61 research outputs found
Onset of Superfluidity in 4He Films Adsorbed on Disordered Substrates
We have studied 4He films adsorbed in two porous glasses, aerogel and Vycor,
using high precision torsional oscillator and DC calorimetry techniques. Our
investigation focused on the onset of superfluidity at low temperatures as the
4He coverage is increased. Torsional oscillator measurements of the 4He-aerogel
system were used to determine the superfluid density of films with transition
temperatures as low as 20 mK. Heat capacity measurements of the 4He-Vycor
system probed the excitation spectrum of both non-superfluid and superfluid
films for temperatures down to 10 mK. Both sets of measurements suggest that
the critical coverage for the onset of superfluidity corresponds to a mobility
edge in the chemical potential, so that the onset transition is the bosonic
analog of a superconductor-insulator transition. The superfluid density
measurements, however, are not in agreement with the scaling theory of an onset
transition from a gapless, Bose glass phase to a superfluid. The heat capacity
measurements show that the non-superfluid phase is better characterized as an
insulator with a gap.Comment: 15 pages (RevTex), 21 figures (postscript
Critical exponents and equation of state of the three-dimensional Heisenberg universality class
We improve the theoretical estimates of the critical exponents for the
three-dimensional Heisenberg universality class. We find gamma=1.3960(9),
nu=0.7112(5), eta=0.0375(5), alpha=-0.1336(15), beta=0.3689(3), and
delta=4.783(3). We consider an improved lattice phi^4 Hamiltonian with
suppressed leading scaling corrections. Our results are obtained by combining
Monte Carlo simulations based on finite-size scaling methods and
high-temperature expansions. The critical exponents are computed from
high-temperature expansions specialized to the phi^4 improved model. By the
same technique we determine the coefficients of the small-magnetization
expansion of the equation of state. This expansion is extended analytically by
means of approximate parametric representations, obtaining the equation of
state in the whole critical region. We also determine a number of universal
amplitude ratios.Comment: 40 pages, final version. In publication in Phys. Rev.
Arguments against the requirement of a biological license application for human pancreatic islets: The position statement of the islets for us collaborative presented during the fda advisory committee meeting
The Food and Drug Administration (FDA) has been regulating human islets for allo-transplantation as a biologic drug in the US. Consequently, the requirement of a biological license application (BLA) approval before clinical use of islet transplantation as a standard of care procedure has stalled the development of the field for the last 20 years. Herein, we provide our commentary to the multiple FDA’s position papers and guidance for industry arguing that BLA requirement has been inappropriately applied to allogeneic islets, which was delivered to the FDA Cellular, Tissue and Gene Therapies Advisory Committee on 15 April 2021. We provided evidence that BLA requirement and drug related regulations are inadequate in reassuring islet product quality and potency as well as patient safety and clinical outcomes. As leaders in the field of transplantation and endocrinology under the “Islets for US Collaborative” designation, we examined the current regulatory status of islet transplantation in the US and identified several anticipated negative consequences of the BLA approval. In our commentary we also offer an alternative pathway for islet transplantation under the regulatory framework for organ transplantation, which would address deficiencies of in current system
Diagnosis of primary ciliary dyskinesia: An official American thoracic society clinical practice guideline
Background: This document presents the American Thoracic Society clinical practice guidelines for the diagnosis of primary ciliary dyskinesia (PCD). Target Audience: Clinicians investigating adult and pediatric patients for possible PCD. Methods: Systematic reviews and, when appropriate, meta-Analyses were conducted to summarize all available evidence pertinent to our clinical questions. Evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach for diagnosis and discussed by amultidisciplinary panelwith expertise in PCD. Predetermined conflict-of-interest management strategies were applied, and recommendations were formulated, written, and graded exclusively by the nonconflicted panelists. Three conflicted individuals were also prohibited from writing, editing, or providing feedback on the relevant sections of the manuscript. Results: After considering diagnostic test accuracy, confidence in the estimates for each diagnostic test, relative importance of test results studied, desirable and undesirable direct consequences of each diagnostic test, downstream consequences of each diagnostic test result, patient values and preferences, costs, feasibility, acceptability, and implications for health equity, the panel made recommendations for or against the use of specific diagnostic tests as compared with using the current reference standard (transmission electron microscopy and/or genetic testing) for the diagnosis of PCD. Conclusions: The panel formulated and provided a rationale for the direction as well as for the strength of each recommendation to establish the diagnosis of PCD
Implementing core outcomes in kidney disease: report of the Standardized Outcomes in Nephrology (SONG) implementation workshop
There are an estimated 14,000 randomized trials published in chronic kidney disease. The most frequently reported outcomes are biochemical endpoints, rather than clinical and patient-reported outcomes including cardiovascular disease, mortality, and quality of life. While many trials have focused on optimizing kidney health, the heterogeneity and uncertain relevance of outcomes reported across trials may limit their policy and practice impact. The international Standardized Outcomes in Nephrology (SONG) Initiative was formed to identify core outcomes that are critically important to patients and health professionals, to be reported consistently across trials. We convened a SONG Implementation Workshop to discuss the implementation of core outcomes. Eighty-two patients/caregivers and health professionals participated in plenary and breakout discussions. In this report, we summarize the findings of the workshop in two main themes: socializing the concept of core outcomes, and demonstrating feasibility and usability. We outline implementation strategies and pathways to be established through partnership with stakeholders, which may bolster acceptance and reporting of core outcomes in trials, and encourage their use by end-users such as guideline producers and policymakers to help improve patient-important outcomes
BK Virus Infection is Associated with Hematuria and Renal Impairment in Recipients of Allogeneic Hematopoetic Stem Cell Transplants
Erratum: Renal Impairment and Clinical Outcomes of <i>Clostridium difficile</i> Infection in Two Randomized Trials
<b><i>Background/Aims:</i></b> Patients with chronic kidney disease (CKD) have increased risk for <i>Clostridium difficile</i> infection (CDI) and for subsequent mortality. We determined the effect of CKD on response to treatment for CDI. <b><i>Methods:</i></b> This is a post hoc analysis of two randomized controlled phase 3 trials that enrolled patients with CDI. Patients received either fidaxomicin 200 mg b.i.d. or vancomycin 125 mg q.i.d. for 10 days. Univariate and multivariate analyses compared end points by treatment received and CKD stage. <b><i>Results:</i></b> At baseline, 27, 21, and 9% of the patients had stage 2 (60-89 ml/min/1.73 m<sup>2</sup>), stage 3 (30-59), and stage 4 or higher (<30) CKD. Cure rates were similar for normal (91%) and stage 2 CKD (92%), but declined to 80% for stage 3 and to 75% for stage 4 CKD (p < 0.001 for trend). Time to resolution of diarrhea (TTROD) increased with stage 3 and stage 4 CKD. CDI recurrence rates 4 weeks after treatment were 16, 20, 27, and 24% for normal, stage 2, stage 3, and stage 4 or higher CKD, respectively. Mortality increased with CKD stage. In multivariate analyses, stage 3 or higher CKD correlated with lower odds of cure, greater chance of recurrence, and lower odds of sustained response 28 days after treatment. Initial cure rates were similar in the vancomycin or fidaxomicin groups; however, the rate of recurrence was higher following vancomycin treatment independent of renal function. The presence of immunosuppression did not alter this effect. <b><i>Conclusion:</i></b> Progressive CKD is associated with increased TTROD, lower cure rates, and higher recurrence rates with treatment of CDI
Establishing a core outcome measure for fatigue in patients on Hemodialysis: a Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) Consensus Workshop Report
Stephen McDonald is one of the SONG-HD Fatigue Workshop Collaborators who participated in The SONG-HD Fatigue Consensus Workshop held at Conference Chicago in Chicago, IL, in November 2016.Fatigue is one of the most highly prioritized outcomes for patients and clinicians, but remains infrequently and inconsistently reported across trials in hemodialysis. We convened an international Standardized Outcomes in Nephrology–Hemodialysis (SONG-HD) consensus workshop with stakeholders to discuss the development and implementation of a core outcome measure for fatigue. 15 patients/caregivers and 42 health professionals (clinicians, researchers, policy makers, and industry representatives) from 9 countries participated in breakout discussions. Transcripts were analyzed thematically. 4 themes for a core outcome measure emerged. Drawing attention to a distinct and all-encompassing symptom was explicitly recognizing fatigue as a multifaceted symptom unique to hemodialysis. Emphasizing the pervasive impact of fatigue on life participation justified the focus on how fatigue severely impaired the patient’s ability to do usual activities. Ensuring relevance and accuracy in measuring fatigue would facilitate shared decision making about treatment. Minimizing burden of administration meant avoiding the cognitive burden, additional time, and resources required to use the measure. A core outcome measure that is simple, is short, and includes a focus on the severity of the impact of fatigue on life participation may facilitate consistent and meaningful measurement of fatigue in all trials to inform decision making and care of patients receiving hemodialysis.Angela Ju, Mark Unruh, Sara Davison, Juan Dapueto, Mary Amanda Dew, Richard Fluck, Michael Germain, Sarbjit V. Jassal, Gregorio Obrador, Donal O’Donoghue, Michelle A. Josephson, Jonathan C. Craig, Andrea Viecelli, Emma O’Lone, Camilla S. Hanson, Braden Manns, Benedicte Sautenet, Martin Howell, Bharathi Reddy, Caroline Wilkie, Claudia Rutherford, and Allison Tong, on behalf of the SONG-HD Fatigue Workshop Collaborator
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