancer cell proliferation, arrested the cell cycle, induced apoptosis, and decreased the production of lactate and ATP. 3-BrPA significantly reduced the glycolytic enzyme hexokinase activity, while SCT selectively inhibited phosphofructokinase-1 activity. Furthermore, 3-BrPA and SCT upregulated the expression of pro-apoptotic proteins (Bax, cytochrome c, and cleaved caspase-3) and downregulated the expression of anti-apoptotic proteins (Bcl-2 and survivin). Finally, our animal model of gastric cancer indicated that intraperitoneal injection of 3-BrPA and SCT suppressed orthotopic transplantation tumor growth and induced tumor apoptosis. Taken together, these results suggest that 3-BrPA and SCT selectively suppress glycolytic enzymes, decrease ATP production, induce mitochondrial-mediated apoptosis, downregulate survivin, and inhibit tumor growth. Moreover, an intraperitoneal injection is an effective form of administration of 3-BrPA and SCT.

International practice patterns and factors associated with non-conventional hemodialysis utilization

Directory of Open Access Journals (Sweden)

Allen Nathan

2011-12-01

Full Text Available Abstract Background The purpose of our study was to determine characteristics that influence the utilization of non-conventional hemodialysis (NCHD therapies and its subtypes (nocturnal (NHD, short daily (SDHD, long conventional (LCHD and conventional hemodialysis (CHD as well as provider attitudes regarding the evidence for NCHD use. Methods An international cohort of subscribers of a nephrology education website http://www.nephrologynow.com was invited to participate in an online survey. Non-conventional hemodialysis was defined as any forms of hemodialysis delivered > 3 treatments per week and/or > 4 hours per session. NHD and SDHD included both home and in-centre. Respondents were categorized as CHD if their centre only offered conventional thrice weekly hemodialysis. Variables associated with NCHD and its subtypes were determined using multivariate logistic regression analysis. The survey assessed multiple domains regarding NCHD including reasons for initiating and discontinuing, for not offering and attitudes regarding evidence. Results 544 surveys were completed leading to a 15.6% response rate. The final cohort was limited to 311 physicians. Dialysis modalities utilized among the respondents were as follows: NCHD194 (62.4%, NHD 83 (26.7%, SDHD 107 (34.4%, LCHD 81 (26% and CHD 117 (37.6%. The geographic regions of participants were as follows: 11.9% Canada, 26.7% USA, 21.5% Europe, 6.1% Australia/New Zealand, 10% Africa/Middle East, 10.9% Asia and 12.9% South America. Variables associated with NCHD utilization included NCHD training (OR 2.47 CI 1.25-4.16, government physician reimbursement (OR 2.66, CI 1.11-6.40, practicing at an academic centre (OR 2.28 CI 1.25-4.16, higher national health care expenditure and number of ESRD patients per centre. Hemodialysis providers with patients on NCHD were significantly more likely to agree with the statements that NCHD improves quality of life, improves nutritional status, reduces EPO requirements

Efficiency Analysis of German Electricity Distribution Utilities : Non-Parametric and Parametric Tests

OpenAIRE

von Hirschhausen, Christian R.; Cullmann, Astrid

2005-01-01

Abstract This paper applies parametric and non-parametric and parametric tests to assess the efficiency of electricity distribution companies in Germany. We address traditional issues in electricity sector benchmarking, such as the role of scale effects and optimal utility size, as well as new evidence specific to the situation in Germany. We use labour, capital, and peak load capacity as inputs, and units sold and the number of customers as output. The data cover 307 (out of 553) ...

Three-dimensional reconstruction of the biliary tract using spiral computed tomography. Three-dimensional cholangiography

International Nuclear Information System (INIS)

Gon, Masanori; Ogura, Norihiro; Uetsuji, Shouji; Ueyama, Yasuo

1995-01-01

In this study, 310 patients with benign biliary diseases, 20 with gallbladder cancer, and 8 with biliary tract carcinoma underwent spiral CT (SCT) scanning at cholangiography. Depiction rate of the shape of the conjunction site of the gallbladder and biliary tract was 27.5% by conventional intravenous cholangiography (DIC), 92.5% by ERC, and 90.0% by DIC-SCT. Abnormal cystic duct course was admitted in 14.1%. Multiplanar reconstruction by DIC-SCT enabled identification of the common bile duct and intrahepatic bile duct stone. Three-dimensional reconstruction of DIC-SCT was effective in evaluating obstruction of the anastomosis or passing condition of after hepatico-jejunostomy. Two-dimensional SCT images through PTCD tube enabled degree of hepatic invasion in bile duct cancer, and three-dimensional images were useful in grasping the morphology of the bile duct branches near the obstruction site. DIC-SCT is therefore considered a useful procedure as non-invasive examination of bile duct lesions. (S.Y.)

Evidence of displacement-driven maturation along the San Cristobal Trough transform plate boundary

Science.gov (United States)

Neely, James S.; Furlong, Kevin P.

2018-03-01

The San Cristobal Trough (SCT), formed by the tearing of the Australia plate as it subducts under the Pacific plate near the Solomon Islands, provides an opportunity to study the transform boundary development process. Recent seismicity (2013-2016) along the 280 km long SCT, known as a Subduction-Transform Edge Propagator (STEP) fault, highlights the tearing process and ongoing development of the plate boundary. The region's earthquakes reveal two key characteristics. First, earthquakes at the western terminus of the SCT, which we interpret to indicate the Australia plate tearing, display disparate fault geometries. These events demonstrate that plate tearing is accommodated via multiple intersecting planes rather than a single through-going fault. Second, the SCT hosts sequences of Mw ∼7 strike-slip earthquakes that migrate westward through a rapid succession of events. Sequences in 1993 and 2015 both began along the eastern SCT and propagated west, but neither progression ruptured into or nucleated a large earthquake within the region near the tear. Utilizing b-value and Coulomb Failure Stress analyses, we examine these along-strike variations in the SCT's seismicity. b-Values are highest along the youngest, western end of the SCT and decrease with increasing distance from the tear. This trend may reflect increasing strain localization with increasing displacement. Coulomb Failure Stress analyses indicate that the stress conditions were conducive to continued western propagation of the 1993 and 2015 sequences suggesting that the unruptured western SCT may have fault geometries or properties that inhibit continued rupture. Our results indicate a displacement-driven fault maturation process. The multi-plane Australia plate tearing likely creates a western SCT with diffuse strain accommodated along a network of disorganized faults. After ∼90 km of cumulative displacement (∼900,000 yr of plate motion), strain localizes and faults align, allowing the SCT to host

MHD simulation study of compact toroid injection into magnetized plasmas

International Nuclear Information System (INIS)

Suzuki, Yoshio; Kishimoto, Yasuaki

2000-01-01

To understand the fuelling process in a fusion device by a compact toroid (CT) plasmoid injection method, we have carried out MHD numerical simulations where a spheromak-like CT (SCT) is injected into a magnetized target plasma region. So far, we revealed that the penetration depth of the SCT plasma becomes shorter than that estimated from the conducting sphere (CS) model, because in the simulation the Lorentz force of the target magnetic field sequentially decelerates the injected SCT while in the CS model only the magnetic pressure force acts as the deceleration mechanism. In this study, we represent the new theoretical model where the injected SCT is decelerated by both the magnetic pressure force and the magnetic tension force (we call it the non-slipping sphere (NS) model) and investigate in detail the deceleration mechanism of the SCT by comparison with simulation results. As a result, it is found that the decrease of the SCT kinetic energy in the simulation coincides with that in the NS model more than in the CS model. It means that not only the magnetic pressure force but also the magnetic tension force acts as the deceleration mechanism of the SCT. Furthermore, it is revealed that magnetic reconnection between the SCT magnetic field and the target magnetic field plays a role to relax the SCT deceleration. (author)

Does high-resolution CT has diagnostic value in patients presenting with respiratory symptoms after hematopoietic stem cell transplantation?

International Nuclear Information System (INIS)

Wijers, Sofieke C.; Boelens, Jaap Jan; Raphael, Martine F.; Beek, Frederik J.; Jong, Pim A. de

2011-01-01

Background: Hematopoietic stem cell transplantation (SCT) can be complicated by a variety of live-threatening infectious and non-infectious pulmonary complications. The management of these complications is critically dependent on the most probable diagnosis, which is in part based on imaging work-up. Methods: Systematic review of the literature related to the diagnostic value of high-resolution computed tomography (HRCT) in patients who underwent SCT and developed respiratory symptoms. Results: Literature review did not reveal systematic cohort studies that included patients with respiratory symptoms post-SCT who underwent HRCT and had a well-defined outcome. Most studies selected participants based on their final diagnosis instead of the indication for diagnostic testing in practice. Nevertheless, several papers clearly indicated a potential role for HRCT when complications after SCT occur. A variety of articles described the role of certain HRCT findings in the diagnosis of specific infectious complications, but less data were available for non-infectious complications. Conclusion: We believe more diagnostic studies are needed to determine the value of HRCT for a specific diagnosis in SCT-recipients who present with respiratory symptoms at the transplant clinic. Currently, radiologists should be cautious since HRCT interpretation in these patients is not unambiguous.

Computed tomography with continuous transport and continuous scanner rotation for laparoscopic cholecystectomy

International Nuclear Information System (INIS)

Kwon, A-Hon; Uetsuji, Shoji; Boku, Tsunehide; Yamada, Osamu; Inoue, Tomohisa; Kamiyama, Yasuo

1995-01-01

We investigated 58 cases of cholecystolithiasis including 8 cases of choledocholithiasis treated with laparoscopic cholecystectomy. All patients received spiral CT scanning with drip infusion cholangiography (DIC-SCT), and 16 patients received endoscopic retrograde cholangiography (ERC), and the detection rates of the gallbladder, the bile duct and the cystic duct were compared. The gallbladder could be seen in 86.2% of cases with DIC-SCT and in 63.8% of cases with conventional DIC. The junction between the cystic duct and the common bile duct could be seen in 18 of 58 cases with DIC and in 49 of 58 cases with DIC-SCT. The DIC-SCT showed significantly superior anatomical datails compared with images with conventional DIC. A comparison of DIC, ERC and DIC-SCT revealed that the junction between the cystic duct and the common bile duct could be identified in 14 of 16 cases undergoing ERC, in 13 of 16 cases receiving DIC-SCT and in 4 of 16 cases receiving DIC. Significant differences were noted among DIC-SCT, ERC and conventional DIC. We concluded that DIC-SCT is easy, non-invasive and useful for the preoperative assessment of laparoscopic cholecystectomy and also helpful for avoiding damage to the bile duct. (author)

Utilization of Adult and Non-Formal Education Programs in Combating Rural Poverty in Nigeria

Science.gov (United States)

Ihejirika, John Chinedu

2012-01-01

The purpose of this paper was to examine the concept of poverty and its causes in Nigeria and to analyze how adult and non-formal education programs can be utilized to reduce rural poverty in Nigeria. In spite of Nigeria's affluence in human and material resources, it is classified among countries with high level of poverty. Incidentally, the…

POWER-GEN '90 conference papers: Volume 3 (Environmental trends and issues) and Volume 4 (Case histories - Non-utility power generation)

International Nuclear Information System (INIS)

Anon.

1990-01-01

This is book 2 of a collection of papers presented at the Third International Power Generation Industries Conference on December 4-6, 1990. The book contains Volume 3, Environmental Trends and Issues, and Volume 4, Case Histories - Non-utility Power Generation. The topics of the papers include environmental legislative and regulatory trends, acid rain compliance strategies and technologies, other global environmental concerns, gas fired systems, solid and waste fuels, despatching and wheeling, and strategies for purchasing non-utility power

Application of Cu-polyimide flex circuit and Al-on-glass pitch adapter for the ATLAS SCT barrel hybrid

CERN Document Server

Unno, Y; Ikegami, Y; Iwata, Y; Kohriki, T; Kondo, T; Nakano, I; Ohsugi, T; Takashima, R; Tanaka, R; Terada, S; Ujiie, N

2005-01-01

We applied the surface build-up Cu-polyimide flex-circuit technology with laser vias to the ATLAS SCT barrel hybrid to be made in one piece from the connector to the electronics sections including cables. The hybrids, reinforced with carbon-carbon substrates, provide mechanical strength, thermal conductivity, low-radiation length, and stability in application-specific integrated circuit (ASIC) operation. By following the design rules, we experienced little trouble in breaking the traces. The pitch adapter between the sensor and the ASICs was made of aluminum traces on glass substrate. We identified that the generation of whiskers around the wire-bonding feet was correlated with the hardness of metallized aluminum. The appropriate hardness has been achieved by keeping the temperature of the glasses as low as room temperature during the metallization. The argon plasma cleaning procedure cleaned the contamination on the gold pads of the hybrids for successful wire bonding, although it was unsuccessful in the alu...

Prospective, Randomized, Double-Blind, Phase III Clinical Trial of Anti-T-Lymphocyte Globulin to Assess Impact on Chronic Graft-Versus-Host Disease-Free Survival in Patients Undergoing HLA-Matched Unrelated Myeloablative Hematopoietic Cell Transplantation.

Science.gov (United States)

Soiffer, Robert J; Kim, Haesook T; McGuirk, Joseph; Horwitz, Mitchell E; Johnston, Laura; Patnaik, Mrinal M; Rybka, Witold; Artz, Andrew; Porter, David L; Shea, Thomas C; Boyer, Michael W; Maziarz, Richard T; Shaughnessy, Paul J; Gergis, Usama; Safah, Hana; Reshef, Ran; DiPersio, John F; Stiff, Patrick J; Vusirikala, Madhuri; Szer, Jeff; Holter, Jennifer; Levine, James D; Martin, Paul J; Pidala, Joseph A; Lewis, Ian D; Ho, Vincent T; Alyea, Edwin P; Ritz, Jerome; Glavin, Frank; Westervelt, Peter; Jagasia, Madan H; Chen, Yi-Bin

2017-12-20

Purpose Several open-label randomized studies have suggested that in vivo T-cell depletion with anti-T-lymphocyte globulin (ATLG; formerly antithymocyte globulin-Fresenius) reduces chronic graft-versus-host disease (cGVHD) without compromising survival. We report a prospective, double-blind phase III trial to investigate the effect of ATLG (Neovii Biotech, Lexington, MA) on cGVHD-free survival. Patients and Methods Two hundred fifty-four patients 18 to 65 years of age with acute leukemia or myelodysplastic syndrome who underwent myeloablative HLA-matched unrelated hematopoietic cell transplantation (HCT) were randomly assigned one to one to placebo (n =128 placebo) or ATLG (n = 126) treatment at 27 sites. Patients received either ATLG or placebo 20 mg/kg per day on days -3, -2, -1 in addition to tacrolimus and methotrexate as GVHD prophylaxis. The primary study end point was moderate-severe cGVHD-free survival. Results Despite a reduction in grade 2 to 4 acute GVHD (23% v 40%; P = .004) and moderate-severe cGVHD (12% v 33%; P < .001) in ATLG recipients, no difference in moderate-severe cGVHD-free survival between ATLG and placebo was found (2-year estimate: 48% v 44%, respectively; P = .47). Both progression-free survival (PFS) and overall survival (OS) were lower with ATLG (2-year estimate: 47% v 65% [ P = .04] and 59% v 74% [ P = .034], respectively). Multivariable analysis confirmed that ATLG was associated with inferior PFS (hazard ratio, 1.55; 95% CI, 1.05 to 2.28; P = .026) and OS (hazard ratio, 1.74; 95% CI, 1.12 to 2.71; P = .01). Conclusion In this prospective, randomized, double-blind trial of ATLG in unrelated myeloablative HCT, the incorporation of ATLG did not improve moderate-severe cGVHD-free survival. Moderate-severe cGVHD was significantly lower with ATLG, but PFS and OS also were lower. Additional analyses are needed to understand the appropriate role for ATLG in HCT.

Preferential and Non-Preferential Approaches to Trade Liberalization in East Asia: What Differences Do Utilization Rates and Reciprocity Make?

OpenAIRE

Menon, Jayant

2013-01-01

Previous studies on the impacts of free trade agreements (FTAs) in East Asia have assumed full utilization of preferences. The evidence suggests that this assumption is seriously in error, with the estimated uptake particularly low in East Asia. In this paper, we assume a more realistic utilization rate in estimating impacts. We find that actual utilization rates significantly diminish the benefits from preferential liberalization, but in a non-linear way. Reciprocity is an important motivati...

Health Resource Utilization in Patients with Advanced Non-Small Cell Lung Cancer Receiving Chemotherapy in China.

Science.gov (United States)

Shi, Jing; Zhu, Jun

2016-01-01

Chemotherapy is the preferred treatment regimen for advanced lung cancer patients. This study investigated the health resources utilized by and medical expenses of patients with non-small cell lung cancer (NSCLC) as well as the influence of various chemotherapy regimens on the final medical costs in China. The aim of this study was to provide physicians with a reference to use as the basis for their choice of treatment. Data were collected from the Shanghai Chest Hospital's medical charts and billing database. The collected patient information included the baseline characteristics, medical history, chemotherapy regimens, and medical costs, which were used to estimate the health resources utilized by patients and the cost of treatment. This study included 328 patients, and the average total medical cost was $US14,165. This cost included drugs, which accounted for as much as 78.91% of the total cost, and chemotherapy drugs, which accounted for 51.58% of total drug expenses. The most frequently utilized chemotherapy drug was carboplatin, and the most expensive chemotherapy drug was erlotinib. In drug combinations, gemcitabine was utilized most frequently, the combination of gemcitabine and paclitaxel was the most expensive, and cisplatin was the least expensive drug. Epidermal growth factor receptor-positive patients were treated with targeted drug therapy (icotinib, erlotinib, and gefitinib). The use of recombinant human endostatin was often combined with a vinorelbine plus cisplatin regimen. Traditional Chinese medicines were the most frequently utilized non-chemotherapy drugs, and these drugs were also the most expensive. The final cost significantly depended on the specific chemotherapy regimen; thus, the rationale and cost of the chemotherapy regimen and adjuvant chemotherapy should be considered in patients with advanced NSCLC.

Alloreactive regulatory T cells allow the generation of mixed chimerism and transplant tolerance

Directory of Open Access Journals (Sweden)

Paulina eRuiz

2015-11-01

Full Text Available The induction of donor-specific transplant tolerance is one of the main goals of modern immunology. Establishment of a mixed chimerism state in the transplant recipient has proven to be a suitable strategy for the induction of long-term allograft tolerance; however, current experimental recipient preconditioning protocols have many side effects, and are not feasible for use in future therapies. In order to improve the current mixed chimerism induction protocols, we developed a non-myeloablative bone-marrow transplant protocol using retinoic acid induced alloantigen-specific Tregs, clinically available immunosuppressive drugs and lower doses of irradiation. We demonstrate that retinoic acid induced alloantigen-specific Tregs in addition to a non-myeloablative bone-marrow transplant protocol generates stable mixed chimerism and induce tolerance to allogeneic secondary skin allografts in mice. Therefore, the establishment of mixed chimerism through the use of donor-specific Tregs rather than non-specific immunosuppression could have a potential use in organ transplantation.

Factors affecting the potential of direct load control for non-generating utilities. Final report. [Distribution and wholesale power supply interaction

Energy Technology Data Exchange (ETDEWEB)

None

1979-04-01

Several alternatives are available for achieving load management, including direct or voluntary control of customer loads, customer or utility energy storage systems for diurnal load shifting, and expanded interconnection and operation of electric power systems. All of these alternatives are available to the fully integrated (generating, transmitting and distributing) electric utility and the analysis of their effects encompasses the power supply and delivery system. However, the costs and benefits of the alternatives to the fully integrated electric utility are perhaps not so obvious. Therefore, by considering a non-generating utility, this analysis focuses upon the distribution system and wholesale power supply interaction as a step toward an analysis including the power supply and delivery system. This report develops an analysis procedure and discusses some of the relevant factors to be consdered in the application of direct load control for a non-generating utility system. The analysis concentrates on the distribution system only to determine the effect of rates and payback as a result of direct load control. Thus, the study is responsive to the specific needs of the non-generating utility. This analysis of direct load control encompasses the determination of those loads amenable to control, the selection of a suitable one-way communications system to rend control and the estimation of expected benefits and costs. The complementary functions to the application of direct load control such as automatic meter reading via the addition of a bi-directional communications system and voltage control are not included in the analysis but are detailed for future consideration.

Predictors and moderators of biopsychological social stress responses following brief self-compassion meditation training.

Science.gov (United States)

Arch, Joanna J; Landy, Lauren N; Brown, Kirk Warren

2016-07-01

Arch et al. (2014) demonstrated that brief self-compassion meditation training (SCT) dampened sympathetic (salivary alpha-amylase) and subjective anxiety responses to the Trier Social Stress Test (TSST), relative to attention and no-instruction control conditions. The present study examined baseline predictors and moderators of these SCT intervention effects. Baseline characteristics included two stress vulnerability traits (social anxiety and rumination) and two potential resiliency traits (non-attachment and self-compassion). We investigated how these traits moderated the effects of SCT on response to the TSST, relative to the control conditions. We also tested how these individual differences predicted TSST responses across conditions in order to uncover characteristics that confer increased vulnerability and resiliency to social stressors. Trait non-attachment, rumination (for sympathetic TSST response only), and social anxiety (for subjective TSST response only) interacted with training condition to moderate TSST responses such that following SCT, lower attachment and lower social anxiety predicted lower TSST stress responses, relative to those scoring higher on these traits. In contrast, trait self-compassion neither moderated nor predicted responses to the TSST. Thus, although SCT had robust effects on buffering stress across individuals with varying levels of trait self-compassion, other psychological traits enhanced or dampened the effect of SCT on TSST responses. These findings support the importance of examining the role of relevant baseline psychological traits to predict sympathetic and subjective responses to social evaluative threat, particularly in the context of resiliency training. Copyright © 2016 Elsevier Ltd. All rights reserved.

The neural basis of self-face recognition after self-concept threat and comparison with important others.

Science.gov (United States)

Guan, Lili; Qi, Mingming; Zhang, Qinglin; Yang, Juan

2014-01-01

The implicit positive association (IPA) theory attributed self-face advantage to the IPA with self-concept. Previous behavioral study has found that self-concept threat (SCT) could eliminate the self-advantage in face recognition over familiar-face, without taking levels of facial familiarity into account. The current event-related potential study aimed to investigate whether SCT could eliminate the self-face advantage over stranger-face. Fifteen participants completed a "self-friend" comparison task in which participants identified the face orientation of self-face and friend-face after SCT and non-self-concept threat (NSCT) priming, and a "self-stranger" comparison task was also completed in which participants identified the face orientation of self-face and stranger-face after SCT and NSCT priming. The results showed that the N2 amplitudes were more negative for processing friend-face than self-face after NSCT priming, but there was no significant difference between them after SCT priming. Moreover, the N2 amplitudes were more negative for processing stranger-face than self-face both after SCT priming and after NSCT priming. Furthermore, SCT manipulated the N2 amplitudes of friend-face rather than self-face. Overall, the present study made a supplementary to the current IPA theory and further indicated that SCT would only eliminate this self-face recognition advantage when comparing with important others.

Subfoveal choroidal thickness predicts macular atrophy in age-related macular degeneration: results from the TREX-AMD trial.

Science.gov (United States)

Fan, Wenying; Abdelfattah, Nizar Saleh; Uji, Akihito; Lei, Jianqin; Ip, Michael; Sadda, SriniVas R; Wykoff, Charles C

2018-03-01

Our purpose was to evaluate the relationship between subfoveal choroidal thickness (SCT) and development of macular atrophy (MA) in eyes with age-related macular degeneration (AMD). This was a prospective, multicenter study. Sixty participants (120 eyes) in the TREX-AMD trial (NCT01648292) with treatment-naïve neovascular AMD (NVAMD) in at least one eye were included. SCT was measured by certified reading center graders at baseline using spectral domain optical coherence tomography (SDOCT). The baseline SCT was correlated with the presence of MA at baseline and development of incident MA by month 18. Generalized estimating equations were used to account for information from both eyes. Baseline SCT in eyes with MA was statistically significantly less than in those without MA in both the dry AMD (DAMD) (P = 0.04) and NVAMD (P = 0.01) groups. Comparison of baseline SCT between MA developers and non-MA developers revealed a statistically significant difference (P = 0.03). Receiver operating characteristic curve (ROC) analysis showed the cut-off threshold of SCT for predicting the development of MA in cases without MA at baseline was 124 μm (AUC = 0.772; Sensitivity = 0.923; Specificity = 0.5). Among eyes without MA at baseline, those with baseline SCT ≤124 μm were 4.3 times more likely to develop MA (Odds ratio: 4.3, 95% confidence interval: 1.6-12, P = 0.005) than those with baseline SCT >124 μm. Eyes with AMD and MA had less SCT than those without MA. Eyes with less baseline SCT also appear to be at higher risk to develop MA within 18 months.

Non-utility generation and demand management reliability of customer delivery systems

International Nuclear Information System (INIS)

Hamoud, G.A.; Wang, L.

1995-01-01

A probabilistic methodology for evaluating the impact of non-utility generation (NUG) and demand management programs (DMP) on supply reliability of customer delivery systems was presented. The proposed method was based on the criteria that the supply reliability to the customers on the delivery system should not be affected by the integration of either NUG or DMPs. The method considered station load profile, load forecast, and uncertainty in size and availability of the nuio. Impacts on system reliability were expressed in terms of possible delays of the in-service date for new facilities or in terms of an increase in the system load carrying capability. Examples to illustrate the proposed methodology were provided. 10 refs., 8 tabs., 2 figs

Subjective expected utility with non-increasing risk aversion

NARCIS (Netherlands)

Wakker, P.P.

1989-01-01

It is shown that assumptions about risk aversion, usually studied under the presupposition of expected utility maximization, have a surprising extra merit at an earlier stage of the measurement work: together with the sure-thing principle, these assumptions imply subjective expected utility

Electric energy supply and non-utility generation: A comparative analysis of B.C. and Wisconsin

International Nuclear Information System (INIS)

Logan, J.A.

1993-01-01

The pricing policies and buyback rates (those concerned with purchase of non-utility generation, NUG) of British Columbia (BC) Hydro are examined along with their effectiveness in encouraging the efficient use and development of power. Specifically, the levels of self-generation within BC's pulp mills are examined as well as mill manager attitudes to increasing energy production. BC Hydro's encouragement of self-generation is determined by examining the ratio of the industrial rate for pulp mills to the utility's long-run marginal cost of power. BC Hydro's buyback policies are also examined to determine the level of encouragement they provide for increased self-generation. Comparisons are made with similar data, wherever possible, from utilities and pulp mills in Wisconsin. The comparison reveals similarities with respect to pulp mills' attitudes toward increasing self-generation capacity. A significant difference is noted in terms of the amount of pulp mill self-generation: Wisconsin mills generate substantially more of their own energy requirements than BC mills. Wisconsin utilities provided greater markup through their industrial rates, and also provided the greater encouragement for increased self-generation through their buyback policies. BC Hydro is the only utility that offered a load displacement policy, however. In summary, the policies and regulations of both BC and Wisconsin utilities have the potential to encourage greater industrial self-sufficiency and increased levels of self-generated power. Existing levels of encouragement are not determined solely by economic considerations but also reflect utility planning objectives. 97 refs., 3 figs., 20 tabs

Characteristics Associated With Utilization of VA and Non-VA Care Among Iraq and Afghanistan Veterans With Post-Traumatic Stress Disorder.

Science.gov (United States)

Finley, Erin P; Mader, Michael; Bollinger, Mary J; Haro, Elizabeth K; Garcia, Hector A; Huynh, Alexis K; Pugh, Jacqueline A; Pugh, Mary Jo

2017-11-01

Post-traumatic stress disorder (PTSD) affects nearly one-fifth of Iraq and Afghanistan Veterans (IAV). The Department of Veterans Affairs (VA) has invested in making evidence-based psychotherapies for PTSD available at every VA facility nationwide; however, an unknown number of veterans opt to receive care in the community rather than with VA. We compared PTSD care utilization patterns among Texas IAV with PTSD, an ethnically, geographically, and economically diverse group. To identify IAV in Texas with service-connected disability for PTSD, we used a crosswalk of VA administrative data from the Operation Enduring Freedom/Operation Iraqi Freedom Roster and service-connected disability data from the Veterans Benefits Administration. We then surveyed a random sample of 1,128 veterans from the cohort, stratified by sex, rurality, and past use/nonuse of any VA care. Respondents were classified into current utilization groups (VA only, non-VA only, dual care, and no professional PTSD treatment) on the basis of reported PTSD care in the prior 12 months. Responses were weighted to account for sample stratification and for response rate within each strata. Utilization group characteristics were compared to the population mean using the one sample Z-test for proportions, or the t-test for means. A multinomial logistic regression model was used to identify survey variables significantly associated with current utilization group. 249 IAV completed the survey (28.4% response rate). Respondents reported receiving PTSD care: in the VA only (58.3%); in military or community-based settings (including private practitioners) (non-VA only, 8.7%); and in both VA and non-VA settings (dual care, 14.5%). The remainder (18.5%) reported no professional PTSD care in the prior year. Veterans ineligible for Department of Defense care, uncomfortable talking about their problems, and opposed to medication were more likely to receive non-VA care only, whereas those with lower household income

Ancillary lung parenchymal findings at spiral CT scanning in pulmonary embolism. Relationship to chest sonography

International Nuclear Information System (INIS)

Reissig, Angelika; Heyne, Jens-Peter; Kroegel, Claus

2004-01-01

Introduction/objective: The aim of the study was to compare findings of transthoracic sonography (TS) and of spiral computed tomography (sCT) in patients with suspected pulmonary embolism (PE). Methods and patients: Peripheral parenchymal and pleural findings of TS and sCT were compared in 62 patients (25 females, 37 males; mean age 62.2 years) with suspected PE. Results: In 39 patients PE was established, of whose pleura-based lesions could be detected by TS in 30 patients and by sCT in 31 patients. Whilst in three of the patients parenchymal lesions were exclusively detected by sonography, no peripheral abnormalities could be discovered with either technique in five patients. Among the nine patients lacking peripheral abnormalities on sonography, four revealed peripheral lesions in sCT. In 23 patients without PE, peripheral consolidations at CT were detected in six patients whereas two showed lesions on TS. With respect to the appearance, pleura-based wedge-shaped consolidations were the main parenchymal alterations (82.4% at TS, 66.1% at sCT) as compared with non-wedge-shaped consolidations (17.6% at TS, 33.9% at sCT). Peripheral lesions were located preferentially within the lower lobes. In addition, both localised and basal pleural effusion associated with PE could be demonstrated in 58.9% at TS and in 23.1% by sCT. Discussions and conclusion: The study shows that in PE parenchymal and pleural changes are detectable by TS and sCT. If parenchymal findings are present at sCT, peripheral PE should be considered, even in the absence of directly visible emboli

Ancillary lung parenchymal findings at spiral CT scanning in pulmonary embolism. Relationship to chest sonography

Energy Technology Data Exchange (ETDEWEB)

Reissig, Angelika E-mail: angelika.reissig@med.uni-jena.de; Heyne, Jens-Peter; Kroegel, Claus

2004-03-01

Introduction/objective: The aim of the study was to compare findings of transthoracic sonography (TS) and of spiral computed tomography (sCT) in patients with suspected pulmonary embolism (PE). Methods and patients: Peripheral parenchymal and pleural findings of TS and sCT were compared in 62 patients (25 females, 37 males; mean age 62.2 years) with suspected PE. Results: In 39 patients PE was established, of whose pleura-based lesions could be detected by TS in 30 patients and by sCT in 31 patients. Whilst in three of the patients parenchymal lesions were exclusively detected by sonography, no peripheral abnormalities could be discovered with either technique in five patients. Among the nine patients lacking peripheral abnormalities on sonography, four revealed peripheral lesions in sCT. In 23 patients without PE, peripheral consolidations at CT were detected in six patients whereas two showed lesions on TS. With respect to the appearance, pleura-based wedge-shaped consolidations were the main parenchymal alterations (82.4% at TS, 66.1% at sCT) as compared with non-wedge-shaped consolidations (17.6% at TS, 33.9% at sCT). Peripheral lesions were located preferentially within the lower lobes. In addition, both localised and basal pleural effusion associated with PE could be demonstrated in 58.9% at TS and in 23.1% by sCT. Discussions and conclusion: The study shows that in PE parenchymal and pleural changes are detectable by TS and sCT. If parenchymal findings are present at sCT, peripheral PE should be considered, even in the absence of directly visible emboli.

Health care utilization, somatic and mental health distress, and well-being among widowed and non-widowed female survivors of war

Science.gov (United States)

2012-01-01

Background The aim of the study was to assess levels of somatic and mental health distress, well-being, AS WELL AS utilization of primary and specialist health care services among war-related widowed and non-widowed female civilian survivors of war. Methods 100 war-related widowed lone mothers and 106 non-widowed mothers who had experienced the Kosovo war ten years previously participated in the study. Measures of somatic, depressive, post-traumatic stress, anxiety, and grief complaints, subjective well-being, and utilization of health care services during the previous three months were used. Results Compared to non-widowed mothers, widowed lone mothers reported significantly higher levels of somatic, depressive, post-traumatic stress, and anxiety complaints. Further, they reported significantly lower levels of subjective well-being as composed of positive and negative affect and satisfaction with life. More than half of both widowed and non-widowed mothers reported utilization of health care services during the last three months, without significant differences between the groups. However, only three percent of widowed lone mothers and four percent of non-bereaved mothers reported utilization of mental health services during the last three months, despite high levels of mental health distress especially among widowed lone mothers. Among widowed lone mothers, severity of prolonged grief symptoms significantly predicted number of contacts of specialist health care use over and above sociodemographic variables, number of war-related events, and other psychopathology. Conclusion War-related widowed lone mothers suffer from elevated somatic and mental distress even a decade after the war. The tiny proportion of widowed lone mothers in use of mental health services can be seen as a reflection of lack of previous and current mental health services to meet mental health needs of this population. PMID:22578096

Low health literacy and healthcare utilization among immigrants and non-immigrants in Switzerland.

Science.gov (United States)

Mantwill, Sarah; Schulz, Peter J

2017-11-01

This study aimed at investigating the association between functional health literacy and knowledge on when to seek medical help for potentially harmless (overutilization) or serious (underutilization) situations among immigrants and non-immigrants in Switzerland. Data was collected among three immigrant groups and the native population (N=1146) in the German- and Italian-speaking part of Switzerland. Health literacy was assessed with the Short Test of Functional Health Literacy (S-TOFHLA) and three Brief Health Literacy Screeners. Over- and underutilization of healthcare services was assessed with items asking participants about when to seek medical help for minor, respectively major, physical symptoms. Immigrants were more likely to seek medical help when unwarranted (overutilization). Health literacy, when assessed with the S-TOFHLA, was significantly associated with over- and underutilization. Yet, once controlled for covariates, the association between health literacy and overutilization was negative. Immigration background and micro-cultural differences emerged as important predictors of utilization. Results suggest that functional health literacy is directly related to healthcare utilization. The effects might be amplified by (micro-)cultural differences. Healthcare providers should be aware of differences in health literacy and utilization patterns among different population groups. Communication between patients and providers should be literacy and culturally sensitive. Copyright © 2017 Elsevier B.V. All rights reserved.

An essay pertaining to the supply and price of natural gas as fuel for electric utilities and independent power producers; and, the related growth of non-utility generators to meet capacity shortfalls in the next decade

International Nuclear Information System (INIS)

Clements, J.R.

1990-01-01

This paper addresses the impact natural gas and petroleum prices have on how the electric power industry decides to meet increasing demand for electric power. The topics of the paper include the pricing impact of the Iraq-Kuwait conflict, the BTU parity argument, electric utility capacity shortfalls in 1993, the growth of the non-utility generator and the independent power developer market, natural gas as the desired fuel of the decade, the financial strategy in acquiring natural gas reserves, the cost and availability of natural gas supplies for non-utility generators, and the reluctance of the gas producers to enter long term contracts

Enabling and Predisposing Factors for the Utilization of Preventive Dental Health Care in Migrants and Non-Migrants in Germany

Directory of Open Access Journals (Sweden)

Patrick Brzoska

2017-08-01

Full Text Available BackgroundIn many European countries including Germany, migrants utilize preventive services less frequently than the majority population. This is also true for the utilization of dental checkups. Little is known about which demographic, social, behavioral, and health-related factors influence the decision of migrants to seek preventive dental health care and how these factors differ from those in non-migrants. The aim of the present study was to examine the role of these factors among migrants and non-migrants residing in Germany.MethodsData from cross-sectional national health surveys are used, providing information on preventive dental health behavior from n = 41,220 individuals, of which 15.0% are migrants. Andersen’s Behavioral Model of Health Services Use is the conceptual framework of the investigation. Multiple logistic regression models were applied to examine the role of different predisposing and enabling factors. Interaction terms were included in order to examine whether determinants differ between migrants and non-migrants. Average marginal effects (AMEs are reported in addition to odds ratios (ORs as measures of effect size which are robust against bias arising from unobserved heterogeneity.ResultsMigrants are at an about 36% lower chance of utilizing regular dental checkups than non-migrants [OR = 0.64 (95% confidence interval, 95% CI: 0.61, 0.68; AME = −0.081 (95% CI = −0.093, −0.069]. Differences are partly explained by the influence of demographic, social, behavioral, and health-related factors [adjusted OR = 0.69 (95% CI: 0.64, 0.73; AME = −0.065 (95% CI = −0.076, −0.053]. Younger age, being male, lower socioeconomic status, a non-statutory health insurance, not living in a relationship, living in the Western part of Germany and in an urban setting, and poor limited social support were associated with a lower chance of utilizing regular dental checkups. Interaction effects could be

The role of positron emission tomography with 18F-fluorodeoxyglucose integrated with computed tomography in the evaluation of patients with multiple myeloma undergoing allogeneic stem cell transplantation.

Science.gov (United States)

Patriarca, Francesca; Carobolante, Francesca; Zamagni, Elena; Montefusco, Vittorio; Bruno, Benedetto; Englaro, Emanuaela; Nanni, Cristina; Geatti, Onelio; Isola, Miriam; Sperotto, Alessandra; Buttignol, Silvia; Stocchi, Raffaella; Corradini, Paolo; Cavo, Michele; Fanin, Renato

2015-06-01

PFS: 51% versus 25%, P = .03; 2-year OS: 81% versus 47%, P = .001). This study indicates that PET/CT imaging before and after allo-SCT is significantly associated with the outcome, suggesting the utility of this technique for MM staging before allo-SCT and for response monitoring after the transplantation. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Oil prices: The role of refinery utilization, futures markets and non-linearities

International Nuclear Information System (INIS)

Kaufmann, Robert K.; Mann, Michael; Dees, Stephane; Gasteuil, Audrey

2008-01-01

We test the hypothesis that real oil prices are determined in part by refinery capacity, non-linearities in supply conditions, and/or expectations and that observed changes in these variables can account for the rise in prices between 2004 and 2006. Results indicate that the refining sector plays an important role in the recent price increase, but not in the way described by many analysts. The relationship is negative such that higher refinery utilization rates reduce crude oil prices. This effect is associated with shifts in the production of heavy and light grades of crude oil and price spreads between them. Non-linear relationships between OPEC capacity and oil prices as well as conditions on the futures markets also account for changes in real oil prices. Together, these factors allow the model to generate a one-step ahead out-of-sample forecast that performs as well as forecasts implied by far-month contracts on the New York Mercantile Exchange and is able to account for much of the $27 rise in crude oil prices between 2004 and 2006. (author)

Relationship between ruminal ammonia and non-protein nitrogen utilization by ruminants

International Nuclear Information System (INIS)

Satter, L.D.; Roffler, R.E.

1976-01-01

Non-protein nitrogen (NPN) may be utilized as well as plant protein when ruminal ammonia nitrogen concentration is low ( 3 -N at 5 mg/100 ml will provide considerably less metabolizable protein, and the amount of metabolizable protein will be directly proportional to the amount of protein that escapes degradation. A simplified scheme for estimating metabolizable protein is presented. It has the flexibility needed for accommodating different feedstuffs, yet is easy to apply. The proposed scheme is based upon ruminal ammonia concentration, which in turn reflects protein intake, ration fermentability and protein degradation, the major determinants of protein supply to the lower intestine. It has the potential of more accurately describing the nutritional value of dietary crude protein, particularly if both protein and NPN are in the diet. (author)

Utilizing the non-bridge oxygen model to predict the glass viscosity

International Nuclear Information System (INIS)

Choi, Kwansik; Sheng, Jiawei; Maeng, Sung Jun; Song, Myung Jae

1998-01-01

Viscosity is the most important process property of waste glass. Viscosity measurement is difficult and costs much. Non-bridging Oxygen (NBO) model which relates glass composition to viscosity had been developed for high level waste at the Savannah River Site (SRS). This research utilized this NBO model to predict the viscosity of KEPRI's 55 glasses. It was found that there was a linear relationship between the measured viscosity and the predicted viscosity. The NBO model could be used to predict glass viscosity in glass formulation development. However the precision of predicted viscosity is out of satisfaction because the composition ranges are very different between the SRS and KEPRI glasses. The modification of NBO calculation, which included modification of alkaline earth elements and TiO 2 , could not strikingly improve the precision of predicted values

Imaging diagnosis of acute pulmonary thromboembolism

International Nuclear Information System (INIS)

Mut, Fernando

2005-01-01

Pulmonary embolism (PE) is a frequent disease which requires an accurate diagnosis in order to establish an effective treatment considering that anticoagulant therapy may lead to complications. Lung ventilation / perfusion scintigraphy (LS V/Q) has been employed as the imaging meted of choice in patients with suspicion of PE. Pulmonary angiography is considered invasive, hence its utilization is usually reserved for otherwise unresolved cases. Other methods like venous Doppler ultrasound and echocardiography have a complementary role or are not widely indicated. The introduction of spiral CT (SCT), specially with multislice capabilities has made available a fast, relatively economic and efficient method for non-invasive diagnosis of PE. Availability of the technique is increasing and it has been included in some diagnostic algorithms for PE as the initial method of evaluation (and sometimes the only one). However, most research has been performed comparing this state-of-the-art technology with classical radionuclide protocols instead of using updated techniques such as SPECT and ultrafine radio aerosols. Moreover, SCT delivers much higher dose rates to the patient which must be taken into account specially in young individuals. In general, available evidence shows superior sensitivity of LS V/Q with higher specificity of SCT, within a context of similar overall accuracy provided optimized protocols are employed. Interpretation criteria for LS V/Q should be revised in an attempt to minimize indeterminate results, and together with the routine utilization of SPECT and novel ventilation systems should improve the performance of LS V/Q. The choice of the initial diagnostic modality should be guided by a correct determination of pre-test probability, clinical characteristics of the patient potentially influencing the efficacy and safety of the method, availability of the different techniques, relative costs and operator's experience. Such a selective and pragmatic

Cross-gender Comparison of Metacognitive Strategies Utilized by Omani Students in Reading Comprehension Classes

Directory of Open Access Journals (Sweden)

Manizheh Alami

2016-07-01

Full Text Available Given the fact that English is the language of the latest technological and scientific developments, comprehending English texts has priority for students to gain the knowledge and skills they will need in the future. However, most Omani students are not efficient L2 readers and do not have sufficient competence in reading authentic English texts. There is a variety of factors that might affect Omani students’ ability to read and comprehend English texts effectively. To find out what factors are involved in Omani students’ reading comprehension, in the first place, it is necessary to know what strategies they employ in reading. To this end, the current study attempts  to explore Omani students reported use of reading strategies using ‘Metacognitive Awareness of Reading Strategies Inventory’ (MARSI developed by Mokhtari and Reichard (2002. The self-reported survey completed by 200 students (90 female and110 male who enrolled for Advanced Foundation program (level 4 at Salalah College of Technology (SCT. The results show that SCT students’ awareness of metacognitive strategies is at medium level (3.46. Furthermore, the comparison between two gender groups (Males Vs. Females shows that male students use metacognitive reading strategies moderately (3.28 while female students use them more frequently (3.64. The outcomes of the study contribute to the improvement of SCT students reading ability and can be used by teachers to teach students different strategies to build meaning of the reading material which is among the goals of any educational system.

ADAM results from the May 95 SCT beam test, and an update on the Higgs to four lepton analysis

International Nuclear Information System (INIS)

Fares, F.J.; Taylor, G.N.

1995-01-01

The Atlas Detector Analog Memory (ADAM) chip has been designed for use at the Large Hadron Collider as a digital front end readout for the μ-strip detectors used in the ATLAS semiconductor Tracker (SCT). A particle level study has been done and shows that is possible to see a signal above background. the main cut against the background being impact parameter and calorimeter isolation cuts. The current analysis involves repeating the particle level study, however using a full simulation of the ATLAS detector using the GEANT package. In particular the impact of the Inner tracker design on this decay channel is being investigated. A full simulation of Higgs and tt-bar events was performed using the geometry described in the ATLAS technical proposal. A full reconstruction was performed using electro-magnetic calorimeter ( EM) clusters as track seeds. A crude EM calibration, using simulated electrons at four different energies, was also performed to correct for the energy. Preliminary results indicate that the impact parameter cut against the tt-bar background doesn't work when doing a full detector simulation

Utility values associated with advanced or metastatic non-small cell lung cancer: data needs for economic modeling.

Science.gov (United States)

Brown, Jacqueline; Cook, Keziah; Adamski, Kelly; Lau, Jocelyn; Bargo, Danielle; Breen, Sarah; Chawla, Anita

2017-04-01

Cost-effectiveness analyses often inform healthcare reimbursement decisions. The preferred measure of effectiveness is the quality adjusted life year (QALY) gained, where the quality of life adjustment is measured in terms of utility. Areas covered: We assessed the availability and variation of utility values for health states associated with advanced or metastatic non-small cell lung cancer (NSCLC) to identify values appropriate for cost-effectiveness models assessing alternative treatments. Our systematic search of six electronic databases (January 2000 to August 2015) found the current literature to be sparse in terms of utility values associated with NSCLC, identifying 27 studies. Utility values were most frequently reported over time and by treatment type, and less frequently by disease response, stage of disease, adverse events or disease comorbidities. Expert commentary: In response to rising healthcare costs, payers increasingly consider the cost-effectiveness of novel treatments in reimbursement decisions, especially in oncology. As the number of therapies available to treat NSCLC increases, cost-effectiveness analyses will play a key role in reimbursement decisions in this area. Quantifying the relationship between health and quality of life for NSCLC patients via utility values is an important component of assessing the cost effectiveness of novel treatments.

Contrasting lexical similarity and formal definitions in SNOMED CT: consistency and implications.

Science.gov (United States)

Agrawal, Ankur; Elhanan, Gai

2014-02-01

To quantify the presence of and evaluate an approach for detection of inconsistencies in the formal definitions of SNOMED CT (SCT) concepts utilizing a lexical method. Utilizing SCT's Procedure hierarchy, we algorithmically formulated similarity sets: groups of concepts with similar lexical structure of their fully specified name. We formulated five random samples, each with 50 similarity sets, based on the same parameter: number of parents, attributes, groups, all the former as well as a randomly selected control sample. All samples' sets were reviewed for types of formal definition inconsistencies: hierarchical, attribute assignment, attribute target values, groups, and definitional. For the Procedure hierarchy, 2111 similarity sets were formulated, covering 18.1% of eligible concepts. The evaluation revealed that 38 (Control) to 70% (Different relationships) of similarity sets within the samples exhibited significant inconsistencies. The rate of inconsistencies for the sample with different relationships was highly significant compared to Control, as well as the number of attribute assignment and hierarchical inconsistencies within their respective samples. While, at this time of the HITECH initiative, the formal definitions of SCT are only a minor consideration, in the grand scheme of sophisticated, meaningful use of captured clinical data, they are essential. However, significant portion of the concepts in the most semantically complex hierarchy of SCT, the Procedure hierarchy, are modeled inconsistently in a manner that affects their computability. Lexical methods can efficiently identify such inconsistencies and possibly allow for their algorithmic resolution. Copyright © 2013 Elsevier Inc. All rights reserved.

Imaging in haematopoietic stem cell transplantation

International Nuclear Information System (INIS)

Evans, A.; Steward, C.G.; Lyburn, I.D.; Grier, D.J.

2003-01-01

Haematopoietic stem cell transplantation (SCT) is used to treat a wide range of malignant and non-malignant haematological conditions, solid malignancies, and metabolic and autoimmune diseases. Although imaging has a limited role before SCT, it is important after transplantation when it may support the clinical diagnosis of a variety of complications. It may also be used to monitor the effect of therapy and to detect recurrence of the underlying disease if the transplant is unsuccessful. We present a pictorial review of the imaging of patients who have undergone SCT, based upon 15 years experience in a large unit performing both adult and paediatric transplants

Imaging in haematopoietic stem cell transplantation

Energy Technology Data Exchange (ETDEWEB)

Evans, A.; Steward, C.G.; Lyburn, I.D.; Grier, D.J

2003-03-01

Haematopoietic stem cell transplantation (SCT) is used to treat a wide range of malignant and non-malignant haematological conditions, solid malignancies, and metabolic and autoimmune diseases. Although imaging has a limited role before SCT, it is important after transplantation when it may support the clinical diagnosis of a variety of complications. It may also be used to monitor the effect of therapy and to detect recurrence of the underlying disease if the transplant is unsuccessful. We present a pictorial review of the imaging of patients who have undergone SCT, based upon 15 years experience in a large unit performing both adult and paediatric transplants.

Outcome of high-risk stage 3 neuroblastoma with myeloablative therapy and 13-cis-retinoic acid: a report from the Children's Oncology Group.

Science.gov (United States)

Park, Julie R; Villablanca, Judith G; London, Wendy B; Gerbing, Robert B; Haas-Kogan, Daphne; Adkins, E Stanton; Attiyeh, Edward F; Maris, John M; Seeger, Robert C; Reynolds, C Patrick; Matthay, Katherine K

2009-01-01

The components of therapy required for patients with INSS Stage 3 neuroblastoma and high-risk features remain controversial. A retrospective cohort design was used to determine if intensive chemoradiotherapy with purged autologous bone marrow rescue (ABMT) and/or 13-cis-retinoic acid (13-cis-RA) improved outcome for patients with high-risk neuroblastoma that was not metastatic to distant sites. We identified 72 patients with INSS Stage 3 neuroblastoma enrolled between 1991 and 1996 on the Phase 3 CCG-3891 randomized trial. Patients were analyzed on an intent-to-treat basis using a log-rank test. The 5-year event-free survival (EFS) and overall survival (OS) rates for patients with Stage 3 neuroblastoma were 55 +/- 6% and 59 +/- 6%, respectively (n = 72). Patients randomized to ABMT (n = 20) had 5-year EFS of 65 +/- 11% and OS of 65 +/- 11% compared to 41 +/- 11 (P = 0.21) and 46 +/- 11% (P = 0.23) for patients randomized to CC (n = 23), respectively. Patients randomized to 13-cis-RA (n = 23) had 5-year EFS of 70 +/- 10% and OS of 78 +/- 9% compared to 63 +/- 12% (P = 0.67) and 67 +/- 12% (P = 0.55) for those receiving no further therapy (n = 16), respectively. Patients randomized to both ABMT and 13-cis-RA (n = 6) had a 5-year EFS of 80 +/- 11% and OS of 100%. Patients with high-risk Stage 3 neuroblastoma have an overall poor prognosis despite aggressive chemoradiotherapy. Further studies are warranted to determine if myeloablative consolidation followed by 13-cis-RA maintenance therapy statistically significantly improves outcome.

BAT2 and BAT3 polymorphisms as novel genetic risk factors for rejection after HLA-related SCT.

Science.gov (United States)

Piras, Ignazio Stefano; Angius, Andrea; Andreani, Marco; Testi, Manuela; Lucarelli, Guido; Floris, Matteo; Marktel, Sarah; Ciceri, Fabio; La Nasa, Giorgio; Fleischhauer, Katharina; Roncarolo, Maria Grazia; Bulfone, Alessandro; Gregori, Silvia; Bacchetta, Rosa

2014-11-01

The genetic background of donor and recipient is an important factor determining the outcome of allogeneic hematopoietic SCT (allo-HSCT). We applied whole-genome analysis to investigate genetic variants-other than HLA class I and II-associated with negative outcome after HLA-identical sibling allo-HSCT in a cohort of 110 β-Thalassemic patients. We identified two single-nucleotide polymorphisms (SNPs) in BAT2 (A/G) and BAT3 (T/C) genes, SNP rs11538264 and SNP rs10484558, both located in the HLA class III region, in strong linkage disequilibrium between each other (R(2)=0.92). When considered as single SNP, none of them reached a significant association with graft rejection (nominal P<0.00001 for BAT2 SNP rs11538264, and P<0.0001 for BAT3 SNP rs10484558), whereas the BAT2/BAT3 A/C haplotype was present at significantly higher frequency in patients who rejected as compared to those with functional graft (30.0% vs 2.6%, nominal P=1.15 × 10(-8); and adjusted P=0.0071). The BAT2/BAT3 polymorphisms and specifically the A/C haplotype may represent a novel immunogenetic factor associated with graft rejection in patients undergoing allo-HSCT.

Frequent induction of chromosomal aberrations in in vivo skin fibroblasts after allogeneic stem cell transplantation: hints to chromosomal instability after irradiation

International Nuclear Information System (INIS)

Massenkeil, G.; Zschieschang, P.; Thiel, G.; Hemmati, P. G.; Budach, V.; Dörken, B.; Pross, J.; Arnold, R.

2015-01-01

Total body irradiation (TBI) has been part of standard conditioning regimens before allogeneic stem cell transplantation for many years. Its effect on normal tissue in these patients has not been studied extensively. We studied the in vivo cytogenetic effects of TBI and high-dose chemotherapy on skin fibroblasts from 35 allogeneic stem cell transplantation (SCT) patients. Biopsies were obtained prospectively (n = 18 patients) before, 3 and 12 months after allogeneic SCT and retrospectively (n = 17 patients) 23–65 months after SCT for G-banded chromosome analysis. Chromosomal aberrations were detected in 2/18 patients (11 %) before allogeneic SCT, in 12/13 patients (92 %) after 3 months, in all patients after 12 months and in all patients in the retrospective group after allogeneic SCT. The percentage of aberrant cells was significantly higher at all times after allogeneic SCT compared to baseline analysis. Reciprocal translocations were the most common aberrations, but all other types of stable, structural chromosomal aberrations were also observed. Clonal aberrations were observed, but only in three cases they were detected in independently cultured flasks. A tendency to non-random clustering throughout the genome was observed. The percentage of aberrant cells was not different between patients with and without secondary malignancies in this study group. High-dose chemotherapy and TBI leads to severe chromosomal damage in skin fibroblasts of patients after SCT. Our long-term data suggest that this damage increases with time, possibly due to in vivo radiation-induced chromosomal instability

Fiscal Drag as an Automatic Stability Tool, in the Case of New Regulation with Price Criteria in Automotive Sectors Special Consumption Tax (SCT

Directory of Open Access Journals (Sweden)

Abdurrahman TARAKTAŞ

2017-12-01

Full Text Available Fiscal drag is a result of real or nominal expanding economy and progressive taxation. In general, individuals are forced to enter the upper tax bracket depending on their increased income or expenditure. More tax burden can result in less consumption. Fiscal drag, lack of spending or excessive taxation can cause the economy to slow down. Traditional view suggests that fiscal drag may serve as a natural automatic stabilizer to cool the economy. However, this view ignores the supply side and in particular the potential effects of the high tax burden on economy. This study examines the extent to which the expected automatic stabilization function can be performed and the possible side effects on economic balances and income distribution of fiscal drag in our country in the case of new regulation with price criteria in automotive sectors Special Consumption Tax (SCT.

The effect of health and dental insurance on US children's dental care utilization for urgent and non-urgent dental problems - 2008.

Science.gov (United States)

Naavaal, Shillpa; Barker, Laurie K; Griffin, Susan O

2017-12-01

We examined the association between utilization of care for a dental problem (utilization-DP) and parent-reported dental problem (DP) urgency among children with DP by type of health care insurance coverage. We used weighted 2008 National Health Interview Survey data from 2,834 children, aged 2-17 years with at least one DP within the 6 months preceding survey. Explanatory variables were selected based on Andersen's model of healthcare utilization. Need was considered urgent if DP included toothache, bleeding gums, broken or missing teeth, broken or missing filling, or decayed teeth and otherwise as non-urgent. The primary enabling variable, insurance, had four categories: none, private health no dental coverage (PHND), private health and dental (PHD), or Medicaid/State Children's Health Insurance Program (SCHIP). Predisposing variables included sociodemographic characteristics. We used bivariate and multivariate analyses to identify explanatory variables' association with utilization-DP. Using logistic regression, we obtained adjusted estimates of utilization-DP by urgency for each insurance category. In bivariate analyses, utilization-DP was associated with both insurance and urgency. In multivariate analyses, the difference in percent utilizing care for an urgent versus non-urgent DP among children covered by Medicaid/SCHIP was 32 percentage points; PHD, 25 percentage points; PHND, 12 percentage points; and no insurance, 14 percentage points. The difference in utilization by DP urgency was higher for children with Medicaid/SCHIP compared with either PHND or uninsured children. Expansion of Medicaid/SCHIP may permit children to receive care for urgent DPs who otherwise may not, due to lack of dental insurance. © 2016 American Association of Public Health Dentistry.

The utilization of tidal currents by the larvae of an estuarine fish

African Journals Online (AJOL)

model 33 SCT meter. Current speed was measured at each station using a Savonius rotor, prior to taking a plankton tow at that station. Surface current speed was measured 0,25 m from the surface and bottom current speed 1,25 m off the bottom. After the recording of physical data, a plankton tow was taken between the ...

Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatment-seeking youth.

Science.gov (United States)

Rappaport, B I; Pagliaccio, D; Pine, D S; Klein, D N; Jarcho, J M

2017-10-01

The Screen for Child Anxiety and Related Emotional Disorder (SCARED) may be differentially sensitive to detecting specific or comorbid anxiety diagnoses in treatment-seeking and non-treatment-seeking youth. We assessed the SCARED's discriminant validity, diagnostic utility, and informant agreement using parent- and self-report from healthy and treatment-seeking anxious youth (Study 1, N=585) and from non-treatment-seeking anxious youth (Study 2, N=331) diagnosed with generalized anxiety disorder (GAD), social anxiety disorder (SAD), or comorbid GAD+SAD. Among treatment-seeking youth, the SCARED showed good diagnostic utility and specificity, differentiating healthy, comorbid, and non-comorbid anxious youth. Child-parent agreement was modest: healthy child self-reports were higher than parent-reports whereas anxious child self-reports were similar or lower than parent-reports. Less consistent results emerged for diagnostic utility, specificity, and informant agreement among non-treatment-seeking youth. Given the number of non-treatment seeking anxious youth (N=33), generalizability of these findings may be limited. Together, results suggest informants may provide distinct information about children's anxiety symptoms. Copyright © 2017 Elsevier Ltd. All rights reserved.

Amplitude Modulation of Pulsation Modes in Delta Scuti Stars

Science.gov (United States)

Bowman, Dominic M.

2017-10-01

The pulsations in δ Sct stars are excited by a heat engine driving mechanism caused by increased opacity in their surface layers, and have pulsation periods of order a few hours. Space based observations in the last decade have revealed a diverse range of pulsational behaviour in these stars, which is investigated using an ensemble of 983 δ Sct stars observed continuously for 4 yr by the Kepler Space Telescope. A statistical search for amplitude modulation of pulsation modes is carried out and it is shown that 61.3 per cent of the 983 δ Sct stars exhibit significant amplitude modulation in at least a single pulsation mode, and that this is uncorrelated with effective temperature and surface gravity. Hence, the majority of δ Sct stars exhibit amplitude modulation, with time-scales of years and longer demonstrated to be significant in these stars both observationally and theoretically. An archetypal example of amplitude modulation in a δ Sct star is KIC 7106205, which contains only a single pulsation mode that varies significantly in amplitude whilst all other pulsation modes stay constant in amplitude and phase throughout the 4-yr Kepler data set. Therefore, the visible pulsational energy budget in this star, and many others, is not conserved over 4 yr. Models of beating of close-frequency pulsation modes are used to identify δ Sct stars with frequencies that lie closer than 0.001 d^{-1}, which are barely resolved using 4 yr of Kepler observations, and maintain their independent identities over 4 yr. Mode coupling models are used to quantify the strength of coupling and distinguish between non-linearity in the form of combination frequencies and non-linearity in the form of resonant mode coupling for families of pulsation modes in several stars. The changes in stellar structure caused by stellar evolution are investigated for two high amplitude δ Sct (HADS) stars in the Kepler data set, revealing a positive quadratic change in phase for the fundamental and

Increased levels of anti-non-Gal IgG following pig-to-baboon bone marrow transplantation correlate with failure of engraftment

Science.gov (United States)

Liang, Fan; Wamala, Isaac; Scalea, Joseph; Tena, Aseda; Cormack, Taylor; Pratts, Shannon; Struuck, Raimon Duran; Elias, Nahel; Hertl, Martin; Huang, Christene A.; Sachs, David H.

2013-01-01

Background The development of genetically modified pigs which lack the expression of alpha 1–3 galactosyl transferase, (GalT-KO pigs) has facilitated the xenogeneic transplantation of porcine organs and tissues into primates by avoiding hyperacute rejection due to pre-existing antibodies against the Gal epitope. However, antibodies against other antigens (anti-non-Gal antibodies), are found at varying levels in the pre-transplant sera of most primates. We have previously found that baboons with high levels of pre-transplant anti-non-Gal IgG, conditioned with a non-myeloablative conditioning regimen, failed to engraft following pig-to-baboon bone marrow transplantation [8]. Two baboons with low levels of pre-transplant anti-non-Gal IgG, conditioned with the same regimen, showed porcine bone marrow progenitors at 28 days following transplantation, suggesting engraftment. These baboons also showed evidence of donor-specific hypo-responsiveness. This observation led us to investigate the hypothesis that selecting for baboon recipients with low pre-transplant anti-non-Gal IgG levels might improve engraftment levels following GalT-KO pig-to-baboon bone marrow transplantation. Methods Five baboons, with low pre-transplant anti-non-Gal IgG levels, received transplantation of bone marrow cells (1–5 × 10^9/kg of recipient weight) from GalT-KO pigs. They received a non-myeloablative conditioning regimen consisting of low-dose total body irradiation (150cGy), thymic irradiation (700cGy), anti-thymocyte globulin (ATG) and tacrolimus. In addition, two baboons received Rituximab and Bortezomib (Velcade) treatment as well as extra-corporeal immunoadsorption using GalT-KO pig livers. Bone marrow engraftment was assessed by porcine-specific PCR on colony forming units (CFU) of day 28 bone marrow aspirates. Anti-non-Gal antibody levels were assessed by serum binding towards GalT-KO PBMC using flow cytometry (FACS). Peripheral macro-chimerism was measured by FACS using pig and

Effect of heart failure reversal treatment as add-on therapy in patients with chronic heart failure: A randomized, open-label study.

Science.gov (United States)

Sane, Rohit; Aklujkar, Abhijeet; Patil, Atul; Mandole, Rahul

The present study was designed to evaluate effect of heart failure reversal therapy (HFRT) using herbal procedure (panchakarma) and allied therapies, as add-on to standard CHF treatment (SCT) in chronic heart failure (CHF) patients. This open-label, randomized study conducted in CHF patients (aged: 25-65 years, ejection fraction: 30-65%), had 3-phases: 1-week screening, 6-week treatment (randomized [1:1] to HFRT+SCT or SCT-alone) and follow-up (12-week). Twice weekly HFRT (60-75min) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara (concoction dripping treatment) and basti (enema) was administered. Primary endpoints included evaluation of change in metabolic equivalents of task (MET) and peak oxygen uptake (VO 2peak ) from baseline, at end of 6-week treatment and follow-up at week-18 (non-parametric rank ANCOVA analysis). Safety and quality of life (QoL) was assessed. Seventy CHF patients (n=35, each treatment-arm; mean [SD] age: 53.0 [8.6], 80% men) were enrolled in the study. All patients completed treatment phase. Add-on HFRT caused a significant increase in METs (least square mean difference [LSMD], 6-week: 1.536, p=0.0002; 18-week: -1.254, p=0.0089) and VO 2peak (LSMD, 6-week: -5.52, p=0.0002; 18-week: -4.517, p=0.0089) as compared with SCT-alone. Results were suggestive of improved functional capacity in patients with HFRT (QoL; Mean [SD] HFRT+SCT vs. SCT-alone; 6-week: -0.44 [0.34] vs. -0.06 [0.25], p<0.0001 and 18-week: -0.53 [0.35] vs. -0.29 [0.26], p=0.0013). Seven treatment-emergent adverse events (mild severity) were reported in HFRT-arm. Findings of this study highlight therapeutic efficacy of add-on HFRT vs. SCT-alone in CHF patients. The non-invasive HFRT showed no safety concerns. Copyright © 2016. Published by Elsevier B.V.

Dynamic decision making without expected utility

DEFF Research Database (Denmark)

Nielsen, Thomas Dyhre; Jaffray, Jean-Yves

2006-01-01

Non-expected utility theories, such as rank dependent utility (RDU) theory, have been proposed as alternative models to EU theory in decision making under risk. These models do not share the separability property of expected utility theory. This implies that, in a decision tree, if the reduction...... maker’s discordant goals at the different decision nodes. Relative to the computations involved in the standard expected utility evaluation of a decision problem, the main computational increase is due to the identification of non-dominated strategies by linear programming. A simulation, using the rank...

The utilization of VUJE specialists non-destructive testing qualification at international cooperation with company TECNATOM

International Nuclear Information System (INIS)

Kuna, M.

2006-01-01

The utilization of VUJE specialists non-destructive testing qualification at cooperation with company TECNATOM. The obtain of QDA qualification for ET examination for possibility of qualified evaluation in the foreign NPP (USA, Brazil). The acquired practical experiences by evaluation of ET data from NPP Angra Brazil and Waltz Mill USA. The obtain of SNT-TC-1A and EPRI qualification for the UT evaluation of penetration tube welds measurements. The practical experience during the measurement on NPP Shearon Harris (Author)

International travel patterns and travel risks for stem cell transplant recipients.

Science.gov (United States)

Mikati, Tarek; Griffin, Kenneth; Lane, Dakotah; Matasar, Matthew; Shah, Monika K

2015-01-01

Stem cell transplantation (SCT) is being increasingly utilized for multiple medical illnesses. However, there is limited knowledge about international travel patterns and travel-related illnesses of stem cell transplant recipients (SCTRs). An observational cross-sectional study was conducted among 979 SCTRs at Memorial Sloan Kettering Cancer Center using a previously standardized and validated questionnaire. International travel post SCT, pre-travel health advice, exposure risks, and travel-related illnesses were queried. A total of 516 SCTRs completed the survey (55% response rate); of these, 40% were allogeneic SCTRs. A total of 229 (44.3%) respondents reported international travel outside the United States and Canada post SCT. The international travel incidence was 32% [95% confidence interval CI 28-36] within 2 years after SCT. Using multivariable Cox regression analysis, variables significantly associated with international travel within first 2 years after SCT were history of international travel prior to SCT [hazard ratio (HR) = 5.3, 95% CI 2.3-12.0], autologous SCT (HR = 2.6, 95% CI 1.6-2.8), foreign birth (HR = 2.3, 95% CI 1.5-3.3), and high income (HR = 2.0, 95% CI 1.8-3.7). During their first trip, 64 travelers (28%) had traveled to destinations that may have required vaccination or malaria chemoprophylaxis. Only 56% reported seeking pre-travel health advice. Of those who traveled, 16 travelers (7%) became ill enough to require medical attention during their first trip after SCT. Ill travelers were more likely to have visited high-risk areas (60 vs 26%, p = 0.005), to have had a longer mean trip duration (24 vs 12 days, p = 0.0002), and to have visited friends and relatives (69 vs 21%, p travel was common among SCTRs within 2 years after SCT and was mainly to low-risk destinations. Although the overall incidence of travel-related illnesses was low, certain subgroups of travelers were at a significantly higher risk. Pre

Vascular Platform to Define Hematopoietic Stem Cell Factors and Enhance Regenerative Hematopoiesis

Directory of Open Access Journals (Sweden)

Michael G. Poulos

2015-11-01

Full Text Available Hematopoietic stem cells (HSCs inhabit distinct microenvironments within the adult bone marrow (BM, which govern the delicate balance between HSC quiescence, self-renewal, and differentiation. Previous reports have proposed that HSCs localize to the vascular niche, comprised of endothelium and tightly associated perivascular cells. Herein, we examine the capacity of BM endothelial cells (BMECs to support ex vivo and in vivo hematopoiesis. We demonstrate that AKT1-activated BMECs (BMEC-Akt1 have a unique transcription factor/cytokine profile that supports functional HSCs in lieu of complex serum and cytokine supplementation. Additionally, transplantation of BMEC-Akt1 cells enhanced regenerative hematopoiesis following myeloablative irradiation. These data demonstrate that BMEC-Akt1 cultures can be used as a platform for the discovery of pro-HSC factors and justify the utility of BMECs as a cellular therapy. This technical advance may lead to the development of therapies designed to decrease pancytopenias associated with myeloablative regimens used to treat a wide array of disease states.

Current status of U.S. coal utilization and non-fuel uses of fossil fuels

International Nuclear Information System (INIS)

Song, C.S.; Schobert, H.; Scaroni, A.W.

1997-01-01

An understanding of the current situation is important for projecting the future direction of coal utilization. The world's annual consumption of coal in 1995 was 5104.01 million short tons (MST, 1 short ton = 0.907 metric ton). Coal plays a very important role in the US energy supply; US coal production in 1995 totaled 1033 MST, including 611.1 MST of bituminous coal, 328.4 MST of subbituminous coal, 86.1 MST of lignite, and 4.1 MST of anthracite. US coal consumption totaled 940.6 MST, with 88.1% in electric utilities, 3.5% in coke plants, 7.8% for other industrial uses, and only 0.6% in the residential and commercial sectors. The amount of fossil resources used for non-fuel purposes accounted for 8.4% of the total annual consumption in 1995. Non-fuel uses of fossil fuels particularly coal may become more important in the future. The demonstrated coal reserves in the world are large enough for consumption for over 220 years at the 1995 level, while proven oil reserves are only about 40 times the world's 1995 consumption level. Coal has several positive attributes when considered as a feedstock for aromatic chemicals, specialty chemicals, and carbon-based materials. Existing nonfuel uses of coals include (1) high temperature carbonization of bituminous and subbituminous coals to make metallurgical coke; (2) gasification of coal to make synthesis gases and other chemicals; (3) use of coal in manufacturing other materials such as activated carbons, carbon molecular sieves (CMS) and production of phosphorus (phosphoric acid); (4) the use of coal tars from carbonization and gasification for making aromatic and phenolic chemicals; (5) the use of coal tar pitch for making carbon fibers and activated carbon fibers; and (6) other non-fuel products derived from coal including combustion by-products. Coal may become more important both as an energy source and as the source of chemical feedstocks in the 21st century

Stem Cell Therapy on the Internet: Information Quality and Content Analysis of English Language Web Pages Returned by Google

Directory of Open Access Journals (Sweden)

Douglas Meehan

2017-12-01

Full Text Available There are expectations that stem cell therapy (SCT will treat many currently untreatable diseases. The Internet is widely used by patients seeking information about new treatments, and hence, analyzing websites is a representative sample of the information available to the public. Our aim was to understand what information the public would find when searching for information on SCT on Google, as this would inform us on how lay people form their knowledge about SCT. We analyzed the content and information quality of the first 200 websites returned by a Google.com search on SCT. Most websites returned were from treatment centers (TCs, 44% followed by news and medical professional websites. The specialty most mentioned in non-TC websites was “neurological” (67%, followed by “cardiovascular” (42%, while the most frequent indication for which SCT is offered by TCs was musculoskeletal (89% followed by neurological (47%. 45% of the centers specialized in treating 1 specialty, 10% offer 2, and 45% offered between 3 and 18 different specialties. Of the 78 TCs, 65% were in the USA, 23% in Asia, and 8% in Latin America. None of the centers offered SCT based on embryonic cells. Health information quality (JAMA score, measuring trustworthiness was lowest for TCs and commercial websites and highest for scientific journals and health portals. This study shows a disconnection between information about SCT and what is actually offered by TCs. The study also shows that TCs, potentially acting in a regulatory gray area, have a high visibility on the Internet.

Donor-Recipient Matching for KIR Genotypes Reduces Chronic GVHD and Missing Inhibitory KIR Ligands Protect against Relapse after Myeloablative, HLA Matched Hematopoietic Cell Transplantation.

Directory of Open Access Journals (Sweden)

Rehan Mujeeb Faridi

Full Text Available Allogeneic hematopoietic cell transplantation (HCT can be curative for many hematologic diseases. However, complications such as graft-versus-host disease (GVHD and relapse of primary malignancy remain significant and are the leading causes of morbidity and mortality. Effects of killer Ig-like receptors (KIR-influenced NK cells on HCT outcomes have been extensively pursued over the last decade. However, the relevance of the reported algorithms on HLA matched myeloablative HCT with rabbit antithymocyte globulin (ATG is used for GVHD prophylaxis remains elusive. Here we examined the role of KIR and KIR-ligands of donor-recipient pairs in modifying the outcomes of ATG conditioned HLA matched sibling and unrelated donor HCT.The study cohort consisted of 281 HLA matched sibling and unrelated donor-recipient pairs of first allogeneic marrow or blood stem cell transplantation allocated into 'discovery' (135 pairs and 'validation' (146 pairs cohorts. High resolution HLA typing was obtained from the medical charts and KIR gene repertoires were obtained by a Luminex® based SSO method. All surviving patients were followed-up for a minimum of two years. KIR and HLA class I distributions of HCT pairs were stratified as per applicable definitions and were tested for their association with cause specific outcomes [acute GVHD grade II-IV (aGVHD, chronic GVHD needing systemic therapy (cGVHD and relapse] using a multivariate competing risks regression model as well as with survival outcomes [relapse-free survival (RFS, cGVHD & relapse free survival (cGRFS and overall survival (OS] by multivariate Cox proportional hazards regression model. A significant association between KIR genotype mismatching (KIR-B/x donor into KIR-AA recipient or vice versa and cGVHD was found in both discovery (p = 0.001; SHR = 2.78; 95%CI: 1.50-5.17 and validation cohorts (p = 0.005; SHR = 2.61; 95%CI: 1.33-5.11. High incidence of cGVHD associated with KIR genotype mismatching was

Donor-Recipient Matching for KIR Genotypes Reduces Chronic GVHD and Missing Inhibitory KIR Ligands Protect against Relapse after Myeloablative, HLA Matched Hematopoietic Cell Transplantation.

Science.gov (United States)

Faridi, Rehan Mujeeb; Kemp, Taylor J; Dharmani-Khan, Poonam; Lewis, Victor; Tripathi, Gaurav; Rajalingam, Raja; Daly, Andrew; Berka, Noureddine; Storek, Jan; Masood Khan, Faisal

2016-01-01

Allogeneic hematopoietic cell transplantation (HCT) can be curative for many hematologic diseases. However, complications such as graft-versus-host disease (GVHD) and relapse of primary malignancy remain significant and are the leading causes of morbidity and mortality. Effects of killer Ig-like receptors (KIR)-influenced NK cells on HCT outcomes have been extensively pursued over the last decade. However, the relevance of the reported algorithms on HLA matched myeloablative HCT with rabbit antithymocyte globulin (ATG) is used for GVHD prophylaxis remains elusive. Here we examined the role of KIR and KIR-ligands of donor-recipient pairs in modifying the outcomes of ATG conditioned HLA matched sibling and unrelated donor HCT. The study cohort consisted of 281 HLA matched sibling and unrelated donor-recipient pairs of first allogeneic marrow or blood stem cell transplantation allocated into 'discovery' (135 pairs) and 'validation' (146 pairs) cohorts. High resolution HLA typing was obtained from the medical charts and KIR gene repertoires were obtained by a Luminex® based SSO method. All surviving patients were followed-up for a minimum of two years. KIR and HLA class I distributions of HCT pairs were stratified as per applicable definitions and were tested for their association with cause specific outcomes [acute GVHD grade II-IV (aGVHD), chronic GVHD needing systemic therapy (cGVHD) and relapse] using a multivariate competing risks regression model as well as with survival outcomes [relapse-free survival (RFS), cGVHD & relapse free survival (cGRFS) and overall survival (OS)] by multivariate Cox proportional hazards regression model. A significant association between KIR genotype mismatching (KIR-B/x donor into KIR-AA recipient or vice versa) and cGVHD was found in both discovery (p = 0.001; SHR = 2.78; 95%CI: 1.50-5.17) and validation cohorts (p = 0.005; SHR = 2.61; 95%CI: 1.33-5.11). High incidence of cGVHD associated with KIR genotype mismatching was applicable

131I-MIBG followed by consolidation with busulfan, melphalan and autologous stem cell transplantation for refractory neuroblastoma.

Science.gov (United States)

French, Sarah; DuBois, Steven G; Horn, Biljana; Granger, Meaghan; Hawkins, Randall; Pass, Amy; Plummer, Ellen; Matthay, Katherine

2013-05-01

(131) I-metaiodobenzylguanidine (MIBG) produces a 37% response rate in relapsed/refractory neuroblastoma, and could be used to improve remission status prior to myeloablative chemotherapy with autologous stem cell transplant (ASCT). The purpose of our report was to evaluate safety and response with MIBG therapy followed by myeloablative busulfan and melphalan (BuMel) with ASCT in patients with refractory neuroblastoma. Retrospective chart review was done on patients treated with MIBG (18 mCi/kg) on Day 1 and ASCT on day 14. Six to eight weeks after MIBG, patients without progressive disease received IV busulfan on days -6 to -2 (target Css 700-900), melphalan (140 mg/m2 IV) on day -1, and ASCT on Day 0. Response and toxicity were evaluated after MIBG and again after myeloablative therapy. Eight patients completed MIBG/ASCT followed by BuMel/ASCT. MIBG was well tolerated, with grade 3 or 4 non-hematologic toxicity limited to one patient with sepsis. Grade 3 mucositis occurred in six patients after BuMel/ASCT. One patient developed sinusoidal obstructive syndrome (SOS) and died 50 days post-ASCT following myeloablative conditioning. All patients engrafted neutrophils (median 16.5 days) and platelets (median 32 days) after BuMel, excluding the patient with SOS. After all therapy, there were three complete, two partial, and one minor response in seven evaluable patients. MIBG at doses up to 18 mCi/kg can be safely administered 6 weeks prior to a BuMel consolidative regimen for refractory neuroblastoma. Preceding MIBG did not impair engraftment following BuMel. This regimen is being further evaluated in a Children's Oncology Group (COG) trial. Copyright © 2012 Wiley Periodicals, Inc.

Measures for increased nutrition and utilization of non-conventional food resources during disasters in Africa.

Science.gov (United States)

Nur, I M

1999-01-01

The basic causes of the poor performance of the food and agricultural sector in the different parts of Africa are external, internal, and natural. The general recession in the Continent limits the capacity of the respective countries to import food to supplement inadequate domestic production and supplies. There are a number of nutritious food resources, both cultivated and gathered in the different ecological zones of Africa, whose production and consumption can be increased to ensure adequate food security and a nutritious diet, especially during disasters. These food resources could include: cereals, legumes, fruits, vegetables, fish, and insects. These food resources already are available over wide geographical areas in Africa and are utilized or utilized to a limited extent. Therefore, strategies to increase food supply, eradicate hunger and malnutrition, and keep people alive in times of disasters should have as a priority, the cultivation and consumption of non-conventional food resources in the respective communities and countries.

Port and Supply-Chain Security Initiatives in the United States and Abroad

Science.gov (United States)

2006-01-01

Secretaria de Comunicacion y Transportes (SCT), “Get to Know Us,” Online. Available: http://portal.sct.gob.mx:80/SctPortal/apPAMnager/Portal/Sct;jsessionid... Comunicacion y Transportes (SCT), “Principal Advancements in the Sector” SCT: Annual Report 2005, Online. Available: http://portal.sct.gob.mx:80...SctPortal/apPAMnager/Portal/Sct?_nfpb=true&_pageLabel=B28002. Accessed: June 20, 2006. 564 Secretaria de Comunicacion y Transportes (SCT), “Structure

Operating and impact of the compensation mechanism of the electric utility charges on the energy offer in non connected areas

International Nuclear Information System (INIS)

Levratto, N.

2005-01-01

Since the law of the 10 february 2000 relative to the modernization and the development of the electric utility, the France adopted a mechanism aiming to compensate the costs subjected by EDF and other suppliers providing a public utility mission in the domain of the electricity production and distribution. This document takes stock on the organization, the evaluation and the economical and environmental consequences of the implementing of a compensation system of costs bond to the electricity production in non connected areas. (A.L.B.)

High-throughput bioscreening system utilizing high-performance affinity magnetic carriers exhibiting minimal non-specific protein binding

International Nuclear Information System (INIS)

Hanyu, Naohiro; Nishio, Kosuke; Hatakeyama, Mamoru; Yasuno, Hiroshi; Tanaka, Toshiyuki; Tada, Masaru; Nakagawa, Takashi; Sandhu, Adarsh; Abe, Masanori; Handa, Hiroshi

2009-01-01

For affinity purification of drug target protein we have developed magnetic carriers, narrow in size distribution (184±9 nm), which exhibit minimal non-specific binding of unwanted proteins. The carriers were highly dispersed in aqueous solutions and highly resistant to organic solvents, which enabled immobilization of various hydrophobic chemicals as probes on the carrier surfaces. Utilizing the carriers we have automated the process of separation and purification of the target proteins that had been done by manual operation previously.

Attention-deficit/hyperactivity disorder dimensions and sluggish cognitive tempo symptoms in relation to college students' sleep functioning.

Science.gov (United States)

Becker, Stephen P; Luebbe, Aaron M; Langberg, Joshua M

2014-12-01

This study examined separate inattentive, hyperactive, and impulsive dimensions of attention-deficit/hyperactivity disorder (ADHD), as well as sluggish cognitive tempo (SCT) symptoms, in relation to college students' sleep functioning. Participants were 288 college students (ages 17-24; 65 % female; 90 % non-Hispanic White; 12 % self-reported having an ADHD diagnoses) who completed measures of ADHD/SCT symptoms and sleep functioning. Participants reported obtaining an average of 6.8 h of sleep per night (only 26 % reported obtaining ≥8 h of sleep) and having a sleep onset latency of 25 min. 63 % were classified as "poor sleepers," and poor sleepers had higher rates of ADHD and SCT symptoms than "good sleepers". Path analysis controlling for ADHD status and psychiatric medication use was used to determine associations between psychopathology and sleep functioning domains. Above and beyond covariates and other psychopathologies, hyperactivity (but not impulsivity) was significantly associated with poorer sleep quality, longer sleep latency, shorter sleep duration, and more use of sleep medications. SCT symptoms (but not inattention) were significantly associated with poorer sleep quality and increased nighttime sleep disturbance (e.g., having bad dreams, waking up in the middle of the night, feeling too cold or too hot). Both inattention and SCT were associated with greater daytime dysfunction. Regression analyses demonstrated that hyperactivity predicted sleep quality above and beyond the influence of daytime dysfunction, and inattention and SCT predicted daytime dysfunction above and beyond sleep quality. Further studies are needed to examine the interrelations of nighttime sleep functioning, ADHD/SCT, and daytime dysfunction, as well to elucidate mechanisms contributing to related functional impairments.

Outcome of High-Risk Stage 3 Neuroblastoma with Myeloablative Therapy and 13-cis-Retinoic Acid: A Report from the Children’s Oncology Group

Science.gov (United States)

Park, Julie R.; Villablanca, Judith G.; London, Wendy B.; Gerbing, Robert B.; Haas-Kogan, Daphne; Stanton Adkins, E.; Attiyeh, Edward F.; Maris, John M.; Seeger, Robert C.; Patrick Reynolds, C.; Matthay, Katherine K.

2009-01-01

Background The components of therapy required for patients with INSS Stage 3 neuroblastoma and high risk features remain controversial. Procedure A retrospective cohort design was used to determine if intensive chemoradiotherapy with purged autologous bone marrow rescue (ABMT) and/or 13-cis-retinoic acid (13-cis-RA) improved outcome for patients with high-risk neuroblastoma that was not metastatic to distant sites. We identified 72 patients with INSS Stage 3 neuroblastoma enrolled between 1991 and 1996 on the Phase III CCG 3891 randomized trial. Patients were analyzed on an intent-to-treat basis using a log-rank test. Results The 5-year event-free survival (EFS) and overall survival (OS) rates for patients with Stage 3 neuroblastoma were 55 +/- 6% and 59% +/- 6%, respectively (n=72). Patients randomized to ABMT (n=20) had 5-year EFS of 65% +/- 11% and OS of 65% +/- 11% compared to 41% +/- 11 (p=0.21) and 46% +/- 11% (p=0.23) for patients randomized to CC (n=23), respectively. Patients randomized to 13-cis-RA (n=23) had 5-year EFS of 70% +/- 10% and OS of 78% +/- 9% compared to 63% +/- 12% (p=0.67) and 67% +/- 12% (p=0.55) for those receiving no further therapy (n=16), respectively. Patients randomized to both ABMT and 13-cis-RA (n=6) had a 5-year EFS of 80% ± 11% and OS of 100%. Conclusion Patients with high-risk Stage 3 neuroblastoma have an overall poor prognosis despite aggressive chemoradiotherapy. Further studies are warranted to determine if myeloablative consolidation followed by 13-cis-RA maintenance therapy statistically significantly improves outcome. PMID:18937318

Amendment of the assured delivery provisions of BPA's Long-Term Intertie Access Policy and increased assured delivery: Access for non-scheduling utilities. Record of decision

International Nuclear Information System (INIS)

1994-06-01

Bonneville Power Administration's BPA's preferred alternative for providing non-Federal Pacific Northwest-Pacific Southwest (PNW-PSW) Intertie access is to adopt the Capacity Ownership alternative combined with the Increased Assured Delivery--Access for Non-Scheduling Utilities alternative. BPA's decision to offer Capacity Ownership was documented in a March 1994 Non-Federal Capacity Ownership Record of Decision (ROD). This ROD documents BPA's decision to facilitate PNW-PSW Intertie access by proceeding with (1) bidirectional Increased Assured Delivery--Access for Non Scheduling Utilities; and (2) amending the Assured Delivery provisions of BPA's Long-Term Intertie Access Policy (LTIAP). Given that the various non-Federal PNW-PSW Intertie access alternatives in the NFP EIS all allowed for different types of contracts, little environmental impact difference among the alternatives was found. Rather, environmental impact was found to be associated with whether exchange contracts or firm power sales contracts would predominate. Such impacts and related environmental analysis are discussed further in section 3.0 of this ROD

High dose melphalan in the treatment of advanced neuroblastoma: results of a randomised trial (ENSG-1) by the European Neuroblastoma Study Group

NARCIS (Netherlands)

Pritchard, Jon; Cotterill, Simon J.; Germond, Shirley M.; Imeson, John; de Kraker, Jan; Jones, David R.

2005-01-01

High dose myeloablative chemotherapy ("megatherapy"), with haematopoietic stem cell support, is now widely used to consolidate response to induction chemotherapy in patients with advanced neuroblastoma. In this study (European Neuroblastoma Study Group, ENSG1), the value of melphalan myeloablative

Combined social cognitive and neurocognitive rehabilitation strategies in schizophrenia: neuropsychological and psychopathological influences on Theory of Mind improvement.

Science.gov (United States)

Bechi, M; Bosia, M; Spangaro, M; Buonocore, M; Cocchi, F; Pigoni, A; Piantanida, M; Guglielmino, C; Bianchi, L; Smeraldi, E; Cavallaro, R

2015-11-01

Neurocognitive and social cognitive impairments represent important treatment targets in schizophrenia, as they are significant predictors of functional outcome. Different rehabilitative interventions have recently been developed, addressing both cognitive and psychosocial domains. Although promising, results are still heterogeneous and predictors of treatment outcome are not yet identified. In this study we evaluated the efficacy of two newly developed social cognitive interventions, respectively based on the use of videotaped material and comic strips, combined with domain-specific Cognitive Remediation Therapy (CRT). We also analysed possible predictors of training outcome, including basal neurocognitive performance, the degree of cognitive improvement after CRT and psychopathological variables. Seventy-five patients with schizophrenia treated with CRT, were randomly assigned to: social cognitive training (SCT) group, Theory of Mind Intervention (ToMI) group, and active control group (ACG). ANOVAs showed that SCT and ToMI groups improved significantly in ToM measures, whereas the ACG did not. We reported no influences of neuropsychological measures and improvement after CRT on changes in ToM. Both paranoid and non-paranoid subjects improved significantly after ToMI and SCT, without differences between groups, despite the better performance in basal ToM found among paranoid patients. In the ACG only non-paranoid patients showed an improvement in non-verbal ToM. Results showed that both ToMI and SCT are effective in improving ToM in schizophrenia with no influence of neuropsychological domains. Our data also suggest that paranoid symptoms may discriminate between different types of ToM difficulties in schizophrenia.

Hematopoietic stem cell transplantation from non-sibling matched family donors for patients with thalassemia major in Jordan.

Science.gov (United States)

Hussein, Ayad Ahmed; Al-Zaben, Abdulhadi; Khattab, Eman; Haroun, Anas; Frangoul, Haydar

2016-02-01

There are limited data on the outcome of patients with thalassemia receiving HSCT from non-sibling matched family donors. Of the 341 patients with thalassemia major that underwent donor search at our center from January 2003 to December 2011, 236 (69.2%) had fully matched family donor of which 28 patients (8.2%) had non-sibling matched family donors identified. We report on seven patients with a median age of eight yr (4-21) who underwent myeloablative (n = 4) or RIC (n = 3) HSCT. The median age of the donors was 33 yr (4-47), three were parents, two first cousins, one paternal uncle, and one paternal aunt. All patients achieved primary neutrophil and platelet engraftment at a median of 18 (13-20) and 16 days (11-20), respectively. One patient developed grade II acute GVHD, and two patients developed limited chronic GVHD. One patient experienced secondary GF requiring a second transplant. At a median follow-up of 69 months (7-110), all patients are alive and thalassemia free. Our data emphasize the need for extended family HLA typing for patients with thalassemia major in regions where there is high rate of consanguinity. Transplant from non-sibling matched family donor can result in excellent outcome. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Health care utilization, somatic and mental health distress, and well-being among widowed and non-widowed female survivors of war

NARCIS (Netherlands)

Morina, N.; Emmelkamp, P.M.G.

2012-01-01

Background The aim of the study was to assess levels of somatic and mental health distress, well-being, AS WELL AS utilization of primary and specialist health care services among war-related widowed and non-widowed female civilian survivors of war. Methods 100 war-related widowed lone mothers and

Impact of Autologous and Allogeneic Stem Cell Transplantation in Peripheral T-Cell Lymphomas

Directory of Open Access Journals (Sweden)

Peter Reimer

2010-01-01

Full Text Available Peripheral T/NK-cell lymphomas (PTCLs are rare malignancies characterized by poor prognosis. So far, no standard therapy has been established, due to the lack of randomised studies. High-dose therapy and autologous stem cell transplantation (HDT-autoSCT have shown good feasibility with low toxicity in retrospective studies. In relapsing and refractory PTCL several comparison analyses suggest similar efficacy for PTCL when compared with aggressive B-cell lymphoma. In the upfront setting, prospective data show promising results with a long-lasting overall survival in a relevant subset of patients. Achieving a complete remission at transplantation seems to be the most important prognostic factor. Allogeneic stem cell transplantation (alloSCT has been investigated only as salvage treatment. Especially when using reduced intensity conditioning regimen, eligible patients seem to benefit from this approach. To define the role for upfront stem cell transplantation a randomised trial by the German High-Grade Non-Hodgkin Lymphoma Study Group comparing HDT-autoSCT and alloSCT will be initiated this year.

ATLAS Silicon Microstrip Tracker Operation and Performance

CERN Document Server

Barone, G; The ATLAS collaboration

2013-01-01

The Semi-Conductor Tracker (SCT) is a silicon strip detector and one of the key precision tracking devices in the Inner Detector of the ATLAS experiment at CERN LHC. The SCT is constructed of 4088 silicon detector modules for a total of 6.3 million strips. Each module is designed, constructed and tested to operate as a stand-alone unit, mechanically, electrically, optically and thermally. The modules are mounted into two types of structures: one barrel (4 cylinders) and two end-cap systems (9 disks on each end of the barrel). In the talk the current results from the successful operation of the SCT Detector at the LHC and its status after three years of operation will be presented. We will report on the operation of the detector including an overview of the issues we encountered and the observation of significant increases in leakage currents (as expected) from bulk damage due to non-ionising radiation. The main emphasis will be given to the tracking performance of the SCT and the data quality during the >2 ye...

Performance and operation experience of the Atlas Semiconductor Tracker

CERN Document Server

Liang, Zhijun

2014-01-01

We report on the operation and performance of the ATLAS Semi-Conductor Tracker (SCT), which has been functioning for 3 years in the high luminosity, high radiation environment of the Large Hadron Collider at CERN. Well also report on the few im- provements of the SCT foreseen for the high energy run of the LHC. We find 99.3% of the SCT modules are operational, the noise occupancy and hit efficiency exceed the design specifications; the alignment is very close to the ideal to allow on-line track reconstruc- tion and invariant mass determination. We will report on the operation and performance of the detector including an overview of the issues encountered. We observe a significant increase in leakage currents from bulk damage due to non-ionizing radiation and make comparisons with the predictions.

ACTIVATION OF T. GONDII INFECTION AFTER ALLOGENEIC TRANSPLANTATION OF HEMATOPOIETIC STEM CELLS: DEPENDENCE ON TIME OF TRANSPLANTATION AND SEROLOGICAL STATUS OF THE PATIENTS

Directory of Open Access Journals (Sweden)

A. B. Chukhlovin

2014-01-01

Full Text Available The article focuses on aspects of T. gondii reactivation/reinfection in patients undergoing allogeneic hematopoietic stem cell transplantation (alloHSCT. We have observed 297 patients who received conditioning therapy and allogeneic grafts due to different oncohematological or lymphoproliferative diseases (1 to 60 years old, at a mediane of 19 years. Conditioning regimens were either myeloablative (35%, or non-myeloablative (65%. DNA diagnostics of T. gondii was performed on a regular basis at 0 to 6 months post-HSCT. IgG and IgM antibodies against T. gondii were determined in 78 patients before HSCT, as well as in their donors. T. gondii DNA post-transplant proved to be positive in 13% of blood specimens, 9% of cerebrospinal liquor samples, 11% of bronchoalveolar cell lavages, and in 5% of urine sediments. In adolescent patients (10 to 14 years old, an increased prevalence of T. gondii was found in patients who received myeloablative treatment (p = 0.01. When assessing posttransplant dynamics of T. gondii, we have revealed distinct increase in the pathogen excretion within 1st month after HSCT (p = 0.03. Finally, initial presence of IgG antibodies against T. gondii in the patients was associated with lower incidence of the pathogen reactivation post-transplant.

Testing the association between the incidence of schizophrenia and social capital in an urban area.

Science.gov (United States)

Kirkbride, J B; Boydell, J; Ploubidis, G B; Morgan, C; Dazzan, P; McKenzie, K; Murray, R M; Jones, P B

2008-08-01

Social capital has been considered aetiologically important in schizophrenia but the empirical evidence to support this hypothesis is absent. We tested whether social capital, measured at the neighbourhood level, was associated with the incidence of schizophrenia (ICD-10 F20). MethodWe administered a cross-sectional questionnaire on social capital to 5% of the adult population in 33 neighbourhoods (wards) in South London (n=16 459). The questionnaire contained items relating to two social capital constructs: social cohesion and trust (SC&T) and social disorganization (SocD). Schizophrenia incidence rates, estimated using data from the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study, provided the outcome. We used multi-level Poisson regression to test our hypothesis while controlling for individual- and neighbourhood-level characteristics. We identified 148 cases during 565 576 person-years at-risk. Twenty-six per cent of the variation in incidence rates was attributable to neighbourhood-level characteristics. Response from the social capital survey was 25.7%. The association between SC&T and schizophrenia was U-shaped. Compared with neighbourhoods with medial levels of SC&T, incidence rates were significantly higher in neighbourhoods with low [incidence rates ratio (IRR) 2.0, 95% confidence interval (CI) 1.2-3.3] and high (IRR 2.5, 95% CI 1.3-4.8) levels of SC&T, independent of age, sex, ethnicity, ethnic density, ethnic fragmentation and socio-economic deprivation. ConclusionNeighbourhood variation in SC&T was non-linearly associated with the incidence of schizophrenia within an urban area. Neighbourhoods with low SC&T may fail to mediate social stress whereas high SC&T neighbourhoods may have greater informal social control or may increase the risk of schizophrenia for residents excluded from accessing available social capital.

Hydrogen production with short contact time. Catalytic partial oxidation of hydrocarbons and oxygenated compounds: Recent advances in pilot- and bench-scale testing and process design

Energy Technology Data Exchange (ETDEWEB)

Guarinoni, A.; Ponzo, R.; Basini, L. [ENI Refining and Marketing Div., San Donato Milanese (Italy)

2010-12-30

ENI R and D has been active for fifteen years in the development of Short Contact Time - Catalytic Partial Oxidation (SCT-CPO) technologies for producing Hydrogen/Synthesis Gas. From the beginning the experimental work addressed either at defining the fundamental principles or the technical and economical potential of the technology. Good experimental responses, technical solutions' simplicity and flexibility, favourable techno-economical evaluations promoted the progressive widening of the field of the investigations. From Natural Gas (NG) the range of ''processable'' Hydrocarbons extended to Liquefied Petroleum Gas (LPG) and Gasoils, including those characterised by high levels of unsaturated and sulphurated molecules and, lately, to other compounds with biological origin. The extensive work led to the definition of different technological solutions, grouped as follows: Technology 1: Air Blown SCT-CPO of Gaseous Hydrocarbons and/or Light Compounds with biological origin Technology 2: Enriched Air/Oxygen Blown SCT-CPO of Gaseous Hydrocarbons and/or Light Compounds with biological origin Technology 3: Enriched Air/Oxygen Blown SCT-CPO of Liquid Hydrocarbons and/or Compounds with biological origin Recently, the licence rights on a non-exclusive basis for the commercialisation of SCT-CPO based processes for H{sub 2}/Synthesis gas production from light hydrocarbons with production capacity lower than 5,000 Nm{sup 3}/h of H{sub 2} or 7,500 Nm3/h of syngas have been assigned to two external companies. In parallel, development of medium- and large-scale plant solutions is progressing within the ENI group framework. These last activities are addressed to the utilisation of SCT-CPO for matching the variable Hydrogen demand in several contexts of oil refining operation. This paper will report on the current status of SCT-CPO with a focus on experimental results obtained, either at pilot- and bench- scale level. (orig.)

Hematopoietic Stem Cell Transplantation in Thalassemia and Sickle Cell Anemia

Science.gov (United States)

Lucarelli, Guido; Isgrò, Antonella; Sodani, Pietro; Gaziev, Javid

2012-01-01

The globally widespread single-gene disorders β-thalassemia and sickle cell anemia (SCA) can only be cured by allogeneic hematopoietic stem cell transplantation (HSCT). HSCT treatment of thalassemia has substantially improved over the last two decades, with advancements in preventive strategies, control of transplant-related complications, and preparative regimens. A risk class–based transplantation approach results in disease-free survival probabilities of 90%, 84%, and 78% for class 1, 2, and 3 thalassemia patients, respectively. Because of disease advancement, adult thalassemia patients have a higher risk for transplant-related toxicity and a 65% cure rate. Patients without matched donors could benefit from haploidentical mother-to-child transplantation. There is a high cure rate for children with SCA who receive HSCT following myeloablative conditioning protocols. Novel non-myeloablative transplantation protocols could make HSCT available to adult SCA patients who were previously excluded from allogeneic stem cell transplantation. PMID:22553502

How social cognitive theory can help oncology-based health professionals promote physical activity among breast cancer survivors.

Science.gov (United States)

Short, C E; James, E L; Plotnikoff, R C

2013-08-01

The majority of post treatment breast cancer survivors do not engage in physical activity (PA) at the recommended level. The promotion of PA among this group has the potential to dramatically improve quality of life and health outcomes. To maximise effectiveness, programs should be theory-based and address key determinants of PA behaviour. Social Cognitive Theory (SCT) has shown particular promise for developing and guiding PA interventions, but future research regarding how each SCT construct relates to PA among this group is needed. This study aims to explore how core SCT constructs impact on PA participation among post treatment breast cancer survivors, and gain greater insights into how to shape PA program strategies that will be appealing and effective for this group. Post treatment breast cancer survivors were recruited from the Breast Cancer Network Australia's review and survey group. Semi-structured telephone interviews examined PA patterns and SCT constructs and data were analysed thematically. Eight post treatment breast cancer survivors participated in the study. Changes in activity level since diagnosis were common; in most cases this reflected a decline in PA. Key social cognitive and environmental influences on PA were described under the following themes: knowledge, outcome expectations, self-efficacy and personal, behavioural and environment facilitators and inhibitors. The results of this study demonstrate the utility of SCT for guiding PA programs. Insight into how social cognitive factors may influence PA behaviour in this group is offered and direction for how oncology-based health professionals can promote PA among breast cancer survivors is provided. Copyright © 2012 Elsevier Ltd. All rights reserved.

Lipolytic actions of secretin in mouse adipocytes[S

Science.gov (United States)

Sekar, Revathi; Chow, Billy K. C.

2014-01-01

Secretin (Sct), a classical gut hormone, is now known to play pleiotropic functions in the body including osmoregulation, digestion, and feeding control. As Sct has long been implicated to regulate metabolism, in this report, we have investigated a potential lipolytic action of Sct. In our preliminary studies, both Sct levels in circulation and Sct receptor (SctR) transcripts in adipose tissue were upregulated during fasting, suggesting a potential physiological relevance of Sct in regulating lipolysis. Using SctR knockout and Sct knockout mice as controls, we show that Sct is able to stimulate lipolysis in vitro in isolated adipocytes dose- and time-dependently, as well as acute lipolysis in vivo. H-89, a protein kinase A (PKA) inhibitor, was found to attenuate lipolytic effects of 1 μM Sct in vitro, while a significant increase in PKA activity upon Sct injection was observed in the adipose tissue in vivo. Sct was also found to stimulate phosphorylation at 660ser of hormone sensitive lipase (HSL) and to bring about the translocation of HSL from cytosol to the lipid droplet. In summary, our data demonstrate for the first time the in vivo and in vitro lipolytic effects of Sct, and that this function is mediated by PKA and HSL. PMID:24273196

Detection of Frauds and Other Non-technical Losses in Power Utilities using Smart Meters: A Review

Science.gov (United States)

Ahmad, Tanveer; Ul Hasan, Qadeer

2016-06-01

Analysis of losses in power distribution system and techniques to mitigate these are two active areas of research especially in energy scarce countries like Pakistan to increase the availability of power without installing new generation. Since total energy losses account for both technical losses (TL) as well as non-technical losses (NTLs). Utility companies in developing countries are incurring of major financial losses due to non-technical losses. NTLs lead to a series of additional losses, such as damage to the network (infrastructure and the reduction of network reliability) etc. The purpose of this paper is to perform an introductory investigation of non-technical losses in power distribution systems. Additionally, analysis of NTLs using consumer energy consumption data with the help of Linear Regression Analysis has been carried out. This data focuses on the Low Voltage (LV) distribution network, which includes: residential, commercial, agricultural and industrial consumers by using the monthly kWh interval data acquired over a period (one month) of time using smart meters. In this research different prevention techniques are also discussed to prevent illegal use of electricity in the distribution of electrical power system.

A System-Wide Approach to Physician Efficiency and Utilization Rates for Non-Operating Room Anesthesia Sites.

Science.gov (United States)

Tsai, Mitchell H; Huynh, Tinh T; Breidenstein, Max W; O'Donnell, Stephen E; Ehrenfeld, Jesse M; Urman, Richard D

2017-07-01

There has been little in the development or application of operating room (OR) management metrics to non-operating room anesthesia (NORA) sites. This is in contrast to the well-developed management framework for the OR management. We hypothesized that by adopting the concept of physician efficiency, we could determine the applicability of this clinical productivity benchmark for physicians providing services for NORA cases at a tertiary care center. We conducted a retrospective data analysis of NORA sites at an academic, rural hospital, including both adult and pediatric patients. Using the time stamps from WiseOR® (Palo Alto, CA), we calculated site utilization and physician efficiency for each day. We defined scheduling efficiency (SE) as the number of staffed anesthesiologists divided by the number of staffed sites and stratified the data into three categories (SE 1). The mean physician efficiency was 0.293 (95% CI, [0.281, 0.305]), and the mean site utilization was 0.328 (95% CI, [0.314, 0.343]). When days were stratified by scheduling efficiency (SE 1), we found differences between physician efficiency and site utilization. On days where scheduling efficiency was less than 1, that is, there are more sites than physicians, mean physician efficiency (95% CI, [0.326, 0.402]) was higher than mean site utilization (95% CI, [0.250, 0.296]). We demonstrate that scheduling efficiency vis-à-vis physician efficiency as an OR management metric diverge when anesthesiologists travel between NORA sites. When the opportunity to scale operational efficiencies is limited, increasing scheduling efficiency by incorporating different NORA sites into a "block" allocation on any given day may be the only suitable tactical alternative.

The performance of SCT128A ASICs when reading out silicon sensors and a study of $B^{0}_{s}\\to D^{+-}_{s} \\pi^{-+}$ at LHCb

CERN Document Server

Charles, M J; Harnew, N

2003-01-01

LHCb is a future detector which will take data at the CERN Large Hadron Collider proton-proton collider. It is optimized for B physics and will make precision measurements of CP violation parameters and flavour mixing. Measurements of time-dependent asymmetries and decay rates require accurate reconstruction of the B meson production and decay vertices; this is achieved with a silicon microstrip VErtex LOcator (VELO). In this thesis, an overview of silicon strip detectors (SSDs) is given and the choice of sensor technology at LHCb justified. Data from beam tests in which prototype VELO SSDs were read out using SCT128A electronics are presented and analysed. The time response of the system is measured and the implications for LHC-speed readout are discussed. The effect of detector input capacitance is investigated. Measurements of the mass and width differences of the Bs mass eigenstates, Delta M_s and Delta Gamma_s, will be possible at LHCb. Recent theoretical predictions for these parameters are given and it...

Polarization-independent rapidly tunable optical add-drop multiplexer utilizing non-polarizing beam splitters in Ti:LiNbO3

Science.gov (United States)

Shin, Yong-Wook; Sung, Won Ju; Eknoyan, O.; Madsen, C. K.; Taylor, H. F.

2012-04-01

A polarization-independent four-port wavelength-tunable optical add drop multiplexer (OADM) that utilizes non-polarizing relaxed beam splitters has been analyzed and demonstrated in Ti:LiNbO3 at the 1530 nm wavelength regime. The design utilizes an asymmetric interferometer configuration with strain induced index grating for polarization coupling along its arms that are shifted in position relative to each other. Experimental results of the filter response agree with theoretical predictions. Electrooptic tuning over a range of 15.7 nm at a rate of 0.08 nm/V has been measured. A temporal response < 46 ns to a 20 V step change in tuning voltage has been demonstrated. Fiber-to-fiber insertion loss is ~ 6.5 dB.

Non-Gaussian Statistical Communication Theory

CERN Document Server

Middleton, David

2012-01-01

The book is based on the observation that communication is the central operation of discovery in all the sciences. In its "active mode" we use it to "interrogate" the physical world, sending appropriate "signals" and receiving nature's "reply". In the "passive mode" we receive nature's signals directly. Since we never know a prioriwhat particular return signal will be forthcoming, we must necessarily adopt a probabilistic model of communication. This has developed over the approximately seventy years since it's beginning, into a Statistical Communication Theory (or SCT). Here it is the set or

Experience of the application of the distribution of utilities for the non agricultural cooperatives

Directory of Open Access Journals (Sweden)

Juan Luis Alfonso Alemán

2016-12-01

Full Text Available The cooperatives in Cuba assumes a series of particularities characteristic of the concrete conditions of our country, it is an autochthonous fruit of the measures carried out soon after the victory of the Revolution that in the current moments with the implementation of the Limits of the Economic and Social Politics of the Party and the Revolution transcends the sphere of the agricultural production and sandal other sectors of the national economy. Even when the nature of this process is of experimental character and in spite of the remarkable youth of the on experiences in practice, important results are obtained that sustain the viability and sostenibility of this implementation project. Nevertheless, they are revealed a group of inadequacies that you/they affect in a direct way the administration in these new cooperative ways whose solution will allow to base new decisions for the sake of its improvement, one of these he/she has to do with the current system of distribution of utilities that doesn't guarantee the efficient and effective development of the process of socioeconomic administration of these entities. For it the objective of this work consists on structuring a system of distribution of utilities in the non Agricultural Cooperatives that it allows the constitution of funds of own resources that you/they contribute to the efficient and effective development of its process socioeconomic administration.

Correction: An unsymmetrical non-fullerene acceptor: synthesis via direct heteroarylation, self-assembly, and utility as a low energy absorber in organic photovoltaic cells.

Science.gov (United States)

Payne, Abby-Jo; Li, Shi; Dayneko, Sergey V; Risko, Chad; Welch, Gregory C

2017-09-21

Correction for 'An unsymmetrical non-fullerene acceptor: synthesis via direct heteroarylation, self-assembly, and utility as a low energy absorber in organic photovoltaic cells' by Abby-Jo Payne et al., Chem. Commun., 2017, 53, 10168-10171.

A Systematic Overview of Radiation Therapy Effects in Non-Hodgkin's Lymphoma

International Nuclear Information System (INIS)

Gustavsson, Anita; Osterman, Birgitta; Cavallin-Staahl, Eva

2003-01-01

-dose methotrexate therapy seems to lead to longer survival than radiotherapy alone. No randomized trials have been performed. There is fairly good support for primary chemotherapy including high-dose methotrexate followed by radiotherapy in patients below 60 years. To minimize the risk of neurotoxicity of combined modality treatment it has been proposed to use chemotherapy alone and delay radiotherapy for relapse, especially in patients above 60 years, or use it in chemotherapy-resistant disease. Optimal chemotherapy regimen is not defined and the role of radiotherapy remains to be determined. Head and neck lymphomas: There is some support for combined modality treatment with chemotherapy and radiotherapy for aggressive lymphomas in Waldeyer's ring with limited disease. There are sparse data supporting radiotherapy alone in localized indolent lymphomas in salivary glands. Radioimmunotherapy (RIT): Radioimmunotherapy is a new treatment modality with systemic radiation for patients with advanced NHL, where conventional external beam radiotherapy plays only a minor role. Several phase I and II studies with RIT have documented promising results. A variety of monoclonal antibodies, radionuclides and study designs with both myeloablative and non-myeloablative approach have resulted in high response rates in patients with recurrent or refractory NHL. One randomized clinical trial is published, showing superior therapy results with radiolabelled antibody compared with the corresponding unlabelled antibody

Nonlinear convective analysis of a rotating Oldroyd-B nanofluid layer under thermal non-equilibrium utilizing Al2O3-EG colloidal suspension

Science.gov (United States)

Agarwal, Shilpi; Rana, Puneet

2016-04-01

In this paper, we examine a layer of Oldroyd-B nanofluid for linear and nonlinear regimes under local thermal non-equilibrium conditions for the classical Rayleigh-Bénard problem. The free-free boundary condition has been implemented with the flux for nanoparticle concentration being zero at edges. The Oberbeck-Boussinesq approximation holds good and for the rotational effect Coriolis term is included in the momentum equation. A two-temperature model explains the effect of local thermal non-equilibrium among the particle and fluid phases. The criteria for onset of stationary convection has been derived as a function of the non-dimensionalized parameters involved including the Taylor number. The assumed boundary conditions negate the possibility of overstability due to the absence of opposing forces responsible for it. The thermal Nusselt number has been obtained utilizing a weak nonlinear theory in terms of various pertinent parameters in the steady and transient mode, and has been depicted graphically. The main findings signify that the rotation has a stabilizing effect on the system. The stress relaxation parameter λ_1 inhibits whereas the strain retardation parameter λ_2 exhibits heat transfer utilizing Al2O3 nanofluids.

The Financial Burden of Non-Communicable Chronic Diseases in Rural Nigeria: Wealth and Gender Heterogeneity in Health Care Utilization and Health Expenditures

NARCIS (Netherlands)

Janssens, Wendy; Goedecke, Jann; de Bree, Godelieve J.; Aderibigbe, Sunday A.; Akande, Tanimola M.; Mesnard, Alice

2016-01-01

Better insights into health care utilization and out-of-pocket expenditures for non-communicable chronic diseases (NCCD) are needed to develop accessible health care and limit the increasing financial burden of NCCDs in Sub-Saharan Africa. A household survey was conducted in rural Kwara State,

Impact of on-site cardiac catheterization on resource utilization and fatal and non-fatal outcomes after acute myocardial infarction

Directory of Open Access Journals (Sweden)

Richard Hugues

2006-11-01

Full Text Available Abstract Background Patterns of care for acute myocardial infarction (AMI strongly depend on the availability of on-site cardiac catheterization facilities. Although the management found at hospitals without on-site catheterization does not lead to increased mortality, little it known about its impact on resource utilization and non-fatal outcomes. Methods We identified all patients (n = 35,289 admitted with a first AMI in the province of Quebec between January 1, 1996 and March 31, 1999 using population-based administrative databases. Medical resource utilization and non-fatal and fatal outcomes were compared among patients admitted to hospitals with and without on-site cardiac catheterization facilities. Results Cardiac catheterization and PCI were more frequently performed among patients admitted to hospitals with catheterization facilities. However, non-invasive procedures were not used more frequently at hospitals without catheterization facilities. To the contrary, echocardiography [odds ratio (OR, 2.04; 95% confidence interval (CI, 1.93–2.16] and multi-gated acquisition imaging (OR, 1.24; 95% CI, 1.17–1.32 were used more frequently at hospitals with catheterization, and exercise treadmill testing (OR, 1.02; 95% CI, 0.91–1.15 and Sestamibi/Thallium imaging (OR, 0.93; 95% CI, 0.88–0.98 were used similarly at hospitals with and without catheterization. Use of anti-ischemic medications and frequency of emergency room and physician visits, were similar at both types of institutions. Readmission rates for AMI-related cardiac complications and mortality were also similar [adjusted hazard ratio, recurrent AMI: 1.02, 95% CI, 0.89–1.16; congestive heart failure: 1.02; 95% CI, 0.90–1.15; unstable angina: 0.93; 95% CI, 0.85–1.02; mortality: 0.99; 95% CI, 0.93–1.05]. Conclusion Although on-site availability of cardiac catheterization facilities is associated with greater use of invasive cardiac procedures, non-availability of

N-utilization in non-inversion tillage systems

DEFF Research Database (Denmark)

Hansen, Elly Møller; Munkholm, Lars Juhl; Olesen, Jørgen E

2011-01-01

When changing from ploughing to non-inversion tillage, N rates are of particular importance both for farmers and the environment. A tillage and fertilizer experiment was established in Denmark under temperate coastal climatic conditions to evaluate the N fertilizer responses on yields and N uptake......–30 kg N ha−1 of the total fertilizer N amount in autumn to autumn-sown crops (1.00NAut). In all the crop rotations, straw was chopped and retained after harvest. Different types of N fertilizer responses were observed in the six crops, but generally yields were lower with non-inversion tillage than...... with ploughing. On two occasions, yields in ploughed plots were significantly (p able to offset the growth reduction, which resulted from poor growth in patches probably caused...

Utilization of health care services by migrants in Europe

DEFF Research Database (Denmark)

Graetz, V.; Rechel, B.; Groot, W.

2017-01-01

: Compared with previous systematic reviews, the results indicate a clearer picture of the differences in health service utilization between migrants and non-migrants in Europe. Areas timely for developing research: A comprehensive comparison across European countries is impossible because the number......Introduction: Our study reviewed the empirical evidence on the utilization of health care services by migrants in Europe, and on differences in health service utilization between migrants and non-migrants across European countries. Sources of data: A systematic literature review was performed......, searching the databases Medline, Cinahl and Embase and covering the period from January 2009 to April 2016. The final number of articles included was 39. Areas of agreement: Utilization of accident and emergency services and hospitalizations were higher among migrants compared with non-migrants in most...

Urea utilization in growing lambs. 7

International Nuclear Information System (INIS)

Ulbrich, M.

1989-01-01

The utilization quota of NPN and pure feed protein for body protein synthesis was calculated on the basis of N balance experiments with 15 N-labelled urea with the help of model concepts of a 3-pool model and its mathematical usage. In lambs weighing 13 kg the efficiency of amino acid and nucleic acid synthesis in the non-amino acid N pool was 64%. This results in a total utilization quota for NPN and pure protein in the ration of 40% and 60%, resp. Lambs weighing 27 kg showed an efficiency in amino acid and nucleic acid synthesis in the non-AA N pool of 77% and in the AA N pool of 60%. The total utilization quota of NPN was 47% and that of pure protein 56%. The pure protein in the ration was thus about twice as well utilized for total protein synthesis and for protein syntesis for crude protein retention as the NPN compounds in the ration. (author)

Outcome of children with high-risk acute myeloid leukemia given autologous or allogeneic hematopoietic cell transplantation in the aieop AML-2002/01 study.

Science.gov (United States)

Locatelli, F; Masetti, R; Rondelli, R; Zecca, M; Fagioli, F; Rovelli, A; Messina, C; Lanino, E; Bertaina, A; Favre, C; Giorgiani, G; Ripaldi, M; Ziino, O; Palumbo, G; Pillon, M; Pession, A; Rutella, S; Prete, A

2015-02-01

We analyzed the outcome of 243 children with high-risk (HR) AML in first CR1 enrolled in the AIEOP-2002/01 protocol, who were given either allogeneic (ALLO; n=141) or autologous (AUTO; n=102) hematopoietic SCT (HSCT), depending on the availability of a HLA-compatible sibling. Infants, patients with AML-M7, or complex karyotype or those with FLT3-ITD, were eligible to be transplanted also from alternative donors. All patients received a myeloablative regimen combining busulfan, cyclophosphamide and melphalan; [corrected] AUTO-HSCT patients received BM cells in most cases, while in children given ALLO-HSCT stem cell source was BM in 96, peripheral blood in 19 and cord blood in 26. With a median follow-up of 57 months (range 12-130), the probability of disease-free survival (DFS) was 73% and 63% in patients given either ALLO- or AUTO-HSCT, respectively (P=NS). Although the cumulative incidence (CI) of relapse was lower in ALLO- than in AUTO-HSCT recipients (17% vs 28%, respectively; P=0.043), the CI of TRM was 7% in both groups. Patients transplanted with unrelated donor cord blood had a remarkable 92.3% 8-year DFS probability. Altogether, these data confirm that HSCT is a suitable option for preventing leukemia recurrence in HR children with CR1 AML.

Non-streaming high-efficiency perforated semiconductor neutron detectors, methods of making same and measuring wand and detector modules utilizing same

Science.gov (United States)

McGregor, Douglas S.; Shultis, John K.; Rice, Blake B.; McNeil, Walter J.; Solomon, Clell J.; Patterson, Eric L.; Bellinger, Steven L.

2010-12-21

Non-streaming high-efficiency perforated semiconductor neutron detectors, method of making same and measuring wands and detector modules utilizing same are disclosed. The detectors have improved mechanical structure, flattened angular detector responses, and reduced leakage current. A plurality of such detectors can be assembled into imaging arrays, and can be used for neutron radiography, remote neutron sensing, cold neutron imaging, SNM monitoring, and various other applications.

Lipeo-sCT: a novel reversible lipidized salmon calcitonin derivative, its biophysical properties and hypocalcemic activity.

Science.gov (United States)

Cheng, Weiqiang; Lim, Lee-Yong

2009-05-12

We have previously described the design and synthesis of Mal-sCT and compared its biological activity with its reversible counterpart, REAL-sCT. Mal-sCT was salmon calcitonin (sCT) conjugated with two molecules of an epsilon-maleimido lysine derivative of palmitic acid via non-reversible thioether bonds at its cysteine residues while REAL-sCT was sCT conjugated with two molecules of a cysteine derivative of palmitic acid via reducible disulfide bonds at its cysteine residues. Neither compounds when dissolved in water could reproducibly improved the oral deliverability of sCT. The purpose of this study was to characterize and evaluate Lipeo-sCT, a novel sCT analog conjugated via reducible disulfide bonds with two amphiphilic groups consisting of a hydrophobic hexadecyl moiety attached via an ether bond to a hydrophilic triethylene glycol moiety. Lipeo-sCT was successfully synthesized by a 4-step reaction, purified and identified by ESI-MS. Analysis by dynamic light scattering (DLS) and transmission electron microscopy (TEM) suggested it had a propensity to form aggregates in water, although the aggregation behavior was controllable by modulating solvent polarity. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay indicated a lack of cytotoxicity against the Caco-2 cells at up to 100 microM. Compared with sCT, Lipeo-sCT lowered plasma calcium to comparable levels when injected subcutaneously at 0.15 mg/kg into female Wistar rats, but the hypocalcemic activity of Lipeo-sCT was prolonged by at least 6 more hours. This was attributable to a continual regeneration of sCT from Lipeo-sCT. sCT was detectable in plasma 8h following subcutaneous injection of Lipeo-sCT (1.90 mg/kg), while Lipeo-sCT was not observed in plasma at all time points. By comparison, sCT was detectable in plasma for less than 2.5h following subcutaneous injection at an equivalent dose (1.50mg/kg). Data from this study complement those of previous studies, and add to the body of

Atypical presentation of Legionella pneumonia among patients with underlying cancer: A fifteen-year review.

Science.gov (United States)

del Castillo, Maria; Lucca, Anabella; Plodkowski, Andrew; Huang, Yao-Ting; Kaplan, Janice; Gilhuley, Kathleen; Babady, N Esther; Seo, Susan K; Kamboj, Mini

2016-01-01

Immunocompromised patients, especially those receiving treatment with corticosteroids and cytotoxic chemotherapy are at increased risk for developing Legionella pneumonia. The aim of this study was to determine clinical and radiographic characteristics of pulmonary infection due to Legionella in persons undergoing treatment for cancer and stem cell transplant (SCT) recipients. Retrospective review of Legionella cases at MSKCC over a fifteen-year study period from January 1999 and December 2013. Cases were identified by review of microbiology records. During the study period, 40 cases of Legionella infection were identified; nine among these were due to non-pneumophila species. Most cases occurred during the summer. The majority [8/9, (89%)] of patients with non-pneumophila infection had underlying hematologic malignancy, compared to 18/31 (58%) with Legionella pneumophila infections. Radiographic findings were varied-nodular infiltrates mimicking invasive fungal infection were seen only among patients with hematologic malignancy and hematopoietic stem cell transplant (SCT) recipients and were frequently associated with non-pneumophila infections (50% vs 16%; P = 0.0594). All cases of nodular Legionella pneumonia were found incidentally or had an indolent clinical course. Legionella should be considered in the differential diagnosis of nodular lung lesions in immunocompromised patients, especially those with hematologic malignancy and SCT recipients. Most cases of nodular disease due to Legionella are associated with non-pneumophila infections. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Does Emotion Dysregulation Mediate the Association Between Sluggish Cognitive Tempo and College Students' Social Impairment?

Science.gov (United States)

Flannery, Andrew J; Becker, Stephen P; Luebbe, Aaron M

2016-09-01

Studies demonstrate an association between sluggish cognitive tempo (SCT) and social impairment, although no studies have tested possible mechanisms of this association. This study aimed to (a) examine SCT in relation to college students' social functioning; (b) test if SCT is significantly associated with emotion dysregulation beyond depressive, anxious, and ADHD symptoms; and (c) test if emotion dysregulation mediates the association between SCT symptoms and social impairment. College students (N = 158) completed measures of psychopathology symptoms, emotion dysregulation, and social functioning. Participants with elevated SCT (12%) had higher ADHD, depressive, and anxious symptoms in addition to poorer emotion regulation and social adjustment than participants without elevated SCT. Above and beyond other psychopathologies, SCT was significantly associated with social impairment but not general interpersonal functioning. SCT was also associated with emotion dysregulation, even after accounting for the expectedly strong association between depression and emotion dysregulation. Further analyses supported emotion dysregulation as a mediator of the association between SCT and social impairment. These findings are important for theoretical models of SCT and underscore the need for additional, longitudinal research. © The Author(s) 2014.

Mean-Variance portfolio optimization by using non constant mean and volatility based on the negative exponential utility function

Science.gov (United States)

Soeryana, Endang; Halim, Nurfadhlina Bt Abdul; Sukono, Rusyaman, Endang; Supian, Sudradjat

2017-03-01

Investments in stocks investors are also faced with the issue of risk, due to daily price of stock also fluctuate. For minimize the level of risk, investors usually forming an investment portfolio. Establishment of a portfolio consisting of several stocks are intended to get the optimal composition of the investment portfolio. This paper discussed about optimizing investment portfolio of Mean-Variance to stocks by using mean and volatility is not constant based on the Negative Exponential Utility Function. Non constant mean analyzed using models Autoregressive Moving Average (ARMA), while non constant volatility models are analyzed using the Generalized Autoregressive Conditional heteroscedastic (GARCH). Optimization process is performed by using the Lagrangian multiplier technique. As a numerical illustration, the method is used to analyze some stocks in Indonesia. The expected result is to get the proportion of investment in each stock analyzed

Exploring the utility of DNA barcoding in species delimitation of Polypedilum (Tripodura) non-biting midges (Diptera: Chironomidae).

Science.gov (United States)

Song, Chao; Wang, Qian; Zhang, Ruilei; Sun, Bingjiao; Wang, Xinhua

2016-02-16

In this study, we tested the utility of the mitochondrial gene cytochrome c oxidase subunit 1 (CO1) as the barcode region to deal with taxonomical problems of Polypedilum (Tripodura) non-biting midges (Diptera: Chironomidae). The 114 DNA barcodes representing 27 morphospecies are divided into 33 well separated clusters based on both Neighbor Joining and Maximum Likelihood methods. DNA barcodes revealed an 82% success rate in matching with morphospecies. The selected DNA barcode data support 37-64 operational taxonomic units (OTUs) based on the methods of Automatic Barcode Gap Discovery (ABGD) and Poisson Tree Process (PTP). Furthermore, a priori species based on consistent phenotypic variations were attested by molecular analysis, and a taxonomical misidentification of barcode sequences from GenBank was found. We could not observe a distinct barcode gap but an overlap ranged from 9-12%. Our results supported DNA barcoding as an ideal method to detect cryptic species, delimit sibling species, and associate different life stages in non-biting midges.

Encouraging smokers to quit: the cost effectiveness of reimbursing the costs of smoking cessation treatment.

Science.gov (United States)

Kaper, Janneke; Wagena, Edwin J; van Schayck, Constant P; Severens, Johan L

2006-01-01

Smoking cessation should be encouraged in order to increase life expectancy and reduce smoking-related healthcare costs. Results of a randomised trial suggested that reimbursing the costs of smoking cessation treatment (SCT) may lead to an increased use of SCT and an increased number of quitters versus no reimbursement. To assess whether reimbursement for SCT is a cost-effective intervention (from the Dutch societal perspective), we calculated the incremental costs per quitter and extrapolated this outcome to incremental costs per QALY saved versus no reimbursement. In the reimbursement trial, 1266 Dutch smokers were randomly assigned to the intervention or control group using a randomised double consent design. Reimbursement for SCT was offered to the intervention group for a period of 6 months. No reimbursement was offered to the control group. Prolonged abstinence from smoking was determined 6 months after the end of the reimbursement period. The QALYs gained from quitting were calculated until 80 years of age using data from the US. Costs (year 2002 values) were determined from the societal perspective during the reimbursement period (May-November 2002). Benefits were discounted at 4% per annum. The uncertainty of the incremental cost-effectiveness ratios was estimated using non-parametric bootstrapping. Eighteen participants in the control group (2.8%) and 35 participants in the intervention group (5.5%) successfully quit smoking. The costs per participant were 291 euro and 322 euro, respectively. If society is willing to pay 1000 euro or 10,000 euro for an additional 12-month quitter, the probability that reimbursement for SCT would be cost effective was 50% or 95%, respectively. If society is willing to pay 18,000 euro for a QALY, the probability that reimbursement for SCT would be cost effective was 95%. However, the external validity of the extrapolation from quitters to QALYs is uncertain and several assumptions had to be made. Reimbursement for SCT may

Detection of Echinococcus multilocularis by MC-PCR: evaluation of diagnostic sensitivity and specificity without gold standard

Directory of Open Access Journals (Sweden)

Helene Wahlström

2016-03-01

Full Text Available Introduction: A semi-automated magnetic capture probe-based DNA extraction and real-time PCR method (MC-PCR, allowing for a more efficient large-scale surveillance of Echinococcus multilocularis occurrence, has been developed. The test sensitivity has previously been evaluated using the sedimentation and counting technique (SCT as a gold standard. However, as the sensitivity of the SCT is not 1, test characteristics of the MC-PCR was also evaluated using latent class analysis, a methodology not requiring a gold standard. Materials and methods: Test results, MC-PCR and SCT, from a previous evaluation of the MC-PCR using 177 foxes shot in the spring (n=108 and autumn 2012 (n=69 in high prevalence areas in Switzerland were used. Latent class analysis was used to estimate the test characteristics of the MC-PCR. Although it is not the primary aim of this study, estimates of the test characteristics of the SCT were also obtained. Results and discussion: This study showed that the sensitivity of the MC-PCR was 0.88 [95% posterior credible interval (PCI 0.80–0.93], which was not significantly different than the SCT, 0.83 (95% PCI 0.76–0.88, which is currently considered as the gold standard. The specificity of both tests was high, 0.98 (95% PCI 0.94–0.99 for the MC-PCR and 0.99 (95% PCI 0.99–1 for the SCT. In a previous study, using fox scats from a low prevalence area, the specificity of the MC-PCR was higher, 0.999% (95% PCI 0.997–1. One reason for the lower estimate of the specificity in this study could be that the MC-PCR detects DNA from infected but non-infectious rodents eaten by foxes. When using MC-PCR in low prevalence areas or areas free from the parasite, a positive result in the MC-PCR should be regarded as a true positive. Conclusion: The sensitivity of the MC-PCR (0.88 was comparable to the sensitivity of SCT (0.83.

Calgary's new CIS provides flexibility to offer outstanding service in a competitive electricity market

International Nuclear Information System (INIS)

Cole, M.

1999-01-01

The City of Calgary, driven by the specter of Year 2000 issues as well as deregulation, decided to replace its 18-year old mainframe with state-of-the-art customer information system for all its utility customers. The system selected is the SCT Banner Customer Information System from Enlogix, headquartered in Toronto. This is the only software developed that was actually in use by other utilities, including Westcoast Energy, Toronto Hydro, Edison Source and PG and E in California. The conversion from an S-390 mainframe system relies on Banner's Oracle database technology. The main server, an IBM-RS 6000, will be stationed at an Enlogix data center, located in Calgary. Desktop workstations using Pentium II processors, with 350 MHz will be used. The major factors in favor of the Banner System were the SCT and Enlogix proven implementation methodologies. The implementation, expected to take about a year, will change about 100 major policies, but the utility is going forward with only nine modifications to match its processes to industry standards. The system has been 'Canadianized' to fulfill unique measurements, regulatory and tax requirements

Satisfaction and Healthcare Utilization of Transgender and Gender Non-Conforming Individuals in NYC: A Community-Based Participatory Study.

Science.gov (United States)

Radix, Anita E; Lelutiu-Weinberger, Corina; Gamarel, Kristi E

2014-12-01

Transgender and gender non-conforming (TGNC) individuals face high levels of discrimination and mistreatment, including within social and medical service settings, which may lead to negative health and psychosocial sequelae. Given the many barriers to competent care, we sought to determine points of intervention by assessing the current needs, satisfaction, and health care utilization of TGNC individuals in New York City as reported by TGNC individuals. In January 2013, fifty TGNC individuals were recruited via flyers and direct referrals from healthcare professionals within community spaces and pertinent venues. We administered a brief survey and conducted four focus groups exploring participants' health care utilization and perceived barriers to care, routine care, hormone and silicone use, and recommendations for improving transgender services. Participants were 18- to 64-years-old, racially/ethnically diverse, and the majority were medically insured, underwent routine health care in the last year, and received an HIV test in their lifetime. A significant proportion reported taking hormones prescribed by a medical provider and were in the care of knowledgeable providers. Participants perceived four areas where barriers persisted: utilization of preventive services, access to transition-related procedures, access to legal assistance, and inclusion of TGNC individuals in public health education and campaigns. Structural interventions are needed, such as comprehensive provider training programs for all level staff to better serve the needs of TGNC individuals, increase service utilization and improve wellbeing, while effecting lasting institutional change. Service provision establishments should hire more TGNC staff and integrate transgender care into existing practices.

Three dimensional simulation study of spheromak injection into magnetized plasmas

International Nuclear Information System (INIS)

Suzuki, Y.; Watanabe, T.H.; Sato, T.; Hayashi, T.

2000-01-01

The three dimensional dynamics of a spheromak-like compact toroid (SCT) plasmoid, which is injected into a magnetized target plasma region, is investigated by using MHD numerical simulations. It is found that the process of SCT penetration into this region is much more complicated than that which has been analysed so far by using a conducting sphere (CS) model. The injected SCT suffers from a tilting instability, which grows with a similar timescale to that of the SCT penetration. The instability is accompanied by magnetic reconnection between the SCT magnetic field and the target magnetic field, which disrupts the magnetic configuration of the SCT. Magnetic reconnection plays a role in supplying the high density plasma, initially confined in the SCT magnetic field, to the target region. The penetration depth of the SCT high density plasma is also examined. It is shown to be shorter than that estimated from the CS model. The SCT high density plasma is decelerated mainly by the Lorentz force of the target magnetic field, which includes not only the magnetic pressure force but also the magnetic tension force. Furthermore, by comparing the SCT plasmoid injection with the bare plasmoid injection, magnetic reconnection is considered to relax the magnetic tension force, i.e. the deceleration of the SCT plasmoid. (author)

Exercise training utilizing body weight-supported treadmill walking with a young adult with cerebral palsy who was non-ambulatory.

Science.gov (United States)

DiBiasio, Paula A; Lewis, Cynthia L

2012-11-01

The purpose of this case report is to determine the effects of exercise training using body weight-supported treadmill walking (BWSTW) with an 18-year-old male diagnosed with Cerebral palsy (CP) who was non-ambulatory and not receiving physical therapy. Outcome measures included the Pediatric Quality of Life Inventory (PedsQL), the Pediatric Evaluation of Disability Inventory (PEDI), heart rate (HR), rate of perceived exertion, 3-minute walk test and physiological cost index (PCI). BWSTW sessions took place twice a week for 6 weeks with a reduction of approximately 40% of the patient's weight. Over-ground 3-minute walk test distance and PCI were essentially unchanged. BWSTW exercise time increased by 67% with a 43% increase in speed while average working HR decreased by 8%. BWSTW PCI decreased by 26%. PedsQL parent report improved in all domains. PedsQL self-report demonstrated a mild decrease. PEDI showed improvements in self-care and mobility. Exercise utilizing BWSTW resulted in a positive training effect for this young adult with CP who was non-ambulatory. Developing effective and efficient protocols for exercise training utilizing BWSTW may aid in the use of this form of exercise and further quantify outcomes. Ensuring that young adults with CP have safe and feasible options to exercise and be physically active on a regular basis is an important role of a physical therapist.

Production of Solar Cells in Space from Non Specific Ores by Utilization of Electronically Enhanced Sputtering

Science.gov (United States)

Curreri, Peter A.

2009-01-01

An ideal method of construction in space would utilize some form of the Universal Differentiator and Universal Constructor as described by Von Neumann (1). The Universal Differentiator is an idealized non ore specific extractive device which is capable of breaking any ore into its constituent elements, and the Universal Constructor can utilize these elements to build any device with controllability to the nanometer scale. During the Human Exploration Initiative program in the early 1990s a conceptual study was done (2) to understand whether such devices were feasible with near term technology for the utilization of space resources and energy. A candidate system was proposed which would utilize electronically enhanced sputtering as the differentiator. Highly ionized ions would be accelerated to a kinetic energy at which the interaction between them and the lattice elections in the ore would be at a maximum. Experiments have shown that the maximum disintegration of raw material occurs at an ion kinetic energy of about 5 MeV, regardless of the composition and structure of the raw material. Devices that could produce charged ion beams in this energy range in space were being tested in the early 1990s. At this energy, for example an ion in a beam of fluorine ions yields about 8 uranium ions from uranium fluoride, 1,400 hydrogen and oxygen atoms from ice, or 7,000 atoms from sulfur dioxide ice. The ions from the disintegrated ore would then be driven by an electrical field into a discriminator in the form of a mass spectrometer, where the magnetic field would divert the ions into collectors for future use or used directly in molecular beam construction techniques. The process would require 10-7 Torr vacuum which would be available in space or on the moon. If the process were used to make thin film silicon solar cells (ignoring any energy inefficiency for beam production), then energy break even for solar cells in space would occur after 14 days.

The Internal, External, and Diagnostic Validity of Sluggish Cognitive Tempo: A Meta-Analysis and Critical Review

Science.gov (United States)

Becker, Stephen P.; Leopold, Daniel R.; Burns, G. Leonard; Jarrett, Matthew A.; Langberg, Joshua M.; Marshall, Stephen A.; McBurnett, Keith; Waschbusch, Daniel A.; Willcutt, Erik G.

2015-01-01

Objective To conduct the first meta-analysis evaluating the internal and external validity of the sluggish cognitive tempo (SCT) construct as related to or distinct from attention-deficit/hyperactivity disorder (ADHD) and as associated with functional impairment and neuropsychological functioning. Method Electronic databases were searched through September 2015 for studies examining the factor structure and/or correlates of SCT in children or adults. The search procedures identified 73 papers. The core SCT behaviors included across studies, as well as factor loadings and reliability estimates, were reviewed to evaluate internal validity. Pooled correlation effect sizes using random effects models were used to evaluate SCT in relation to external validity domains (i.e., demographics, other psychopathologies, functional impairment, and neuropsychological functioning). Results Strong support was found for the internal validity of the SCT construct. Specifically, across factor analytic studies including over 19,000 individuals, 13 SCT items loaded consistently on an SCT factor as opposed to an ADHD factor. Findings also support the reliability (i.e., internal consistency, test-retest reliability, inter-rater reliability) of SCT. In terms of external validity, there is some indication that SCT may increase with age (r = 0.11) and be associated with lower socioeconomic status (r = 0.10). Modest (potentially negligible) support was found for SCT symptoms being higher in males than females in children (r = 0.05) but not adults. SCT is more strongly associated with ADHD inattention (r = 0.63 in children, r = 0.72 in adults) than with ADHD hyperactivity-impulsivity (r = 0.32 in children, r = 0.46 in adults), and it likewise appears that SCT is more strongly associated with internalizing symptoms than with externalizing symptoms. SCT is associated with significant global, social, and academic impairment (rs = 0.38–0.44). Effects for neuropsychological functioning are mixed

The Knockout of Secretin in Cerebellar Purkinje Cells Impairs Mouse Motor Coordination and Motor Learning

Science.gov (United States)

Zhang, Li; Chung, Sookja Kim; Chow, Billy Kwok Chong

2014-01-01

Secretin (SCT) was first considered to be a gut hormone regulating gastrointestinal functions when discovered. Recently, however, central actions of SCT have drawn intense research interest and are supported by the broad distribution of SCT in specific neuronal populations and by in vivo physiological studies regarding its role in water homeostasis and food intake. The direct action of SCT on a central neuron was first discovered in cerebellar Purkinje cells in which SCT from cerebellar Purkinje cells was found to potentiate GABAergic inhibitory transmission from presynaptic basket cells. Because Purkinje neurons have a major role in motor coordination and learning functions, we hypothesize a behavioral modulatory function for SCT. In this study, we successfully generated a mouse model in which the SCT gene was deleted specifically in Purkinje cells. This mouse line was tested together with SCT knockout and SCT receptor knockout mice in a full battery of behavioral tasks. We found that the knockout of SCT in Purkinje neurons did not affect general motor ability or the anxiety level in open field tests. However, knockout mice did exhibit impairments in neuromuscular strength, motor coordination, and motor learning abilities, as shown by wire hanging, vertical climbing, and rotarod tests. In addition, SCT knockout in Purkinje cells possibly led to the delayed development of motor neurons, as supported by the later occurrence of key neural reflexes. In summary, our data suggest a role in motor coordination and motor learning for SCT expressed in cerebellar Purkinje cells. PMID:24356714

Is increased energy utilization linked to greater cultural complexity? Energy utilization by Australian Aboriginals and traditional swidden agriculturalists

Energy Technology Data Exchange (ETDEWEB)

Reijnders, L. [Expertisecentrum Duurzame Ontwikkeling en Instituut voor Biodiversiteit en Ecosysteem Dynamica ECDO/IBED, University of Amsterdam, Amsterdam (Netherlands)

2006-09-15

Theories have been proposed that link increases in energy utilization to increases in cultural complexity. Indeed, available estimates of per capita non-food energy utilization by hunter - gatherers and by people practising swidden agriculture in wooded areas, focusing on fuel wood use, are roughly 1 - 2 orders of magnitude lower than for industrial societies. The latter are in the range of 0.8 - 3.4 x 10{sup 5} MJ year{sup -1}. However, apart from the use of fuel wood, the former estimates have not included work performed by burning vegetation. Here quantitative estimates are given of recent energy utilization linked to burning biomass by Australian Aboriginals and people practising traditional swidden agriculture. Per capita energy utilization linked to biomass burning by Australian Aboriginals is estimated at 1.6 x 10{sup 6} to 4.0 x 10{sup 7} MJ year{sup -1}. Estimated per capita energy utilization associated with burning biomass in traditional swidden agriculture in the tropical rainforests of Kalimantan and Venezuela, the dry forest of north-eastern Brazil and the miombo woodland of Zambia is in the range of 1.0 x 10{sup 5} to 6.3 x 10{sup 5} MJ year{sup -1}. The values for non-food energy utilization reported here are at variance with theories that link increases in energy utilization to increases in cultural complexity.

Late effects of stem cell transplantation

International Nuclear Information System (INIS)

Ishiko, Yuka; Ishida, Yuji; Kou, Katsuyoshi; Honda, Koujirou; Kigasawa, Hisato; Ishikawa, Kumiko; Ohnuma, Kei; Toyoda, Yasunori; Nishihira, Hirokazu

1999-01-01

We reviewed growth and endocrine functions in 29 patients who underwent stem cell transplantation (SCT) at the Kanagawa Children's Medical Center and survived without disease for more than 1 year after their SCT. In our study, the more severe decrease of height standard deviation score (SDS) was observed in children who had undergone SCT at an earlier age, using total body irradiation (TBI). The risk factor of hypothyroidism after SCT was the cranial irradiation before SCT. Gonadal dysfunction occurred frequently in both boys and girls regardless of preparative regimen before SCT. It is important to observe carefully the effect of SCT on growth and endocrine function, and to consider whether the hormonal therapy is indicated. (author)

Developing a reproducible non-line-of-sight experimental setup for testing wireless medical device coexistence utilizing ZigBee.

Science.gov (United States)

LaSorte, Nickolas J; Rajab, Samer A; Refai, Hazem H

2012-11-01

The integration of heterogeneous wireless technologies is believed to aid revolutionary healthcare delivery in hospitals and residential care. Wireless medical device coexistence is a growing concern given the ubiquity of wireless technology. In spite of this, a consensus standard that addresses risks associated with wireless heterogeneous networks has not been adopted. This paper serves as a starting point by recommending a practice for assessing the coexistence of a wireless medical device in a non-line-of-sight environment utilizing 802.15.4 in a practical, versatile, and reproducible test setup. This paper provides an extensive survey of other coexistence studies concerning 802.15.4 and 802.11 and reports on the authors' coexistence testing inside and outside an anechoic chamber. Results are compared against a non-line-of-sight test setup. Findings relative to co-channel and adjacent channel interference were consistent with results reported in the literature.

Atomoxetine-Related Change in Sluggish Cognitive Tempo Is Partially Independent of Change in Attention-Deficit/Hyperactivity Disorder Inattentive Symptoms.

Science.gov (United States)

McBurnett, Keith; Clemow, David; Williams, David; Villodas, Miguel; Wietecha, Linda; Barkley, Russell

2017-02-01

To evaluate effects of atomoxetine versus placebo on sluggish cognitive tempo (SCT) and determine factors affecting improvement of SCT in children with attention-deficit/hyperactivity disorder (ADHD) with dyslexia (ADHD+D) or dyslexia only. This is a post hoc analysis of a 16-week placebo-controlled, double-blind randomized phase of a previously reported atomoxetine study in children aged 10-16 years with ADHD+D, Dyslexia-only, or ADHD-only (no placebo arm). Least squares mean changes from baseline to endpoint for atomoxetine versus placebo on the Kiddie-Sluggish Cognitive Tempo Interview (K-SCT) (Parent, Teacher, and Youth) were analyzed using analysis of covariance and multiple regression (partial R 2 ) analyses to test contributions of ADHD and dyslexia to improvements in K-SCT scores. Results were examined for the three informants within the three diagnostic groups (nine outcomes). Atomoxetine treatment was associated with significant reductions from baseline in seven of the nine outcomes using the p = 0.05 significance level, appropriate for exploratory analysis. When change in ADHD symptom severity was controlled, all of the seven SCT outcomes remained significant; changes in effect sizes were minimal. Regression analyses using SCT change as the criterion found a significant contribution by inattention change only for parent report, whereas, baseline SCT severity was a significant predictor in the randomized groups with the exception of teacher report in the Dyslexia-only group. Given that controlling for change in ADHD symptoms had little effect on change in SCT scores, findings suggest that change in SCT is substantially independent of change in ADHD. By inference, SCT and its response to treatment is a partially distinct phenomenon from ADHD response. Regression analyses did not reveal global effects of inattention change on SCT change; instead, baseline SCT severity was the strongest predictor of placebo-controlled treatment effect on SCT. Atomoxetine

Effectiveness of antenatal screening for sickle cell trait: the impact on women's self-report of sickle cell trait status.

Science.gov (United States)

Knight-Madden, J M; Reid, M; Younger, N; Francis, D; McFarlane, S; Wilks, R

2012-03-01

The sickle gene frequency in the Jamaican population has not changed over a generation. It is unknown whether routine antenatal screening for sickle cell trait (SCT) has affected women's knowledge of their SCT status. The aim of this study was to compare the prevalence of self-reported SCT in parous women to the prevalence in nulliparous women, men and to the observed prevalence of SCT measured in an antenatal clinic. All participants in the nationally representative Jamaica Health and Lifestyle Survey 2008 were asked whether they had the SCT. The impact of gender, age, educational attainment, geographical location, and pregnancy on self-reported SCT were assessed. The prevalence of SCT in women attending a large antenatal clinic concurrently was compared to that reported by women of child-bearing age in the lifestyle survey. Self-report significantly underestimated the prevalence of SCT (2·9% versus 10·1%, Peducation were more likely than those with presecondary education (P = 0·01) and women more likely than men (3·2% versus 1·1%, P = 0·001) to report having SCT. Women who had been pregnant were no more likely than other women to report having SCT (3·1% versus 4·1%, P = 0·4). Attendance at antenatal clinic where SCT screening is routine, is not associated with increased self-report of SCT. Screening programs must ensure that, as well as technically accurate screening, there is effective communication of the results of screening for SCT to those tested to help reduce the public health burden of sickle cell disease in tropical countries.

Clinical Utility of Circulating Tumor Cells in ALK-Positive Non-Small-Cell Lung Cancer.

Science.gov (United States)

Faugeroux, Vincent; Pailler, Emma; Auger, Nathalie; Taylor, Melissa; Farace, Françoise

2014-01-01

The advent of rationally targeted therapies such as small-molecule tyrosine kinase inhibitors (TKIs) has considerably transformed the therapeutic management of a subset of patients with non-small-cell lung cancer (NSCLC) harboring defined molecular abnormalities. When such genetic molecular alterations are detected the use of specific TKI has demonstrated better results (overall response rate, progression free survival) compared to systemic therapy. However, the detection of such molecular abnormalities is complicated by the difficulty in obtaining sufficient tumor material, in terms of quantity and quality, from a biopsy. Here, we described how circulating tumor cells (CTCs) can have a clinical utility in anaplastic lymphoma kinase (ALK) positive NSCLC patients to diagnose ALK-EML4 gene rearrangement and to guide therapeutic management of these patients. The ability to detect genetic abnormalities such ALK rearrangement in CTCs shows that these cells could offer new perspectives both for the diagnosis and the monitoring of ALK-positive patients eligible for treatment with ALK inhibitors.

The Application of the SCT and the ANP Model to Refine the Most Critical ICT Determinants in Minimizing the Digital Divide

Directory of Open Access Journals (Sweden)

Ming-Yuan Hsieh

2014-01-01

Full Text Available This research cross-employed the social cognition theory (SCT and the analytical network process (ANP model in qualitative analyses and the multiple criteria decision making (MCDM methodology in quantitative measurements to comprehensively re-identify the most critical information communication technology (ICT determinants in minimizing the digital divide (DD. After measuring the complete importance of related priority weight w (eigenvector from the survey results given to various experts, the complete synthetically comparative index numbers (SCIN from the evaluation model used conveyed two distinct consequences. First, the highest SCIN scores for the ANP, F-ANP, and G-ANP models are 0.5516, 0.3771, and 0.4791, respectively, and are located in the “ICT can positively minimize the level of DD” (ICTCPMDD column in the summarized results table. Secondly, the highest evaluated weighted score of assessed criteria of 0.5801 is located in the Diversified Mobile Applications (DMAPP column. From these results, there are two contributive findings that can be deduced. First, ICT indeed proved the determinative influences and interplays in the level of DD which means that the undeveloped, developing, and emerging regions are apparently able to minimize the level of DD by means of the ICT development. Second, the Diversified Mobile Applications (DMAPP is the most critical determinant of ICT in minimizing the level of digital divide.

Sluggish cognitive tempo in abnormal child psychology: an historical overview and introduction to the special section.

Science.gov (United States)

Becker, Stephen P; Marshall, Stephen A; McBurnett, Keith

2014-01-01

There has recently been a resurgence of interest in Sluggish Cognitive Tempo (SCT) as an important construct in the field of abnormal child psychology. Characterized by drowsiness, daydreaming, lethargy, mental confusion, and slowed thinking/behavior, SCT has primarily been studied as a feature of Attention-Deficit/Hyperactivity Disorder (ADHD), and namely the predominately inattentive subtype/presentation. Although SCT is strongly associated with ADHD inattention, research increasingly supports the possibility that SCT is distinct from ADHD or perhaps a different mental health condition altogether, with unique relations to child and adolescent psychosocial adjustment. This introductory article to the Special Section on SCT provides an historical overview of the SCT construct and briefly describes the contributions of the eight empirical papers included in the Special Section. Given the emerging importance of SCT for abnormal psychology and clinical science, there is a clear need for additional studies that examine (1) the measurement, structure, and multidimensional nature of SCT, (2) SCT as statistically distinct from not only ADHD-inattention but also other psychopathologies (particularly depression and anxiety), (3) genetic and environmental contributions to the development of SCT symptoms, and (4) functional impairments associated with SCT. This Special Section brings together papers to advance the current knowledge related to these issues as well as to spur research in this exciting and expanding area of abnormal psychology.

Eclipsing binary stars with a δ Scuti component

Science.gov (United States)

Kahraman Aliçavuş, F.; Soydugan, E.; Smalley, B.; Kubát, J.

2017-09-01

Eclipsing binaries with a δ Sct component are powerful tools to derive the fundamental parameters and probe the internal structure of stars. In this study, spectral analysis of six primary δ Sct components in eclipsing binaries has been performed. Values of Teff, v sin I, and metallicity for the stars have been derived from medium-resolution spectroscopy. Additionally, a revised list of δ Sct stars in eclipsing binaries is presented. In this list, we have only given the δ Sct stars in eclipsing binaries to show the effects of the secondary components and tidal-locking on the pulsations of primary δ Sct components. The stellar pulsation, atmospheric and fundamental parameters (e.g. mass, radius) of 92 δ Sct stars in eclipsing binaries have been gathered. Comparison of the properties of single and eclipsing binary member δ Sct stars has been made. We find that single δ Sct stars pulsate in longer periods and with higher amplitudes than the primary δ Sct components in eclipsing binaries. The v sin I of δ Sct components is found to be significantly lower than that of single δ Sct stars. Relationships between the pulsation periods, amplitudes and stellar parameters in our list have been examined. Significant correlations between the pulsation periods and the orbital periods, Teff, log g, radius, mass ratio, v sin I and the filling factor have been found.

How Glycosaminoglycans Promote Fibrillation of Salmon Calcitonin*

Science.gov (United States)

Malmos, Kirsten Gade; Bjerring, Morten; Jessen, Christian Moestrup; Nielsen, Erik Holm Toustrup; Poulsen, Ebbe T.; Christiansen, Gunna; Vosegaard, Thomas; Skrydstrup, Troels; Enghild, Jan J.; Pedersen, Jan Skov; Otzen, Daniel E.

2016-01-01

Glycosaminoglycans (GAGs) bind all known amyloid plaques and help store protein hormones in (acidic) granular vesicles, but the molecular mechanisms underlying these important effects are unclear. Here we investigate GAG interactions with the peptide hormone salmon calcitonin (sCT). GAGs induce fast sCT fibrillation at acidic pH and only bind monomeric sCT at acidic pH, inducing sCT helicity. Increasing GAG sulfation expands the pH range for binding. Heparin, the most highly sulfated GAG, binds sCT in the pH interval 3–7. Small angle x-ray scattering indicates that sCT monomers densely decorate and pack single heparin chains, possibly via hydrophobic patches on helical sCT. sCT fibrillates without GAGs, but heparin binding accelerates the process by decreasing the otherwise long fibrillation lag times at low pH and accelerates fibril growth rates at neutral pH. sCT·heparin complexes form β-sheet-rich heparin-covered fibrils. Solid-state NMR reveals that heparin does not alter the sCT fibrillary core around Lys11 but makes changes to Val8 on the exterior side of the β-strand, possibly through contacts to Lys18. Thus GAGs significantly modulate sCT fibrillation in a pH-dependent manner by interacting with both monomeric and aggregated sCT. PMID:27281819

Relational trustworthiness: how status affects intra-organizational inequality in job autonomy.

Science.gov (United States)

Campos-Castillo, Celeste; Ewoodzie, Kwesi

2014-03-01

Recent accounts of trustworthiness have moved away from treating it as a stable, individual-level attribute toward viewing it as a variable situated in a relational context, but have not been formalized or supported empirically. We extend status characteristics theory (SCT) to develop formal propositions about relational trustworthiness. We posit that members of task- and collectively oriented groups (non-consciously) infer three qualities from their relative status that are commonly used to determine an individual's trustworthiness: ability, benevolence, and integrity. We apply our formalization to clarify ambiguities regarding intra-organizational job autonomy inequality, thereby linking SCT to broader disparities rooted in job autonomy. We analyze data from a vignette experiment and the General Social Survey to test incrementally how well our propositions generalize across different settings and populations. Results generally support our proposed links between status and intra-organizational job autonomy. We discuss implications for SCT in understanding broader patterns of inequalities. Copyright © 2013 Elsevier Inc. All rights reserved.

Combined cord blood and bone marrow transplantation from the same human leucocyte antigen-identical sibling donor for children with malignant and non-malignant diseases.

Science.gov (United States)

Tucunduva, Luciana; Volt, Fernanda; Cunha, Renato; Locatelli, Franco; Zecca, Marco; Yesilipek, Akif; Caniglia, Maurizio; Güngör, Tayfun; Aksoylar, Serap; Fagioli, Franca; Bertrand, Yves; Addari, Maria Carmen; de la Fuente, Josu; Winiarski, Jacek; Biondi, Andrea; Sengeloev, Henrik; Badell, Isabel; Mellgren, Karin; de Heredia, Cristina Díaz; Sedlacek, Petr; Vora, Ajay; Rocha, Vanderson; Ruggeri, Annalisa; Gluckman, Eliane

2015-04-01

Umbilical cord blood (UCB) from an human leucocyte antigen (HLA)-identical sibling can be used for transplantation of patients with malignant and non-malignant diseases. However, the low cellular content of most UCB units represents a limitation to this approach. An option to increase cell dose is to harvest bone marrow (BM) cells from the same donor and infuse them along with the UCB. We studied 156 children who received such a combined graft between 1992 and 2011. Median age was 7 years and 78% of patients (n = 122) were transplanted for non-malignant diseases, mainly haemoglobinopathies. Acute leukaemia (n = 26) was the most frequent malignant diagnosis. Most patients (91%) received myeloablative conditioning. Median donor age was 1·7 years, median infused nucleated cell dose was 24·4 × 10(7) /kg and median follow-up was 41 months. Sixty-days neutrophil recovery occurred in 96% of patients at a median of 17 d. The probabilities of grade-II-IV acute and chronic graft-versus-host disease (GVHD) were 19% and 10%, respectively. Four-year overall survival was 90% (68% malignant; 97% non-malignant diseases) with 3% probability of death. In conclusion, combined UCB and BM transplantation from an HLA-identical sibling donor is an effective treatment for children with malignant and non-malignant disorders with high overall survival and low incidence of GVHD. © 2014 John Wiley & Sons Ltd.

Long non-coding RNAs: Mechanism of action and functional utility

OpenAIRE

Bhat, Shakil Ahmad; Ahmad, Syed Mudasir; Mumtaz, Peerzada Tajamul; Malik, Abrar Ahad; Dar, Mashooq Ahmad; Urwat, Uneeb; Shah, Riaz Ahmad; Ganai, Nazir Ahmad

2016-01-01

Recent RNA sequencing studies have revealed that most of the human genome is transcribed, but very little of the total transcriptomes has the ability to encode proteins. Long non-coding RNAs (lncRNAs) are non-coding transcripts longer than 200 nucleotides. Members of the non-coding genome include microRNA (miRNA), small regulatory RNAs and other short RNAs. Most of long non-coding RNA (lncRNAs) are poorly annotated. Recent recognition about lncRNAs highlights their effects in many biological ...

Atypical serum immunofixation patterns frequently emerge in immunomodulatory therapy and are associated with a high degree of response in multiple myeloma.

Science.gov (United States)

Mark, Tomer; Jayabalan, David; Coleman, Morton; Pearse, Roger N; Wang, Y Lynn; Lent, Richard; Christos, Paul J; Lee, Joong W; Agrawal, Yash P; Matthew, Susan; Ely, Scott; Mazumdar, Madhu; Cesarman, Ethel; Leonard, John P; Furman, Richard R; Chen-Kiang, Selina; Niesvizky, Ruben

2008-12-01

The M-protein is the major reference measure for response in multiple myeloma (MM) and its correct interpretation is key to clinical management. The emergence of oligoclonal banding is recognized as a benign finding in the postautologous stem cell transplantation setting (ASCT) for MM but its significance during non-myeloablative therapy is unknown. In a study of the immunomodulatory combination BiRD, (lenalidomide and dexamethasone with clarithromycin), we frequently detected the emergence of mono- and oligo-clonal immunoglobulins unrelated to the baseline diagnostic M-protein. The new M-proteins seen on serum immunofixation electrophoresis were clearly different in either heavy or light chain component(s) from the original M-spike protein and were termed atypical serum immunofixation patterns (ASIPs). Overall, 24/72 (33%) patients treated with BiRD developed ASIPs. Patients who developed ASIPs compared with patients treated with BiRD without ASIPs, had a significantly greater overall response (100% vs. 85%) and complete response rates (71% vs. 23%). ASIPs were not associated with new clonal plasma cells or other lymphoproliferative processes, and molecular remissions were documented. This is the first time this phenomenon has been seen with regularity in non-myeloablative therapy for MM. Analogous to the ASCT experience, ASIPs do not signal incipient disease progression, but rather herald robust response.

Utilization of radiation in non destructive tests

International Nuclear Information System (INIS)

Lopes, R.T.; Jesus, E.F.O. de; Junqueira, M.M.; Matos, J.A. de; Castello Branco, L.M.; Barros Junior, J.D.; Borges, J.C.

1987-01-01

The Nuclear Instrumentation Laboratory from COPPE/UFRJ has been developed techniques for using nuclear radiations to obtain images for non-destructive materials testing and medicine. With this objective, some prototypes of transmission computerized tomography systems using parallel beans and fan beans, with computer automation, including the mathematical process of image reprocessing and presentation in videos or printers are constructed [pt

Hospital utilization, costs and mortality rates during the first 5 years of life: a population study of ART and non-ART singletons.

Science.gov (United States)

Chambers, G M; Lee, E; Hoang, V P; Hansen, M; Bower, C; Sullivan, E A

2014-03-01

Do singletons conceived following assisted reproduction technologies (ARTs) have significantly different hospital utilization, and therefore costs, compared with non-ART children during the first 5 years of life? ART singletons have longer hospital birth-admissions and a small increased risk of re-admission during the first 5 years of life resulting in higher costs of hospital care. ART singletons are at greater risk of adverse perinatal outcomes compared with non-ART singletons. Long-term physical and mental health outcomes of ART singletons are generally reassuring. There is a scarcity of information on health service utilization and the health economic impact of ART conceived children. A population cohort study using linked birth, hospital and death records. Perinatal outcomes, hospital utilization and costs, and mortality rates were compared for non-ART and ART singletons to 5 years. Adjustments were made for maternal age, parity, sex, birth year, socioeconomic status and funding source. Australian Diagnosis Related Groups cost-weights were used to derive costs. All costs are reported in 2009/2010 Australian dollars. All babies born in Western Australia between 1994 and 2003 were included; 224 425 non-ART singletons and 2199 ART conceived singletons. Hospital admission and death records in Western Australia linked to 2008 were used. Overall, ART singletons had a significantly longer length of stay during the birth-admission (mean difference 1.8 days, P birth-admission ($1473). The independent residual cost associated with ART conception was $342 during the birth-admission and an additional $548 up to 5 years of age, indicating that being conceived as an ART child predicts not only higher birth-admission costs but excess costs to at least 5 years of age. This study could not investigate the impact of different ART practices and techniques on perinatal outcomes or hospital utilization, nor could it adjust for parental characteristics such as cause of infertility

Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation.

NARCIS (Netherlands)

Auner, H.W.; Szydlo, R.; Biezen, A. van; Iacobelli, S.; Gahrton, G.; Milpied, N.; Volin, L.; Janssen, J.; Nguyen Quoc, S.; Michallet, M.; Schoemans, H.; Cheikh, J. El; Petersen, E.; Guilhot, F.; Schonland, S.; Ahlberg, L.; Morris, C.; Garderet, L.; Witte, T.J. de; Kroger, N.

2013-01-01

Outcomes and prognostic factors of reduced intensity-conditioned allo-SCT (RIC allo-SCT) for multiple myeloma (MM) relapsing or progressing after prior autologous (auto)-SCT are not well defined. We performed an analysis of 413 MM patients who received a related or unrelated RIC allo-SCT for the

Similar Survival for Patients Undergoing Reduced-Intensity Total Body Irradiation (TBI) Versus Myeloablative TBI as Conditioning for Allogeneic Transplant in Acute Leukemia

Energy Technology Data Exchange (ETDEWEB)

Mikell, John L., E-mail: jmikell@emory.edu [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Waller, Edmund K. [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Switchenko, Jeffrey M. [Department of Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Rangaraju, Sravanti; Ali, Zahir; Graiser, Michael [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hall, William A. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Langston, Amelia A. [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Esiashvili, Natia [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Khoury, H. Jean [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Khan, Mohammad K. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

2014-06-01

Purpose: Hematopoietic stem cell transplantation (HSCT) is the mainstay of treatment for adults with acute leukemia. Total body irradiation (TBI) remains an important part of the conditioning regimen for HCST. For those patients unable to tolerate myeloablative TBI (mTBI), reduced intensity TBI (riTBI) is commonly used. In this study we compared outcomes of patients undergoing mTBI with those of patients undergoing riTBI in our institution. Methods and Materials: We performed a retrospective review of all patients with acute leukemia who underwent TBI-based conditioning, using a prospectively acquired database of HSCT patients treated at our institution. Patient data including details of the transplantation procedure, disease status, Karnofsky performance status (KPS), response rates, toxicity, survival time, and time to progression were extracted. Patient outcomes for various radiation therapy regimens were examined. Descriptive statistical analysis was performed. Results: Between June 1985 and July 2012, 226 patients with acute leukemia underwent TBI as conditioning for HSCT. Of those patients, 180 had full radiation therapy data available; 83 had acute lymphoblastic leukemia and 94 had acute myelogenous leukemia; 45 patients received riTBI, and 135 received mTBI. Median overall survival (OS) was 13.7 months. Median relapse-free survival (RFS) for all patients was 10.2 months. Controlling for age, sex, KPS, disease status, and diagnosis, there were no significant differences in OS or RFS between patients who underwent riTBI and those who underwent mTBI (P=.402, P=.499, respectively). Median length of hospital stay was shorter for patients who received riTBI than for those who received mTBI (16 days vs 23 days, respectively; P<.001), and intensive care unit admissions were less frequent following riTBI than mTBI (2.22% vs 12.69%, respectively, P=.043). Nonrelapse survival rates were also similar (P=.186). Conclusions: No differences in OS or RFS were seen between

High-resolution ex vivo imaging of coronary artery stents using 64-slice computed tomography - initial experience

International Nuclear Information System (INIS)

Rist, Carsten; Nikolaou, Konstantin; Wintersperger, Bernd J.; Reiser, Maximilian F.; Becker, Christoph R.; Flohr, Thomas

2006-01-01

The aim of the study was to evaluate the potential of new-generation multi-slice computed tomography (CT) scanner technology for the delineation of coronary artery stents in an ex vivo setting. Nine stents of various diameters (seven stents 3 mm, two stents 2.5 mm) were implanted into the coronary arteries of ex vivo porcine hearts and filled with a mixture of an iodine-containing contrast agent. Specimens were scanned with a 16-slice CT (16SCT) machine; (Somatom Sensation 16, Siemens Medical Solutions), slice thickness 0.75 mm, and a 64-slice CT (64SCT, Somatom Sensation 64), slice-thickness 0.6 mm. Stent diameters as well as contrast densities were measured, on both the 16SCT and 64SCT images. No significant differences of CT densities were observed between the 16SCT and 64SCT images outside the stent lumen: 265±25HU and 254±16HU (P=0.33), respectively. CT densities derived from the 64SCT images and 16SCT images within the stent lumen were 367±36HU versus 402±28HU, P<0.05, respectively. Inner and outer stent diameters as measured from 16SCT and 64SCT images were 2.68±0.08 mm versus 2.81±0.07 mm and 3.29±0.06 mm versus 3.18±0.07 mm (P<0.05), respectively. The new 64SCT scanner proved to be superior in the ex vivo assessment of coronary artery stents to the conventional 16SCT machine. Increased spatial resolution allows for improved assessment of the coronary artery stent lumen. (orig.)

CONCRETE SUPPORT DESIGN FOR MISCELLANEOUS ESF UTILITIES

International Nuclear Information System (INIS)

Misiak, T.A.

1999-01-01

The purpose and objective of this analysis is to design concrete supports for the miscellaneous utility equipment used at the Exploratory Studies Facility (ESF). Two utility systems are analyzed: (1) the surface collection tanks of the Waste Water System, and (2) the chemical tracer mixing and storage tanks of the Non-Potable Water System. This analysis satisfies design recommended in the Title III Evaluation Reports for the Subsurface Fire Water System and Subsurface Portion of the Non-Potable Water System (CRWMS M andO 1998a) and Waste Water Systems (CRWMS M andO 1998b)

Utility/Manufacturers Robots Users Group: a partnership promoting the applications of robots in all utility industries

International Nuclear Information System (INIS)

Meieran, H.B.; Roman, H.T.

1988-01-01

The purpose of this presentation is to describe the roles and the goals of the recently established Utility/Manufacturers Robots Users Group (U/M RUG), an organization which is dedicated to promoting the employment of robots in all utility facilities. This group is composed of volunteer representatives from the utilities, robot manufacturers, service organizations/consulting groups, academia, national and non-government funding agencies, and national laboratories. Although the Group primarily serves as a forum and a guide for technology transfer, exchanging ideas, and promoting philosophies of applications among its members, it also provides this type of assistance to external groups and agencies. (author)

Uncovering a clinical portrait of sluggish cognitive tempo within an evaluation for attention-deficit/hyperactivity disorder: A case study.

Science.gov (United States)

Becker, Stephen P; Ciesielski, Heather A; Rood, Jennifer E; Froehlich, Tanya E; Garner, Annie A; Tamm, Leanne; Epstein, Jeffery N

2016-01-01

Despite the burgeoning scientific literature examining the sluggish cognitive tempo (SCT) construct, very little is known about the clinical presentation of SCT. In clinical cases where SCT is suspected, it is critical to carefully assess not only for attention-deficit/hyperactivity disorder (ADHD) but also for other comorbidities that may account for the SCT-related behaviors, especially internalizing symptoms and sleep problems. The current case study provides a clinical description of SCT in a 7-year-old girl, offering a real-life portrait of SCT while also providing an opportunity to qualitatively differentiate between SCT and ADHD, other psychopathologies (e.g. depression, anxiety), and potentially related domains of functioning (e.g. sleep, executive functioning [EF]). "Jessica" was described by herself, parents, and teacher as being much slower than her peers in completing schoolwork, despite standardized testing showing Jessica to have above average intelligence and academic achievement. Jessica's parents completed rating scales indicating high levels of SCT symptoms and daytime sleepiness, as well as mildly elevated EF deficits. More research is needed to determine how to best conceptualize, assess, and treat SCT, and Jessica's case underscores the importance of further work in this area. © The Author(s) 2014.

PWR in-core nuclear fuel management optimization utilizing nodal (non-linear NEM) generalized perturbation theory

International Nuclear Information System (INIS)

Maldonado, G.I.; Turinsky, P.J.; Kropaczek, D.J.

1993-01-01

The computational capability of efficiently and accurately evaluate reactor core attributes (i.e., k eff and power distributions as a function of cycle burnup) utilizing a second-order accurate advanced nodal Generalized Perturbation Theory (GPT) model has been developed. The GPT model is derived from the forward non-linear iterative Nodal Expansion Method (NEM) strategy, thereby extending its inherent savings in memory storage and high computational efficiency to also encompass GPT via the preservation of the finite-difference matrix structure. The above development was easily implemented into the existing coarse-mesh finite-difference GPT-based in-core fuel management optimization code FORMOSA-P, thus combining the proven robustness of its adaptive Simulated Annealing (SA) multiple-objective optimization algorithm with a high-fidelity NEM GPT neutronics model to produce a powerful computational tool used to generate families of near-optimum loading patterns for PWRs. (orig.)

"ROLE OF ALLOGENEIC TRANSPLANTATION IN MULTIPLE MYELOMA IN THE ERA OF NEW DRUGS"

Directory of Open Access Journals (Sweden)

Benedetto Bruno

2010-06-01

            Allografting is a potentially curative treatment for a subset of multiple myeloma patients for its well documented graft-vs-myeloma effects. However, its role has been hotly debated. Even though molecular remissions have been reported up to 50% after high-dose myeloablative conditionings, their applications, given the high toxicity, have been for long limited to younger relapsed/refractory patients. These limitations have greatly been reduced through the introduction of non-myeloablative/reduced-intensity conditionings.             The introduction of new drugs, characterised by low risks of early mortality, indeed requires to define role and timing of an allograft to capture the subset of patients who may most benefit from graft-vs-myeloma effects.   Ultimately, new drugs should not be viewed as mutually exclusive with an allograft. They may be employed to achieve profound cytoreduction before and enhance graft-versus-myeloma effects as consolidation/maintenance therapy after an allograft. However, this combination should be explored only in well-designed clinical trials.

Operational issues of present ATLAS strip detector

CERN Document Server

Yacoob, S; The ATLAS collaboration

2013-01-01

Current results from the successful operation of the Semi-Conductor Tracker (SCT) Detector at the LHC and its status after three years of operation is presented. This note reports on the operation of the detector including an overview of the issues we encountered and the observation of significant increases in leakage currents from bulk damage due to non-ionising radiation, there have been a small number of significant changes effecting detector operation since the contribution to the previous conference in the series [1]. The main emphasis is given to the tracking performance of the SCT and the data quality during the many months of data-taking (the LHC delivered 47 pb

Long non-coding RNAs: Mechanism of action and functional utility

Directory of Open Access Journals (Sweden)

Shakil Ahmad Bhat

2016-10-01

Full Text Available Recent RNA sequencing studies have revealed that most of the human genome is transcribed, but very little of the total transcriptomes has the ability to encode proteins. Long non-coding RNAs (lncRNAs are non-coding transcripts longer than 200 nucleotides. Members of the non-coding genome include microRNA (miRNA, small regulatory RNAs and other short RNAs. Most of long non-coding RNA (lncRNAs are poorly annotated. Recent recognition about lncRNAs highlights their effects in many biological and pathological processes. LncRNAs are dysfunctional in a variety of human diseases varying from cancerous to non-cancerous diseases. Characterization of these lncRNA genes and their modes of action may allow their use for diagnosis, monitoring of progression and targeted therapies in various diseases. In this review, we summarize the functional perspectives as well as the mechanism of action of lncRNAs. Keywords: LncRNA, X-chromosome inactivation, Genome imprinting, Transcription regulation, Cancer, Immunity

Precise Detection of Buried Underground Utilities by Non-destructive Electromagnetic Survey

International Nuclear Information System (INIS)

Shon, Ho Woong; Lee, Seung Hee; Lee, Kang Won

2002-01-01

To detect the position and depth of buried underground utilities, method of Ground Penetrating Radar(GPR) survey is the most commonly used. However, the skin-depth of GPR is very shallow, and in the places where subsurface materials are not homogeneous and are compose of clays and/or salts and gravels, GPR method has limitations in application and interpretation. The aim of this study is to overcome these limitations of GPR survey. For this purpose the site where the GPR survey is unsuccessful to detect the underground big pipes is selected, and soil tests were conducted to confirm the reason why GPR method was not applicable. Non-destructive high-frequency electromagnetic (HFEM) survey was newly developed and was applied in the study area to prove the effectiveness of this new technique. The frequency ranges 2kHz∼4MHz and the skin depth is about 30m. The HFEM measures the electric field and magnetic field perpendicular to each other to get the impedance from which vertical electric resistivity distribution at the measured point can be deduced. By adopting the capacitive coupled electrodes, it can make the measuring time shorter, and can be applied to the places covered by asphalt an and/or concrete. In addition to the above mentioned advantages, noise due to high-voltage power line is much reduced by stacking the signals. As a result, the HFEM was successful in detecting the buried underground objects. Therefore this method is a promising new technique that can be applied in the lots of fields, such as geotechnical and archaeological surveys

Inter-utility trade review

International Nuclear Information System (INIS)

Warnes, E.M.; Vaahedi, E.

1991-01-01

The National Energy Board was requested by the Minister of Energy, Mines and Resources to identify possible measures to improve cooperation among Canadian electrical utilities and to enhance access for buyers and sellers of electricity to available transmission capacity through intervening systems for wheeling purposes. To identify measures to improve cooperation, a questionnaire was sent to electric utilities and other interested parties on the present extent and future possibilities for inter-utility cooperation. The questionnaire and its results are presented. It was found that there already exists a significant amount of inter-utility cooperation in Canada. Such cooperation generally involves interchanges of economy energy, non-economic capacity and energy, coordinated operation, resource sharing, maintenance scheduling, emergency supports, etc. There is a very limited degree of integrated generation expansion planning. Typically, these agreements are carried out under interconnection agreements negotiated on a bi-lateral basis. The highest current degree of cooperation exists under the auspices of the Alberta interconnected power system pool. Wheeling is limited and generally restricted to cases where the sender and receiver are the same entity or where power is wheeled to a utility purchasing it from the wheeler's system. 2 figs., 3 tabs

Secretin Modulates the Postnatal Development of Mouse Cerebellar Cortex Via PKA- and ERK-dependent Pathways

Directory of Open Access Journals (Sweden)

Lei Wang

2017-11-01

Full Text Available Postnatal development of the cerebellum is critical for its intact function such as motor coordination and has been implicated in the pathogenesis of psychiatric disorders. We previously reported that deprivation of secretin (SCT from cerebellar Purkinje neurons impaired motor coordination and motor learning function, while leaving the potential role of SCT in cerebellar development to be determined. SCT and its receptor (SCTR were constitutively expressed in the postnatal cerebellum in a temporal and cell-specific manner. Using a SCT knockout mouse model, we provided direct evidence showing altered developmental patterns of Purkinje cells (PCs and granular cells (GCs. SCT deprivation reduced the PC density, impaired the PC dendritic formation, induced accelerated GC migration and potentiated cerebellar apoptosis. Furthermore, our results indicated the involvement of protein kinase A (PKA and extracellular signal regulated kinase (ERK signaling pathways in SCT-mediated protective effects against neuronal apoptosis. Results of this study illustrated a novel function of SCT in the postnatal development of cerebellum, emphasizing the necessary role of SCT in cerebellar-related functions.

9 CFR 77.39 - Other interstate movements.

Science.gov (United States)

2010-01-01

... cervid classified as a suspect on the SCT test must be quarantined until it is slaughtered or retested by... must be administered within the first 10 days following the SCT test or, if not, must be administered at least 90 days after the SCT test. If the CCT test is administered within 10 days of the SCT test...

Trial-Based Cost-Utility Analysis of Icotinib versus Gefitinib as Second-Line Therapy for Advanced Non-Small Cell Lung Cancer in China.

Science.gov (United States)

Zhang, Chunxiang; Zhang, Hongmei; Shi, Jinning; Wang, Dong; Zhang, Xiuwei; Yang, Jian; Zhai, Qizhi; Ma, Aixia

2016-01-01

Our objective is to compare the cost-utility of icotinib and gefitinib for the second-line treatment of advanced non-small cell lung cancer (NSCLC) from the perspective of the Chinese healthcare system. Model technology was applied to assess the data of randomized clinical trials and the direct medical costs from the perspective of the Chinese healthcare system. Five-year quality-adjusted life years (QALYs) and incremental cost-utility ratios (ICURs) were calculated. One-way and probabilistic sensitivity analyses (PSA) were performed. Our model suggested that the median progression-free survival (PFS) was 4.2 months in the icotinib group and 3.5 months in the gefitinib group while they were 4.6 months and 3.4 months, respectively, in the trials. The 5-year QALYs was 0.279 in the icotinib group and 0.269 in the gefitinib group, and the according medical costs were $10662.82 and $13127.57. The ICUR/QALY of icotinib versus gefitinib presented negative in this study. The most sensitive parameter to the ICUR was utility of PFS, ranging from $-1,259,991.25 to $-182,296.61; accordingly the icotinib treatment consistently represented a dominant cost-utility strategy. The icotinib strategy, as a second-line therapy for advanced NSCLC patients in China, is the preferred strategy relative to gefitinib because of the dominant cost-utility. In addition, icotinib shows a good curative effect and safety, resulting in a strong demand for the Chinese market.

Trial-Based Cost-Utility Analysis of Icotinib versus Gefitinib as Second-Line Therapy for Advanced Non-Small Cell Lung Cancer in China.

Directory of Open Access Journals (Sweden)

Chunxiang Zhang

Full Text Available Our objective is to compare the cost-utility of icotinib and gefitinib for the second-line treatment of advanced non-small cell lung cancer (NSCLC from the perspective of the Chinese healthcare system.Model technology was applied to assess the data of randomized clinical trials and the direct medical costs from the perspective of the Chinese healthcare system. Five-year quality-adjusted life years (QALYs and incremental cost-utility ratios (ICURs were calculated. One-way and probabilistic sensitivity analyses (PSA were performed.Our model suggested that the median progression-free survival (PFS was 4.2 months in the icotinib group and 3.5 months in the gefitinib group while they were 4.6 months and 3.4 months, respectively, in the trials. The 5-year QALYs was 0.279 in the icotinib group and 0.269 in the gefitinib group, and the according medical costs were $10662.82 and $13127.57. The ICUR/QALY of icotinib versus gefitinib presented negative in this study. The most sensitive parameter to the ICUR was utility of PFS, ranging from $-1,259,991.25 to $-182,296.61; accordingly the icotinib treatment consistently represented a dominant cost-utility strategy.The icotinib strategy, as a second-line therapy for advanced NSCLC patients in China, is the preferred strategy relative to gefitinib because of the dominant cost-utility. In addition, icotinib shows a good curative effect and safety, resulting in a strong demand for the Chinese market.

Numerical Study on Sensitivity of Pollutant Dispersion on Turbulent Schmidt Number in a Street Canyon

Science.gov (United States)

WANG, J.; Kim, J.

2014-12-01

In this study, sensitivity of pollutant dispersion on turbulent Schmidt number (Sct) was investigated in a street canyon using a computational fluid dynamics (CFD) model. For this, numerical simulations with systematically varied Sct were performed and the CFD model results were validated against a wind‒tunnel measurement data. The results showed that root mean square error (RMSE) was quite dependent on Sct and dispersion patterns of non‒reactive scalar pollutant with different Sct were quite different among the simulation results. The RMSE was lowest in the case of Sct = 0.35 and the apparent dispersion pattern was most similar to the wind‒tunnel data in the case of Sct = 0.35. Also, numerical simulations using spatially weighted Sct were additionally performed in order for the best reproduction of the wind‒tunnel data. Detailed method and procedure to find the best reproduction will be presented.

Does Sluggish Cognitive Tempo Fit within a Bi-factor Model of Attention-Deficit/Hyperactivity Disorder?

Science.gov (United States)

Garner, Annie A.; Peugh, James; Becker, Stephen P.; Kingery, Kathleen M.; Tamm, Leanne; Vaughn, Aaron J.; Ciesielski, Heather; Simon, John O.; Loren, Richard E. A.; Epstein, Jeffery N.

2014-01-01

Objective Studies demonstrate sluggish cognitive tempo (SCT) symptoms to be distinct from inattentive and hyperactive-impulsive dimensions of Attention-Deficit/Hyperactivity Disorder (ADHD). No study has examined SCT within a bi-factor model of ADHD whereby SCT may form a specific factor distinct from inattention and hyperactivity/impulsivity while still fitting within a general ADHD factor, which was the purpose of the current study. Method 168 children were recruited from an ADHD clinic. Most (92%) met diagnostic criteria for ADHD. Parents and teachers completed measures of ADHD and SCT. Results Although SCT symptoms were strongly associated with inattention they loaded onto a factor independent of ADHD ‘g’. Results were consistent across parent and teacher ratings. Conclusions SCT is structurally distinct from inattention as well as from the general ADHD latent symptom structure. Findings support a growing body of research suggesting SCT to be distinct and separate from ADHD. PMID:25005039

Trade-off decisions in distribution utility management

Science.gov (United States)

Slavickas, Rimas Anthony

As a result of the "unbundling" of traditional monopolistic electricity generation and transmission enterprises into a free-market economy, power distribution utilities are faced with very difficult decisions pertaining to electricity supply options and quality of service to the customers. The management of distribution utilities has become increasingly complex, versatile, and dynamic to the extent that conventional, non-automated management tools are almost useless and obsolete. This thesis presents a novel and unified approach to managing electricity supply options and quality of service to customers. The technique formulates the problem in terms of variables, parameters, and constraints. An advanced Mixed Integer Programming (MIP) optimization formulation is developed together with novel, logical, decision-making algorithms. These tools enable the utility management to optimize various cost components and assess their time-trend impacts, taking into account the intangible issues such as customer perception, customer expectation, social pressures, and public response to service deterioration. The above concepts are further generalized and a Logical Proportion Analysis (LPA) methodology and associated software have been developed. Solutions using numbers are replaced with solutions using words (character strings) which more closely emulate the human decision-making process and advance the art of decision-making in the power utility environment. Using practical distribution utility operation data and customer surveys, the developments outlined in this thesis are successfully applied to several important utility management problems. These involve the evaluation of alternative electricity supply options, the impact of rate structures on utility business, and the decision of whether to continue to purchase from a main grid or generate locally (partially or totally) by building Non-Utility Generation (NUG).

The role of spiral CT in patients with intermediate probability V/Q scans: can spiral CT replace pulmonary angiography?

International Nuclear Information System (INIS)

Vu, T.; Glenn, D.; Lovett, I.; Moses, J.; Wadhwa, S.S.; Nour, R.

2000-01-01

Full text: Spiral CT (SCT) has been advocated as a replacement for pulmonary angiography (PA)in patients with intermediate probability (IP) ventilation-perfusion lung scans (V/Q). More generally it has been proposed as a replacement for V/Q to detect Pulmonary Embolism. This study investigates the accuracy of SCT in the IP patient group 31 patients with IP scans (Modified PIOPED criteria) who were not at high risk of contrast nephrotoxicity were enrolled to have both SCT and PA within the 24 hours following their V/Q. Patients were classified as IP due to a single segmental mismatch (n=7) or a matched V/Q abnormality corresponding to CXR opacity (n=21), or both (n=3). PA is the gold standard for the detection of PE. SCT was read by an experienced radiologist blinded to the PA results. SCT was performed according to standard protocol. All SCT were technically satisfactory for interpretation. Pulmonary embolism was present in 9/31 patients (29%). Of the patients with PE detected by PA, SCT was positive in 4 (44% sensitivity). Of the 22 patients who did not have PE, SCT was negative in 21 and positive in one (96% specificity). In conclusion SCT has limited sensitivity for the detection of PE in patients with IP lung scans. SCT may not be an adequate replacement for PA. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

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

Science.gov (United States)

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

2006-01-01

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

"Beating osteoARThritis": development of a stepped care strategy to optimize utilization and timing of non-surgical treatment modalities for patients with hip or knee osteoarthritis

NARCIS (Netherlands)

Smink, A.J.; Ende, C.H.; Vliet-Vlieland, Th.P.M.; Swierstra, B.A.; Kortland, J.H.; Bijlsma, J.W.; Voorn, T.B.; Schers, H.J.; Bierma-Zeinstra, S.M.; Dekker, J.

2011-01-01

Inadequacies in health care practices have been reported despite existing guidelines to manage hip or knee osteoarthritis. To facilitate guideline implementation and improve utilization of non-surgical treatment options a care strategy should be developed. This study describes the development of an

"Beating osteoARThritis": Development of a stepped care strategy to optimize utilization and timing of non-surgical treatment modalities for patients with hip or knee osteoarthritis

NARCIS (Netherlands)

Smink, A.J.; Ende, C.H.M. van den; Vliet Vlieland, T.P.M.; Swierstra, B.A.; Kortland, J.H.; Bijlsma, J.W.J.; Voorn, T.B.; Schers, H.J.; Bierma-Zeinstra, S.M.; Dekker, J.

2011-01-01

Inadequacies in health care practices have been reported despite existing guidelines to manage hip or knee osteoarthritis. To facilitate guideline implementation and improve utilization of non-surgical treatment options a care strategy should be developed. This study describes the development of an

Resourceful utilization technology for natural gas

International Nuclear Information System (INIS)

Matsumura, Y.

1994-01-01

This paper is a description of new applications that will contribute in increasing the demand for natural gas. First, technical issues to turn natural gas into a more resourceful fuel (efficient transportation and storage, integrated utilization of energies, uses as non-fuel), and also pitch-based high performance carbon materials and utilization techniques in the field of energy (isotropic carbon fiber, activated carbon fiber, spherical carbon micro-beads, high modulus carbon fiber). (TEC)

On the Path to SunShot - Utility Regulatory Business Model Reforms forAddressing the Financial Impacts of Distributed Solar on Utilities

Energy Technology Data Exchange (ETDEWEB)

None, None

2016-05-01

Net-energy metering (NEM) with volumetric retail electricity pricing has enabled rapid proliferation of distributed photovoltaics (DPV) in the United States. However, this transformation is raising concerns about the potential for higher electricity rates and cost-shifting to non-solar customers, reduced utility shareholder profitability, reduced utility earnings opportunities, and inefficient resource allocation. Although DPV deployment in most utility territories remains too low to produce significant impacts, these concerns have motivated real and proposed reforms to utility regulatory and business models, with profound implications for future DPV deployment. This report explores the challenges and opportunities associated with such reforms in the context of the U.S. Department of Energy’s SunShot Initiative. As such, the report focuses on a subset of a broader range of reforms underway in the electric utility sector. Drawing on original analysis and existing literature, we analyze the significance of DPV’s financial impacts on utilities and non-solar ratepayers under current NEM rules and rate designs, the projected effects of proposed NEM and rate reforms on DPV deployment, and alternative reforms that could address utility and ratepayer concerns while supporting continued DPV growth. We categorize reforms into one or more of four conceptual strategies. Understanding how specific reforms map onto these general strategies can help decision makers identify and prioritize options for addressing specific DPV concerns that balance stakeholder interests.

Physical Activity in Parents of Young African American Children: The Application of Social Cognitive Theory.

Science.gov (United States)

Webber-Ritchey, Kashica J; Taylor-Piliae, Ruth E; Loescher, Lois J

2018-02-01

Social cognitive theory (SCT) proposes that personal and environmental factors influence behavior bidirectionally. Research examining the personal and environmental factors of physical activity (PA) among African Americans (AAs) framed by SCT is scarce. The purpose of this article is to enhance knowledge of SCT as a foundation for health promotion and PA research, in general, and among AAs. Findings from a previous study provide exemplars for key factors and relationships in SCT. The SCT serves as a good framework for researchers studying health promotion and PA in generalamong AA parents.

TU-AB-BRA-02: An Efficient Atlas-Based Synthetic CT Generation Method

International Nuclear Information System (INIS)

Han, X

2016-01-01

Purpose: A major obstacle for MR-only radiotherapy is the need to generate an accurate synthetic CT (sCT) from MR image(s) of a patient for the purposes of dose calculation and DRR generation. We propose here an accurate and efficient atlas-based sCT generation method, which has a computation speed largely independent of the number of atlases used. Methods: Atlas-based sCT generation requires a set of atlases with co-registered CT and MR images. Unlike existing methods that align each atlas to the new patient independently, we first create an average atlas and pre-align every atlas to the average atlas space. When a new patient arrives, we compute only one deformable image registration to align the patient MR image to the average atlas, which indirectly aligns the patient to all pre-aligned atlases. A patch-based non-local weighted fusion is performed in the average atlas space to generate the sCT for the patient, which is then warped back to the original patient space. We further adapt a PatchMatch algorithm that can quickly find top matches between patches of the patient image and all atlas images, which makes the patch fusion step also independent of the number of atlases used. Results: Nineteen brain tumour patients with both CT and T1-weighted MR images are used as testing data and a leave-one-out validation is performed. Each sCT generated is compared against the original CT image of the same patient on a voxel-by-voxel basis. The proposed method produces a mean absolute error (MAE) of 98.6±26.9 HU overall. The accuracy is comparable with a conventional implementation scheme, but the computation time is reduced from over an hour to four minutes. Conclusion: An average atlas space patch fusion approach can produce highly accurate sCT estimations very efficiently. Further validation on dose computation accuracy and using a larger patient cohort is warranted. The author is a full time employee of Elekta, Inc.

Utilization of maternal health services by the migrant population living in the non-notified slums of Hyderabad city, India

Directory of Open Access Journals (Sweden)

Jagjivan Babu Geddam

2017-03-01

Full Text Available Background: Despite increase in accessibility and utilization of maternal health services in the state of Telangana, penetration of these services in vulnerable communities is inadequate. Aims & Objectives: To understand the determinants of utilization of reproductive health services by migrant population living in non-notified slums of Hyderabad city in the Indian state of Telangana. Material & Methods: It is a community based cross sectional study of 761 rural to urban internal migrant mothers with a child of less than 2 years of age residing for a period minimum of 30 days and not more than 10 years. Information was collected for socio demographic details, antenatal care and child delivery. Results: Mothers receiving at least 4 antenatal care visits and institutional deliveries in migrants was 69.6% and 69% respectively, compared to 85.8% and 97% in general population of Hyderabad city. The likelihood of mothers receiving adequate care is 6.7 times higher in mothers with secondary education compared to formal education. The likelihood of institutional delivery is 7.8 times higher in mothers availing adequate antenatal care versus inadequate care and 2.2 times higher in mothers with secondary education versus formal education. Conclusion: Utilization of antenatal care services and promotion of institutional deliveries can be improved by acting on the supply side barriers such as health care infrastructure and demand side barriers such as indirect consumer costs, financial constraints and community engagement

Cosmic tests and performance of the ATLAS SemiConductor Tracker Barrels

International Nuclear Information System (INIS)

Demirkoez, Bilge M.

2007-01-01

ATLAS is a multi-purpose particle detector for the LHC and will detect proton collisions with center of mass energy of 14TeV. Part of the central inner detector, the SemiConductor Tracker (SCT) barrel, is now fully integrated with the Transition Radiation Tracker (TRT) barrel. The SCT module performance has been measured after module production, after macro-assembly of modules onto barrels, after arrival at CERN and again partially after integration with the TRT. The module noise average per channel has been stable and is 4.5x10 -5 , well below the design specification of 5x10 -4 . There is no evidence for common mode noise problems and 99.8% of the 3.2 million channels of the SCT barrels are functional. The cosmics running of the SCT and TRT was the first large scale test of the physics mode of the SCT online software framework. A large sector, 468 SCT modules, has been timed in and read out during the cosmic tests. Tracks have been reconstructed through the SCT and the TRT sectors. Present residuals from tracks (without alignment) are better than the specified building tolerances of the SCT

The self-consistent energy system with an enhanced non-proliferated core concept for global nuclear energy utilization

International Nuclear Information System (INIS)

Kawashima, Masatoshi; Arie, Kazuo; Araki, Yoshio; Sato, Mitsuyoshi; Mori, Kenji; Nakayama, Yoshiyuki; Nakazono, Ryuichi; Kuroda, Yuji; Ishiguma, Kazuo; Fujii-e, Yoichi

2008-01-01

A sustainable nuclear energy system was developed based on the concept of Self-Consistent Nuclear Energy System (SCNES). Our study that trans-uranium (TRU) metallic fuel fast reactor cycle coupled with recycling of five long-lived fission products (LLFP) as well as actinides is the most promising system for the sustainable nuclear utilization. Efficient utilization of uranium-238 through the SCNES concept opens the doors to prolong the lifetime of nuclear energy systems towards several tens of thousand years. Recent evolution of the concept revealed compatibility of fuel sustainability, minor actinide (MA) minimization and non-proliferation aspects for peaceful use of nuclear energy systems through the discussion. As for those TRU compositions stabilized under fast neutron spectra, plutonium isotope fractions are remained in the range of reactor grade classification with high fraction of Pu240 isotope. Recent evolution of the SCNES concept has revealed that TRU recycling can cope with enhancing non-proliferation efforts in peaceful use with the 'no-blanket and multi-zoning core' concept. Therefore, the realization of SCNES is most important. In addition, along the process to the goals, a three-step approach is proposed to solve concurrent problems raised in the LWR systems. We discussed possible roles and contribution to the near future demand along worldwide expansion of LWR capacities by applying the 1st generation SCNES. MA fractions in TRU are more than 10% from LWR discharged fuels and even higher up to 20% in fuels from long interim storages. TRU recycling in the 1st generation SCNES system can reduce the MA fractions down to 4-5% in a few decades. This capability significantly releases 'MA' pressures in down-stream of LWR systems. Current efforts for enhancing capabilities for energy generation by LWR systems are efficient against the global warming crisis. In parallel to those movements, early realization of the SCNES concept can be the most viable decision

Comparison of 18F-fluorodeoxyglucose positron emission tomography/computed tomography, hydro-stomach computed tomography, and their combination for detecting primary gastric cancer

International Nuclear Information System (INIS)

Jang, Hye Young; Chung, Woo Suk; Song, E Rang; Kim, Jin Suk

2015-01-01

To retrospectively compare the diagnostic accuracy for detecting primary gastric cancer on positron emission tomography/computed tomography (PET/CT) and hydro-stomach CT (S-CT) and determine whether the combination of the two techniques improves diagnostic performance. A total of 253 patients with pathologically proven primary gastric cancer underwent PET/CT and S-CT for the preoperative evaluation. Two radiologists independently reviewed the three sets (PET/CT set, S-CT set, and the combined set) of PET/CT and S-CT in a random order. They graded the likelihood for the presence of primary gastric cancer based on a 4-point scale. The diagnostic accuracy of the PET/CT set, the S-CT set, and the combined set were determined by the area under the alternative-free receiver operating characteristic curve, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Diagnostic accuracy, sensitivity, and NPV for detecting all gastric cancers and early gastric cancers (EGCs) were significantly higher with the combined set than those with the PET/CT and S-CT sets. Specificity and PPV were significantly higher with the PET/CT set than those with the combined and S-CT set for detecting all gastric cancers and EGCs. The combination of PET/CT and S-CT is more accurate than S-CT alone, particularly for detecting EGCs.

Comparison of {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography, hydro-stomach computed tomography, and their combination for detecting primary gastric cancer

Energy Technology Data Exchange (ETDEWEB)

Jang, Hye Young; Chung, Woo Suk; Song, E Rang; Kim, Jin Suk [Konyang University Myunggok Medical Research Institute, Konyang University Hospital, Konyang University College of Medicine, Daejeon (Korea, Republic of)

2015-01-15

To retrospectively compare the diagnostic accuracy for detecting primary gastric cancer on positron emission tomography/computed tomography (PET/CT) and hydro-stomach CT (S-CT) and determine whether the combination of the two techniques improves diagnostic performance. A total of 253 patients with pathologically proven primary gastric cancer underwent PET/CT and S-CT for the preoperative evaluation. Two radiologists independently reviewed the three sets (PET/CT set, S-CT set, and the combined set) of PET/CT and S-CT in a random order. They graded the likelihood for the presence of primary gastric cancer based on a 4-point scale. The diagnostic accuracy of the PET/CT set, the S-CT set, and the combined set were determined by the area under the alternative-free receiver operating characteristic curve, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Diagnostic accuracy, sensitivity, and NPV for detecting all gastric cancers and early gastric cancers (EGCs) were significantly higher with the combined set than those with the PET/CT and S-CT sets. Specificity and PPV were significantly higher with the PET/CT set than those with the combined and S-CT set for detecting all gastric cancers and EGCs. The combination of PET/CT and S-CT is more accurate than S-CT alone, particularly for detecting EGCs.

Availability and Utilization of Anganwadi Services in an Adopted Urban Area of Wardha

Directory of Open Access Journals (Sweden)

Bhagat VM

2016-01-01

Full Text Available Background - The ICDS is world’s largest community-based child nutrition and development programme aimed at holistic development of children (0-6 years, expectant and nursing mothers through the Anganwadi centers (AWC. Improvement in nutritional and health status of their beneficiaries to prevent morbidities and mortalities due to malnutrition is one of the important objectives of ICDS. Objectives: To determine the availability and extent of utilization of AWC services by the beneficiaries, and to study factors influencing utilization and reasons for non/under utilization. Methodology: A community based cross-sectional study conducted in three well defined adopted urban field practice areas of a rural tertiary health care facility in Wardha, Maharashtra. A cluster comprising of 40 households was identified in each area to provide 140 study participants. Epi-info-3.7.1 for univariate and SYSTAT-12 used for multivariate analysis. Results: Overall 89.29% of beneficiaries utilized one or more services of AWC. Working women and those with lower socio-economic status had significantly and independently lower/non utilization of AWC services. Conclusions: Most of the study participants were aware and utilized the services of AWC. Among the women not utilizing the services; the reasons for non-utilization need to be addressed for optimal utilization of AWCs.

Clinical-grade generation of peptide-stimulated CMV/EBV-specific T cells from G-CSF mobilized stem cell grafts.

Science.gov (United States)

Gary, Regina; Aigner, Michael; Moi, Stephanie; Schaffer, Stefanie; Gottmann, Anja; Maas, Stefanie; Zimmermann, Robert; Zingsem, Jürgen; Strobel, Julian; Mackensen, Andreas; Mautner, Josef; Moosmann, Andreas; Gerbitz, Armin

2018-05-09

A major complication after allogeneic hematopoietic stem cell transplantation (aSCT) is the reactivation of herpesviruses such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Both viruses cause significant mortality and compromise quality of life after aSCT. Preventive transfer of virus-specific T cells can suppress reactivation by re-establishing functional antiviral immune responses in immunocompromised hosts. We have developed a good manufacturing practice protocol to generate CMV/EBV-peptide-stimulated T cells from leukapheresis products of G-CSF mobilized and non-mobilized donors. Our procedure selectively expands virus-specific CD8+ und CD4+ T cells over 9 days using a generic pool of 34 CMV and EBV peptides that represent well-defined dominant T-cell epitopes with various HLA restrictions. For HLA class I, this set of peptides covers at least 80% of the European population. CMV/EBV-specific T cells were successfully expanded from leukapheresis material of both G-CSF mobilized and non-mobilized donors. The protocol allows administration shortly after stem cell transplantation (d30+), storage over liquid nitrogen for iterated applications, and protection of the stem cell donor by avoiding a second leukapheresis. Our protocol allows for rapid and cost-efficient production of T cells for early transfusion after aSCT as a preventive approach. It is currently evaluated in a phase I/IIa clinical trial.

Non Linear Step By Step Seismic Response and the Push Over Analysis Comparison of a Reinforced Concrete of Ductile Frames 25 Level Building

International Nuclear Information System (INIS)

Avila, Jorge A.; Martinez, Eduardo

2008-01-01

Based on a ductile frames 25 level building, a non-linear analysis with increased monotonically lateral loads (Push-Over) was made in order to determine its collapse and its principal responses were compared against the time-history seismic responses determined with the SCT-EW-85 record. The seismic-resistance design and faced to gravitational loads was made according to the Complementary Technical Norms of Concrete Structures Design (NTC-Concrete) and the NTC-Seismic of the Mexico City Code (RDF-04), satisfying the limit service states (relative lateral displacement between story height maximum relations, story drifts ≤0.012) and failure (seismic behavior factor, Q = 3). The compressible (soft) seismic zone III b and the office use type (group B) were considered. The non-lineal responses were determined with nominal and over-resistance effects. The comparison were made with base shear force-roof lateral displacement relations, global distribution of plastic hinges, failure mechanics tendency, lateral displacements and story drift and its distribution along the height of the building, local and global ductility demands, etc. For the non-linear static analysis with increased monotonically lateral loads, was important to select the type of lateral forces distribution

Sluggish cognitive tempo and attention-deficit/hyperactivity disorder (ADHD) inattention in the home and school contexts: Parent and teacher invariance and cross-setting validity.

Science.gov (United States)

Burns, G Leonard; Becker, Stephen P; Servera, Mateu; Bernad, Maria Del Mar; García-Banda, Gloria

2017-02-01

This study examined whether sluggish cognitive tempo (SCT) and attention-deficit/hyperactivity disorder (ADHD) inattention (IN) symptoms demonstrated cross-setting invariance and unique associations with symptom and impairment dimensions across settings (i.e., home SCT and ADHD-IN uniquely predicting school symptom and impairment dimensions, and vice versa). Mothers, fathers, primary teachers, and secondary teachers rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), anxiety, depression, academic impairment, social impairment, and peer rejection dimensions for 585 Spanish 3rd-grade children (53% boys). Within-setting (i.e., mothers, fathers; primary, secondary teachers) and cross-settings (i.e., home, school) invariance was found for both SCT and ADHD-IN. From home to school, higher levels of home SCT predicted lower levels of school ADHD-HI and higher levels of school academic impairment after controlling for home ADHD-IN, whereas higher levels of home ADHD-IN predicted higher levels of school ADHD-HI, ODD, anxiety, depression, academic impairment, and peer rejection after controlling for home SCT. From school to home, higher levels of school SCT predicted lower levels of home ADHD-HI and ODD and higher levels of home anxiety, depression, academic impairment, and social impairment after controlling for school ADHD-IN, whereas higher levels of school ADHD-IN predicted higher levels of home ADHD-HI, ODD, and academic impairment after controlling for school SCT. Although SCT at home and school was able to uniquely predict symptom and impairment dimensions in the other setting, SCT at school was a better predictor than ADHD-IN at school of psychopathology and impairment at home. Findings provide additional support for SCT's validity relative to ADHD-IN. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Causal inference in survival analysis using pseudo-observations.

Science.gov (United States)

Andersen, Per K; Syriopoulou, Elisavet; Parner, Erik T

2017-07-30

Causal inference for non-censored response variables, such as binary or quantitative outcomes, is often based on either (1) direct standardization ('G-formula') or (2) inverse probability of treatment assignment weights ('propensity score'). To do causal inference in survival analysis, one needs to address right-censoring, and often, special techniques are required for that purpose. We will show how censoring can be dealt with 'once and for all' by means of so-called pseudo-observations when doing causal inference in survival analysis. The pseudo-observations can be used as a replacement of the outcomes without censoring when applying 'standard' causal inference methods, such as (1) or (2) earlier. We study this idea for estimating the average causal effect of a binary treatment on the survival probability, the restricted mean lifetime, and the cumulative incidence in a competing risks situation. The methods will be illustrated in a small simulation study and via a study of patients with acute myeloid leukemia who received either myeloablative or non-myeloablative conditioning before allogeneic hematopoetic cell transplantation. We will estimate the average causal effect of the conditioning regime on outcomes such as the 3-year overall survival probability and the 3-year risk of chronic graft-versus-host disease. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Justify Your Answer: The Role of Written Think Aloud in Script Concordance Testing.

Science.gov (United States)

Power, Alyssa; Lemay, Jean-Francois; Cooke, Suzette

2017-01-01

Construct: Clinical reasoning assessment is a growing area of interest in the medical education literature. Script concordance testing (SCT) evaluates clinical reasoning in conditions of uncertainty and has emerged as an innovative tool in the domain of clinical reasoning assessment. SCT quantifies the degree of concordance between a learner and an experienced clinician and attempts to capture the breadth of responses of expert clinicians, acknowledging the significant yet acceptable variation in practice under situations of uncertainty. SCT has been shown to be a valid and reliable clinical reasoning assessment tool. However, as SCT provides only quantitative information, it may not provide a complete assessment of clinical reasoning. Think aloud (TA) is a qualitative research tool used in clinical reasoning assessment in which learners verbalize their thought process around an assigned task. This study explores the use of TA, in the form of written reflection, in SCT to assess resident clinical reasoning, hypothesizing that the information obtained from the written TA would enrich the quantitative data obtained through SCT. Ninety-one pediatric postgraduate trainees and 21 pediatricians from 4 Canadian training centers completed an online test consisting of 24 SCT cases immediately followed by retrospective written TA. Six of 24 cases were selected to gather TA data. These cases were chosen to allow all phases of clinical decision making (diagnosis, investigation, and treatment) to be represented in the TA data. Inductive thematic analysis was employed when systematically reviewing TA responses. Three main benefits of adding written TA to SCT were identified: (a) uncovering instances of incorrect clinical reasoning despite a correct SCT response, (b) revealing sound clinical reasoning in the context of a suboptimal SCT response, and (c) detecting question misinterpretation. Written TA can optimize SCT by demonstrating when correct examinee responses are based on

Extreme heterogeneity of myeloablative total body irradiation techniques in clinical practice: a survey of the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation.

Science.gov (United States)

Giebel, Sebastian; Miszczyk, Leszek; Slosarek, Krzysztof; Moukhtari, Leila; Ciceri, Fabio; Esteve, Jordi; Gorin, Norbert-Claude; Labopin, Myriam; Nagler, Arnon; Schmid, Christoph; Mohty, Mohamad

2014-09-01

Total body irradiation (TBI) is widely used for conditioning before hematopoietic cell transplantation. Its efficacy and toxicity may depend on many methodological aspects. The goal of the current study was to explore current clinical practice in this field. A questionnaire was sent to all centers collaborating in the European Group for Blood and Marrow Transplantation and included 19 questions regarding various aspects of TBI. A total of 56 centers from 23 countries responded. All centers differed with regard to at least 1 answer. The total maximum dose of TBI used for myeloablative transplantation ranged from 8 grays (Gy) to 14.4 Gy, whereas the dose per fraction was 1.65 Gy to 8 Gy. A total of 16 dose/fractionation modalities were identified. The dose rate ranged from 2.25 centigrays to 37.5 centigrays per minute. The treatment unit was linear accelerator (LINAC) (91%) or cobalt unit (9%). Beams (photons) used for LINAC were reported to range from 6 to 25 megavolts. The most frequent technique used for irradiation was "patient in 1 field," in which 2 fields and 2 patient positions per fraction are used (64%). In 41% of centers, patients were immobilized during TBI. Approximately 93% of centers used in vivo dosimetry with accepted discrepancies between the planned and measured doses of 1.5% to 10%. In 84% of centers, the lungs were shielded during irradiation. The maximum accepted dose for the lungs was 6 Gy to 14.4 Gy. TBI is an extremely heterogeneous treatment modality. The findings of the current study should warrant caution in the interpretation of clinical studies involving TBI. Further investigation is needed to evaluate how methodological differences influence outcome. Efforts to standardize the method should be considered. © 2014 American Cancer Society.

Study protocol of cost-effectiveness and cost-utility of a biopsychosocial multidisciplinary intervention in the evolution of non-specific sub-acute low back pain in the working population: cluster randomised trial

Directory of Open Access Journals (Sweden)

de Kort Nelleke

2011-08-01

Full Text Available Abstract Background Low back pain (LBP, with high incidence and prevalence rate, is one of the most common reasons to consult the health system and is responsible for a significant amount of sick leave, leading to high health and social costs. The objective of the study is to assess the cost-effectiveness and cost-utility analysis of a multidisciplinary biopsychosocial educational group intervention (MBEGI of non-specific sub-acute LBP in comparison with the usual care in the working population recruited in primary healthcare centres. Methods/design The study design is a cost-effectiveness and cost-utility analysis of a MBEGI in comparison with the usual care of non-specific sub-acute LBP. Measures on effectiveness and costs of both interventions will be obtained from a cluster randomised controlled clinical trial carried out in 38 Catalan primary health care centres, enrolling 932 patients between 18 and 65 years old with a diagnosis of non-specific sub-acute LBP. Effectiveness measures are: pharmaceutical treatments, work sick leave (% and duration in days, Roland Morris disability, McGill pain intensity, Fear Avoidance Beliefs (FAB and Golberg Questionnaires. Utility measures will be calculated from the SF-12. The analysis will be performed from a social perspective. The temporal horizon is at 3 months (change to chronic LBP and 12 months (evaluate the outcomes at long term. Assessment of outcomes will be blinded and will follow the intention-to-treat principle. Discussion We hope to demonstrate the cost-effectiveness and cost-utility of MBEGI, see an improvement in the patients' quality of life, achieve a reduction in the duration of episodes and the chronicity of non-specific low back pain, and be able to report a decrease in the social costs. If the intervention is cost-effectiveness and cost-utility, it could be applied to Primary Health Care Centres. Trial registration ISRCTN: ISRCTN58719694

Association among sickle cell trait, fitness, and cardiovascular risk factors in CARDIA.

Science.gov (United States)

Liem, Robert I; Chan, Cheeling; Vu, Thanh-Huyen T; Fornage, Myriam; Thompson, Alexis A; Liu, Kiang; Carnethon, Mercedes R

2017-02-09

The contribution of sickle cell trait (SCT) to racial disparities in cardiopulmonary fitness is not known, despite concerns that SCT is associated with exertion-related sudden death. We evaluated the association of SCT status with cross-sectional and longitudinal changes in fitness and risk for hypertension, diabetes, and metabolic syndrome over the course of 25 years among 1995 African Americans (56% women, 18-30 years old) in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Overall, the prevalence of SCT was 6.8% (136/1995) in CARDIA, and over the course of 25 years, 46% (738/1590), 18% (288/1631), and 40% (645/1,611) of all participants developed hypertension, diabetes, and metabolic syndrome, respectively. Compared with participants without SCT, participants with SCT had similar baseline measures of fitness in cross-section, including exercise duration (535 vs 540 seconds; P = .62), estimated metabolic equivalent of tasks (METs; 11.6 vs 11.7; P = .80), maximum heart rate (174 vs 175 beats/min; P = .41), and heart rate at 2 minutes recovery (44 vs 43 beats/min; P = .28). In our secondary analysis, there was neither an association of SCT status with longitudinal changes in fitness nor an association with development of hypertension, diabetes, or metabolic syndrome after adjustment for sex, baseline age, body mass index, fitness, and physical activity. SCT is not associated with reduced fitness in this longitudinal study of young African American adults, suggesting the increased risk for exertion-related sudden death in SCT carriers is unlikely related to fitness. SCT status also is not an independent risk factor for developing hypertension, diabetes, or metabolic syndrome. © 2017 by The American Society of Hematology.

Adaptive Statistical Iterative Reconstruction-Applied Ultra-Low-Dose CT with Radiography-Comparable Radiation Dose: Usefulness for Lung Nodule Detection.

Science.gov (United States)

Yoon, Hyun Jung; Chung, Myung Jin; Hwang, Hye Sun; Moon, Jung Won; Lee, Kyung Soo

2015-01-01

To assess the performance of adaptive statistical iterative reconstruction (ASIR)-applied ultra-low-dose CT (ULDCT) in detecting small lung nodules. Thirty patients underwent both ULDCT and standard dose CT (SCT). After determining the reference standard nodules, five observers, blinded to the reference standard reading results, independently evaluated SCT and both subsets of ASIR- and filtered back projection (FBP)-driven ULDCT images. Data assessed by observers were compared statistically. Converted effective doses in SCT and ULDCT were 2.81 ± 0.92 and 0.17 ± 0.02 mSv, respectively. A total of 114 lung nodules were detected on SCT as a standard reference. There was no statistically significant difference in sensitivity between ASIR-driven ULDCT and SCT for three out of the five observers (p = 0.678, 0.735, ASIR-driven ULDCT in three out of the five observers (p ASIR-driven ULDCT, and SCT were 0.682, 0.772, and 0.821, respectively, and there were no significant differences in FOM values between ASIR-driven ULDCT and SCT (p = 0.11), but the FOM value of FBP-driven ULDCT was significantly lower than that of ASIR-driven ULDCT and SCT (p = 0.01 and 0.00). Adaptive statistical iterative reconstruction-driven ULDCT delivering a radiation dose of only 0.17 mSv offers acceptable sensitivity in nodule detection compared with SCT and has better performance than FBP-driven ULDCT.

CROSS DRIFT ALCOVE/NICHE UTILITIES ANALYSIS

International Nuclear Information System (INIS)

S. Goodin

1999-01-01

The purpose of this analysis is to provide the design basis and general arrangement requirements of the non-potable water, waste water, compressed air and ventilation (post excavation) utilities required in support of the Cross Drift alcoves and niches

Why environmental and resource economists should care about non-expected utility models

Energy Technology Data Exchange (ETDEWEB)

Shaw, W. Douglass; Woodward, Richard T. [Department of Agricultural Economics, Texas A and M University (United States)

2008-01-15

Experimental and theoretical analysis has shown that the conventional expected utility (EU) and subjective expected utility (SEU) models, which are linear in probabilities, have serious limitations in certain situations. We argue here that these limitations are often highly relevant to the work that environmental and natural resource economists do. We discuss some of the experimental evidence and alternatives to the SEU. We consider the theory used, the problems studied, and the methods employed by resource economists. Finally, we highlight some recent work that has begun to use some of the alternatives to the EU and SEU frameworks and discuss areas where much future work is needed. (author)

Detection of pulmonary metastases with pathological correlation: effect of breathing on the accuracy of spiral CT. Editor`s note

Energy Technology Data Exchange (ETDEWEB)

Coakley, F.V. [Abdominal Imaging Section, Department of Radiology, University of California, San Francisco, CA (United States); Cohen, M.D. [Department of Radiology, Riley Hospital for Children, Indianapolis, IN (United States); Waters, D.J. [Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN (United States); Davis, M.M. [Department of Pathology, Riley Hospital for Children, Indianapolis, IN (United States); Karmazyn, B. [Department of Radiology, Riley Hospital for Children, Indianapolis, IN (United States); Gonin, R. [Division of Biostatistics, Department of Medicine, Riley Hospital for Children, Indianapolis, IN (United States); Hanna, M.P. [Division of Biostatistics, Department of Medicine, Riley Hospital for Children, Indianapolis, IN (United States)

1997-07-01

Background. CT of the chest for suspected pulmonary metastases in adults is generally performed using a breath-hold technique. The results may not be applicable to young children in whom breath-holding may be impossible. Objective. Determine the effect of breathing on the accuracy of pulmonary metastasis detection by spiral CT (SCT). Materials and methods. Prior to euthanasia four anesthetized dogs with metastatic osteosarcoma underwent SCT with a collimation of 5 mm and a pitch of 2, during both induced breath-hold and normal quiet breathing. Images were reconstructed as contiguous 5-mm slices. Macroscopically evident metastases were noted at postmortem. Hard-copy SCT images were reviewed by ten radiologists, each of whom circled all suspected metastases. SCT images were compared with postmortem results to determine true and false positives. Results. The pathologist identified 132 macroscopically evident pulmonary metastases. For metastasis detection, there was no significant difference between breath-hold SCT and breathing SCT. Conclusion. In our animal model, SCT can be performed during normal resting breathing without significant loss of accuracy in the detection of pulmonary metastases. (orig.). With 3 tabs.

Detection of pulmonary metastases with pathological correlation: effect of breathing on the accuracy of spiral CT. Editor's note

International Nuclear Information System (INIS)

Coakley, F.V.; Cohen, M.D.; Waters, D.J.; Davis, M.M.; Karmazyn, B.; Gonin, R.; Hanna, M.P.

1997-01-01

Background. CT of the chest for suspected pulmonary metastases in adults is generally performed using a breath-hold technique. The results may not be applicable to young children in whom breath-holding may be impossible. Objective. Determine the effect of breathing on the accuracy of pulmonary metastasis detection by spiral CT (SCT). Materials and methods. Prior to euthanasia four anesthetized dogs with metastatic osteosarcoma underwent SCT with a collimation of 5 mm and a pitch of 2, during both induced breath-hold and normal quiet breathing. Images were reconstructed as contiguous 5-mm slices. Macroscopically evident metastases were noted at postmortem. Hard-copy SCT images were reviewed by ten radiologists, each of whom circled all suspected metastases. SCT images were compared with postmortem results to determine true and false positives. Results. The pathologist identified 132 macroscopically evident pulmonary metastases. For metastasis detection, there was no significant difference between breath-hold SCT and breathing SCT. Conclusion. In our animal model, SCT can be performed during normal resting breathing without significant loss of accuracy in the detection of pulmonary metastases. (orig.). With 3 tabs

Rhabdomyolysis in a Sickle Cell Trait Positive Active Duty Male Soldier.

Science.gov (United States)

Saxena, Pulkit; Chavarria, Christopher; Thurlow, John

2016-01-01

Exertional rhabdomyolysis is a complication of sickle cell trait (SCT) likely first reported in the military population over 40 years ago. Although commonly a benign condition, numerous studies and case reports have identified SCT positive patients to be at increased risk for rhabdomyolysis, compartment syndrome and sudden cardiac death. We report a recent case of an SCT positive African American active duty male Soldier who suffered exertional rhabdomyolysis following an Army Physical Fitness Test. His course was complicated by acute renal failure requiring hemodialysis, and he eventually recovered renal function. The diagnosis was significantly delayed despite a typical clinical presentation and available SCT screening results. The case highlights the importance of the recognition of SCT as a risk factor for severe rhabdomyolysis, and suggests more must be done for an effective SCT screening program for the active duty military population.

Estimating CO2 Emission Reduction of Non-capture CO2 Utilization (NCCU) Technology

International Nuclear Information System (INIS)

Lee, Ji Hyun; Lee, Dong Woog; Gyu, Jang Se; Kwak, No-Sang; Lee, In Young; Jang, Kyung Ryoung; Shim, Jae-Goo; Choi, Jong Shin

2015-01-01

Estimating potential of CO 2 emission reduction of non-capture CO 2 utilization (NCCU) technology was evaluated. NCCU is sodium bicarbonate production technology through the carbonation reaction of CO 2 contained in the flue gas. For the estimating the CO 2 emission reduction, process simulation using process simulator (PRO/II) based on a chemical plant which could handle CO 2 of 100 tons per day was performed, Also for the estimation of the indirect CO 2 reduction, the solvay process which is a conventional technology for the production of sodium carbonate/sodium bicarbonate, was studied. The results of the analysis showed that in case of the solvay process, overall CO 2 emission was estimated as 48,862 ton per year based on the energy consumption for the production of NaHCO 3 (7.4 GJ/tNaHCO 3 ). While for the NCCU technology, the direct CO 2 reduction through the CO 2 carbonation was estimated as 36,500 ton per year and the indirect CO 2 reduction through the lower energy consumption was 46,885 ton per year which lead to 83,385 ton per year in total. From these results, it could be concluded that sodium bicarbonate production technology through the carbonation reaction of CO 2 contained in the flue was energy efficient and could be one of the promising technology for the low CO 2 emission technology.