The risks and benefits of long-term use of hydroxyurea in sickle cell anemia: A 17.5 year follow-up.

A randomized, controlled clinical trial established the efficacy and safety of short-term use of hydroxyurea in adult sickle cell anemia. To examine the risks and benefits of long-term hydroxyurea usage, patients in this trial were followed for 17.5 years during which they could start or stop hydroxyurea. The purpose of this follow-up was to search for adverse outcomes and estimate mortality. For each outcome and for mortality, exact 95% confidence intervals were calculated, or tests were conducted at alpha = 0.05 level (P-value \u3c0.05 for statistical significance). Although the death rate in the overall study cohort was high (43.1%; 4.4 per 100 person-years), mortality was reduced in individuals with long-term exposure to hydroxyurea. Survival curves demonstrated a significant reduction in deaths with long-term exposure. Twenty-four percent of deaths were due to pulmonary complications; 87.1% occurred in patients who never took hydroxyurea or took it for \u3c5 years. Stroke, organ dysfunction, infection, and malignancy were similar in all groups. Our results, while no longer the product of a randomized study because of the ethical concerns of withholding an efficacious treatment, suggest that long-term use of hydroxyurea is safe and might decrease mortality

Did Steroid Use Enhance the Performance of the Mitchell Batters? The Effect of Alleged Performance Enhancing Drug Use on Offensive Performance from 1995 to 2007

Introduction: The Mitchell Report to the Commissioner of Baseball sought to characterize the extent to which the use of performance enhancing drugs (PEDs) proliferated through baseball during the last 15 years. While the Report was not primarily initiated to expose individual players, it nonetheless contained detailed accounts of alleged PED abuse by 89 current and former players including seasons in which the abuse occurred and type of abuse (steroids or human growth hormone (HGH)). Previous analyses have largely focused on the impact of PED abuse on individual players (Barry Bonds and Roger Clemens, for instance). The present study integrates data from the Mitchell Report to make inferences about the overall effects of PED abuse on offensive production.Methods: The Lahman database was queried for all offensive seasons from 1995 to 2007 (minimum 50 PA, no pitchers). Runs created per 27 outs (RC27) was used as an estimate of the offensive production of a player in a season. An adjusted RC27 (ADJRC27) was obtained by accounting for career progression effects to reduce the influence of the expected change in performance over time due to age. Information from the Mitchell Report identified each player season as a PED season or a non-PED season. General linear mixed effects models were constructed that modeled ADJRC27 as a function of PED use (Yes or No). Multiple models were considered to assess the PED effect under various assumptions.Results: The baseline model estimated a mean non-steroid ADJRC27 during the study period of 4.58. The effect of steroid use was an additional 0.58 ADJRC27, an increase in production of 12.6% (p=0.0108). Additional models considered the effect of being a player mentioned in the Mitchell Report, adjustments for baseline performance, and the influential effect of Barry Bonds' performance. The estimated steroid effect ranged from 3.9% to 18.0% among twelve different models. Similar analysis of HGH use showed no evidence of performance improvement.Conclusions: This analysis suggests a significant and substantial performance advantage for players who used steroids during the study period. It is estimated that offensive production increased approximately 12% in steroid users versus non-users. This analysis represents the first attempt to quantify the overall effect of PED abuse on offensive performance in baseball.

Neutron flux measurements around PLT

Using Indium activation foils, the toroidal and poloidal neutron emission patterns were determined for PLT plasmas which include ICRF and neutral beam heating. The activities produced the /sup 115/In (n,n') /sup 115m/In reaction were determined by counting the 336 keV ..gamma.. line of the /sup 115m/In decay. This activation cross section falls just below 2.5 MeV so that the influence of scattered neutrons of degraded energies is reduced. From the magnitude of the activity, the absolute calibration of the PLT fusion neutron emission is obtained with less than or equal to 40% accuracy

Scheduling in a Multi-Agent Environment

. A new scheduling agent for existing CIM multi-agent system is being currently developed at the Technical University of Kosice. The basic idea is to create an agent based on Scheduling Program developed at the Technical University of Kosice. The Scheduling Program was developed in the ECL i PS e programming language using its constraint logic programming capabilities. It is used for solving JobShop problems. This paper gives the reader some basic information about prepared software. 1 Introduction The basic idea of CIM (Computer Integrated Manufacturing) is to integrate all company activities into a unified management structure exploring a large scale hierarchy of computers. Considering all possible activities (planning, scheduling, product design, manufacturing, etc.) and the fact that some of these tasks are running in parallel on geographically distributed sites, the integration is a nontrivial problem. DISCIM - geographically DIStributed decision making system for CIM [1]. DI..