Triplet vs doublet lenalidomide-containing regimens for the treatment of elderly patients with newly diagnosed multiple myeloma

Lenalidomide-dexamethasone improved outcome in newly diagnosed elderly multiple myeloma patients. We randomly assigned 662 patients who were age \u202165 years or transplantation-ineligible to receive induction with melphalan-prednisone-lenalidomide (MPR) or cyclophosphamide-prednisone-lenalidomide (CPR) or lenalidomide plus lowdose dexamethasone (Rd). The primary end point was progression-free survival (PFS) in triplet (MPR and CPR) vs doublet (Rd) lenalidomide-containing regimens. After a median follow-up of 39 months, the medianPFSwas22 months for the triplet combinations and 21 months for the doublet (P 5 .284). The median overall survival (OS) was not reached in either arms, and the 4-year OS was 67% for the triplet and 58% for the doublet arms (P 5 .709). By considering the 3 treatment arms separately, no difference in outcome was detected among MPR, CPR, and Rd. The most common grade \u20213 toxicity was neutropenia: 64% in MPR, 29% in CPR, and 25% in Rd patients (P < .0001). Grade \u20213 nonhematologic toxicities were similar among arms and were mainly infections (6.5% to 11%), constitutional (3.5% to 9.5%), and cardiac (4.5% to 6%), with no difference among the arms. In conclusion, in the overall population, the alkylator-containing tripletsMPRandCPRwere not superior to the alkylator-free doublet Rd, which was associated with lower toxicit

Inductive Plasma Thruster (IPT) design for an Atmosphere-Breathing Electric Propulsion System (ABEP)

Challenging space missions include those at very low altitudes, where the atmosphere is source of aerodynamic drag on the spacecraft, therefore an efficient propulsion system is required to extend the mission lifetime. One solution is Atmosphere-Breathing Electric Propulsion (ABEP). It collects atmospheric particles to use as propellant for an electric thruster. This would minimize the requirement of limited propellant availability. The system could be applied to any planet with atmosphere, enabling new mission at these altitude ranges for continuous orbiting. Challenging is also the presence of reactive chemical species, such as atomic oxygen in Earth orbit. Such components are erosion source of (not only) propulsion system components, i.e. acceleration grids, electrodes, and discharge channels of conventional EP systems (RIT and HET). IRS is developing within the DISCOVERER project an intake and a thruster for an ABEP system. This paper deals with the design and first operation of the inductive plasma thruster (IPT) developed at IRS. The paper describes its design aided by numerical tools such as HELIC and ADAMANT. Such a device is based on RF electrodeless discharge aided by externally applied static magnetic field. The IPT is composed by a movable injector, to variate the discharge channel length, and a movable electromagnet to variate position and intensity of the magnetic field. By changing these parameters along with a novel antenna design for electric propulsion, the aim is to achieve the highest efficiency for the ionization stage by enabling the formation of helicon-based discharge. Finally, the designed IPT is presented and the feature of the birdcage antenna highlighted

Parameter Dependent H∞ Controller Design by Finite Dimensional LMI Optimization: Application to Trade-off Dependent Control

International audienceThe design of a parameter dependent H∞ controller for a parameter dependent plant is considered. A solution can be proposed as a parameter dependent LMI optimization problem, that is, an infinite dimensional problem. In the case of rational dependence, an approach is proposed involving an optimization problem over parameter independent LMI constraints (which is finite dimensional). The obtained conditions are less conservative than previous ones. An application to the trade-off dependent controller design with the control of a DC motor is developed to emphasize the interest of our approach

Parameterized H<inf>∞</inf> controller design for adaptative trade-off by finite dimensional LMI optimization

International audienc

A Reduced-order Observer-predictor for Nonlinear Systems with Delayed Measurements

International audienc

Laryngeal mask airway: Is the management of neonates requiring positive pressure ventilation at birth changing?

Objective: To evaluate the impact of the laryngeal mask airway (LMA) on neonatal resuscitation policy. Design: We analyzed retrospectively the records of neonates requiring positive pressure ventilation (PPV) at birth before (1996) and after (2000) the introduction of the LMA into our delivery suites. In addition, the outcome of neonates treated with the LMA was compared with that of neonates matched for gestational age and mode of delivery who were resuscitated using a face mask. Results: During the year 2000, 95 out of 380 (25%) resuscitated neonates were treated with the LMA. The LMA was effective in 94 out of 95 (99%) of these infants. Over the same period, the percentage of neonates receiving tracheal intubation (TI) at birth (34%) was significantly reduced compared with the figure for 1996 (67%). There were no reported complications associated with the use of the LMA. Seventy-four out of the 95 neonates treated with the LMA were considered suitable for matching for gestational age and mode of delivery with 74 neonates treated with a face mask. No differences were found between the two groups for birth weight, Apgar scores, need for tracheal intubation, need for admission to the Neonatal Intensive Care Unit (NICU), primary diagnosis at discharge and primary outcomes. The LMA provided effective ventilation in four neonates in whom the face mask failed. Conclusions: The LMA is changing neonatal resuscitation practice in our Institution. Our data suggest that it is a safe and useful alternative method for respiratory support in neonates requiring PPV at birth, which merits further study. \ua9 2004 Elsevier Ireland Ltd. All rights reserved