On the control and suppression of the Rayleigh-Taylor instability using electric fields

It is shown theoretically that an electric field can be used to control and suppress the classical Rayleigh-Taylor instability found in stratified flows when a heavy fluid lies above lighter fluid. Dielectric fluids of arbitrary viscosities and densities are considered and a theory is presented to show that a horizontal electric field (acting in the plane of the undisturbed liquid-liquid surface), causes growth rates and critical stability wavenumbers to be reduced thus shifting the instability to longer wavelengths. This facilitates complete stabilization in a given finite domain above a critical value of the electric field strength. Direct numerical simulations based on the Navier-Stokes equations coupled to the electrostatic fields are carried out and the linear theory is used to critically evaluate the codes before computing into the fully nonlinear stage. Excellent agreement is found between theory and simulations, both in unstable cases that compare growth rates and in stable cases that compare frequencies of oscillation and damping rates. Computations in the fully nonlinear regime supporting finger formation and roll-up show that a weak electric field slows down finger growth and that there exists a critical value of the field strength, for a given system, above which complete stabilization can take place. The effectiveness of the stabilization is lost if the initial amplitude is large enough or if the field is switched on too late. We also present a numerical experiment that utilizes a simple on-off protocol for the electric field to produce sustained time periodic interfacial oscillations. It is suggested that such phenomena can be useful in inducing mixing. A physical centimeter-sized model consisting of stratified water and olive oil layers is shown to be within the realm of the stabilization mechanism for field strengths that are approximately 2 × 104  V/m

Evaluating patient engagement with a digital intervention for adolescent and young adult (AYA) stem cell transplant survivors

https://openworks.mdanderson.org/sumexp22/1109/thumbnail.jp

2: Donor-Recipient Host-Versus-Graft Human Leukocyte Antigen Mismatches and Outcome of Cord Blood Transplants

Digitalitzat per Artypla

The Evolution of Chimeric Antigen Receptor T-Cell Therapy in Children, Adolescents and Young Adults with Acute Lymphoblastic Leukemia

Chimeric antigen receptor T-cell (CAR T) therapy is a revolutionary treatment for pediatric, adolescent and young adult patients (AYA) with relapsed/refractory B-cell acute lymphoblastic leukemia. While the landscape of immunotherapy continues to rapidly evolve, widespread use of CAR T therapy is limited and many questions remain regarding the durability of CAR T therapy, methods to avoid CAR T therapy resistance and the role of consolidative stem cell transplant. Modified strategies to develop effective and persistent CAR T cells at lower costs and decreased toxicities are warranted. In this review we present current indications, limitations and future directions of CAR T therapy for ALL in the pediatric and AYA population

Post-Transplant Cyclophosphamide after Matched Sibling and Unrelated Donor Hematopoietic Stem Cell Transplantation in Pediatric Patients with Acute Myeloid Leukemia

Non-relapse mortality due to GVHD and infections represents a major source of morbidity and mortality in pediatric HSCT recipients. Post-transplant cyclophosphamide (PTCy) has emerged as an effective and safe GVHD prophylaxis strategy, with improved GVHD and relapse-free survival in matched (related and unrelated) and mismatched haploidentical HSCT adult recipients. However, there are no published data in pediatric patients with acute myeloid leukemia who received matched-donor HSCT with PTCy. We demonstrate, in this case series, that the use of PTCy in this population is potentially safe, effective in preventing acute GVHD, does not impair engraftment, is associated with reduced non-relapse mortality, and does not hinder immune reconstitution post HSCT

Implementing Rounding Checklists in a Pediatric Oncologic Intensive Care Unit

Standardized rounding checklists during multidisciplinary rounds (MDR) can reduce medical errors and decrease length of pediatric intensive care unit (PICU) and hospital stay. We added a standardized process for MDR in our oncologic PICU. Our study was a quality improvement initiative, utilizing a four-stage Plan–Do–Study–Act (PDSA) model to standardize MDR in our PICU over 3 months, from January 2020 to March 2020. We distributed surveys to PICU RNs to assess their understanding regarding communication during MDR. We created a standardized rounding checklist that addressed key elements during MDR. Safety event reports before and after implementation of our initiative were retrospectively reviewed to assess our initiative’s impact on safety events. Our intervention increased standardization of PICU MDR from 0% to 70% over three months, from January 2020 to March 2020. We sustained a rate of zero for CLABSI, CAUTI, and VAP during the 12-month period prior to, during, and post-intervention. Implementation of a standardized rounding checklist may improve closed-loop communication amongst the healthcare team, facilitate dialogue between patients’ families and the healthcare team, and reduce safety events. Additional staffing for resource RNs, who assist with high acuity patients, has also facilitated bedside RN participation in MDR, without interruptions in clinical care