Allogeneic bone marrow transplantation in second remission of childhood acute lymphoblastic leukemia: a population-based case control study from the Nordic countries

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldThis study compares allogeneic BMT with conventional chemotherapy for childhood ALL in second remission. Seventy-five children were transplanted between July 1981 and December 1995. For each patient two control patients matching the following criteria were selected from the Nordic database of ALL: (1) time of diagnosis, (2) T vs. non-T ALL, (3) site of relapse, (4) initial risk group, (5) sex and (6) relapse or =6 months after cessation of therapy. The minimal time of follow-up was 24 months. Mortality rate in CR2, leukemic relapse rate and the proportion in continued second remission were 16/75 (21%), 22/75 (29%) and 37/75 (50%), respectively. P2.-EFS for the BMT group was significantly better than that for the control group (0.40 vs. 0.23, P = 0.02). Children transplanted for bone marrow relapses in particular had a higher P2.-EFS (0.35 vs. 0.15 for the control group, P<0.01). Also, children grafted for early BM relapses had a higher P2.-EFS (0.32 vs. 0.11 for the control group P = 0.01). The outcome was similar when children were transplanted after early or late relapse. Also, there was no difference in outcome between the BMT and the chemotherapy group for children with late relapses. We conclude that allogeneic BMT with an HLA-identical sibling donor or other family donor should be performed in children relapsing in bone marrow during therapy or within 6 months of discontinuing therapy

Recommendations from the ERAS® Society for standards for the development of enhanced recovery after surgery guidelines

BackgroundERAS® Society guidelines are holistic, multidisciplinary tools designed to improve outcomes after surgery. The enhanced recovery after surgery (ERAS) approach was initially developed for colorectal surgery and has been implemented successfully across a large number of settings, resulting in improved patient outcomes. As the ERAS approach is increasingly being adopted worldwide and new guidelines are being generated for new populations, there is a need to define an ERAS® Society guideline and the methodology that should be followed in its development.MethodsThe ERAS® Society recommended approach for developing new guidelines is based on the creation of multidisciplinary guideline development groups responsible for defining topics, planning the literature search, and assessing the quality of the evidence.ResultsClear definitions for the elements of an ERAS guideline involve multimodal and multidisciplinary approaches impacting on multiple patient outcomes. Recommended methodology for guideline development follows a rigorous approach with systematic identification and evaluation of evidence, and consensus‐based development of recommendations. Guidelines should then be evaluated and reviewed regularly to ensure that the best and most up‐to‐date evidence is used consistently to support surgical patients.ConclusionThere is a need for a standardized, evidence‐informed approach to both the development of new ERAS® Society guidelines, and the adaptation and revision of existing guidelines

Abundance Analysis of HE2148-1247, A Star With Extremely Enhanced Neutron Capture Elements

Abundances for 27 elements in the very metal poor dwarf star HE2148-1247 are presented, including many of the neutron capture elements. We establish that HE2148-1247 is a very highly s-process enhanced star with anomalously high Eu as well, Eu/H about half Solar, demonstrating the large addition of heavy nuclei at [Fe/H] = -2.3 dex. Ba and La are enhanced by a somewhat larger factor and reach the solar abundance, while Pb significantly exceeds it. Ba/Eu is ten times the solar r-process ratio but much less than that of the s-process, indicating a substantial r-process addition as well. C and N are also very highly enhanced. We have found that HE2148-1247 is a radial velocity variable. The C, N and the s-process element enhancements thus presumably were produced through mass transfer from a former AGB binary companion. The large enhancement of heavy r-nuclides also requires an additional source as this is far above any inventory in the ISM at such low [Fe/H]. We further hypothesize that accretion onto the white dwarf from the envelope of the star caused accretion induced collapse of the white dwarf, forming a neutron star, which then produced heavy r-nuclides and again contaminated its companion. (abridged)Comment: Accepted by the Astrophysical Journal. Companion paper by Qian and Wasserburg follow

Isotope shift in the electron affinity of chlorine

The specific mass shift in the electron affinity between ^{35}Cl and ^{37}Cl has been determined by tunable laser photodetachment spectroscopy to be -0.51(14) GHz. The isotope shift was observed as a difference in the onset of the photodetachment process for the two isotopes. In addition, the electron affinity of Cl was found to be 29138.59(22) cm^{-1}, giving a factor of 2 improvement in the accuracy over earlier measurements. Many-body calculations including lowest-order correlation effects demonstrates the sensitivity of the specific mass shift and show that the inclusion of higher-order correlation effects would be necessary for a quantitative description.Comment: 16 pages, 6 figures, LaTeX2e, amsmat

Fundamental Strings in Open String Theory at the Tachyonic Vacuum

We show that the world-volume theory on a D-p-brane at the tachyonic vacuum has solitonic string solutions whose dynamics is governed by the Nambu-Goto action of a string moving in (25+1) dimensional space-time. This provides strong evidence for the conjecture that at this vacuum the full (25+1) dimensional Poincare invariance is restored. We also use this result to argue that the open string field theory at the tachyonic vacuum must contain closed string excitations.Comment: LaTeX file, 16 pages, references and clarification adde

Exact boundary conditions in numerical relativity using multiple grids: scalar field tests

Cauchy-Characteristic Matching (CCM), the combination of a central 3+1 Cauchy code with an exterior characteristic code connected across a time-like interface, is a promising technique for the generation and extraction of gravitational waves. While it provides a tool for the exact specification of boundary conditions for the Cauchy evolution, it also allows to follow gravitational radiation all the way to infinity, where it is unambiguously defined. We present a new fourth order accurate finite difference CCM scheme for a first order reduction of the wave equation around a Schwarzschild black hole in axisymmetry. The matching at the interface between the Cauchy and the characteristic regions is done by transfering appropriate characteristic/null variables. Numerical experiments indicate that the algorithm is fourth order convergent. As an application we reproduce the expected late-time tail decay for the scalar field.Comment: 14 pages, 5 figures. Included changes suggested by referee

Towards a tensionless string field theory for the N=(2,0) CFT in d=6

We describe progress in using the field theory of tensionless strings to arrive at a Lagrangian for the six-dimensional $\mathcal N=(2,0)$ conformal theory. We construct the free part of the theory and propose an ansatz for the cubic vertex in light-cone superspace. By requiring closure of the $(2,0)$ supersymmetry algebra, we fix the cubic vertex up to two parameters.Comment: 46 pages, 2 figures. V2: references added; minor changes and improvement

Kinky D-branes and straight strings of open string tachyon effective theory

In this letter we construct the kink D1-brane super D-helix solution and its T-dual the D2-brane supertube using the effective action of non-BPS tachyonic D-branes . In the limit of zero angular momentum, both types of solutions collapse to zero radius, giving rise respectively to a degenerate string configuration corresponding to a particle travelling with the speed of light and to a static straight string configuration. These solutions share all the properties of fundamental strings and do not have the pathological behavior of other solutions previously found in this context. A short discussion on the ``generalized gauge transformations'' suggested by Sen is used to justify the validity of our approach.Comment: 10 pages, latex, typos corrected and references adde

Tidal Volume Single Breath Washout of Two Tracer Gases - A Practical and Promising Lung Function Test

Small airway disease frequently occurs in chronic lung diseases and may cause ventilation inhomogeneity (VI), which can be assessed by washout tests of inert tracer gas. Using two tracer gases with unequal molar mass (MM) and diffusivity increases specificity for VI in different lung zones. Currently washout tests are underutilised due to the time and effort required for measurements. The aim of this study was to develop and validate a simple technique for a new tidal single breath washout test (SBW) of sulfur hexafluoride (SF(6)) and helium (He) using an ultrasonic flowmeter (USFM)