Therapy reduction in patients with Down syndrome and myeloid leukemia: the international ML-DS 2006 trial

Children with myeloid leukemia associated with Down syndrome (ML-DS) have superior outcome compared with non-DS patients, but suffer from higher constitutional cytotoxic drug susceptibility. We analyzed the outcome of 170 pediatric patients with ML-DS enrolled in the prospective, multicenter, open-label, nonrandomized ML-DS 2006 trial by Nordic Society for Pediatric Hematology and Oncology (NOPHO), Dutch Childhood Oncology Group (DCOG), and Acute Myeloid Leukemia–Berlin-Frankfurt-Münster (AML-BFM) study group. Compared with the historical control arm (reduced-intensity protocol for ML-DS patients from the AML-BFM 98 trial), treatment intensity was reduced by lowering the cumulative dose of etoposide (950 to 450 mg/m2) and intrathecal central nervous system prophylaxis while omitting maintenance therapy. Still, 5-year overall survival (89% 6 3% vs 90% 6 4%; Plog-rank 5 .64), event-free survival (EFS; 87% 6 3% vs 89% 6 4%; Plog-rank 5 .71), and cumulative incidence of relapse/ nonresponse (CIR/NR; 6% 6 3% vs 6% 6 2%; PGray 5 .03) did not significantly differ between the ML-DS 2006 trial and the historical control arm. Poor early treatment response (5-year EFS, 58% 6 16% vs 88% 6 3%; Plog rank 5 .0008) and gain of chromosome 8 (CIR/NR, 16% 6 7% vs 3% 6 2%, PGray 5 .02; 5-year EFS, 73% 6 8% vs 91% 6 4%, Plog rank 5 .018) were identified as independent prognostic factors predicting a worse EFS. Five of 7 relapsed patients (71%) with cytogenetic data had trisomy 8. Our study reveals prognostic markers for children with ML-DS and illustrates that reducing therapy did not impair excellent outcome. The trial was registered at EudraCT as #2007-006219-2. (Blood. 2017;129(25): 3314-3321

Pre - Inflationary Clues from String Theory ?

"Brane supersymmetry breaking" occurs in String Theory when the only available combinations of D-branes and orientifolds are not mutually BPS and yet do not introduce tree-level tachyon instabilities. It is characterized by the emergence of a steep exponential potential, and thus by the absence of maximally symmetric vacua. The corresponding low-energy supergravity admits intriguing spatially-flat cosmological solutions where a scalar field is forced to climb up toward the steep potential after an initial singularity, and additional milder terms can inject an inflationary phase during the ensuing descent. We show that, in the resulting power spectra of scalar perturbations, an infrared suppression is typically followed by a pre-inflationary peak that reflects the end of the climbing phase and can lie well apart from the approximately scale invariant profile. A first look at WMAP9 raw data shows that, while the chi^2 fits for the low-l CMB angular power spectrum are clearly compatible with an almost scale invariant behavior, they display nonetheless an eye-catching preference for this type of setting within a perturbative string regime.Comment: 34 pages, LaTeX, 16 eps figures. Relative displacement in fig. 14 and some typos corrected, references and acknowledgments updated. To appear in JCA

Prognostic impact of proliferative index determined by quantitative image analysis and the International Prognostic Index in patients with mantle cell lymphoma

Background: The proliferative index (PI) is a powerful prognostic factor in mantle cell lymphoma (MCL); however, its utility is hampered by interobserver variability. The mantle cell international prognostic index (MIPI) has been reported to have prognostic importance. In this study, we determined the prognostic value of the PI as determined by quantitative image analysis in MCL

EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on establishing Food-Based Dietary Guidelines

This Opinion of the EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA) provides guidance on the translation of nutrient based dietary advice into guidance, intended for the European population as a whole, on the contribution of different foods or food groups to an overall diet that would help to maintain good health through optimal nutrition (food-based dietary guidelines). The main focus of this Opinion is put on the scientific process of developing food-based dietary guidelines (FBDG) for the diverse European populations, following a stepwise approach which should ideally consist of: 1) Identification of diet-health relationships, 2) Identification of country specific diet-related health problems, 3) Identification of nutrients of public health importance, 4) Identification of foods relevant for FBDG, 5) Identification of food consumption patterns, 6) Testing and optimising FBDG and 7) Graphical representations of FBDG. FBDG should focus on the diet-disease relationships of particular relevance to the specific population and should be developed using a multi-disciplinary approach. The early involvement of stakeholders is recommended to promote the acceptance of the outcome. FBDG should be consistent with other public policies that have an impact on food availability and be integrated with other policies related to health promotion. Once established, FBDG should be implemented and their impact monitored and evaluate

Scientific Opinion on the substantiation of a health claim related to fermented milk containing Lactobacillus casei DN-114 001 plus yoghurt symbiosis (Actimel\uae), and reduction of Clostridium difficile toxins in the gut of patients receiving antibiotics and reduced risk of acute diarrhoea in patients receiving antibiotics pursuant to Article 14 of Regulation (EC) No 1924/2006

Following an application from Danone Produits Frais France submitted pursuant to Article 14 of Regulation (EC) No 1924/2006 via the Competent Authority of France, the Panel on Dietetic Products, Nutrition and Allergies was asked to deliver an opinion on the scientific substantiation of a health claim related to a fermented milk drink Actimel\uae containing Lactobacillus casei (Lc) DN-114 001 and reduction of the presence of Clostridium difficile toxins in the gut which reduces the incidence of acute diarrhoea. The Panel considers that the food constituent, Actimel\uae, which is the subject of the health claim, is sufficiently characterised. The Panel considers that reducing the risk of Clostridium difficile diarrhoea by reducing the presence of C. difficile toxins is a beneficial physiological effect. In total the applicant indicated seven publications on human studies, three unpublished human studies, eight published and one unpublished non-human studies to be pertinent for the claimed effect. In weighing the evidence, the Panel took into account that human and animal studies showed partial survival of Lc DN-114 001 during its gastrointestinal passage, that one human intervention study with Actimel\uae which showed a statistically significant risk reduction for CDAD had considerable limitations, that there were only limited data on the effect of Actimel\uae on the reduction C. difficile toxins (the risk factor) in humans, that one study which showed an inhibitory effect of Lc DN-114 001 on the growth of C. difficile in vitro does not predict the occurrence of an effect against C. difficile in humans, that five further human studies do not support the proposed mechanisms by which Actimel\uae could exert the claimed effect, and that the evidence provided from a further two animal and three in vitro studies does not establish that effects of Actimel\uae or Lc DN-114 001 in these model systems related to immune function and infection can predict the occurrence of such effects in humans. The Panel concludes that the evidence provided is insufficient to establish a cause and effect relationship between the consumption of Actimel\uae and a reduction of the risk of C. difficile diarrhoea by reducing the presence of C. difficile toxins

Scientific opinion on the substantiation of health claims related to olive oil and maintenance of normal blood LDL-cholesterol concentrations (ID 1316, 1332), maintenance of normal (fasting) blood concentrations of triglycerides (ID 1316, 1332), maintenance of normal blood HDL-cholesterol concentrations (ID 1316, 1332) and maintenance of normal blood glucose concentrations (ID 4244) pursuant to Article 13(1) of Regulation (EC) No 1924/2006

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies was asked to provide a scientific opinion on a list of health claims pursuant to Article 13 of Regulation (EC) No 1924/2006. This opinion addresses the scientific substantiation of health claims in relation to olive oil and maintenance of normal blood LDL-cholesterol concentrations, maintenance of normal (fasting) blood concentrations of triglycerides, maintenance of normal blood HDL-cholesterol concentrations and maintenance of normal blood glucose concentrations. The scientific substantiation is based on the information provided by the Member States in the consolidated list of Article 13 health claims and references that EFSA has received from Member States or directly from stakeholders. The food that is the subject of the health claims is olive oil. The Panel considers that olive oil is sufficiently characterised in relation to the claimed effect

Scientific opinion on the substantiation of health claims related to maize oil and maintenance of normal blood LDL-cholesterol concentrations (ID 3086) pursuant to article 13(1) of regulation (EC) No 1924/2006

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies was asked to provide a scientific opinion on a list of health claims pursuant to Article 13 of Regulation (EC) No 1924/2006. This opinion addresses the scientific substantiation of health claims in relation to maize oil and maintenance of normal blood LDL-cholesterol concentrations. The scientific substantiation is based on the information provided by the Member States in the consolidated list of Article 13 health claims and references that EFSA has received from Member States or directly from stakeholders. The food that is the subject of the health claim is maize oil. The Panel considers that maize oil is sufficiently characterised in relation to the claimed effect. The claimed effect is \u201ccorn oil with a guaranteed polyunsaturated fatty acids content (56 % of total fatty acids), supplemented with vitamin E\u201d. The target population is assumed to be the general population. In the context of the proposed wordings, the Panel assumes that the claimed effect refers to maintenance of normal LDL-blood cholesterol concentrations. The Panel considers that maintenance of normal blood LDL-cholesterol concentrations is a beneficial physiological effect. No studies that investigated whether maize oil had a cholesterol-lowering effect beyond what could be expected from the fatty acid composition of maize oil have been provided. On the basis of the data presented, the Panel concludes that a cause and effect relationship has not been established between the consumption of maize oil and maintenance of normal blood LDL-cholesterol concentrations beyond what could be expected from the fatty acid composition of maize oil. A claim on the replacement of mixtures of SFAs with cis-MUFAs and/or cis-PUFAs in foods or diets and maintenance of normal blood LDL-cholesterol concentrations has already been assessed with a favourable outcome. A claim on linoleic acid and maintenance of normal blood cholesterol concentrations has also already been assessed with a favourable outcome

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.

Elasticity and Petri nets

Digital electronic systems typically use synchronous clocks and primarily assume fixed duration of their operations to simplify the design process. Time elastic systems can be constructed either by replacing the clock with communication handshakes (asynchronous version) or by augmenting the clock with a synchronous version of a handshake (synchronous version). Time elastic systems can tolerate static and dynamic changes in delays (asynchronous case) or latencies (synchronous case) of operations that can be used for modularity, ease of reuse and better power-delay trade-off. This paper describes methods for the modeling, performance analysis and optimization of elastic systems using Marked Graphs and their extensions capable of describing behavior with early evaluation. The paper uses synchronous elastic systems (aka latency-tolerant systems) for illustrating the use of Petri nets, however, most of the methods can be applied without changes (except changing the delay model associated with events of the system) to asynchronous elastic systems.Peer ReviewedPostprint (author's final draft

Scientific Opinion on the substantiation of health claims related to iron and formation of red blood cells and haemoglobin (ID 374, 2889), oxygen transport (ID 255), contribution to normal energy-yielding metabolism (ID 255), reduction of tiredness and fatigue (ID 255, 374, 2889), biotransformation of xenobiotic substances (ID 258), and activity of heart, liver and muscles (ID 397) pursuant to Article 13(1) of Regulation (EC) No 1924/2006

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies was asked to provide a scientific opinion on a list of health claims pursuant to Article 13 of Regulation (EC) No 1924/2006. This opinion addresses the scientific substantiation of health claims in relation to iron and formation of red blood cells and haemoglobin, oxygen transport, contribution to normal energy-yielding metabolism, reduction of tiredness and fatigue, biotransformation of xenobiotic substances and \u201cactivity of heart, liver and muscles\u201d. The scientific substantiation is based on the information provided by the Member States in the consolidated list of Article 13 health claims and references that EFSA has received from Member States or directly from stakeholders. The food constituent that is the subject of the health claims is iron. The Panel considers that iron is sufficiently characterised