The effect of oxygen saturation targeting on retinal blood vessel growth using retinal image data from the BOOST-II UK Trial

Purpose: Retinopathy of prematurity (ROP) is a disorder of developing retinal blood vessels in preterm infants. The purpose of this nested study was to investigate the effects of higher (91-95%) and lower (85-89%) oxygen saturation (SpO2) targeting on retinal blood vessel growth in preterm infants. Methods: Retinal blood vessel growth in the higher (91-95%) and lower (85-89%) oxygen saturation (SpO2) targeting groups was compared. Suitable RetCam (Clarity, Pleasanton, CA, USA) images collected in the BOOST-II UK trial were used. The distances between the centre of the optic disc and the ROP ridge in the temporal and nasal retina were measured in pixel units. Results: Images from 38 infants were studied, 20 from the higher SpO2 target group and 18 from the lower SpO2 target group. On average, temporal blood vessels extended further from the optic disc than nasal blood vessels, mean (standard deviation (SD)) 463.39 (55.05) pixels compared with 360.13 (44.47) pixels, respectively, P<0.0001. Temporal blood vessels extended less far from the optic disc in the higher SpO2 target group than in the lower SpO2 target group: mean (SD) 449.83 (56.16) pixels compared with 480.02 (49.94), respectively, P=0.055. Nasal retinal blood vessel measurements were broadly similar in the higher and lower SpO2 target groups; mean (SD) 353.96 (41.95) compared with 370.00 (48.82) pixels, respectively, P=0.38. Conclusions: Relatively high oxygen saturation targeting (91-95%) was associated with a trend (P=0.055) towards reduced retinal blood vessel growth in this study of preterm infants

The effects of continued azacitidine treatment cycles on response in higher risk patients with myelodysplastic syndromes: an update

The international, phase III, multi-centre AZA-001 trial demonstrated azacitidine (AZA) is the first treatment to significantly extend overall survival (OS) in higher risk myelodysplastic syndromes (MDS) patients (Fenaux (2007) Blood 110 817). The current treatment paradigm, which is based on a relationship between complete remission (CR) and survival, is increasingly being questioned (Cheson (2006) Blood 108 419). Results of AZA-001 show CR is sufficient but not necessary to prolong OS (List (2008) Clin Oncol 26 7006). Indeed, the AZA CR rate in AZA-001 was modest (17%), while partial remission (PR, 12%) and haematological improvement (HI, 49%) were also predictive of prolonged survival. This analysis was conducted to assess the median number of AZA treatment cycles associated with achievement of first response, as measured by IWG 2000-defined CR, PR or HI (major + minor). The number of treatment cycles from first response to best response was also measured

Efficiency improvement of a ground coupled heat pump system from energy management

The installed capacity of an air conditioning system is usually higher than the average cooling or heating demand along the year. So, most of the time, the system is working under its actual capacity. In this contribution, we study the way to improve the efficiency of a ground coupled heat pump air conditioning system by adapting its produced thermal energy to the actual thermal demand. For this purpose, an air conditioning system composed by a ground coupled heat pump and a central fan coil linked to an office located in a cooling dominated area was simulated, and a new management strategy aiming to diminish electrical consumption was developed under the basic constraint that comfort requirements are kept. This strategy takes advantage of the possibility of managing the air flow in the fan, the water mass flows in the internal and external hydraulic systems, and the set point temperature in the heat pump to achieve this objective. The electrical consumption of the system is calculated for the new management strategy and compared with the results obtained for a conventional one, resulting in estimated energy savings around 30%This work has been supported by the Spanish Government under projects "Modelado y simulacion de sistemas energeticos complejos" (2005 Ramon y Cajal program), "Modelado, simulacion y validacion experimental de la transferencia de calor en el entorno de la edificacion" (ENE2008-0059/CON). A. Sala is grateful to the financial support of grants DPI2008-06731-c02-01 (Spanish Government), and Generalitat Valenciana Prometeo/2008/088.Pardo García, N.; Montero Reguera, ÁE.; Sala Piqueras, A.; Martos Torres, J.; Urchueguía Schölzel, JF. (2011). Efficiency improvement of a ground coupled heat pump system from energy management. Applied Thermal Engineering. 31(2):391-398. https://doi.org/10.1016/j.applthermaleng.2010.09.016S39139831

Azacitidine prolongs overall survival and reduces infections and hospitalizations in patients with WHO-defined acute myeloid leukaemia compared with conventional care regimens: an update

Azacitidine (AZA), as demonstrated in the phase III trial (AZA-001), is the first MDS treatment to significantly prolong overall survival (OS) in higher risk MDS pts ((2007) Blood 110 817). Approximately, one-third of the patients (pts) enrolled in AZA-001 were FAB RAEB-T (≥20–30% blasts) and now meet the WHO criteria for acute myeloid leukaemia (AML) ((1999) Blood 17 3835). Considering the poor prognosis (median survival <1 year) and the poor response to chemotherapy in these pts, this sub-group analysis evaluated the effects of AZA versus conventional care regimens (CCR) on OS and on response rates in pts with WHO AML

Associations between health-related quality of life, physical function and fear of falling in older fallers receiving home care

Falls and injuries in older adults have significant consequences and costs, both personal and to society. Although having a high incidence of falls, high prevalence of fear of falling and a lower quality of life, older adults receiving home care are underrepresented in research on older fallers. The objective of this study is to determine the associations between health-related quality of life (HRQOL), fear of falling and physical function in older fallers receiving home care

A Measurement of the Coulomb Dissociation of 8B at 254 MeV/nucleon and the 8B Solar Neutrino Flux

We have measured the Coulomb dissociation of 8B into 7Be and proton at 254 MeV/nucleon using a large-acceptance focusing spectrometer. The astrophysical S17 factor for the 7Be(p,gamma)8B reaction at E{c.m.} = 0.25-2.78 MeV is deduced yielding S17(0)=20.6 \pm 1.2 (exp.) \pm 1.0 (theo.) eV-b. This result agrees with the presently adopted zero-energy S17 factor obtained in direct-reaction measurements and with the results of other Coulomb-dissociation studies performed at 46.5 and 51.2 MeV/nucleon.Comment: paper to be published in Phys. Rev. Lett. 3 figures. New Version fixes formatting problems with the figures only. There are no other change

Pirfenidone in idiopathic pulmonary fibrosis:expert panel discussion on the management of drug-related adverse events

Pirfenidone is currently the only approved therapy for idiopathic pulmonary fibrosis, following studies demonstrating that treatment reduces the decline in lung function and improves progression-free survival. Although generally well tolerated, a minority of patients discontinue therapy due to gastrointestinal and skin-related adverse events (AEs). This review summarizes recommendations based on existing guidelines, research evidence, and consensus opinions of expert authors, with the aim of providing practicing physicians with the specific clinical information needed to educate the patient and better manage pirfenidone-related AEs with continued pirfenidone treatment. The main recommendations to help prevent and/or mitigate gastrointestinal and skin-related AEs include taking pirfenidone during (or after) a meal, avoiding sun exposure, wearing protective clothing, and applying a broad-spectrum sunscreen with high ultraviolet (UV) A and UVB protection. These measures can help optimize AE management, which is key to maintaining patients on an optimal treatment dose.Correction in: Advances in Therapy, Volume 31, Issue 5, pp 575-576 , doi: 10.1007/s12325-014-0118-8</p

Isospin dependent multifragmentation of relativistic projectiles

The N/Z dependence of projectile fragmentation at relativistic energies has been studied with the ALADIN forward spectrometer at the GSI Schwerionen Synchrotron (SIS). Stable and radioactive Sn and La beams with an incident energy of 600 MeV per nucleon have been used in order to explore a wide range of isotopic compositions. For the interpretation of the data, calculations with the statistical multifragmentation model for a properly chosen ensemble of excited sources were performed. The parameters of the ensemble, representing the variety of excited spectator nuclei expected in a participant-spectator scenario, are determined empirically by searching for an optimum reproduction of the measured fragment-charge distributions and correlations. An overall very good agreement is obtained. The possible modification of the liquid-drop parameters of the fragment description in the hot freeze-out environment is studied, and a significant reduction of the symmetry-term coefficient is found necessary to reproduce the mean neutron-to-proton ratios /Z and the isoscaling parameters of Z<=10 fragments. The calculations are, furthermore, used to address open questions regarding the modification of the surface-term coefficient at freeze-out, the N/Z dependence of the nuclear caloric curve, and the isotopic evolution of the spectator system between its formation during the initial cascade stage of the reaction and its subsequent breakup.Comment: 23 pages, 29 figures, published in Physical Review

Randomized Control Trial of Postnatal rhIGF-1/rhIGFBP-3 Replacement in Preterm Infants: Post-hoc Analysis of Its Effect on Brain Injury

Background: Postnatal insulin-like growth factor-1 (IGF-1) replacement with recombinant human (rh)IGF-1 and IGF binding protein-3 (rhIGF-1/rhIGFBP-3) is being studied as a potential treatment to reduce comorbidities of prematurity. We have recently reported on a phase II, multicenter, randomized, controlled trial comparing postnatal rhIGF-1/rhIGFBP-3 replacement with standard of care (SOC) in extremely preterm infants (NCT01096784). Maximum severity of retinopathy of prematurity was the primary endpoint of the trial and presence of GMH-IVH/PHI one of the pre-specified secondary endpoints. Infants therefore received serial cranial ultrasound scans (CUS) between birth and term age. In this post-hoc analysis we present a detailed analysis of the CUS data of this trial and evaluate the effect of postnatal rhIGF-1/rhIGFBP-3 replacement on the incidence of different kinds of brain injury in extremely preterm infants. Methods: This report is an exploratory post-hoc analysis of a phase II trial in which infants <28 weeks gestational age were randomly allocated to rhIGF-1/rhIGFBP-3 or SOC. Serial cranial ultrasounds were performed between birth and term-equivalent age. Presence of germinal matrix hemorrhage and intraventricular hemorrhage (GMH-IVH), periventricular hemorrhagic infarction (PHI), post-hemorrhagic ventricular dilatation, and white matter injury (WMI) were scored by two independent masked readers. Results: The analysis included 117 infants; 58 received rhIGF-1/rhIGFBP-3 and 59 received SOC. A trend toward less grade II–III GMH-IVH and PHI was observed in treated infants vs. SOC. A subanalysis of infants without evidence of GMH-IVH at study entry (n = 104) showed reduced progression to GMH-IVH in treated infants (25.0% [13/52] vs. 40.4% [21/52]; not significant). No effects of rhIGF-1/rhIGFBP-3 on WMI were observed. Conclusion: The potential protective effect of rhIGF-1/rhIGFBP-3 on the occurrence of GMH-IVH/PHI appeared most pronounced in infants with no evidence of GMH-IVH at treatment start

Neutron recognition in the LAND detector for large neutron multiplicity

The performance of the LAND neutron detector is studied. Using an event-mixing technique based on one-neutron data obtained in the S107 experiment at the GSI laboratory, we test the efficiency of various analytic tools used to determine the multiplicity and kinematic properties of detected neutrons. A new algorithm developed recently for recognizing neutron showers from spectator decays in the ALADIN experiment S254 is described in detail. Its performance is assessed in comparison with other methods. The properties of the observed neutron events are used to estimate the detection efficiency of LAND in this experiment.Comment: 16 pages, 8 figure